scholarly journals Prevention, Diagnosis and Management of Post-Surgical Mediastinitis in Adults Consensus Guidelines of the Spanish Society of Cardiovascular Infections (SEICAV), the Spanish Society of Thoracic and Cardiovascular Surgery (SECTCV) and the Biomedical Research Centre Network for Respiratory Diseases (CIBERES)

2021 ◽  
Vol 10 (23) ◽  
pp. 5566
Author(s):  
Emilio Bouza ◽  
Arístides de Alarcón ◽  
María Carmen Fariñas ◽  
Juan Gálvez ◽  
Miguel Ángel Goenaga ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Biomedical Research ◽  
Respiratory Diseases ◽  
Cardiovascular Surgery ◽  
Research Centre ◽  
Care Providers ◽  
Process Of Care ◽  
Spanish Society ◽  
Diagnosis And Management ◽  
Consensus Document

This is a consensus document of the Spanish Society of Cardiovascular Infections (SEICAV), the Spanish Society of Thoracic and Cardiovascular Surgery (SECTCV) and the Biomedical Research Centre Network for Respiratory Diseases (CIBERES). These three entities have brought together a multidisciplinary group of experts that includes anaesthesiologists, cardiac and cardiothoracic surgeons, clinical microbiologists, infectious diseases and intensive care specialists, internal medicine doctors and radiologists. Despite the clinical and economic consequences of sternal wound infections, to date, there are no specific guidelines for the prevention, diagnosis and management of mediastinitis based on a multidisciplinary consensus. The purpose of the present document is to provide evidence-based guidance on the most effective diagnosis and management of patients who have experienced or are at risk of developing a post-surgical mediastinitis infection in order to optimise patient outcomes and the process of care. The intended users of the document are health care providers who help patients make decisions regarding their treatment, aiming to optimise the benefits and minimise any harm as well as the workload.

scholarly journals Approach to the Assessment and Management of Adult Patients With Atopic Dermatitis: A Consensus Document

2018 ◽  
Vol 22 (1_suppl) ◽  
pp. 3S-5S ◽  
Author(s):  
Melinda J. Gooderham ◽  
Chih-ho Hong ◽  
Lorne Albrecht ◽  
Robert Bissonnette ◽  
Gurbir Dhadwal ◽  
...  
Keyword(s):  
Health Care ◽  
Atopic Dermatitis ◽  
Health Care Providers ◽  
Expert Panel ◽  
Adult Patients ◽  
Clinical Expertise ◽  
Care Providers ◽  
Consensus Document ◽  
Practical Management ◽  
Consensus Statements

Background: Atopic dermatitis (AD) is a chronic, relapsing, and remitting inflammatory skin disease with complex pathophysiology, primarily driven by type 2 inflammation. Existing guidelines often do not reflect all current therapeutic options and guidance on the practical management of patients with AD is lacking. Objectives: To develop practical, up-to-date guidance on the assessment and management of adult patients with AD. Methods: An expert panel of 17 Canadian experts, including 16 dermatologists and 1 allergist, with extensive clinical experience managing moderate-to-severe AD reviewed the available literature from the past 5 years using a defined list of key search terms. This literature, along with clinical expertise and opinion, was used to draft concise, clinically relevant reviews of the current literature. Based on these reviews, experts developed and voted on recommendations and statements to reflect the practical management of adult patients with AD as a guide for health care providers in Canada and across the globe, using a prespecified agreement cutoff of 75%. Results: Eleven consensus statements were approved by the expert panel and reflected 4 key domains: pathophysiology, assessment, comorbidities, and treatment. Conclusions: These statements aim to provide a framework for the assessment and management of adult patients with AD and to guide health care providers in practically relevant aspects of patient management.

scholarly journals Haemophilia in France: Modelisation of the Clinical Pathway for Patients

2022 ◽  
Vol 19 (2) ◽  
pp. 646
Author(s):  
Karen Beny ◽  
Benjamin du Sartz de Vigneulles ◽  
Florence Carrouel ◽  
Denis Bourgeois ◽  
Valérie Gay ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Health Professionals ◽  
Care Pathway ◽  
Exploratory Research ◽  
Care Providers ◽  
Process Of Care ◽  
Treatment Delivery ◽  
Community Environment ◽  
Specialized Service ◽  
A Current

