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https://www.readbyqxmd.com/read/28092064/critical-congenital-heart-disease-newborn-screening-implementation-lessons-learned
#1
Monica R McClain, John S Hokanson, Regina Grazel, Kim Naarden Van Braun, Lorraine F Garg, Michelle R Morris, Kathleen Moline, Keri Urquhart, Amy Nance, Harper Randall, Marci K Sontag
Introduction The purpose of this article is to present the collective experiences of six federally-funded critical congenital heart disease (CCHD) newborn screening implementation projects to assist federal and state policy makers and public health to implement CCHD screening. Methods A qualitative assessment and summary from six demonstration project grantees and other state representatives involved in the implementation of CCHD screening programs are presented in the following areas: legislation, provider and family education, screening algorithms and interpretation, data collection and quality improvement, telemedicine, home and rural births, and neonatal intensive care unit populations...
January 16, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28087902/a-review-of-the-preventability-of-maternal-mortality-in-one-hospital-system-in-louisiana-usa
#2
James J Morong, Jane K Martin, Robert S Ware, Alfred G Robichaux
OBJECTIVE: To determine preventability of in-hospital maternal mortality in the Ochsner Health System (OHS) in the US state of Louisiana. METHODS: A retrospective study was undertaken of all known cases of in-hospital maternal death (during pregnancy or within 42 days of termination) that occurred within OHS facilities in 1995-2013. Associations between characteristics and mortality and preventability were investigated. Incidence rate ratios (IRRs) were calculated in view of varying reference values...
December 9, 2016: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28069561/cancer-survivors-experience-with-telehealth-a-systematic-review-and-thematic-synthesis
#3
REVIEW
Anna Cox, Grace Lucas, Afrodita Marcu, Marianne Piano, Wendy Grosvenor, Freda Mold, Roma Maguire, Emma Ream
BACKGROUND: Net survival rates of cancer are increasing worldwide, placing a strain on health service provision. There is a drive to transfer the care of cancer survivors-individuals living with and beyond cancer-to the community and encourage them to play an active role in their own care. Telehealth, the use of technology in remote exchange of data and communication between patients and health care professionals (HCPs), is an important contributor to this evolving model of care. Telehealth interventions are "complex," and understanding patient experiences of them is important in evaluating their impact...
January 9, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28060001/incidence-of-skin-tears-and-risk-factors-a-systematic-literature-review
#4
Kelly Cristina Strazzieri-Pulido, Giovana Ribau Picolo Peres, Ticiane Carolina Gonçalves Faustino Campanili, Vera Lúcia Conceição de Gouveia Santos
Skin tears are traumatic wounds resulting from friction and shearing forces. Clinical practice strongly indicates that skin tears are a prevalent problem but their incidence is not well established in the literature. This systematic literature review identified and evaluated the available literature on the incidence and risk factors for skin tears in adults and the elderly. Inclusion criteria were epidemiological studies published in English, Spanish, or Portuguese languages from January 1990 through June 2014 and available in full text...
January 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28053973/noninvasive-ventilation-during-the-weaning-process-in-chronically-critically-ill-patients
#5
Jesus Sancho, Emilio Servera, Luis Jara-Palomares, Emilia Barrot, Raquel Sanchez-Oro-Gómez, F Javier Gómez de Terreros, M Jesús Martín-Vicente, Isabel Utrabo, M Belen Núñez, Alicia Binimelis, Ernest Sala, Enrique Zamora, Gonzalo Segrelles, Angel Ortega-Gonzalez, Fernando Masa
Chronically critically ill patients often undergo prolonged mechanical ventilation. The role of noninvasive ventilation (NIV) during weaning of these patients remains unclear. The aim of this study was to determine the value of NIV and whether a parameter can predict the need for NIV in chronically critically ill patients during the weaning process. We conducted a prospective study that included chronically critically ill patients admitted to Spanish respiratory care units. The weaning method used consisted of progressive periods of spontaneous breathing trials...
