Eval Clin Pract Research Articles

Concretization, please: A commentary on Turcotte, Holmes, and Murray.

Concretization, please: A commentary on Turcotte, Holmes, and Murray.

Understanding the research agenda within renal nursing: an ANNUK project

Journal of Kidney CareVol. 8, No. 2 Society UpdateUnderstanding the research agenda within renal nursing: an ANNUK projectSarah BrandSarah BrandEmail: E-mail Address: [email protected]Assistant Divisional Nurse, CAS; Senior Research Nurse, Renal and Transplant UnitSearch for more papers by this authorSarah BrandPublished Online:21 Mar 2023https://doi.org/10.12968/jokc.2023.8.2.91AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References AbuRuz ME, Hayeah HA, Al-Dweik G, Al-Akash HY. Knowledge, attitudes, and practice about evidence-based practice: a Jordanian study. Health Science Journal. 2017;11(2):1. https://doi.org/10.21767/1791-809X.1000489 Google ScholarEmpranza JL, Cabello JB, Burls AJ. Does evidence-based practice improve patient outcomes? An analysis of a natural experiment in a Spanish hospital. J Eval Clin Pract. 2015;21(6):1059–1065. https://doi.org/10.1111/jep.12460 Google ScholarMelnyk BM, Fineout-Overhold E, Stillwell SB, Williamson KM. Evidence-based practice: step by step: igniting a spirit of inquiry. Am J Nurse. 2009;109(11):49–52. https://doi.org/10.1097/01/NAJ.0000363354.53883.58 Google ScholarMelnyk BM, Fineout-Overhold E, Stillwell SB, Williamson KM. Evidence-based practice: step by step: the seven steps of evidence-based practice. Am J Nurse. 2010;110(1):51–53. https://doi.org/10.1097/01.NAJ.0000366056.06605.d2 Google ScholarPowers J. Increasing capacity for nursing research in magnet-designated organizations to promote nursing research. Appl Nurs Res. 2020;55(1):1–6. https://doi.org/10.1016/j.apnr.2020.151286 Google ScholarSmyth A, Carter V, Dube A, Cannaby AM. How a better understanding of nursing research roles may help to embed research into clinical structures. Br J Nurs. 2022;31(17):1–7. https://doi.org/10.12968/bjon.2022.31.17.902 Google ScholarStraus SE, Glasziou P, Richardson WS, Haynes RB. Evidence-based medicine: how to practice and teach it. Edinburgh: Churchill Livingstone Elsevier; 2011 Google Scholar FiguresReferencesRelatedDetails 2 March 2023Volume 8Issue 2ISSN (print): 2397-9534ISSN (online): 2397-9542 Metrics History Published online 21 March 2023 Published in print 2 March 2023 Information© MA Healthcare LimitedKeywordssupportcollaborative workingspeacial interest groupsspecialist nursesPDF download

The German version of the Cultural Competence Assessment (CCA-G): cross-cultural adaptation and validation study in Austrian acute care settings

BackgroundAdapting practices to respond sensitively to increasingly culturally diverse patients can be challenging. Therefore, cultural competence among nurses needs to be assessed to evaluate their current cultural competence and the need for interventions to improve daily nursing practice. Little is known about cultural competence of nurses in German-speaking countries, including Austria, as there is currently no validated tool in German to assess cultural competence in nurses. The aims of this study were to translate and cross-culturally adapt the Cultural Competence Assessment scale in German and to evaluate its psychometric properties.MethodsThis is a methodology study with a cross-sectional design. Conducting a convenience sampling, Austrian nurses working in the direct care of patients in acute care settings were invited to participate in this study. Data collection was conducted in March 2021. The translation and cross-cultural adaptation were conducted by following the guidelines of Sousa et al. (J Eval Clin Pract 17:268-74, 2011) and Beaton et al. (Spine 25:3186-91, 2000). The face and content validity, structural validity, and internal consistency reliability of the Cultural Competence Assessment scale, which consists of 25 items, was evaluated. Data were analysed using content validity index, confirmatory factor analyses as well as McDonald’s Omega. Descriptive statistics were computed with the statistical software IBM SPSS Statistics 26, while the confirmatory factor analysis was conducted with the R package Lavaan.ResultsOverall, 915 nurses completed the questionnaire. Twenty items had an acceptable item content validity index. Using confirmatory factor analyses, a two-factor model with 14 items yielded a good fit (x2/df = 3.16; CFI = .923; TLI = .908; RMSEA = .055 (.049–.062) and SRMR = .039). Internal consistency reliability was found to be acceptable, as indicated by a Omega of .87.ConclusionThe German version of the Cultural Competence Assessment scale (CCA-G) can be recommended for measuring cultural competence behaviour of nurses in acute care settings. The 14-item scale showed strong construct validity and acceptable internal consistency. Further research using repeated measures could determine the cultural sensitivity and indicate if the tool is applicable in other healthcare settings and for other healthcare professionals.

