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"Intermediate Care"

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https://www.readbyqxmd.com/read/29781978/mixed-methods-evaluation-of-real-time-safety-reporting-by-hospitalized-patients-and-their-care-partners-the-mysafecare-application
#1
Sarah A Collins, Brittany Couture, Ann DeBord Smith, Esteban Gershanik, Elizabeth Lilley, Frank Chang, Cathy Yoon, Stuart Lipsitz, Aziz Sheikh, James Benneyan, David W Bates
OBJECTIVE: The aims of the study were to evaluate the amount and content of data patients and care partners reported using a real-time electronic safety tool compared with other reporting mechanisms and to understand their perspectives on safety concerns and reporting in the hospital. METHODS: This study used mixed methods including 20-month preimplementation and postimplementation trial evaluating MySafeCare, a web-based application, which allows hospitalized patients/care partners to report safety concerns in real time...
April 27, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/29776396/delivery-of-the-second-twin-influence-of-presentation-on-neonatal-outcome-a-case-controlled-study
#2
Gerhard Bogner, Valentina Wallner, Claudius Fazelnia, Martina Strobl, Birgit Volgger, Thorsten Fischer, Volker R Jacobs
BACKGROUND: Spontaneous vaginal twin delivery after 32nd week of gestation is safe when first twin presenting cephalic. Aim of this study is to identify obstetric factors influencing the condition of second twin and to verify whether non-cephalic presentation and vaginal breech delivery of the second twin is safe. METHODS: This is a retrospective case controlled cohort study of 717 uncomplicated twin deliveries ≥32 + 0 weeks of gestation from 2005 to 2014 in two tertiary perinatal centers...
May 18, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29774729/intermediate-care-unit-an-efficient-and-flexible-facility-or-a-limbo-between-icu-and-ward
#3
Edoardo De Robertis
No abstract text is available yet for this article.
May 15, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29767825/-palliative-sedation-development-and-consensus-of-a-german-language-documentation-template
#4
C Klein, C Wittmann, K N Wendt, C Ostgathe, S Stiel
BACKGROUND: Palliative sedation (PS) serves as a therapeutic option in cases of otherwise intractable suffering. As the use of sedative and hypnotic medication in many diverse situations is a core competency of anesthesiology, anesthesiologists are confronted with questions of sedative therapy at the end of life in institutions for specialized palliative care, in intensive care units and intermediate care wards. In recent years a number of guidelines have been published internationally but so far no official guidelines exist in Germany...
May 16, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29740807/the-mental-health-parity-and-addiction-equity-act-evaluation-study-impact-on-nonquantitative-treatment-limits-for-specialty-behavioral-health-care
#5
Amber Gayle Thalmayer, Jessica M Harwood, Sarah Friedman, Francisca Azocar, L Amy Watson, Haiyong Xu, Susan L Ettner
OBJECTIVE: To assess frequency, type, and extent of behavioral health (BH) nonquantitative treatment limits (NQTLs) before and after implementation of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). DATA SOURCES: Secondary administrative data for Optum carve-out and carve-in plans. STUDY DESIGN: Cross-tabulations and "two-part" regression models were estimated to assess associations of parity period with NQTLs...
May 8, 2018: Health Services Research
https://www.readbyqxmd.com/read/29737781/epidemiology-and-prognoses-in-a-medical-intermediate-care-unit
#6
Mona Morland, Rolf Haagensen, Fredrik A Dahl, Jan-Erik Berdal
BACKGROUND: The purpose of medical intermediate care units is the observation and treatment of patients with incipient or manifest organ failure. We wished to obtain data on which conditions result in admission to these units and the prognosis for these patients. MATERIAL AND METHOD: All patients admitted to the medical intermediate care unit at Akershus University Hospital in 2014 were registered prospectively with reason for admission, period of hospitalisation, degree of severity, comorbidity, last place of hospitalisation prior to medical intermediate care and treatment limitations (do-not-resuscitate order and/or do-not-intubate order)...
