Journal articles: 'Nursing in medical clinic'

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Hand (née Davies), Philippa R. "Non-medical prescribing of systemic anticancer therapy in a multidisciplinary team oncology clinic." British Journal of Nursing 28, no. 11 (June 13, 2019): 715–20. http://dx.doi.org/10.12968/bjon.2019.28.11.715.

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The number of people diagnosed and living with cancer in the UK continues to rise, placing increasing demands on specialist cancer care services. The incidence and prevalence of neuroendocrine tumours (NETs) has increased. An NET remains a rare cancer requiring specialist care and the clinical nurse specialist (CNS) team is ideally placed to support these patients. Oncology clinics are becoming increasingly pressured and the need to think of innovative ways of reducing pressure while maintaining and enhancing the patient's experience is important. A new multidisciplinary team (MDT) systemic anti-cancer therapy (SACT) clinic for NET patients was developed that incorporated a CNS SACT non-medical prescriber (NMP) to improve patient experience and reduce the number of oncologist clinic reviews. Methods and analysis: the clinic was designed and a protocol developed to help ensure safe practice and support for the CNS NMP. The patient experience was prioritised and the medical team was involved in the design. All NMP SACT prescriptions were reviewed and questionnaires were given to patients after 3 months. A questionnaire was also given to all oncologists within the clinic and to the oncology pharmacist for analysis. Findings: 29 SACT NMP prescriptions for 15 patients were written. Patient and medical colleague feedback was positive. Discussion: this experience has helped to highlight the positive impact of innovative clinics that combine the expertise of both independent nurse practitioners and the medical team. This has paved the way for further clinics of this kind within the author's trust and the NET service.

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Marx, M. S., D. Wolf, L. Pheng, V. Walker, A. Elises, R. C. Feldman, P. Werner, J. Cohen-Mansfield, S. Dubroff, and S. Lipson. "Eye Care in a Nursing Home." Journal of Visual Impairment & Blindness 85, no. 3 (March 1991): 105–7. http://dx.doi.org/10.1177/0145482x9108500305.

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This article describes an example of an in-house eye care clinic for elderly nursing home residents. The success of this clinic is due not to any one person, but to the combined efforts of a team: a clinic supervisor, a nursing assistant, a medical assistant, an ophthalmic technician, and an ophthalmologist. The implications of providing good and effective eye care to nursing home residents are discussed.

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Westberg, Sarah M., and Kathrine Beeksma. "Advancing Medication Reconciliation in an Outpatient Internal Medicine Clinic through a Pharmacist-Led Educational Initiative." INNOVATIONS in pharmacy 1, no. 1 (June 1, 2010): 11. http://dx.doi.org/10.24926/iip.v1i1.194.

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Objectives: To develop and deliver an effective pharmacist-led educational initiative to clinic staff to advance medication reconciliation in the electronic medical record of an outpatient internal medicine clinic. Methods: An educational initiative designed to improve the ability of nursing staff in medication reconciliation was launched in the outpatient internal medicine clinic of a regional healthcare system. The education was provided by the pharmacist to clinic nursing staff, including registered nurses, licensed practical nurses, and certified medical assistants. The impact of this training was measured through pre-initiation and post-implementation surveys, competency assessments and an audit. Results: The educational initiative was successfully designed and delivered to clinic nursing staff. Assessment of the initiative found that all nursing staff completing competency assessments successfully passed. Pre-initiation- and post-implementation- survey responses on the self-assessed ability to gather and document accurate medication lists did not show significant changes. Informal observations in the clinic indicated that this initiative changed the culture of the clinic, creating increased awareness of the importance of accurate medications and increased emphasis on medication reconciliation. Conclusions: The expertise of pharmacists can be utilized to educate nursing staff on the skills and abilities necessary to gather and document accurate medication lists. This study did not find measurable changes in the accuracy of medication lists in this clinic. Future research is needed to determine the best methods to train health professionals in medication reconciliation to ensure accurate medication lists in the outpatient setting. Type: Original Research

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Silva, Wellington Mariano da, and Raul Amaral de Araújo. "Systematization of nursing records by software: experience in a medical clinic." Revista Enfermagem Digital Cuidado e Promoção da Saúde 4, no. 1 (2019): 57–64. http://dx.doi.org/10.5935/2446-5682.20190011.

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Singh, Vinod, Geraldine Hughes, and S. E. Goh. "Depot clinic: consumers' viewpoint." Psychiatric Bulletin 19, no. 12 (December 1995): 728–30. http://dx.doi.org/10.1192/pb.19.12.728.

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With the emphasis on ‘care in the community’ there have been moves to provide psychiatric care away from the large psychiatric hospitals, which have resulted in the development of community mental health teams and the expansion of primary care and health centres to cater for people with psychiatric needs. The opinions of patients attending a hospital-based depot neuroleptic clinic are reported. A 17-item questionnaire was designed addressing the functioning of the clinic, including aspects of the medical and nursing care offered and the overall service provided. The majority of patients were in favour of attending this facility and expressed their wish for the service to continue.

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Fishburn, Andrew, and Nicola Fishburn. "Establishing a nurse-led thyroid cancer follow-up clinic." British Journal of Nursing 30, no. 4 (February 25, 2021): S28—S35. http://dx.doi.org/10.12968/bjon.2021.30.4.s28.

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Thyroid cancer is a complex disease requiring management by a large multidisciplinary team. The number of patients with a diagnosis of thyroid cancer is significantly increasing year-on-year, and traditional models of consultant-led follow up are no longer sustainable. Although nurse-led cancer follow-up clinics are becomining increasingly common, thyroid cancer nurse-led follow-up clinics are rare. An excellent understanding of the disease, treatment and management of risk of disease recurrence is essential for safe patient care, and is discussed in this article. The clinic discussed uses the skill set of head and neck nurse specialists, including psychological support, coping strategies for long-term side effects of treatment and non-medical prescribing. A patient survey of the service revealed high levels of patient satisfaction and a desire to continue face-to-face consultations rather than telephone clinics.

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Howland, Chelsea, Laurel Despins, Jeri Sindt, Bonnie Wakefield, and David R. Mehr. "Primary Care Clinic Nurse Activities with a Telehealth Monitoring System." Western Journal of Nursing Research 43, no. 1 (January 2020): 5–12. http://dx.doi.org/10.1177/0193945920923082.

