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https://www.readbyqxmd.com/read/29472274/bridging-gaps-in-care-implementation-of-a-pharmacist-led-transitions-of-care-program
#1
Andria F Brantley, Deanna M Rossi, Shalonda Barnes-Warren, Jon Carlo Francisco, Ira Schatten, Vishwas Dave
PURPOSE: The development and implementation of a hospitalwide, pharmacist-led transitions-of-care (TOC) program are described. METHODS: This 21-week quality improvement initiative was conducted from October 1, 2015, to February 26, 2016, at Memorial Hospital Pembroke. A TOC team was comprised of pharmacists, a pharmacy resident, pharmacy students, a physician, case managers, and nurses. All patients over the age of 18 admitted to the inpatient telemetry unit were included in this initiative...
March 1, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29471704/flow-diverter-stents-for-endovascular-management-of-non-fetal-posterior-communicating-artery-aneurysms-analysis-on-aneurysm-occlusion-vessel-patency-and-patient-outcome
#2
Anna Luisa Kühn, Guilherme Dabus, Peter Kan, Ajay K Wakhloo, Ajit S Puri
Background Use of flow-diversion technology in the treatment of incidental and recanalized posterior communicating artery (PComA) aneurysms. Methods Patients treated with the Pipeline embolization device (PED) for PComA aneurysms were identified and included in our retrospective analysis. We evaluated aneurysm characteristics, modified Rankin Scale score (mRS) on admission, angiography follow-up, and patient clinical outcome at discharge, at three to nine months, and at 12-18 months. Results We included 56 patients with a mean age of 56 years...
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29463442/-perception-of-primary-care-physicians-on-the-integration-with-cardiology-through-continuity-of-healthcare-programs-in-secondary-prevention
#3
J Cosin-Sales, D Orozco Beltrán, R Ledesma Rodríguez, A Barbon Ortiz Casado, G Fernández
OBJECTIVE: To determine the perception of Primary Care (PC) physicians on the integration with cardiology (CA) through continuity of healthcare programs. MATERIAL AND METHODS: A cross-sectional and multicentre study was conducted, in which a total of 200 PC physicians from all over Spain completed a qualitative survey that evaluated the level of integration with CA in secondary prevention. Physicians were grouped according to the level of PC-CA integration. RESULTS: The integration between CA and PC was good, but it was better in those centres with a higher integration (74...
February 17, 2018: Semergen
https://www.readbyqxmd.com/read/29463163/staff-perceptions-of-adult-day-centers-providing-post-acute-care-for-persons-with-dementia
#4
Holly Dabelko-Schoeny, Ji Won Shin, Emily Kowal, Janine Overcash, Jeffrey M Caterino, Mary Beth Happ
The purpose of this study was to examine the perception of adult day services (ADS) staff and hospital discharge planners regarding the feasibility of ADS to provide post-acute care (PAC) for persons with dementia. We conducted key informant interviews with emergency department (ED) and inpatient hospital discharge planners ( n = 9), and two focus groups with ADS staff ( n = 15) representing five ADS programs. Four thematic categories were identified from the discharge planners, including concerns for patients, factors influencing discharge, experience with ADS, and conditions for ADS referrals...
February 1, 2018: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
https://www.readbyqxmd.com/read/29459058/how-older-adults-experience-an-emergency-department-visit-development-and-validation-of-measures
#5
Jane McCusker, Deniz Cetin-Sahin, Sylvie Cossette, Francine Ducharme, Alain Vadeboncoeur, T T Minh Vu, Nathalie Veillette, Antonio Ciampi, Eric Belzile, Simon Berthelot, Paul-André Lachance, Rick Mah
STUDY OBJECTIVE: This study aims to develop and validate measures of experiences of an emergency department (ED) visit suitable for use by older adults or their family members. METHODS: A cohort of patients aged 75 years and older who were discharged home was recruited at 4 EDs. At 1 week after the visit, patients or family members were interviewed by telephone to assess problems experienced at the visit. Twenty-six questions based on 6 domains of care found in the literature were developed: 16 questions were administered to all patients; 10 questions were administered to bed patients only...
