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https://www.readbyqxmd.com/read/29449317/it-takes-a-village-to-move-a-hospital-simulation-improves-intensive-care-team-preparedness-for-a-move-to-a-new-site
#1
Conall Francoeur, Sarah Shea, Margaret Ruddy, Patricia Fontela, Farhan Bhanji, Saleem Razack, Ronald Gottesman, Tanya Di Genova
OBJECTIVES: To evaluate in-situ simulation to prepare a PICU to move to a new, redesigned unit. METHODS: The study setting is an academic PICU. This is a cross-sectional study using in-situ simulations of common PICU admissions. Postsimulation, participants completed a survey comparing the perception of preparedness pre- and postsimulation (via a 10-point Likert scale). Participants were resurveyed 6 months postmove to assess whether effects persisted. Qualitative data were obtained via thematic review of the survey comment section and from postsimulation debriefing...
February 15, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29438856/the-surgical-management-of-dysphagia-secondary-to-diffuse-idiopathic-skeletal-hyperostosis
#2
Y C Lui Jonathan, P Sayal, G Prezerakos, V Russo, D Choi, A T H Casey
OBJECTIVE: This study reviews the management pathway and surgical outcomes of patients referred to and operated on at a tertiary neurosurgical centre, for dysphagia associated with anterolateral cervical hyperostosis (ACH) in diffuse idiopathic skeletal hyperostosis (DISH). PATIENTS & METHODS: Electronic patient records for 6 patients who had undergone anterior cervical osteophytectomy for dysphagia secondary to ACH were reviewed. ACH diagnosis was made by an Ear, Nose and Throat (ENT) specialist and patients were referred to a neurosurgical-led multidisciplinary team (MDT) for review...
February 7, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29432207/prevalence-of-comorbid-conditions-pre-existing-and-diagnosed-at-a-tertiary-care-pediatric-weight-management-clinic
#3
Griselle Leon, Elizabeth de Klerk, Josephine Ho, Michelle Jackman, Raylene A Reimer, Kimberly E Connors, Paola Luca
BACKGROUND: Childhood obesity places individuals at risk for a multitude of physical and mental health problems. The aim of this study was to assess the prevalence of obesity related comorbidities diagnosed prior to and after attending a tertiary care pediatric weight management clinic. METHODS: A cross sectional retrospective chart review of patients 2-17 years old seen in the weight management clinic at Alberta Children's Hospital from May 2012 to May 2014. RESULTS: A total of 199 patients were included in the review...
February 13, 2018: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/29415717/implementing-large-scale-fast-track-diagnostics-in-a-comprehensive-cancer-center-pre-and-post-measurement-data
#4
W H van Harten, N Goedbloed, A H Boekhout, S Heintzbergen
BACKGROUND: In general, patients with a cancer suspicion visit the hospital multiple times before diagnosis is completed. Using various "operations management" techniques a few fast track diagnostic services were implemented in the Netherlands Cancer Institute (NKI) in 2006. Growing patient numbers and increasing process complexity, led to diminished service levels. To decrease the amount of patient visits and to extend these services beyond the (obvious) breast cancer services, fast track diagnostics is now implemented for all 18 cancer types that present with a frequency of minimally one per week...
February 7, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29408777/streamlined-triage-and-transfer-protocols-improve-door-to-puncture-time-for-endovascular-thrombectomy-in-acute-ischemic-stroke
#5
Akash P Kansagra, Adam N Wallace, David R Curfman, James D McEachern, Christopher J Moran, DeWitte T Cross, Jin-Moo Lee, Andria L Ford, S Goyal Manu, Peter D Panagos, Colin P Derdeyn
OBJECTIVE: Shorter time from symptom onset to treatment is associated with improved outcomes in patients who undergo mechanical thrombectomy for treatment of acute ischemic stroke due to emergent large vessel occlusion. In this work, we detail pre-thrombectomy process improvements in a multi-hospital network and report the effect on door-to-puncture time in patients undergoing mechanical thrombectomy. PATIENTS AND METHODS: A streamlined workflow was adopted to minimize door-to-puncture time...
