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https://www.readbyqxmd.com/read/28207411/reporting-altered-test-results-in-hemolyzed-samples-is-the-cure-worse-than-the-disease
#1
Giuseppe Lippi, Gianfranco Cervellin, Mario Plebani
The management of laboratory data in unsuitable (hemolyzed) samples remains an almost unresolved dilemma. Whether or not laboratory test results obtained by measuring unsuitable specimens should be made available to the clinicians has been the matter of fierce debates over the past decades. Recently, an intriguing alternative to suppressing test results and recollecting the specimen has been put forward, entailing the definition and implementation of specific algorithms that would finally allow reporting a preanalytically altered laboratory value within a specific comment about its uncertainty of measurement...
February 16, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28199477/use-of-unsolicited-patient-observations-to-identify-surgeons-with-increased-risk-for-postoperative-complications
#2
William O Cooper, Oscar Guillamondegui, O Joe Hines, C Scott Hultman, Rachel R Kelz, Perry Shen, David A Spain, John F Sweeney, Ilene N Moore, Joseph Hopkins, Ira R Horowitz, Russell M Howerton, J Wayne Meredith, Nathan O Spell, Patricia Sullivan, Henry J Domenico, James W Pichert, Thomas F Catron, Lynn E Webb, Roger R Dmochowski, Jan Karrass, Gerald B Hickson
Importance: Unsolicited patient observations are associated with risk of medical malpractice claims. Because lawsuits may be triggered by an unexpected adverse outcome superimposed on a strained patient-physician relationship, a question remains as to whether behaviors that generate patient dissatisfaction might also contribute to the genesis of adverse outcomes themselves. Objective: To examine whether patients of surgeons with a history of higher numbers of unsolicited patient observations are at greater risk for postoperative complications than patients whose surgeons generate fewer such unsolicited patient observations...
February 15, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28187759/supporting-adherence-to-oral-anticancer-agents-clinical-practice-and-clues-to-improve-care-provided-by-physicians-nurse-practitioners-nurses-and-pharmacists
#3
Lonneke Timmers, Christel C L M Boons, Mathieu Verbrugghe, Bart J F van den Bemt, Ann Van Hecke, Jacqueline G Hugtenburg
BACKGROUND: Healthcare provider (HCP) activities and attitudes towards patients strongly influence medication adherence. The aim of this study was to assess current clinical practices to support patients in adhering to treatment with oral anticancer agents (OACA) and to explore clues to improve the management of medication adherence. METHODS: A cross-sectional, observational study among HCPs in (haemato-)oncology settings in Belgium and the Netherlands was conducted in 2014 using a composite questionnaire...
February 10, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28184017/an-update-of-the-hong-kong-epilepsy-guideline-consensus-statement-on-the-use-of-antiepileptic-drugs-in-hong-kong
#4
J Ky Fong, E Ly Chan, H Leung, I Chan, R Sk Chang, G Cy Fong, E Lw Fung, C Ht Lui, B Bh Fung, T L Poon, D Siu, H T Wong, E Yeung, A Wy Yung, C Xl Zhu
OBJECTIVE: New information about antiepileptic drugs has arisen since the publication of the Hong Kong Epilepsy Guideline in 2009. This article set out to fill the knowledge gap between 2007 and 2016 on the use of antiepileptic drugs in Hong Kong. PARTICIPANTS: Between May 2014 and April 2016, four consensus meetings were held in Hong Kong, where a group comprising 15 professionals (neurologists, paediatricians, neurosurgeons, radiologists, and clinical psychologists) from both public and private sectors aimed to review the best available evidence and update all practising physicians on a range of clinical issues including drug-related matters...
