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https://www.readbyqxmd.com/read/29793191/development-and-validation-of-a-prediction-model-for-functional-decline-in-older-medical-inpatients
#1
Toshihiko Takada, Shingo Fukuma, Yosuke Yamamoto, Yukio Tsugihashi, Hiroyuki Nagano, Michio Hayashi, Jun Miyashita, Teruhisa Azuma, Shunichi Fukuhara
OBJECTIVE: To prevent functional decline in older inpatients, identification of high-risk patients is crucial. The aim of this study was to develop and validate a prediction model to assess the risk of functional decline in older medical inpatients. METHODS: In this retrospective cohort study, patients ≥65 years admitted acutely to medical wards were included. The healthcare database of 246 acute care hospitals (n = 229,913) was used for derivation, and two acute care hospitals (n = 1767 and 5443, respectively) were used for validation...
May 17, 2018: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29792980/language-used-by-health-care-professionals-to-describe-dying-at-an-acute-care-hospital
#2
Kirsten Wentlandt, Philippe Toupin, Natalia Novosedlik, Lisa W Le, Camilla Zimmermann, Ebru Kaya
PURPOSE: To understand the language used to describe the deterioration and death of patients in an acute academic tertiary care centre, and to identify whether patient diagnoses or palliative care(PC) involvement was associated with clearer descriptions of this process. METHODS: We conducted a retrospective chart review of the final admission of 150 patients who died on an inpatient internal medicine unit. Conventional and summative content analysis was performed of the language used to describe, either directly or indirectly, that the patient's death was imminent...
May 21, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29792390/mental-health-crisis-resolution-teams-and-crisis-care-systems-in-england-a-national-survey
#3
Brynmor Lloyd-Evans, Danielle Lamb, Joseph Barnby, Michelle Eskinazi, Amelia Turner, Sonia Johnson
Aims and methodA national survey investigated the implementation of mental health crisis resolution teams (CRTs) in England. CRTs were mapped and team managers completed an online survey. RESULTS: Ninety-five per cent of mapped CRTs (n = 233) completed the survey. Few CRTs adhered fully to national policy guidelines. CRT implementation and local acute care system contexts varied substantially. Access to CRTs for working-age adults appears to have improved, compared with a similar survey in 2012, despite no evidence of higher staffing levels...
May 24, 2018: BJPsych Bulletin
https://www.readbyqxmd.com/read/29792312/identification-of-patients-with-hemoglobin-ss-s%C3%AE-0-thalassemia-disease-and-pain-crises-within-electronic-health-records
#4
Ashima Singh, Javier Mora, Julie A Panepinto
Electronic health records (EHRs) are a source of big data that provide opportunities for conducting population-based studies and creating learning health systems, especially for rare conditions such as sickle cell disease (SCD). The objective of our study is to validate algorithms for accurate identification of patients with hemoglobin (Hb) SS/Sβ0 thalassemia and acute care encounters for pain among SCD patients within EHR warehouse. We used data for children receiving care at Children's Hospital of Wisconsin from 2013 to 2016 to test the accuracy of the 2 algorithms...
June 12, 2018: Blood Advances
https://www.readbyqxmd.com/read/29791762/ethical-dilemmas-in-nursing-an-integrative-review
#5
REVIEW
Jennifer Rainer, Joanne Kraenzle Schneider, Rebecca A Lorenz
AIMS: The purpose of this integrative review was to identify themes and gaps in the literature to stimulate researchers to develop strategies to guide decision-making among clinical nurses faced with ethical dilemmas. BACKGROUND: The concept of ethical dilemmas has been well explored in nursing because of the frequency of ethical dilemmas in practice and the toll these dilemmas can take on nurses. Although ethical dilemmas are prevalent in nursing practice, frequently leading to moral distress, there is little guidance in the literature to help nurses resolve them...
May 23, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29791310/ways-of-knowing-as-a-framework-for-developing-reflective-practice-among-nursing-students
#6
T Diane Campbell, Kelly Penz, Marie Dietrich-Leurer, Karen Juckes, Kathy Rodger
Abstract Background:Nursing students face the challenge of developing a comprehensive understanding of the complex role of the registered nurse across various clinical settings. Frameworks such as the "ways of knowing", help students conceptualize and critically reflect upon important processes in their professional learning. However, the academic language used to describe frameworks can be challenging. PURPOSE: This manuscript has two purposes. First, to briefly describe the historical climate influencing the development of nursing as a discipline...
May 23, 2018: International Journal of Nursing Education Scholarship
https://www.readbyqxmd.com/read/29790981/economic-impact-of-aging-on-the-initial-spine-care-of-patients-with-acute-spine-trauma-from-bedside-to-teller
#7
Julio C Furlan, Michael G Fehlings, B Catharine Craven
BACKGROUND: Aging of the population has prompted an escalation of service utilization and costs in many jurisdictions including North America. However, relatively little is known on the economic impact of old age on the management of acute spine trauma (AST). OBJECTIVE: To examine the potential effects of age on the service utilization and costs of the management of patients with acute spine trauma. METHODS: This retrospective cohort study included consecutive patients with AST admitted to an acute spine care unit of a Canadian quaternary university hospital between February, 2002 and September, 2007...