May 8, 2018: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
https://www.readbyqxmd.com/read/29715703/icu-readmission-after-cardiac-surgery-still-a-matter-of-concern
#7
Philipp Kolat, Patricia Guttenberger, Michael Ried, Julia Kapahnke, Assad Haneya, Christof Schmid, Claudius Diez
BACKGROUND:  Despite improvements in diagnostics and perioperative care, readmission to intensive care unit (ICU) after cardiac surgery is still a severe drawback for patients with considerable morbidity, mortality, and costs. Aim of this retrospective analysis was to disentangle independent risk factors for ICU readmission. MATERIAL AND METHODS:  Between 01/2004 and 12/2012, 336 out of 9,555 (3.5%) patients undergoing cardiac surgery at the Department of Cardiothoracic Surgery in Regensburg (Germany) were readmitted to ICU...
May 1, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29686878/limitation-of-life-support-techniques-at-admission-to-the-intensive-care-unit-a-multicenter-prospective-cohort-study
#8
Olga Rubio, Anna Arnau, Sílvia Cano, Carles Subirà, Begoña Balerdi, María Eugenía Perea, Miguel Fernández-Vivas, María Barber, Noemí Llamas, Susana Altaba, Ana Prieto, Vicente Gómez, Mar Martin, Marta Paz, Belen Quesada, Valentí Español, Juan Carlos Montejo, José Manuel Gomez, Gloria Miro, Judith Xirgú, Ana Ortega, Pedro Rascado, Juan María Sánchez, Alfredo Marcos, Ana Tizon, Pablo Monedero, Elisabeth Zabala, Cristina Murcia, Ines Torrejon, Kenneth Planas, José Manuel Añon, Gonzalo Hernandez, María-Del-Mar Fernandez, Consuelo Guía, Vanesa Arauzo, José Miguel Perez, Rosa Catalan, Javier Gonzalez, Rosa Poyo, Roser Tomas, Iñaki Saralegui, Jordi Mancebo, Charles Sprung, Rafael Fernández
Purpose: To determine the frequency of limitations on life support techniques (LLSTs) on admission to intensive care units (ICU), factors associated, and 30-day survival in patients with LLST on ICU admission. Methods: This prospective observational study included all patients admitted to 39 ICUs in a 45-day period in 2011. We recorded hospitals' characteristics (availability of intermediate care units, usual availability of ICU beds, and financial model) and patients' characteristics (demographics, reason for admission, functional status, risk of death, and LLST on ICU admission (withholding/withdrawing; specific techniques affected))...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29669268/frailty-and-cognitive-status-evaluation-can-better-predict-mortality-in-older-adults
#9
Ivan Aprahamian, Claudia Kimie Suemoto, Márlon Juliano Romero Aliberti, Sileno de Queiroz Fortes Filho, Juliana de Araújo Melo, Sumika Mori Lin, Wilson Jacob Filho
OBJECTIVES: to evaluate the improvement in one-year mortality prediction after adding a 2-min cognitive screening to a simple 1-min frailty detection instrument. Secondary outcomes were new activities of daily living (ADL) disability and falls. DESIGN: Prospective cohort study. SETTING: A geriatric day-hospital for intermediate care. PARTICIPANTS: A total of 701 older adults with an acute or decompensated disease (79...
April 11, 2018: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29589696/-palliative-care-pathways-of-older-patients
#10
Lourdes Zubieta, Réjean Hébert, Michel Raîche
INTRODUCTION: To determine the palliative care pathways of older patients in Sherbrooke, Qc by examining their transfers to other facilities. METHODS: This analysis was conducted by linking 3 databases: emergency department, hospitalizations and nursing homes. The study period ranged from January 2011 to December 2015. SPSS was used for statistical analysis. The study only included palliative care patients. RESULTS: 25% of patients waited less than 7 days for transfer, and 74% waited less than 3 weeks...
