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pre-hospital medicine

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https://www.readbyqxmd.com/read/28333297/effect-of-adding-a-mobile-health-intervention-to-a-multimodal-antimicrobial-stewardship-programme-across-three-teaching-hospitals-an-interrupted-time-series-study
#1
E Charani, M Gharbi, L S P Moore, E Castro-Sanchéz, W Lawson, M Gilchrist, A H Holmes
Objectives: To evaluate the impact of adding a mobile health (mHealth) decision support system for antibiotic prescribing to an established antimicrobial stewardship programme (ASP). Methods: In August 2011, the antimicrobial prescribing policy was converted into a mobile application (app). A segmented regression analysis of interrupted time series was used to assess the impact of the app on prescribing indicators, using data (2008-14) from a biannual point prevalence survey of medical and surgical wards...
February 28, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28306741/pre-hospital-midazolam-for-benzodiazepine-treated-seizures-before-and-after-the-rapid-anticonvulsant-medication-prior-to-arrival-trial-a-national-observational-cohort-study
#2
Eytan Shtull-Leber, Robert Silbergleit, William J Meurer
BACKGROUND: Implementation of evidence-based treatment for pre-hospital status epilepticus can improve outcomes. We hypothesized that publication of a pivotal pre-hospital clinical trial (RAMPART), demonstrating superiority of intramuscular midazolam over intravenous lorazepam, altered the national utilization rates of midazolam for pre-hospital benzodiazepine-treated seizures, while upholding its safety and efficacy outside the trial setting. METHODS AND FINDINGS: This is a retrospective, observational cohort study of pre-hospital patient encounters throughout the United States in the National Emergency Medicine Services Information System database, from January 2010 through December 2014...
2017: PloS One
https://www.readbyqxmd.com/read/28290953/chief-of-residents-for-quality-improvement-and-patient-safety-a-recipe-for-a-new-role-in-graduate-medical-education
#3
Kelly Ferraro, Randall Zernzach, Stephen Maturo, Christopher Nagy, Rebecca Barrett
INTRODUCTION: The San Antonio Uniformed Services Health Education Consortium (SAUSHEC) is the largest group of residency programs in the Department of Defense. In an effort to provide improved Quality Improvement and Patient Safety (QI/PS) training for its residents, SAUSHEC created the position of Chief of QI/PS for Residents in the academic year 2014-2015. The Chief of QI/PS for Residents was based in the Internal Medicine residency program but also assisted with SAUSHEC-wide QI/PS projects...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28286822/ability-of-ultrasonography-in-detection-of-different-extremity-bone-fractures-a-case-series-study
#4
Farzad Bozorgi, Massoud Shayesteh Azar, Seyed Hossein Montazer, Aroona Chabra, Seyed Farshad Heidari, Alireza Khalilian
INTRODUCTION: Despite radiography being the gold standard in evaluation of orthopedic injuries, using bedside ultrasonography has several potential supremacies such as avoiding exposure to ionizing radiation, availability in pre-hospital settings, being extensively accessible, and ability to be used on the bedside. The aim of the present study is to evaluate the diagnostic accuracy of ultrasonography in detection of extremity bone fractures. METHODS: This study is a case series study, which was prospectively conducted on multiple blunt trauma patients, who were 18 years old or older, had stable hemodynamic, Glasgow coma scale 15, and signs or symptoms of a possible extremity bone fracture...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28277237/does-rapid-blood-sampling-affect-the-retention-time-of-patients-with-low-acuity-complaints-in-the-emergency-department
#5
Ju Young Lee, Sang Hoon Oh, Kyu Nam Park, Jee Yong Lim, Jung Min Lee, Hyun Suk Park, Han Joon Kim
INTRODUCTION: The objective of this study was to investigate whether rapid blood sampling during triage led to shorter stays in the emergency department for patients with low-acuity complaints. METHODS: A retrospective study was conducted in the emergency department (ED) of a tertiary university hospital in South Korea. A pre- and post-intervention comparison analysis was completed over one-month periods in June and September 2014. Data included triage level of the patient, time from the ED visit to receiving the doctor's orders, result time of complete blood cell count (CBC) and blood chemistry (BC), length of stay (LOS) for all discharged patients who required blood sampling...
