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Quality and patient safety

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https://www.readbyqxmd.com/read/27926632/a-pooled-analysis-of-robotic-versus-laparoscopic-surgery-for-colon-cancer
#1
Bo-Shi Duan, Guo-Hua Zhao, Helen Yang, Yue Wang
OBJECTIVE: An increasing number of studies have been reported since the "Da Vinci" Robotic System was used in gastrointestinal disease. Thus, we conducted this meta-analysis to evaluate the safety and efficacy of robotic colectomy (RC) compared with laparoscopic colectomy (LC) in the treatment of colon cancer. METHOD: A systematic search of Medline, Embase databases, and the Cochrane Library was performed to identify studies that compared RC and LC and were published up to February 2015...
December 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/27926620/tapping-magnet%C3%A2-s-culture-of-innovation-to-improve-the-patient-experience
#2
Jennifer Rainer
As incentives grow for healthcare organizations to improve the patient experience, an increasing number choose to add consumers directly into their leadership structures. In this final installment about the value of patient and family advisory councils, the senior director of quality at a large, Magnet®-recognized Texas hospital explains how tapping into a well-established Magnet culture helped the organization adopt innovative approaches that produced positive change. Based on an interview with the author, she notes that seeing basic issues through patients' eyes challenged long-held beliefs and led to improvements in a wide variety of areas...
January 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/27926563/truth-in-reporting-how-data-capture-methods-obfuscate-actual-surgical-site-infection-rates-within-a-health-care-network-system
#3
Liliana Bordeianou, Christy E Cauley, Donna Antonelli, Sarah Bird, David Rattner, Matthew Hutter, Sadiqa Mahmood, Deborah Schnipper, Marc Rubin, Ronald Bleday, Pardon Kenney, David Berger
BACKGROUND: Two systems measure surgical site infection rates following colorectal surgeries: the American College of Surgeons National Surgical Quality Improvement Program and the Centers for Disease Control and Prevention National Healthcare Safety Network. The Centers for Medicare & Medicaid Services pay-for-performance initiatives use National Healthcare Safety Network data for hospital comparisons. OBJECTIVE: This study aimed to compare database concordance...
January 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27926562/long-term-experience-of-magnetic-anal-sphincter-augmentation-in-patients-with-fecal-incontinence
#4
Jeremy Sugrue, Paul-Antoine Lehur, Robert D Madoff, Shane McNevin, Steen Buntzen, Søren Laurberg, Anders Mellgren
BACKGROUND: Magnetic anal sphincter augmentation is a novel technique for the treatment of patients with fecal incontinence. OBJECTIVE: The current study reports the long-term effectiveness and safety of this new treatment modality. DESIGN: This was a prospective multicenter pilot study. SETTINGS: The study was performed at 4 clinical sites in Europe and the United States. PATIENTS: The cohort included patients with severe fecal incontinence for ≥6 months who had previously failed conservative therapy and were implanted with a magnetic anal sphincter device between 2008 and 2011...
January 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27925796/a-severe-asthma-disease-signature-from-gene-expression-profiling-of-peripheral-blood-from-u-biopred-cohorts
#5
Jeannette Bigler, Michael Boedigheimer, James P R Schofield, Paul J Skipp, Julie Corfield, Anthony Rowe, Ana R Sousa, Martin Timour, Lori Twehues, Xuguang Hu, Graham Roberts, Andrew A Welcher, Wen Yu, Kian F Chung, Ian M Adcock, Peter J Sterk, Ratko Djukanović
RATIONALE: Stratification of asthma at the molecular level, especially using accessible biospecimens, could greatly enable patient selection for targeted therapy. OBJECTIVES: To determine the value of blood to identify transcriptional differences between clinically defined asthmatic and non-asthmatic groups, identify potential patient subgroups based on gene expression, and explore biological pathways associated with identified differences. METHODS: Transcriptomics profiles were generated by microarray analysis of blood from 610 asthmatic and control participants in U-BIOPRED...
