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emergency department revisits

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https://www.readbyqxmd.com/read/28816890/improving-timeliness-of-%C3%AE-agonist-and-corticosteroid-administration-in-patients-with-acute-wheezing
#1
Mandisa McIver, William Stoudemire, Cherrelle Smith-Ramsey, Mousumee Panigrahi, Christine Walsh-Kelly
OBJECTIVE: Timely delivery of β-agonists and steroids to patients with acute recurrent wheezing is a key component of the National Heart, Lung, and Blood Institute recommended emergency department (ED) asthma care. We conducted an ED improvement initiative to standardize asthma care and improve time to treatments. METHODS: Our multidisciplinary team identified key contributing factors to timeliness, developed key driver diagrams, implemented and refined a management pathway, designed and executed rapid cycle improvements, and implemented interventions...
August 14, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28814479/early-prediction-of-hospital-admission-for-emergency-department-patients-a-comparison-between-patients-younger-or-older-than-70-years
#2
Jacinta A Lucke, Jelle de Gelder, Fleur Clarijs, Christian Heringhaus, Anton J M de Craen, Anne J Fogteloo, Gerard J Blauw, Bas de Groot, Simon P Mooijaart
OBJECTIVE: The aim of this study was to develop models that predict hospital admission to ED of patients younger and older than 70 and compare their performance. METHODS: Prediction models were derived in a retrospective observational study of all patients≥18 years old visiting the ED of a university hospital during the first 6 months of 2012. Patients were stratified into two age groups (<70 years old and ≥70 years old). Multivariable logistic regression analysis was used to identify predictors of hospital admission among factors available immediately after patient arrival to the ED...
August 16, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28809587/severe-asthma-emergency-care-patient-driven-solutions
#3
Karen Newell, Chris Corrigan, Geoffrey Punshon, Alison Leary
Purpose Patients with severe asthma were choosing not to use the emergency department (ED) in extremis and were self-medicating when experiencing severe asthma, putting their lives at risk. This local issue reflected a nationwide situation. The purpose of this paper is to better understand the reasons behind patients' reluctance to attend ED and to consider practical solutions in a structured way. Design/methodology/approach Systems thinking (soft systems methodology) was used to examine the issues resulting in this reluctance to attend the ED...
August 14, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28764160/revisiting-nitrofurantoin-for-vancomycin-resistant-enterococci
#4
Suneeta Meena, Sarita Mohapatra, Seema Sood, Benu Dhawan, Bimal Ku Das, Arti Kapil
INTRODUCTION: Enterococcal infection has emerged as a major therapeutic challenge. Emergence of High Level Aminoglycoside Resistance (HLAR) and Vancomycin-Resistant Enterococcus (VRE) has further limited the drug therapy in enterococcal infections. However, nitrofuratoin being an old drug reported to have less resistance in comparison to the other classes of antimicrobial agents. AIM: To detect susceptibility of nitrofurantoin against VRE isolates from Urinary Tract Infection (UTI) of outdoor and indoor patient departments...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28757746/characteristics-and-outcomes-of-patients-with-emergency-department-revisits-within-72-hours-and-subsequent-admission-to-the-intensive-care-unit
#5
I-Ting Tsai, Cheuk-Kwan Sun, Chao-Sung Chang, Kuo-Hsin Lee, Chih-Yu Liang, Chih-Wei Hsu
OBJECTIVE: This study aimed to investigate the characteristics and outcomes of patients with emergency department (ED) revisits within 72 hours and subsequent admission to the intensive care unit (ICU). MATERIALS AND METHODS: The medical records of all adult patients revisiting the ED of a single tertiary referral medical center with ICU admissions between January 2012 and September 2014 were reviewed in terms of patient characteristics, clinical manifestations, diagnoses, triage according to the Taiwan Triage and Acuity Scale, causes of revisits, and mortality...
