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https://www.readbyqxmd.com/read/29222625/using-patient-feedback-to-optimize-the-design-of-a-certolizumab-pegol-electromechanical-self-injection-device-insights-from-human-factors-studies
#1
Barbara Domańska, Oliver Stumpp, Steven Poon, Serkan Oray, Irina Mountian, Clovis Pichon
INTRODUCTION: We incorporated patient feedback from human factors studies (HFS) in the patient-centric design and validation of ava®, an electromechanical device (e-Device) for self-injecting the anti-tumor necrosis factor certolizumab pegol (CZP). METHODS: Healthcare professionals, caregivers, healthy volunteers, and patients with rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, or Crohn's disease participated in 11 formative HFS to optimize the e-Device design through intended user feedback; nine studies involved simulated injections...
December 8, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/29201634/innovative-chest-physiotherapy-techniques-the-metaneb%C3%A2-system-in-the-intubated-child-with-extensive-burns
#2
Alexandra Ferguson, Sarah Wright
Introduction: The Metaneb® is a new generation Intrapulmonary Percussive Ventilation device utilised by the physiotherapist to assist airway clearance by providing calibrated oscillations during inspiration up to 3.8Hz. Predominantly used in the adult chronic respiratory patient, with anecdotal evidence in intubated patients, it was also proven to be safe in a paediatric lung model lab study. This case report outlines the first use of the Metaneb® with an intubated child in Australia...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29189706/unplanned-extubations-in-intensive-care-unit-evidences-for-risk-factors-a-literature-review
#3
Chiara Cosentino, Mattia Fama, Chiara Foà, Giorgia Bromuri, Serena Giannini, Marco Saraceno, Angela Spagnoletta, Mbemo Tenkue, Elena Trevisi, Leopoldo Sarli
BACKGROUND AND AIM: Unplanned extubations (UE) are getting more and more relevant in Critical Care, becoming a quality and care safeness outcome. This happens because after an UE the patient can face some complications concerning the airway management, respiratory and hemodynamic problems, lengthen in the hospital stay and in the mechanical ventilation time.  The aim of this review is identify and classify the factors that could increase UE risk. METHODOLOGY: A systematic review of scientific articles was performed consulting the databases PubMed, Cinahl, Medline, EBSCOhost and Google Scholar...
November 30, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29176376/anticipated-and-unanticipated-difficult-airway-management
#4
Zeping Xu, Wuhua Ma, Douglas L Hester, Yandong Jiang
PURPOSE OF REVIEW: Management of difficult airway is far from optimal despite of continuous progress in science and technology. The purpose of this review is to summarize the current research in the field and bring readers up to date. RECENT FINDINGS: New technologies for intubation make providers more confident to handle difficult airways, but there is lack of evidence indicating the reduction in incidence of 'cannot intubate cannot ventilate (CICV)'. Optimization of mask ventilation should reduce the incidence of difficult mask ventilation but it is greatly underappreciated...
November 15, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29174776/management-of-surge-in-extracorporeal-membrane-oxygenation-transport
#5
Michael Salna, Scott Chicotka, Mauer Biscotti, Cara Agerstrand, Peter Liou, Mark Ginsburg, Roy Oommen, Joshua R Sonett, Daniel Brodie, Matthew Bacchetta
BACKGROUND: Transporting patients receiving extracorporeal membrane oxygenation (ECMO) support is safe and reliable with a dedicated program and established management protocols. As our program has grown, our teams have had to adapt to manage surges in transport volume while maintaining patient safety. We assessed the outcomes at peak use of our ECMO transport services during surges. METHODS: We conducted a single-center retrospective review of all patients transported to our institution while supported with ECMO from September 2008 to September 2016...
November 23, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29158645/evaluation-of-functional-outcome-of-pilon-fractures-managed-with-limited-internal-fixation-and-external-fixation-a-prospective-clinical-study
#6
Umesh Kumar Meena, Mahesh Chand Bansal, Prateek Behera, Rahul Upadhyay, Gyan Chand Gothwal
Introduction: The management of pilon fractures is controversial primarily due to the high rate of complications irrespective of the mode of treatment. Limited internal fixation with external fixation is associated with minimal soft tissue handling. This may reduce the chances of wound dehiscence and infection. This study was designed to evaluate the functional and clinical outcomes in patients treated with limited internal fixation combined with external fixation in pilon fractures. Material and methods: This study was conducted as a prospective clinical study on 56 skeletally mature patients with closed fractures with poor skin condition, and with open grade 1 and grade 2 distal tibial intra-articular fractures...
November 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29139101/-endobronchial-ultrasound-ebus-an-update-2017
#7
K Darwiche, F Özkan, C Wolters, S Eisenmann
Endobronchial Ultrasound (EBUS) with the two modalities curved and radial EBUS significantly improved the diagnostics in several pulmonary diseases. The examination and staging of mediastinal and hilar lymph nodes in patients with known or suspected lung malignancy as well as the evaluation of unknown pulmonary or mediastinal lesions can be achieved with minimal invasive means when using EBUS. More invasive surgical procedures for diagnostic purposes can be omitted. The diagnostic yield also increases when EBUS is applied in sarcoidosis or mediastinal lymph node tuberculosis but only to some extend in case of lymphoma...
