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https://www.readbyqxmd.com/read/29137820/does-acute-care-for-the-elderly-ace-unit-decrease-the-incidence-of-falls
#1
Ahmed Abdalla, Mehul Adhaduk, Raad A Haddad, Yanal Alnimer, Carlos F Ríos-Bedoya, Ghassan Bachuwa
To determine whether acute care for the elderly (ACE) units decrease the incidence of patient falls compared to general medical and surgical (GMS) units, a non-concurrent prospective study included individuals aged 65 and older admitted to ACE or GMS units over a 2-year span was done. There were 7069 admissions corresponded to 28,401 patient-days. A total of 149 falls were reported for an overall incidence rate (IR) of 5.2 falls per 1000 patient-days, 95% CI, 4.4/1000-6.1/1000 patient-days. The falls IR ratio for patients in ACE unit compared to those in non-ACE units after adjusting for age, sex, prescribed psychotropics and hypnotics, and Morse Fall Score was 0...
November 11, 2017: Geriatric Nursing
https://www.readbyqxmd.com/read/29137199/epidemiology-of-bone-fracture-in-female-trauma-patients-based-on-risks-of-osteoporosis-assessed-using-the-osteoporosis-self-assessment-tool-for-asians-score
#2
Cheng-Shyuan Rau, Shao-Chun Wu, Pao-Jen Kuo, Yi-Chun Chen, Peng-Chen Chien, Hsiao-Yun Hsieh, Ching-Hua Hsieh
Background: Osteoporotic fractures are defined as low-impact fractures resulting from low-level trauma. However, the exclusion of high-level trauma fractures may result in underestimation of the contribution of osteoporosis to fractures. In this study, we aimed to investigate the fracture patterns of female trauma patients with various risks of osteoporosis based on the Osteoporosis Self-Assessment Tool for Asians (OSTA) score. Methods: According to the data retrieved from the Trauma Registry System of a Level I trauma center between 1 January 2009 and 31 December 2015, a total of 6707 patients aged ≥40 years and hospitalized for the treatment of traumatic bone fracture were categorized as high-risk (OSTA < -4, n = 1585), medium-risk (-1 ≥ OSTA ≥ -4, n = 1985), and low-risk (OSTA > -1, n = 3137) patients...
November 13, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29135850/incorporating-nurse-input-and-evidence-into-a-newly-designed-unit-to-improve-patient-and-nursing-outcomes
#3
Jennifer Tafelmeyer, Robin Wicks, Jeannine Brant, Laurie Smith
OBJECTIVE: The aim of this study was to identify processes, outcomes, and lessons learned from designing a new evidence-based unit. A research study was conducted simultaneously to rigorously measure changes in patient and staff outcomes. BACKGROUND: Nursing leadership and frontline nursing engagement are critical in evidence-based design to promote positive outcomes and workflow. METHODS: Quality indicators were tracked premove and postmove...
December 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/29135692/ultrasound-with-neurostimulation-compared-with-ultrasound-guidance-alone-for-lumbar-plexus-block-a-randomised-single-blinded-equivalence-trial
#4
Vanlapa Arnuntasupakul, Theerawat Chalachewa, Prangmalee Leurcharusmee, Worakamol Tiyaprasertkul, Roderick J Finlayson, De Q Tran
BACKGROUND: Ultrasound-guided lumbar plexus blocks usually require confirmatory neurostimulation. A simpler alternative is to inject local anaesthetic inside the posteromedial quadrant of the psoas muscle under ultrasound guidance. OBJECTIVE: We hypothesised that both techniques would result in similar total anaesthesia time, defined as the sum of performance and onset time. DESIGN: A randomised, observer-blinded, equivalence trial (equivalence margin = 7...