December 7, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27925422/preventing-hospital-acquired-venous-thromboembolism-improving-patient-safety-with-interdisciplinary-teamwork-quality-improvement-analytics-and-data-transparency
#6
REVIEW
Anneliese M Schleyer, Ellen Robinson, Roxana Dumitru, Mark Taylor, Kimberly Hayes, Ronald Pergamit, Daphne M Beingessner, Mark C Zaros, Joseph Cuschieri
BACKGROUND: Hospital-acquired venous thromboembolism (HA-VTE) is a potentially preventable cause of morbidity and mortality. Despite high rates of venous thromboembolism (VTE) prophylaxis in accordance with an institutional guideline, VTE remains the most common hospital-acquired condition in our institution. OBJECTIVE: To improve the safety of all hospitalized patients, examine current VTE prevention practices, identify opportunities for improvement, and decrease rates of HA-VTE...
December 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/27924072/p53-and-murine-double-mimute-2-mdm2-expression-changes-and-significance-in-different-types-of-endometrial-lesions
#7
Zhongyong Jiang, Wanqing Xu, Gang Dan, Yuan Liu, Jie Xiong
BACKGROUND Endometrial lesions are common in obstetrics and gynecology, including endometrial polyps, uterine adenomyosis, and malignant endometrial adenocarcinoma. Endometrial lesions seriously affect women's health, fertility, quality of life, and life safety. As a pro-apoptosis gene, p53 is considered to be closely related with human tumors. Murine double mimute 2 (MDM2) is an oncogene that can promote tumor occurrence and development. P53 and MDM2 expression and significance in different types of endometrial lesions have not been fully elucidated...
December 7, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27923390/the-rapid-ctca-trial-rapid-assessment-of-potential-ischaemic-heart-disease-with-ctca-a-multicentre-parallel-group-randomised-trial-to-compare-early-computerised-tomography-coronary-angiography-versus-standard-care-in-patients-presenting-with-suspected-or-confirmed
#8
Alasdair J Gray, Carl Roobottom, Jason E Smith, Steve Goodacre, Katherine Oatey, Rachel O'Brien, Robert F Storey, Lumine Na, Steff C Lewis, Praveen Thokala, David E Newby
BACKGROUND: Emergency department attendances with chest pain requiring assessment for acute coronary syndrome (ACS) are a major global health issue. Standard assessment includes history, examination, electrocardiogram (ECG) and serial troponin testing. Computerised tomography coronary angiography (CTCA) enables additional anatomical assessment of patients for coronary artery disease (CAD) but has only been studied in very low-risk patients. This trial aims to investigate the effect of early CTCA upon interventions, event rates and health care costs in patients with suspected/confirmed ACS who are at intermediate risk...
December 7, 2016: Trials
https://www.readbyqxmd.com/read/27922901/simulation-using-teamstepps-to-promote-interprofessional-education-and-collaborative-practice
#9
Trent Reed, Trisha Leann Horsley, Keith Muccino, Donna Quinones, Viva Jo Siddall, Janet McCarthy, William Adams
Effective interprofessional collaborative practice is critical to maximizing patient safety and providing quality patient care; incorporating these strategies into the curriculum is an important step toward implementation. This study assessed whether TeamSTEPPS training using simulation could improve student knowledge of TeamSTEPPS principles, self-efficacy toward interprofessional collaborative practice, and team performance. Students (N = 201) demonstrated significant improvement in all of the targeted measurements...
December 5, 2016: Nurse Educator
https://www.readbyqxmd.com/read/27922870/quality-and-safety-in-health-care-part-xx-goal-directed-fluid-therapy-and-the-universal-protocol
#10
Jay A Harolds
There have been numerous initiatives to improve quality and safety in surgery. Goal-directed fluid therapy and a quality bundle for emergency laparotomy surgery are two of them. The establishment of a Universal Protocol to prevent the wrong procedure, the wrong patient having a procedure, or the wrong site for a procedure is an important safeguard for patients.
