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quality intensive care

Rachel Bosshard, Karl O'Reilly, Stephen Ralston, Shkun Chadda, David Cork
BACKGROUND: Acute myeloid leukemia (AML) is a rare hematologic malignancy largely affecting older adults. Comorbidities may compromise fitness and eligibility for high-intensity chemotherapy (HIC). This study presents the results of two systematic reviews (SRs) assessing (1) the impact of AML and current treatments on health-related quality of life (HRQoL), and (2) the economic burden and cost drivers of AML in patients who are ineligible for HIC. METHODS: Electronic searches (MEDLINE, EMBASE, EconLit, Cochrane library) were supplemented with manual searching of conference, utility, and HTA databases...
July 18, 2018: Cancer Treatment Reviews
Jin-Hua Liao, Rong-Fang Hu, Li-Jing Su, Shuo Wang, Qin Xu, Xiao-Fang Qian, Hong-Gu He
BACKGROUND: Nonpharmacological interventions are often used to promote sleep among preterm infants in the neonatal intensive care unit (NICU). However, there is a lack of synthesis in the evidence of their effectiveness. AIM: To synthesize the evidence on the effectiveness of nonpharmacological interventions on NICU preterm infants' sleep during hospital stay. METHODS: Seven databases were searched, including MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Wan-fang database, China National Knowledge Infrastructure, China Biological Medicine Database, and VIP Journal Integration Platform from their inceptions to August 2017...
August 11, 2018: Worldviews on Evidence-based Nursing
Remila Rezhake, Xiao-Qian Xu, Sandrine Montigny, Anouk Berger, Shang-Ying Hu, Zhi-Hua Liu, Rengaswamy Sankaranarayanan, You-Lin Qiao, Partha Basu, Fang-Hui Zhao
Cancer care professionals are pivotal in translating the knowledge into action in the continuum of cancer control process. Unfortunately, in China and the Association of South-east Asian Nations (ASEAN), limited training opportunities are available for health professionals in the area of cancer prevention and control. Therefore, the Cancer Hospital, Chinese Academy of Medical Sciences (CICAMS), and the International Agency for Research on Cancer (IARC) collaboratively designed and held the China-ASEAN Cancer Control and Prevention Training Program to provide continuing education opportunities for cancer professionals from China and ASEAN countries...
August 11, 2018: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
Lindsay Lief, David A Berlin, Renee C Maciejewski, Li Westman, Amanda Su, Zara R Cooper, Daniel J Ouyang, Geraldine Epping, Heather Derry, David Russell, Eliza Gentzler, Paul K Maciejewski, Holly G Prigerson
RATIONALE: Caring for patients at the end of life is emotionally taxing and may contribute to burnout. Nevertheless, little is known about the factors associated with emotional distress in ICU nurses. OBJECTIVE: To identify patient and family factors associated with nurses' emotional distress in caring for dying patients in the intensive care unit (ICU). METHODS: One hundred nurses who cared for 200 deceased ICU patients at two large, academic medical centers in the Northeast United States were interviewed about patients' psychological and physical symptoms, their reactions to those patient experiences (e...
August 10, 2018: Annals of the American Thoracic Society
Fouad Atallah, Peter S Bernstein, Danilo Acosta Diaz, Howard Minkoff
The Adverse Outcome Index, originally designed to provide an objective inventory of adverse outcomes, is often promoted as a tool for assessing the quality of inpatient obstetric care. Although the Adverse Outcome Index is well described, and its outcomes are easy to collect, it has notable drawbacks such as "paradoxical measures" (eg, blood transfusions are counted as adverse measures even when they are used appropriately) and the dominance of certain measures within the Adverse Outcome Index that can drive scores (eg, neonatal intensive care unit admissions)...
August 6, 2018: Obstetrics and Gynecology
Jinsoo Min, Youlim Kim, Jung-Kyu Lee, Hannah Lee, Jinwoo Lee, Kyung Su Kim, Young-Jae Cho, You Hwan Jo, Ho Geol Ryu, Kyuseok Kim, Sang-Min Lee, Yeon Joo Lee
Although family satisfaction is an important indicator for quality improvement of intensive care units (ICUs), few studies have translated family satisfaction data into quality improvement in Asia. A prospective multicenter study was conducted to evaluate family satisfaction regarding the care of patients and their family.The family satisfaction in the ICU (FS-ICU) questionnaire was administered from January 2015 to February 2016 at ICUs of 3 tertiary teaching hospitals in South Korea. Family members of adult patients, staying at an ICU for ≥48 hours, were included...
