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Discharge instructions

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https://www.readbyqxmd.com/read/28816893/periarticular-liposomal-bupivacaine-injection-versus-intra-articular-bupivacaine-infusion-catheter-for-analgesia-after-total-knee-arthroplasty-a-double-blinded-randomized-controlled-trial
#1
Eric B Smith, Gregory S Kazarian, Mitchell G Maltenfort, Jess H Lonner, Peter F Sharkey, Robert P Good
BACKGROUND: Intra-articular bupivacaine hydrochloride (HCl) infusion catheters and periarticular injections of liposomal bupivacaine are often used as postoperative local anesthetics. The purpose of this study was to compare the efficacies of these local anesthetics following total knee arthroplasty. METHODS: This study was a superiority trial with a randomized, controlled, double-blinded design. Patients were randomly assigned to either delivery of bupivacaine HCl by the ON-Q* Pain Relief System pump (n = 96) or by an injection of Exparel (liposomal bupivacaine) (n = 104)...
August 16, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28816517/targeted-areas-for-improving-health-literacy-after-traumatic-brain-injury
#2
Megan Moore, Taniga Kiatchai, Rajiv C Ayyagari, Monica S Vavilala
OBJECTIVE: To develop a framework to identify targeted areas for improving health literacy for caregivers after traumatic brain injury (TBI). METHOD: Qualitative study using inductive and deductive qualitative content analysis was conducted in a large, urban, level I trauma centre. Interviews were conducted with 23 caregivers of persons with TBI. Participants' perspectives on communication and preparation for discharge were explored and understanding of commonly used words and discharge instructions were assessed...
August 17, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28799705/the-process-of-intrapartum-care-among-skilled-birth-attendants-in-the-dominican-republic-and-maternal-perceptions-of-care-during-labor-and-birth-a-case-report
#3
Peter Schindler, Rosa Burgos, Kimberly Vuong, Hilary Aviela Lerner, Elsa Evangelista, Flor Josefina Rodriguez, Lourdes Peralta Polanco, Jennifer Foster
INTRODUCTION: The World Health Organization calls for situation analyses of maternity settings globally to improve maternal-newborn health. This study evaluated the care processes of skilled birth attendants and women's satisfaction with the care in a public hospital in the Dominican Republic. The purpose of the assessment was to establish a baseline to build quality improvements. METHODS: A cross-sectional, mixed-methods, observational study was conducted by an international team...
August 11, 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28791786/emergency-department-provider-perspectives-on-benzodiazepine-opioid-co-prescribing-a-qualitative-study
#4
Howard S Kim, Danielle M McCarthy, Jason A Hoppe, D Mark Courtney, Bruce L Lambert
OBJECTIVE: Benzodiazepines and opioids are prescribed simultaneously (i.e. "co-prescribed") in many clinical settings, despite guidelines advising against this practice and mounting evidence that concomitant use of both medications increases overdose risk. This study sought to characterize the contexts in which benzodiazepine-opioid co-prescribing occurs and providers' reasons for co-prescribing. METHODS: We conducted focus groups with ED providers (resident and attending physicians, advanced practice providers, and pharmacists) from three hospitals using semi-structured interviews to elicit perspectives on benzodiazepine-opioid co-prescribing...
August 9, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28791441/postoperative-pain-control-by-intercostal-nerve-block-after-augmentation-mammoplasty
#5
Chang Min Kang, Woo Jeong Kim, Sean Hyuck Yoon, Chul Bum Cho, Jeong Su Shim
BACKGROUND: In breast augmentation with implant, there is severe pain due to damage from expansion of breast tissue and the pectoralis major. Therefore, the authors conducted this study to analyze the effectiveness of postoperative intercostal nerve block (ICNB) in reducing postoperative pain after breast augmentation with implant. METHOD: Forty-four female patients were enrolled in the study. Just before awaking from general anesthesia, 34 cases were injected with 0...
