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Clinical audit

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https://www.readbyqxmd.com/read/28104042/electronic-health-records-and-online-medical-records-an-asset-or-a-liability-under-current-conditions
#1
Judith Allen-Graham, Lauren Mitchell, Natalie Heriot, Roksana Armani, David Langton, Michele Levinson, Alan Young, Julian A Smith, Tom Kotsimbos, John W Wilson
Objective The aim of the present study was to audit the current use of medical records to determine completeness and concordance with other sources of medical information.Methods Medical records for 40 patients from each of five Melbourne major metropolitan hospitals were randomly selected (n=200). A quantitative audit was performed for detailed patient information and medical record keeping, as well as data collection, storage and utilisation. Using each hospital's current online clinical database, scanned files and paperwork available for each patient audited, the reviewers sourced as much relevant information as possible within a 30-min time allocation from both the record and the discharge summary...
January 20, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28103161/nurses-practice-in-preventing-postoperative-wound-infections-an-observational-study
#2
S Ding, F Lin, A P Marshall, B M Gillespie
OBJECTIVE: Surgical site infections (SSIs) are serious postoperative complications that may lead to undesired patient outcomes. Previous research has used survey and chart audit methods to describe wound care practices. However, little research has been published using contemporaneous observations to describe the surgical wound management practices of nurses. The aim of this study was to prospectively describe surgical nurses' postoperative wound care practices and the extent to which observed surgical wound practices aligned with evidence-based guideline recommendations...
January 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28102928/reduction-in-colposcopy-workload-and-associated-clinical-activity-following-hpv-catch-up-vaccination-programme-in-scotland-an-ecological-study
#3
M E Cruickshank, J Pan, S C Cotton, K Kavanagh, C Robertson, K Cuschieri, H Cubie, T Palmer, K G Pollock
OBJECTIVE: To measure patterns of clinical activity at colposcopy before and after vaccinated women entered the Scottish Cervical Screening Programme (SCSP). DESIGN: Population-based observational study using nationally collected data. SETTING: Scottish colposcopy clinics. SAMPLE: All women with a date of birth on or after 1 January 1985 who attended colposcopy in Scotland between 2008-2014. METHODS: Routinely collected data from the Scottish National Colposcopy Clinical Information Audit System (NCCIAS) was extracted, including: referral criteria, referral cervical cytology, colposcopic findings, clinical procedures and histology results...
January 19, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28099713/systematic-review-of-obstetric-care-from-a-women-centered-perspective-in-nigeria-since-2000
#4
REVIEW
Atsumi Hirose, Oluwatoyin Owolabi, Mari Imamura, Friday Okonofua, Julia Hussein
BACKGROUND: A women-centered approach can improve the quality of patient care. OBJECTIVE: To review issues in the provision of obstetric care from a patient-centered care perspective in Nigeria. SEARCH STRATEGY: Using terms related to maternal and perinatal mortality, in combination with "Nigeria", MEDLINE, Embase, CINAHL, Web of Knowledge, and African Journal Online were searched, between December 1, 2013 and January 31, 2014, for articles in any language...
January 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28097997/the-4c-framework-for-making-reasonable-adjustments-for-people-with-learning-disabilities
#5
Daniel Marsden, Rachel Giles
Background People with learning disabilities experience significant inequalities in accessing healthcare. Legal frameworks, such as the Equality Act 2010, are intended to reduce such disparities in care, and require organisations to make 'reasonable adjustments' for people with disabilities, including learning disabilities. However, reasonable adjustments are often not clearly defined or adequately implemented in clinical practice. Aim To examine and synthesise the challenges in caring for people with learning disabilities to develop a framework for making reasonable adjustments for people with learning disabilities in hospital...
January 18, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28097737/epidemiological-data-of-type-1-diabetes-mellitus-in-children-in-uzbekistan-1998-2014
#6
Gulnara N Rakhimova, Nasiba U Alimova, Alexsandr Ryaboshtan, Boris Waldman, Graham D Ogle, Said I Ismailov
AIMS: We aimed to determine the incidence, prevalence and mortality of type 1 diabetes (T1D) in Uzbekistan in children <15 years old. METHODS: In a prospective study from 1998 to 2014 the primary ascertainment of incidence, prevalence and mortality, and cause of death was via data collected by endocrinology dispensaries in Uzbekistan's 14 administrative divisions. A second data collection for 2008-2010 from a national audit in 2011 was used to determine age structure...
January 17, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28097450/contemporary-thoughts-on-the-management-of-spigelian-hernia
#7
V Webber, C Low, R J E Skipworth, S Kumar, A C de Beaux, B Tulloh
BACKGROUND: Spigelian hernias are said to be a rare condition of the elderly population, usually arising below the arcuate line. Local experience has led us to challenge these commonly held beliefs. METHODS: Operations for Spigelian hernia from 2006-2016 were identified from the Edinburgh Lothian Surgical Audit computerised database and case notes were reviewed. RESULTS: One hundred and one patients underwent surgery for 107 Spigelian hernias in the 10-year period...