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The purpose of this study was to evaluate differences in the types of nursing activities and communication processes reported in a primary care clinic between patients who used a home-based monitoring system to electronically communicate self-monitored blood glucose and blood pressure values and those who assumed usual care. Data were extracted from electronic medical records from individuals who participated in a randomized controlled trial comparing in-home monitoring and usual care in patients with Type 2 diabetes and hypertension being treated in a primary care clinic. Data about nursing activities initiated by primary care clinic nurses were compared between groups using descriptive statistics and independent t-tests. Significant differences between groups were identified for the direct care nursing activities of providing lifestyle and health education, medication adjustments, and patient follow-up. This study provides evidence of greater nursing activity reported in a primary care clinic in patients who utilized a home-based monitoring system.

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Han, Seo Young, Su Jin Kwak, Bo Gyeong Choi, Hyeong Ju Jeon, and Myung Kyung Lee. "Association of nursing activity participation and clinical practice stress with career maturity during clinical practice of nursing college students." Journal of Korean Academic Society of Nursing Education 26, no. 4 (November 30, 2020): 337–47. http://dx.doi.org/10.5977/jkasne.2020.26.4.337.

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Purpose: The purpose of this study was to figure out the association of nursing activity participation and clinical practice stress with career maturity during clinical practice among nursing college students.Methods: Participants of the study were 201 nursing college students located in nationwide regions. Data collection was performed between July 18 and August 8, 2019. Data analyses were performed through an independent t-test, ANOVA, Pearson’s correlation coefficient, and multiple linear regression analysis using SPSS WIN 25.0.Results: The results of this study were as follows. We ran multiple regression analyses to see which critical factors influenced career maturity. The general characteristics significantly associated with career maturity were preference for clinical nursing, admission to nursing college due to belief, time off, and being satisfied with clinical practice. Regarding clinical practice stress, clinic environment, interpersonal relationship conflict, inappropriate role model and conflict with patients were significantly associated with career maturity.Conclusion: This study suggested that, to improve nursing students’ career maturity, nursing colleges and training fields should collaboratively make an efforts to reduce students’ stress by building educational clinic environments including managing conflicts in interpersonal relationships among patients, caregivers, and medical and non-medical personnel, and improving inappropriate role models in nursing.

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Ubaldo, Isabela, Eliane Matos, Nádia Chiodelli Salum, Juliana Balbinot Reis Girondi, and Lícia Brito Shiroma. "NANDA International nursing diagnoses in patients admitted to a medical clinic unit." Revista da Rede de Enfermagem do Nordeste 18, no. 1 (June 12, 2017): 68. http://dx.doi.org/10.15253/2175-6783.2017000100010.

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Guzhvina, Oxana. "Analysis of nursing staff of SBHE «Volgograd regional oncology clinic №3»." Medsestra (Nurse), no. 4 (April 1, 2020): 49–55. http://dx.doi.org/10.33920/med-05-2004-08.

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The article, based on the data obtained from the questionnaire of nurses with at least five years of work in the oncology clinic, considers the daily amount of their work and the degree of satisfaction with their work. The results will be the basis for further research in the field of quality of working life of nurses of the institution. As is known, one of the components of the effective work of medical and preventive institutions is the quality of working life of secondary medical personnel.

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Caffey, Carmen, Anthony Jeffries, Allison J. Zelikoff, Mona Chambers, Barclay T. Stewart, and Tam N. Pham. "109 Outpatient Nursing Care Charges: A Process Improvement Project." Journal of Burn Care & Research 42, Supplement_1 (April 1, 2021): S73—S74. http://dx.doi.org/10.1093/jbcr/irab032.113.

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Abstract Introduction High wound care complexity in a burn clinic mandates adequate nurse staffing and expertise to manage increasingly large wounds as outpatient. To achieve these service needs, appropriate charge capture is important for revenue generation. Our burn clinic performed a process improvement (PI) project using a Plan, Do, Study, Act (PDSA) cycle to improve the accuracy of charge capture for wound care episodes over the past 2 fiscal years (FY). Methods In the first phase (PLAN), we reviewed charges by 1-month sampling in FY20. We engaged stakeholders (medical and nursing providers, managers, revenue integrity and compliance teams) through iterative meetings. We performed a stakeholder analysis to identify their level of engagement, influence, and attitudes toward this PI. We next devised strategies for stakeholders to champion the project. The team developed and trialed the process by focusing on burn wound care Common Procedural Terminology (CPT) codes. In FY21, nurses began to enter CPT codes in accordance with burn wound care performed (DO). We then repeated a 1-month sampling of charges in FY21 (STUDY). We are now consolidating the new strategy, refreshing stakeholder engagement, and expanding it within our hospital (ACT). Results We identified multiple billing errors and opportunities to improve CPT code documentation for nursing wound care procedures in FY20. Stakeholder interviews revealed a gap between accurate billing and current practice. We proposed to alter the wound care billing workflow. Stakeholder engagement was high and well-represented among professional disciplines. In FY21 implementation, clinic nurses received the clinic coding in-service and were oriented to resource tools. We verified billing practice adherence via the institutional compliance department. FY21 sampling indicated a marked increase in accurate charges for burn wound care in the clinic (net+ $36,691). We have implemented real-time audits, identified and documented problems as they arise, and obtained feedback from nurses. The clinic is investigating non-burn wound care charge capture and has disseminated our findings through institutional shared governance. Conclusions The financial performance of outpatient burn nursing needs to be closely evaluated in today’s shifting healthcare environment. Using a PDSA process led by nurses, the accuracy of charge capture for complex wound care has substantially improved and led to increased revenue. This model is potentially translatable to other specialty clinics.

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Lyapina, Irina, and Larisa Karaseva. "Role of nursing staff in organizing and giving ole of nursing staff in organizing and giving lessons for tuberculosis patients." Medsestra (Nurse), no. 6 (June 1, 2020): 22–29. http://dx.doi.org/10.33920/med-05-2006-07.

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The article emphasizes the importance and necessity of establishing a School for Tuberculosis Patients. The results of the questionnaire of medical nurses and patients of the anti-tuberculosis clinic are presented to the readers. The author shares the experience of organizing the School and draws attention to the fact that the best means of safety for the medical worker and the patient in the medical organization is competent actions of all participants of the process.

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&NA;. "Introducing the Cleveland Clinic WOC Nursing Hall of Fame." Journal of Wound, Ostomy and Continence Nursing 40, no. 5 (2013): 460. http://dx.doi.org/10.1097/won.0b013e3182a402a9.

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Erwin-Toth, Paula. "Clinic-on-wheels." Journal of Wound, Ostomy and Continence Nursing 13, no. 3 (May 1986): 123. http://dx.doi.org/10.1097/00152192-198605000-00050.

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Heale, Roberta, Elizabeth Wenghofer, Susan James, and Marie-Luce Garceau. "Quality of Care for Patients With Diabetes and Mulitmorbidity Registered at Nurse Practitioner-Led Clinics." Canadian Journal of Nursing Research 50, no. 1 (December 7, 2017): 20–27. http://dx.doi.org/10.1177/0844562117744137.

