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https://www.readbyqxmd.com/read/29766017/outcomes-according-to-discharge-location-for-persons-who-inject-drugs-receiving-outpatient-parenteral-antimicrobial-therapy
#1
Helen T D'Couto, Gregory K Robbins, Kevin L Ard, Sarah E Wakeman, Justin Alves, Sandra B Nelson
Background: Opioid use disorder poses a significant public health risk. Persons who inject drugs (PWID) suffer from high mortality and morbidity secondary to serious infectious diseases, often requiring prolonged courses of outpatient parenteral antibiotics. The goal of this study was to determine the outcomes of PWID discharged to home or to a skilled nursing or rehabilitation facility (SNF/rehab) with parenteral antibiotic treatment under an outpatient parenteral antimicrobial therapy (OPAT) program...
May 2018: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29762314/effectiveness-of-dexmedetomidine-versus-propofol-on-extubation-times-length-of-stay-and-mortality-rates-in-adult-cardiac-surgery-patients-a-systematic-review-and-meta-analysis
#2
John Nguyen, Noel Nacpil
OBJECTIVE: To determine the effects of dexmedetomidine versus propofol on extubation time, intensive care unit (ICU) length of stay, total hospital length of stay and in-hospital mortality rates in cardiac surgery patients. INTRODUCTION: Recovery from cardiovascular surgery involves weaning from mechanical ventilation. Mechanical ventilation decreases the work of breathing for patients by inhaling oxygen and exhaling carbon dioxide via a ventilator or breathing machine...
May 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29761672/emergency-department-administration-of-oxycodone-by-nurses-treating-musculoskeletal-pain-an-observational-prospective
#3
Mansour Khoury, Sigalit Caspi, Ruth Stalnikowics, Elad Peless, Ela Raiizman, Shaden Salameh
BACKGROUND: Acute musculoskeletal pain is one of the most commonly reported symptoms among patients visiting the emergency department (ED). Treatment with over-the-counter pain medications, given by nurses, results in improved pain management and reduces the waiting time to drug administration without significant side effects. Opioid analgesics are extensively used for acute pain in the ED. Compared to morphine, oxycodone has a much more specific pharmacological activity, higher analgesic potential, and more tolerable side effects...
May 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29752701/pain-agreements-and-healthcare-utilization-in-a-veterans-affairs-primary-care-population-a-retrospective-chart-review
#4
Cynthia Kay, Erica Wozniak, Alice Ching, Joanne Bernstein
INTRODUCTION: The prevalence of chronic pain is enormous. In America, the management of chronic pain and opioids remains a critical focus. Guidelines recommend pain agreements as part of the management of chronic pain and opioids; however, evidence of improvement in patient outcomes is lacking. An aspect of patient outcome includes utilization of healthcare resources, such as emergency department visits and hospitalizations. It remains uncertain whether the use of pain agreements lessens healthcare utilization...
May 11, 2018: Pain and Therapy
https://www.readbyqxmd.com/read/29741749/improving-nursing-confidence-and-consistency-in-assessment-of-opioid-withdrawal-efficacy-of-simulation-and-debriefing
#5
Deborah Corrigan, Richard L Mix, Glen A Palmer, Stephen A Olson
The purpose of the current study was to determine if the amount of confidence in completing the Clinical Opiate Withdrawal Scale (COWS) varied among participants and whether consistency in scoring outcomes to patients occurred with COWS assessment among groups assigned to simulation and debriefing conditions. Sixty nursing staff were randomized into three groups: (a) scenario; (b) scenario and simulation; and (c) scenario, simulation, and debriefing. Staff were administered a questionnaire to assess their confidence before (i...
