A Nurse-Driven Peripherally Inserted Central CatheterTeam Exhibits Excellence Through Teamwork

2006 ◽  
Vol 11 (3) ◽  
pp. 135-143 ◽  
Author(s):  
Renee Ean ◽  
Jane Kirmse ◽  
Jennifer Roslien ◽  
Kate Dickerson ◽  
Elizabeth Grimes ◽  
...  
Keyword(s):  
Organizational Performance ◽  
Patient Outcomes ◽  
Collaborative Research ◽  
National Level ◽  
Success Rates ◽  
Staff Time ◽  
The Past ◽  
Placement Success ◽  
Improve Patient

Abstract Studies have demonstrated that a dedicated peripherally inserted central catheter (PICC) team can reduce costs, lead to efficient use of staff time, improve patient outcomes, and improve organizational performance. A dedicated, nurse-driven PICC team at the authors' facility has demonstrated excellence through teamwork. Over the past three years, the PICC team has made significant strides in the quality of service provided to patients. The goals of the team consisted of (1) improving PICC-placement success rates; (2) developing an electronic database to track patient outcomes; (3) constructing protocols and guidelines to improve efficiency, appropriate use of PICC lines, and patient safety; and (4) pursuing collaborative research projects, publications, and presentations at the local and national level.

Addressing the Scottish burden of wounds through the Lens of Profound Knowledge

2021 ◽  
Vol 30 (Sup20) ◽  
pp. S34-S40
Author(s):  
Jenni MacDonald
Keyword(s):  
Patient Outcomes ◽  
Wound Care ◽  
Cost Effective ◽  
Theory Of Knowledge ◽  
Care Needs ◽  
Profound Knowledge ◽  
The Cost ◽  
Improve Patient ◽  
Growing Population

The prevalence of wounds and the cost of treating them are increasing year on year. Improving the quality of wound care will improve patient outcomes and is a financial necessity. The Lens of Profound Knowledge is a tool that can be used to support quality improvement and identify where action is needed. It allows exploration of an organisation through four aspects—appreciate the system, understanding variation, psychology, and theory of knowledge—and working on all four aspects simultaneously is believed to increase the likelihood of achieving improvement. Improvements at and between all levels—microsystem (such as frontline services), mesosystem (health boards) and macrosystem (NHS Scotland)—would reduce variation in practice and prove to be both clinically and cost-effective. Given the rapidly growing population of people with unhealed wounds, wound care needs to be valued at all system levels and be adequately resourced.

scholarly journals Communication with the Migraine Patient

2002 ◽  
Vol 29 (S2) ◽  
pp. S1-S2 ◽  
Author(s):  
W.J. Becker
Keyword(s):  
Patient Outcomes ◽  
Communication Skills ◽  
Migraine Patient ◽  
Laboratory Tests ◽  
Good Communication ◽  
The Past ◽  
Physician Patient Communication ◽  
Physical Findings ◽  
Physician Patient ◽  
Improve Patient

Much has been added to our knowledge of effective physician-patient communication by the research of the past two decades. Good communication skills are especially important for the clinician dealing with a migraine patient, as neither laboratory tests nor diagnostic physical findings are available to assist the physician in diagnosis and treatment. It is important for clinicians to understand that effective communication skills can be taught and learned and that, once mastered, they have the potential to improve patient outcomes.

scholarly journals Patient-reported outcomes in clinical practice

Hematology ◽  
2015 ◽  
Vol 2015 (1) ◽  
pp. 501-506 ◽  
Author(s):  
Sarah Dobrozsi ◽  
Julie Panepinto
Keyword(s):  
Clinical Practice ◽  
Patient Outcomes ◽  
Patient Reported Outcomes ◽  
Clinical Care ◽  
Patient Reported Outcome ◽  
Physician Communication ◽  
Valuable Data ◽  
Patient Reported ◽  
Improve Patient

Abstract Patient-reported outcome (PRO) measurement plays an increasingly important role in health care and understanding health outcomes. PROs are any report of a patient's health status that comes directly from the patient, and can measure patient symptoms, patient function, and quality-of-life. PROs have been used successfully to assess impairment in a clinical setting. Use of PROs to systematically quantify the patient experience provides valuable data to assist with clinical care; however, initiating use of PROs in clinical practice can be daunting. Here we provide suggestions for implementation of PROs and examples of opportunities to use PROs to tailor individual patient therapy to improve patient outcomes, patient–physician communication, and the quality of care for hematology/oncology patients.

