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https://www.readbyqxmd.com/read/28092800/effect-of-venepuncture-process-design-on-efficiency-and-failure-rates-a-simulation-model-study-for-secondary-care
#1
Sean Reed, Rasa Remenyte-Prescott, Ben Rees
BACKGROUND: Healthcare aims to deliver good patient outcomes. For many clinical procedures there are multiple alternative task sequences that can be performed. These deviations can influence procedure reliability, efficiency of usage of hospital resources and risk to staff and patient safety. Venepuncture is one of the most common invasive procedures in healthcare. Literature of clinical practice shows evidence of wide variability in the procedure order and the duration of each step, which can depend on attributes, such as patient health, sampling method and staff skills...
December 29, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28091865/improving-the-diagnostic-workup-of-hyponatremia-in-the-setting-of-kidney-disease-a-continuing-medical-education-cme-initiative
#2
Ladan Golestaneh, Joel Neugarten, William Southern, Faraj Kargoli, Amanda Raff
PURPOSE: Hyponatremia is a common electrolyte disorder and is associated with mortality. We examined the frequency of appropriate testing in response to an episode of inpatient hyponatremia in a large urban hospital to better inform our educational intervention. We then evaluated the impact of a live CME activity with a focus on CKD- and ESRD-associated hyponatremia physiology, on diagnostic practices of audience hospitalist attendings. METHODS: We performed a retrospective database analysis of all patients admitted to Montefiore Medical Center in 2014 to examine the performance of hospital staff in response to hyponatremia across all CKD stages...
January 13, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28090467/early-infant-feeding-practices-may-influence-the-onset-of-symptomatic-celiac-disease
#3
Shailja Vajpayee, Shiv Dayal Sharma, Rajkumar Gupta, Alok Goyal, Aakash Sharma
PURPOSE: To study whether breastfeeding and breastfeeding status during gluten introduction influences the age at diagnosis of celiac disease (CD). In addition to study, whether the timing of gluten introduction influences the age at diagnosis of CD. METHODS: It was a hospital based observational study. Total 198 patients diagnosed with CD as per modified European Society of Pediatric Gastroenterology, Hepatology and Nutrition (2012) criteria, aged between 6 months to 6 years were included...
December 2016: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/28090099/first-year-pharmacy-students-views-on-their-chosen-professional-career
#4
Lezley-Anne Hanna, Fergal Askin, Maurice Hall
Objective. To investigate what factors influenced students to study pharmacy and determine in which sector they hoped to gain employment, both in the short and longer term. Methods. First-year pharmacy students (n=124) were invited to complete a paper-based, self-administered questionnaire consisting of 4 sections. Descriptive statistics and nonparametric tests were conducted. Results. One hundred (96.8% response rate) students completed the questionnaire (22.5% male; 77.5% female). Key influential factors for choosing pharmacy included: enjoyment of science at school, a desire to improve people's health and wellbeing, and to work in health care...
November 25, 2016: American Journal of Pharmaceutical Education
https://www.readbyqxmd.com/read/28089082/backcasting-to-identify-food-waste-prevention-and-mitigation-opportunities-for-infant-feeding-in-maternity-services
#5
Yvonne Ryan-Fogarty, Genevieve Becker, Richard Moles, Bernadette O'Regan
Food waste in hospitals is of major concern for two reasons: one, healthcare needs to move toward preventative and demand led models for sustainability and two, food system sustainability needs to seek preventative measures such as diet adaptation and waste prevention. The impact of breast-milk substitute use on health services are well established in literature in terms of healthcare implications, cost and resourcing, however as a food demand and waste management issue little has been published to date. This paper presents the use of a desk based backcasting method to analyse food waste prevention, mitigation and management options within the Irish Maternity Service...
