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https://www.readbyqxmd.com/read/29053531/nursing-student-collaborative-with-meals-on-wheels-home-visits-for-at-risk-senior-adults
#1
Susan Campbell, Jill M Berg
Nursing students at Washington State University Tri-Cities Campus are taking part in a program to provide care for homebound senior adults enrolled in home delivery meal services. Students perform home safety, functional, and cognitive assessments while learning the challenges of meeting nutritional needs of an at-risk senior adult population. This article outlines the program and its outcomes after two years of collaboration. Meals on Wheels is identified as an innovative placement for meeting nursing program outcomes and clinical practice hours...
October 20, 2017: Nursing Education Perspectives
https://www.readbyqxmd.com/read/29052224/opiate-prescribing-in-hospitalized-older-adults-patterns-and-outcomes
#2
Sutapa Maiti, Liron Sinvani, Michele Pisano, Andrzej Kozikowski, Vidhi Patel, Meredith Akerman, Karishma Patel, Christopher Smilios, Christian Nouryan, Guang Qiu, Renee Pekmezaris, Gisele Wolf-Klein
BACKGROUND/OBJECTIVES: Whereas opiate prescribing patterns have been well described in outpatient and emergency department settings, they have been less defined in hospitalized older adults. The objective was to describe patterns of opiate prescribing and associated outcomes in hospitalized older adults. DESIGN: Retrospective cohort study. SETTING: Tertiary care facility. PARTICIPANTS: Hospitalized medical patients aged 65 and older (N = 9,245; mean age 80...
October 20, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29052065/robotic-ventral-hernia-repair-is-not-superior-to-laparoscopic-a-national-database-review
#3
Priscila Armijo, Akshay Pratap, Yi Wang, Valerie Shostrom, Dmitry Oleynikov
BACKGROUND: Minimally invasive surgery (MIS) use for ventral hernia repair has increased over the last decade. Whether outcomes are improved by robotic assistance remains a subject of debate. The aim of this study is to evaluate outcomes (including cost, complications, length of stay (LOS), and pain medication utilization) in patients who underwent an open (OVHR), laparoscopic (LVHR), or robotic (RVHR) ventral hernia repair (VHR). METHODS: The Vizient database was queried using ICD-9 procedure and diagnosis codes for patients who underwent VHR from January 2013 to September 2015...
October 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29051983/delayed-manifestations-of-abdominal-trauma-follow-up-abdominopelvic-ct-in-posttraumatic-patients
#4
Khaled Y Elbanna, Mohammed F Mohammed, Shih-Chieh Huang, David Mak, J Philip Dawe, Emilie Joos, Heather Wong, Faisal Khosa, Savvas Nicolaou
PURPOSE: Our study aims to investigate the frequency and patterns of delayed manifestations of abdominal and pelvic injuries which may not be identified or which fail to manifest on the initial abdominopelvic CT in posttraumatic patients. METHODS: For our institutional review board (IRB)-approved retrospective study, our hospital trauma registry was queried for patients with blunt multitrauma and Injury Severity Score (ISS) ≥ 16 between January 2010 and August 2016, yielding 3735 patients...
October 19, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/29051001/episode-based-payment-variation-for-urological-cancer-surgery
#5
Chad Ellimoottil, Jonathan Li, Zaojun Ye, James M Dupree, Hye Sung Min, Deborah Kaye, Lindsey A Herrel, David C Miller
OBJECTIVE: To investigate payment variation for three common urological cancer surgeries and evaluate the potential for applying bundled payment programs to these procedures. METHODS: Using 2008-2011 Surveillance, Epidemiology, and End Results-Medicare linked data, we identified all beneficiaries aged greater than 65 years who underwent cystectomy, prostatectomy, or nephrectomy for cancer. Total episode payments were determined by aggregating hospital, professional, and post-acute care claims from the index surgical hospitalization through 90 days post-discharge...
October 16, 2017: Urology
https://www.readbyqxmd.com/read/29050906/hospital-readmissions-related-to-clostridium-difficile-infection-in-the-united-states
#6
Abhishek Deshpande, Chaitanya Pant, Mojtaba Olyaee, Curtis J Donskey
Using a national readmissions database, we report a significant burden of Clostridium difficile-associated readmissions in the United States manifested as a high rate of rehospitalizations and substantial hospital stays and costs.
October 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/29050888/influence-of-discharge-timing-and-diagnosis-on-outcomes-of-pediatric-laparoscopic-cholecystectomy
#7
Sarah B Cairo, George Ventro, Holly A Meyers, David H Rothstein
BACKGROUND: This study evaluated the influence of discharge timing (same day versus other) on 30-day hospital readmissions after laparoscopic cholecystectomy in pediatric patients. Wound complication and readmission rates also were evaluated among patients with different operative indications. METHODS: The database of the National Surgical Quality Improvement Program-Pediatric (2012-2015) was queried for patients <18 years old who underwent laparoscopic cholecystectomy...
