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https://www.readbyqxmd.com/read/28198758/medication-reconciliation-failures-in-children-and-young-adults-with-chronic-disease-during-intensive-and-intermediate-care
#1
Danielle D DeCourcey, Melanie Silverman, Esther Chang, Al Ozonoff, Carolyn Stickney, Darla Pichoff, Alexandra Oldershaw, Jonathan A Finkelstein
OBJECTIVES: Although medication reconciliation has become standard during hospital admission, rates of unintentional medication discrepancies during intensive care of pediatric patients with chronic disease are unknown. Such discrepancies are an important cause of adverse drug events in adults with chronic illness and are associated with unintentional discontinuation of chronic medications. We sought to determine the rate, type, timing, and predictors of potentially harmful unintentional medication discrepancies in children and young adults with chronic disease...
February 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28148613/delirium-in-trauma-patients-prevalence-and-predictors
#2
Kathryn T Von Rueden, Breighanna Wallizer, Paul Thurman, Karen McQuillan, Tiffany Andrews, Jennifer Merenda, Heesook Son
BACKGROUND: Delirium is associated with increased mortality, morbidity, hospital costs, and postdischarge cognitive dysfunction. Most research focuses on nontrauma patients receiving mechanical ventilation in the intensive care unit. OBJECTIVES: To determine the prevalence and predictors of delirium in trauma patients residing in intensive and intermediate care units of an academic medical center. METHODS: Trauma patients were screened for delirium by using the Confusion Assessment Method for the Intensive Care Unit...
February 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28119313/the-association-between-cognitive-impairment-and-functional-outcome-in-hospitalised-older-patients-a-systematic-review-and-meta-analysis
#3
Peter Hartley, Nathalie Gibbins, Amanda Saunders, Kerry Alexander, Eimear Conroy, Rebecca Dixon, Joseph Lang, Jasmine Luckett, Tim Luddington, Roman Romero-Ortuno
BACKGROUND: in hospitalised older adults, cognitive impairments are common and may be associated with functional outcomes. Our aim was to systematically review this association. METHOD: we systematically searched MEDLINE, CINAHL, AMED and PsycINFO from inception to April 2016. Non-English language studies were filtered out at search stage. All types of studies were considered for inclusion except reviews, conference abstracts, dissertations and case studies. POPULATION: community-dwelling or institutionalised older adults aged 65 years or more, who are acutely hospitalised and have information on history of dementia and/or cognitive scores on admission...
January 23, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28103212/coverage-with-tetanus-diphtheria-and-acellular-pertussis-vaccine-and-influenza-vaccine-among-pregnant-women-minnesota-march-2013-december-2014
#4
Alexandra Barber, Miriam Halstead Muscoplat, Anna Fedorowicz
Pertussis and influenza infections can result in severe disease in infants. The diphtheria, tetanus, acellular pertussis (DTaP) vaccine is recommended for infants beginning at age 2 months, and influenza vaccine is recommended for infants aged ≥6 months. Vaccination of pregnant women induces the production of antibodies that are transferred across the placenta to the fetus and provide passive protection until infants are old enough to receive DTaP and influenza vaccines (1-3). To protect young infants before they are age-eligible for vaccination, the Advisory Committee on Immunization Practices (ACIP) has recommended since 2004 that all women who are or will be pregnant during influenza season receive inactivated influenza vaccine (1), and since 2013 that all pregnant women receive the tetanus, diphtheria, acellular pertussis (Tdap) vaccine (3)...
January 20, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28101669/outcomes-and-trends-of-peripartum-maternal-admission-to-the-intensive-care-unit
#5
Alex Farr, Agnes Lenz-Gebhart, Sabrina Einig, Clemens Ortner, Iris Holzer, Marie Elhenicky, Peter W Husslein, Rainer Lehner
BACKGROUND: The number of pregnant women with severe comorbidities is increasing. The aim of the present study was to analyze outcomes and determine trends in women who required peripartum admission to the intensive care unit (ICU). METHODS: In this retrospective study, we identified all women who were admitted to the ICU between the second trimester of pregnancy and 6 weeks postpartum. Women with ICU admission between 2011 and 2014 were assigned to the study group, whereas those admitted between 1996 and 2003 were assigned to the historical group...
