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"Transitions of care"

Susanne Lohmann, Elke Mattern, Gertrud M Ayerle
OBJECTIVE: To explore how midwives perceive patient preferences related to midwifery care in Germany. DESIGN: This qualitative study, which was part of a larger study, used a hermeneutic-interpretive approach and involved focus group interviews with midwives. Data collection and analysis were done in a conjoined fashion between April 2015 and September 2016. SETTING: Four focus group interviews were conducted in four different federal states of Germany...
February 10, 2018: Midwifery
Muhammad M Fareed, Rizwan Ishtiaq, Thomas J Galloway
Overall radiation treatment time has long been recognized as an important factor in head and neck tumor control. The concern of tumor growth in waiting time either before starting radiotherapy or during treatment is substantial given its negative impact on clinical outcome. There is an overwhelming evidence that increasing the time to initiate treatment increases the tumor burden and worsens the prognosis. This effect is more pronounced especially in patients with an early stage cancer disease. Delay in treatment initiation is contributed by both health care- and patient-related factors...
March 12, 2018: Current Treatment Options in Oncology
Anne L Donovan, J Matthew Aldrich, A Kendall Gross, Denise M Barchas, Kevin C Thornton, Hildy M Schell-Chaple, Michael A Gropper, Angela K M Lipshutz
OBJECTIVES: We describe the importance of interprofessional care in modern critical care medicine. This review highlights the essential roles played by specific members of the interprofessional care team, including patients and family members, and discusses quality improvement initiatives that require interprofessional collaboration for success. DATA SOURCES: Studies were identified through MEDLINE search using a variety of search phrases related to interprofessional care, critical care provider types, and quality improvement initiatives...
March 7, 2018: Critical Care Medicine
S S Almarzoky Abuhussain, K J Goodlet, M D Nailor, D P Nicolau
Skin and skin structure infections (SSSIs) refer to a collection of clinical infectious syndromes involving layers of skin and associated soft tissues. Although associated with less morbidity and mortality than other common skin infections, SSSIs represent a significant increasing source of healthcare expense, with a prevalence of 500 episodes per 10,000 patient-years in the United States resulting in burdening health care systems, of approximately $6 billion annually. Areas covered: Opportunities to reduce costs of care associated with SSSI are highlighted, including transitions of care and avoiding unnecessary hospital admissions...
March 9, 2018: Expert Review of Pharmacoeconomics & Outcomes Research
Mei Ling Lim, Bei Yi Paulynn Yong, Mei Qi Maggie Mar, Shin Yuh Ang, Mei Mei Chan, Madeleine Lam, Ngian Choo Janet Chong, Violeta Lopez
BACKGROUND: The number of patients on home enteral nutrition (HEN) is on the increase due to advancement in technology and shift in focus of providing care from acute to community care settings. AIM: This study aimed to explore the experiences of community nurses and home carers, in caring for patients on HEN. METHODS: A mixed-method approach was adopted. (i) A face-to-face survey design was used to elicit experience of carers of patients on HEN...
March 8, 2018: Journal of Clinical Nursing
Alexander J Skokan, Robert Caleb Kovell
PURPOSE OF REVIEW: As long-term survival with complex congenital and pediatric diseases has improved, more patients with congenital genitourinary conditions are living into adulthood. These patients can continue to face lifelong issues related to their conditions, including urinary incontinence, recurrent urinary tract infections, chronic kidney disease, and difficulties with sexual health and function. RECENT FINDINGS: The practice of transitional urology continues to grow nationwide and abroad, and it will be important to develop evidence-based practices for coordinated transition of these patients into the adult health care setting...
March 7, 2018: Current Urology Reports
Sandra Braaf, Shanthi Ameratunga, Andrew Nunn, Nicola Christie, Warwick Teague, Rodney Judson, Belinda J Gabbe
BACKGROUND: Navigating complex health care systems during the multiple phases of recovery following major trauma entails many challenges for injured patients. Patients' experiences communicating with health professionals are of particular importance in this context. The aim of this study was to explore seriously injured patients' perceptions of communication with and information provided by health professionals in their first 3-years following injury. METHODS: A qualitative study designed was used, nested within a population-based longitudinal cohort study...
