scholarly journals Current practice and challenges in screening for visual perception deficits after stroke: a qualitative study

2019 ◽  
Author(s):  
Kathleen Vancleef ◽  
Michael J Colwell ◽  
Olivia Hewitt ◽  
Nele Demeyere
Keyword(s):  
Visual Perception ◽  
Health Care Professionals ◽  
Care Pathway ◽  
Occupational Therapists ◽  
Stroke Survivor ◽  
Service Evaluation ◽  
Screening Tools ◽  
Evidence Based ◽  
Training Requirements ◽  
Bedside Testing

AbstractAIMWe aimed to document current clinical practice and needs in screening for visual perception problems after stroke to inform development of new screening tools.METHODSWe interviewed 25 health care professionals (12 occupational therapists, 13 orthoptists) from 16 organisations in England. Interviews were transcribed and coded in NVivo Software. Data were thematically analysed using the Value Proposition Canvas, a model which establishes what people want to achieve, the challenges they face and what facilitates their jobs.RESULTSParticipants’ understanding of visual perception varied and often included sensory and cognitive deficits. Occupational therapists commonly screened for visual field deficits and hemispatial neglect, while other aspects of visual cognition were rarely assessed. They decided on referrals to orthoptists for further assessment. Screening generally occurred during functional assessments and/or with in-house developed tools. Challenges to practice were: lack of time, lack of training, environmental and stroke survivor factors (e.g. aphasia), insufficient continuation of care, and test characteristics (e.g. not evidence-based). Facilitators to practice were: quick and practical tools, experienced staff or tools with minimal training requirements, a streamlined care pathway between a stroke unit and eye hospital supported by occupational therapists and orthoptists.CONCLUSIONScreening employs non-standardised assessments and rarely covers visual perceptual deficits in higher order perception. Our service evaluation demonstrates the need for a standardised visual perception screen, which should ideally be 15 minutes or less, be portable, and require minimal equipment. The screen should be suitable for bedside testing in noisy environments, inclusive for participants with aphasia and evidence-based.

Clinical Effectiveness: Systematic Reviews and Evidence-Based Practice in Occupational Therapy

1997 ◽  
Vol 60 (11) ◽  
pp. 479-483 ◽  
Author(s):  
Katrina Bannigan
Keyword(s):  
Health Care ◽  
Occupational Therapy ◽  
Systematic Reviews ◽  
Health Care Professionals ◽  
Research Evidence ◽  
Evidence Based Practice ◽  
Occupational Therapists ◽  
Evidence Based ◽  
Sources Of Information ◽  
High Quality

Evidence-based health care can be defined as an approach to health care that involves finding and using up-to-date research into the effectiveness of health care interventions to inform decision making (Entwistle et al, 1996). For many occupational therapists, the practicalities of keeping up to date with the best research evidence is difficult; however, through the National Health Service Centre for Reviews and Dissemination (NHS CRD), the NHS Research and Development (R&D) Programme is aiming to improve the availability of high quality research evidence to all health care professionals. The NHS CRD carries out and commissions systematic reviews. Systematic reviews are a means of pulling together large quantities of research information and are considered to be one of the most reliable sources of information about effectiveness (Chalmers and Altman, 1995). The NHS CRD also disseminates the findings of systematic reviews, one method of which is through the Database of Abstracts of Reviews of Effectiveness (DARE). The relevance of systematic reviews to the clinical practice of occupational therapists is explored in this paper using two examples: a poor quality and a high quality systematic review identified from the abstracting process for DARE. Both reviews are directly relevant to occupational therapy, being about sensory integration and falls in the elderly respectively. The implications of these reviews for evidence-based practice in occupational therapy are discussed.

Evidence-Based Practice and Occupational Therapy

1997 ◽  
Vol 60 (11) ◽  
pp. 474-478 ◽  
Author(s):  
Walter Lloyd-Smith
Keyword(s):  
Health Care Professionals ◽  
Evidence Based Practice ◽  
Occupational Therapists ◽  
Evidence Based ◽  
Care Services ◽  
Health And Social Care ◽  
History Of ◽  
Research Findings ◽  
Key Issues ◽  
Market Driven

Occupational therapists, like other health care professionals, are constantly being asked to confront major changes in the way health and social care services are structured and, in turn, how their working practices are organised. In order for the market-driven National Health Service to function, it requires detailed information on whether services are clinically effective. The use of evidence-based practice has been widely advocated as one way to meet these demands. This article focuses on evidence-based practice as an approach, and considers its implications and relevance for occupational therapists. First, a short history of the background of evidence-based practice is given, followed by a discussion of recent social and political developments which have increased demands for its wider use. A number of key issues associated with evidence-based practice are then considered, including implementing research findings into practice; the nature of evidence itself; time; the accessibility of research findings; and skills required for evidence-based practice. Practical suggestions are also offered to enable therapists to make the most appropriate use of evidence-based practice. The aim of this article is to stimulate debate about evidence-based decision making for practitioners.

