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https://www.readbyqxmd.com/read/28495353/identifying-patient-related-information-problems-a-study-of-information-use-by-patient-care-teams-during-morning-rounds
#1
Alison R Murphy, Madhu C Reddy
OBJECTIVE: This study identifies the types of patient-related information problems (PIPs) that patient-care teams encounter during morning rounds, and how those PIPs are identified and managed. PIPs are any issues related to patient information (e.g., wrong, missing, incomplete information) that affect the patient-care team's ability to perform their work. Not addressing PIPs can lead to workflow challenges, delayed patient-care decisions, and negative impacts to the patient. MATERIALS AND METHODS: We employed qualitative data collection methods by shadowing patient-care teams during 29 morning rounds resulting in 155h of observation...
June 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28490367/vitamin-d-deficiency-among-smear-positive-pulmonary-tuberculosis-patients-and-their-tuberculosis-negative-household-contacts-in-northwest-ethiopia-a-case-control-study
#2
Belay Tessema, Feleke Moges, Dereje Habte, Nebiyu Hiruy, Shewaye Yismaw, Kassahun Melkieneh, Yewulsew Kassie, Belaineh Girma, Muluken Melese, Pedro G Suarez
BACKGROUND: Vitamin D is a fat-soluble vitamin that increases the immunity against tuberculosis (TB), decreases the re-activation of latent TB and reduces the severity of active TB disease. Epidemiological studies on the prevalence of vitamin D deficiency, and its association with TB showed inconsistent results in different countries. This study was aimed to determine the prevalence of vitamin D deficiency and its association with TB in Northwest Ethiopia. METHODS: A case-control study was conducted among smear positive pulmonary tuberculosis patients and their household contacts without symptoms suggestive of TB...
May 11, 2017: Annals of Clinical Microbiology and Antimicrobials
https://www.readbyqxmd.com/read/28467455/year-round-spatiotemporal-distribution-of-harbour-porpoises-within-and-around-the-maryland-wind-energy-area
#3
Jessica E Wingfield, Michael O'Brien, Vyacheslav Lyubchich, Jason J Roberts, Patrick N Halpin, Aaron N Rice, Helen Bailey
Offshore windfarms provide renewable energy, but activities during the construction phase can affect marine mammals. To understand how the construction of an offshore windfarm in the Maryland Wind Energy Area (WEA) off Maryland, USA, might impact harbour porpoises (Phocoena phocoena), it is essential to determine their poorly understood year-round distribution. Although habitat-based models can help predict the occurrence of species in areas with limited or no sampling, they require validation to determine the accuracy of the predictions...
2017: PloS One
https://www.readbyqxmd.com/read/28465810/quantitative-optimization-of-emergency-department-s-nurses-of-an-educational-hospital-a-case-study
#4
Mohammad Hosein Mehrolhasani, Ali Mouseli, Leila Vali, Zahra Mastaneh
INTRODUCTION: Nurses account for the majority of human resources in hospitals, as such that 62% of the workforce and 36% of hospital expenditures are related to nurses. Considering its vital role in offering round-the-clock emergency healthcare services, an Emergency Department (ED) requires adequate nurses. Therefore, this study was conducted to optimize the number of nurses in ED. METHODS: This was an applied study conducted using a Linear Programming (LP) model in 2015...
February 2017: Electronic Physician
https://www.readbyqxmd.com/read/28384964/post-extubation-bronchospasm-in-an-undiagnosed-case-of-ascariasis-anaesthetic-challenges
#5
Ravindra Gehlot, Shekhar Suman Saxena, Indira Kumari, Virendra Verma, Aditya Bidwaikar
One of the most prevalent parasitic infestation is ascariasis which poses a great challenge to both the person being infested with and the treating medical team. We present here a case of round worm (Ascaris lumbricoides) infestation. A 40-year-old male, weighing 60 kg, diagnosed as perforation peritonitis, was scheduled for emergency exploratory laparotomy. The round worm was crawling out from duodenal perforation vent during laparotomy confirming the infestation. Patient later developed bronchospasm in post-extubation period and was managed accordingly...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28352467/electronic-printed-ward-round-proformas-freeing-up-doctors-time
#6
Darren Fernandes, Philip Eneje
The role of a junior doctor involves preparing for the morning ward round. At a time when there are gaps on rotas and doctors' time is more stretched, this can be a source of significant delay and thus a loss of working time. We therefore looked at ways in which we could make the ward round a more efficient place by introducing specific electronic, printed ward round proformas. We used the average time taken to write proformas per patient and the average time taken per patient on the ward round. This would then enable us to make fair comparisons with future changes that were made using the plan, do, study, and act principles of quality improvement...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28351066/bringing-rounds-back-to-the-patient-a-one-year-evaluation-of-the-chiefs-service-model-for-inpatient-teaching
#7
Nadia L Bennett, Judd D Flesch, Peter Cronholm, James B Reilly, Jack Ende
PURPOSE: The Chiefs' Service (CS), a structured approach to inpatient teaching rounds, focuses on resident education and patient-centered care without disrupting patient census sizes or admitting cycles. It has five key elements: morning huddles; bedside rounds; diagnostic "time-outs"; day-of-discharge rounds; and postdischarge follow-up rounds. The authors hypothesized the CS model would be well received by residents and considered more effective than more-traditional rounds. METHOD: The CS was implemented on Penn Presbyterian Medical Center's general medicine inpatient service using a quasi-experimental design...
