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"multiple hospitalizations"

Katie E Pettit, Joseph S Turner, Katherine A Pollard, Bryce B Buente, Aloysius J Humbert, Anthony J Perkins, Cherri D Hobgood, Jeffrey A Kline
Introduction: Effective communication between clinicians and patients has been shown to improve patient outcomes, reduce malpractice liability, and is now being tied to reimbursement. Use of a communication strategy known as "scripting" has been suggested to improve patient satisfaction in multiple hospital settings, but the frequency with which medical students use this strategy and whether this affects patient perception of medical student care is unknown. Our objective was to measure the use of targeted communication skills after an educational intervention as well as to further clarify the relationship between communication element usage and patient satisfaction...
May 2018: Western Journal of Emergency Medicine
Heather J-M Diaz, Dale Ainsworth, Mathew C Schmidtlein
The Patient Protection and Affordable Care Act of 2010 mandated nonprofit hospitals to complete community health needs assessments (CHNAs) every 3 years to identify priority health needs for the community they serve. The CHNA must include input from the community in the determination of health needs. Large variation exists across CHNAs on methods used in the integration of quantitative and qualitative data both in the determination and prioritization of health needs and those needs chosen by the hospital for community benefit funding...
May 1, 2018: Health Promotion Practice
Martha F Mherekumombe
Children and young people with life-limiting illnesses who need palliative care often have complex diverse medical conditions that may involve multiple hospital presentations, medical admissions, care, or transfer to other medical care facilities. In order to provide patients with holistic care in any location, palliative care clinicians need to carefully consider the ways to maintain continuity of care which enhances the child's quality of life. An emerging model of care known as "Pop Up" describes the approaches to supporting children and young people in any facility...
April 26, 2018: Children
Kim Mooney-Doyle, Jessica Keim-Malpass, Lisa C Lindley
Recent estimates indicate that over 40,000 children die annually in the United States and a majority have life-limiting conditions. Children at end of life require extensive healthcare resources, including multiple hospital readmissions and emergency room visits. Yet, many children still suffer from symptoms at end of life-including fatigue, pain, dyspnea, and anxiety-with less than 10% of these children utilizing hospice care services. A critical barrier to pediatric hospice use was the original federal regulations associated with the hospice care that required a diagnosis of 6 months to live and the discontinuation of all curative treatments...
January 1, 2018: Nursing Ethics
Ahmad Almalki
INTRODUCTION: The described case is a patient with pancreatic arteriovenous malformation involving the entire pancreas and complicated with intrapancereatic abscess. PRESENTATION OF CASE: A 47 years-old was suffering from episodes of abdominal pain and vomiting with multiple hospital visits without reaching a diagnosis for four months. Contrast-enhanced computed tomography scan (CECT) done which shows a 1.6 × 1.4 cm fluid collection was seen in uncinate process of the pancreas, Magnetic resonance imaging (MRI) demonstrates abnormal vasculature involving the pancreas...
March 22, 2018: International Journal of Surgery Case Reports
Siva Harsha Yedlapati, Scott H Stewart
Aims: Hospital readmissions serve as a major benchmark for the quality of care and alcohol withdrawal (AW) may lead to multiple hospitalizations and readmissions. We sought to evaluate readmission rates and predictors of having AW-related readmissions in a nationally representative sample. Short summary: In a nationally representative sample, AW readmission within 30 days and multiple readmissions during the year were high and were particularly predicted by discharge against medical advice (AMA), comorbid psychosis, comorbid depression, poor socioeconomic status, comorbid drug abuse and alcohol-related medical disease...
March 30, 2018: Alcohol and Alcoholism: International Journal of the Medical Council on Alcoholism
Nitin Sajankila, Jack C He, Brenda M Zosa, Debra L Allen, Jeffrey A Claridge
A Regional Trauma Network (RTN), composed of one level I and several lower-level trauma centers (TCs) across multiple hospital systems, was established in 2010. This collaborative network used a unified triage protocol and a single transfer center. The impact of this RTN was assessed by evaluating regional mortality changes before and after RTN establishment. Patients in the state trauma registry aged 15 and older from 2006 to 2012 were analyzed; 2006 to 2009 and 2010 to 2012 were designated as pre-RTN and RTN periods, respectively...