Harmonising patient-access programmes: the Dutch DRUG Access Protocol platform.

Over the past decades, many new targeted anticancer drugs have been introduced, and many more are expected to follow. Many of these drugs are only being tested in non-randomised studies, as they target small and newly defined patient populations. This approach is concerning, given that non-randomised studies are susceptible to bias and confounding and there is no consensus on critical appraisal tools or review methodologies. 1 Quigley JM Thompson JC Halfpenny NJ Scott DA Critical appraisal of nonrandomized studies—a review of recommended and commonly used tools. J Eval Clin Pract. 2019; 25: 44-52 Google Scholar Health-care authorities and payers, therefore, often raise concerns about the clinical effectiveness and cost-effectiveness of these therapies, which leads to lengthy dossier evaluation and price negotiations. The DRUG Access Protocol: access inequality and European harmonisationWe commend the initiators of the DRUG Access Protocol (DAP) for their efforts to combine earlier access to medicine with structured data collection.1 Although this is a novel programme in the Netherlands, similar programmes covering compassionate use, evidence generation, and reimbursement are already in effect in England (Early Access to Medicines Scheme) and France (L'Accès Précoce).2,3 The benefits of the DAP in providing conditional reimbursement of registered drugs and thereby creating access are evident. Full-Text PDF The DRUG Access Protocol: access inequality and European harmonisation – Authors' replyWe would like to respond to the comments of Tobias Polak and colleagues on the establishment of the DRUG Access Protocol (DAP) in the Netherlands.1 First, we fully agree that there is a clear, unmet need to systematically collect data and prevent delayed and unequal access to effective drugs; these were the most important reasons for initiating DAP. Therefore, the concerns of Polak and colleagues surprised us. First, DAP is indeed a national solution, simply because each country has its own system for evaluating drugs and reimbursement. Full-Text PDF

Healthcare professionals and further engagement in research

British Journal of Neuroscience NursingVol. 17, No. 5 EditorialHealthcare professionals and further engagement in researchAlison McLoughlinAlison McLoughlinSearch for more papers by this authorAlison McLoughlinPublished Online:25 Oct 2021https://doi.org/10.12968/bjnn.2021.17.5.176AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Boaz A, Hanney S, Jones T, Soper B. Does the engagement of clinicians and organisations in research improve healthcare performance: a three-stage review. BMJ Open. 2015;5(12):e009415. https://doi.org/10.1136/bmjopen-2015-009415 Crossref, Google ScholarDimova S, Prideaux R, Ball S, et al. Enabling NHS Staff to contribute to research: reflecting on current practice and informing future opportunities. RAND Europe. 2018. www.rand.org/pubs/research_reports/RR2679.html (accessed 20 September 2021) Google ScholarDepartment of Health and Social Care. Developing the role of the clinical academic researcher in the nursing, midwifery and allied health professions. 2021. www.gov.uk/government/publications/developing-the-role-of-the-clinical-academic-researcher-in-the-nursing-midwifery-and-allied-health-professions (accessed 20 September 2021) Google ScholarGibbs CL, Lowton K. The role of the clinical research nurse. Nurs Stand. 2012;26(27):37–40. https://doi.org/10.7748/ns2012.03.26.27.37.c8986 Crossref, Google ScholarJones D, Keenan A. The rise and rise of NMAHPs in UK clinical research. Future Healthc J. 2021;8(2). https://doi.org/10.7861/fhj.2021-0098 Crossref, Google ScholarJonker L, Fisher SJ, Dagnan D. Patients admitted to more research-active hospitals have more confidence in staff and are better informed about their condition and medication: Results from a retrospective cross-sectional study. J Eval Clin Pract. 2020;26(1):203–208. https://doi.org/10.1111/jep.13118 Crossref, Google ScholarNational Institute for Health Research. CQC Inspections to give more exposure to clinical research taking place in the NHS. 2018. www.nihr.ac.uk/news/cqc-inspections-to-give-more-exposure-to-clinical-research-taking-place-in-nhs-trusts/11185 (accessed 20 September 2021) Google ScholarOzdemir BA, Karthikesalingam A, Sinha S et al. Research activity and the association with mortality. PLoS One. 2015;10(2):e0118253. https://doi.org/10.1371/journal.pone.0118253 Crossref, Google ScholarRoyal College of Physicians. Delivering research for all: expectations and aspirations for the NHS in England. 2019. www.rcplondon.ac.uk/guidelines-policy/delivering-research-all-expectations-and-aspirations-nhs-england (accessed 20 September 2021) Google ScholarScala E, Price C, Day J. An integrative review of engaging clinical nurses in nursing research. J Nurs Scholarsh. 2016;48(4):423–430. https://doi.org/10.1111/jnu.12223 Crossref, Google ScholarTrusson D, Rowley E, Bramley L. A mixed-methods study of challenges and benefits of clinical academic careers for nurses, midwives and allied health professionals. BMJ Open. 2019;9(10):e030595. https://doi.org/10.1136/bmjopen-2019-030595 Crossref, Google ScholarWestwood G, Richardson A, Latter S, Macleod Clark J, Fader M. Building clinical academic leadership capacity: sustainability through partnership. J Res Nurs. 2018;23(4):346–357. https://doi.org/10.1177/1744987117748348 Crossref, Google Scholar FiguresReferencesRelatedDetails 2 October 2021Volume 17Issue 5ISSN (print): 1747-0307ISSN (online): 2052-2800 Metrics History Published online 25 October 2021 Published in print 2 October 2021 Information© MA Healthcare LimitedPDF download

