scholarly journals Survey on pain in patients with chronic skin lesions

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Ciro Falasconi ◽  
Vincenzo Amalfi ◽  
Patrizia Baroni ◽  
Giovanni Vito Corona ◽  
Corrado Maria Durante ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Clinical Practice ◽  
Pain Management ◽  
Skin Lesions ◽  
The Body ◽  
Body Of Knowledge ◽  
Common Practices ◽  
Chronic Skin

In the three months period between March and June 2016 we launched a survey on the AUIC website, open to the contribution of all members, to evaluate the most widespread habits and the most common practices (for therapy and overall healthcare) concerning pain management for patients with chronic skin lesions (CSL). We decided to evaluate this aspect of our clinical practice because we believe that the problems connected to “pain” in patients affected by CSL often becomes an issue even larger than the ulcer itself for both patients and their families. Furthermore, the theme “pain” is strongly felt at all levels; the body of knowledge in its regard is increasingly large and widespread and the means at our disposal to address this particular aspect of the care of CSL are continually increasing. For these reasons it seemed fair to focus the attention of all members on this clinical and healthcare problem, in order to collect useful information to improve the overall quality of care for our patients.

Nurses’ Perceptions of a Care Plan Information Technology Solution With Hundreds of Clinical Practice Guidelines in Adult Intensive Care Units: Survey Study (Preprint)

2018 ◽  
Author(s):  
Azizeh Khaled Sowan ◽  
Meghan Leibas ◽  
Albert Tarriela ◽  
Charles Reed
Keyword(s):  
Intensive Care ◽  
Quality Of Care ◽  
Clinical Practice ◽  
Nursing Care ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Care Plan ◽  
System Use ◽  
Nurses Perceptions

BACKGROUND The integration of clinical practice guidelines (CPGs) into the nursing care plan and documentation systems aims to translate evidence into practice, improve safety and quality of care, and standardize care processes. OBJECTIVE This study aimed to evaluate nurses’ perceptions of the usability of a nursing care plan solution that includes 234 CPGs. METHODS A total of 100 nurses from 4 adult intensive care units (ICUs) responded to a survey measuring nurses’ perceptions of system usability. The survey included 37 rated items and 3 open-ended questions. RESULTS Nurses’ perceptions were favorable with more than 60.0% (60/100) in agreement on 12 features of the system and negative to moderate with 20.0% (20/100), to 59.0% (59/100) in agreement on 19 features. The majority of the nurses (80/100, 80.0% to 90/100, 90.0%) agreed on 4 missing safety features within the system. More than half of the nurses believed they would benefit from refresher classes on system use. Overall satisfaction with the system was just above average (54/100, 54.0%). Common positive themes from the narrative data were related to the system serving as a reminder for complete documentation and individualizing patient care. Common negative aspects were related to duplicate charting, difficulty locating CPGs, missing unit-specific CPGs, irrelevancy of information, and lack of perceived system value on patient outcomes. No relationship was found between years of system use or ICU experience and satisfaction with the system (P=.10 to P=.25). CONCLUSIONS Care plan systems in ICUs should be easy to navigate; support efficient documentation; present relevant, unit-specific, and easy-to-find information; endorse interdisciplinary communication; and improve safety and quality of care.

scholarly journals Pain management after lung surgery

2014 ◽  
Vol 4 (1) ◽  
Author(s):  
Maria Frödin ◽  
Margareta Warrén Stomberg
Keyword(s):  
Quality Of Care ◽  
Pain Management ◽  
Postoperative Pain ◽  
Severe Pain ◽  
Postoperative Pain Management ◽  
Lung Surgery ◽  
Moderate Pain ◽  
Number Of Patients ◽  
Severe Postoperative Pain

Pain management is an integral challenge in nursing and includes the responsibility of managing patients’ pain, evaluating pain therapy and ensuring the quality of care. The aims of this study were to explore patients’ experiences of pain after lung surgery and evaluate their satisfaction with the postoperative pain management. A descriptive design was used which studied 51 participants undergoing lung surgery. The incidence of moderate postoperative pain varied from 36- 58% among the participants and severe pain from 11-26%, during their hospital stay. Thirty-nine percent had more pain than expected. After three months, 20% experienced moderate pain and 4% experienced severe pain, while after six months, 16% experienced moderate pain. The desired quality of care goal was not fully achieved. We conclude that a large number of patients experienced moderate and severe postoperative pain and more than one third had more pain than expected. However, 88% were satisfied with the pain management. The findings confirm the severity of pain experienced after lung surgery and facilitate the apparent need for the continued improvement of postoperative pain management following this procedure.

