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"order set" or "order sets" or "carepath" or "care path"

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https://www.readbyqxmd.com/read/28821215/implementation-of-global-strategies-to-prevent-hospital-onset-clostridium-difficile-infection-targeting-proton-pump-inhibitors-and-probiotics
#1
Paul O Lewis, Timothy S Lundberg, Jennifer L Tharp, Clay W Runnels
BACKGROUND: Proton pump inhibitors (PPIs) have been identified as a significant risk factor for the development of Clostridium difficile infection (CDI). Probiotics given concurrently with antibiotics have been shown to have a moderate impact on preventing CDI. OBJECTIVE: To evaluate the effectiveness of hospital-wide interventions designed to reduce PPI use and increase probiotics and whether these interventions were associated with a change in the incidence of hospital onset (HO)-CDI...
August 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28764393/constructing-an-autonomous-system-with-infinitely-many-chaotic-attractors
#2
Xu Zhang, Guanrong Chen
Some classical chaotic systems such as the Lorenz system and Chua system have finite numbers of chaotic attractors. This letter develops a simple, effective method for constructing lower-dimensional autonomous systems with infinitely many chaotic attractors. As an application, a Lorenz-type system and a Rössler-type system with infinitely many chaotic attractors are constructed with bifurcation analysis, and with an extension to the fractional-order setting.
July 2017: Chaos
https://www.readbyqxmd.com/read/28760168/the-impact-of-a-computerized-clinical-decision-support-tool-on-inappropriate-clostridium-difficile-testing
#3
Duncan R White, Keith W Hamilton, David A Pegues, Asaf Hanish, Craig A Umscheid
OBJECTIVE To evaluate the effectiveness of a computerized clinical decision support intervention aimed at reducing inappropriate Clostridium difficile testing DESIGN Retrospective cohort study SETTING University of Pennsylvania Health System, comprised of 3 large tertiary-care hospitals PATIENTS All adult patients admitted over a 2-year period INTERVENTION Providers were required to use an order set integrated into a commercial electronic health record to order C. difficile toxin testing. The order set identified patients who had received laxatives within the previous 36 hours and displayed a message asking providers to consider stopping laxatives and reassessing in 24 hours prior to ordering C...
August 1, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28755062/how-low-can-you-go-reducing-rates-of-hypoglycemia-in-the-non-critical-care-hospital-setting
#4
REVIEW
Kristen Kulasa, Patricia Juang
PURPOSE OF REVIEW: The purpose of this review is to discuss strategies to reduce rates of hypoglycemia in the non-critical care setting. RECENT FINDINGS: Strategies to reduce hypoglycemia rates should focus on the most common causes of iatrogenic hypoglycemia. Creating a standardized insulin order set with built-in clinical decision support can help reduce rates of hypoglycemia. Coordination of blood glucose monitoring, meal tray delivery, and insulin administration is an important and challenging task...
September 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28727629/an-automated-inpatient-split-dose-bowel-preparation-system-improves-colonoscopy-quality-and-reduces-repeat-procedures
#5
Rena Yadlapati, Elyse R Johnston, Adam B Gluskin, Dyanna L Gregory, Rachel Cyrus, Lindsay Werth, Jody D Ciolino, David P Grande, Rajesh N Keswani
BACKGROUND/GOALS: Inpatient colonoscopy preparations are often inadequate, compromising patient safety and procedure quality, while resulting in greater hospital costs. The aims of this study were to: (1) design and implement an electronic inpatient split-dose bowel preparation order set; (2) assess the intervention's impact upon preparation adequacy, repeated colonoscopies, hospital days, and costs. STUDY: We conducted a single center prospective pragmatic quasiexperimental study of hospitalized adults undergoing colonoscopy...
July 19, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28726156/remote-monitoring-and-consultation-of-inpatient-populations-with-diabetes
#6
REVIEW
Robert J Rushakoff, Joshua A Rushakoff, Zachary Kornberg, Heidemarie Windham MacMaster, Arti D Shah
PURPOSE OF REVIEW: Inpatient hyperglycemia is common and is linked to increased morbidity and mortality. We review current and innovative ways diabetes specialists consult in the management of inpatient diabetes. RECENT FINDINGS: With electronic medical records (EMRs), remote monitoring and intervention may improve the management of inpatient hyperglycemia. Automated reports allow monitoring of glucose levels and allow diabetes teams to intervene through formal or remote consultation...
September 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28725791/quality-improvement-intervention-for-reduction-of-redundant-testing
#7
Alan M Ducatman, Danyel H Tacker, Barbara S Ducatman, Dustin Long, Peter L Perrotta, Hannah Lawther, Kelly Pennington, Owen Lander, Mary Warden, Conard Failinger, Kevin Halbritter, Ronald Pellegrino, Marney Treese, Jeffrey A Stead, Eric Glass, Lauren Cianciaruso, Konrad C Nau
Laboratory data are critical to analyzing and improving clinical quality. In the setting of residual use of creatine kinase M and B isoenzyme testing for myocardial infarction, we assessed disease outcomes of discordant creatine kinase M and B isoenzyme +/troponin I (-) test pairs in order to address anticipated clinician concerns about potential loss of case-finding sensitivity following proposed discontinuation of routine creatine kinase and creatine kinase M and B isoenzyme testing. Time-sequenced interventions were introduced...
