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Anne L Donovan, J Matthew Aldrich, A Kendall Gross, Denise M Barchas, Kevin C Thornton, Hildy M Schell-Chaple, Michael A Gropper, Angela K M Lipshutz
OBJECTIVES: We describe the importance of interprofessional care in modern critical care medicine. This review highlights the essential roles played by specific members of the interprofessional care team, including patients and family members, and discusses quality improvement initiatives that require interprofessional collaboration for success. DATA SOURCES: Studies were identified through MEDLINE search using a variety of search phrases related to interprofessional care, critical care provider types, and quality improvement initiatives...
March 7, 2018: Critical Care Medicine
Stefan Baumann, Nikos Werner, Karim Ibrahim, Ralf Westenfeld, Fadi Al-Rashid, Jan-Malte Sinning, Dirk Westermann, Andreas Schäfer, Konstantinos Karatolios, Timm Bauer, Tobias Becher, Ibrahim Akin
BACKGROUND: Percutaneous coronary intervention (PCI) is an alternative strategy to coronary artery bypass grafting (CABG) in patients with high perioperative risk. The microaxial Impella® pump (Abiomed, Danvers, MA, USA), used as prophylactic and temporary support, is currently the most common device for "protected high-risk PCI" to ensure hemodynamic stability during complex coronary intervention. METHODS: The study is an observational, retrospective multi-center registry...
March 8, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Omid Nikoubashman, Kolja Schürmann, Ahmed E Othman, Jan-Philipp Bach, Martin Wiesmann, Arno Reich
Background and Purpose: With the advent of endovascular stroke treatment (EST) with mechanical thrombectomy, stroke treatment has also become more challenging. Purpose of this study was to investigate whether a fulltime neuroradiological on-site service and workflow optimization with a structured documentation of the interdisciplinary stroke workflow resulted in improved procedural times. Material and Methods: Procedural times of 322 consecutive patients, who received EST (1) before ( n = 96) and (2) after ( n = 126) establishing a 24-hour neuroradiological on-site service as well as (3) after implementation of a structured interdisciplinary workflow documentation ("Stroke Check") ( n = 100), were analysed...
2018: BioMed Research International
Stefania Barbieri, Paolo Feltracco, Vittorio Lucchetta, Rosa Maria Gaudio, Alberto Tredese, Mauro Bergamini, Gianna Vettore, Vincenzo Pietrantonio, Francesco Maria Avato, Daniele Donato, Deris Gianni Boemo, Maria Vittoria Nesoti, Rossella Snenghi
BACKGROUND: NekNomination, also known as NekNominate, Neck and Nominate, or Neck Nomination, is a social network-based drinking game which is thought to have originated in Australia and spread all over the world between 2013 and 2014. Individuals record videos of themselves while rapidly drinking excessive quantities of alcoholic drinks (necking) and then nominate friends to outdo them within 24 hours; the videos are then posted on social media such as Facebook or YouTube. The consequences of this drinking game have been very dangerous; at least 5 people under age 30 years have died after drinking deadly cocktails, and many others have suffered from alcohol intoxication...
January 31, 2018: Interactive Journal of Medical Research
Augusto Biasini, Fiorella Monti, Maria Chiara Laguardia, Marcello Stella, Lucia Marvulli, Erica Neri
BACKGROUND AND AIM OF THE STUDY: Extrauterine growth restriction and failure to thrive remain a major problem in Extremely Low Birth Weight infants. Nutritional support in preterm babies has the objective to improve the achieve rate of growth similar to those of the fetus in utero at the equivalent gestational age. The aim of the study was to evaluate feeding tolerance, intrahospital growth, neurological outcome and anthropometric data until 24 months of corrected age (mca) from different protein intake assumed by preterm babies <1250 g during their stay in NICU...
January 16, 2018: Acta Bio-medica: Atenei Parmensis
Ruth-Aoibheann O'Leary, Brian Marsh, Paul O'Connor
BACKGROUND: Transfer of critically ill patients within the hospital is commonly associated with adverse incidents, but, despite this, no standardised training exists on how to carry out this task. Very little information is published in the literature on the learning needs of staff undertaking these transfers, and this limits our ability to provide a focused and appropriate educational intervention. AIMS: This study aimed to explore the organisational, environmental and individual issues that increase risk to patients during intrahospital transport (IHT) and to explore the potential educational solutions to these issues as articulated by these practitioners...
