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https://www.readbyqxmd.com/read/28530779/predictive-factors-for-early-hospital-readmission-and-1-year-mortality-in-elder-patients-following-surgical-treatment-of-a-hip-fracture
#1
Hakan Sofu, Hanifi Üçpunar, Yalkın Çamurcu, Serda Duman, Mehmet Nuri Konya, Sarper Gürsu, Vedat Şahin
BACKGROUND: Early hospital readmission after surgically treated hip fracture is a common entity, often involving an adverse event and causing strains on an already overburdened healthcare system. The main purposes of the present study were to determine the 30-day readmission rate, analyze the predictive factors for early hospital readmissions, and assess 1-year mortality following surgical treatment of hip fracture in elderly patients. Retrospective case-control study. METHODS: In total, 517 patients with a mean age of 74 years were evaluated...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28481167/impact-of-a-mobile-health-application-on-user-engagement-and-pregnancy-outcomes-among-wyoming-medicaid-members
#2
James Bush, Dilek E Barlow, Jennie Echols, Jasmine Wilkerson, Katherine Bellevin
BACKGROUND: Pregnancy and birth outcomes are a critical area of healthcare, yet negative outcomes like C-sections and preterm births remain widespread. Studies show that early and ongoing prenatal care can improve outcomes; however, in-person care is difficult to deliver in rural areas. This article examines the impact of mobile health technology on user engagement and birth outcomes in a Wyoming pilot study. The pilot did face some limitations; namely, the small app user group size and scant demographic information collected from users...
May 8, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28480212/understanding-early-goal-directed-mobilization-in-the-surgical-intensive-care-unit
#3
EDITORIAL
Navya Reddy Alugubelli, Awsse Al-Ani, Dale M Needham, Ann M Parker
No abstract text is available yet for this article.
April 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28461551/organizational-domains-and-variation-in-attitudes-of-intensive-care-providers-toward-the-abcde-bundle
#4
Leanne M Boehm, Eduard E Vasilevskis, Mary S Dietrich, Nancy Wells, E Wesley Ely, Pratik Pandharipande, Lorraine C Mion
BACKGROUND: The ABCDE interprofessional bundle (Awakening and Breathing Coordination, Delirium monitoring and management, and Early mobility) reduces delirium and weakness in critically ill patients. OBJECTIVE: To understand the relationship between organizational domains and provider attitudes. METHODS: A 1-time electronic survey of 315 care providers in 10 intensive care units across the country to examine associations between organizational domains (policy/protocol factors, unit milieu, tasks, labor quality, labor quantity, and physical environment) and provider attitudes about perceived ease of completion, perceived safety, confidence, and perceived strength of evidence regarding the ABCDE bundle...
May 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/28457689/development-of-a-neuro-early-mobilization-protocol-for-use-in-a-neuroscience-intensive-care-unit
#5
Megan A Brissie, Meg Zomorodi, Sharmila Soares-Sardinha, J Dedrick Jordan
OBJECTIVE: Through evaluation of the literature and working with a team of multidisciplinary healthcare providers, our objective was to refine an interprofessional Neuro Early Mobilization Protocol for complex patients in the Neuroscience Intensive Care Unit. RESEARCH METHODOLOGY: Using the literature as a guide, key stakeholders, from multiple professions, designed and refined a Neuro Early Mobilization Protocol. SETTING: This project took place at a large academic medical center in the southeast United States classified as both a Level I Trauma Center and Comprehensive Stroke Center...
April 27, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28438605/identifying-barriers-to-delivering-the-abcde-bundle-to-minimize-adverse-outcomes-for-mechanically-ventilated-patients-a-systematic-review
#6
Deena Kelly Costa, Matthew White, Emily Ginier, Milisa Manojlovich, Sushant Govindan, Theodore J Iwashyna, Anne E Sales
BACKGROUND: Improved outcomes are associated with the Awakening, Breathing Coordination, Delirium and Early mobility/exercise (ABCDE) bundle; however, implementation issues are common. As yet, no study has integrated the barriers to ABCDE to provide an overview of reasons for less successful efforts. The purpose of this review was to identify and catalog the barriers to ABCDE delivery based on a widely used implementation framework, and provide a resource to guide clinicians in overcoming barriers to implementation...
