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https://www.readbyqxmd.com/read/28812056/initiating-a-standardized-regional-referral-and-counter-referral-system-in-guatemala-a-mixed-methods-study
#1
Rupa Kapoor, Leslie Avendaño, Maria Antonieta Sandoval, Andrea T Cruz, Esther M Sampayo, Miguel A Soto, Elizabeth A Camp, Heather L Crouse
Background:Few data exist for referral processes in resource-limited settings. We utilized mixed-methods to evaluate the impact of a standardized algorithm and training module developed for locally identified needs in referral/counter-referral procedures between primary health centers (PHCs) and a Guatemalan referral hospital. Methods: PHC personnel and hospital physicians participated in surveys and focus groups pre-implementation and 3, 6, and 12 months post-implementation to evaluate providers' experience with the system...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/28811137/influence-of-guidelines-on-management-of-paediatric-mild-traumatic-brain-injury-ct-assessment-and-admission-policy
#2
J J Lenstra, A R A Pikstra, J M Fock, Z Metting, J van der Naalt
BACKGROUND: The annual number of paediatric injury-related emergency visits and application of computed tomography (CT) has substantially increased, with associated higher risk of malignancies. In 2010, a guideline for CT-assessment based on risk factors for patients with mild traumatic brain injury (mTBI) became effective in all Emergency Departments (ED) in the Netherlands. This study evaluated the influence of this guideline on the frequency of CT-assessments, hospital admissions and factors that are related to guideline adherence...
August 3, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/28811042/understanding-readmissions-in-children-undergoing-surgery-a-pediatric-nsqip-analysis
#3
Afif N Kulaylat, Dorothy V Rocourt, Anthony Y Tsai, Kathryn L Martin, Brett W Engbrecht, Mary C Santos, Robert E Cilley, Christopher S Hollenbeak, Peter W Dillon
BACKGROUND: Readmission is increasingly being utilized as an important clinical outcome and measure of hospital quality. Our aim was to delineate rates, risk factors, and reasons for unplanned readmission in pediatric surgery. MATERIALS AND METHODS: Retrospective review of pediatric patients (n=130,274) undergoing surgery (2013-2014) at hospitals enrolled in the Pediatric National Surgical Quality Improvement Program (NSQIP-P) was performed. Logistic regression was used to model factors associated with unplanned 30-day readmission...
July 31, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28810931/a-comprehensive-regional-clinical-and-educational-ecpr-protocol-decreases-time-to-ecmo-in-patients-with-refractory-out-of-hospital-cardiac-arrest
#4
Brian Grunau, Sarah Carrier, Jamil Bashir, William Dick, Luke Harris, Robert Boone, Dan Kalla, Frank Scheuermeyer, Brian Twaites, Ron Straight, James Abel, Ken McDonald, Ruth MacRedmond, David Agulnik, Joe Finkler, Jeanne MacLeod, Jim Christenson, Anson Cheung
OBJECTIVE: Extracorporeal membrane oxygenation within CPR (ECPR) may improve survival for refractory out-of-hospital cardiac arrest (OHCA). We developed a prehospital, emergency department (ED), and hospital-based clinical and educational protocol to improve the key variable of time-to-ECPR (TTE). METHODS: In a single urban health region we involved key prehospital, clinical, and administrative stakeholders over a 2-year period, to develop a regional ECPR program with destination to a single urban tertiary care hospital...
August 16, 2017: CJEM
https://www.readbyqxmd.com/read/28810133/floor-of-mouth-hematoma-following-dental-implant-placement-systematic-review-and-case-presentation
#5
REVIEW
Catherine Law, Peyman Alam, Farzad Borumandi
PURPOSE: The authors provide a structured review of reported cases of floor-of-mouth hematoma during or after dental implantation and frequent causes and management and present a related case. MATERIALS AND METHODS: An online search of the medical literature was conducted from 1990 through 2016. The following search terms were used: floor of mouth hematoma, sublingual hematoma, dental implant hematoma, implant in mandible, and complication of dental implant. Abstracts were screened for relevance to the aims of the review...
July 21, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28808892/incidence-rates-and-predictors-of-colectomy-for-ulcerative-colitis-in-the-era-of-biologics-results-from-a-provincial-database
#6
Maria Abou Khalil, Marylise Boutros, Hacene Nedjar, Nancy Morin, Gabriela Ghitulescu, Carol-Ann Vasilevsky, Philip Gordon, Elham Rahme
BACKGROUND: We evaluated long-term incidence and identified risk factors of colectomy in pre-biologics and biologics eras for treatment of ulcerative colitis. METHODS: After IRB approval, using data obtained from the Régie d'assurance maladie du Québec, we defined two cohorts: pre-biologics (1998-2004) and biologics (2005-2011) eras. Patients with inflammatory bowel disease or colectomy 1 year prior to first diagnosis of ulcerative colitis were excluded. Multivariate logistic regression model compared patient baseline characteristics...
