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https://www.readbyqxmd.com/read/28822624/evaluating-an-australian-emergency-nurse-practitioner-candidate-training-program
#1
Sharyn J Plath, Mary Wright, Julia Hocking
Nurse Practitioners (NPs) receive core clinical training at master's level, with their employer providing the opportunity to upskill in clinical and procedural competencies. It is increasingly recognised that this generic education requires supplementary training for operating effectively within a specific clinical environment. In this paper we describe a pilot program designed to train Australian NP Candidates to work effectively within the Emergency Department Fast Track model of care. The training program consisted of a 12-month period: four hours in-house training per week over two semesters, running concurrently with the NP candidate's University semesters, and 3 months' clinical practice to consolidate...
August 16, 2017: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/28806303/does-a-combination-of-laparoscopic-approach-and-full-fast-track-multimodal-management-decrease-postoperative-morbidity-a-multicenter-randomized-controlled-trial
#2
Léon Maggiori, Eric Rullier, Jérémie H Lefevre, Jean-Marc Régimbeau, Stéphane Berdah, Mehdi Karoui, Jérome Loriau, Arnaud Alvès, Eric Vicaut, Yves Panis
OBJECTIVE: The aim of this study was to assess whether association of laparoscopic approach and full fast track multimodal (FFT) management can reduce postoperative morbidity after colorectal cancer surgery, as compared to laparoscopic approach with limited fast-track program (LFT). SUMMARY OF BACKGROUND DATA: Recent advances in colorectal cancer surgery are introduction of laparoscopy and FFT implementation. METHODS: Patients eligible for elective laparoscopic colorectal cancer surgery were randomized into 2 groups: FFT or LFT care (with only early oral intake and mobilization starting on Day 1)...
August 11, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28801413/effectiveness-of-rehabilitation-after-a-total-hip-arthroplasty-a-protocol-for-an-observational-study-for-the-comparison-of-usual-care-in-the-netherlands-versus-germany
#3
Gesine H Seeber, Annet Wijnen, Djordje Lazovic, Sjoerd K Bulstra, Günter Dietz, Christiaan P van Lingen, Martin Stevens
INTRODUCTION: Osteoarthritis is the most common joint disorder worldwide. Total hip arthroplasty (THA) is considered one of the most effective treatments for end-stage hip osteoarthritis. The number of THAs is expected to increase dramatically in the coming decades. Usual postoperative rehabilitation after primary THA differs between the German and the Dutch system. In the Netherlands, patients undergo fast-track surgery and are discharged into their home environment within a few days without receiving any aftercare...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28800859/the-role-of-psychiatric-diagnoses-for-outcome-after-hip-and-knee%C3%A2-arthroplasty
#4
Silas H Gylvin, Christoffer C Jørgensen, Anders F Jensen, Gunnar H Gislason, Henrik Kehlet
BACKGROUND: Surgical patients receiving psychopharmacologic treatment have been associated with adverse outcomes in total hip and knee arthroplasty (THA and TKA). The purpose of this study was to investigate whether a specific high-risk group of patients receiving psychopharmacologic treatment could be identified based upon a nationwide psychiatric diagnosis register. METHODS: From 7 different orthopedic centers, 8288 THA and TKA patients were included from January 2010 to November 2012 of which 943 (11...
