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https://www.readbyqxmd.com/read/28334556/impact-of-a-hospitalwide-quality-improvement-initiative-on-emergency-department-throughput-and-crowding-measures
#1
James D Melton, Fred Blind, A Brad Hall, Maureen Leckie, April Novotny
BACKGROUND: This pre- and postintervention analysis evaluates the impact of a systemwide, comprehensive, executively supported quality improvement (QI) project on emergency department (ED) throughput measures and crowding in a large nonacademic community hospital. METHODS: The two primary endpoints used to assess the impact of the project were (1) the percentage of all patients who were door-in to door-out in less than three hours and (2) the percentage of patients who left without being seen (LWBS)...
December 2016: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334503/the-fetal-safety-of-clomiphene-citrate-a-population-based-retrospective-cohort-study
#2
Asher Weller, Sharon Daniel, Gideon Koren, Eitan Lunenfeld, Amalia Levy
OBJECTIVE: To evaluate whether exposure to CC for ovulation induction is associated with either overall major malformations or specific fetal anomalies. DESIGN: We conducted a population-based retrospective cohort. Exposure was defined as CC dispension from two months before conception through the first month of pregnancy. SETTINGS: Four databases were combined: medication, birth, hospitalization and pregnancy terminations. POPULATION: The study included all women in southern Israel who gave birth or underwent pregnancy termination at Soroka Medical Center from 1998 to 2009...
March 23, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28334471/the-clinical-applicability-of-a-daily-summary-of-patients-self-reported-postoperative-pain-a-repeated-measure-analysis
#3
Lotta Wikström, Kerstin Eriksson, Bengt Fridlund, Mats Nilsson, Kristofer Årestedt, Anders Broström
AIM AND OBJECTIVES: (I) to determine if a central tendency, median, based on patients' self-rated pain is a clinically applicable daily measure to show patients' postoperative pain on the first day after major surgery (II) and to determine the number of self-ratings required for the calculation of this measure. BACKGROUND: Perioperative pain traits in medical records are difficult to overview. The clinical applicability of a daily documented summarising measure of patients' self-rated pain scores is little explored...
March 23, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28333925/video-based-educational-intervention-associated-with-improved-stroke-literacy-self-efficacy-and-patient-satisfaction
#4
Mary Carter Denny, Farhaan Vahidy, Kim Y T Vu, Anjail Z Sharrief, Sean I Savitz
BACKGROUND AND PURPOSE: Interventions are needed to improve stroke literacy among recent stroke survivors. We developed an educational video for patients hospitalized with acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH). METHODS: A 5-minute stroke education video was shown to our AIS and ICH patients admitted from March to June 2015. Demographics and a 5-minute protocol Montreal Cognitive Assessment were also collected. Questions related to stroke knowledge, self-efficacy, and patient satisfaction were answered before, immediately after, and 30 days after the video...
2017: PloS One
https://www.readbyqxmd.com/read/28333409/missed-opportunities-for-antimicrobial-stewardship-in-pre-school-children-admitted-to-hospital-with-lower-respiratory-tract-infection
#5
Tony Walls, Erika Stark, Philip Pattemore, Lance Jennings
AIM: To describe the usage of multiplex polymerase chain reaction on nasopharyngeal swab (NPS) samples in pre-school children presenting with lower respiratory tract infection (LRTI) at Christchurch Hospital, and its impact on the use of antibiotics empirically and at discharge. METHODS: This retrospective cohort study included 237 children, ages 3 months to 5 years, admitted to hospital during the winter months of 2012-2015 with a diagnosis of community-acquired LRTI...
March 23, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28333321/preconception-and-early-pregnancy-maternal-haemodynamic-changes-in-healthy-women-in-relation-to-pregnancy-viability
#6
F L Foo, A Collins, C M McEniery, P R Bennett, I B Wilkinson, C C Lees
STUDY QUESTION: Are there differences in preconception cardiovascular function between women who have a viable pregnancy and those who have a first trimester miscarriage? SUMMARY ANSWER: Preconception cardiovascular function of central haemodynamics and arterial function are similar between women who have a viable pregnancy and those who have a first trimester miscarriage. WHAT IS KNOWN ALREADY: Miscarriages have been associated with increased long-term cardiovascular disease risk, and arterial and cardiovascular dysfunction has been hypothesised as the common link...
