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Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

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At least 631 records · Page 35Linked to original sources
PubMed1993

Issues in contemporary cardiac rehabilitation: a historical perspective.

Cardiac rehabilitation consists of exercise, psychosocial support and education and is prescribed most often for patients with coronary heart disease. Its purpose is to facilitate readaptation to normal life through the achievement of maximal functional capability and to reduce heart disease risk factors. It began historically with progressive ambulation after myocardial infarction and by 1980 became a standardized inpatient therapy performed according to a stepped procedure. Predischarge exercise testing was added and has become a meaningful contribution to the concept of risk stratification after an acute coronary event. Rehabilitation has subsequently become part of the outpatient environment and is delivered by multiple models. Meta-analyses have shown that rehabilitation reduces overall and cardiovascular deaths by about 20% and sudden death by about 37% during the year after an acute myocardial infarction. The significance of this, however, must now be modulated by the dynamic role of aggressive coronary intervention. Selection for such intervention has become an important adjunctive aspect of rehabilitation. Newer findings suggest that those stratified at low risk will benefit most by the modification of coronary risk factors, and that patients previously thought to be poor candidates for rehabilitation (such as those with significant left ventricular dysfunction and low work capacity) may experience substantial relative functional benefit. Beyond risk stratification, important contemporary issues include surveillance of patients after angioplasty, the effectiveness of rehabilitation in the attenuation or reversal of both native and vein graft atherosclerosis and consideration of such currently emphasized end points as quality of life and economic evaluation.

Bed Rest↗
PubMed1990

Effective use of patient education illustrations.

Effective illustrations can greatly enhance patient education materials, yet many illustrations do not aid instruction as much as they could. By following the above recommendations, patient education materials developers and illustrators can together accomplish their objectives.

Audiovisual Aids↗
PubMed1994

The provision of patient and family education.

Health-care professionals no longer have the option on whether or not to include patient health education into patient care. The U.S. Joint Commission on Accreditation of Health Care Organizations (JCAHO) requires that patient and family education is provided in specifically identified areas. In order for health providing institutions to be approved, these standards must be met. Health-care providers, however, should realize that patient health education (PHE) can be delivered in a variety of ways and JCAHO does not set conditions as to which methods of delivery are applied. Several modes of PHE approaches are cited in this article, along with an example as to how to put them into practice.

Delivery of Health Care↗
PubMed2004

Clinical trial of an educational intervention to achieve recommended cholesterol levels in patients with coronary artery disease.

BACKGROUND: Despite national efforts to improve cholesterol management for patients with coronary artery disease, many patients are not reaching recommended cholesterol target levels. We sought to determine whether a nurse-based educational intervention, designed to educate patients with confirmed coronary artery disease about personal low-density lipoprotein (LDL) cholesterol target levels and encourage partnership with physicians, could increase adherence with National Cholesterol Education Program target levels (LDL cholesterol level < or =100 mg/dL). METHODS: Patients hospitalized with confirmed coronary artery disease were randomized to undergo a nurse-based educational intervention (375 patients) or usual care (381 patients) for a 12-month period after hospitalization. The primary outcome was the proportion of patients at the LDL cholesterol target level 1 year after hospitalization. The secondary outcome was the proportion of patients with accurate knowledge of LDL cholesterol target levels. RESULTS: The groups were similar at baseline in demographic and clinical characteristics, percent at LDL cholesterol target level (43.9% and 41.1%, respectively), and percent with knowledge of LDL cholesterol target levels (both 5%). The proportion of patients at LDL cholesterol target levels at 1 year did not differ between the intervention (70.2%) and usual care group (67.4%, P =.46). At the conclusion of the trial, patient knowledge about LDL cholesterol target level was higher for the intervention group than the usual care group (19.6% and 6.7%, respectively, P =.001), but this was not associated with improved cholesterol management. CONCLUSIONS: Our nurse-based educational intervention did not result in a significant increase in the proportion of patients who reached target LDL cholesterol levels 1 year after hospitalization. Although the intervention improved patient knowledge of LDL cholesterol target levels, overall rates of LDL cholesterol knowledge remained low, and it was not associated with improved cholesterol management.

Aged↗
PubMed2004

The association between quality improvement activities performed by managed care organizations and quality of care.

