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Journal of Evaluation in Clinical Practice

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https://www.readbyqxmd.com/read/28322488/surgical-glue-in-laparoscopic-sleeve-gastrectomy-an-initial-experience-and-cost-effectiveness-analysis
#1
Gregoire Mercier, Marcelo Loureiro, Vera Georgescu, El Mehdi Skalli, Marius Nedelcu, Mohamed Ramadan, Jean Michel Fabre, Patrick Lefebvre, David Nocca
RATIONALE, AIMS, AND OBJECTIVES: Laparoscopic sleeve gastrectomy (LSG) is one of the most common bariatric procedures. Gastric leaks and bleeding are the most frequent complications, associated with a high clinical and economic burden. The best method of staple line reinforcement in LSG is debated. Surgical glue is one of the options available. The aim of this study was to assess the safety, efficiency, and relative cost-effectiveness of surgical glue used to perform LSG in morbid obese adults as compared with standard stapling...
March 21, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28322487/methodology-for-senior-proof-guidelines-a-practice-example-from-the-netherlands
#2
Barbara C van Munster, Johanna E A Portielje, Andrea B Maier, Arend J Arends, Johannes J A de Beer
RATIONALE, AIMS AND OBJECTIVES: Evidence-based guidelines constitute a foundation for medical decision making. It is often unclear whether recommendations in general guidelines also apply to older people. This study aimed to develop a methodology to increase the focus on older people in the development of guidelines. METHODS: The methodology distinguishes 4 groups of older people: (1) relatively healthy older people; (2) older people with 1 additional specific (interfering) comorbid condition; (3) older people with multimorbidity; and (4) vulnerable older people...
March 21, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28295871/promoting-resource-stewardship-reducing-inappropriate-free-thyroid-hormone-testing
#3
Julie A Gilmour, Alanna Weisman, Steven Orlov, Robert J Goldberg, Alyse Goldberg, Hayley Baranek, Geetha Mukerji
RATIONALE: Free thyroxine (fT4) and free triiodothyronine (fT3) tests are often ordered when not clinically warranted. Preventing laboratory overuse by reducing inappropriate fT4 and fT3 testing is one strategy to promote resource stewardship. OBJECTIVES: (1) To characterize the frequency of inappropriate fT4 and fT3 testing and (2) to implement a quality improvement strategy aimed at reducing the number of these tests performed. METHODS: Quality improvement tools were used to create sequential change ideas: (1) education of physicians regarding appropriate indications for ordering fT4/fT3 and (2) implementation of a hospital-wide laboratory and forced-function system with a reflex fT4...
March 14, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28276168/letter-in-response-to-vaughan-graham-and-cott-2016-phronesis-practical-wisdom-the-role-of-professional-practice-knowledge-in-the-clinical-reasoning-of-bobath-instructors-j-eval-clin-pract-doi-10-1111-jep-12641
#4
LETTER
https://www.readbyqxmd.com/read/28271587/strategies-for-reduction-in-the-duration-of-intravenous-drug-use-interest-of-drug-tracers-as-quality-indicators-to-improve-intravenous-to-oral-switch
#5
Jennifer Corny, Simon Perreau, Anne-Pauline Thivilliers, Céline Leplay, Delphine Chevalier, Hélène Beaussier, Yvonnick Bézie
RATIONALE, AIMS, AND OBJECTIVES: Intravenous (IV) to oral (PO) drug switch is a challenge for tertiary care institutions for several reasons: catheter-related infections, patient's pain and discomfort or higher costs, and overuse of IV drugs considered as an irrational use of medicines. The objective was to evaluate yearly acetaminophen and proton-pump inhibiters' (PPIs) IV/PO ratios from 2011 to 2015 and to determine their correlation with all drugs IV/PO ratios and their relevance as drug tracers...
March 7, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28260233/long-term-effects-of-a-computer-based-nutritional-training-program-for-inpatient-hospital-care
#6
Albert Westergren, Ellinor Edfors, Erika Norberg, Anna Stubbendorff, Gita Hedin, Martin Wetterstrand, Peter Hagell
RATIONALE: A previous short-term study showed that a computer-based training in eating and nutrition increased the probability for hospital inpatients at undernutrition (UN) risk to receive nutritional treatment and care without increasing overtreatment (providing nutritional treatment to those not at UN risk). The aim of this study was to investigate if a computer-based training in eating and nutrition influences the precision in nutritional treatment and care in a longer-term perspective...
March 5, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28251768/diabetes-care-comparison-of-patients-and-healthcare-professionals-assessment-using-the-pacic-instrument
#7
E Gijs, E Zuercher, V Henry, D Morin, R Bize, I Peytremann-Bridevaux
RATIONALE, AIMS AND OBJECTIVE: Whereas the Patient Assessment of Chronic Illness Care (PACIC) instrument measures the extent to which care received by patients is congruent with the Chronic Care Model, the 5As model emphasizes self-management and community resources, 2 key components of the Chronic Care Model. We aimed at comparing evaluation of diabetes care, as reported by patients with diabetes and healthcare professionals (HCPs), using these instruments. METHODS: Two independent samples, patients with diabetes (n = 395) and HCPs (including primary and secondary care physicians and nurses; n = 287), responded to the 20-item PACIC and the six 5As model questions...
