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https://www.readbyqxmd.com/read/28340500/advanced-practice-registered-nurses-and-long-acting-reversible-contraception
#1
Patricia J Kelly, An-Lin Cheng, Kimberly Carlson, Jacki Witt
INTRODUCTION: Advanced practice registered nurses (APRNs) are in an excellent position to address the high rates of unintended pregnancy in the United States by providing long-acting reversible contraceptives (LARCs). These methods are significant in their effectiveness in preventing pregnancy in individual women and in having population-level effects on unintended pregnancy. The aim of this study was to learn more about APRN practices around long-acting reversible contraception and influences on those practices...
March 24, 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28340130/falling-down-on-the-job-evaluation-and-treatment-of-fall-risk-among-older-adults-with-upper-extremity-fragility-fractures
#2
Christine M McDonough, Carrie H Colla, Donald Carmichael, Anna N A Tosteson, Tor D Tosteson, John-Erik Bell, Robert V Cantu, Jonathan D Lurie, Julie P W Bynum
Background: Clinical practice guidelines recommend fall risk assessment and intervention for older adults who sustain a fall-related injury to prevent future injury and mobility decline. Objective: To describe how often Medicare beneficiaries with upper extremity fracture receive evaluation and treatment for fall risk. Design: Observational cohort. Methods Subjects: Fee-for-service beneficiaries age 66 to 99 treated as outpatients for proximal humerus or distal radius/ulna ("wrist") fragility fractures were studied using Carrier and Outpatient Hospital files...
March 2, 2017: Physical Therapy
https://www.readbyqxmd.com/read/28339685/information-needs-of-generalists-and-specialists-using-online-best-practice-algorithms-to-answer-clinical-questions
#3
David A Cook, Kristi J Sorensen, Jane A Linderbaum, Laurie J Pencille, Deborah J Rhodes
Objective: : To better understand clinician information needs and learning opportunities by exploring the use of best-practice algorithms across different training levels and specialties. Methods: : We developed interactive online algorithms (care process models [CPMs]) that integrate current guidelines, recent evidence, and local expertise to represent cross-disciplinary best practices for managing clinical problems. We reviewed CPM usage logs from January 2014 to June 2015 and compared usage across specialty and provider type...
February 19, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28339551/anticoagulant-and-antiplatelet-management-for-spinal-procedures-a-prospective-descriptive-study-and-interpretation-of-guidelines
#4
Bradly S Goodman, L McLean House, Sridhar Vallabhaneni, Srinivas Mallempati, Matthew R Willey, Matthew Thomas Smith
Setting.:  Epidural hematoma rarely complicates interventional spine procedures. While anticoagulant and antiplatelet drugs increase bleeding risk, cessation may precipitate serious thromboembolic events. The Spine Intervention Society (SIS) and American Society of Regional Anesthesia and Pain Medicine (ASRA) put forth guidelines that dissent with regard to management of hemostatically active agents during commonly performed spinal injections. Objective.:  To validate an antiplatelet/anticoagulant management table based on modifications of the SIS 2013 and ASRA 2015 guidelines...
October 6, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339474/a-decrease-in-intact-parathyroid-hormone-ipth-levels-is-associated-with-higher-mortality-in-prevalent-hemodialysis-patients
#5
Ricardo Villa-Bellosta, Laura Rodriguez-Osorio, Sebastian Mas, Younes Abadi, Mercedes Rubert, Concepción de la Piedra, Carolina Gracia-Iguacel, Ignacio Mahillo, Alberto Ortiz, Jesús Egido, Emilio González-Parra
BACKGROUND: The mortality of dialysis patients is 10- to 100-fold higher than in the general population. Baseline serum PTH levels, and more recently, changes in serum PTH levels (ΔPTH) over time, have been associated to mortality in dialysis patients. METHODS: We explored the relationship between ΔPTH over 1 year with mortality over the next year in a prospective cohort of 115 prevalent hemodialysis patients from a single center that had median baseline iPTH levels within guideline recommendations...
