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https://www.readbyqxmd.com/read/29049997/discrepancies-between-perceived-and-measured-cognition-in-kidney-transplant-recipients-implications-for-clinical-management
#1
Aditi Gupta, Tashra S Thomas, Jeffrey A Klein, Robert N Montgomery, Jonathan D Mahnken, David K Johnson, David A Drew, Mark J Sarnak, Jeffrey M Burns
BACKGROUND: Cognitive impairment is common in kidney transplant (KT) recipients and affects quality of life, graft survival, morbidity, and mortality. Failure to identify patients with cognitive impairment can withhold appropriate and timely intervention. This study determines whether measured cognition with standard screening tools offers any advantage over perceived cognition in screening transplant patients for cognitive impairment. METHODS: Cognition was assessed in 157 KT recipients using the Montreal Cognitive Assessment (MoCA; measured cognition)...
October 20, 2017: Nephron
https://www.readbyqxmd.com/read/29049256/learning-from-clinical-experience-with-necrotizing-fasciitis-treatment-and-management
#2
Yukun Liu, Ke Guo, Jiaming Sun
GENERAL PURPOSE: To provide information about necrotizing fasciitis (NF), how to recognize it, and evidence-based treatment. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After completing this continuing education activity, you should be able to: ABSTRACT: Necrotizing fasciitis is a threatening, rapidly progressive, infectious disease of the soft tissue...
November 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29049055/oxidized-regenerated-cellulose-collagen-dressings-review-of-evidence-and-recommendations
#3
Stephanie Wu, Andrew J Applewhite, Jeffrey Niezgoda, Robert Snyder, Jayesh Shah, Breda Cullen, Gregory Schultz, Janis Harrison, Rosemary Hill, Melania Howell, Marcus Speyrer, Howard Utra, Jean de Leon, Wayne Lee, Terry Treadwell
OBJECTIVE: Healthcare systems are being challenged to manage increasing numbers of nonhealing wounds. Wound dressings are one of the first lines of defense in wound management, and numerous options exist. The oxidized regenerated cellulose (ORC)/collagen dressing may offer healthcare providers a robust and cost-effective tool for use in a variety of wounds. DESIGN: A multidisciplinary panel meeting was convened to discuss the use of ORC/collagen dressings in wound care and provide practice recommendations...
November 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29047331/-i-can-t-bend-it-and-it-hurts-like-mad-direct-observation-of-gout-consultations-in-routine-primary-health-care
#4
Anthony Dowell, Caroline Morris, Lindsay Macdonald, Maria Stubbe
BACKGROUND: Gout is the most common form of inflammatory arthritis and is associated with considerable co-morbidity. It is usually managed in the primary care setting with a combination of lifestyle modification and pharmacological therapy. This study describes patterns of communication about gout observed in interactions between patients and primary care practitioners during routine consultations. METHODS: Secondary analysis of video-recordings of individual healthcare consultations between patients and a range of primary care practitioners (including general practitioners, practice nurses, podiatrists and dietitians) from an archived database...
October 18, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/29046259/assessing-the-impact-of-quality-improvement-measures-on-catheter-related-blood-stream-infections-and-catheter-salvage-experience-from-a-national-intestinal-failure-unit
#5
A Bond, A Teubner, M Taylor, C Cawley, A Abraham, M Dibb, P R Chadwick, M Soop, G Carlson, S Lal
BACKGROUND & AIMS: Prevention of catheter related blood stream infections (CRBSI) and salvage of infected central venous catheters (CVC) are vital to maintaining long term venous access in patients needing home parenteral nutrition (HPN). It remains unclear as to whether patients are best trained for catheter care at home or in hospital or whether CRBSIs are lower if the patient self-cares for the CVC. Furthermore, there is minimal data on the longer term outcome following salvage of infected catheter and limited consensus on agreed protocols for catheter salvage...
