• Title/Summary/Keyword: multidisciplinary care

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Optimizing Heart Failure Management: A Review of the Clinical Pharmacist Integration to the Multidisciplinary Health Care Team

  • Esteban Zavaleta-Monestel;Sebastian Arguedas-Chacon;Alonso Quiros-Romero;Jose Miguel Chaverri-Fernandez;Bruno Serrano-Arias;Jose Pablo Diaz-Madriz;Jonathan Garcia-Montero;Mario Osvaldo Speranza-Sanchez
    • International Journal of Heart Failure
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    • v.6 no.1
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    • pp.1-10
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    • 2024
  • Heart failure (HF) stands as a prevalent chronic ailment, imposing a substantial burden on global healthcare systems due to recurrent hospitalizations, intricate management, persistent symptoms, and polypharmacy challenges. The augmentation of patient safety and treatment efficacy across various care stages, facilitated by a multidisciplinary HF team inclusive of a clinical pharmacist, emerges as paramount. Evidence underscores that the collaborative engagement of a physician and a clinical pharmacist engenders proficient and secure management, forestalling avoidable adversities stemming from drug reactions and prescription inaccuracies. This synergistic approach tailors treatments optimally to individual patients. Post-discharge, the vulnerability of HF patients to re-hospitalization looms large, historically holding sway as the foremost cause of 30-day readmissions. Diverse strategies have been instituted to fortify patient well-being, leading to the formulation of specialized transitional care programs that shepherd patients effectively from hospital to outpatient settings. These initiatives have demonstrably curtailed readmission rates. This review outlines a spectrum of roles assumed by clinical pharmacists within the healthcare cohort, spanning inpatient care, transitional phases, and outpatient services. Moreover, it traverses a compendium of studies spotlighting the affirmative impact instigated by integrating clinical pharmacists into these fields.

The role of the Neonatal Nurse Specialist in 21st Century (21세기 신생아 전문 간호사의 역할과 전망)

  • Lee, Ja-Hyung
    • Korean Parent-Child Health Journal
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    • v.3 no.2
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    • pp.81-93
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    • 2000
  • The role of the neonatal nurse specialist has been well established over the past decade and now reform in 21st century. Neonatal nurse specialists responsibilities in caring for critically and long-term chronically ill infants and their families are very important. Neonatal nurse specialists have a two fold responsibility in caring for these infants. First, through acquiring advanced practice education in complex neonatal care and diagnostic skills, neonatal nurse specialists meet the physiologic needs of the infant. Second, neonatal nurse specialists provide a more holistic approach to their care through evaluating the family in treatment plans and involving the family in discharge planning for the infant. In some institutions, neonatal nurse specialists are directly involved in institutional and/or home follow-up care and case management also. It is the neonatal nurse specialists responsibility to function collaboratively with the multidisciplinary team in managing critically or chronically ill infants from admission to discharge. The role of the neonatal nurse specialist case manager can be described as one that focuses on individualized care of the infant, while providing continuity of care to both the infant and family. The neonatal nurse specialist's role will vary depending on the neonatal intensive care unit(NICU). Therefore, the multidisciplinary collaborative approach to long-term management of infants in the NICU is extremely important to provide successful transition to home or to long-term rehabilitative care facilities because care for the chronically ill infant is complex and multifaceted. I suggest the role of neonatal nurse specialist in 21st century are as follows. 1. Diagnostic/patient assessment 2. Management of patient health/illness 3. Administering/monitoring therapeutic interventions and regimens 4. Monitoring/ensuring quality of health care practices 5. Organization and work role 6. Helping role 7. Teaching/coaching role 8. Management of rapidly changing situations 9. Consulting role The advanced practice nursing model of care delivered by neonatal nurse specialist's in the NICU incorporates medical and nursing role functions and emphasizes holism, caring, and a health perspective for critically and chronically ill neonates and their families.

