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https://www.readbyqxmd.com/read/28214255/clinical-outcomes-and-90-day-costs-following-hemiarthroplasty-or-total-hip-arthroplasty-for-hip-fracture
#1
Christine I Nichols, Joshua G Vose, Ryan M Nunley
BACKGROUND: In the era of bundled payments, many hospitals are responsible for costs from admission through 90 days postdischarge. Although bundled episodes for hip fracture will have a separate target price for the bundle, little is known about the 90-day resource use burden for this patient population. METHODS: Using Medicare 100% Standard Analytic Files (2010-2014), we identified patients undergoing hemiarthroplasty or total hip arthroplasty (THA). Patients were aged 65 and older with admitting diagnosis of closed hip fracture, no concurrent fractures of the lower limb, and no history of hip surgery in the prior 12 months baseline...
January 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28212250/economic-impact-of-nonmodifiable-risk-factors-in-orthopaedic-fracture-care-is-bundled-payment-feasible
#2
Siddharth A Mahure, Lorraine Hutzler, Richard S Yoon, Joseph A Bosco
OBJECTIVES: To determine whether bundled payments are feasible in the orthopaedic fracture setting, and the potential economic implications of this reimbursement structure. DESIGN: Prospective. SETTING: Multicenter. PATIENTS/PARTICIPANTS: Between 2004 and 2014, a total of 23,643 operatively treated patients with fracture and 544,067 patients with total joint arthroplasty (TJA) were identified using the New York State Statewide Planning and Research Cooperative System database...
March 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28212182/what-s-new-in-obstetric-anesthesia-the-2016-gerard-w-ostheimer-lecture
#3
Philip E Hess
This special article presents potentially important trends and issues affecting the field of obstetric anesthesia drawn from publications in 2015. Both maternal mortality and morbidity in the United States have increased in recent years because, in part, of the changing demographics of the childbearing population. Pregnant women are older and have more pre-existing conditions and complex medical histories. Cardiovascular and noncardiovascular medical diseases now account for half of maternal deaths in the United States...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28202769/project-impact-pilot-report-feasibility-of-implementing-a-hospital-to-home-transition-bundle
#4
Leah A Mallory, Snezana Nena Osorio, B Stephen Prato, Jennifer DiPace, Lisa Schmutter, Paula Soung, Amanda Rogers, William J Woodall, Kayla Burley, Sandra Gage, David Cooperberg
BACKGROUND AND OBJECTIVES: To improve hospital to home transitions, a 4-element pediatric patient-centered transition bundle was developed, including: a transition readiness checklist; predischarge teach-back education; timely and complete written handoff to the primary care provider; and a postdischarge phone call. The objective of this study was to demonstrate the feasibility of bundle implementation and report initial outcomes at 4 pilot sites. Outcome measures included postdischarge caregiver ability to teach-back key home management information and 30-day reuse rates...
February 15, 2017: Pediatrics
https://www.readbyqxmd.com/read/28202628/effects-of-upgrade-versus-de-novo-cardiac-resynchronization-therapy-on-clinical-response-and-long-term-survival-results-from-a-multicenter-study
#5
Mate Vamos, Julia W Erath, Zsolt Bari, Denes Vagany, Sven P Linzbach, Tatsiana Burmistrava, Carsten W Israel, Gabor Z Duray, Stefan H Hohnloser
BACKGROUND: Benefits of cardiac resynchronization therapy (CRT) on morbidity and mortality in selected patients are well known. Although the number of upgrade procedures from single- or dual-chamber devices to CRT is increasing, there are only sparse data on the outcomes of upgrade procedures compared with de novo CRT. This study aimed to evaluate clinical response and survival in patients receiving de novo versus upgrade CRT defibrillator therapy. METHODS AND RESULTS: Prospectively collected outcome data were compared in patients undergoing de novo or upgrade CRT defibrillator implantation at 3 implant centers in Germany and Hungary...
