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https://www.readbyqxmd.com/read/29790142/-application-of-care-bundles-to-reduce-medical-device-related-pressure-injury-mdrpi-incidence-in-a-coronary-care-unit
#1
Shu-Ling Wang, Pao-Yu Chuang, Wan-Chuan Su
BACKGROUND & PROBLEMS : Pressure injuries increase the cost of medical care and prolong hospitalization. The incidence of pressure injury at the target coronary care unit (CCU) from January to August 2016 was 1.1%, which was significantly higher than the 0.4% defined in the 2015 Taiwan Clinical Performance Indicators (TCPI) system. Medical device related pressure injury (MDRPI) accounted for 73.1% of the pressure injuries (incidence: 0.8%). The main causes of the high incidence of MDRPI were: (1) inadequate decompression dressing and restraint equipment, (2) incomplete implementation of prevention interventions in the CCU, (3) inadequate knowledge of MDRPI prevention among nurses, (4) deficient standards for preventing MDRPI, (5) ineffective MDRPI-related education, and (6) insufficient auditing frequencies...
June 2018: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/29786020/use-of-international-foundations-of-medicine-clinical-sciences-examination-to-evaluate-students-performance-in-the-local-examination-at-the-university-of-sharjah-united-arab-emirates
#2
Nihar Ranjan Dash, Mohamed Elhassan Abdalla, Amal Hussein
Background: Several medical schools around the world are moving away from isolated, locally developed in-house assessments to the introduction of external examinations into their curriculum. Although the objective varies, it is typically done to evaluate, audit, and compare students' performance to international standards. Similarly, the International Foundations of Medicine-Clinical Sciences Examination (IFOM-CSE) was introduced in the College of Medicine at the University of Sharjah as an external assessment criterion in addition to the existing in-house assessments...
September 2017: Education for Health: Change in Training & Practice
https://www.readbyqxmd.com/read/29784465/-proper-use-of-fluoroquinolones-in-hospitalized-elderly-patients-realisation-of-a-clinical-audit-in-geriatric-hospitals-of-lyon-university-hospital
#3
C Papailhau, S Gaujard, R Girard, L Bourguignon, C Mouchoux
INTRODUCTION: Fluoroquinolones (FQ) are widely used because of their broad spectrum and their ease of use, especially in the elderly. Nevertheless, their misuse is behind the development and the emergence of bacterial resistances. The objective of this study was to evaluate the compliance of FQ prescriptions in the elderly hospitalized, before and after pharmaceutical interventions (PI). METHODS: A prospective clinical audit was conducted for three months in three geriatric hospitals...
May 18, 2018: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/29783971/posterior-urethral-valves-10-years-audit-of-epidemiologic-diagnostic-and-therapeutic-aspects-in-yaound%C3%A3-gynaeco-obstetric-and-paediatric-hospital
#4
Faustin Felicien Mouafo Tambo, Paul Nkemtendong Tolefac, Marcelin Ngowe Ngowe, Jacqueline Ze Minkande, Landry Mbouche, Georgette Guemkam, Neville Alemnju Telelen, Fru Fobuzshi Angwafo, Aurelien Maurice Sosso
BACKGROUND: The incidence of posterior urethral valve (PUV) is estimated at 1:5000-1:8000 males. It is the most common paediatric urologic urgency and the most common cause of male obstructive uropathy and chronic renal failure in children. The study aimed to describe the experience of Yaoundé gynaeco-obstetrics and paediatric hospital in the management of PUV. METHODS: Retrospectively, medical records were retrieved over a ten year period and all data recorded and analyzed for study objectives...
May 21, 2018: BMC Urology
https://www.readbyqxmd.com/read/29782353/implementing-best-practice-into-the-emergency-department-triage-process
#5
Luke Burgess, Kathryn Kynoch, Sonia Hines
BACKGROUND: Triage is the process by which emergency departments (EDs) sort patients presenting for medical treatment. The Australasian Triage Scale, validated to measure urgency, answers the question 'This patient should wait for medical assessment and treatment no longer than…' Multiple patients may present within short time frames, and some will have conditions that have outcomes directly related to timeliness of treatment such as stroke, sepsis and myocardial infarction. The safety of patients within the ED is thus directly related to the triage system...