February 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28181897/-discontinuation-of-potentially-inappropriate-medications-at-the-end-of-life-perspectives-from-patients-their-relatives-and-physicians
#5
E C T Geijteman, M M A Tempelman, M K Dees, B A A Huisman, R S G M Perez, L van Zuylen, A van der Heide
OBJECTIVE: To obtain insight into the perspectives of patients, relatives and physicians towards potentially inappropriate medications (PIMs) at the end of life. DESIGN: Qualitative interview study. METHOD: An analysis of in-depth interviews with 17 patients who were diagnosed as having a life expectancy of less than three months, 12 patient relatives, and 20 medical specialists and 12 general practitioners who cared for them. For analysis we applied the constant comparative method, which forms part of the grounded theory approach...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28156679/decision-support-needs-assessment-in-newly-diagnosed-malignant-glioma
#6
Camilo E Fadul, Heather Wishart
: 33 Background: Diagnosis of malignant glioma is catastrophic and standard treatment options remain non-curative. Patients are not guaranteed a good outcome, have significantly decreased QOL and exposure to risk. Shared decision making, is believed to diffuse decisional distress accompanying complex situations. METHODS: Semi-structured interviews explored patient, caregiver and physician perceptions of standard of care treatment recommendations following diagnosis...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152936/improving-transitions-of-care-through-implementation-of-a-standardized-handoff-at-a-comprehensive-cancer-center
#7
Mohamed Ait Aiss, Helene P Phu, Lakeisha R Day, Varkey Abraham, Karen Chen, Mejia Rodrigo, Shehla Razvi, Carmen E Gonzalez, Norman Brito-Dellan, Srinivas Banala, David Rubio, Nicole Vaughan-Adams, Debra S Ruiz, Tan Jens, Charles F Levenback, Michael M Frumovitz, Behrouz Zand, Carmelita P Escalante
: 242 Background: Communication failures cause two-thirds of sentinel events in hospitals. These adverse occurrences are often both fatal and preventable. Consequently, improving the quality of handoffs has been identified by multiple accreditation constituents as a top priority patient safety goal. This project was part of an institutional initiative to standardize handoffs among physicians, trainees, and midlevel providers. METHODS: Four subgroups were identified as pilot areas: Gynecologic Oncology (Gyn Onc) fellows to nocturnalists, Surgical Oncology fellows, Pediatric Oncology residents and fellows, and Emergency Center attending staff to inpatient hospitalists...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152929/safer-transitions-of-care-at-a-major-cancer-center-the-emergency-center-to-hospitalist-experience
#8
Carmen E Gonzalez, Norman Brito-Dellan, David Rubio, Mohamed Ait Aiss, Terry Rice, Karen Chen, Diane C Bodurka, Carmelita P Escalante
: 247 Background: Failures in communication lead to serious medical errors particularly during transitions of care. A standardized handoff of patients requiring admission to the inpatient setting between the Emergency Center (EC) and the Hospitalist Inpatient Service (HIS) at a comprehensive cancer center was lacking during this vulnerable time. METHODS: A quality pilot study using Plan, Do, Study, Act methodology was conducted. First, root cause analysis and process mapping of the current state was performed to identify pitfalls of the handoff process between the EC and the Hospitalist Service...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152921/integrating-a-simple-screening-tool-in-the-electronic-medical-record-to-standardize-patient-needs-identification-process
#9
Audrey Caspar-Clark, Neal Niznan, Rebecca Cammy
: 156 Background: Unidentified psychosocial and nutrition needs can impede a patient's quality of life during cancer treatment. Nutritional, social, and logistical patient needs may be overlooked without a standardized identification process. With the increasing use of the electronic medical record (EMR), simple screening tools to identify psychosocial needs and nutritional concerns can be implemented. METHODS: The University of Pennsylvania's Department of Radiation Oncology integrated a simple six-question "yes" or "no" response screen directly into the nursing assessment in the EMR to quickly and easily trigger high-risk patient referrals to social work and nutrition services...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28151787/critical-care-nurses-perceptions-of-end-of-life-care-obstacles-comparative-17-year-data
#10
Renea L Beckstrand, Nicole Lamoreaux, Karlen E Luthy, Janelle L B Macintosh
BACKGROUND: Nurses working in intensive care units (ICUs) frequently care for patients and their families at the end of life (EOL). Providing high-quality EOL care is important for both patients and families, yet ICU nurses face many obstacles that hinder EOL care. Researchers have identified various ICU nurse-perceived obstacles, but no studies have been found addressing the progress that has been made for the last 17 years. OBJECTIVE: The aims of this study were to determine the most common and current obstacles in EOL care as perceived by ICU nurses and then to evaluate whether meaningful changes have occurred since data were first gathered in 1998...