January 12, 2018: Irish Journal of Medical Science
Brittany Ransom, Karen Winters
What is the effectiveness of the I-PASS mnemonic in reducing handoff related errors during inter- or intrahospital transfers for hospitalized patients?The objective of this systematic review is to identify the impact of the I-PASS mnemonic during hospitalized patient inter- or intrahospital transfers on medication errors, transfer delays, treatment delays and mortality.More specifically, the objective is to identify the effect that the I-PASS mnemonic has on handoff related errors during inter or intrahospital patient transfers by comparing rates pre and post I-PASS implementation...
January 2018: JBI Database of Systematic Reviews and Implementation Reports
Julie Haesebaert, Norbert Nighoghossian, Catherine Mercier, Anne Termoz, Sylvie Porthault, Laurent Derex, Pierre-Yves Gueugniaud, Estelle Bravant, Muriel Rabilloud, Anne-Marie Schott
BACKGROUND AND PURPOSE: A suboptimal number of ischemic stroke patients eligible for thrombolysis actually receive it, partly because of extended inhospital delays. We developed a comprehensive program designed for emergency unit staff and evaluated its effectiveness for reducing intrahospital times and improving access to thrombolysis. METHODS: We conducted a randomized stepped-wedge controlled trial in 18 emergency unit. The sequentially implemented training intervention, targeting emergency physicians and nurses, was based on specifically designed videos and interactive simulation workshops on intrahospital management optimization...
January 10, 2018: Stroke; a Journal of Cerebral Circulation
Moussa Toudou Daouda, Siham Bouchal, Naima Chtaou, Aouatef Midaoui, Zouahyr Souirti, Faouzi Belahsen
BACKGROUND: Thrombolysis alert (TA) is a procedure triggered every time a patient consults for sudden focal neurological deficit within 4.5 hours. OBJECTIVE: We aimed to determine firstly the etiological profile of TA and secondly to evaluate the delays in the management not only of thrombolyzed patients but also of nonthrombolyzed patients to determine the intrahospital delays to optimize. METHODS: Patients aged over 18 years who consulted for sudden focal neurological deficit within 4...
December 29, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Sabrina Corrêa da Costa Ribeiro, Ricardo Tavares de Carvalho, Juraci Aparecida Rocha, Roger Daglius Dias
OBJECTIVE: The use of palliative care (PC) screening criteria to trigger PC consultations may optimize the utilization of PC services, improve patient comfort, and reduce invasive and futile end-of-life care. The aim of the present study was to assess the criterion validity and inter-rater reliability of a PC screening tool for patients admitted to an emergency department intensive care unit (ED-ICU). METHOD: Observational retrospective study evaluating PC screening criteria based on the presence of advanced diagnosis and the use of two "surprise questions" (traditional and modified)...
December 26, 2017: Palliative & Supportive Care
Dominik Melhem, Serge Daneault
OBJECTIVE: To explore the needs of cancer patients in palliative care and to determine how care providers, including family physicians, could meet these needs more fully. DESIGN: Qualitative study performed using semistructured interviews. SETTING: Palliative care departments (ambulatory and intrahospital). PARTICIPANTS: Twelve patients with a diagnosis of cancer deemed to be in the palliative phase, who had already received either chemotherapy or radiation treatment...
December 2017: Canadian Family Physician Médecin de Famille Canadien
Laura Amato, Danilo Fusco, Anna Acampora, Katia Bontempi, Alessandro Cesare Rosa, Paola Colais, Fabio Cruciani, Mariangela D'Ovidio, Francesca Mataloni, Silvia Minozzi, Zuzana Mitrova, Luigi Pinnarelli, Rosella Saulle, Salvatore Soldati, Chiara Sorge, Simona Vecchi, Martina Ventura, Marina Davoli
BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions...
September 2017: Epidemiologia e Prevenzione
Johannes Patzelt, Miriam Ulrich, Harry Magunia, Reinhard Sauter, Michal Droppa, Rezo Jorbenadze, Annika S Becker, Tobias Walker, Ralph Stephan von Bardeleben, Christian Grasshoff, Peter Rosenberger, Meinrad Gawaz, Peter Seizer, Harald F Langer
BACKGROUND: Percutaneous edge-to-edge mitral valve repair (PMVR) has become an established treatment option for mitral regurgitation in patients not eligible for surgical repair. Currently, most procedures are performed under general anesthesia (GA). An increasing number of centers, however, are performing the procedure under deep sedation (DS). Here, we compared patients undergoing PMVR with GA or DS. METHODS AND RESULTS: A total of 271 consecutive patients underwent PMVR at our institution between May 2014 and December 2016...
