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https://www.readbyqxmd.com/read/29149456/effect-of-a-thermal-care-bundle-on-the-prevention-detection-and-treatment-of-perioperative-inadvertent-hypothermia
#1
Jed Duff, Kim Walker, Karen-Leigh Edward, Nicholas Ralph, Jo-Ann Giandinoto, Kimberley Alexander, Jeffrey Gow, John Stephenson
AIMS AND OBJECTIVES: To improve the prevention, detection, and treatment of perioperative inadvertent hypothermia (PIH) in adult surgical patients by implementing a Thermal Care Bundle. BACKGROUND: Keeping patients normothermic perioperatively prevents adverse surgical outcomes. Hypothermia leads to serious complications including increased risk of surgical bleeding, surgical site infections, and morbid cardiac events. The Thermal Care Bundle consists of three elements: 1) assess risk; 2) record temperature; and (3) actively warm...
November 17, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29148172/quality-of-handwritten-surgical-operative-notes-from-surgical-trainees-a-noteworthy-issue
#2
Tatenda C Nzenza, Todd Manning, Simeon Ngweso, Marlon Perera, Shomik Sengupta, Damien Bolton, Nathan Lawrentschuk
BACKGROUND: Surgical operation notes are crucial for medical record keeping and information flow in continued patient care. In addition to inherent medical implications, the quality of operative notes also has important economic and medico-legal ramifications. Further, well-documented records can also be useful for audit purposes and propagation of research, facilitating the improvement of delivery of care to patients. We aimed to assess the quality of surgical operation notes written by junior doctors and trainees against a set standard, to ascertain whether these standards were met...
November 17, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29141623/low-uptake-of-aboriginal-interpreters-in-healthcare-exploration-of-current-use-in-australia-s-northern-territory
#3
Anna P Ralph, Anne Lowell, Jean Murphy, Tara Dias, Deborah Butler, Brian Spain, Jaquelyne T Hughes, Lauren Campbell, Barbara Bauert, Claire Salter, Kylie Tune, Alan Cass
BACKGROUND: In Australia's Northern Territory, most Aboriginal people primarily speak an Aboriginal language. Poor communication between healthcare providers and Aboriginal people results in adverse outcomes including death. This study aimed to identify remediable barriers to utilisation of Aboriginal Interpreter services at the Northern Territory's tertiary hospital, which currently manages over 25,000 Aboriginal inpatients annually. METHODS: This is a multi-method study using key stakeholder discussions, medical file audit, bookings data from the Aboriginal Interpreter Service 2000-2015 and an online cross-sectional staff survey...
November 15, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29137585/association-of-positive-fluid-balance-and-mortality-in-sepsis-and-septic-shock-in-an-australian-cohort
#4
M G Pittard, S J Huang, A S McLean, S R Orde
In patients with septic shock, a correlation between positive fluid balance and worsened outcomes has been reported in multiple observational studies worldwide. No published data exists in an Australasian cohort. We set out to explore this association in our institution. We conducted a retrospective audit of patient records from August 2012 to May 2015 in a single-centre, 24-bed surgical and medical intensive care unit (ICU) in Sydney, Australia. All patients with septic shock were included. Exclusion criteria included length of stay less than 24 hours or vasopressors needed for less than six hours...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29135754/implementation-of-a-pediatric-behavioral-staffing-algorithm-in-an-acute-hospital-a-best-practice-implementation-project
#5
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/29134926/influence-of-stroke-coordinators-on-delivery-of-acute-stroke-care-and-hospital-outcomes-an-observational-study
#6
Tara Purvis, Monique F Kilkenny, Sandy Middleton, Dominique A Cadilhac
Background Stroke coordinators have been inconsistently used in various countries to support stroke care in hospital. Aim To investigate the association between stroke coordinators and the provision of evidence-based care and patient outcomes in hospitals with acute stroke units. Methods Observational study using cross-sectional data from the 2015 National Acute Services Audit Program (Australia): including a retrospective medical record audit (40 records from each hospital) and a self-reported survey of organizational resources for stroke...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29132455/going-beyond-the-9-1-1-call-what-bc-emergency-health-services-is-doing-to-improve-timely-access-to-emergency-care
#7
Kerry Campbell, Jessica Jaiven, Kimberly Banfield, Corinne Begg, Janice Butler, Leanne Thain
British Columbia Emergency Health Services (BCEHS) uses an internationally recognized Medical Priority Dispatch System to assign appropriate responses to 9-1-1 calls based on patients' clinical acuity. In 2015, 71% of Omega calls (classified as calls involving low acuity injuries) were assigned an ambulance. To better meet patients' needs, BCEHS collaborated with HealthLink BC's Nursing Services (HLBC NS) to audit over 2,000 calls. Based on the results, three Plan, Do, Study, Act (PDSA) cycles were implemented, yielding a 35% decrease in ambulances assigned and a 173% increase in referrals to HLBC NS to provide more suitable support...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/29130288/optimising-early-neonatal-nutrition-using-translational-research-methodology
#8
Denise Page, Melissa Gilroy, Elizabeth Hurrion, Lisa Clark, Shelley Wilkinson
AIM: Preterm birth has been described as a 'nutritional emergency', with these infants often born with minimal nutrition reserves. Failure to provide adequate early nutrition jeopardises growth and neurodevelopment. Consensual nutrition guidelines exist for infants who weigh <1500 g; however, audits have identified shortfalls in their adherence, consequently highlighting an evidence-practice gap. This work aimed to identify the barriers to the delivery of early optimal nutrition in a tertiary-level Neonatal Critical Care Unit to inform an implementation project to ensure best practice care...
