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https://www.readbyqxmd.com/read/29684258/reduction-of-peripartum-racial-and-ethnic-disparities-a-conceptual-framework-and-maternal-safety-consensus-bundle
#1
Elizabeth A Howell, Haywood Brown, Jessica Brumley, Allison S Bryant, Aaron B Caughey, Andria M Cornell, Jacqueline H Grant, Kimberly D Gregory, Susan M Gullo, Katy B Kozhimannil, Jill M Mhyre, Paloma Toledo, Robyn D'Oria, Martha Ngoh, William A Grobman
Racial and ethnic disparities exist in both perinatal outcomes and health care quality. For example, black women are 3 to 4 times more likely to die from pregnancy-related causes and have more than a 2-fold greater risk of severe maternal morbidity than white women. In an effort to achieve health equity in maternal morbidity and mortality, a multidisciplinary workgroup of the National Partnership for Maternal Safety, within the Council on Patient Safety in Women's Health Care, developed a concept article for the bundle on reduction of peripartum disparities...
April 23, 2018: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/29683895/reduction-of-peripartum-racial-and-ethnic-disparities-a-conceptual-framework-and-maternal-safety-consensus-bundle
#2
Elizabeth A Howell, Haywood Brown, Jessica Brumley, Allison S Bryant, Aaron B Caughey, Andria M Cornell, Jacqueline H Grant, Kimberly D Gregory, Susan M Gullo, Katy B Kozhimannil, Jill M Mhyre, Paloma Toledo, Robyn DʼOria, Martha Ngoh, William A Grobman
Racial and ethnic disparities exist in both perinatal outcomes and health care quality. For example, black women are three to four times more likely to die from pregnancy-related causes and have more than a twofold greater risk of severe maternal morbidity than white women. In an effort to achieve health equity in maternal morbidity and mortality, a multidisciplinary workgroup of the National Partnership for Maternal Safety, within the Council on Patient Safety in Women's Health Care, developed a concept article for the bundle on reduction of peripartum disparities...
May 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29683736/helping-nurses-help-pivcs-decision-aids-for-daily-assessment-and-maintenance
#3
Gillian Ray-Barruel, Claire M Rickard
Improving the safety and quality of health care relies on implementing evidence-based findings into every-day clinical practice. Numerous clinical decision aids have been developed to guide nursing care of the patient with a peripheral intravenous catheter (PIVC), including standards, guidelines, decision frameworks, bundles, policies, procedures, algorithms, pathways, checklists and scoring tools. While all are created with the intention of facilitating the delivery of safe, effective nursing care and improving patient outcomes, there are distinct differences in methodology and design between them, and many are based on expert opinion and historical practice rather than high-quality evidence...
April 26, 2018: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29682619/path-of-least-resistance-how-computerised-provider-order-entry-can-lead-to-and-reduce-wasteful-practices
#4
Joseph Choi, Cori Rebecca Atlin
Background: Computerised provider order entry (CPOE) is rapidly becoming the mainstay in clinical care and has the potential to improve provider efficiency and accuracy. However, this hinges on careful planning and implementation. Poorly planned CPOE order sets can lead to undetected errors and waste. In our emergency department (ED), lactate dehydrogenase (LDH) was bundled into various blood work panels but had little clinical value. Objectives: This quality improvement initiative aimed to reduce unnecessary LDH testing in the ED...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29678137/supporting-teams-to-optimize-function-and-independence-in-veterans-a-multi-study-program-and-mixed-methods-protocol
#5
Virginia Wang, Kelli Allen, Courtney H Van Houtven, Cynthia Coffman, Nina Sperber, Elizabeth P Mahanna, Cathleen Colón-Emeric, Helen Hoenig, George L Jackson, Teresa M Damush, Erika Price, Susan N Hastings
BACKGROUND: Successful implementation of new clinical programs depends on effectively establishing, reorganizing, or enhancing team structures and processes to coordinate the work of individuals who are interdependent in their tasks, manage relationships, and share responsibility for outcomes. However, a one-size-fits-all approach is rarely effective. In partnership with VA national clinical leaders and local clinical champions, the Optimizing Function and Independence VA Quality Enhancement Research Initiative program (Function QUERI) will evaluate efforts to implement team-based clinical programs for Veterans at risk for functional decline and disability...
