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Discharge communication

Anthony Pio Dimech, Matthew Sammut, Kelvin Cortis, Nebosja Petrovic
INTRODUCTION: Communications between an artery and the bowel are termed arterio-enteric fistulae. These are uncommon and mainly involve the aorta and duodenum. They can cause fatal haemorrhage. A primary aorto-enteric fistula has several aetiologies, one of which is post-radiotherapy. CASE REPORT: 75-year old gentleman presented with acute upper gastrointestinal bleeding and haemorrhagic shock. He had a past history of right colonic cancer treated by resection and radiotherapy...
June 4, 2018: International Journal of Surgery Case Reports
Diego A Martinez, Erin M Kane, Mehdi Jalalpour, James Scheulen, Hetal Rupani, Rohit Toteja, Charles Barbara, Bree Bush, Scott R Levin
Efforts to monitoring and managing hospital capacity depend on the ability to extract relevant time-stamped data from electronic medical records and other information technologies. However, the various characterizations of patient flow, cohort decisions, sub-processes, and the diverse stakeholders requiring data visibility create further overlying complexity. We use the Donabedian model to prioritize patient flow metrics and build an electronic dashboard for enabling communication. Ten metrics were identified as key indicators including outcome (length of stay, 30-day readmission, operating room exit delays, capacity-related diversions), process (timely inpatient unit discharge, emergency department disposition), and structural metrics (occupancy, discharge volume, boarding, bed assignation duration)...
June 18, 2018: Journal of Medical Systems
Rachel Ann Spencer, Simon Edward Frank Spencer, Sarah Rodgers, Stephen M Campbell, Anthony John Avery
BACKGROUND: There is a need for greater understanding of the epidemiology of primary care patient safety in order to generate solutions to prevent future harm. AIM: To estimate the rate of failures in processing actions requested in hospital discharge summaries, and to determine factors associated with these failures. DESIGN AND SETTING: The authors undertook a retrospective records review. The study population was emergency admissions for patients aged ≥75 years, drawn from 10 practices in three areas of England...
June 18, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
Teresa Connolly, Ellen Mahoney
AIMS AND OBJECTIVES: This study investigated the experiences of ischemic stroke survivors (ISSs) during the transitional period from the hospital through the first four weeks after discharge home. BACKGROUND: ISSs describe the transition from hospital to home as an important time in their recovery and describe various physical and cognitive concerns early within the recovery period. Adequate transitional care interventions should be informed by such experiences...
June 12, 2018: Journal of Clinical Nursing
Robin Digby, Danielle Bolster, Andrew Perta, Tracey K Bucknall
AIM: To explore allied health staff perceptions on the role of nurses in sub-acute care wards. BACKGROUND: A consequence of earlier discharge from acute hospitals is higher acuity of patients in sub-acute care. The impact on nurses' roles and required skill mix remains unknown. Similarly, nurses' integration into the rehabilitation team is ambiguous. DESIGN: Descriptive qualitative inquiry. METHODS: Semi-structured interviews conducted with 14 allied health staff from one sub-acute care facility in Melbourne, Australia...
June 12, 2018: Journal of Clinical Nursing
Peter H Kilmarx, Elizabeth Gonese, David A Lewis, Z Mike Chirenje, Beth A Tippett Barr, Ahmed S Latif, Lovemore Gwanzura, H Hunter Handsfield, Anna Machiha, Owen Mugurungi, Cornelius A Rietmeijer
BACKGROUND: HIV and other sexually transmitted infections (STI) frequently co-occur. We conducted HIV diagnostic testing in an assessment of the etiologies of major STI syndromes in Zimbabwe. METHODS: A total of 600 patients were enrolled at six geographically diverse, high-volume STI clinics in Zimbabwe in 2014-15: 200 men with urethral discharge, 200 women with vaginal discharge, and 100 men and 100 women each with genital ulcer disease (GUD). Patients completed a questionnaire, underwent a genital examination, and had specimens taken for etiologic testing...
