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ED Administration

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https://www.readbyqxmd.com/read/28646519/the-association-of-health-literacy-with-preventable-ed-visits-a-cross-sectional-study
#1
Meenakshi P Balakrishnan, Jill Boylston Herndon, Jingnan Zhang, Thomas Payton, Jonathan Shuster, Donna L Carden
BACKGROUND: Policy-makers argue that emergency department (ED) visits for conditions preventable with high-quality outpatient care contribute to waste in the healthcare system. However, access to ambulatory care is uneven, especially for vulnerable populations like minorities, the poor and those with limited health literacy. The impact of limited health literacy on ED visits that are preventable with timely, high-quality ambulatory care is unknown. OBJECTIVE: To determine the association of health literacy and preventable ED visits...
June 24, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28633003/assessment-of-selected-overdose-poisoning-indicators-in-health-care-administrative-data-in-4-states-2012
#2
Beth Hume, Barbara Gabella, Jeanne Hathaway, Scott Proescholdbell, Cristy Sneddon, Elizabeth Brutsch, Riley Hedin, Christopher J Drucker
OBJECTIVES: In 2012, a consensus document was developed on drug overdose poisoning definitions. We took the opportunity to apply these new definitions to health care administrative data in 4 states. Our objective was to calculate and compare drug (particularly opioid) poisoning rates in these 4 states for 4 selected Injury Surveillance Workgroup 7 (ISW7) drug poisoning indicators, using 2 ISW7 surveillance definitions, Option A and Option B. We also identified factors related to the health care administrative data used by each state that might contribute to poisoning rate variations...
January 1, 2017: Public Health Reports
https://www.readbyqxmd.com/read/28632589/emergency-department-visits-following-elective-total-hip-and-knee-replacement-surgery-identifying-gaps-in-continuity-of-care
#3
Micaela A Finnegan, Robyn Shaffer, Austin Remington, Jereen Kwong, Catherine Curtin, Tina Hernandez-Boussard
BACKGROUND: Major joint replacement surgical procedures are common, elective procedures with a care episode that includes both inpatient readmissions and postoperative emergency department (ED) visits. Inpatient readmissions are well studied; however, to our knowledge, little is known about ED visits following these procedures. We sought to characterize 30-day ED visits following a major joint replacement surgical procedure. METHODS: We used administrative records from California, Florida, and New York, from 2010 through 2012, to identify adults undergoing total knee and hip arthroplasty...
June 21, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28631577/the-impact-of-opioid-medications-on-subsequent-fractures-in-discharged-emergency-department-patients-with-peripheral-vertigo
#4
Keerat Grewal, Peter C Austin, Moira K Kapral, Hong Lu, Clare L Atzema
BACKGROUND: Vertigo is common in the emergency department (ED). Most aetiologies are peripheral and do not require hospitalization, but many patients still fear falling. Some patients may be taking opioid analgesic medications (for other reasons); the risk of falls leading to fractures among patients with vertigo could be potentiated by the simultaneous use of opioids. OBJECTIVES: To examine the risk of fractures in discharged ED patients with peripheral vertigo who were being prescribed opioids during the same time period...
June 20, 2017: CJEM
https://www.readbyqxmd.com/read/28619081/burnout-among-workers-in-emergency-departments-in-palestinian-hospitals-prevalence-and-associated-factors
#5
Motasem Hamdan, Asma'a Abu Hamra
BACKGROUND: Working in Emergency Departments (EDs) entails high work pressure and stress due to witnessing human suffering and the unpredictable nature of the work. This environment puts personnel at risk of burnout. This analysis aims to assess burnout levels and associated risk factors among health workers in EDs in Palestinian hospitals. Also, it examines the association between burnout and workplace violence, as well as with job turnover. METHODS: Cross-sectional design utilising a self-administered questionnaire was used to collect data from all workers at 14 EDs; 8 from the West Bank and 6 from the Gaza Strip...
