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https://www.readbyqxmd.com/read/29783270/reducing-alarm-fatigue-in-two-neonatal-intensive-care-units-through-a-quality-improvement-collaboration
#1
Kendall R Johnson, James I Hagadorn, David W Sink
OBJECTIVE:  To reduce nonactionable oximeter alarms by 80% without increasing time infants were hypoxemic (oxygen saturation [SpO2 ] ≤ 80%) or hyperoxemic (SpO2  > 95% while on supplemental oxygen). STUDY DESIGN:  In 2015, a multidisciplinary team at Connecticut Children's Medical Center initiated a quality improvement project to reduce nonactionable oximeter alarms in two referral neonatal intensive care units (NICUs). Changes made through improvement cycles included reduction of the low oximeter alarm limit for specific populations, increased low alarm delay, development of postmenstrual age-based alarm profiles, and updated bedside visual reminders...
May 21, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29781978/mixed-methods-evaluation-of-real-time-safety-reporting-by-hospitalized-patients-and-their-care-partners-the-mysafecare-application
#2
Sarah A Collins, Brittany Couture, Ann DeBord Smith, Esteban Gershanik, Elizabeth Lilley, Frank Chang, Cathy Yoon, Stuart Lipsitz, Aziz Sheikh, James Benneyan, David W Bates
OBJECTIVE: The aims of the study were to evaluate the amount and content of data patients and care partners reported using a real-time electronic safety tool compared with other reporting mechanisms and to understand their perspectives on safety concerns and reporting in the hospital. METHODS: This study used mixed methods including 20-month preimplementation and postimplementation trial evaluating MySafeCare, a web-based application, which allows hospitalized patients/care partners to report safety concerns in real time...
April 27, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/29781924/changes-in-psychiatric-and-medical-conditions-and-health-care-utilization-following-a-diagnosis-of-sexual-assault-a-retrospective-cohort-study
#3
Kelly C Young-Wolff, Varada Sarovar, Daniella Klebaner, Felicia Chi, Brigid McCaw
INTRODUCTION: Sexual assault (SA) is alarmingly common and is associated with higher prevalence of psychiatric and medical conditions. However, many prior studies are limited to cross-sectional designs. Health care systems with electronic health records provide unique longitudinal data to examine whether SA is associated with changes in health and health care utilization. METHODS: The sample included 1350 Kaiser Permanente Northern California adult female patients with a SA diagnosis from 2009 to 2015 and 4050 adult female patients without a SA diagnosis, matched on age, medical facility, and continuous enrollment during the study period...
May 17, 2018: Medical Care
https://www.readbyqxmd.com/read/29781791/the-facilitators-and-challenges-of-dying-at-home-with-dementia-a-narrative-synthesis
#4
Caroline Mogan, Mari Lloyd-Williams, Karen Harrison Dening, Christopher Dowrick
BACKGROUND: It is reported that, given the right support, most people would prefer to die at home, yet a very small minority of people with dementia do so. At present, knowledge gaps remain on how best to support end-of-life care at home for people with dementia. AIM: To identify and understand the challenges and facilitators of providing end-of-life care at home for people with dementia. DESIGN: Narrative synthesis of qualitative and quantitative data...
June 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29781055/psychosocial-comorbidities-related-to-return-to-work-rates-following-aneurysmal-subarachnoid-hemorrhage
#5
Eleanor R Turi, Yvette Conley, Elizabeth Crago, Paula Sherwood, Samuel M Poloyac, Dianxu Ren, Ansley G Stanfill
Purpose Ability to return to work (RTW) after stroke has been shown to have positive psychosocial benefits on survivors. Although one-fifth of aneurysmal subarachnoid hemorrhage (aSAH) survivors suffer from poor psychosocial outcomes, the relationship between such outcomes and RTW post-stroke is not clear. This project explores the relationship between age, gender, race, marital status, anxiety and depression and RTW 3 and 12 months post-aSAH. Methods Demographic and clinical variables were collected from the electronic medical record at the time of aSAH admission...
