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Quality and patient safety

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https://www.readbyqxmd.com/read/29346638/standardized-languages-and-notations-for-graphical-modelling-of-patient-care-processes-a-systematic-review
#1
Pierpaolo Mincarone, Carlo Giacomo Leo, Maria Del Mar Trujillo-Martín, Jan Manson, Roberto Guarino, Giuseppe Ponzini, Saverio Sabina
Purpose: The importance of working toward quality improvement in healthcare implies an increasing interest in analysing, understanding and optimizing process logic and sequences of activities embedded in healthcare processes. Their graphical representation promotes faster learning, higher retention and better compliance. The study identifies standardized graphical languages and notations applied to patient care processes and investigates their usefulness in the healthcare setting. Data sources: Peer-reviewed literature up to 19 May 2016...
January 16, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29346570/implementation-status-of-morbidity-and-mortality-conferences-in-swiss-hospitals-a-national-cross-sectional-survey-study
#2
Isabelle Praplan-Rudaz, Yvonne Pfeiffer, David L B Schwappach
Objective: To determine the implementation status and current practice of morbidity and mortality conferences (M&MCs) in Switzerland. Design: A national cross-sectional online survey was conducted in spring 2017. The questionnaire focused on overall goals, structure and procedures of hospital M&MCs. Further topics included satisfaction, perceived effectiveness and support requirements. Setting: A total of 913 chief physicians of surgery and internal medicine, and specialist fields of obstetrics and gynaecology, anaesthesiology and intensive care from Swiss acute care hospitals were invited to the survey...
January 16, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29345593/antithrombotic-therapy-after-tavr
#3
Tobias Geisler, Michal Droppa, Karin Mueller, Oliver Borst
Transvascular aortic valve replacement (TAVR) has emerged as a treatment option in patients with severe aortic stenosis who are inoperable and has recently been evaluated in patients with intermediate surgical risk. The number of procedures is increasing worldwide in parallel with the demographic changes in industrial countries. The risk for cerebral embolism is of main concern and represents a major determinant for prognosis and quality of live after TAVR. The empiric antithrombotic therapy consists of dual antiplatelet therapy (DAPT); however the risk-benefit of this approach is lacking evidence from randomized, placebo-controlled trials regarding choice and duration of antithrombotic treatment...
January 17, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29345553/quality-and-variability-of-patient-directions-in-electronic-prescriptions-in-the-ambulatory-care-setting
#4
Yuze Yang, Stacy Ward-Charlerie, Ajit A Dhavle, Michael T Rupp, James Green
BACKGROUND: The prescriber's directions to the patient (Sig) are one of the most quality-sensitive components of a prescription order. Owing to their free-text format, the Sig data that are transmitted in electronic prescriptions (e-prescriptions) have the potential to produce interpretation challenges at receiving pharmacies that may threaten patient safety and also negatively affect medication labeling and patient counseling. Ensuring that all data transmitted in the e-prescription are complete and unambiguous is essential for minimizing disruptions in workflow at prescribers' offices and receiving pharmacies and optimizing the safety and effectiveness of patient care...
January 18, 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29344622/barriers-to-and-facilitators-of-implementing-enhanced-recovery-pathways-using-an-implementation-framework-a-systematic-review
#5
Alexander B Stone, Christina T Yuan, Michael A Rosen, Michael C Grant, Lauren E Benishek, Elizabeth Hanahan, Lisa H Lubomski, Clifford Ko, Elizabeth C Wick
Importance: Enhanced recovery pathways (ERPs) have the potential to reduce length of hospital stay, costs, and complications following surgery but can be challenging to implement. Objective: To examine the body of literature on ERPs to assess how authors describe barriers and facilitators of ERP implementation and identify, in aggregate, the best practices that should be considered utilizing the Consolidated Framework for Implementation Research (CFIR) to extract these elements and summarize common barriers and facilitators according to its 5 major domains: (1) intervention characteristics, (2) inner setting, (3) outer setting, (4) characteristics of the individuals, and (5) the process of implementation...