June 15, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28611890/index-to-predict-in-hospital-mortality-in-older-adults-after-non-traumatic-emergency-department-intubations
#6
Kei Ouchi, Samuel Hohmann, Tadahiro Goto, Peter Ueda, Emily L Aaronson, Daniel J Pallin, Marcia A Testa, James A Tulsky, Jeremiah D Schuur, Mara A Schonberg
INTRODUCTION: Our goal was to develop and validate an index to predict in-hospital mortality in older adults after non-traumatic emergency department (ED) intubations. METHODS: We used Vizient administrative data from hospitalizations of 22,374 adults ≥75 years who underwent non-traumatic ED intubation from 2008-2015 at nearly 300 U.S. hospitals to develop and validate an index to predict in-hospital mortality. We randomly selected one half of participants for the development cohort and one half for the validation cohort...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611878/physician-variability-in-management-of-emergency-department-patients-with-chest-pain
#7
Peter B Smulowitz, Orit Barrett, Matthew M Hall, Shamai A Grossman, Edward A Ullman, Victor Novack
INTRODUCTION: Chest pain is a common emergency department (ED) presentation accounting for 8-10 million visits per year in the United States. Physician-level factors such as risk tolerance are predictive of admission rates. The recent advent of accelerated diagnostic pathways and ED observation units may have an impact in reducing variation in admission rates on the individual physician level. METHODS: We conducted a single-institution retrospective observational study of ED patients with a diagnosis of chest pain as determined by diagnostic code from our hospital administrative database...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28610634/medication-related-visits-in-a-pediatric-emergency-department-an-8-years-retrospective-analysis
#8
Cristiano Rosafio, Serena Paioli, Cinzia Del Giovane, Valentina Cenciarelli, Nilla Viani, Paolo Bertolani, Lorenzo Iughetti
BACKGROUND: There are limited data on the characterization of medication-related visits (MRVs) to the emergency department (ED) in pediatric patients in Italy. We have estimated the frequency, severity, and classification of MRVs to the ED in pediatric patients. METHODS: We retrospectively analyzed data for children seeking medical evaluation for a MRV over an 8 years period. A medication-related ED visit was identified by using a random pharmacist assessment, emergency physician assessment, and in case of conflicting events, by a third investigators random assessment...
June 13, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/28608863/nicotine-affects-hydrogen-sulfide-concentrations-in-mouse-kidney-and-heart-but-not-in-brain-and-liver-tissues
#9
Jerzy Wiliński, Bogdan Wiliński, Eugeniusz Somogyi, Joanna Piotrowska, Tomasz Kameczura, Małgorzata Zygmunt
Nicotine, a potent parasympathomimetic alkaloid with stimulant effects, is contributing to addictive properties of tobacco smoking and is though used in the smoking cessation therapy. Hydrogen sulfide (H2S) is involved in physiology and pathophysiology of various systems in mammals. The interactions between nicotine and H2S are not fully recognized. The aim of the study is to assess the influence of nicotine on the H2S tissue concentrations in different mouse organs. Adult CBA male mice were administered intraperitoneally 1...
2017: Folia Medica Cracoviensia
https://www.readbyqxmd.com/read/28602858/verbal-abuse-and-physical-assault-in-the-emergency-department-rates-of-violence-perceptions-of-safety-and-attitudes-towards-security
#10
Bradley Partridge, Julia Affleck
INTRODUCTION: Emergency Department (ED) workers are prone to occupational violence, however the extent and impact of this may not be evenly felt across all roles in the ED. AIMS: Explore: 1) the rate of verbal abuse and physical assaults experienced by ED staff, 2) perceptions of safety, 3) attitudes towards security officers, and 4) formal reporting of incidents. METHODS: 330 ED workers were surveyed at four public hospitals in one metropolitan health service district in Queensland, Australia, including 179 nurses, 83 medical staff, 44 administration staff, 14 allied health, and 9 operational...
