48,530 research outputs found

    An Electronic Delphi Study to Establish Pediatric Intensive Care Nursing Research Priorities in Twenty European Countries*

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    OBJECTIVES:: To identify and to establish research priorities for pediatric intensive care nursing science across Europe. DESIGN:: A modified three-round electronic Delphi technique was applied. Questionnaires were translated into seven different languages. SETTING:: European PICUs. PARTICIPANTS:: The participants included pediatric intensive care clinical nurses, managers, educators, and researchers. In round 1, the qualitative responses were analyzed by content analysis and a list of research statements and domains was generated. In rounds 2 and 3, the statements were ranked on a scale of one to six (not important to most important). Mean scores and SDs were calculated for rounds 2 and 3. INTERVENTIONS:: None. MEASUREMENTS AND MAIN RESULTS:: Round 1 started with 90 participants, with round 3 completed by 64 (71%). The seven highest ranking statements ( 5.0 mean score) were related to end-of-life care, decision making around forgoing and sustaining treatment, prevention of pain, education and competencies for pediatric intensive care nurses, reducing healthcare-associated infections, identifying appropriate nurse staffing levels, and implementing evidence into nursing practice. Nine research domains were prioritized, and these were as follows: 1) clinical nursing care practices, 2) pain and sedation, 3) quality and safety, 4) respiratory and mechanical ventilation, 5) child- and family-centered care, 6) ethics, 7) professional issues in nursing, 8) hemodynamcis and resuscitation, and 9) trauma and neurocritical care. CONCLUSIONS:: The results of this study inform the European Society of Pediatric and Neonatal Intensive Care's nursing research agenda in the future. The results allow nurse researchers within Europe to encourage collaborative initiatives for nursing research

    Lessons From a Health Information Technology Demonstration in New York Nursing Homes

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    Outlines the New York State Nursing Home Health Information Technology Demonstration Project; variations in organizational aims in adopting HIT, perceived or real effects, and resulting quality improvement efforts; and considerations for replication

    Nurses’ Perception of Discharging the Medically Complex Pediatric Patient

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    The purpose of this study is to query the nurses for their perceptions of the barriers and facilitators of discharging medically complex pediatric patients from a freestanding children’s hospital in central California. Using a mixed methods research design via an online survey, 90 nurses identified 3 distinct themes that act as barriers. Those barriers include: 1) knowing the plan of care, 2) time, and 3) disposition of the family. Several implications for improving the discharge process for medically complex patients and overcoming the identified barriers include strategies to improve multidisciplinary communication, implementation of a Family Learning Center, use of video interpreters when in-person interpreters are not available, and respect for discharge readiness. Recognizing and implementing the appropriate interventions based on nurses’ feedback have the potential to improve quality and patient safety

    Engaging persons with mental illness and/or substance use disorder in care coordination services: an improvement project at a federally qualified community health center

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    Background: Mental health and substance use disorders seldom occur in isolation. They frequently accompany each other, as well as a substantial number of chronic general medical illnesses. Consequently, mental health conditions, substance-use disorders, and general health conditions are frequently co-occurring, and coordination of all of these types of health care is essential to improved health outcomes (Institute of Medicine, 2006). The U.S. system of healthcare is failing to identify, engage, and effectively treat people who are suffering from behavioral health conditions (Blanco, Coye, Knickman, Krishnan, Krystal, Pincus, Rauch, Simon, Vitiello, 2016). Because of poor coordination and lack of engagement, people often experience disrupted care and an over-reliance on emergency department and hospital care. At Lowell Community Health Center where this project takes place persons with a primary behavioral health diagnosis contribute to the highest utilization of emergency and inpatient hospital services. In July of 2018, Lowell CHC collaborated with Lowell House, Inc. to form a care coordination program to outreach and engage individuals identified as high utilizers of inpatient and emergency hospital services. Aim: The aim of this project is to describe the attributes of the population of patients who successfully engaged into care for the first six months of this new program, with recommendations for improvement to inform future program design. Method: The population of patients who successfully engaged in care in the first 6 months of the program described by independent variables consisting of age, gender, race, and preferred language. Dependent variable consisting of type of outreach. Data was evaluated to determine attributes of patients who successfully engaged in care and if correlations exist between variables and successful engagement. Results: The first six months of the program implementation demonstrated successful engagement and activation of 17.5% of patients. The average patient is described as low-income, 50-64 years of age, non-English speaking female with dual-diagnosis residing in the greater Lowell area. Themes regarding successful outreach type included telephonic and face-to-face being the most successful method of engagement. Although successful engagement was noted, longer-term efforts and analysis should focus on successful outreach and engagement strategies, emergency room utilization, treatment adherence and service adherence. Conclusions: The findings of this project indicate that having a team-based, multidisciplinary and multi-cultural approach to care coordination has led to successful engagement of 186 individuals within the first 6 months of this new program

    Conscientious objection – does it also apply to nursing students?

