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2.
J Clin Nurs ; 29(1-2): 53-59, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31241794

RESUMO

AIMS AND OBJECTIVES: To examine the association between registered nurses' (referred to as "nurses" for brevity) shifts of 12 hr or more and presence of continuing educational programmes; ability to discuss patient care with other nurses; assignments that foster continuity of care; and patient care information being lost during handovers. BACKGROUND: The introduction of long shifts (i.e., shifts of 12 hr or more) remains controversial. While there are claims of efficiency, studies have shown long shifts to be associated with adverse effects on quality of care. Efficiency claims are predicated on the assumption that long shifts reduce overlaps between shifts; these overlaps are believed to be unproductive and dangerous. However, there are potentially valuable educational and communication activities that occur during these overlaps. DESIGN: Cross-sectional survey of 31,627 nurses within 487 hospitals in 12 European countries. METHODS: The associations were measured through generalised linear mixed models. The study methods were compliant with the STROBE checklist. RESULTS: When nurses worked shifts of 12 hr or more, they were less likely to report having continuing educational programmes; and time to discuss patient care with other nurses, compared to nurses working 8 hr or less. Nurses working shifts of 12 hr or more were less likely to report assignments that foster continuity of care, albeit the association was not significant. Similarly, working long shifts was associated with reports of patient care information being lost during handovers, although association was not significant. CONCLUSION: Working shifts of 12 hr or more is associated with reduced educational activities and fewer opportunities to discuss patient care, with potential negative consequences for safe and effective care. RELEVANCE TO CLINICAL PRACTICE: Implementation of long shifts should be questioned, as reduced opportunity to discuss care or participate in educational activities may jeopardise the quality and safety of care for patients.


Assuntos
Continuidade da Assistência ao Paciente/normas , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Jornada de Trabalho em Turnos/estatística & dados numéricos , Estudos Transversais , Educação Continuada/estatística & dados numéricos , Europa (Continente) , Feminino , Hospitais , Humanos , Relações Interprofissionais , Masculino , Recursos Humanos de Enfermagem no Hospital/organização & administração , Recursos Humanos de Enfermagem no Hospital/psicologia , Jornada de Trabalho em Turnos/psicologia , Inquéritos e Questionários
3.
Rev Med Chil ; 147(5): 589-601, 2019 May.
Artigo em Espanhol | MEDLINE | ID: mdl-31859891

RESUMO

BACKGROUND: The Family and Community Health Model (MAIS) establishes the continuity of care as an essential principle. The Family Study, as a clinical strategy, allows to have sufficient and timely information and knowledge about users of health care services, facilitates their accompaniment and is a source of information to improve the quality of care and the management of health centers. AIM: To develop a tool to conduct family studies, devised by experts in Primary Health Care. MATERIAL AND METHODS: Using a qualitative method, an electronic Delphi was conducted on 24 experts on primary health care. Afterwards, the content validation was carried out with the participation of judges. RESULTS: The resulting tool considers two levels of family assessment. It allows to distinguish those families that would benefit from interventions of greater complexity than those derived from the usual care of health centers. CONCLUSIONS: The tool to perform family studies responds to the informational and continuity component of Continuity of Patient Care principle. It may be a proposal for the continuous improvement of Chilean primary care.


Assuntos
Técnica Delfos , Saúde da Família/normas , Atenção Primária à Saúde/normas , Inquéritos e Questionários/normas , Adulto , Chile , Continuidade da Assistência ao Paciente/normas , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Qualidade da Assistência à Saúde/normas , Reprodutibilidade dos Testes , Fatores Socioeconômicos
4.
BMJ ; 367: l6109, 2019 11 13.
Artigo em Inglês | MEDLINE | ID: mdl-31722884

