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https://www.readbyqxmd.com/read/27925423/the-johns-hopkins-venous-thromboembolism-collaborative-multidisciplinary-team-approach-to-achieve-perfect-prophylaxis
#1
REVIEW
Michael B Streiff, Brandyn D Lau, Deborah B Hobson, Peggy S Kraus, Kenneth M Shermock, Dauryne L Shaffer, Victor O Popoola, Jonathan K Aboagye, Norma A Farrow, Paula J Horn, Hasan M Shihab, Peter J Pronovost, Elliott R Haut
Venous thromboembolism (VTE) is an important cause of preventable harm in hospitalized patients. The critical steps in delivery of optimal VTE prevention care include (1) assessment of VTE and bleeding risk for each patient, (2) prescription of risk-appropriate VTE prophylaxis, (3) administration of risk-appropriate VTE prophylaxis in a patient-centered manner, and (4) continuously monitoring outcomes to identify new opportunities for learning and performance improvement. To ensure that every hospitalized patient receives VTE prophylaxis consistent with their individual risk level and personal care preferences, we organized a multidisciplinary task force, the Johns Hopkins VTE Collaborative...
December 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/27911013/the-cost-of-care-homes-for-people-with-dementia-in-england-a-modelling-approach
#2
Renee Romeo, Martin Knapp, Suzanne Salverda, Martin Orrell, Jane Fossey, Clive Ballard
OBJECTIVES: To examine the cost of care for people with dementia in institutional care settings, to understand the major cost drivers and to highlight opportunities for service development. METHODS: Data on 277 residents with dementia in 16 UK residential or nursing homes were collected. We estimated care and support costs and fitted models to the data. Sensitivity analyses were also conducted. RESULTS: Care home residents cost £792 weekly: 95% of the costs accounted for by direct fees...
December 2, 2016: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27898134/quality-pain-care-for-older-adults-in-an-era-of-suspicion-and-scrutiny
#3
Barbara St Marie, Paul Arnstein
In two decades, the pendulum has swung from focusing on the undertreatment of pain by prescribers who fail to use medically necessary opioid agents to an intense focus on overprescribing opioid medications and the harms they cause. Within these two extremes rests the older adult with pain and in need of safe and effective care. Today, health care providers are practicing in an era of scrutiny, with new guidelines and regulations superseding their compassion and clinical judgment about the best treatment options when older adults have pain across the care continuum...
December 1, 2016: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/27898133/opioid-misuse-abuse-and-quality-persistent-pain-management-in-older-adults
#4
Yu-Ping Chang, Peggy Compton
The United States is amid an epidemic of prescription opioid drug abuse, bringing with it not only high rates of overdose, but growing rates of heroin abuse and addiction. Liberal opioid drug prescribing on the part of well-meaning clinicians has in part fueled this epidemic, being correlated to opioid death and addiction treatment admission rates. Misuse and abuse of prescription opioid drugs is greatest among young adults (ages 18 to 25); however, the fastest growing age group for opioid drug misuse/abuse is older (ages 50 to 64)...
December 1, 2016: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/27898132/community-models-of-care-a-scoping-review
#5
Lindsay Mullins, Lisa E Skemp, Meridean L Maas
Nurse preparation and role in community models of care for older adults is not well documented. The purpose of the current structured scoping literature review was to identify nurse-led or nurse-involved community models of care for older adults, articulate the nurse's role and preparation in the model, and identify Triple Aim policy implications. Literature from 2008 through 2014 yielded 34 models identified in 51 articles. Twenty-one of 34 models were evaluated and none clearly articulated the full impact of a nurse role...
December 1, 2016: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/27871040/mobile-technology-in-clinical-teaching
#6
B J Mackay, J Anderson, T Harding
Technology is having a profound effect on education in the 21st century and nurse educators are being challenged to integrate technological innovation to assist students in their learning. This paper reports a study on the introduction of smart mobile technology to support student learning in the clinical environment. In a climate of collaborative inquiry, clinical lecturers and two researchers from the same department carried out a project in three phases: formation, implementation and analysis. Following the formation phase, six clinical lecturers adopted iPads to support their clinical teaching (implementation phase)...
