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https://www.readbyqxmd.com/read/28789825/the-effect-of-the-quality-of-vital-sign-recording-on-clinical-decision-making-in-a-regional-acute-care-trauma-ward
#1
Claire M Keene, Victor Y Kong, Damian L Clarke, Petra Brysiewicz
PURPOSE: Recording vital signs is important in the hospital setting and the quality of this documentation influences clinical decision making. The Modified Early Warning Score (MEWS) uses vital signs to categorise the severity of a patient's physiological derangement and illustrates the clinical impact of vital signs in detecting patient deterioration and making management decisions. This descriptive study measured the quality of vital sign recordings in an acute care trauma setting, and used the MEWS to determine the impact the documentation quality had on the detection of physiological derangements and thus, clinical decision making...
July 5, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28771487/cardiorespiratory-dynamics-measured-from-continuous-ecg-monitoring-improves-detection-of-deterioration-in-acute-care-patients-a-retrospective-cohort-study
#2
Travis J Moss, Matthew T Clark, James Forrest Calland, Kyle B Enfield, John D Voss, Douglas E Lake, J Randall Moorman
BACKGROUND: Charted vital signs and laboratory results represent intermittent samples of a patient's dynamic physiologic state and have been used to calculate early warning scores to identify patients at risk of clinical deterioration. We hypothesized that the addition of cardiorespiratory dynamics measured from continuous electrocardiography (ECG) monitoring to intermittently sampled data improves the predictive validity of models trained to detect clinical deterioration prior to intensive care unit (ICU) transfer or unanticipated death...
2017: PloS One
https://www.readbyqxmd.com/read/28763311/inter-rater-reliability-of-two-paediatric-early-warning-score-tools
#3
Claus S Jensen, Hanne Aagaard, Hanne V Olesen, Hans Kirkegaard
BACKGROUND: Paediatric early warning score (PEWS) assessment tools can assist healthcare providers in the timely detection and recognition of subtle patient condition changes signalling clinical deterioration. However, PEWS tools instrument data are only as reliable and accurate as the caregivers who obtain and document the parameters. OBJECTIVE: The aim of this study is to evaluate inter-rater reliability among nurses using PEWS systems. DESIGN: The study was carried out in five paediatrics departments in the Central Denmark Region...
July 31, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28762646/predicting-unplanned-readmissions-to-a-pediatric-cardiac-intensive-care-unit-using-predischarge-pediatric-early-warning-scores
#4
Ashley R Kroeger, Jacqueline Morrison, Andrew H Smith
OBJECTIVE: Unplanned readmission to the pediatric cardiac intensive care unit (CICU) is associated with significant morbidity and mortality. The Pediatric Early Warning Score (PEWS) predicts ward patients at risk for decompensation but has not been previously reported to identify at-risk patients with cardiac disease prior to ward transfer. This study aimed to determine whether PEWS prior to transfer may serve as a predictor of unplanned readmission to the CICU. DESIGN: All patients discharged from a tertiary children's hospital CICU from September 2012 through August 2015 were included for analysis...
August 1, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28749356/improving-alzheimeres-disease-classification-by-combining-multiple-measures
#5
Jin Liu, Jianxin Wang, Zhenjun Tang, Bin Hu, Fang-Xiang Wu, Yi Pan
Several anatomical magnetic resonance imaging (MRI) markers for Alzheimer's disease (AD) have been identified. Cortical gray matter volume, cortical thickness, and subcortical volume have been used successfully to assist the diagnosis of Alzheimer's disease (AD) including its early warning and developing stages, e.g., mild cognitive impairment (MCI) including MCI converted to AD (MCIc) and MCI not converted to AD (MCInc). Currently, these anatomical MRI measures have mainly been used separately. Thus, the full potential of anatomical MRI scans for AD diagnosis might not yet have been used optimally...