May 17, 2018: International Journal of Evidence-based Healthcare
https://www.readbyqxmd.com/read/29780430/healthcare-professionals-perceptions-on-the-emotional-impact-of-having-an-inadequate-response-to-antidepressant-medications-survey-and-prospective-patient-audit
#6
Rajnish Mago, Andrea Fagiolini, Emmanuelle Weiller, Catherine Weiss
Background: Despite the availability of effective antidepressants, about half of patients with major depressive disorder (MDD) display an inadequate response to their initial treatment. A large patient survey recently reported that 29.8% of MDD patients experiencing an inadequate treatment response felt frustrated about their medication and 19.2% were frustrated with their healthcare provider. This survey and chart audit evaluated healthcare professionals' (HCP) views on the emotional impact of having an inadequate response to antidepressant medication...
2018: Annals of General Psychiatry
https://www.readbyqxmd.com/read/29778435/hand-hygiene-compliance-rates-fact-or-fiction
#7
Mary-Louise McLaws, Yen Lee Angela Kwok
BACKGROUND: The mandatory national hand hygiene program requires Australian public hospitals to use direct human auditing to establish compliance rates. To establish the magnitude of the Hawthorne effect, we compared direct human audit rates with concurrent automated surveillance rates. METHODS: A large tertiary Australian teaching hospital previously trialed automated surveillance while simultaneously performing mandatory human audits for 20 minutes daily on a medical and a surgical ward...
May 16, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29777153/depression-and-diabetes-distress-in-adults-with-type-2-diabetes-results-from-the-australian-national-diabetes-audit-anda-2016
#8
Natalie Nanayakkara, Anthony Pease, Sanjeeva Ranasinha, Natalie Wischer, Sofianos Andrikopoulos, Jane Speight, Barbora de Courten, Sophia Zoungas
This study explores the prevalence of, and factors associated with, likely depression and diabetes distress in adults with type 2 diabetes in a large, national sample. Australian National Diabetes Audit data were analysed from adults with type 2 diabetes attending 50 diabetes centres. The Brief Case find for Depression and Diabetes Distress Score 17 were administered to screen for likely depression and diabetes-related distress, respectively. A total of 2,552 adults with type 2 diabetes participated: (mean ± SD) age was 63 ± 13 years, diabetes duration was 12 ± 10 years, and HbA1c was 8 ± 2%...
May 18, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29776982/variable-effectiveness-of-stepwise-implementation-of-nudge-type-interventions-to-improve-provider-compliance-with-intraoperative-low-tidal-volume-ventilation
#9
Vikas N O'Reilly-Shah, George S Easton, Craig S Jabaley, Grant C Lynde
BACKGROUND: Identifying mechanisms to improve provider compliance with quality metrics is a common goal across medical disciplines. Nudge interventions are minimally invasive strategies that can influence behavioural changes and are increasingly used within healthcare settings. We hypothesised that nudge interventions may improve provider compliance with lung-protective ventilation (LPV) strategies during general anaesthesia. METHODS: We developed an audit and feedback dashboard that included information on both provider-level and department-level compliance with LPV strategies in two academic hospitals, two non-academic hospitals and two academic surgery centres affiliated with a single healthcare system...
May 18, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29771994/prevalence-outcome-and-quality-of-care-among-children-hospitalized-with-severe-acute-malnutrition-in-kenyan-hospitals-a-multi-site-observational-study
#10
Susan Gachau, Grace Irimu, Philip Ayieko, Samuel Akech, Ambrose Agweyu, Mike English
BACKGROUND: Severe acute malnutrition (SAM) remains a major cause of admission and inpatient mortality worldwide in children aged less than 5 years. In this study, we explored SAM prevalence and outcomes in children admitted in 13 Kenyan hospitals participating in a Clinical Information Network (CIN). We also describe their immediate in-patient management. METHODS: We analyzed data for children aged 1-59 months collected retrospectively from medical records after discharge...
