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https://www.readbyqxmd.com/read/28526311/dramatic-effects-of-a-new-antimicrobial-stewardship-program-in-a-rural-community-hospital
#1
Claudia R Libertin, Stephanie H Watson, William L Tillett, Joy H Peterson
BACKGROUND: New Joint Commission antimicrobial stewardship requirements took effect on January 1, 2017, promoted as a central strategy for coping with the emerging problems of antimicrobial resistance and Clostridium difficile infection. Our objective was to measure the effects of a new antimicrobial stewardship program (ASP) in a rural community hospital with no prior ASP, in the context of having a new infectious disease specialist on staff. METHODS: An ASP team was formed to implement a prospective audit with health care provider feedback and targeting 12 antimicrobial agents in a rural hospital in Georgia...
May 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28526230/shared-decision-making-in-taiwan
#2
Hsun-Hsiang Liao, Huey-Wen Liang, Hou-Chaung Chen, Ching-I Chang, Pa-Chun Wang, Chung-Liang Shih
The paper aims to introduce the current status of shared decision making (SDM) in Taiwan under its mixed health care system and single-payer health insurance system. With experiences in promoting both evidence based medicine and patient safety, the Joint Commission of Taiwan has implemented a nationwide SDM program under the aegis of the Ministry of Health and Welfare since 2016, incorporating multiple approaches such as developing patient decision aids (PDAs), executing the Medical Decision Aids Campaign, establishing a SDM platform, and integrating SDM in clinical practice...
May 17, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28522282/quality-indicators-for-the-use-of-systemic-antibiotics-in-dentistry
#3
Rugzan Jameel Hussein, Robert Krohn, Petra Kaufmann-Kolle, Gerald Willms
BACKGROUND: Risks resulted from using systemic antibiotics such as increasing rates of bacterial resistance, allergy and side effects should be always weighed individually for each patient against any potential benefits. Routine antibiotic prescribing must be therefore discouraged. The Federal Joint Committee ("Gemeinsamer Bundesauschuss", G-BA) commissioned the AQUA-Institute with the development of an external quality assurance procedure, examining systemic antibiotic use in periodontal, conservative and surgical treatments in ambulatory dental health care...
May 15, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28502556/morbidity-and-mortality-conference-is-not-sufficient-for-surgical-quality-control-processes-and-outcomes-of-a-successful-attending-physician-peer-review-committee
#4
H David Reines, Amber W Trickey, Jean Donovan
BACKGROUND: Physician Peer Review (PPR) is required by The Joint Commission to assure examination of individual and group outcomes. Although surgeons may utilize Morbidity and Mortality (M&M) conference, applying these data to determine Focused Professional Practice Evaluations involves outcomes review. A PPR Committee of senior surgeons was created. This report describes one institution's surgical PPR process and results. METHOD: A two-year (2014-2015) retrospective review of significant non-trauma complications and unanticipated deaths evaluated by PPR was performed...
May 3, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28490883/retrospective-analysis-of-non-laboratory-based-adverse-drug-reactions-induced-by-intravenous-radiocontrast-agents-in-a-joint-commission-international-accredited-academic-medical-center-hospital-in-china
#5
Qin-Lan Chen, Xiao-Ying Zhao, Xiao-Mi Wang, Na Lv, Ling-Ling Zhu, Hui-Min Xu, Quan Zhou
The authors retrospectively analyzed the pattern and characteristics of non-laboratory-based adverse drug reactions (ADRs) induced by intravenous radiocontrast agents in a large-scale hospital in China during 2014-2015. There were 314 ADR cases among 118,208 patients receiving enhanced CT or MRI examinations. The frequency of moderate/severe ADRs defined by Chinese Society of Radiology (ie, severe vomiting, systematic urticaria, facial swelling, dyspnea, vasovagal reaction, laryngeal edema, seizure, trembling, convulsions, unconsciousness, shock, death, and other unexpected adverse reactions) was rare (0...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28482371/guidelines-for-the-treatment-of-head-injury-in-adults
#6
R Firsching, E Rickels, U M Mauer, O W Sakowitz, M Messing-Jünger, K Engelhard, P Schwenkreis, J Linn, K Schwerdtfeger
The workshop of scientific medical faculties (Arbeitsgemeinschaft wissenschaftlicher medizinischer Fakultäten [AWMF]) of Germany has asked societies of specific medical disciplines to jointly publish guidelines on the treatment of diseases and injuries. On behalf of the Deutsche Gesellschaft für Neurochirurgie, its commission on guidelines initiated an interdisciplinary approach to publish guidelines on the treatment of head injury in adults. These guidelines were published in German by the AWMF in late 2015...
May 8, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28473333/the-clinical-and-cost-effectiveness-of-a-virtual-fracture-clinic-service-an-interrupted-time-series-analysis-and-before-and-after-comparison
#7
A McKirdy, A M Imbuldeniya
OBJECTIVES: To assess the clinical and cost-effectiveness of a virtual fracture clinic (VFC) model, and supplement the literature regarding this service as recommended by The National Institute for Health and Care Excellence (NICE) and the British Orthopaedic Association (BOA). METHODS: This was a retrospective study including all patients (17 116) referred to fracture clinics in a London District General Hospital from May 2013 to April 2016, using hospital-level data...
