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https://www.readbyqxmd.com/read/29018058/impact-of-an-inpatient-electronic-prescribing-system-on-prescribing-error-causation-a-qualitative-evaluation-in-an-english-hospital
#1
Seetal Jheeta Puaar, Bryony Dean Franklin
BACKGROUND: Few studies have applied a systems approach to understanding the causes of specific prescribing errors in the context of hospital electronic prescribing (EP). A comprehensive understanding of underlying causes is essential for developing effective interventions to improve prescribing safety. Our objectives were to explore prescribers' perspectives of the causes of errors occurring with EP and to make recommendations to maximise benefits and minimise risks. METHODS: We studied a large hospital using inpatient EP...
October 10, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28944966/inpatient-management-of-children-with-recessive-dystrophic-epidermolysis-bullosa-a-review
#2
REVIEW
Alvin W Li, Brea Prindaville, Scot T Bateman, Timothy E Gibson, Karen Wiss
Recessive dystrophic epidermolysis bullosa is a disorder marked by skin and mucosal blistering after minimal trauma. Even the most routine procedures in the hospital, if done incorrectly, can precipitate extensive skin loss, pain, and scarring. Most providers have little experience working with patients with this degree of skin fragility. When a person with recessive dystrophic epidermolysis bullosa is admitted to the hospital, there are multiple considerations to keep in mind while strategizing an effective care plan: avoidance of new blisters with a "hands-off" approach; careful consideration of all indwelling devices; symptomatic management of pain, itch, and anxiety; coordination of dressing changes; aggressive treatment of skin infections; environmental and staffing considerations; and awareness of other chronic complications that affect care, such as anemia, malnutrition, and chronic pain...
September 25, 2017: Pediatric Dermatology
https://www.readbyqxmd.com/read/28898984/analysis-of-daily-laboratory-orders-at-a-large-urban-academic-center-a-multifaceted-approach-to-changing-test-ordering-patterns
#3
Joseph W Rudolf, Anand S Dighe, Christopher M Coley, Irina K Kamis, Bradley M Wertheim, Douglas E Wright, Kent B Lewandrowski, Jason M Baron
Objectives: We sought to address concerns regarding recurring inpatient laboratory test order practices (daily laboratory tests) through a multifaceted approach to changing ordering patterns. Methods: We engaged in an interdepartmental collaboration to foster mindful test ordering through clinical policy creation, electronic clinical decision support, and continuous auditing and feedback. Results: Annualized daily order volumes decreased from approximately 25,000 to 10,000 during a 33-month postintervention review...
August 1, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28857975/finding-like-minded-partners-to-span-the-continuum-of-care
#4
Bruce Lawrence
This is an era of profound industry transformation, characterized by such forces as acceleration away from inpatient-centered care and toward alternative payment models, rising rates of chronic disease, and an aging population. Add to this mix physician and nurse shortages and a newfound understanding that today's patients are informed consumers, and the reality becomes clear: Healthcare providers must be adaptable, agile, and innovative to survive. Sometimes, the best way forward in transformative times is collaboration with other like-minded organizations...
October 2017: Frontiers of Health Services Management
https://www.readbyqxmd.com/read/28827214/mobile-mindfulness-intervention-on-an-acute-psychiatric-unit-feasibility-and-acceptability-study
#5
Lisa A Mistler, Dror Ben-Zeev, Elizabeth Carpenter-Song, Mary F Brunette, Matthew J Friedman
BACKGROUND: Aggression and violence on acute psychiatric inpatient units is extensive and leads to negative sequelae for staff and patients. With increasingly acute inpatient milieus due to shorter lengths of stay, inpatient staff is limited in training and time to be able to provide treatments. Mobile technology provides a new platform for offering treatment on such units, but it has not been tested for feasibility or usability in this particular setting. OBJECTIVE: The aim of this study was to examine the feasibility, usability, and acceptability of a brief mindfulness meditation mobile phone app intended to reduce anger and aggression in acute psychiatric inpatients with schizophrenia, schizoaffective disorder, or bipolar disorder, and a history of violence...
