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PubMed Journals Articles About "Decision-making - The Benefit Of Bedside CRP Within Ambulance Care" RSS

09:34 EST 24th January 2020 | BioPortfolio

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Showing "Decision making Benefit Bedside Within Ambulance Care" PubMed Articles 1–25 of 18,000+

Paramedics and serious illness: communication training.

The need to empower Ambulance Service staff at the point of delivery of end of life care (EoLC) is crucial. We describe the delivery, outcomes and potential impact of the Serious Illness Conversation project delivered to Welsh Ambulance Service Trust (WAST) staff. Over an 18-month period, 368 WAST staff attended face-to-face teaching, which included serious illness conversation communication skills, symptom control and 'shared decision making'.


Off to a good start after a cancer diagnosis: implementation of a time out consultation in primary care before cancer treatment decision.

Supportive care for cancer patients may benefit from improving treatment decisions and optimal use of the family physicians' and specialists' strengths. To improve shared decision-making (SDM) and facilitate continuity of primary care during treatment, a cancer care path including a "time out consultation" (TOC) in primary care before treatment decision, was implemented. This study assesses the uptake of a TOC and the added value for SDM.

Overview of the main challenges in shared decision making in a multicultural and diverse society in the intensive and critical care setting.

In shared decision making, health care professionals and patients collaborate in making health-related choices. This process is based on autonomy and constitutes one to the elements of patient-centered care. However, there are situations where shared decision making is more difficult, if not impossible, due to barriers, which may be related to language, culture, education, or mental capacity and external factors like the state of emergency or the availability of alternative sources of information.


Naloxone-precipitated withdrawal ameliorates impairment of cost-benefit decision making in morphine-treated rats: involvement of BDNF, p-GSK3-β, and p-CREB in the amygdala.

Several studies indicated that morphine administration impairs cognitive brain functions. Therefore, in the current study, we investigated the effect of subchronic exposure to morphine and its withdrawal on effort- and/or delay-based forms of cost-benefit decision making and alterations in p-CREB/CREB ratio, p-GSK3β/GSK3β ratio, and BDNF level during decision making in the amygdala. Our data displayed an impairment of both forms of cost-benefit decision making following subchronic exposure to morphine. Ho...

Artificial nutrition and hydration for children and young people towards end of life: consensus guidelines across four specialist paediatric palliative care centres.

There is a paucity of evidence on the role, use, benefit and challenges of artificial nutrition and hydration (ANH) in children at end of life. Parents express the difficulty they face with making the decision to withdraw ANH. Decision-making on the role of ANH in an individual child requires careful multidisciplinary team deliberation and clear goals of care with children and families. Four paediatric palliative care specialist centres reviewed the current literature and developed consensus guidelines on A...

Preferences for end-of-life care and decision-making among older and seriously ill inpatients: a cross-sectional study.

Older and seriously ill Australians are often admitted to hospital in the last year of their life. The extent to which these individuals have considered important aspects of end-of-life care, including location in which care is provided, goals of care, and involvement of others in decision-making is unclear.

Assessing the electronic Bedside Paediatric Early Warning System: A simulation study on decision-making and usability.

The Bedside Paediatric Early Warning System (BedsidePEWS) is a clinical decision support tool designed to augment clinician expertise, objectively identify children at risk for clinical deterioration, and standardize and prioritize care to improve outcomes in community settings. Although the paper-based BedsidePEWS documentation record has been shown to improve clinicians' perception of their ability to detect deterioration and follow care recommendations, research is needed to asses this impact empirically...

Technology-mediated macrocognition: Investigating how physicians, nurses, and respiratory therapists make critical decisions.

Although intensive care clinicians are expected to make data-driven critical decisions using the technologies available to them, the effect of those technologies on decision-making are not well understood. Using the macrocognitive framework, we studied critical decision-making and technology use to understand how different specialists within teams make decisions and guide the development of decision-making support technologies.

The patient with severe traumatic brain injury: clinical decision-making: the first 60 min and beyond.

There is an urgent need to discuss the uncertainties and paradoxes in clinical decision-making after severe traumatic brain injury (s-TBI). This could improve transparency, reduce variability of practice and enhance shared decision-making with proxies.

The Ethic of Responsibility: Max Weber's Verstehen and Shared Decision-Making in Patient-Centred Care.

Whereas evidence-based medicine (EBM) encourages the translation of medical research into decision-making through clinical practice guidelines (CPGs), patient-centred care (PCC) aims to integrate patient values through shared decision-making. In order to successfully integrate EBM and PCC, I propose a method of orienting physician decision-making to overcome the different obligations set out by a formally-rational EBM and substantively-rational ethics of care. I engage with Weber's concepts "the ethic of re...

Shared Decision Making: Radiology's Role and Opportunities.

The purpose of this article is to present a targeted literature review describing the current state of radiology initiatives in support of shared decision making and gaps that offer opportunities for innovation and improvement. Breaking down the shared decision-making process into its four major components (access to information, comprehension of the information, appraisal of the information, application of knowledge in care decisions) reveals the role of radiologists in the decision-making process and opp...

