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https://www.readbyqxmd.com/read/28215922/early-postdischarge-stop-hf-clinic-reduces-30-day-readmissions-in-old-and-frail-patients-with-heart-failure
#1
Cristina Pacho, Mar Domingo, Raquel Núñez, Josep Lupón, Pedro Moliner, Marta de Antonio, Beatriz González, Javier Santesmases, Emili Vela, Jordi Tor, Antoni Bayes-Genis
INTRODUCTION AND OBJECTIVES: Heart failure (HF) is associated with a high rate of readmissions within 30 days postdischarge. Strategies to lower readmission rates generally show modest results. To reduce readmission rates, we developed a STructured multidisciplinary outpatient clinic for Old and frail Postdischarge patients hospitalized for HF (STOP-HF-Clinic). METHODS: This prospective all-comers study enrolled patients discharged from internal medicine or geriatric wards after HF hospitalization...
February 16, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28214255/clinical-outcomes-and-90-day-costs-following-hemiarthroplasty-or-total-hip-arthroplasty-for-hip-fracture
#2
Christine I Nichols, Joshua G Vose, Ryan M Nunley
BACKGROUND: In the era of bundled payments, many hospitals are responsible for costs from admission through 90 days postdischarge. Although bundled episodes for hip fracture will have a separate target price for the bundle, little is known about the 90-day resource use burden for this patient population. METHODS: Using Medicare 100% Standard Analytic Files (2010-2014), we identified patients undergoing hemiarthroplasty or total hip arthroplasty (THA). Patients were aged 65 and older with admitting diagnosis of closed hip fracture, no concurrent fractures of the lower limb, and no history of hip surgery in the prior 12 months baseline...
January 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28211131/congenital-diaphragmatic-hernia-outcomes-of-neonates-treated-at-mayo-clinic-with-and-without-extracorporeal-membrane-oxygenation
#3
Katarina Bojanić, Jason M Woodbury, Alexandre N Cavalcante, Ruža Grizelj, Garth F Asay, Christopher E Colby, William A Carey, Gregory J Schears, Toby N Weingarten, Darrell R Schroeder, Juraj Sprung
BACKGROUND: Congenital diaphragmatic hernia (CDH) is a rare anomaly with high mortality and long-term comorbid conditions. AIMS: Our aim was to describe the presenting characteristics, treatment, and outcomes of consecutive patients with CDH treated at our institution. METHODS: We performed a retrospective cohort study and identified consecutive neonates treated for CDH from 2001 to 2015 at our institution. For all patients identified, we reviewed hospital and postdischarge data for neonatal, disease, and treatment characteristics...
March 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28202769/project-impact-pilot-report-feasibility-of-implementing-a-hospital-to-home-transition-bundle
#4
Leah A Mallory, Snezana Nena Osorio, B Stephen Prato, Jennifer DiPace, Lisa Schmutter, Paula Soung, Amanda Rogers, William J Woodall, Kayla Burley, Sandra Gage, David Cooperberg
BACKGROUND AND OBJECTIVES: To improve hospital to home transitions, a 4-element pediatric patient-centered transition bundle was developed, including: a transition readiness checklist; predischarge teach-back education; timely and complete written handoff to the primary care provider; and a postdischarge phone call. The objective of this study was to demonstrate the feasibility of bundle implementation and report initial outcomes at 4 pilot sites. Outcome measures included postdischarge caregiver ability to teach-back key home management information and 30-day reuse rates...
February 15, 2017: Pediatrics
https://www.readbyqxmd.com/read/28188268/design-and-rationale-of-a-randomized-trial-of-a-care-transition-strategy-in-patients-with-acute-heart-failure-discharged-from-the-emergency-department-guided-hf-get-with-the-guidelines-in-emergency-department-patients-with-heart-failure
#5
Gregory J Fermann, Phillip D Levy, Peter Pang, Javed Butler, S Imran Ayaz, Douglas Char, Patrick Dunn, Cathy A Jenkins, Christy Kampe, Yosef Khan, Vijaya A Kumar, JoAnn Lindenfeld, Dandan Liu, Karen Miller, W Frank Peacock, Samaa Rizk, Chad Robichaux, Russell L Rothman, Jon Schrock, Adam Singer, Sarah A Sterling, Alan B Storrow, Cheryl Walsh, John Wilburn, Sean P Collins
: GUIDED-HF (Get With the Guidelines in Emergency Department Patients With Heart Failure) is a multicenter randomized trial of a patient-centered transitional care intervention in patients with acute heart failure (AHF) who are discharged either directly from the emergency department (ED) or after a brief period of ED-based observation. To optimize care and reduce ED and hospital revisits, there has been significant emphasis on improving transitions at the time of hospital discharge for patients with HF...