August 21, 2017: JMIR Mental Health
https://www.readbyqxmd.com/read/28803040/attachment-and-thought-problems-in-an-adolescent-inpatient-sample-the-mediational-role-of-theory-of-mind
#6
Jessica R Hart, Amanda Venta, Carla Sharp
BACKGROUND: Previous research has documented increased incidence of insecure attachment and theory of mind (ToM) deficits in individuals experiencing psychotic disorders. ToM has been theorized as a possible mediator of the relation between attachment and psychosis (Korver-Nieberg et al., 2014). The current study sought to extend this area of research to adolescents for the first time by examining adolescent-parent attachment and ToM in inpatient adolescents. METHODS: Participants were 362 inpatient adolescents and their parents; participants completed the Child Attachment Interview, Movie for the Assessment of Social Cognition, Youth Self Report, and Child Behavior Checklist...
July 13, 2017: Comprehensive Psychiatry
https://www.readbyqxmd.com/read/28799470/referral-to-an-acute-child-and-adolescent-inpatient-unit-the-experiences-and-views-of-community-mental-health-referrers
#7
Josephine Stanton, Viktor Lahdenperä, Virginia Braun
Admission to an acute mental health inpatient unit is a significant event for a young person. The interface between inpatient and community teams negotiating the admission and later discharge can be fraught. To understand how to improve the transition between inpatient and community care, we interviewed 48 community clinicians about their experiences of engaging with an acute child and adolescent mental health inpatient unit. Through thematic analysis, we identified management of risk was a central issue. Participants wanted more time in hospital, and more communication and collaboration...
September 2017: Qualitative Health Research
https://www.readbyqxmd.com/read/28745943/integrating-caring-into-patient-centered-care-through-interprofessional-education-and-ethics-the-caring-project
#8
Jane S Mahoney, Cynthia Mulder, Susan Hardesty, Alok Madan
In an era of health care that is driven by biological and technical advances, there is a need to safeguard the caring component of care, the humanistic part of care. With this in mind, the authors constructed a Patient-Centered Caring model consisting of three overlapping constructs: delivering customer service, understanding the illness experience, and providing trauma-informed care. These practices operate within an interprofessional competency context. The authors describe an interprofessional educational project focused on understanding the illness experience and providing trauma-informed care to faculty, staff, and administrators in an inpatient psychiatric setting...
2017: Bulletin of the Menninger Clinic
https://www.readbyqxmd.com/read/28734167/mindfulness-practice-moderates-the-relationship-between-craving-and-substance-use-in-a-clinical-sample
#9
Matthew C Enkema, Sarah Bowen
Relapse following treatment for substance use disorders is highly prevalent, and craving has been shown to be a primary predictor of relapse. Mindfulness-Based Relapse Prevention (MBRP) is a psychosocial aftercare program integrating mindfulness and cognitive-behavioral approaches, aimed at reducing the risk and severity of relapse. Results from a recent randomized clinical trial demonstrate enhanced remission resilience for MBRP participants versus both cognitive-behavioral and treatment-as-usual controls...
October 1, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28727175/the-cost-of-treating-diabetic-ketoacidosis-in-the-uk-a-national-survey-of-hospital-resource-use
#10
K K Dhatariya, C Skedgel, R Fordham
AIM: Diabetic ketoacidosis is a commonly encountered metabolic emergency. In 2014, a national survey was conducted looking at the management of diabetic ketoacidosis in adult patients across the UK. The survey reported the clinical management of individual patients as well as institutional factors that teams felt were important in helping to deliver that care. However, the costs of treating diabetic ketoacidosis were not reported. METHODS: We used a 'bottom up' approach to cost analysis to determine the total expense associated with treating diabetic ketoacidosis in a mixed population sample...