2018: PloS One
Tariq Waqar, Hafiz Muhammad Farhan Ali Rizvi, Muhammad Zubair Ahmed Ansari
Coronary artery fistula is an exceedingly uncommon congenital disorder characterized by fistulous communication of a coronary artery with asystemic or pulmonary vessel or a heart chamber. Small fistulas are asymptomatic and benign while large fistulas present in a variety of ways like heart failure, arrhythmias or endocarditis. We report here a rare case of eight years old girl who presented to us with history of shortness of breath and palpitation. Her echocardiography revealed a moderately large right coronary artery fistula that was opening into right ventricle...
May 2018: JPMA. the Journal of the Pakistan Medical Association
K A Lockman, W H Lee, R Sinha, W L Teoh, C Bickler, S Dummer, A Veiraiah
Time and resource constraints have often led to the use of assessment records as discharge communications from acute and emergency departments. However, whether this addresses the primary care needs has not been demonstrated. This study examined the optimal structure that can impart key discharge information effectively using feedback from general practitioners (GP). We implemented an electronic assessment template that focused on the most relevant headings. Prespecified process measures were examined and qualitative thematic analysis of free-text comments from GP surveys were conducted to optimise the document...
2018: Acute Medicine
Jane Ferguson, Liz Seston, Darren M Ashcroft
BACKGROUND: Transition between care settings is a time of high risk for preventable medication errors. Poor communication about medication changes on discharge from hospital can result in adverse drug events and medicines-related readmissions. Refer-to-Pharmacy is a novel electronic referral system that allows hospital pharmacy staff to refer patients from their bedside to their community pharmacist for post-hospital discharge medication support. The aim of this study was to examine factors that promoted or inhibited the implementation of Refer-to-Pharmacy in hospital and community settings...
June 7, 2018: BMC Health Services Research
Spiros L Blackburn, Christa B Swisher, Andrew W Grande, Alba Rubi, Laura Zitella Verbick, Aaron McCabe, Shivanand P Lad
BACKGROUND AND IMPORTANCE: The amount of subarachnoid blood and the presence of toxic blood breakdown products in the cerebrospinal fluid (CSF) have long been associated with poor outcomes in aneurysmal subarachnoid hemorrhage. The Neurapheresis™ system (Minnetronix Inc, St. Paul, Minnesota) has been developed to filter CSF and remove blood products, and is being investigated for safety and feasibility in the ExtracorPoreal FILtration of subarachnoid hemorrhage via SpinaL CAtheteR (PILLAR) study...
June 5, 2018: Operative Neurosurgery (Hagerstown, Md.)
Xi-Yang Zhang, Yun Han, Ya-Bing Zhang, Ke-Xuan Liu, Bin Liu
BACKGROUND: In order to reduce the irritation of the airway during tracheobronchial foreign body (TFB) removal, tracheal surface anesthesia is usually performed using a laryngotracheal topical anesthesia (LTA) kit (LTA20, Highgreen Medical Technology Company, China), but difficulty in withdrawing the LTA kit is rarely reported. We present a case of a difficulty to withdraw the LTA kit due to its entrapment by the movement of a TFB. CASE PRESENTATION: A 1-year-old girl was undergoing TFB removal...
June 1, 2018: BMC Anesthesiology
Ragnhild Hellesø, Heidi Gautun
The use of digitalized collaboration between levels of care is expected to improve coordination in patients' transitions. The aim of this study was to investigate how safe and effective e-messages were regarding discharge planning between hospital nurses and the municipal level of administration. A nationwide survey was conducted among 2 431 Norwegian nurses working in inpatient wards in general hospitals. A majority (86%) of the nurses used e-messages as their main mode of communication with the administration when older patients were discharged...
2018: Studies in Health Technology and Informatics
Alyse Lennox, Sandra Braaf, De Villiers Smit, Peter Cameron, Judy A Lowthian
OBJECTIVE: To explore health professionals' perspectives about caring for community-dwelling older patients in the ED. METHODS: This exploratory qualitative study was undertaken with emergency nursing, medical and allied health staff from the ED of a large metropolitan public hospital in Melbourne. Nine focus groups (n = 54) and seven interviews were conducted between 2013 and 2014. Data were thematically analysed. RESULTS: Health professionals described tailoring their approach when caring for older patients, including adopting a specific communication approach (i...