May 8, 2018: Journal of Psychosocial Nursing and Mental Health Services
https://www.readbyqxmd.com/read/29739484/outpatient-pharmacologic-weaning-for-neonatal-abstinence-syndrome-a-systematic-review
#6
Jodie Murphy-Oikonen, Karen McQueen
AimThe purpose of this systematic review was to assess the literature regarding the effectiveness and safety of outpatient pharmacologic weaning for infants with neonatal abstinence syndrome (NAS). BACKGROUND: NAS is a multi-system disorder observed in infants experiencing withdrawal from opioid exposure in utero. Infants requiring pharmacologic treatment to manage withdrawal, traditionally receive treatment as a hospital inpatient resulting in lengthy hospitalization periods. However, there is evidence to suggest that some healthcare institutions are continuing outpatient pharmacologic weaning for select infants in a home environment...
May 9, 2018: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/29733096/does-familiarity-with-cdc-guidelines-continuing-education-and-provider-characteristics-influence-adherence-to-chronic-pain-management-practices-and-opioid-prescribing
#7
Jean C McCalmont, Kim D Jones, Robert M Bennett, Ronald Friend
OBJECTIVES: (1) To assess providers' experience and knowledge of chronic noncancer pain (CNCP) management. (2) To assess providers' utilization of the Centers for Disease Control and Prevention (CDC) 2016 Guideline for Prescribing Opioids for Chronic Pain. (3) To assess the influence of the 2016 CDC guideline on provider confidence in managing CNCP and adherence to the CDC recommendations. METHODS: A cross-sectional, web-based survey conducted with 417 Oregon prescribing providers, divided into three continuing medical education (CME) groups composed of minimal (0-3), moderate (4-10), and high (≥11) hours of training...
March 2018: Journal of Opioid Management
https://www.readbyqxmd.com/read/29709268/literature-review-assessment-of-opioid-related-sedation-and-the-pasero-opioid-sedation-scale
#8
Katherine R Hall, Angela Y Stanley
PURPOSE: To examine sedation scales and monitoring practices, specifically evaluating utilization of the Pasero Opioid Sedation Scale (POSS) in the clinical setting. DESIGN: Literature review. METHODS: A thorough review of the literature was conducted using three databases from January 2009 to June 2016. FINDINGS: A total of six articles were selected for the review; three descriptive survey-based design, two quasi-experimental design, and one evidence-based practice project...
April 28, 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29691843/a-systems-approach-to-identify-factors-influencing-adverse-drug-events-in-nursing-homes
#9
Ali Azeez Al-Jumaili, William R Doucette
The objectives of the study were to identify the incidence rate and characteristics of adverse drug events (ADEs) in nursing homes (NHs) using the ADE trigger tool and to evaluate the relationships between resident and facility work system factors and incidence of ADEs using the System Engineering Initiative for Patient Safety (SEIPS) model. The study used 2 observational quantitative methods, retrospective resident chart extraction, and surveys. The participating staff included Directors of nursing, registered nurses, certified nurse assistants (CNAs)...
April 24, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29689257/use-of-diphenhydramine-as-an-adjunctive-sedative-for-colonoscopy-in-patients-on-chronic-opioid-therapy-a-randomized-controlled-trial
#10
Salman Nusrat, Mohammed F Madhoun, William M Tierney
BACKGROUND AND AIMS: Chronic opioid use increases tolerance to sedatives. Diphenhydramine is recommended for difficult-to-sedate patients during endoscopic procedures. We hypothesized that the addition of diphenhydramine to midazolam and fentanyl would improve objective and subjective measures of procedural sedation. METHODS: This randomized, double-blind, placebo-controlled trial included patients on chronic opioids undergoing colonoscopy. Patients were randomized to receive intravenous 50 mg of diphenhydramine (N=61) or placebo (N=58), in addition to fentanyl and midazolam...
