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https://www.readbyqxmd.com/read/29045696/group-visits-for-overdose-education-and-naloxone-distribution-in-primary-care-a-pilot-quality-improvement-initiative
#1
Juliette F Spelman, Stephanie Peglow, Amy R Schwartz, Lucille Burgo-Black, Katelyn McNamara, William C Becker
Objective: Opioid prescribing for chronic pain significantly contributes to opioid overdose deaths in the United States. Naloxone as a take-home antidote to opioid overdose is underutilized and has not been evaluated in the high-risk chronic pain population. The objective was to increase overdose education and naloxone distribution (OEND) to high-risk patients on long-term opioid therapy for pain by utilizing group visits in primary care. Design: Quality improvement intervention among two primary care clinics...
October 16, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29042345/the-association-of-patient-factors-digital-access-and-online-behavior-on-sustained-patient-portal-use-a-prospective-cohort-of-enrolled-users
#2
Susan S Woods, Christopher W Forsberg, Erin C Schwartz, Kim M Nazi, Judith H Hibbard, Thomas K Houston, Martha Gerrity
BACKGROUND: As electronic health records and computerized workflows expand, there are unprecedented opportunities to digitally connect with patients using secure portals. To realize the value of patient portals, initial reach across populations will need to be demonstrated, as well as sustained usage over time. OBJECTIVE: The study aim was to identify patient factors associated with short-term and long-term portal usage after patients registered to access all portal functions...
October 17, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29042263/facility-level-factors-and-outcomes-after-skilled-nursing-facility-admission-for-trauma-and-surgical-patients
#3
Lucas W Thornblade, Saman Arbabi, David R Flum, Qian Qiu, Vanessa J Fawcett, Giana H Davidson
OBJECTIVE: Patients discharged to skilled nursing facilities (SNFs) have worse outcomes than those discharged to home, but whether this is due to differences in facility-level factors in addition to patient characteristics is not known. We aimed to determine whether SNF-level factors including nurse staffing and patient density are associated with outcomes after acute hospitalization for trauma or surgery. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: Retrospective study of patients discharged to Medicare-certified SNFs after trauma or major surgery from 2007 to 2009...
October 14, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29041982/costs-related-to-cardiac-arrest-management-a-systematic-review-protocol
#4
Guillaume Geri, Joshua Gilgan, Carolyn Ziegler, Wanrudee Isaranuwatchai, Laurie J Morrison
BACKGROUND: Each year, about 500,000 people suffer a cardiac arrest (either out-of-hospital or in-hospital) in the USA. Although significant improvements in survival have occurred through the implementation of complex high-quality protocols of care, global costs related to such management are not clearly described. METHODS: We will undertake a systematic review of the published literature on costs related to the acute phase of cardiac arrest management (from collapse to hospital discharge)...
October 17, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/29040678/extended-models-for-nosocomial-infection-parameter-estimation-and-model-selection
#5
Alun Thomas, Karim Khader, Andrew Redd, Molly Leecaster, Yue Zhang, Makoto Jones, Tom Greene, Matthew Samore
We consider extensions to previous models for patient level nosocomial infection in several ways, provide a specification of the likelihoods for these new models, specify new update steps required for stochastic integration, and provide programs that implement these methods to obtain parameter estimates and model choice statistics. Previous susceptible-infected models are extended to allow for a latent period between initial exposure to the pathogen and the patient becoming themselves infectious, and the possibility of decolonization...
October 12, 2017: Mathematical Medicine and Biology: a Journal of the IMA
https://www.readbyqxmd.com/read/29040497/the-association-between-fall-frequency-injury-risk-and-characteristics-of-falls-in-older-residents-of-long-term-care-do-recurrent-fallers-fall-more-safely
#6
Kimberley S van Schooten, Yijian Yang, Fabio Feldman, Ming Leung, Heather McKay, Joanie Sims-Gould, Stephen N Robinovitch
Background: Although a fall is a necessary prerequisite to a fall-related injury, previous studies suggest that frequent fallers are at lower injury risk for a given fall. We tested the hypotheses that differences in protective responses or the circumstances of falls underlie differences in injury risk with fall frequency. Methods: We analyzed video footage of 897 falls experienced by 220 long-term care residents (mean age 82±9 yrs) to identify the cause of imbalance, activity leading to falling, direction of fall initiation, balance recovery and fall protective responses, and occurrence of impact to the head or hip...
