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https://www.readbyqxmd.com/read/100001003/emergency-management-of-sepsis-the-simple-stuff-saves-lives
#1
David Sweet, Julian Marsden, Kendall Ho, Christina Krause, James A Russell
Many emergency departments have implemented sepsis protocols since the 2001 publication of results from the early goal-directed therapy trial, which showed early targeted resuscitation lowers mortality. As part of an attempt to improve clinical and operational outcomes for emergency departments across British Columbia, we reviewed sepsis management literature and considered sepsis protocol implementation in the province’s emergency departments. During the literature review we found that many observational studies confirmed an association between implementation of emergency sepsis protocols and decreased mortality...
May 2012: BC medical journal: BCMJ
https://www.readbyqxmd.com/read/29356210/clinical-course-and-prognostic-factors-across-different-musculoskeletal-pain-sites-a-secondary-analysis-of-individual-patient-data-from-randomised-clinical-trials
#2
D J Green, M Lewis, G Mansell, M Artus, K S Dziedzic, E M Hay, N E Foster, D A van der Windt
BACKGROUND: Previous research has identified similar prognostic factors in patients with musculoskeletal (MSK) conditions regardless of pain presentation, generating opportunities for management based on prognosis rather than specific pain presentation. METHODS: Data from seven RCTs (2,483 participants) evaluating a range of primary care interventions for different MSK pain conditions were used to investigate the course of symptoms and explore similarities and differences in predictors of outcome...
January 22, 2018: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/29356192/how-much-of-toyota-s-philosophy-is-embedded-in-health-care-at-the-organisational-level-a-review
#3
Alain Antierens, Dimitri Beeckman, Sofie Verhaeghe, Dries Myny, Ann Van Hecke
AIMS: Identify which of Toyota's principles are reported in health care institutions at the organisational level and to identify the type of reported outcomes related to the effectiveness of lean production reported in these studies. BACKGROUND: No scientific research has been conducted to determine which of Toyota's principles are embedded in health care systems. This knowledge is needed to perform targeted adjustments in health care. EVALUATION: Sixty studies were identified for the final analysis...
January 22, 2018: Journal of Nursing Management
https://www.readbyqxmd.com/read/29356176/tools-of-the-trade-improving-nurses-ability-to-access-and-evaluate-research
#4
Martha R Sleutel, John W Bullion, Ronnie Sullivan
AIM: To evaluate the effect of a manager-required RN competency on staff nurses' perceived knowledge, ability and frequency of information-seeking activities. BACKGROUND: Basing clinical practice on research and standards of care is essential to delivering appropriate care with optimal outcomes. Nurses' information-seeking abilities are critical for acquiring evidence-based answers to aid clinical decision-making, yet nurses under-utilize library resources and report barriers...
January 22, 2018: Journal of Nursing Management
https://www.readbyqxmd.com/read/29356165/period-prevalence-and-reporting-rate-of-medication-errors-among-nurses-in-iran-a-systematic-review-and-meta-analysis
#5
Behzad Karami Matin, Mohammad Hajizadeh, Bijan Nouri, Shahab Rezaeian, Masoud Mohammadi, Satar Rezaei
AIMS: To estimate the 1-year period prevalence of medication errors and the reporting rate to nurse managers among nurses working in hospitals in Iran. BACKGROUND: Medication errors are one of the main factors affecting the quality of hospital services and reducing patient safety in health care systems. METHOD: A literature search from Iranian and international scientific databases was developed to find relevant studies. Meta-regression was used to identify which characteristics may have a confounding effect on the pooled prevalence estimates...
January 22, 2018: Journal of Nursing Management
https://www.readbyqxmd.com/read/29356078/diabetes-and-technology-in-2030-a-utopian-or-dystopian-future
#6
D Kerr, C Axelrod, C Hoppe, D C Klonoff
The ability of an individual living with diabetes to have human-to-human contact with their healthcare provider is not keeping pace with the number of people developing diabetes. From a futurist perspective, however, this dichotomy of diabetes care represents an opportunity for digital healthcare. The focus of technological innovation is unlikely to be the replacement of the multidisciplinary diabetes team but rather the provision of meaningful individual and family support between clinic visits and, on a larger scale, the facilitation of population health management for diabetes...
January 22, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29356072/flash-forward-a-review-of-flash-glucose-monitoring
#7
REVIEW
L Leelarathna, G Wilmot
The FreeStyle Libre flash glucose monitor became available on prescription (subject to local health authority approval) in all four nations of the UK from November 2017, a watershed moment in the history of diabetes care. Calibration free, the FreeStyle Libre is a disc worn on the arm for 14 days which is designed largely to replace the recommended 4-10 painful finger-stick blood glucose tests required each day for the self-management of diabetes. This review discusses clinical data from randomized and observational studies, considers device accuracy metrics and deliberates its popularity and the potential challenges that this new device brings to diabetes care in the UK...
