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https://www.readbyqxmd.com/read/29331398/critical-differences-between-elective-and-emergency-surgery-identifying-domains-for-quality-improvement-in-emergency-general-surgery
#1
Alexandra B Columbus, Megan A Morris, Elizabeth J Lilley, Alyssa F Harlow, Adil H Haider, Ali Salim, Joaquim M Havens
OBJECTIVE: The objective of our study was to characterize providers' impressions of factors contributing to disproportionate rates of morbidity and mortality in emergency general surgery to identify targets for care quality improvement. BACKGROUND: Emergency general surgery is characterized by a high-cost burden and disproportionate morbidity and mortality. Factors contributing to these observed disparities are not comprehensively understood and targets for quality improvement have not been formally developed...
January 10, 2018: Surgery
https://www.readbyqxmd.com/read/29319654/trauma-and-intensive-care-nursing-knowledge-and-attitude-of-foley-catheter-insertion-and-maintenance
#2
Brenda Shaver, Stephanie A Eyerly-Webb, Zoe Gibney, Linda Silverman, Candace Pineda, Rachele J Solomon
In the acute care setting, the majority of urinary tract infections are associated with indwelling urinary catheters. Despite guidelines for proper use, catheter-associated urinary tract infections (CAUTIs) continue to occur in critically ill/injured patients. There is a paucity of data on the translation between CAUTI prevention education and behavioral change. This project evaluated nurse's clinical knowledge and attitude toward Foley catheter insertion and maintenance to determine the benefits of addressing gaps in knowledge and inconsistencies in attitude through education...
January 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29318344/severe-casualties-from-bastille-day-attack-in-nice-france
#3
Federico Solla, Joseph Carboni, Arnaud Fernandez, Audrey Dupont, Nathalie Chivoret, Gilles Brézac, Virginie Rampal, Jean Bréaud
PURPOSE: To describe the most severe casualties from the July 14th, 2016 terror attack in Nice that were treated at the Lenval University Children's Hospital (LUCH) of Nice (France). METHODS: Retrospective study about casualties treated at LUCH from Bastille Day Attack with injuries resulting in the need for surgery, resuscitation, or death. The type of lesions and surgery, duration of hospitalizations, complications, psychological status, and outcome at discharge were collected...
January 9, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29240656/hospital-acquired-pressure-injury-risk-adjusted-comparisons-in-an-integrated-healthcare-delivery-system
#4
June Rondinelli, Stephen Zuniga, Patricia Kipnis, Lina Najib Kawar, Vincent Liu, Gabriel J Escobar
BACKGROUND: Although healthcare organizations have decreased hospital-acquired pressure injury (HAPI) rates, HAPIs are not eliminated, driving further examination in both nursing and health services research. OBJECTIVE: The objective was to describe HAPI incidence, risk factors, and risk-adjusted hospital variation within a California integrated healthcare system. METHODS: Inpatient episodes were included in this retrospective cohort if patients were hospitalized between January 1, 2013, and June 30, 2015...
January 2018: Nursing Research
https://www.readbyqxmd.com/read/29216349/developing-a-standard-set-of-patient-centred-outcomes-for-inflammatory-bowel-disease-an-international-cross-disciplinary-consensus
#5
Andrew H Kim, Charlotte Roberts, Brian G Feagan, Rupa Banerjee, Willem Bemelman, Keith Bodger, Marc Derieppe, Axel Dignass, Richard Driscoll, Ray Fitzpatrick, Janette Gaarentstroom-Lunt, Peter D Higgins, Paulo Gustavo Kotze, Jillian Meissner, Marian O'Connor, Zhi-Hua Ran, Corey A Siegel, Helen Terry, Welmoed K van Deen, C Janneke van der Woude, Alandra Weaver, Suk-Kyun Yang, Bruce E Sands, Séverine Vermeire, Simon Pl Travis
Background and Aims: Success in delivering value-based healthcare involves measuring outcomes that matter most to patients. Our aim was to develop a minimum Standard Set of patient-centred outcome measures for inflammatory bowel disease (IBD), for use in different healthcare settings. Methods: An international working group (n=25) representing patients, patient associations, gastroenterologists, surgeons, specialist nurses, IBD registries and patient-reported outcome measure (PROM) methodologists participated in a series of teleconferences incorporating a modified Delphi process...
December 5, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/29215421/educating-emergency-department-nurses-about-miscarriage
#6
Joyce L Merrigan
Miscarriage is the unwanted ending of a pregnancy before 20 weeks gestation. Women experiencing miscarriage require specialized care from nurses and other healthcare professionals. Many women are dissatisfied with emergency care related to miscarriage and desire honest communication, validation of urgency, and more robust information at discharge. Perinatal bereavement education offers an opportunity for emergency department nurses to acquire specific knowledge and communication skills that assist with understanding the individualized experience of early pregnancy loss...
