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https://www.readbyqxmd.com/read/28226033/effectiveness-of-pharmacovigilance-multifaceted-educational-intervention-related-to-the-knowledge-skills-and-attitudes-of-multidisciplinary-hospital-staff
#1
Fabiana Rossi Varallo, Cleopatra S Planeta, Patricia de Carvalho Mastroianni
OBJECTIVES: Most educational interventions in pharmacovigilance are designed to encourage physicians to report adverse drug reactions. However, multidisciplinary teams may play an important role in reporting drug-related problems. This study assessed the impact of a multifaceted educational intervention in pharmacovigilance on the knowledge, skills and attitudes of hospital professionals. METHOD: This prospective, open-label, non-randomized study was performed in a medium-complexity hospital in São Paulo, Brazil...
January 1, 2017: Clinics
https://www.readbyqxmd.com/read/28224346/dedication-increases-productivity-an-analysis-of-the-implementation-of-a-dedicated-medical-team-in-the-emergency-department
#2
Pedro Ramos, José Artur Paiva
BACKGROUND: In several European countries, emergency departments (EDs) now employ a dedicated team of full-time emergency medicine (EM) physicians, with a distinct leadership and bed-side emergency training, in all similar to other hospital departments. In Portugal, however, there are still two very different models for staffing EDs: a classic model, where EDs are mostly staffed with young inexperienced physicians from different medical departments who take turns in the ED in 12-h shifts and a dedicated model, recently implemented in some hospitals, where the ED is staffed by a team of doctors with specific medical competencies in emergency medicine that work full-time in the ED...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28215135/rapid-response-team-diagnoses-frequencies-and-related-hospital-mortality
#3
Roger J Smith, John D Santamaria, Espedito E Faraone, Jennifer A Holmes, David A Reid
OBJECTIVES: To describe the frequency and hospital mortality of problems (diagnoses) encountered by a rapid response team (RRT), and to identify the most common diagnoses for RRT triggers and for treating units. DESIGN: For each RRT event in 2015 at a tertiary hospital for adults, we chose the diagnosis that best explained the RRT event from a pre-defined list after reviewing relevant test results and clinical notes. RESULTS: There were 937 RRT events during 700 admissions and there were 58 different RRT diagnoses in 11 diagnosis groups...
March 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28215132/physiological-antecedents-and-ward-clinician-responses-before-medical-emergency-team-activation
#4
Stephanie K Sprogis, Judy Currey, Julie Considine, Ian Baldwin, Daryl Jones
OBJECTIVES: To investigate the frequency, characteristics and timing of objectively measured clinical instability in adult ward patients in the 24 hours preceding activation of the medical emergency team (MET). We also examined ward clinician responses to documented clinical instability. DESIGN, SETTING AND PARTICIPANTS: A descriptive, exploratory design with a retrospective medical record audit. We descriptively analysed data from 200 ward patients reviewed by the MET at a tertiary teaching hospital in Melbourne, Australia, during 2014...
March 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28205213/haemodynamic-changes-to-a-midazolam-fentanyl-rocuronium-protocol-for-pre-hospital-anaesthesia-following-return-of-spontaneous-circulation-after-cardiac-arrest
#5
M Miller, C Groombridge, R Lyon
Following the return of spontaneous circulation after out-of-hospital cardiac arrest, neurological dysfunction, airway or ventilatory compromise can impede transport to early percutaneous coronary intervention, necessitating pre-hospital or emergency department anaesthesia to facilitate this procedure. There are no published reports of the ideal induction agents in these patients. We sought to describe haemodynamic changes associated with induction of anaesthesia using a midazolam (0.1 mg.kg(-1) ), fentanyl (2 μg...
February 15, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28198956/evaluating-pharmaceutical-waste-disposal-in-pediatric-units
#6
Maria Angélica Randoli de Almeida, Ana Maria Miranda Martins Wilson, Maria Angélica Sorgini Peterlini
OBJECTIVE: To verify the disposal of pharmaceutical waste performed in pediatric units. METHOD: A descriptive and observational study conducted in a university hospital. The convenience sample consisted of pharmaceuticals discarded during the study period. Handling and disposal during preparation and administration were observed. Data collection took place at pre-established times and was performed using a pre-validated instrument. RESULTS: 356 drugs disposals were identified (35...