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    The conscientious clause in nursing can be defined as a kind of special ethical and legal regulation which gives nurses right to object to actively perform certain medical procedures which are against their personal system of values. Usually these values are associated with nurses’ religious beliefs, but not always. Scope of this regulation differs throughout the world. However, it is emphasized that right to the conscientious objection is not absolute and this regulation can not be used in cases of danger to life or serious damage to the health of the patient. Medical procedures to which nurses hold conscientious objection are often within reproductive health services. However, we can also find reports on the use of this right i.e. in end-of-life care and in the process of the implementation of medical experiments. The main issue underlined in the discussion regarding practising conscientious objection in the clinical setting is the collision of two human rights: the right to conscientious objection of medical personnel and the right of patients to specific medical procedures which are legal in their country. If a procedure is legally available in a country it means that patients can expect to receive it, on the other hand, all citizens, including health care workers, have the right to protect their moral identity and the right to object to the implementation of a procedure to which they have a specific objection. It is very difficult to find good ethical and legal balance between these two perspectives

    Email for clinical communication between healthcare professionals

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    Background Email is a popular and commonly-used method of communication, but its use in healthcare is not routine. Where email communication has been utilised in health care, its purposes have included use for clinical communication between healthcare professionals, but the effects of using email in this way are not known. This review assesses the use of email for two-way clinical communication between healthcare professionals. Objectives To assess the effects of healthcare professionals using email to communicate clinical information, on healthcare professional outcomes, patient outcomes, health service performance, and service efficiency and acceptability, when compared to other forms of communicating clinical information. Search methods We searched: the Cochrane Consumers and Communication Review Group Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1 2010), MEDLINE (OvidSP) (1950 to January 2010), EMBASE (OvidSP) (1980 to January 2010), PsycINFO (1967 to January 2010), CINAHL (EbscoHOST) (1982 to February 2010), and ERIC (CSA) (1965 to January 2010). We searched grey literature: theses/dissertation repositories, trials registers and Google Scholar (searched July 2010). We used additional search methods: examining reference lists, contacting authors. Selection criteria Randomised controlled trials, quasi-randomised trials, controlled before and after studies and interrupted time series studies examining interventions in which healthcare professionals used email for communicating clinical information, and that took the form of 1) unsecured email 2) secure email or 3) web messaging. All healthcare professionals, patients and caregivers in all settings were considered. Data collection and analysis Two authors independently assessed studies for inclusion, assessed the included studies' risk of bias, and extracted data. We contacted study authors for additional information. We report all measures as per the study report. Main results We included one randomised controlled trial involving 327 patients and 159 healthcare providers at baseline. It compared an email to physicians containing patient-specific osteoporosis risk information and guidelines for evaluation and treatment with usual care (no email). This study was at high risk of bias for the allocation concealment and blinding domains. The email reminder changed health professional actions significantly, with professionals more likely to provide guideline-recommended osteoporosis treatment (bone density measurement and/or osteoporosis medication) when compared with usual care. The evidence for its impact on patient behaviours/actions was inconclusive. One measure found that the electronic medical reminder message impacted patient behaviour positively: patients had a higher calcium intake, and two found no difference between the two groups. The study did not assess primary health service outcomes or harms. Authors' conclusions As only one study was identified for inclusion, the results are inadequate to inform clinical practice in regard to the use of email for clinical communication between healthcare professionals. Future research needs to use high-quality study designs that take advantage of the most recent developments in information technology, with consideration of the complexity of email as an intervention, and costs

    Email for clinical communication between healthcare professionals

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    Email is one of the most widely used methods of communication, but its use in healthcare is still uncommon. Where email communication has been utilised in health care, its purposes have included clinical communication between healthcare professionals, but the effects of using email in this way are not well known. We updated a 2012 review of the use of email for two-way clinical communication between healthcare professionals

    Academic careers: the value of individual mentorship on research career progression

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    The paper discusses how individual mentoring may impact positively on career pathway development for potential and future clinical academic researchers in nursing and allied health professions. Methods: The paper draws on a number of data sources and methodologies in order to fulfil the aims. Firstly, international literature provides an insight into mentoring processes and impact on career development. This is followed by a review of the mentoring experiences based on a UK study on the professorial populations in nursing and allied health professions. The final section reports on results of interviews with early and advanced researchers on their experiences of mentoring. Results: Individual mentoring is valued highly by health care professionals at all stages of career development. It is considered particularly useful when people are in transition towards a more challenging career role.Individuals in receipt of mentoring both formal and informal, report improved confidence in their cability to achieve their career goals. Mentees report improved levels of competence achieved through knowledge aquisition, networking and ability to probelm solve. Conclusions/Summary: Mentoring is considered an important process for health care professionals at all stages of their career. Opportunities to access and receive mentoring support for health care staff in the UK remain limited and sporadic in nature. There are examples of excellent mentoring schemes in place within some institutons and organisations but a national strategy to support mentoring has yet to be developed Key words: Clinical academic careers, mentoring, nursing, allied health profession

    Critical factors affecting consumer acceptance of online health communication: an application of service quality models

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    The paper examines critical factors affecting consumer behavioral intentions in accepting online health communication through social networking sites. Unlike recent research under this topic, the paper assimilates some components of service quality dimensions and consumer behavior theories. The paper employs factor analysis and structural equation modelling analysis with latent variables to identify critical factors from the survey data collected from Korean consumers. The results of the study identifies three major constructs: consumer needs for health information, the perceived value of tangible attributes of health information providers, and the perceived value of intangible attributes of health information providers. The results show that consumer needs for health information and the tangible and intangible attributes of health information providers should be considered as important antecedents of accepting online health communication through social networking sites. The findings suggest that the success of online health communication via social networking sites largely depends on the tangible and intangible attributes of health information providers
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