October 12, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/29032792/centralisation-of-oesophagectomy-in-australia-is-only-caseload-critical
#7
Richard Hummel, Ngoc Hoang Ha, Andrew Lord, Markus I Trochsler, Guy Maddern, Harsh Kanhere
Objective High caseload is considered one of the most important factors for good outcomes after high-risk surgeries such as oesophagectomy. However, many Australian centres perform low volumes of oesophagectomies due to demographics. The aim of the present study was to audit outcome after oesophagectomy in an Australian low-volume centre over a period of 13 years and to discuss potential contributors to outcome other than just case volume.Methods Perioperative and long-term outcomes of all oesophagectomies over a 13-year period in a low-volume Australian tertiary care centre were analysed retrospectively...
October 16, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29031431/implementing-an-antibiotic-stewardship-program-at-a-long-term-acute-care-hospital-in-detroit-michigan
#8
Ammara Mushtaq, Reda A Awali, Suganya Chandramohan, Amar Krishna, Caitlin Biedron, Olufemi Jegede, Teena Chopra
BACKGROUND: The objective of the study was to assess health care providers' (HCPs) knowledge and attitude toward antimicrobial resistance (AMR) and implement an antimicrobial stewardship program (ASP) in a long-term acute care hospital (LTACH). METHODS: A questionnaire on antibiotic use and resistance was administered to HCP in an LTACH in Detroit, Michigan, between August 2011 and October 2011. Concurrently, a retrospective review of common antibiotic prescription practices and costs was conducted...
October 11, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/29030677/safe-surgery-for-all-early-lessons-from-implementing-a-national-government-driven-surgical-plan-in-ethiopia
#9
Daniel Burssa, Atlibachew Teshome, Katherine Iverson, Olivia Ahearn, Tigistu Ashengo, David Barash, Erin Barringer, Isabelle Citron, Kaya Garringer, Victoria McKitrick, John Meara, Abraham Mengistu, Swagoto Mukhopadhyay, Cheri Reynolds, Mark Shrime, Asha Varghese, Samson Esseye, Abebe Bekele
Recognizing the unmet need for surgical care in Ethiopia, the Federal Ministry of Health (FMOH) has pioneered innovative methodologies for surgical system development with Saving Lives through Safe Surgery (SaLTS). SaLTS is a national flagship initiative designed to improve access to safe, essential and emergency surgical and anaesthesia care across all levels of the healthcare system. Sustained commitment from the FMOH and their recruitment of implementing partners has led to notable accomplishments across the breadth of the surgical system, including but not limited to: (1) Leadership, management and governance-a nationally scaled surgical leadership and mentorship programme, (2) Infrastructure-operating room construction and oxygen delivery plan, (3) Supplies and logistics-a national essential surgical procedure and equipment list, (4) Human resource development-a Surgical Workforce Expansion Plan and Anaesthesia National Roadmap, (5) Advocacy and partnership-strong FMOH partnership with international organizations, including GE Foundation's SafeSurgery2020 initiative, (6) Innovation-facility-driven identification of problems and solutions, (7) Quality of surgical and anaesthesia care service delivery-a national peri-operative guideline and WHO Surgical Safety Checklist implementation, and (8) Monitoring and evaluation-a comprehensive plan for short-term and long-term assessment of surgical quality and capacity...
October 13, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29030309/hearing-the-voice-of-the-resident-in-long-term-care-facilities-an-internationally-based-approach-to-assessing-quality-of-life
#10
John N Morris, Anja Declercq, John P Hirdes, Harriet Finne-Soveri, Brant E Fries, Mary L James, Leon Geffen, Vahe Kehyayan, Kai Saks, Katarzyna Szczerbińska, Eva Topinkova
OBJECTIVES: interRAI launched this study to introduce a set of standardized self-report measures through which residents of long-term care facilities (LTCFs) could describe their quality of life and services. This article reports on the international development effort, describing measures relative to privacy, food, security, comfort, autonomy, respect, staff responsiveness, relationships with staff, friendships, and activities. First, we evaluated these items individually and then combined them in summary scales...
