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"Audit and feedback"

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https://www.readbyqxmd.com/read/29792971/impact-of-active-surveillance-and-infection-control-measures-on-carbapenem-resistant-gram-negative-bacterial-colonization-and-infections-in-intensive-care
#1
T Karampatakis, K Tsergouli, E Iosifidis, C Antachopoulos, A Karapanagiotou, A Karyoti, N Gritsi-Gerogianni, A Tsakris, E Roilides
BACKGROUND: Carbapenem-resistant Gram-negative bacteria (CRGNB) infections constitute a global threat for critically ill patients and the outcome of their hospitalization. Early identification of CRGNB through rectal surveillance cultures and routine infection control measures including contact precautions, use of appropriate disinfectants, staff education on cleaning, and hand hygiene may reduce the dissemination of CRGNB. AIM: To assess the impact of enhanced infection control measures on CRGNB infections in a nine-bed polyvalent intensive care unit in a tertiary level hospital in an endemic area...
May 21, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29790913/impact-of-implementing-antibiotic-stewardship-programs-in-15-small-hospitals-a-cluster-randomized-intervention
#2
Edward Stenehjem, Adam L Hersh, Whitney R Buckel, Peter Jones, Xiaoming Sheng, R Scott Evans, John P Burke, Bert K Lopansri, Rajendu Srivastava, Tom Greene, Andrew T Pavia
Background: Studies on the implementation of antibiotic stewardship programs (ASPs) in small hospitals are limited. Accreditation organizations now require all hospitals to have ASPs. Methods: The objective of this cluster-randomized intervention was to assess the effectiveness of implementing ASPs in Intermountain Healthcare's 15 small hospitals. Each hospital was randomized to 1 of 3 ASPs of escalating intensity. Program 1 hospitals were provided basic antibiotic stewardship education and tools, access to an infectious disease hotline, and antibiotic utilization data...
February 23, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29790866/audit-and-feedback-a-quality-improvement-study-to-increase-pneumococcal-vaccination-rates
#3
Rebecca Culver Clark, Kimberly Ferren Carter, Julie Jackson, Deborah Hodges
The purpose of this quality improvement study was to explore the impact of audit and feedback on the pneumococcal immunization rate for at-risk adults in ambulatory settings. Study findings support the hypothesis that timely, individualized audit and feedback can have a positive impact on immunization rate; generalized feedback that did not provide actionable information did not have the same impact. The difference between the interventions was significant, χ (1, N = 1993) = 124.7, P <.001.
July 2018: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/29776982/variable-effectiveness-of-stepwise-implementation-of-nudge-type-interventions-to-improve-provider-compliance-with-intraoperative-low-tidal-volume-ventilation
#4
Vikas N O'Reilly-Shah, George S Easton, Craig S Jabaley, Grant C Lynde
BACKGROUND: Identifying mechanisms to improve provider compliance with quality metrics is a common goal across medical disciplines. Nudge interventions are minimally invasive strategies that can influence behavioural changes and are increasingly used within healthcare settings. We hypothesised that nudge interventions may improve provider compliance with lung-protective ventilation (LPV) strategies during general anaesthesia. METHODS: We developed an audit and feedback dashboard that included information on both provider-level and department-level compliance with LPV strategies in two academic hospitals, two non-academic hospitals and two academic surgery centres affiliated with a single healthcare system...
May 18, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29771994/prevalence-outcome-and-quality-of-care-among-children-hospitalized-with-severe-acute-malnutrition-in-kenyan-hospitals-a-multi-site-observational-study
#5
Susan Gachau, Grace Irimu, Philip Ayieko, Samuel Akech, Ambrose Agweyu, Mike English
BACKGROUND: Severe acute malnutrition (SAM) remains a major cause of admission and inpatient mortality worldwide in children aged less than 5 years. In this study, we explored SAM prevalence and outcomes in children admitted in 13 Kenyan hospitals participating in a Clinical Information Network (CIN). We also describe their immediate in-patient management. METHODS: We analyzed data for children aged 1-59 months collected retrospectively from medical records after discharge...