October 27, 2016: International Emergency Nursing
https://www.readbyqxmd.com/read/28275282/additive-manufacturing-for-surgical-planning-of-mandibular-fracture
#6
Nadja Maria da Silva Oliveira Brito, Renata de Souza Coelho Soares, Erik Lafitt Tavares Monteiro, Sergio Charifker Ribeiro Martins, Josuel Raimundo Cavalcante, Rafael Grotta Grempel, José Augusto de Oliveira Neto
Currently, imaging techniques such as Computed Tomography with three-dimensional reconstruction (3D) and Magnetic Resonances are being routinely used in pre-surgical planning in all fields of medicine. Nowadays, virtual three-dimensional images, commonly displayed on two-dimensional surfaces, such as the computer screen, can be used to produce rapidly prototyped models, with excellent dimensional accuracy and fine reproduction of anatomical structures, providing professionals with the ability to use the biomodel in planning and simulating medical and dental procedures (oral and maxillofacial surgery, making individualized facial implants and prostheses, measurements and previous adaptations of prefabricated fixation plates), thus contributing to considerable reductions in surgical time and consequently the duration of anesthesia, minimizing infection risks and reducing hospital costs...
December 2016: Acta Stomatologica Croatica
https://www.readbyqxmd.com/read/28272590/all-together-now-impact-of-a-regionalization-and-bedside-rounding-initiative-on-the-efficiency-and-inclusiveness-of-clinical-rounds
#7
Kristin T L Huang, Jacquelyn Minahan, Patricia Brita-Rossi, Patricia Aylward, Joel T Katz, Christopher Roy, Jeffrey L Schnipper, Robert Boxer
BACKGROUND: Attending rounds at academic medical centers are often disconnected from patients and team members who are not physicians. Regionalization of care teams may facilitate bedside rounding and more frequent interactions among doctors, nurses, and patients. OBJECTIVE: We used time-motion analysis to investigate how regionalization of medical teams and encouragement of bedside rounds affect participants on rounds and rounding time. DESIGN AND SETTING: We used pre-post analysis to study the effects of care redesign on teams' daily rounds on a general medicine service at an academic medical center...
March 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28272589/standardized-attending-rounds-to-improve-the-patient-experience-a-pragmatic-cluster-randomized-controlled-trial
#8
Bradley Monash, Nader Najafi, Michelle Mourad, Alvin Rajkomar, Sumant R Ranji, Margaret C Fang, Marcia Glass, Dimiter Milev, Yile Ding, Andy Shen, Bradley A Sharpe, James D Harrison
BACKGROUND: At academic medical centers, attending rounds (AR) serve to coordinate patient care and educate trainees, yet variably involve patients. OBJECTIVE: To determine the impact of standardized bedside AR on patient satisfaction with rounds. DESIGN: Cluster randomized controlled trial. SETTING: 500-bed urban, quaternary care hospital. PATIENTS: 1200 patients admitted to the medicine service...
March 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28272588/the-impact-of-bedside-interdisciplinary-rounds-on-length-of-stay-and-complications
#9
Andrew S Dunn, Maria Reyna, Brian Radbill, Michael Parides, Claudia Colgan, Tobi Osio, Ari Benson, Nicole Brown, Joy Cambe, Margo Zwerling, Natalia Egorova, Harold Kaplan
BACKGROUND: Communication among team members within hospitals is typically fragmented. Bedside interdisciplinary rounds (IDR) have the potential to improve communication and outcomes through enhanced structure and patient engagement. OBJECTIVE: To decrease length of stay (LOS) and complications through the transformation of daily IDR to a bedside model. DESIGN: Controlled trial. SETTING: 2 geographic areas of a medical unit using a clinical microsystem structure...
March 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28265176/development-of-education-program-for-physical-therapy-assistant-in-quang-tri-province-of-vietnam
#10
Jin Won Noh, Sang Hyun Cho, Min Hee Kim, Eun Joo Kim
[Purpose] The purpose of the present study was to develop an education program for physical therapy assistants in order to provide high quality physical therapy for the province of Quang Tri in Vietnam. [Subjects and Methods] Subjects consisted of 9 professors in Quang Tri medical college and 1 physical therapist in Quang Tri General hospital. The survey research to lecturer for education of physical therapy assistant in Quang Tri medical college was conducted as pre-analysis of demand for the physical therapy assistant curriculum development...
