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hospital at home

Iulia D Ursan, Jerry A Krishnan, A Simon Pickard, Elizabeth Calhoun, Robert DiDomenico, Valentin Prieto-Centurion, Jamie B Sullivan, Lauren Valentino, Mark V Williams, Min Joo
Limited socioeconomic resources contribute to high readmission rates at minority serving institutions (MSIs). A better understanding of patient-level factors and need for patient navigators could inform approaches to enhance care transitions tailored to these vulnerable patient populations. We sought to understand the perspectives of patients and their caregivers about hospital to home transitions from an MSI, as well as their attitudes about patient navigators to facilitate care transitions. We conducted qualitative research using focus groups (FGs)-five disease-specific patient FGs and two caregiver FGs, including 23 patients and 10 caregivers...
2016: Journal of Health Care for the Poor and Underserved
Andrea Gruneir, Lauren E Griffith, Kathryn Fisher, Dilzayn Panjwani, Sima Gandhi, Li Sheng, Chris Patterson, Amiram Gafni, Jenny Ploeg, Maureen Markle-Reid
OBJECTIVE: To characterize comorbid chronic conditions, describe health services use, and estimate health care costs among community-dwelling older adults with prior stroke. METHODS: This is a retrospective cohort study using administrative data from Ontario, Canada. We identified all community-dwelling individuals aged 66 and over on April 1, 2008 (baseline), who had experienced a stroke at least 6 months prior. We estimated the prevalence of 14 comorbid conditions at baseline; we captured all physician visits, emergency department visits, hospital admissions, home care contacts, and associated costs over 5 years stratifying by number of comorbid conditions...
October 19, 2016: Neurology
Diane VonBehren, Molly M Killion, Carol Burke, Betsy Finkelmeier, Brigit Zamora
Three teams of perinatal expert nurses participated in planning and designing a new maternity unit, operationalizing the move to the new space, and evaluating care processes and workflows after the move. The hospitals involved were University of California, San Francisco Benioff Children's Hospital, Prentice Women's Hospital of Northwestern Memorial Healthcare in Chicago, IL, and Florida Hospital Orlando, Florida Hospital for Women. Although each team discussed specific details and lessons learned, there is remarkable consistency among the experiences of these teams and with the discussion of the process by the team at Mercy Hospital St...
November 2016: MCN. the American Journal of Maternal Child Nursing
Wednesday Marie A Sevilla, Barbara McElhanon
Enteral nutrition is delivered via the gastrointestinal tract when oral intake is not sufficient to maintain nutrition status. There is evidence that long-term home enteral nutrition (HEN) can be advantageous to pediatric patients by improving quality of life and function. Data from pediatric patients receiving either nasogastric tube or gastrostomy tube feeds indicate good outcomes in terms of maintaining and improving nutrition status as evidenced by anthropometric measurements. As the number of pediatric patients requiring HEN increases, development of an effective program to allow smooth transition to the home is necessary...
October 18, 2016: Nutrition in Clinical Practice
Mari-Lynn Drainoni, Elisa A Koppelman, James A Feldman, Alexander Y Walley, Patricia M Mitchell, Jacqueline Ellison, Edward Bernstein
BACKGROUND: The increase in opioid overdose deaths has become a national public health crisis. Naloxone is an important tool in opioid overdose prevention. Distribution of nasal naloxone has been found to be a feasible, and effective intervention in community settings and may have potential high applicability in the emergency department, which is often the initial point of care for persons at high risk of overdose. One safety net hospital introduced an innovative policy to offer take-home nasal naloxone via a standing order to ensure distribution to patients at risk for overdose...
October 18, 2016: BMC Research Notes
Rebecca DeVries, David Kriebel, Susan Sama
BACKGROUND: Exacerbations of chronic obstructive pulmonary disease (COPD) contribute greatly to increased morbidity, mortality and diminished quality of life. Recent studies report moderately strong positive associations between exposures to several air pollutants and COPD-related emergency department (ED) visits and hospital admissions (HA). Studies that use clinically defined exacerbations rather than counting ED visits and HA may be more sensitive to environmental triggers like air pollution, but very few such studies exist...
October 18, 2016: Environmental Health: a Global Access Science Source
Carmel T Collins, Jennifer Gillis, Andrew J McPhee, Hiroki Suganuma, Maria Makrides
BACKGROUND: Preterm infants start milk feeds by gavage tube. As they mature, sucking feeds are gradually introduced. Women who choose to breast feed their preterm infant are not always able to be in hospital with their baby and need an alternative approach to feeding. Most commonly, milk (expressed breast milk or formula) is given by bottle. Whether using bottles during establishment of breast feeds is detrimental to breast feeding success is a topic of ongoing debate. OBJECTIVES: To identify the effects of avoidance of bottle feeds during establishment of breast feeding on the likelihood of successful breast feeding, and to assess the safety of alternatives to bottle feeds...