January 22, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29355988/variation-in-practice-patterns-and-outcomes-across-united-network-for-organ-sharing-allocation-regions
#8
Dushyanth Srinivasan, Benjamin Vaccaro, Pooja Rao, Rohit Ghosh, Prashant Warier, Tariq Ahmad, Nihar Desai
BACKGROUND: The number of heart transplants performed is limited by organ availability and is managed by the United Network for Organ Sharing (UNOS). Efforts are underway to make organ disbursement more equitable as demand increases. HYPOTHESIS: Significant variation exists in contemporary patterns of care, wait times, and outcomes among patients undergoing heart transplantation across UNOS regions. METHODS: We identified adult patients undergoing first, single-organ heart transplantation between January 2006 and December 2014 in the UNOS dataset and compared sociodemographic and clinical profiles, wait times, use of mechanical circulatory support (MCS), status at time of transplantation, and 1-year survival across UNOS regions...
January 22, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29355883/optimizing-pain-management-through-opioid-deprescribing
#9
Rachel Lumish, Joshana K Goga, Nicole J Brandt
The use of opioid drug therapy in older adults has increased over the past decade. Although use of opioid drugs may be clinically warranted, ongoing use needs to be monitored closely to evaluate risks and benefits, especially with the potential for adverse events and misuse. An opioid drug deprescribing protocol would provide clinicians with a method to assess an individual's need for opioid agents, as well as a systematic process to taper opioid drug therapy when deemed appropriate. Although more than 60 studies have reported methods for deprescribing, there is currently no established guideline for discontinuing opioid medications...
January 1, 2018: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/29355879/influence-of-teamwork-on-health-care-workers-perceptions-about-care-delivery-and-job-satisfaction
#10
Sherry Dahlke, Sarah Stahlke, Robin Coatsworth-Puspoky
The aim of the current study was to examine the nature of teamwork in care facilities and its impact on the effectiveness of care delivery to older adults and job satisfaction among health care workers. A focused ethnography was conducted at two care facilities where older adults reside. Analysis of interviews with 22 participants revealed perceptions of teamwork and understandings about facilitators of and barriers to effective teamwork. Participants indicated that team relationships impacted care provided and job satisfaction...
January 16, 2018: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/29355877/emergency-department-use-by-community-dwelling-individuals-with-dementia-in-the-united-states-an-integrative-review
#11
Lauren J Hunt, Lorinda A Coombs, Caroline E Stephens
As part of the National Plan to Address Alzheimer's Disease, reducing potentially avoidable emergency department (ED) use by individuals with dementia has been identified as a component of enhancing the quality and efficiency of care for this population. To help inform the development of interventions to achieve this goal, an integrative review was conducted to: (a) compare rates and reasons for ED visits by community-dwelling individuals with and without dementia, considering also the effect of dementia subtype and severity; and (b) identify other risk factors for increased ED use among community-dwelling individuals with dementia...
January 16, 2018: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/29355804/continuous-lumbar-cistern-drainage-before-surgical-clipping-for-aneurysmal-subarachnoid-hemorrhage
#12
Ning Xu, Hao Meng, Tianyi Liu, Yingli Feng, Yuan Qi, Honglei Wang
BACKGROUND: Lumbar drainage (LD) is the choice for the treatment of acute hydrocephalus and increased intracranial pressure in patients with subarachnoid hemorrhage (SAH). It also reduces vasospasm risk and delayed ischemic neurological events. We evaluated the role of LD in the preoperative management of patients with aneurysmal SAH (aSAH). PATIENTS AND METHODS: From January 2011 to January 2013, 520 patients with aSAH were subjected to clipping surgery and were prospectively enrolled in this study...
January 17, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29355793/position-of-the-french-working-group-on-perioperative-haemostasis-gihp-on-viscoelastic-tests-what-role-for-which-indication-in-bleeding-situations
#13
Stéphanie Roullet, Emmanuel de Maistre, Brigitte Ickx, Normand Blais, Sophie Susen, David Faraoni, Delphine Garrigue, Fanny Bonhomme, Anne Godier, Dominique Lasne
PURPOSE: Viscoelastic tests (VETs), thromboelastography (TEG®) and thromboelastometry (ROTEM®) are global tests of coagulation performed on whole blood. They evaluate the mechanical strength of a clot as it builds and develops after coagulation itself. The time required to obtain haemostasis results remains a major problem for clinicians dealing with bleeding, although some teams have developed a rapid laboratory response strategy. Indeed, the value of rapid point-of-care diagnostic devices such as VETs has increased over the years...