scholarly journals An Integrated Care Pathway for Self-Injurious Behavior for Individuals with IDD: Improving Practice through Training

2016 ◽  
Vol 1 (2) ◽  
Keyword(s):  
Health Care ◽  
Best Practices ◽  
Integrated Care ◽  
Health Care Professionals ◽  
Care Pathway ◽  
Evidence Based ◽  
Treatment Team ◽  
Intellectual And Developmental Disability ◽  
Integrated Care Pathway ◽  
Clinical Variation

This paper addresses the lack of knowledge and lack of standardization for treating individuals who engage in selfinjurious behavior (SIB) to the head. An evidence-based integrated care pathway is described that was created for health care professionals treating individuals with intellectual and developmental disability (IDD) who engage in frequent and/or significant SIB. It is anticipated that this pathway will increase treatment team knowledge of best practices, decrease clinical variation, standardize care, and improve clinical outcomes with this vulnerable population.

Visual Perceptual Deficit Screening in Stroke Survivors: Evaluation of Current Practice in the United Kingdom and Republic of Ireland

2021 ◽  
Author(s):  
Michael James Colwell ◽  
Nele Demeyere ◽  
Kathleen Vancleef
Keyword(s):  
United Kingdom ◽  
Visual Perception ◽  
Current Practice ◽  
Occupational Therapists ◽  
Screening Tools ◽  
Stroke Survivors ◽  
Visual Neglect ◽  
Perceptual Deficit ◽  
Post Stroke ◽  
The United Kingdom

PURPOSEVisual perceptual deficits are frequently underdiagnosed in stroke survivors compared to sensory vision deficits or visual neglect. To better understand this imparity, we evaluated current practice for screening post-stroke visual perceptual deficits.METHODSWe conducted a survey targeted at stroke clinicians involved in screening visual perceptual deficits across the United Kingdom and Republic of Ireland.RESULTSForty orthoptists and 174 occupational therapists responded to the survey. Visual perceptual deficit screening was primarily conducted by occupational therapists (94%), with approximately 75-100% of stroke survivors screened per month. Respondents lacked consensus on whether several common post-stroke visual deficits were perceptual or not. During screening, respondents primarily relied on self-reports and observation (94%), while assessment batteries (58%) and screening tools were underutilised (56%) and selected inappropriately (66%). Respondents reported lack of training in visual perception screening (20%) and physical/cognitive condition of stroke survivors (19%) as extremely challenging during screening.CONCLUSIONSVisual perceptual deficits are screened post-stroke at a similar rate to sensory vision or visual neglect. Underdiagnosis of visual perceptual deficits may stem from both reliance on subjective and non-standardised screening approaches, and conflicting definitions of visual perception held among clinicians. We recommend increased training provision and brief performance-based screening tools.

The Preschool Stuttering Screen for Health Care Professionals

2011 ◽  
Vol 21 (2) ◽  
pp. 59-62
Author(s):  
Joseph Donaher ◽  
Christina Deery ◽  
Sarah Vogel
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Differential Diagnosis ◽  
Preschool Children ◽  
Health Care Professionals ◽  
Healthcare Professionals ◽  
Evidence Based ◽  
Developmental Profile

Healthcare professionals require a thorough understanding of stuttering since they frequently play an important role in the identification and differential diagnosis of stuttering for preschool children. This paper introduces The Preschool Stuttering Screen for Healthcare Professionals (PSSHP) which highlights risk factors identified in the literature as being associated with persistent stuttering. By integrating the results of the checklist with a child’s developmental profile, healthcare professionals can make better-informed, evidence-based decisions for their patients.

scholarly journals “This Is the Result of Something Else”: Experiences of Men That Abused Drugs and Had Experienced Childhood Trauma

2021 ◽  
Vol 15 (2) ◽  
pp. 155798832110093
Author(s):  
Margret Torshamar Georgsdottir ◽  
Sigrun Sigurdardottir ◽  
Hrafnhildur Gunnthorsdottir
Keyword(s):  
Health Care ◽  
Drug Abuse ◽  
Childhood Trauma ◽  
Health Care Professionals ◽  
Psychological Trauma ◽  
Screening Tools ◽  
Public Health Issue ◽  
Coping Mechanism ◽  
Addictive Behaviors ◽  
Abused Drugs

