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https://www.readbyqxmd.com/read/28538140/comparison-of-policies-for-recognising-and-responding-to-clinical-deterioration-across-five-victorian-health-services
#1
Julie Considine, Anastasia F Hutchison, Helen Rawson, Alison M Hutchinson, Tracey Bucknall, Trisha Dunning, Mari Botti, Maxine M Duke, Maryann Street
Objectives The aim of the present study was to describe and compare organisational guidance documents related to recognising and responding to clinical deterioration across five health services in Victoria, Australia.Methods Guidance documents were obtained from five health services, comprising 13 acute care hospitals, eight subacute care hospitals and approximately 5500 beds. Analysis was guided by a specific policy analysis framework and a priori themes.Results In all, 22 guidance documents and five graphic observation and response charts were reviewed...
May 25, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28528623/organizational-perspectives-of-nurse-executives-in-15-hospitals-on-the-impact-and-effectiveness-of-rapid-response-teams
#2
Patricia L Smith, Jean McSweeney
BACKGROUND: Many hospitals use rapid response teams (RRTs) to respond to deteriorating patients, but it remains unclear what organizations actually monitor. Understanding what organizations value in an RRT may help clarify measurement choices. Interviews were conducted to determine how organizational leaders perceived and evaluated their hospitals' RRTs. METHODS: The study used a descriptive, qualitative design. Participants were nurse executives and key informants in 300- to 500-bed hospitals in the south-central United States and were recruited using purposive and snowball sampling...
June 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28507888/spine-stereotactic-body-radiotherapy-indications-outcomes-and-points-of-caution
#3
Chia-Lin Tseng, Wietse Eppinga, Raphaele Charest-Morin, Hany Soliman, Sten Myrehaug, Pejman Jabehdar Maralani, Mikki Campbell, Young K Lee, Charles Fisher, Michael G Fehlings, Eric L Chang, Simon S Lo, Arjun Sahgal
STUDY DESIGN: A broad narrative review. OBJECTIVES: The objective of this article is to provide a technical review of spine stereotactic body radiotherapy (SBRT) planning and delivery, indications for treatment, outcomes, complications, and the challenges of response assessment. The surgical approach to spinal metastases is discussed with an overview of emerging minimally invasive techniques. METHODS: A comprehensive review of the literature was conducted on the techniques, outcomes, and developments in SBRT and surgery for spinal metastases...
April 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28505171/rapid-deployment-of-a-mobile-biosafety-level-3-laboratory-in-sierra-leone-during-the-2014-ebola-virus-epidemic
#4
Yi Zhang, Yan Gong, Chengyu Wang, Wensen Liu, Zhongyi Wang, Zhiping Xia, Zhaoyang Bu, Huijun Lu, Yang Sun, Xiaoguang Zhang, Yuxi Cao, Fan Yang, Haoxiang Su, Yi Hu, Yongqiang Deng, Bo Zhou, Zongzheng Zhao, Yingying Fu, David Kargbo, Foday Dafae, Brima Kargbo, Alex Kanu, Linna Liu, Jun Qian, Zhendong Guo
BACKGROUND: Ebola virus emerged in West Africa in December 2013. The high population mobility and poor public health infrastructure in this region led to the development of the largest Ebola virus disease (EVD) outbreak to date. METHODOLOGY/PRINCIPAL FINDINGS: On September 26, 2014, China dispatched a Mobile Biosafety Level-3 Laboratory (MBSL-3 Lab) and a well-trained diagnostic team to Sierra Leone to assist in EVD diagnosis using quantitative real-time PCR, which allowed the diagnosis of suspected EVD cases in less than 4 hours from the time of sample receiving...
May 15, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28483444/critical-care-clinician-perceptions-of-factors-leading-to-medical-emergency-team-review
#5
Judy Currey, Josh Allen, Daryl Jones
BACKGROUND: The introduction of rapid response systems has reduced the incidence of in-hospital cardiac arrest; however, many instances of clinical deterioration are unrecognised. Afferent limb failure is common and may be associated with unplanned intensive care admissions, heightened mortality and prolonged length of stay. Patients reviewed by a Medical Emergency Team are inherently vulnerable with a high in-hospital mortality. OBJECTIVE: To explore perceptions of intensive care unit (ICU) staff who attend deteriorating acute care ward patients regarding current problems, barriers and potential solutions to recognising and responding to clinical deterioration that culminates in a Medical Emergency Team review...
