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https://www.readbyqxmd.com/read/29224590/comparative-emergency-department-resource-utilisation-across-age-groups
#1
Ellen Burkett, Melinda G Martin-Khan, Leonard C Gray
Objectives The aim of the present study was to assess comparative emergency department (ED) resource utilisation across age groups.Methods A retrospective analysis of data collected in the National Non-admitted Patient Emergency Department Care Database was undertaken to assess comparative ED resource utilisation across six age groups (0-14, 15-35, 36-64, 65-74, 75-84 and ≥85 years) with previously used surrogate markers of ED resource utilisation.Results Older people had significantly higher resource utilisation for their individual ED episodes of care than younger people, with the effect increasing with advancing age...
December 11, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29219828/improving-care-for-older-patients-in-the-acute-setting-a-qualitative-study-with-healthcare-providers
#2
C Brouwers, H Merten, M Willems, D J Habraken, F W Bloemers, T H Biesheuvel, L S van Galen, P W B Nanayakkara, C Wagner
BACKGROUND: The proportion of older people needing acute care is rapidly growing, thereby posing an increased burden on the acute care chain. The aim of this study is to gain more insight into the obstacles and potential improvement opportunities of the acute care process for older patients arriving at the hospital. METHODS: Semi-structured interviews were conducted to determine the experiences of 18 different primary (i.e. general practitioner, community nurse) and secondary healthcare professionals (i...
October 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/29216837/the-role-of-gender-in-the-active-attitude-toward-treatment-and-health-among-older-patients-in-primary-health-care-self-assessed-health-status-and-sociodemographic-factors-as-moderators
#3
Joanna Chylińska, Magdalena Łazarewicz, Marta Rzadkiewicz, Mirosława Adamus, Mariusz Jaworski, Gørill Haugan, Monica Lillefjel, Geir A Espnes, Dorota Włodarczyk
BACKGROUND: Active attitude toward treatment and health (ATH) leads to improved cooperation and better health outcomes in patients. Supporting it in the population of older adults is a growing need in primary care. Recognising the role of gender, health and other sociodemographic factors can help to distinguish patients who need the most assistance in activation from general practitioners (GPs). The objective of the study was to investigate gender differences in ATH as well as the moderating role of self-assessed health (SAH) and selected sociodemographic factors (age, education, financial status, marital status)...
December 8, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/29212638/reversal-strategies-for-newer-oral-anticoagulants
#4
Adam J Singer, Susan Wilson
Nonvitamin K antagonist oral anticoagulants have advantages compared with warfarin, but both types of anticoagulants come with uncertainty about how best to manage life-threatening bleeding events, urgent surgeries, and invasive procedures. Nurse practitioners and physician assistants may need to manage such emergency situations in the critical care setting. Achieving hemostasis quickly is key, and efforts to do so have relied mainly on blood products. Targeted reversal agents are in clinical development and one, idarucizumab, which reverses dabigatran anticoagulation, has been approved...
2017: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/29210768/safety-and-security-concerns-of-nurses-working-in-the-intensive-care-unit-a-qualitative-study
#5
Yolanda Keys, Jaynelle F Stichler
Intensive care units (ICUs) exist to serve as a safe place for critically ill patients to receive care from skilled practitioners. In this qualitative study, ICU nurses shared their perspectives on elements that promote safety and security on their units. After obtaining institutional review board approval, participants participated in telephone interviews with a nurse researcher who has experience as a bedside ICU nurse. Five categories and 14 themes were identified and then confirmed using member checking...
January 2018: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/29209788/-reform-of-emergency-physician-training-in-austria-finally-up-to-date
#6
REVIEW
H Trimmel, M Baubin, J Kreutziger, G Frank, G Prause
During the last 20 years Austrian prehospital emergency medical services (EMS) have significantly improved. The structure and organization of Austrian EMS comply with European standards but training requirements for prehospital EMS physicians are insufficient when compared with other countries. Although some EMS systems follow the German or Swiss postgraduate training concepts, the legal requirements in Austria defining the scope of mandatory training for physicians in the prehospital setting are only minimal...
December 5, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29206564/advance-care-planning-in-an-accountable-care-organization-is-associated-with-increased-advanced-directive-documentation-and-decreased-costs
#7
William F Bond, Minchul Kim, Chris M Franciskovich, Jason E Weinberg, Jessica D Svendsen, Linda S Fehr, Amy Funk, Robert Sawicki, Carl V Asche
BACKGROUND: Advance care planning (ACP) documents patient wishes and increases awareness of palliative care options. OBJECTIVE: To study the association of outpatient ACP with advanced directive documentation, utilization, and costs of care. DESIGN: This was a case-control study of cases with ACP who died matched 1:1 with controls. We used 12 months of data pre-ACP/prematch and predeath. We compared rates of documentation with logit model regression and conducted a difference-in-difference analysis using generalized linear models for utilization and costs...
