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https://www.readbyqxmd.com/read/27919281/incidence-causes-and-consequences-of-preventable-adverse-drug-events-protocol-for-an-overview-of-reviews
#1
Brian Hutton, Salmaan Kanji, Erika McDonald, Fatemeh Yazdi, Dianna Wolfe, Kednapa Thavorn, Sally Pepper, Laurie Chapman, Becky Skidmore, David Moher
BACKGROUND: Medication errors represent a noteworthy source of harm to patients. In recent years, several systematic reviews have assessed the frequency and causes of these events, as well as other factors such as commonly associated drugs, their incidence in different specialties, and their consequences to patients. Despite this past literature, there remains a need to study discrepancies between these reviews and establish the current state of the evidence. The planned review will bring together, compare, and contract existing evidence related to the occurrence of medication errors in acute and continuing/long-term care settings...
December 5, 2016: Systematic Reviews
https://www.readbyqxmd.com/read/27918931/effectiveness-of-an-educational-intervention-the-encourage-autonomous-self-enrichment-program-in-patients-with-chronic-kidney-disease-a-randomized-controlled-trial
#2
Hiroko Joboshi, Michiyo Oka
BACKGROUND: Self-management is an important step toward preventing and impeding the progression of chronic kidney disease. However, patients with chronic kidney disease may have few or no subjective symptoms and therefore might consider self-management to be unnecessary. Effective support and encouragement of self-management in patients with chronic kidney disease is therefore required. OBJECTIVES: This study tested the effectiveness of the Encourage Autonomous Self-Enrichment patient education program, which supports patient autonomy and intrinsic motivations with the aim of improving self-efficacy and sustaining self-management, on perceived self-efficacy, self-management behaviors, and physiological endpoints (blood pressure and renal function parameters) in patients with chronic kidney disease...
November 22, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/27916378/incidence-and-significance-of-postoperative-complications-occurring-between-discharge-and-30%C3%A2-days-a-prospective-cohort-study
#3
John C Woodfield, Wiqqas Jamil, Peter M Sagar
BACKGROUND: Accurate documentation of complications is fundamental to clinical audit and research. While it is established that accurate diagnosis of surgical site infection (SSI) requires follow-up for 30 days; for other complications, there are minimal data quantifying their importance between discharge and 30 days. METHODS: In this prospective cohort study, inpatients undergoing general or vascular surgery were reviewed daily for complications by the medical team and a research fellow...
November 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27904631/the-effect-of-clinical-supervision-model-on-high-alert-medication-safety-in-intensive-care-units-nurses
#4
Asghar Khalifehzadeh Esfahani, Fatemeh Ramezany Varzaneh, Tahereh Changiz
BACKGROUND: Medication errors and adverse drug events of high alert medication are one of the major problems in therapeutic system. The purpose of the present study was to investigate ύthe effect of clinical supervision model on high alert medication safety in intensive care units nurses. MATERIALS AND METHODS: This was a quasi-experimental study conducted on 32 nurses of intensive care units. The researcher observed the administration of high alert drugs including heparin, warfarin, norepinephrine, dobutamine, and dopamine by nurses and recorded the scores of the work in preventing medication errors, the work in preventing adverse drug events, and medication safety...
September 2016: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/27903757/beyond-hand-hygiene-a-qualitative-study-of-the-everyday-work-of-preventing-cross-contamination-on-hospital-wards
#5
Su-Yin Hor, Claire Hooker, Rick Iedema, Mary Wyer, Gwendolyn L Gilbert, Christine Jorm, Matthew Vincent Neil O'Sullivan
BACKGROUND: Hospital-acquired infections are the most common adverse event for inpatients worldwide. Efforts to prevent microbial cross-contamination currently focus on hand hygiene and use of personal protective equipment (PPE), with variable success. Better understanding is needed of infection prevention and control (IPC) in routine clinical practice. METHODS: We report on an interventionist video-reflexive ethnography study that explored how healthcare workers performed IPC in three wards in two hospitals in New South Wales, Australia: an intensive care unit and two general surgical wards...
