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Hospital quality

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https://www.readbyqxmd.com/read/28231607/position-in-the-second-stage-of-labour-for-women-with-epidural-anaesthesia
#1
REVIEW
Marion Kibuka, Jim G Thornton
BACKGROUND: Epidural analgesia for pain relief in labour prolongs the second stage of labour and results in more instrumental deliveries. It has been suggested that a more upright position of the mother during all or part of the second stage may counteract these adverse effects. This is an update of a Cochrane review first published in 2013. OBJECTIVES: To assess the effects of different birthing positions (upright and recumbent) during the second stage of labour, on important maternal and fetal outcomes for women with epidural analgesia...
February 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28231606/user-participation-is-a-family-matter-a-multiple-case-study-of-the-experiences-of-older-hospitalized-people-and-their-relatives
#2
Ingrid Nyborg, Lars Johan Danbolt, Marit Kirkevold
AIMS AND OBJECTIVES: The purpose of this multiple case study was to compare and contrast older people's and their relatives' experiences of participation in decision-making processes regarding the planning of everyday life after discharge from hospital. BACKGROUND: Internationally, patient involvement in health services is established to benefit patient health and to improve quality of the services. The literature shows that at hospital discharge older people would benefit from better communication and more active participation of relatives in the discharge planning...
February 23, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28231320/improved-image-quality-and-diagnostic-potential-using-ultra-high-resolution-computed-tomography-of-the-lung-with-small-scan-fov-a-prospective-study
#3
Huiyuan Zhu, Lian Zhang, Yali Wang, Preeti Hamal, Xiaofang You, Haixia Mao, Fei Li, Xiwen Sun
The aim of this study was to assess whether CT imaging using an ultra-high-resolution CT (UHRCT) scan with a small scan field of view (FOV) provides higher image quality and helps to reduce the follow-up period compared with a conventional high-resolution CT (CHRCT) scan. We identified patients with at least one pulmonary nodule at our hospital from July 2015 to November 2015. CHRCT and UHRCT scans were conducted in all enrolled patients. Three experienced radiologists evaluated the image quality using a 5-point score and made diagnoses...
2017: PloS One
https://www.readbyqxmd.com/read/28230899/shared-care-across-the-interface-between-primary-and-specialty-care-in-management-of-long-term-conditions
#4
REVIEW
Susan M Smith, Gráinne Cousins, Barbara Clyne, Shane Allwright, Tom O'Dowd
BACKGROUND: Shared care has been used in the management of many chronic conditions with the assumption that it delivers better care than primary or specialty care alone; however, little is known about the effectiveness of shared care. OBJECTIVES: To determine the effectiveness of shared care health service interventions designed to improve the management of chronic disease across the primary/specialty care interface. This is an update of a previously published review...
February 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28230578/essential-and-nonessential-blood-testing-in-the-clinical-teaching-unit
#5
Cody Sherren, Andrew Day, Roy Ilan
OBJECTIVES: The aim of the study was to evaluate the essential and nonessential blood tests ordered on the internal medicine clinical teaching units (CTUs) at Kingston General Hospital. Our aim was to establish a baseline performance measure identifying appropriate use of laboratory tests that could be used to inform improvement over time. METHODS: For an 8-week period, 14 CTU attending physicians at Kingston General Hospital were surveyed. They were asked for each of their patients, "What blood tests do you consider to be essential for tomorrow morning to maintain appropriate care for this patient?" The following day, blood tests that were ordered were compared with the "essential" list previously given by the attending physicians...
February 22, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28230574/patient-safety-culture-in-mutual-insurance-companies-in-spain
#6
Rafael Manzanera, José Joaquín Mira, Manel Plana, Daniel Moya, Mercedes Guilabert, Jordi Ortner
OBJECTIVES: The aim of the study was to assess the safety culture in a mutual insurance sector, searching for improvement opportunities. This sector offers health insurance for work-related injuries and occupational illnesses and represents an annual volume of patients corresponding to approximately 10% of the working population in Europe. METHODS: A cross-sectional study was conducted to assess the safety culture in the mutual insurance sector in Spain. All physicians, nurses, and physiotherapists (N = 816) working in the organization in hospitals, outpatient clinics, and managerial settings were invited to reply to an online survey...
