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Patient Safety and Quality

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https://www.readbyqxmd.com/read/28226352/-postoperative-complication-registration-in-gastric-cancer-surgery-from-2005-to-2016-a-learning-curve-in-our-institution
#1
Zhouqiao Wu, Jinyao Shi, Fei Shan, Ziyu Li, Jiafu Ji
OBJECTIVE: To analyze the change in postoperative complication rate after gastric cancer surgery registered in the Peking University Cancer Hospital in recent 11 years and the learning curve of complication registration, and to investigate how to improve the complication registration and evaluation in gastric cancer surgery. METHODS: Patients who underwent open or laparoscopic gastric cancer surgery between April 14, 2005 and February 15, 2016 in our institution were included in the study, and those without essential clinical and administrative data were excluded...
February 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28225544/in-defense-of-clinical-autopsy-and-its-practice-in-cuba
#2
Alfredo D Espinosa-Brito, José Hurtado de Mendoza-Amat
There has been a notable decrease in the global practice of clinical autopsy; the rate has fallen to below 10%, even in high-income countries. This is attributed to several causes, including increased costs, overreliance on modern diagnostic techniques, cultural and religious factors, the emergence of new infectious diseases and negative attitudes on the part of doctors, even pathologists. Alternative methods to autopsy in postmortem studies have been developed based on imaging, endoscopy and biopsy (all quite expensive)...
January 2017: MEDICC Review
https://www.readbyqxmd.com/read/28224269/severe-pelvic-organ-prolapse-treated-by-vaginal-native-tissue-repair-long-term-analysis-of-outcomes-in-146-patients
#3
Michele Carlo Schiavi, Giorgia Perniola, Violante Di Donato, Virginia Sibilla Visentin, Flaminia Vena, Anna Di Pinto, Marzio Angelo Zullo, Marco Monti, Pierluigi Benedetti Panici
AIMS: The aim of this study was to assess the effectiveness and safety of vaginal native tissue repair (VNTR) as a surgical treatment for severe pelvic organ prolapse (POP) and, second, to evaluate the impact on the quality-of-life (QoL) and sexual function. METHODS: Women with symptomatic POP (≥III stage according to POP Quantification System) with or without stress urinary incontinence (SUI) underwent VNTR. The clinical stage, 3-day voiding diary, and urodynamic testing were evaluated in the preoperative and postoperative times, respectively...
February 21, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28224102/practical-strategies-for-increasing-efficiency-and-effectiveness-in-critical-care-education
#4
REVIEW
Maurice F Joyce, Sheri Berg, Edward A Bittner
Technological advances and evolving demands in medical care have led to challenges in ensuring adequate training for providers of critical care. Reliance on the traditional experience-based training model alone is insufficient for ensuring quality and safety in patient care. This article provides a brief overview of the existing educational practice within the critical care environment. Challenges to education within common daily activities of critical care practice are reviewed. Some practical evidence-based educational approaches are then described which can be incorporated into the daily practice of critical care without disrupting workflow or compromising the quality of patient care...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28224099/using-quality-improvement-methods-to-increase-use-of-pain-prevention-strategies-for-childhood-vaccination
#5
Jennifer Verrill Schurman, Amanda D Deacy, Rebecca J Johnson, Jolynn Parker, Kristi Williams, Dustin Wallace, Mark Connelly, Lynn Anson, Kevin Mroczka
AIM: To increase evidence-based pain prevention strategy use during routine vaccinations in a pediatric primary care clinic using quality improvement methodology. METHODS: Specific intervention strategies (i.e., comfort positioning, nonnutritive sucking and sucrose analgesia, distraction) were identified, selected and introduced in three waves, using a Plan-Do-Study-Act framework. System-wide change was measured from baseline to post-intervention by: (1) percent of vaccination visits during which an evidence-based pain prevention strategy was reported as being used; and (2) caregiver satisfaction ratings following the visit...
