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https://www.readbyqxmd.com/read/28437209/conversations-about-goals-and-values-are-feasible-and-acceptable-in-long-term-acute-care-hospitals-a-pilot-study
#1
Daniela J Lamas, Robert L Owens, R Nicholas Nace, Anthony F Massaro, Nathan J Pertsch, Susan T Moore, Rachelle E Bernacki, Susan D Block
RATIONALE: The chronically critically ill have survived acute critical illness but require prolonged mechanical ventilation. These patients are frequently transferred from acute care to long-term acute care hospitals (LTACHs) for prolonged recovery, yet many suffer setbacks requiring readmission to acute care. The patient's relatively improved condition while at the LTACH might be an opportunity for communication regarding care goals; however, there have been no prior studies of the feasibility of such conversations in the LTACH...
February 24, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28437203/using-the-surprise-question-to-identify-those-with-unmet-palliative-care-needs-in-emergency-and-inpatient-settings-what-do-clinicians-think
#2
Samir A Haydar, Lisa Almeder, Lauren Michalakes, Paul K J Han, Tania D Strout
BACKGROUND: The surprise question (SQ), "Would you be surprised if this patient died within the next year?" is effective in identifying end-stage renal disease and cancer patients at high risk of death and therefore potentially unmet palliative care needs. Following implementation of the SQ in our acute care setting, we sought to explore hospital-based providers' perceptions of the tool. OBJECTIVES: To evaluate (1) providers' perceptions regarding the feasibility of SQ use in emergency and inpatient settings, (2) clinician perceptions regarding the utility of the SQ, and (3) barriers to SQ use...
February 16, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28437201/the-impact-of-community-based-palliative-care-on-utilization-and-cost-of-acute-care-hospital-services-in-the-last-year-of-life
#3
David Youens, Rachael Moorin
BACKGROUND: Community-based palliative care may potentially benefit patients by offering their preferred care at the end of life and benefit systems by reducing hospital use. OBJECTIVE: To compare place of death and acute care hospital use in the last year of life between cancer decedents who did and did not access a community-based palliative care service (PCS). DESIGN: Retrospective observational cohort study using linked individual administrative records from cancer registry, hospital, emergency department (ED), mortality, and PCS databases...
February 16, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28436613/paediatric-acute-care-highlights-from-the-paediatric-acute-care-advanced-paediatric-life-support-conference-adelaide-2016
#4
Stephen Ss Teo, Jacquie Schutz, Jane Stanford, Arjun Rao
The Paediatric Acute Care Conference (PACC) is an annual conference organised by Advanced Paediatric Life Support Australia to advance paediatric acute care topics for clinicians in pre-hospital medicine, EDs, acute paediatrics, intensive care and anaesthesia. The PACC 2016 was held at Glenelg, Adelaide, Australia. We provide a summary of some of the presentations.
April 24, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28434458/relationship-between-state-malpractice-environment-and-quality-of-health-care-in-the-united-states
#5
Karl Y Bilimoria, Jeanette W Chung, Christina A Minami, Min-Woong Sohn, Emily S Pavey, Jane L Holl, Michelle M Mello
BACKGROUND: One major intent of the medical malpractice system in the United States is to deter negligent care and to create incentives for delivering high-quality health care. A study was conducted to assess whether state-level measures of malpractice risk were associated with hospital quality and patient safety. METHODS: In an observational study of short-term, acute-care general hospitals in the United States that publicly reported in the Centers for Medicaid & Medicare Services Hospital Compare in 2011, hierarchical regression models were used to estimate associations between state-specific malpractice environment measures (rates of paid claims, average Medicare Malpractice Geographic Practice Cost Index [MGPCI], absence of tort reform laws, and a composite measure) and measures of hospital quality (processes of care, imaging utilization, 30-day mortality and readmission, Agency for Healthcare Research and Quality Patient Safety Indicators, and patient experience from the Hospital Consumer Assessment of Healthcare Providers and Systems [HCAHPS])...
