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https://www.readbyqxmd.com/read/29468262/a-consensus-based-criterion-standard-for-the-requirement-of-a-trauma-team
#1
Christian Waydhas, Markus Baake, Lars Becker, Boris Buck, Helena Düsing, Björn Heindl, Kai Oliver Jensen, Rolf Lefering, Carsten Mand, T Paffrath, Uwe Schweigkofler, Kai Sprengel, Heiko Trentzsch, Bernd Wohlrath, Dan Bieler
BACKGROUND: Trauma team activation (TTA) represents a considerable expenditure of trauma centre resources. It is mainly triggered by field triage criteria. The overall quality of the criteria may be evaluated based on the rate of over- and undertriage. However, there is no gold standard that defines which adult patients truly require a trauma team. The objective of this study was to develop consensus-based criteria defining the necessity for a trauma team. METHODS: A consensus group was formed by trauma specialists experienced in emergency and trauma care with a specific interest in field triage and having previously participated in guideline development...
February 21, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29437836/prospective-observational-study-on-high-value-care-topics-discussed-on-multidisciplinary-rounds
#2
Jimmy B Beck, Corrie E McDaniel, Miranda C Bradford, Doug Brock, Carolyn D Sy, Tiffany Chen, Jeffrey Foti, Andrew A White
OBJECTIVES: Establishing a high-value care (HVC) culture within an institution requires a multidisciplinary commitment and participation. Bedside rounds provide an ideal environment for role modeling and learning behaviors that promote an HVC culture. However, little is understood regarding the types of HVC discussions that take place at the bedside and who participates in those discussions. METHODS: A prospective observational study at a tertiary-care, university-affiliated, free-standing children's hospital...
February 6, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29428043/trauma-surgeons-save-lives-scribes-save-trauma-surgeons
#3
Joseph F Golob, John J Como, Jeffrey A Claridge
With the advent of the electronic medical record, the documentation burden of the trauma surgeon has become overwhelming. To help, our trauma division added scribes to the rounding team. We hypothesized that scribe utilization would improve our documentation efficiency and offer a financial benefit to the institution. A review of trauma surgeon documentation and billing was performed at a Level I trauma center over two time periods: January to May 2014 (no scribes) and January to May 2015 (scribes). The number of notes written by trauma surgeons was obtained, as were documentation charges...
January 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29419625/use-of-a-standardized-care-communication-checklist-during-multidisciplinary-rounds-in-pediatric-cardiac-intensive-care-a-best-practice-implementation-project
#4
Julianna Boydston
OBJECTIVES: This project aimed to improve thoroughness and continuity of care of patients in a pediatric cardiac intensive care unit. Specific objectives were to increase support of clinical nurse and family participation in multidisciplinary rounds (MDR), as well as full use of a multi-component Complex Care Checklist (CCC) by all nurses in this unit. INTRODUCTION: Communication and collaboration are paramount for safe care and positive outcomes of critically ill patients hospitalized in intensive care units...
February 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29392597/service-and-education-the-association-between-workload-patient-complexity-and-teaching-on-internal-medicine-inpatient-services
#5
Temple A Ratcliffe, Meghan A Crabtree, Raymond F Palmer, Jacqueline A Pugh, Holly J Lanham, Luci K Leykum
BACKGROUND: Attending rounds remain the primary venue for formal teaching and learning at academic medical centers. Little is known about the effect of increasing clinical demands on teaching during attending rounds. OBJECTIVE: To explore the relationships among teaching time, teaching topics, clinical workload, and patient complexity variables. DESIGN: Observational study of medicine teaching teams from September 2008 through August 2014...
February 1, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29356677/caring-for-seniors-living-with-dementia-means-caring-for-their-caregivers-too
#6
Annie Poirier, Philippe Voyer, France Légaré, Michèle Morin, Holly O Witteman, Edeltraut Kröger, Bernard Martineau, Charo Rodríguez, Anik Mc Giguere
To improve the care of seniors living with dementia, current initiatives typically target better identification and treatment of the patient. Our recent survey, however, shows we should also focus more on the needs of the informal caregivers who care for this population in primary care settings. This three-round Delphi survey sought caregivers' views on the most frequent and difficult decisions that seniors with dementia, their informal caregivers, and health care providers face in primary care settings in the province of Quebec...
January 22, 2018: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
https://www.readbyqxmd.com/read/29340632/developing-a-set-of-indicators-to-monitor-quality-in-ambulatory-diabetes-care-using-a-modified-delphi-panel-process
#7
Geetha Mukerji, Ilana Halperin, Katie Hunter, Phillip Segal, Maria Wolfs, Lindsay Bevan, Lianne Jeffs, Jeannette Goguen
Objective: There is a large evidence to practice gap in diabetes care with limited performance assessments that capture the full spectrum of care delivery. Our study aimed to develop a set of ambulatory diabetes quality indicators across six domains (effectiveness, safety, patient-centered, timely, equitable and efficient) to provide a broad view of quality. Design: A modified Delphi panel process was conducted. Phase I involved compiling a list of indicators through literature review and generation of patient and healthcare provider-derived indicators through interviews and surveys, respectively...
