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https://www.readbyqxmd.com/read/28549416/management-of-intra-operative-acute-pulmonary-embolism-during-general-anesthesia-a-case-report
#1
Yuanyuan Mao, Shuai Wen, Gezi Chen, Wei Zhang, Yanqiu Ai, Jingjing Yuan
BACKGROUND: Acute pulmonary embolism (APE) can be life-threatening. Early detection is even more difficult for patients under general anesthesia as common symptoms are not available and the pathophysiological course of intra-operative APE is influenced by procedures of surgery and anesthesia, which makes patients under general anesthesia a distinctive group. CASE PRESENTATION: We report a case of APE during orthopedic surgery under general anesthesia. A 64-year-old female with atrial fibrillation and surgical history of varicosity underwent total right hip replacement surgery under general anesthesia...
May 26, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28544891/emergence-of-ultrafast-sparsely-synchronized-rhythms-and-their-responses-to-external-stimuli-in-an-inhomogeneous-small-world-complex-neuronal-network
#2
Sang-Yoon Kim, Woochang Lim
We consider an inhomogeneous small-world network (SWN) composed of inhibitory short-range (SR) and long-range (LR) interneurons, and investigate the effect of network architecture on emergence of synchronized brain rhythms by varying the fraction of LR interneurons plong. The betweenness centralities of the LR and SR interneurons (characterizing the potentiality in controlling communication between other interneurons) are distinctly different. Hence, in view of the betweenness, SWNs we consider are inhomogeneous, unlike the "canonical" Watts-Strogatz SWN with nearly the same betweenness centralities...
April 28, 2017: Neural Networks: the Official Journal of the International Neural Network Society
https://www.readbyqxmd.com/read/28543671/patient-centred-dietetic-care-from-the-perspectives-of-older-malnourished-patients
#3
E Hazzard, L Barone, M Mason, K Lambert, A McMahon
BACKGROUND: Governing organisations for health services currently recommend a patient-centred (PC) approach to practice for all health professions, including dietetics. For the vulnerable older malnourished patient, this approach needs to be prioritised to improve outcomes. The paucity of patient experience data likely limits evidence-based, patient-centred care (PCC) from being implemented effectively. The present study aimed to identify quality indicators of dietetic services from the perspectives of older malnourished patients to inform evidence-based PC dietetic care...
May 22, 2017: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
https://www.readbyqxmd.com/read/28538964/effect-of-a-modified-hospital-elder-life-program-on-delirium-and-length-of-hospital-stay-in-patients-undergoing-abdominal-surgery-a-cluster-randomized-clinical-trial
#4
Cheryl Chia-Hui Chen, Hsiu-Ching Li, Jin-Tung Liang, I-Rue Lai, Jerry Dwi Trijoyo Purnomo, Yi-Ting Yang, Been-Ren Lin, John Huang, Ching-Yao Yang, Yu-Wen Tien, Chiung-Nien Chen, Ming-Tsan Lin, Guan-Hua Huang, Sharon K Inouye
Importance: Older patients undergoing abdominal surgery commonly experience preventable delirium, which extends their hospital length of stay (LOS). Objective: To examine whether a modified Hospital Elder Life Program (mHELP) reduces incident delirium and LOS in older patients undergoing abdominal surgery. Design, Setting, and Participants: This cluster randomized clinical trial of 577 eligible patients enrolled 377 older patients (≥65 years of age) undergoing gastrectomy, pancreaticoduodenectomy, and colectomy at a 2000-bed urban medical center in Taipei, Taiwan, from August 1, 2009, through October 31, 2012...
May 24, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28536228/clostridium-difficile-extraintestinal-abscess-a-rare-complication
#5
Vamsi Krishna Kantamaneni, Krishna C Gurram, Abhijit Kulkarni
Extraintestinal Clostridium difficile is rare. A 74-year-old man with a history of ulcerative colitis presented after a fall. Trauma work-up showed liver cirrhosis. Two days later he developed abdominal pain, distension, diarrhoea and leucocytosis. Stool tested positive for C. difficile CT abdomen showed pancolitis with toxic megacolon. Total abdominal colectomy and ileostomy with a rectal stump was performed. He was discharged, but was readmitted with sepsis. CT abdomen showed a 10.4×7.2 cm fluid collection in the pelvis...
