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https://www.readbyqxmd.com/read/28231357/cne-quiz-communication-between-acute-care-hospitals-and-skilled-nursing-facilities-during-care-transitions-a-retrospective-chart-review
#1
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March 1, 2017: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/28230575/patients-and-care-partners-perspectives-on-dignity-and-respect-during-acute-care-hospitalization
#2
Priscilla K Gazarian, Constance R C Morrison, Lisa Soleymani Lehmann, Orly Tamir, David W Bates, Ronen Rozenblum
BACKGROUND: Delivering patient-centered care (PCC) is essential to our healthcare system. Patient dignity and respect are foundational elements of PCC. Understanding patients' and their care partner's perspectives on the meaning of dignity and respect within a clinical care environment is critical to achieving our goal of PCC. OBJECTIVE: The aim of the study was to understand how patients and their care partners define, describe, and experience dignity and respect during hospitalization...
February 22, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28225500/the-prevalence-of-potentially-preventable-deaths-in-an-acute-care-hospital-a-retrospective-cohort
#3
Daniel M Kobewka, Carl van Walraven, Monica Taljaard, Paul Ronksley, Alan J Forster
Studies estimate that 6% to 27% of deaths in hospitals might be prevented with higher quality care. These estimates may be inaccurate because they fail to account for the uncertainty associated with classifying preventability. The purpose of this study was to measure the prevalence of preventable deaths, accounting for the uncertainty in preventability ratings.We created standardized structured case abstracts for all deaths at a multisite academic teaching hospital over a 3-month period. Each case abstract was evaluated independently by 4 reviewers who rated death preventability on a 100-point scale ranging from 0 ("Definitely not preventable") to 100 ("Definitely preventable")...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28225447/environmental-market-factors-associated-with-electronic-health-record-adoption-among-cancer-hospitals
#4
Will L Tarver, Nir Menachemi
BACKGROUND: Although recent literature has explored the relationship between various environmental market characteristics and the adoption of electronic health records (EHRs) among general, acute care hospitals, no such research currently exists for specialty hospitals, including those providing cancer care. PURPOSE: The aim of the study was to examine the relationship between market characteristics and the adoption of EHRs among Commission on Cancer (CoC)-accredited hospitals...
February 22, 2017: Health Care Management Review
https://www.readbyqxmd.com/read/28225049/prevalence-and-predictors-of-weight-change-post-discharge-from-hospital-a-study-of-the-canadian-malnutrition-task-force
#5
H Keller, M Laporte, H Payette, J Allard, P Bernier, D Duerksen, L Gramlich, K Jeejeebhoy
BACKGROUND/OBJECTIVES: Little is known about factors associated with weight change post discharge from hospital; yet poor nutritional status in the transition from hospital to community can result in readmission. This exploratory study aimed to determine the factors associated with weight change 30 days post discharge defined as weight gain (WG; 5+ pounds), weight loss (WL; 5+pounds) or weight stable (WS). SUBJECTS/METHODS: A total of 922 medical or surgical patients were recruited from 16 acute care hospitals in 8 Canadian provinces...
February 22, 2017: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28220453/epidemiology-of-sepsis-in-catalonia-analysis-of-incidence-and-outcomes-in-a-european-setting
#6
Juan Carlos Yébenes, Juan Carlos Ruiz-Rodriguez, Ricard Ferrer, Montserrat Clèries, Anna Bosch, Carol Lorencio, Alejandro Rodriguez, Xavier Nuvials, Ignacio Martin-Loeches, Antoni Artigas
BACKGROUND: Up-to-date identification of local trends in sepsis incidence and outcomes is of considerable public health importance. The aim of our study was to estimate annual incidence rates and in-hospital mortality trends for hospitalized patients with sepsis in a European setting, while avoiding selection bias in relation to different complexity hospitals. METHODS: A large retrospective analysis of a 5-year period (2008-2012) was conducted of hospital discharge records obtained from the Catalan Health System (CatSalut) Minimum Basic Data Set for Acute-Care Hospitals (a mandatory population-based register of admissions to all public and private acute-care hospitals in Catalonia)...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28219452/stop-stroke-a-brief-report-on-door-to-needle-times-and-performance-after-implementing-an-acute-care-coordination-medical-application-and-implications-to-emergency-medical-services
#7
Robert Dickson, Adrian Nedelcut, Melissa McPeek Nedelcut
OBJECTIVE: The objective of this study was to evaluate the effect of the Stop Stroke (Pulsara; Bozeman, Montana USA) medical application on door-to-needle (DTN) time in patients presenting to the emergency department (ED) with an acute ischemic stroke (AIS). METHODS: This was a retrospective cohort study of the Good Shepherd Health System (Longview, Texas USA) stroke quality improvement dashboard for a 25-month period from February 2012 through February 2014. Data analysis includes all data from Center for Medicare and Medicaid Services (CMS; Baltimore, Maryland USA) reportable cases receiving Tissue Plasminogen Activator (TPA) for AIS during the study period...