May 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28472291/antibiotic-stewardship-in-small-hospitals-barriers-and-potential-solutions
#8
Edward Stenehjem, David Y Hyun, Ed Septimus, Kalvin C Yu, Marc Meyer, Deepa Raj, Arjun Srinivasan
Antibiotic stewardship programs (ASPs) improve antibiotic prescribing. 73% of United States (US) hospitals have < 200 beds. Small hospitals (< 200 beds) have similar rates of antibiotic prescribing compared to large hospitals but the majority of small hospitals lack ASPs that satisfy the Centers for Disease Control and Prevention's (CDC) core elements. All hospitals, regardless of size, are now required to have ASPs by The Joint Commission and the Centers for Medicare and Medicaid Services has proposed a similar requirement...
May 2, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28469529/protected-areas-in-the-world-s-ecoregions-how-well-connected-are-they
#9
Santiago Saura, Lucy Bastin, Luca Battistella, Andrea Mandrici, Grégoire Dubois
Protected areas (PAs) are the main instrument for biodiversity conservation, which has triggered the development of numerous indicators and assessments on their coverage, performance and efficiency. The connectivity of the PA networks at a global scale has however been much less explored; previous studies have either focused on particular regions of the world or have only considered some types of PAs. Here we present, and globally assess, ProtConn, an indicator of PA connectivity that (i) quantifies the percentage of a study region covered by protected connected lands, (ii) can be partitioned in several components depicting different categories of land (unprotected, protected or transboundary) through which movement between protected locations may occur, (iii) is easy to communicate, to compare with PA coverage and to use in the assessment of global targets for PA systems...
May 2017: Ecological Indicators
https://www.readbyqxmd.com/read/28456413/deaths-amenable-to-health-care-converging-trends-in-the-eu
#10
REVIEW
Anke Weber, Marie Clerc
Amenable mortality has been recently included in the joint monitoring tool by the European Commission and Member States to assess a country's health system performance. Amenable deaths are premature deaths, which should not have occurred at this stage in the light of timely and effective health care. This paper recalculated annual amenable mortality rates for 28EU countries and the EU for the period 1994-2013 based on the recently published list of deaths amenable to health care by Eurostat. Thereby, it offers a consistent calculation of amenable mortality across European Member States and provides time series data on amenable mortality...
April 1, 2017: Health Policy
https://www.readbyqxmd.com/read/28450954/downregulation-of-a-novel-long-non-coding-rna-loc389332-is-associated-with-poor-prognosis-and-tumor-progression-in-clear-cell-renal-cell-carcinoma
#11
Ping Jin, Juan Wang, Yu Liu
It has been demonstrated that various long non-coding RNAs (lncRNAs) may have key roles in various types of cancer. Clear cell renal cell carcinoma (ccRCC) is the most common subtype of all RCCs, accounting for 70-80% of all cases. The present study identified a novel lncRNA and investigated its clinical significance and physiological function in ccRCC. The expression pattern of the novel lncRNA LOC389332 in 30 ccRCC tissue samples was examined using reverse-transcription quantitative polymerase chain reaction...
March 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28447899/the-american-college-of-surgeons-minimum-standards-for-hospitals-and-the-provision-of-high-quality-laboratory-services
#12
James R Wright
CONTEXT: - The first major project of the American College of Surgeons (Chicago, Illinois), founded in 1913, was implementing Minimum Standards for Hospitals. The 1918 standard (1) established medical staff organizations in hospitals; (2) restricted membership to licensed practitioners in good standing; (3) mandated that the medical staff work with hospital administration to develop and adopt regulations and policies governing their professional work; (4) required standardized, accessible medical records; and (5) required availability of diagnostic and therapeutic facilities...
May 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/28437523/emergency-department-query-for-patient-centered-approaches-to-sexual-orientation-and-gender-identity-the-equality-study
#13
Adil H Haider, Eric B Schneider, Lisa M Kodadek, Rachel R Adler, Anju Ranjit, Maya Torain, Ryan Y Shields, Claire Snyder, Jeremiah D Schuur, Laura Vail, Danielle German, Susan Peterson, Brandyn D Lau
Importance: The Institute of Medicine and The Joint Commission recommend routine documentation of patients' sexual orientation in health care settings. Currently, very few health care systems collect these data since patient preferences and health care professionals' support regarding collection of data about patient sexual orientation are unknown. Objective: To identify the optimal patient-centered approach to collect sexual orientation data in the emergency department (ED) in the Emergency Department Query for Patient-Centered Approaches to Sexual Orientation and Gender Identity study...