February 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28183828/a-qualitative-study-of-emergency-physicians-perspectives-on-proms-in-the-emergency-department
#6
Katie N Dainty, Bianca Seaton, Andreas Laupacis, Michael Schull, Samuel Vaillancourt
INTRODUCTION: There is a growing emphasis on including patients' perspectives on outcomes as a measure of quality care. To date, this has been challenging in the emergency department (ED) setting. To better understand the root of this challenge, we looked to ED physicians' perspectives on their role, relationships and responsibilities to inform future development and implementation of patient-reported outcome measures (PROMs). METHODS: ED physicians from hospitals across Canada were invited to participate in interviews using a snowballing sampling technique...
February 9, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28182809/impact-of-patient-centered-discharge-tools-a-systematic-review
#7
REVIEW
Karen Okrainec, Davina Lau, Howard B Abrams, Shoshanna Hahn-Goldberg, Ronak Brahmbhatt, Tai Huynh, Kenneth Lam, Chaim M Bell
BACKGROUND: Patient-centered discharge tools provide an opportunity to engage patients, enhance patient understanding, and improve capacity for self-care and postdischarge outcomes. PURPOSE: To review studies that engaged patients in the design or delivery of discharge instruction tools and that tested their effect among hospitalized patients. DATA SOURCES: We conducted a search of 12 databases and journals from January 1994 through May 2014, and references of retrieved studies...
February 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28174166/early-rehospitalization-after-prolonged-intensive-care-unit-stay-post-cardiac-surgery-outcomes-and-modifiable-risk-factors
#8
Rizwan A Manji, Rakesh C Arora, Rohit K Singal, Brett M Hiebert, Alan H Menkis
BACKGROUND: Prolonged intensive care unit length of stay (prICULOS) following cardiac surgery (CS) in older adults is increasingly common but rehospitalization characteristics and outcomes are understudied. We sought to describe the rehospitalization characteristics and subsequent non-institutionalized survival of prICULOS (ICULOS ≥5 days) patients and identify modifiable risk factors to decrease 30-day rehospitalization. METHODS AND RESULTS: Consecutive patients from January 1, 2000 to December 31, 2011 were analyzed utilizing linked clinical and administrative databases...
February 7, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28168428/longer-than-average-length-of-stay-in-acute-heart-failure-determinants-and-outcomes
#9
H R Omar, M Guglin
BACKGROUND: Increased length of stay (LOS) during acute heart failure (HF) hospitalization is associated with readmission and mortality. METHODS: The ESCAPE trial data were utilized to identify determinants and post-discharge outcomes of patients with acute systolic HF requiring longer-than-average LOS (≥7 days). The study endpoints were 6‑month all-cause mortality, all-cause rehospitalization, and the composite endpoint of death, cardiac rehospitalization, and cardiac transplant...
February 6, 2017: Herz
https://www.readbyqxmd.com/read/28159420/efficacy-in-deep-vein-thrombosis-prevention-with-extended-mechanical-compression-device-therapy-and-prophylactic-aspirin-following-total-knee-arthroplasty-a-randomized-control-trial
#10
Mark A Snyder, Alexandra N Sympson, Christina M Scheuerman, Justin L Gregg, Lala R Hussain
BACKGROUND: Aspirin at 325 mg twice daily is now included as a nationally approved venous thromboembolism (VTE) prophylaxis protocol for low-risk total knee arthroplasty (TKA) patients. The purpose of this study is to examine whether there is a difference in deep vein thrombosis (DVT) occurrence after a limited tourniquet TKA using aspirin-based prophylaxis with or without extended use of mechanical compression device (MCD) therapy. METHODS: One hundred limited tourniquet TKA patients, whose DVT risk was managed with aspirin 325 mg twice daily for 3 weeks, were randomized to either using an MCD during hospitalization only or extended use at home up to 6 weeks postoperatively...
