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Botsch A, Acierno A, Ballas D. Clinical Simulation Augments Traditional Interviewing of Advanced Practice Provider Candidates. J Nurse Pract 2022. [DOI: 10.1016/j.nurpra.2021.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
The management of patients after cardiothoracic surgery can be very complex. Variabilities exist in hemodynamic status after cardiac surgery and the use of cardiopulmonary bypass – all of which can have a significant impact on myocardial Frank–Starling curves. Typically, invasive monitoring with pulmonary artery catheters is used to assess the complex physiology that these patients experience in the perioperative setting. However, the use of invasive monitoring is not without risk, and the broader benefits are poorly defined. Furthermore, there is growing evidence to support the use of hemodynamic early goal-directed therapy to optimize outcomes in critically ill patients. The purpose of this editorial statement is the review of some of the current literature with regards to the utility of goal-directed therapy as applied to the postoperative cardiac surgical patient.
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Affiliation(s)
- Zoe Goldthwaite
- Department of Cardiothoracic and Vascular Surgery, The Medical Center of Aurora, Aurora, CO, USA
| | - Michael S Firstenberg
- Department of Cardiothoracic and Vascular Surgery, The Medical Center of Aurora, Aurora, CO, USA
| | - Alex Botsch
- Department of Critical Care Medicine, Summa Akron City Hospital, Akron, OH, USA
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Ahmed RA, Botsch A, Ballas D, Benner A, Hammond J, Schnick T, Khobrani A, George R, Polansky M. Advanced Practice Provider Critical Care Boot Camp: A Simulation-Based Curriculum. J Med Educ Curric Dev 2019; 6:2382120519840350. [PMID: 31001592 PMCID: PMC6454646 DOI: 10.1177/2382120519840350] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 02/28/2019] [Indexed: 06/09/2023]
Abstract
The demand for advanced practice providers (APPs) is increasing across the United States to meet necessary provider staffing requirements including in intensive care settings. Currently, participation in formal postgraduate training programs, or residencies, for APPs is not required for clinical practice, such that most of the APPs immediately enter into the workforce following completion of their initial graduate-level training. Consequently, this results in a supervised training period until APPs develop the necessary competencies to practice more autonomously. Educational programs that support specialty competency development may facilitate the transition of APPs into clinical practice, allowing them to be credentialed to perform essential procedures as quickly as possible. The goal of this boot camp was to provide training for APPs in common critical care, high-risk procedures, and to provide leadership development for high-risk cases to expedite their orientation process. The following manuscript describes our experience with the development, implementation, and short-term evaluation of this training program.
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Affiliation(s)
- Rami A Ahmed
- Department of Medical Education, School
of Medicine, Indiana University, Indianapolis, IN, USA
| | - Alex Botsch
- Summa Health System, Division of Trauma,
Department of Surgery, Akron, OH, USA
| | - Derek Ballas
- Summa Health System, Division of Trauma,
Department of Surgery, Akron, OH, USA
| | - Alma Benner
- Summa Health System, Division of Trauma,
Department of Surgery, Akron, OH, USA
| | - Jared Hammond
- Summa Health System, Division of Trauma,
Department of Surgery, Akron, OH, USA
| | - Tim Schnick
- Summa Health System, Division of Trauma,
Department of Surgery, Akron, OH, USA
| | - Ahmad Khobrani
- Summa Health System, Division of Trauma,
Department of Surgery, Akron, OH, USA
| | - Richard George
- Summa Health System, Division of Trauma,
Department of Surgery, Akron, OH, USA
| | - Maura Polansky
- Department of Medical Education, School
of Medicine and Health Sciences, The George Washington University, Washington, DC,
USA
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Botsch A, Firstenberg MS. Comment on the Edwards FloTrac ™/Vigileo versus pulmonary artery catheter study: What is really going on with this patient? Int J Crit Illn Inj Sci 2017; 7:183-184. [PMID: 28971035 PMCID: PMC5613413 DOI: 10.4103/ijciis.ijciis_44_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Alex Botsch
- Department of Critical Care Medicine, Summa Akron City Hospital, Akron, Ohio 44304, USA
| | - Michael S Firstenberg
- Department of Surgery (Cardiothoracic), Summa Akron City Hospital, Akron, Ohio 44304, USA
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