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29 records – page 1 of 3.

Source
AWHONN Lifelines. 2001 Jun-Jul;5(3):46-54
Publication Type
Article
Author
V. Bassett
Author Affiliation
Ottawa Hospital-Civic Campus, Ottawa, ON.
Source
AWHONN Lifelines. 2001 Jun-Jul;5(3):46-54
Language
English
Publication Type
Article
Keywords
Breast Feeding
Critical Pathways - organization & administration - standards
Humans
Infant, Newborn
Medical Records
Ontario
PubMed ID
11982263 View in PubMed
Less detail

Birth to breast--a feeding care map for the NICU: helping the extremely low birth weight infant navigate the course.

https://arctichealth.org/en/permalink/ahliterature153822
Source
Neonatal Netw. 2008 Nov-Dec;27(6):371-7
Publication Type
Article
Author
Dorothy Dougherty
Maureen Luther
Author Affiliation
Sunnybrook Health Sciences Centre, Neonatal Intensive Care Unit, Toronto, Ontario, Canada. dorothy.dougherty@sunnybrook.ca
Source
Neonatal Netw. 2008 Nov-Dec;27(6):371-7
Language
English
Publication Type
Article
Keywords
Benchmarking
Breast Feeding - psychology
Colostrum
Critical Pathways - organization & administration
Evidence-Based Nursing
Humans
Infant care
Infant, Extremely Low Birth Weight - physiology - psychology
Infant, Newborn
Intensive Care, Neonatal - organization & administration
Mothers - education - psychology
Neonatal Nursing - organization & administration
Nurse's Role - psychology
Ontario
Patient Care Planning - organization & administration
Patient Education as Topic
Posture
Rooming-in Care
Social Support
Sucking Behavior
Suction - education - psychology
Abstract
Breast milk has been shown to contribute significantly to positive neurodevelopmental and medical outcomes in the extremely low birth weight (ELBW) infant population. It is crucial that ELBW infants receive their mother's colostrum as a first feeding, followed by expressed breast milk for as long as possible. Evidence-based literature supports the difficult challenges both mothers and ELBW infants face if they are to succeed at breast pumping and breastfeeding. Influencing factors include the medical fragility of the infant, limited frequency and duration of kangaroo care between mother and infant, lack of an adequate volume of breast milk, as well as inconsistent or incorrect information surrounding the use of breast milk and breastfeeding. A feeding care map as described in this article can help the bedside nurse assist the mother-ELBW infant dyad in optimizing breast milk volumes, laying the groundwork for breastfeeding. Displaying supportive practices and preterm infant developmental milestones, the map categorizes infant, maternal, and dyad feeding issues along a progressive time line from admission to discharge.
Notes
Comment In: Neonatal Netw. 2009 Jul-Aug;28(4):267-8; author reply 26819592371
PubMed ID
19065966 View in PubMed
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Cancer patient pathways in Denmark as a joint effort between bureaucrats, health professionals and politicians--a national Danish project.

https://arctichealth.org/en/permalink/ahliterature129150
Source
Health Policy. 2012 Apr;105(1):65-70
Publication Type
Article
Date
Apr-2012
Author
Helene Bilsted Probst
Zubair Butt Hussain
Ole Andersen
Author Affiliation
Department of Planning, The National Board of Health, Islands Brygge 67, DK-2300 Copenhagen S, Denmark.
Source
Health Policy. 2012 Apr;105(1):65-70
Date
Apr-2012
Language
English
Publication Type
Article
Keywords
Cooperative Behavior
Critical Pathways - organization & administration
Denmark
Government Agencies
Health Personnel
Humans
Models, organizational
National health programs - organization & administration
Neoplasms - mortality - therapy
Politics
Program Development
Program Evaluation
Waiting Lists
Abstract
In 2007 and 2008 Danish Cancer Patient Pathways for 32 cancer types were developed and afterwards implemented on a national scale. Often bureaucrats, health professionals and politicians look upon the health sector in different ways and work independent of each other. In Denmark, as indeed internationally, patient pathways are frequently developed solely by health professionals and the consequence may be major difficulties in implementing the pathways on a national scale. In this article we describe how national Danish Cancer Patient Pathways were developed with a consensus seeking model and the impact it has had on the health system. The model used in Denmark ensured involvement and cooperation between bureaucrats, health professionals and politicians and afterwards a successful national implementation. The Cancer Patient Pathways has significantly reduced waiting times which is thought to increase survival. This experience gives important input to the continuous challenges on how to implement evidence based medicine on a national scale and stipulates a model for this process.
PubMed ID
22136810 View in PubMed
Less detail