April 21, 2018: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29675049/administration-of-intravenous-morphine-for-acute-pain-in-the-emergency-department-inflicts-an-economic-burden-in-europe
#11
Montserrat Casamayor, Karen DiDonato, Marc Hennebert, Luca Brazzi, Gregor Prosen
Background: Acute pain is among the leading causes of referral to the emergency department (ED) in industrialized countries. Its management mainly depends on intensity. Moderate-to-severe pain is treated with intravenous (IV) administered opioids, of which morphine is the most commonly used in the ED. We have estimated the burden of IV administration of morphine in the five key European countries (EU5) using a micro-costing approach. Scope: A structured literature review was conducted to identify clinical guidelines for acute pain management in EU5 and clinical studies conducted in the ED setting...
2018: Drugs in Context
https://www.readbyqxmd.com/read/29674362/implementation-of-an-evidence-based-model-of-care-for-low-back-pain-in-emergency-departments-protocol-for-the-sydney-health-partners-emergency-department-shaped-trial
#12
Gustavo C Machado, Bethan Richards, Chris Needs, Rachelle Buchbinder, Ian A Harris, Kirsten Howard, Kirsten McCaffery, Laurent Billot, James Edwards, Eileen Rogan, Rochelle Facer, David Lord Cowell, Chris G Maher
INTRODUCTION: Patients with low back pain often seek care in emergency departments, but the problem is that many patients receive unnecessary or ineffective interventions and at the same time miss out on the basics of care, such as advice on self-management. This pattern of care has important consequences for the healthcare system (expensive and inefficient) and for patients (poor health outcomes). We hypothesised that the implementation of an evidence-based model of care for low back pain will improve emergency care by reducing inappropriate overuse of tests and treatments and improving patient outcomes...
April 19, 2018: BMJ Open
https://www.readbyqxmd.com/read/29673974/randomized-controlled-trial-of-nurse-delivered-cognitive-behavioral-therapy-versus-supportive-psychotherapy-telehealth-interventions-for-chronic-back-pain
#13
Thomas Rutledge, J Hampton Atkinson, Rachael Holloway, Tatiana Chircop-Rollick, John D'Andrea, Steven R Garfin, Shetal Patel, Donald B Penzien, Mark Wallace, Anne L Weickgenant, Mark Slater
This study evaluated a nurse-delivered, telehealth intervention of cognitive behavioral therapy versus supportive psychotherapy for chronic back pain. Participants (N=61) had chronic back pain (pain "daily" ≥ 6 months at an intensity ≥4/10 scale) and were randomized to an 8-week, 12-session, Cognitive Behavioral Therapy (CBT) or to Supportive Care (SC) matched for frequency, format, and time, with each treatment delivered by a primary care nurse. The primary outcome was the Roland Morris Disability Questionnaire (RMDQ)...
April 16, 2018: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29617065/relationships-between-self-injurious-behaviors-pain-reactivity-and-%C3%AE-endorphin-in-children-and-adolescents-with-autism
#14
Sylvie Tordjman, George M Anderson, Annaëlle Charrier, Cécile Oriol, Solenn Kermarrec, Roberto Canitano, Michel Botbol, Nathalie Coulon, Corinne Antoine, Sylvie Brailly-Tabard, David Cohen, Hazar Haidar, Séverine Trabado, Michèle Carlier, Guillaume Bronsard, Laurent Mottron
OBJECTIVE: Autism and certain associated behaviors including self-injurious behaviors (SIB) and atypical pain reactivity have been hypothesized to result from excessive opioid activity. The objective of this study was to examine the relationships between SIB, pain reactivity, and β-endorphin levels in autism. METHODS: Study participants were recruited between 2007 and 2012 from day care centers and included 74 children and adolescents diagnosed with autism (according to DSM-IV-TR, ICD-10, and CFTMEA) and intellectual disability...
March 13, 2018: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/29616917/naloxone-distribution-and-training-for-patients-with-high-risk-opioid-use-in-a-veterans-affairs-community-based-primary-care-clinic
#15
Katie E Raffel, Leila Y Beach, John Lin, Jacob E Berchuck, Shelly Abram, Elizabeth Markle, Shalini Patel
CONTEXT: Naloxone distribution has historically been implemented in a community-based, expanded public health model; however, there is now a need to further explore primary care clinic-based naloxone delivery to effectively address the nationwide opioid epidemic. OBJECTIVE: To create a general medicine infrastructure to identify patients with high-risk opioid use and provide 25% of this population with naloxone autoinjector prescription and training within a 6-month period...
