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Preventable emergency visits

Carrie Daymont, Fran Balamuth, Halden F Scott, Christopher P Bonafide, Patrick W Brady, Holly Depinet, Elizabeth R Alpern
OBJECTIVE: The aim of this study was to identify emergency department (ED) heart rate (HR) values that identify children at elevated risk of ED revisit with admission. METHODS: We performed a retrospective cohort study of patients 0 to 18 years old discharged from a tertiary-care pediatric ED from January 2013 to December 2014. We created percentile curves for the last recorded HR for age using data from calendar year 2013 and used receiver operating characteristic (ROC) curves to characterize the performance of the percentiles for predicting ED revisit with admission within 72 hours...
July 16, 2018: Pediatric Emergency Care
Graham Wilson, Colleen Sameoto, Eleanor Fitzpatrick, Katrina F Hurley
INTRODUCTION: In 2007, the Canadian Pediatric Society (CPS) advised against the recreational use of trampolines at home and reaffirmed that statement in 2013. We evaluated the impact of this position statement on trampoline-related injuries at the IWK Health Centre in Halifax, Nova Scotia. METHODS: We completed a retrospective analysis (2001-2015) using the IWK Health Centre's Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) database. The time frame was divided into a pre-statement, post-statement, and post-reaffirmed statement...
May 10, 2018: Curēus
Fan Di Xia, Mary Fuhlbrigge, Erica Dommasch, Cara Joyce, Arash Mostaghimi
Introduction: Little is known about emergency department (ED) utilization for herpes simplex viruses (HSV) types 1 and 2 in the United States. Our goal was to determine the utilization and cost burden associated with HSV infection visits to U.S. EDs in recent years from 2006-2013. Methods: We analyzed the Nationwide Emergency Department Sample (NEDS) database, the largest national database of hospital-based ED visits in the U.S., to determine the number of visits and the cost associated with HSV visits from 2006-2013...
July 2018: Western Journal of Emergency Medicine
Miranda Laurant, Mieke van der Biezen, Nancy Wijers, Kanokwaroon Watananirun, Evangelos Kontopantelis, Anneke Jah van Vught
BACKGROUND: Current and expected problems such as ageing, increased prevalence of chronic conditions and multi-morbidity, increased emphasis on healthy lifestyle and prevention, and substitution for care from hospitals by care provided in the community encourage countries worldwide to develop new models of primary care delivery. Owing to the fact that many tasks do not necessarily require the knowledge and skills of a doctor, interest in using nurses to expand the capacity of the primary care workforce is increasing...
July 16, 2018: Cochrane Database of Systematic Reviews
Kyungsu Kim, Jeremy Beach, Ambikaipakan Senthilselvan, Niko Yiannakoulias, Larry Svenson, Hyocher Kim, Donald C Voaklander
BACKGROUND: Understanding of the specific risk of agricultural injury sustained by different populations of children and adolescents is needed for effective safety intervention. OBJECTIVE: To compare the rates and patterns of agricultural injury incidence (fatal and non-fatal injury) between farm and non-farm children less than 18 years of age in Alberta, Canada. METHODS: A total of 115 378 children (five subgroups: two groups of farm children and three groups of non-farm children) in Alberta were followed from 1999 to 2010 to examine injury incidence using the linkage of three administrative health databases...
July 12, 2018: American Journal of Industrial Medicine
Steven R Steinhubl, Jill Waalen, Alison M Edwards, Lauren M Ariniello, Rajesh R Mehta, Gail S Ebner, Chureen Carter, Katie Baca-Motes, Elise Felicione, Troy Sarich, Eric J Topol
Importance: Opportunistic screening for atrial fibrillation (AF) is recommended, and improved methods of early identification could allow for the initiation of appropriate therapies to prevent the adverse health outcomes associated with AF. Objective: To determine the effect of a self-applied wearable electrocardiogram (ECG) patch in detecting AF and the clinical consequences associated with such a detection strategy. Design, Setting, and Participants: A direct-to-participant randomized clinical trial and prospective matched observational cohort study were conducted among members of a large national health plan...
July 10, 2018: JAMA: the Journal of the American Medical Association
Mauricio La Rosa, Victoria Jauk, George Saade, Kim Boggess, Sherri Longo, Erin A S Clark, Sean Esplin, Kirsten Cleary, Ronald Wapner, Kellett Letson, Michelle Y Owens, Sean Blackwell, Jeff M Szychowski, William W Andrews, Alan T Tita
OBJECTIVE: To evaluate the association of institutional protocols for vaginal preparation with antiseptic solution and the surgical site infection rate in women undergoing cesarean delivery during labor. METHODS: This is a secondary analysis of a multicenter randomized controlled trial of adjunctive azithromycin prophylaxis for cesarean delivery performed in laboring patients with viable pregnancies. The primary outcome for this analysis was the rate of superficial or deep surgical site infection within 6 weeks postpartum, as per Centers for Disease Control and Prevention criteria...
