Gc best practices_miteshpatel_q3
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Best practice guidelines are designed for populations but can be challenging for individual patients. Providers should focus on creating value for patients. The researchers created a tool called "The Value Framework" to help providers decide if interventions will create value for their individual patients by incorporating clinical judgment into guidelines.
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Outcomes research examines the end results of healthcare services to provide scientific evidence to inform decisions. It can assess nursing interventions, patient behaviors, job performance, and nursing-sensitive outcomes over short, intermediate, or long time periods. Positive aspects include bringing current research to healthcare delivery and improving patient outcomes while reducing costs. Negative aspects include healthcare providers lacking access to current research and hospital policies not always aligning with recommendations. The Agency for Healthcare Research and Quality and Patient-Centered Outcomes Research Institute conduct outcomes research to improve healthcare safety, quality, accessibility, equity, and affordability.
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The document discusses quality improvement for reducing diarrhea cases through a handwashing program. It proposes using the FADE model and microsystems approach to design the program. Measurement tools would quantitatively and qualitatively assess handwashing rates, diarrhea incidence, and impact. Ethical considerations include informed consent, confidentiality, and balancing risk of spreading infection against the duty to protect patients. Overall the program aims to determine if handwashing increases and diarrhea cases decrease.
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This document discusses the treatment of diarrhea in Vietnam following natural disasters. It provides background on diarrhea, noting that it is commonly caused by contaminated food or water. It then outlines how nurses in Vietnam typically treat diarrhea cases, which often involves oral rehydration and monitoring due to limited hospital resources. The document also addresses diarrhea as a major public health issue after disasters in Vietnam, when flooding can spread diseases. It explores quality improvement models for addressing diarrhea treatment, including the FADE and microsystems models.
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2) Rounding involves checking on patients' needs, pain levels, comfort and safety every 1-2 hours.
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Outcomes research examines the end results of healthcare services to provide scientific evidence to inform decisions. It can assess nursing interventions, patient behaviors, job performance, and nursing-sensitive outcomes over short, intermediate, or long time periods. Positive aspects include bringing current research to healthcare delivery and improving patient outcomes while reducing costs. Negative aspects include healthcare providers lacking access to current research and hospital policies not always aligning with recommendations. The Agency for Healthcare Research and Quality and Patient-Centered Outcomes Research Institute conduct outcomes research to improve healthcare safety, quality, accessibility, equity, and affordability.
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The document discusses quality improvement for reducing diarrhea cases through a handwashing program. It proposes using the FADE model and microsystems approach to design the program. Measurement tools would quantitatively and qualitatively assess handwashing rates, diarrhea incidence, and impact. Ethical considerations include informed consent, confidentiality, and balancing risk of spreading infection against the duty to protect patients. Overall the program aims to determine if handwashing increases and diarrhea cases decrease.
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This document discusses hourly rounding, which involves nurses checking on patients on an hourly basis. It presents national averages for HCAHPS scores and outlines several improved outcomes associated with hourly rounding such as patient satisfaction, safety, and reduced call light usage. The 6P protocol is described which involves greeting the patient and addressing their pain, personal needs, positioning, bathroom needs, and environment. Benefits of hourly rounding include increased HCAHPS scores, hospital reimbursement, and nurse satisfaction and efficiency.
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This document summarizes a research project that aims to improve care for frail older patients through a co-design approach. Key points:
- Researchers from University College Dublin are partnering with healthcare practitioners and patient advocacy groups to design and test a frailty care pathway at St. Vincent's University Hospital.
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- Emerging ideas from workshops include improved communication, mobility, nutrition, hydration and information for patients. Intentional rounding is being tested as a method to regularly check on patients' needs.
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1) Two hospitals implemented regular hourly rounding programs to improve patient experience.
2) Rounding involves checking on patients' needs, pain levels, comfort and safety every 1-2 hours.
3) Early results show reductions in falls and improvements in HCAHPS scores for nursing communication and responsiveness.
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This document discusses hourly rounding, a quality improvement project to improve patient satisfaction and outcomes. It describes who can perform hourly rounding, which involves assessing patients' pain, bathroom needs, possessions, mobility, and other needs every hour. Studies show hourly rounding can increase patient satisfaction scores, decrease call light usage and falls, and improve the work of nurses and other staff. Proper staff training and support is needed to successfully implement hourly rounding.