A clinical pathway for treating pneumonia in the nursing home: part I: the nursing perspective.

https://arctichealth.org/en/permalink/ahliterature168881
Source
J Am Med Dir Assoc. 2006 Jun;7(5):271-8
Publication Type
Article
Date
Jun-2006
Author
Soo Chan Carusone
Mark Loeb
Lynne Lohfeld
Author Affiliation
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
Source
J Am Med Dir Assoc. 2006 Jun;7(5):271-8
Date
Jun-2006
Language
English
Publication Type
Article
Keywords
Aged
Attitude of Health Personnel
Bed Occupancy - statistics & numerical data
Clinical Competence - standards
Critical Pathways - organization & administration
Cross Infection - diagnosis - therapy
Decision Trees
Education, Nursing, Continuing
Focus Groups
Geriatric Nursing - education - organization & administration
Health Facility Size - statistics & numerical data
Health services needs and demand
Hospitalization - statistics & numerical data
Humans
Nurse's Role
Nursing Homes
Nursing Methodology Research
Nursing Staff - education - psychology
Ontario
Pneumonia - diagnosis - therapy
Qualitative Research
Quality of Health Care - standards
Questionnaires
Self Efficacy
Abstract
This paper examines nursing staff's perspectives on the utility and sustainability of a clinical pathway for treating nursing home residents with pneumonia.
A qualitative (case study) design was used.
Data were collected from 6 nursing homes in Southern Ontario (5 from metro regions and 1 from a nonmetro region). Nursing homes were drawn from a larger randomized controlled trial of a clinical pathway for nursing home-acquired pneumonia conducted between 2001 and 2005. The clinical pathway was designed to assist in the identification, diagnosis, and management of pneumonia, including a decision tool for determining the appropriate location of treatment (hospital versus nursing home).
A total of 7 focus groups and 1 one-on-one interview were conducted between February 2003 and May 2004. Interview data were analyzed using the template style, described by Miller and Crabtree, to identify key themes.
Nurses strongly supported the idea of the clinical pathway and believed that providing pneumonia care in the nursing home was better for the resident. As a result of using the clinical pathway, nurses felt that pneumonia was being identified, diagnosed, and treated earlier, resulting in fewer hospitalizations. In addition to the benefits to resident care, the nurses felt that their skills and knowledge also improved. Nurses generally supported the implementation of the pathway although some concern was expressed about the additional responsibility and resources that would entail.
The implementation of a clinical pathway for treating pneumonia in nursing homes and quick access to a backup clinician are desired by nurses who also believe it will result in better care and fewer hospitalizations of residents.
PubMed ID
16765862 View in PubMed
Less detail

[Clinical pathways for rehabilitation of adults with acquired brain injury].

https://arctichealth.org/en/permalink/ahliterature125994
Source
Ugeskr Laeger. 2012 Mar 19;174(12):798
Publication Type
Article
Date
Mar-19-2012

Context challenges the champion: improving hip fracture care in a Swedish university hospital.