December 5, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29203681/patients-views-on-interactions-with-practitioners-for-type-2-diabetes-a-longitudinal-qualitative-study-in-primary-care-over-10-years
#8
Hajira Dambha-Miller, Barbora Silarova, Greg Irving, Ann Louise Kinmonth, Simon J Griffin
BACKGROUND: It has been suggested that interactions between patients and practitioners in primary care have the potential to delay progression of complications in type 2 diabetes. However, as primary care faces greater pressures, patient experiences of patient-practitioner interactions might be changing. AIM: To explore the views of patients with type 2 diabetes on factors that are of significance to them in patient-practitioner interactions in primary care after diagnosis, and over the last 10 years of living with the disease...
December 4, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29199901/an-evaluation-of-practitioner-s-experience-of-service-users-seeking-community-detoxification-from-benzodiazepines
#9
Marianne Wall, Sharon Lambert, Aidan Horan
A recent report in Ireland identified that two-thirds of poisoning deaths involved poly drug use with an average of four different drugs involved. Of these, benzodiazepines were the most common drug group involved. Concern has been expressed regarding high levels of benzodiazepine prescriptions globally. Community-based detoxification programs are required, but detoxification is complex with associated high risks, such as overdose. This study utilized a survey to gather the experiences of a range of drug workers in addiction settings in the southern region of Ireland who are tasked with the management of supporting service users who wish to detoxify from benzodiazepines...
December 4, 2017: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/29198489/opiate-use-disorders-and-overdose-medical-students-experiences-satisfaction-with-learning-and-attitudes-toward-community-naloxone-provision
#10
H Tobin, J Klimas, T Barry, M Egan, G Bury
INTRODUCTION: Opiate use disorder is a common condition in healthcare services in Ireland, where over 200 opiate overdose deaths occur annually. There is limited addiction medicine education at undergraduate level and medical graduates may not be adequately prepared to diagnose and manage opioid use disorders and emergency drug overdose presentations. Therefore, we examined final-year medical students' learning experiences and attitudes toward opioid use disorder, overdose and community naloxone provision as an emerging overdose treatment...
November 22, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/29194331/kaiser-s-school-of-nursing-a-70-year-legacy-of-disruptive-innovation
#11
Jim DʼAlfonso, Deloras Jones, Terri Moss
A legacy project was launched in 2016 to research, capture, and record the history and voice of Kaiser Foundation School of Nursing alumni. The inspirational stories of these early nursing pioneers emerged within a disruptive and innovative health care system known as Kaiser Permanente. Led by a doctorally prepared nurse director, the new school boldly rejected the dominant social norms of the 1940s by welcoming minorities and offering an unprecedented curriculum that prioritized prevention, health promotion, and wellness over conventional institutionalized sick care models...
January 2018: Nursing Administration Quarterly
https://www.readbyqxmd.com/read/29191400/-primary-care-in-portugal
#12
T Sánchez-Sagrado
The economic crisis and deterioration of the Portuguese National Health service has forced professionals to leave the country. The Portuguese National Health System was introduced in 1976, but it has been unable to provide citizens with the social and health advantages of an equality of access and free national health system. The Portuguese National Health System is financed by taxes. However, a 35% of its incomes are from private sources. The health minister decides the budget, and it is based on an historical financing plus a per capita system...
November 27, 2017: Semergen
https://www.readbyqxmd.com/read/29191200/emergency-general-surgery-in-rwandan-district-hospitals-a-cross-sectional-study-of-spectrum-management-and-patient-outcomes
#13
Christophe Mpirimbanyi, Alexandre Nyirimodoka, Yihan Lin, Bethany L Hedt-Gauthier, Jackline Odhiambo, Theoneste Nkurunziza, Joaquim M Havens, Jack Omondi, Emile Rwamasirabo, Faustin Ntirenganya, Gabriel Toma, Joel Mubiligi, Scheilla Bayitondere, Robert Riviello
BACKGROUND: Management of emergency general surgical conditions remains a challenge in rural sub-Saharan Africa due to issues such as insufficient human capacity and infrastructure. This study describes the burden of emergency general surgical conditions and the ability to provide care for these conditions at three rural district hospitals in Rwanda. METHODS: This retrospective cross-sectional study included all patients presenting to Butaro, Kirehe and Rwinkwavu District Hospitals between January 1st 2015 and December 31st 2015 with emergency general surgical conditions, defined as non-traumatic, non-obstetric acute care surgical conditions...
December 1, 2017: BMC Surgery
https://www.readbyqxmd.com/read/29189085/sharing-end-of-life-care-preferences-with-family-members-who-has-the-discussion-and-who-does-not
#14
Lindsay J Peterson, Debra Dobbs, Hongdao Meng, Alyssa Gamaldo, Kevin O'Neil, Kathryn Hyer
BACKGROUND: Research suggests that greater engagement in family discussions concerning end-of-life (EOL) care preferences could improve advance care planning and EOL outcomes. However, a substantial number of people have not had such discussions. OBJECTIVE: The study's objective was to understand attitudes and experiences influencing engagement in discussions of EOL care preferences with family members, including the role of healthcare providers in such discussions...
