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https://www.readbyqxmd.com/read/28070029/the-relationship-between-scores-and-outcomes-for-polytrauma-patients-in-the-emergency-department-a-case-study
#1
Maria Gioffre-Florio, Letizia Maria Murabito, Carmela Visalli, Alessandra Villari, Floriana Lauritano, Carla Bramanti, Fausto Fama
AIM: Traumas are one of the most relevant pathological events in health care, because of clinical and prognostic relevance. Morbidity and mortality rates are strongly affected by the timely and correct approach to the patient (golden hour). The objective of this study was to investigate the possible influence of the diagnostic time and of the Injury Severity Score (ISS) on outcomes in trauma patients. MATERIAL OF STUDY: Out of a total of 240,833 emergency patients, we observed, 447 polytrauma...
December 29, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28066851/analysis-of-smartphone-interruptions-on-academic-general-internal-medicine-wards-frequent-interruptions-may-cause-a-crisis-mode-work-climate
#2
Alon Vaisman, Robert C Wu
INTRODUCTION: Hospital-based medical services are increasingly utilizing team-based pagers and smartphones to streamline communications. However, an unintended consequence may be higher volumes of interruptions potentially leading to medical error. There is likely a level at which interruptions are excessive and cause a 'crisis mode' climate. METHODS: We retrospectively collected phone, text messaging, and email interruptions directed to hospital-assigned smartphones on eight General Internal Medicine (GIM) teams at two tertiary care centres in Toronto, Ontario from April 2013 to September 2014...
January 4, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28065962/compliance-of-surgical-hand-washing-before-surgery-role-of-remote-video-surveillance
#3
Ambreen Khan, Sidrah Nausheen
OBJECTIVE: To evaluate and increase the compliance of surgical hand scrubbing with periodic feedback. METHODS: This study was conducted at the Aga Khan Hospital for Women and Children, Karachi, Pakistan, from April to July 2014. A remote video auditing system consisting of human auditors was used for visualising surgical hand wash compliance of the surgical team. The equipment, which used motion sensor, was installed in the scrub area wall, visualising the scrub sink only...
January 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28062529/a-mixed-reality-simulator-concept-for-future-medical-emergency-response-team-training
#4
Robert J Stone, R Guest, P Mahoney, D Lamb, C Gibson
The UK Defence Medical Service's Pre-Hospital Emergency Care (PHEC) capability includes rapid-deployment Medical Emergency Response Teams (MERTs) comprising tri-service trauma consultants, paramedics and specialised nurses, all of whom are qualified to administer emergency care under extreme conditions to improve the survival prospects of combat casualties. The pre-deployment training of MERT personnel is designed to foster individual knowledge, skills and abilities in PHEC and in small team performance and cohesion in 'mission-specific' contexts...
January 6, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28058496/-traumatology-in-the-elderly-multimodal-prevention-of-delirium-and-use-of-augmentation-techniques
#5
D Wähnert, A Roos, J Glasbrenner, K Ilting-Reuke, P Ohrmann, G Hempel, T Duning, N Roeder, M J Raschke
Recent data show that 20-80% of surgery patients are affected by delirium during inpatient clinical treatment. The medical consequences are often dramatic and include a 20 times higher mortality and treatment expenses of the medical unit increase considerably. At the University Hospital of Münster a multimodal and interdisciplinary concept for prevention and management of delirium was developed: all patients older than 65 years admitted for surgery are screened by a specialized team for the risk of developing delirium and treated by members of the team if there is a risk of delirium...
January 5, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28057949/impact-of-targeted-educational-interventions-on-clostridium-difficile-infection-treatment-in-critically-ill-adults
#6
Drayton A Hammond, Catherine A Hughes, Jacob T Painter, Rose E Pennick, Kshitij Chatterjee, Bradley Boye, Nikhil Meena
Background: Clostridium difficile infection (CDI) is a growing clinical and economic burden throughout the world. Pharmacists often are members of the primary care team in the intensive care unit (ICU) setting; however, the impact of pharmacists educating other health care providers on appropriateness of CDI treatment has not been previously examined. Objective: This study was performed to determine the impact of structured educational interventions on CDI treatment on appropriateness of CDI treatment and clinical outcomes...
December 2016: Hospital Pharmacy
https://www.readbyqxmd.com/read/28052576/pre-operative-oral-nutritional-supplementation-with-dietary-advice-versus-dietary-advice-alone-in-weight-losing-patients-with-colorectal-cancer-single-blind-randomized-controlled-trial
#7
Sorrel T Burden, Debra J Gibson, Simon Lal, James Hill, Mark Pilling, Mattias Soop, Aswatha Ramesh, Chris Todd
BACKGROUND: Pre-operative weight loss has been consistently associated with increased post-operative morbidity. The study aims to determine if pre-operative oral nutritional supplements (ONSs) with dietary advice reduce post-operative complications. METHODS: Single-blinded randomized controlled trial. People with colorectal cancer scheduled for surgery with pre-operative weight loss >1 kg/3-6 months were randomized by using stratified blocks (1:1 ratio) in six hospitals (1 November 2013-28 February 2015)...