March 30, 2018: Permanente Journal
https://www.readbyqxmd.com/read/29606684/en-route-care-provided-by-us-navy-nurses-in-iraq-and-afghanistan
#16
Virginia S Blackman, Benjamin D Walrath, Lauren K Reeves, Alejandra G Mora, Joseph K Maddry, Zsolt T Stockinger
BACKGROUND: US Navy nurses provide en route care for critically injured combat casualties without having a formal program for training, utilization, or evaluation. Little is known about missions supported by Navy nurses. OBJECTIVES: To characterize the number and types of patients transported and skill sets required by Navy nurses during 2 combat support deployments. METHODS: All interfacility casualty transfers between 2 separate facilities in Iraq and Afghanistan were assessed...
April 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/29601219/an-examination-of-the-perceived-impact-of-a-continuing-interprofessional-education-experience-on-opiate-prescribing-practices
#17
Roberto Cardarelli, William Elder, Sarah Weatherford, Karen L Roper, Dana King, Charlotte Workman, Kathryn Stewart, Chong Kim, William Betz
Chronic pain is increasingly recognized as a public health problem. We assessed the effectiveness of a multi-modal, interprofessional educational approach aimed at empowering healthcare professionals to make deliberative changes, especially in opiate prescribing practices. Education activities included enduring webcasts, regional interprofessional roundtable events, and state-level conference presentations within targeted Kentucky and West Virginia regions of the United States. Over 1,000 participants accessed the various activities...
March 30, 2018: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/29599018/sex-and-race-or-ethnicity-disparities-in-opioid-prescriptions-for-dental-diagnoses-among-patients-receiving-medicaid
#18
Chandrashekar Janakiram, Natalia I Chalmers, Paul Fontelo, Vojtech Huser, Gabriela Lopez Mitnik, Timothy J Iafolla, Avery R Brow, Bruce A Dye
BACKGROUND: The objective of this study was to identify specific factors (sex, race or ethnicity, and health care provider type) associated with patient receipt of an opioid prescription after a dental diagnosis. METHODS: The authors used Medicaid claims dated from January 1, 2013, through September 30, 2015, for 13 US states in this study. The authors identified oral health-related conditions by using International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes 520...
April 2018: Journal of the American Dental Association
https://www.readbyqxmd.com/read/29596288/management-of-intracranial-pressure-part-i-pharmacologic-interventions
#19
Tara L Sacco, Samantha A Delibert
Dangerous, sustained elevation in intracranial pressure (ICP) is a risk for any patient following severe brain injury. Intracranial pressure elevations that do not respond to initial management are considered refractory to treatment, or rICP. Patients are at significant risk of secondary brain injury and permanent loss of function resulting from rICP. Both nonpharmacologic and pharmacologic interventions are utilized to intervene when a patient experiences either elevation in ICP or rICP. In part 1 of this 2-part series, pharmacologic interventions are discussed...
May 2018: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/29580676/research-of-falls-risk-of-taking-central-nervous-system-drugs-in-oncology-inpatients
#20
Yadi Li, Qing Zhang, Xuhong Yang, Lijun Zheng, Jun Yang, Huan Zhao, Dongdong Yang
This study aimed to analyze the medication use and related falls risk of central nervous system(CNS) drugs in oncology inpatients, explore the association between CNS drugs and falls. In this study, we enrolled inpatients, hospitalized in the oncology department of the Teaching Hospital of Chengdu University of Traditional Chinese Medicine, from March 2013 to October 2015. All inpatients were divided into two groups: taking-CNS drugs group (treatment group) and non CNS drugs group (control group). The falls risk between two groups were being compared and analyzed...
January 12, 2018: Current Problems in Cancer
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