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https://www.readbyqxmd.com/read/28340500/advanced-practice-registered-nurses-and-long-acting-reversible-contraception
#1
Patricia J Kelly, An-Lin Cheng, Kimberly Carlson, Jacki Witt
INTRODUCTION: Advanced practice registered nurses (APRNs) are in an excellent position to address the high rates of unintended pregnancy in the United States by providing long-acting reversible contraceptives (LARCs). These methods are significant in their effectiveness in preventing pregnancy in individual women and in having population-level effects on unintended pregnancy. The aim of this study was to learn more about APRN practices around long-acting reversible contraception and influences on those practices...
March 24, 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28339735/triage-quality-control-is-missing-tools-a-new-observation-technique-for-ed-quality-improvement
#2
Tomi Malmström, Veli-Pekka Harjola, Paulus Torkki, Salla Kumpulainen, Raija Malmström
Objective: Correct assessment of patient urgency is critical to ensuring patient safety in emergency departments (EDs). Although significant time and effort have been devoted to developing triage systems, less attention has been paid to the development of quality control. The aim of this study is to introduce and test observation technique, which enables identifying of patient groups at risk of erroneous assessment in triage. The introduced technique is aimed to be less laborious to use than existing triage quality control methods...
February 23, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28338416/impact-of-a-complex-care-management-model-on-cost-and-utilization-among-adolescents-and-young-adults-with-special-care-and-health-needs
#3
Daniel D Maeng, Susan R Snyder, Thomas W Davis, Janet F Tomcavage
Adolescents and young adults with special care and health needs in the United States-many of whom have Medicaid coverage-at the transition phase between pediatric and adult care often experience critical care gaps. To address this challenge, a new model-referred to as Comprehensive Care Clinic (CCC)-has been developed and implemented by Geisinger Health System since 2012. CCC comprises a care team, consisting of a generalist physician, advanced practitioner, pharmacist, and a nurse case manager, that develops and closely follows a coordinated care plan...
March 24, 2017: Population Health Management
https://www.readbyqxmd.com/read/28333613/collaborative-management-of-neurocognitive-disorders-in-primary-care-explorations-of-an-attempt-at-culture-change
#4
Lewis Mehl-Madrona, Barbara Mainguy
INTRODUCTION: Minor neurocognitive disorder (MiND; previously mild cognitive impairment) is a transitional zone between normal cognitive function and early stages of major neurocognitive disorder (previously called dementia). Of people with MiND, 5% to 10% progress to major neurocognitive disorder. Simple interventions such as memory activities, balance exercises, and anti-inflammatory diets have been shown to improve cognitive ability. Also, education and support in group settings have proved beneficial for patients with MiND...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28330941/nurse-driven-clinical-pathway-for-inpatient-asthma-a-randomized-controlled-trial
#5
Catherine M Pound, Victoria Gelt, Salwa Akiki, Kaylee Eady, Katherine Moreau, Franco Momoli, Barbara Murchison, Roger Zemek, Brett Mulholland, Tom Kovesi
OBJECTIVE: We examined the impact of a nurse-driven clinical pathway on length of stay (LOS) for children hospitalized with asthma. METHODS: We conducted a randomized controlled trial involving children hospitalized with asthma. Nurses of children in the intervention group weaned salbutamol frequency using an asthma scoring tool, whereas physicians weaned salbutamol frequency for the control group patients as per standard care. The primary outcome was LOS in hours...
March 22, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28330829/does-telehealth-monitoring-identify-exacerbations-of-chronic-obstructive-pulmonary-disease-and-reduce-hospitalisations-an-analysis-of-system-data
#6
Melissa Kargiannakis, Deborah A Fitzsimmons, Claire L Bentley, Gail A Mountain
BACKGROUND: The increasing prevalence and associated cost of treating chronic obstructive pulmonary disease (COPD) is unsustainable. Health care organizations are focusing on ways to support self-management and prevent hospital admissions, including telehealth-monitoring services capturing physiological and health status data. This paper reports on data captured during a pilot randomized controlled trial of telehealth-supported care within a community-based service for patients discharged from hospital following an exacerbation of their COPD...
March 22, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28326901/continuity-of-care-to-prevent-readmissions-for-patients-with-chronic-obstructive-pulmonary-disease-a-systematic-review-and-meta-analysis
#7
Fen Yang, Zhen-Fang Xiong, Chongming Yang, Lin Li, Guiyuan Qiao, Yuncui Wang, Taoyun Zheng, Huijuan He, Hui Hu
Readmissions of patients with chronic obstructive pulmonary disease (COPD) to hospitals cast a heavy burden to health care systems. This meta-analysis was aimed to assess the efficacy of continuity of care as interventions, which reduced readmission and mortality rates of such patients. PubMed, Cochrane Library and Embase were searched for articles published before July 2015. A total of 31 reports with randomized controlled trials (RCTs) were finally included in this meta-analysis. The results showed that health education reduced all-cause readmission at 3 months...