May 21, 2018: Journal of Occupational Rehabilitation
https://www.readbyqxmd.com/read/29780773/clinical-characteristics-and-outcomes-of-placental-site-trophoblastic-tumor-experience-of-single-institution-in-korea
#6
Hye-Joo Lee, Wonkyo Shin, Yun Jeong Jang, Chel Hun Choi, Jeong-Won Lee, Duk-Soo Bae, Byoung-Gie Kim
Objective: Placental site trophoblastic tumor (PSTT) is the rarest form of gestational trophoblastic disease (GTD) and the optimum management is still controversial. In this study, we analyzed the clinical features, treatment, and outcomes of 6 consecutive patients with PSTT treated in our institution. Methods: The electronic medical record database of Samsung Medical Center was screened to identify patients with PSTT from 1994 to 2017. Medical records for the details of each patient's clinical features and treatment were extracted and reviewed...
May 2018: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/29780031/adolescent-self-consent-for-vaccinations-protocol-for-a-mixed-methods-systematic-review
#7
Harriet Fisher, Matthew Hickman, John Macleod, Suzanne Audrey
INTRODUCTION: The recent global expansion of routine adolescent vaccination programmes has the potential to protect young people against the acquisition of infectious disease and improve their health. Although in many countries the legal framework supports young people to provide consent for medical interventions if they are considered competent, written parental consent can act as a barrier to uptake as it is frequently a condition of adolescent vaccination programmes. The aim of this systematic review protocol is to document the methods which will be used to identify, appraise and synthesise the available qualitative and quantitative evidence to address: (1) whether implementation of adolescent self-consent procedures can increase vaccination uptake and (2) the barriers and facilitators to implementation of adolescent self-consent procedures...
May 20, 2018: BMJ Open
https://www.readbyqxmd.com/read/29779949/disease-heritability-inferred-from-familial-relationships-reported-in-medical-records
#8
Fernanda C G Polubriaginof, Rami Vanguri, Kayla Quinnies, Gillian M Belbin, Alexandre Yahi, Hojjat Salmasian, Tal Lorberbaum, Victor Nwankwo, Li Li, Mark M Shervey, Patricia Glowe, Iuliana Ionita-Laza, Mary Simmerling, George Hripcsak, Suzanne Bakken, David Goldstein, Krzysztof Kiryluk, Eimear E Kenny, Joel Dudley, David K Vawdrey, Nicholas P Tatonetti
Heritability is essential for understanding the biological causes of disease but requires laborious patient recruitment and phenotype ascertainment. Electronic health records (EHRs) passively capture a wide range of clinically relevant data and provide a resource for studying the heritability of traits that are not typically accessible. EHRs contain next-of-kin information collected via patient emergency contact forms, but until now, these data have gone unused in research. We mined emergency contact data at three academic medical centers and identified 7...
May 15, 2018: Cell
https://www.readbyqxmd.com/read/29779723/checking-the-potential-shift-to-perceived-usefulness-the-analysis-of-users-response-to-the-updated-electronic-health-record-core-features
#9
Petar Rajković, Dejan Aleksić, Dragan Janković, Aleksandar Milenković, Ivan Petković
OBJECTIVE: The primary objective of this paper is to identify the main factors which have an impact on the users' attitude towards the functionalities representing the perceived ease of use and to those representing the perceived usefulness. Another objective is to examine whether there occurred a shift towards the perceived usefulness of users' behavior over a period of time. To support these objectives, two different cases are examined - the case in which users are simultaneously offered basic and updated functionalities, and the one in which users are offered a completely new set of features...
July 2018: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29779713/regional-differences-in-electronic-medical-record-adoption-in-japan-a-nationwide-longitudinal-ecological-study
#10
Hideaki Kawaguchi, Soichi Koike, Kazuhiko Ohe
PURPOSE: Regional differences in the adoption of electronic medical records (EMR) are a major problem, yet little is known about these differences internationally. We analyzed regional differences in EMR adoption in Japan and evaluated factors associated with these differences. METHODS: This nationwide ecological study used secondary data from all secondary medical service areas (SMSAs) in fiscal years 2008 (n = 348) and 2014 (n = 344). For each SMSA we collected the following information from a Japanese national database: the number of medical facilities that had adopted EMR, the population density, the average per capita income, the number of working doctors per 1000 people, and the proportion of interns to all working doctors...
