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https://www.readbyqxmd.com/read/28549221/preventing-underfeeding-and-overfeeding-a-clinician-s-guide-to-the-acquisition-and-implementation-of-indirect-calorimetry
#1
Amy K Ladd, Heather E Skillman, Matthew A Haemer, Peter M Mourani
BACKGROUND: In critically ill patients, indirect calorimetry (IC) is the gold standard to determine energy needs, as the use of predictive equations can result in underfeeding or overfeeding. The aim of this quality improvement (QI) initiative was to describe the rationale for and implementation of a process to target energy provision according to IC measurements in a tertiary academic medical center pediatric intensive care unit (PICU). MATERIALS AND METHODS: To justify the purchase of an indirect calorimeter for clinical use, a needs assessment was conducted, followed by a training and implementation period...
May 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28549142/how-do-performance-based-financing-programmes-measure-quality-of-care-a-descriptive-analysis-of-68-quality-checklists-from-28-low-and-middle-income-countries
#2
Erik Josephson, Jessica Gergen, Martha Coe, Samantha Ski, Supriya Madhavan, Sebastian Bauhoff
This paper seeks to systematically describe the length and content of quality checklists used in performance-based financing programmes, their similarities and differences, and how checklists have evolved over time. We compiled a list of supply-side, health facility-based performance-based financing (PBF) programmes in low- and lower middle-income countries based on a document review. We then solicited PBF manuals and quality checklists from implementers and donors of these PBF mechanisms. We entered each indicator from each quality checklist into a database verbatim in English, and translated into English from French where appropriate, and categorized each indicator according to the Donabedian framework and an author-derived categorization...
May 26, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28549099/impact-of-resident-and-fellow-changeovers-on-patient-outcomes-a-nationwide-cross-sectional-study
#3
Jean-David Zeitoun, Jeanne Reboul-Marty, Jérémie H Lefèvre
Findings regarding the association of cohort changeovers with patient outcomes are mixed. We sought to examine the association of resident and fellow changeovers with a comprehensive set of indicators. We performed a cross-sectional comparative study including all French teaching and non-teaching hospitals. All-cause mortality and length of stay were assessed. Focused analysis for three medical conditions (myocardial infarction, intestinal hemorrhage, stroke) and three surgical procedures (colorectal, vascular and spine surgery) was performed regarding other quality and efficiency indicators (readmissions, intensive care unit admission, transfers)...
May 25, 2017: European Journal of Public Health
https://www.readbyqxmd.com/read/28549051/pressure-injuries-in-inpatient-care-facilities-in-the-czech-republic-analysis-of-a-national-electronic-database
#4
Andrea Pokorná, Klára Benešová, Jiří Jarkovský, Jan Mužík, Dimitri Beeckman
PURPOSE: The purpose of this study was to analyze pressure injury (PI) occurrence upon admission and at any time during the hospital course inpatients care facilities in the Czech Republic. Secondary aims were to evaluate demographic and clinical data of patients with PI and the impact of a PI on length of stay (LOS) in the hospital. DESIGN: Retrospective, cross-sectional analysis. SETTING AND SUBJECTS: The sample comprised data of hospitalized patients entered into the National Register of Hospitalized Patients (NRHOSP) database of the Czech Republic between 2007 and 2014 with a diagnosis L89 (pressure ulcer of unspecified site based on the International Classification of Diseases, Tenth Revision, ICD-10)...
May 25, 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28549047/health-related-quality-of-life-and-sleep-disorders-in-patients-with-a-urostomy-is-there-a-relationship
#5
Chie Furukawa, Ikuharu Morioka
PURPOSE: The purpose of this study was to evaluate the relationship between health-related quality of life (HRQOL) and sleep disorders in persons living with a urostomy. DESIGN: A cross-sectional descriptive study. SUBJECTS AND SETTINGS: Eighty-six adults with a urostomy who were cared for in a stoma outpatient clinic of a hospital in Osaka, Japan, for at least 1 month before data collection, and who were attending support group meetings comprised the sample...
May 25, 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28549015/early-oral-feeding-following-mckeown-minimally-invasive-esophagectomy-an-open-label-randomized-controlled-noninferiority-trial
#6
Hai-Bo Sun, Yin Li, Xian-Ben Liu, Rui-Xiang Zhang, Zong-Fei Wang, Toni Lerut, Chia-Chuan Liu, Alfonso Fiorelli, Yin-Kai Chao, Daniela Molena, Robert J Cerfolio, Soji Ozawa, Andrew C Chang
OBJECTIVE: Our objective was to evaluate the impact of early oral feeding (EOF) on postoperative cardiac, respiratory, and gastrointestinal (CRG) complications after McKeown minimally invasive esophagectomy for esophageal cancer. SUMMARY BACKGROUND DATA: Nil-by-mouth with enteral tube feeding is routinely practiced after esophagectomy. METHODS: Patients were randomly allocated to receive oral feeding on the first postoperative day (EOF group) or late oral feeding (LOF group) 7 days after surgery...
