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quality health care

Donna Franklin, Franz E Babl, Luregn J Schlapbach, Ed Oakley, Simon Craig, Jocelyn Neutze, Jeremy Furyk, John F Fraser, Mark Jones, Jennifer A Whitty, Stuart R Dalziel, Andreas Schibler
BACKGROUND: High-flow oxygen therapy through a nasal cannula has been increasingly used in infants with bronchiolitis, despite limited high-quality evidence of its efficacy. The efficacy of high-flow oxygen therapy through a nasal cannula in settings other than intensive care units (ICUs) is unclear. METHODS: In this multicenter, randomized, controlled trial, we assigned infants younger than 12 months of age who had bronchiolitis and a need for supplemental oxygen therapy to receive either high-flow oxygen therapy (high-flow group) or standard oxygen therapy (standard-therapy group)...
March 22, 2018: New England Journal of Medicine
Danieli Parreira da Silva Stalisz da Paixão, Josemar Batista, Eliane Cristina Sanches Maziero, Francine Taporosky Alpendre, Marly Ryoko Amaya, Elaine Drehmer de Almeida Cruz
OBJECTIVE: To investigate compliance of national patient safety protocols in Emergency Care Units (UPA) of the Paraná State. METHOD: From April until September 2016, the exploratory stage of the action research was conducted on stratified sampling with 377 patients of eight units, with use of verification instrument of basic safety actions. RESULTS: The absence of systematic identification of patients, fall risk assessment and signaling and development of pressure injuries were evidenced...
2018: Revista Brasileira de Enfermagem
João Manuel Graveto, Cristina Santos, Paulo Santos Costa, Elisabete Fernandes, Susana Alarico, Nádia Osório, Helena Albano, Vânia Oliveira
OBJECTIVE: To describe the determining factors in hand hygiene management among nurses and identify associated collective health challenges. METHOD: Cross-sectional descriptive study. Data were collected using a questionnaire that was applied in four internal medicine units of a hospital of reference in Portugal. RESULTS: The sample was composed of 50 nurses aged 26 to 55 years (mean age of 34.88 years); 80% were women, 58% had a Bachelor's degree, and had 5-30 years of nursing practice (X̄ =11...
2018: Revista Brasileira de Enfermagem
Patrícia Couto, Paulo Almeida Pereira, Manuel Nunes, Rui Amaral Mendes
Individuals with disabilities are regarded as a highly vulnerable population group, particularly as far as oral health is concern. However, few studies have assessed the impact of the oral condition on the quality of life of these individuals. Therefore, the aim of this study is to expand knowledge on the oral health status of the Portuguese adults with mild intellectual disability, and to assess how the patient's oral health is related to their quality of life. A sample of 240 adults with mild intellectual disabilities linked to the Portuguese Federation for Intellectual Disability, were interviewed using a previously validated version of the Oral Health Impact Profile...
2018: PloS One
Mekonen Eshete Abebe, Wakgari Deressa, Victoria Oladugba, Arwa Owais, Taye Hailu, Fikre Abate, Abiye Hailu, Yohannes Demissie, Shiferaw Degu, Bezuwork Alemayehu, Mulualem Gessesse, Milliard Deribew, Paul Egl Gravem, Peter Mossey, Azeez Butali
OBJECTIVE: To assess the oral health-related quality of life (OH-RQoL) using a translated standardized measure in an understudied population of Ethiopian children born with orofacial clefts (OFCs) and their parents. METHODS: Using a descriptive study design, we assessed the OH-RQoL of 41 patients with OFCs between the ages of 8 and 17 years and their parents. Participants received multidisciplinary cleft care from 2008 to 2016. They completed an Amharic translation of the Child Oral Health Impact Profile (COHIP)...
January 1, 2018: Cleft Palate-craniofacial Journal
Kenneth E Thorpe, Peter Joski, Kenton J Johnston
Antibiotic-resistant infections are a global health care concern. The Centers for Disease Control and Prevention estimates that 23,000 Americans with these infections die each year. Rising infection rates add to the costs of health care and compromise the quality of medical and surgical procedures provided. Little is known about the national health care costs attributable to treating the infections. Using data from the Medical Expenditure Panel Survey, we estimated the incremental health care costs of treating a resistant infection as well as the total national costs of treating such infections...
March 21, 2018: Health Affairs
John Tingle
John Tingle discusses the latest Care Quality Commission annual report on how health services in England are applying the Mental Health Act 1983, which reveals with some worrying findings.