January 30, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29406182/guidelines-for-the-management-of-tracheal-intubation-in-critically-ill-adults
#6
A Higgs, B A McGrath, C Goddard, J Rangasami, G Suntharalingam, R Gale, T M Cook
These guidelines describe a comprehensive strategy to optimize oxygenation, airway management, and tracheal intubation in critically ill patients, in all hospital locations. They are a direct response to the 4 th National Audit Project of the Royal College of Anaesthetists and Difficult Airway Society, which highlighted deficient management of these extremely vulnerable patients leading to major complications and avoidable deaths. They are founded on robust evidence where available, supplemented by expert consensus opinion where it is not...
February 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29397270/device-related-pressure-ulcers-pre-and-post-identification-and-intervention
#7
Pamela Clay, Casey Cruz, Keith Ayotte, Jeremy Jones, Susan B Fowler
PROBLEM: From 2014 to 2016, device related pressure injuries accounted for 62-81% of all hospital acquired pressure injuries. From January to June 2014, there were 5 BiPAP/CPAP pressure injuries noted, accounting for 3.579 injuries per 1000 ventilator days. In 2015, hospital data revealed that 26.5% of all hospital acquired pressure injuries occurred to prone surgical spine patients. METHODS: Collaborative teams including respiratory therapists and operating room staff were convened and crafted new strategies...
January 31, 2018: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/29391379/training-approaches-for-the-deployment-of-a-mechanical-chest-compression-device-a-randomised-controlled-manikin-study
#8
Keith Couper, Rochelle M Velho, Tom Quinn, Anne Devrell, Ranjit Lall, Barry Orriss, Joyce Yeung, Gavin D Perkins
OBJECTIVES: To evaluate the effect of training strategy on team deployment of a mechanical chest compression device. DESIGN: Randomised controlled manikin trial. SETTING: Large teaching hospital in the UK. PARTICIPANTS: Twenty teams, each comprising three clinicians. Participating individuals were health professionals with intermediate or advanced resuscitation training. INTERVENTIONS: Teams were randomised in a 1:1 ratio to receive either standard mechanical chest compression device training or pit-crew device training...
February 1, 2018: BMJ Open
https://www.readbyqxmd.com/read/29389459/-who-s-covering-this-patient-developing-a-first-contact-provider-fcp-designation-in-an-electronic-health-record
#9
Anisha Chandiramani, Janet Gervasio, Michelle Johnson, Jessica Kolek, Steven Zibrat, Dana Edelson
BACKGROUND: Safe and efficient inpatient care depends on accurate identification of the licensed independent practitioner (LIP) primarily responsible for each admitted patient. The inability to do so has far-reaching consequences, including poor communication among care teams, delays in patient care (including critical result reporting), and significant threats to patient safety. METHODS: At the University of Chicago Medical Center, an 800-bed academic hospital, a new Epic feature, called First-Contact Provider (FCP), was developed to identify the responsible LIP for each inpatient...
February 2018: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/29382251/setting-up-a-clinical-trial-for-a-novel-disease-a-case-study-of-the-doxycycline-for-the-treatment-of-nodding-syndrome-trial%C3%A2-%C3%A2-challenges-enablers-and-lessons-learned
#10
Ronald Anguzu, Pamela R Akun, Rodney Ogwang, Abdul Rahman Shour, Rogers Sekibira, Albert Ningwa, Phellister Nakamya, Catherine Abbo, Amos D Mwaka, Bernard Opar, Richard Idro
A large amount of preparation goes into setting up trials. Different challenges and lessons are experienced. Our trial, testing a treatment for nodding syndrome, an acquired neurological disorder of unknown cause affecting thousands of children in Eastern Africa, provides a unique case study. As part of a study to determine the aetiology, understand pathogenesis and develop specific treatment, we set up a clinical trial in a remote district hospital in Uganda. This paper describes our experiences and documents supportive structures (enablers), challenges faced and lessons learned during set-up of the trial...
