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Quality improvement in primary care

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https://www.readbyqxmd.com/read/29667726/interventions-for-infantile-haemangiomas-of-the-skin
#1
REVIEW
Monica Novoa, Eulalia Baselga, Sandra Beltran, Lucia Giraldo, Ali Shahbaz, Hector Pardo-Hernandez, Ingrid Arevalo-Rodriguez
BACKGROUND: Infantile haemangiomas (previously known as strawberry birthmarks) are soft, raised swellings of the skin that occur in 3% to 10% of infants. These benign vascular tumours are usually uncomplicated and tend to regress spontaneously. However, when haemangiomas occur in high-risk areas, such as near the eyes, throat, or nose, impairing their function, or when complications develop, intervention may be necessary. This is an update of a Cochrane Review first published in 2011...
April 18, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29667562/caregiver-perceptions-of-a-fruit-and-vegetable-prescription-programme-for-low-income-paediatric-patients
#2
Amy Saxe-Custack, Heather Claire Lofton, Mona Hanna-Attisha, Colleen Victor, Gwendolyn Reyes, Tiffany Ceja, Jenny LaChance
OBJECTIVE: The physical and social environments that surround children should support good health. However, challenges with food security and access prevent many children from consuming a healthy diet, which is critical to proper growth and development. The present study sought to gain a better understanding of primary care initiatives to address these issues in a low-income setting. DESIGN: Following the relocation of a paediatric clinic to a farmers' market building and the implementation of a fruit and vegetable prescription programme, researchers conducted thirty-two semi-structured interviews with caregivers...
April 18, 2018: Public Health Nutrition
https://www.readbyqxmd.com/read/29665791/a-cost-effectiveness-study-of-ict-training-among-the-visually-impaired-in-the-netherlands
#3
Nathalie J S Patty, Marc Koopmanschap, Kim Holtzer-Goor
BACKGROUND: Due to the ageing population, the number of visually impaired people in the Netherlands will increase. To ensure the future availability of services in rehabilitative eye care, we aim to assess the cost-effectiveness of information and communication technology (ICT) training among visually impaired adults from a societal perspective, using primary data from two large rehabilitative eye care providers in the Netherlands. METHODS: Participants were asked to fill in a questionnaire, which used six different instruments at three different time points: pre training, post training and three months post training...
April 17, 2018: BMC Ophthalmology
https://www.readbyqxmd.com/read/29665585/-outpatient-emergency-care-for-nursing-home-residents-a-status-quo-from-a-nursing-perspective
#4
Markus Bleckwenn, Linnea Bell, Rieke Schnakenberg, Klaus Weckbecker, Manuela Klaschik
AIM OF THE STUDY: At present about 2 million people need care in Germany, about one third of them live in old people's homes or nursing homes. Outpatient emergency care of nursing home residents is ensured by primary care physicians, the medical emergency service and the emergency services. Emergency care has rarely been examined from the perspective of nurses. Therefore, in our study, we investigated how the nurses perceive medical care in medical emergencies and what suggestions for improvements they have...
April 17, 2018: Das Gesundheitswesen
https://www.readbyqxmd.com/read/29664873/effects-of-a-picu-status-asthmaticus-de-escalation-pathway-on-length-of-stay-and-albuterol-use
#5
Steven Brennan, Lia Lowrie, Jamie Wooldridge
OBJECTIVES: Evaluate the effects of an asthma de-escalation clinical pathway on selected outcomes for patients admitted to a PICU with status asthmaticus. DESIGN: Time series quality improvement trial. SETTING: PICU in a tertiary care children's hospital. PATIENTS: Children age 2-18 years old with a known diagnosis of asthma presenting with status asthmaticus. INTERVENTION: One-hundred five admissions to a PICU for status asthmaticus were treated according to a new de-escalation pathway between August 15, 2015, and August 30, 2016...