May 22, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29790446/ninety-to-nothing-a-pdsa-quality-improvement-project
#8
Gayle Linda Prybutok
Purpose The purpose of this paper is to present a case study of a successful quality improvement project in an acute care hospital focused on reducing the time of the total patient visit in the emergency department. Design/methodology/approach A multidisciplinary quality improvement team, using the PDSA (Plan, Do, Study, Act) Cycle, analyzed the emergency department care delivery process and sequentially made process improvements that contributed to project success. Findings The average turnaround time goal of 90 minutes or less per visit was achieved in four months, and the organization enjoyed significant collateral benefits both internal to the organization and for its customers...
May 14, 2018: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/29789926/patterns-of-platinum-drug-use-in-an-acute-care-setting-a-retrospective-study
#9
Evangeline Armstrong-Gordon, Danijela Gnjidic, Andrew J McLachlan, Bayan Hosseini, Andrew Grant, Philip J Beale, Nial J Wheate
PURPOSE: Platinum drugs have been in use in cancer treatment for more than 40 years, but little is known about the pattern of their use. The aim of this study was to examine the patterns of platinum drug use, with a secondary aim to describe the occurrence of dose reductions. METHODS: A retrospective analysis was conducted of oncology pharmacy dispensing records from a single hospital in Australia. Data related to drug choice, regimen and dose reductions were included in this study if the patient had received their last round of chemotherapy between November 2014 and July 2015...
May 22, 2018: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/29789332/elevated-potassium-levels-in-patients-with-congestive-heart-failure-occurrence-risk-factors-and-clinical-outcomes-a-danish-population-based-cohort-study
#10
Reimar Wernich Thomsen, Sia Kromann Nicolaisen, Pål Hasvold, Ricardo Garcia-Sanchez, Lars Pedersen, Kasper Adelborg, Martin Egfjord, Kenneth Egstrup, Henrik Toft Sørensen
BACKGROUND: Data on the true burden of hyperkalemia in patients with heart failure (HF) in a real-world setting are limited. METHODS AND RESULTS: Incidence rates of hyperkalemia (first blood test with a potassium level >5.0 mmol/L) in primary or hospital care were assessed in a population-based cohort of patients with incident HF diagnoses in northern Denmark from 2000 to 2012. Risk factors and clinical outcomes were compared in patients with HF with versus without hyperkalemia...
May 22, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29788819/nurse-spiritual-care-prevalence-and-correlates
#11
Iris Mamier, Elizabeth Johnston Taylor, Betty Wehtje Winslow
Many nurses embrace spiritual care as integral to holistic care. Evidence documenting the frequency of spiritual care provided in acute care settings, however, is sparse and weak. For this cross-sectional, correlational study, data were collected from N = 554 tertiary care nurses using the Nurse Spiritual Care Therapeutics Scale (NSCTS) measuring their self-reported spiritual care with patients/family members over the last 72 to 80 hours at work. While the most frequently endorsed practices centered on presence, listening, and spiritual assessment, the overall NSCTS score remained modest ( M = 37; SD = 12; possible range = 17-85)...
May 1, 2018: Western Journal of Nursing Research
https://www.readbyqxmd.com/read/29787535/can-acute-care-surgeons-perform-while-fatigued-an-east-multicenter-study
#12
Kevin M Schuster, Joshua P Hazelton, Deviney Rattigan, Linh Nguyen, Dennis Kim, Lara H Spence, David Turay, Xian Luo-Owen, Javier Martin Perez, Saraswati Dayal, Melissa Blatt, Casey Hill, Bishwajit Bhattacharya
BACKGROUND: Fatigued surgeon performance has only been assessed in simulated sessions or retrospectively after a night on call. We hypothesized that objectively assessed fatigue of acute care surgeons affects patient outcome. METHODS: Five acute care surgery services prospectively identified emergency cases over 27 months. Emergency cases were defined by the surgeon identifying the patient as requiring immediate operation upon consultation or admission. Within 48 hours surgeons reported, sleep time accumulated prior to operation, if non-clinical delays to operation occurred and patient volume during the shift...
May 21, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29787404/hospital-value-based-purchasing-and-trauma-certified-hospitals-performance
#13
Aaron Spaulding, Hanadi Hamadi, Luis Martinez, Timothy Martin, Justin M Purnell, Mei Zhao
INTRODUCTION: Hospital Value-Based Purchasing (HVBP) is an initiative that rewards acute-care hospitals with incentive payments for the quality of care they provide. A hospital's trauma certification has the potential to influence HVBP scores as attaining the certification provides indication of the service quality offered by the hospital. As such, this study focuses on hospitals' level of trauma certification attainment through the American College of Surgeons and whether this certification is associated with greater HVBP...
