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https://www.readbyqxmd.com/read/28630690/incidence-and-risk-factors-for-surgical-site-infections-in-obstetric-and-gynecological-surgeries-from-a-teaching-hospital-in-rural-india
#1
Ashish Pathak, Kalpana Mahadik, Manmat B Swami, Pulak K Roy, Megha Sharma, Vijay K Mahadik, Cecilia Stålsby Lundborg
BACKGROUND: Surgical site infections (SSI) are one of the most common healthcare associated infections in the low-middle income countries. Data on incidence and risk factors for SSI following surgeries in general and Obstetric and Gynecological surgeries in particular are scare. This study set out to identify risk factors for SSI in patients undergoing Obstetric and Gynecological surgeries in an Indian rural hospital. METHODS: Patients who underwent a surgical procedure between September 2010 to February 2013 in the 60-bedded ward of Obstetric and Gynecology department were included...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28612407/pre-registration-interprofessional-clinical-education-in-the-workplace-a-realist-review
#2
Fiona Kent, Jacinta Hayes, Sharon Glass, Charlotte E Rees
CONTEXT: The inclusion of interprofessional education opportunities in clinical placements for pre-registration learners has recently been proposed as a strategy to enhance graduates' skills in collaborative practice. OBJECTIVES: A realist review was undertaken to ascertain the contexts, mechanisms and outcomes of formal interprofessional clinical workplace learning. METHODS: Initial scoping was carried out, after which Ovid MEDLINE, CINAHL and EMBASE were searched from 2005 to April 2016 to identify formal interprofessional workplace educational interventions involving pre-registration learners...
June 14, 2017: Medical Education
https://www.readbyqxmd.com/read/28610011/two-new-species-of-free-living-marine-nematodes-of-the-family-oxystominidae-chitwood-1935-enoplida-with-a-review-of-the-genus-i-thalassoalaimus-i-de-man-1893-from-the-argentine-coast
#3
Antonela Martelli, Virginia Lo Russo, Gabriela Villares, Catalina T Pastor DE Ward
Two new free-living marine nematodes of the family Oxystominidae are described from San Antonio Bay (Río Negro) and San José Gulf (Chubut). Litinium australis sp. n., is characterized by having a rounded tail, by the first and second crown of cephalic setae with different lengths, gubernaculum with apophysis and by the presence of at least four precloacal papillae; Thalassoalaimus nestori sp. n., is characterized by having a conical tail, cephalic setae equal in length, gubernaculum with rounded and dorso-caudally directed apophysis and two precloacal papillae...
April 6, 2017: Zootaxa
https://www.readbyqxmd.com/read/28608289/-antibiotic-stewardship-a%C3%A2-programmatic-approach-to-improved-antimicrobial-management
#4
REVIEW
Martin Müller, Patrick Lehmann, Christian Willy
Due to the increasing selection and prevalence of multidrug-resistant gram-negative bacteria and the insufficient development of novel antibiotics, the responsible and prudent use of the available antimicrobial drugs is of major importance. In Germany the rational use of anti-infectives considering the local antimicrobial resistance situation is defined in the infection protection act of 2011. An important tool to follow legal regulations and to improve the treatment of bacterial infections is the antimicrobial stewardship (AMS) concept...
June 12, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28607676/evaluating-the-quality-improvement-impact-of-the-global-tracheostomy-collaborative-in-four-diverse-nhs-hospitals
#5
Brendan A McGrath, James Lynch, Barbarella Bonvento, Sarah Wallace, Val Poole, Ann Farrell, Cristina Diaz, Sadie Khwaja, David W Roberson
Tracheostomies are predominantly used in Head & Neck Surgery and the critically ill. The needs of these complex patients frequently cross traditional speciality working boundaries and locations and any resulting airway problems can rapidly lead to significant harm. The Global Tracheostomy Collaborative (GTC) was formed in 2012 with the aim of bringing together international expertise in tracheostomy care in order to bring about rapid adoption of best practices and to improve the quality and safety of care to this vulnerable group...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28561887/reconciling-patient-and-provider-priorities-for-improving-the-care-of-critically-ill-patients-a-consensus-method-and-qualitative-analysis-of-decision-making
#6
Emily McKenzie, Melissa L Potestio, Jamie M Boyd, Daniel J Niven, Rebecca Brundin-Mather, Sean M Bagshaw, Henry T Stelfox
BACKGROUND: Providers have traditionally established priorities for quality improvement; however, patients and their family members have recently become involved in priority setting. Little is known about how to reconcile priorities of different stakeholder groups into a single prioritized list that is actionable for organizations. OBJECTIVE: To describe the decision-making process for establishing consensus used by a diverse panel of stakeholders to reconcile two sets of quality improvement priorities (provider/decision maker priorities n=9; patient/family priorities n=19) into a single prioritized list...