February 1, 2018: American Surgeon
Bin Yang, Peng Xu, Yichao Shi, Jixiu Xu, Lianwen Zheng, Haisong Li, Lianghong Ma, Shenmin Yang, Yong Zhao, Yan Zhang, Qiang Du, Qingjun Chu, Bin Chen, Yan Tan, Xiangru Li, Chaobin Li, Fa Sun, Yongtong Zhu, Hongjun Li
BACKGROUND: Knowledge on the occurrence of erectile dysfunction (ED) and timely ovulatory intercourse failure (TOIF) in Chinese men of infertile couples is limited. AIM: To obtain representative estimates of ED and TOIF in Chinese men of infertile couples and to analyze potential risk factors associated with ED. METHODS: 4,299 Chinese men of infertile couples with an average age of 32.85 ± 5.98 years were surveyed using the 5-item International Index of Erectile Function (IIEF-5) questionnaire for their ED occurrence...
March 22, 2018: Journal of Sexual Medicine
Dan Schenkat, Steve Rough, Amanda Hansen, David Chen, Scott Knoer
PURPOSE: The results of a survey of multihospital pharmacy leaders are summarized, and a road map for creating organizational value with the pharmacy enterprise is presented. SUMMARY: A survey was designed to evaluate the level of integration of pharmacy services across each system's multiple hospitals, determine the most commonly integrated services, determine whether value was quantified when services were integrated, collect common barriers for finding value through integration, and identify strategies for successfully overcoming these barriers...
April 1, 2018: American Journal of Health-system Pharmacy: AJHP
Xiaolei Xiong, Zhiguo Zhang, Jing Ren, Jie Zhang, Xiaoyun Pan, Liang Zhang, Shiwei Gong, Si Jin
BACKGROUND: China's universal medical insurance system (UMIS) is designed to promote social fairness through improving access to medical services and reducing out-of-pocket (OOP) costs for all Chinese. However, it is still not known whether UMIS has a significant impact on the accessibility of medical service supply and the affordability, as well as the seeking-care choice, of patients in China. METHODS: Segmented time-series regression analysis, as a powerful statistical method of interrupted time series design, was used to estimate the changes in the quantity and quality of medical service supply before and after the implementation of UMIS...
2018: PloS One
Craig D Newgard, Rochelle Fu, Susan Malveau, Tom Rea, Denise E Griffiths, Eileen Bulger, Pat Klotz, Abbie Tirrell, Dana Zive
Conducting out-of-hospital research is unique and challenging and requires tracking patients across multiple phases of care, using multiple sources of patient records and multiple hospitals. The logistics and strategies used for out-of-hospital research are distinct from other forms of clinical research. The increasing use of electronic health records (EHRs) by hospitals and emergency medical services (EMS) agencies presents a large opportunity for accelerating out-of-hospital research, as well as particular challenges...
March 1, 2018: Prehospital Emergency Care
Mohammad Jafferany, Zaira Khalid, Katherine A McDonald, Amanda J Shelley
Factitious disorder can present in multiple health care settings, with patients intentionally producing symptoms to assume the sick role. This assumption of the sick role can result in multiple hospitalizations with unnecessary diagnostic workup, as well as invasive diagnostic procedures that can lead to worrisome side effects. Differential diagnoses that should be ruled out include malingering, somatic symptom disorder, and anxiety disorders. For many providers, patients with factitious disorder can be a challenge to treat because the etiology of the disorder remains unclear...
February 22, 2018: Primary Care Companion to CNS Disorders
Melissa Horlait, Simon Van Belle, Mark Leys
BACKGROUND: Multidisciplinary team meetings (MDTMs) have become standard practice in oncology and gained the status of the key decision-making forum for cancer patient management. The current literature provides evidence that MDTMs are achieving their intended objectives but there are also indications to question the positive impact of MDTMs in oncology settings. For cancer management to be patient-centered, it is crucial that medical information as well as psychosocial aspects-such as the patients' living situation, possible family problems, patients' mental state, and patients' perceptions and values or preferences towards treatment or care-are considered and discussed during MDTMs...
