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https://www.readbyqxmd.com/read/29787349/head-and-neck-cancer-patients-rates-reasons-and-risk-factors-for-30-day-unplanned-readmission
#1
Michael K Ghiam, Alexander Langerman, Zoukaa Sargi, Sarah Rohde
Objective To analyze rates, risk factors, and complications for 30-day readmission among head and neck cancer (HNC) patients. Methods Retrospective review of administrative records from Vizient (Irving, Texas) Clinical Data Base/Resource Manager on HNC patients who underwent a head and neck surgical procedure from January 2013 through September 2015 at 176 academic and community medical centers. Results Of the 18,121 patients included in the study, 2502 patients were readmitted within 30 days (13.8%). Mean time to readmission was 11 ± 8...
May 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29782436/effectiveness-of-the-neonatal-discharge-program-for-very-low-birth-weight-infants-on-parental-efficacy-and-psychological-distress
#2
Lakshmi Shandra Bos, Shefaly Shorey, Tamill Salvee Kulantaipian, Jane S P Sng, Wilson W S Tam, Serena S L Koh
This pilot study aimed to (i) evaluate the effectiveness of a neonatal discharge program, (ii) identify relationships between parent and infant factors and parental efficacy and psychological distress, and (iii) identify ways to improve the neonatal discharge program. A quasiexperimental 1-group pretest/posttest design was used. Through consecutive sampling, 42 participants were recruited. Data were collected using self-report questionnaires. Self-administering instruments gathered data on parental efficacy and psychological distress as well as feedback and recommendations on the intervention...
May 17, 2018: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/29773712/acute-kidney-injury-and-risk-of-heart-failure-and-atherosclerotic-events
#3
Alan S Go, Chi-Yuan Hsu, Jingrong Yang, Thida C Tan, Sijie Zheng, Juan D Ordonez, Kathleen D Liu
BACKGROUND AND OBJECTIVES: AKI in the hospital is common and is associated with excess mortality. We examined whether AKI is also independently associated with a higher risk of different cardiovascular events in the first year after discharge. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a retrospective analysis of a cohort between 2006 and 2013 with follow-up through 2014, within Kaiser Permanente Northern California. We identified all adults admitted to 21 hospitals who had one or more in-hospital serum creatinine test result and survived to discharge...
May 17, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29771807/administration-of-an-oral-hydration-solution-prevents-electrolyte-and-fluid-disturbances-and-reduces-readmissions-in-patients-with-a-diverting-ileostomy-after-colorectal-surgery-a-prospective-randomized-controlled-trial
#4
Athanasios Migdanis, Georgios Koukoulis, Ioannis Mamaloudis, Ioannis Baloyiannis, Ioannis Migdanis, Maria Kanaki, Eleni Malissiova, Georgios Tzovaras
BACKGROUND: Patients with a newly formed ileostomy often develop electrolyte abnormalities and dehydration. OBJECTIVE: The study assessed the prophylactic effect of an isotonic hydration solution on dehydration and electrolyte abnormalities in patients with a newly formed ileostomy. DESIGN: This was a prospective, randomized, controlled trial (NCT02036346). SETTINGS: The study was conducted at a single surgical unit of a public university hospital...
May 15, 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29766499/optimal-timing-of-physician-visits-after-hospital-discharge-to-reduce-readmission
#5
Bruno D Riverin, Erin C Strumpf, Ashley I Naimi, Patricia Li
OBJECTIVE: To identify the optimal timing of in-person physician visit after hospital discharge to yield the largest reduction in readmission among elderly or chronically ill patients. DATA SOURCES/STUDY SETTING/EXTRACTION METHODS: We extracted insurance billing data on 620,656 admissions for any cause from 2002 to 2009 in Quebec, Canada. STUDY DESIGN: We used flexible survival models to estimate inverse probability weights for the precise timing (days) of in-person physician visit after discharge and weighted competing risk outcome models...