July 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28794660/a-renal-colic-fast-track-pathway-to-improve-waiting-times-and-outcomes-for-patients-presenting-to-the-emergency-department
#5
Omar Al Kadhi, Kate Manley, Madhavi Natarajan, Valmiki Lutchmedial, Abbi Forsyth, Kate Tabrett, Jonathan Betteridge, William Finch, Heinrich Hollis
INTRODUCTION: Renal colic is commonly encountered in the emergency department (ED). We validated a fast track renal colic (FTRC) initiative to decrease patient waiting times and streamline patient flow. METHOD: The FTRC pathway was devised according to the National Institute for Health and Care Excellence clinical summary criteria for the management of patients with suspected renal colic. ED triage nurses use the pathway to identify patients with likely renal colic suitable for fast track to analgesia, investigation and management...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/28793781/second-line-antiretroviral-therapy-in-sub-saharan-africa-it-s-time-to-mind-the-gaps
#6
Richard Andrew Murphy, Richard Court, Gary Maartens, Henry Sunpath
The delay between first-line antiretroviral therapy (ART) failure and initiation of second-line ART - in resource-limited settings - can be prolonged. Increasing evidence links delayed antiretroviral switch with increased risk for opportunistic infection (OI) and death, particularly in patients with advanced HIV at the time of first-line failure. As access to viral load monitoring widens beyond a few countries, mechanisms are needed to optimize the use of routine virologic monitoring and assure that first-line regimen failure results in prompt second-line switch...
August 10, 2017: AIDS Research and Human Retroviruses
https://www.readbyqxmd.com/read/28782113/fast-tracking-and-extubation-in-paediatric-cardiac-surgery
#7
EDITORIAL
P K Suominen, M F Haney
No abstract text is available yet for this article.
September 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28774663/fast-track-vs-delayed-insertion-of-the-levonorgestrel-releasing-intrauterine-system-after-early-medical-abortion-a-randomized-trial
#8
Riina Korjamo, Maarit Mentula, Oskari Heikinheimo
OBJECTIVE: To compare levonorgestrel (LNG) 52-mg intrauterine system (IUS) expulsion rates with fast track (≤ three days) or delayed (2-4weeks) insertion following mifepristone and misoprostol medical abortion. STUDY DESIGN: In this pilot trial we randomized 108 women≤63days gestation to fast-track (n=55) or delayed (n=53) insertion. Follow-up visits occurred at 2-4weeks, three months and one year. We assessed total and partial expulsion at three months and one year, adverse effects and bleeding profiles...
July 31, 2017: Contraception
https://www.readbyqxmd.com/read/28770594/multi-month-prescriptions-fast-track-refills-and-community-art-groups-results-from-a-process-evaluation-in-malawi-on-using-differentiated-models-of-care-to-achieve-national-hiv-treatment-goals
#9
REVIEW
Margaret L Prust, Clement K Banda, Rose Nyirenda, Frank Chimbwandira, Thokozani Kalua, Andreas Jahn, Michael Eliya, Katie Callahan, Peter Ehrenkranz, Marta R Prescott, Elizabeth A McCarthy, Elya Tagar, Andrews Gunda
INTRODUCTION: In order to facilitate scale-up of antiretroviral therapy (ART) in Malawi, innovative and pragmatic models have been developed to optimize the efficiency of HIV service delivery. In particular, three models of differentiated care have emerged for stable patients: adjusted appointment spacing through multi-month scripting (MMS); fast-track drug refills (FTRs) on alternating visits; and community ART groups (CAGs) where group members rotate in collecting medications at the facility for all members...
July 21, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28767478/a-case-report-on-ultrasound-guided-serratus-plane-block-and-fast-track-tracheal-extubation-in-the-operating-room-for-thoracic-trauma-patients-is-it-possible
#10
Pierfrancesco Fusco, Paolo Scimia, Stefano Di Carlo, Ambra Testa, Antonio Luciani, Emiliano Petrucci, Franco Marinangeli
Painful rib fractures may be a factor in trauma patients remaining intubated and being given postoperative mechanical ventilation after emergency surgery. Regional techniques could provide sufficient analgesia in these patients to enable weaning and extubation and thus prevent or minimize complications related to prolonged ventilatory support. We describe a trauma patient with multiple rib fractures requiring an emergency splenectomy for whom an ultrasound-guided serratus plane block provided good quality pain relief for his rib fractures and enabled fast-track extubation in the operating room...
