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https://www.readbyqxmd.com/read/29346570/implementation-status-of-morbidity-and-mortality-conferences-in-swiss-hospitals-a-national-cross-sectional-survey-study
#1
Isabelle Praplan-Rudaz, Yvonne Pfeiffer, David L B Schwappach
Objective: To determine the implementation status and current practice of morbidity and mortality conferences (M&MCs) in Switzerland. Design: A national cross-sectional online survey was conducted in spring 2017. The questionnaire focused on overall goals, structure and procedures of hospital M&MCs. Further topics included satisfaction, perceived effectiveness and support requirements. Setting: A total of 913 chief physicians of surgery and internal medicine, and specialist fields of obstetrics and gynaecology, anaesthesiology and intensive care from Swiss acute care hospitals were invited to the survey...
January 16, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29345756/clinical-intentions-of-antibiotics-prescribed-upon-discharge-to-hospice-care
#2
Sarah A Servid, Brie N Noble, Erik K Fromme, Jon P Furuno
OBJECTIVES: To better understand the clinical intentions for antibiotic prescribing upon discharge from acute care to hospice care. DESIGN: Retrospective cohort study. SETTING: Five hundred forty-four-bed academic, acute-care, tertiary referral hospital in Portland, Oregon. PARTICIPANTS: Adults (≥18) who received an outpatient prescription for antibiotics on discharge from an acute care hospital to hospice care between January 1, 2009 and December 31, 2011 (N = 149)...
January 18, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29342019/hot-spotting-as-a-strategy-to-identify-high-cost-surgical-populations
#3
Sarah P Shubeck, Jyothi R Thumma, Justin B Dimick, Hari Nathan
OBJECTIVE: The aim of this study was to determine the feasibility of "hot spotting" in elective surgical populations. BACKGROUND: Prospective identification of high-cost patients, known as "hot spotting," is well developed in medical populations, but has not been performed in surgical populations. Population-based management of surgical expenditures requires identification of high-cost surgical patients to allow for effective implementation of cost-saving strategies...
January 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29340148/reducing-unnecessary-culturing-a-systems-approach-to-evaluating-urine-culture-ordering-and-collection-practices-among-nurses-in-two-acute-care-settings
#4
Robert Redwood, Mary Jo Knobloch, Daniela C Pellegrini, Matthew J Ziegler, Michael Pulia, Nasia Safdar
Background: Inappropriate ordering and acquisition of urine cultures leads to unnecessary treatment of asymptomatic bacteriuria (ASB). Treatment of ASB contributes to antimicrobial resistance particularly among hospital-acquired organisms. Our objective was to investigate urine culture ordering and collection practices among nurses to identify key system-level and human factor barriers and facilitators that affect optimal ordering and collection practices. Methods: We conducted two focus groups, one with ED nurses and the other with ICU nurses...
2018: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/29337091/a-clinically-meaningful-interpretation-of-the-prospective-investigation-of-pulmonary-embolism-diagnosis-pioped-ii-and-iii-data
#5
Paul Cronin, Ben A Dwamena
RATIONALE AND OBJECTIVES: This study aimed to calculate the multiple-level likelihood ratios (LRs) and posttest probabilities for a positive, indeterminate, or negative test result for multidetector computed tomography pulmonary angiography (MDCTPA) ± computed tomography venography (CTV) and magnetic resonance pulmonary angiography (MRPA) ± magnetic resonance venography (MRV) for each clinical probability level (two-, three-, and four-level) for the nine most commonly used clinical prediction rules (CPRs) (Wells, Geneva, Miniati, and Charlotte)...
January 11, 2018: Academic Radiology
https://www.readbyqxmd.com/read/29336769/processes-of-health-care-delivery-education-and-provider-satisfaction-in-acute-care-surgery-a-systematic-review
#6
DeGirolamo Kristin, Patrick B Murphy, Karan D'Souza, Jacques X Zhang, Neil Parry, Elliott Haut, W Robert Leeper, Ken Leslie, Kelly N Vogt, S Morad Hameed
In recent years, significant workload, high acuity, and complexity of emergency general surgery conditions have led hospitals to replace the traditional on-call model with dedicated acute care surgery (ACS) service models. A systematic search of Ovid, EMBASE, and MEDLINE was undertaken to examine the impact of ACS services on health-care delivery processes and cost, education, and provider satisfaction. From 1827 papers, reviewers identified 22 studies that met inclusion criteria and subsequently used The Evidence-Based Practice for Improving Quality method and Newcastle-Ottawa Scale to score quality and level of evidence...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29336766/the-implications-of-transfer-to-an-acute-care-surgical-tertiary-service
#7
Rebecca Britt, Pamela Davis, Anjali Gresens, Leonard Weireter, T J Novosel, Jay Collins, L D Britt
Tertiary hospitals are increasingly called on by smaller hospitals and free-standing emergency rooms (ERs) to provide surgical care for complex patients. This study assesses patients transferred to an acute care surgery service. The ER and transfer center logs, as well as billing data, were reviewed for 12 months for all cases evaluated by acute care surgery. The charts were reviewed for demographics, comorbidities, and outcomes. A total of 111 transferred patients with complete data were identified, with 59 transferred from another hospital and 52 from a free-standing ER...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29336502/nursing-teamwork-in-a-health-system-a-multisite-study
#8
Jennifer A Kaiser, Judith B Westers
AIM: The aim of this study was to examine how the facets of teamwork exist among nurse-only teams in acute and continuing care settings. BACKGROUND: The health care 'team' conventionally describes the interdisciplinary team in both literature and practice. Nursing-specific teams are rarely considered in the literature. An examination of this specific professional cohort is important to understand how teamwork exists among those who provide the majority of patient care...
