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Critical care quality

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https://www.readbyqxmd.com/read/29792459/teamwork-in-healthcare-key-discoveries-enabling-safer-high-quality-care
#1
Michael A Rosen, Deborah DiazGranados, Aaron S Dietz, Lauren E Benishek, David Thompson, Peter J Pronovost, Sallie J Weaver
Few industries match the scale of health care. In the United States alone, an estimated 85% of the population has at least 1 health care encounter annually and at least one quarter of these people experience 4 to 9 encounters annually. A single visit requires collaboration among a multidisciplinary group of clinicians, administrative staff, patients, and their loved ones. Multiple visits often occur across different clinicians working in different organizations. Ineffective care coordination and the underlying suboptimal teamwork processes are a public health issue...
May 2018: American Psychologist
https://www.readbyqxmd.com/read/29791945/global-health-epilepsy
#2
Amza Ali
Epilepsy is a frequently misunderstood and highly stigmatized condition. Major treatment gaps exist across the world, most so in areas of financial constraint. Classification permits the best approaches to treatment and to ascertaining prognosis. The International League Against Epilepsy's new classification system emphasizes clinical aspects and utilizes all available resources to determine whether it is a focal or generalized epilepsy. The most important tools are a careful history, clinical examination, electroencephalography, and appropriate neuroimaging...
April 2018: Seminars in Neurology
https://www.readbyqxmd.com/read/29791247/a-randomized-trial-of-a-family-support-intervention-in-intensive-care-units
#3
Douglas B White, Derek C Angus, Anne-Marie Shields, Praewpannarai Buddadhumaruk, Caroline Pidro, Cynthia Paner, Elizabeth Chaitin, Chung-Chou H Chang, Francis Pike, Lisa Weissfeld, Jeremy M Kahn, Joseph M Darby, Amy Kowinsky, Susan Martin, Robert M Arnold
Background Surrogate decision makers for incapacitated, critically ill patients often struggle with decisions related to goals of care. Such decisions cause psychological distress in surrogates and may lead to treatment that does not align with patients' preferences. Methods We conducted a stepped-wedge, cluster-randomized trial involving patients with a high risk of death and their surrogates in five intensive care units (ICUs) to compare a multicomponent family-support intervention delivered by the interprofessional ICU team with usual care...
May 23, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29789183/-do-not-do-recommendations-of-the-working-groups-of-the-spanish-society-of-intensive-and-critical-care-medicine-and-coronary-units-semicyuc-for-the-management-of-critically-ill-patients
#4
F J González de Molina Ortiz, F Gordó Vidal, A Estella García, P Morrondo Valdeolmillos, J F Fernández Ortega, J Caballero López, P V Pérez Villares, M A Ballesteros Sanz, C de Haro López, J A Sanchez-Izquierdo Riera, A Serrano Lázaro, M P Fuset Cabanes, L J Terceros Almanza, X Nuvials Casals, J Baldirà Martínez de Irujo
The project "Commitment to Quality of Scientific Societies", promoted since 2013 by the Spanish Ministry of Health, seeks to reduce unnecessary health interventions that have not proven effective, have little or doubtful effectiveness, or are not cost-effective. The objective is to establish the "do not do" recommendations for the management of critically ill patients. A panel of experts from the 13 working groups (WGs) of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC) was selected and nominated by virtue of clinical expertise and/or scientific experience to carry out the recommendations...
May 19, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29784455/incidence-and-risk-factors-associated-with-30-day-post-operative-venous-thromboembolism-a-nsqip-pediatric-analysis
#5
Jennifer J Ahn, Paul A Merguerian, Margarett Shnorhavorian
INTRO: Venous thromboembolism (VTE) is a rare event in children, but can cause significant morbidity and mortality. The majority of research on pediatric VTE has been in the trauma and critical care populations. The incidence of VTE after surgery in children is not well-established. OBJECTIVE: The objective was to evaluate the incidence of VTE in the 30 days after surgery, as well as associated risk factors. STUDY DESIGN: All cases in the National Surgical Quality Improvement Program Pediatric (NSQIPP) database from 2012 to 2015 were assessed for presence of post-operative VTE...