August 2018: Medicine (Baltimore)
Sue Carol Verrillo, Maria Cvach, Krysia Warren Hudson, Bradford D Winters
BACKGROUND: Episodic vital sign collection (eVSC), as single data points, gives an incomplete picture of adult patients' postoperative physiologic status. LOCAL PROBLEM: Late detection of patient deterioration resulted in poor patient outcomes on a postsurgical unit. METHODS: Baseline demographic and outcome data were collected through retrospective chart review of all patients admitted to the surgical unit for 12 weeks prior to this quality improvement project...
August 7, 2018: Journal of Nursing Care Quality
Mari Takashima, Jessica Schults, Gabor Mihala, Amanda Corley, Amanda Ullman
OBJECTIVES: To examine the proportion and rate of central venous access device failure and complications across central venous access device types in adult intensive care. DATA SOURCES: A systematic search was undertaken in the electronic databases Cochrane Central Register of Controlled Trials (CENTRAL), Embase, U.S. National Library of Medicine National Institutes of Health (MEDLINE), and Cumulative Index to Nursing and Allied Health (CINAHL) in September 2017...
August 7, 2018: Critical Care Medicine
Juliana M Bernstein, Peter Graven, Kathleen Drago, Konrad Dobbertin, Elizabeth Eckstrom
OBJECTIVES: To design a value-driven, interprofessional inpatient geriatric consultation program coordinated with systems-level changes and studied outcomes and costs. DESIGN: Propensity-matched case-control study of older adults hospitalized at an academic medical center (AMC) who did or did not receive geriatric consultation. SETTING: Single tertiary-care AMC in Portland, Oregon. PARTICIPANTS: Adults aged 70 and older who received an inpatient geriatric consultation (n=464) and propensity-matched controls admitted before development of the consultation program (n=2,381)...
August 10, 2018: Journal of the American Geriatrics Society
Taras Grosh, Nabil M Elkassabany
Enhanced recovery after surgery (ERAS) protocols depend on multidisciplinary care and should be peer-reviewed and data-driven. ERAS has reduced hospital length of stay and complications, simultaneously improving patient outcomes. ERAS protocol after shoulder arthroplasty features multidisciplinary collaboration among different perioperative services and multimodal analgesia with a focus on regional anesthesia. Despite success, adoption is not universal because ERAS protocols are resource intensive. They require clinicians invested in the success of these programs and patients who can take charge of their own health...
September 2018: Anesthesiology Clinics
Kelly C Vranas, Christopher G Slatore, Meeta Prasad Kerlin
Telemedicine coverage of intensive care units (ICUs) is an organizational innovation that has been touted as a means to improve access to and quality of critical care. The purpose of this narrative review is to discuss the different organizational models of ICU telemedicine and factors that have influenced its adoption, and to review the existing literature to consider whether it has lived up to its promise. We conclude by suggesting future directions to fill in some of the existing gaps in the evidence.
August 9, 2018: Annals of the American Thoracic Society
Tara M Brinkman, Kirsten K Ness, Zhenghong Li, I-Chan Huang, Kevin R Krull, Amar Gajjar, Thomas E Merchant, James L Klosky, Robyn E Partin, Ingrid Tonning Olsson, Frederick Boop, Paul Klimo, Wassim Chemaitilly, Raja B Khan, Deokumar Srivastava, Leslie L Robison, Melissa M Hudson, Gregory T Armstrong
Purpose Beyond survival, achieving independence is a primary goal for adult survivors of pediatric CNS tumors. However, the prevalence of and risk factors for failure to achieve independence, assessed with multiple concurrent indicators, have not been examined. Patients and Methods Functional and social independence was assessed in 306 survivors (astrocytoma [n = 130], medulloblastoma [n = 77], ependymoma [n = 36], and other [n = 63]; median current age, 25.3 years [range, 18.9 to 53.1 years]; time since diagnosis, 16...
August 9, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Caitlin McArthur, John Hirdes, Ashok Chaurasia, Katherine Berg, Lora Giangregorio
OBJECTIVES: To describe the proportion of residents receiving rehabilitation in long-term care (LTC) homes, and scores on activities of daily living (ADL) and falls quality indicators (QIs) before and after change from fee-for-service to an episode of care model; and to evaluate the effect of the change on the QIs. DATA SOURCES: Secondary data were collected from all LTC homes in Ontario, Canada, between January 1, 2011 and March 31, 2015. Variables of interest were the proportion of residents per home receiving physical therapy (PT), and the scores on seven ADL and one falls QI...