February 16, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29454739/spanish-and-catalan-translation-cultural-adaptation-and-validation-of-the-picker-patient-experience-questionnaire-15
#6
M J Bertran, M Viñarás, M Salamero, F Garcia, C Graham, A McCulloch, J Escarrabill
OBJECTIVE: To develop and test a culturally adapted core set of questions to measure patients' experience after in-patient care. MATERIAL AND METHODS: Following the methodology recommended by international guides, a basic set of patient experience questions, selected from Picker Institute Europe questionnaires (originally in English), was translated to Spanish and Catalan. Acceptability, construct validity and reliability of the adapted questionnaire were assessed via a cross-sectional validation study...
February 14, 2018: Revista de Calidad Asistencial: Organo de la Sociedad Española de Calidad Asistencial
https://www.readbyqxmd.com/read/29449290/community-based-rehabilitation-training-after-stroke-results-of-a-pilot-randomised-controlled-trial-retrain-investigating-acceptability-and-feasibility
#7
Sarah G Dean, Leon Poltawski, Anne Forster, Rod S Taylor, Anne Spencer, Martin James, Rhoda Allison, Shirley Stevens, Meriel Norris, Anthony I Shepherd, Paolo Landa, Richard M Pulsford, Laura Hollands, Raff Calitri
OBJECTIVES: To assess acceptability and feasibility of trial processes and the Rehabilitation Training (ReTrain) intervention including an assessment of intervention fidelity. DESIGN: A two-group, assessor-blinded, randomised controlled trial with parallel mixed methods process and economic evaluations. SETTING: Community settings across two sites in Devon. PARTICIPANTS: Eligible participants were: 18 years old or over, with a diagnosis of stroke and with self-reported mobility issues, no contraindications to physical activity, discharged from National Health Service or any other formal rehabilitation programme at least 1 month before, willing to be randomised to either control or ReTrain and attend the training venue, possessing cognitive capacity and communication ability sufficient to participate...
February 15, 2018: BMJ Open
https://www.readbyqxmd.com/read/29444853/interprofessional-teamwork-innovation-model-itim-to-promote-communication-and-patient-centred-coordinated-care
#8
Jing Li, Preetham Talari, Andrew Kelly, Barbara Latham, Sherri Dotson, Kim Manning, Lisa Thornsberry, Colleen Swartz, Mark V Williams
BACKGROUND: Despite recommendations and the need to accelerate redesign of delivery models to be team-based and patient-centred, professional silos and cultural and structural barriers that inhibit working together and communicating effectively still predominate in the hospital setting. Aiming to improve team-based rounding, we developed, implemented and evaluated the Interprofessional Teamwork Innovation Model (ITIM). METHODS: This quality improvement (QI) study was conducted at an academic medical centre...
February 14, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29444842/task-specific-sensory-coding-strategies-are-matched-to-detection-and-discrimination-performance
#9
K M Allen, G Marsat
The acquisition of sensory information is limited by the neural encoding method used, constraining perceptual abilities. The most relevant aspects of stimuli may change as behavioral context changes, making efficient encoding of information more challenging. Sensory systems must balance rapid detection of a stimulus with perception of fine details that enable discrimination between similar stimuli. We show that in a species of weakly electric fish, Apteronotus leptorhynchus , two coding strategies are employed for these separate behavioral tasks...
February 14, 2018: Journal of Experimental Biology
https://www.readbyqxmd.com/read/29439475/partial-discharge-monitoring-on-metal-enclosed-switchgear-with-distributed-non-contact-sensors
#10
Chongxing Zhang, Ming Dong, Ming Ren, Wenguang Huang, Jierui Zhou, Xuze Gao, Ricardo Albarracín
Metal-enclosed switchgear, which are widely used in the distribution of electrical energy, play an important role in power distribution networks. Their safe operation is directly related to the reliability of power system as well as the power quality on the consumer side. Partial discharge detection is an effective way to identify potential faults and can be utilized for insulation diagnosis of metal-enclosed switchgear. The transient earth voltage method, an effective non-intrusive method, has substantial engineering application value for estimating the insulation condition of switchgear...
