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https://www.readbyqxmd.com/read/27906760/improving-the-quality-of-ward-based-surgical-care-with-a-human-factors-intervention-bundle
#1
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
https://www.readbyqxmd.com/read/27895678/prostate-brachytherapy-in-ghana-our-initial-experience
#2
James Edward Mensah, Joel Yarney, Verna Vanderpuye, Evans Akpakli, Samuel Tagoe, Evans Sasu
PURPOSE: This study presents the experience of a brachytherapy team in Ghana with a focus on technology transfer and outcome. The team was initially proctored by experienced physicians from Europe and South Africa. MATERIAL AND METHODS: A total of 90 consecutive patients underwent either brachytherapy alone or brachytherapy in combination with external beam radiotherapy for prostate carcinoma between July 2008 and February 2014 at Korle Bu Teaching Hospital, Accra, Ghana...
October 2016: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/27891574/termination-of-pre-hospital-resuscitation-by-anaesthesiologists-causes-and-consequences-a-retrospective-study
#3
S Mikkelsen, H M Lossius, L G Binderup, C Schaffalitzky de Muckadell, P Toft, A T Lassen
AIM: Differentiating between a newly deceased patient and the lifeless patient in whom immediate resuscitation is required may be facilitated by a pre-hospital anaesthesiologist. The purpose of our study was to investigate to what extent and why the pre-hospital anaesthesiologist pronounced life extinct in situations where an emergency medical technician (EMT) would have been required to resuscitate. METHODS: All lifeless patients seen pre-hospitally by the anaesthesiologist-manned Mobile Emergency Care Unit in Odense, Denmark, from 2010 to 2014 were retrospectively studied...
November 27, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27890713/allogeneic-human-mesenchymal-stem-cells-in-patients-with-idiopathic-pulmonary-fibrosis-via-intravenous-delivery-aether-a-phase-i-safety-clinical-trial
#4
Marilyn K Glassberg, Julia Minkiewicz, Rebecca L Toonkel, Emmanuelle S Simonet, Gustavo A Rubio, Darcy Difede, Shirin Shafazand, Aisha Khan, Marietsy V Pujol, Vincent F LaRussa, Lisa H Lancaster, Glenn D Rosen, Joel Fishman, Yolanda N Mageto, Adam Mendizabal, Joshua M Hare
BACKGROUND: Despite recent FDA approval of two new drugs for idiopathic pulmonary fibrosis (IPF), curative therapies remain elusive and mortality remains high. Pre-clinical and clinical data support the safety of human mesenchymal stem cells as a potential novel therapy for this fatal condition. The AETHER trial was the first study designed to evaluate the safety of a single infusion of bone marrow-derived mesenchymal stem cells in patients with idiopathic pulmonary fibrosis. METHODS: Nine patients with mild to moderate IPF were sequentially assigned to one of three cohorts and dosed with a single intravenous infusion of 20, 100, or 200 x 10(6) human bone marrow-derived mesenchymal stem cells per infusion from young, unrelated, male donors...
November 24, 2016: Chest
https://www.readbyqxmd.com/read/27888199/risk-factors-for-decreased-cardiac-output-after-coronary-artery-bypass-grafting-a-prospective-cohort-study
#5
Eduarda Ribeiro Dos Santos, Camila Takao Lopes, Vera Lucia Regina Maria, Alba Lucia Bottura Leite de Barros
BACKGROUND: No previous study has investigated the predictive risk factors of the nursing diagnosis of risk for decreased cardiac output after coronary artery bypass grafting (CABG). AIMS: This study aimed to identify the predictive risk factors of the nursing diagnosis of risk for decreased cardiac output after CABG. METHODS: This was a prospective cohort study performed at a cardiac university hospital in São Paulo, Brazil and 257 adult patients undergoing CABG were included...
November 25, 2016: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/27887578/evaluation-of-an-international-educational-programme-for-health-care-professionals-on-best-practice-in-the-management-of-a-perinatal-death-improving-perinatal-mortality-review-and-outcomes-via-education-improve
#6
Paul A Gardiner, Alison L Kent, Viviana Rodriguez, Aleena M Wojcieszek, David Ellwood, Adrienne Gordon, Patricia A Wilson, Diana M Bond, Adrian Charles, Susan Arbuckle, Glenn J Gardener, Jeremy J Oats, Jan Jaap Erwich, Fleurisca J Korteweg, T H Nguyen Duc, Susannah Hopkins Leisher, Kamal Kishore, Robert M Silver, Alexander E Heazell, Claire Storey, Vicki Flenady
BACKGROUND: Stillbirths and neonatal deaths are devastating events for both parents and clinicians and are global public health concerns. Careful clinical management after these deaths is required, including appropriate investigation and assessment to determine cause (s) to prevent future losses, and to improve bereavement care for families. An educational programme for health care professionals working in maternal and child health has been designed to address these needs according to the Perinatal Society of Australia and New Zealand Guideline for Perinatal Mortality: IMproving Perinatal mortality Review and Outcomes Via Education (IMPROVE)...
