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111.
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Mary Dunnion MSc in Advanced Nursing BSc RGN Assumpta Ryan PhD M.Ed BSc RN PGCTHE FHEA Debbie Goode PhD MSc PGCert PGDip BA RN SFHEA Sonja McIlfatrick PhD MSc BSc RN FHEA FRCSI FRCN FAAN 《International journal of older people nursing》2023,18(3):e12529
Background
For many older people the emergency department (ED) is an important but sometimes difficult step in their healthcare journey. They often attend the ED with co and multi morbidities. Discharge home at evenings and weekends when post-discharge support services are limited can result in a delay or failure to follow through on their discharge plan leading to adverse health outcomes and in some cases, readmission to ED.Objective
The aim of this integrative review was to identify and appraise the support available to older people following discharge from the ED out of hours (OOH).Methods
For this review, out of hours referred to those times after 17.30 until 08.00 a.m. on Mondays to Fridays, all hours on weekends and public holidays. Whittemore and Knafl's (Journal of Advanced Nursing, 2005;52:546), framework was used to guide all stages of the review process. Articles were retrieved following a rigorous search of published works using various databases, the grey literature and hand search of the reference lists of the studies included.Results
In total 31 articles were included in the review. These comprised systematic reviews, randomised control studies, cohort studies and surveys. Main themes identified included processes that enable support, support provision by health and social care professionals and telephone follow-up. Results identified a significant dearth of out of hours discharge research and a strong recommendation for more concise and thorough research in this important area of care transition.Conclusion
Older person discharge home from the ED presents an associated risk as previous research has identified frequent readmission and periods of ill health and dependency. Out of hours discharge can be even more problematic when it may be difficult to arrange support services and ensure continuity of care. Further work in this area is required, taking cognisance of the findings and recommendations identified in this review. 相似文献113.
Robert W. McConkey RANP RNP MSc BSc PG Dip PG Cert Therese Kelly RANP RNP MSc PG Dip PG Cert Rachael Dalton RANP RNT RNP MSc BSc PG Dip Geraldine Rooney cANP RNP BSc PG Dip PG Cert Michelle Healy cANP BSc PG Cert Louise Murphy PhD BSc PG Dip RPN RNT Maura Dowling PhD MSc RGN RNT 《International Journal of Urological Nursing》2023,17(1):78-83
Evidence based practice is essential to advanced practice nursing, enabling the delivery of quality care and improved patient outcomes. As the name suggests, it requires healthcare decisions to be based on the best available and current evidence. Advanced practice nurses need astute critical analysis skills to appraise the evolving literature, and require research skills to lead on scientific inquiry and develop the profession. Yet, advanced practice nurses may not recognize themselves as research leaders. Participation in a journal club can promote evidence-based practice, improve clinician's critical thinking skills, and expose members to different research methodologies, however, nurses continue to face barriers to participation in these clubs. Establishing a clinical-academic partnership appears to be both mutually beneficial for clinicians and academics and is a significant enabler in the sustainability and functioning of the club through sharing expertise and experience. A supportive workplace culture is favourable to research utilization and knowledge translation. This paper outlines the role, practicalities, challenges, and benefits of setting up a hybrid urology journal and research club for advanced practice nurses in a clinical-academic partnership. 相似文献
114.
Kath Padgett BSc MA PGDip Cert Ed RMN Christine Rhodes BSc MSc RGN RM RN Child RHV Maureen Lumb Penny Morris BA Sue Sherwin BA MA PGCHE RMN Jools Symons BA MA Joannie Tate Ken Townend 《Health expectations》2014,17(3):418-428
Background Involving service users and carers in decisions about their health care is a key feature of health‐care practice. Professional health and social care students need to develop skills and attributes to best enable this to happen. Aims The aims were to explore service user and carer perceptions of behaviours, attributes and context required to enable shared decision making; to compare these perceptions to those of students and academic staff with a view to utilizing the findings to inform the development of student assessment tools. Methods A mixed methods approach was used including action learning groups (ALG) and an iterative process alongside a modified Delphi survey. Participants The ALGs were from an existing service user and carer network. The survey was sent to sixty students, sixty academics and 30 service users from 16 different professional disciplines, spanning four Universities in England. Results The collaborative enquiry process and survey identified general agreement that being open and honest, listening, showing respect, giving time and being up to date were important. The qualitative findings identified that individual interpretation was a key factor. An unexpected result was an insight into possible insecurities of students. Conclusions The findings indicate that distilling rich qualitative information into a format for student assessment tools could be problematic as the individual context could be lost, it is therefore proposed that the information could be better used as a learning rather than assessment tool. Several of those involved identified how they valued the process and found it beneficial. 相似文献
115.
