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https://www.readbyqxmd.com/read/28817750/the-surgeon-on-service-model-for-timely-economically-viable-inpatient-care-of-tracheostomy-patients-in-academic-pediatric-otolaryngology
#1
Jennifer M Lavin, James W Schroeder, Dana M Thompson
Importance: The traditional practice model for pediatric otolaryngologists at high-volume academic centers is to simultaneously balance outpatient care responsibilities with those of the inpatient service, emergency department, and ambulatory care clinics. This model leads to challenges with care coordination, timeliness of nonemergency operative care, and consistent participation in care and consultation at the attending surgeon level. The "surgeon on service" (SOS) model-where faculty members rotate to manage the inpatient service in lieu of outpatient responsibilities-has been described as one method to address this conundrum...
August 17, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28816198/lingual-frenectomy-in-joubert-syndrome
#2
Vivek Gurjar, Minal Gurjar, Channaveer Pattanshetti, Banashree Sankeshwari
AIM: Our aim is to present a case of a rare disorder, such as Joubert syndrome (JS) which required oral surgical intervention under general anesthesia at a very young age to help in achieving normal developmental milestones. BACKGROUND: Ciliopathies are an emerging class of diseases of which JS is a significant member. There have been very few cases of JS with its distinguishing features which have been reported in recent literature. CASE REPORT: We herewith present a case of JS who reported to our unit with a complaint of speech abnormality...
August 1, 2017: Journal of Contemporary Dental Practice
https://www.readbyqxmd.com/read/28811014/assessing-need-for-pharmacist-involvement-to-improve-care-coordination-for-patients-on-lai-antipsychotics-transitioning-from-hospital-to-home-a-work-system-approach
#3
Olufunmilola Abraham, Michelle N Myers, Amanda L Brothers, Jamie Montgomery, Bryan A Norman, Tanya Fabian
BACKGROUND: The use of Long-Acting Injectable (LAI) antipsychotic medications has increased for patients with Serious Mental Illness (SMI). Care coordination for this population is complex, and pharmacist involvement may improve and support long-term medication adherence and patient outcomes. OBJECTIVES: (1) Examine pharmacists' role in addressing care coordination and adherence challenges for patients taking Long-Acting Injectable (LAI) antipsychotics; and (2) explore patients' medication use experiences with LAI antipsychotics and educational needs...
September 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28807480/opportunities-and-challenges-in-screening-for-childhood-sexual-abuse
#4
Deepa L Sekhar, Jennifer L Kraschnewski, Heather L Stuckey, Pamela D Witt, Erica B Francis, Ginger A Moore, Paul L Morgan, Jennie G Noll
Retrospective studies suggest 1 in 4 girls and 1 in 6 boys will experience sexual abuse before 18 years of age, resulting in future morbidity. Successful interventions exist, however, victims are reluctant to disclose. Screening for childhood sexual abuse (CSA) may provide an opportunity to overcome this barrier, yet no current model for universal CSA screening exists. We sought to understand the perspective of key stakeholders on CSA screening through qualitative research. Eight focus groups of 7-10 participants each (n=62) were conducted from April-September 2016...
August 11, 2017: Child Abuse & Neglect
https://www.readbyqxmd.com/read/28806942/impact-of-inpatient-care-in-emergency-department-on-outcomes-a-quasi-experimental-cohort-study
#5
Aisha Lateef, Soo Hoon Lee, Dale Andrew Fisher, Wei-Ping Goh, Hui Fen Han, Uma Chandra Segara, Tiong Beng Sim, Malcolm Mahadehvan, Khean Teik Goh, Noel Cheah, Aymeric Yt Lim, Phillip H Phan, Reshma A Merchant
BACKGROUND: Hospitals around the world are faced with the issue of boarders in emergency department (ED), patients marked for admission but with no available inpatient bed. Boarder status is known to be associated with delayed inpatient care and suboptimal outcomes. A new care delivery system was developed in our institution where boarders received full inpatient care from a designated medical team, acute medical team (AMT), while still residing at ED. The current study examines the impact of this AMT intervention on patient outcomes...
August 14, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28806373/patient-aligned-care-team-engagement-to-connect-veterans-experiencing-homelessness-with-appropriate-health-care
#6
Adi V Gundlapalli, Andrew Redd, Daniel Bolton, Megan E Vanneman, Marjorie E Carter, Erin Johnson, Matthew H Samore, Jamison D Fargo, Thomas P O'Toole
BACKGROUND: Veterans experiencing homelessness frequently use emergency and urgent care (ED). OBJECTIVE: To examine the effect of a Patient-aligned Care Team (PACT) model tailored to the unique needs of Veterans experiencing homelessness (H-PACT) on frequency and type of ED visits in Veterans Health Administration (VHA) medical facilities. RESEARCH DESIGN: During a 12-month period, ED visits for 3981 homeless Veterans enrolled in (1) H-PACT at 20 VHA medical centers (enrolled) were compared with those of (2) 24,363 homeless Veterans not enrolled in H-PACT at the same sites (nonenrolled), and (3) 23,542 homeless Veterans at 12 non-H-PACT sites (usual care) using a difference-in-differences approach...
