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Clinical audit

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https://www.readbyqxmd.com/read/28240996/impact-of-the-opioid-safety-initiative-on-opioid-related-prescribing-in-veterans
#1
Lewei A Lin, Amy S B Bohnert, Robert D Kerns, Michael A Clay, Dara Ganoczy, Mark A Ilgen
The Veterans Health Administration (VHA) designed the Opioid Safety Initiative (OSI) to help decrease opioid prescribing practices associated with adverse outcomes. Key components included disseminating a dashboard tool that aggregates electronic medical record data to audit real-time opioid-related prescribing and identifying a clinical leader at each facility to implement the tool and promote safer prescribing. This study examines changes associated with OSI implementation in October 2013 among all adult VHA patients who filled outpatient opioid prescriptions...
January 4, 2017: Pain
https://www.readbyqxmd.com/read/28240500/sharp-force-fatalities-at-the-pretoria-medico-legal-laboratory-2012-2013
#2
L Mitton, L du Toit-Prinsloo
BACKGROUND: South Africa's crude death rate was recorded as the highest in the world in 2014. In 2013, 47 murders occurred daily nationwide, and it was confirmed that sharp force fatalities were frequent events. The aim of our study was to review the fatalities of persons admitted to the Pretoria Medico-Legal Laboratory over a two-year period. Understanding the magnitude of the problem, identifying the most commonly injured area and the mechanism of death in cases where the patient died in hospital could aid in the clinical management of some of these cases in order to reduce mortality...
June 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28240466/liberal-transfusion-strategies-still-the-trend-in-burn-surgery
#3
N L Allorto, M D T Smith, D L Clarke
OBJECTIVE: Blood is a limited resource in middle-income countries such as South Africa. Transfusion is associated with complications and expense. We aimed to understand our transfusion practices in burn surgery as well as ascertain the opinion of a broader group of surgeons and anaesthetists regarding transfusion triggers in order to understand the rationale and bias that drives current transfusion practice in our setting. METHOD: Firstly, we investigated the current blood practices at our regional burn service through an audit of perioperative notes for all patients receiving packed cell transfusions in a 24-month period...
September 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28237620/the-national-hip-fracture-database-nhfd-using-a-national-clinical-audit-to-raise-standards-of-nursing-care
#4
EDITORIAL
Antony Johansen, Christopher Boulton, Karen Hertz, Michael Ellis, Vivienne Burgon, Sunil Rai, Rob Wakeman
The National Hip Fracture Database (NHFD) is a key clinical governance programme for staff working in trauma wards across England, Wales and Northern Ireland. It uses prospectively collected information about the 65,000 people who present with hip fracture each year, and links these with information about the quality of care and outcome for each individual. The NHFD can, therefore, provide a picture of the care offered to frail older people with this injury - people who, between them, occupy nearly half of inpatient trauma beds...
January 23, 2017: International Journal of Orthopaedic and Trauma Nursing
https://www.readbyqxmd.com/read/28236734/midwives-provision-of-antimalaria-services-to-pregnant-women-in-uganda
#5
Richard Serunkuma Bbosa, Valerie Janet Ehlers
OBJECTIVES: malaria causes complications during 80% of all pregnancies in Uganda. However, only 48% of Ugandan pregnant women took one dose of intermittent preventive therapy while merely 27% took the second dose during 2011. This study investigated midwives' provision of anti-malaria services in the Buikwe District of Uganda. DESIGN: a quantitative exploratory descriptive design was used. SETTING: prenatal clinics (n=16) in the Buikwe District of Uganda RESPONDENTS: questionnaires were completed by 40 (out of a population of 45) midwives...
