scholarly journals Pressure Injury Outcomes of a Prone-Positioning Protocol in Patients With COVID and ARDS

2021 ◽  
pp. e1-e8
Author(s):  
Connie Johnson ◽  
Nicholas A. Giordano ◽  
Lopa Patel ◽  
Karyn A. Book ◽  
Jennifer Mac ◽  
...  
Keyword(s):  
Comparison Group ◽  
Intervention Group ◽  
Treatment Method ◽  
Skin Care ◽  
Nurse Specialist ◽  
Prone Positioning ◽  
Mixed Effect ◽  
Care Nurse ◽  
Pressure Injury ◽  
Injury Outcomes

Background During the COVID-19 outbreak, standard methods for treating acute respiratory distress syndrome (ARDS) were used for patients presenting with ARDS. One such treatment method involves placing patients prone to improve oxygenation and reduce mortality risk. Challenges in preventing pressure injuries in patients placed prone have been reported, and no studies have explored the effects of including a certified wound and skin care nurse as part of the care team on the incidence of pressure injuries in SARS-CoV-2–infected patients with ARDS. Objectives To evaluate the association between including a certified wound and skin care nurse on a multiprofessional pronation team and prevention of pressure injuries in SARS-CoV-2–infected patients with ARDS. Methods This multicenter observational cohort study used retrospective data from the electronic health record. The intervention group consisted of SARS-CoV-2–infected patients diagnosed with ARDS who were treated by a multidisciplinary prone-positioning team that included a certified wound and skin care nurse specialist. The comparison group of SARS-CoV-2–infected patients with ARDS was treated by a multidisciplinary prone-positioning team that did not include a certified wound and skin care nurse specialist. Results As shown by multivariable logistic regression mixed-effect modeling, patients in the intervention group had a 97% lower adjusted odds ratio of a pressure injury developing than did patients in the comparison group (0.03 [95% CI, 0.01–0.14]; P < .001). Conclusion The inclusion of a certified wound and skin care nurse on a multiprofessional prone-positioning team significantly reduced the odds of pressure injuries developing in patients infected with SARS-CoV-2.

Effectiveness of a Care Delivery Model for High-Need Older Adults in Communities

2020 ◽  
pp. 104973152098235
Author(s):  
Kuei-Min Chen ◽  
Hui-Fen Hsu ◽  
Li-Yen Yang ◽  
Chiang-Ching Chang ◽  
Yu-Ming Chen ◽  
...  
Keyword(s):  
Older Adults ◽  
Repeated Measures ◽  
Comparison Group ◽  
Care Delivery ◽  
Intervention Group ◽  
Community Dwelling ◽  
Delivery Model ◽  
Positive Effects ◽  
Repeated Measures Design ◽  
Care Delivery Model

Purpose: This study aimed to test the effectiveness of High-Need Community-Dwelling Older Adults Care Delivery Model (HCOACDM) in Taiwan. Methods: A cluster randomized controlled trial with repeated measures design was conducted in eight community care centers, involving 145 high-need older adults who were assigned to the intervention group or comparison group. The HCOACDM was provided over 6 months. Functional ability, quality of life, depressive symptoms, and health care and social service utilizations were measured at baseline, at 3 months, and 6 months into the intervention. The participants’ satisfaction was measured at the end of 6-month intervention. Results: Positive effects were shown on all variables in the intervention group at both the 3-month and 6-month intervals (all p < .05). The intervention group had a higher satisfaction with care delivery than the comparison group ( p < .05). Discussion: The promising findings supported a long-term implementation of the HCOACDM as applicable and beneficial.

scholarly journals OP0010 EFFECTIVENESS OF THE MAKING IT WORK™ PROGRAM AT IMPROVING PRESENTEEISM AND WORK CESSATION IN WORKERS WITH INFLAMMATORY ARTHRITIS – RESULTS OF A RANDOMIZED CONTROLLED TRIAL

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 7.1-8
Author(s):  
A. Luquini ◽  
Y. Zheng ◽  
H. Xie ◽  
C. Backman ◽  
P. Rogers ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Work Disability ◽  
Inflammatory Arthritis ◽  
Missing Values ◽  
Controlled Trial ◽  
Intervention Group ◽  
Secondary Outcome ◽  
Mixed Effect ◽  
Randomized Controlled ◽  
Baseline Characteristics