January 6, 2017: Waste Management
https://www.readbyqxmd.com/read/28087997/experience-in-action-moderating-care-in-web-based-patient-feedback
#6
Malte Ziewitz
What does it take to mobilise experiences of care and make them useful for improving services? This article draws on ethnographic fieldwork with a UK-based patient feedback website to develop a critical perspective on patient experience as a contingent accomplishment and a focal point for eliciting, provoking, and respecifying relations of accountability. Following a single posting from the moderation room back to the author and into the wards and offices of the hospital, I show how moderators, carers, and clinical staff respond to and act upon a seemingly stable experience...
December 21, 2016: Social Science & Medicine
https://www.readbyqxmd.com/read/28087832/comparison-of-cardiovascular-risk-algorithms-in-patients-with-vs-without-rheumatoid-arthritis-and-the-role-of-c-reactive-protein-in-predicting-cardiovascular-outcomes-in-rheumatoid-arthritis
#7
Evo Alemao, Hélène Cawston, François Bourhis, Maiwenn Al, Maureen Rutten-van Molken, Katherine P Liao, Daniel H Solomon
OBJECTIVES: The aims were to compare the performance of cardiovascular risk calculators, Framingham Risk Score (FRS) and QRISK2, in RA and matched non-RA patients and to evaluate whether their performance could be enhanced by the addition of CRP. METHODS: We conducted a retrospective analysis, using a clinical practice data set linked to Hospital Episode Statistics (HES) data from the UK. Patients presenting with at least one RA diagnosis code and no prior cardiovascular events were matched to non-RA patients using disease risk scores...
January 12, 2017: Rheumatology
https://www.readbyqxmd.com/read/28087496/digital-pills-to-measure-opioid-ingestion-patterns-in-emergency-department-patients-with-acute-fracture-pain-a-pilot-study
#8
Peter R Chai, Stephanie Carreiro, Brendan J Innes, Rochelle K Rosen, Conall O'Cleirigh, Kenneth H Mayer, Edward W Boyer
BACKGROUND: Nonadherence to prescribed regimens for opioid analgesic agents contributes to increasing opioid abuse and overdose death. Opioids are frequently prescribed on an as-needed basis, placing the responsibility to determine opioid dose and frequency with the patient. There is wide variability in physician prescribing patterns because of the lack of data describing how patients actually use as-needed opioid analgesics. Digital pill systems have a radiofrequency emitter that directly measures medication ingestion events, and they provide an opportunity to discover the dose, timing, and duration of opioid therapy...
January 13, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28086848/using-intervention-mapping-to-develop-the-parents-as-agents-of-change-pac-%C3%A2-intervention-for-managing-pediatric-obesity
#9
Geoff D C Ball, Aislin R Mushquash, Rachel A Keaschuk, Kathryn A Ambler, Amanda S Newton
BACKGROUND: Pediatric obesity has become increasingly prevalent over recent decades. In view of the psychosocial and physical health risks, and the high likelihood that children with obesity will grow to become adults with obesity, there is a clear need to develop evidence-based interventions that can be delivered in the health care system to optimize the health and well-being of children with obesity and their families. The aim of this paper is to describe the development, implementation, and planned evaluation of a parent-based weight management intervention designed for parents of 8-12 year olds with obesity...
January 13, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28086760/education-of-pediatric-subspecialty-fellows-in-transport-medicine-a-national-survey
#10
Geoffrey E Mickells, Denise M Goodman, Ranna A Rozenfeld
BACKGROUND: The transport of critically ill patients to children's hospitals is essential to current practice. The AAP Section on Transport Medicine has raised concerns about future leadership in the field as trainees receive less exposure to transport medicine. This study identifies the priorities of pediatric subspecialty fellows, fellowship directors and nursing directors in transport medicine education. METHODS: Internet based surveys were distributed to fellows, fellowship directors and nursing directors of transport teams affiliated with ACGME-approved fellowships in Neonatal-Perinatal Medicine (NPM), Pediatric Critical Care Medicine (PCCM), and Pediatric Emergency Medicine (PEM)...