November 11, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29134776/acute-chest-syndrome-among-children-hospitalized-with-vaso-occlusive-crisis-a-nationwide-study-in-the-united-states
#5
Takuto Takahashi, Yusuke Okubo, Atsuhiko Handa
PURPOSE: Acute chest syndrome (ACS) is a common complication among pediatric inpatients with sickle cell disease and vaso-occlusive crisis (VOC). However, little is known about the factors associated with ACS complication. The present study assessed the epidemiological features of children hospitalized with VOC and ascertained factors associated with ACS complication. METHODS: Hospital discharge records of patients with VOC aged <20 years were obtained for the years 2003, 2006, 2009, and 2012 from the Kids' Inpatient Database...
November 14, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29133324/effects-of-falls-prevention-interventions-on-falls-outcomes-for-hospitalised-adults-protocol-for-a-systematic-review-with-meta-analysis
#6
Susan C Slade, David L Carey, Anne-Marie Hill, Meg E Morris
INTRODUCTION: Falls are a major global public health problem and leading cause of accidental or unintentional injury and hospitalisation. Falls in hospital are associated with longer length of stay, readmissions and poor outcomes. Falls prevention is informed by knowledge of reversible falls risk factors and accurate risk identification. The extent to which hospital falls are prevented by evidence-based practice, patient self-management initiatives, environmental modifications and optimisation of falls prevention systems awaits confirmation...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29132658/-elderly-hospitalised-people-and-walking-capacities
#7
Camille Castel, Pascale Lescure, Gilles Loggia, Rémi Morello, Rémi De Mil, Guillaume Saint-Lorant
Falls in the elderly are frequent. A study carried out over 6 months in a university hospital's acute geriatric unit highlighted the real walking capacities of hospitalised elderly people. It also changed the perception of caregivers, doctors and nurses with regard to the real physical aptitudes of these patients enabling the risk of falls to be reduced in preparation for their return home or to a residential care home.
November 2017: Soins. Gérontologie
https://www.readbyqxmd.com/read/29132427/risk-of-falling-among-hospitalized-patients-with-high-modified-morse-scores-could-be-further-stratified
#8
Irina Gringauz, Yael Shemesh, Amir Dagan, Irina Israelov, Dana Feldman, Naama Pelz-Sinvani, Dan Justo, Gad Segal
BACKGROUND: Falls during hospitalization harbor both clinical and financial outcomes. The modified Morse fall scale [MMFS] is widely used for an in-hospital risk-of-fall assessment. Nevertheless, the majority of patients at risk of falling, i.e. with high MMFS, do not fall. The aim of this study was to ascertain our study hypothesis that certain patients' characteristics (e.g. serum electrolytes, usage of a walking device etc.) could further stratify the risk of falls among hospitalized patients with MMFS...
November 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29127555/continuous-monitoring-of-blood-pressure-by-analyzing-the-blood-flow-sound-of-arteriovenous-fistula-in-hemodialysis-patients
#9
Yuka Kamijo, Eiichiro Kanda, Hayato Horiuchi, Noriyuki Kounoue, Keisuke Ono, Keizo Maeda, Akane Yanai, Kazuya Honda, Ryuji Tsujimoto, Mai Yanagi, Yoshitaka Ishibashi, Masayuki Yoshida
BACKGROUND: Patients with end-stage renal disease undergoing hemodialysis (HD) have an elevated risk of cardiovascular disease-related morbidity and mortality. To prevent from such a life-threatening event, the continuous blood pressure (BP) monitoring system may contribute to detect BP decline in early stages and may help to do appropriate disposal. Our research team has introduced an electronic stethoscope (Asahi Kasei Co, Ltd., Tokyo, Japan), which translates sound intensity of Arteriovenous Fistula (AVF) to BP data using the technique of Fourier transformation that can predict continuous BP non-invasively...
