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https://www.readbyqxmd.com/read/28931363/a-guideline-based-policy-to-decrease-intensive-care-unit-admission-rates-for-accidental-hypothermia
#1
Herman R Sequeira, Hesham E Mohamed, Neal Hakimi, Dorothy B Wakefield, Jonathan Fine
RATIONALE: Despite guidelines advising passive rewarming for mild accidental hypothermia (AH), patients are frequently admitted to intensive care unit (ICU) for active rewarming using a forced-air warming device. We implemented a new policy at our institution aimed at safely reducing ICU admissions for AH. We analyzed our practice pre- and post-policy intervention and compared our experiences with acute care hospitals in Connecticut. METHODS: A retrospective chart review was performed on 203 participants with AH identified by primary and secondary discharge codes...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28929424/aphasia-as-a-predictor-of-stroke-outcome
#2
REVIEW
Ronald M Lazar, Amelia K Boehme
PURPOSE OF REVIEW: Aphasia is a common feature of stroke, affecting 21-38% of acute stroke patients and an estimated 1 million stroke survivors. Although stroke, as a syndrome, is the leading cause of disability in the USA, less is known about the independent impact of aphasia on stroke outcomes. RECENT FINDINGS: During the acute stroke period, aphasia has been found to increase length of stay, inpatient complications, overall neurological disability, mortality, and to alter discharge disposition...
September 19, 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28921446/can-a-novel-icu-data-display-positively-affect-patient-outcomes-and-save-lives
#3
Natalia Olchanski, Mikhail A Dziadzko, Ing C Tiong, Craig E Daniels, Steve G Peters, John C O'Horo, Michelle N Gong
The aim of this study was to quantify the impact of ProCCESs AWARE, Ambient Clinical Analytics, Rochester, MN, a novel acute care electronic medical record interface, on a range of care process and patient health outcome metrics in intensive care units (ICUs). ProCCESs AWARE is a novel acute care EMR interface that contains built-in tools for error prevention, practice surveillance, decision support and reporting. We compared outcomes before and after AWARE implementation using a prospective cohort and a historical control...
September 18, 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28919813/a-prospective-double-blinded-randomized-comparison-of-ultrasound-guided-femoral-nerve-block-with-lateral-femoral-cutaneous-nerve-block-versus-standard-anesthetic-management-for-pain-control-during-and-after-traumatic-femur-fracture-repair-in-the-pediatric-population
#4
Nicole M Elsey, Joseph D Tobias, Kevin E Klingele, Ralph J Beltran, Tarun Bhalla, David Martin, Giorgio Veneziano, Julie Rice, Dmitry Tumin
BACKGROUND: Traumatic injury of the femur resulting in femoral fracture may result in significant postoperative pain. As with other causes of acute pain, regional anesthesia may offer a benefit over conventional therapy with intravenous opioids. This study prospectively assesses the effects of femoral nerve blockade with a lateral femoral cutaneous nerve block (FN-LFCN) on intraoperative anesthetic requirements, postoperative pain scores, and opioid requirements. MATERIALS AND METHODS: Seventeen pediatric patients (age 2-18 years) undergoing surgical repair of a traumatic femur fracture fulfilled the study criteria and were randomly assigned to general anesthesia with either an FN-LFCN block (n = 10) or intravenous opioids (n = 7)...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28918410/-just-like-a-normal-pain-what-do-people-with-diabetes-mellitus-experience-when-having-a-myocardial-infarction-a-qualitative-study-recruited-from-uk-hospitals
#5
Nikita Berman, Melvyn Mark Jones, Daan A De Coster
OBJECTIVE: The objective of the study was to investigate the symptoms people with diabetes experience when having a myocardial infarction (MI), their illness narrative and how they present their symptoms to the health service. SETTING: Three London (UK) hospitals (coronary care units and medical wards). PARTICIPANTS: Patients were recruited with diabetes mellitus (DM) (types 1 and 2) with a clinical presentation of MI (ST elevated MI (STEMI), non-ST elevated MI (NSTEMI), acute MI unspecified and cardiac arrest)...