March 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/28150129/psychosocial-factors-associated-with-the-uptake-of-contralateral-prophylactic-mastectomy-among-brca1-2-mutation-noncarriers-with-newly-diagnosed-breast-cancer
#11
Jada G Hamilton, Margaux C Genoff, Melissa Salerno, Kimberly Amoroso, Sherry R Boyar, Margaret Sheehan, Megan Harlan Fleischut, Beth Siegel, Angela G Arnold, Erin E Salo-Mullen, Jennifer L Hay, Kenneth Offit, Mark E Robson
PURPOSE: Women who are newly diagnosed with breast cancer may consider contralateral prophylactic mastectomy (CPM) to reduce their future risk of cancer in their unaffected breast. Pre-surgical BRCA1/2 genetic testing can provide valuable risk information to guide this choice. However, little is understood about why BRCA1/2 mutation noncarriers, who are generally not at substantially elevated risk of contralateral disease, select CPM. METHODS: We examined the uptake of CPM among breast cancer patients identified as BRCA1/2 mutation noncarriers (n = 92) as part of a larger prospective study of the impact of pre-surgical BRCA1/2 testing...
February 1, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28144164/quantifying-the-relationship-between-patient-characteristics-and-involvement-in-developing-and-implementing-a-treatment-plan
#12
Natalie T Roy, Erin E Ulrich
OBJECTIVE: Improving the patient-physician relationship through patient involvement in the care may lead to improved patient safety and better health outcomes. There exists a gap in knowledge in identifying factors that affect self-reported patient involvement in individualized treatment plans. The objectives of this study were to 1) describe patients' perceptions of their involvement in the creation and implementation of their treatment plans and 2) determine if patient involvement varied by medical condition or demographic characteristics...
2017: Drug, Healthcare and Patient Safety
https://www.readbyqxmd.com/read/28143793/parent-and-provider-experience-and-shared-understanding-after-a-family-centered-nighttime-communication-intervention
#13
Alisa Khan, Jennifer Baird, Jayne E Rogers, Stephannie L Furtak, Kathryn A Williams, Brenda Allair, Katherine P Litterer, Meesha Sharma, Alla Smith, Mark A Schuster, Christopher P Landrigan
OBJECTIVE: To assess parent and provider experience and shared understanding after a family-centered, multidisciplinary nighttime communication intervention (nurse-physician brief, family huddle, family update sheet). METHODS: Prospective intervention study at a children's hospital from 5/2013-10/2013 (pre-intervention) and 5/2014-10/2014 (post-intervention). Participants included 464 parents, 176 nurses, and 52 resident-physicians of 582 hospitalized 0-17-year-old patients...
January 28, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28139408/british-columbian-healthcare-providers-perspectives-on-facilitators-and-barriers-to-adhering-to-pediatric-diabetes-treatment-guidelines
#14
Bonnie McIntosh, Karine Khatchadourian, Shazhan Amed
OBJECTIVES: There are few studies exploring why adherence to clinical practice guidelines for the treatment of childhood type 1 diabetes is suboptimal. Our objective was to describe healthcare providers' perspectives on the facilitators of and barriers to adhering to pediatric diabetes treatment guidelines. METHODS: We fielded an electronic survey to 260 pediatric diabetes healthcare providers (physicians, nurses, dietitians) in British Columbia, Canada, followed by qualitative interviews with a purposeful sample (N=15) of physicians and allied healthcare providers...
January 27, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28127586/accrual-patterns-for-clinical-studies-involving-quantitative-imaging-results-of-an-nci-quantitative-imaging-network-qin-survey
#15
Brenda F Kurland, Sameer Aggarwal, Thomas E Yankeelov, Elizabeth R Gerstner, James M Mountz, Hannah M Linden, Ella F Jones, Kellie L Bodeker, John M Buatti
Patient accrual is essential for the success of oncology clinical trials. Recruitment for trials involving the development of quantitative imaging biomarkers may face different challenges than treatment trials. This study surveyed investigators and study personnel for evaluating accrual performance and perceived barriers to accrual and for soliciting solutions to these accrual challenges that are specific to quantitative imaging-based trials. Responses for 25 prospective studies were received from 12 sites...
