O Crew Resource Management como Contributo da Ciência Aeronáutica para a Ciência Médica

Background: The availability and popularity of oral anti-cancer therapy has recently increased. In this shift of delivery, control over downstream steps in the process moves to patients, families, and the extended care team. Unique challenges have been identified including effective patient education, adherence, and monitoring. The purpose of this quality improvement project was to standardize the approach to initiating oral anti-cancer patient care. Methods: A quality improvement team developed and implemented a standard approach for before, during, and after initiation of oral anti-cancer therapy. Key components included ensuring completion of informed consent, electronic orders within an evidence-based treatment plan, and adherence monitoring with a specific emphasis on patient education. Education prior to initiating therapy was standardized through both an education folder and one-on-one teaching sessions with an oncology nurse. A voluntary, anonymous 4-question paper survey (deemed clinical quality improvement by the IRB) solicited feedback from patients to assess both the educational materials and teaching session. Questions included perceived acceptability of the content and whether materials guided conversation, provoked questions, and complimented the teaching. An opportunity for comments was provided. Results: A 3-month collection period yielded overwhelmingly positive results. 100% of patients (n=18) felt the education materials provided were “just right” and provoked discussion with the care team. 94% of patients felt the educational materials and teaching session were complimentary. Conclusions: As oral anti-cancer therapy becomes more common, it is vital to form a collaborative partnership with the patient, family, and the extended care team to ensure overall success. Standardized educational content supports the transfer of expert knowledge to ensure adherence, management, and patient safety, ultimately improving patient outcomes. A standard approach that includes informed consent, orders within a treatment plan, adherence monitoring, and patient education prior to initiating oral anti-cancer therapy is one way to ensure quality, comprehensive patient care.

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The role of the patient care team in elderly people decision on influenza vaccination

Patient Education and Counseling ◽

10.1016/j.pec.2004.08.017 ◽

2005 ◽

Vol 58 (2) ◽

pp. 203-208 ◽

Cited By ~ 5

Author(s):

Uzi Milman ◽

Shlomi Ben-Moshe ◽

Doron Hermoni

Keyword(s):

Influenza Vaccination ◽

Patient Care ◽

Elderly People ◽

Patient Care Team ◽

Care Team

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Empecilhos e soluções para relação médico-enfermeiro: revisão narrativa / Obstacles and solutions for medical-nurse relationship: narrative review

Arquivos Médicos dos Hospitais e da Faculdade de Ciências Médicas da Santa Casa de São Paulo ◽

10.26432/1809-3019.2020.65.034 ◽

2020 ◽

Vol 65 (1) ◽

pp. 1

Author(s):

Mateus Da Silveira Cespedes ◽

José Carlos Rosa Pires de Souza ◽

Suellem Luzia Costa Borges

Keyword(s):

