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Quality improvement in primary care

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https://www.readbyqxmd.com/read/29055243/physiological-vital-sign-ranges-in-newborns-from-34-weeks-gestation-a-systematic-review
#1
REVIEW
Michelle Paliwoda, Karen New, Mark Davies, Fiona Bogossian
CONTEXT: The birth process and the moments thereafter are a crucial time for newborns as they adapt to extra uterine life. The adaptive process begins immediately and can take a number of days to complete. The process involves initiating and maintaining respirations, thermoregulation, and the change from foetal circulation to newborn circulation. The majority of newborns successfully adapt to extra uterine life, some experience difficulty. Early warning tools may assist clinicians identify early signs of failure to adapt and/or deterioration but these are dependent on 'Normal' vital sign reference ranges for triggering an escalation of care...
October 9, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29054184/under-utilization-of-pacemaker-therapy-for-sinus-node-dysfunction-real-world-data-from-south-asia
#2
C Narasimhan, J Sanyal, R Sethi, Y Kothari, F T N Malik, U Pandurangi, N Khan, S Sahu, J Lande, H Sachanandani, A Naik
OBJECTIVE: Chronic symptomatic sinus node dysfunction (SND), the most common bradyarrhythmia, can be effectively managed by permanent cardiac pacing. Yet the care pathway and barriers to adoption of pacing therapy are not well understood - particularly in low volume implanting countries. The IMPROVE Brady study is a quality improvement initiative being conducted at centers in South Asia, Latin America, and Russia. We assessed the rates of SND diagnosis and pacemaker treatment for SND in the South Asia cohort...
September 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/29052663/self-management-intervention-for-adult-cancer-survivors-after-treatment-a-systematic-review-and-meta-analysis
#3
Soo Hyun Kim, Kisook Kim, Deborah K Mayer
PROBLEM IDENTIFICATION: This study aims to evaluate the effects of self-management interventions (SMIs) for cancer survivors who completed primary treatment. 
. LITERATURE SEARCH: Using PubMed, EMBASE, CINAHL®, PsycINFO®, and Cochrane Central Register of Controlled Trails (CENTRAL), the authors conducted a systematic search of randomized, controlled trials published in English from database conception through June 2016. 
. DATA EVALUATION: The meta-analysis was conducted with Cochrane Review Manager, version 5...
November 1, 2017: Oncology Nursing Forum
https://www.readbyqxmd.com/read/29052117/clinical-impact-of-an-interdisciplinary-patient-safety-program-for-managing-drug-related-problems-in-a-long-term-care-hospital
#4
Oreto Ruiz-Millo, Mónica Climente-Martí, Ana María Galbis-Bernácer, José Ramón Navarro-Sanz
Background Medication reviews intended to identify drug-related problems (DRPs) have been researched in primary care, acute care and nursing homes rather than in long-term care hospitals (LTCHs). Objectives To assess the clinical impact of an interdisciplinary pharmacotherapy quality improvement and patient safety program in elderly patients with polypharmacy admitted to an LTCH. Setting An interventional, longitudinal, prospective study was conducted in a Spanish LTCH Method A total of 162 elderly (≥ 70 years) patients with polypharmacy (≥ 5 medications) were included...
October 19, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29050887/antibiotic-stewardship-in-the-newborn-surgical-patient-a%C3%A2-quality-improvement-project-in-the-neonatal-intensive-care-unit
#5
Sarah Walker, Ankur Datta, Roxanne L Massoumi, Erica R Gross, Michael Uhing, Marjorie J Arca
BACKGROUND: There is significant diversity in the utilization of antibiotics for neonates undergoing surgical procedures. Our institution standardized antibiotic administration for surgical neonates, in which no empiric antibiotics were given to infants with surgical conditions postnatally, and antibiotics are given no more than 72 hours perioperatively. METHODS: We compared the time periods before and after implementation of antibiotic protocol in an institution review board-approved, retrospective review of neonates with congenital surgical conditions who underwent surgical correction within 30 days after birth...
