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https://www.readbyqxmd.com/read/29453329/management-characteristics-and-outcomes-of-patients-with-acute-coronary-syndrome-in-sri-lanka
#1
Priyadarshani Galappatthy, Vipula R Bataduwaarachchi, Priyanga Ranasinghe, Gamini K S Galappatthy, Maheshi Wijayabandara, Dinuka S Warapitiya, Mythily Sivapathasundaram, Thilini Wickramarathna, Upul Senarath, Sathasivam Sridharan, Chandrika N Wijeyaratne, Ruvan Ekanayaka
BACKGROUND: Ischaemic heart disease is the leading cause of in-hospital mortality in Sri Lanka. Acute Coronary Syndrome Sri Lanka Audit Project (ACSSLAP) is the first national clinical-audit project that evaluated patient characteristics, clinical outcomes and care provided by state-sector hospitals. METHODS: ACSSLAP prospectively evaluated acute care, in-hospital care and discharge plans provided by all state-sector hospitals managing patients with ACS. Data were collected from 30 consecutive patients from each hospital during 2-4 weeks window...
February 16, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29444787/randomised-controlled-pragmatic-clinical-trial-evaluating-the-effectiveness-of-a-discharge-follow-up-phone-call-on-30-day-hospital-readmissions-balancing-pragmatic-and-explanatory-design-considerations
#2
Maame Yaa A B Yiadom, Henry Domenico, Daniel Byrne, Michele Marie Hasselblad, Cheryl L Gatto, Sunil Kripalani, Neesha Choma, Sarah Tucker, Li Wang, Monisha C Bhatia, Johnston Morrison, Frank E Harrell, Tina Hartert, Gordon Bernard
INTRODUCTION: Hospital readmissions within 30 days are a healthcare quality problem associated with increased costs and poor health outcomes. Identifying interventions to improve patients' successful transition from inpatient to outpatient care is a continued challenge. METHODS AND ANALYSIS: This is a single-centre pragmatic randomised and controlled clinical trial examining the effectiveness of a discharge follow-up phone call to reduce 30-day inpatient readmissions...
February 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29439684/prediction-of-post-acute-care-demand-in-medical-and-neurological-inpatients-diagnostic-assessment-of-the-post-acute-discharge-score-a-prospective-cohort-study
#3
Antoinette Conca, Angela Gabele, Barbara Reutlinger, Philipp Schuetz, Alexander Kutz, Sebastian Haubitz, Lukas Faessler, Marcus Batschwaroff, Ursula Schild, Zeljka Caldara, Katharina Regez, Susanne Schirlo, Gabi Vossler, Timo Kahles, Krassen Nedeltchev, Anja Keller, Andreas Huber, Sabina De Geest, Ulrich Buergi, Petra Tobias, Martine Louis Simonet, Beat Mueller, Petra Schäfer-Keller
BACKGROUND: Early identification of patients requiring transfer to post-acute care (PAC) facilities shortens hospital stays. With a focus on interprofessional assessment of biopsychosocial risk, this study's aim was to assess medical and neurological patients' post-acute care discharge (PACD) scores on days 1 and 3 after hospital admission regarding diagnostic accuracy and effectiveness as an early screening tool. The transfer to PAC facilities served as the outcome ("gold standard")...
February 13, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29431385/glucose-management-in-hospitalized-patients
#4
Charles Kodner, Laurie Anderson, Katherine Pohlgeers
Glucose management in hospitalized patients poses challenges to physicians, including identifying blood glucose targets, judicious use of oral diabetes mellitus medications, and implementing appropriate insulin regimens. Uncontrolled blood glucose levels can lead to deleterious effects on wound healing, increased risk of infection, and delays in surgical procedures or discharge from the hospital. Previously recommended strict blood glucose targets for hospitalized patients result in more cases of hypoglycemia without improvement in patient outcomes...
