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"Acute care"

Teryl K Nuckols, Emmett Keeler, Sally C Morton, Laura Anderson, Brian Doyle, Marika Booth, Roberta Shanman, Jonathan Grein, Paul Shekelle
Importance: Although quality improvement (QI) interventions can reduce central-line-associated bloodstream infections (CLABSI) and catheter-related bloodstream infections (CRBSI), their economic value is uncertain. Objective: To systematically review economic evaluations of QI interventions designed to prevent CLABSI and/or CRBSI in acute care hospitals. Evidence Review: A search of Ovid MEDLINE, Econlit, Centre for Reviews & Dissemination, New York Academy of Medicine's Grey Literature Report, Worldcat, prior systematic reviews (January 2004 to July 2016), and IDWeek conference abstracts (2013-2016), was conducted from 2013 to 2016...
October 24, 2016: JAMA Internal Medicine
Celia Laur, Hannah Marcus, Sumantra Ray, Heather Keller
Understanding the knowledge, attitudes, and practices (KAP) of hospital staff is needed to improve care activities that support the detection/prevention/treatment of malnutrition, yet quality measures are lacking. The purpose was to develop (study 1) and assess the administration and discriminative potential (study 2) of using such a KAP measure in acute care. In study 1, a 27-question KAP questionnaire was developed, face validated (n = 5), and tested for reliability (n = 35). Kappa and Intraclass Correlation (ICC) were determined...
October 20, 2016: Healthcare (Basel, Switzerland)
Jon P Wietholter, Charles D Ponte, Dustin M Long
BACKGROUND: Few publications have addressed the perceptions of pharmacists and physicians regarding the value of clinical pharmacist services. A survey-based study was conducted to determine whether Internal Medicine (IM) and Family Medicine (FM) pharmacists and physicians differed in their attitudes regarding the benefits of collaboration in an acute care setting. OBJECTIVES: The primary objective was to evaluate perceived differences regarding self-assessment of value between IM and FM pharmacists...
October 24, 2016: International Journal of Pharmacy Practice
Miriam N Lango, Elizabeth Handorf, Ellis Arjmand
OBJECTIVES: To describe the deployment of otolaryngologists and evaluate factors associated with the geographic distribution of otolaryngologists in the United States. STUDY DESIGN: Cross-sectional study. METHODS: The otolaryngology physician supply was defined as the number of otolaryngologists per 100,000 in the hospital referral region (HRR). The otolaryngology physician supply was derived from the American Medical Association Masterfile or from the Medicare Enrollment and Provider Utilization Files...
October 24, 2016: Laryngoscope
Jane Kellett, Greg Kyle, Catherine Itsiopoulos, Mark Naunton, Narelle Luff
Malnutrition is a significant issue in the hospital setting. This cross-sectional, observational study determined the prevalence of malnutrition amongst 189 adult inpatients in a teaching hospital using the Patient-Generated Subjective Global Assessment tool and compared data to control groups for coding of malnutrition to determine the estimated unclaimed financial reimbursement associated with this comorbidity. Fifty-three percent of inpatients were classified as malnourished. Significant associations were found between malnutrition and increasing age, decreasing body mass index, and increased length of stay...
2016: Journal of Nutrition and Metabolism
Michael J Silverman
Background: There has been an increasing emphasis on recovery as the expectation for people with mental health disorders. Purpose: The purpose of this effectiveness study is to determine if group-based educational music therapy can immediately impact state hope for recovery in acute care mental health patients. Research questions included: will acute care mental health inpatients who participate in a single music therapy session have higher agency and pathway aspects of state hope for recovery than patients in a control condition? Will there be differences in state hope for recovery as a result of hope-oriented songwriting or lyric analysis interventions? Method: Participants (N = 169) were cluster randomized to one of three single-session conditions: lyric analysis, songwriting, or wait-list control...
2016: Frontiers in Psychology
Vijay Christopher Kannan, Nicole Hodgson, Andrew Lau, Kate Goodin, Andrea Freyer Dugas, Frank LoVecchio
STUDY OBJECTIVE: We seek to use a novel layered-surveillance approach to localize influenza clusters within an acute care population. The first layer of this system is a syndromic surveillance screen to guide rapid polymerase chain reaction testing. The second layer is geolocalization and cluster analysis of these patients. We posit that any identified clusters could represent at-risk populations who could serve as high-yield targets for preventive medical interventions. METHODS: This was a prospective observational surveillance study...
