Sirine Dos Santos Sousa

Patient-oriented, compassionate Nurse with a 16-year history in direct patient care, leadership and healthcare administration. Highly accomplished in precepting and educating healthcare teams to enhance patient care standards. Skilled in administering quality care to patients in long-term, home, hospice, medical-surgical, step-down and rehabilitative environments. Demonstrated leadership abilities that guide teams towards excellence in producing positive patient outcomes. Highly adaptable outpatient palliative Nurse dedicated to providing exceptional care and compassion to patients. Promoting kindness and dedication that ensures patient dignity while assisting loved ones with emotional needs. Compassionate Hospice Nurse offering top-notch skills in patient needs assessment and medication management. A pleasant individual with over 5 years caring for end-of-life patients. Ready to join a new company that appreciates exceptional care and exemplary nursing skills. Patient-driven professional promoting attention to detail and the drive to help and assist others. Calm and poised even in the most stressful environments. Seeking the opportunity to join a new organization in the role of outpatient palliative care. Energetic individual offering 16 years' experience providing exceptional palliative care to patients. A friendly Palliative Nurse knowledgeable in pain management techniques, caregiver support and consistent needs assessment. Dedicated and well-qualified Palliative Oncology RN offering proven skills in patient care, medication administration and treatment implementation. Detail-oriented, responsive and proficient in routine care and emergency response. Brings 5+ year record in field. Highly-motivated employee with desire to take on new challenges. Strong worth ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills. Hardworking and reliable registered nurse with strong ability in multitasking. Offering comprehensive detailed phone assessments and practice. Highly organized, proactive and punctual with team-oriented mentality. Responsible and motivated student ready to apply education in the workplace. Offers excellent technical abilities with software and applications, ability to handle challenging work, and excellent time management skills. Ambitious, career-focused job seeker, anxious to obtain a new Palliative position to help expand career while achieving company goals.

• Completed Oncology Certification (CONc)
• CPR certification

• Image of the month in the JOGC (Journal of obstetrics and gynaecology)
• Vulvar Lichen Sclerosus
  Michael Shier, BSc, MD, FRCSC, Sirine El-Khatib, RN, BScN
  The Colposcopy Unit, Department of Obstetrics and Gynaecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto ON

ABSTRACT

Background: Emergency Department (ED) visits for cancer patients nearing the end-of-life are frustrating, costly and considered an indicator of poor-quality end-of-life care. To date, interventions to reduce ED use in this population have been clinician focused. The decision to visit the ED is however, a personal and complex one and the literature is lacking in interventions to reduce patient ED use that are patient-informed.

Aim: To reduce the monthly ED visit rate for patients in an oncology palliative care clinic by 20% over 1 year using patient-informed interventions.[MB1]

Design: We conducted an interrupted time series analysis following the model for improvement. A patient-informed root cause analysis was performed to guide the implementation of a bundle of three change concepts: (1) improving patients’ after-hours access to hospital and home care (2) increasing video virtual visits; and (3) screening for caregiver burnout.

Setting: This was a single-centre quality improvement study that occurred in the palliative care clinic at a tertiary care cancer centre.

Results:Monthly ED visit rates declined by 24% (p[MB2] ) with evidence of sustained improvement. The percentage of ED visits that resulted in a hospital admission of < 48hrs remained unchanged. Fidelity was attained by the interventions associated with the first change concept.

Conclusion:Improving patients’ after-hours access to hospital and home care was associated with a clinically and statistically significant reduction in ED visits. This is the first study in the palliative oncology population to implement patient-informed interventions to reduce ED use.

Key Words: Palliative Care; Emergency Department; End-of-Life; Quality Improvement

[MB1]I think this is the aim of the intervention, but is not the aim of the study, which the abstract is summarizing. Should it be something like: to examine the effect of a patient-informed intervention on ED use?

[MB2]Consider removing spaces from p-values throughout the entire manuscript to save on words.

• Discussing adverse events from RCC oral treatments
• Education on most common side effects and treatment options
• Providing available resources for pts and families.