RESUMO

OBJECTIVE: To review and summarise the evidence on the prevalence of colorectal adenomas and cancers at a follow-up screening colonoscopy after negative index colonoscopy, stratified by interval between examinations and by sex. DESIGN: Systematic review and meta-analysis of all available studies. DATA SOURCES: PubMed, Web of Science, and Embase. Two investigators independently extracted characteristics and results of identified studies and performed standardised quality ratings. ELIGIBILITY CRITERIA: Studies assessing the outcome of a follow-up colonoscopy among participants at average risk for colorectal cancer with a negative previous colonoscopy (no adenomas). RESULTS: 28 studies were identified, including 22 cohort studies, five cross sectional studies, and one case-control study. Findings for an interval between colonoscopies of one to five, five to 10, and more than 10 years were reported by 17, 16, and three studies, respectively. Summary estimates of prevalences of any neoplasm were 20.7% (95% confidence interval 15.8% to 25.5%), 23.0% (18.0% to 28.0%), and 21.9% (14.9% to 29.0%) for one to five, five to 10, and more than 10 years between colonoscopies. Corresponding summary estimates of prevalences of any advanced neoplasm were 2.8% (2.0% to 3.7%), 3.2% (2.2% to 4.1%), and 7.0% (5.3% to 8.7%). Seven studies also reported findings stratified by sex. Summary estimates stratified by interval and sex were consistently higher for men than for women. CONCLUSIONS: Although detection of any neoplasms was observed in more than 20% of participants within five years of a negative screening colonoscopy, detection of advanced neoplasms within 10 years was rare. Our findings suggest that 10 year intervals for colonoscopy screening after a negative colonoscopy, as currently recommended, may be adequate, but more studies are needed to strengthen the empirical basis for pertinent recommendations and to investigate even longer intervals. STUDY REGISTRATION: Prospero CRD42019127842.


Assuntos
Colonoscopia/métodos , Neoplasias Colorretais , Detecção Precoce de Câncer , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/patologia , Continuidade da Assistência ao Paciente/normas , Detecção Precoce de Câncer/métodos , Detecção Precoce de Câncer/normas , Humanos , Prevalência , Medição de Risco/estatística & dados numéricos
5.
BMC Health Serv Res ; 19(1): 849, 2019 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-31747909

RESUMO

BACKGROUND: Over the past two decades, we have seen a nationwide increase in the use of medical-legal partnerships (MLPs) to address health disparities affecting vulnerable populations. These partnerships increase medical teams' capacity to address social and environmental threats to patients' health, such as unsafe housing conditions, through partnership with legal professionals. Despite expansions in the use of MLP care models in health care settings, the health outcomes efficacy of MLPs has yet to be examined, particularly for complex chronic conditions such as HIV. METHODS: This on-going mixed-methods study utilizes institutional case study and intervention mapping methodologies to develop an HIV-specific medical legal partnership logic model. Up-to-date, the organizational qualitative data has been collected. The next steps of this study consists of: (1) recruitment of 100 MLP providers through a national survey of clinics, community-based organizations, and hospitals; (2) in-depth interviewing of 50 dyads of MLP service providers and clients living with HIV to gauge the potential large-scale impact of legal partnerships on addressing the unmet needs of this population; and, (3) the development of an MLP intervention model to improve HIV care continuum outcomes using intervention mapping. DISCUSSION: The proposed study is highly significant because it targets a vulnerable population, PLWHA, and consists of formative and developmental work to investigate the impact of MLPs on health, legal, and psychosocial outcomes within this population. MLPs offer an integrated approach to healthcare delivery that seems promising for meeting the needs of PLWHA, but has yet to be rigorously assessed within this population.


Assuntos
Continuidade da Assistência ao Paciente/normas , Assistência à Saúde/legislação & jurisprudência , Infecções por HIV/terapia , Relações Interprofissionais , Adolescente , Adulto , Idoso , Continuidade da Assistência ao Paciente/legislação & jurisprudência , Assistência à Saúde/normas , Feminino , Disparidades em Assistência à Saúde/legislação & jurisprudência , Habitação/legislação & jurisprudência , Habitação/normas , Humanos , Serviços Jurídicos , Masculino , Pessoa de Meia-Idade , Estados Unidos , Populações Vulneráveis/legislação & jurisprudência , Adulto Jovem
6.
J Stroke Cerebrovasc Dis ; 28(12): 104445, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31627997

RESUMO

BACKGROUND: Stroke is a leading cause of disability worldwide with a great impact on quality of life. Ain Shams University Hospital is a tertiary center for neurology and a pioneer in offering comprehensive stroke service in the region. METHODS: A cross sectional study in which an 8 domains questionnaire was applied to all cerebrovascular stroke patients who were admitted to the stroke unit of the neurology department of Ain Shams University Hospital in the period from January 2016 till May 2017, with the aim to define pitfalls in post discharge. RESULTS: From our study show that 20% of all patients discharged from acute stroke unit did not have further follow up with any stroke doctor. Moreover, 60% of patients were not seen by a physiotherapist after discharge, including almost half of patients with moderate or severe disability on discharge who are expected to have ongoing care needs. Patients who developed stroke complications were more likely to seek follow up. As expected, continuous follow up was associated with increased adherence to secondary preventive medications. CONCLUSIONS: Patient needs should be assessed before patient discharge and patient and care givers should have clear written information on required follow up with stroke doctors, and arrangements made for receiving adequate rehabilitation post discharge.