Perceptions of shared decision making in severe mental illness: An integrative review.

Shared decision making (SDM) has been broadly advocated in health services and constitutes an important component of patient centred care and relationship based care.

Medical Decision-Making in Foster Care: Considerations for the Care of Children with Medical Complexity.

To explore how medical decision-making for children with medical complexity (CMC) occurs in the context of foster care (FC).

The Bayesian Approach to Decision Making and Analysis in Nutrition Research and Practice.

This is part of a series of monographs on research design and analysis. The purpose of this article is to describe the purposes of and approach to conducting Bayesian decision making and analysis. Bayesian decision making involves basing decisions on the probability of a successful outcome, where this probability is informed by both prior information and new evidence the decision maker obtains. The statistical analysis that underlies the calculation of these probabilities is Bayesian analysis. In recent yea...

Enhanced Youden's index with net benefit: A feasible approach for optimal-threshold determination in shared decision making.

To establish an enhanced Youden's index with net benefit, as a scientific method for optimal-threshold determination in shared decision making.

Addressing fragmentation in paediatric palliative care.

Paediatric palliative care (PPC) is an emerging specialty that aims at improving quality of life for patients and their families. The main goals of Paediatric palliative care (PPC) are to evaluate and minimize suffering in all domains (physical, psychosocial and spiritual), promote shared decision making and coordinate care. PPC is complex, and fundamentally different from adult palliative care in that it involves rare conditions, high-tech care, children in diverse developmental stages and complex proxy de...

End-of-Life Decision-Making for ICU Patients With Limited English Proficiency: A Qualitative Study of Healthcare Team Insights.

Research indicates that the increasing population of over 25 million people in the United States who have limited English proficiency experience differences in decision-making and subsequent care at end of life in the ICU when compared with the general population. The objective of this study was to assess the perceptions of healthcare team members about the factors that influence discussions and decision-making about end of life for patients and family members with limited English proficiency in the ICU.

A Pragmatic Trial of Suicide Risk Assessment and Ambulance Transport Decision Making Among Emergency Medical Services Providers: Implications for Patient Consent.

Practitioners' positive attitudes promote shared decision-making in mental health care.

There is a growing expectation of implementing shared decision making (SDM) in today's health care service, including mental health care. Traditional understanding of SDM may be too narrow to capture the complexity of treatments of mental health problems. Although the patients' contribution to SDM is well described, the contribution from the health care practitioners is less explored. Therefore, our aim was to explore the attitudes of practitioners in mental health care and the associations between practiti...

Antibiotic decision making in surgical intensive care: a qualitative analysis.

Antibiotic use in hospitals is high, particularly in surgical specialty and intensive care units. Antimicrobial stewardship programmes (ASPs) are increasingly intervening in antibiotic use by surgeons and intensivists. However, there is limited information on the features which characterize antibiotic decision making in the surgical intensive care unit (SICU), an area in hospital practice where critically ill surgery patients can be kept under close observation.

Palliative care in chronic heart failure: a theoretically guided, qualitative meta-synthesis of decision-making.

International clinical practice guidelines recommend that patients with chronic heart failure receive timely and high-quality palliative care. However, integrating palliative care is highly variable and dependent on decision-making and care models. This meta-synthesis aimed to examine health care professionals' decision-making processes and explore factors impacting decisions to refer or deliver palliative care in chronic heart failure. The electronic databases SCOPUS, CINAHL, and Medline were searched. Inc...

A Practical Approach to Clinical Antibiotic Stewardship in the ICU Patient with Severe Infection.

Patients with severe infections are often treated with multiple courses of antibiotics in the intensive care unit (ICU), making the ICU a true antibiotic hotspot. The increasing incidence of multidrug resistance worldwide emphasizes the need for continued efforts in developing and implementing antibiotic stewardship programs. Using a pragmatic approach for the bedside clinical team, this review will highlight different key moments for antibiotic decision making throughout the course of the antibiotic treatm...

Impact of paediatric critical illness and injury on families: An updated systematic review.

paediatric ICUs (PICU) that have adopted family-centered care models welcome families to the critically ill child's bedside to partner with clinicians in decision-making and the provision of care. The aim of this review was to synthesize the evidence on the impact of critical illness and injury on families of children admitted to the PICU to identify research needs in paediatric critical care.

Shared decision-making for older adults with cardiovascular disease.

Shared decision-making is appropriate for clinical decisions involving multiple reasonable options, which occur frequently in the cardiovascular care of older adults. The process includes the communication of relevant factual information between the patient and the clinician, elicitation of patient preferences, and a mutual agreement on the best course of action to meet the patient's personal goals. For older adults, there are common challenges and considerations with regard to shared decision-making, some ...

Shared Decision Making: Improving Patient Outcomes by Understanding the Benefits of and Barriers to Effective Communication.

Shared decision making (SDM) is a healthcare delivery model that mandates patient-centered care for clinical practice. Practicing SDM ensures that patients and family caregivers are engaged in making decisions about their care and treatment with healthcare providers. This article reviews the evidence on how nurses can influence the outcomes of cancer treatment decisions by using the SDM model.


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