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https://www.readbyqxmd.com/read/29333496/improving-the-wait-time-to-consultation-at-the-emergency-department
#1
Yuzeng Shen, Lin Hui Lee
Prolonged wait times at the emergency department (ED) are associated with increased morbidity and mortality, and decreased patient satisfaction. Reducing wait times at the ED is challenging. The objective of this study is to determine if the implementation of a series of interventions would help decrease the wait time to consultation (WTC) for patients at the ED within 6 months. Interventions include creation of a common board detailing work output, matching manpower to patient arrivals and adopting a team-based model of care...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29332302/preoperative-cognitive-impairment-as-a-predictor-of-postoperative-outcomes-in-a-collaborative-care-model
#2
Kahli Zietlow, Shelley R McDonald, Richard Sloane, Jeffrey Browndyke, Sandhya Lagoo-Deenadayalan, Mitchell T Heflin
OBJECTIVES: To compare postoperative outcomes of individuals with and without cognitive impairment enrolled in the Perioperative Optimization of Senior Health (POSH) program at Duke University, a comanagement model involving surgery, anesthesia, and geriatrics. DESIGN: Retrospective analysis of individuals enrolled in a quality improvement program. SETTING: Tertiary academic center. PARTICIPANTS: Older adults undergoing surgery and referred to POSH (N = 157)...
January 13, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29330986/use-of-psychoactive-drugs-among-medical-undergraduates-in-abbottabad
#3
Haq Nawaz, Aftab Alam Khan, Saima Bukhari
BACKGROUND: Psychoactive substance abuse is prevalent among medical undergraduates of Pakistan, India & Western countries which can adversely affect the physical & psychological grooming of a medical undergraduate thus threatening to compromise their role as future physicians & health-care providers in the society. The objective of the present cross-sectional study was to explore the prevalence and patterns of psychoactive substance/drug consumption among undergraduate students of a public sector medical college in Abbottabad...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29330235/primary-care-physician-perspectives-about-antipsychotics-and-other-medications-for-symptoms-of-dementia
#4
J William Kerns, Jonathan D Winter, Katherine M Winter, Terry Boyd, Rebecca S Etz
BACKGROUND: Guidelines, policies, and warnings have been applied to reduce the use of medications for behavioral and psychological symptoms of dementia (BPSD). Because of rare dangerous side effects, antipsychotics have been singled out in these efforts. However, antipsychotics are still prescribed "off label" to hundreds of thousands of seniors residing in nursing homes and communities. Our objective was to evaluate how and why primary-care physicians (PCPs) employ nonpharmacologic strategies and drugs for BPSD...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29329555/exercise-during-and-after-neoadjuvant-rectal-cancer-treatment-the-exert-trial-study-protocol-for-a-randomized-controlled-trial
#5
Andria R Morielli, Nawaid Usmani, Normand G Boulé, Diane Severin, Keith Tankel, Tirath Nijjar, Kurian Joseph, Alysa Fairchild, Kerry S Courneya
BACKGROUND: Standard treatment for locally advanced rectal cancer includes 5-6 weeks of neoadjuvant chemoradiotherapy (NACRT) followed by total mesorectal excision 6-8 weeks later. NACRT improves local disease control and surgical outcomes but also causes side effects including fatigue, diarrhea, hand-foot syndrome, and physical deconditioning that may impede quality of life (QoL), treatment completion, treatment response, and long-term prognosis. Interventions to improve treatment outcomes and manage side effects that are safe, tolerable and low-cost are highly desirable...
January 12, 2018: Trials
https://www.readbyqxmd.com/read/29326414/-effect-of-debriefing-based-on-the-clinical-judgment-model-on-simulation-based-learning-outcomes-of-end-of-life-care-for-nursing-students-a-non-randomized-controlled-trial
#6
Kyung In Jeong, Ja Yun Choi
PURPOSE: This study was conducted to identify effects of debriefing based on the clinical judgment model for nursing students on their knowledge, skill performance, clinical judgment, self-confidence and learner satisfaction during simulation based end-of-life care (ELC) education. METHODS: Simulation based ELC education was developed in six steps as follows: selection of learning subjects and objects, development of learning tools, a trial run of simulation-based education, students' skill training, and evaluators' training...
December 2017: Journal of Korean Academy of Nursing
https://www.readbyqxmd.com/read/29324048/peer-observation-of-rounds-leads-to-collegial-discussion-of-teaching
#7
J Rush Pierce, Patrick Rendón, Deepti Rao
PROBLEM: Faculty in the Division of Hospital Medicine provide most of the clinical teaching for learners at our institution. The majority of these faculty are Assistant Professors with limited formal instruction in clinical teaching. Previous Divisional strategies to improve clinical teaching ability included discussion of effective teaching behaviors, developing written expectations for teaching faculty, and instituting seminars on effective clinical teaching. Heretofore, the Division had not utilized a direct observation exercise...
