Improving Caregivers’ Perceived Involvement in Care Through Facilitating Communication with Hospital Providers

2021 ◽  
Author(s):  
◽  
Heather Manolas
Keyword(s):  
Acute Care ◽  
Family Involvement ◽  
Best Practice ◽  
Healthcare Setting ◽  
Cognitively Impaired ◽  
Evidence Based ◽  
Care Planning ◽  
Loved One ◽  
Delirium Prevention ◽  
Perceived Involvement

Practice Problem: Involvement of family in care-planning for prevention of delirium in acute care settings is crucial, yet remains underutilized in those who are cognitively impaired. Despite the incidence of delirium in acute care worsening during COVID-19, many factors have led to it being placed on the back burner. PICOT: In caregivers of cognitively impaired individuals, can implementation of an evidence-based, best practice tool that advocates for evidence-based delirium prevention strategies tailored to their loved-one and facilitates family involvement in care planning for these strategies during a healthcare experience as compared to no other intervention improve confidence in, and involvement in, care-planning within 2 months? Evidence: Overwhelming evidence exists supporting the effectiveness of a non-pharmacological, multicomponent strategy for prevention of delirium in the healthcare setting, to include family involvement. Intervention: To support family involvement in delirium prevention should a hospitalization occur, the American Geriatrics Society CoCare: Help Program Delirium Prevention Amidst COVID-19 Toolkit was offered to caregivers at an organization that provides support services to families living with Alzheimer’s. Outcome: There was a statistically significant improvement in caregivers’ perceptions of, and confidence in, involvement in care after having received the Toolkit, as measured by 3 pre/post survey M-PICS/I-PICS questions (n=2, p=.010; p=.017; p=.35). Caregiver intent to use the toolkit to become more involved in care to prevent delirium in acute care situations was very often to always (76%). Anecdotal feedback suggested that hospitals should look at policies and practices that ensure patients and families feel free to advocate, and work to eliminate fear of repercussion. Conclusion: In the age of COVID-19, it is vital that more of these such efforts by healthcare professionals ensue to protect this population from a worsening crisis, despite the many challenges they themselves face.

Meeting the Best Practice for Hearing Aid Verification in Children: Challenges and Future Directions

2019 ◽  
Vol 28 (4) ◽  
pp. 877-894
Author(s):  
Nur Azyani Amri ◽  
Tian Kar Quar ◽  
Foong Yen Chong
Keyword(s):  
Clinical Practice ◽  
Hearing Aids ◽  
Best Practice ◽  
Hearing Aid ◽  
Evidence Based ◽  
Future Directions ◽  
Major Barrier ◽  
Klang Valley ◽  
Age Range ◽  
Fitting Hearing Aids

Purpose This study examined the current pediatric amplification practice with an emphasis on hearing aid verification using probe microphone measurement (PMM), among audiologists in Klang Valley, Malaysia. Frequency of practice, access to PMM system, practiced protocols, barriers, and perception toward the benefits of PMM were identified through a survey. Method A questionnaire was distributed to and filled in by the audiologists who provided pediatric amplification service in Klang Valley, Malaysia. One hundred eight ( N = 108) audiologists, composed of 90.3% women and 9.7% men (age range: 23–48 years), participated in the survey. Results PMM was not a clinical routine practiced by a majority of the audiologists, despite its recognition as the best clinical practice that should be incorporated into protocols for fitting hearing aids in children. Variations in practice existed warranting further steps to improve the current practice for children with hearing impairment. The lack of access to PMM equipment was 1 major barrier for the audiologists to practice real-ear verification. Practitioners' characteristics such as time constraints, low confidence, and knowledge levels were also identified as barriers that impede the uptake of the evidence-based practice. Conclusions The implementation of PMM in clinical practice remains a challenge to the audiology profession. A knowledge-transfer approach that takes into consideration the barriers and involves effective collaboration or engagement between the knowledge providers and potential stakeholders is required to promote the clinical application of evidence-based best practice.