April 21, 2017: Chest
https://www.readbyqxmd.com/read/28428892/a-comparison-of-earlier-and-enhanced-rehabilitation-of-mechanically-ventilated-patients-in-critical-care-compared-to-standard-care-rehab-study-protocol-for-a-single-site-randomised-controlled-feasibility-trial
#7
Catherine Snelson, Charlotte Jones, Gemma Atkins, James Hodson, Tony Whitehouse, Tonny Veenith, David Thickett, Emma Reeves, Aisling McLaughlin, Lauren Cooper, David McWilliams
BACKGROUND: Mortality from critical illness is improving, but survivors suffer from prolonged weakness and psychological and cognitive impairments. Maximising the recovery after critical illness has been highlighted as a research priority, especially in relation to an ageing population who present with higher rates of pre-morbid disability. Small studies have shown that starting rehabilitation early within the intensive care unit (ICU) improves short-term outcomes. Systematic reviews have highlighted the need for robust multicentre randomised controlled trials with longer term follow-up...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28427745/how-to-approach-the-acute-respiratory-distress-syndrome-prevention-plan-and-prudence
#8
REVIEW
Younsuck Koh
The acute respiratory distress syndrome (ARDS) is typically manifested by refractory hypoxemia with high mortality. A correct diagnosis is the first step to achieve better outcomes. An early intervention to manage modifiable risk factors of ARDS development and the avoidance of aggravating factors that increase disease severity and progression should be carefully addressed. A management plan is necessary at an early stage of ARDS to determine the level of intensive care. It should be carefully decided which therapeutic measures should be performed depending on the patient׳s underlying clinical condition...
May 2017: Respiratory Investigation
https://www.readbyqxmd.com/read/28414164/a-pre-hospital-extracorporeal-cardio-pulmonary-resuscitation-ecpr-strategy-for-treatment-of-refractory-out-hospital-cardiac-arrest-an-observational-study-and-propensity-analysis
#9
Lionel Lamhaut, Alice Hutin, Etienne Puymirat, Jérome Jouan, Jean-Herlé Raphalen, Romain Jouffroy, Murielle Jaffry, Christelle Dagron, Kim An, Florence Dumas, Eloi Marijon, Wulfran Bougouin, Jean-Pierre Tourtier, Frédéric Baud, Xavier Jouven, Nicolas Danchin, Christian Spaulding, Pierre Carli
BACKGROUND: Out of hospital cardiac arrest (OHCA) mortality rates remain very high with poor neurological outcome in survivors. Extracorporeal cardiopulmonary resuscitation (ECPR) is one of the treatments of refractory OHCA. This study used data from the mobile intensive care unit (MOICU) as part of the emergency medical system of Paris, and included all consecutive patients treated with ECPR (including pre-hospital ECPR) from 2011 to 2015 for the treatment of refractory OHCA, comparing two historical ECPR management strategies...
April 14, 2017: Resuscitation
https://www.readbyqxmd.com/read/28410275/implementation-of-an-icu-bundle-an-interprofessional-quality-improvement-project-to-enhance-delirium-management-and-monitor-delirium-prevalence-in-a-single-picu
#10
Shari Simone, Sarah Edwards, Allison Lardieri, L Kyle Walker, Ana Lia Graciano, Omayma A Kishk, Jason W Custer
OBJECTIVES: To examine the impact of an ICU bundle on delirium screening and prevalence and describe characteristics of delirium cases. DESIGN: Quality improvement project with prospective observational analysis. SETTING: Nineteen-bed PICU in an urban academic medical center. PATIENTS: All consecutive patients admitted from December 1, 2013, to September 30, 2015. INTERVENTIONS: A multidisciplinary team implemented an ICU bundle consisting of three clinical protocols: delirium, sedation, and early mobilization using the Plan-Do-Study-Act cycles as part of a quality improvement project...
