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Quality and patient safety

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https://www.readbyqxmd.com/read/28340242/insertion-of-miniaturized-cardiac-monitors-outside-the-catheter-operating-room-experience-and-practical-advice
#1
Jan Steffel, David Jay Wright, Harald Schäfer, Tabinda Rashid-Fadel, Thorsten Lewalter
Minor surgical procedures are increasingly being performed as outpatient procedures in settings outside hospital operating rooms (ORs). In electrophysiology, the recent miniaturization of insertable cardiac monitors (ICMs) has enabled the routine insertion of the device as a minimally invasive procedure without the need of a catheter OR. However, a shift to office-based environments for minor surgical procedures is associated with some concerns, particularly with respect to patient- and procedure-related safety in the new setting...
March 17, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28340232/a-proposed-set-of-metrics-to-reduce-patient-safety-risk-from-within-the-anatomic-pathology-laboratory
#2
Peter Banks, Richard Brown, Alex Laslowski, Yvonne Daniels, Phil Branton, John Carpenter, Richard Zarbo, Ramses Forsyth, Yan-Hui Liu, Shane Kohl, Joachim Diebold, Shinobu Masuda, Tim Plummer, Eslie Dennis
Background: Anatomic pathology laboratory workflow consists of 3 major specimen handling processes. Among the workflow are preanalytic, analytic, and postanalytic phases that contain multistep subprocesses with great impact on patient care. A worldwide representation of experts came together to create a system of metrics, as a basis for laboratories worldwide, to help them evaluate and improve specimen handling to reduce patient safety risk. Method: Members of the Initiative for Anatomic Pathology Laboratory Patient Safety (IAPLPS) pooled their extensive expertise to generate a list of metrics highlighting processes with high and low risk for adverse patient outcomes...
March 18, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28340229/meaningful-use-in-the-safety-net-a-rapid-ethnography-of-patient-portal-implementation-at-five-community-health-centers-in-california
#3
Sara L Ackerman, Urmimala Sarkar, Lina Tieu, Margaret A Handley, Dean Schillinger, Kenneth Hahn, Mekhala Hoskote, Gato Gourley, Courtney Lyles
Objective: US health care institutions are implementing secure websites (patient portals) to achieve federal Meaningful Use (MU) certification. We sought to understand efforts to implement portals in "safety net" health care systems that provide services for low-income populations. Materials and Methods: Our rapid ethnography involved visits at 4 California safety net health systems and in-depth interviews at a fifth. Visits included interviews with clinicians and executives ( n  = 12), informal focus groups with front-line staff ( n  = 35), observations of patient portal sign-up procedures and clinic work, review of marketing materials and portal use data, and a brief survey ( n  = 45)...
March 15, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28340107/association-between-the-application-of-iso-9001-2008-alone-or-in-combination-with-health-specific-standards-and-quality-related-activities-in-hungarian-hospitals
#4
Viktor Dombrádi, Orsolya Karola Csenteri, János Sándor, Sándor Godény
Objective: To investigate how International Organization for Standardization (ISO) 9001 and the Hungarian Health Care Standards (HHCS) certifications are associated with quality management, patient safety, patient rights and human resource management activities. Design: A cross-sectional study was implemented using the 2009 Hungarian hospital survey's database. Setting: Hungary. Participants: Fifty-three general hospitals were included in the statistical analysis...
March 7, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28340044/oral-ghrelin-receptor-agonist-mk-0677-increases-serum-insulin-like-growth-factor-1-in-hemodialysis-patients-a-randomized-blinded-study
#5
Garland A Campbell, James T Patrie, Bruce D Gaylinn, Michael O Thorner, Warren K Bolton
Background: . Protein-energy wasting (PEW) in end-stage renal disease (ESRD) patients is associated with increased morbidity and mortality, but options for treatment are limited. Growth hormone (GH) increases insulin-like growth factor 1 (IGF-1), with improved nutritional parameters, but must be given subcutaneously and does not provide normal GH secretion patterns. MK-0677, an oral ghrelin receptor agonist (GRA), maintains normal GH secretion and increases lean body mass in normal subjects; it has not been studied in dialysis patients, an essential step in assessing efficacy and safety prior to clinical trials...