November 2016: Revista da Escola de Enfermagem da U S P
https://www.readbyqxmd.com/read/28193242/process-evaluation-of-a-cluster-randomised-trial-testing-a-pressure-ulcer-prevention-care-bundle-a-mixed-methods-study
#7
Shelley Roberts, Elizabeth McInnes, Tracey Bucknall, Marianne Wallis, Merrilyn Banks, Wendy Chaboyer
BACKGROUND: As pressure ulcers contribute to significant patient burden and increased health care costs, their prevention is a clinical priority. Our team developed and tested a complex intervention, a pressure ulcer prevention care bundle promoting patient participation in care, in a cluster-randomised trial. The UK Medical Research Council recommends process evaluation of complex interventions to provide insight into why they work or fail and how they might be improved. This study aimed to evaluate processes underpinning implementation of the intervention and explore end-users' perceptions of it, in order to give a deeper understanding of its effects...
February 13, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28193125/preparation-for-practice-a-novel-role-for-general-practice-in-pre-foundation-assistantships
#8
Peter S J Ryan, Gerard J Gormley, Nigel D Hart
BACKGROUND: Hospital-based undergraduate assistantships are now widely established in medical school curricula. They are considered to improve graduates' preparedness for practice in their role as a foundation doctor. Foundation doctors play a key team role in ensuring patient safety during complex transitions across the hospital/primary care interface, and their self-reported preparedness for practice still varies considerably. AIMS: We sought to explore what spending one week of the pre-foundation assistantship in General Practice might add...
February 13, 2017: Education for Primary Care
https://www.readbyqxmd.com/read/28191792/laparoscopic-management-of-recurrent-ureteropelvic-junction-obstruction-following-pyeloplasty-a-single-surgical-team-experience-with-38-cases
#9
Francesco Chiancone, Maurizio Fedelini, Luigi Pucci, Clemente Meccariello, Paolo Fedelini
PURPOSE: To describe and analyze our experience with Anderson-Hynes transperitoneal laparoscopic pyeloplasty (LP) in the treatment of recurrent ureteropelvic junction obstruction (UPJO). MATERIALS AND METHODS: 38 consecutive patients who underwent transperitoneal laparoscopic redo-pyeloplasty between January 2007 and January 2015 at our department were included in the analysis. 36 patients were previously treated with dismembered pyeloplasty and 2 patients underwent a retrograde endopyelotomy...
January 27, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28184172/practically-prepared-pre-intern-student-views-following-an-education-package
#10
Susan McKenzie, Craig Mellis
BACKGROUND: Graduating medical students enter their internship with varied levels of practical experience in procedural skills. To address this problem, many medical schools have introduced intensive skill training courses immediately prior to graduation. This study examines the impact of a pre-intern (PrInt) education package, consisting of a short intensive course, followed by a one-month clinical attachment. METHODS: In September 2014, all PrInt students (n = 53) at the Central Clinical School (Sydney, NSW, Australia) attended three days of intensive training...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28157808/improved-clinical-performance-and-teamwork-of-pediatric-interprofessional-resuscitation-teams-with-a-simulation-based-educational-intervention
#11
Elaine Gilfoyle, Deanna A Koot, John C Annear, Farhan Bhanji, Adam Cheng, Jonathan P Duff, Vincent J Grant, Cecilia E St George-Hyslop, Nicole J Delaloye, Afrothite Kotsakis, Carolyn D McCoy, Christa E Ramsay, Matthew J Weiss, Ronald D Gottesman
OBJECTIVES: To measure the effect of a 1-day team training course for pediatric interprofessional resuscitation team members on adherence to Pediatric Advanced Life Support guidelines, team efficiency, and teamwork in a simulated clinical environment. DESIGN: Multicenter prospective interventional study. SETTING: Four tertiary-care children's hospitals in Canada from June 2011 to January 2015. SUBJECTS: Interprofessional pediatric resuscitation teams including resident physicians, ICU nurse practitioners, registered nurses, and registered respiratory therapists (n = 300; 51 teams)...
