Canadian Journal of Respiratory Therapy最新文献

{"title":"Re: Late diagnosis of COVID-19 and hypercoagulable state.","authors":"Rujittika Mungmunpuntipantip, Viroj Wiwanitkit","doi":"10.29390/cjrt-2022-026","DOIUrl":"https://doi.org/10.29390/cjrt-2022-026","url":null,"abstract":"We would like to share ideas on the publication “Late diagnosis of COVID-19 in a 34-year-old man in a hypercoagulable state: A case report [1].” According to Desdiani, the increased mortality rate of COVID-19 patients is mostly due to a hypercoagulable state, and early recognition and therapy of the hypercoagulable state, including the use of LMWH, can lessen the severity of COVID-19 symptoms [1]. The patient was first diagnosed with dengue hemorrhagic fever and had thrombocytopenia and increased liver transaminase tests. The delayed diagnosis of COVID-19 because of misclassification as another infec- tion is a serious issue. An early study during the COVID-19 outbreak suggested that misdiagnosis as dengue fever could be a factor in COVID-19 diagnosis delays [2]. In the present study, the hypercoagula-bility might be due to the disease progression. This finding shows the difficulty in differential diagnosis between the COVID-19 and dengue since dengue can be the cause of thrombotic thrombocytopenic purpura and multiple inflammatory syndrome [3]. Finally, the chance of concurrent medical problems between COVID-19","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":" ","pages":"84"},"PeriodicalIF":0.0,"publicationDate":"2022-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9f/ed/cjrt-2022-026.PMC9212079.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40481053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Designing behavioral interventions using the capability-opportunity-motivation-behavior model and the theoretical domains framework to optimize oxygen saturation maintenance by NICU providers.","authors":"Kevin Middleton,&nbsp;Connie Williams,&nbsp;Deborah Bernard,&nbsp;Kanekal Suresh Gautham,&nbsp;Sandesh Shivananda","doi":"10.29390/cjrt-2021-075","DOIUrl":"https://doi.org/10.29390/cjrt-2021-075","url":null,"abstract":"<p><strong>Objective: </strong>Despite evidence-based guidelines, SpO₂ maintenance-related practices of care providers remain inconsistent. Our aim was to evaluate the impact of interprofessional learning workshops, bedside coaching, and neonatal intensive care unit (NICU) level enablers on targeted behavioral change of NICU staff, focusing on SpO₂ maintenance.</p><p><strong>Methods: </strong>NICU is a specialized area of the hospital with sophisticated monitors where multidisciplinary staff provide round-the-clock care for sick and preterm infants. As a subset of a quality improvement project to improve SpO₂ maintenance and reduce desaturation events, three targeted evidence-based staff behaviors were deemed as important based on established capability-opportunity-motivation-behavior and theoretical domains framework models: setting SpO₂ alarm limits, using SpO₂ alarm management algorithms, and reporting daily summaries of SpO₂ during rounds. We conducted interprofessional workshops, provided bedside coaching, and altered unit NICU processes (guidelines, automated SpO₂ histogram printouts, defined staff standard work) and measured demonstrable changes in staff reaction, learning, and behaviors by direct observation of behaviors and survey questionnaires.</p><p><strong>Results: </strong>Two hundred and seventy-five (87%) and 210 (80%) of NICU staff attended workshops and received bedside coaching, respectively. The proportion of staff expressing satisfaction with workshop and bedside coaching was 85% and 82%, respectively. The proportion of staff reporting improvement in their knowledge and confidence related to SpO₂ maintenance increased significantly following the workshop. Targeted behaviors related to SpO₂ maintenance like setting appropriate alarm limits, adhering to SpO₂ management algorithm, and reporting daily SpO₂ summaries during rounds increased from 80% to 96%, 0% to 64%, and 20% to 70%, respectively.</p><p><strong>Conclusion: </strong>Focused behavioral change interventions aimed at improving staff capability, opportunity, and motivation resulted in a demonstrable change in targeted staff behaviors related to SpO₂ maintenance. Further research is needed to establish ways of optimizing intended staff behaviors while implementing care bundles in a given setting.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":" ","pages":"77-83"},"PeriodicalIF":0.0,"publicationDate":"2022-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/95/17/cjrt-2021-075.PMC9212080.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40480657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes and follow-up for children intubated in an adult-based community hospital system: A retrospective chart review.","authors":"Mika L Nonoyama,&nbsp;Vinay Kukreti,&nbsp;Efrosini Papaconstantinou,&nbsp;Natascha Kozlowski,&nbsp;Sarah Tsimelkas","doi":"10.29390/cjrt-2022-015","DOIUrl":"https://doi.org/10.29390/cjrt-2022-015","url":null,"abstract":"<p><strong>Objectives: </strong>Emergency intubation is a high-risk procedure in children. Studies describing intubation practices in locations other than pediatric centres are scarce and varied. This study described pediatric intubations in adult-based community emergency departments (EDs) and determined what factors were associated with intubated-related adverse events (AEs) and described outcomes of children transferred to a quaternary care pediatric institution.