February 11, 2018: Sensors
https://www.readbyqxmd.com/read/29434461/emotional-consequences-of-delays-in-spinal-rehabilitation-unit-admission-or-discharge-a-qualitative-study-on-the-importance-of-communication
#11
Narelle Warren, Karin Walford, Annisha Susilo, Peter Wayne New
Objective: To explore the influence of health communications on the emotional consequences of delays in transfer from acute hospital into a spinal rehabilitation unit (SRU) or delays in discharge from SRU. Methods: Semi-structured interviews were conducted in this exploratory, thematic qualitative research design in an SRU, Melbourne, Australia. Results: Six patients experienced delay in admission to (n = 4) or discharge from (n = 3) the SRU, with one person experiencing both an admission and discharge delay...
2018: Topics in Spinal Cord Injury Rehabilitation
https://www.readbyqxmd.com/read/29433486/information-about-management-of-chronic-drug-therapies-prescribed-at-hospital-discharge-does-it-affect-patients-knowledge-and-self-confidence
#12
Claudia Pileggi, Emilia Caligiuri, Carmelo G A Nobile, Maria Pavia
BACKGROUND: Hospital stay represents the opportunity for a change of therapy, about which patients may not know indications, contraindications, and mode of administration, which may lead to dosing errors, drug interactions, side effects, etc. It is therefore vital to communicate appropriate information to the discharged patient with a new prescription drug. The purpose of the study was to evaluate: 1) how communication about new chronic therapies is managed at hospital discharge and what kind of information is provided to patients; 2) to what extent patients are aware and confident in the management of these medications; 3) whether the way communication is provided affects patients' awareness and self-confidence in the management of these therapies...
February 12, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29430447/mechanisms-involved-in-brain-dysfunction-in-mechanically-ventilated-critically-ill-patients-implications-and-therapeutics
#13
REVIEW
Marc Turon, Sol Fernández-Gonzalo, Candelaria de Haro, Rudys Magrans, Josefina López-Aguilar, Lluís Blanch
Critical illness may lead to significant long-term neurological morbidity and patients frequently develop neuropsychological disturbances including acute delirium or memory impairment after intensive care unit (ICU) discharge. Mechanical ventilation (MV) is a risk factor to the development of adverse neurocognitive outcomes. Patients undergoing MV for long periods present neurologic impairment with memory and cognitive alteration. Delirium is considered an acute form of brain dysfunction and its prevalence rises in mechanically ventilated patients...
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29428346/improvement-on-the-coma-recovery-scale-revised-during-the-first-four-weeks-of-hospital-stay-predicts-outcome-at-discharge-in-intensive-rehabilitation-after-severe-brain-injury
#14
Emilio Portaccio, Azzurra Morrocchesi, Anna Maria Romoli, Bahia Hakiki, Maria Pia Taglioli, Elena Lippi, Martina Di Renzone, Antonello Grippo, Claudio Macchi
OBJECTIVES: to evaluate the prognostic utility of serial assessment on the Coma Recovery Scale-Revised (CRS-R) during the first 4 weeks of intensive rehabilitation in patients surviving from severe brain injury DESIGN: prospective cohort study PARTICIPANTS: Patients consecutively admitted to the Intensive Rehabilitation Unit at the IRCCS Don Gnocchi Foundation (Florence, Italy). Inclusion criteria were diagnosis of unresponsive wakefulness syndrome (UWS) or minimally conscious state (MCS) due to acquired brain injury, age older than 18 years...
February 8, 2018: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29426318/hospital-discharge-documentation-of-a-designated-clinician-for-follow-up-care-and-30-day-outcomes-in-hip-fracture-and-stroke-patients-discharged-to-sub-acute-care
#15
Andrea L Gilmore-Bykovskyi, Korey A Kennelty, Eva DuGoff, Amy J H Kind
BACKGROUND: Transitions to sub-acute care are regularly complicated by inadequate discharge communication, which is exacerbated by a lack of clarity regarding accountability for important follow-up care. Patients discharged to sub-acute care often have complex medical conditions and are at heightened risk for poor post-hospital outcomes, yet many do not see a provider until 30 days post discharge due to current standards in Medicare regulations. Lack of designation of a responsible clinician or clinic for follow-up care may adversely impact patient outcomes, but the magnitude of this potential impact has not been previously studied...