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Background Nurse Practitioner-Led Clinics are a new model of primary healthcare in Ontario. Nurse Practitioner-Led Clinics are distinctive in that nurse practitioners are the primary care providers working with an interprofessional team. There have been no evaluations of the quality of care within the Nurse Practitioner-Led Clinic model. Purpose Evaluation of the Nurse Practitioner-Led Clinic model, specifically for complex clinical presentations, will provide insights that may be used to inform improvements to the delivery of care in the Nurse Practitioner-Led Clinics. The aim of this study was to evaluate the extent to which diabetes care was complete and to determine the impact of organizational tools, including electronic medical record tracking, diabetes care template, and referral to community programs, on the completeness of care for patients with diabetes and multimorbidity at Nurse Practitioner-Led Clinics. Methods An audit of 30 charts was conducted at five different Nurse Practitioner-Led Clinics (n = 150) for patients with diabetes and at least one other chronic condition. Indicators included patient and organizational characteristics as well as diabetes care items taken from diabetes clinical guidelines. Results Overall, care for patients with diabetes and multimorbidity in Nurse Practitioner-Led Clinics was complete. However, there were no significant associations between patient or organizational characteristics and the extent to which diabetes care was complete.

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Peterson, Michael C., Todd L. Ebbert, Mike W. Edwards, and James Willmore. "NOTES: Disposition of Pharmaceutical Samples from a Private Medical Clinic." Journal of the American Pharmacists Association 44, no. 3 (May 2004): 397–98. http://dx.doi.org/10.1331/154434504323064039.

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Chmielewski, Eric, and Joseph L. Cesarz. "A framework to increase prescription capture from health-system clinics." American Journal of Health-System Pharmacy 77, no. 8 (March 11, 2020): 658–62. http://dx.doi.org/10.1093/ajhp/zxaa023.

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Abstract Purpose To develop and implement an interprofessional framework to increase the capture of health system–generated prescriptions within health system–owned pharmacies. Summary Low prescription capture rates within a health system’s internal pharmacies led to an interdisciplinary process improvement effort. A framework was developed to assess the baseline prescription capture rate, select clinics for improvement, understand clinic workflows and key drivers of pharmacy selection, design strategies to increase prescription capture, implement targeted efforts, and measure the effectiveness of the intervention(s). Employing this framework provided revised workflows for nursing and medical assistant staff scripting and for referral of patients to internal pharmacies. These workflows were pilot tested at 3 system clinics. Results indicated that overall prescription capture increased by 2.9 to 4.1 percentage points (range, 10 to 86 prescriptions per month) and specialty prescription capture increased by 11.6 to 26.7 percentage points (range, 4 to 26 prescriptions per month) for each clinic within the first 2 months. A total of 99 new patients were referred to internal pharmacies within the first month. Conclusion Development and implementation of a framework to increase prescription capture from health system clinics helped increase capture, enhanced clinic engagement and knowledge about pharmacy services, and supported positive clinic-pharmacy relationships.

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Yurko, L. C., C. P. Brandt, T. L. Coffee, and C. J. Yowler. "Medical Center Utilization of an Outpatient Burn Clinic." Journal of Burn Care & Rehabilitation 23 (March 2002): S108. http://dx.doi.org/10.1097/00004630-200203002-00131.

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Feudtner, John Christopher. "Clio in the Clinic: History in Medical Practice (review)." Bulletin of the History of Medicine 81, no. 2 (2007): 495–96. http://dx.doi.org/10.1353/bhm.2007.0029.

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Carney, Hazel C., Susan Little, Dawn Brownlee-Tomasso, Andrea M. Harvey, Erica Mattox, Sheilah Robertson, Renee Rucinsky, and Donna Stephens Manley. "AAFP and ISFM Feline-Friendly Nursing Care Guidelines." Journal of Feline Medicine and Surgery 14, no. 5 (April 17, 2012): 337–49. http://dx.doi.org/10.1177/1098612x12445002.

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Nursing care: The term nursing care means different things to different people. The authors of these AAFP and ISFM Feline-Friendly Nursing Care Guidelines define nursing care as any interaction between the cat and the veterinary team (veterinarian, technician or nurse, receptionist or other support staff) in the clinic, or between the cat and its owner at home, that promotes wellness or recovery from illness or injury and addresses the patient’s physical and emotional wellbeing. Nursing care also helps the sick or convalescing cat engage in activities that it would be unable to perform without help. Guidelines rationale: The purpose of the Guidelines is to help all members of the veterinary team understand the basic concepts of nursing care, both in the clinic and at home. This includes methods for keeping the patient warm, comfortable, well nourished, clean and groomed. The Guidelines provide numerous practical tips gleaned from the authors’ many years of clinical experience and encourage veterinary team members to look at feline nursing care in ways they previously may not have considered. Overarching goal: The primary goal of feline-friendly nursing care is to make the cat feel safe and secure throughout its medical experience.

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Ford, Yvonne. "Perioperative Nursing Clinics." AORN Journal 92, no. 4 (October 2010): 483–84. http://dx.doi.org/10.1016/j.aorn.2010.07.002.

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Galowitz, Paula. "The Opportunities and Challenges of an Interdisciplinary Clinic." International Journal of Clinical Legal Education 18 (July 8, 2014): 165. http://dx.doi.org/10.19164/ijcle.v18i0.5.

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<p>Law school clinics in many countries increasingly provide the major opportunities that law students have to engage in interdisciplinary collaborations with other professionals. The collaboration may be with a wide range of professionals, such as: doctors and medical students; social workers and social work students; business school students; engineering faculty and students including biomedical engineering students; nursing students; and experts in public health, education, mental health or palliative care. It can occur in diverse contexts or targeted to specific populations, such as children, the elderly, victims of domestic violence or low-income business owners.</p><p>Some examples of these interdisciplinary clinics illustrate their variety. Clinical legal education initiatives in South Africa, Thailand and Ukraine promoted public health through programs that partnered with the Law and Health Initiative of the Open Society Institute’s Public Health Programs. In South Africa, palliative care was integrated with legal services; law students worked with staff at a hospice association to conduct workshops on wills, debts and family law for hospice caregivers. In Ukraine a Medical Law Clinic was started to advise and represent clients; in Thailand a law clinic wrote an HIV/AIDS Community Legal Education Manual, collaborated with organizations working on health and human rights issues to discuss harm reduction and incarceration, and implemented community education programs in prisons, detention centers and community centers. At Palacky University in the Czech Republic a new Patient’s Rights Legal Clinic, which prepares students to give legal advice, is taught by lecturers of the medical faculty and lawyers from a human rights non-profit. A clinic in the United States provides business planning and legal advice to small businesses; law and business students collaborate to assist with community economic development. Another United States clinic combines students in law, business, medicine, social work, biomedical engineering, and arts and sciences in a collaboration focused on intellectual property and business formation, with an emphasis on biodiversity and agricultural-biotechnology innovations.</p>

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De Vries, Beth, Cynthia Darling-Fisher, Anne C. Thomas, and Elizabeth B. Belanger-Shugart. "Implementation and outcomes of group medical appointments in an outpatient specialty care clinic." Journal of the American Academy of Nurse Practitioners 20, no. 3 (March 2008): 163–69. http://dx.doi.org/10.1111/j.1745-7599.2007.00300.x.