July 2018: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29779687/lack-of-improvement-in-antimicrobial-prescribing-after-a-diagnosis-of-clostridium-difficile-and-impact-on-recurrence
#11
Richard L Watson, Christopher J Graber
BACKGROUND: Antimicrobial use is one of the largest modifiable risk factors for development of Clostridium difficile infection (CDI). We sought to determine if a recent diagnosis of CDI affected the appropriateness of subsequent antimicrobial prescribing. METHODS: This study is a retrospective electronic chart review of the Greater Los Angeles Veterans Administration. Medication administration records were reviewed for all patients with new CDI from 2015-2016 to determine the appropriateness (drug choice, duration, and dosage) of all non-CDI antimicrobials prescribed within 90 days pre- and post-initial CDI (iCDI) positive testing...
May 17, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29779553/social-work-student-and-practitioner-roles-in-integrated-care-settings
#12
Erin P Fraher, Erica Lynn Richman, Lisa de Saxe Zerden, Brianna Lombardi
INTRODUCTION: Social workers are increasingly being deployed in integrated medical and behavioral healthcare settings but information about the roles they fill in these settings is not well understood. This study sought to identify the functions that social workers perform in integrated settings and identify where they acquired the necessary skills to perform them. METHODS: Master of social work students (n=21) and their field supervisors (n=21) who were part of a Health Resources and Services Administration-funded program to train and expand the behavioral health workforce in integrated settings were asked how often they engaged in 28 functions, where they learned to perform those functions, and the degree to which their roles overlapped with others on the healthcare team...
June 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29779480/production-and-characterization-of-nanoparticle-based-hyaluronate-gel-containing-retinyl-palmitate-for-wound-healing
#13
Elisabetta Esposito, Alessandra Pecorelli, Maddalena Sguizzato, Markus Drechsler, Paolo Mariani, Federica Carducci, Franco Cervellati, Rita Cortesi, Giuseppe Valacchi
BACKGROUND: Wound healing is a biological process that can get in a state of pathologic inflammation, requiring the use of specific medications able to promote proper tissue repair. OBJECTIVE: The study describes the production and characterization of nanoparticle based gel for wound healing treatment designed to deliver hyaluronic acid and retinyl palmitate onto the skin. METHOD: Tristearin solid lipid nanoparticles and nanostructured lipid carriers based on a tristearin and caprylic/capric triglyceride mixture were produced and characterized...
May 18, 2018: Current Drug Delivery
https://www.readbyqxmd.com/read/29779188/vitreomacular-interface-abnormalities-in-patients-with-diabetic-macular-oedema-and-their-implications-on-the-response-to-anti-vegf-therapy
#14
Michael Mikhail, Stephen Stewart, Felicia Seow, Ruth Hogg, Noemi Lois
PURPOSE: To determine whether the presence of vitreomacular interface abnormalities (VMIA) in patients with diabetic macular oedema (DMO) modifies the response to ranibizumab. METHODS: Medical records and spectral-domain optical coherence tomography (SD-OCT) scans of consecutive patients with centre-involving DMO initiating therapy with ranibizumab between December 2013 and March 2014 at the Belfast Health and Social Care Trust were reviewed. Patients were identified through an electronic database...
May 19, 2018: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/29778962/micro-porous-polyetheretherketone-implants-decorated-with-bmp-2-via-phosphorylated-gelatin-coating-for-enhancing-cell-adhesion-and-osteogenic-differentiation
#15
Jiuping Wu, Linlong Li, Chuan Fu, Fan Yang, Zixue Jiao, Xincui Shi, Yoshihiro Ito, Zongliang Wang, Qinyi Liu, Peibiao Zhang
Polyetheretherketone (PEEK) is a high-performance semicrystalline thermoplastic polymer that is widely used in the orthopedics treatment. However, due to its biological inertness, the surface modification of PEEK using different methods to improve the biocompatibility remains a significant challenge. Herein, we attempted to use the covalently coating of phosphorylated gelatin loaded with bone morphogenetic protein 2 (BMP-2) on hydroxylated micro-porous PEEK films for enhancing the biological activity. Environmental scanning electron microscope (ESEM), fourier transform infrared spectroscopy (FT-IR), X-ray photoelectron spectroscopy (XPS) and water contact angle measurements were applied to characterize the surface of modified or untreated PEEK films...
May 15, 2018: Colloids and Surfaces. B, Biointerfaces
https://www.readbyqxmd.com/read/29778301/behavioral-coping-plans-one-inter-professional-team-s-approach-to-patient-centered-care
#16
Katherine Wittling, Jessica Palumbo Dufur, Ashley McClain, Margaret Gettis
BACKGROUND: Surgical encounters for children with Autism Spectrum Disorder (ASD) are stressful to patients, families and health care providers. It is recognized that parents best anticipate needs of children with ASD. Including a family in the plan of care for the child is imperative. In response to the need for targeted, tailored care, an inter-professional surgical services team convened to determine best practices for addressing a behavioral and developmental plan for children with ASD in the surgical services arena...
