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Rapid response team

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https://www.readbyqxmd.com/read/29341963/role-of-the-anesthesiologist-intensivist-outside-the-icu-opportunity-to-add-value-for-the-hospital-or-an-unnecessary-distraction
#1
Suzanne Bennett, Erin Grawe, Courtney Jones, Sean A Josephs, Maggie Mechlin, William E Hurford
PURPOSE OF REVIEW: Given the extremely expensive nature of critical care medicine, it seems logical that intensivists should play an active role in designing efficient systems of care. The true value of intensivists, however, is not well defined. RECENT FINDINGS: Anesthesiologists have taken key roles in improving patient safety in the operating room. Anesthesia-related mortality rates have decreased from 20 deaths per 100 000 anesthetics in the early 1980s to less than one death per 100 000 currently...
January 15, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29304039/establishing-ebola-virus-disease-evd-diagnostics-using-genexpert-technology-at-a-mobile-laboratory-in-liberia-impact-on-outbreak-response-case-management-and-laboratory-systems-strengthening
#2
Philomena Raftery, Orla Condell, Christine Wasunna, Jonathan Kpaka, Ruth Zwizwai, Mahmood Nuha, Mosoka Fallah, Maxwell Freeman, Victoria Harris, Mark Miller, April Baller, Moses Massaquoi, Victoria Katawera, John Saindon, Philip Bemah, Esther Hamblion, Evelyn Castle, Desmond Williams, Alex Gasasira, Tolbert Nyenswah
The 2014-16 Ebola Virus Disease (EVD) outbreak in West Africa highlighted the necessity for readily available, accurate and rapid diagnostics. The magnitude of the outbreak and the re-emergence of clusters of EVD cases following the declaration of interrupted transmission in Liberia, reinforced the need for sustained diagnostics to support surveillance and emergency preparedness. We describe implementation of the Xpert Ebola Assay, a rapid molecular diagnostic test run on the GeneXpert platform, at a mobile laboratory in Liberia and the subsequent impact on EVD outbreak response, case management and laboratory system strengthening...
January 2018: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/29303946/use-of-rapid-response-teams-in-psychiatry-variables-that-impact-safety
#3
Ryan Greytak, Joanna Y Wang, Yea-Jen Hsu, Jill Marsteller, Geetha Jayaram
OBJECTIVE: The addition of rapid response teams (RRTs) has emerged as a treatment option for medically deteriorating psychiatric inpatients. The goal of this study was to identify risk factors for use of RRTs at the time of initial psychiatric evaluation and develop measures to predict use of this emergent medical intervention. We have not located any studies that have previously addressed this issue. METHODS: We studied the use of RRTs and code teams (CTs) on inpatient general and specialty psychiatric services in a large urban academic psychiatric hospital...
November 2017: Journal of Psychiatric Practice
https://www.readbyqxmd.com/read/29302603/what-are-the-ethical-dimensions-in-the-profession-of-intensive-care-specialist
#4
REVIEW
Jean-Pierre Quenot, Fiona Ecarnot, Nicolas Meunier-Beillard, Auguste Dargent, Jean-Pierre Eraldi, François Bougerol, Audrey Large, Pascal Andreu, Jean-Philippe Rigaud
Two essential components of the profession of a medical doctor are the constant review of the patient's therapeutic project, and collaboration between healthcare professionals. The profession of intensive care unit (ICU) physician goes further in terms of responsibility, vis-à-vis the intensive treatments dispensed to the patients, and the physician's responsibilities towards the patient's family and the caregiving team, also bearing in mind that ICU care is costly in terms of human and financial resources...
December 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29298314/improving-mapping-for-ebola-response-through-mobilising-a-local-community-with-self-owned-smartphones-tonkolili-district-sierra-leone-january-2015
#5
Laura M Nic Lochlainn, Ivan Gayton, Georgios Theocharopoulos, Robin Edwards, Kostas Danis, Ronald Kremer, Karline Kleijer, Sumaila M Tejan, Mohamed Sankoh, Augustin Jimissa, Jane Greig, Grazia Caleo
BACKGROUND: During the 2014-16 Ebola virus disease (EVD) outbreak, the Magburaka Ebola Management Centre (EMC) operated by Médecins Sans Frontières (MSF) in Tonkolili District, Sierra Leone, identified that available district maps lacked up-to-date village information to facilitate timely implementation of EVD control strategies. In January 2015, we undertook a survey in chiefdoms within the MSF EMC catchment area to collect mapping and village data. We explore the feasibility and cost to mobilise a local community for this survey, describe validation against existing mapping sources and use of the data to prioritise areas for interventions, and lessons learned...
