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Quality and patient safety

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https://www.readbyqxmd.com/read/28109895/pilot-study-of-the-mirabilis-system-prototype-for-rapid-noninvasive-uterine-fibroid-treatment-using-an-ultrasound-guided-volumetric-shell-ablation-technique
#1
Jessica E Parsons, Michael P H Lau, Patrick J Martin, Joel J Islas Lagos, Juan M Aguilar Aguirre, José G Garza Leal
STUDY OBJECTIVE: The primary objective of this pilot study was to evaluate the safety and acute tissue ablation efficacy of a transabdominal high-intensity focused ultrasound (HIFU) prototype device that uses ultrasound imaging guidance for rapid noninvasive ablation of uterine fibroids. The secondary objective was to assess preliminary fibroid-related symptom improvement and fibroid volume reduction at 3 - 6 months post-treatment in subsets of patients. DESIGN: Multi-center prospective single-arm pilot study (Canadian Task Force Classification II-2) SETTING: University-affiliated teaching hospital and private community hospital PATIENTS: Women with a diagnosis of symptomatic uterine fibroids planning to undergo hysterectomy INTERVENTIONS: Seventy-three (73) women underwent transabdominal ultrasound-guided HIFU treatment using a volumetric ablation technique referred to as 'shell ablation,' in which the HIFU energy is deposited in patterns that partially encapsulate the peripheral region of the targeted fibroid(s)...
January 18, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28109665/a-randomized-double-blind-comparison-of-the-efficacy-and-safety-of-low-dose-olanzapine-plus-low-dose-trifluoperazine-versus-full-dose-olanzapine-in-the-acute-treatment-of-schizophrenia
#2
Ching-Hua Lin, Fu-Chiang Wang, Shih-Chi Lin, Yu-Hui Huang, Cheng-Chung Chen
OBJECTIVE: Antipsychotic polypharmacy is common in clinical practice, but not recommended in guidelines for treating schizophrenia patients. This study aimed to compare the efficacy and safety of low-dose olanzapine plus low-dose trifluoperazine (a first-generation antipsychotic [FGA]) to full-dose olanzapine (a second-generation antipsychotic [SGA]) in the treatment of acute schizophrenia. METHOD: In this 6-week, double-blind, fixed-dose study, patients were randomized to receive 5mg/day of olanzapine plus 5mg/day of trifluoperazine or 10mg/day of olanzapine for 6weeks...
January 18, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28109632/the-american-college-of-radiology-and-the-american-brachytherapy-society-practice-parameter-for-transperineal-permanent-brachytherapy-of-prostate-cancer
#3
Nathan H J Bittner, Peter F Orio, Gregory S Merrick, Bradley R Prestidge, Alan Charles Hartford, Seth A Rosenthal
Transperineal permanent brachytherapy is a safe and effective treatment option for patients with organ-confined prostate cancer. Careful adherence to established brachytherapy standards has been shown to improve the likelihood of procedural success and reduce the incidence of treatment-related morbidity. A collaborative effort of the American College of Radiology (ACR) and the American Brachytherapy Society (ABS) has produced practice parameters for LDR prostate brachytherapy. These practice parameters define the qualifications and responsibilities of all the involved personnel, including the radiation oncologist, physicist and dosimetrist...
January 2017: Brachytherapy
https://www.readbyqxmd.com/read/28108139/emergency-department-waiting-room-nurse-role-a-key-informant-perspective
#4
Innes Kelli, Jackson Debra, Plummer Virginia, Elliott Doug
BACKGROUND: Emergency departments have become overcrowded with increased waiting times. Strategies to decrease waiting times include time-based key performance indicators and introduction of a waiting room nurse role. The aim of the waiting room nurse role is to expedite care by assessing and managing patients in the waiting room. There is limited literature examining this role. METHODS: This paper presents results of semi-structured interviews with five key informants to explore why and how the waiting room nurse role was implemented in Australian emergency departments...