November 2017: Pneumologie
https://www.readbyqxmd.com/read/29131034/clinical-trial-and-registry-data
#8
Melinda Gooderham, Kim Papp
Physicians rely on safety and efficacy data from pivotal trials to guide treatment decisions and manage patients. Even with robust clinical trial data, there remain questions regarding rare safety events and generalizability. Registries complement clinical trials. By evaluating effectiveness and safety in broad patient populations and often providing longer term or larger numbers of patients or both compared to clinical trials, registries consolidate and may extend the safety observations derived from pivotal trials...
2018: Current Problems in Dermatology
https://www.readbyqxmd.com/read/29122975/efficiency-and-thoroughness-trade-offs-in-high-volume-organisational-routines-an-ethnographic-study-of-prescribing-safety-in-primary-care
#9
Suzanne Grant, Bruce Guthrie
BACKGROUND: Prescribing is a high-volume primary care routine where both speed and attention to detail are required. One approach to examining how organisations approach quality and safety in the face of high workloads is Hollnagel's Efficiency and Thoroughness Trade-Off (ETTO). Hollnagel argues that safety is aligned with thoroughness and that a choice is required between efficiency and thoroughness as it is not usually possible to maximise both. This study aimed to ethnographically examine the efficiency and thoroughness trade-offs made by different UK general practices in the achievement of prescribing safety...
November 9, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29106668/usim-a-new-device-and-app-for-case-specific-intraoperative-ultrasound-simulation-and-rehearsal-in-neurosurgery-a-preliminary-study
#10
Alessandro Perin, Francesco Ugo Prada, Michela Moraldo, Andrea Schiappacasse, Tommaso Francesco Galbiati, Enrico Gambatesa, Piergiorgio d'Orio, Nicole Irene Riker, Curzio Basso, Matteo Santoro, Torstein Ragnar Meling, Karl Schaller, Francesco DiMeco
BACKGROUND: Intraoperative ultrasound (iUS) is an excellent aid for neurosurgeons to perform better and safer operations thanks to real time, continuous, and high-quality intraoperative visualization. OBJECTIVE: To develop an innovative training method to teach how to perform iUS in neurosurgery. METHODS: Patients undergoing surgery for different brain or spine lesions were iUS scanned (before opening the dura) in order to arrange a collection of 3-dimensional, US images; this set of data was matched and paired to preoperatively acquired magnetic resonance images in order to create a library of neurosurgical cases to be studied offline for training and rehearsal purposes...
June 29, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29096710/putting-research-in-place-an-innovative-approach-to-providing-contextualized-evidence-synthesis-for-decision-makers
#11
Stephen Bornstein, Rochelle Baker, Pablo Navarro, Sarah Mackey, David Speed, Melissa Sullivan
BACKGROUND: The Contextualized Health Research Synthesis Program (CHRSP), developed in 2007 by the Newfoundland and Labrador Centre for Applied Health Research, produces contextualized knowledge syntheses for health-system decision makers. The program provides timely, relevant, and easy-to-understand scientific evidence; optimizes evidence uptake; and, most importantly, attunes research questions and evidence to the specific context in which knowledge users must apply the findings. METHODS: As an integrated knowledge translation (KT) method, CHRSP: Involves intensive partnerships with senior healthcare decision makers who propose priority research topics and participate on research teams; Considers local context both in framing the research question and in reporting the findings; Makes economical use of resources by utilizing a limited number of staff; Uses a combination of external and local experts; and Works quickly by synthesizing high-level systematic review evidence rather than primary studies...
November 2, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/29092070/radiopaque-gelified-ethanol-application-in-lumbar-intervertebral-soft-disc-herniations-croatian-multicentric-study
#12
Karlo Houra, Darko Perovic, Ivan Rados, Drazen Kvesic
Objective: Minimally invasive percutaneous spinal procedures are popular in trying to reduce spinal pain. The aim of this paper is to evaluate the safety of intervertebral disc chemonucleolysis and to report the effectiveness of a percutaneous, minimally invasive treatment for contained herniated intervertebral discs in the lumbar spine using the recently marketed radiopaque gelified ethanol. Methods: Pain relief before and after the procedure was self-evaluated by each patient using a verbal numeric scale (VNS) ranging from 0 to 10...
October 28, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29080986/use-of-the-t%C3%A3-bingen-splint-for-the-initial-management-of-severely-dysplastic-and-unstable-hips-in-newborns-with-ddh-an-alternative-to-fettweis-plaster-and-pavlik-harness
#13
Hannes Kubo, Hakan Pilge, Kristina Weimann-Stahlschmidt, Karoline Stefanovska, Bettina Westhoff, Ruediger Krauspe
AIM: Hip dysplasia is one of the most common skeletal disorders. As a late consequence 20-25% of the patients are at risk to develop secondary osteoarthritis and may require total hip replacement early in life. The treatment principles of hip dislocation are (1) concentric reposition, (2) retention, i.e., plaster in human post or Pavlik harness and (3) maturation in abduction flexion orthesis. The Tübingen splint was introduced as a further development of abduction devices for the treatment of (residual) hip dysplasia with stable hips...
