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https://www.readbyqxmd.com/read/28817376/association-between-hospice-spending-on-patient-care-and-rates-of-hospitalization-and-medicare-expenditures-of-hospice-enrollees
#1
Melissa D Aldridge, Andrew J Epstein, Abraham A Brody, Eric J Lee, R Sean Morrison, Elizabeth H Bradley
BACKGROUND: Care at the end of life is increasingly fragmented and is characterized by multiple hospitalizations, even among patients enrolled with hospice. OBJECTIVE: To determine whether hospice spending on direct patient care (including the cost of home visits, drugs, equipment, and counseling) is associated with hospital utilization and Medicare expenditures of hospice enrollees. DESIGN: Longitudinal, observational cohort study (2008-2010)...
August 17, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28807696/a-tailored-intervention-to-improving-the-quality-of-intrahospital-nursing-handover
#2
Jochen Bergs, Frank Lambrechts, Ines Mulleneers, Kim Lenaerts, Caroline Hauquier, Geert Proesmans, Sarah Creemers, Dominique Vandijck
INTRODUCTION: Nursing handover is a process central to the delivery of high-quality and safe care. We aimed to improve the quality of nursing handover from the emergency department to ward and intensive care unit (ICU). METHODS: A quasi-experimental non-equivalent control group pre-test - post-test design was applied. Handover quality was measured using the Handover Evaluation Scale (HES). A tailored intervention, inspired by appreciative inquiry, was designed to improve the implementation of an existing handover form and procedure...
August 11, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28797590/antibiotic-stewardship-programs-in-nursing-homes-a-systematic-review
#3
REVIEW
Diana Feldstein, Philip D Sloane, Cynthia Feltner
INTRODUCTION: Antibiotic stewardship programs (ASPs) are coordinated interventions promoting the appropriate use of antibiotics to improve patient outcomes and reduce microbial resistance. These programs are now mandated in nursing homes (NHs) but it is unclear if these programs improve resident outcomes. This systematic review evaluated the current evidence regarding outcomes of ASPs in the NH. METHODS: PubMed, CINAHL, EMBASE, and the Cochrane Library were systematically searched for intervention trials of ASPs performed in NHs that evaluated final health outcomes (mortality and Clostridium difficile infections), healthcare utilization outcomes (emergency department visits and hospital admissions) and intermediate health outcomes (number of antibiotics prescribed, adherence to recommended guidelines)...
August 7, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28796559/improvements-in-patient-and-health-system-outcomes-using-an-integrated-oncology-and-palliative-medicine-approach-on-a-solid-tumor-inpatient-service
#4
Richard F Riedel, Kim Slusser, Steve Power, Christopher A Jones, Thomas W LeBlanc, Arif H Kamal, Devi Desai, Deborah Allen, Yinxi Yu, Steven Wolf, Anthony N Galanos
PURPOSE: Early palliative care (PC) improves outcomes for outpatients with advanced cancer. Its effect on hospitalized patients with cancer is unknown. Herein, we report on the influence of a novel, fully integrated inpatient medical oncology and PC partnership at a tertiary medical center during its first year of implementation. METHODS: We conducted a retrospective, longitudinal, pre- and postintervention cohort study at Duke University Hospital. Pre- and postintervention cohorts were defined as all patients admitted to the solid tumor inpatient service from September 1, 2009, to June 30, 2010, and September 1, 2011 to June 30, 2012, respectively...
August 10, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28793094/therapeutic-nursing-care-transition-in-sexuality-of-the-elderly-caregiving-spouse
#5
Claudia Feio da Maia Lima, Célia Pereira Caldas, Iraci Dos Santos, Liana Amorim Correa Trotte, Bárbara Martins Corrêa da Silva
Objective: To understand the transitions experienced, and the conditions and expected response patterns to changes in sexuality of the spouse-caregiver of the elderly, during progression of the dementia process. Method: A qualitative research study, conducted at the neurogeriatric clinic between May of 2014 and May of 2015. An intensive, individual interview was administered to 12 elderly caregivers. Thematic content analysis was applied, using the theoretical model of Transition Theory...