January 17, 2017: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/28107576/non-invasive-anaesthetic-methods-for-dermatological-laser-procedures-a-systematic-review
#5
REVIEW
K Greveling, E P Prens, L Liu, M B A van Doorn
Pain is a common side-effect of dermatological laser procedures. Non-invasive anaesthetic drugs and anaesthetic procedures can be used to provide pain relief and increase patient satisfaction and treatment efficacy. However, it remains unclear which method provides the best pain relief. The objective of this systematic review was therefore to assess the efficacy and safety of non-invasive anaesthetic methods during dermatological laser procedures. A systematic literature search was conducted. Randomized and non-randomized controlled clinical trials (RCTs and CCTs) were included...
January 20, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28107451/effect-of-nocturnal-hemodialysis-versus-conventional-hemodialysis-on-end-stage-renal-disease-a-meta-analysis-and-systematic-review
#6
Fangjie Liu, Yiting Sun, Tianhua Xu, Li Sun, Linlin Liu, Wei Sun, Xin Feng, Jianfei Ma, Lining Wang, Li Yao
OBJECTIVES: The purpose of this study is to assess the efficacy and safety of nocturnal hemodialysis on end-stage renal disease (ESRD) patients. METHODS: We searched Medline, EmBase, and the Cochrance Central Register of Controlled Trials for studies up to January 2016. Analysis was done to compare variant outcomes of different hemodialysis schedules, including mortality, cardiovascular-associated variables, uremia-associated variables, quality of life (QOL), side-effects, and drug usage...
2017: PloS One
https://www.readbyqxmd.com/read/28107397/efficacy-and-safety-of-everolimus-for-maintenance-immunosuppression-of-kidney-transplantation-a-meta-analysis-of-randomized-controlled-trials
#7
Jinyu Liu, Dong Liu, Juan Li, Lan Zhu, Chengliang Zhang, Kai Lei, Qiling Xu, Ruxu You
BACKGROUND: Conversion to everolimus is often used in kidney transplantation to overcome calcineurin inhibitor (CNI) nephrotoxicity but there is conflicting evidence for this approach. OBJECTIVES: To investigate the benefits and harm from randomized clinical trials (RCTs) involving the conversion from CNI to everolimus after kidney transplantation. METHODS: Databases were searched up to March 2016. Two reviewers independently assessed trials for eligibility and quality, and extracted data...
2017: PloS One
https://www.readbyqxmd.com/read/28107394/quality-of-documentation-as-a-surrogate-marker-for-awareness-and-training-effectiveness-of-phtls-courses-part-of-the-prospective-longitudinal-mixed-methods-epptc-trial
#8
David Häske, Stefan K Beckers, Marzellus Hofmann, Rolf Lefering, Bernhard Gliwitzky, Christoph C Wölfl, Paul Grützner, Ulrich Stöckle, Marc Dieroff, Matthias Münzberg
OBJECTIVE: Care for severely injured patients requires multidisciplinary teamwork. A decrease in the number of accident victims ultimately affects the routine and skills. PHTLS ("Pre-Hospital Trauma Life Support") courses are established two-day courses for medical and non-medical rescue service personnel, aimed at improving the pre-hospital care of trauma patients worldwide. The study aims the examination of the quality of documentation before and after PHTLS courses as a surrogate endpoint of training effectiveness and awareness...
2017: PloS One
https://www.readbyqxmd.com/read/28107335/aromatherapy-using-essential-oils-as-a-supportive-therapy%C3%A2
#9
Debra Reis, Tisha Jones
Essential oils can be a great adjunct to cancer care, aiding in the management of side effects, such as insomnia and nausea. Healthcare professionals should be knowledgeable about the quality and safety of essential oils when using them for clinical purposes. Using lesser quality essential oils and not understanding safety guidelines can negatively affect clinical outcomes. This article provides an overview of how nurses can help patients with cancer safely use essential oils as a supportive therapy.