July 25, 2017: IEEE/ACM Transactions on Computational Biology and Bioinformatics
https://www.readbyqxmd.com/read/28743479/integrating-heart-rate-variability-vital-signs-electrocardiogram-and-troponin-to-triage-chest-pain-patients-in-the-ed
#6
Jeffrey Tadashi Sakamoto, Nan Liu, Zhi Xiong Koh, Dagang Guo, Micah Liam Arthur Heldeweg, Janson Cheng Ji Ng, Marcus Eng Hock Ong
BACKGROUND: Current triage methods for chest pain patients typically utilize symptoms, electrocardiogram (ECG), and vital sign data, requiring interpretation by dedicated triage clinicians. In contrast, we aimed to create a quickly obtainable model integrating the objective parameters of heart rate variability (HRV), troponin, ECG, and vital signs to improve accuracy and efficiency of triage for chest pain patients in the emergency department (ED). METHODS: Adult patients presenting to the ED with chest pain from September 2010 to July 2015 were conveniently recruited...
July 17, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28737573/investigating-the-impact-of-different-suspicion-of-infection-criteria-on-the-accuracy-of-quick-sepsis-related-organ-failure-assessment-systemic-inflammatory-response-syndrome-and-early-warning-scores
#7
Matthew M Churpek, Ashley Snyder, Sarah Sokol, Natasha N Pettit, Dana P Edelson
OBJECTIVE: Studies in sepsis are limited by heterogeneity regarding what constitutes suspicion of infection. We sought to compare potential suspicion criteria using antibiotic and culture order combinations in terms of patient characteristics and outcomes. We further sought to determine the impact of differing criteria on the accuracy of sepsis screening tools and early warning scores. DESIGN: Observational cohort study. SETTING: Academic center from November 2008 to January 2016...
July 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28715794/an-introduction-to-the-emergency-department-adult-clinical-escalation-protocol-ed-ace
#8
Eoin Coughlan, Una Geary, Abel Wakai, Ronan O'Sullivan, John Browne, Eilish McAuliffe, Marie Ward, Fiona McDaid, Conor Deasy
PURPOSE OF THE STUDY: This study demonstrates how a participatory action research approach was used to address the challenge of the early and effective detection of the deteriorating patient in the ED setting. The approach enabled a systematic approach to patient monitoring and escalation of care to be developed to address the wide-ranging spectrum of undifferentiated presentations and the phases of ED care from triage to patient admission. This paper presents a longitudinal patient monitoring system, which aims to provide monitoring and escalation of care, where necessary, of adult patients from triage to admission to hospital in a manner that is feasible in the unique ED environment...
November 14, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28699997/accuracy-of-a-pediatric-early-warning-score-in-the-recognition-of-clinical-deterioration
#9
Juliana de Oliveira Freitas Miranda, Climene Laura de Camargo, Carlito Lopes Nascimento, Daniel Sales Portela, Alan Monaghan
Objective: to evaluate the accuracy of the version of the Brighton Pediatric Early Warning Score translated and adapted for the Brazilian context, in the recognition of clinical deterioration. Method: a diagnostic test study to measure the accuracy of the Brighton Pediatric Early Warning Score for the Brazilian context, in relation to a reference standard. The sample consisted of 271 children, aged 0 to 10 years, blindly evaluated by a nurse and a physician, specialists in pediatrics, with interval of 5 to 10 minutes between the evaluations, for the application of the Brighton Pediatric Early Warning Score for the Brazilian context and of the reference standard...
July 10, 2017: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/28691745/prospective-evaluation-of-the-whitt-neonatal-trigger-score-in-an-at-risk-neonatal-population
#10
Anna Robinson, Lucinda C Winckworth, Georgios Eleftheriou, Rebecca Hewitson, Harriet Holme
AIM: The aim of this study was to prospectively evaluate the Whitt Neonatal Trigger Score (W-NTS), determining optimum threshold scores for consideration of medical intervention and intensive care unit admission. METHODS: All neonates on the postnatal ward (PNW) with a set of pre-defined risk factors were scored on the W-NTS. Neonates were divided into three groups: 'unwell' admitted to neonatal intensive care unit (NICU); 'well', who remained on the PNW receiving standard care; and 'intervention', who received antibiotics but did not require admission to NICU...
