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Emergency room care

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https://www.readbyqxmd.com/read/28726526/integrated-care-coordination-by-an-interprofessional-team-reduces-emergency-department-visits-and-hospitalisations-at-an-academic-health-centre
#1
Anne H Gaglioti, Patrick Barlow, Kate DuChene Thoma, George R Bergus
People with chronic behavioural and physical health conditions have higher healthcare costs and mortality rates than patients with chronic physical conditions alone. As a result, there has been promotion of integrated care for this group. It is important to train primary care residents to practice in integrated models of care with interprofessional teams and to evaluate the effectiveness of integrated care models to promote high-quality care for this at-risk group. We implemented an integrated, interprofessional care management programme for adults with chronic mental and physical health needs as part of a curriculum for family medicine and family medicine psychiatry residents...
July 20, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28726118/epidural-steroid-injection-related-events-requiring-hospitalisation-or-emergency-room-visits-among-52-935-procedures-performed-at-a-single-centre
#2
Joon Woo Lee, Eugene Lee, Guen Young Lee, Yusuhn Kang, Joong Mo Ahn, Heung Sik Kang
OBJECTIVES: To analyse the incidence and type of epidural steroid injection (ESI)-related adverse events, including procedure-related complications and drug-related systemic effects requiring hospitalisation or emergency room (ER) visits. METHODS: This study included 52,935 ESI procedures performed in 22,059 patients in our department from March 2004 to February 2016. Of these, we retrospectively reviewed the cases of 1570 patients (1713 procedures) who were hospitalised or visited the ER within 1 month after ESI...
July 19, 2017: European Radiology
https://www.readbyqxmd.com/read/28722561/the-quality-of-free-antenatal-and-delivery-services-in-northern-sierra-leone
#3
Manso M Koroma, Samuel S Kamara, Evelyn A Bangura, Mohamed A Kamara, Virgil Lokossou, Namoudou Keita
BACKGROUND: The number of maternal deaths in sub-Saharan Africa continues to be overwhelmingly high. In West Africa, Sierra Leone leads the list, with the highest maternal mortality ratio. In 2010, financial barriers were removed as an incentive for more women to use available antenatal, delivery and postnatal services. Few published studies have examined the quality of free antenatal services and access to emergency obstetric care in Sierra Leone. METHODS: A cross-sectional survey was conducted in 2014 in all 97 peripheral health facilities and three hospitals in Bombali District, Northern Region...
July 12, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/28722299/cost-and-health-care-utilization-implications-of-bariatric-surgery-versus-intensive-lifestyle-and-medical-intervention-for-type-2-diabetes
#4
Souvik Banerjee, Louis P Garrison, David R Flum, David E Arterburn
OBJECTIVE: The aim of this study was to compare the cost and health care utilization of patients with obesity and type 2 diabetes mellitus (T2DM) randomized into either Roux-en-Y gastric bypass (RYGB) surgery or an intensive lifestyle and medical intervention (ILMI). METHODS: This analysis (N = 745) is based on 2-year follow-up of a small randomized controlled trial (RCT); adult patients with obesity and T2DM were recruited between 2011 and 2012 from Kaiser Permanente Washington...
July 19, 2017: Obesity
https://www.readbyqxmd.com/read/28721570/task-shifting-the-use-of-laypersons-for-acquisition-of-vital-signs-data-for-clinical-decision-making-in-the-emergency-room-following-traumatic-injury
#5
Bryce E Haac, Jared R Gallaher, Charles Mabedi, Andrew J Geyer, Anthony G Charles
IMPORTANCE: In resource-limited settings, identification of successful and sustainable task-shifting interventions is important for improving care. OBJECTIVE: To determine whether the training of lay people to take vital signs as trauma clerks is an effective and sustainable method to increase availability of vital signs in the initial evaluation of trauma patients. DESIGN: We conducted a quasi-experimental study of patients presenting with traumatic injury pre- and post-intervention...