Forming a Doctor-Patient Alliance During COVID-19 to Enhance Treatment Outcomes for Obsessive-Compulsive Disorder.

Forming a Doctor-Patient Alliance During COVID-19 to Enhance Treatment Outcomes for Obsessive-Compulsive Disorder.

Using preprints in evidence synthesis: Commentary on experience during the COVID-19 pandemic

Using preprints in evidence synthesis: Commentary on experience during the COVID-19 pandemic

Reply to: Let us not rush back to odds ratios in meta-analysis

Leucht [ [1] Leucht S. Let us not rush back to odds ratios without a recommendation to convert them to interpretable measures. J Clin Epidemiol. 2021; : S0895-4356-4358https://doi.org/10.1016/j.jclinepi.2021.02.017 Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar ] responds to our paper [ [2] Doi SA Furuya-Kanamori L Xu C Lin L Chivese T Thalib L. Questionable utility of the relative risk in clinical research: a call for change to practice. J Clin Epidemiol. 2020; (S0895-4356(20)31171-9) Abstract Full Text Full Text PDF Scopus (23) Google Scholar ] and raises the point that odds ratios (OR) are less intuitive and suggests that we should temper the recommendation that ORs should be preferred over relative risks (RRs) in meta-analyses. Leucht suggests that even if meta-analysts were to derive RRs from ORs, since they use average baseline risks from the included trials, the RR calculated directly will usually be similar to that derived from an OR. While it may be possible (as in the example cited by Leucht) for the RR and OR to numerically coincide, there are two reasons why this cannot be recommended. First, the RRs across studies at different baseline risks are not comparable and therefore should not be synthesized [ [2] Doi SA Furuya-Kanamori L Xu C Lin L Chivese T Thalib L. Questionable utility of the relative risk in clinical research: a call for change to practice. J Clin Epidemiol. 2020; (S0895-4356(20)31171-9) Abstract Full Text Full Text PDF Scopus (23) Google Scholar ]. Second, the synthesized RR (had the baseline risks across studies been similar) cannot be applied beyond the baseline risk observed. For example a RR of 2 at a baseline risk of 40% does not apply to a baseline risk of 60% [ [2] Doi SA Furuya-Kanamori L Xu C Lin L Chivese T Thalib L. Questionable utility of the relative risk in clinical research: a call for change to practice. J Clin Epidemiol. 2020; (S0895-4356(20)31171-9) Abstract Full Text Full Text PDF Scopus (23) Google Scholar , [3] Llewelyn H. The scope and conventions of evidence-based medicine need to be widened to deal with ``too much medicine''. J Eval Clin Pract. 2018; 24: 1026-1032 Crossref PubMed Scopus (7) Google Scholar . Thus RRs lack transportability across clinical settings and patient risk profiles and therefore should not be the effect size of interest in meta-analysis.

