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Early supported discharge

Gabriella Di Lascio, Edvin Prifti, Elmi Messai, Adriano Peris, Guy Harmelin, Roland Xhaxho, Albana Fico, Guido Sani, Massimo Bonacchi
INTRODUCTION: Status asthmaticus is a life-threatening condition characterized by progressive respiratory failure due to asthma that is unresponsive to standard therapeutic measures. We used extracorporeal membrane oxygenation (ECMO) to treat patients with near-fatal status asthamticus who did not respond to aggressive medical therapies and mechanical ventilation under controlled permissive hypercapnia. MATERIALS AND METHODS: Between January 2011 and October 2015, we treated 16 adult patients with status asthmaticus (8 women, 8 men, mean age: 50...
October 6, 2016: Perfusion
Lei Cheng, Yuxia Zhang, Ying Gu, Chunmei Lu, Qing Liu, Hao Yuan
BACKGROUND: Supporting and involving the families of pre-term infants' in the discharge process provides them with confidence in caring for their infants at home. In an effort to facilitate families' readiness for discharge, the neonatal unit (NU) of the Children's Hospital of Fudan University has implemented a best practice project. OBJECTIVES: The aim of this project was to integrate the best available evidence on facilitating families' readiness for discharge into the nursing practice of the Children's Hospital of Fudan University...
September 2016: JBI Database of Systematic Reviews and Implementation Reports
A Rumshisky, M Ghassemi, T Naumann, P Szolovits, V M Castro, T H McCoy, R H Perlis
The ability to predict psychiatric readmission would facilitate the development of interventions to reduce this risk, a major driver of psychiatric health-care costs. The symptoms or characteristics of illness course necessary to develop reliable predictors are not available in coded billing data, but may be present in narrative electronic health record (EHR) discharge summaries. We identified a cohort of individuals admitted to a psychiatric inpatient unit between 1994 and 2012 with a principal diagnosis of major depressive disorder, and extracted inpatient psychiatric discharge narrative notes...
October 18, 2016: Translational Psychiatry
Jonathan D Rich, Igor Gosev, Chetan B Patel, Susan Joseph, Jason N Katz, Peter M Eckman, Sangjin Lee, Kartik Sundareswaran, Ahmet Kilic, Brian Bethea, Behzad Soleimani, Brian Lima, Nir Uriel, Michael Kiernan
BACKGROUND: Early right-sided heart failure (RHF) after left ventricular assist device (LVAD) implantation is associated with increased mortality, but little is known about patients who develop late RHF (LRHF). We evaluated the incidence, risk factors, and clinical impact of LRHF in patients supported by axial-flow LVADs. METHODS: Data were analyzed from 537 patients enrolled in the HeartMate II (HM II; Thoratec/St. Jude) destination therapy clinical trial. LRHF was defined as the development of clinical RHF accompanied by the need for inotropic support occurring more than 30 days after discharge from the index LVAD implant hospitalization...
August 20, 2016: Journal of Heart and Lung Transplantation
Hui-Chuan Huang, Chien-Hung Chang, Chaur-Jong Hu, Meei-Ling Shyu, Chin-I Chen, Chih-Shan Huang, Hsiu-Ting Tsai, Hsiu-Ju Chang
OBJECTIVE: To explore the temporal effects of psychological distress on the functional recovery among stroke survivors. DESIGN: A longitudinal follow-up study. All participants were interviewed at 5 days after stroke onset, and at 1, 2, 3, and 6 months after discharge from acute care hospitals. SETTING: Neurology inpatient and outpatient departments and rehabilitation clinics. PARTICIPANTS: First-time stroke participants (N=62) without cognitive impairment, psychiatric disorders, or cancer were recruited...
October 12, 2016: Archives of Physical Medicine and Rehabilitation
Ilaria Bergese, Simona Frigerio, Marco Clari, Emanuele Castagno, Antonietta De Clemente, Elena Ponticelli, Enrica Scavino, Paola Berchialla
OBJECTIVES: Return visit (RV) to the emergency department (ED) is considered a benchmarking clinical indicator for health care quality. The purpose of this study was to develop a predictive model for early readmission risk in pediatric EDs comparing the performances of 2 learning machine algorithms. METHODS: A retrospective study based on all children younger than 15 years spontaneously returning within 120 hours after discharge was conducted in an Italian university children's hospital between October 2012 and April 2013...
