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Clinical audit

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https://www.readbyqxmd.com/read/28822603/the-impact-of-hospital-volume-on-perioperative-outcomes-of-rectal-cancer
#1
F H W Jonker, J A W Hagemans, C Verhoef, J W A Burger
BACKGROUND: The purpose of this study was to investigate the impact of hospital volume on perioperative outcomes of clinical tumour stage (cT)1-3 and cT4 rectal cancer. METHODS: 16.162 patients operated for rectal cancer enrolled in the Dutch Surgical Colorectal Audit were included. Hospitals were divided into low (<20 cases/year), medium (21-50 cases/year) and high (>50 cases/year) volume for cT1-3 rectal cancer, and for cT4 rectal cancer into low (1-4 cases/year), medium (5-9 cases/year) and high (≥10 cases/year) volume...
July 29, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28820848/ranibizumab-and-aflibercept-for-the-treatment-of-pigment-epithelial-detachment-in-neovascular-age-related-macular-degeneration-data-from-an-observational-study
#2
Anagha Vaze, Vuong Nguyen, Vincent Daien, Jennifer J Arnold, Stephanie H Young, Chui M Cheung, Ecosse Lamoureux, Mayuri Bhargava, Daniel Barthelmes, Mark C Gillies
PURPOSE: To assess the effect of intravitreal ranibizumab and aflibercept on retinal pigment epithelial detachment (RPED) in patients with neovascular age-related macular degeneration. METHODS: This was a retrospective analysis of data from a prospectively designed and implemented clinical audit. Analysis included change in RPED dimensions and visual acuity in 92/233 treatment-naive eyes with neovascular age-related macular degeneration and RPED 6 months after treatment with either aflibercept or ranibizumab...
August 16, 2017: Retina
https://www.readbyqxmd.com/read/28819527/-evaluation-of-the-compliance-rate-of-partograph-use-in-a-tunisian-maternity-ward-a-targeted-clinical-audit
#3
Latifa Merzougui, Nedia Marwen, Tarek Barhoumi, Afef Ben Ltaeifa, Hajer Hannachi, Roukaya Jaballah, Ridha Fatnassi
Partograph is an essential tool in routine delivery room practices. It is a written reflection of the quality of mother and child health management during delivery and in the immediate post-partum period. Our study aims to assess compliance rate of partograph use within our maternity ward and to propose areas for improvement of its quality. We conducted a retrospective clinical audit of 400 patients? medical records who gave birth on the labour ward at University of Kairouan from 1 January to 31 December 2014...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28817791/using-practice-facilitation-to-increase-rates-of-colorectal-cancer-screening-in-community-health-centers-north-carolina-2012-2013-feasibility-facilitators-and-barriers
#4
Bryan J Weiner, Catherine L Rohweder, Jennifer E Scott, Randall Teal, Alecia Slade, Allison M Deal, Naima Jihad, Marti Wolf
INTRODUCTION: Practice facilitation involves trained individuals working with practice staff to conduct quality improvement activities and support delivery of evidence-based clinical services. We examined the feasibility of using practice facilitation to assist federally qualified health centers (FQHCs) to increase colorectal cancer screening rates in North Carolina. METHODS: The intervention consisted of 12 months of facilitation in 3 FQHCs. We conducted chart audits to obtain data on changes in documented recommendation for colorectal cancer screening and completed screening...
August 17, 2017: Preventing Chronic Disease
https://www.readbyqxmd.com/read/28817734/treatment-gap-and-barriers-for-mental-health-care-a-cross-sectional-community-survey-in-nepal
#5
Nagendra P Luitel, Mark J D Jordans, Brandon A Kohrt, Sujit D Rathod, Ivan H Komproe
CONTEXT: There is limited research on the gap between the burden of mental disorders and treatment use in low- and middle-income countries. OBJECTIVES: The aim of this study was to assess the treatment gap among adults with depressive disorder (DD) and alcohol use disorder (AUD) and to examine possible barriers to initiation and continuation of mental health treatment in Nepal. METHODS: A three-stage sampling technique was used in the study to select 1,983 adults from 10 Village Development Committees (VDCs) of Chitwan district...
