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https://www.readbyqxmd.com/read/29454135/short-term-outcomes-following-posterior-cervical-fusion-among-octogenarians-with-cervical-spondylotic-myelopathy-a-nsqip-database-analysis
#1
Caroline E Vonck, Joseph E Tanenbaum, Thomas T Bomberger, Edward C Benzel, Jason W Savage, Iain H Kalfas, Thomas E Mroz, Michael P Steinmetz
BACKGROUND: Context: Degenerative changes in the cervical spine occur in an age-dependent manner. As the U.S. population continues to age, the incidence of age-dependent, multi-level, degenerative cervical pathologies is expected to increase. Similarly, the average age of patients with cervical spondylotic myelopathy (CSM) will likely trend upward. Posterior cervical fusion (PCF) is often the treatment modality of choice in the management of multi-level cervical spine disease. Although outcomes following anterior cervical fusion for degenerative disease have been studied among older patients (aged 80 years and older), it is unknown if these results extend to octogenarian patients undergoing PCF for the surgical management of CSM...
February 14, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29447854/risk-factors-associated-complications-for-postoperative-urinary-retention-after-lumbar-surgery-for-lumbar-spinal-stenosis
#2
Joshua L Golubovsky, Haariss Ilyas, Jinxiao Chen, Joseph E Tanenbaum, Thomas E Mroz, Michael P Steinmetz
BACKGROUND CONTEXT: Postoperative Urinary Retention (POUR) is a very common post-operative complication of all surgeries (5 - 70%) that may lead to complications such as urinary tract infection (UTI), bladder over-distention, autonomic dysregulation, and increased postoperative length of stay (LOS). Within the field of spine surgery, the reported incidence of POUR is highly variable (5.6 - 38%). Lack of clear stratification of surgical level, spinal pathology, and inadequate sample size is a major limitation of available studies concerning POUR following spine surgery that may lead to inconsistency in the incidence of POUR and the ability to model its occurrence and consequences...
February 12, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29442297/a-single-center-cost-analysis-of-treating-primary-and-metastatic-brain-cancers-with-either-brain-laser-interstitial-thermal-therapy-litt-or-craniotomy
#3
Eric C Leuthardt, Jeff Voigt, Albert H Kim, Pete Sylvester
BACKGROUND: Brain laser interstitial thermal therapy (LITT) under magnetic resonance imaging (MRI) guidance has recently gained US clinical approval for the ablation of soft, neurological tissue. LITT is a minimally invasive alternative to craniotomy. OBJECTIVE: While safety and efficacy are the focus of most current LITT studies, it is unclear how acute care costs (inpatient care ± aftercare) of LITT compare to craniotomy in an academic medical center. Therefore, the purpose of this analysis is to examine these costs of using brain LITT under MRI guidance compared to craniotomy in complex anatomies...
March 2017: PharmacoEconomics Open
https://www.readbyqxmd.com/read/29438790/cervical-spinal-fusion-16-year-trends-in-epidemiology-indications-and-in-hospital-outcomes-by-surgical-approach
#4
Stephan N Salzmann, Peter B Derman, Lukas P Lampe, Janina Kueper, Ting Jung Pan, Jingyan Yang, Jennifer Shue, Federico P Girardi, Stephen Lyman, Alexander P Hughes
BACKGROUND: The rate of cervical spinal fusion has been increasing significantly. However, there is paucity of literature describing trends based on surgical approach using complete population databases. We investigated the approach-based trends in epidemiology, indications and in-hospital outcomes of cervical spinal fusion. METHODS: New York's Statewide Planning and Research Cooperative System database was queried to identify patients who underwent primary subaxial cervical fusion from 1997-2012...
February 10, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29429881/short-term-morbidity-and-readmissions-increase-with-skilled-nursing-facility-discharge-after-total-joint-arthroplasty-in-a-medicare-eligible-and-skilled-nursing-facility-eligible-patient-cohort
#5
Jessell M Owens, John J Callaghan, Kyle R Duchman, Nicholas A Bedard, Jesse E Otero
BACKGROUND: The benefits of discharge to a skilled nursing facility (SNF) in Medicare-eligible patients after total joint arthroplasty (TJA) have recently been scrutinized. The purpose of this study was to determine short-term complication and readmission rates for SNF versus home discharge in patients eligible for Medicare and SNF discharge. METHODS: Patients who underwent TJA between 2012 and 2013 were identified in the National Surgical Quality Improvement Project database...
January 11, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29428772/the-effect-of-integration-of-hospitals-and-post-acute-care-providers-on-medicare-payment-and-patient-outcomes
#6
R Tamara Konetzka, Elizabeth A Stuart, Rachel M Werner
In this paper we examine empirically the effect of integration on Medicare payment and rehospitalization. We use 2005-2013 data on Medicare beneficiaries receiving post-acute care (PAC) in the U.S. to examine integration between hospitals and the two most common post-acute care settings: skilled nursing facilities (SNFs) and home health agencies (HHA), using two measures of integration-formal vertical integration and informal integration representing preferential relationships between providers without formal relationships...
