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https://www.readbyqxmd.com/read/29235927/risk-factors-for-hospital-death-in-conditions-needing-palliative-care-nationwide-population-based-death-certificate-study
#1
Barbara Gomes, Maria João Pinheiro, Sílvia Lopes, Maja de Brito, Vera P Sarmento, Pedro Lopes Ferreira, Henrique Barros
BACKGROUND: Most people would prefer to die at home as opposed to hospital; therefore, understanding mortality patterns by place of death is essential for health resources allocation. AIM: We examined trends and risk factors for hospital death in conditions needing palliative care in a country without integrated palliative care. DESIGN: This is a death certificate study. We examined factors associated with hospital death using logistic regression...
November 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/29235900/treatment-and-discharge-patterns-among-patients-hospitalized-with-non-valvular-atrial-fibrillation-transitioning-from-the-inpatient-to-outpatient-setting
#2
Henry J Henk, Feng Cao, Kenneth Tuell, Kwanza Price, Prianka Singh, Jack Mardekian, Kevin Odell, Chad Patel, Wilson Tan, George H Sands, Shalabh Singhal, Jeffrey Trocio, Lien Vo
OBJECTIVE: To evaluate inpatient oral anticoagulant (OAC) treatment, discharge location, and post-discharge OAC treatment for patients hospitalized with non-valvular atrial fibrillation (NVAF). RESEARCH DESIGN AND METHODS: Retrospective study using claims data linked to hospital electronic health records (EHR). Patients (N = 2,484) were hospitalized with a primary (38%) or secondary (62%) diagnosis of AF without evidence of mitral valvular heart disease or valve replacement between January 2009 and September 2013...
December 13, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29235421/how-should-we-talk-about-palliative-care-death-and-dying-a-qualitative-study-exploring-perspectives-from-caregivers-of-people-with-advanced-cancer
#3
Anna Collins, Sue-Anne McLachlan, Jennifer Philip
BACKGROUND: Health professionals commonly underestimate caregiver needs for information about palliative care, death and dying and may feel poorly prepared to discuss these issues. Few studies have sought caregiver perspectives of these communication practices. AIM: To explore caregiver perspectives on communication about death, dying and the introduction to palliative care, with a view towards a series of caregiver-informed recommendations for use in clinical practice...
December 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/29234948/assessing-documentation-of-critical-imaging-result-follow-up-recommendations-in-emergency-department-discharge-instructions
#4
Anurag Gupta, Ronilda Lacson, Patricia C Balthazar, Shan Haq, Adam B Landman, Ramin Khorasani
To facilitate follow-up of critical test results across transitions in patient care settings, we implemented an electronic discharge module that enabled care providers to include follow-up recommendations in the discharge instructions. We assessed the impact of this module on documentation of follow-up recommendations for critical imaging findings in Emergency Department (ED) discharge instructions. We studied 240 patients with critical imaging findings discharged from the ED before (n = 80) and after (n = 160) implementation of the module...
December 12, 2017: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
https://www.readbyqxmd.com/read/29233720/a-pragmatic-randomized-comparative-effectiveness-trial-of-transitional-care-for-a-socioeconomically-diverse-population-design-rationale-and-baseline-characteristics
#5
Christine Schaeffer, Caroline Teter, Emily A Finch, Courtney Hurt, Mary Kate Keeter, David T Liss, Angela Rogers, Avani Sheth, Ronald Ackermann
Transitional care programs have been widely used to reduce readmissions and improve the quality and safety of the handoff process between hospital and outpatient providers. Very little is known about effective transitional care interventions among patients who are uninsured or with Medicaid. This paper describes the design and baseline characteristics of a pragmatic randomized comparative effectiveness trial of transitional care. Northwestern Medical Group- Transitional Care (NMG-TC) care model was developed to address the needs of patients with multiple medical problems that required lifestyle changes and were amenable to office-based management...