October 16, 2017: Surgery
https://www.readbyqxmd.com/read/29050810/how-to-not-detonate-the-bomb-the-case-of-the-italian-national-health-service
#6
G La Torre, A Federici
Why is Italy one of the world's highest ranked for ability and quality of healthcare in relationship to the resources invested? The last decade has been characterized by many Italian Regions with Recovery Plans, whose main focus was on short-term issues with a high impact on healthcare costs. Italy is now leaving this phase and at the regional level there will be an increase of new hirings in the healthcare sectors, as stated by the Ministry of Health. There is a large amount of scientific literature that supports the role of factors such as lifestyles, diet and genetics as the base of population health...
October 16, 2017: Public Health
https://www.readbyqxmd.com/read/29050149/-accuracy-analysis-and-comparison-of-different-serological-detection-methods-in-syphilis
#7
M Hu, N Liu, Y Y Cai, T Lei, M Zhang
Objective: To compare the accuracy of different methods by reviewing syphilis serologic screening external quality assessment (EQA) data of Chinese primary health care institutions. Methods: The EQA was based on one or two distinct shipments from 2011 to 2016. Each shipment consisted of five serum samples. The laboratories performed the EQA and sent back the results by the deadline. The results were analyzed using the standard procedures and methods. Results: Six different methods were used for syphilis serologic screening: enzyme linked immunosorbent assay, colloidal gold method, Treponema pallidum particle agglutination (TPPA) test, rapid plasma reagin card test, toluidine red unheated serum reagin test and chemiluminescence immunoassay...
September 26, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29047413/itactic-implementing-treatment-algorithms-for-the-correction-of-trauma-induced-coagulopathy-study-protocol-for-a-multicentre-randomised-controlled-trial
#8
Kjersti Baksaas-Aasen, Lewis Gall, Simon Eaglestone, Claire Rourke, Nicole P Juffermans, J Carel Goslings, Paal Aksel Naess, Susan van Dieren, Sisse Rye Ostrowski, Jakob Stensballe, Marc Maegele, Simon J Stanworth, Christine Gaarder, Karim Brohi, Per I Johansson
BACKGROUND: Traumatic injury is the fourth leading cause of death globally. Half of all trauma deaths are due to bleeding and most of these will occur within 6 h of injury. Haemorrhagic shock following injury has been shown to induce a clotting dysfunction within minutes, and this early trauma-induced coagulopathy (TIC) may exacerbate bleeding and is associated with higher mortality and morbidity. In spite of improved resuscitation strategies over the last decade, current transfusion therapy still fails to correct TIC during ongoing haemorrhage and evidence for the optimal management of bleeding trauma patients is lacking...
October 18, 2017: Trials
https://www.readbyqxmd.com/read/29046266/guidelines-and-mhealth-to-improve-quality-of-hypertension-and-type-2-diabetes-care-for-vulnerable-populations-in-lebanon-longitudinal-cohort-study
#9
Shannon Doocy, Kenneth E Paik, Emily Lyles, Hok Hei Tam, Zeina Fahed, Eric Winkler, Kaisa Kontunen, Abdalla Mkanna, Gilbert Burnham
BACKGROUND: Given the protracted nature of the crisis in Syria, the large noncommunicable disease (NCD) caseload of Syrian refugees and host Lebanese, and the high costs of providing NCD care, the implications for Lebanon's health system are vast. OBJECTIVE: The aim of this study was to evaluate the effectiveness of treatment guidelines and a mobile health (mHealth) app on quality of care and health outcomes in primary care settings in Lebanon. METHODS: A longitudinal cohort study was implemented from January 2015 to August 2016 to evaluate the effectiveness of treatment guidelines and an mHealth app on quality of care and health outcomes for Syrian and Lebanese patients in Lebanese primary health care (PHC) facilities...
October 18, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/29046259/assessing-the-impact-of-quality-improvement-measures-on-catheter-related-blood-stream-infections-and-catheter-salvage-experience-from-a-national-intestinal-failure-unit
#10
A Bond, A Teubner, M Taylor, C Cawley, A Abraham, M Dibb, P R Chadwick, M Soop, G Carlson, S Lal
BACKGROUND & AIMS: Prevention of catheter related blood stream infections (CRBSI) and salvage of infected central venous catheters (CVC) are vital to maintaining long term venous access in patients needing home parenteral nutrition (HPN). It remains unclear as to whether patients are best trained for catheter care at home or in hospital or whether CRBSIs are lower if the patient self-cares for the CVC. Furthermore, there is minimal data on the longer term outcome following salvage of infected catheter and limited consensus on agreed protocols for catheter salvage...