May 31, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28541515/recalmin-the-association-between-management-of-spanish-national-health-service-internal-medical-units-and-health-outcomes
#7
Antonio Zapatero-Gaviria, Francisco Javier Elola-Somoza, Emilio Casariego-Vales, Cristina Fernandez-Perez, Ricardo Gomez-Huelgas, José Luis Bernal, Raquel Barba-Martín
Objective: To investigate the association between management of Internal Medical Units (IMUs) with outcomes (mortality and length of stay) within the Spanish National Health Service. Design: Data on management were obtained from a descriptive transversal study performed among IMUs of the acute hospitals. Outcome indicators were taken from an administrative database of all hospital discharges from the IMUs. Setting: Spanish National Health Service...
May 24, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28504810/using-a-structured-checklist-to-improve-the-orthopedic-ward-round-a-prospective-cohort-study
#8
Adrian J Talia, James Drummond, Cameron Muirhead, Phong Tran
Comprehensive and timely documentation on orthopedic ward rounds continues to be problematic, leading to delayed or inappropriate patient care and miscommunication between health care providers. The authors introduced a simple checklist to improve the documentation on orthopedic ward rounds in their institution. A prospective cohort study was performed. Standard care was provided for cohort A. During a 2-week period, the documentation of patient care by physicians following a ward round was assessed in terms of venous thromboembolism prophylaxis, fasting status, wound or dressing plan, weight-bearing status, and important surgical details...
May 15, 2017: Orthopedics
https://www.readbyqxmd.com/read/28488302/the-big-d-eal-professional-identity-through-discursive-constructions-of-patient
#9
Brett Schrewe, Joanna Bates, Dan Pratt, Claudia W Ruitenberg, William H McKellin
CONTEXT: Professional identity formation has become a key focus for medical education. Who one becomes as a physician is contingent upon learning to conceptualise who the other is as a patient, yet, at a time when influential ideologies such as patient-centred care have become espoused values, there has been little empirical investigation into assumptions of 'patient' that trainees take up as they progress through their training. METHODS: Our team employed a critical discourse analysis approach to transcripts originally produced from a micro-ethnography of medical student learning on an acute care in-patient paediatric ward...
June 2017: Medical Education
https://www.readbyqxmd.com/read/28429527/balancing-health-care-education-and-patient-care-in-the-uk-workplace-a-realist-synthesis
#10
Sarah Sholl, Rola Ajjawi, Helen Allbutt, Jane Butler, Divya Jindal-Snape, Jill Morrison, Charlotte Rees
CONTEXT: Patient care activity has recently increased without a proportionate rise in workforce numbers, impacting negatively on health care workplace learning. Health care professionals are prepared in part by spending time in clinical practice, and for medical staff this constitutes a contribution to service. Although stakeholders have identified the balance between health care professional education and patient care as a key priority for medical education research, there have been very few reviews to date on this important topic...
April 20, 2017: Medical Education
https://www.readbyqxmd.com/read/28421924/nursingstandard-com
#11
(no author information available yet)
1 Intentional rounding, the system of hourly rounds by nurses in hospital wards, may not improve communication with patients, according to research. Some patients said they did not have conversations with nurses but just answered questions. Read more: rcni.com/rounding-research.
April 19, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28406339/a-case-study-of-healthcare-providers-goals-during-interprofessional-rounds
#12
Michael Prystajecky, Tiffany Lee, Sylvia Abonyi, Robert Perry, Heather Ward
Daily interprofessional rounds enhance collaboration among healthcare providers and improve hospital performance measures. However, it is unclear how healthcare providers' goals influence the processes and outcomes of interprofessional rounds. The purpose of this case study was to explore the goals of healthcare providers attending interprofessional rounds in an internal medicine ward. The second purpose was to explore the challenges encountered by healthcare providers while pursuing these goals. Three focus groups were held with healthcare providers of diverse professional backgrounds...
April 13, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28401716/prescribing-and-medication-communication-on-the-post-take-ward-round
#13
Brooke Myers, Charles Mitchell, Jenny A Whitty, Peter Donovan, Ian Coombes
Gaps in communication between medical officers and poor planning are associated with prescribing errors and may result in patient harm. This study describes medication communication on post-take ward rounds (PTWR). Over 6 weeks on 24 PTWR, 130 patients, prescribed 1244 medications, were observed. Of these, 811 (65%) medications were discussed, with 249 discussions (relating to 126 medications) being 'in-depth'. Of 191 planned medication-related actions, 38 (20%) were not implemented by the end of the PTWR and 21 (11%) by time of discharge from hospital...