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February 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28106160/evaluation-of-three-block-anesthesia-methods-for-pain-management-during-mandibular-third-molar-extraction-a-meta-analysis
#10
Fanyuan Yu, Yao Xiao, Hanghang Liu, Fanzi Wu, Feng Lou, Dian Chen, Mingru Bai, Dingming Huang, Chenglin Wang, Ling Ye
A patient's pain during mandibular third molar extraction often creates problems for a dental surgeon and can also cause immense patient discomfort, such as decreased quality of life, serious complications, or even danger to the patients' lives. Effective pain management is therefore of great importance. Conventional block anesthesia method often fails to control such pain completely during an operation. Therefore, two available alternatives, Gow-Gates (G-G) and Vazirani-Akinosi (V-A) methods, have been developed...
January 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28105882/quality-improvement-in-hospitals-barriers-and-facilitators
#11
Dick E Zoutman, B Douglas Ford
Purpose The purpose of this paper is to examine quality improvement (QI) initiatives in acute care hospitals, the factors associated with success, and the impacts on patient care and safety. Design/methodology/approach An extensive online survey was completed by senior managers responsible for QI. The survey assessed QI project types, QI methods, staff engagement, and barriers and factors in the success of QI initiatives. Findings The response rate was 37 percent, 46 surveys were completed from 125 acute care hospitals...
February 13, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28104490/increasing-trainee-reporting-of-adverse-events-with-monthly-trainee-directed-review-of-adverse-events
#12
Alla Smith, Jonathan Hatoun, James Moses
OBJECTIVE: Underreporting of adverse events by physicians is a barrier to improving patient safety. In an effort to increase resident and medical student (hereafter "trainee") reporting of adverse events, trainees developed and led a monthly conference during which they reviewed adverse-event reports, identified system vulnerabilities and designed solutions to those vulnerabilities. METHODS: Monthly conferences over the 22-month study period were led by pediatric trainees, and attended by fellow trainees, departmental leadership, and members of the hospital's quality improvement team...
January 16, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28104022/-immune-checkpoint-inhibitor-therapy-in-advanced-head-and-neck-cancer
#13
W Hang, Z X Xu, Q Zhang, X Lu, G Liu
Immune checkpoint inhibitor therapy, which targets regulatory pathways in T cells to enhance antitumor immune responses, improves the life quality of cancer patients and has joined the ranks of surgery, radiation, and chemotherapy to become a major choice for cancer therapy. Over the past few years, multiple exciting results have been obtained on checkpoint inhibitor therapy in advanced head and neck cancer. However, questions such as patient selection and biomarkers for assessing the therapy are largely unsolved...
January 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/28103925/protocol-for-a-realist-review-of-workplace-learning-in-postgraduate-medical-education-and-training
#14
Anel Wiese, Caroline Kilty, Colm Bergin, Patrick Flood, Na Fu, Mary Horgan, Agnes Higgins, Bridget Maher, Grainne O'Kane, Lucia Prihodova, Dubhfeasa Slattery, Deirdre Bennett
BACKGROUND: Postgraduate medical education and training (PGMET) is a complex social process which happens predominantly during the delivery of patient care. The clinical learning environment (CLE), the context for PGMET, shapes the development of the doctors who learn and work within it, ultimately impacting the quality and safety of patient care. Clinical workplaces are complex, dynamic systems in which learning emerges from non-linear interactions within a network of related factors and activities...
January 19, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28103911/comparison-of-the-effectiveness-and-safety-of-topical-versus-intravenous-tranexamic-acid-in-primary-total-knee-arthroplasty-a-meta-analysis-of-randomized-controlled-trials
#15
Tao-Ping Chen, Yu-Min Chen, Jian-Bao Jiao, Yun-Fei Wang, Li-Gang Qian, Zhao Guo, Zheng Ma, Cui-Yu Han, Tong-Huan Shi
BACKGROUND: This study aims to compare the effectiveness and safety of topical versus intravenous tranexamic acid (TXA) in reducing blood loss in primary total knee arthroplasty (TKA). METHODS: PubMed, Embase, the Cochrane Library, Web of Science, Chinese Biomedicine Literature (CBM), Wanfang Database and China National Knowledge Infrastructure (CNKI), and Google Scholar were searched for randomized controlled studies (RCTs) that compared topical versus intravenous TXA in terms of reducing blood loss during TKA from their inception to September 2015...