Drug abuse is a serious public health issue that may have irreversible consequences. Research has revealed that childhood psychological trauma can promote addictive behaviors in adulthood and that drugs are often used as a coping mechanism. Men are less likely to report trauma and seek help than women. The purpose of this qualitative study was to explore the experience of men in Iceland who have abused drugs and experienced childhood psychological trauma, to increase knowledge and deepen the understanding of trauma and addiction. Participants were seven men who had both experienced childhood trauma and had a history of drug abuse. Two interviews were conducted with each participant. The main findings suggest that participants abused drugs as a coping mechanism due to the trauma experienced in childhood. For some participants, seeking companionship was a key component of their drug use. Participants were mostly dissatisfied with treatment resources in Iceland; waiting lists were long and too much focus was on religion. Five main themes were identified: emotional impact, self-medication for pain, gender expectations, impermanence of thoughts, and loss of a sense of wholeness. Increased societal and professional awareness of the linkage between trauma and drug abuse is needed, as are additional resources specific to men who have experienced childhood trauma and drug abuse. It is important to integrate trauma focused services into health-care settings to educate health-care professionals on trauma and the consequences thereof, in addition to utilizing screening tools such as the Adverse Childhood Experience Questionnaire for those seeking assistance.

scholarly journals Building capacity for implementation—the KT Challenge

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Agnes T. Black ◽  
Marla Steinberg ◽  
Amanda E. Chisholm ◽  
Kristi Coldwell ◽  
Alison M. Hoens ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Professionals ◽  
Qualitative Data ◽  
Practice Change ◽  
Evidence Based ◽  
Science Literature ◽  
Health Care Settings ◽  
Improvement Programs ◽  
The Impact

Abstract Background The KT Challenge program supports health care professionals to effectively implement evidence-based practices. Unlike other knowledge translation (KT) programs, this program is grounded in capacity building, focuses on health care professionals (HCPs), and uses a multi-component intervention. This study presents the evaluation of the KT Challenge program to assess the impact on uptake, KT capacity, and practice change. Methods The evaluation used a mixed-methods retrospective pre-post design involving surveys and review of documents such as teams’ final reports. Online surveys collecting both quantitative and qualitative data were deployed at four time points (after both workshops, 6 months into implementation, and at the end of the 2-year funded projects) to measure KT capacity (knowledge, skills, and confidence) and impact on practice change. Qualitative data was analyzed using a general inductive approach and quantitative data was analyzed using non-parametric statistics. Results Participants reported statistically significant increases in knowledge and confidence across both workshops, at the 6-month mark of their projects, and at the end of their projects. In addition, at the 6-month check-in, practitioners reported statistically significant improvements in their ability to implement practice changes. In the first cohort of the program, of the teams who were able to complete their projects, half were able to show demonstrable practice changes. Conclusions The KT Challenge was successful in improving the capacity of HCPs to implement evidence-based practice changes and has begun to show demonstrable improvements in a number of practice areas. The program is relevant to a variety of HCPs working in diverse practice settings and is relatively inexpensive to implement. Like all practice improvement programs in health care settings, a number of challenges emerged stemming from the high turnover of staff and the limited capacity of some practitioners to take on anything beyond direct patient care. Efforts to address these challenges have been added to subsequent cohorts of the program and ongoing evaluation will examine if they are successful. The KT Challenge program has continued to garner great interest among practitioners, even in the midst of dealing with the COVID-19 pandemic, and shows promise for organizations looking for better ways to mobilize knowledge to improve patient care and empower staff. This study contributes to the implementation science literature by providing a description and evaluation of a new model for embedding KT practice skills in health care settings.

Quality Assessment of HTA reports: a Critical Appraisal Toolkit within an institutional HTA program

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Bossi ◽  
M Tringali ◽  
P Colombo ◽  
C Mazzali ◽  
G Puleo ◽  
...  
Keyword(s):  
Health Care Professionals ◽  
Critical Appraisal ◽  
Population Aging ◽  
Clinical Effectiveness ◽  
Evidence Based ◽  
Lombardy Region ◽  
Double Blinded ◽  
Sustainable Health ◽  
Local Healthcare