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Griffith is a multicultural city in south-western NSW, with a population of 16,972, with a greater population living in the surrounding rural and remote areas. Palliative Care & End of Life [EOL] Services, were being provided by a wide range of service providers, in both acute and community sectors. Despite Strategic Planning and Model of Care directives, variation in the integration of services and a lack of resources meant that patients and carers were subject to variations in methods of service delivery.
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Intentional nurse rounding is a structured process where nurses regularly check on patients to address pain, bathroom needs, positioning, and comfort. The evidence shows it can reduce patient call lights by 38%, increase patient satisfaction scores by 12 points, and lower falls by 50% and pressure ulcers by 14%. Key factors for successful implementation include linking the rounds to aims like fall reduction, using measures related to the aims, getting staff and patient input, achieving results before expanding, and celebrating successes.
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Hourly rounding involves nurses proactively checking on patients on an hourly basis to address any needs related to pain, bathroom use, positioning, and proximity of items. Studies have shown that hourly rounding can reduce call light usage by 38%, falls by 50-60%, pressure ulcers by 14%, and improve patient satisfaction scores. Hospitals that implemented hourly rounding also saw increased nursing satisfaction and efficiency due to answering fewer call lights and having more time for other tasks.
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The American Nurses Association (ANA) has a reading room where nurses and consumers can read a variety of position statements. One position statement discusses the expectation that "at the baccalaureate level, education for research prepares nurses to read research critically and to use existing standards to determine the readiness of research for utilization in clinical practice" (American Nursing Association, 2006, p. 8). Developing a project proposal that requires students to critically appraise research and addresses clinical problems through a well-developed solution is a means by which professional studies students at Grand Canyon University meet this expectation and demonstrate mastery of baccalaureate essential skills.
Completion of the capstone experience is evidence that students are able to more fully participate in research and evidence-based practices through their ability to:
Identify clinical problems requiring investigation
Utilize evidence-based literature to answer clinical questions
Critically analyze and critique qualitative studies
Critically analyze and critique quantitative studies
Critically synthesize the literature to make best practice decisions
Assist novice nurses, peers, and interdisciplinary health care workers to utilize evidence-based literature and synthesize research information
Influence the selection of appropriate methods of data collection
Collect data, evaluate data, disseminate findings, and implement best practices in a wide variety of patient care settings
Diffusion of Innovation
Vital information regarding best practices may be disseminated to a broad community of nurses, but it does not necessarily mean nurses will apply the knowledge. What, therefore, is the next step? One theory to consider is diffusion of innovations, originally proposed by Rogers in 1962 (Rogers, 2003). Rogers (2003) postulates that adopters of any new innovation or idea can be categorized based on a bell curve. The categories are: innovators, early adopters, early majority, late majority, and laggards. Awareness, interest, evaluation, trial, and adoption influences an adopter's willingness and ability to adopt a new innovation.
Each category has characteristics that help managers, educators, and researchers determine if someone is ready to adopt a new innovation. As the predictable pattern suggests, innovation will first be accepted and integrated into practice first by early adopters, then by the majority.
Cochrane Collaboration
The Cochrane Collaboration is a great example of dedicated health professionals committed to researching, synthesizing, and disseminating best evidence for providing best practices to help health care workers guide practice. It is the longest running electronic publication in health care.
Cochrane was instrumental in making it known that health care prac.
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Office-GAP is a program designed to improve treatment for patients with diabetes and heart disease through shared decision making. The COMRADE survey was used to assess patient satisfaction with physician communication and confidence in decisions before and after the Office-GAP intervention at 3 and 6 months. Preliminary results are still being analyzed but the study aims to show that shared decision making through Office-GAP can increase patient satisfaction and confidence in healthcare decisions.
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Hospital Pathways programme - Intentional Rounding
Intentional nurse rounding is a structured process where nurses regularly check on patients to address pain, bathroom needs, positioning, and comfort. The evidence shows it can reduce patient call lights by 38%, increase patient satisfaction scores by 12 points, and lower falls by 50% and pressure ulcers by 14%. Key factors for successful implementation include linking the rounds to aims like fall reduction, using measures related to the aims, getting staff and patient input, achieving results before expanding, and celebrating successes.
How supportive are clinical teams of patients self-managing
The document discusses a study that measured how supportive clinical teams are of patients with chronic kidney disease developing skills to self-manage their condition. A survey was given to 358 staff across 10 renal units to measure their support using the Clinical Support for Patient Activation Measure. The results found that most staff support self-management, though some barriers like time constraints and lack of support services were noted. Overall, the study provides a snapshot of attitudes around patient-centered care and highlights the need to further develop healthcare professionals' skills in partnering with patients.