February 9, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29422157/the-effects-of-an-interprofessional-patient-centered-communication-intervention-for-patients-with-communication-disorders
#16
Katherine S McGilton, Riva Sorin-Peters, Elizabeth Rochon, Veronique Boscart, Mary Fox, Charlene H Chu, Steven C Stewart, Souraya Sidani
PURPOSE OF THE STUDY: This small scale study examined the influence of an interprofessional (IP) evidence based patient-centered communication intervention (PCCI), delivered by trained nurses in collaboration with Speech Language Pathologists, on patient outcomes in an active stroke rehabilitation setting. DESIGN AND METHODS: The setting constraints imposed the use of a single-group pretest and post-test design to determine the influence of the intervention on patient outcomes...
February 2018: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/29422045/evaluating-organizational-change-in-health-care-the-patient-centered-hospital-model
#17
Carlo V Fiorio, Mara Gorli, Stefano Verzillo
BACKGROUND: An increasing number of hospitals react to recent demographic, epidemiological and managerial challenges moving from a traditional organizational model to a Patient-Centered (PC) hospital model. Although the theoretical managerial literature on the PC hospital model is vast, quantitative evaluations of the performance of hospitals that moved from the traditional to the PC organizational structure is scarce. However, quantitative analysis of effects of managerial changes is important and can provide additional argument in support of innovation...
February 8, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29412776/50-years-of-microneurography-learning-the-language-of-the-peripheral-sympathetic-nervous-system-in-humans
#18
J Kevin Shoemaker, Mark B Badrov, Stephen A Klassen, Paul J Fadel
As a primary component of homeostasis, the sympathetic nervous system enables rapid adjustments to stress through its ability to communicate messages among organs and cause targeted and graded end organ responses. Key in this communication model is the pattern of neural signals emanating from the central to peripheral components of the sympathetic nervous system. But what is the communication strategy employed in peripheral sympathetic nerve activity (SNA)? Can we develop and interpret the system of coding in SNA that improves our understanding of the neural control of the circulation? In 1968, Hagbarth and Vallbo reported the first use of microneurographic methods to record sympathetic discharges in peripheral nerves of conscious humans, allowing quantification of SNA at rest and sympathetic responsiveness to physiological stressors in health and disease...
February 7, 2018: Journal of Neurophysiology
https://www.readbyqxmd.com/read/29411662/empowerment-environment-and-person-centred-care-a-qualitative-study-exploring-the-hospital-experience-for-adults-with-cognitive-impairment
#19
Laura Prato, Lyndsay Lindley, Miriam Boyles, Louise Robinson, Clare Abley
It is acknowledged that there are many challenges to ensuring a positive hospital experience for patients with cognitive impairment. The study ('Improving hospital care for adults with cognitive impairment') aimed to explore the positive and negative experiences of older adults with cognitive impairment (dementia and delirium) and their relatives and/or carers, during an acute hospital stay, from admission to discharge, using a qualitative, case study methodology. Six participants with cognitive impairment, eight relatives and 59 members of the health care team were recruited...
January 1, 2018: Dementia
https://www.readbyqxmd.com/read/29411238/hospital-level-care-at-home-for-acutely-ill-adults-a-pilot-randomized-controlled-trial
#20
David M Levine, Kei Ouchi, Bonnie Blanchfield, Keren Diamond, Adam Licurse, Charles T Pu, Jeffrey L Schnipper
BACKGROUND: Hospitals are standard of care for acute illness, but hospitals can be unsafe, uncomfortable, and expensive. Providing substitutive hospital-level care in a patient's home potentially reduces cost while maintaining or improving quality, safety, and patient experience, although evidence from randomized controlled trials in the US is lacking. OBJECTIVE: Determine if home hospital care reduces cost while maintaining quality, safety, and patient experience...
February 6, 2018: Journal of General Internal Medicine
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