Background:Arthritis often leads to presenteeism (decreased at-work productivity), missed days from work and permanent work disability, leading to reduced quality of life and high costs to individuals and society. Yet, health services addressing the employment needs of people with arthritis are lacking.Objectives:We evaluated the effectiveness of the Making-it-WorkTM(MiW) program, an online self-management program developed to help people with inflammatory arthritis (IA) deal with employment issues.Methods:A multi-center RCT evaluated the effectiveness of MiW at improving presenteeism and preventing work cessation (WC) over two years. Participants were recruited from rheumatologist practices, consumer organizations and arthritis programs, in three Canadian provinces. Eligibility criteria: diagnosis of IA, employed, age 18-59, and concerned about ability to work. Participants were randomized 1:1 to MiW or usual care plus printed material on workplace tips. MiW consists of five online self-learning modules and group meetings, and individual vocational counselling and ergonomic consultations. Questionnaires were administered every 6 months. Outcomes were presenteeism [Rheumatoid Arthritis Work Instability Scale (RA-WIS)], time to WC ≥ 6 months, and time to WC ≥ 2 months (secondary outcome). Baseline characteristics (age, gender, ethnicity, occupation, education, disease duration and self-employment) were collected. Intention-to-treat (ITT) longitudinal analysis of RA-WIS using linear mixed effect regression models with 2-year comparison as primary endpoint and survival analysis for time to WC using Kaplan-Meier and Cox Proportional Hazard models were performed. Robustness analyses were conducted by using various missing values imputation methods like last observation carried forward, imputation using worse possible outcomes and model-based multiple imputations; using square root transformation of RA-WIS outcome; and adjusting for baseline covariates. SAS version 9.4 was used.Results:A total of 564 participants were recruited, with 478 (84.75%) completing 2-year follow-up. Baseline characteristics were similar between groups. Mean RA-WIS scores were significantly lower in the intervention group from 6 months onwards, with the greatest difference observed at 2 years (-1.78, 95%CI: -2.7, -0.9, p < .0001), yielding a standardized effect size of 32%. Satisfactory robustness was observed. Work cessation occurred less often in intervention than control groups, but only reached statistical significance for WC ≥ 2 months (WC ≥ 6 months: 31 versus 44 events, aHR 0.70, 95%CI: 0.44, 1.11, p = 0.13; WC ≥ 2 months: 39 versus 61 events, aHR: 0.65, 95%CI: 0.43, 0.98, p = 0.04).Conclusion:Results of the RCT reveal the program was effective at improving presenteeism and preventing short-term WC. Effectiveness at preventing long-term work disability will be assessed at 5 years. This program fills one of the most important and costly unmet needs for people with inflammatory arthritis.References:[1]Carruthers EC, Rogers P, Backman CL, et al. “Employment and arthritis: making it work” a randomized controlled trial evaluating an online program to help people with inflammatory arthritis maintain employment (study protocol).BMC Med Inform Decis Mak. 2014;14:59. Published 2014 Jul 21. doi:10.1186/1472-6947-14-59Disclosure of Interests:Andre Luquini: None declared, Yufei Zheng: None declared, Hui Xie: None declared, Catherine Backman: None declared, Pamela Rogers: None declared, Alex Kwok: None declared, Astrid Knight: None declared, Monique Gignac: None declared, Dianne Mosher: None declared, Linda Li: None declared, John Esdaile: None declared, Carter Thorne Consultant of: Abbvie, Centocor, Janssen, Lilly, Medexus/Medac, Pfizer, Speakers bureau: Medexus/Medac, Diane Lacaille: None declared

scholarly journals Effectiveness of a Care Delivery Model for High-Need Community-Dwelling Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 279-279
Author(s):  
Kuei-Min Chen ◽  
Hui-Fen Hsu
Keyword(s):  
Older Adults ◽  
Comparison Group ◽  
Care Delivery ◽  
Care Service ◽  
Intervention Group ◽  
Community Dwelling ◽  
Delivery Model ◽  
Care Services ◽  
Care Delivery Model ◽  
Community Dwelling Older Adults