2018: PloS One
https://www.readbyqxmd.com/read/29760597/application-of-an-incident-taxonomy-for-radiation-therapy-analysis-of-five-years-of-data-from-three-integrated-cancer-centres
#6
Stuart Greenham, Stephen Manley, Kirsty Turnbull, Matthew Hoffmann, Amara Fonseca, Justin Westhuyzen, Andrew Last, Noel J Aherne, Thomas P Shakespeare
Aim: To develop and apply a clinical incident taxonomy for radiation therapy. Background: Capturing clinical incident information that focuses on near-miss events is critical for achieving higher levels of safety and reliability. Methods and materials: A clinical incident taxonomy for radiation therapy was established; coding categories were prescription, consent, simulation, voluming, dosimetry, treatment, bolus, shielding, imaging, quality assurance and coordination of care...
May 2018: Reports of Practical Oncology and Radiotherapy
https://www.readbyqxmd.com/read/29757346/effectiveness-of-a-multifaceted-intervention-to-reduce-night-time-sedative-use-in-a-rehabilitation-unit-a-pre-post-intervention-study
#7
Juliana Delos Reyes, Anthony T Sharkey, Laura Morrison, Maria Costello, Cate Crowe, Robert Murphy, Shaun T O'Keeffe, Eamon C Mulkerrin
Background: night-time sedation prescribed during a hospital stay can result in long-term use of such medications in older people. We examined the effectiveness of a multifaceted intervention to reduce night time sedation in an inpatient rehabilitation unit. Methods: an initial retrospective survey of night-time sedative use was followed by prospective re-evaluation after a number of changes were made including education of staff and of patients regarding the potential hazards of sedative medications, measures to promote sleep hygiene and facilitate a 'quiet time' after 10 pm and development of a withdrawal protocol for patients on long-term night sedation...
May 11, 2018: Age and Ageing
https://www.readbyqxmd.com/read/29747564/reduse-reducing-antipsychotic-and-benzodiazepine-prescribing-in-residential-aged-care-facilities
#8
Juanita L Westbury, Peter Gee, Tristan Ling, Donnamay T Brown, Katherine H Franks, Ivan Bindoff, Aidan Bindoff, Gregory M Peterson
OBJECTIVE: To assess the impact of a multi-strategic, interdisciplinary intervention on antipsychotic and benzodiazepine prescribing in residential aged care facilities (RACFs). Design, setting: Prospective, longitudinal intervention in Australian RACFs, April 2014 - March 2016. PARTICIPANTS: 150 RACFs (with 12 157 residents) comprised the main participant group; two further groups were consultant pharmacists (staff education) and community pharmacies (prescribing data)...
May 14, 2018: Medical Journal of Australia
https://www.readbyqxmd.com/read/29743225/ambulatory-antibiotic-stewardship-through-a-human-factors-engineering-approach-a-systematic-review
#9
Sara C Keller, Pranita D Tamma, Sara E Cosgrove, Melissa A Miller, Heather Sateia, Julie Szymczak, Ayse P Gurses, Jeffrey A Linder
INTRODUCTION: In the United States, most antibiotics are prescribed in ambulatory settings. Human factors engineering, which explores interactions between people and the place where they work, has successfully improved quality of care. However, human factors engineering models have not been explored to frame what is known about ambulatory antibiotic stewardship (AS) interventions and barriers and facilitators to their implementation. METHODS: We conducted a systematic review and searched OVID MEDLINE, Embase, Scopus, Web of Science, and CINAHL to identify controlled interventions and qualitative studies of ambulatory AS and determine whether and how they incorporated principles from a human factors engineering model, the Systems Engineering Initiative for Patient Safety 2...