November 25, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27885679/clinical-auditing-as-an-instrument-for-quality-improvement-in-breast-cancer-care-in-the-netherlands-the-national-nabon-breast-cancer-audit
#7
Annelotte C M van Bommel, Pauline E R Spronk, Marie-Jeanne T F D Vrancken Peeters, Agnes Jager, Marc Lobbes, John H Maduro, Marc A M Mureau, Kay Schreuder, Carolien H Smorenburg, Janneke Verloop, Pieter J Westenend, Michel W J M Wouters, Sabine Siesling, Vivianne C G Tjan-Heijnen, Thijs van Dalen
BACKGROUND: In 2011, the NABON Breast Cancer Audit (NBCA) was instituted as a nation-wide audit to address quality of breast cancer care and guideline adherence in the Netherlands. The development of the NBCA and the results of 4 years of auditing are described. METHODS: Clinical and pathological characteristics of patients diagnosed with invasive breast cancer or in situ carcinoma (DCIS) and information regarding diagnosis and treatment are collected in all hospitals (n = 92) in the Netherlands...
November 25, 2016: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27878507/the-scope-and-value-of-an-anticoagulation-stewardship-program-at-a-community-teaching-hospital
#8
Maura K Wychowski, Christina I Ruscio, Peter A Kouides, Ronald L Sham
To report the impact of an inpatient anticoagulation stewardship program at a community hospital to promote optimal anticoagulant use. The anticoagulation team (ACT) stewardship program consists of two clinical pharmacists and hematologists to provide oversight of anticoagulants, high cost reversal agents including prothrombin complex concentrate (PCC, Kcentra™), and heparin-induced thrombocytopenia (HIT) management. Intervention data and number of charts reviewed were collected. Average cost avoidance data was applied to ACT interventions to estimate cost savings...
November 22, 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27875857/retrospective-review-of-prothrombinex-use-by-saas-medstar
#9
Roy Fischer, Simon Brettig, Andrew Pearce
OBJECTIVE: The aim of this study was to review and describe the use of Prothrombinex by a physician-led retrieval service based remote from a hospital blood bank. METHODS: This is a retrospective observational study. Patients to whom Prothrombinex was administered by the retrieval team were identified from the retrieval service patient database. The paper case cards of the identified patients were then manually reviewed and the data matched to patients in the state-wide electronic laboratory record...
November 22, 2016: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/27874995/changes-in-self-efficacy-collective-efficacy-and-patient-outcome-following-interprofessional-simulation-training-on-postpartum-haemorrhage
#10
Signe Egenberg, Pål Øian, Torbjørn Moe Eggebø, Mirjana Grujic Arsenovic, Lars Edvin Bru
AIMS AND OBJECTIVES: To examine whether interprofessional simulation training on management of postpartum haemorrhage enhances self-efficacy and collective efficacy and reduces the blood transfusion rate after birth. BACKGROUND: Postpartum haemorrhage is a leading cause of maternal morbidity and mortality worldwide, although it is preventable in most cases. Interprofessional simulation training might help improve the competence of health professionals dealing with postpartum haemorrhage, and more information is needed to determine its potential...
November 22, 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27846837/prevalence-aetiology-treatment-and-outcomes-of-shock-in-children-admitted-to-kenyan-hospitals
#11
George Mbevi, Philip Ayieko, Grace Irimu, Samuel Akech, Mike English
BACKGROUND: Shock may complicate several acute childhood illnesses in hospitals within low-income countries and has a high case fatality. Hypovolemic shock secondary to diarrhoea/dehydration and septic shock are thought to be common, but there are few reliable data on prevalence or treatment that differ for the two major forms of shock. Examining prevalence and treatment practices has become important since reports suggest high risks from liberal use of fluid boluses in African children...
November 16, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27827002/nursing-students-experience-of-practice-placements
#12
Kathleen MacDonald, Kirstie Paterson, Jessica Wallar
Clinical practice placements are an essential component of pre-registration nursing programmes. Integration into a new team in an unfamiliar setting, which has its own values, practices, culture and language, can be stressful for nursing students. This article presents and discusses students' reflections on preparing for, entering and leaving practice placements. Ten students who participated in fortnightly group reflective sessions, discussed and analysed their learning experiences while on practice placements in an acute hospital...
November 2, 2016: Nursing Standard
https://www.readbyqxmd.com/read/27826766/implementation-of-the-vocera-communication-system-in-a-quaternary-perioperative-environment
#13
Tynan H Friend, Samantha J Jennings, Martin S Copenhaver, Wilton C Levine
In the hospital, fast and efficient communication among clinicians and other employees is paramount to ensure optimal patient care, workflow efficiency, patient safety and patient comfort. The implementation of the wireless Vocera® Badge, a hands-free wearable device distributed to perioperative team members, has increased communication efficiency across the perioperative environment at Massachusetts General Hospital (MGH). This quality improvement project, based upon identical pre- and post-implementation surveys, used qualitative and quantitative analysis to determine if and how the Vocera system affected the timeliness of information flow, ease of communication, and operating room noise levels throughout the perioperative environment...
