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https://www.readbyqxmd.com/read/27933150/implementing-mobile-devices-to-reduce-non-rostered-workload-for-junior-doctors
#1
Allan Plant, Suzanne Round, Joe Bourne
There is a large body of evidence demonstrating the detrimental effect of long work hours on the performance, mood, and job satisfaction of junior doctors. By extension these effects carry over into the realm of patient safety, compromising the quality of care provision. House officers in the general surgery department of Tauranga Hospital, New Zealand are often required to arrive at work well before their rostered start time of 7.30am to hand write the results of clinical investigations on their patient lists...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27927811/improving-multidisciplinary-severe-sepsis-management-using-the-sepsis-six%C3%A2
#2
Amar Bhat, Maryam Asghar, Gagandeep Raulia, Amit Keiran John Mandal
Each year in the UK, it is estimated that more than 100,000 people are admitted to hospital with sepsis and around 37,000 people will die as a result of the condition. We present an audit, re-audit and the implications these have had on the management of severe sepsis using the Sepsis Six, ultimately through actively promoting teamwork to initiate the protocol. This led to a significant improvement in management, decreasing admissions to the intensive care unit (ITU), length of stay in hospital and the number of patient deaths...
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27920700/primary-ewing-sarcoma-primitive-neuroectodermal-tumor-of-the-stomach
#3
Safi Khuri, Hayim Gilshtein, Sa'd Sayidaa, Bishara Bishara, Yoram Kluger
Ewing sarcoma/primitive neuroectodermal tumor (ES/PNET) is a tumor of small round cells arising in skeletal tissues. These tumors rarely arise in the stomach. We present a 31-year-old healthy female patient who was admitted to our surgical ward due to upper gastrointestinal hemorrhage. Upper endoscopy revealed a large ulcerated bleeding mass originating from the lesser curvature. Biopsy revealed tumor cell immunoreactivity positive for CD99, vimentin, and Ki67 (an index of proliferation). These findings were compatible with gastric ES/PNET...
September 2016: Case Reports in Oncology
https://www.readbyqxmd.com/read/27919400/a-novel-concept-for-integrating-and-delivering-health-information-using-a-comprehensive-digital-dashboard-an-analysis-of-healthcare-professionals-intention-to-adopt-a-new-system-and-the-trend-of-its-real-usage
#4
Keehyuck Lee, Se Young Jung, Hee Hwang, Sooyoung Yoo, Hyun Young Baek, Rong-Min Baek, Seok Kim
OBJECTIVE: To introduce a new concept of medical dashboard system called BESTBoard. Such a system was implemented in all wards in a tertiary academic hospital to explore the development process, core designs, functions, usability and feasibility. METHODS: The task-force team made user interface designs for 6 months based on a need analysis. Hardware configuration and software development was carried out for 3 months. We conducted a survey of 383 physicians and nurses to determine the usability and feasibility of the system...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27906914/the-impact-of-a-surgical-assessment-unit-on-numbers-of-general-surgery-outliers
#5
Alexandra Jacobson, Garth Poole, Andrew G Hill, Magdalena Biggar
AIMS: Patient care and efficiency outcomes are improved if acute patients admitted to non-specialty (outlier) wards are minimised.1 Assessment units may help to reduce numbers of outlier patients.2 A surgical assessment unit (SAU) was recently established at Middlemore Hospital. We aimed to determine the impact of its introduction on numbers of general surgery outliers on post-acute ward rounds. METHODS: A 10-bed SAU was introduced in July 2015, coinciding with the closure of 20 beds on the general surgical wards...
December 2, 2016: New Zealand Medical Journal
https://www.readbyqxmd.com/read/27906760/improving-the-quality-of-ward-based-surgical-care-with-a-human-factors-intervention-bundle
#6
Maximilian J Johnston, Sonal Arora, Dominic King, Ara Darzi
OBJECTIVE: This study aimed to explore the impact of a human factors intervention bundle on the quality of ward-based surgical care in a UK hospital. SUMMARY OF BACKGROUND DATA: Improving the culture of a surgical team is a difficult task. Engagement with stakeholders before intervention is key. Studies have shown that appropriate supervision can enhance surgical ward safety. METHODS: A pre-post intervention study was conducted. The intervention bundle consisted of twice-daily attending ward rounds, a "chief resident of the week" available at all times on the ward, an escalation of care protocol and team contact cards...
