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https://www.readbyqxmd.com/read/28726539/rethinking-transitions-of-care-an-interprofessional-transfer-triage-protocol-in-post-acute-care
#1
Radha V Patel, Lauri Wright, Brittany Hay
Readmissions to hospitals from post-acute care (PAC) units within long-term care settings have been rapidly increasing over the past decade, and are drivers of increased healthcare costs. With an average of $11,000 per admission, there is a need for strategies to reduce 30-day preventable hospital readmission rates. In 2018, incentives and penalties will be instituted for long-term care facilities failing to meet all-cause, all-condition hospital readmission rate performance measures. An interprofessional team (IPT) developed and implemented a Transfer Triage Protocol used in conjunction with the INTERACT programme to enhance clinical decision-making and assess the potential to reduce the facility's 30-day preventable hospital readmission rates by 10% within 6 weeks of implementation...
July 20, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28716775/acute-rehabilitation-after-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-in-major-trauma
#2
Jessica Anne Rich, Julia Coleman, Camille Devaux, Karen Hoffman
We report a 23-year-old woman admitted post cyclist versus heavy goods vehicle accident in December 2014. This was the second case the life-saving procedure, that is, resuscitative endovascular balloon occlusion of the aorta (REBOA) was performed on at the roadside. This advanced procedure was performed due to the extensive haemorrhage from this patient's complex pelvic fracture . As a result of REBOA, the patient consequently lost her left lower limb and underwent a variety of complex pelvic and lower limb surgeries...
July 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28716014/the-comprehensive-post-acute-stroke-services-compass-study-design-and-methods-for-a-cluster-randomized-pragmatic-trial
#3
Pamela W Duncan, Cheryl D Bushnell, Wayne D Rosamond, Sara B Jones Berkeley, Sabina B Gesell, Ralph B D'Agostino, Walter T Ambrosius, Blair Barton-Percival, Janet Prvu Bettger, Sylvia W Coleman, Doyle M Cummings, Janet K Freburger, Jacqueline Halladay, Anna M Johnson, Anna M Kucharska-Newton, Gladys Lundy-Lamm, Barbara J Lutz, Laurie H Mettam, Amy M Pastva, Mysha E Sissine, Betsy Vetter
BACKGROUND: Patients discharged home after stroke face significant challenges managing residual neurological deficits, secondary prevention, and pre-existing chronic conditions. Post-discharge care is often fragmented leading to increased healthcare costs, readmissions, and sub-optimal utilization of rehabilitation and community services. The COMprehensive Post-Acute Stroke Services (COMPASS) Study is an ongoing cluster-randomized pragmatic trial to assess the effectiveness of a comprehensive, evidence-based, post-acute care model on patient-centered outcomes...
July 17, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28713659/a-descriptive-report-of-early-mobilization-for-critically-ill-ventilated-patients-with-cancer
#4
Amanda Weeks, Claudine Campbell, Prabalini Rajendram, Weiji Shi, Louis Voigt
BACKGROUND: Early mobilization protocols have been successfully implemented to improve function in critically ill patients; however, no study has focused on the oncology population. OBJECTIVES: To investigate the feasibility of early mobilization and describe the rehabilitation interventions and discharge outcomes in a cohort of critically ill patients with cancer. DESIGN: Retrospective review. METHODS: A retrospective analysis of patients with cancer who participated in occupational and physical therapy while on mechanical ventilation utilizing an institutional early mobilization protocol from June 2010 - July 2011, was completed...
July 2017: Rehabilitation Oncology
https://www.readbyqxmd.com/read/28706581/early-acute-kidney-injury-after-liver-transplantation-predisposing-factors-and-clinical-implications
#5
Suehana Rahman, Brian R Davidson, Susan V Mallett
AIM: To investigate the additional clinical impact of hepatic ischaemia reperfusion injury (HIRI) on patients sustaining acute kidney injury (AKI) following liver transplantation. METHODS: This was a single-centre retrospective study of consecutive adult patients undergoing orthotopic liver transplantation (OLT) between January 2013 and June 2014. Early AKI was identified by measuring serum creatinine at 24 h post OLT (> 1.5 × baseline) or by the use of continuous veno-venous haemofiltration (CVVHF) during the early post-operative period...