August 9, 2018: Health Services Research
Jenifer Jeba, Shrikant Atreya, Sulagna Chakraborty, Nikki Pease, Ann Thyle, Alka Ganesh, Gayatri Palat, Lulu Matthew, Sahaya Anbarasi, Raman Kumar, Mary Ann Muckaden, Alan Barnard, Mhoira Leng, Dan Munday, Scott A Murray
Purpose: This joint position statement, by the Indian Association of Palliative Care (IAPC) and Academy of Family Physicians of India (AFPI), proposes to address gaps in palliative care provision in the country by developing a community-based palliative care model that will empower primary care physicians to provide basic palliative care. Evidence: India ranks very poorly, 67th of 80 countries in the quality of death index. Two-thirds of patients who die need palliative care and many such patients spend the last hours of life in the Intensive care unit...
March 2018: Journal of Family Medicine and Primary Care
Pedro N M P Coelho, Luís M R P C Miranda, Pedro M P Barros, José I G Fragata
OBJECTIVES: Cardiac surgery has little effect on life expectancy in elderly patients. Thus, improving the quality of life should be the main factor affecting therapeutic decisions. Most studies on quality of life in elderly patients undergoing cardiac surgery report improvement but have limitations. Consequently, we assessed improvements in the quality of life of elderly patients undergoing elective cardiac surgery, identified influencing variables and established patterns of mental and physical health variations in the first year postoperatively...
July 31, 2018: Interactive Cardiovascular and Thoracic Surgery
Cristina Barbero, Simon Messer, Ayyaz Ali, David P Jenkins, John Dunning, Steven Tsui, Jasvir Parmar
OBJECTIVES: Donor organ utilization and shortage remain the major limitations to the opportunity of a lung transplantation (LTx). Donation after circulatory determined death (DCD) has been adopted as a source of additional organs worldwide. However, concerns about organ quality and ischaemia-reperfusion injury have limited its application. The aim of this study was to retrospectively analyse a single-centre experience in the DCD LTx and compare early and mid-term outcomes with those from a standard donation after brain death (DBD)...
August 1, 2018: European Journal of Cardio-thoracic Surgery
Purva Mathur
Background: Healthcare-associated infections (HCAI/HAIs) are one of the most common adverse events in patient care and account for substantial morbidity and mortality. The high rates of HCAIs in a facility are an indicator of poor quality of healthcare services. According to the World Health Organization, at any time, up to 7% of patients in developed and 10% in developing countries will acquire at least one HAI. These infections also present a significant economic burden at the societal level...
April 2018: Indian Journal of Medical Microbiology
Fausto Roila, Guglielmo Fumi, Benedetta Ruggeri, Andrea Antonuzzo, Carla Ripamonti, Sonia Fatigoni, Luigi Cavanna, Stefania Gori, Alessandra Fabi, Nicola Marzano, Claudio Graiff, Vitaliana De Sanctis, Aurora Mirabile, Samantha Serpentini, Chiara Bocci, Maria Simona Pino, Giuseppina Cilenti, Claudio Verusio, Enzo Ballatori
BACKGROUND: Fatigue is one of the most distressing symptoms of cancer patients. Its characteristics and impact on quality of life have not been fully explored and treatment of cancer-related fatigue in Italian oncological centers has not been codified. METHODS: A cross-sectional study was carried out on all patients attending for any reason the 24 participating centers in two non-consecutive days. Patients with fatigue filled out the Brief Fatigue Inventory (BFI) questionnaire and reported any pharmacological or non-pharmacological treatment for fatigue...
August 6, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Faisca Richer, Emilie Robert, Michèle Boileau-Falardeau, Anne-Lou McNeil Gauthier
OBJECTIVE: We describe the adaptation of an early childcare and development program to the Indigenous context of the Cree territory in Québec. We also share lessons on the challenging implementation of home visits by Indigenous family support workers (FSWs), which is a critical component of the intervention. PARTICIPANTS: Â Mashkûpímâtsît Awash (AMA) aims to enhance the health and well-being of pregnant mothers, young children, and their families by providing intensive interdisciplinary care and follow-up...
August 6, 2018: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
Gihad E Nesrallah, Stephanie N Dixon, Marnie MacKinnon, Sarbjit Vanita Jassal, Sarah E Bota, Jade S Dirk, Erin Arthurs, Peter G Blake, Manish M Sood, Amit X Garg, Sara N Davison
Background: Many patients who receive chronic hemodialysis have a limited life expectancy comparable to that of patients with metastatic cancer. However, patterns of home palliative care use among patients receiving hemodialysis are unknown. Objectives: We aimed to undertake a current-state analysis to inform measurement and quality improvement in palliative service use in Ontario. Methods: We conducted a descriptive study of outcomes and home palliative care use by Ontario residents maintained on chronic dialysis using multiple provincial healthcare datasets...
2018: Canadian Journal of Kidney Health and Disease
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