Academic literature on the topic 'Clinical Nursing: Primary (Preventative)'
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Journal articles on the topic "Clinical Nursing: Primary (Preventative)"
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Endicott, Kendal M., Charles B. Drucker, Hakan Orbay, Joseph J. DuBose, Khanjan Nagarsheth, Shahab Toursavadkohi, and Rajabrata Sarkar. "Intraoperative Fragmentation and Retention of Endovascular Devices: Clinical Consequences and Preventative Strategies." Vascular and Endovascular Surgery 54, no. 2 (November 5, 2019): 118–25. http://dx.doi.org/10.1177/1538574419886193.
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Background: Expanded applications and increasing volumes of complex endovascular procedures have increased the risk of unintended intraoperative fragmentation and retention of catheters and sheaths. We describe a series of retained or fragmented endovascular devices, a quality improvement program to address this unmet need for improved detection of catheter fragmentation, and the results of this program. Methods: Cases utilizing endovascular devices that resulted in a retained catheter fragment were identified and analyzed during divisional quality improvement review. One consistent area of concern was operating room (OR) staff unfamiliarity with verifying the integrity of an endovascular device. In response, a slide-based training protocol of focused, endovascular nursing education was implemented. Following perceived lack of improvement after this approach, we developed a handheld visual reference display of the tips of common catheters and sheaths. Staff was surveyed before and after intervention to assess the educational value of the display and the impact on staff device familiarity. Results: All 4 described cases resulted in an unplanned return to the OR for retrieval of the fragmented catheter or sheath. No thromboembolic complications were observed, although associated intra-arterial thrombus was noted in 2 cases. Thirty-four OR nurses were polled to trial the visual reference display initiative, with 70% of those reporting primary surgical assignments outside of cardiovascular ORs. Introduction of the new visual reference display improved staff confidence in their ability to identify a broken device (2.4-3.7, P < .001). This improvement was most significant in OR staff with primary assignments in noncardiovascular services. Conclusion: Current OR standard operating procedures fail to address the potential for unintentionally retained catheters and wires during endovascular procedures. Our novel visual reference display of common endovascular items rather than conventional in-service training improved the ability of staff to identify device fragmentation at the time of the index procedure.
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Marshall, Bob, Sue Floyd, and Rachel Forrest. "Clinical outcomes and patients perceptions of nurse-led healthy lifestyle clinics." Journal of Primary Health Care 3, no. 1 (2011): 48. http://dx.doi.org/10.1071/hc11048.
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BACKGROUND AND CONTEXT: The Nurse-Led Healthy Lifestyle Clinics focussed on lifestyle issues for patients with known health inequalities. Much of the nursing was educative and preventative care. This evaluation assessed patient experiences and opinions, as well as clinical outcomes. ASSESSMENT OF PROBLEM: Information came from clinical outcome data for 2850 individuals and 424 patient satisfaction surveys. Results: Patients were aged 095 years (45% between 40 and 59 years); 60% Pakeha/European, 31.4% Maori, 4.2% Pacific and 4.4% other ethnicities. Only 19% of claimants (approximately 40% were Maori or Pacific) came from quintile 5 addresses, suggesting the target population was not reached effectively. Ninety-four percent of patients had a better understanding of their diagnosis, medication and treatment plan, and were more motivated to self-manage their health needs. This increase in patient empowerment is a significant outcome of the project. Clinical outcome data showed no significant differences between first and last clinic visits for average weight, blood pressure, smoking, glycosylated haemoglobin levels, waist circumference or cardiovascular risk. Significant improvements were shown in the Dartmouth Primary Care Cooperative Information results for social activity, change in health, and overall health (n=89). STRATEGIES FOR IMPROVEMENT: More effective techniques to access the target population have been implemented, as has an extended period for review of clinical outcomes. LESSONS: More focussed evaluation of clinical outcomes is necessary to provide quantitative data on the clinics. The large percentage of patients who felt more empowered to self-manage their health needs suggests the clinics were effective in this area. KEYWORDS: Nurse-led clinics; life style; program evaluation; patient satisfaction; health status disparities
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Gorelick, Philip B. "Community Engagement: Lessons Learned From the AAASPS and SDBA." Stroke 53, no. 3 (March 2022): 654–62. http://dx.doi.org/10.1161/strokeaha.121.034554.
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Community engagement is a means to help overcome challenges to the delivery of health care and preventative services. On the occasion of the 2021 International Stroke Conference Edgar J. Kenton III Lecture, I review community engagement strategies utilized in the AAASPS trial (African-American Antiplatelet Stroke Prevention Study) and SDBA (Studies of Dementia in the Black Aged) observational studies that I directed. The main community engagement strategies included use of home visits (bringing the study to the community), engagement of churches, community advisors, community physicians, other healthcare providers, major Black community organizations, and utilization of diversity training. Community engagement strategies were a major component of AAASPS and SDBA that helped to ensure successful recruitment and retention of an underrepresented community in clinical trial and observational studies. Lessons learned from these studies largely carried out in the 1980s and 1990s helped to dispel myths that Blacks could not be recruited into large-scale clinical trials, emphasized the importance of studying underrepresented groups with adequate statistical power to test primary study hypotheses, and provided foundational recruitment and retention methods for future consideration.
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WONG, Sio Mui, Wen ZENG, Iek Long LO, Chong LAM, and Hong Lei LOU. "Development and Psychometric Evaluation of a Chinese Instrument of Knowledge, Attitude and Preventive Practice on Dementia Care in Macao." American Journal of Alzheimer's Disease & Other Dementias® 38 (January 2023): 153331752211493. http://dx.doi.org/10.1177/15333175221149358.
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Background Very few instruments to integrate knowledge, attitude and practice into dementia care as a holistic perspective were available to the Chinese. Method This article documented the development of a 30-item self-administered Chinese instrument of knowledge, attitude and preventive practice on dementia care and reported the results of psychometric testing among 1500 Chinese in Macao Special Administrative Region (SAR), including 234 primary health professionals, 272 staff working at day-care centers and nursing homes, 586 high school students and 408 community-dwelling older people. The Chinese instrument was developed through literature review and committee review. The psychometric methods were used to evaluate the reliability and validity of the Chinese instrument as measures of knowledge, attitude and preventive practice on dementia care for the Chinese. Results The preliminary results indicated that the Content Validity Index of the Chinese instrument was .973 and Cronbach’s alpha coefficient of the Chinese instrument was .842, among which Knowledge subscale, Attitude subscale and Preventive Practice subscale were .749, .633 and .845 respectively. The means and standard deviation were 65.13 ± 24.56 for Knowledge subscale, 74.76 ± 8.37 for Attitude subscale, 73.22 ± 14.05 for Preventative Practice subscale, and 70.99 ± 11.27 for the Chinese instrument. Conclusion The 30-item self-administered Chinese instrument of knowledge, attitude and preventive practice on dementia care had satisfied the psychometric evaluation well enough to warrant further use, and could also have particular implications for other Chinese populations all over the world.
