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Transitions in the hospital

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https://www.readbyqxmd.com/read/28742770/role-of-the-perioperative-surgical-home-in-optimizing-the-perioperative-use-of-opioids
#1
Thomas R Vetter, Zeev N Kain
Several federal agencies have recently noted that the United States is in the midst of an unprecedented "opioid epidemic," with an increasing number of opioid-related overdoses and deaths. Providers currently face 3 population-level, public health challenges in providing optimal perioperative pain care: (1) the continued lack of overall improvement in the excessive incidence of inadequately treated postoperative pain, (2) minimizing or preventing postoperative opioid-related side effects, and (3) addressing current opioid prescribing patterns, and the accompanying problematic surge in prescription opioid diversion, misuse, abuse, addiction, and overdose...
July 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28742223/impact-and-implementation-of-a-sustainable-regional-telestroke-network
#2
Annemarei Ranta, Jeremy Lanford, Suzanne Busch, Carolyn Providence, Ivan Iniesta, Ian Rosemergy, Andrew Wilson, Pietro Cariga, Victoria Richmond, John Gommans
INTRODUCTION: Telestroke uses videoconferencing (VC) technology to allow off-site experts to provide stroke thrombolysis decision support to less experienced front line clinicians. This project aimed to assess the impact of a new telestroke service on thrombolysis rates and door-to-needle times in participating provincial hospitals and service resources to aid transition to a sustainably telestroke service. METHODS: This is a sequential comparison of 'pre' (December 2015 to May 2016) and 'postr' (June 2016 to December 2016) implementation outcomes...
July 25, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28742011/toward-late-career-transitioning-a-proposal-for-academic-surgeons
#3
Robin Richards, Robin McLeod, David Latter, Shaf Keshavjee, Ori Rotstein, Michael G Fehlings, Najma Ahmed, Avery Nathens, James Rutka
In the absence of a defined retirement age, academic surgeons need to develop plans for transition as they approach the end of their academic surgical careers. The development of a plan for late career transition represents an opportunity for departments of surgery across Canada to initiate a constructive process in cooperation with the key stakeholders in the hospital or institution. The goal of the process is to develop an individual plan for each faculty member that is agreeable to the academic surgeon; informs the surgical leadership; and allows the late career surgeon, the hospital, the division and the department to make plans for the future...
August 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28739535/importance-and-feasibility-of-transitional-care-for-children-with-medical-complexity-results-of-a-multi-stakeholder-delphi-process
#4
JoAnna K Leyenaar, Paul A Rizzo, Dmitry Khodyakov, Laurel K Leslie, Peter K Lindenauer, Rita Mangione-Smith
BACKGROUND: Children with medical complexity (CMC) account for disproportionate hospital utilization and adverse outcomes following discharge, and several gaps exist regarding the quality of hospital-to-home transitional care for this population. We conducted an expert elicitation process to identify important and feasible hospital-to-home transitional care interventions for CMC from the perspectives of parents and healthcare professionals. METHODS: We conducted a two-round electronic Delphi process to identify important and feasible transitional care interventions...
July 21, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28737412/integrated-care-clinic-creating-enhanced-clinical-pathways-for-integrated-behavioral-health-care-in-a-family-medicine-residency-clinic-serving-a-low-income-minority-population
#5
Jerica M Berge, Lisa Trump, Stephanie Trudeau, Damir S Utržan, Michele Mandrich, Andrew Slattengren, Tanner Nissly, Laura Miller, Macaran Baird, Eli Coleman, Michael Wootten
INTRODUCTION: Research examining the implementation and effectiveness of integrated behavioral health (BH) care in family medicine/primary care is growing. However, research identifying ways to consistently use integrated BH in busy family medicine/primary care settings with underserved populations is limited. This study describes 1 family medicine clinic's transformation into a fully integrated BH care clinic through the development of an Integrated Care Clinic (ICC) and enhanced clinical pathways to promote regular use of behavioral health clinicians (BHCs)...
July 24, 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28737266/nephrolithiasis-a-complication-of-pediatric-diabetic-ketoacidosis
#6
Sungeeta Agrawal, Robin Kremsdorf, Serife Uysal, Meghan E Fredette, Lisa Swartz Topor
OBJECTIVE: To determine the frequency of nephrolithiasis as a complication of diabetic ketoacidosis (DKA) in pediatrics. METHODS: We performed a retrospective chart review of patients with DKA admitted to a pediatric hospital between January 2009 and July 2016. We identified patients with nephrolithiasis during admission for DKA. RESULTS: We identified 395 episodes of DKA over 7.5 years. Nephrolithiasis developed as a complication of DKA in 3 of those admissions (0...
July 24, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28734504/-relationship-between-family-variables-and-conjugal-adjustment
#7
Nerea Jiménez-Picón, Joaquín-Salvador Lima-Rodríguez, Marta Lima-Serrano
OBJECTIVE: To determine whether family variables, such as type of relationship, years of marriage, existence of offspring, number of members of family, stage of family life cycle, transition between stages, perceived social support, and/or stressful life events are related to conjugal adjustment. DESIGN: A cross-sectional and correlational study using questionnaires. LOCATION: Primary care and hospital units of selected centres in the province of Seville, Spain...
