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https://www.readbyqxmd.com/read/28435481/a-patient-centered-emergency-department-management-strategy-for-sickle-cell-disease-super-utilizers
#1
Grant G Simpson, Hallie R Hahn, Alex A Powel, Robert R Leverence, Linda A Morris, Lara G Thompson, Marc S Zumberg, Deepa J Borde, Joseph A Tyndall, Jonathan J Shuster, Donald M Yealy, Brandon R Allen
INTRODUCTION: A subpopulation of sickle-cell disease patients, termed super-utilizers, presents frequently to emergency departments (EDs) for vaso-occlusive events and may consume disproportionate resources without broader health benefit. To address the healthcare needs of this vulnerable patient population, we piloted a multidisciplinary intervention seeking to create and use individualized patient care plans that alter utilization through coordinated care. Our goals were to assess feasibility primarily, and to assess resource use secondarily...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28431202/pharmacological-interventions-for-acute-pancreatitis
#2
REVIEW
Elisabetta Moggia, Rahul Koti, Ajay P Belgaumkar, Federico Fazio, Stephen P Pereira, Brian R Davidson, Kurinchi Selvan Gurusamy
BACKGROUND: In people with acute pancreatitis, it is unclear what the role should be for medical treatment as an addition to supportive care such as fluid and electrolyte balance and organ support in people with organ failure. OBJECTIVES: To assess the effects of different pharmacological interventions in people with acute pancreatitis. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL, 2016, Issue 9), MEDLINE, Embase, Science Citation Index Expanded, and trial registers to October 2016 to identify randomised controlled trials (RCTs)...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28422404/the-use-of-resuscitation-plans-at-a-tertiary-australian-hospital-room-for-improvement
#3
Roger J Smith, John D Santamaria, Jennifer A Holmes, Espedito E Faraone, Patricia N Hurune, David A Reid
OBJECTIVES: To evaluate the introduction of a document for recording the resuscitation plans of patients at a tertiary hospital. The 'Acute Resuscitation Plan' (ARP) was introduced in September 2014, superseding the 'Not for Cardiopulmonary Resuscitation (CPR)' form. Unlike the Not for CPR form, the ARP was relevant to patients with and without resuscitation limits. DESIGN: Retrospective audit of the records of all admissions to the hospital from January-June 2014 (Not for CPR period) and January-June 2015 (ARP period)...
April 19, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28421912/a-survey-of-school-nurse-emergency-preparedness-2014-2015
#4
Margaret R Ugalde, Danielle Guffey, Charles G Minard, Angelo P Giardino, Gwendolyn A Johnson
Well-prepared school nurses are more likely to handle emergencies properly. Thus, assessing crisis management preparedness is important. In August 2014, a questionnaire was sent to 275 nurses in a large Texas school system to collect data about nurse and school characteristics, emergency frequency and management, and equipment availability. Completed surveys (201, 73%) were analyzed. Fisher's exact test was used to evaluate comparisons among nurses' confidence levels, school characteristics, emergencies, and medical emergency response plans (MERP)...
January 1, 2017: Journal of School Nursing: the Official Publication of the National Association of School Nurses
https://www.readbyqxmd.com/read/28419384/risk-factors-for-serious-prescription-opioid-induced-respiratory-depression-or-overdose-comparison-of-commercially-insured-and-veterans-health-affairs-populations
#5
Pramit A Nadpara, Andrew R Joyce, E Lenn Murrelle, Nathan W Carroll, Norman V Carroll, Marie Barnard, Barbara K Zedler
Objective. : To characterize the risk factors associated with overdose or serious opioid-induced respiratory depression (OIRD) among medical users of prescription opioids in a commercially insured population (CIP) and to compare risk factor profiles between the CIP and Veterans Health Administration (VHA) population. Subjects and Methods. : Analysis of data from 18,365,497 patients in the IMS PharMetrics Plus health plan claims database (CIP) who were dispensed a prescription opioid in 2009 to 2013...