September 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28912916/acute-liver-failure-in-a-patient-travelling-from-asia-the-other-face-of-the-coin-of-infectious-disease
#6
Balen Abdulrahman, Mohamed H Ahmed, John Ramage
We present a case of a 63-year-old male who had travelled from South India to United Kingdom (UK) visiting relatives. He had developed episodes of diarrhea, vomiting and fevers while travelling and on assessment in hospital, mild abdominal distension was noted with rapid deterioration to hypovolemic shock. Initial blood test showed a low platelet count with deranged liver function tests (LFTs). It was noted that during admission to intensive care unit (ICU), blood continued to ooze from a previous surgical laparoscopy wound, central and arterial line access sites...
August 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28910238/telemanagement-of-heart-failure-patients-across-the-post-acute-care-continuum
#7
Amy Dadosky, Heather Overbeck, Laura Barbetta, Ken Bertke, Maureen Corl, Kathleen Daly, Natasha Hiles, Nancy Rector, Eugene Chung, Santosh Menon
BACKGROUND: Heart failure (HF) is a chronic condition causing nearly 1 million hospital admissions annually in the United States with 25% of patients rehospitalized within 30 days. INTRODUCTION: The purpose of this study was to investigate whether telemanagement of HF patients throughout the post-acute continuum of care would reduce rehospitalization rates and improve patient self-care knowledge and satisfaction. MATERIALS AND METHODS: HF patients discharged to a skilled nursing facility (SNF) received telemanagement by HF clinicians with opportunity for continuation at home with assistance of home healthcare (HHC) nurses...
September 13, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28905076/-life-after-ards
#8
REVIEW
B Sensen, S Braune, G de Heer, T Bein, S Kluge
Patients who survive acute respiratory distress syndrome (ARDS) often suffer from long-term physical and psychological sequelae. Lung function is commonly only mildly reduced, whereas general physical activity and walking distance are often compromised. Most markedly, these patients have a high incidence of depression, anxiety, and posttraumatic stress disorder. The rate of cognitive dysfunction is as high as 70-100% at the time of hospital discharge, and remains 46-80% and 20% one year and five years post discharge, respectively...
September 13, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28901791/determinants-of-1-year-survival-in-critically-ill-acute-leukemia-patients-a-grrr-oh-study
#9
Márcio Tavares, Virginie Lemiale, Djamel Mokart, Frédéric Pène, Etienne Lengliné, Achille Kouatchet, Julien Mayaux, François Vincent, Martine Nyunga, Fabrice Bruneel, Antoine Rabbat, Christine Lebert, Pierre Perez, Anne-Pascale Meert, Dominique Benoit, Michael Darmon, Elie Azoulay
Acute leukemia (AL) is the most common hematological malignancy requiring intensive care unit (ICU) management. Data on long-term survival are limited. This is a post hoc analysis of the prospective multicenter data from France and Belgium: A Groupe de Recherche Respiratoire en Réanimation Onco-Hématologique [A Research Group on Acute Respiratory Failure in Onco-Hematological Patients (French)] Study, to identify determinants of 1-year survival in critically ill AL patients. A total of 278 patients were admitted in the 17 participating ICUs...
September 13, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28893432/effects-of-person-centred-care-after-an-event-of-acute-coronary-syndrome-two-year-follow-up-of-a-randomised-controlled-trial
#10
Andreas Fors, Karl Swedberg, Kerstin Ulin, Axel Wolf, Inger Ekman
AIM: To assess the long-term effect of person-centred care (PCC) in patients with acute coronary syndrome (ACS). METHOD: Patients with ACS were randomly assigned to treatment as usual (control group) or an added PCC intervention for six months. The primary endpoint was a composite score of changes in general self-efficacy≥five units, return to work or to a prior activity level and re-hospitalisation or death. RESULTS: The composite score improved in the PCC intervention group (n=94) at a two-year follow-up compared with the control group (n=105) (18...
