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Pre-Hospital Care

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https://www.readbyqxmd.com/read/28212589/a-multicenter-initiative-for-critical-congenital-heart-disease-newborn-screening-in-texas-neonatal-intensive-care-units
#1
Alice Gong, Charleta Guillory, Liza Creel, Judith Ellen Livingtson, Tiffany M McKee-Garrett, Regine Fortunov
Objective The objective of this study was to implement a strategy for critical congenital heart disease (CCHD) newborn screening in the neonatal intensive care unit (NICU). Design A NICU-specific curriculum, screening algorithm, slide presentations, and templates of orders, policies, and procedures were developed into a toolkit for training NICU personnel. Screening was conducted on first and second screen pre- and postductal oxygen saturations (SpO2) on newborns admitted or transferred to the NICU. Results We trained 347 NICU personnel in 13 Texas hospitals, representing rural, suburban, and metropolitan settings...
February 17, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28212425/job-satisfaction-and-determinant-factors-among-midwives-working-at-health-facilities-in-addis-ababa-city-ethiopia
#2
Eyasu Tamru Bekru, Amsale Cherie, Antehun Alemayehu Anjulo
BACKGROUND: Midwives are the primary source of care and support for mothers and newborns at the most vulnerable time in their lives.The Ethiopian National Reproductive Health Strategy targeted reduction of Maternal Mortality rate to 267/100,000 live births in the years 2006-2015. Midwives play a crucial role in the care of pregnant women, from the first antenatal visit right through to the delivery and the postpartum period. METHODOLOGY: Institution based cross-sectional study was carried out from March 2015 to April 2015 in Addis Ababa city, Ethiopia to assess job satisfaction and its determinants among midwives working at government health facilities...
2017: PloS One
https://www.readbyqxmd.com/read/28210351/cross-continuum-tool-is-associated-with-reduced-utilization-and-cost-for-frequent-high-need-users
#3
Lauran Hardin, Adam Kilian, Leslie Muller, Kevin Callison, Michael Olgren
INTRODUCTION: High-need, high-cost (HNHC) patients can over-use acute care services, a pattern of behavior associated with many poor outcomes that disproportionately contributes to increased U.S. healthcare cost. Our objective was to reduce healthcare cost and improve outcomes by optimizing the system of care. We targeted HNHC patients and identified root causes of frequent healthcare utilization. We developed a cross-continuum intervention process and a succinct tool called a Complex Care Map (CCM)© that addresses fragmentation in the system and links providers to a comprehensive individualized analysis of the patient story and causes for frequent access to health services...
February 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28209449/maxillofacial-and-concomitant-serious-injuries-an-eight-year-single-center-experience
#4
Fausto Fama, Marco Cicciu, Alessandro Sindoni, Enrico Nastro-Siniscalchi, Roberto Falzea, Gabriele Cervino, Francesca Polito, Francesco De Ponte, Maria Gioffre-Florio
PURPOSE: Maxillofacial injuries are frequently associated with multiple trauma and can determine functional and aesthetic bad outcomes. The severity of maxillofacial injuries may be considerable and can divert clinicians' attention from other concomitant injuries which is less evident but potentially life-threatening. The aim of this study was to find out the concomitant injuries in patients referred to the Emergency Department (ED) of the University Hospital of Messina (North-East Sicily, Italy) for maxillofacial traumas...
January 20, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28209192/learning-from-2523-trauma-deaths-in-india-opportunities-to-prevent-in-hospital-deaths
#5
Nobhojit Roy, Deepa Kizhakke Veetil, Monty Uttam Khajanchi, Vineet Kumar, Harris Solomon, Jyoti Kamble, Debojit Basak, Göran Tomson, Johan von Schreeb
BACKGROUND: A systematic analysis of trauma deaths is a step towards trauma quality improvement in Indian hospitals. This study estimates the magnitude of preventable trauma deaths in five Indian hospitals, and uses a peer-review process to identify opportunities for improvement (OFI) in trauma care delivery. METHODS: All trauma deaths that occurred within 30 days of hospitalization in five urban university hospitals in India were retrospectively abstracted for demography, mechanism of injury, transfer status, injury description by clinical, investigation and operative findings...
February 16, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28207841/barriers-and-enablers-to-the-implementation-of-the-6-pack-falls-prevention-program-a-pre-implementation-study-in-hospitals-participating-in-a-cluster-randomised-controlled-trial
#6
Darshini R Ayton, Anna L Barker, Renata T Morello, Caroline A Brand, Jason Talevski, Fiona S Landgren, Mayer M Melhem, Evelyn Bian, Sandra G Brauer, Keith D Hill, Patricia M Livingston, Mari Botti
Evidence for effective falls prevention interventions in acute wards is limited. One reason for this may be suboptimal program implementation. This study aimed to identify perceived barriers and enablers of the implementation of the 6-PACK falls prevention program to inform the implementation in a randomised controlled trial. Strategies to optimise successful implementation of 6-PACK were also sought. A mixed-methods approach was applied in 24 acute wards from 6 Australian hospitals. Participants were nurses working on participating wards and senior hospital staff including Nurse Unit Managers; senior physicians; Directors of Nursing; and senior personnel involved in quality and safety or falls prevention...