December 3, 2016: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/27922866/quality-and-safety-in-health-care-part-xix-variants-of-the-eras-program
#11
Jay A Harolds
The integrated recovery pathway is a variant of the enhanced recovery pathway after surgery program, which saw a further decrease in complications and mean length of stay after a change in culture was instituted with more accountability of the staff to following the pathway. This was accomplished using a team-based comprehensive unit-based safety program. It has also been found that another variant of the enhanced recovery pathway after surgery program had a further improvement of patient outcomes after instituting a "preventive surgical site infection bundle...
December 3, 2016: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/27922474/embracing-a-nurse-driven-alcohol-withdrawal-protocol-through-quality-improvement
#12
John Barrett, Maria Jansen, April Cooper, Matthew Felbinger, Faith Waters
BACKGROUND: Alcohol withdrawal can lead to severe complications including seizures, delirium tremens, and death if not treated appropriately. Nurses are critical to the safety and outcomes of these patients. OBJECTIVE: The objective of this retrospective study was to determine if nursing education on a community hospital's alcohol withdrawal protocol led to improved nursing compliance. METHODS: This is a quality improvement project involving a two-part retrospective review-an initial needs assessment followed by nursing education and a subsequent posteducation retrospective review...
October 2016: Journal of Addictions Nursing
https://www.readbyqxmd.com/read/27921374/efficacy-of-a-novel-granulocyte-monocyte-apheresis-adsorber-device-in-the-treatment-of-inflammatory-bowel-diseases-a-pilot-study
#13
Maria Di Girolamo, Alessandro Sartini, Rosina Critelli, Angela Bertani, Alberto Merighi, Erica Villa
Granulocyte monocyte apheresis (GMA) is a non-pharmacological treatment for inflammatory bowel disease. In our study, we tested a novel GMA adsorber device in terms of clinical efficacy and safety in patients' non-response to pharmacological therapy. Secondary outcomes were the evaluation of adsorber's technical performance, the reduction of inflammatory markers and the improvement of patients' life quality. The prospective study included 18 patients enrolled from 2011 to 2012 with a monitoring of 48 weeks...
December 5, 2016: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/27921028/two-year-results-after-convective-radiofrequency-water-vapor-thermal-therapy-of-symptomatic-benign-prostatic-hyperplasia
#14
Christopher M Dixon, Edwin Rijo Cedano, Dalibor Pacik, Vítězslav Vit, Gabriel Varga, Lennart Wagrell, Thayne R Larson, Lance A Mynderse
OBJECTIVE: The objective of this study was to assess the effectiveness and safety of convective radiofrequency (RF) water vapor thermal therapy in men with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH); a pilot study design with 2-year follow-up evaluations. PATIENTS AND METHODS: Men aged ≥45 years with an International Prostate Symptom Score ≥13, a maximum urinary flow rate (Qmax) ≤15 mL/s, and prostate volume 20-120 cc were enrolled in a prospective, open-label pilot study using convective RF water vapor energy with the Rezūm System...
2016: Research and Reports in Urology
https://www.readbyqxmd.com/read/27920685/lipofilling-a-new-therapeutic-option-for-the-treatment-of-lupus-panniculitis-induced-atrophy
#15
Laura Polivka, Marc Revol, Maxime Battistella, Hervé Bachelez
Lupus panniculitis is a rare manifestation of cutaneous lupus erythematosus, which may lead to major aesthetic sequelae with a severe impact on patients' quality of life. We report 2 cases supporting the short- and long-term efficacy and safety of lipofilling in the treatment of lupus panniculitis-induced atrophy. These observations pave the way for prospective, larger-scale studies in patients with scarring lupus panniculitis, provided that the autoimmune pathogenic process is in complete, stable remission...