January 2017: Acad Pathol
https://www.readbyqxmd.com/read/28723587/evaluation-of-an-electronic-clinical-decision-support-tool-for-incident-elevated-bp-in-adolescents
#8
Elyse Olshen Kharbanda, Stephen E Asche, Alan Sinaiko, James D Nordin, Heidi L Ekstrom, Patricia Fontaine, Steven P Dehmer, Nancy E Sherwood, Patrick J O'Connor
OBJECTIVE: To evaluate, among adolescents 10-17 years with an incident hypertensive BP (≥95(th) percentile) at a primary care visit, whether TeenBP, a novel electronic health record (EHR) linked clinical decision support tool (CDS), improved recognition of elevated BP and return for follow-up BP evaluation. METHODS: We conducted a pragmatic cluster randomized trial in 20 primary care clinics in a large Midwestern medical group. Ten clinics received the TeenBP CDS, including an alert to remeasure a hypertensive BP at that visit, an alert that a hypertensive BP should be repeated in 1-3 weeks and patient-specific order sets...
July 16, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28721790/administering-and-monitoring-high-alert-medications-in-acute-care
#9
Joseph Macale Ruff Cajanding
The nurse's primary role in the medication process is to ensure that drugs are administered safely to patients, thus reducing the risk of unnecessary harm or injury. High-alert medications are a particular concern for healthcare professionals, since they are associated with an increased risk of causing patient harm. This article identifies high-risk medications and outlines measures that can be used to prevent potential harm to patients as a result of these medications, including computerised provider order entry, Tall Man lettering, order sets, independent double-checks and proactive patient monitoring...
July 19, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28714196/impact-of-an-electronic-health-record-alert-in-primary-care-on-increasing-hepatitis-c-screening-and-curative-treatment-for-baby-boomers
#10
Monica A Konerman, Mary Thomson, Kristen Gray, Meghan Moore, Hetal Choxi, Elizabeth Seif, Anna Sf Lok
Despite effective treatment for chronic hepatitis C (CHC), deficiencies in diagnosis and access preclude disease elimination. Screening of baby boomers remains low. The aims of this study were to assess the impact of an electronic health record (EHR) based prompt on HCV screening rates in baby boomers in primary care, and access to specialty care and treatment among those newly diagnosed. We implemented an EHR based "Best Practice Advisory" (BPA) that prompted primary care providers (PCPs) to perform HCV screening for patients seen in primary care clinic: 1) born between 1945-1965; 2) lacked a prior diagnosis of HCV infection; and 3) lacked prior documented anti-HCV testing...
July 17, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28698381/reasons-for-computerised-provider-order-entry-cpoe-based-inpatient-medication-ordering-errors-an-observational-study-of-voided-orders
#11
Joanna Abraham, Thomas G Kannampallil, Alan Jarman, Shivy Sharma, Christine Rash, Gordon Schiff, William Galanter
OBJECTIVE: Medication voiding is a computerised provider order entry (CPOE)-based discontinuation mechanism that allows clinicians to identify erroneous medication orders. We investigated the accuracy of voiding as an indicator of clinician identification and interception of a medication ordering error, and investigated reasons and root contributors for medication ordering errors. METHOD: Using voided orders identified with a void alert, we conducted interviews with ordering and voiding clinicians, followed by patient chart reviews...
July 11, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28697098/implementation-of-a-risk-based-heparin-protocol-for-postpartum-venous-thromboembolism-prevention
#12
Elizabeth Robison, Kent Heyborne, Amanda A Allshouse, Carolyn Valdez, Torri D Metz
OBJECTIVE: To evaluate the effect of a postpartum risk-based low-molecular-weight heparin protocol for venous thromboembolism prevention. METHODS: We conducted a retrospective cohort study of postpartum women at a safety net hospital before (2013), during (2014), and after (2015) implementation of a risk-based enoxaparin thromboembolism prevention protocol. The calculated sample size was based on a primary outcome of enoxaparin administration rate. Secondary outcomes included incidence of postpartum thromboembolism, wound complications, and 30-day readmission rates...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28682895/acute-decompensated-heart-failure-in-the-emergency-department-identification-of-early-predictors-of-outcome
#13
Luigi Mario Castello, Luca Molinari, Alessandra Renghi, Elena Peruzzi, Andrea Capponi, Gian Carlo Avanzi, Mario Pirisi
Identification of clinical factors that can predict mortality and hospital early readmission in acute decompensated heart failure (ADHF) patients can help emergency department (ED) physician optimize the care-path and resource utilization.We conducted a retrospective observational study of 530 ADHF patients evaluated in the ED of an Italian academic hospital in 2013.Median age was 82 years, females were 55%; 31.1% of patients were discharged directly from the ED (12.5% after short staying in the observation unit), while 68...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28672291/effects-of-an-intervention-to-reduce-hospitalizations-from-nursing-homes-a-randomized-implementation-trial-of-the-interact-program
#14
Robert L Kane, Peter Huckfeldt, Ruth Tappen, Gabriella Engstrom, Carolina Rojido, David Newman, Zhiyou Yang, Joseph G Ouslander
Importance: Medicare payment initiatives are spurring efforts to reduce potentially avoidable hospitalizations. Objective: To determine whether training and support for implementation of a nursing home (NH) quality improvement program (Interventions to Reduce Acute Care Transfers [INTERACT]) reduced hospital admissions and emergency department (ED) visits. Design, Setting, and Participants: This analysis compared changes in hospitalization and ED visit rates between the preintervention and postintervention periods for NHs randomly assigned to receive training and implementation support on INTERACT to changes in control NHs...