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29733352/adaptation-of-a-hospital-electronic-referral-system-for-antimicrobial-stewardship-prospective-audit-and-feedback-rounds
#10
Matthew D M Rawlins, Edward Raby, Frank M Sanfilippo, Rae Douglass, Jonathan Chambers, Duncan McLellan, John R Dyer
Objective: To evaluate the impact of the adaptation of an existing electronic referral application for use in antimicrobial stewardship prospective audit and feedback rounds (antimicrobial rounds). Design: Retrospective, single-centre observational study between March 2015 and February 2016. Setting: A new quaternary referral centre. Study Participants: Adults referred for antimicrobial rounds outside of the intensive care and haematology units...
May 4, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29729830/integrating-staff-nurses-in-antibiotic-stewardship-opportunities-and-barriers
#11
Elizabeth Monsees, Lori Popejoy, Mary Anne Jackson, Brian Lee, Jennifer Goldman
BACKGROUND: Nursing has been called for greater participation in antibiotic stewardship. Although many of the functions that are integral to successful stewardship are within the scope of bedside nurses, data evaluating nursing engagement in stewardship are limited. The objective of this study was to identify nurses' roles and confidence in engaging in stewardship practices by conducting a survey of pediatric staff nurses employed at a 354-bed freestanding children's hospital with a well-established prospective audit and feedback stewardship program...
May 2, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29723913/observational-pre-post-study-showed-that-a-quality-improvement-project-reduced-paediatric-antibiotic-prescribing-rates-in-primary-care
#12
Simona Di Mario, Carlo Gagliotti, Rossella Buttazzi, Luca Cisbani, Chiara Di Girolamo, Antonio Brambilla, Maria Luisa Moro
AIM: This study assessed the effectiveness of a quality improvement project that aimed to promote more considered antibiotic prescribing in paediatric primary care. Method This was an observational pre-post study that used patient-level prescribing data from the Emilia-Romagna region of Italy to monitor indicators from 2005 to 2016. Multilevel interventions and activities started in 2007 and these included developing guidelines and updates, disseminating evidence, audits and feedback, public information campaigns, engaging health managers and performance incentives...
May 3, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29720267/efficacy-of-postoperative-pain-management-in-head-and-neck-cancer-patients
#13
Ashley Hinther, Steven C Nakoneshny, Shamir P Chandarana, T Wayne Matthews, Joseph C Dort
BACKGROUND: Our study quantifies the effectiveness of perioperative pain control in a cohort of patients undergoing major head and neck surgery with free flap reconstruction. Our long-term goal is to improve pain control and thereby increase mobility, decrease postoperative complications and decrease hospital stay. METHODS: A retrospective analysis was performed at a tertiary, academic head and neck surgical oncology program in Calgary, Alberta, Canada from January 1, 2015 - December 31, 2015...
May 2, 2018: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29708081/predictors-of-antimicrobial-stewardship-program-recommendation-disagreement
#14
Laura L Bio, Jenna F Kruger, Betty P Lee, Matthew S Wood, Hayden T Schwenk
OBJECTIVETo identify predictors of disagreement with antimicrobial stewardship prospective audit and feedback recommendations (PAFR) at a free-standing children's hospital.DESIGNRetrospective cohort study of audits performed during the antimicrobial stewardship program (ASP) from March 30, 2015, to April 17, 2017.METHODSThe ASP included audits of antimicrobial use and communicated PAFR to the care team, with follow-up on adherence to recommendations. The primary outcome was disagreement with PAFR. Potential predictors for disagreement, including patient-level, antimicrobial, programmatic, and provider-level factors, were assessed using bivariate and multivariate logistic regression models...
April 30, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29694456/a-matter-of-urgency-reducing-clinical-text-message-interruptions-during-educational-sessions
#15
Arielle Mendel, Anthony Lott, Lisha Lo, Robert Wu
BACKGROUND: Text messaging is increasingly replacing paging as a tool to reach physicians on medical wards. However, this phenomenon has resulted in high volumes of nonurgent messages that can disrupt the learning climate. OBJECTIVE: Our objective was to reduce nonurgent educational interruptions to residents on general internal medicine. DESIGN, SETTING, PATIENTS: This was a quality improvement project conducted at an academic hospital network...