December 2016: Tomography: a Journal for Imaging Research
https://www.readbyqxmd.com/read/28105993/percutaneous-coronary-intervention-using-a-combination-of-robotics-and-telecommunications-by-an-operator-in-a-separate-physical-location-from-the-patient-an-early-exploration-into-the-feasibility-of-telestenting-the-remote-pci-study
#16
Ryan D Madder, Stacie M VanOosterhout, Mark E Jacoby, J Stewart Collins, Andrew S Borgman, Abbey N Mulder, Matthew A Elmore, Jessica L Campbell, Richard F McNamara, David H Wohns
AIMS: The present study explores the feasibility of telestenting, wherein a physician operator performs stenting on a patient in a separate physical location using a combination of robotics and telecommunications. METHODS AND RESULTS: Patients undergoing robotic stenting were eligible for inclusion. All manipulations of guidewires, balloons, and stents were performed robotically by a physician operator located in an isolated separate room outside the procedure room housing the patient...
January 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28091704/medical-students-medication-communication-skills-regarding-drug-prescription-a-qualitative-analysis-of-simulated-physician-patient-consultations
#17
Katarina Hauser, Jan Matthes
PURPOSE: Poor medication communication of physicians to patients is detrimental, e.g. for medication adherence. Reasons for physicians' deficits in medication communication may be unfavourable conditions in daily practice or already insufficient training during their (undergraduate) medical studies. We explored medical students' communication on new medications in simulated physician-patient conversations to identify actual deficits indicating apparent educational needs. METHODS: Fifth year medical students attending a mandatory course at the University of Cologne had simulated physician-patient consultations aiming at drug prescription...
January 14, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28070939/oncologists-perspectives-on-post-cancer-treatment-communication-and-care-coordination-with-primary-care-physicians
#18
C N Klabunde, D Haggstrom, K L Kahn, S W Gray, B Kim, B Liu, J Eisenstein, N L Keating
Post-treatment cancer care is often fragmented and of suboptimal quality. We explored factors that may affect cancer survivors' post-treatment care coordination, including oncologists' use of electronic technologies such as e-mail and integrated electronic health records (EHRs) to communicate with primary care physicians (PCPs). We used data from a survey (357 respondents; participation rate 52.9%) conducted in 2012-2013 among medical oncologists caring for patients in a large US study of cancer care delivery and outcomes...
January 10, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/28048405/su-f-p-12-leveraging-a-communication-tool-to-assess-imrt-planning-process-efficiency-and-identify-improvement-opportunities
#19
J Evans
PURPOSE: To utilize an existing patient-specific IMRT QA communication tool to quantify our department's compliance with existing IMRT planning policies and to identify opportunities for improvement. METHODS: A centralized network-based spreadsheet is utilized by our dosimetrists to communicate to the physics team when an IMRT plan is ready for patient-specific QA measurement. Since Feb. 2014, the dosimetrists and physicists track additional date information for each case including treatment start, contour approval, plan approval, and QA measurement...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28008576/-barriers-to-addressing-pregnant-patients-cigarette-and-alcohol-use-a-focus-group-study-with-gynecologists
#20
A Stiegler, L Bieber, K Karacay, F Wernz, A Batra
Objectives/Purpose: Alcohol drinking and tobacco smoking pose high health risks for the unborn child. Even though routine testing during the course of pregnancy facilitates early intervention, addressing substance use in pregnancy seems to be more difficult. The aim of the study was to identify barriers to addressing pregnant patients' cigarette and alcohol use. Methods: 2 focus groups (in total N=10 participants) were conducted with gynaecologists. The transcripts of the discussions were analysed using Mayring's approach of qualitative text analysis...
December 2016: Das Gesundheitswesen
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