Corrigendum

Journal of Evaluation in Clinical PracticeVolume 27, Issue 1 p. 204-204 CORRIGENDUMFree Access Corrigendum This article corrects the following: Improving screening and brief intervention activities in primary health care: Secondary analysis of professional accuracy based on the AUDIT-C J. Palacio-Vieira PhD, L. Segura MSc, P. Anderson MD, MPH, PhD, FRCP, A. Wolstenholme MA(Hons) MPH, C. Drummond PhD, P. Bendtsen PhD, M. Wojnar PhD, E. Kaner PhD, HonFRCP, HonMFPH, M.N. Keurhorst PhD, B. Steenkiste PhD, K. Kłoda PhD, A. Mierzecki PhD, K. Parkinson PhD, D. Newbury-Birch PhD, K. Okulicz-Kozaryn MD, P. Deluca PhD, J. Colom MSc, A. Gual PhD, Volume 24Issue 2Journal of Evaluation in Clinical Practice pages: 369-374 First Published online: December 1, 2017 First published: 22 October 2020 https://doi.org/10.1111/jep.13505AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL In article Palacio-Vieira J et al1 , an acknowledgement section was missed and should have read: Acknowledgements Segura L. Performs this work in the context of the Interuniversity Doctoral Study Program in Psychology of Communication and Change. Autonomous University of Barcelona (UAB) and University of Barcelona (UB). The authors wish to apologize for the oversight. References 1Palacio-Vieira J, Segura L, Anderson P, et al. Improving screening and brief intervention activities in primary health care: Secondary analysis of professional accuracy based on the AUDIT-C. J Eval Clin Pract. 2018; 24(2): 369- 374. Volume27, Issue1February 2021Pages 204-204 ReferencesRelatedInformation

The classic “Carrot-and-stick approach”: Addressing underutilization of ICD-10 increased data granularity

The classic “Carrot-and-stick approach”: Addressing underutilization of ICD-10 increased data granularity

A critical review of the development of advanced practice competency frameworks and their contribution to autonomous practice

A critical review of the development of advanced practice competency frameworks and their contribution to autonomous practice

Finding the key to learning

British Journal of Healthcare AssistantsVol. 14, No. 2 ProfessionalFinding the key to learningAngela GraingerAngela GraingerConsultant Editor, BJHCA, and Senior Lecturer, BPP University School of NursingSearch for more papers by this authorAngela GraingerPublished Online:12 Feb 2020https://doi.org/10.12968/bjha.2020.14.2.63AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Biggs J, Tang C. Teaching for quality learning at university. London: Open University Press; 2011 Google ScholarBritton JC, Lissek S, Grillon C, Norcross MA, Pine DS. Development of anxiety: the role of threat appraisal and fear learning. Depress Anxiety. 2011 Jan;28(1):5–17 Crossref, Google ScholarCavendish C. The Cavendish review. An independent report into a review of healthcare assistants and support workers in NHS and social care. 2013. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/236212/Cavendish_Review.pdf (accessed 9 January 2020) Google ScholarDaines J, Daines C, Graham B. Adult learning, adult teaching. 4th edn. Cardiff: Welsh Academic Press; 2006 Google ScholarEvans D, Allen H. Emotional intelligence: its role in training. Nurs Times. 2002 Jul 2–8;98(27):41–42 Google ScholarGibbs G. Learning by doing: a guide into teaching and learning methods. Oxford: Further Education Unit, Oxford Polytechnic; 1988. Google ScholarGolman D. Emotional intelligence: why it can matter more than IQ. London: Bloomsbury Publishing; 1996 Google ScholarGrainger A. Lifelong learning, personal growth and resilience. British Journal of Healthcare Assistants. 2019;13(2):90–94 Link, Google ScholarHancock H, Campbell S, Ramprogus V, Kilgour J. Role development in healthcare assistants: the impact of education on practice. J Eval Clin Pract. 2005 Oct;11(5):489–498 Crossref, Google ScholarJohns C, ed. Becoming a reflective practitioner. 5th edn. Oxford: Wiley Blackwell; 2017 Google ScholarKessler I, Heron P, Dopson S, Magee H, Swain D, Askham J. The nature and consequences of support workers in a hospital setting. NIHR Service Delivery and Organisation Programmes. National Institute for Health Research. 2010. http://www.netscc.ac.uk/netscc/hsdr/files/project/SDO_FR_08-1619-155_V01.pdf (accessed 9 January 2020) Google ScholarKolb DA. Experiential learning: experience as the source of learning and development. Englewood Cliffs NJ: Prentice Hall; 1984 Google ScholarNursing and Midwifery Council. What is a nursing associate? 2019. https://www.nmc.org.uk/standards/nursing-associates/what-is-a-nursing-associate/ (accessed 9 January 2020) Google ScholarOxford English Dictionary. The definition of learning. Oxford: Oxford University Press; 2016 Google ScholarRolfe G, Freshwater D, Jasper M. Critical reflection in nursing and the helping professions: a user's guide. Basingstoke: Palgrave Macmillan; 2001 Google ScholarRoyal College of Physicians. National Early Warning Score (NEWS 2). 2017. https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2 (accessed 9 January 2020) Google ScholarThornley C. The invisible workers: an investigation into the pay and employment of health care assistants in the NHS. London: Unison; 1997 Google ScholarThornley C. A question of competence? Re-revaluating the role of the nursing auxiliary and healthcare assistants in the NHS. J Clin Nurs. 2000 May;9(3):451–458 Crossref, Google ScholarTosey P, Mathison J. Neuro-linguistic programming: its potential for learning and teaching in formal education. Paper presented at the European Conference on Educational Research. University of Hamburg, Germany. 17–20 September 2003. 2003. Leeds.ac.uk/educol/documents/00003319.htm (accessed 27th December 2019) Google ScholarVan Ameringen M, Mancini C, Farvolden P. The impact of anxiety disorders on educational achievement. J Anxiety Disord. 2003;17(5):561–71 Crossref, Google Scholar FiguresReferencesRelatedDetailsCited bySupporting others to learn: the role of the HCAAngela Grainger8 May 2020 | British Journal of Healthcare Assistants, Vol. 14, No. 5 2 February 2020Volume 14Issue 2ISSN (print): 1753-1586ISSN (online): 2052-4420 Metrics History Published online 12 February 2020 Published in print 2 February 2020 Information© MA Healthcare LimitedPDF download