May 25, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28548972/assessment-of-adult-malnutrition-and-prognosis-with-bioelectrical-impedance-analysis-phase-angle-and-impedance-ratio
#7
Henry C Lukaski, Ursula G Kyle, Jens Kondrup
PURPOSE OF REVIEW: Malnutrition affects prognosis in many groups of patients. Although screening tools are available to identify adults at risk for poor nutritional status, a need exists to improve the assessment of malnutrition by identifying the loss of functional tissues that can lead to frailty, compromised physical function, and increased risk of morbidity and mortality, particularly among hospitalized and ill patients and older adults. Bioimpedance analysis (BIA) offers a practical approach to identify malnutrition and prognosis by assessing whole-body cell membrane quality and depicting fluid distribution for an individual...
May 25, 2017: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/28548914/quality-of-paediatric-hospice-care-for-children-with-and-without-multiple-complex-chronic-conditions
#8
Lisa C Lindley, Jessica Keim-Malpass
BACKGROUND: Hospice care for children with multiple complex chronic conditions (MCCC) is complicated given their unique health at the end of life (EOL). Little is known about the quality of the hospice care MCCC children receive and how that might differ from children without MCCC. OBJECTIVE: To compare the quality of hospice care (i.e., structures, processes, outcomes) between children with and without MCCC. METHODS: This retrospective, comparative study used data from the National Home and Hospice Care Survey, which included a nationally representative sample of paediatric hospice patients...
May 2, 2017: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/28548904/utilization-of-a-patient-centered-asthma-passport-tool-in-a-subspecialty-clinic
#9
Jonathan Greenberg, Olga Prushinskaya, Joshua D Harris, Gillian Guidetti-Myers, Jacqueline Steiding, Gregory S Sawicki, Jonathan M Gaffin
INTRODUCTION: Despite available and effective tools for asthma self-assessment (Asthma Control Test, ACT) and self-management (Asthma Action Plan, AAP), they are underutilized in outpatient specialty clinics. We evaluated the impact of a patient-centered checklist, the Asthma Passport, on improving ACT and AAP utilization in clinic. METHODS: This was a randomized, interventional quality-improvement project in which the Asthma Passport was distributed to 120 pediatric asthma patients over the duration of 16 weeks...
May 26, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28548592/intracranial-pressure-monitoring-in-severe-blunt-head-trauma-does-the-type-of-monitoring-device-matter
#10
Alberto Aiolfi, Desmond Khor, Jayun Cho, Elizabeth Benjamin, Kenji Inaba, Demetrios Demetriades
OBJECTIVE Intracranial pressure (ICP) monitoring has become the standard of care in the management of severe head trauma. Intraventricular devices (IVDs) and intraparenchymal devices (IPDs) are the 2 most commonly used techniques for ICP monitoring. Despite the widespread use of these devices, very few studies have investigated the effect of device type on outcomes. The purpose of the present study was to compare outcomes between 2 types of ICP monitoring devices in patients with isolated severe blunt head trauma...
May 26, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28548479/insular-gliomas-a-surgical-reappraisal-based-on-a-systematic-review-of-the-literature
#11
Domenico Murrone, Rodolfo Maduri, Afif Afif, Domenico Chirchiglia, Isabelle Pelissou-Guyotat, Jacques Guyotat, Francesco Signorelli
INTRODUCTION: Insular gliomas are heterogeneous lesions whose management presents multiple challenges for their tendency to affect young patients in good neurological and cognitive conditions, their deep anatomic location and proximity with critical functional and vascular structures. The appropriate management of insular gliomas requires a multidisciplinary evidence-centred teamwork grounded on the best anatomic, neurophysiological and oncological knowledge. The present study provides a reappraisal of the management of insular gliomas based on a systematic review of the literature with the aim of guiding clinicians in the management of such tumors...
May 25, 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/28548315/aapm-medical-physics-practice-guideline-8-a-linear-accelerator-performance-tests
#12
Koren Smith, Peter Balter, John Duhon, Gerald A White, David L Vassy, Robin A Miller, Christopher F Serago, Lynne A Fairobent
PURPOSE: The purpose of this guideline is to provide a list of critical performance tests in order to assist the Qualified Medical Physicist (QMP) in establishing and maintaining a safe and effective quality assurance (QA) program. The performance tests on a linear accelerator (linac) should be selected to fit the clinical patterns of use of the accelerator and care should be given to perform tests which are relevant to detecting errors related to the specific use of the accelerator. METHODS: A risk assessment was performed on tests from current task group reports on linac QA to highlight those tests that are most effective at maintaining safety and quality for the patient...
May 26, 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28548247/market-for-artemether-lumefantrine-to-treat-childhood-malaria-in-a-district-of-southern-mozambique
#13
Sergi Alonso, Khátia Munguambe, Elisa Sicuri
Malaria is one of the leading causes of death in sub-Saharan Africa. Artemisinin-based combination therapies are used as first-line treatment drugs, but their market is far from competitive. Market failures include limited availability, low quality, lack of information, and high costs of access. We estimated the theoretical demand for one of the most common artemisinin-based combination therapies, artemether-lumefantrine (AL), and its determinants among caregivers of children with malaria seeking care at public health facilities, thus, entitled to receive drugs for free, in southern Mozambique (year 2012)...
