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

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https://www.readbyqxmd.com/read/29212880/standardizing-the-evaluation-of-nonaccidental-trauma-in-a-large-pediatric-emergency-department
#1
Lauren C Riney, Theresa M Frey, Emily T Fain, Elena M Duma, Berkeley L Bennett, Eileen Murtagh Kurowski
BACKGROUND AND OBJECTIVES: Variability exists in the evaluation of nonaccidental trauma (NAT) in the pediatric emergency department because of misconceptions and individual bias of clinicians. Further maltreatment, injury, and death can ensue if these children are not evaluated appropriately. The implementation of guidelines for NAT evaluation has been successful in decreasing differences in care as influenced by race and ethnicity of the patient and their family. Our Specific, Measurable, Achievable, Realistic, and Timely aim was to increase the percent of patients evaluated in the emergency department for NAT who receive guideline-adherent evaluation from 47% to 80% by December 31, 2016...
December 6, 2017: Pediatrics
https://www.readbyqxmd.com/read/29212546/electronic-laboratory-medicine-ordering-with-evidence-based-order-sets-in-primary-care-elmo-study-protocol-for-a-cluster-randomised-trial
#2
Nicolas Delvaux, An De Sutter, Stijn Van de Velde, Dirk Ramaekers, Steffen Fieuws, Bert Aertgeerts
BACKGROUND: Laboratory testing is an important clinical act with a valuable role in screening, diagnosis, management and monitoring of diseases or therapies. However, inappropriate laboratory test ordering is frequent, burdening health care spending and negatively influencing quality of care. Inappropriate tests may also result in false-positive results and potentially cause excessive downstream activities. Clinical decision support systems (CDSSs) have shown promising results to influence the test-ordering behaviour of physicians and to improve appropriateness...
December 6, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29207983/protocol-for-project-impact-improving-millions-hearts-for-provider-and-community-transformation-a-quasi-experimental-evaluation-of-an-integrated-electronic-health-record-and-community-health-worker-intervention-study-to-improve-hypertension-management-among
#3
Priscilla M Lopez, Jennifer Zanowiak, Keith Goldfeld, Katarzyna Wyka, Ahmad Masoud, Susan Beane, Rashi Kumar, Phoebe Laughlin, Chau Trinh-Shevrin, Lorna Thorpe, Nadia Islam
BACKGROUND: The Million Hearts® initiative aims to prevent heart disease and stroke in the United States by mobilizing public and private sectors around a core set of objectives, with particular attention on improving blood pressure control. South Asians in particular have disproportionately high rates of hypertension and face numerous cultural, linguistic, and social barriers to accessing healthcare. Interventions utilizing Health information technology (HIT) and community health worker (CHW)-led patient coaching have each been demonstrated to be effective at advancing Million Hearts® goals, yet few studies have investigated the potential impact of integrating these strategies into a clinical-community linkage initiative...
December 6, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29207907/implementation-of-a-goal-directed-mechanical-ventilation-order-set-driven-by-respiratory-therapists-improves-compliance-with-best-practices-for-mechanical-ventilation
#4
Misty A Radosevich, Brendan T Wanta, Todd J Meyer, Verlin W Weber, Daniel R Brown, Nathan J Smischney, Daniel A Diedrich
PURPOSE: Data regarding best practices for ventilator management strategies that improve outcomes in acute respiratory distress syndrome (ARDS) are readily available. However, little is known regarding processes to ensure compliance with these strategies. We developed a goal-directed mechanical ventilation order set that included physician-specified lung-protective ventilation and oxygenation goals to be implemented by respiratory therapists (RTs). We sought as a primary outcome to determine whether an RT-driven order set with predefined oxygenation and ventilation goals could be implemented and associated with improved adherence with best practice...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29162640/outcomes-of-a-clinical-pathway-to-standardize-use-of-maintenance-intravenous-fluids
#5
Sahar N Rooholamini, Holly Clifton, Wren Haaland, Caitlin McGrath, Surabhi B Vora, Claudia S Crowell, Holly Romero, Jeffrey Foti
OBJECTIVES: Improper use of maintenance intravenous fluids (IVFs) may cause serious hospital-acquired harm. We created an evidence-based clinical pathway to guide providers on the indications for IVF, its preferred composition, and appropriate clinical monitoring. METHODS: Pathway implementation was supported by the creation of an electronic order set (PowerPlan) and hospital-wide education. Outcomes were measured among pathway-eligible patients for the years before (July 1, 2014-June 30, 2015) and after (July 1, 2015-June 30, 2016) implementation...
