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Ambulatory Care

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https://www.readbyqxmd.com/read/29691269/implementation-of-a-pharmacy-managed-program-for-the-transition-of-chemotherapy-to-the-outpatient-setting
#1
Ali McBride, Christopher J Campen, James Camamo, Marie Maloney, Daniel Persky, Sandra E Kurtin, Nikki L Barket, Ravitharan Krishnadasan, Emad Elquza, Faiz Anwer, Kurt Weibel
PURPOSE: Implementation of a pharmacy-managed program for the transition of chemotherapy to the outpatient setting is described. SUMMARY: The University of Arizona Cancer Center and Banner-University Medical Center Tucson are affiliated not-for-profit academic medical centers in Tucson, Arizona, whose facilities include a hospital and ambulatory care clinics that maintain 3 outpatient infusion centers. The cancer center pharmacy currently employs 25 pharmacists, with 4 clinical pharmacists serving both the inpatient and outpatient treatment sites...
May 1, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29688509/racial-and-ethnic-disparities-in-the-evaluation-and-management-of-pain-in-the-outpatient-setting-2006-2015
#2
Dan P Ly
Objective: Much is known about racial and ethnic disparities in receipt of opioids for pain in emergency departments. Less is known about such disparities in the evaluation and management of pain in the outpatient setting. Methods: Using the nationally representative National Ambulatory Medical Care Survey (NAMCS), we estimated disparities in visit time with physicians and opioid receipt in the outpatient setting. We focused on patients whose reason for visiting was abdominal pain or back pain...
April 20, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29686832/patterns-and-predictors-of-depression-treatment-among-older-adults-with-parkinson-s-disease-and-depression-in-ambulatory-care-settings-in-the-united-states
#3
Sandipan Bhattacharjee, Nina Vadiei, Lisa Goldstone, Ziyad Alrabiah, Scott J Sherman
Little is known regarding depression treatment patterns and predictors among older adults with comorbid Parkinson's disease and depression (dPD) in the United States (US). The objective of this study was to assess the patterns and predictors of depression treatment among older adults with dPD in the US. We adopted a cross-sectional study design by pooling multiple-year data (2005-2011) from the National Ambulatory Medical Care Survey (NAMCS) and the outpatient department of the National Hospital Ambulatory Medical Care Survey (NHAMCS)...
2018: Parkinson's Disease
https://www.readbyqxmd.com/read/29686754/comprehensive-revenue-and-expense-data-collection-methodology-for-teaching-health-centers-a-model-for-accountable-graduate-medical-education-financing
#4
Marsha Regenstein, John E Snyder, Mariellen Malloy Jewers, Kiki Nocella, Fitzhugh Mullan
Background : Despite considerable federal investment, graduate medical education financing is neither transparent for estimating residency training costs nor accountable for effectively producing a physician workforce that matches the nation's health care needs. The Teaching Health Center Graduate Medical Education (THCGME) program's authorization in 2010 provided an opportunity to establish a more transparent financing mechanism. Objective : We developed a standardized methodology for quantifying the necessary investment to train primary care physicians in high-need communities...
April 2018: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/29684836/ambulatory-care-education-preparing-nurses-for-the-future-of-healthcare
#5
EDITORIAL
Caroline Varner Coburn, Deena Gilland, Melissa Owen, Angela Amar
In the current healthcare environment, ambulatory care nursing is increasingly recognized as an efficient and effective way of collaborating with clients to improve health outcomes and to focus on prevention. Nursing skills in ambulatory care are both valuable and necessary. However, few undergraduate nursing programs provide content on ambulatory care or significant clinical experience outside the context of an acute care setting. To meet this gap in education, a baccalaureate undergraduate course in ambulatory care nursing was created to address the growing need for RNs in this field...
March 24, 2018: Nurse Education Today
https://www.readbyqxmd.com/read/29679228/recovery-time-after-oral-and-maxillofacial-ambulatory-surgery-with-dexmedetomidine-an-observational-study
#6
Belen Hernando, Antonio Martinez-Simon, Elena Cacho-Asenjo, Iñaki F Troconiz, Cristina Honorato-Cia, Alfredo Panadero, Luis L Naval, Jorge M Nuñez-Cordoba
OBJECTIVES: To evaluate the relationship between pharmacokinetic descriptors of dexmedetomidine (predicted area under the curve during the procedure, predicted plasma level at the end of the procedure, and duration of procedure) and sedation depth (proportion of time with bispectral index < 85 during the procedure) with recovery time after ambulatory procedures. MATERIALS AND METHODS: Clinical observational study of patients undergoing oral and maxillofacial ambulatory surgery with dexmedetomidine as sole sedative agent...
