scholarly journals 12 `Risk feeding’ for Older People: a Retrospective Case Series to Review the Decision Making Process

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Niamh O'Loughlin ◽  
Oonagh McCarthy
Keyword(s):  
Decision Making ◽  
Average Length ◽  
Hospital Setting ◽  
Case Series ◽  
Oral Intake ◽  
Acute Hospital ◽  
Best Interests ◽  
Retrospective Case ◽  
The Individual ◽  
Acute Hospital Setting

Abstract Background `Risk feeding' is a term commonly used when an individual continues to eat and drink despite a perceived risk of choking or aspiration. It is suspected that there is significant variability around how a decision of ‘risk feeding’ is made for older people in the acute hospital setting, particularly whether or not the individual and his/her family are involved. This is of particular interest under the Assisted Decision Making (Capacity) Act 2015. Aims To investigate individuals' participation in decision-making regarding `risk feeding' To investigate the duration individuals are kept NPO pending `risk feeding' decisions Methods A retrospective case series was completed. 18 medical charts were reviewed for collection of the following data: Average length an individual was NPO pending decision regarding oral intakeDiscussion between individual and medical team regarding oral intakeThe individual's capacity for decision making regarding oral intakeDiscussion of what is in the best interests of the individualDiscussion with family/NOKExplicit plan regarding oral intake Results Average length NPO: 1 day (range 0-4 days) Discussion with patient: 17% Patient capacity for decision making: 17% Best interests discussion: 66% Discussion with family/NOK: 77% Explicit plan: 66% Conclusion There is significant variability in decision making for `risk feeding' with older adults in the acute hospital setting. Individuals are not consistently involved in their plan to `risk feed'. In some cases there was reliance on family members to decide on `risk feeding', in others the medical team made decision in the best interests of the individual. Individuals are being kept NPO for a period of time to allow decision making, without knowledge of why this is so. The review highlights the need for individual involvement in decision regarding dysphagia and oral intake. Multidisciplinary education and guidance is recommended to ensure consistent ethical decision making.

scholarly journals Nurses’ decision‐making, practices and perceptions of patient involvement in medication administration in an acute hospital setting

2019 ◽  
Vol 75 (6) ◽  
pp. 1316-1327 ◽  
Author(s):  
Tracey Bucknall ◽  
Mariann Fossum ◽  
Alison M. Hutchinson ◽  
Mari Botti ◽  
Julie Considine ◽  
...  
Keyword(s):  
Decision Making ◽  
Patient Involvement ◽  
Hospital Setting ◽  
Medication Administration ◽  
Acute Hospital ◽  
Acute Hospital Setting

“EduKation demenz® Nursing” in the acute hospital setting

2021 ◽  
Author(s):  
Thomas Johann Gehr ◽  
Cornel Christian Sieber ◽  
Ellen Freiberger ◽  
Sabine Alexandra Engel
Keyword(s):  
Hospital Setting ◽  
Acute Hospital ◽  
Acute Hospital Setting

Same-Admission Microvascular Maxillofacial Ballistic Trauma Reconstruction Using Virtual Surgical Planning: A Case Series and Systematic Review

2021 ◽  
pp. 194338752110264
Author(s):  
Sean A. Knudson ◽  
Kristopher M. Day ◽  
Patrick Kelley ◽  
Pablo Padilla ◽  
Ian X. Collier ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Planning ◽  
Average Length ◽  
Case Series ◽  
Retrospective Case ◽  
Oral Nutrition ◽  
Microsurgical Reconstruction ◽  
Virtual Surgical Planning ◽  
And Function ◽  
Ballistic Trauma

Study Design: Retrospective case series; systematic review. Objective: It is unknown whether the use of virtual surgical planning (VSP) to facilitate same-admission microsurgical reconstruction of the mandible following acute maxillofacial ballistic trauma (MBT) is sufficient to achieve definitive reconstruction and functional occlusion. Methods: A single-center retrospective analysis was conducted for patients who underwent microsurgical reconstruction of the mandible using VSP after acute MBT. The PubMed/MEDLINE, Embase, ScienceDirect, and Scopus databases were systematically reviewed using blinded screening. Studies were evaluated via thematic analysis. Results: Five patients were treated by same-admission and microsurgical reconstruction of the mandible using VSP. We observed an average of 16.4 ± 9.1 days between initial presentation and reconstruction, an average length of stay of 51.6 ± 17.9 days, 6.2 ± 2.8 operations, and 1.6 ± 0.9 free flaps per patient. Four types and 8 total flaps were employed, most commonly the anterior lateral thigh flap (37.5%). Care yielded complete flap survival. Each patient experienced at least 1 minor complication. All patients achieved centric occlusion, oral nutrition, and an approximation of their baseline facial aesthetic. Follow up was 191.0 ± 183.9 weeks. Systematic review produced 8 articles that adhered to inclusion criteria. Consensus themes in the literature were found for clinical goal and function of VSP when practicing MBT reconstruction, yet disagreement was found surrounding optimal treatment timeline. Conclusions: Same-admission microsurgical reconstruction after MBT is safe and effective to re-establish mandibular form and function. VSP did not delay reconstruction, given the need for preparation prior to definitive reconstruction.

A simulation study of the interception of prescribing errors by clinical pharmacists in an acute hospital setting

2015 ◽  
Vol 21 (4) ◽  
pp. 673-680 ◽  
Author(s):  
Thibaut Caruba ◽  
Abdelali Boussadi ◽  
Emilie Lenain ◽  
Virginie Korb-Savoldelli ◽  
Florence Gillaizeau ◽  
...  
Keyword(s):  
Simulation Study ◽  
Hospital Setting ◽  
Acute Hospital ◽  
Prescribing Errors ◽  
Clinical Pharmacists ◽  
Acute Hospital Setting

scholarly journals The use of a modified ‘surprise’ question to identify and recruit dying patients into a research project in an acute hospital setting

2012 ◽  
Vol 2 (Suppl 1) ◽  
pp. A8.2-A8 ◽  
Author(s):  
Jane Gibbins ◽  
Sophia Bloor ◽  
Colette Reid ◽  
Melanie Burcombe ◽  
Rachel McCoubrie ◽  
...  
Keyword(s):  
Hospital Setting ◽  
Acute Hospital ◽  
Research Project ◽  
Dying Patients ◽  
Surprise Question ◽  
Acute Hospital Setting
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