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https://www.readbyqxmd.com/read/28422448/the-benefits-of-clinical-facilitators-on-improving-stroke-care-in-acute-hospitals-a-new-program-for-australia
#1
Tara Purvis, Karen Moss, Linda Francis, Karen Borschmann, Monique F Kilkenny, Sonia Denisenko, Christopher F Bladin, Dominique A Cadilhac
BACKGROUND: Care gaps for stroke lead to preventable disability and deaths. The Victorian State Government implemented a program of employing clinical Facilitators on a fixed-term basis for up to three years (2008-2011) in eight hospitals to improve stroke care. The Facilitators were to establish stroke units where absent, implement evidence-based management protocols and provide staff education within an agreed work plan. The aim of this study was to determine if the Facilitator role was associated with improved stroke care, and to describe factors supporting or mitigating enhancements to care...
April 19, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28420542/improving-prehospital-trauma-care-in-rwanda-through-continuous-quality-improvement-an-interrupted-time-series-analysis
#2
John W Scott, Jeanne D'Arc Nyinawankusi, Samuel Enumah, Rebecca Maine, Eric Uwitonze, Yihan Hu, Ignace Kabagema, Jean Claude Byiringiro, Robert Riviello, Sudha Jayaraman
INTRODUCTION: Injury is a major cause of premature death and disability in East Africa, and high-quality pre-hospital care is essential for optimal trauma outcomes. The Rwandan pre-hospital emergency care service (SAMU) uses an electronic database to evaluate and optimize pre-hospital care through a continuous quality improvement programme (CQIP), beginning March 2014. MATERIALS AND METHODS: The SAMU database was used to assess pre-hospital quality metrics including supplementary oxygen for hypoxia (O2), intravenous fluids for hypotension (IVF), cervical collar placement for head injuries (c-collar), and either splinting (splint) or administration of pain medications (pain) for long bone fractures...
April 5, 2017: Injury
https://www.readbyqxmd.com/read/28418101/effect-of-an-electronic-medication-administration-record-application-on-patient-safety
#3
Noelia Vicente Oliveros, Teresa Gramage Caro, Covadonga Pérez Menendez-Conde, Ana María Álvarez-Díaz, Sagrario Martín-Aragón Álvarez, Teresa Bermejo Vicedo, Eva Delgado Silveira
RATIONALE, AIMS, AND OBJECTIVES: To evaluate the effect of an electronic medication administration record (eMAR) application on the rate of medication errors in medication administration recording (ME-MAR). METHODS: A before-and-after, quasiexperimental study was conducted in a university hospital that implemented the eMAR application in March 2014. Data collection was conducted in April 2012 (pre-) and June 2014 (post-) by two pharmacists. The ME-MARs were analysed by the staff involved to identify their cause...
April 18, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28416852/-first-aid-system-for-trauma-development-and-status
#4
D K Chen, W C Lin, P Zhang, S J Kuang, W Huang, T B Wang
With the great progress of the economy, the level of industrialization has been increasing year by year, which leads to an increase in accidental trauma accidents. Chinese annual death of trauma is already more than 400 000, which makes trauma the fifth most common cause of death, following malignant tumor, heart, brain and respiratory diseases. Trauma is the leading cause of the death of young adults. At the same time, trauma has become a serious social problem in peace time. Trauma throws great treats on human health and life...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28414164/a-pre-hospital-extracorporeal-cardio-pulmonary-resuscitation-ecpr-strategy-for-treatment-of-refractory-out-hospital-cardiac-arrest-an-observational-study-and-propensity-analysis
#5
Lionel Lamhaut, Alice Hutin, Etienne Puymirat, Jérome Jouan, Jean-Herlé Raphalen, Romain Jouffroy, Murielle Jaffry, Christelle Dagron, Kim An, Florence Dumas, Eloi Marijon, Wulfran Bougouin, Jean-Pierre Tourtier, Frédéric Baud, Xavier Jouven, Nicolas Danchin, Christian Spaulding, Pierre Carli
BACKGROUND: Out of hospital cardiac arrest (OHCA) mortality rates remain very high with poor neurological outcome in survivors. Extracorporeal cardiopulmonary resuscitation (ECPR) is one of the treatments of refractory OHCA. This study used data from the mobile intensive care unit (MOICU) as part of the emergency medical system of Paris, and included all consecutive patients treated with ECPR (including pre-hospital ECPR) from 2011 to 2015 for the treatment of refractory OHCA, comparing two historical ECPR management strategies...