July 18, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28721327/two-catastrophes-in-one-patient-drug-reaction-with-eosinophilia-and-systemic-symptoms-and-toxic-shock-syndrome
#6
Moayed Ibrahim, Diana L Nunley
A 70-year-old, immunocompromised patient presented to the emergency room (ER) five weeks after she was started on clopidogrel. She complained of skin eruption, mouth ulcers, fatigue, and myalgia over the past two weeks. Labs showed severe hyponatremia, acute kidney injury, rhabdomyolysis, hyperkalemia, and elevated liver enzymes. She was treated with steroids and discharged after her condition improved. However, a month later, she returned to the ER, complaining of nausea, vomiting, diarrhea, dizziness, chills, and shortness of breath over the past two days...
June 15, 2017: Curēus
https://www.readbyqxmd.com/read/28721028/frailty-in-community-dwelling-older-adults-association-with-adverse-outcomes
#7
Sergio Sánchez-García, Carmen García-Peña, Antoni Salvà, Rosalinda Sánchez-Arenas, Víctor Granados-García, Juan Cuadros-Moreno, Laura Bárbara Velázquez-Olmedo, Ángel Cárdenas-Bahena
BACKGROUND: The study of frailty is important to identify the additional needs of medical long-term care and prevent adverse outcomes in community dwelling older adults. This study aimed to determine the prevalence of frailty and its association with adverse outcomes in community dwelling older adults. METHODS: A cross-sectional study was carried out from April to September 2014. The population sample was 1,252 older adults (≥60 years) who were beneficiaries of the Mexican Institute of Social Security (IMSS) in Mexico City...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28717331/knowledge-and-awareness-of-first-aid-of-avulsed-tooth-among-physicians-and-nurses-of-hospital-emergency-department
#8
Sudeep Sreepad Iyer, Antarmayee Panigrahi, Shalini Sharma
INTRODUCTION: Physicians and nurses of emergency department are often the first line of qualified health-care providers attending the patient in person or parent's query over phone reporting immediately following the dental avulsion. Prompt action by them becomes the decisive factor in survival and prognosis of the tooth. Although a few researchers have evaluated knowledge of emergency room physicians, there is scanty of reports concerning nurses who play a climacteric role. MATERIALS AND METHODS: A 10-item questionnaire regarding clinical situation apropos dental injury and tooth avulsion, inquiring knowledge of physicians and nurses was administered to 150 each of nursing professionals and physicians of the emergency department...
April 2017: Journal of Pharmacy & Bioallied Sciences
https://www.readbyqxmd.com/read/28713217/the-burden-of-illness-related-to-chronic-obstructive-pulmonary-disease-exacerbations-in-qu%C3%A3-bec-canada
#9
Tam Dang-Tan, Shiyuan Zhang, Ruben V Tavares, Melissa Stutz, Afisi S Ismaila, Julie Vaillancourt, Diane Corriveau, Richard H Stanford, Xiwu Lin, Gilbert A Nadeau, Alexander Simidchiev, Daria Parsons, John S Sampalis
BACKGROUND: Chronic obstructive pulmonary disease (COPD) prevalence in Canada has risen over time. COPD-related exacerbations contribute to the increased health care utilization (HCU) in this population. This study investigated the impact of exacerbations on COPD-related HCU. METHODS: This retrospective observational cohort study used patient data from the Québec provincial health insurance databases. Eligible patients with a new HCU claim with a diagnostic billing for COPD during 2001-2010 were followed until March 31, 2011...
2017: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/28712683/-stratification-of-thoracic-pain-with-modified-heart-score-and-its-relationship-to-short-term-cardiovascular-events
#10
Manuel Chacón-Diaz, Jorge Salinas, Rafael Doig
OBJECTIVE: Chest pain is a major reason for emergency room care worldwide. The relationship between the Modified Heart Score and the presence of major cardiac events at 30 days after emergency admission was evaluated. METHODS: Retrospective, observational study in a single center. In patients older than 18 years old, who were treated for chest pain, in whom the Modified HEART Score was applied at admission and related to the presence of major cardiac events (myocardial infarction, death, hospitalization due to cardiac causes and percutaneous coronary revascularization Or surgical) at 30 days of follow-up...