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Beveridge, Allan. "Are Depot Clinics Out of Date?" Bulletin of the Royal College of Psychiatrists 11, no. 3 (March 1987): 92–93. http://dx.doi.org/10.1192/s0140078900024494.

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Depot Clinics or ‘Moderate Clinics’ tend to be similar. They are usually regarded as ‘low priority’ and often staffed by clinical assistants with only a limited training in psychiatry. Typically a large number of patients turn up each week, and there is little time for a detailed assessment of their needs. The clinic is often seen as ‘a chore’ by medical and nursing staff who may feel that the long-term care and support of patients with chronic disabling illnesses lacks excitement. One gains the impression that the patients with the less attractive personalities or those presenting repetitive management problems are more likely to be referred.

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Ingram, Shirley, and Barkat Khan. "Discharge planning in a cardiology out-patient clinic: a clinical audit." International Journal of Health Care Quality Assurance 27, no. 7 (August 5, 2014): 573–80. http://dx.doi.org/10.1108/ijhcqa-12-2012-0126.

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Purpose – The purpose of this paper is to audit the active discharge (DC) planning process in a general cardiology clinic, by pre-assessing patients’ medical notes and highlighting those suitable for potential DC to the clinic physician. Design/methodology/approach – The cardiology clinical nurse specialist (CNS) identified patients’ for nine- to 12-month return visits one week prior to attendance. The previous consultation letter was accessed and information was documented by the CNS in the medical record. The key performance indicator (KPI) used was patient DCs for each clinic visit. The process was audited at three separate times to reflect recommended action carried out. Findings – The CNS pre-assessment and presence at the clinics significantly increased total DCs during the first period compared to usual care, 11 vs 34 per cent (p<0.0001). During the third audit period, DCs fell (9 per cent) with a reduction in CNS pre-assessed DCs (10 per cent). Recommendations were implemented. The process was continued by clinic administration staff, colour coding all nine- to 12-month returns, resulted in a 19 per cent DC rate in 2012. Practical implications – CNS pre-assessment and highlighting DC suitability increased the number of patient DCs. As the CNS presence at the clinic reduced so did the rate of DC. Specific personnel need to be responsible for monitoring and reminding staff of the process; this does not always have to be medical or nursing. Originality/value – Implementing positive discharging procedures is aimed at improving quality, increasing efficiency and accessibility of services for patients. This audit describes a process to promote DC planning from cardiology outpatients.

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Woodward, Michael Clifford, and Erin Woodward. "A national survey of memory clinics in Australia." International Psychogeriatrics 21, no. 4 (August 2009): 696–702. http://dx.doi.org/10.1017/s1041610209009156.

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ABSTRACTBackground:There is limited information describing memory clinics at a national level in Australia. The aim of this study was to gather information about the resourcing, practices and clinical diagnoses of Australian memory clinics.Methods:A postal survey was sent to all Australian memory clinics identified by key specialists working in dementia assessment services.Results:Of 23 surveys sent out, 14 were returned. Most clinics are located in Victoria where they receive Victorian state funding. The average clinic has 1.67 effective full time clinical staff including 0.42 medical staff, 0.24 allied health staff, 0.53 clinical nursing staff and 0.48 psychologists. Clinics are open on average twice a week and each half-day clinic has two new and three review patients, seeing new patients twice initially then once more over 12 months. Patients wait 10 weeks for initial assessment with 59% referred by general practitioners. The Mini-mental State Examination and clock drawing are utilized universally. The most common diagnoses are Alzheimer's disease (37.8%) and mild cognitive impairment (19.8%) but 6.9% of patients have no cognitive impairment.Conclusions:This survey has provided useful benchmarking data on Australian memory clinics which can also be used by other countries for comparative analyses.

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Syed Elias, Sharifah Munirah, Aniawanis Makhtar, and Nor Hazwani Ahmad Tarmidi. "Factors associated with suicidal ideation among older people in medical outpatient clinic." Enfermería Clínica 31 (April 2021): S356—S360. http://dx.doi.org/10.1016/j.enfcli.2020.09.026.

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Landry, Margaret M. "ENTEROSTOMAL THERAPY CLINIC-ON-WHEELS." Journal of Wound, Ostomy and Continence Nursing 13, no. 1 (January 1986): 31–33. http://dx.doi.org/10.1097/00152192-198601000-00040.

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Ludlow, Helen, Nabihah Malik, Jeff Turner, John Green, and Louise Hanna. "Gastrointestinal symptoms of pelvic radiation disease (part 4): professional awareness and specialist support." Gastrointestinal Nursing 18, no. 5 (June 2, 2020): 30–34. http://dx.doi.org/10.12968/gasn.2020.18.5.30.

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This is the fourth and final article in a series on the gastrointestinal (GI) symptoms of pelvic radiation disease (PRD). Published studies and patient reports suggest that health professionals lack of awareness of PRD. This professional awareness can be improved with third-sector advocacy and provision of simple screening tools, such as Assessment of Late Effects of Radiotherapy-Bowel (ALERT-B). In South Wales, patients with suspected PRD are referred to a PRD specialist nurse in either a gastroenterology clinic or a gynae-oncology follow-up clinic. These two nurse-led clinics demonstrate different ways to identify, assess and manage patients with late GI effects of PRD. Data from these clinics suggest that systematic investigations based on appropriate guidance are effective in identifying these symptoms, many of which can be managed or treated. The rising incidence of PRD and lack of specialist services suggests that the NHS needs to provide more funding to care for patients beyond the end of their cancer treatment.

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Edwards, Ruth, Carol Abullarade, and Nancy Turnbull. "Nursing management and follow-up of the postoperative vascular patient in a clinic setting." Journal of Vascular Nursing 14, no. 3 (September 1996): 62–67. http://dx.doi.org/10.1016/s1062-0303(96)80002-1.

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Larsson, Inga E., Monika J. M. Sahlsten, Kerstin Segesten, and Kaety A. E. Plos. "Patients' Perceptions of Nurses' Behaviour That Influence Patient Participation in Nursing Care: A Critical Incident Study." Nursing Research and Practice 2011 (2011): 1–8. http://dx.doi.org/10.1155/2011/534060.

