Factors that contribute to underrecognition of delirium by registered nurses in acute care settings: a scoping review of the literature to explain this phenomenon

2014 ◽  
Vol 24 (7-8) ◽  
pp. 906-915 ◽  
Author(s):  
Mohamed El Hussein ◽  
Sandra Hirst ◽  
Vincent Salyers
Keyword(s):  
Registered Nurses ◽  
Acute Care ◽  
Scoping Review ◽  
Review Of The Literature ◽  
Acute Care Settings

Methods used to attribute costs avoided from pharmacist interventions in acute care: A scoping review

2021 ◽  
Author(s):  
Sujita W Narayan ◽  
Ivo Abraham ◽  
Brian L Erstad ◽  
Curtis E Haas ◽  
Arthur Sanders ◽  
...  
Keyword(s):  
Acute Care ◽  
Scoping Review ◽  
Pharmacy Practice ◽  
Economic Implications ◽  
Medline Search ◽  
Cost Avoidance ◽  
Harmful Consequence ◽  
Pharmacist Interventions ◽  
Acute Care Settings ◽  
Human Participants

Abstract Purpose Cost-avoidance studies are common in pharmacy practice literature. This scoping review summarizes, critiques, and identifies current limitations of the methods that have been used to determine cost avoidance associated with pharmacists’ interventions in acute care settings. Methods An Embase and MEDLINE search was conducted to identify studies that estimated cost avoidance from pharmacist interventions in acute care settings. We included studies with human participants and articles published in English from July 2010 to January 2021, with the intent of summarizing the evidence most relevant to contemporary practice. Results The database search retrieved 129 articles, of which 39 were included. Among these publications, less than half (18 of 39) mentioned whether the researchers assigned a probability for the occurrence of a harmful consequence in the absence of an intervention; thus, a 100% probability of a harmful consequence was assumed. Eleven of the 39 articles identified the specific harm that would occur in the absence of intervention. No clear methods of estimating cost avoidance could be identified for 7 studies. Among all 39 included articles, only 1 attributed both a probability to the potential harm and identified the cost specific to that harm. Conclusion Cost-avoidance studies of pharmacists’ interventions in acute care settings over the last decade have common flaws and provide estimates that are likely to be inflated. There is a need for guidance on consistent methodology for such investigations for reporting of results and to confirm the validity of their economic implications.

scholarly journals Reasonable adjustments for people with intellectual disability in acute care: a scoping review of the evidence

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e039647
Author(s):  
Mairead Moloney ◽  
Therese Hennessy ◽  
Owen Doody
Keyword(s):  
Intellectual Disability ◽  
Acute Care ◽  
Scoping Review ◽  
Service Provision ◽  
Care Setting ◽  
Acute Care Setting ◽  
Inclusion Criteria ◽  
Health Service Provision ◽  
Acute Care Settings ◽  
Fair Access

ObjectivesPeople with intellectual disability are vulnerable in terms of health service provision due to increased comorbidity, higher dependency and cognitive impairment. This review explored the literature to ascertain what reasonable adjustments are evident in acute care to support people with intellectual disability, ensuring they have fair access and utilisation of health services.DesignScoping review.SettingAcute care settings.MethodsFive databases were systematically searched to identify studies that reported on the implementation of reasonable adjustments. Authors worked in pairs to screen studies for inclusion, data were extracted and charted and findings were synthesised according to content and themes.ResultsOf the 7770 records identified, six studies were included in the review. The volume of evidence was influenced by specific inclusion criteria, and only papers that reported on the actual implementation of a reasonable adjustment within an acute care setting were included. Many papers reported on the concept of reasonable adjustment; however, few identified its applications in practice.ConclusionsThe scoping review highlights a lack of research on the practice and implementation of reasonable adjustments within acute care settings. There is a need for increased support, education and the provision of intellectual disability specialists across acute care settings.

scholarly journals Restricted visitation policies in acute care settings during the COVID-19 pandemic: a scoping review

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Stephana J. Moss ◽  
Karla D. Krewulak ◽  
Henry T. Stelfox ◽  
Sofia B. Ahmed ◽  
Melanie C. Anglin ◽  
...  
Keyword(s):  
Acute Care ◽  
Scoping Review ◽  
Healthcare Professionals ◽  
Case Series ◽  
Well Being ◽  
Primary Data ◽  
Cochrane Central Register ◽  
Negative Consequences ◽  
Primary Research ◽  
Acute Care Settings

