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https://www.readbyqxmd.com/read/29155341/outpatient-elective-posterior-lumbar-fusions-appear-to-be-safely-considered-for-appropriately-selected-patients
#1
Patawut Bovonratwet, Taylor D Ottesen, Raj J Gala, Daniel R Rubio, Nathaniel T Ondeck, Ryan P McLynn, Jonathan N Grauer
BACKGROUND CONTEXT: There has been growing interest in performing posterior lumbar fusions (PLFs) in the outpatient setting to optimize patient satisfaction and reduce cost. Although still done in only a small percentage of cases, this has been more possible due to advances in surgical techniques and anesthesia. However, data on the perioperative course of outpatient compared to inpatient PLF in a large sample size is scarce. PURPOSE: To compare perioperative complications between outpatient and inpatient PLF in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database...
November 16, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29154748/cdc-safety-training-course-for-ebola-virus-disease-healthcare-workers
#2
Rupa Narra, Jeremy Sobel, Catherine Piper, Deborah Gould, Nahid Bhadelia, Mary Dott, Anthony Fiore, William A Fischer, Mary Jo Frawley, Patricia M Griffin, Douglas Hamilton, Barbara Mahon, Satish K Pillai, Emily F Veltus, Robert Tauxe, Michael Jhung
Response to sudden epidemic infectious disease emergencies can demand intensive and specialized training, as demonstrated in 2014 when Ebola virus disease (EVD) rapidly spread throughout West Africa. The medical community quickly became overwhelmed because of limited staff, supplies, and Ebola treatment units (ETUs). Because a mechanism to rapidly increase trained healthcare workers was needed, the US Centers for Disease Control and Prevention developed and implemented an introductory EVD safety training course to prepare US healthcare workers to work in West Africa ETUs...
December 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/29154396/nurses-experiences-of-unprofessional-behaviors-in-the-emergency-department-a-qualitative-study
#3
Naser Parizad, Hadi Hassankhani, Azad Rahmani, Eesa Mohammadi, Violeta Lopez, Michelle Cleary
The nursing profession is focused on serving others and has high expectations that each member behaves professionally and ethically, as articulated in nursing codes of practice and conduct. Where these are not upheld, inappropriate and unprofessional workplace behaviors follow. Regrettably, unprofessional behavior is neither new nor constrained to the nursing profession, but is known to negatively impact staff and workplace relationships, and importantly, patient safety and care. The aim of this qualitative study was to explore Iranian nurses' experiences of professional communication between colleagues in the emergency department...
November 20, 2017: Nursing & Health Sciences
https://www.readbyqxmd.com/read/29154017/patient-attitudes-and-experiences-that-predict-medication-discontinuation-in-the-veterans-health-administration
#4
Amy Linsky, Steven R Simon, Kelly Stolzmann, Mark Meterko
OBJECTIVES: Polypharmacy is associated with adverse medication effects. One potential solution is deprescribing, which is the intentional, proactive, rational discontinuation of a medication that is no longer indicated or for which the potential harms outweigh the potential benefits. We identified patient characteristics, attitudes, and health care experiences associated with medication discontinuation. DESIGN, SETTING, AND PARTICIPANTS: We conducted a national mail survey, with the use of the Patient Perceptions of Discontinuation (PPoD) instrument, of 1600 veterans receiving primary care at Veterans Affairs (VA) medical centers and prescribed 5 or more concurrent medications...
November 16, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/29153772/effectiveness-and-safety-of-transcatheter-aortic-valve-implantation-for-aortic-stenosis-in-patients-with-porcelain-aorta
#5
Fernando Ramirez-Del Val, Sameer A Hirji, Maroun Yammine, Julius I Ejiofor, Siobhan McGurk, Anthony Norman, Prem Shekar, Sary Aranki, Deepak L Bhatt, Pinak Shah, Lawrence H Cohn, Tsuyoshi Kaneko
Surgical aortic valve replacement (SAVR) in patients with porcelain aorta is considered a high-risk procedure. Hence, transcatheter aortic valve implantation (TAVI) is emerging as the intervention of choice. However, there is a paucity of data directly comparing TAVI with SAVR in patients with porcelain aorta. We compared outcomes of TAVI versus SAVR in high-risk patients with porcelain between March 2012 and June 2015. The TAVI group included 54 patients, whereas 130 SAVR patients with porcelain aorta were identified (operated on between 2004 and 2015)...