July 10, 2018: Obstetrics and Gynecology
Ines Basso, Laura Simionato, Valerio Dimonte, Serena Scaglione, Sara Campagna
. The Emergency Department visits of Nursing Home residents: descriptive study in a Nursing Home. INTRODUCTION: Many Emergency Departments (ED) transfers of Nursing Home (NH) residents are potentially avoidable or even inappropriate since problems could be prevented or managed in the NH. AIM: To describe characteristics and outcomes of NH residents transferred to ED for respiratory, cardiovascular and neurological problems and symptoms of infection. METHODS: A retrospective descriptive study using clinical records data from 2013-2016 of a NH was conducted...
April 2018: Assistenza Infermieristica e Ricerca: AIR
Kazuo Miyazawa, Yusuke Kondo, Marehiko Ueda, Takatsugu Kajiyama, Masahiro Nakano, Masayuki Inagaki, Joerg O Schwab, Samuel F Sears, Yoshio Kobayashi
BACKGROUND: Patient-reported outcomes of implantable cardioverter defibrillator (ICD), such as those with shock anxiety, have emerged as important endpoints that are related to quality of life (QOL), but they have not been well studied in a sample of the Japanese population. Therefore, we prospectively examined changes in shock anxiety in a large sample of Japanese patients with an ICD. METHODS: We recruited 214 consecutive patients with an ICD who visited the outpatient clinic...
July 10, 2018: Pacing and Clinical Electrophysiology: PACE
Mallika Marar, Peter Gabriel, Wei-Ting Hwang, Daniel R Owen, Melody Ju, Charles B Simone, John Christodouleas, Neha Vapiwala, Abigail T Berman
PURPOSE: Acute hospital encounters in patients undergoing curative-intent radiation therapy (RT) have not previously been well characterized. Understanding acute visit patterns among RT patients yields insights for risk assessments and cancer urgent care clinics that could decrease hospitalization rates and reduce health care costs. This study aims to identify patient, disease-site, and treatment characteristics associated with emergency department visits and inpatient admissions in cancer patients treated with definitive RT...
July 15, 2018: International Journal of Radiation Oncology, Biology, Physics
John Kinsman, John Angrén, Fredrik Elgh, Maria Furberg, Paola A Mosquera, Laura Otero-García, René Snacken, Tarik Derrough, Paloma Carrillo Santisteve, Massimo Ciotti, Svetla Tsolova
BACKGROUND: EU Decision 1082/2013/EU on serious cross-border health threats provides a legal basis for collaboration between EU Member States, and between international and European level institutions on preparedness, prevention, and mitigation in the event of a public health emergency. The Decision provides a context for the present study, which aims to identify good practices and lessons learned in preparedness and response to Middle East Respiratory Syndrome (MERS) (in UK, Greece, and Spain) and poliomyelitis (in Poland and Cyprus)...
July 6, 2018: BMC Health Services Research
Inna Kaminecki, Renuka Verma, Jacqueline Brunetto, Loyda I Rivera
While the incidence of acute rheumatic fever (ARF) in the United States has declined over the past years, the disease remains one of the causes of severe cardiovascular morbidity in children. The index of suspicion for ARF in health care providers may be low due to decreasing incidence of the disease and clinical presentation that can mimic other conditions. We present the case of a 5-year-old boy with a history of intermittent fevers, fatigue, migratory joint pain, and weight loss following group A Streptococcus pharyngitis...
2018: Case Reports in Pediatrics
Megan Benner, Victoria Steiner, Linda L Pierce
Individuals with dementia in the United States have higher rates of hospitalizations and emergency department visits compared to those without. This descriptive study examined the frequency of hospitalizations and emergency department visits among community-dwelling individuals with dementia, reasons for hospitalizations and emergency department visits, and caregivers' actions to prevent these events. Family caregivers ( n = 63) from education/support groups offered through Alzheimer's Association chapters in western Ohio completed a survey...
