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Transitions in care

Bruno Viaggi, Daniele Poole, Omar Tujjar, Silvia Marchiani, Agostino Ognibene, Stefano Finazzi
Biomarkers are widely used to confirm the presence of infection. However, it would be of the greatest importance to predict in advance the occurrence or worsening of organ dysfunction in infected patients allowing timely antibiotic escalation. This study investigates the ability of procalcitonin (PCT) and MR-proADM to predict the transition to sepsis in infected patients. The study was conducted in a neurointensive care unit over a three-month period. We included both patients with and without infection to investigate the specificity of organ dysfunction prediction in infected patients...
2018: PloS One
Hima B John, Charis Suraj, Sanjeev M Padankatti, Tunny Sebastian, Earnest Rajapandian
BACKGROUND: Premature infants have difficulties in transitioning from gavage to breastfeeding. Targeted interventions to support breastfeeding in premature infants in the neonatal intensive care unit are scarce. PURPOSE: This pilot study evaluates the effectiveness of nonnutritive sucking at the mother's breast in premature infants to facilitate breastfeeding performance and exclusive breastfeeding. METHODS: The study design constituted a single-blinded randomized control trial, with 9 participants randomly allocated into experimental (n = 4) and control (n = 5) groups...
August 10, 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Donna M Wilson, Stephen Birch
AIMS: Most people approaching the end of life develop care needs, which typically change over time. Moves between care settings may be required as health deteriorates. However, in some cases, care setting transitions may have little to do with end-of-life care needs and instead reflect the needs, demands, availability, or funding provisions of the country or funding body and organizations providing care. This paper is a scoping review of the international peer-reviewed research literature to gain evidence on the frequency and types of end-of-life care setting transitions, and the reasons for these moves...
August 13, 2018: Scandinavian Journal of Public Health
Andrew Applewhite, Saeed A Chowdhry, Michael Desvigne, Allen Gabriel, Rosemary Hill, Mary Anne Obst, Dawn Shepherd, Marcus Speyrer, Terry Treadwell, Lindsey Waddell
The increase in wound prevalence means more patients with wounds are being transferred through care settings than ever before. Although the goals of therapy may be the same in both settings, wound care therapies and dressings differ in availability and appropriateness for each setting. Negative pressure wound therapy (NPWT) modalities and oxidized regenerated cellulose (ORC)/collagen (C)/silver-ORC dressings are available in both inpatient and outpatient care settings, but (to-date) lack comprehensive information regarding best practices in transitioning use of these therapies between various care settings...
August 2018: Wounds: a Compendium of Clinical Research and Practice
Birgitta Wallerstedt, Eva Benzein, Kristina Schildmeijer, Anna Sandgren
BACKGROUND: Despite increased attention and knowledge in palliative care, there is still confusion concerning how to interpret the concept of palliative care and implement it in practice. This can result in difficulties for healthcare professionals in identifying patients whom would benefit from palliative care, which, in turn, could lead to a delay in meeting patients' needs. AIM: To explore healthcare professionals' perceptions of palliative care. METHOD: Data were collected through twelve interprofessional focus group interviews in community care and hospital wards in south Sweden (n = 74)...
August 13, 2018: Scandinavian Journal of Caring Sciences
Selma M Mourad, Cate Curtis, Guy Gudex, Margaret Merrilees, John Peek, Lynn Sadler
BACKGROUND: The Patient-Centred Questionnaire-Infertility (PCQ-Infertility) has proven to be a reliable instrument to assess the extent of patient-centredness of fertility care in European countries. AIMS: To validate the PCQ-Infertility in New Zealand (NZ) and to compare results with international experience. MATERIALS AND METHODS: A cross-sectional 46-item questionnaire study among 409 women undergoing publicly funded fertility care (intrauterine insemination or in vitro fertilisation / intracytoplasmic sperm injection) in three fertility clinics in the Northern Auckland region was performed between October 2015 and September 2016...
