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https://www.readbyqxmd.com/read/29656619/impact-of-resident-involvement-in-neurosurgery-an-american-college-of-surgeons-national-surgical-quality-improvement-program-database-analysis-of-33-977-patients
#1
Andreea Seicean, Prateek Kumar, Sinziana Seicean, Duncan Neuhauser, Warren R Selman, Nicholas C Bambakidis
OBJECTIVE: There is conflicting and limited literature on the effect of intraoperative resident involvement on surgical outcomes. Our study assessed effects of resident involvement on outcomes in patients undergoing neurosurgery. METHODS: We identified 33,977 adult neurosurgical cases from 374 hospitals in the 2006-2012 National Surgical Quality Improvement Program, a prospectively collected national database with established reproducibility and validity. Outcomes were compared according to resident involvement before and after 1:1 matching on procedure and perioperative risk factors...
March 2018: Neurospine
https://www.readbyqxmd.com/read/29656387/a-nationwide-analysis-of-30-day-adverse-events-unplanned-readmission-and-length-of-hospital-stay-after-peripheral-nerve-surgery-in-extremities-and-the-brachial-plexus
#2
Enrico Martin, Ivo S Muskens, Joeky T Senders, David J Cote, Timothy R Smith, Marike L D Broekman
BACKGROUND: Little is known on adverse events and their timing after peripheral nerve surgery in extremities. The aim of this study is to identify predictors and typical timing of complications, unplanned readmission, and length of hospital stay for patients undergoing peripheral nerve surgery in the extremities. METHODS: Data were extracted from the National Surgical Quality Improvement Program (NSQIP) registry from 2005 to 2015. Adult patients undergoing peripheral nerve surgery in the extremities were included...
April 15, 2018: Microsurgery
https://www.readbyqxmd.com/read/29655786/quality-improvement-initiative-to-prevent-admission-hypothermia-in-very-low-birth-weight-newborns
#3
Milena Frazer, Amy Ciarlo, Jill Herr, Carrie-Ellen Briere
OBJECTIVE: To decrease rates of admission hypothermia (<36 °C) in very-low-birth-weight (VLBW) newborns (<1,500 g). DESIGN: Quality improvement initiative. SETTING/LOCAL PROBLEM: Urban, Level IV NICU with 32 patient beds. The number of VLBW newborns admitted with temperatures less than 36 °C was greater than in comparable NICUs in the Vermont Oxford Network. PARTICIPANTS: Neonates born in 2016 who weighed less than 1,500 g at birth...
April 12, 2018: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/29655517/integrating-pregnancy-prevention-into-an-hiv-counseling-and-testing-program-in-pediatric-primary-care
#4
Noah J Wheeler, Krishna K Upadhya, Marie-Sophie Tawe, Kathy Tomaszewski, Renata Arrington-Sanders, Arik V Marcell
PURPOSE: Certified health educator (CHE)-based HIV counseling and testing typically focus on HIV and sexually transmitted infection (STI) prevention only. A quality improvement initiative examined integrating assessment of reproductive life plans, counseling about pregnancy prevention, and contraception referral into a CHE-based HIV testing program. METHODS: Between February 2014 and January 2017, in one urban pediatric primary care clinic serving patients aged 0-25, CHEs assessed sexual history, HIV risk, short-term (i...
April 11, 2018: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/29653064/longitudinal-evaluation-of-quality-improvement-and-public-health-accreditation-readiness-in-nebraska-local-health-departments-2011-2016
#5
Li-Wu Chen, Abbey Gregg, David Palm
OBJECTIVES: Public health accreditation is intended to improve the performance of public health departments, and quality improvement (QI) is an important component of the Public Health Accreditation Board process. The objective of this study was to evaluate the QI maturity and accreditation readiness of local health departments (LHDs) in Nebraska during a 6-year period that included several statewide initiatives to progress readiness, including funding and technical assistance. METHODS: We used a mixed-methods approach that consisted of both online surveys and key informant interviews to assess QI maturity and accreditation readiness...
