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Healthcare management

T Kuchuloria, T Akhvlediani, N Akhvlediani
This root cause analysis concerns the conflict in the Eastern Ukraine and its impact on healthcare delivery in the context of treating internally displaced persons (IDPs). Inadequate treatment of tuberculosis (TB) was selected as a major topic for intervention planning in conflict areas in Ukraine. With respect to treating TB among IDPs, rapid diagnosis and adequate nutrition and shelter are important components of care and disease control. The DOT, supported by trained primary healthcare providers equipped with rapid MDR TB diagnostic capacities, need to provide appropriate shelter and nutrition to IDPs...
September 2016: Georgian Medical News
Marleen Kunneman, Victor M Montori, Ana Castaneda-Guarderas, Erik P Hess
Both the practice of medicine and the expectations of patients regarding their care are changing. A point of confluence is in the need for medicine to be more patient centered, and in the need for patients to be more involved in their care.(1,2) This confluence is particularly pertinent when more than one reasonable approach is available to manage the patient's situation, and when those approaches differ in ways that matter to patients.(3) In shared decision-making (SDM), clinicians and patients work together to understand the patient's situation and to determine how best to address it...
October 21, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Jill K Logan, Hardin Pantle
PURPOSE: The role of topical tranexamic acid in the management of anterior epistaxis in adult patients in the emergency department (ED) is examined. SUMMARY: The use of alternative agents for the treatment of epistaxis before the use of nasal packing may be reasonable due to patient discomfort, potential complications, and the need for follow-up with a healthcare provider for packing removal. One such agent is tranexamic acid. Two published studies evaluated the off-label use of topical tranexamic acid for the treatment of epistaxis...
November 1, 2016: American Journal of Health-system Pharmacy: AJHP
J-E Bibault, A Pernet, V Mollo, L Gourdon, O Martin, P Giraud
PURPOSE: With the increase of treatment complexity, enhancing safety is a key concern in radiation oncology. Beyond the involvement of the healthcare professional, patient involvement and empowerment could play a major role in that setting. We explored how patients perceived and fulfilled that role during their radiation treatment. MATERIALS AND METHODS: A voluntary and anonymous questionnaire was administered to all patients treated in our department between November 2013 and May 2014...
October 18, 2016: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Chantal Arditi, Bernard Burnand, Isabelle Peytremann-Bridevaux
BACKGROUND: To reduce the burden of asthma, chronic disease management (CDM) programmes have been widely implemented and evaluated. Reviews including randomised controlled trials (RCTs) suggest that CDM programmes for asthma are effective. Other study designs are however often used for pragmatic reasons, but excluded from these reviews because of their design. We aimed to examine what complementary information could be retrieved from the addition of non-randomised studies to the studies included in a published Cochrane review on asthma CDM programmes, for healthcare stakeholders involved in the development, implementation, conduct or long-term sustainability of such programmes...
October 21, 2016: BMC Health Services Research
Karen H Wang, Joseph L Goulet, Constance M Carroll, Melissa Skanderson, Samah Fodeh, Joseph Erdos, Julie A Womack, Erica A Abel, Harini Bathulapalli, Amy C Justice, Marcella Nunez-Smith, Cynthia A Brandt
BACKGROUND: Healthcare mobility, defined as healthcare utilization in more than one distinct healthcare system, may have detrimental effects on outcomes of care. We characterized healthcare mobility and associated characteristics among a national sample of Veterans. METHODS: Using the Veterans Health Administration Electronic Health Record, we conducted a retrospective cohort study to quantify healthcare mobility within a four year period. We examined the association between sociodemographic and clinical characteristics and healthcare mobility, and characterized possible temporal and geographic patterns of healthcare mobility...
October 21, 2016: BMC Health Services Research
A P M Suzanne Giesbers, Roel L J Schouteten, Erik Poutsma, Beatrice I J M van der Heijden, Theo van Achterberg
BACKGROUND: Providing nursing teams with feedback on quality measurements is used as a quality improvement instrument in healthcare organizations worldwide. Previous research indicated contradictory results regarding the effect of such feedback on both nurses' well-being and performance. OBJECTIVES: Building on the Job Demands-Resources model this study explores: (1) whether and how nurses' perceptions of feedback on quality measurements (as a burdening job demand or rather as an intrinsically or extrinsically motivating job resource) are respectively related to nurses' well-being and performance; and (2) whether and how team reflection influences nurses' perceptions...