May 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28434457/system-changes-to-implement-the-joint-commission-tobacco-treatment-tob-performance-measures-for-improving-the-treatment-of-tobacco-use-among-hospitalized-patients
#6
Donna Shelley, Keith S Goldfeld, Hannah Park, Ana Mola, Ryan Sullivan, Jonathan Austrian
BACKGROUND: In 2012 The Joint Commission implemented new Tobacco Treatment (TOB) performance measures for hospitals. A study evaluated the impact of a hospital-based electronic health record (EHR) intervention on adherence to the revised TOB measures. METHODS: The study was conducted in two acute care hospitals in New York City. Data abstracted from the EHR were analyzed retrospectively from 4,871 smokers discharged between December 2012 and March 2015 to evaluate the impact of two interventions: an order set to prompt clinicians to prescribe pharmacotherapy and a nurse-delivered counseling module that automatically populated the nursing care plan for all smokers...
May 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28434270/what-is-stable-pain-control-a-prospective-longitudinal-study-to-assess-the-clinical-value-of-a-personalized-pain-goal
#7
Robin Fainsinger, Cheryl Nekolaichuk, Lara Fainsinger, Viki Muller, Lisa Fainsinger, Pablo Amigo, Amanda Brisebois, Sarah Burton-Macleod, Sunita Ghosh, Rebekah Gilbert, Yoko Tarumi, Vincent Thai, Gary Wolch
BACKGROUND: A universal consensus regarding standardized pain outcomes does not exist. The personalized pain goal has been suggested as a clinically relevant outcome measure. AIM: To assess the feasibility of obtaining a personalized pain goal and to compare a clinically based personalized pain goal definition versus a research-based study definition for stable pain. DESIGN: Prospective longitudinal descriptive study. MEASURES: The attending physician completed routine assessments, including a personalized pain goal and the Edmonton Classification System for Cancer Pain, and followed patients daily until stable pain control, death, or discharge...
April 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28433398/multi-state-survey-of-healthcare-associated-infections-in-acute-care-hospitals-in-brazil
#8
C Magno Castelo Branco Fortaleza, M C Padoveze, C R Veiga Kiffer, A L Barth, Irna C do Rosário Souza Carneiro, H I Garcia Giamberardino, J L Nobre Rodrigues, L Santos Filho, M J Gonçalves de Mello, M Severino Pereira, P Pinto Gontijo Filho, M Rocha, E A Servolo de Medeiros, A C Campos Pignatari
BACKGROUND: Healthcare-associated infections (HCAIs) challenge public health in developing countries such as Brazil, which harbour social inequalities and variations in the complexity of healthcare and regional development. AIM: To describe the prevalence of HCAIs in hospitals in a sample of hospitals in Brazil. METHODS: A prevalence survey conducted in 2011-13 enrolled 152 hospitals from the five macro-regions in Brazil. Hospitals were classified as large (≥200 beds), medium (50-199 beds) or small sized (<50 beds)...
March 23, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28432853/an-evidence-based-approach-to-reducing-cardiac-telemetry-alarm-fatigue
#9
Ekta Srinivasa, Jaspreet Mankoo, Charles Kerr
BACKGROUND: It is estimated that between 80% and 99% of alarms in the clinical areas are in actionable alarms (Gross, Dahl, & Nielson). Alarm management is one of the Joint Commission's National Patient Safety Goals (2014) because sentinel events have directly been linked to the devices generating these alarms. PURPOSE: At an acute care facility in Boston, a multidisciplinary team consisting of Nursing, Biomedical Engineers, Patient Safety and Providers was formed to conduct a pilot study on the state of telemetry alarms on a surgical floor...