January 1, 2018: Public Health Reports
https://www.readbyqxmd.com/read/29652752/practice-change-from-intermittent-medication-boluses-to-bolusing-from-a-continuous-infusion-in-pediatric-critical-care-a-quality-improvement-project
#6
Jessica L Hochstetler, A Jill Thompson, Natalie M Ball, Melissa C Evans, Shaun C Frame, A Lauren Haney, Amelia K Little, Jaime L O'Donnell, Bryna M Rickett, Elizabeth H Mack
OBJECTIVES: To determine whether implementing a guideline to bolus medications from continuous infusions in PICUs affects nursing satisfaction, patient safety, central line entries, medication utilization, or cost. DESIGN: This is a pre- and postimplementation quality improvement study. SETTING: An 11-bed ICU and 14-bed cardiac ICU in a university-affiliated children's hospital. PATIENTS: Patients less than 18 years old admitted to the PICU or pediatric cardiac ICU receiving a continuous infusion of dexmedetomidine, midazolam, fentanyl, morphine, vecuronium, or cisatracurium from May 2015 to May 2016, excluding November 2015 (washout period), were eligible for inclusion...
April 12, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29652736/recommendations-and-extraction-of-clinical-variables-of-pediatric-multiple-sclerosis-using-common-data-elements
#7
Pamela Newland, John M Newland, Verna L Hendricks-Ferguson, Judith M Smith, Brant J Oliver
PURPOSE: The purpose of this article was to demonstrate the feasibility of using common data elements (CDEs) to search for information on the pediatric patient with multiple sclerosis (MS) and provide recommendations for future quality improvement and research in the use of CDEs for pediatric MS symptom management strategies Methods: The St. Louis Children's Hospital (SLCH), Washington University (WU) pediatrics data network was evaluated for use of CDEs identified from a database to identify variables in pediatric MS, including the key clinical features from the disease course of MS...
April 12, 2018: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/29652735/nursing-sensitive-outcomes-after-severe-traumatic-brain-injury-a-nationwide-study
#8
Lene Odgaard, Lena Aadal, Marianne Eskildsen, Ingrid Poulsen
BACKGROUND: Complications such as infections and conditions after immobilization are frequent after severe traumatic brain injury (TBI) due to compromised bodily functions. Traditionally, bodily functions are core elements in nursing, and therefore nurses in the rehabilitation departments are pivotal in the prevention of complications. Hence, the frequency of complications is an indicator of nursing care quality, which can be included in nursing-sensitive outcome indicators. To do so, it is necessary to know the frequency of the selected complications...
April 12, 2018: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/29652630/effects-of-a-sleep-hygiene-text-message-intervention-on-sleep-in-college-students
#9
Christine S Gipson, Jenifer M Chilton, Suzanne S Dickerson, Danita Alfred, Barbara K Haas
OBJECTIVE: To test the effectiveness of a text-message intervention to promote sleep hygiene to improve sleep in young adult college students. PARTICIPANTS: A convenience sample of undergraduate students from one Southwestern university (n = 96), 18-26 years old, recruited in August 2015. METHODS: A 2-group pretest-posttest experimental design assigned participants to receive biweekly text messages about sleep hygiene or healthy behaviors for six weeks...
April 13, 2018: Journal of American College Health: J of ACH
https://www.readbyqxmd.com/read/29652559/point-prevalence-survey-of-antibiotic-use-and-resistance-at-a-referral-hospital-in-kenya-findings-and-implications
#10
Caleb Okoth, Sylvia Opanga, Faith Okalebo, Margaret Oluka, Amanj Baker Kurdi, Brian Godman
BACKGROUND AND AIMS: A substantial amount of antibiotic use in hospitals may be inappropriate, potentially leading to the development and spread of antibiotic resistance, adverse effects, mortality and increased hospital costs. The objective was to assess current patterns of antibiotic use in a leading referral hospital in Western Kenya. This would lead to the identification of opportunities for quality improvement in this hospital and across Kenya. METHODOLOGY: A point prevalence survey was carried out with data abstracted principally from patient medical records supplemented by interviews from physicians when needed...
April 13, 2018: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/29651758/the-role-of-emergency-medicine-clerkship-e-portfolio-to-monitor-the-learning-experience-of-students-in-different-settings-a-prospective-cohort-study
#11
Arif Alper Cevik, Sami Shaban, Margret El Zubeir, Fikri M Abu-Zidan
BACKGROUND: Although emergency departments provide acute care learning opportunities for medical students, student exposure to recommended curriculum presentations and procedures are limited. In this perspective, clinical environments providing learning opportunities for students should be monitored as part of an ongoing quality improvement process. This study aims to analyze student exposures and their involvement levels in two different hospitals (Tawam and Al Ain) so as to improve the teaching and learning activities...