Process-of-care studies participate in improving the efficiency of the care pathway for patient with haemophilia (CPPH) and rationalize the multidisciplinary management of patients. Our objective is to establish a current overview of the different actors involved in the management of patients with haemophilia and to provide an accurate description of the patient trajectory. This is a qualitative exploratory research based on interviews of the principal health professionals of four haemophilia services, between November 2019 and February 2020, in France. Mapping of the CPPH processes within the different institutions and/or services, as well as the rupture zones, were identified. Treatment delivery and biological analyses were carried out exclusively in healthcare institutions. The main liberal health professionals solicited were nurses, physiotherapists and general practitioner. Obstacles and barriers within the specialized service, with other hospital services and external hospital or private services, community health care providers et community environment and individual one was complex and multiples. Our research identified potential concerns that need to be addressed to improve future studies to identify influential elements. Similarly, other qualitative studies will have to be conducted on the perceptions and literacy of patients with haemophilia to develop a global interactive mapping of their trajectories.

scholarly journals Approach to the Assessment and Management of Pediatric Patients with Atopic Dermatitis: A Consensus Document. Section II: Comorbid Disease in Pediatric Atopic Dermatitis

2019 ◽  
Vol 23 (5_suppl) ◽  
pp. 12S-18S ◽  
Author(s):  
Chih-ho Hong ◽  
Marissa Joseph ◽  
Vy HD Kim ◽  
Perla Lansang ◽  
Irene Lara-Corrales
Keyword(s):  
Atopic Dermatitis ◽  
Health Care Providers ◽  
Pediatric Patients ◽  
Allergic Diseases ◽  
Care Providers ◽  
Barrier Dysfunction ◽  
Consensus Document ◽  
Common Skin ◽  
Genetic And Environmental Factors ◽  
Skin Conditions

Pediatric atopic dermatitis (AD) is one of the most common skin conditions encountered by health-care providers caring for infants, children, and adolescents. Pediatric patients with AD may present with other allergic and nonallergic comorbidities that require appropriate treatment and referral. They may also experience a trajectory of allergic diseases known as the atopic march, which depends on a complex interaction between genetic and environmental factors and likely involves early epidermal barrier dysfunction. Here we provide a review and clinical recommendations on the assessment and referral of comorbidities in pediatric AD.

scholarly journals Expert Perspectives on Hereditary Angioedema: Key Areas for Advancements in Care across the Patient Journey

2016 ◽  
Vol 7 (3) ◽  
pp. ar.2016.7.0165 ◽  
Author(s):  
Aleena Banerji ◽  
Murat Baş ◽  
Jonathan A. Bernstein ◽  
Isabelle Boccon-Gibod ◽  
Maria Bova ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Hereditary Angioedema ◽  
Delayed Diagnosis ◽  
Scientific Data ◽  
Online Information ◽  
Care Providers ◽  
C1 Inhibitor Deficiency ◽  
Patient Journey ◽  
Diagnosis And Management ◽  
Awareness Campaigns

Background Published literature documents the substantial burden of hereditary angioedema (HAE) with C1 inhibitor deficiency on the quality of life and work productivity of patients. However, despite advances in the field and the availability of guidelines to advise health care providers (HCP) on the diagnosis and management of HAE, there are still many challenges to overcome. For example, delayed diagnosis and misdiagnosis are common, and treatment practices vary worldwide. Objective An international expert panel was convened to consider opportunities for improvements that would benefit patients with HAE. Methods Based on professional and personal experiences, the experts developed schematics to describe the journey of patients through the following stages: (1) onset of symptoms and initial evaluation; (2) referral/diagnosis; and (3) management of HAE. More importantly, the panel identified key areas in which it was possible to optimize the support provided to patients and HCPs along this journey. Results Overall, this approach highlighted the need for wider dissemination of algorithms and scientific data to more effectively educate HCPs from multiple disciplines and the need for more research to inform appropriate treatment decisions. Furthermore, HAE awareness campaigns, accurate online information, and referral to patient advocacy groups were all considered helpful approaches to support patients. Conclusion More detailed and widespread information on the diagnosis and management of HAE is needed and may lead to advancements in care throughout the journey of the patient with HAE.