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Sartain, Sarah, John Price, Brooke Bitner, Elizabeth Wolfe, and Daniel Ortiz. "Determination of Antimicrobial Prescribing Practices in an Integrated Health System Emergency Department." Kansas Journal of Medicine 13 (June 25, 2020): 131–33. http://dx.doi.org/10.17161/kjm.v13i.13812.
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Introduction. Antibiotic stewardship utilizes interprofessional collaborative practices, including professionals from medicine, pharmacy, nursing, social services, and clinical laboratory science, to identify potential problems proactively. A tertiary care integrated health system’s Emergency Department (ED) aimed to identify antimicrobials prescribed to the outpatient community as part of a proactive antimicrobial stewardship project.
Methods. A pilot, prospective, snapshot of a tertiary community hospital’s outpatient antimicrobial prescribing habits was conducted. All subjects were identified via a daily report of patients discharged from the ED over 30 days in the summer of 2017 and individually reviewed for prescribed antimicrobial(s). Exclusions were hospital admission, antimicrobial sensitivity, and antimicrobial courses less than five days or more than 14 days. The primary goal was determining the number of antimicrobial oral tablets/capsule prescriptions to adult outpatients within a 5 to 14-day treatment window. Secondary goals were to include the diagnosis, non-capsule/tablet antimicrobial, pediatric patients, and prescriptions outside the treatment window.
Results. Total number of antimicrobial prescriptions over the 30-day period was 653 in 5,520 individual visits. Total number of adults prescribed oral antimicrobials was 467 (15.6 daily). Patients were diagnosed with infections including urinary tract, cellulitis, soft tissue injury, abscess, upper respiratory, dental caries, gastrointestinal, sexually transmitted, otitis media/externa, pneumonia, viral, pyelonephritis, tick-borne, fungal, Bell’s Palsy, and sepsis. The number of non-adult, non-oral, and outside window treatment antimicrobial prescriptions were 186 (6.2 daily). With an average 184 patients treated in the ED daily, approximately 11.8% received antimicrobial treatment on discharge.
Conclusion. Important aspects of the project were the evaluation of antimicrobial prescribing habits for a midwest ED and identification of potential complications requiring future interventions for follow-up or preventative measures to assist in patient care and community health. Areas of practice improvement were identified inadvertently as a result of this project. Potential future studies included seasonal variability, whether the patient obtained a prescription and complied with treatment, and differences between inpatient and outpatient antimicrobial prescribing practices.
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Barton-Wright, Philip. "Clinical supervision and primary nursing." British Journal of Nursing 3, no. 1 (January 13, 1994): 23–30. http://dx.doi.org/10.12968/bjon.1994.3.1.23.
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Kieliszek, Agata, Chitra Venugopal, Blessing Bassey-Archibong, Fred Lam, Sheila Singh, and Nikoo Aghaei. "STEM-01. TARGETING BRAIN METASTASIS-INITIATING CELLS: A PREVENTATIVE APPROACH." Neuro-Oncology 22, Supplement_2 (November 2020): ii196. http://dx.doi.org/10.1093/neuonc/noaa215.818.
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Abstract BACKGROUND The incidence of brain metastases (BM) is tenfold higher than primary brain tumors. BM commonly originate from primary lung, breast, and melanoma tumors with a 90% mortality rate within one year of diagnosis. Current standard of care for BM includes surgical resection with concurrent chemoradiation, but does not extend median survival past 16 months, posing a large unmet need to identify novel therapies against BM. METHODS From a large in-house biobank of patient-derived BM cell lines, the Singh Lab has generated murine orthotopic patient-derived xenograft (PDX) models of lung, breast, and melanoma BM that recapitulate the stages of BM progression as seen in humans. Using these three PDX models, we identified a population of “pre-metastatic” brain metastasis-initiating cells (BMICs) that are newly arrived in the brain but have yet to form detectable tumors. Pre-metastatic BMICs are not detectable in human patients but are important therapeutic targets with the potential to prevent BM in at-risk patients. RESULTS RNA sequencing of pre-metastatic BMICs from all three PDX primary tumor models with subsequent Connectivity Map analysis identified novel compounds that have the potential of killing all three types of BMICs. In particular, we identified two compounds that have selective killing of BMICs in vitro from all three primary tumor cohorts while sparing non-cancerous cells. We further characterized their ability to inhibit the self-renewal and proliferative properties of BMICs. Ongoing in vivo work will investigate the compounds’ preclinical utilities in preventing BM. CONCLUSION Identification of novel small molecules that target BMICs could prevent the formation of BM completely and dramatically improve the prognosis of at-risk cancer patients.
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Tognetti, Valdinéia Maria, Naiara de Paula Ferreira-Nobilo, and Maria da Luz Rosário de Sousa. "Clinical management of caries by public and private university dental students." Revista de Odontologia da UNESP 42, no. 6 (December 2013): 401–7. http://dx.doi.org/10.1590/s1807-25772013000600002.
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OBJECTIVE: The aim of this study was to verify the clinical approach knowledge of graduate students from two colleges (public and private) concerning dental caries. MATERIAL AND METHOD:A case report containing patient general data, photos, and radiographs were presented for the students, which responded tests and a discursive question. Discursive answers were analyzed according to content analysis technique, and posteriorly dichotomized for statistical analysis. (Chi-square, p<0.05). RESULT: Response rates (n=72) were 85.71% in the public college, and 92.30% in the private college. After x-rays evaluation and considering the diverse dynamics by which both schools perform their patient care management, it was observed that less than 10% of the public college students would perform conservative procedures in primary teeth, while at least 30% of private college students would decide for conservative procedures for all cases (p<0.001). Concerning the permanent dentition, the majority of the public college students would perform "conservative" approach. "Preventative-conservative practice" was similarly observed amongst public and private college students. CONCLUSION:Both in public and in private college were similar curative e approaches (primary teeth) and preventative +conservative (permanent teeth).
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Primiero, Clare A., Tatiane Yanes, Anna Finnane, H. Peter Soyer, and Aideen M. McInerney-Leo. "A Systematic Review on the Impact of Genetic Testing for Familial Melanoma I: Primary and Secondary Preventative Behaviours." Dermatology 237, no. 5 (2021): 806–15. http://dx.doi.org/10.1159/000513919.