February 20, 2017: Midwifery
https://www.readbyqxmd.com/read/28236559/an-external-dosimetry-audit-programme-to-credential-static-and-rotational-imrt-delivery-for-clinical-trials-quality-assurance
#6
David J Eaton, Justine Tyler, Alex Backshall, David Bernstein, Antony Carver, Anne Gasnier, Julia Henderson, Jonathan Lee, Rushil Patel, Yatman Tsang, Huiqi Yang, Rada Zotova, Emma Wells
PURPOSE: External dosimetry audits give confidence in the safe and accurate delivery of radiotherapy. The RTTQA group have performed an on-site audit programme for trial recruiting centres, who have recently implemented static or rotational IMRT, and those with major changes to planning or delivery systems. METHODS: Measurements of reference beam output were performed by the host centre, and by the auditor using independent equipment. Verification of clinical plans was performed using the ArcCheck helical diode array...
February 21, 2017: Physica Medica: PM
https://www.readbyqxmd.com/read/28235461/how-well-are-pulses-measured-practice-based-evidence-from-an-observational-study-of-acutely-ill-medical-patients-during-their-hospital-admission
#7
Martin Otyek Opio, John Kellett
INTRODUCTION: although taking a radial pulse is considered to be an essential clinical skill there have been few reports on how well it is measured in clinical practice, and how its accuracy and precision are influenced by rate, rhythm and blood pressure. METHODS: this study is a retrospective quality audit carried out as part of a larger ongoing prospective observational trial. The radial pulse rates recorded by two research nurses were compared with the ECG heart rates measured on acutely ill medical patients during their admission to a resource poor hospital in sub-Saharan Africa...
February 21, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28229530/an-audit-of-anticholinergic-medication-changes-in-older-hospitalised-patients-using-the-anticholinergic-drug-scale
#8
Michele Lee, Hugh Carl Hanger
OBJECTIVE: In patients discharged from an Older Person's Health hospital, we assessed 1) the prevalence of anticholinergic medications in this study population and 2) changes in anticholinergic drug burden during admission using the Anticholinergic Drug Scale (ADS). METHODS: Cases were identified between September 2010 and January 2011 using discharge coding data. Clinical notes were reviewed to determine which regular oral medications were commenced, altered or ceased during admission with their respective ADS level...
February 23, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28228820/temperature-elevation-measured-in-a-tissue-mimicking-phantom-for-transvaginal-ultrasound-at-clinical-settings
#9
Piero Miloro, Eleanor Martin, Adam Shaw
INTRODUCTION: This paper reports the results of an audit to assess the possible thermal hazard associated with the clinical use of ultrasound scanners in UK Hospitals for transvaginal ultrasound imaging. METHODS: An anatomically relevant phantom composed of a block of agar-based tissue mimicking material with embedded thermal sensors was developed. Seventeen hospitals around the UK were visited and a total of 64 configurations were tested. A representative typical scanning protocol was adopted, which primarily used B-mode with 30 s periods of colour-flow and pulsed Doppler modes for both gynaecology and obstetrics pre-sets...
February 2017: Ultrasound: Journal of the British Medical Ultrasound Society
https://www.readbyqxmd.com/read/28224275/the-english-national-screening-programme-for-diabetic-retinopathy-2003-2016
#10
Peter H Scanlon
The aim of the English NHS Diabetic Eye Screening Programme is to reduce the risk of sight loss amongst people with diabetes by the prompt identification and effective treatment if necessary of sight-threatening diabetic retinopathy, at the appropriate stage during the disease process. In order to achieve the delivery of evidence-based, population-based screening programmes, it was recognised that certain key components were required. It is necessary to identify the eligible population in order to deliver the programme to the maximum number of people with diabetes...
February 22, 2017: Acta Diabetologica
https://www.readbyqxmd.com/read/28222036/vascular-risk-factors-are-associated-with-retinal-arteriolar-narrowing-and-venular-widening-in-children-and-adolescents-with-type-1-diabetes
#11
Stuart Keel, Catherine Itsiopoulos, Konstandina Koklanis, Meri Vukicevic, Fergus Cameron, Laima Brazionis
BACKGROUND: The aim of the study was to describe the relationship of retinal arteriolar and venular calibre with vascular risk factors in children and adolescents with type 1 diabetes. METHODS: In this hospital-based cross-sectional study, the medical files of 483 children and adolescents with type 1 diabetes were audited to collect retinal images and relevant clinical data. Retinal vascular calibre was measured using standardised protocols. RESULTS: After multivariable adjustments, a vascular risk profile that included: older age, higher serum creatinine, higher systolic blood pressure (SBP), higher body mass index (BMI), abnormal estimated glomerular filtration rate (eGFR), lower high-density lipoproteins (HDL) cholesterol, longer duration of diabetes and higher serum sodium was associated with narrower central retinal artery equivalent (CRAE) (95% CI=-4...