2017: PloS One
https://www.readbyqxmd.com/read/28207570/international-survey-of-critically-ill-children-with-acute-neurologic-insults-the-prevalence-of-acute-critical-neurological-disease-in-children-a-global-epidemiological-assessment-study
#7
Ericka L Fink, Patrick M Kochanek, Robert C Tasker, John Beca, Michael J Bell, Robert S B Clark, Jamie Hutchison, Monica S Vavilala, Anthony Fabio, Derek C Angus, R Scott Watson
OBJECTIVE: The international scope of critical neurologic insults in children is unknown. Our objective was to assess the prevalence and outcomes of children admitted to PICUs with acute neurologic insults. DESIGN: Prospective study. SETTING: Multicenter (n = 107 PICUs) and multinational (23 countries, 79% in North America and Europe). PATIENTS: Children 7 days to 17 years old admitted to the ICU with new traumatic brain injury, stroke, cardiac arrest, CNS infection or inflammation, status epilepticus, spinal cord injury, hydrocephalus, or brain mass...
February 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28205395/pregnancy-outcomes-and-contraceptive-use-in-patients-with-systemic-lupus-erythematosus-rheumatoid-arthritis-and-women-without-a-chronic-illness-a-comparative-study
#8
Priyadarshani Galappatthy, Jayan D D Jayasinghe, Sampath C Paththinige, Rezvi M H Sheriff, Lalith S Wijayaratne
OBJECTIVES: To compare the pregnancy outcomes and contraceptive practices in systemic lupus erythematosus (SLE), rheumatoid arthritis (RA) and women with no chronic illness (WNCI) in a tertiary care referral center in Colombo, Sri Lanka. METHODS: Patients with SLE satisfying American College of Rheumatology criteria for diagnosis and history of pregnancies were recruited from university lupus clinic, National Hospital of Sri Lanka (NHSL). Age-matched women with history of pregnancy and RA were recruited from the rheumatology clinic, NHSL and WNCI from a surgical clinic...
February 16, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/28203538/robotic-mitral-valve-repair-for-degenerative-posterior-leaflet-prolapse
#9
Hoda Javadikasgari, Rakesh M Suri, Bassman Tappuni, Ashley M Lowry, Tomislav Mihaljevic, Stephanie Mick, A Marc Gillinov
BACKGROUND: Robotic mitral valve (MV) repair is the least invasive surgical approach to the MV and provides unparalleled access to the valve. We sought to assess technical aspects and clinical outcomes of robotic MV repair for isolated posterior leaflet prolapse by examining the first 623 such cases performed in a tertiary care center. METHODS: We reviewed the first 623 patients (mean age 56±9.7 years) with isolated posterior leaflet prolapse who underwent robotic primary MV repair from 01/2006 to 11/2013...
January 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28203098/health-care-resource-utilization-before-and-after-natalizumab-initiation-among-patients-with-multiple-sclerosis-in-germany
#10
Crystal Watson, Christine Prosser, Sebastian Braun, Pamela B Landsman-Blumberg, Erika Gleissner, Sarah Naoshy
BACKGROUND: Multiple sclerosis (MS), a progressive neurodegenerative disease, greatly impacts the quality of life and economic status of people affected by this disease. In Germany, the total annual cost of MS is estimated at €40,000 per person with MS. Natalizumab has shown to slow MS disease progression, reduce relapses, and improve the quality of life of people with MS. OBJECTIVE: To evaluate MS-related and all-cause health care resource utilization and costs among German MS patients during the 12 months before and after initiation of natalizumab in a real-world setting...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28202829/-treatment-strategy-and-results-of-carotid-endarterectomy-in-chronic-renal-failure-patients
#11
Takeo Murahashi, Kenji Kamiyama, Toshiaki Osato, Toshiichi Watanabe, Tatsuya Ogino, Hironori Sugio, Hideki Endo, Kazuki Takahira, Koichiro Shindo, Shuhei Takahashi, Hirohiko Nakamura
INTRODUCTION: The number of patients receiving chronic dialysis treatment in Japan currently exceeds 300,000 people. Few reports have described carotid endarterectomy(CEA)for chronic renal failure patients because of the unacceptable rate of perioperative stroke and other morbidities. A strategy for and treatment results of CEA for chronic renal failure patients in our hospital are described herein. METHODS: The present study included 6 patients who underwent CEA while receiving dialysis treatment between April 2011 and November 2014...
