Writing a Simulation Scenario: A Step-By-Step Guide

2016 ◽  
Vol 27 (1) ◽  
pp. 62-70 ◽  
Author(s):  
Deborah Bambini
Keyword(s):  
Best Practices ◽  
Health Care Providers ◽  
Nursing Faculty ◽  
Clinical Settings ◽  
Evidence Based ◽  
Care Providers ◽  
Clinical Area ◽  
Step Process ◽  
Academic Settings ◽  
Simulation Scenario

Simulation is becoming a widely used method of helping nurses learn and maintain competency in the clinical area for both staff educators in clinical settings and nursing faculty in academic settings. Designing an effective simulation experience requires thoughtful planning, knowledge of educational principles, and knowledge of best practices in both simulation and clinical practice. An evidence-based strategy for writing a simulation scenario for nurses and other health care providers in any setting is described. A step-by-step process is outlined that incorporates best practices. Examples and suggestions are provided to help readers create quality simulation experiences.

Promoting Women’s Participation in Maternity Care in Lebanon

2015 ◽  
Vol 5 (3) ◽  
pp. 166-176 ◽  
Author(s):  
Tamar Kabakian-Khasholian ◽  
Rawan Shayboub ◽  
Mona Kanaan ◽  
Ziyad Mahfoud ◽  
Faysal El Kak
Keyword(s):  
Best Practices ◽  
Communication Skills ◽  
Health Care Providers ◽  
Maternity Care ◽  
Controlled Trial ◽  
Effective Communication ◽  
Evidence Based ◽  
Care Providers ◽  
Cluster Randomized ◽  
Evidence Based Care

This study examined the effect of providing evidence-based information to women and enabling them to use effective communication skills on requesting changes in maternity care. A cluster randomized controlled trial was conducted where pregnant women, from 65 private obstetric clinics, were recruited from 2 regions in Lebanon. The intervention consisted of 2 prenatal sessions on evidence-based care and effective communication skills. Women in the intervention arm were more likely to request not to have an enema (odds ratio [OR] = 5.57; confidence interval [CI] = 2.44–12.71), to request keeping their infants for prolonged time in their room (OR= 2.1; CI = 1.43–3.09), and to actually being able to keep their infants in their rooms for longer periods (OR= 2.39; CI = 1.13–5.04), compared to women in the control arm. Knowledge on best practices was significantly improved. Informing women about best practices and enhancing communication skills with providers of care can facilitate change in the provision of health services. More consideration needs to be given to the commitment of health care providers and senior staff within hospitals to ensure the scaling up of such interventions.

scholarly journals Ethical Considerations on Pediatric Genetic Testing Results in Electronic Health Records

2020 ◽  
Vol 11 (05) ◽  
pp. 755-763
Author(s):  
Shibani Kanungo ◽  
Jayne Barr ◽  
Parker Crutchfield ◽  
Casey Fealko ◽  
Neelkamal Soares
Keyword(s):  
Genetic Testing ◽  
Best Practices ◽  
Health Care Providers ◽  
Genetic Information ◽  
Ethical Issues ◽  
Interdisciplinary Approach ◽  
Care Providers ◽  
Ethical Considerations ◽  
Electronic Health ◽  
Genetic Results

Abstract Background Advances in technology and access to expanded genetic testing have resulted in more children and adolescents receiving genetic testing for diagnostic and prognostic purposes. With increased adoption of the electronic health record (EHR), genetic testing is increasingly resulted in the EHR. However, this leads to challenges in both storage and disclosure of genetic results, particularly when parental results are combined with child genetic results. Privacy and Ethical Considerations Accidental disclosure and erroneous documentation of genetic results can occur due to the nature of their presentation in the EHR and documentation processes by clinicians. Genetic information is both sensitive and identifying, and requires a considered approach to both timing and extent of disclosure to families and access to clinicians. Methods This article uses an interdisciplinary approach to explore ethical issues surrounding privacy, confidentiality of genetic data, and access to genetic results by health care providers and family members, and provides suggestions in a stakeholder format for best practices on this topic for clinicians and informaticians. Suggestions are made for clinicians on documenting and accessing genetic information in the EHR, and on collaborating with genetics specialists and disclosure of genetic results to families. Additional considerations for families including ethics around results of adolescents and special scenarios for blended families and foster minors are also provided. Finally, administrators and informaticians are provided best practices on both institutional processes and EHR architecture, including security and access control, with emphasis on the minimum necessary paradigm and parent/patient engagement and control of the use and disclosure of data. Conclusion The authors hope that these best practices energize specialty societies to craft practice guidelines on genetic information management in the EHR with interdisciplinary input that addresses all stakeholder needs.