Quality of Care: Performance Measurement and Quality Improvement in Clinical Practice

2021 ◽  
Author(s):  
Sonali P. Desai ◽  
Allen Kachalia
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Quality Of Care ◽  
Clinical Practice ◽  
Performance Measurement ◽  
Clinical Performance ◽  
The United States ◽  
Performance Measure ◽  
Care Performance

Attention to the quality of care within the United States health care system has grown tremendously over the past decade. We have witnessed a significant change in how quality improvement and clinical performance measurement are approached. The current focus on quality and safety stems in part from the increasingly clear realization that more services and technological advancement are not automatically equivalent to high-quality care. Much of the discussion about cost and quality in health care is shifting towards the concept of value. Value is defined as health outcomes achieved per dollar spent (in other words, an assessment of the quality of care per cost). This chapter reviews the current state of quality improvement in health care and, because improvement cannot be determined without measurement, reviews several aspects of effective clinical performance measurement. Since many measures are already in place, the chapter describes some of the organizations involved in quality measurement and improvement, as well the approaches they utilize. It looks at the multiple strategies in place to improve quality, from process management to collaboration, from financial incentives to transparency, and reviews newer models of care delivery that may materialize in the near future. Tables list types of quality measures, characteristics to consider when developing a quality measure, and organizations involved in quality improvement and performance measurement. A figure shows strategies used by the federal government to spur performance measurement and quality improvement. This review contains 1 figure, 3 tables, and 56 references Keywords: Quality of care, performance measure, quality improvement, clinical practice, sigma six, transparency

scholarly journals Problem-posing triggers or where do mathematics competition problems come from?

2020 ◽  
Vol 105 (3) ◽  
pp. 389-406 ◽  
Author(s):  
Igor’ Kontorovich
Keyword(s):  
Everyday Life ◽  
Elementary Mathematics ◽  
Mathematical Optimization ◽  
The Body ◽  
Problem Posing ◽  
School Students ◽  
Body Of Knowledge ◽  
Educational Literature ◽  
Life Tasks

AbstractSpurred by Kilpatrick’s (1987) “Where do good problems come from?”, this study explores problem-posing triggers of experienced problem posers for mathematics competitions. Triggers are conceived as instances of noticing, where an impulse draws a poser’s attention and “triggers off” a mathematical re-action, one of the outcomes of which is a creation of a problem that gets accepted to some mathematics competition. The data were collected from 26 problem posers residing in nine countries, and who had experience in creating problems for national, regional, and international competitions. Three types of triggers emerged from the analysis: (i) Instances where the participants extracted mathematical phenomena from activities that are replete with modern elementary mathematics. These triggers were described in emotionally loaded terms that resonated with appreciation, surprise, challenge, and feeling of innovation. (ii) Cases where the participants abstracted mathematical phenomena from common everyday-life tasks in which mathematical optimization was beneficial. These situations emphasized participants’ desire to compensate for self-disappointment with an initially made decision and the value of finding a better alternative. (iii) Situations where the participants were asked to pose a problem ‘here and now’. The posers were unanimous in their dislike of such situations. They elaborated on how difficult it is to pose ‘here and now’ and highlighted the low quality of the resulting problems. The findings are situated in the body of knowledge on expert problem posing and educational literature on school students and teachers.

PP30 ‘I can’t remember’ – patients views of receiving pain management from paramedics for suspected hip fracture

2019 ◽  
Vol 36 (1) ◽  
pp. e12.1-e12
Author(s):  
Bridie Evans ◽  
Alan Brown ◽  
Jenna Bulger ◽  
Greg Fegan ◽  
Simon Ford ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Hip Fracture ◽  
Pain Management ◽  
Prehospital Care ◽  
Face To Face ◽  
Experience Of Care ◽  
Ambulance Transport ◽  
Fascia Iliaca Compartment Block ◽  
To Receive

BackgroundUp to 40% of patients with suspected hip fracture report inadequate or no pre-hospital pain management. Morphine may raise risk of complications and may be avoided by paramedics. Fascia Iliaca Compartment Block (FICB) is used in Emergency Department and orthopaedic wards. The RAPID trial tested feasibility of paramedics administering FICB to patients with suspected hip fracture.ObjectiveTo explore patients’ views and experience of care received for suspected hip fracture and in particular FICB before ambulance transport to hospital.MethodWe interviewed six patients and the daughter of a patient who received FICB to manage their suspected hip fracture. Interviews, by telephone or face-to-face, were audio-recorded with consent. We conducted thematic analysis of transcripts. Two researchers, one paramedic and one lay member were in the analysis teamResultsRespondents’ memory of prehospital care was dominated by their experience of extreme pain. While they recalled events before falling, they only had partial memory of care prior to hip surgery. Although they recalled paramedics’ arrival, which they reported was up to six hours after their injury, respondents said they remembered little else. Just one recalled consenting to receiving FICB and could describe the process. Other respondents said they were in too much pain to comprehend what occurred or respond coherently. They explained their priority was to receive pain management and they expected the paramedics to treat them safely and effectively. Respondents appeared to be a stoical and trusting group who accepted the treatment they were offered. They did recall high quality of care and praised paramedics for their reassuring and calm manner.ConclusionsHip fracture patients’ overwhelming memory of injury and treatment was of pain and their priority was to receive pain relief. The quality of care, reassurance and administration of pain management was more important to patients than the mechanism of delivering the intervention.

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