March 3, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28339993/one-year-efficacy-and-safety-of-the-iron-based-phosphate-binder-sucroferric-oxyhydroxide-in-patients-on-peritoneal-dialysis
#6
Jürgen Floege, Adrian C Covic, Markus Ketteler, Johannes Mann, Anjay Rastogi, Bruce Spinowitz, Viatcheslav Rakov, Laura J Lisk, Stuart M Sprague
Background.: Sucroferric oxyhydroxide is a noncalcium, iron-based phosphate binder that demonstrated sustained serum phosphorus control, good tolerability and lower pill burden compared with sevelamer carbonate (sevelamer) in a Phase 3 study conducted in dialysis patients. This subanalysis examines the efficacy and tolerability of sucroferric oxyhydroxide and sevelamer in the peritoneal dialysis (PD) patient population. Methods.: The initial study (NCT01324128) and its extension (NCT01464190) were multicenter, Phase 3, open-label, randomized (2:1), active-controlled trials comparing sucroferric oxyhydroxide (1...
February 23, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28339735/triage-quality-control-is-missing-tools-a-new-observation-technique-for-ed-quality-improvement
#7
Tomi Malmström, Veli-Pekka Harjola, Paulus Torkki, Salla Kumpulainen, Raija Malmström
Objective: Correct assessment of patient urgency is critical to ensuring patient safety in emergency departments (EDs). Although significant time and effort have been devoted to developing triage systems, less attention has been paid to the development of quality control. The aim of this study is to introduce and test observation technique, which enables identifying of patient groups at risk of erroneous assessment in triage. The introduced technique is aimed to be less laborious to use than existing triage quality control methods...
February 23, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28339698/learning-from-errors-analysis-of-medication-order-voiding-in-cpoe-systems
#8
Thomas G Kannampallil, Joanna Abraham, Anna Solotskaya, Sneha G Philip, Bruce L Lambert, Gordon D Schiff, Adam Wright, William L Galanter
Objective: Medication order voiding allows clinicians to indicate that an existing order was placed in error. We explored whether the order voiding function could be used to record and study medication ordering errors. Materials and Methods: We examined medication orders from an academic medical center for a 6-year period (2006-2011; n  = 5 804 150). We categorized orders based on status (void, not void) and clinician-provided reasons for voiding. We used multivariable logistic regression to investigate the association between order voiding and clinician, patient, and order characteristics...
February 19, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28339581/rationale-and-design-of-the-budapest-crt-upgrade-study-a-prospective-randomized-multicentre-clinical-trial
#9
Bela Merkely, Annamaria Kosztin, Attila Roka, Laszlo Geller, Endre Zima, Attila Kovacs, Andras Mihaly Boros, Helmut Klein, Jerzy K Wranicz, Gerhard Hindricks, Marcell Clemens, Gabor Z Duray, Arthur J Moss, Ilan Goldenberg, Valentina Kutyifa
Aims: There is lack of conclusive evidence from randomized clinical trials on the efficacy and safety of upgrade to cardiac resynchronization therapy (CRT) in patients with implanted pacemakers (PM) or defibrillators (ICD) with reduced left ventricular ejection fraction (LVEF) and chronic heart failure (HF). The BUDAPEST-CRT Upgrade Study was designed to compare the efficacy and safety of CRT upgrade from conventional PM or ICD therapy in patients with intermittent or permanent right ventricular (RV) septal/apical pacing, reduced LVEF, and symptomatic HF...
October 6, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28339340/patient-perspectives-on-language-discordance-during-healthcare-visits-findings-from-the-extremely-high-density-multicultural-state-of-qatar
#10
Huda Abdelrahim, Maha Elnashar, Amal Khidir, Amal Killawi, Maya Hammoud, Abdul Latif Al-Khal, Michael D Fetters
Reducing language and cultural barriers in healthcare are significant factors in resolving health disparities. Qatar's rapidly growing multicultural population presents new challenges to the healthcare system. The purpose of this research was to explore patients' perspectives about language discordance, and the strategies used to overcome language barriers during patients' visits. Participants were recruited and interviewed from four language groups (Arabic = 24, English = 20, Hindi = 20, and Urdu = 20), all of whom were living in Qatar and utilizing Hamad General Hospital-Outpatient Clinics as a source of their healthcare services...
