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

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https://www.readbyqxmd.com/read/29682619/path-of-least-resistance-how-computerised-provider-order-entry-can-lead-to-and-reduce-wasteful-practices
#1
Joseph Choi, Cori Rebecca Atlin
Background: Computerised provider order entry (CPOE) is rapidly becoming the mainstay in clinical care and has the potential to improve provider efficiency and accuracy. However, this hinges on careful planning and implementation. Poorly planned CPOE order sets can lead to undetected errors and waste. In our emergency department (ED), lactate dehydrogenase (LDH) was bundled into various blood work panels but had little clinical value. Objectives: This quality improvement initiative aimed to reduce unnecessary LDH testing in the ED...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29668279/effect-of-coulomb-correlation-on-the-magnetic-properties-of-mn-clusters
#2
Chengxi Huang, Jian Zhou, Kaiming Deng, Erjun Kan, Puru Jena
In spite of decades of research, a fundamental understanding of the unusual magnetic behavior of small Mn clusters remains a challenge. Experiments show that Mn2 is antiferromagnetic while small clusters containing up to five Mn atoms are ferromagnetic with magnetic moments of 5 µB/atom, and become ferrimagnetic as they grow further. Theoretical studies based on density functional theory (DFT), on the other hand, find Mn2 to be ferromagnetic, with ferrimagnetic order setting in at different sizes that depend upon the computational methods used...
April 18, 2018: Journal of Physical Chemistry. A
https://www.readbyqxmd.com/read/29659856/integration-of-physical-abuse-clinical-decision-support-into-the-electronic-health-record-at-a-tertiary-care-children-s-hospital
#3
Srinivasan Suresh, Richard A Saladino, Janet Fromkin, Emily Heineman, Tom McGinn, Rudolph Richichi, Rachel P Berger
Objective: To evaluate the effect of a previously validated electronic health record-based child abuse trigger system on physician compliance with clinical guidelines for evaluation of physical abuse. Methods: A randomized controlled trial (RCT) with comparison to a preintervention group was performed. RCT-experimental subjects' providers received alerts with a direct link to a physical abuse-specific order set. RCT-control subjects' providers had no alerts, but could manually search for the order set...
April 12, 2018: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29644992/the-lived-experience-of-parents-whose-children-discharged-to-home-after-cardiac-surgery-for-congenital-heart-disease
#4
Silvio Simeone, Nicol Platone, Marco Perrone, Valentina Marras, Gianluca Pucciarelli, Martina Benedetti, Grazia Dell'Angelo, Teresa Rea, Assunta Guillari, Paola Da Valle, Gianpaolo Gargiulo, Stefano Botti, Giovanna Artioli, Giuseppe Comentale, Salvatore Ferrigno, Gaetano Palma, Stefania Baratta
BACKGROUND: Congenital Heart Diseases (CHDs) afflicting children are estimated in 8 per 1000 live births. Recent advances in surgery and medical treatments allowed an improvement in survival rates leading to changes in diseases management as chronic conditions. Parents involvement during clinical pathways is considered an essential component of care, but frequently they experience stress and anxiety conditions during the care path. These feelings are typical of the pre and peri-operative period, however they don't disappear easily and sometimes they can increase after hospital discharge, affecting the family environment and its behaviors...
April 4, 2018: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29642732/evaluation-of-appropriate-sodium-polystyrene-sulfonate-use-with-a-hyperkalemia-order-set-a-pilot-study
#5
Zachary T Mueller, Andrew J Crannage
BACKGROUND: No consensus guidelines exist to assist practitioners in the management of hyperkalemia. Sodium polystyrene sulfonate (SPS) is a common treatment option for hyperkalemia. To aid health-care professionals, a hyperkalemia order set was created at a 979-bed community teaching hospital. OBJECTIVE: The objective of this study was to determine whether use of a hyperkalemia order set is associated with appropriate use of SPS. METHODS: Orders for SPS were evaluated for appropriateness in this retrospective cohort of adult patients...
January 1, 2018: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29605025/fewer-thromboembolic-events-after-implementation-of-a-venous-thromboembolism-risk-stratification-tool
#6
Florence E Turrentine, Min-Woong Sohn, Susan L Wilson, Crockett Stanley, Wendy Novicoff, Robert G Sawyer, Michael D Williams
BACKGROUND: Deep venous thrombosis and pulmonary embolus are leading preventable causes of death after surgery. Venous thromboembolism (VTE) prophylaxis management guidelines, with evidenced-based recommendations, are available in the literature. However, over 40% of "at-risk" surgical patients fail to receive appropriate VTE prophylaxis. Decision support-based interventions to reduce venous thromboembolic events were explored. METHODS: A venous thromboembolic risk stratification tool embedded in the electronic medical record, Epic, linking risk category to venous thromboembolic prophylaxis order sets was created, implemented, and analyzed for general surgery patients...
