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Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

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Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
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During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
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Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
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Nurses bear specific legal responsibilities under several federal statutes, including:
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Interdisciplinary Protocol for Surgery in Older Persons: Development and Implementation.

Paula E Lester1, Deanna Ripley2, Roseann Grandelli2

  • 1NYU Long Island School of Medicine, Mineola, NY, USA.

Journal of the American Medical Directors Association
|March 1, 2022
PubMed
Summary
This summary is machine-generated.

A new protocol for older surgical patients improved advance care plan documentation. Further research is needed to confirm its impact on other outcomes like delirium and length of stay.

Keywords:
Perioperative assessmentcomprehensive geriatric assessmentgeriatric protocols

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Area of Science:

  • Geriatric Medicine
  • Surgical Quality Improvement
  • Perioperative Care

Background:

  • Aging populations necessitate improved surgical care for older adults (≥75 years).
  • Physiologic changes in older adults increase surgical complication, morbidity, and mortality risks.

Purpose of the Study:

  • To pilot a comprehensive, interdisciplinary perioperative protocol for older surgical patients.
  • To assess the protocol's impact on advance care planning, postoperative delirium, and length of stay.

Main Methods:

  • Implementation of screening tools for cognitive, functional, and nutritional deficits.
  • Inclusion of Geriatric Nurse Champions and a Geriatric Surgery Quality Committee.
  • Comparison of intervention group with a pre-intervention cohort matched for demographics and comorbidities.

Main Results:

  • Significantly higher rates of advance care plan documentation in the intervention group (P < .001).
  • No significant difference in postoperative delirium or length of stay between groups.
  • Potential explanations for minimal impact include small sample size and concurrent hospital initiatives.

Conclusions:

  • The protocol shows promise in improving advance care plan documentation for older surgical patients.
  • Further research with larger sample sizes and in different settings is warranted to validate broader impacts.
  • Unrecognized factors or intrinsic higher risk in older adults may limit the protocol's overall effectiveness.