Role expansion for nurses in the cardiac catheter laboratory: findings from a systematic scoping review

2020 ◽  
Vol 15 (4) ◽  
pp. 1-14
Author(s):  
Iain Gillingham ◽  
Lis Neubeck ◽  
Brian Williams ◽  
Susan Dawkes

Background/aims The cardiac catheter laboratory offers services to patients with a variety of conditions. These may include coronary heart disease, structural heart disorders and cardiac electrophysiological syndromes. Owing to the complex nature of an evolving health service and the increasing demands placed on healthcare workers, it is essential that innovative paradigms of service delivery are identified. This scoping review examines the state of knowledge regarding the rationale for change, solutions and potential consequences of expanding the roles of nurses in the cardiac catheter lab. Methods An exploratory scoping study approach was employed, using an established framework. Databases searched included the Cumulative Index to Nursing and Allied Health Literature, Medline and Google Scholar. A systematic search strategy spanning a date range from 1988–2018 was formulated. Titles and abstracts of 172 papers were screened; a total of 20 papers were identified for full review, including 16 from the UK, one from the United States, two from Europe and one from Australia. Results Literature to date concentrated on seven key areas: (1) drivers for change, (2) principles underpinning change, (3) ways of developing the workforce, (4) appropriate change management, (5) recommendations for practice, (6) barriers and facilitators, and (7) outcomes. Conclusions The cardiac catheter lab is under pressure to meet the variable demands placed upon it. There is documented evidence of a shortage of cardiac physiologists, which has a direct and measurable impact on operational efficiency and patient care. The concept of expanding the nurse's role to incorporate aspects of the cardiac physiologist's role has been explored and could be a potential solution. Role expansion and advanced practice is a well-explored model in nursing. There are many themes associated with this issue, which are outlined in this paper. There needs to be more evidence surrounding the patient's perceptions in relation to professional roles in the workplace. An economic evaluation of the costs and benefits of a multiskilled workforce would be a challenging but worthwhile endeavour.

2013 ◽  
pp. 81-120 ◽  
Author(s):  
Susanne Durst

Intangibles are viewed as the key drivers in most industries, and current research shows that firms voluntarily disclose information about their investments in intangibles and their potential benefits. Yet little is known of the risks relating to such resources and the disclosures firms make about such risks. In order to obtain a more balanced and complete picture of firms' activities, information about the risky side of their intangibles is also needed. This exploratory study provides some descriptive insights into intangibles-related risk disclosure in a sample of 16 large banks from the United States (US), United Kingdom (UK), Germany and Italy. Annual report data is analyzed using the three Intellectual Capital dimensions. Study findings illustrate the variety of intangibles-related risk disclosure as demonstrated by the banks involved.


2014 ◽  
Vol 23 (3) ◽  
pp. 381-388 ◽  
Author(s):  
Euan Hague ◽  
Alan Mackie

The United States media have given rather little attention to the question of the Scottish referendum despite important economic, political and military links between the US and the UK/Scotland. For some in the US a ‘no’ vote would be greeted with relief given these ties: for others, a ‘yes’ vote would be acclaimed as an underdog escaping England's imperium, a narrative clearly echoing America's own founding story. This article explores commentary in the US press and media as well as reporting evidence from on-going interviews with the Scottish diaspora in the US. It concludes that there is as complex a picture of the 2014 referendum in the United States as there is in Scotland.


2020 ◽  
Vol 119 (820) ◽  
pp. 303-309
Author(s):  
J. Nicholas Ziegler

Comparing the virus responses in Germany, the United Kingdom, and the United States shows that in order for scientific expertise to result in effective policy, rational political leadership is required. Each of these three countries is known for advanced biomedical research, yet their experiences in the COVID-19 pandemic diverged widely. Germany’s political leadership carefully followed scientific advice and organized public–private partnerships to scale up testing, resulting in relatively low infection levels. The UK and US political responses were far more erratic and less informed by scientific advice—and proved much less effective.


2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Eko Wahyono ◽  
Rizka Amalia ◽  
Ikma Citra Ranteallo

This research further examines the video entitled “what is the truth about post-factual politics?” about the case in the United States related to Trump and in the UK related to Brexit. The phenomenon of Post truth/post factual also occurs in Indonesia as seen in the political struggle experienced by Ahok in the governor election (DKI Jakarta). Through Michel Foucault's approach to post truth with assertive logic, the mass media is constructed for the interested parties and ignores the real reality. The conclusion of this study indicates that new media was able to spread various discourses ranging from influencing the way of thoughts, behavior of society to the ideology adopted by a society.Keywords: Post factual, post truth, new media


2019 ◽  
Author(s):  
Allison Hirsch ◽  
Mahip Grewal ◽  
Anthony James Martorell ◽  
Brian Michael Iacoviello