scholarly journals “What is the actual goal of the pathway?”: examining emergency department physician and nurse perspectives on the implementation of a pediatric concussion pathway using the theoretical domains framework

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anh Ly ◽  
Roger Zemek ◽  
Bruce Wright ◽  
Jennifer Zwicker ◽  
Kathryn Schneider ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Care Providers ◽  
Clinical Pathways ◽  
Theoretical Domains Framework ◽  
Local Context ◽  
Emergency Department Physician ◽  
Evidence Based ◽  
Care Providers ◽  
Structured Interviews ◽  
Pediatric Concussion

Abstract Background Multiple evidence-based clinical practice guidelines (CPGs) exist to guide the management of concussion in children, but few have been translated into clinical pathways (CP), which operationalize guidelines into accessible and actionable algorithms that can be more readily implemented by health care providers. This study aimed to identify the clinical behaviours, attitudinal factors, and environmental contexts that potentially influence the implementation of a clinical pathway for pediatric concussion. Methods Semi-structured interviews were conducted from October 2017 to January 2018 with 42 emergency department clinicians (17 physicians, 25 nurses) at five urban emergency departments in Alberta, Canada. A Theoretical Domains Framework (TDF)-informed interview guide contained open-ended questions intended to gather feedback on the proposed pathway developed for the study, as well as factors that could potentially influence its implementation. Results The original 14 domains of the TDF were collapsed into 6 clusters based on significant overlap between domains in the issues discussed by clinicians: 1) knowledge, skills, and practice; 2) professional roles and identity; 3) attitudes, beliefs, and motivations; 4) goals and priorities; 5) local context and resources; and 6) engagement and collaboration. The 6 clusters identified in the interviews each reflect 2–4 predominant topics that can be condensed into six overarching themes regarding clinicians’ views on the implementation of a concussion CP: 1) standardization in the midst of evolving research; 2) clarifying and communicating goals; 3) knowledge dissemination and alignment of information; 4) a team-oriented approach; 5) site engagement; and 6) streamlining clinical processes. Conclusion Application of a comprehensive, evidence-based, and theory-driven framework in conjunction with an inductive thematic analysis approach enabled six themes to emerge as to how to successfullly implement a concussion CP.

Translating Evidence-Based Interventions Into Practice

2011 ◽  
Vol 12 (6_suppl_1) ◽  
pp. 9S-19S ◽  
Author(s):  
Meera Viswanathan ◽  
Linda Lux ◽  
Kathleen N. Lohr ◽  
Tammeka Swinson Evans ◽  
Lucia Rojas Smith ◽  
...  
Keyword(s):  
Health Care Providers ◽  
System Integration ◽  
Pediatric Asthma ◽  
Evidence Based ◽  
Extensive Literature ◽  
Care Providers ◽  
Planning Period ◽  
Community Based ◽  
Asthma Morbidity ◽  
Effective Interventions