May 8, 2018: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29783090/inter-and-intra-disciplinary-collaboration-and-patient-safety-outcomes-in-u-s-acute-care-hospital-units-a-cross-sectional-study
#6
Chenjuan Ma, Shin Hye Park, Jingjing Shang
BACKGROUND: Collaboration among healthcare providers has been considered a promising strategy for improving care quality and patient outcomes. Despite mounting evidence demonstrating the impact of collaboration on outcomes of healthcare providers, there is little empirical evidence on the relationship between collaboration and patient safety outcomes, particularly at the patient care unit level. OBJECTIVES: The purpose of this study is to identify the extent to which interdisciplinary collaboration between nurses and physicians and intradisciplinary collaboration among nurses on patient care units are associated with patient safety outcomes...
May 2, 2018: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29783031/a-unique-all-payer-rate-setting-system-controls-the-cost-but-not-the-racial-disparity-in-lower-extremity-revascularization-procedures
#7
Besma Nejim, Robert J Beaulieu, Husain Alshaikh, Mohammed Hamouda, Joseph Canner, Mahmoud B Malas
BACKGROUND: Patients with peripheral arterial disease (PAD) often have high comorbidity burden that may complicate post-interventional course and drive increased healthcare expenditures. Racial disparity had been observed in lower extremity revascularization (LER) patterns and outcomes. In 2014, Maryland adopted an all-payer rate setting system to limit the rising hospitalization costs. This resulted in an aggregate payment system in which hospital compensation takes place as an overall per capita expenditure for hospital services...
May 18, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29780766/racial-ethnic-differences-in-health-insurance-adequacy-and-consistency-among-children-evidence-from-the-2011-12-national-survey-of-children-s-health
#8
Tulay G Soylu, Eman Elashkar, Fatemah Aloudah, Munir Ahmed, Panagiota Kitsantas
Background: Surveillance of disparities in healthcare insurance, services and quality of care among children are critical for properly serving the medical/healthcare needs of underserved populations. The purpose of this study was to assess racial/ethnic differences in children's (0 to 17 years old) health insurance adequacy and consistency (child has insurance coverage for the last 12 months). Design and methods: We used data from the 2011/2012 National Survey of Children's Health (n=79,474)...
February 5, 2018: Journal of Public Health Research
https://www.readbyqxmd.com/read/29779426/community-efforts-to-reduce-racial-and-ethnic-health-disparities-challenges-and-facilitators-identified-by-16-multistakeholder-alliances
#9
Jaime Hamil, Juliet Yonek, Yasmin Mahmud, Raymond Kang, Ariane Garrett, Philethea Duckett, Muriel Jean-Jacques
The Robert Wood Johnson Foundation's Aligning Forces for Quality (AF4Q) program aimed to improve health care quality and reduce racial and ethnic disparities in 16 diverse communities in the United States from 2006 to 2015; yet most communities failed to make substantive progress toward advancing health care equity by the program's end. This qualitative analysis of key stakeholder interviews aims to identify the major contributors to success versus failure in addressing local health disparities during AF4Q and identified five major themes...
May 1, 2018: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29779161/empowering-lay-counsellors-with-technology-masivukeni-a-standardized-multimedia-counselling-support-tool-to-deliver-art-counselling
#10
H Gouse, R N Robbins, C A Mellins, A Kingon, J Rowe, M Henry, R H Remien, A Pearson, F Victor, J A Joska
Lay-counsellors in resource-limited settings convey critical HIV- and ART-information, and face challenges including limited training and variable application of counselling. This study explored lay-counsellors and Department of Health (DoH) perspectives on the utility of a multimedia adherence counselling program. Masivukeni, an mHealth application that provides scaffolding for delivering standardized ART counselling was used in a 3-year randomized control trail at two primary health care clinics in Cape Town, South Africa...