Automated Dispensing Cabinets Can Help or Hinder Patient Safety Based On the Implementation of Safeguard Strategies

Automated dispensing cabinets (ADCs), also known as automated distribution devices or automated dispensing machines, were first introduced in hospitals in the 1980s and function as an electronic point-of-care storage device for medication distribution. 1 Paparella S. Automated medication dispensing systems: not error free. J Emerg Nurs. 2006; 32: 71-74 Abstract Full Text Full Text PDF PubMed Scopus (16) Google Scholar , 2 Harolds J.A. Harolds L.B. Quality and safety in health care, part x. Other technology to reduce medication errors. Clin Nucl Med. 2016; 41: 376-378 Google Scholar , 3 Grissinger M. Safeguards for using and designing automated dispensing cabinets. P T. 2012; 37: 490-530 PubMed Google Scholar , 4 Brummond P.W. Chen D.F. Churchill W.W. et al. ASHP guidelines on preventing diversion of controlled substances. Am J Health Syst Pharm. 2017; 74: 325-348 Google Scholar , 5 Roman C. Poole S. Walker C. Smit D.V. Dooley M.J. A “time and motion” evaluation of automated dispensing machines in the emergency department. Australas Emerg Nurs J. 2016; 19: 112-117 Abstract Full Text Full Text PDF Scopus (15) Google Scholar Varying levels of decentralized drug distribution can be accomplished using an ADC, including in outpatient areas, such as the emergency department. 6 Findlay R. Webb A. Lund J. Implementation of advanced inventory management functionality in automated dispensing cabinets. Hosp Pharm. 2015; 50: 603-608 Google Scholar , 7 McCarthy Jr., B.C. Ferker M. Implementation and optimization of automated dispensing cabinet technology. Am J Health Syst Pharm. 2016; 73: 1531-1536 Google Scholar , 8 Fanning L. Jones N. Manias E. Impact of automated dispensing cabinets on medication selection and preparation error rates in an emergency department: a prospective and direct observational before-and-after study. J Eval Clin Pract. 2016; 22: 156-163 Google Scholar ADC functionality has advanced over the years, providing the potential for safety advantages compared with nonautomated storage options, such as reduced medication selection errors, enhanced efficiency among nursing and pharmacy disciplines, and the ability to monitor inventory and deter drug diversion by way of accurate medication tracking and record keeping. 3 Grissinger M. Safeguards for using and designing automated dispensing cabinets. P T. 2012; 37: 490-530 PubMed Google Scholar , 5 Roman C. Poole S. Walker C. Smit D.V. Dooley M.J. A “time and motion” evaluation of automated dispensing machines in the emergency department. Australas Emerg Nurs J. 2016; 19: 112-117 Abstract Full Text Full Text PDF Scopus (15) Google Scholar , 7 McCarthy Jr., B.C. Ferker M. Implementation and optimization of automated dispensing cabinet technology. Am J Health Syst Pharm. 2016; 73: 1531-1536 Google Scholar , 8 Fanning L. Jones N. Manias E. Impact of automated dispensing cabinets on medication selection and preparation error rates in an emergency department: a prospective and direct observational before-and-after study. J Eval Clin Pract. 2016; 22: 156-163 Google Scholar , 9 Billstein-Leber M. Carillo C.J.D. Cassano A.T. Moline K. Robertson J.J. ASHP guidelines on preventing medication errors in hospitals. Am J Health Syst Pharm. 2018; 75: 1493-1517 Google Scholar However, such safety gains can be achieved only with careful planning and implementation of automated dispensing systems, along with well-designed and clearly communicated practice expectations for practitioner interaction with the device. Without attention to such details, the risk of medication errors can still be present with ADC use. Samantha J. Burton is 2018-19 Institute for Safe Medication Practices (ISMP*) Safe Medication Management Fellow, ISMP, Horsham, PA.

