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Clinical audit

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https://www.readbyqxmd.com/read/29029117/the-european-registry-for-patients-with-mechanical-circulatory-support-euromacs-of-the-european-association-for-cardio-thoracic-surgery-eacts-second-report
#1
Theo M M H de By, Paul Mohacsi, Brigitta Gahl, Armin Zittermann, Thomas Krabatsch, Finn Gustafsson, Pascal Leprince, Bart Meyns, Ivan Netuka, Kadir Caliskan, Evaristo Castedo, Francesco Musumeci, André Vincentelli, Roland Hetzer, Jan Gummert
OBJECTIVES: The European Registry for Patients with Mechanical Circulatory Support (EUROMACS) was founded in Berlin, Germany. EUROMACS is supported fully by the European Association for Cardio-Thoracic Surgery (EACTS) and, since 2014, has functioned as a committee of the EACTS. The purpose of having the EUROMACS as a part of the EACTS is to accumulate clinical data related to long-term mechanical circulatory support for scientific purposes and to publish annual reports. METHODS: Participating hospitals contributed surgical and cardiological pre-, peri- and long-term postoperative data of mechanical circulatory support implants to the registry...
September 29, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29026761/postherpetic-neuralgia-diabetic-neuropathy-and-trigeminal-neuralgia-chronic-peripheral-neuropathic-pain-in-58-480-rural-italian-primary-care-patients
#2
Nicola Buono, Hans Thulesius, Ferdinando Petrazzuoli, Elena Castelli, Marco Cambielli
INTRODUCTION: Chronic peripheral neuropathic pain (CPNP) is a condition due to peripheral nervous system diseases or injury, but its prevalence is unknown in Italian primary care. AIM: The aim of this study is to assess the prevalence of CPNP in a rural primary care area in Northern Italy. MATERIALS AND METHODS: A multicenter audit study was carried out in a rural area in Northern Italy with 113 participating general practitioners (GPs) seeing 58,480 patients >18 years during 3 months...
January 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29025839/family-attitudes-actions-decisions-and-experiences-following-implementation-of-deemed-consent-and-the-human-transplantation-wales-act-2013-mixed-method-study-protocol
#3
Jane Noyes, Karen Morgan, Phillip Walton, Abigail Roberts, Leah Mclaughlin, Michael Stephens
INTRODUCTION: The Human Transplantation (Wales) Act 2013 (the Act) introduced a 'soft opt-out' system of organ donation on 1 December 2015. Citizens are encouraged to make their organ donation decision known during their lifetime. In order to work, the Act and media campaign need to create a context, whereby organ donation becomes the norm, and create a mechanism for people to behave as intended (formally register their decision; consider appointing a representative; convey their donation decision to their families and friends or do nothing-deemed consent)...
October 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29023974/diabetes-related-major-lower-limb-amputation-incidence-is-strongly-related-to-diabetic-foot-service-provision-and-improves-with-enhancement-of-services-peer-review-of-the-south-west-of-england
#4
R B Paisey, A Abbott, R Levenson, A Harrington, D Browne, J Moore, M Bamford, M Roe
AIMS: To investigate the relationship between high diabetes-related lower limb amputation incidence and foot care services in the South-West region of England. METHODS: The introduction of 10 key elements of foot care service provision in one area of the South-West resulted in stabilization of foot ulcer incidence and sustained reduction in amputation incidence from 2007. Services introduced included administrative support, standardized general practice foot screening, improved community podiatry staffing, hospital multidisciplinary foot clinics, effective care pathways, availability of an orthotist and audit...
October 11, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29022081/surgical-management-and-outcomes-of-12-cases-of-wilms-tumour-with-intracardiac-extension-from-a-single-centre
#5
Sharon G Cox, A Davidson, J Thomas, A Brooks, J Hewitson, A Numanoglu, A J W Millar
PURPOSE: To review demographics, effect of preoperative chemotherapy on tumour thrombus, imaging, operative strategy, and outcomes of 12 patients presenting with intracardiac extension of Wilms tumour thrombus. METHODS: A retrospective audit was undertaken on patients with intracardiac extension of Wilms tumour. Patients were identified from the oncology database and information obtained on clinical presentation, stage, preoperative treatment, surgical procedures and complications, histology, and survival status...
October 11, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/29021100/the-value-of-endomyocardial-biopsy-in-diagnosis-and-guiding-therapy
#6
Tayyaba Khan, Dinesh Selvakumar, Siddharth Trivedi, Karan Rao, Mehmet Harapoz, Aravinda Thiagalingam, A Robert Denniss, Winny Varikatt
Endomyocardial biopsy (EMB) is a highly-specialised procedure that is associated with some controversy as to its diagnostic role due to its inconsistency in diagnosing a wide variety of cardiac diseases. Given the advances and sophistication in echocardiography and cardiac magnetic resonance imaging (MRI), the vast majority of cardiac diseases can be diagnosed by these non-invasive procedures. Under-sampling and the fact that biopsy site is limited to the right side of the interventricular septum further limits its value...