May 19, 2018: AIDS and Behavior
https://www.readbyqxmd.com/read/29775501/educational-interventions-for-improving-primary-caregiver-complementary-feeding-practices-for-children-aged-24-months-and-under
#11
REVIEW
Dachi Arikpo, Ededet Sewanu Edet, Moriam T Chibuzor, Friday Odey, Deborah M Caldwell
BACKGROUND: Although complementary feeding is a universal practice, the methods and manner in which it is practiced vary between cultures, individuals and socioeconomic classes. The period of complementary feeding is a critical time of transition in the life of an infant, and inappropriate complementary feeding practices, with their associated adverse health consequences, remain a significant global public health problem. Educational interventions are widely acknowledged as effective in promoting public health strategy, and those aimed at improving complementary feeding practices provide information about proper complementary feeding practices to caregivers of infants/children...
May 18, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29774713/-a-composite-indicator-for-maternity-hospital-classification
#12
Giovanna Fantaci, Mauro Ferrante, Giuseppe Ettore, Salvatore Scondotto
OBJECTIVES: to propose a composite indicator for maternity hospital classification. DESIGN: descriptive analysis of maternity hospitals through a composite indicator and analysis of its association with infant readmissions within 30 days from the childbirth. SETTING AND PARTICIPANTS: 56 maternity units in Sicily, accounting for 44.436 newborns in 2014. MAIN OUTCOME MEASURES: infant readmission rates within 30 days from the childbirth...
March 2018: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/29773605/using-patient-whiteboards-to-engage-families-in-harm-prevention-and-care-planning-a-quality-improvement-study
#13
Katherine Nowacki, Tondeleyo Gonzalez, Jennifer Mehnert, Amy Jacquemard, Amy Tyler
OBJECTIVES: Whiteboards are a valuable tool used to facilitate communication between families and the care team, but they were underused in our institution. Our aim was to increase families' knowledge of their child's plan of care, safety plan, and medical care team names by increasing the use of patient whiteboards with inpatient populations at a freestanding quaternary care children's hospital. METHODS: With this quality improvement study, we redesigned the whiteboard template to address the following 4 main barriers to use: (1) not having enough space to explain concepts to families, (2) having too much information to complete, (3) unclear roles of who completes the whiteboard, and (4) forgetting to update the whiteboard...
May 17, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29771469/health-literacy-in-pressure-injury-findings-from-a-mixed-methods-study-of-community-based-patients-and-carers
#14
Lisa A Durrant, James Taylor, Helen Thompson, Kim Usher, Debra Jackson
The present study, drawn from a larger mixed-methods case study, provides insights into the health literacy of community-based patients with pressure injuries, and their carers, and critically analyzes the patient information resources available; crucial because health literacy is associated with patient care and outcomes for patients. Two datasets were used to better understand patient literacy in relation to pressure injury: (i) narratives from patients and carers; and (ii) analysis of patient education resources...
May 17, 2018: Nursing & Health Sciences
https://www.readbyqxmd.com/read/29771251/-ebm-guidelines-protocols-knowledge-attitudes-and-utilization-in-the-era-of-law-on-professional-responsibility-and-safety-of-health-care
#15
Silvia Minozzi, Francesca Ruggiero, Matteo Capobussi, Marien González-Lorenzo, Micaela La Regina, Alessandro Squizzato, Lorenzo Moja, Francesco Orlandini
INTRODUCTION: <AbstractText Label="INTRODUCTION" NlmCategory="BACKGROUND">The knowledge of principles and methods of Evidence Based Medicine (EBM) and the use of Clinical Practice Guidelines to inform clinical decisions are recognised as key instruments to improve the quality of care. In Italy the Parliament has revised the legal system that rules the responsibilities of health professionals and health care safety, prescribing health professionals to adhere to guidelines and good practice recommendations...