November 21, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29152476/early-recovery-pathway-for-hepatectomy-data-driven-liver-resection-care-and-recovery
#6
REVIEW
Susanne G Warner, Zeljka Jutric, Liana Nisimova, Yuman Fong
In recent years, great progress has been made toward safer hepatobiliary surgical interventions. This has resulted in more widely available treatments for patients who in the past were ineligible for curative resection of primary liver tumors, liver metastases, and advanced biliary tumors. However, the rise in procedures has seen increasingly heterogeneous perioperative management, yielding strikingly disparate outcomes. A number of groups have attempted to standardize perioperative care in an effort to create enhanced recovery pathways (ERPs) and provide clinicians with a dependable roadmap to success following hepatectomy...
October 2017: Hepatobiliary Surgery and Nutrition
https://www.readbyqxmd.com/read/29121848/effectively-reducing-amylase-testing-using-computer-order-entry-in-the-emergency-department-quality-improvement-without-eliminating-physician-choice
#7
Cassie Jaeger, Paul Sullivan, James Waymack, David Griffen Griffen
BACKGROUND: Amylase and lipase, pancreatic biomarkers, are measured in acute pancreatitis diagnosis. Since amylase testing does not add diagnostic value, lipase testing alone is recommended. Despite new recommendations, many physicians and staff continue to test both amylase and lipase. OBJECTIVE: To reduce unnecessary diagnostic testing in acute pancreatitis. METHODS: The pre-checked amylase test within the Emergency Department's Computerized Provider Order Entry (CPOE) abdominal pain order set was changed to an un-checked state, but kept as an option to order with a single click...
October 6, 2017: Journal of Innovation in Health Informatics
https://www.readbyqxmd.com/read/29117833/management-of-the-pediatric-patient-following-upper-extremity-replantation-or-revascularization-a-suggested-protocol
#8
Alec Sundet, Kyros Ipaktchi, Claudia Kunrath, Rodrigo N Banegas
BACKGROUND: Traumatic pediatric amputations of the hand and upper extremity can have long-term financial, psychological, developmental, and functional consequences that readily extend beyond the realm of that which is normally encountered in comparatively injured adults. These factors, along with a paucity of medical comorbidities, have guided a more liberal and aggressive approach to treating pediatric amputations in hopes of optimizing psychosocial, aesthetic, and developmental outcomes...
December 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/29114874/the-revolt-of-the-rust-belt-place-and-politics-in-the-age-of-anger
#9
Michael McQuarrie
This paper argues that the election of Donald Trump is the product of a confluence of historical factors rather than the distinctive appeal of the victor himself. By paying particular attention to the geography of unusual voting behaviour the analytical question comes into view: why did so much uncharacteristic voting occur in the Rust Belt states of the upper Midwest? It is impossible to answer this question adequately using conventional categorical attributes. The usual hypotheses of 'economic anxiety' and white revanchism are unable to account for sudden shifts in the voting behaviour of both white and black voters in post-industrial territories...
November 2017: British Journal of Sociology
https://www.readbyqxmd.com/read/29103751/cost-effectiveness-of-nivolumab-for-recurrent-or-metastatic-head-and-neck-cancer%C3%A2
#10
Matthew C Ward, Chirag Shah, David J Adelstein, Jessica L Geiger, Jacob A Miller, Shlomo A Koyfman, Mendel E Singer
OBJECTIVE: Nivolumab is the first drug to demonstrate a survival benefit for platinum-refractory recurrent or metastatic head and neck cancer. We performed a cost-utility analysis to assess the economic value of nivolumab as compared to alternative standard agents in this context. MATERIALS AND METHODS: Using data from the CheckMate 141 trial, we constructed a Markov simulation model from the US payer's perspective to evaluate the cost-effectiveness of nivolumab compared to physician choice of either cetuximab, methotrexate or docetaxel...
