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https://www.readbyqxmd.com/read/28429987/beyond-integrated-care
#1
Thomas Plochg, Stefania Ilinca, Mirko Noordegraaf
Integrated care tops the health care agenda. But more integration alone will not remedy the crisis in health care, and there is a danger in the increasingly prevalent conceptualization of care integration as a goal in itself rather than as an instrument for improving performance. Operating integrated care systems, staffed by an overly specialized medical workforce, is unsustainable in terms of human and financial resources and is likely to produce little benefit for patients with multi-morbidity. An alternative approach involves health care leaders going beyond integrated care and nurturing transformative change from within the medical workforce instead...
January 1, 2017: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/28427302/increasing-influenza-immunization-rates-among-retail-employees-an-evidence-based-approach
#2
Leigh Montejo, Rachel Richesson, B Iris Padilla, Michael E Zychowicz, Crystal Hambley
Influenza has a significant impact on the health of Americans and the U.S. economy. Annual influenza immunization can decrease the burden of influenza-related illnesses for both employees and employers. This project evaluated a nurse practitioner-led intervention to increase influenza immunization rates among retail employees from August through December of the 2015-2016 influenza season. The sample included employees from retail locations with on-site convenience care clinics staffed by nurse practitioners...
April 1, 2017: Workplace Health & Safety
https://www.readbyqxmd.com/read/28426678/nutrition-education-improves-dietary-diversity-of-children-6-23-months-at-community-level-results-from-a-cluster-randomized-controlled-trial-in-malawi
#3
Judith Kuchenbecker, Anika Reinbott, Beatrice Mtimuni, Michael B Krawinkel, Irmgard Jordan
BACKGROUND: Low dietary quality and quantity and inappropriate feeding practices can cause undernutrition. Poor nutritional status in early childhood is associated with growth faltering. The objective of the study was to assess the potential of community-based nutrition education to improve height-for-age z-scores in children 6-23 months of age. METHODS AND FINDINGS: We carried out a cluster-randomized-controlled trial to assess the effectiveness of nutrition education...
2017: PloS One
https://www.readbyqxmd.com/read/28426522/patient-safety-culture-survey-in-pediatric-complex-care-settings-a-factor-analysis
#4
Amanda J Hessels, Meghan Murray, Bevin Cohen, Elaine L Larson
OBJECTIVES: Children with complex medical needs are increasing in number and demanding the services of pediatric long-term care facilities (pLTC), which require a focus on patient safety culture (PSC). However, no tool to measure PSC has been tested in this unique hybrid acute care-residential setting. The objective of this study was to evaluate the psychometric properties of the Nursing Home Survey on Patient Safety Culture tool slightly modified for use in the pLTC setting. METHODS: Factor analyses were performed on data collected from 239 staff at 3 pLTC in 2012...
April 19, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28426189/issues-confronting-rural-pharmacies-after-a-decade-of-medicare-part-d
#5
Fred Ullrich, Abiodun Salako, Keith Mueller
Purpose. The RUPRI Center for Rural Health Policy Analysis has been monitoring the status of rural independent pharmacies since the implementation of Medicare Part D in 2005. After a decade of Part D, we reassess in this brief the issues that concern rural pharmacies and may ultimately challenge their provision of services. This reassessment is based on survey responses from rural pharmacists. Key Findings: (1) Rural pharmacists indicated that two challenges--direct and indirect remuneration (DIR) fees, and delayed maximum allowable cost (MAC) adjustment--ranked highest on scales of both magnitude and immediacy...
April 2017: Rural Policy Brief
https://www.readbyqxmd.com/read/28425612/oral-health-programmes-in-indigenous-communities-worldwide-lessons-learned-from-the-field-a-qualitative-systematic-review
#6
Carrie Tsai, Anthony Blinkhorn, Michelle Irving
OBJECTIVES: This systematic review examines the evidence on the effectiveness of programmes that aim to improve the oral health of Indigenous populations worldwide, as well as presents a qualitative analysis to explore the design and implementation of these initiatives. METHODS: MEDLINE and EMBASE were searched. Studies were included if they described an oral health programme for an Indigenous population in any country worldwide. A thematic synthesis of the qualitative findings was undertaken for each study's results and discussion sections...
April 20, 2017: Community Dentistry and Oral Epidemiology
https://www.readbyqxmd.com/read/28424800/progressing-care-in-the-medical-high-dependency-unit-unit-configurations-staffing-standards-and-daily-routine
#7
Christopher John Wright, Russell Allan
There are currently various models of care for provision of high dependency care for acutely ill medical patients across the UK. Acute Physicians are integral to the development and progression of this both challenging and rewarding area of medicine. This article outlines current standards, best evidence, and our own experience of both setting up and developing a medical high dependency unit (MHDU).