May 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28532856/implementation-of-a-referral-to-discharge-glycemic-control-initiative-for-reduction-of-surgical-site-infections-in-gynecologic-oncology-patients
#6
Laura Hopkins, Jennifer Brown-Broderick, James Hearn, Janine Malcolm, James Chan, Wendy Hicks-Boucher, Filomena De Sousa, Mark C Walker, Sylvain Gagné
OBJECTIVE(S): To evaluate the frequency of surgical site infections before and after implementation of a comprehensive, multidisciplinary perioperative glycemic control initiative. STUDY METHODS: As part of a CUSP (Comprehensive Unit-based Safety Program) initiative, between January 5 and December 18, 2015, we implemented comprehensive, multidisciplinary glycemic control initiative to reduce SSI rates in patients undergoing major pelvic surgery for a gynecologic malignancy ('Group II')...
May 20, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28530068/-newborn-discharge-letter-as-a-communication-document-for-continuity-of-care
#7
Jacob Urkin, Zachi Grossman, Gil Chapnick, Daniella Landau
AIMS: To check information items in newborn discharge letters from various delivery rooms and compare them to the expectations of community pediatricians. BACKGROUND: The newborn discharge letter is the document that supports the transition of care from the hospital stay to life at home and in the community. It usually summarizes medical information related to the baby's family, maternal pregnancies, delivery and the stay in hospital until discharge. It is primarily a communication tool between healthcare professionals...
November 2016: Harefuah
https://www.readbyqxmd.com/read/28524382/an-observational-study-of-patient-care-outcomes-sensitive-to-handover-quality-in-the-post-anaesthetic-care-unit
#8
Nichole Lillibridge, Mari Botti, Beverley Wood, Bernice Redley
AIMS AND OBJECTIVES: To identify patient care outcome indicators sensitive to the quality of interprofessional handover between the anaesthetist and the Post-Anaesthetic Care Unit nurse. BACKGROUND: The relationship between interprofessional clinical handover when patients are transferred from the operating theatre to the Post-Anaesthetic Care Unit and patient outcomes of subsequent patient care delivery is not well understood. DESIGN: Naturalistic, exploratory descriptive design using observation...
May 19, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28523476/impact-of-a-patient-navigator-program-on-hospital-based-and-outpatient-utilization-over-180%C3%A2-days-in-a-safety-net-health-system
#9
Richard B Balaban, Fang Zhang, Catherine E Vialle-Valentin, Alison A Galbraith, Marguerite E Burns, Marc R Larochelle, Dennis Ross-Degnan
BACKGROUND: With emerging global payment structures, medical systems need to understand longer-term impacts of care transition strategies. OBJECTIVE: To determine the effect of a care transition program using patient navigators (PNs) on health service utilization among high-risk safety-net patients over a 180-day period. DESIGN: Randomized controlled trial conducted October 2011 through April 2013. PARTICIPANTS: Patients admitted to the general medicine service with ≥1 readmission risk factor: (1) age ≥ 60; (2) in-network inpatient admission within prior 6 months; (3) index length of stay ≥ 3 days; or (4) admission diagnosis of heart failure or (5) chronic obstructive pulmonary disease...
May 18, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28523465/development-and-validation-of-a-cross-country-hospital-patient-quality-of-care-assessment-tool-in-europe
#10
Amanda Villiers-Tuthill, Karolina Doulougeri, Hannah McGee, Anthony Montgomery, Efharis Panagopoulou, Karen Morgan
BACKGROUND: Patient perceptions of quality of care (QoC) are directly linked with patient safety and clinical effectiveness. We need patient-designed QoC instruments that work across languages and countries to optimise studies across systems in this area. Few QoC measurement tools exist that assess all aspects of QoC from the patient perspective. This paper describes the development and validation of a comprehensive measure to assess patient perceptions of QoC that incorporates technical and interpersonal aspects of care and is grounded in the established Institute of Medicine (IOM) QoC framework...
