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https://www.readbyqxmd.com/read/28637090/early-warning-systems-and-rapid-response-to-the-deteriorating-patient-in-hospital-a-realist-evaluation
#1
Jennifer Mcgaughey, Peter O'Halloran, Sam Porter, John Trinder, Bronagh Blackwood
AIM: To identify those contexts and mechanisms that enable or constrain the implementation of Rapid Response Systems on acute general hospital wards to recognise and respond to patient deterioration. BACKGROUND: Rapid Response Systems allow deteriorating patients to be recognised using Early Warning Systems, referred early via escalation protocols and managed at the bedside by competent staff. DESIGN: Realist Evaluation. METHODS: The research design was an embedded multiple case study approach of four wards in two hospitals in Northern Ireland which followed the principles of Realist Evaluation...
June 21, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28636843/hospital-inpatient-admissions-with-dehydration-and-or-malnutrition-in-medicare-beneficiaries-receiving-enteral-nutrition-a-cohort-study
#2
Rachel Drake, Audrey Ozols, William J Nadeau, Mary Jo Braid-Forbes
BACKGROUND: Enteral nutrition (EN) supports many older and disabled Americans. This study describes the frequency and cost of acute care hospitalization with dehydration and/or malnutrition of Medicare beneficiaries receiving EN, focusing on those receiving home EN. METHODS: Medicare 5% Standard Analytic Files were used to determine Medicare spending for EN supplies and the proportion and cost of beneficiaries receiving EN, specifically home EN, admitted to the hospital with dehydration and/or malnutrition...
June 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28634631/sages-university-masters-program-a-structured-curriculum-for-deliberate-lifelong-learning
#3
Daniel B Jones, Dimitrios Stefanidis, James R Korndorffer, Justin B Dimick, Brian P Jacob, Linda Schultz, Daniel J Scott
BACKGROUND: Postgraduate training has been haphazard to date. Surgeons have relied on attendance to annual meetings and multiple choice study guides to demonstrate maintenance of certification and continuing medical education. METHODS: SAGES held a retreat to develop the concept and scope of the Masters Program. Surveys were sent to SAGES members to guide curriculum development and selection of anchoring operations. RESULTS: SAGES has developed an educational curriculum across eight domains (Acute Care, Biliary, Bariatric, Colorectal, Hernia, Foregut, Flex Endoscopy, and Robotic Surrey) incorporating SAGES educational materials and guidelines, social media, coaching and mentoring...
June 20, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28634501/subarachnoid-hemorrhage-and-long-term-stroke-risk-after-traumatic-brain-injury
#4
Nicholas A Morris, Joséphine Cool, Alexander E Merkler, Hooman Kamel
BACKGROUND: Recent studies suggest that traumatic brain injury (TBI) is a risk factor for subsequent ischemic stroke, even years after the initial insult. The mechanisms of the association remain unclear. The presence of traumatic subarachnoid hemorrhage (tSAH) may mediate the effect of TBI on long-term stroke risk, as it has previously been linked to short-term vasospasm and delayed cerebral ischemia. METHODS: Using administrative claims data, we conducted a retrospective cohort study of acute care hospitalizations...
July 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28634168/contributions-of-children-with-multiple-chronic-conditions-to-pediatric-hospitalizations-in-the-united-states-a-retrospective-cohort-analysis
#5
Jay G Berry, Arlene S Ash, Eyal Cohen, Fareesa Hasan, Chris Feudtner, Matt Hall
BACKGROUND: Children with multiple chronic conditions (CMCC) are increasingly using hospital care. We assessed how much of US pediatric inpatient care is used by CMCC and which chronic conditions are the key drivers of hospital use. METHODS: A retrospective analysis of all 2.3 million US acute-care hospital discharges in 2012 for children age 0 to 18 years in the Kids' Inpatient Database. The ∼4.5 million US hospitalizations for pregnancy, childbirth, and newborn and neonatal care were not assessed...
June 20, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28633483/an-informatics-research-agenda-to-support-patient-and-family-empowerment-and-engagement-in-care-and-recovery-during-and-after-hospitalization
#6
Sarah Collins, Patricia Dykes, David W Bates, Brittany Couture, Ronen Rozenblum, Jennifer Prey, Kristin O'Reilly, Patricia Q Bourie, Cindy Dwyer, S Ryan Greysen, Jeffery Smith, Michael Gropper, Anuj K Dalal
As part of an interdisciplinary acute care patient portal task force with members from 10 academic medical centers and professional organizations, we held a national workshop with 71 attendees representing over 30 health systems, professional organizations, and technology companies. Our consensus approach identified 7 key sociotechnical and evaluation research focus areas related to the consumption and capture of information from patients, care partners (eg, family, friends), and clinicians through portals in the acute and post-acute care settings...