November 2016: Annals of Emergency Medicine
Shady A Rehim, Stephanie DeMoor, Richard Olmsted, Daniel L Dent, Jessica Parker-Raley
BACKGROUND: Hospital action teams comprise interdisciplinary health care providers working simultaneously to treat critically ill patients. Assessments designed to evaluate communication effectiveness or "nontechnical" performance of these teams are essential to minimize medical errors and improve team productivity. Although multiple communication tools are available, the characteristics and psychometric validity of these instruments have yet to be systematically compared. OBJECTIVE: To identify assessments used to evaluate the communication or "nontechnical" performance of hospital action teams and summarize evidence to develop and validate these instruments...
October 19, 2016: Journal of Surgical Education
Andrew S Hwang, Steven J Atlas, Johan Hong, Jeffrey M Ashburner, Adrian H Zai, Richard W Grant, Clemens S Hong
BACKGROUND: A better understanding of the attributes of patients who require more effort to manage may improve risk adjustment approaches and lead to more efficient resource allocation, improved patient care and health outcomes, and reduced burnout in primary care clinicians. OBJECTIVE: To identify and characterize high-effort patients from the physician's perspective. DESIGN: Cohort study. PARTICIPANTS: Ninety-nine primary care physicians in an academic primary care network...
October 21, 2016: Journal of General Internal Medicine
Eugene Lin, Manjula Kurella Tamura, Maria E Montez-Rath, Glenn M Chertow
Introduction The use of administrative data to capture 30-day readmission rates in end-stage renal disease is challenging since Medicare combines claims from acute care, inpatient rehabilitation (IRF), and long-term care hospital stays into a single "Inpatient" file. For data prior to 2012, the United States Renal Data System does not contain the variables necessary to easily identify different facility types, making it likely that prior studies have inaccurately estimated 30-day readmission rates. Methods For this report, we developed two methods (a "simple method" and a "rehabilitation-adjusted method") to identify acute care, IRF, and long-term care hospital stays from United States Renal Data System claims data, and compared them to methods used in previously published reports...
October 20, 2016: Hemodialysis International
Richard Aschbacher, Elisabetta Pagani, Massimo Confalonieri, Claudio Farina, Paolo Fazii, Francesco Luzzaro, Pier Giorgio Montanera, Aurora Piazza, Laura Pagani
BACKGROUND: Rates of colonization and infection with multidrug-resistant (MDR) bacteria are increasing worldwide, in both acute care hospitals and long-term care facilities (LTCFs). Italy has one of the highest prevalence of MDR bacteria in European countries, especially with regard to methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum β-lactamase (ESBL) or carbapenemase producing Enterobacteriaceae (CPE). METHOD: Review of studies on colonization by MDR bacteria from Italian LTCFs, risk factors for colonization and molecular characteristics of surveillance and clinical isolates, compared with other European countries...
2016: Antimicrobial Resistance and Infection Control
Mary E W Dankbaar, Maartje Bakhuys Roozeboom, Esther A P B Oprins, Frans Rutten, Jeroen J G van Merrienboer, Jan L C M van Saase, Stephanie C E Schuit
INTRODUCTION: Training emergency care skills is critical for patient safety but cost intensive. Serious games have been proposed as an engaging self-directed learning tool for complex skills. The objective of this study was to compare the cognitive skills and motivation of medical residents who only used a course manual as preparation for classroom training on emergency care with residents who used an additional serious game. METHODS: This was a quasi-experimental study with residents preparing for a rotation in the emergency department...
October 19, 2016: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
Andrea Gruneir, Lauren E Griffith, Kathryn Fisher, Dilzayn Panjwani, Sima Gandhi, Li Sheng, Chris Patterson, Amiram Gafni, Jenny Ploeg, Maureen Markle-Reid
OBJECTIVE: To characterize comorbid chronic conditions, describe health services use, and estimate health care costs among community-dwelling older adults with prior stroke. METHODS: This is a retrospective cohort study using administrative data from Ontario, Canada. We identified all community-dwelling individuals aged 66 and over on April 1, 2008 (baseline), who had experienced a stroke at least 6 months prior. We estimated the prevalence of 14 comorbid conditions at baseline; we captured all physician visits, emergency department visits, hospital admissions, home care contacts, and associated costs over 5 years stratifying by number of comorbid conditions...
October 19, 2016: Neurology
Douglas A E White, Erik S Anderson, Sarah K Pfeil, Laura J Deering, Tamara Todorovic, Tarak K Trivedi
BACKGROUND: Recent studies demonstrate high rates of previously undiagnosed hepatitis C virus (HCV) infection among patients screened in urban emergency departments (ED). Experts caution, however, that public health interventions, such as screening for infectious diseases, must not interfere with the primary mission of EDs to provide timely acute care. Increases in ED length of stay (LOS) have been associated with decreased quality of ED care. OBJECTIVE: In this study, we assess the influence of an integrated HCV screening protocol on ED LOS...