May 18, 2017: Patient
https://www.readbyqxmd.com/read/28514524/transition-from-hospital-to-home-parents-perception-of-their-preparation-and-readiness-for-discharge-with-their-preterm-infant
#11
Laurene Aydon, Yvonne Hauck, Jamee Murdoch, Daphne Siu, Mary Sharp
AIMS: To explore the experiences of parents with babies born between 28-32 weeks gestation during transition through the Neonatal Intensive Care Unit (NICU) and discharge to home. BACKGROUND: Following birth of a preterm baby, parents undergo a momentous journey through the NICU prior to their arrival home. The complexity of the journey varies on the degree of prematurity and problems faced by each baby. The NICU environment has many stressors and facilitating education to assist parents to feel ready for discharge can be challenging for all health professionals...
May 17, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28511191/death-by-suicide-within-1-week-of-hospital-discharge-a-retrospective-study-of-root-cause-analysis-reports
#12
Natalie Riblet, Brian Shiner, Bradley V Watts, Peter Mills, Brett Rusch, Robin R Hemphill
There is a high risk for death by suicide after discharge from an inpatient mental health unit. To better understand system and organizational factors associated with postdischarge suicide, we reviewed root cause analysis reports of suicide within 7 days of discharge from across all Veterans Health Administration inpatient mental health units between 2002 and 2015. There were 141 reports of suicide within 7 days of discharge, and a large proportion (43.3%, n = 61) followed an unplanned discharge. Root causes fell into three major themes including challenges for clinicians and patients after the established process of care, awareness and communication of suicide risk, and flaws in the established process of care...
May 16, 2017: Journal of Nervous and Mental Disease
https://www.readbyqxmd.com/read/28509706/length-of-stay-mortality-cost-and-perceptions-of-care-associated-with-transition-from-an-open-to-closed-staffing-model-in-the-cardiac-intensive-care-unit
#13
Jason N Katz, Anton Lishmanov, Sean van Diepen, Dongqing Yu, Haipeng Shen, Eric Pauley, Jatin Bhatia, Adam Buntaine, Arun Das, Cristie Dangerfield, Brooke McLaughlin, George A Stouffer, Prashant Kaul
BACKGROUND: Organizational models in the intensive care unit (ICU) have classically been described as either closed or open, depending on the presence or absence of a dedicated ICU team. Although a closed model has been shown to improve patient outcomes in medical and surgical ICUs, the merits of various care models have not been previously explored in the cardiac ICU (CICU) setting. METHODS: From November 2012 to March 2014, data were prospectively collected on all admissions before and after transition from an open to closed CICU at our institution...
June 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28501452/promoting-same-day-discharge-for-gynecologic-oncology-patients-in-minimally-invasive-hysterectomy
#14
Cynthia R Fountain, Laura J Havrilesky
BACKGROUND: Despite clear data demonstrating feasibility, safety, and cost-effectiveness of same-day discharge after minimally invasive hysterectomy, there is a paucity of data suggesting ways to increase same-day discharge rates. OBJECTIVE: To promote same-day discharge following minimally invasive hysterectomy using preoperative patient education videos, provider same-day discharge awareness initiatives, and standardization of postoperative management. To investigate reasons for overnight admission after surgery (non-same-day discharge)...
May 10, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28495145/medication-discrepancy-rates-among-medicaid-recipients-at-hospital-discharge
#15
Tracy D Perry, Ann Marie Nye, Steven W Johnson
OBJECTIVES: To compare the rate of discrepancies per patient for medications changed during hospitalization in patients with and without prescription provider comments at hospital discharge. Secondary objectives included comparing 35-day readmission rates, describing the overall medication discrepancy rate stratified by age group and type of discrepancy, collecting average number of medication changes, and reporting percentage change in admission medications at discharge. METHODS: This single-center prospective cohort included NC Medicaid recipients discharged from East Carolina University Family Medicine service from November 1, 2015, to January 31, 2016...