June 8, 2017: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/28601272/safety-considerations-and-guideline-based-safe-use-recommendations-for-bolus-dose-vasopressors-in-the-emergency-department
#11
Devin Holden, Jessica Ramich, Edward Timm, Denis Pauze, Timothy Lesar
The use of intermittently administered doses of vasopressors to correct hypotension in the emergency department (ED), commonly referred to as bolus-dose pressors, push-dose pressors, Neo-sticks, or phenyl sticks, has been widely advocated outside of the traditional printed medical literature. No outcomes data of this practice exist to demonstrate benefits over traditional continuous infusion of vasopressors. Use of bolus-dose vasopressors in the ED setting raises a number of patient safety concerns, and misuse and errors in the preparation and administration of bolus-dose vasopressors may result in patient harm...
June 7, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28601270/comparative-effectiveness-of-patient-controlled-analgesia-for-treating-acute-pain-in-the-emergency%C3%A2-department
#12
Polly E Bijur, Angela M Mills, Andrew K Chang, Deborah White, Andrew Restivo, Shaun Persaud, Clyde B Schechter, E John Gallagher, Adrienne J Birnbaum
STUDY OBJECTIVE: We assess the effectiveness of patient-controlled analgesia in the emergency department (ED). We hypothesized that decline in pain intensity from 30 to 120 minutes after initial intravenous opioid administration is greater in patients receiving morphine by patient-controlled analgesia compared with usual care and would differ by a clinically significant amount. METHOD: This was a pragmatic randomized controlled trial of patient-controlled analgesia and usual care (opioid and dose at physician's discretion) in 4 EDs...
June 7, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28597505/renal-effects-of-an-emergency-department-chloride-restrictive-intravenous-fluid-strategy-in-patients-admitted-to-hospital-for-more-than-48-hours
#13
Nor'azim Mohd Yunos, Rinaldo Bellomo, David McD Taylor, Simon Judkins, Fergus Kerr, Harvey Sutcliffe, Colin Hegarty, Michael Bailey
OBJECTIVE: Patients commonly receive i.v. fluids in the ED. It is still unclear whether the choice of i.v. fluids in this setting influences renal or patient outcomes. We aimed to assess the effects of restricting i.v. chloride administration in the ED on the incidence of acute kidney injury (AKI). METHODS: We conducted a before-and-after trial with 5008 consecutive ED-treated hospital admissions in the control period and 5146 consecutive admissions in the intervention period...
June 8, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28595574/limitations-of-pulmonary-embolism-icd-10-codes-in-emergency-department-administrative-data-let-the-buyer-beware
#14
Kristin Burles, Grant Innes, Kevin Senior, Eddy Lang, Andrew McRae
BACKGROUND: Administrative data is a useful tool for research and quality improvement; however, validity of research findings based on these data depends on their reliability. Diagnoses assigned by physicians are subsequently converted by nosologists to ICD-10 codes (International Statistical Classification of Diseases and Related Health Problems, 10th Revision). Several groups have reported ICD-9 coding errors in inpatient data that have implications for research, quality improvement, and policymaking, but few have assessed ICD-10 code validity in ambulatory care databases...
June 8, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/28587696/uncomplicated-urinary-tract-infections-in-the-emergency-department-a-review-of-local-practice-patterns
#15
Elizabeth Poon, Lauren Self, Shelley L McLeod, Sean Caine, Bjug Borgundvaag
OBJECTIVES: To determine the number of urine cultures ordered for women who presented to the emergency department (ED) with symptoms of uncomplicated UTI, and whether a culture result impacted subsequent management. METHODS: This was a retrospective chart review of non-pregnant women aged 18-39 presenting to one of two academic EDs with a discharge diagnosis of uncomplicated UTI over a one-year study period. Patients were excluded if there was documentation of fever, immunocompromised state, diabetes mellitus, absence of lower urinary tract symptoms, ED administration of intravenous antibiotics, a previous UTI treated with antibiotics in the last 90 days, two weeks post-partum or post-instrumentation...
