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Coiner S, Hernandez A, Midyette P, Patel B, Talley M. Nurse-Led Care Coordination in a Transitional Clinic for Uninsured Patients With Diabetes. Prof Case Manag 2024:01269241-990000000-00016. [PMID: 38557562 DOI: 10.1097/ncm.0000000000000732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
PURPOSE/OBJECTIVES The purpose of this article is to inform the reader of the practice of the registered nurse care coordinator (RNCC) within an interprofessional, nurse-led clinic serving uninsured diabetic patients in a large urban city. This clinic serves as a transitional care clinic, providing integrated diabetes management and assisting patients to establish with other primary care doctors in the community once appropriate. The clinic uses an interprofessional collaborative practice (IPCP) model with the RNCC at the center of patient onboarding, integrated responsive care, and clinic transitioning. PRIMARY PRACTICE SETTING Interprofessional, nurse-led clinic for uninsured patients with diabetes. FINDINGS/CONCLUSIONS Interprofessional models of care are strengthened using a specialized care coordinator. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE Care coordination is a key component in case management of a population with chronic disease. The RNCC, having specialized clinical expertise, is an essential member of the interdisciplinary team, contributing a wide range of resources to assist patients in achieving successful outcomes managing diabetes. Transitional care coordination, moving from unmanaged to managed diabetes care, is part of a bundled health care process fundamental to this clinic's IPCP model. In a transitional clinic setting, frequent interaction with patients through onboarding, routine check-ins, and warm handoff helps support and empower the patient to be engaged in their personal health care journey.
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Affiliation(s)
- Sarah Coiner
- Sarah Coiner, DNP, RN-BC, CNL, CNE, CDCES, is an instructor at The University of Alabama at Birmingham (UAB) School of Nursing (SON) and a certified clinical nurse leader. She holds a faculty practice as a nursing care coordinator at the UAB PATH Clinic and is a certified diabetes care and education specialist
- Alison Hernandez, PhD, MPH, RN, is a nurse clinic manager at the UAB PATH Clinic. She received a PhD in Public Health at Umea University, Sweden, and completed her BSN at UAB. Her doctoral research focused on nurses' performance in rural Guatemala. Her career interest is developing the nursing profession's role in addressing health inequities
- Paula Midyette, MSN, CCNS, CCRN-K, CNE, CDCES, is an adjunct didactic instructor at UAB SON and is a certified adult health clinical nurse specialist. She holds a faculty practice as a nursing care coordinator at the UAB PATH Clinic and is a certified diabetes care and education specialist
- Bela Patel, DNP, CRNP, NP-C, is a certified adult-gerontology primary care nurse practitioner. Currently, she works as an assistant professor at UAB SON and maintains her faculty practice as the lead nurse practitioner at the PATH Clinic that specializes in providing care to the indigent population with diabetes
- Michele Talley, PhD, ACNP-BC, FNAP, FAANP, FAAN, is Professor, Associate Dean for Clinical and Global Partnerships at UAB SON, and Director of the UAB PATH Clinic. Her focus is on transforming care of diabetes using innovative models
| | - Alison Hernandez
- Sarah Coiner, DNP, RN-BC, CNL, CNE, CDCES, is an instructor at The University of Alabama at Birmingham (UAB) School of Nursing (SON) and a certified clinical nurse leader. She holds a faculty practice as a nursing care coordinator at the UAB PATH Clinic and is a certified diabetes care and education specialist
- Alison Hernandez, PhD, MPH, RN, is a nurse clinic manager at the UAB PATH Clinic. She received a PhD in Public Health at Umea University, Sweden, and completed her BSN at UAB. Her doctoral research focused on nurses' performance in rural Guatemala. Her career interest is developing the nursing profession's role in addressing health inequities
- Paula Midyette, MSN, CCNS, CCRN-K, CNE, CDCES, is an adjunct didactic instructor at UAB SON and is a certified adult health clinical nurse specialist. She holds a faculty practice as a nursing care coordinator at the UAB PATH Clinic and is a certified diabetes care and education specialist
- Bela Patel, DNP, CRNP, NP-C, is a certified adult-gerontology primary care nurse practitioner. Currently, she works as an assistant professor at UAB SON and maintains her faculty practice as the lead nurse practitioner at the PATH Clinic that specializes in providing care to the indigent population with diabetes
