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https://www.readbyqxmd.com/read/29032792/centralisation-of-oesophagectomy-in-australia-is-only-caseload-critical
#1
Richard Hummel, Ngoc Hoang Ha, Andrew Lord, Markus I Trochsler, Guy Maddern, Harsh Kanhere
Objective High caseload is considered one of the most important factors for good outcomes after high-risk surgeries such as oesophagectomy. However, many Australian centres perform low volumes of oesophagectomies due to demographics. The aim of the present study was to audit outcome after oesophagectomy in an Australian low-volume centre over a period of 13 years and to discuss potential contributors to outcome other than just case volume.Methods Perioperative and long-term outcomes of all oesophagectomies over a 13-year period in a low-volume Australian tertiary care centre were analysed retrospectively...
October 16, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29028774/seeking-humanizing-care-in-patient-centered-care-process-a-grounded-theory-study
#2
Mohammad Ali Cheraghi, Maryam Esmaeili, Mahvash Salsali
Patient-centered care is both a goal in itself and a tool for enhancing health outcomes. The application of patient-centered care in health care services globally however is diverse. This article reports on a study that sought to introduce patient-centered care. The aim of this study is to explore the process of providing patient-centered care in critical care units. The study used a grounded theory method. Data were collected on 5 critical care units in Tehran University of Medical Sciences. Purposive and theoretical sampling directed the collection of data using 29 semistructured interviews with 27 participants (nurses, patients, and physician)...
November 2017: Holistic Nursing Practice
https://www.readbyqxmd.com/read/29026930/-burnout-a%C3%A2-call-for-action
#3
REVIEW
C S Hartog
BACKGROUND: Burnout is an emerging topic and has recently been the subject of a position paper of the US American Society of Critical Care Medicine. OBJECTIVES: To give an overview over prevalence, causes, and relevance of burnout in intensive care unit (ICU) clinicians and point to potential prevention strategies MATERIALS AND METHODS: Narrative review. RESULTS AND CONCLUSION: Burnout is a job-related state which results from long-lasting, permanent work overload when short spells of recreation, for instance during the weekend, are not effective to reduce exhaustion, vegetative symptoms, loss of efficiency, and depersonalization...
October 12, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29024808/critical-care-nurses-experiences-of-withdrawal-of-treatment-a-systematic-review-of-qualitative-evidence
#4
REVIEW
Brandi Vanderspank-Wright, Nikolaos Efstathiou, Amanda D Vandyk
BACKGROUND: Death and dying is a reality of the clinical context of the intensive care unit. Death often follows a decision to withdraw life-sustaining treatments. Critical care nurses, are the primary care providers to patients and families at the end-of-life in the intensive care unit. OBJECTIVE: To synthesize qualitative evidence on the experiences of critical care nurses who have cared for patients and families throughout the process of withdrawal of life-sustaining treatment...
September 28, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29023584/intravenous-fluid-prescribing-errors-in-children-mixed-methods-analysis-of-critical-incidents
#5
Richard L Conn, Steven McVea, Angela Carrington, Tim Dornan
INTRODUCTION: Recent National Institute for Health and Care Excellence (NICE) guidelines aim to improve intravenous (IV) fluid prescribing for children, but existing evidence about how and why fluid prescribing errors occur is limited. Studying this can lead to more effective implementation, through education and systems design. AIMS: Identify types of IV fluid prescribing errors reported in practiceAnalyse factors that contribute to errorsProvide guidance to educators and those responsible for designing systems...
2017: PloS One
https://www.readbyqxmd.com/read/29023260/dysphagia-in-mechanically-ventilated-icu-patients-dynamics-a-prospective-observational-trial
#6
Joerg C Schefold, David Berger, Patrick Zürcher, Michael Lensch, Andrea Perren, Stephan M Jakob, Ilkka Parviainen, Jukka Takala
OBJECTIVES: Swallowing disorders may be associated with adverse clinical outcomes in patients following invasive mechanical ventilation. We investigated the incidence of dysphagia, its time course, and association with clinically relevant outcomes in extubated critically ill patients. DESIGN: Prospective observational trial with systematic dysphagia screening and follow-up until 90 days or death. SETTINGS: ICU of a tertiary care academic center...
October 11, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29019630/prolonged-hospital-discharge-for-children-with-technology-dependency-a-source-of-health-care-disparities
#7
Sarah A Sobotka, Rishi K Agrawal, Michael E Msall
Children with ventilator assistance have been supported in living at home since 1981 when parental advocacy ushered in a change to Medicaid policy. As the population of children who use medical technology such as long-term ventilation increases, we must critically evaluate our systems for preparing families for home life. Discharge delays persist in the modern era because of fragmentation between hospital and home systems. These discharge delays result in children spending time in less developmentally rich environments, further exacerbating the health and development disparities of children with complex disabilities...
