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Clinical audit

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https://www.readbyqxmd.com/read/28535025/missad-diagnos-av-h%C3%A3-lseneruptur-vanligast-hos-%C3%A3-ldre-patienter
#1
Thomas Fridén, Tomas Movin, Åke Andrén-Sandberg
We audited forty-six patients with a rupture of the Achilles tendon notified to the Swedish regulatory authority (the Health and Social Care Inspectorate) due to suspicion of malpractice. The patients' history and clinical presentation differed from those with a more classical acute rupture. The diagnostic errors were often found in patients older than 60 years, they were just as common in women as in men and the symptoms often had a subacute start. In most patients, the diagnostic errors were due to an incomplete clinical examination...
May 23, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28530520/cardiovascular-disease-and-gout-real-world-experience-evaluating-patient-characteristics-treatment-patterns-and-health-care-utilization
#2
Michael H Pillinger, Sripal Bangalore, Alyssa B Klein, Scott Baumgartner, Robert Morlock
BACKGROUND: Gout, hyperuricemia, and cardiovascular disease (CVD) are prevalent conditions in the United States, and while they share common risk factors such as obesity, hypertension, hypercholesterolemia, and type 2 diabetes mellitus, relatively little is known about what patient and disease characteristics may link CVD with hyperuricemia and gout and how the presence of both diseases affects management decisions differently than for patients with gout alone. OBJECTIVE: To identify differences in patient characteristics, patterns of urate-lowering therapy (ULT) use, and gout control in gout patients with and without cardiovascular comorbidity...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28530481/hormone-replacement-therapy-in-pre-menopausal-women-undergoing-bilateral-salpingo-oophorectomy-for-benign-disease-a-review-of-practice
#3
Alison Richardson, Emily West, Mike Cust
Introduction The National Institute for Health and Care Excellence (NICE) guideline on the diagnosis and management of the menopause states that women who are likely to go through the menopause as a result of surgical treatment should be offered information about the menopause and the importance of starting hormonal replacement therapy before they have their treatment. Objectives To determine compliance with NICE guidelines at the Royal Derby Hospital. Study design We undertook a retrospective review of all pre-menopausal women undergoing bilateral salpingo-oophorectomy for benign pathology between 1 January 2016 and 30 June 2016...
January 1, 2017: Post Reproductive Health
https://www.readbyqxmd.com/read/28528578/a-cluster-randomized-trial-to-reduce-caesarean-delivery-rates-in-quebec-cost-effectiveness-analysis
#4
Mira Johri, Edmond S W Ng, Clara Bermudez-Tamayo, Jeffrey S Hoch, Thierry Ducruet, Nils Chaillet
BACKGROUND: Widespread increases in caesarean section (CS) rates have sparked concerns about risks to mothers and infants and rising healthcare costs. A multicentre, two-arm, cluster-randomized trial in Quebec, Canada assessed whether an audit and feedback intervention targeting health professionals would reduce CS rates for pregnant women compared to usual care, and concluded that it reduced CS rates without adverse effects on maternal or neonatal health. The effect was statistically significant but clinically small...
May 22, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28527647/correlation-between-plasma-homocysteine-levels-and-craving-in-alcohol-dependent-stabilized-patients
#5
Maurizio Coppola, Raffaella Mondola
BACKGROUND & AIMS: Homocysteine is a sulfur amino acid strictly related with alcohol consumption. In alcoholics, hyperhomocysteinemia can increase the risk of various alcohol-related disorders such as: brain atrophy, epileptic seizures during withdrawal, and mood disorders. OBJECTIVE: To evaluate the correlation among serum homocysteine concentrations, craving, hazardous and harmful patterns of alcohol consumption in patients stabilized for withdrawal symptoms. METHODS: Participants were adult outpatients accessed at the Addiction Treatment Unit...
May 6, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28526041/implementation-of-enhanced-recovery-after-surgery-a-strategy-to-transform-surgical-care-across-a-health-system
#6
Leah M Gramlich, Caroline E Sheppard, Tracy Wasylak, Loreen E Gilmour, Olle Ljungqvist, Carlota Basualdo-Hammond, Gregg Nelson
BACKGROUND: Enhanced Recovery After Surgery (ERAS) programs have been shown to have a positive impact on outcome. The ERAS care system includes an evidence-based guideline, an implementation program, and an interactive audit system to support practice change. The purpose of this study is to describe the use of the Theoretic Domains Framework (TDF) in changing surgical care and application of the Quality Enhancement Research Initiative (QUERI) model to analyze end-to-end implementation of ERAS in colorectal surgery across multiple sites within a single health system...
May 19, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28524896/distress-screening-evaluating-a-protocol-for-gynecologic-cancer-survivors%C3%A2
#7
Cynae Johnson, Marshalee George, Amanda N Fader
BACKGROUND: A gynecologic cancer diagnosis and subsequent treatment may cause significant morbidity, leading to increased distress levels and poorer quality of life (QOL) for survivors. Clinicians have explored opportunities to integrate comprehensive distress management protocols into clinical settings using existing supportive care resources.