October 10, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29153225/are-there-clinical-signs-and-symptoms-of-infection-to-indicate-the-presence-of-multidrug-resistant-bacteria-in-venous-ulcers
#6
Silvana de Lima Vieira Dos Santos, Marlene Andrade Martins, Marinésia Aparecida do Prado, José Verdú Soriano, Maria Márcia Bachion
The selection of topical and systemic therapies for the treatment of venous ulcers with signs of infection is challenging and should be accompanied by specific precautionary measures to protect against cross-contamination in the presence of multidrug-resistant microorganisms. However, there are still no clinical indicators for this situation, and confirmation of resistant strains occurs through culture and sensitivity, which can take up to 14 days. During this period, protective measures may no longer be taken, contributing to the spread of these pathogens...
December 2017: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
https://www.readbyqxmd.com/read/29153222/-simulation-in-health-to-improve-the-delivery-of-care
#7
Antoine Tesnière, Cynthia Fleury
Simulation in health care is a very effective training tool. Using mannequins, 'standardised patients' or virtual care environments, it encourages participants to reflect on nursing practices while practising in a safe and controlled space.
November 2017: Soins; la Revue de Référence Infirmière
https://www.readbyqxmd.com/read/29153075/is-whole-colon-investigation-by-colonoscopy-computerised-tomography-colonography-or-barium-enema-necessary-for-all-patients-with-colorectal-cancer-symptoms-and-for-which-patients-would-flexible-sigmoidoscopy-suffice-a-retrospective-cohort-study
#8
Wendy Atkin, Kate Wooldrage, Urvi Shah, Kate Skinner, Jeremy P Brown, Willie Hamilton, Ines Kralj-Hans, Michael R Thompson, Karen G Flashman, Steve Halligan, Siwan Thomas-Gibson, Margaret Vance, Amanda J Cross
BACKGROUND: For patients referred to hospital with suspected colorectal cancer (CRC), it is current standard clinical practice to conduct an examination of the whole colon and rectum. However, studies have shown that an examination of the distal colorectum using flexible sigmoidoscopy (FS) can be a safe and clinically effective investigation for some patients. These findings require validation in a multicentre study. OBJECTIVES: To investigate the links between patient symptoms at presentation and CRC risk by subsite, and to provide evidence of whether or not FS is an effective alternative to whole-colon investigation (WCI) in patients whose symptoms do not suggest proximal or obstructive disease...
November 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29152759/retrieval-of-adult-patients-on-extracorporeal-membrane-oxygenation-by-an-intensive-care-physician-model
#9
Aidan J C Burrell, David V Pilcher, Vincent A Pellegrino, Stephen A Bernard
The optimal staffing model during the inter-hospital transfer of patients on extracorporeal membrane oxygenation (ECMO) is not known. We report the complications and outcomes of patients who were commenced on ECMO at a referring hospital by intensive care physicians and compare these findings with patients who had ECMO established at an ECMO center in Australia. This was a single center, retrospective observational study based on a prospectively collected ECMO database from Melbourne, Australia. Patients with severe cardiac and/or respiratory failure failing conventional supportive treatment between 2007-2013 were placed on ECMO via a physician-led model of ECMO retrieval, including two intensivists in a four person team, using percutaneous ECMO cannulation...
