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

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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
#1
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;1-4.
February 14, 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
#2
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
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/29395173/the-sensitivity-of-clinician-diagnosis-of-sepsis-in-tertiary-and-community-based-emergency-settings
#6
Halden F Scott, Emily E Greenwald, Lalit Bajaj, Sara J Deakyne Davies, Lina Brou, Allison Kempe
OBJECTIVES: To assess whether the risk of missed clinician diagnosis of pediatric sepsis requiring care in the intensive care unit (ICU) was greater in community vs tertiary pediatric emergency care settings with sepsis pathways. STUDY DESIGN: An observational cohort study in a tertiary pediatric emergency department (ED) staffed by pediatric emergency physicians and 4 affiliated community pediatric ED/urgent care sites staffed by general pediatricians. Use of an institutional sepsis order set or pathway was considered clinician diagnosis of sepsis...
January 25, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29384776/evaluating-an-order-set-for-improvement-of-quality-outcomes-in-diabetic-ketoacidosis
#7
Anna Marie Joyner Blair, Bernita K Hamilton, Amy Spurlock
The timely management of diabetic ketoacidosis (DKA) is essential to avoid lengthy hospitalizations and poor clinical outcomes. There is often an absence of ownership for glycemic management in hospitalized patients, most notably in those with a diagnosis other than diabetes. Evidence supports the use of evidence-based DKA protocols. The purpose of this project was to determine whether utilization of an evidence-based order set versus an individualized provider approach for the treatment and management of DKA decreases resolution time and occurrences of hypoglycemia and improves clinical outcomes...
January 2018: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/29382230/how-to-optimize-the-prescription-of-laboratory-tests-success-and-failures-in-an-academic-hospital
#8
Catherine Fillée, Claire Beguin, Laurence Habimana, Catherine Hubert, Marianne Philippe
In the context of the flat-rate reimbursements in healthcare, we reviewed physicians' behavior towards laboratory test ordering. We demonstrated how it could be improved when a specific stage of the patient management is considered. We took a multi-step approach to analyze the laboratory test orders in the context of planned laparoscopic cholecystectomy in a general teaching hospital. A reference order set was defined through a collaborative analysis between clinicians and laboratory physicians. The clinical and financial impacts were then evaluated over a period of 24 months...
January 30, 2018: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/29371241/clinical-decision-support-for-recognition-and-management-of-hypertension-a-randomized-trial
#9
Elyse O Kharbanda, Steve E Asche, Alan R Sinaiko, Heidi L Ekstrom, James D Nordin, Nancy E Sherwood, Patricia L Fontaine, Steven P Dehmer, Deepika Appana, Patrick O'Connor
OBJECTIVES: Although blood pressure (BP) is routinely measured in outpatient visits, elevated BP and hypertension are often not recognized. We evaluated whether an electronic health record-linked clinical decision support (CDS) tool could improve the recognition and management of hypertension in adolescents. METHODS: We randomly assigned 20 primary care clinics within an integrated care system to CDS or usual care. At intervention sites, the CDS displayed BPs and percentiles, identified incident hypertension on the basis of current or previous BPs, and offered tailored order sets...
January 25, 2018: Pediatrics
https://www.readbyqxmd.com/read/29353243/impact-of-order-set-design-on-urine-culturing-practices-at-an-academic-medical-centre-emergency-department
#10
Satish Munigala, Ronald R Jackups, Robert F Poirier, Stephen Y Liang, Helen Wood, S Reza Jafarzadeh, David K Warren
BACKGROUND: Urinalysis and urine culture are commonly ordered tests in the emergency department (ED). We evaluated the impact of removal of order sets from the 'frequently ordered test' in the computerised physician order entry system (CPOE) on urine testing practices. METHODS: We conducted a before (1 September to 20 October 2015) and after (21 October to 30 November 2015) study of ED patients. The intervention consisted of retaining 'urinalysis with reflex to microscopy' as the only urine test in a highly accessible list of frequently ordered tests in the CPOE system...
January 20, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29347877/part-set-cueing-impairment-facilitation-in-semantic-memory
#11
Matthew R Kelley, Sushmeena A Parihar
The present study explored the influence of part-set cues in semantic memory using tests of "free" recall, reconstruction of order, and serial recall. Nine distinct categories of information were used (e.g., Zodiac signs, Harry Potter books, Star Wars films, planets). The results showed part-set cueing impairment for all three "free" recall sets, whereas part-set cueing facilitation was evident for five of the six ordered sets. Generally, the present results parallel those often observed across episodic tasks, which could indicate that similar mechanisms contribute to part-set cueing effects in both episodic and semantic memory...
January 19, 2018: Memory
https://www.readbyqxmd.com/read/29331633/organ-donation-in-the-icu-a-document-analysis-of-institutional-policies-protocols-and-order-sets
#12
Simon J W Oczkowski, John E Centofanti, Pamela Durepos, Erika Arseneau, Julija Kelecevic, Deborah J Cook, Maureen O Meade
OBJECTIVE: To better understand how local policies influence organ donation rates. RESEARCH METHODOLOGY/DESIGN: We conducted a document analysis of our ICU organ donation policies, protocols and order sets. We used a systematic search of our institution's policy library to identify documents related to organ donation. We used Mindnode software to create a publication timeline, basic statistics to describe document characteristics, and qualitative content analysis to extract document themes...