April 13, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28388372/protein-delivery-in-the-intensive-care-unit-optimal-or-suboptimal
#11
Daren K Heyland, Peter J M Weijs, Jorge A Coss-Bu, Beth Taylor, Arnold S Kristof, Grant E O'Keefe, Robert G Martindale
Emerging evidence suggests that exogenous protein/amino acid supplementation has the potential to improve the recovery of critically ill patients. After a careful review of the published evidence, experts have concluded that critically ill patients should receive up to 2.0-2.5 g/kg/d of protein. Despite this, however, recent review of current International Nutrition Survey data suggests that protein in critically ill patients is underprescribed and grossly underdelivered. Furthermore, the survey suggests that most of protein administration comes from enteral nutrition (EN) despite the availability of products and protocols that enhance the delivery of protein/amino acids in the intensive care unit (ICU) setting...
April 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28355933/interprofessional-survey-of-perceived-barriers-and-facilitators-to-early-mobilization-of-critically-ill-patients-in-montreal-canada
#12
David E Anekwe, Karen Kin-Yue Koo, Michel de Marchie, Peter Goldberg, Dev Jayaraman, Jadranka Spahija
OBJECTIVE: Early mobilization is safe, feasible, and associated with better outcomes in patients with critical illness. However, barriers to mobilization in clinical practice still exist. The objective of this study was to assess the knowledge and practice patterns of intensive care unit (ICU) clinicians, as well as the barriers and facilitators to early mobilization. DESIGN: Cross-sectional survey. SETTING: Intensive care units of 3 university-affiliated hospitals in Montreal, Canada...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28323670/prevention-of-respiratory-complications-of-the-surgical-patient-actionable-plan-for-continued-process-improvement
#13
Katarina J Ruscic, Stephanie D Grabitz, Maíra I Rudolph, Matthias Eikermann
PURPOSE OF REVIEW: Postoperative respiratory complications (PRCs) increase hospitalization time, 30-day mortality and costs by up to $35 000. These outcomes measures have gained prominence as bundled payments have become more common. RECENT FINDINGS: Results of recent quantitative effectiveness studies and clinical trials provide a framework that helps develop center-specific treatment guidelines, tailored to minimize the risk of PRCs. The implementation of those protocols should be guided by a local, respected, and visible facilitator who leads proper implementation while inviting center-specific input from surgeons, anesthesiologists, and other perioperative stakeholders...
June 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28289812/the-icm-research-agenda-on-intensive-care-unit-acquired-weakness
#14
Nicola Latronico, Margaret Herridge, Ramona O Hopkins, Derek Angus, Nicholas Hart, Greet Hermans, Theodore Iwashyna, Yaseen Arabi, Giuseppe Citerio, E Wesley Ely, Jesse Hall, Sangeeta Mehta, Kathleen Puntillo, Johannes Van den Hoeven, Hannah Wunsch, Deborah Cook, Claudia Dos Santos, Gordon Rubenfeld, Jean-Louis Vincent, Greet Van den Berghe, Elie Azoulay, Dale M Needham
We present areas of uncertainty concerning intensive care unit-acquired weakness (ICUAW) and identify areas for future research. Age, pre-ICU functional and cognitive state, concurrent illness, frailty, and health trajectories impact outcomes and should be assessed to stratify patients. In the ICU, early assessment of limb and diaphragm muscle strength and function using nonvolitional tests may be useful, but comparison with established methods of global and specific muscle strength and physical function and determination of their reliability and normal values would be important to advance these techniques...
March 13, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28283324/early-mobilization-why-what-for-and-how
#15
A R Miranda Rocha, B P Martinez, V Z Maldaner da Silva, L A Forgiarini Junior
Early mobilization strategies in the intensive care unit may result in the prevention and reduction of polyneuromyopathy in the critical patient, improved quality of life, shortened ICU and hospital stay, and lesser mortality during hospitalization. However, it is well known that factors such as the protocol used, the population included in the studies, the timing of the strategy, the severity of the patients and different barriers directly influence the outcomes. This study examines the main protocols described in the literature and their associated results...
March 7, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28261491/design-of-smart-neonatal-health-monitoring-system-using-smcc
#16
Debashis De, Anwesha Mukherjee, Arkaprabha Sau, Ishita Bhakta
Automated health monitoring and alert system development is a demanding research area today. Most of the currently available monitoring and controlling medical devices are wired which limits freeness of working environment. Wireless sensor network (WSN) is a better alternative in such an environment. Neonatal intensive care unit is used to take care of sick and premature neonates. Hypothermia is an independent risk factor for neonatal mortality and morbidity. To prevent it an automated monitoring system is required...