November 19, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29152469/eyebrow-incision-for-surgical-evacuation-of-a-lobar-intracerebral-hematoma-with-a-novel-endoport-system
#10
Dale Ding, Colin J Przybylowski, Robert M Starke, R Webster Crowley, Kenneth C Liu
Large lobar intracerebral hemorrhages (ICHs) can cause rapid neurological deterioration, and affected patients have low rates of survival and functional independence. Currently, the role of surgical intervention in the management patients with lobar ICHs is controversial. Minimally invasive technologies have been developed which may potentially decrease the operative morbidity of ICH surgery. The aim of this case report is to describe the technical aspects of the use of a novel minimally invasive endoport system, the BrainPath (NICO, Indianapolis, IN, USA), through an eyebrow incision for evacuation of a large lobar hematoma...
June 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/29151009/risk-stratification-triage-and-implementation-of-an-expedited-hip-fracture-treatment-protocol-is-it-safe-and-effective
#11
William Zelenty, Richard Yoon, Lorraine Hutzler, Nirmal Tejwani, Joseph Bosco
INTRODUCTION: The population of patients in the USA over the age of 65 is expected to significantly increase over the next 40 years. These patients are at increased risk for hip fractures and will pose a burden to providers in the near future. In order to provide high value care, providers will need to maintain positive outcomes, mitigate complications, and reduce overall cost burdens. This study was designed to investigate the safety and efficacy of a patient transfer protocol between a large academic medical center and a single specialty orthopaedic institution...
December 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29149933/nutrition-therapy-in-sepsis
#12
REVIEW
Paul E Wischmeyer
Sepsis is characterized by early massive catabolism, lean body mass (LBM) loss, and escalating hypermetabolism persisting for months to years. Early enteral nutrition should attempt to correct micronutrient/vitamin deficiencies, deliver adequate protein and moderated nonprotein calories, as well-nourished patients can generate reasonable endogenous energy. After resuscitation, increasing protein/calories are needed to attenuate LBM loss and promote recovery. Malnutrition screening is essential, and parenteral nutrition can be safely added when enteral nutrition is failing based on preillness malnutrition...
January 2018: Critical Care Clinics
https://www.readbyqxmd.com/read/29149122/leukostasis-management-to-prevent-crisis-in-acute-leukemia%C3%A2
#13
Lisa M Blackburn, Shelly Brown, Aimee Munyon, Michelle Orovets
BACKGROUND: Hyperleukocytosis, a peripheral white blood cell count greater than 100,000/mm3,is most commonly seen in patients with newly diagnosed or relapsed acute lymphoblastic leukemia and acute myeloid leukemia. Leukostasis is a reduction in blood flow related to hyperviscosity. Hyperleukocytosis, causing leukostasis, is an oncologic emergency and requires an exacting assessment and rapid response with appropriate intervention to prevent morbidity and mortality in the first week after diagnosis...
December 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/29148607/the-art-of-oral-handovers-a-participant-observational-study-by-undergraduate-students-in-a-hospital-setting
#14
Tove Giske, Sunniva Nese Melås, Kari Anne Einarsen
AIMS AND OBJECTIVES: This study explores the conditions for oral handovers between shifts in a hospital setting, and how these impact patient safety and quality of care. BACKGROUND: Oral handovers transfer patient information and nursing responsibilities between shifts. Short written summaries of patients can complement an oral handover. How to find the balance between a standardised protocol for handovers and tailoring variations to specific patients and situations is debated in the literature...
November 17, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29148105/experiences-of-nurse-case-managers-within-a-central-discharge-planning-role-of-collaboration-between-physicians-patients-and-other-healthcare-professionals-a-sociocultural-qualitative-study
#15
Jorun E Thoma, Marion A Waite
AIMS AND OBJECTIVES: Purpose of this study was to gain knowledge of Nurse Case Managers' (NCM) experiences within the German acute care context of collaboration with patients and physicians in a discharge planning role. Further to learn about patients' assignment to the management of the NCMs. Explicitly, to explore critical incidences of interactions between NCM, patients and health care practitioner in discharge planning to understand the factor that contributes to effective collaboration...