June 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28704244/implementation-of-a-standardized-transfusion-protocol-for-cardiac-patients-treated-with-venoarterial-extracorporeal-membrane-oxygenation-is-associated-with-decreased-blood-component-utilization-and-may-improve-clinical-outcome
#6
Christine M Cahill, Neil Blumberg, Amy E Schmidt, Peter A Knight, Amber L Melvin, Howard T Massey, Joseph M Delehanty, Seth B Zebrak, Majed A Refaai
BACKGROUND: Extracorporeal membrane oxygenation supplies oxygenated blood to the body supporting the heart and lungs. Survival rates of 20% to 50% are reported among patients receiving ECMO for cardiac arrest, severe cardiogenic shock, or failure to wean from cardiopulmonary bypass following cardiac surgery. Bleeding is one of the most common complications in ECMO patients due to coagulopathy, systemic anticoagulation, and the presence of large bore cannulas at systemic pressure. Absence of a standardized transfusion protocol in this population leads to inconsistent transfusion practices...
July 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28702957/non-invasive-ventilation-for-the-management-of-acute-hypercapnic-respiratory-failure-due-to-exacerbation-of-chronic-obstructive-pulmonary-disease
#7
REVIEW
Christian R Osadnik, Vanessa S Tee, Kristin V Carson-Chahhoud, Joanna Picot, Jadwiga A Wedzicha, Brian J Smith
BACKGROUND: Non-invasive ventilation (NIV) with bi-level positive airway pressure (BiPAP) is commonly used to treat patients admitted to hospital with acute hypercapnic respiratory failure (AHRF) secondary to an acute exacerbation of chronic obstructive pulmonary disease (AECOPD). OBJECTIVES: To compare the efficacy of NIV applied in conjunction with usual care versus usual care involving no mechanical ventilation alone in adults with AHRF due to AECOPD. The aim of this review is to update the evidence base with the goals of supporting clinical practice and providing recommendations for future evaluation and research...
July 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28701223/low-dose-immunoglobulin-g-is-not-associated-with-mortality-in-patients-with-sepsis-and-septic-shock
#8
Yusuke Iizuka, Masamitsu Sanui, Yusuke Sasabuchi, Alan Kawarai Lefor, Mineji Hayakawa, Shinjiro Saito, Shigehiko Uchino, Kazuma Yamakawa, Daisuke Kudo, Kohei Takimoto, Toshihiko Mayumi, Takeo Azuhata, Fumihito Ito, Shodai Yoshihiro, Katsura Hayakawa, Tsuyoshi Nakashima, Takayuki Ogura, Eiichiro Noda, Yoshihiko Nakamura, Ryosuke Sekine, Yoshiaki Yoshikawa, Motohiro Sekino, Keiko Ueno, Yuko Okuda, Masayuki Watanabe, Akihito Tampo, Nobuyuki Saito, Yuya Kitai, Hiroki Takahashi, Iwao Kobayashi, Yutaka Kondo, Wataru Matsunaga, Sho Nachi, Toru Miike, Hiroshi Takahashi, Shuhei Takauji, Kensuke Umakoshi, Takafumi Todaka, Hiroshi Kodaira, Kohkichi Andoh, Takehiko Kasai, Yoshiaki Iwashita, Hideaki Arai, Masato Murata, Masahiro Yamane, Kazuhiro Shiga, Naoto Hori
BACKGROUND: The administration of low-dose intravenous immunoglobulin G (IVIgG) (5 g/day for 3 days; approximate total 0.3 g/kg) is widely used as an adjunctive treatment for patients with sepsis in Japan, but its efficacy in the reduction of mortality has not been evaluated. We investigated whether the administration of low-dose IVIgG is associated with clinically important outcomes including intensive care unit (ICU) and in-hospital mortality. METHODS: This is a post-hoc subgroup analysis of data from a retrospective cohort study, the Japan Septic Disseminated Intravascular Coagulation (JSEPTIC DIC) study...
July 13, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28698343/protocol-for-an-observational-study-of-delirium-in-the-post-anaesthesia-care-unit-pacu-as-a-potential-predictor-of-subsequent-postoperative-delirium
#9
Victoria Cui, Catherine M Tedeschi, Vanessa L Kronzer, Sherry L McKinnon, Michael S Avidan
INTRODUCTION: Postoperative delirium can be a serious consequence of major surgery, associated with longer hospital stays, readmission, cognitive and functional deterioration and mortality. Delirium is an acute, reversible disorder characterised by fluctuating course, inattention, disorganised thinking and altered level of consciousness. Delirium occurring in the hours immediately following anaesthesia and delirium occurring in the postoperative period of 1-5 days have been described as distinct clinical entities...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28697155/effect-of-a-training-strategy-in-improving-medication-fallacies-during-pediatric-cardiopulmonary-resuscitation-a-before-and-after-study-from-a-developing-country
#10
Jhuma Sankar, Rashmi Ranjan Das, Samarendra Mahapatro, M Jeeva Sankar
OBJECTIVE: This study aims to evaluate the effect of structured training on resident performance in improving medication fallacies during pediatric cardiopulmonary resuscitation (CPR). METHODS: This before-and-after study was conducted in the pediatric acute care areas of tertiary care teaching hospitals of a developing country from August to December 2015. Case records of children younger than 18 years who underwent CPR were reviewed. Senior residents rotating through pediatric emergency department and pediatric intensive care unit were evaluated for their knowledge...