January 17, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28097305/enhanced-recovery-after-surgery-a-review
#8
Olle Ljungqvist, Michael Scott, Kenneth C Fearon
Importance: Enhanced Recovery After Surgery (ERAS) is a paradigm shift in perioperative care, resulting in substantial improvements in clinical outcomes and cost savings. Observations: Enhanced Recovery After Surgery is a multimodal, multidisciplinary approach to the care of the surgical patient. Enhanced Recovery After Surgery process implementation involves a team consisting of surgeons, anesthetists, an ERAS coordinator (often a nurse or a physician assistant), and staff from units that care for the surgical patient...
January 11, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28096916/an-audit-of-referral-and-treatment-patterns-of-high-risk-prostate-cancer-patients-in-alberta
#9
Majed Alghamdi, Amandeep Taggar, Derek Tilley, Marc Kerba, Xanthoula Kostaras, Geoffrey Gotto, Michael Sia
INTRODUCTION: We aimed to determine the impact of clinical practice guidelines (CPG) on rates of radiation oncologist (RO) referral, androgen-deprivation therapy (ADT), radiation therapy (RT), and radical prostatectomy (RP) in patients with high-risk prostate cancer (HR-PCa). METHODS: All men >18 years, diagnosed with PCa in 2005 and 2012 were identified from the Alberta Cancer Registry. Patient age, aggregated clinical risk group (ACRG) score, Gleason score (GS), pre-treatment prostate-specific antigen (PSA), RO referral, and treatment received were extracted from electronic medical records...
November 2016: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28093900/who-is-responsible-for-metabolic-screening-for-mental-health-clients-taking-antipsychotic-medications
#10
Tamara Ward, Dianne Wynaden, Karen Heslop
Metabolic syndrome is common in mental health consumer populations, and is linked to cardiovascular disease, stroke and diabetes. Metabolic screening is a way of recognising consumers who are at risk of developing metabolic syndrome but internationally screening rates remain low. A retrospective audit was completed at one Australian public mental health service on the case files of 100 randomly selected consumers to determine nurses level of compliance with metabolic screening policies over a 12 month period...
January 17, 2017: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/28092471/genomics-pipelines-and-data-integration-challenges-and-opportunities-in-the-research-setting
#11
Jeremy Davis-Turak, Sean M Courtney, E Starr Hazard, W Bailey Glen, Willian da Silveira, Timothy Wesselman, Larry P Harbin, Bethany J Wolf, Dongjun Chung, Gary Hardiman
The emergence and mass utilization of high-throughput (HT) technologies, including sequencing technologies (genomics) and mass spectrometry (proteomics, metabolomics, lipids), has allowed geneticists, biologists, and biostatisticians to bridge the gap between genotype and phenotype on a massive scale. These new technologies have brought rapid advances in our understanding of cell biology, evolutionary history, microbial environments, and are increasingly providing new insights and applications towards clinical care and personalized medicine...
January 16, 2017: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/28088222/clinical-importance-of-personality-difficulties-diagnostically-sub-threshold-personality-disorders
#12
Max Karukivi, Tero Vahlberg, Kalle Horjamo, Minna Nevalainen, Jyrki Korkeila
BACKGROUND: Current categorical classification of personality disorders has been criticized for overlooking the dimensional nature of personality and that it may miss some sub-threshold personality disturbances of clinical significance. We aimed to evaluate the clinical importance of these conditions. For this, we used a simple four-level dimensional categorization based on the severity of personality disturbance. METHODS: The sample consisted of 352 patients admitted to mental health services...
January 14, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28088171/assessing-the-sustainability-of-daily-chlorhexidine-bathing-in-the-intensive-care-unit-of-a-veteran-s-hospital-by-examining-nurses-perspectives-and-experiences
#13
Jackson S Musuuza, Tonya J Roberts, Pascale Carayon, Nasia Safdar
BACKGROUND: Daily bathing with chlorhexidine gluconate (CHG) of intensive care unit (ICU) patients has been shown to reduce healthcare-associated infections and colonization by multidrug resistant organisms. The objective of this project was to describe the process of daily CHG bathing and identify the barriers and facilitators that can influence its successful adoption and sustainability in an ICU of a Veterans Administration Hospital. METHODS: We conducted 26 semi-structured interviews with a convenience sample of 4 nurse managers (NMs), 13 registered nurses (RNs) and 9 health care technicians (HCTs) working in the ICU...