December 9, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29233434/assessing-students-knowledge-regarding-the-roles-and-responsibilities-of-a-pharmacist-with-focus-on-care-transitions-through-simulation
#6
Erini S Serag-Bolos, Aimon C Miranda, Shyam R Gelot, Sheetal P Dharia, Kristy M Shaeer
BACKGROUND AND PURPOSE: To evaluate the impact of a pharmacist-focused transitions of care (TOC) simulation on students' perceptions and knowledge of pharmacist roles in the healthcare continuum. Educational Activity and Setting: Two simulations, highlighting pharmacist roles in various practice settings, were conducted within the Pharmaceutical Skills courses in the third-year doctor of pharmacy curriculum. Patient cases were built utilizing electronic medical records (EMR). Students' knowledge was assessed before and after the simulations regarding pharmacist involvement in medication reconciliation, reduction in patient readmissions, reduction of inappropriate medication use, roles and communication on an interprofessional team, and involvement with health information technology (HIT) during care transitions...
July 2017: Currents in Pharmacy Teaching & Learning
https://www.readbyqxmd.com/read/29233313/pharmacy-student-involvement-in-a-transition-of-care-program
#7
Raquel Hertig, Rina Ackerman, Brenda Zagar, Serina Tart
BACKGROUND AND PURPOSE: Cape Fear Valley Medical Center (CFVMC) implemented a Community Paramedic Program (CPP) to improve the transition of hospitalized patients to the home setting. In this program, paramedics conduct home visits for 30 days after qualifying patients are discharged. This article describes pharmacy services provided to CPP patients by fourth-year pharmacy students on Advanced Pharmacy Practice Experiences (APPE) that assisted with home visits. EDUCATIONAL ACTIVITY AND SETTING: Students were oriented to the CPP and patient interview technique was assessed through a role-play scenario...
September 2017: Currents in Pharmacy Teaching & Learning
https://www.readbyqxmd.com/read/29231962/symptoms-reported-by-frail-elderly-adults-independently-predict-30-day-hospital-readmission-or-emergency-department-care
#8
Lynn S Borkenhagen, Rozalina G McCoy, Rachel D Havyer, Stephanie M Peterson, James M Naessens, Paul Y Takahashi
OBJECTIVES: To assess the degree to which self-reported symptoms predict unplanned readmission or emergency department (ED) care within 30 days of high-risk, elderly adults enrolled in a posthospitalization care transition program (CTP). DESIGN: Retrospective cohort study. SETTING: Posthospitalization CTP at Mayo Clinic, Rochester, Minnesota, from January 1, 2013, through March 3, 2015. PARTICIPANTS: Frail, elderly adults (N = 230; mean age 83...
December 12, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29231788/the-2018-inter-agency-field-manual-on-reproductive-health-in-humanitarian-settings-revising-the-global-standards
#9
Angel M Foster, Dabney P Evans, Melissa Garcia, Sarah Knaster, Sandra Krause, Therese McGinn, Sarah Rich, Meera Shah, Hannah Tappis, Erin Wheeler
Since the 1990s, the Inter-agency field manual on reproductive health in humanitarian settings (IAFM) has provided authoritative guidance on reproductive health service provision during different phases of complex humanitarian emergencies. In 2018, the Inter-Agency Working Group on Reproductive Health in Crises will release a new edition of this global resource. In this article, we describe the collaborative and inter-sectoral revision process and highlight major changes in the 2018 IAFM. Key revisions to the manual include repositioning unintended pregnancy prevention within and explicitly incorporating safe abortion care into the Minimum Initial Service Package (MISP) chapter, which outlines a set of priority activities to be implemented at the outset of a humanitarian crisis; stronger guidance on the transition from the MISP to comprehensive sexual and reproductive health services; and the addition of a logistics chapter...
December 12, 2017: Reproductive Health Matters
https://www.readbyqxmd.com/read/29231472/-acupuncture-with-smoothing-liver-and-regulating-qi-for-post-stroke-slow-transit-constipation-and-its-gastrointestinal-hormone-level
#10
Yanhong Gao, Jianmei Li, Mao Su, Yanling Li
OBJECTIVE: To compare the efficacy between acupuncture with smoothing liver and regulating qi and lactulose for post-stroke slow transit constipation(STC) and to explore the mechanism. METHODS: Sixty patients were randomized into an acupuncture group and a medication group,30 cases in each one. Based on the comprehensive stroke unit care,acupuncture with smoothing liver and regulating qi was used at Danzhong(CV 17),Qihai(CV 6),Tianshu(ST 25),Neiguan(PC 6),Gongsun(SP 4) and Taichong(LR 3) in the acupuncture group,once a day...