</p><p><strong>Methods: </strong>This is a retrospective review of data collected between January 2006 and March 2017 at Lakeridge Health and Hospital for Sick Children (SickKids). Patients were <18 years and intubated in Lakeridge Health EDs; those intubated prior to ED arrival were excluded. Primary outcomes were intubation first-pass success (FPS) and AEs secondary to intubation.</p><p><strong>Results: </strong>Patients (<i>n</i> = 121) were analyzed, and median (interquartile range (IQR)) age was 3.7 (0.4-14.3) years. There were 76 (62.8%) FPS, with no difference between pediatricians (<i>n</i> = 25, 23%) or anaesthetists (<i>n =</i> 12, 11%), versus all other providers (paramedic <i>n =</i> 13 (12%), ED physician <i>n =</i> 37 (34%), respiratory therapist <i>n =</i> 20 (18%), transfer team <i>n =</i> 2 (2%)). The proportion of AEs was 24 (19.8%, <i>n =</i> 21 minor, <i>n =</i> 3 major), with no significant difference between pediatricians or anaesthetists versus all other providers. Data from 68 children transferred to SickKids were available, with the majority extubated within a short median (IQR) time of admission, 1.2 (0.29-3.8) days.</p><p><strong>Conclusions: </strong>Pediatric intubations were rare in a Canadian adult-based community hospital system. Most intubations demonstrated FPS with relatively few AEs and no significant differences between health provider type. Future investigations should utilize multi-centred data to inform strategies suited for organizations' unique practice cultures, including training programs.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":" ","pages":"69-76"},"PeriodicalIF":0.0,"publicationDate":"2022-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a6/a0/cjrt-2022-015.PMC9187052.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40403082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reflecting back to move forward.","authors":"Justin Sorge","doi":"10.29390/cjrt-2019-008","DOIUrl":"10.29390/cjrt-2019-008","url":null,"abstract":"","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"55 ","pages":"iii-iv"},"PeriodicalIF":0.0,"publicationDate":"2019-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/31/ae/cjrt-2019-008.PMC6690264.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41215377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proceedings from the Canadian Society of Respiratory Therapists Annual Conference May 24-26, 2018","authors":"","doi":"10.29390/001c.86147","DOIUrl":"https://doi.org/10.29390/001c.86147","url":null,"abstract":"","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73542298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards an enhanced conceptualization of fidelity for instructional design in simulation-based respiratory therapy education.","authors":"Andrew J West,&nbsp;Beaumie Kim,&nbsp;Gale Parchoma","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Despite the apparent centrality of fidelity to clinical simulation instructional design and practice in respiratory therapy education, it remains one of most contested constructs in the simulation literature. Fidelity has been described as educationally under-theorized resulting in an emphasis often being placed on technological sophistication rather than theory-informed design, particularly in respiratory therapy. This article critically examines various conceptualizations of fidelity in the field of clinical simulation in an effort to inform its instructional design practices. We adopt the perspective that a shift in the theoretic lens from individualistic to a more socio-cultural orientation may better support our understanding of learning in simulation environments. The instructional design framework (IDF) developed by the Canadian Network for Simulation in Healthcare provides a solid pedagogical foundation on which to base clinical simulations design. The IDF has also been a platform upon which designers can frame the characteristics of simulation environments. We propose an enhanced IDF informed by contemporary education theory describing the joint learning relationship that exists between learners and technology-enhanced learning environments. The enhanced IDF includes each of the interdependent design elements in the original model and incorporates a socio-culturally informed conceptualization of fidelity. The framework will be useful in fostering the relationships that support an effective clinical simulation learning environment. This will be of particular value to practitioners, researchers, and theorists in the clinical simulation-based respiratory therapy education field.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"53 4","pages":"69-74"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/87/e8/cjrt-53-004-cjrt.2017-69.PMC6422225.