- Michele Talley, PhD, ACNP-BC, FNAP, FAANP, FAAN, is Professor, Associate Dean for Clinical and Global Partnerships at UAB SON, and Director of the UAB PATH Clinic. Her focus is on transforming care of diabetes using innovative models
| | - Paula Midyette
- Sarah Coiner, DNP, RN-BC, CNL, CNE, CDCES, is an instructor at The University of Alabama at Birmingham (UAB) School of Nursing (SON) and a certified clinical nurse leader. She holds a faculty practice as a nursing care coordinator at the UAB PATH Clinic and is a certified diabetes care and education specialist
- Alison Hernandez, PhD, MPH, RN, is a nurse clinic manager at the UAB PATH Clinic. She received a PhD in Public Health at Umea University, Sweden, and completed her BSN at UAB. Her doctoral research focused on nurses' performance in rural Guatemala. Her career interest is developing the nursing profession's role in addressing health inequities
- Paula Midyette, MSN, CCNS, CCRN-K, CNE, CDCES, is an adjunct didactic instructor at UAB SON and is a certified adult health clinical nurse specialist. She holds a faculty practice as a nursing care coordinator at the UAB PATH Clinic and is a certified diabetes care and education specialist
- Bela Patel, DNP, CRNP, NP-C, is a certified adult-gerontology primary care nurse practitioner. Currently, she works as an assistant professor at UAB SON and maintains her faculty practice as the lead nurse practitioner at the PATH Clinic that specializes in providing care to the indigent population with diabetes
- Michele Talley, PhD, ACNP-BC, FNAP, FAANP, FAAN, is Professor, Associate Dean for Clinical and Global Partnerships at UAB SON, and Director of the UAB PATH Clinic. Her focus is on transforming care of diabetes using innovative models
| | - Bela Patel
- Sarah Coiner, DNP, RN-BC, CNL, CNE, CDCES, is an instructor at The University of Alabama at Birmingham (UAB) School of Nursing (SON) and a certified clinical nurse leader. She holds a faculty practice as a nursing care coordinator at the UAB PATH Clinic and is a certified diabetes care and education specialist
- Alison Hernandez, PhD, MPH, RN, is a nurse clinic manager at the UAB PATH Clinic. She received a PhD in Public Health at Umea University, Sweden, and completed her BSN at UAB. Her doctoral research focused on nurses' performance in rural Guatemala. Her career interest is developing the nursing profession's role in addressing health inequities
- Paula Midyette, MSN, CCNS, CCRN-K, CNE, CDCES, is an adjunct didactic instructor at UAB SON and is a certified adult health clinical nurse specialist. She holds a faculty practice as a nursing care coordinator at the UAB PATH Clinic and is a certified diabetes care and education specialist
- Bela Patel, DNP, CRNP, NP-C, is a certified adult-gerontology primary care nurse practitioner. Currently, she works as an assistant professor at UAB SON and maintains her faculty practice as the lead nurse practitioner at the PATH Clinic that specializes in providing care to the indigent population with diabetes
- Michele Talley, PhD, ACNP-BC, FNAP, FAANP, FAAN, is Professor, Associate Dean for Clinical and Global Partnerships at UAB SON, and Director of the UAB PATH Clinic. Her focus is on transforming care of diabetes using innovative models
| | - Michele Talley
- Sarah Coiner, DNP, RN-BC, CNL, CNE, CDCES, is an instructor at The University of Alabama at Birmingham (UAB) School of Nursing (SON) and a certified clinical nurse leader. She holds a faculty practice as a nursing care coordinator at the UAB PATH Clinic and is a certified diabetes care and education specialist
- Alison Hernandez, PhD, MPH, RN, is a nurse clinic manager at the UAB PATH Clinic. She received a PhD in Public Health at Umea University, Sweden, and completed her BSN at UAB. Her doctoral research focused on nurses' performance in rural Guatemala. Her career interest is developing the nursing profession's role in addressing health inequities
- Paula Midyette, MSN, CCNS, CCRN-K, CNE, CDCES, is an adjunct didactic instructor at UAB SON and is a certified adult health clinical nurse specialist. She holds a faculty practice as a nursing care coordinator at the UAB PATH Clinic and is a certified diabetes care and education specialist
- Bela Patel, DNP, CRNP, NP-C, is a certified adult-gerontology primary care nurse practitioner. Currently, she works as an assistant professor at UAB SON and maintains her faculty practice as the lead nurse practitioner at the PATH Clinic that specializes in providing care to the indigent population with diabetes
- Michele Talley, PhD, ACNP-BC, FNAP, FAANP, FAAN, is Professor, Associate Dean for Clinical and Global Partnerships at UAB SON, and Director of the UAB PATH Clinic. Her focus is on transforming care of diabetes using innovative models