November 10, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/29125861/identification-of-hospitalized-elderly-patients-at-risk-for-adverse-in-hospital-outcomes-in-a-university-orthopedics-and-trauma-surgery-environment
#10
Janine Gronewold, Christian Dahlmann, Marcus Jäger, Dirk M Hermann
BACKGROUND: As a consequence of demographic changes, hospitals are confronted with increasing numbers of elderly patients, who are at high risk of adverse events during hospitalization. Geriatric risk screening followed by comprehensive geriatric assessment (CGA) and treatment has been requested by geriatric societies and task forces to identify patients at risk. Since empirical evidence on factors predisposing to adverse hospital events is scarce, we now prospectively evaluated implications of geriatric risk screening followed by CGA in a university hospital department of orthopedics and trauma surgery...
2017: PloS One
https://www.readbyqxmd.com/read/29124913/measurement-of-lying-and-standing-blood-pressure-in-hospital
#11
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/29123863/successful-non-operative-management-of-traumatic-extrahepatic-portal-venous-injury-without-intraperitoneal-hemorrhage-a-case-report
#12
Kunio Hamanaka, Yuusuke Hirokawa, Tsuyoshi Itoh, Mitsuhiro Fujino, Kenichi Kano, Satoru Beppu, Nozomu Sasahashi, Kei Nishiyama
Case: A 52-year-old woman was admitted to our hospital with hypotension after falling from the fifth floor of an apartment building. Contrast-enhanced computed tomography showed liver injury with extravasation of contrast material from the hepatic artery, and extrahepatic portal venous injury with extravasation and pseudoaneurysm. Intra-abdominal hemorrhage was not observed, and bleeding was confined to the retroperitoneal space. Hepatic arteriography showed extravasation, while portal venography showed pseudoaneurysm but no extravasation...
April 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29123856/accidental-falls-related-to-clearing-heavy-snow-on-rooftops-in-a-rural-heavy-snow-area-in-japan
#13
Seigo Yamaguchi, Hiroshi Endoh, Masakazu Nitta
Aim: The purpose of this study is to describe our experience with patients who fell from rooftops while clearing snow. The falls occurred in rural areas that receive heavy snowfall and are undergoing depopulation and an increasing proportion of elderly residents. Methods: A retrospective observational chart review was carried out at the sole hospital providing emergency services in a rural heavy snow area in Japan. Results: A total of 70 patients were enrolled during four winter seasons between December 2009 and March 2013...
April 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29123840/a-system-of-delivering-medical-staff-members-by-helicopter-to-manage-severely-wounded-patients-in-an-area-where-medical-resources-are-limited
#14
Kohei Ishikawa, Kazuhiko Omori, Hiromichi Ohsaka, Kei Jitsuiki, Toshihiko Yoshizawa, Yasumasa Oode, Mutsumi Sakurada, Atsuhiko Mogami, Youichi Yanagawa
Aim: We review the case of a severely injured patient to evaluate the system of delivering medical staff by helicopter in areas with limited medical resources. Methods: The patient's chart was reviewed, summarized, and presented. Results: A 22-year-old woman attempted a suicidal fall after using a knife to stab herself. She was transported to a local hospital. A radiological study revealed fractures to the patient's face and the base of her skull, pneumocephalus, traumatic subarachnoid hemorrhage, stab wounds to the neck and chest, pneumothorax, unstable pelvic fracture, and right femoral shaft fracture...
January 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29122806/diagnostic-utility-of-appetite-loss-in-addition-to-existing-prediction-models-for-community-acquired-pneumonia-in-the-elderly-a-prospective-diagnostic-study-in-acute-care-hospitals-in-japan
#15
Toshihiko Takada, Yosuke Yamamoto, Kazuhiko Terada, Mitsuyasu Ohta, Wakako Mikami, Hajime Yokota, Michio Hayashi, Jun Miyashita, Teruhisa Azuma, Shingo Fukuma, Shunichi Fukuhara
OBJECTIVE: Diagnosis of community-acquired pneumonia (CAP) in the elderly is often delayed because of atypical presentation and non-specific symptoms, such as appetite loss, falls and disturbance in consciousness. The aim of this study was to investigate the external validity of existing prediction models and the added value of the non-specific symptoms for the diagnosis of CAP in elderly patients. DESIGN: Prospective cohort study. SETTING: General medicine departments of three teaching hospitals in Japan...
