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Post-discharge interventions

Shefaly Shorey, Cornelia Chee, Yap-Seng Chong, Esperanza Debby Ng, Ying Lau, Cindy-Lee Dennis
BACKGROUND: Multiple international agencies, including the World Health Organization and the International Monetary Fund, have emphasized the importance of maternal mental health for optimal child health and development. Adequate social support is vital for the most vulnerable to postpartum mood disorders. Hence, an urgent need for sustainable social support programs to aid mothers ease into their new parenting role exists. OBJECTIVE: This study protocol aims to examine the effectiveness of a technology-based peer support intervention program among mothers at risk for postnatal depression in the early postpartum period...
March 14, 2018: JMIR Research Protocols
Hanh Ngo, Roberto Forero, David Mountain, Daniel Fatovich, Wing Nicola Man, Peter Sprivulis, Mohammed Mohsin, Sam Toloo, Antonio Celenza, Gerard Fitzgerald, Sally McCarthy, Ken Hillman
BACKGROUND: In 2009, the Western Australian (WA) Government introduced the Four-Hour Rule (FHR) program. The policy stated that most patients presenting to Emergency Departments (EDs) were to be seen and either admitted, transferred, or discharged within 4 hours. This study utilised de-identified data from five participating hospitals, before and after FHR implementation, to assess the impact of the FHR on several areas of ED functioning. METHODS: A state (WA) population-based intervention study design, using longitudinal data obtained from administrative health databases via record linkage methodology, and interrupted time series analysis technique...
2018: PloS One
Christian Hassager, Ken Nagao, David Hildick-Smith
The prognosis after out-of-hospital cardiac arrest (OHCA) has improved in the past few decades because of advances in interventions used outside and in hospital. About half of patients who have OHCA with initial ventricular tachycardia or ventricular fibrillation and who are admitted to hospital in coma after return of spontaneous circulation will survive to discharge with a reasonable neurological status. In this Series paper we discuss in-hospital management of patients with post-cardiac-arrest syndrome. In most patients, the most important in-hospital interventions other than routine intensive care are continuous active treatment (in non-comatose and comatose patients and including circulatory support in selected patients), cooling of core temperature to 32-36°C by targeted temperature management for at least 24 h, immediate coronary angiography with or without percutaneous coronary intervention, and delay of final prognosis until at least 72 h after OHCA...
March 10, 2018: Lancet
Ashequl M Islam, Gaurav Alreja, Jaya Mallidi, Mohammed Ziaul Hoque, Jennifer Friderici
OBJECTIVE: To assess feasibility, safety, and patient satisfaction of same-day discharge (SD) following peripheral arterial interventions. BACKGROUND: Although diagnostic angiography is routinely performed as a same-day procedure, same-day percutaneous trans-luminal angioplasty is less common. Because there is very low incidence of peri-procedural complications after 4 hr, discharge after this window is possible provided the patient is able to ambulate and has necessary social support...
March 14, 2018: Catheterization and Cardiovascular Interventions
Luke Miller, Thanh Hogan, Benedick Bato, Donald Floresca, Aaron Spaulding
The patient experience in the hospital has become an increasingly important measure of how well a healthcare system functions. Poor experiences as reported by patients have been associated with decreased compliance to medication instructions as well as increased recovery time from illness. While other studies have demonstrated the benefit of pharmacist counseling during patient discharge, the benefit of pharmacist intervention during the patient's hospital stay remains to be seen. This study was an institutional review board-approved pre-/post-analysis assessing patients' perception of medication communications during hospitalization in an academic teaching hospital...
March 2018: Journal of Healthcare Management / American College of Healthcare Executives
Rocco Friebel, Katharina Hauck, Paul Aylin, Adam Steventon
OBJECTIVE: To assess trends in 30-day emergency readmission rates across England over one decade. DESIGN: Retrospective study design. SETTING: 150 non-specialist hospital trusts in England. PARTICIPANTS: 23 069 134 patients above 18 years of age who were readmitted following an initial admission (n=62 584 297) between April 2006 and February 2016. PRIMARY AND SECONDARY OUTCOMES: We examined emergency admissions that occurred within 30 days of discharge from hospital ('emergency readmissions') as a measure of healthcare quality...
March 12, 2018: BMJ Open
Benjamin James Tarrant, Anne Holland, Caitlin Le Maitre, Rebecca Robinson, Monique Corbett, Janet Bondarenko, Brenda Button, Bruce Thompson, Greg Snell
BACKGROUND AND PURPOSE: Physiotherapy "standard care" for the acute post lung transplant recipient has not yet been documented. We aimed to analyse how soon patients commence exercise and how much time is dedicated to this during physiotherapy sessions acutely post lung transplantation. METHODS: Prospective observational study of bilateral sequential and single lung transplant recipients for any indication, ≥18 years. Participants were observed during 6 physiotherapy sessions: 3 initial and 3 prior to acute inpatient discharge...