April 2017: COPD
https://www.readbyqxmd.com/read/28323721/registered-nurses-in-primary-care-emerging-new-roles-and-contributions-to-team-based-care-in-high-performing-practices
#8
Margaret Flinter, Clarissa Hsu, DeAnn Cromp, MaryJoan D Ladden, Edward H Wagner
The years since the passage of the Affordable Care Act have seen substantial changes in the organization and delivery of primary care. These changes have emphasized greater team involvement in care and expansion of the roles of each team member including registered nurses (RNs). This study examined the roles of RNs in 30 exemplary primary care practices. We identified the emergence of new roles and activities for RNs characterized by greater involvement in face-to-face patient care and care management, their own daily schedule of patient visits and contacts, and considerable autonomy in the care of their patients...
March 20, 2017: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/28320789/-right-home-a-randomised-controlled-trial-of-sustained-nurse-home-visiting-from-pregnancy-to-child-age-2%C3%A2-years-versus-usual-care-to-improve-parent-care-parent-responsivity-and-the-home-learning-environment-at-2%C3%A2-years
#9
Sharon Goldfeld, Anna Price, Hannah Bryson, Tracey Bruce, Fiona Mensah, Francesca Orsini, Lisa Gold, Harriet Hiscock, Charlene Smith, Lara Bishop, Dianne Jackson, Lynn Kemp
INTRODUCTION: By the time children start school, inequities in learning, development and health outcomes are already evident. Sustained nurse home visiting (SNHV) offers a potential platform for families experiencing adversity, who often have limited access to services. While SNHV programmes have been growing in popularity in Australia and internationally, it is not known whether they can improve children's learning and development when offered via the Australian service system. The right@home trial aims to investigate the effectiveness of an SNHV programme, offered to women from pregnancy to child age 2 years, in improving parent care of and responsivity to the child, and the home learning environment...
March 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28319992/organizational-and-community-factors-associated-with-magnet-status-of-u-s-hospitals
#10
Teresa Wai Chi Tai, Sherry I Bame
The Magnet Recognition Program for healthcare organizations promotes excellence in nursing services and professional practices. However, organizational and community characteristics that contribute to the adoption of Magnet status remain unexplained. Investigating organizational and community factors will help determine systematic structural and contextual dimensions of Magnet hospitals previously shown to be more cost-effective in comparison with non-Magnet hospitals. Using the baseline 2005 database of all Magnet hospitals in the United States, the authors selected a matched sample to determine key organizational and community characteristics associated with Magnet adoption while controlling for regional and local factors...
January 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28319813/the-clinical-implications-of-legalizing-marijuana-are-physician-and-non-physician-providers-prepared
#11
Elizabeth Brooks, Doris C Gundersen, Erin Flynn, Ashley Brooks-Russell, Sheana Bull
INTRODUCTION: Passage of voter-driven marijuana reform laws signals a shift in public attitudes for marijuana use. For providers, legalization may necessitate practice modifications, particularly regarding patient-provider conversations about use and risk. We examined healthcare providers' knowledge of marijuana laws and health implications, professional practice behaviors, and attitudes about training. MATERIALS AND METHODS: We surveyed 114 Colorado-based providers who care for children, adolescents, pregnant and breastfeeding women using a Venue-Day-Time survey methodology throughout Colorado...
March 10, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/28317804/a-survey-on-undiagnosed-active-pulmonary-tuberculosis-among-pregnant-mothers-in-mekelle-and-surrounding-districts-in-tigray-ethiopia
#12
Dawit Gebreegziabiher, Kelemework Adane, Markos Abebe
OBJECTIVE/BACKGROUND: To determine the prevalence of undiagnosed active pulmonary tuberculosis (PTB) cases and sensitivity, specificity, and positive and negative predictive values of symptom combinations for undiagnosed TB infection in human immunodeficiency virus (HIV)-positive and HIV-negative pregnant mothers attending antenatal care (ANC) clinics. Mycobacterium TB and HIV are the leading causes of death among women of reproductive age worldwide. Symptom screening is the first step in the World Health Organization (WHO)-recommended TB intensified case finding algorithm for people living with HIV...
January 2017: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28302674/urine-culture-follow-up-and-antimicrobial-stewardship-in-a-pediatric-urgent-care-network
#13
Dipanwita Saha, Jimisha Patel, Don Buckingham, David Thornton, Terry Barber, Joshua R Watson
BACKGROUND AND OBJECTIVES: Empiric antibiotic therapy for presumed urinary tract infection (UTI) leads to unnecessary antibiotic exposure in many children whose urine culture results fail to confirm the diagnosis. The objective of this quality improvement study was to improve follow-up management of negative urine culture results in the off-campus urgent care network of Nationwide Children's Hospital to reduce inappropriate antibiotic exposure in children. METHODS: A multidisciplinary task force developed and implemented a protocol for routine nurse and clinician follow-up of urine culture results, discontinuation of unnecessary antibiotics, and documentation in the electronic medical record...