January 10, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29324209/using-process-improvement-tools-to-improve-the-care-of-patients-with-neutropenic-fever-in-the-emergency-room
#13
Avantika Dang, Lauren N Gjolaj, Myka Whitman, Gustavo Fernandez
PURPOSE: The purpose of this study was to improve the care of patients with neutropenic fever in an academic acute care hospital's emergency room (ER). METHODS: Using the define, measure, analyze, improve, control method, a two-phase project with three critical to quality metrics (reduction in time to antibiotic administration, increase in percentage of patients with neutropenic fever identified as an oncology emergency, and increase in patients cohorted on oncology units) was completed...
January 2018: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29302876/improving-the-quality-of-inpatient-bowel-preparation-for-colonoscopies
#14
Sarah K Argyropoulos, S Kashif Mahmood, Emily J Campbell, James M Richter
BACKGROUND: Hospitalized patients completing bowel preparation for colonoscopy typically have preparations of poorer quality when compared to outpatient populations. AIMS: Our study aimed to evaluate the effectiveness of a performance improvement program in improving colonoscopy preparation for an inpatient population. METHODS: We identified a cohort of adult patients (n = 641) undergoing an inpatient colonoscopy during a 12-month period at an academic medical center and compared a multifactor intervention group to a historical baseline group...
January 4, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29298109/the-progression-of-end-of-life-wishes-and-concordance-with-end-of-life-care
#15
Jennifer Hopping-Winn, Juliette Mullin, Laurel March, Michelle Caughey, Melissa Stern, Jill Jarvie
Since 2013, Kaiser Permanente Northern California has engaged in a systematic effort to elicit, document, and honor the care preferences of patients as they near the end of life. This is done through its Advanced Steps program, in which selected patients discuss their preferences for future medical care with their healthcare agent during a structured conversation with a trained advance care planning facilitator. The facilitator then translates the patient's wishes into an actionable medical order set using a Physician's Order for Life-Sustaining Treatment (POLST) form...
January 3, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29288234/recovery-from-n-deprivation-is-a-transcriptionally-and-functionally-distinct-state-in-chlamydomonas
#16
Chia-Hong Tsai, Sahra Uygun, Rebecca Roston, Shin-Han Shiu, Christoph Benning
Facing adverse conditions such as nitrogen (N) deprivation, microalgae enter cellular quiescence, a reversible cell cycle arrest with drastic changes in metabolism allowing cells to remain viable. Recovering from N deprivation and quiescence is an active and orderly process as we are showing here for Chlamydomonas reinhardtii. We conducted comparative transcriptomics on this alga to discern processes relevant to quiescence in the context of N deprivation and recovery following refeeding. A mutant with slow recovery from N deprivation, compromised hydrolysis of triacylglycerols 7 (cht7), was included to better define the regulatory processes governing the respective transitions...
December 29, 2017: Plant Physiology
https://www.readbyqxmd.com/read/29276678/understanding-bicycling-in-cities-using-system-dynamics-modelling
#17
Alexandra Macmillan, James Woodcock
Background: Increasing urban bicycling has established net benefits for human and environmental health. Questions remain about which policies are needed and in what order, to achieve an increase in cycling while avoiding negative consequences. Novel ways of considering cycling policy are needed, bringing together expertise across policy, community and research to develop a shared understanding of the dynamically complex cycling system. In this paper we use a collaborative learning process to develop a dynamic causal model of urban cycling to develop consensus about the nature and order of policies needed in different cycling contexts to optimise outcomes...
December 2017: Journal of Transport & Health
https://www.readbyqxmd.com/read/29276558/before-after-study-of-an-electronic-order-set-for-reversal-of-vitamin-k-antagonist-associated-intracerebral-hemorrhage
#18
Jeffrey R Vitt, Lynn V Do, Nirav H Shah, Gary Fong, Nicole Y Nguyen, Anthony S Kim
Background: Vitamin K antagonist (VKA)-associated intracerebral hemorrhages (ICHs) are more likely to expand and are associated with higher mortality than primary ICH. Prompt reversal of anticoagulant effect with prothrombin complex concentrate (PCC) may promote hemostasis and decrease hematoma expansion. The aim of this study was to evaluate the impact of an electronic order set designed to standardize and facilitate more timely reversal of coagulopathy in VKA-associated ICH. Methods: We identified all adults who received PCC for VKA-associated ICH from June 2012 to June 2015 at University of California San Francisco Medical Center, which included a period before and after an electronic order set became available in 2014...
January 2018: Neurohospitalist
https://www.readbyqxmd.com/read/29258525/advancing-perinatal-patient-safety-through-application-of-safety-science-principles-using-health-it
#19
Jennifer Webb, Asta Sorensen, Samantha Sommerness, Beth Lasater, Kamila Mistry, Leila Kahwati
BACKGROUND: The use of health information technology (IT) has been shown to promote patient safety in Labor and Delivery (L&D) units. The use of health IT to apply safety science principles (e.g., standardization) to L&D unit processes may further advance perinatal safety. METHODS: Semi-structured interviews were conducted with L&D units participating in the Agency for Healthcare Research and Quality's (AHRQ's) Safety Program for Perinatal Care (SPPC) to assess units' experience with program implementation...
December 19, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29212880/standardizing-the-evaluation-of-nonaccidental-trauma-in-a-large-pediatric-emergency-department
#20
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
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