Improving Perioperative Communication Through the Use of a Nurse Navigator: An Integrative Review

Patient-centered communication practices are critical for ensuring that patients have optimal care experiences and clinical outcomes. Unfortunately, today’s health care environment often presents numerous barriers to consistent and clear information exchange. These barriers are magnified in dynamic and fast-paced care environments such as the perioperative setting, where numerous interactions and communication exchanges must occur. The purpose of this integrative review is to examine the value of the nurse navigator role within the perioperative setting and evaluate whether it can improve patient and family satisfaction with communication and the care experience. The review includes the identification and appraisal of relevant literature to substantiate the impact of a nurse navigator in overcoming environmental barriers, enhancing patient education, decreasing patient and familial anxiety, and improving patient satisfaction. The analysis of current literature provides strong evidence for the value of a nurse navigator within the unique perioperative care setting. This review will help inform patient- and family-centered communication processes that can lead to improved care quality and outcomes

Need to Know Review Number two: What Local Government Needs to Know about Public Health

This review of existing research on local government and public health focuses on the leadership role of local government in developing local public health systems that are capable of addressing the wider determinants of health

Promoting Handwashing and Sanitation Behaviour Change in Low- and Middle-Income Countries: A Mixed-Method Systematic Review

This systematic review shows which promotional approaches are effective in changing handwashing and sanitation behaviour and which implementation factors affect the success or failure of such interventions. The authors find that promotional approaches can be effective in terms of handwashing with soap, latrine use, safe faeces disposal and open defecation. No one specific approach is most effective. However, several promotional elements do induce behaviour change. Different barriers and facilitators that influence implementing promotional approaches should be carefully considered when developing new policy, programming, practice, or research in this area

A Clinical Nurse Leader Nurse Navigator Program for Heart Failure Patients

The purpose of this integrative review is to examine the literature regarding nurse-led educational interventions, transitional care (TC) strategies for heart failure (HF) patients, nurse navigation, HF self-care, and the clinical nurse leader (CNL) role to support integrating a CNL into the care delivery model serving as a nurse navigator (NN) for adult HF patients being discharged home from the hospital. The basis for this review is to identify an innovative way to improve patient reported and clinical outcomes for the HF population which increases each year. The economic and symptom burden associated with this disease is high further enhanced by poor transitions in care leading to avoidable hospital readmissions. Whittemore and Knafl’s (2005) methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines served as the framework for this review. A total of 32 articles were obtained after an extensive literature search each addressing one of the five components to be examined for synthesis. The information gathered collectively supports a CNL integrated care delivery model best conveyed in a structure, process, outcome model

An exploration of perceived stress, burnout syndrome, and self-efficacy in a group of Polish air traffic controllers and maritime navigators : similarities and differences

Background: This cross-sectional study aimed to assess the level of perceived stress and occupational burnout in groups of Polish maritime navigators and air traffic controllers. The study was part of research into occupational groups regarded as equally emotionally burdened. We tested the usability of a model linking occupational burnout, perceived stress, and seniority. Methods: The set of questionnaires, including the link burnout questionnaire, perceived stress scale—10, and generalized self-efficacy scale were distributed to 54 maritime navigators and 88 air traffic controllers (rate of return: 18–56%). Spearman’s rho, χ2 test, the Mann–Whitney U test, Cohen’s d and Hedge’s g coefficients, linear regression, and F statistic were used. Results: The assumption that persons employed in occupations with the special professional requirements as air traffic controllers and maritime navigator with a risk of strong, chronic emotional overload evaluate their life situation as less stressful than other employees was confirmed. A higher level of occupational burnout was observed in groups of controllers and navigators compared to an equally emotionally burdening occupational group of Polish firefighters, but not Polish psychiatrists. The research groups differed regarding the source of stress: fear of helplessness in the air traffic controller group and inefficacy in overcoming adversities in the maritime navigators. Maritime navigators reported a higher level of occupational burnout, deterioration of relations with coworkers, and disappointment with their work compared to the air traffic controllers. Conclusions: The results showed differences in factors linked to workplace demands and the personal predispositions of employees, and the role these may play in mutual relations between occupational burnout, life situation evaluation, and personal resources. We postulate that the level of perceived stress should be taken into account in the studies of occupational burnout syndrome