Abstract Issue With population aging, increased demand for healthcare and limited availability of economic and human resources, well-functioning and sustainable health systems have to rely on rigorous and evidence-based assessments of complex technologies' clinical effectiveness and safety. The Lombardy Region in Northern Italy has a well-established HTA program that offers technical support to its hospitals' network to produce and to review Health Technology Assessment (HTA) reports. Description of the Problem To better coordinate the HTA network and to reduce self-referencing of University and Community hospitals, Lombardy Region carried out an intense field training and distance learning from year 2017, with a project aimed at involving health care professionals in an accurate evaluation of technologies in 18 HTA reports. The regional HTA Supporting Centre developed a Toolkit for the critical appraisal of reports and supporting literature to improve the quality of hospital-based reports. Results In compliance with the regional Law DGR XI/1046 17.12.2018 and the framework proposed, during year 2019 hospitals used the Toolkit to help writing complete and good quality HTA reports on 37 different technologies. With a Public Health resident internship, the Toolkit was revised, extended and then used in 2020 by the hospital's HTA network during the double blinded peer review, mandated by the regional Law DGR XI/2672 16.12.2019, of the year 2019 HTA reports. Detailed results will be presented at the conference. Lessons We observed an increase in number of HTA reports from 2018 to 2019, a greater language's and format's homogeneity and an improvement in the quality of some reports, which will be submitted to the Regional HTA Committee for appraisal and reimbursement. Key messages The development and use of a Critical Appraisal Toolkit in an Regional HTA program can help hospitals write complete and good quality HTA reports. A centrally supported quality improvement of distributed assessment activities in a network of hospitals can enhance the production of HTA reports, relevant to the needs of a local healthcare system.

scholarly journals Canadian Nationwide Survey on Pediatric Malnutrition Management in Tertiary Hospitals

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2635
Author(s):  
Koen Huysentruyt ◽  
Kim Brunet-Wood ◽  
Robert Bandsma ◽  
Leah Gramlich ◽  
Bonnie Fleming-Carroll ◽  
...  
Keyword(s):  
Health Care Professionals ◽  
Care Pathway ◽  
Clinical Care ◽  
Tertiary Care ◽  
Nationwide Survey ◽  
Nutritional Screening ◽  
Pediatric Hospitals ◽  
Adoption And Implementation ◽  
Clinical Care Pathway

Background: Disease-associated malnutrition (DAM) is common in hospitalized children. This survey aimed to assess current in-hospital practices for clinical care of pediatric DAM in Canada. Methods: An electronic survey was sent to all 15 tertiary pediatric hospitals in Canada and addressed all pillars of malnutrition care: screening, assessment, treatment, monitoring and follow-up. Results: Responses of 120 health care professionals were used from all 15 hospitals; 57.5% were medical doctors (MDs), 26.7% registered dietitians (RDs) and 15.8% nurses (RNs). An overarching protocol for prevention, detection and intervention of pediatric malnutrition was present or “a work in progress”, according to 9.6% of respondents. Routine nutritional screening on admission was sometimes or always performed, according to 58.8%, although the modality differed among hospitals and profession. For children with poor nutritional status, lack of nutritional follow-up after discharge was reported by 48.5%. Conclusions: The presence of a standardized protocol for the clinical assessment and management of DAM is uncommon in pediatric tertiary care hospitals in Canada. Routine nutritional screening upon admission has not been widely adopted. Moreover, ongoing nutritional care of malnourished children after discharge seems cumbersome. These findings call for the adoption and implementation of a uniform clinical care pathway for malnutrition among pediatric hospitals.

scholarly journals Nurses and Pharmaceutical Care: Interprofessional, Evidence-Based Working to Improve Patient Care and Outcomes

2021 ◽  
Vol 18 (11) ◽  
pp. 5973
Author(s):  
Tinne Dilles ◽  
Jana Heczkova ◽  
Styliani Tziaferi ◽  
Ann Karin Helgesen ◽  
Vigdis Abrahamsen Grøndahl ◽  
...  
Keyword(s):  
Health Care ◽  
Pharmaceutical Care ◽  
Health Care Professionals ◽  
Interprofessional Collaboration ◽  
Improve Patient Care ◽  
Modern Medicine ◽  
Care Quality ◽  
Practice Research ◽  
Evidence Based ◽  
Research Education

Pharmaceutical care necessitates significant efforts from patients, informal caregivers, the interprofessional team of health care professionals and health care system administrators. Collaboration, mutual respect and agreement amongst all stakeholders regarding responsibilities throughout the complex process of pharmaceutical care is needed before patients can take full advantage of modern medicine. Based on the literature and policy documents, in this position paper, we reflect on opportunities for integrated evidence-based pharmaceutical care to improve care quality and patient outcomes from a nursing perspective. Despite the consensus that interprofessional collaboration is essential, in clinical practice, research, education and policy-making challenges are often not addressed interprofessionally. This paper concludes with specific advises to move towards the implementation of more interprofessional, evidence-based pharmaceutical care.

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