February 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28202189/does-the-presence-of-a-urinary-catheter-predict-severe-sepsis-in-a-bacteraemic-cohort
#6
M Melzer, C Welch
BACKGROUND: Sepsis is a major cause of mortality with an estimated 37,000 deaths in the UK each year. This study aimed to determine host factors that can predict severe sepsis in a bacteraemic cohort. METHODS: From December 2012 to November 2013, demographic, clinical and microbiological data were collected on consecutive patients with bacteraemia at a London teaching hospital. These data were used to categorize patients as having severe or non-severe sepsis. Multi-variate logistic regression was used to determine the association between host factors and severe sepsis...
January 16, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28197738/vaccines-for-staphylococcus-aureus-and-target-populations
#7
Clarissa Pozzi, Reuben Olaniyi, Lassi Liljeroos, Ilaria Galgani, Rino Rappuoli, Fabio Bagnoli
Staphylococcus aureus is a leading pathogen in surgical site, intensive care unit, and skin infections, as well as healthcare-associated pneumonias. These infections are associated with an enormous burden of morbidity, mortality, and increase of hospital length of stay and patient cost. S. aureus is impressively fast in acquiring antibiotic resistance, and multidrug-resistant strains are a serious threat to human health. Due to resistance or insufficient effectiveness, antibiotics and bundle measures leave a tremendous unmet medical need worldwide...
February 15, 2017: Current Topics in Microbiology and Immunology
https://www.readbyqxmd.com/read/28197216/introducing-the-comprehensive-unit-based-safety-program-for-mechanically-ventilated-patients-in-saudi-arabian-intensive-care-units
#8
Raymond M Khan, Maha Aljuaid, Hanan Aqeel, Mohammed M Aboudeif, Shaimaa Elatwey, Rajeh Shehab, Yasser Mandourah, Khalid Maghrabi, Hassan Hawa, Imran Khalid, Ismael Qushmaq, Asad Latif, Bickey Chang, Sean M Berenholtz, Sultan Tayar, Khloud Al-Harbi, Amin Yousef, Anas A Amr, Yaseen M Arabi
Over the past decade, there have been major improvements to the care of mechanically ventilated patients (MVPs). Earlier initiatives used the concept of ventilator care bundles (sets of interventions), with a primary focus on reducing ventilator-associated pneumonia. However, recent evidence has led to a more comprehensive approach: The ABCDE bundle (Awakening and Breathing trial Coordination, Delirium management and Early mobilization). The approach of the Comprehensive Unit-based Safety Program (CUSP) was developed by patient safety researchers at the Johns Hopkins Hospital and is supported by the Agency for Healthcare Research and Quality to improve local safety cultures and to learn from defects by utilizing a validated structured framework...
January 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/28195000/prevention-of-tracheostomy-related-hospital-acquired-pressure-ulcers
#9
Thomas R O'Toole, Natalie Jacobs, Brian Hondorp, Laura Crawford, Lisa R Boudreau, Jill Jeffe, Brian Stein, Phillip LoSavio
Objective To determine if standardization of perioperative tracheostomy care procedures decreased the incidence of hospital-acquired tracheostomy-related pressure ulcers. Methods All patients at least 18 years old who underwent placement of a tracheostomy tube in the operating room from July 1, 2014, through June 30, 2015, were cared for postoperatively through an institutionally adopted quality improvement protocol. This included 4 elements: (1) placement of a hydrocolloid dressing underneath the tracheostomy flange in the postoperative period, (2) removal of plate sutures within 7 days of the tracheostomy procedure, (3) placement of a polyurethane foam dressing after suture removal, and (4) neutral positioning of the head...