November 10, 2016: Nurse Education in Practice
https://www.readbyqxmd.com/read/27862188/systematic-review-of-measurement-properties-of-self-reported-instruments-for-evaluating-self-care-in-adults
#7
REVIEW
Maria Matarese, Marzia Lommi, Maria Grazia De Marinis
AIMS: The aims of this study were as follows: to identify instruments developed to assess self-care in healthy adults; to determine the theory on which they were based; their validity and reliability properties and to synthesize the evidence on their measurement properties. BACKGROUND: Many instruments have been developed to assess self-care in many different populations and conditions. Clinicians and researchers should select the most appropriate self-care instrument based on the knowledge of their measurement properties...
November 11, 2016: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/27857271/how-exercise-can-benefit-patients-with-cancer
#8
Rita Musanti
Thirty years ago, the first article on exercise for patients with cancer appeared in the cancer research literature. The time from that first article to the present has included oncology nurses taking the lead in investigations related to exercise and cancer-related symptoms, most notably cancer-related fatigue (CRF). The Oncology Nursing Society (ONS) has been instrumental in publishing much of the research on exercise and cancer and continues in that tradition by issuing this supplement to the Clinical Journal of Oncology Nursing...
December 1, 2016: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/27853285/selecting-an-open-access-journal-for-publication-be-cautious
#9
Lilian Hoffecker, Marie Hastings-Tolsma, Deborah Vincent, Heidi Zuniga
Nurse scholars and clinicians seek to publish their research and scholarly findings to strengthen both nursing science and clinical practice. Traditionally subscription-based publications have been the mainstay of knowledge dissemination. However, subscription costs have tended to restrict access to many journals to a small, specialized, academic community, a limitation that has contributed to the development of open access (OA) publications. OA journals have a powerful appeal as they allow greater access to scholars and consumers on a global level...
December 4, 2015: Online Journal of Issues in Nursing
https://www.readbyqxmd.com/read/27845806/hospitalized-older-adults-with-established-delirium-recognition-documentation-and-reporting
#10
Margarete L Zalon, Sonia Sandhaus, Mary Kovaleski, Paula Roe-Prior
Delirium, a life-threatening complication for hospitalized older adults associated with adverse outcomes, is often underrecognized and underreported. The purpose of the current study was to analyze delirium documentation for hospitalized older adults. Charts of 34 patients, aged 71 and older with documented delirium and referral to a Hospital Elder Life Program, were reviewed. With the exception of International Classification of Diseases-9 coding, delirium was only mentioned in 12 (35.3%) charts, although descriptors potentially indicative of delirium were usually recorded...
November 15, 2016: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/27821141/knowledge-attitude-and-practice-of-healthcare-ethics-among-resident-doctors-and-ward-nurses-from-a-resource-poor-setting-nepal
#11
Samaj Adhikari, Kumar Paudel, Arja R Aro, Tara Ballav Adhikari, Bipin Adhikari, Shiva Raj Mishra
BACKGROUND: Healthcare ethics is neglected in clinical practice in LMICs (Low and Middle Income Countries) such as Nepal. The main objective of this study was to assess the current status of knowledge, attitude and practice of healthcare ethics among resident doctors and ward nurses in a tertiary teaching hospital in Nepal. METHODS: This was a cross sectional study conducted among resident doctors (n = 118) and ward nurses (n = 86) in the largest tertiary care teaching hospital of Nepal during January- February 2016 with a self-administered questionnaire...