October 2016: ERJ Open Research
https://www.readbyqxmd.com/read/28052526/effectiveness-of-a-multi-layer-foam-dressing-in-preventing-sacral-pressure-ulcers-for-the-early-acute-care-of-patients-with-a-traumatic-spinal-cord-injury-comparison-with-the-use-of-a-gel-mattress
#6
Andréane Richard-Denis, Cynthia Thompson, Jean-Marc Mac-Thiong
Individuals with spinal cord injury are at risk of sacral pressure ulcers due to, among other reasons, prolonged immobilisation. The effectiveness of a multi-layer foam dressing installed pre-operatively in reducing sacral pressure ulcer occurrence in spinal cord injured patients was compared to that of using a gel mattress, and stratified analyses were performed on patients with complete tetraplegia and paraplegia. Socio-demographic and clinical data were collected from 315 patients admitted in a level-I trauma centre following a spinal cord injury between April 2010 and March 2016...
January 4, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28052158/factors-associated-with-nontransfer-in-trauma-patients-meeting-american-college-of-surgeons-criteria-for-transfer-at-nontertiary-centers
#7
Quanhong Zhou, Matthew R Rosengart, Timothy R Billiar, Andrew B Peitzman, Jason L Sperry, Joshua B Brown
Importance: Secondary triage from nontertiary centers is vital to trauma system success. It remains unclear what factors are associated with nontransfer among patients who should be considered for transfer to facilities providing higher-level care. Objective: To identify factors associated with nontransfer among patients meeting American College of Surgeons (ACS) guideline criteria for transfer from nontertiary centers. Design, Setting, and Participants: A retrospective cohort study was performed using multilevel logistic regression to ascertain factors associated with nontransfer from nontertiary centers, including demographics, injury characteristics, and center resources...
January 4, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28045146/synthesis-driven-structure-dependent-optical-behavior-in-phase-tunable-nayf4-yb-er-based-motifs-and-associated-heterostructures
#8
Haiqing Liu, Jinkyu Han, Coray McBean, Crystal S Lewis, Prahlad Kumar Routh, Mircea Cotlet, Stanislaus S Wong
Understanding the key parameters necessary for generating uniform Er,Yb co-activated NaYF4 possessing various selected phases (i.e. cubic or hexagonal) represents an important chemical strategy towards tailoring optical behavior in these systems. Herein, we report on a straightforward hydrothermal synthesis in which the separate effects of reaction temperature, reaction time, and precursor stoichiometry in the absence of any surfactant were independently investigated. Interestingly, the presence and the concentration of NH4OH appear to be the most critical determinants of the phase and morphology...
January 18, 2017: Physical Chemistry Chemical Physics: PCCP
https://www.readbyqxmd.com/read/28042074/a-communications-bundle-to-improve-satisfaction-for-critically-ill-patients-and-their-families-a-prospective-cohort-pilot-study
#9
Rana L Awdish, Dana Buick, Maria Kokas, Hanan Berlin, Catherine Jackman, Cari Williamson, Michael P Mendez, Kristen Chasteen
CONTEXT: Communication skills training with simulated patients is used by many academic centers, but how to translate skills learned in simulated settings to improve communication in real encounters has not been described. OBJECTIVE: We developed a communications bundle to facilitate skill transfer from simulation to real encounters and improve patient and/or family satisfaction with physician communication. We tested the feasibility of its use in our hospital's medical intensive care unit (MICU)...
December 29, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28040139/prenatal-diagnosis-of-paternal-duplication-of-11p15-5%C3%A2-14-3-its-implication-of-beckwith-wiedemann-syndrome
#10
Kuan Ju Chen, Yu Mei Liu, Chien Hong Li, Yao Lung Chang, Shuenn Dyh Chang
OBJECTIVE: To characterize a prenatally detected chromosomal aberration with molecular cytogenetic approaches and explore its relationship with Beckwith-Wiedemann syndrome (BWS). CASE REPORT: A 33-year-old woman, gravida 2, para 0, was referred to our prenatal clinic at 20+ weeks due to an abnormal amniocentesis karyotyping finding, which showed 46,XY,add(11)(q24.2)dn. The mother conceived through in vitro fertilization-intracytoplasmic sperm injection (IVF-ICSI), then embryo transfer...