October 19, 2016: Cochrane Database of Systematic Reviews
Lei Cheng, Yuxia Zhang, Ying Gu, Chunmei Lu, Qing Liu, Hao Yuan
BACKGROUND: Supporting and involving the families of pre-term infants' in the discharge process provides them with confidence in caring for their infants at home. In an effort to facilitate families' readiness for discharge, the neonatal unit (NU) of the Children's Hospital of Fudan University has implemented a best practice project. OBJECTIVES: The aim of this project was to integrate the best available evidence on facilitating families' readiness for discharge into the nursing practice of the Children's Hospital of Fudan University...
September 2016: JBI Database of Systematic Reviews and Implementation Reports
Cedric Mabire, Andrew Dwyer, Antoine Garnier, Joanie Pellet
BACKGROUND: Inadequate discharge planning for the growing elderly population poses significant challenges for health services. Effective discharge planning interventions have been examined in several studies, but little information is available on nursing's role or the specific components of these interventions. Despite the research published on the importance of discharge planning, the impact on patient's health outcomes still needs to be proven in practice. OBJECTIVES: To determine the best available evidence on the effectiveness of discharge planning interventions involving at least one nurse on health-related outcomes for elderly inpatients discharged home and to assess the relative impact of individual components of discharge planning interventions...
September 2016: JBI Database of Systematic Reviews and Implementation Reports
Tone Kristin Bergersen, Elisabeth Storheim, Stina Gundersen, Linn Kleven, Maria Johnson, Leiv Sandvik, Kari Jorunn Kvaerner, Nils-Otto Ørjasæter
OBJECTIVE: The aim of this study was to test the efficacy of a wound support network model between the primary home care service and the hospital. The impact on wound healing rate, cost benefit, and transfer of knowledge was investigated. INTERVENTION: The intervention group was exposed to a wound support network (n = 32), and the control group continued standard organization of treatment (n = 21). DESIGN: Nonrandomized controlled study; observations were made before (baseline) and after the implementation of the intervention (12 weeks)...
November 2016: Advances in Skin & Wound Care
Amos Grünebaum, Laurence B McCullough, Birgit Arabin, Joachim Dudenhausen, Brooke Orosz, Frank A Chervenak
INTRODUCTION: The objective of this study was to evaluate the underlying causes of neonatal mortality (NNM) in midwife-attended home births and compare them to hospital births attended by a midwife or a physician in the United States (US). METHODS: A retrospective cohort study of the Centers for Disease Control (CDC) linked birth/infant death data set (linked files) for 2008 through 2012 of singleton, term (≥37 weeks) births and normal newborn weights (≥2500 grams)...
October 18, 2016: Journal of Perinatal Medicine
John W Pickering, Jaimi H Greenslade, Louise Cullen, Dylan Flaws, William Parsonage, Sally Aldous, Peter George, Andrew Worster, Peter A Kavsak, Martin P Than
BACKGROUND: -The European Society of Cardiology (ESC) new guidelines to rule-in and rule-out acute myocardial infarction (AMI) in the emergency department (ED) include a rapid assessment algorithm based on high-sensitivity cardiac troponin and sampling at zero and one hour. ED physicians require very high sensitivity to confidently rule-out AMI, while cardiologists aim to minimise false positive results. METHODS: -High-sensitivity troponin I (hs-cTnI) and T (hs-cTnT) assays were used to measure troponin concentrations in patients presenting with chest-pain symptoms and being investigated for possible acute coronary syndrome at hospitals in New Zealand, Australia and Canada...
October 17, 2016: Circulation
Michael L James, Margueritte Cox, Ying Xian, Eric E Smith, Deepak L Bhatt, Phillip J Schulte, Adrian Hernandez, Gregg C Fonarow, Lee H Schwamm
BACKGROUND: Compared to ischemic stroke, sex differences in response to intracerebral hemorrhage (ICH) are largely unexplored, and their potential interactions with patient age have not been examined. This study hypothesized that risk for poor outcome is greater in women with increasing age. METHODS AND RESULTS: The Get With The Guidelines(®)-Stroke database was used to assess differences between men and women with ICH. Data from 192,826 ICH patients admitted from January 1, 2009 through March 31, 2014 to 1,728 fully participating sites were analyzed using logistic regression to test interactions between age/sex and outcome...