October 11, 2016: International Journal of Nursing Studies
Silvana Granado Nogueira da Gama, Elaine Fernandes Viellas, Jacqueline Alves Torres, Maria Helena Bastos, Odaléa Maria Brüggemann, Mariza Miranda Theme Filha, Arthur Orlando Correa Schilithz, Maria do Carmo Leal
BACKGROUND: The participation of nurses and midwives in vaginal birth care is limited in Brazil, and there are no national data regarding their involvement. The goal was to describe the participation of nurses and nurse-midwives in childbirth care in Brazil in the years 2011 and 2012, and to analyze the association between hospitals with nurses and nurse-midwives in labor and birth care and the use of good practices, and their influence in the reduction of unnecessary interventions, including cesarean sections...
October 17, 2016: Reproductive Health
M Bryant Howren, Jeffrey S Gonzalez
The current issue is devoted broadly to research on treatment adherence and chronic illness self-management behavior. As the prevalence of chronic illness increases, the pervasive problem of treatment nonadherence is increasingly viewed as having a major impact on treatment outcomes, public health and healthcare costs, making this issue particularly timely. Sixteen articles spanning an array of topics are presented; articles include empirical studies, statistical simulations, systematic reviews, and theoretical commentaries...
October 20, 2016: Journal of Behavioral Medicine
Lai Heng Lee
The group of new oral anticoagulants or NOACs, now termed direct oral anticoagulants or DOACs, with their favourable results from large scale phase III clinical trials, represent a major advancement and expanded armamentarium in antithrombotic therapy. Dabigatran, rivaroxaban, apixaban and edoxaban are now in clinical routine use for prevention and treatment of arterial and venous thrombotic diseases as addressed in their clinical trials. Usage of the DOACs is expected to increase as clinicians gain more experience and reassurance with data from the real world studies which are generally consistent with that from clinical trials...
2016: Thrombosis Journal
Martin Duignan, Mary McGibney
BACKGROUND: Patellar dislocations are common, particularly in the adolescent polulation. Registered Advanced Nurse Practitioners are healthcare professionals who can appropriately manage these injuries to minimise the risk of chronicity. METHODS: This is a case study which uses a clinical examplar from the authors practice focusing on the assessment, diagnosis and managment of patellar dislocations. Particular reference is made of the significance of the MPFL. RESULTS: This paper highlights the importance of recognition of appropriate management of patellar dislocations in the ED setting...
October 17, 2016: International Emergency Nursing
Mahlet Fikreyesus, Matiwos Soboka, Garumma Tolu Feyissa
BACKGROUND: Psychotic relapse leads to repeated hospitalization and negatively affects the clinical prognosis of the patients. Information on prevalence of relapse among patients with psychotic disorders in Ethiopian setting is scarce. This study aimed to assess the prevalence of relapse among patients with psychotic disorders attending services in Jimma University Specialized Hospital (JUSH). METHODS: Data were collected using interviewer administered questionnaire...
October 20, 2016: BMC Psychiatry
Fawziah Marra, Mei Chong, Mehdi Najafzadeh
BACKGROUND: Recent studies have shown an increasing incidence of herpes zoster (HZ) infection, which may be related to the introduction of varicella vaccination programs in children. We examined the epidemiology and treatment costs of HZ and post-herpetic neuralgia (PHN) over time in British Columbia, Canada. METHODS: The cohort consisted of all cases with HZ infection from January 1, 1997 and December 31, 2012. Incident zoster was defined as a case (ICD-9 053 or ICD-10 B02) without a previous episode of HZ or PHN in the previous 12 months...