https://arctichealth.org/en/permalink/ahliterature125785
Source
Int J Health Care Qual Assur. 2012;25(2):118-33
Publication Type
Article
Date
2012
Author
Susanne Löfgren
Johan Hansson
John Øvretveit
Mats Brommels
Author Affiliation
Medical Management Centre, Karolinska Institutet, Stockholm, Sweden. susanne.lofgren@ki.se
Source
Int J Health Care Qual Assur. 2012;25(2):118-33
Date
2012
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Critical Pathways - organization & administration - standards
Hip Fractures - rehabilitation - surgery
Hospitals, University - organization & administration - standards
Humans
Interviews as Topic
Organizational Case Studies
Quality Improvement - organization & administration - standards
Sweden
Time Factors
Abstract
The purpose of this paper is to describe and explain a clinician-led improvement of a hip fracture care process in a university hospital, and to assess the results and factors helping and hindering change implementation.
The paper has a mixed methods case study design. Data collection was guided by a framework directing attention to the content and process of the change, its context and outcomes.
Using a multiprofessional project team, beneficial changes in the early parts of the care process were achieved, but inability to change surgical staff work practices meant that the original goal of operating patients within 24 hours was not reached. After three years, top management introduced a hospital-wide process improvement programme, which "took over" the responsibility for improving hip fracture care.
A clear vision why change is needed and what needs to be done, which is well communicated by a respected clinical leader, can motivate personnel, but other influences are also needed to bring about change. Without a plan agreed and supported by top management, changes are likely to be limited to parts of the process and improvements to patient care may be minimal. These and other findings may be applicable to similar situations in other services.
This case study is an illustration of both the strengths and the weaknesses of a "bottom-up, clinician-champion-led improvement initiative" in a complex university hospital.
PubMed ID
22455177 View in PubMed
Less detail

Continuity of care in ambulatory surgery critical pathways: the patients' perceptions.

https://arctichealth.org/en/permalink/ahliterature149766
Source
Medsurg Nurs. 2009 May-Jun;18(3):169-73
Publication Type
Article
Author
Marja Renholm
Tarja Suominen
Ann-Marie Turtiainen
Helena Leino-Kilpi
Author Affiliation
Helsinki University Central Hospital, Helsinki, Finland.
Source
Medsurg Nurs. 2009 May-Jun;18(3):169-73
Language
English
Publication Type
Article
Keywords
Adult
Aftercare - psychology
Ambulatory Surgical Procedures - nursing - psychology
Attitude to Health
Continuity of Patient Care - organization & administration
Critical Pathways - organization & administration
Female
Finland
Humans
Inpatients - psychology
Internal-External Control
Male
Middle Aged
Motivation
Nursing Methodology Research
Patient-Centered Care - organization & administration
Perioperative Care - psychology
Preoperative Care - psychology
Professional-Patient Relations
Quality of Health Care
Questionnaires
Time and Motion Studies
Abstract
This study dealt with patients' experiences of the continuity of care through an ambulatory surgical critical pathway. Data were collected from theme interviews conducted with surgical patients 25 days after their procedures. Important factors in continuity of care were defined as time flow, coordination flow, caring relationship flow, and information flow.
PubMed ID
19591363 View in PubMed
Less detail

A cross-sectional survey of levels of care and response mechanisms for evolving critical illness in hospitalized children.

