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https://www.readbyqxmd.com/read/29423767/patient-understanding-of-discharge-instructions-in-the-emergency-department-do-different-patients-need-different-approaches
#1
Hasan Sheikh, Aleksandar Brezar, Agata Dzwonek, Lawrence Yau, Lisa A Calder
BACKGROUND: Previous studies have demonstrated that patients have poor understanding of the discharge instructions provided from the emergency department (ED). The aims of this study are to determine if patient factors, such as income and level of education, correlate with patient understanding of discharge instructions and to explore if different patient populations prefer different resources for receiving discharge instructions. METHODS: We conducted live observations of physicians providing discharge instructions in the ED to 100 patients followed by a patient survey to determine their understanding in four domains (diagnosis, treatment plan, follow-up instructions, and return to ED (RTED) instructions) and collect patient demographics...
February 8, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29407627/transition-of-care-for-patients-with-venous-thromboembolism-rationale-design-and-implementation-of-a-quality-intervention-project-conducted-at-american-thrombosis-and-hemostasis-network-athn-affiliated-sites
#2
Julie Jaffray, Madhvi Rajpurkar, Anjali Sharathkumar, Kavita Patel, James Munn, Dunlei Cheng, Ellen McCarthy, Maria DeSancho
INTRODUCTION: Medication errors frequently occur during transition from the inpatient to outpatient setting. Anticoagulants are associated with serious medical errors, including major bleeding. Standardized transition of care (TOC) techniques in patients with venous thromboembolism (VTE) have not been developed. METHODS: This ongoing project conducted by the American Thrombosis and Hemostasis Network (ATHN) aims to improve TOC for newly diagnosed VTE patients on anticoagulation from the inpatient to outpatient setting, and identify characteristics of patients on direct oral anticoagulants (DOACs) and their TOC...
February 1, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29407420/changes-in-emergency-department-concordance-with-guidelines-for-the-management-of-stinging-insect-induced-anaphylaxis-1999-2001-versus-2013-2015
#3
Sunday Clark, Krislyn M Boggs, Diana S Balekian, Kohei Hasegawa, Phuong Vo, Brian H Rowe, Carlos A Camargo
BACKGROUND: Changes in emergency department (ED) concordance with guidelines for the management of stinging insect-induced anaphylaxis (SIIA) are not known. OBJECTIVE: We describe temporal changes in ED concordance with guidelines for the management of SIIAs. METHODS: We analyzed data from two multicenter retrospective studies of patients with stinging insect-related acute allergic reactions seen in one of 14 North American EDs during two time periods: 1999-2001 and 2013-2015...
January 30, 2018: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/29400070/effect-of-accelerometer-based-feedback-on-physical-activity-in-hospitalized-patients-with-ischemic-stroke-a-randomized-controlled-trial
#4
Masashi Kanai, Kazuhiro P Izawa, Miki Kobayashi, Akira Onishi, Hiroki Kubo, Masafumi Nozoe, Kyoshi Mase, Shinichi Shimada
OBJECTIVE: To evaluate the effect of accelerometer-based feedback on physical activity in hospitalized patients with ischemic stroke. DESIGN: Randomized controlled trial. SETTING: Acute care hospital. SUBJECTS: A total of 55 patients with ischemic stroke who could walk without assistance were randomly assigned to the intervention group ( n = 27) or the control group ( n = 28). INTERVENTIONS: At the baseline measurement, patients did not receive accelerometer-based feedback...
February 1, 2018: Clinical Rehabilitation
https://www.readbyqxmd.com/read/29392958/using-written-instructions-to-improve-the-quality-of-emergency-department-discharge-communication-an-interdisciplinary-patient-centered-approach
#5
Justin N Hall, Jeffrey P Graham, Melissa McGowan, Amy H Y Cheng
No abstract text is available yet for this article.
February 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29388917/-non-cardiac-chest-pain-and-its-association-with-persistent-chest-pain-and-poor-mental-well-being
#6
Erla Svansdottir, Sesselja Hreggvidsdottir, Bjorg Sigurdardottir, Elisabet Benedikz, Karl Andersen, Hrobjartur Darri Karlsson
INTRODUCTION: An estimated 50-75% of visits to cardiac emergency departments are due to chest pain which is non-cardiac in nature (non-cardiac chest pain (NCCP). This study evaluates the prevalence of NCCP in the emergency departments at Landspitali, and assesses its association with continued chest-pain post discharge, mental well--being and the information-provision provided to NCCP patients during hospitalization. MATERIAL AND METHODS: Participants were 390 patients (18-65 years) presenting with chest pain to the cardiac emergency or the general emergency department at Landspitali from October 2015-May 2016...
February 2018: Læknablađiđ
https://www.readbyqxmd.com/read/29387943/life-threatening-complications-post-liposuction
#7
Hiba Ezzeddine, Ahmad Husari, Hussein Nassar, Mariam Kanso, Ghina El Nounou, Mohamad Khalife, Walid Faraj
BACKGROUND: Liposuction is one of the most commonly performed aesthetic procedures. It is performed worldwide as an outpatient procedure. However, the complications are underestimated and underreported by caregivers. We present a case of delayed diagnosis of bilothorax secondary to liver and gallbladder injury after tumescent liposuction. METHODS: A 26-year-old female patient was transferred to our emergency department from an aesthetic clinic with worsening dyspnea, tachypnea and fatigue...
