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Journal of Neurology - 相似文献
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Barriers and Facilitators of Colorectal Cancer Screening for Patients of Rural Accountable Care Organization Clinics: A Multilevel Analysis 下载免费PDF全文
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Margaret Saari RN PhD Erin Patterson RN PhD Shawna Kelly RN MN‐NP Adult CNN Ann E. Tourangeau RN PhD 《Health & social care in the community》2018,26(2):240-249
To meet increasing demand for home care, the role of personal support workers (PSWs) is shifting from providing primarily personal and supportive care to include care activities previously provided by regulated health professionals (RHPs). Much of the research examining this shift focuses on specialty programmes, with few studies investigating the daily care being provided by PSWs, frequency of care activities being provided by PSWs, and characteristics of the population receiving more complex tasks. Between January and April 2015, a review of 517 home‐care service user charts was undertaken in Ontario, Canada, to: (1) describe the range of tasks being performed by PSWs in home care, (2) identify tasks transferred by RHPs to PSWs, and (3) examine characteristics of service users receiving transferred care. Findings indicate that normally, PSWs provide personal and supportive care commensurate with their training. However, in approximately one quarter of care plans reviewed, PSWs also completed more complex care activities transferred to them by RHPs. Service users receiving transferred care were older and had higher levels of cognitive and functional impairment. Although there is potential for the expansion of home‐care services through increased utilisation of PSWs, healthcare leadership must ensure that the right provider is being utilised at the right time and in the right place to ensure safe and effective quality care. Thus, several actions are recommended: PSW core competencies be clearly articulated, processes used to transfer care activities from RHPs to PSWs be standardised and a team‐based approach to the delivery of home‐care services be considered. Utilisation of a team‐based model can help establish positive relationships among home‐care providers, provide increased support for PSWs, allow for easier scheduling of initial training and ensure regular reassessments of PSW competence among PSWs providing added skills. 相似文献
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Michael StoeszKristin Wood NP Wesley ClarkYoung-Min Kwon MD PhD Andrew A. Freiberg 《The Journal of arthroplasty》2014
This study prospectively evaluated the clinical utility of a noninvasive transcutaneous device for postoperative hemoglobin measurement in 100 total hip and knee arthroplasty patients. A protocol to measure hemoglobin noninvasively, prior to venipuncture, successfully avoided venipuncture in 73% of patients. In the remaining 27 patients, there were a total of 48 venipunctures performed during the postoperative hospitalization period due to reasons including transcutaneous hemoglobin measurement less than or equal to 9 g/dL (19), inability to obtain a transcutaneous hemoglobin measurement (8), clinical signs of anemia (3), and noncompliance with the study protocol (18). Such screening protocols may provide a convenient and cost-effective alternative to routine venipuncture for identifying patients at risk for blood transfusion after elective joint arthroplasty. 相似文献
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Mahmoud Kaddoura PhD CAGS APRN NP‐C CNE Olga Van‐Dyke PhD CAGS MSN RN Qing Yang PhD 《Nursing & health sciences》2016,18(3):350-354
Nurses confront complex problems and decisions that require critical thinking in order to identify patient needs and implement best practices. An active strategy for teaching students the skills to think critically is the concept map. This study explores the development of critical thinking among nursing students in a required pathophysiology and pharmacology course during the first year of a Bachelor of Science in Nursing in response to concept mapping as an interventional strategy, using the Health Education Systems, Incorporated critical thinking test. A two‐group experimental study with a pretest and posttest design was used. Participants were randomly divided into a control group (n = 42) taught by traditional didactic lecturing alone, and an intervention group (n = 41), taught by traditional didactic lecturing with concept mapping. Students in the concept mapping group performed much better on the Health Education Systems, Incorporated than students in the control group. It is recommended that deans, program directors, and nursing faculties evaluate their curricula to integrate concept map teaching strategies in courses in order to develop critical thinking abilities in their students. 相似文献
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Single arm phase II study of oral vitamin B12 for the treatment of musculoskeletal symptoms associated with aromatase inhibitors in women with early stage breast cancer 下载免费PDF全文
Aleli Campbell MS Rosalinda Heydarian NP Cecilia Ochoa MPH Alok Kumar Dwivedi PhD Zeina A. Nahleh MD 《The breast journal》2018,24(3):260-268
Breast cancer patients receiving endocrine therapy with aromatase Inhibitors (AIs) often experience musculoskeletal and joint‐related side effects. The purpose of this study was to evaluate the effect of Vitamin B12 supplements on musculoskeletal symptoms such as pain and arthralgias induced by AIs and to correlate response with serum and inflammatory biomarkers. Upon receiving approval by the Institutional Review Board (IRB), the majority of the patients consented into the study were treated at the Texas Tech Breast Care Center. Included were patients who had a diagnosis of invasive breast cancer (Stages I‐III), and were experiencing significant musculoskeletal symptoms associated to AIs. Only patients with an average pain score ≥ 4, as assessed by the Brief Pain Inventory‐Short Form (BPI‐SF) questionnaire, were included in the study. Participants received 2500 mcg of sublingual vitamin B12 daily for 90 days. Assessments at baseline and at 3 months included: BPI‐SF pain scores, the impact on quality of life determined by Functional Assessment of Cancer Therapy–Endocrine Symptoms (FACT‐ES), and correlative serum markers relative to baseline (a pre‐post study). A total of forty‐one patients were enrolled. Average pain scores were improved by 34% (P < .0001) at 3 months compared to baseline. In addition, a 23% improvement in worst pain was noted (P = .0003). Analysis of the results for the FACT‐ES scoring showed improvement on all scales. No significant adverse events were observed. Decrease in pain score was correlated with increased serum B12 levels. This study suggests that Vitamin B12 reduces pain and improves quality of life for patients taking AIs who experienced AI‐related musculoskeletal symptoms. If confirmed in large randomized prospective trials, Vitamin B12 would be a safe and cost‐effective option for the treatment of AI‐related musculoskeletal symptoms. 相似文献
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Christine Miaskowski RN PhD Steven M. Paul PhD Karin Snowberg MA Maura Abbott PhD AOCNP CPNP Hala T. Borno MD Susan M. Chang MD Lee May Chen MD Bevin Cohen RN MPH PhD Bruce A. Cooper PhD Marilyn J. Hammer RN PhD Stacey A. Kenfield ScD Kord M. Kober PhD Angela Laffan MS NP Jon D. Levine MD PhD Rachel Pozzar RN PhD FNP-BC Kim Rhoads MD MS MPH Katy K. Tsai MD Erin L. Van Blarigan ScD Katherine Van Loon MD MPH 《Cancer》2021,127(17):3246-3253