October 2016: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/28702257/the-relationship-between-diabetes-mellitus-and-30-day-readmission-rates
#6
Stephanie Ostling, Jennifer Wyckoff, Scott L Ciarkowski, Chih-Wen Pai, Hae Mi Choe, Vinita Bahl, Roma Gianchandani
BACKGROUND: It is estimated that 9.3% of the population in the United States have diabetes mellitus (DM), 28% of which are undiagnosed. The high prevalence of DM makes it a common comorbid condition in hospitalized patients. In recent years, government agencies and healthcare systems have increasingly focused on 30-day readmission rates to determine the complexity of their patient populations and to improve quality. Thirty-day readmission rates for hospitalized patients with DM are reported to be between 14...
2017: Clinical Diabetes and Endocrinology
https://www.readbyqxmd.com/read/28688769/revisit-subsequent-hospitalization-recurrent-fall-and-death-within-6-months-after-a-fall-among-elderly-emergency-department-patients
#7
Jiraporn Sri-On, Gregory P Tirrell, Jonathan F Bean, Lewis A Lipsitz, Shan W Liu
STUDY OBJECTIVE: We seek to describe the risk during 6 months and specific risk factors for recurrent falls, emergency department (ED) revisits, subsequent hospitalizations, and death within 6 months after a fall-related ED presentation. METHODS: This was a secondary analysis of a retrospective cohort of elderly fall patients who presented to the ED from one urban teaching hospital. We included patients aged 65 years and older who had an ED fall visit in 2012. We examined the frequency and risk factors of adverse events (composite of recurrent falls, ED revisits, subsequent hospitalization, and death, selected a priori) at 6 months...
June 29, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28655589/identification-of-seniors-at-risk-isar-in-the-emergency-room-a-prospective-study
#8
João Paulo de Almeida Tavares, Pedro Sá-Couto, Marie Boltz, Elizabeth Capezuti
INTRODUCTION: The Identification of Seniors at Risk (ISAR) is one of the most frequently utilized risk screening tools in emergency departments (ED). The goal of this study was to evaluate the predictive validity of the ISAR screening tool for adverse outcomes in an ED. METHODS: This was a prospective single-center observational study in a Portuguese urban university hospital ED, and included 402 older adults (OA). After triage, baseline sociodemographic and clinic data were collected by the researcher and the ISAR was administered...
June 24, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28634181/outcomes-after-observation-stays-among-older-adult-medicare-beneficiaries-in-the-usa-retrospective-cohort-study
#9
Kumar Dharmarajan, Li Qin, Maggie Bierlein, Jennie E S Choi, Zhenqiu Lin, Nihar R Desai, Erica S Spatz, Harlan M Krumholz, Arjun K Venkatesh
Objective To characterize rates and trends over time of emergency department treatment-and-discharge stays, repeat observation stays, inpatient stays, any hospital revisit, and death within 30 days of discharge from observation stays.Design Retrospective cohort study.Setting 4750 hospitals in the USA.Participants Nationally representative sample of Medicare fee for service beneficiaries aged 65 or over discharged after 363 037 index observation stays, 2 540 000 index emergency department treatment-and-discharge stays, and 2 667 525 index inpatient stays from 2006-11...
June 20, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28628705/time-to-appendectomy-and-risk-of-complicated-appendicitis-and-adverse-outcomes-in-children
#10
Stephanie K Serres, Danielle B Cameron, Charity C Glass, Dionne A Graham, David Zurakowski, Mahima Karki, Seema P Anandalwar, Shawn J Rangel
Importance: Management of appendicitis as an urgent rather than emergency procedure has become an increasingly common practice in children. Controversy remains as to whether this practice is associated with increased risk of complicated appendicitis and adverse events. Objective: To examine the association between time to appendectomy (TTA) and risk of complicated appendicitis and postoperative complications. Design, Setting, and Participants: In this retrospective cohort study using the Pediatric National Surgical Quality Improvement Program appendectomy pilot database, 2429 children younger than 18 years who underwent appendectomy within 24 hours of presentation at 23 children's hospitals from January 1, 2013, through December 31, 2014, were studied...