October 8, 2017: Pathology
https://www.readbyqxmd.com/read/29019421/management-of-acute-pain-in-the-postoperative-setting-the-importance-of-quality-indicators
#7
Winfried Meissner, Frank Huygen, Edmund A M Neugebauer, Jürgen Osterbrink, Dan Benhamou, Neil Betteridge, Flaminia Coluzzi, José De Andres, William Fawcett, Dominique Fletcher, Eija Kalso, Henrik Kehlet, Bart Morlion, Antonio Montes Pérez, Joseph Pergolizzi, Michael Schäfer
Despite the introduction of evidence-based recommendations for postoperative pain management (POPM), the consensus is that pain control remains suboptimal. Barriers to achieving patient-satisfactory analgesia include deficient knowledge regarding POPM among staff, lack of instructions, insufficient pain assessments and sub-optimal treatment. Effective monitoring of POPM is essential to enable policy makers and healthcare providers to improve the quality of care. Quality indicators (QIs) are quantitative measures of clinical practice that can monitor, evaluate and guide the quality of care provided to patients...
October 11, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29019329/implications-of-observer-variation-in-gleason-scoring-of-prostate-cancer-on-clinical-management-a-collaborative-audit
#8
A Harbias, E Salmo, A Crump
BACKGROUND: Prostate cancer is the most frequently diagnosed cancer in men. Histological tumour grade is a strong predictor of outcome and helps determine what treatment options are offered. There are numerous studies on Inter-observer agreement/variability on prostate cancer grading. In this study, we were looking to establish if disconcordance between pathologists when grading prostate cancer, could affect treatment options offered to men. METHODS: In Greater Manchester West Cancer Sector, all prostate cancer biopsies undergo a central review by three pathologists with a special interest in urological pathology prior to referral for treatment at specialist centres...
September 2017: Gulf Journal of Oncology
https://www.readbyqxmd.com/read/29016980/effectiveness-and-cost-effectiveness-of-opportunistic-screening-and-stepped-care-interventions-for-older-alcohol-users-in-primary-care
#9
Simon Coulton, Martin Bland, Helen Crosby, Veronica Dale, Colin Drummond, Christine Godfrey, Eileen Kaner, Jennifer Sweetman, Ruth McGovern, Dorothy Newbury-Birch, Steve Parrott, Gillian Tober, Judith Watson, Qi Wu
Aims: To compare the clinical effectiveness and cost-effectiveness of a stepped-care intervention versus a minimal intervention for the treatment of older hazardous alcohol users in primary care. Method: Multi-centre, pragmatic RCT, set in Primary Care in UK. Patients aged ≥ 55 years scoring ≥ 8 on the Alcohol Use Disorders Identification Test were allocated either to 5-min of brief advice or to 'Stepped Care': an initial 20-min of behavioural change counselling, with Step 2 being three sessions of Motivational Enhancement Therapy and Step 3 referral to local alcohol services (progression between each Step being determined by outcomes 1 month after each Step)...
September 8, 2017: Alcohol and Alcoholism: International Journal of the Medical Council on Alcoholism
https://www.readbyqxmd.com/read/28994502/pro-protein-subtilisin-kexin-9-pcsk9-inhibition-in-practice-lipid-clinic-experience-in-2-contrasting-uk-centres
#10
Monika Kohli, Kinjal Patel, Zofia MacMahon, Radha Ramachandran, Martin A Crook, Timothy M Reynolds, Anthony S Wierzbicki
BACKGROUND: Prescribing criteria have been suggested for proprotein convertase subtilisin kexin-9 (PCSK-9) inhibitors but few studies exist of their real-world effectiveness. METHODS: This study audited PCSK-9 inhibitor therapy in 105 consecutive patients from two hospital centres-a university hospital (UH; n = 70) and a district general hospital (DGH; n = 35). Baseline characteristics including cardiovascular disease risk factors, NICE qualification criteria, efficacy and side effects were assessed...
