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https://www.readbyqxmd.com/read/28809591/reducing-inappropriate-non-steroidal-anti-inflammatory-prescription-in-primary-care-patients-with-chronic-kidney-disease
#1
David M Keohane, Thomas Dennehy, Kenneth P Keohane, Eamonn Shanahan
Purpose The purpose of this paper is to reduce inappropriate non-steroidal anti-inflammatory prescribing in primary care patients with chronic kidney disease (CKD). Once diagnosed, CKD management involves delaying progression to end stage renal failure and preventing complications. It is well established that non-steroidal anti-inflammatories have a negative effect on kidney function and consequently, all nephrology consensus groups suggest avoiding this drug class in CKD. Design/methodology/approach The sampling criteria included all practice patients with a known CKD risk factor...
August 14, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28809390/clinical-features-and-surgical-outcomes-of-cervical-spondylotic-myelopathy-in-patients-of-different-ages-a-retrospective-study
#2
R J Zhang, C L Shen, J X Zhang, X J Zhang, F L Dong, H Tao, P W Song, P Ge, P Xu, H Q Zhang
STUDY DESIGN: Retrospective chart audit. OBJECTIVES: This study aims to compare the clinical features and surgical outcomes in patients with cervical spondylotic myelopathy (CSM) among different age groups. SETTING: The first Affiliated Hospital of Anhui Medical University, China. METHODS: A total of 460 patients with CSM who were surgically treated over the period of 1995-2009 were investigated. Considering the peak age (40-60 years old) for the onset of symptoms, we divided the patients into three groups by age: young (<40), middle-aged (40-60), and old (>60)...
August 15, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28808942/primary-care-providers-opening-of-time-sensitive-alerts-sent-to-commercial-electronic-health-record-inbaskets
#3
Sarah L Cutrona, Hassan Fouayzi, Laura Burns, Rajani S Sadasivam, Kathleen M Mazor, Jerry H Gurwitz, Lawrence Garber, Devi Sundaresan, Thomas K Houston, Terry S Field
BACKGROUND: Time-sensitive alerts are among the many types of clinical notifications delivered to physicians' secure InBaskets within commercial electronic health records (EHRs). A delayed alert review can impact patient safety and compromise care. OBJECTIVE: To characterize factors associated with opening of non-interruptive time-sensitive alerts delivered into primary care provider (PCP) InBaskets. DESIGN AND PARTICIPANTS: We analyzed data for 799 automated alerts...
August 14, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28806495/international-uptake-of-a-proven-intervention-to-reduce-death-and-dependency-in-acute-stroke-a-cross-sectional-survey-following-the-qasc-trial
#4
Sandy Middleton, Dominik Bruch, Cintia Martinez-Garduno, Simeon Dale, Maria McNamara
BACKGROUND: Uptake of proven interventions requires dedicated resources that may only result in local implementation, thus precluding international practice change. We explored international uptake through online dissemination of the fever, sugar, and swallow (FeSS) protocols from the Quality in Acute Stroke Care (QASC) trial, which showed decreased death and dependency by 15.7% 90-day poststroke. AIMS: To identify: (a) the clinical discipline of healthcare professionals who downloaded the QASC resources; (b) the purpose for downloading; (c) successful implementation of any or all the FeSS protocols; (d) barriers to implementation; and (e) associations with self-reported successful implementation...
August 14, 2017: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/28799272/results-of-a-national-multicenter-audit-assessment-of-gynecologic-history-in-surgical-patients
#5
Michael S J Wilson, Matilda Powell-Bowns, Andrew G Robertson, Andreas Luhmann, Colin H Richards
OBJECTIVE: To determine the adequacy of assessing gynecologic history for females of reproductive age (FRA) admitted to a general surgery department. METHODS: The present prospective multicenter audit included FRA who were admitted for elective or emergency procedures to general surgery departments in Scotland between May 11 and May 25, 2015. Data were compared between patients who were admitted for elective and emergency treatment. RESULTS: There were 530 FRA included from 18 centers, including 169 (31...