February 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28156626/effect-of-a-communication-skills-intervention-on-resident-comfort-and-knowledge-of-discussing-goals-of-care-and-advance-care-planning
#12
Elizabeth Golding, Aaron Lampkin, Mary Walker Larach, Lawrence Klima
: 50 Background: Inpatient providers are sometimes challenged with advanced care planning for their patients. At a teaching hospital, resident physicians find themselves tasked with this responsibility for inpatients they may have only just met, as well as in their assigned outpatient panel. Education on communication skills though has been shown to improve resident comfort level and knowledge of discussing goals of care and advance care planning. METHODS: Internal medicine categorical residents (n = 15) and preliminary (n = 3) residents at a university-affiliated, community hospital learned the fundamentals of discussing goals of care and advance care planning using selected modules from the Center for Advancing Palliative Care's (CAPC) online curriculum in communication skills during their outpatient clinic rotation from February through June 2016...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156608/when-home-means-another-nation-the-power-and-pitfalls-of-repatriation-at-the-end-of-life-from-a-tertiary-cancer-centre
#13
(no author information available yet)
: 46 Background: How people die lives on in the memory of those who survive. It is therefore pivotal for palliative teams to help craft an ending in line with patient and family goals. It has been observed in a tertiary cancer centre that there is often a spiritual imperative for patients to return to their nation of birth, once treatment is stopped and mortality accepted. METHODS: Retrospective chart review of 3 patients repatriated for end of life care to their nation of birth (Romania, Portugal, Ireland), focusing on: the conversations about the goal of repatriation and its meaning to the patient; the practical barriers and enablers of repatriation of patients with advanced cancer...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152936/improving-transitions-of-care-through-implementation-of-a-standardized-handoff-at-a-comprehensive-cancer-center
#14
Mohamed Ait Aiss, Helene P Phu, Lakeisha R Day, Varkey Abraham, Karen Chen, Mejia Rodrigo, Shehla Razvi, Carmen E Gonzalez, Norman Brito-Dellan, Srinivas Banala, David Rubio, Nicole Vaughan-Adams, Debra S Ruiz, Tan Jens, Charles F Levenback, Michael M Frumovitz, Behrouz Zand, Carmelita P Escalante
: 242 Background: Communication failures cause two-thirds of sentinel events in hospitals. These adverse occurrences are often both fatal and preventable. Consequently, improving the quality of handoffs has been identified by multiple accreditation constituents as a top priority patient safety goal. This project was part of an institutional initiative to standardize handoffs among physicians, trainees, and midlevel providers. METHODS: Four subgroups were identified as pilot areas: Gynecologic Oncology (Gyn Onc) fellows to nocturnalists, Surgical Oncology fellows, Pediatric Oncology residents and fellows, and Emergency Center attending staff to inpatient hospitalists...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152832/estimating-the-cost-savings-of-a-comprehensive-hospital-based-palliative-care-program
#15
Chunhua Lu, John P McQuade, Thomas J Smith, A Rab Razzak
: 2 Background: In FY 2012, Johns Hopkins Medicine (JHM) established a palliative care inpatient unit (PCU). The PCU received patients as transfers and direct admissions. PCUs can improve care (Roza K, et al. JPM 2015) and lower per diem costs compared to usual care (Smith TJ, et al. JPM 2003; Goldstein J, et al. JPSM 2015). This project studied the financial impact of the PCU and PC program on JHM. METHODS: Using one fiscal year of admissions, the team calculated the per day variable cost of pre-transfer in to palliative care (from ED) and palliative care transfer...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152806/reducing-patient-wait-time-on-an-inpatient-hematology-and-transplant-unit
#16
Rory Joseph Makielski, Kurt Osterby, Mike Fallon, Nicole Domask, Vicki Hubbard, Eva Allen, Blythe Gage, Gail Hettrick, Jessica Fischer, Andrew Brown, Brianna Grahn, Brett Welhouse, Hannah Draayers, Mark Juckett, Jean Ligocki, Ruth O'Regan, Laurie Kaufman