November 2017: Nutrition & Dietetics: the Journal of the Dietitians Association of Australia
https://www.readbyqxmd.com/read/29129518/breast-cancer-screening-with-digital-breast-tomosynthesis-4-year-experience-and-comparison-with-national-data
#9
Huay-Ben Pan, Kam-Fai Wong, Anthony Yao, Giu-Cheng Hsu, Chen-Pin Chou, Huei-Lung Liang, Jer-Shyung Huang, Hung-Ju Li, Shu-Chin Wang, Tsung-Lung Yang
BACKGROUND: To determine if mammography combined with tomosynthesis (DBT) leads to superior performance in screening for breast cancer compared to digital mammography alone. METHODS: We retrospectively collected data from A) the results of population-based mammography-screening provided by the National Cancer Registry in Taiwan, and B) the results from all screening mammography performed with DBT from 2012 through 2015 at Veterans General Hospital Kaohsiung (VGHKS) since the institution of DBT at the end of 2011...
November 9, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29124913/measurement-of-lying-and-standing-blood-pressure-in-hospital
#10
Shelagh O'Riordan, Naomi Vasilakis, Labib Hussain, Rowena Schoo, Julie Whitney, Julie Windsor, Khim Horton, Finbarr Martin
Measuring lying and standing blood pressure (BP) is an important clinical observation in older hospital inpatients. This is because a drop in BP on standing, known as orthostatic hypotension (OH) is common in older people and in acute illness and, therefore, in hospital patients. OH increases the risk of a fall in hospital. Simple measures such as changes in medication or rehydration can reduce this drop in BP and reduce the risk of falls. In a recent snapshot audit in England and Wales of 179 acute hospitals and 4,846 patients aged 65 years and over admitted with an acute illness, only 16% had a lying and standing BP recorded within 48 hours...
September 29, 2017: Nursing Older People
https://www.readbyqxmd.com/read/29121623/metabolic-monitoring-in-new-zealand-district-health-board-mental-health-services
#11
Aimee Staveley, Ian Soosay, Anthony J O'Brien
AIM: To audit New Zealand district health boards' (DHBs) metabolic monitoring policies in relation to consumers prescribed second-generation antipsychotic medications using a best practice guideline. METHODS: Metabolic monitoring policies from DHBs and one private clinic were analysed in relation to a best practice standard developed from the current literature and published guidelines relevant to metabolic syndrome. RESULTS: Fourteen of New Zealand's 20 DHBs currently have metabolic monitoring policies for consumers prescribed antipsychotic medication...
November 10, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/29121175/association-of-the-presence-of-trainees-with-outpatient-appointment-times-in-an-ophthalmology-clinic
#12
Isaac H Goldstein, Michelle R Hribar, Sarah Read-Brown, Michael F Chiang
Importance: Physicians face pressure to improve clinical efficiency, particularly with electronic health record (EHR) adoption and gradual shifts toward value-based reimbursement models. These pressures are especially pronounced in academic medical centers, where delivery of care must be balanced with medical education. However, the association of the presence of trainees with clinical efficiency in outpatient ophthalmology clinics is not known. Objective: To quantify the association of the presence of trainees (residents and fellows) and efficiency in an outpatient ophthalmology clinic...
November 9, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/29120878/investigating-the-effects-of-under-triage-by-existing-major-incident-triage-tools
#13
James M Vassallo, Jason E Smith, Lee A Wallis
OBJECTIVES: Triage is a key principle in the effective management of a major incident. Its effectiveness is a balance between identifying those in need of life-saving intervention, and those triaged incorrectly as either needing/not needing life-saving intervention. The primary aim of this study was to report mortality in those under-triaged by existing major incident triage tools. Secondary aims were to report the ability of triage tools at identifying serious injury by body region (defined as the Abbreviated Injury Scale≥3)...
November 8, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29120503/route-to-improving-type-1-diabetes-mellitus-glycaemic-outcomes-real-world-evidence-taken-from-the-national-diabetes-audit
#14
A H Heald, M Livingston, A Fryer, G Y C Moreno, N Malipatil, R Gadsby, W Ollier, M Lunt, M Stedman, R J Young
AIM: To use general practice-level data for England, available through the National Diabetes Audit, and primary care prescribing data to identify prescription treatment factors associated with variations in achieved glucose control (HbA1c ). METHODS: General practice-level National Diabetes Audit data on Type 1 diabetes, including details of population characteristics, services, proportion of people achieving target glycaemic control [HbA1c ≤58 mmol/mol (7.5%)] and proportion of people at high glycaemic risk [HbA1c >86 mmol/ml (10%)], were linked to 2013-2016 primary care diabetes prescribing data on insulin types and blood glucose monitoring for all people with diabetes...