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Patient participation is an important basis for nursing care and medical treatment and is a legal right in many Western countries. Studies have established that patients consider participation to be both obvious and important, but there are also findings showing the opposite and patients often prefer a passive recipient role. Knowledge of what may influence patients' participation is thus of great importance. The aim was to identify incidents and nurses' behaviours that influence patients' participation in nursing care based on patients' experiences from inpatient somatic care. The Critical Incident Technique (CIT) was employed. Interviews were performed with patients (), recruited from somatic inpatient care at an internal medical clinic in West Sweden. This study provided a picture of incidents, nurses' behaviours that stimulate or inhibit patients' participation, and patient reactions on nurses' behaviours. Incidents took place during medical ward round, nursing ward round, information session, nursing documentation, drug administration, and meal.

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Bowler, William A., Jeanine Bresnahan, Ann Bradfish, and Christine Fernandez. "An Integrated Approach to Methicillin-ResistantStaphylococcus aureusControl in a Rural, Regional-Referral Healthcare Setting." Infection Control & Hospital Epidemiology 31, no. 3 (March 2010): 269–75. http://dx.doi.org/10.1086/650445.

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Objective.To curtail the prevalence and cross-transmission of methicillin-resistantStaphylococcus aureus(MRSA) in a rural healthcare setting.Design.Before-after, quasi-experimental quality improvement study.Setting.A regional-referral hospital, 5 affiliated nursing homes, and an outpatient MRSA clinic.Interventions.Residents of the 5 nursing homes were screened for MRSA at baseline and 1 year later. Active surveillance cultures were performed on subsequently admitted nursing home residents, “high-risk” patients admitted to the hospital, and household contacts of clinic patients. The decolonization regimen consisted of systemic therapy with minocycline and rifampin and topical therapy with nasal mupirocin ointment and 5% tea tree oil body wash. Three separate samples for cultures to document clearance of MRSA colonization were obtained at 1-week intervals 1 month after the completion of decolonization therapy. Samples for follow-up cultures were obtained at month 6 and month 12 after the completion of decolonization therapy.Results.After intervention and follow-up for 12 months or more, the prevalence of MRSA carriage at the nursing homes decreased by 67% (P<.001), and 120 (82%) of 147 nursing home residents and 111 (89%) of 125 clinic patients remained culture-negative for MRSA. Twenty-three (24%) of 95 new clinic patients had at least 1 MRSA-positive contact. Mupirocin resistance did not develop. In the hospital, the incidence rate of nosocomial MRSA infection decreased from 0.64 infections per 1,000 patient-days before the interventions to 0.40 infections per 1,000 patient-days 1 year after the interventions and to 0.32 infections per 1,000 patient-days 2 years after the intervention (P<.01).Conclusions.Use of active surveillance cultures and decolonization therapy was effective in decreasing the prevalence of asymptomatic carriage, the incidence of nosocomial infection, and the overall prevalence of MRSA in our rural healthcare setting.

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Stepleman, Lara M., Rebecca Jump, Sarah F. Shelton, and Mary D. Hughes. "Psychological Consultation Services at a Multiple Sclerosis Clinic." International Journal of MS Care 11, no. 4 (January 1, 2009): 180–86. http://dx.doi.org/10.7224/1537-2073-11.4.180.

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Despite the existence of effective treatments for mental health problems in patients with multiple sclerosis (MS), such problems often go untreated or undertreated because of a variety of patient, provider, and organizational factors. As untreated psychological difficulties can interfere with MS treatment adherence, a collaborative partnership between medical and mental health providers is crucial. In the fall of 2003, the Medical College of Georgia's Augusta MS Center implemented an MS psychological consultation service. The goal of this service is to remove barriers to the emotional well-being of individuals with MS through convenient, collaborative, and coordinated psychological services provided during routine MS medical appointments. To better understand patient use of this new program and the types of problems addressed, we conducted a retrospective review of documentation from 197 consultations held from July 2004 through June 2006. Summary data on demographics, presenting problems, and resultant treatment plans reflect a broad array of concerns for which psychological consultation was sought, including psychiatric symptoms, difficulties with adjustment to illness, and cognitive problems. Given the barriers to mental health care for MS patients and the unique skills psychologists bring to the multidisciplinary MS team, on-site psychological consultation may be an effective method of providing mental health services to the MS population.

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Bjegovich-Weidman, Marija, Max Haid, Santhosh Kumar, Carol Huibregtse, Jean McDonald, and Santosh Krishnan. "Establishing a Community-Based Lung Cancer Multidisciplinary Clinic As Part of a Large Integrated Health Care System: Aurora Health Care." Journal of Oncology Practice 6, no. 6 (November 2010): e27-e30. http://dx.doi.org/10.1200/jop.2010.000022.

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This Lung Cancer Multidisciplinary Clinic (MDC) included medical and radiation oncologists, a thoracic surgeon, and a pulmonologist and met every third week. Establishment of the clinic resulted in improvements in quality of care, patient satisfaction, and patient retention.

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Alexander, Mariam, Matthew Stuart, Jose Nahun Galeas, Roy Browne, Jim McCarthy, and Stuart H. Packer. "Improving vaccine administration in patients with solid malignancies in the outpatient setting." Journal of Clinical Oncology 38, no. 29_suppl (October 10, 2020): 194. http://dx.doi.org/10.1200/jco.2020.38.29_suppl.194.

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194 Background: Pneumococcal and influenza vaccinations are recommended for all patients with any malignancy in accordance with the Infectious Disease Society of America. Patients undergoing chemotherapy for solid tumors have a 40-50 fold higher risk for the development of invasive pneumococcal disease compared to healthy adults with a case fatality rate of 35% and should receive the sequential 13-valent pneumococcal conjugate vaccine (PCV13) and 23-valent pneumococcal polysaccharide vaccine (PPSV23). In the outpatient setting, lack of provider knowledge, complexity of the pneumococcal vaccine regimen and disruption in work-flow of a busy clinic can lead to low rates of administration. Towards this end, we conducted a quality project to improve administration of both pneumococcal and influenza vaccines by at least 50% at one of our outpatient oncology clinics at Montefiore Medical Center in Bronx, NY during a 4 month period. Methods: We first provided provider and nursing education with regard to safety and efficacy of the vaccines in both the clinic as well as the infusion setting. Nurses were then prompted to screen patients and offer the vaccines during intake prior to all infusions and clinic visits. We created bulk orders which allowed nurses greater control of releasing vaccine orders previously entered by the director of the clinic. We also posted “cheat-sheets” on optimal timing, safety and sequence of administration of the vaccines in every patient room and nursing station. After our first cycle, we identified that there was a delay in work-flow in the outpatient clinic with delivery of the vaccines to the clinic from the pharmacy. We therefore obtained a secure vaccine fridge that was placed at the nursing station, which allowed nurses easy access to the vaccines. Results: When vaccine administration during the 2018-2019 influenza season was compared to the 2019-2020 influenza season, we found that these interventions improved the administration of the influenza vaccine by 70%. There was a dramatic increase in the number of PCV-13 vaccines administered by 350% (more than 5-fold) and increase in PPVS-23 by 12.5%. No immediate adverse reactions during this cycle were reported to our nurse manager. Conclusions: A simple intervention of improved work-flow of vaccine administration and increased education of providers and nurses translated to a dramatic improvement in the administration of influenza and PCV-13 vaccines in a busy outpatient oncology clinic.

