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https://www.readbyqxmd.com/read/28433453/attending-documentation-contribution-to-billing-at-an-academic-emergency-department-with-an-electronic-health-record
#1
Brian J Yun, Stephen C Dorner, Brian M Baccari, John Brennan, Karen Smith, Ali S Raja, Benjamin A White
INTRODUCTION: In emergency medicine (EM), patient care documentation serves many functions, including supporting reimbursement. In addition, many electronic health record systems facilitate automatically populating certain data fields. As a result, in the academic model, the attending's note may now more often recapitulate many of the same elements found in the resident's or physician assistant's (PA) note. We sought to determine the value of additional attending documentation, and how often the attending documentation prevented a downcoding event...
April 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28432924/bringing-a-novel-to-practice-an-interpretive-study-of-reading-a-novel-in-an-undergraduate-nursing-practicum-course
#2
Graham McCaffrey, Lorraine Venturato, J David Patterson, Jennifer Langille, Roberta Jackson, Tom Rosenal
Novels are one humanities resource available to educators in health disciplines to support student reflection on their own professional practice and therapeutic relationships with patients. An interdisciplinary team, including nurses, a physician, and an English instructor, carried out an interpretive study of the use of a novel by clinical nursing instructors in an undergraduate practicum course. Students placed in assisted living or long term care facilities for the elderly were expected to read a contemporary work, Exit Lines, by Joan Barfoot, which is set in a comparable facility...
April 4, 2017: Nurse Education in Practice
https://www.readbyqxmd.com/read/28431428/computational-and-in-vitro-experimental-investigation-of-intrathecal-drug-distribution-parametric-study-of-the-effect-of-injection-volume-cerebrospinal-fluid-pulsatility-and-drug-uptake
#3
Kevin M Tangen, Roxanne Leval, Ankit I Mehta, Andreas A Linninger
BACKGROUND: Intrathecal drug delivery is an attractive option to circumvent the blood-brain barrier for pain management through its increased efficacy of pain relief, reduction in adverse side effects, and cost-effectiveness. Unfortunately, there are limited guidelines for physicians to choose infusion or drug pump settings to administer therapeutic doses to specific regions of the spine or the brain. Although empiric trialing of intrathecal drugs is critical to determine the sustained side effects, currently there is no inexpensive in vitro method to guide the selection of spinal drug delivery parameters...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28430569/courage-and-compassion-virtues-in-caring-for-so-called-difficult-patients
#4
Michael Hawking, Farr A Curlin, John D Yoon
What, if anything, can medical ethics offer to assist in the care of the "difficult" patient? We begin with a discussion of virtue theory and its application to medical ethics. We conceptualize the "difficult" patient as an example of a "moral stress test" that especially challenges the physician's character, requiring the good physician to display the virtues of courage and compassion. We then consider two clinical vignettes to flesh out how these virtues might come into play in the care of "difficult" patients, and we conclude with a brief proposal for how medical educators might cultivate these essential character traits in physicians-in-training...
April 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28428097/care-coordination-and-comprehensive-electronic-health-records-are-associated-with-increased-transition-planning-activities
#5
Niraj Sharma, Kitty O'Hare, Karen G O'Connor, Umbereen Nehal, Megumi J Okumura
OBJECTIVE: Youth with Special Health Care Needs (YSHCN) require assistance from their pediatricians to transition to adult care. There is little data on what transition resources pediatricians have. This paper studies if care coordination and/or comprehensive electronic health record (CEHR) implementation are associated with improved transition processes. METHODS: Using AAP Periodic Survey #79, we report whether practices generated written transition plans, assisted in finding adult providers, and discussed confidentiality issues...
April 18, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28426800/neutrophil-lymphocyte-ratio-predicts-short-term-mortality-in-patients-with-hepatitis-b-virus-related-acute-on-chronic-liver-failure-treated-with-an-artificial-liver-support-system
#6
Zeng Fan, Chen EnQiang, Du Ling Yao, Yan LiBo, Li Hong, Bai Lang, Feng Ping, Tang Hong
AIM: Hepatitis B virus-related acute-on-chronic liver failure has high short-term mortality. Artificial liver support systems (ALSS) may improve outcome and avoid liver transplantation, but predicting short-term prognosis in such patients is difficult. This study aimed to determine whether the neutrophil-lymphocyte ratio (NLR), an inflammation marker, predicted mortality in patients treated with ALSS. METHODS: A total of 560 patients with hepatitis B virus-related acute-on-chronic liver failure were enrolled, 338 were treated with ALSS and the others treated with standard of care(SOC)...
2017: PloS One
https://www.readbyqxmd.com/read/28426572/nonhealing-ulcers-in-patients-with-tophaceous-gout-a-systematic-review
#7
Gretl Lam, Frank L Ross, Ernest S Chiu
GENERAL PURPOSE: To provide information from a review of the literature about chronic ulcers associated with tophaceous gout. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant should be better able to:1. Identify the pathophysiology of tophaceous gout, its presentation, phases, and common comorbidities...