2018: PloS One
https://www.readbyqxmd.com/read/29760272/physical-activity-assessment-and-counseling-in-quebec-family-medicine-groups
#11
Aurélie Baillot, Jean-Patrice Baillargeon, Alex Paré, Thomas G Poder, Christine Brown, Marie-France Langlois
OBJECTIVE: To determine how often primary health care providers (PHCPs) in family medicine groups (FMGs) assess physical activity (PA) levels, provide PA counseling (PAC), and refer patients to exercise professionals; to describe patients' PA levels, physical fitness, and satisfaction regarding their PA management in FMGs; to describe available PA materials in FMGs and PHCPs' PAC self-efficacy and PA knowledge; and to identify characteristics of patients and PHCPs that determine the assessment of PA and PAC provided by PHCPs...
May 2018: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29757346/effectiveness-of-a-multifaceted-intervention-to-reduce-night-time-sedative-use-in-a-rehabilitation-unit-a-pre-post-intervention-study
#12
Juliana Delos Reyes, Anthony T Sharkey, Laura Morrison, Maria Costello, Cate Crowe, Robert Murphy, Shaun T O'Keeffe, Eamon C Mulkerrin
Background: night-time sedation prescribed during a hospital stay can result in long-term use of such medications in older people. We examined the effectiveness of a multifaceted intervention to reduce night time sedation in an inpatient rehabilitation unit. Methods: an initial retrospective survey of night-time sedative use was followed by prospective re-evaluation after a number of changes were made including education of staff and of patients regarding the potential hazards of sedative medications, measures to promote sleep hygiene and facilitate a 'quiet time' after 10 pm and development of a withdrawal protocol for patients on long-term night sedation...
May 11, 2018: Age and Ageing
https://www.readbyqxmd.com/read/29754594/review-of-medication-errors-that-are-new-or-likely-to-occur-more-frequently-with-electronic-medication-management-systems
#13
Melita Van de Vreede, Anne McGrath, Jan de Clifford
Objective. The aim of the present study was to identify and quantify medication errors reportedly related to electronic medication management systems (eMMS) and those considered likely to occur more frequently with eMMS. This included developing a new classification system relevant to eMMS errors. Methods. Eight Victorian hospitals with eMMS participated in a retrospective audit of reported medication incidents from their incident reporting databases between May and July 2014. Site-appointed project officers submitted deidentified incidents they deemed new or likely to occur more frequently due to eMMS, together with the Incident Severity Rating (ISR)...
May 14, 2018: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29751806/pain-medicine-content-teaching-and-assessment-in-medical-school-curricula-in-australia-and-new-zealand
#14
Elspeth Erica Shipton, Frank Bate, Raymond Garrick, Carole Steketee, Eric John Visser
BACKGROUND: The objective of pain medicine education is to provide medical students with opportunities to develop their knowledge, skills and professional attitudes that will lead to their becoming safe, capable, and compassionate medical practitioners who are able to meet the healthcare needs of persons in pain. This study was undertaken to identify and describe the delivery of pain medicine education at medical schools in Australia and New Zealand. METHOD: All 23 medical schools in Australia and New Zealand in 2016 were included in this study...
May 11, 2018: BMC Medical Education
https://www.readbyqxmd.com/read/29750227/facilitators-context-of-and-barriers-to-acute-coronary-syndrome-care-at-kenyatta-national-hospital-nairobi-kenya-a-qualitative-analysis
#15
Ehete Bahiru, Tecla Temu, Julia Mwanga, Kevin Ndede, Sophie Vusha, Bernard Gitura, Carey Farquhar, Frederick Bukachi, Mark D Huffman
BACKGROUND: The prevalence of ischaemic heart disease and its acute manifestation, acute coronary syndrome (ACS), is growing throughout sub-Saharan Africa, including Kenya. To address this increasing problem, we sought to understand the facilitators, context of and barriers to ACS care at Kenyatta National Hospital, with the aim of improving the quality of care of ACS. METHODS: We conducted in-depth interviews with healthcare providers involved in the management of ACS patients from January to February 2017 at Kenyatta National Hospital in Nairobi, Kenya...