July 2017: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/28777289/sarcopenia-increases-risk-of-long-term-mortality-in-elderly-patients-undergoing-emergency-abdominal-surgery
#6
Erika L Rangel, Arturo J Rios-Diaz, Jennifer W Uyeda, Manuel Castillo-Angeles, Zara Cooper, Olubode A Olufajo, Ali Salim, Aaron D Sodickson
BACKGROUND: Frailty is associated with poor surgical outcomes in elderly patients but is difficult to measure in the emergency setting. Sarcopenia, or the loss of lean muscle mass, is a surrogate for frailty and can be measured using cross-sectional imaging. We sought to determine the impact of sarcopenia on one-year mortality after emergency abdominal surgery in elderly patients. METHODS: Sarcopenia was assessed in patients ≥70 years old who underwent emergency abdominal surgery at a single hospital from 2006-2011...
August 3, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28777159/icu-admission-after-surgery-who-benefits
#7
Sadia Ghaffar, Rupert M Pearse, Michael A Gillies
PURPOSE OF REVIEW: Death following surgery remains a major cause of death worldwide, and ICU admission following major surgery is considered a standard of care in many healthcare systems. However, ICU resources are finite and expensive, thus identifying those most likely to benefit is of great importance. RECENT FINDINGS: Advances in surgical and perioperative management have moved the focus of postoperative care to preventing complications and reducing duration of hospitalisation...
August 1, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28777116/emergency-airway-response-team-simulation-training-a-nursing-perspective
#8
Janet T Crimlisk, Gintas P Krisciunas, Gregory A Grillone, R Mauricio Gonzalez, Michael R Winter, Susan C Griever, Eduarda Fernandes, Ron Medzon, Joseph S Blansfield, Adam Blumenthal
BACKGROUND: Simulation-based education is an important tool in the training of professionals in the medical field, especially for low-frequency, high-risk events. An interprofessional simulation-based training program was developed to enhance Emergency Airway Response Team (EART) knowledge, team dynamics, and personnel confidence. This quality improvement study evaluated the EART simulation training results of nurse participants. METHOD: Twenty-four simulation-based classes of 4-hour sessions were conducted during a 12-week period...
September 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/28772186/an-evaluation-of-involving-family-caregivers-in-the-self-care-of-heart-failure-patients-on-hospital-readmission-randomised-controlled-trial-the-family-study
#9
Hiba Deek, Sungwon Chang, Phillip J Newton, Samar Noureddine, Sally C Inglis, Ghina Al Arab, Samer Kabbani, Wael Chalak, Nadim Timani, Peter S Macdonald, Patricia M Davidson
BACKGROUND: The prevalence of heart failure is increasing in Lebanon but to date there is no systematic evaluation of a disease management intervention. OBJECTIVE: The aim of this study was to evaluate the effect of involving family caregivers in the self-care of patients with heart failure on the risk of hospital readmission. DESIGN: A multi-site, block randomised controlled trial. SETTINGS: The study was conducted over a 13-month period in three tertiary medical centres in Beirut and Mount Lebanon, Lebanon...
July 25, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28763181/-triage-duration-times-a-prospective-descriptive-study-in-a-level-1%C3%A2-emergency-department
#10
Chiara Sanson, Monica Gandar, Roberta Aloisi
OBJECTIVE: To analyze nursing complexity level and its relationship with mortality and length of stay. METHOD: Observational study carried out between 1/06/2014 to 21/06/2015 at High Dependency Unit of an Italian University Hospital. The nursing needs and the Index of Caring Complexity (Indice di Complessità Assistenziale, ICA) were collected following the "Modello delle Prestazioni Infermieristiche". RESULTS: Data from 506 patients were collected for a maximum of 4 days of hospital stay (1,436 data collection)...