August 13, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Simon Read, Heather Waterman, James E Morgan, Robert A Harper, Anne Fiona Spencer, Penelope Stanford
Purpose: "She wouldn't remember. Even when I go through, and she's decided to go to bed, I'll say I'll come and do her drops. If I didn't say that, they wouldn't be done." Dementia is widely considered as a key factor in whether patients take their medication as prescribed. However, few studies have examined the effect of dementia on medication management strategies for glaucoma including how patient and carer needs impact adherence and long-term prognosis. We report findings from a qualitative grounded theory study incorporating the views of patients, carers, and healthcare professionals...
2018: Patient Preference and Adherence
Manoella Sibat, Christine Herrenknecht, Hélène Taiana Darius, Mélanie Roué, Mireille Chinain, Philipp Hess
Ciguatera Fish Poisoning (CFP) is primarily caused by consumption of tropical and sub-tropical fish contaminated by Ciguatoxins (CTXs). These lipid-soluble, polyether neurotoxins are produced by dinoflagellates in the genera Gambierdiscus and Fukuyoa. While there is no regulatory level in Europe for CTXs, the European Food Safety Authority (EFSA) adopted the United States guidance level of 0.01 μg P-CTX1B of fish. This limit is extremely low and requires significant improvement in the detection of CTXs...
August 4, 2018: Journal of Chromatography. A
Jonathan Penm, Régis Vaillancourt, Annie Pouliot
BACKGROUND: Medication discrepancies occur in up to 80% of hospitalized patients during transitions of care, either at admission or discharge. However, numerous organization have different definitions of medication reconciliation which may result in variations of services being implemented. OBJECTIVE: To develop a consensus definition of medication reconciliation and define the essential components of medication reconciliation based on international consensus using a modified Delphi process...
August 1, 2018: Research in Social & Administrative Pharmacy: RSAP
Joëlle Darwiche, Anne Milek, Jean-Philippe Antonietti, Yvan Vial
BACKGROUND: Pregnancy after infertility is a challenging experience. The first-trimester screening test may add stress. Partner support reduces psychological distress in pregnant women after spontaneous conception. No data are available for women who conceive via assisted reproductive technology. AIM: To assess whether there was a difference between couples who underwent assisted reproductive technology and couples who conceived spontaneously in the support they felt they provided to their partner and whether their perception of support received from their partner reduced their distress...
August 9, 2018: Women and Birth: Journal of the Australian College of Midwives
Amelia Barwise, Carolina Jaramillo, Paul Novotny, Mark L Wieland, Charat Thongprayoon, Ognjen Gajic, Michael E Wilson
OBJECTIVE: To determine whether code status, advance directives, and decisions to limit life support were different for patients with limited English proficiency (LEP) in the intensive care unit (ICU) as compared with patients whose primary language was English. PATIENTS AND METHODS: We conducted a retrospective cohort study in adult patients admitted to 7 ICUs in a single tertiary academic medical center from May 31, 2011, through June 1, 2014. RESULTS: Of the 27,523 patients admitted to the ICU, 779 (2...
August 9, 2018: Mayo Clinic Proceedings
Kevin C Heslin, Marguerite L Barrett
BACKGROUND: In October 2015, the United States transitioned health care diagnosis codes from the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) to the Tenth Revision (ICD-10-CM). Trend analyses of alcohol-related stays could show discontinuities solely from the change in classification systems. This study examined the impact of the ICD-10-CM coding system on estimates of hospital stays involving alcohol-related diagnoses. METHODS: This analysis used 2014-2017 administrative data from the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project State Inpatient Databases for 17 states...
August 12, 2018: Alcoholism, Clinical and Experimental Research
C Browne, P Wall, S Batt, R Bennett
Developing a professional identity is an essential transition for nursing students as they move through their undergraduate degree. Professional identity is described as a person's perception of themselves within a profession or the collective identity of the profession. The formation of a professional identity is an evolving process, shaped by the media, educational experiences and role modelling. The aim of this study was to develop a greater understanding of the perceptions that students, about to embark on their undergraduate nursing degree, had of the nursing profession...
July 10, 2018: Nurse Education in Practice
Sarita March, Jessica Keim-Malpass
PURPOSE: Children with hypoplastic left heart syndrome (HLHS) experience numerous vulnerabilities during transitions from hospital to home during their first year of life. This paper examines the parents' responses to the situations they experience during the initial interstage transition as described through illness blogs. DESIGN AND METHODS: A qualitative descriptive design through inductive theme development using thematic analysis was performed for this study...