2018: Global Health Action
https://www.readbyqxmd.com/read/29370895/pelvic-and-lower-extremity-immobilization-for-cloacal-exstrophy-bladder-and-abdominal-closure-in-neonates-and-older-children
#11
Karl S Benz, John Jayman, Mahir Maruf, Timothy Baumgartner, Matthew C Kasprenski, Daniel A Friedlander, Heather N Di Carlo, Paul D Sponseller, John P Gearhart
INTRODUCTION: Successful bladder closure in cloacal exstrophy (CE) is best accomplished through a multidisciplinary team and attention to pre- and postoperative technique. This study from a high volume exstrophy center investigates outcomes and complications of primary and reoperative bladder closures in patients immobilized with spica cast or patients with external fixation (EF) and skin traction. METHODS: The authors reviewed an institutionally approved and daily updated database of 1311 patients with exstrophy-epispadias complex and identified patients with cloacal exstrophy born between 1975 and 2015 who had undergone primary or reoperative bladder closures...
December 27, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29367917/update-on-open-reduction-and-internal-fixation-of-unstable-pelvic-fractures-during-pregnancy-case-reports
#12
Carlos Roberto Schwartsmann, Carlos Alberto de Souza Macedo, Carlos Roberto Galia, Ricardo Horta Miranda, Leandro de Freitas Spinelli, Marco Tonding Ferreira
This article aims to report four cases of unstable pelvic fractures in pregnant women treated by open reduction and internal fixation. Cases report: The study included four cases of pregnant women with unstable pelvic fractures; their outcomes were analyzed and discussed. Data were obtained from two University Hospitals. The mean age of women was 23 years; most (3/4) were primiparous, with a mean pregnancy age of 23 weeks. Two women had Malgaigne-type fractures and the other two had symphyseal disjunction associated with acetabular fractures...
January 2018: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/29366668/the-influence-of-learning-environment-on-trainee-pharmacy-technicians-education-and-training-experiences
#13
Ellen I Schafheutle, Samuel D Jee, Sarah C Willis
BACKGROUND: In Great Britain (GB), pharmacy technicians (PTs) are registered professionals, with their education and training regulated; little is known about this or the learning environment in which it takes place. OBJECTIVES: This study aimed to profile recently registered pre-registration trainee pharmacy technicians (PTPTs) in GB and capture views on PTPTs' training experiences, focussing on differences in community and hospital settings. METHODS: A mixed methods study was conducted in 2013-14, following university ethics approval...
December 16, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29361098/patient-decision-making-about-emergency-and-planned-stoma-surgery-for-ibd-a-qualitative-exploration-of-patient-and-clinician-perspectives
#14
Lesley Dibley, Wladyslawa Czuber-Dochan, Tiffany Wade, Julie Duncan, Jennie Burch, Janindra Warusavitarne, Christine Norton, Micol Artom, Liam O'Sullivan, Azmina Verjee, Denise Cann
Background: Many inflammatory bowel disease (IBD) patients worry about stoma-forming surgery (SFS), sometimes enduring poor bowel-related quality of life to avoid it. Anticipation of SFS and whether expectations match experience is underreported. This qualitative study explored influences on patients' SFS decision-making and compared preoperative concerns with postoperative outcomes. Methods: We purposively recruited participants with IBD from UK hospital outpatient and community sources, and IBD clinicians from public hospitals...
January 18, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29344355/impact-of-an-antifungal-stewardship-intervention-on-optimization-of-candidemia-management
#15
Hana Rac, Jamie L Wagner, S Travis King, Katie E Barber, Kayla R Stover
Background: Candidemia represents a leading cause of healthcare-associated bloodstream infections with significant morbidity and mortality. Previous studies have demonstrated that comprehensive care bundles improve candidemia management but are time-consuming. Objective: To determine the impact of a one-time targeted candidemia intervention on time to initiation of adequate therapy compared to standard of care. Methods: This Institutional Review Board (IRB)-approved, quasi-experiment evaluated a targeted candidemia intervention involving a single phone call to the primary team providing recommendations for care...
