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Quality improvement intensive care

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https://www.readbyqxmd.com/read/28648809/improving-quality-in-measuring-time-to-initiation-of-cpr-during-in-hospital-resuscitation
#1
Ashley Siems, Elyse Tomaino, Anne Watson, Michael C Spaeder, Lillian Su
OBJECTIVE: Time from the onset of "low or no flow" indicators of cardiac failure to initiation of cardiopulmonary resuscitation is an important quality metric thought to improve the likelihood of survival and preservation of end organ function. We hypothesized that delays in initiation of chest compressions were under recognized during in-hospital resuscitation and aimed to develop a system which identifies the actual time of deterioration during cardiac events. METHODS: Retrospective review on prospectively identified resuscitation records and monitor data were compared...
June 22, 2017: Resuscitation
https://www.readbyqxmd.com/read/28644698/sleep-disturbance-after-hospitalization-and-critical-illness-a-systematic-review
#2
Marcus T Altman, Melissa P Knauert, Margaret A Pisani
BACKGROUND: Sleep disturbance during intensive care unit (ICU) admission is common and severe. Sleep disturbance has been observed in survivors of critical illness even after transfer out of the ICU. Not only is sleep important to overall health and well-being, but patients after critical illness are also in a physiologically vulnerable state. Understanding how sleep disturbance impacts recovery from critical illness after hospital discharge is therefore clinically meaningful. OBJECTIVE: This systematic review aimed to summarize studies that identify the prevalence of and risk factors for sleep disturbance after hospital discharge for critical illness survivors...
June 23, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28641999/effect-of-pharmacist-care-on-medication-adherence-and-cardiovascular-outcomes-among-patients-post-acute-coronary-syndrome-a%C3%A2-systematic-review
#3
REVIEW
Maguy Saffouh El Hajj, Myriam Jihad Jaam, Ahmed Awaisu
BACKGROUND: The impact of collaborative and multidisciplinary health care on the outcomes of care in patients with acute coronary syndromes (ACS) is well-established in the literature. However, there is lack of high quality evidence on the role of pharmacist care in this setting. OBJECTIVE: This systematic review aimed to evaluate the impact of pharmacist care on patient outcomes (readmission, mortality, emergency visits, and medication adherence) in patients with ACS at or post-discharge...
June 13, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28641749/congenital-diaphragmatic-hernia-the-role-of-multi-institutional-collaboration-and-patient-registries-in-supporting-best-practice
#4
Pamela A Lally, Erik D Skarsgard
Among congenital malformations, congenital diaphragmatic hernia (CDH) is distinguished by its relatively low occurrence rate, need for resource intensive, integrated multidisciplinary care, and widespread variation in practice and outcome. Although randomized controlled trials (RCTs) are considered the gold standard for generating evidence, they are poorly suited to the study of a condition like CDH due to challenges in illness severity adjustment, unpredictability in clinical course and the impact limitations of studying a single intervention at a time...
June 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28641703/a-randomised-controlled-trial-to-assess-the-cost-effectiveness-of-intensive-versus-no-scheduled-follow-up-in-patients-who-have-undergone-resection-for-colorectal-cancer-with-curative-intent
#5
David Mant, Alastair Gray, Siân Pugh, Helen Campbell, Stephen George, Alice Fuller, Bethany Shinkins, Andrea Corkhill, Jane Mellor, Elizabeth Dixon, Louisa Little, Rafael Perera-Salazar, John Primrose
BACKGROUND: Intensive follow-up after surgery for colorectal cancer is common practice but lacks a firm evidence base. OBJECTIVE: To assess whether or not augmenting symptomatic follow-up in primary care with two intensive methods of follow-up [monitoring of blood carcinoembryonic antigen (CEA) levels and scheduled imaging] is effective and cost-effective in detecting the recurrence of colorectal cancer treatable surgically with curative intent. DESIGN: Randomised controlled open-label trial...
