Use of the Ultrasound Technique as Compared to the Standard Technique for the Improvement of Venous Cannulation in Patients with Difficult Access

(1) Objective. We aimed to demonstrate that the use of the ultrasound-guided technique facilitates peripheral venous cannulation as compared to the standard technique in patients with difficult access at emergency services. (2) Method. A case–control study, randomized research. Variables were collected from a population with non-palpable or not visible veins, classified into size risk groups for 6 months. In the comparative analysis, the patients were divided into two groups: the cases group was composed of patients to whom the peripheral venous cannulation was performed with the ultrasound-guided technique (UST), while the control was composed of patients with whom the standard technique (ST) was performed. The ultrasound LOGIQ P5 750VA from General Electric Healthcare, with an 11 mHz linear probe, was utilized, along with peripheral venous catheters model Insyte™ Autoguard™ with gauges of 14G to 26G. (3) Results. Seventy-two cases. The use of the ultrasound decreased the time (618.34s ST, 126s UST) and the number of punctures (2.92 ST, 1.23 UST); about 25% of the patients did not have complications with the UST, as compared to 8% with the ST. The use of the ultrasound decreased the pain experienced by 1.44 points in the visual analog scale, as compared to 0.11 points with the ST. The rate of success of the first try with the UST was 76%, as compared to 16% of the ST. The gauge of the catheter increased with the UST, with successful cannulations obtained with 20G (56%) and 18G (41%) gauges. (4) Conclusions. The use of ultrasound facilitates venous cannulation according to the variables of the study. The ultrasound visualization of the vessels is associated with the selection of the catheter gauge. There was no relation between the complications and the depth of the blood vessels.Enfermerí

Mental health

PHN Discussion Paper #2 – Mental Health notes a key role for Primary Health Networks in realising effective and lasting improvement in mental health outcomes, through adopting a person-centred approach in service design and enabling integration across service providers in local health systems. The 2014 National Mental Health Commission report noted that “They (PHNs) can work in partnership and apply targeted, value-for-money interventions across the whole continuum of mental wellbeing and ill-health to meet the needs of their communities.” Notwithstanding this, there are challenges and barriers to be resolved in order to effect meaningful and sustainable improvement in mental health outcomes and health system performance.  Further exploration of the challenges and barriers is warranted in order to enable PHNs to deliver on their objectives.&nbsp

Primary Health Network critical success factors

The Primary Health Network (PHN) program has the potential to make a significant positive difference in health outcomes for all Australians. PHN Discussion Paper #1 - Primary Health Network Critical Success Factors reflects on the lessons learnt from previous organised primary health care models in Australia, considers the factors that are essential for PHNs to create true public value, and identifies some key issues which PHNs and the Government need to address to ensure that PHNs are given every opportunity to succeed

Trust in Intensive Care Patients, Family, and Healthcare Professionals: The Development of a Conceptual Framework Followed by a Case Study

Intensive care patients experience anxiety, pain, uncertainty, and total dependency. In general, it is important to develop trust between the healthcare professionals (HCPs), patients, and their family. Trust building in the ICU setting is challenging because of the time sensitivity of decision making and the dependency of patients on health care professionals. The objectives of this study are the development of a trust framework and then to use this framework in a case study in the intensive care. In three steps we developed a comprehensive trust framework from the literature concerning trust. First, we identified the elements of trust. Second, we adapted and integrated the dimensions to six concepts to construct the trust framework. Third, these concepts are incorporated into a comprehensive trust framework. In a case study we explored the facilitators and barriers within this framework in eight semi-open interviews with healthcare professionals and eight patients or partners. Trust was first explored inductively and then deductively. We showed that HCPs, patients, and family have largely the same perspective regarding the facilitators of trust, in which communication emerged as the most important one. Other facilitators are maintaining an open feedback culture for HCPs and being aware of patients’ physical and informational privacy. Patients want to be approached as an individual with individual needs. Dishonesty and differences in values and norms were the most important barriers. To contribute to a positive perception of health delivery and to avoid conflicts between HCP and patients or their family we formulated five practical recommendations

Healthcare Robotics

Robots have the potential to be a game changer in healthcare: improving health and well-being, filling care gaps, supporting care givers, and aiding health care workers. However, before robots are able to be widely deployed, it is crucial that both the research and industrial communities work together to establish a strong evidence-base for healthcare robotics, and surmount likely adoption barriers. This article presents a broad contextualization of robots in healthcare by identifying key stakeholders, care settings, and tasks; reviewing recent advances in healthcare robotics; and outlining major challenges and opportunities to their adoption.Comment: 8 pages, Communications of the ACM, 201