November 30, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27903757/beyond-hand-hygiene-a-qualitative-study-of-the-everyday-work-of-preventing-cross-contamination-on-hospital-wards
#7
Su-Yin Hor, Claire Hooker, Rick Iedema, Mary Wyer, Gwendolyn L Gilbert, Christine Jorm, Matthew Vincent Neil O'Sullivan
BACKGROUND: Hospital-acquired infections are the most common adverse event for inpatients worldwide. Efforts to prevent microbial cross-contamination currently focus on hand hygiene and use of personal protective equipment (PPE), with variable success. Better understanding is needed of infection prevention and control (IPC) in routine clinical practice. METHODS: We report on an interventionist video-reflexive ethnography study that explored how healthcare workers performed IPC in three wards in two hospitals in New South Wales, Australia: an intensive care unit and two general surgical wards...
November 30, 2016: BMJ Quality & Safety
https://www.readbyqxmd.com/read/27897753/safe-use-of-drug-trolleys
#8
Matt Griffiths
All medicines should be locked away in a treatment room, drug trolley or the patient's bedside locker. If you are doing a drug round on the ward and have to leave the trolley unattended for any reason, it is essential that you lock it.
November 16, 2016: Nursing Standard
https://www.readbyqxmd.com/read/27892224/good-hand-hygiene-is-essential
#9
Shan Moses
During a second-year placement on a 25-bed medical ward, I attended a ward round with a medical consultant and his team, to observe how they assessed patients and decided on a care plan. The team was made up of seven staff members, including four junior doctors. They saw about 13 patients on our ward before heading to other wards.
November 23, 2016: Nursing Standard
https://www.readbyqxmd.com/read/27883874/structured-interdisciplinary-bedside-rounds-do-not-reduce-length-of-hospital-stay-and-28-day-re-admission-rate-among-older-people-hospitalised-with-acute-illness-an-australian-study
#10
Elizabeth Huynh, David Basic, Rinaldo Gonzales, Chris Shanley
Objective Structured interdisciplinary bedside rounds (SIBR) are being implemented across many hospitals in Australia despite limited evidence of their effectiveness. This study evaluated the effect of SIBR on two interconnected outcomes, namely length of stay (LOS) and 28-day re-admission.Methods In the present before-after study of 3644 patients, twice-weekly SIBR were implemented on two aged care wards. Although weekly case conferences were shortened during SIBR, all other practices remained unchanged. Demographic, medical and frailty measures were considered in appropriate analyses...
November 25, 2016: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/27865003/capturing-early-signs-of-deterioration-the-dutch-early-nurse-worry-indicator-score-denwis-and-its-value-in-the-rapid-response-system
#11
Gooske Douw, Getty Huisman-de Waal, Arthur R H van Zanten, Johannes G van der Hoeven, Lisette Schoonhoven
OBJECTIVES: To determine the predictive value of individual and combined DENWIS-indicators at various Early-Warning-Score (EWS)-levels, differentiating between EWSs reaching the trigger-threshold to call an RRT and EWS-levels not reaching this point. INTRODUCTION: DENWIS comprises nine indicators underlying nurses' 'worry' about a patients' condition. All indicators independently show significant association with unplanned Intensive-Care/High-Dependency-Unit (ICU/HDU)-admission or unexpected mortality...
November 16, 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27843792/a-study-of-medication-errors-in-a-tertiary-care-hospital
#12
Nrupal Patel, Mira Desai, Samdih Shah, Prakruti Patel, Anuradha Gandhi
OBJECTIVE: To determine the nature and types of medication errors (MEs), to evaluate occurrence of drug-drug interactions (DDIs), and assess rationality of prescription orders in a tertiary care teaching hospital. MATERIALS AND METHODS: A prospective, observational study was conducted in General Medicine and Pediatric ward of Civil Hospital, Ahmedabad during October 2012 to January 2014. MEs were categorized as prescription error, dispensing error, and administration error (AE)...
October 2016: Perspectives in Clinical Research
https://www.readbyqxmd.com/read/27832561/improved-hospital-mortality-with-a-low-met-dose-the-importance-of-a-modified-early-warning-score-and-communication-tool
#13
D V Mullany, M Ziegenfuss, M A Goleby, H E Ward
Rapid response systems have been mandated for the recognition and management of the deteriorating patient. Increasing medical emergency team (MET) dose may be associated with improved outcomes. Large numbers of MET calls may divert resources from the program providing the service unless additional personnel are provided. To describe the implementation and outcomes of a multifaceted rapid response system (RRS) in a teaching hospital, we conducted an observational study. The RRS consisted of the introduction of a MET together with 1) redesign of the ward observation chart with the vital sign variables colour-coded to identify variation from normal; 2) mandated minimum frequency of vital sign measurement; 3) three formal levels of escalation based on the degree of physiological instability as measured by a modified early warning score (MEWS); 4) COMPASS© education and e-learning package with a two-hour face-to-face small group tutorial; 5) practise in escalation and communication using the ISBAR (Identify, Situation, Background, Assessment, Response/Recommendation) communication tool...
