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https://www.readbyqxmd.com/read/28817503/interprovider-communication-using-a-scheduled-provider-alert-response-communication-system-in-3-inpatient-neurology-units
#1
James E Siegler, Dan Finegan, Scott E Kasner, Raymond S Price
BACKGROUND: Nonemergent communications between nursing staff and residents often occur randomly throughout the workday at teaching institutions, resulting in inefficiency and interruptions of scheduled resident educational conferences or periods of overnight rest. OBJECTIVE: The aim of this study was to determine whether a quality improvement communication strategy can reduce interruptive notifications during scheduled resident didactic sessions. METHODS: We conducted a prospective, mixed-methods trial of a communication strategy between nurses and residents in 3 neurology units of an academic institution...
August 16, 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28817376/association-between-hospice-spending-on-patient-care-and-rates-of-hospitalization-and-medicare-expenditures-of-hospice-enrollees
#2
Melissa D Aldridge, Andrew J Epstein, Abraham A Brody, Eric J Lee, R Sean Morrison, Elizabeth H Bradley
BACKGROUND: Care at the end of life is increasingly fragmented and is characterized by multiple hospitalizations, even among patients enrolled with hospice. OBJECTIVE: To determine whether hospice spending on direct patient care (including the cost of home visits, drugs, equipment, and counseling) is associated with hospital utilization and Medicare expenditures of hospice enrollees. DESIGN: Longitudinal, observational cohort study (2008-2010)...
August 17, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28817366/trajectory-of-dyspnea-and-respiratory-distress-among-patients-in-the-last-month-of-life
#3
Margaret L Campbell, Jason M Kiernan, John Strandmark, Hossein N Yarandi
BACKGROUND: The trajectory of dyspnea has been reported among patients approaching the end of life. However, patients near death have been dropped from longitudinal studies or excluded altogether because of an inability to self-report; proxy estimates have been reported. It is not known whether dyspnea or respiratory distress remains stable, escalates, or abates as patients reach last days. OBJECTIVE: Determine trajectory of dyspnea (self-reported) and respiratory distress (observed) among patients who were approaching death...
August 17, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28817180/preventable-and-mitigable-adverse-events-in-cancer-care-measuring-risk-and-harm-across-the-continuum
#4
Allison Lipitz-Snyderman, David Pfister, David Classen, Coral L Atoria, Aileen Killen, Andrew S Epstein, Christopher Anderson, Elizabeth Fortier, Saul N Weingart
BACKGROUND: Patient safety is a critical concern in clinical oncology, but the ability to measure adverse events (AEs) across cancer care is limited by a narrow focus on treatment-related toxicities. The objective of this study was to assess the nature and extent of AEs among cancer patients across inpatient and outpatient settings. METHODS: This was a retrospective cohort study of 400 adult patients selected by stratified random sampling who had breast (n = 128), colorectal (n = 136), or lung cancer (n = 136) treated at a comprehensive cancer center in 2012...
August 17, 2017: Cancer
https://www.readbyqxmd.com/read/28816806/autologous-blood-transfusion-for-postpartum-hemorrhage
#5
Julia A Greenawalt, Denise Zernell
Postpartum hemorrhage (PPH) is a leading contributor to maternal morbidity and mortality in the United States and globally. Although the rate of PPH is generally decreasing nationally, severity of PPH appears to be increasing, potentially related to the various comorbidities associated with women of childbearing age. There is increasing evidence of risks associated with allogeneic blood transfusion, which has historically been the classic therapeutic approach for treatment to PPH. Pregnant women are particularly susceptible to the implications of sensitization to red cell antigens, a common sequela to allogenic blood transfusion...
September 2017: MCN. the American Journal of Maternal Child Nursing
https://www.readbyqxmd.com/read/28815825/the-prevalence-and-specific-characteristics-of-hospitalised-pressure-ulcer-patients-a-multicentre-cross-sectional-study
#6
Qing Zhou, Ting Yu, Yuan Liu, Ruifen Shi, Suping Tian, Chaoxia Yang, Huaxiu Gan, Yanying Zhu, Xia Liang, Ling Wang, Zhenhua Wu, Jinping Huang, Ailing Hu
OBJECTIVE: The present study aimed to ascertain the pressure ulcer prevalence in secondary and tertiary general hospitals in different areas of Guangdong Province in China and explore the possible risk factors that are related to pressure ulcers. BACKGROUND: Few multicentre studies have been conducted on pressure ulcer prevalence in Chinese hospitals. DESIGN: A cross-sectional study design was used. METHODS: Data from a total of 25,264 patients were included in the analysis at 25 hospitals in China...
August 17, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28814583/does-use-of-point-of-care-testing-improve-cost-effectiveness-of-the-nhs-health-check-programme-in-the-primary-care-setting-a-cost-minimisation-analysis
#7
Austen El-Osta, Maria Woringer, Elena Pizzo, Talitha Verhoef, Claire Dickie, Melody Z Ni, Jeremy R Huddy, Michael Soljak, George B Hanna, Azeem Majeed
OBJECTIVE: To determine if use of point of care testing (POCT) is less costly than laboratory testing to the National Health Service (NHS) in delivering the NHS Health Check (NHSHC) programme in the primary care setting. DESIGN: Observational study and theoretical mathematical model with microcosting approach. SETTING: We collected data on NHSHC delivered at nine general practices (seven using POCT; two not using POCT). PARTICIPANTS: We recruited nine general practices offering NHSHC and a pathology services laboratory in the same area...