March 7, 2018: BMC Health Services Research
Christina R Whitehouse, Nancy C Sharts-Hopko, Suzanne C Smeltzer, David A Horowitz
The aim of the current study was to compare outcomes for older adults with type 2 diabetes mellitus and obesity following participation in a transitional care intervention that included diabetes self-management education (DSME) and homecare. The three groups analyzed comprised an inpatient DSME plus homecare group (n = 35); an inpatient DSME only group (n = 100); and a group who received usual care (n = 45). Outcomes of interest included rehospitalization rates and hemoglobin A1C (A1C) for up to 1-year post hospital discharge...
March 1, 2018: Research in Gerontological Nursing
Sarah L Anderson, Joel C Marrs
This article reviews current literature on the role of pharmacists in the transition of care (TOC) for patients with heart failure (HF) and the impact of their contributions on therapeutic and economic outcomes. Optimizing the TOC for patients with HF from the hospital to the community/home is crucial for improving outcomes and decreasing high rates of hospital readmissions, which are associated with increased morbidity, mortality, and costs. A multidisciplinary team approach to the management of patients with HF facilitates the transition from the hospital to the ambulatory care setting, allowing for the consideration of medical, pharmacological, and lifestyle variables that impact the care of individual patients...
February 27, 2018: Advances in Therapy
Aodhnait S Fahy, Christopher R Moir
Colorectal adenomatous polyposis syndromes encompass a diverse group of disorders with varying modes of inheritance and penetrance. Children may present with overt disease or within screening programs for families at high risk. We provide an overview of the array of pediatric polyposis syndromes, current screening recommendations, and surgical indications and technical considerations. Optimal disease management for these pediatric patients is still evolving and has implications for screening, surveillance, pediatric surgical management, and transition of care gastroenterologic neoplasia physicians and surgeons...
March 2018: Clinics in Colon and Rectal Surgery
Bridgette L Kram, Jennifer M Schultheis, Shawn J Kram, Christopher E Cox
PURPOSE: To evaluate whether a pharmacist-initiated electronic handoff tool can reduce the overall, and potentially inappropriate, hospital discharge prescribing rate of atypical antipsychotics (AAP) initiated in AAP-naive critically ill adults. METHODS: This pre-post quality improvement study was initiated in 5 intensive care units (ICUs) at a large academic medical center. An electronic handoff tool (iVent) was utilized in the post-intervention period to enhance pharmacist communication at inpatient transitions of care...
January 1, 2018: Journal of Pharmacy Practice
Maram G Katoue, Jean Ker
BACKGROUND: Using the medicines reconciliation tool which involves preparing an updated list of patient's medications at each transition of care can significantly enhance patient safety. The pharmacist has been leading this process in western healthcare systems. Little is known about pharmacists' role in medicines reconciliation in Middle Eastern Countries. OBJECTIVES: To explore the implementation of medicines reconciliation in Kuwait hospitals, pharmacists' role in this process and perceptions of the challenges in implementing it in practice...
January 5, 2018: Health Policy
Andria F Brantley, Deanna M Rossi, Shalonda Barnes-Warren, Jon Carlo Francisco, Ira Schatten, Vishwas Dave
PURPOSE: The development and implementation of a hospitalwide, pharmacist-led transitions-of-care (TOC) program are described. METHODS: This 21-week quality improvement initiative was conducted from October 1, 2015, to February 26, 2016, at Memorial Hospital Pembroke. A TOC team was comprised of pharmacists, a pharmacy resident, pharmacy students, a physician, case managers, and nurses. All patients over the age of 18 admitted to the inpatient telemetry unit were included in this initiative...
March 1, 2018: American Journal of Health-system Pharmacy: AJHP
J E Kang, J M Yu, J H Choi, I-M Chung, W B Pyun, S A Kim, E K Lee, N Y Han, J-H Yoon, J M Oh, S J Rhie
WHAT IS KNOWN AND OBJECTIVE: Drug therapies are critical for preventing secondary complications in acute coronary syndrome (ACS). The purpose of this study was to develop and apply a pharmaceutical care service (PCS) algorithm for ACS and confirm that it is applicable through a prospective clinical trial. METHODS: The ACS-PCS algorithm was developed according to extant evidence-based treatment and pharmaceutical care guidelines. Quality assurance was conducted through two methods: literature comparison and expert panel evaluation...