April 20, 2018: Clinical Oral Investigations
https://www.readbyqxmd.com/read/29678531/-restructuring-of-medical-specialist-treatment-using-the-example-of-ambulatory-special-medical-care-asv-taking-a-critical-look-at-its-aims-and-implementation
#7
REVIEW
Robert Dengler, Manfred Cassens
With the GKV-VStG act in 2012, the former section 116b SGB V was transformed into ambulatory special medical care (ASV). This system comprises the diagnosis and therapy of rare or complex diseases which are difficult to treat, in need of a special qualification of doctors, an interdisciplinary cooperation and/or special facilities. For the first time, a uniform regulatory framework was established for the participation of office- as well as hospital-based doctors in ambulatory care. There is no planning of demand or licensed permission...
April 18, 2018: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/29678319/cancellation-of-surgeries-integrative-review
#8
Narmeen Al Talalwah, Kimberly H McIltrot
PURPOSE: To analyze cancellations of surgeries and identify evidence-based interventions to address this issue. DESIGN: Integrative literature review. METHODS: An integrative literature search was conducted in four databases: CINAHL, PubMed, Embase, and Cochrane and included literature sources dated January 2011 to January 2016. The complete list of search terms consisted of the following: ambulatory surgery, day surgery center, elective surgical procedure, elective operation, elective surgery, schedule, access to care, surgery cancellation, operation cancellation, and surgery delay...
April 17, 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29678177/healthcare-resource-use-and-economic-burden-attributable-to-respiratory-syncytial-virus-in-the-united-states-a-claims-database-analysis
#9
Caroline Amand, Sabine Tong, Alexia Kieffer, Moe H Kyaw
BACKGROUND: Despite several studies that have estimated the economic impact of Respiratory Syncytial Virus (RSV) in infants, limited data are available on healthcare resource use and costs attributable to RSV across age groups. The aim of this study was to quantify age-specific RSV-related healthcare resource use and costs on the US healthcare system. METHODS: This retrospective case-control study identified patients aged ≥1 year with an RSV event in the Truven Health Marketscan® Commercial Claims and Encounters and Medicare Supplemental and Coordination of Benefits databases between August 31, 2012 and August 1, 2013...
April 20, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29677126/patient-education-on-oral-anticoagulation
#10
Emily M Hawes
Given the potential harm associated with anticoagulant use, patient education is often provided as a standard of care and emphasized across healthcare settings. Effective anticoagulation education involves face-to-face interaction with a trained professional who ensures that the patient understands the risks involved, the precautions that should be taken, and the need for regular monitoring. The teaching should be tailored to each patient, accompanied with written resources and utilize the teach-back method...
April 20, 2018: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/29675545/a-novel-approach-to-improving-ambulatory-outpatient-management-of-low-risk-febrile-neutropenia-an-enhanced-supportive-care-esc-clinic
#11
Tim Cooksley, Geraldine Campbell, Tamer Al-Sayed, Lisa LaMola, Richard Berman
PURPOSE: Outpatient management of low risk febrile neutropenia patients (LRFN) identified by the MASCC score is a safe and effective strategy. Early supportive care has been shown to improve outcomes in patients with care. We developed an innovative ambulatory outpatient "enhanced supportive care" (ESC) clinic combining emergency oncology and supportive care through which we incorporated the management of patients with LRFN. METHODS: An ESC clinic was started in January 2017 at a tertiary cancer hospital in the North West of England...
April 19, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29675072/phenol-versus-botulinum-toxin-a-injection-in-ambulatory-cerebral-palsy-spastic-diplegia-a-comparative-study
#12
Nitesh Gonnade, Vaibhav Lokhande, Mohammed Ajij, Anil Gaur, Kamalakant Shukla
The aim of this study is to compare the treatment effectiveness of botulinum toxin type A (BTX-A) and phenol blocks in the management of lower limb spasticity and to measure improvement in gross motor functional outcome in children with cerebral palsy (CP). This is a hospital-based prospective, noncontrolled randomized study that took place in a tertiary care center. A total of 61 ambulatory children with CP spastic diplegia, aged from 4 to 10 years, were randomly divided into two groups and included in this study...
October 2017: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/29673918/-day-hospital-in-internal-medicine-a-chance-for-ambulatory-care
#13
A Grasland, E Mortier
INTRODUCTION: Internal medicine is an in-hospital speciality. Along with its expertise in rare diseases, it shares with general medicine the global care of patients but its place in the ambulatory shift has yet to be defined. The objective of our work was to evaluate the benefits of an internal medicine day-hospital devoted to general medicine. METHODS: Named "Centre Vi'TAL" to underline the link between the city and the hospital, this novel activity was implemented in order to respond quickly to general practitioners having difficulties to synthesize their complex patients or facing diagnostic or therapeutic problems...
April 16, 2018: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/29672172/ongoing-initiatives-to-improve-the-use-of-antibiotics-in-botswana-university-of-botswana-symposium-meeting-report
#14
Celda Tiroyakgosi, Matshediso Matome, Emily Summers, Yohana Mashalla, Bene Anand Paramadhas, Sajini Souda, Brighid Malone, Fatima Sinkala, Joyce Kgatlwane, Brian Godman, Keneilwe Mmopi, Amos Massele
The objective of this meeting was to discuss ongoing initiatives in Botswana since February 2016 to improve antibiotic use. Subsequently, use the findings to refine national and local action plans. There was a high rate of antibiotic prescribing among ambulatory care patients in the public sector (42.7%) as well as for patients with URTIs in the private sector (72.9%). Prophylactic antibiotics were given to 73.3% of surgical patients to reduce surgical site infections (SSIs) in a leading tertiary hospital in Botswana; however, SSIs at 9% of patients can be reduced further with better timing of antibiotic prophylaxis...