January 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/27815753/pediatric-ethics-and-communication-excellence-peace-rounds-decreasing-moral-distress-and-patient-length-of-stay-in-the-picu
#14
Lucia Wocial, Veda Ackerman, Brian Leland, Brian Benneyworth, Vinit Patel, Yan Tong, Mara Nitu
This paper describes a practice innovation: the addition of formal weekly discussions of patients with prolonged PICU stay to reduce healthcare providers' moral distress and decrease length of stay for patients with life-threatening illnesses. We evaluated the innovation using a pre/post intervention design measuring provider moral distress and comparing patient outcomes using retrospective historical controls. Physicians and nurses on staff in our pediatric intensive care unit in a quaternary care children's hospital participated in the evaluation...
November 4, 2016: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/27811176/a-standardized-neurointerventional-thrombectomy-protocol-leads-to-faster-recanalization-times
#15
Donald Frei, Constance McGraw, Kathryn McCarthy, Michelle Whaley, Richard J Bellon, David Loy, Jeff Wagner, Alessandro Orlando, David Bar-Or
BACKGROUND AND PURPOSE: Intra-arterial therapy (IAT) is most effective when performed rapidly after ischemic stroke onset. However, there are limited performance benchmarks in IAT and there is a scarcity of information on how to structure an effective IAT protocol and its impact on time to treatment. The objective of our study was to detail a standardized IAT protocol, and to assess its influence on time to treatment in ischemic stroke. METHODS: This was a retrospective observational study over 4 years at a comprehensive stroke center...
November 3, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27810131/the-impact-of-major-trauma-network-triage-systems-on-patients-with-major-burns
#16
Metin Nizamoglu, Edmund Fitzgerald O'Connor, Sarah Bache, Evgenia Theodorakopoulou, Sankhya Sen, Peter Sherren, David Barnes, Peter Dziewulski
INTRODUCTION: Trauma is a leading cause of death and disability worldwide. Patients presenting with severe trauma and burns benefit from specifically trained multidisciplinary teams. Regional trauma systems have shown improved outcomes for trauma patients. The aim of this study is to determine whether the development of major trauma systems have improved the management of patients with major burns. METHODS: A retrospective study was performed over a four-year period reviewing all major burns in adults and children received at a regional burns centre in the UK before and after the implementation of the regional trauma systems and major trauma centres (MTC)...
October 31, 2016: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/27799448/use-of-telehealth-to-treat-and-manage-chronic-viral-hepatitis-in-regional-queensland
#17
Kandice Keogh, Paul Clark, Patricia C Valery, Steven M McPhail, Candise Bradshaw, Melany Day, Anthony C Smith
For regional and rural Queenslanders, chronic viral hepatitis treatment is a major unmet health need, with restricted access to specialists outside of tertiary, largely metropolitan hospitals. To increase treatment of chronic viral hepatitis in regional Queensland, a team-based telehealth model was expanded. This expansion embedded an initial nursing consultation prior to specialist telehealth consultation. We conducted a retrospective audit of the introduction and expansion of hepatology telehealth services...
December 2016: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/27785868/is-there-a-role-for-patients-and-their-relatives-in-escalating-clinical-deterioration-in-hospital-a-systematic-review
#18
REVIEW
Abigail K Albutt, Jane K O'Hara, Mark T Conner, Stephen J Fletcher, Rebecca J Lawton
BACKGROUND: Measures exist to improve early recognition of, and response to, deteriorating patients in hospital. However, deteriorating patients continue to go unrecognized. To address this, interventions have been developed that invite patients and relatives to escalate patient deterioration to a rapid response team (RRT). OBJECTIVE: To systematically review articles that describe these interventions and investigate their effectiveness at reducing preventable deterioration...
October 26, 2016: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/27777314/integrating-lean-exploration-loops-into-healthcare-facility-design-schematic-phase
#19
Kendra Johnson, Lukasz Mazur, Janet Chadwick, Pegah Pooya, Alison Amos, John McCreery
PURPOSE: To explore how Lean can add value during the schematic 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 surgical tower to house 19 operating rooms (ORs) and support spaces including pre- and post-op, central processing and distribution, and materials management. Surgical services project leadership asked for Lean practitioners' support during the design process...
October 24, 2016: HERD
https://www.readbyqxmd.com/read/27771192/-access-to-kidney-transplantation-s-waiting-list-setting-up-a-clinical-pathway
#20
Salvatore Citarda, Roula Galland, Jean-Michel Poux, Abdallah Guerraoui, Patrick Hallonet, Marie Lino-Daniel, Pascale Thivend, Agnès Caillette-Beaudoin
Early information about the kidney transplant is recommended to begin quickly the process of registration on the kidney transplantation waiting list, even for the patients not dialyzed at stage V of the renal insufficiency. It is a strategic choice for the patient care. From the arrival of all the patients in our center of dialysis, a systematic evaluation of the access to the kidney transplant waiting list is organized thanks to a clinical pathway. The impact of this new organization was estimated at 18 months with regard to the information about the kidney transplant transmitted to the patient, of the time required for the assessment of pre-kidney transplant evaluation, and of putting in contraindication...
October 19, 2016: Néphrologie & Thérapeutique
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