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Integrated Care Setting for the Elderly and the Roles of Social Workers (노인복지분야의 통합적 케어와 사회복지사의 역할)

  • Yoon, Kyeong-A
    • The Journal of the Korea Contents Association
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    • v.19 no.3
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    • pp.441-456
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    • 2019
  • The objective of this study was to explore the elements and effects of integrated care interventions for the elderly, and to describe the roles of social workers on the multidisciplinary teams. A rapid systematic review was conducted through a database-based search and a manual search. The main findings are as follows: First, Key elements of integrated care for the elderly were case management, individual multidisciplinary care plan, service characteristics, centrality of client needs, patient education, and self-management. Second, In terms of care experience and health of the elderly, and economic analysis, although the results were mixed, there were some positive effects on program participants compared to the control groups. Third, social workers have been found to serve as case managers, care managers, care coordinators, and direct service providers. Based on these results, educational and policy implications were suggested.

The Development of Multidisciplinary Cancer Patient Education·Counseling Questionnaire and Satisfaction Survey (다직종 암환자 교육·상담에 대한 설문 개발과 환자 만족도 조사)

  • Lee, Min Jeong;Geum, Min Jung;Kim, Jae Song;Kim, Soo Hyun;Son, Eun Sun;Lee, Sang Geul;Song, Su Kyung;Choi, Hye Jin
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.2
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    • pp.138-145
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    • 2018
  • Background: Presently, a multidisciplinary team of doctors, pharmacists, nurses, and dietitians provides patient education to impart information on chemotherapy. However, studies on multidisciplinary education satisfaction are inadequate. In this study, we aimed to contribute to the improvement of quality of multidisciplinary education counseling for patients with cancer by developing a satisfaction questionnaire and analyzing the satisfaction survey. Methods: A questionnaire was developed by an expert group, and the responses were recorded using the 5-point Likert scale. After conducting a pre-test, factor analysis was performed to evaluate validity. The reliability of the questionnaire was measured by Cronbach's alpha coefficient. A satisfaction survey was conducted by self-administration method. Results: Based on the results of factor analysis, factors can be divided into two parts: "overall education" and "each team member's education" (total 14 questions). The construct validity and reliability of the questionnaire are sufficiently high. Fifty-one patients took the survey between January 2, 2018 and January 20, 2018. Twenty-six (51%) patients responded that they were "very satisfied" and 22 (43.1%) patients responded that they were "satisfied". Conclusion: By developing a questionnaire on multidisciplinary education counseling for patients with cancer, it is possible to perform evaluation and research of cancer patient education. This study will contribute to the management and improvement of quality of multidisciplinary education.

Determination the nursing student's clinical competency based on new nurses' job analysis (신규간호사의 직무분석을 통한 간호학생의 실무수행 능력수준 결정)

  • Kang, Ik-Wha;Lee, Eun-Ja;Lee, Kyu-Jung
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.3
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    • pp.497-509
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    • 2001
  • The purpose of this study was to examine frequency of job performance, level of urgency, index of importance experienced by 138 new nurses who were working at 6 hospitals that had over 400 bed in Incheon and Bucheon. The data were analyzed using a SPSS program for descriptive statistics [numbers of job performance, level of urgency, index of importance(job performance+1/4 level of urgency)]. Some of the most frequent job performance were application of aseptic technique, application of principle of infection control, and medication (IV, PO, IM, supply fluid and electrolyte). Some of the most uncommon job performance were activity as a lecturer in nursing department, activity of arrangement of community resources, and participation in multidisciplinary conference. Some of the highest level of urgency were use of aseptic technique, CPR, application of principle of infection control, defibrillation for dysrhythmia, blood transfusion, observation of patient's status in procedure (operation), v/s check, intervention for improvement of respiratory function and medication of antihypertensives. Some of the lowest level of urgency were activity as a lecturer in nursing department, preceptor's activity, supervisor and delegation of job to nurse aids, attendance at nursing conference, activity of arrangement of community resources, participation in clinical teaching practice, participation in multidisciplinary conference, and delegation of patient care. Those were indirect patient care. The order was physiologic integration(60.99%), safety and effective nursing environment, psychosocial care, and health maintenance and improvement. The most importance item in maintenance of physiologic integration was medication. Some of the highest index of importance were aseptic technique and application of principle of infection control, v/s check, observation of patient's status in operation and medication. Some of the lowest index of importance were activity as a lecturer in nursing department, preceptor's activity, activity of arrangement of community resources, participation in multidisciplinary conference, nursing conference, participation in clinical teaching, and delegation of job to nurse aids.