August 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28809602/fertility-preservation-and-sexual-health-after-cancer-therapy
#8
Nigel Pereira, Glenn L Schattman
Recent developments in cancer diagnostics and treatments have considerably improved long-term survival rates. Despite improvements in chemotherapy regimens, more focused radiotherapy and diverse surgical options, cancer treatments often have gonadotoxic side-effects that can manifest as loss of fertility or sexual dysfunction, particularly in young cancer survivors. In this review, we focus on two pertinent quality-of-life issues in female cancer survivors of reproductive age-fertility preservation and sexual function...
August 15, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28807523/multidisciplinary-heart-failure-clinics-are-associated-with-lower-heart-failure-hospitalization-and-mortality-systematic-review-and-meta-analysis
#9
REVIEW
Sumeet Gandhi, Wassim Mosleh, Umesh C Sharma, Catherine Demers, Michael E Farkouh, Jon-David Schwalm
BACKGROUND: Heart failure (HF) clinics (HFCs) are an integral aspect of the strategy for community HF care. METHODS: A systematic search was conducted to retrieve studies. We searched for candidate articles in the PubMed, EMBASE, and Cochrane databases from 1990 to January 2017. RESULTS: We included 16 randomized controlled trials in the meta-analysis with 3999 patients. The HFC group had a lower incidence of the primary composite end point of HF hospitalization and all-cause mortality (odds ratio [OR], 0...
May 24, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28807194/the-impact-of-glasgow-coma-scale-age-prognosis-score-on-geriatric-traumatic-brain-injury-outcomes
#10
Muhammad Khan, Terence O'Keeffe, Faisal Jehan, Narong Kulvatunyou, Abdullah Kattaa, Lynn Gries, Andrew Tang, Bellal Joseph
BACKGROUND: As the population ages, increasing number of geriatric patients sustain traumatic brain injury (TBI). Communication of accurate prognostic information is crucial for making informed decisions on behalf of such patients. Therefore, the aim of our study was to develop a simple and clinically applicable tool that accurately predicts the prognosis in geriatric TBI patients. METHODS: We performed a 1-y (2011) retrospective analysis of isolated geriatric TBI patients (age ≥65 y, head abbreviated injury score [AIS] ≥ 3, and other body AIS < 3) in the National Trauma Data Bank...
August 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28807041/the-feasibility-and-re-aim-evaluation-of-the-tame-health-pilot-study
#11
Zakkoyya H Lewis, Kenneth J Ottenbacher, Steve R Fisher, Kristofer Jennings, Arleen F Brown, Maria C Swartz, Eloisa Martinez, Elizabeth J Lyons
BACKGROUND: Conducting 5 A's counseling in clinic and utilizing technology-based resources are recommended to promote physical activity but little is known about how to implement such an intervention. This investigation aimed to determine the feasibility and acceptability, using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework, of a pragmatic, primary care-based intervention that incorporated 5 A's counseling and self-control through an activity monitor...
August 14, 2017: International Journal of Behavioral Nutrition and Physical Activity
https://www.readbyqxmd.com/read/28806954/-usability-of-data-integration-and-visualization-software-for-multidisciplinary-pediatric-intensive-care-a-human-factors-approach-to-assessing-technology
#12
Ying Ling Lin, Anne-Marie Guerguerian, Jessica Tomasi, Peter Laussen, Patricia Trbovich
BACKGROUND: Intensive care clinicians use several sources of data in order to inform decision-making. We set out to evaluate a new interactive data integration platform called T3™ made available for pediatric intensive care. Three primary functions are supported: tracking of physiologic signals, displaying trajectory, and triggering decisions, by highlighting data or estimating risk of patient instability. We designed a human factors study to identify interface usability issues, to measure ease of use, and to describe interface features that may enable or hinder clinical tasks...
August 14, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28805267/practices-in-the-evaluation-of-potential-kidney-transplant-recipients-who-are-elderly-a-survey-of-us-transplant-centers
#13
Didier A Mandelbrot, Aaron Fleishman, James R Rodrigue, Silas P Norman, Milagros Samaniego
Limited data exists regarding the evaluation and selection of older candidates for transplantation. To help guide the development of program protocols and help define research questions in this area, we surveyed US transplant centers regarding their current practices in the evaluation of older kidney transplant candidates. We emailed a 28-question survey to the medical and surgical directors of 190 adult kidney transplant programs in the US. We received usable responses from 59 programs, a 31.1% response rate...