PURPOSE: Little data are available to assess the efforts of managed care organizations to improve quality of care. This analysis assessed differences in performance rates between organizations with and without quality improvement activities. METHODS: We reviewed 399 self-reported quality improvement activities submitted by organizations seeking accreditation by the National Committee for Quality Assurance. Processes or outcomes assessed in quality improvement activities were linked to corresponding measures in the effectiveness-of-care database of the Health Plan Employer Data and Information Set (HEDIS). Performance rates for managed care organizations with and without quality improvement activities were then compared. RESULTS: The cross-sectional analysis included 79 quality improvement activities from 50 organizations, covering 12 effectiveness-of-care categories. Each activity had a matching performance score in the database. Financial incentives for providers were associated with substantially higher performance rates in organizations employing this type of intervention. Eight effectiveness-of-care categories had at least four organizations reporting specific quality improvement activities for the care category of interest; statistically significant improvements were observed for follow-up visits for patients after hospitalization for mental illness, checkups after delivery, and screening for cervical cancer. CONCLUSION: Based on objective and audited information, the estimated effects of self-reported quality improvement activities were often small and inconsistent. In some instances, the observed effect was contrary to the expected direction. Limitations of the available dataset and the caveats of a cross-sectional study design precluded a number of analytical options. Longer-term, prospective studies are needed to explore further the relation between quality improvement activities and objective measures of clinical performance.

Accreditation↗
PubMed2004

Health care providers' attitudes toward current food safety recommendations for pregnant women.

Semistructured interviews were conducted with 23 health care professionals who work with pregnant women in a preliminary study to understand health care providers' attitudes regarding current food safety recommendations for pregnant women and interest in education and patient materials on food safety during pregnancy. Only 8 of 23 interviewed currently provided food safety information to their pregnant clients. Limited understanding of food safety issues and limited time with patients were barriers to providing such information. Based on their contact time with patients, background, and interest in food safety issues, nurses, visiting nurses, and Special Supplemental Nutrition Program for Women, Infants and Children professionals should be targeted as conveyers of food safety information to pregnant women.

Attitude of Health Personnel↗
PubMed2004

EBA in evidence.

Explore the source record for details and available documents.

Burns↗
PubMed2006

Tobacco cessation in acute and critical care nursing practice: challenges and approaches.

Recently, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) implemented new national core measures, including tobacco-cessation interventions for patients hospitalized because of pneumonia or other pulmonary-related illnesses, acute myocardial infarction, or heart failure. All interventions performed for such patients must be documented in the patient's chart. Because the JCAHO standards for tobacco cessation are implemented hospital-wide, acute and critical care nurses must take an active role in their execution. This article discusses the challenges to integrating tobacco cessation in daily acute and critical care nursing practice and makes recommendations regarding cessation approaches designed to improve health outcomes for tobacco-dependent patients.

Acute Disease↗
PubMed2005

Applying a quality use of medicines framework to using essential oils in nursing practice.

Nurses are increasingly incorporating complementary therapies into their practices. Aromatherapy is one of the most popular therapies. The basis of aromatherapy is essential oils, which are chemically active substances with a long history of safe traditional use and a growing evidence base to support their use in nursing care. In Australia, essential oils are classified and regulated under the same policies as conventional medicines such as the National Medicines Policy and the Quality Use of Medicines (QUM) framework applies. QUM is a framework for selecting and using medicines safely and effectively if medicines are indicated. The key elements of QUM are a systems-based approach to using medicines based on relevant evidence, partnerships, and informed client consent. Clients are placed at the centre of a QUM medication management process, which is consistent with holistic care. Applying a QUM approach to essential oil use, Quality Use of Essential Oils (QUEO), involves developing effective systems for managing essential oils from an holistic perspective that includes structured assessment and diagnostic processes to enable effective essential oil prescribing and outcome monitoring. In a QUEO approach, essential oils are integrated into the client's overall medication regimen and care plan rather than being used as 'add-ons'. Adopting QUEO is consistent with the current national focus on the quality use of therapeutic substances, increases the profile of aromatherapy in nursing care and provides important information to guide future aromatherapy practices.

Aromatherapy↗
PubMed2004

Evidence-based medicine concepts.

Today, the busy clinician benefits from a philosophy of practice that brings together the best applicable evidence and the experiences of clinical work in an effort to provide the best care for individual patients. EBM provides a structured approach that recognizes the contributions of evidence and clinical experience. An EBM practice is efficient and effective in meeting the goal of assuring optimum care. The concepts of EBM make sense for veterinary medicine (even if there are limited numbers of randomized, blinded studies), and clinicians in all types of practice can apply them.

Animals↗