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Transitions in the hospital

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https://www.readbyqxmd.com/read/29150872/predicting-the-onset-of-freezing-of-gait-a-longitudinal-study
#1
Kaylena A Ehgoetz Martens, Emily L Lukasik, Matthew J Georgiades, Moran Gilat, Julie M Hall, Courtney C Walton, Simon J G Lewis
BACKGROUND: Freezing of gait is a disabling symptom of Parkinson's disease that ultimately affects approximately 80% of patients, yet very little research has focused on predicting the onset of freezing of gait and tracking the longitudinal progression of symptoms prior to its onset. The objective of the current study was to examine longitudinal data spanning the transition period when patients with PD developed freezing of gait to identify symptoms that may precede freezing and create a prediction model that identifies those "at risk" for developing freezing of gait in the year to follow...
November 18, 2017: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/29149476/clinical-parameters-before-and-after-the-transition-to-dialysis
#2
Dugan W Maddux, Len A Usvyat, Terry Ketchersid, Yue Jiao, Tommy C Blanchard, Peter Kotanko, Frank M van der Sande, Jeroen P Kooman, Franklin W Maddux
INTRODUCTION: The transition from pre-dialysis chronic kidney disease (CKD) to post-dialysis start is a critical period associated with high patient mortality and increased hospital admissions. Little is known about the trends of key clinical and laboratory parameters through this time of transition to start dialysis. METHODS: De-identified data including demographics, vital signs, lab results, and eGFR from the Fresenius Medical Care-CKD Registry were analyzed to determine trends in clinical and laboratory parameters through the time of transition from 12 months pre-dialysis start to 12 months post-dialysis start...
November 17, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29147726/-radiculomyelopathy-in-schistosomiasis
#3
REVIEW
J Detzler, H Backes, J Guldner
The increasing migration of people from their homeland in far distant regions to Europe in the last few years has strongly influenced the rise of previously rarely seen diseases. They not only originate from the respective homeland but also from the transit countries during the migration process. We report the case of a 27-year-old male migrant from Eritrea, who after months of flight as a refugee travelling through various African countries, presented at our hospital with a progressive, painful radiculopathy...
November 16, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/29147496/markov-chain-based-acute-effect-estimation-of-air-pollution-on-elder-asthma-hospitalization
#4
Li Luo, Fengyi Zhang, Wei Zhang, Lin Sun, Chunyang Li, Debin Huang, Gao Han, Bin Wang
Background: Asthma caused substantial economic and health care burden and is susceptible to air pollution. Particularly, when it comes to elder asthma patient (older than 65), the phenomenon is more significant. The aim of this study is to investigate the Markov-based acute effects of air pollution on elder asthma hospitalizations, in forms of transition probabilities. Methods: A retrospective, population-based study design was used to assess temporal patterns in hospitalizations for asthma in a region of Sichuan province, China...
2017: Journal of Healthcare Engineering
https://www.readbyqxmd.com/read/29147468/use-of-dictation-as-a-tool-to-decrease-documentation-errors-in-electronic-health-records
#5
Samer Al Hadidi, Sunil Upadhaya, Rupal Shastri, Zain Alamarat
Background: Use of Electronic Health Records is increasing. Copy-and-paste function is frequently used with higher rates of documentation errors. Studies to determine the nature of such errors are needed.Objectives: Determination of the effect of implementing a dictation system for completing notes on the quality of clinical documentation. We hypothesized that implementation of the dictation system for note writing would decrease the rate of errors in the progress notes as well as decrease the rate of copying and pasting...
2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29146681/a-qualitative-study-of-patient-involvement-in-medicines-management-after-hospital-discharge-an-under-recognised-source-of-systems-resilience
#6
Beth Fylan, Gerry Armitage, Deirdre Naylor, Alison Blenkinsopp
INTRODUCTION: There are risks to the safety of medicines management when patient care is transferred between healthcare organisations, for example, when a patient is discharged from hospital. Using the theoretical concept of resilience in healthcare, this study aimed to better understand the proactive role that patients can play in creating safer, resilient medicines management at a common transition of care. METHODS: Qualitative interviews with 60 cardiology patients 6 weeks after their discharge from 2 UK hospitals explored patients' experiences with their discharge medicines...