Background: In 2016, in the Canadian province of British Columbia, the Provincial Health Officer declared drug-related overdose deaths a public health emergency. Objectives: In this study, we examine factors associated with recent non-fatal overdose during a time of unprecedented rates of overdose and increasing involvement of fentanyl and fentanyl derivatives in overdose deaths. Methods: Between June and September 2016, a cross-sectional survey was conducted among people who inject drugs (PWID) in Victoria, British Columbia, Canada. Bivariable and multivariable logistic regression analyses were used to examine factors associated with recent non-fatal overdose. Results: A total of 187 PWID were included in the present study, of whom 56 (29.9%) reported having overdosed in the previous 6 months. In multivariable analyses, fentanyl injection (Adjusted Odds Ratio [AOR]?=?2.60; 95% confidence interval [CI]: (1.08?–?6.27) and public injection (AOR?=?2.20; 95% CI: 1.09?–?4.43) were positively associated with recent non-fatal overdose. Conclusions: Fentanyl injection and public injection were associated with an increased likelihood of non-fatal overdose. These findings underscore the need for drug checking, safer sources of opioids and safer injecting interventions as part of overdose prevention strategies. 相似文献
116.
117.
Susanne Coleman BSc RGN E. Andrea Nelson PhD RGN Justin Keen MSc PhD Lyn Wilson MA RGN Elizabeth McGinnis MSc PhD RGN Carol Dealey PhD RGN Nikki Stubbs MSc RGN Delia Muir BA Amanda Farrin MSc Dawn Dowding PhD RN Jos M.G.A. Schols MD PhD Janet Cuddigan PhD RN FAAN Dan Berlowitz MD MPH Edward Jude MD MRCP Peter Vowden MD FRCS Dan L. Bader PhD DSc Amit Gefen PhD Cees W.J. Oomens PhD Lisette Schoonhoven PhD RN Jane Nixon PhD RN 《Journal of advanced nursing》2014,70(10):2339-2352
118.
In today's society one of the most pressing health care problems is family violence. This article focuses on female abuse and how critical care nurses need to gain awareness of their attitudes about battered women, educate themselves about the dynamics of battering and obtain the knowledge and skills needed for effective assessment and nursing intervention. 相似文献
119.
Sarah J Nelson Bethany Drury Daniel Hood Jeremy Harper Tiffany Bernard Chunhua Weng Nan Kennedy Bernie LaSalle Ramkiran Gouripeddi Consuelo H Wilkins Paul Harris 《J Am Med Inform Assoc》2022,29(4):652
ObjectiveThe Recruitment Innovation Center (RIC), partnering with the Trial Innovation Network and institutions in the National Institutes of Health-sponsored Clinical and Translational Science Awards (CTSA) Program, aimed to develop a service line to retrieve study population estimates from electronic health record (EHR) systems for use in selecting enrollment sites for multicenter clinical trials. Our goal was to create and field-test a low burden, low tech, and high-yield method.Materials and MethodsIn building this service line, the RIC strove to complement, rather than replace, CTSA hubs’ existing cohort assessment tools. For each new EHR cohort request, we work with the investigator to develop a computable phenotype algorithm that targets the desired population. CTSA hubs run the phenotype query and return results using a standardized survey. We provide a comprehensive report to the investigator to assist in study site selection.ResultsFrom 2017 to 2020, the RIC developed and socialized 36 phenotype-dependent cohort requests on behalf of investigators. The average response rate to these requests was 73%.DiscussionAchieving enrollment goals in a multicenter clinical trial requires that researchers identify study sites that will provide sufficient enrollment. The fast and flexible method the RIC has developed, with CTSA feedback, allows hubs to query their EHR using a generalizable, vetted phenotype algorithm to produce reliable counts of potentially eligible study participants.ConclusionThe RIC’s EHR cohort assessment process for evaluating sites for multicenter trials has been shown to be efficient and helpful. The model may be replicated for use by other programs. 相似文献
120.