2017: PloS One
https://www.readbyqxmd.com/read/28814990/privacy-and-security-in-multi-user-health-kiosks
#6
Harold Takyi, Valerie Watzlaf, Judith Tabolt Matthews, Leming Zhou, Dilhari Dealmeida
Enforcement of the Health Insurance Portability and Accountability Act (HIPAA) and the Health Information Technology for Economic and Clinical Health Act (HITECH) has gotten stricter and penalties have become more severe in response to a significant increase in computer-related information breaches in recent years. With health information said to be worth twice as much as other forms of information on the underground market, making preservation of privacy and security an integral part of health technology development, rather than an afterthought, not only mitigates risks but also helps to ensure HIPAA and HITECH compliance...
2017: International Journal of Telerehabilitation
https://www.readbyqxmd.com/read/28814444/implementing-an-inpatient-pediatric-prospective-audit-and-feedback-antimicrobial-stewardship-program-within-a-larger-medical-center
#7
Jennifer Lighter-Fisher, Sonya Desai, Anna Stachel, Vinh Philip Pham, Liana Klejmont, Yanina Dubrovskaya
BACKGROUND: Pediatric antimicrobial stewardship programs (ASPs) within larger institutions have unique opportunities to develop programs specialized to the needs of the pediatric program. In January 2013, our institution established a formalized pediatric ASP utilizing the prospective audit and feedback process. In an effort to standardize therapy and improve quality of care, members of the ASP developed evidence-based guidelines for management of common inpatient pediatric infections...
August 16, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28813173/development-of-a-dermatology-diagnostic-techniques-teaching-session-a-nine-step-approach
#8
Robin M Farrell, Linda G Shell
Creating effective learning experiences for veterinary clinical skills and procedures can be a challenging task. Drawing from both medical and veterinary education literature and personal experiences as practicing veterinarians and educators, the authors share nine key steps that describe the development process of a pre-clinical veterinary clinical skills teaching session. Relevant research and pedagogical principles supporting the effectiveness of the proposed nine-step process were identified and discussed...
August 16, 2017: Journal of Veterinary Medical Education
https://www.readbyqxmd.com/read/28813003/self-assessment-of-antimicrobial-stewardship-in-primary-care-self-reported-practice-using-the-target-primary-care-self-assessment-tool
#9
Rebecca Owens, Leah Ffion Jones, Michael Moore, Dirk Pilat, Cliodna McNulty
Multifaceted antimicrobial stewardship (AMS) interventions including: antibiotic guidance, reviews of antibiotic use using audits, education, patient facing materials, and self-assessment, are successful in improving antimicrobial use. We aimed to measure the self-reported AMS activity of staff completing a self-assessment tool (SAT). The Royal College of General Practitioners (RCGP)/Public Health England (PHE) SAT enables participants considering an AMS eLearning course to answer 12 short questions about their AMS activities...
August 16, 2017: Antibiotics
https://www.readbyqxmd.com/read/28812815/stakeholders-perspectives-on-the-success-drivers-in-ghana-s-national-health-insurance-scheme-identifying-policy-translation-issues
#10
Adam Fusheini, Gordon Marnoch, Ann Marie Gray
BACKGROUND: Ghana's National Health Insurance Scheme (NHIS), established by an Act of Parliament (Act 650), in 2003 and since replaced by Act 852 of 2012 remains, in African terms, unprecedented in terms of growth and coverage. As a result, the scheme has received praise for its associated legal reforms, clinical audit mechanisms and for serving as a hub for knowledge sharing and learning within the context of South-South cooperation. The scheme continues to shape national health insurance thinking in Africa...
October 1, 2016: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/28809390/clinical-features-and-surgical-outcomes-of-cervical-spondylotic-myelopathy-in-patients-of-different-ages-a-retrospective-study
#11
R J Zhang, C L Shen, J X Zhang, X J Zhang, F L Dong, H Tao, P W Song, P Ge, P Xu, H Q Zhang
STUDY DESIGN: Retrospective chart audit. OBJECTIVES: This study aims to compare the clinical features and surgical outcomes in patients with cervical spondylotic myelopathy (CSM) among different age groups. SETTING: The first Affiliated Hospital of Anhui Medical University, China. METHODS: A total of 460 patients with CSM who were surgically treated over the period of 1995-2009 were investigated. Considering the peak age (40-60 years old) for the onset of symptoms, we divided the patients into three groups by age: young (<40), middle-aged (40-60), and old (>60)...
