scholarly journals Errata ao artigo “Parto por Cesariana em Grávida com COVID-19: O Primeiro Caso Descrito em Portugal”, publicado em Acta Med Port 2020 Jun;33(6):429-431

2020 ◽  
Vol 33 (6) ◽  
pp. 449
Author(s):  
Joana Lyra ◽  
Rita Valente ◽  
Marta Rosário ◽  
Mariana Guimarães
Keyword(s):  
Infectious Diseases ◽  
Multidisciplinary Team ◽  
Shared Decision ◽  
Postnatal Transmission ◽  
Thoughtful Discussion ◽  
Multi Disciplinary Team

Article published with errors:https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13883On page 430, section “Discussion”, line 5, where it reads: (...) given the conflicting data about pre and postnatal transmission,6,7 a multi-disciplinary team consensus comprising obstetricians, neonatologists and infectious diseases specialists at our institution decided on mother-neonate separation immediately after birth until both were tested negative for SARS-CoV-2.4It should read: (...) given the conflicting data about pre and postnatal transmission,6,7 after thoughtful discussion between a multidisciplinary team and the mother, and respecting her expressed will, a shared decision was made of mother infant separation immediately after birth until both were tested negative for SARS-CoV-2.4 Artigo publicado com erros:https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13883Na página 430, secção “Discussão”, linha 6, onde se lê: (...) given the conflicting data about pre and postnatal transmission,6,7 a multi-disciplinary team consensus comprising obstetricians, neonatologists and infectious diseases specialists at our institution decided on mother-neonate separation immediately after birth until both were tested negative for SARS-CoV-2.4Deverá ler-se: (...) given the conflicting data about pre and postnatal transmission,6,7 after thoughtful discussion between a multidisciplinary team and the mother, and respecting her expressed will, a shared decision was made of mother infant separation immediately after birth until both were tested negative for SARS-CoV-2.4

scholarly journals Verification of Healthcare Personnel Immunity as a Strategy for Measles Preparedness

2020 ◽  
Vol 41 (S1) ◽  
pp. s431-s432
Author(s):  
Rachael Snyders ◽  
Hilary Babcock ◽  
Christopher Blank
Keyword(s):  
Infectious Diseases ◽  
Multidisciplinary Team ◽  
The United States ◽  
Transmission Risk ◽  
Healthcare Personnel ◽  
Serological Tests ◽  
Preparedness Plan ◽  
Vaccine Preventable Diseases ◽  
Measles Outbreaks ◽  
Centralized Database

Background: Immunization resistance is fueling a resurgence of vaccine-preventable diseases in the United States, where several large measles outbreaks and 1,282 measles cases were reported in 2019. Concern about these measles outbreaks prompted a large healthcare organization to develop a preparedness plan to limit healthcare-associated transmission. Verification of employee rubeola immunity and immunization when necessary was prioritized because of transmission risk to nonimmune employees and role of the healthcare personnel in responding to measles cases. Methods: The organization employs ∼31,000 people in diverse settings. A multidisciplinary team was formed by infection prevention, infectious diseases, occupational health, and nursing departments to develop the preparedness plan. Immunity was monitored using a centralized database. Employees without evidence of immunity were asked to provide proof of vaccination, defined by the CDC as 2 appropriately timed doses of rubeola-containing vaccine, or laboratory confirmation of immunity. Employees were given 30 days to provide documentation or to obtain a titer at the organization’s expense. Staff with negative titers were given 2 weeks to coordinate with the occupational heath department for vaccination. Requests for medical or religious accommodations were evaluated by occupational heath staff, the occupational heath medical director, and the human resources department. All employees were included, though patient-interfacing employees in departments considered higher risk were prioritized. These areas were the emergency, dermatology, infectious diseases, labor and delivery, obstetrics, and pediatrics departments. Results: At the onset of the initiative in June 2019, 4,009 employees lacked evidence of immunity. As of November 2019, evidence of immunity had been obtained for 3,709 employees (92.5%): serological evidence of immunity was obtained for 2,856 (71.2%), vaccine was administered to 584 (14.6%), and evidence of previous vaccination was provided by 269 (6.7%). Evidence of immunity has not been documented for 300 (7.5%). The organization administered 3,626 serological tests and provided 997 vaccines, costing ∼$132,000. Disposition by serological testing is summarized in Table 1. Conclusions: A measles preparedness strategy should include proactive assessment of employees’ immune status. It is possible to expediently assess a large number of employees using a multidisciplinary team with access to a centralized database. Consideration may be given to prioritization of high-risk departments and patient-interfacing roles to manage workload.Funding: NoneDisclosures: None