November 16, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29145548/supported-discharge-teams-for-older-people-in-hospital-acute-care-hospital-a-randomised-controlled-trial
#7
Matthew Parsons, John Parsons, Paul Rouse, Avinesh Pillai, Sean Mathieson, Rochelle Parsons, Christine Smith, Tim Kenealy
Background: Supported Discharge Teams aim to help with the transition from hospital to home, whilst reducing hospital length-of-stay. Despite their obvious attraction, the evidence remains mixed, ranging from strong support for disease-specific interventions to less favourable results for generic services. Objective: To determine whether older people referred to a Supported Discharge Team have: (i) reduced length-of-stay in hospital; (ii) reduced risk of hospital readmission; and (iii) reduced healthcare costs...
November 14, 2017: Age and Ageing
https://www.readbyqxmd.com/read/29144163/demand-for-ct-scans-increases-during-transition-from-paediatric-to-adult-care-an-observational-study-from-2009-to-2015
#8
Pete Thurley, Jonathan Crookdake, Mark Norwood, Nigel Sturrock, Andrew W Fogarty
OBJECTIVE: Avoiding unnecessary radiation exposure is a clinical priority in children and young adults. We aimed to explore demand for CT scans in a busy general hospital with particular interest in the period of transition from paediatric to adult medical care. METHODS: We used an observational epidemiological study based in a teaching hospital. Data were obtained on numbers and rates of CT scans from 2009 to 2015. The main outcome was age-stratified rates of receiving a CT scan...
November 16, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/29143195/normal-values-of-high-resolution-manometry-in-supine-and-upright-positions-in-a-thai-population
#9
Pitichote Hiranyatheb, Suriya Chakkaphak, Supphamat Chirnaksorn, Pattaraporn Lekhaka, Kaimuk Petsrikun, Kornkanok Somboonpun
BACKGROUND: Although cut-off values used in high-resolution manometry (HRM) to diagnose esophageal motility disorders are based on representative samples of the US population and assume a supine position, differences in population and body positioning can reportedly affect results. AIMS: To establish normal HRM values for Thai people in both supine and upright positions. METHODS: Forty-one healthy subjects were recruited, each of whom underwent solid-state HRM with ten 5-mL swallows of water in both the supine and upright positions...
November 15, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29141187/factors-associated-with-final-year-nursing-students-desire-to-work-in-the-primary-health-care-setting-findings-from-a-national-cross-sectional-survey
#10
Jacqueline G Bloomfield, Christina Aggar, Tamsin H T Thomas, Christopher J Gordon
BACKGROUND: Registered nurses are under-represented in the primary health care setting both internationally and in Australia, and this shortage is predicted to worsen. To address the increasingly complex healthcare needs of an ageing population, it is vital to develop and sustain a primary health care nursing workforce, yet attracting nurses is challenging. In Australia, registered nurses graduating from university typically commence their careers in hospital-based transition to professional practice programs...
October 23, 2017: Nurse Education Today
https://www.readbyqxmd.com/read/29136017/practices-in-security-and-confidentiality-of-hiv-aids-patients-information-a-national-survey-among-staff-at-hiv-outpatient-clinics-in-vietnam
#11
Nguyen Khac Hai, Saranath Lawpoolsri, Podjanee Jittamala, Phan Thi Thu Huong, Jaranit Kaewkungwal
INTRODUCTION: Breach of confidentiality or invasion of privacy from the collection and use of medical records, particularly those of patients with HIV/AIDS or other diseases sensitive to stigmatization, should be prevented by all related stakeholders in healthcare settings. The main focus of this study was to assess practices regarding security and confidentiality of HIV-related information among staff at HIV outpatient clinics (HIV-OPCs) in Vietnam. METHODS: A descriptive cross-sectional study was conducted at all 312 HIV-OPCs across the country using an online survey technique...