January 11, 2018: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/29323832/influences-of-a-church-based-intervention-on-falls-risk-among-seniors
#8
Morgan Briggs, Jeffrey A Morzinski, Julie Ellis
BACKGROUND AND OBJECTIVES: Prior studies illustrate that community-based programs effectively decrease falls risk in older adults and that faith-based programs improve health behaviors. The literature is unclear whether faith-based initiatives reduce seniors' fall risks. To tackle this gap, a long-term partnership led by 10 urban churches, a nearby nursing school, and a medical school developed a study with 3 objectives: determine baseline health concerns associated with falls (eg, depression, polypharmacy), implement a nurse-led, faith-based health education initiative for community-dwelling African American seniors at-risk of hospitalization, and assess pre- to post -program fall frequency...
August 2017: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/29322683/exploring-the-research-culture-of-nurses-and-allied-health-professionals-ahps-in-a-research-focused-and-a-non-research-focused-healthcare-organisation-in-the-uk
#9
Manju Luckson, Fiona Duncan, Azita Rajai, Carol Haigh
AIMS AND OBJECTIVES: There is a gap in knowledge about the research culture of nurses and Allied Health Professionals (AHPs) in the UK, and the influence of a dedicated research strategy and funding. It is important to understand the culture in order to effectively promote evidence - based patient care. The primary aim of this research was to explore the influence of research focused exposure on the research culture of nurses and AHPs in the UK, and to identify if there was a difference in the research culture between a research- focused and non-research - focused clinical area (City and Riverside Hospitals)...
January 10, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29317368/interdisciplinary-care-model-independently-decreases-use-of-critical-care-services-after-corrective-surgery-for-adult-degenerative-scoliosis
#10
Owoicho Adogwa, Aladine A Elsamadicy, Amanda R Sergesketter, Michael Ongele, Victoria Vuong, Syed Khalid, Jessica Moreno, Joseph Cheng, Isaac O Karikari, Carlos A Bagley
OBJECTIVE: Interdisciplinary management of elderly patients requiring spine surgery has been shown to improve short and long-term outcomes. The aim of this study is to determine whether an interdisciplinary team approach mitigates use of intensive care unit (ICU) resources. METHODS: A unique co-management model for elderly patients undergoing lumbar fusion surgery was implemented at a major academic medical center. The Peri-operative Optimization of Senior Health Program(POSH) was launched with the aim of improving outcomes in elderly patients(>65-years-old) undergoing complex lumbar spine surgery...
January 6, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29316884/sharp-injuries-a-cross-sectional-study-among-health-care-workers-in-a-provincial-teaching-hospital-in-china
#11
Zhuo Cui, Jingrui Zhu, Xiangjun Zhang, Bairu Wang, Xiaojun Li
BACKGROUND: The objectives of this study are to investigate the incidence and reporting behavior of sharp injuries among healthcare workers (HCWs) and identify the risk factors associated with these injuries. METHODS: A cross-sectional survey was conducted in February 2017 in a provincial teaching hospital in China. Data were collected from 901 HCWs using a self-administered questionnaire which included demographic information, experience, and reporting behavior of sharp injuries...
January 10, 2018: Environmental Health and Preventive Medicine
https://www.readbyqxmd.com/read/29314188/-seniors-only-want-respect-designing-an-oral-health-program-for-older-adults
#12
Ivette Estrada, Carol Kunzel, Eric W Schrimshaw, Ariel P Greenblatt, Sara S Metcalf, Mary E Northridge
AIM: Persistent socioeconomic disparities in the oral disease burden contribute to pain and suffering among vulnerable and underserved populations who face systemic barriers to access oral health care, including older adults living in disadvantaged urban neighborhoods. The aim of this study is to gain the views of racial/ethnic minority older adults regarding what they believe would support them and their peers in visiting the dentist regularly. METHODS AND RESULTS: Focus groups were conducted and digitally audio-recorded from 2013 to 2015 with 194 racial/ethnic minority women and men aged 50 years and older living in northern Manhattan who participated in one of 24 focus group sessions about improving oral health for older adults...
January 4, 2018: Special Care in Dentistry
https://www.readbyqxmd.com/read/29310735/what-do-clinical-supervisors-require-to-teach-residents-in-family-medicine-how-to-care-for-seniors
#13
Anik M C Giguere, Paule Lebel, Michèle Morin, Françoise Proust, Charo Rodríguez, Valerie Carnovale, Louise Champagne, France Légaré, Pierre-Hugues Carmichael, Bernard Martineau, Philippe Karazivan, Pierre J Durand
We assessed clinicians' continuing professional development (CPD) needs at family practice teaching clinics in the province of Quebec. Our mixed methodology design comprised an environmental scan of training programs at four family medicine departments, an expert panel to determine priority clinical situations for senior care, a supervisors survey to assess their perceived CPD needs, and interviews to help understand the rationale behind their needs. From the environmental scan, the expert panel selected 13 priority situations...