November 2017: Oral Oncology
https://www.readbyqxmd.com/read/29097379/data-science-in-radiology-a-path-forward
#11
Hugo Jwl Aerts
Artificial intelligence (AI), especially deep learning, has the potential to fundamentally alter clinical radiology. AI algorithms, which excel in quantifying complex patterns in data, have shown remarkable progress in applications ranging from self-driving cars to speech recognition. The AI application within radiology, known as radiomics, can provide detailed quantifications of the radiographic characteristics of underlying tissues. This information can be used throughout the clinical care path to improve diagnosis and treatment planning, as well as assess treatment response...
November 2, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/29050875/subcutaneous-mastectomy-in-female-to-male-transsexuals-optimizing-perioperative-and-operative-management-in-8-years-clinical-experience
#12
Andreas Wolter, Till Scholz, Naja Pluto, Jens Diedrichson, Andreas Arens-Landwehr, Jutta Liebau
INTRODUCTION: The incidence of complications, especially acute hematoma requiring surgical revision in female-to-male transsexuals (FTMTS), is consistently highly documented in literature with up to 33%. Since 2008 we perform subcutaneous mastectomies in FTMTS with an annually increasing number of cases. Due to an initially high hematoma revision rate in the previously published cohort (2008-2013), we implemented peri- and postoperative preventive measures and compared the results with the recent patient cohort (2014-2016)...
September 29, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29045991/naloxone-counseling-for-harm-reduction-and-patient-engagement
#13
Jonathan K Han, Lucas G Hill, Marianne E Koenig, Niladri Das
BACKGROUND AND OBJECTIVES: The United States is experiencing an epidemic of opioid-related deaths. Naloxone, the drug of choice for reversing acute opioid overdose, is not routinely prescribed for outpatient use. The aims of this project were to improve naloxone awareness, increase naloxone prescribing, and prevent opioid overdoses. METHODS: A naloxone counseling intervention was implemented in three family health centers by an interprofessional team of providers including family medicine physicians, clinical pharmacists, and social workers...
October 2017: Family Medicine
https://www.readbyqxmd.com/read/29034259/problem-adaptation-therapy-for-pain-path-pain-a-psychosocial-intervention-for-older-adults-with-chronic-pain-and-negative-emotions-in-primary-care
#14
Dimitris N Kiosses, Lisa D Ravdin, Amy Stern, Ruth Bolier, Cara Kenien, M Carrington Reid
Chronic pain is highly prevalent in older adults, contributes to activity restriction and social isolation, disrupts family and interpersonal relationships, and poses a significant economic burden to society. Negative emotions such as sadness, anxiety, helplessness, and hopelessness are associated with chronic pain and contribute to poor quality of life, impaired interpersonal and social functioning, and increased disability. Psychosocial interventions for older adults with chronic pain have been historically developed for, and are almost exclusively delivered to, cognitively intact patients...
2017: Geriatrics
https://www.readbyqxmd.com/read/28991018/clinical-nurse-specialist-driven-practice-change-standardizing-vital-sign-monitoring
#15
Kelly M Derby, Natalie A Hartung, Sherry L Wolf, Heather L Zak, Laura K Evenson
PURPOSE: The purpose of this project was to standardize vital sign (VS) monitoring throughout a patient's stay in the hospital, including at admission, following transitions to different levels of care, reassessment of abnormal VS results, daily monitoring, and before dismissal. The population of focus was adult general and progressive care patients. DESCRIPTION OF THE PROJECT: Standards for VS monitoring, documentation, and provider notification were established...