May 8, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28492587/-intentional-roundings-in-general-medical-practice-the-experience-of-the-azienda-ospedali-riuniti-marche-nord-italy
#16
Serena Frassini, Donatella Giovannini, Mariarosaria Gargiulo, Amina Warid, Sonia Tonucci, Maria Capalbo
INTRODUCTION: The "intentional roundings" are planned rounds, conducted at regular intervals by nursing staff to anticipate care, comfort, hospitality and psychological needs of hospitalized users. These purposes are achieved with a structured way to make observations and carry out activities for well-being and patient safety, documenting what was done with a structured ad hoc form. In the United Kingdom, as well as in the USA, intentional rounding is an established model of care that improve the safety of provided care, to reduce the occurrence of preventable events, address proactively basic caring needs, and that increase users and staff satisfaction...
April 2017: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/28491308/novel-combined-patient-instruction-and-discharge-summary-tool-improves-timeliness-of-documentation-and-outpatient-provider-satisfaction
#17
Meredith Gilliam, Sarah L Krein, Karen Belanger, Karen E Fowler, Derek E Dimcheff, Gabriel Solomon
BACKGROUND: Incomplete or delayed access to discharge information by outpatient providers and patients contributes to discontinuity of care and poor outcomes. OBJECTIVE: To evaluate the effect of a new electronic discharge summary tool on the timeliness of documentation and communication with outpatient providers. METHODS: In June 2012, we implemented an electronic discharge summary tool at our 145-bed university-affiliated Veterans Affairs hospital...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/28488353/effectiveness-of-a-shared-team-approach-between-nurses-and-doctors-for-improved-risk-factor-management-in-survivors-of-stroke-a-cluster-randomized-controlled-trial
#18
M T Olaiya, J Kim, M R Nelson, V K Srikanth, C F Bladin, R P Gerraty, S M Fitzgerald, T Phan, J Frayne, D A Cadilhac, A G Thrift
BACKGROUND AND PURPOSE: Limited evidence exists on the benefits of organized care for improving risk factor control in patients with stroke or transient ischaemic attack. The effectiveness of an individualized management programme in reducing absolute cardiovascular disease risk in this high-risk population was determined. METHODS: This was a prospective, multicentre, cluster-randomized controlled trial with blinded assessment of outcomes and intention-to-treat analysis...
May 10, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28479220/electronic-medication-complete-communication-strategy-for-opioid-prescriptions-in-the-emergency-department-rationale-and-design-for-a-three-arm-provider-randomized-trial
#19
Danielle M McCarthy, D Mark Courtney, Patrick M Lank, Kenzie A Cameron, Andrea M Russell, Laura M Curtis, Kwang-Youn A Kim, Surrey M Walton, Enid Montague, Abbie L Lyden, Stephanie J Gravenor, Michael S Wolf
BACKGROUND: Thousands of people die annually from prescription opioid overdoses; however there are few strategies to ensure patients receive medication risk information at the time of prescribing. OBJECTIVES: To compare the effectiveness of the Emergency Department (ED) Electronic Medication Complete Communication (EMC(2)) Opioid Strategy (with and without text messaging) to promote safe medication use and improved patient knowledge as compared to usual care. METHODS: The ED EMC(2) Opioid Strategy consists of 5 automated components to promote safe medication use: 1) physician reminder to counsel, 2) inbox message sent on to the patient's primary care physician, 3) pharmacist message on the prescription to counsel, 4) MedSheet supporting prescription information, and 5) patient-centered Take-Wait-Stop wording of prescription instructions...
May 4, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28475938/electrochemical-performance-of-2d-polyaniline-anchored-cus-graphene-nano-active-composite-as-anode-material-for-lithium-ion-battery
#20
Shahid Iqbal, Ali Bahadur, Aamer Saeed, Kebin Zhou, Muhammad Shoaib, Muhammad Waqas
Lithium-ion battery (LIB) is a revolutionary step in the electric energy storage technology for making green environment. In the present communication, a LIB anode material was constructed by using graphene/polyaniline/CuS nanocomposite (GR/PANI/CuS NC) as a high-performance electrode. Initially, pure covellite CuS nanoplates (NPs) of the hexagonal structure were synthesized by hydrothermal route and then GR/PANI/CuS NC was fabricated by in-situ polymerization of aniline in the presence of CuS NPs and graphene nanosheets (GR NSs) as host matrix...
April 27, 2017: Journal of Colloid and Interface Science
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