: 87 Background: The University of Wisconsin Hematology and Bone Marrow Transplant services admit 250 patients per year for scheduled treatment. Time from patient arrival to chemotherapy initiation averages 7 hours. This long time leads to patient dissatisfaction and prolonged length of stay. Chemotherapy often begins in the evening when physicians and pharmacists are not on site to clarify treatment questions. METHODS: A multidisciplinary team was formed in April 2015 as part of the ASCO Quality Training Program...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152791/improving-venous-thromboembolism-vte-prophylaxis-for-hospitalized-malignant-hematology-bone-marrow-transplant-heme-bmt-patients
#17
John Dzundza, Archana Ajmera, Ashley Gustafson, Mimi Lo, Richard Fong, Larissa Graff, Bao Dao, Rebecca Young, Lloyd Earl Damon, Thomas G Martin, Rebecca Leah Olin
: 79 Background: Hospitalized patients on the heme/BMT service at our academic cancer center have historically not received pharmacologic VTE prophylaxis (VTEP) due to concerns regarding thrombocytopenia and bleeding risk. However, a retrospective review of heme/BMT admissions from 2009 to 2013 revealed that 59% of hospital-acquired VTE cases occurred at a platelet count > 50 x 10E9/L, suggesting missed opportunities for VTE prevention. METHODS: To implement VTEP on the heme/BMT service, a multidisciplinary quality improvement team developed a pilot intervention with 5 strategies: 1) identification of heme/BMT-specific contraindications to VTEP, 2) standardized use of VTEP for all heme/BMT patients unless contraindications are present, 3) hold parameter for platelet count < 50 x 10E9/L within the VTEP order, 4) note template to document VTEP plan, and 5) provider, nurse, pharmacist, and patient education...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152785/engaging-patients-with-their-self-reported-symptom-outcomes-trended-data
#18
Diane Denny, Carmon Greene, Morgan Hannaford, Maurie Markman
: 69 Background: Cancer Treatment Centers of America, Inc. (CTCA) is a national network of hospitals that specialize in the treatment of patients fighting complex or advanced-stage cancer. The Symptom Inventory Tool (SIT) is an assessment tool that captures the patients' perceived symptom burden for real-time clinical intervention. Patients take a baseline SIT assessment at new patient intake and are eligible to take the SIT every 21 days. The SIT is comprised of the M.D. Anderson Symptom Inventory tool, a validated assessment instrument, along with additional questions and a free text box that were created by CTCA...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152731/clinical-trial-enrollment-expansion-to-the-community
#19
Jessica A Zerillo, Andrea Kruse, Natalie Faye Sinclair, Maureen Patrick, Lauren McGovern, Frances Fuller, Kelly O'Neil, Nicole Hixon, Kristie Weeks, Bruce E Johnson, Ian E Krop, Jen Savoie, Farah Daftary, Michael Constantine, Mona S Kaddis, Humberto A Rossi, Naeem Tahir, Andrew David Norden
: 112 Background: Oncology patients at community cancer practices generally do not access clinical trials to the same degree as patients at academic medical centers. Collaborations between research and clinical teams across academic hospitals and their affiliated community sites may help to improve this disparity. METHODS: To improve clinical trial enrollment, a multidisciplinary team of research and clinical staff from the Dana-Farber Cancer Institute main campus and a community-based satellite site implemented a program to enhance identification of breast cancer patients eligible for clinical trials...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28149801/bupivacaine-application-reduces-post-thyroidectomy-pain-cerrahpasa-experience
#20
Serkan Teksoz, Akif Enes Arikan, Selen Soylu, Safak Emre Erbabacan, Murat Ozcan, Yusuf Bukey
BACKGROUND: We aimed to evaluate the impact of bupivacaine administration into the surgical field after total thyroidectomy on post-operative pain and analgesic requirement with a double-blind, prospective, clinical and randomized study. METHODS: The study was performed between 2010 and 2011. Pain assessment was performed with the visual analog score (VAS). Patients were pre-operatively, randomly divided into two groups to receive either bupivacaine or saline. One group received a 10-mL of bupivacaine solution while the other group was treated with the same volume of 0...
December 2016: Gland Surgery
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