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Clinical audit

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https://www.readbyqxmd.com/read/28346655/high-prevalence-of-alcohol-use-disorders-in-patients-with-inflammatory-skin-diseases
#1
K Al-Jefri, D Newbury-Birch, C R Muirhead, E Gilvarry, V Araújo-Soares, N J Reynolds, E Kaner, P J Hampton
BACKGROUND: There is a known association between psoriasis and heavy alcohol consumption. Causality remains unclear with evidence supporting both alcohol triggering psoriasis and psoriasis predisposing to heavy alcohol consumption. However, the association between heavy alcohol consumption and other inflammatory skin diseases remains to be defined. OBJECTIVE: To examine the prevalence of heavy drinking using the Alcohol Use Disorders Identification Test (AUDIT) in patients with inflammatory skin disease...
March 27, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/28346109/assessing-process-of-paediatric-care-in-a-resource-limited-setting-a-cross-sectional-audit-of-district-hospitals-in-rwanda
#2
Celestin Hategeka, Jeannie Shoveller, Lisine Tuyisenge, Larry D Lynd
BACKGROUND: Routine assessment of quality of care helps identify deficiencies which need to be improved. While gaps in the emergency care of children have been documented across sub-Saharan Africa, data from Rwanda are lacking. OBJECTIVE: To assess the care of sick infants and children admitted to Rwandan district hospitals and the extent to which it follows currently recommended clinical practice guidelines in Rwanda. METHODS: Data were gathered during a retrospective cross-sectional audit of eight district hospitals across Rwanda in 2012/2013...
March 27, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28345368/sponsors-and-investigative-staffs-perceptions-of-the-current-investigational-new-drug-safety-reporting-process-in-oncology-trials
#3
Raymond Perez, Patrick Archdeacon, Nancy Roach, Robert Goodwin, Jonathan Jarow, Nina Stuccio, Annemarie Forrest
BACKGROUND/AIMS: The Food and Drug Administration's final rule on investigational new drug application safety reporting, effective from 28 March 2011, clarified the reporting requirements for serious and unexpected suspected adverse reactions occurring in clinical trials. The Clinical Trials Transformation Initiative released recommendations in 2013 to assist implementation of the final rule; however, anecdotal reports and data from a Food and Drug Administration audit indicated that a majority of reports being submitted were still uninformative and did not result in actionable changes...
March 1, 2017: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/28345188/treatment-of-gonorrhoea-in-auckland-new-zealand-marked-variation-in-prescriber-adherence-to-treatment-guidelines
#4
Rose Forster, Ms Diana Ng, Arlo Upton, Rick Franklin, Mark Thomas
BACKGROUND: The relentless emergence and spread of strains of Neisseria gonorrhoeae that are resistant to many antimicrobial agents has led to frequent changes in treatment guidelines, with a consequent risk that prescribers may not be aware of current guidelines. METHODS: We audited the treatment given to adult patients with laboratory proven gonorrhoea in Auckland, New Zealand, during the first six months of 2015. RESULTS: Treatment compliant with the current New Zealand Sexual Health Society (NZSHS) guidelines was administered in only 65% (458/706) episodes overall...
March 27, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28340935/individual-and-hospital-related-determinants-of-potentially-inappropriate-admissions-emerging-from-administrative-records
#5
Marco Fusco, Alessandra Buja, Paolo Piergentili, Maria Teresa Golfetto, Gianni Serafin, Silvia Gallo, Livio Dalla Barba, Vincenzo Baldo
INTRODUCTION: The appropriate use of health care is an important issue in developed countries. The purpose of this study was to ascertain the extent of potentially inappropriate hospital admissions and their individual, clinical and hospital-related determinants. METHODS: Medical records were analyzed for the year 2014 held by the Local Heath Unit n. 13 in the Veneto Region of north-east Italy (19,000 records). The outcomes calculated were: admissions for conditions amenable to day hospital care; brief medical admissions; outlier lengths of stay for elderly patients' medical admissions; and medical admissions to surgical wards...