August 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28757097/nursing-role-on-rapid-recovery-programmes-fast-track
#11
Alfonso Sevillano-Jiménez, Manuel Romero-Saldaña, Guillermo Molina-Recio
Rapid recovery (RR) or fast-track programmes are aimed at reducing surgical stress, leading to a reduction in nurse workload, costs and hospital stay, greater patient empowerment, early post-surgical recovery and reduced morbidity and mortality. These new protocols require the coordinated participation of a multidisciplinary team. Based on an integrative review of the literature, this paper aims to define the concept of a RR or fast track programme and show the existing evidence on the implementation of these programmes in nursing...
July 27, 2017: Enfermería Clínica
https://www.readbyqxmd.com/read/28755510/raising-awareness-of-graves-orbitopathy-with-early-warning-cards
#12
Anna Mitchell, Janis Hickey, Bijay Vaidya, Rhianne Mason, Ramzi Ajjan, Nicola Zammitt, Petros Perros, Colin Dayan
BACKGROUND: Clinically significant Graves' orbitopathy (GO) develops in about 25% of those with Graves' disease (GD); most cases of GD in the UK are managed by endocrinologists. Despite this, patients report significant delays before a diagnosis of GO is made. Measures to increase awareness of the early signs of GO and establishing a fast-track referral pathway to specialist care should overcome these delays and potentially improve outcomes. AIMS: We aimed to determine whether issuing a "GO early warning card" to all GD patients raises awareness of GO and facilitates early diagnosis, what percentage of cards result in a telephone contact, the number of "false reports" from card carriers and patient perceptions of the cards...
July 29, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28755147/meta-analysis-of-tumour-burden-in-pre-operative-axillary-ultrasound-positive-and-negative-breast-cancer-patients
#13
REVIEW
Muneer Ahmed, F Jozsa, R Baker, I T Rubio, J Benson, M Douek
BACKGROUND: Management of the axilla in breast cancer is becoming increasingly conservative. Patients identified with a low axillary nodal burden (two or fewer involved nodes) at sentinel node biopsy (SNB) can avoid completion axillary node clearance (cANC). 'Fast track' to ANC in patients with involved nodes on pre-operative ultrasound may be over-treating a subgroup of these patients with low nodal burden, which would have precluded their need for ANC. This systematic review assesses the proportion of patients with involved nodes on pre-operative axillary ultrasound, which would fit low axillary burden criteria...
July 28, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28751437/enhanced-recovery-after-surgery-for-hip-and-knee-arthroplasty-a-systematic-review-and-meta-analysis
#14
Shibai Zhu, Wenwei Qian, Chao Jiang, Canhua Ye, Xi Chen
OBJECTIVES: To collect data of randomised controlled trials (RCTs) and clinical controlled trials (CCTs) for evaluating the effects of enhanced recovery after surgery on postoperative recovery of patients who received total hip arthroplasty (THA) or total knee arthroplasty (TKA). METHODS: Relevant, published studies were identified using the following key words: arthroplasty, joint replacement, enhanced recovery after surgery, fast track surgery, multi-mode analgesia, diet management, or steroid hormones...
July 27, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28744857/the-effect-of-pre-operative-methylprednisolone-on-early-endothelial-damage-after-total-knee-arthroplasty-a-randomised-double-blind-placebo-controlled-trial
#15
V Lindberg-Larsen, S R Ostrowski, M Lindberg-Larsen, M L Rovsing, P I Johansson, H Kehlet
We wished to evaluate whether inhibition of the systemic inflammatory response by a single pre-operative dose of methylprednisolone reduced markers of early endothelial damage after fast-track total knee arthroplasty. We randomly allocated 70 patients undergoing elective unilateral total knee arthroplasty (1:1) to receive either pre-operative intravenous methylprednisolone 125 mg (methylprednisolone group) or isotonic saline (control group). All procedures were performed under spinal anaesthesia without a tourniquet, using a standardised multimodal analgesic regime...
