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https://www.readbyqxmd.com/read/27920244/are-the-registry-data-reliable-an-audit-of-a-regional-trauma-registry-in-the-netherlands
#1
E E Horton, P Krijnen, H M Molenaar, I B Schipper
OBJECTIVE: Data in trauma registries need to be reliable when used for evaluation of injury management, trauma protocols and hospital statistics. The aim of this audit was to analyse the reliability of the data in the Trauma Centre West Netherlands (TCWN) region. DESIGN: Routinely registered trauma patients from all nine hospitals in the TCWN region were re-registered by a registrar for analysis. SETTING: Nine hospitals in the TCWN region in the Netherlands...
December 4, 2016: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/27920085/quality-of-prescribing-of-antipsychotic-medication-for-people-with-intellectual-disability-under-the-care-of-uk-mental-health-services-a-cross-sectional-audit-of-clinical-practice
#2
Carol Paton, Sumera Bhatti, Kiran Purandare, Ashok Roy, Tre Barnes
OBJECTIVES: To determine the prevalence and quality of antipsychotic prescribing for people with intellectual disability (ID). DESIGN: A clinical audit of prescribing practice in the context of a quality improvement programme. Practice standards for audit were derived from relevant, evidence-based guidelines, including NICE. Data were mainly collected from the clinical records, but to determine the clinical rationale for using antipsychotic medication in individual cases, prescribers could also be directly questioned...
December 5, 2016: BMJ Open
https://www.readbyqxmd.com/read/27912976/implications-of-a-negative-abdominal-ct-in-the-management-of-pediatric-blunt-abdominal-trauma
#3
Sarah Braungart, Thomas Beattie, Paula Midgley, Mark Powis
BACKGROUND: No consensus exists on management of children with a negative trauma CT following blunt abdominal trauma (BAT). Asymptomatic children are frequently "admitted for observation" following negative CT owing to concerns about missing an intraabdominal injury (IAI) without evidence for this practice. We aimed to investigate the feasibility of discharge following a negative CT scan in children sustaining blunt abdominal trauma. METHODS: Retrospective audit at a UK paediatric major trauma center and review of the literature...
November 14, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27884843/traumatic-brain-injury-in-england-and-wales-prospective-audit-of-epidemiology-complications-and-standardised-mortality
#4
T Lawrence, A Helmy, O Bouamra, M Woodford, F Lecky, P J Hutchinson
OBJECTIVES: To provide a comprehensive assessment of the management of traumatic brain injury (TBI) relating to epidemiology, complications and standardised mortality across specialist units. DESIGN: The Trauma Audit and Research Network collects data prospectively on patients suffering trauma across England and Wales. We analysed all data collected on patients with TBI between April 2014 and June 2015. SETTING: Data were collected on patients presenting to emergency departments across 187 hospitals including 26 with specialist neurosurgical services, incorporating factors previously identified in the Ps14 multivariate logistic regression (Ps14(n)) model multivariate TBI outcome prediction model...
November 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27876477/current-prescribing-practices-for-skin-and-soft-tissue-infections-in-nursing-homes
#5
Diana Feldstein, Philip D Sloane, David Weber, Kimberly Ward, David Reed, Sheryl Zimmerman
OBJECTIVES: Antibiotic stewardship has been called for across all sites of health care, including nursing homes (NHs). Skin and soft tissue infections (SSTIs) are the third most common indication for antibiotics in the NH, and so should be a focus of stewardship. This study audited medical records to identify signs and symptoms of SSTIs treated with antibiotics in relation to the McGeer criteria for surveillance, the Loeb minimum criteria for antibiotic initiation, and prescribing recommendations of the Infectious Disease Society of America...
November 18, 2016: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/27868190/intensive-care-medicine-in-rural-sub-saharan-africa
#6
M W Dünser, R M Towey, J Amito, M Mer
We undertook an audit in a rural Ugandan hospital that describes the epidemiology and mortality of 5147 patients admitted to the intensive care unit. The most frequent admission diagnoses were postoperative state (including following trauma) (2014/5147; 39.1%), medical conditions (709; 13.8%) and traumatic brain injury (629; 12.2%). Intensive care unit mortality was 27.8%, differing between age groups (p < 0.001). Intensive care unit mortality was highest for neonatal tetanus (29/37; 78.4%) and lowest for foreign body aspiration (4/204; 2...
November 21, 2016: Anaesthesia
https://www.readbyqxmd.com/read/27855275/epidemiology-and-aetiology-of-traumatic-cardiac-arrest-in-england-and-wales-a-retrospective-database-analysis
#7
Ed Barnard, David Yates, Antoinette Edwards, Marisol Fragoso-Iñiguez, Tom Jenks, Jason E Smith
BACKGROUND: Historically, reported survival from traumatic cardiac arrest (TCA) was extremely low. More recent publications have recorded survival to discharge of up to 8%. This improvement is likely to be multi-factorial; however, there are currently no published data describing the epidemiology or aetiology of TCA in England and Wales to guide future practice improvement. METHODS: Population-based analysis of 2009-2015 Trauma Audit and Research Network (TARN) data...