August 8, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28777774/symptom-guided-emergency-department-discharge-instructions-for-children-with-concussion
#6
Talia M Brooks, Marissa M Smith, Renee M Silvis, Trudy Lerer, Christine Henry Mulvey, Ralynne Maitland, Amy L Dunn, Kelsey Logan, Sharon R Smith
OBJECTIVES: The objective was to evaluate the use and utility of a novel set of emergency department discharge instructions (DIs) for concussion based on a child's ongoing symptoms: symptom-guided DIs (symptom DIs). Differences in clinical outcomes were also assessed. METHODS: A convenience sample of 114 children aged 7 to 17 years presenting to an urban pediatric emergency department with a complaint of concussion was assembled. Children were randomized to standard DIs or symptom DIs...
August 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28771756/visiting-nurses-posthospital-medication-management-in-home-health-care-an-ethnographic-study
#7
Mette Geil Kollerup, Tine Curtis, Birgitte Schantz Laursen
BACKGROUND: Medication management is the most challenging component of a successful transition from hospital to home, a challenge of growing complexity as the number of older persons living with chronic conditions grows, along with increasingly specialised and accelerated hospital treatment plans. Thus, many patients are discharged with complex medication regimen instructions, accentuating the risk of medication errors that may cause readmission, adverse drug events and a need for further health care...
August 3, 2017: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/28763410/risk-factors-for-prolonged-opioid-use-following-spine-surgery-and-the-association-with-surgical-intensity-among-opioid-naive-patients
#8
Andrew J Schoenfeld, Kenneth Nwosu, Wei Jiang, Allan L Yau, Muhammad Ali Chaudhary, Rebecca E Scully, Tracey Koehlmoos, James D Kang, Adil H Haider
BACKGROUND: There is a growing concern that the use of prescription opioids following surgical interventions, including spine surgery, may predispose patients to chronic opioid use and abuse. We sought to estimate the proportion of patients using opioids up to 1 year after discharge following common spinal surgical procedures and to identify factors associated with sustained opioid use. METHODS: This study utilized 2006 to 2014 data from TRICARE insurance claims obtained from the Military Health System Data Repository...
August 2, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28754526/telephone-cardiopulmonary-resuscitation-is-independently-associated-with-improved-survival-and-improved-functional-outcome-after-out-of-hospital-cardiac-arrest
#9
Zhixin Wu, Micah Panczyk, Daniel W Spaite, Chengcheng Hu, Hidetada Fukushima, Blake Langlais, John Sutter, Bentley J Bobrow
AIM OF STUDY: This study aims to quantify the relative impact of Dispatcher-Initiated Telephone cardiopulmonary resuscitation (TCPR) on survival and survival with favorable functional outcome after out-of-hospital cardiac arrest (OHCA) in a population of patients served by multiple emergency dispatch centers and more than 130 emergency medical services (EMS) agencies. METHODS: We conducted a retrospective, observational study of EMS-treated adult (≥18 years) patients with OHCA of presumed cardiac origin in Arizona, between January 1, 2011, and December 31, 2014...
July 25, 2017: Resuscitation
https://www.readbyqxmd.com/read/28752502/attitude-of-patients-healthcare-professionals-and-noninjured-lay-persons-towards-online-video-instructions-on-mild-traumatic-brain-injury-a-cross-sectional-study
#10
Amber E Hoek, Maaike van den Hamer, Carianne K Deelstra, Ed F van Beeck, Diederik W J Dippel, Juanita A Haagsma, Pleunie P M Rood
BACKGROUND: The objective of this study was to determine the attitude of patients, healthcare professionals, and noninjured lay persons towards adding a video with discharge instructions to patient care for patients with mild traumatic brain injury (MTBI). A survey was conducted at the emergency department (ED). Participants consisted of MTBI patients (n = 50), healthcare professionals (n = 50), and noninjured lay persons (n = 50). The participants viewed a video with discharge instructions on MTBI and filled out a questionnaire that measured their attitude towards the use of a video as part of discharge instructions...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28739657/parental-management-of-discharge-instructions-a-systematic-review
#11
REVIEW
Alexander F Glick, Jonathan S Farkas, Joseph Nicholson, Benard P Dreyer, Melissa Fears, Christopher Bandera, Tanya Stolper, Nicole Gerber, H Shonna Yin
CONTEXT: Parents often manage complex instructions when their children are discharged from the inpatient setting or emergency department (ED); misunderstanding instructions can put children at risk for adverse outcomes. Parents' ability to manage discharge instructions has not been examined before in a systematic review. OBJECTIVE: To perform a systematic review of the literature related to parental management (knowledge and execution) of inpatient and ED discharge instructions...