September 2016: Case Reports in Dermatology
https://www.readbyqxmd.com/read/27920546/chronotherapy-with-low-dose-modified-release-prednisone-for-the-management-of-rheumatoid-arthritis-a-review
#16
REVIEW
Stefano Paolo Beltrametti, Aurora Ianniello, Clara Ricci
To date, rheumatoid arthritis (RA) remains a debilitating, life-threatening disease. One major concern is morning symptoms (MS), as they considerably impair the patients' quality of life and ability to work. MS change in a circadian fashion, resembling the fluctuations of inflammatory cytokines such as interleukin-6, whose levels are higher in RA patients compared to healthy donors. Conversely, serum levels of the potent anti-inflammatory glucocorticoid cortisol are similar to that of healthy subjects, suggesting an imbalance that sustains a pro-inflammatory state...
2016: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/27920228/exploring-novel-paths-towards-protein-signatures-of-chronic-pain
#17
David Gomez-Varela, Manuela Schmidt
Pain is a major symptom of many medical conditions and the worldwide number one reason for people to seek medical assistance. It affects the quality of life of patients and poses a heavy financial burden on society with high costs of treatment and lost productivity. Furthermore, the treatment of chronic pain presents a big challenge as pain therapeutics often lack efficacy and exhibit minimal safety profiles. The latter can be largely attributed to the fact that current therapies target molecules with key physiological functions throughout the body...
2016: Molecular Pain
https://www.readbyqxmd.com/read/27919915/chemoprevention-of-colorectal-cancer-in-individuals-with-previous-colorectal-neoplasia-systematic-review-and-network-meta-analysis
#18
Parambir S Dulai, Siddharth Singh, Evelyn Marquez, Rohan Khera, Larry J Prokop, Paul J Limburg, Samir Gupta, Mohammad Hassan Murad
OBJECTIVE:  To assess the comparative efficacy and safety of candidate agents (low and high dose aspirin, non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs), calcium, vitamin D, folic acid, alone or in combination) for prevention of advanced metachronous neoplasia (that is, occurring at different times after resection of initial neoplasia) in individuals with previous colorectal neoplasia, through a systematic review and network meta-analysis. DATA SOURCES:  Medline, Embase, Web of Science, from inception to 15 October 2015; clinical trial registries...
December 5, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27919836/concomitant-hiatal-hernia-repair-with-laparoscopic-sleeve-gastrectomy-is-safe-analysis-of-the-acs-nsqip-database
#19
Hanaa N Dakour Aridi, Hani Tamim, Aurelie Mailhac, Bassem Y Safadi
BACKGROUND: Gastroesophageal acid reflux disease (GERD) is prevalent after laparoscopic sleeve gastrectomy (LSG), a common bariatric surgical procedure worldwide. Some studies have suggested that concomitant hiatal hernia repair (HHR) during LSG reduces the risk of GERD, but this has not been substantiated. Little is known about the safety of adding an HHR in this setting. The present study aims to compare 30-day morbidity and mortality and length of hospital stay between patients undergoing LSG alone and those undergoing LSG with HHR...
October 5, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/27919387/impacts-of-structuring-the-electronic-health-record-results-of-a-systematic-literature-review-from-the-perspective-of-secondary-use-of-patient-data
#20
REVIEW
Riikka Vuokko, Päivi Mäkelä-Bengs, Hannele Hyppönen, Minna Lindqvist, Persephone Doupi
PURPOSE: To explore the impacts that structuring of electronic health records (EHRs) has had from the perspective of secondary use of patient data as reflected in currently published literature. This paper presents the results of a systematic literature review aimed at answering the following questions; (1) what are the common methods of structuring patient data to serve secondary use purposes; (2) what are the common methods of evaluating patient data structuring in the secondary use context, and (3) what impacts or outcomes of EHR structuring have been reported from the secondary use perspective...
January 2017: International Journal of Medical Informatics
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