July 10, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28686949/early-maladaptive-schemas-and-suicidal-risk-in-an-iranian-sample-of-patients-with-obsessive-compulsive-disorder
#11
Vahid Khosravani, Farangis Sharifi Bastan, Mehdi Samimi Ardestani, Razieh Jamaati Ardakani
There are few studies on suicidal risk and its related factors in patients diagnosed with obsessive-compulsive disorder (OCD). This study investigated the associations of early maladaptive schemas, OC symptom dimensions, OCD severity, depression and anxiety with suicidality (i.e., suicidal ideation and suicide attempts) in OCD patients. Sixty OCD outpatients completed the Scale for Suicide Ideation (SSI), the Young Schema Questionnaire-Short Form (YSQ-SF), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Dimensional Obsessive-Compulsive Scale (DOCS) and the Depression Anxiety Stress Scales (DASS-21)...
September 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28679490/continuous-monitoring-of-vital-signs-using-wearable-devices-on-the-general-ward-pilot-study
#12
Mariska Weenk, Harry van Goor, Bas Frietman, Lucien Jlpg Engelen, Cornelis Jhm van Laarhoven, Jan Smit, Sebastian Jh Bredie, Tom H van de Belt
BACKGROUND: Measurement of vital signs in hospitalized patients is necessary to assess the clinical situation of the patient. Early warning scores (EWS), such as the modified early warning score (MEWS), are generally calculated 3 times a day, but these may not capture early deterioration. A delay in diagnosing deterioration is associated with increased mortality. Continuous monitoring with wearable devices might detect clinical deterioration at an earlier stage, which allows clinicians to take corrective actions...
July 5, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28670880/awareness-about-breast-cancer-and-its-screening-among-rural-egyptian-women-minia-district-a-population-based-study
#13
Ebtesam Esmail Hassan, Amany Edward Seedhom, Eman Mohamed Mahfouz
Background: Recent global cancer statistics indicate rising global incidence of breast cancer and the increase is occurring at a faster rate in developing countries. Training women how to carry out breast self-examination (BSE) can help them to be alert to any abnormalities in their breasts to speedily seek medical consultation. Health behavior may be influenced by level of awareness about breast cancer. Methods: A cross-sectional community- based study aimed to assess the level of knowledge about breast cancer risk factors, early warning signs, screening approaches and related predictors...
June 25, 2017: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/28646727/pulmonary-embolism-prognostic-factors-and-length-of-hospital-stay-a-cohort-study
#14
Marco Paolo Donadini, Francesco Dentali, Marco Castellaneta, Paola Gnerre, Micaela La Regina, Luca Masotti, Filippo Pieralli, Fulvio Pomero, Roberta Re, Luigina Guasti, Walter Ageno, Alessandro Squizzato
INTRODUCTION: Patients with pulmonary embolism (PE) are commonly admitted to hospital for their initial treatment. We aimed to assess the association of length of hospital stay with commonly available clinical variables and their combinations. METHODS: A retrospective multicenter cohort study was conducted on consecutive PE patients admitted to eight Italian centers. Logistic regression analysis was performed to evaluate the association between the length of hospital stay and the Pulmonary Embolism Severity Index (PESI) parameters, National Early Warning Score (NEWS) and other possible determinants...
June 8, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28638239/using-transfer-learning-for-improved-mortality-prediction-in-a-data-scarce-hospital-setting
#15
Thomas Desautels, Jacob Calvert, Jana Hoffman, Qingqing Mao, Melissa Jay, Grant Fletcher, Chris Barton, Uli Chettipally, Yaniv Kerem, Ritankar Das
Algorithm-based clinical decision support (CDS) systems associate patient-derived health data with outcomes of interest, such as in-hospital mortality. However, the quality of such associations often depends on the availability of site-specific training data. Without sufficient quantities of data, the underlying statistical apparatus cannot differentiate useful patterns from noise and, as a result, may underperform. This initial training data burden limits the widespread, out-of-the-box, use of machine learning-based risk scoring systems...
