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Inpatient management

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https://www.readbyqxmd.com/read/27932029/implementing-a-resident-acute-care-surgery-service-improving-resident-education-and-patient-care
#1
Olga Kantor, Andrew B Schneider, Marko Rojnica, Andrew J Benjamin, Nancy Schindler, Mitchell C Posner, Jeffrey B Matthews, Kevin K Roggin
BACKGROUND: To simulate the duties and responsibilities of an attending surgeon and allow senior residents more intraoperative and perioperative autonomy, our program created a new resident acute care surgery consult service. METHODS: We structured resident acute care surgery as a new admitting and inpatient consult service managed by chief and senior residents with attending supervision. When appropriate, the chief resident served as a teaching assistant in the operation...
December 5, 2016: Surgery
https://www.readbyqxmd.com/read/27932010/bottleneck-analysis-approach-to-accelerate-newborn-care-services-in-two-regions-in-ghana-implications-for-national-newborn-care
#2
A E Yawson, J K Awoonor-Williams, I Sagoe-Moses, P K Aboagye, A O Yawson, L K Senaya, G Bonsu, J B Eleeza, E E A Agongo, H K Banskota
OBJECTIVE: The aim of this work is to describe application of a data-driven approach (bottleneck analysis [BNA] approach process) to accelerate newborn care services in two regions and what effect it had on national-level newborn care interventions in Ghana. STUDY DESIGN: A mixed-method approach was used for the study. The BNA tool generated quantitative data and group discussions provided phenomenological explanations to identified service gaps. METHODS: Regional newborn care health service assessments were conducted in November 2013 through desk reviews, field and health facility visits and coaching/mentorship...
December 2016: Public Health
https://www.readbyqxmd.com/read/27929678/inpatient-glucose-management-teams-evidence-for-a-common-sense-practice
#3
Archana Reddy Sadhu
No abstract text is available yet for this article.
December 2016: Endocrine Practice
https://www.readbyqxmd.com/read/27929242/community-acquired-pneumonia-in-adults-diagnosis-and-management
#4
Alexander Kaysin, Anthony J Viera
Community-acquired pneumonia is a leading cause of death. Risk factors include older age and medical comorbidities. Diagnosis is suggested by a history of cough, dyspnea, pleuritic pain, or acute functional or cognitive decline, with abnormal vital signs (e.g., fever, tachycardia) and lung examination findings. Diagnosis should be confirmed by chest radiography or ultrasonography. Validated prediction scores for pneumonia severity can guide the decision between outpatient and inpatient therapy. Using procalcitonin as a biomarker for severe infection may further assist with risk stratification...
November 1, 2016: American Family Physician
https://www.readbyqxmd.com/read/27928991/mortality-in-patients-with-diabetes-mellitus-and-addison-s-disease-a-nationwide-matched-observational-cohort-study
#5
Dimitrios Chantzichristos, Anders Persson, Björn Eliasson, Mervete Miftaraj, Stefan Franzén, Ragnhildur Bergthorsdottir, Soffia Gudbjörnsdottir, Ann-Marie Svensson, Gudmundur Johannsson
OBJECTIVE: Our hypothesis was that patients with diabetes mellitus obtain an additional risk of death if they develop Addison's disease (AD). DESIGN AND METHODS: Nationwide, matched, observational cohort study cross-referencing the Swedish National Diabetes Register with Inpatient, Cancer and Cause of Death Registers in patients with diabetes (type 1 and 2) and AD and matched controls with diabetes. Clinical characteristics at baseline, overall, and cause-specific mortality were assessed...
January 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/27927519/a-rapid-recovery-pathway-for-adolescent-idiopathic-scoliosis-that-improves-pain-control-and-reduces-time-to-inpatient-recovery-after-posterior-spinal-fusion
#6
Alex L Gornitzky, John M Flynn, Wallis T Muhly, Wudbhav N Sankar
STUDY DESIGN: Retrospective comparative cohort. OBJECTIVES: To determine if a standardized multimodal analgesic and rehabilitation protocol (rapid recovery pathway [RRP]) in adolescent idiopathic scoliosis (AIS) patients undergoing posterior spinal fusion (PSF) could improve pain control, reduce opioid-related complications, and expedite early mobilization. BACKGROUND: Several reports have described postoperative recovery pathways for AIS patients undergoing PSF that shorten length of stay (LOS) without reporting the impact such pathways might have on patients' pain or quality of recovery...