December 2016: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28039294/process-mapping-evaluation-of-medication-reconciliation-in-academic-teaching-hospitals-a-critical-step-in-quality-improvement
#11
Anne Holbrook, James M Bowen, Harsit Patel, Chris O'Brien, John J You, Roshan Tahavori, Jeff Doleweerd, Tim Berezny, Dan Perri, Carmine Nieuwstraten, Sue Troyan, Ameen Patel
BACKGROUND: Medication reconciliation (MedRec) has been a mandated or recommended activity in Canada, the USA and the UK for nearly 10 years. Accreditation bodies in North America will soon require MedRec for every admission, transfer and discharge of every patient. Studies of MedRec have revealed unintentional discrepancies in prescriptions but no clear evidence that clinically important outcomes are improved, leading to widely variable practices. Our objective was to apply process mapping methodology to MedRec to clarify current processes and resource usage, identify potential efficiencies and gaps in care, and make recommendations for improvement in the light of current literature evidence of effectiveness...
December 30, 2016: BMJ Open
https://www.readbyqxmd.com/read/28035038/factors-precipitating-the-risk-of-aspiration-in-hospitalized-patients-findings-from-a-multicentre-critical-incident-technique-study
#12
Alvisa Palese, Lucia Lesa, Giulia Stroppolo, Giulia Lupieri, Stefano Tardivo, Silvio Brusaferro
OBJECTIVE: To elucidate factors, other than those clinical, precipitating the risk of aspiration in hospitalized patients. DESIGN: The Critical Incident Technique was adopted for this study in 2015. SETTING: Three departments located in two academic hospitals in the northeast of Italy, equipped with 800 and 1500 beds, respectively. PARTICIPANTS: A purposeful sample of 12 registered nurses (RN), all of whom (i) had reported one or more episodes of aspiration during the longitudinal survey, (ii) had worked ≥3 years in the department, and (iii) were willing to participate, were included...
December 29, 2016: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28028426/nonprofessional-care-in-chronic-critically-ill-patient-a-qualitative-study
#13
Leila Mardanian Dehkordi, Monireh Babashahi, Alireza Irajpour
BACKGROUND: Decision-making about patients with critical condition transfer from Intensive Care Unit to the general wards be delegated to their families. The aim of the study was explaining the experiences of family caregiver's about care of chronic critically ill patient. METHODS: This study was conducted with a qualitative content analysis using unstructured interview. Participants were selected purposively from May 2014 to May 2015 and data collection continued until data saturation...
2016: International Journal of Preventive Medicine
https://www.readbyqxmd.com/read/28005912/benchmarking-prehospital-and-emergency-department-care-for-argentine-children-with-traumatic-brain-injury-for-the-south-american-guideline-adherence-group
#14
Monica S Vavilala, Silvia B Lujan, Qian Qiu, Gustavo J Petroni, Nicolás M Ballarini, Nahuel Guadagnoli, María Alejandra Depetris, Gabriela A Faguaga, Gloria M Baggio, Leonardo O Busso, Mirta E García, Osvaldo R González Carrillo, Paula L Medici, Silvia S Sáenz, Elida E Vanella, Anthony Fabio, Michael J Bell
OBJECTIVE: There is little information on the type of early care provided to children with traumatic brain injury (TBI) in low middle income countries. We benchmarked early prehospital [PH] and emergency department [ED] pediatric TBI care in Argentina. METHODS: We conducted a secondary analysis of data from patients previously enrolled in a prospective seven center study of children with TBI. Eligible participants were patients 0-18 years, and had diagnosis of TBI (admission Glasgow Coma scale score [GCS] < 13 or with GCS 14-15 and abnormal head CT scan within 48 hours of admission, and head AIS > 0)...
2016: PloS One
https://www.readbyqxmd.com/read/27995904/nanox-a-new-model-to-predict-cell-survival-in-the-context-of-particle-therapy
#15
Micaela Cunha, Caterina Monini, Etienne Testa, Michael Beuve
Particle therapy is increasingly attractive for treating tumors and the number of facilities offering it is rising worldwide. Due to the well-known enhanced effectiveness of ions, it is of utmost importance to plan treatments with great care to ensure tumor killing and healthy tissues sparing. Hence, the accurate quantification of the relative biological effectiveness (RBE) of ions, used in the calculation of the biological dose, is critical. Nevertheless, the RBE is a complex function of many parameters and its determination requires modeling...