April 24, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28437132/home-enteral-nutrition-updates-trends-and-challenges
#14
Karen Martin, Gabriela Gardner
The true prevalence of home enteral nutrition (HEN) utilization is unclear and requires further study. HEN therapy has remained virtually unchanged for several decades. However, new trends in HEN are evolving; enteral nutrition is undergoing changes ranging from enteral feeding devices, ingredients used, practice innovations, and challenges with reimbursement. A 2006 Joint Commission call to action that reported 2 sentinel events related to misconnections set things into motion for the transition of enteral device connectors to become specific for enteral nutrition use, which will affect patients who receive HEN...
April 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28434457/system-changes-to-implement-the-joint-commission-tobacco-treatment-tob-performance-measures-for-improving-the-treatment-of-tobacco-use-among-hospitalized-patients
#15
Donna Shelley, Keith S Goldfeld, Hannah Park, Ana Mola, Ryan Sullivan, Jonathan Austrian
BACKGROUND: In 2012 The Joint Commission implemented new Tobacco Treatment (TOB) performance measures for hospitals. A study evaluated the impact of a hospital-based electronic health record (EHR) intervention on adherence to the revised TOB measures. METHODS: The study was conducted in two acute care hospitals in New York City. Data abstracted from the EHR were analyzed retrospectively from 4,871 smokers discharged between December 2012 and March 2015 to evaluate the impact of two interventions: an order set to prompt clinicians to prescribe pharmacotherapy and a nurse-delivered counseling module that automatically populated the nursing care plan for all smokers...
May 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28432853/an-evidence-based-approach-to-reducing-cardiac-telemetry-alarm-fatigue
#16
Ekta Srinivasa, Jaspreet Mankoo, Charles Kerr
BACKGROUND: It is estimated that between 80% and 99% of alarms in the clinical areas are in actionable alarms (Gross, Dahl, & Nielson). Alarm management is one of the Joint Commission's National Patient Safety Goals (2014) because sentinel events have directly been linked to the devices generating these alarms. PURPOSE: At an acute care facility in Boston, a multidisciplinary team consisting of Nursing, Biomedical Engineers, Patient Safety and Providers was formed to conduct a pilot study on the state of telemetry alarms on a surgical floor...
April 22, 2017: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/28431874/regional-disparities-in-the-quality-of-stroke-care
#17
Seth Seabury, Katalin Bognar, Yaping Xu, Caroline Huber, S Renee Commerford, Darren Tayama
BACKGROUND AND PURPOSE: There is widespread geographic variation in healthcare quality, but we often lack clear strategies for improving quality in underserved areas. This study characterized geographic disparities in stroke care quality to assess whether improved access to neurological services has the potential to bridge the care quality gap, particularly in terms of alteplase (rt-PA) administration. METHODS: This was a retrospective study using quality performance data from the 2015 Hospital Compare database linked to information on certification status from the Joint Commission and information on local access to neurological services from the Area Health Resources File...
March 19, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28412084/coding-update-of-the-smfm-definition-of-low%C3%A2-risk%C3%A2-for-cesarean-delivery-from-icd-9-cm-to%C3%A2-icd-10-cm
#18
Joanne Armstrong, Patricia McDermott, George R Saade, Sindhu K Srinivas
In 2015, the Society for Maternal-Fetal Medicine developed a low risk for cesarean delivery definition based on administrative claims-based diagnosis codes described by the International Classification of Diseases, Ninth Revision, Clinical Modification. The Society for Maternal-Fetal Medicine definition is a clinical enrichment of 2 available measures from the Joint Commission and the Agency for Healthcare Research and Quality measures. The Society for Maternal-Fetal Medicine measure excludes diagnosis codes that represent clinically relevant risk factors that are absolute or relative contraindications to vaginal birth while retaining diagnosis codes such as labor disorders that are discretionary risk factors for cesarean delivery...
April 13, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28410834/wearing-id-badges-in-the-operating-room-environment-is-reconsideration-warranted
#19
Matthew H Hogue, Kris P Heilmann, John J Callaghan
BACKGROUND: Surgical site infection and nosocomial infections in general have appropriately undergone increased scrutiny over the last decade. Numerous studies have documented pathogenic bacterial contamination of personal items such as cell phones, pagers, ties, and pens in the hospital setting. It is our understanding that Joint Commission on Accreditation of Healthcare Organizations requires all personnel to wear an identification badge at all times, which includes the operating room environment...
February 3, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28400963/psychiatry-and-the-geriatric-syndromes-creating-constructive-interfaces
#20
EDITORIAL
Simon Thacker, Mike Skelton, Rowan Harwood
Integrating mental and physical healthcare is difficult to achieve because of professional and organisational barriers. Psychiatrists recognise the problems resulting from fragmentation of services and want continuity of care for patients, but commissioning and service structures perpetuate these problems. One way forward may be to follow the syndromic model employed by geriatricians as a means of avoiding over-emphasis on diagnosis above the pragmatics of implementing multi-component, coordinated care. Commissioners need to be made aware of the overlap and complementarity of skills possessed by old age psychiatry and geriatric medicine to create joint services for people vulnerable to dementia and delirium...
April 2017: BJPsych Bulletin
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