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https://www.readbyqxmd.com/read/27914920/can-lowering-the-guidance-force-of-robot-assisted-gait-training-induce-a-sufficient-metabolic-demand-in-subacute-dependent-ambulatory-stroke-patients
#1
So Young Lee, Eun Young Han, Bo Ryun Kim, Min Ho Chun, Yong Ki Lee
OBJECTIVE: To assess the effects of guidance force (GF) and gait speed (GS) on cardiorespiratory responses and energy cost in subacute dependent ambulatory stroke patients. DESIGN: Cross sectional study. SETTING: University rehabilitation hospital. PARTICIPANTS: Ten subacute stroke patients (mean age: 64.50±19.20), who were dependent ambulators (functional ambulation category [FAC] ≤2). INTERVENTIONS: Patients participated in cardiorespiratory tests during robot-assisted gait training...
November 30, 2016: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/27899538/reducing-unplanned-extubations-in-the-nicu-using-lean-methodology
#2
EDITORIAL
Bonnie M Powell, Edeltraud Gilbert, Teresa A Volsko
BACKGROUND: Unplanned extubations can lead to iatrogenic injury and have the potential to contribute to serious safety events. We adopted lean methodology to reduce the unplanned extubation rate in a Level 3b NICU. We hypothesized that the use of a rapid-cycle PDSA (plan, do, study, act) initiative would reduce the unplanned extubation rate. METHODS: Baseline unplanned extubation data were collected from November 1, 2012 to June 6, 2014. A voice of the customer survey ascertained perceptions regarding unplanned extubation causes and impact on care...
December 2016: Respiratory Care
https://www.readbyqxmd.com/read/27899531/a-respiratory-therapist-disease-management-program-for-patients-hospitalized-with-copd
#3
Patty C Silver, Marin H Kollef, Darnetta Clinkscale, Peggy Watts, Robin Kidder, Brittany Eads, Debbie Bennett, Carolyn Lora, Michael Quartaro
BACKGROUND: Patients with COPD often require repeated emergency department visits and hospitalizations for COPD exacerbations. Such readmissions increase health-care costs and expose COPD patients to the added risks of nosocomial infections and increased mortality. METHODS: To determine whether a respiratory therapist (RT) disease management program could reduce re-hospitalization and emergency department visits, a prospective, single-center, unblinded, randomized trial was performed...
November 29, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27895218/a-new-approach-to-identify-high-burnout-medical-staffs-by-kernel-k-means-cluster-analysis-in-a-regional-teaching-hospital-in-taiwan
#4
Yii-Ching Lee, Shian-Chang Huang, Chih-Hsuan Huang, Hsin-Hung Wu
This study uses kernel k-means cluster analysis to identify medical staffs with high burnout. The data collected in October to November 2014 are from the emotional exhaustion dimension of the Chinese version of Safety Attitudes Questionnaire in a regional teaching hospital in Taiwan. The number of effective questionnaires including the entire staffs such as physicians, nurses, technicians, pharmacists, medical administrators, and respiratory therapists is 680. The results show that 8 clusters are generated by kernel k-means method...
2016: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/27888716/family-participation-in-intensive-care-unit-rounds-comparing-family-and-provider-perspectives
#5
Selena S Au, Amanda Roze des Ordons, Andrea Soo, Simon Guienguere, Henry T Stelfox
PURPOSE: To describe and compare intensive care unit (ICU) patient family member and provider experiences, preferences, and perceptions of family participation in ICU rounds. METHODS: Cross-sectional survey of ICU family members and providers of patients admitted to 4 medical-surgical ICUs from September 2014 to March 2015. MEASUREMENTS AND MAIN RESULTS: Surveys were completed by 63 (62%) family members and 258 (43%) providers. Provider respondents included physicians (9%), nurses (56%), respiratory therapists (24%), and other ICU team members (11%)...
November 4, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27853320/burnout-in-the-neonatal-intensive-care-unit-and-its-relation-to-healthcare-associated-infections
#6
D S Tawfik, J B Sexton, P Kan, P J Sharek, C C Nisbet, J Rigdon, H C Lee, J Profit
OBJECTIVE: To examine burnout prevalence among California neonatal intensive care units (NICUs) and to test the relation between burnout and healthcare-associated infection (HAI) rates in very low birth weight (VLBW) neonates. STUDY DESIGN: Retrospective observational study of provider perceptions of burnout from 2073 nurse practitioners, physicians, registered nurses and respiratory therapists, using a validated four-item questionnaire based on the Maslach Burnout Inventory...
November 17, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27827333/quality-improvement-project-to-improve-timeliness-between-bronchodilator-treatments-from-emergency-department-to-medical-wards
#7
Jennifer R Cockerham, Gary R Lowe, Randy Willis, Ryan M Stecks, Ariel Berlinski
BACKGROUND: Quality improvement methodology was applied to study sporadic reports that patients with asthma were not given bronchodilator treatments or assessed within an appropriate time frame when they were admitted from the emergency department to the medical ward. The goal was to increase the number of patients who had an interval between emergency department assessment/bronchodilator treatment and medical ward assessment/treatment of <120 min. METHODS: A flow chart diagram, a fishbone diagram, data collection, intervention implementation, and data monitoring and analysis were used in this study...