February 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28202076/developing-quality-indicators-for-physician-staffed-emergency-medical-services-a-consensus-process
#12
Helge Haugland, Marius Rehn, Pål Klepstad, Andreas Krüger
BACKGROUND: There is increasing interest for quality measurement in health care services; pre-hospital emergency medical services (EMS) included. However, attempts of measuring the quality of physician-staffed EMS (P-EMS) are scarce. The aim of this study was to develop a set of quality indicators for international P-EMS to allow quality improvement initiatives. METHODS: A four-step modified nominal group technique process (expert panel method) was used. RESULTS: The expert panel reached consensus on 26 quality indicators for P-EMS...
February 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28199053/the-effect-of-tonsillectomy-on-the-morbidity-from-recurrent-tonsillitis
#13
C M Douglas, K Lang, W M Whitmer, J A Wilson, K Mackenzie
BACKGROUND: Tonsillitis is a common condition with an incidence in UK general practice of 37 per 1000 population a year(1) . Recurrent tonsillitis results in significant morbidity and impacts on individuals' quality of life. This study assesses the morbidity and quality of life of adults with recurrent tonsillitis, and the impact of surgical intervention on their health state. OBJECTIVES: 1.To describe disease specific and global quality of life for adults with recurrent tonsillitis six months after tonsillectomy, using two instruments: the Health Impact of Throat Problems (HITP) and EuroQol-visual analogue scale (EQ-VAS) questionnaire...
February 15, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28199038/the-duration-of-intrapartum-maternal-hyperglycaemia-predicts-neonatal-hypoglycaemia-in-women-with-pre-existing-diabetes
#14
T Joshi, C Oldmeadow, J Attia, K Wynne
AIM: There is a high incidence of neonatal hypoglycaemia in neonates born to mothers with pre-existing diabetes. This often necessitates admission to the neonatal intensive care. Guidelines suggest maintaining intrapartum blood glucose levels (BGLs) of 4-7 mmol/l in women with diabetes to reduce the risk of neonatal hypoglycaemia. This study assessed whether intrapartum BGLs in women with pre-gestational Type 1 and 2 diabetes were predictive of neonatal hypoglycaemia. METHODS: A retrospective analysis of 261 births delivered at a tertiary hospital in Australia from 2009 to 2014...
February 15, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28198956/evaluating-pharmaceutical-waste-disposal-in-pediatric-units
#15
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/28198338/an-analysis-of-delegation-styles-among-newly-qualified-nurses
#16
Carin Magnusson, Helen Allan, Khim Horton, Martin Johnson, Karen Evans, Elaine Ball
Aim The aim of this research was to explore how newly qualified nurses learn to organise, delegate and supervise care in hospital wards when working with and supervising healthcare assistants. It was part of a wider UK research project to explore how newly qualified nurses recontextualise the knowledge they have gained during their pre-registration nurse education programmes for use in clinical practice. Method Ethnographic case studies were conducted in three hospital sites in England. Data collection methods included participant observations and semi-structured interviews with newly qualified nurses, healthcare assistants and ward managers...
February 15, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28196506/the-success-of-pre-hospital-tracheal-intubation-by-different-pre-hospital-providers-a-systematic-literature-review-and-meta-analysis
#17
K Crewdson, D J Lockey, J Røislien, H M Lossius, M Rehn
BACKGROUND: Pre-hospital basic airway interventions can be ineffective at providing adequate oxygenation and ventilation in some severely ill or injured patients, and advanced airway interventions are then required. Controversy exists regarding the level of provider required to perform successful pre-hospital intubation. A previous meta-analysis reported pre-hospital intubation success rates of 0.849 for non-physicians versus 0.991 for physicians. The evidence base on the topic has expanded significantly in the last 10 years...
February 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28195969/acute-mesenteric-ischemia-among-postcardiac-surgery-patients-presenting-with-multiple-organ-failure
#18
Alexis Guillaume, Sébastien Pili-Floury, Sidney Chocron, Eric Delabrousse, Bénédicte De Parseval, Stephane Koch, Emmanuel Samain, Gilles Capellier, Gaël Piton
BACKGROUND: Acute mesenteric ischemia (AMI) is a rare but severe complication after cardiac surgery. However, AMI is likely to be more frequent in the subgroup of patients presenting with multiple organ failure after a cardiac surgery. The primary objective of this study was to identify AMI risk factors among patients requiring intensive care unit (ICU) admission after cardiac surgery. METHODS: Retrospective observational study of all the patients requiring admission to two ICUs in a large university hospital after a cardiac surgery procedure...
March 2017: Shock
https://www.readbyqxmd.com/read/28193242/process-evaluation-of-a-cluster-randomised-trial-testing-a-pressure-ulcer-prevention-care-bundle-a-mixed-methods-study
#19
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
#20
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
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