February 8, 2017: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/28224098/video-recording-of-neonatal-resuscitation-a-feasibility-study-to-inform-widespread-adoption
#6
Sandesh Shivananda, Jennifer Twiss, Enas El-Gouhary, Salhab El-Helou, Connie Williams, Prashanth Murthy, Gautham Suresh
AIM: To determine the feasibility of introducing video recording (VR) of neonatal resuscitation (NR) in a perinatal centre. METHODS: This was a prospective cohort quality improvement study on preterm infants and their caregivers. Based on evidence and experience of other centers using VR intervention, a contextually relevant implementation and evaluation strategy was designed in the planning phase. The components of intervention were pre-resuscitation team huddle, VR of NR and video debriefing (VD), all occurring on the same day...
February 8, 2017: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/28223874/towards-safety-of-oral-anti-cancer-agents-the-need-to-educate-our-pharmacists
#7
Sanaa Saeed Mekdad, Adher Dhaya AlSayed
Introduction: The global prevalence of cancer is rising. Use of oral anticancer medications has expanded exponentially. Knowledge about these medications as well as safe handling guidelines has not kept abreast with the rapidity these medications are applied in clinical practice. They pose serious hazards on all personal involved in handling these medications as well as on patients and their caregivers. We addressed the gaps in knowledge and safe handling of oral anticancer agents among pharmacists in institutional based cancer care...
January 2017: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
https://www.readbyqxmd.com/read/28223091/safety-of-concomitant-cholecystectomy-at-the-time-of-laparoscopic-sleeve-gastrectomy-analysis-of-the-american-college-of-surgeons-national-surgical-quality-improvement-program-database
#8
Hanaa N Dakour-Aridi, Hebah M El-Rayess, Hussein Abou-Abbass, Ibrahim Abu-Gheida, Robert H Habib, Bassem Y Safadi
BACKGROUND: The indication and safety of concomitant cholecystectomy (CC) during bariatric surgical procedures are topics of controversy. Studies on the outcomes of CC with laparoscopic sleeve gastrectomy (LSG) are scarce. OBJECTIVES: To assess the safety and 30-day surgical outcomes of CC with LSG. METHODS: A retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program database 2010 to 2013. Univariate and multivariate analyses were used...
December 23, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28222770/what-do-patients-with-diabetes-and-providers-think-of-an-innovative-australian-model-of-remote-diabetic-retinopathy-screening-a-qualitative-study
#9
Nicola M Glasson, Sarah L Larkins, Lisa J Crossland
BACKGROUND: Diabetic retinopathy (DR) is the commonest cause of preventable blindness in working age populations, but up to 98% of visual loss secondary to DR can be prevented with early detection and treatment. In 2012, an innovative outreach DR screening model was implemented in remote communities in a state of Australia. The aim of this study was to explore the acceptability of this unique DR screening model to patients, health professionals and other key stakeholders. METHODS: This descriptive qualitative study used semi-structured interviews with patients opportunistically recruited whilst attending DR screening, and purposefully selected health care professionals either working within or impacted by the programme...
February 22, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28222709/combined-application-versus-topical-and-intravenous-application-of-tranexamic-acid-following-primary-total-hip-arthroplasty-a-meta-analysis
#10
Pei Zhang, Yuan Liang, Pengtao Chen, Yongchao Fang, Jinshan He, Jingcheng Wang
BACKGROUND: The use of intravenous (IV) or topical tranexamic acid (TXA) in total hip arthroplasty has been proven to be effective and safe in total hip arthroplasty. However, which of these two administration routes is better has not been determined. The combined administration of TXA has been used in total knee arthroplasty with satisfactory results. We hypothesized that combined application of TXA may be the most effective way without increased rate of thrombotic events such as deep vein thrombosis (DVT) and pulmonary embolisms (PE) in patients subjected to primary total hip replacement (THA)...
February 21, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28222472/telemedizin-chancen-in-der-schmerztherapie
#11
Carla Nau
Pain is generally undertreated and there is a need to differentiate and improve access to appropriate pain care. The growing Field of telehealth offers a novel opportunity for pain care, exploiting mainly communicative and pharmacological therapeutic principles. Rationale for telemedicine for the management of chronic pain are the potential to overcome timely, economical, and structural barriers for the access to specialized pain care as well as the general open mindedness of physicians and patients towards this technology...