2018: PloS One
https://www.readbyqxmd.com/read/29297390/methodology-for-a-mixed-methods-multi-country-study-to-assess-recognition-of-and-response-to-maternal-and-newborn-illness
#6
Allisyn C Moran, Danielle Charlet, Supriya Madhavan, Kumudha Aruldas, Marie Donaldson, Fatuma Manzi, Monica Okuga, Alfonso Rosales, Vandana Sharma, Michael Celone, Neal Brandes, James M Sherry
BACKGROUND: Although maternal and newborn mortality have decreased 44 and 46% respectively between 1990 and 2015, achievement of ambitious Sustainable Development Goal targets requires accelerated progress. Mortality reduction requires a renewed focus on the continuum of maternal and newborn care from the household to the health facility. Although barriers to accessing skilled care are documented for specific contexts, there is a lack of systematic evidence on how women and families identify maternal and newborn illness and make decisions and subsequent care-seeking patterns...
December 21, 2017: Journal of Health, Population, and Nutrition
https://www.readbyqxmd.com/read/29283868/a-review-of-the-essential-components-of-quality-palliative-care-in-the-home
#7
Hsien Seow, Daryl Bainbridge
OBJECTIVE: The home is an important and often preferable setting of palliative care. While much research has demonstrated the benefits of specialized palliative homecare on patient and system outcomes, there has been little delineation of the underlying components of these efficacious programs. We synthesized the essential elements of palliative homecare from a combined review of successful programs, perspectives of patients and caregivers, and views of healthcare providers in palliative care...
January 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29280908/expanding-the-presence-of-primary-services-at-rapid-response-team-activations-a-quality-improvement-project
#8
Alice Gallo de Moraes, John C OʼHoro, Ronaldo A Sevilla-Berrios, Gina Iacovella, Andrea Lenhertz, Julie Schmidt, Jennifer Elmer, Richard Oeckler, Sean Caples, Jeffrey B Jensen
Rapid response teams (RRTs) were implemented to provide critical care services for deteriorating patients outside of intensive care units. To date, research on RRT has been conflicting, with some studies showing significant mortality benefit and reduction in cardiac arrest events and others showing no benefit. However, studies have consistently showed improved outcomes when RRTs work closely with primary services. Baseline data analysis at our institution found that primary services were present only on 50% of RRT activations...
January 2018: Quality Management in Health Care
https://www.readbyqxmd.com/read/29279338/rapid-response-teams-in-pediatric-patients-well-intentioned-but-do-they-really-help
#9
EDITORIAL
Joshua Koch, Sandeep R Das
No abstract text is available yet for this article.
January 2, 2018: Circulation
https://www.readbyqxmd.com/read/29278987/impact-of-pharmacist-intervention-on-selection-and-timing-of-appropriate-antimicrobial-therapy-in-septic-shock
#10
Melanie E Laine, Jeremy D Flynn, Alexander H Flannery
BACKGROUND: Current guidelines for septic shock management recommend administration of appropriate, broad-spectrum antimicrobials within 1 hour of recognition. OBJECTIVE: To evaluate the interventions pharmacists make as part of a sepsis response team and to determine if these interventions increase the proportion of patients with appropriate empiric antimicrobial therapy. METHODS: A retrospective cohort study was undertaken reviewing adult patients in a large, academic medical center with confirmed septic shock who had an order for a "sepsis bundle," which includes notification of a pharmacist to assess adequacy of empiric therapy...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29274170/the-impact-of-early-warning-score-and-rapid-response-systems-on-nurses-competence-an-integrative-literature-review-and-synthesis
#11
REVIEW
Jørghild Karlotte Jensen, Randi Skår, Bodil Tveit
AIMS AND OBJECTIVES: This paper is an integrative review that seeks to describe, interpret and synthesise the current research findings on the impact of the Early Warning Score and Rapid Response Systems on nurses' competence in identifying and managing deteriorating patients in general hospital wards. BACKGROUND: As patient safety initiatives designed to ensure the early identification and management of deteriorating patients, the Early Warning Score and Rapid Response Systems have broad appeal...
