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https://www.readbyqxmd.com/read/29908198/in-hospital-delays-result-in-worse-patient-outcomes-and-higher-cost-after-cardiac-surgery
#1
Diane R M Somlo, Nelson P Repenning, Abeel A Mangi
BACKGROUND: Contemporary reimbursement systems allow hospitals to maintain profitability by offering procedural services. However, increasing procedural volume can be met with structural inefficiencies that in turn cause delays, worse patient outcomes, and increased cost. METHODS: A multidisciplinary team assessed operations and outcomes at the Heart and Vascular Center at Yale New Haven Hospital, a tertiary academic medical center. Data were analyzed retrospectively to assess delays in transferring patients between care environments, patient outcomes, and cost...
June 13, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29908152/reducing-readmissions-in-patients-with-both-heart-failure-and-chronic-obstructive-pulmonary-disease
#2
REVIEW
Ravi Kalhan, R Kannan Mutharasan
Patients with both chronic obstructive pulmonary disease (COPD) and heart failure (HF) pose particularly high costs to the healthcare system. These diseases arise from similar root causes, have overlapping symptoms, and share similar clinical courses. Because of these strong parallels, strategies to reduce readmissions in patients with both conditions share synergies. Here we present 10 practical tips to reduce readmissions in this challenging population. 1: Diagnose the population accurately. 2: Detect admissions for exacerbations early and consider risk-stratification...
June 13, 2018: Chest
https://www.readbyqxmd.com/read/29907553/development-and-evaluation-of-an-ethical-guideline-for-decisions-to-limit-life-prolonging-treatment-in-advanced-cancer-protocol-for-a-monocentric-mixed-method-interventional-study
#3
Katsiaryna Laryionava, Katja Mehlis, Elena Bierwirth, Friederike Mumm, Wolfgang Hiddemann, Pia Heußner, Eva C Winkler
BACKGROUND: Many patients with advanced cancer receive chemotherapy close to death and are referred too late to palliative or hospice care, and therefore die under therapy or in intensive care units. Oncologists still have difficulties in involving patients appropriately in decisions about limiting tumor-specific or life-prolonging treatment. OBJECTIVE: The aim of this Ethics Policy for Advanced Care Planning and Limiting Treatment Study is to develop an ethical guideline for end-of-life decisions and to evaluate the impact of this guideline on clinical practice regarding the following target goals: reduction of decisional conflicts, improvement of documentation transparency and traceability, reduction of distress of the caregiver team, and better knowledge and consideration of patients' preferences...
June 15, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29907508/using-a-real-time-location-system-to-measure-patient-flow-in-a-radiation-oncology-outpatient-clinic
#4
Kevin Conley, Chester Chambers, Shereef Elnahal, Amanda Choflet, Kayode Williams, Theodore DeWeese, Joseph Herman, Maqbool Dada
PURPOSE: Common performance metrics for outpatient clinics define the time between patient arrival and entry into an examination room as "waiting time." Time spent in the room is considered processing time. This characterization systematically ignores time spent in the examination room waiting for service. If these definitions are used, performance will consistently understate total waiting times and overstate processing times. Correcting such errors will provide a better understanding of system behavior...
May 5, 2018: Practical Radiation Oncology
https://www.readbyqxmd.com/read/29907274/a-targeted-management-approach-to-cardiogenic-shock
#5
REVIEW
Mithun Chakravarthy, Masaki Tsukashita, Srinivas Murali
Cardiogenic shock is a clinical syndrome characterized by low cardiac output and sustained tissue hypoperfusion resulting in end-organ dysfunction and death. In-hospital mortality rates range from 50% to 60%. Urgent diagnosis, timely transfer to a tertiary or quaternary medical facility with critical care management capabilities and multidisciplinary shock teams is a must to increase survival. Aggressive, hemodynamically guided medical management with careful monitoring of clinical and hemodynamic parameters with timely use of appropriate mechanical circulatory support devices is often necessary...
July 2018: Critical Care Clinics
https://www.readbyqxmd.com/read/29907175/-hypnoanalgesia-a-complementary-therapy-for-painful-care-procedures
#6
Jean-Guy Martinez, Marie-Pierre Delaunay, Nathalie Tomasso, Alexandre Guy, Thierry Joffre
In the framework of the management of patients receiving hyperbaric oxygen therapy, hypnoanalgesia is a complementary pain management tool, notably during the changing of dressings. Trained in this management of care-related pain, the teams of the hypebaric medicine centre in Lyon share their experience.
June 2018: Revue de L'infirmière
https://www.readbyqxmd.com/read/29907173/-the-hyperbaric-chamber-a-hostile-working-environment
#7
Thierry Joffre, Nathalie Tomasso, Alexandre Guy, Jean-Guy Martinez, Karim Tazarourte
Nursing practice in the hyperbaric environment draws on very specific skills. This setting, which is presented as a therapeutic tool in a range of indications, is also a hostile care environment for health professionals. A team from Lyon reveals the characteristics of nursing practice in a hyperbaric chamber.