February 21, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/28221896/accuracy-and-thoroughness-of-treatment-summaries-provided-as-part-of-survivorship-care-plans-prepared-by-two-cancer-centers
#12
Amye J Tevaarwerk, William G Hocking, Jamie L Zeal, Mindy Gribble, Lori Seaborne, Kevin A Buhr, Kari B Wisinski, Mark E Burkard, Douglas A Wiegmann, Mary E Sesto
PURPOSE: Treatment summaries prepared as part of survivorship care planning should correctly and thoroughly report diagnosis and treatment information. METHODS: As part of a clinical trial, summaries were prepared for patients with stage 0 to III breast cancer at two cancer centers. Summaries were prepared per the standard of care at each center via two methods: using the electronic health record (EHR) to create and facilitate autopopulation of content or using manual data entry into an external software program to create the summary...
February 21, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28221255/royal-college-of-ophthalmologists-national-database-study-of-vitreoretinal-surgery-report-7-intersurgeon-variations-in-primary-rhegmatogenous-retinal-detachment-failure
#13
Ahmed B Sallam, Paul H J Donachie, David Yorston, David H W Steel, Tom H Williamson, Timothy L Jackson, John M Sparrow, Robert L Johnston
BACKGROUND/PURPOSE: To audit variations in primary rhegmatogenous retinal detachment (RD) anatomical failure rates between surgeons, grades of surgeons, and techniques of RD surgery. METHODS: Clinical data of a total of 5,857 eyes undergoing primary RD surgery, from 2000 to 2013 were retrospectively extracted from 15 centers using the same commercially available electronic medical record system, from three vitreoretinal units using an in-house electronic medical record, and from the British and Eire Association of Vitreoretinal Surgeons online registry...
February 17, 2017: Retina
https://www.readbyqxmd.com/read/28220410/an-audit-of-the-use-of-gonadorelin-analogues-to-prevent-recurrent-acute-symptoms-in-patients-with-acute-porphyria-in-the-united-kingdom
#14
Danja Schulenburg-Brand, Tricia Gardiner, Simon Guppy, David C Rees, Penelope Stein, Julian Barth, M Felicity Stewart, Michael Badminton
Severe recurrent acute attacks of porphyria have traditionally been treated with either prophylactic human haemin or gonadorelin analogues (GnA) in females. Evidence on the most effective treatment for this patient subgroup is lacking. This audit surveyed the use of prophylactic GnA in the UK.Twenty female patients (who experienced between 2 and 45 acute attacks of porphyria requiring hospitalisation and treatment with human haemin prior to GnA prophylaxis) were included in the audit. Data was retrospectively collected based on patient history and case review...
February 21, 2017: JIMD Reports
https://www.readbyqxmd.com/read/28219333/uk-national-clinical-audit-management-of-pregnancies-in-women-with-hiv
#15
S Raffe, H Curtis, P Tookey, H Peters, A Freedman, Y Gilleece
BACKGROUND: The potential for HIV transmission between a pregnant woman and her unborn child was first recognized in 1982. Since then a complex package of measures to reduce risk has been developed. This project aims to review UK management of HIV in pregnancy as part of the British HIV Association (BHIVA) audit programme. METHODS: The National Study of HIV in Pregnancy and Childhood (NSHPC), a population-based surveillance study, provided data for pregnancies with an expected delivery date from 1/1/13 - 30/6/14...