August 14, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28807696/a-tailored-intervention-to-improving-the-quality-of-intrahospital-nursing-handover
#7
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/28807456/post-hospitalization-experiences-of-older-adults-diagnosed-with-diabetes-it-was-daunting
#8
Jacqueline B La Manna, Angeline Bushy, Denise Gammonley
Multimorbidity combined with geriatric syndromes in older adults with diabetes exacerbate their risks for poor post-discharge outcomes. The purpose of this study was to examine self-described hospital-to-home transition challenges encountered by older adults with a diagnosis of diabetes within the first 30 days following discharge. The qualitative responses for this paper emerged from a larger mixed methods study (n = 96) in which participants provided free responses specifying transition challenges during follow-up telephone interviews on the 7th day (n = 67) and 30th day (n = 55) post-discharge...
August 11, 2017: Geriatric Nursing
https://www.readbyqxmd.com/read/28807442/age-is-related-to-neurological-outcome-in-patients-with-out-of-hospital-cardiac-arrest-ohca-receiving-therapeutic-hypothermia-th
#9
Se Jong Oh, Jin Joo Kim, Jae Ho Jang, In Cheol Hwang, Jae Hyuk Woo, Yong Su Lim, Hyuk Jun Yang
INTRODUCTION: In this study, we retrospectively reviewed the patients' outcomes after cardiac arrest based on age in one center, to determine whether geriatric patients had worse outcomes. METHODS: This was a single-center, retrospective cohort study. The patients admitted to the intensive care unit on successful resuscitation after OHCA were retrospectively identified and evaluated. RESULTS: This was a retrospective cohort study of patients over 18years of-age with return of spontaneous circulation (ROSC) (>24h) after cardiac arrest who were admitted to the emergency intensive care unit (EICU) and received post-cardiac arrest care between March 2007 and December 2013...
July 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28806942/impact-of-inpatient-care-in-emergency-department-on-outcomes-a-quasi-experimental-cohort-study
#10
Aisha Lateef, Soo Hoon Lee, Dale Andrew Fisher, Wei-Ping Goh, Hui Fen Han, Uma Chandra Segara, Tiong Beng Sim, Malcolm Mahadehvan, Khean Teik Goh, Noel Cheah, Aymeric Yt Lim, Phillip H Phan, Reshma A Merchant
BACKGROUND: Hospitals around the world are faced with the issue of boarders in emergency department (ED), patients marked for admission but with no available inpatient bed. Boarder status is known to be associated with delayed inpatient care and suboptimal outcomes. A new care delivery system was developed in our institution where boarders received full inpatient care from a designated medical team, acute medical team (AMT), while still residing at ED. The current study examines the impact of this AMT intervention on patient outcomes...
August 14, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28805455/the-effect-of-a-peer-support-intervention-on-early-recovery-outcomes-in-men-recovering-from-coronary-bypass-surgery-a-randomized-controlled-trial
#11
Tracey Jf Colella, Kathryn King-Shier
BACKGROUND AND AIM: Examine the effect of a professionally-guided telephone peer support intervention on recovery outcomes including depression, perceived social support, and health services utilization after coronary artery bypass graft surgery (CABG). METHODS: A randomized controlled trial was conducted with post-coronary artery bypass graft surgery men ( N=185) who were randomized before hospital discharge. The intervention arm received telephone-based peer support through weekly telephone calls from a peer volunteer over six weeks, initiated within 3-4 days of discharge...
August 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28800938/using-hospital-use-trends-to-improve-transitional-care
#12
Joe Feinglass, Celeste A Mallama, Angela Rogers, Caroline Teter, Courtney Hurt, Christine Schaeffer
BACKGROUND: This study evaluates the Northwestern Medicine Group Transitional Care clinic (NMG-TC), which transitions patients from an urban hospital to primary care at partner community clinics. We evaluate change over the 55 month study period in emergency department, observation or inpatient use within 90 days of an initial NMG-TC visit. METHODS: Electronic health records were used to determine patient demographic, insurance and clinical characteristics, including inflation-adjusted total hospital charges in the 90 days prior and the 90 days after an initial NMG-TC visit...
August 8, 2017: Healthcare
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
#13
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/28795066/otolaryngological-presentations-in-times-of-terror-profile-from-a-tertiary-health-center-in-north-central-nigeria
#14
Adeyi A Adoga, Daniel D Kokong, Kenneth N Ozoilo
OBJECTIVES: To report the incidence, socio-demographic characteristics, otorhinolaryngological presentations and outcomes of management of patients at the Jos University Teaching Hospital following terror attacks. METHODS: A prospective descriptive hospital based study of consecutive patients presenting with ear, nose and throat injuries as a result of bomb blasts and ethno-religious crises within a six-year period and managed at the Jos University Teaching Hospital were studied for age, gender, ear, nose and throat presentations, injury mechanism, interventions and outcome of interventions...