August 1, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28562277/reducing-hospitalization-rates-for-children-with-anaphylaxis
#11
Karen S Farbman, Kenneth A Michelson, Mark I Neuman, Timothy E Dribin, Lynda C Schneider, Anne M Stack
BACKGROUND AND OBJECTIVES: Most children with anaphylaxis in the emergency department (ED) are hospitalized. Opportunities exist to safely reduce the hospitalization rate for children with anaphylaxis by decreasing unnecessary hospitalizations. A quality improvement (QI) intervention was conducted to improve care and reduce hospitalization rates for children with anaphylaxis. METHODS: We used the Model for Improvement and began with development and implementation in 2011 of a locally developed evidence-based guideline based on national recommendations for the management of anaphylaxis...
June 2017: Pediatrics
https://www.readbyqxmd.com/read/28559030/the-effect-of-utilization-review-on-emergency-department-operations
#12
Shoma Desai, Phillip F Gruber, Erick Eiting, Seth A Seabury, Wendy J Mack, Christian Voyageur, Veronica Vasquez, Hyung T Kim, Sophie Terp
STUDY OBJECTIVE: Increasingly, hospitals are using utilization review software to reduce hospital admissions in an effort to contain costs. Such practices have the potential to increase the number of unsafe discharges, particularly in public safety-net hospitals. Utilization review software tools are not well studied with regard to their effect on emergency department (ED) operations. We study the effect of prospectively used admission decision support on ED operations. METHODS: In 2012, Los Angeles County + University of Southern California Medical Center implemented prospective use of computerized admission criteria...
May 27, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28557725/reduced-radiation-in-children-presenting-to-the-ed-with-suspected-ventricular-shunt-complication
#13
Ronald F Marchese, Erin S Schwartz, Gregory G Heuer, Jane Lavelle, Jimmy W Huh, Louis M Bell, Xianqun Luan, Joseph J Zorc
BACKGROUND: Ventricular shunt complications in children can be severe and life-threatening if not identified and treated in a timely manner. Evaluation for shunt obstruction is not without risk, including lifetime cumulative radiation as patients routinely receive computed tomography (CT) scans of the brain and shunt series (multiple radiographs of the skull, neck, chest, and abdomen). METHODS: A multidisciplinary team collaborated to develop a clinical pathway with the goal of standardizing the evaluation and management of patients with suspected shunt complication...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28545851/sex-specific-risk-of-emergency-department-revisits-and-early-readmission-following-myocardial-infarction
#14
Magnus Lundbäck, Danijela Gasevic, Eric Rullman, Toralph Ruge, Axel C Carlsson, Martin J Holzmann
BACKGROUND: Readmissions within 30days after hospitalization have been introduced as a measure of quality of care. There is a paucity of data regarding sex-specific risk of early readmissions after myocardial infarction (MI). OBJECTIVES: To investigate the association between sex and revisits to the emergency department (ED), and readmissions after MI. METHODS: All patients with chest pain, diagnosed with MI at the Karolinska University Hospital during 2011 and 2012 were included...
September 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28535970/upper-extremity-deep-venous-thrombosis-after-port-insertion-what-are-the-risk-factors
#15
Omidreza Tabatabaie, Gyulnara G Kasumova, Tara S Kent, Mariam F Eskander, Ayotunde B Fadayomi, Sing Chau Ng, Jonathan F Critchlow, Nicholas E Tawa, Jennifer F Tseng
BACKGROUND: Totally implantable venous access devices (ports) are widely used, especially for cancer chemotherapy. Although their use has been associated with upper extremity deep venous thrombosis, the risk factors of upper extremity deep venous thrombosis in patients with a port are not studied adequately. METHODS: The Healthcare Cost and Utilization Project's Florida State Ambulatory Surgery and Services Database was queried between 2007 and 2011 for patients who underwent outpatient port insertion, identified by Current Procedural Terminology code...