February 7, 2018: Journal of Health Economics
https://www.readbyqxmd.com/read/29427179/evaluating-the-quality-of-patient-decision-making-regarding-post-acute-care
#7
Robert E Burke, Jacqueline Jones, Emily Lawrence, Amy Ladebue, Roman Ayele, Chelsea Leonard, Brandi Lippmann, Daniel D Matlock, Rebecca Allyn, Ethan Cumbler
BACKGROUND: Despite a national focus on post-acute care brought about by recent payment reforms, relatively little is known about how hospitalized older adults and their caregivers decide whether to go to a skilled nursing facility (SNF) after hospitalization. OBJECTIVE: We sought to understand to what extent hospitalized older adults and their caregivers are empowered to make a high-quality decision about utilizing an SNF for post-acute care and what contextual or process elements led to satisfaction with the outcome of their decision once in SNF...
February 9, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29422170/-mobile-technology-to-improve-heart-failure-outcomes-a-proof-of-concept-paper
#8
Ponrathi Athilingam, Bradlee A Jenkins, Heather Zumpano, Miguel A Labrador
BACKGROUND: Heart failure (HF) causes significant symptom burden and human suffering with considerable economic burden due to hospital readmissions. Targeted interventions to encourage and support self-management behavior is warranted. AIM: To test the proof of concept of a mobile application (HeartMapp) in improving self-care management of patients with heart failure. METHOD: An exploratory inquiry used a field study strategy with purposeful sampling and constant comparative analysis to test the proof of concept of HeartMapp using The Business Model Canvas framework...
February 2018: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/29407255/using-research-evidence-to-inform-staff-learning-needs-in-cross-cultural-communication-in-aged-care-homes
#9
David Gillham, Anita De Bellis, Lily Xiao, Eileen Willis, Ann Harrington, Wendy Morey, Lesley Jeffers
BACKGROUND: Developed countries worldwide are facing an unprecedented demand for aged care services, with recent migrants of diverse linguistic and cultural backgrounds increasingly recruited as care workers while at the same time there is growing cultural diversity among aged care residents. This situation is compounded by rapidly changing technology and varied educational levels of care workers from diverse backgrounds. OBJECTIVES: The objectives were threefold: to identify staff learning needs to enable them to provide high-quality cross-cultural care; to improve team cohesion; and identify preferred learning approaches...
February 2, 2018: Nurse Education Today
https://www.readbyqxmd.com/read/29405592/increased-mortality-in-octogenarians-treated-for-lifestyle-limiting-claudication
#10
Y Erben, C I Mena-Hurtado, S M Miller, R A Jean, B J Sumpio, C A Velasquez, H Mojibian, J Aruny, A Dardik, B E Sumpio
OBJECTIVE: Treatment for lifestyle limiting claudication (LLC) that is due to infra-inguinal peripheral artery disease relies on either bypass, angioplasty, and/or stenting. Given the enthusiasm and shift toward more endovascular therapy for treatment of LLC, we sought to analyze whether octogenarians benefit from infra-inguinal interventions in the same manner as their younger counterparts. METHODS: We identified all patients admitted for elective treatment of LLC from the Nationwide Inpatient Sample from 2003 to 2012, who received open surgical or endovascular intervention for infra-inguinal peripheral arterial disease...
February 6, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29404575/factors-associated-with-variation-in-long-term-acute-care-hospital-vs-skilled-nursing-facility-use-among-hospitalized-older-adults
#11
Anil N Makam, Oanh Kieu Nguyen, Lei Xuan, Michael E Miller, James S Goodwin, Ethan A Halm
Importance: Despite providing an overlapping level of care, it is unknown why hospitalized older adults are transferred to long-term acute care hospitals (LTACs) vs less costly skilled nursing facilities (SNFs) for postacute care. Objective: To examine factors associated with variation in LTAC vs SNF transfer among hospitalized older adults. Design, Setting, and Participants: We conducted this retrospective observational cohort study of hospitalized older adults (≥65 years) transferred to an LTAC vs SNF during fiscal year 2012 using national 5% Medicare data...
February 5, 2018: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29397032/impact-of-gastrostomy-feeding-tube-placement-on-the-1-year-trajectory-of-care-in-patients-after-stroke
#12
Janina Wilmskoetter, Annie N Simpson, Sarah L Logan, Kit N Simpson, Heather S Bonilha
BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) feeding tubes are commonly placed in acute stroke patients with a need for enteral nutrition. However, PEG tubes are associated with medical complications and a decrease in quality of life. We compared the 1-year care trajectory of stroke patients with and without PEG tube placement to enhance knowledge about the long-term impact of PEG tube placement. METHODS: We conducted a retrospective analysis of commercially insured stroke patients included in the Truven Health MarketScan Research Databases of 2011...
February 3, 2018: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/29396165/sustainability-of-a-nurse-driven-early-progressive-mobility-protocol-and-patient-clinical-and-psychological-health-outcomes-and-in-a-neurological-intensive-care-unit
#13
Kate E Klein, James F Bena, Malissa Mulkey, Nancy M Albert
OBJECTIVES: To determine sustainable impact of an early progressive mobility protocol on mobility level and clinical outcomes. DESIGN/METHODS: Prospective, longitudinal, comparative study using three time points (pre-, immediate post-intervention and 12-month post-intervention sustainability). Analyses included comparative statistics and multivariable modelling. Data were collected by clinical nurses, from administrative databases. Psychological health data were collected using a valid, reliable tool...