February 12, 2017: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
https://www.readbyqxmd.com/read/29230903/nurse-manager-succession-planning-a-cost-benefit-analysis
#11
Tracy Phillips, Jennifer L Evans, Stephanie Tooley, Maria R Shirey
AIM: This commentary presents a cost-benefit analysis to advocate for the use of succession planning to mitigate the problems ensuing from nurse manager turnover. BACKGROUND: An estimated 75% of nurse managers will leave the workforce by 2020. Many benefits are associated with proactively identifying and developing internal candidates. Fewer than 7% of health care organisations have implemented formal leadership succession planning programmes. EVALUATION: A cost-benefit analysis of a formal succession-planning programme from one hospital illustrates the benefits of the programme in their organisation and can be replicated easily...
December 12, 2017: Journal of Nursing Management
https://www.readbyqxmd.com/read/29230607/the-effect-of-high-count-rates-on-cardiac-perfusion-quantification-in-a-simultaneous-pet-mr-system-using-a-cardiac-perfusion-phantom
#12
Jim O' Doherty, Zacharias Chalampalakis, Paul Schleyer, Muhummad Sohaib Nazir, Amedeo Chiribiri, Paul K Marsden
BACKGROUND: PET-MRI is under investigation as a new strategy for quantitative myocardial perfusion imaging. Consideration is required as to the maximum scanner count rate in order to limit dead-time losses resulting from administered activity in the scanner field of view during the first pass of the radiotracer. RESULTS: We performed a decaying-source experiment to investigate the high count-rate performance of a PET-MR system (Siemens mMR) over the expected range of activities during a clinical study...
December 11, 2017: EJNMMI Physics
https://www.readbyqxmd.com/read/29230400/perspectives-of-post-acute-transition-of-care-for-cardiac-surgery-patients
#13
REVIEW
Nicoleta Stoicea, Tian You, Andrew Eiterman, Clifton Hartwell, Victor Davila, Stephen Marjoribanks, Cristina Florescu, Sergio Daniel Bergese, Barbara Rogers
Post-acute care (PAC) facilities improve patient recovery, as measured by activities of daily living, rehabilitation, hospital readmission, and survival rates. Seamless transitions between discharge and PAC settings continue to be challenges that hamper patient outcomes, specifically problems with effective communication and coordination between hospitals and PAC facilities at patient discharge, patient adherence and access to cardiac rehabilitation (CR) services, caregiver burden, and the financial impact of care...
2017: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29230392/non-invasive-monitoring-of-cardiac-output-in-critical-care-medicine
#14
REVIEW
Lee S Nguyen, Pierre Squara
Critically ill patients require close hemodynamic monitoring to titrate treatment on a regular basis. It allows administering fluid with parsimony and adjusting inotropes and vasoactive drugs when necessary. Although invasive monitoring is considered as the reference method, non-invasive monitoring presents the obvious advantage of being associated with fewer complications, at the expanse of accuracy, precision, and step-response change. A great many methods and devices are now used over the world, and this article focuses on several of them, providing with a brief review of related underlying physical principles and validation articles analysis...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/29229650/improving-contraceptive-access-use-and-method-mix-by-task-sharing-implanon-insertion-to-frontline-health-workers-the-experience-of-the-integrated-family-health-program-in-ethiopia
#15
Yewondwossen Tilahun, Candace Lew, Bekele Belayihun, Kidest Lulu Hagos, Mengistu Asnake
In 2009, the Ethiopian Federal Ministry of Health launched an Implanon scale-up program with the goal of improving the availability of long-acting reversible contraceptive (LARC) methods at the community level. The Integrated Family Health Program (IFHP) supported the ministry to train Health Extension Workers (HEWs), a cadre of frontline health workers, on Implanon insertion. Prior to this task-sharing initiative, HEWs were only permitted to provide short-acting contraceptive methods; Implanon insertion services were only available at higher-level health facilities, such as health centers and above...