Methods for Utilizing Multidisciplinary Team to Create Novel Visual Alarm Designs That Improve Recognition of Patient Decompensation and Alarm Response

2019 ◽  
Vol 8 (1) ◽  
pp. 257-260
Author(s):  
Chelsea R. Horwood ◽  
Morgan Fitzgerald ◽  
Susan D. Moffatt-Bruce ◽  
Michael F. Rayo
Keyword(s):  
Adverse Events ◽  
Human Factors ◽  
Multidisciplinary Team ◽  
Medical Center ◽  
Visual Display ◽  
System Engineering ◽  
Medical Community ◽  
Team Approach ◽  
Alarm Response ◽  
Multi Disciplinary Team

The overwhelming number of alarms on medical center floors are false and nonactionable. This leads to delay in alarm response and adverse events. Furthermore, current alarm technology does not have the ability to display patient trends, it only displays one isolated patient event. This paper focuses on describing the methods for creating novel visual displays that incorporates alarm technology and patient decompensation events. Through a multi-disciplinary team approach, that is centered on human factors and system engineers, a novel visual display was created that integrated current alarm technology with patient data. The new displays were better able to predict decompensation and alarm validity. It is crucial to integrate partners from all facets of the medical community and from human factors and system engineering to form an accurate understanding and modeling of patients

scholarly journals 607. Identifying Intervention Opportunities to Prevent Readmissions during OPAT

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S365-S365
Author(s):  
Michael J Swartwood ◽  
Claire E Farel ◽  
Nikolaos Mavrogiorgos ◽  
Renae A Boerneke ◽  
Ashley Marx ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Infectious Diseases ◽  
Median Time ◽  
Care Coordination ◽  
Multidisciplinary Team ◽  
Primary Care Providers ◽  
Care Providers ◽  
Post Discharge ◽  
Icd 10

Abstract Background Patients receiving outpatient parenteral antimicrobial therapy (OPAT) experience high rates of unplanned readmissions. To inform interventions that may reduce risk of unplanned readmissions during OPAT, we examined the frequency and reasons for readmission in a large cohort of OPAT patients. Methods We analyzed data on all patients enrolled in UNC’s OPAT program from February 2015-February 2020. Patients were evaluated by an infectious diseases (ID) physician prior to OPAT enrollment, discharged with >14 remaining days of prescribed therapy, and received care coordination and systematic monitoring by an ID pharmacist. We abstracted EHR data into a REDCap database to ascertain information on each patient’s OPAT course and readmission details: length of stay, primary ICD-9-CM/ICD-10-CM diagnosis code associated with readmission, and reason for readmission from clinical notes. Diagnosis codes and notes were adjudicated and summarized by a multidisciplinary team. Results Among 1,165 OPAT courses, 19% resulted in at least one readmission during therapy, lasting for a median length of stay of 5 days. Among those patients who were readmitted during OPAT, the median time from OPAT start to readmission was 17 days (interquartile range, IQR: 8-29 days). 66% of readmissions preceded the scheduled follow-up appointment during OPAT (median time to scheduled follow-up was 27 days, IQR: 15-35 days). 55% of readmissions were unrelated to OPAT diagnosis. Based on ICD-9-CM/ICD-10-CM code classifications, the most common infectious diseases-related reasons for readmission were worsening OPAT infection (18%), OPAT-related adverse drug reaction (12%), and new infection (11%). Conclusion One-fifth of OPAT courses resulted in readmission during therapy. Half of readmissions were associated with OPAT or other infection, and half were for other reasons. Earlier post-discharge follow-up by a multidisciplinary team (including primary care providers, case management, and OPAT) might prevent infection-related readmissions for OPAT patients. Future work should also address the need for enhanced care coordination with non-infectious disease providers to manage OPAT patients. Disclosures All Authors: No reported disclosures

Shared decision-making attitudes and practices in multidisciplinary cancer care teams.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 180-180
Author(s):  
Christina Mangir ◽  
Leigh Boehmer ◽  
Sandra E. Kurtin ◽  
Lalan S. Wilfong ◽  
Rena Kass ◽  
...  
Keyword(s):  
Decision Making ◽  
Health Literacy ◽  
Shared Decision Making ◽  
Multidisciplinary Team ◽  
Decision Aids ◽  
Shared Decision ◽  
Patient Decision Aids ◽  
Attitudes And Practices ◽  
Patient Decision ◽  
Wide Range

