Background Post-resuscitation debriefing (PRD) is the process of facilitated, reflective discussion, enabling team-based interpersonal feedback and identification of systems-level barriers to patient care. The importance and benefits of PRD are well recognized; however, numerous barriers exist, preventing its practical implementation. Use of a debriefing tool can aid with facilitating debriefing, creating realistic objectives, and providing feedback. Objectives To assess utility of two PRD tools, Debriefing In Situ Conversation after Emergent Resuscitation Now (DISCERN) and Post-Code Pause (PCP), through user preference. Secondary aims included evaluating differences in quality, subject matter, and types of feedback between tools and implications on quality improvement and patient safety. Methods Prospective, crossover study over a 12-month period from February 2019 to January 2020. Two PDR tools were implemented in 8 week-long blocks in acute care settings at a tertiary care children’s hospital. Debriefings were triggered for any intubation, resuscitation, serious/unanticipated patient outcome, or by request for distressing situations. Post-debriefing, team members completed survey evaluations of the PDR tool used. Descriptive statistics were used to analyze survey responses. A thematic analysis was conducted to identify themes that emerged from qualitative responses. Results A total of 114 debriefings took place, representing 655 total survey responses, 327 (49.9%) using PCP and 328 (50.1%) using DISCERN. 65.2% of participants found that PCP provided emotional support while only 50% of respondents reported emotional support from DISCERN. PCP was found to more strongly support clinical education (61.2% vs 56.7%). There were no significant differences in ease of use, support of the debrief process, number of newly identified improvement opportunities, or comfort in making comments or raising questions during debriefs between tools. Thematic analysis revealed six key themes: communication, quality of care, team function & dynamics, resource allocation, preparation and response, and support. Conclusion Both tools provide teams with an opportunity to reflect on critical events. PCP provided a more organized approach to debriefing, guided the conversation to key areas, and discussed team member wellbeing. When implementing a PRD tool, environmental constraints, desired level of emotional support, and the extent to which open ended data is deemed valuable should be considered.
18 Background: Cancer self-management involves active partnership between patients and their informal caregivers (ICs). There is a dearth of literature on ICs to lung cancer patients. Multi-modality treatment and profound challenges in symptom management and lifestyle adjustment are hallmarks of this population. This study aimed to describe the characteristics of, and resources utilized by ICs to lung cancer patients and examine the association between symptom severity and a) caregiver burden and b) perceived support. Methods: This study was conducted at a cancer centre north of Toronto, Canada. Dyads of lung cancer patients receiving outpatient treatment and their self-identified ICs (N = 39) were recruited. Upon consent, participants completed a one-time survey which assessed study variables employing previously validated instruments, including: patient’s functional status, caregiver burden, caregiver’s perceived social support and utilization of resources to enhance self-management. Descriptive analysis was used to describe our sample and frequency of resource utilization. Pearson’s correlation was used to examine the association between symptom severity and a) caregiver burden and b) perceived support. Results: The study sample consisted of middle-aged patients and caregivers (median 55-64 years). A majority of caregivers were female (76.2%), received education above college level (56.1%) and were immediate family members (80.9%). The most frequently utilized resources were the lung cancer patient handbook (48.8%), followed by personal support worker (29.3%). Caregiver support group was the least utilized (10%) resource. Patient’s symptom severity was negatively correlated with one aspect of caregiver burden, caregiver’s self-esteem (r = -0.36, p < 0.05). Conclusions: Findings indicated similarities in caregiver demographics to carers of other patient populations. Informational support and material aid appeared to be the most important resources. Patients’ well-being had the greatest impact on caregivers’ self-esteem, indicating implications on person-centred care and collaborative patient-provider relationships to support patient self-management.
Objective The objective of this study was to determine whether suturing or conservative management of tongue lacerations results in differences in wound healing and functional outcome. The secondary aim was to identify whether antibiotics are required in the treatment of tongue lacerations. Methods Studies published between December 1954 and August 2020 were extracted from MEDLINE via PubMed, Embase via OVID, CINAHL via EBSCO, Web of Science, and the Cochrane Library and evaluated for inclusion based on predetermined inclusion and exclusion criteria by two independent reviewers in accordance with PRISMA guidelines. Results The search yielded a total of 16,111 articles, 124 of which were evaluated by full-text review, resulting in 11 articles included in this systematic review representing 142 unique cases of tongue lacerations. At least 26 lacerations (18.3%) included penetration of the muscle layer of the tongue, and 24 (16.9%) were classified as full-thickness lacerations. Thirty-five of the 142 tongue lacerations (24.6%) were sutured. The remaining lacerations underwent some form of conservative management. The majority of studies reported excellent healing of tongue lacerations regardless of the management method, with minimal scarring and excellent return to normal functional status. No cases of infection were reported. Conclusions Current literature is inconsistent with regards to indications and guidelines for primary repair of tongue lacerations. The majority of tongue lacerations reported in the literature heal with excellent outcomes regardless of management method. Physician judgement along with patient and parental preference based on potential risks of the procedure should be used when deciding whether a tongue laceration requires primary repair. Tongue lacerations in otherwise healthy individuals are at very low risk of infection.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.