Background: Although it is widely known that evidence-based practice (EBP) improves healthcare quality, reliability, and patient outcomes as well as reduces variations in care and costs, it is still not the standard of care delivered by practicing clinicians across the globe. Adoption of specific EBP competencies for nurses and advanced practice nurses (APNs) who practice in real-world healthcare settings can assist institutions in achieving high-value, low-cost evidence-based health care.
Pregnancy after liver transplantation (LT) is increasingly common and is a frequent scenario that transplant physicians, obstetricians, and midwives encounter. This review summarizes the key issues surrounding preconception, pregnancy‐related outcomes, immunosuppression, and breastfeeding in female LT recipients. Prepregnancy counseling in these patients should include recommendations to delay conception for at least 1‐2 years after LT and discussions about effective methods of contraception. Female LT recipients are generally recommended to continue immunosuppression during pregnancy to prevent allograft rejection; however, individual regimens may need to be altered. Although pregnancy outcomes are overall favorable, there is an increased risk of maternal and fetal complications. Pregnancy in this cohort remains high risk and should be managed vigilantly in a multidisciplinary setting. We aim to review the available evidence from national registries, population‐based studies, and case series and to provide recommendations for attending clinicians.
Objective. To provide interdisciplinary structured activities in academic and clinical settings for introducing the concept of professionalism to health professions students. Design. Undergraduate and graduate students from 8 health care disciplines including pharmacy, nursing, communication sciences and disorders, dietetics and nutrition science, genetic counseling, advanced medical imaging, medical technology, and physical therapy participated in an orientation program focusing on interdisciplinary health care and professionalism, as well as a field experience. Assessment. Survey results from both components (orientation, n 5 284; field experience, n 5 123) indicated that the project was valuable in increasing students' awareness of (1) the importance of professionalism in the clinical setting and (2) the potential contributions of their profession to the health care team. Conclusion. Health professions curricula should include interdisciplinary learning opportunities that enhance collaboration, collegiality, and professionalism among future members of the health care team.
Airway management is germane to safe patient care. Keys to management of difficult airways (DAs) are the "Right People, Right Parts, and Right Place" (R3P3). Successful management of DA requires clinicians who have adequate training, experience, and equipment. Policies were implemented to optimize the management of DAs. One identified inpatients with potential DAs, whereas the other addressed creation and deployment of "Alpha Teams" (ATs). In the event of impending respiratory compromise, an AT was called in the same manner as a code blue. Health care providers were educated about these process changes, and ATs were tested using computerized patient simulators and self-paced observations. Testing assessed performance before, immediately after, and 30 days after the seminar. Changes in, and retention of, knowledge about DAs was analyzed. The goal of the R3P3 was to identify DAs and then to bring a well-trained hospital-wide AT to the bedside to decrease response time, rapidly establish a definitive airway, and improve survivability in an airway emergency.
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