March 22, 2018: British Journal of Nursing: BJN
Yi Dong, Kun Fang, Xin Wang, Shengdi Chen, Xueyuan Liu, Yuwu Zhao, Yangtai Guan, Dingfang Cai, Gang Li, Jianmin Liu, Jianren Liu, Jianhua Zhuang, Panshi Wang, Xin Chen, Haipeng Shen, David Z Wang, Ying Xian, Wuwei Feng, Bruce Cv Campbell, Mark Parsons, Qiang Dong
Background Several stroke outcome and quality control projects have demonstrated the success in stroke care quality improvement through structured process. However, Chinese health-care systems are challenged with its overwhelming numbers of patients, limited resources, and large regional disparities. Aim To improve quality of stroke care to address regional disparities through process improvement. Method and design The Shanghai Stroke Service System (4S) is established as a regional network for stroke care quality improvement in the Shanghai metropolitan area...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
Emmanuelle Rial-Sebbag
The use of health data is increasingly seen as a central issue for research and also for care. The generation of these data is an added value for the conduct of large-scale studies, it is even considered as an (r) evolution in the methodology of research or even for personalized medicine. Several factors have influenced the acceleration in the use of health data (advances in genetics, technology and diversification of sources) leading to a re-questioning of the legal principles for the protection of health data in both French law and European law...
October 27, 2017: Journal International de Bioéthique et D'éthique des Sciences
Rimen Lim
Sleep disturbance is a significant issue for patients in intensive care units (ICUs), which can affect their health and recovery from illness. Therefore, it is important to consider ways to address sleep disturbance in these settings. One strategy that has been suggested is the use of 'quiet time' interventions, which involve a defined period where there is a reduction in controllable light and sound, and where interruptions at the patient's bedside are minimised. AIM: To determine the effectiveness of quiet time interventions in improving patients' sleep quality in ICUs; to investigate other potential clinical benefits of quiet time interventions; and to consider the effect of incorporating open visitation when implementing quiet time interventions...
March 21, 2018: Nursing Standard
Farideh Kazemi, Fatemeh Nahidi, Nourossadat Kariman
Background and objective: Pregnancy-related physiologic and psychosocial alterations can impact on the body and cause symptoms which may affect quality of life. Since qualitative studies can provide more in-depth understanding of quality of life and its determining factors, this study was conducted with the aim of exploring factors affecting pregnant women's quality of life. Methods: A qualitative descriptive study with conventional content analysis approach was made using the conventional content analysis approach on a purposeful sample of sixteen pregnant Iranian women in Hamadan, Iran from May 2015 to December 2015...
December 2017: Electronic Physician
Christopher J Smith, Russell J Buzalko, Nathan Anderson, Joel Michalski, Jordan Warchol, Stephen Ducey, Chad E Branecki
Introduction: Miscommunication during inter-unit handoffs between emergency and internal medicine physicians may jeopardize patient safety. Our goal was to evaluate the impact of a structured communication strategy on the quality of admission handoffs. Methods: We conducted a mixed-methods, pre-test/post-test study at a 560-bed academic health center with 60,000 emergency department (ED) patient visits per year. Admission-handoff best practices were integrated into a modified SBAR format, resulting in the Situation, Background, Assessment, Responsibilities & Risk, Discussion & Disposition, Read-back & Record (SBAR-DR) model...
March 2018: Western Journal of Emergency Medicine
Martin Klietz, Amelie Tulke, Lars H Müschen, Lejla Paracka, Christoph Schrader, Dirk W Dressler, Florian Wegner
Background: Parkinson's disease (PD) is the second most frequent neurodegenerative disease of the elderly. Patients suffer from various motor and non-motor symptoms leading to reduced health-related quality of life (HRQOL) and an increased mortality. Their loss of autonomy due to dementia, psychosis, depression, motor impairments, falls, and swallowing deficits defines a phase when palliative care interventions might help to sustain or even improve quality of life. Objective: The aim of this study was to investigate the current status of palliative care implementation and quality of life in a local cohort of advanced PD patients in order to frame and improve future care...