May 2017: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/28426548/the-medex-northwest-physician-assistant-program-a-synopsis
#8
Kevin Lohenry
No abstract text is available yet for this article.
April 19, 2017: Journal of Physician Assistant Education
https://www.readbyqxmd.com/read/28426307/how-california-prepared-for-implementation-of-physician-assisted-death-a-primer
#9
Laura A Petrillo, Elizabeth Dzeng, Krista L Harrison, Lindsay Forbes, Benjamin Scribner, Barbara A Koenig
Physician-assisted death is now legal in California, and similar laws are being considered in many other states. The California law includes safeguards, yet health care providers will face practical and ethical issues while implementing physician-assisted death that are not addressed by the law. To help providers and health care facilities in California prepare to provide optimal care to patients who inquire about physician-assisted death, we brought together experts from California, Oregon, and Washington...
April 20, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28426127/postpartum-hypertension-etiology-diagnosis-and-management
#10
Kathryn J Sharma, Sarah J Kilpatrick
Importance: Postpartum hypertension complicates approximately 2% of pregnancies and, similar to antepartum severe hypertension, can have devastating consequences including maternal death. Objective: This review aims to increase the knowledge and skills of women's health care providers in understanding, diagnosing, and managing hypertension in the postpartum period. Results: Hypertension complicating pregnancy, including postpartum, is defined as systolic blood pressure 140 mm Hg or greater and/or diastolic blood pressure 90 mm Hg or greater on 2 or more occasions at least 4 hours apart...
April 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/28425684/single-versus-two-operator-endoscopic-biliary-cannulation-technique-a-multicenter-matched-case-analysis-and-a-literature-review
#11
Roberto DI Mitri, Rinaldo Pellicano, Leonardo H Eusebi, Filippo Mocciaro, Luigi M Montalbano, Angela Alibrandi, Giuseppe Iabichino, Maria A Palamara, Marco Giunta, Cristina Linea, Monica Arena, Giulia M Pecoraro, Enrico Opocher, Matteo Barabino, Carmelo Luigiano
BACKGROUND: The aim of this study was to compare the outcomes of physician-controlled, using both long and short endoscopic-retrograde-cholangiopancreatography wire systems, and assistant-controlled guide-wire biliary cannulation techniques, and to perform a literature review on this topic. METHODS: The endoscopic databases of three Endoscopic Centers were reviewed to identify all consecutive patients with an intact papilla who, between July 2013 and December 2014, underwent an endoscopic-retrograde-cholangiopancreatography...
April 19, 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/28423861/a-digital-framework-to-support-providers-and-patients-in-diabetes-related-behavior-modification
#12
Samina Abidi, Michael Vallis, Helena Piccinini-Vallis, Syed Ali Imran, Syed Sibte Raza Abidi
We present Diabetes Web-Centric Information and Support Environment (D-WISE) that features: (a) Decision support tool to assist family physicians to administer Behavior Modification (BM) strategies to patients; and (b) Patient BM application that offers BM strategies and motivational interventions to engage patients. We take a knowledge management approach, using semantic web technologies, to model the social cognition theory constructs, Canadian diabetes guidelines and BM protocols used locally, in terms of a BM ontology that drives the BM decision support to physicians and BM strategy adherence monitoring and messaging to patients...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423763/learning-healthcare-system-for-the-prescription-of-genetic-testing-in-the-gynecological-cancer-risk
#13
Cristina Suárez-Mejías, Alicia Martínez-García, María Ángeles Martínez-Maestre, José Manuel Silvan-Alfaro, Jesús Moreno Conde, Carlos Luis Parra-Calderón
Clinical evidence demonstrates that BRCA 1 and BRCA2 mutations can develop a gynecological cancer but genetic testing has a high cost to the healthcare system. Besides, several studies in the literature indicate that performing these genetic tests to the population is not cost-efficient. Currently, our physicians do not have a system to provide them the support for prescribing genetic tests. A Decision Support System for prescribing these genetic tests in BRCA1 and BRCA2 and preventing gynecological cancer risks has been designed, developed and deployed in the Virgen del Rocío University Hospital (VRUH)...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28422795/trial-design-and-endpoint-evaluation-in-clinical-studies-addressing-chronic-back-pain
#14
Peter Staats
STUDY DESIGN: A review of the literature evaluating clinical trials of chronic back pain. OBJECTIVE: To assist physicians in assessing the quality of clinical trial data to make the most informed treatment decisions. SUMMARY OF BACKGROUND DATA: Chronic pain is a tremendous public health issue, affecting close to 100 million adults in the United States, and costs the American people billions of dollars. One traditional treatment approach, the long-term use of opiate medications, has recently come under intense scrutiny for problems with complications, diversion, abuse, addiction and lack of efficacy...