June 2018: Revue de L'infirmière
https://www.readbyqxmd.com/read/29906771/academic-stress-and-active-learning-of-nursing-students-a-cross-sectional-study
#8
Nicola Magnavita, Carlo Chiorri
BACKGROUND: The active role of nursing students is particularly important in the delivery of health care, since playing an active role at the bedside and the use of active and collaborative engagement of students in the nursing activities has been associated with improved student learning. This is consistent with Karasek's learning hypothesis, but it has never been tested on nursing students. This study aimed at investigating whether nursing students in high control conditions reported lower levels of work impairment than students in the conditions with low control, compared them with a group of healthcare workers (HCWs), and tested the moderating role of social support at work...
June 8, 2018: Nurse Education Today
https://www.readbyqxmd.com/read/29906596/are-we-missing-respiratory-viral-infections-in-infants-and-children-comparison-of-a-hospital-based-quality-management-system-with-standard-of-care
#9
Maren Alchikh, Tim Conrad, Christian Hoppe, Xiaolin Ma, Eeva Broberg, Pasi Penttinen, Janine Reiche, Barbara Biere, Brunhilde Schweiger, Barbara Rath
OBJECTIVES: Hospital-based surveillance of influenza and acute respiratory infections relies on ICD-codes and hospital laboratory reports (Standard-of-Care). It is unclear how many cases are missed with either method, i.e. remain undiagnosed/coded as influenza and other respiratory virus infections. Various influenza-like illness (ILI) definitions co-exist with little guidance on how to use them. We are comparing the diagnostic accuracy of standard surveillance methods with a prospective quality management (QM-Program) at a Berlin children's hospital with the Robert-Koch-Institute (RKI)...
June 12, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29906201/neuroergonomics-quantitative-modeling-of-individual-shared-and-team-neurodynamic-information
#10
Ronald H Stevens, Trysha L Galloway, Ann Willemsen-Dunlap
OBJECTIVE: The aim of this study was to use the same quantitative measure and scale to directly compare the neurodynamic information/organizations of individual team members with those of the team. BACKGROUND: Team processes are difficult to separate from those of individual team members due to the lack of quantitative measures that can be applied to both process sets. METHOD: Second-by-second symbolic representations were created of each team member's electroencephalographic power, and quantitative estimates of their neurodynamic organizations were calculated from the Shannon entropy of the symbolic data streams...
June 1, 2018: Human Factors
https://www.readbyqxmd.com/read/29905913/development-of-low-cost-locally-sourced-two-component-compression-bandages-in-western-kenya
#11
Aileen Y Chang, Edith C Tonui, Douglas Momanyi, Alex R Mills, Paul Wasike, Rakhi Karwa, Toby A Maurer, Sonak D Pastakia
INTRODUCTION: Compression therapy is well-established standard of care for chronic leg ulcers from venous disease and lymphedema. Chronic leg ulcers and lymphedema have a significant impact on quality of life, driven by pain, foul odor, and restricted mobility. Provision of layered compression therapy in resource-limited settings, as in Western Kenya and other regions of sub-Saharan Africa, is a major challenge due to several barriers: availability, affordability, and access to healthcare facilities...
June 15, 2018: Dermatology and Therapy
https://www.readbyqxmd.com/read/29905634/ability-to-assent-in-pediatric-critical-care-research-a-prospective-environmental-scan-of-two-canadian-picus
#12
Katharine J O'Hearn, Dori-Ann Martin, Maryse Dagenais, Kusum Menon
OBJECTIVES: To determine the number of patients considered not appropriate to approach for assent within the first 24 hours of PICU admission. DESIGN: Exploratory prospective 1-month environmental scan. SETTING: Two tertiary Canadian PICUs. PATIENTS: Ninety patients age newborn to 17 years old admitted to the PICU during September 2016 (Site 1) or May 2017 (Site 2). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: At PICU admission, 81% of patients were deemed not appropriate to approach for assent most commonly due to age, influence of psychotropic medications, and/or mechanical ventilation...
June 13, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29905501/top-ten-tips-palliative-care-clinicians-should-know-about-interventional-symptom-management-options-when-caring-for-patients-with-gastrointestinal-malignancies
#13
Alyson M Johnson, Joshua P Spaete, Paul S Jowell, Arif H Kamal, Deborah A Fisher
Patients diagnosed with advanced stages of gastrointestinal (GI) malignancies are often quite symptomatic, with symptoms primarily related to anatomic sites of obstruction. Endoscopic approaches to the palliation of GI malignancies have begun to overtake surgical approaches as first line in interventional management. We brought together a team of interventional gastroenterologists and palliative care experts to collate practical pearls for the types of endoscopic interventions used for symptom management in patients with GI malignancies...