December 2016: Respiratory Care
https://www.readbyqxmd.com/read/27811530/clinical-examination-does-not-predict-response-to-albuterol-in-ventilated-infants-with-bronchiolitis
#8
Craig M Schramm, Kathleen A Sala, Christopher L Carroll
OBJECTIVE: Bronchiolitis is a common respiratory infection in infants that is sometimes treated with albuterol. Response to albuterol is determined by clinical assessment, but this subjective determination is potentially unreliable. In this study, we compared providers' clinical assessment of response to albuterol with the measurement of response by pulmonary mechanics in intubated, sedated, and ventilated infants. DESIGN: Before and 20 minutes following racemic albuterol therapy, a nurse, respiratory therapist, and physician performed simultaneous examinations and assessed response to albuterol in a population of intubated infants with bronchiolitis...
November 1, 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27802956/education-on-patient-ventilator-synchrony-clinicians-knowledge-level-and-duration-of-mechanical-ventilation
#9
Donna Lynch-Smith, Carol Lynn Thompson, Rexann G Pickering, Jim Y Wan
BACKGROUND: Improved recognition of patient-ventilator asynchrony may reduce duration of mechanical ventilation. OBJECTIVE: To evaluate the effects of education about patient-ventilator synchrony on clinicians' level of knowledge and patients' mean duration of mechanical ventilation. METHODS: A quasi-experimental 1-group pretest-posttest study was performed in a 16-bed intensive care unit. Analysis included 33 clinicians and 97 ventilator patients...
November 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/27787325/an-evidence-based-infant-safe-sleep-program-to-reduce-sudden-unexplained-infant-deaths
#10
Whitney Zachritz, Megan Fulmer, Nicole Chaney
: : Objective: The purpose of this project was to design, implement, and evaluate a safe sleep program for expectant mothers and the families of infants discharged from our hospital's neonatal intensive care unit (NICU). It was prompted by the sleep-related deaths of two infants in the community, both of whom had been discharged from our NICU. METHODS: A six-member interdisciplinary team comprising nurses, a physician, an occupational therapist, and a respiratory therapist developed a safe sleep program in an effort to identify and implement evidence-based safe sleep practices for infants in the NICU...
November 2016: American Journal of Nursing
https://www.readbyqxmd.com/read/27769627/-obstructive-sleep-apnea-hypopnea-syndrome-in-children-clinical-diagnosis
#11
G Aubertin, C Schröder, F Sevin, F Clouteau, M-D Lamblin, M-F Vecchierini
The French Society of Research and Sleep Medicine (SFRMS) organized a meeting on obstructive sleep apnea syndrome (OSAS) in children. A multidisciplinary group of specialists (pulmonologist, ENT surgeons, pediatricians, orofacial myofunctional therapists, neurophysiologists, and sleep specialists) reached a consensus on the value of isolated or clustered clinical symptoms and of questionnaires completed by parents in the clinical diagnosis and in assessing the severity of OSAS. Are clinical history with validated questionnaires and a rigorous physical examination sufficient to suspect OSAS, to appreciate its severity, and finally to confirm the diagnosis? Usually, a sleep recording of respiratory parameters remains mandatory for the diagnosis of OSAS to be made...
October 18, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27749438/interprofessional-perspectives-on-abcde-bundle-implementation-a-focus-group-study
#12
Leanne M Boehm, Eduard E Vasilevskis, Lorraine C Mion
BACKGROUND: The ABCDE bundle is a multifaceted, interprofessional intervention that is associated with reduced ventilator and delirium days as well as increased likelihood of mobility in intensive care. OBJECTIVES: The aim of this study is to describe organizational domains that contribute to variation in ABCDE bundle implementation as reported by intensive care unit providers and to examine the capability of a conceptual framework for identifying variation in ABCDE bundle implementation...
November 2016: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/27721661/short-term-pulmonary-rehabilitation-for-a-female-patient-with-chronic-scleroderma-under-a-single-case-research-design
#13
Jirakrit Leelarungrayub, Decha Pinkaew, Khanittha Wonglangka, Wichai Eungpinichpong, Jakkrit Klaphajone
Although previously proposed that chronic scleroderma should be cared for clinically and early rehabilitation should be performed in hospital by a chest physical therapist, little evidence is currently available on its benefits. Therefore, this study demonstrated the benefits of short-term pulmonary rehabilitation during hospitalization in a female patient with chronic scleroderma. The aim of rehabilitation was to improve ventilation and gas exchange by using airway clearance, chest mobilization, and breathing-relearning techniques, including strengthening the respiratory system and the muscles of the limbs by using the BreathMax(®) device and elastic bands...