November 2017: Clinical Nurse Specialist CNS
https://www.readbyqxmd.com/read/28982259/the-comfort-measures-order-set-at-a-tertiary-care-academic-hospital-is-there-a-comparable-difference-in-end-of-life-care-between-patients-dying-in-acute-care-when-cmos-is-utilized
#16
Christine Lau, Kalli Stilos, Allyson Nowell, Fanchea Lau, Jennifer Moore, Lesia Wynnychuk
BACKGROUND: Standardized protocols have been previously shown to be helpful in managing end-of-life (EOL) care in hospital. The comfort measures order set (CMOS), a standardized framework for assessing imminently dying patients' symptoms and needs, was implemented at a tertiary academic hospital. OBJECTIVE: We assessed whether there were comparable differences in the care of a dying patient when the CMOS was utilized and when it was not. METHODS: A retrospective chart review was completed on patients admitted under oncology and general internal medicine, who were referred to the inpatient palliative care team for "EOL care" between February 2015 and March 2016...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28982216/resolve-conflicting-rankings-of-outcomes-in-network-meta-analysis-partial-ordering-of-treatments
#17
Gerta Rücker, Guido Schwarzer
Network meta-analysis has evolved into a core method for evidence synthesis in health care. In network meta-analysis, three or more treatments for a given medical condition are compared, based on a number of clinical studies, usually randomized controlled trials. Often many different endpoints are investigated, related to different aspects of the patient's outcome, such as efficacy, safety, acceptability or costs of a treatment. Different outcomes may lead to different rankings of the treatments. We use the existing theory of partially ordered sets and show how the relations between the treatments in a network meta-analysis can be illustrated by Hasse diagrams, that is, directed graphs showing the partial order relations, and by structured scatter plots and biplots...
October 5, 2017: Research Synthesis Methods
https://www.readbyqxmd.com/read/28979171/the-health-and-life-path-of-rare-disease-patients-results-of-the-2015-french-barometer
#18
Thomas Heuyer, Sonia Pavan, Christine Vicard
PURPOSE: A barometer has been set up to provide better knowledge about the daily situation of French rare disease (RD) patients, their families and relatives, in order to contribute to the elaboration of improvement measures. This report focuses on the care and life path of RD patients. PATIENTS AND METHODS: A preliminary survey was carried out with three patients, five parents and three RD experts to identify the main hurdles and disruptions in the life path of RD patients...
2017: Patient related Outcome Measures
https://www.readbyqxmd.com/read/28964298/implementation-of-a-perioperative-surgical-home-protocol-for-pediatric-patients-presenting-for-adenoidectomy
#19
Vidya T Raman, Dmitry Tumin, Joshua Uffman, Arlyne K Thung, Candice Burrier, Kris R Jatana, Charles Elmaraghy, Joseph D Tobias
INTRODUCTION: The perioperative surgical home (PSH) is a patient-centered model designed to improve health, streamline the delivery of health care, and reduce the cost of care. Following the national introduction of PSH in 2014 by the ASA, adult hospitals have reported success with this model, with studies validating the benefits of PSH including reducing length of stay, lowering costs, and improving patient satisfaction. METHODS: Eligible patients, ranging in age from 16-35 months of age, were identified by the pre-admission testing (PAT) registered nurses (RNs) and faculty anesthesiologists upon review of the patient history...
October 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28958797/patient-compliance-with-electronic-patient-reported-outcomes-following-shoulder-arthroscopy
#20
Eric C Makhni, John D Higgins, Jason T Hamamoto, Brian J Cole, Anthony A Romeo, Nikhil N Verma
PURPOSE: To determine the patient compliance in completing electronically administered patient-reported outcome (PRO) scores following shoulder arthroscopy, and to determine if dedicated research assistants improve patient compliance. METHODS: Patients undergoing arthroscopic shoulder surgery from January 1, 2014, to December 31, 2014, were prospectively enrolled into an electronic data collection system with retrospective review of compliance data. A total of 143 patients were included in this study; 406 patients were excluded (for any or all of the following reasons, such as incomplete follow-up, inaccessibility to the order sets, and inability to complete the order sets)...
November 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
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