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https://www.readbyqxmd.com/read/29234148/quality-improvement-to-reduce-chronic-lung-disease-rates-in-very-low-birth-weight-infants-high-compliance-with-a-respiratory-care-bundle-in-a-small-nicu
#1
Zuzanna Kubicka, Eyad Zahr, Tamara Rousseau, Henry A Feldman, John Fiascone
OBJECTIVE: Reduce chronic lung disease by 10% among very-low birth weight infants by implementing a consistent respiratory care bundle. STUDY DESIGN: Prospective quality improvement study of infants below 32 weeks gestation in a small neonatal intensive care unit. A respiratory care bundle to eliminate inter-provider variability and minimize use of mechanical ventilation was implemented. This included: defining delivery room management with use of continuous positive airway pressure/nasal intermittent positive pressure ventilation, uniform intubation/extubation criteria, and standardizing ventilation/post-extubation support...
December 12, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29229107/clinical-characterization-of-52-patients-with-immunoglobulin-g4-related-disease-in-a-single-tertiary-center-in-japan-special-reference-to-lung-disease-in-thoracic-high-resolution-computed-tomography
#2
Takeshi Saraya, Kosuke Ohkuma, Masachika Fujiwara, Chika Miyaoka, Shoko Wada, Takayasu Watanabe, Sunao Mikura, Manami Inoue, Miku Oda, Mitsuru Sada, Yukari Ogawa, Kojiro Honda, Masaki Tamura, Takuma Yokoyama, Daisuke Kurai, Haruyuki Ishii, Hajime Takizawa
BACKGROUND: Immunoglobulin G4-related disease (IgG4-RD) is a rare multi-organ disorder. Physicians rarely encounter patients with IgG4-RD and its range of symptoms. METHODS: To elucidate the clinical characterization of IgG4-RD, along with the clinical significance of lung involvement, we retrospectively reviewed the medical records of patients who satisfied the comprehensive diagnostic criteria for IgG4-RD. RESULTS: We identified 52 patients with IgG4-RD...
November 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/29225790/update-on-ventilator-associated-pneumonia
#3
REVIEW
Jean-Francois Timsit, Wafa Esaied, Mathilde Neuville, Lila Bouadma, Bruno Mourvllier
Ventilator-associated pneumonia (VAP) is the most frequent life-threatening nosocomial infection in intensive care units. The diagnostic is difficult because radiological and clinical signs are inaccurate and could be associated with various respiratory diseases. The concept of infection-related ventilator-associated complication has been proposed as a surrogate of VAP to be used as a benchmark indicator of quality of care. Indeed, bundles of prevention measures are effective in decreasing the VAP rate. In case of VAP suspicion, respiratory secretions must be collected for bacteriological secretions before any new antimicrobials...
2017: F1000Research
https://www.readbyqxmd.com/read/29223321/is-there-value-in-retrospective-90-day-bundle-payment-models-for-shoulder-arthroplasty-procedures
#4
Susan M Odum, Nady Hamid, Bryce A Van Doren, Leo R Spector
BACKGROUND: The Centers for Medicare & Medicaid Services Bundled Payments for Care Improvement (BPCI) initiative was implemented as part of the Affordable Care Act. We implemented a retrospective payment model 2 for a 90-day total shoulder arthroplasty (TSA) episode to assess the value of TSA BPCI at our private practice. METHODS: Expenditures and postacute event rates of 132 fee-for-service (FFS) patients who underwent a TSA operation between 2009 and 2012 were compared with 333 BPCI patients who had a TSA operation in 2015...
December 7, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29219922/multimodal-prehabilitation-programs-as-a-bundle-of-care-in-gastrointestinal-cancer-surgery-a-systematic-review
#5
Vladimir Bolshinsky, Michael H-G Li, Hilmy Ismail, Kate Burbury, Bernhard Riedel, Alexander Heriot
BACKGROUND: Prehabilitation reflects a proactive process of preoperative optimization undertaken between cancer diagnosis and definitive surgical treatment, with the intent of improving physiological capacity to withstand the major insult of surgery. Prehabilitation before GI cancer surgery is currently not widely adopted, and most research has focused on unimodal interventions such as exercise therapy, nutritional supplementation, and hematinic optimization. A review of the existing literature was undertaken to investigate the impact of multimodal prehabilitation programs as a "bundle of care...