April 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28302341/communication-behaviors-and-patient-autonomy-in-hospital-care-a-qualitative-study
#8
Zackary D Berger, Emily F Boss, Mary Catherine Beach
BACKGROUND: Little is known about how hospitalized patients share decisions with physicians. METHODS: We conducted an observational study of patient-doctor communication on an inpatient medicine service among 18 hospitalized patients and 9 physicians. A research assistant (RA) approached newly hospitalized patients and their physicians before morning rounds and obtained consent. The RA audio recorded morning rounds, and then separately interviewed both patient and physician...
March 7, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28281375/undergraduate-medical-students-perceptions-of-their-learning-experience-in-pediatric-rotation-at-king-abdulaziz-university-medical-college-in-jeddah-saudi-arabia
#9
Nadia M Fida, Mohammed Farouq, Dhuha Alamawi, Hayat Kamfar
AIM: This study aimed to evaluate fifth-year medical students' perception of their learning experience during pediatric rotation at the medical college of King Abdulaziz University (KAU), Jeddah, Saudi Arabia. METHOD: This cross-sectional study was conducted by distributing a questionnaire to fifth-year students who attended the pediatric rotation at KAU, during 2013-2014. RESULTS: Three hundred fifty-six out of 360 students agreed to participate, representing a response rate of 99%...
March 10, 2017: Medical Teacher
https://www.readbyqxmd.com/read/28148543/ordering-interruptions-in-a-tertiary-care-center-a-prospective-observational-study
#10
Nina M Dadlez, Gabriella Azzarone, Mark J Sinnett, Micah Resnick, H Michael Ushay, Jason S Adelman, Molly Broder, Carol Duh-Leong, Joyce Huang, Victoria Kiely, Ariella Nadler, Vayola Nelson, Jared Simcik, Michael L Rinke
OBJECTIVES: By self-report, interruptions may contribute to up to 80% of ordering errors. A greater understanding of the frequency and context of interruptions during ordering is needed to identify targets for intervention. We sought to characterize the epidemiology of interruptions during order placement in the pediatric inpatient setting. METHODS: This prospective observational study conducted 1-hour-long structured observations on morning rounds and afternoons and evenings in the resident workroom...
February 1, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28089404/the-schhs-hip-fracture-clinical-network-experience-improving-care-and-outcomes-through-an-interprofessional-approach
#11
Gillian Puckeridge, Morné Terblanche, Debbie Massey
BACKGROUND: Hip fractures are a major global health care issue, with the 1.26 million estimated cases in 1990 predicted to increase to 4.5 million by 2050. Varying models of care have been developed to improve outcomes following fragility hip fractures. Most of these care models embrace an interprofessional approach to care. Specialist orthopedic nurses play an important role in the management of fragility hip fracture patients and their contribution to the interprofessional health care team is an important predictor of patient outcomes...
December 18, 2016: International Journal of Orthopaedic and Trauma Nursing
https://www.readbyqxmd.com/read/27872081/novel-effects-of-lapatinib-revealed-in-the-african-trypanosome-by-using-hypothesis-generating-proteomics-and-chemical-biology-strategies
#12
Paul J Guyett, Ranjan Behera, Yuko Ogata, Michael Pollastri, Kojo Mensa-Wilmot
Human African trypanosomiasis is a neglected tropical disease caused by the protozoan parasite Trypanosoma brucei Lapatinib, a human epidermal growth factor receptor (EGFR) inhibitor, can cure 25% of trypanosome-infected mice, although the parasite lacks EGFR-like tyrosine kinases. Four trypanosome protein kinases associate with lapatinib, suggesting that the drug may be a multitargeted inhibitor of phosphoprotein signaling in the bloodstream trypanosome. Phosphoprotein signaling pathways in T. brucei have diverged significantly from those in humans...
February 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/27865524/exposure-to-uv-filters-during-summer-and-winter-in-danish-kindergarten-children
#13
Marianna Krause, Anna-Maria Andersson, Niels E Skakkebaek, Hanne Frederiksen
BACKGROUND: Ultra violet (UV) filters with known or suspected endocrine disrupting properties are widely used in sunscreens and other personal care products, clothing, food packaging and many other consumer products. Danish kindergarten children have sunscreens applied daily during summer to prevent skin burns. OBJECTIVES: To estimate the assumed contribution of sunscreens to the total exposure to UV filters, we measured the urinary excretion of UV filters during summer and winter in kindergarten children...