May 15, 2018: Health Services Research
https://www.readbyqxmd.com/read/29766132/red-cell-distribution-width-predicts-out-of-hospital-outcomes-in-critically-ill-emergency-general-surgery-patients
#6
Joaquim Michael Havens, Anupamaa J Seshadri, Ali Salim, Kenneth B Christopher
Introduction: Red cell distribution width (RDW) is associated with mortality and bloodstream infection risk in critically ill patients. We hypothesized that an increase in RDW at hospital discharge in critically ill patients who received emergency general surgery (EGS) would be associated with increased mortality after hospital discharge. Methods: We performed a two-center observational study of patients treated in medical and surgical intensive care units. We studied 1567 patients, who received critical care between 1998 and 2012 who underwent EGS and survived hospitalization...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29764689/patient-identified-needs-related-to-seeking-a-diagnosis-in-the-emergency-department
#7
Angela M Gerolamo, Annemarie Jutel, Danielle Kovalsky, Alexzandra Gentsch, Amanda M B Doty, Kristin L Rising
STUDY OBJECTIVE: Although diagnosis is a valuable tool for health care providers, and often the reason patients say they are seeking care, it may not serve the same needs for patients as for providers. The objective of this study is to explore what patients specifically want addressed when seeking a diagnosis at their emergency department (ED) visit. We propose that understanding these needs will facilitate a more patient-centered approach to acute care delivery. METHODS: This qualitative study uses semistructured telephone interviews with participants recently discharged from the ED of a large urban academic teaching hospital to explore their expectations of their ED visit and postdischarge experiences...
May 12, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29763977/transforming-care-to-evidence-based-practice-with-scripted-messages-an-improvement-project-for-pain-management-in-outpatient-surgical-patients
#8
Lanell M Bellury, Karen Mullinax, Judi Mozingo, Berta Dantzler, Nancy McGee
BACKGROUND: Outpatient surgeries are common and most patients experience pain postoperatively requiring nursing attention to pain management. Scripting, recommended for consistent, targeted communication to improve patient satisfaction, has limited evidence to support its use. AIMS: To explore the effect of scripted messages on self-reported pain control and patient satisfaction with care in outpatient surgical patients. METHODS: A retrospective medical record review pre- and postintervention evaluated a pain management scripted message delivered at two time points (preoperatively and postoperatively)...
May 15, 2018: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/29759288/perioperative-surgical-home-for-the-patient-with-chronic-pain
#9
REVIEW
Talal W Khan, Smith Manion
The management of acute pain for the phenotypically different patient who suffers from chronic pain is challenging. The care of these patients is expensive and siloed. The physician-led, multidisciplinary, patient-centric, care coordination framework of the perioperative surgical home is an optimal vehicle for the management of these patients. The engagement of physician anesthesiologists in the optimization, in-hospital management, and postdischarge care of the patient with chronic pain will lead to improved outcomes, reduced health care expenditures, and improve the health of this challenging population...
June 2018: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29754981/dialysis-patients-undergoing-total-knee-arthroplasty-have-significantly-increased-odds-of-perioperative-adverse-events-independent-of-demographic-and-comorbidity-factors
#10
Taylor D Ottesen, Cheryl K Zogg, Monique S Haynes, Rohil Malpani, Kirthi S Bellamkonda, Jonathan N Grauer
BACKGROUND: The prevalence of dialysis-dependent patients is growing, and an increasing number of these patients are being considered for total knee arthroplasty (TKA). Studies assessing the preoperative risk associated with TKA in this population are limited to institutional cohorts with small sample sizes or national inpatient databases that lack follow-up data. METHODS: The 2006-2015 National Surgical Quality Improvement Program databases were queried for adult patients undergoing elective TKA...