October 6, 2016: Pediatric Emergency Care
Stefan Permien, Sylvio Indris, Gero Neubüser, Andy Fiedler, Lorenz Kienle, Stefan Zander, Stephen Doyle, Björn Richter, Wolfgang Bensch
A composite consisting of CoFe2 O4 spinel nanoparticles and reduced graphite oxide (rGO) is studied as an anode material during Li uptake and release by applying synchrotron operando X-ray diffraction (XRD) and operando X-ray absorption spectroscopy (XAS), yielding a comprehensive picture of the reaction mechanisms. In the early stages of Li uptake, a monoxide is formed as an intermediate phase containing Fe(2+) and Co(2+) ions; this observation is in contrast to reaction pathways proposed in the literature...
October 10, 2016: Chemistry: a European Journal
Bhawna Gupta, Ali Dodge-Khatami, Juan Tucker, Mary B Taylor, Douglas Maposa, Miguel Urencio, Jorge D Salazar
BACKGROUND: Antegrade cerebral perfusion (ACP) typically is used with deep hypothermia for cerebral protection during aortic arch reconstructions. The impact of ACP on cerebral oxygenation and serum creatinine at a more tepid 25 °C was studied in newborns and children. METHODS: Between 2010 and 2014, 61 newborns and children (<5 years old) underwent aortic arch reconstruction using moderate hypothermia (25.0±0.9 °C) with ACP and a pH-stat blood gas management strategy...
July 2016: Translational pediatrics
Shima Sakai, Noriko Yamamoto-Mitani, Yukari Takai, Hiroki Fukahori, Yasuko Ogata
AIMS: To develop the Discharge Planning of Ward Nurses (DPWN), a Japanese self-evaluation instrument for ward nurses' discharge planning practices. DESIGN: Cross-sectional survey. METHODS: Participants were 624 ward nurses from six hospitals in Japan with a discharge planning department. Items about discharge planning practices were collected from literature and interviews with nurses and researchers. Construct validity, concurrent validity, internal consistency and test-retest reliability were tested...
January 2016: Nurs Open
Oili Dahl, Marie Wickman, Viveca Björnhagen, Mona Friberg, Yvonne Wengström
BACKGROUND: The first year after severe burn is a psychologically challenging period for the patient. Patients may still struggle with burn-related physical and psychological problems such as posttraumatic stress disorder (PTSD) and body image dissatisfaction (BID). AIM: This study investigates the presence of PTSD, BID and coping, at three, six and twelve months after discharge for early identification of patients in need of focused support during rehabilitation...
October 1, 2016: Burns: Journal of the International Society for Burn Injuries
Lars W Andersen, Tia T Raymond, Robert A Berg, Vinay M Nadkarni, Anne V Grossestreuer, Tobias Kurth, Michael W Donnino
Importance: Tracheal intubation is common during pediatric in-hospital cardiac arrest, although the relationship between intubation during cardiac arrest and outcomes is unknown. Objective: To determine if intubation during pediatric in-hospital cardiac arrest is associated with improved outcomes. Design, Setting, and Participants: Observational study of data from United States hospitals in the Get With the Guidelines-Resuscitation registry...
October 4, 2016: JAMA: the Journal of the American Medical Association
Laura Lauria, Angela Spinelli, Michele Grandolfo
INTRODUCTION: Breastfeeding is widely recommended. Updated data are needed to assess its prevalence and the effectiveness of interventions. Breastfeeding practices in Italy need to be promoted and monitored with updated and standard data The objective of this study is to provide estimates of the prevalence of breastfeeding and exclusively breastfeeding and to identify factors that may be modified to improve them. MATERIALS AND METHODS: Two population-based follow-up surveys were conducted to evaluate the quality of maternal care in 25 Local Health Units (LHUs) in Italy during 2008-2011...
July 2016: Annali Dell'Istituto Superiore di Sanità
Lisa Mondzelewski, Sheila Gahagan, Christine Johnson, Hala Madanat, Kyung Rhee
BACKGROUND AND OBJECTIVES: Newborn circumcision, particularly in the first 24 hours of life, has been thought to adversely affect breastfeeding initiation. However, no studies specifically support an association between early circumcision and difficulty with breastfeeding initiation or maintenance. This study was designed to determine whether timing of newborn circumcision affects rates of exclusive breastfeeding during the first 2 weeks of life. METHODS: A retrospective study of 797 newborn boys and their mothers was conducted at a large military hospital...
