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https://www.readbyqxmd.com/read/29223750/choosing-pre-conception-planning-for-women-families-counselling-and-informed-consent-part-2-pre-conception-reproductive-planning-lifestyle-immunization-and-psychosocial-issues
#1
REVIEW
R Douglas Wilson
OBJECTIVE: To inform reproductive and other health care providers about pre-conception evaluation, including considerations for reproductive planning, lifestyle modification, immunization status and attitudes, and psychosocial issues. OPTIONS: This counselling information can be used for patient education and planning and possible pre-conception and/or prenatal testing. OUTCOMES: This information may allow for improved risk assessment when pre-conception counselling for individual patients and their families is used...
December 6, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29222362/randomized-controlled-evaluation-of-an-insulin-pen-storage-policy
#2
Haley G Gibbs, Tara McLernon, Rosemary Call, Katie Outten, Leigh Efird, Peter A Doyle, Elizabeth A Stuart, Nestoras Mathioudakis, Nicole Glasgow, Avadhut Joshi, Pravin George, Bob Feroli, Elizabeth K Zink
PURPOSE: Results of a quality-improvement project to enhance safeguards against "wrong-pen-to-patient" insulin pen errors by permitting secure bedside storage of insulin pens are reported. METHODS: A cluster-randomized controlled evaluation was conducted at an academic medical center to assess adherence with institutional policy on insulin pen storage before and after implementation of a revised policy allowing pen storage in locking boxes in patient rooms. In phase 1 of the study, baseline data on policy adherence were captured for 8 patient care units (4 designated as intervention units and 4 designated as control units)...
December 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29219876/effectiveness-of-patient-centered-interventions-on-falls-in-the-acute-care-setting-compared-to-usual-care-a-systematic-review
#3
Donna Avanecean, Dawn Calliste, Teresita Contreras, Yeogyeong Lim, Aileen Fitzpatrick
BACKGROUND: Unintentional falls during hospitalization remain a concern for healthcare institutions globally despite implementation of various improvement strategies. Although the incidence of falls has been of heightened focus for many years and numerous studies have been done evaluating different approaches for fall prevention, fall rates remain high in acute care settings. Patient fall risk scales tend to address only particular intrinsic and extrinsic factors but do not adequately assess a patient's current fall risk status, subsequently warranting more patient-centered risk assessments and interventions...
December 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29218822/european-academy-of-neurology-european-stroke-organisation-consensus-statement-and-practical-guidance-for-pre-hospital-management-of-stroke
#4
A Kobayashi, A Czlonkowska, G A Ford, A C Fonseca, G J Luijckx, J Korv, N Pérez de la Ossa, C Price, D Russell, A Tsiskaridze, M Messmer-Wullen, J De Keyser
Reduction of delay between onset and hospital arrival and adequate pre-hospital care of persons with acute stroke are important for improving chances of a favorable outcome. The objective is to recommend evidence-based practices for the management of patients with suspected stroke in the pre-hospital setting. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology was used to define the key clinical questions. An expert panel then reviewed the literature, established the quality of the evidence, and made recommendations...
December 7, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29218820/frequency-of-going-outdoors-and-health-related-quality-of-life-among-older-adults-examining-the-moderating-role-of-living-alone-and-employment-status
#5
Kazuhiro Harada, Kouhei Masumoto, Keiko Katagiri, Ai Fukuzawa, Makoto Chogahara, Narihiko Kondo, Shuichi Okada
AIM: Going outdoors more frequently is beneficial for maintaining and improving health-related quality of life (HRQOL) among older adults. However, individual differences can alter the effects of going outdoors. The present study aimed to examine whether relationships between going outdoors and HRQOL were moderated by living alone and employment status. METHODS: The present study was a secondary analysis of 14-month prospective data (n = 613). Variables used in this study were baseline data on the frequency of going outdoors, HRQOL (physical and mental component summary scores assessed using the Japanese version of the Medical Outcomes study Short Form 8-Item Health Survey), living alone, employment status, potential confounders (sex, age, educational level and instrumental activities of daily living) and follow-up data on HRQOL...
December 7, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29218814/knowledge-compliance-with-good-clinical-practices-and-barriers-to-effective-control-of-postoperative-pain-among-nurses-from-hospitals-with-and-without-a-hospital-without-pain-certificate
#6
Lucyna Tomaszek, Grażyna Dębska
AIMS AND OBJECTIVES: (1) To compare knowledge and compliance with good clinical practices regarding control of postoperative pain among nurses employed at hospitals with and without a "Hospital without Pain" certificate. (2) To identify the determinants of nurses' knowledge. (3) To define barriers to effective control of postoperative pain. BACKGROUND: Only a slight improvement in postoperative pain control has been observed recently, if any. Implementation of good clinical practices in the control of postoperative pain requires involvement of nurses...