April 13, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28416023/the-new-childhood-arthritis-and-rheumatology-research-alliance-carra-registry-design-rationale-and-characteristics-of-patients-enrolled-in-the-first-12%C3%A2-months
#6
Timothy Beukelman, Yukiko Kimura, Norman T Ilowite, Kelly Mieszkalski, Marc D Natter, Grendel Burrell, Brian Best, Jason Jones, Laura E Schanberg
BACKGROUND: Herein we describe the history, design, and rationale of the new Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry and present the characteristics of patients with juvenile idiopathic arthritis (JIA) enrolled in the first 12 months of operation. METHODS: The CARRA Registry began prospectively collecting data in the United States and Canada in July 2015 to evaluate the safety of therapeutic agents in persons with childhood-onset rheumatic disease, initially restricted to JIA...
April 17, 2017: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/28404197/mercaptopurine-versus-placebo-to-prevent-recurrence-of-crohn-s-disease-after-surgical-resection-toppic-a-multicentre-double-blind-randomised-controlled-trial
#7
Craig Mowat, Ian Arnott, Aiden Cahill, Malcolm Smith, Tariq Ahmad, Sreedhar Subramanian, Simon Travis, John Morris, John Hamlin, Anjan Dhar, Chuka Nwokolo, Cathryn Edwards, Tom Creed, Stuart Bloom, Mohamed Yousif, Linzi Thomas, Simon Campbell, Stephen J Lewis, Shaji Sebastian, Sandip Sen, Simon Lal, Chris Hawkey, Charles Murray, Fraser Cummings, Jason Goh, James O Lindsay, Naila Arebi, Lindsay Potts, Aileen J McKinley, John M Thomson, John A Todd, Mhairi Collie, Malcolm G Dunlop, Ashley Mowat, Daniel R Gaya, Jack Winter, Graham D Naismith, Holly Ennis, Catriona Keerie, Steff Lewis, Robin J Prescott, Nicholas A Kennedy, Jack Satsangi
BACKGROUND: Up to 60% of patients with Crohn's disease need intestinal resection within the first 10 years of diagnosis, and postoperative recurrence is common. We investigated whether mercaptopurine can prevent or delay postoperative clinical recurrence of Crohn's disease. METHODS: We did a randomised, placebo-controlled, double-blind trial at 29 UK secondary and tertiary hospitals of patients (aged >16 years in Scotland or >18 years in England and Wales) who had a confirmed diagnosis of Crohn's disease and had undergone intestinal resection...
December 2016: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28396033/improving-transitions-of-care-across-the-spectrum-of-healthcare-delivery-a-multidisciplinary-approach-to-understanding-variability-in-outcomes-across-hospitals-and-skilled-nursing-facilities
#8
Giana H Davidson, Elizabeth Austin, Lucas Thornblade, Louise Simpson, Thuan D Ong, Hanh Pan, David R Flum
INTRODUCTION: Improving coordination during transitions of care from the hospital to Skilled Nursing Facilities (SNF)s is critical for improving healthcare quality. In 2014, we formed (Improving Nursing Facility Outcomes using Real-Time Metrics, INFORM) to improve transitions of care by identifying structural and process factors that lead to poor clinical outcomes and hospital readmission. METHODS: Stakeholders from 10 SNFs and 4 hospitals collaborated to assess the current hospital and system-level challenges to safe transitions of care and identify targets for interventions...
April 5, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28394204/medication-adherence-staying-within-the-boundaries-of-safety
#9
Robin Sue Mickelson, Richard J Holden
An important domain of patient safety is the management of medications in home and community settings by patients and their caregiving network. This study applied human factors/ergonomics theories and methods to data about medication adherence collected from 61 patients with heart failure accompanied by 31 informal caregivers living in the US. Seventy non-adherence events were identified, described, and analysed for performance shaping factors. Half were classified as errors and half as violations. Performance shaping factors included elements of the person or team (e...