October 10, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29045909/an-integrative-review-of-graduate-transition-programmes-developmental-considerations-for-nursing-management
#6
REVIEW
Shannon Bakon, Judy Craft, Lisa Wirihana, Martin Christensen, Jennie Barr, Lily Tsai
Graduate transition programmes have been developed to recruit new nursing staff and facilitate an effective transition from nursing student to Registered Nurse within the clinical environment. Therefore the aim of this paper was to explore the various elements included in nursing graduate transition programmes. An integrative review was undertaken incorporating a strict inclusion criterion, critical appraisal, and thematic analysis of 30 studies. There are numerous transition programmes available yet there remains a lack of transparency regarding their aims/objectives, course content, support timeframe and the type of support provided...
October 10, 2017: Nurse Education in Practice
https://www.readbyqxmd.com/read/29045582/strategies-to-reduce-injuries-and-develop-confidence-in-elders-stride-a-cluster-randomized-pragmatic-trial-of-a-multifactorial-fall-injury-prevention-strategy-design-and-methods
#7
Shalender Bhasin, Thomas M Gill, David B Reuben, Nancy K Latham, Jerry H Gurwitz, Patricia Dykes, Siobhan McMahon, Thomas W Storer, Pamela W Duncan, David A Ganz, Shehzad Basaria, Michael E Miller, Thomas G Travison, Erich J Greene, James Dziura, Denise Esserman, Heather Allore, Martha B Carnie, Maureen Fagan, Catherine Hanson, Dorothy Baker, Susan L Greenspan, Neil Alexander, Fred Ko, Albert L Siu, Elena Volpi, Albert W Wu, Jeremy Rich, Stephen C Waring, Robert Wallace, Carri Casteel, Jay Magaziner, Peter Charpentier, Charles Lu, Katy Araujo, Haseena Rajeevan, Scott Margolis, Richard Eder, Joanne M McGloin, Eleni Skokos, Jocelyn Wiggins, Lawrence Garber, Steven B Clauser, Rosaly Correa-De-Araujo, Peter Peduzzi
Background: Fall injuries are a major cause of morbidity and mortality among older adults. We describe the design of a pragmatic trial to compare the effectiveness of an evidence-based, patient-centered multifactorial fall injury prevention strategy to an enhanced usual care. Methods: Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE) is a 40-month cluster-randomized, parallel-group, superiority, pragmatic trial being conducted at 86 primary care practices in 10 healthcare systems across USA...
October 14, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/29045284/increasing-colorectal-cancer-screening-using-a-quality-improvement-approach-in-a-nurse-managed-primary-care-clinic
#8
Diane Hountz, Jennifer Coddington, Karen J Foli, Janet Thorlton
According to the American Cancer Society, 1 in 23 Americans will be diagnosed with colorectal cancer (CRC) in their lifetime. Screening for CRC is an effective, yet underused preventive approach. This is especially true in rural areas, where only 35% of patients were found to be up to date on their screenings in 2014. Increasing CRC screening can produce positive patient outcomes by early recognition and removal of precancerous polyps. The purpose of this project was to use quality improvement (QI) interventions to increase CRC screening rates at a nurse-managed clinic in rural Indiana...
October 17, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29045256/a-quality-improvement-initiative-to-increase-scoring-consistency-and-accuracy-of-the-finnegan-tool-challenges-in-obtaining-reliable-assessments-of-drug-withdrawal-in-neonatal-abstinence-syndrome
#9
Wendy Timpson, Cheryl Killoran, Louise Maranda, Alan Picarillo, Elisabeth Bloch-Salisbury
BACKGROUND: Current practice for diagnosing neonatal abstinence syndrome and guiding pharmacological management of neonatal drug withdrawal is dependent on nursing assessments and repeated evaluation of clinical signs. PURPOSE: This single-center quality improvement initiative was designed to improve accuracy and consistency of Finnegan scores among neonatal nurses. METHODS: One-hundred seventy neonatal nurses participated in a single-session withdrawal-assessment program that incorporated education, scoring guidelines, and a restructured Finnegan scale...
