View source for Periarticular histiocytic sarcoma with center metastasis inside a kitty

Central vascular access device (CVAD) placement is a common procedure in children. When selecting a CVAD, available evidence and specified indications should be used to choose the device that best supports the patient's treatment and carries the lowest risks. A multidisciplinary team developed a care algorithm to standardize preoperative screening before pediatric CVAD placement, with 3 major parts CVAD selection, patient risk stratification, and preoperative evaluation. Using a stepwise approach of provider education and incorporation into the electronic health record, the team achieved 82% stratification among inpatients. The team's algorithm integrates the existing literature and recommendations for safe and effective CVAD placement.Approximately 43 500 000 family caregivers provide unpaid care to an adult or child. Most caregivers provide care to older adults, most often parents. Caregivers are often ill-prepared to assist their loved ones, creating or increasing caregiving burden and/or risk of compassion fatigue, potentially leading to critical "caregiving tipping points." Identifying families who are experiencing increased burden or risk of compassion fatigue is a skill that nurses, including infusion nurses, who have unique entrée into the caregiving situation, should develop. The purpose of this article is to describe "impending" tipping points before they occur and to offer solutions for how nurses can help caregiving families identify them and access additional supportive services.The Infusion Nurses Society asserts that a comprehensive organizational approach to vascular access device (VAD) care and management is imperative to ensure safe and efficacious patient care. It is essential that each organization (1) develops policies and procedures to align VAD care and management with recognized standards of practice; (2) integrates unique aspects of organization-selected VAD care products into policies and procedures and establishes expectations for adherence to these organizational directives; (3) develops a framework for gathering and analyzing clinical data related to patient outcomes for VAD care and management; (4) utilizes quality outcome data to facilitate evidence-based best practices within the organization; and (5) evaluates and facilitates educational programming to validate clinician competency.A significant number of quantitative studies have associated a positive or healthy work environment with job satisfaction. Nurses, patients, and organizational characteristics have been studied as contributing factors. [https://www.selleckchem.com/products/MK-1775.html MK-1775] Other studies have focused on structural or physical environmental factors such as noise, space, or lighting as influencing to satisfaction. Little research has focused on how a changed work environment initiated by an organization for improved patient care affected the nurses' perceptions of how their practice had changed. The purpose of this qualitative study was to determine nurses' perceptions of a changed work environment on their practice, specifically patient care. Twelve nurses participated in the semistructured interviews. Interviews were transcribed verbatim and content analysis was used to identify categories of phrases and the resulting major themes. Most importantly, and the significant overall theme of patient- and family-centered improved care described their perceptions of this change. Other themes included camaraderie, nurse-patient relationships, being valued by the organization, and efficiency for decreasing stress. The results illuminate and extend some of the findings from prior quantitative studies on professional practice environments. A major contribution of this research is the perception of the nurses, often overlooked in quantitative studies. Significant was the nurses' view that the changed environment improved patient- and family-centered care although, as in other study findings, there was a view that peer camaraderie decreased.Nursing Peer Review is a foundational and essential element of professional nursing practice. It is a systematic methodology to improve nurse and patient outcomes. The process can be labor-intensive and cumbersome in managing data from diverse data sources, especially if the process is manual. Directors of Professional Practice in a health care system partnered with an external vendor to create an interactive software platform where technology was leveraged to streamline the review process including review of aggregate data and trend analyses and generate reports using an electronic database. This resulted in a 75% reduction in the number of steps and subsequently the time required to complete the review process from initial screening to referral and closure. The generation of actionable data facilitated active engagement of clinical nurses in addressing identified clinical issues using process improvement and evidence-based practice methods. A critical feature of the software platform is that it provides actionable data that can be used to improve patient safety and fosters accountability for clinical nurses to promote self-regulation of nursing practice.Hospitals are under increased pressure to address both financial and capacity constraints to improve their clinical operations. Effective capacity management programs have become a key driver of clinical operations for managing the flow of patients into and out of the hospital. Many high-functioning medical centers have developed capacity management programs to strategically address patient throughput. Discharging patients from the hospital is one fundamental, but complex, patient flow initiative for efficient patient throughput. Despite advances in optimizing patient flow, there is a lack of understanding associated with the structure and processes to efficiently discharge patients. This article outlines a discharge timeliness project where advanced practice providers are principal leaders of designing a safe and efficient patient discharge prototype. Design thinking was used to develop a patient discharge prototype that included 6 key areas that led to improved discharge times on a cardiac surgery step-down unit.