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Clinical Outcomes of Multidisciplinary Team Care on the Regulation of Chronic Kidney Disease - Mineral and Bone Disorder (CKD-MBD) in Patients Undergoing Dialysis (미네랄 골질환 합병증을 가진 투석환자에서 다학제 팀 서비스의 임상적 성과)

  • Han, Nayoung;Lee, Sang-Min;Hong, Jin Yi;Noh, Hye Jin;Ji, Eunhee;Song, Yun-Kyoung;Song, Jeeyoun;Kim, In-Wha;Kim, Yon Su;Oh, Jung Mi
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.4
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    • pp.318-323
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    • 2016
  • Background: Multidisciplinary team care (MTC) is a collaborative approach to treatment plan and ongoing care. We aimed to evaluate the clinical effect of MTC on the regulation of chronic kidney disease-mineral and bone disorder (CKD-MBD) complications in dialysis patients. Methods: This retrospective observational study was approved by the institutional review board. Among patients who have undergone dialysis at admission, the patients admitted to the nephrology ward were allocated to MTC group, and the others to usual care (UC) group. The MTC group had collaborative care by nephrologists, nurses, pharmacists, and nutritionists. The endpoints were the regulation of corrected calcium (cCa) and phosphate (P), the percent of patients in target level of cCa-P product ($cCa{\times}P$), and the prescription rate of non-calcium based P-binders. Results: A total of 163 patients were included from January to December 2009. A significant difference was shown in the percentage of patients in target $cCa{\times}P$ level at admission (MTC vs. UC, 81.40% vs. 91.67%; P = 0.038), but there was no significant difference at discharge. During admission, the cCa and P levels of patients in only UC group were significantly changed. In addition, compared with UC group, patients in MTC group were more likely prescribed appropriate P-binders, when they had higher $cCa{\times}P$ levels than $55mg^2/dL^2$ (P <0.001). Conclusion: It was found that MTC had beneficial effect on improving the regulation of CKD-MBD and the appropriate phosphate binder uses. Therefore, application of the MTC is anticipated to enhance quality of clinical care in chronic diseases.

The Importance of Multidisciplinary Management during Prenatal Care for Cleft Lip and Palate

  • Han, Hyun Ho;Choi, Eun Jeong;Kim, Ji Min;Shin, Jong Chul;Rhie, Jong Won
    • Archives of Plastic Surgery
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    • v.43 no.2
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    • pp.153-159
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    • 2016
  • Background The prenatal ultrasound detection of cleft lip with or without cleft palate (CL/P) and its continuous management in the prenatal, perinatal, and postnatal periods using a multidisciplinary team approach can be beneficial for parents and their infants. In this report, we share our experiences with the prenatal detection of CL/P and the multidisciplinary management of this malformation in our institution's Congenital Disease Center. Methods The multidisciplinary team of the Congenital Disease Center for mothers of children with CL/P is composed of obstetricians, plastic and reconstructive surgeons, pediatricians, and psychiatrists. A total of 11 fetuses were diagnosed with CL/P from March 2009 to December 2013, and their mothers were referred to the Congenital Disease Center of our hospital. When CL/P is suspected in the prenatal ultrasound screening examination, the pregnant woman is referred to our center for further evaluation. Results The abortion rate was 28% (3/11). The concordance rate of the sonographic and final diagnoses was 100%. Ten women (91%) reported that they were satisfied with the multidisciplinary management in our center. Conclusions Although a child with a birth defect is unlikely to be received well, the women whose fetuses were diagnosed with CL/P on prenatal ultrasound screening and who underwent multidisciplinary team management were more likely to decide to continue their pregnancy.