BACKGROUND Digital Therapeutics (DTx) provide evidence based therapeutic health interventions that have been clinically validated to deliver therapeutic outcomes, such that the software is the treatment. Digital methodologies are increasingly adopted to conduct clinical trials due to advantages they provide including increases in efficiency and decreases in trial costs. Digital therapeutics are digital by design and can leverage the potential of digital and remote clinical trial methods. OBJECTIVE The principal purpose of this scoping review is to review the literature to determine whether digital technologies are being used in DTx clinical research, which type are being used and whether publications are noting any advantages to their use. As DTx development is an emerging field there are likely gaps in the knowledge base regarding DTx and clinical trials, and the purpose of this review is to illuminate those gaps. A secondary purpose is to consider questions which emerged during the review process including whether fully remote digital clinical research is appropriate for all health conditions and whether digital clinical trial methods are inline with the principles of Good Clinical Practice. METHODS 1,326 records were identified by searching research databases and 1,227 reviewed at the full-article level in order to determine if they were appropriate for inclusion. Confirmation of clinical trial status, use of digital clinical research methods and digital therapeutic status as well as inclusion and exclusion criteria were applied in order to determine relevant articles. Digital methods employed in DTx research were extracted from each article and these data were synthesized in order to determine which digital methods are currently used in clinical trial research. RESULTS After applying our criteria for scoping review inclusion, 11 articles were identified. All articles used at least one form of digital clinical research methodology enabling an element of remote research. The most commonly used digital methods are those related to recruitment, enrollment and the assessment of outcomes. A small number of articles reported using other methods such as online compensation (n = 3), or digital reminders for participants (n = 5). The majority of digital therapeutics clinical research using digital methods is conducted in the United States and increasing number of articles using digital methods are published each year. CONCLUSIONS Digital methods are used in clinical trial research evaluating DTx, though not frequently as evidenced by the low proportion of articles included in this review. Fully remote clinical trial research is not yet the standard, more frequently authors are using partially remote methods. Additionally, there is tremendous variability in the level of detail describing digital methods within the literature. As digital technologies continue to advance and the clinical research DTx literature matures, digital methods which facilitate remote research may be used more frequently.


2019 ◽  
Vol 5 (2) ◽  
pp. 214-240
Author(s):  
Rob J Gruijters ◽  
Tak Wing Chan ◽  
John Ermisch

Despite an impressive rise in school enrolment rates over the past few decades, there are concerns about growing inequality of educational opportunity in China. In this article, we examine the level and trend of educational mobility in China, and compare them to the situation in Germany, the Netherlands, the UK and the USA. Educational mobility is defined as the association between parents’ and children’s educational attainment. We show that China’s economic boom has been accompanied by a large decline in relative educational mobility chances, as measured by odds ratios. To elaborate, relative rates of educational mobility in China were, by international standards, quite high for those who grew up under state socialism. For the most recent cohorts, however, educational mobility rates have dropped to levels that are comparable to those of European countries, although they are still higher than the US level.


Genealogy ◽  
2021 ◽  
Vol 5 (2) ◽  
pp. 32
Author(s):  
Araceli Orozco-Figueroa

Recently, Black, Indigenous, and other People of Color (BIPOC) have encountered an escalation in adverse social conditions and trauma events in the United States. For individuals of Mexican ancestry in the United States (IMA-US), these recent events represent the latest chapter in their history of adversity: a history that can help us understand their social and health disparities. This paper utilized a scoping review to provide a historical and interdisciplinary perspective on discussions of mental health and substance use disorders relevant to IMA-US. The scoping review process yielded 16 peer reviewed sources from various disciplines, published from 1998 through 2018. Major themes included historically traumatic events, inter-generational responses to historical trauma, and vehicles of transmission of trauma narratives. Recommendations for healing from historical and contemporary oppression are discussed. This review expands the clinical baseline knowledge relevant to the diagnosis, treatment, and prevention of contemporary traumatic exposures for IMA-US.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Danielle M. Nash ◽  
Zohra Bhimani ◽  
Jennifer Rayner ◽  
Merrick Zwarenstein

Abstract Background Learning health systems have been gaining traction over the past decade. The purpose of this study was to understand the spread of learning health systems in primary care, including where they have been implemented, how they are operating, and potential challenges and solutions. Methods We completed a scoping review by systematically searching OVID Medline®, Embase®, IEEE Xplore®, and reviewing specific journals from 2007 to 2020. We also completed a Google search to identify gray literature. Results We reviewed 1924 articles through our database search and 51 articles from other sources, from which we identified 21 unique learning health systems based on 62 data sources. Only one of these learning health systems was implemented exclusively in a primary care setting, where all others were integrated health systems or networks that also included other care settings. Eighteen of the 21 were in the United States. Examples of how these learning health systems were being used included real-time clinical surveillance, quality improvement initiatives, pragmatic trials at the point of care, and decision support. Many challenges and potential solutions were identified regarding data, sustainability, promoting a learning culture, prioritization processes, involvement of community, and balancing quality improvement versus research. Conclusions We identified 21 learning health systems, which all appear at an early stage of development, and only one was primary care only. We summarized and provided examples of integrated health systems and data networks that can be considered early models in the growing global movement to advance learning health systems in primary care.


Author(s):  
Miriam Blume ◽  
Petra Rattay ◽  
Stephanie Hoffmann ◽  
Jacob Spallek ◽  
Lydia Sander ◽  
...  

This scoping review systematically mapped evidence of the mediating and moderating effects of family characteristics on health inequalities in school-aged children and adolescents (6–18 years) in countries with developed economies in Europe and North America. We conducted a systematic scoping review following the PRISMA extension for Scoping Reviews recommendations. We searched the PubMed, PsycINFO and Scopus databases. Two reviewers independently screened titles, abstracts and full texts. Evidence was synthesized narratively. Of the 12,403 records initially identified, 50 articles were included in the synthesis. The included studies were conducted in the United States (n = 27), Europe (n = 18), Canada (n = 3), or in multiple countries combined (n = 2). We found that mental health was the most frequently assessed health outcome. The included studies reported that different family characteristics mediated or moderated health inequalities. Parental mental health, parenting practices, and parent-child-relationships were most frequently examined, and were found to be important mediating or moderating factors. In addition, family conflict and distress were relevant family characteristics. Future research should integrate additional health outcomes besides mental health, and attempt to integrate the complexity of families. The family characteristics identified in this review represent potential starting points for reducing health inequalities in childhood and adolescence.


Sign in / Sign up

Export Citation Format

Share Document