December 8, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29217525/integration-of-mobile-devices-to-facilitate-patient-care-and-teaching-during-family-centered-rounds
#7
Angela S Byrd, Pamela M McMahon, Richard J Vath, Michael Bolton, Melissa Roy
OBJECTIVES: The increasing prevalence of mobile devices in clinical settings has the potential to improve both patient care and education. The benefits are particularly promising in the context of family-centered rounds in inpatient pediatric settings. We aimed to increase mobile device usage by inpatient rounding teams by 50% in 6 months. We hoped to demonstrate that use of mobile devices would improve access to patient care and educational information and to determine if use would improve efficiency and perceptions of clinical teaching...
December 7, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29217370/a-quality-improvement-initiative-to-increase-tdap-tetanus-diphtheria-acellular-pertussis-vaccination-coverage-among-direct-health-care-providers-at-a-children-s-hospital
#8
Changhong Jiang, LaQuita Whitmore-Sisco, Aditya H Gaur, Elisabeth E Adderson
OBJECTIVES: Health care providers (HCP) are at high risk of acquiring and transmitting pertussis to susceptible family members, co-workers, and patients. Public health authorities recommend administering a single dose of Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) vaccine to all adults, including HCP, to increase adult immunity to pertussis. We set a quality improvement goal to increase Tdap vaccination coverage among HCP who provided direct patient care at a children's hospital from 58% to 90% over 18 months...
December 4, 2017: Vaccine
https://www.readbyqxmd.com/read/29212536/towards-healthy-learning-climates-in-postgraduate-medical-education-exploring-the-role-of-hospital-wide-education-committees
#9
Milou E W M Silkens, Kiki M J M H Lombarts, Albert J J A Scherpbier, Maas Jan Heineman, Onyebuchi A Arah
BACKGROUND: Postgraduate medical education prepares residents for delivery of high quality patient care during training as well as for later practice, which makes high quality residency training programs crucial to safeguard patient care. Healthy learning climates contribute to high quality postgraduate medical education. In several countries, modernization of postgraduate medical education has resulted in hospital-wide responsibilities for monitoring learning climates. This study investigates the association between the actions undertaken by hospital-wide education committees and learning climates in postgraduate medical education...
December 6, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/29210756/the-survey-checklist-manifesto
#10
Hunter Gehlbach, Anthony R Artino
Checklists can mitigate a multitude of high-cost mistakes in fields ranging from surgery to aviation. As part of a standard protocol, checklists may provide many benefits, including improved equity and communication among team members and more efficient integration of different processes during complex tasks. Mostly, though, checklists serve as easy, efficient means to remind professionals of what they already know but can easily forget. By improving processes, checklists can reduce procedural errors, miscommunications, and even deaths...
November 28, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29210554/improving-patient-safety-common-outpatient-medical-errors
#11
Joshua Davis, Heather Bittner-Fagan, Margot Savoy
Medical errors are common and can lead to patient harm and death. Most research on errors has focused on inpatient care, yet errors are at least as common in the outpatient setting and likely are underreported. Common types of errors in the outpatient setting are diagnostic, drug, and testing errors. The most effective specific interventions for reducing errors in the outpatient setting remain unknown. Considering the current lack of data, the authors recommend a quality improvement approach to understanding local factors in patient safety...
December 2017: FP Essentials
https://www.readbyqxmd.com/read/29209663/electronic-medical-record-alert-improves-hcv-testing-for-baby-boomers-in-primary-care-setting-adults-born-during-1945-1965
#12
Eyad Al-Hihi, Caylin Shankweiler, David Stricklen, Cheryl Gibson, Winston Dunn
Method: This project aims to implement the HCV birth cohort screening guidelines over a 9-month period in the primary care setting at the University of Kansas Health System General Internal Medicine Division. The project team measured the number of patients in the baby boomer population who received a one-time screen for HCV. An electronic medical record (EMR) intervention was implemented to identify baby boomers who did not have an HCV screening or diagnosis. Additionally, education was provided to all primary care providers in the clinic to increase awareness of the HCV birth cohort screening...
2017: BMJ Open Quality
https://www.readbyqxmd.com/read/29206705/institution-of-just-culture-physician-peer-review-in-an-academic-medical-center
#13
Judith K Volkar, Paul Phrampus, Dennis English, Ronald Johnson, Ashley Medeiros, Mark Zacharia, Richard Beigi
OBJECTIVES: For academic medical centers to improve quality outcomes, identification and optimization of opportunities for improvement are necessary. Effective clinical peer review frequently has limitations on timeliness, transparency, and consideration of system processes related to untoward clinical outcomes. We developed a process to overcome these barriers and capture opportunities for process improvement identified within the clinical peer review system. METHODS: A multidisciplinary committee was formed to evaluate the current process of physician peer review at Magee Womens Hospital of the University of Pittsburgh Medical Center...