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Bares, Sara H., Susan Swindells, Joshua P. Havens, Ann Fitzgerald, B. Kay Grant, and Devin R. Nickol. "Implementation of an HIV clinic-based interprofessional education curriculum for nursing, medical and pharmacy students." Journal of Interprofessional Education & Practice 11 (June 2018): 37–42. http://dx.doi.org/10.1016/j.xjep.2018.02.002.

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Pocuis, Jesse, Sam Man-Hoi Li, Mary M. Janci, and Hilaire J. Thompson. "Exploring Diabetic Foot Exam Performance in a Specialty Clinic." Clinical Nursing Research 26, no. 1 (July 26, 2016): 82–92. http://dx.doi.org/10.1177/1054773815596699.

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Detection of diabetic foot complications is key to amputation prevention. This study used survey and retrospective record review to examine the relationship between frequency and performance of clinician’s diabetic foot examinations on performance of patient home self-foot examinations. An additional aim was to assess clinician performance of annual foot examination per American Diabetes Association (ADA) guidelines in a specialty clinic. The relationships between demographic characteristics, diabetic foot ulcer beliefs, health literacy, HbA1c level, and foot self-exam performance was also examined. No relationship was found between the performance frequency of foot examinations by providers and patient self-examination ( N = 88). The presence of specific barriers to self-management was significantly higher in those patients who did not complete daily home self-foot examinations. Only 16% of patients’ charts reviewed met the ADA criteria for a complete annual foot exam. Motivational interviewing during patient visits could be a strategy to break down barriers to self-foot exam performance. Furthermore, the development of an Electronic Medical Record (EMR)–based diabetic foot exam template to improve provider documentation may improve compliance with ADA recommendations.

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S., Ruby, and Roberto C.S. "Impact Study on Health Beyond Bar Extension Services of the Bataan Peninsula State University College of Nursing and Midwifery." African Journal of Health, Nursing and Midwifery 4, no. 5 (August 23, 2021): 75–84. http://dx.doi.org/10.52589/ajhnm-bw23iznf.

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Health Beyond Bar (HBB) is 4-year project aimed to help persons deprived of liberty (PDLs) at Bataan District Jail in Balanga to improve health conditions and situations through provision of health service and health education. A medical clinic was established in 2015 under the auspices of the College of Nursing and Midwifery and financial assistance from Bataan Governor and Department of Health. To assess the impact and determine objectives attainment, the study delved on: What is the level of increment of trained and educated PDLs in the HBB program? What are the health problems managed from the period of 2019 to 2020? What is the prevalence rate of communicable diseases managed from the period of 2017 to 2020? Are there significant differences in the prevalence rate of communicable diseases managed in the facility? Records review and data scrutiny were used. A consistent percentage increment of trained PDLs creating an impact in their health conditions was observed. Number of trainings conducted in 2018 compared to other years also have increased. Eight common health problems were managed by the clinic and a considerable increase in the number of these were managed in the clinic. Prevalence of Tuberculosis and Sexually Transmitted Diseases have considerably declined. An erratic prevalence in skin disease was observed. Likewise, it’s prevalence was noted to be significant, while the rest of the health conditions were not significantly different. A new strategy of implementation of Health Education Session and Training may be adopted where offerings may be done on a two-week cycle per quarterly. A more innovative delivery of training programs may improve the numbers and retention of information shared. A robust approach to health education related to skin disease may be devised. Lastly, the Medical Clinic may use creative information drive in compliance and monitoring of prevalent health conditions.

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Pottle, Alison. "A Nurse-Led Rapid Access Chest Pain Clinic—Experience from the First 3 Years." European Journal of Cardiovascular Nursing 4, no. 3 (September 2005): 227–33. http://dx.doi.org/10.1016/j.ejcnurse.2005.03.003.

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Background: The clinical presentation of chest pain is a major problem for primary health care professionals. Rapid access chest pain clinics (RACPC) enable quick assessment, investigation and formation of a treatment plan for such patients without a waiting list. There has been a chest pain clinic in operation at Harefield Hospital since 1988. Until 2001, the cardiology registrars were responsible for the clinic. Beginning in January 2001, the management of the clinic was taken over by the Cardiology Nurse Consultant. This paper will describe the organisation and outcomes of the first 3 years of this nurse-run RACPC. Process: Patients are seen within 2 weeks of referral in line with the National Service Framework for Coronary Heart Disease [Department of Health. National service framework for coronary heart disease. Dept of Health; 2000. London.]. An electrocardiogram (ECG) is recorded on arrival in the clinic and the Nurse Consultant then examines the patients and decides if further investigation is required. Analysis of Results: Four hundred and fifty-four patients were seen in the clinic from January 2001–December 2003. Three hundred and twenty-four patients (71.4%) underwent exercise testing of which 54 (16.7%) had a positive result. One hundred and thirteen patients (24.9%) were referred for angiography. Of these, 75 (66.4%) had coronary heart disease. Thirty-three patients (29.2%) have undergone percutaneous coronary intervention (PCI) and 19 (16.8%) have required coronary artery bypass grafting (CABG). Twenty-three patients (20.4%) are being treated medically. Satisfaction with the service offered by the clinic was high, evidenced by the results of questionnaires sent to patients. Conclusion: This paper demonstrates that nurses can successfully run RACPCs without an increased risk of incorrect diagnosis. These clinics offer patients timely access to assessment of their chest pain and facilitate early diagnosis of cardiac disease. They are also well accepted by the patients attending the clinic.

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&NA;. "HIGHLIGHTS FROM THE CLEVELAND CLINIC ETNEP." Journal of Wound, Ostomy and Continence Nursing 15, no. 6 (November 1988): 43A. http://dx.doi.org/10.1097/00152192-198811000-00011.