July 13, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28707460/the-effect-of-hospice-consultation-on-aggressive-treatment-of-lung-cancer
#11
Shin Hye Yoo, Bhumsuk Keam, Miso Kim, Tae Min Kim, Dong-Wan Kim, Dae Seog Heo
Purpose: The aims of this study were to investigate trends of aggressive treatment of non-small cell lung cancer (NSCLC) patients at the end-of-life (EOL) during the recent five years and examine the relationship between hospice consultation (HC) and aggressive care. Materials and Methods: The medical records of 789 patients with stage IIIB-IV NSCLC at SNUH who received palliative chemotherapy and died from 2010 to 2014 were retrospectively reviewed. Indicators of aggressive treatment were evaluated, and the association of HC with these indicators was analyzed...
July 14, 2017: Cancer Research and Treatment: Official Journal of Korean Cancer Association
https://www.readbyqxmd.com/read/28706585/atrial-tachyarrhythmia-in-adult-congenital-heart-disease
#12
REVIEW
Arsha Karbassi, Krishnakumar Nair, Louise Harris, Rachel M Wald, S Lucy Roche
The adult congenital heart disease (ACHD) population continues to grow and most cardiologists, emergency room physicians and family doctors will intermittently come into contact with these patients. Oftentimes this may be in the setting of a presentation with atrial tachyarrhythmia; one of the commonest late complications of ACHD and problem with potentially serious implications. Providing appropriate initial care and ongoing management of atrial tachyarrhythmia in ACHD patients requires a degree of specialist knowledge and an awareness of certain key issues...
June 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28706168/-the-effects-of-violence-coping-program-based-on-middle-range-theory-of-resilience-on-emergency-room-nurses-resilience-violence-coping-nursing-competency-and-burnout
#13
Seung Min Lee, Kyung Mi Sung
PURPOSE: The purpose of this study was to examine the effects of a violence coping program (VCP) based on Polk's middle-range theory of resilience on nursing competency, resilience, burnout, and the ability to cope with violence in nurses working in emergency rooms. METHODS: A quasi-experimental study, with a nonequivalent control group and a pretest-posttest design, was conducted. Participants were 36 nurses who worked in emergency rooms and had experienced violence; 18 nurses from D hospital and 18 nurses from C hospital were assigned to the experimental and control groups, respectively...
June 2017: Journal of Korean Academy of Nursing
https://www.readbyqxmd.com/read/28704074/quantifying-the-relative-importance-to-patients-of-avoiding-symptoms-and-outcomes-of-heart-failure
#14
A Brett Hauber, Engels N Obi, Mark A Price, Diane Whalley, Chun-Lan Chang
OBJECTIVE: To evaluate heart failure (HF) patients' disease knowledge and preferences for avoiding different disease outcomes. METHODS: An online survey was administered to 400 individuals with a self-reported diagnosis of HF to elicit relative importance weights (RIWs) for avoiding 11 potential HF symptoms and outcomes using best-worst scaling. The survey also included questions about individuals' HF knowledge, and demographic and disease-experience characteristics...
July 13, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28694308/association-of-delay-of-urgent-or-emergency-surgery-with-mortality-and-use-of-health-care-resources-a-propensity-score-matched-observational-cohort-study
#15
Daniel I McIsaac, Karim Abdulla, Homer Yang, Sudhir Sundaresan, Paula Doering, Sandeep Green Vaswani, Kednapa Thavorn, Alan J Forster
BACKGROUND: Delay of surgery for hip fracture is associated with increased risk of morbidity and mortality, but the effects of surgical delays on mortality and resource use in the context of other emergency surgeries is poorly described. Our objective was to measure the independent association between delay of emergency surgery and in-hospital mortality, length of stay and costs. METHODS: We identified all adult patients who underwent emergency noncardiac surgery between January 2012 and October 2014 at a single tertiary care centre...