February 21, 2018: Journal of Clinical Pharmacy and Therapeutics
Philomine A van Pelt, Radboud J E M Dolhain, Aike A Kruize, Judy J W Ammerlaan, Johanna W Hazes, Johannes W J Bijlsma, Nico M Wulffraat
OBJECTIVES: Reaching a certain age, juvenile idiopathic arthritis (JIA) patients in paediatric care are transferred to adult care. An increased disease activity after transfer and increased dropout has been suggested, however, evidence is scarce. Our aim is to determine whether the process of transition is associated with increased disease-activity and dropout, and to identify associated factors. METHODS: During a 3-year prospective transition cohort study, paediatric patients (14-17yrs) were transferred to adult care...
January 2018: Clinical and Experimental Rheumatology
JoAnna K Leyenaar, Paul A Rizzo, Emily R O'Brien, Peter K Lindenauer
BACKGROUND: Hospital admission, like hospital discharge, represents a transition of care associated with changes in setting, healthcare providers and clinical management. While considerable efforts have focused on improving the quality and safety of hospital-to-home transitions, there has been little focus on transitions into hospital. OBJECTIVES: Among children hospitalised with ambulatory care sensitive conditions, we aimed to characterise families' experiences as they transitioned from outpatient to inpatient care, identify hospital admission processes and outcomes most important to families and determine how parental perspectives differed between children admitted directly and through emergency departments (ED)...
February 16, 2018: BMJ Quality & Safety
Darryl Abrams, A Reshad Garan, Akram Abdelbary, Matthew Bacchetta, Robert H Bartlett, James Beck, Jan Belohlavek, Yih-Sharng Chen, Eddy Fan, Niall D Ferguson, Jo-Anne Fowles, John Fraser, Michelle Gong, Ibrahim F Hassan, Carol Hodgson, Xiaotong Hou, Katarzyna Hryniewicz, Shingo Ichiba, William A Jakobleff, Roberto Lorusso, Graeme MacLaren, Shay McGuinness, Thomas Mueller, Pauline K Park, Giles Peek, Vin Pellegrino, Susanna Price, Erika B Rosenzweig, Tetsuya Sakamoto, Leonardo Salazar, Matthieu Schmidt, Arthur S Slutsky, Christian Spaulding, Hiroo Takayama, Koji Takeda, Alain Vuylsteke, Alain Combes, Daniel Brodie
Extracorporeal membrane oxygenation (ECMO) has been used increasingly for both respiratory and cardiac failure in adult patients. Indications for ECMO use in cardiac failure include severe refractory cardiogenic shock, refractory ventricular arrhythmia, active cardiopulmonary resuscitation for cardiac arrest, and acute or decompensated right heart failure. Evidence is emerging to guide the use of this therapy for some of these indications, but there remains a need for additional evidence to guide best practices...
February 15, 2018: Intensive Care Medicine
J van Os, P H Delespaul
In a given year, around 25% of the Dutch population may experience significant mental health problems, much more than the mental health service can attend to, given a maximum capacity of 6% of the population per year. Due to the lack of a public mental health system, there is fierce competition over who gets to receive care from mental health services and little control over how the level of needs can be matched with the appropriate intensity of care. As a result, resources are being wasted and both overtreatment and undertreatment are prevalent...
2018: Tijdschrift Voor Psychiatrie
Kerrie Westaway, Oliver Frank, Russell Shute, Anna Moffat, Vanessa LeBlanc, Debra Rowett, Natalie Blacker, Elizabeth Roughead
AIM: Behavioral and psychological symptoms of dementia are often managed inappropriately with antipsychotic medicines. The TOP 5 program, which involves recording up to five relevant and meaningful tips that assist in personalizing care for the person with dementia, has been tested in the hospital setting and transitions of care in Australia, and has been found to be useful. Our study aimed to adapt the TOP 5 program as a strategy to support people with dementia in a primary care setting and to test the acceptability of our adapted TOP 5 program materials...
February 9, 2018: International Journal of Evidence-based Healthcare
Sarah B Cairo, Indrajit Majumdar, Aurora Pryor, Alan Posner, Carroll M Harmon, David H Rothstein
Obesity in pediatric patients is rising with nearly one third of children in the USA classified as overweight and up to 16-18% of the adolescent population obese with at least one comorbid condition. Consequently, bariatric procedures in this population have increased without consistent recommendations for follow-up and transition to adult providers. This review describes the known and potential long-term consequences of bariatric surgery in pediatric patients, reviews the current literature on transitions of care for adolescent patients with chronic illnesses...
February 9, 2018: Obesity Surgery
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