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Carman, Cynthia A., and Kathy Wettstein. "FROM WOUND CLINIC TO HOME HEALTH." Journal of Wound, Ostomy and Continence Nursing 35, Supplement (May 2008): S53. http://dx.doi.org/10.1097/01.won.0000319406.26062.7c.

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Arpin, Corinne, Véronique Dubois, Laure Coulange, Catherine André, Isabelle Fischer, Patrick Noury, Frédéric Grobost, et al. "Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae in Community and Private Health Care Centers." Antimicrobial Agents and Chemotherapy 47, no. 11 (November 2003): 3506–14. http://dx.doi.org/10.1128/aac.47.11.3506-3514.2003.

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ABSTRACT In 1999, 39 of 2,599 isolates of the family Enterobacteriaceae (1.5%) collected by eight private laboratories in the Aquitaine region in France produced an extended-spectrum β-lactamase (ESBL). Among these were 19 Enterobacter aerogenes isolates; 8 Klebsiella pneumoniae isolates; 6 Escherichia coli isolates; 3 Proteus mirabilis isolates; and 1 isolate each of Serratia marcescens, Morganella morganii, and Providencia stuartii. ESBL producers were isolated from 38 patients, including 33 residents of 11 clinics or nursing homes and 5 ambulatory patients. Seven different ESBLs were characterized. These mainly consisted of TEM-24 (25 isolates) and TEM-21 (9 isolates), but TEM-15 (2 isolates) and TEM-3, TEM-19, SHV-4, and CTX-M-1 (1 isolate each) were also characterized. Seven strains showed the coexistence of different TEM- and/or SHV-encoding genes, including a new SHV-1 variant, SHV-44, defined by the substitution R205L previously reported for SHV-3 in association with S238G. The epidemiology of the ESBL producers was investigated by random amplification of polymorphic DNA, typing by enterobacterial repetitive intergenic consensus PCR, analysis of resistance cotransferred with the ESBL, and analysis of the restriction profiles of the ESBL-encoding plasmids. Of the TEM-24-expressing strains, 18 were E. aerogenes isolates, including 9 from the same clinic, that were representatives of the epidemic clone disseminating in France. Of the TEM-21-producing strains that belonged to different species of the family Enterobacteriaceae (E. coli, K. pneumoniae, and P. mirabilis), 8 were isolated in the same nursing home. Outbreaks due to strain and/or plasmid dissemination in these clinic and nursing home were demonstrated. The presence of ESBL producers in five ambulatory patients probably resulted from nosocomial acquisition. Our data highlight the serious need to monitor patients for ESBL-producing Enterobacteriaceae in general practice.

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Finlay, Esme, Kristina Newport, Shanthi Sivendran, Laurel Kilpatrick, Michelle Owens, and Mary K. Buss. "Models of Outpatient Palliative Care Clinics for Patients With Cancer." Journal of Oncology Practice 15, no. 4 (April 2019): 187–93. http://dx.doi.org/10.1200/jop.18.00634.

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PURPOSE: Early integration of outpatient palliative care (OPC) benefits patients with advanced cancer and also the health care systems in which these patients are seen. Successful development and implementation of models of OPC require attention to the needs and values of both the patients being served and the institution providing service. SUMMARY: In the 2016 clinical guideline, ASCO recommended integrating palliative care early in the disease trajectory alongside cancer-directed treatment. Despite strong endorsement and robust evidence of benefit, many patients with cancer lack access to OPC. Here we define different models of care delivery in four successful palliative care clinics in four distinct health care settings: an academic medical center, a safety net hospital, a community health system, and a hospice-staffed clinic embedded in a community cancer center. The description of each clinic includes details on setting, staffing, volume, policies, and processes. CONCLUSION: The development of robust and capable OPC clinics is necessary to meet the growing demand for these services among patients with advanced cancer. This summary of key aspects of functional OPC clinics will enable health care institutions to evaluate their specific needs and develop programs that will be successful within the environment of an individual institution.

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Costa, Priscila, Amanda Pereira Duarte, Aline Santa Cruz Belela-Anacleto, Paula Rosenberg de Andrade, Maria Magda Ferreira Gomes Balieiro, and Maria De La Ó. Ramallo Veríssimo. "Nursing diagnoses in primary health care consultations to newborns." Revista Brasileira de Enfermagem 71, no. 6 (December 2018): 2961–68. http://dx.doi.org/10.1590/0034-7167-2017-0954.

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ABSTRACT Objective: To describe and analyze nursing diagnoses established on newborns’ medical consultations in a primary health care service. Method: Descriptive, analytical and quantitative study performed in a primary health care clinic in São Paulo. Data were collected from the medical records of 37 children treated in 39 nursing consultations during their neonatal period. The identified nursing diagnoses were analyzed regarding: frequency, classification in strengthening or exhaustion in light of the health-disease process, and the correspondence with the essential needs of infants. Results: 372 diagnoses were identified, most of them of strengthening (71%), such as efficient development (n = 37) and effective growth (n = 36). Among the exhaustion diagnoses (29%), there was a predominance of risk for suffocation (n = 15) and impaired tissue integrity (n = 14). Most diagnoses corresponded to the need of physical protection and security. Conclusion: Families are strengthened in the care of the essential needs of newborns, however, preventing diseases is necessary.

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Fedoniuk, L. Ya, E. Burgess-Pinto, S. Yastremska, and C. Shumka. "HEALTHY POPULATION STUDY – OPPORTUNITIES TO DEVELOP GLOBAL CITIZENS AND HEALTH CARE PROFESSIONALS." Вісник медичних і біологічних досліджень, no. 2 (January 31, 2020): 55–58. http://dx.doi.org/10.11603/bmbr.2706-6290.2019.2.10579.

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The aim of the work. Cooperation between MacEwan University and I. Horbachevsky Ternopil National Medical University in the realization of the educational programme of Public Health. Materials and Methods. 23 students of the MacEwan University Nursing Faculty (including Canada, Ghana, Nigeria, and India) spent one week at I. Horbachevsky Ternopil National Medical University (TNMU). The work of students and teachers was focused on interactive learning of questions of global/planetary health issues and included flipped classroom format, seminars, team-based learning and field clinics coordinated by MacEwan faculty members in partnership with the TNMU members. Results and Discussion. Cooperation between TNMU and MacEwan University corresponds to the strategy of the MacEwan University Nursing Faculty: Nurses making a difference in the health of global communities and mission: transformative learning in nursing education and professional practice. The educational course was organized to the students to align with three essential components of planetary health: relationality, sustainability, and ways of knowing. Through interactive learning in an international setting, students developed a shared understanding of how people relate to each other and to their environments, compared Canadian and Ukrainian approaches to the Sustainable Development Goals, and created space for understanding different ways of knowing and how these enhance health and wellbeing. Students visited a variety of health care facilities, including pediatric clinics, mental health hospital, HIV clinic, perinatal centre, orphanages, and rehabilitation centres. Conclusions. Co-creation of the program, and involving Ukrainian students offers opportunities to examine and change nursing education and professional practice. The face-to-face format of the trip is invaluable in enhancing emotional and informal learning as well as developing capacity as global citizens. The course provides an excellent foundation for students who wish to pursue graduate studies in global health either in Nursing or in Public Health.