March 12, 2018: Physiotherapy Research International: the Journal for Researchers and Clinicians in Physical Therapy
B Wilkins, S Hullikunte, M Simmonds, A Sasse, P D Larsen, S A Harding
BACKGROUND: We assessed the effect of a pre-discharge medication checklist on discharge prescription rates of guideline recommended medications following myocardial infarction. In addition, we assessed what proportion of the residual prescribing gap following implementation of the checklist was due to the presence of contraindications. METHODS: We examined baseline prescription rates of guideline recommended medications in 100 patients discharged from our institution following acute myocardial infarction...
November 14, 2017: Heart, Lung & Circulation
M Elizabeth Wilcox, Andrew S Lim, Ruxandra Pinto, Sandra E Black, Mary Pat McAndrews, Gordon D Rubenfeld
BACKGROUND: Few studies have investigated sleep in patients after intensive care despite the possibility that inadequate sleep might further complicate an acute illness impeding recovery. AIMS: Our objectives were to assess the quality and quantity of a patients' sleep on the ward by polysomnography (PSG) within a week of intensive care unit (ICU) discharge and to explore the prevalence of key in-ICU risk factors for persistent sleep fragmentation. METHODS: We enrolled twenty patients after they have been mechanically ventilated for at least 3 days and survived to ICU discharge...
March 9, 2018: Internal Medicine Journal
Julius C Mwita, Sajini Souda, Mgaywa Gmd Magafu, Amos Massele, Brian Godman, Michael Mwandri
OBJECTIVES: Antibiotic prophylaxis in surgery is known to reduce the rate of surgical site infections (SSI) as well as shorten hospital stay. However, there is currently a scarcity of data on antibiotic prophylaxis and SSIs among African countries including Botswana. Consequently, this study aimed to address this. METHODS: A prospective study involving 400 patients was carried out at a leading tertiary hospital in Botswana from 2014-2015. Patients' demographic information, type of surgery performed and peri-operative use of antibiotics were documented...
March 9, 2018: Hospital Practice (Minneapolis)
Scott D Casey, Bryn E Mumma
BACKGROUND: Sex, race, and insurance status are associated with treatment and outcomes in several cardiovascular diseases. These disparities, however, have not been well-studied in out-of-hospital cardiac arrest (OHCA). OBJECTIVE: Our objective was to evaluate the association of patient sex, race, and insurance status with hospital treatments and outcomes following OHCA. METHODS: We studied adult patients in the 2011-2015 California Office of Statewide Health Planning and Development (OSHPD) Patient Discharge Database with a "present on admission" diagnosis of cardiac arrest (ICD-9-CM 427...
March 5, 2018: Resuscitation
Josephine M E Gibson, Lois H Thomas, J J Harrison, Caroline Leigh Watkins
AIMS AND OBJECTIVES: To explore the views and experiences of stroke survivors and carers about a systematic voiding programme for post-stroke incontinence. BACKGROUND: Urinary incontinence after stroke is common and associated with poorer functional outcome. Structured assessment and management are potentially effective interventions but it is important that there is a good understanding of stroke survivors' and carers' views of their acceptability and implementation...
March 8, 2018: Journal of Clinical Nursing
Matthew Cox, Catherine O'Connor, Katie Biggs, Daniel Hind, Oscar Bortolami, Matthew Franklin, Barbara Collins, Stephen Walters, Allan Wailoo, Julie Channell, Paul Albert, Ursula Freeman, Stephen Bourke, Michael Steiner, Jon Miles, Tom O'Brien, David McWilliams, Terry Schofield, John O'Reilly, Rodney Hughes
BACKGROUND: Chronic obstructive pulmonary disease (COPD) affects > 3 million people in the UK. Acute exacerbations of COPD (AECOPD) are the second most common reason for emergency hospital admission in the UK. Pulmonary rehabilitation is usual care for stable COPD but there is little evidence for early pulmonary rehabilitation (EPR) following AECOPD, either in hospital or immediately post discharge. OBJECTIVE: To assess the feasibility of recruiting patients, collecting data and delivering EPR to patients with AECOPD to evaluate EPR compared with usual care...
March 2018: Health Technology Assessment: HTA
Antonio F Corno, Saravanan Durairaj, Robert H Anderson
Aorto-ventricular tunnel is an extremely rare congenital heart defect, consisting of failure of attachment of an aortic leaflet along the semilunar hinge. In all published reports the leaflet involved was either the right coronary leaflet, most frequently, or the left coronary leaflet, in most of the cases opening toward the left ventricle, with only one-eighth of the reported cases communicating with the right ventricle. Treatment of the aorto-ventricular tunnel has been anecdotally reported by interventional closure with a device and more frequently with surgical approach, either as an isolated malformation or as associated lesions...