December 23, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28153990/race-and-sex-differences-in-post-myocardial-infarction-angina-frequency-and-risk-of-1-year-unplanned-rehospitalization
#11
Connie N Hess, Lisa A Kaltenbach, Jacob A Doll, David J Cohen, Eric D Peterson, Tracy Y Wang
BACKGROUND: Race and sex disparities in in-hospital treatment and outcomes of patients with acute myocardial infarction (MI) have been described, but little is known about race and sex differences in post-MI angina and long-term risk of unplanned rehospitalization. We examined race and sex differences in post-MI angina frequency and 1-year unplanned rehospitalization to identify factors associated with unplanned rehospitalization, testing for whether race and sex modify these relationships...
February 7, 2017: Circulation
https://www.readbyqxmd.com/read/28152330/randomized-controlled-trial-on-effect-of-intermittent-early-versus-late-kangaroo-mother-care-on-human-milk-feeding-in-low-birth-weight-neonates
#12
Dhaarani Jayaraman, Kanya Mukhopadhyay, Anil Kumar Bhalla, Lakhbir Kaur Dhaliwal
BACKGROUND: Breastfeeding at discharge among sick low-birth-weight (LBW) infants is low despite counseling and intervention like kangaroo mother care (KMC). Research aim: The aim was to study the effects of early initiation of KMC on exclusive human milk feeding, growth, mortality, and morbidities in LBW neonates compared with late initiation of KMC during the hospital stay and postdischarge. METHODS: A randomized controlled trial was conducted in level 2 and 3 areas of a tertiary care neonatal unit over 15 months...
February 1, 2017: Journal of Human Lactation: Official Journal of International Lactation Consultant Association
https://www.readbyqxmd.com/read/28152175/life-space-assessment-predicts-hospital-readmission-in-home-limited-adults
#13
Roya Fathi, Peter Bacchetti, Mary N Haan, Thomas K Houston, Kanan Patel, Christine S Ritchie
OBJECTIVES: To describe the association between restricted life-space and characteristics of community-dwelling adults hospitalized for congestive heart failure (CHF) or chronic obstructive pulmonary disease (COPD), to estimate the effect of hospitalization on postdischarge mobility, and to determine whether baseline restricted life-space predicts hospital readmission. DESIGN: Observational. SETTING: Urban academic hospital that serves as a safety net for urban and rural populations with low resources and serves central and northern Alabama...
February 2, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28150384/effects-of-a-hospital-community-partnership-transitional-program-in-patients-with-coronary-heart-disease-in-chengdu-china-a-randomized-controlled-trial
#14
Xiao-Yi Cao, Lang Tian, Lin Chen, Xiao-Lian Jiang
AIM: To evaluate the effects of a hospital-community partnership transitional program among patients with coronary heart disease. METHODS: This was a randomized controlled trial with 236 patients who were randomized into two groups. The patients in the control group received the usual care. In contrast, the patients in the study group received the transitional care program. The data were collected at the baseline, 30 days, and 90 days after discharge. The primary outcomes were the 30 and 90 day readmission rates after discharge...
February 1, 2017: Japan Journal of Nursing Science: JJNS
https://www.readbyqxmd.com/read/28148613/delirium-in-trauma-patients-prevalence-and-predictors
#15
Kathryn T Von Rueden, Breighanna Wallizer, Paul Thurman, Karen McQuillan, Tiffany Andrews, Jennifer Merenda, Heesook Son
BACKGROUND: Delirium is associated with increased mortality, morbidity, hospital costs, and postdischarge cognitive dysfunction. Most research focuses on nontrauma patients receiving mechanical ventilation in the intensive care unit. OBJECTIVES: To determine the prevalence and predictors of delirium in trauma patients residing in intensive and intermediate care units of an academic medical center. METHODS: Trauma patients were screened for delirium by using the Confusion Assessment Method for the Intensive Care Unit...