May 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29584845/%C3%AE-blockers-in-myocardial-infarction-issues-with-standard-admission-order-sets
#7
Arjun Gupta, Sandeep R Das, Ambarish Pandey
No abstract text is available yet for this article.
March 27, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29584825/from-guideline-to-order-set-to-patient-harm
#8
EDITORIAL
Sachin D Shah, Adam S Cifu
No abstract text is available yet for this article.
March 27, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29557862/does-vancomycin-powder-decrease-surgical-site-infections-in-growing-spine-surgery-a-preliminary-study
#9
George H Thompson, Connie Poe-Kochert, Christina K Hardesty, Jochen Son-Hing, R Justin Mistovich
BACKGROUND: Vancomycin powder has been demonstrated to be safe in children, and yet there are no data on its use to reduce surgical site infections (SSIs) in surgery for early-onset scoliosis. METHODS: We performed a retrospective study of our patients treated for early-onset scoliosis in the period of 2010 to 2016. In 2010, we updated our standardized perioperative growing spine care path. The only later change was the gradual introduction of intrawound vancomycin powder...
March 21, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29547577/pharmacists-as-interprofessional-collaborators-and-leaders-through-clinical-pathways
#10
Sherine Ismail, Mohamed Osman, Rayf Abulezz, Hani Alhamdan, K H Mujtaba Quadri
Pharmacists possess pivotal competencies and expertise in developing clinical pathways (CPs). We present a tertiary care facility experience of pharmacists vis-a-vis interprofessional collaboration for designing and implementing CPs. We participated in the development of CPs as leading members of a collaborative team of healthcare professionals. We reviewed literature, aligning it with hospital formulary and institutional standards, and participated in weekly team meetings for six months. Several tools and services were adapted to guide prescribing and standardization of care through time-bound order sets...
March 16, 2018: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/29525499/a-quality-improvement-project-incorporating-preoperative-warming-to-prevent-perioperative-hypothermia-in-major-burns
#11
A D Rogers, M Saggaf, N Ziolkowski
BACKGROUND: Patients with extensive burn injuries are susceptible to a host of accompanying adverse effects should they develop perioperative hypothermia, which occurs in up to ¼ of all major burn cases. This quality improvement project aimed to reduce the incidence of perioperative hypothermia to below 10% of cases in patients with major burn (Total Body Surface Area [TBSA] >15%), within a one year period. METHODS: A baseline diagnostic phase was undertaken to provide a greater understanding of the incidence, natural history and risk factors of perioperative hypothermia...
March 7, 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29523537/implementation-of-an-integrated-computerized-prescriber-order-entry-system-for-chemotherapy-in-a-multisite-safety-net-health-system
#12
Clement Chung, Shital Patel, Rosetta Lee, Lily Fu, Sean Reilly, Tuyet Ho, Jason Lionetti, Michael D George, Pam Taylor
PURPOSE: The development of a computerized prescriber order-entry (CPOE) system for chemotherapy in a multisite safety-net health system and the challenges to its successful implementation are described. SUMMARY: Before CPOE for chemotherapy was first implemented and embedded in the electronic medical record system of Harris Health System (HHS), pharmacy personnel relied on regimen-specific preprinted order sets. However, due to differences in practice styles and workflow logistics, the paper orders across the 3 facilities were mostly site specific, with varying clinical content...
March 15, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29506459/a-pilot-study-a-teaching-electronic-medical-record-for-educating-and-assessing-residents-in-the-care-of-patients
#13
Joshua Smith, W Graham Carlos, Cynthia S Johnson, Blaine Takesue, Debra Litzelman
OBJECTIVE: We tested a novel, web-based teaching electronic medical record to teach and assess residents' ability to enter appropriate admission orders for patients admitted to the intensive care unit. The primary objective was to determine if this tool could improve the learners' ability to enter an evidence-based, comprehensive initial care plan for critically ill patients. METHODS: The authors created three modules using de-identifed real patient data from selected patients that were admitted to the intensive care unit...
December 2018: Medical Education Online
https://www.readbyqxmd.com/read/29467276/neonatal-jaundice-improved-quality-and-cost-savings-after-implementation-of-a-standard-pathway
#14
Holly M Romero, Coral Ringer, Michael G Leu, Elaine Beardsley, Karen Kelly, Megan D Fesinmeyer, Wren L Haaland, James B Johnson, Darren Migita
OBJECTIVES: Seattle Children's Hospital sought to optimize the value equation for neonatal jaundice patients by creating a standard care pathway. METHODS: An evidence-based pathway for management of neonatal jaundice was created. This included multidisciplinary team assembly, comprehensive literature review, creation of a treatment algorithm and computer order sets, formulation of goals and metrics, roll-out of an education program for end users, and ongoing pathway improvement...