2016: Clinical Medicine Insights. Circulatory, Respiratory and Pulmonary Medicine
https://www.readbyqxmd.com/read/27689958/barriers-to-translation-of-physical-activity-into-the-lung-cancer-model-of-care-a-qualitative-study-of-clinicians-perspectives
#14
Catherine L Granger, Linda Denehy, Louisa Remedios, Sarah Retica, Pimsiri Phongpagdi, Nicholas Hart, Selina M Parry
RATIONALE: Evidence-based clinical practice guidelines recommend physical activity (physical activity) for people with lung cancer, however evidence has not translated into clinical practice and the majority of patients do not meet recommended activity levels. OBJECTIVES: To identify factors (barriers and enablers) that influence clinicians' translation of the physical activity guidelines into practice. METHODS: Qualitative study involving 17 participants (three respiratory physicians, two thoracic surgeons, two oncologists, two nurses, eight physical therapists) who were recruited using purposive sampling from five hospitals in Melbourne, Australia...
September 30, 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27661864/point-prevalence-study-of-mobilization-practices-for-acute-respiratory-failure-patients-in-the-united-states
#15
Sarah Elizabeth Jolley, Marc Moss, Dale M Needham, Ellen Caldwell, Peter E Morris, Russell R Miller, Nancy Ringwood, Megan Anders, Karen K Koo, Stephanie E Gundel, Selina M Parry, Catherine L Hough
OBJECTIVE: Early mobility in mechanically ventilated patients is safe, feasible, and may improve functional outcomes. We sought to determine the prevalence and character of mobility for ICU patients with acute respiratory failure in U.S. ICUs. DESIGN: Two-day cross-sectional point prevalence study. SETTING: Forty-two ICUs across 17 Acute Respiratory Distress Syndrome Network hospitals. PATIENTS: Adult patients (≥ 18 yr old) with acute respiratory failure requiring mechanical ventilation...
September 22, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27634920/perspective-on-physical-therapist-management-of-functional-constipation
#16
Susan E George, Diane F Borello-France
Functional constipation is a common bowel disorder leading to activity restrictions and reduced health-related quality of life. Typically, this condition is initially managed with prescription of laxatives or fiber supplementation, or both. However, these interventions are often ineffective and fail to address the underlying pathophysiology and impairments contributing to this condition. Physical therapists possess the knowledge and skills to diagnose and manage a wide range of musculoskeletal and motor coordination impairments that may contribute to functional constipation...
September 15, 2016: Physical Therapy
https://www.readbyqxmd.com/read/27625421/the-importance-of-ground-critical-care-transport-a-case-series-and-literature-review
#17
Susan R Wilcox, Michael Ries, Ted A Bouthiller, E Dean Berry, Travis L Dowdy, Sharon DeGrace
Critical care transport (CCT) teams are specialized transport services, comprised of highly trained paramedics, nurses, and occasionally respiratory therapists, offering an expanded scope of practice beyond advanced life support (ALS) emergency medical service teams. We report 4 cases of patients with severe acute respiratory distress syndrome from influenza in need of extracorporeal membrane oxygenation evaluation at a tertiary care center, transported by ground. Our medical center did not previously have a ground CCT service, and therefore, in these cases, a physician and/or a respiratory therapist was sent with the paramedic team...
September 13, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27587869/can-respiratory-therapists-impact-copd-readmissions-and-costs
#18
EDITORIAL
Garry W Kauffman
No abstract text is available yet for this article.
September 2016: Respiratory Care
https://www.readbyqxmd.com/read/27564667/detecting-alpha-1-antitrypsin-deficiency
#19
James K Stoller
Alpha-1 antitrypsin deficiency is a widely underrecognized condition, with evidence of persisting long diagnostic delays and patients' frequent need to see multiple physicians before initial diagnosis. Reasons for underrecognition include inadequate understanding of alpha-1 antitrypsin deficiency by physicians and allied health care providers; failure to implement available, guideline-based practice recommendations; and the belief that effective therapy is unavailable. Multiple studies have described both the results of screening and targeted detection of individuals with alpha-1 antitrypsin deficiency, with both varying strategies employed to identify at-risk individuals and varying results of testing...
August 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27548743/cross-sectional-survey-of-canadian-pediatric-critical-care-transport
#20
Atsushi Kawaguchi, Anna Gunz, Allan de Caen
OBJECTIVES: This study aimed to better understand the unique aspects of pediatric critical care transport programs across Canada by characterizing the current workforce of each transport program. METHODS: A cross-sectional questionnaire was sent to the 13 medical directors of Canada's pediatric critical care transport teams, and to 2 nonhospital-affiliated transport services. If a children's hospital did not have a dedicated team for pediatric transport, the regional transport team providing this service was identified...
August 20, 2016: Pediatric Emergency Care
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