April 22, 2017: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/28431908/implementation-of-a-person-centered-medical-care-model-in-a-skilled-nursing-facility-a-pilot-evaluation
#10
Kathleen Abrahamson, Jaclyn Myers, Arif Nazir
OBJECTIVES: The objective of this study was to evaluate the feasibility and impact of implementing a person-centered medical care model for post-acute care residents within a skilled nursing facility (SNF). DESIGN: A mixed-method (qualitative and quantitative) pilot evaluation. SETTING: An 89-bed SNF located within a large midwestern city. PARTICIPANTS: Forty SNF post-acute patients admitted to the facility during a 6-month period were enrolled in the pilot evaluation...
April 18, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28431633/greater-healthcare-utilization-and-costs-among-black-persons-compared-to-white-persons-with-aphasia-in-the-north-carolina-stroke-belt
#11
Charles Ellis, Rose Y Hardy, Richard C Lindrooth
PURPOSE: To examine racial differences in healthcare utilization and costs for persons with aphasia (PWA) being treated in acute care hospitals in North Carolina (NC). METHODS: NC Healthcare Cost and Utilization Project State Inpatient Database (HCUP-SID) data from 2011-2012 were analyzed to examine healthcare utilization and costs of care for stroke patients with aphasia. Analyses emphasized length of stay, charges and cost of general hospital services. Generalized linear models (GLM) were constructed to determine the impact of demographic characteristics, stroke/illness severity, and observed hospital characteristics on utilization and costs...
May 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28427944/creating-a-global-acute-care-surgery-fellowship-to-meet-international-need
#12
Amina I Merchant, Camila B Walters, Julie Valenzuela, Kelly A McQueen, Addison K May
INTRODUCTION: Existing Acute Care Surgery (ACS) fellowships are positioned to develop well-trained surgeons with specific skills to facilitate improvements in care delivery in Global ACS. Many resident and fellowship programs offer clinical electives that expose trainees to operative experiences, exposing trainees to the needs in resource-challenged settings. However, most lack a focus on long-term development and research designed to enhance the country's local skills, capability, and capacity...
April 17, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28427882/effects-of-bystander-cpr-following-out-of-hospital-cardiac-arrest-on-hospital-costs-and-long-term-survival
#13
Guillaume Geri, Carol Fahrenbruch, Hendrika Meischke, Ian Painter, Lindsay White, Thomas D Rea, Marcia R Weaver
BACKGROUND: Bystander cardiopulmonary resuscitation (CPR) is associated with a greater likelihood of survival to hospital discharge after out-of-hospital cardiac arrest (OHCA). However the long-term survival benefits in relationship to cost have not been well-studied. We evaluated bystander CPR, hospital-based costs, and long-term survival following OHCA in order to assess the potential cost-effectiveness of bystander CPR. PATIENTS AND METHODS: We conducted a retrospective cohort study of consecutive EMS-treated OHCA patients >=12years who arrested prior to EMS arrival and outside a nursing facility between 2001 and 2010 in greater King County, WA...
April 18, 2017: Resuscitation
https://www.readbyqxmd.com/read/28426891/experiences-of-nurses-with-the-care-of-patients-with-dementia-in-acute-hospitals-a-secondary-analysis
#14
Christiane Pinkert, Eva Faul, Susi Saxer, Melanie Burgstaller, Doris Kamleitner, Hanna Mayer
AIM AND OBJECTIVES: The aim was to describe nurses' experiences in caring for people with dementia (PwD) in acute hospital settings. BACKGROUND: Recent research suggests that nurses' experience in caring for PwD in acute hospitals is characterized by frustration, overall job dissatisfaction and feelings of powerlessness and guilt. Despite a growing body of knowledge concerning the care of PwD in acute care settings, it remains unclear how nurses in acute hospitals provide care for PwD and what general conditions characterize the nursing care provided to these patients...
April 20, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28426522/patient-safety-culture-survey-in-pediatric-complex-care-settings-a-factor-analysis
#15
Amanda J Hessels, Meghan Murray, Bevin Cohen, Elaine L Larson
OBJECTIVES: Children with complex medical needs are increasing in number and demanding the services of pediatric long-term care facilities (pLTC), which require a focus on patient safety culture (PSC). However, no tool to measure PSC has been tested in this unique hybrid acute care-residential setting. The objective of this study was to evaluate the psychometric properties of the Nursing Home Survey on Patient Safety Culture tool slightly modified for use in the pLTC setting. METHODS: Factor analyses were performed on data collected from 239 staff at 3 pLTC in 2012...