Pediatric asthma is a multifactorial disease, requiring complex, interrelated interventions addressing children, families, schools, and communities. The Merck Childhood Asthma Network, Inc. (MCAN) is a nonprofit organization that provides support to translate evidence-based interventions from research to practice. MCAN developed the rationale and vision for the program through a phased approach, including an extensive literature review, stakeholder engagement, and evaluation of funding gaps. The analysis pointed to the need to identify pediatric asthma interventions implemented in urban U.S. settings that have demonstrated efficacy and materials for replication and to translate the interventions into wider practice. In addition to this overall MCAN objective, specific goals included service and system integration through linkages among health care providers, schools, community-based organizations, patients, parents, and other caregivers. MCAN selected sites based on demonstrated ability to implement effective interventions and to address multiple contexts of pediatric asthma prevention and management. Selected MCAN program sites were mature institutions or organizations with significant infrastructure, existing funding, and the ability to provide services without requiring a lengthy planning period. Program sites were located in communities with high asthma morbidity and intended to integrate new elements into existing programs to create comprehensive care approaches.

scholarly journals A Study Protocol for Increasing Access to Smoking Cessation Treatments for Low-Income Minority Smokers

2021 ◽  
Vol 9 ◽  
Author(s):  
Alicia K. Matthews ◽  
Karriem S. Watson ◽  
Cherdsak Duang ◽  
Alana Steffen ◽  
Robert Winn
Keyword(s):  
Health Care ◽  
Smoking Cessation ◽  
Health Care Providers ◽  
Low Income ◽  
Access To Health Care ◽  
Social Determinant ◽  
Evidence Based ◽  
Patient Portal ◽  
Care Providers ◽  
Access To Health

Background: Smoking rates among low-income patients are double those of the general population. Access to health care is an essential social determinant of health. Federally qualified health care centers (FQHC) are government-supported and community-based centers to increase access to health care for non-insured and underinsured patients. However, barriers to implementation impact adherence and sustainability of evidence-based smoking cessation within FQHC settings. To address this implementation barrier, our multi-disciplinary team proposes Mi QUIT CARE (Mile Square QUITCommunity-Access-Referral-Expansion) to establish the acceptability, feasibility, and capacity of an FQHC system to deliver an evidence-based and multi-level intervention to increase patient engagement with a state tobacco quitline.Methods: A mixed-method approach, rooted in an implementation science framework of RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance), will be used in this hybrid effectiveness-implementation design. We aim to evaluate the efficacy of a novel delivery system (patient portal) for increasing access to smoking cessation treatment. In preparation for a future randomized clinical trial of Mi QUIT CARE, we will conduct the following developmental research: (1) Examine the burden of tobacco among patient populations served by our partner FQHC, (2) Evaluate among FQHC patients and health care providers, knowledge, attitudes, barriers, and facilitators related to smoking cessation and our intervention components, (3) Evaluate the use of tailored communication strategies and patient navigation to increase patient portal uptake among patients, and (4) To test the acceptability, feasibility, and capacity of the partner FQHC to deliver Mi QUIT CARE.Discussion: This study provides a model for developing and implementing smoking and other health promotion interventions for low-income patients delivered via patient health portals. If successful, the intervention has important implications for addressing a critical social determinant of cancer and other tobacco-related morbidities.Trial Registration: U.S. National Institutes of Health Clinical Trials, NCT04827420, https://clinicaltrials.gov/ct2/show/NCT04827420.

scholarly journals Faktor-Faktor yang Mempengaruhi Self-care Behavior pada Klien dengan Hipertensi di Komunitas

2020 ◽  
Vol 11 ◽  
pp. 37
Author(s):  
Wimar Anugrah Romadhon ◽  
Bernadetta Germia Aridamayanti ◽  
Anggi Hanafiah Syanif ◽  
Gevi Melliya Sari
Keyword(s):  
Health Care Providers ◽  
Self Efficacy ◽  
Self Care ◽  
Google Scholar ◽  
Evidence Based ◽  
Care Providers ◽  
Inclusion Criteria ◽  
Salt Diet ◽  
Low Salt ◽  
Care Behavior