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<b><i>Background:</i></b> Increasing availability of panel testing for known high-penetrance familial melanoma genes has made it possible to improve risk awareness in those at greatest risk. Prior to wider implementation, the role of genetic testing in preventing melanoma, through influencing primary and secondary preventative behaviours, requires clarification. <b><i>Methods:</i></b> Database searches of PubMed, Embase, CINAHL, PsycINFO and the Cochrane Library were conducted for studies describing preventative behaviour outcomes in response to genetic testing for melanoma risk. Publications describing original research of any study type were screened for eligibility. <b><i>Results:</i></b> Eighteen publications describing 11 unique studies were reviewed. Outcomes assessed are based on health behaviour recommendations for those at increased risk: adherence to sun-protective behaviour (SPB); clinical skin examinations (CSE); skin self-examinations (SSE); and family discussion of risk. Overall, modest increases in adherence to primary prevention strategies of SPB were observed following genetic testing. Importantly, there were no net decreases in SPB found amongst non-carriers. For secondary preventative behaviour outcomes, including CSE and SSE, increases in post-test intentions and long-term adherence were reported across several subgroups in approximately half of the studies. While this increase reached significance in mutation carriers in some studies, one study reported a significant decline in annual CSE adherence of non-mutation carriers. <b><i>Conclusions:</i></b> Evidence reviewed suggests that genetic testing has a modestly positive impact on preventative behaviour in high-risk individuals. Furthermore, improvements are observed regardless of mutation carrier status, although greater adherence is found in carriers. While additional studies of more diverse cohorts would be needed to inform clinical recommendations, the findings are encouraging and suggest that genetic testing for melanoma has a positive impact on preventative behaviours.
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Phillips, Lisa, Alison R. Yung, Narelle Hearn, Colleen McFarlane, Mats Hallgren, and Patrick D. McGorry. "Preventative Mental Health Care: Accessing the Target Population." Australian & New Zealand Journal of Psychiatry 33, no. 6 (December 1999): 912–17. http://dx.doi.org/10.1046/j.1440-1614.1999.00613.x.
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Objective: Preventative approaches to mental illness are becoming a focus of clinical and research settings. To date, however, few clinical programs have been established with this primary aim. This descriptive paper summarises patterns of referral to one service providing clinical care for young people known to be at high risk of developing a psychotic illness. Methods and results: A 20-month survey of referrals to the service revealed that most patients had a prolonged and circuitous route to assessment. Additionally, a lengthy time period elapsed between the onset of symptoms and initiation of help seeking. Conclusions: Information arising from this survey may influence the development of strategies to improve access to this service and others aimed at the prevention of psychosis. Further, this information may affect the development of generalised pre-ventative mental health services for young people.
Dissertations / Theses on the topic "Clinical Nursing: Primary (Preventative)"
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Weierbach, Florence M., and Marietta P. Stanton. "Interface of Prelicensure Clinical Education, Case Management and Rural Nurse Theory in Appalachian Primary Care Clinics." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/7380.
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Leflore, Glenda. "Applying Clinical Guidelines to Curtail Opioid Overprescribing in Primary Care." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3699.
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The purpose of this scholarly project was to evaluate an evidence-based quality improvement program implemented in 2016 in a clinical practice setting to curtail overprescribing of opioids for noncancer pain management. In 2001, the National Pharmaceutical Council and The Joint Commission on Accreditation and Hospital Accreditation initiated a standard of practice for opioid use in noncancer pain management that resulted in opioid overprescribing and a 200% increase in opioid-related deaths and incalculable societal costs. Primary care providers including nurse practitioners issue the greatest number of opioid prescriptions; therefore, to address the problem of opioid overprescribing, the 2016 Centers for Disease Control and Prevention guidelines for opioid administration were implemented as a quality improvement program in a primary care setting with 10 providers. Lewin's change model was the vehicle for change and included an ongoing audit developed for tracking provider prescribing rates. The project sought to determine if adoption of the opioid administration guidelines reduced the prescribing rates in a clinical practice setting and thereby justify expanding the program to other primary clinic sites. A pre- post-single group comparison was conducted of prescribing rates from May 15, 2015 prior to implementing the guidelines and December 19, 2016 after the guidelines were in place. Analysis from t tests indicated a 41% (p < .01) reduction in prescribing rates. The project promotes positive social change through the decreased individual and societal cost of opioid- related deaths.
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Nel, Natalie. "Experiences and perceptions of primary health care students utilizing simulation laboratories." Thesis, Stellenbosch : Stellenbosch University, 2011. http://hdl.handle.net/10019.1/17814.
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Thesis (MCur)--Stellenbosch University, 2011.ENGLISH ABSTRACT: Simulation refers to a teaching method that is used to teach students clinical skills. The use of mannequins is the most common type of simulation. Given the pivotal role that simulation plays in teaching students clinical skills, it is important to understand the experience and perceptions students have utilizing simulation laboratories. The aim of the study was to explore the experience and perceptions of primary health care students utilizing simulation laboratories. The researcher posed the following research question as a guide for this study: “What are the experiences and perceptions of primary health care students utilizing simulation laboratories?” A qualitative approach with a phenomenological research design was applied. A purposive sample of n=10 and a focus group of 7 participants was drawn from a total population of 232 primary health care students. An interview guide was designed based on the objectives of the study and validated by experts in Nursing, Education and the Ethics Committee at the Faculty of Health Sciences, Stellenbosch University. Experts in the field of teaching and learning, nursing and research methodology were consulted to determine the feasibility and content of the study, to evaluate the research process and outcome. Two (2) trained fieldworkers were responsible for collecting the data. Data was collected by means of individual interviews and by interviewing a focus group. The transcription of the interviews was done by the researcher. The data that emerged from the data analysis was coded and categorised into themes and subthemes. The five themes that emerged were simulation as a teaching method; a mannequin offering effective learning; confidence in clinical practice; structure of the course; and a support system. The researcher compiled a written account of the interpretations that emerged from the data analysis and verified this with the fieldworkers. In addition, member checking was done on two (2) of the participants from the focus group as well as two (2) of the participants from the individual interviews, to validate the transcribed data. The Conceptual Theoretical Framework of Bloom supports the findings of this study. The findings suggest that the mannequins should be upgraded regularly and should be able to register a response. It is recommended that a mannequin should be designed which is computer programmed according to different conditions which will include the signs and symptoms of those diseases for example tuberculosis. The participants need to be placed in the clinical environment at a much earlier stage in their programme. Peer group teaching and assessment should be introduced in the programme. Further research is recommended since institutions and disciplinaries working with simulation were not included in the study.