December 23, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29258978/the-effectiveness-of-text-messaging-for-detection-and-management-of-hypertension-in-indigenous-people-in-canada-protocol-for-a-randomized-controlled-trial
#12
Karen Yeates, Norm Campbell, Marion A Maar, Nancy Perkins, Peter Liu, Jessica Sleeth, Carter Smith, Colin McAllister, Diane Hua-Stewart, George Wells, Sheldon W Tobe
BACKGROUND: Hypertension, the leading cause of morbidity and mortality, affects more than 1 billion people and is responsible globally for 10 million deaths annually. Hypertension can be controlled on a national level; in Canada, for example, awareness, treatment, and control improved dramatically from only 16% in 1990 to 66% currently. The ongoing development, dissemination, and implementation of Hypertension Canada's clinical practice guidelines is considered to be responsible, in part, for achieving these high levels of control and the associated improvements in cardiovascular outcomes...
December 19, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/29238161/prevalence-and-causes-of-blindness-visual-impairment-and-cataract-surgery-in-timor-leste
#13
Marcelino Correia, Taraprasad Das, Julia Magno, Bernadette M Pereira, Valerio Andrade, Hans Limburg, John Trevelyan, Jill Keeffe, Nitin Verma, Yuddha Sapkota
Purpose: To estimate the prevalence and causes of blindness and visual impairment, cataract surgical coverage (CSC), visual outcome of cataract surgery, and barriers to uptake cataract surgery in Timor-Leste. Method: In a nationwide rapid assessment of avoidable blindness (RAAB), the latest population (1,066,409) and household data were used to create a sampling frame which consists of 2,227 population units (study clusters) from all 13 districts, with populations of 450-900 per unit...
2017: Clinical Ophthalmology
https://www.readbyqxmd.com/read/29225958/overcoming-challenges-in-implementing-the-who-surgical-safety-checklist-lessons-learnt-from-using-a-checklist-training-course-to-facilitate-rapid-scale-up-in-madagascar
#14
REVIEW
Kristin L Close, Linden S Baxter, Vaonandianina A Ravelojaona, Hasiniaina N Rakotoarison, Emily Bruno, Alison Herbert, Vanessa Andean, James Callahan, Hery H Andriamanjato, Michelle C White
The WHO Surgical Safety Checklist was launched in 2009, and appropriate use reduces mortality, surgical site infections and complications after surgery by up to 50%. Implementation across low-income and middle-income countries has been slow; published evidence is restricted to reports from a few single institutions, and significant challenges to successful implementation have been identified and presented. The Mercy Ships Medical Capacity Building team developed a multidisciplinary 3-day Surgical Safety Checklist training programme designed for rapid wide-scale implementation in all regional referral hospitals in Madagascar...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29225117/rapid-response-events-in-hospitalized-patients-patient-symptoms-and-clinician-communication
#15
Charles A Austin, Summer Choudhury, Taylor Lincoln, Lydia H Chang, Christopher E Cox, Mark A Weaver, Laura C Hanson, Judith E Nelson, Shannon S Carson
CONTEXT: Patients triggering Rapid Response Team (RRT) intervention are at high risk for adverse outcomes. Data on symptom burden of these patients does not currently exist and current symptom management and communication practices of RRT clinicians are unknown. OBJECTIVES: We sought to identify the symptom experience of Rapid Response Team (RRT) patients and observe how RRT clinicians communicate with patients and their families. METHODS: We conducted a prospective, observational study from August - December 2015...