2017: PloS One
https://www.readbyqxmd.com/read/28334856/evaluating-the-effects-of-organizational-and-educational-interventions-on-adherence-to-clinical-practice-guidelines-in-a-low-resource-primary-care-setting-in-kenya
#6
Joseph R Egger, Kayla Stankevitz, Robert Korom, Philip Angwenyi, Brittney Sullivan, Jun Wang, Sonia Hatfield, Emma Smith, Karishma Popli, Jessica Gross
Background: Mid-level care providers serve as the backbone of primary care in many parts of sub-Saharan Africa. Despite this, research suggests that the quality and consistency of this care is uneven. This study assessed the degree to which a set of four simple, low-cost interventions could improve adherence to a set of clinical quality measures (CQMs) associated with four common health conditions seen in a resource-constrained primary care setting. Methods: A quasi-experimental, longitudinal study was carried out in three primary care clinics in Nairobi, Kenya from August 2014 to January, 2015...
March 15, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28334713/pulsed-dose-rate-brachytherapy-for-the-treatment-of-endometrial-cancer
#7
Francesca De Felice, Rossella Caiazzo, Ilaria Benevento, Daniela Musio, Filippo Rubini, Vincenzo Tombolini
Endometrial cancer (EC) is the most frequent gynecologic malignancy. The aim of this review is to outline clinical practice recommendations, to suggest a technical solution, and to advise doses selection for pulsed-dose rate (PDR) brachytherapy in EC. Electronic bibliographic databases, including PubMed, clinicaltrials.gov, and the American Society of Clinical Oncology (ASCO) Meeting Library, were searched for articles in English. Clinical guidelines and systematic reviews were also considered. The appropriate therapeutic approach should consider risk factors for tumor relapse and PDR brachytherapy and have a convincing role in this multidisciplinary scenario...
March 24, 2017: Oncology
https://www.readbyqxmd.com/read/28334585/uptake-and-utilization-of-practice-guidelines-in-hospitals-in-the-united-states-the-case-of-routine-episiotomy
#8
Katy B Kozhimannil, Pinar Karaca-Mandic, Cori J Blauer-Peterson, Neel T Shah, Jonathan M Snowden
BACKGROUND: The gap between publishing and implementing guidelines differs based on practice setting, including hospital geography and teaching status. On March 31, 2006, a Practice Bulletin published by the American College of Obstetricians and Gynecologists (ACOG) recommended against the routine use of episiotomy and urged clinicians to make judicious decisions to restrict the use of the procedure. OBJECTIVE: This study investigated changes in trends of episiotomy use before and after the ACOG Practice Guideline was issued in 2006, focusing on differences by hospital geographic location (rural/urban) and teaching status...
January 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334584/delayed-workup-of-rectal-bleeding-in-adult-primary-care-examining-process-of-care-failures
#9
Saul N Weingart, Elena M Stoffel, Daniel C Chung, Thomas D Sequist, Ruth I Lederman, Stephen R Pelletier, Helen M Shields
BACKGROUND: Although delayed colorectal cancer diagnoses figure prominently in medical malpractice claims, little is known about the quality of primary care clinicians' workup of rectal bleeding. METHODS: In this study, 438 patients were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for rectal bleeding, hemorrhoids, and blood in the stool at 10 Boston adult primary care practices. Following nurse chart abstraction, physician reviewers assessed the overall quality of care and key care processes...
January 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334559/design-and-hospitalwide-implementation-of-a-standardized-discharge-summary-in-an-electronic-health-record
#10
Shannon M Dean, Andrea Gilmore-Bykovskyi, Joel Buchanan, Brad Ehlenfeldt, Amy J H Kind
BACKGROUND: The hospital discharge summary is the primary method used to communicate a patient's plan of care to the next provider(s). Despite the existence of regulations and guidelines outlining the optimal content for the discharge summary and its importance in facilitating an effective transition to posthospital care, incomplete discharge summaries remain a common problem that may contribute to poor posthospital outcomes. Electronic health records (EHRs) are regularly used as a platform on which standardization of content and format can be implemented...