November 2016: Health Policy
https://www.readbyqxmd.com/read/28340857/reducing-socioeconomic-inequalities-in-copd-care-in-the-hospital-outpatient-setting-a-nationwide-initiative
#6
Sandra S Tøttenborg, Peter Lange, Reimar W Thomsen, Henrik Nielsen, Søren P Johnsen
OBJECTIVE: Socioeconomic differences in quality of care have been suggested to contribute to inequality in clinical prognosis of COPD. We examined socioeconomic differences in the quality of COPD outpatient care and the potential of a systematic quality improvement initiative in reducing potential socioeconomic differences. METHODS: A mandatory national quality improvement initiative has since 2008 monitored the quality of COPD care at all national pulmonary specialized outpatient clinics in Denmark using six evidence-based process performance measures...
April 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28334565/year-end-resident-clinic-handoffs-narrative-review-and-recommendations-for-improvement
#7
Amber T Pincavage, Michael J Donnelly, John Q Young, Vineet M Arora
BACKGROUND: Year-end clinic handoffs in resident continuity clinics are an important patient safety issue. METHODS: Intervention articles addressing the year-end resident clinic handoff were identified in a targeted literature search. These articles were reviewed and abstracted to summarize the current literature. On the basis of these reviews and consensus expert opinion, recommendations to improve year-end clinic handoffs were developed. RESULTS: Of 23 identified articles, 10 intervention articles in the fields of internal medicine, internal medicine-pediatrics, psychiatry, and family medicine were ultimately included...
February 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28329432/user-compliance-with-documenting-on-a-track-and-trigger-based-observation-and-response-chart-a-two-phase-multi-site-audit-study
#8
Doug Elliott, Emily Allen, Sharon McKinley, Lin Perry, Christine Duffield, Margaret Fry, Robyn Gallagher, Rick Iedema, Michael Roche
AIMS: To examine user compliance and completeness of documentation with a newly designed Observation and Response Chart and whether a rapid response system call was triggered when clinically indicated. BACKGROUND: Timely recognition and responses to patient deterioration in hospital general wards remains a challenge for health care systems globally. Evaluating practice initiatives to improve recognition and response are required. DESIGN: Two-phase audit...
March 22, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28329027/prevalence-and-predictors-for-compensated-advanced-chronic-liver-disease-c-acld-in-patients-with-chronic-hepatitis-delta-virus-hdv-infection
#9
Ingrid Couto, Marilu Victoria, Valdiléa G Veloso, Lorena Rodrigues, Beatriz Grinsztejn, Marcus Lacerda, Flamir Victoria, Hugo Perazzo
OBJECTIVE: The study aimed to evaluate the prevalence and predictor factors for compensated advanced chronic liver disease (c-ACLD) in patients with hepatitis Delta virus (HDV) infection. METHODS: This cross-sectional study included consecutive HDV-infected patients defined by positive anti-HDV. Patients with hepatitis C coinfection, liver transplantation or presence of conditions that limit liver (LSM) or spleen stiffness measurement (SSM) were excluded. Blood tests, abdominal ultrasound, SSM and LSM by transient elastography (FibroScan®) were performed at the same day...
2017: PloS One
https://www.readbyqxmd.com/read/28328654/outcomes-for-children-receiving-noninvasive-ventilation-as-the-first-line-mode-of-mechanical-ventilation-at-intensive-care-admission-a-propensity-score-matched-cohort-study
#10
Jenny V Morris, Padmanabhan Ramnarayan, Roger C Parslow, Sarah J Fleming
OBJECTIVES: To compare outcomes of children receiving noninvasive ventilation with those receiving invasive ventilation as first-line mode of mechanical ventilation following unplanned intensive care admission. DESIGN: Propensity score-matched cohort study analyzing data prospectively collected by the Pediatric Intensive Care Audit Network over 8 years (2007-2014). SETTING: Thirty-one PICUs in the United Kingdom and Ireland; twenty-one of whom submitted Pediatric Critical Care Minimum Dataset data for the entire study period...