November 14, 2016: Resuscitation
https://www.readbyqxmd.com/read/27828002/an-integrated-intervention-for-increasing-clinical-nurses-knowledge-of-hiv-aids-related-occupational-safety
#8
Liping He, Zhiyan Lu, Jing Huang, Yiping Zhou, Jian Huang, Yongyi Bi, Jun Li
Background: Approximately 35 new HIV (Human Immunodeficiency Virus, HIV) cases and at least 1000 serious infections are transmitted annually to health care workers. In China, HIV prevalence is increasing and nursing personnel are encountering these individuals more than in the past. Contaminated needle-stick injuries represent a significant occupational burden for nurses. Evidence suggests that nurses in China may not fully understand HIV/AIDS (Acquired immunodeficiency syndrome, AIDS) and HIV-related occupational safety...
November 7, 2016: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/27812103/association-of-an-in-house-blood-bank-with-therapy-and-outcome-in-severely-injured-patients-an-analysis-of-18-573-patients-from-the-traumaregister-dgu%C3%A2
#9
Florian Debus, Rolf Lefering, Philipp Lechler, Tim Schwarting, Benjamin Bockmann, Erwin Strasser, Carsten Mand, Steffen Ruchholtz, Michael Frink
INTRODUCTION: Hemorrhagic shock remains one of the most common causes of death in severely injured patients. It is unknown to what extent the presence of a blood bank in a trauma center influences therapy and outcome in such patients. MATERIAL AND METHODS: We retrospectively analyzed prospectively recorded data from the TraumaRegister DGU® and the TraumaNetzwerk DGU®. Inclusion criteria were Injury Severity Score (ISS) ≥ 16, primarily treated patients, and hospital admission 2 years before or after the audit process...
2016: PloS One
https://www.readbyqxmd.com/read/27808624/how-to-suture-a-wound
#10
Joseph Bonham
Rationale and key points This article explores how to suture a wound using several common techniques. The use of different suture techniques depends on various factors, including the type of wound, its location, skin thickness, wound tension and cosmetic considerations. » Nurses should have a comprehensive understanding of the relevant anatomy and underlying structures, and the expertise to determine that suturing, rather than other methods of wound closure, is appropriate in each case. » Nurses should work within their scope of practice and to agreed departmental protocols...
October 19, 2016: Nursing Standard
https://www.readbyqxmd.com/read/27791418/a-review-of-the-management-of-blunt-splenic-trauma-in-england-and-wales-have-regional-trauma-networks-influenced-management-strategies-and-outcomes
#11
P Yiannoullou, C Hall, K Newton, B Pearce, O Bouamra, T Jenks, A B Scrimshire, G Hughes, F Lecky, Adh Macdonald
INTRODUCTION The spleen remains one of the most frequently injured organs following blunt abdominal trauma. In 2012, regional trauma networks were launched across England and Wales with the aim of improving outcomes following trauma. This retrospective cohort study investigated the management and outcomes of blunt splenic injuries before and after the establishment of regional trauma networks. METHODS A dataset was drawn from the Trauma Audit Research Network database of all splenic injuries admitted to English and Welsh hospitals from 1 April 2010 to 31 March 2014...
October 28, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27789565/is-there-a-weekend-effect-in-major-trauma
#12
David Metcalfe, Daniel C Perry, Omar Bouamra, Ali Salim, Fiona E Lecky, Maralyn Woodford, Antoinette Edwards, Matthew L Costa
BACKGROUND: Many previous studies have shown that patients admitted to hospital at weekends have worse outcomes than those on other days. It has been proposed that parity of clinical services throughout the week could mitigate the 'weekend effect'. This study aimed to determine whether or not a weekend effect is observed within an all-hours consultant-led major trauma service. METHODS: We undertook an observational cohort study using data submitted by all 22 major trauma centres (MTCs) in England to the Trauma Audit & Research Network...
October 27, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27779599/-delay-to-or-fails-to-identify-adverse-outcomes-at-a-level-i-trauma-center
#13
Paul R Lewis, Jayraan Badiee, Michael J Sise, Richard Y Calvo, Jason B Brill, James D Wallace, Steven R Shackford, Casey E Dunne, Vishal Bansal, C Beth Sise
BACKGROUND: The American College of Surgeons Committee on Trauma devised process audit filters to identify opportunities for improvement (OFI), prevent adverse outcomes, and improve quality. Delay to the operating room for primary trauma laparotomy is a process audit filter that has not been definitively associated with improved outcomes. We sought to evaluate the effectiveness of delay to the operating room of greater than 2 hours (DOR) to independently identify an adverse outcome or an OFI at our Level I trauma center...