July 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/28792986/-implementation-of-the-mobile-emergency-medical-service-in-brazil-action-strategies-and-structural-dimension
#15
Gisele O'Dwyer, Mariana Teixeira Konder, Luciano Pereira Reciputti, Cesar Macedo, Monica Guimarães Macau Lopes
The Mobile Emergency Medical Service (SAMU) was the first component of the National Policy for Emergency Care implemented in Brazil in the early 2000. The article analyzed the implementation of mobile pre-hospital emergency care in Brazil. The methods included document analysis, interviews with state emergency care coordinators, and an expert panel. The theoretical reference was the strategic conduct analysis from Giddens' Structuration Theory. The results showed uneven implementation of the SAMU between states and regions of Brazil, identifying six patterns of implementation, considering the states' capacity to expand the population coverage and regionalize the service...
August 7, 2017: Cadernos de Saúde Pública
https://www.readbyqxmd.com/read/28792256/triage-of-septic-patients-using-qsofa-criteria-at-the-samu-regulation-a-retrospective-analysis
#16
R Jouffroy, A Saade, A Carpentier, S Ellouze, P Philippe, R Idialisoa, P Carli, B Vivien
PURPOSE: One of the major prognostic factors in the management of sepsis is the early initiation of appropriate treatment. To serve this purpose, early identification and triage of patients are crucial steps, which are still not optimal. The objective of this study was to determine whether the quick Sequential (Sepsis-related) Organ Failure Assessment (qSOFA) score is an accurate method for prehospital triaging of septic patients. We evaluated whether the use of qSOFA criteria collected by the Service Mobile d'Urgence et de Réanimation 15 (SAMU 15) regulation call center during prehospital care would facilitate appropriate intensive care unit (ICU) admission of patients with septic syndromes...
August 9, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28789790/depression-anxiety-quality-of-life-and-predictors-of-depressive-disorders-in-caregivers-of-patients-with-head-and-neck-cancer-a-six-month-follow-up-study
#17
Chun-Yi Lee, Yu Lee, Liang-Jen Wang, Chih-Yen Chien, Fu-Min Fang, Pao-Yen Lin
OBJECTIVE: Caregivers of patients with cancer experience a variety of psychological distress. This study aimed to investigate the mental health status and depressive disorder predictors in caregivers of patients with head and neck cancer (HNC) over a six-month follow-up. METHODS: We recruited the participants for this study from a HNC outpatient clinic in a medical center from February 2012 to January 2013. Caregivers of HNC patients were evaluated with the Structured Clinical Interview for the DSM-IV, Clinician Version, the Hospital Anxiety and Depression Scale, the Short Form 36 Health Survey (SF-36), and the Family APGAR index...
September 2017: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/28782875/comparison-of-trauma-care-systems-in-asian-countries-a-systematic-literature-review
#18
Se Jin Choi, Moon Young Oh, Na Rae Kim, Yoo Joong Jung, Young Sun Ro, Sang Do Shin
OBJECTIVE: The study aims to compare the trauma care systems in Asian countries. METHODS: Asian countries were categorised into three groups; 'lower middle-income country', 'upper middle-income country' and 'high-income country'. The Medline/PubMed database was searched for articles published from January 2005 to December 2014 using relevant key words. Articles were excluded if they examined a specific injury mechanism, referred to a specific age group, and/or did not have full text available...
August 7, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28780916/assessing-and-improving-hospital-mass-casualty-preparedness-a-no-notice-exercise
#19
Daniel A Waxman, Edward W Chan, Francesca Pillemer, Timothy Wj Smith, Mahshid Abir, Christopher Nelson
In recent years, mass-casualty incidents (MCIs) have become more frequent and deadly, while emergency department (ED) crowding has grown steadily worse and widespread. The ability of hospitals to implement an effective mass-casualty surge plan, immediately and expertly, has therefore never been more important. Yet, mass-casualty exercises tend to be highly choreographed, pre-scheduled events that provide limited insight into hospitals' true capacity to respond to a no-notice event under real-world conditions...
August 7, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28777020/direct-medical-costs-of-treatment-in-newly-diagnosed-high-grade-glioma-among-commercially-insured-us-patients
#20
Shan Jiang, Kala Hill, Dipen Patel, A Reginald Waldeck, Marc Botteman, Abdalla Aly, Andrew D Norden
AIM: This analysis assessed the direct medical costs of newly-diagnosed, temozolomide (TMZ)-treated glioblastoma (GBM) from the perspective of a US commercial setting. MATERIALS AND METHODS: The analysis included subjects identified from the IMS PharMetrics LifeLink Plus™ claims database from January 1, 2008 to August 31, 2014 who were ≥18 years of age, had ≥1 malignant brain cancer diagnosis, had brain surgery ≤90 days prior to TMZ initiation, had TMZ treatment, and were continuously enrolled for ≥12 months pre-diagnosis and ≥1 month post-diagnosis...
August 16, 2017: Journal of Medical Economics
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