October 18, 2016: Journal of Women's Health
Juan Herrera-Tejedor
The preferences of the very elderly are not taken into account in healthcare planning. For this reason, a medical literature review was performed in order to fill the gap in appropriate information on this issue. The majority of them think that they receive good healthcare. They favour building a trusting relationship, with the physician handling their decision-making. They also maximise their quality of life at the expense of quantity, and give great importance to comfort and safety. Most of them express the wish to be cared for and die at home...
October 14, 2016: Revista Española de Geriatría y Gerontología
Alexander Y Li, Tej D Azad, Anand Veeravagu, Inderpreet Bhatti, Amy Li, Tyler Cole, Atman Desai, John K Ratliff
STUDY DESIGN: Propensity score matched retrospective study using a nationwide longitudinal database. OBJECTIVE: To quantify the longitudinal economic impact of venous thromboembolism (VTE) complications in spinal fusion patients. SUMMARY OF BACKGROUND DATA: VTE is a rare and serious complication that may occur after spine surgery. The long-term socioeconomic impact understanding of these events has been limited by small sample sizes and a lack of longitudinal follow-up...
October 12, 2016: Clinical Spine Surgery
Derenda Lovelace, Diane Hancock, Sabrina S Hughes, Phyllis R Wyche, Claire Jenkins, Cindy Logan
BACKGROUND: In 2011, the Hunter Holmes McGuire Veterans Administration Medical Center (VAMC) in Richmond, VA, had a cumulative readmission rate and emergency department (ED) revisits for discharged Veterans of 1 in 5. In 2012, a transitional care program (TCP) was implemented to improve care coordination and outcomes among Veterans, with an emphasis on geriatric patients with chronic disease. This TCP was created with an interdisciplinary approach using intensive case management interventions, with a goal of reducing Veteran ED and hospital revisits by 30%...
November 2016: Professional Case Management
Karen Thomson, Sophie R Pestieau, Janish J Patel, Heather Gordish-Dressman, Ariana Mirzada, Zeev N Kain, Matthew E Oetgen
BACKGROUND: The Perioperative Surgical Home (PSH) is a patient-centered, team-based approach that aims to improve the value of perioperative care. We implemented a PSH for patients with adolescent idiopathic scoliosis who were undergoing posterior spinal fusion at Children's National Health System. We hypothesized that this PSH would improve patient surgical outcomes and reduce hospital length of stay (LOS). METHODS: A multidisciplinary group created evidence-based protocols for the preoperative, operative, postoperative, and postdischarge care of this patient population...
October 3, 2016: Anesthesia and Analgesia
Ronelle E Welton, David J Williams, Danny Liew
BACKGROUND: This study provides the first contemporary epidemiological insight into venomous injuries based on demographics and geography in Australia in the timeframe 2000-2013. METHODS: Analysis of national hospitalisation and mortality data to examine the incidence of injury and death due to envenoming in Australia. Rates were calculated using the intercensal population for all Australian age groups. RESULTS: Over the study period, deaths were due to an anaphylactic event (0...
October 17, 2016: Internal Medicine Journal
Adam C Raikes, Sydney Y Schaefer
STUDY OBJECTIVES: A number of subjective and objective studies provide compelling evidence of chronic postconcussion changes in sleep, yet very little is known about the acute effects of concussion on sleep quality and quantity. Therefore, the purpose of this prospective pilot study was to use actigraphy to examine the changes in sleep quality and quantity acutely following concussion at home rather than in a hospital or sleep laboratory. METHODS: Seventeen young adults (7 with acute concussion, 10 controls) were recruited for this study...
October 10, 2016: Sleep
Annelies Colliers, Roy Remmen, Marie-Luise Streffer, Barbara Michiels, Stefaan Bartholomeeusen, Koenraad G Monsieurs, Jef Goris, Samuel Coenen, Veronique Verhoeven, Hilde Philips
BACKGROUND: The implementation of general practitioner cooperatives (GPC) for out-of-hours (OOH) primary care, raises the question if the location of a GPC adjacent to a hospital reduces the OOH caseload of the emergency department (ED). METHODS: Two natural experiments were used in this before-after study, the effect of the implementation of two GPCs in two different regions on the out-of-hours caseload of the local EDs was compared. One GPC was located adjacent to the ED of a general hospital, the other was not...
October 17, 2016: Acta Clinica Belgica
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