March 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28325204/from-board-to-bedside-how-the-application-of-financial-structures-to-safety-and-quality-can-drive-accountability-in-a-large-health-care-system
#11
J Matthew Austin, Renee Demski, Tiffany Callender, K H Ken Lee, Ann Hoffman, Lisa Allen, Deborah A Radke, Yungjin Kim, Ronald J Werthman, Ronald R Peterson, Peter J Pronovost
BACKGROUND: As the health care system in the United States places greater emphasis on the public reporting of quality and safety data and its use to determine payment, provider organizations must implement structures that ensure discipline and rigor regarding these data. An academic health system, as part of a performance management system, applied four key components of a financial reporting structure to support the goal of top-to-bottom accountability for improving quality and safety...
April 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28323556/psychometric-properties-of-the-alcohol-use-disorders-identification-test-consumption-audit-c-in-public-first-responders
#12
Hyeonseok S Jeong, Shinwon Park, Soo Mee Lim, Jiyoung Ma, Ilhyang Kang, Jungyoon Kim, Eui-Jung Kim, Yejee J Choi, Jae-Ho Lim, Yong-An Chung, In Kyoon Lyoo, Sujung Yoon, Jieun E Kim
Problematic alcohol consumption is prevalent among first responders because alcohol is commonly used to cope with occupational stress and frequent exposure to traumatic incidents, making them an at-risk population for alcohol use disorders (AUD). This study investigated the psychometric properties of the Korean version of the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) among public first responders. The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders-IV-Text Revision (SCID), AUDIT-C, AUDIT, and CAGE were administered to 222 public first responders, who were recruited by convenience sampling...
March 21, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/28321301/early-aspirin-administration-post-coronary-artery-bypass-graft-surgery-changing-hospital-culture-through-a-two-cycled-audit
#13
Shefali Parikh, Justin Ratnasingham
"Early Aspirin" or a medium dose of aspirin 6 hours after Coronary Artery Bypass Graft (CABG) Surgery is strongly recommend by international guidelines (EACTS 2007/AHA 2011 guidelines, Level1a evidence) to protect venous graft patency. However, compliance with Early Aspirin prescription at our centre is poor due to long standing hospital cultural practices and lack of awareness. We completed a two-cycled retrospective audit of 53 (September 2015 Baseline), 65 (January 2016 First Cycle) and 58 (June 2016 Second Cycle) consecutive CABG patients...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28321282/challenges-with-targeted-viral-load-testing-for-medical-inpatients-at-queen-elizabeth-central-hospital-in-blantyre-malawi
#14
Alison Craik, Priyanka Patel, Pratiksha Patel, Jane Mallewa, Ken Malisita, Joseph Bitilinyu-Bangoh, Joep J van Oosterhout, Christine Kelly
BACKGROUND: Approximately 75% of medical inpatients at Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi are HIV seropositive, and a third of these patients are on antiretroviral therapy (ART). Malawi guidelines recommend targeted viral load (VL) testing for patients on ART for at least one year who report excellent adherence and present with a WHO clinical stage 3 or 4 HIV disease. A switch to second-line ART is only indicated if a VL result >5000 copies/mL confirms treatment failure...
December 2016: Malawi Medical Journal: the Journal of Medical Association of Malawi
https://www.readbyqxmd.com/read/28318891/lessons-from-a-national-audit-of-acute-pancreatitis-a-summary-of-the-ncepod-report-treat-the-cause
#15
REVIEW
D A O'Reilly, S J McPherson, M T Sinclair, N Smith
The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) is an independent organisation whose remit is to review the quality of medical and surgical care provided in the United Kingdom. We undertook a review into the care provided to patients treated for acute pancreatitis during a 6 month study period between 1st January and 30th June 2014. This included assessment of care at an organisational level, clinical level within hospitals and external peer review. From a random sample, 712 patients underwent hospital clinician review and 418 patients had external peer review...