April 20, 2018: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/29747564/reduse-reducing-antipsychotic-and-benzodiazepine-prescribing-in-residential-aged-care-facilities
#16
Juanita L Westbury, Peter Gee, Tristan Ling, Donnamay T Brown, Katherine H Franks, Ivan Bindoff, Aidan Bindoff, Gregory M Peterson
OBJECTIVE: To assess the impact of a multi-strategic, interdisciplinary intervention on antipsychotic and benzodiazepine prescribing in residential aged care facilities (RACFs). Design, setting: Prospective, longitudinal intervention in Australian RACFs, April 2014 - March 2016. PARTICIPANTS: 150 RACFs (with 12 157 residents) comprised the main participant group; two further groups were consultant pharmacists (staff education) and community pharmacies (prescribing data)...
May 14, 2018: Medical Journal of Australia
https://www.readbyqxmd.com/read/29744539/community-based-pre-pregnancy-care-programme-improves-pregnancy-preparation-in-women-with-pregestational-diabetes
#17
Jennifer M Yamamoto, Deborah J F Hughes, Mark L Evans, Vithian Karunakaran, John D A Clark, Nicholas J Morrish, Gerry A Rayman, Peter H Winocour, Clare Hambling, Amanda W Harries, Michael J Sampson, Helen R Murphy
AIMS/HYPOTHESIS: Women with diabetes remain at increased risk of adverse pregnancy outcomes associated with poor pregnancy preparation. However, women with type 2 diabetes are less aware of and less likely to access pre-pregnancy care (PPC) compared with women with type 1 diabetes. We developed and evaluated a community-based PPC programme with the aim of improving pregnancy preparation in all women with pregestational diabetes. METHODS: This was a prospective cohort study comparing pregnancy preparation measures before and during/after the PPC intervention in women with pre-existing diabetes from 1 June 2013 to 28 February 2017...
May 9, 2018: Diabetologia
https://www.readbyqxmd.com/read/29741519/addressing-prescription-discrepancies-in-renal-patients-a-prospective-audit
#18
S Lam, S Docherty, J E Taylor
Background Management of chronic renal failure requires complex medication regimens to manage hypertension, hyperlipidaemia, diabetes, phosphate, anaemia and acidosis. Patient engagement in medicine management is essential to avoid potential harm. Methods We prospectively audited the rate of discrepancies between our hospital record of patient medications and their current prescription. We investigated whether changes to appointment letters reduced the number of discrepancies. Results The proportion of patients attending renal outpatient clinics failing to bring a list or unable to recall their medications fell over a 3-year period following changes to appointment letters (median proportion: 0...
March 2018: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/29740931/antimicrobial-prescription-in-patients-dying-from-chronic-obstructive-pulmonary-disease
#19
John Taverner, Lauren Ross, Claire Bartlett, M Luthe, J Ong, Louis Irving, Natasha Smallwood
INTRODUCTION: Despite rising antimicrobial resistance, treatment guidelines for COPD exacerbations are frequently ignored. Patients with terminal conditions are often prescribed antimicrobials despite the goal of care to reduce burdensome treatments. The appropriateness of antimicrobials in patients dying from an exacerbation of COPD is unknown. AIM: To review antimicrobial prescription at the time of death in patients who died from COPD. METHODS: A retrospective medical record audit was performed for 475 patients who died over twelve years (2004-2015)...
May 9, 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29737196/changing-characteristics-of-a-psychiatric-emergency-care-centre-an-eight-year-follow-up-study
#20
Joanne Seymour, Tristan Chapman, Vladan Starcevic, Kirupamani Viswasam, Vlasios Brakoulias
OBJECTIVE: The objective of this study was to report changes in characteristics of admissions to an established Psychiatric Emergency Care Centre (PECC) eight years after its opening. METHOD: Key clinical characteristics of admissions to the PECC were documented for 327 patients in 2015 and compared with the 477 patients in 2007, which is when the centre first opened. The characteristics of admission were evaluated using an audit of medical records from June to December in both 2007 and 2015...
May 1, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
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