The use of the objective structured clinical examination (OSCE) in a practice-based health discipline: Academic and student experience in paramedicine

2020 ◽  
Vol 3 (2) ◽  
Author(s):  
Andy Bell ◽  
Jennifer Kelly ◽  
Peter Lewis
Keyword(s):  
Clinical Examination ◽  
Best Practice ◽  
Assessment Tool ◽  
Clinical Performance ◽  
Reliability And Validity ◽  
Specific Area ◽  
Training Model ◽  
Objective Structured Clinical Examination ◽  
Evidence Based ◽  
Effective Measure

Abstract:Purpose:Over the past two decades, the discipline of Paramedicine has seen expediential growth as it moved from a work-based training model to that of an autonomous profession grounded in academia.  With limited evidence-based literature examining assessment in paramedicine, this paper aims to describe student and academic views on the preference for OSCE as an assessment modality, the sufficiency of pre-OSCE instruction, and whether or not OSCE performance is a perceived indicator of clinical performance.Design/Methods:A voluntary, anonymous survey was conducted to examine the perception of the reliability and validity of the Objective Structured Clinical Examination (OSCE) as an assessment tool by students sitting the examination and the academics that facilitate the assessment. Findings:The results of this study revealed that the more confident the students are in the reliability and validity of the assessment, the more likely they are to perceive the assessment as an effective measure of their clinical performance.  The perception of reliability and validity differs when acted upon by additional variables, with the level of anxiety associated with the assessment and the adequacy of feedback of performance cited as major influencers. Research Implications:The findings from this study indicate the need for further paramedicine discipline specific research into assessment methodologies to determine best practice models for high quality assessment.Practical Implications:The development of evidence based best practice guidelines for the assessment of student paramedics should be of the upmost importance to a young, developing profession such as paramedicine.Originality/Value: There is very little research in the discipline specific area of assessment for paramedicine and discipline specific education research is essential for professional growth.Limitations:The principal researcher was a faculty member of one of the institutions surveyed.  However, all data was non identifiable at time of data collection.  Key WordsParamedic; paramedicine; objective structured clinical examinations; OSCE; education; assessment.

Design and Development of a Web-based Delirium Preventive Application for Long-term Care Facilities: A Methodological Study (Preprint)

2020 ◽  
Author(s):  
Kyoung Ja Moon ◽  
Chang-Sik Son ◽  
Jong-Ha Lee ◽  
Mina Park
Keyword(s):  
Risk Factors ◽  
Long Term Care ◽  
Cloud System ◽  
Evidence Based ◽  
Methodological Study ◽  
Term Care ◽  
Web Based ◽  
Care Facilities ◽  
Delirium Prevention

BACKGROUND Long-term care facilities demonstrate low levels of knowledge and care for patients with delirium and are often not properly equipped with an electronic medical record system, thereby hindering systematic approaches to delirium monitoring. OBJECTIVE This study aims to develop a web-based delirium preventive application (app), with an integrated predictive model, for long-term care (LTC) facilities using artificial intelligence (AI). METHODS This methodological study was conducted to develop an app and link it with the Amazon cloud system. The app was developed based on an evidence-based literature review and the validity of the AI prediction model algorithm. Participants comprised 206 persons admitted to LTC facilities. The app was developed in 5 phases. First, through a review of evidence-based literature, risk factors for predicting delirium and non-pharmaceutical contents for preventive intervention were identified. Second, the app, consisting of several screens, was designed; this involved providing basic information, predicting the onset of delirium according to risk factors, assessing delirium, and intervening for prevention. Third, based on the existing data, predictive analysis was performed, and the algorithm developed through this was calculated at the site linked to the web through the Amazon cloud system and sent back to the app. Fourth, a pilot test using the developed app was conducted with 33 patients. Fifth, the app was finalized. RESULTS We developed the Web_DeliPREVENT_4LCF for patients of LTC facilities. This app provides information on delirium, inputs risk factors, predicts and informs the degree of delirium risk, and enables delirium measurement or delirium prevention interventions to be immediately implemented with a verified tool. CONCLUSIONS This web-based application is evidence-based and offers easy mobilization and care to patients with delirium in LTC facilities. Therefore, the use of this app improves the unrecognized of delirium and predicts the degree of delirium risk, thereby helping initiatives for delirium prevention and providing interventions. This would ultimately improve patient safety and quality of care. CLINICALTRIAL none