December 2, 2017: Journal of the American Heart Association
Markus Latzke, Michael Schiffinger, Dominik Zellhofer, Johannes Steyrer
BACKGROUND: Intrahospital patient transports (IHTs) in intensive care involve an appreciable risk of adverse events (AEs). Research on determinants of AE occurrence during IHT has hitherto focused on patient, transport, and intensive care unit (ICU) characteristics. By contrast, the role of "soft" factors, although arguably relevant for IHTs and a topic of interest in general health care settings, has not yet been explored. PURPOSE: The study aims at examining the effect of safety climate and team processes on the occurrence of AE during IHT and whether team processes mediate the effect of safety climate...
November 15, 2017: Health Care Management Review
Marina Muñoz, Milena Camargo, Dora Inés Ríos-Chaparro, Paula Gómez, Manuel Alfonso Patarroyo, Juan David Ramírez
Background: Clostridium difficile infection (CDI) leads to the onset of antibiotic-associated diarrhea (AAD) and a wide range of gastrointestinal pathologies. Currently, CDI is one of the most important opportunistic infections at the intrahospital level and an exponential increase in community-acquired infections has been reported. Herein, we evaluated the relationships (at phylogenetic and genetic population structure levels), as well as the molecular toxigenic and antibiotic resistance profiles of a set of isolates established from a case of community acquired-CDI...
2017: Gut Pathogens
A Franke, D Bieler, B Friemert, E Kollig, S Flohe
Due to the recent terrorist attacks in Paris, Brussels, Ansbach, Munich, Berlin and more recently Manchester and London, terrorism is realized as a present threat to our society and social life, as well as a challenge for the health care system. Without fueling anxiety, there is a need for sensitization to this subject and to familiarize all concerned with the special kind of terrorist attack-related injuries, the operational priorities and tactics and the individual basic principles of preclinical and hospital care...
October 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Shinji Nakahara, Tetsuya Sakamoto, Takashi Fujita, Tomohide Koyama, Yoichi Katayama, Seizan Tanabe, Yasuhiro Yamamoto
Aims: Accurate evaluation of health care quality requires high-quality data, and case ascertainment (confirming eligible cases and deaths) is a foundation for accurate data collection. This study examined the accuracy of case ascertainment from two Japanese data sources. Methods: Using hospital-level data, we investigated the concordance in ascertaining trauma cases between a nationwide trauma registry (the Japan Trauma Data Bank) and annual government evaluations of tertiary hospitals between April 2012 and March 2013...
October 2017: Acute Medicine & Surgery
Vincent Roule, Katrien Blanchart, Xavier Humbert, Damien Legallois, Adrien Lemaitre, Paul Milliez, Farzin Beygui, Joachim Alexandre
BACKGROUND: Patients over 75 account for more than one third of those presenting with myocardial infarction and more than 50% of intrahospital mortality. There are no specific guidelines for the management of acute coronary syndromes (ACS) in the elderly. SETTING: Although antithrombotic therapy seems to be effective and safe in such patients, it requires specific precautions and treatment adjustments because of the higher bleeding risk due to comorbidities such as renal function impairment and malnutrition...
December 2017: Cardiovascular Drugs and Therapy
Francielli Mary Pereira Gimenez, Wesley Henrique Bueno de Camargo, Ana Clara Beraldo Gomes, Thaylla Sumyre Nihei, Monique Walicheki Maria Andrade, Maria Laura de A F Sé Valverde, Larissa D' Epiro de Souza Campos, Debora Carvalho Grion, Josiane Festti, Cintia Magalhães Carvalho Grion
PURPOSE: To describe adverse events occurring during intrahospital transportation of adult patients hospitalized in an Intensive Care Unit (ICU) and to evaluate the association with morbidity and mortality. METHOD: Prospective cohort study from July 2014 to July 2015. Data collection comprised clinical data, prognostic scores, length of stay, and outcome at hospital discharge. Data was collected on transport and adverse events. Adverse events were classified according to the World Health Organization following the degree of damage...
2017: Critical Care Research and Practice
Marios-Nikos Psychogios, Daniel Behme, Katharina Schregel, Ioannis Tsogkas, Ilko L Maier, Johanna Rosemarie Leyhe, Antonia Zapf, Julia Tran, Mathias Bähr, Jan Liman, Michael Knauth
BACKGROUND AND PURPOSE: Intrahospital time delays significantly affect the neurological outcome of stroke patients with large-vessel occlusion. This study was conducted to determine whether a one-stop management can reduce intrahospital times of patients with acute large-vessel occlusion. METHODS: In this observational study, we report the first 30 consecutive stroke patients imaged and treated in the same room. As part of our protocol, we transported patients with a National Institutes of Health Stroke Scale score of ≥10 directly to the angio suite, bypassing multidetector computed tomography (CT)...
November 2017: Stroke; a Journal of Cerebral Circulation
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