April 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28401682/guideline-based-intervention-to-reduce-telemetry-rates-in-a-large-tertiary-centre
#14
Satish Ramkumar, Edward H Tsoi, Ajay Raghunath, Floyd F Dias, Christopher Li Wai Suen, Andrew H Tsoi, Darren R Mansfield
BACKGROUND: Inappropriate cardiac telemetry use is associated with reduced patient flow and increased health care costs. AIM: To evaluate the outcomes of guideline-based application of cardiac telemetry. METHODS: Phase I involved a prospective audit(03-09/2011) of telemetry use at a tertiary hospital. Data was collected on indication for telemetry and clinical outcomes. Phase II prospectively included patients > 18yrs under general medicine requiring ward based telemetry...
April 12, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28401600/involvement-of-patients-perspectives-on-treatment-with-non-invasive-ventilation-in-patients-with-copd-a-qualitative-study
#15
Helle Marie Christensen, Lotte Huniche, Ingrid L Titlestad
AIMS AND OBJECTIVES: To clarify COPD patients' perspectives on treatment with non-invasive ventilation and develop management strategies for the treatment based on these perspectives. BACKGROUND: The effect of treating COPD patients with non-invasive ventilation is well documented, as is the problem of patient difficulties in tolerating the treatment. Knowledge of how patients with COPD experience and evaluate treatment with non-invasive ventilation is limited; therefore, more information of patient perspectives is needed to develop treatment practices in respiratory medicine...
April 12, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28397171/pediatric-antibiotic-stewardship-successful-interventions-to-reduce-broad-spectrum-antibiotic-use-on-general-pediatric-wards
#16
Katharina Kreitmeyr, Ulrich von Both, Alenka Pecar, Johannes P Borde, Rafael Mikolajczyk, Johannes Huebner
PURPOSE: Antibiotic stewardship programs (ASP) optimize antibiotic usage and combat antibiotic resistance of bacteria. The objective of this study was to assess the impact of specific ASP interventions on antibiotic consumption in general pediatric wards. METHODS: We conducted a prospective study to compare a pre-intervention (Sept.-Dec. 2014) and post-intervention (Sept.-Dec. 2015) period. An ASP bundle was established including (1) infectious diseases (ID) ward rounds (prospective-audit-with-feedback), (2) ID consultation service, (3) internal guidelines on empiric antibiotic therapy...
April 10, 2017: Infection
https://www.readbyqxmd.com/read/28397007/preparing-medical-students-for-clinical-practice-easing-the-transition
#17
Alexandra R Teagle, Maria George, Nicola Gainsborough, Inam Haq, Michael Okorie
The transition from medical student to junior doctor is a challenge; the UK General Medical Council has issued guidance emphasizing the importance of adequate preparation of medical students for clinical practice. This study aimed to determine whether a junior doctor-led simulation-based course is an effective way of preparing final year medical students for practice as a junior doctor.We piloted a new 'preparation for practice' course for final year medical students prior to beginning as Foundation Year 1 (first year of practice) doctors...
April 10, 2017: Perspectives on Medical Education
https://www.readbyqxmd.com/read/28375953/co-producing-interprofessional-round-work-designing-spaces-for-patient-partnership
#18
Karin Thörne, Boel Andersson-Gäre, Håkan Hult, Madeleine Abrandt-Dahlgren
Within wide-ranging quality improvement agendas, patient involvement in health care is widely accepted as crucial. Ward rounds that include patients' active participation are growing as an approach to involve patients, ensure safety, and improve quality. An emerging approach to studying quality improvement is to focus on "clinical microsystems," where patients, professionals, and information systems interact. This provides an opportunity to study ward rounds more deeply. A new model of conducting ward rounds implemented through quality improvement work was studied, using the theory of practice architectures as an analytical tool...
April 2017: Quality Management in Health Care
https://www.readbyqxmd.com/read/28371049/using-simulation-to-prepare-for-clinical-practice
#19
James Morgan, Victoria Green, John Blair
BACKGROUND: A significant proportion of medical students feel underprepared for clinical practice, especially in skills such as decision making, prioritisation and prescribing. Changes to medical curricula, including assistantships and shadowing, provide supervised practise, but students remain unable to fully take responsibility for patient care. Simulation may assist in addressing this deficit. A simulation course entitled 'Simulated ward round and professional skills' (SWAPS) was developed to improve student preparation for clinical practice...
March 30, 2017: Clinical Teacher
https://www.readbyqxmd.com/read/28352467/electronic-printed-ward-round-proformas-freeing-up-doctors-time
#20
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
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