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https://www.readbyqxmd.com/read/29351876/vital-signs-analysis-algorithm-detects-inflammatory-response-in-premature-infants-with-late-onset-sepsis-and-necrotizing-enterocolitis
#1
Leena B Mithal, Ram Yogev, Hannah L Palac, Daniel Kaminsky, Ilan Gur, Karen K Mestan
BACKGROUND: Nonspecific clinical signs and suboptimal diagnostic tests limit accurate identification of late onset sepsis (LOS) and necrotizing enterocolitis (NEC) in premature infants, resulting in significant morbidity and antibiotic overuse. An infant's systemic inflammatory response may be identified earlier than clinical suspicion through analysis of multiple vital signs by a computerized algorithm (RALIS). AIM: To evaluate the revised RALIS algorithm for detection of LOS and NEC in preterm infants...
January 16, 2018: Early Human Development
https://www.readbyqxmd.com/read/29349905/would-you-like-to-add-a-weight-after-this-blood-pressure-doctor-discovery-of-potentially-actionable-associations-between-the-provision-of-multiple-screens-in-primary-care
#2
Sumeet Kalia, Michelle Greiver, Xu Zhao, Christopher Meaney, Rahim Moineddin, Babak Aliarzadeh, Eva Grunfeld, Frank Sullivan
RATIONALE, AIMS, AND OBJECTIVE: Guidelines recommend screening for risk factors associated with chronic diseases but current electronic prompts have limited effects. Our objective was to discover and rank associations between the presence of screens to plan more efficient prompts in primary care. METHODS: Risk factors with the greatest impact on chronic diseases are associated with blood pressure, body mass index, waist circumference, glycaemic and lipid levels, smoking, alcohol use, diet, and exercise...
January 19, 2018: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29329456/designing-and-evaluating-an-automated-system-for-real-time-medication-administration-error-detection-in-a-neonatal-intensive-care-unit
#3
Yizhao Ni, Todd Lingren, Eric S Hall, Matthew Leonard, Kristin Melton, Eric S Kirkendall
Background: Timely identification of medication administration errors (MAEs) promises great benefits for mitigating medication errors and associated harm. Despite previous efforts utilizing computerized methods to monitor medication errors, sustaining effective and accurate detection of MAEs remains challenging. In this study, we developed a real-time MAE detection system and evaluated its performance prior to system integration into institutional workflows. Methods: Our prospective observational study included automated MAE detection of 10 high-risk medications and fluids for patients admitted to the neonatal intensive care unit at Cincinnati Children's Hospital Medical Center during a 4-month period...
January 10, 2018: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29323437/parenteral-nutrition-safety-the-story-continues
#4
REVIEW
Phil Ayers, Joseph Boullata, Gordon Sacks
Parenteral nutrition (PN) is an important therapeutic modality used for a variety of indications in adults, children, and infants. PN is a complex, high-alert medication that requires appropriate education and ongoing competency assessment to ensure a safe process. PN is not recognized by many organizations as a medication, which leads to underreporting of errors. This article will provide important insight and recommendations to promote a safe PN process.
January 11, 2018: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/29320600/providing-physicians-with-feedback-on-medication-adherence-for-people-with-chronic-diseases-taking-long-term-medication
#5
REVIEW
Vincent Zaugg, Virginie Korb-Savoldelli, Pierre Durieux, Brigitte Sabatier
BACKGROUND: Poor medication adherence decreases treatment efficacy and worsens clinical outcomes, but average rates of adherence to long-term pharmacological treatments for chronic illnesses are only about 50%. Interventions for improving medication adherence largely focus on patients rather than on physicians; however, the strategies shown to be effective are complex and difficult to implement in clinical practice. There is a need for new care models addressing the problem of medication adherence, integrating this problem into the patient care process...
January 10, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29301226/impact-of-pharmacist-conducted-comprehensive-medication-reviews-for-older-adult-patients-to-reduce-medication-related-problems
#6
Whitney J Kiel, Shaun W Phillips
Older adults are demanding increased healthcare attention with regards to prescription use due in large part to highly complex medication regimens. As patients age, medications often have a more pronounced effect on older adults, negatively impacting patient safety and increasing healthcare costs. Comprehensive medication reviews (CMRs) optimize medications for elderly patients and help to avoid inappropriate medication use. Previous literature has shown that such CMRs can successfully identify and reduce the number of medication-related problems and improve acute healthcare utilization...
December 31, 2017: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/29296269/clinicomicrobiological-spectrum-of-infective-endocarditis-from-a-tertiary-care-centre-in-south-india
#7
Kanne Padmaja, Sukanya Sudhaharan, Lakshmi Vemu, Oruganti Sai Satish, Padmasri Chavali, Mamidi Neeraja
Background and Objectives: Infective endocarditis (IE) is a microbial infection of the endothelial surface of the cardiac-valves. Rapid diagnosis, effective treatment and prompt recognition of complications are essential, in order to improve the outcome. We retrospectively reviewed and determined the clinical characteristics, microbiological profile and management strategies of IE cases, changing microbial spectrum of pathogens and outcome in Native Valve Endocarditis (NVE) and Prosthetic Valve Endocarditis (PVE) cases...