January 31, 2018: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/29378577/risks-predicting-prolonged-hospital-discharge-boarding-in-a-regional-acute-care-hospital
#8
Sajid A Shaikh, Richard D Robinson, Radhika Cheeti, Shyamanand Rath, Chad D Cowden, Frank Rosinia, Nestor R Zenarosa, Hao Wang
BACKGROUND: Prolonged hospital discharge boarding can impact patient flow resulting in upstream Emergency Department crowding. We aim to determine the risks predicting prolonged hospital discharge boarding and their direct and indirect effects on patient flow. METHODS: Retrospective review of a single hospital discharge database was conducted. Variables including type of disposition, disposition boarding time, case management consultation, discharge medications prescriptions, severity of illness, and patient homeless status were analyzed in a multivariate logistic regression model...
January 30, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29372186/newborn-follow-up-after-discharge-from-a-tertiary-care-hospital-in-the-western-cape-region-of-south-africa-a-prospective-observational-cohort-study
#9
Jean Paul Muambangu Milambo, KaWing Cho, Charles Okwundu, Abiola Olowoyeye, Leonidas Ndayisaba, Sanjay Chand, Mark H Corden
Background: Current practice in the Western Cape region of South Africa is to discharge newborns born in-hospital within 24 h following uncomplicated vaginal delivery and two days after caesarean section. Mothers are instructed to bring their newborn to a clinic after discharge for a health assessment. We sought to determine the rate of newborn follow-up visits and the potential barriers to timely follow-up. Methods: Mother-newborn dyads at Tygerberg Hospital in Cape Town, South Africa were enrolled from November 2014 to April 2015...
2018: Global Health Research and Policy
https://www.readbyqxmd.com/read/29345256/caregiver-perspectives-on-communication-during-hospitalization-at-an-academic-pediatric-institution-a-qualitative-study
#10
Lauren G Solan, Andrew F Beck, Stephanie A Shardo, Hadley S Sauers-Ford, Jeffrey M Simmons, Samir S Shah, Susan N Sherman
OBJECTIVE: Communication among those involved in a child's care during hospitalization can mitigate or exacerbate family stress and confusion. As part of a broader qualitative study, we present an in-depth understanding of communication issues experienced by families during their child's hospitalization and during the transition to home. METHODS: Focus groups and individual interviews stratified by socioeconomic status included caregivers of children recently discharged from a children's hospital after acute illnesses...
January 18, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29345011/effectiveness-of-a-patient-education-plan-on-knowledge-ofpost-op-venous-thromboembolism-survival-skills
#11
Julie Green, Esther I Bernhofer
AIMS AND OBJECTIVES: To investigate the effectiveness of a multi-method venous thromboembolism prevention patient education plan on participants' knowledge retention. BACKGROUND: A potential complication of surgery requiring general anesthesia, worldwide, is the development of life-threatening venous thromboembolism. Patients need education on preventing, recognizing, and immediately responding to a suspected thromboembolism. Written instructional materials given to patients at discharge may be inadequate...
January 18, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29342066/resident-participation-in-fixation-of-intertrochanteric-hip-fractures-analysis-of-the-nsqip-database
#12
Alexander L Neuwirth, Russell N Stitzlein, Madalyn G Neuwirth, Rachel K Kelz, Samir Mehta
BACKGROUND: Future generations of orthopaedic surgeons must continue to be trained in the surgical management of hip fractures. This study assesses the effect of resident participation on outcomes for the treatment of intertrochanteric hip fractures. METHODS: The National Surgical Quality Improvement Program (NSQIP) database (2010 to 2013) was queried for intertrochanteric hip fractures (International Classification of Diseases, 9th Revision, Clinical Modification [ICD-9-CM] code 820...
January 17, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29342059/patients-living-alone-can-be-safely-discharged-directly-home-after-total-joint-arthroplasty-a-prospective-cohort-study
#13
Andrew N Fleischman, Matthew S Austin, James J Purtill, Javad Parvizi, William J Hozack
BACKGROUND: Despite the expense and potential hazards of inpatient rehabilitation, there is a prevailing belief that patients living alone cannot be safely discharged directly home after total joint arthroplasty. The purpose of this study was to assess the safety and efficacy of direct home discharge for patients living alone during convalescence after primary total joint arthroplasty. METHODS: We prospectively studied 910 consecutive patients undergoing primary, unilateral total hip arthroplasty or total knee arthroplasty over an 8-month period...
