scholarly journals Deprescribing benzodiazepines: Do Brazilian package inserts address this issue?

2021 ◽  
Vol 15 ◽  
Author(s):  
Marlon Silva Tinoco ◽  
Marcela Oliveira Baldoni ◽  
Ériks Oliveira Silva ◽  
Amanda Maria de Paiva ◽  
Paula Resende Daher Chaves ◽  
...  
Keyword(s):  
Health Professionals ◽  
Treatment Duration ◽  
Package Insert ◽  
Health Surveillance ◽  
Package Inserts ◽  
Length Of Treatment ◽  
Continuous Use ◽  
Benzodiazepine Drugs

OBJECTIVE: To analyze the presence and quality of content on drug deprescribing in Brazilian package inserts for benzodiazepine drugs. METHODS: Documentary study where we analyzed data on deprescribing extracted from electronic package inserts of drugs containing benzodiazepines; these documents were available at the Brazilian Health Surveillance Agency website. Our search was performed independently by 2 researchers who used the following keywords: “deprescription,” “withdrawal,” and “tapering.” The deprescribing plan, when presented by the package insert, was compared to deprescribing protocols for benzodiazepines found in the literature. Moreover, we assessed the presence of guidance on the maximum length of treatment and risks of long-term use. RESULTS: We found 12 package inserts for benzodiazepines and 100% of them suggested gradual withdrawal; only 1 (8.33%) suggested a systematized deprescribing plan. One document (8.33%) did not offer guidance on maximum treatment duration. Eleven (91.67%) had the information on long-term use possibly causing dependence or tolerance, and 1 (8.33%) did not describe the risks of continuous use. CONCLUSIONS: It is known that benzodiazepines should be withdrawn in a gradual and schematized manner, but package inserts do not currently bring this information in detail. It is of utmost importance that health professionals be educated on their conduct, hence the necessity for updating medication package inserts.

Teamwork

2018 ◽  
pp. 587-594
Author(s):  
Maria Flynn ◽  
Dave Mercer
Keyword(s):  
Health Professionals ◽  
Healthcare Setting ◽  
Healthcare Services ◽  
Health Condition ◽  
Illness Episode ◽  
Wide Range ◽  
Working Together ◽  
Effective Organization

The importance of teamworking has been long established in healthcare, with nurses working both as part of a nursing team and as members of the wider multidisciplinary team. The effective organization and delivery of healthcare services depends upon a wide range of health professionals, patients, families, and carers working together to achieve the best health outcomes and quality of life. Whether healthcare is necessary for an acute illness episode, helping someone with a long-term health condition achieve an acceptable level of function, or supporting a person who is dying, placing people at the centre of care decisions demands effective teamworking. Understanding the nature and characteristics of teams can help nurses to work effectively and uphold professional caring values when working with people in any healthcare setting. This chapter outlines the key definitions and characteristics of teamworking.

scholarly journals Providing care to long-term mechanically ventilated patients in Germany – Current situation and needs for action from the perspective of health professionals / Die Versorgung langzeitbeatmeter Patienten in Deutschland – Aktuelle Situation und Handlungsbedarfe aus der Sicht von Gesundheitsberufsangehörigen

2020 ◽  
Vol 7 (1) ◽  
pp. 53-65
Author(s):  
Yvonne Lehmann ◽  
Susanne Stark ◽  
Michael Ewers
Keyword(s):  
Health Professionals ◽  
Invasive Mechanical Ventilation ◽  
Life Quality ◽  
Control Mechanisms ◽  
Health Providers ◽  
Patient Centered ◽  
Patient Pathways ◽  
Number Of Patients

AbstractBackgroundThe number of patients depending on long-term invasive mechanical ventilation (IMV) has been increasing for several years. Anecdotal reports indicate heterogeneous health structures, opaque patient pathways, nontransparent and sometimes questionable practices in individual areas of care, inadequate quality standards and control mechanisms in Germany. However, there is hardly any empirical data on this topic.AimTo report findings from a qualitative study conducted as part of a complex research project to assess the appropriateness of care provided to IMV patients in Germany.MethodsThirteen semi-structured expert interviews were conducted with 22 health professionals providing care for IMV patients. The data analysis was conducted with MAXQDA according to the framework by Meuser and Nagel.ResultsInterviewees emphasized similar healthcare deficits. They considered health providers to be nontransparent and influenced by secondary interests. Quality of care is reported to be jeopardized by shortage of trained staff. Warranty of self-determination and participatory decision-making is not a matter of fact. Clarifying issues of sustaining life, quality of life and shaping the end of life is often ignored. The professionals are familiar with the patient pathways, allocation processes and responsibilities described in existing guidelines, but criticize the fact that they are not sufficiently binding. Accordingly, patient pathways are frequently individual results of experience-based, informal networking, and often left to chance.ConclusionsThe results point to a considerable need for action to reach an appropriate, integrated, patient-centered level of care for long-term IMV patients and ensure its quality.

