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Using Multivariate Statistics

https://caltcm.memberclicks.net/assets/documents/acc_aha_chf_2013_guidelines.pdf

2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines

According to W. Edwards Deming, American companies require nothing less than a transformation of management style and of governmental relations with industry. In Out of the Crisis, originally published in 1982, Deming offers a theory of management based on his famous 14 Points for Management. Management's failure to plan for the future, he claims, brings about loss of market, which brings about loss of jobs. Management must be judged not only by the quarterly dividend, but by innovative plans to stay in business, protect investment, ensure future dividends, and provide more jobs through improved product and service. In simple, direct language, he explains the principles of management transformation and how to apply them.

Out of the Crisis

http://science.sciencemag.org/content/sci/201/4359/899.2.full.pdf

Phenomenology of perception.

Mariell Jessup, MD, FACC, FAHA, Chair [*][1]

William T. Abraham, MD, FACC, FAHA[†][2]

Donald E. Casey, MD, MPH, MBA[‡][3]

Arthur M. Feldman, MD, PhD, FACC, FAHA[§][4]

Gary S. Francis, MD, FACC, FAHA[§][4]

Theodore G. Ganiats, MD[∥][5]

Marvin A. Konstam, MD, FACC[¶][6]

Donna M.

/pdf/2009-focused-update-incorporated-into-the-acc-aha-2005-3z9lhvyqwq.pdf

2009 Focused Update Incorporated Into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: Developed in Collaboration With the International Society for Heart and Lung Transplantation

The purpose of this book is to provide nurses with the best available research, thereby enabling better decisions that result in improved health care and safety practices and lead to better outcomes. Nurses often are the ones who find errors and prevent pa tient harm. In their focus on patient safety, nurses identify critical issues and research for evidence-based practice. This book is a great resource for practicing nurses, nurse educators, re searchers, leaders, and students. The Agency for Healthcare Research and Quality strongly promotes that safety and quality of health care is dependent on the availability of the best research possible and the ability to deliver results of research into the hands of practitioners, policy makers, and consumers. This text is a culmination of subject expert knowledge, practice, and research from 89 contributors who represent a broad range of nurses and senior researchers across the nation. The topics covered in this text provide excellent background for any clinician, nurse educator, or nurse leader. The topics include • evidence-based practice, • patient-centered care, • working environment for nurses, • care models, and • patient acuity. The chapters provide an easy-tounderstand guide and include a background section and analysis of the literature based on the topic presented. Practice implications are identified at the end of each chapter and guide efforts for improving quality and patient care. Research implications for each topic outline target areas for improvement and can be used by clinicians to inform and guide practice. There are also questions and issues to develop or expand thesis topics and research papers, which faculty members may find useful. A section on critical opportunities contains current topics, including wrong site surgery, communication hand offs by nurses, medication administration safety, medication reconciliation, and personal safety for nurses. These topics are very well presented with numerous research citations and examples from all areas of nursing— from patient entry to the facility to discharge and home care. The authors use exhibits, tables, guides, templates, models, and representations within each chapter and conclude with a list of references including web sites for further independent review and citation. The volumes are written in a manner that allows for quick access, and they are

Patient Safety and Quality: An Evidence-Based Handbook for Nurses

This systematic evidence review supports the American College of Physicians guideline on palliative care at the end of life. Strong to moderate evidence supports use of various treatments for cance...

Evidence for Improving Palliative Care at the End of Life: A Systematic Review

For the vast majority of Americans, the end of life includes a prolonged experience of chronic progressive disease, often associated with uncertainty, pain, suffering, and cost (Hogan et al. 2000; Lunney et al. 2003; National Consensus Project 2004; Teno 2005). For these reasons, coupled with an expansion of knowledge and research in managing and improving the dying experience, end-of-life care has been designated as a priority area for quality improvement, policy change and implementation, and cost effectiveness of work (Institute of Medicine 1997; Institute for the Future 2003; National Consensus Project 2004). In order to address end-of-life care, clinicians, administrators, researchers, and policy makers need to be able to evaluate the patient and caregiver experience.

However, end-of-life care is not a singular entity with a universal experience and well agreed upon course of care. Prognostication is poor and imprecise for most conditions, and patients and caregivers cope with illness for years, often with different trajectories of functional decline and needs (Lynn et al. 1997; Steinhauser et al. 2000, 2001; Patrick, Engelberg, and Curtis 2001; Lunney et al. 2003; Patrick et al. 2003; National Consensus Project 2004). The differing patterns of decline, as well as variable factors such as age, race, gender, culture, and preferences, suggest the need for diverse measures to assess the full spectrum of patients' and caregivers' end-of-life experience. From the health care system and policy perspective, it is also useful to consider the role of settings of care such as nursing homes, hospitals, home care, or hospice all play important roles and face different challenges in delivering care.

Substantial consensus derived from expert opinion and confirmed through nationally representative surveys of patients, families, and providers has established the principle domains to guide evaluation of the end-of-life experience (Hanson, Danis, and Garrett 1997; Lynn et al. 1997; Singer, Martin, and Kelner 1999; Steinhauser et al. 2000, 2001; Patrick, Engelberg, and Curtis 2001; Patrick et al. 2003; Wenrich et al. 2003; National Consensus Project 2004; Teno et al. 2004). Patients and families endorse important concerns including the extent to which care addresses pain and other physical and emotional symptoms, advance care planning, continuity of care, spiritual well-being, practical support for caregiving, and overall satisfaction. End-of-life care and palliative care have evolved over the last two decades to apply increasingly rigorous scientific methods to assess outcomes in these domains (National Consensus Project 2004; Teno 2005). Developing an adequate evidence base for improving end-of-life care requires reliable and valid measures of the patient and caregiver experience that also allow for comparability across the important care settings, populations, and clinical conditions.

As a part of systematic review of end-of-life care and outcomes, we identified measures that evaluate domains of the patient and caregiver experience and described their psychometric properties. Our objectives were to characterize measures that are available for evaluating end-of-life care and to characterize their use in the highest quality intervention studies that have been conducted in the field.

/pdf/a-systematic-review-of-measures-of-end-of-life-care-and-its-4093i935vz.pdf

A systematic review of measures of end-of-life care and its outcomes.

Learning to provide safe and quality health care requires technical expertise, the ability to think critically, experience, and clinical judgment. The high-performance expectation of nurses is dependent upon the nurses’ continual learning, professional accountability, independent and interdependent decisionmaking, and creative problem-solving abilities.

Clinical Reasoning, Decisionmaking, and Action: Thinking Critically and Clinically

Whatever the acronym of the method (e.g., TQM, CQI) or tool used (e.g., FMEA or Six Sigma), the important component of quality improvement is a dynamic process that often employs more than one quality improvement tool. Quality improvement requires five essential elements for success: fostering and sustaining a culture of change and safety, developing and clarifying an understanding of the problem, involving key stakeholders, testing change strategies, and continuous monitoring of performance and reporting of findings to sustain the change.

Ronda G. Hughes

Papers

Patient Safety and Quality: An Evidence-Based Handbook for Nurses

Evidence for Improving Palliative Care at the End of Life: A Systematic Review

A systematic review of measures of end-of-life care and its outcomes.

Clinical Reasoning, Decisionmaking, and Action: Thinking Critically and Clinically

Tools and Strategies for Quality Improvement and Patient Safety