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Continuity of Care Document

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https://www.readbyqxmd.com/read/27920085/quality-of-prescribing-of-antipsychotic-medication-for-people-with-intellectual-disability-under-the-care-of-uk-mental-health-services-a-cross-sectional-audit-of-clinical-practice
#1
Carol Paton, Sumera Bhatti, Kiran Purandare, Ashok Roy, Tre Barnes
OBJECTIVES: To determine the prevalence and quality of antipsychotic prescribing for people with intellectual disability (ID). DESIGN: A clinical audit of prescribing practice in the context of a quality improvement programme. Practice standards for audit were derived from relevant, evidence-based guidelines, including NICE. Data were mainly collected from the clinical records, but to determine the clinical rationale for using antipsychotic medication in individual cases, prescribers could also be directly questioned...
December 5, 2016: BMJ Open
https://www.readbyqxmd.com/read/27914815/findings-from-an-online-survey-assessing-the-burden-and-management-of-seasonal-allergic-rhinoconjunctivitis-in-us-patients
#2
Eli O Meltzer, Judith Rosen Farrar, Cary Sennett
BACKGROUND: Seasonal allergic rhinoconjunctivitis (SARC) affects ≥16% of the US population annually. Telephone and in-office surveys have demonstrated negative effects of allergic rhinitis (AR) symptoms on sleep, daily activities, productivity, concentration, and emotions. OBJECTIVE: The objective of this study was to assess the patient-perceived burden of SARC in relation to newer treatments, increased access to treatments, and changing management protocols. METHODS: An online survey of symptom experience, impact on daily life, and management was conducted in US respondents who suffer (or whose child suffers) from SARC symptoms...
November 30, 2016: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/27906197/treatment-and-follow-up-of-venous-thrombosis-in-the-neonatal-intensive-care-unit-a-retrospective-study
#3
J C Bohnhoff, S A DiSilvio, R K Aneja, J R Shenk, Y A Domnina, B S Brozanski, M Good
OBJECTIVE: The critically ill, premature patients of neonatal intensive care units are susceptible to venous thrombosis, an adverse event associated with short- and long-term morbidity. Venous thrombosis is frequently treated with low-molecular-weight heparins (LMWHs) such as enoxaparin, but optimal dosing of LMWH must balance the morbidity of venous thrombosis with the potential adverse affects of anticoagulation. The optimal dosing of enoxaparin for premature infants is unclear. The objective of this study was to describe enoxaparin therapy and follow-up in critically ill neonates diagnosed with venous thrombosis...
December 1, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27905954/measuring-and-tracking-obesity-inequality-in-the-united-states-evidence-from-nhanes-1971-2014
#4
Tae-Young Pak, Susana Ferreira, Gregory Colson
BACKGROUND: Because people care about their weight relative to peers and society, obesity inequality plays a role in explaining obesity incidence and the impacts of being obese on subjective well-being. While the increase in obesity prevalence and mean body mass index (BMI) is well documented, the measurement of distributional changes and corresponding obesity inequality is yet to be fully explored. METHODS: The present study analyzed BMI data for adults aged 20 to 74 from the National Health and Nutritional Examination Survey (NHANES) I (1971-1974), II (1976-1980), III (1988-1994), and continuous NHANES (1999-2014)...
April 4, 2016: Population Health Metrics
https://www.readbyqxmd.com/read/27903209/incidence-and-cost-of-stress-ulcer-prophylaxis-after-discharge-from-the-intensive-care-unit-a-retrospective-study
#5
Benedict Tan, Richard Norman, Ed Litton, Chloe Heath, David J Hawkins, Ravi Krishnamurthy, Ravikiran Sonawane, Matthew H Anstey
OBJECTIVE: To describe current patterns in initiation and cessation of proton pump inhibitors (PPIs) for stress ulcer prophylaxis (SUP) in intensive care units, and to assess the costs associated with inappropriate (non-evidence-based) SUP. DESIGN, SETTING AND PARTICIPANTS: Retrospective observational study in five ICUs in Western Australia. We assessed the medical records of consecutive patients admitted to the ICUs between September 2013 and January 2015. Patients aged < 18 years were excluded...
December 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/27896407/mixed-methods-assessment-of-trauma-and-acute-care-surgical-quality-improvement-programs-in-peru
#6
Lacey N LaGrone, Amy K Fuhs, Eduardo Huaman Egoavil, Manuel J A Rodriguez Castro, Roberto Valderrama, Leah N Isquith-Dicker, Jaime Herrera-Matta, Charles N Mock
BACKGROUND: Evidence for the positive impact of quality improvement (QI) programs on morbidity, mortality, patient satisfaction, and cost is strong. Data regarding the status of QI programs in low- and middle-income countries, as well as in-depth examination of barriers and facilitators to their implementation, are limited. METHODS: This cross-sectional, descriptive study employed a mixed-methods design, including distribution of an anonymous quantitative survey and individual interviews with healthcare providers who participate in the care of the injured at ten large hospitals in Lima, Peru...