June 7, 2017: CJEM
https://www.readbyqxmd.com/read/28579067/the-beneficial-effect-of-fesoterodine-a-competitive-muscarinic-receptor-antagonist-on-erectile-dysfunction-in-streptozotocin-induced-diabetic-rats
#16
Didem Yilmaz-Oral, Nur Bayatli, Serap Gur
OBJECTIVE: To investigate the possible role of fesoterodine (a competitive muscarinic receptor antagonist) on erectile dysfunction (ED) in streptozotocin-induced diabetic rats. MATERIALS AND METHODS: A total of 16 adult male Sprague-Dawley rats were equally divided into control and diabetic group. Diabetes was induced by a single intravenous injection of streptozotocin (25-35mg/kg). In vivo erectile responses were evaluated by the stimulation of cavernosal nerves and repeated after intracavernosal injection of fesoterodine (1µM) in rats...
June 1, 2017: Urology
https://www.readbyqxmd.com/read/28573362/resource-utilization-in-emergency-department-patients-with-known-or-suspected-poisoning
#17
Stephen J Traub, Soroush Saghafian, Matthew R Buras, M'Hamed Temkit
INTRODUCTION: Previous work has shown poisoning-related emergency department (ED) visits are increasing, and these visits are resource-intensive. Little is known, however, about how resource utilization for patients with known or suspected poisoning differs from that of general ED patients. METHODS: We reviewed 4 years of operational data at a single ED. We identified visits due to known or suspected poisoning (index cases), and paired them with time-matched controls...
June 1, 2017: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/28561945/beta-blocker-administration-during-emergency-department-evaluation-for-acute-coronary-syndrome-is-associated-with-lower-posttraumatic-stress-symptoms-1-month-later
#18
Laura Meli, Bernard P Chang, Daichi Shimbo, Brendan W Swan, Donald Edmondson, Jennifer A Sumner
We examined whether beta blocker administration in the emergency department (ED) during evaluation for suspected acute coronary syndrome (ACS) was associated with posttraumatic stress disorder (PTSD) symptoms 1-month later. Participants (N = 350) were enrolled in the Reactions to Acute Care and Hospitalization (REACH) study, an ongoing observational cohort study of ED predictors of medical and psychological outcomes after evaluation for suspected ACS. Beta blockade during evaluation in the ED was extracted from medical records, and PTSD symptoms in response to the experience of suspected ACS were assessed 1-month later via telephone...
May 31, 2017: Journal of Traumatic Stress
https://www.readbyqxmd.com/read/28553127/real-world-health-care-utilization-in-asthma-patients-using-albuterol-sulfate-inhalation-aerosol-proair-%C3%A2-hfa-with-and-without-integrated-dose-counters
#19
Edward M Kerwin, Thomas J Ferro, Rinat Ariely, Debra E Irwin, Ruchir Parikh
BACKGROUND: Accurate tracking of the administered dose of asthma rescue inhalers is critical for optimal disease management and is related to reductions in rates of unscheduled health care utilization in asthma patients. There are few published data on the real-world impact of rescue inhalers with integrated dose counters (IDCs) on health care resource utilization (HRU) for asthma patients. This study evaluates HRU among users of ProAir(®) hydrofluoroalkane (HFA) (albuterol sulfate inhalation aerosol), with IDC versus without IDC, in asthma patients...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28547702/emerging-treatments-in-eating-disorders
#20
REVIEW
Michael Lutter
Eating disorders (EDs), including anorexia nervosa, bulimia nervosa, and binge-eating disorder, constitute a class of common and deadly psychiatric disorders. While numerous studies in humans highlight the important role of neurobiological alterations in the development of ED-related behaviors, the precise neural substrate that mediates this risk is unknown. Historically, pharmacological interventions have played a limited role in the treatment of eating disorders, typically providing symptomatic relief of comorbid psychiatric issues, like depression and anxiety, in support of the standard nutritional and psychological treatments...
May 25, 2017: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
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