February 2017: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/28259184/can-we-rely-on-out-of-hospital-blood-samples-a-prospective-interventional-study-on-the-pre-analytical-stability-of-blood-samples-under-prehospital-emergency-medicine-conditions
#11
Johannes Prottengeier, Nicola Jess, Frank Harig, Christine Gall, Joachim Schmidt, Torsten Birkholz
BACKGROUND: Prehospital intravenous access provides the opportunity to sample blood from an emergency patient at the earliest possible moment in the course of acute illness and in a state prior to therapeutic interventions. Our study investigates the pre-analytical stability of biomarkers in prehospital emergency medicine and will answer the question whether an approach of blood sampling out in the field will deliver valid laboratory results. METHODS: We prepared pairs of blood samples from healthy volunteers and volunteering patients post cardio-thoracic surgery...
March 4, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28257475/awareness-and-attitudes-of-pre-exposure-prophylaxis-for-hiv-prevention-among-physicians-in-guatemala-implications-for-country-wide-implementation
#12
Ian Ross, Carlos Mejia, Johanna Melendez, Philip A Chan, Amy C Nunn, William Powderly, Katherine Goodenberger, Jingxia Liu, Kenneth H Mayer, Rupa R Patel
INTRODUCTION: HIV continues to be a major health concern with approximately 2.1 million new infections occurring worldwide in 2015. In Central America, Guatemala had the highest incident number of HIV infections (3,700) in 2015. Antiretroviral pre-exposure prophylaxis (PrEP) was recently recommended by the World Health Organization (WHO) as an efficacious intervention to prevent HIV transmission. PrEP implementation efforts are underway in Guatemala and success will require providers that are knowledgeable and willing to prescribe PrEP...
2017: PloS One
https://www.readbyqxmd.com/read/28255734/robot-assisted-laparoscopic-transperitoneal-infrarenal-lymphadenectomy-in-patients-with-locally-advanced-cervical-cancer-by-single-docking-do-we-need-a-backup-procedure
#13
Fatih Gucer, Selim Misirlioglu, Nuri Ceydeli, Cagatay Taskiran
To present our initial experience on the feasibility of robotic transperitoneal para-aortic lymphadenectomy up to left renal vein via single docking approach by high port insertion technique followed by left shoulder docking as a rescue backup procedure in surgically obstructed patients undergoing surgical staging because of locally advanced cervical cancer (LACC). Prospective observational preliminary study. Canadian Task Force classification II-3. Tertiary-care academic affiliated private hospital. Ten patients with LACC who underwent robotic transperitoneal infrarenal para-aortic lymphadenectomy between January 2012 and December 2014...
March 2, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28246379/the-antibiotic-resistance-crisis-with-a-focus-on-the-united-states
#14
REVIEW
Evan Martens, Arnold L Demain
Beginning with the discovery of penicillin by Alexander Fleming in the late 1920s, antibiotics have revolutionized the field of medicine. They have saved millions of lives each year, alleviated pain and suffering, and have even been used prophylactically for the prevention of infectious diseases. However, we have now reached a crisis where many antibiotics are no longer effective against even the simplest infections. Such infections often result in an increased number of hospitalizations, more treatment failures and the persistence of drug-resistant pathogens...
March 1, 2017: Journal of Antibiotics
https://www.readbyqxmd.com/read/28239452/intervening-with-healthcare-workers-hand-hygiene-compliance-knowledge-and-perception-in-a-limited-resource-hospital-in-indonesia-a-randomized-controlled-trial-study
#15
Dewi Santosaningsih, Dewi Erikawati, Sanarto Santoso, Noorhamdani Noorhamdani, Irene Ratridewi, Didi Candradikusuma, Iin N Chozin, Thomas E C J Huwae, Gwen van der Donk, Eva van Boven, Anne F Voor In 't Holt, Henri A Verbrugh, Juliëtte A Severin
BACKGROUND: Hand hygiene is recognized as an important measure to prevent healthcare-associated infections. Hand hygiene adherence among healthcare workers is associated with their knowledge and perception. This study aimed to evaluate the effect of three different educational programs on improving hand hygiene compliance, knowledge, and perception among healthcare workers in a tertiary care hospital in Indonesia. METHODS: The study was performed from May to October 2014 and divided into a pre-intervention, intervention, and post-intervention phase...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28229980/acupuncture-improves-intestinal-absorption-of-iron-in-iron-deficient-obese-patients-a-randomized-controlled-preliminary-trial
#16
RANDOMIZED CONTROLLED TRIAL
Xin-Cai Xie, Yan-Qiang Cao, Qian Gao, Chen Wang, Man Li, Shou-Gang Wei
BACKGROUND: Obesity has an adverse effect on iron status. Hepcidin-mediated inhibition of iron absorption in the duodenum is a potential mechanism. Iron-deficient obese patients have diminished response to oral iron therapy. This study was designed to assess whether acupuncture could promote the efficacy of oral iron supplementation for the treatment of obesity-related iron deficiency (ID). METHODS: Sixty ID or ID anemia (IDA) patients with obesity were screened at Beijing Hospital of Traditional Chinese Medicine and were randomly allocated to receive either oral iron replacement allied with acupuncture weight loss treatment (acupuncture group, n = 30) or oral iron combined with sham-acupuncture treatment (control group, n = 30)...