January 19, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28103444/efficacy-and-safety-of-a-recombinant-factor-viii-produced-from-a-human-cell-line-simoctocog-alfa
#16
Massimo Franchini, Pier Mannuccio Mannucci
The development of inhibitors against infused factor VIII (FVIII) has a detrimental impact on health and quality of life of patients with hemophilia A. Several observational studies and a recently published randomized trial indicate that the inhibitor risk in previously untreated patients (PUPs) is higher following the use of recombinant FVIII (rFVIII) products compared with plasma-derived FVIII concentrates. There is currently a great interest towards newer rFVIII products that adopt various technological solutions to reduce the inhibitor risk...
January 19, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28103397/the-economic-burden-of-nurse-sensitive-adverse-events-in-22-medical-surgical-units-retrospective-and-matching-analysis
#17
Eric Tchouaket, Carl-Ardy Dubois, Danielle D'Amour
AIMS: To assess the economic burden of nurse-sensitive adverse events (NSAEs) in 22 acute care units in Quebec by estimating excess hospital-related costs and calculating resulting additional hospital days. BACKGROUND: Recent changes in the worldwide economic and financial contexts have made the cost of patient safety a topical issue. Yet our knowledge about the economic burden of safety of nursing care is quite limited in Canada in general and Quebec in particular...
January 19, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28101753/effect-and-safety-of-paroxetine-combined-with-zolpidem-in-treatment-of-primary-insomnia
#18
Z H Yu, X H Xu, S D Wang, M F Song, Y Liu, Y Yin, H J Mao, G Z Tang
PURPOSE: Primary insomnia is a persistent and recurrent disorder as well as a risk factor for depression. The aim of this study was to determine whether the zolpidem combined with paroxetine would be effective in the treatment of patients with primary insomnia. METHODS: Ninety patients meeting DSM-IV criteria for primary insomnia were randomly assigned to 8 weeks of treatment with zolpidem combined with paroxetine (the combined treatment group, n = 45) or zolpidem combined with placebo (the control group, n = 45)...
January 18, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28101720/enhanced-recovery-after-surgery-programs-for-liver-resection-a-meta-analysis
#19
Cheng Wang, Guoqun Zheng, Wenlong Zhang, Fabiao Zhang, Shangdong Lv, Aidong Wang, Zheping Fang
BACKGROUND AND AIMS: Due to the limited number of high-quality randomized controlled trials on enhanced recovery after surgery for hepatectomy, previous reviews have not been sufficiently comprehensive. Our objectives were to evaluate and compare the safety and efficacy of enhanced recovery after surgery programs and traditional care in patients undergoing open or laparoscopic surgery and to assess the optimized items for hepatectomy. METHODS: We searched the PubMed, Embase, and the Cochrane Library databases for all the relevant studies regardless of study design...
January 18, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28101651/eslicarbazepine-acetate-its-effectiveness-as-adjunctive-therapy-in-clinical-trials-and-open-studies
#20
REVIEW
S D Shorvon, E Trinka, B J Steinhoff, M Holtkamp, V Villanueva, J Peltola, E Ben-Menachem
Eslicarbazepine acetate (ESL) is a once-daily antiepileptic drug that is approved as adjunctive therapy in adults with focal-onset seizures. Following oral administration, ESL is rapidly metabolized to its active metabolite, eslicarbazepine, which acts primarily by enhancing slow inactivation of voltage-gated sodium channels. The efficacy and safety/tolerability of ESL in the adjunctive setting were established in a comprehensive Phase III program (n = 1702 randomized patients) and this evidence has been supported by several open studies (n = 864)...
January 18, 2017: Journal of Neurology
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