A Systematic Review of Nursing Interventions in Patients with Extracorporeal Membrane Oxygenation (ECMO) (체외막산소공급(ECMO) 치료 환자의 간호 중재에 대한 체계적 고찰)

  • Su-Min Park;Guan-Woung Jo
    • Journal of The Korean Society of Integrative Medicine
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    • v.12 no.3
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    • pp.237-247
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    • 2024
  • Purpose : This study aimed to systematically review the effectiveness of nursing interventions for patients receiving extracorporeal membrane oxygenation (ECMO). As the use of ECMO increases in critical care settings, it is important to understand how nursing interventions affect patient outcomes, survival, and complication rates. Methods : This systematic review followed the preferred reporting items for systematic reviews and meta-analysis guidelines. A literature search was performed using terms related to ECMO and nursing interventions in several international electronic databases including CINAHL, Embase, MEDLINE, and Web of Science. Studies were screened and selected according to predefined eligibility criteria, focusing on those that evaluated the impact of nursing interventions on adult. Data extraction and risk-of-bias assessment were independently performed by two researchers. Results : A total of 647 studies were identified, and seven met the inclusion criteria for qualitative analysis. The included studies demonstrated that high-quality nursing care significantly improves clinical outcomes and reduces complications in patients receiving ECMO. Effective nursing interventions included prone positioning combined with ECMO for patients with acute respiratory distress syndrome, meticulous infection control, comprehensive and continuous nursing protocols, skilled nursing, and multidisciplinary management. These interventions have been shown to improve oxygenation, reduce complications, such as bleeding, manage blood pressure, and enhance overall clinical outcomes. Conclusion : High-quality nursing interventions are critical to improve survival and reduce complications in patients receiving ECMO. Implementing a multidisciplinary approach and comprehensive nursing protocols, including infection control and psychological support, is essential for the effective management of these patients. The findings of this study provide a foundation for the development of practical guidelines and educational programs to improve the quality of care for patients undergoing ECMO, ultimately enhancing the effectiveness of ECMO treatment and patient outcomes.

Family-Centered Care for Hospitalized Children: Concept Analysis (입원 아동의 가족중심돌봄 개념분석)

  • Jung, So Young;Tak, Young Ran
    • Child Health Nursing Research
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    • v.23 no.1
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    • pp.28-36
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    • 2017
  • Purpose: This paper is a report on the concept analysis of family-centered care for hospitalized children. Methods: The concept analysis approach of Walker and Avant was used. A search of multidisciplinary literature published between 1960 and 2016 was undertaken using the keyword 'family centered care' or 'family centered nursing' combined with hospitalized children. Attributes, antecedents, and consequences were inductively derived from the citations analyzed (n=19). Results: The attributes of family-centered care included (1) family respect, (2) collaboration, (3) family support, and (4) information sharing. These attributes are influenced by the 'willingness of family to participate', 'competency and willingness of staff,' and 'institution policy and system.' Additionally, family-centered care does significantly impact 'the health of the children', 'family empowerment' and 'work satisfaction and self-confidence of staff'. Conclusion: Family-centered care of hospitalized children as defined by the result of this study will contribute to the theoretical foundation for application in pediatric nursing practice.

A Study on the Japanese Home Care Service (일본의 가정방문사업에 관한 연구)

  • Lee Hea-Young;Park Rae-Joon;Kim Jin-Sang;Choi Jin-Ho
    • The Journal of Korean Physical Therapy
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    • v.12 no.1
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    • pp.113-118
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    • 2000
  • The purpose of this study was to review the Japanese home care service and analyse the necessity for the home care service and the team approaching. The subjects of this study were 23 Korean students who visited on the Japanese home n due to the curriculum of university. The data were collected from sep. 1 to nov. 30, 1999. The main results of this study were as follows : 1. There was consisted of some nurses, physical therapists, medical doctors, occupational therapists as a team of home care service. They visited patients as multidisciplinary team. 2. The qualities of service was good, and the attitude of patient was positive. 3. There was necessity for rehabilitation home care service in Korea. 4. There was necessity for team work through the rehabilitation home care service in Korea.

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