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https://www.readbyqxmd.com/read/28806744/sustainability-of-knowledge-implementation-in-a-low-and-middle-income-context-experiences-from-a-facilitation-project-in-vietnam-targeting-maternal-and-neonatal-health
#1
Leif Eriksson, Anna Bergström, Dinh Thi Phuong Hoa, Nguyen Thu Nga, Ann Catrine Eldh
BACKGROUND: In a previous trial in Vietnam, a facilitation strategy to secure evidence-based practice in primary care resulted in reduced neonatal mortality over a period of three years. While little is known as to what ensures sustainability in the implementation of community-based strategies, the aim of this study was to investigate factors promoting or hindering implementation, and sustainability of knowledge implementation strategies, by means of the former Neonatal Knowledge Into Practice (NeoKIP) trial...
2017: PloS One
https://www.readbyqxmd.com/read/28806579/access-to-emergency-care-services-a-transversal-ecological-study-about-brazilian-emergency-health-care-network
#2
T A H Rocha, N C da Silva, P V Amaral, A C Q Barbosa, J V M Rocha, V Alvares, D G de Almeida, E Thumé, E B A F Thomaz, R C de Sousa Queiroz, M R de Souza, A Lein, N Toomey, C A Staton, J R N Vissoci, L A Facchini
OBJECTIVES: Studies of health geography are important in the planning and allocation of emergency health services. The geographical distribution of health facilities is an important factor in timely and quality access to emergency services; therefore, the present study analyzed the emergency health care network in Brazil, focusing the analysis at the roles of small hospitals (SHs). STUDY DESIGN: Cross-sectional ecological study. METHODS: Data were collected from 9429 hospitals of which 3524 were SHs and 5905 were high-complexity centers (HCCs)...
August 11, 2017: Public Health
https://www.readbyqxmd.com/read/28806489/characteristics-of-spontaneous-births-attended-by-midwives-and-physicians-in-us-hospitals-in-2014
#3
Patrick Thornton
INTRODUCTION: This study compares characteristics and birth outcomes of women attended by certified nurse-midwives/certified midwives (midwives) and physicians in US hospitals in 2014. METHODS: Data reported in 2014 on the 2003 version of the US birth certificate were examined. Spontaneous vaginal births attributed to midwives and physicians and occurring in hospitals were included. Demographic and risk profiles and adjusted odds ratios for maternal and newborn outcomes were compared by provider type...
August 14, 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28806281/ventilator-associated-pneumonia-in-neonatal-intensive-care-unit-due-to-chryseobacterium-indologenes
#4
Vicente S Antonello, Priscila Daht, Janaína Polli, Milton Gross, Maurício Colvero
Ventilator-associated pneumonia (VAP) represents one of the most common nosocomial infections in neonatal intensive care units, increasing morbidity and mortality, and associated costs. The authors report the case of a neonatal patient with VAP secondary to Chryseobacterium indologenes and a review of the literature. . The most effective empiric treatment for C. indologenes infection remains unclear due to limited data in the literature, and therefore, therapy should be adjusted in accordance with the result of the susceptibility profile...
August 10, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28805942/maternal-and-neonatal-outcomes-following-abnormally-invasive-placenta-a-population-based-record-linkage-study
#5
Heather J Baldwin, Jillian A Patterson, Tanya A Nippita, Siranda Torvaldsen, Ibinabo Ibiebele, Judy M Simpson, Jane B Ford
INTRODUCTION: Abnormally invasive placenta (AIP) involves abnormal adherence of the placenta to the myometrium, and is associated with severe pregnancy complications such as blood transfusion and hysterectomy. Knowledge of outcomes has been limited by small sample sizes and a focus on maternal rather than neonatal outcomes. This study uses population-level data collected over ten years to investigate maternal and neonatal outcomes and trends in incidence of AIP (also known as placenta accreta, increta and percreta)...
August 14, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28805619/intrauterine-fetal-death-caused-by-seatbelt-injury
#6
Shizuka Yamada, Koji Nishijima, Jin Takahashi, Nozomu Takahashi, Chiyo Tamamura, Yoshio Yoshida
OBJECTIVE: Severe motor vehicle accidents involving pregnant women can result in fetal and neonatal death. We describe a case in which fetal death occurred due to relatively mild seatbelt injuries and present the characteristic magnetic resonance imaging (MRI) findings of the placenta. CASE REPORT: A 26-year-old primigravid woman at 20 weeks gestation was involved in an automobile accident. Although she suffered only a seatbelt injury, fetal death subsequently occurred...