March 2, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28251758/meeting-patient-needs-trumps-adherence-a-cross-sectional-study-of-adherence-and-adaptations-when-national-guidelines-are-used-in-practice
#8
Mikael Kakeeto, Robert Lundmark, Henna Hasson, Ulrica von Thiele Schwarz
RATIONALE, AIMS AND OBJECTIVES: In the evidence-to-practice pathway, guidelines are developed to provide a practical summary of evidence and stimulate change. However, when guidelines are used in practice, adherence to the recommendations in guidelines is limited, and adaptations are common. Thus, we need more detailed knowledge about adherence and adaptations when guidelines are used in practice to understand the end of the evidence-to-practice pathway. Subsequently, the aim is to examine adherence to and adaptations of recommendations in the Swedish National Guidelines for Methods of Preventing Disease...
March 2, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28251754/clinicians-guide-for-cue-based-transition-to-oral-feeding-in-preterm-infants-an-easy-to-use-clinical-guide
#9
Welma Lubbe
RATIONALE, AIMS AND OBJECTIVES: This article aims to provide evidence to guide multidisciplinary clinical practitioners towards successful initiation and long-term maintenance of oral feeding in preterm infants, directed by the individual infant maturity. METHOD: A comprehensive review of primary research, explorative work, existing guidelines, and evidence-based opinions regarding the transition to oral feeding in preterm infants was studied to compile this document...
March 2, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28220984/enacting-open-disclosure-in-the-uk-national-health-service-a-qualitative-exploration
#10
Reema Harrison, Yvonne Birks, Kate Bosanquet, Rick Iedema
BACKGROUND: Open and honest discussion between healthcare providers and patients and families affected by error is considered to be a central feature of high quality and safer patient care, evidenced by the implementation of open disclosure policies and guidance internationally. This paper discusses the perceived enablers that UK doctors and nurses report as facilitating the enactment of open disclosure. METHODS: Semistructured interviews with 13 doctors and 22 nurses from a range of levels and specialities from 5 national health service hospitals and primary care trusts in the UK were conducted and analysed using a framework approach...
February 21, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28220638/a-novel-clinical-framework-the-use-of-dispositions-in-clinical-practice-a-person-centred-approach
#11
Matthew Low
This paper explores a novel clinical framework that is underpinned by a specific philosophical perspective of causation and its utility in clinical practice. A dispositional theory of causation may overcome challenges that clinicians face in complex clinical presentations including those that are medically unexplained. Dispositionalism identifies causes not as regular events necessitating an effect but rather phenomena, which are highly complex, context-sensitive, and which tend toward an effect. Diagnostic uncertainty and causal explanation are significant challenges in terms of clinical reasoning, communication, and the overall therapeutic outcome...
February 21, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28220577/real-world-evaluation-of-the-smoking-cessation-services-in-the-rio-de-janeiro-municipality-brazil
#12
Letícia Casado, Luiz Claudio Santos Thuler
INTRODUCTION: In recent years, there has been a growing recommendation for process evaluation of the smoking cessation programmes in the world. This study sought to evaluate smoking cessation services, with special attention to the degree to which public health care facilities adhere to governmental standards of practice. METHODS: A cross-sectional study examined smoking cessation services by using a key-informant approach. All the services that delivered smoking cessation treatment in 2013 at the National Health System of the Rio de Janeiro municipality, Brazil, were included in the study...
February 21, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28220558/supporting-patients-with-type-1-diabetes-using-continuous-subcutaneous-insulin-infusion-therapy-difficulties-disconnections-and-disarray
#13
Lin Perry, Steven James, Robyn Gallagher, Janet Dunbabin, Katharine Steinbeck, Julia Lowe
RATIONALE, AIMS, AND OBJECTIVES: Use of continuous subcutaneous insulin infusion therapy in type 1 diabetes management is high. However, the incorporation of this technology into self-care is not without challenges, and the support of an appropriately skilled health care team is recommended. This study aimed to examine the support context for patients using continuous subcutaneous insulin infusion therapy from the health care professional perspective, as well as contextual influences for health care professionals and their patients...
February 21, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28205360/advanced-serious-illness-multimorbidity-and-multibeneficence-the-role-of-communication
#14
Jeffrey Cohn
Sturmberg et al write about multimorbidity as "several diagnosable diseases within the same individual." They posit that this syndrome is the result of multiple interconnected disturbances reflecting scale-free, fractal signs of pathology ranging from biochemical/hormonal alterations at one end of a spectrum to community and societal ills at the other. In this commentary, I will be focusing on 3 perspectives: 1) a preterminal phase of multimorbidity that is indicative of that loss of reparative or even homeokinetic properties, known by some as "advanced serious illness"; 2) the manifestations of advanced serious illness multimorbidity that, using the same networks that connect into the patient, are signs of this syndrome at the levels of the immediate family/friend social network, the broader community, and society at large; and 3) the potential for these same networks that transmit pathological forces to convey the positive effects of therapeutic interventions in a scale-free manner, with a focus on how conversation can lead to what I'm calling "multibeneficence...