June 17, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28633126/emergency-incarcerated-obturator-hernia-repair-with-biologic-mesh-in-a-male-patient-after-ipsilateral-hip-disarticulation-a-case-report
#7
Rodolfo J Oviedo, Alexander H W Molinari
INTRODUCTION: An obturator hernia is an uncommon form of abdominal hernia that is difficult to diagnose due to its non-distinct presentation. This case investigates an emergency treatment of an obturator hernia presenting in a patient with an ipsilateral hip disarticulation in a 266-bed community hospital. PRESENTATION OF CASE: A 53-year old man with a history of a left hip disarticulation 3-weeks prior presented to the emergency department with fever, nausea, vomiting, and diarrhea for the past 5-days...
June 8, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28632541/hospital-based-acute-care-within-7-days-of-discharge-after-outpatient-arthroscopic-shoulder-surgery
#8
Jiabin Liu, David N Flynn, Wai-Man Liu, Lee A Fleisher, Nabil M Elkassabany
BACKGROUND: The rate of hospital-based acute care (defined as hospital transfer at discharge, emergency department [ED] visit, or subsequent inpatient hospital [IP] admission) after outpatient procedure is gaining momentum as a quality metric for ambulatory surgery. However, the incidence and reasons for hospital-based acute care after arthroscopic shoulder surgery are poorly understood. METHODS: We studied adult patients who underwent outpatient arthroscopic shoulder procedures in New York State between 2011 and 2013 using the Healthcare Cost and Utilization Project database...
June 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28632094/the-interactive-effects-of-social-support-and-physical-functioning-on-hiv-medical-outcomes-among-african-americans-whom-inject-drugs
#9
Allysha C Maragh-Bass, Julie A Denison, Roland J Thorpe, Amy R Knowlton
Research suggests a syndemic of substance use, mental illness, and familial conflict is associated with poor HIV medical outcomes among African American persons living with HIV (PLHIV). Social support may facilitate positive health outcomes. This study explores psychosocial correlates of HIV medical outcomes, defined as undetectable viral load (UVL) and acute care minimization. Data were from baseline of the BEACON study (N = 351). UVL was ≤40 copies/mL. Acute care minimization was defined as no ER visits and/or hospitalizations in 6 months...
February 15, 2017: Journal of Ethnicity in Substance Abuse
https://www.readbyqxmd.com/read/28629071/hemostatic-kaolin-polyurethane-foam-composites-for-multifunctional-wound-dressing-applications
#10
Jeffrey G Lundin, Christopher L McGann, Grant C Daniels, Benjamin C Streifel, James H Wynne
There are numerous challenges associated with the acute care of traumatic limb injuries in forward military settings. A lack of immediate medical facilities necessitates that the wound dressing perform multiple tasks including exudate control, infection prevention, and physical protection of the wound for extended periods of time. Here, kaolin was incorporated into recently developed robust polyurethane (PU) hydrogel foams at 1-10wt% in an effort to impart hemostatic character. ATR-IR and gel fraction analysis demonstrated that the facile, one-pot synthesis of the PU hydrogel was unaffected by kaolin loading, as well as the use of a non-toxic catalyst, which significantly improved cytocompatibility of the materials...
October 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28628531/costs-and-length-of-stay-for-the-acute-care-of-patients-with-motor-complete-spinal-cord-injury-following-cervical-trauma-the-impact-of-early-transfer-to-specialized-acute-sci-center
#11
Andréane Richard-Denis, Debbie Ehrmann Feldman, Cynthia Thompson, Étienne Bourassa-Moreau, Jean-Marc Mac-Thiong
OBJECTIVE: Acute spinal cord injury (SCI) centers aim to optimize outcome following SCI. However, there is no timeframe to transfer patients from regional to SCI centers in order to promote cost-efficiency of acute care. Our objective was to compare costs and length of stay (LOS) following early and late transfer to the SCI center. DESIGN: A retrospective cohort study involving 116 individuals was conducted. Group 1 (n = 87) was managed in an SCI center promptly after the trauma, whereas group 2 (n = 29) was transferred to the SCI center only after surgery...
July 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28626086/nursing-skill-mix-in-european-hospitals-cross-sectional-study-of-the-association-with-mortality-patient-ratings-and-quality-of-care
#12
Linda H Aiken, Douglas Sloane, Peter Griffiths, Anne Marie Rafferty, Luk Bruyneel, Matthew McHugh, Claudia B Maier, Teresa Moreno-Casbas, Jane E Ball, Dietmar Ausserhofer, Walter Sermeus
OBJECTIVES: To determine the association of hospital nursing skill mix with patient mortality, patient ratings of their care and indicators of quality of care. DESIGN: Cross-sectional patient discharge data, hospital characteristics and nurse and patient survey data were merged and analysed using generalised estimating equations (GEE) and logistic regression models. SETTING: Adult acute care hospitals in Belgium, England, Finland, Ireland, Spain and Switzerland...
July 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28625170/indirect-versus-direct-standardization-methods-for-reporting-healthcare-associated-infections-an-analysis-of-central-line-associated-bloodstream-infections-in-maryland
#13
Lyndsay M O'Hara, Max Masnick, Surbhi Leekha, Sarah S Jackson, Natalia Blanco, Anthony D Harris
Whether healthcare-associated infection data should be presented using indirect (current CMS/CDC methodology) or direct standardization remains controversial. We applied both methods to central-line-associated bloodstream infection data from 45 acute-care hospitals in Maryland from 2012 to 2014. We found that the 2 methods generate different hospital rankings with payment implications. Infect Control Hosp Epidemiol 2017;1-4.