May 5, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28483067/simulation-testing-of-pediatric-rapid-response-teams-can-simulation-be-used-to-determine-the-best-team-structure
#6
EDITORIAL
David A Young
No abstract text is available yet for this article.
May 5, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28482890/crisis-checklists-for-in-hospital-emergencies-expert-consensus-simulation-testing-and-recommendations-for-a-template-determined-by-a-multi-institutional-and-multi-disciplinary-learning-collaborative
#7
Christian P Subbe, John Kellett, Paul Barach, Catriona Chaloner, Hayley Cleaver, Tim Cooksley, Erik Korsten, Eilish Croke, Elinor Davis, Ashley Jr De Bie, Lesley Durham, Chris Hancock, Jilian Hartin, Tracy Savijn, John Welch
BACKGROUND: 'Failure to rescue' of hospitalized patients with deteriorating physiology on general wards is caused by a complex array of organisational, technical and cultural failures including a lack of standardized team and individual expected responses and actions. The aim of this study using a learning collaborative method was to develop consensus recomendations on the utility and effectiveness of checklists as training and operational tools to assist in improving the skills of general ward staff on the effective rescue of patients with abnormal physiology...
May 8, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28469897/using-real-time-anonymous-staff-feedback-to-improve-staff-experience-and-engagement
#8
Anne Frampton, Fiona Fox, Andrew Hollowood, Kate Northstone, Ruta Margelyte, Stephanie Smith-Clarke, Sabi Redwood
Improving staff engagement has become a priority for NHS leaders, although efforts in this area vary between organisations. University Hospital Bristol NHS Foundation Trust (UH Bristol) is a tertiary teaching hospital where concerns about staff satisfaction and communication were reflected in the 2014 staff survey. To improve staff engagement, a real-time feedback mechanism to capture staff experience and to facilitate feedback from local leaders, was developed and piloted using the Model for Improvement. Initially piloted in two areas in January 2015, the Staff Participation Engagement and Communication application (SPEaC-app) was gradually rolled out to 23 areas within the trust by November 2016...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28465003/the-modified-rapid-emergency-medicine-score-a-novel-trauma-triage-tool-to-predict-in-hospital-mortality
#9
Ross T Miller, Niaman Nazir, Tracy McDonald, Chad M Cannon
BACKGROUND: Trauma systems currently rely on imperfect and subjective tools to prioritize responses and resources, thus there is a critical need to develop a more accurate trauma severity score. Our objective was to modify the Rapid Emergency Medicine (REMS) Score for the trauma population and test its accuracy as a predictor of in-hospital mortality when compared to other currently used scores, including the Revised Trauma Score (RTS), the Injury Severity Score (ISS), the "Mechanism, Glasgow Coma Scale, Age and Arterial Pressure" (MGAP) score, and the Shock Index (SI) score...
April 25, 2017: Injury
https://www.readbyqxmd.com/read/28460698/when-nursing-assertion-stops-a-qualitative-study-to-examine-the-cultural-barriers-involved-in-escalation-of-care-in-a-pediatric-hospital
#10
REVIEW
Jodi Thrasher, Heidi McNeely, Bonnie Adrian
Pediatric codes outside the ICU are associated with increased morbidity and mortality. This qualitative research highlights results from confidential interviews with 10 pediatric nurses with experience of caring for children who required rapid response, code response, or transfer to intensive care. Detailed examination of nurses' experiences revealed local factors that facilitate and inhibit timely transfer of critical patients. Nurses identified themes including the impact of nurse assertiveness, providers' lack of understanding of nursing, team communication, and other hospital cultural barriers...