February 22, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28230041/gefitinib-single-drug-in-treatment-of-advanced-esophageal-cancer
#7
Yingjun Xu, Zhihui Xie, Yan Shi, Mengwei Zhang, Jia Pan, Yanming Li, Hong Lu
OBJECTIVE: The objective of this study is to evaluate the clinical efficacy and toxicity of gefitinib single drug in treatment of advanced esophageal cancer. MATERIALS AND METHODS: Forty-one case of advanced esophageal cancer were included from February 2012 to June 2016 in the Department of Oncology, Huaihe Hospital of Henan University. All of the included 41 cases were pathology or cytology confirmed of esophageal cancer with advanced stage with previously chemotherapy regimen of cisplatin or fluorouracil...
December 2016: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/28229625/is-pain-at-discharge-a-risk-factor-for-unplanned-hospital-readmission
#8
Mieke Deschepper, Peter Vermeir, Dirk Vogelaers, Jacques Devulder, Kristof Eeckloo
INTRODUCTION: Unplanned readmissions are associated with a high cost to health insurances and the incidence of preventable readmissions could be considered as a quality indicator for the initial hospital admission. We aimed to assess the predictive value for unplanned readmission of higher pain scores at discharge of the initial admission as well as of other pain and demographic characteristics. The documentation of significant associations would provide further support for a structured pain management policy...
February 23, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28229508/meditation-training-for-people-with-amyotrophic-lateral-sclerosis-a-randomized-clinical-trial
#9
F Pagnini, A Marconi, A Tagliaferri, G M Manzoni, R Gatto, V Fabiani, G Gragnano, G Rossi, E Volpato, P Banfi, A Palmieri, F Graziano, G Castelnuovo, M Corbo, E Molinari, N Riva, V Sansone, C Lunetta
BACKGROUND AND PURPOSE: Studies investigating psychological interventions for the promotion of well-being in people with amyotrophic lateral sclerosis (ALS) are lacking. The purpose of the current study was to examine the use of an ALS-specific mindfulness-based intervention for improving quality of life in this population. METHODS: A randomized, open-label and controlled clinical trial was conducted on the efficacy of an ALS-specific meditation programme in promoting quality of life...
February 23, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28229377/important-treatment-outcomes-for-patients-with-psoriatic-arthritis-a-multisite-qualitative-study
#10
Emma Dures, Sarah Hewlett, Jane Lord, Clive Bowen, Neil McHugh, William Tillett
BACKGROUND: Psoriatic arthritis (PsA) is a variable and complex inflammatory condition. Symptoms can compromise physical function, reduce quality of life, and accrue significant health costs. Commonly used patient-reported outcomes largely reflect the professionals' perspective, however it is not known whether they capture what is important to patients. OBJECTIVE: The aim of our study was to identify treatment outcomes important to patients with PsA. METHODS: Eight focus groups that were audio recorded, transcribed, anonymised and analysed using inductive thematic analysis were conducted at five hospital sites...
February 22, 2017: Patient
https://www.readbyqxmd.com/read/28229295/benchmarking-of-venous-thromboembolism-prophylaxis-practice-with-ent-uk-guidelines
#11
Ali S Al-Qahtani
The aim of this study was to benchmark our guidelines of prevention of venous thromboembolism (VTE) in ENT surgical population against ENT.UK guidelines, and also to encourage healthcare providers to utilize benchmarking as an effective method of improving performance. The study design is prospective descriptive analysis. The setting of this study is tertiary referral centre (Assir Central Hospital, Abha, Saudi Arabia). In this study, we are benchmarking our practice guidelines of the prevention of VTE in the ENT surgical population against that of ENT...