July 2016: Spine Deformity
https://www.readbyqxmd.com/read/27927494/increasing-rates-of-surgical-management-of-multilevel-spinal-curvature-in-elderly-patients
#7
David C Sing, Ryan Khanna, Jeremy D Shaw, Lionel N Metz, Shane Burch, Sigurd H Berven
STUDY DESIGN: Retrospective analysis of Nationwide Inpatient Sample (NIS) database. OBJECTIVE: To analyze trends in utilization and hospital charges for multilevel spinal curvature surgery in patients over 60 from 2004 to 2011. SUMMARY OF BACKGROUND DATA: Multilevel spinal curvature has been increasingly recognized as a major source of morbidity in patients over sixty years of age. The economic burden of non-operative management for spinal curvature is elusive and likely underestimated...
September 2016: Spine Deformity
https://www.readbyqxmd.com/read/27926560/using-modified-frailty-index-to-predict-safe-discharge-within-48-hours-of-ileostomy-closure
#8
Yuxiang Wen, Murad A Jabir, Eslam M G Dosokey, Dongjin Choi, Clayton C Petro, Justin T Brady, Scott R Steele, Conor P Delaney
BACKGROUND: Enhanced recovery pathways allow for safe discharge and optimal outcomes within 48 hours after ileostomy closure. Unfortunately, some patients undergoing ileostomy closure have prolonged hospital stays. We have shown previously that the Modified Frailty Index can help predict patients who will fail early discharge after laparoscopic colorectal surgery. OBJECTIVE: The purpose of this study was to use the Modified Frailty Index to identify patients who were safe for early discharge after ileostomy closure...
January 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27921381/cost-analysis-of-the-treatment-of-severe-acute-malnutrition-in-west-africa
#9
Sheila Isanaka, Nicolas A Menzies, Jessica Sayyad, Mudasiru Ayoola, Rebecca F Grais, Stéphane Doyon
We present an updated cost analysis to provide new estimates of the cost of providing community-based treatment for severe acute malnutrition, including expenditure shares for major cost categories. We calculated total and per child costs from a provider perspective. We categorized costs into three main activities (outpatient treatment, inpatient treatment, and management/administration) and four cost categories within each activity (personnel; therapeutic food; medical supplies; and infrastructure and logistical support)...
December 5, 2016: Maternal & Child Nutrition
https://www.readbyqxmd.com/read/27920544/pharmaceutical-interventions-in-the-management-of-tuberculosis-in-a-pneumophtisiology-department-ivory-coast
#10
Danho Pascal Abrogoua, Boua Alexis Thierry Kamenan, Brou Jean Marcel Ahui, Elisée Doffou
OBJECTIVES: This study aims to analyze the profile and relevance of pharmaceutical interventions (PIs) in the management of tuberculosis (TB) at inpatient settings. PATIENTS AND METHODS: Cross-sectional descriptive study conducted from March to December 2014 within the inpatient unit of pneumophtisiology department, Ivory Coast. Information collected was based on the classification of drug-related problems (DRPs) and PIs outlined by the French Society of Clinical Pharmacy...