June 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28456829/the-evolution-of-a-pediatric-ventricular-assist-device-program-the-boston-children-s-hospital-experience
#11
Beth Hawkins, Francis Fynn-Thompson, Kevin P Daly, Michelle Corf, Elizabeth Blume, Jean Connor, Courtney Porter, Christopher Almond, Christina VanderPluym
Mechanical circulatory support in the form of ventricular assist devices (VADs) in children has undergone rapid growth in the last decade. With expansion of device options available for larger children and adolescents, the field of outpatient VAD support has flourished, with many programs unprepared for the clinical, programmatic, and administrative responsibilities. From preimplantation VAD evaluation and patient education to postimplant VAD management, the VAD program, staffed with an interdisciplinary team, is essential to providing safe, effective, and sustainable care for a new technology in an exceedingly complex patient population...
April 29, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28447391/transcriptional-response-of-escherichia-coli-to-ammonia-and-glucose-fluctuations
#12
Joana Danica Simen, Michael Löffler, Günter Jäger, Karin Schäferhoff, Andreas Freund, Jakob Matthes, Jan Müller, Ralf Takors
In large-scale production processes, metabolic control is typically achieved by limited supply of essential nutrients such as glucose or ammonia. With increasing bioreactor dimensions, microbial producers such as Escherichia coli are exposed to changing substrate availabilities due to limited mixing. In turn, cells sense and respond to these dynamic conditions leading to frequent activation of their regulatory programmes. Previously, we characterized short- and long-term strategies of cells to adapt to glucose fluctuations...
April 26, 2017: Microbial Biotechnology
https://www.readbyqxmd.com/read/28445242/increased-mortality-and-length-of-stay-associated-with-medical-emergency-team-review-in-hospitalized-pediatric-patients-a-retrospective-cohort-study
#13
Brianna McKelvie, James Dayre McNally, Jason Chan, Franco Momoli, Christa Ramsay, Anna-Theresa Lobos
OBJECTIVE: Rapid response systems using medical emergency teams reduce hospital wide cardiorespiratory arrest and mortality. While rapid response systems improve hospital-wide outcomes, children receiving medical emergency team review may still be at increased risk for morbidity and mortality. The study purpose was to compare the length of stay and mortality rate in children receiving a medical emergency team review with those of other hospitalized children. DESIGN: Retrospective cohort study...
April 25, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28434554/the-simulation-based-assessment-of-pediatric-rapid-response-teams
#14
James J Fehr, Mary E McBride, John R Boulet, David J Murray
OBJECTIVE: To create scenarios of simulated decompensating pediatric patients to train pediatric rapid response teams (RRTs) and to determine whether the scenario scores provide a valid assessment of RRT performance with the hypothesis that RRTs led by intensivists-in-training would be better prepared to manage the scenarios than teams led by nurse practitioners. STUDY DESIGN: A set of 10 simulated scenarios was designed for the training and assessment of pediatric RRTs...
April 20, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28420542/improving-prehospital-trauma-care-in-rwanda-through-continuous-quality-improvement-an-interrupted-time-series-analysis
#15
John W Scott, Jeanne D'Arc Nyinawankusi, Samuel Enumah, Rebecca Maine, Eric Uwitonze, Yihan Hu, Ignace Kabagema, Jean Claude Byiringiro, Robert Riviello, Sudha Jayaraman
INTRODUCTION: Injury is a major cause of premature death and disability in East Africa, and high-quality pre-hospital care is essential for optimal trauma outcomes. The Rwandan pre-hospital emergency care service (SAMU) uses an electronic database to evaluate and optimize pre-hospital care through a continuous quality improvement programme (CQIP), beginning March 2014. MATERIALS AND METHODS: The SAMU database was used to assess pre-hospital quality metrics including supplementary oxygen for hypoxia (O2), intravenous fluids for hypotension (IVF), cervical collar placement for head injuries (c-collar), and either splinting (splint) or administration of pain medications (pain) for long bone fractures...