April 16, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29664798/pouch-volvulus-in-patients-having-undergone-restorative-proctocolectomy-for-ulcerative-colitis-a-case-series
#6
Rachel M Landisch, Paul M Knechtges, Mary F Otterson, Kirk A Ludwig, Timothy J Ridolfi
BACKGROUND: Restorative proctocolectomy with IPAA improves quality of life in patients with medically refractory ulcerative colitis. Although bowel obstruction is common, pouch volvulus is rare and described only in case reports. Diagnosis can be challenging, resulting in delayed care and heightened morbidity. OBJECTIVE: The purpose of this study was to delineate the symptoms and successful management strategies used in patients with IPAA volvulus that result in pouch salvage...
April 16, 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29664739/ce-original-research-exploring-clinicians-perceptions-about-sustaining-an-evidence-based-fall-prevention-program
#7
Rebecca B Porter, Laura Cullen, Michele Farrington, Grace Matthews, Sharon Tucker
Findings from this qualitative study may help improve sustainability. ABSTRACT: Purpose: This study aimed to address the knowledge gap between implementing and sustaining evidencebased fall prevention practices for hospitalized patients by exploring perspectives of the interprofessional health care team. DESIGN: A qualitative design was used to capture insights from clinicians across disciplines in a large midwestern academic medical center. METHODS: Four homogenous semistructured focus groups and three individual interviews involving a total of 20 clinicians were conducted between October 2013 and March 2014...
April 16, 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/29664169/improving-quality-of-care-for-patients-with-iron-deficiency-anemia-presenting-to-the-emergency-department
#8
Fatima Khadadah, Jeannie Callum, Dominick Shelton, Yulia Lin
BACKGROUND: Patients presenting to the emergency department (ED) with iron deficiency anemia (IDA) are underrecognized, undertreated with iron, and overtransfused. A 3-month audit of red blood cell (RBC) transfusions at the Sunnybrook Health Sciences Centre ED in 2013 showed that only 53% of transfusions for IDA were appropriate. The aim of this quality improvement project was to increase the rate of appropriate transfusion to greater than 80%. STUDY DESIGN AND METHODS: Since November 2013, several quality improvement interventions have been implemented, including educational presentations, development of an algorithm on IDA management in the ED, and development of an ED IDA toolkit...
April 17, 2018: Transfusion
https://www.readbyqxmd.com/read/29663516/a-2-year-prospective-study-of-single-implant-mandibular-overdentures-patient-reported-outcomes-and-prosthodontic-events
#9
Túlio Eduardo Nogueira, Fernanda Maria Oliveira Aguiar, Bento Alves de Barcelos, Cláudio Rodrigues Leles
OBJECTIVE: This prospective clinical trial aimed to assess clinical and patient-reported outcomes of the single-implant mandibular overdenture treatment (SIMO) after a 2-year follow-up period. MATERIALS AND METHODS: An external hexagon implant was inserted in the mandibular midline of 45 complete denture wearers. Participants had a mean age of 63.4 (SD = 8.3), and 75.6% were female. Based on the primary stability of the implant, immediate loading was performed in 38 patients (84...
April 16, 2018: Clinical Oral Implants Research
https://www.readbyqxmd.com/read/29663065/-individual-activation-of-dementia-sufferers-in-a-home-setting-a-randomized-controlled-study
#10
Renate Stemmer, Elmar Gräßel, Martin Schmid
BACKGROUND AND OBJECTIVES: The present project investigated the hypothesis that a multimodal individual activation of people with mild to moderate dementia in the home setting during a 6-month intervention period leads to improved everyday practice and cognitive abilities compared to the control group. MATERIAL AND METHODS: Intervention: a practical activation was performed by relatives 6 days per week. Cognitive stimulation took place once a week and was done by an external person...
April 16, 2018: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/29662064/the-use-of-electronic-alerts-in-primary-care-computer-systems-to-identify-the-excessive-prescription-of-short-acting-beta-2-agonists-for-people-with-asthma-a-systematic-review
#11
REVIEW
Shauna McKibben, Anna De Simoni, Andy Bush, Mike Thomas, Chris Griffiths
Computers are increasingly used to improve prescribing decisions in the management of long-term conditions however the effects on asthma prescribing remain unclear. We aimed to synthesise the evidence for the use of computerised alerts that identify excessive prescribing of short-acting beta2 -agonists (SABAs) to improve asthma management for people with asthma. MEDLINE, CINAHL, Embase, Cochrane and Scopus databases (1990-2016) were searched for randomised controlled trials using electronic alerts to identify excessive prescribing of SABAs for people with asthma in primary care...