August 15, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28808942/primary-care-providers-opening-of-time-sensitive-alerts-sent-to-commercial-electronic-health-record-inbaskets
#12
Sarah L Cutrona, Hassan Fouayzi, Laura Burns, Rajani S Sadasivam, Kathleen M Mazor, Jerry H Gurwitz, Lawrence Garber, Devi Sundaresan, Thomas K Houston, Terry S Field
BACKGROUND: Time-sensitive alerts are among the many types of clinical notifications delivered to physicians' secure InBaskets within commercial electronic health records (EHRs). A delayed alert review can impact patient safety and compromise care. OBJECTIVE: To characterize factors associated with opening of non-interruptive time-sensitive alerts delivered into primary care provider (PCP) InBaskets. DESIGN AND PARTICIPANTS: We analyzed data for 799 automated alerts...
August 14, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28806495/international-uptake-of-a-proven-intervention-to-reduce-death-and-dependency-in-acute-stroke-a-cross-sectional-survey-following-the-qasc-trial
#13
Sandy Middleton, Dominik Bruch, Cintia Martinez-Garduno, Simeon Dale, Maria McNamara
BACKGROUND: Uptake of proven interventions requires dedicated resources that may only result in local implementation, thus precluding international practice change. We explored international uptake through online dissemination of the fever, sugar, and swallow (FeSS) protocols from the Quality in Acute Stroke Care (QASC) trial, which showed decreased death and dependency by 15.7% 90-day poststroke. AIMS: To identify: (a) the clinical discipline of healthcare professionals who downloaded the QASC resources; (b) the purpose for downloading; (c) successful implementation of any or all the FeSS protocols; (d) barriers to implementation; and (e) associations with self-reported successful implementation...
August 14, 2017: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/28803651/using-national-hip-fracture-registries-and-audit-databases-to-develop-an-international-perspective
#14
Antony Johansen, David Golding, Louise Brent, Jacqueline Close, Jan-Erik Gjertsen, Graeme Holt, Ami Hommel, Alma B Pedersen, Niels Dieter Röck, Karl-Göran Thorngren
Hip fracture is the commonest reason for older people to need emergency anaesthesia and surgery, and leads to prolonged dependence for many of those who survive. People with this injury are usually identified very early in their hospital care, so hip fracture is an ideal marker condition with which to audit the care offered to older people by health services around the world. We have reviewed the reports of eight national audit programmes, to examine the approach used in each, and highlight differences in case mix, management and outcomes in different countries...
August 2, 2017: Injury
https://www.readbyqxmd.com/read/28799561/retinal-detachment-repair-and-cataract-surgery-in-patients-with-atopic-dermatitis
#15
V Gnana Jothi, S McGimpsey, J A Sharkey, W C Chan
PurposeThe aim of this study is to report a case series of ocular complications including retinal detachment (RD) and cataract in atopic dermatitis (AD) and surgical management involving a majority of Caucasian patients.Patients and methodsThis study is an observational case series, originally designed as an audit. It involves detailed discussion of history, clinical features, and surgical management of patients presenting with retinal detachment and cataracts secondary to severe AD. Six consecutive patients with diagnosis of severe AD requiring posterior segment and cataract surgery were included in the study...
August 11, 2017: Eye
https://www.readbyqxmd.com/read/28798994/intra-operative-fluoroscopic-radiation-exposure-in-orthopaedic-trauma-theatre
#16
Mustafa S Rashid, Sheweidin Aziz, Syed Haydar, Simon S Fleming, Amit Datta
INTRODUCTION: Radiation exposure from intra-operative fluoroscopy in orthopaedic trauma surgery is a common occupational hazard. References for fluoroscopy use in the operating room for commonly performed operations have not been reported adequately. This study aimed to report appropriate intra-operative fluoroscopy use in orthopaedic trauma and compare the effect of surgery type and surgeon grade on radiation exposure. METHODS: Data on 849 cases over an 18-month period were analysed retrospectively...