February 21, 2018: Pediatrics
https://www.readbyqxmd.com/read/29464276/after-the-fall-improving-osteoporosis-treatment-following-hip-fracture
#15
B W Kuiper, S Graybill, J M Tate, N Kaufman, D Bersabe
Osteoporotic hip fractures can be life changing and can increase mortality. Treatment of osteoporosis following hip fracture is often delayed. We began offering osteoporosis medication during hospitalization for hip fracture, dramatically increasing the number of patients meeting standard of care. INTRODUCTION: Osteoporotic hip fracture is a debilitating condition with major morbidity and mortality implications. Osteoporosis medication given within 90 days of hip fracture improves mortality and reduces risk of future fractures...
February 20, 2018: Osteoporosis International
https://www.readbyqxmd.com/read/29439746/antimicrobial-stewardship-program-implementation-of-a-quality-improvement-intervention-using-real-time-feedback-and-an-electronic-order-set-for-the-management-of-staphylococcus-aureus-bacteremia
#16
Rossana Rosa, Bruno Zavala, Natalie Cain, Shweta Anjan, Laura Aragon, Lilian M Abbo
Antimicrobial stewardship programs can optimize the management of Staphylococcus aureus bacteremia by integrating information technology and microbiology laboratory resources. This study describes our experience implementing an intervention consisting of real-time feedback and the use of an electronic order set for the management of S. aureus bacteremia. Infect Control Hosp Epidemiol 2018;39:346-349.
March 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29438145/dramatic-reduction-in-hospital-acquired-pressure-injuries-using-a-pink-paper-reminder-system
#17
David C Shieh, Christine M Berringer, Roselyn Pantoja, Juji Resureccion, Joria M Rainbolt, Amena Hokoki
OBJECTIVE: The goal of this quality improvement project was to reduce the number of hospital-acquired pressure injuries (HAPIs) by flagging extremely high-risk patients with a pink paper reminder system and implementing a pressure injury prevention order set. METHODS: The pink paper reminder system is an innovative, cost-neutral, simple approach to identify patients at highest risk of pressure injury development who meet specific criteria. There are 2 steps to this intervention...
March 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29437531/improving-population-health-among-uninsured-patients-with-diabetes
#18
Michele H Talley, Shea Polancich, Jason B Williamson, Jennifer S Frank, William Curry, John F Russell, Cynthia Selleck
Diabetes is a leading cause of morbidity and mortality; prevalence of diabetes is especially high in the southeastern United States among minority populations and those from lower socioeconomic sectors without access to health care services. The purpose of this project was to evaluate the clinical and financial outcomes of a nurse-led, interprofessional collaborative practice model that provides care coordination and transitional care for uninsured patients with diabetes. Data for this study were collected and evaluated from medical records of patients seen at the Providing Access to Health Care (PATH) Clinic between August 1, 2015, through May 30, 2017...
February 13, 2018: Population Health Management
https://www.readbyqxmd.com/read/29395845/qualitative-evaluation-of-the-barriers-and-facilitators-influencing-the-use-of-an-electronic-basal-bolus-insulin-therapy-protocol-to-improve-the-care-of-adult-inpatients-with-diabetes
#19
Karmon E Helmle, Alun L Edwards, Andre W Kushniruk, Elizabeth M Borycki
OBJECTIVES: A qualitative evaluation of the perceived impact of a new evidence-informed electronic basal bolus insulin therapy order set on clinical workflow and practice, and exploration of potential barriers and facilitators to electronic basal bolus insulin order set uptake and use in acute care facilities for various acute care team members. METHODS: We conducted 9 semistructured focus groups with multidisciplinary nursing staff (n=22), resident trainees (n=24) and attending physicians (n=23) involved in the delivery of inpatient diabetes care at 3 adult acute care facilities...
January 29, 2018: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/29395477/www-mesothelioma-information-surfing-on-unreliable-waters-a-cross-sectional-study-into-the-content-and-quality-of-online-informational-resources-for-mesothelioma-patients
#20
S Sadaf Soloukey Tbalvandany, A Alexander P W M Maat, R Robin Cornelissen, J Joost J M E Nuyttens, J Johanna J M Takkenberg
OBJECTIVE: Malignant Mesothelioma (MM) is a rare asbestos related disease mostly diagnosed in low-skilled patients. The decision-making process for MM treatment is complicated, making an adequate provision of information necessary. The objective of this study is to assess the content and quality of online informational resources available for Dutch MM patients. METHODS: The first 100 hits of a Google search were studied using the JAMA benchmarks, the Modified Information Score (MIS) and the International Patient Decision Aid Standard Scoring (IPDAS)...
January 29, 2018: Patient Education and Counseling
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