April 20, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29675875/effects-of-a-supportive-care-bundle-on-sleep-variables-of-preterm-infants-during-hospitalization
#6
Hsiang-Yun Lan, Luke Yang, Kao-Hsian Hsieh, Ti Yin, Yue-Cune Chang, Jen-Jiuan Liaw
Sleep is important for preterm infants' brain development, but they are frequently exposed to painful procedures in the neonatal intensive care unit (NICU) that disturb their sleep cycle and affect their growth. The purpose of this study was to examine the prolonged effects of a supportive care bundle (modulation of the infants' states, non-nutritive sucking, facilitated tucking, and oral sucrose feeding) on preterm infants' sleep variables (sleep efficiency, total sleep time, sleep latency, and frequency of wake bouts) during hospitalization...
April 20, 2018: Research in Nursing & Health
https://www.readbyqxmd.com/read/29674065/a-miniaturized-monolith-mwcnts-cooh-multi-stir-rod-microextractor-device-for-trace-parabens-determination-in-cosmetic-and-personal-care-products
#7
Fonthip Makkliang, Proespichaya Kanatharana, Panote Thavarungkul, Chongdee Thammakhet-Buranachai
A portable and simple microextractor device was constructed by aligning six miniaturized multi-stir-rod microextractors. Each microextractor was prepared from rod-like multiwalled carbon nanotubes functionalized with a carboxylic group (MWCNTs-COOH) in composite monoliths that were bundled together and connected to a small DC motor. Using six of these microextractors, the device could extract six samples at the same time. A scanning electron microscope (SEM) showed the MWCNTs-COOH well distributed throughout the highly porous structure of the monolith-MWCNTs-COOH-stir-rod...
July 1, 2018: Talanta
https://www.readbyqxmd.com/read/29673803/paying-hospital-specialists-experiences-and-lessons-from-eight-high-income-countries
#8
Wilm Quentin, Alexander Geissler, Friedrich Wittenbecher, Geoff Ballinger, Robert Berenson, Karen Bloor, Dana A Forgione, Peer Köpf, Madelon Kroneman, Lisbeth Serden, Raúl Suarez, Johan W van Manen, Reinhard Busse
Payment systems for specialists in hospitals can have far reaching consequences for the efficiency and quality of care. This article presents a comparative analysis of payment systems for specialists in hospitals of eight high-income countries (Canada, England, France, Germany, Sweden, Switzerland, the Netherlands, and the USA/Medicare system). A theoretical framework highlighting the incentives of different payment systems is used to identify potentially interesting reform approaches. In five countries,most specialists work as employees - but in Canada, the Netherlands and the USA, a majority of specialists are self-employed...
March 23, 2018: Health Policy
https://www.readbyqxmd.com/read/29667919/assessment-of-community-pediatric-providers-approach-to-a-child-with-celiac-disease-and-available-serological-testing-associated-with-a-large-tertiary-care-center
#9
Leina S Alrabadi, Anthony F Porto
An evidence-practice gap for use of celiac disease testing can lead to poor resource utilization. False positive tests may lead to unnecessary diet changes, gastroenterology consults, parental/patient concern, and additional testing and expenses complicated by varied available celiac bundles. An understanding of pediatric provider practices according to guideline recommendations further improves this gap.
April 1, 2018: Clinical Pediatrics
https://www.readbyqxmd.com/read/29665727/changes-in-central-line-associated-bloodstream-infection-rates-among-children-with-immune-compromised-conditions-an-11-year-review
#10
Lauri A Linder, Cheryl Gerdy, Yeonjung Jo, Andrew Wilson
This article describes changes in central line-associated bloodstream infection (CLABSI) rates among common causative organisms over an 11-year period on a pediatric inpatient unit prior to and following CLABSI reduction strategies. The setting for this descriptive cohort design study was a 32-bed inpatient unit in a tertiary pediatric hospital serving children with immune compromised conditions, including cancer and recipients of hematopoietic stem cell and solid organ transplants. Between January 2006 and December 2016, 265 CLABSIs involving 189 patients were reported...