March 16, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28333297/effect-of-adding-a-mobile-health-intervention-to-a-multimodal-antimicrobial-stewardship-programme-across-three-teaching-hospitals-an-interrupted-time-series-study
#7
E Charani, M Gharbi, L S P Moore, E Castro-Sanchéz, W Lawson, M Gilchrist, A H Holmes
Objectives: To evaluate the impact of adding a mobile health (mHealth) decision support system for antibiotic prescribing to an established antimicrobial stewardship programme (ASP). Methods: In August 2011, the antimicrobial prescribing policy was converted into a mobile application (app). A segmented regression analysis of interrupted time series was used to assess the impact of the app on prescribing indicators, using data (2008-14) from a biannual point prevalence survey of medical and surgical wards...
February 28, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28332874/long-term-outcome-of-the-different-treatment-alternatives-for-recurrent-and-persistent-cushing-s-disease
#8
Ana Laura Espinosa-de-Los-Monteros, Ernesto Sosa-Eroza, Etual Espinosa, Victoria Mendoza, Rocio Arreola, Moises Mercado
BACKGROUND: Treatment alternatives for persistent and recurrent Cushing's disease (CD) include pituitary surgical reintervention, radiotherapy, pharmacotherapy and bilateral adrenalectomy (BA). The decision of which of these alternatives is better suited for the individual patient rests on clinical judgment and the availability of resources. OBJECTIVE: To evaluate the long-term efficacy of the different secondary interventions for persistent and recurrent Cushing's disease...
March 23, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28332195/skin-cancer-history-sun-related-attitudes-behaviour-and-sunburn-among-renal-transplant-recipients-versus-general-population
#9
Vivian Ka Ying Leung, Suzanne Jane Dobbinson, David Josef Goodman, John Kanellis, Alvin Heong Chong
BACKGROUND/OBJECTIVES: Renal transplant recipients (RTR) have both an excessive skin cancer incidence and a high mortality rate. In Australia RTR receive extensive public education on skin cancer and many undergo further education pre/post-transplant. This study examines whether RTR have sufficiently rigorous sun protection behaviour compared with the general population. METHODS: Altogether 179 RTR from two large Melbourne hospitals involving skin clinic teams in patient care were recruited to undergo cross-sectional telephone interviews...
March 23, 2017: Australasian Journal of Dermatology
https://www.readbyqxmd.com/read/28331990/a-patient-s-perception-of-their-hospital-stay-influences-the-functional-outcome-and-satisfaction-of-total-knee-arthroplasty
#10
N D Clement, D Macdonald, R Burnett, A H R W Simpson, C R Howie
INTRODUCTION: To assess whether patient satisfaction with their hospital stay influences the early outcome of total knee arthroplasty (TKA). METHODS: During a 5-year period patients undergoing primary TKA at the study centre had prospective outcome data recorded (n = 2264). The Oxford knee score (OKS) and the short form (SF)-12 were recorded pre-operatively and 1 year post-operatively when satisfaction with their TKA was also assessed. Patient satisfaction with their hospital stay was also evaluated and their reasons for it were qualitatively documented...
March 22, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28331615/nuclear-irf-1-expression-as-a-mechanism-to-assess-capability-to-express-pd-l1-and-response-to-pd-1-therapy-in-metastatic-melanoma
#11
James W Smithy, Lauren M Moore, Vasiliki Pelekanou, Jamaal Rehman, Patricia Gaule, Pok Fai Wong, Veronique M Neumeister, Mario Sznol, Harriet M Kluger, David L Rimm
BACKGROUND: Predictive biomarkers for antibodies against programmed death 1 (PD-1) remain a major unmet need in metastatic melanoma. Specifically, response is seen in tumors that do not express programmed death ligand 1 (PD-L1), highlighting the need for a more sensitive biomarker. We hypothesize that capacity to express PD-L1, as assessed by an assay for a PD-L1 transcription factor, interferon regulatory factor 1 (IRF-1), may better distinguish patients likely to benefit from anti-PD-1 immunotherapy...