January 3, 2017: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/28050224/perspectives-from-geriatric-in-patients-with-heart-failure-and-their-caregivers-on-gaps-in-care-quality
#8
Nahid Azad, G Lemay, J Li, M Benzaquen, L Khoury
BACKGROUND: Evidence indicates that care experiences for complex HF patients could be improved by simple organizational and process changes, rather than complex clinical mechanisms. This survey identifies care gaps and recommends simple changes. METHODS: The study utilized both quantitative and qualitative methods at The Ottawa Hospital, Geriatric Medical Unit during a three-month period. RESULTS: Nineteen patients (average age 85, 12 female) surveyed...
December 2016: Canadian Geriatrics Journal: CGJ
https://www.readbyqxmd.com/read/28045940/applying-the-integrated-practice-unit-concept-to-a-modified-virtual-ward-model-of-care-for-patients-at-highest-risk-of-readmission-a-randomized-controlled-trial
#9
Lian Leng Low, Shu Yun Tan, Matthew Joo Ming Ng, Wei Yi Tay, Lee Beng Ng, Kanchana Balasubramaniam, Rachel Marie Towle, Kheng Hock Lee
BACKGROUND: Emerging evidence from the virtual ward care model showed that multidisciplinary case management are inadequate to reduce readmissions or death for high risk patients. There is consensus that interventions should encompass both pre-hospital discharge and post-discharge transitional care to be effective. Integrated practice units (IPU) had been proposed as an approach of restructuring the organization and work processes of multidisciplinary teams to achieve value in healthcare...
2017: PloS One
https://www.readbyqxmd.com/read/28042074/a-communications-bundle-to-improve-satisfaction-for-critically-ill-patients-and-their-families-a-prospective-cohort-pilot-study
#10
Rana L Awdish, Dana Buick, Maria Kokas, Hanan Berlin, Catherine Jackman, Cari Williamson, Michael P Mendez, Kristen Chasteen
CONTEXT: Communication skills training with simulated patients is used by many academic centers, but how to translate skills learned in simulated settings to improve communication in real encounters has not been described. OBJECTIVE: We developed a communications bundle to facilitate skill transfer from simulation to real encounters and improve patient and/or family satisfaction with physician communication. We tested the feasibility of its use in our hospital's medical intensive care unit (MICU)...
December 29, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28042009/so-you-want-to-conduct-a-randomised-trial-learnings-from-a-failed-feasibility-study-of-a-crisis-resource-management-prompt-during-simulated-paediatric-resuscitation
#11
Rachel Teis, Jyai Allen, Nigel Lee, Sue Kildea
BACKGROUND: No study has tested a Crisis Resource Management prompt on resuscitation performance. METHODS: We conducted a feasibility, unblinded, parallel-group, randomised controlled trial at one Australian paediatric hospital (June-September 2014). Eligible participants were any doctor, nurse, or nurse manager who would normally be involved in a Medical Emergency Team simulation. The unit of block randomisation was one of six scenarios (3 control:3 intervention) with or without a verbal prompt...
December 29, 2016: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/28027338/effect-of-an-intensive-outpatient-program-to-augment-primary-care-for-high-need-veterans-affairs-patients-a-randomized-clinical-trial
#12
Donna M Zulman, Christine Pal Chee, Stephen C Ezeji-Okoye, Jonathan G Shaw, Tyson H Holmes, James S Kahn, Steven M Asch
Importance: Many organizations are adopting intensive outpatient care programs for high-need patients, yet little is known about their effectiveness in integrated systems with established patient-centered medical homes. Objective: To evaluate how augmenting the Veterans Affairs (VA) medical home (Patient Aligned Care Teams [PACT]) with an Intensive Management program (ImPACT) influences high-need patients' costs, health care utilization, and experience. Design, Setting, and Participants: Randomized clinical trial at a single VA facility...
December 27, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27998897/antithrombotic-stewardship-a-multidisciplinary-team-approach-towards-improving-antithrombotic-therapy-outcomes-during-and-after-hospitalisation-a-study-protocol
#13
Albert R Dreijer, Marieke J H A Kruip, Jeroen Diepstraten, Suzanne Polinder, Rolf Brouwer, Frank W G Leebeek, Arnold G Vulto, Patricia M L A van den Bemt
INTRODUCTION: Antithrombotic therapy carries high risks for patient safety. Antithrombotics belong to the top 5 medications involved in potentially preventable hospital admissions related to medication. To provide a standard for antithrombotic therapy and stress the importance of providing optimal care to patients on antithrombotic therapy, the Landelijke Standaard Ketenzorg Antistolling (LSKA; Dutch guideline on integrated antithrombotic care) was drafted. However, the mere publication of this guideline does not guarantee its implementation...
December 20, 2016: BMJ Open
https://www.readbyqxmd.com/read/27998323/short-and-long-term-reduction-of-door-to-needle-time-in-thrombolysis-for-acute-stroke
#14
Bing Yu Chen, Aimen Moussaddy, Mark R Keezer, Yan Deschaintre, Alexandre Y Poppe
BACKGROUND: More timely administration of tissue plasminogen activator (alteplase) for patients with acute ischemic stroke yields greater clinical benefits. We implemented door-to-needle (DTN) time reduction strategies at our center and evaluated their short- and long-term effects on in-hospital treatment delays and clinical outcomes. METHODS: Strategies, including stroke team prenotification, direct computed tomography transfer, not routinely waiting for laboratory results and alteplase delivery on the computed tomography table, were implemented in June 2013...