April 5, 2017: Injury
https://www.readbyqxmd.com/read/28415972/community-based-survey-during-rabies-outbreaks-in-rangjung-town-trashigang-eastern-bhutan-2016
#16
Tenzin Tenzin, Jamyang Namgyal, Sangay Letho
BACKGROUND: Rabies is a highly fatal disease transmitted through the bite of a rabid animal. Human deaths can be prevented by prompt administering of rabies vaccine and rabies immunoglobulin following the exposure. An assessment of community knowledge, awareness and practices on rabies is important during outbreak to understand their preparedness and target educational messages and response activities by the rapid response team. METHODS: A rabies outbreak has occurred in Rangjung town, eastern Bhutan on 4 October 2016...
April 17, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28412015/managing-sepsis-electronic-recognition-rapid-response-teams-and-standardized-care-save-lives
#17
Faheem W Guirgis, Lisa Jones, Rhemar Esma, Alice Weiss, Kaitlin McCurdy, Jason Ferreira, Christina Cannon, Laura McLauchlin, Carmen Smotherman, Dale F Kraemer, Cynthia Gerdik, Kendall Webb, Jin Ra, Frederick A Moore, Kelly Gray-Eurom
PURPOSE: Sepsis can lead to poor outcomes when treatment is delayed or inadequate. The purpose of this study was to evaluate outcomes after initiation of a hospital-wide sepsis alert program. MATERIALS AND METHODS: Retrospective review of patients ≥18years treated for sepsis. RESULTS: There were 3917 sepsis admissions: 1929 admissions before, and 1988 in the after phase. Mean age (57.3 vs. 57.1, p=0.94) and Charlson Comorbidity Scores (2...
April 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28409600/postpartum-hemorrhage-prevention-and-treatment
#18
Ann Evensen, Janice M Anderson, Patricia Fontaine
Postpartum hemorrhage is common and can occur in patients without risk factors for hemorrhage. Active management of the third stage of labor should be used routinely to reduce its incidence. Use of oxytocin after delivery of the anterior shoulder is the most important and effective component of this practice. Oxytocin is more effective than misoprostol for prevention and treatment of uterine atony and has fewer adverse effects. Routine episiotomy should be avoided to decrease blood loss and the risk of anal laceration...
April 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28409055/enhanced-surveillance-for-the-third-united-nations-conference-on-small-island-developing-states-apia-samoa-september-2014
#19
Paul White, Salanieta Saketa, Alexis Durand, Saine Vaai-Nielsen, Tile Ah Leong-Lui, Take Naseri, Ailuai Matalima, Filipina Amosa, Alize Mercier, Christelle Lepers, Vjesh Lal, Richard Wojcik, Sheri Lewis, Adam Roth, Yvan Souares, Onofre Edwin Merilles, Damian Hoy
The Ministry of Health in Samoa, in partnership with the Pacific Community, successfully implemented enhanced surveillance for the high-profile Third United Nations Conference on Small Island Developing States held concurrently with the popular local Teuila festival during a widespread chikungunya outbreak in September 2014. Samoa's weekly syndromic surveillance system was expanded to 12 syndromes and 10 sentinel sites from four syndromes and seven sentinel sites; sites included the national hospital, four private health clinics and three national health service clinics...
January 2017: Western Pacific Surveillance and Response Journal: WPSAR
https://www.readbyqxmd.com/read/28401688/goals-of-patient-care-system-change-with-video-based-education-increases-rates-of-advance-cardiopulmonary-resuscitation-decision-making-and-discussions-in-hospitalised-rehabilitation-patients
#20
Claire Johnson, Jeffrey Chong, Anne Wilkinson, Barbara Hayes, Sonia Tait, Nicholas Waldron
BACKGROUND: Advance CPR discussions and decision-making are not routine clinical practice in the hospital setting. Frail older patients may be at risk of non-beneficial CPR. AIM: To assess the utility and safety of two interventions to increase CPR decision-making, documentation and communication for hospitalised older patients. METHODS: A pre-post study tested two interventions: i) standard ward-based education forums with CPR content; and ii) a combined, two-pronged strategy with 'Goals of Patient Care' (GoPC) system change and structured video-based workshop; against usual practice (ie no formal training)...
April 12, 2017: Internal Medicine Journal
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