2017: Journal for Immunotherapy of Cancer
https://www.readbyqxmd.com/read/28330932/respond-a-programme-to-prevent-secondary-falls-in-older-people-presenting-to-the-emergency-department-with-a-fall-protocol-for-an-economic-evaluation
#12
R T Morello, R L Morris, K D Hill, T P Haines, G Arendts, J Redfern, C D Etherton-Beer, J A Lowthian, C A Brand, D Liew, J J Watts, A L Barker
BACKGROUND: Falls remain common for community-dwelling older people and impose a substantial economic burden to the healthcare system. RESPOND is a novel falls prevention programme that aims to reduce secondary falls and fall injuries among older people who present to a hospital emergency department (ED) with a fall. The present protocol describes a prospective economic evaluation examining the incremental cost-effectiveness of the RESPOND programme, compared with usual care practice, from the Australian health system perspective...
April 2017: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
https://www.readbyqxmd.com/read/28330522/passive-range-of-motion-exercise-to-enhance-growth-in-infants-following-the-norwood-procedure-a-safety-and-feasibility-trial
#13
Linda M Lambert, Felicia L Trachtenberg, Victoria L Pemberton, Janine Wood, Shelley Andreas, Robin Schlosser, Teresa Barnard, Kaitlyn Daniels, Ann T Harrington, Nicholas Dagincourt, Thomas A Miller
OBJECTIVE: The aim of this study was to evaluate the safety and feasibility of a passive range of motion exercise programme for infants with CHD. Study design This non-randomised pilot study enrolled 20 neonates following Stage I palliation for single-ventricle physiology. Trained physical therapists administered standardised 15-20-minute passive range of motion protocol, for up to 21 days or until hospital discharge. Safety assessments included vital signs measured before, during, and after the exercise as well as adverse events recorded through the pre-Stage II follow-up...
March 23, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28329246/lymphovascular-invasion-and-extracapsular-invasion-are-risk-factors-for-distant-recurrence-after-preoperative-chemoradiotherapy-and-oesophagectomy-in-patients-with-oesophageal-squamous-cell-carcinoma
#14
Po-Kuei Hsu, Ling-I Chien, Lei-Chi Wang, Teh-Ying Chou
OBJECTIVES: Patients with oesophageal squamous cell carcinoma have a high risk of disease recurrence even after trimodality treatments, which include preoperative chemoradiotherapy and oesophagectomy. We aimed to identify the histological factors that are associated with loco-regional and distant recurrence. METHODS: A retrospective review of a prospectively established database identified patients who received preoperative chemoradiotherapy and oesophagectomy for squamous cell carcinoma...
February 27, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28329149/prediction-of-long-term-cognitive-decline-following-postoperative-delirium-in-older-adults
#15
Elizabeth E Devore, Tamara G Fong, Edward R Marcantonio, Eva M Schmitt, Thomas G Travison, Richard N Jones, Sharon K Inouye
Background: Increasing evidence suggests that postoperative delirium may result in long-term cognitive decline among older adults. Risk factors for such cognitive decline are unknown. Methods: We studied 126 older participants without delirium or dementia upon entering the Successful AGing After Elective Surgery (SAGES) study, who developed postoperative delirium and completed repeated cognitive assessments (up to 36 months of follow-up). Pre-surgical factors were assessed preoperatively and divided into nine groupings of related factors ("domains")...