November 17, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29147798/the-reassuring-potential-of-spinal-imaging-results-development-and-testing-of-a-brief-psycho-education-intervention-for-patients-attending-secondary-care
#16
Emma L Karran, Yun-Hom Yau, Susan L Hillier, G Lorimer Moseley
PURPOSE: To develop and test a standardised method of interpreting spinal imaging findings in a manner designed to reassure patients with low back pain and promote engagement in an active recovery. METHODS: A five-phase development and testing process involved collaborative working party contributions, informal and formal appraisal of the intervention content by clinicians and consumers, a two-stage online evaluation of the take-home patient resource, and onsite testing...
November 17, 2017: European Spine Journal
https://www.readbyqxmd.com/read/29146633/comparison-of-outcomes-of-antibiotic-drugs-and-appendectomy-coda-trial-a-protocol-for-the-pragmatic-randomised-study-of-appendicitis-treatment
#17
Giana H Davidson, David R Flum, David A Talan, Larry G Kessler, Danielle C Lavallee, Bonnie J Bizzell, Farhood Farjah, Skye D Stewart, Anusha Krishnadasan, Erin E Carney, Erika M Wolff, Bryan A Comstock, Sarah E Monsell, Patrick J Heagerty, Annie P Ehlers, Daniel A DeUgarte, Amy H Kaji, Heather L Evans, Julianna T Yu, Katherine A Mandell, Ian C Doten, Kevin S Clive, Karen M McGrane, Brandon C Tudor, Careen S Foster, Darin J Saltzman, Richard C Thirlby, Erin O Lange, Amber K Sabbatini, Gregory J Moran
INTRODUCTION: Several European studies suggest that some patients with appendicitis can be treated safely with antibiotics. A portion of patients eventually undergo appendectomy within a year, with 10%-15% failing to respond in the initial period and a similar additional proportion with suspected recurrent episodes requiring appendectomy. Nearly all patients with appendicitis in the USA are still treated with surgery. A rigorous comparative effectiveness trial in the USA that is sufficiently large and pragmatic to incorporate usual variations in care and measures the patient experience is needed to determine whether antibiotics are as good as appendectomy...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29146420/extracorporeal-membrane-oxygenation-used-successfully-in-a-near-fatal-case-of-opioid-induced-acute-respiratory-distress-syndrome
#18
Karen Greenberg, Benjamin Kohl
Acute Respiratory Distress Syndrome (ARDS) was first recognized during the 1960s. It is a distinct type of hypoxemic respiratory failure characterized by acute abnormality of both lungs. Extracorporeal membrane oxygenation (ECMO) is being increasingly used for patients with severe ARDS refractory to otherwise conventional management. A 29year old male arrived with Emergency Medical Services (EMS) status post presumed heroin overdose. He was administered Naloxone 2mg intravenously prior to arrival in the emergency department...
November 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29145988/outpatient-shoulder-arthroplasty
#19
REVIEW
Tyler J Brolin, Thomas W Throckmorton
Health care policy makers have placed increased attention on the cost of health care making outpatient joint arthroplasty an attractive alternative to routine hospital admission. Recent studies have shown outpatient shoulder arthroplasty is a safe and cost-effective alternative to inpatient shoulder arthroplasty. Proper patient selection, patient education, effective pain management strategies, and attention to intraoperative blood loss are keys in the success of outpatient shoulder arthroplasty.
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29145847/a-path-analysis-study-of-factors-influencing-hospital-staff-perceptions-of-quality-of-care-factors-associated-with-patient-satisfaction-and-patient-experience
#20
Sandra G Leggat, Leila Karimi, Timothy Bartram
BACKGROUND: Hospital staff are interested in information on patient satisfaction and patient experience that can help them improve quality of care. Staff perceptions of quality of care have been identified as useful proxies when patient data are not available. This study explores the organizational factors and staff attitudes that influence staff perceptions of the quality of the care they provide in relation to patient satisfaction and patient experience. METHODS: Cross sectional survey completed by 258 staff of a large multi-campus, integrated metropolitan hospital in Australia...
November 16, 2017: BMC Health Services Research
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