180 Background: Patients who engage in decision making are more likely to experience confidence in treatment decisions, satisfaction with treatment, and trust in clinicians. The Association of Community Cancer Centers (ACCC) conducted a survey to explore multidisciplinary team attitudes and practices around shared decision-making (SDM) and health literacy. Methods: ACCC convened a steering committee of multidisciplinary specialists and advocacy representatives to guide this research. The survey included 26 mostly closed-ended questions and was open to multidisciplinary cancer programs from 10/29/19 to 2/20/20. Exploratory analysis was performed on this data set of 305 complete responses. Results: While most respondents reported engaging patients in decision-making to some degree, only 50% reported that SDM is a top organizational priority. 33% reported organizational efforts to formally integrate SDM into the clinical workflow, with only 15% indicating staff opportunities for basic SDM training. The three most frequently cited perceived barriers to engaging in SDM were patients feeling overwhelmed (53%), wanting to defer decisions to clinicians (46%), and having limited health literacy (46%). Only 13% indicated that lack of time was a barrier. Less than half (41%) of respondents reported using patient decision aids to support SDM. Respondents represented a wide range of multidisciplinary team members, though surgical oncologists and general surgeons (20% and 16% respectively) are overrepresented in the results. Conclusions: SDM is commonly accepted as essential to patient engagement but clarity in terminology and prioritizing formal integration of SDM into practice is limited. Strategies to improve integration of SDM into oncology practice should include: 1) Educational initiatives and tools to overcome barriers to SDM, including patient decision aids and SDM training, 2) Initiatives to address health literacy as it relates to patient and caregiver engagement in decision making, 3) Psychosocial support for patients whose emotional upset is a barrier to SDM, 4) Healthcare policies that encourage and incentive providers to engage in SDM. Future analyses will require concurrent assessment of patient, caregiver, healthcare professional, and administrator perspectives.

scholarly journals Quality of Life after Total Glosso-Laryngectomy

2007 ◽  
Vol 54 (1) ◽  
pp. 29-38 ◽  
Author(s):  
Leanie Engelbrecht ◽  
Anita Van der Merwe
Keyword(s):  
Quality Of Life ◽  
Decision Making ◽  
South African ◽  
Thematic Analysis ◽  
Oral Communication ◽  
Well Being ◽  
Shared Decision ◽  
Structured Interviews ◽  
Multi Disciplinary Team

The article explores the quality of life of two participants who had undergone total glosso-laryngectomy as treatment for advanced tongue base cancer. Semi-structured interviews were conducted and questions relating to the effects of treatment on physical, functional, social and psychological well-being were asked. Thematic analysis of the interviews was done to determine recurring themes in the answers of the participants. The findings showed that total glosso-laryngectomy has a significant impact on quality of life. A good quality of life can be maintained in a patient who has an extensive support structure and can achieve intelligible oral communication. Pre-operative counselling by a multi-disciplinary team is important for a person to make an informed decision regarding surgery for head and neck cancer. Shared decision-making needs to be addressed in the South African service delivery context.

Shared decision making in palliative cancer care: a literature review

2013 ◽  
Vol 13 (3) ◽  
pp. 340-349 ◽  
Author(s):  
C. Feuz
Keyword(s):  
Decision Making ◽  
Radiation Therapy ◽  
Informed Consent ◽  
Cancer Patients ◽  
Shared Decision Making ◽  
Multidisciplinary Team ◽  
English Literature ◽  
Treatment Options ◽  
Professional Autonomy ◽  
Shared Decision

AbstractBackgroundPatients require information to make informed decisions and consent to medical treatment. Shared decision making (SDM) is a methodology that promotes a patient-centred approach to informed consent and demonstrates respect for autonomyPurposeThe purpose of this paper is to critically review the legal and ethical issues relevant to Canadian and UK informed consent and SDM practices and how these processes relate to current palliative care practices, with a particular emphasis on radiation therapy.MethodologyA review of the English literature from 2003 to 2013 was performed using the databases PubMed (NML), OVID Medline and Google Scholar.Results and ConclusionsThe literature identifies that palliative cancer patients desire the opportunity to be involved with decision-making discussions, which has shown to increase knowledge and result in better health-related outcomes. However, ethical and legal issues regarding the practicality of including this patient population in SDM discussions raises questions about validity of consent. For SDM to be considered a valid methodology to obtain informed consent, open and honest communication between the patient and multidisciplinary team is essential. Treatment options for palliative cancer patients are often complex and SDM allows healthcare professionals and patients to exchange information and negotiate feasible treatment options based on medical expertise and patient preferences.Legal frameworks have defined current standards of practice for various healthcare professions, including radiation therapy. Radiation therapists, as members of the multidisciplinary team, are currently key contributors in providing information to patients regarding the radiotherapy process. Individuals working within advanced practice roles have the ability to develop skills once considered to be within medical domains and have begun to incorporate the delegated act of obtaining informed consent into practice which has shown to increase professional autonomy, accountability and improves patient-centred care.

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