October 20, 2016: BMC Infectious Diseases
Antonio Miguel Cruz, Mayra R Guarín
To date, there are no broadly accepted or accurate models to determine appropriate staffing [levels] for clinical engineering departments (CEDs). The purpose of this study is to determine what the determinants of the staffing levels are (total number of full time equivalents (FTEs)) in CEDs in healthcare organisations. In doing so, we used a cross-sectional exploratory approach by using a multivariate regression model over a secondary source of data information from the AAMI Benchmarking Solutions-Healthcare Technology Management database...
October 21, 2016: Journal of Medical Engineering & Technology
Lavi Oud
BACKGROUND The demand for critical care services among elderly with dementia outpaces that of their non-dementia elderly counterparts. However, there are scarce data on the corresponding attributes among ICU-managed patients with dementia. MATERIAL AND METHODS We used the Texas Inpatient Public Use Data File to examine temporal trends of the demographics, burden of comorbidities, measures of severity of illness, use of healthcare resources, and short-term outcomes among hospitalizations aged 65 years or older with a reported diagnosis of dementia, who were admitted to ICU (D-ICU hospitalizations) between 2001 and 2010...
October 20, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Andrea Bowyer, Colin F Royse
PURPOSE OF REVIEW: Recovery after surgery is a complex interplay of the patient, the surgery, and the perioperative anaesthesia management. Assessment of recovery should address the needs of multiple stakeholders, including the institutions and healthcare providers, but primarily should be focused on the patients and their perception of quality of recovery and return to normalcy. This review will summarize the development of assessment of recovery to a multidimensional dichotomous construct that requires a real-time assessment tool validated for repeat measures and containing cognitive assessment...
October 18, 2016: Current Opinion in Anaesthesiology
Rupert M Pearse, Tom E Abbott, Richard Haslop, Tahania Ahmad, Brennan C Kahan, Claudia Filipini, Andrew Rhodes, Marco Ranieri
BACKGROUND: Over 300 million patients undergo surgery worldwide each year. Postoperative morbidity - particularly respiratory complications - are most frequent and severe among high-risk patients undergoing major abdominal surgery. However, standard treatments, like physiotherapy or supplemental oxygen, often fail to prevent these. Preliminary research suggests that prophylactic continuous positive airways pressure (CPAP) can reduce the risk of postoperative respiratory complications...
October 20, 2016: Minerva Anestesiologica
Erin Dean
New research involving more than 350 care home nurses, managers, community healthcare professionals and nurse educators has identified priority areas for CPD - with personal care, dementia care and managing long-term conditions top of the list.
October 12, 2016: Nursing Standard
Timothy D Girard, Waleed Alhazzani, John P Kress, Daniel R Ouellette, Gregory A Schmidt, Jonathon D Truwit, Suzanne M Burns, Scott K Epstein, Andres Esteban, Eddy Fan, Miquel Ferrer, Gilles L Fraser, Michelle Gong, Catherine Hough, Sangeeta Mehta, Rahul Nanchal, Sheena Patel, Amy J Pawlik, Curtis N Sessler, Thomas Strøm, William Schweickert, Kevin C Wilson, Peter E Morris
BACKGROUND: Interventions that lead to earlier liberation from mechanical ventilation can improve patient outcomes. This guideline, a collaborative effort between the American Thoracic Society (ATS) and the American College of Chest Physicians (CHEST), provides evidence-based recommendations to optimize liberation from mechanical ventilation in critically ill adults. METHODS: Two methodologists performed evidence syntheses to summarize available evidence relevant to key questions about liberation from mechanical ventilation...
October 20, 2016: American Journal of Respiratory and Critical Care Medicine
Rajeev Gupta, Raghuvir Singh Khedar, Raja Babu Panwar
Hypertension is the most important cause of global burden of disease. It is highly prevalent in India and other low and lower-middle income countries. Prevalence of uncontrolled hypertension varies from 70-90% and is significantly greater in rural vs urban locations. Guidelines based treatment strategy has improved blood pressure (BP) control in high income countries but no context-specific guidelines exist in low and lower-middle income countries such as India. There are numerous barriers to proper BP control in these countries and include political apathy, bureaucratic inertia, weak health systems, overburdened healthcare providers and unempowered patients...
September 2016: Journal of the Association of Physicians of India
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