2016: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/27918778/efficacy-of-oral-risperidone-haloperidol-or-placebo-for-symptoms-of-delirium-among-patients-in-palliative-care-a-randomized-clinical-trial
#11
Meera R Agar, Peter G Lawlor, Stephen Quinn, Brian Draper, Gideon A Caplan, Debra Rowett, Christine Sanderson, Janet Hardy, Brian Le, Simon Eckermann, Nicola McCaffrey, Linda Devilee, Belinda Fazekas, Mark Hill, David C Currow
Importance: Antipsychotics are widely used for distressing symptoms of delirium, but efficacy has not been established in placebo-controlled trials in palliative care. Objective: To determine efficacy of risperidone or haloperidol relative to placebo in relieving target symptoms of delirium associated with distress among patients receiving palliative care. Design, Setting, and Participants: A double-blind, parallel-arm, dose-titrated randomized clinical trial was conducted at 11 Australian inpatient hospice or hospital palliative care services between August 13, 2008, and April 2, 2014, among participants with life-limiting illness, delirium, and a delirium symptoms score (sum of Nursing Delirium Screening Scale behavioral, communication, and perceptual items) of 1 or more...
December 5, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27916378/incidence-and-significance-of-postoperative-complications-occurring-between-discharge-and-30%C3%A2-days-a-prospective-cohort-study
#12
John C Woodfield, Wiqqas Jamil, Peter M Sagar
BACKGROUND: Accurate documentation of complications is fundamental to clinical audit and research. While it is established that accurate diagnosis of surgical site infection (SSI) requires follow-up for 30 days; for other complications, there are minimal data quantifying their importance between discharge and 30 days. METHODS: In this prospective cohort study, inpatients undergoing general or vascular surgery were reviewed daily for complications by the medical team and a research fellow...
November 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27915323/the-role-of-neonatal-nurses-in-the-prevention-of-retinopathy-of-prematurity
#13
Geetanjli Kalyan, Sarah Moxon
The main risk factors for preterm babies developing retinopathy of prematurity (ROP) are poorly administered supplemental oxygen, infections, poor weight gain and transfusion of blood products, meaning ROP is sensitive to the quality of neonatal inpatient care provided, especially the nursing care. Nurses are the primary caregivers in neonatal units and play a critical role in preventing ROP related blindness. We discuss the role of the neonatal nurse in prevention of ROP based on a framework of five dimensions of care: specialist knowledge, clinical advocacy, leadership and mentorship, service management and counselling...
November 7, 2016: Indian Pediatrics
https://www.readbyqxmd.com/read/27915313/update-on-blindness-due-to-retinopathy-of-prematurity-globally-and-in-india
#14
Hannah Blencowe, Sarah Moxon, Clare Gilbert
Retinopathy of prematurity (ROP), a well-known complication of preterm birth that can result in avoidable blindness and visual impairment, is especially sensitive to the quality of neonatal inpatient care and appropriate, well-monitored oxygen. In 2010, the annual incidence of blindness and visual impairment from ROP was estimated to be 32,200 cases worldwide. The greatest burden is seen in middle-income countries, particularly where coverage of neonatal inpatient care has expanded without due attention to the quality of care provided, and the neonatal nursing skills and training of those providing this care...
November 7, 2016: Indian Pediatrics
https://www.readbyqxmd.com/read/27915096/universal-contact-precautions-do-not-change-the-prevalence-of-antibiotic-resistant-organisms-in-a-tertiary-burn-unit
#15
Adelyn L Ho, Reid Chambers, Claudia Malic, Anthony Papp
OBJECTIVE: The prevalence of antibiotic-resistant organisms (ARO) in burn units is increasing worldwide and contributes significantly to morbidity and mortality. Study aims are to describe the burden of AROs in burn patients admitted to a tertiary burn unit, to evaluate the impact of contact precautions implemented after an outbreak of antibiotic-resistant Acinetobacter baumannii, and to identify possible predictors of ARO acquisition. METHODS: Data of burn inpatients between 2006 and 2010 were retrospectively reviewed...
November 30, 2016: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/27913984/basal-insulin-persistence-associated-factors-and-outcomes-after-treatment-initiation-a-retrospective-database-study-among-people-with-type-2-diabetes-mellitus-in-japan
#16
Irene Hadjiyianni, Urvi Desai, Shuichi Suzuki, Jasmina I Ivanova, Dachuang Cao, Noam Y Kirson, Dai Chida, Caroline Enloe, Howard G Birnbaum, Magaly Perez-Nieves
INTRODUCTION: The objective of this study was to assess basal insulin persistence, associated factors, and economic outcomes for insulin-naïve people with type 2 diabetes mellitus (T2DM) in Japan. METHODS: People aged at least 18 years with T2DM with first claim for basal insulin between May 2006 and April 2013 (index date), no insulin use before index date, and continuous insurance coverage for 6 months before (baseline) and 12 months after index date were selected from the Japan Medical Center Database...