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Ghozali MT, Mutiara TA. Promoting knowledge of metered dose inhaler (MDI) usage among pharmacy professional students through a mobile app. J Asthma 2024:1-12. [PMID: 38236014 DOI: 10.1080/02770903.2024.2306622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/13/2024] [Indexed: 01/19/2024]
Abstract
INTRODUCTION Efficient asthma management necessitates optimal usage of metered-dose inhalers (MDIs). As future health professionals, pharmacy students are pivotal in disseminating accurate methodologies for MDI usage. Despite having hands-on experience, there is room to enhance their comprehension, highlighting the need for prompt patient educational interventions. OBJECTIVE This study aims to evaluate the effectiveness of a mobile app-assisted educational method in improving pharmacy students' understanding of MDI usage. METHODS A pre-experimental study was conducted from March to August 2021 with 45 participants enrolled in the Pharmacist Professional Study Program at the Faculty of Medicine and Health Sciences, Universitas Muhammadiyah Yogyakarta. Using a one-group pretest-post-test design, the study measured the app's impact on students' knowledge and MDI usage skills. RESULTS The intervention significantly improved students' scores on a 9-step MDI usage checklist, with increases ranging from 0.10 to 0.50 across verbal and motor components. A Mann-Whitney U test validated these findings, showing a statistically significant p-value of 0.001. CONCLUSION The mobile app-assisted educational approach substantially enhanced pharmacy students' proficiency in MDI use. The significant rise in mean scores for the 9-step checklist, along with the notable p-value, supports the effectiveness of this intervention in healthcare education.
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Affiliation(s)
- Muhammad Thesa Ghozali
- Department of Pharmaceutical Management, School of Pharmacy, Universitas Muhammadiyah Yogyakarta, Indonesia
| | - Tasya Aulia Mutiara
- Undergraduate Program, School of Pharmacy, Universitas Muhammadiyah Yogyakarta, Indonesia
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Dumbhare O, Taksande A. Neonatal Abstinence Syndrome: An Insight Over Impact of Maternal Substance Use. Cureus 2023; 15:e47980. [PMID: 38034154 PMCID: PMC10686242 DOI: 10.7759/cureus.47980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
Neonatal abstinence syndrome (NAS) highlights the intricate interplay between maternal substance use during pregnancy and the challenges neonates face from the distressing global opioid crisis. This comprehensive review captures the multilayered landscape of NAS, encircling its underlying mechanisms, epidemiology, diagnostic intricacies, clinical manifestations, continuing developmental impacts, treatment paradigms, and the crucial role of multidisciplinary care. The core pathophysiology of NAS involves the transplacental passage of addictive substances, activating chemical dependence in the maturing fetus, which is characterized by neurotransmitter dysregulation, neuroadaptations, and receptor sensitization. A diverse clinical presentation ranges from central nervous system hyperactivity and autonomic dysregulation to gastrointestinal manifestations, necessitating homogenous assessment tools such as the Finnegan Neonatal Abstinence Scoring System. The demand for a multilayered approach is essential for comprehensive management, involving pharmacological interventions like morphine or methadone and non-pharmacological strategies such as swaddling. The complications of NAS are not only limited to but are also well beyond infancy, leading to behavioral, longstanding cognitive, and socioemotional consequences. Addressing these developmental arcs demands decisive longitudinal monitoring and early interventions. NAS management is fundamentally multidisciplinary, requiring the teamwork of nurses, social workers, psychologists, pediatricians, and neonatologists. Apart from the clinical realm, managing the psychosocial needs of families traversing NAS requires resources and empathy. A crucial comprehensive approach is essential to confront the challenges and limitations of NAS. From early identification and prevention to longstanding support through pharmacological, non-pharmacological, and psychological channels, it creates a holistic structure that emerges as the basis for understanding the complicated relationship between maternal substance use and its impact on neonates. An amalgamation of community engagement, society, policy initiatives, and medical expertise is essential to mitigate the repercussions of NAS and adopt healthier outcomes for affected infants.