April 25, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29686983/systematic-multimethod-assessment-of-adaptations-across-four-diverse-health-systems-interventions
#16
Borsika A Rabin, Marina McCreight, Catherine Battaglia, Roman Ayele, Robert E Burke, Paul L Hess, Joseph W Frank, Russell E Glasgow
Background: Many health outcomes and implementation science studies have demonstrated the importance of tailoring evidence-based care interventions to local context to improve fit. By adapting to local culture, history, resources, characteristics, and priorities, interventions are more likely to lead to improved outcomes. However, it is unclear how best to adapt evidence-based programs and promising innovations. There are few guides or examples of how to best categorize or assess health-care adaptations, and even fewer that are brief and practical for use by non-researchers...
2018: Frontiers in Public Health
https://www.readbyqxmd.com/read/29680199/a-systematic-review-of-strategies-for-reducing-missed-opportunities-for-vaccination
#17
REVIEW
Anelisa Jaca, Lindi Mathebula, Arthur Iweze, Elizabeth Pienaar, Charles S Wiysonge
BACKGROUND: Missed opportunities for vaccination (MOVs) occur when persons eligible for vaccination visit a health facility and do not get the vaccines they need. We conducted a systematic review to assess effects of interventions for reducing MOVs. METHODS: We searched PubMed, Scopus, and the Cochrane Central Register of Controlled Trials in April 2017. Three authors independently screened search outputs, reviewed potentially eligible papers, assessed risk of bias, and extracted data; resolving disagreements by consensus...
April 18, 2018: Vaccine
https://www.readbyqxmd.com/read/29674362/implementation-of-an-evidence-based-model-of-care-for-low-back-pain-in-emergency-departments-protocol-for-the-sydney-health-partners-emergency-department-shaped-trial
#18
Gustavo C Machado, Bethan Richards, Chris Needs, Rachelle Buchbinder, Ian A Harris, Kirsten Howard, Kirsten McCaffery, Laurent Billot, James Edwards, Eileen Rogan, Rochelle Facer, David Lord Cowell, Chris G Maher
INTRODUCTION: Patients with low back pain often seek care in emergency departments, but the problem is that many patients receive unnecessary or ineffective interventions and at the same time miss out on the basics of care, such as advice on self-management. This pattern of care has important consequences for the healthcare system (expensive and inefficient) and for patients (poor health outcomes). We hypothesised that the implementation of an evidence-based model of care for low back pain will improve emergency care by reducing inappropriate overuse of tests and treatments and improving patient outcomes...
April 19, 2018: BMJ Open
https://www.readbyqxmd.com/read/29659311/a-knowledge-translation-intervention-designed-using-audit-and-feedback-and-the-theoretical-domains-framework-for-physical-therapists-working-in-inpatient-rehabilitation-a-case-report
#19
Wendy Romney, Nancy Salbach, James Scott Parrott, Judith E Deutsch
BACKGROUND AND PURPOSE: Little is known about the process of engaging key stakeholders to select and design a knowledge translation (KT) intervention to increase the use of an outcome measure using audit and feedback. The purpose of this case report was to describe the development of a KT intervention designed with organizational support to increase physical therapists' (PTs) use of a selected outcome measure in an inpatient sub-acute rehabilitation hospital. CASE DESCRIPTION: Eleven PTs who worked at a sub-acute rehabilitation hospital participated...
April 16, 2018: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/29595430/surveillance-software-and-prospective-audit-and-feedback-rounds-advance-antimicrobial-stewardship-at-an-acute-care-community-hospital
#20
Anna Lee, Susan John, Reena Lovinsky
Antimicrobial stewardship is a key strategy to facilitate judicious antimicrobial use. Software that can amalgamate prescribing and microbiology information in near real-time reporting and track antimicrobial resistance patterns aids timely interventions. This article examines the impact of a clinical surveillance software used to identify patients for prospective audit and feedback rounds by an antimicrobial stewardship team on antibiotic utilization, patient outcomes and workload efficiencies at an acute care community hospital...
January 2018: Healthcare Quarterly
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