February 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28144974/thinking-about-the-patient-s-wishes-practical-wisdom-of-discharge-planning-nurses-in-assisting-surrogate-decision-making
#16
Yoko Kageyama, Midori Asano
BACKGROUND: The accelerating trend towards shorter hospital stays in Japan has made modes of decision-making essential for effective patient transition from the hospital to recuperation in the regional community, and the ageing of the population has brought a rise in surrogate decision-making by the families of patients lacking decision-making ('self-decision') capacity. AIM: To verbalise and elucidate the practical wisdom of discharge planning nurses by focusing on the perceptions and judgements, they apply in practice and describing their methodology in concrete terms...
January 31, 2017: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/28138264/validation-of-the-scale-on-satisfaction-of-adolescents-with-postoperative-pain-management-idiopathic-scoliosis-sap-s
#17
Christelle Khadra, Sylvie Le May, Ariane Ballard, Jean Théroux, Sylvie Charette, Edith Villeneuve, Stefan Parent, Argerie Tsimicalis, Jill MacLaren Chorney
BACKGROUND: Spinal fusion is a common orthopedic surgery in children and adolescents and is associated with high pain levels postoperatively. If the pain is not well managed, negative outcomes may ensue. To our knowledge, there is no measure in English that assesses patient's satisfaction with postoperative pain management following idiopathic scoliosis surgery. The aim of the present study was to assess the psychometric properties of the satisfaction subscale of the English version of the Satisfaction of Adolescents with Postoperative pain management - idiopathic Scoliosis (SAP-S) scale...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28125824/discharge-handoff-communication-and-pediatric-readmissions
#18
Ryan J Coller, Thomas S Klitzner, Adrianna A Saenz, Carlos F Lerner, Lauren G Alderette, Bergen B Nelson, Paul J Chung
BACKGROUND: Improvement in hospital transitional care has become a major national priority, although the impact on children's postdischarge outcomes is unclear. OBJECTIVE: To characterize common handoff practices between hospital and primary care providers (PCPs), and test the hypothesis that common handoff practices would be associated with fewer unplanned readmissions. DESIGN, SETTING, AND PATIENTS: This prospective cohort study enrolled randomly selected pediatric patients during an acute hospitalization at a tertiary children's hospital in 2012-2014...
January 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28122396/predictors-of-postoperative-falls-in-the-first-and-second-postoperative-years-among-elderly-hip-fracture-patients
#19
Hsiang-Fen Yeh, Jung-Hua Shao, Chia-Lin Li, Chi-Chuan Wu, Yea-Ing L Shyu
AIM AND OBJECTIVES: To explore risk factors for a single fall and multiple falls in the first and second postoperative years among older people hip fracture patients. BACKGROUND: Older people hip fracture patients have a high probability of falling again after a fall incident. Risk factors for postoperative falls among older people hip fracture patients in Taiwan remain to be confirmed. DESIGN: Secondary analysis. METHODS: Data collected from control groups of two clinical trials conducted during 2001-2004 and during 2005-2009 were selected...
January 25, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28108793/effective-cerebrovascular-thrombectomy-requires-well-organized-structures-real-world-experiences-of-a%C3%A2-regional-stroke-network-between-2012-2015
#20
Maria Sophie Stockinger, Johannes Trenkler, Tim von Oertzen, Karin Nussbaumer, Michael Sonnberger, Wolfgang Schimetta, Anthony C Pereira, Gerhard Traxler, Claudia Dorninger, Hans-Peter Haring
BACKGROUND: The objective of this study was to analyse the Neurothrombectomy Network registry of the Neuromed Campus (NMC) of the Kepler University Hospital in Linz (Austria). The data were compared to the results of recently published thrombectomy trials (MR CLEAN, ESCAPE, EXTEND-IA, SWIFT-PRIME, REVASCAT and THRACE). METHODS: We retrospectively studied 246 patients with acute ischemic stroke who underwent thrombectomy between January 2012 and December 2015 at the NMC in Upper Austria...
January 20, 2017: Wiener Klinische Wochenschrift
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