Assuntos
Continuidade da Assistência ao Paciente/normas , Hospitais Universitários , Sumários de Alta do Paciente Hospitalar/normas , Alta do Paciente/normas , Padrões de Prática Médica/normas , Prevenção Secundária/normas , Acidente Vascular Cerebral/terapia , Idoso , Estudos Transversais , Avaliação da Deficiência , Egito , Feminino , Fidelidade a Diretrizes/normas , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Modalidades de Fisioterapia/normas , Guias de Prática Clínica como Assunto/normas , Prognóstico , Melhoria de Qualidade/normas , Indicadores de Qualidade em Assistência à Saúde/normas , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/fisiopatologia , Centros de Atenção Terciária
7.
Urology ; 134: 109-115, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31487509

RESUMO

OBJECTIVE: To examine the potential of LACE+ scores, in patients undergoing urologic surgery, to predict short-term undesirable outcomes. METHODS: Coarsened exact matching was used to assess the predictive value of the LACE+ index among all urologic surgery cases over a 2-year period (2016-2018) at 1 health system (n = 9824). Study subjects were matched on characteristics not assessed by LACE+, including duration of surgery and race, among others. For comparison of outcomes, matched populations were compared by LACE+ quartile with Q4 as the referent group: Q4 vs Q1, Q4 vs Q2, Q4 vs Q3. RESULTS: Seven hundred and twenty-two patients were matched for Q1-Q4; 1120 patients were matched for Q2-Q4; 2550 patients were matched for Q3-Q4. Escalating LACE+ score significantly predicted increased readmission (2.86% vs 4.91% for Q2 vs Q4; P = .012) and Emergency Room (ER) visits at 30 days postop (5.69% vs 11.37% for Q1 vs Q4, 4.11% vs 11.45% for Q2 vs Q4, 8.29% vs 13.32% for Q3 vs Q4; P <.001 for all). Increasing LACE score did not predict reoperation within 30 days or rate of death over follow-up within 30 postoperative days. CONCLUSION: The results of this study suggest that the LACE+ index is suitable as a prediction model for important patient outcomes in a urologic surgery population including unanticipated readmission and ER evaluation.


Assuntos
Serviço Hospitalar de Emergência , Readmissão do Paciente , Complicações Pós-Operatórias , Procedimentos Cirúrgicos Urológicos , Adulto , Idoso , Continuidade da Assistência ao Paciente/normas , Serviço Hospitalar de Emergência/economia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Humanos , Masculino , Sobremedicalização/prevenção & controle , Pessoa de Meia-Idade , Duração da Cirurgia , Readmissão do Paciente/economia , Readmissão do Paciente/estatística & dados numéricos , Complicações Pós-Operatórias/economia , Complicações Pós-Operatórias/mortalidade , Complicações Pós-Operatórias/terapia , Prognóstico , Reoperação/estatística & dados numéricos , Estados Unidos/epidemiologia , Procedimentos Cirúrgicos Urológicos/efeitos adversos , Procedimentos Cirúrgicos Urológicos/estatística & dados numéricos
8.
Rev Lat Am Enfermagem ; 27: e3162, 2019 Aug 19.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31432917

RESUMO

OBJECTIVE: to describe the activities developed by the liaison nurses for the continuity of care after hospital discharge. METHOD: descriptive, qualitative study, based on the theoretical reference. Strength Based Care. The sample comprised 23 liaison nurses. The data was collected through a semi-structured questionnaire via Survey Monkey electronic platform and analyzed through the content analysis technique, with pre-defined categories. RESULTS: among the liaison nurses, nine (39.14%), between 35 and 44 years of age; 17 (73.91%) were female; 15 (65.22%) were working eleven years or more nurse and 11 (47.82%), were between six and ten years old as a liaison nurse. The professionals participate in the identification of the patients who need care after hospital discharge, coordinate the planning of the hospital discharge and transfer the patient's information to an extra-hospital service. CONCLUSION: the activities developed by the liaison nurses focus on the needs of the patient and the articulation with the extra-hospital services, and can be adapted to the Brazilian context as a strategy to minimize the discontinuity of care at the time of hospital discharge.