November 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/29429847/the-impact-of-geriatric-focused-nurse-assessment-and-intervention-in-the-emergency-department-a-systematic-review
#5
REVIEW
M Malik, Z Moore, D Patton, T O'Connor, L E Nugent
BACKGROUND: Nursing assessment of elderly patients is imperative in Emergency Departments (ED) while providing interventions that increase independence facilitating discharge to primary healthcare. AIMS: To systematically review the impact of geriatric focused nurse assessment and intervention in the ED on hospital utilisation in terms of admission rate, ED revisits and length of hospital stay (LOHS). METHODS: Search strategy used following databases; Cochrane, Medline, CINAHL, Embase, Scopus and Web of Knowledge; And terms; geriatric nurse assessment, nurse discharge planning, geriatric nurse specialist, nurse intervention, emergency department, accident and emergency, patient outcomes, discharge, admissions, readmissions, hospital utilization, hospitalization, length of stay/hospital stay...
February 8, 2018: International Emergency Nursing
https://www.readbyqxmd.com/read/29425882/family-meetings-in-in-patient-specialist-palliative-care-a-mechanism-to-convey-empathy
#6
Liz Forbat, Karemah Francois, Lynne O'Callaghan, Julie Kulikowski
CONTEXT: Family meetings are increasingly used in palliative care, yet have little empirical evidence of their impact in in-patient settings. OBJECTIVES: To examine whether relatives report more empathy following a family meeting in a specialist palliative care in-patient ward. METHODS: Pre/post self-complete questionnaires measuring relational empathy and information needs were administered. Qualitative interviews were also conducted. Data were collected over nine months from one inpatient specialist palliative care unit...
February 6, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29423259/comprehensive-geriatric-assessment-pilot-of-a-randomized-control-study-in-a-swedish-acute-hospital-a-feasibility-study
#7
Theresa Westgård, Isabelle Ottenvall Hammar, Eva Holmgren, Anna Ehrenberg, Aase Wisten, Anne W Ekdahl, Synneve Dahlin-Ivanoff, Katarina Wilhelmson
Background: Comprehensive geriatric assessment (CGA) represent an important component of geriatric acute hospital care for frail older people, secured by a multidisciplinary team who addresses the multiple needs of physical health, functional ability, psychological state, cognition and social status. The primary objective of the pilot study was to determine feasibility for recruitment and retention rates. Secondary objectives were to establish proof of principle that CGA has the potential to increase patient safety...
2018: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29411329/geriatricians-and-the-older-emergency-general-surgical-patient-proactive-assessment-and-patient-centred-interventions-salford-pop-gs
#8
Arturo Vilches-Moraga, Jenny Fox
Increasing numbers of older patients require Emergency admission under General Surgery (EGS). This is a group of heterogeneous and often complex individuals with varying degrees of multimorbidity, polypharmacy, functional, mobility and cognitive impairment. Our article describes the benefits of comprehensive assessment coupled with patient-centred multiprofessional interventions and timely discharge planning. We discuss diverse service models and describe our experience in the planning, development and consolidation of a perioperative service for older EGS patients...
February 6, 2018: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/29405017/-the-promotion-of-resources-integration-in-long-term-care-service-the-experience-of-taipei-city-hospital
#9
Meng-Ping Wu, Chao-Ming Huang, Wen-Jung Sun, Chih-Yuan Shih, Su-Hsuan Hsu, Sheng-Jean Huang
The home-based medical care integrated plan under Taiwan National Health Insurance has changed from paying for home-based medical care, home-based nursing, home-based respiratory treatment, and palliative care to paying for a single, continuous home-based care service package. Formerly, physician-visit regulations limited home visits for home-based nursing to providing medical related assessments only. This limitation not only did not provide practical assistance to the public but also caused additional problems for those with mobility problems or who faced difficulties in making visits hospital...
February 2018: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/29404943/prediction-of-future-chronic-opioid-use-among-hospitalized-patients
#10
S L Calcaterra, S Scarbro, M L Hull, A D Forber, I A Binswanger, K L Colborn
BACKGROUND: Opioids are commonly prescribed in the hospital; yet, little is known about which patients will progress to chronic opioid therapy (COT) following discharge. We defined COT as receipt of ≥ 90-day supply of opioids with < 30-day gap in supply over a 180-day period or receipt of ≥ 10 opioid prescriptions over 1 year. Predictive tools to identify hospitalized patients at risk for future chronic opioid use could have clinical utility to improve pain management strategies and patient education during hospitalization and discharge...