Partnering with Parents: Establishing Effective Long-Term Relationships with Parents in the NICU

2006 ◽  
Vol 25 (5) ◽  
pp. 329-337 ◽  
Author(s):  
Mary McAllister ◽  
Kim Dionne
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Parental Role ◽  
Parent Perspectives ◽  
Duration Of Hospitalization ◽  
Newborn Intensive Care

Advances in health care have led to unprecedented innovation in the care provided to critically ill newborns. One outcome of this new reality is that newborn intensive care units have become “homes” for fragile infants who require long-term hospitalization. Clearly, NICUs were never so envisioned; thus, this reality has resulted in challenges for families and health professionals alike. As the duration of hospitalization increases, relationships between families and health care professionals become increasingly important. Parents of hospitalized newborns face fear, anxiety, and frustration as they struggle to cope with an ill child while developing their parental role. The quality of relationships established between families and health care professionals is crucial to their coping and adaptation. This article addresses challenges faced by families whose infants experience extended hospitalization, applies a model to help health care professionals understand parent perspectives, and proposes strategies to promote effective partnerships and alliances with families.

scholarly journals Brief Online Focused Attention Meditation Training: Immediate Impact

2016 ◽  
Vol 22 (3) ◽  
pp. 395-400 ◽  
Author(s):  
Kathi J. Kemper ◽  
Nisha Rao
Keyword(s):  
Negative Affect ◽  
Social Workers ◽  
Health Professionals ◽  
Online Training ◽  
Focused Attention ◽  
Positive And Negative Affect ◽  
Before And After ◽  
Relaxation Stress

Background. There is increasing interest in brief, online training in mind-body skills to improve resilience in health professionals. Methods. We analyzed data from an online training program in focused attention meditation. Resilience, relaxation, stress, positive and negative affect, and flourishing were measured before and after training using standardized scales. Results. The 379 participants included nurses (31%), physicians (21%), social workers and psychologists (10%), and others (38%). At baseline, participants reported high levels of stress (mean 16.7 compared with population norms of 12-14). Completing modules was associated with small but significant improvements in relaxation, resilience, stress, positive and negative affect, and flourishing ( P <. 01 for all) Conclusion. Online focused attention meditation training reaches diverse health professionals and is associated with improvements in relaxation, resilience, stress, affect, and flourishing. Additional research is warranted to compare the long-term cost-effectiveness of different amounts and types of mind-body training on clinician burnout and quality of care.

Improving Quality of Care through Risk Management Knowledge Transfer and Quality Assurance in Nursing Care

2012 ◽  
pp. 233-241
Author(s):  
Kleopatra Alamantariotou
Keyword(s):  
Health Care ◽  
Risk Management ◽  
Quality Assurance ◽  
Quality Of Care ◽  
Knowledge Transfer ◽  
Nursing Care ◽  
Health Professionals ◽  
Careful Consideration

The purpose of this chapter is to provide innovative knowledge and creative ideas of improving quality of care and to explore how risk management and Knowledge transfer and quality assurance can improve health care. Under careful consideration, our purpose is to summarize which factors improve and promote the quality of care and which factors diminish quality. There are forms of ongoing efforts to make performance better. Quality improvement must be a long-term, continuous effort, reducing errors and providing a safe trust environment for health professionals and patients. After reading this chapter, you should know the answer to these questions: What role can risk management and knowledge transfer play in quality of care? How can risk management and knowledge transfer work together? What are the factors that improve risk management and quality assurance in health care? How does knowledge transfer support, inform, and improve care?

scholarly journals Brief Online Mindfulness Training

2016 ◽  
Vol 22 (1) ◽  
pp. 75-80 ◽  
Author(s):  
Kathi J. Kemper
Keyword(s):  
Health Professionals ◽  
Online Training ◽  
Mindfulness Training ◽  
Five Facet Mindfulness Questionnaire ◽  
Self Reflection ◽  
Mindful Attention Awareness Scale ◽  
The Impact ◽  
Different Doses

Background. Online training is feasible, but the impact of brief mindfulness training on health professionals needs to be better understood. Methods. We analyzed data from health professionals and trainees who completed self-reflection exercises embedded in online mindfulness training between May 2014 and September, 2015; their changes in mindfulness were measured using standardized scales. Results. Participants included nurses (34%), physicians (24%), social workers and psychologists (10%), dietitians (8%), and others (25%); 85% were women, and 20% were trainees. The most popular module was Introduction to Mindfulness (n = 161), followed by Mindfulness in Daily Life (n = 146), and Mindful Breathing and Walking (n = 129); most (68%) participants who took 1 module took all 3 modules. There were no differences in participation in any module by gender, trainee status, or profession. Completing modules was associated with small but significant improvements on the Cognitive and Affective Mindfulness Scale–Revised, the Mindful Attention Awareness Scale, and the Five Facet Mindfulness Questionnaire ( P < 0.001 for all). Conclusion. Online training reaches diverse health professionals and is associated with immediate improvements in mindfulness. Additional research is warranted to compare the long-term cost-effectiveness of different doses of online and in-person mindfulness training on clinician burnout and quality of care.