April 2017: Professioni Infermieristiche
https://www.readbyqxmd.com/read/28754600/building-blocks-for-institutional-preparation-of-ctl019-delivery
#11
REVIEW
Joseph McGuirk, Edmund K Waller, Muna Qayed, Sunil Abhyankar, Solveig Ericson, Peter Holman, Christopher Keir, G Douglas Myers
Chimeric antigen receptor (CAR) T-cell therapy is an investigational immunocellular therapy that reprograms a patient's cytotoxic T cells to engage and eliminate malignant cells. CAR T-cell therapies targeting the CD19 antigen have demonstrated high efficacy in clinical trials for patients with B-cell malignancies and may potentially be available on a broader scale in the future. CAR T-cell therapy begins with the collection of a sufficient number of T cells from a patient's peripheral blood through leukapheresis...
July 25, 2017: Cytotherapy
https://www.readbyqxmd.com/read/28752835/advanced-competencies-mapping-of-critical-care-nursing-a-qualitative-research-in-two-intensive-care-units
#12
Emanuela Alfieri, Marina Mori, Valentina Barbui, Leopoldo Sarli
BACKGROUND AND AIM: Nowadays, in Italy, the nursing profession has suffered important changes in response to the needs of citizens' health and to improve the quality of the health service in the country.  At the basis of this development there is an increase of the nurses' knowledge, competencies and responsibilities. Currently, the presence of nurses who have followed post-basic training paths, and the subsequent acquisition of advanced clinical knowledge and specializations, has made it essential for the presence of competencies mappings for each specialty, also to differentiate them from general care nurses...
July 18, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28752794/relationship-between-perceived-organizational-justice-and-moral-distress-in-intensive-care-unit-nurses
#13
Ghazaleh Haghighinezhad, Foroozan Atashzadeh-Shoorideh, Tahereh Ashktorab, Jamileh Mohtashami, Maasoumeh Barkhordari-Sharifabad
BACKGROUND: The nature of the nursing profession pays more attention to ethics of healthcare than its therapeutic dimension. One of the prevalent moral issues in this profession is moral distress. Moral distress appears more in intensive care units due to the widespread need for moral decision-making regarding treatment and care in emergency situations. In this connection, organizational justice is of high importance and, as a significant motivational tool, leaves important impacts upon attitude and behavior of personnel...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28727183/a-randomised-controlled-trial-on-a-nurse-led-smartphone-based-self-management-programme-for-patients-with-poorly-controlled-type-2-diabetes-a-study-protocol
#14
Wenru Wang, Betsy Seah, Ying Jiang, Violeta Lopez, Cherry Tan, Suan Tee Lim, Hongliang Ren, Yin Hao Khoo
AIM: To develop and compare a nurse-led smartphone-based self-management programme with an existing nurse-led diabetes service on health-related outcomes for patients with poorly controlled type 2 diabetes in Singapore. BACKGROUND: Over the past decades, Asia has emerged as the 'diabetes epicentre' in the world due to rapid economic development, urbanisation and nutrition transition. There is an urgent need to develop more effective care management strategies in response to this rising diabetes epidemic...
July 20, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28705570/la-pose-de-voie-veineuse-p%C3%A3-diatrique-par-les-%C3%A3-quipes-de-smur-adultes
#15
REVIEW
Frédéric Lemoine, Hugues Lefort, Sabine Lemoine, Benoît Frattini, Daniel Jost
Paediatric perfusion during pre-hospital care is a major issue in the event of life-threatening emergencies. Access, often restricted, to backup specialising in paediatrics, implies the existence of practices on protocols for the adult mobile emergency and intensive care service (Smur) in partnership with paediatricians. Paediatric perfusion practices were assessed in these teams. The results show the presence of a paediatric protocol in the adult Smur teams is not very common. Nursing practices seem to be evolving towards the recommendations, thanks to technological advances such as the use of the intraosseous device...