January 16, 2018: Journal of Nursing Management
https://www.readbyqxmd.com/read/29334273/the-barthel-index-and-the-cumulated-ambulation-score-are-superior-to-the-de-morton-mobility-index-for-the-early-assessment-of-outcome-in-patients-with-a-hip-fracture-admitted-to-an-acute-geriatric-ward
#9
Signe Hulsbæk, Rikke Faebo Larsen, Susanne Rosthøj, Morten Tange Kristensen
PURPOSE: To examine clinimetric properties of the de Morton Mobility Index (DEMMI) in patients with hip fracture in comparison with the modified Barthel Index (BI), Cumulated Ambulation Score (CAS), and 30-s Chair Stand Test (30-s CST). MATERIALS AND METHODS: Two hundred and twenty two patients with a hip fracture admitted to a geriatric ward following surgery were assessed on day 1 and at discharge (mean of 9 [SD 5.1] post-surgery days). RESULTS: Ninety eight percent and 89% of patients were not able to perform the 30-s CST at baseline and at discharge (large floor effect), respectively...
January 15, 2018: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29330238/changing-patterns-of-mental-health-care-use-the-role-of-integrated-mental-health-services-in-veteran-affairs-primary-care
#10
Lucinda B Leung, Jean Yoon, Lisa V Rubenstein, Edward P Post, Maureen E Metzger, Kenneth B Wells, Catherine A Sugar, José J Escarce
OBJECTIVE: Aiming to foster timely, high-quality mental health care for Veterans, VA's Primary Care-Mental Health Integration (PC-MHI) embeds mental health specialists in primary care and promotes care management for depression. PC-MHI and patient-centered medical home providers work together to provide the bulk of mental health care for primary care patients with low-to-moderate-complexity mental health conditions. This study examines whether increasing primary care clinic engagement in PC-MHI services is associated with changes in patient health care utilization and costs...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29327478/interventions-to-improve-working-conditions-of-nursing-staff-in-acute-care-hospitals-scoping-review
#11
Sergio Barrientos-Trigo, Laura Vega-Vázquez, Rocío De Diego-Cordero, Bárbara Badanta-Romero, Ana M Porcel-Gálvez
AIM: To conduct a scoping review to examine and map the interventions proposed for the improvement of the working conditions of nursing staff in acute care hospitals. BACKGROUND: The Registered Nurse Forecasting (RN4CAST) project and other studies have determined the impact that the nursing staff has on the quality of care. The nursing staff's higher levels of burnout, job dissatisfaction and negative perception of the quality of care provided caused worse health outcomes...
January 11, 2018: Journal of Nursing Management
https://www.readbyqxmd.com/read/29326477/the-oral-health-status-of-older-patients-in-acute-care-on-admission-and-day-7-in-two-australian-hospitals
#12
(no author information available yet)
Good oral hygiene needed to prevent hospital acquired aspiration pneumonia in older patients.
January 12, 2018: British Dental Journal
https://www.readbyqxmd.com/read/29326333/comet-a-multicomponent-home-based-disease-management-programme-versus-routine-care-in-severe-copd
#13
Romain Kessler, Pere Casan-Clara, Dieter Koehler, Silvia Tognella, Jose Luis Viejo, Roberto W Dal Negro, Salvador Díaz-Lobato, Karina Reissig, José Miguel Rodríguez González-Moro, Gilles Devouassoux, Jean-Michel Chavaillon, Pierre Botrus, Jean-Michel Arnal, Julio Ancochea, Anne Bergeron-Lafaurie, Carlos De Abajo, Winfried J Randerath, Andreas Bastian, Christian G Cornelissen, Georg Nilius, Joëlle B Texereau, Jean Bourbeau
The COPD Patient Management European Trial (COMET) investigated the efficacy and safety of a home-based COPD disease management intervention for severe COPD patients.The study was an international open-design clinical trial in COPD patients (forced expiratory volume in 1 s <50% of predicted value) randomised 1:1 to the disease management intervention or to the usual management practices at the study centre. The disease management intervention included a self-management programme, home telemonitoring, care coordination and medical management...