September 2017: Medical Care
https://www.readbyqxmd.com/read/28802869/use-of-a-standardized-procedure-to-improve-behavioral-health-patients-care-a-quality-improvement-initiative
#7
Elizabeth J Winokur, Jeannine Loucks, Glenn H Raup
PROBLEM: Meeting the complex needs of behavioral health (BH) patients in the emergency department is an ongoing challenge. Delays in care can have adverse consequences for patient and staff safety and delay transfer to specialized care. METHODS: A quality improvement, nurse-driven initiative using a standardized procedure (STP) was developed and implemented in our busy Southern California Emergency Department, which focused on improving time to first medication and reduction of restraints...
August 9, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28802446/toward-a-process-level-view-of-distributed-healthcare-tasks-medication-management-as-a-case-study
#8
Nicole E Werner, Seema Malkana, Ayse P Gurses, Bruce Leff, Alicia I Arbaje
We aim to highlight the importance of using a process-level view in analyzing distributed healthcare tasks through a case study analysis of medication management (MM). MM during older adults' hospital-to-skilled-home-healthcare (SHHC) transitions is a healthcare process with tasks distributed across people, organizations, and time. MM has typically been studied at the task level, but a process-level is needed to fully understand and improve MM during transitions. A process-level view allows for a broader investigation of how tasks are distributed throughout the work system through an investigation of interactions and the resultant emergent properties...
November 2017: Applied Ergonomics
https://www.readbyqxmd.com/read/28801944/the-emergence-of-second-generation-lethal-injection-protocols-a-brief-history-and-review
#9
Daniel R Malcom, Frank Romanelli
The history of capital punishment in the United States is long and controversial. In many cases, lethal injection has brought medical personnel, ethically and professionally charged with preserving life, into the arena of assisting the state in taking life. Recent US Supreme Court decisions, including Baze v. Rees and Glossip v. Gross, have evaluated and condoned lethal injection protocols. Despite the judicial validation of some midazolam-containing protocols, controversy exists as to the level of unconsciousness provided due to the ceiling effects of the drug...
August 12, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28801082/-how-to-videos-improve-residents-performance-of-essential-perioperative-electronic-medical-records-and-clinical-tasks
#10
Veronica Zoghbi, Robert C Caskey, Kristoffel R Dumon, Jacqueline M Soegaard Ballester, Ari D Brooks, Jon B Morris, Daniel T Dempsey
OBJECTIVE: The ability to use electronic medical records (EMR) is an essential skill for surgical residents. However, frustration and anxiety surrounding EMR tasks may detract from clinical performance. We created a series of brief, 1-3 minutes "how to" videos demonstrating 7 key perioperative EMR tasks: booking OR cases, placing preprocedure orders, ordering negative-pressure wound dressing supplies, updating day-of-surgery history and physical notes, writing brief operative notes, discharging patients from the postanesthesia care unit, and checking vital signs...
August 8, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28799272/results-of-a-national-multicenter-audit-assessment-of-gynecologic-history-in-surgical-patients
#11
Michael S J Wilson, Matilda Powell-Bowns, Andrew G Robertson, Andreas Luhmann, Colin H Richards
OBJECTIVE: To determine the adequacy of assessing gynecologic history for females of reproductive age (FRA) admitted to a general surgery department. METHODS: The present prospective multicenter audit included FRA who were admitted for elective or emergency procedures to general surgery departments in Scotland between May 11 and May 25, 2015. Data were compared between patients who were admitted for elective and emergency treatment. RESULTS: There were 530 FRA included from 18 centers, including 169 (31...
August 11, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28799002/intolerance-and-violence-against-doctors
#12
REVIEW
Meharban Singh
Intolerance and grouse against doctors is a global phenomenon but India seems to lead the world in violence against doctors. According to World Health Organization, about 8-38% healthcare workers suffer physical violence at some point in their careers. Many more are verbally abused or threatened. Public is almost behaving like health sector terrorists. The spate of increasing attacks on doctors by damaging their property and causing physical injury is not acceptable by any civilized society. The public is becoming increasingly intolerant to a large number of social issues because of poor governance and vote bank politics...
August 11, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28793963/the-effect-of-team-based-cardiopulmonary-resuscitation-on-outcomes-in-out-of-hospital-cardiac-arrest-patients-a-meta-analysis
#13
Sola Kim, Ki Ok Ahn, Seungmin Jeong
OBJECTIVES: The objective of this systematic review and meta-analysis was to determine the effects of team cardiopulmonary resuscitation (CPR) on outcomes of patients with out-of-hospital cardiac arrest (OHCA). METHODS: A systematic literature review was performed using PubMed, EMBASE, and the Cochrane database to identify relevant articles for this meta-analysis. All studies that described the implementation of team CPR performed by emergency medical services for OHCA patients with presumed cardiac etiology were included in this study...