May 24, 2018: Emergency Medicine Australasia: EMA
Suman Rao, Prashanth Thankachan, Bharadwaj Amrutur, Maryann Washington, Prem K Mony
Background: Remote biomonitoring of vital parameters in hospitals and homes has the potential to improve coverage and quality of maternal and neonatal health. Wearable sensors coupled with modern information and communication technology now offer an opportunity to monitor temperatures and kangaroo mother care (KMC) adherence in a continuous and real-time manner remotely for several days' duration in hospital and home settings. Using an innovative remote biomonitoring device to measure both temperature and baby position, we undertook a techno-feasibility study in preparation for a clinical trial...
2018: Pilot and Feasibility Studies
Li-Juan Jie, Melanie Kleynen, Kenneth Meijer, Anna Beurskens, Susy Braun
BACKGROUND: A significant part of neurological rehabilitation focuses on facilitating the learning of motor skills. Training can adopt either (more) explicit or (more) implicit forms of motor learning. Gait is one of the most practiced motor skills within rehabilitation in people after stroke because it is an important criterion for discharge and requirement for functioning at home. OBJECTIVE: The aim of this study was to describe the design of a randomized controlled study assessing the effects of implicit motor learning compared with the explicit motor learning in gait rehabilitation of people suffering from stroke...
May 24, 2018: JMIR Research Protocols
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
Kai-Li Chen, Chia-Ming Chang, Ching-Huey Chen, Mei-Chih Huang
BACKGROUND: Communicating with patients, especially geriatric patients, is a challenge for medical professionals. Medical message receiving and expectations among hospitalized elderly patients have not been studied. PURPOSE: The aim of this study was to explore medical message receiving and expectations concerning medical information among hospitalized elderly patients in Taiwan. METHODS: A descriptive study design was used. Convenience sampling was applied, and the research was conducted in a geriatric ward in a medical center in southern Taiwan...
June 2018: Journal of Nursing Research: JNR
Pedro Díaz de Cerio Canduela, Ismael Arán González, Rafael Barberá Durban, Alexander Sistiaga Suárez, Marc Tobed Secall, Pablo L Parente Arias
Total laryngectomy remains essential treatment for locally advanced laryngeal carcinoma, related to better survival rates. However, it involves changes for the patient, such as the inability to communicate verbally, breathing or aesthetic changes, which affect their quality of life and require comprehensive rehabilitation. This paper was written by the total laryngectomy rehabilitation workgroup of the National Head and Neck and Skull Base working committee of the Spanish Society of Otolaryngology and Head and Neck Surgery...
May 18, 2018: Acta Otorrinolaringológica Española
Eugenio Neri, Enrico Tucci, Giulio Tommasino, Giulia Guaccio, Carmelo Ricci, Pierleone Lucatelli, Marco Cini, Roberto Ceresa, Antonio Benvenuti, Luigi Muzzi
Background: Residual false channel is common after repair of type A acute aortic dissection (TAAAD). Starting from our recent series of TAAAD patients we carried out a retrospective analysis, regarding the failure of primary exclusion at the time of the initial operation. We classified the location of the principal entry tears perfusing the residual false channel. The proposed technique represents our attempt to correct the mechanism of false channel perfusion during primary repair. We describe a new technique designed to address some limitations of standard hemiarch aortic replacement...
2018: Journal of Visualized Surgery
Yulia Ginzburg, Inbar Shmilovitz, Nechama Monastyrsky, Ronit Endevelt, Danit R Shahar
BACKGROUND & AIMS: Data on the continuity of nutritional care in the transition from the hospital to the community is scarce although its impact on medical complications is highly significant. The aim of the current study is to determine level of adherence to dietary recommendations after hospitalization and identify barriers for adherence. METHODS: A prospective study among patients age ≥65 who were treated with oral nutritional supplements (ONS) during their hospitalization and discharged with dietary recommendations...
June 2018: Clinical Nutrition ESPEN
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