April 14, 2017: Resuscitation
https://www.readbyqxmd.com/read/28411062/incidence-and-characteristics-of-positive-pressure-ventilation-delivered-to-newborns-in-a-us-tertiary-academic-hospital
#6
Dana E Niles, Courtney Cines, Elena Insley, Elizabeth E Foglia, Okan U Elci, Christiane Skåre, Theresa Olasveengen, Anne Ades, Michael Posencheg, Vinay M Nadkarni, Jo Kramer-Johansen
INTRODUCTION: The Neonatal Resuscitation Program (NRP) guidelines recommend positive pressure ventilation (PPV) in the first 60s of life to support perinatal transition in non-breathing newborns. Our aim was to describe the incidence and characteristics of newborn PPV using real-time observation in the delivery unit. METHODS: Prospective, observational, quality improvement study conducted at a tertiary academic hospital. Deliveries during randomized weekday/evening 8-h shifts were attended by a trained observer...
April 12, 2017: Resuscitation
https://www.readbyqxmd.com/read/28409010/specialist-intervention-is-associated-with-improved-patient-outcomes-in-patients-with-decompensated-heart-failure-evaluation-of-the-impact-of-a-multidisciplinary-inpatient-heart-failure-team
#7
Jayne Masters, Geraint Morton, Isabel Anton, Jane Szymanski, Elizabeth Greenwood, Joanna Grogono, Andrew S Flett, John G F Cleland, Peter J Cowburn
OBJECTIVE: The study aimed to evaluate the impact of a multidisciplinary inpatient heart failure team (HFT) on treatment, hospital readmissions and mortality of patients with decompensated heart failure (HF). METHODS: A retrospective service evaluation was undertaken in a UK tertiary centre university hospital comparing 196 patients admitted with HF in the 6 months prior to the introduction of the HFT (pre-HFT) with all 211 patients seen by the HFT (post-HFT) during its first operational year...
2017: Open Heart
https://www.readbyqxmd.com/read/28406486/promoting-teamwork-may-improve-infant-care-processes-during-delivery-room-management-florida-perinatal-quality-collaborative-s-approach
#8
M Balakrishnan, N Falk-Smith, L A Detman, B Miladinovic, W M Sappenfield, J S Curran, T L Ashmeade
BACKGROUND: LOCAL PROBLEM: Inadequate understanding of compliance with standardized evidence-based DR management. INTERVENTIONS: Promote inter-professional teamwork and a bundle of interventions focusing on resuscitation team roles, equipment check, and debriefing using QI methodology. Optimize delivery room (DR) management to achieve 10-min SPO2 targets, delayed-cord clamping (DCC), team role assignment and debriefings in >50% of deliveries, and achieve normothermia in >75% of infants...
April 13, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28403510/-new-to-me-changing-patient-understanding-of-psoriasis-and-identifying-mechanisms-of-change-the-pso-well-%C3%A2-patient-materials-mixed-methods-feasibility-study
#9
P A Nelson, K Kane, C J Pearce, C Bundy, A Chisholm, R Hilton, R Thorneloe, H Young, C E M Griffiths, L Cordingley
BACKGROUND: Psoriasis is an inflammatory, long-term condition (LTC) involving co-morbidities, unhealthy lifestyle and significant life impact. Patients' understanding of psoriasis is limited and support lacking. The Common-Sense Self-Regulatory Model emphasises the role of illness/treatment beliefs on coping/self-management. New 'Pso Well(®) ' patient materials informed by the model addressed: psoriasis as a LTC; medications management; and lifestyle behaviours. OBJECTIVES: To investigate whether Pso Well(®) materials: 1) broaden understanding of psoriasis without increasing anxiety; 2) are acceptable and; 3) comprise features that appear to effect change...