July 19, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28734149/discharge-management-strategies-and-post-discharge-care-interventions-for-depression-systematic%C3%A2-review-and-meta-analysis
#8
REVIEW
F Holzinger, S Fahrenkrog, S Roll, F Kleefeld, M Adli, C Heintze
BACKGROUND: Patients with depression require treatment continuity when discharged from inpatient care. Interventions aimed at optimizing transition into outpatient care may be effective in preventing symptom deterioration and readmission. We aimed to evaluate the effectiveness of care transition interventions for patients with depression after psychiatric hospitalization. METHODS: Systematic review and random-effects meta-analysis of controlled trials. Primary outcomes were readmissions and symptoms of depression...
July 11, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28733982/postoperative-complications-in-individuals-aged-70-and-over-undergoing-elective-surgery-for-colorectal-cancer
#9
Katleen Fagard, Julie Casaer, Albert Wolthuis, Johan Flamaing, Koen Milisen, Jean-Pierre Lobelle, Hans Wildiers, Cindy Kenis
AIM: This study aims to describe the nature, incidence, severity and outcomes of in-hospital postoperative complications (POCs) in older patients undergoing elective surgery for colorectal cancer (CRC).. METHOD: Patients were identified from a prospectively collected database (2009-2015) focusing on the implementation of geriatric screening and assessment in patients with cancer. Medical and surgical POCs were retrieved retrospectively from the medical records, and the severity of the POCs was graded by the Clavien-Dindo (CD) grading system...
July 22, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28729315/sequence-analysis-to-assess-labour-market-participation-following-vocational-rehabilitation-an-observational-study-among-patients-sick-listed-with-low-back-pain-from-a-randomised-clinical-trial-in-denmark
#10
Louise Lindholdt, Merete Labriola, Claus Vinther Nielsen, Trine Allerslev Horsbøl, Thomas Lund
INTRODUCTION: The return-to-work (RTW) process after long-term sickness absence is often complex and long and implies multiple shifts between different labour market states for the absentee. Standard methods for examining RTW research typically rely on the analysis of one outcome measure at a time, which will not capture the many possible states and transitions the absentee can go through. The purpose of this study was to explore the potential added value of sequence analysis in supplement to standard regression analysis of a multidisciplinary RTW intervention among patients with low back pain (LBP)...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28728804/pharmacy-technician-self-efficacies-insight-to-aid-future-education-staff-development-and-workforce-planning
#11
Shane P Desselle, Ryan Hoh, Erin R Holmes, Amanpreet Gill, Lemuel Zamora
BACKGROUND: The roles of pharmacy technicians are increasingly prominent given pharmacy's transition to patient-centered activities and evolving scopes of practice in many U.S. states and throughout the world. OBJECTIVES: The aims of this study were to assess U.S. pharmacy technicians' self-efficacies for and attitudes toward performing current and emerging roles in hospital and in community pharmacy and to identify factors related to pharmacy technician self-efficacies in these roles...
July 15, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28728582/basic-parametric-analysis-for-a-multi-state-model-in-hospital-epidemiology
#12
Maja von Cube, Martin Schumacher, Martin Wolkewitz
BACKGROUND: The extended illness-death model is a useful tool to study the risks and consequences of hospital-acquired infections (HAIs). The statistical quantities of interest are the transition-specific hazard rates and the transition probabilities as well as attributable mortality (AM) and the population-attributable fraction (PAF). In the most general case calculation of these expressions is mathematically complex. METHODS: When assuming time-constant hazards calculation of the quantities of interest is facilitated...
July 20, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/28727713/local-brain-activity-differences-between-herpes-zoster-and-postherpetic-neuralgia-patients-a-resting-state-functional-mri-study
#13
Song Cao, Ying Li, Wenwen Deng, Bangyong Qin, Yi Zhang, Peng Xie, Jie Yuan, Buwei Yu, Tian Yu
BACKGROUND: Herpes zoster (HZ) can develop into postherpetic neuralgia (PHN), both of which are painful diseases. PHN patients suffer chronic pain and emotional disorders. Previous studies showed that the PHN brain displayed abnormal activity and structural change, but the difference in brain activity between HZ and PHN is still not known. OBJECTIVES: To identify regional brain activity changes in HZ and PHN brains with resting-state functional magnetic resonance imaging (rs-fMRI) technique, and to observe the differences between HZ and PHN patients...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28727708/efficacy-of-short-term-spinal-cord-stimulation-in-acute-subacute-zoster-related-pain-a-retrospective-study
#14
Dao-Song Dong, Xue Yu, Cheng-Fu Wan, Yan Liu, Lin Zhao, Qi Xi, Wen-Yao Cui, Qiu-Shi Wang, Tao Song
BACKGROUND: Postherpetic neuralgia (PHN) is a refractory condition that impairs the patient's quality of life (QoL), it develops secondary to herpes zoster infection. Therefore, it's important to prevent the transition of acute/subacute zoster-related pain to PHN. Despite of numerous studies, the optimal intervention that reduces PHN incidence is still unknown. OBJECTIVE: We evaluate the efficacy of short-term spinal cord stimulation (stSCS) in patients with refractory acute/subacute zoster-related pain...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28727619/an-innovative-transitional-care-program-improves-community-health
#15
Barbara M Richardson
In this month's Magnet® Perspectives column, Barbara Richardson, MSN, RN-BC, CCRN, clinical nurse specialist at the Southwestern Vermont Medical Center, examines the ways in which a robust transitional care program improves community health, reduces readmissions and emergency department visits, and provides valuable social support for even the most complex patients. Richardson shares critical factors that impacted the program's success, including a Magnet® environment of innovation, a visionary hospital leadership team, strong community alliances, and collaborative solutions to previously intractable problems...