Assuntos
Continuidade da Assistência ao Paciente/normas , Papel do Profissional de Enfermagem , Recursos Humanos de Enfermagem no Hospital/normas , Alta do Paciente/estatística & dados numéricos , Adulto , Brasil , Canadá , Feminino , Hospitais Universitários , Humanos , Masculino , Transferência de Pacientes , Pesquisa Qualitativa , Inquéritos e Questionários
9.
Diabetes Metab Syndr ; 13(4): 2533-2539, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31405673

RESUMO

AIM: A large percentage of gestational diabetes (GDM) are undiagnosed, and prevalence of postpartum type 2 diabetes (T2DM) is unknown, especially in developing countries. This study assessed barriers to GDM diagnosis and postpartum follow-up; to determine educational needs. MATERIALS AND METHODS: This was a clinical observational study of records and procedures of antenatal services at two hospitals. Laboratory and medical records were reviewed for availability of data on anthropometrics, blood glucose, gestational age, urinalysis, and lipid profile for GDM register. Antenatal clinic protocol was observed for GDM diagnosis. BMI was derived and data were analyzed using SPSS version 20. RESULTS: Critical barriers attributable to health systems included lack of screening for blood sugar as part of routine antenatal protocol, and lack of GDM registers at both facilities. There was 6.5% registration of pregnancies in first trimester, 22% pre-pregnancy obesity, and 2.6% high blood pressure. Positive glucosuria cases were not followed-up for GDM diagnosis. CONCLUSIONS: There is neither concerted effort to diagnose GDM, nor systematic records of screening and postpartum follow-up. The gap in diabetology knowledge and practice calls for re-training of antenatal healthcare professionals. GDM screening checklist needs to be established and positive results entered into GDM registers for proper management during and after delivery.


Assuntos
Continuidade da Assistência ao Paciente/normas , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Gestacional/fisiopatologia , Pessoal de Saúde/educação , Período Pós-Parto , Guias de Prática Clínica como Assunto/normas , Adulto , Biomarcadores/análise , Feminino , Seguimentos , Humanos , Nigéria/epidemiologia , Gravidez , Prevalência , Prognóstico
10.
Presse Med ; 48(7-8 Pt 1): e209-e215, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31421945

RESUMO

AIM: Identified Palliative Care Beds (Lits Identifiés Soins Palliatifs - LISPs) is a French specificity. Primarily created to integrate palliative care culture into conventional hospital units, the relevance of this measure became a controversial issue. Nowadays, hospital teams continue to frequently encounter complex situations regarding medical care for palliative patients. To the best of our knowledge, there is only one study, a quantitative one, bridging the gap about that subject. It showed failure in practicing palliative care work around LISP. Our study is based on a qualitative method that complements the quantitative study. It aimed to describe difficulties that limit palliative care practices in managing adult patients in LISP. METHOD: This qualitative exploratory survey was conducted with a sample of health service professionals (n=20), from senior physicians to caregivers. Each semi-structured interview included open questions regarding their experiences, feelings and difficulties with palliative care practices on LISP. It also included closed questions concerning interviewee's demographics and career course. The data for this research were submitted to a two-stage analysis: first, a global review of each interview was performed to identify trends. Then, a detailed breakdown, question by question, was implemented. RESULTS: From a quantitative perspective, the interviews revealed 305 difficulties, indicating the gaps and barriers limiting the implementation of a palliative approach in these services. From a qualitative perspective, five topics raised our attention by their recurrence in discourses: (1) partial knowledge about palliative care definition and legislation mostly due to a lack of training; (2) need for time; (3) need for human resources; (4) need for communication; (5) hard time in transitioning from curative to palliative care. PERSPECTIVE: This survey gives the opportunity to understand health service professionals' difficulties in practicing palliative care in conventional medical services. It raises the central issue of the pricing reform on the health institutes activity. It also provides angles of inquiry to improve LISP effectiveness. This qualitative and descriptive study was designed to explore difficulties in practicing palliative care around LISP. Nevertheless, according to the size of the sample, results will need to be confirmed by a more extensive qualitative survey.