January 14, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28088109/carbetocin-versus-oxytocin-for-prevention-of-post-partum-haemorrhage-at-caesarean-section-in-the-united-kingdom-an-economic-impact-analysis
#14
Helen A van der Nelson, Tim Draycott, Dimitrios Siassakos, Christopher W H Yau, Anthony J Hatswell
OBJECTIVE: To determine the economic impact of the introduction of carbetocin for the prevention of postpartum haemorrhage (PPH) at caesarean section, compared to oxytocin. STUDY DESIGN: The model is a decision tree conducted from a UK National Health Service perspective. 1500 caesarean sections (both elective and emergency) were modelled over a 12 month period. Efficacy data was taken from a published Cochrane meta-analysis, and costs from NHS Reference costs, the British National Formulary and the NHS electronic Medicines Information Tool...
January 3, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28086813/information-exchange-networks-of-health-care-providers-and-evidence-based-cardiovascular-risk-management-an-observational-study
#15
Naomi Heijmans, Jan van Lieshout, Michel Wensing
BACKGROUND: Although a wide range of preventive and clinical interventions has targeted cardiovascular risk management (CVRM), outcomes remain suboptimal. Therefore, the question is what additional determinants of CVRM and outcomes can be identified and addressed to optimize CVRM. In this study, we aimed to identify new perspectives for improving healthcare delivery and explored associations between information exchange networks of health care providers and evidence-based CVRM. METHODS: This observational study was performed parallel to a randomized clinical trial which aimed to improve professional performance of practice nurses in the Netherlands...
January 13, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28081061/vital-signs-decrease-in-incidence-of-diabetes-related-end-stage-renal-disease-among-american-indians-alaska-natives-united-states-1996-2013
#16
Ann Bullock, Nilka Ríos Burrows, Andrew S Narva, Karen Sheff, Israel Hora, Akaki Lekiachvili, Hannah Cain, David Espey
BACKGROUND: American Indians and Alaska Natives (AI/AN) have the highest diabetes prevalence among any racial/ethnic group in the United States. Among AI/AN, diabetes accounts for 69% of new cases of end-stage renal disease (ESRD), defined as kidney failure treated with dialysis or transplantation. During 1982-1996, diabetes-related ESRD (ESRD-D) in AI/AN increased substantially and disproportionately compared with other racial/ethnic groups. METHODS: Data from the U...
January 13, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28078474/clinical-audit-effectively-bridges-the-evidence-practice-gap-in-chronic-subdural-haematoma-management
#17
Jignesh Tailor, D Fernando, Z Sidhu, R Foley, K D Abeysinghe, D C Walsh
BACKGROUND: Placement of a subdural drain after drainage of chronic subdural haematoma (CSDH) has been shown to reduce the rate of recurrence in several randomised controlled trials (RCT). The most recently published RCT was from Cambridge, UK, in 2009. Despite class I evidence for the use of subdural drains, it is unclear whether these results have been translated into clinical practice. In this clinical audit we review the use of subdural drains in our institution before and after the publication of the 2009 RCT results...
January 11, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28077613/socioeconomic-deprivation-and-the-outcome-of-pulmonary-rehabilitation-in-england-and-wales
#18
Michael C Steiner, Derek Lowe, Katy Beckford, John Blakey, Charlotte E Bolton, Sarah Elkin, William D-C Man, C Michael Roberts, Louise Sewell, Paul Walker, Sally J Singh
BACKGROUND: Pulmonary rehabilitation (PR) improves exercise capacity and health status in patients with COPD, but many patients assessed for PR do not complete therapy. It is unknown whether socioeconomic deprivation associates with rates of completion of PR or the magnitude of clinical benefits bequeathed by PR. METHODS: PR services across England and Wales enrolled patients to the National PR audit in 2015. Deprivation was assessed using Index of Multiple Deprivation (IMD) derived from postcodes...
January 11, 2017: Thorax
https://www.readbyqxmd.com/read/28073792/adult-parenteral-nutrition-in-the-north-of-england-a-region-wide-audit
#19
Jessica K Dyson, Nick Thompson
OBJECTIVES: Parenteral nutrition (PN) is widely used to provide nutritional support to patients with inaccessible or inadequate length of gut or non-functioning gut. The objective was to compare practice in PN administration to results of the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report, 'A Mixed Bag', and to establish whether good practice was being followed within this part of the UK. SETTING: Using the Northern Nutrition Network (NNN), we examined the care of adult patients receiving PN in all 10 secondary care hospitals in our region...
January 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28071865/the-impact-of-evidence-based-sepsis-guidelines-on-emergency-department-clinical-practice-a-pre-post-medical-record-audit
#20
Bernadine Romero, Margaret Fry, Michael Roche
AIMS AND OBJECTIVES: The aim of this study was to explore the number of patients presenting with sepsis before and after guideline implementation; the impact of sepsis guidelines on triage assessment, Emergency Department management and time to antibiotics. BACKGROUND: Sepsis remains one of the leading causes of mortality and morbidity within hospitals. Globally, strategies have been implemented to reduce morbidity and mortality rates, which rely on the early recognition and management of sepsis...
January 10, 2017: Journal of Clinical Nursing
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