Abstract Background Restricted visitation policies in acute care settings because of the COVID-19 pandemic have negative consequences. The objective of this scoping review is to identify impacts of restricted visitation policies in acute care settings, and describe perspectives and mitigation approaches among patients, families, and healthcare professionals. Methods We searched Medline, Embase, PsycINFO, Healthstar, CINAHL, Cochrane Central Register of Controlled Trials on January 01/2021, unrestricted, for published primary research records reporting any study design. We included secondary (e.g., reviews) and non-research records (e.g., commentaries), and performed manual searches in web-based resources. We excluded records that did not report primary data. Two reviewers independently abstracted data in duplicate. Results Of 7810 citations, we included 155 records. Sixty-six records (43%) were primary research; 29 (44%) case reports or case series, and 26 (39%) cohort studies; 21 (14%) were literature reviews and 8 (5%) were expert recommendations; 54 (35%) were commentary, editorial, or opinion pieces. Restricted visitation policies impacted coping and daily function (n = 31, 20%) and mental health outcomes (n = 29, 19%) of patients, families, and healthcare professionals. Participants described a need for coping and support (n = 107, 69%), connection and communication (n = 107, 69%), and awareness of state of well-being (n = 101, 65%). Eighty-seven approaches to mitigate impact of restricted visitation were identified, targeting families (n = 61, 70%), patients (n = 51, 59%), and healthcare professionals (n = 40, 46%). Conclusions Patients, families, and healthcare professionals were impacted by restricted visitation polices in acute care settings during COVID-19. The consequences of this approach on patients and families are understudied and warrant evaluation of approaches to mitigate their impact. Future pandemic policy development should include the perspectives of patients, families, and healthcare professionals. Trial registration: The review was registered on PROSPERO (CRD42020221662) and a protocol peer-reviewed prior to data extraction.

Screening for depression and anxiety among patients with acute coronary syndrome in acute care settings: a scoping review

2020 ◽  
Vol 18 (9) ◽  
pp. 1932-1969
Author(s):  
Tania S. Marin ◽  
Sandra Walsh ◽  
Nikki May ◽  
Martin Jones ◽  
Richard Gray ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Acute Care ◽  
Scoping Review ◽  
Depression And Anxiety ◽  
Coronary Syndrome ◽  
Acute Care Settings

scholarly journals LO72: Assessing non-technical skills in prehospital ad hoc team resuscitation

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S34
Author(s):  
J. Evans ◽  
D. Lingard ◽  
D. Peddle ◽  
M. Slack
Keyword(s):  
Acute Care ◽  
Scoping Review ◽  
Full Text ◽  
Ad Hoc ◽  
Technical Skills ◽  
Skills Training ◽  
Educational Models ◽  
Successful Resuscitation ◽  
Acute Care Settings ◽  
Ad Hoc Teams

Introduction: Successful resuscitation in the ED cannot occur without a viable patient, and in many cases patient viability is dependent upon optimal prehospital resuscitation performed by ad hoc teams formed in real time. Currently, little is known about the cognitive and interpersonal skills, or non-technical skills, that are essential for effective team collaboration under these conditions. We have completed a scoping review to provide a state of the literature and develop a taxonomy of the non-technical skills pertinent to ad hoc teams in prehospital settings. Methods: Our scoping review searched four databases (EMBASE, Medline, Cinahl, and Psychinfo) for articles related to resuscitation in acute care settings. No date criteria were applied, but only full text articles written in English were included. Articles underwent two-reviewer title & abstract screening, full text screening, and analysis. A quality review asked three questions: Are keywords defined? Is the article well-situated within the existing literature? Does the article contribute back to the existing body of knowledge? Although statistical analyses are not appropriate for this scoping review, analysis included a descriptive-analytical framework for organizing data. Results: Of 6932 screened articles, 38 were included in analysis, five articles examined prehospital teams, and one addressed the ad hoc nature of these teams. Only one of these articles met our three quality criteria. Nevertheless, our analysis suggests a rudimentary taxonomy whereby the primary objective of a team leader is to overcome this barrier by facilitating the development of optimal team situational awareness, fostered through timely and accurate briefings with closed-loop communication. Conclusion: This scoping review has identified that non-technical skills pertaining to resuscitation in acute care settings are becoming a widely examined phenomenon; however, few studies contribute in any meaningful way to our understanding of how non-technical skills training can be tailored to those performing as members of ad hoc prehospital resuscitation teams. As the need for interprofessional training is becoming more pressing, we anticipate this review will provide essential guidance for future inquiry as well as design for both educational models and organizational systems-based interventions.