Rethinking the doctor-patient relationship: toward a hermeneutically-informed epistemology of medical practice.

Although typically implicit, clinicians face an inherent conflict between their roles as medical healers and as providers of technical biomedicine (Scott et al. in Philos Ethics Humanit Med 4:11, 2009). This conflict arises from the tension between the physicalist model which still predominates in medical training and practice and the extra-physicalist dimensions of medical practice as epitomised in the concept of patient-centred care. More specifically, the problem is that, as grounded in a "borrowed" physicalist philosophy, the dominant "applied scientist" model exhibits a number of limitations which severely restrict its ability to underwrite the effective practice of care. Moreover, being structural in character, these problems cannot be resolved by piecemeal modifications of the existing model, nor by an appeal to evidence-based medicine (Miles in J Eval Clin Pract 15(6):887-890, 2009; Miles in Folia Med 55(1):5-24, 2013; Miles et al. in J Eval Clin Pract 14(5):621-649, 2008). Hence, the need for medical theorists to "partner with experts in the humanities to build a sui generis philosophy of medicine" (Whatley in J Eval Clin Pract 20(6):961-964, 2014, p.961). In response, the present paper seeks to vindicate the merits of hermeneutically-informed template in providing the requisite grounding. While capable of correcting for the limitations of the applied scientist model, a hermeneutically-informed template is a "both/and" approach, which seeks to complement rather than exclude the physicalist dimension, and thereby aspires to reconcile technical mastery with patient-centred care, rather than eschew one in favour of the other. As such, it can provide a cogent philosophical template for current best practice, which does justice to the art as well as the science of medical care.

SOAP to SOAP-V: A New Paradigm for Teaching Students High Value Care

SOAP to SOAP-V: A New Paradigm for Teaching Students High Value Care

Cost Effectiveness of Achieving Targets of Low-Density Lipoprotein Particle Number Versus Low-Density Lipoprotein Cholesterol Level

A recent analysis of a commercially insured US population found fewer cardiovascular disease (CVD) events in high-risk patients attaining low levels of low-density lipoprotein (LDL), as measured by LDL particle number (LDL-P) versus low LDL cholesterol (LDL-C). Here, we investigated the cost effectiveness of LDL-lowering therapy guided by LDL-P. Patients were selected from the HealthCore Integrated Research Database and followed for 12 to 36months. Patients who achieved LDL-P <1,000nmol/l were placed into the LDL-P cohort, whereas those without LDL-P tests, but who achieved LDL-C <100mg/dl, were placed into the LDL-C cohort. CVD-related costs included all health plan paid amounts related to CVD events or lipid management. Cost effectiveness was assessed through incremental cost-effectiveness ratios, defined as difference in total costs across the cohorts divided by difference in CVD events, measured over follow-up. Each cohort included 2,094, 1,242, and 705 patients over 12-, 24-, and 36-month follow-up. Patients in the LDL-P cohort received more aggressive lipid-lowering therapy and had fewer CVD events during follow-up compared to patients in the LDL-C cohort. This led to greater pharmacy costs and lower medical costs over time. Incremental cost-effectiveness ratio estimates ranged from $23,131 per CVD event avoided at 12months to $3,439 and-$4,555 at 24- and 36-month follow-up, suggesting a high likelihood that achieving LDL-P <1,000nmol/l is cost effective. In conclusion, LDL-lowering therapy guided by LDL-P was demonstrated to be cost effective, with greater clinical and economic benefit seen over longer time horizons and with the increased use of generic statins.

PWE-416 Does a general surgery dual-specialty consultant on-call system improve emergency access to appropriate specialist surgery?

Introduction Subspecialisation within general surgery has resulted in concerns over the provision of emergency surgical care. Outcomes after some elective surgery have been shown to be better when performed by a surgeons of an appropriate subspeciality.1Some advocate emergency surgery should be considered in the same way, and performed by appropriately trained specialists. A dual consultant on-call system has been proposed as a means of ensuring this occur. This study aims to identify whether patients receive subspecialty emergency surgical intervention using an in-hours dual consultant on-call system. Method A prospective review of all emergency laparotomies performed at a single centre from 11/01/2014 to 12/01/2015. Data was collected on indication for surgery, operative findings, subspecialty interest of operating surgeon, and the timeliness of surgery compared to CEPOD operative urgency grading. Operations were classified as General: suitable for any surgeon (GEN); Upper Gastrointestinal (UGI); and Colorectal (COL). Our centre operated a dual consultant on call system within normal working hours, and single consultant outside hours. Results 306 emergency laparotomies were identified. 169 (55%) were classified as GEN; 22 (7%), UGI; 115 (38%), COL by procedure. The most senior surgeon present was consultant in 281 (92%) of cases, Specialist Trainee in 24 (8%), and unknown in 1. (36) 12% of cases were due to a complication of previous surgery. 20% of cases were performed out-of-hours. Within normal working hours, 90 of 103 (87.4%) operations of a specialist nature were performed by a consultant surgeon of that specialty. Outside of these hours, this figure was 15 out of 27 (55.6%). 95% of cases were performed within the NCEPOD operative timing classification. Conclusion A dual consultant on-call system does result in the majority of patients receiving emergency care by a surgeon with the appropriate subspeciality interest, and allows this to occur in a timely fashion. Disclosure of interest None Declared. Reference Anwar S, Fraser S, Hill J. Surgical specialization and training – its relation to clinical outcome for colorectal cancer surgery. J Eval Clin Pract. 2012 Feb;18(1):5–11