July 3, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28651562/grape-a-pathway-template-method-to-characterize-tissue-specific-functionality-from-gene-expression-profiles
#15
Michael I Klein, David F Stern, Hongyu Zhao
BACKGROUND: Personalizing treatment regimes based on gene expression profiles of individual tumors will facilitate management of cancer. Although many methods have been developed to identify pathways perturbed in tumors, the results are often not generalizable across independent datasets due to the presence of platform/batch effects. There is a need to develop methods that are robust to platform/batch effects and able to identify perturbed pathways in individual samples. RESULTS: We present Gene-Ranking Analysis of Pathway Expression (GRAPE) as a novel method to identify abnormal pathways in individual samples that is robust to platform/batch effects in gene expression profiles generated by multiple platforms...
June 26, 2017: BMC Bioinformatics
https://www.readbyqxmd.com/read/28633453/a-multifaceted-quality-improvement-strategy-reduces-the-risk-of-catheter-associated-urinary-tract-infection
#16
Cecelia N Theobald, Matthew J Resnick, Thomas Spain, Robert S Dittus, Christianne L Roumie
Objective: Catheter-associated urinary tract infections (CAUTIs) are common and preventable hospital-acquired infections, yet their rate continues to rise nationwide. We describe the implementation of a multifaceted program to reduce catheter use and CAUTI rates while simultaneously addressing barriers to long-term success. Design/Setting/Participants: Pre-post study of medical inpatient veterans between December 2012 and February 2015. Intervention: Five component intervention: (i) a bedside catheter reminder; (ii) multidisciplinary educational campaign; (iii) structured catheter order set with clinical decision support; (iv) automated catheter discontinuation orders; and (v) protocol for post-catheter removal care...
June 17, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28627287/utilizing-the-electronic-health-record-to-improve-advance-care-planning-a-systematic-review
#17
Michael Todd Huber, Janelle Deneen Highland, Venkatesan Ram Krishnamoorthi, Joyce Wing-Yi Tang
PURPOSE: Advance care planning may ensure care that is concordant with patient wishes. However, advance care plans are frequently absent when needed due to failure to engage patients in planning, inability to access prior documentation, or poor documentation quality. Interventions utilizing tools within the electronic health record (EHR) may address these barriers at the point of care. We aimed to identify EHR interventions previously utilized to improve advance care plans. METHODS: We systematically searched 7 databases for observational and experimental studies of EHR interventions associated with advance care plans...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28615974/presurgical-cleft-lip-and-palate-orthopedics-an-overview
#18
REVIEW
Ibtesam Alzain, Waeil Batwa, Alex Cash, Zuhair A Murshid
Patients with cleft lip and/or palate go through a lifelong journey of multidisciplinary care, starting from before birth and extending until adulthood. Presurgical orthopedic (PSO) treatment is one of the earliest stages of this care plan. In this paper we provide a review of the PSO treatment. This review should help general and specialist dentists to better understand the cleft patient care path and to be able to answer patient queries more efficiently. The objectives of this paper were to review the basic principles of PSO treatment, the various types of techniques used in this therapy, and the protocol followed, and to critically evaluate the advantages and disadvantages of some of these techniques...
2017: Clinical, Cosmetic and Investigational Dentistry
https://www.readbyqxmd.com/read/28613161/deformation-based-curved-shape-representation
#19
Girum G Demisse, Djamila Aouada, Bjorn Ottersten
In this paper, we introduce a deformation based representation space for curved shapes in Rn. Given an ordered set of points sampled from a curved shape, the proposed method represents the set as an element of a finite dimensional matrix Lie group. Variation due to scale and location are filtered in a preprocessing stage, while shapes that vary only in rotation are identified by an equivalence relationship. The use of a finite dimensional matrix Lie group leads to a similarity metric with an explicit geodesic solution...
June 2, 2017: IEEE Transactions on Pattern Analysis and Machine Intelligence
https://www.readbyqxmd.com/read/28607851/order-sets-for-enhanced-recovery-after-surgery-protocol
#20
Melissa Shea-Budgell, Christiaan Schrag, Danielle Dumestre, Arezoo Astanehe, Claire Temple-Oberle
No abstract text is available yet for this article.
May 2017: Plastic and Reconstructive Surgery. Global Open
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