October 10, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29045984/results-of-the-2017-national-resident-matching-program%C3%A2-and-the-american-osteopathic-association-intern-resident-registration-program
#11
Stanley M Kozakowski, Alexandra Travis, Julie P Marcinek, Ashley Bentley, Gerald T Fetter
The purpose of medicine as a profession is to meet the health needs of people and communities. Despite empirical evidence worldwide that an appropriate foundation of primary care in a health care system leads to improved health outcomes, improved experience of health care, a reduction in health disparities, and lower overall cost of care, publicly available data from National Resident Matching Program® (NRMP) and the American Osteopathic Association (AOA) Intern/Resident Registration Program show that PGY-1 family medicine and primary care positions offered in the NRMP Match continue to grow, but are losing ground in comparison to the growth of non-primary care specialties...
October 2017: Family Medicine
https://www.readbyqxmd.com/read/29045696/group-visits-for-overdose-education-and-naloxone-distribution-in-primary-care-a-pilot-quality-improvement-initiative
#12
Juliette F Spelman, Stephanie Peglow, Amy R Schwartz, Lucille Burgo-Black, Katelyn McNamara, William C Becker
Objective: Opioid prescribing for chronic pain significantly contributes to opioid overdose deaths in the United States. Naloxone as a take-home antidote to opioid overdose is underutilized and has not been evaluated in the high-risk chronic pain population. The objective was to increase overdose education and naloxone distribution (OEND) to high-risk patients on long-term opioid therapy for pain by utilizing group visits in primary care. Design: Quality improvement intervention among two primary care clinics...
October 16, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29045653/a-quality-improvement-project-to-reduce-hypothermia-in-preterm-infants-on-admission-to-the-neonatal-intensive-care-unit
#13
Wai Yan Yip, Bin Huey Quek, Mary Choi Wan Fong, Thilagamangai, Sally Siew Gim Ong, Bee Leong Lim, Bo Chu Lo, Pratibha Agarwal
Objective: To study effectiveness of quality improvement interventions in reducing hypothermia in preterm infants on admission to neonatal intensive care unit. Design: Quality improvement methodologies including multidisciplinary planning and implementation of evidence-based interventions. Data during and post-implementation were collected. Setting and participants: In total, 84 preterm infants with birth weights ≤ 1500 g delivered during implementation period (October 2008-April 2009) were compared with 168 historical controls and 947 infants in the subsequent 4 years...
October 17, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29045631/implementation-of-advance-care-planning-in-israel-a-convergence-of-top-down-and-bottom-up-processes
#14
Netta Bentur, Shelley Sternberg
Although public health has traditionally been concerned with primary, secondary, and tertiary prevention, more attention needs to be focused on patient-centered care at the end of life. Improved access to quality end-of-life care can be achieved by advance care planning (ACP). In this article, we present an example of the processes of change regarding ACP and preparing advance directives (ADs) that have begun to take place in Israel in recent years. We argue that these processes derive from the synergy between legislation on the one hand, and initiatives and action by health organizations on the other...
October 13, 2017: Gerontologist
https://www.readbyqxmd.com/read/29045609/stakeholder-perspectives-on-the-optimizing-patient-transfers-impacting-medical-quality-and-improving-symptoms-transforming-institutional-care-optimistic-project
#15
Mary Ersek, Susan E Hickman, Anne C Thomas, Brittany Bernard, Kathleen T Unroe, Suzanne Meeks
Background and Objectives: The need to reduce burdensome and costly hospitalizations of frail nursing home residents is well documented. The Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) project achieved this reduction through a multicomponent collaborative care model. We conducted an implementation-focused project evaluation to describe stakeholders' perspectives on (a) the most and least effective components of the intervention; (b) barriers to implementation; and (c) program features that promoted its adoption...