AFRIKAANSE OPSOMMING: Simulasie verwys na ’n onderrigmetode wat gebruik word om studente kliniese vaardighede aan te leer. Die gebruik van mannekyne is die mees algemene vorm van simulasie. Gegee die deurslaggewende rol wat simulasie speel in die onderrig van kliniese vaardighede aan studente, is dit belangrik om die ervaring en persepsies van studente wat gebruik maak van simulasie-laboratoriums, te wete te kom. Die doel van hierdie studie was om die ervaring en persepsies van primêre gesondheidssorgstudente wat van simulasie-laboratoriums gebruik maak, te ondersoek. Die navorser het die volgende navorsingsvraag as ’n riglyn vir hierdie studie gestel: “Wat is die ervaringe en persepsies van primêre gesondheidssorgstudente wat simulasielaboratoriums gebruik?” ’n Kwalitatiewe benadering met ’n fenomenologiese navorsingsontwerp is toegepas. ’n Doelbewuste steekproef van n=10 en ’n fokusgroep van 7 deelnemers is geneem vanuit ’n totale bevolking van 232 primêre gesondheidsorgstudente. ’n Onderhoudgids is ontwerp, gebaseer op die doelwitte van die studie en gevalideer deur kundiges in Verpleging, Opvoedkunde en die Etiese Komitee van die Fakulteit van Gesondheidswetenskappe aan die Universiteit van Stellenbosch. Kundiges op die gebied van onderrig en leer, verpleging en navorsingsmetodologie is geraadpleeg om die haalbaarheid en inhoud van die studie te bepaal vir die evaluering van die navorsingsprosedure en uitkomste. Twee (2) opgeleide veldwerkers was verantwoordelik om die data te versamel. Die data was versamel deur middel van individuele onderhoude en ‘n onderhoud met ‘n fokus groep. Die onderhoude was getranskribeer deur die navorser. Die data wat uit die analise gekom het, is geënkodeer en gekategoriseer in temas en subtemas. Die vyf temas wat hieruit voortgespruit het, is simulasie as ’n onderrigmetode; ’n mannekyn wat effektiewe leer bied; vertroue in die kliniese praktyk; die struktuur van die kursus; en ’n ondersteuningssisteem. Die navorser het ’n geskrewe verslag saamgestel van die weergawe van die data-analise wat saamgestel en deur die veldwerker geverifieer is. Bykomend is die kontrole van lede van twee (2) van die deelnemers van die fokusgroep, asook twee (2) van die deelnemers vanuit die individuele onderhoude gedoen, om die getranskribeerde data se geldigheid te verklaar. Die Konseptuele Teoretiese Raamwerk van Bloom rugsteun die bevindinge van hierdie studie. Die bevindinge beveel aan dat die mannekyne gereeld opgegradeer behoort te word en dat hulle ’n respons moet kan registreer. Dit word aanbeveel dat ’n mannekyn ontwerp behoort te word wat rekenaar geprogrammeerd is volgens die verskillende toestande wat die tekens en simptome van siektes soos tuberkulose insluit. Die deelnemers behoort in ’n baie vroeë stadium van die program in die kliniese omgewing geplaas te word. Verdere navorsing word aanbeveel, aangesien inrigtings en dissiplines wat met simulasie gemoeid is, nie in hierdie studie ingesluit is nie.
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Mortenson, Brett Jerome, and Brett Jerome Mortenson. "Development and Evaluation of a Clinical Practice Guideline to Promote Evidence-Based Treatment of Pediatric Concussions in Primary Care." Diss., The University of Arizona, 2016. http://hdl.handle.net/10150/621798.
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Introduction and Rationale: Concussions account for the majority of traumatic brain injuries in children. Currently there more than 500,000 pediatric concussions per year and that number is likely low due to under-reporting (Rose, Weber, Collen,& Heyer, 2015). Most symptoms of concussion are easily recognized to the trained pediatric primary care provider. Yet, symptom management and recommendations for rest, exercise, specialty care referral, and return to normal activities can be challenging for many providers, due to the lack of evidence and lack of formal recommendations by any organization (Rose et al., 2015; Silverberg & Iverson, 2013). Purpose and Objective: The main purpose of this Doctor of Nursing Practice (DNP) project is to develop evidence-based clinical practice guidelines (CPG) for pediatric primary care providers. The objective is to provide a CPG that offers clinical guidance when managing pediatric concussion patients in the primary care setting. This CPG will also provide clarity for pediatric primary care providers (PCP) when determining what options are available in treatment for pediatric concussions. Methods: The working framework of this project was The Appraisal of Guidelines for Research & Evaluation II (AGREE II). The American Academy of Pediatrics (AAP) procedure for reporting clinical guidelines, in the form of key action statements, was used as the model for development of the CPG. Results: The CPG was appraised using the AGREE II instrument, which provides valid and reliable scores and data used in the evaluation of CPG's. Six domains were evaluated, and the CPG yielded scores above 80% for all categories. The overall standard deviation was 0, which indicts a very low level of discrepancy between users of the instrument. Conclusion: This DNP project addresses an evidence and primary care practice gap. With a large number of pediatric concussions, a consistent management approach will ensure a safe and therapeutic recovery. A CPG was developed and evaluated using the AGREE II instrument. The CPG was found to meet the standards for general recommended use in pediatric primary care.
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Wilson, Kendra Marie. "Improving the Rate of Diabetes Preventative Care Practices in a Nurse Practitioner Owned Family Clinic: A Quality Improvement Project." Diss., The University of Arizona, 2016. http://hdl.handle.net/10150/612952.
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Background: Type 2 diabetes mellitus (T2DM) is a complex health condition that impacts multiple organ systems and contributes to both acute and chronic health problems. In the United States (U.S.), T2DM is a growing health concern with increasing prevalence among both adult and pediatric populations (American Diabetes Association [ADA], 2015; Dea, 2011). Developing a comprehensive plan of care that incorporates a multifaceted treatment and prevention plan is necessary to address this growing health concern and reduce overall morbidity and mortality. Problem: The Edmund Primary Care (EPC) practice data for routine annual diabetic foot exams, annual eye exams, annual urine microalbumin, smoking cessation education and recommendations for pneumococcal polysaccharide do not meet the ADA (American Diabetes Association, 2015) recommendations for patients with T2DM.Design: Quality improvement (QI) project applying the Plan-Do-Study-Act (PDSA) cycle to develop a process change to improve diabetic preventative care measures for hemoglobin A1C, urine microalbumin, diabetic foot exams, and optometry referrals. Setting: A small, nurse practitioner owned, family practice clinic targeting patients 18 years and older with a diagnosis of T2DM.Intervention: A fishbone diagram to conduct a root cause analysis led to identification of key factors contributing to the problem. A comprehensive process change integrating a Diabetic Assessment Flow Sheet (DAFS) and diabetic foot exam sheet was developed to address the problem. Expected Outcome: Increase in rates of completion to at least 90% over eight weeks. Results: Analyzed with run charts demonstrating an increase in rates of completion to 100% for A1C, urine microalbumin, diabetic foot exams, and optometry referrals. A positive percent of change for each measure is as follows: A1C 7%; urine microalbumin 43%; diabetic foot exams 150%; and referrals to optometrist 43%. Significance: This QI project emphasizes the importance of implementing a system to evaluate the quality of care being delivered. It also highlights the usefulness of the PDSA cycle as a method to implementing quality improvement measures in health care. Lastly, this QI project demonstrated the effectiveness of flow sheets in improving the quality of care delivered to patients with T2DM.
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Enochs, Shannon. "Bridging the Gap between Emotional Trauma Practice Guidelines and Care Delivery in the Primary Care Setting." Thesis, Brandman University, 2019. http://pqdtopen.proquest.com/#viewpdf?dispub=13428017.