Procedural Sedation Simulation
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Rehabilitation aims to help individuals regain function and independence after injury or illness through processes like relearning skills, adapting to new abilities, and promoting maximum quality of life. It involves an interdisciplinary team that may include physicians, nurses, therapists and social workers. As part of the team, nurses play several key roles like educating and caring for patients, collaborating with other providers, and advocating for patients' needs and goals. The overall focus is on empowering patients and helping them optimize their capabilities.
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Early comprehensive geriatric assessments (CGA) conducted within 24 hours of admission led to shorter hospital stays and better care planning for elderly patients admitted to Wigan Infirmary compared to general geriatric admissions. A single geriatric trainee and nurse practitioner performed CGAs on 20 patients over 8 weeks using a pre-piloted assessment document, identifying needs for further testing, social services, medication reviews, and rehabilitation. The CGAs also facilitated advanced care planning addressing post-discharge needs. Patients who received early CGA had a mean length of stay of 5.9 days versus 12.2 days for general geriatric admissions, demonstrating the effectiveness of early CGA with limited resources in a district general hospital setting.
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Engaging clinicians and patients in the concept and importance of activation
Jonathon Hope, from the Think Kidneys Transforming Participation in CKD team presented at The Kings Fund.
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Hourly rounding involves nurses proactively checking on patients on an hourly basis to address any needs related to pain, bathroom use, positioning, and proximity of items. Studies have shown that hourly rounding can reduce call light usage by 38%, falls by 50-60%, pressure ulcers by 14%, and improve patient satisfaction scores. Hospitals that implemented hourly rounding also saw increased nursing satisfaction and efficiency due to answering fewer call lights and having more time for other tasks.
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The document discusses competencies needed by future medical laboratory science practitioners to improve patient safety and healthcare quality in the 21st century. It outlines six quality aims and five core competencies put forth by the Institute of Medicine. These include developing skills in areas like evidence-based practice, quality improvement, health information technology, patient-centered care, and interdisciplinary teamwork. The document argues that by integrating these concepts into their education, future practitioners will be better prepared to deliver safe and effective laboratory services in modern healthcare systems.
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PCORI challenged teams to develop a proposal or prototype for a patient/researcher ‘matching’ mechanism or system that can effectively connect potential partners interested in seeking funding for rigorous patient-centered outcomes research. Two winners will be announced.
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Heart failure resources
This study aims to determine if a nurse-delivered discharge planning bundle that includes a follow-up phone call within 1 week of discharge will decrease rapid readmissions of patients with heart failure. The researchers will implement a discharge care bundle including patient education and a follow-up phone call on a hospital unit. They will compare rates of readmission before and after the intervention to see if the bundle reduces readmissions. The goal is to improve patient outcomes and lower healthcare costs for heart failure patients.
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The American Nurses Association (ANA) has a reading room where nurses and consumers can read a variety of position statements. One position statement discusses the expectation that "at the baccalaureate level, education for research prepares nurses to read research critically and to use existing standards to determine the readiness of research for utilization in clinical practice" (American Nursing Association, 2006, p. 8). Developing a project proposal that requires students to critically appraise research and addresses clinical problems through a well-developed solution is a means by which professional studies students at Grand Canyon University meet this expectation and demonstrate mastery of baccalaureate essential skills.
Completion of the capstone experience is evidence that students are able to more fully participate in research and evidence-based practices through their ability to:
Identify clinical problems requiring investigation
Utilize evidence-based literature to answer clinical questions
Critically analyze and critique qualitative studies
Critically analyze and critique quantitative studies
Critically synthesize the literature to make best practice decisions
Assist novice nurses, peers, and interdisciplinary health care workers to utilize evidence-based literature and synthesize research information
Influence the selection of appropriate methods of data collection
Collect data, evaluate data, disseminate findings, and implement best practices in a wide variety of patient care settings
Diffusion of Innovation
Vital information regarding best practices may be disseminated to a broad community of nurses, but it does not necessarily mean nurses will apply the knowledge. What, therefore, is the next step? One theory to consider is diffusion of innovations, originally proposed by Rogers in 1962 (Rogers, 2003). Rogers (2003) postulates that adopters of any new innovation or idea can be categorized based on a bell curve. The categories are: innovators, early adopters, early majority, late majority, and laggards. Awareness, interest, evaluation, trial, and adoption influences an adopter's willingness and ability to adopt a new innovation.