Background: self-care behavior is an important thing that needs to be considered by clients with hypertension which consists of several components, namely the use of drugs, low-salt diet, physical activity, smoking, weight management and alcohol consumption. Purpose: to show the factors that influence self-care behavior in clients with hypertension. Method: the database used to identify suitable articles obtained from Scopus, ProQuest and Google Scholar, limited to the last 5 years of publication from 2014 to 2019, English, and fulltext articles. The literature review used the keyword "Self-care behavior, Hypertension". In searching articles used "AND". Only 12 articles met the inclusion criteria. This review was from 12 of these articles. Results: self-care behavior in hypertensive clients were influenced by several factors, namely family support, self-efficacy, knowledge, and spirituality. Conclusion: factors related to self-care behavior and pathways can help health care providers develop and design evidence-based interventions for clients with hypertension. Recommendation: Community nurses understand the factors that influence self-care behavior in hypertensive clients in the community so they are able to provide appropriate nursing care. Keywords: factors of self-care behavior; hypertension; community ABSTRAK Latar belakang: self-care behavior merupakan hal penting yang perlu diperhatikan oleh klien dengan hipertensi yang terdiri dari beberapa komponen yaitu penggunaan obat-obatan, diet rendah garam, aktifitas fisik, merokok, manajemen berat badan dan konsumsi alkohol. Tujuan: untuk melihat adanya faktor-faktor yang mempengaruhi self-care behavior pada klien dengan hipertensi. Metode: database digunakan untuk mengidentifikasi artikel yang sesuai diperoleh dari Scopus, ProQuest dan Google Scholar terbatas untuk publikasi 5 tahun terakhir dari 2014 hingga 2019, bahasa inggris, dan fulltex article. Tinjauan literatur menggunakan kata kunci “factors of self-care behavior, Hypertension”. Dalam pencarian artikel menggunakan "AND". Hanya 12 artikel yang memenuhi kriteria inklusi. Ulasan ini berasal dari 12 artikel tersebut. Hasil: self-care behavior pada klien hipertensi dipengaruhi oleh beberapa faktor yaitu dukungan keluarga, self-efficacy, faktor personal, dan spiritualitas. Simpulan: faktor-faktor yang terkait dengan self-care behavior dan jalurnya dapat membantu penyedia layanan kesehatan mengembangkan dan mendesain intervensi bebasis bukti pada klien dengan hipertensi. Saran: Perawat komunitas memahami faktor-faktor yang mempengaruhi self-care behavior pada klien hipertensi di komunitas sehingga mampu memberikan asuhan keperawatan yang tepat. Kata kunci: factors of self-care behavior; hypertension; community

Infection risk and prophylaxis in patients with lymphoid cancer

Blood ◽  
2021 ◽  
Author(s):  
Nancy Law ◽  
Randy A. Taplitz
Keyword(s):  
Risk Factors ◽  
Health Care Providers ◽  
Treatment Approach ◽  
Antimicrobial Prophylaxis ◽  
Cancer Therapeutics ◽  
Infection Risk ◽  
Evidence Based ◽  
Care Providers ◽  
Additional Risk ◽  
Common Cause

Infections are a common cause of morbidity and mortality in patients with lymphoid cancer. With evolving cancer therapeutics, including new targeted and immunotherapies, clinicians need to be aware of additional risk factors and infections that may arise in patients treated with these agents. This "How I Treat" article will highlight fundamental issues including risk factors for infection, infectious diseases screenings and antimicrobial prophylaxis recommendations in patients with lymphoid cancers. We present 4 scenarios of patients with lymphoid cancers with varied infections and describe a treatment approach based on a combination of evidence-based data and experience, as there are limitations in objective infection data especially with newer agents. The goal of this discussion is to provide a framework for institutions and health care providers to develop their own approach in preventing and treating infections in patients with lymphoid cancer.