October 2017: Iranian Journal of Microbiology
https://www.readbyqxmd.com/read/29287034/electronic-medical-record-alert-associated-with-reduced-opioid-and-benzodiazepine-coprescribing-in-high-risk-veteran-patients
#8
Carol A Malte, Douglas Berger, Andrew J Saxon, Hildi J Hagedorn, Carol E Achtmeyer, Anthony J Mariano, Eric J Hawkins
BACKGROUND: Over the past decade, overdoses involving opioids and benzodiazepines have risen at alarming rates, making reductions in coprescribing of these medications a priority, particularly among patients who may be susceptible to adverse events due to high-risk conditions. OBJECTIVES: This quality improvement project evaluated the effectiveness of a medication alert designed to reduce opioid and benzodiazepine coprescribing among Veterans with known high-risk conditions (substance use, sleep apnea, suicide-risk, age 65 and above) at 1 Veterans Affairs (VA) health care system...
December 28, 2017: Medical Care
https://www.readbyqxmd.com/read/29278992/comorbidity-polytherapy-and-drug-interactions-in-a-neurological-context-an-example-of-a-multidisciplinary-approach-to-promote-the-rational-use-of-drugs
#9
Giulia Busa, Alessandro Burlina, Vera Damuzzo, Marco Chiumente, Angelo C Palozzo
PURPOSE: A high number of adverse drug reactions (ADRs), mainly caused by drug-drug interactions (DDIs), occur in neurological wards and few data are available about incidence and prevalence of DDIs in this context. This study investigated-(1) the prevalence of drug-drug and drug-disease interactions in patients admitted to a neurological unit in Italy, (2) the risk factors for DDIs, and (3) the diseases and the drug classes mostly involved in drug-drug and drug-disease interactions. METHODS: For 2 months, we performed a retrospective, observational study in the neurological unit of St Bassiano Hospital, enrolling 79 patients who received a drug prescription at discharge...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29273612/interprofessional-care-collaboration-for-patients-with-heart-failure
#10
Amanda Boykin, Danielle Wright, Lydia Stevens, Lauren Gardner
PURPOSE: An innovative collaborative care model to improve transitions of care (TOC) for patients with heart failure (HF) is described. SUMMARY: As part of a broad effort by New Hanover Regional Medical Center (NHRMC) to reduce avoidable 30-day hospital readmissions and decrease associated healthcare costs through a team-centered, value-based approach to patient care, an interprofessional team was formed to help reduce hospital readmissions among discharged patients with HF...
January 1, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29238106/measures-and-effects-on-prevention-of-fall-the-role-of-a-fall-working-group-at-a-university-hospital
#11
Kazuyoshi Kobayashi, Kei Ando, Yuko Inagaki, Yusuke Suzuki, Yoshimasa Nagao, Naoki Ishiguro, Shiro Imagama
Fall in hospitalized patients can cause trauma and fractures, which can reduce ADL and QOL, whereas prevention of fall decreases medical expenses. The purpose of this study is to examine prevention of fall due to intervention from a fall working group established in our hospital. The working group focused on three main points. First, colored wrist bands for patients classified as grade 3 risk for fall are used to alert medical staff. Second, information on fall prevention was distributed to patients. Third, standardization of two bed fences and reduced use of slippers for inpatients have been introduced...
November 2017: Nagoya Journal of Medical Science
https://www.readbyqxmd.com/read/29236913/impact-of-the-delay-to-start-treatment-in-patients-with-lung-cancer-treated-in-a-densely-populated-area-of-brazil
#12
Fernando Conrado Abrao, Igor Renato Louro Bruno de Abreu, Roberto Odebrecht Rocha, Felipe Dourado Munhoz, João Henrique Godoy Rodrigues, Riad Naim Younes
OBJECTIVES: The aim of this study is to evaluate the access of patients with lung cancer in a densely populated area of São Paulo to the Brazilian Public Health System, focusing on the time spent from symptom onset or initial diagnosis until the beginning of treatment. METHODS: We retrospectively reviewed 509 patients with malignant lung neoplasms who were admitted to a single reference oncology center of the public health system between July 2008 and December 2014...
November 2017: Clinics
https://www.readbyqxmd.com/read/29232260/high-alert-medication-stratification-tool-revised-an-exploratory-study-of-an-objective-standardized-medication-safety-tool
#13
Natalie C Washburn, Heather A Dossett, Andrew C Fritschle, Kerri E Degenkolb, Monica R Macik, Todd A Walroth
OBJECTIVE: To develop an objective tool designed to standardize the identification of high-alert medications (HAMs) according to patient safety risk. METHODS: Medications were evaluated using the High-Alert Medication Stratification Tool (HAMST). Tool revision occurred through assessing medications on an organization-approved HAM list and comparing scores with control medications not included on the list. Because of variations in HAMST interpretation by end users in interdisciplinary committees, a revision of the scoring tool was completed to create the High-Alert Medication Stratification Tool-Revised (HAMST-R), and the assessment was repeated...