Patient Care ◽

Patient Care Team ◽

Narrative Review ◽

Care Team ◽

Care Hospital ◽

Hospital Organization ◽

High Turnover ◽

Good Doctor ◽

External Pressures ◽

Hospital Organization And Administration

Objetivos: Identificar e descrever os empecilhos e as soluções para a boa relação médico-enfermeiro. Métodos: trata-se de uma revisão narrativa da literatura com 10 estudos entre 2006 e 2018 que apresentavam como descritores “Relações Médico-Enfermeiro” e “Equipe de Assistência ao Paciente”, cuja pergunta norteadora foi quais os empecilhos e soluções para uma boa relação médico-enfermeiro? Resultados: encontraram-se como empecilhos: déficits na comunicação, pontos de vista conflitantes, alta rotatividade, pressões externas, funções ambíguas, conflito de tarefa, hierarquia, conhecimento técnico e hostilidade prévia. As soluções encontradas foram: redução da carga horária, melhora da estrutura, troca de informações frequentes e sucintas, estímulo às discussões de casos clínicos e propostas terapêuticas conjuntas, valorização dos profissionais mais antigos, delimitação clara da autoridade, responsabilidade e competência de cada profissional, manutenção de relação afetuosa extra-profissional, confiança e valorização dos profissionais. Conclusão: é necessário delimitar os fatores de piora na relação e pôr em prática as soluções oferecidas para desenvolver os profissionais e proporcioná-los melhor ambiente de trabalho.Palavras Chave: Relações médico-enfermeiro, Equipe de assistência ao paciente, Administração hospitalar, Corpo clínico hospitalar, Planejamento hospitalar ABSTRACT:Objectives: To identify and describe the obstacles and solutions for a good doctor-nurse relationship. Methods: it is a narrative review of the literature with 10 studies between 2006 and 2018 that presented as descriptors "Doctor-Nurse Relations" and "Patient Care Team", whose guiding question was what are the obstacles and solutions for a good relationship nurse-doctor? Results: found as impediments: deficits in communication, conflicting points of view, high turnover, external pressures, ambiguous functions, task conflict, hierarchy, technical knowledge and previous hostility. The solutions found were: reducing the workload, improving the structure, exchanging frequent and succinct information, encouraging discussions of clinical cases and joint therapeutic proposals, valuing the oldest professionals, clearly defining the authority, responsibility and competence of each professional, maintenance of an extra-professional affectionate relationship, trust and valorization of the professionals. Conclusion: it is necessary to delimit the factors that worsen the relationship and put into practice the solutions offered to develop professionals and provide them with a better work environment.Key words: Physician-nurse relations; Patient care team; Hospital administration; Teams, health care; Hospital organization and administration

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The prevalence of neutropenia in chemotherapy cancer patients at a provincial hospital, Thailand

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.880 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

Y Suwannapong ◽

D Chinwong ◽

N Niamhun

Keyword(s):

Febrile Neutropenia ◽

Patient Care ◽

Cancer Patients ◽

Patient Care Team ◽

Care Team ◽

Cost Of Treatment ◽

Cross Sectional ◽

Practical Action ◽

Provincial Hospital ◽

Chemotherapy Patients

Abstract Introduction Cancer patients with neutropenia (<1500 cell/mm3 absolute neutrophil count [ANC]) are at high risk of febrile neutropenia and serious complications which can cause the delay treatment, reduction of chemotherapy dose, leading to morbidity and mortality. We lack of information of the prevalence of neutropenia in Thailand and its' consequences. Thus, this cross-sectional study aimed to investigate the prevalence of neutropenia at a provincial hospital in northern Thailand. Methods We retrospectively reviewed electronic medical records of cancer patients with solid tumor and receiving chemotherapy from September 2018 to October 2019. Results A total of 248 cancer patients (79 men, 169 women, mean age of 58.36±12.03) were included. The top 3 cancers were colon, breast and lung cancer (50.53%, 34.33%, 6.88%). They received chemotherapy 1,803 cycles of treatment. The top 3 regimens of treatment were FOLFOX (oxaliplatin/ fluorouracil/ leucovorin), AC (doxorubicin/ cyclophosphamide) and paclitaxel (42.65%, 17.75%, 9.67%). The prevalence of neutropenia (<1500 cell/mm3) was 264 episodes: 64 episodes of ANC 1,000-1,500 cell/mm3 (3.55%); 172 episodes of ANC 500-1,000 cell/mm3 (9.54%); and 28 episodes of ANC <500 cell/mm3 (1.55%). Most of them were postponed the treatment, but 16 episodes were still received chemotherapy. The dose of chemotherapy in 78 episodes were decreased and 16 episodes were related to the treatment of febrile neutropenia. The treatment of febrile neutropenia chemotherapy patients was 8 + 3 days with an average of US$ 400 per person, per cost of treatment. Conclusions We found that the effects of neutropenia in chemotherapy patients were delayed treatment, dose reduction and a major risk factor of febrile neutropenia. This decreased the efficiency of chemotherapy in patients with cancer. The result should be informed and encouraged our patient care team to develop practical action for prevention and management of serious neutropenic events. Key messages The result should be informed and encouraged our patient care team to develop practical action for prevention and management of serious neutropenic events. If we can manage cancer patients with neutropenia, the cost of treatment for serious febrile neutropenia and other complications will be reduced.

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