November 8, 2016: BMC Medical Ethics
https://www.readbyqxmd.com/read/27805799/early-detection-of-critical-illness-outside-the-intensive-care-unit-clarifying-treatment-plans-and-honoring-goals-of-care-using-a-supportive-care-team
#12
Russ Granich, Zoe Sutton, Yan S Kim, Megan Anderson, Helen Wood, John E Scharf, Arona Ragins, Gabriel J Escobar
Given the high mortality experienced by patients who deteriorate outside the intensive care unit, issues related to patient preferences around escalation of care are common. However, the literature on early warning systems (EWSs) provides limited information on how respecting patient preferences can be incorporated into clinical workflows. In this report, we describe how we developed workflows for integrating supportive care with an automated EWS in the context of a 2-hospital pilot. We used the Institute for Healthcare Improvement's Plan-Do-Study-Act approach to achieve consensus with clinicians and administrators...
November 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/27805798/incorporating-an-early-detection-system-into-routine-clinical-practice-in-two-community-hospitals
#13
B Alex Dummett, Carmen Adams, Elizabeth Scruth, Vincent Liu, Margaret Guo, Gabriel J Escobar
Efforts to improve outcomes of patients who deteriorate outside the intensive care unit have included the use of rapid response teams (RRTs) as well as manual and automated prognostic scores. Although automated early warning systems (EWSs) are starting to enter clinical practice, there are few reports describing implementation and the processes required to integrate early warning approaches into hospitalists' workflows. We describe the implementation process at 2 community hospitals that deployed an EWS. We employed the Institute for Healthcare Improvement's iterative Plan-Do-Study-Act approach...
November 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/27805796/implementation-of-a-multicenter-performance-improvement-program-for-early-detection-and-treatment-of-severe-sepsis-in-general-medical-surgical-wards
#14
Christa Schorr, Andrew Odden, Laura Evans, Gabriel J Escobar, Snehal Gandhi, Sean Townsend, Mitchell Levy
Sepsis is a leading cause of in-hospital death, and evidence suggests a higher mortality in patients presenting with sepsis on the ward compared to those presenting to the emergency department. Ward patients who develop severe sepsis may have poor outcomes for a variety of reasons, including delayed diagnosis, lack of readily available staffing, and delayed treatment. We report on a multihospital quality improvement program for early detection and treatment of sepsis on general medical-surgical wards. We describe a multipronged approach to improve severe sepsis outcomes using the Institute for Healthcare Improvement's Plan-Do-Study-Act model...
November 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/27805712/deprescribing-to-reduce-medication-use-will-this-help-your-patient
#15
Robert H Howland
Polypharmacotherapy is a commonly used, but frequently criticized, clinical practice. Deprescribing is the process of discontinuing inappropriate or unnecessary medications, with the goals of decreasing adverse events and drug-drug interactions, simplifying medication regimens to enhance adherence, and reducing costs associated with medication use while maintaining or improving clinical outcomes. Studies of groups of patients suggest that deprescribing medication is feasible and safe, but individual experiences are masked by group data...
November 1, 2016: Journal of Psychosocial Nursing and Mental Health Services
https://www.readbyqxmd.com/read/27802843/tackling-obesity-in-areas-of-high-social-deprivation-clinical-effectiveness-and-cost-effectiveness-of-a-task-based-weight-management-group-programme-a-randomised-controlled-trial-and-economic-evaluation
#16
Hayden McRobbie, Peter Hajek, Sarrah Peerbux, Brennan C Kahan, Sandra Eldridge, Dominic Trépel, Steve Parrott, Chris Griffiths, Sarah Snuggs, Katie Myers Smith
BACKGROUND: An increasing number of people require help to manage their weight. The NHS recommends weight loss advice by general practitioners and/or a referral to a practice nurse. Although this is helpful for some, more effective approaches that can be disseminated economically on a large scale are needed. OBJECTIVE: To assess whether or not a task-based weight management programme [Weight Action Programme (WAP)] has better long-term effects than a 'best practice' intervention provided in primary care by practice nurses...