January 18, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28100559/what-is-involved-in-medicines-management-across-care-boundaries-a-qualitative-study-of-healthcare-practitioners-experiences-in-the-case-of-acute-kidney-injury
#6
Denham L Phipps, Rebecca L Morris, Tom Blakeman, Darren M Ashcroft
OBJECTIVES: To examine the role of individual and collective cognitive work in managing medicines for acute kidney injury (AKI), this being an example of a clinical scenario that crosses the boundaries of care organisations and specialties. DESIGN: Qualitative design, informed by a realist perspective and using semistructured interviews as the data source. The data were analysed using template analysis. SETTING: Primary, secondary and intermediate care in England...
January 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28096296/a-critical-asthma-standardized-clinical-and-management-plan-reduces-duration-of-critical-asthma-therapy
#7
Jackson Wong, Michael S D Agus, Dionne A Graham, Elliot Melendez
BACKGROUND AND OBJECTIVE: Reduction of critical asthma management time can reduce intensive care utilization. The goal of this study was to determine whether a Critical Asthma Standardized Clinical Assessment and Management Plan (SCAMP) can decrease length of critical asthma management time. METHODS: This retrospective study compared critical asthma management times in children managed before and after implementation of a Critical Asthma SCAMP. The SCAMP used an asthma severity score management scheme to guide stepwise escalation and weaning of therapies...
February 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28075489/cough-augmentation-techniques-for-extubation-or-weaning-critically-ill-patients-from-mechanical-ventilation
#8
REVIEW
Louise Rose, Neill Kj Adhikari, David Leasa, Dean A Fergusson, Douglas McKim
BACKGROUND: There are various reasons why weaning and extubation failure occur, but ineffective cough and secretion retention can play a significant role. Cough augmentation techniques, such as lung volume recruitment or manually- and mechanically-assisted cough, are used to prevent and manage respiratory complications associated with chronic conditions, particularly neuromuscular disease, and may improve short- and long-term outcomes for people with acute respiratory failure. However, the role of cough augmentation to facilitate extubation and prevent post-extubation respiratory failure is unclear...
January 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28058770/robotic-versus-open-liver-resections-a-case-matched-comparison
#9
Philippe Morel, Minoa Jung, Sorina Cornateanu, Leo Buehler, Pietro Majno, Christian Toso, Nicolas C Buchs, Laura Rubbia-Brandt, Monika E Hagen
BACKGROUND: Most hepatic resections are currently performed using an open approach. Robotic surgery might enable the transition of these procedures to minimally invasive surgery. METHODS: Pre-, peri- and post-operative data of all patients who underwent a liver resection from 2009/2012 to 2001/2015, were collected prospectively. All robotic resection patients were matched 1:1 to patients who underwent open surgery. Pre- and perioperative data, up to 30 days, were analyzed...
January 6, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/28057619/david-oliver-improving-access-to-intermediate-care
#10
David Oliver
No abstract text is available yet for this article.
January 5, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28056335/effects-of-handling-and-environment-on-preterm-newborns-sleeping-in-incubators
#11
Kelly Cristina Sbampato Calado Orsi, Marta José Avena, Marcia Lurdes de Cacia Pradella-Hallinan, Mavilde da Luz Gonçalves Pedreira, Miriam Harumi Tsunemi, Ariane Ferreira Machado Avelar, Eliana Moreira Pinheiro
OBJECTIVE: To describe the total sleep time, stages of sleep, and wakefulness of preterm newborns and correlate them to levels of sound pressure, light, temperature, relative air humidity, and handling inside incubators. DESIGN: Observational, correlational study. SETTING: A neonatal intermediate care unit. PARTICIPANTS: Twelve preterm newborns, who were 32.2 ± 4.2 weeks gestational age and weighed 1,606 ± 317 g. METHODS: Sleep records were assessed by polysomnograph...