July 2018: Dementia
Geetanjali R Kamath, Emanuela Taioli, Natalia N Egorova, Josep M Llovet, Ponni V Perumalswami, Jeffrey J Weiss, Myron Schwartz, Stanley Ewala, Nina A Bickell
Introduction: Liver cancer is the fastest increasing cancer in the United States and is one of the leading causes of cancer-related death in New York City (NYC), with wide disparities among neighborhoods. The purpose of this cross-sectional study was to describe liver cancer incidence by neighborhood and examine its association with risk factors. This information can inform preventive and treatment interventions. Materials and methods: Publicly available data were collected on adult NYC residents ( n  = 6,407,022)...
2018: Frontiers in Oncology
Cody D Black, Kednapa Thavorn, Douglas Coyle, Glenys Smith, Lise M Bjerre
INTRODUCTION: Adverse drug events (ADEs) are common in older persons and contribute significantly to emergency department visits, hospitalisations and mortality. ADEs are often due to potentially inappropriate prescriptions (PIP) or potentially inappropriate omissions (PIO), and are avoidable if inappropriate prescriptions or omissions are identified and prevented. Identifying PIP/PIO at the population level through the application of PIP/PIO assessment tools to health administrative data can provide a unique opportunity to assess the economic burden of PIP/PIO on the healthcare system beyond medication costs which is yet to be done...
June 27, 2018: BMJ Open
Lauren Clack, Walter Zingg, Sanjay Saint, Alejandra Casillas, Sylvie Touveneau, Fabricio da Liberdade Jantarada, Ursina Willi, Tjallie van der Kooi, Laura J Damschroder, Jane H Forman, Molly Harrod, Sarah Krein, Didier Pittet, Hugo Sax
OBJECTIVE: The Prevention of Hospital Infections by Intervention and Training (PROHIBIT) project included a cluster-randomised, stepped wedge, controlled study to evaluate multiple strategies to prevent catheter-related bloodstream infection. We report an in-depth investigation of the main barriers, facilitators and contextual factors relevant to successfully implementing these strategies in European acute care hospitals. METHODS: Qualitative comparative case study in 6 of the 14 European PROHIBIT hospitals...
June 27, 2018: BMJ Quality & Safety
L C Martens, S Rajasekharan, W Jacquet, J D Vandenbulcke, J W G Van Acker, R G E C Cauwels
AIM: This was primarily to perform a retrospective analysis of 1000 emergency dental visits in order to characterize the nature of the dental emergency and the treatment provided and secondly to define a guideline for dental emergency treatment in children including pain management. MATERIALS AND METHODS: A retrospective review was conducted of 1000 patients (aged 0-16 years) who visited the dental emergency service of the paediatric dental clinic at the Ghent University Hospital, Belgium over a period of 3 years...
June 13, 2018: European Archives of Paediatric Dentistry: Official Journal of the European Academy of Paediatric Dentistry
Monika Mitra, Susan L Parish, Ilhom Akobirshoev, Eliana Rosenthal, Tiffany A Moore Simas
Objectives This study examined the risk of postpartum hospital admissions and emergency department (ED) visits among US women with intellectual and developmental disabilities (IDD). Methods We used the 2002-2012 Pregnancy to Early Life Longitudinal Data System and identified deliveries to women with and without IDD. Women with IDD (n = 1104) or case subjects were identified from the International Classification of Diseases and Related Health Problems 9th Revision (ICD-9 CM) codes. The study primary outcome measures were any postpartum hospital admission and any ED visit during three critical postpartum periods (1-42, 43-90, and 1-365 days)...
June 9, 2018: Maternal and Child Health Journal
Masaki Shiraishi, Takao Ishii, Yoshiyasu Kigawa, Masaya Tayama, Keisuke Inoue, Kenji Narita, Masaru Tateno, Chiaki Kawanishi
Many patients with mental disorders visit emergency departments (EDs). However, the majority of these patients do not receive psychiatric assessment. In the present study, we investigated the detailed proportion of patients with mental disorders visiting an urban ED in the largest northern city in Japan. A retrospective chart review study was performed at a University Hospital from January 2012 to December 2015. The reasons for psychiatric consultations made by ED staff, and the primary psychiatric diagnoses were investigated...
June 28, 2018: Psychiatry Investigation
Timothy P Daaleman, Dawn Brock, Mark Gwynne, Sam Weir, Iris Dickinson, Beth Willis, Alfred Reid
BACKGROUND: Lean is emerging as a quality improvement (QI) strategy in health care, but there has been minimal adoption in primary care teaching practices. This study describes a strategy for implementing Lean in an academic family medicine center and provides a formative assessment of this approach. METHODS: A case study of the University of North Carolina Family Medicine Center that used the Consolidated Framework for Implementation Research to guide a formative evaluation...
July 2018: Quality Management in Health Care
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