scholarly journals The Preventive Role of Hydrogen-Rich Water in Thioacetamide-Induced Cholangiofibrosis in Rat Assessed by Automated Histological Classification

2021 ◽  
Vol 12 ◽  
Author(s):  
Chaofu Li ◽  
Xing Zhao ◽  
Xiaoqiang Gu ◽  
Ying Chen ◽  
Guanzhen Yu
Keyword(s):  
Quality Of Life ◽  
Intestinal Flora ◽  
Rna Seq ◽  
Genetic Changes ◽  
Whole Process ◽  
Continuous Use ◽  
Rat Livers

Background: Cholangiofibrosis is a controversial intrahepatic cholangial lesion that precedes the development of cholangiocarcinoma. Here, we demonstrate that molecular hydrogen (H2) can be used to effectively prevent cholangiofibrosis.Methods: The safety and quality of life (QOL) of rats was firstly evaluated. H2 was administered to rats subjected to thioacetamide (TAA)-induced cholangiofibrosis throughout the whole process. Then, rats were administrated with TAA for 3 months and then followed by H2 intervention. Rat livers were harvested and assessed by light microscopy and convolutional neural network. RNA-seq was performed to analyze the genetic changes in these animal models.Results: Continuous use of H2-rich water was safe and improved QOL.The incidence and average number of cholangiofibrosis in the liver were higher in the TAA group (100%, 12.0 ± 10.07) than that in the H2 group (57.1%, 2.86 ± 5.43). The AI algorithm revealed higher Alesion/Aliver in the TAA group (19.6% ± 9.01) than that in the H2 group (7.54% ± 11.0). RNA-seq analysis revealed that H2 results in a decline in glycolysis. Moreover, in the third experiment, the incidence of microscopic or suspicious tumors and the ratio of liver lesions was decreased after long-term use of H2 (12.5%, 0.57% ± 0.45) compared with untreated group (100%, 0.98% ± 0.73). A number of intestinal microbiota was changed after H2 usage, including clostridiaceae_1, ruminococcus, turicibacter, coriobacteriales, actinobacteria, and firmicutes_bacterium.Conclusion: Hydrogen-rich water protects against liver injury and cholangiofibrosis and improved quality of life partially through regulating the composition of intestinal flora.

Thinking Beyond Language: Intervention for Severe Aphasia

2009 ◽  
Vol 19 (1) ◽  
pp. 15-22 ◽  
Author(s):  
Nina Simmons-Mackie
Keyword(s):  
Quality Of Life ◽  
Communication Training ◽  
Language Intervention ◽  
Specific Training ◽  
Environmental Support ◽  
Total Communication ◽  
Communication Partners

Abstract Purpose: This article addresses several intervention approaches that aim to improve life for individuals with severe aphasia. Because severe aphasia significantly compromises language, often for the long term, recommended approaches focus on additional domains that affect quality of life. Treatments are discussed that involve increasing participation in personally relevant life situations, enhancing environmental support for communication and participation, and improving communicative confidence. Methods: Interventions that have been suggested in the aphasia literature as particularly appropriate for people with severe aphasia include training in total communication, training of communication partners, and activity specific training. Conclusion: Several intervention approaches can be implemented to enhance life with severe aphasia.

Communication Disordered: Program Implementation in Long-Term Care

2016 ◽  
Vol 1 (15) ◽  
pp. 64-67
Author(s):  
George Barnes ◽  
Joseph Salemi
Keyword(s):  
Program Implementation ◽  
Long Term Care ◽  
Family Satisfaction ◽  
Regulatory Compliance ◽  
Care Staff ◽  
Term Care ◽  
Staff Members ◽  
Change Policy

The organizational structure of long-term care (LTC) facilities often removes the rehab department from the interdisciplinary work culture, inhibiting the speech-language pathologist's (SLP's) communication with the facility administration and limiting the SLP's influence when implementing clinical programs. The SLP then is unable to change policy or monitor the actions of the care staff. When the SLP asks staff members to follow protocols not yet accepted by facility policy, staff may be unable to respond due to confusing or conflicting protocol. The SLP needs to involve members of the facility administration in the policy-making process in order to create successful clinical programs. The SLP must overcome communication barriers by understanding the needs of the administration to explain how staff compliance with clinical goals improves quality of care, regulatory compliance, and patient-family satisfaction, and has the potential to enhance revenue for the facility. By taking this approach, the SLP has a greater opportunity to increase safety, independence, and quality of life for patients who otherwise may not receive access to the appropriate services.

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