January 11, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29315327/ambivalence-in-pregnancy-intentions-the-effect-of-quality-of-care-and-context-among-a-cohort-of-women-attending-family-planning-clinics-in-kenya
#8
Eliud Wekesa, Ian Askew, Timothy Abuya
CONTEXT: Ambivalence in pregnancy intentions is well-documented in sub-Saharan African (SSA) settings and has been associated with inconsistent use of contraception, thereby exposing women using contraception to the possibility of unintended pregnancies. A better understanding of the potential role for client counseling interventions in enabling women to achieve their pregnancy intentions is essential for aiding program efforts to reduce unintended pregnancies. OBJECTIVE: To measure ambivalence in pregnancy intentions longitudinally and determine its association with the quality of care received, controlling for demographic, socio-economic and contextual factors among a cohort of family planning (FP) clients in Kenya...
2018: PloS One
https://www.readbyqxmd.com/read/29315137/reducing-ischemic-injury-from-indwelling-peripheral-arterial-catheters-in-a-pediatric-cardiac-icu-a-quality-improvement-initiative
#9
Adam C Adler, Stephanie Helman, Cynthia Field, Judith J Stellar, Lauren A Brown, Nicole Omensetter, Andrew T Costarino, Mahsun Yuerek, Karen S Bender
OBJECTIVES: To reduce the number of ischemic arterial catheter injuries in children with congenital or acquired heart disease. DESIGN: This is a quality improvement study with pre- and postintervention groups. SETTING: University-affiliated pediatric cardiac center in a quaternary care freestanding children's hospital. PATIENTS: All patients with an indwelling peripheral arterial catheter placed in the Children's Hospital of Philadelphia Cardiac Center associated with an admission to the Cardiac Intensive Cardiac Unit from January 2015 to July 2017 are included...
January 8, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29315035/does-a-daily-consultant-ward-round-affect-the-outcomes-of-orthopaedic-patients
#10
Kwaku W Baryeh, David Elliott, Ziad Harb, Radcliffe Lisk
INTRODUCTION: In the UK, more than 60 000 patients present with a fractured neck of femur each year. These patients represent a huge financial cost. This study looks at the 30-day readmissions and total length of hospital stay of patients presenting with a fractured neck of femur, as well as length of stay in non-hip fracture trauma patients, following the change to a daily consultant-led ward round. METHODS: A total of 200 records of patients with fractured neck of femur were reviewed with data collected retrospectively and prospectively following the introduction of the daily consultant-led ward round...
January 2, 2018: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29300237/dedicated-afternoon-rounds-for-icu-patients-families-and-family-satisfaction-with-care
#11
Urs Weber, Jennifer Johnson, Nathanial Anderson, Andrea K Knies, Belinda Nhundu, Cynthia Bautista, Kevin B Huang, Muhammad Hamza, Jessica White, Anna Coppola, Kathleen M Akgün, David M Greer, Evie G Marcolini, Emily J Gilmore, Nils H Petersen, Nona Timario, Kelly Poskus, Kevin N Sheth, David Y Hwang
OBJECTIVE: It was hypothesized that adding dedicated afternoon rounds for patients' families to supplement standard family support would improve overall family satisfaction with care in a neuroscience ICU. DESIGN: Pre- and postimplementation (pre-I and post-I) design. SETTING: Single academic neuroscience ICU. PATIENTS: Patients in the neuroscience ICU admitted for longer than 72 hours or made comfort measures only at any point during neuroscience ICU admission...
January 3, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29299000/roles-of-infectious-diseases-consultant-pharmacists-and-antimicrobial-stewardship-pharmacists-a-survey-of-canadian-tertiary-care-academic-hospitals
#12
Jessica E Beach, Tasha D Ramsey, Sean K Gorman, Tim T Y Lau
Background: Infectious diseases consultant (IDC) pharmacists work within an IDC service to care for inpatients with complex infections. With Accreditation Canada's new Required Organizational Practice promoting the establishment of antimicrobial stewardship (AMS) programs, AMS pharmacists are being employed in acute care hospitals. There is potential for overlap in responsibilities between IDC and AMS pharmacists, but there is no literature outlining the current duties for each group in Canada...
November 2017: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/29273227/the-effect-of-individual-radiographers-on-rates-of-attendance-to-breast-screening-a-7-year-retrospective-study
#13
S L Savaridas, J Brook, J P Codde, M Bulsara, E Wylie
AIM: To establish whether individual radiographers had significantly different rescreening rates whilst controlling for other known confounding factors. MATERIALS AND METHODS: Women aged 50-69 years were identified from a state-wide screening database at their first screening attendance during the study period (2007-2013). The radiographer performing this index screen and potential confounding factors were recorded and subsequent screening behaviour was assessed...