2017: Biomedical Informatics Insights
https://www.readbyqxmd.com/read/28635463/an-overview-of-the-evidence-based-practice-process-for-novice-researchers
#16
Emma Rowles, Amanda McNaughton
This article explores how nurses can use evidence-based practice to critique and evaluate the rationale and evidence for specific nursing procedures or practices. Through the development of a focused research question and search strategy, nurses can select and critique relevant research articles to answer the research question, which can support the provision of optimal practice and high-quality care. This article demonstrates the process of evidence-based practice, with the aim of increasing novice researchers' confidence in applying this process in practice...
June 21, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28628498/earlier-physical-therapy-input-is-associated-with-a-reduced-length-of-hospital-stay-and-reduced-care-needs-on-discharge-in-frail-older-inpatients-an-observational-study
#17
Peter J Hartley, Victoria L Keevil, Ledia Alushi, Rebecca L Charles, Eimear B Conroy, Patricia M Costello, Becki Dixon, Aida M Dolinska-Grzybek, Diana Vajda, Roman Romero-Ortuno
BACKGROUND AND PURPOSE: Pressures on hospital bed occupancy in the English National Health Service have focused attention on enhanced service delivery models and methods by which physical therapists might contribute to effective cost savings, while retaining a patient-centered approach. Earlier access to physical therapy may lead to better outcomes in frail older inpatients, but this has not been well studied in acute National Health Service hospitals. Our aim was to retrospectively study the associations between early physical therapy input and length of hospital stay (LOS), functional outcomes, and care needs on discharge...
June 16, 2017: Journal of Geriatric Physical Therapy
https://www.readbyqxmd.com/read/28608136/early-impairment-of-intracranial-conduction-time-predicts-mortality-in-deeply-sedated-critically-ill-patients-a-prospective-observational-pilot-study
#18
Eric Azabou, Benjamin Rohaut, Nicholas Heming, Eric Magalhaes, Régine Morizot-Koutlidis, Stanislas Kandelman, Jeremy Allary, Guy Moneger, Andrea Polito, Virginie Maxime, Djillali Annane, Frederic Lofaso, Fabrice Chrétien, Jean Mantz, Raphael Porcher, Tarek Sharshar
BACKGROUND: Somatosensory (SSEP) and brainstem auditory (BAEP) evoked potentials are neurophysiological tools which, respectively, explore the intracranial conduction time (ICCT) and the intrapontine conduction time (IPCT). The prognostic values of prolonged cerebral conduction times in deeply sedated patients have never been assessed. Sedated patients are at risk of developing new neurological complications, undetected. In this prospective observational bi-center pilot study, we investigated whether early impairment of SSEP's ICCT and/or BAEP's IPCT could predict in-ICU mortality or altered mental status (AMS), in deeply sedated critically ill patients...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28595614/a-multicentre-randomised-intervention-study-of-the-paediatric-early-warning-score-study-protocol-for-a-randomised-controlled-trial
#19
Claus Sixtus Jensen, Hanne Aagaard, Hanne Vebert Olesen, Hans Kirkegaard
BACKGROUND: Patients' evolving critical illness can be predicted and prevented. However, failure to identify the signs of critical illness and subsequent lack of appropriate action for patients developing acute and critical illness remain a problem. Challenges in assessing whether a child is critically ill may be due to children's often uncharacteristic symptoms of serious illness. Children may seem relatively unaffected until shortly before circulatory and respiratory failure and cardiac arrest...
June 8, 2017: Trials
https://www.readbyqxmd.com/read/28592360/clinical-study-of-a-new-modified-early-warning-system-scoring-system-some-lingering-doubts
#20
Xianshi Zhou, Ye Ye, Guanghua Tang
No abstract text is available yet for this article.
June 1, 2017: Journal of Critical Care
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