June 15, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29905094/development-of-a-digital-clinical-pathway-for-emergency-medicine-lessons-from-usability-testing-and-implementation-failure
#14
Marc Gutenstein, John W Pickering, Martin Than
Clinical pathways are used to support the management of patients in emergency departments. An existing document-based clinical pathway was used as the foundation on which to design and build a digital clinical pathway for acute chest pain, with the aim of improving clinical calculations, clinician decision-making, documentation, and data collection. Established principles of decision support system design were used to build an application within the existing electronic health record, before testing with a multidisciplinary team of doctors using a think-aloud protocol...
June 1, 2018: Health Informatics Journal
https://www.readbyqxmd.com/read/29905084/test-results-management-and-distributed-cognition-in-electronic-health-record-enabled-primary-care
#15
Michael W Smith, Ashley M Hughes, Charnetta Brown, Elise Russo And, Traber D Giardina, Praveen Mehta, Hardeep Singh
Managing abnormal test results in primary care involves coordination across various settings. This study identifies how primary care teams manage test results in a large, computerized healthcare system in order to inform health information technology requirements for test results management and other distributed healthcare services. At five US Veterans Health Administration facilities, we interviewed 37 primary care team members, including 16 primary care providers, 12 registered nurses, and 9 licensed practical nurses...
June 1, 2018: Health Informatics Journal
https://www.readbyqxmd.com/read/29904190/the-childbearing-experience-of-women-with-spinal-cord-injury-in-iran-a-phenomenological-study
#16
Zahra Khazaeipour, Alireza Nikbakht-Nasrabadi, Nooredin Mohammadi, Alireza Salehi-Nejad, Maryam Shabany
STUDY DESIGN: This was a qualitative study conducted using an interpretative phenomenological approach. OBJECTIVES: This study investigated the experience of pregnancy and childbirth in women with spinal cord injury (SCI). SETTING: Brain and Spinal Cord Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran. METHODS: The data were collected using telecommunication and face-to-face semi-structured interviews with eight women with SCI...
June 14, 2018: Spinal Cord
https://www.readbyqxmd.com/read/29904160/genetic-evaluation-of-cardiomyopathy-a-clinical-practice-resource-of-the-american-college-of-medical-genetics-and-genomics-acmg
#17
Ray E Hershberger, Michael M Givertz, Carolyn Y Ho, Daniel P Judge, Paul F Kantor, Kim L McBride, Ana Morales, Matthew R G Taylor, Matteo Vatta, Stephanie M Ware
PURPOSE: The purpose of this document is to provide updated guidance for the genetic evaluation of cardiomyopathy and for an approach to manage secondary findings from cardiomyopathy genes. The genetic bases of the primary cardiomyopathies (dilated, hypertrophic, arrhythmogenic right ventricular, and restrictive) have been established, and each is medically actionable; in most cases established treatments or interventions are available to improve survival, reduce morbidity, and enhance quality of life...
June 14, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/29904090/tuberculosis-and-oral-healthcare-provision
#18
S Clough, A Shaw, C Morgan
Tuberculosis (TB) is a preventable and curable infection, but remains a significant cause of death. The dental team is likely to encounter patients with a history of TB, however, at present there is limited guidance available to inform the provision of oral healthcare for this patient group. This may lead to confusion with delays in care. There is a potential health risk posed to patients and co-workers by a member of the dental team who becomes infected. TB has the potential to be a major issue for oral healthcare in the United Kingdom (UK)...
June 15, 2018: British Dental Journal
https://www.readbyqxmd.com/read/29903701/impact-of-a-web-based-electronic-health-record-on-behavioral-health-service-delivery-for-children-and-adolescents-randomized-controlled-trial
#19
Eric J Bruns, Alyssa N Hook, Elizabeth M Parker, Isabella Esposito, April Sather, Ryan M Parigoris, Aaron R Lyon, Kelly L Hyde
BACKGROUND: Electronic health records (EHRs) have been widely proposed as a mechanism for improving health care quality. However, rigorous research on the impact of EHR systems on behavioral health service delivery is scant, especially for children and adolescents. OBJECTIVE: The current study evaluated the usability of an EHR developed to support the implementation of the Wraparound care coordination model for children and youth with complex behavioral health needs, and impact of the EHR on service processes, fidelity, and proximal outcomes...
June 14, 2018: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29903687/adolescents-experiences-of-obesity-surgery-a-qualitative-study
#20
Karin Nordin, Anna-Lena Brorsson, Kerstin Ekbom
BACKGROUND: The positive effects of behavioural treatment and weight management in adolescents with severe obesity are modest. Obesity surgery can be an option for adolescents, but is not the first-hand choice of treatment. The knowledge about adolescents' own experiences of having undergone surgery and their thoughts and feelings of the follow-up period are limited. OBJECTIVES: To describe adolescents' decision to go through obesity surgery as teenager and their experiences of the follow-up period...
April 26, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
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