February 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28193455/assessment-of-the-effectiveness-of-a-ventilator-associated-pneumonia-prevention-bundle-that-contains-endotracheal-tube-with-subglottic-drainage-and-cuff-pressure-monitorization
#10
Ozlem Akdogan, Yasemin Ersoy, Ciğdem Kuzucu, Ender Gedik, Turkan Togal, Funda Yetkin
The effectiveness of prevention bundles on the occurrence and mortality of ventilator associated pneumonia (VAP) was evaluated in many studies. However, the effectiveness of endotracheal tube with subglottic secretion drainage (ETT-SD) and cuff pressure monitorization in VAP bundles have not been adequately assessed. In this study, we aimed to evaluate the effectiveness of VAP bundle containing ETT-SD and cuff pressure monitorization. This was a prospective, controlled study that was carried out between March 2011 and April 2012 including intubated patients...
February 10, 2017: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28193242/process-evaluation-of-a-cluster-randomised-trial-testing-a-pressure-ulcer-prevention-care-bundle-a-mixed-methods-study
#11
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/28190757/consensus-bundle-on-maternal-mental-health-perinatal-depression-and-anxiety
#12
Susan Kendig, John P Keats, M Camille Hoffman, Lisa B Kay, Emily S Miller, Tiffany A Moore Simas, Ariela Frieder, Barbara Hackley, Pec Indman, Christena Raines, Kisha Semenuk, Katherine L Wisner, Lauren A Lemieux
Perinatal mood and anxiety disorders are among the most common mental health conditions encountered by women of reproductive age. When left untreated, perinatal mood and anxiety disorders can have profound adverse effects on women and their children, ranging from increased risk of poor adherence to medical care, exacerbation of medical conditions, loss of interpersonal and financial resources, smoking and substance use, suicide, and infanticide. Perinatal mood and anxiety disorders are associated with increased risks of maternal and infant mortality and morbidity and are recognized as a significant patient safety issue...
February 4, 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/28185325/a-case-of-high-grade-astrocytoma-with-braf-and-atrx-mutations-following-a-long-standing-course-over-two-decades
#13
Satoshi Nakata 中田 聡, Keishi Horiguchi, Shogo Ishiuchi, Yuhei Yoshimoto, Seiji Yamada, Sumihito Nobusawa, Hayato Ikota, Junko Hirato, Hideaki Yokoo
Pediatric high-grade gliomas are rare and occasionally hard to classify. These tumors often feature a well-demarcated histology and are expected to have a better outcome than ordinary diffuse high-grade gliomas in adults. We herein report a case of circumscribed high-grade glioma that showed a distinct molecular profile and followed an excellent course for 26 years. The patient, a 3-year-old boy at onset, presented with a contrast-enhancing mass in the right temporal lobe and underwent resection. Histologically, the tumor mainly consisted of compact bundles of GFAP-positive spindle cells...
February 9, 2017: Neuropathology: Official Journal of the Japanese Society of Neuropathology
https://www.readbyqxmd.com/read/28182855/consensus-bundle-on-prevention-of-surgical-site-infections-after-major-gynecologic-surgery
#14
Joseph E Pellegrini, Paloma Toledo, David E Soper, William C Bradford, Deborah A Cruz, Barbara S Levy, Lauren A Lemieux
Surgical site infections are the most common complication of surgery in the United states. Of surgeries in women of reproductive age, hysterectomy is one of the most frequently performed, second only to cesarean birth. Therefore, prevention of surgical site infections in women undergoing gynecologic surgery is an ideal topic for a patient safety bundle. The primary purpose of this safety bundle is to provide recommendations that can be implemented into any surgical environment in an effot to reduce the incidence of surgical site infection...
February 6, 2017: AANA Journal
https://www.readbyqxmd.com/read/28181613/in-situ-mechanical-investigation-of-carbon-nanotube-graphene-junction-in-three-dimensional-carbon-nanostructures
#15
Yingchao Yang, Nam Dong Kim, Vikas Varshney, Sangwook Sihn, Yilun Li, Ajit K Roy, James M Tour, Jun Lou
Hierarchically organized three-dimensional (3D) carbon nanotubes/graphene (CNTs/graphene) hybrid nanostructures hold great promises in composite and battery applications. Understanding the junction strength between CNTs and graphene is crucial for utilizing such special nanostructures. Here, in situ pulling an individual CNT bundle out of graphene is carried out for the first time using a nanomechanical tester developed in-house, and the measured junction strength of CNTs/graphene is 2.23 ± 0.56 GPa. The post transmission electron microscopy (TEM) analysis of remained graphene after peeling off CNT forest confirms that the failure during pull-out test occurs at the CNT-graphene junction...