Ulcerative colitis

2019 ◽  
Vol 12 (9) ◽  
pp. 501-506
Author(s):  
Charlie Andrews
Keyword(s):  
Quality Of Life ◽  
Ulcerative Colitis ◽  
Primary Care ◽  
Patient Outcomes ◽  
Colon And Rectum ◽  
Inflammatory Bowel ◽  
Primary Care Clinicians ◽  
Improve Patient ◽  
Prompt Diagnosis

Ulcerative colitis is a form of inflammatory bowel disease. It is a chronic relapsing condition affecting the colon and rectum and can cause a variety of symptoms, the commonest of which is bloody diarrhoea. Prompt diagnosis, as well as flare identification and management by primary care clinicians can improve patient outcomes such as disease progression and effects on quality of life.

scholarly journals Evolution of posterior cervical and occipitocervical fusion and instrumentation

2004 ◽  
Vol 16 (1) ◽  
pp. 1-15 ◽  
Author(s):  
John R. Vender ◽  
Andy J. Rekito ◽  
Steven J. Harrison ◽  
Dennis E. McDonnell
Keyword(s):  
Patient Outcomes ◽  
Biomechanical Testing ◽  
Spinal Instrumentation ◽  
Direct Methods ◽  
Success Rates ◽  
Occipitocervical Fusion ◽  
Complex Disorders ◽  
The Past ◽  
Key Events ◽  
Halo Orthosis

The past several decades have been the setting for a remarkable evolution of spinal instrumentation technology. The advancements that have been made have allowed previously complex disorders of the cervical spine, the atlantoaxial articulation, and the occipitocervical junction to be managed more effectively with direct methods of internal fixation and arthrodesis. This has resulted in improvements in patient outcomes and fusion success rates. The improved strength of instrumentation constructs allows minimal, if any, external bracing, obviating the need for a halo orthosis in many cases. In this paper the authors review key events that have occurred in neuroimaging, biomechanical testing, and the development of fusion and instrumentation constructs.

scholarly journals Heart Failure: Novel and Emerging Therapies

2020 ◽  
Vol 15 (SP1) ◽  
pp. 22-26
Author(s):  
Shiva Nandiwada ◽  
Justin Ezekowitz ◽  
Nawaf Al-Majed
Keyword(s):  
Heart Failure ◽  
Patient Outcomes ◽  
Poor Prognosis ◽  
Large Scale ◽  
Novel Therapies ◽  
Efficacy And Safety ◽  
Emerging Therapies ◽  
Interventional Therapies ◽  
Improve Patient

Heart failure (HF) is increasing in prevalence and continues to have poor prognosis despite using up-to-date guideline-directed medical treatment and device intervention. There is a dire need for new therapies that can improve patient outcomes. New recently tested medical and interventional therapies have proven effective in reducing the morbidity, mortality and improving the quality of life for patients with HF and these therapies are discussed in details in this review. Ongoing large scale clinical trials are underway to determine the efficacy and safety of novel therapies of HF. Development of these medical and interventional therapies are improving our understanding of HF and paving the way to better clinical outcomes.

scholarly journals Cardiac rehabilitation after acute myocardial infarction in Sweden – evaluation of programme characteristics and adherence to European guidelines: The Perfect Cardiac Rehabilitation (Perfect-CR) study

2019 ◽  
Vol 27 (1) ◽  
pp. 18-27 ◽  
Author(s):  
Halldora Ögmundsdottir Michelsen ◽  
Ingela Sjölin ◽  
Mona Schlyter ◽  
Emil Hagström ◽  
Anna Kiessling ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Rehabilitation ◽  
Patient Outcomes ◽  
National Level ◽  
Rehabilitation Programme ◽  
Cardiac Rehabilitation Programme ◽  
Rehabilitation Team ◽  
European Guidelines