February 22, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28228574/delays-in-door-to-needle-times-and-their-impact-on-treatment-time-and-outcomes-in-get-with-the-guidelines-stroke
#12
Noreen Kamal, Shubin Sheng, Ying Xian, Roland Matsouaka, Michael D Hill, Deepak L Bhatt, Jeffrey L Saver, Mathew J Reeves, Gregg C Fonarow, Lee H Schwamm, Eric E Smith
BACKGROUND AND PURPOSE: Despite quality improvement programs such as the American Heart Association/American Stroke Association Target Stroke initiative, a substantial portion of acute ischemic stroke patients are still treated with tissue-type plasminogen activator (alteplase) later than 60 minutes from arrival. This study aims to describe the documented reasons for delays and the associations between reasons for delays and patient outcomes. METHODS: We analyzed the characteristics of 55 296 patients who received intravenous alteplase in 1422 hospitals participating in Get With The Guidelines-Stroke from October 2012 to April 2015, excluding transferred patients and inpatient strokes...
February 22, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28228452/does-the-use-of-a-decision-aid-improve-decision-making-in-prosthetic-heart-valve-selection-a-multicenter-randomized-trial
#13
Nelleke M Korteland, Yunus Ahmed, David R Koolbergen, Marjan Brouwer, Frederiek de Heer, Jolanda Kluin, Eline F Bruggemans, Robert J M Klautz, Anne M Stiggelbout, Jeroen J J Bucx, Jolien W Roos-Hesselink, Peter Polak, Thanasie Markou, Inge van den Broek, Rene Ligthart, Ad J J C Bogers, Johanna J M Takkenberg
BACKGROUND: A Dutch online patient decision aid to support prosthetic heart valve selection was recently developed. A multicenter randomized controlled trial was conducted to assess whether use of the patient decision aid results in optimization of shared decision making in prosthetic heart valve selection. METHODS AND RESULTS: In a 5-center randomized controlled trial, patients were allocated to receive either standard preoperative care (control group) or additional access to the patient decision aid (intervention group)...
February 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28228344/emergency-department-return-visits-within-a-large-geographic-area
#14
Mimi Truong, Garth Meckler, Quynh H Doan
BACKGROUND: Return visits to the emergency department (RTED) contribute to overcrowding and may be a quality of care indicator. Previous studies focused on factors predicting returns to and from the same center. Little is known about RTEDs across a range of community and specialty hospitals within a large geographic area. OBJECTIVE: We sought to measure the frequency of pediatric RTEDs and describe their directional pattern across centers in a large catchment area...
February 19, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28228342/evaluation-of-the-implementation-of-the-south-african-triage-system-at-an-academic-hospital-in-central-haiti
#15
Shada A Rouhani, Emily Aaronson, Angella Jacques, Sandy Brice, Regan H Marsh
BACKGROUND: Effective triage is an important part of high quality emergency care, yet is frequently lacking in resource-limited settings. The South African Triage Scale (SATS) is designed for these settings and consists of a numeric score (triage early warning score, TEWS) and a list of clinical signs (known as discriminators). Our objective was to evaluate the implementation of SATS at a new teaching hospital in Haiti. METHODS: A random sample of emergency department charts from October 2013 were retrospectively reviewed for the completeness and accuracy of the triage form, correct calculation of the triage score, and final patient disposition...
February 19, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28228204/hospital-charge-and-health-care-quality-in-bariatric-surgery
#16
Dana A Telem, Jie Yang, Maria Altieri, Mark Talamini, Qiao Zhang, Aurora D Pryor
To determine if hospital charges correlate with patient outcomes after bariatric surgery. A retrospective review of 46,180 patients who underwent bariatric surgery from 2004-2010 was performed. Patients were identified using the New York Statewide Planning and Research Cooperative System database. Hospitals were categorized on estimates from a multiple linear regression model for charge: low (<$25,027.00), medium ($25,027.00-$35,449.00), and high (≥$35,449.01). Patient outcomes were compared among the charge classification...