October 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/29017656/-development-and-construction-mode-of-critical-care-medicine-22-years-of-development-and-construction-of-intensive-care-units-of-guizhou-medical-university
#8
Difen Wang, Ying Liu, Jiangquan Fu, Yuanyi Liu, Yumei Cheng, Ying Wang, Liang Li, Ming Liu, Yan Tang, Feng Shen, Xu Liu, Jia Yuan, Xianjun Chen, Hongying Bi, Hongxia Wang, Wei Li, Qimin Chen, Cui Wang
OBJECTIVE: To provide decision-making basis for promoting the rapid and healthy development of critical care medicine/intensive care unit (ICU) through discussing the mode of development and construction of the department of ICU. METHODS: The situations of ICU of Affiliated Hospital of Guizhou Medical University from July 1994 to December 2016 were analyzed and summed up. Data of the situations in different development stages included the location and area of the ward, the number of beds, the number of physicians and nurses, the structure of academic titles and educational levels, the number of patients admitted to ICU per year, the proportion of patients used ventilator per year, the mortality, the mode of the discipline management, the number of medical postgraduates and undergraduates trained in the ICU, the number of teaching hours, the achievements, the number of research projects, the number of published monographs and papers, the number of the multicenter trials that we participated in, the construction of the team, the personal honor, and so on...
October 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29016982/burnout-in-belgian-physicians-and-nurses
#9
S Vandenbroeck, E Van Gerven, H De Witte, K Vanhaecht, L Godderis
Background: Burnout in healthcare is a worldwide problem. However, most studies focus narrowly on work-related factors and outcomes in one health profession or speciality. Aims: To investigate the prevalence of burnout and its association with job demands, job resources, individual well-being, work-related attitudes and behaviour in physicians and nurses across different specialties. Methods: Multi-centre cross-sectional study of physicians and nurses working in Belgian hospitals...
September 6, 2017: Occupational Medicine
https://www.readbyqxmd.com/read/29016464/perceptions-of-diabetes-self-care-management-among-older-singaporeans-with-type-2-diabetes-a-qualitative-study
#10
Cherry Chay Lee Tan, Karis Kin Fong Cheng, Chee Fang Sum, Jasmine Sew Hong Shew, Eleanor Holydard, Wenru Wang
BACKGROUND: Given the global shift in aging populations and the associated increasing prevalence of diabetes, it is critical to explore new approaches in diabetic self-care management. In Singapore, what has been overlooked to date is an in-depth, contextually based examination of the needs, expectations, and barriers faced in self-care management by older adults with Type 2 diabetes. PURPOSE: This study aimed to explore the experiences of older Singaporeans with Type 2 diabetes in diabetes self-care management to understand their perceived needs, expectations, and barriers associated with their diabetes self-care management...
October 10, 2017: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/29016462/the-medical-futility-experience-of-nurses-in-caring-for-critically-ill-patients
#11
Ming-Yi Hsu, Shu-Fen Su, Lien-Ying Chiang, Sou-Jen Shih, Yu-Chen Chen
BACKGROUND: Medical futility is a key bioethical concern. In Taiwan, policymakers tend to provide care standards and evaluation guidelines for critically ill and terminal patients whose treatment is medically futile. However, the current status of medical futility for critically ill patients is inadequate, and no consensus currently exists on the definition of medical futility. PURPOSE: The aim of this study was to understand the medical futility experiences of intensive care nurses...
October 10, 2017: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/28993286/spirit-trial-a-phase-iii-pragmatic-trial-of-an-advance-care-planning-intervention-in-esrd
#12
Mi-Kyung Song, Mark L Unruh, Amita Manatunga, Laura C Plantinga, Janice Lea, Manisha Jhamb, Abhijit V Kshirsagar, Sandra E Ward
Advance care planning (ACP) is a central tenet of dialysis care, but the vast majority of dialysis patients report never engaging in ACP discussions with their care providers. Over the last decade, we have developed and iteratively tested SPIRIT (Sharing Patient's Illness Representation to Increase Trust), a theory-based, patient- and family-centered advance care planning intervention. SPIRIT is a six-step, two-session, face-to-face intervention to promote cognitive and emotional preparation for end-of-life decision making for patients with ESRD and their surrogates...
October 6, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28991816/does-hospital-size-affect-patient-satisfaction
#13
Daniel C McFarland, Megan Johnson Shen, Patricia Parker, Sandra Meyerson, Randall F Holcombe
BACKGROUND: Centers for Medicare & Medicaid Services reimbursement is now contingent on quality measures such as patient satisfaction as determined by Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). In providing patient-centered care that is guided by patient satisfaction measures, it is critical to understand system-level factors that may influence how patients assess their care experiences. One important system-level influence to consider is hospital size...