October 10, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29028255/wipe-sampling-method-and-evaluation-of-environmental-variables-for-assessing-surface-contamination-of-10-antineoplastic-drugs-by-liquid-chromatography-tandem-mass-spectrometry
#11
Manuel Colombo, Matthew Jeronimo, George Astrakianakis, Chirag Apte, Chun-Yip Hon
This paper describes a novel wipe sampling and high-performance liquid chromatography/tandem mass spectrometry (HPLC-MS/MS) method capable of simultaneously detecting 10 antineoplastic drugs (5-fluorouracil, oxaliplatin, methotrexate, vindesine, ifosfamide, cyclophosphamide, vincristine, vinblastine, docetaxel, and paclitaxel). The good overall recoveries and sensitivity values of this method along with the comparatively short run time (8 min) allows for its use in routine monitoring in health care facilities...
October 1, 2017: Annals of Work Exposures and Health
https://www.readbyqxmd.com/read/29026866/a-prospective-observational-study-of-the-epidemiology-management-and-outcomes-of-skin-and-soft-tissue-infections-due-to-carbapenem-resistant-enterobacteriaceae
#12
Oryan Henig, Eric Cober, Sandra S Richter, Federico Perez, Robert A Salata, Robert C Kalayjian, Richard R Watkins, Steve Marshall, Susan D Rudin, T Nicholas Domitrovic, Andrea M Hujer, Kristine M Hujer, Yohei Doi, Scott Evans, Vance G Fowler, Robert A Bonomo, David van Duin, Keith S Kaye
BACKGROUND: This study was performed to characterize the epidemiology, management, and outcomes of skin and soft tissue infection (SSTI) and colonization due to carbapenem-resistant Enterobacteriaceae (CRE). METHODS: Patients from the Consortium on Resistance Against Carbapenem in Klebsiella and Other Enterobacteriaceae (CRACKLE-1) from December 24, 2011 to October 1, 2014 with wound cultures positive for CRE were included in the study. Predictors of surgical intervention were analyzed...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29020290/implementing-antimicrobial-stewardship-in-long-term-care-settings-an-integrative-review-using-a-human-factors-approach
#13
Morgan J Katz, Ayse P Gurses, Pranita D Tamma, Sara E Cosgrove, Melissa A Miller, Robin L P Jump
Implementing effective antimicrobial stewardship in long-term care facilities (LTCFs) is associated with challenges distinct from those faced by hospitals. LTCFs generally care for elderly populations who are vulnerable to infection, have prescribers who are often off-site, and have limited access to timely diagnostic testing. Identification of feasible interventions in LTCFs is important, particularly given the new requirement for stewardship programs by the Centers for Medicare and Medicaid Services (CMS)...
June 20, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29020166/long-term-impact-of-an-educational-antimicrobial-stewardship-program-on-hospital-acquired-candidemia-and-multidrug-resistant-bloodstream-infections-a-quasi-experimental-study-of-interrupted-time-series-analysis
#14
José Molina, Germán Peñalva, María V Gil-Navarro, Julia Praena, José A Lepe, María A Pérez-Moreno, Carmen Ferrándiz, Teresa Aldabó, Manuela Aguilar, Peter Olbrich, Manuel E Jiménez-Mejías, María L Gascón, Rosario Amaya-Villar, Olaf Neth, María J Rodríguez-Hernández, Antonio Gutiérrez-Pizarraya, José Garnacho-Montero, Cristina Montero, Josefina Cano, Julián Palomino, Raquel Valencia, Rocío Álvarez, Elisa Cordero, Marta Herrero, José M Cisneros
Background: The global crisis of bacterial resistance urges the scientific community to implement intervention programs in healthcare facilities to promote an appropriate use of antibiotics. However, the clinical benefits or the impact on resistance of these interventions has not been definitively proven. Methods: We designed a quasi-experimental intervention study with an interrupted time-series analysis. A multidisciplinary team conducted a multifaceted educational intervention in our tertiary-care hospital over a five-year period...
August 7, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29017634/factors-influencing-new-rns-supervisory-performance-in-long-term-care-facilities
#15
Dawn Prentice, Veronique Boscart, Katherine S McGilton, Astrid Escrig
In long-term care facilities (LTCF), registered nurses (RNs) perform both clinical and supervisory roles as part of a team aiming to provide high-quality care to residents. The residents have several co-morbidities and complex care needs. Unfortunately, new RNs receive minimal preparation in gerontology and supervisory experience during their program, leading to low retention rates and affecting resident outcomes. This qualitative study explored factors that influence supervisory performance of new RNs in LTCF from the perspective of 24 participants from Ontario, Canada...