January 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29219906/targeted-interventions-to-advance-a-culture-of-inquiry-at-a-large-multicampus-hospital-among-nurses
#6
Eileen J Carter, Reynaldo R Rivera, Kelly A Gallagher, Kenrick D Cato
OBJECTIVES: The aim of this study is to assist nurse leaders in developing innovative structures to foster a culture of inquiry among professional nurses. BACKGROUND: Critical to nurse's engagement in evidence-based practice (EBP) is a culture of inquiry, in which nurses critically evaluate patient care activities and actively review existing evidence to address identified clinical issues. A bundle of structural interventions was implemented across a large, multisite hospital to advance a culture of inquiry...
January 2018: Journal of Nursing Administration
https://www.readbyqxmd.com/read/29216937/-significance-of-peripheral-perfusion-index-in-early-diagnosis-and-goal-directed-therapy-of-septic-shock-patients-a-prospective-single-blind-randomized-controlled-trial
#7
Yuanfeng Shi, Ruihong Yin, Yanli Wang, Jiguang Li, Xiaobing Chen, Yongpeng Xie, Caihong Gu, Xiuzhen Zou, Kexi Liu
OBJECTIVE: To investigate the application of peripheral perfusion index (PPI) in early diagnosis and goal-directed therapy of septic shock, and to provide reference for the early clinical diagnosis and treatment of septic shock. METHODS: A prospective single-blind randomized controlled trial (RCT) was conducted. Adult patients with sepsis admitted to emergency medical department and intensive care unit (ICU) of the First People's Hospital of Lianyungang City in Jiangsu Province from January 2013 to December 2016 were enrolled...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29211195/impact-of-two-bundles-on-central-catheter-related-bloodstream-infection-in-critically-ill-patients
#8
Cristobal Felipe Padilla Fortunatti
OBJECTIVE: To evaluate the impact of the implementation of insertion and maintenance bundles on the rates of catheter-related bloodstream infection in an intensive care unit. METHOD: This is a quasi-experimental, before-and-after study with a non-equivalent control group. During a six-month period, insertion and maintenance bundles for the central venous catheters were implemented. Supervision guidelines were developed to assess compliance with the bundle and catheter characteristics...
December 4, 2017: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/29210750/insights-about-the-economic-impact-of-chronic-obstructive-pulmonary-disease-readmissions-post-implementation-of-the-hospital-readmission-reduction-program
#9
Valerie G Press, R Tamara Konetzka, Steven R White
PURPOSE OF REVIEW: Chronic obstructive pulmonary disease (COPD) affects over 12 million adults in the United States and is the third leading cause of 30-day readmissions. COPD is costly with almost $50 billion in direct costs annually. Total COPD costs can be up to double the identified direct costs because of comorbid disease and numerous indirect costs such as absenteeism. Acute exacerbations of COPD (AECOPD) are responsible for up to 70% of COPD-related healthcare costs; hospital readmissions alone account for over $15 billion annually...
November 27, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29208666/epidemiology-of-uk-neonatal-infections-the-neonin-infection-surveillance-network
#10
Benjamin Cailes, Christina Kortsalioudaki, Jim Buttery, Santosh Pattnayak, Anne Greenough, Jean Matthes, Alison Bedford Russell, Nigel Kennea, Paul T Heath
OBJECTIVE: To describe the epidemiology of neonatal infection over the past decade in UK neonatal units. DESIGN: Retrospective analysis of prospectively collected infection surveillance network data from 2005 to 2014. SETTING: 30 neonatal units in the UK. PATIENTS: Newborns on participating neonatal units who had a positive blood, cerebrospinal fluid or urine culture and were treated with at least 5 days of appropriate antibiotics...
December 5, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29204493/comparison-of-adverse-events-rates-and-hospital-cost-between-customized-individually-made-implants-and-standard-off-the-shelf-implants-for-total-knee-arthroplasty
#11
Steven D Culler, Greg M Martin, Alyssa Swearingen
Background: This study compares selected hospital outcomes between patients undergoing total knee arthroplasty (TKA) using either a customized individually made (CIM) implant or a standard off-the-shelf (OTS) implant. Methods: A retrospective review was conducted on 248 consecutive TKA patients treated in a single institution, by the same surgeon. Patients received either CIM (126) or OTS (122) implants. Study data were collected from patients' medical record or the hospital's administrative billing record...