December 2016: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334476/implementing-guidelines-for-preventing-identifying-and-treating-adolescent-overweight-and-obesity-school-nurses-perceptions-of-the-challenges-involved
#11
Sølvi Helseth, Kirsti Riiser, Bettina Holmberg Fagerlund, Nina Misvaer
AIMS AND OBJECTIVES: We aimed to gain a better understanding of school nurses' perceptions of the challenges involved in implementing national guidelines on managing overweight and obesity in adolescents. BACKGROUND: National guidelines for the management of childhood overweight and obesity are developed in many countries to translate scientific knowledge into practice. However, several challenges are involved in their implementation. DESIGN AND METHODS: A qualitative design with focus group interviews was chosen for data collection...
March 23, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28334336/ophthalmic-screening-patterns-among-youths-with-diabetes-enrolled-in-a-large-us-managed-care-network
#12
Sophia Y Wang, Chris A Andrews, Thomas W Gardner, Michael Wood, Kanakadurga Singer, Joshua D Stein
Importance: Ophthalmic screening to check for diabetic retinopathy (DR) is important to prevent vision loss in persons with diabetes. The American Academy of Ophthalmology recommends that ophthalmic screening for DR occur beginning at 5 years after initial diabetes diagnosis for youths with type 1 diabetes; the American Diabetes Association recommends screening of youths with type 2 diabetes at the time of initial diagnosis. To our knowledge, it is unknown to what extent youths with diabetes obtain eye examinations in accordance with these guidelines...
March 23, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/28333831/deployed-skills-training-for-whole-blood-collection-by-a-special-operations-expeditionary-surgical-team
#13
Linda C Benavides, Iain M Smith, Jerome M Benavides, Douglas M Bowley, Heidi A Doughty, Jonathan B Lundy
BACKGROUND: Non-compressible hemorrhage is the leading cause of potentially preventable battlefield death. Combining casualty retrieval from the battlefield and damage control resuscitation (DCR) within the "golden hour" increases survival. However, transfusion requirements may exceed the current blood component stocks held by forward surgical teams. Warm fresh whole blood (WFWB) is an alternative. We report WFWB transfusion training developed by and delivered to a US Golden Hour Offset Surgical Treatment Team (GHOST-T) and the resulting improvement in confidence with WFWB transfusion...
March 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28331823/small-pulmonary-nodules-in-baseline-and-incidence-screening-rounds-of-low-dose-ct-lung-cancer-screening
#14
REVIEW
Joan E Walter, Marjolein A Heuvelmans, Matthijs Oudkerk
Currently, lung cancer screening by low-dose computed tomography (LDCT) is widely recommended for high-risk individuals by US guidelines, but there still is an ongoing debate concerning respective recommendations for European countries. Nevertheless, the available data regarding pulmonary nodules released by lung cancer screening studies could improve future screening guidelines, as well as the clinical practice of incidentally detected pulmonary nodules on routine CT scans. Most lung cancer screening trials present results for baseline and incidence screening rounds separately, clustering pulmonary nodules initially found at baseline screening and newly detected pulmonary nodules after baseline screening together...