A Novel Computer-Based Virtual Counselor-Delivered Alcohol Reduction Intervention: Acceptability, Adaptability and Feasibility among Adults with HIV or TB in Indian Clinical Settings (Preprint)

2021 ◽  
Author(s):  
Nishi Suryavanshi ◽  
Gauri Dhumal ◽  
Samyra Cox ◽  
Shashikala Sangle ◽  
Andrea DeLuca ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Health Care Providers ◽  
Clinical Care ◽  
Clinical Settings ◽  
Care Hospital ◽  
Care Providers ◽  
Unhealthy Alcohol Use ◽  
Unhealthy Alcohol ◽  
Computer Based ◽  
Alcohol Reduction

BACKGROUND Unhealthy alcohol use is associated with increased morbidity and mortality among persons with HIV and/or TB. Computer-Based interventions (CBI) can reduce unhealthy alcohol use, are scalable, and may improve outcomes among patients with HIV or TB. OBJECTIVE We assessed the acceptability, adaptability, and feasibility of a novel CBI for alcohol reduction in HIV and TB clinical settings in Pune, India. METHODS We conducted 10 in-depth interviews (IDIs) with persons with alcohol use disorder (AUD); [TB (n=6), HIV (n=2), HIV-TB co-infected (n=1) selected using convenience sampling method, No HIV or TB disease (n=1)], one focus group (FG) with members of alcoholics anonymous (AA) (n=12, and two FGs with health care providers (HCPs) of a tertiary care hospital (n=22). All participants reviewed and provided feedback on a CBI for AUD delivered by a 3-D virtual counselor. Qualitative data were analyzed using structured framework analysis. RESULTS Majority (n=9) of IDI respondents were male with median age 42 (IQR; 38-45) years. AA FG participants were all male (n=12) and HCPs FG participants were predominantly female (n=15). Feedback was organized into 3 domains: 1) Virtual counselor acceptability; 2) Intervention adaptability; and 3) feasibility of CBI intervention in clinic settings. Overall IDI participants found the virtual counselor to be acceptable and felt comfortable honestly answering alcohol-related questions. All FG participants preferred a human virtual counselor to an animal virtual counselor so as to potentially increase CBI engagement. Additionally, interaction with a live human counselor would further enhance the program’s effectiveness by providing more flexible interaction. HCP FGs noted the importance of adding information on the effects of alcohol on HIV and TB outcomes because patients were not viewed as appreciating these linkages. For local adaptation, more information on types of alcoholic drinks, additional drinking triggers, motivators and activities to substitute for drinking alcohol were suggested by all FG participants. Intervention duration (~20 minutes) and pace were deemed appropriate. HCPs reported that CBI provides systematic, standardized counseling. All FG and IDI reported that CBI could be implemented in Indian clinical settings with assistance from HIV or TB program staff. CONCLUSIONS With cultural tailoring to patients with HIV and TB in Indian clinical care settings, a virtual counselor-delivered alcohol intervention is acceptable, appears feasible to implement, particularly if coupled with person-delivered counseling.

Best Practices to Promote Patient and Donor Engagement to Care in Living Donor Transplant

2017 ◽  
pp. 306-327
Author(s):  
Emanuela Saita ◽  
Susanna Zanini ◽  
Enrico Minetti ◽  
Chiara Acquati
Keyword(s):  
Health Care ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Best Practices ◽  
Health Care Providers ◽  
Living Donor ◽  
Care Providers ◽  
Health Care Outcomes ◽  
Care Outcomes ◽  
Donor Kidney Transplantation

Increasing evidence has demonstrated that patients' involvement promotes better health care outcomes and cost-effectiveness of services. However, limited literature is available about the experience of living donor kidney transplantation and best practices to promote patients and donors' engagement. Aim of the present chapter is to review the literature about patient engagement in the context of chronic kidney disease, and to introduce an innovative protocol developed to promote potential donors and recipients' participation and adherence to care at the Niguarda Ca' Granda Hospital in Milan (Italy). Results are critical to reflect on the identification of best practices for patients' engagement in the context of chronic kidney disease. Through a better understanding of the emotional and affective dynamics and the relational implications that may influence the elaboration of the information given by health care providers, it will be possible to develop evidence-informed interventions.

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