August 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28804867/sources-of-distress-for-physicians-and-nurses-working-in-swiss-neonatal-intensive-care-units
#7
Sabine D Klein, Hans Ulrich Bucher, Manya J Hendriks, Ruth Baumann-Hölzle, Jürg C Streuli, Thomas M Berger, Jean-Claude Fauchère, On Behalf Of The Swiss Neonatal End-Of-Life Study Group
BACKGROUND: Medical personnel working in intensive care often face difficult ethical dilemmas. These may represent important sources of distress and may lead to a diminished self-perceived quality of care and eventually to burnout. AIMS OF THE STUDY: The aim of this study was to identify work-related sources of distress and to assess symptoms of burnout among physicians and nurses working in Swiss neonatal intensive care units (NICUs). METHODS: In summer 2015, we conducted an anonymous online survey comprising 140 questions about difficult ethical decisions concerning extremely preterm infants...
August 14, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28804787/burden-of-paediatric-respiratory-syncytial-virus-disease-and-potential-effect-of-different-immunisation-strategies-a-modelling-and-cost-effectiveness-analysis-for-england
#8
Deborah Cromer, Albert Jan van Hoek, Anthony T Newall, Andrew J Pollard, Mark Jit
BACKGROUND: Vaccines and prophylactic antibodies against respiratory syncytial virus (RSV) are in development and likely to be available in the next 5-10 years. The most efficient way to use these products when they become available is an important consideration for public health decision makers. METHODS: We performed a multivariate regression analysis to estimate the burden of RSV in children younger than 5 years in England (UK), a representative high-income temperate country, and used these results to assess the potential effect of different RSV immunisation strategies (targeting vaccination for infants, or pregnant women, or prophylactic antibodies for neonates)...
August 2017: Lancet. Public Health
https://www.readbyqxmd.com/read/28803228/utility-of-routine-urine-cmv-pcr-and-total-serum-igm-testing-of-small-for-gestational-age-infants-a-single-center-review
#9
Michael M Espiritu, Sean Bailey, Elena V Wachtel, Pradeep V Mally
BACKGROUND: Due to the extremely low incidence of TORCH (toxoplasmosis, rubella, CMV, herpes simplex virus) infections, diagnostic testing of all small for gestational age (SGA) infants aimed at TORCH etiologies may incur unnecessary tests and cost. OBJECTIVE: To determine the frequency of urine CMV PCR and total IgM testing among infants with birth weight <10% and the rate of test positivity. To evaluate the frequency of alternative etiologies of SGA in tested infants...
August 14, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28802823/access-to-and-use-of-health-services-as-factors-associated-with-neonatal-mortality-in-the-north-northeast-and-vale-do-jequitinhonha-regions-brazil
#10
Cristiane B Batista, Márcia L de Carvalho, Ana Glória G Vasconcelos
OBJECTIVE: To analyze the factors associated with neonatal mortality related to health services accessibility and use. METHODS: Case-control study of live births in 2008 in small- and medium-sized municipalities in the North, Northeast, and Vale do Jequitinhonha regions, Brazil. A probabilistic sample stratified by region, population size, and information adequacy was generated for the choice of municipalities. Of these, all municipalities with 20,000 inhabitants or less were included in the study (36 municipalities), whereas the remainder were selected according to the probability method proportional to population size, totaling 20 cities with 20,001-50,000 inhabitants and 19 municipalities with 50,001-200,000 inhabitants...
August 9, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28802350/improving-quality-improvement-in-neonatal-perinatal-care
#11
EDITORIAL
Munish Gupta, Heather C Kaplan
No abstract text is available yet for this article.
September 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/28802348/alarm-safety-and-alarm-fatigue
#12
REVIEW
Kendall R Johnson, James I Hagadorn, David W Sink
Clinical alarm systems have received significant attention in recent years following warnings from hospital accrediting and health care technology organizations regarding patient harm caused by unsafe practices. Alarm desensitization or fatigue from frequent, false, or unnecessary alarms, has led to serious events and even patient deaths. Other concerns include settings inappropriate to patient population or condition, inadequate staff training, and improper use or disabling. Research on human factors in alarm response and of functionality of medical devices will help clinicians develop appropriate policies, practices, and device settings for clinical alarms in neonatal intensive care units...
September 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/28802347/using-quality-improvement-tools-to-reduce-chronic-lung-disease
#13
REVIEW
Alan Peter Picarillo, Waldemar Carlo
Rates of chronic lung disease (CLD) in very low birthweight infants have not decreased at the same pace as other neonatal morbidities over the past 20 years. Multifactorial causes of CLD make this common morbidity difficult to reduce, although there have been several successful quality improvement (QI) projects in individual neonatal intensive care units. QI projects have become a mainstay of neonatal care over the past decade, with an increasing number of publications devoted to this topic. A specific QI project for CLD must be based on best available evidence in the medical literature, expert recommendations, or based on work by previous QI initiatives...