April 12, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/28401688/goals-of-patient-care-system-change-with-video-based-education-increases-rates-of-advance-cardiopulmonary-resuscitation-decision-making-and-discussions-in-hospitalised-rehabilitation-patients
#10
Claire Johnson, Jeffrey Chong, Anne Wilkinson, Barbara Hayes, Sonia Tait, Nicholas Waldron
BACKGROUND: Advance CPR discussions and decision-making are not routine clinical practice in the hospital setting. Frail older patients may be at risk of non-beneficial CPR. AIM: To assess the utility and safety of two interventions to increase CPR decision-making, documentation and communication for hospitalised older patients. METHODS: A pre-post study tested two interventions: i) standard ward-based education forums with CPR content; and ii) a combined, two-pronged strategy with 'Goals of Patient Care' (GoPC) system change and structured video-based workshop; against usual practice (ie no formal training)...
April 12, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28400887/antibiotic-prophylaxis-in-orbital-fractures
#11
Benjamin Reiss, Lamise Rajjoub, Tamer Mansour, Tony Chen, Aisha Mumtaz
PURPOSE: To determine whether prophylactic antibiotic use in patients with orbital fracture prevent orbital infection. DESIGN: Retrospective cohort study. PARTICIPANTS: All patients diagnosed with orbital fracture between January 1, 2008 and March 1, 2014 at The George Washington University Hospital and Clinics. MAIN OUTCOME MEASURES: Development of orbital infection. RESULTS: One hundred seventy-two patients with orbital fracture met our inclusion and exclusion criteria...
2017: Open Ophthalmology Journal
https://www.readbyqxmd.com/read/28398695/social-disadvantage-and-developmental-diagnosis-in-pre-schoolers
#12
Norma Kayrouz, Susan L Milne, Jenny L McDonald
AIM: To explore the association between social disadvantage and developmental diagnoses in pre-school children. METHODS: Between 2012 and 2015, 845 pre-school children were assessed by the Child Assessment Team at Campbelltown Hospital. A social worker interviewed 469 families and these children were eligible for inclusion in the study. Autism spectrum disorder (ASD) was confirmed in 290 children. Of those without ASD, 72 did not have global developmental delay (GDD) and were excluded from the study...
April 11, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28397548/pre-natal-diagnosis-of-thalassaemia-in-sri-lanka-a-ten-year-review
#13
Kalinga Khemal Nanayakkara, Undugodage Ganganath Rodrigo, Kuda Liyanage Nandika Perera, Chinthani Deepthi Nanayakkara
Thalassaemia is the commonest monogenic disease in Sri Lanka, affecting over 3500 children and half-a-million thalassaemia carriers. This is a review of 82 amniocenteses performed from 2006 to 2016, in the largest prenatal diagnoses study for thalassaemia carried out in Sri Lanka. Amniocenteses were performed between 11 and 12 weeks of ultrasonically confirmed gestation, on mothers with previous thalassaemia major children pregnant for the second time and nulliparous thalassaemia trait women married to trait partners...
April 11, 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28396900/multidisciplinary-team-approach-to-traumatic-spinal-cord-injuries-a-single-institution-s-quality-improvement-project
#14
Georgina Alizo, Jason D Sciarretta, Stefanie Gibson, Keely Muertos, Sharon Holmes, Felicia Denittis, Joseph Cheatle, John Davis, Antonio Pepe
BACKGROUND: A stepwise multidisciplinary team (MDT) approach to the injured trauma patient has been reported to have an overall benefit, with reduction in mortality and improved morbidity. Based on clinical experience, we hypothesized that implementation of a dedicated Spinal Cord Injury Service (SCIS) would impact outcomes of a patient specific population on the trauma service. METHODS: The trauma center registry was retrospectively queried, from January 2011 through December 2015, for patients presenting with a spinal cord injury...
April 10, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28395091/morbidity-among-the-israeli-defense-force-response-team-during-nepal-post-earthquake-mission-2015
#15
Tamar Lachish, Aviad Bar, Heli Alalouf, Ofer Merin, Eli Schwartz
Background: On 25 April 2015, a 7.8-magnitude earthquake struck Nepal. Soon after, the Israel Defense Force (IDF) dispatched a rapid-response team and opened a tertiary field hospital in Kathmandu. There is limited data regarding the spectrum of diseases among rescue teams to disease-stricken areas. The aim of this study was to assess the morbidity among the field-hospital staff during the mission. Methods: The rescue team was deployed for a 2-week mission in Kathmandu...
