Removal of femoral sheaths by registered nurses: issues and outcomes

1996 ◽  
Vol 16 (2) ◽  
pp. 32-36 ◽  
Author(s):  
S Schickel ◽  
SN Cronin ◽  
A Mize ◽  
C Voelker
Keyword(s):  
Critical Care ◽  
Knowledge Base ◽  
Cost Effective ◽  
Critical Care Nurses ◽  
Quality Cost ◽  
Adequate Knowledge ◽  
Effective Care ◽  
Margin Of Safety ◽  
Competency Evaluation ◽  
Removal Technique

The results of this evaluation indicate that specially trained critical care nurses can remove femoral sheaths with an acceptable margin of safety. As a result, these nurses can provide quality, cost-effective care to angioplasty patients. However, before this procedure is included as part of the RN's responsibility, written protocols are needed to identify appropriate patients, proper removal technique, and specific actions to take if complications occur. In addition, plans must be developed for initial education and ongoing competency evaluation to ensure that each nurse involved maintains an adequate knowledge base and skill level.

Response to Dr Stone

PEDIATRICS ◽  
1995 ◽  
Vol 96 (4) ◽  
pp. 850-851
Author(s):  
Howard A. Pearson
Keyword(s):  
Nurse Practitioners ◽  
Cost Effective ◽  
The United States ◽  
Health Maintenance Organizations ◽  
Quality Health Care ◽  
Quality Cost ◽  
Health Maintenance ◽  
Effective Care ◽  
Quality Health

Dr Elsa Stone, in her usual organized and lucid fashion, has presented the case for inclusion of pediatric nurse practitioners (PNPs) in private pediatric practices. She bases her conclusions on her nearly 10 years of positive experience with a PNP in her own practice in Connecticut. Dr Stone describes the PNP population and demography, describes the training curriculum of PNPs, and discusses the scope of work of these individuals. She concludes that "there is substantial evidence that PNPs provide quality health care and that collaborative teams of pediatricians and PNPs can provide high-quality, cost-effective care to a broader spectrum of children than can be served by either profession alone." The American Academy of Pediatrics (AAP) has insisted for several years that there is a shortage of pediatricians to meet the expanding needs of the children of the United States. Furthermore, pediatricians—because of system changes—will be expected increasingly to provide a variety of time-intensive services. Dr Stone believes that many of these services can be well provided by PNPs. Within the AAP, there have been some concerns about the role of PNPs. Of particular worry seems to be the possibility that PNPs might decide to practice independently, leading to a lower quality of care for their patients. Less often stated, but clearly an issue, is that PNPs are viewed by some pediatricians as potential competitors. Dr Stone's demographic analysis of what PNPs are currently doing is relevant to these concerns. One third of PNPs work in private pediatric practices or health maintenance organizations.

scholarly journals Interpersonal Communication among Critical Care Nurses: an Ethnographic Study

2020 ◽  
Vol 9 (1) ◽  
pp. 57-64
Author(s):  
Tayebeh Mahvar ◽  
Nooredin Mohammadi ◽  
Naima Seyedfatemi ◽  
AbouAli Vedadhir
Keyword(s):  
Critical Care ◽  
Interpersonal Communication ◽  
Critical Care Nurses ◽  
Ethnographic Study ◽  
Critical Conditions ◽  
Structured Interviews ◽  
Critical Care Units ◽  
Effective Care ◽  
High Level ◽  
Communication Culture

Introduction: Interpersonal communication in critical care units is one of the most important factors due to complicated and critical conditions of patients. Nurses’ confrontation with ethical distresses and conflict resolution techniques are often influenced by the culture governing these units. This study aimed to explore interpersonal communication culture among critical care nurses. Methods: A focused ethnographic approach was used to conduct study in Iran. The research method was based on the research evolutionary cycle model recommended by Spradley (1980). Data were collected over six months through purposeful sampling and semi structured interviews (n=18) and participation observation (n=43). The data were obtained over six months of observation and interview with participants. Data analysis was done by Spradley method and was interpreted to discover the meaning units from the obtained themes. MAXQDA10 was used to manage data. Results: Five major domains of observations and high-level consensus were extracted in this study, including grouping, work-life interaction, professionalism, organizational atmosphere and experience. Conclusion: Development of interpersonal communication culture is influenced by various factors. Besides, the working models and nurses’ use of workspace are indispensable components of effective communication at workplace. The findings of this study can be helpful in determining appropriate strategies and practices to resolve communication problems among nurses by specifying challenges, thereby leading to proper communication among nurses, promoting this communication and finally providing high quality and more effective care.

Collaborative Quality Initiative in the Treatment of Breast and Lung Cancer: An Important Step Toward High Quality Cost-Effective Care

2013 ◽  
Vol 87 (2) ◽  
pp. S498-S499 ◽  
Author(s):  
J.M. Vainshtein ◽  
J.A. Hayman ◽  
J.M. Moran ◽  
K.A. Griffith ◽  
R. Jagsi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cost Effective ◽  
High Quality ◽  
Quality Cost ◽  
Effective Care

scholarly journals Managing the economic challenges in the treatment of heart failure

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ileana L. Piña ◽  
Larry A. Allen ◽  
Nihar R. Desai
Keyword(s):  
Heart Failure ◽  
Digital Health ◽  
Cost Effective ◽  
Cost Of Care ◽  
Quality Cost ◽  
Bundled Payment ◽  
Reward Delivery ◽  
Effective Care ◽  
Care Health ◽  
Care Improvement

Abstract Background Treatment of heart failure is complex and inherently challenging. Patients traverse multiple practice settings as inpatients and outpatients, often resulting in fragmented care. The Center for Medicare and Medicaid Services is implementing payment programs that reward delivery of high-quality, cost-effective care, and one of the newer programs, the Bundled Payment for Care Improvement Advanced program, attempts to improve the coordination of care across practices for a hospitalization episode and post-acute care. The quality and cost of care contribute to its value, but value may be defined in different ways by different entities. Conclusions The rapidly changing world of digital health may contribute to or detract from the quality and cost of care. Health systems, payers, and patients are all grappling with these issues, which were reviewed at a symposium at the Heart Failure Society of America conference in Philadelphia, Pennsylvania on September 14, 2019. This article constitutes the proceedings from that symposium.

scholarly journals Expressive writing as an intervention to decrease distress in pediatric critical care nurses

2018 ◽  
Vol 6 (3) ◽  
pp. 96 ◽  
Author(s):  
Julie Ann Perry ◽  
Peggy Ward-Smith
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Nursing Staff ◽  
Critically Ill Patients ◽  
Expressive Writing ◽  
Cost Effective ◽  
Critical Care Nurses ◽  
Common Phenomenon ◽  
Staff Satisfaction ◽  
Pediatric Critical Care

Experiencing distress is a common phenomenon among pediatric critical care nurses. Expressive writing provides a cost-effective and easily implemented intervention nurses can utilize to address distress as a consequence of providing care for critically ill patients. This intervention may decrease the array of consequences of distress and improve nursing staff satisfaction and retention.

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