November 28, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27895940/real-time-reporting-of-small-operational-failures-in-nursing-care
#7
Kathleen R Stevens, Robert L Ferrer
Addressing microsystem problems from the frontline holds promise for quality enhancement. Frontline providers are urged to apply quality improvement; yet no systematic approach to problem detection has been tested. This study investigated a self-report approach to detecting operational failures encountered during patient care. Methods. Data were collected from 5 medical-surgical units over 4 weeks. Unit staff documented operational failures on a small distinctive Pocket Card. Frequency distributions for the operational failures in each category were calculated for each hospital overall and disaggregated by shift...
2016: Nursing Research and Practice
https://www.readbyqxmd.com/read/27895341/bringing-efficiency-into-practice-a-quality-improvement-initiative-to-reduce-operating-room-turnaround-time
#8
Hasanat Sharif, Noman Shehzad, Joveria Farooqi, Sana Karim, Sana Akbar
Operating room (OR) turnaround time (TAT) is the minimal essential time required for cleaning of OR and preparation for the next case. The TAT inversely affects OR efficiency. Several factors related to personnel, equipment and scheduling have been identified as causes of increased TAT. We conducted the study to identify factors that affect OR TAT and to propose recommendations for its reduction. The retrospective study, conducted at Aga Khan University Hospital, Karachi, comprised TAT records related to March 2014...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27894560/analysis-of-temperature-variability-in-medication-storage-compartments-in-emergency-transport-helicopters
#9
Margaret A O'Donnell, Justin Whitfield
The purpose of this study was to determine whether the temperature in medication storage compartments in air medical helicopters was within United States Pharmacopeia (USP)-defined limits for controlled room temperature. This was a prospective study using data obtained from a continuous temperature monitoring device. A total of 4 monitors were placed within 2 medication storage locations in 2 identical helicopters. The data collection period lasted 2 weeks during the summer and winter seasons. Data retrieved from monitors were compared against USP parameters for proper medication storage...
November 2016: Air Medical Journal
https://www.readbyqxmd.com/read/27893909/curricular-path-to-value-integrating-an-academic-electronic-health-record
#10
Jennifer Sorensen, Linda Campbell
BACKGROUND: Regulatory mandates consistently focus on quality, safety, and improving patient care as better evidence surfaces. One of those mandates is the adoption of electronic health records (EHRs) across all patient care settings. New graduate nurses must know how to access patient data and document and synthesize patient information accurately to plan safe, quality care and mitigate potential errors. METHOD: In an undergraduate nursing program, the objectives were to provide faculty with simple teaching strategies that promoted ease of integrating an academic EHR (AEHR) across a curriculum, as well as to steadily increase students' use of an AEHR...
December 1, 2016: Journal of Nursing Education
https://www.readbyqxmd.com/read/27893575/variations-in-burn-excision-and-grafting-a-survey-of-the-american-burn-association
#11
Jacqueline S Israel, David G Greenhalgh, Angela L Gibson
It is unknown whether variations in burn care affect outcomes or affect the success of emerging therapeutics. The purpose of this study was to assess burn surgeons' preferences in excision and grafting to determine if surgical technique affects outcomes. A 71-item survey evaluating skin grafting techniques was emailed to members of the American Burn Association in July and August 2015. The survey was anonymous and voluntary. Relationships between variables were evaluated using Fisher's exact test. A P-value of ≤...
November 15, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/27888863/helicobacter-pylori-related-diseases
#12
Javier P Gisbert
This article describes the main conclusions drawn from the presentations on Helicobacter pylori infection in Digestive Diseases Week, 2016. Despite the undeniable widespread reduction in the prevalence of this infection, infection rates continue to be high in developing countries. The prevalence of clarithromycin, metronidazole and quinolone resistance is markedly high in most countries and continues to rise. The management of H. pylori infection in patients with peptic ulcers still leaves much to be desired...
September 2016: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/27879984/no-end-in-sight-benzodiazepine-use-in-older-adults-in-the-united-states
#13
Donovan T Maust, Helen C Kales, Ilse R Wiechers, Frederic C Blow, Mark Olfson
OBJECTIVES: To establish the rate of new and continuation of benzodiazepine use in older adults seen by nonpsychiatrist physicians and to identify subpopulations at risk of new and continuation benzodiazepine use. DESIGN: Cross-sectional analysis. SETTING: National Ambulatory Medical Care Survey (2007-10). PARTICIPANTS: Adults visiting office-based nonpsychiatrist physicians (n = 98,818) who were prescribed a benzodiazepine (new or continuation)...
November 23, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27878902/a-retrospective-comparison-of-intrathecal-morphine-and-epidural-hydromorphone-for-analgesia-following-posterior-spinal-fusion-in-adolescents-with-idiopathic-scoliosis
#14
Rebecca A Hong, Kathleen M Gibbons, G Ying Li, Ashlee Holman, Terri Voepel-Lewis
BACKGROUND: Posterior spinal fusion to correct idiopathic scoliosis is associated with severe postoperative pain. Intrathecal morphine is commonly used for analgesia after adolescent posterior spinal fusion; however, anticipating and managing the increase in pain scores after resolution of analgesic effect of intrathecal morphine analgesia is challenging. In 2014, we developed a clinical protocol detailing both the administration of intrathecal morphine intraoperatively and the transition to routine, scheduled oral analgesics at 18 h postoperatively...