Assuntos
Continuidade da Assistência ao Paciente , Unidades Hospitalares/organização & administração , Cuidados Paliativos/organização & administração , Equipe de Assistência ao Paciente/organização & administração , Padrões de Prática Médica , Qualidade da Assistência à Saúde/organização & administração , Adulto , Atitude do Pessoal de Saúde , Cuidadores/organização & administração , Cuidadores/normas , Barreiras de Comunicação , Continuidade da Assistência ao Paciente/organização & administração , Continuidade da Assistência ao Paciente/normas , Assistência à Saúde/métodos , Assistência à Saúde/organização & administração , Assistência à Saúde/normas , Arquitetura de Instituições de Saúde/normas , França , Conhecimentos, Atitudes e Prática em Saúde , Número de Leitos em Hospital , Unidades Hospitalares/normas , Humanos , Entrevistas como Assunto , Satisfação no Emprego , Cuidados Paliativos/psicologia , Cuidados Paliativos/normas , Equipe de Assistência ao Paciente/normas , Padrões de Prática Médica/organização & administração , Padrões de Prática Médica/normas , Pesquisa Qualitativa , Qualidade da Assistência à Saúde/normas , Estudos Retrospectivos , Inquéritos e Questionários
11.
AJR Am J Roentgenol ; 213(4): 880-885, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31268733

RESUMO

OBJECTIVE. The purpose of this study was to evaluate the impact of an information technology-enabled quality improvement initiative on timeliness of patient contact and scheduling of screening mammography recall. MATERIALS AND METHODS. The study was conducted in a screening practice (two ambulatory centers, A and B; two hospitals, C and D) that uses offline batch results (A, B, C) and same-day results (D) with on-site (A, C, D) or off-site (B) coordinators scheduling recalls. Before the intervention, radiologists at sites A, B, and C conveyed recalls via paper lists to coordinators after batch interpretation. At site D, coordinators received recall lists several times a day. In March 2017 an electronic alert system was implemented to notify coordinators of recall at report signing with required closed-loop acknowledgment once recall was scheduled. Mean time (hours, excluding weekends) to schedule diagnostic evaluation was compared for 4-month periods before and after intervention by two-tailed t test and statistical process control analyses. RESULTS. Recall rates were 9.5% (1356/14,315) before and 8.9% (1432/16,034) after the intervention (p = 0.10). Mean time to schedule screening decreased after the intervention as follows: site A from 86 to 65 hours (-24.4%, p = 0.01); site B, 116 to 70 hours (-39.7%, p < 0.0001); site C, 98 to 65 hours (-33.7%, p = 0.002); and site D, 49 to 42 hours (-14.3%, p = 0.21). Statistical process control analysis showed significant sustained improvements at sites A, B, and C in mean time to patient contact and scheduling of diagnostic evaluation. CONCLUSION. An information technology-enabled quality improvement initiative to notify coordinators of screening recalls in real time with required patient contact and scheduling acknowledgment reduced time to diagnostic scheduling in a multisite practice. The greatest impact was found at the site with off-site coordinators, the least at the site performing same-day interpretation.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Continuidade da Assistência ao Paciente/normas , Tecnologia da Informação , Mamografia , Melhoria de Qualidade , Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade
12.
Nurs Clin North Am ; 54(3): 313-323, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31331619

RESUMO

The burden of neurologic disease in the United States continues to increase due to a growing older population, increased life expectancy, and improved mortality after cancer and cardiac disease. Emergency medical services (EMS) providers are responding to more patients with stroke, traumatic neurologic injury, neuromuscular weakness, seizure, and spontaneous cardiac arrest. Efficient prehospital care and triage to facilities with specialized services improve outcomes. Effective handoff from EMS to an emergency department ensures continuity of care and patient safety. Although advancements in prehospital cardiopulmonary resuscitation have increased rates of return to spontaneous circulation, a large proportion of patients sustain neurologic injury.


Assuntos
Continuidade da Assistência ao Paciente/normas , Serviços Médicos de Emergência/normas , Doenças do Sistema Nervoso/diagnóstico , Doenças do Sistema Nervoso/terapia , Transferência da Responsabilidade pelo Paciente/normas , Guias de Prática Clínica como Assunto , Triagem/normas , Humanos , Estados Unidos
13.
Nurs Clin North Am ; 54(3): 335-345, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31331621

RESUMO

Handoff of patients from the operating room to the intensive care unit is a complex process. It involves 2 teams of caregivers, the physical relocation of the patient and monitoring equipment, and tight time constraints. Research and quality projects have focused on checklists and protocols to standardize handoff processes and content. Interventions also include requiring all team members be present, a team leader identified, and prehandoff communication. Outcome evaluation is limited by lack of standardized outcomes to define a good handoff. Instead, handoff content is often used as a proxy. Studies with larger sample sizes using rigorous methods are needed.