2017: Acute Medicine
https://www.readbyqxmd.com/read/28422935/the-baptist-health-nurse-retention-questionnaire-a-methodological-study-part-1
#8
Alexander Lengerich, Andrew Bugajski, Matthew Marchese, Brittany Hall, Susan Yackzan, Claire Davies, Dorothy Brockopp
OBJECTIVE: The purposes of this study were to develop and test the Baptist Health Nurse Retention Questionnaire (BHNRQ) and examine the importance of nurse retention factors. BACKGROUND: Multiple factors, including increasing patient acuity levels, have led to concerns regarding nurse retention. An understanding of current factors related to retention is limited. METHODS: To establish the psychometric properties of the BHNRQ, data were collected from 279 bedside nurses at a 391-bed, Magnet® redesignated community hospital...
May 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/28421900/the-magnitude-and-factors-related-to-facility-based-maternal-mortality-in-mozambique
#9
Leonardo Chavane, Martinho Dgedge, Olivier Degomme, Osvaldo Loquiha, Marc Aerts, Marleen Temmerman
Facility-based maternal mortality remains an important public health problem in Mozambique. A number of factors associated with health system functioning can be described behind the occurrence of these deaths. This paper aimed to evaluate the magnitude of the health facility-based maternal mortality, its geographical distribution and to assess the health facility factors implicated in the occurrence of these deaths. A secondary analysis was done on data from the survey on maternal health needs performed by the Ministry of Health of Mozambique in 2008...
May 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28420595/using-an-array-of-implementation-strategies-to-improve-success-rates-of-pharmacist-initiated-medication-therapy-management-services-in-community-pharmacies
#10
Rachel Stafford, Jeremy Thomas, Nalin Payakachat, Tiffany Diemer, Michele Lang, Brooke Kordsmeier, Geoffrey Curran
BACKGROUND: With the introduction of the Centers for Medicare and Medicaid Services Stars Measure program has come a greater expectation of Medication Therapy Management (MTM) services from community pharmacies. To meet the growing demand of these services, pharmacies have sought out various methods of engaging pharmacists to provide MTM. Barriers for completing MTM include inadequate time to complete the services, insufficient staffing, lack of sufficient compensation, billing difficulty, lack of interest among patients (including refusing MTM services when offered), inadequate training/experience, and lack of support from management...
April 8, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28414537/developing-a-caseload-classification-tool-for-community-nursing
#11
Helen Chapman, Margaret Kilner, Rebekah Matthews, Abi White, Angela Thompson, Sally Fowler-Davis, Lisa Farndon
Acuity and dependency in the community nursing caseload in combination with safe staffing levels are a national issue of concern. Current evidence suggests that there are no clear approaches to determining staff capacity and skill mix in these community settings. As community nursing caseloads are large with differing complexities, there is a need to allocate community nursing with the best skill mix to achieve the best patient outcomes. A city-wide service improvement initiative developed a tool to classify and categorise patient demand and this was linked to an electronic patient record system...
April 2, 2017: British Journal of Community Nursing
https://www.readbyqxmd.com/read/28413140/is-day-of-surgery-associated-with-adverse-clinical-and-economic-outcomes-following-primary-total-knee-arthroplasty
#12
Matthew R Boylan, Dean C Perfetti, Qais Naziri, Aditya V Maheshwari, Carl B Paulino, Michael A Mont
BACKGROUND: As orthopedics transition to value-based purchasing, hospitals and providers are incentivized to identify inefficiencies of care delivery. In our experience, weekends are characterized by decreased staffing of ancillary services to coordinate patient discharges, which can lead to prolonged hospital stays for many of our primary total knee arthroplasty (TKA) admissions. METHODS: We identified 115,053 patients who underwent primary TKA on a weekday between 2009 and 2013 in New York State...
March 22, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28412072/do-slow-and-steady-residents-win-the-race-modeling-the-effects-of-peak-and-overall-resident-productivity-in-the-emergency-department
#13
Joshua W Joseph, Victor Novack, Matthew L Wong, Larry A Nathanson, Leon D Sanchez
BACKGROUND: Emergency medicine residents need to be staffed in a way that balances operational needs with their educational experience. Key to developing an optimal schedule is knowing a resident's expected productivity, a poorly understood metric. OBJECTIVE: We sought to measure how a resident's busiest (peak) workload affects their overall productivity for the shift. METHODS: We conducted a retrospective, observational study of resident productivity at an urban, tertiary care center with a 3-year Accreditation Council for Graduate Medical Education-approved emergency medicine training program, with 55,000 visits annually...