May 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28640822/effective-treatment-options-for-musculoskeletal-pain-in-primary-care-a-systematic-overview-of-current-evidence
#6
Opeyemi O Babatunde, Joanne L Jordan, Danielle A Van der Windt, Jonathan C Hill, Nadine E Foster, Joanne Protheroe
BACKGROUND & AIMS: Musculoskeletal pain, the most common cause of disability globally, is most frequently managed in primary care. People with musculoskeletal pain in different body regions share similar characteristics, prognosis, and may respond to similar treatments. This overview aims to summarise current best evidence on currently available treatment options for the five most common musculoskeletal pain presentations (back, neck, shoulder, knee and multi-site pain) in primary care...
2017: PloS One
https://www.readbyqxmd.com/read/28638517/writing-well-the-long-term-effect-on-empathy-observation-and-physician-writing-through-a-residency-writers-workshop
#7
Megan Lemay, John Encandela, Lisa Sanders, Anna Reisman
BACKGROUND: Writing narratives during medical training can provide a way to derive meaning from challenging experiences, enhance reflection, and combat burnout. The Yale Internal Medicine Residency Writers' Workshop, an annual 2-day intensive workshop followed by faculty-guided writing revision and publication, has been training resident physicians in the craft of writing since 2003. OBJECTIVE: The study aimed to assess the long-term effects of a craft-focused writers' workshop for residents on empathy, observation skills, and future writing...
June 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28637554/the-g60-trauma-center-a-future-consideration
#8
Marko Bukur, Joshua Simon, Joseph Catino, Margaret Crawford, Ivan Puente, Fahim Habib
With a considerably increasing elderly population, we sought to determine whether the volume of elderly trauma patients treated impacted outcomes at two different Level I trauma centers. This is a retrospective review of all elderly patients (>60 years) at two state-verified Level I trauma centers over the past five years. The elderly trauma center (ETC) saw a greater proportion (52%) of elderly patients than the reference trauma center (30%, TC). Demographic and clinical characteristics were abstracted and stratified into ETC and TC groups for comparison...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28636076/prevalence-and-impact-of-obesity-in-people-with-haemophilia-review-of-literature-and-expert-discussion-around-implementing-weight-management-guidelines
#9
REVIEW
S Kahan, A Cuker, R F Kushner, J Maahs, M Recht, T Wadden, T Willis, S Majumdar, D Ungar, D Cooper
Obesity affects more than 35% of Americans, increasing the risk of more than 200 comorbid conditions, impaired quality of life and premature mortality. This review aimed to summarize literature published over the past 15 years regarding the prevalence and impact of obesity in people with haemophilia (PWH) and to discuss implementing general guidelines for weight management in the context of the haemophilia comprehensive care team. Although few studies have assessed the effects of obesity on haemophilia-specific outcomes, existing evidence indicates an important impact of weight status on lower extremity joint range of motion and functional disability, with potentially important effects on overall quality of life...
June 21, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28634768/futile-treatment-a-review
#10
Lenko Šarić, Ivana Prkić, Marko Jukić
The main goal of intensive care medicine is helping patients survive acute threats to their lives, while preserving and restoring life quality. Because of medical advancements, it is now possible to sustain life to an extent that would previously have been difficult to imagine. However, the goals of medicine are not to preserve organ function or physiological activity but to treat and improve the health of a person as a whole. When dealing with medical futilities, physicians and other members of the care team should be aware of some ethical principles...
June 20, 2017: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/28629338/a-phase-2-randomized-trial-to-evaluate-the-impact-of-a-supervised-exercise-program-on-cardiotoxicity-at-3%C3%A2-months-in-patients-with-her2-overexpressing-breast-cancer-undergoing-adjuvant-treatment-by-trastuzumab-design-of-the-cardapac-study
#11
Quentin Jacquinot, Nathalie Meneveau, Marion Chatot, Franck Bonnetain, Bruno Degano, Malika Bouhaddi, Gilles Dumoulin, Dewi Vernerey, Xavier Pivot, Fabienne Mougin
BACKGROUND: The overexpression of human epidermal growth factor receptor-2 (HER2) in breast cancer is a poor prognosis. Trastuzumab improves overall survival but is associated with cardiotoxicity, especially a decline in left ventricular ejection fraction (LVEF). In addition, chemotherapy and radiotherapy increase fatigue and pain, decrease physical capacity and health-related quality of life. To date, no study has evaluated the benefits of physical activity on the side effects of treatment in patients with HER2 positive breast cancer...