September 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28882655/brief-psychological-intervention-in-phase-i-of-cardiac-rehabilitation-after-acute-coronary-syndrome
#11
Ana Cláudia Fernandes, Teresa McIntyre, Rui Coelho, Joana Prata, Maria Júlia Maciel
INTRODUCTION: Acute coronary syndrome (ACS) is an important cause of mortality and significant personal and financial costs. Cardiac rehabilitation (CR) programs have shown positive effects in reducing cardiovascular mortality and improving functional capacity. However, adherence is low and appears to be influenced by psychosocial factors, such as patients' cognitions and emotional state. The objective was to evaluate the efficacy of a brief in-hospital psychological intervention to promote cognitive and emotional adaptation after ACS...
September 4, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28870188/assessing-the-impact-of-the-introduction-of-an-electronic-hospital-discharge-system-on-the-completeness-and-timeliness-of-discharge-communication-a-before-and-after-study
#12
Rajnikant L Mehta, Bryn Baxendale, Katie Roth, Victoria Caswell, Ivan Le Jeune, Jack Hawkins, Haya Zedan, Anthony J Avery
BACKGROUND: Hospital discharge summaries are a key communication tool ensuring continuity of care between primary and secondary care. Incomplete or untimely communication of information increases risk of hospital readmission and associated complications. The aim of this study was to evaluate whether the introduction of a new electronic discharge system (NewEDS) was associated with improvements in the completeness and timeliness of discharge information, in Nottingham University Hospitals NHS Trust, England...
September 5, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28865892/comparison-of-readmission-rates-after-acute-myocardial-infarction-in-3-patient-age-groups-18-to-44-45-to-64-and-%C3%A2-65-years-in-the-united-states
#13
Rohan Khera, Snigdha Jain, Ambarish Pandey, Vijay Agusala, Dharam J Kumbhani, Sandeep R Das, Jarett D Berry, James A de Lemos, Saket Girotra
Postacute myocardial infarction (AMI) readmissions are common among Medicare beneficiaries (≥65 years) and are associated with significant resource utilization. However, patterns of AMI readmissions for younger age groups in the United States are not known. In the Nationwide Readmissions Database, a nationally representative all-payer database of inpatient hospitalizations, we identified 212,171 index AMI hospitalizations in January to November 2013, weighted to represent 478,247 hospitalizations nationally (mean age 66...
August 4, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28863026/transfusion-of-older-red-blood-cells-increases-the-risk-of-acute-kidney-injury-after-orthotopic-liver-transplantation-a-propensity-score-analysis
#14
Yue Wang, Qingshan Li, Tao Ma, Xuemin Liu, Bo Wang, Zheng Wu, Shaonong Dang, Yi Lv, Rongqian Wu
BACKGROUND: Acute kidney injury (AKI) is a common and serious complication of orthotopic liver transplantation (OLT). Transfusion of older red blood cells (RBCs) has been implicated in poor outcomes in trauma, cardiac surgery, and critically ill patients. However, whether transfusion of older RBCs plays any role in post-OLT AKI remained unknown. The aim of this study was to investigate the effect of the age of transfused RBCs on post-OLT AKI. METHODS: The clinical data of consecutive adult patients who received donation after cardiac death and underwent OLT from December 2011 to December 2015 were analyzed...
August 31, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28860727/the-role-of-caregivers-in-interfacility-care-transitions-a-qualitative-study
#15
Lianne Jeffs, Marianne Saragosa, Madelyn P Law, Kerry Kuluski, Sherry Espin, Jane Merkley
A qualitative design was used to explore the nature of caregiver involvement in care transitions of patients being transferred from an acute care hospital to a rehabilitation hospital. Participants included older adults (n=13), informal caregivers (n=9), and health care professionals (n=50) from inpatient orthopedic units in two academic health science centers and one orthopedic inpatient rehabilitation unit. Semistructured interviews were conducted, audio-taped, and transcribed. Directed content analysis revealed the following four themes: watching, being an active care provider, advocating, and navigating the health care system...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28858955/variability-in-acuity-in-acute-care
#16
Amy L Garcia
OBJECTIVE: This study was designed to describe variable acuity among 1 population of acute care patients. BACKGROUND: Acuity, defined as the individual patient need for nursing care, can inform level of care, nurse staffing, and the nurse-to-patient assignment. Nurse-generated data in the electronic health record can be mined and analyzed for decision support. METHODS: This study used a descriptive, retrospective analysis of repeated measures of acuity generated from 28 739 nursing assessments of 405 consecutive subjects treated for heart failure (HF) in a 455-bed southern hospital...