January 13, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28079974/findings-from-a-pilot-study-bringing-evidence-based-practice-to-the-bedside
#11
Mary Ann Friesen, Joni M Brady, Renee Milligan, Patricia Christensen
BACKGROUND: To translate research supporting inpatient care outcomes and provide evidence-based care, registered nurses (RNs) need continuing education and mentoring support to adopt evidence-based practice (EBP). AIMS: The aim of this study was to assess a demonstration project intended to pilot and evaluate a structured EBP education with mentoring innovation for nurses in a multihospital system. METHODS: Nurses from five units in five hospitals were included in an education with mentoring innovation to implement the Johns Hopkins Nursing Evidence-Based Practice Model and the Advancing Research and Clinical practice through close Collaboration (ARCC) Model...
January 12, 2017: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/28079411/enteral-tube-feeding-using-good-practice-to-prevent-infection
#12
Hardip Malhi
Enteral tube feeding is the delivery of nutritionally complete feed via a tube into the gut. It is used for patients who are unable to meet their nutritional needs orally. Enteral feeding can be given through a variety of different tubes that access the gastrointestinal tract either via the stomach or the small bowel. The contamination of enteral feed can often be overlooked as a source of bacterial infection. Enteral feeds can become contaminated in a variety of different ways. Most often infections result in extended lengths of stay in hospital and patients also need additional therapies and treatments in order to resolve these infections...
January 12, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28078766/lost-in-transformation-reviving-ethics-of-care-in-hospital-cultures-of-evidence-based-healthcare
#13
Annelise Norlyk, Anita Haahr, Pia Dreyer, Bente Martinsen
Drawing on previous empirical research, we provide an exemplary narrative to illustrate how patients have experienced hospital care organized according to evidence-based fast-track programmes. The aim of this paper was to analyse and discuss if and how it is possible to include patients' individual perspectives in an evidence-based practice as seen from the point of view of nursing theory. The paper highlights two conflicting courses of development. One is a course of standardization founded on evidence-based recommendations, which specify a set of rules that the patient must follow rigorously...
January 12, 2017: Nursing Inquiry
https://www.readbyqxmd.com/read/28077413/cancer-related-hospitalisations-and-unknown-stage-prostate-cancer-a-population-based-record-linkage-study
#14
Qingwei Luo, Xue Qin Yu, David Paul Smith, David Eamon Goldsbury, Claire Cooke-Yarborough, Manish Indravadan Patel, Dianne Lesley O'Connell
OBJECTIVES: To identify reasons for prostate cancer stage being recorded as 'unknown' in Australia's largest population-based cancer registry. DESIGN: Prospective population-based cohort. SETTING: New South Wales (NSW) is the most populous state in Australia, with almost one third of the total national population. PARTICIPANTS: NSW Cancer Registry (NSWCR) records for prostate cancer cases diagnosed in 2001-2009 were linked to the NSW Admitted Patient Data Collection (APDC) for 2000-2010...
January 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28077162/a-fixed-inhaled-nitrous-oxide-oxygen-mixture-as-an-analgesic-for-adult-cancer-patients-with-breakthrough-pain-study-protocol-for-a-randomized-controlled-trial
#15
Qiang Liu, Yu Wang, Xiang-Jiang Luo, Ning-Ju Wang, Ping Chen, Xin Jin, Guo-Xia Mu, Xiao-Min Chai, Yue-Juan Zhang, Yu-Xiang Li, Jian-Qiang Yu
BACKGROUND: The management of breakthrough pain in cancer patients is always a challenge for medical professions. Occurring in 80% of cancer patients with advanced disease, breakthrough pain significantly decreases both patient's and caregiver's quality of life. The aim of this study is to assess the analgesic efficacy of a fixed inhaled nitrous oxide/oxygen mixture for adult cancer patients with breakthrough pain. METHODS/DESIGN: This is a randomized, placebo-controlled, double-blind study; it will be conducted in the General Hospital of Ningxia Medical University...