November 22, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27875602/practice-facilitation-for-pcmh-implementation-in-residency-practices
#15
Emilie Buscaj, Tristen Hall, Linda Montgomery, Douglas H Fernald, Jaclyn King, Nicole Deaner, W Perry Dickinson
BACKGROUND AND OBJECTIVES: Primary care residency programs continue to adapt and change to become high-performing training sites for advanced primary care. Practice facilitation is a key method to assist practices in implementing organizational changes. This evaluation described the unique nature and essential roles and qualities of practice facilitation for residency program patient-centered medical home (PCMH) transformation. METHODS: Evaluation of the Colorado Residency PCMH Project from 2009 through 2014 included template and immersion-crystallization approaches to qualitative analysis of field notes, key informant interviews, and meeting documentation to identify themes related to external facilitation for practice transformation in 11 Colorado primary care residency practices...
November 2016: Family Medicine
https://www.readbyqxmd.com/read/27869728/a-holistic-model-of-care-to-support-those-living-with-and-beyond-cancer
#16
Tamara Cadet, Cindy Davis, Jacinta Elks, Patricia Wilson
BACKGROUND: Globally, the burden of cancer continues to increase and it is well-documented that while not a homogeneous population, cancer patients and cancer survivors face many physical, psychological, social, spiritual, and financial issues. Cancer care is shifting from a disease-focused to a patient-centered approach resulting in an increased need to address these concerns. METHODS: Utilizing a quality improvement approach, this paper describes an integrated cancer care model at Bloomhill Cancer Center (BCC) in Queensland, Australia that demonstrates the ability to meet the holistic needs of patients living with and beyond cancer and to identify opportunities for better practice and service provision...
November 18, 2016: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/27867239/legal-status-and-health-care-mexican-origin-children-in-california-2001-2014
#17
R S Oropesa, Nancy S Landale, Marianne M Hillemeier
Using restricted data from the 2001-2014 California Health Interview Surveys, this research illuminates the role of legal status in health care among Mexican-origin children. The first objective is to provide a population-level overview of trends in health care access and utilization, along with the legal statuses of parents and children. The second objective is to examine the nature of associations between children's health care and legal status over time. We identify specific status-based distinctions that matter and investigate how their importance is changing...
October 2016: Population Research and Policy Review
https://www.readbyqxmd.com/read/27862103/pharmacokinetics-of-imipenem-cilastatin-burn-intensive-care-unit-patients-undergoing-high-dose-continuous-venovenous-hemofiltation
#18
Bradley A Boucher, Joanna Q Hudson, David M Hill, Joseph M Swanson, G Christopher Wood, S Casey Laizure, Angela Arnold-Ross, Zhe-Yi Hu, William L Hickerson
STUDY OBJECTIVE: High dose continuous venovenous hemofiltration (CVVH) is a continuous renal replacement therapy (CRRT) used frequently inpatients with burns. However, antibiotic dosing is based on inference from studies assessing substantially different methods of CRRT. To address this knowledge gap for imipenem/cilastatin (I-C) we evaluated the systemic and extracorporeal clearances (CL) of I-C in patients with burns undergoing high dose CVVH. DESIGN: Prospective clinical pharmacokinetic study...
November 9, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27852819/factors-influencing-advance-care-planning-among-older-adults-in-two-socioeconomically-diverse-living-communities
#19
Jennifer L Tripken, Cathy Elrod, Susan Bills
BACKGROUND/OBJECTIVES: Advance care planning (ACP) is an iterative, complex, and dynamic process of discussion, decision-making, and documentation about end-of-life care. The extent to which this process takes place in older adults in diverse socioeconomic settings is not well documented. The aim of this study was to assess the knowledge, attitudes, and beliefs about ACP among older adults in two socioeconomically diverse settings to identify the individual and contextual factors that influence behaviors regarding end-of-life care...
November 15, 2016: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/27833899/development-and-validation-of-an-algorithm-to-identify-patients-with-multiple-myeloma-using-administrative-claims-data
#20
Nicole Princic, Chris Gregory, Tina Willson, Maya Mahue, Diana Felici, Winifred Werther, Gregory Lenhart, Kathleen A Foley
PURPOSE: The objective was to expand on prior work by developing and validating a new algorithm to identify multiple myeloma (MM) patients in administrative claims. METHODS: Two files were constructed to select MM cases from MarketScan Oncology Electronic Medical Records (EMR) and controls from the MarketScan Primary Care EMR during January 1, 2000-March 31, 2014. Patients were linked to MarketScan claims databases, and files were merged. Eligible cases were age ≥18, had a diagnosis and visit for MM in the Oncology EMR, and were continuously enrolled in claims for ≥90 days preceding and ≥30 days after diagnosis...
2016: Frontiers in Oncology
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