Repair of congenital diaphragmatic hernia under high-frequency oscillatory ventilation in high-risk patients: an opportunity for earlier repair while minimizing lung injury.

BACKGROUNDRepair of congenital diaphragmatic hernia (CDH) is ideally delayed until ventilatory parameters are stabilized and patients are switched to conventional ventilation. However, in selected high-risk patients, repair can be performed earlier while they are still on high-frequency oscillatory ventilation (HFOV).DESIGN AND SETTINGSA retrospective review of all CDH cases treated in our tertiary referral center between 1997 and 2013.METHODSIn 1997, we started repairing selected high-risk CDH cases under HFOV with or without inhaled nitric oxide (iNO). All repairs were performed once the infants’ blood gas levels were acceptable. The infants were gradually weaned to conventional ventilation followed by extubation as their ventilatory parameters improved. Their records were reviewed to determine the group-wide outcomes.RESULTSBetween 1997 and 2013, 55 infants with CDH were treated in our institute; of these 12 high-risk cases were repaired under HFOV/iNO combinations and 1 was repaired without iNO. All patients had significant pulmonary hypertension and 8 had herniated livers. The mean age at repair was 9.1 (6.3) days. Two mortalities occurred at the first and tenth postoperative days. Among the remaining 11 survivors, the median ventilation and hospitalization days were 29.5 (11–84) and 45.5 (25–107), respectively, and the median duration under HFOV and conventional ventilation days were 15 (9–40) and 12 (3–47), respectively.CONCLUSIONCDH repair can be performed earlier under HFOV and iNO. The possible advantages are earlier restoration of normal anatomy and earlier start of enteral feeding while minimizing the risk of lung injury.