January 17, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29344223/application-of-intensity-modulated-radiation-therapy-in-the-treatment-of-nasopharyngeal-carcinoma
#6
Hao Yan, Xiaoming Cao, Jinmei Wang
The objective of the present study was to investigate the application values of the intensity-modulated radiation therapy (IMRT) and the three-dimensional conformal radiation therapy (3D-CRT) in the treatment of nasopharyngeal carcinoma (NPC). A total of 124 patients diagnosed with nasopharyngeal carcinomas were included into the study and randomly divided into the control group and the observation group, with 62 patients in each group. The 3D-CRT combined with postoperative chemotherapy were performed on the control group and the observation group received IMRT combined with postoperative chemotherapy, and then were followed up for a median duration of 25...
December 2017: Oncology Letters
https://www.readbyqxmd.com/read/29343468/onabotulinum-toxin-a-injections-for-sleep-bruxism-a-double-blind-placebo-controlled-study
#7
William G Ondo, Jerald H Simmons, Muhammad H Shahid, Vera Hashem, Christine Hunter, Joseph Jankovic
OBJECTIVES: To test the safety and efficacy of onabotulinum toxin-A (BoNT-A) injections into the masseter and temporalis muscles in patients with symptomatic sleep bruxism. METHODS: Participants 18 to 85 years old with clinically diagnosed sleep bruxism confirmed by polysomnography were enrolled in this randomized, placebo-controlled, 1:1, parallel-design trial with open-label extension. Participants were injected with BoNT-A 200 units (60 into each masseter and 40 into each temporalis) or placebo and were evaluated at 4 to 8 weeks after the initial treatment visit...
January 17, 2018: Neurology
https://www.readbyqxmd.com/read/29343410/random-uncertainty-of-photometric-determination-of-hemolysis-index-on-the-abbott-architect-c16000-platform
#8
Elena Aloisio, Assunta Carnevale, Sara Pasqualetti, Sarah Birindelli, Alberto Dolci, Mauro Panteghini
BACKGROUND: Automatic photometric determination of the hemolysis index (HI) on serum and plasma samples is central to detect potential interferences of in vitro hemolysis on laboratory tests. When HI is above an established cut-off for interference, results may suffer from a significant bias and undermine clinical reliability of the test. Despite its undeniable importance for patient safety, the analytical performance of HI estimation is not usually checked in laboratories. Here we evaluated for the first time the random source of measurement uncertainty of HI determination on the two Abbott Architect c16000 platforms in use in our laboratory...
January 14, 2018: Clinical Biochemistry
https://www.readbyqxmd.com/read/29342248/clinical-considerations-of-the-role-of-palbociclib-in-the-management-of-advanced-breast-cancer-patients-with-and-without-visceral-metastases
#9
N C Turner, R S Finn, M Martin, S-A Im, A DeMichele, J Ettl, V Diéras, S Moulder, O Lipatov, M Colleoni, M Cristofanilli, D R Lu, A Mori, C Giorgetti, S Iyer, C Huang Bartlett, K A Gelmon
Background: This report assesses the efficacy and safety of palbociclib plus endocrine therapy (ET) in women with hormone receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer (ABC) with or without visceral metastases. Patients and methods: Pre- and postmenopausal women with disease progression following prior ET (PALOMA-3; N=521) and postmenopausal women untreated for ABC (PALOMA-2; N=666) were randomized 2:1 to ET (fulvestrant or letrozole, respectively) plus palbociclib or placebo...
January 11, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/29341822/aripiprazole-long-acting-injectable-for-maintenance-treatment-of-bipolar-i-disorder-in-adults
#10
Arpit Aggarwal, Lindsey Schrimpf, John Lauriello
Bipolar I disorder is a serious and disabling psychiatric illness. It is associated with a significant reduction in quality of life and an increased risk for suicide. Pharmacotherapy is essential for both the acute and maintenance treatment of bi-polar I disorder. While multiple oral medications are recommended for the maintenance treatment, there are not many long-acting injectable medications approved for this indication. New treatments that would improve patient adherence have the potential for decreasing relapses and improving patients' ability to remain functional members of society...