2018: Frontiers in Neurology
Jennifer L Walton, Diane K Dunn, Nhi Y Haines, Ilana Heisler, Michael T Bigham, Teresa A Volsko
BACKGROUND: The American Academy of Pediatrics Section on Transport recommends the use of portable ventilators during the transport of patients with advanced airways. We sought to identify knowledge gaps and evaluate the effectiveness of a transport ventilator competency boot camp. METHODS: Electronic health records of children requiring ventilatory support during air and ground interfacility transport from January 1 through December 31, 2015, were reviewed to determine when manual ventilation was used in lieu of a portable ventilator, and simulations were constructed from commonly occurring scenarios...
March 20, 2018: Respiratory Care
Clare Whicher, Hermione Clare Price, Richard Ig Holt
Objective There have been concerns about the effects of antipsychotics on weight gain and the development of type 2 diabetes (T2DM). This article aims to provide an up to date review on the evidence addressing this issue and the practical implications for the management of people taking antipsychotics in the context of T2DM. Methods We carried out searches on MEDLINE/PUBMED and the website in August 2017 using the terms 'antipsychotic' and 'diabetes' or 'glucose' citing articles published after 2006 preferentially...
March 20, 2018: European Journal of Endocrinology
Amit K Mathur, Jayant Talwalkar
There is growing interest in the quality of health care delivery in liver transplantation. Multiple stakeholders, including patients, transplant providers and their hospitals, payers, and regulatory bodies have an interest in measuring and monitoring quality in the liver transplant process, and understanding differences in quality across centers. This article aims to provide an overview of quality measurement and regulatory issues in liver transplantation performed within the United States. We review how broader definitions of health care quality should be applied to liver transplant care models, outline the status quo including regulatory agencies, public reporting mechanisms, and requirements around quality assurance and performance improvement (QAPI) activities...
March 17, 2018: Journal of Hepatology
T N Anand, Linju M Joseph, A V Geetha, Joyita Chowdhury, Dorairaj Prabhakaran, Panniyammakal Jeemon
BACKGROUND: One of the potential strategies to improve health care delivery in understaffed low- and middle-income countries (LMICs) is task sharing, where specific tasks are transferred from more qualified health care cadre to a lesser trained cadre. Dyslipidemia is a major risk factor for cardiovascular disease but often it is not managed appropriately. OBJECTIVE: We conducted a systematic review with the objective to identify and evaluate the effect of task sharing interventions on dyslipidemia in LMICs...
February 16, 2018: Journal of Clinical Lipidology
Abdullah Ali Alshehari, Silvia Park, Harunor Rashid
BACKGROUND: Hand hygiene (HH) compliance among health care workers (HCWs) in intensive care units (ICUs) is disconcertingly low. AIM: This mini systematic review aims to identify the effective intervention(s) for increasing HH compliance among HCWs in adult ICUs. METHODS: Two major electronic databases, OVID Medline and CINAHL, were searched by using a combination of MeSH terms and text words (e.g. hand hygiene, hand washing, compliance, adher*, improve*, develop* and intensive care unit) for relevant articles...
March 17, 2018: Journal of Hospital Infection
Sumit Kane, Matilda Rial, Maryse Kok, Anthony Matere, Marjolein Dieleman, Jacqueline E W Broerse
BACKGROUND: South Sudan has one of the worst health and maternal health situations in the world. Across South Sudan, while maternal health services at the primary care level are not well developed, even where they exist, many women do not use them. Developing location specific understanding of what hinders women from using services is key to developing and implementing locally appropriate public health interventions. METHODS: A qualitative study was conducted to gain insight into what hinders women from using maternal health services...
March 20, 2018: Reproductive Health
Nora E Fritz, Nicholas R Boileau, Julie C Stout, Rebecca Ready, Joel S Perlmutter, Jane S Paulsen, Kimberly Quaid, Stacey Barton, Michael K McCormack, Susan L Perlman, Noelle E Carlozzi
Up to 90% of individuals with Huntington's disease (HD)-a progressive, inherited neurodegenerative disorder-experience apathy. Apathy is particularly debilitating because it is marked by a reduction in goal-directed behaviors, including self-care, social interactions, and mobility. The objective of this study was to examine relationships between variables of apathy, functional status, physical function, cognitive function, behavioral status/emotional function, and health-related quality of life. Clinician-rated measures of physical, cognitive, and behavioral function, including one clinician-rated item on apathy, and self-reported measures of physical function, health-related quality of life, and emotional, cognitive, and social function were collected in a single session from 487 persons with the HD mutation (prodromal, N=193; early-stage manifest, N=186; late-stage manifest, N=108)...
March 21, 2018: Journal of Neuropsychiatry and Clinical Neurosciences
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