August 14, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28803724/implementation-and-outcomes-of-an-evidence-based-precepting-program-for-burn-nurses
#14
Johnnie R Robbins, Krystal K Valdez-Delgado, Nicole W Caldwell, Linda H Yoder, Elizabeth J Hayes, Michaèl G Barba, Hope L Greeley, Colleen Mitchell, Elizabeth A Mann-Salinas
INTRODUCTION: There is significant nationwide interest in transitioning new and new-to-specialty nurses into practice, especially in burn care. Lack of a structured transition program in our Burn Center was recognized as a contributing factor for nursing dissatisfaction and increased turnover compared to other hospital units. Employee evaluations exposed a need for more didactic instruction, hands-on learning, and preceptor support. The goal of this project was to implement an evidence-based transition to practice program specific to the burn specialty...
August 10, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28803357/determinants-of-functional-outcome-in-hip-fracture-the-role-of-comorbidity
#15
Bernardo Gialanella, Paola Prometti, Vittoria Monguzzi, Cristina Ferlucci, Paola Baiardi, Laura Comini
BACKGROUND AND AIMS: Executed studies did not clearly identify which index of comorbidity was an independent outcome determinant. The aim of this prospective observational cohort study was to address this issue. METHODS: We analyzed 200 consecutive patients with hip fracture. All patients underwent rehabilitation. At admission comorbidity was assessed through the cumulative severity, severity index, and comorbidity index of the Cumulative Illness Rating Scale. Discharge scores and effectiveness in the Functional Independence Measure motor subscale, and discharge destination were the outcome measures...
August 12, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28801394/the-role-of-nurse-specialists-in-the-delivery-of-integrated-diabetes-care-a-cross-sectional-survey-of-diabetes-nurse-specialist-services
#16
Fiona Riordan, Sheena M McHugh, Katie Murphy, Julie Barrett, Patricia M Kearney
OBJECTIVES: International evidence suggests the diabetes nurse specialist (DNS) has a key role in supporting integrated management of diabetes. We examine whether hospital and community DNS currently support the integration of care, examine regional variation in aspects of the service relevant to the delivery of integrated care and identify barriers to service delivery and areas for improvement. DESIGN: A cross-sectional survey of hospital and community-based DNS in Ireland...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28800866/five-year-trends-of-critical-care-practice-and-outcomes
#17
Craig M Lilly, Sunil Swami, Xinggang Liu, Richard R Riker, Omar Badawi
BACKGROUND: Longitudinal analyses of large detailed adult critical care datasets provide insights into practice trends and generate useful outcome and process benchmarks. METHODS: Data representing 991,571 consecutive critical care visits to160 United States adult ICUs during 2009 to 2013 from the eICU Research Institute clinical practice database were used to quantitate patient characteristics, APACHE IV based acuity predictions, treatments, and outcomes. Analyses for changes over time were performed for patient characteristics, entry and discharge locations, primary admission diagnosis, treatments, adherence to consensus ICU best practices, length of stay (LOS), and inpatient mortality...
August 8, 2017: Chest
https://www.readbyqxmd.com/read/28799947/care-of-500-1500-gram-premature-infants-in-hybrid-incubators
#18
Holly Boyd, M Colleen Brand, Joseph Hagan
BACKGROUND: Although technological advances have improved devices used to maintain the temperatures of 500- to 1500-g infants, managing the thermal environment remains challenging. PURPOSE: To evaluate the effects of 2 methods of thermal support provided by a hybrid incubator during routine care in the first week of life. METHODS: This descriptive, comparative study evaluates changes in temperature, humidity, heart rate, and oxygen saturation in the incubator versus radiant warmer (canopy) modes of hybrid warmers using data downloaded from the incubator and the monitor...
August 9, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/28798228/technical-peer-review-methods-and-outcomes
#19
Andrew M Keenan, Toni Cranston, Kelsey Hill, Derek J Stocker
Peer review among physicians, nurses and pharmacy staff is routine, yet uncommon in the field of nuclear medicine technology. While not a requirement of regulatory agencies, nuclear medicine technical peer review can greatly enhance the quality of patient care in both hospital and outpatient settings. To date, detailed methods for accomplishing this task have not been previously published. Methods: 19,688 nuclear medicine studies performed at a single institution over a five-year period were critically reviewed...
August 10, 2017: Journal of Nuclear Medicine Technology
https://www.readbyqxmd.com/read/28797590/antibiotic-stewardship-programs-in-nursing-homes-a-systematic-review
#20
REVIEW
Diana Feldstein, Philip D Sloane, Cynthia Feltner
INTRODUCTION: Antibiotic stewardship programs (ASPs) are coordinated interventions promoting the appropriate use of antibiotics to improve patient outcomes and reduce microbial resistance. These programs are now mandated in nursing homes (NHs) but it is unclear if these programs improve resident outcomes. This systematic review evaluated the current evidence regarding outcomes of ASPs in the NH. METHODS: PubMed, CINAHL, EMBASE, and the Cochrane Library were systematically searched for intervention trials of ASPs performed in NHs that evaluated final health outcomes (mortality and Clostridium difficile infections), healthcare utilization outcomes (emergency department visits and hospital admissions) and intermediate health outcomes (number of antibiotics prescribed, adherence to recommended guidelines)...
August 7, 2017: Journal of the American Medical Directors Association
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