April 1, 2018: Journal of Pediatric Oncology Nursing: Official Journal of the Association of Pediatric Oncology Nurses
https://www.readbyqxmd.com/read/29661260/implementing-routine-blood-borne-virus-testing-for-hcv-hbv-and-hiv-at-a-london-emergency-department-uncovering-the-iceberg
#11
S Parry, N Bundle, S Ullah, G R Foster, K Ahmad, C Y W Tong, S Balasegaram, C Orkin
UK guidelines recommend routine HIV testing in high prevalence emergency departments (ED) and targeted testing for HBV and HCV. The 'Going Viral' campaign implemented opt-out blood-borne virus (BBV) testing in adults in a high prevalence ED, to assess seroprevalence, uptake, linkage to care (LTC) rates and staff time taken to achieve LTC. Diagnosis status (new/known/unknown), current engagement in care, and severity of disease was established. LTC was defined as patient informed plus ⩾1 clinic visit. A total of 6211/24 981 ED attendees were tested (uptake 25%); 257 (4...
April 17, 2018: Epidemiology and Infection
https://www.readbyqxmd.com/read/29656967/conversion-vs-primary-total-hip-arthroplasty-increased-cost-of-care-and-perioperative-complications
#12
Sean P Ryan, Marcus DiLallo, David E Attarian, William A Jiranek, Thorsten M Seyler
BACKGROUND: With the increasing incidence of hip fractures and hip preservation surgeries, there has been a concomitant rise in the number of conversion total hip arthroplasties (THAs) performed. Prior studies have shown higher complication rates in conversion THA. However, there is a paucity of data showing differences in cost between these 2 procedures. Currently, the Center for Medicare and Medicaid Services bundles primary and conversion THA in the same Medicare Severity-Diagnosis Related Group for hospital reimbursement...
March 15, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29655592/development-of-a-blunt-chest-injury-care-bundle-an-integrative-review
#13
REVIEW
Sarah Kourouche, Thomas Buckley, Belinda Munroe, Kate Curtis
BACKGROUND: Blunt chest injuries (BCI) are associated with high rates of morbidity and mortality. There are many interventions for BCI which may be able to be combined as a care bundle for improved and more consistent outcomes. OBJECTIVE: To review and integrate the BCI management interventions to inform the development of a BCI care bundle. METHODS: A structured search of the literature was conducted to identify studies evaluating interventions for patients with BCI...
April 7, 2018: Injury
https://www.readbyqxmd.com/read/29652764/our-surgical-repair-for-macrostomia-with-two-novel-small-triangular-flaps-long-term-follow-up-and-results
#14
Jumpei Tsumoto, Keisuke Imai, Takeshi Masuoka, Daisuke Sakahara, Koji Kawamoto, Songsu Kang, Masayuki Komune
BACKGROUND: The surgical methods for repairing congenital macrostomia should be carefully selected from both functional and aesthetic points of view. The surgical correction of macrostomia results in normal orbicularis oris function and symmetry of the repaired lip. Herein, we report our novel technique and the results obtained, assessed retrospectively. METHODS: Twelve primary cases of macrostomia underwent surgical repair between 1996 and 2013. The age at operation ranged from 3 to 78 months...
March 28, 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29650559/care-in-chronic-obstructive-lung-disease-carol-a-randomised-trial-in-general-practice
#15
Stefan Markun, Thomas Rosemann, Kaba Dalla-Lana, Claudia Steurer-Stey
Background: Disease management of chronic obstructive pulmonary disease (COPD) is complex and shortcomings in general practice care for COPD are common. A care bundle is a disease management aid reminding and steering specific elements of care. Objectives: To test whether a COPD care bundle delivered to general practitioners (GPs) and practice assistants (PAs) increases the implementation of key elements of COPD care. Methods: Cluster-randomised clinical trial, 1:1 randomisation of GPs, one-year follow-up. The intervention introduced a COPD care bundle and aimed at enhancing collaboration between GPs and PAs...