June 19, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28623040/-neuro-ophthalmological-conditions-study-of-the-clinical-care-pathway
#14
I Layat, G Challe, P LeHoang, B Bodaghi, V Touitou
INTRODUCTION: Neuro-ophthalmologic conditions require specialized multidisciplinary management, both medical and surgical, for patients affected by visual loss due to nervous system disease. The primary goal of this study is to define the specificity of neuro-ophthalmology within the realm of visual health. The secondary goal is to review clinical care pathways by studying the organization of management, in terms of accessibility to care and personalization of the care pathway. PATIENTS AND METHODS: A field study was carried out from February to June 2015, within the ophthalmology service of the Pitié-Salpêtrière University Medical Center in Paris...
June 13, 2017: Journal Français D'ophtalmologie
https://www.readbyqxmd.com/read/28622983/the-effect-of-a-comprehensive-care-transition-model-on-cost-and-utilization-for-medically-complex-children-with-cerebral-palsy
#15
Steven W Howard, Zidong Zhang, Paula Buchanan, Eric Armbrecht, Christine Williams, Geneva Wilson, Janna Hutchinson, Lindsey Pearson, Samantha Ellsworth, Caitlin M Byler, Travis Loux, Jing Wang, Steph Bernell, Nicholas Holekamp
INTRODUCTION: Our aim was to evaluate cost and acute care utilization related to an organized approach to care coordination and transitional care after major acute care hospitalization for children with medical complexities, including cerebral palsy. METHODS: A retrospective cohort of 32 patients from Ranken Jordan Pediatric Bridge Hospital (RJPBH) who received the Care Beyond the Bedside model was compared with 151 patients receiving standard care elsewhere across Missouri...
June 13, 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28622821/the-therapeutic-discharge-an-approach-to-dealing-with-deceptive-patients
#16
John B Taylor, Scott R Beach, Nicholas Kontos
OBJECTIVE: Patients with factitious disorder or malingering behaviors pose particular problems in acute care settings. We sought to describe a manner to effectively discharge these patients and keep further harm, iatrogenic or otherwise, from being inflicted. METHOD: Once an indication has been identified, the therapeutic discharge can be carried out in a stepwise fashion, resulting in a safe discharge. We outlined how to prepare for, and execute, the therapeutic discharge, along with preemptive consideration of complications that may arise...
May 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/28622214/acute-care-nurse-practitioners-and-physician-assistants-in-critical-care-transforming-education-and-practice
#17
W Robert Grabenkort, Heather H Meissen, Sara R Gregg, Craig M Coopersmith
No abstract text is available yet for this article.
July 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28618208/experiences-of-registered-nurses-transitioning-from-employment-in-acute-care-to-primary-health-care-quantitative-findings-from-a-mixed-methods-study
#18
Christine Ashley, Elizabeth Halcomb, Angela Brown, Kath Peters
AIM: To describe the experiences of registered nurses who transition from acute to primary health care (PHC) employment. BACKGROUND: Internationally the provision of health care in PHC settings is increasing. Nurses are moving from acute care employment to meet the growing demand for a PHC workforce. However, little is known about the transition experiences of these nurses. DESIGN: A sequential mixed methods study comprising a survey, and semi-structured interviews...
June 15, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28618095/a-qualitative-formative-evaluation-of-a-patient-centred-patient-safety-intervention-delivered-in-collaboration-with-hospital-volunteers
#19
Gemma Louch, Jane O'Hara, Mohammed A Mohammed
BACKGROUND: Evidence suggests that patients can meaningfully feed back to healthcare providers about the safety of their care. The PRASE (Patient Reporting and Action for a Safe Environment) intervention provides a way to systematically collect feedback from patients to support service improvement. The intervention is being implemented in acute care settings with patient feedback collected by hospital volunteers for the first time. OBJECTIVE: To undertake a formative evaluation which explores the feasibility and acceptability of the PRASE intervention delivered in collaboration with hospital volunteers from the perspectives of key stakeholders...
June 15, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28618040/optimising-implementation-of-a-patient-assessment-framework-for-emergency-nurses-a-mixed-method-study
#20
Belinda Munroe, Kate Curtis, Thomas Buckley, Melinda Lewis, Lou Atkins
AIMS AND OBJECTIVES: To determine potential facilitators and barriers and tailor interventions to optimise future implementation of a patient-assessment framework into emergency nursing practice. BACKGROUND: An evidence-informed patient-assessment framework HIRAID (History, Identify Red flags, Assessment, Interventions, Diagnostics, communication and reassessment) improves the quality of patient assessments performed by emergency nurses. Facilitators and barriers must be understood and tailored interventions selected to optimise implementation...
June 15, 2017: Journal of Clinical Nursing
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