February 16, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28205323/an-evaluation-of-the-costs-and-consequences-of-children-community-nursing-teams
#15
Sebastian Hinde, Victoria Allgar, Gerry Richardson, Gemma Spiers, Gillian Parker, Yvonne Birks
AIMS: Recent years have seen an increasing shift towards providing care in the community, epitomised by the role of Children's Community Nursing (CCN) teams. However, there have been few attempts to use robust evaluative methods to interrogate the impact of such services. This study sought to evaluate whether reduction in secondary care costs, resulting from the introduction of 2 CCN teams, was sufficient to offset the additional cost of commissioning. METHODS: Among the potential benefits of the CCN teams is a reduction in the burden placed on secondary care through the delivery of care at home; it is this potential reduction which is evaluated in this study via a 2-part analytical method...
February 16, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28205311/management-of-cardiovascular-risk-factors-in-patients-with-anca-associated-vasculitis
#16
Carsten Paul Bramlage, Juliane Kröplin, Manuel Wallbach, Joan Minguet, Katherine Helen Smith, Stephan Lüders, Joachim Schrader, Susan Patschan, Oliver Gross, Cornelia Deutsch, Peter Bramlage, Gerhard Anton Müller, Michael Koziolek
OBJECTIVES: Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is accompanied by increased cardiovascular (CV) risk. Treatment of AAV patients includes the management of conventional CV risk factors, primarily hypertension and hypercholesterolemia, while lipoprotein(a) (LP(a)) is an emerging potential target. METHODS: We performed a multicenter, retrospective study in Germany. Patients were considered if they were between 18 and 90 years old and presented with AAV...
February 16, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28205299/perioperative-hypothermia-during-hip-fracture-surgery-an-observational-study
#17
Usha Gurunathan, Christopher Stonell, Paul Fulbrook
RATIONALE: Elderly patients are at high risk of accidental perioperative hypothermia. The primary objective of this study was to measure the changes in body temperature and the incidence of hypothermia in elderly patients undergoing hip fracture surgery. METHODS: We conducted a prospective observational study on all adult patients undergoing surgery for fractured neck of femur between December 2013 and July 2014. We monitored their temperatures in different perioperative areas at multiple time points and also noted the warming methods used...
February 16, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28194852/development-of-a-transformation-model-to-derive-general-population-based-utility-mapping-the-pruritus-visual-analog-scale-vas-to-the-eq-5d-utility
#18
Sun-Young Park, Eun-Ja Park, Hae Sun Suh, Dongmun Ha, Eui-Kyung Lee
RATIONALE, AIMS, AND OBJECTIVES: Although nonpreference-based disease-specific measures are widely used in clinical studies, they cannot generate utilities for economic evaluation. A solution to this problem is to estimate utilities from disease-specific instruments using the mapping function. This study aimed to develop a transformation model for mapping the pruritus-visual analog scale (VAS) to the EuroQol 5-Dimension 3-Level (EQ-5D-3L) utility index in pruritus. METHODS: A cross-sectional survey was conducted with a sample (n = 268) drawn from the general population of South Korea...
February 14, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28176419/quality-assessment-of-palliative-home-care-in-italy
#19
Gianlorenzo Scaccabarozzi, Pietro Giorgio Lovaglio, Fabrizio Limonta, Maddalena Floriani, Giacomo Pellegrini
RATIONALE: The complexity of end-of-life care, represented by a large number of units caring for dying patients, of different types of organizations motivates the importance of measure the quality of provided care. Despite the law 38/2010 promulgated to remove the barriers and provide affordable access to palliative care, measurement, and monitoring of processes of home care providers in Italy has not been attempted. AIMS AND OBJECTIVES: Using data drawn by an institutional voluntary observatory established in Italy in 2013, collecting home palliative care units caring for people between January and December 2013, we assess the degree to which Italian home palliative care teams endorse a set of standards required by the 38/2010 law and best practices as emerged from the literature...
February 7, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28145067/the-bundle-approach-to-reduce-the-surgical-site-infection-rate
#20
Fabrizio Bert, Sebastian Giacomelli, Viola Amprino, Giulio Pieve, Daniela Ceresetti, Marco Testa, Carla M Zotti
RATIONALE, AIMS, AND OBJECTIVES: In Italy, since 2008, the surveillance of surgical site infections (SSIs) has been conducted following ECDC recommendations, according to the protocol of the National System of Surveillance of Surgical Site Infections. In 2009, in Piedmont region, where the study was conducted, it was introduced a survey of a "bundle" for every patient under SSIs surveillance. The bundle includes 5 items: infection risk index calculation, preoperative shower, trichotomy, antibiotic prophylaxis, and body temperature control...
February 1, 2017: Journal of Evaluation in Clinical Practice
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