December 7, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29224702/early-intervention-to-restore-function-and-maintain-healthy-trajectory
#16
REVIEW
Juan Jover, Lydia Abasolo
The health of the global population has undergone rapid transformation. Life expectancy and chronic conditions are increasing, and persons aged 65 years or older have become the fastest growing segment of population. The worldwide picture of disease burden is increasingly defined by disability instead of premature mortality. Population growth, ageing and sedentary lifestyles, particularly in developing countries, will result in a crisis for the population health that requires a multi-system response. The growing awareness of the diseases burden increases the need for accurate measurement and assessment of the burden and measurement of the impact of any public health action...
April 2017: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/29217831/the-public-health-impact-of-a-new-simple-practical-technique-for-collection-and-transfer-of-toxic-jellyfish-specimens-and-for-nematocyst-identification
#17
Lakkana Thaikruea, Sineenart Santidherakul
Our team aimed to create a new, simple, and inexpensive technique for collecting and transferring of toxic jellyfish specimens and for nematocysts identification. We collected tentacles of Chironex spp., Morbakka spp., and Physalia spp., and transferred them from the beaches by standard and by 'vacuum sticky tape' (VST) techniques. For the VST technique, our team placed the sticky tape on a tentacle and then folded it over to seal the tentacle in the equivalent of a vacuum. We kept the VST in room temperature...
December 7, 2017: Journal of Public Health Policy
https://www.readbyqxmd.com/read/29217376/safety-tolerability-and-immunogenicity-of-two-zika-virus-dna-vaccine-candidates-in-healthy-adults-randomised-open-label-phase-1-clinical-trials
#18
Martin R Gaudinski, Katherine V Houser, Kaitlyn M Morabito, Zonghui Hu, Galina Yamshchikov, Ro Shauna Rothwell, Nina Berkowitz, Floreliz Mendoza, Jamie G Saunders, Laura Novik, Cynthia S Hendel, LaSonji A Holman, Ingelise J Gordon, Josephine H Cox, Srilatha Edupuganti, Monica A McArthur, Nadine G Rouphael, Kirsten E Lyke, Ginny E Cummings, Sandra Sitar, Robert T Bailer, Bryant M Foreman, Katherine Burgomaster, Rebecca S Pelc, David N Gordon, Christina R DeMaso, Kimberly A Dowd, Carolyn Laurencot, Richard M Schwartz, John R Mascola, Barney S Graham, Theodore C Pierson, Julie E Ledgerwood, Grace L Chen
BACKGROUND: The Zika virus epidemic and associated congenital infections have prompted rapid vaccine development. We assessed two new DNA vaccines expressing premembrane and envelope Zika virus structural proteins. METHODS: We did two phase 1, randomised, open-label trials involving healthy adult volunteers. The VRC 319 trial, done in three centres, assessed plasmid VRC5288 (Zika virus and Japanese encephalitis virus chimera), and the VRC 320, done in one centre, assessed plasmid VRC5283 (wild-type Zika virus)...
December 4, 2017: Lancet
https://www.readbyqxmd.com/read/29214598/evaluation-of-a-wireless-portable-wearable-multi-parameter-vital-signs-monitor-in-hospitalized-neurological-and-neurosurgical-patients
#19
Robert S Weller, Kristina L Foard, Timothy N Harwood
Unrecognized changes in patients' vital signs can result in preventable deaths in hospitalized patients. Few publications or studies instituting routine patient monitoring have described implementation and the setting of alarm parameters for vital signs. We wanted to determine if continuous multi-parameter patient monitoring can be accomplished with an alarm rate that is acceptable to hospital floor nurses and to compare the rate of patient deterioration events to those observed with routine vital sign monitoring...
December 6, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29210766/tele-icu-and-patient-safety-considerations
#20
Erkan Hassan
The tele-ICU is designed to leverage, not replace, the need for bedside clinical expertise in the diagnosis, treatment, and assessment of various critical illnesses. Tele-ICUs are primarily decentralized or centralized models with differing advantages and disadvantages. The centralized model has sufficiently powered published data to be associated with improved mortality and ICU length of stay in a cost-effective manner. Factors associated with improved clinical outcomes include improved compliance with best practices; providing off-hours implementation of the bedside physician's care plan; and identification of and rapid response to physiological instability (initial clinical review within 1 hour) and rapid response to alerts, alarms, or direct notification by bedside clinicians...
January 2018: Critical Care Nursing Quarterly
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