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When patients present with complaints of anxiety or depression, providers in the primary care setting often prescribe anxiolytics or antidepressants without conducting an early emotional trauma or adverse childhood experiences assessment. Several studies demonstrate the link between early emotional trauma (EET) or adverse childhood experiences (ACEs) and the increased risk of anxiety or depression as adults. This Clinical Scholarly Project (CSP) implemented the use of the Adverse Childhood Experience (ACE) Questionnaire with patients who had a diagnosis of anxiety or depression in the primary care setting to increase patient access to resources and align clinical practice with practice guidelines. Participants included eight primary care providers, 30 patients and 21 chart review patients. The CSP utilized a quasi-experimental design to determine if the use of the ACE Questionnaire by patients with anxiety or depression would result in patients receiving more community resources (to include counseling), strengthen the provider-patient relationship, increase provider comfort in discussing ACEs with their patients and result in patients receiving care that was evidence based. Patient sample participants received significantly more resources (M = 8.27, SD = 2.27) than the chart audit sample (M = 0.90, SD = 0.30). Patient sample members received an average of eight resources (M = 8.27) and utilized an average of five resources (M = 5.07). Use of the ACE Questionnaire resulted in more trust in provider-patient relationship by patients (80.0%) and the majority of the provider sample more comfortable discussing ACEs after the project (85.7%).
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Ray, Robyn T. "Utilization of a Clinical Reminder System to Increase the Incidence of HIV Screening in a Primary Care Clinic." Thesis, University of Louisiana at Lafayette, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3712863.
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HIV infection is a leading cause of morbidity and mortality in our country today with nearly 1.2 million Americans living with HIV infection. Early recognition of infection is imperative for appropriate initiation of treatment to prevent comorbidities. Additionally, identification of infection can serve as a primary preventative measure to reduce spread of the disease. National organizations have supported the initiation of routine screening policies for HIV in health care settings. Primary care providers are uniquely positioned to be able to offer HIV screenings and identify infected persons very early in the course of the disease. Despite support for routine testing in the literature and by national evidence-based guidelines, testing is still not offered routinely in the primary care setting. The purpose of this project was to explore if a clinical reminder improves the frequency of HIV screening offered in a rural primary care clinic (PCC) located in Central Louisiana. Results of the project did show a statistically significant increase in the frequency of HIV screening offered following implementation of the clinical reminder system.
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Mayers, Patricia Margaret. "Nurses’ experiences of guideline implementation in primary health care settings." Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/1437.
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Thesis (DPhil (Psychology))—University of Stellenbosch, 2010.ENGLISH ABSTRACT: This dissertation examines how nurses in primary health care in South Africa make use of guidelines. Primary level health care is reliant primarily on nurses, who are under-resourced and often overwhelmed by the complex needs of their clients in the context of the TB and HIV/AIDS epidemic. Despite various continuing education strategies to promote current and evidence-based practice, there are many barriers to providing optimal care. Clinical practice guidelines using best evidence are an important tool for updating health professionals in current practice, particularly at primary care level, where busy practitioners often do not have time or sufficient access to the best evidence. Despite this, we know little of the practitioners’ experiences of guideline use. This study describes experiences of nurses in implementing clinical practice guidelines in the delivery of health care in selected primary level contexts in the Free State Province. The primary research question for this study was “What are the experiences of nurses in using guidelines in primary health care facilities?” A qualitative research approach, drawing on a psychoanalytic framework, was adopted. Three linked studies were conducted, utilising secondary data analysis of transcripts collected during the PALSA (Practical approach to Lung Health in South Africa) RCT study (sub-study 1), document description and review of guidelines used in primary care settings (sub-study 2), observation of nurses in practice and during patient consultations, and focus group discussions with nurses in primary health care facilities (sub-study 3). After the introduction of new format guidelines with onsite training and access to good support and updates, nurses reported feeling more confident, as the guidelines were explicit and gave them clear direction as to when a patient would need referral to the medical practitioner. When the guidelines were followed, and the patient responded positively to an intervention, this gave nurses a sense of credibility and validated their role as primary level health care providers. Guidelines available in the primary care clinics covered a wide variety of clinical conditions, were inconsistent, often outdated and even contradictory. A detailed comparison of two selected guidelines, the South African TB control guidelines and the PALSA PLUS guidelines, both in everyday use in the Free State province, shows that the preferences expressed by the nurses in sub-study 1 are evident in the layout, colour, and user-friendliness of the PALSA PLUS guideline. Nurses in the Free State province do use guidelines, but not consistently. Nurses make clinical judgments and decisions based on experience, alternative knowledges and intuitive responses, in consultation with colleagues and through the use of guidelines. Very few guidelines were used regularly, and each nurse had her preferences for a limited number of guidelines which she found useful. There is a clear need for integrated approaches to the information needs and support of nurses and nurse practitioners at primary care level. Guidelines play a role in promoting learning, changing professional practice and strengthening health care delivery by nurse practitioners at primary level. They can also be thought of as a strategy the health care system uses to defend against the possibility of its health professionals not meeting its expectations of providing quality care. Guidelines may contain anxiety and improve the quality of care, or compromise practice through the imposition of controls. The use of guidelines in primary care settings facilitates decision making, may contain practitioner anxiety and improve the quality of care, yet guidelines pose challenges to creative discernment of the patient’s symptoms in relation to his/her personal circumstances and may impact on the personalised holistic care approach which characterises the essence of nursing. Today’s primary care nurse and nurse practitioner needs to be a competent clinician, compassionate carer, and confident co-ordinator – the overlapping roles of caring, diagnosing and treating and managing. The challenge for the nurse in primary care is to combine her traditional caring and co-ordination role into a role which encompasses curing, caring and co-ordination, a new, yet critically important identity for the 21st century nurse.