February 26, 2018: JMIR Research Protocols
S Takadama, H Nakaminami, A Sato, M Shoshi, T Fujii, N Noguchi
OBJECTIVES: Panton-Valentine leukocidin (PVL) gene (lukS/F-PV)-positive community-acquired methicillin-resistant Staphylococcus aureus (MRSA), particularly the USA300 clone, is a health concern worldwide. Recently, community-acquired MRSA clones have been found to spread and persist in hospital settings. We aimed to investigate the prevalence and molecular epidemiologic features of lukS/F-PV-positive MRSA in Japanese hospitals. METHODS: A total of 3433 MRSA isolated from nine hospitals in 2011-2015 were assessed...
February 16, 2018: Clinical Microbiology and Infection
E C Deasy, E M Moloney, M A Boyle, J S Swan, D A Geoghegan, G I Brennan, T E Fleming, M J O'Donnell, D C Coleman
BACKGROUND: Outbreaks of infection associated with microbial biofilm in hospital hand washbasin U-bends are being reported increasingly. In a previous study, the efficacy of a prototype automated U-bend decontamination method was demonstrated for a single non-hospital pattern washbasin. It used two electrochemically activated solutions (ECA) generated from brine: catholyte with detergent properties and anolyte with disinfectant properties. AIM: To develop and test a large-scale automated ECA treatment system to decontaminate 10 hospital pattern washbasin U-bends simultaneously in a busy hospital clinic...
February 2, 2018: Journal of Hospital Infection
Katharina L van Santen, Jonathan R Edwards, Amy K Webb, Lori A Pollack, Erin O'Leary, Melinda M Neuhauser, Arjun Srinivasan, Daniel A Pollock
Background: To provide a standardized, risk-adjusted method for summarizing antibiotic use (AU) and to enable hospitals to track their AU over time and compare their AU data to national benchmarks, CDC developed a new metric, the Standardized Antimicrobial Administration Ratio (SAAR). Methods: Hospitals reporting to the National Healthcare Safety Network (NHSN) AU Option collect and submit aggregated AU data electronically as antimicrobial days of therapy per patient days present...
February 2, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
S Suresh, G S De Oliveira
BACKGROUND: The knowledge regarding appropriate dosage of local anaesthetics for peripheral nerve blocks in children is very scarce. The main objective of the current investigation was to evaluate dosing patterns of local anaesthetics in children receiving peripheral nerve blocks across multiple paediatric hospitals in the USA. We also sought to estimate the incidence of local anaesthetic systemic toxicity. METHODS: This is an observational study using the Pediatric Regional Anesthesia Network (PRAN) database...
February 2018: British Journal of Anaesthesia
Mei-Feng Huang, Chen-Hsiang Su, Hung-Pin Tu, Tai-Ling Liu, Chih-Lung Lin, Cheng-Sheng Chen, Yi-Chun Yeh
Mental disorders may confer a high risk of traumatic brain injury, but only rare studies have investigated mood disorders. This nationwide cohort study compared the risk of traumatic brain injury in patients with and without bipolar disorder. We compared 1017 patients with bipolar disorder who received inpatient treatment and 9080 compared patients. The annual incidence rate of traumatic brain injury was calculated as the number of new cases divided by the total number of person-years in the available records...
March 2018: Psychiatry Research
Rebekah J Nevel, Errine T Garnett, Deneen A Schaudies, Lisa R Young
RATIONALE: Neuroendocrine cell hyperplasia of infancy (NEHI) typically presents in infancy with tachypnea, retractions, and hypoxemia. Some infants have failure to thrive, yet the frequency of this and other non-respiratory phenotypic features have not been delineated. While gradual improvement occurs, the clinical course is variable and the duration of supplemental oxygen requirement has not been defined. OBJECTIVES: Our objective was to identify factors in NEHI that may drive differences in clinical course...
May 2018: Pediatric Pulmonology
Joseph M Banno, Katherine Shield, Krunal Patel, Anupam A Sule
Mycobacterium abscessus is a fast growing, non-tubercular mycobacterium (NTM) found in water. NTM bacteremia is usually seen in immunocompromised patients who have intravascular catheters. Mycobacterium abscessus bacteremia is often caused by exposure to contaminated water supply in hemodialysis units. A 28-year-old female with poorly controlled diabetes mellitus, end stage renal disease (on hemodialysis via Ash catheter), and recurrent deep vein thrombosis presented to the hospital with proximal right leg deep vein thrombosis...
November 27, 2017: Curēus
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