April 19, 2018: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/29669232/relationship-between-clinic-and-ambulatory-blood-pressure-measurements-and-mortality
#15
José R Banegas, Luis M Ruilope, Alejandro de la Sierra, Ernest Vinyoles, Manuel Gorostidi, Juan J de la Cruz, Gema Ruiz-Hurtado, Julián Segura, Fernando Rodríguez-Artalejo, Bryan Williams
BACKGROUND: Evidence for the influence of ambulatory blood pressure on prognosis derives mainly from population-based studies and a few relatively small clinical investigations. This study examined the associations of blood pressure measured in the clinic (clinic blood pressure) and 24-hour ambulatory blood pressure with all-cause and cardiovascular mortality in a large cohort of patients in primary care. METHODS: We analyzed data from a registry-based, multicenter, national cohort that included 63,910 adults recruited from 2004 through 2014 in Spain...
April 19, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29668213/physician-and-patient-tools-to-improve-chronic-kidney-disease-care
#16
Thomas D Sequist, Alison M Holliday, E John Orav, David W Bates, Bradley M Denker
OBJECTIVES: To determine if electronic health record (EHR) tools and patient engagement can improve the quality of chronic kidney disease (CKD) care. STUDY DESIGN: Randomized controlled trial. METHODS: We enrolled 153 primary care physicians caring for 3947 high-risk and 3744 low-risk patients with stage III CKD across 13 ambulatory health centers in eastern Massachusetts. Intervention physicians received a set of electronic alerts during office visits recommending risk-appropriate CKD care...
April 1, 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/29666309/hospital-admissions-associated-with-medication-non-adherence-a-systematic-review-of-prospective-observational-studies
#17
Pajaree Mongkhon, Darren M Ashcroft, C Norman Scholfield, Chuenjid Kongkaew
BACKGROUND: Medication non-adherence in ambulatory care has received substantial attention in the literature, but less so as it affects acute care. Accordingly, we aimed to estimate the frequency with which non-adherence to medication contributes to hospital admissions. METHODS: We searched the Cochrane Library, EMBASE, Cumulative Index to Nursing and Allied Health Literature, International Pharmaceutical Abstracts and PubMed (until December 2017) to identify prospective observational studies that examined prevalence rates of hospital admissions associated with medication non-adherence...
April 17, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29665016/underreporting-of-fall-injuries-of-older-adults-implications-for-wellness-visit-fall-risk-screening
#18
Geoffrey J Hoffman, Jinkyung Ha, Neil B Alexander, Kenneth M Langa, Mary Tinetti, Lillian C Min
OBJECTIVES: To compare the accuracy of and factors affecting the accuracy of self-reported fall-related injuries (SFRIs) with those of administratively obtained FRIs (AFRIs). DESIGN: Retrospective observational study SETTING: United States PARTICIPANTS: Fee-for-service Medicare beneficiaries aged 65 and older (N=47,215). MEASUREMENTS: We used 24-month self-report recall data from 2000-2012 Health and Retirement Study data to identify SFRIs and linked inpatient, outpatient, and ambulatory Medicare data to identify AFRIs...
April 17, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29664767/the-proportion-of-young-women-tested-for-chlamydia-who-had-urogenital-symptoms-in-physician-offices
#19
Chirag G Patel, Shivika Trivedi, Guoyu Tao
Using National Ambulatory Medical Care Survey (NAMCS) data during 2006-2015, we estimated the proportions of young women tested for chlamydia who were symptomatic (urogenital symptoms) or asymptomatic in physician offices. Among women tested for chlamydia, the proportions of women with and without urogenital symptoms were 31.6% and 59.2%, respectively.
April 17, 2018: Sexually Transmitted Diseases
https://www.readbyqxmd.com/read/29664504/contribution-of-the-use-of-basic-telemedicine-tools-to-the-care-of-children-and-adolescents-with-juvenile-idiopathic-arthritis-at-the-puerto-montt-hospital-chile
#20
A S Strickler, J Palma, R Charris, T Candia, M Grez, B González, A King, V Rivera
Children and adolescents with rheumatologic diseases require specialized and comprehensive care, but pediatric rheumatologists and immunologists are concentrated in hospitals with specific, high-cost and modern technology. Considering that some patients with juvenile idiopathic arthritis (JIA) live in rural, remote and limited accessibility areas, the use of Telemedicine (TM) can optimize diag nosis, follow-up and prognosis. OBJECTIVE: Reporting 10 years of experience of a mixed care model: face-to-face and distance, using basic TM; the institutional impact, advantages, disadvantages and acceptance informed by parents and patients...
February 2018: Revista Chilena de Pediatría
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