November 30, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29188694/supra-therapeutic-oral-paracetamol-overdose-in-adults-an-update-for-the-dental-team
#15
Ross Leader, James Hackett, Ahmed Al-Naher
Paracetamol (acetaminophen) is a commonly used analgesic; its 'over the counter' availability, low cost and popularity amongst patients often make it the first choice for dental pain. It is in this that its potential toxicity, made more complicated by the ever extending range of paracetamol-containing products, make the understanding of this medication key to the safe management of patients presenting to surgery with dental pain. Clinical relevance: The purpose of this article is to supply dental practitioners with the knowledge to manage patients who present having taken an oral supra-therapeutic paracetamol overdose...
May 2017: Dental Update
https://www.readbyqxmd.com/read/29188481/using-case-management-in-a-universal-health-coverage-system-to-improve-quality-of-life-of-frequent-emergency-department-users-a-randomized-controlled-trial
#16
Katia Iglesias, Stéphanie Baggio, Karine Moschetti, Jean-Blaise Wasserfallen, Olivier Hugli, Jean-Bernard Daeppen, Bernard Burnand, Patrick Bodenmann
PURPOSE: Frequent Emergency Department users are likely to experience poor quality of life (QOL). Case management interventions are efficient in responding to the complex needs of this population, but their effects on QOL have not been tested yet. Therefore, the aim of our study was to examine to what extent a case management intervention improved frequent Emergency Department users' QOL in a universal health coverage system. METHODS: Data were part of a randomized controlled trial designed to improve frequent Emergency Department users' QOL at the Lausanne University Hospital, Switzerland...
November 29, 2017: Quality of Life Research
https://www.readbyqxmd.com/read/29183318/the-development-implementation-and-evaluation-of-clinical-pathways-for-chronic-obstructive-pulmonary-disease-copd-in-saskatchewan-protocol-for-an-interrupted-times-series-evaluation
#17
Thomas Rotter, Christopher Plishka, Mohammed Rashaad Hansia, Donna Goodridge, Erika Penz, Leigh Kinsman, Adegboyega Lawal, Sheryl O'Quinn, Nancy Buchan, Patricia Comfort, Prakesh Patel, Sheila Anderson, Tanya Winkel, Rae Lynn Lang, Darcy D Marciniuk
BACKGROUND: Chronic obstructive pulmonary disease (COPD) has substantial economic and human costs; it is expected to be the third leading cause of death worldwide by 2030. To minimize these costs high quality guidelines have been developed. However, guidelines alone rarely result in meaningful change. One method of integrating guidelines into practice is the use of clinical pathways (CPWs). CPWs bring available evidence to a range of healthcare professionals by detailing the essential steps in care and adapting guidelines to the local context...
November 28, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29180548/primary-care-providers-perspectives-on-errors-of-omission
#18
Lusine Poghosyan, Allison A Norful, Elaine Fleck, Jean-Marie Bruzzese, AkkeNeel Talsma, Angela Nannini
BACKGROUND: Despite recent focus on patient safety in primary care, little attention has been paid to errors of omission, which represent significant gaps in care and threaten patient safety in primary care but are not well studied or categorized. The purpose of this study was to develop a typology of errors of omission from the perspectives of primary care providers (PCPs) and understand what factors within practices lead to or prevent these omissions. METHODS: A qualitative descriptive design was used to collect data from 26 PCPs, both physicians and nurse practitioners, from the New York State through individual interviews...
November 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29176341/community-based-home-health-programs-and-chronic-disease-synthesis-of-the-literature
#19
Tonya Vandiver, Tracy Anderson, Brittani Boston, Cynthia Bowers, Norma Hall
PURPOSE OF STUDY: This article reviewed and evaluated literature on the various community-based home health programs and their effectiveness at preventing hospital admissions in adults. The research question addressed is as follows: Do community-based home health programs decrease hospital admissions in adult patients with chronic disease? PRIMARY PRACTICE SETTING: The primary practice setting evaluated in this review of the literature was community-based home health programs...
January 2018: Professional Case Management
https://www.readbyqxmd.com/read/29174462/critical-care-and-personalized-or-precision-medicine-who-needs-whom
#20
Shihab Sugeir, Stephen Naylor
The current paradigm of modern healthcare is a reactive response to patient symptoms, subsequent diagnosis and corresponding treatment of the specific disease(s). This approach is predicated on methodologies first espoused by the Cnidean School of Medicine approximately 2500years ago. More recently escalating healthcare costs and relatively poor disease treatment outcomes have fermented a rethink in how we carry out medical practices. This has led to the emergence of "P-Medicine" in the form of Personalized and Precision Medicine...
November 16, 2017: Journal of Critical Care
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