May 2018: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/29771222/structure-of-health-care-dyad-leadership-an-organization-s-experience
#16
Anurag Saxena, Maura Davies, Don Philippon
Purpose This study aims to explore the structural aspects (roles, responsibilities and reporting) of dyad leadership in one health-care organization (HCO). Design/methodology/approach The perceptions of 32 leaders (17 physician leaders and 15 dyad co-leaders) in formal leadership positions (six first-level with formal authority limited to teams or divisions, 23 middle-level with wider departmental or program responsibility and three senior-level with institution-wide authority) were obtained through focus groups and surveys...
May 8, 2018: Leadership in Health Services
https://www.readbyqxmd.com/read/29770813/nanomaterial-based-devices-for-point-of-care-diagnostic-applications
#17
Daniel Quesada-González, Arben Merkoçi
In this review, we have discussed the capabilities of nanomaterials for point-of-care (PoC) diagnostics and explained how these materials can help to strengthen, miniaturize and improve the quality of diagnostic devices. Since the optical, electrochemical and other physical properties of nanomaterials are dictated by their composition, size and shape, these factors are critical in the design and function of nanomaterial-based PoC diagnostics.
May 17, 2018: Chemical Society Reviews
https://www.readbyqxmd.com/read/29769505/efficacy-of-0-5-hyperbaric-bupivacaine-with-dexamethasone-versus-0-5-hyperbaric-bupivacaine-alone-in-spinal-anaesthesia-for-patient-undergoing-lower-abdominal-urological-and-lower-limb-orthopedic-surgeries
#18
M M Haque, M A Aleem, F H Haque, A B Siddique, R Afrose
Spinal anaesthesia with local anaesthetics has limited duration. Different additives have been used to prolong spinal anaesthesia. The aim of this study was to determine the efficacy of adding dexamethasone to bupivacaine in spinal anaesthesia specially whether it would prolong the duration of sensory block/ surgical analgesia and post-operative analgesia/pain free period or not. This randomized, prospective, double-blind, clinical study was conducted in the Department of Anaesthesia, Analgesia and Critical Care of Combined Military Hospital, Chittagong from October 2016 to August 2017...
April 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29768646/-maturity-levels-of-quality-and-risk-management-at-the-university-hospital-schleswig-holstein
#19
Jill Jussli-Melchers, Carsten Hilbert, Iris Jahnke, Kai Wehkamp, Annette Rogge, Sandra Freitag-Wolf, Heike A Kahla-Witzsch, Jens Scholz, Rainer Petzina
INTRODUCTION: Quality and risk management in hospitals are not only required by law but also for an optimal patient-centered and process-optimized patient care. To evaluate the maturity levels of quality and risk management at the University Hospital Schleswig-Holstein (UKSH), a structured analytical tool was developed for easy and efficient application. METHODS: Four criteria concerning quality management - quality assurance (QS), critical incident reporting system (CIRS), complaint management (BM) and process management (PM) - were evaluated with a structured questionnaire...
May 16, 2018: Das Gesundheitswesen
https://www.readbyqxmd.com/read/29768610/factors-associated-with-the-utilization-of-dental-health-services-by-the-pediatric-population-an-integrative-review
#20
Davi Silva Carvalho Curi, Andreia Cristina Leal Figueiredo, Silvia Regina Jamelli
This integrative literature review aimed to analyze studies about factors associated with the utilization of dental health services by the pediatric population between zero and 15 years old, published between 2006 and 2016 and available in Portuguese, English or Spanish. A survey of articles in the Lilacs and Medline databases was carried out, using the search strategy: ("dental care/utilization" OR "dental health services/utilization") AND ("child" OR "child, preschool") AND NOT adult...
May 2018: Ciência & Saúde Coletiva
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