February 9, 2017: Nanoscale
https://www.readbyqxmd.com/read/28180003/ventilator-associated-pneumonia-and-the-importance-of-education-of-icu-nurses-on-prevention-preliminary-results
#16
REVIEW
Bence Mogyoródi, Erzsébet Dunai, János Gál, Zsolt Iványi
BACKGROUND AND AIMS: Ventilator-associated pneumonia (VAP) increases intensive care unit (ICU) length of stay, ICU mortality, the number of ventilator days, and costs. We implemented a VAP bundle and investigated its efficacy on prevention. MATERIALS AND METHODS: A prospective observational study was conducted between January 1, 2015 and December 31, 2015 in a 12-bed multidisciplinary ICU. The bundle was implemented on July 02, 2015. Comparative analysis was performed before and after the implementation of the bundle...
December 2016: Interventional Medicine & Applied Science
https://www.readbyqxmd.com/read/28179250/impact-of-pharmacist-management-of-pain-agitation-and-delirium-in-the-intensive-care-unit-through-participation-in-multidisciplinary-bundle-rounds
#17
Patricia Louzon, Heath Jennings, Mahmood Ali, Marijo Kraisinger
PURPOSE: A two-phase program to increase pharmacist involvement in management of pain, agitation and delirium (PAD) at a large community teaching hospital is described. SUMMARY: Florida Orlando Hospital implemented a two-phase initiative to decrease intensive care unit (ICU) length of stay (LOS), ventilator use, sedative use, and hospital expenditures while advancing pharmacists' scope of practice. Phase 1 of the initiative involved a pilot project to evaluate pharmacist management of sedative therapy for mechanically ventilated patients...
February 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28178041/consensus-bundle-on-maternal-mental-health-perinatal-depression-and-anxiety
#18
Susan Kendig, John P Keats, M Camille Hoffman, Lisa B Kay, Emily S Miller, Tiffany A Moore Simas, Ariela Frieder, Barbara Hackley, Pec Indman, Christena Raines, Kisha Semenuk, Katherine L Wisner, Lauren A Lemieux
Perinatal mood and anxiety disorders are among the most common mental health conditions encountered by women of reproductive age. When left untreated, perinatal mood and anxiety disorders can have profound adverse effects on women and their children, ranging from increased risk of poor adherence to medical care, exacerbation of medical conditions, loss of interpersonal and financial resources, smoking and substance use, suicide, and infanticide. Perinatal mood and anxiety disorders are associated with increased risks of maternal and infant mortality and morbidity and are recognized as a significant patient safety issue...
February 6, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28173796/identification-of-factors-that-support-successful-implementation-of-care-bundles-in-the-acute-medical-setting-a-qualitative-study
#19
Stuart A Green, Derek Bell, Nicholas Mays
BACKGROUND: Clinical guidelines offer an accessible synthesis of the best evidence of effectiveness of interventions, providing recommendations and standards for clinical practice. Many guidelines are relevant to the diagnosis and management of the acutely unwell patient during the first 24-48 h of admission. Care bundles are comprised of a small number of evidence-based interventions that when implemented together aim to achieve better outcomes than when implemented individually. Care bundles that are explicitly developed from guidelines to provide a set of related evidence-based actions have been shown to improve the care of many conditions in emergency, acute and critical care settings...
February 7, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28158575/a-flowchart-for-building-evidence-based-care-bundles-in-intensive-care-based-on-a-systematic-review
#20
Marjon Borgert, Jan Binnekade, Frederique Paulus, Astrid Goossens, Dave Dongelmans
No abstract text is available yet for this article.
February 2, 2017: International Journal for Quality in Health Care
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