December 2, 2016: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/27913722/impact-of-a-multidisciplinary-round-visit-for-the-management-of-dysphagia-utilizing-a-wi-fi-based-wireless-flexible-endoscopic-evaluation-of-swallowing
#17
Koichi Sakakura, Masayuki Tazawa, Natsuko Otani, Masato Takagi, Mariko Morita, Minori Kurosaki, Tomoko Chiyoda, Yuri Kanai, Ayaka Endo, Takaaki Murata, Masato Shino, Yuki Yokobori, Kenji Shirakura, Naoki Wada, Kazuaki Chikamatsu
OBJECTIVES: The management of dysphagia requires a multidisciplinary approach, especially in large-scale hospitals. We introduce a novel protocol using a Wi-Fi-based flexible endoscopic evaluation of swallowing (FEES) system and aim to verify its effectiveness in evaluation and rehabilitation of inpatients with dysphagia. METHOD: We conducted novel Wi-Fi-based FEES at the bedside using 3 iPads as monitors and recorders. Functional outcomes of swallowing in 2 different hospitals for acute care with conventional wired or wireless FEES were compared retrospectively...
January 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/27913030/confounding-variables-and-the-performance-of-triggers-in-detecting-unreported-adverse-drug-reactions
#18
Fabiana Rossi Varallo, Carolina Dagli-Hernandez, Caroline Pagotto, Tales Rubens de Nadai, Maria Teresa Herdeiro, Patricia de Carvalho Mastroianni
PURPOSE: This study explored the performance of trigger in detecting adverse drug reactions (ADRs), the confounding variables impairing the causal association of the ADRs, and the underreporting rate by hospital health professionals. METHODS: A 6-month cross-sectional study was conducted in a public general hospital. Data collection was conducted in 2 stages: (1) screening of patient hospitalizations to identify suspected ADRs with 9 triggers developed by the Institute of Healthcare Improvement; and (2) chart review to perform the causality assessment of the suspected ADRs identified, to describe the confounding variables associated with detection of suspected ADRs that were not drug induced, and to analyze the positive predictive value of triggers in recognizing ADRs...
November 29, 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27912992/brain-tumors-and-metastases
#19
REVIEW
Mary M Vargo
Patients with brain tumor exhibit wide-ranging prognoses and functional implications of their disease and treatments. In general, the supportive care needs of patients with brain tumor, including disabling effects, have been recognized to be high. This review (1) briefly summarizes brain tumor types, treatments, and prognostic information for the rehabilitation clinician; (2) reviews evidence for rehabilitation, including acute inpatient rehabilitation and cognitive rehabilitation, and the approaches to selected common symptom and medical management issues; and (3) examines emerging data about survivorship, such as employment, community integration, and fitness...
February 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27911071/severe-brain-injury-in-massachusetts-assessing-the-continuum-of-care
#20
Laura Lorenz, Gabrielle Katz
Acquired brain injury (ABI) is a major public health problem in Massachusetts (Hackman et al, 2014) and includes traumatic brain injury (TBI), stroke, ABI-related infectious diseases, metabolic disorders affecting the central nervous system (brain and spinal cord), and brain tumor. Advances in emergency medical care and neurosurgery mean that more people are surviving severe traumatic brain injury (Trexler et al, 2014). Yet many patients with severe TBI in particular, are not receiving inpatient services after initial treatment (Hackman et al, 2014; CDC, 2014) or later that are known to be effective (Malec & Kean, 2015; Lewis & Horn, 2015; BI Commission, 2011; Kolakowsky-Hayner et al, 2000; Interviews)...
December 10, 2015: Issue Brief
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