May 18, 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29787343/predicting-financial-distress-in-acute-care-hospitals
#14
James R Langabeer, Karima H Lalani, Tiffany Champagne-Langabeer, Jeffrey R Helton
Hospitals continue to face financial pressures from healthcare reform and heightened competition. In this study, our objective was to quantify the financial distress in acute care hospitals in Texas, applying multivariate logistic regression in a four-year longitudinal analysis. Of the 310 acute care hospitals, 50 (16.1%) were in financial distress in the most recent year, up considerably year over year. Distressed hospitals had fewer beds, lower patient acuity, and less outpatient revenues than those in good financial condition...
May 22, 2018: Hospital Topics
https://www.readbyqxmd.com/read/29784607/telestroke-adoption-among-community-hospitals-in-north-carolina-a-cross-sectional-study
#15
Christopher M Shea, Amir Alishahi Tabriz, Kea Turner, Steve North, Kristin L Reiter
OBJECTIVE: This study identifies community and hospital characteristics associated with adoption of telestroke among acute care hospitals in North Carolina (NC). METHODS: Our sample included 107 hospitals located in NC. Our analytic dataset included variables from the American Hospital Association (AHA) annual survey, AHA Health IT supplement, Healthcare Cost Report Information System, and Centers for Disease Control and Prevention's WONDER online database. We supplemented our secondary sources with data on telestroke adoption and market-level variables developed for NC...
May 18, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29784262/using-pictures-to-assess-pain-location-in-children
#16
Phyllis J Mesko, Aris Beoglos Eliades
PURPOSE: This study uses the Pain Area Locator (PAL) tool, a picture communication aid with body and medical equipment icons, to identify pain location in postoperative pediatric patients and assesses discrepancies between nurses' pain location assessment and pain location identified using the PAL tool. DESIGN: This descriptive study used a quantitative, comparative design, with a convenience sample of pediatric postoperative patients undergoing same-day surgeries at a free-standing, acute care, Magnet designated pediatric hospital...
June 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29783090/inter-and-intra-disciplinary-collaboration-and-patient-safety-outcomes-in-u-s-acute-care-hospital-units-a-cross-sectional-study
#17
Chenjuan Ma, Shin Hye Park, Jingjing Shang
BACKGROUND: Collaboration among healthcare providers has been considered a promising strategy for improving care quality and patient outcomes. Despite mounting evidence demonstrating the impact of collaboration on outcomes of healthcare providers, there is little empirical evidence on the relationship between collaboration and patient safety outcomes, particularly at the patient care unit level. OBJECTIVES: The purpose of this study is to identify the extent to which interdisciplinary collaboration between nurses and physicians and intradisciplinary collaboration among nurses on patient care units are associated with patient safety outcomes...
May 2, 2018: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29782417/prevalence-and-analysis-of-medical-device-related-pressure-injuries-results-from-the-international-pressure-ulcer-prevalence-survey
#18
Susan A Kayser, Catherine A VanGilder, Elizabeth A Ayello, Charlie Lachenbruch
OBJECTIVE: To examine the prevalence and characteristics of medical device-related pressure injuries (MDR PIs) in a large, generalizable database. METHODS: This study is a retrospective analysis of the 2016 International Pressure Ulcer Prevalence data. Data were limited to US and Canadian facilities. Facilities included acute care, long-term care, rehabilitation, long-term acute care hospitals, and hospice. Analysis included 102,865 adult patients; 99,876 had complete data and were the focus of the analysis and are reported in the results below...
June 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29781978/mixed-methods-evaluation-of-real-time-safety-reporting-by-hospitalized-patients-and-their-care-partners-the-mysafecare-application
#19
Sarah A Collins, Brittany Couture, Ann DeBord Smith, Esteban Gershanik, Elizabeth Lilley, Frank Chang, Cathy Yoon, Stuart Lipsitz, Aziz Sheikh, James Benneyan, David W Bates
OBJECTIVE: The aims of the study were to evaluate the amount and content of data patients and care partners reported using a real-time electronic safety tool compared with other reporting mechanisms and to understand their perspectives on safety concerns and reporting in the hospital. METHODS: This study used mixed methods including 20-month preimplementation and postimplementation trial evaluating MySafeCare, a web-based application, which allows hospitalized patients/care partners to report safety concerns in real time...
April 27, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/29781780/physical-therapists-know-function-an-opinion-on-mobility-and-level-of-activity-during-hospitalization-for-adult-inpatients
#20
Audrey M Johnson, Janice Kuperstein, Dana Howell, Esther E Dupont-Versteegden
Negative consequences of immobility during hospitalization are widely known and remain undisputed. Evidence of low mobility for general medicine adult inpatients persists. Patients who experience hospital acquired functional decline due to low mobility require costly post-acute care services. The impact of immobility on post-acute care physical function and quality of life is directly at odds with value-based care. New Medicare payment models emphasize value-based care to promote care improvement and better patient outcomes...
May 21, 2018: Hospital Topics
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