April 16, 2018: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/29661247/informing-implementation-of-quality-improvement-in-australian-primary-care
#12
Charlotte Hespe, Lucie Rychetnik, David Peiris, Mark Harris
BACKGROUND: Quality Improvement (QI) initiatives in primary care are effective at improving uptake of evidence based guidelines, but are difficult to implement and sustain. In Australia meso-level health organisations such as Primary health care Organisations (PHCO) offer new opportunities to implement area-wide QI programs. This study sought to identify enablers and barriers to implementation of an existing Australian QI program and to identify strategic directions that PHCOs can use in the ongoing development of QI in this environment...
April 16, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29661239/neonatal-care-practices-in-sub-saharan-africa-a-systematic-review-of-quantitative-and-qualitative-data
#13
REVIEW
Margaret Bee, Anushree Shiroor, Zelee Hill
BACKGROUND: Recommended immediate newborn care practices include thermal care (immediate drying and wrapping, skin-to-skin contact after delivery, delayed bathing), hygienic cord care and early initiation of breastfeeding. This paper systematically reviews quantitative and qualitative data from sub-Saharan Africa on the prevalence of key immediate newborn care practices and the factors that influence them. METHODS: Studies were identified by searching relevant databases and websites, contacting national and international academics and implementers and hand-searching reference lists of included articles...
April 16, 2018: Journal of Health, Population, and Nutrition
https://www.readbyqxmd.com/read/29661196/the-women-s-heart-health-programme-a-pilot-trial-of-sex-specific-cardiovascular-management
#14
Ting Ting Low, Siew Pang Chan, Shin Hnin Wai, Zhou Ang, Kyu Kyu, Kim Yee Lee, Anne Ching, Sarah Comer, Naomi Qiu Pin Tan, Elizabeth Grace Hui En Thong, Tracy Nang, Mohan Dutta, Carolyn S P Lam
BACKGROUND: There is increasing knowledge of sex-specific differences in cardiovascular disease and recognition of sex disparities in management. In our study, we investigated whether a cardiovascular programme tailored to the specific needs of women could lead to improved outcomes. METHODS: We randomised 100 female patients to receive cardiology follow-up with the conventional sex-neutral cardiac programme (control), or the sex-tailored Women's Heart Health Programme (intervention)...
April 16, 2018: BMC Women's Health
https://www.readbyqxmd.com/read/29658846/tobacco-free-policies-and-tobacco-cessation-systems-at-health-centers-serving-lesbian-gay-bisexual-and-transgender-clients
#15
Joseph G L Lee, Megan E DeMarco, Matthew R Beymer, Chelsea L Shover, Robert K Bolan
PURPOSE: LGBT populations have high rates of tobacco use. Health centers serving LGBT clients are an important source of care. The researchers aimed to assess the implementation of recommended systems-level tobacco cessation interventions at these health centers. METHODS: Using systematic searching, directories, and expert review, we identified health centers serving LGBT clients that provide primary care. We conducted phone-based, semi-structured interviews with administrators (n = 11) between September 2016 and March 2017 regarding implementation of the Clinical Practice Guideline, Treating Tobacco Use and Dependence: 2008 Update (the Guideline)...
April 16, 2018: LGBT Health
https://www.readbyqxmd.com/read/29656607/expert-agreement-in-the-interpretation-of-lung-ultrasound-studies-performed-on-mechanically-ventilated-patients
#16
Scott J Millington, Robert T Arntfield, Robert Jie Guo, Seth Koenig, Pierre Kory, Vicki Noble, Haney Mallemat, Jordan R Schoenherr
OBJECTIVES: Although lung ultrasound (US) has been shown to have high diagnostic accuracy in patients presenting with acute dyspnea, its precision in critically ill patients is unknown. We investigated common areas of agreement and disagreement by studying 6 experts as they interpreted lung US studies in a cohort of intensive care unit (ICU) patients. METHODS: A previous study by our group asked experts to rate the quality of 150 lung US studies performed by 10 novices in a population of mechanically ventilated patients...