July 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/28727183/a-randomised-controlled-trial-on-a-nurse-led-smartphone-based-self-management-programme-for-patients-with-poorly-controlled-type-2-diabetes-a-study-protocol
#16
Wenru Wang, Betsy Seah, Ying Jiang, Violeta Lopez, Cherry Tan, Suan Tee Lim, Hongliang Ren, Yin Hao Khoo
AIM: To develop and compare a nurse-led smartphone-based self-management programme with an existing nurse-led diabetes service on health-related outcomes for patients with poorly controlled type 2 diabetes in Singapore. BACKGROUND: Over the past decades, Asia has emerged as the 'diabetes epicentre' in the world due to rapid economic development, urbanisation and nutrition transition. There is an urgent need to develop more effective care management strategies in response to this rising diabetes epidemic...
July 20, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28726539/rethinking-transitions-of-care-an-interprofessional-transfer-triage-protocol-in-post-acute-care
#17
Radha V Patel, Lauri Wright, Brittany Hay
Readmissions to hospitals from post-acute care (PAC) units within long-term care settings have been rapidly increasing over the past decade, and are drivers of increased healthcare costs. With an average of $11,000 per admission, there is a need for strategies to reduce 30-day preventable hospital readmission rates. In 2018, incentives and penalties will be instituted for long-term care facilities failing to meet all-cause, all-condition hospital readmission rate performance measures. An interprofessional team (IPT) developed and implemented a Transfer Triage Protocol used in conjunction with the INTERACT programme to enhance clinical decision-making and assess the potential to reduce the facility's 30-day preventable hospital readmission rates by 10% within 6 weeks of implementation...
July 20, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28726145/robotic-gastric-bypass-may-lead-to-fewer-complications-compared-with-laparoscopy
#18
Dimitrios Stefanidis, Savannah B Bailey, Timothy Kuwada, Connie Simms, Keith Gersin
BACKGROUND: Robotic technology leads to improved visualization and precision over laparoscopy but also higher cost of care. The benefits of this technology to patient outcomes are controversial. Our objective was to assess whether the application of robotic surgery to Roux-en-Y gastric bypass (RYGB) would lead to improved patient outcomes. METHODS: A prospectively collected database at a bariatric center of excellence was reviewed for all RYGB procedures performed by one surgeon between 2007 and 2015...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28724511/apps-for-health-related-education-in-pharmacy-practice-needs-assessment-survey-among-patients-within-a-large-metropolitan-area
#19
Sean M Mirk, Nicole Marie Wegrzyn
BACKGROUND: Patient education resources are crucial to the effectiveness of prescribed pharmacotherapy. However, user interest and patient preference for these materials is lacking. Regardless of the field, nearly every article on designing mHealth apps references the lack of end-user involvement as a key flaw to sustainable design. The traditional paper-based methods of patient education are difficult to tailor to a patient's specific needs and learning styles, but a customizable app might be beneficial...
July 19, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28724383/molecular-characterization-and-genetic-relatedness-of-clinically-acinetobacter-baumanii-isolates-conferring-increased-resistance-to-the-first-and-second-generations-of-tetracyclines-in-iran
#20
Zahra Meshkat, Himen Salimizand, Yousef Amini, Mostafa Khakshoor, Davoud Mansouri, Hadi Farsiani, Kiarash Ghazvini, Adel Najafi
BACKGROUND: The increasing resistance of Acinetobacter baumannii to antibiotics has recently been regarded as a notable therapeutic difficulty. Evaluating resistance rates of some A. baumannii isolates to tetracyclines had an impact on understanding the antibiotic resistance dissemination. By comparing genetic characteristics and relatedness of A. baumannii isolates, we are able to determine the transition dynamics of outbreak isolates. METHODS: A total of 72 non-duplicate isolates of A...
July 19, 2017: Annals of Clinical Microbiology and Antimicrobials
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