January 2018: Therapeutic Advances in Infectious Disease
https://www.readbyqxmd.com/read/29338852/simulation-based-multidisciplinary-team-training-decreases-time-to-critical-operations-for-trauma-patients
#16
Margaret Murphy, Kate Curtis, Mary K Lam, Cameron S Palmer, Jeremy Hsu, Andrea McCloughen
BACKGROUND: Simulation has been promoted as a platform for training trauma teams. However, it is not clear if this training has an impact on health service delivery and patient outcomes. This study evaluates the association between implementation of a simulation based multidisciplinary trauma team training program at a metropolitan trauma centre and subsequent patient outcomes. METHOD: This was a retrospective review of trauma registry data collected at an 850-bed Level 1 Adult Trauma Centre in Sydney, Australia...
January 8, 2018: Injury
https://www.readbyqxmd.com/read/29330982/assessment-of-safety-levels-in-operation-rooms-at-two-major-tertiary-care-public-hospitals-of-karachi-safe-surgery-saves-life
#17
Muhammad Saeed Minhas, Muhammad Muzzammil, Jahanzeb Effendi
BACKGROUND: The objectives of this study are to determine the knowledge and attitude towards surgical safety among the health care professionals including surgeons, anaesthetist, hospital administrators, and operation room personnel and raise awareness towards the importance of safe surgery. METHODS: A pilot cross- sectional study of 543 healthcare providers working in the operating rooms and the surgical intensive care units was conducted in two tertiary care hospitals, within a study period of one month...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29325555/the-readiness-of-hospital-pharmacists-in-kuwait-to-practise-evidence-based-medicine-a-cross-sectional-study
#18
Ali Jasem Buabbas, Fatemah Mohammad Alsaleh, Hamza Mohamad Al-Shawaf, Ali Abdullah, Abdullah Almajran
BACKGROUND: The evolving role of pharmacists in providing pharmaceutical care, as part of the healthcare team, challenges them to acquire up-to-date knowledge of medicines to make the best clinical decisions. The volume of medical literature is on the increase, and it is important to utilise these resources to optimise patients' therapeutic outcomes. This study aimed at assessing the readiness of government hospital pharmacists in practising evidence-based medicine (EBM) in Kuwait in regards to their attitude, knowledge and skills, as well as the perceived barriers and facilitators...
January 11, 2018: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29325527/single-center-experience-with-laparoscopic-adrenalectomy-on-a-large-clinical-series
#19
Giovanni Conzo, Claudio Gambardella, Giancarlo Candela, Alessandro Sanguinetti, Andrea Polistena, Guglielmo Clarizia, Renato Patrone, Francesco Di Capua, Chiara Offi, Mario Musella, Sergio Iorio, Giseppe Bellastella, Daniela Pasquali, Annamaria De Bellis, Antonio Sinisi, Nicola Avenia
BACKGROUND: Laparoscopic adrenalectomy is considered the gold standard technique for the treatment of benign small and medium size adrenal masses (<6 cm), due to low morbidity rate, short hospitalization and patient rapid recovery. The aim of our study is to analyse the feasibility and efficiency of this surgical approach in a broad spectrum of adrenal gland pathologies. METHODS: Pre-operative, intra-operative and post-operative data from 126 patients undergone laparoscopic adrenalectomy between January 2003 and December 2015 were retrospectively collected and reviewed...
January 11, 2018: BMC Surgery
https://www.readbyqxmd.com/read/29323832/influences-of-a-church-based-intervention-on-falls-risk-among-seniors
#20
Morgan Briggs, Jeffrey A Morzinski, Julie Ellis
BACKGROUND AND OBJECTIVES: Prior studies illustrate that community-based programs effectively decrease falls risk in older adults and that faith-based programs improve health behaviors. The literature is unclear whether faith-based initiatives reduce seniors' fall risks. To tackle this gap, a long-term partnership led by 10 urban churches, a nearby nursing school, and a medical school developed a study with 3 objectives: determine baseline health concerns associated with falls (eg, depression, polypharmacy), implement a nurse-led, faith-based health education initiative for community-dwelling African American seniors at-risk of hospitalization, and assess pre- to post -program fall frequency...
August 2017: WMJ: Official Publication of the State Medical Society of Wisconsin
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