December 12, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/29225117/rapid-response-events-in-hospitalized-patients-patient-symptoms-and-clinician-communication
#14
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/29194912/sharing-of-prescription-analgesics-amongst-patients-in-family-practice-frequency-and-associated-factors
#15
F Markotic, D Jurisic, M Curkovic, M Puljiz, M Novinscak, K Bonassin, D Vrdoljak, Z Vojvodic, S Permozer Hajdarovic, T Pekez-Pavlisko, M Tomicic, I Diminic-Lisica, S Fabris Ivsic, D Nejasmic, I Miosic, I Novak, L Puljak
OBJECTIVE: To analyse the frequency of nonrecreational prescription analgesic sharing, associated factors and differences between lenders and borrowers. METHODS: A cross-sectional study was conducted in 10 outpatient family medicine practices in Croatia amongst 1000 patients to whom their physicians have prescribed analgesics at least once in their lives. A questionnaire was used to collect data about patients' pain intensity, prescription analgesic sharing habits, factors associated with this behaviour, perception of risks associated with the conduct and demographic data...
December 1, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/29180925/marjolin-s-ulcer-in-chronic-wounds-review-of-available-literature
#16
REVIEW
Dariusz Bazaliński, Joanna Przybek-Mita, Beata Barańska, Paweł Więch
Marjolin's ulcer is a rare, aggressive skin cancer developing in scar tissue, chronic ulcers and areas affected by inflammations. Its incidence is estimated to range from 1% to 2% of all burn scars. It most frequently takes the form of squamous cell carcinoma which sometimes is diagnosed during examination of lesions developing in scars and hard-to-heal chronic wounds (pressure sores, leg ulcers). Therapeutic management of Marjolin's ulcer requires well-designed treatment plan to ensure optimal medical care and good quality of life for the patient...
2017: Contemporary Oncology Współczesna Onkologia
https://www.readbyqxmd.com/read/29173289/user-centered-collaborative-design-and-development-of-an-inpatient-safety-dashboard
#17
Eli Mlaver, Jeffrey L Schnipper, Robert B Boxer, Dominic J Breuer, Esteban F Gershanik, Patricia C Dykes, Anthony F Massaro, James Benneyan, David W Bates, Lisa S Lehmann
Patient safety remains a key concern in hospital care. This article summarizes the iterative participatory development, features, functions, and preliminary evaluation of a patient safety dashboard for interdisciplinary rounding teams on inpatient medical services. This electronic health record (EHR)-embedded dashboard collects real-time data covering 13 safety domains through web services and applies logic to generate stratified alerts with an interactive check-box function. The technological infrastructure is adaptable to other EHR environments...
December 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/29170352/55%C3%A2-mini-sim-innovative-bite-sized-simulation-teaching-in-a-busy-children-s-emergency-department
#18
Rachel Sunley, Karen Moloney, Jessica Parker, Christopher Arrowsmith, Kirsty Brown, Alex Wilson
: Emergency Medicine requires a highly skilled workforce who are passionate about delivering excellent patient care. Shift patterns linked with the ever increasing numbers of patients who attend Emergency Departments puts strain on educating the workforce and fostering team togetherness.Our objective in devising and instigating the 'Mini Sim' programme was to embed regular in-situ simulation training to enhance the learning of all staff within our Emergency Department team, building a highly trained workforce to deliver excellent care within the remit of our busy department...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29143576/a-nationwide-study-of-health-related-quality-of-life-stress-pain-or-discomfort-and-the-use-of-medicine-among-problem-gamblers
#19
Ola Ekholm, Michael Davidsen, Christina Viskum Lytken Larsen, Knud Juel
AIM: The aim of this study was to investigate the associations between problem gambling and health-related quality of life, stress, pain or discomfort and the use of analgesics and sleeping pills. METHODS: Data derives from the Danish Health and Morbidity Survey 2010. The survey was based on a random sample of 25,000 adult Danes (response rate: 61%), and data were collected via a self-administered questionnaire. The Lie/Bet Questionnaire was used as the screening instrument for problem gambling...
November 1, 2017: Scandinavian Journal of Public Health
https://www.readbyqxmd.com/read/29124665/evaluation-of-definite-anaphylaxis-drug-allergy-alert-overrides-in-inpatient-and-outpatient-settings
#20
Adrian Wong, Diane L Seger, Sarah P Slight, Mary G Amato, Patrick E Beeler, Julie M Fiskio, David W Bates
INTRODUCTION: Drug-allergy interaction (DAI) alerts are generated when a known adverse sensitivity-inducing substance is prescribed. A recent study at our institution showed that providers overrode most DAI alerts, including those that warned against potentially life-threatening 'anaphylaxis'. OBJECTIVE: The aim of this study was to determine the rate of anaphylaxis overrides, the reasons for these overrides, whether the overrides were appropriate, and if harm occurred from overrides...
November 9, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
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