January 31, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29391101/comparative-analysis-of-laparoscopic-and-open-approaches-in-emergency-abdominal-surgery
#14
Anaar Siletz, Jonathan Grotts, Catherine Lewis, Areti Tillou, Henry Magill Cryer, Ali Cheaito
The objective of this study was to evaluate usage and outcomes of emergency laparoscopic versus open surgery at a single tertiary academic center. Over a three-year period 165 patients were identified retrospectively using National Surgical Quality Improvement Program results. Appendectomies and cholecystectomies were excluded. Open and laparoscopic approaches were compared regarding preoperative and operative characteristics, the development of postoperative complications, 30-day mortality, and length of hospital stay...
October 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29387881/knowledge-confidence-and-practice-patterns-of-speech-language-pathologists-working-with-adults-with-traumatic-brain-injury
#15
Sarah Riedeman, Lyn Turkstra
Purpose: Although speech-language pathologists (SLPs) are important members of the health care team serving adults with traumatic brain injury (TBI) with cognitive-communication disorders, little is known about services SLPs deliver and how they rate their own knowledge and skills. The aims of this study were to identify practice patterns, knowledge, and confidence levels of SLPs working with adults with TBI with cognitive-communication disorders. Method: We surveyed 100 SLPs from rural and urban hospitals, skilled nursing facilities, and outpatient clinics in Wisconsin and analyzed data descriptively...
February 6, 2018: American Journal of Speech-language Pathology
https://www.readbyqxmd.com/read/29385256/implementing-a-cardiac-skills-orientation-and-simulation-program
#16
Maureen W Hemingway, Patrice Osgood, Mildred Mannion
Patients with cardiac morbidities admitted for cardiac surgical procedures require perioperative nurses with a high level of complex nursing skills. Orienting new cardiac team members takes commitment and perseverance in light of variable staffing levels, high-acuity patient populations, an active cardiac surgical schedule, and the unpredictability of scheduling patients undergoing cardiac transplantation. At an academic medical center in Boston, these issues presented opportunities to orient new staff members to the scrub person role, but hampered efforts to provide active learning opportunities in a safe environment...
February 2018: AORN Journal
https://www.readbyqxmd.com/read/29384585/continuing-education-preferences-facilitators-and-barriers-for-nursing-home-nurses
#17
Mary J Dyck, Myoung Jin Kim
BACKGROUND: The purpose of the study was to determine the continuing education needs for nursing home nurses in rural central Illinois and to determine any potential facilitators or barriers to obtaining continuing education. METHOD: Data were collected using the Educational Needs Assessment questionnaire. Descriptive statistics were computed to examine continuing education preferences, facilitators, and barriers among nursing home nurses. Independent samples t tests were used to compare preferences between administrative and staff nurses...
January 1, 2018: Journal of Continuing Education in Nursing
https://www.readbyqxmd.com/read/29381678/hospital-discharge-and-selecting-a-skilled-nursing-facility-a-comparison-of-experiences-and-perspectives-of-patients-and-their-families
#18
(no author information available yet)
No abstract text is available yet for this article.
March 2018: Professional Case Management
https://www.readbyqxmd.com/read/29381669/hospital-discharge-and-selecting-a-skilled-nursing-facility-a-comparison-of-experiences-and-perspectives-of-patients-and-their-families
#19
Dara H Sorkin, Alpesh Amin, David L Weimer, Joseph Sharit, Heather Ladd, Dana B Mukamel
PURPOSE OF STUDY: A currently proposed rule by the Centers for Medicare & Medicaid Services would require providers to devote more resources to discharge planning from hospitals to ensure the prioritization of patient preferences and goals in the discharge planning process. Annually, more than 3 million persons enter a nursing home in the United States, with the vast majority of patients coming directly from hospitals. Although early evidence suggests more family involvement than patient involvement in the discharge process, most of this work has relied on retrospective reports of the decision-making process postplacement...
March 2018: Professional Case Management
https://www.readbyqxmd.com/read/29378577/risks-predicting-prolonged-hospital-discharge-boarding-in-a-regional-acute-care-hospital
#20
Sajid A Shaikh, Richard D Robinson, Radhika Cheeti, Shyamanand Rath, Chad D Cowden, Frank Rosinia, Nestor R Zenarosa, Hao Wang
BACKGROUND: Prolonged hospital discharge boarding can impact patient flow resulting in upstream Emergency Department crowding. We aim to determine the risks predicting prolonged hospital discharge boarding and their direct and indirect effects on patient flow. METHODS: Retrospective review of a single hospital discharge database was conducted. Variables including type of disposition, disposition boarding time, case management consultation, discharge medications prescriptions, severity of illness, and patient homeless status were analyzed in a multivariate logistic regression model...
January 30, 2018: BMC Health Services Research
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