August 11, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28792802/utility-of-bi-rads-assessment-category-4-subdivisions-for-screening-breast-mri
#6
Roberta M Strigel, Elizabeth S Burnside, Mai Elezaby, Amy M Fowler, Frederick Kelcz, Lonie R Salkowski, Wendy B DeMartini
OBJECTIVE: BI-RADS for mammography and ultrasound subdivides category 4 assessments by likelihood of malignancy into categories 4A (> 2% to ≤ 10%), 4B (> 10% to ≤ 50%), and 4C (> 50% to < 95%). Category 4 is not subdivided for breast MRI because of a paucity of data. The purpose of the present study is to determine the utility of categories 4A, 4B, and 4C for MRI by calculating their positive predictive values (PPVs) and comparing them with BI-RADS-specified rates of malignancy for mammography and ultrasound...
June 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28792620/cut-point-levels-of-phosphatidylethanol-to-identify-alcohol-misuse-in-a-mixed-cohort-including-critically-ill-patients
#7
Majid Afshar, Ellen L Burnham, Cara Joyce, Brendan J Clark, Meagan Yong, Jeannette Gaydos, Richard S Cooper, Gordon S Smith, Elizabeth J Kovacs, Erin M Lowery
BACKGROUND: Although alcohol misuse is associated with deleterious outcomes in critically ill patients, its detection by either self-report or examination of biomarkers is difficult to obtain consistently. Phosphatidylethanol (PEth) is a direct alcohol biomarker that can characterize alcohol consumption patterns; however, its diagnostic accuracy in identifying misuse in critically ill patients is unknown. METHODS: PEth values were obtained in a mixed cohort comprised of 122 individuals from medical and burn intensive care units (n=33), alcohol detoxification unit (n=51), and healthy volunteers (n=38)...
August 9, 2017: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/28790791/mortality-audit-of-medical-patients-at-armed-forces-hospitals
#8
K V S Hari Kumar, N S Ajai Chandra
The mortality statistics of the medical patients at our tertiary care hospitals are sparse and lacking. We studied the mortality characteristics of the patients admitted to medical wards and intensive care unit at two hospitals based on the available fatal documents. Our objectives include analysis of the cause of death, duration of stay and presence of sepsis. The deceased (103 males, 47 females) had a mean age of 64.6 ± 15.5 yrs and mean duration of stay 7.1 ± 12.3 days. Infections and sepsis syndrome (33%), respiratory (17%), neurological (15%) and cardiovascular disorders (10%) were the top four causes of the mortality...
July 2017: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/28780552/a-surveillance-study-to-determine-the-accuracy-of-mild-traumatic-brain-injury-diagnosis-in-an-emergency-department-protocol-for-a-retrospective-cohort-study
#9
Ilaria Pozzato, Ian D Cameron, Susanne Meares, Annette Kifley, Kim Van Vu, Anthony Liang, Mark Gillett, Ashley Craig, Bamini Gopinath
INTRODUCTION: Previous literature confirms that a mild traumatic brain injury (mTBI) may result in long-term emotional impacts and, in vulnerable subgroups, cognitive deficits. The accurate diagnosis of mTBI and its written documentation is an important first step towards providing appropriate and timely clinical care. Surveillance studies involving emergency department (ED) and hospital-based data need to be prioritised as these provide incident mTBI estimates. This project will advance existing research findings by estimating the occurrence of mTBI among those attending an ED and quantifying the accuracy of mTBI diagnoses recorded by ED staff through a comprehensive audit of ED records...
August 4, 2017: BMJ Open
https://www.readbyqxmd.com/read/28780551/the-indigenous-counselling-and-nicotine-ican-quit-in-pregnancy-pilot-study-protocol-a-feasibility-step-wedge-cluster-randomised-trial-to-improve-health-providers-management-of-smoking-during-pregnancy
#10
Yael Bar-Zeev, Billie Bonevski, Michelle Bovill, Maree Gruppetta, Chris Oldmeadow, Kerrin Palazzi, Lou Atkins, Jennifer Reath, Gillian S Gould
INTRODUCTION: Indigenous women have the highest smoking prevalence during pregnancy (47%) in Australia. Health professionals report lack of knowledge, skills and confidence to effectively manage smoking among pregnant women in general. We developed a behaviour change intervention aimed to improve health professionals' management of smoking in Indigenous pregnant women-the Indigenous Counselling And Nicotine (ICAN) QUIT in Pregnancy. This intervention includes webinar training for health professionals, an educational resources package for health professionals and pregnant women, free oral nicotine replacement therapy (NRT) for pregnant women, and audit and feedback on health professionals' performance...