December 20, 2016: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/27993546/post-resuscitation-management-of-cardiac-arrest-patients-in-the-critical-care-environment-a-retrospective-audit-of-compliance-with-evidence-based-guidelines
#16
REVIEW
A Milonas, A Hutchinson, D Charlesworth, A Doric, J Green, J Considine
BACKGROUND: There is a clear relationship between evidence-based post resuscitation care and survival and functional status at hospital discharge. The Australian Resuscitation Council (ARC) recommends protocol driven care to enhance chance of survival following cardiac arrest. Healthcare providers have an obligation to ensure protocol driven post resuscitation care is timely and evidence based. OBJECTIVES: The aim of this study was to examine adherence to best practice guidelines for post resuscitation care in the first 24h from Return of Spontaneous Circulation for patients admitted to the intensive care unit from the emergency department having suffered out of hospital or emergency department cardiac arrest and survived initial resuscitation...
December 16, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/27965560/ketamine-50-years-of-modulating-the-mind
#17
REVIEW
Linda Li, Phillip E Vlisides
Ketamine was introduced into clinical practice in the 1960s and continues to be both clinically useful and scientifically fascinating. With considerably diverse molecular targets and neurophysiological properties, ketamine's effects on the central nervous system remain incompletely understood. Investigators have leveraged the unique characteristics of ketamine to explore the invariant, fundamental mechanisms of anesthetic action. Emerging evidence indicates that ketamine-mediated anesthesia may occur via disruption of corticocortical information transfer in a frontal-to-parietal ("top down") distribution...
2016: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/27958242/rural-posting-experience-requests-for-transfer-and-perspectives-about-critical-factors-for-staff-retention-among-primary-health-care-workers-in-urban-kano-nigeria
#18
U M Lawan, G T Amole, J H Khayi
BACKGROUND: Inadequate skilled manpower at rural posts is a serious impediment toward equitable and universal access to healthcare in Nigeria. OBJECTIVE: To examine the experiences of primary health care (PHC) workers on rural assignments, requests for transfer, and perspectives about critical factors for retention of healthcare workers at rural posts. MATERIALS AND METHODS: Using descriptive cross-sectional design, 262 PHC workers in Kano were studied...
January 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/27942002/the-impact-of-adding-a-physician-assistant-to-a-critical-care-outreach-team
#19
Hayley B Gershengorn, Yunchao Xu, Carri W Chan, Mor Armony, Michelle N Gong
RATIONALE: Hospitals are increasingly using critical care outreach teams (CCOTs) to respond to patients deteriorating outside intensive care units (ICUs). CCOT staffing is variable across hospitals and optimal team composition is unknown. OBJECTIVES: To assess whether adding a critical care medicine trained physician assistant (CCM-PA) to a critical care outreach team (CCOT) impacts clinical and process outcomes. METHODS: We performed a retrospective study of two cohorts-one with a CCM-PA added to the CCOT (intervention hospital) and one with no staffing change (control hospital)-at two facilities in the same system...
2016: PloS One
https://www.readbyqxmd.com/read/27939327/survival-implications-of-time-to-surgical-treatment-of-endometrial-cancers
#20
David I Shalowitz, Andrew J Epstein, Lindsey Buckingham, Emily M Ko, Robert L Giuntoli
BACKGROUND: Optimal care for women with endometrial cancers often involves transfer of care from diagnosing physicians (eg, obstetrician-gynecologists) to treating physicians (eg, gynecologic oncologists.) It is critical to determine the effect of time to treatment on cancer outcomes to set best practices guidelines for referral processes. OBJECTIVE: We sought to determine the impact of time from diagnosis of endometrial cancer to surgical treatment on mortality and to characterize those patients who may be at highest risk for worsened survival related to surgical timing...
December 9, 2016: American Journal of Obstetrics and Gynecology
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