October 11, 2017: Canadian Journal on Aging, la Revue Canadienne du Vieillissement
https://www.readbyqxmd.com/read/29017453/positive-and-negative-outcomes-of-informal-caregiving-at-home-and-in-institutionalised-long-term-care-a-cross-sectional-study
#16
Silke F Metzelthin, Ellen Verbakel, Marja Y Veenstra, Job van Exel, Antonius W Ambergen, Gertrudis I J M Kempen
BACKGROUND: Our ageing society is putting tremendous strain on public health and welfare programs to meet the needs of ageing individuals. Promoting informal caregiving is one way for policymakers to reduce this burden. However, caregiving may be experienced as stressful and is associated with adverse health consequences. While quite a lot of research focuses on caregiving for community-dwelling older adults, little is known about informal care in institutionalised long-term care (ILTC)...
October 10, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28994446/colonization-of-residents-and-staff-of-an-italian-long-term-care-facility-and-an-adjacent-acute-care-hospital-geriatric-unit-by-multidrug-resistant-bacteria
#17
Albert March, Richard Aschbacher, Ferisa Sleghel, Gertrud Soelva, Malgorzata Kaczor, Roberta Migliavacca, Aurora Piazza, Vittoria Mattioni Marchetti, Laura Pagani, Katia Scalzo, Valentina Pasquetto, Elisabetta Pagani
In 2016, we undertook a point prevalence screening study for Enterobacteriaceae with extended-spectrum β-lactamases (ESBLs), high-level AmpC cephalosporinases and carbapenemases, and also methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin resistant enterococci (VRE) in a long-term care facility (LTCF) and the associated acute care hospital geriatric unit in Bolzano, Northern Italy. Urine samples and rectal, inguinal, oropharyngeal and nasal swabs were plated on selective agars. Demographic data were collected...
October 10, 2017: New Microbiologica
https://www.readbyqxmd.com/read/28991827/sepsis-survivors-admitted-to-skilled-nursing-facilities-cognitive-impairment-activities-of-daily-living-dependence-and-survival
#18
William J Ehlenbach, Andrea Gilmore-Bykovskyi, Michael D Repplinger, Ryan P Westergaard, Elizabeth A Jacobs, Amy J H Kind, Maureen Smith
OBJECTIVE: Severe sepsis survivors frequently experience cognitive and physical functional impairment. The degree of impairment and its association with mortality is understudied, particularly among those discharged to a skilled nursing facility. Our objective was to quantify the cognitive and physical impairment among severe sepsis survivors discharged to a skilled nursing facility and to investigate the relationship between impairment and long-term mortality. DESIGN: Retrospective cohort study...
October 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28990958/chronic-obstructive-pulmonary-disease-in-the-long-term-care-setting-current-practices-challenges-and-unmet-needs
#19
Manuel Suarez-Barcelo, Joseph L Micca, Sharon Clackum, Gary T Ferguson
: Chronic obstructive pulmonary disease (COPD) is a prevalent and disabling disorder in the United States, especially affecting older individuals, women, and those with a history of smoking. Studies show that COPD may be underrepresented, underdiagnosed, and undertreated in elderly patients residing in long-term care (LTC) facilities. The quality of care for LTC residents with COPD is heterogeneous in regard to both the facility and the patient. For LTC facilities, care should be driven by staff education, interstaff communication, and interfacility communication...
November 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28983383/the-incidence-of-hip-fractures-in-long-term-care-homes-in-saskatchewan-from-2008-to-2012-an-analysis-of-provincial-administrative-databases
#20
Lilian U Thorpe, Susan J Whiting, Wenbin Li, William Dust, Thomas Hadjistavropoulos, Gary Teare
BACKGROUND: Hip fractures (HFs) represent an important cause of morbidity and mortality among adults in long-term care (LTC), but lack of detailed epidemiological data poses challenges to intervention planning. We aimed to determine the incidence of HFs among permanent LTC residents in Saskatchewan between 2008 and 2012, using linked, provincial administrative health databases, exploring associations between outcomes and basic individual and institutional characteristics. METHODS: We utilized the Ministry of Health databases to select HF cases based on ICD 10 diagnoses fracture of head and neck of femur, pertrochanteric fracture and subtrochanteric fracture of femur...
September 2017: Canadian Geriatrics Journal: CGJ
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