March 24, 2017: Journal of Health Communication
https://www.readbyqxmd.com/read/28338301/analgesia-for-patients-undergoing-shockwave-lithotripsy-for-urinary-stones-a-systematic-review-and-meta-analysis
#11
Omar M Aboumarzouk, Rami Hasan, Ali Tasleem, Martin Mariappan, Rachael Hutton, John Fitzpatrick, Laura Beatty, Gareth E Jones, Tarik Amer
BACKGROUND: Shock wave lithotripsy (SWL) is the first line treatment modality for a significant proportion of patients with upper urinary tracts stones. Simple analgesics, opioids and non-steroidal anti-inflammatory drugs (NSAIDs) are all suitable agents but the relative efficacy and tolerability of these agents is uncertain. OBJECTIVES: To determine the efficacy of the different types of analgesics used for the control of pain during SWL for urinary stones. MATERIALS AND METHODS: We searched the Cochrane Renal Group's Specialised Register, MEDLINE, EMBASE and also hand-searched reference lists of relevant articles (Figure-1)...
March 24, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28338265/acupuncture-plus-moxibustion-for-herpes-zoster-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#12
REVIEW
Meaghan E Coyle, Haiying Liang, Kaiyi Wang, Anthony Lin Zhang, Xinfeng Guo, Chuanjian Lu, Charlie C Xue
Herpes zoster is an acute inflammatory condition which can have a significant impact on quality of life. Antiviral therapies are effective, but do not meet patients' expectations of symptomatic relief. Acupuncture and moxibustion have been used for herpes zoster; this systematic review evaluated their efficacy and safety. Nine English and Chinese databases were searched from their inceptions to March 2016. Randomized controlled trials evaluating the combination of acupuncture plus moxibustion in adult herpes zoster were included...
March 24, 2017: Dermatologic Therapy
https://www.readbyqxmd.com/read/28338223/efficacy-and-safety-of-ustekinumab-in-japanese-patients-with-severe-atopic-dermatitis-a-randomised-double-blind-placebo-controlled-phase-2-study
#13
H Saeki, K Kabashima, Y Tokura, Y Murata, A Shiraishi, R Tamamura, B Randazzo, K Imanaka
BACKGROUND: Ustekinumab, a fully human monoclonal antibody against interleukin-12/23, may be potentially effective for severe atopic dermatitis (AD) treatment. OBJECTIVES: To evaluate efficacy and safety of ustekinumab 45 mg and 90 mg in severe AD patients. METHODS: In this placebo-controlled, randomised, phase 2 study, adult Japanese patients (aged 20-65 years) with severe or very severe AD entered a 12-week double-blind treatment period to receive (1:1:1) ustekinumab 45 mg, 90 mg or placebo subcutaneous injections at weeks 0 and 4; follow-up until week 24...
March 24, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/28337883/evaluation-of-tolerance-and-safety-of-conversion-from-mycophenolate-mofetil-to-enteric-coated-mycophenolic-acid-in-renal-transplant-recipients
#14
L W Qiao, Q S Qu, X Jiang
This study was designed to evaluate the curative effect of conversion from mycophenolate mofetil (MMF) to enteric-coated mycophenolate sodium tablets (EC-MPS) and its safety. One hundred and twenty renal transplant recipients who developed MMF-associated chronic diarrhea were selected as research subjects and treated with EC-MPS. The patients were followed up for 12 months to compare the improvement of gastrointestinal symptoms and the indexes such as carbon dioxide combining power (CO2CP), serum sodium, serum potassium, serum creatinine (Scr) and 24-h urine protein before and after conversion treatment...
January 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28337872/safety-and-pharmacodynamic-mechanism-of-ropivacaine-lumbar-anesthesia-in-cesarean-section
#15
Q Liu, J J Wang, H Y Yan, Y Q Wang, C W Qin, M L Li
Lumbar anesthesia is the preferred anesthetic approach for puerperae undergoing cesarean section in China. To observe the safety of administering different doses of ropivacaine for cesarean section and its pharmacodynamic mechanism, we randomly divided 180 pregnant women undergoing cesarean section into three groups: group A, 10 mg ropivacaine (0.50%); group B, 12 mg ropivacaine (0.50%); and group C, 14 mg ropivacaine (0.50%). Pharmacodynamic index, anesthesia quality and incidence of untoward reactions of each group were observed...
