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Elizabeth T Gershoff, Sarah A Font, Catherine A Taylor, Rebecca H Foster, Ann Budzak Garza, Denyse Olson-Dorff, Amy Terreros, Monica Nielsen-Parker, Lisa Spector
Several medical professional organizations, including the American Academy of Pediatrics, recommend that parents avoid hitting children for disciplinary purposes (e.g., spanking) and that medical professionals advise parents to use alternative methods. The extent to which medical professionals continue to endorse spanking is unknown. This study is the first to examine attitudes about spanking among staff throughout medical settings, including non-direct care staff. A total of 2580 staff at a large general medical center and 733 staff at a children's hospital completed an online survey; respondents were roughly divided between staff who provide direct care to patients (e...
October 13, 2016: Child Abuse & Neglect
Ambrose Hon-Wai Wong, Joan Combellick, Beth Ann Wispelwey, Allison Squires, Maureen Gang
OBJECTIVES: The emergency department (ED) has been recognized as a high-risk environment for workplace violence. Acutely agitated patients who perpetrate violence against healthcare workers represent a complex care challenge in the ED. Recommendations to improve safety are often based on expert opinion rather than empirical data. In this study we aim to describe the lived experience of staff members caring for this population in order to provide a broad perspective of ED patient violence...
October 15, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Eliana de Andrade Trotta, Fernanda Cristina Scarpa, Michel George El Halal, José Roberto Goldim, Paulo Roberto Antonacci Carvalho
OBJECTIVE: To evaluate the perceptions of physicians, nurses and nursing technicians of their participation in the decision-making process surrounding life support limitation in terminally ill pediatric patients, with comparisons by professional category. METHODS: A cross-sectional study was conducted in the pediatric intensive care unit of a tertiary public university hospital with the participation of physicians, nurses and nursing technicians. The MacArthur Admission Experience Survey Voice Scale was used to assess and quantify the perceptions of professionals who assisted 17 pediatric patients with life support limitation within 24 hours after the outcome of each patient was determined...
September 2016: Revista Brasileira de Terapia Intensiva
Jeffrey S Reichard, Scott Savage, Stephen F Eckel
PURPOSE: A transitions of care program at an academic teaching hospital was designed to reengineer the fragmented discharge process. The team included a pharmacy technician, called a transition specialist, who coordinated the medication needs of discharging patients. This study intends to assess the impact of the transitions of care program on patient satisfaction scores. METHODS: Two datasets of Press Ganey and Hospital Consumer Assessment of Healthcare Providers (HCAHPS) were analyzed...
November 2015: Hospital Pharmacy
Jonathan Clarke, Renata Puertas, Aachal Kotecha, Paul J Foster, Keith Barton
BACKGROUND/AIMS: To examine the agreement in clinical decisions of glaucoma status made in a virtual glaucoma clinic with those made during a face-to-face consultation. METHODS: A trained nurse and technicians entered data prospectively for 204 patients into a proforma. A subsequent face-to-face clinical assessment was completed by either a glaucoma consultant or fellow. Proformas were reviewed remotely by one of two additional glaucoma consultants, and 12 months later, by the clinicians who had undertaken the original clinical examination...
October 11, 2016: British Journal of Ophthalmology
Luana Sicuro Correa, Yara Hahr Marques Hökerberg, Raquel de Vasconcellos Carvalhaes de Oliveira, Danielle Martins de Souza Barros, Helenara Abadia Ferreira Alexandria, Regina Paiva Daumas, Carlos Augusto Ferreira de Andrade, Sonia Regina Lambert Passos, Patrícia Brasil
OBJECTIVE: The aim of this study was to describe the use of dengue warning signs by pediatric healthcare staff in the Brazilian public health care system. METHODS: Cross-sectional study (2012) with physicians, nurses, and nurse technicians assisting children in five health care facilities. Participants reported the use and importance of dengue warning signs in pediatrics clinical practice through a structured questionnaire. Differences in the use of signs (chi-square test) and in the ranking assigned to each of them (Kruskal-Wallis) were assessed according to health care occupation and level of care (p<0...
2016: PloS One
Elizabeth Story-Roller, Melvin P Weinstein
Blood cultures (BC) are the standard method for diagnosis of bloodstream infections (BSI). However, the average BC contamination rate (CR) in US hospitals is 2.9%, potentially resulting in unnecessary antibiotic use and excessive therapy costs. Several studies have compared various skin antisepsis agents without a clear consensus as to which agent is most effective in reducing contamination. A prospective, randomized crossover study was performed at Robert Wood Johnson University Hospital (RWJUH) directly comparing blood culture contamination rates using chlorhexidine vs...