July 30, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28789733/mobile-health-care-for-people-who-are-homeless
#14
Angela L Caires
Individuals experiencing homelessness face significant challenges on a daily basis. The ongoing need to find shelter, safety, and food becomes a priority and often supersedes the need for health care. People who are homeless have significantly higher morbidity and mortality rates than those who are sheltered, at least in part because care is sought when health care issues become acute and more difficult to manage from a medical standpoint. Most acute care for this population is provided in the emergency department, which is more expensive and more fragmented than regular care provided by a primary provider...
August 1, 2017: Creative Nursing
https://www.readbyqxmd.com/read/28789726/disaster-coverage-predication-for-the-emerging-tethered-balloon-technology-capability-for-preparedness-detection-mitigation-and-response
#15
Saeed H Alsamhi, Mohd Samar Ansari, Navin S Rajput
OBJECTIVE: A disaster is a consequence of natural hazards and terrorist acts, which have significant potential to disrupt the entire wireless communication infrastructure. Therefore, the essential rescue squads and recovery operations during a catastrophic event will be severely debilitated. To provide efficient communication services, and to reduce casualty mortality and morbidity during the catastrophic events, we proposed the Tethered Balloon technology for disaster preparedness, detection, mitigation, and recovery assessment...
August 9, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/28782875/comparison-of-trauma-care-systems-in-asian-countries-a-systematic-literature-review
#16
Se Jin Choi, Moon Young Oh, Na Rae Kim, Yoo Joong Jung, Young Sun Ro, Sang Do Shin
OBJECTIVE: The study aims to compare the trauma care systems in Asian countries. METHODS: Asian countries were categorised into three groups; 'lower middle-income country', 'upper middle-income country' and 'high-income country'. The Medline/PubMed database was searched for articles published from January 2005 to December 2014 using relevant key words. Articles were excluded if they examined a specific injury mechanism, referred to a specific age group, and/or did not have full text available...
August 7, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28782004/second-flexner-century-the-democratization-of-medical-knowledge-repurposing-a-general-pathology-course-into-multigrade-level-gateway-courses
#17
Ronald S Weinstein, Amy L Waer, John B Weinstein, Margaret M Briehl, Michael J Holcomb, Kristine A Erps, Angelette L Holtrust, Julie M Tomkins, Gail P Barker, Elizabeth A Krupinski
Starting in 1910, the "Flexner Revolution" in medical education catalyzed the transformation of the US medical education enterprise from a proprietary medical school dominated system into a university-based medical school system. In the 21st century, what we refer to as the "Second Flexner Century" shifts focus from the education of medical students to the education of the general population in the "4 health literacies." Compared with the remarkable success of the first Flexner Revolution, retrofitting medical science education into the US general population today, starting with K-12 students, is a more daunting task...
January 2017: Acad Pathol
https://www.readbyqxmd.com/read/28781898/suicide-by-ingestion-of-caffeine
#18
Frédéric Aknouche, Emilie Guibert, Alison Tessier, Aude Eibel, Pascal Kintz
BACKGROUND: Mr K, aged 48, was found sweating by his partner at home at 11.50 pm. He claimed to have attempted suicide. She immediately called the Emergency Unit to ask for support. At the phone, the physician on duty indicated her to give a pill of Lysanxia (prazepam) to decrease the level of stress of the victim. However, the clinical situation worsened and he was taken to the hospital at 1.00 am. At his arrival at 1.28 am he was in cardiac arrest. Despite intensive resuscitation manoeuvres, death was pronounced at 2...
2017: Egyptian journal of forensic sciences
https://www.readbyqxmd.com/read/28780315/closed-loop-communication-improves-task-completion-in-pediatric-trauma-resuscitation
#19
Ibrahim Abd El-Shafy, Jennifer Delgado, Meredith Akerman, Francesca Bullaro, Nathan A M Christopherson, Jose M Prince
BACKGROUND: Pediatric trauma care requires effective and clear communication in a time-sensitive manner amongst a variety of disciplines. Programs such as Crew Resource Management in aviation have been developed to systematically prevent errors. Similarly, teamSTEPPS has been promoted in healthcare with a strong focus on communication. We aim to evaluate the ability of closed-loop communication to improve time-to-task completion in pediatric trauma activations. METHODS: All pediatric trauma activations from January to September, 2016 at an American College of Surgeons verified level I pediatric trauma center were video recorded and included in the study...
August 2, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28777116/emergency-airway-response-team-simulation-training-a-nursing-perspective
#20
Janet T Crimlisk, Gintas P Krisciunas, Gregory A Grillone, R Mauricio Gonzalez, Michael R Winter, Susan C Griever, Eduarda Fernandes, Ron Medzon, Joseph S Blansfield, Adam Blumenthal
BACKGROUND: Simulation-based education is an important tool in the training of professionals in the medical field, especially for low-frequency, high-risk events. An interprofessional simulation-based training program was developed to enhance Emergency Airway Response Team (EART) knowledge, team dynamics, and personnel confidence. This quality improvement study evaluated the EART simulation training results of nurse participants. METHOD: Twenty-four simulation-based classes of 4-hour sessions were conducted during a 12-week period...
September 2017: Dimensions of Critical Care Nursing: DCCN
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