October 10, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28993141/therapeutic-inertia-amongst-general-practitioners-with-interest-in-diabetes
#11
Samuel Seidu, Tun Than, Deb Kar, Amrit Lamba, Pam Brown, Azhar Zafar, Rizwan Hussain, Ahmed Amjad, Mathew Capehorn, Elizabeth Martin, Kevin Fernando, Jim McMoran, David Millar-Jones, Shahzada Kahn, Nigel Campbell, Richard Brice, Rahul Mohan, Mukesh Mistry, Naresh Kanumilli, Joan St John, Richard Quigley, Colin Kenny, Kamlesh Khunti
INTRODUCTION: As the therapeutic options in the management of type 2 diabetes increase, there is an increase confusion among health care professionals, thus leading to the phenomenon of therapeutic inertia. This is the failure to escalate or de-escalate treatment when the clinical need for this is required. It has been studied extensively in various settings, however, it has never been reported in any studies focusing solely on primary care physicians with an interest in diabetes. This group is increasingly becoming the focus of managing complex diabetes care in the community, albeit with the support from specialists...
October 6, 2017: Primary Care Diabetes
https://www.readbyqxmd.com/read/28992753/pelvic-vein-embolisation-of-gonadal-and-internal-iliac-veins-can-be-performed-safely-and-with-good-technical-results-in-an-ambulatory-vein-clinic-under-local-anaesthetic-alone-results-from-two-years-experience
#12
Mark S Whiteley, Chiyinde Lewis-Shiell, Sophia I Bishop, Eluned L Davis, Tim J Fernandez-Hart, Previn Diwakar, David Beckett
Objectives Pelvic vein embolisation is increasing in venous practice for the treatment of conditions associated with pelvic venous reflux. In July 2014, we introduced a local anaesthetic "walk-in walk-out" pelvic vein embolisation service situated in a vein clinic, remote from a hospital. Methods Prospective audit of all patients undergoing pelvic vein embolisation for pelvic venous reflux. All patients had serum urea and electrolytes tested before procedure. Embolisation coils used were interlock embolisation coils (Boston Scientific, USA) as they can be repositioned after deployment and before release...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/28991096/evaluation-of-intervention-fidelity-in-a-multisite-clinical-trial-in-persons-with-multiple-sclerosis
#13
Janet D Morrison, Heather Becker, Alexa K Stuifbergen
BACKGROUND: Careful consideration of intervention fidelity is critical to establishing the validity and reliability of research findings, yet such reports are often lacking in the research literature. It is imperative that intervention fidelity be methodically evaluated and reported to promote the translation of effective interventions into sound evidence-based practice. PURPOSE: The purpose of this article is to explore strategies used to promote intervention fidelity, incorporating examples from a multisite clinical trial, that illustrate the National Institutes of Health Behavior Change Consortium's 5 domains for recommended treatment practices: (1) study design, (2) facilitator training, (3) intervention delivery, (4) intervention receipt, and (5) intervention enactment...
October 5, 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28989910/clinical-implications-of-tigrt-algorithm-for-external-audit-in-radiation-oncology
#14
Daryoush Shahbazi-Gahrouei, Mohsen Saeb, Shahram Monadi, Iraj Jabbari
BACKGROUND: Performing audits play an important role in quality assurance program in radiation oncology. Among different algorithms, TiGRT is one of the common application software for dose calculation. This study aimed to clinical implications of TiGRT algorithm to measure dose and compared to calculated dose delivered to the patients for a variety of cases, with and without the presence of inhomogeneities and beam modifiers. MATERIALS AND METHODS: Nonhomogeneous phantom as quality dose verification phantom, Farmer ionization chambers, and PC-electrometer (Sun Nuclear, USA) as a reference class electrometer was employed throughout the audit in linear accelerators 6 and 18 MV energies (Siemens ONCOR Impression Plus, Germany)...
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/28989891/effect-of-a-low-calorie-diet-on-restoration-of-normoglycemia-in-obese-subjects-with-type-2-diabetes
#15
Anjali Amit Bhatt, Priya K Choudhari, Rutuja R Mahajan, Mehmood G Sayyad, Devi D Pratyush, Imtiaz Hasan, Rajesh S Javherani, Manish M Bothale, Vedavati B Purandare, Ambika Gopalakrishnan Unnikrishnan
INTRODUCTION: Type 2 diabetes mellitus (T2DM) is considered to be an inevitably progressive disease. Complex therapies add to the financial and psychological burden. Very low-calorie diets (LCDs) are emerging as an option in the management of type 2 diabetes. METHODS: We performed a clinical audit of patients with T2DM who received 12 weeks of LCD. RESULTS: This case series documents that 6 out of 12 participants (median baseline HbA1c 9%) achieved HbA1c level in nondiabetes range with LCD despite stopping all antidiabetes medications...