July 2017: Soins. Pédiatrie, Puériculture
https://www.readbyqxmd.com/read/28699991/factors-influencing-the-missed-nursing-care-in-patients-from-a-private-hospital
#16
Raúl Hernández-Cruz, María Guadalupe Moreno-Monsiváis, Sofía Cheverría-Rivera, Aracely Díaz-Oviedo
Objective: to determine the factors that influence the missed nursing care in hospitalized patients. Methods: descriptive correlational study developed at a private hospital in Mexico. To identify the missed nursing care and related factors, the MISSCARE survey was used, which measures the care missed and associated factors. The care missed and the factors were grouped in global and dimension rates. For the analysis, descriptive statistics, Spearman's correlation and simple linear regression were used...
July 10, 2017: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/28697503/update-of-sepsis-in-the-intensive-care-unit
#17
Kelly Roveran Genga, James A Russell
Sepsis, the most common cause of admission to an intensive care unit (ICU), has had an increased incidence and prevalence over the last years with a simultaneous decrease in its short-term mortality. Sepsis survivors are more frequently discharged from hospital and often experience long-term outcomes such as late mortality, immune dysfunction, secondary infections, impaired quality of life, and unplanned readmissions. Early recognition and management of sepsis have challenged emergency care and critical care physicians and nurses...
July 12, 2017: Journal of Innate Immunity
https://www.readbyqxmd.com/read/28658397/perception-of-nursing-and-medical-professionals-on-patient-safety-in-neonatal-intensive-care-units
#18
Andreia Tomazoni, Patrícia Kuerten Rocha, Mariana Batista Ribeiro, Leonardo S Serapião, Sabrina de Souza, Bruna Figueiredo Manzo
Objective: To describe patient safety in the perception of nursing and medical professionals of neonatal intensive care units. Method: Exploratory and descriptive study with a qualitative approach, using the instrument Hospital Survey on Patient Safety Culture for data collection. Twenty-eight nursing and medical professionals of three neonatal intensive care units in the city of Florianópolis, state of Santa Catarina, participated in the study, from 2013 to 2015...
June 26, 2017: Revista Gaúcha de Enfermagem
https://www.readbyqxmd.com/read/28645964/the-predictive-value-of-serial-changes-in-diaphragm-function-during-the-spontaneous-breathing-trial-for-weaning-outcome-a-study-protocol
#19
Pengmin Zhou, Zhongheng Zhang, Yucai Hong, Huabo Cai, Hui Zhao, Peifeng Xu, Yiming Zhao, Shengping Lin, Xuchang Qin, JiaWei Guo, Yun Pan, Junru Dai
INTRODUCTION: There is a variety of tools being used in clinical practice for the prediction of weaning success from mechanical ventilation. However, their diagnostic performances are less than satisfactory. The purpose of this study is to investigate the value of serial changes in diaphragm function measured by ultrasound during the spontaneous breathing trial (SBT) as a weaning predictor. METHODS AND ANALYSIS: This is a prospective observational study conducted in a 10-bed medical emergency intensive care unit (EICU) in a university-affiliated hospital...
June 23, 2017: BMJ Open
https://www.readbyqxmd.com/read/28643577/an-assessment-of-advance-relatives-approach-for-brain-death-organ-donation
#20
Carine Michaut, Antoine Baumann, Hélène Gregoire, Corinne Laviale, Gérard Audibert, Xavier Ducrocq
BACKGROUND: Advance announcement of forthcoming brain death has developed to enable intensivists and organ procurement organisation coordinators to more appropriately, and separately from each other, explain to relatives brain death and the subsequent post-mortem organ donation opportunity. Research aim: The aim was to assess how potentially involved healthcare professionals perceived ethical issues surrounding the strategy of advance approach. RESEARCH DESIGN: A multi-centre opinion survey using an anonymous self-administered questionnaire was conducted in the six-member hospitals of the publicly funded East of France regional organ and tissue procurement network called 'Prélor'...
January 1, 2017: Nursing Ethics
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