May 17, 2018: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/29777388/a-retrospective-study-of-opioid-prescribing-patterns-at-hospital-discharge-in-surgical-patients-with-obstructive-sleep-apnea
#17
Samir M Kendale, Jing Wang, Jeanna D Blitz, Steven Calvino, Germaine Cuff, Nicholas Barone, Andrew D Rosenberg, Lisa Doan
PURPOSE: Obstructive sleep apnea (OSA) is a risk factor for complications with postoperative opioid use, and in those patients with known or suspected OSA, minimization of postoperative opioids is recommended. We hypothesize that despite these recommendations, surgical patients with known or suspected OSA are prescribed postoperative opioids at hospital discharge at similar doses to those without OSA. METHODS: This was a retrospective analysis of the electronic health records of surgical patients from 1 November 2016 to 30 April 2017 at a single academic institution...
May 18, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29777340/2017-update-of-the-turkish-league-against-rheumatism-tlar-evidence-based-recommendations-for-the-management-of-knee-osteoarthritis
#18
REVIEW
Tiraje Tuncer, Fatih Hasan Cay, Lale Altan, Gulcan Gurer, Cahit Kacar, Suheda Ozcakir, Sahap Atik, Figen Ayhan, Berrin Durmaz, Nurten Eskiyurt, Hakan Genc, Yesim GokceKutsal, Rezzan Gunaydin, Simin Hepguler, Sami Hizmetli, Taciser Kaya, Yesim Kurtais, Merih Saridogan, Dilsad Sindel, Serap Sutbeyaz, Omer Faruk Sendur, Hatice Ugurlu, Zeliha Unlu
In a Turkish League Against Rheumatism (TLAR) project, evidence-based recommendations for the management of knee osteoarthritis (OA) was developed for the first time in our country in 2012 (TLAR-2012). In accordance with developing medical knowledge and scientific evidence, recommendations were updated. The committee was composed of 22 physical medicine and rehabilitation specialists (4 have rheumatology subspeciality also) and an orthopaedic surgeon. Systematic literature search were applied on Pubmed, Embase, Cochrane and Turkish Medical Index for the dates between January the 1st 2012 and January the 29th of 2015...
May 17, 2018: Rheumatology International
https://www.readbyqxmd.com/read/29777125/development-of-an-algorithm-to-identify-patients-with-physician-documented-insomnia
#19
Uri Kartoun, Rahul Aggarwal, Andrew L Beam, Jennifer K Pai, Arnaub K Chatterjee, Timothy P Fitzgerald, Isaac S Kohane, Stanley Y Shaw
We developed an insomnia classification algorithm by interrogating an electronic medical records (EMR) database of 314,292 patients. The patients received care at Massachusetts General Hospital (MGH), Brigham and Women's Hospital (BWH), or both, between 1992 and 2010. Our algorithm combined structured variables (such as International Classification of Diseases 9th Revision [ICD-9] codes, prescriptions, laboratory observations) and unstructured variables (such as text mentions of sleep and psychiatric disorders in clinical narrative notes)...
May 18, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29777021/serum-6-bromotryptophan-levels-identified-as-a-risk-factor-for-ckd-progression
#20
Adrienne Tin, Girish Nadkarni, Anne M Evans, Cheryl A Winkler, Erwin Bottinger, Casey M Rebholz, Mark J Sarnak, Lesley A Inker, Andrew S Levey, Michael S Lipkowitz, Lawrence J Appel, Dan E Arking, Josef Coresh, Morgan E Grams
Background Metabolite levels reflect physiologic homeostasis and may serve as biomarkers of disease progression. Identifying metabolites associated with APOL1 risk alleles-genetic variants associated with CKD risk commonly present in persons of African descent-may reveal novel markers of CKD progression relevant to other populations. Methods We evaluated associations between the number of APOL1 risk alleles and 760 serum metabolites identified via untargeted profiling in participants of the African American Study of Kidney Disease and Hypertension (AASK) ( n =588; Bonferroni significance threshold P <6...
May 18, 2018: Journal of the American Society of Nephrology: JASN
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