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https://www.readbyqxmd.com/read/28531281/standard-vs-intensified-management-of-heart-failure-to-reduce-healthcare-costs-results-of-a-multicentre-randomized-controlled-trial
#1
P A Scuffham, J Ball, J D Horowitz, C Wong, P J Newton, P Macdonald, J McVeigh, A Rischbieth, N Emanuele, M J Carrington, C M Reid, Y K Chan, S Stewart
Aims: To determine if an intensified form of heart failure management programme (INT-HF-MP) based on individual profiling is superior to standard management (SM) in reducing health care costs during 12-month follow-up (primary endpoint). Methods and results: A multicentre randomized trial involving 787 patients (full analysis set) discharged from four tertiary hospitals with chronic HF who were randomized to SM (n = 391) or INT-HF-MP (n = 396). Mean age was 74 ± 12 years, 65% had HF with a reduced ejection fraction (31...
May 20, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28527727/patient-outcomes-following-lower-leg-major-amputations-for-peripheral-arterial-disease-a-series-review
#2
Susan Monaro, Sandra West, Janice Gullick
INTRODUCTION: Despite improvements in revascularization, major amputation remains a significant part of the case-mix in vascular surgical units. These patients tend to be elderly with complex pathology, resulting in poor outcomes and longer lengths of stay (LOS). AIM: This series review provides a description of the patient complexities and outcomes in an Australian cohort undergoing major lower limb amputation for peripheral arterial disease. METHOD: Medical records coded for major amputation between July 2012 and June 2013 in an Australian government funded, tertiary hospital were retrospectively reviewed and descriptively analyzed...
June 2017: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
https://www.readbyqxmd.com/read/28527638/shared-decision-making-in-australia-in-2017
#3
Lyndal Trevena, Heather L Shepherd, Carissa Bonner, Jesse Jansen, Anne E Cust, Julie Leask, Narelle Shadbolt, Chris Del Mar, Kirsten McCaffery, Tammy Hoffmann
Shared Decision Making (SDM) is now firmly established within national clinical standards for accrediting hospitals, day procedure services, public dental services and medical education in Australia, with plans to align general practice, aged care and disability service. Implementation of these standards and training of health professionals is a key challenge for the Australian health sector at this time. Consumer involvement in health research, policy and clinical service governance has also increased, with a major focus on encouraging patients to ask questions during their clinical care...
May 17, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28525825/what-is-to-blame-for-postnatal-pelvic-floor-dysfunction-in-primiparous-women-pre-pregnancy-or-intrapartum-risk-factors
#4
Constantin M Durnea, Ali S Khashan, Louise C Kenny, Uliana A Durnea, James C Dornan, Suzanne M O'Sullivan, Barry A O'Reilly
BACKGROUND: The aetiology of pelvic floor dysfunction (PFD) is still poorly understood. However childbearing is recognized as a major risk factor. OBJECTIVES: To elucidate the natural history of PFD by investigating the impact of the mode of delivery on postnatal pelvic floor dysfunction in primiparas, when PFD existing before the first pregnancy is taken into consideration. STUDY DESIGN: 4P-study (Prevalence and Predictors of Pelvic floor dysfunction in Primips) is a prospective cohort study, nested within the Screening for Pregnancy Endpoints (SCOPE) study set in a tertiary referral teaching hospital with 9000 deliveries annually...
April 23, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28524255/enablers-and-barriers-to-the-use-of-antibiotic-guidelines-in-the-assessment-and-treatment-of-community-acquired-pneumonia-a-qualitative-study-of-clinicians-perspectives
#5
Antoine Sedrak, Mahesan Anpalahan, Karen Luetsch
BACKGROUND: Community-acquired pneumonia (CAP) is a common condition and a number of guidelines have been developed for its assessment and treatment. Adherence to guidelines by clinicians varies and particularly the prescribing of antibiotics often remains suboptimal. OBJECTIVE: The aim of this study was to elucidate potential barriers and enablers to the adherence to antibiotic guidelines by clinicians treating CAP in an Australian hospital. METHODS: Semi-structured interviews were conducted with purposively recruited senior prescribers who regularly treat CAP in an Australian hospital...
May 19, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28524097/vegetable-and-fruit-intake-and-fracture-related-hospitalisations-a-prospective-study-of-older-women
#6
Lauren C Blekkenhorst, Jonathan M Hodgson, Joshua R Lewis, Amanda Devine, Richard J Woodman, Wai H Lim, Germaine Wong, Kun Zhu, Catherine P Bondonno, Natalie C Ward, Richard L Prince
The importance of vegetable and fruit intakes for the prevention of fracture in older women is not well understood. Few studies have explored vegetable and fruit intakes separately, or the associations of specific types of vegetables and fruits with fracture hospitalisations. The objective of this study was to examine the associations of vegetable and fruit intakes, separately, and specific types of vegetables and fruits with fracture-related hospitalisations in a prospective cohort of women aged ≥70 years...