2017: PloS One
https://www.readbyqxmd.com/read/29135761/ten-ceo-imperatives-for-healthcare-transformation-lessons-from-top-performing-academic-medical-centers
#12
J Seth Chatfield, Clinton O Longenecker, Laurence S Fink, Jeffery P Gold
The transition from a delivery model based on volume to a model based on value is underpinning an unprecedented rate of change in healthcare. Our research identifies academic medical centers that have successfully moved their organizations from a volume-based care delivery model to a model that is based on value, achieving top decile performance in the transition. We asked senior leaders about their key imperatives in achieving system-wide healthcare transformations.Major teaching hospitals were sampled using data envelopment analysis to identify hospitals that produced the best value-based purchasing process of care, Hospital Consumer Assessment of Healthcare Providers and Systems scores, and mortality scores with the most efficient utilization of human and financial organizational resources...
November 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/29135754/implementation-of-a-pediatric-behavioral-staffing-algorithm-in-an-acute-hospital-a-best-practice-implementation-project
#13
Tamara O'Connor
BACKGROUND: A progressive decline in acute psychiatric facility beds has led to a steadily increasing number of pediatric psychiatric patients hospitalized on acute care medical-surgical units. Clinical nurses in this environment feel ill-equipped to provide quality behavioral health care. AIMS/OBJECTIVES: This project aimed to improve continuity of care as well as staff and patient safety in pediatric acute and transitional care units. The specific objectives related to implementation of a resource allocation algorithm for staffing behavioral health admissions and consistent use of an interdisciplinary psychiatric huddle...
November 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29132369/impact-of-pharmacist-led-medication-management-in-care-transitions
#14
Seungwon Yang
BACKGROUND: When patients are discharged from hospital to home, it is a highlighted vulnerable period for which medication - related problems are prevalent. Researchers have proposed a telephone follow-up intervention as a means to reduce hospital readmissions. However, the outcome of the intervention with the engagement of pharmacists in managing patients' medicines after discharge has not been well explored. The objectives of this study were (1) to determine whether a pharmacist telephone follow-up intervention focusing on patients' medicines management support is associated with a reduction in 30-day readmission rates and (2) to describe the number and types of pharmacist interventions in care transitions...
November 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29132042/long-range-interactions-keep-bacterial-cells-from-liquid-solid-interfaces-evidence-of-a-bacteria-exclusion-zone-near-nafion-surfaces-and-possible-implications-for-bacterial-attachment
#15
Yifan Cheng, Carmen I Moraru
Hydrophilic surfaces of both abiotic and biological origin have been shown to bear particle-exclusion zones as large as hundreds of micrometers at liquid-solid interfaces. Here we present the first systematic investigation and evidence for bacteria-free exclusion zones for several bacterial strains, including pathogens associated with hospital infections and/or foodborne outbreaks: Staphylococcus aureus, Escherichia coli O157:H7, and Listeria monocytogenes. Tests were carried out both in a phosphate buffer, as well as triptic soy broth (TSB) of high ionic strength...
November 10, 2017: Colloids and Surfaces. B, Biointerfaces
https://www.readbyqxmd.com/read/29130991/pre-end-stage-renal-disease-hemoglobin-variability-predicts-post-end-stage-renal-disease-mortality-in-patients-transitioning-to-dialysis
#16
Keiichi Sumida, Charles Dyer Diskin, Miklos Z Molnar, Praveen K Potukuchi, Fridtjof Thomas, Jun Ling Lu, Connie M Rhee, Elani Streja, Kunihiro Yamagata, Kamyar Kalantar-Zadeh, Csaba P Kovesdy
BACKGROUND: Hemoglobin variability (Hb-var) has been associated with increased mortality both in non-dialysis dependent chronic kidney disease (NDD-CKD) and end-stage renal disease (ESRD) patients. However, the impact of Hb-var in advanced NDD-CKD on outcomes after dialysis initiation remains unknown. METHODS: Among 11,872 US veterans with advanced NDD-CKD transitioning to dialysis between October 2007 through September 2011, we assessed Hb-var calculated from the residual SD of at least 3 Hb values during the last 6 months before dialysis initiation (prelude period) using within-subject linear regression models, and stratified into quartiles...