Background While patient performance after participating in cardiac rehabilitation programmes after acute myocardial infarction is regularly reported through registry and survey data, information on cardiac rehabilitation programme characteristics is less well described. Aim The aim of this study was to evaluate Swedish cardiac rehabilitation programme characteristics and adherence to European Guidelines on Cardiovascular Disease Prevention. Method Cardiac rehabilitation programme characteristics at all 78 cardiac rehabilitation centres in Sweden in 2016 were surveyed using a web-based questionnaire (100% response rate). The questions were based on core components of cardiac rehabilitation as recommended by European Guidelines. Results There was a wide variation in programme duration (2–14 months). All programmes reported offering an individual post-discharge visit with a nurse, and 90% ( n = 70) did so within three weeks from discharge. Most programmes offered centre-based exercise training ( n = 76, 97%) and group educational sessions ( n = 61, 78%). All programmes reported to the national audit, SWEDEHEART, and 60% ( n = 47) reported that performance was regularly assessed using audit data, to improve quality of care. Ninety-six per cent ( n = 75) had a core team consisting of a cardiologist, a physiotherapist and a nurse and 76% ( n = 59) reported having a medical director. Having other allied healthcare professionals included in the cardiac rehabilitation team varied. Forty per cent ( n = 31) reported having regular team meetings where nurses, physiotherapists and cardiologist could discuss patient cases. Conclusion The overall quality of cardiac rehabilitation programmes provided in Sweden is high. Still, there are several areas of potential improvement. Monitoring programme characteristics as well as patient outcomes might improve programme quality and patient outcomes both at a local and a national level.

Platelet-Rich Preparations to Improve Healing. Part II: Platelet Activation and Enrichment, Leukocyte Inclusion, and Other Selection Criteria

2014 ◽  
Vol 40 (4) ◽  
pp. 511-521 ◽  
Author(s):  
Vicki L Davis ◽  
Alaeddin B Abukabda ◽  
Nicholas M Radio ◽  
Paula A Witt-Enderby ◽  
William P Clafshenkel ◽  
...  
Keyword(s):  
Growth Factor ◽  
Patient Outcomes ◽  
Selection Criteria ◽  
Platelet Rich Plasma ◽  
Simple Preparation ◽  
Different Types ◽  
Platelet Concentration ◽  
Improve Patient ◽  
Tgf Β1

Multiple platelet-rich preparations have been reported to improve wound and bone healing, such as platelet-rich plasma (PRP) and platelet rich fibrin (PRF). The different methods employed during their preparation are important, as they influence the quality of the product applied to a wound or surgical site. Besides the general protocol for preparing the platelet-rich product (discussed in Part 1 of this review), multiple choices need to be considered during its preparation. For example, activation of the platelets is required for the release and enmeshment of growth factors, but the method of activation may influence the resulting matrix, growth factor availability, and healing. Additionally, some methods enrich leukocytes as well as platelets, but others are designed to be leukocyte-poor. Leukocytes have many important roles in healing and their inclusion in PRP results in increased platelet concentrations. Platelet and growth factor enrichment reported for the different types of platelet-rich preparations are also compared. Generally, TGF-β1 and PDGF levels were higher in preparations that contain leukocytes compared to leukocyte-poor PRP. However, platelet concentration may be the most reliable criterion for comparing different preparations. These and other criteria are described to help guide dental and medical professionals, in large and small practices, in selecting the best procedures for their patients. The healing benefits of platelet-rich preparations along with the low risk and availability of simple preparation procedures should encourage more clinicians to incorporate platelet-rich products in their practice to accelerate healing, reduce adverse events, and improve patient outcomes.

scholarly journals Hemostasis, Hematoma Expansion, and Outcomes after Intracerebral Hemorrhage

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4886-4886
Author(s):  
Paul F Lindholm ◽  
Hau C. Kwaan ◽  
Andrew M Naidech
Keyword(s):  
Quality Of Life ◽  
Machine Learning ◽  
Intracerebral Hemorrhage ◽  
Patient Outcomes ◽  
Platelet Function ◽  
Hematoma Expansion ◽  
Platelet Activity ◽  
Coagulation Activation ◽  
Improve Patient