November 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/27829453/measuring-the-operational-impact-of-digitized-hospital-records-a-mixed-methods-study
#14
Philip J Scott, Paul J Curley, Paul B Williams, Ian P Linehan, Steven H Shaha
BACKGROUND: Digitized (scanned) medical records have been seen as a means for hospitals to reduce costs and improve access to records. However, clinical usability of digitized records can potentially have negative effects on productivity. METHODS: Data were collected during follow-up outpatient consultations in two NHS hospitals by non-clinical observers using a work sampling approach in which pre-defined categories of clinician time usage were specified. Quantitative data was analysed using two-way ANOVA models and the Mann-Whitney U test...
November 10, 2016: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/27817170/hospital-pharmacists-seen-through-the-eyes-of-physicians-qualitative-semi-structured-interviews
#15
Clare Béchet, Renaud Pichon, André Giordan, Pascal Bonnabry
Background Pharmacist-physician collaboration can lead to many positive outcomes. However, collaboration between healthcare providers is complex and rarely performed optimally. Objectives To study physician-pharmacist collaboration in hospital settings, from the physician's point of view. Setting Eight regional non-teaching hospital facilities, within a local area of northwest Switzerland, supplied by an independent central pharmacy. Method Physicians were sampled using a maximal variation purposive method...
November 5, 2016: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/27817169/development-and-content-validation-of-an-assessment-tool-for-medicine-compounding-on-hospital-wards
#16
Eeva Suvikas-Peltonen, Eija Granfors, Ercan Celikkayalar, Raisa Laaksonen, Joni Palmgren, Marja Airaksinen
Background Medicines should be compounded by using an aseptic technique to assure patient safety. The parenteral administration of microbiologically contaminated doses can result in bacteriaemia, other morbidity and even death. Objective The purpose was to develop and content validate an assessment tool for medicine compounding on hospital wards suitable for self-assessment and external audit to ensure the safety of medicine compounding on wards. Setting Finland as setting. Method The first draft of the tool was based on ISMP "Guidelines for safe preparation of sterile compounds" and a systematic literature search...
November 5, 2016: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/27769740/epico-3-0-management-of-non-neutropenic-patients-in-medical-wards
#17
Ricardo Ferrer, Rafael Zaragoza, Alejandro H Rodríguez, Emilio Maseda, Pedro Llinares, Santiago Grau, Francisco Álvarez-Lerma, Guillermo Quindós, Miguel Salavert, Rafael Huarte
BACKGROUND: Although the management of invasive fungal infection (IFI) has improved, a number of controversies persist regarding the approach to invasive fungal infection in non-neutropenic medical ward patients. AIMS: To identify the essential clinical knowledge to elaborate a set of recommendations with a high level of consensus necessary for the management of IFI in non-neutropenic medical ward patients. METHODS: A prospective, Spanish questionnaire, which measures consensus through the Delphi technique, was anonymously answered and e-mailed by 30 multidisciplinary national experts, all specialists (intensivists, anesthesiologists, microbiologists, pharmacologists and specialists in infectious diseases) in IFI and belonging to six scientific national societies...
October 18, 2016: Revista Iberoamericana de Micología
https://www.readbyqxmd.com/read/27761998/brownies-bioethics-rounds-on-the-wards
#18
Thalia Arawi
No abstract text is available yet for this article.
November 2016: Medical Education
https://www.readbyqxmd.com/read/27661999/furthering-the-validity-of-a-tool-to-assess-simulated-pregnancy-options-counseling-skills
#19
Carla Lupi, Melissa Ward-Peterson, Stefany Coxe, Suzanne Minor, Irmanie Eliacin, Vivian Obeso
OBJECTIVE: To further the validity of a tool to assess nondirective pregnancy options counseling skills. METHODS: Using a cross-sectional design, we explored four sources of construct validity evidence for an objective structured clinical examination for training and assessment of nondirective pregnancy options counseling: content, response process, internal structure, and relations to other variables. Content of the previously developed tool was enhanced through input from five family medicine educators...
October 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27635599/deriving-icd-10-codes-for-patient-safety-indicators-for-large-scale-surveillance-using-administrative-hospital-data
#20
Danielle A Southern, Bernard Burnand, Saskia E Droesler, Ward Flemons, Alan J Forster, Yana Gurevich, James Harrison, Hude Quan, Harold A Pincus, Patrick S Romano, Vijaya Sundararajan, Nenad Kostanjsek, William A Ghali
BACKGROUND: Existing administrative data patient safety indicators (PSIs) have been limited by uncertainty around the timing of onset of included diagnoses. OBJECTIVE: We undertook de novo PSI development through a data-driven approach that drew upon "diagnosis timing" information available in some countries' administrative hospital data. RESEARCH DESIGN: Administrative database analysis and modified Delphi rating process. SUBJECTS: All hospitalized adults in Canada in 2009...
September 15, 2016: Medical Care
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