October 17, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/29044479/the-strategies-to-reduce-injuries-and-develop-confidence-in-elders-intervention-falls-risk-factor-assessment-and-management-patient-engagement-and-nurse-co-management
#10
David B Reuben, Priscilla Gazarian, Neil Alexander, Katy Araujo, Dorothy Baker, Jonathan F Bean, Chad Boult, Peter Charpentier, Pamela Duncan, Nancy Latham, Rosanne M Leipzig, Lisa M Quintiliani, Thomas Storer, Siobhan McMahon
In response to the epidemic of falls and serious falls-related injuries in older persons, in 2014, the Patient Centered Outcomes Research Institute (PCORI) and the National Institute on Aging funded a pragmatic trial, Strategies to Reduce Injuries and Develop confidence in Elders (STRIDE) to compare the effects of a multifactorial intervention with those of an enhanced usual care intervention. The STRIDE multifactorial intervention consists of five major components that registered nurses deliver in the role of falls care managers, co-managing fall risk in partnership with patients and their primary care providers (PCPs)...
October 17, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29042383/health-education-for-patients-with-acute-coronary-syndrome-and-type-2-diabetes-mellitus-an-umbrella-review-of-systematic-reviews-and-meta-analyses
#11
Xian-Liang Liu, Yan Shi, Karen Willis, Chiung-Jung Jo Wu, Maree Johnson
OBJECTIVES: This umbrella review aimed to identify the current evidence on health education-related interventions for patients with acute coronary syndrome (ACS) or type two diabetes mellitus (T2DM); identify the educational content, delivery methods, intensity, duration and setting required. The purpose was to provide recommendations for educational interventions for high-risk patients with both ACS and T2DM. DESIGN: Umbrella review of systematic reviews and meta-analyses...
October 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29041785/professional-nurses-lived-experiences-regarding-the-performance-management-system-in-the-mopani-district
#12
Sheillah H Mboweni, Lufuno Makhado
BACKGROUND: The purpose of the performance management system (PMS) is planning, monitoring, evaluation and development of employees to meet the organisational goals and objectives and transform of service delivery to excellence of the organisation. However, public services are deteriorating and implementation of PMS stimulated different views among professional nurses (PNs) in the Mopani district clinics, which warrants exploration and documentation of the findings. OBJECTIVE: The objective of this study was to explore and describe the PNs' perceptions towards PMS...
October 13, 2017: Curationis
https://www.readbyqxmd.com/read/29040811/mobile-emergency-simulation-training-for-rural-health-providers
#13
Douglas Martin, Brent Bekiaris, Gregory Hansen
INTRODUCTION: Mobile emergency simulation offers innovative continuing medical educational support to regions that may lack access to such opportunities. Furthermore, satisfaction is a critical element for active learning. Together, the authors evaluated Canadian rural healthcare providers' satisfaction from high fidelity emergency simulation training using a modified motorhome as a mobile education unit (MEU). METHODS: Over a 5-month period, data was collected during 14 educational sessions in nine different southern Manitoban communities...
July 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/29040331/primary-care-models-for-treating-opioid-use-disorders-what-actually-works-a-systematic-review
#14
Pooja Lagisetty, Katarzyna Klasa, Christopher Bush, Michele Heisler, Vineet Chopra, Amy Bohnert
BACKGROUND: Primary care-based models for Medication-Assisted Treatment (MAT) have been shown to reduce mortality for Opioid Use Disorder (OUD) and have equivalent efficacy to MAT in specialty substance treatment facilities. OBJECTIVE: The objective of this study is to systematically analyze current evidence-based, primary care OUD MAT interventions and identify program structures and processes associated with improved patient outcomes in order to guide future policy and implementation in primary care settings...
2017: PloS One
https://www.readbyqxmd.com/read/29038971/the-implementation-of-targeted-temperature-management-an-evidence-based-guideline-from-the-neurocritical-care-society
#15
Lori Kennedy Madden, Michelle Hill, Teresa L May, Theresa Human, Mary McKenna Guanci, Judith Jacobi, Melissa V Moreda, Neeraj Badjatia
BACKGROUND: Targeted temperature management (TTM) is often used in neurocritical care to minimize secondary neurologic injury and improve outcomes. TTM encompasses therapeutic hypothermia, controlled normothermia, and treatment of fever. TTM is best supported by evidence from neonatal hypoxic-ischemic encephalopathy and out-of-hospital cardiac arrest, although it has also been explored in ischemic stroke, traumatic brain injury, and intracranial hemorrhage patients. Critical care clinicians using TTM must select appropriate cooling techniques, provide a reasonable rate of cooling, manage shivering, and ensure adequate patient monitoring among other challenges...