2018: Frontiers in Pediatrics
A R Watkins, E J Parente
BACKGROUND: Guttural pouch mycosis (GPM) is a cause of nasal discharge, dysphagia, and fatal haemorrhage in the horse. OBJECTIVES: To report the complications and success of salpingopharyngeal fistulation in horses with GPM. We hypothesised that creating a direct static opening into the guttural pouch from the pharynx would cause a regression of fungal plaques due to a change in the guttural pouch environment and that this treatment would result in resolution of infection prior to secondary complications...
March 7, 2018: Equine Veterinary Journal
Maria L Pacella, Jeffrey M Girard, Aidan G C Wright, Brian Suffoletto, Clifton W Callaway
OBJECTIVES: Psychosocial factors and responses to injury modify the transition from acute to chronic pain. Specifically, posttraumatic stress disorder symptoms (PTSS; reexperiencing, avoidance, and hyperarousal symptoms) exacerbate and co-occur with chronic pain. Yet no study has prospectively considered the associations among these psychological processes and pain reports using experience sampling methods (ESM) during the acute aftermath of injury. This study applied ESM via daily text messaging to monitor and detect relationships among psychosocial factors and post-injury pain across the first 14-days after emergency department (ED) discharge...
March 7, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Hirotoshi Watanabe, Takeshi Morimoto, Hiroki Shiomi, Yusuke Yoshikawa, Takao Kato, Naritatsu Saito, Satoshi Shizuta, Koh Ono, Kyohei Yamaji, Kenji Ando, Shuichiro Kaji, Yutaka Furukawa, Masaharu Akao, Tetsuya Ishikawa, Takashi Tamura, Yoshito Yamamoto, Toshiya Muramatsu, Satoru Suwa, Yoshihisa Nakagawa, Kazushige Kadota, Yoshiki Takatsu, Hideo Nishikawa, Yoshikazu Hiasa, Yasuhiko Hayashi, Shunichi Miyazaki, Takeshi Kimura
It is unknown whether there is a threshold of creatine kinase (CK) or CK-MB affecting the subsequent mortality for post-discharge myocardial infarction (PDMI) after percutaneous coronary intervention. Current study sought to evaluate the impact of PDMI. The study population included 30,051 patients with successful coronary stenting and discharged alive in the pooled patient-level database of 4 Japanese studies (j-Cypher registry, CREDO-Kyoto PCI/CABG registry cohort-2, RESET, and NEXT). During 4.4 ± 1...
March 5, 2018: Cardiovascular Intervention and Therapeutics
Rafaelle Spear, Jonathan Sobocinski, Adrien Hertault, Matthieu Delloye, Richard Azzauiu, Dominique Fabre, Stéphan Haulon
OBJECTIVES: To evaluate the outcomes of the second generation BeGraft balloon expandable covered stent Graft System (Bentley InnoMed, Hechingen, Germany) implanted as bridging stent grafts during fenestrated endovascular aortic repair (FEVAR) of complex aneurysms. DESIGN: This was a single centre prospective study including all consecutive patients treated by FEVAR performed with second generation BeGraft stent grafts as bridging stents. METHODS: Demographics of patients, diameter and length of the bridging stent grafts, technical success, re-interventions, occlusions, post-operative events, and imaging (Cone Beam CT and/or CT scan, and contrast enhanced ultrasound) were prospectively collected in an electronic database...
February 28, 2018: European Journal of Vascular and Endovascular Surgery
Olaya I Brewer Gutierrez, Shayan S Irani, Saowanee Ngamruengphong, Hanaa D Aridi, Rastislav Kunda, Ali Siddiqui, Markus Dollhopf, Jose Nieto, Yen-I Chen, Nadav Sahar, Majidah A Bukhari, Omid Sanaei, Marcia I Canto, Vikesh K Singh, Richard Kozarek, Mouen A Khashab
BACKGROUND:  Afferent loop syndrome (ALS) is traditionally managed surgically and, more recently, endoscopically. The role of endoscopic ultrasound-guided entero-enterostomy (EUS-EE) has not been well described. The aim of this study was to assess the technical and clinical success and safety of EUS-EE. METHODS:  This was a multicenter, retrospective series at six centers in patients with ALS treated by EUS-EE. Data on patients treated with enteroscopy-assisted luminal stenting (EALS) at a single center were also collected...
March 2, 2018: Endoscopy
Christina R Whitehouse, Nancy C Sharts-Hopko, Suzanne C Smeltzer, David A Horowitz
The aim of the current study was to compare outcomes for older adults with type 2 diabetes mellitus and obesity following participation in a transitional care intervention that included diabetes self-management education (DSME) and homecare. The three groups analyzed comprised an inpatient DSME plus homecare group (n = 35); an inpatient DSME only group (n = 100); and a group who received usual care (n = 45). Outcomes of interest included rehospitalization rates and hemoglobin A1C (A1C) for up to 1-year post hospital discharge...
March 1, 2018: Research in Gerontological Nursing
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