December 19, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/29260229/guidelines-for-the-content-of-statistical-analysis-plans-in-clinical-trials
#14
Carrol Gamble, Ashma Krishan, Deborah Stocken, Steff Lewis, Edmund Juszczak, Caroline Doré, Paula R Williamson, Douglas G Altman, Alan Montgomery, Pilar Lim, Jesse Berlin, Stephen Senn, Simon Day, Yolanda Barbachano, Elizabeth Loder
Importance: While guidance on statistical principles for clinical trials exists, there is an absence of guidance covering the required content of statistical analysis plans (SAPs) to support transparency and reproducibility. Objective: To develop recommendations for a minimum set of items that should be addressed in SAPs for clinical trials, developed with input from statisticians, previous guideline authors, journal editors, regulators, and funders. Design: Funders and regulators (n = 39) of randomized trials were contacted and the literature was searched to identify existing guidance; a survey of current practice was conducted across the network of UK Clinical Research Collaboration-registered trial units (n = 46, 1 unit had 2 responders) and a Delphi survey (n = 73 invited participants) was conducted to establish consensus on SAPs...
December 19, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29258455/motivations-and-barriers-to-uptake-and-use-of-female-initiated-biomedical-hiv-prevention-products-in-sub-saharan-africa-an-adapted-meta-ethnography
#15
Robyn Eakle, Adam Bourne, Caitlin Jarrett, Jonathan Stadler, Heidi Larson
BACKGROUND: Women bear a disproportionate burden of HIV throughout the world prompting extensive research into HIV prevention products for women which has met with varied success. With an aim of informing future policy and programming, this review examines the barriers and motivations to the uptake and use of female initiated products in sub-Saharan countries. METHODS: We conducted a systematic review as an adapted meta-ethnography of qualitative data focused on actual use of products...
December 19, 2017: BMC Public Health
https://www.readbyqxmd.com/read/29242517/the-crisis-at-christmas-dental-service-a-review-of-an-annual-volunteer-led-dental-service-for-homeless-and-vulnerably-housed-people-in-london
#16
J Doughty, S Stagnell, N Shah, A Vasey, C Gillard
Background The UK charity Crisis originated in 1967 as a response to the increasing numbers of homeless people in London, and the first Crisis at Christmas event for rough sleepers was established in 1971. Since then, Crisis has provided numerous services over the Christmas period to the most vulnerable members of society. One of these is the Crisis at Christmas Dental Service (CCDS) which provides emergency and routine dental care from 23-29 of December each year. The charity is entirely dependent on voluntary staffing and industry donations including materials and facilities...
December 15, 2017: British Dental Journal
https://www.readbyqxmd.com/read/29236096/how-exemplary-teaching-physicians-interact-with-hospitalized-patients
#17
Sanjay Saint, Molly Harrod, Karen E Fowler, Nathan Houchens
BACKGROUND: Effectively interacting with patients defines the consummate clinician. OBJECTIVE: As part of a broader study, we examined how 12 carefully selected attending physicians interacted with patients during inpatient teaching rounds. DESIGN: A multisite study using an exploratory, qualitative approach. PARTICIPANTS: Exemplary teaching physicians were identified using modified snowball sampling. Of 59 potential participants, 16 were contacted, and 12 agreed to participate...
December 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29206884/rapid-research-and-implementation-priority-setting-for-wound-care-uncertainties
#18
Trish A Gray, Jo C Dumville, Janice Christie, Nicky A Cullum
INTRODUCTION: People with complex wounds are more likely to be elderly, living with multimorbidity and wound related symptoms. A variety of products are available for managing complex wounds and a range of healthcare professionals are involved in wound care, yet there is a lack of good evidence to guide practice and services. These factors create uncertainty for those who deliver and those who manage wound care. Formal priority setting for research and implementation topics is needed to more accurately target the gaps in treatment and services...
2017: PloS One
https://www.readbyqxmd.com/read/29205299/key-learning-outcomes-for-clinical-pharmacology-and-therapeutics-education-in-europe-a-modified-delphi-study
#19
D J Brinkman, J Tichelaar, L B Mokkink, T Christiaens, R Likic, R Maciulaitis, J Costa, E J Sanz, S R Maxwell, M C Richir, M A van Agtmael
Harmonizing clinical pharmacology and therapeutics (CPT) education in Europe is necessary to ensure that the prescribing competency of future doctors is of an uniform high standard. As there are currently no uniform requirements, our aim was to achieve consensus on key learning outcomes for undergraduate CPT education in Europe. We used a modified Delphi method consisting of three questionnaire rounds and a panel meeting. 129 experts from 27 European countries were asked to rate 307 learning outcomes. 92 experts (71%) completed all three questionnaire rounds, and 33 experts (26%) attended the meeting...
December 5, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29190306/letter-to-the-editor-the-authors-reply-what-can-be-done-to-maintain-positive-patient-experience-and-improve-residents-satisfaction-and-vstandardized-attending-rounds-to-improve-the-patient-experience-a-pragmatic-cluster-randomized-controlled-trial
#20
Bradley Monash, Margaret C Fang, James Harrison
We thank Talrai et al. for their comments in response to our randomized controlled trial evaluating the impact of standardized rounds on patient, attending, and trainee satisfaction. We agree that many factors beyond rounding structure contribute to resident satisfaction, including those highlighted by the authors, and would enthusiastically welcome additional research in this realm.
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
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