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Affiliation(s)
- Omkar Dumbhare
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Amar Taksande
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Al Rowily A, Aloudah N, Jalal Z, Abutaleb MH, Paudyal V. Views, experiences and contributory factors related to medication errors associated with direct oral anticoagulants: a qualitative study with physicians and nurses. Int J Clin Pharm 2022; 44:1057-1066. [PMID: 35731467 PMCID: PMC9393124 DOI: 10.1007/s11096-022-01448-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/14/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Direct oral anticoagulants (DOACs) have become preferable for the management of thromboembolic events. Recent publications have however identified high volume of medication errors related to DOACs. There is limited literature on why and how such errors occur or happen in clinical practice. AIM This study aimed to explore views, experiences, contributory factors related to DOACs medication errors from the perspectives of healthcare professionals. METHOD Semi-structured interviews using online videoconferencing were conducted with physicians and nurses from tertiary care hospitals in three different regions in Saudi Arabia. Questions included views, experiences and perceived factors contributing to errors. Interviews were transcribed verbatim and were thematically analyzed using MAXQDA Analytics Pro 2020 (VERBI Software). RESULTS The semi-structured interviews (n = 34) included physicians (n = 20) and nurses (n = 14) until data saturation was achieved. The analysis identified five themes: Factors related to healthcare professionals (e.g. knowledge, confidence and access to guidelines); Factors related to patients (e.g. comorbidity, polypharmacy, medication review, and communication barriers); Factors related to organization (e.g. guidelines, safety culture and incidents reporting system); Factors related to the DOACs medications (e.g. lack of availability of antidotes and dosing issues); and Strategies for error prevention/mitigation (e.g. the need for professional training and routine medication review). CONCLUSION Healthcare professionals identified errors in relation to DOACs as multifactorial including their own and patient lack of knowledge, lack of clinical guidelines and organizational factors including safety culture. Medication review and reconciliation on discharge were key strategies suggested to reduce DOACs related errors. These strategies support the role of pharmacists as direct patients care providers to minimize DOACs errors.
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Affiliation(s)
- Abdulrhman Al Rowily
- School of Pharmacy, Institute of Clinical Sciences, College of Medical and Dental Sciences, Sir Robert Aitken Institute for Medical Research, University of Birmingham, Birmingham, B15 2TT, UK. .,Pharmaceutical Care Department, King Fahad Military Medical Complex (KFMMC), Medical Department, Ministry of Defense, Dhahran, Saudi Arabia.
| | - Nouf Aloudah
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Zahraa Jalal
- School of Pharmacy, Institute of Clinical Sciences, College of Medical and Dental Sciences, Sir Robert Aitken Institute for Medical Research, University of Birmingham, Birmingham, B15 2TT UK
| | - Mohammed H. Abutaleb
- Pharmaceutical Care Department, King Fahad Central Hospital, Jazan Health Affairs, Ministry of Health, Jazan, Saudi Arabia
| | - Vibhu Paudyal
- School of Pharmacy, Institute of Clinical Sciences, College of Medical and Dental Sciences, Sir Robert Aitken Institute for Medical Research, University of Birmingham, Birmingham, B15 2TT UK
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