February 5, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29398316/nurse-led-discharge-in-pediatric-care-a-scoping-review
#11
REVIEW
Sydney Breneol, Aaron Hatty, Andrea Bishop, Janet A Curran
PROBLEM: Patients and caregivers frequently report feeling ill-prepared during the transition from hospital to home. Given the privileged position nurses occupy within the health care setting, they are often an appropriate health care professional to lead the discharge process. We aimed to map what is currently known about nurse-led/facilitated discharge programs, interventions, models, or frameworks for the pediatric population. ELIGIBILITY CRITERIA: We conducted a scoping review following the Joanna Briggs Institute Methodology...
February 1, 2018: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/29392865/improving-nutritional-discharge-planning-and-follow-up-in-older-medical-inpatients-hospital-to-home-outreach-for-malnourished-elders
#12
Adrienne M Young, Alison M Mudge, Merrilyn D Banks, Lauren Rogers, Kristen Demedio, Elisabeth Isenring
AIM: Nutritional decline during and after acute hospitalisation is common amongst older people. This quality improvement initiative aimed to introduce a dietitian-led discharge planning and follow-up program (Hospital to Home Outreach for Malnourished Elders, HHOME) at two hospitals within usual resources to improve nutritional and functional recovery. METHODS: Prospective pre-post evaluation design was used. Medical patients aged 65+ years at-risk of malnutrition and discharged to independent living were eligible...
February 2, 2018: Nutrition & Dietetics: the Journal of the Dietitians Association of Australia
https://www.readbyqxmd.com/read/29389458/an-initiative-to-change-inpatient-practice-leveraging-the-patient-medical-home-for-postdischarge-follow-up
#13
Paul Marcus, Kelly Hautala, Nazima Allaudeen
BACKGROUND: The standard of care for hospital discharge planning includes arranging follow-up appointments, usually with a primary care provider. However, follow-up phone calls instead of face-to-face visits may be an appropriate alternative for some patients. This option was explored within the framework of the US Department of Veterans Affairs (VA) patient-centered medical home model of care, the Patient Aligned Care Team. METHODS: At a VA hospital, a pilot study was conducted on the use of phone calls from members of a patient's medical home as posthospital discharge follow-up rather than the traditional face-to-face provider model...
February 2018: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/29381672/simulated-interprofessional-education-discharge-planning-meeting-to-improve-skills-necessary-for-effective-interprofessional-practice
#14
Leslie M Smith, Megan Keiser, Carman Turkelson, Amy M Yorke, Benjamin Sachs, Karen Berg
PURPOSE OF STUDY: The purpose of this study was to evaluate the use of a simulation-enhanced interprofessional education (Sim-IPE) discharge planning learning experience using simulated patients (SPs), to explore the ability for students to communicate with each other and to a patient/caregiver, and to use clinical thinking to make a safe and appropriate interprofessional discharge recommendation. PRIMARY PRACTICE SETTING(S): Educational institution; university simulation center...
March 2018: Professional Case Management
https://www.readbyqxmd.com/read/29381669/hospital-discharge-and-selecting-a-skilled-nursing-facility-a-comparison-of-experiences-and-perspectives-of-patients-and-their-families
#15
Dara H Sorkin, Alpesh Amin, David L Weimer, Joseph Sharit, Heather Ladd, Dana B Mukamel
PURPOSE OF STUDY: A currently proposed rule by the Centers for Medicare & Medicaid Services would require providers to devote more resources to discharge planning from hospitals to ensure the prioritization of patient preferences and goals in the discharge planning process. Annually, more than 3 million persons enter a nursing home in the United States, with the vast majority of patients coming directly from hospitals. Although early evidence suggests more family involvement than patient involvement in the discharge process, most of this work has relied on retrospective reports of the decision-making process postplacement...