AFRIKAANSE OPSOMMING: Die proefskrif ondersoek hoe verpleegsters in primêre gesondheidsorg in Suid-Afrika van riglyne gebruik maak. Primêre vlak gesondheidsorg steun hoofsaaklik op verpleegsters, alhoewel hulle verswelg word deur die komplekse behoeftes van hul kliënte in die konteks van die TB en HIV/AIDS epidemie. Ten spyte van verskeie volgehoue onderrigstrategieë om die huidige en bewese basiese te bevorder, is daar verskeie struikelblokke om optimale versorging te voorsien. Kliniese praktyk riglyne voorsien die beste bewyse en is 'n belangrike hulpmiddel om praktiserende professionele gesondheidswerkers, veral op die vlak van primêre gesondheidsorg, op hoogte van sake te hou. Besige programme en onvoldoende toegang tot hierdie riglyne weerhou dikwels die gesondheidswerkers van bestaande inligting. Dit is egter onbekend wat gesondheidswerkers se ondervinding en gebruik van riglyne is. Die studie beskryf versorgers se ervaring van die implementering van kliniese praktyk riglyne vir gesondheidsorg in primêre vlak kontekste in die Vrystaatprovinsie. 'n Kwalitatiewe navorsingsbenadering wat steun op 'n psigoanalitiese raamwerk, is gebruik. Drie verbandhoudende studies is gedoen wat sekondêre data analise transkripsies gebruik het wat verkry is gedurende die PALSA (Practical Approach to Lung Health in South Africa): RCT (Willekeurig Gekontroleerde Toets) studie (sub-studie 1), beskrywing van dokumentasie en oorsig van riglyne wat in primêre vlak ontwikkeling gebruik is (sub-studie 2), en observasie van verpleegsters in die praktyk en gedurende konsultasies met pasiënte, en fokusgroep besprekings met verpleegsters in primêre vlak gesondheidsorg fasiliteite (sub-studie 3). Na die bekendstelling van 'n nuwe formaat riglyne vir indiensopleiding en toegang tot goeie ondersteuning, het die verpleegsters meer selfversekerd gevoel omdat die riglyne duideliker was en aan hulle 'n beter aanduiding gegee het wanneer 'n pasiënt verwysing na 'n mediese praktisyn benodig het. Wanneer die riglyne gevolg is en die pasiënt positief op behandeling gereageer het, het dit aan hulle 'n gevoel van agting en deug vir hulle rol in primêre vlak gesondheidsorg gegee het. Beskikbare riglyne in primêre sorg klinieke dek 'n wye verskeidenheid kliniese kondisies, is onsamehangend, dikwels verouderd en selfs soms weersprekend. 'n Gedetailleerde vergelyking is tussen twee geselekteerde riglyne gedoen: die Suid-Afrikaanse TB kontrole riglyne en die PALSA PLUS riglyne. Beide word daagliks in die Vrystaatprovinsie gebruik. Die verpleegsters in sub-studie 1 het a.g.v. die uitleg, kleur en gebruikersvriendelikheid die PALSA PLUS riglyne verkies. Verpleegsters in die Vrystaat gebruik wel riglyne maar nie op 'n gereelde grondslag nie. Hulle maak eerder kliniese keuses en besluite gebaseer op ondervinding, alternatiewe kennis en intuïtiewe gevoel, in konsultasie met kollegas en na bestudering van die riglyne. Baie min riglyne is gereeld gebruik, en elke verpleegster het haar voorkeure vir 'n beperkte aantal riglyne wat sy bruikbaar vind. Daar is 'n duidelike behoefte aan 'n geïntegreerde benadering tot die informasiebehoeftes en ondersteuning aan verpleegsters en praktisyns op primêre sorg vlak. Riglyne speel 'n belangrike rol in die bevordering van onderrig, verandering van professionele praktyke en die versterking van gesondheidsorg wat deur verpleegsters in primêre vlak gesondheidsorg gelewer kan word. Dit kan ook gesien word as 'n strategie wat die gesondheidsorgsisteem kan gebruik om te verseker dat gesondheidswerkers kwaliteit diens lewer. Riglyne kan moontlik angstigheid beperk en verhoogde versorgingskwaliteit bring, of dit kan gesondheidsorg benadeel deur die afdwing van kontrolemaatreëls. Die gebruik van riglyne in primêre sorg fasiliteer besluitneming, en mag dalk angstigheid by die praktisyn beperk, wat dan die kwaliteit van versorging kan verhoog. Riglyne bied uitdagings aan die kreatiewe oordeelsvermoë om die pasiënt se simptome te sien binne die konteks van sy/haar omstandighede en mag 'n impak hê op persoonlike holistiese versorging wat die aard en kern van verpleging is. Die huidige primêre sorg verplegingspraktisyn moet 'n bekwame klinikus, ontfermende versorger en betroubare koördineerder wees – met oorvleuelende rolle van versorging, diagnosering en behandeling, en bestuur. Die uitdaging vir die verpleegster in primêre sorg is om die tradisionele versorging en koördinering te kombineer tot 'n omvattende rol van genesing, versorging en koördinasie; 'n nuwe, maar krities-belangrike identiteit vir die 21ste-eeuse versorger.
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Moses, Barnitta Latricia. "Addressing Bullying Behavior in Pediatric Patients Using a Clinical Practice Guideline." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6929.
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Childhood bullying can lead to adverse physical and mental health outcomes for both the victim and the bully. Risk factors for bullying can be related to gender, race, sexual preference, and having any type of disability. A pediatric primary care clinic in a large, metropolitan area, the focus for this project, did not have an evidenced-based clinical practice guideline (CPG) for providers to facilitate the management of children who presented with reported bullying. The project, guided by the Tanner's integrated model of clinical judgement, addressed the question whether a CPG would facilitate the early recognition and treatment of bullying in the pediatric clinical site. Using a literature search, a CPG was developed with evidence that included 6 recommendations ranging from clinical assessment and screening to advocacy. The CPG was then evaluated by 4 expert panelists using the AGREE II tool. Panelists included 2 pediatric medical doctors, 1 pediatric school nurse, and 1 mental health nurse practitioner. The panel evaluation results revealed a score of 81 out of a possible 100, where a score of 71 was the standard for acceptable results for the 6 recommendations. Results from the expert panel were used to modify the CPG, after which the guideline was presented to the panel for final approval. One final recommendation of the panel was to include a provision for referral and follow up for children identified with bullying. The finalized CPG was presented to the medical director of the pediatric clinic for implementation. The implications of the project for positive social change include decreased variations in clinical practice, early detection and intervention of bullying, improved effectiveness and quality of care, and decreased costly and preventable adverse events.
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Quam, Jennifer M. "Knowledge of Assessment and Management of Childhood Obesity Among Rural Primary Care Nurse Practitioners." Diss., The University of Arizona, 2016. http://hdl.handle.net/10150/612863.
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Objective: New Mexico nurse practitioners contribute to the prevention and management of pediatric obesity. This study aimed to assess nurse practitioners' knowledge, attitudes, and behaviors, which were unknown in New Mexico, to counseling frequency in the assessment and management of overweight and obese pediatric patients. This was done using clinical practice guidelines (CPG). The study also sought to learn nurse practitioners' insights on needed resources for clinical practice. Rural and urban nurse practitioners' responses were then compared to the study aims. Methods: This descriptive pilot study surveyed members of the New Mexico Nurse Practitioner Council (NMNPC) to evaluate their knowledge, attitudes, and behaviors, in addition to the counseling frequencies expected to result in patient change. The survey used the platform Qualtrics and measured answers using a four-point Likert scale. Rural and urban comparisons were evaluated for each variable (knowledge, attitudes, and behaviors) in order to investigate relationships. Despite the underpowered sample size, data were analyzed for feasibility of future studies using descriptive statistics, Spearman's Rho Correlation, and Mann-Whitney U testing. Results: Fifteen nurse practitioners were included in the statistical analysis. The data found the nurse practitioners' self-reported responses exhibited knowledge, positive attitudes, and confident behaviors using pediatric obesity CPGs. The increases in these parameters correlated reported needing a quick CPG tool that can be used in practice. In all, rural nurse practitioners reported a slightly higher usage of pediatric obesity CPGs than urban nurse practitioners. Conclusion: The feasibility of this study's assessment of nurse practitioners' knowledge, attitudes, and behaviors using CPGs will assist in developing interventions to impact patient outcomes. The study also found that resources needed by New Mexico nurse practitioners were similar to those desired by other providers throughout literature. Rural compared to urban nurse practitioners findings indicated the need for further research. Future studies should include all health care providers in New Mexico in order to further explore aims of this study and development of interventions on overweight and obese pediatric CPGs to positively impact practice.
