Implementation and evaluation of a quality improvement process to improve pain management in a hospice setting
Program Development; Program Evaluation; Non-U.S. Gov't; Administration; retrospective studies; Human; Support; Nursing Audit; Hospice Care/standards; Outcome and Process Assessment (Health Care)/organization &; Pain/nursing; Total Quality Management/organization & administration
The purpose of this article is to describe the implementation and evaluation of a quality improvement process to improve pain management in a hospice setting. A retrospective chart audit of 702 patient visits pre- and 536 patient visits post-implementation of quality improvement strategies measured five aspects of pain management: complaints of pain, severity of pain, changes in patient's pain medication regime required, patient and family teaching, and use of complementary therapies. Of these measures a significant change was found in the documentation of pain assessment, recognition of changes required in the medication regime, and patient and family teaching.
1998
Duggleby W; Alden C
American Journal Of Hospice & Palliative Medicine
1998
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
Reviewing audit: barriers and facilitating factors for effective clinical audit
Physician-Patient Relations; Great Britain; Medical Staff; Leadership; Physician's Role; Interprofessional Relations; Patient Satisfaction; Quality of Health Care; Job Satisfaction; Hospitals; MEDLINE; Family Practice; Primary Health Care; Non-U.S. Gov't; Comparative Study; Evaluation Studies; retrospective studies; Databases; Hospital; Support; General; Attitude of Health Personnel; Nursing Audit; Bibliographic; Medical Audit/standards; Medical Records/standards; Partnership Practice
OBJECTIVE: To review the literature on the benefits and disadvantages of clinical and medical audit, and to assess the main facilitators and barriers to conducting the audit process. DESIGN: A comprehensive literature review was undertaken through a thorough review of Medline and CINAHL databases using the keywords of "audit", "audit of audits", and "evaluation of audits" and a handsearch of the indexes of relevant journals for key papers. RESULTS: Findings from 93 publications were reviewed. These ranged from single case studies of individual audit projects through retrospective reviews of departmental audit programmes to studies of interface projects between primary and secondary care. The studies reviewed incorporated the experiences of a wide variety of clinicians, from medical consultants to professionals allied to medicine and from those involved in unidisciplinary and multidisciplinary ventures. Perceived benefits of audit included improved communication among colleagues and other professional groups, improved patient care, increased professional satisfaction, and better administration. Some disadvantages of audit were perceived as diminished clinical ownership, fear of litigation, hierarchical and territorial suspicions, and professional isolation. The main barriers to clinical audit can be classified under five main headings. These are lack of resources, lack of expertise or advice in project design and analysis, problems between groups and group members, lack of an overall plan for audit, and organisational impediments. Key facilitating factors to audit were also identified: they included modern medical records systems, effective training, dedicated staff, protected time, structured programmes, and a shared dialogue between purchasers and providers. CONCLUSIONS: Clinical audit can be a valuable assistance to any programme which aims to improve the quality of health care and its delivery. Yet without a coherent strategy aimed at nurturing effective audits, valuable opportunities will be lost. Paying careful attention to the professional attitudes highlighted in this review may help audit to deliver on some of its promise.
2000
Johnston G; Crombie IK; Davies HT; Alder EM; Millard A
Quality In Health Care
2000
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
The development of an interdisciplinary outpatient clinic in specialist palliative care
Humans; England; Questionnaires; Program Evaluation; Patient Satisfaction; Nursing Assessment; Nursing Evaluation Research; Outpatient Clinics; Palliative Care/organization & administration; Models; Nursing; Needs Assessment/organization & administration; Patient Care Team/organization & administration; Hospital/organization & administration; Nursing Audit; Practice Guidelines as Topic/standards; Program Development/methods
The interdisciplinary team approach is essential in the assessment and management of the palliative care of patients and their families. An innovative approach has been developed to allow the interdisciplinary team to see patients and their families in an outpatient clinic setting. This has allowed an improved assessment and has demonstrated to patients that a wider approach is undertaken. These interdisciplinary outpatient clinics have been audited and appear to be effective, and acceptable to patients and families.
2004
Oliver D
International Journal Of Palliative Nursing
2004
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.12968/ijpn.2004.10.9.16050" target="_blank" rel="noreferrer">10.12968/ijpn.2004.10.9.16050</a>
Developing the Liverpool Care Pathway for the dying child
Child; Humans; England; Health Services Needs and Demand; Pilot Projects; Nurse's Role; Evidence-Based Medicine; Nursing Assessment; Nursing Evaluation Research; Benchmarking; adolescent; Preschool; PedPal Lit; infant; Practice Guidelines; retrospective studies; Documentation/standards; Patient Care Team/organization & administration; Outcome and Process Assessment (Health Care)/organization & administration; Nursing Audit; Palliative Care/organization & administration; Pediatric Nursing/organization & administration; Critical Pathways/organization & administration; Nursing Records/standards; Total Quality Management/organization & administration
In most western societies the death of a child is a rare occurrence. When it does occur, it typically takes place after a period of intensive and often prolonged treatment. In light of the relative infrequency of these events in clinical practice, ensuring that all dying children and their families receive consistent and appropriate care remains a challenge. A retrospective audit of documentation of care for dying children in two paediatric units in the north-west of England illustrated that the care provided was not always documented consistently. This paper highlights work currently underway to develop an integrated care pathway for the care of the dying child based on the Liverpool Care Pathway (LCP). The aim of this work is to facilitate the delivery and recording of optimum care for all dying children and their families.
2006
Matthews K; Gambles M; Ellershaw JE; Brook L; Williams M; Hodgson A; Barber M
Paediatric Nursing
2006
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article