April 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28405807/management-and-outcomes-of-acute-surgical-patients-at-a-district-hospital-in-uganda-with-non-physician-emergency-clinicians
#14
Caleb Dresser, Usha Periyanayagam, Brad Dreifuss, Robert Wangoda, Julius Luyimbaazi, Mark Bisanzo
INTRODUCTION: Acute surgical care services in rural Sub-Saharan Africa suffer from human resource and systemic constraints. Developing emergency care systems and task sharing aspects of acute surgical care addresses many of these issues. This paper investigates the degree to which specialized non-physicians practicing in a dedicated Emergency Department contribute to the effective and efficient management of acute surgical patients. METHODS: This is a retrospective review of an electronic quality assurance database of patients presenting to an Emergency Department in rural Uganda staffed by non-physician clinicians trained in emergency care...
April 12, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28403715/job-satisfaction-low-in-ambulance-trusts
#15
(no author information available yet)
Staff at ambulance trusts have painted a bleak picture of their work experiences, revealing high dissatisfaction over pay, staffing levels and the incidence of work-related injuries.
April 13, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28402750/an-efficient-nurse-practitioner-led-community-based-service-model-for-delivering-coordinated-care-to-persons-with-serious-mental-illness-at-risk-for-homelessness
#16
Jeannemarie Baker, Jasmine L Travers, Penelope Buschman, Jacqueline A Merrill
BACKGROUND: Access to mental health care is a struggle for those with serious mental illness (SMI). About 25% of homeless suffer from SMI, compared with 4.2% of the general population. OBJECTIVE: From 2003 to 2012, St. Paul's Center (SPC) operated a unique model to provide quality care to the homeless and those at risk for homelessness, incarceration, and unnecessary hospitalization because of SMI. Data were available for analysis for the years 2008 to 2010. DESIGN: The SPC was developed, managed, and staffed by board-certified psychiatric/mental health nurse practitioners, offering comprehensive mental health services and coordinated interventions...
April 1, 2017: Journal of the American Psychiatric Nurses Association
https://www.readbyqxmd.com/read/28401120/estimating-patient-borne-water-and-electricity-costs-in-home-hemodialysis-a-simulation
#17
Matthew Nickel, Wes Rideout, Nikhil Shah, Frances Reintjes, Justin Z Chen, Robert Burrell, Robert P Pauly
BACKGROUND: Home hemodialysis is associated with lower costs to the health care system compared with conventional facility-based hemodialysis because of lower staffing and overhead costs, and by transferring the treatment cost of utilities (water and power) to the patient. The purpose of this study was to determine the utility costs of home hemodialysis and create a formula such that patients and renal programs can estimate the annual patient-borne costs involved with this type of treatment...
January 2017: CMAJ Open
https://www.readbyqxmd.com/read/28400127/community-residential-facilities-in-mental-health-services-a-ten-year-comparison-in-lombardy
#18
Angelo Barbato, Graziella Civenti, Barbara D'Avanzo
Residential mental health services grew steadily since 2000 in Italy. A reorganisation of residential facilities was implemented in 2007 in Lombardy, introducing supported housing in addition to staffed facilities. We compare the provision and characteristics of residential facilities in the 2007 and 2016. In 2007 there were 3462 beds (35.9/100,000 population) in 276 facilities. In 2016 beds were 4783 (47.8/100,000) in 520 facilities. The increase were unevenly distributed in the public and private sector, and the overall increase was due to a higher increase in the private sector...
March 27, 2017: Health Policy
https://www.readbyqxmd.com/read/28399769/halting-review-heralded-negative-policy-shift
#19
Stephanie Jones-Berry
The decision in 2015 to shelve a national evidence review on safe staffing was shocking and has had ongoing policy implications, a senior nurse researcher has warned.
April 12, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28398697/effects-of-targeting-lower-versus-higher-arterial-oxygen-saturations-on-death-or-disability-in-preterm-infants
#20
REVIEW
Lisa M Askie, Brian A Darlow, Peter G Davis, Neil Finer, Ben Stenson, Maximo Vento, Robin Whyte
BACKGROUND: The use of supplemental oxygen in the care of extremely preterm infants has been common practice since the 1940s. Despite this, there is little agreement regarding which oxygen saturation (SpO₂) ranges to target to maximise short- or long-term growth and development, while minimising harms. There are two opposing concerns. Lower oxygen levels (targeting SpO₂ at 90% or less) may impair neurodevelopment or result in death. Higher oxygen levels (targeting SpO₂ greater than 90%) may increase severe retinopathy of prematurity or chronic lung disease...
April 11, 2017: Cochrane Database of Systematic Reviews
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