November 30, 2016: BMJ Quality & Safety
https://www.readbyqxmd.com/read/27899496/hormonal-contraception-and-risk-of-thromboembolism-in-women-with-diabetes
#6
Sarah H O'Brien, Terah Koch, Sara K Vesely, Eleanor Bimla Schwarz
OBJECTIVE: To investigate safety of hormonal contraception with regard to thromboembolic events in women with type 1 or 2 diabetes. RESEARCH DESIGN AND METHODS: We used data from 2002-2011 in Clinformatics Data Mart to identify women in the U.S., 14-44 years of age, with an ICD-9-CM code for diabetes and a prescription for a diabetic medication or device. We examined contraceptive claims and compared time to thromboembolism (venous thrombosis, stroke, or myocardial infarction) among women with diabetes dispensed hormonal contraception using a modification of Cox regression to control for age, smoking, obesity, hypertension, hyperlipidemia, diabetic complications, and history of cancer; we excluded data for 3 months after women gave birth...
November 29, 2016: Diabetes Care
https://www.readbyqxmd.com/read/27888945/radiology-as-the-point-of-cancer-patient-and-care%C3%A2-team-engagement-applying-the-4r-model-at%C3%A2-a-patient-s-breast-cancer-care-initiation
#7
Christine B Weldon, Sarah M Friedewald, Swati A Kulkarni, Melissa A Simon, Ruth C Carlos, Jonathan B Strauss, Mikele M Bunce, Art Small, Julia R Trosman
Radiologists aspire to improve patient experience and engagement, as part of the Triple Aim of health reform. Patient engagement requires active partnerships among health providers and patients, and rigorous teamwork provides a mechanism for this. Patient and care team engagement are crucial at the time of cancer diagnosis and care initiation but are complicated by the necessity to orchestrate many interdependent consultations and care events in a short time. Radiology often serves as the patient entry point into the cancer care system, especially for breast cancer...
December 2016: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/27887691/cost-effectiveness-of-achieving-targets-of-low-density-lipoprotein-particle-number-versus-low-density-lipoprotein-cholesterol-level
#8
Michael Grabner, Deborah A Winegar, Rajeshwari S Punekar, Ralph A Quimbo, Mark J Cziraky, William C Cromwell
A recent analysis of a commercially insured US population found fewer cardiovascular disease (CVD) events in high-risk patients attaining low levels of low-density lipoprotein (LDL), as measured by LDL particle number (LDL-P) versus low LDL cholesterol (LDL-C). Here, we investigated the cost effectiveness of LDL-lowering therapy guided by LDL-P. Patients were selected from the HealthCore Integrated Research Database and followed for 12 to 36 months. Patients who achieved LDL-P <1,000 nmol/l were placed into the LDL-P cohort, whereas those without LDL-P tests, but who achieved LDL-C <100 mg/dl, were placed into the LDL-C cohort...
October 31, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27885090/the-impact-of-circadian-rhythms-on-medical-imaging-and-radiotherapy-regimes-for-the-paediatric-patient
#9
E Forssell-Aronsson, R A Quinlan
Daily rhythmic changes are found in cellular events in cell cycle, DNA repair, apoptosis and angiogenesis in both normal and tumour tissue, as well as in enzymatic activity and drug metabolism. In this paper, we hypothesize that circadian rhythms need to be considered in radiation protection and optimization in personalized medicine, especially for paediatric care. The sensitivity of the eye lens to ionizing radiation makes the case for limiting damage to the lens epithelium by planning medical radio-imaging procedures for the afternoon, rather than the morning...
November 24, 2016: Radiation Protection Dosimetry
https://www.readbyqxmd.com/read/27884850/comparative-effectiveness-and-safety-of-oral-anticoagulants-for-atrial-fibrillation-in-real-world-practice-a-population-based-cohort-study-protocol
#10
Anne Holbrook, Colin Dormuth, Richard Morrow, Agnes Lee, Sue Troyan, Guowei Li, Eleanor Pullenyegum
INTRODUCTION: Anticoagulants are arguably the most important drug family of all, based on the frequency and duration of their use, and the clinical importance and frequency of benefits and harms. Several direct acting oral anticoagulants (DOACs) have recently joined warfarin for the treatment of atrial fibrillation, with a resultant significant expansion in use of oral anticoagulants (OACs). Our objectives are to compare safety and effectiveness of DOACs versus warfarin in a full population where anticoagulation management is good and to identify which types of patients do better with DOACs versus warfarin and vice versa...