May 18, 2017: Nutrients
https://www.readbyqxmd.com/read/28522387/australian-private-midwives-with-hospital-visiting-rights-in-queensland-structures-and-processes-impacting-clinical-outcomes
#7
J Fenwick, H Brittain, J Gamble
BACKGROUND: Reporting the outcomes for women and newborns accessing private midwives with visiting rights in Australia is important, especially since this data cannot currently be disaggregated from routinely collected perinatal data. AIM: 1) Evaluate the outcomes of women and newborns cared for by midwives with visiting access at one Queensland facility and 2) explore private midwives views about the structures and processes contributing to clinical outcomes. METHODS: Mixed methods...
May 15, 2017: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/28521830/evidence-based-policy-responses-to-strengthen-health-community-and-legislative-systems-that-care-for-women-in-australia-with-female-genital-mutilation-cutting
#8
REVIEW
Nesrin Varol, John J Hall, Kirsten Black, Sabera Turkmani, Angela Dawson
BACKGROUND: The physical and psychological impact of female genital mutilation / cutting (FGM/C) can be substantial, long term, and irreversible. Parts of the health sector in Australia have developed guidelines in the management of FGM/C, but large gaps exist in community and professional knowledge of the consequences and treatment of FGM/C. The prevalence of FGM/C amongst Australian women is unknown. Our article reviews the literature on research on FGM/C in Australia, which focuses on health system response to women and girls with FGM/C...
May 18, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28520865/impact-of-an-integrated-antibiotic-allergy-testing-program-on-antimicrobial-stewardship-a-multicenter-evaluation
#9
Jason A Trubiano, Karin A Thursky, Andrew J Stewardson, Karen Urbancic, Leon J Worth, Cheryl Jackson, Wendy Stevenson, Michael Sutherland, Monica A Slavin, M Lindsay Grayson, Elizabeth J Phillips
Background.: Despite the high prevalence of patient-reported antibiotic allergy (so-called antibiotic allergy labels [AALs]) and their impact on antibiotic prescribing, incorporation of antibiotic allergy testing (AAT) into antimicrobial stewardship (AMS) programs (AAT-AMS) is not widespread. We aimed to evaluate the impact of an AAT-AMS program on AAL prevalence, antibiotic usage, and appropriateness of prescribing. Methods.: AAT-AMS was implemented at two large Australian hospitals during a 14-month period beginning May 2015...
May 18, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28514641/mapping-workforce-configuration-and-operational-models-in-australian-emergency-departments-a-national-survey
#10
Glenn Gardner, Anne Gardner, Sandy Middleton, Julie Considine, Gerard Fitzgerald, Luke Christofis, Anna Doubrovsky, Margaret Adams, Jane O'Connell
Objective Hospital emergency departments (ED) in Australia and internationally have been experiencing increased demand, resulting in reduced hospital quality, impaired access and adverse health outcomes. Effective evaluation of new ED service models and their effect on outcomes is reliant on baseline measures of the staffing configuration and organisational characteristics of the EDs being studied. The aim of the present study was to comprehensively measure these variables in Australian EDs.Methods Australian hospital EDs with 24-h medical and nursing cover were identified and invited to participate in the study...
May 18, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28514640/digital-disruption-syndromes
#11
Clair Sullivan, Andrew Staib
The digital transformation of hospitals in Australia is occurring rapidly in order to facilitate innovation and improve efficiency. Rapid transformation can cause temporary disruption of hospital workflows and staff as processes are adapted to the new digital workflows. The aim of this paper is to outline various types of digital disruption and some strategies for effective management. A large tertiary university hospital recently underwent a rapid, successful roll-out of an integrated electronic medical record (EMR)...
May 18, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28512920/an-audit-of-adherence-to-heart-failure-guidelines-in-an-australian-hospital-a-pharmacist-perspective
#12
Viviane Khalil, Melanie Danninger, Wei Wang, Hanan Khalil
RATIONALE, AIMS, AND OBJECTIVES: The Australian National Heart Foundation Guidelines have been developed to guide clinicians on how to best manage chronic heart failure (CHF) patients according to the current best available evidence. The primary aim of this study is to evaluate the proportion of patients prescribed evidence-based therapy (EBT) for CHF on discharge at this Australian metropolitan hospital and factors affecting its prescribing. The secondary aims are to examine the proportion of patients prescribed EBT on discharge on cardiac wards compared to medical wards and to explore the role of the pharmacist in the management of these patients...
May 17, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28509590/health-care-costs-associated-with-australian-tertiary-inflammatory-bowel-disease-care
#13
Belinda Jackson, Danny Con, Ronald Ma, Alexandra Gorelik, Danny Liew, Peter De Cruz
INTRODUCTION: We aimed to describe the total costs of illness for IBD patients and compare the costs of patients with active disease to those with inactive disease. MATERIALS AND METHODS: Resource use for IBD management was itemized for attributable costs (AUD) among all IBD patients over a 12-month period at an Australian hospital. RESULTS: One hundred and eighty-three patients were included (87 ulcerative colitis (UC); 93 Crohn's disease (CD); three IBD-unclassified)...