January 2018: Clinical Schizophrenia & related Psychoses
https://www.readbyqxmd.com/read/29341174/sensing-performance-safety-and-patient-acceptability-of-long-dipole-cardiac-monitor-an-innovative-axillary-insertion
#11
Giovanni Bisignani, Silvana De Bonis, Antonio Bisignani, Luigi Mancuso, Daniele Giacopelli
BACKGROUND: The recommended location for implantable cardiac monitor (ICM) insertion is the left pectoral region. We tested whether an innovative left axillary implantation approach could be applicable for a new ICM, characterized by a long sensing dipole. METHODS: We considered a series of 55 patients consecutively implanted with a long-dipole ICM (BioMonitor 2); the first 30 subjects underwent prepectoral location insertion, while the subsequent 25 received the ICM in the axillary region...
January 17, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29340732/-electronic-decision-support-to-promote-medication-safety
#12
REVIEW
Walter E Haefeli, Hanna M Seidling
Because of its inherent complexity, it is a considerable challenge to tailor drug treatment to a prevalent disease and its subgroups, which are increasingly defined by genomic variability (personalized medicine) and require consideration of context information such as co-morbidity, co-medication, patient preferences, and the specific characteristics of the healthcare sector. Thus, optimum treatment decisions might not be taken intuitively any longer, because decisions must be made both rapidly and increasingly based on analyses of complex relations of numerous variables that exceed the processing performance of a human brain...
January 16, 2018: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/29340632/developing-a-set-of-indicators-to-monitor-quality-in-ambulatory-diabetes-care-using-a-modified-delphi-panel-process
#13
Geetha Mukerji, Ilana Halperin, Katie Hunter, Phillip Segal, Maria Wolfs, Lindsay Bevan, Lianne Jeffs, Jeannette Goguen
Objective: There is a large evidence to practice gap in diabetes care with limited performance assessments that capture the full spectrum of care delivery. Our study aimed to develop a set of ambulatory diabetes quality indicators across six domains (effectiveness, safety, patient-centered, timely, equitable and efficient) to provide a broad view of quality. Design: A modified Delphi panel process was conducted. Phase I involved compiling a list of indicators through literature review and generation of patient and healthcare provider-derived indicators through interviews and surveys, respectively...
January 11, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29340541/safety-criteria-to-start-early-mobilization-in-intensive-care-units-systematic-review
#14
Thais Martins Albanaz da Conceição, Ana Inês Gonzáles, Fernanda Cabral Xavier Sarmento de Figueiredo, Danielle Soares Rocha Vieira, Daiana Cristine Bündchen
Mobilization of critically ill patients admitted to intensive care units should be performed based on safety criteria. The aim of the present review was to establish which safety criteria are most often used to start early mobilization for patients under mechanical ventilation admitted to intensive care units. Articles were searched in the PubMed, PEDro, LILACS, Cochrane and CINAHL databases; randomized and quasi-randomized clinical trials, cohort studies, comparative studies with or without simultaneous controls, case series with 10 or more consecutive cases and descriptive studies were included...
October 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29339292/selective-hcn1-block-as-a-strategy-to-control-oxaliplatin-induced-neuropathy
#15
F Resta, L Micheli, A Laurino, V Spinelli, T Mello, L Sartiani, L Di Cesare Mannelli, E Cerbai, C Ghelardini, M N Romanelli, G Mannaioni, A Masi
Chemotherapy-Induced Peripheral Neuropathy (CIPN) is the most frequent adverse effect of pharmacological cancer treatments. The occurrence of neuropathy prevents the administration of fully-effective drug regimen, affects negatively the quality of life of patients, and may lead to therapy discontinuation. CIPN is currently treated with anticonvulsants, antidepressants, opioids and non-opioid analgesics, all of which are flawed by insufficient anti-hyperalgesic efficacy or addictive potential. Understandably, developing new drugs targeting CIPN-specific pathogenic mechanisms would dramatically improve efficacy and tolerability of anti-neuropathic therapies...