November 16, 2016: Environment International
https://www.readbyqxmd.com/read/27757740/design-and-%C3%AE-testing-of-an-electronic-rounding-tool-certainp-to-improve-process-of-care-in-pediatric-intensive-care-unit
#14
Manasi Hulyalkar, Stephen J Gleich, Rahul Kashyap, Amelia Barwise, Harsheen Kaur, Yue Dong, Lei Fan, Srinivas Murthy, Grace M Arteaga, Sandeep Tripathi
Increasing process complexity in the pediatric intensive care unit (PICU) can lead to information overload resulting in missing pertinent information and potential errors during morning rounds. An efficient model using a novel electronic rounding tool was designed as part of a broader critical care decision support system-checklist for early recognition and treatment of acute illness and injury in pediatrics (CERTAINp). We aimed to evaluate its impact on improving the process of care during rounding. Prospective pre- and post-interventional data included: team performance baseline assessment, patient safety discussion, guideline adherence, rounding time, and a survey of Residents' and Nurses' perception using a Likert scale...
October 18, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27649819/on-being-fired-when-patients-or-their-parents-fire-their-physician
#15
Christy L Cummings
Wait, what? I've been fired?" I repeated, in the middle of morning rounds in the neonatal intensive care unit. Finally, the nurse who was taking care of our patient, Angela, responded, "Her parents fired you last night. They've already called Patient Relations. They want a new doctor." My heart sank. Only days into my block of service time as the attending physician in the NICU and I was fired, axed, canned, rejected by a family. How could this have happened? On my first day of service, I had introduced myself to Angela's parents, and I had then met with them daily to review results and the plan and to answer their questions...
September 2016: Hastings Center Report
https://www.readbyqxmd.com/read/27613415/can-persuasive-and-demonstrative-messages-to-visitors-reduce-littering-in-river-beaches
#16
Ana M Cingolani, Iván Barberá, Daniel Renison, Fernando R Barri
Littering of public areas is a significant problem worldwide. Here we evaluate the success of persuasive and demonstrative messages at reducing littering in highly visited river beaches in Argentina. We made an intervention at the beaches which consisted of a personalized verbal request asking visitors to take their litter to the waste cans (persuasive message) while they were exposed to the example of picking up the litter already left on the beach (demonstrative message). We conducted 102 observations distributed over 29 dates, two years and four beaches...
December 2016: Waste Management
https://www.readbyqxmd.com/read/27611580/impact-of-altered-medication-administration-time-on-interdisciplinary-bedside-rounds-on-academic-medical-ward
#17
Eric Young, Jaime Paulk, James Beck, Mel Anderson, McKenna Burck, Luke Jobman, Chad Stickrath
Interdisciplinary rounds provide a valuable venue for delivering patient-centered care but are difficult to implement due to time constraints and coordination challenges. In this article, we describe a unique model for fostering a culture of bedside interdisciplinary rounds through adjustment of the morning medication administration time, auditing physician communication with nurses, and displaying physician performance in public areas. Implementation of this model led to measurable improvements in physician-to-nurse communication on rounds, teamwork climate, and provider job satisfaction...
September 8, 2016: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/27540245/opinions-of-users-of-pharmacy-service-provided-to-picu
#18
Rhian Isaac, Astrid Gerrard, Kevin Bazaz
BACKGROUND: Pressures to open pharmacy services 7 days a week, with no financial input for these extra resources, has knock on effects that may dilute accessibility to clinical pharmacists in specialist areas. AIMS: The aim of this survey was to assess opinions of the users of the current pharmacy services to PICU and the planned extended hours provision. METHOD: An e-survey was sent to PIC Consultants, Advanced Nurse Practitioners, and Senior Nursing Staff following a six month period of increased clinical pharmacists time allocation to PIC...
September 2016: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27538395/interprofessional-team-interactions-about-complex-care-in-the-icu-pilot-development-of-an-observational-rating-tool
#19
Deena Kelly Costa, Jennifer Dammeyer, Matthew White, Jose Galinato, Robert Hyzy, Milisa Manojlovich, Anne Sales
BACKGROUND: The awakening and breathing coordination, delirium, and early mobility (ABCDE) bundle is a multicomponent complex intervention that improves outcomes for critically ill adults yet is inconsistently implemented. Effective interprofessional team function (how the team interacts) is key to ABCDE delivery but little is known about how to measure team interactions. The purpose of our study was to examine the reliability of an observational rating tool to assess team interactions about ABCDE in one ICU...
August 18, 2016: BMC Research Notes
https://www.readbyqxmd.com/read/27456181/successful-introduction-of-a-daily-checklist-to-enhance-compliance-with-accepted-standards-of-care-in-the-medical-intensive-care-unit
#20
A Nama, S Sviri, A Abutbul, I Stav, P V van Heerden
We introduced a simple checklist to act as an aid to memory for our junior medical staff to ensure that every patient in the intensive care unit (ICU) received every appropriate element of a bundle of care every day. The checklist was developed in consultation with our junior doctors and was designed to be completed every morning for every patient by the junior doctor reviewing the patient. The completed checklist was then checked again by the attending intensivist on the main daily ward round to ensure all the appropriate elements of the checklist had been applied to the patient...
July 2016: Anaesthesia and Intensive Care
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