April 12, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29629985/ventilator-bundle-and-its-effects-on-mortality-among-icu-patients-a-meta-analysis
#16
Claudia Pileggi, Valentina Mascaro, Aida Bianco, Carmelo G A Nobile, Maria Pavia
OBJECTIVES: To assess the effectiveness of the ventilator bundle in the reduction of mortality in ICU patients. DATA SOURCES: PubMed, Scopus, Web of Science, Cochrane Library for studies published until June 2017. STUDY SELECTION: Included studies: randomized controlled trials or any kind of nonrandomized intervention studies, made reference to a ventilator bundle approach, assessed mortality in ICU-ventilated adult patients. DATA EXTRACTION: Items extracted: study characteristics, description of the bundle approach, number of patients in the comparison groups, hospital/ICU mortality, ventilator-associated pneumonia-related mortality, assessment of compliance to ventilator bundle and its score...
April 6, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29628347/impact-of-selective-digestive-decontamination-without-systemic-antibiotics-in-a-major-heart-surgery-intensive-care-unit
#17
María Jesús Pérez-Granda, José M Barrio, Javier Hortal, Almudena Burillo, Patricia Muñoz, Emilio Bouza
PURPOSE: The incidence density of ventilator-associated pneumonia (VAP) is higher in patients undergoing major heart surgery than in other populations, despite the introduction of bundles of preventive measures, because many risk factors are not amenable to intervention. Selective digestive decontamination (SDD) has been shown to be efficacious for decreasing the frequency of VAP, although it has not been incorporated into the routine of most intensive care units. The objective of our study was to evaluate the efficacy of SDD without parenteral antibiotics for preventing VAP in a major heart surgery intensive care unit...
March 12, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29628197/bundled-payments-for-care-improvement-in-the-private-sector-a-win-for-everyone
#18
Jared S Preston, Darleen Caccavale, Amy Smith, Lauren E Stull, David A Harwood, Stephen Kayiaros
BACKGROUND: To help slow the rising costs associated with total joint arthroplasty (TJA), the Centers for Medicare and Medicaid Services introduced the Bundled Payments for Care Improvement (BPCI) initiative. The purpose of this study is to report our 1-year experience with BPCI in our 2 arthroplasty surgeon private practice. METHODS: In this series, a historical baseline group is compared with our first year under BPCI. We reviewed the cohorts with respect to hospital length of stay (LOS), readmission rates, discharge disposition, postacute care LOS, and overall savings on a per episode basis...
March 14, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29623307/implications-of-drg-classification-in-a-bundled-payment-initiative-for-copd
#19
Trisha M Parekh, Surya P Bhatt, Andrew O Westfall, James M Wells, Denay Kirkpatrick, Anand S Iyer, Michael Mugavero, James H Willig, Mark T Dransfield
OBJECTIVES: Institutions participating in the Medicare Bundled Payments for Care Improvement (BPCI) initiative invest significantly in efforts to reduce readmissions and costs for patients who are included in the program. Eligibility for the BPCI initiative is determined by diagnosis-related group (DRG) classification. The implications of this methodology for chronic diseases are not known. We hypothesized that patients included in a BPCI initiative for chronic obstructive pulmonary disease (COPD) would have less severe illness and decreased hospital utilization compared with those excluded from the bundled payment initiative...
December 2017: American Journal of Accountable Care
https://www.readbyqxmd.com/read/29622493/hip-fracture-does-not-belong-in-the-elective-arthroplasty-bundle-presentation-outcomes-and-service-utilization-differ-in-fracture-arthroplasty-care
#20
William C Schroer, Paul J Diesfeld, Angela R LeMarr, Diane J Morton, Mary E Reedy
BACKGROUND: Center for Medicare and Medicaid Services reimbursement is the same for hip arthroplasty performed electively for arthritis and urgently for femoral neck fracture. METHODS: An analytic report of hip arthroplasty for a 5-hospital network identified 2362 cases performed from January 2014 to May 2016. Resource utilization was determined using 90-day charges. RESULTS: The fracture population (623 hips) was older (P < .01), had more medical comorbidities (28...
March 14, 2018: Journal of Arthroplasty
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