April 19, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28425138/delivering-dignified-care-a-realist-synthesis-of-evidence-that-promotes-effective-listening-to-and-learning-from-older-people-s-feedback-in-acute-care-settings
#16
REVIEW
Megan Dickson, Helen Riddell, Fiona Gilmour, Brendan McCormack
AIMS AND OBJECTIVES: This review aims to explore effective mechanisms for listening to and learning from feedback from older people in the context of acute care. BACKGROUND: Maintaining the dignity of older people in acute care has become an issue of international concern. In the United Kingdom, recommendations for care improvement have led to the formation of an implementation group, the 'Listening and Learning Hospitals Pilot Project'. This literature review forms phase 1 of the project...
April 20, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28424194/common-care-practices-among-effective-community-based-specialist-palliative-care-teams-a-qualitative-study
#17
Hsien Seow, Daryl Bainbridge, Melissa Brouwers, Deanna Bryant, Sue Tan Toyofuku, Mary Lou Kelley
OBJECTIVE: Evidence has shown that, despite wide variation in models of care, community-based specialist palliative care teams can improve outcomes and reduce acute care use at end of life. The goal of this study was to explore similarities in care practices among effective and diverse specialist teams to inform the development of other community-based teams. METHODS: Interviews with 78 providers and administrators from 11 distinct community-based specialist palliative care teams from Ontario, Canada were conducted...
April 19, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28423225/exercise-interventions-for-patients-with-pediatric-cancer-during-inpatient-acute-care-a-systematic-review-of-literature
#18
REVIEW
Vanessa Rustler, Meaghan Hagerty, Julia Daeggelmann, Stacey Marjerrison, Wilhelm Bloch, Freerk T Baumann
Physical inactivity has been shown to exacerbate negative side effects experienced by pediatric patients undergoing cancer therapy. Exercise interventions are being created in response. This review summarizes current exercise intervention data in the inpatient pediatric oncology setting. Two independent reviewers collected literature from three databases, and analyzed data following the PRISMA statement for systematic reviews and meta-analyses. Ten studies were included, representing 204 patients. Good adherence, positive trends in health status, and no adverse events were noted...
April 19, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28422931/development-and-psychometric-evaluation-of-the-professional-practice-work-environment-inventory
#19
Jeanette Ives Erickson, Mary E Duffy, Marianne Ditomassi, Dorothy Jones
OBJECTIVE: The purpose is to examine the psychometric properties of the professional practice work environment inventory (PPWEI). BACKGROUND: Derived from the Professional Practice Environment (PPE) and the Revised PPE scales, the PPWEI was designed to measure 8 components of the PPE that can be used to assist nurse administrators in decision-making. METHODS: A psychometric evaluation was undertaken with 874 nurses who were providing direct care to patients at the Massachusetts General Hospital and who provided no missing data on the newly developed 72-item PPWEI...
May 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/28422899/variation-in-adult-traumatic-brain-injury-outcomes-in-the-united-states
#20
Nathaniel H Greene, Mary A Kernic, Monica S Vavilala, Frederick P Rivara
OBJECTIVE: To ascertain the degree of variation, by state of acute care hospitalization, in outcomes associated with traumatic brain injury (TBI) in an adult population. SETTING: All acute care hospitals in 21 states in the United States in the year 2010. PARTICIPANTS: Adult (> 18 years) patients (N = 95 546) admitted to a hospital with a moderate or severe TBI. DESIGN: Retrospective cohort study using data from State Inpatient Databases from Agency for Healthcare Research and Quality's Healthcare Cost and Utilization Project...
April 18, 2017: Journal of Head Trauma Rehabilitation
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