Books on the topic "Clinical Nursing: Primary (Preventative)"
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Rogers, Bonnie. Occupational health nursing guidelines for primary clinical conditions. Beverly Farms, Massachusetts: OEM Press, 2009.
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1948-, Pearson Alan, ed. Primary nursing: Nursing in the Burford and Oxford Nursing Development Units. London: Chapman and Hall, 1989.
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Essentials for today's nursing assistant. Upper Saddle River, N.J: Prentice Hall, 1999.
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A, Grubbs Peggy. Essentials for today's nursing assistant. Upper Saddle River, N.J: Prentice Hall, 2003.
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Rowe, Robbin. Hello, I'm your primary nurse. [Bethesda, Md.?]: U.S. Dept. of Health and Human Services, Public Health Service, National Institutes of Health, Clinical Center, 1989.
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Clinical guidelines for advanced practice nursing: An interdisciplinary approach. 2nd ed. Sudbury, Mass: Jones & Bartlett Learning, 2012.
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1946-, Greene Carla, and Singer Robert W, eds. Handbook of adult primary care. New York: Wiley, 1987.
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Compact clinical guide to chronic pain management: Evidence-based approach for primary care. New York, NY: Springer Pub. Co., 2011.
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Randall, Michael D. Disease management: A guide to clinical pharmacology. 2nd ed. London: Pharmaceutical Press, 2009.
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M, Saxe JoAnne, ed. Microscopic procedures for primary care providers. Philadelphia: Lippincott Raven, 1999.
Find full textBook chapters on the topic "Clinical Nursing: Primary (Preventative)"
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Veitch, Karen. "The Challenge of Primary Care." In Clinical Skills in Nursing, 82–95. London: Macmillan Education UK, 1999. http://dx.doi.org/10.1007/978-1-349-14724-3_7.
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Frith, Jennifer, and Nelson J. Chao. "Oncology Nursing Care." In The Comprehensive Cancer Center, 57–62. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-82052-7_7.
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AbstractThis chapter explores the recommendations in developing oncology nursing care for a comprehensive medical center. Nursing orientation, continuing education, and competencies are required for the oncology nurse to remain successful in care delivery. Nurse–patient ratios should be benchmarked with other competitive centers, acuity taken into consideration, and various workflows depending on the clinical settings. Nurses play an instrumental role in delivering oncology care, from preventative screening, throughout the continuum, and into end-of-life care.
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Bramwell, Donna, Kath Checkland, Jolanta Shields, and Pauline Allen. "2000s: Transforming Community Services." In Community Nursing Services in England, 61–73. Cham: Springer International Publishing, 2023. http://dx.doi.org/10.1007/978-3-031-17084-3_6.
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AbstractThe new millennium saw the publication of The NHS Plan in 2000, which bought a welcome focus to community health services (CHS) and the role of community nursing. We outline the proposals contained in the plan which furthered the quasi-marketisation of the NHS and increased commissioning of health care at the local level of Primary Care Trusts (PCTs)—replacing Health Authorities (HAs) and Primary Care Groups (PCGs). A further review by Lord Darzi and subsequent policy, Transforming Community Services: Enabling new patterns of provision (DoH, 2009) instigated the separation of commissioning/provision and laid out timetables for how PCTs were to do this. The long held roles of the district nursing service continues in this era, although not always clearly defined, understood or acknowledged and policy attempts to expand their remit feature heavily. This included more clinical tasks as well as focusing on such things as public health/health protection and promotion programmes that improve health and reduce inequalities. This chapter also describes the uncertainty for frontline nurses that the Transforming Community Services (TCS) brought in terms of who their employer would be or what management arrangements they would work under given the establishment of some standalone Trusts, some third sector and some combined acute/community Trusts. The aims of the TCS programme were bold but in reality achieved little by the end of the era.
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Bramwell, Donna, Kath Checkland, Jolanta Shields, and Pauline Allen. "2010–2015: The Health and Social Care Act, NHS Fragmentation." In Community Nursing Services in England, 75–82. Cham: Springer International Publishing, 2023. http://dx.doi.org/10.1007/978-3-031-17084-3_7.
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AbstractA change of government in 2010 brought fresh NHS reforms and a new Health and Social Care Act (HSCA, 2012). Both, along with the 2014, Five Year Forward View (NHSE) set the tone for this Chapter. We discuss how the continued emphasis on competition between providers, and the introduction of Clinical Commissioning Groups (CCGs) which replaced Primary Care Trusts (PCTs) as commissioners of community services, impacted on community nursing service management and delivery. Policy shifted in favour of a more co-operative approach to service provision and familiar agendas were set out for keeping people out of hospital with reform based around integration between health care sectors and between health and social care services. There was little change on the ground for district nurses in this era despite increasing emphasis on integrated care, collaborative, cross-sector working (i.e. with LA social care) and multi-disciplinary team management of complex patients. The HSCA 2012 began to unravel almost as soon as it was enacted, with the emphasis on competition undermined by the Five Year Forward View shift towards integration between sectors as a dominant organising principle. Community Health Services (CHS) were, to some extent, protected from the fragmentation associated with the Act, and in terms of district nursing practice, this era generated little change with patterns of service provision remaining very much as they were following the upheaval generated by the Transforming Community Services agenda.
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Burch, Jennie, and Brigitte Collins. "Gall bladder." In Oxford Handbook of Gastrointestinal Nursing, 191–200. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198833178.003.0008.
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The gall bladder chapter describes conditions and diseases of the small organ of the gall bladder. The common diseases of the gall bladder are described with the more frequently presenting symptoms listed for the nurse. The occurrence rates of these pancreatic conditions are defined and any potential causes described. The investigations that are used to diagnose the condition are explored. Treatment options or preventative measures are also explored with a description of any potential complications. There are a number of conditions and diseases related to the gall bladder that include primary sclerosing cholangitis and gallstone. Inflammation of the gallbladder, cholecystitis may be acute or chronic. Succinct details related to people with diseases and conditions of the gall bladder are easy to use by the nurse within clinical practice.
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"Primary Health Care Clinical Situation." In Foundations of Professional Nursing. New York, NY: Springer Publishing Company, 2016. http://dx.doi.org/10.1891/9780826133656.ap02.