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Stone, Christopher J. L., Andrew Robinson, Erin Brown, Mihaela Mates, Conrad B. Falkson, Timothy Owen, Allison Ashworth, et al. "Improving Timeliness of Oncology Assessment and Cancer Treatment Through Implementation of a Multidisciplinary Lung Cancer Clinic." Journal of Oncology Practice 15, no. 2 (February 2019): e169-e177. http://dx.doi.org/10.1200/jop.18.00214.

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PURPOSE: Timely lung cancer care has been associated with improved clinical outcomes and patient satisfaction. We identified improvement opportunities in lung cancer management pathways at Kingston Health Sciences Centre. Quality improvement strategies led to the implementation of a multidisciplinary lung cancer clinic (MDC). METHODS: We set an outcome measure of decreasing the time from diagnosis to first cancer treatment by 10 days within 6 months of clinic implementation. We implemented a weekly MDC that involved respirologists, medical oncologists, and radiation oncologists at which patients with new lung cancer diagnoses were offered concurrent oncology consultation. We used Plan-Do-Study-Act cycles to guide our improvement initiatives. A total of five Plan-Do-Study-Act cycles spanned 14 months and consisted of an MDC pilot clinic, large-scale MDC launching, debriefing meetings, and clinic expansion. Pre-MDC data were analyzed retrospectively to establish baseline and prospectively for improvement. Statistical Process Control XmR(i) charts were used to report data. RESULTS: Since MDC initiation, 128 patients have been seen in 34 MDC clinics (3.8 patients per clinic). Mean days from diagnosis to first oncology assessment decreased from 12.4 days to 3.9 days, and mean days from diagnosis to first cancer treatment decreased from 39.5 to 15.0 days, both of which demonstrated special cause variation. Time to assessment and treatment improved for patients with every stage of lung cancer and for both small-cell and non–small-cell subtypes. CONCLUSION: MDC shortens the time from lung cancer diagnosis to oncology assessment and treatment. Time to treatment improved more than time to oncology assessment, which suggests the improvement is related to benefits beyond faster oncology assessment.

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Kudo, Yoshikuni, Hisanori Kawasaki, and Toshio Fujioka. "Clinic-based educational strategies utilized for practical training of common medical devices focusing on medical and nursing care for the elderly prior to formal on-site clinic training." An Official Journal of the Japan Primary Care Association 36, no. 1 (2013): 27–31. http://dx.doi.org/10.14442/generalist.36.27.

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Halperin, Ofra, and Olga Bronshtein. "The attitudes of nursing students and clinical instructors towards reporting irregular incidents in the medical clinic." Nurse Education in Practice 36 (March 2019): 34–39. http://dx.doi.org/10.1016/j.nepr.2019.02.018.

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Carro, George W., Bruce Brockstein, Thomas A. Hensing, Patrick Joseph Fleming, Shannon Maureen Gavin, Wayne Spath, Abigail Harper, Wendy Hui, William J. Uhlig, and Brad Hughes. "Evaluation of oral chemotherapy prescribing at an outpatient oncology clinic." Journal of Clinical Oncology 31, no. 31_suppl (November 1, 2013): 191. http://dx.doi.org/10.1200/jco.2013.31.31_suppl.191.

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191 Background: Oral chemotherapy’s exponentially increasing role in the treatment of malignancies continues to pose unique challenges to oncology. The American Society of Clinical Oncology (ASCO) and Oncology Nursing Society (ONS) drafted measures in the Chemotherapy Administration Safety Standards that help address some of these issues concerning oral chemotherapy. There is a lack of data describing the prescribing process for oral chemotherapy. In a retrospective chart review, prescriptions at a hospital-based outpatient oncology center were evaluated for completeness of prescribing and follow up measures. Methods: A retrospective chart review of ten oral chemotherapy medications from May 2012 to July 2012 was conducted. The primary outcome measure was compliance with ASCO and ONS Chemotherapy Administration Safety Standards. A secondary outcome was frequency of pharmacist interventions on oral chemotherapy prescriptions. Results: 412 prescriptions were evaluated. Prescriptions were graded on a scale from 1 to 8. One point was given for inclusion of each of the following: prescribing physician, patient name, drug name, dose, dosing methodology, quantity, refills, and accurate directions. Of all the prescriptions, 23% contained all aspects of a complete prescription. The most common reasons for point deductions were contradictory or unclear directions and allowing refills for oral chemotherapy which should not be refillable. Four percent of prescriptions had a documented pharmacist intervention. Conclusions: This study revealed areas for improvement in the prescribing process of oral chemotherapy. Targeting directions and refill fields within prescription templates will improve compliance with ASCO and ONS standards. This can be accomplished by implementing customized oral chemotherapy prescription templates within treatment plans in the electronic medical record system. Unlike chemotherapy administered in the clinic setting, oral chemotherapy prescriptions are not generally reviewed by oncology trained pharmacists. With the collaboration of medical and nursing staff, a new work flow was implemented which includes pharmacist review of electronic oral chemotherapy prescriptions.

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Holroyd, Suzanne. "Visual Hallucinations in a Geriatric Psychiatry Clinic: Prevalence and Associated Diagnoses." Journal of Geriatric Psychiatry and Neurology 9, no. 4 (December 1996): 171–75. http://dx.doi.org/10.1177/089198879600900403.

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Visual hallucinations are associated with a variety of psychiatric, medical, neurologic, and ophthalmologic disorders. One hundred forty outpatients presenting to a geriatric psychiatric clinic were screened for visual hallucinations and assessed on a number of descriptive variables, medical history, ophthalmologic history, psychiatric diagnosis, and cognitive score. The data revealed that 14 patients (10%) experienced visual hallucinations. Presence of visual hallucinations was significantly associated with diagnoses of dementia or delirium, living in a nursing home, lower cognitive score, and presence of auditory hallucinations and delusions. There was no association to number of medications, age, gender, or presence of eye disease. No patient had ‘insight’ into their visual hallucinations. Despite the numerous disorders that are associated with visual hallucinations, the most common causes in a geriatric psychiatry clinic are dementia and delirium. Clinicians assessing older patients with visual hallucinations should first carefully evaluate for these disorders.

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Journal articles on the topic 'Nursing in medical clinic'

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