December 21, 2016: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/27956210/surgical-reconstruction-of-giant-penoscrotal-lymphoedema-in-sub-saharan-africa
#15
Ayo A Salako, Jimoh K Olabanji, Ayodeji O Oladele, Gideon H Alabi, Ifedayo E Adejare, Rotimi A David
OBJECTIVE: To present management challenges, surgical technique and outcome associated with penoscrotal reconstruction in patients with giant scrotal lymphoedema in sub-Saharan Africa. METHOD: A prospective study of all patients who had penoscrotal reconstruction for giant scrotal lymphoedema at our university teaching hospital between January 2003 and December 2012 was carried out. Patients' pre-operative clinical evaluation findings, operative technique and post-operative course were reviewed after obtaining ethical approval and informed consent from the patients...
December 9, 2016: Urology
https://www.readbyqxmd.com/read/27942002/the-impact-of-adding-a-physician-assistant-to-a-critical-care-outreach-team
#16
Hayley B Gershengorn, Yunchao Xu, Carri W Chan, Mor Armony, Michelle N Gong
RATIONALE: Hospitals are increasingly using critical care outreach teams (CCOTs) to respond to patients deteriorating outside intensive care units (ICUs). CCOT staffing is variable across hospitals and optimal team composition is unknown. OBJECTIVES: To assess whether adding a critical care medicine trained physician assistant (CCM-PA) to a critical care outreach team (CCOT) impacts clinical and process outcomes. METHODS: We performed a retrospective study of two cohorts-one with a CCM-PA added to the CCOT (intervention hospital) and one with no staffing change (control hospital)-at two facilities in the same system...
2016: PloS One
https://www.readbyqxmd.com/read/27941470/simbu-ptosis-an-outreach-approach-to-myogenic-ptosis-in-eastern-highlands-of-papua-new-guinea-experience-and-results-from-a-high-volume-oculoplastic-surgical-camp
#17
Anna G Gushchin, Alison V Crum, Ben B Limbu, Edward P Quigley, Michael S Seward, Geoffrey C Tabin
PURPOSE: To present the results of a high-volume oculoplastic surgical outreach in a remote region of Simbu Province in the Eastern Highlands of Papua New Guinea. The authors describe the clinical features and evaluation and treatment of a novel ptosis syndrome found in this area. DESIGN: A team of 4 international ophthalmologists and 3 local doctors and 3 local nurses involved in a high-volume field intervention for all patients presenting with a bilateral ptosis to Mingende Rural Hospital...
December 9, 2016: Ophthalmic Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27927790/integrating-lean-exploration-loops-into-healthcare-facility-design-programming-phase
#18
Lukasz M Mazur, Kendra Johnson, Pegah Pooya, Janet Chadwick, John McCreery
PURPOSE: To explore what, when, and how Lean methods and tools can add value during the programming phase of design through providing additional resources and support to project leadership and the architectural design team. BACKGROUND: This case study-based research took place at one large academic hospital during design efforts of a surgical tower to house 19 operating rooms (ORs) and support spaces including pre- and postop, central processing and distribution, and materials management...
December 7, 2016: HERD
https://www.readbyqxmd.com/read/27915317/initiating-retinopathy-of-prematurity-screening-before-discharge-from-the-neonatal-care-unit-effect-on-enrolment-in-rural-india
#19
Anand Vinekar, Chaitra Jayadev, Shwetha Mangalesh, Mathew Kurian, Mangat Dogra, Noel Bauer, Bhujang Shetty
OBJECTIVE: To compare the benefits of initiating Retinopathy of Prematurity (ROP) screening at first contact with the admitted infant prior to hospital discharge ('early screening') with screening performed between 21 and 28 days after birth ('conventional screening') in rural India. DESIGN: Prospective study. SETTING: Two Level II neonatal intensive care units (NICU), from two district headquarters in Karnataka state. PARTICIPANTS: Participants: 329 infants admitted in the two NICUs...
November 7, 2016: Indian Pediatrics
https://www.readbyqxmd.com/read/27906760/improving-the-quality-of-ward-based-surgical-care-with-a-human-factors-intervention-bundle
#20
Maximilian J Johnston, Sonal Arora, Dominic King, Ara Darzi
OBJECTIVE: This study aimed to explore the impact of a human factors intervention bundle on the quality of ward-based surgical care in a UK hospital. SUMMARY OF BACKGROUND DATA: Improving the culture of a surgical team is a difficult task. Engagement with stakeholders before intervention is key. Studies have shown that appropriate supervision can enhance surgical ward safety. METHODS: A pre-post intervention study was conducted. The intervention bundle consisted of twice-daily attending ward rounds, a "chief resident of the week" available at all times on the ward, an escalation of care protocol and team contact cards...
November 30, 2016: Annals of Surgery
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