Abstract The effectiveness of sufficient care coordination for high-need community-dwelling older adults has not been discussed. This study aimed to examine the effectiveness of a newly-developed care delivery model for high-need community-dwelling older adults. A cluster randomized controlled trial with repeated measures design was employed. A total of 145 high-need older adults participated in the study and were randomly assigned to either the intervention group or comparison group. A categorized list of care services based on the types of high-need older adults as the intervention allowed care coordinators to make adequate care service linkages. The intervention period ranged over 6 months with regulated home visits and assesssments. Functional ability, quality of life, depressive symptoms, and healthcare and social service utilizations were measured at baseline, and at 3 and 6 months into the intervention. The participants’ satisfaction with care delivery was measured at the end of 6-month intervention. Results showed that the intervention group had a better functional ability, a higher quality of life, reduced depressive symptoms, and more efficient healthcare and social service utilizations than the comparison group at both the 3-month and 6-month intervals (all p &lt; .05). By the end of the 6-month study, the intervention group were more satisfied with the care service linkages than the comparison group (p &lt; .05). The positive effects of providing a categorized list of care services for care coordinators to make service linkages have been evidenced by the outcomes. The promising findings supported a further longer-term implementation of the care delivery model.

Medics as a Channel for Worksite Health Promotion in Remote Global Locations

2012 ◽  
Vol 26 (6) ◽  
pp. 352-355 ◽  
Author(s):  
Piroska A. Bisits Bullen
Keyword(s):  
Health Promotion ◽  
Survey Data ◽  
Comparison Group ◽  
Intervention Group ◽  
Target Population ◽  
Monthly Basis ◽  
Remote Environment ◽  
Worksite Health ◽  
Barriers To Implementation ◽  
Language And Education

Purpose. In the energy and mining sectors, it is common for employees to work in geographically remote locations, often with a medic for emergency response. This study evaluated an intervention to increase the number of medics conducting health promotion in remote worksites. Design. Interviews were conducted to gather data for informing intervention and survey development. The intervention was evaluated in a quasiexperimental posttest-only comparison group design using survey data collected at baseline and again after 12 months. Setting. The intervention was implemented in remote worksites (N = 201). There were 96 worksites in the intervention condition and 105 sites in the control condition. Subjects. The target population was medics, including nurses, doctors, and paramedics, operating in remote worksites in 44 countries. Intervention. The intervention was a series of campaign tool kits. The tool kits were adapted to the remote environment and could be customized for culture, language, and education level. Measures. The survey assessed frequency of health promotion activities, satisfaction with the intervention, and barriers to implementation. Analysis. Survey data were analyzed using descriptive statistics and χ2 tests. Interview results were coded to identify themes. Results. Most medics (88%) in the intervention group reported running “tool box talks” (short education sessions) on at least a monthly basis, compared with 78% in the comparison group (p = .056). The trend was similar for displaying posters (71% vs. 55%; p = .021) and advocating for policy changes (84% vs. 71%; p = .027). Medic satisfaction was high. Difficulty distributing tool kits was the main barrier to implementation. Conclusions. When provided with appropriate tools, medics may be an ideal channel for health promotion in remote worksites.

scholarly journals The treatment of patients with chronic rhinosinusitis in the conditions of sanatorium and preventive measures

2020 ◽  
Vol 19 (2) ◽  
pp. 57-63
Author(s):  
S. I. Pshenichnyi ◽  
◽  
R. K. Tulebaev ◽  
T. M. Azhenov ◽  
◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Nasal Mucosa ◽  
Paranasal Sinuses ◽  
Comparison Group ◽  
Treatment Method ◽  
Functional Disorders ◽  
Acid Base Balance ◽  
Natural Factors ◽  
Base Balance ◽  
Chronic Rhino Sinusitis

The objective of the research is to study of clinical and functional disorders of the nasal mucosa and paranasal sinuses of patients with chronic rhino sinusitis, as well as to make the choice of the optimal treatment method in a sanatorium using natural factors. A survey of 145 patients (94 men and 51 women) with chronic rhinosinusitis at the age of 18 to 65 years was conducted. Of these, male accounted for 64.8%, female – 35.2%. In patients with pathology of the paranasal sinuses, functional disorders of the nasal mucosa and paranasal sinuses were revealed. Particularly, violations of mucociliary clearance, acid-base balance of the nasal mucosa, and a decrease in nasal patency according to the data of active anterior rhinomanometry were defined. The use of natural factors as a treatment: inhalation of natural mineral water Maibalyk and mud applications on the paranasal sinus area significantly improved the course of way of chronic rhinosinusitis and led to normalization of the functional parameters of the nasal mucosa, in contrast to the comparison group (60 people). The comparison group did not use with Maibalyk natural water inhalations and mud applications from Lake Maybalyk, but used only ordinary alkaline inhalations.