March 15, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28329083/impact-of-a-public-awareness-campaign-on-out-of-hospital-cardiac-arrest-incidence-and-mortality-rates
#16
Ziad Nehme, Emily Andrew, Stephen Bernard, Harry Patsamanis, Peter Cameron, Janet E Bray, Ian T Meredith, Karen Smith
Aims: Increased public awareness of the warning signs of a heart attack and the importance of early medical intervention may help to prevent premature deaths from out-of-hospital cardiac arrest (OHCA). We sought to investigate the impact of the Heart Foundation's public awareness campaigns on the monthly incidence of, and deaths from, OHCA in Melbourne, Australia. Methods and results: Between July 2005 and June 2015, we included registry data for 25 060 OHCA of presumed cardiac aetiology...
November 2, 2016: European Heart Journal
https://www.readbyqxmd.com/read/28329036/predictive-value-of-plaque-morphology-assessed-by-frequency-domain-optical-coherence-tomography-for-impaired-microvascular-perfusion-after-elective-stent-implantation-the-intracoronary-electrocardiogram-study
#17
Hiroki Ikenaga, Satoshi Kurisu, Tsukasa Nakao, Shingo Kono, Yoji Sumimoto, Noriaki Watanabe, Takashi Shimonaga, Tadanao Higaki, Toshitaka Iwasaki, Naoya Mitsuba, Ken Ishibashi, Yoshihiro Dohi, Yukihiro Fukuda, Yasuki Kihara
Aims: This study was undertaken to assess the association between plaque features at culprit lesions assessed by frequency-domain optical coherence tomography (FD-OCT) and impaired microvascular perfusion estimated by intracoronary electrocardiogram (IcECG) after elective percutaneous coronary intervention (PCI). Furthermore, we investigated whether IcECG could predict future cardiac events. Methods and results: This study consisted of 84 patients who underwent both FD-OCT and IcECG during PCI...
March 7, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28328692/experience-with-a-care-process-model-in-the-evaluation-of-pediatric-musculoskeletal-infections-in-a-pediatric-emergency-department
#18
Lina Patel, Jeff Michael, Nancy Allen, Lisa Schroeder, Lisa Berglund, Jason G Newland
OBJECTIVES: Care process models (CPMs) for certain conditions have improved clinical outcomes in children. This study describes the implementation and impact of a CPM for the evaluation of musculoskeletal infections in a pediatric emergency department (ED). METHODS: A retrospective pre-post intervention study was performed to analyze the impact of a musculoskeletal infection CPM. Patients were identified retrospectively through electronic order history for imaging of an extremity or joint and recommended laboratory tests...
March 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28328648/the-economic-and-clinical-impact-of-sustained-use-of-a-progressive-mobility-program-in-a-neuro-icu
#19
Jeannette M Hester, Peggy R Guin, Gale D Danek, Jaime R Thomas, William L Titsworth, Richard K Reed, Terrie Vasilopoulos, Brenda G Fahy
OBJECTIVE: To investigate a progressive mobility program in a neurocritical care population with the hypothesis that the benefits and outcomes of the program (e.g., decreased length of stay) would have a significant positive economic impact. DESIGN: Retrospective analysis of economic and clinical outcome data before, immediately following, and 2 years after implementation of the Progressive Upright Mobility Protocol Plus program (UF Health Shands Hospital, Gainesville, FL) involving a series of planned movements in a sequential manner with an additional six levels of rehabilitation in the neuro-ICU at UF Health Shands Hospital...
March 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28327947/factors-associated-with-pre-and-postoperative-seizures-in-1033-patients-undergoing-supratentorial-meningioma-resection
#20
William C Chen, Stephen T Magill, Dario J Englot, Joe D Baal, Sagar Wagle, Jonathan W Rick, Michael W McDermott
BACKGROUND: Risk factors for pre- and postoperative seizures in supratentorial meningiomas are understudied compared to other brain tumors. OBJECTIVE: To report seizure frequency and identify factors associated with pre- and postoperative seizures in a large single-center population study of patients undergoing resection of supratentorial meningioma. METHODS: Retrospective chart review of 1033 subjects undergoing resection of supratentorial meningioma at the author's institution (1991-2014)...
March 15, 2017: Neurosurgery
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