April 19, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29754866/outpatient-pharmacotherapy-for-neonatal-abstinence-syndrome
#11
Faouzi I Maalouf, William O Cooper, James C Slaughter, Judith Dudley, Stephen W Patrick
OBJECTIVE: To determine differences in lengths of stay, length of therapy, emergency department (ED) utilization, and hospital readmissions between infants with neonatal abstinence syndrome (NAS) treated exclusively with inpatient pharmacotherapy compared with those discharged on outpatient pharmacotherapy. STUDY DESIGN: This retrospective cohort study of infants enrolled in the Tennessee Medicaid program used administrative and vital records data from 2009 to 2011...
May 7, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29752854/perioperative-factors-associated-with-persistent-opioid-use-after-extensive-abdominal-surgery-in-children-and-adolescents-a-retrospective-cohort-study
#12
Pascal Owusu-Agyemang, Juan P Cata, Antoinette Van Meter, Ravish Kapoor, Acsa M Zavala, Uduak U Williams, January Tsai, Elizabeth Rebello, Lei Feng, Andrea Hayes-Jordan
BACKGROUND: In adults, preoperative opioid use and higher perioperative opioid consumption have been associated with higher odds of persistent opioid use after surgery. There are limited data on the prevalence and factors associated with persistent opioid use after major oncologic surgery in children. AIMS: In this study, we sought to determine the prevalence and factors associated with the development of persistent opioid use in a group of children and adolescents who had undergone cytoreductive surgery with hyperthermic intraperitoneal chemotherapy...
May 12, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29750681/predischarge-and-postdischarge-risk-factors-for-hospital-readmission-among-patients-with-diabetes
#13
Abhijana Karunakaran, Huaqing Zhao, Daniel J Rubin
BACKGROUND: Hospital readmission within 30 days of discharge (30-d readmission) is an undesirable outcome. Readmission of patients with diabetes is common and costly. Most of the studies that have examined readmission risk factors among diabetes patients did not include potentially important clinical data. OBJECTIVES: To provide a more comprehensive understanding of 30-day readmission risk factors among patients with diabetes based on predischarge and postdischarge data...
May 10, 2018: Medical Care
https://www.readbyqxmd.com/read/29748346/validation-of-the-health-assets-index-in-the-australian-inpatient-setting-a-multicentre-prospective-cohort-protocol-study
#14
Katherine Gregorevic, Ruth E Hubbard, Nancye May Peel, Wen Kwang Lim
INTRODUCTION: It is well known that frail older adults are at increased risk for mortality and functional decline on admission to hospital. Systematic review demonstrates that health assets are associated with improved outcomes for hospitalised older adults. The health assets index (HAI) has been developed to measure health assets in the hospital setting. A protocol has been developed to determine the predictive validity of the HAI for frail older adults. METHODS AND ANALYSIS: The HAI was developed based on a systematic review and secondary analysis of the interRAI-Acute Care (interRAI-AC) dataset...
May 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29747788/predictors-of-uncertainty-among-postdischarge-coronary-artery-bypass-graft-patients-in-jordan
#15
Maha Subih, Mahmoud Al-Kalaldeh, Ibrahim Salami, Lourance Al-Hadid, Loai Abu-Sharour
Uncertainty impacts negatively on adaptation and disease outcomes. During recovery, coronary artery bypass graft (CABG) patients experience uncertainty, symptom distress, and learning needs. This study aimed to examine predictors associated with uncertainty among CABG patients. This cross-sectional correlational study recruited CABG patients conveniently from out-patient clinics 1 month after discharge. Participants completed a self-administered questionnaire which included: demographic questionnaire, Mishel's Uncertainty of Illness Scale, Cardiac Symptoms Survey, and Cardiac Patients Learning Needs...
June 2018: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
https://www.readbyqxmd.com/read/29746689/impact-of-hospital-context-on-transitioning-patients-from-hospital-to-skilled-nursing-facility-a-grounded-theory-study
#16
Barbara J King, Andrea L Gilmore-Bykovskyi, Tonya J Roberts, Korey A Kennelty, Jacquelyn F Mirr, Michael B Gehring, Melissa N Dattalo, Amy J H Kind
Background: Twenty-five percentage of patients who are transferred from hospital settings to skilled nursing facilities (SNFs) are rehospitalized within 30 days. One significant factor in poorly executed transitions is the discharge process used by hospital providers. Objective: The objective of this study was to examine how health care providers in hospitals transition care from hospital to SNF, what actions they took based on their understanding of transitioning care, and what conditions influence provider behavior...