November 7, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/29130717/effect-of-the-implementation-of-the-mixed-cafeteria-system-in-a-hospital-nutrition-and-dietetic-service
#17
Kamila Pires de Carvalho, Flaviana Pereira de Oliveira Martins, Isis Danyelle Dias Custódio, Emanuelle Do Nascimento Santos Lima, Daniela Nogueira Prado de Souza, Yara Cristina de Paiva Maia
INTRODUCTION: The type of service offered by the nutrition and dietetics service (NDS) of a hospital has a direct impact on food waste. OBJECTIVE: To evaluate waste in the transition from a simple to a mixed cafeteria service. METHODOLOGY: The study was carried out in a NDS of a University Hospital during 60 days (30 days for each type of service). The meals prepared and distributed and the leftovers of lunch and dinner were weighed. RESULTS: Per capita values of non-usable leftovers were below the acceptable range (7-25 g), not varying with the service transition (p = 0...
October 24, 2017: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/29130267/long-term-impact-of-a-postdischarge-community-health-worker-intervention-on-health-care-costs-in-a-safety-net-system
#18
Alison A Galbraith, David J Meyers, Dennis Ross-Degnan, Marguerite E Burns, Catherine E Vialle-Valentin, Marc R Larochelle, Sharon Touw, Fang Zhang, Meredith Rosenthal, Richard B Balaban
OBJECTIVE: Patient navigators (PNs) may represent a cost-effective strategy to improve transitional care and reduce hospital readmissions. We evaluated the impact of a PN intervention on health system costs in the 180 days after discharge for high-risk patients in a safety-net system. DATA SOURCE/SETTING: Primary and secondary data from an academic safety-net health system. STUDY DESIGN: We compared per-patient utilization and costs, overall and by age, for high-risk, medical service patients randomized to the PN intervention relative to usual care between October 2011 and April 2013...
December 2017: Health Services Research
https://www.readbyqxmd.com/read/29130139/portable-abdomen-radiography-moving-to-thickness-based-protocols
#19
Adrian A Sánchez, Ingrid Reiser, Tina Baxter, Yue Zhang, Joshua H Finkle, Zheng Feng Lu, Kate A Feinstein
BACKGROUND: Default pediatric protocols on many digital radiography systems are configured based on patient age. However, age does not adequately characterize patient size, which is the principal determinant of proper imaging technique. Use of default pediatric protocols by inexperienced technologists can result in patient overexposure, inadequate image quality, or repeated examinations. OBJECTIVE: To ensure diagnostic image quality at a well-managed patient radiation exposure by transitioning to thickness-based protocols for pediatric portable abdomen radiography...
November 12, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/29129345/defining-value-based-care-in-cardiac-and-vascular-anesthesiology-the-past-present-and-future-of-perioperative-cardiovascular-care
#20
REVIEW
Lavinia M Kolarczyk, Harendra Arora, Michael W Manning, David A Zvara, Robert S Isaak
Health care reimbursement models are transitioning from volume-based to value-based models. Value-based models focus on patient outcomes both during the hospital admission and postdischarge. These models place emphasis on cost, quality of care, and coordination of multidisciplinary services. Perioperative physicians are challenged to evaluate traditional practices to ensure coordinated, cost-effective, and evidence-based care. With the Centers for Medicare and Medicaid Services planned introduction of bundled payments for coronary artery bypass graft surgery, cardiovascular anesthesiologists are financially responsible for postdischarge outcomes...
September 28, 2017: Journal of Cardiothoracic and Vascular Anesthesia
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