. OBJECTIVES: The aims were to improve multidisciplinary management of distress using a clinical pathway for gynecologic cancer survivors and to improve patient satisfaction with distress management...
June 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28524616/how-to-implement-live-video-recording-in-the-clinical-environment-a-practical-guide-for-clinical-services
#8
Adam Lloyd, Alistair Dewar, Simon Edgar, Dave Caesar, Paul Gowens, Gareth Clegg
BACKGROUND: The use of video in healthcare is becoming more common, particularly in simulation and educational settings. However, video recording live episodes of clinical care is far less routine. AIM: To provide a practical guide for clinical services to embed live video recording. MATERIALS AND METHODS: Using Kotter's 8-step process for leading change, we provide a 'how to' guide to navigate the challenges required to implement a continuous video-audit system based on our experience of video recording in our emergency department resuscitation rooms...
May 19, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28524253/improving-patient-safety-the-impact-of-an-outpatients-electronic-handover-system-in-a-tertiary-dermatology-department
#9
Flora Poon, Raymond Martyres, Anthony Denahy, George Varigos
BACKGROUND/OBJECTIVES: Electronic medical records (EMR) can improve quality healthcare, patient safety and streamline workflow to improve efficiency of a department. Despite the known benefits and difficulties of EMR systems, there is limited data on the impact and definable effectiveness it can have within a dermatology unit. We present an outpatients' EMR known as an electronic handover system (EHS) from its inception, delivery and audit of its use in evaluating the true impact. METHODS: An audit of the EHS was conducted from 1 March to 31 August 2014...
May 19, 2017: Australasian Journal of Dermatology
https://www.readbyqxmd.com/read/28522387/australian-private-midwives-with-hospital-visiting-rights-in-queensland-structures-and-processes-impacting-clinical-outcomes
#10
J Fenwick, H Brittain, J Gamble
BACKGROUND: Reporting the outcomes for women and newborns accessing private midwives with visiting rights in Australia is important, especially since this data cannot currently be disaggregated from routinely collected perinatal data. AIM: 1) Evaluate the outcomes of women and newborns cared for by midwives with visiting access at one Queensland facility and 2) explore private midwives views about the structures and processes contributing to clinical outcomes. METHODS: Mixed methods...
May 15, 2017: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/28521750/data-for-improvement-and-clinical-excellence-a-report-of-an-interrupted-time-series-trial-of-feedback-in-home-care
#11
Kimberly D Fraser, Anne E Sales, Melba Andrea B Baylon, Corinne Schalm, John J Miklavcic
BACKGROUND: There is substantial evidence about the effectiveness of audit with feedback, but none that we know have been conducted in home care settings. The primary purpose of the Data for Improvement and Clinical Excellence - Home Care (DICE-HC) project was to evaluate the effects of an audit and feedback delivered to care providers on home care client outcomes. The objective of this paper is to report the effects of feedback on four specific quality indicators: pain, falls, delirium, and hospital visits...
May 18, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28521065/eelab-an-innovative-educational-resource-in-occupational-medicine
#12
A Y Zhou, J Dodman, L Hussey, D Sen, C Rayner, N Zarin, R Agius
Background: Postgraduate education, training and clinical governance in occupational medicine (OM) require easily accessible yet rigorous, research and evidence-based tools based on actual clinical practice. Aims: To develop and evaluate an online resource helping physicians develop their OM skills using their own cases of work-related ill-health (WRIH). Methods: WRIH data reported by general practitioners (GPs) to The Health and Occupation Research (THOR) network were used to identify common OM clinical problems, their reported causes and management...
May 17, 2017: Occupational Medicine
https://www.readbyqxmd.com/read/28521010/prospective-audit-of-a-pathway-for-in-patient-pain-management-of-chronic-abdominal-pain-a-novel-and-cost-effective-strategy
#13
Gopinath Niraj, Sanjay Chaudhri
Background.:  Unexplained abdominal pain is a common cause of hospital admission and utilizes significant resource. Current in-patient pain management of acute exacerbation of chronic abdominal pain is primarily directed at pharmacological and psychological management strategies in this group of complex patients. We adopted a novel approach that proved to be both clinically effective and cost-effective. Design.:  Adult patients admitted to a surgical ward with acute exacerbation of chronic abdominal pain referred to in-patient pain management were prospectively audited over a two-year period at a single tertiary centre...
May 17, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28516734/does-co-occurring-borderline-personality-disorder-influence-acute-phase-treatment-for-first-episode-psychosis
#14
Shona M Francey, Martina Jovev, Christina Phassouliotis, Sue M Cotton, Andrew M Chanen
BACKGROUND: This aims of this study were: (1) to determine the prevalence of co-occurring borderline personality disorder (BPD) in a first-episode psychosis (FEP) sample; (2) to determine differences between patients with and without BPD on demographics, comorbidities and clinical risks and other variables; and (3) to examine whether BPD comorbidity influenced treatment received by patients for FEP during their first 3 months after service entry to a specialist early psychosis service...