https://arctichealth.org/en/permalink/ahliterature164444
Source
Pediatrics. 2007 Apr;119(4):e940-6
Publication Type
Article
Date
Apr-2007
Author
Stephanie D VandenBerg
Jamie S Hutchison
Christopher S Parshuram
Author Affiliation
Department of Critical Care Medicine, Research Institute, Hospital for Sick Children, 555 University Ave, Toronto, Ontario, Canada M5G 1X8.
Source
Pediatrics. 2007 Apr;119(4):e940-6
Date
Apr-2007
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Canada - epidemiology
Cardiopulmonary Resuscitation - utilization
Cause of Death
Child
Child, Hospitalized - statistics & numerical data
Child, Preschool
Critical Care - organization & administration
Critical Illness - mortality - therapy
Critical Pathways - organization & administration
Cross-Sectional Studies
Emergency Service, Hospital - organization & administration
Female
Health Care Surveys
Heart Arrest - mortality - therapy
Hospitals, Pediatric
Humans
Intensive Care Units, Pediatric - organization & administration
Linear Models
Male
Patient Care Team - utilization
Probability
Quality Assurance, Health Care
Questionnaires
Survival Analysis
Triage - utilization
United States - epidemiology
Abstract
Recognition and treatment of evolving critical illness is a fundamental element of hospital care. Hospital systems should triage patients to receive appropriate levels of care. We describe here the levels of care, the frequency of near or actual cardiopulmonary arrest (code-blue events), identification mechanisms, and responses to evolving critical illness in hospitalized children.
A cross-sectional telephone survey of Canadian and American hospitals with > or = 50 pediatric acute care beds or > or = 2 pediatric wards was performed. Regression analysis identified factors associated with the frequency of code-blue events after adjustment for hospital volume.
Responses from 388 (84%) hospitals identified the 181 eligible pediatric hospitals included in this survey. All had a PICU, 99 (55%) had high-dependency units, 101 (56%) had extracorporeal membrane oxygenation therapy, and 69 (38%) used extracorporeal membrane oxygenation therapy for refractory cardiopulmonary arrest. All of the hospitals had immediate-response teams. They were activated 4676 times in the previous 12 months. Twenty-four percent of hospitals had activation criteria for immediate-response teams. Urgent-response teams to treat children who were clinically deteriorating but not at immediate risk of cardiopulmonary arrest were available in 136 (75%) hospitals; 29 (17%) had formal medical emergency teams, and 92 (51%) consulted the PICU. Code-blue events were more common in hospitals with extracorporeal membrane oxygenation therapy, cardiopulmonary bypass, and larger PICU size.
Currently, the organization of Canadian and American pediatric hospitals includes dedicated areas to match patient acuity and additional personnel to stabilize and facilitate transfer. The functioning of these systems of care results in calls for immediate medical assistance for ward patients approximately 5000 times annually.
PubMed ID
17387170 View in PubMed
Less detail

Dental care pathway of Quebecers after a broken filling.

https://arctichealth.org/en/permalink/ahliterature176848
Source
Community Dent Health. 2004 Dec;21(4):277-84
Publication Type
Article
Date
Dec-2004
Author
Christophe Bedos
Jean-Marc Brodeur
Mike Benigeri
Marie Olivier
Author Affiliation
McGill University, Faculty of Dentistry, Montreal, Quebec, Canada. christophe.bedos@mcgill.ca
Source
Community Dent Health. 2004 Dec;21(4):277-84
Date
Dec-2004
Language
English
Publication Type
Article
Keywords
Adult
Continuity of Patient Care - organization & administration
Critical Pathways - organization & administration
Dental Care - organization & administration
Dental Restoration Failure
Female
Health Behavior
Humans
Logistic Models
Patient Acceptance of Health Care
Quebec
Questionnaires
Socioeconomic Factors
Time Factors
Abstract
The objectives were to 1) describe the dental care pathway of adults after sustaining a broken filling, and particularly, the patient delay in seeking care as well as the continuity of care, and 2) identify factors associated with the decisions taken.
In 1998-99, 5,469 Quebec women aged 30 to 44 years completed a self-administered questionnaire in which they indicated whether they had experienced a dental problem in the previous 12 months. From then on, the questions identified the decisions they made during the process of consulting a dentist.
32.4% of the respondents had experienced a dental problem within the last 12 months. Among them, 38.0% reported a broken filling. 65.1% of those who identified a broken filling decided immediately to consult a dentist and 34.9% chose to wait and see. Patient delay was over one month in 44.0% of the cases. When asked by the dentist to come back in order to complete the treatment. 90.6% agreed, 3.2% decided to consult another dentist, and 6.21% chose not to consult. Logistic regression analyses show that patient delay was associated with low income, low degree of inconvenience (symptoms), low degree of perceived seriousness, and absence of a family dentist.
This study reveals important social disparities: after sustaining a broken filling, which remains an important problem in industrialised societies, patient delay, interruption of the dental care episode and extraction are more frequent in low-income groups. It also reveals that a wait-and-see attitude is more frequent than an interruption of the dental care episode after the first visit.
PubMed ID
15617412 View in PubMed
Less detail

29 records – page 1 of 3.