July 11, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28688940/thoracostomy-tube-removal-implementation-of-a-multidisciplinary-procedural-pain-management-guideline
#11
Lisa M Ring, Anne Watson
OBJECTIVE: Thoracostomy tubes are placed following cardiothoracic surgery for the repair or palliation of congenital heart defects. The aim of this project was to develop and implement a clinical practice guideline for the provision of optimal analgesia during removal of thoracostomy tubes in pediatric postoperative cardiothoracic surgery patients. METHODS: Methods used include a nonexperimental design utilizing chart audits to determine baseline documentation as well as procedure note evaluation to determine both baseline documentation and compliance with the new guideline...
July 6, 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28688703/impact-of-qrs-duration-on-decision-of-early-removal-of-pacing-catheter-after-transcatheter-aortic-valve-replacement-with-corevalve-device
#12
Masao Takahashi, Gauthier Mouillet, Ronan Deballon, Arnaud Sudre, Nicolas Lellouche, Pascal Lim, Thomas Modine, Eric Vanbelle, Jean-Luc Dubois-Rande, Emmanuel Teiger
The purpose of this study was to determine the predictability of QRS duration (QRSd) for temporary pacing catheter removal in patients implanted with CoreValve. Permanent pacemaker implantation is a known complication after transcatheter aortic valve replacement (TAVI) with CoreValve. Although post-TAVI QRSd is highly predictive for advanced atrioventricular block (AVB), management of delayed AVB after TAVI remains unclear. We conducted a multicentric, prospective study of 156 consecutive patients who underwent TAVI with CoreValve between December 2010 and January 2013...
June 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28688653/ethnic-disparities-in-traumatic-brain-injury-care-referral-in-a-hispanic-majority-population
#13
Hailey C Budnick, Alan H Tyroch, Stacey A Milan
BACKGROUND: Functional outcomes after traumatic brain injury (TBI) can be significantly improved by discharge to posthospitalization care facilities. Many variables influence the discharge disposition of the TBI patient, including insurance status, patient condition, and patient prognosis. The literature has demonstrated an ethnic disparity in posthospitalization care referral, with Hispanics being discharged to rehabilitation and nursing facilities less often than non-Hispanics. However, this relationship has not been studied in a Hispanic-majority population, and thus, this study seeks to determine if differences in neurorehabilitation referrals exist among ethnic groups in a predominately Hispanic region...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28682981/risk-factors-of-delayed-onset-posttraumatic-stress-disorder-in-chronically-critically-ill-patients
#14
Gloria-Beatrice Wintermann, Jenny Rosendahl, Kerstin Weidner, Bernhard Strauß, Katja Petrowski
The main aim of this study was to investigate factors associated with a delayed-onset posttraumatic stress disorder (PTSD) after the intensive care unit (ICU) treatment of patients with a chronic critical illness (CCI). Patients (n = 97) with critical illness polyneuropathy or critical illness myopathy were interviewed via the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. The diagnosis of the acute stress disorder was assessed within 1 month (t1), the diagnosis of PTSD at 3 (t2) and 6 (t3) months after transfer from the acute care ICU to the post-acute ICU...
July 5, 2017: Journal of Nervous and Mental Disease
https://www.readbyqxmd.com/read/28662370/early-exposure-to-recommended-calorie-delivery-in-the-intensive-care-unit-is-associated-with-increased-mortality-in-patients-with-acute-respiratory-distress-syndrome
#15
Sarah J Peterson, Omar B Lateef, Sally Freels, Liam McKeever, Giamila Fantuzzi, Carol A Braunschweig
BACKGROUND: The Intensive Nutrition in Acute Lung Injury: Clinical Trial (INTACT), designed to evaluate outcomes of calorie delivery from acute respiratory distress syndrome (ARDS) diagnosis through hospital discharge, was stopped due to higher mortality in the intervention group. Post hoc analysis found timing and dose of calorie delivery influenced mortality. The objective of this retrospective cohort study was to determine if early vs late calorie exposure changed the hazard of death among a larger sample of patients with ARDS...