February 2017: Healthcare Technology Letters
https://www.readbyqxmd.com/read/28231030/safety-of-patient-mobilization-and-rehabilitation-in-the-intensive-care-unit-systematic-review-with-meta-analysis
#17
Peter Nydahl, Thiti Sricharoenchai, Saurabh Chandra, Firuzan Sari Kundt, Minxuan Huang, Magdalena Fischill, Dale M Needham
BACKGROUND: Early mobilization and rehabilitation of patients in intensive care units (ICUs) may improve physical function, and reduce the duration of delirium, mechanical ventilation, and ICU length of stay. However, safety concerns are an important barrier to widespread implementation. OBJECTIVES: To synthesize safety data regarding patient mobilization and rehabilitation in the ICU, including falls, removal of endotracheal tubes, removal or dysfunction of intravascular catheters, removal of other catheters/tubes, cardiac arrest, hemodynamic changes, and desaturation...
May 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28230563/implementation-of-an-early-mobility-pathway-in-neurointensive-care-unit-patients-with-external-ventricular-devices
#18
Megan Moyer, Bethany Young, Eileen Maloney Wilensky, Joseph Borst, William Pino, Marisa Hart, Jesse LoBreglio, Derek Zaleski, Isaira Leonor, David Kung, Michelle Smith, Eric Zager, M Sean Grady, Monisha Kumar
BACKGROUND: Patients with an external ventricular drain (EVD) may not be readily mobilized because of concerns of catheter dislodgment and/or inappropriate cerebrospinal fluid drainage. Delayed mobilization may result in longer hospital stays and an increased risk for complications related to immobility. We aimed to determine the safety, feasibility, and outcome of an EVD mobilization protocol in patients with subarachnoid hemorrhage (SAH). METHODS: A multidisciplinary group developed a formal algorithm for the mobilization of patients with SAH with EVDs...
April 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28222805/use-of-activity-tracking-in-major-visceral-surgery-the-enhanced-perioperative-mobilization-epm-trial-study-protocol-for-a-randomized-controlled-trial
#19
Steffen Wolk, Theresa Meißner, Sebastian Linke, Benjamin Müssle, Ann Wierick, Andreas Bogner, Dorothée Sturm, Nuh N Rahbari, Marius Distler, Jürgen Weitz, Thilo Welsch
BACKGROUND: Enhanced recovery after surgery (ERAS) programs are aimed at minimizing postoperative stress and accelerating postoperative recovery by implementing multiple perioperative principles. "Early mobilization" is one such principle, but the quality of assessment and monitoring is poor, and evidence of improved outcome is lacking. Activity trackers allow precise monitoring and automatic feedback to the patients to enhance their motivation for early mobilization. The aim of the study is to monitor and increase the postoperative mobilization of patients by giving them continuous automatic feedback in the form of a step count using activity-tracking wristbands...
February 21, 2017: Trials
https://www.readbyqxmd.com/read/28197216/introducing-the-comprehensive-unit-based-safety-program-for-mechanically-ventilated-patients-in-saudi-arabian-intensive-care-units
#20
Raymond M Khan, Maha Aljuaid, Hanan Aqeel, Mohammed M Aboudeif, Shaimaa Elatwey, Rajeh Shehab, Yasser Mandourah, Khalid Maghrabi, Hassan Hawa, Imran Khalid, Ismael Qushmaq, Asad Latif, Bickey Chang, Sean M Berenholtz, Sultan Tayar, Khloud Al-Harbi, Amin Yousef, Anas A Amr, Yaseen M Arabi
Over the past decade, there have been major improvements to the care of mechanically ventilated patients (MVPs). Earlier initiatives used the concept of ventilator care bundles (sets of interventions), with a primary focus on reducing ventilator-associated pneumonia. However, recent evidence has led to a more comprehensive approach: The ABCDE bundle (Awakening and Breathing trial Coordination, Delirium management and Early mobilization). The approach of the Comprehensive Unit-based Safety Program (CUSP) was developed by patient safety researchers at the Johns Hopkins Hospital and is supported by the Agency for Healthcare Research and Quality to improve local safety cultures and to learn from defects by utilizing a validated structured framework...
January 2017: Annals of Thoracic Medicine
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