February 21, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28216064/internal-fixation-of-acetabular-fractures-in-an-older-population-using-the-timi-approach-midterm-results-of-a-prospective-study
#8
Rene Aigner, Ralf Hellige, Sabine Knippel, Ludwig Oberkircher, Steffen Ruchholtz, Benjamin Buecking
INTRODUCTION: The incidence of geriatric acetabular fractures continues to increase due to demographic changes. In the elderly, anterior column fractures are common, and standard approaches are associated with a considerable risk for surgery-associated complications. Therefore, a minimally invasive approach was developed in our department. The aim of this study was to examine early and mid-term results regarding the use of this novel two-incision minimally invasive (TIMI) approach in patients aged over 55 years with acetabular fractures...
February 3, 2017: Injury
https://www.readbyqxmd.com/read/28215655/the-caregiver-perspective-on-unscheduled-72-hour-return-visits-to-pediatric-acute-care-sites-a-focus-on-discharge-processes
#9
Nidhya Navanandan, Sarah K Schmidt, Natasha Cabrera, Michael C DiStefano, Rakesh D Mistry
OBJECTIVE: To characterize pediatric caregivers' reasons for 72-hour emergency department (ED) and urgent care (UC) returns. METHODS: A sample of caregivers returning within 72 hours of initial visit to a pediatric ED or affiliated UC site were surveyed from 11/14-6/15; patients evaluated at outside ED/UCs, scheduled for return, or non-English/Spanish speaking were excluded. Caregiver surveys underwent item generation, validation, and pilot testing. Survey items included caregiver reasons for unscheduled returns, with a specific assessment of delivery of key components of discharge instructions (diagnosis, duration of illness, home care, return precautions)...
February 12, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28214474/emergency-department-utilisation-by-older-people-in-metropolitan-melbourne-2008-12-findings-from-the-reducing-older-patient
#10
Danielle Mazza, Christopher Pearce, Angela Joe, Lyle R Turner, Bianca Brijnath, Colette Browning, Marianne Shearer, Judy Lowthian
Objective Older patients are over-represented in emergency departments (ED), with many presenting for conditions that could potentially be managed in general practice. The aims of the present study were to examine the characteristics of ED presentations by older patients and to identify patient factors contributing to potentially avoidable general practitioner (PAGP)-type presentations.Methods A retrospective analysis was performed of routinely collected data comprising ED presentations by patients aged ≥70 years at public hospitals across metropolitan Melbourne from January 2008 to December 2012...
February 20, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28214255/clinical-outcomes-and-90-day-costs-following-hemiarthroplasty-or-total-hip-arthroplasty-for-hip-fracture
#11
Christine I Nichols, Joshua G Vose, Ryan M Nunley
BACKGROUND: In the era of bundled payments, many hospitals are responsible for costs from admission through 90 days postdischarge. Although bundled episodes for hip fracture will have a separate target price for the bundle, little is known about the 90-day resource use burden for this patient population. METHODS: Using Medicare 100% Standard Analytic Files (2010-2014), we identified patients undergoing hemiarthroplasty or total hip arthroplasty (THA). Patients were aged 65 and older with admitting diagnosis of closed hip fracture, no concurrent fractures of the lower limb, and no history of hip surgery in the prior 12 months baseline...
January 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28212167/the-varying-roles-of-nurses-during-interfacility-care-transitions
#12
Lianne Jeffs, Marianne Saragosa, Madelyn Law, Kerry Kuluski, Sherry Espin, Heidi Parker, Kristen Collins
This study explored health care professionals' perceptions and experiences associated with the role of point-of-care nurses during care transitions from an acute care hospital to a rehabilitation setting to being discharged home. We used a qualitative exploratory design and semistructured interviews. Content analysis revealed 3 themes that point to the ambiguity related to the roles that nurses enact with older patients during care transitions. We suggest ways to better support nurses to engage in quality care transitions...
February 15, 2017: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/28210351/cross-continuum-tool-is-associated-with-reduced-utilization-and-cost-for-frequent-high-need-users
#13
Lauran Hardin, Adam Kilian, Leslie Muller, Kevin Callison, Michael Olgren
INTRODUCTION: High-need, high-cost (HNHC) patients can over-use acute care services, a pattern of behavior associated with many poor outcomes that disproportionately contributes to increased U.S. healthcare cost. Our objective was to reduce healthcare cost and improve outcomes by optimizing the system of care. We targeted HNHC patients and identified root causes of frequent healthcare utilization. We developed a cross-continuum intervention process and a succinct tool called a Complex Care Map (CCM)© that addresses fragmentation in the system and links providers to a comprehensive individualized analysis of the patient story and causes for frequent access to health services...