January 2, 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/27994871/short-term-outcomes-after-distal-pancreatectomy-laparotomy-vs-laparoscopy-a-single-center-series
#12
Gaëtan-Romain Joliat, Nicolas Demartines, Nermin Halkic, David Petermann, Markus Schäfer
BACKGROUND: Laparoscopic distal pancreatectomy was introduced 15 years ago, but it is still not widely used. The aim of the study was to compare the postoperative complications and length of stay between open and laparoscopic distal pancreatectomy. MATERIALS AND METHODS: A search of our institutional pancreas database was performed. All consecutive distal pancreatectomy patients from 2000 to 2015 were identified. Demographics, peri- and postoperative outcomes were reviewed...
January 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/27974368/reinventing-the-community-hospital-a-retrospective-population-based-cohort-study-of-a-natural-experiment-using-register-data
#13
Jayson O Swanson, Terje P Hagen
OBJECTIVES: To investigate whether implementation of municipal acute bed units (MAUs) resulting from the Norwegian Coordination Reform (2012) was associated with reductions in hospital admissions, particularly for the elderly. DESIGN: A municipality-based retrospective comparative cohort study using monthly population-based registry data analysed with fixed-effects log-log regressions. SETTING: Norwegian municipalities and hospitals. POPULATION: All patients admitted to secondary hospital care in Norway between 2010 and 2014, excluding psychiatric admissions, with additional focus on admission type and elderly age subgroups...
December 13, 2016: BMJ Open
https://www.readbyqxmd.com/read/27965236/outcomes-of-emergency-medical-patients-admitted-to-an-intermediate-care-unit-with-detailed-admission-guidelines
#14
Catherine E Simpson, Sarina K Sahetya, Robert W Bradsher, Eric L Scholten, William Bain, Shazia M Siddique, David N Hager
BACKGROUND: An important, but not well characterized, population receiving intermediate care is that of medical patients admitted directly from the emergency department. OBJECTIVE: To characterize emergency medical patients and their outcomes when admitted to an intermediate care unit with clearly defined admission guidelines. METHODS: Demographic data, admitting diagnoses, illness severity, comorbid conditions, lengths of stay, and hospital mortality were characterized for all emergency medical patients admitted directly to an intermediate care unit from July through December 2012...
December 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/27959354/delivering-comprehensive-geriatric-assessment-in-new-settings-advice-for-frontline-clinicians
#15
J R Gladman
Over the decades, as the principles of comprehensive geriatric assessment have been established, there have been attempts to apply its principles to settings other than acute hospital medical wards or the general communitydwelling older population, for example, to other settings where older people with infirmity are found. The purpose of this paper is to describe and reflect upon the application of and evidence for comprehensive geriatric assessment in these new settings and give some advice to clinicians about how to optimise their contributions to these processes...
September 2016: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/27943277/the-mental-health-parity-and-addiction-equity-act-evaluation-study-impact-on-mental-health-financial-requirements-among-commercial-carve-in-plans
#16
Sarah A Friedman, Amber G Thalmayer, Francisca Azocar, Haiyong Xu, Jessica M Harwood, Michael K Ong, Laura Lambert Johnson, Susan L Ettner
OBJECTIVE: Did mental health cost-sharing decrease following implementation of the Mental Health Parity and Addiction Equity Act (MHPAEA)? DATA SOURCE: Specialty mental health copayments, coinsurance, and deductibles, 2008-2013, were obtained from benefits databases for "carve-in" plans from a national commercial managed behavioral health organization. STUDY DESIGN: Bivariate and regression-adjusted analyses compare the probability of use and (conditional) level of cost-sharing pre- and postparity...