Background: Intracerebral hemorrhage (ICH) is a serious complication of stroke with significant morbidity and mortality. Intracerebral bleeding and hematoma expansion (HE) cause displacement and damage to brain tissue leading to disability and death. An important approach to improve patient outcomes from ICH is to prevent HE. Our ability to improve patient outcomes depends on our ability to recognize HE and the associated hemostatic mechanisms. This study is designed to evaluate biomarkers of platelet function, coagulation and fibrinolysis and relate these biomarkers to statistically powerful estimates of HE and patient outcomes. Study Design and Methods: Patients with acute ICH within the first 12 hours of the onset of symptoms will be studied to identify hemostasis biomarkers which may predict hematoma expansion. Major inclusion criteria: Spontaneous ICH within 12 hours of symptom onset; age at least 21 years; consent from the patient or a representative. Exclusion criteria: hereditary hemostasis disorders, history of malignancy, vascular malformation suspected or on imaging, sepsis, comorbid condition that is likely to be disabling or fatal, hemoglobin less than 7.5 g/dL, pregnancy. Statistical methods: We will test the hypothesis that each hemostasis biomarker predicts HE by using Mann-Whitney U (for non-parametric) or ANOVA (for normally distributed results). We will set P<0.01 given the multiple biomarkers to be assessed. The 80% power using a Mann-Whitney U to test the hypothesis that the distributions of HE are 3 mL different would require 147 patients (calculations made with PASS v.12, NCSS Inc., Kaysville, UT). Machine learning techniques will be applied to hemostasis biomarkers to predict the modified Rankin score (mRS), T Scores of HRQoL, and T Scores of NIH Toolbox outcomes. Precision-recall and receiver operating characteristic (ROC) curves will be constructed, and area under the curve will be compared. Biomarker selection or companion diagnostics: This study will measure platelet activity, coagulation activation and fibrinolysis in patients with acute onset (less than 12 hours) intracerebral hemorrhage ICH to determine hemostatic mechanisms of hematoma expansion. Global activity of platelets, coagulation factors and fibrinolysis activity are measured by thromboelastogram (TEG) and rotational thromboelastometry (ROTEM) assays. Platelet activity is also measured with Platelet Function assay, PFA-100, Platelet Aspirin Assay and the Platelet P2Y12 Assay. Coagulation activation is measured by Tissue Factor antigen and activity and Thrombin Generation Assay. Fibrinolysis is assayed by Plasmin/antiplasmin (PAP) complex, Fibrinogen, D-Dimer and PAI-1 antigen and activity. Study treatment, endpoints: The hemostatic parameters and hematoma expansion are compared to patient outcomes measured by the mRS and health related quality of life (HRQoL) and objective outcomes measures from the NIH toolbox to determine the relationship to patient outcomes. The mRS is a standard outcome measure for patients with ICH. The NIH developed and validated HRQoL measures Patient-Reported Outcomes Measurement Information System (PROMIS), Quality of Life in Neurological Disorders (Neuro-QoL), and objective function NIH Toolbox are the most sensitive and provide statistically powerful estimates of patient outcomes in survivors of ICH. Future Directions: This study is designed to identify hemostatic factor abnormalities and mechanisms of ICH hematoma expansion treatable with targeted therapies (e.g., desmopressin to counteract aspirin effect or fibrinolysis inhibitors). Machine learning algorithms will be employed for predicting patient outcomes after ICH and may illuminate when HE is most impactful and determine specific therapies which improve patient outcomes. This study is funded by a National Institutes of Health (NIH)/ The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) grant ID: SP0049593; R01 NS110779. Disclosures Naidech: NIH: Other: NS110779-Grant.

scholarly journals Exploring patient views of empathic optimistic communication for osteoarthritis in primary care: A qualitative interview study using vignettes

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0014
Author(s):  
Emily Lyness ◽  
Jane Louise Vennik ◽  
Felicity Bishop ◽  
Pranati Misurya ◽  
Jeremy Howick ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Outcomes ◽  
Structured Interviews ◽  
Knee Oa ◽  
Qualitative Interview Study ◽  
Empathic Communication ◽  
Case Vignettes ◽  
Digital Training ◽  
Improve Patient

BackgroundOsteoarthritis (OA) causes pain and disability. An empathic optimistic consultation approach can improve patient quality of life, satisfaction with care, and reduce pain. However, expressing empathic optimism may be overlooked in busy primary care consultations and there is limited understanding of patients’ views about this approach.AimTo explore patients’ perspectives on clinician communication of empathy and optimism in primary care OA consultations.Design & settingVignette study with qualitative semi-structured interviews.SettingPurposefully sampled patients (n=33) aged 45+ with hip/knee OA from Wessex GP practices.MethodFifteen participants watched two filmed OA consultations with a GP, and eighteen participants read two case vignettes. In both formats, one GP depicted an empathic optimistic approach and one GP had a ‘neutral’ approach. Semi-structured interviews were conducted with all participants and analysed using thematic analysis.ResultsPatients recognised that empathic communication enhanced interactions, helping to engender a sense of trust in their clinician. They felt it was acceptable for GPs to convey optimism only if it was realistic, personalised and embedded within an empathic consultation. Discussing patients’ experiences and views with them, and conveying an accurate understanding of these experiences improves the credibility of optimistic messages.ConclusionPatients value communication with empathy and optimism, but it requires a fine balance to ensure messages remain realistic and trustworthy. Increased use of a realistic optimistic approach within an empathic consultation could enhance consultations for OA and other chronic conditions, and improve patient outcomes. Digital training to help GPs implement these findings is being developed.

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