April 12, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29650875/-medical-home-care-support-activities-by-clinics-in-japan-developments-since-2008
#12
Maki Matsukawa, Yumi Fukuyama, Yuko Nakakita, Akiko Akiyama
The purpose of this study is to investigate the comparative changes over time of the home care supporting clinics(HCSCs) in each of the 4 Secondary Medical Areas within Mie Prefecture. There were 129 HCSCs activity reports in 2008, and 170 in 2014. The number of patients and the number of deceased patients have increased in Mie Prefecture. These findings suggest that improvements in the home-care staff recruitment system should be further expanded throughout Mie Prefecture and, in particular, the quality improved in the Higashi-Kishu area...
March 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29650804/exploring-variation-in-glycemic-control-across-and-within-eight-high-income-countries-a-cross-sectional-analysis-of-64-666-children-and-adolescents-with-type-1-diabetes
#13
Dimitrios Charalampopoulos, Julia M Hermann, Jannet Svensson, Torild Skrivarhaug, David M Maahs, Karin Akesson, Justin T Warner, Reinhard W Holl, Niels H Birkebæk, Ann K Drivvoll, Kellee M Miller, Ann-Marie Svensson, Terence Stephenson, Sabine E Hofer, Siri Fredheim, Siv J Kummernes, Nicole Foster, Lena Hanberger, Rakesh Amin, Birgit Rami-Merhar, Anders Johansen, Knut Dahl-Jørgensen, Mark Clements, Ragnar Hanas
OBJECTIVE: International studies on childhood type 1 diabetes (T1D) have focused on whole-country mean HbA1c levels, thereby concealing potential variations within countries. We aimed to explore the variations in HbA1c across and within eight high-income countries to best inform international benchmarking and policy recommendations. RESEARCH DESIGN AND METHODS: Data were collected between 2013 and 2014 from 64,666 children with T1D who were <18 years of age across 528 centers in Germany, Austria, England, Wales, US, Sweden, Denmark, and Norway...
April 12, 2018: Diabetes Care
https://www.readbyqxmd.com/read/29650705/outcomes-of-peripheral-vascular-interventions-in-select-patients-with-lower-extremity-acute-limb-ischemia
#14
Elica Inagaki, Alik Farber, Jeffrey A Kalish, Mohammad H Eslami, Jeffrey J Siracuse, Robert T Eberhardt, Denis V Rybin, Gheorghe Doros, Naomi M Hamburg
BACKGROUND: Contemporary data on patients presenting with acute limb ischemia (ALI), who are selected for treatment with endovascular peripheral vascular interventions (PVI), are limited. Our study examined outcomes following endovascular PVI in patients with ALI by comparing with patients treated for chronic critical limb ischemia using a regional quality improvement registry. METHODS AND RESULTS: Of the 11 035 patients in the Vascular Study Group of New England PVI database (2010-2014), we identified 365 patients treated for lower extremity ALI who were 5:1 frequency matched (by procedure year and arterial segments treated) to 1808 patients treated for critical limb ischemia...
April 12, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29649972/exploring-barriers-to-the-use-of-formal-maternal-health-services-and-priority-areas-for-action-in-sidama-zone-southern-ethiopia
#15
Aschenaki Z Kea, Olivia Tulloch, Daniel G Datiko, Sally Theobald, Maryse C Kok
BACKGROUND: In 2015 the maternal mortality ratio for Ethiopia was 353 per 100,000 live births. Large numbers of women do not use maternal health services. This study aimed to identify factors influencing the use of maternal health services at the primary health care unit (PHCU) level in rural communities in Sidama zone, south Ethiopia in order to design quality improvement interventions. METHODS: We conducted a qualitative study in six woredas in 2013: 14 focus group discussions (FGDs) and 44 in-depth interviews with purposefully selected community members (women, male, traditional birth attendants, local kebele administrators), health professionals and health extension workers (HEWs) at PHCUs...