July 20, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28702870/randomized-controlled-trial-of-brief-mindfulness-training-and-hypnotic-suggestion-for-acute-pain-relief-in-the-hospital-setting
#11
Eric L Garland, Anne K Baker, Paula Larsen, Michael R Riquino, Sarah E Priddy, Elizabeth Thomas, Adam W Hanley, Patricia Galbraith, Nathan Wanner, Yoshio Nakamura
BACKGROUND: Medical management of acute pain among hospital inpatients may be enhanced by mind-body interventions. OBJECTIVE: We hypothesized that a single, scripted session of mindfulness training focused on acceptance of pain or hypnotic suggestion focused on changing pain sensations through imagery would significantly reduce acute pain intensity and unpleasantness compared to a psychoeducation pain coping control. We also hypothesized that mindfulness and suggestion would produce significant improvements in secondary outcomes including relaxation, pleasant body sensations, anxiety, and desire for opioids, compared to the control condition...
July 12, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28601000/themes-and-trends-in-intentional-self-poisoning-perspectives-from-critical-care-toxicology
#12
J J Rasimas, Erica E Smolcic, Courtney M Sinclair
This research investigated the substances employed by and experiences of patients who come to acute treatment after self-poisoning. A retrospective search of the Toxicology Investigators Consortium Registry was performed to characterize a large cohort of patients. A detailed prospective study of one inpatient toxicology service was also conducted. Patients chose readily available agents for self-poisoning. Most cases involved at least one substance that affects the central nervous system (CNS). The majority were prescription psychotropics and narcotics...
September 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28600645/acceptance-and-commitment-therapy-for-perinatal-mood-and-anxiety-disorders-development-of-an-inpatient-group-intervention
#13
REVIEW
Alexa Bonacquisti, Matthew J Cohen, Crystal Edler Schiller
Perinatal mood and anxiety disorders are a leading cause of morbidity and mortality for childbearing women. Current treatments, such as cognitive behavioral therapy and interpersonal therapy, have demonstrated modest success in addressing perinatal psychiatric symptoms; however, additional treatment options are needed to address the limitations of current approaches, particularly for women experiencing moderate to severe perinatal mental illness during pregnancy or postpartum. We discuss the use of acceptance and commitment therapy (ACT) as a promising treatment approach that may be uniquely suited for perinatal women due to its emphasis of values, mindfulness, and acceptance; these psychological constructs notably address the significant psychiatric and behavioral health condition comorbidity, somatic symptoms, and stigma associated with perinatal mood and anxiety disorders...
June 10, 2017: Archives of Women's Mental Health
https://www.readbyqxmd.com/read/28577695/mind-the-gap-hospitalizations-from-multiple-sources-in-a-longitudinal-study
#14
Samuel T Savitz, Sally C Stearns, Jennifer S Groves, Anna M Kucharska-Newton, Lindsay G S Bengtson, Lisa Wruck
BACKGROUND: Medicare claims and prospective studies with self-reported utilization are important sources of hospitalization data for epidemiologic and outcomes research. OBJECTIVES: To assess the concordance of Medicare claims merged with interview-based surveillance data to determine factors associated with source completeness. METHODS: The Atherosclerosis Risk in Communities (ARIC) study recruited 15,792 cohort participants aged 45 to 64 years in the period 1987 to 1989 from four communities...
June 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28540605/characteristics-of-rheumatoid-arthritis-patients-undergoing-reverse-shoulder-arthroplasty
#15
Julio J Jauregui, J Paul Hovis, S Ashfaq Hasan
The risks and complication profile of reverse total shoulder arthroplasty (RSA) in rheumatoid arthritis (RA) patients has yet to be clearly defined as most studies have small cohorts. Using a large inpatient database, the purpose on our study was to determine the overall demographics, hospitalization characteristics, and early complication rates in rheumatoid patients and compared these to rotator-cuff arthropathy patients without RA undergoing RSA. Utilizing United States Nationwide Inpatient Sample from 2010 to 2013, we evaluated a total of 919 RA RSA and compared them to 8097 patients without RA undergoing RSA...