The influence of hospitable design and service on patient responses

A study of 216 respondents examined a medical center environment’s influence on patient responses. A stimulus–organism–response (S-O-R) model was adapted to the theory that more hospitable healthcare servicescape elements will affect patients’ overall satisfaction with healthcare experience, loyalty intentions, and willingness to pay out-of-pocket expenses for healthcare services. Servicescape elements included atmospherics of the healthcare environment, service delivery by healthcare staff, physical design of the healthcare environment, and wayfinding. Results of structural equation modeling confirmed that the four servicescape elements – had a significant impact on patients’ overall satisfaction with the healthcare experience. Furthermore, overall satisfaction with the healthcare experience predicted patients’ loyalty intentions and willingness to pay out-of-pocket expenses for healthcare services. The study makes a significant contribution to the empirical modeling of patients’ behavioral responses to hospitable healthcare environments

Exploring Patient Satisfaction among Transgender and Non-Binary Identified Healthcare Users: The Role of Microaggressions and Inclusive Healthcare Settings

Patient satisfaction is an important indicator of quality of healthcare delivery. Transgender and non-binary (TGNB) people regularly report experiencing discrimination when in healthcare settings and few TGNB-inclusive services are available. Researchers have not examined how discrimination and access to TGNB-inclusive services are associated with patient satisfaction among TGNB healthcare users. Among a convenience sample of TGNB people (n = 146) from Canada and the United States, I examined the relationship between patient satisfaction, experiencing microaggressions from primary healthcare providers, and receiving care in a TGNB-inclusive healthcare setting. The results from a multivariable linear regression suggest that experiencing microaggressions is negatively associated with patient satisfaction while obtaining services from an inclusive healthcare setting is positively associated with satisfaction. These findings emphasize the importance of preparing healthcare providers to engage in inclusive practice with TGNB healthcare users, especially in terms of avoiding microaggressions. They also highlight the importance of creating TGNB-inclusive healthcare settings in fostering patient satisfaction. Researchers, medical professionals, and others working towards health equity, should consider the implications of these findings when developing solutions to improve healthcare access and patient satisfaction

Perceptions of Healthcare, Health Status, and Discrimination Among African-American Veterans

The Institute of Medicine identified access to healthcare and race-based discrimination as important barriers to quality healthcare that contributes to health disparities. This study (1) describes African-American veterans’ perceptions of healthcare services and perceived discrimination in healthcare and (2) investigates the relationship between perceived discrimination and patient perceptions of care, satisfaction with healthcare, and health status. A convenience sample of 141 African-American veterans in Boston completed surveys from May to June 2006. Respondents reported an average of 16 lifetime experiences of discrimination and over half recalled a situation when they experienced discrimination in healthcare. Modest ratings of perceived quality of care, and satisfaction with healthcare reflect areas for improvement. Perceived healthcare discrimination was negatively and significantly associated with satisfaction (p\u3c0.001), perceived quality of care (p\u3c0.01), and physical functioning (p\u3c0.05). Policies eliminating discrimination in healthcare are needed to improve patient satisfaction, quality of care, and health outcomes of African- American veterans

Theology at the coal-face of hospitalisation - the development and evaluation of a postgraduate certificate in Healthcare Chaplaincy

Healthcare chaplaincy is working towards recognition as a registered health profession. An accredited programme of professional education is part of that process. The University of Glasgow supported by NHS Education for Scotland have developed a programme of professional education for healthcare chaplains that is integrated into an MSc. (MedSci) in healthcare. This article outlines the commissioning, development and evaluation of a postgraduate certificate in healthcare chaplaincy by students, clinical mentors and experienced healthcare chaplains. It also highlights an innovative approach to practice development in spiritual and religious care in healthcare

Accessing Patient Records in Virtual Healthcare Organisations

The ARTEMIS project is developing a semantic web service based P2P interoperability infrastructure for healthcare information systems that will allow healthcare providers to securely share patient records within virtual healthcare organisations. Authorisation decisions to access patient records across organisation boundaries can be very dynamic and must occur within a strict legislative framework. In ARTEMIS we are developing a dynamic authorisation mechanism called PBAC that provides a means of contextual and process oriented access control to enforce healthcare business processes. PBAC demonstrates how healthcare providers can dynamically share patient records for care pathways across organisation boundaries