October 3, 2016: Hospital Pediatrics
Barbara DeVoe, Anita Roth, Gregory Maurer, Michal Tamuz, Martin Lesser, Renee Pekmezaris, Amgad N Makaryus, Alan Hartman, Paola DiMarzio
BACKGROUND: The Modified Early Warning Score (MEWS) helps identify patients experiencing a decline in physiological parameters that indicate risk for cardiac arrest (CA). OBJECTIVES: To assess the association between MEWS values and patient survival following in-hospital CA. METHODS: Retrospective cohort study of patients who experienced in-hospital CA. The relationship between CA survival and MEWS values as well as other risk factors such as age, gender and type of electrographic cardiac rhythms was analyzed using logistic regression...
October 1, 2016: Heart & Lung: the Journal of Critical Care
Thomas Monks, David Worthington, Michael Allen, Martin Pitt, Ken Stein, Martin A James
BACKGROUND: Mathematical capacity planning methods that can take account of variations in patient complexity, admission rates and delayed discharges have long been available, but their implementation in complex pathways such as stroke care remains limited. Instead simple average based estimates are commonplace. These methods often substantially underestimate capacity requirements. We analyse the capacity requirements for acute and community stroke services in a pathway with over 630 admissions per year...
September 29, 2016: BMC Health Services Research
Richard Cheng, Danny Ramzy, Babak Azarbal, Francisco A Arabia, Fardad Esmailian, Lawrence S Czer, Jon A Kobashigawa, Jaime D Moriguchi
For Interagency Registry for Mechanically Assisted Circulatory Support profiles 1 and 2 cardiogenic shock patients initially placed on extracorporeal membrane oxygenation (ECMO), whether crossover to more durable devices is associated with increased survival, and its optimal timing, are not established. Profiles 1 and 2 patients placed on mechanical support were prospectively registered. Survival and successful hospital discharge were compared between patients placed on ECMO only, ECMO with early crossover, and ECMO with delayed crossover...
September 23, 2016: Artificial Organs
Shefaly Shorey, Yvonne Peng Mei Ng, Dorthe Boe Danbjørg, Cindy-Lee Dennis, Evalotte Morelius
AIMS: The aim of this study was to describe a study protocol that evaluates the effectiveness of the 'Home-but not Alone' educational programme delivered via a mobile health application in improving parenting outcomes. BACKGROUND: The development in mobile-based technology gives us the opportunity to develop an accessible educational programme that can be potentially beneficial to new parents. However, there is a scarcity of theory-based educational programmes that have incorporated technology such as a mobile health application in the early postpartum period...
September 21, 2016: Journal of Advanced Nursing
Mikko T Ovaska, Timo Nuutinen, Rami Madanat, Tatu J Mäkinen, Tim Söderlund
It is a common practice that patients have a scheduled follow-up visit with radiographs following ankle fracture surgery. The aim of this study was to evaluate whether an early outpatient visit (<3 weeks) after ankle fracture surgery resulted in a change in patient management. For this study, 878 consecutive operatively treated ankle fracture patients with an early outpatient clinical-radiological visit were reviewed. The outcome measure was a change in treatment plan defined as any procedure, medication, or surgical intervention that is not typically implemented during the uncomplicated healing process of an acute fracture...
September 7, 2016: Injury
Brenda Ohta, Ana Mola, Peri Rosenfeld, Shauna Ford
BACKGROUND/METHODS: Readmission prevention is a marker of patient care quality and requires comprehensive, early discharge planning for safe hospital transitions. Effectively performed, this process supports patient satisfaction, efficient resource utilization, and care integration. This study developed/tested the utility of a predictive early discharge risk assessment with 366 elective orthopedic/cardiovascular surgery patients. Quality improvement cycles were undertaken for the design and to inform analytic plan...
2016: International Journal of Integrated Care
Federico Coccolini, Massimo Sartelli, Fausto Catena, Marco Ceresoli, Giulia Montori, Luca Ansaloni
BACKGROUND: Since the incorporation of the early hemodynamic resuscitation in septic shock according to the early goal-directed therapy (EGDT) protocol among the 6-hour resuscitation bundle of the Surviving Sepsis Campaign guidelines, a great debate has been raised about the issue. The present meta-analysis aims to determine whether the resuscitative phase really takes advantages by being performed with EGDT. METHODS: A systematic review with meta-analysis of randomized controlled trials (RCTs) of EGDT versus usual care in patients with early septic shock was performed...
November 2016: Journal of Trauma and Acute Care Surgery
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