Assuntos
Continuidade da Assistência ao Paciente/normas , Unidades de Terapia Intensiva/normas , Comunicação Interdisciplinar , Colaboração Intersetorial , Salas Cirúrgicas/normas , Transferência da Responsabilidade pelo Paciente/normas , Guias de Prática Clínica como Assunto , Humanos
14.
Nurs Clin North Am ; 54(3): 367-384, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31331624

RESUMO

A systematic review of qualitative studies that examined the experience of early supported discharge (ESD) from the perspective of patients with stroke and their caregivers and health care providers revealed an emphasis on psychosocial aspects-the patient-provider relationship, the value of the home environment, and the ability to tailor treatment to meet patient-oriented goals. Patients, caregivers, and providers stressed the importance of clear and systematic communication throughout the ESD process to support transitions, prevent duplication of services, foster trust in relationships, and ensure that patients and caregivers have the knowledge and skills required to manage a chronic condition long term.


Assuntos
Cuidadores/psicologia , Continuidade da Assistência ao Paciente/normas , Pessoal de Saúde/psicologia , Alta do Paciente/normas , Pacientes/psicologia , Reabilitação do Acidente Vascular Cerebral/normas , Cuidado Transicional/normas , Humanos , Guias de Prática Clínica como Assunto , Pesquisa Qualitativa
15.
Nurs Clin North Am ; 54(3): 385-397, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31331625

RESUMO

Advances in stroke detection and treatment have increased the number of patients discharged home following an index stroke admission. Unfortunately, the science of how to facilitate transition of care (TOC) from hospital to home has not kept pace with decades-long focus on restoring cerebral perfusion. This article examines TOC interventions in stroke populations published after the 2011 Agency for Healthcare Research and Quality report. Early supported discharge is the leading TOC intervention. Diversity of outcome measures and use of poorly defined comparators limits generalizability. There is no clear best practice to define interventions targeted at the hospital to home transition.


Assuntos
Continuidade da Assistência ao Paciente/normas , Serviços de Assistência Domiciliar/normas , Alta do Paciente/normas , Guias de Prática Clínica como Assunto , Reabilitação do Acidente Vascular Cerebral/normas , Cuidado Transicional/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
16.
Nurs Clin North Am ; 54(3): 399-408, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31331626

RESUMO

Survivors of stroke require long-term follow-up with a focus on rehabilitation, prevention of depression and anxiety, and support for carer. Research is needed in many areas of poststroke care to identify interventions that may ameliorate the sequelae.


Assuntos
Cuidadores/psicologia , Continuidade da Assistência ao Paciente/normas , Guias de Prática Clínica como Assunto , Reabilitação do Acidente Vascular Cerebral/normas , Sobreviventes/psicologia , Cuidado Transicional/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa
17.
Nurs Clin North Am ; 54(3): 409-423, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31331627

RESUMO

The trajectory status of patients with mild, moderate, and severe traumatic brain injury from emergency room evaluation, through acute care (intensive care if severe) and discharge is discussed. Additional considerations for elderly population and common complications associated with severe traumatic brain injury are also covered.


Assuntos
Lesões Encefálicas Traumáticas/reabilitação , Continuidade da Assistência ao Paciente/normas , Cuidados Críticos/normas , Serviços Médicos de Emergência/normas , Alta do Paciente/normas , Enfermagem em Reabilitação/normas , Cuidado Transicional/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto
18.
Nurs Clin North Am ; 54(3): 425-435, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31331628

RESUMO

Epilepsy is a complex neurologic disease that requires both medical management and self-management. People with epilepsy and their families complete many transitions throughout the health care system in managing this disease. This article reviews key transitions for people with epilepsy and discusses strategies for improving these transitions.


Assuntos
Continuidade da Assistência ao Paciente/normas , Cuidados Críticos/normas , Serviços Médicos de Emergência/normas , Epilepsia/terapia , Alta do Paciente/normas , Enfermagem em Reabilitação/normas , Cuidado Transicional/normas , Humanos , Guias de Prática Clínica como Assunto
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