April 15, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29655517/integrating-pregnancy-prevention-into-an-hiv-counseling-and-testing-program-in-pediatric-primary-care
#17
Noah J Wheeler, Krishna K Upadhya, Marie-Sophie Tawe, Kathy Tomaszewski, Renata Arrington-Sanders, Arik V Marcell
PURPOSE: Certified health educator (CHE)-based HIV counseling and testing typically focus on HIV and sexually transmitted infection (STI) prevention only. A quality improvement initiative examined integrating assessment of reproductive life plans, counseling about pregnancy prevention, and contraception referral into a CHE-based HIV testing program. METHODS: Between February 2014 and January 2017, in one urban pediatric primary care clinic serving patients aged 0-25, CHEs assessed sexual history, HIV risk, short-term (i...
April 11, 2018: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/29652246/metformin-in-non-diabetic-hyperglycaemia-the-glint-feasibility-rct
#18
Simon J Griffin, M Angelyn Bethel, Rury R Holman, Kamlesh Khunti, Nicholas Wareham, Gwen Brierley, Melanie Davies, Andrew Dymond, Rose Eichenberger, Philip Evans, Alastair Gray, Colin Greaves, Kyla Harrington, Graham Hitman, Greg Irving, Sarah Lessels, Ann Millward, John R Petrie, Martin Rutter, Mike Sampson, Naveed Sattar, Stephen Sharp
BACKGROUND: The treatment of people with diabetes with metformin can reduce cardiovascular disease (CVD) and may reduce the risk of cancer. However, it is unknown whether or not metformin can reduce the risk of these outcomes in people with elevated blood glucose levels below the threshold for diabetes [i.e. non-diabetic hyperglycaemia (NDH)]. OBJECTIVE: To assess the feasibility of the Glucose Lowering In Non-diabetic hyperglycaemia Trial (GLINT) and to estimate the key parameters to inform the design of the full trial...
April 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29651981/lamotrigine-for-people-with-borderline-personality-disorder-a-rct
#19
Mike J Crawford, Rahil Sanatinia, Barbara Barrett, Gillian Cunningham, Oliver Dale, Poushali Ganguli, Geoff Lawrence-Smith, Verity C Leeson, Fenella Lemonsky, Georgia Lykomitrou-Matthews, Alan Montgomery, Richard Morriss, Jasna Munjiza, Carol Paton, Iwona Skorodzien, Vineet Singh, Wei Tan, Peter Tyrer, Joseph G Reilly
BACKGROUND: No drug treatments are currently licensed for the treatment of borderline personality disorder (BPD). Despite this, people with this condition are frequently prescribed psychotropic medications and often with considerable polypharmacy. Preliminary studies have indicated that mood stabilisers may be of benefit to people with BPD. OBJECTIVE: To examine the clinical effectiveness and cost-effectiveness of lamotrigine for people with BPD. DESIGN: A two-arm, double-blind, placebo-controlled individually randomised trial of lamotrigine versus placebo...
April 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29650902/-the-significance-of-pharmacist-intervention-focused-on-improvement-of-adverse-events-and-cancer-pain
#20
Fumitaka Kawaguchi, Jun Watanabe, Takafumi Tsuneki, Akihiko Kikkawa
It was reported that focusing on palliative care for patients with cancer improved their anxiety and depression and prolonged their survival. Similarly, the pharmacist intervention for cancer patients suggested the improvement in anxiety and depression; but, such improvement has not yet been demonstrated by focusing on pharmacist attitudes and behaviors of which the patients were the primary beneficiaries. Therefore, we evaluated the significance of pharmacist intervention focusing on improvement of adverse events and cancer pain...
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
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