October 16, 2017: Surgery
https://www.readbyqxmd.com/read/29050845/high-rate-of-isolated-right-ventricular-dysfunction-in-patients-with-non-significant-computed-tomographic-pulmonary-angiography
#8
Frances M Russell, Jeffrey A Kline, Timothy Lahm
BACKGROUND: Right ventricular (RV) dysfunction and pulmonary hypertension (PH) are commonly unrecognized in the emergency department (ED), but are associated with poor outcomes. Prior research has found a 30% prevalence of isolated RV dysfunction in ED patients after non-significant computed tomographic pulmonary angiography (CTPA). We aimed to prospectively define the prevalence of RV dysfunction and/or PH in short of breath ED patients, and assess outcomes. METHODS: Prospective observational study of patients with a non-significant CTPA...
October 10, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29049548/multimodal-analgesia-in-outpatient-head-and-neck-surgery-a-feasibility-and-safety-study
#9
Justin Oltman, Oleg Militsakh, Mark D'Agostino, Brittany Kauffman, Robert Lindau, Andrew Coughlin, William Lydiatt, Daniel Lydiatt, Russell Smith, Aru Panwar
Importance: Perioperative analgesia strategies that rely solely on narcotics may contribute to adverse effects and concerns about opioid abuse or dependence. Multimodal analgesia protocols incorporating nonnarcotic agents may reduce the need for postoperative narcotic use. Objective: To evaluate the feasibility and safety of a multimodal analgesia protocol for outpatient head and neck surgical procedures and to identify the association of the multimodal analgesia protocol with postoperative pain perception scores and patient satisfaction...
October 19, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29049189/the-prevalence-and-long-term-variation-of-hospital-readmission-for-patients-with-diabetes-in-tianjin-china-a-cross-sectional-study
#10
Xiaoqian Liu, Yuting Guo, Dandan Li, Zhuang Cui, Yuanyuan Liu, Changping Li, Jun Ma
Little is known about hospital readmission for patients with diabetes in China. We aimed to assess the temporal pattern, risk factors, and variations of all-cause readmission among hospitalized patients with diabetes in Tianjin, China, from 2008 to 2013.The Tianjin Basic Medical Insurance Register System database was used to identify discharged patients with diabetes from 2008 to 2013. The influential factors and trends of rehospitalization were analyzed for 30-, 60- and 90-day predicted readmission rates. The Blinder-Oaxaca decomposition was used to explain the readmission variations between 2008 and 2013...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29046768/smartphones-and-e-tablets-in-perioperative-medicine
#11
REVIEW
Frederic Michard
Smartphones and electronic tablets (e-tablets) have become ubiquitous devices. Their ease of use, smartness, accessibility, mobility and connectivity create unique opportunities to improve quality of surgical care from prehabilitation to rehabilitation. Before surgery, digital applications (Apps), serious games and text messaging may help for a better control of risk factors (hypertension, overweight), for smoking cessation, and for optimizing adherence to preoperative recommendations (e.g., regarding anticoagulation or antihypertensive treatments)...
October 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29046387/congenital-heart-surgery-on-in-hospital-mortality-in-trisomy-13-and-18
#12
Katherine A Kosiv, Jeffrey M Gossett, Shasha Bai, R Thomas Collins
BACKGROUND AND OBJECTIVES: Congenital heart disease (CHD) is common in trisomy 13 (T13) and trisomy 18 (T18), but surgical repair has not been offered in most centers. Data on outcomes of congenital heart surgery (CHS) for T13 and T18 are lacking. We sought to determine the impact of CHS on in-hospital mortality in T13 and T18. METHODS: Data from the 2004 to 2015 Pediatric Health Information System database were used to identify inpatients with T13 or T18 and CHD...
October 18, 2017: Pediatrics
https://www.readbyqxmd.com/read/29046386/social-determinants-of-health-and-hospital-readmission
#13
Yonit Lax, Maria Martinez, Nicole M Brown
No abstract text is available yet for this article.
October 18, 2017: Pediatrics
https://www.readbyqxmd.com/read/29046102/hip-fracture-surgery-in-mixed-use-emergency-theatres-is-the-infection-risk-increased-a-retrospective-matched-cohort-study
#14
S K Agarwal, A A Khan, M Solan, M Lemon
Introduction The National Institute of Health and Care Excellence recommends that people with hip fracture should have surgery on the day of, or the day after, admission. However, there remains unacceptable variation in performance around the country, with a range of 13-91% of patients meeting this target. Dedicated trauma lists have insufficient capacity in many hospitals. We occasionally employ a mixed-use emergency theatre to facilitate early surgery. Increased risk of infection has been raised as a concern owing to microbial surface contamination from a preceding unclean case and lack of laminar flow in these theatres...