January 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29325725/who-goes-to-inpatient-rehabilitation-or-skilled-nursing-facilities-unexpectedly-following-total-knee-arthroplasty
#14
Alexander J Rondon, Timothy L Tan, Max R Greenky, Karan Goswami, Noam Shohat, Jessica L Phillips, James J Purtill
BACKGROUND: Inpatient rehabilitation facilities (IRFs) and skilled nursing facilities (SNFs) represent a significant portion of post-operative expenses of bundled payments for total knee arthroplasty (TKA). Although many surgeons no longer routinely send patients to IRFs or SNFs, some patients are unable to be discharged directly home. This study identified patient factors for discharge to post-acute care facilities with an institutional protocol of discharging TKA patients home. METHODS: A retrospective review of patients undergoing primary unilateral TKA at a single institution from 2012 to 2017 was performed...
December 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29325583/an-integrated-delivery-of-care-approach-to-improve-patient-reported-physical-function-and-mental-wellbeing-after-orthopedic-trauma-study-protocol-for-a-randomized-controlled-trial
#15
Laura Zdziarski-Horodyski, MaryBeth Horodyski, Kalia K Sadasivan, Jennifer Hagen, Terrie Vasilopoulos, Matthew Patrick, Robert Guenther, Heather K Vincent
BACKGROUND: Orthopedic trauma injury impacts nearly 2.8 million people each year. Despite surgical improvements and excellent survivorship rates, many patients experience poor quality of life (QOL) outcomes years later. Psychological distress commonly occurs after injury. Distressed patients more frequently experience rehospitalizations, pain medication dependence, and low QOL. This study was developed to test whether an integrative care approach (IntCare; ten-step program of emotional support, education, customized resources, and medical care) was superior to usual care (UsCare)...
January 11, 2018: Trials
https://www.readbyqxmd.com/read/29324563/nutritional-screening-assessment-and-implementation-strategies-for-adults-in-an-australian-acute-tertiary-hospital-a-best-practice-implementation-report
#16
Louise Smith, Amanda Chapman, Kelli Flowers, Kylie Wright, Tanghua Chen, Charmaine O'Connor, Cecilia Astorga, Nevenka Francis, Gia Vigh, Craig Wainwright
OBJECTIVE: The project aimed to improve the effectiveness of nutritional screening and assessment practices through clinical audits and the implementation of evidence-based practice recommendations. INTRODUCTION: In the absence of optimal nutrition, health may decline and potentially manifest as adverse health outcomes. In a hospitalized person, poor nutrition may adversely impact on the person's outcome. If the nutritional status can be ascertained, nutritional needs can be addressed and potential risks minimized...
January 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29324551/the-i-pass-mnemonic-and-the-occurrence-of-handoff-related-errors-in-adult-acute-care-hospitals-a-systematic-review-protocol
#17
Brittany Ransom, Karen Winters
What is the effectiveness of the I-PASS mnemonic in reducing handoff related errors during inter- or intrahospital transfers for hospitalized patients?The objective of this systematic review is to identify the impact of the I-PASS mnemonic during hospitalized patient inter- or intrahospital transfers on medication errors, transfer delays, treatment delays and mortality.More specifically, the objective is to identify the effect that the I-PASS mnemonic has on handoff related errors during inter or intrahospital patient transfers by comparing rates pre and post I-PASS implementation...
January 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29324429/a-pilot-clinical-study-of-a-safe-and-efficient-stool-management-system-in-patients-with-fecal-incontinence
#18
Ashlee Garcia, Sally Fung, Karen Lou Kennedy-Evans
INTRODUCTION: According to the Wound Ostomy Continence Nursing Society's Continence Committee, the incidence of fecal incontinence (FI) can occur from 18% to 37% in an acute care setting. A stool management system has been designed to manage FI in bedridden patients and has proven to be efficacious in wound management and prevention and infection control, provide safer patient outcomes, and enhance ease of nursing. OBJECTIVE: This study aims to evaluate the safety and efficacy of an intrarectal device intended to manage fecal incontinence in hospitalized bedridden patients through nonclinical and clinical testings...
December 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/29324209/using-process-improvement-tools-to-improve-the-care-of-patients-with-neutropenic-fever-in-the-emergency-room
#19
Avantika Dang, Lauren N Gjolaj, Myka Whitman, Gustavo Fernandez
PURPOSE: The purpose of this study was to improve the care of patients with neutropenic fever in an academic acute care hospital's emergency room (ER). METHODS: Using the define, measure, analyze, improve, control method, a two-phase project with three critical to quality metrics (reduction in time to antibiotic administration, increase in percentage of patients with neutropenic fever identified as an oncology emergency, and increase in patients cohorted on oncology units) was completed...
January 2018: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29323989/rapid-response-a-multiprofessional-approach-to-hospital-at-home
#20
Sara Dowell, George Moss, Katy Odedra
The provision of 'hospital at home' is not new to the 21st century but pressure from the reduction in the number of hospital beds, population growth, an ageing population and subsequent extended time living with long-term conditions means such services are increasingly necessary. However, research by the authors found services that already exist do not operate 24 hours a day or provide a single multiprofessional approach. Gloucestershire's rapid response (RR) service provides specialist, coordinated, comprehensive and supportive assessment and treatment 24 hours a day in the patient's own home...
January 11, 2018: British Journal of Nursing: BJN
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