August 4, 2017: BMJ Open
https://www.readbyqxmd.com/read/28774374/effectiveness-and-cost-effectiveness-of-serum-b-type-natriuretic-peptide-testing-and-monitoring-in-patients-with-heart-failure-in-primary-and-secondary-care-an-evidence-synthesis-cohort-study-and-cost-effectiveness-model
#11
Maria Pufulete, Rachel Maishman, Lucy Dabner, Syed Mohiuddin, William Hollingworth, Chris A Rogers, Julian Higgins, Mark Dayer, John Macleod, Sarah Purdy, Theresa McDonagh, Angus Nightingale, Rachael Williams, Barnaby C Reeves
BACKGROUND: Heart failure (HF) affects around 500,000 people in the UK. HF medications are frequently underprescribed and B-type natriuretic peptide (BNP)-guided therapy may help to optimise treatment. OBJECTIVE: To evaluate the clinical effectiveness and cost-effectiveness of BNP-guided therapy compared with symptom-guided therapy in HF patients. DESIGN: Systematic review, cohort study and cost-effectiveness model. SETTING: A literature review and usual care in the NHS...
August 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28768366/semi-automatic-electronic-stent-register-a-novel-approach-to-preventing-ureteric-stents-lost-to-follow-up
#12
James W H Macneil, Peter Michail, Manish I Patel, Julie Ashbourne, Simon V Bariol, David A Ende, Tania A Hossack, Howard Lau, Audrey C Wang, Andrew J Brooks
BACKGROUND: Ureteric stents are indispensable tools in modern urology; however, the risk of them not being followed-up once inserted poses medical and medico-legal risks. Stent registers are a common solution to mitigate this risk; however, manual registers are logistically challenging, especially for busy units. METHODS: Western Sydney Local Health District developed a novel Semi-Automatic Electronic Stent Register (SAESR) utilizing billing information to track stent insertions...
August 2, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28767690/a-simplified-prevention-bundle-with-dual-hand-hygiene-audit-reduces-early-onset-ventilator-associated-pneumonia-in-cardiovascular-surgery-units-an-interrupted-time-series-analysis
#13
Kang-Cheng Su, Yu Ru Kou, Fang-Chi Lin, Chieh-Hung Wu, Jia-Yih Feng, Shiang-Fen Huang, Tao-Fen Shiung, Kwei-Chun Chung, Yu-Hsiu Tung, Kuang-Yao Yang, Shi-Chuan Chang
BACKGROUND: To investigate the effect of a simplified prevention bundle with alcohol-based, dual hand hygiene (HH) audit on the incidence of early-onset ventilation-associated pneumonia (VAP). METHODS: This 3-year, quasi-experimental study with interrupted time-series analysis was conducted in two cardiovascular surgery intensive care units in a medical center. Unaware external HH audit (eHH) performed by non-unit-based observers was a routine task before and after bundle implementation...
2017: PloS One
https://www.readbyqxmd.com/read/28767296/advance-care-planning-discussions-with-adolescent-and-young-adult-cancer-patients-admitted-to-a-community-palliative-care-service-a-retrospective-case-note-audit
#14
Sophie Fletcher, Rachel Hughes, Sarah Pickstock, Kirsten Auret
PURPOSE: Adolescents and young adults (AYA) with cancer are a cohort requiring specialized healthcare models to address unique cognitive and physical challenges. Advance care planning (ACP) discussions likely warrant age-appropriate adaptation, yet, there is little Australian research data available to inform best practice for this group. The goal of this work is to inform future models of ACP discussions for AYA. METHODS: Retrospective medical record audit of AYA patients and an adult comparison group, diagnosed with a malignancy and referred to a community hospice service, in Western Australia, in the period between January 1, 2012 and December 1, 2015...
August 2, 2017: Journal of Adolescent and Young Adult Oncology
https://www.readbyqxmd.com/read/28766529/-the-coroner-s-autopsies-in-the-great-britain-the-problems-related-to-the-quality-of-the-studies-standardization-auditing-financial-support-and-the-approaches-to-their-solution-part-2
#15
I Ju Makarov, T A Kuprina, A A Gusarov, V A Fetisov
This article extends the previous publication of the authors based on the analysis of the detailed report of the experts of the National Confidential Enquiry into Patient Outcome and Death program (NCEPOD) issued in the Great Britain in 2006. The analysis has demonstrated that all autopsy studies should invariably involve measurement of the corpse length and weight (including body mass index) as well as the detailed description of all injuries to the body (or references to their absence). All autopsy studies should be carried out only by a medical professional (e...