February 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28222356/extinction-of-avoidance-behavior-by-safety-learning-depends-on-endocannabinoid-signaling-in-the-hippocampus
#12
Vincenzo Micale, Jens Stepan, Angela Jurik, Fabricio A Pamplona, Rudolph Marsch, Filippo Drago, Matthias Eder, Carsten T Wotjak
The development of exaggerated avoidance behavior is largely responsible for the decreased quality of life in patients suffering from anxiety disorders. Studies using animal models have contributed to the understanding of the neural mechanisms underlying the acquisition of avoidance responses. However, much less is known about its extinction. Here we provide evidence in mice that learning about the safety of an environment (i.e., safety learning) rather than repeated execution of the avoided response in absence of negative consequences (i...
February 3, 2017: Journal of Psychiatric Research
https://www.readbyqxmd.com/read/28220480/quality-and-stability-of-extemporaneous-pyridoxal-phosphate-preparations-used-in-the-treatment-of-paediatric-epilepsy
#13
Abeer H A Mohamed-Ahmed, Matthew P Wilson, Maedelyn Albuera, Ting Chen, Philippa B Mills, Emma J Footitt, Peter T Clayton, Catherine Tuleu
OBJECTIVES: To assess the pyridoxal 5'-phosphate (PLP) content and stability of extemporaneous PLP liquids prepared from dietary supplements used for the treatment of vitamin B6 -dependent epilepsy. METHODS: Pyridoxal 5'-phosphate liquids were prepared in accordance with the guidelines given to patients from marketed 50 mg PLP dietary capsules and tablets. The PLP content and its stability were evaluated under conditions resembling the clinical setting using reverse phase HPLC and mass spectrometry...
February 21, 2017: Journal of Pharmacy and Pharmacology
https://www.readbyqxmd.com/read/28220457/innovative-development-path-of-ethnomedicines-the-interpretation-of-the-path
#14
REVIEW
Zhaoyun Zhu, Dehuan Fu, Yali Gui, Tao Cui, Jingkun Wang, Ting Wang, Zhizhong Yang, Yanfei Niu, Zhennan She, Li Wang
One of the primary purposes of the innovative development of ethnomedicines is to use their excellent safety and significant efficacy to serve a broader population. To achieve this purpose, modern scientific and technological means should be referenced, and relevant national laws and regulations as well as technical guides should be strictly followed to develop standards and to perform systemic research in producing ethnomedicines. Finally, ethnomedicines, which are applied to a limited extent in ethnic areas, can be transformed into safe, effective, and quality-controllable medical products to relieve the pain of more patients...
February 21, 2017: Frontiers of Medicine
https://www.readbyqxmd.com/read/28219694/lenalidomide-maintenance-in-patients-with-relapsed-diffuse-large-b-cell-lymphoma-who-are-not-eligible-for-autologous-stem-cell-transplantation-an-open-label-single-arm-multicentre-phase-2-trial
#15
Andrés J M Ferreri, Marianna Sassone, Francesco Zaja, Alessandro Re, Michele Spina, Alice Di Rocco, Alberto Fabbri, Caterina Stelitano, Maurizio Frezzato, Chiara Rusconi, Renato Zambello, Suzana Couto, Yan Ren, Annalisa Arcari, Giovanni Bertoldero, Alessandro Nonis, Lydia Scarfò, Teresa Calimeri, Caterina Cecchetti, Marianna Chiozzotto, Silvia Govi, Maurilio Ponzoni
BACKGROUND: Patients with relapsed diffuse large B-cell lymphoma (DLBCL) not eligible for autologous stem cell transplantation (ASCT) or having relapse after ASCT have a low likelihood of cure. Single-drug maintenance after salvage therapy might be an attractive strategy to prolong survival in these patients. Lenalidomide is a suitable candidate for long-lasting maintenance as it is an oral drug, active against DLBCL that can be taken for years with an acceptable toxicity profile. We designed a study to investigate safety and efficacy of lenalidomide maintenance in patients with chemosensitive relapse of DLBCL not eligible for ASCT or having relapse after ASCT...