October 19, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29045975/-comparison-and-discussion-of-different-surgical-methods-used-to-treat-vesicovaginal-fistulas
#15
W Y Zhang, H Hu, X P Zhang, Y R Sun, H R Wang, K X Xu
OBJECTIVE: To compare the feasibility and prognosis of different surgical methods used for vesicovaginal fistulas and to explore the value of electrocoagulation treating small ones. METHODS: The medical data of 19 patients who had undertaken transvaginal VVF repairs in Peking University People's Hospital between October 2008 and November 2016 were retrospectively collected. The follow-ups were performed. The patients' age ranged from 31 to 55 years with the median age of 48 years and the history length ranged from 1 month to 24 months with the median length of 3 months...
October 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/29045342/hypertensive-disorders-of-pregnancy-and-postpartum-readmission-in-the-united-states-national-surveillance-of-the-revolving-door
#16
Mulubrhan F Mogos, Jason L Salemi, Kiara K Spooner, Barbara L McFarlin, Hamisu H Salihu
OBJECTIVES: Hypertensive disorders of pregnancy (HDP) represent the most common cause of maternal-fetal morbidity and mortality. Yet, the prevalence and cost of postpartum (42-day) readmission (PPR) among HDP-complicated pregnancies in the United States remains unknown. This study provides national prevalence and cost estimates of HDP, and examine factors associated with potentially preventable PPR following HDP-complicated pregnancies. METHOD: The 2013 and 2014 Nationwide Readmissions Databases were used to investigate HDP and PPR among delivery hospitalizations to women aged 15-49 years...
October 16, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/29045205/effect-of-a-hospital-wide-measure-on-the-readmissions-reduction-program
#17
Rachael B Zuckerman, Karen E Joynt Maddox, Steven H Sheingold, Lena M Chen, Arnold M Epstein
BACKGROUND: The Hospital Readmissions Reduction Program penalizes hospitals that have high 30-day readmission rates across specific conditions. There is support for changing to a hospital-wide readmission measure to broaden hospital eligibility and provide incentives for improvement across more conditions. METHODS: We used Medicare claims from 2011 through 2013 to evaluate the number of hospitals that were eligible for penalties, in that they met a volume threshold of 25 admissions over a 3-year period for a specific condition or 25 admissions over a 1-year period for the cohorts included in the hospital-wide measure...
October 19, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29044643/fidaxomicin-versus-vancomycin-as-a-first-line-treatment-for-clostridium-difficile-associated-diarrhea-cdad-in-specific-patient-populations-a-pharmacoeconomic-evaluation
#18
Kelly R Reveles, Jennifer L Backo, Frank A Corvino, Marko Zivkovic, Kelly C Broderick
OBJECTIVES: The reduction in recurrent Clostridium difficile-associated diarrhea (CDAD) with fidaxomicin therapy may reduce hospital readmissions and lead to lower overall CDAD costs. However, studies assessing the cost-effectiveness of fidaxomicin as first-line therapy from the United States (US) hospital perspective are lacking. This study evaluated the costs associated with utilizing fidaxomicin or vancomycin as a first-line therapy for CDAD in specific patient populations from a US hospital perspective...
October 17, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29044457/secondary-prevention-medication-use-after-myocardial-infarction-in-u-s-nursing-home-residents
#19
Andrew R Zullo, Sadia Sharmin, Yoojin Lee, Lori A Daiello, Nishant R Shah, W John Boscardin, David D Dore, Sei J Lee, Michael A Steinman
BACKGROUND/OBJECTIVES: Secondary prevention medications are recommended for older adults after acute myocardial infarction (AMI), but little is known about whether nursing home (NH) residents receive these medications. The objective was to evaluate new use of secondary prevention medications after AMI in NH residents who were previously nonusers and to evaluate what factors were associated with use. DESIGN: Retrospective cohort using linked national Minimum Data Set assessments; Online Survey, Certification and Reporting records; and Medicare claims...
October 17, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29043966/hospital-at-home-a-review-of-our-experience
#20
Edmond C Y U, Glyn A Pryor, Martyn J Parker
INTRODUCTION: Hospital at home (HAH) is a service that provides home-based nursing and rehabilitation services whose aim is to prevent admission or to facilitate early discharge from care in an acute hospital. METHODS: We evaluated the effectiveness of early discharge hospital at home (HAH) schemes for hip fracture patients over a 27-year period in a district general hospital in the United Kingdom. A long-term database for audit and research purposes is maintained for all hip fracture patients admitted to Peterborough City Hospital...
2017: SICOT-J
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