Strategies to increase physician engagement in acute care settings: a scoping review

2019 ◽  
Vol 33 (7/8) ◽  
pp. 902-918
Author(s):  
Graham Shaw ◽  
Neale Smith ◽  
Asif Khowaja ◽  
Craig Mitton ◽  
Jean-Louis Denis ◽  
...  
Keyword(s):  
Acute Care ◽  
Scoping Review ◽  
English Language ◽  
Institutional Work ◽  
Content Type ◽  
Organizational Goals ◽  
Physician Engagement ◽  
Stage Process ◽  
System Improvement ◽  
Acute Care Settings

Purpose Despite growing attention to physician engagement there is a lack of literature to guide the development of physician-led interventions. A scoping review was conducted to describe physician-led strategies that have been implemented to promote increased physician engagement in acute care settings. Strategies are viewed through the theoretical lens of institutional work to advance the understanding about how the theory can be applied. The paper aims to discuss this issue. Design/methodology/approach Searches were conducted in English-language publications (2012–2017). Of 35 retained articles, 15 were from the gray literature; and 20 were peer reviewed. The review was guided by Arskey and O’Malley’s (2005) five-stage process. Findings Five themes reflecting different foci of physician-led activity were examined from the perspective of institutional work: systematically analyze context using participatory methods; work collaboratively toward locally defined, shared targets and build in processes to monitor progress; expand physicians’ role and capacity to include leadership toward shared organizational goals; promote appropriate rewards and incentives for work that builds engagement; and invest in opportunities for formal and informal communication and interaction. Practical implications Physicians considering action to increase their engagement in system improvement may benefit from analysis of local opportunities and barriers in selecting context-relevant activities that will motivate participation and build engagement through a balance of institutional work. Originality/value The paper considers the potential for physicians to initiate and support activity that will increase their engagement. It provides pragmatic strategies for designing intervention and research using the theoretical lens of institutional work.

Nurses' tension-based ethical decision making in rural acute care settings

2020 ◽  
Vol 27 (4) ◽  
pp. 1032-1043
Author(s):  
Manal M Alzghoul ◽  
Kristen Jones-Bonofiglio
Keyword(s):  
Decision Making ◽  
Registered Nurses ◽  
Acute Care ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Acute Care Hospitals ◽  
Ethical Challenges ◽  
Northern Ontario ◽  
Ethical Conflicts ◽  
Acute Care Settings

Background Nurses in acute care are frequently involved in ethical decision making and experience a higher prevalence of ethical conflicts and dilemmas. Nurses in underresourced rural acute care settings also are likely to face unique ethical challenges. However, rarely have the particular contexts of these experiences in rural acute care settings been researched. A culture of silence and fear in small towns has made exploring these issues difficult. Objectives To explore registered nurses’ experiences of ethical issues and ethical decision making in rural acute care hospitals in northern Ontario, Canada. Research design Guided by an interpretive descriptive approach, data were collected by two nurse researchers using in-depth, individual, and semistructured telephone interviews. Data were managed with NVivo v.11 and analyzed using inductive, comparative, thematic analyses. Participants and research context The participants were eight registered nurses working in two acute care hospitals in northern Ontario. Ethical considerations Ethical protocols were followed in accordance with ethics approval from the researchers’ university and the hospitals. Findings Results identified four themes that culminated in the development of a quadruple helix ethical decision-making framework of power, trust, care, and fear. Discussion and conclusion The participants described complex ethical conflicts and dilemmas in acute care settings that were influenced by the context of working and living in small rural communities in northern Ontario. Nurses described navigating ethics in practice using a tension-based approach to ethical decision making, needing to carry these issues silently and often having no resolution to ethical challenges. These findings have important implications for nursing education, research, and practice. Nurses need safe spaces, formal ethics support, and improved access to resources. Additional ethics education and training specific to the unique contexts of rural settings are needed.

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