American Academy of Otolaryngology–Head and Neck Surgery/Foundation Reg-ent Registry: Purpose, Properties, and Priorities

2021 ◽  
pp. 019459982098413
Author(s):  
Cecelia E. Schmalbach ◽  
Jean Brereton ◽  
Cathlin Bowman ◽  
James C. Denneny
Keyword(s):  
American Academy ◽  
Head And Neck ◽  
Best Practice ◽  
Medical Center ◽  
Quality Care ◽  
Academic Medical Center ◽  
Neck Surgery ◽  
Performance Measure ◽  
Head And Neck Surgery ◽  
Evidence Based

Objective (1) To describe the patient and membership cohort captured by the otolaryngology-based specialty-specific Reg-ent registry. (2) To outline the capabilities of the Reg-ent registry, including the process by which members can access evidence-based data to address knowledge gaps identified by the American Academy of Otolaryngology–Head and Neck Surgery/Foundation and ultimately define “quality” for our field of otolaryngology–head and neck surgery. Methods Data analytics was performed on Reg-ent (2015-2020) Results A total of 1629 participants from 239 practices were enrolled in Reg-ent, and 42 health care specialties were represented. Reg-ent encompassed 6,496,477 unique patients and 24,296,713 encounters/visits: the 45- to 64-year age group had the highest representation (n = 1,597,618, 28.1%); 3,867,835 (60.3%) patients identified as Caucasian; and “private” was the most common insurance (33%), followed by Blue Cross/Blue Shield (22%). Allergic rhinitis–unspecified and sensorineural hearing loss–bilateral were the top 2 diagnoses (9% each). Overall, 302 research gaps were identified from 17 clinical practice guidelines. Discussion Reg-ent benefits are vast—from monitoring one’s practice to defining otolaryngology–head and neck surgery quality, participating in advocacy, and conducting research. Reg-ent provides mechanisms for benchmarking, quality assessment, and performance measure development, with the objective of defining and guiding best practice in otolaryngology–head and neck surgery. To be successful, patient diversity must be achieved to include ethnicity and socioeconomic status. Increasing academic medical center membership will assist in achieving diversity so that the quality domain of equitable care is achieved. Implications for Practice Reg-ent provides the first ever registry that is specific to otolaryngology–head and neck surgery and compliant with HIPAA (Health Insurance Portability and Accountability Act) to collect patient outcomes and define evidence-based quality care.

scholarly journals Implementing Delirium Prevention in the Era of COVID-19

2021 ◽  
Vol 79 (1) ◽  
pp. 31-36
Author(s):  
Nila S. Radhakrishnan ◽  
Mariam Mufti ◽  
Daniel Ortiz ◽  
Suzanne T. Maye ◽  
Jennifer Melara ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Quality Care ◽  
Tertiary Care ◽  
Cognitive Stimulation ◽  
Evidence Based ◽  
Care Hospital ◽  
Future Studies ◽  
Delirium Prevention ◽  
Prevention Model ◽  
Prevention Methods

Patients admitted with COVID-19 can develop delirium due to predisposing factors, isolation, and the illness itself. Standard delirium prevention methods focus on interaction and stimulation. It can be challenging to deliver these methods of care in COVID settings where it is necessary to increase patient isolation. This paper presents a typical clinical vignette of representative patients in a tertiary care hospital and how a medical team modified an evidence-based delirium prevention model to deliver high-quality care to COVID-19 patients. The implemented model focuses on four areas of delirium-prevention: Mobility, Sleep, Cognitive Stimulation, and Nutrition. Future studies will be needed to track quantitative outcome measures.

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