May 20, 2017: Surgery
https://www.readbyqxmd.com/read/28513890/risk-of-hospitalisation-after-early-revisit-in-the-emergency-department
#16
Giorgio Cozzi, Sergio Ghirardo, Ilaria Fiorese, Ilaria Proietti, Lorenzo Monasta, Marta Minute, Egidio Barbi, Lorenzo Calligaris
AIM: Early-revisits are frequent in the paediatric emergency department (ED) setting, but few data are available about early-revisited patients. The aim of this study was to investigate the hospitalisation rate of a population of early-revisited patients and to detect if an early-revisited patient was at risk of a more severe disease. METHODS: Between June 2014 and January 2015, we conducted a retrospective cohort study, considering all patients presented to the ED of a tertiary level children's hospital in Italy...
May 17, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28511472/short-term-unscheduled-revisits-to-paediatric-emergency-department-a-six-year-data
#17
Onder Kilicaslan, Feruza Turan Sönmez, Harun Gunes, Ramazan Cahit Temizkan, Kenan Kocabay, Ayhan Saritas
INTRODUCTION: Reviewing the reasons for return visits within 24 hours is a very important method of determining possible problems of emergency health care. Several causes stay behind unscheduled emergency return visits. Therefore, identifying these factors is crucial to set strategies in order to decrease the number of unnecessary visits. AIM: To define the characteristics of the patients returning to the Paediatric Emergency Department (PED) within 24 hours via determining rate, number and demographic data of patients...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28484958/markers-of-diuretic-resistance-in-emergency-department-patients-with-acute-heart-failure
#18
Andrew Doering, Cathy A Jenkins, Alan B Storrow, JoAnn Lindenfeld, Gregory J Fermann, Karen F Miller, Matthew Sperling, Sean P Collins
BACKGROUND: Loop diuretics are common therapy for emergency department (ED) patients with acute heart failure (AHF). Diuretic resistance (DR) is a term used to describe blunted natriuretic response to loop diuretics. It would be important to detect DR prior to it becoming clinically apparent, so early interventions can be initiated. However, several definitions have been proposed, and it is not clear if they identify similar patients. We compared these definitions and described the clinical characteristics of patients who fulfilled them...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28457526/delayed-diagnoses-in-children-with-constipation-multicenter-retrospective-cohort-study
#19
Stephen B Freedman, Jonathan Rodean, Matthew Hall, Elizabeth R Alpern, Paul L Aronson, Harold K Simon, Samir S Shah, Jennifer R Marin, Eyal Cohen, Rustin B Morse, Yiannis Katsogridakis, Jay G Berry, Mark I Neuman
OBJECTIVE: The use of abdominal radiographs contributes to increased healthcare costs, radiation exposure, and potentially to misdiagnoses. We evaluated the association between abdominal radiograph performance and emergency department (ED) revisits with important alternate diagnosis among children with constipation. STUDY DESIGN: Retrospective cohort study of children aged <18 years diagnosed with constipation at one of 23 EDs from 2004 to 2015. The primary exposure was abdominal radiograph performance...
April 28, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28442924/a-framework-for-measuring-self-management-effectiveness-and-health-care-use-among-pediatric-asthma-patients-and-families
#20
REVIEW
Pavani Rangachari
Asthma is associated with substantial health care expenditures, including an estimated US$56 billion per year in direct costs. A recurring theme in the asthma management literature is that costly asthma symptoms, including hospitalizations and multiple emergency department (ED)/outpatient visits, can often be prevented through patient/family adherence to the national (National Institutes of Health Expert Panel Report-3) guidelines for effective self-management of asthma, specifically 1) medication adherence and 2) environmental trigger avoidance, as outlined in the patient's personalized Asthma-Action Plan...
2017: Journal of Asthma and Allergy
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