December 12, 2016: Health Services Research
https://www.readbyqxmd.com/read/27894709/external-validation-in-an-intermediate-unit-of-a-respiratory-decompensation-model-trained-in-an-intensive-care-unit
#17
Holly N Blackburn, Matthew T Clark, Travis J Moss, Jeffrey S Young, J Randall Moorman, Douglas E Lake, J Forrest Calland
BACKGROUND: Preventing urgent intubation and upgrade in level of care in patients with subclinical deterioration could be of great utility in hospitalized patients. Early detection should result in decreased mortality, duration of stay, and/or resource use. The goal of this study was to externally validate a previously developed, vital sign-based, intensive care unit, respiratory instability model on a separate population, intermediate care patients. METHODS: From May 2014 to May 2016, the model calculated relative risk of adverse events every 15 minutes (n = 373,271 observations) for 2,050 patients in a surgical intermediate care unit...
November 25, 2016: Surgery
https://www.readbyqxmd.com/read/27869887/-anmco-position-paper-hospital-discharge-planning
#18
Mauro Mennuni, Michele Massimo Gulizia, Gianfranco Alunni, Antonio Francesco Amico, Francesco Maria Bovenzi, Roberto Caporale, Furio Colivicchi, Andrea Di Lenarda, Giuseppe Di Tano, Sabrina Egman, Francesco Fattirolli, Domenico Gabrielli, Giovanna Geraci, Giovanni Gregorio, Gian Francesco Mureddu, Federico Nardi, Donatella Radini, Carmine Riccio, Fausto Rigo, Marco Sicuro, Stefano Urbinati, Guerrino Zuin
Hospital discharge is often poorly standardized and is characterized by discontinuity and fragmentation of care, putting patients at high risk of post-discharge adverse events and early readmission. The present ANMCO position paper reviews the modifiable components of the hospital discharge process related to adverse events or rehospitalizations and suggests the optimal methods for redesign the whole discharge process. The key principles for proper hospital discharge or transfer of care acknowledge that hospital discharge:- is not an isolated event, but a process that has to be planned immediately after admission, ensuring that the patient and the caregiver understand and contribute to the planned decisions as equal partners;- is facilitated by a comprehensive systemic approach that begins with a multidimensional evaluation process;- must be organized by an operator who is responsible for the coordination of all phases of the hospital patient pathway, involving afterwards the physician and transferring to them the information and responsibility;- is the result of an integrated multidisciplinary team approach;- uses appropriately the transitional and intermediate care services;- is carried out in an organized system of care and continuum of services;- programs the passage of information to after-discharge services...
September 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/27865022/exploring-the-experiences-of-patients-attending-day-hospitals-in-the-rural-scotland-capturing-the-patient-s-voice
#19
Elizabeth Adamson, Janette Pow, Fiona Houston, Pamela Redpath
AIM: The aim of the study was to understand the meaning of person-centred compassionate care for people attending Day Hospitals in rural Scotland BACKGROUND: Increasing numbers of older people are living with chronic conditions and require support to live at home. Intermediate care services such as Day Hospitals can enable this. Much previous research about Day Hospitals focused on organizational aspects of care. This study set out to capture the voice of the patient using this service...
November 16, 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27858510/patterns-of-naloxone-use-in-hospitalized-patients
#20
Lisa Yung, Kelly C Lee, Chih Hsu, Timothy Furnish, Rabia S Atayee
OBJECTIVES: Naloxone is indicated for reversal of opioid-induced respiratory depression. The objective of this study is to evaluate patterns of naloxone use in hospitalized patients. METHODS: Retrospective chart review at the University of California, San Diego Health. Subjects included adults ≥18 years old who were admitted to and received naloxone in the medical-surgical, telemetry, intermediate care, or obstetrics/gynecology units from May 1(st), 2014 to April 30(th), 2015...
January 2017: Postgraduate Medicine
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