May 8, 2018: Gerontologist
https://www.readbyqxmd.com/read/29746348/homeless-status-postdischarge-health-care-utilization-and-readmission-after-surgery
#17
Ashley Titan, Laura Graham, Amy Rosen, Kamal Itani, Laurel A Copeland, Hillary J Mull, Edith Burns, Joshua Richman, Stefan Kertesz, Tyler Wahl, Melanie Morris, Jeffery Whittle, Gordon Telford, Mark Wilson, Mary Hawn
INTRODUCTION: Homeless Veterans are vulnerable to poor care transitions, yet little research has examined their risk of readmission following inpatient surgery. This study investigates the predictors of surgical readmission among homeless relative to housed Veteran patients. METHODS: Inpatient general, vascular, and orthopedic surgeries occurring in the Veterans Health Administration from 2008 to 2014 were identified. Administrative International Classification of Diseases, Ninth Revision, Clinical Modification codes and Veterans Health Administration clinic stops were used to identify homeless patients...
June 2018: Medical Care
https://www.readbyqxmd.com/read/29745236/effect-of-ambulatory-transitional-care-management-on-30-day-readmission-rates
#18
Jonathan Ballard, Wade Rankin, Karen L Roper, Sarah Weatherford, Roberto Cardarelli
A process improvement initiative for transitional care management (TCM) was evaluated for effectiveness in reducing 30-day readmission rates in a retrospective cohort study. Regression models analyzed the association between level of TCM component implementation and readmission rates among patients discharged from a university medical center hospital. Of the 1884 patients meeting inclusion criteria, only 3.7% (70) experienced a 30-day readmission. Patients receiving the full complement of TCM had 86.6% decreased odds of readmission compared with patients who did not receive TCM ( P < ...
May 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29743157/parents-experiences-of-caring-for-their-child-at-the-time-of-discharge-after-cardiac-surgery-and-during-the-postdischarge-period-qualitative-study-using-an-online-forum
#19
Jo Wray, Katherine Brown, Jenifer Tregay, Sonya Crowe, Rachel Knowles, Kate Bull, Faith Gibson
BACKGROUND: Congenital heart disease (CHD) is the most common class of birth defects, which encompasses a broad spectrum of severity ranging from relatively minor to extremely complex. Improvements in surgery and intensive care have resulted in an increasing number of infants with the most complex lesions surviving after surgery until the time of discharge from the hospital, but there remain concerns about out-of-hospital mortality, variability in how services are provided at the time of discharge and beyond, and difficulties experienced by some families in accessing care...
May 9, 2018: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29739799/healthcare-utilization-and-statin-re-initiation-among-medicare-beneficiaries-with-a-history-of-myocardial-infarction
#20
John N Booth, Lisandro D Colantonio, Robert S Rosenson, Monika M Safford, Ligong Chen, Meredith L Kilgore, Todd M Brown, Benjamin Taylor, Ricardo Dent, Keri L Monda, Paul Muntner, Emily B Levitan
BACKGROUND: Contact with the healthcare system represents an opportunity for individuals who discontinue statins to re-initiate treatment. To help identify opportunities for healthcare providers to emphasize the risk-lowering benefits accrued through restarting statins, we determined the types of healthcare utilization associated with statin re-initiation among patients with history of a myocardial infarction. METHODS AND RESULTS: Medicare beneficiaries with a statin pharmacy fill claim within 30 days of hospital discharge for a myocardial infarction in 2007 to 2012 (n=158 795) were followed for 182 days postdischarge to identify treatment discontinuation, defined as 60 continuous days without statins (n=24 461)...
May 8, 2018: Journal of the American Heart Association
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