October 25, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27779097/factors-affecting-the-deceased-organ-donation-rate-in-the-chinese-community-an-audit-of-hospital-medical-records-in-hong-kong
#14
C Y Cheung, M L Pong, S F Au Yeung, K F Chau
INTRODUCTION: The number of actual donors per million population is the most commonly used metric to measure organ donation rates worldwide. It is deemed inadequate, however, because it does not take into account the potential donor pool. The aim of this study was to determine the true potential for solid organ donation from deceased brain-dead donors and the reasons for non-donation from potential donors in the Chinese community. METHODS: Medical records of all hospital deaths between 1 January and 31 December 2014 at a large regional hospital in Hong Kong were reviewed...
December 2016: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/27706879/acute-kidney-injury-post-major-orthopaedic-surgery-a-single-centre-case-control-study
#15
Tracey Ying, Samantha Chan, Stephen Lane, Christine Somerville
AIM: To identify risk factors for acute kidney injury following major orthopaedic surgery. METHODS: We included all patients undergoing major orthopaedic surgery at University Hospital Geelong between 2008 and 2014 in the study. Out of 2188 surgeries audited, we identified cases of acute kidney injury using the RIFLE criteria and matched those to controls 2:1 for age, sex, procedure and chronic kidney disease stage. We reviewed their records for risk factors of postoperative acute kidney injury, including medications such as gentamicin, diuretics, non-steroidal anti-inflammatory drugs and angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use...
October 5, 2016: Nephrology
https://www.readbyqxmd.com/read/27699761/strategies-to-improve-the-implementation-of-healthy-eating-physical-activity-and-obesity-prevention-policies-practices-or-programmes-within-childcare-services
#16
REVIEW
Luke Wolfenden, Jannah Jones, Christopher M Williams, Meghan Finch, Rebecca J Wyse, Melanie Kingsland, Flora Tzelepis, John Wiggers, Amanda J Williams, Kirsty Seward, Tameka Small, Vivian Welch, Debbie Booth, Sze Lin Yoong
BACKGROUND: Despite the existence of effective interventions and best-practice guideline recommendations for childcare services to implement policies, practices and programmes to promote child healthy eating, physical activity and prevent unhealthy weight gain, many services fail to do so. OBJECTIVES: The primary aim of the review was to examine the effectiveness of strategies aimed at improving the implementation of policies, practices or programmes by childcare services that promote child healthy eating, physical activity and/or obesity prevention...
October 4, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27697845/presentation-of-neurogenic-shock-within-the-emergency-department
#17
Matthew Pritam Taylor, Paul Wrenn, Andrew David O'Donnell
BACKGROUND: Injury to the spinal cord can result in loss of sympathetic innervation causing a drop in BP and HR, this condition is known as neurogenic shock. There is debate among the literature on how and when neurogenic shock presents and what values of HR and BP should be used to define it. Previous studies do not take into account multiple prehospital and emergency department recordings. OBJECTIVE: To improve understanding of how neurogenic shock presents in humans, allowing better identification and treatment...
October 3, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27683694/cervical-spine-immobilization-in-the-elderly-population
#18
Prashanth J Rao, Kevin Phan, Ralph J Mobbs, David Wilson, Jonathon Ball
BACKGROUND: Immobilization of the cervical spine is a cornerstone of spinal injury management. In the context of suspected cervical spine injury, patients are immobilized in a 'neutral position' based on the head and trunk resting on a flat surface. It is hypothesized that the increased thoracic kyphosis and loss of cervical lordosis seen in elderly patients may require alternative cervical immobilization, compared with the 'neutral position'. METHODS: To investigate this, an audit of pan-scan CT performed on consecutive major trauma patients aged over 65 years was carried out over a 6-month period...
March 2016: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/27670805/identification-of-patients-with-cervical-sci-suitable-for-early-nerve-transfer-to-achieve-hand-opening
#19
J W Simcock, J A Dunn, N T Buckley, K D Mohammed, G P Beadel, A G Rothwell
STUDY DESIGN: Retrospective audit. OBJECTIVES: The objective of this study was to identify the proportion of patients with cervical spinal cord injury who would potentially benefit from nerve transfer surgery to gain active hand opening, and to determine when a safe nerve transfer decision can be made. SETTING: Christchurch, New Zealand. METHODS: Case note review of the first 12 months following acute cervical spinal cord injury (2007-2012)...
September 27, 2016: Spinal Cord
https://www.readbyqxmd.com/read/27664900/the-role-of-computed-tomography-angiography-in-the-detection-of-aerodigestive-tract-injury-following-penetrating-neck-injury
#20
Andre S Madsen, George Oosthuizen, Grant L Laing, John L Bruce, Damian Luiz Clarke
BACKGROUND: The purpose of this study was to audit our experience with computed tomography angiography (CTA) for the detection of aerodigestive tract injury (ADTI) following penetrating neck injury (PNI) and to assess the significance of deep surgical emphysema on CTA. METHODS: A prospectively maintained trauma registry at the Pietermaritzburg Metropolitan Trauma Service, Pietermaritzburg, South Africa was retrospectively interrogated. The data of all patients with PNI investigated with CTA over a 4-y period were reviewed...
October 2016: Journal of Surgical Research
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