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

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https://www.readbyqxmd.com/read/28991018/clinical-nurse-specialist-driven-practice-change-standardizing-vital-sign-monitoring
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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)...
September 25, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28944630/-coordinating-complex-nursing-care-building-a-guidance-tool-for-cancer-patients-to-direct-them-towards-the-coordination-nurse
#7
Raphael Froger, Benoit Allenet, Pascale Guillem
Introduction : following the 2009-2013 Cancer Plan, the experimental oncology nursing coordination (IDEC) showed a positive impact on the fluidity of care pathways. The 2014-2019 cancer plan guides their mission to complex cases. The objective of this study is to build a tool to facilitate the recruitment of patients likely to experience a complex path. Method : two phases have formed this research. The first one collected the elements of the dimensions that can predict the complexity of the care path, by focus group...
April 19, 2017: Recherche en Soins Infirmiers
https://www.readbyqxmd.com/read/28932097/an-extended-inequality-approach-for-evaluating-decision-making-units-with-a-single-output
#8
Xiao-Li Meng, Fu-Gui Shi
In this work, an extended evaluation approach for decision making units (DMUs) with a single output is proposed. Firstly, the input and output data for each DMU are changed in the same proportion until all the outputs are equal, and then the coordinate system is established with input i as the ith coordinate axis. Secondly, in the coordinate system, the production possibility set, which is spanned by all the DMUs without the evaluated DMU, is expressed by inequalities. Moreover, the mathematical expression of the line segment joining the origin to the evaluated DMU is given...
2017: Journal of Inequalities and Applications
https://www.readbyqxmd.com/read/28912197/standard-admission-order-sets-promote-ordering-of-unnecessary-investigations-a-quasi-randomised-evaluation-in-a-simulated-setting
#9
Benjamin Leis, Andrew Frost, Rhonda Bryce, Kelly Coverett
No abstract text is available yet for this article.
September 14, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28887350/institutional-care-paths-development-implementation-and-evaluation
#10
Mandy C Leonard, Seth R Bauer, Christine Ahrens, Anita Reddy, Irene Katzan
PURPOSE: The Cleveland Clinic experience with care paths, including their creation and implementation, challenges overcome during development and testing, and outcomes of selected care path evaluations, is described. SUMMARY: Care paths are tools to assist healthcare professionals in practicing evidence-based medicine. The Cleveland Clinic health system has implemented or is developing approximately 100 care paths, including care paths designed to optimize management of sepsis and septic shock and to promote timely use of i...
September 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28886183/effectiveness-of-tori-line-use-to-reduce-seabird-bycatch-in-pelagic-longline-fishing
#11
Andrés Domingo, Sebastián Jiménez, Martin Abreu, Rodrigo Forselledo, Oliver Yates
Industrial longline fisheries cause the death of large numbers of seabirds annually. Various mitigation measures have been proposed, including the use of tori lines. In this study the efficiency of a single tori line to reduce seabird bycatch was tested on pelagic longline vessels (25-37m length). Thirteen fishing trips were carried out in the area and season of the highest bycatch rates recorded in the southwest Atlantic (2009-2011). We deployed two treatments in random order: sets with a tori line and without a tori line (control treatment)...
2017: PloS One
https://www.readbyqxmd.com/read/28885238/improving-the-implementation-of-lung-cancer-screening-guidelines-at-an-academic-primary-care-practice
#12
Alison T Brenner, Laura Cubillos, Katherine Birchard, Caleb Doyle-Burr, John Eick, Louise Henderson, Laura Jones, Michael Massaro, Bailey Minish, Paul Molina, Michael Pignone, Shana Ratner, Maria Patricia Rivera, Daniel S Reuland
Expert groups recommend annual chest computed tomography for lung cancer screening (LCS) in high-risk patients. Lung cancer screening in primary care is a complex process that includes identification of the at-risk population, comorbidity assessment, and shared decision making. We identified three key processes required for high-quality screening implementation in our academic primary care practice: (1) systematic collection of lifetime cumulative smoking history to identify potentially eligible patients; (2) visit-based clinical reminders and order sets embedded in the electronic health record (EHR); and (3) tools to facilitate shared decision making and appropriate test ordering...
September 1, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28877642/to-assess-the-success-of-computerized-order-sets-and-pharmacy-education-modules-in-improving-antiretroviral-prescribing
#13
Dhara Mehta, Bella Kohn, Michael Blumenfeld, Harold W Horowitz
PURPOSE: To assess the success of order set and pharmacist training improvement (OSPTI) in improving prescription of antiretroviral therapy (ART) in a tertiary care, public, teaching hospital. METHODS: In this pre-OSPTI (January 2012 through June 2013) and post-OSPTI study (July 2013 through September 2014), an infectious disease pharmacist reviewed all patients on ART. A review of intervention data in July 2013 led to order-set changes in the hospital's computerized order entry system for frequently intervened on antiretrovirals: ritonavir, tenofovir, emtricitabine/tenofovir disoproxil fumarate (FTC/TDF), and lamivudine...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28870378/-think-aloud-and-near-live-usability-testing-of-two-complex-clinical-decision-support-tools
#14
Safiya Richardson, Rebecca Mishuris, Alexander O'Connell, David Feldstein, Rachel Hess, Paul Smith, Lauren McCullagh, Thomas McGinn, Devin Mann
OBJECTIVES: Low provider adoption continues to be a significant barrier to realizing the potential of clinical decision support. "Think Aloud" and "Near Live" usability testing were conducted on two clinical decision support tools. Each was composed of an alert, a clinical prediction rule which estimated risk of either group A Streptococcus pharyngitis or pneumonia and an automatic order set based on risk. The objective of this study was to further understanding of the facilitators of usability and to evaluate the types of additional information gained from proceeding to "Near Live" testing after completing "Think Aloud"...
October 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28852673/-tweak-your-order-set-implementation-of-modified-laboratory-order-set-improves-hepatitis-c-virus-screening-rates-in-people-living-with-human-immunodeficiency-virus
#15
Alysse G Wurcel, Daniel D Chen, Kenneth K H Chui, Tamsin A Knox
There are several barriers to annual hepatitis C virus antibody (HCVAb) testing, including lack of provider knowledge of the changing HCV epidemic and provider underestimation of a patient's risk. We identified low rates of testing for HCVAb in people living with human immunodeficiency virus (HIV) in our outpatient HIV Infectious Diseases clinic, and we developed a quality improvement project to increase rates of HCVAb screening.
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28830432/utility-of-autoimmune-serology-testing-in-the-assessment-of-uncharacterized-interstitial-lung-disease-a-large-retrospective-cohort-review
#16
Mohammad Alsumrain, Federica De Giacomi, Shireen Mirza, Teng Moua
BACKGROUND: Autoimmune serologies are often obtained in the initial evaluation of uncharacterized interstitial lung disease (ILD). Whether this practice is helpful in delineating connective-tissue disease related ILD (CTD-ILD) is not well known. We assessed the frequency of incident CTD-ILD as detected by autoimmune serology testing and presenting clinical signs and symptoms. METHODS: Consecutive patients seen at our institution over a four year period with newly diagnosed uncharacterized ILD and autoimmune serologic testing were included...
August 23, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28821215/implementation-of-global-strategies-to-prevent-hospital-onset-clostridium-difficile-infection-targeting-proton-pump-inhibitors-and-probiotics
#17
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...
October 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28764393/constructing-an-autonomous-system-with-infinitely-many-chaotic-attractors
#18
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
#19
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...
October 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
#20
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
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