December 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/29200351/risk-adjustment-may-lessen-penalties-on-hospitals-treating-complex-cardiac-patients-under-medicare-s-bundled-payments
#12
Adam A Markovitz, Chandy Ellimoottil, Devraj Sukul, Samyukta Mullangi, Lena M Chen, Brahmajee K Nallamothu, Andrew M Ryan
To reduce variation in spending, Medicare has considered implementing a cardiac bundled payment program for acute myocardial infarction and coronary artery bypass graft. Because the proposed program does not account for patient risk factors when calculating hospital penalties or rewards ("reconciliation payments"), it might unfairly penalize certain hospitals. We estimated the impact of adjusting for patients' medical complexity and social risk on reconciliation payments for Medicare beneficiaries hospitalized for the two conditions in the period 2011-13...
December 2017: Health Affairs
https://www.readbyqxmd.com/read/29198953/national-bundle-care-program-implementation-to-reduce-ventilator-associated-pneumonia-in-intensive-care-units-in-taiwan
#13
Chin-Chuan Kao, Hsiu-Tzy Chiang, Chih-Yu Chen, Ching-Tzu Hung, Ying-Chun Chen, Li-Hsiang Su, Zhi-Yuan Shi, Jein-Wei Liu, Chang-Pan Liu, Yin-Ching Chuang, Wen-Chien Ko, Yen-Hsu Chen, Shu-Hui Tseng, Chun-Ming Lee, Min-Chi Lu, Po-Ren Hsueh
BACKGROUND/PURPOSE: This study investigated the impact of implementing ventilator-associated pneumonia (VAP) bundle care on the rates of VAP in intensive care units (ICUs) in Taiwan. METHODS: A total of 10 ICUs (bed number, 170), including surgical (SICUs) (n = 7), cardiovascular/surgical (CV/S-ICUs) (n = 1), and medical ICUs (MICUs) (n = 2) from 10 hospitals (7 medical center hospitals and 3 regional hospitals) were enrolled in this quality-improvement project...
December 1, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/29198732/application-of-process-mapping-to-understand-integration-of-high-risk-medicine-care-bundles-within-community-pharmacy-practice
#14
Natalie M Weir, Rosemary Newham, Emma D Corcoran, Ashwag Ali Atallah Al-Gethami, Ali Mohammed Abd Alridha, Paul Bowie, Anne Watson, Marion Bennie
OBJECTIVE: The Scottish Patient Safety Programme - Pharmacy in Primary Care collaborative is a quality improvement initiative adopting the Institute of Healthcare Improvement Breakthrough Series collaborative approach. The programme developed and piloted High Risk Medicine (HRM) Care Bundles (CB), focused on warfarin and non-steroidal anti-inflammatories (NSAIDs), within 27 community pharmacies over 4 NHS Regions. Each CB involves clinical assessment and patient education, although the CB content varies between regions...
November 21, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29194494/impact-of-bundled-payments-on-hip-fracture-outcomes-a-nationwide-population-based-study
#15
Yu-Chi Tung, Hsien-Yen Chang, Guann-Ming Chang
Objective: Establishing one price for all bundled services for a particular illness, which has become the key to healthcare reform efforts, is designed to encourage health professionals to coordinate their care for patients. Limited information is available, however, concerning whether bundled payments are associated with changes in patient outcomes. Nationwide longitudinal population-based data were used to examine the effect of bundled payments on hip fracture outcomes. Design: An interrupted time series design with a comparison group...
November 29, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29189950/cost-assessment-of-a-new-oral-care-program-in-the-intensive-care-unit-to-prevent-ventilator-associated-pneumonia
#16
Jérôme Ory, Charline Mourgues, Evelyne Raybaud, Russell Chabanne, Jean Christophe Jourdy, Fabien Belard, Renaud Guérin, Bernard Cosserant, Jean Sébastien Faure, Laure Calvet, Bruno Pereira, Dominique Guelon, Ousmane Traore, Laurent Gerbaud
OBJECTIVES: Ventilator-associated pneumonia (VAP) is the most frequent hospital-acquired infections in intensive care units (ICU). In the bundle of care to prevent the VAP, the oral care is very important strategies, to decrease the oropharyngeal bacterial colonization and presence of causative bacteria of VAP. In view of the paucity of medical economics studies, our objective was to determine the cost of implementing this oral care program for preventing VAP. MATERIALS AND METHODS: In five ICUs, during period 1, caregivers used a foam stick for oral care and, during period 2, a stick and tooth brushing with aspiration...