February 2017: Translational Lung Cancer Research
https://www.readbyqxmd.com/read/28331607/-simplified-international-recommendations-for-the-implementation-of-patient-blood-management-sir4pbm
#15
Patrick Meybohm, Bernd Froessler, Lawrence T Goodnough, Andrew A Klein, Manuel Muñoz, Michael F Murphy, Toby Richards, Aryeh Shander, Donat R Spahn, Kai Zacharowski
BACKGROUND: More than 30% of the world's population are anemic with serious medical and economic consequences. Red blood cell transfusion is the mainstay to correct anemia, but it is also one of the top five overused procedures and carries its own risk and cost burden. Patient blood management (PBM) is a patient-centered and multidisciplinary approach to manage anemia, minimize iatrogenic blood loss, and harness tolerance to anemia in an effort to improve patient outcome. Despite resolution 63...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/28331043/world-health-organization-treatment-guidelines-for-drug-resistant-tuberculosis-2016-update
#16
Dennis Falzon, Holger J Schünemann, Elizabeth Harausz, Licé González-Angulo, Christian Lienhardt, Ernesto Jaramillo, Karin Weyer
Antimicrobial resistance is a major global concern. Tuberculosis (TB) strains resistant to rifampicin and other TB medicines challenge patient survival and public health. The World Health Organization (WHO) has published treatment guidelines for drug-resistant TB since 1997 and last updated them in 2016 based on reviews of aggregated and individual patient data from published and unpublished studies. An international expert panel formulated recommendations following the GRADE approach. The new WHO guidelines recommend a standardised 9-12 months shorter treatment regimen as first choice in patients with multidrug- or rifampicin-resistant TB (MDR/RR-TB) strains not resistant to fluoroquinolones or second-line injectable agents; resistance to these two classes of core second-line medicines is rapidly detectable with molecular diagnostics also approved by WHO in 2016...
March 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28330379/patient-self-defined-goals
#17
Sandra Ellen Schellinger, Eric Worden Anderson, Monica Schmitz Frazer, Cindy Lynn Cain
This research, a descriptive qualitative analysis of self-defined serious illness goals, expands the knowledge of what goals are important beyond the physical-making existing disease-specific guidelines more holistic. Integration of goals of care discussions and documentation is standard for quality palliative care but not consistently executed into general and specialty practice. Over 14 months, lay health-care workers (care guides) provided monthly supportive visits for 160 patients with advanced heart failure, cancer, and dementia expected to die in 2 to 3 years...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28329463/current-practices-in-the-timing-of-stage-2-palliation
#18
James M Meza, Robert D B Jaquiss, Brett R Anderson, Michael-Alice Moga, James K Kirklin, George Sarris, William G Williams, Brian W McCrindle
BACKGROUND: Mortality through single-ventricle palliation remains high and the effect of the timing of stage 2 palliation (S2P) is not well understood. We investigated current practice patterns in the timing of S2P across two professional societies and compared them to actual practice patterns from two databases of patients who underwent S2P. METHODS: A ten-question survey was distributed to the members of the Congenital Heart Surgeons' Society (CHSS) and the European Congenital Heart Surgeons' Association (ECHSA)...
March 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28329432/user-compliance-with-documenting-on-a-track-and-trigger-based-observation-and-response-chart-a-two-phase-multi-site-audit-study
#19
Doug Elliott, Emily Allen, Sharon McKinley, Lin Perry, Christine Duffield, Margaret Fry, Robyn Gallagher, Rick Iedema, Michael Roche
AIMS: To examine user compliance and completeness of documentation with a newly designed Observation and Response Chart and whether a rapid response system call was triggered when clinically indicated. BACKGROUND: Timely recognition and responses to patient deterioration in hospital general wards remains a challenge for health care systems globally. Evaluating practice initiatives to improve recognition and response are required. DESIGN: Two-phase audit...
March 22, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28329415/the-hand-hygiene-compliance-of-student-nurses-during-clinical-placements
#20
Jorun Saetre Sundal, Anne Grethe Aune, Eline Storvig, Jenny Kristin Aasland, Kaja Linn Fjeldsaeter, Kirsti Torjuul
AIMS AND OBJECTIVES: To observe student nurses' overall and moment-specific hand hygiene compliance during clinical placement. BACKGROUND: Hand hygiene is the single most important measure to prevent healthcare-associated infections (HAIs). However, research has shown low compliance among healthcare workers. During clinical placements, student nurses perform various nursing tasks and procedures to a large number of patients, requiring extensive patient contact. It is crucial that they practice correct hand hygiene in order to prevent healthcare-associated infections...
March 22, 2017: Journal of Clinical Nursing
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