May 18, 2017: Early Intervention in Psychiatry
https://www.readbyqxmd.com/read/28512920/an-audit-of-adherence-to-heart-failure-guidelines-in-an-australian-hospital-a-pharmacist-perspective
#15
Viviane Khalil, Melanie Danninger, Wei Wang, Hanan Khalil
RATIONALE, AIMS, AND OBJECTIVES: The Australian National Heart Foundation Guidelines have been developed to guide clinicians on how to best manage chronic heart failure (CHF) patients according to the current best available evidence. The primary aim of this study is to evaluate the proportion of patients prescribed evidence-based therapy (EBT) for CHF on discharge at this Australian metropolitan hospital and factors affecting its prescribing. The secondary aims are to examine the proportion of patients prescribed EBT on discharge on cardiac wards compared to medical wards and to explore the role of the pharmacist in the management of these patients...
May 17, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28503269/an-assessment-of-patient-waiting-and-consultation-time-in-a-primary-healthcare-clinic
#16
B A Ahmad, K Khairatul, A Farnaza
Waiting is a common phenomenon in the doctor's waiting room. The purpose of this audit is to assess patient waiting time and doctor consultation time in a primary healthcare clinic and to formulate strategies for improvement. This audit was conducted at a primary care clinic for 4 weeks using the universal sampling method. All patients who attended the clinic during this period was included in the study except for those who required more time to be seen such as those who were critically ill, aggressive or those who came for repeat medication or procedures only without needing to see the doctor...
2017: Malaysian Family Physician
https://www.readbyqxmd.com/read/28501050/do-patients-discharged-from-advanced-practice-physiotherapy-led-clinics-re-present-to-specialist-medical-services
#17
Angela T Chang, Belinda Gavaghan, Shaun O'Leary, Liza-Jane McBride, Maree Raymer
Objective The aim of the present study was to determine the rates of re-referral to specialist out-patient clinics for patients previously managed and discharged from an advanced practice physiotherapy-led service in three metropolitan hospitals.Methods A retrospective audit was undertaken of 462 patient cases with non-urgent musculoskeletal conditions discharged between 1 April 2014 and 30 March 2015 from three metropolitan hospitals. These patients had been discharged from the physiotherapy-led service without requiring specialist medical review...
May 15, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28500868/type-1-diabetes-mellitus-care-and-education-in-china-the-3c-study-of-coverage-cost-and-care-in-beijing-and-shantou
#18
Helen C McGuire, Linong Ji, Katarzyna Kissimova-Skarbek, David Whiting, Florencia Aguirre, Puhong Zhang, Shaoda Lin, Chunxiu Gong, Weigang Zhao, Juming Lu, Xiaohui Guo, Ying Ji, Till Seuring, Tianpei Hong, Lishu Chen, Jianping Weng, Zhiguang Zhou
AIMS: The paucity of data on Type 1 diabetes in China hinders progress in care and policy-making. This study compares Type 1 diabetes care and clinical outcomes in Beijing and Shantou with current clinical guidelines. METHODS: The 3C Study was a cross-sectional study of the clinical practices and outcomes of people with Type 1 diabetes. The study sequentially enrolled 849 participants from hospital records, inpatient wards, and outpatient clinics. Data were collected via face-to-face interviews with patients and health professionals, the Summary of Diabetes Self-Care Activities, medical records, and venous blood samples...
February 28, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28499377/calculating-hospital-length-of-stay-using-the-hospital-episode-statistics-a-comparison-of-methodologies
#19
John Busby, Sarah Purdy, William Hollingworth
BACKGROUND: Accurate calculation of hospital length of stay (LOS) from the English Hospital Episode Statistics (HES) is important for a wide range of audit and research purposes. The two methodologies which are commonly used to achieve this differ in their accuracy and complexity. We compare these methods and make recommendations on when each is most appropriate. METHODS: We calculated LOS using continuous inpatient spells (CIPS), which link care spanning across multiple hospitals, and spells, which do not, for six conditions with short (dyspepsia or other stomach function, ENT infection), medium (dehydration and gastroenteritis, perforated or bleeding ulcer), and long (stroke, fractured proximal femur) average LOS...
May 12, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28497502/improving-outcome-of-fungal-diseases-guiding-experts-and-patients-towards-excellence
#20
Oliver A Cornely, Cornelia Lass-Flörl, Katrien Lagrou, Valentina Arsic-Arsenijevic, Martin Hoenigl
Invasive fungal infections are on the rise and during recent years understanding the epidemiology of fungal infections improved. Over 1 billion people are affected and 25 million patients are at imminent risk of severe organ damage or death due to fungal infection. The European Confederation of Medical Mycology (ECMM), founded in 1993, is the roof organisation of 23 National Medical Mycology Societies in Europe. ECMM fights fungal infections at various levels, by creating and distributing scientific knowledge and promoting scientific exchange...
May 12, 2017: Mycoses
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