February 20, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28218465/compliance-with-national-guidelines-on-isotretinoin-where-are-we-2-years-since-the-last-audit-results-of-the-national-isotretinoin-re-audit-2014
#16
L S Exton, S T Cheung, A G Brain, M F Mohd Mustapa, D A R de Berker
BACKGROUND: In 2010, the British Association of Dermatologists (BAD) published clinical guidelines for the safe introduction and continued use of isotretinoin in patients with acne in the UK. The BAD provides UK dermatologists with a facility for national audit, and it undertook an audit on compliance with these guidelines in 2012. AIM: To determine current clinical practices relating to use of isotretinoin among dermatologists in the UK (including geographical variations) as measured against BAD standards, and to ascertain any improvement since the 2012 audit...
February 20, 2017: Clinical and Experimental Dermatology
https://www.readbyqxmd.com/read/28216357/measuring-abdominal-aortic-diameters-in-routine-abdominal-computed-tomography-scans-and-implications-for-abdominal-aortic-aneurysm-screening
#17
Rachel Claridge, Sam Arnold, Neil Morrison, André M van Rij
OBJECTIVE: This study aimed to determine the prevalence and relevance of incidental abdominal aortic aneurysm (AAA) on routine abdominal computed tomography (CT) and to audit the performance of radiologists to identify and report AAA. METHODS: A retrospective audit of all abdominal CT scans performed on men and women ≥50 years at Dunedin Public Hospital between January 2013 and September 2014 was carried out. All CT scans for planning of AAA treatment or follow-up were excluded...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28216308/craniofacial-implants-at-a-single-centre-2005-2015-retrospective-review-of-451-implants
#18
R Elledge, J Chaggar, N Knapp, T Martin, N White, D Evriviades, S Edmondson, S Parmar
Craniofacial endosseous implants are regularly used to support prostheses in the rehabilitation of complex defects, but reported success rates vary. To review our own clinical practice over 10 years, and particularly to examine the impact of radiotherapy and the timing of placement on the survival of implants, we retrospectively audited the records for all patients who had endosseous implants for prosthetic rehabilitation in our unit between 2005 and 2015. We reviewed 167 records, which gave 451 implants, of which, 222 (49%) were auricular, 98 (22%) nasal, and 131 (29%) orbital...
February 16, 2017: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/28215929/each-baby-counts-national-quality-improvement-programme-to-reduce-intrapartum-related-deaths-and-brain-injuries-in-term-babies
#19
REVIEW
Louise Robertson, Hannah Knight, Edward Prosser Snelling, Emily Petch, Marian Knight, Alan Cameron, Zarko Alfirevic
Although the most recent MBRRACE-UK (Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK) perinatal mortality report has shown a downward trend in perinatal mortality, the UK still lags behind the best-performing countries in Europe. The burden of perinatal morbidity and mortality is wide-reaching and devastating for the families and care-providers involved. The aim of the Each Baby Counts (EBC) project is to reduce intrapartum term stillbirths, early neonatal deaths, and severe brain injuries by 50% by 2020...
February 16, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28215661/post-deployment-screening-for-mental-disorders-and-tailored-advice-about-help-seeking-in-the-uk-military-a-cluster-randomised-controlled-trial
#20
Roberto J Rona, Howard Burdett, Mizanur Khondoker, Melanie Chesnokov, Kevin Green, David Pernet, Norman Jones, Neil Greenberg, Simon Wessely, Nicola T Fear
BACKGROUND: The effectiveness of post-deployment screening for mental disorders has not been assessed in a randomised controlled trial. We aimed to assess whether post-deployment screening for post-traumatic stress disorder (PTSD), depression, anxiety, or alcohol misuse was effective. We defined screening as the presumptive identification of a previously unrecognised disorder using tests to distinguish those who probably had the disorder from those who probably did not so that those people with a probable disorder could be referred appropriately, and assessed effectiveness and consequences for help-seeking by the odds ratio at follow-up between those receiving tailored help-seeking advice and those who received general mental health advice...
February 16, 2017: Lancet
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