July 24, 2017: Pediatrics
https://www.readbyqxmd.com/read/28738911/sentinel-visits-in-emergency-department-patients-with-diabetes-mellitus-as-a-warning-sign-for-hyperglycemic-emergencies
#12
Justin W Yan, Katherine M Gushulak, Melanie P Columbus, Alexandra L Hamelin, George A Wells, Ian G Stiell
OBJECTIVES: Patients with poorly controlled diabetes mellitus may have a sentinel emergency department (ED) visit for a precipitating condition prior to presenting for a hyperglycemic emergency, such as diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS). This study's objective was to describe the epidemiology and outcomes of patients with a sentinel ED visit prior to their hyperglycemic emergency visit. METHODS: This was a 1-year health records review of patients≥18 years old presenting to one of four tertiary care EDs with a discharge diagnosis of hyperglycemia, DKA, or HHS...
July 25, 2017: CJEM
https://www.readbyqxmd.com/read/28733370/reliable-adherence-to-a-copd-care-bundle-mitigates-system-level-failures-and-reduces-copd-readmissions-a-system-redesign-using-improvement-science
#13
Muhammad Ahsan Zafar, Ralph J Panos, Jonathan Ko, Lisa C Otten, Anthony Gentene, Maria Guido, Katherine Clark, Caroline Lee, Jamie Robertson, Evaline A Alessandrini
BACKGROUND: Readmissions of chronic obstructive pulmonary disease (COPD) have devastating effects on patient quality-of-life, disease progression and healthcare cost. Effective interventions to reduce COPD readmissions are needed. OBJECTIVES: Reduce 30-day all-cause readmissions by (1) creating a COPD care bundle that addresses care delivery failures, (2) using improvement science to achieve 90% bundle adherence. SETTING: An 800-bed academic hospital in Ohio, USA...
July 21, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28725840/the-impact-of-revised-discharge-instructions-on-patient-satisfaction
#14
Heather Markey Waniga, Travis Gerke, Alena Shoemaker, Derek Bourgoine, Pracha Eamranond
INTRODUCTION: The impact of discharge instructions on a patient's experience is not fully understood. This research explored whether nurse- and physician-generated discharge instructions had a positive effect on patient perceptions regarding their discharge experience. METHODS: We compared Press Ganey discharge-related patient satisfaction scores for the year prior to and the year subsequent to implementing revised discharge instructions for all patients admitted to a 180-bed community-based hospital...
September 2016: Journal of patient experience
https://www.readbyqxmd.com/read/28709485/biofilm-colonization-of-mycobacterium-abscessus-new-threat-in-hospital-acquired-surgical-site-infection
#15
Roumi Ghosh, Soumen Das, Harish Kela, Asmita De, Jayeeta Haldar, Prasanta Kumar Maiti
INTRODUCTION: Rapidly growing non-tuberculous mycobacteria (NTM) are hazardous cause of post-operative soft tissue infection leading to nosocomial outbreaks following various surgical procedures, especially laparoscopic surgeries using heat sensitive, non-autoclavable surgical instruments. METHODOLOGY: Surgery department of our hospital noticed increase in rate of post-laparoscopic abdominal port site infection (PSI) and informed the Microbiology Department. A prospective investigational study of defined cases with the aim of source tracing and formulation of infection control measures was initiated...