April 18, 2017: Spine
https://www.readbyqxmd.com/read/28421563/the-current-utilization-and-perceptions-of-prescription-drug-monitoring-programs-among-emergency-medicine-providers-in-florida
#15
Henry W Young, Joseph A Tyndall, Linda B Cottler
BACKGROUND: Pain is among the most commonly treated symptoms in the emergency department, and opioids are commonly prescribed from the emergency department to treat moderate to severe pain. Prescription drug monitoring programs (PDMP) can be used to assist physicians identify individuals at increased risk to misuse or abuse opioids. While the use of the PDMP has been shown useful among clinicians, in the past, utilization of the PDMP has been less than optimal. The objective of this study was to assess the current utilization and perceptions of the prescription drug monitoring program among emergency medicine providers in Florida...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28420647/incremental-value-of-transthoracic-doppler-echocardiography-assessed-coronary-flow-reserve-in-patients-with-suspected-myocardial-ischemia-undergoing-myocardial-perfusion-scintigraphy
#16
Li-Ming Gan, Sara Svedlund, Ann Wittfeldt, Charlotte Eklund, Sinsia Gao, Göran Matejka, Anders Jeppsson, Per Albertsson, Elmir Omerovic, Amir Lerman
BACKGROUND: Adenosine-assisted transthoracic Doppler-derived coronary flow reserve (TDE-CFR) reflects coronary vascular function. The prognostic and incremental value of left anterior descending coronary artery TDE-CFR above myocardial perfusion scintigraphy in patients with suspected myocardial ischemia has not yet been studied. METHODS AND RESULTS: Three hundred seventy-one patients (mean age, 62.3±8.7 years; 46.8% males) referred to myocardial perfusion scintigraphy attributed to suspected myocardial ischemia were included in the study...
April 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28419618/correspondence-response-to-letter-to-the-editor-ultrasound-assisted-lumbar-puncture-on-infants-in-the-pediatric-emergency-department
#17
Michael Gorn
We would like to thank our reader for his/her interest in our work and continuing support of point-of-care ultrasound in pediatric emergency medicine. Our study was conducted at a large academic emergency department with pediatrics and emergency medicine residents, nurse practitioners who function at or above the level of a senior resident (PGY-3 and 4), and pediatric emergency fellows who function as attending physicians. As a routine, all initial lumbar puncture (LP) attempts are made by learners. This article is protected by copyright...
April 17, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28416957/the-need-for-a-well-organized-video-assisted-asthma-education-program-at-korean-primary-care-clinics
#18
Yee Hyung Kim, Kwang Ha Yoo, Jee-Hong Yoo, Tae-Eun Kim, Deog Kyeom Kim, Yong Bum Park, Chin Kook Rhee, Tae-Hyung Kim, Young Sam Kim, Hyoung Kyu Yoon, Soo-Jung Um, I-Nae Park, Yon Ju Ryu, Jae-Woo Jung, Yong Il Hwang, Heung Bum Lee, Sung-Chul Lim, Sung Soo Jung, Eun-Kyung Kim, Woo Jin Kim, Sung-Soon Lee, Jaechun Lee, Ki Uk Kim, Hyun Kuk Kim, Sang Ha Kim, Joo Hun Park, Kyeong Cheol Shin, Kang Hyeon Choe, Ho-Kee Yum
BACKGROUND: The purpose of this study was to assess the effect of our new video-assisted asthma education program on patients' knowledge regarding asthma and asthma control. METHODS: Adult asthmatics who were diagnosed by primary care physicians and followed for at least 1 year were educated via smart devices and pamphlets. The education sessions were carried out three times at 2-week intervals. Each education period lasted at most 5 minutes. The effectiveness was then evaluated using questionnaires and an asthma control test (ACT)...
April 2017: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28414408/family-medicine-research-in-the-united-states-from-the-late-1960s-into-the-future
#19
Marjorie A Bowman, Sean C Lucan, Thomas C Rosenthal, Arch G Mainous, Paul A James
When the new field of family medicine research began a half century ago, multiple individuals and organizations emphasized that research was a key mission. Since the field's inception, there have been notable research successes for which family medicine organizations, researchers, and leaders-assisted by federal and state governments and private foundations-can take credit. Research is a requirement for family medicine residency programs but not individual residents, and multiple family medicine departments offer research training in various forms for learners at all levels, including research fellowships...
April 2017: Family Medicine
https://www.readbyqxmd.com/read/28411323/practice-patterns-for-the-prophylaxis-and-treatment-of-acute-radiation-dermatitis-in-the-united-states
#20
Patricia Lucey, Christos Zouzias, Loren Franco, Sravana K Chennupati, Shalom Kalnicki, Beth N McLellan
PURPOSE: Due to the inconclusive evidence for available treatment options, management of radiation dermatitis (RD) varies among practitioners. This study defines and reviews the current treatment patterns for RD in the USA, providing guidance for practicing physicians as well as directions for future research. METHODS: An online survey of 21 questions was emailed to all 5626 members of the 2013 American Society for Radiation Oncology (ASTRO) directory, which included radiation oncologists, residents, fellows, physician assistants, nurse practitioners, registered nurses and other care providers...
April 14, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
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