scholarly journals Self-Care Options for Resilient Educators (SCORE) Teaches Aspiring Teachers How to Manage Stress in Light of COVID-Related Disruptions

2021 ◽  
Vol 06 (04) ◽  
pp. 1-1
Author(s):  
Brandis M. Ansley ◽  
◽  
Meagan A. Wander ◽  
Keyword(s):  
Stress Management ◽  
Comparison Group ◽  
Secondary Trauma ◽  
Intervention Group ◽  
Self Care ◽  
Management Training ◽  
Medium Effects ◽  
Post Intervention ◽  
Stress Management Training ◽  
Quasi Experimental

Self-Care Options for Resilient Educators (SCORE) is an 8-week, asynchronous virtual training program that teaches stress management skills relevant to educators’ job-related responsibilities and interpersonal interactions. From January-April 2020, 28 pre-service teachers participated in a quasi-experimental study of SCORE’s feasibility and preliminary efficacy. Volunteers chose to either complete SCORE concurrent with their teaching internship or to complete the same assessments for comparison purposes. Recruitment and implementation took place prior to COVID-19 disruptions. Then, six weeks into SCORE, the participants encountered unanticipated school closures and uncertainties associated with their internships (e.g., Would they be able to complete their internships and degree programs? Would they be eligible to teach the next school year?). Despite disruptions to their teaching internships, the remote format of SCORE allowed the study to continue and for participants to complete the full training. Pre-intervention to post-intervention changes in outcomes for the intervention group reflected large effect sizes for decreases in burnout and increases in teacher efficacy. There were medium effects for increased self-compassion and small-to-medium effects for increased cognitive reappraisal. However, pre-to-post intervention differences for the comparison group were relatively unchanged on most indicators. Results for secondary traumatic stress was remarkable, as the comparison group demonstrated a medium-to-large effect for an increase at post-intervention. This measure, however, revealed no effect in change for program participants. This finding is noteworthy and suggests that participation in SCORE or a similar program may help mitigate the potentially harmful effects of exposure to secondary trauma. Overall, this study’s results support arguments for including stress management training during pre-service teaching internships.

Integrating Clinical Nurse Specialists into the Treatment of Primary Care Patients with Depression

2003 ◽  
Vol 33 (1) ◽  
pp. 17-37 ◽  
Author(s):  
Ralph W. Swindle ◽  
Jaya K. Rao ◽  
Ahdy Helmy ◽  
Laurie Plue ◽  
X. H. Zhou ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Depressive Symptoms ◽  
Integrated Care ◽  
Medical Center ◽  
Treatment Plan ◽  
Intervention Group ◽  
Nurse Specialist ◽  
Clinical Nurse ◽  
Primary Care Patients

Objective: To examine the effectiveness of integrating generalist and specialist care for veterans with depression. Method: We conducted a randomized trial of patients screening positive for depression at two Veterans Affairs Medical Center general medicine clinic firms. Control firm physicians were notified prior to the encounter when eligible patients had PRIME-MD depression diagnoses. In the intervention firm, a mental health clinical nurse specialist (CNS) was to: design a treatment plan; implement that plan with the primary care physician; and monitor patients via telephone or visits at two weeks, one month and two months. Primary outcomes (depressive symptoms, patient satisfaction with health care) were collected at 3 and 12 months. Results: Of 268 randomized patients, 246 (92%) and 222 (83%) completed 3- and 12-month follow-up interviews. There were no between-group differences in depressive symptoms or satisfaction at 3 or 12 months. The intervention group had greater chart documentation of depression at baseline (63% versus 33%, p = 0.003) and a higher referral rate to mental health services at 3 months (27% versus 9%, p = 0.019). There was no difference in the rate of new prescriptions for, or adequate dosing of, anti-depressant medications. In 40% of patients, CNSs disagreed with the PRIME-MD depression diagnosis, and their rates of watchful waiting were correspondingly high. Conclusions: Implementing an integrated care model did not occur as intended. Experienced CNSs often did not see the need for treatment in many primary care patients identified by the PRIME-MD. Integrating integrated care models in actual practice may prove challenging.