September 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28989570/eye-and-foot-checks-in-patients-with-diabetes-on-haemodialysis-are-they-done-and-who-does-them
#16
Nadira Bibi Mothojakan, Shazia Hussain, Kieran McCafferty, Mohammed Magdi Yaqoob, Tahseen Ahmad Chowdhury
AIM: To determine if retinal and foot checks are carried out on patients with diabetes receiving haemodialysis. METHODS: Eighty-four patients with diabetes receiving haemodialysis were asked if they recalled having eye and foot screening in the last year, and if so, by whom was the check done. RESULTS: Seventy-seven (91.7%) patients recalled having an eye check in the preceding 12 mo. Of these, 52 (67.5%) did so in an ophthalmology clinic, 17 (22%) in retinal screening, three (3...
September 15, 2017: World Journal of Diabetes
https://www.readbyqxmd.com/read/28989491/an-evaluation-of-the-effectiveness-of-an-algorithm-intervention-in-reducing-inappropriate-faecal-samples-sent-for-clostridium-difficile-testing
#17
Irene Thompson, Colin Lavelle, Laurence Leonard
BACKGROUND: Clostridium difficile (C. difficile) is a leading cause of infectious diarrhoea in hospitals. Sending faecal samples for testing expedites diagnosis and appropriate treatment. Clinical suspicion of C. difficile based on patient history, signs and symptoms is the basis for sampling. Sending faecal samples from patients with diarrhoea 'just in case' the patient has C. difficile may be an indication of poor clinical management. AIM: To evaluate the effectiveness of an intervention by an Infection Prevention and Control Team (IPCT) in reducing inappropriate faecal samples sent for C...
November 2016: Journal of Infection Prevention
https://www.readbyqxmd.com/read/28988220/laboratory-performance-of-sweat-conductivity-for-the-screening-of-cystic-fibrosis
#18
Ronda F Greaves, Lisa Jolly, John Massie, Sue Scott, Veronica C Wiley, Michael P Metz, Richard J Mackay
BACKGROUND: There are several complementary English-language guidelines for the performance of the sweat chloride test. These guidelines also incorporate information for the collection of conductivity samples. However, recommendations for the measurement and reporting of sweat conductivity are less clear than for sweat chloride. The aim of the study was to develop an understanding of the testing and reporting practices of sweat conductivity in Australasian laboratories. METHODS: A survey specifically directed at conductivity testing was sent to the 12 laboratories registered with the Royal College of Pathologists of Australasia Quality Assurance Programs...
October 9, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28986062/quality-control-of-regional-wall-motion-analysis-in-stress-echo-2020
#19
Quirino Ciampi, Eugenio Picano, Marco Paterni, Clarissa Borguezan Daros, Iana Simova, José Luis de Castro E Silva Pretto, Maria Chiara Scali, Nicola Gaibazzi, Sergio Severino, Ana Djordjevic-Dikic, Jaroslaw D Kasprzak, Angela Zagatina, Albert Varga, Jorge Lowenstein, Pablo Martin Merlo, Miguel Amor, Jelena Celutkiene, Julio E Perez, Giovanni Di Salvo, Maurizio Galderisi, Fabio Mori, Marco Fabio Costantino, Laura Massa, Milica Dekleva, Daniel Quesada Chaves, Paolo Trambaiolo, Rodolfo Citro, Paolo Colonna, Fausto Rigo, Marco A R Torres, Ines Monte, Ivan Stankovic, Aleksander Neskovic, Lauro Cortigiani, Federica Re, Claudio Dodi, Antonello D'Andrea, Bruno Villari, Ayana Arystan, Michele De Nes, Clara Carpeggiani
BACKGROUND: The trial "Stress Echo (SE) 2020" evaluates novel applications of SE beyond coronary artery disease. The aim of the study was control quality and harmonize reading criteria. METHODS: One reader from 78 centers of the SE 2020 network asked for credentials to read a set of 20 SE video-clips selected by the core lab. All aspiring centers met the pre-requisite of high-volume and the years of experience in SE ranged from 5 to 31years (mean value 18years)...
October 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28985800/the-application-of-a-6s-lean-initiative-to-improve-workflow-for-emergency-eye-examination-rooms
#20
Samir Nazarali, Jaspreet Rayat, Hilary Salmonson, Theodora Moss, Pamela Mathura, Karim F Damji
BACKGROUND: Ophthalmology residents on call at the Royal Alexandra Hospital identified workplace disorganization and lack of standardization in emergency eye examination rooms as an impediment to efficient patient treatment. OBJECTIVE: The aim of the study was to use the "6S Lean" model to improve workflow in eye examination rooms at the Royal Alexandra Hospital. METHODS: With the assistance of quality improvement consultants, the "6S Lean" model was applied to the current operation of the emergency eye clinic examination rooms...
October 2017: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
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