November 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/29122796/association-between-organisational-and-workplace-cultures-and-patient-outcomes-systematic-review
#16
Jeffrey Braithwaite, Jessica Herkes, Kristiana Ludlow, Luke Testa, Gina Lamprell
DESIGN AND OBJECTIVES: Every organisation has a unique culture. There is a widely held view that a positive organisational culture is related to positive patient outcomes. Following the Preferred Reporting Items for Systematic Review and Meta-Analyses statement, we systematically reviewed and synthesised the evidence on the extent to which organisational and workplace cultures are associated with patient outcomes. SETTING: A variety of healthcare facilities, including hospitals, general practices, pharmacies, military hospitals, aged care facilities, mental health and other healthcare contexts...
November 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/29121033/identification-of-seniors-at-risk-scale-as-a-simple-tool-of-elderly-patients-assessment-in-an-acute-hospital-department
#17
Anna Gałuszewska, Barbara Gryglewska, Stanisław Górski, Anna Kańtoch, Tomasz Grodzicki
INTRODUCTION: e aim of the study was to evaluate the usefulness of Identification of Seniors at Risk (ISAR) scale among elderly patients admitted to the department of internal medicine. MATERIAL AND METHODS: The ISAR score was performed among patients aged >59 years a er admission to the hospital ward. Data from medical history about diseases, taken medicines, falls, length of hospital stay and mortality were compared in patients with ISAR score of 0-1 and over 1 and in subjects with and without history of falls...
2017: Folia Medica Cracoviensia
https://www.readbyqxmd.com/read/29120237/does-service-timing-matter-for-psychological-outcomes-in-cardiac-rehabilitation-insights-from-the-national-audit-of-cardiac-rehabilitation
#18
Jennifer Sumner, Jan R Böhnke, Patrick Doherty
Background The presence of mental health conditions in cardiac rehabilitation (CR) patients such as anxiety and depression can lead to reduced programme adherence, increased mortality and increased re-occurrence of cardiovascular events undermining the aims and benefit of CR. Earlier research has identified a relationship between delayed commencement of CR and poorer physical activity outcomes. This study wished to explore whether a similar relationship between CR wait time and mental health outcomes can be found and to what degree participation in CR varies by mental health status...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/29119221/preparing-japanese-surgeons-for-potential-mass-casualty-situations-will-require-innovative-and-systematic-programs
#19
H Uchino, V Y Kong, J L Bruce, G V Oosthuizen, W Bekker, G L Laing, D L Clarke
INTRODUCTION: The ongoing state of global geo-political instability means that it is prudent to prepare civilian surgeons to manage major military-type trauma. Japan has enjoyed a prolonged period of peace and consequently it is unlikely that surgeons will have been exposed to a sufficient volume of cases. This study reviews the state of trauma training and preparedness in Japan and reviews the trauma workload of a major Japanese emergency medical center and compared with a major South African trauma center with the intention of quantifying and comparing the time needed to gain adequate exposure to major trauma at the two centers...
November 8, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29118488/the-role-of-trabeculectomy-in-enhancing-glaucoma-patient-s-quality-of-life
#20
Ibrahim H Binibrahim, Anders K Bergström
PURPOSE: Is to control intraocular pressure (IOP) (up to 21 mmHg), to decrease medical treatment after trabeculectomy and to slow down or stop progression and deterioration in visual fields in glaucoma patients. METHODS: A retrospective study. The charts of all trabeculectomies done in the Department of Ophthalmology at the Skåne University Hospital, Sweden during 2010 were retrospectively evaluated. The study was performed during fall 2012, so the longest follow-up is almost 2 years...
September 2017: Oman Journal of Ophthalmology
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