January 2018: MCN. the American Journal of Maternal Child Nursing
https://www.readbyqxmd.com/read/29205442/palliative-care-for-end-of-life-patients-in-a-basic-emergency-service
#7
REVIEW
Maria Eduarda Diniz Pereira, António Barbosa, Maria Dos Anjos Dixe
This research sought to describe the care provided by the nursing staff of the Western Department of the Basic Emergency Service for end-of-life patients. This was a retrospective, quantitative, exploratory and descriptive (level I) study, which sought to research the nursing records of 83 patients from admission to death. Patients who met the following inclusion criteria were considered eligible: adults; had an oncological or nononcological, advanced and irreversible chronic disease; and died in the Basic Emergency Service in the period from January 2011 to December 2012...
December 5, 2017: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/29202118/emergency-department-asthma-medication-delivery-program-an-initiative-to-provide-discharge-prescriptions-and-education
#8
Kayla Durkin, Tricia Montgomery, Kristen Lamberjack, Cindy C Hafer, James Naprawa, Shannon Yarosz
Background: Prescription fill rates for children being discharged from the emergency department (ED) after asthma exacerbations are low, placing the child at risk for additional ED visits or admissions for asthma. This article describes the implementation of an ED asthma prescription delivery service designed to improve pharmacy prescription capture and decrease ED revisit rates. Methods: A core group developed a service to provide asthma prescriptions and education to patients in their ED room before discharge...
July 2017: Pediatric Quality & Safety
https://www.readbyqxmd.com/read/29191263/persistent-and-severe-hypoglycemia-associated-with-trimethoprim-sulfamethoxazole-in-a-frail-diabetic-man-on-polypharmacy-a-case-report-and-literature-review%C3%A2
#9
Raffaella Rossio, Sara Arcudi, Flora Peyvandi, Stefania Piconi
OBJECTIVE: Trimethoprim-sulfamethoxazole (co-trimoxazole) is a commonly used broad-spectrum antibiotic, but it can be associated with potentially serious adverse effects, often not recognized by clinicians. This is a relevant problem in elderly patients, who are particularly susceptible to adverse drug reactions. Moreover, multiple medications taken by older people increase the risk for adverse drug reactions and drug-drug interactions. CASE REPORT: We report the case of an 85-year-old man with diabetes mellitus who attended the emergency room with severe hypoglycemia that persisted despite multiple intravenous bolus doses and continuous infusion of glucose...
November 30, 2017: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29189967/evaluation-of-a-specialized-oncology-nursing-supportive-care-intervention-in-newly-diagnosed-breast-and-colorectal-cancer-patients-following-surgery-a-cluster-randomized-trial
#10
Jonathan Sussman, Daryl Bainbridge, Timothy J Whelan, Kevin Brazil, Sameer Parpia, Jennifer Wiernikowski, Susan Schiff, Gary Rodin, Myles Sergeant, Doris Howell
BACKGROUND: Better coordination of supportive services during the early phases of cancer care has been proposed to improve the care experience of patients. We conducted a randomized trial to test a community-based nurse-led coordination of care intervention in cancer patients. METHODS: Surgical practices were cluster randomized to a control group involving usual care practices or a standardized nursing intervention consisting of an in-person supportive care assessment with ongoing support to meet identified needs, including linkage to community services...
November 30, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29189646/the-impact-of-early-involvement-in-a-postdischarge-support-program-for-ostomy-surgery-patients-on-preventable-healthcare-utilization
#11
Sirikan Rojanasarot
PURPOSE: To evaluate the impact of a postdischarge ostomy support program as an adjunct to nurse-led ostomy care on preventable healthcare utilization. DESIGN: A cross-sectional study. SUBJECTS AND SETTING: A postdischarge support program offered by an ostomy product's manufacturer provides persons living with an ostomy with patient-centered and easily accessible assistance. Individuals who underwent ostomy surgery within 18 months prior to the survey date were selected from an ostomy patient database maintained by the ostomy patient support program provider...