October 17, 2017: Gerontologist
https://www.readbyqxmd.com/read/29045284/increasing-colorectal-cancer-screening-using-a-quality-improvement-approach-in-a-nurse-managed-primary-care-clinic
#16
Diane Hountz, Jennifer Coddington, Karen J Foli, Janet Thorlton
According to the American Cancer Society, 1 in 23 Americans will be diagnosed with colorectal cancer (CRC) in their lifetime. Screening for CRC is an effective, yet underused preventive approach. This is especially true in rural areas, where only 35% of patients were found to be up to date on their screenings in 2014. Increasing CRC screening can produce positive patient outcomes by early recognition and removal of precancerous polyps. The purpose of this project was to use quality improvement (QI) interventions to increase CRC screening rates at a nurse-managed clinic in rural Indiana...
October 17, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29044832/understanding-acceptability-of-and-engagement-with-web-based-interventions-aiming-to-improve-quality-of-life-in-cancer-survivors-a-synthesis-of-current-research
#17
REVIEW
Teresa Corbett, Karmpaul Singh, Liz Payne, Katherine Bradbury, Claire Foster, Eila Watson, Alison Richardson, Paul Little, Lucy Yardley
PURPOSE: This review sought to summarize existing knowledge in order to inform the development of an online intervention that aims to improve quality of life after cancer treatment. METHODS: To inform our intervention, we searched for studies relating to web-based interventions designed to improve QoL in adults who have completed primary treatment for breast, prostate and colorectal cancer (as these are three of the most common cancers and impact a large number of cancer survivors)...
October 17, 2017: Psycho-oncology
https://www.readbyqxmd.com/read/29044409/improving-pain-care-with-project-echo-in-community-health-centers
#18
Daren Anderson, Ianita Zlateva, Bennet Davis, Lauren Bifulco, Tierney Giannotti, Emil Coman, Douglas Spegman
Objective: Pain is an extremely common complaint in primary care, and patient outcomes are often suboptimal. This project evaluated the impact of Project ECHO Pain videoconference case-based learning sessions on knowledge and quality of pain care in two Federally Qualified Health Centers. Design: Quasi-experimental, pre-post intervention, with comparison group. Setting: Two large, multisite federally qualified health centers in Connecticut and Arizona...
October 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29044354/protocol-for-the-evaluation-of-a-chronic-care-model-experience-in-rome
#19
D Mipatrini, A Sinopoli, C Sestili, M Di Marcoberardino, P Giuliani, G Grasso, A Lancia, E Megli, R Mete, M G Pennafina, M Pirrò, S Tartaglia, F Vero, G La Torre
INTRODUCTION: Chronic diseases are the leading cause of death and disability in almost all over the world; in Europe causing over 9 million deaths per year according to WHO estimates. A promising health organization model for chronic disease management is represented by the Chronic Care Model (CCM). In the 12th district of the ASL Roma 2 since 4 years was implemented a CCM for the management of patients affected by diabetes and/or at high cardiovascular risk. OBJECTIVE: Aim of this study is to evaluate the effectiveness of the Chronic Care Model (CCM) for the management of chronic disease in terms of mortality reduction, avoidable hospitalizations reduction and improvement of clinical parameters...
September 2017: La Clinica Terapeutica
https://www.readbyqxmd.com/read/29043594/specialty-care-access-network-extension-of-community-healthcare-outcomes-model-program-for-liver-disease-improves-specialty-care-access
#20
Lisa M Glass, Akbar K Waljee, Heather McCurdy, Grace L Su, Anne Sales
BACKGROUND AND AIMS: To improve subspecialty access, VA Ann Arbor Healthcare System (VAAAHS) implemented the first Specialty Care Access Network (SCAN)-Extension of Community Healthcare Outcomes (ECHO) in chronic liver disease. SCAN-ECHO Liver links primary care providers (PCPs) to hepatologists via secure video-teleconferencing. We aim to describe characteristics of participants (PCPs) and patients (clinical question and diagnosis) in SCAN-ECHO Liver. METHODS: This is a prospective study of the VAAAHS SCAN-ECHO Liver (June 10, 2011-March 31, 2015)...
October 17, 2017: Digestive Diseases and Sciences
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