August 10, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28793287/early-discharge-programme-on-hospital-at-home-evaluation-for-patients-with-immediate-postoperative-course-after-laparoscopic-colorectal-surgery
#17
Marcos Pajarón-Guerrero, Manuel Francisco Fernández-Miera, Juan Carlos Dueñas-Puebla, Carmen Cagigas-Fernández, Iciar Allende-Mancisidor, Lidia Cristóbal-Poch, Manuel Gómez-Fleitas, Maria Asuncion Manzano-Peral, Carmen Rosa Gonzalez-Fernandez, Ana Aguilera-Zubizarreta, Pedro Sanroma-Mendizábal
BACKGROUND: To audit the safety of the early hospital discharge care model offered by a Hospital-at-home (HAH) unit during early postoperative follow-up of these patients, and to determine whether this care model is more efficient compared to the traditional care model. METHODS: A prospective study of 50 patients included consecutively for 1 year in an early discharge programme after laparoscopic colorectal surgery was performed. As of day 3 after surgery, if the patient met the relevant inclusion criteria they were transferred to the HAH unit...
August 9, 2017: European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes
https://www.readbyqxmd.com/read/28792802/utility-of-bi-rads-assessment-category-4-subdivisions-for-screening-breast-mri
#18
Roberta M Strigel, Elizabeth S Burnside, Mai Elezaby, Amy M Fowler, Frederick Kelcz, Lonie R Salkowski, Wendy B DeMartini
OBJECTIVE: BI-RADS for mammography and ultrasound subdivides category 4 assessments by likelihood of malignancy into categories 4A (> 2% to ≤ 10%), 4B (> 10% to ≤ 50%), and 4C (> 50% to < 95%). Category 4 is not subdivided for breast MRI because of a paucity of data. The purpose of the present study is to determine the utility of categories 4A, 4B, and 4C for MRI by calculating their positive predictive values (PPVs) and comparing them with BI-RADS-specified rates of malignancy for mammography and ultrasound...
June 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28790154/ckm-glu83gly-is-associated-with-blunted-creatine-kinase-variation-but-not-with-myalgia
#19
Moneeza Kalhan Siddiqui, Abirami Veluchamy, Cyrielle Maroteau, Roger Tavendale, Fiona Carr, Ewan Pearson, Helen Colhoun, Andrew D Morris, Jacob George, Alexander Doney, Munir Pirmohamed, Ana Alfirevic, Mia Wadelius, Anke H Maitland van der Zee, Paul M Ridker, Daniel I Chasman, Colin N A Palmer
BACKGROUND: To test the association of a recently reported variant in the creatine kinase (CK) muscle gene, CKM Glu83Gly (rs11559024) with constitutive creatine phosphokinase (CK) levels, CK variation, and inducibility. Given the diagnostic importance of CK in determining muscle damage, we tested the association of the variant with myalgia. METHODS AND RESULTS: Meta-analysis between longitudinal cohort GoDARTS (Genetics of Diabetes Audit and Research, Tayside Scotland), minor allele frequency (=0...
August 2017: Circulation. Cardiovascular Genetics
https://www.readbyqxmd.com/read/28780702/clinical-implementation-of-synthesized-mammography-with-digital-breast-tomosynthesis-in-a-routine-clinical-practice
#20
Phoebe E Freer, Joanna Riegert, Laura Eisenmenger, Dominik Ose, Nicole Winkler, Matthew A Stein, Gregory J Stoddard, Rachel Hess
BACKGROUND: Most published studies evaluating digital breast tomosynthesis (DBT) included a separate 2-dimensional full-field digital mammogram (FFDM) for DBT screening protocols, increasing radiation from screening mammography. Synthesized mammography (SM) creates a 2-dimensional image from the DBT source data, and if used in place of FFDM, it reduces radiation of DBT screening. This study evaluated the implementation of SM + DBT in routine screening practice in terms of recall rates, cancer detection rates (CDR), % of minimal cancers, % of node-positive cancers, and positive predictive values (PPV)...
August 5, 2017: Breast Cancer Research and Treatment
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