October 5, 2016: Journal of Clinical Microbiology
Grayson Peek, Udobi Campbell, Matthew Kelm
Objective: The impact of providing nursing staff access to data collected through a medication dose tracking technology (MDTT) web portal was investigated. Methods: A quasi-experimental, nonrandomized, pre-post intervention study was conducted in the Cardiothoracic Intensive Care Unit (CTICU) at Duke University Hospital. The change in the number of medication requests per dispense routed to the pharmacy electronic health record (EHR) in-basket was analyzed pre and post web portal access. Other endpoints included the number of MDTT web portal queries per day by nursing staff, change in nursing satisfaction survey scores, and technician time associated with processing medication requests pre and post web portal access...
September 2016: Hospital Pharmacy
Teresa Bandeira, Ricardo Ferreira, Inês Azevedo
Portugal has experienced rapid decline of neonatal and infant mortality in the last century, similar to that of other western European states. The joint venture of pediatricians and obstetricians with adequate top-down government commissions for maternal and child health for the decision making by health administrators and a well-defined schedule of preventive and managerial measures in the community and in hospitals are the most likely explanations for this success. Another achievement of child health care services is the registry for special diseases...
October 2016: Journal of Pediatrics
H Guanche Garcell, A Villanueva Arias, E Guilarte García, R N Alfonso Serrano
BACKGROUND: Health care workers (HCW) are at high risk of contracting various infectious diseases and play a dual role in the transmission of infections in health care facilities. OBJECTIVE: To determine the seroprotection against hepatitis B, measles, rubella, and varicella among HCWs in a community hospital in Qatar. METHODS: This is a cross-sectional survey conducted in a 75-bed community hospital in Dukhan, Qatar. From August 2012 to December 2015, 705 HCWs were tested for the presence of IgG antibodies for measles, rubella, and varicella, and also for hepatitis B surface antigen (HBsAg)...
October 2016: International Journal of Occupational and Environmental Medicine
Petra Duran-Gehring, Laurie Bryant, Jennifer A Reynolds, Petra Aldridge, Colleen J Kalynych, Faheem W Guirgis
OBJECTIVES: To report our success and complication rates with emergency department (ED) technician-performed ultrasound (US)-guided peripheral intravenous (IV) catheter placement and to compare our results to similar studies in the literature. METHODS: We conducted a retrospective review of a prospective database of patients who underwent US-guided peripheral IV catheter placement attempts for clinical care in the ED. All patients meeting difficult IV access criteria who had a US-guided peripheral IV catheter placement attempted by a trained ED technician were included...
September 14, 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Régis Vaillancourt, Annie Pouliot, Kim Streitenberger, Sylvia Hyland, Pierre Thabet
BACKGROUND: Inherent risks are associated with the preparation and administration of medications. As such, a key aspect of medication safety is to ensure safe medication management practices. OBJECTIVE: To identify key medication safety issues and high-alert drug classes that might benefit from implementation of pictograms, for use by health care providers, to enhance medication administration safety. This study was the first step in the development of such pictograms...
July 2016: Canadian Journal of Hospital Pharmacy
A Autret, D Choupeaux, M Le Mée
Tomotherapy is a technique of IMRT and IGRT using a linear accelerator and a helical CT-scanner. To reach this targeting of precision, the repositioning of the patient is essential. The use of a contention adapted according to the location of the disease and the morphology of the patient is necessary for the safety of this one and the treatment. Once the patient positioned on the reference table, technicians of imager's team check by the acquisition of helical imagery with the reference CT-scanner the position of the patient, the zone of the PTV and healthy organs in the protected surroundings...
October 2016: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Abdul Rafay Qazi, Furqan Ali Siddiqui, Salman Faridi, Urooj Nadeem, Nida Iqbal Umer, Zainab Saeed Mohsini, Muhammad Muzzammil Edhi, Mehmood Khan
BACKGROUND: Needle stick injuries (NSIs) have the potential of causing Hepatitis B and Hepatitis C, which is constantly adding to the burden of chronic liver disease in our country. It poses a risk to Health Care Workers (HCWs) and the patients they deal with. In order to limit the spread of these viruses, it is imperative that these HCWs be fully equipped with knowledge regarding prevention of NSIs and dealing with one, regardless of their designation. We therefore aimed to assess and compare the level of awareness about precautions for needle stick injuries amongst all those greatest at risk...