2016: PloS One
C A Whicher, R Shah, H Gleeson, L Vaughan, L Albon
It had become a familiar routine. My seventh admission with diabetic ketoacidosis (DKA) in a year. Each time I was admitted it was the same; a DKA protocol, a diabetes specialist nurse visit, and a few questions from the doctors checking if "everything is okay?" On each admission, I would be discharged home after a couple of days. We all knew I'd be back again within a month or two.
2016: Acute Medicine
I-Shiang Tzeng, Su-Hsun Liu, Kuan-Fu Chen, Chin-Chieh Wu, Jih-Chang Chen
To reduce patient boarding time at the emergency department (ED) and to improve the overall quality of the emergent care system in Taiwan, the Minister of Health and Welfare of Taiwan (MOHW) piloted the Grading Responsible Hospitals for Acute Care (GRHAC) audit program in 2007-2009.The aim of the study was to evaluate the impact of the GRHAC audit program on the identification and management of acute myocardial infarction (AMI)-associated ED visits by describing and comparing the incidence of AMI-associated ED visits before (2003-2007), during (2007-2009), and after (2009-2012) the initial audit program implementation...
October 2016: Medicine (Baltimore)
Patricia C Henwood, David C Mackenzie, Joshua S Rempell, Emily Douglass, Damas Dukundane, Andrew S Liteplo, Megan M Leo, Alice F Murray, Samuel Vaillancourt, Anthony J Dean, Resa E Lewiss, Stephen Rulisa, Elizabeth Krebs, A K Raja Rao, Emmanuel Rudakemwa, Vincent Rusanganwa, Patrick Kyanmanywa, Vicki E Noble
OBJECTIVE: We delivered a point-of-care ultrasound training programme in a resource-limited setting in Rwanda, and sought to determine participants' knowledge and skill retention. We also measured trainees' assessment of the usefulness of ultrasound in clinical practice. METHODS: This was a prospective cohort study of 17 Rwandan physicians participating in a point-of-care ultrasound training programme. The follow-up period was 1 year. Participants completed a 10-day ultrasound course, with follow-up training delivered over the subsequent 12 months...
October 19, 2016: Tropical Medicine & International Health: TM & IH
Caroline H D Jones, Margaret Glogowska, Louise Locock, Daniel S Lasserson
BACKGROUND: Many point of care diagnostic technologies are available which produce results within minutes, and offer the opportunity to deliver acute care out of hospital settings. Increasing access to diagnostics at the point of care could increase the volume and scope of acute ambulatory care. Yet these technologies are not routinely used in many settings. We aimed to explore how point of care testing is used in a setting where it has become 'normalized' (embedded in everyday practice), in order to inform future adoption and implementation in other settings...
October 19, 2016: BMC Health Services Research
M Namdari, A Eatemadi, B Negahdari
Brain natriuretic peptide (BNP), also known as a B-type natriuretic peptide, is one of the important biomarkers with a proven role in the diagnosis of congestive heart failure (CHF). Researchers from the different clinical field have researched into the performance features of BNP testing in the acute care set-up to assist and improve in diagnosing CHF and in predicting future morbidity and mortality rates. The potency of BNP has also been researched into in cases like myocardial ischemia and infarction, cor pulmonale, and acute pulmonary embolism (PE)...
September 30, 2016: Cellular and Molecular Biology
Alessandro Cassini, Diamantis Plachouras, Tim Eckmanns, Muna Abu Sin, Hans-Peter Blank, Tanja Ducomble, Sebastian Haller, Thomas Harder, Anja Klingeberg, Madlen Sixtensson, Edward Velasco, Bettina Weiß, Piotr Kramarz, Dominique L Monnet, Mirjam E Kretzschmar, Carl Suetens
BACKGROUND: Estimating the burden of healthcare-associated infections (HAIs) compared to other communicable diseases is an ongoing challenge given the need for good quality data on the incidence of these infections and the involved comorbidities. Based on the methodology of the Burden of Communicable Diseases in Europe (BCoDE) project and 2011-2012 data from the European Centre for Disease Prevention and Control (ECDC) point prevalence survey (PPS) of HAIs and antimicrobial use in European acute care hospitals, we estimated the burden of six common HAIs...
October 2016: PLoS Medicine
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