October 28, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29076113/a-knowledge-modeling-approach-to-integrate-multiple-clinical-practice-guidelines-to-provide-evidence-based-clinical-decision-support-for-managing-comorbid-conditions
#14
Samina Abidi
Clinical management of comorbidities is a challenge, especially in a clinical decision support setting, as it requires the safe and efficient reconciliation of multiple disease-specific clinical procedures to formulate a comorbid therapeutic plan that is both effective and safe for the patient. In this paper we pursue the integration of multiple disease-specific Clinical Practice Guidelines (CPG) in order to manage co-morbidities within a computerized Clinical Decision Support System (CDSS). We present a CPG integration framework-termed as COMET (Comorbidity Ontological Modeling & ExecuTion) that manifests a knowledge management approach to model, computerize and integrate multiple CPG to yield a comorbid CPG knowledge model that upon execution can provide evidence-based recommendations for handling comorbid patients...
October 26, 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/29061869/infection-prevention-and-control-in-pediatric-ambulatory-settings
#15
REVIEW
Mobeen H Rathore, Mary Anne Jackson
Since the American Academy of Pediatrics published its statement titled "Infection Prevention and Control in Pediatric Ambulatory Settings" in 2007, there have been significant changes that prompted this updated statement. Infection prevention and control is an integral part of pediatric practice in ambulatory medical settings as well as in hospitals. Infection prevention and control practices should begin at the time the ambulatory visit is scheduled. All health care personnel should be educated regarding the routes of transmission and techniques used to prevent the transmission of infectious agents...
November 2017: Pediatrics
https://www.readbyqxmd.com/read/29049891/implementation-of-a-safe-patient-handling-program-in-a-multihospital-health-system-from-inception-to-sustainability-successes-over-8-years-and-ongoing-challenges
#16
(no author information available yet)
No abstract text is available yet for this article.
November 2017: Workplace Health & Safety
https://www.readbyqxmd.com/read/29037434/clinical-evaluation-of-the-feline-neurologic-patient
#17
REVIEW
Amanda R Taylor, Sharon C Kerwin
Efficient, gentle, and safe handling of cats can result in complete neurologic evaluations and accurate neuroanatomic localizations. The clinic environment should facilitate the examination by providing a quiet and secure environment for the cat. When direct examination of a cat is not possible, the practitioner should fully use indirect methods of examination and video recordings of cat behavior or clinical signs. Direct examination of a cat should proceed in a logical order, where the most useful tests are performed early on in the examination...
October 13, 2017: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/29036857/outcomes-of-safe-patient-handling-and-mobilization-programs-a-meta-analysis
#18
Erin Teeple, Jamie E Collins, Swastina Shrestha, Jack T Dennerlein, Elena Losina, Jeffrey N Katz
BACKGROUND: Variability in patient care settings and the range of patient handling tasks present challenges in developing and evaluating safe patient handling and mobilization (SPHM) programs. OBJECTIVE: We performed a systematic meta-analysis of SPHM program evaluations. METHODS: Systematic literature review identified published SPHM program evaluations. Injury Rate Ratios (IRR), pre- to post-intervention, were used to estimate intervention effects and to examine the influence of patient care level, program components, and follow-up time using meta-regression...
2017: Work: a Journal of Prevention, Assessment, and Rehabilitation
https://www.readbyqxmd.com/read/29018871/-pacemaker-defibrillator-and-co-perioperative-handling-of-cardiac-implantable-electronic-devices
#19
K Ott, H Pressl, M Schramm, A Wutzl
The number of patients treated with cardiac implantable electronic devices (CIED) is continously increasing. Knowledge of the medical indications and technical mode of functioning of these devices is a basic prerequisite for the safe perioperative care of this patient cohort. The CIEDs are subjected to a multitude of disturbing influences in the perioperative setting. This can result in potentially dangerous complications, such as exit block and oversensing. The safe performance of interventions is possible as long as some basic rules are followed...
October 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28982645/workarounds-emerging-from-electronic-health-record-system-usage-consequences-for-patient-safety-effectiveness-of-care-and-efficiency-of-care
#20
Vincent Blijleven, Kitty Koelemeijer, Marijntje Wetzels, Monique Jaspers
BACKGROUND: Health care providers resort to informal temporary practices known as workarounds for handling exceptions to normal workflow unintendedly imposed by electronic health record systems (EHRs). Although workarounds may seem favorable at first sight, they are generally suboptimal and may jeopardize patient safety, effectiveness of care, and efficiency of care. OBJECTIVE: Research into the scope and impact of EHR workarounds on patient care processes is scarce...
October 5, 2017: JMIR Human Factors
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