March 2018: Professional Case Management
https://www.readbyqxmd.com/read/29373987/hospital-recruitment-for-a-pragmatic-cluster-randomized-clinical-trial-lessons-learned-from-the-compass-study
#16
Anna M Johnson, Sara B Jones, Pamela W Duncan, Cheryl D Bushnell, Sylvia W Coleman, Laurie H Mettam, Anna M Kucharska-Newton, Mysha E Sissine, Wayne D Rosamond
BACKGROUND: Pragmatic randomized clinical trials are essential to determine the effectiveness of interventions in "real-world" clinical practice. These trials frequently use a cluster-randomized methodology, with randomization at the site level. Despite policymakers' increased interest in supporting pragmatic randomized clinical trials, no studies to date have reported on the unique recruitment challenges faced by cluster-randomized pragmatic trials. We investigated key challenges and successful strategies for hospital recruitment in the Comprehensive Post-Acute Stroke Services (COMPASS) study...
January 26, 2018: Trials
https://www.readbyqxmd.com/read/29359578/the-development-and-implementation-of-a-discharge-checklist-for-psychiatric-inpatients-a-pilot-study
#17
Yasmin Khanbhai, Michael Nance, David Smith
OBJECTIVES: Readmission rates are a routinely used measure of patient and service outcomes, potentially improved by discharge planning. This pilot study aimed to develop a discharge checklist for psychiatric inpatients, exploring its feasibility, applicability, and impact on readmission rates. METHODS: The study used a quasi-experimental, pre-post intervention design. The checklist was designed from an evidence-based literature review, and introduced for a three-month period, comparing 28-day readmission rates with the previous three months using interrupted time series analysis...
January 1, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/29350222/a-prescription-for-note-bloat-an-effective-progress-note-template
#18
Daniel Khan, Elizabeth Stewart, Mark Duncan, Edward Lee, Wendy Simon, Clement Lee, Jodi Friedman, Hilary Mosher, Katherine Harris, John Bell, Bradley Sharpe, Neveen El-Farra
BACKGROUND: United States hospitals have widely adopted electronic health records (EHRs). Despite the potential for EHRs to increase efficiency, there is concern that documentation quality has suffered. OBJECTIVE: To examine the impact of an educational session bundled with a progress note template on note quality, length, and timeliness. DESIGN: A multicenter, nonrandomized prospective trial. SETTING: Four academic hospitals across the United States...
January 19, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29347987/determinants-of-long-term-outcome-in-icu-survivors-results-from-the-frog-icu-study
#19
Etienne Gayat, Alain Cariou, Nicolas Deye, Antoine Vieillard-Baron, Samir Jaber, Charles Damoisel, Qin Lu, Xavier Monnet, Isabelle Rennuit, Elie Azoulay, Marc Léone, Heikel Oueslati, Bertrand Guidet, Diane Friedman, Antoine Tesnière, Romain Sonneville, Philippe Montravers, Sébastien Pili-Floury, Jean-Yves Lefrant, Jacques Duranteau, Pierre-François Laterre, Nicolas Brechot, Karine Chevreul, Morgane Michel, Bernard Cholley, Matthieu Legrand, Jean-Marie Launay, Eric Vicaut, Mervyn Singer, Matthieu Resche-Rigon, Alexandre Mebazaa
BACKGROUND: Intensive care unit (ICU) survivors have reduced long-term survival compared to the general population. Identifying parameters at ICU discharge that are associated with poor long-term outcomes may prove useful in targeting an at-risk population. The main objective of the study was to identify clinical and biological determinants of death in the year following ICU discharge. METHODS: FROG-ICU was a prospective, observational, multicenter cohort study of ICU survivors followed 1 year after discharge, including 21 medical, surgical or mixed ICUs in France and Belgium...
January 18, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29344539/agreement-between-heart-failure-patients-and-their-primary-caregivers-on-symptom-assessment
#20
Hassan Sharifi, Mohammad Ali Rezaei, Nastaran Heydari Khayat, Neda Mohammadinia
Background: To decrease the readmission rate of heart failure (HF) patients, patients and their caregivers (CGs) should participate in symptoms assessment. This study aimed to assess the agreement between HF patients and their CGs on symptoms assessment. Methods: Using a correlational design, 100 HF patients with their CGs (100 dyads) were recruited from Department of Cardiology, Iranshahr, during August-December 2014. Data were collected using modified Heart Failure Symptom Survey (HFSS)...
January 2018: International Journal of Community Based Nursing and Midwifery
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