November 30, 2017: Clinical Oral Investigations
https://www.readbyqxmd.com/read/29189346/impact-of-quality-bundle-enforcement-by-a-critical-care-pharmacist-on-patient-outcome-and-costs
#17
Géraldine Leguelinel-Blache, Tri-Long Nguyen, Benjamin Louart, Hélène Poujol, Jean-Philippe Lavigne, Jason A Roberts, Laurent Muller, Jean-Marie Kinowski, Claire Roger, Jean-Yves Lefrant
OBJECTIVES: Surgical and medical ICU patients are at high risk of mortality and provide a significant cost to the healthcare system. The aim of this study is to describe the effect of pharmacist-led interventions on drug therapy and clinical strategies on ICU patient outcome and hospital costs. DESIGN: Before and after study in two French ICUs (16 and 10 beds). PATIENTS: ICU patients. INTERVENTION: From January 1, 2013, to June 30, 2015, a pharmacist observation period was compared with an intervention period in which a critical care pharmacist provided recommendations to clinicians regarding sedative drugs and doses, choice of mechanical ventilation mode and related settings, antimicrobial de-escalation, and central venous and urinary catheters removal...
November 20, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29187217/the-effects-of-care-bundles-on-patient-outcomes-a-systematic-review-and-meta-analysis
#18
REVIEW
Jacqueline F Lavallée, Trish A Gray, Jo Dumville, Wanda Russell, Nicky Cullum
BACKGROUND: Care bundles are a set of three to five evidence-informed practices performed collectively and reliably to improve the quality of care. Care bundles are used widely across healthcare settings with the aim of preventing and managing different health conditions. This is the first systematic review designed to determine the effects of care bundles on patient outcomes and the behaviour of healthcare workers in relation to fidelity with care bundles. METHODS: This systematic review is reported in line with the PRISMA statement for reporting systematic reviews and meta-analyses...
November 29, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29185601/adherence-to-central-venous-catheter-insertion-bundle-in-neonatal-and-pediatric-units
#19
Fernanda Lopes de Araújo, Bruna Figueiredo Manzo, Anna Caroline Leite Costa, Allana Dos Reis Corrêa, Juliana de Oliveira Marcatto, Delma Aurélia da Silva Simão
OBJECTIVE: To describe the observed behavior of professionals in two neonatal and pediatric intensive care units regarding the use of central venous catheter insertion bundle, and the clinical and birth profile of neonates and children who received the devices. METHOD: A quantitative descriptive exploratory study was conducted in two intensive care units of a public hospital in Belo Horizonte with neonates and children, between February and September 2016. RESULTS: The sample consisted of 59 observed implants of central venous catheter...
November 27, 2017: Revista da Escola de Enfermagem da U S P
https://www.readbyqxmd.com/read/29180473/new-mechanisms-of-resistance-to-mek-inhibitors-in-melanoma-revealed-by-intravital-imaging
#20
Hailey E Brighton, Steven P Angus, Tao Bo, Jose Roques, Alicia C Tagliatela, David Darr, Kubra Karagoz, Noah Sciaky, Michael Gatza, Norman E Sharpless, Gary L Johnson, James E Bear
Targeted therapeutics that are initially effective in cancer patients nearly invariably engender resistance at some stage, an inherent challenge in the use of any molecular targeted drug in cancer settings. In this study, we evaluated resistance mechanisms arising in metastatic melanoma to MAPK pathway kinase inhibitors, as a strategy to identify candidate strategies to limit risks of resistance. To investigate longitudinal responses, we developed an intravital serial imaging approach that can directly visualize drug response in an inducible RAF-driven, autochthonous murine model of melanoma incorporating a fluorescent reporter allele (tdTomatoLSL)...
November 27, 2017: Cancer Research
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