Facilitators and barriers of implementing and delivering social prescribing services: a systematic review

BACKGROUND: Social Prescribing is a service in primary care that involves the referral of patients with non-clinical needs to local services and activities provided by the third sector (community, voluntary, and social enterprise sector). Social Prescribing aims to promote partnership working between the health and the social sector to address the wider determinants of health. To date, there is a weak evidence base for Social Prescribing services. The objective of the review was to identify factors that facilitate and hinder the implementation and delivery of SP services based in general practice involving a navigator. METHODS: We searched eleven databases, the grey literature, and the reference lists of relevant studies to identify the barriers and facilitators to the implementation and delivery of Social Prescribing services in June and July 2016. Searches were limited to literature written in English. No date restrictions were applied. Findings were synthesised narratively, employing thematic analysis. The Mixed Methods Appraisal Tool Version 2011 was used to evaluate the methodological quality of included studies. RESULTS: Eight studies were included in the review. The synthesis identified a range of factors that facilitate and hinder the implementation and delivery of SP services. Facilitators and barriers were related to: the implementation approach, legal agreements, leadership, management and organisation, staff turnover, staff engagement, relationships and communication between partners and stakeholders, characteristics of general practices, and the local infrastructure. The quality of most included studies was poor and the review identified a lack of published literature on factors that facilitate and hinder the implementation and delivery of Social Prescribing services. CONCLUSION: The review identified a range of factors that facilitate and hinder the implementation and delivery of Social Prescribing services. Findings of this review provide an insight for commissioners, managers, and providers to guide the implementation and delivery of future Social Prescribing services. More high quality research and transparent reporting of findings is needed in this fiel

Reducing 30-Day Hospital Readmission Among Mentally Ill Homeless Men with Substance Use Disorder

Abstract Background: Psychiatric inpatient readmission of mentally ill homeless men is greater than that of the overall population. Substance use disorders co-occur with high prevalence in patients diagnosed with mental illness. For mentally ill homeless individuals discharged after inpatient treatment, substance use disorder negatively impacts health behavior, and medication non-compliant, resulting in hospital readmission. Problem: In an acute care psychiatric facility in Northern California, the greatest readmission after inpatient hospitalization occurs at 53.9% in a week and 74.8% in two weeks of discharge. For homeless individuals, substance use disorder complicates personal problems and decreases the likelihood of a long-term exit from homelessness. As a result, hospital readmissions among the homeless population are higher than in the general population. One of the problems faced by this unit is frequent readmissions of the same group of homeless patients two to three times every month (24-36 times per year). Methods: Implementing a nurse navigator program in the mental health unit is anticipated to improve the transition of care between the inpatient setting and the facility\u27s other mental health outpatient clinics. The goal of this nurse navigator is to ensure that patients are medication compliant immediately after discharge from the inpatient unit and can keep outpatient appointments to support medication compliance. Conclusion: Evidence from the published literature presented a compelling need to include follow-up care, comprehensive discharge planning, and nurse navigation

Refining Triage Documentation Practices in a Metropolitan Emergency Department

Problem California ranks ninth nationwide for its lengthy emergency department wait times, presenting a pressing challenge for healthcare facilities. Context This quality improvement project, set in the emergency department of a large urban hospital in the Bay Area, aimed to address this issue by targeting workflow efficiency through the reduction of triage times. Intervention The intervention centered on implementing changes to the triage documentation, informed by staff feedback obtained through an opinion survey. Proposed modifications included the elimination of redundant questions, consolidation of related categories, and a logical reorganization of triage topics. Measures Key measures utilized in the project included triage times and pre- and post-intervention nursing opinion surveys. Results Despite encountering time constraints and other limitations, the intervention was not fully implemented, and post-intervention data collection did not occur. However, pre-implementation surveys revealed strong staff support for the proposed changes, indicating the potential efficacy of the intervention. Conclusion Future recommendations for this project include prioritizing the implementation of the intervention and conducting post-implementation data collection to facilitate meaningful comparisons and further inform improvement efforts