September 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/28802344/creating-a-highly-reliable-neonatal-intensive-care-unit-through-safer-systems-of-care
#14
REVIEW
Patoula G Panagos, Stephen A Pearlman
Neonates requiring intensive care are at high risk for medical errors due to their unique characteristics and high acuity. Designing a safer work environment begins with safe processes. Creating a culture of safety demands the involvement of all organizational levels and an interdisciplinary approach. Adverse events can result from suboptimal communication and lack of a shared mental model. This chapter describes tools to promote better patient safety in the NICU through monitoring adverse events, improving communication and using information technology...
September 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/28802343/using-statistical-process-control-to-drive-improvement-in-neonatal-care-a-practical-introduction-to-control-charts
#15
REVIEW
Munish Gupta, Heather C Kaplan
Quality improvement (QI) is based on measuring performance over time, and variation in data measured over time must be understood to guide change and make optimal improvements. Common cause variation is natural variation owing to factors inherent to any process; special cause variation is unnatural variation owing to external factors. Statistical process control methods, and particularly control charts, are robust tools for understanding data over time and identifying common and special cause variation. This review provides a practical introduction to the use of control charts in health care QI, with a focus on neonatology...
September 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/28802342/improving-value-in-neonatal-intensive-care
#16
REVIEW
Timmy Ho, John A F Zupancic, DeWayne M Pursley, Dmitry Dukhovny
Work within the US health care system has sought to improve outcomes, decrease costs, and improve the patient experience. Combining those three elements leads to value-added care. Quality improvement within neonatology has focused primarily on the improvement of clinical outcomes without explicit consideration of cost. Future improvement efforts in neonatology should consider opportunities to decrease or eliminate waste, and improve outcomes. Consideration of how a change affects all stakeholders reveals potential cost-saving opportunities, and developing aims with value in mind facilitates understanding and goal-setting with senior administrative leaders...
September 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/28802341/using-health-information-technology-to-improve-safety-in-neonatal-care-a-systematic-review-of-the-literature
#17
REVIEW
Kristin R Melton, Yizhao Ni, Heather L Tubbs-Cooley, Kathleen E Walsh
Health information technology (HIT) interventions may improve neonatal patient safety but may also introduce new errors. The objective of this review was to evaluate the evidence for use of HIT interventions to improve safety in neonatal care. Evidence for improvement exists for interventions like computerized provider order entry in the neonatal population, but is lacking for several other interventions. Many unique applications of HIT are emerging as technology and use of the electronic health record expands...
September 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/28802340/improving-neonatal-care-a-global-perspective
#18
REVIEW
Danielle Yerdon Ehret, Jacquelyn Knupp Patterson, Carl Lewis Bose
Each year, approximately 2.7 million babies die during the neonatal period; more than 90% of these deaths occur in developing countries, largely from preventable causes. The known, evidence-based, simple, low-cost interventions that may improve neonatal survival often have low or unknown baseline coverage rates. Gaps in coverage of essential interventions and in quality of care may be amenable to improvement strategies. However, often these gaps are not easily identified. A variety of international organizations have recommended key indicators of quality and established roadmaps for improving neonatal outcomes...
September 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/28802339/family-involvement-in-quality-improvement-from-bedside-advocate-to-system-advisor
#19
REVIEW
Joanna F Celenza, Denise Zayack, Madge E Buus-Frank, Jeffrey D Horbar
Family involvement in newborn intensive care quality improvement dates back to the 1980s. In recent years, there has been an evolution of support for family partnerships at the bedside, transforming parents from being passively present to being active and engaged caregivers and team members. Through those same efforts, a transformational understanding of the power of the family perspective in system design and improvement has occurred. Even with the progression and deepening of this involvement, opportunities exist to learn from families and to improve the quality of neonatal care as a result of the unique family perspective...
September 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/28802337/eliminating-undesirable-variation-in-neonatal-practice-balancing-standardization-and-customization
#20
REVIEW
Maya Balakrishnan, Aarti Raghavan, Gautham K Suresh
Consistency of care and elimination of unnecessary and harmful variation are underemphasized aspects of health care quality. This article describes the prevalence and patterns of practice variation in health care and neonatology; discusses the potential role of standardization as a solution to eliminating wasteful and harmful practice variation, particularly when it is founded on principles of evidence-based medicine; and proposes ways to balance standardization and customization of practice to ultimately improve the quality of neonatal care...
September 2017: Clinics in Perinatology
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