June 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28652635/-risk-factors-for-delirium-in-intensive-care-unit-br-in-liver-transplant-patients
#16
Filippo Binda, Alessandro Galazzi, Alessandra Brambilla, Ileana Adamini, Dario Laquintana
. Risk factors for delirium in intensive care unit in liver transplant patients. INTRODUCTION: Delirium is a disorder of the state of consciousness characterized by acute onset and temporal variability of cognitive abilities. It is frequent in intensive care unit (ICU) and it is associated with worst outcomes. AIM: To identify risk factors for the development of delirium in patients in intensive care unit (ICU) after orthotopic liver transplantation (OLTx). METHODS: Observational retrospective study on all the patients undergoing OLTx between January 2014 and December 2015...
April 2017: Assistenza Infermieristica e Ricerca: AIR
https://www.readbyqxmd.com/read/28652630/-sici-gise-community-campania-survey-donna-tavi-incanta-perioperative-and-short-term-outcome-of-transcatheter-aortic-valve-implantation-in-women
#17
Tiziana Attisano, Angelo Silverio, Emilio Di Lorenzo, Tullio Tesorio, Domenico Di Girolamo, Paolo Golino, Arturo Giordano, Giuseppe Valva, Giovanni Esposito, Maurizio Cappelli Bigazzi, Carlo Briguori, Ida Monteforte, Giovanni Dialetto, Paolo Rubino, Francesco Vigorito, Pietro Giudice, Ciro Mauro
BACKGROUND: Nowadays the prognostic role of gender as a relevant factor after transcatheter aortic valve implantation (TAVI) is still unfair, since available data in the literature are few and uneven. The aim of this survey was to collect acute and 30-day safety and efficacy clinical data in high- and intermediate-risk women, who underwent TAVI with new-generation devices, in the Campania Region. METHODS: All medium and high-volume TAVI centers in Campania have been invited to fulfill an online, ad-hoc questionnaire, collecting pre-, peri- and post-procedural data concerning female patients, treated between January and December 2016...
June 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28650682/de-escalation-training-to-medical-surgical-nurses-in-the-acute-care-setting
#18
Kimberly Lynn Ferrara, Mary Lynn Davis-Ajami, Joan Insalaco Warren, Lyn Stankiewicz Murphy
Violence is increasing on medical-surgical units as a "silent epidemic." This quality improvement project employs a small non-experimental, single-group, pre- and post-test design (N = 11) to determine the effectiveness of de-escalation training on medical-surgical nurses' confidence levels when dealing with agitated patients. Regardless of age, education, or years of experience, scores improved for each question on Thackrey's (1987) Confidence in Coping with Patient Aggression Instrument after implementing Ten Domains of De-escalation by Richmond et al...
June 26, 2017: Issues in Mental Health Nursing
https://www.readbyqxmd.com/read/28649868/early-eye-movement-desensitisation-and-reprocessing-emdr-intervention-in-a-disaster-mental-health-care-context
#19
Anna Saltini, Daniela Rebecchi, Chiara Callerame, Isabel Fernandez, Elisa Bergonzini, Fabrizio Starace
'Early psychological intervention' is defined as commencing treatment within three months of the traumatic event, with the aim to prevent or treat posttraumatic stress disorder, ongoing distress or acute stress disorder. In natural disaster situations, specific issues may limit the amount of time available for treatment and the possibility of interventions. Eye Movement Desensitisation and Reprocessing (EMDR) can be used without regard to these limits. The aim of the study is to evaluate the effects of EMDR, Recent Traumatic Episode Protocol (R-TEP) provided within three months of the traumatic event to a large sample of individuals exposed to the earthquake that hit Emilia Romagna Region (Northern Italy) in 2012...
June 25, 2017: Psychology, Health & Medicine
https://www.readbyqxmd.com/read/28648353/healthcare-contact-and-treatment-uptake-following-hepatitis-c-virus-screening-and-counseling-among-rural-appalachian-people-who-use-drugs
#20
Dustin B Stephens, April M Young, Jennifer R Havens
BACKGROUND: Hepatitis C virus (HCV) remains a major contributor to morbidity and mortality worldwide. Since 2009, Kentucky has led the United States in cases of acute HCV, driven largely by injection drug use in rural areas. Improved treatment regimens hold promise of mitigating the impact and transmission of HCV, but numerous barriers obstruct people who inject drugs (PWID) from receiving care, particularly in medically underserved settings. METHODS: 503 rural people who use drugs were recruited using respondent-driven sampling and received HCV screening and post-test counseling...
June 22, 2017: International Journal on Drug Policy
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