January 17, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29355509/severe-asthma-in-primary-care-identification-and-management
#14
REVIEW
Jennifer L Trevor, Bradley E Chipps
Most patients with asthma are managed by primary care providers. Severe asthma is associated with substantial morbidity and health care resource use, and long-term sequelae of severe asthma include airway remodeling and a greater risk of developing chronic obstructive pulmonary disease. These consequences highlight the importance of early identification and improved management of patients with severe asthma. Although treatment guidelines can be confusing and it can be difficult to keep abreast of updates, routine assessments of lung function, frequency and severity of exacerbations, symptom control, and medication adherence in the primary care setting provide the necessary information for identifying severe asthma and determining appropriate management strategies...
January 16, 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29355428/silver-fluoride-as-a-treatment-for-dental-caries
#15
J A Horst
Medical management of caries is a distinct treatment philosophy that employs topical minimally invasive therapies that treat the disease and is not merely prevention. This strategy is justified as an alternative or supplement to traditional care by significant disease recurrence rates following comprehensive operative treatment under general anesthesia. Silver diamine fluoride (SDF) is one agent to enable effective noninvasive treatment. The announcement of breakthrough therapy designation by the Food and Drug Administration (FDA) suggests that SDF may become the first FDA-approved drug for treating caries...
February 2018: Advances in Dental Research
https://www.readbyqxmd.com/read/29355411/potential-uses-of-arginine-in-dentistry
#16
M M Nascimento
Carious lesions develop in tooth surfaces where there is an imbalance of the processes of acid and alkali production by supragingival biofilms. Since low pH is the main driving factor in the development of carious lesions, most efforts to identify an effective anticaries therapy have focused on targeting the acid-producing bacteria and their mechanisms of acid production. An expanding area of oral microbiology has now been devoted to explore microbial metabolic activities that help to neutralize biofilm pH and thus inhibit the caries process...
February 2018: Advances in Dental Research
https://www.readbyqxmd.com/read/29355409/changes-in-caries-risk-in-a-practice-based-randomized-controlled-trial
#17
P Rechmann, B W Chaffee, B M T Rechmann, J D B Featherstone
To demonstrate that Caries Management by Risk Assessment (CAMBRA) can be successfully implemented in dental practice, 30 dentists were recruited to perform a 2-y CAMBRA trial. Twenty-one dentists (18 private practices, 3 community clinics) participated in a randomized, controlled, parallel-arm, double-blind clinical trial with individual-level assignment of 460 participants to standard of care (control) versus active CAMBRA treatment (intervention). Control or active antimicrobial and remineralizing agents were dispensed at baseline and 6-, 12-, 18-, and 24-mo recall visits according to risk level and assigned treatment arm...
February 2018: Advances in Dental Research
https://www.readbyqxmd.com/read/29355393/burden-and-management-of-noncommunicable-diseases-after-earthquakes-and-tsunamis
#18
Amit Suneja, Maxim Gakh, Lainie Rutkow
This integrative review examines extant literature assessing the burden and management of noncommunicable diseases 6 months or more after earthquakes and tsunamis. We conducted an integrative review to identify and characterize the strength of published studies about noncommunicable disease-specific outcomes and interventions at least 6 months after an earthquake and/or tsunami. We included disasters that occurred from 2004 to 2016. We focused primarily on the World Health Organization noncommunicable disease designations to define chronic disease, but we also included chronic renal disease, risk factors for noncommunicable diseases, and other chronic diseases or symptoms...
January 22, 2018: Health Security
https://www.readbyqxmd.com/read/29355141/an-observational-study-of-incidence-risk-factors-outcome-of-systemic-inflammatory-response-organ-dysfunction-following-major-trauma
#19
Satish Balkrishna Dharap, Sanket Vishnu Ekhande
BACKGROUND & OBJECTIVES: Trauma is known to lead to systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS), which is often a cause of late deaths after injury. SIRS and MODS have been objectively measured using scoring systems. This prospective observational study was carried out in a tertiary care hospital in India to evaluate SIRS and MODS following trauma in terms of their incidence, the associated risk factors and the effect on the outcome. METHODS: All adult patients with major life- and limb-threatening trauma were included...
September 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/29355127/bringing-a-structural-perspective-to-work-framing-occupational-safety-and-health-disparities-for-nursing-assistants-with-work-related-musculoskeletal-disorders
#20
Alysa D Haas, Daniel A Hunter, Ninica L Howard
BACKGROUND: Certified Nursing Assistants (CNAs) experience a high risk of work-related musculoskeletal disorders (WMSDs) and are further made vulnerable by their situation in low levels of workplace and societal hierarchies of power and privilege. OBJECTIVE: This study applies structural vulnerability theory to CNA WMSD experiences in order to identify structural factors that may influence such injuries. METHODS: A sample of CNAs (n = 26) working in Nursing and Residential Care Facilities (NRCFs) was selected from workers who filed a claim during 2011-2014 for a WMSD of the back, shoulder, knee, or hand/wrist in the Washington State Department of Labor & Industries workers' compensation system...
January 19, 2018: Work: a Journal of Prevention, Assessment, and Rehabilitation
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