January 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28337422/the-combined-use-of-computer-guided-minimally-invasive-flapless-corticotomy-and-clear-aligners-as-a-novel-approach-to-moderate-crowding-a-case-report
#16
Michele Cassetta, Federica Altieri, Stefano Pandolfi, Matteo Giansanti
The aim of this case report was to describe an innovative orthodontic treatment method that combined surgical and orthodontic techniques. The novel method was used to achieve a positive result in a case of moderate crowding by employing a computer-guided piezocision procedure followed by the use of clear aligners. A 23-year-old woman had a malocclusion with moderate crowding. Her periodontal indices, oral health-related quality of life (OHRQoL), and treatment time were evaluated. The treatment included interproximal corticotomy cuts extending through the entire thickness of the cortical layer, without a full-thickness flap reflection...
March 2017: Korean Journal of Orthodontics
https://www.readbyqxmd.com/read/28336738/single-stage-osseointegrated-reconstruction-and-rehabilitation-of-lower-limb-amputees-the-osseointegration-group-of-australia-accelerated-protocol-2-ogaap-2-for-a-prospective-cohort-study
#17
Munjed Al Muderis, William Lu, Kevin Tetsworth, Belinda Bosley, Jiao Jiao Li
INTRODUCTION: Lower limb amputations have detrimental influences on the quality of life, function and body image of the affected patients. Following amputation, prolonged rehabilitation is required for patients to be fitted with traditional socket prostheses, and many patients experience symptomatic socket-residuum interface problems which lead to reduced prosthetic use and quality of life. Osseointegration has recently emerged as a novel approach for the reconstruction of amputated limbs, which overcomes many of the socket-related problems by directly attaching the prosthesis to the skeletal residuum...
March 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28336258/a-comparison-of-combined-intravenous-and-topical-administration-of-tranexamic-acid-with-intravenous-tranexamic-acid-alone-for-blood-loss-reduction-after-total-hip-arthroplasty-a-meta-analysis
#18
REVIEW
Xiangcheng Liu, Jinglong Liu, Ganghe Sun
BACKGROUND: The optimal dose and protocol of tranexamic acid (TXA) for reducing blood loss in total hip arthroplasty (THA) is controversial. Intravenous TXA (IV-TXA) and combined IV-TXA with topical TXA are the two common protocol after THA. A meta-analysis of randomized controlled trials (RCTs) to compare the efficacy and safety of combined IV and topical TXA with IV-TXA alone in reducing blood loss after THA. METHODS: PubMed, Medline, Embase, Web of Science, the Cochrane Library, China Wanfang database and Google database were searched from the inception to February 2017 to identify RCTs that comparing combined IV and topical TXA with IV-TXA alone for patients prepared for primary THA...
March 20, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28335770/a-model-of-influences-on-the-clinical-learning-environment-the-case-for-change-at-one-u-s-medical-school
#19
Howard B Fleit, Richard J Iuli, Janet E Fischel, Wei-Hsin Lu, Latha Chandran
BACKGROUND: The learning environment within a school of medicine influences medical students' values and their professional development. Despite national requirements to monitor the learning environment, mistreatment of medical students persists. METHODS: We designed a program called WE SMILE: We can Eradicate Student Mistreatment In the Learning Environment with a vision to enhance trainee and faculty awareness and ultimately eliminate medical student mistreatment...
March 23, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28334586/processes-for-identifying-and-reviewing-adverse-events-and-near-misses-at-an-academic-medical-center
#20
William Martinez, Lisa Soleymani Lehmann, Yue-Yung Hu, Sonali Parekh Desai, Jo Shapiro
BACKGROUND: Conferences, processes, and/or meetings in which adverse events and near misses are reviewed within clinical programs at a single academic medical center were identified. METHODS: Leaders of conferences, processes, or meetings-"process leaders"-in which adverse events and near misses were reviewed were surveyed. RESULTS: On the basis of responses from all 45 process leaders, processes were classified into (1) Morbidity and Mortality Conferences (MMCs), (2) Quality Assurance (QA) Meetings, and (3) Educational Conferences...
January 2017: Joint Commission Journal on Quality and Patient Safety
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