November 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27869899/-patients-with-non-st-elevation-acute-coronary-syndrome-managed-without-coronary-revascularization-an-undertreated-population
#11
Alberto Menozzi, Leonardo De Luca, Zoran Olivari, Roberta Rossini, Marco Ferlini, Daniela Lina, Maurizio Giuseppe Abrignani, Piera Capranzano, Nazario Carrabba, Marcello Galvani, Alfredo Marchese, Gianfranco Mazzotta, Luciano Moretti, Nicola Signore, Massimo Uguccioni, Stefano De Servi
Non-ST-elevation acute coronary syndromes (NSTE-ACS) represent one of the most common clinical presentations of ischemic heart disease. Patients with NSTE-ACS are a heterogeneous population, with different clinical features and prognosis. A significant proportion of this population is medically managed, without any revascularization. In the Italian EYESHOT and French FAST-MI registries, patients managed with a conservative strategy were 40% and 35%, respectively. NSTE-ACS patients not undergoing coronary revascularization are at higher risk of adverse cardiovascular events and have a worse prognosis, including short- and long-term mortality, compared with those receiving revascularization...
October 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/27861446/preoperative-renal-insufficiency-underreporting-and-association-with-readmission-and-major-postoperative-morbidity-in-an-academic-medical-center
#12
Jeanna D Blitz, Marny H Shoham, Yixin Fang, Venod Narine, Neeraj Mehta, Beamy S Sharma, Paul Shekane, Samir Kendale
BACKGROUND: Making a formal diagnosis of chronic kidney disease (CKD) in the preoperative setting may be challenging because of lack of longitudinal data. We explored the predictive value of a single reduced preoperative estimated glomerular filtration rate (eGFR) value on adverse patient outcomes in the first 30 days after elective surgery. We compared the rate of major postoperative adverse events, including 30-day readmission rate, hospital length of stay, infection, acute kidney injury (AKI), and myocardial infarction across patients with declining preoperative eGFR values...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27859465/meta-analysis-of-aggregate-data-on-medical-events
#13
Björn Holzhauer
Meta-analyses of clinical trials often treat the number of patients experiencing a medical event as binomially distributed when individual patient data for fitting standard time-to-event models are unavailable. Assuming identical drop-out time distributions across arms, random censorship, and low proportions of patients with an event, a binomial approach results in a valid test of the null hypothesis of no treatment effect with minimal loss in efficiency compared with time-to-event methods. To deal with differences in follow-up-at the cost of assuming specific distributions for event and drop-out times-we propose a hierarchical multivariate meta-analysis model using the aggregate data likelihood based on the number of cases, fatal cases, and discontinuations in each group, as well as the planned trial duration and groups sizes...
November 18, 2016: Statistics in Medicine
https://www.readbyqxmd.com/read/27855589/twice-daily-telaprevir-for-posttransplant-genotype-1-hepatitis-c-virus-a-prospective-safety-efficacy-and-pharmacokinetics-study
#14
Raymond A Rubin, Mark W Russo, Kimberly A Brown, Robert J Fontana, Josh Levitsky, Hugo Vargas, Eric M Yoshida, Robert S Brown
OBJECTIVES: Our objective was to determine the safety, efficacy, and pharmacokinetics of telaprevir plus pegylated interferon alfa 2a and ribavirin for chronic, posttransplant genotype 1 hepatitis C virus infection. MATERIALS AND METHODS: A prospective, single-arm, multicenter, open-label, phase 2b study was conducted at 22 North American sites to assess the safety, efficacy, and pharmacokinetics of pegylated interferon alfa 2a, ribavirin, and twice daily telaprevir in liver transplant recipients with recurrent, chronic hepatitis C without cirrhosis...
November 18, 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27846004/implementation-of-a-risk-stratification-and-management-pathway-for-acute-chest-pain-in-the-emergency-department
#15
Christopher W Baugh, Jeffrey O Greenberg, Simon A Mahler, Joshua M Kosowsky, Jeremiah D Schuur, Siddharth Parmar, George R Ciociolo, Christina W Carr, Roya Ghazinouri, Benjamin M Scirica
OBJECTIVES: Chest pain is a common complaint in the emergency department, and a small but important minority represents an acute coronary syndrome (ACS). Variation in diagnostic workup, risk stratification, and management may result in underuse, misuse, and/or overuse of resources. METHODS: From July to October 2014, we conducted a prospective cohort study in an academic medical center by implementing a Standardized Clinical Assessment and Management Plan (SCAMP) for chest pain based on the HEART score...