February 16, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28219617/techniques-and-outcomes-of-emergency-airway-management-in-japan-an-analysis-of-two-multicentre-prospective-observational-studies-2010-2016
#16
Yukari Goto, Tadahiro Goto, Yusuke Hagiwara, Yusuke Tsugawa, Hiroko Watase, Hiroshi Okamoto, Kohei Hasegawa
OBJECTIVES: Continuous surveillance of emergency airway management practice is imperative in improving quality of care and patient safety. We aimed to investigate the changes in the practice of emergency airway management and the related outcomes in the emergency departments (EDs) in Japan. METHODS: We conducted an analysis of the data from two prospective, observational, multicentre registries of emergency airway management-the Japanese Emergency Airway Network (JEAN)-1 and -2 Registries from April 2010 through May 2016...
February 17, 2017: Resuscitation
https://www.readbyqxmd.com/read/28219385/language-support-for-linguistic-minority-chronic-hepatitis-b-c-patients-an-exploratory-study-of-availability-and-clinicians-perceptions-of-language-barriers-in-six-european-countries
#17
Abby M Falla, Irene K Veldhuijzen, Amena A Ahmad, Miriam Levi, Jan Hendrik Richardus
BACKGROUND: Language support for linguistic minorities can improve patient safety, clinical outcomes and the quality of health care. Most chronic hepatitis B/C infections in Europe are detected among people born in endemic countries mostly in Africa, Asia and Central/Eastern Europe, groups that may experience language barriers when accessing health care services in their host countries. We investigated availability of interpreters and translated materials for linguistic minority hepatitis B/C patients...
February 20, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28219338/effectiveness-and-safety-of-a-home-based-cardiac-rehabilitation-programme-of-mixed-surveillance-in-patients-with-ischemic-heart-disease-at-moderate-cardiovascular-risk-a-randomised-controlled-clinical-trial
#18
Raquel Bravo-Escobar, Alicia González-Represas, Adela María Gómez-González, Angel Montiel-Trujillo, Rafael Aguilar-Jimenez, Rosa Carrasco-Ruíz, Pablo Salinas-Sánchez
BACKGROUND: Previous studies have documented the feasibility of home-based cardiac rehabilitation programmes in low-risk patients with ischemic heart disease, but a similar solution needs to be found for patients at moderate cardiovascular risk. The objective of this study was to analyse the effectiveness and safety of a home-based cardiac rehabilitation programme of mixed surveillance in patients with ischemic cardiopathology at moderate cardiovascular risk. METHODS: A randomised, controlled clinical trial was designed wherein 28 patients with stable coronary artery disease at moderate cardiovascular risk, who met the selection criteria for this study, participated...
February 20, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28219315/near-peers-improve-patient-safety-training-in-the-preclinical-curriculum
#19
Sally R Raty, Cayla R Teal, Elizabeth A Nelson, Anne C Gill
BACKGROUND: Accrediting bodies require medical schools to teach patient safety and residents to develop teaching skills in patient safety. We created a patient safety course in the preclinical curriculum and used continuous quality improvement to make changes over time. OBJECTIVE: To assess the impact of resident teaching on student perceptions of a Patient Safety course. DESIGN: Using the Institute for Healthcare Improvement patient safety curriculum as a frame, the course included the seven IHI modules, large group lectures and small group facilitated discussions...
2017: Medical Education Online
https://www.readbyqxmd.com/read/28217549/anticoagulation-control-among-patients-with-nonvalvular-atrial-fibrillation-a-single-tertiary-cardiac-center-experience
#20
Shaban Mohammed, Amer H S Aljundi, Mohamed Kasem, Mohammed Alhashemi, Ayman El-Menyar
There is a limited knowledge about the predictors of anticoagulation control in patients with nonvalvular atrial fibrillation (NVAF). Furthermore, few reports addressed the role of time in therapeutic range (TTR) that could reflect the safety and efficacy of anticoagulation therapy. We aimed to assess factors that affect the quality of anticoagulation therapy utilizing TTR in patients with NVAF. A retrospective observational study was conducted for patients with NVAF who were maintained on warfarin >6 months at a tertiary cardiac care hospital...
January 2017: Journal of Advanced Pharmaceutical Technology & Research
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