January 9, 2018: Canadian Journal on Aging, la Revue Canadienne du Vieillissement
https://www.readbyqxmd.com/read/29306578/utility-of-a-standardized-fourth-year-medical-student-surgical-preparatory-curriculum-program-director-perceptions
#14
Melissa K Stewart, Rebecca C Henry, Jesse M Ehrenfeld, Kyla P Terhune
OBJECTIVE: Each July, surgical interns arrive to residency with variable skills, knowledge, and clinical experience. To standardize and improve intern preparation, the American College of Surgeons (ACS), Association of Program Directors in Surgery, and Association for Surgical Education developed a pilot Resident Prep Curriculum (RPC). To date, no studies have analyzed these efforts. We aimed to discern program director (PD) perceptions of RPC participants as an initial means of analysis...
January 3, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29304857/a-qualitative-exploration-of-the-discharge-process-and-factors-predisposing-to-readmissions-to-the-intensive-care-unit
#15
Uchenna R Ofoma, Yue Dong, Ognjen Gajic, Brian W Pickering
BACKGROUND: Quantitative studies have demonstrated several factors predictive of readmissions to intensive care. Clinical decision tools, derived from these factors have failed to reduce readmission rates. The purpose of this study was to qualitatively explore the experiences and perceptions of physicians and nurses to gain more insight into intensive care readmissions. METHODS: Semi-structured interviews of intensive care unit (ICU) and general medicine care providers explored work routines, understanding and perceptions of the discharge process, and readmissions to intensive care...
January 5, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29302091/engaging-pharmacy-students-in-research-through-near-peer-training
#16
Benjamin J Lee, Nathaniel J Rhodes, Marc H Scheetz, Milena M McLaughlin
Objective. To describe the implementation of a near-peer training model within a student research program. Methods. A near-peer training model was implemented in a pharmacy student research program to promote development of effective teaching skills and research competencies. Under the supervision of a research mentor, senior learners precepted junior learners in various aspects of translational research. A three-step teaching process was employed throughout the experience in which junior learners performed an assigned task, senior learners provided guidance and mentorship, and research mentors provided feedback for improvement...
November 2017: American Journal of Pharmaceutical Education
https://www.readbyqxmd.com/read/29299815/older-adults-perceptions-of-the-causes-and-consequences-of-healthcare-overuse-a-qualitative-study
#17
Ariel R Green, Monica Tung, Jodi B Segal
BACKGROUND: Overuse of healthcare is pervasive in the United States, often exposing patients to harm with little likelihood of benefit. Older Americans are particularly vulnerable to overuse and impacted by it, yet it is unknown whether older patients perceive overuse as a consequential problem. OBJECTIVE: To explore the experiences and perspectives of older adults with respect to healthcare overuse in order to develop a framework for understanding and reducing overuse in older adults...
January 3, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29299599/association-of-integrated-care-coordination-with-postsurgical-outcomes-in-high-risk-older-adults-the-perioperative-optimization-of-senior-health-posh-initiative
#18
Shelley R McDonald, Mitchell T Heflin, Heather E Whitson, Thomas O Dalton, Michael E Lidsky, Phillip Liu, Cornelia M Poer, Richard Sloane, Julie K Thacker, Heidi K White, Mamata Yanamadala, Sandhya A Lagoo-Deenadayalan
Importance: Older adults undergoing elective surgery experience higher rates of preventable postoperative complications than younger patients. Objective: To assess clinical outcomes for older adults undergoing elective abdominal surgery via a collaborative intervention by surgery, geriatrics, and anesthesia focused on perioperative health optimization. Design, Setting, and Participants: Perioperative Optimization of Senior Health (POSH) is a quality improvement initiative with prospective data collection...
January 3, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29295000/abuse-of-older-persons-with-cognitive-and-physical-impairments-comparing-percentages-across-informants-and-operational-definitions
#19
Boye Fang, Elsie Yan
This study compared percentages of elder abuse reported by older adults and their family caregivers, using reports from attending medical professionals to triangulate the reports. Percentages were also compared using different criteria proposed in the literature. In total, 1,002 older Chinese aged 55 years or above and their primary family caregivers were recruited from three leading public hospitals in Guangdong, People's Republic of China. Caregivers and care recipients were separately interviewed and provided information on their demographic characteristics and past year percentages of abuse...
November 1, 2017: Journal of Interpersonal Violence
https://www.readbyqxmd.com/read/29291178/a-competency-based-simulation-curriculum-for-surgical-resident-trauma-resuscitation-skills
#20
Matthew L Moorman, Tony R Capizzani, Michelle A Feliciano, Judith C French
Background: Evidence-based curricula for nonprocedural simulation training in general surgery are lacking. Residency programs are required to implement simulation training despite this shortcoming. The goal of this project was the development of a simulation curriculum that measurably improves milestone performance and replaces traditional experienced-based training with a competency-based model. Materials and Methods: SimMan 3G® (Laerdal Medical, Wappingers Falls, NY, USA) was utilized for simulation...
October 2017: International Journal of Critical Illness and Injury Science
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