Effectiveness of a Job Search Training Program for Youth With Visual Impairments

2018 ◽  
Vol 42 (4) ◽  
pp. 214-224 ◽  
Author(s):  
Jennifer L. Cmar ◽  
Michele C. McDonnall
Keyword(s):  
Job Search ◽  
Work Experience ◽  
Comparison Group ◽  
Visual Impairments ◽  
Intervention Group ◽  
Work Experiences ◽  
Effective Work ◽  
Quasi Experimental ◽  
Search Training ◽  
And Behavior

Early work experiences predict future employment for youth with visual impairments, particularly when youth find jobs independently, but research has not supported the efficacy of sponsored work for this population. The most effective work experience programs include additional components such as job search assistance, and job search interventions are effective at improving employment outcomes. Thus, we conducted a quasi-experimental study to evaluate the effectiveness of adding job search training to a summer work experience program with 42 youth with visual impairments. Intervention group youth significantly increased job search knowledge and behavior compared with comparison group youth, and both groups increased in job search self-efficacy. Although additional research is needed, this study provides initial evidence of the job search program’s effectiveness.

Indication of Treatment For Children And Adolescents With Postural Tachycardia Syndrome By Intravenous Saline Infusion

2022 ◽  
Author(s):  
Yoshitoki Yanagimoto ◽  
Yuko Ishizaki ◽  
Yoko Nakai ◽  
Miki Minami ◽  
Rinako Tamai ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Comparison Group ◽  
Intervention Group ◽  
Saline Infusion ◽  
Postural Tachycardia Syndrome ◽  
Postural Tachycardia ◽  
Before And After ◽  
Intravenous Saline ◽  
The Mean ◽  
Standing Test

Abstract Background: Intravenous saline infusion is considered effective for the treatment of postural tachycardia syndrome (POTS) in adults. However, few studies have assessed the efficacy of intravenous saline infusion for POTS in children and adolescents. Aim: This study aimed to evaluate the efficacy of intravenous saline infusion in children and adolescents with POTS.Methods: A total of 107 children with POTS (median age: 13 years, range: 10–15 years) were enrolled. Eighty-eight children were in the intravenous saline infusion group and 19 children were in the comparison group. Blood pressure (BP) and pulse rate (PR) were recorded before and after standing. A standing test was performed early in the morning for 2 consecutive days. A volume of 1.5 L of saline was administered intravenously to each participant in the intervention group for a mean duration of 17 hours between the two standing tests.Results: The mean change in PR was significantly lower in the intervention group than in the comparison group during the second test (36.9 vs. 52.8 beats/minute, p<0.001). Additionally, the mean change in PR was significantly lower in the second test than in the first test (44.7 beats/minute) in the intervention group (p<0.001). However, the mean change in systolic BP was not different before and after intravenous saline infusion between the two groups or between the two tests in each group.Conclusion: Intravenous saline infusion reduces the increased PR on standing in children with POTS. Intravenous saline infusion improves tachycardia in children with POTS when standing.

Improving Family Communications at the End of Life: Implications for Length of Stay in the Intensive Care Unit and Resource Use

2003 ◽  
Vol 12 (4) ◽  
pp. 317-324 ◽  
Author(s):  
Tom Ahrens ◽  
Valerie Yancey ◽  
Marin Kollef
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
End Of Life ◽  
Resource Utilization ◽  
Intervention Group ◽  
Clinical Nurse Specialist ◽  
Control Group ◽  
Nurse Specialist ◽  
Clinical Nurse

• Background Inadequate communication persists between healthcare professionals and patients and patients’ families in intensive care units. Unwanted or ineffective treatments can occur when patients’ goals of care are unknown or not honored, increasing costs and care. Having the primary physician provide medical information and then having a physician and clinical nurse specialist team improve opportunities for patients and their families to process that information could improve the situation. This model has not been tested for its effect on patients’ outcomes and resource utilization.• Objectives To evaluate the effect of a communication team that included a physician and a clinical nurse specialist on length of stay and costs for patients near the end of life in the intensive care unit.• Methods During a 1-year period, patients judged to be at high risk for death (N = 151) were divided into 2 groups: 43 patients who were cared for by the medical director teamed with a clinical nurse specialist and 108 patients who received standard care, provided by an attending physician.• Results Compared with the control group, patients in the intervention group had significantly shorter stays in both the intensive care unit (6.1 vs 9.5 days) and the hospital (11.3 vs 16.4 days) and had lower fixed ($15 559 vs $24 080) and variable ($5087 vs $8035) costs.• Conclusions Use of a physician and a clinical nurse specialist focused on improving communication with patients and patients’ families reduced lengths of stay and resource utilization.

Sign in / Sign up

Export Citation Format

Share Document