March 1, 2017: Journal of Travel Medicine
https://www.readbyqxmd.com/read/28394732/impact-of-a-brief-addiction-medicine-training-experience-on-knowledge-self-assessment-among-medical-learners
#16
Jan Klimas, Keith Ahamad, Christoper Fairgrieve, Mark McLean, Annabel Mead, Seonaid Nolan, Evan Wood
BACKGROUND: Implementation of evidence-based approaches to the treatment of various substance use disorders is needed to tackle the existing epidemic of substance use and related harms. Most clinicians, however, lack knowledge and practical experience with these approaches. Given this deficit, the authors examined the impact of an inpatient elective in addiction medicine amongst medical trainees on addiction-related knowledge and medical management. METHODS: Trainees who completed an elective with a hospital-based Addiction Medicine Consult Team (AMCT) in Vancouver, Canada, from May 2015 to May 2016, completed a 9-item self-evaluation scale before and immediately after the elective...
February 21, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28385346/timing-of-surgical-antimicrobial-prophylaxis-a-phase-3-randomised-controlled-trial
#17
Walter P Weber, Edin Mujagic, Marcel Zwahlen, Marcel Bundi, Henry Hoffmann, Savas D Soysal, Marko Kraljević, Tarik Delko, Marco von Strauss, Lukas Iselin, Richard X Sousa Da Silva, Jasmin Zeindler, Rachel Rosenthal, Heidi Misteli, Christoph Kindler, Peter Müller, Ramon Saccilotto, Andrea Kopp Lugli, Mark Kaufmann, Lorenz Gürke, Daniel Oertli, Evelin Bucheli-Laffer, Julia Landin, Andreas F Widmer, Christoph A Fux, Walter R Marti
BACKGROUND: Based on observational studies, administration of surgical antimicrobial prophylaxis (SAP) for the prevention of surgical site infection (SSI) is recommended within 60 min before incision. However, the precise optimum timing is unknown. This trial compared early versus late administration of SAP before surgery. METHODS: In this phase 3 randomised controlled superiority trial, we included general surgery adult inpatients (age ≥18 years) at two Swiss hospitals in Basel and Aarau...
April 3, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28377840/bacterial-contamination-of-anaesthetic-and-vasopressor-drugs-in-the-operating-theatres-ameliyathanelerde-anestetik-ve-vazopress%C3%A3-r-%C3%A4-la%C3%A3-lar%C3%A4-n-bakteriyel-kontaminasyonu
#18
Rongrong Rueangchira-Urai, Panthila Rujirojindakul, Alan Frederick Geater, Edward McNeil
OBJECTIVE: The aim of this study was to determine the incidence of bacterial and fungal contamination in anaesthetic and vasopressor drugs before and after use in operating theatres. METHODS: A cross-sectional study was conducted in the operating theatres of a university hospital. We collected 945 samples of three different drugs, namely, propofol, vecuronium and ephedrine, from 20 operating rooms and refrigerators where the unused drugs were stored. Each drug was divided into two groups, the pre-use group and the post-use group...
February 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28375881/institutional-substance-use-disorder-intervention-improves-general-internist-preparedness-attitudes-and-clinical-practice
#19
Sarah E Wakeman, Genevieve Pham Kanter, Karen Donelan
OBJECTIVE: To assess the impact of hospital substance use disorder (SUD) initiative, which, beginning in October 2014, implemented an inpatient addiction consult team, a postdischarge addiction clinic, recovery coaches, and SUD treatment within primary care on general internists' attitudes, clinical practice, and preparedness to care for SUD. METHODS: Pre and postintervention survey of general internal medicine physicians at Massachusetts General Hospital, in Boston, Massachusetts, in September 2014 (n = 290) and 2015 (n = 296) was conducted...
April 3, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28359162/shifting-landscapes
#20
Lindsey Fay, Allison Carll-White, Aric Schadler, Kathy Isaacs, Kevin Real
OBJECTIVE: The focus of this research was to analyze the impact of decentralized and centralized hospital design layouts on the delivery of efficient care and the resultant level of caregiver satisfaction. BACKGROUND: An interdisciplinary team conducted a multiphased pre- and postoccupancy evaluation of a cardiovascular service line in an academic hospital that moved from a centralized to decentralized model. This study examined the impact of walkability, room usage, allocation of time, and visibility to better understand efficiency in the care environment...
January 1, 2017: HERD
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