The One Million Global Catheters PIVC worldwide prevalence study

British Journal of NursingVol. 23, No. Sup8 Research and GuidelinesThe One Million Global Catheters PIVC worldwide prevalence studyEvan AlexandrouEvan AlexandrouSearch for more papers by this authorEvan AlexandrouPublished Online:6 May 2014https://doi.org/10.12968/bjon.2014.23.Sup8.S16AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Ahlqvist M, Berglund B, Nordstrom G, Klang B, Wirén M, Johansson E (2010) A new reliable tool (PVC assess) for assessment of peripheral venous catheters. J Eval Clin Pract 16(6): 1108–15. doi: https://doi.org/10.1111/j.1365-2753.2009.01278.x Crossref, Medline, Google ScholarKagel EM, Rayan GM (2004) Intravenous catheter complications in the hand and forearm. J Trauma 56(1): 123–7. doi: https://doi.org/10.1097/01.TA.0000058126.72962.74 Crossref, Medline, Google ScholarMaki DG, Kluger DM, Crnich CJ (2006) The risk of bloodstream infection in adults with different intravascular devices: a systematic review of 200 published prospective studies. Mayo Clin Proc 81(9): 1159–71. http://bit.ly/R9JTjG Google ScholarWebster J, Clarke S, Paterson Det al. (2008) Routine care of peripheral intravenous catheters versus clinically indicated replacement: randomised controlled trial. BMJ 337: a339. doi: https://doi.org/http://dx.doi.org/10.1136/bmj.a339 Crossref, Medline, Google ScholarZingg W, Pittet D (2009) Peripheral venous catheters: an under-evaluated problem. Int J Antimicrob Agents 34(Suppl 4): S38–42. doi: https://doi.org/10.1016/S0924-8579(09)70565-5 Crossref, Medline, Google Scholar FiguresReferencesRelatedDetailsCited byThe effects of ultrasound guidance on first-attempt success for difficult peripheral intravenous catheterization: a systematic review and meta-analysis20 January 2023 | European Journal of Emergency Medicine, Vol. 30, No. 2Ultraschallgesteuerte periphere Venenpunktion bei schlechtem Venenstatus8 February 2023 | Die Anaesthesiologie, Vol. 23The effect of clinical guideline education on the knowledge and practice of nurses for peripheral intravenous catheter placement based on short message service: A quasi-experimental study30 May 2022 | The Journal of Vascular Access, Vol. 24Ultrasound-Guided Peripheral Intravenous Catheter Insertion Training Reduces Use of Midline Catheters in Hospitalized Patients With Difficult Intravenous Access27 September 2021 | Journal of Patient Safety, Vol. 18, No. 3The impact of a notched peripheral intravenous catheter on the first attempt success rate in hospitalized adults: Block-randomized trial2 February 2021 | The Journal of Vascular Access, Vol. 23, No. 2Development of a Three-Dimensionally Printed Ultrasound-Guided Peripheral Intravenous Catheter PhantomCureus, Vol. 23The Role of Ultrasound in the Ambulatory Setting9 March 2021Difficult intravenous access as an independent predictor of delayed care and prolonged length of stay in the emergency department19 August 2020 | Journal of the American College of Emergency Physicians Open, Vol. 1, No. 6Subcutaneous hydration and medications infusions (effectiveness, safety, acceptability): A systematic review of systematic reviews24 August 2020 | PLOS ONE, Vol. 15, No. 8Nurse-Performed Ultrasound-Guided Technique for Difficult Peripheral Intravenous Access in Critically Ill Patients: A Randomized Controlled Trial3 April 2020 | Journal of the Association for Vascular Access, Vol. 25, No. 2Better With UltrasoundChest, Vol. 157, No. 2Accès veineux central en radiologie interventionnelleLa Presse Médicale, Vol. 48, No. 10Vessel health and preservation: An integrative review14 November 2018 | Journal of Clinical Nursing, Vol. 28, No. 7-8Road map for improvement: Point prevalence audit and survey of central venous access devices in paediatric acute care6 October 2016 | Journal of Paediatrics and Child Health, Vol. 53, No. 2Indications for Peripheral, Midline, and Central Catheters: Summary of the Michigan Appropriateness Guide for Intravenous Catheters RecommendationsJournal of the Association for Vascular Access, Vol. 21, No. 3Ultrasonography Versus Landmark for Peripheral Intravenous Cannulation: A Randomized Controlled TrialAnnals of Emergency Medicine, Vol. 68, No. 1Development of the UK Vessel Health and Preservation (VHP) framework: a multi-organisational collaborativeJournal of Infection Prevention, Vol. 17, No. 2Effectiveness of a training program in compliance with recommendations for venous lines care30 July 2015 | BMC Infectious Diseases, Vol. 15, No. 1 23 April 2014Volume 23Issue Sup8ISSN (print): 0966-0461ISSN (online): 2052-2819 Metrics History Published online 6 May 2014 Published in print 23 April 2014 Information© MA Healthcare LimitedPDF download

Training doctors and nurses for interdependence

British Journal of Healthcare ManagementVol. 20, No. 1 CommentaryTraining doctors and nurses for interdependenceBenjamin G VoyerBenjamin G VoyerSearch for more papers by this authorBenjamin G VoyerPublished Online:18 Feb 2014https://doi.org/10.12968/bjhc.2014.20.1.30AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Leonard M, Graham S, Bonacum D (2004) The human factor: the critical importance of effective teamwork and communication in providing safe care. Qual Saf Health Care l3(Suppl. 1): 85–90 Crossref, Google ScholarMarkus HR, Kitayama S (1991) Culture and the self: implications for cognition, emotion, and motivation. Psychological Review 98(2): 224–53 Crossref, Google ScholarReader T, Flin R, Mearns K, Cuthbertson B, (2011) Team situation awareness and the anticipation of patient progress during ICU rounds. BMJ Qual Saf 20(12): 1035–42 Crossref, Google ScholarSingelis TM (1994) The measurement of independent and interdependent self-construals. Personality and Social Psychology Bulletin 20(5): 580–91 Crossref, Google ScholarUndre S, Sevdalis N, Healey A, Darzi A, Vincent C (2006) Teamwork in the operating theatre: cohesion or confusion? J Eval Clin Pract 12(2): 182–9 Crossref, Google ScholarVoyer BG McIntosh B (2013) The psychological consequences of power on self-perception: implications for leadership. Leadership & Organization Development Journal 34(7): 639–60 Crossref, Google ScholarVoyer BG, Reader TW (2013) The self-construal of nurses and doctors: beliefs on interdependence and independence in geriatric care. J AdvNurs 69(12): 2696–706 Google Scholar FiguresReferencesRelatedDetails 1 January 2014Volume 20Issue 1ISSN (print): 1358-0574ISSN (online): 1759-7382 Metrics History Published online 18 February 2014 Published in print 1 January 2014 Information© MA Healthcare LimitedPDF download