July 26, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28735120/outpatient-lumbar-microdiscectomy-in-france-from-an-economic-imperative-to-a-clinical-standard-an-observational-study-of-201-cases
#16
Bertrand Debono, Pascal Sabatier, Valérie Garnault, Olivier Hamel, Philippe Bousquet, Jean-Paul Lescure, Jean-Yves Plas
PURPOSE: The outpatient lumbar discectomy procedures have been established for more than 2 decades. However, especially in Europe, there are still obstacles to the development of these procedures, which may be related to medicoeconomic imperatives, and to several factors concerning both surgeons and patients. We describe our initial experience in introducing this method in our institution. METHODS: During a 3-year period, 201 patients met the criteria for ambulatory lumbar microdiscectomy...
July 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28726359/earplugs-during-the-first-night-after-cardiothoracic-surgery-may-improve-a-fast-track-protocol
#17
Johannes Menger, Bernhard Urbanek, Keso Skhirtladze-Dworschak, Viktoria Wolf, Arabella Fischer, Harald Rinösl, Martin Dworschak
BACKGROUND: Sleep deprivation after major surgery is common and associated with worse outcome. Noise is one important reason for sleep fragmentation, which contributes to enhanced morbidity. The purpose of this work was to evaluate the impact of earplugs on patients' sleep quality during their first night after cardiothoracic surgery to eventually improve an existing fast-track concept. METHODS: Sixty-three patients undergoing cardiothoracic surgery eligible for a postoperative fast- track regimen on our cardiothoracic post anaesthesia care unit (C-PACU) were prospectively included...
July 20, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28718497/review-of-hiv-treatment-progress-gaps-and-challenges-in-the-caribbean-2005-2015
#18
Yitades Gebre, Nikkiah Meoshi Forbes, Abena Peters
Objective: To highlight the current context of the HIV response in the Caribbean and what remains to be addressed to close gaps in HIV treatment and care and end AIDS by 2030. Methods: We reviewed and analyzed reports from peer-reviewed and gray literature for the period of 2005-2015 on HIV treatment progress and gaps in the Caribbean, based on searches done in four bibliographic databases and three organizations' websites and/or libraries. Data were extracted using forms detailing study objectives, thematic areas for HIV care and treatment in the Caribbean, results, and other key information...
December 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/28714834/adjusting-patients-streaming-initiated-by-a-wait-time-threshold-in-emergency-department-for-minimizing-opportunity-cost
#19
Byungjoon B J Kim, Theodore R Delbridge, Dawn B Kendrick
Purpose Two different systems for streaming patients were considered to improve efficiency measures such as waiting times (WTs) and length of stay (LOS) for a current emergency department (ED). A typical fast track area (FTA) and a fast track with a wait time threshold (FTW) were designed and compared effectiveness measures from the perspective of total opportunity cost of all patients' WTs in the ED. The paper aims to discuss these issues. Design/methodology/approach This retrospective case study used computerized ED patient arrival to discharge time logs (between July 1, 2009 and June 30, 2010) to build computer simulation models for the FTA and fast track with wait time threshold systems...
July 10, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28711332/predictors-of-operating-room-extubation-in-adult-cardiac-surgery
#20
Kathirvel Subramaniam, Diana S DeAndrade, Daniel R Mandell, Andrew D Althouse, Rajan Manmohan, Stephen A Esper, Jeffrey M Varga, Vinay Badhwar
OBJECTIVE: The primary objective of the study was to identify perioperative factors associated with successful immediate extubation in the operating room after adult cardiac surgery. The secondary objective was to derive a simplified predictive scoring system to guide clinicians in operating room extubation. METHODS: All 1518 patients in this retrospective cohort study underwent standardized fast-track cardiac anesthetic protocol during adult cardiac surgery. Perioperative variables between patients who had successful extubation in the operating room versus in the intensive care unit were retrospectively analyzed using both univariate and multivariable logistic regression analyses...
June 13, 2017: Journal of Thoracic and Cardiovascular Surgery
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