scholarly journals A Study on Health Seeking Behaviors of Patients of Post-Kala-Azar Dermal Leishmaniasis

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Ariful Basher ◽  
Proggananda Nath ◽  
Shah Golam Nabi ◽  
Shahjada Selim ◽  
Md Fashiur Rahman ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Patient Delay ◽  
Research Centre ◽  
Initial Symptom ◽  
Care Providers ◽  
System Delay ◽  
Health Seeking ◽  
Kala Azar ◽  
History Of

Post-Kala-Azar Dermal Leishmaniasis (PKDL) remains a major public health threat in Bangladesh. A cross-sectional study was carried out in Surya Kanta Kala azar Research Centre (SKKRC), Mymensingh, from January 2012 to July 2013 to evaluate the health seeking behaviour and the length of delay of PKDL management. The consecutive 200 diagnosed PKDL cases that got treatment in SKKRC hospital were subjected to evaluation. Most (98%) of the patients were not aware and had no knowledge about PKDL, though 87.5% had a history of history of Kala-azar treatment. Many patients reported first to village doctor (15.5%), the pharmacy shop (10%), or traditional health provider (7.5%) upon recognition of symptom. The time between the initial symptom recognition and first medical consultation (patient delay) ranged from 10 days to 4745 days (13 years) with a median of 373 days (mean: 696; IQR: 138 to 900 days). The time between first medical consultations to definite treatment (system delay) ranged from 0 days to 1971 days (5.4 years), with a median delay of 14 days (mean: 46.48; IQR: 7 to 44 days) that was reported in this study. Age, education, occupation, and residential status had significant association with patient delay (P<0.05). Educational status, occupation, number of treatment providers, and first health care provider had a significant association with system delay (P<0.05). Success in PKDL diagnosis and treatment requires specific behavior from patients and health care providers which facilitate those practices.

scholarly journals Approach to the Assessment and Management of Pediatric Patients With Atopic Dermatitis: A Consensus Document. Section I: Overview of Pediatric Atopic Dermatitis

2019 ◽  
Vol 23 (5_suppl) ◽  
pp. 3S-11S ◽  
Author(s):  
Irene Lara-Corrales ◽  
James N. Bergman ◽  
Ian Landells ◽  
Michele L. Ramien ◽  
Perla Lansang
Keyword(s):  
Atopic Dermatitis ◽  
Health Care Providers ◽  
Patient Reported Outcomes ◽  
Assessment Tools ◽  
Care Providers ◽  
Patient Counseling ◽  
Consensus Document ◽  
Subjective Assessments ◽  
Patient Reported

Pediatric atopic dermatitis (AD) is one of the most common dermatoses encountered by health-care providers treating children. Diagnosis of AD is clinical, with no universally accepted biomarkers or assessment tools. Patient-reported outcomes and subjective assessments of quality of life in both the patient and family are important considerations when treating pediatric AD. Here, we provide an overview of pediatric AD epidemiology, its clinical presentation, burden, diagnosis, and assessment, with a focus on implications for patient counseling in order to optimize care.

Care planning for pressure ulcers in hospice: The team effect

2004 ◽  
Vol 2 (3) ◽  
pp. 283-289 ◽  
Author(s):  
ANDREW EISENBERGER ◽  
JOMARIE ZELEZNIK
Keyword(s):  
Family Caregivers ◽  
Health Care Providers ◽  
Pressure Ulcer ◽  
Pressure Ulcers ◽  
Direct Care ◽  
Standards Of Care ◽  
Care Planning ◽  
Primary Role ◽  
Care Providers ◽  
Process Of Care