August 31, 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/28854198/consequences-and-coping-strategies-six-years-after-a-subarachnoid-hemorrhage-a-qualitative-study
#17
Hanna C Persson, Karin Törnbom, Katharina S Sunnerhagen, Marie Törnbom
BACKGROUND: After a subarachnoid haemorrhage (SAH), continuing impairment is common and may impact the person's life. There is a lack of knowledge regarding long-term consequences experienced. PURPOSE: To explore experiences of the care and rehabilitation as well as the consequences and strategies used to cope with everyday life six years post SAH. METHODS: An explorative interview study with a qualitative design. Individual interviews, with open ended questions, using an interview guide were performed with sixteen participants (mean age 63, 8 men, 8 women) six years post SAH...
2017: PloS One
https://www.readbyqxmd.com/read/28852474/the-prevalence-of-pulmonary-complications-after-thoracic-and-abdominal-surgery-and-associated-risk-factors-in-patients-admitted-at-a-government-hospital-in-harare-zimbabwe-a-retrospective-study
#18
Cathrine Tadyanemhandu, Rufaro Mukombachoto, Clement Nhunzvi, Farayi Kaseke, Vasco Chikwasha, Samson Chengetanai, Shamila Manie
BACKGROUND: The burden of HIV/AIDS in Sub-Saharan Africa has presented unusual and challenging acute surgical problems across all specialties. Thoraco-abdominal surgery cuts through muscle and thereby disrupts the normal anatomy and activity of the respiratory muscles leading to reduced lung volumes and putting the patients at greater risk of developing post-operative pulmonary complications (PPCs). PPCs remain an important cause of post-operative morbidity, mortality, and impacts on the long-term outcomes of patients post hospital discharge...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/28845902/persistence-of-delirium-after-cessation-of-sedatives-and-analgesics-and-impact-on-clinical-outcomes-in-critically-ill-patients
#19
Michael T Kenes, Joanna L Stollings, Li Wang, Timothy D Girard, E Wesley Ely, Pratik P Pandharipande
STUDY OBJECTIVE: As delirium is a common manifestation in critically ill patients and is associated with worse clinical outcomes, we sought to characterize the reversibility of delirium after discontinuation of sedation and to determine whether sedation-associated delirium that rapidly reverses impacts clinical outcomes. DESIGN: Post hoc subgroup analysis of prospectively collected data from a previously published study. PATIENTS: Seventy adults admitted to a medical intensive care unit (ICU) between March and July 2012 who required mechanical ventilation with continuous analgesia and/or sedation and underwent a spontaneous awakening trial (SAT)...
August 28, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28844232/a-multicomponent-fall-prevention-strategy-reduces-falls-at-an-academic-medical-center
#20
Dan France, Jenny Slayton, Sonya Moore, Henry Domenico, Julia Matthews, Robin L Steaban, Neesha Choma
BACKGROUND: While the reduction in fall rates has not kept pace with the reduction of other hospital-acquired conditions, patient safety research and quality improvement (QI) initiatives at the system and hospital levels have achieved positive results and provide insights into potentially effective risk reduction strategies. An academic medical center developed a QI-based multicomponent strategy for fall prevention and pilot tested it for six months in three high-risk units-the Neuroscience Acute Care Unit, the Myelosuppression/Stem Cell Transplant Unit, and the Acute Care for the Elderly Unit-before implementing and evaluating the strategy hospitalwide...
September 2017: Joint Commission Journal on Quality and Patient Safety
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