January 11, 2017: Trials
https://www.readbyqxmd.com/read/28077080/should-patients-older-than-65-years-be-offered-a-second-kidney-transplant
#16
Kristian Heldal, Anders Hartmann, Kjersti Lønning, Torbjørn Leivestad, Anna V Reisæter, Pål-Dag Line, Hallvard Holdaas, Karsten Midtvedt
BACKGROUND: Age and number of recipients in need of kidney re-transplantation are increasing. Re-transplantation practices and outcomes in elderly recipients are not previously explored. We aimed to retrospectively evaluate the outcomes of recipients 65 years and older receiving their second deceased donor allograft. METHODS: The study was designed as a retrospective registry based study. All recipients 65 years or older who received a deceased donor kidney transplant at Oslo University Hospital between 2000 and 2014 were included in the study...
January 11, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28076685/diffusion-of-evidence-based-intensive-care-unit-organizational-practices-a-state-wide-analysis
#17
Rachel Kohn, Vanessa Madden, Jeremy M Kahn, David A Asch, Amber E Barnato, Scott D Halpern, Meeta Prasad Kerlin
RATIONALE: Several intensive care unit (ICU) organizational practices have been associated with improved patient outcomes. However, the uptake of these evidence-based practices is unknown. OBJECTIVE: To assess diffusion of ICU organizational practices across the state of Pennsylvania. METHODS: We conducted two web-based, cross-sectional surveys of ICU organizational practices in Pennsylvania acute care hospitals, in 2005 (chief nursing officer respondents) and 2014 (ICU nurse manager respondents)...
January 11, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28074570/development-of-the-sbirt-checklist-for-observation-in-real-time-score
#18
Janice A Vendetti, Bonnie G McRee, Frances K Del Boca
BACKGROUND AND AIMS: Screening, Brief Intervention and Referral to Treatment (SBIRT) programs have been implemented widely in medical settings, with little attention focused on how well providers adhere to evidence-based service delivery in everyday practice. The purposes of this paper were to: (1) introduce a flexible, relatively simple methodology, the SBIRT Checklist for Observation in Real-time (SCORe), to assess adherence to evidence-based practice and provide preliminary evidence supporting its criterion validity; and (2) illustrate the feasibility and potential utility of the SCORe by analyzing observations of providers within four large-scale SBIRT programs in the United States...
February 2017: Addiction
https://www.readbyqxmd.com/read/28074438/is-there-variation-in-procedural-utilization-for-lumbar-spine-disorders-between-a-fee-for-service-and-salaried-healthcare-system
#19
Andrew J Schoenfeld, Heeren Makanji, Wei Jiang, Tracey Koehlmoos, Christopher M Bono, Adil H Haider
BACKGROUND: Whether compensation for professional services drives the use of those services is an important question that has not been answered in a robust manner. Specifically, there is a growing concern that spine care practitioners may preferentially choose more costly or invasive procedures in a fee-for-service system, irrespective of the underlying lumbar disorder being treated. QUESTIONS/PURPOSES: (1) Were proportions of interbody fusions higher in the fee-for-service setting as opposed to the salaried Department of Defense setting? (2) Were the odds of interbody fusion increased in a fee-for-service setting after controlling for indications for surgery? METHODS: Patients surgically treated for lumbar disc herniation, spinal stenosis, and spondylolisthesis (2006-2014) were identified...
January 10, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28073792/adult-parenteral-nutrition-in-the-north-of-england-a-region-wide-audit
#20
Jessica K Dyson, Nick Thompson
OBJECTIVES: Parenteral nutrition (PN) is widely used to provide nutritional support to patients with inaccessible or inadequate length of gut or non-functioning gut. The objective was to compare practice in PN administration to results of the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report, 'A Mixed Bag', and to establish whether good practice was being followed within this part of the UK. SETTING: Using the Northern Nutrition Network (NNN), we examined the care of adult patients receiving PN in all 10 secondary care hospitals in our region...
January 10, 2017: BMJ Open
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