January 12, 2018: Neuropharmacology
https://www.readbyqxmd.com/read/29338934/systematic-review-of-the-safety-and-effectiveness-of-peripheral-neurostimulation-of-the-sphenopalatine-ganglion-for-the-treatment-of-refractory-chronic-cluster-headache
#16
L M Sánchez-Gómez, M Polo-deSantos, A Pinel-González, C Oreja-Guevara, S Luengo-Matos
INTRODUCTION: This study aimed to assess the safety and effectiveness of peripheral neurostimulation of the sphenopalatine ganglion (SPG) in the treatment of refractory chronic cluster headache. DEVELOPMENT: Various medical databases were used to perform a systematic review of the scientific literature. The search for articles continued until 31 October 2016, and included clinical trials, systematic reviews and/or meta-analyses, health technology assessment reports, and clinical practice guidelines that included measurements of efficiency/effectiveness or adverse effects associated with the treatment...
January 12, 2018: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/29338448/the-safety-of-palbociclib-for-the-treatment-of-advanced-breast-cancer
#17
Tom Degenhardt, Rachel Wuerstlein, Tanja Eggersmann, Nadia Harbeck
Despite improvements in the diagnosis and management of early stage breast cancer, about one third of the patients still progress to metastatic disease. Most of the patients with metastatic breast cancer have a hormone receptor positive and human epidermal growth factor receptor 2 negative subtype with a median survival of more than 3 years. For these patients, endocrine therapy with its favorable toxicity profile is the current standard of care. However, patients with metastatic breast cancer have an incurable disease...
January 17, 2018: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/29337780/efficacy-and-safety-of-sodium-picosulfate-magnesium-citrate-for-bowel-preparation-in-a-physically-disabled-outpatient-population-a-randomized-endoscopist-blinded-comparison-with-ascorbic-acid-enriched-polyethylene-glycol-solution-plus-bisacodyl-the-pico-movi
#18
Elisabeth M H Mathus-Vliegen, Karin van der Vliet, Inge J Wignand-van der Storm, John S Stadwijk
BACKGROUND: Because of its volume, adequate bowel preparation remains problematic in physically unfit patients. OBJECTIVE: This study aimed to compare a small-volume sodium picosulfate/magnesium citrate preparation with a 2-L ascorbic acid-enriched polyethylene glycol solution plus bisacodyl. DESIGN: This study has a noninferiority design, assuming that ascorbic acid-enriched polyethylene glycol solution plus bisacodyl is 70% efficacious in achieving an Ottawa score ≤7 and accepting a difference in success rate of <15% with a target enrollment of 146 patients per group...
February 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29337443/-update-in-surgical-oncology
#19
Daniel Clerc, Didier Roulin, Nicolas Demartines, Emmanuel Melloul
In 2017, data from large multicentre randomized controlled trials assessed the safety of minimally invasive techniques for liver or esophagus resection with similar oncologic outcome compared to open approach. Patients also benefit from progress in medical oncology in particular with the development of new targeted therapies, offering surgery to patients with initially non-resectable disease. The increase in complete tumor response after neoadjuvant treatment allows more conservative approaches, like organ preserving surgery for rectal cancer...
January 10, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29336645/physical-exercise-prior-to-hematopoietic-stem-cell-transplantation-a-feasibility-study
#20
Inge E P M van Haren, J Bart Staal, Carin M Potting, Femke Atsma, Thomas J Hoogeboom, Nicole M A Blijlevens, Maria W G Nijhuis-van der Sanden
PURPOSE: This study explores the feasibility and preliminary effectiveness of an exercise program in people scheduled for hematopoietic stem cell transplantation (HSCT). METHODS: In this controlled clinical trial, we compare pre-transplantation exercise to no exercise in the waiting period for an allogeneic of autologous HSCT. The supervised individually tailored exercise program (4-6 weeks) consisted of aerobic endurance, muscle strength, and relaxation exercises, administered twice a week in the period prior to HSCT...
January 16, 2018: Physiotherapy Theory and Practice
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