February 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28228123/the-effects-of-exercise-on-pain-fatigue-insomnia-and-health-perceptions-in-patients-with-operable-advanced-stage-rectal-cancer-prior-to-surgery-a-pilot-trial
#17
Jennifer Brunet, Shaunna Burke, Michael P W Grocott, Malcolm A West, Sandy Jack
BACKGROUND: Promoting quality of life (QoL) is a key priority in cancer care. We investigated the hypothesis that, in comparison to usual care, exercise post-neoadjuvant chemoradiation therapy/prior to surgical resection will reduce pain, fatigue, and insomnia, and will improve physical and mental health perceptions in patients with locally advanced stage rectal cancer. METHODS: In this non-randomized controlled pilot trial, patients in the supervised exercise group (EG; M age = 64 years; 64% male) and in the control group (CG; M age = 72 years; 69% male) completed the European Organization for Research and Treatment of Cancer core Quality of Life questionnaire and the RAND 36-Item Health Survey three times: pre-neoadjuvant chemoradiation therapy (Time 1; n EC = 24; n CG = 11), post-neoadjuvant chemoradiation therapy/pre-exercise intervention (Time 2; n EC = 23; n CG = 10), and post-exercise intervention (Time 3; n EC = 22; n CG = 10)...
February 23, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28227726/mobile-teleradiology-system-suitable-for-m-health-services-supporting-content-and-semantic-based-image-retrieval-on-a-grid-infrastructure
#18
Alexandra La Cruz, Ruben Medina, Francisco Vega, Wilson Perez, Blanca Ochoa, Victor Saquicela, Mauricio Espinoza, Lizandro Solano-Quinde, Maria-Esther Vidal, Alexandra La Cruz, Ruben Medina, Francisco Vega, Wilson Perez, Blanca Ochoa, Victor Saquicela, Mauricio Espinoza, Lizandro Solano-Quinde, Maria-Esther Vidal, Victor Saquicela, Francisco Vega, Mauricio Espinoza, Lizandro Solano-Quinde, Blanca Ochoa, Maria-Esther Vidal, Alexandra La Cruz, Ruben Medina, Wilson Perez
Teleradiology systems tackle the problem of transferring radiological images between medical image workstations for facilitating different medical activities, e.g., diagnosis, treatment and follow up a patient, medical training, or consulting second opinion. Nowadays, m-Health (aka mobile health) is becoming popular because of high quality of mobile displays, although remains a work in progress. In this paper a mobile teleradiology system is reported, which main contribution is the development of a platform: (1) supported by a Grid infrastructure, (2) using biomedical ontologies for adding semantic annotations on medical images, and (3) supporting semantic and content-based image retrieval...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227227/multi-task-transfer-learning-for-in-hospital-death-prediction-of-icu-patients
#19
Chandan Karmakar, Budhaditya Saha, Marimuthu Palaniswami, Svetha Venkatesh, Chandan Karmakar, Budhaditya Saha, Marimuthu Palaniswami, Svetha Venkatesh, Budhaditya Saha, Marimuthu Palaniswami, Svetha Venkatesh, Chandan Karmakar
Multi-Task Transfer Learning (MTTL) is an efficient approach for learning from inter-related tasks with small sample size and imbalanced class distribution. Since the intensive care unit (ICU) data set (publicly available in Physionet) has subjects from four different ICU types, we hypothesize that there is an underlying relatedness amongst various ICU types. Therefore, this study aims to explore MTTL model for in-hospital mortality prediction of ICU patients. We used single-task learning (STL) approach on the augmented data as well as individual ICU data and compared the performance with the proposed MTTL model...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226763/detection-of-diabetic-foot-hyperthermia-by-using-a-regionalization-method-based-on-the-plantar-angiosomes-on-infrared-images
#20
Y Liu, A Polo, M Zequera, R Harba, R Canals, L Vilcahuaman, Y Bello, Y Liu, A Polo, M Zequera, R Harba, R Canals, L Vilcahuaman, Y Bello, A Polo, M Zequera, Y Liu, Y Bello, R Canals, L Vilcahuaman, R Harba
Prevention of serious diabetic foot complication like ulceration or infection is an important issue. As the development of thermal graphic technologies, foot temperature-guided avoidance therapy has been recommended. Doctors from Hospital National Dos de Mayo are studying on the risk of the diabetic foot passing from Grade 0 to Grade 1 in the Wagner Scale. This risk to develop ulcers is related to the temperature difference of corresponding area between left and right foot. Generally speaking, the diabetic foot with greater mean temperature difference has more potential to develop ulcers; especially, area whose temperature difference of more than 2...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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