May 24, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28513351/mind-the-fathers-associations-of-parental-childhood-adversities-with-borderline-personality-disorder-pathology-in-female-adolescents
#16
Corinna Reichl, Romuald Brunner, Anna Fuchs, Birger Holz, Peter Parzer, Gloria Fischer-Waldschmidt, Franz Resch, Michael Kaess
Previous research revealed significant relations between the experience of childhood adversity (CA) and the development of borderline personality disorder (BPD) in adulthood. However, it is still uncertain whether parental CA could have a transgenerational association with adolescent BPD. We investigated associations between parents' CA (antipathy, neglect, physical abuse) and BPD traits within a clinical adolescent sample and tested for mediating variables. The sample consists of 91 female inpatients, along with 84 mothers and 59 fathers...
May 17, 2017: Journal of Personality Disorders
https://www.readbyqxmd.com/read/28493518/on-the-relationships-between-dsm-5-dysfunctional-personality-traits-and-social-cognition-deficits-a-study-in-a-sample-of-consecutively-admitted-italian-psychotherapy-patients
#17
Andrea Fossati, Antonella Somma, Robert F Krueger, Kristian E Markon, Serena Borroni
This study aims at testing the hypothesis that the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) alternative model of personality disorder (AMPD) traits may be significantly associated with deficits on 2 different social cognition tasks, namely, the Reading the Mind in the Eyes Test and the Movie for the Assessment of Social Cognition, in a sample of consecutively admitted inpatients and outpatients. The sample was composed of 181 consecutively admitted participants (57.5% women; mean age = 38...
May 11, 2017: Clinical Psychology & Psychotherapy
https://www.readbyqxmd.com/read/28475123/acceptance-and-commitment-therapy-for-inpatients-with-psychosis-the-reach-study-protocol-for-treatment-development-and-pilot-testing
#18
Brandon A Gaudiano, Carter H Davis, Gary Epstein-Lubow, Jennifer E Johnson, Kim T Mueser, Ivan W Miller
Patients with schizophrenia-spectrum disorders frequently require treatment at inpatient hospitals during periods of acute illness for crisis management and stabilization. Acceptance and Commitment Therapy (ACT), a "third wave" cognitive-behavioral intervention that employs innovative mindfulness-based strategies, has shown initial efficacy in randomized controlled trials for improving acute and post-discharge outcomes in patients with psychosis when studied in acute-care psychiatric hospitals in the U.S. However, the intervention has not been widely adopted in its current form because of its use of an individual-only format and delivery by doctoral-level research therapists with extensive prior experience using ACT...
May 5, 2017: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/28471275/trait-mindfulness-and-progression-to-injection-use-in-youth-with-opioid-addiction
#19
J Deanna Wilson, Hoa Vo, Pamela Matson, Hoover Adger, Gabriela Barnett, Marc Fishman
BACKGROUND: Many youth initiate opioid misuse with prescription opioids and transition over time to more severe substance-using behaviors, including injection. Trait mindfulness is a potentially protective factor. OBJECTIVES: This is a cross-sectional study characterizing a sample of opioid-using youth by level of mindfulness and examines the potential effect modification of emotion regulation on the relationship between mindfulness and progression to injection opioid use...
May 4, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/28465360/male-sex-associated-with-increased-risk-of-neonatal-abstinence-syndrome
#20
M Katherine Charles, William O Cooper, Lauren M Jansson, Judith Dudley, James C Slaughter, Stephen W Patrick
BACKGROUND: Neonatal abstinence syndrome (NAS) is a postnatal opioid withdrawal syndrome. Factors associated with development of the syndrome are poorly understood; however, infant sex may influence the risk of NAS. Our objective was to determine if infant sex was associated with the development or severity of the syndrome in a large population-based cohort. METHODS: This retrospective cohort study used vital statistics and prescription, outpatient, and inpatient administrative data for mothers and infants enrolled in the Tennessee Medicaid program between 2009 and 2011...
June 2017: Hospital Pediatrics
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