Objective: The standards of care for patients at risk for or with a pressure ulcer in hospitals and nursing homes focus on prevention and ulcer healing using an interdisciplinary approach. Although not a primary hospice condition, pressure ulcers are not uncommon in dying patients. Their management in hospices, particularly the involvement of family caregivers, has not been studied. The objective of this study is to identify the factors that influence care planning for the prevention and treatment of pressure ulcers in hospice patients and develop a taxonomy to use for further study.Methods: A telephone survey was conducted with 18 hospice directors of clinical services and 10 direct-care nurses. Descriptive qualitative data analysis using grounded theory was utilized.Results: The following three themes were identified: (1) the primary role of the hospice nurse is an educator rather than a wound care provider; (2) hospice providers perceive the barriers and burdens of family caregiver involvement in pressure ulcer care to be bodily location of the pressure ulcer, unpleasant wound characteristics, fear of causing pain, guilt, and having to acknowledge the dying process when a new pressure ulcer develops; and (3) the “team effect” describes the collaboration between family caregivers and the health care providers to establish individualized achievable goals of care ranging from pressure ulcer prevention to acceptance of a pressure ulcer and symptom palliation.Significance of results: Pressure ulcer care planning is a model of collaborative decision making between family caregivers and hospice providers for a condition that occurs as a secondary condition in hospice. A pressure ulcer places significant burdens on family caregivers distinct from common end-of-life symptoms whose treatment is directed at the patient. Because the goals of pressure ulcer care appear to be individualized for a dying patient and their caregivers, the basis of quality-of-care evaluations should be the process of care rather than the outcome of an incident pressure ulcer.

Pediatric Care for Children Whose Parents Are Gay or Lesbian

PEDIATRICS ◽  
1996 ◽  
Vol 97 (5) ◽  
pp. 629-635
Author(s):  
Ellen C. Perrin ◽  
Heidi Kulkin
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Pediatric Care ◽  
Care Providers ◽  
Process Of Care ◽  
Developmental Transitions ◽  
Pediatric Health ◽  
Number Of Children ◽  
Gay Parents ◽  
Pediatric Health Care

Background. A growing number of children have at least one parent who is gay or lesbian. There is no evidence that these children experience any particular difficulties as a result of their parents' sexual orientation. Considerable evidence suggests that the provision of health care may not address the special needs and concerns of gay men and lesbians adequately. No research has been done regarding the pediatric care of children whose parents are gay or lesbian. It is likely that there are predictable challenges and developmental transitions for these children and parents for which pediatricians and other health care providers might be helpful advisers. Objective. This exploratory project sought to describe the experiences that lesbian and gay parents and their children have had with the pediatric health care system. We were interested in describing experiences that had been especially affirming and others that had been troublesome and in gathering suggestions regarding changes in the structure and process of care. Methodology. Two hundred fifty-five parents completed an open-ended questionnaire. Responses were coded and tabulated. Results. Most parents described considerable success in obtaining pediatric care that was affirming, supportive, and satisfactory. On the other hand, many parents noted deficiencies in pediatric offices, clinics, emergency departments, and hospitals, many of which could be corrected easily. Conclusions. We have summarized the accumulated advice to pediatric health care providers and have described some of the developmental transitions that are potentially appropriate opportunities for pediatric intervention.

scholarly journals Approach to the Assessment and Management of Adult Patients With Atopic Dermatitis: A Consensus Document. Section V: Consensus Statements on the Assessment and Management of Adult Patients With Moderate-to-Severe Atopic Dermatitis

2018 ◽  
Vol 22 (1_suppl) ◽  
pp. 30S-35S ◽  
Author(s):  
Chih-ho Hong ◽  
Melinda J. Gooderham ◽  
Lorne Albrecht ◽  
Robert Bissonnette ◽  
Gurbir Dhadwal ◽  
...  
Keyword(s):  
Health Care ◽  
Atopic Dermatitis ◽  
Health Care Providers ◽  
Treatment Options ◽  
Adult Patients ◽  
Severe Atopic Dermatitis ◽  
Care Providers ◽  
Extensive Experience ◽  
Consensus Document ◽  
Consensus Statements

This document is a concise, current, and practical guide for dermatologists and other health care providers managing adult patients with moderate-to-severe atopic dermatitis (AD). The recommendations made here are based on a consensus of specialists with extensive experience managing patients with AD. Topics reviewed in this publication include AD pathophysiology, assessment, comorbidities, and treatment options.

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