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This proposal submission from clinicalMessage responds to the Matchmaking Innovation request to help connect patients and researchers differently. The clinicalMessage platform can engage providers, patients, and researchers to collaboratively develop research questions, share data according to consent, and disseminate results to improve population health outcomes. clinicalMessage currently provides capabilities for patient engagement, provider decision support, and outcomes registries. Partnering with Matchmaking could help clinicalMessage expand these capabilities to more populations and research areas. The proposal demonstrates how clinicalMessage meets the criteria of connecting diverse groups, developing usable models, and maximizing patient-centeredness while ensuring scientific rigor in potential collaborations.
EVIDENCE BASED PRACTICE
This document provides an overview of evidence-based practice (EBP) in healthcare. It defines EBP as integrating the best research evidence, clinical expertise, and patient values and preferences. The key elements of EBP are outlined, including formulating answerable clinical questions using the PICOT format, searching for and appraising evidence, applying evidence to individual patients, and evaluating outcomes. The steps of the EBP process and strategies to bridge the research-practice gap are also summarized. Overall, the document emphasizes that EBP aims to improve clinical decision-making and patient outcomes by basing practices on rigorous research evidence rather than tradition alone.
introduction to evidence based practice 1
evidence based practice that hlps in you reasarch and ease you in reaseach practice. in this presentation many things are given which you learn n your research article.
175 muster2014 dickey
This document outlines a case-based learning approach using interprofessional peer review. Students from various health professions participate in teleconferences reviewing real patient cases from rural Texas hospitals. The peer review process allows students to apply their knowledge to real clinical situations and receive constructive feedback from other professionals. Students found this approach improved their confidence in decision making and interprofessional communication skills. Incorporating students exposes them early in their careers to appreciating a team approach and systems-level perspective for improving patient safety.
The Saskatchewan Surgical Initiative: Lessons Learned
The Surgical Initiative concluded on March 31, 2014; the first system Hoshin to “graduate” to everyday work. Join us for an interactive discussion of the lessons learned over four years of transformational change.
Better Knowledge. Better Health? Making Research Relevant, Accessible, and P...
This document discusses making research more relevant, accessible, and prioritized to patient needs through systematic reviews and knowledge translation. It emphasizes:
1) Involving patients throughout the research process to ensure the questions asked and outcomes measured are truly important to patients.
2) Ensuring research findings are disseminated through various channels in a timely, accessible, and understandable manner so they can inform healthcare decisions.
3) The importance of validity, relevance, and translating research into practical applications to benefit patients.
Systematic reviews of
This document discusses systematic reviews and their usefulness for busy dental practitioners. It introduces the problem of information overload for clinicians trying to stay up to date. Systematic reviews provide a solution by synthesizing large amounts of research into concise summaries. The key features that make systematic reviews reliable include having a clearly defined clinical question, conducting a comprehensive search for relevant studies, using explicit criteria to include/exclude studies, assessing study validity, analyzing inconsistencies, appropriately combining findings, and conclusions supported by evidence. Systematic reviews offer clinicians summaries of the best available evidence to inform patient care decisions.
Change in Healthcare Organizations.docx
This document provides instructions for a proposal to address a problem and drive change within a healthcare organization or the nursing profession. The proposal must identify an issue, describe evidence-based solutions and barriers to change, and develop an implementation plan involving an interprofessional team. Examples of issues include improving patient safety, addressing the nursing shortage, or developing programs around technology, mobility, or mentoring within an organization. The completed 4-6 page proposal must analyze the problem's impacts, cite evidence-based interventions, overcome potential barriers, and outline steps and resources to apply solutions with input from other healthcare professionals.
EVIDENCE BASED DENTISTRY (EBD)
This document provides an overview of evidence-based dentistry (EBD). It begins with an introduction and history of EBD, noting it was first mentioned in dental literature in the 1990s. It then defines EBD as using systematic assessments of scientific evidence, clinical expertise, and patient preferences/needs. The document outlines the goals and steps of EBD, including asking answerable clinical questions, acquiring evidence, appraising evidence, applying evidence to patients, and assessing outcomes. It discusses benefits like using highest quality research and treating patients consistently. In conclusion, the document states EBD provides an ethical, patient-centered approach through combining clinical expertise, high quality evidence, and patient preferences.
Quality , standrads and ethics
This document outlines quality of care standards, ethics, and legal issues in healthcare. It discusses key aspects of quality like safety, effectiveness, patient-centered care, and timely care. It also examines measuring quality through structures, processes, and outcomes. Standards of care from organizations like the American Nurses Association are presented for nursing practice. Common ethical issues in nursing involving confidentiality, restraints, and end-of-life care are also summarized.