February 17, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28318513/improving-risk-adjustment-for-mortality-after-pediatric-cardiac-surgery-the-uk-prais2-model
#16
Libby Rogers, Katherine L Brown, Rodney C Franklin, Gareth Ambler, David Anderson, David J Barron, Sonya Crowe, Kate English, John Stickley, Shane Tibby, Victor Tsang, Martin Utley, Thomas Witter, Christina Pagel
BACKGROUND: Partial Risk Adjustment in Surgery (PRAiS), a risk model for 30-day mortality after children's heart surgery, has been used by the UK National Congenital Heart Disease Audit to report expected risk-adjusted survival since 2013. This study aimed to improve the model by incorporating additional comorbidity and diagnostic information. METHODS: The model development dataset was all procedures performed between 2009 and 2014 in all UK and Ireland congenital cardiac centers...
March 15, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28317511/randomized-study-of-assessment-effects-on-alcohol-use-by-persons-with-hiv-in-rural-uganda
#17
Nneka I Emenyonu, Robin Fatch, Winnie R Muyindike, Allen Kekibiina, Sarah Woolf-King, Judith A Hahn
OBJECTIVE: Unhealthy alcohol use is a crucial driver of HIV in sub-Saharan Africa, and interventions are needed. The goal of this study was to assess whether assessment itself (assessment reactivity) causes declines in alcohol use in a research study in persons with HIV in Uganda. METHOD: Study participants were adult patients of the Immune Suppression Syndrome (ISS) Clinic in Mbarara, Uganda, who were new to HIV care and reported any alcohol consumption in the prior year...
March 2017: Journal of Studies on Alcohol and Drugs
https://www.readbyqxmd.com/read/28306586/voice-outcomes-post-total-laryngectomy
#18
Anne Hurren, Nick Miller
PURPOSE OF REVIEW: A consensus and body of robust evidence has developed regarding optimal laryngeal voice outcome measures. This contrasts with a lack of clarity for equivalent assessments in alaryngeal voice. Addressing this situation would enable clinicians to select the best tools currently available to facilitate research, audit and clinical practice. This is important because of the limited knowledge regarding the optimal surgical or reconstruction techniques and rehabilitation regimes for the laryngectomy population...
March 16, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28306417/the-management-and-outcome-for-patients-with-chronic-subdural-hematoma-a-prospective-multicenter-observational-cohort-study-in-the-united-kingdom
#19
Paul M Brennan, Angelos G Kolias, Alexis J Joannides, Jonathan Shapey, Hani J Marcus, Barbara A Gregson, Patrick J Grover, Peter J Hutchinson, Ian C Coulter
OBJECTIVE Symptomatic chronic subdural hematoma (CSDH) will become an increasingly common presentation in neurosurgical practice as the population ages, but quality evidence is still lacking to guide the optimal management for these patients. The British Neurosurgical Trainee Research Collaborative (BNTRC) was established by neurosurgical trainees in 2012 to improve research by combining the efforts of trainees in each of the United Kingdom (UK) and Ireland's neurosurgical units (NSUs). The authors present the first study by the BNTRC that describes current management and outcomes for patients with CSDH throughout the UK and Ireland...
March 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28303388/the-impact-of-antibiotic-stewardship-programs-in-combating-quinolone-resistance-a-systematic-review-and-recommendations-for-more-efficient-interventions
#20
REVIEW
Vasiliki Pitiriga, Georgia Vrioni, George Saroglou, Athanasios Tsakris
Quinolones are among the most commonly prescribed antibiotics worldwide. A clear relationship has been demonstrated between excessive quinolone use and the steady increase in the incidence of quinolone-resistant bacterial pathogens, both in hospital and community sites. In addition, exposure to quinolones has been associated with colonization and infection with healthcare-associated pathogens such as methicillin-resistant Staphylococcus aureus and Clostridium difficile in hospitalized patients. Therefore, the management of quinolone prescribing in hospitals through antibiotic stewardship programs is considered crucial...
March 16, 2017: Advances in Therapy
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