August 11, 2018: Journal for Specialists in Pediatric Nursing: JSPN
Wassim Bedrouni
The imminent legalization of recreational cannabis represents a considerable public health challenge that requires proactive measures to ensure a responsible transition. The federal government recognizes the need for strict regulation to reduce cannabis-related health harms, notably among the youth. Additionally, the government plans to oversee a national public awareness campaign as part of a harm-reduction strategy. In light of the public health risks of cannabis legalization, this paper proposes the implementation of increasingly popular, evidence-based, preventive, and therapeutic digital interventions to minimize the harms of this policy among adolescents and young adults...
August 10, 2018: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
Natalie L Davis, Nina Shah
Discharging neonates in a proper car safety seat is standard of care in the United States and many other countries. However, not every neonate can be safely positioned in a standard semi-upright car seat. In these cases, providers may opt for a travel device that allows the infant to lie flat, either supine or prone, known as a car bed. Minimal evidence exists to guide providers on car bed safety and help determine which infants would benefit from discharge in a car bed. In this article, we provide a comprehensive summary of existing literature on the safety of car beds for motor vehicle travel, car bed use in specific patient populations, and car beds vs...
August 10, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
William V Padula, Peter J Pronovost, Mary Beth F Makic, Heidi L Wald, Dane Moran, Manish K Mishra, David O Meltzer
OBJECTIVE: Hospital-acquired pressure injuries are localised skin injuries that cause significant mortality and are costly. Nursing best practices prevent pressure injuries, including time-consuming, complex tasks that lack payment incentives. The Braden Scale is an evidence-based stratification tool nurses use daily to assess pressure-injury risk. Our objective was to analyse the cost-utility of performing repeated risk-assessment for pressure-injury prevention in all patients or high-risk groups...
August 10, 2018: BMJ Quality & Safety
Alexander V Fisher, Stephanie A Campbell-Flohr, Laura Sell, Emily Osterhaus, Alexandra W Acher, Kristine Leahy-Gross, Maria Brenny-Fitzpatrick, Amy J H Kind, Pascale Carayon, Daniel E Abbott, Emily R Winslow, Caprice C Greenberg, Sara Fernandes-Taylor, Sharon M Weber
BACKGROUND: Transitional care protocols are effective at reducing readmission for medical patients, yet no evidence-based protocols exist for surgical patients. A transitional care protocol was adapted to meet the needs of patients discharged to home after major abdominal surgery. APPROACH: The Coordinated-Transitional Care (C-TraC) protocol, initially designed for medical patients, was used as the initial framework for the development of a surgery-specific protocol (sC-TraC)...
August 7, 2018: Joint Commission Journal on Quality and Patient Safety
Jennifer L Sullivan, Marlena H Shin, Ryann L Engle, Enzo Yaksic, Carol VanDeusen Lukas, Michael K Paasche-Orlow, Leigh M Starr, Joseph D Restuccia, Sally K Holmes, Amy K Rosen
BACKGROUND: Improving the process of hospital discharge is a critical priority. Interventions to improve care transitions have been shown to reduce the rate of early unplanned readmissions, and consequently, there is growing interest in improving transitions of care between hospital and home through appropriate interventions. Project Re-Engineered Discharge (RED) has shown promise in strengthening the discharge process. Although studies have analyzed the implementation of RED among private-sector hospitals, little is known about how hospitals in the Veterans Health Administration (VHA) have implemented RED...
August 7, 2018: Joint Commission Journal on Quality and Patient Safety
Samira Sami, Ribka Amsalu, Alexander Dimiti, Debra Jackson, Solomon Kenyi, Janet Meyers, Luke C Mullany, Elaine Scudder, Barbara Tomczyk, Kate Kerber
BACKGROUND: Targeted clinical interventions have been associated with a decreased risk of neonatal morbidity and mortality. In conflict-affected countries such as South Sudan, however, implementation of lifesaving interventions face barriers and facilitators that are not well understood. We aimed to describe the factors that influence implementation of a package of facility- and community-based neonatal interventions in four displaced person camps in South Sudan using a health systems framework...
August 10, 2018: BMC Pregnancy and Childbirth
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