December 8, 2017: Global Health, Science and Practice
https://www.readbyqxmd.com/read/29229223/genders-and-individual-treatment-progress-in-non-binary-trans-individuals
#16
Andreas Koehler, Jana Eyssel, Timo O Nieder
BACKGROUND: Health care for transgender and transsexual (ie, trans) individuals has long been based on a binary understanding of gender (ie, feminine vs masculine). However, the existence of non-binary or genderqueer (NBGQ) genders is increasingly recognized by academic and/or health care professionals. AIM: To gain insight into the individual health care experiences and needs of binary and NBGQ individuals to improve their health care outcomes and experience. METHODS: Data were collected using an online survey study on experiences with trans health care...
December 8, 2017: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/29229172/self-management-and-health-care-transition-among-adolescents-and-young-adults-with-chronic-kidney-disease-medical-and-psychosocial-considerations
#17
REVIEW
Maria E Díaz-González de Ferris, Marta Del Villar-Vilchis, Ricardo Guerrero, Victor M Barajas-Valencia, Emily B Vander-Schaaf, Alexandre de Pomposo, Mara Medeiros, Eniko Rak, Guillermo Cantu-Quintanilla, Rupesh Raina, Ana C Alvarez-Elias
Health care transition (HCT) is a process that requires preparation as a continuum from pediatric- to adult-focused services. For adolescents and young adults with chronic or ESRD, this process can be prolonged due to their physical, psychological, family, or ecological factors. HCT preparation is a matter of patient safety and patient rights as the consequences of poor preparation at the time of transfer to adult-focused services are great, including rejection of organs, disease relapse, or even death. We present a case to illustrate important points of HCT preparation, with suggestions for intervention by the interdisciplinary team members who serve (and will serve) these survivors of pediatric-onset health conditions...
November 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/29228878/quality-assessment-in-belgian-st-elevation-myocardial-infarction-patients-results-from-the-belgian-stemi-database
#18
Marc J Claeys, Peter R Sinnaeve, Carl Convens, Philippe Dubois, Suzanne Pourbaix, Pascal Vranckx, Sofie Gevaert, Herbert De Raedt, Christophe Beauloye, Jean-Francois Argacha, Patrick Evrard, Patrick Coussement
The present report describes the quality of care, including in hospital mortality for more than 22.000 STEMI patients admitted in 60 Belgian hospitals for the period 2008-2016. We found a strong increase in the use of primary PCI over time, particularly for patients that were admitted first in a non-PCI capable hospital, reaching a penetration rate of >95%. The transition of thrombolysis to transfer for pPCI in the setting of a STEMI network was, however, associated with an increase of the proportion of patients with prolonged (>120 min) diagnosis-to-balloon time (from 16 to 22%), suggesting still suboptimal interhospital transfer...
December 11, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/29228876/crossing-professional-cultures-a-qualitative-study-of-nurses-working-in-a-medical-school
#19
Eileen McKinlay, Peter Gallagher, Bernadette Jones, Lindsay Macdonald, Christine Barthow
BACKGROUND: Leaving the nursing workforce is often seen as a loss to the profession. However some nurses maintain a current nursing registration and work outside their disciplinary field within university schools of medicine. Little is known about the nature of their work and why they choose to work in this setting. AIM: To explore and describe the experiences of nurses who work in a medical school. DESIGN: Qualitative descriptive informed by autoethnography...
December 11, 2017: Contemporary Nurse
https://www.readbyqxmd.com/read/29226232/connecting-undergraduate-and-postgraduate-medical-education-through-an-elective-epa-based-transitional-year-in-acute-care-an-early-project-report
#20
Gersten Jonker, Reinier G Hoff, Stefan Max, Cor J Kalkman, Olle Ten Cate
Objective: A well-designed final year may ease the transition from medical school to postgraduate training, if it has enough depth to enable the acquisition of early specialty expertise, while keeping enough breadth to support the graduation as all-round physician. Aim of this article is to describe the design of a multidisciplinary dedicated transitional year (DTY) around the theme of recognition and initial treatment of vitally threatened patients. Methods: Undergraduate and postgraduate training directors from the departments of Anaesthesiology, Cardiology, Emergency Medicine, Intensive Care Medicine and Respiratory Medicine at UMC Utrecht and partnering hospitals have collaboratively developed and implemented a curriculum for a final year focusing on three entrustable professional activities (EPAs) in the domain of acute care...
2017: GMS Journal for Medical Education
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