May 16, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28506856/bariatric-surgery-revisions-and-private-health-insurance
#14
Samantha B Meyer, Campbell Thompson, Paul Hakendorf, Chris Horwood, Darlene McNaughton, John Gray, Paul R Ward, Lillian Mwanri, Sue Booth, Lilian Kow, Jacob Chisholm
OBJECTIVE: To identify: 1. The percentage of bariatric procedures that are revisions; 2. What proportion of bariatric revision procedures in public hospitals are for patients whose primary weight loss procedure occurred in a private hospital; 3. The age, sex and level of socioeconomic disadvantage of patients needing revisions. METHODS: An analysis of patient level admission data from the Integrated South Australian Activity Collection (ISAAC) was performed. Data were collected on all revisions for weight loss related procedures at all South Australian public and private hospitals, between 2000-2015 using the ISAAC codes for revision procedures...
May 12, 2017: Obesity Research & Clinical Practice
https://www.readbyqxmd.com/read/28505289/financial-and-environmental-costs-of-reusable-and-single-use-anaesthetic-equipment
#15
F McGain, D Story, T Lim, S McAlister
Background.: An innovative approach to choosing hospital equipment is to consider the environmental costs in addition to other costs and benefits. Methods.: We used life cycle assessment to model the environmental and financial costs of different scenarios of replacing reusable anaesthetic equipment with single-use variants. The primary environmental costs were CO 2 emissions (in CO 2 equivalents) and water use (in litres). We compared energy source mixes between Australia, the UK/Europe, and the USA...
May 15, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28503879/impact-of-an-antimicrobial-stewardship-intervention-on-appropriateness-of-prescribing-for-community-acquired-pneumonia-in-an-australian-regional-hospital
#16
Stuart E Bond, Craig S Boutlis, Wilfred W Yeo, Spiros Miyakis
Community-acquired pneumonia (CAP) is the second commonest indication for antibiotic use in Australian hospitals and is therefore a frequent target for antimicrobial stewardship. A single-centre prospective study was conducted in a regional referral hospital comparing management of adult patients with CAP before and after an educational intervention. We demonstrated a reduction in duration of therapy and reduced inappropriate use of ceftriaxone-based regimens for non-severe CAP.
May 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28500624/temporal-trends-for-thyroid-stimulating-hormone-tsh-and-thyroid-peroxidase-antibody-atpo-testing-across-two-phases-of-iodine-fortification-in-tasmania-1995-2013
#17
A Hong, B Stokes, P Otahal, D Owens, J R Burgess
CONTEXT: Tasmania is an island State of the Australian Commonwealth with a well-documented history of mild iodine deficiency. Between 2001 and 2009 Tasmania experienced two incremental phases of iodine fortification. OBJECTIVE: To examine trends for thyroid stimulating hormone (TSH) and thyroid peroxidase antibody (ATPO) testing and their relationship to different phases of iodine nutrition in the Tasmanian population between 1995 and 2013. DESIGN: Retrospective longitudinal study...
May 13, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28499065/not-sick-enough-experiences-of-carers-of-people-with-mental-illness-negotiating-care-for-their-relatives-with-mental-health-services
#18
Michael Olasoji, Phil Maude, Kay McCauley
AIM: The literature reporting experiences of relatives of people with mental illness regarding their interactions with mental health services identifies many commonalities. However, the actual experience of carers engaging the services and understanding health care systems remains a gap in the literature. The aim of this study was to explore the experiences of carers (of people with a severe mental illness) in a major area mental health service in Victoria Australia as they fulfil their caring role whilst negotiating support for their relative...
May 12, 2017: Journal of Psychiatric and Mental Health Nursing
https://www.readbyqxmd.com/read/28494806/what-makes-weekend-allied-health-services-effective-and-cost-effective-or-not-in-acute-medical-and-surgical-wards-perceptions-of-medical-nursing-and-allied-health-workers
#19
Lisa O'Brien, Deb Mitchell, Elizabeth H Skinner, Romi Haas, Marcelle Ghaly, Fiona McDermott, Kerry May, Terry Haines
BACKGROUND: There is strong public support for acute hospital services to move to genuine 7-day models, including access to multidisciplinary team assessment. This study aimed to identify factors that might enable an effective and cost-effective weekend allied health services on acute hospital wards. METHODS: This qualitative study included 22 focus groups within acute wards with a weekend allied health service and 11 telephone interviews with weekend service providers...
May 12, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28493647/the-liminality-of-the-patient-with-dementia-in-geriatric-rehabilitation-hospitals
#20
Robin Digby, Susan Lee, Allison Williams
AIM: The aim was to explore the experiences of people with dementia in sub-acute geriatric rehabilitation hospitals to critically evaluate the care received by such patients. BACKGROUND: Globally the number of people with dementia is growing and is expected to impact progressively more on health systems. People with dementia can become deconditioned and deteriorate in cognitive function while in hospital. The unfamiliar environment and people can cause the person to become disorientated which then leads to behavioural symptoms which complicate care...
May 11, 2017: Journal of Clinical Nursing
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