April 12, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29649614/missing-data-treatments-matter-an-analysis-of-multiple-imputation-for-anterior-cervical-discectomy-and-fusion-procedures
#16
Nathaniel T Ondeck, Michael C Fu, Laura A Skrip, Ryan P McLynn, Jonathan J Cui, Bryce A Basques, Todd J Albert, Jonathan N Grauer
BACKGROUND CONTEXT: The presence of missing data is a limitation of large datasets, including the National Surgical Quality Improvement Program (NSQIP). In addressing this issue, most studies utilize complete case analysis, which excludes cases with missing data, thus potentially introducing selection bias. Multiple imputation, a statistically rigorous approach that approximates missing data and preserves sample size, may be an improvement over complete case analysis. PURPOSE: To evaluate the impact of using multiple imputation in comparison to complete case analysis for assessing the associations between preoperative laboratory values and adverse outcomes following anterior cervical discectomy and fusion (ACDF) procedures...
April 9, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29649611/predictors-of-adverse-discharge-disposition-in-adult-spinal-deformity-and-associated-costs
#17
Peter G Passias, Gregory W Poorman, Cole A Bortz, Rabia Qureshi, Bassel G Diebo, Justin C Paul, Samantha R Horn, Frank A Segreto, Alexandra Pyne, Cyrus M Jalai, Virginie Lafage, Shay Bess, Frank J Schwab, Hamid Hassanzadeh
BACKGROUND CONTEXT: With advances in the understanding of adult spinal deformity (ASD), more complex osteotomy and fusion techniques are being implemented with increasing frequency. Patients undergoing ASD corrections infrequently require extended acute care, longer inpatient stays, and are discharged to supervised care. Given the necessity of value-based health care, identification of clinical indicators for adverse discharge disposition in ASD surgeries is paramount. PURPOSE: On nationwide and surgeon-created databases, identify predictors of adverse discharge disposition after ASD surgeries and view corresponding differences in charges...
April 9, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29649610/evaluating-the-effect-of-growing-patient-numbers-and-changing-data-elements-in-the-national-surgical-quality-improvement-program-nsqip-database-over-the-years-a-study-of-posterior-lumbar-fusion-outcomes
#18
B N Shultz, P Bovonratwet, N T Ondeck, T D Ottesen, R P McLynn, J N Grauer
BACKGROUND CONTEXT: The use of national databases in spinal surgery outcomes research is increasing. A number of variables collected by the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) changed between 2010 and 2011, coinciding with a rapid increase in the number of patients included per year. However, there has been limited study evaluating the effect that these changes may have on the results of outcomes studies. PURPOSE: To investigate the influence of changing data elements and growth of the NSQIP database on results of lumbar fusion outcomes studies...
April 9, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29649095/measuring-quality-gaps-in-tb-screening-in-south-africa-using-standardised-patient-analysis
#19
Carmen S Christian, Ulf-G Gerdtham, Dumisani Hompashe, Anja Smith, Ronelle Burger
This is the first multi-district Standardised Patient (SP) study in South Africa. It measures the quality of TB screening at primary healthcare (PHC) facilities. We hypothesise that TB screening protocols and best practices are poorly adhered to at the PHC level. The SP method allows researchers to observe how healthcare providers identify, test and advise presumptive TB patients, and whether this aligns with clinical protocols and best practice. The study was conducted at PHC facilities in two provinces and 143 interactions at 39 facilities were analysed...
April 12, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29649040/improvement-in-patient-reported-hearing-after-treatment-with-bevacizumab-in-people-with-neurofibromatosis-type-2
#20
Victoria Huang, Amanda L Bergner, Chris Halpin, Vanessa L Merker, Monica R Sheridan, Brigitte C Widemann, Jaishri O Blakeley, Scott R Plotkin
OBJECTIVE: Assess patient-reported outcomes (PRO) for hearing and tinnitus relative to clinical hearing assessment in people with neurofibromatosis 2 (NF2) associated hearing loss. STUDY DESIGN: Prospective, open label, phase-II clinical trial with PRO administered pre-, post-, and after treatment. SETTING: Three tertiary referral centers. PATIENTS: Fourteen patients with NF2, median age of 30 years (range, 14-79 yr) and progressive hearing loss (median baseline word recognition score, 60%; range, 13-82%)...
April 11, 2018: Otology & Neurotology
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