July 2017: Indian Journal of Tuberculosis
https://www.readbyqxmd.com/read/28707024/experience-of-immediate-ambulation-and-early-discharge-after-tumescent-anesthesia-and-propofol-infusion-in-cosmetic-breast-augmentation
#16
Weiwu Pang, John M Chois, Diana Lambie, Richard Ming-Hui Lin, Zao-Ming Shih
INTRODUCTION: Current cosmetic breast augmentation relies on general anesthesia that normally requires 40 min to total recovery. With experience, the surgical procedure can be completed expediently in 20 min under tumescent anesthesia and propofol full sedation to achieve immediate postoperative ambulation and home discharge readiness, and thus improve patient satisfaction and reduce cost. We retrospectively examined the outcomes of the protocol. MATERIALS AND METHODS: Per protocol, 1200 female patients underwent simple cosmetic breast augmentation accomplished with tumescent anesthesia, immediate mobilization, and early home discharge readiness after surgery...
July 13, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28699944/improving-the-readability-of-pediatric-hospital-medicine-discharge-instructions
#17
Ndidi Unaka, Angela Statile, Karen Jerardi, Devesh Dahale, Joan Morris, Brianna Liberio, Ashley Jenkins, Blair Simpson, Randi Mullaney, Jodi Kelley, Michelle Durling, Jennifer Shafer, Patrick Brady
BACKGROUND: Readable discharge instructions may help caregivers understand and implement care plans following hospitalization. Many caregivers of hospitalized children, however, have limited literacy. We aimed to increase the percentage of discharge instructions written at 7th grade level or lower for hospital medicine patients from 13% to 80% in 6 months. METHODS: Quality improvement efforts targeted a 42-bed unit at the community satellite of our large, urban academic hospital...
July 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28697297/general-practitioner-follow-up-in-older-patients-after-an-emergency-department-admission
#18
Belinda Watson, Chun Wah Michael Tam, Belinda Pellizzon, Lucille Ban, Harry Doan
BACKGROUND: Few studies have investigated older patients with regards to general practice follow-up after an emergency department (ED) admission. We measured the proportion of older patients given explicit general practice follow-up instructions who sought care by day seven after an ED admission. METHODS: Patients discharged from Fairfield Hospital ED (south-western Sydney) who were 65 years and older were approached for a structured telephone interview. Data from the interview and patients' ED discharge summaries were analysed descriptively...
2017: Australian Family Physician
https://www.readbyqxmd.com/read/28682971/loop-ileostomy-closure-as-an-overnight-procedure-institutional-comparison-with-the-national-surgical-quality-improvement-project-data-set
#19
Nicholas G Berger, Raymond Chou, Elliot S Toy, Kirk A Ludwig, Timothy J Ridolfi, Carrie Y Peterson
BACKGROUND: Enhanced recovery pathways have decreased length of stay after colorectal surgery. Loop ileostomy closure remains a challenge, because patients experience high readmission rates, and validation of enhanced recovery pathways has not been demonstrated. This study examined a protocol whereby patients were discharged on the first postoperative day and instructed to advance their diet at home with close telephone follow-up. OBJECTIVE: The hypothesis was that patients can be safely discharged the day after loop closure, leading to shorter length of stay without increased rates of readmission or complications...
August 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28678122/all-cause-versus-complication-specific-readmission-following-total-knee-arthroplasty
#20
Michele D'Apuzzo, Geoffrey Westrich, Chisa Hidaka, Ting Jung Pan, Stephen Lyman
BACKGROUND: Unplanned readmissions have become an important quality indicator, particularly for reimbursement; thus, accurate assessment of readmission frequency and risk factors for readmission is critical. The purpose of this study was to determine (1) the frequency of and (2) risk factors for readmissions for all causes or procedure-specific complications within 30 days after total knee arthroplasty (TKA) as well as (3) the association between hospital volume and readmission rate. METHODS: The Statewide Planning and Research Cooperative System (SPARCS) database from the New York State Department of Health was used to identify 377,705 patients who had undergone primary TKA in the period from 1997 to 2014...
July 5, 2017: Journal of Bone and Joint Surgery. American Volume
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