March 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28228341/doctors-and-nurses-perceptions-of-military-pre-hospital-emergency-care-when-training-becomes-reality
#17
REVIEW
Sten-Ove Andersson, Lars Lundberg, Anders Jonsson, Pia Tingström, Madeleine Abrandt Dahlgren
The aim of this study was to identify physicians' and nurses' perceptions of military pre-hospital emergency care before and after an international mission. A qualitative empirical study with a phenomenographic approach was used. The results after pre-deployment training can be categorised as (1) learning about military medicine and (2) taking care of the casualty. The results after an international mission can be categorised as (1) collaborating with others, (2) providing general health care and (3) improving competence in military medicine...
February 19, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28225315/improving-glycemic-control-safely-in-critical-care-patients-a-collaborative-systems-approach-in-nine-hospitals
#18
Gregory A Maynard, Janet Holdych, Heather Kendall, Karen Harrison, Patricia A Montgomery, Kristen Kulasa
Objective Safely improve glycemic control in the critical care units of nine hospitals. Methods Critical care adult inpatients from nine hospitals with ≥ 4 point-of-care (POC) blood glucose (BG) readings over ≥ 2 days were targeted by collaborative improvement efforts to reduce hyper- and hypo-glycemia. Balanced glucometric goals for each hospital were set targeting improvement from baseline, or goals deemed desirable from Society of Hospital Medicine (SHM) benchmarking data. Collaborative interventions included standardized insulin infusion protocols, hypoglycemia prevention bundles, audit and feedback, education, and measure-vention (coupling measurement of patients "off protocol" with concurrent interventions to correct suboptimal care)...
February 22, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28224346/dedication-increases-productivity-an-analysis-of-the-implementation-of-a-dedicated-medical-team-in-the-emergency-department
#19
Pedro Ramos, José Artur Paiva
BACKGROUND: In several European countries, emergency departments (EDs) now employ a dedicated team of full-time emergency medicine (EM) physicians, with a distinct leadership and bed-side emergency training, in all similar to other hospital departments. In Portugal, however, there are still two very different models for staffing EDs: a classic model, where EDs are mostly staffed with young inexperienced physicians from different medical departments who take turns in the ED in 12-h shifts and a dedicated model, recently implemented in some hospitals, where the ED is staffed by a team of doctors with specific medical competencies in emergency medicine that work full-time in the ED...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28219959/randomised-prospective-medico-economic-nationwide-french-study-of-islet-transplantation-in-patients-with-severely-unstable-type-1-diabetes-the-stabilot-study-protocol
#20
Sandrine Lablanche, Sandra David-Tchouda, Jennifer Margier, Edith Schir, Anne Wojtusciszyn, Sophie Borot, Laurence Kessler, Emmanuel Morelon, Charles Thivolet, François Pattou, Marie Christine Vantyghem, Thierry Berney, Pierre-Yves Benhamou
INTRODUCTION: Islet transplantation may be an appropriate treatment option for patients with severely unstable type 1 diabetes experiencing major glucose variability with severe hypoglycaemia despite intensive insulin therapy. Few data are available on the costs associated with islet transplantation in relation to its benefits. The STABILOT study proposes to assess the economic impact of islet transplantation in comparison with the current best medical treatment defined as sensor-augmented pump (SAP) therapy...
February 20, 2017: BMJ Open
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