May 26, 2017: Health Economics
https://www.readbyqxmd.com/read/28548204/endovascular-treatment-for-ruptured-abdominal-aortic-aneurysm
#14
REVIEW
Stephen Badger, Rachel Forster, Paul H Blair, Peter Ellis, Frank Kee, Denis W Harkin
BACKGROUND: An abdominal aortic aneurysm (AAA) (pathological enlargement of the aorta) is a condition that can occur as a person ages. It is most commonly seen in men older than 65 years of age. Progressive aneurysm enlargement can lead to rupture and massive internal bleeding, which is fatal unless timely repair can be achieved. Despite improvements in perioperative care, mortality remains high (approximately 50%) after conventional open surgical repair. Endovascular aneurysm repair (EVAR), a minimally invasive technique, has been shown to reduce early morbidity and mortality as compared to conventional open surgery for planned AAA repair...
May 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28548195/-qualitative-research-methodology-in-health-care
#15
Paula Bedregal, Carolina Besoain, Alejandro Reinoso, Tamara Zubarew
Health care research requires different methodological approaches such as qualitative and quantitative analyzes to understand the phenomena under study. Qualitative research is usually the least considered. Central elements of the qualitative method are that the object of study is constituted by perceptions, emotions and beliefs, non-random sampling by purpose, circular process of knowledge construction, and methodological rigor throughout the research process, from quality design to the consistency of results...
March 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28548005/geographic-variation-in-diagnostic-ability-and-quality-of-care-metrics-a-case-study-of-ankylosing-spondylitis-and-low-back-pain
#16
Jason Shafrin, Jenny Griffith, Jin Joo Shim, Caroline Huber, Arijit Ganguli, Wade Aubry
Studies examining geographic variation in care for low back pain often focus on process and outcome measures conditional on patient diagnosis but generally do not take into account a physician's ability to diagnose the root cause of low back pain. In our case study, we used increased detection of ankylosing spondylitis-a relatively rare inflammatory back disease-as a proxy for diagnostic ability and measured the relationship between ankylosing spondylitis detection, potentially inappropriate low back pain care, and cost...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28548000/assessment-for-improving-the-performance-of-nicus-the-italian-experience
#17
Simone Fanelli, Antonello Zangrandi
This paper describes neonatal intensive care units (NICU) in Italy using a set of organizational variables identifying management profile. The correlations between variables, and how these are impacted by structural aspects of the department or hospital, are investigated. The research was conducted within the 5-year far-reaching and complex SONAR study run by the Italian Neonatal Network, which maps NICU, monitors outcomes of member centres, defines organizational models, and identifies best practices to improve care quality...
January 1, 2017: Health Services Management Research
https://www.readbyqxmd.com/read/28547996/predicting-health-related-quality-of-life-in-people-living-with-hiv-in-nepal-mental-health-disorders-and-substance-use-determinants
#18
Khem N Pokhrel, Vidya D Sharma, Akira Shibanuma, Kalpana G Pokhrel, Linda B Mlunde, Masamine Jimba
HIV-positive people often experience mental health disorders and engage in substance use. Such conditions tend to impair their health-related quality of life (QOL). Evidence, however, is limited about the influence of mental health disorders and substance use on QOL by gender. Also, little is known about the influences of anxiety and high levels of stress on QOL. We recruited 682 HIV-positive people in Nepal and measured their depression, anxiety, stress levels, substance use, and QOL. Multiple linear regressions assessed the association of mental health disorders and substance use with QOL...
May 26, 2017: AIDS Care
https://www.readbyqxmd.com/read/28547805/quality-and-impact-of-eviq-cancer-treatments-online-www-eviq-org-au-the-medical-oncologist-s-perspective
#19
Lydia P Y Loke, Tina Y T Chen, Craig R Lewis, Robyn L Ward, Shelley A Rushton, Jeremy D Shapiro
INTRODUCTION: eviQ Cancer Treatments Online is a free, web-based resource providing access to over 600 evidence-based treatment protocols in medical oncology, radiation oncology, hematology and cancer genetics. With over 60 000 registrants from 148 countries, eviQ is widely used by cancer clinicians globally. The aim of this study was to examine the perceived quality of eviQ by Australian medical oncologists, the impact it had on their knowledge and practice, and the effect it had on their patients...
May 25, 2017: Asia-Pacific Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28547746/the-support-needs-of-parents-having-a-child-with-a-chronic-kidney-disease-a-focus-group-study
#20
W W Geense, B G I van Gaal, J L Knoll, E A M Cornelissen, T van Achterberg
BACKGROUND: Parents of children with a chronic kidney disease (CKD) have a crucial role in the management of their child's disease. The burden on parents is high: they are often exhausted, depressed and experience high levels of stress and a low quality of life, which could have a negative impact on their child's health outcomes. Support aiming at preventing and reducing parental stress is essential. Therefore, it is necessary to have insight in the problems and support needs among these parents...
May 25, 2017: Child: Care, Health and Development
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