1,721,036 research outputs found
Preoperative education: making every contact count
No full textPatient education is an important part of obtaining informed consent, but can also be used to educate patients about how to prepare for surgery and help them take responsibility for improving their own health to reduce their risk of perioperative complications
Lived experience, enhanced recovery and laparoscopic colonic resection
No full textAim: to explore patients' lived experience of undergoing laparoscopic colonic resection on an enhanced recovery programme.Method: eleven patients were interviewed at home, between 14 and 16 days following discharge. The transcribed interview texts were interpreted with a hermeneutical-phenomenological method.Findings: participants were keen to achieve their goals and participate actively in the enhanced recovery programme. They strived to return to full health as soon as possible after surgery, but all participants indicated that it was taking longer than they had expected. As they became more independent regarding their self-care needs during their hospital stay, participants noticed that the nursing presence became more distant, which could result in unmet psychological needs. Their recovery at home was perceived to be taking longer than it should and was often prolonged by symptoms. The minimally invasive approach associated with laparoscopic surgery led the participants to expect a lesser physical and psychological effect from this major surgery.Conclusion: nurses need to acknowledge and attend not only to the physical but also to the emotional needs of patients on an enhanced recovery programme, right up until the point of discharge. Nurses also need to prepare patients more fully for what to expect after discharge
[Development of an Integrated Perioperative Medicine Pathway] Proceedings of the American Society for Enhanced Recovery/Evidence Based Peri-Operative Medicine 2016 Annual Congress of Enhanced Recovery and Perioperative Medicine:
No full textBackground/Introduction: Perioperative medicine is the patient-centered, multidisciplinary and integrated medical care of patients from the moment of contemplation of surgery until full recovery. It builds on the Enhanced Recovery approach to capitalize on five key opportunities: collaborative decision-making, preoperative lifestyle modification, standardization of perioperative care, achieving full postoperative recovery and using data to drive quality improvement (1). We hypothesize that redesigning the perioperative pathway will add value through improved quality and reduced resource utilization. Methods: Our multidisciplinary team is developing an integrated Perioperative Medicine care pathway at a large tertiary referral University hospital. Current pathways were mapped, analyzed and redesigned with particular focus on specific factors including defining the pathway boundaries, engaging patients and time constraints. Results: Current preoperative pathways were mapped and analyzed (see: Fig 1A). Pathway redesign addressed a number of specific aims (see: Fig1B): identification of the “moment of contemplation of surgery”, early targeted preoperative information gathering through a patient-driven online system; routine physiological assessment to stratify risk early in the preoperative pathway (“patient staging”) by cardiopulmonary exercise testing; a dedicated clinic for patients at high perioperative morbidity/mortality risk, collaborative decision-making and early medical optimization; Fit4Surgery School for all patients undergoing major surgery, targeting patient education, expectation management and lifestyle optimization; standardized perioperative management based on risk strata (see: Fig 2); postoperative care team clinical ward reviews for “at-risk” patients; postoperative electronic data capture to monitor Enhanced Recovery targets, morbidity, and patient-reported outcomes. Conclusion: Perioperative medicine offers a unique opportunity to add value through improved outcomes and reduced resource utilization in patients undergoing major surgery. Extensive pathway redesign may be needed to ensure an integrated approach, maximizing the opportunities for improvements in preoperative optimization and postoperative care. Moving the evaluation of risk to a position earlier in the pre-operative pathway offers opportunities for risk mitigation, collaborative decision-making and optimization of patient health before surgery
What is an enhanced recovery nurse: a literature review and audit.
No full textBackground:the enhanced recovery after surgery (ERAS) programme is an evidence-based pathway used to improve recovery after surgery. Despite consensus in the ERAS community that an ERAS nurse is necessary to the success of the programme, there is no definitive role profile.Objectives:this study aimed to define the role of the ERAS nurse and establish the main responsibilities.Methods:a literature review was undertaken, and a purpose-designed online survey was sent to all nurse members of ERAS UK.Data analysis:data are displayed as percentages with tables and charts.Results:33/89 ERAS nurses responded, describing their main roles as pathway development and implementation, data collection/audit, staff education and project management, as well as patient support and education throughout the pathway.Conclusions:roles vary considerably between ERAS nurses, their impact on the ERAS pathway is unclear, and more research is needed
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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