Risk prediction models for incident type 2 diabetes in Chinese people with intermediate hyperglycemia : a systematic literature review and external validation study

Background People with intermediate hyperglycemia (IH), including impaired fasting glucose and/or impaired glucose tolerance, are at higher risk of developing type 2 diabetes (T2D) than those with normoglycemia. We aimed to evaluate the performance of published T2D risk prediction models in Chinese people with IH to inform them about the choice of primary diabetes prevention measures. Methods A systematic literature search was conducted to identify Asian-derived T2D risk prediction models, which were eligible if they were built on a prospective cohort of Asian adults without diabetes at baseline and utilized routinely-available variables to predict future risk of T2D. These Asian-derived and five prespecified non-Asian derived T2D risk prediction models were divided into BASIC (clinical variables only) and EXTENDED (plus laboratory variables) versions, with validation performed on them in three prospective Chinese IH cohorts: ACE (n = 3241), Luzhou (n = 1333), and TCLSIH (n = 1702). Model performance was assessed in terms of discrimination (C-statistic) and calibration (Hosmer-Lemeshow test). Results Forty-four Asian and five non-Asian studies comprising 21 BASIC and 46 EXTENDED T2D risk prediction models for validation were identified. The majority were at high (n = 43, 87.8%) or unclear (n = 3, 6.1%) risk of bias, while only three studies (6.1%) were scored at low risk of bias. BASIC models showed poor-to-moderate discrimination with C-statistics 0.52-0.60, 0.50-0.59, and 0.50-0.64 in the ACE, Luzhou, and TCLSIH cohorts respectively. EXTENDED models showed poor-to-acceptable discrimination with C-statistics 0.54-0.73, 0.52-0.67, and 0.59-0.78 respectively. Fifteen BASIC and 40 EXTENDED models showed poor calibration (P < 0.05), overpredicting or underestimating the observed diabetes risk. Most recalibrated models showed improved calibration but modestly-to-severely overestimated diabetes risk in the three cohorts. The NAVIGATOR model showed the best discrimination in the three cohorts but had poor calibration (P < 0.05). Conclusions In Chinese people with IH, previously published BASIC models to predict T2D did not exhibit good discrimination or calibration. Several EXTENDED models performed better, but a robust Chinese T2D risk prediction tool in people with IH remains a major unmet need.Peer reviewe

A Bibliometric Analysis of the Top 100 Cited Articles on Hepatic Magnetic Resonance Imaging.

The purpose of this study is to guide the readers to the impact of the articles published on hepatic magnetic resonance imaging (MRI). We searched Scopus using 10 different search terms for hepatic MRI. The selected studies were thoroughly reviewed by two independent authors and any disagreement was sorted out by mutual consensus. The list of articles and journals was downloaded into an excel spreadsheet. Only the top 100 cited articles were selected by mutual consensus among all the authors. These articles were further read in the full-text form and were further categorized into subgroups. Three authors independently reviewed the top 100 selected articles, and subsequently data was extracted from them and analyzed. Our study showed that the highest number of top 100 cited articles on hepatic MRI were from Radiology (30 articles) followed by European Radiology (14 articles). The American Journal of Roentgenology, Radiographics, and Journal of Magnetic Resonance had seven articles each. The United States had the highest number of articles by region. Nineteen other journals contributed only one article each to the list of top 100 cited articles. The contribution of authors to the top 100 cited articles was reviewed; all the authors contributing with more than two articles to the highly cited articles are given in Table 3 in the supplementary material. The maximum number of articles were published during 2009 (14 articles), and for a five-year period, the maximum contribution was made during 2008-2013 (44 articles). Our analysis gives an insight on the frequency of citations of top articles on hepatic MRI, categorizes the subtopics, the timeline of the publications, and contributions from different geographic distributions