December 5, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/29202985/surgical-resident-involvement-in-foot-and-ankle-surgery
#14
Christopher E Gross, David Chang, Samuel B Adams, Selene G Parekh, Jordan D Bohnen
BACKGROUND: Surgical resident participation in the operating room is necessary for education and progression toward safe and independent practice. However, the impact of resident involvement on patient outcomes in foot and ankle surgery is unknown. METHODS: The American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database (2005-2012) was used to identify common foot and ankle procedures (by Current Procedural Taxonomy (CPT) code) performed by orthopedic surgeons...
December 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29202663/experiences-of-patients-with-mental-illness-interactions-with-medical-students-a-systematic-review
#15
Samuel P Dearman, Adam B Joiner, Morris Gordon, Gill Vince
OBJECTIVES: Mental health is a key area for learning within undergraduate medical education. Given the nature of mental illness, interactions may have the potential to uniquely affect patients. This study set out to systematically review studies reporting experiences and perceptions of patients with mental illness' clinical interactions with medical students. This includes which factors encourage patients to interact with medical students and if patients perceive negative and positive effects from these interactions...
January 1, 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/29200834/effects-of-patients-motives-in-choosing-a-provider-on-determining-the-type-of-medical-institution
#16
Yeon-Yong Kim, Jaekyoung Bae, Jin-Seok Lee
Background: Primary care is relatively weak in the Republic of Korea. As the referral system is not well established, patients can freely choose from among clinics, hospitals, and tertiary hospitals. This study was conducted to determine the factors influencing patients' choice of providers. Methods: A survey was conducted of 999 Korean adults aged 19-59 years. An exploratory factor analysis was performed on nine factors influencing their motives in choosing a medical provider...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29199396/educational-intervention-for-physicians-to-address-the-risk-of-opioid-abuse
#17
Margaret K Pasquale, Richard L Sheer, Jack Mardekian, Elizabeth T Masters, Nick C Patel, Amy R Hurwitch, Jennifer J Weber, Anamaria Jorga, Carl L Roland
OBJECTIVE: To evaluate the impact of a pilot intervention for physicians to support their treatment of patients at risk for opioid abuse. SETTING, DESIGN AND PATIENTS, PARTICIPANTS: Patients at risk for opioid abuse enrolled in Medicare plans were identified from July 1, 2012 to April 30, 2014 (N = 2,391), based on a published predictive model, and linked to 4,353 opioid-prescribing physicians. Patient-physician clusters were randomly assigned to one of four interventions using factorial design...
September 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/29198670/difficult-situation-of-pancreas-transplantation-in-the-setting-of-scarce-organ-donation
#18
K-M Chan, C-H Cheng, T-H Wu, C-F Lee, T-J Wu, H-S Chou, W-C Lee
BACKGROUND: Currently, pancreas transplantation has been a promising strategy to restore long-term normoglycemia as well as to improve life quality for patients with insulin-dependent diabetes mellitus (DM). However, the discrepancy between the number of organs needed and the number donated for transplantation is always enormous. Under a setting of scarce organ donations, we examined our limited experience of pancreas transplantation. METHODS: A retrospective review of pancreas transplantations was performed with the use of data from the Taiwan Organ Registry and Sharing Center and the Ministry of Health and Welfare...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29190816/a-national-survey-of-clinical-pharmacy-services-in-county-hospitals-in-china
#19
Dongning Yao, Xiaoyu Xi, Yuankai Huang, Hao Hu, Yuanjia Hu, Yitao Wang, Wenbing Yao
BACKGROUND: Clinical pharmacy is not only a medical science but also an elaborate public health care system firmly related to its subsystems of education, training, qualification authentication, scientific research, management, and human resources. China is a developing country with a tremendous need for improvements in the public health system, including the clinical pharmacy service system. OBJECTIVES: The aim of this research was to evaluate the infrastructure and personnel qualities of clinical pharmacy services in China...
2017: PloS One
https://www.readbyqxmd.com/read/29190402/resident-and-residency-characteristics-associated-with-self-reported-preparedness-for-population-health-management
#20
Erica K Schuster, Lars E Peterson
BACKGROUND AND OBJECTIVES: Population health management (PHM) is an important function of primary care with potential to improve outcomes and decrease costs, but is also among the most difficult strategies to implement in both practices and residency training. Our objective was to determine resident and residency program characteristics associated with graduates' reported preparation to perform PHM. METHODS: We used data from the American Board of Family Medicine (ABFM) Certification Examination registration questionnaire in 2014 and 2015 and ABFM administrative data...
November 2017: Family Medicine
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