January 17, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29340167/subcutaneous-glucagon-infusion-and-continuous-glucose-monitoring-enable-effective-management-of-hypoglycemia-in-a-patient-with-igf-2-producing-hemangiopericytoma
#14
Eric D Buras, Emily Weatherup, Jennifer Wyckoff
Background: Ectopic insulin-like growth factor (IGF)-2 production is a rare complication of an array of epithelial and mesenchymal tumors, and can clinically manifest as life-threatening hypoglycemia. Case presentation: A 49-year-old woman with 13-year history of metastatic hemangiopericytoma, previously treated with multiple rounds of chemotherapy and palliative radiation, presented to the emergency department after a hypoglycemic seizure. On arrival, glucose was 18 mg/dL (1...
2018: Clinical Diabetes and Endocrinology
https://www.readbyqxmd.com/read/29333531/patient-reported-outcome-measures-prom-as-a-preoperative-assessment-tool
#15
Sunghye Kim, Pamela W Duncan, Leanne Groban, Hannah Segal, Rica Moonyeen Abbott, Jeff D Williamson
Aim of review: Patient-reported outcomes (PRO) on functional, social, and behavioral factors might be important preoperative predictors of postoperative outcomes. We conducted a literature review to explore associations of preoperative depression, socioeconomic status, social support, functional status/frailty, cognitive status, self-management skills, health literacy, and nutritional status with surgical outcomes. Methods: Two electronic data bases, including PubMed and Google Scholar, were searched linking either depression, socioeconomic status, social support, functional status/frailty, cognitive status, self-management skills, health literacy, or nutritional status with surgery, postoperative complications, or perioperative period within the past 2 decades...
November 28, 2017: Journal of anesthesia and perioperative medicine
https://www.readbyqxmd.com/read/29329727/parent-activation-in-the-pediatric-emergency-department-theory-vs-reality
#16
Danica B Liberman, Phung K Pham
OBJECTIVE: To measure parent activation and test for its associations with sociodemographics, clinical factors, and short-term outcomes. METHODS: By convenience sampling, 246 parents of children treated in an emergency department (ED) of a children's hospital completed the Parent-Patient Activation Measure (P-PAM) and answered sociodemographic questions. Clinical information was abstracted from medical records. Phone calls to parents and primary care physician offices were conducted within one-month post-ED visit for information about short-term outcomes...
January 8, 2018: Patient Education and Counseling
https://www.readbyqxmd.com/read/29305926/lower-dose-epinephrine-administration-and-out-of-hospital-cardiac-arrest-outcomes
#17
Cameron A Fisk, Michele Olsufka, Lihua Yin, Andrew M McCoy, Andrew J Latimer, Charles Maynard, Graham Nichol, Jonathan Larsen, Leonard A Cobb, Michael R Sayre
BACKGROUND: International guidelines recommend administration of 1 mg of intravenous epinephrine every 3 to 5 minutes during cardiac arrest. The optimal dose of epinephrine is not known. We evaluated the association of reduced frequency and dose of epinephrine with survival after out-of-hospital cardiac arrest (OHCA). METHODS: Included were patients with non-traumatic OHCA treated by advanced life support (ALS) providers from January 1, 2008 to June 30, 2016...
January 3, 2018: Resuscitation
https://www.readbyqxmd.com/read/29280006/minimally-invasive-unicompartmental-knee-arthroplasty
#18
REVIEW
Jean-Yves Jenny
The exact indication for a unicompartmental knee arthroplasty (UKA) remains debated. Minimally invasive techniques have been developed to decrease the surgical trauma related to the prosthesis implantation, and this technique is well fitted to UKA. However, there are concerns about loss of accuracy with minimally invasive techniques. Furthermore, rapid recovery techniques have been developed in order to reduce the length of hospital stay. Again, UKA is well fitted to these new developments of postoperative care...
December 26, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29276765/project-red-impacts-patient-experience
#19
Ramon S Cancino, Chris Manasseh, Lana Kwong, Suzanne E Mitchell, Jessica Martin, Brian W Jack
Background: Hospitalized patients are frequently unprepared to care for themselves after discharge often leading to unplanned hospital readmission. One strategy to reduce readmission rates is improving the quality of patient education and preparation before hospital discharge. The ReEngineered Discharge (RED) is a standardized hospital-based program designed to provide patients and caregivers the information they need to continue care at home. Objectives: We sought to study the impact of the RED intervention on posthospitalization adult patient experience scores in an urban academic safety-net hospital...
December 2017: Journal of Patient Experience
https://www.readbyqxmd.com/read/29276763/a-description-of-patient-and-provider-experience-and-clinical-outcomes-after-heart-failure-shared-medical-appointment
#20
Lisa B Cohen, Melanie Parent, Tracey H Taveira, Sandesh Dev, Wen-Chih Wu
Background: Shared medical appointments (SMAs) are clinical visits in which several patients meet with 1 or more providers at the same time. Objective: To describe the outcomes of an interdisciplinary SMA for veterans recently discharged for heart failure (HF). Methods: A retrospective chart review for patients' readmission rates, survival, medication adherence, and medication-related problems. For qualitative outcomes, we performed semistructured interviews on 12 patients who had undergone HF SMAs and their respective caregivers focusing on care satisfaction, HF knowledge, disease self-care, medication reconciliation, and peer support...
December 2017: Journal of Patient Experience
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