June 19, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28627241/neonatal-intensive-care-unit-layout-and-nurses-work
#12
Megan Doede, Alison M Trinkoff, Ayse P Gurses
Neonatal intensive care units (NICUs) remain one of the few areas in hospitals that still use an open bay (OPBY) design for patient stays greater than 24 hr, housing multiple infants, staff, and families in one large room. This creates high noise levels, contributes to the spread of infection, and affords families little privacy. These problems have given rise to the single-family room NICU. This represents a significant change in the care environment for nurses. This literature review answers the question: When compared to OPBY layout, how does a single family room layout impact neonatal nurses' work? Thirteen studies published between 2006 and 2015 were located...
January 1, 2017: HERD
https://www.readbyqxmd.com/read/28626088/secondary-prevention-of-cardiovascular-disease-in-patients-with-type-2-diabetes-international-insights-from-the-tecos-trial
#13
Neha J Pagidipati, Ann Marie Navar, Karen S Pieper, Jennifer B Green, M Angelyn Bethel, Paul W Armstrong, Robert G Josse, Darren K McGuire, Yuliya Lokhnygina, Jan H Cornel, Sigrun Halvorsen, Timo E Strandberg, Tuncay Delibasi, Rury R Holman, Eric D Peterson
Background -Intensive risk factor modification significantly improves outcomes for patients with diabetes and cardiovascular disease (CVD). However, the degree to which secondary prevention treatment goals are achieved in international clinical practice is unknown. Methods -Attainment of 5 secondary prevention parameters-aspirin use, lipid control (low-density lipoprotein cholesterol <70 mg/dL or statin therapy), blood pressure control (<140 mmHg systolic, <90 mmHg diastolic), angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use, and non-smoking status-was evaluated among 13,616 patients from 38 countries with diabetes and known CVD at entry into TECOS...
June 16, 2017: Circulation
https://www.readbyqxmd.com/read/28625267/-application-of-quality-control-chart-in-quality-control-for-nosocomial-infection-in-intensive-care-unit
#14
Yumei Cheng, Yuanyi Liu, Difen Wang
OBJECTIVE: To explore the application value of control chart in the management of nosocomial infection in intensive care unit (ICU) by using quality control chart to monitor the infections in ICU. METHODS: From October 2011 to June 2016, ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI), namely the three catheters, occurred in ICU of the Affiliated Hospital of Guizhou Medical University were monitored and recorded monthly, then the data was imput into the Excel, and the data was analyzed using SPSS...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625073/the-impact-of-structured-self-monitoring-of-blood-glucose-combined-with-intensive-education-on-hba1c-levels-hospitalizations-and-quality-of-life-parameters-in-insulin-treated-patients-with-diabetes-at-primary-care-in-serbia
#15
Nebojša M Lalić, Katarina Lalić, Aleksandra Jotić, Dejan Stanojević, Dragana Živojinović, Andrija Janićijević, Christopher Parkin
BACKGROUND: We assessed the effect of structured self-monitoring of blood glucose (SMBG), in combination with intensive education, on metabolic control, SMBG frequency, hospitalizations, cardiovascular risk factors, and quality-of-life parameters in patients with insulin-treated diabetes in primary health care settings in Serbia. METHODS: This 6-month, observational, noninterventional study, followed 346 insulin-treated diabetes patients (type 1 diabetes [T1D], n = 57; type 2 diabetes [T2D], n = 289) from 28 primary care centers...