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Longridge, Nicholas, Pete Clarke, Raheel Aftab, and Tariq Ali. "Preventative and Paediatric Dentistry." In Oxford Assess and Progress: Clinical Dentistry, edited by Katharine Boursicot and David Sales. Oxford University Press, 2019. http://dx.doi.org/10.1093/oso/9780198825173.003.0013.
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The child patient can be a challenging and daunting proposition for the junior dentist and dental student. Whilst children can be anxious, uncooperative, and unpredictable, they also present an extremely rewarding opportunity, which, if managed correctly, may go on to influence their healthcare experiences for the rest of their lives. Excellent behavioural management of the child patient (and their parents!) is fundamental to a successful clinical and patient- reported outcome. Aside from possible behavioural issues, paediatric patients may present with a series of unique clinical presentations that require additional skills and knowledge above and beyond those required for adult patients. Differences in the micro- and macro- structures of primary and permanent teeth, coupled with variations in eruption dates, lead to an evolving mixed dentition that can lead to some difficult diagnostic and treatment planning scenarios. Furthermore, dental anxiety and the preponderance for dento- alveolar trauma in children and young adults may exacerbate the patient management of an already complex situation. Prevention is central to paediatric dentistry. However, whilst significant progression has occurred in some areas, poor dietary habits and suboptimal oral hygiene regimes remain significant concerns for the profession, with large numbers of dental extractions still performed under general anaesthesia each year. Key topics include: ● Tooth anatomy and eruption patterns ● Abnormalities of structure and form ● Prevention and management of dental caries, including pulp therapy ● Dental trauma ● Dental extractions and space management ● Behavioural management ● Safeguarding ● Pharmacological management.
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BURROW, G. "Nursing in the Primary Care Setting." In Clinical Practice in Correctional Medicine, 426–59. Elsevier, 2006. http://dx.doi.org/10.1016/b978-0-323-03265-0.50034-8.
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"Nursing in primary care." In Oxford Handbook of Primary Care and Community Nursing, edited by Judy Brook, Caroline McGraw, and Val Thurtle, 35–66. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198831822.003.0002.
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This chapter begins by outlining the different roles that nurses can occupy in primary and community care. It provides information on learning to work in primary and community care, the focus and responsibilities of general practice nursing (including advanced nurse practitioners), school nursing, health visiting, and district nursing. It covers clinical supervision and appraisal, continuing professional development, and facilitating nursing in practice. Research ethics and research governance in primary care and community nursing is discussed, alongside teamwork and leadership development, and innovation and project planning. Finally, it considers information for changing and informing practice.
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"Cancer of unknown primary." In Oxford Handbook of Cancer Nursing, edited by Mike Tadman, Dave Roberts, Mark Foulkes, Mike Tadman, Dave Roberts, and Mark Foulkes, 333–40. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780198701101.003.0025.
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This chapter first considers how cancers of unknown primary (CUP) can be characterized and defined (alongside metastases of unknown origin), before moving on to the incidence of these cancers, associated survival, and overall poor prognosis. Subgroups of patients with CUP with better survival are described. The section then moves on to explore how, in the last 4 years, prior to publication, there has been a change in the approach to managing CUP in an effort to improve overall survival and the treatment options and modalities used to treat CUP. The chapter concludes with a summary of the nursing management of this patient group and how uncertainty around the final diagnosis can have clinical and psychological repercussions.
Conference papers on the topic "Clinical Nursing: Primary (Preventative)"
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B.D. Magobe, Nomasonto, Prof M. Poggenpoel, and Prof C. P. H. Myburgh. "The experiences of primary clinical nurse practitioners in educating patients with hypertension on health-promoting lifestyle measures at primary health care clinics in Soweto." In Annual Worldwide Nursing Conference. Global Science & Technology Forum (GSTF), 2014. http://dx.doi.org/10.5176/2315-4330_wnc14.24.
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Sancho-Agredano, Raül, Montserrat Sola-Pola, Victoria Morin-Fraile, Eva Maria Guix-Comellas, Jordi Galimany-Masclans, Joan Maria Estrada-Masllorens, and Nuria Fabrellas Padres. "HOW NURSING STUDENTS ASSESS THEIR CLINICAL PRACTICE IN PRIMARY HEALTH CARE." In International Technology, Education and Development Conference. IATED, 2016. http://dx.doi.org/10.21125/inted.2016.1209.
Full textReports on the topic "Clinical Nursing: Primary (Preventative)"
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Lumpkin, Shamsie, Isaac Parrish, Austin Terrell, and Dwayne Accardo. Pain Control: Opioid vs. Nonopioid Analgesia During the Immediate Postoperative Period. University of Tennessee Health Science Center, July 2021. http://dx.doi.org/10.21007/con.dnp.2021.0008.
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Background Opioid analgesia has become the mainstay for acute pain management in the postoperative setting. However, the use of opioid medications comes with significant risks and side effects. Due to increasing numbers of prescriptions to those with chronic pain, opioid medications have become more expensive while becoming less effective due to the buildup of patient tolerance. The idea of opioid-free analgesic techniques has rarely been breached in many hospitals. Emerging research has shown that opioid-sparing approaches have resulted in lower reported pain scores across the board, as well as significant cost reductions to hospitals and insurance agencies. In addition to providing adequate pain relief, the predicted cost burden of an opioid-free or opioid-sparing approach is significantly less than traditional methods. Methods The following groups were considered in our inclusion criteria: those who speak the English language, all races and ethnicities, male or female, home medications, those who are at least 18 years of age and able to provide written informed consent, those undergoing inpatient or same-day surgical procedures. In addition, our scoping review includes the following exclusion criteria: those who are non-English speaking, those who are less than 18 years of age, those who are not undergoing surgical procedures while admitted, those who are unable to provide numeric pain score due to clinical status, those who are unable to provide written informed consent, and those who decline participation in the study. Data was extracted by one reviewer and verified by the remaining two group members. Extraction was divided as equally as possible among the 11 listed references. Discrepancies in data extraction were discussed between the article reviewer, project editor, and group leader. Results We identified nine primary sources addressing the use of ketamine as an alternative to opioid analgesia and post-operative pain control. Our findings indicate a positive correlation between perioperative ketamine administration and postoperative pain control. While this information provides insight on opioid-free analgesia, it also revealed the limited amount of research conducted in this area of practice. The strategies for several of the clinical trials limited ketamine administration to a small niche of patients. The included studies provided evidence for lower pain scores, reductions in opioid consumption, and better patient outcomes. Implications for Nursing Practice Based on the results of the studies’ randomized controlled trials and meta-analyses, the effects of ketamine are shown as an adequate analgesic alternative to opioids postoperatively. The cited resources showed that ketamine can be used as a sole agent, or combined effectively with reduced doses of opioids for multimodal therapy. There were noted limitations in some of the research articles. Not all of the cited studies were able to include definitive evidence of proper blinding techniques or randomization methods. Small sample sizes and the inclusion of specific patient populations identified within several of the studies can skew data in one direction or another; therefore, significant clinical results cannot be generalized to patient populations across the board.