April 10, 2017: Ergonomics
https://www.readbyqxmd.com/read/28394084/personalised-asthma-action-plans-for-adults-with-asthma
#10
REVIEW
Timothy L Gatheral, Alison Rushton, David Jw Evans, Caroline A Mulvaney, Nathan R Halcovitch, Gemma Whiteley, Fiona Jr Eccles, Sally Spencer
BACKGROUND: A key aim of asthma care is to empower each person to take control of his or her own condition. A personalised asthma action plan (PAAP), also known as a written action plan, an individualised action plan, or a self-management action plan, contributes to this endeavour. A PAAP includes individualised self-management instructions devised collaboratively with the patient to help maintain asthma control and regain control in the event of an exacerbation. A PAAP includes baseline characteristics (such as lung function), maintenance medication and instructions on how to respond to increasing symptoms and when to seek medical help...
April 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28382876/assessment-of-risks-posed-to-vad-patients-during-disasters
#11
Katherine J Davis, Genevieve O'Shea, Michael Beach
Ventricular assist devices (VADs) are an Advanced Life Support for patients with heart failure. These patients are particularly vulnerable in the event of a disaster. A hazard vulnerability analysis (HVA) was conducted to determine areas of susceptibility for these patients. Lack of electrical power, limited access to medications and anticoagulation, dehydration, extreme temperature and weather environments, conditions which predispose to infection, and evacuation transport are all identified circumstances that place these patients at an increased risk for harm and death...
April 6, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28375414/proceedings-from-bridging-health-disparities-to-address-the-opioid-epidemic-a-symposium-at-the-warren-alpert-medical-school-of-brown-university
#12
Luba Dumenco, Kristina Monteiro, Michael Mello, Sally Collins, Don Operario, Karen Scanlan, Richard Dollase, Paul George
OBJECTIVE/BACKGROUND: In response to the unprecedented rates of illicit drug use, including opioid addiction and overdose in Rhode Island, local healthcare institutions, led by the Warren Alpert Medical School (AMS) of Brown University, collaborated to present "Bridging Health Disparities to Address the Opioid Epidemic." This symposium sought to educate a wide array of healthcare providers and professionals around opioid use disorder, including the state of the opioid crisis in Rhode Island, national efforts around opioid misuse and how providers can work together to stem the opioid crisis in the state...
April 3, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28367749/improving-voluntary-medical-male-circumcision-standards-adherence-and-post-procedure-follow-up-in-uganda-a-mixed-methods-study
#13
Sarah Smith Lunsford, John Byabagambi, Zachariah Falconer-Stout, Esther Karamagi
Voluntary medical male circumcision (VMMC) has been demonstrated to reduce the transmission of HIV by 60%. Scaling up VMMC services requires that they be of high quality, socially accepted, and effective. We evaluated an intervention aimed at improving VMMC standards adherence and patient follow-up rates in nine facilities in Uganda. We also qualitatively explored why some men return for follow-up care and others do not. The completeness and quality of clinical documentation was poor at baseline, but significantly improved at endline...
March 2017: African Journal of AIDS Research: AJAR
https://www.readbyqxmd.com/read/28363933/feasibility-of-melatonin-for-prevention-of-delirium-in-critically-ill-patients-a-protocol-for-a-multicentre-randomised-placebo-controlled-study
#14
Lisa Burry, Damon Scales, David Williamson, Jennifer Foster, Sangeeta Mehta, Melanie Guenette, Eddy Fan, Michael Detsky, Azar Azad, Francis Bernard, Louise Rose
INTRODUCTION: Delirium is highly prevalent in the intensive care unit (ICU) and is associated with adverse clinical outcomes. At this time, there is no drug that effectively prevents delirium in critically ill patients. Alterations in melatonin secretion and metabolism may contribute to the development of delirium. Administration of exogenous melatonin has been shown to prevent delirium in non-critically ill surgical and medical patients. This trial will demonstrate the feasibility of a planned multicentre, randomised controlled trial to test the hypothesis that melatonin can prevent delirium in critically ill patients compared with placebo...