December 1, 2016: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28619038/the-experiences-of-women-with-maternal-near-miss-and-their-perception-of-quality-of-care-in-kelantan-malaysia-a-qualitative-study
#16
Mohd Noor Norhayati, Nik Hussain Nik Hazlina, Ab Razak Asrenee, Zaharah Sulaiman
BACKGROUND: Maternal mortality has been the main way of ascertaining the outcome of maternal and obstetric care. However, maternal morbidities occur more frequently than maternal deaths; therefore, maternal near miss was suggested as a more useful indicator for the evaluation and improvement of maternal health services. Our study aimed to explore the experiences of women with maternal near miss and their perception of the quality of care in Kelantan, Malaysia. METHODS: A qualitative phenomenological approach with in-depth interview method was conducted in two tertiary hospitals in Kelantan, Malaysia...
June 15, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28617932/effect-of-the-treatment-of-type-2-diabetes-mellitus-on-the-development-of-cognitive-impairment-and-dementia
#17
REVIEW
Almudena Areosa Sastre, Robin Wm Vernooij, Magali González-Colaço Harmand, Gabriel Martínez
BACKGROUND: Prevention of cognitive impairment and dementia is an important public health goal. Epidemiological evidence shows a relationship between cognitive impairment and Type 2 diabetes mellitus. The risk of dementia increases with duration of disease. This updated systematic review investigated the effect on cognitive function of the type of treatment and level of metabolic control in people with Type 2 diabetes. OBJECTIVES: To assess the effects of different strategies for managing Type 2 diabetes mellitus on cognitive function and the incidence of dementia...
June 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28617421/a-targeted-noise-reduction-observational-study-for-reducing-noise-in-a-neonatal-intensive-unit
#18
S Chawla, P Barach, M Dwaihy, D Kamat, S Shankaran, B Panaitescu, B Wang, G Natarajan
BACKGROUND: Excessive noise in neonatal intensive care units (NICUs) can interfere with infants' growth, development and healing.Local problem:Sound levels in our NICUs exceeded the recommended levels by the World Health Organization. METHODS: We implemented a noise reduction strategy in an urban, tertiary academic medical center NICU that included baseline noise measurements. We conducted a survey involving staff and visitors regarding their opinions and perceptions of noise levels in the NICU...
June 15, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28615274/detecting-organisational-innovations-leading-to-improved-icu-outcomes-a-protocol-for-a-double-blinded-national-positive-deviance-study-of-critical-care-delivery
#19
Howard Chiou, Jeffrey K Jopling, Jennifer Yang Scott, Meghan Ramsey, Kelly Vranas, Todd H Wagner, Arnold Milstein
INTRODUCTION: There is substantial variability in intensive care unit (ICU) utilisation and quality of care. However, the factors that drive this variation are poorly understood. This study uses a novel adaptation of positive deviance approach-a methodology used in public health that assumes solutions to challenges already exist within the system to detect innovations that are likely to improve intensive care. METHODS AND ANALYSIS: We used the Philips eICU Research Institute database, containing 3...
June 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/28615271/cost-effectiveness-of-a-randomised-trial-of-physical-activity-in-alzheimer-s-disease-a-secondary-analysis-exploring-patient-and-proxy-reported-health-related-quality-of-life-measures-in-denmark
#20
Elizaveta Sopina, Jan Sørensen, Nina Beyer, Steen Gregers Hasselbalch, Gunhild Waldemar
OBJECTIVES: To explore the cost-effectiveness of a supervised moderate-to-high intensity aerobic exercise programme in people diagnosed with Alzheimer's disease (AD) and estimate incremental cost-effectiveness ratios (ICER) using participant-reported and proxy-reported measures of health-related quality of life (HRQoL) DESIGN: A cost-effectiveness analysis of economic and HRQoL data from a randomised trial delivered over 16 weeks. SETTING: Memory clinics in Denmark...
June 14, 2017: BMJ Open
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