November 20, 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/29170352/55%C3%A2-mini-sim-innovative-bite-sized-simulation-teaching-in-a-busy-children-s-emergency-department
#12
Rachel Sunley, Karen Moloney, Jessica Parker, Christopher Arrowsmith, Kirsty Brown, Alex Wilson
: Emergency Medicine requires a highly skilled workforce who are passionate about delivering excellent patient care. Shift patterns linked with the ever increasing numbers of patients who attend Emergency Departments puts strain on educating the workforce and fostering team togetherness.Our objective in devising and instigating the 'Mini Sim' programme was to embed regular in-situ simulation training to enhance the learning of all staff within our Emergency Department team, building a highly trained workforce to deliver excellent care within the remit of our busy department...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29170333/36%C3%A2-frailty-flying-squad-an-emergency-department-focussed-acute-care-of-the-elderly-service-dr-genevieve-robson-royal-united-hospital-nhs-foundation-trust
#13
Samantha Ballham, Scott Buxton, Rosa Camacho, Adrianna Sinclair, Chris Dyer, Nicola Jakeman
INTRODUCTION: The over 75 s make up 20% of our ED attendances. The greatest increase has been in the over 85 s. This very elderly cohort are more likely to be frail and are 10X more likely to require admission than 20-40 year olds and once in hospital have longer stays. There is evidence that multidisciplinary care and early Comprehensive Geriatric Assessment (CGA) improves outcomes for older patients, reducing readmissions, long term care, greater satisfaction and lower costs. The aim of this project was to improve the acute care provided to our older patients at the Front Door of the hospital...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29170323/26%C3%A2-protocol-for-the-upcoming-study-patient-input-monitoring-of-pain-in-the-emergency-room-novel-electronic-log-pimpernel-a-randomised-controlled-trial-of-an-electronic-pain-score-display-in-adults-in-the-emergency-department
#14
Hilary Thornton, Timothy Coats
BACKGROUND: Patient surveys and research have shown that Emergency Department attendees do not receive adequate analgesia. Pain monitoring has not been automated and usually involves a member of staff asking the patient to rate their score with no continuous record, often no specific place to record it and no automated alarm system for scores outside accepted parameters. Few patients have regular monitoring of their pain and our own preliminary research showed that over one week only 58% of patients with moderate to severe pain had a second or subsequent score recorded...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29169918/the-use-of-body-habitus-reference-images-improves-the-ability-of-novices-to-accurately-estimate-children-s-weight-using-the-pawper-xl-tape-system
#15
Mike Wells, Lara Nicole Goldstein, Alison Bentley
BACKGROUND: The original methodology of the PAWPER (Pediatric Advanced Weight Prediction in the Emergency Room) tape relies on a gestalt visual assessment of a child's body habitus to adjust a length-based weight estimation. This assessment is dependent on the user's subjective opinion, which may result in aberrations in accuracy between users and populations. With the development of the second-generation PAWPER XL tape, a more objective method of habitus evaluation was desired. OBJECTIVE: The aim of this study was to evaluate a new, more objective figural reference image system and a new checklist system for quantifying body habitus...
November 20, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29159555/use-of-a-hands-free-instantaneous-closed-loop-communication-device-improves-perception-of-communication-and-workflow-integration-in-an-academic-teaching-hospital-a-pilot-study
#16
Daniel Z Fang, Teja Patil, Ilana Belitskaya-Levy, Marianne Yeung, Keith Posley, Nazima Allaudeen
Efficient and effective communication between providers is critical to quality patient care within a hospital system. Hands free communication devices (HFCD) allow instantaneous, closed-loop communication between physicians and other members of a multidisciplinary team, providing a communication advantage over traditional pager systems. HFCD have been shown to decrease emergency room interruptions, improve nursing communication, improve speed of information flow, and eliminate health care waste. We evaluated the integration of an HFCD with an existing alphanumeric paging system on an acute inpatient medicine service...
November 17, 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/29148125/understanding-the-factors-which-promote-registered-nurses-intent-to-stay-in-critical-care-and-emergency-areas
#17
Mary Van Osch, Kathy Scarborough, Sarah Crowe, Angela C Wolff, Sheryl Reimer-Kirkham
BACKGROUND: Turnover among registered nurses (herein referred to as nurses) working in specialty areas of practice can result in a range of negative outcomes. The retention of specialty nurses at the unit level has important implications for hospital and health systems. These implications include lost knowledge and experience which may in turn impact staff performance levels, patient outcomes, hiring, orientating, development of clinical competence and other aspects of organizational performance...
November 17, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29125364/improving-care-for-patients-with-dementia-in-the-recovery-room
#18
Helena Edis
Caring for patients with dementia emerging from general anaesthesia in the recovery room can be very challenging. Sedation is sometimes necessary in order to nurse patients effectively and avoid any negative consequences of poor post-anaesthetic care. No local or national guidelines could be found to suggest best nursing practice in this situation. Three small-scale innovations were introduced into the recovery room in one hospital as part of a quality improvement project to give alternatives to chemical restraint...
November 9, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29108693/implementation-of-the-medfrat-to-promote-quality-care-and-decrease-falls-in-community-hospital-emergency-rooms
#19
Catherine A McCarty, Theo A Woehrle, Stephen C Waring, Allise M Taran, Laura A Kitch
ABSTRACTPURPOSE: To identify and implement an evidence-based fall-risk assessment tool for use in emergency departments at Essentia Health, a large, primarily rural health care delivery system with 12 emergency departments. METHODS: The Iowa Model of Evidence-Based Practice to Promote Quality Care was used to guide the process. The Memorial Emergency Department Fall-Risk Assessment Tool (MEDFRAT) was programmed into the electronic medical record, along with interventions that could be selected for 2 fall-risk levels...
November 3, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/29094496/knowledge-gap-regarding-dementia-care-among-nurses-in-taiwanese-acute-care-hospitals-a-cross-sectional-study
#20
Pei-Chao Lin, Mei-Hui Hsieh, Meng-Chin Chen, Yung-Mei Yang, Li-Chan Lin
AIM: The quality of dementia care in hospitals is typically substandard. Staff members are underprepared for providing care to older people with dementia. The objective of the present study was to examine dementia care knowledge, attitude and behavior regarding self-education about dementia care among nurses working in different wards. METHODS: This was a descriptive cross-sectional study. The present study was carried out from July 2013 to December 2013. In total, 387 nurses working in different wards were recruited from two hospitals in Taiwan by using convenience sampling...
November 2, 2017: Geriatrics & Gerontology International
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