February 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28209197/accuracy-and-generalizability-of-using-automated-methods-for-identifying-adverse-events-from-electronic-health-record-data-a-validation-study-protocol
#14
Christian M Rochefort, David L Buckeridge, Andréanne Tanguay, Alain Biron, Frédérick D'Aragon, Shengrui Wang, Benoit Gallix, Louis Valiquette, Li-Anne Audet, Todd C Lee, Dev Jayaraman, Bruno Petrucci, Patricia Lefebvre
BACKGROUND: Adverse events (AEs) in acute care hospitals are frequent and associated with significant morbidity, mortality, and costs. Measuring AEs is necessary for quality improvement and benchmarking purposes, but current detection methods lack in accuracy, efficiency, and generalizability. The growing availability of electronic health records (EHR) and the development of natural language processing techniques for encoding narrative data offer an opportunity to develop potentially better methods...
February 16, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28209038/-a-comparison-of-leak-compensation-in-six-acute-care-ventilators-during-non-invasive-ventilation
#15
X S Hu, Y Wang, Z T Wang, P Yan, X G Zhang, S F Zhao, F Xie, H J Gu, L X Xie
Objective: To compare the ability of leak compensation in 6 medical ventilators during non-invasive ventilation. Methods: Six medical ventilators were selected, including 3 non-invasive ventilators (V60, Flexo and Stellar150), and 3 invasive ventilators(Avea, Servo I and BellaVist). Using a lung simulator, the ability of leak compensation was evaluated during triggering and cycling in 2 respiratory mechanics conditions (high airway resistance condition and high elastance resistance condition), and each condition was performed under 2 PEEP levels (4, and 8 cmH(2)O, 1 mmHg=0...
February 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28208030/intensive-care-unit-admission-and-survival-among-older-patients-with-chronic-obstructive-pulmonary-disease-heart-failure-or-myocardial-infarction
#16
Thomas S Valley, Michael W Sjoding, Andrew M Ryan, Theodore J Iwashyna, Colin R Cooke
RATIONALE: Admission to an intensive care unit (ICU) may be beneficial to pneumonia patients with uncertain ICU needs; however, evidence regarding the association between ICU admission and mortality for other common conditions is largely unknown. OBJECTIVES: To estimate the relationship between ICU admission and outcomes for hospitalized patients with exacerbation of chronic obstructive pulmonary disease (COPD), exacerbation of heart failure (HF), or acute myocardial infarction (AMI)...
February 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28207996/the-use-of-a-contextual-modal-and-psychological-classification-of-medication-errors-in-the-emergency-department-a-retrospective-descriptive-study
#17
C J Cabilan, J A Hughes, C Shannon
BACKGROUND: The causes of medication errors are unique in every clinical setting; hence error minimisation strategies are not always effective. For this reason, it is fundamental to understand the causes specific to the emergency department so that targeted strategies can be implemented. OBJECTIVES: To describe the contextual, modal, and psychological classification of medication errors in the emergency department to know the factors associated with the reported medication errors...
February 16, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28207980/questioning-skills-of-clinical-facilitators-supporting-undergraduate-nursing-students
#18
Nicole M Phillips, Maxine M Duke, Rona Weerasuriya
AIMS AND OBJECTIVES: To report on a study investigating questioning skills of clinical facilitators who support the learning of undergraduate nursing students. BACKGROUND: The ability to think critically is integral to decision-making and the provision of safe and quality patient care. Developing students' critical thinking skills is expected of those who supervise and facilitate student learning in the clinical setting. Models used to facilitate student learning in the clinical setting have changed over the years with clinicians having dual responsibility for patient care and facilitating student learning...
February 16, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28202052/primary-care-focus-and-utilization-in-the-medicare-shared-savings-program-accountable-care-organizations
#19
Lindsey A Herrel, John Z Ayanian, Scott R Hawken, David C Miller
BACKGROUND: Although Accountable Care Organizations (ACOs) are defined by the provision of primary care services, the relationship between the intensity of primary care and population-level utilization and costs of health care services has not been examined during early implementation of Medicare Shared Savings Program (MSSP) ACOs. Our objective was to evaluate the association between primary care focus and healthcare utilization and spending in the first performance period of the Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs)...
February 15, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28198660/prediction-of-functional-recovery-six-months-following-traumatic-spinal-cord-injury-during-acute-care-hospitalization
#20
Andréane Richard-Denis, Debbie Feldman, Cynthia Thompson, Jean-Marc Mac-Thiong
OBJECTIVES: To determine factors associated with functional status six months following a traumatic cervical and thoracic spinal cord injury (SCI), with a particular interest in factors related to the acute care hospitalization stay. DESIGN: This is a prospective cohort study. Sixteen potential predictive variables were studied. Univariate regression analyses were first performed to determine the strength of association of each variable independently with the total Spinal Cord Independence Measure (SCIM) score...
February 15, 2017: Journal of Spinal Cord Medicine
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