July 10, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/28693520/strengthening-primary-health-care-teams-with-palliative-care-leaders-protocol-for-a-cluster-randomized-clinical-trial
#16
Joan Llobera, Noemí Sansó, Amador Ruiz, Merce Llagostera, Estefania Serratusell, Carlos Serrano, María Luisa Martín Roselló, Enric Benito, Eusebio J Castaño, Alfonso Leiva
BACKGROUND: The objective of the Balearic Islands Palliative Care (PC) Program is to improve the quality of PC through a shared model consisting of primary health care professionals, home-based PC teams, and PC units in hospitals. According to the World Health Organization (WHO), patients with advanced cancer and other terminal diseases benefit from early identification and proactive PC. We will evaluate the effectiveness of an intervention in which a PC leader is established in the primary health care center, and assess the effect of this intervention on the early identification of patients in need of PC, the efficient use of health care services, and direct health care costs...
July 10, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28685304/perioperative-and-icu-healthcare-analytics-within-a-veterans-integrated-system-network-a-qualitative-gap-analysis
#17
Seshadri Mudumbai, Ferenc Ayer, Jerry Stefanko
Health care facilities are implementing analytics platforms as a way to document quality of care. However, few gap analyses exist on platforms specifically designed for patients treated in the Operating Room, Post-Anesthesia Care Unit, and Intensive Care Unit (ICU). As part of a quality improvement effort, we undertook a gap analysis of an existing analytics platform within the Veterans Healthcare Administration. The objectives were to identify themes associated with 1) current clinical use cases and stakeholder needs; 2) information flow and pain points; and 3) recommendations for future analytics development...
August 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28682895/acute-decompensated-heart-failure-in-the-emergency-department-identification-of-early-predictors-of-outcome
#18
Luigi Mario Castello, Luca Molinari, Alessandra Renghi, Elena Peruzzi, Andrea Capponi, Gian Carlo Avanzi, Mario Pirisi
Identification of clinical factors that can predict mortality and hospital early readmission in acute decompensated heart failure (ADHF) patients can help emergency department (ED) physician optimize the care-path and resource utilization.We conducted a retrospective observational study of 530 ADHF patients evaluated in the ED of an Italian academic hospital in 2013.Median age was 82 years, females were 55%; 31.1% of patients were discharged directly from the ED (12.5% after short staying in the observation unit), while 68...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28682683/setting-quality-improvement-priorities-for-women-receiving-systemic-therapy-for-early-stage-breast-cancer-by-using-population-level-administrative-data
#19
Katherine A Enright, Nathan Taback, Melanie Lynn Powis, Alejandro Gonzalez, Lingsong Yun, Rinku Sutradhar, Maureen E Trudeau, Christopher M Booth, Monika K Krzyzanowska
Purpose Routine evaluation of quality measures (QMs) can drive improvement in cancer systems by highlighting gaps in care. Targeting quality improvement at QMs that demonstrate substantial variation has the potential to make the largest impact at the population level. We developed an approach that uses both variation in performance and number of patients affected by the QM to set priorities for improving the quality of systemic therapy for women with early-stage breast cancer (EBC). Patients and Methods Patients with EBC diagnosed from 2006 to 2010 in Ontario, Canada, were identified in the Ontario Cancer Registry and linked deterministically to multiple health care databases...
July 6, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28681384/development-and-validation-of-a-screening-questionnaire-of-family-mistreatment-against-older-adults-for-use-in-primary-care-settings-in-mexico
#20
María Guadalupe Ruelas-González, Blanca Estela Pelcastre-Villafuerte, Eric Monterrubio-Flores, Jacqueline Elizabeth Alcalde-Rabanal, Doris V Ortega-Altamirano, Ana Lorena Ruano, Pedro J Saturno Hernández
The abuse of older adults is a serious public health issue that can be difficult to identify at the first level of care. Medical and nursing personnel are sometimes unable to identify older adults who suffer family mistreatment. This can occur when victims feel shame or as a result of cultural factors. In the light of this, healthcare personnel require a screening tool that can be used to identify signs of mistreatment. The aim of this study was to develop and validate a screening tool for detecting the familial mistreatment of older adults in primary care settings...
July 6, 2017: Health & Social Care in the Community
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