October 2017: Quality Management in Health Care
https://www.readbyqxmd.com/read/28991602/nurses-experiences-of-end-of-life-care-in-long-term-care-hospitals-in-japan-balancing-improving-the-quality-of-life-and-sustaining-the-lives-of-patients-dying-at-hospitals
#14
Ryo Odachi, Tomoko Tamaki, Mikiko Ito, Taketoshi Okita, Yuri Kitamura, Tomotaka Sobue
PURPOSE: In Japan, about 80% of deaths occur in hospitals, especially long-term care beds. The purpose of this study was to clarify the nursing practices used for such older patients at the end-of-life stage in long-termcare wards via the modified grounded theory approach (M-GTA). METHODS: Data were obtained through semi-structured interviews of nineteen nurses working in cooperating long-term care wards, acute care wards, or hospice services (to allow for constant comparison between these types of wards) in western Japan in 2014...
September 2017: Asian Nursing Research
https://www.readbyqxmd.com/read/28986156/technological-aided-assessment-of-the-acutely-ill-patient-the-case-of-postoperative-complications
#15
C Haahr-Raunkjær, C S Meyhoff, H B D Sørensen, R M Olsen, E K Aasvang
Surgical interventions come with complications and highly reported mortality after major surgery. The mortality may be a result of delayed detection of severe complications due to lower monitoring frequency in the general wards. Several studies have shown that continuous monitoring is superior to the manually intermittent recorded monitoring in terms of detecting abnormal physiological signs. Hopefully improved observations may result in earlier detection and clinical intervention. This narrative review will describe current monitoring possibilities for postoperative patients and how it may prevent complications...
October 3, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28985949/emergency-nurses-perceptions-of-efficiency-and-design-examining-ed-structure-process-and-outcomes
#16
Lindsey Fay, Allison Carll-White, Kevin Real
INTRODUCTION: Due to increasing demands, it is imperative for emergency departments to improve efficiency, while providing safe and effective care. Efficient and quality healthcare delivery are impacted by interactions among the emergency department's physical structure, processes, and outcomes. Examining the interrelationship between these three components is essential for assessing quality of care in the ED setting. Studies simultaneously investigating all three aspects of this model are rare...
October 3, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28982349/critical-care-rotation-impact-on-pediatric-resident-mental-health-and-burnout
#17
Katie K Wolfe, Sharon M Unti
BACKGROUND: Burnout and depression are common among medical trainees and intensive care unit providers, negatively impacting both providers and patients. We hypothesized that at the end of the pediatric intensive care unit (PICU) rotation, there would be an increased prevalence of depression and burnout in pediatric residents when compared to the beginning. METHODS: Pediatric residents were assessed prior to and following their PICU rotation using the Maslach Burnout Inventory, the Center for Epidemiologic Studies Depression Screen and a survey assessing positive and negative aspects of the rotation...
October 5, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28981515/the-heuristics-of-nurse-responsiveness-to-critical-patient-monitor-and-ventilator-alarms-in-a-private-room-neonatal-intensive-care-unit
#18
Rohan Joshi, Heidi van de Mortel, Loe Feijs, Peter Andriessen, Carola van Pul
AIM: Alarm fatigue is a well-recognized patient safety concern in intensive care settings. Decreased nurse responsiveness and slow response times to alarms are the potentially dangerous consequences of alarm fatigue. The aim of this study was to determine the factors that modulate nurse responsiveness to critical patient monitor and ventilator alarms in the context of a private room neonatal intensive care setting. METHODS: The study design comprised of both a questionnaire and video monitoring of nurse-responsiveness to critical alarms...
2017: PloS One
https://www.readbyqxmd.com/read/28980509/hospital-workplace-violence-prevention-in-california-new-regulations
#19
Patricia Pidge Gooch
In response to startling statistics in the increasing number of workplace violence (WPV) incidents against health care workers, California employers across the continuum of care are preparing their organizations to comply with California Occupational Safety and Health Administration (CAL/OSHA) regulation SB 1299. This groundbreaking legislation requires hospitals and other health care settings to implement written strategic prevention plans and broaden the identification and reporting of incidents related to WPV...
October 1, 2017: Workplace Health & Safety
https://www.readbyqxmd.com/read/28980365/technical-rationality-and-the-decentring-of-patients-and-care-delivery-a-critique-of-unavoidable-in-the-context-of-patient-harm
#20
Marie Hutchinson, Debra Jackson, Stacey Wilson
In recent decades, debate on the quality and safety of healthcare has been dominated by a measure and manage administrative rationality. More recently, this rationality has been overlaid by ideas from human factors, ergonomics and systems engineering. Little critical attention has been given in the nursing literature to how risk of harm is understood and actioned, or how patients can be subjectified and marginalised through these discourses. The problem of assuring safety for particular patient groups, and the dominance of technical forms of rationality, has seen the word 'unavoidable' used in connection with intractable forms of patient harm...
October 4, 2017: Nursing Inquiry
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