March 30, 2017: BMJ Open
https://www.readbyqxmd.com/read/28360503/the-role-of-copy-and-paste-function-in-orthopedic-trauma-progress-notes
#15
Wesley Winn, Irshad A Shakir, Heidi Israel, Lisa K Cannada
INTRODUCTION: The electronic medical record (EMR) is standard in institutions. While there is not concern for legibility of notes and access to charts, there is an ease of copy and paste for daily notes. This may not lead to accurate portrayal of patient's status. Our purpose was to evaluate the use of copy and paste functions in daily notes of patients with injuries at high risk for complications. METHODS: IRB approval was obtained for a retrospective review. Inclusion criteria included patients aged 18 and older treated at our Level 1 Trauma Center after implementation of Epic Systems Corporation, Verona, WI, USA...
January 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28353068/-interhospital-transport-of-patients-with-ards
#16
N Jahn, M T Voelker, S Bercker, U Kaisers, S Laudi
In patients with severely compromised gas exchange, interhospital transportation is frequently necessary due to the need to provide access to specialized care. Risks are inherent during transport, so the anticipated benefits of transportation must be weighed against the possible negative outcome during the transport. The use of specialized teams during transportation can help to reduce adverse events. Diligent planning of the transportation, monitoring and medical staff during transport can decrease adverse events and reduce risks...
March 28, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28345444/budgetary-impact-of-cabazitaxel-use-after-docetaxel-treatment-for-metastatic-castration-resistant-prostate-cancer
#17
Kyle Flannery, Ed Drea, Louis Hudspeth, Shelby Corman, Xin Gao, Mei Xue, Raymond Miao
BACKGROUND: With the approval of several new treatments for metastatic castration-resistant prostate cancer (mCRPC), budgetary impact is a concern for health plan decision makers. Budget impact models (BIMs) are becoming a requirement in many countries as part of formulary approval or reimbursement decisions. Cabazitaxel is a second-generation taxane developed to overcome resistance to docetaxel and is approved for the treatment of patients with mCRPC previously treated with a docetaxel-containing regimen...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28342119/returns-to-operating-room-after-colon-and-rectal-surgery-in-a-tertiary-care-academic-medical-center-a-valid-measure-of-surgical-quality
#18
Amy L Lightner, Amy E Glasgow, Elizabeth B Habermann, Robert R Cima
INTRODUCTION: Returns to the operating room (ROR) have been suggested as a marker of surgical quality. Increasingly, quality and value metrics are utilized for reimbursement as well as public reporting to inform health care consumers. We sought to understand the etiology of ROR and assess the validity of simple ROR as a quality metric. METHODS: This was a single referral center retrospective review of all colon and rectal operations between January 1, 2014 and December 31, 2014...
March 24, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28340046/validation-of-a-screening-risk-index-for-serious-prescription-opioid-induced-respiratory-depression-or-overdose-in-a-us-commercial-health-plan-claims-database
#19
Barbara K Zedler, William B Saunders, Andrew R Joyce, Catherine C Vick, E Lenn Murrelle
Objective.:  To validate a risk index that estimates the likelihood of overdose or serious opioid-induced respiratory depression (OIRD) among medical users of prescription opioids. Subjects and Methods.:  A case-control analysis of 18,365,497 patients with an opioid prescription from 2009 to 2013 in the IMS PharMetrics Plus commercially insured health plan claims database (CIP). An OIRD event occurred in 7,234 cases. Four controls were selected per case. Validity of the Risk Index for Overdose or Serious Opioid-induced Respiratory Depression (RIOSORD), developed previously using Veterans Health Administration (VHA) patient data, was assessed...
March 6, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28338879/evidence-for-detection-bias-by-medication-use-in-a-cohort-study-of-breast-cancer-survivors
#20
Heidi S Wirtz, Gregory S Calip, Diana S M Buist, Julie R Gralow, William E Barlow, Shelly Gray, Denise M Boudreau
In previous studies, we found modestly decreased and increased risks of second breast cancer events with the use of statins and antibiotics, respectively, after adjustment for surveillance mammography. We evaluated detection bias by comparing receipt of surveillance mammography among users of these 2 disparate classes of medication. Adult women diagnosed with early-stage breast cancer during 1990-2008 (n = 3,965) while enrolled in an integrated health-care plan (Group Health Cooperative; Washington State) were followed for up to 10 years in the Commonly Used Medications and Breast Cancer Outcomes (COMBO) Study...
April 15, 2017: American Journal of Epidemiology
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