2017: Sudebno-meditsinskaia Ekspertiza
https://www.readbyqxmd.com/read/28765252/management-of-gout-in-a-hospital-setting-a-lost-opportunity
#16
Sarah Wright, Peter T Chapman, Christopher Frampton, John L O'Donnell, Rafi Raja, Lisa Stamp
OBJECTIVE: Management of gout is frequently suboptimal. The aim of this study was to determine the proportion of patients presenting to Christchurch Hospital for a gout flare and to determine whether management for both acute flares and urate lowering was in accordance with international recommendations. METHODS: A retrospective audit was undertaken of all admissions to Christchurch Hospital from June 1, 2013, to May 31, 2014, in which gout was coded as a primary or secondary discharge diagnosis...
August 1, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28765104/a-technological-innovation-to-reduce-prescribing-errors-based-on-implementation-intentions-the-acceptability-and-feasibility-of-myprescribe
#17
Chris Keyworth, Jo Hart, Hong Thoong, Jane Ferguson, Mary Tully
BACKGROUND: Although prescribing of medication in hospitals is rarely an error-free process, prescribers receive little feedback on their mistakes and ways to change future practices. Audit and feedback interventions may be an effective approach to modifying the clinical practice of health professionals, but these may pose logistical challenges when used in hospitals. Moreover, such interventions are often labor intensive. Consequently, there is a need to develop effective and innovative interventions to overcome these challenges and to improve the delivery of feedback on prescribing...
August 1, 2017: JMIR Human Factors
https://www.readbyqxmd.com/read/28758798/reconfiguring-diagnostic-work-in-danish-general-practice-regulation-triage-and-the-receptionist-as-diagnostician
#18
Rikke Sand Andersen, Rikke Aarhus
Health care systems as well as bodies of medical knowledge are dynamic and change as the result of political and social transformations. In recent decades, health care systems have been subjected to a whole assemblage of regulatory practices. The local changes undertaken in Denmark that are being explored here are indicative of a long-term shift that has occurred in many welfare states intended to make public services in the Global North more efficient and transparent. Departing in prolonged field work in Danish general practice and the anthropological literature on audit culture, this paper suggests that the introduction of regulatory practices has enhanced the need for triage as a key organising principle...
July 31, 2017: Anthropology & Medicine
https://www.readbyqxmd.com/read/28758615/determinants-of-implementation-of-isolation-precautions-against-infections-by-multidrug-resistant-microorganisms-a-hospital-based-multicenter-observational-study
#19
Thomas Bénet, Raphaele Girard, Solweig Gerbier-Colomban, Cédric Dananché, Elisabeth Hodille, Olivier Dauwalder, Philippe Vanhems
OBJECTIVES We aimed to ascertain the factors associated with lack of isolation precautions (IP) in patients infected or colonized by third-generation cephalosporin-resistant Enterobacteriaceae (3GCR-E) and methicillin-resistant Staphylococcus aureus (MRSA) in hospital settings. DESIGN Prospective surveillance and audit of practices. SETTING The study included 4 university hospitals in Lyon, France. PARTICIPANTS All patients hospitalized between April and June in 2013 and 2015 were included. Case patients had ≥1 clinical sample positive for MRSA and/or 3GCR-E...
July 31, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28756907/universal-screening-for-alcohol-misuse-in-acute-medical-admissions-is-feasible-and-identifies-patients-at-high-risk-of-liver-disease
#20
Greta Westwood, Paul Meredith, Susan Atkins, Peter Greengross, Paul E Schmidt, Richard J Aspinall
BACKGROUND & AIMS: Many people who die from alcohol related liver disease (ARLD) have a history of recurrent admissions to hospital, representing potential missed opportunities for intervention. Universal screening for alcohol misuse has been advocated but it is not known if this is achievable or effective at detecting individuals at high risk of ARLD. METHODS: We systematically screened all admissions to the Acute Medical Unit (AMU) of a large acute hospital using an electronic data capture system in real time...
July 12, 2017: Journal of Hepatology
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