December 2016: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/27843450/elder-orphans-hiding-in-plain-sight-a-growing-vulnerable-population
#16
Maria T Carney, Janice Fujiwara, Brian E Emmert, Tara A Liberman, Barbara Paris
Adults are increasingly aging alone with multiple chronic diseases and are geographically distant from family or friends. It is challenging for clinicians to identify these individuals, often struggling with managing the growing difficulties and the complexities involved in delivering care to this population. Clinicians often may not recognize or know how to address the needs that these patients have in managing their own health. While many such patients function well at baseline, the slightest insult can initiate a cascade of avoidable negative events...
2016: Current Gerontology and Geriatrics Research
https://www.readbyqxmd.com/read/27843335/incidence-of-clinical-symptoms-during-long-duration-orbital-spaceflight
#17
Brian Crucian, Adriana Babiak-Vazquez, Smith Johnston, Duane L Pierson, C Mark Ott, Clarence Sams
BACKGROUND: The environment of spaceflight may elevate an astronaut's clinical risk for specific diseases. The purpose of this study was to derive, as accurately as currently possible, an assessment of in-flight clinical "incidence" data, based on observed clinical symptoms in astronauts on board the International Space Station (ISS). METHODS: Electronic medical records were examined from 46 long-duration ISS crew members, each serving approximately a 6-month mission on board the ISS, constituting 20...
2016: International Journal of General Medicine
https://www.readbyqxmd.com/read/27836586/intrauterine-contraception-after-medical-abortion-factors-affecting-success-of-early-insertion
#18
Elina Pohjoranta, Satu Suhonen, Maarit Mentula, Oskari Heikinheimo
OBJECTIVE: To assess the success and factors affecting early intrauterine device (IUD) provision after first trimester medical termination of pregnancy (MTOP). STUDY DESIGN: Subgroup analysis of a randomized contraceptive trial assessing the long-term effects of early provision of intrauterine contraception following abortion. Altogether, 606 women undergoing MTOP were included and followed for 3 months. The intervention group (n=307) was offered an IUD (either the levonorgestrel-releasing intrauterine system or copper-IUD) at a follow-up visit 1-4 weeks after MTOP...
November 9, 2016: Contraception
https://www.readbyqxmd.com/read/27822907/multiple-intra-hospital-transports-during-relocation-to-a-new-critical-care-unit
#19
R-A O'Leary, I Conrick-Martin, C O'Loughlin, M-R Curran, B Marsh
OBJECTIVE: Intra-hospital transport (IHT) of critically ill patients is associated with morbidity and mortality. Mass transfer of patients, as happens with unit relocation, is poorly described. We outline the process and adverse events associated with the relocation of a critical care unit. DESIGN: Extensive planning of the relocation targeted patient and equipment transfer, reduction in clinical pressure prior to the event and patient care during the relocation phase...
November 7, 2016: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/27821382/a-prospective-multicenter-randomized-phase-ii-study-to-evaluate-the-efficacy-and-safety-of-eculizumab-in-patients-with-guillain-barr%C3%A3-syndrome-gbs-protocol-of-japanese-eculizumab-trial-for-gbs-jet-gbs
#20
Nobuko Yamaguchi, Sonoko Misawa, Yasunori Sato, Kengo Nagashima, Kanako Katayama, Yukari Sekiguchi, Yuta Iwai, Hiroshi Amino, Tomoki Suichi, Takanori Yokota, Yoichiro Nishida, Nobuo Kohara, Koichi Hirata, Kazutoshi Nishiyama, Ichiro Yabe, Ken-Ichi Kaida, Norihiro Suzuki, Hiroyuki Nodera, Shoji Tsuji, Haruki Koike, Jun-Ichi Kira, Hideki Hanaoka, Susumu Kusunoki, Satoshi Kuwabara
BACKGROUND: Guillain-Barré syndrome (GBS) is an immune-mediated neuropathy that causes acute flaccid paralysis. Immunoglobulin and plasma exchange are established treatments for GBS; however, a substantial number of patients, particularly those with severe disease, have poor recovery and residual deficits. Recent studies suggest that complement activation plays a pivotal role in GBS-associated axonal degeneration, and eculizumab is a humanized monoclonal antibody that specifically binds to complement component 5 and potently inhibits complement activation...
November 7, 2016: JMIR Research Protocols
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