2016: Patient Safety in Surgery
Robert L Kerner, Kathleen Gallo, Michael Cassara, John DʼAngelo, Anthony Egan, John Galbraith Simmons
Simulation in multiple contexts over the course of a 10-week period served as a core learning strategy to orient experienced clinicians before opening a large new urban freestanding emergency department. To ensure technical and procedural skills of all team members, who would provide care without on-site recourse to specialty backup, we designed a comprehensive interprofessional curriculum to verify and regularize a wide range of competencies and best practices for all clinicians. Formulated under the rubric of systems integration, simulation activities aimed to instill a shared culture of patient safety among the entire cohort of 43 experienced emergency physicians, physician assistants, nurses, and patient technicians, most newly hired to the health system, who had never before worked together...
October 2016: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
Richard S Hoehn, Dennis J Hanseman, Alex L Chang, Megan C Daly, Audrey E Ertel, Daniel E Abbott, Shimul A Shah, Ian M Paquette
BACKGROUND: Urgent colectomy is a common procedure with a high mortality rate that is performed by a variety of surgeons and hospitals. We investigated patient, surgeon, and hospital characteristics that predicted mortality after urgent colectomy. METHODS: The University HealthSystem Consortium was queried for adults undergoing urgent or emergent colectomy between 2009 and 2013 (n = 50,707). Hospitals were grouped into quartiles according to risk-adjusted observed-to-expected (O/E) mortality ratios and compared using the 2013 American Hospital Association Annual Survey...
September 1, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Benjamin Lindquist, Matthew C Strehlow, G V Ramana Rao, Jennifer A Newberry
BACKGROUND: Many low- and middle-income countries depend on emergency medical technicians (EMTs), nurses, midwives, and layperson community health workers with limited training to provide a majority of emergency medical, trauma, and obstetric care in the prehospital setting. To improve timely patient care and expand provider scope of practice, nations leverage cellular phones and call centers for real-time online medical direction. However, there exist several barriers to adequate communication that impact the provision of emergency care...
2016: Curēus
Mark E Sharafinski, Elizabeth Sehnert, David Moe, Liyun Zhang, Pippa Simpson, Nghia J Vo
OBJECTIVES: The aim of the study was to determine whether embedding into the radiology report a patient-specific plan in the event of gastrojejunostomy (GJ) tube dysfunction reduces the need for after-hours utilization of pediatric interventional radiology resources for the replacement of GJ tubes. MATERIALS AND METHODS: This is a Health Insurance Portability and Accountability Act compliant, institutional review board-approved retrospective repeated cross-sectional study of patients requiring after-hours (5 PM-7 AM) or weekend (Saturday and Sunday) GJ tube replacement at a dedicated children's hospital, before and after the inclusion of a patient-specific plan in the radiology report as part of the electronic medical record...
September 2016: Journal of Pediatric Gastroenterology and Nutrition
Luke D Rothermel, Jeremy M Lipman
BACKGROUND: To determine the characteristics associated with improved accuracy or reliability of estimating operative blood loss. METHODS: Operating room personnel at a tertiary care hospital evaluated 3 operative simulations and provided estimations of blood loss. The simulations utilized precise, known volumes of porcine blood and saline on tapes, sponges, and in suction containers. Low volume (50 mL), mid volume (300 mL), and high volume (900 mL) blood loss scenarios were used in this simulation...
October 2016: Surgery
Nicholas M Orme, Jeffrey B Geske, Sorin V Pislaru, John Wells Askew, Ryan J Lennon, Bradley R Lewis, Charanjit S Rihal, Patricia A Pellikka, Mandeep Singh
OBJECTIVES: The purpose of this study was to compare the prevalence and impact of work-related musculoskeletal pain in cardiac sonographers to a large control group of peer employees with similar demographics. BACKGROUND: Cardiac sonographers are known to have high levels of occupational musculoskeletal pain. Comparative studies with other employees within cardiology/radiology departments have never been performed. METHODS: An electronic survey was administered to Mayo Clinic employees at six major patient care facilities in four different states...
August 20, 2016: Echocardiography
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