November 9, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29120385/hospital-audit-as-a-useful-tool-in-the-process-of-introducing-falsified-medicines-directive-fmd-into-hospital-pharmacy-settings-a-pilot-study
#15
Urszula Religioni, Damian Swieczkowski, Anna Gawrońska, Anna Kowalczuk, Mariola Drozd, Mikołaj Zerhau, Dariusz Smoliński, Stanisław Radomiński, Natalia Cwalina, David Brindley, Miłosz J Jaguszewski, Piotr Merks
BACKGROUND: Recently, the European Union has introduced the Falsified Medicines Directive (FMD). Additionally, in early 2016, a Delegated Act (DA) related to the FMD was published. The main objective of this study was to evaluate the usefulness of external audits in the context of implementing new regulations provided by the FMD in the secondary care environment. METHODS: The external, in-person workflow audits were performed by an authentication company in three Polish hospital pharmacies...
November 9, 2017: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/29120292/survival-and-negotiation-narratives-of-severe-near-miss-neonatal-complications-of-syrian-women-in-lebanon
#16
Livia Wick
The World Health Organization has elaborated a maternal and neonatal near-miss reporting, audit and feedback system designed to improve the quality of care during and after childbirth. As part of a four-hospital comparative study in the Middle East, this article discusses the experiences of mothers whose newborns suffered from severe complications at birth in the Rafik Hariri University Hospital, the only public hospital in Beirut. Based on in-depth home interviews several weeks after childbirth, it aims to explore the experience of neonatal near-miss events through the mothers' birth narratives...
October 2017: Reproductive Health Matters
https://www.readbyqxmd.com/read/29110295/prevalence-and-variability-in-medications-contributing-to-polypharmacy-in-long-term-care-facilities
#17
Natali Jokanovic, Kris M Jamsen, Edwin C K Tan, Michael J Dooley, Carl M Kirkpatrick, J Simon Bell
BACKGROUND: Research into which medications contribute to polypharmacy and the variability in these medications across long-term care facilities (LTCFs) has been minimal. OBJECTIVE: Our objective was to investigate which medications were more prevalent among residents with polypharmacy and to determine the variability in prescribing of these medications across LTCFs. METHODS: This was a cross-sectional study of 27 LTCFs in regional and rural Victoria, Australia...
December 2017: Drugs—Real World Outcomes
https://www.readbyqxmd.com/read/29110186/patient-safety-ward-round-checklist-via-an-electronic-app-implications-for-harm-prevention
#18
C Keller, S Arsenault, M Lamothe, S R Bostan, R O'Donnell, J Harbison, C P Doherty
INTRODUCTION: Patient safety is a value at the core of modern healthcare. Though awareness in the medical community is growing, implementing systematic approaches similar to those used in other high reliability industries is proving difficult. The aim of this research was twofold, to establish a baseline for patient safety practices on routine ward rounds and to test the feasibility of implementing an electronic patient safety checklist application. METHODS: Two research teams were formed; one auditing a medical team to establish a procedural baseline of "usual care" practice and an intervention team concurrently was enforcing the implementation of the checklist...
November 6, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29108961/rare-ovarian-tumours-epidemiology-treatment-challenges-in-and-outside-a-network-setting
#19
I Ray-Coquard, AnnaLisa Trama, M J Seckl, C Fotopoulou, P Pautier, S Pignata, G Kristensen, G Mangili, H Falconer, L Massuger, J Sehouli, E Pujade-Lauraine, D Lorusso, F Amant, E Rokkones, I Vergote, J A Ledermann
PURPOSE OF THE REVIEW: More than 50% of all gynaecological cancers can be classified as rare tumours (defined as an annual incidence of <6 per 100,000) and such tumours represent an important challenge for clinicians. RECENT FINDINGS: Rare cancers account for more than one fifth of all new cancer diagnoses, more than any of the single common cancers alone. Reviewing the RARECAREnet database, some of the tumours occur infrequently, whilst others because of their natural history have a high prevalence, and therefore appear to be more common, although their incidence is also rare...
November 3, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29107565/rubber-stamp-templates-for-improving-clinical-documentation-a-paper-based-m-health-approach-for-quality-improvement-in-low-resource-settings
#20
Bernadette Kleczka, Anita Musiega, Grace Rabut, Phoebe Wekesa, Paul Mwaniki, Michael Marx, Pratap Kumar
BACKGROUND: The United Nations' Sustainable Development Goal #3.8 targets 'access to quality essential healthcare services'. Clinical practice guidelines are an important tool for ensuring quality of clinical care, but many challenges prevent their use in low-resource settings. Monitoring the use of guidelines relies on cumbersome clinical audits of paper records, and electronic systems face financial and other limitations. Here we describe a unique approach to generating digital data from paper using guideline-based templates, rubber stamps and mobile phones...
October 23, 2017: International Journal of Medical Informatics
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