October 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27797997/stepped-wedge-cluster-randomised-controlled-trial-to-assess-the-effectiveness-of-an-electronic-medication-management-system-to-reduce-medication-errors-adverse-drug-events-and-average-length-of-stay-at-two-paediatric-hospitals-a-study-protocol
#17
J I Westbrook, L Li, M Z Raban, M T Baysari, V Mumford, M Prgomet, A Georgiou, T Kim, R Lake, C McCullagh, L Dalla-Pozza, J Karnon, T A O'Brien, G Ambler, R Day, C T Cowell, M Gazarian, R Worthington, C U Lehmann, L White, D Barbaric, A Gardo, M Kelly, P Kennedy
INTRODUCTION: Medication errors are the most frequent cause of preventable harm in hospitals. Medication management in paediatric patients is particularly complex and consequently potential for harms are greater than in adults. Electronic medication management (eMM) systems are heralded as a highly effective intervention to reduce adverse drug events (ADEs), yet internationally evidence of their effectiveness in paediatric populations is limited. This study will assess the effectiveness of an eMM system to reduce medication errors, ADEs and length of stay (LOS)...
October 21, 2016: BMJ Open
https://www.readbyqxmd.com/read/27786567/compound-glycyrrhizin-plus-conventional-therapy-for-psoriasis-vulgaris-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#18
Jason Jingjie Yu, Claire Shuiqing Zhang, Meaghan E Coyle, Yiqi Du, Anthony Lin Zhang, Xinfeng Guo, Charlie Changli Xue, Chuanjian Lu
Psoriasis vulgaris is a chronic skin condition affecting patients' quality of life. Long-term use of conventional therapy increases risk of unwanted side effects. Compound Glycyrrhizin in conjunction with conventional therapy has been used in clinical practice, but the evidence of such practice has not been evaluated systematically. This review aims to evaluate efficacy and safety of Compound Glycyrrhizin in combination with conventional therapy for psoriasis vulgaris. PubMed, Excerpta Medica dataBASE (Embase), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials, Allied and Complementary Medicine Database (AMED), CiNii, Chinese Biomedical Literature, China National Knowledge Infrastructure, Chinese Scientific Journals Full Text Database and Wanfang Data were searched from their respective inceptions to September, 2015...
October 27, 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27783819/simulation-with-debriefing-and-guided-reflective-journaling-to-stimulate-critical-thinking-in-prelicensure-baccalaureate-degree-nursing-students
#19
Mary L Padden-Denmead, Rose M Scaffidi, Regina M Kerley, Amy Lee Farside
BACKGROUND: Simulation and guided reflective journaling have been identified as effective teaching and learning methods to develop critical thinking (CT) and clinical reasoning skills in nursing students. METHOD: A descriptive correlational design was used to determine the relationship between CT and level of reflection using the Holistic Critical Thinking Skills Rubric (HCTSR) and the level of reflection on action assessment (LORAA), respectively, to evaluate 23 baccalaureate student-guided reflective journal entries after a simulation exercise with guided debriefing and after two subsequent clinical experiences...
November 1, 2016: Journal of Nursing Education
https://www.readbyqxmd.com/read/27765400/failure-rate-of-single-unit-restorations-on-posterior-vital-teeth-a-systematic-review
#20
Kelvin I Afrashtehfar, Elham Emami, Motahareh Ahmadi, Samer Abi-Nader, Faleh Tamimi
STATEMENT OF PROBLEM: No knowledge synthesis exists concerning when to use a direct restoration versus a complete-coverage indirect restoration in posterior vital teeth. PURPOSE: The purpose of this systematic review was to identify the failure rate of conventional single-unit tooth-supported restorations in posterior permanent vital teeth as a function of remaining tooth structure. MATERIAL AND METHODS: Four databases were searched electronically, and 8 selected journals were searched manually up to February 2015...
October 17, 2016: Journal of Prosthetic Dentistry
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