March 16, 2017: Pediatrics
https://www.readbyqxmd.com/read/28301976/medicare-expenditures-associated-with-hospital-and-emergency-department-use-among-beneficiaries-with-dementia
#14
Laura Coots Daras, Zhanlian Feng, Joshua M Wiener, Yevgeniya Kaganova
Understanding expenditure patterns for hospital and emergency department (ED) use among individuals with dementia is crucial to controlling Medicare spending. We analyzed Health and Retirement Study data and Medicare claims, stratified by beneficiaries' residence and proximity to death, to estimate Medicare expenditures for all-cause and potentially avoidable hospitalizations and ED visits. Analysis was limited to the Medicare fee-for-service population age 65 and older. Compared with people without dementia, community residents with dementia had higher average expenditures for hospital and ED services; nursing home residents with dementia had lower average expenditures for all-cause hospitalizations...
January 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28301593/knowledge-attitudes-and-practices-of-south-african-healthcare-workers-regarding-the-prevention-and-treatment-of-influenza-among-hiv-infected-individuals
#15
Jazmin Duque, Sisanda Gaga, David Clark, Madeleine Muller, Bulenani Kuwane, Cheryl Cohen, Sibongile Walaza, Stefano Tempia, Puleng Ramatoboe, Tsakani Furumele, Marc-Alain Widdowson, Meredith L McMorrow, Adam L Cohen
BACKGROUND: The South African Department of Health (DOH) publishes annual guidelines identifying priority groups, including immunosuppressed individuals and healthcare workers (HCW), for influenza vaccination and treatment. How these guidelines have impacted HCW and their patients, particularly those infected with HIV, remains unknown. METHODS: We aimed to describe the knowledge, attitudes and practices regarding influenza and the vaccine among South African HCW...
2017: PloS One
https://www.readbyqxmd.com/read/28301068/characteristics-of-communication-with-older-people-in-home-care-a-qualitative-analysis-of-audio-recordings-of-home-care-visits
#16
Dorte Vesterager Kristensen, Annelie J Sundler, Hilde Eide, Linda Hafskjold, Iren Ruud, Inger K Holmström
AIMS AND OBJECTIVES: To describe the characteristics of communication practice in home care visits between older people (over 65 years old) and nurse assistants (NAs) and to discuss the findings from a person-centered perspective. BACKGROUND: The older population is increasing worldwide, along with the need for health care services in the person's home. To achieve high-quality care, person-centered communication is crucial. DESIGN: A descriptive design with a qualitative inductive approach was used...
March 16, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28296603/another-senseless-death-the-case-for-supervised-injection-facilities
#17
Sarah E Wakeman
Frankie liked to tell people "we made our bones together." He must have said that a hundred times, to every new medical student I introduced to him, to every nurse, and during every one of our many visits. I had a general sense of what he meant, but on the morning I heard that he’d died from an..
March 16, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28295847/effects-on-leisure-activities-and-social-participation-of-a-case-management-intervention-for-frail-older-people-living-at-home-a-randomised-controlled-trial
#18
Marianne Granbom, Jimmie Kristensson, Magnus Sandberg
Frailty causes disability and restrictions on older people's ability to engage in leisure activities and for social participation. The objective of this study was to evaluate the effects of a 1-year case management intervention for frail older people living at home in Sweden in terms of social participation and leisure activities. The study was a randomised controlled trial with repeated follow-ups. The sample (n = 153) was consecutively and randomly assigned to intervention (n = 80) or control groups (n = 73)...
March 12, 2017: Health & Social Care in the Community
https://www.readbyqxmd.com/read/28295145/variation-in-hospice-services-by-location-of-care-nursing-home-versus-assisted-living-facility-versus-home
#19
Kathleen T Unroe, Brittany Bernard, Timothy E Stump, Wanzhu Tu, Christopher M Callahan
OBJECTIVES: To describe differences in hospice services for patients living at home, in nursing homes or in assisted living facilities, including the overall number and duration of visits by different hospice care providers across varying lengths of stay. DESIGN: Retrospective cohort study using hospice patient electronic medical record data. SETTING: Large, national hospice provider. PARTICIPANTS: Data from 32,605 hospice patients who received routine hospice care from 2009 to 2014 were analyzed...
March 14, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28292505/unintentional-methadone-and-buprenorphine-exposures-in-children-developing-prevention-messages
#20
Lauren Schwartz, Maria Mercurio-Zappala, Mary Ann Howland, Robert S Hoffman, Mark K Su
OBJECTIVES: To develop key messages for methadone and buprenorphine safety education material based on an analysis of calls to the NYC Poison Control Center (NYC PCC) and designed for distribution to caregivers of young children. METHODS: Retrospective review of all calls for children 5 years of age and younger involving methadone or buprenorphine from January 1, 2000, to June 15, 2014. A data abstraction form was completed for each case to capture patient demographics, exposure and caller sites, caller relation to patient, qualitative information regarding the exposure scenario, the product information, if naloxone was given, and the medical outcome of the case...
March 2017: Journal of the American Pharmacists Association: JAPhA
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