October 16, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/29036747/prevention-of-multidrug-resistant-infections-from-contaminated-duodenoscopes-position-statement-of-the-european-society-of-gastrointestinal-endoscopy-esge-and-european-society-of-gastroenterology-nurses-and-associates-esgena
#16
Ulrike Beilenhoff, Holger Biering, Reinhard Blum, Jadranka Brljak, Monica Cimbro, Jean-Marc Dumonceau, Cesare Hassan, Michael Jung, Christiane Neumann, Michael Pietsch, Lionel Pineau, Thierry Ponchon, Stanislav Rejchrt, Jean-François Rey, Verona Schmidt, Jayne Tillett, Jeanin van Hooft
Patients should be informed about the benefits and risks of endoscopic retrograde cholangiopancreatography (ERCP)Only specially trained and competent personnel should carry out endoscope reprocessing.Manufacturers of duodenoscopes should provide detailed instructions on how to use and reprocess their equipment.In the case of modifications to their equipment, manufacturers should provide updated instructions for use.Detailed reprocessing protocols based on the manufacturer's instructions for use should clearly lay out the different reprocessing steps necessary for each endoscope model...
October 16, 2017: Endoscopy
https://www.readbyqxmd.com/read/29035901/ce-preeclampsia-current-approaches-to-nursing-management
#17
Cindy M Anderson, Mandy J Schmella
A clinical review of risk factors, diagnostic criteria, and patient care. ABSTRACT: Preeclampsia, one of four hypertensive disorders of pregnancy, has traditionally been characterized as new-onset hypertension and proteinuria developing after 20 weeks' gestation. It is, however, now understood to be a complex, progressive, multisystem disorder with a highly variable presentation and a number of potentially life-threatening complications. The American College of Obstetricians and Gynecologists Task Force on Hypertension in Pregnancy has refined preeclampsia diagnostic criteria accordingly, and as the disorder's pathogenesis has been more clearly defined, new targets for screening, diagnosis, prevention, and treatment have emerged...
October 13, 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/29035894/prevalence-of-potentially-distracting-noncare-activities-and-their-effects-on-vigilance-workload-and-nonroutine-events-during-anesthesia-care
#18
Jason M Slagle, Eric S Porterfield, Amanda N Lorinc, David Afshartous, Matthew S Shotwell, Matthew B Weinger
BACKGROUND: When workload is low, anesthesia providers may perform non-patient care activities of a clinical, educational, or personal nature. Data are limited on the incidence or impact of distractions on actual care. We examined the prevalence of self-initiated nonclinical distractions and their effects on anesthesia workload, vigilance, and the occurrence of nonroutine events. METHODS: In 319 qualifying cases in an academic medical center using a Web-based electronic medical chart, a trained observer recorded video and performed behavioral task analysis...
October 16, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29034707/female-genital-mutilation-implications-for-clinical-practice
#19
Inez von Rège, Daniel Campion
Female genital mutilation (FGM) is an established cultural practice in over 30 countries. It has no health benefits, carries a high risk of physical and psychological harm, and is illegal in many countries including the UK. A sensitive approach is required, both in the management of complications and prevention of this practice. This article discusses the prevalence and classification of FGM, and offers practical advice to nurses and midwives involved in general and obstetric care. Legal aspects, including safeguarding responsibilities and the mandatory duty to report FGM in England and Wales, are outlined...
October 12, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29034698/an-insight-into-the-patient-s-response-to-a-diagnosis-of-urological-cancer
#20
Beverley Anderson
A cancer diagnosis and the patient's response to the news pertains to all types of cancer, however, in this article, the focus is on urological cancer. Intrinsic to the management of this patient group is the urology multidisciplinary team, in which the role of the cancer nurse specialist (CNS) is pivotal. For most people, a cancer diagnosis is arguably their worst fear. It is therefore prudent that a holistic approach is used when determining care and ensuring that appropriate support is forthcoming. This necessitates an assessment of the physical, psychological/emotional, psycho-social, spiritual and cultural components of the individual's healthcare needs, and accordingly, devising a plan of care to secure the best outcomes...
October 12, 2017: British Journal of Nursing: BJN
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