7. The Care Team Reimagined
Donna Cooper and Ayal Bitton - Rethinking the traditional one-patient-to-provider value proposition at Advocate Medical Group, as a way to expand access to care while balancing patient preferences for provider continuity.
Quality Circle.docx
Quality circles originated in Japan after World War II and were inspired by W. Edwards Deming. Quality circles involve voluntary small groups of 6-12 employees who meet regularly to identify improvements in their work area. In healthcare, quality circles are used to (1) identify outstanding features of care, (2) identify obstacles to change, and (3) identify the need for more research. Examples of using quality circles in healthcare include reducing hospital-acquired infections, improving job satisfaction, and enhancing communication.
Clinical policy guidelines
This document contains the 2013 Clinical Policy Guidelines of the National Abortion Federation. It establishes clinical standards, recommendations, and options for abortion care based on rigorous review of medical literature and patient outcomes. The guidelines cover topics such as who can provide abortions, informed consent, infection prevention, ultrasound use, medical and surgical abortion procedures, complications management, and more. The National Abortion Federation develops these guidelines to help ensure safe, legal, and accessible abortion care that promotes health and justice for women.
9 of 13 I VALUE-DRIVENThe Ali & Science of Evidence-Based .docx
9 of 13 I VALUE-DRIVEN
The Ali & Science of Evidence-Based Care
RESEARCH BY MATTHEW WEINSTOCK
T
he shift to a value-driven delivery model hinges on a
key element: patients' achieving the best possible out-
comes. The linchpin to that is ensuring that clinicians
regularly follovi best practices and adhere to evidence-
based protocols.
"If this [transformation] is about value and value equals qual-
ity divided by cost, then it makes sense that you look at the evi-
dence," says Joseph Pepe, M.D., CEO of Catholic Medical Center,
Manchester, N.H.
Pepe, who served as CMC's chief medical officer for 12 years
before moving into the chief executive role in 2012, acknowledges
that one of the biggest stumbling blocks to instituting evidence-
based practice more broadly is the fear that it is "cookbook medi-
cine." That's a passé notion, he says. Evidence-based care is not
only about following results from the most recent clinical studies,
but blending that with a patient's values and desires, as well as
relying on a physician's judgment.
"Physicians have gotten a bad rap," says Jean Slutsky, direc-
tor of the Center for Outcomes and Evidence at the Agency for
Healthcare Research and Quality, when talking about the percep-
tion that doctors routinely reject the move toward evidence-based
care. "Physicians are lifelong learners. The very nature of what
they do is about learning."
A 2008 AHRQ handbook on implementing evidence-based
care supports the notion that this is not a completely rigid process.
It defines evidence-based care as "the use of current best evidence
I ABOUTTHISSERIES I
H&HN created this exclusive Fiscal Fitness series with the support of the VHA last year to highlight strategies
hospitals are using to improve quality of care while increasing efficiencies and reining in expenses. In 2013,
the series will focus on organizations that are demonstrating high-value health care
with measurable results. Follow the Fiscal Fitness series in our magazine, in our
e-newsletter H&HN Daily and on our website at www.hhnmag.com/fiscalfitness.
in conjunction with clinical expertise and patient values to guide health
care decisions." That definition first was popularized by David Sackett,
a Canadian doctor, in a 1996 British Medical Journal editorial. "Good
doctors use both individual clinical expertise and the best available
external evidence, and neither alone is enough," he argued.
For example, Slutsky says, the evidence may suggest that a patient
be put on a certain medication. Best practice may be to prescribe one
pill a day for 10 days. In a shared-decision model, which is also a critical
part of the process, the physician and patient would discuss the best
option available — perhaps it is using a different drug on the formulary
that's more affordable but requires the patient to take the medication
three times a day.
Another factor to consider: "What level of risk for side effects is
the patient wilHng t.
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- 1. Best practice guidelines are designed for Question 3 populations of patients and there is an inevitable challenge when providers are asked to make Given that medicine is an decisions for individuals patients art as well as a science, it’s inevitable that Providers should focus on delivering care that reasonable doctors will creates value for patients disagree on which Our research group has created a tool called “The practices are best. How Value Framework.” It’s a simple and concise can we take this framework to help providers decide if the medical disagreement into account by incorporating intervention will create value for their patients. clinical judgment into guidelines on best practices?