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41142872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The practice of simulation-based assessment in respiratory therapy education.","authors":"Andrew J West,&nbsp;Gale Parchoma","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Clinical simulation has gained prominence as an educational approach in many Canadian respiratory therapy programs and is strongly associated with improved learning, clinical and nonclinical skill, future performance, and patient outcomes. Traditionally, the primary assessment approach employed in clinical simulation has been formative debriefing for learning. Contextual factors, such as limited opportunities for learning in clinical practice and technologically oriented perspectives on learning in clinical simulation, are converging to prompt a move from using formative debriefing sessions that support learning in simulation to employing high-stakes testing intended to measure entry-to-practice competencies. We adopt the perspective that these factors are intricately linked to the profession's regulatory environment, which may strongly influence how simulation practices become embedded with respiratory therapy educational programs. Through this discussion we challenge the profession to consider how environmental factors, including externally derived requirements, may ultimately impact the effectiveness of simulation-based learning environments.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"53 1","pages":"13-16"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b4/ff/cjrt-53-001-cjrt.2017-13.PMC6422207.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41177223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulation Specialists: setting the stage for a new role for Respiratory Therapists in education?","authors":"Jessica Bernard","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"53 4","pages":"64-65"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4c/3f/cjrt-53-004-cjrt.2017-64.PMC6422221.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41118723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stewarding our community's journal.","authors":"Andrew West","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"53 3","pages":"32"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/86/3f/cjrt-53-003-cjrt.2017-32.PMC6422217.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41172271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Partnering for Patti</i>: Shaping future healthcare teams through simulation-enhanced interprofessional education.","authors":"Renée Gordon,&nbsp;Meaghan Flecknell,&nbsp;Tammie Fournier,&nbsp;Diana Dupont,&nbsp;Katelyn Gowlett,&nbsp;Karen E Furlong","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Simulation-enhanced interprofessional education (sim-IPE) is a growing component of undergraduate health curricula, preparing learners for the practice environment and, in doing so, redefining practice culture. The Canadian Interprofessional Health Collaborative (CIHC) has established a national competency framework of integrative competency domains focused on fostering core skills, attitudes, and values in an effort to evolve interprofessional collaboration (IPC). This framework serves as the foundational underpinning for IPE within all health professions. <i>Partnering for Patti</i> is a sim-IPE experience collaboratively developed by faculty from Bachelor of Nursing and Respiratory Therapy programs within two Atlantic institutions leveled for third-year nursing and respiratory therapy students. This event provides an opportunity for participants to enhance their knowledge of the six CIHC IPE domains, and improve their understanding of and appreciation for IPC. Within this context learners must work together, and rely on the expertise of both professional groups to critically think through and improve a declining client scenario. Once complete, debriefing and reflective journaling help participants solidify learning and deduce new frames of understanding. It has been hypothesized that this event enhances student knowledge of CIHC IPE domains, and creates a deeper appreciation for, and understanding of IPC. The primary objective of this research was to determine if participants' understanding of CIHC IPE domains improved, and if perceptions of their own and the other profession were reframed as a result of this innovation.</p><p><strong>Methods: </strong>This article describes the educators' approach in setting up and delivering this learning experience and the results of this event through students' perceptions. This cross-sectional study used a descriptive mixed-methods design. Two data collection tools were used to explore changes in participants' perceptions and event feedback.</p><p><strong>Results: </strong>Data analysis found that the majority of participants identified value in this IPE learning experience. Qualitative and quantitative findings suggest participants developed a deepened appreciation for IPC and an improved understanding of the CIHC IPE competency domains.</p><p><strong>Discussion: </strong>The evaluative findings of this study support the value of <i>Partnering for Patti</i> as a novel IPE learning experience. Although it is unclear to what degree objectives were met, findings strongly support continued integration of this learning experience.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"53 4","pages":"81-87"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/47/27/cjrt-53-004-cjrt.2017-81.PMC6422223.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41172955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}