January 2018: Santé Publique: Revue Multidisciplinaire Pour la Recherche et L'action
https://www.readbyqxmd.com/read/29574429/placenta-accreta-complicated-with-peripartum-cardiomyopathy
#11
Yuditiya Purwosunu, Agrifa Hasiholan Haloho
A 33-year-old G2P1 was referred to our hospital due to placenta accreta. During perioperative preparations, the patient was diagnosed with having a peripartum cardiomyopathy. The patient underwent caesarean hysterectomy at 36 weeks with an associated 2 L blood loss. Haemodynamic maintenance and stabilisation during the operation were challenging, with the combinations of fluid therapy, blood transfusions as well as vasoactive, antifibrinolytic and haemostatic drug. Postoperatively, the patient was managed in the intensive care unit and was subsequently transferred to intermediate care after less than 24 hours' observation...
March 23, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29555177/septic-shock-in-intermediate-care-unit-don-t-play-with-fire
#12
EDITORIAL
Marc Leone, Sophie Medam, Djamel Mokart
No abstract text is available yet for this article.
April 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29551564/a-concept-analysis-of-patient-participation-in-intermediate-care
#13
REVIEW
Linda Aimée Hartford Kvæl, Jonas Debesay, Anne Langaas, Asta Bye, Astrid Bergland
OBJECTIVE: Although the concept of patient participation has been discussed for a number of years, there is still no clear definition of what constitutes the multidimensional concept, and the application of the concept in an intermediate care (IC) context lacks clarity. Therefore this paper seeks to identify and explore the attributes of the concept, to elaborate ways of understanding the concept of patient participation for geriatric patients in the context of IC. METHODS: Walker and Avant's model of Concept analysis [1] based on a literature review...
March 5, 2018: Patient Education and Counseling
https://www.readbyqxmd.com/read/29544354/does-the-design-of-settings-where-acute-care-is-delivered-meet-the-needs-of-older-people-perspectives-of-patients-family-carers-and-staff
#14
Annette Haywood, Sarah Barnes, Hazel Marsh, Stuart G Parker
BACKGROUND: Older people with an acute illness, many of whom are also frail, form a significant proportion of the acute hospital inpatient population. Attention is focusing on ways of improving the physical environment to optimize health outcomes and staff efficiency. PURPOSE: This article explores the effects of the physical environment in three acute care settings: acute hospital site, in-patient rehabilitation hospital, and intermediate care provision (a nursing home with some beds dedicated to intermediate care) chosen to represent different steps on the acute care pathway for older people and gain the perspectives of patients, family carers, and staff...
January 1, 2018: HERD
https://www.readbyqxmd.com/read/29536293/data-driven-optimization-methodology-for-admission-control-in-critical-care-units
#15
Amirhossein Meisami, Jivan Deglise-Hawkinson, Mark E Cowen, Mark P Van Oyen
The decision of whether to admit a patient to a critical care unit is a crucial operational problem that has significant influence on both hospital performance and patient outcomes. Hospitals currently lack a methodology to selectively admit patients to these units in a way that patient health risk metrics can be incorporated while considering the congestion that will occur. The hospital is modeled as a complex loss queueing network with a stochastic model of how long risk-stratified patients spend time in particular units and how they transition between units...
March 13, 2018: Health Care Management Science
https://www.readbyqxmd.com/read/29524940/an-evaluation-of-the-role-of-an-intermediate-care-facility-in-the-continuum-of-care-in-western-cape-south-africa
#16
Sikhumbuzo A Mabunda, Leslie London, David Pienaar
BACKGROUND: A comprehensive primary healthcare (PHC) approach requires clear referral and continuity of care pathways. South Africa is a lower-middle income country (LMIC) that lacks data on the role of intermediate care (IC) services in the health system. This study described the model of service provision at one facility in Cape Town, including reason for admission, the mix of services and skills provided and needed, patient satisfaction, patient outcome and articulation with other services across the spectrum of care...
May 14, 2017: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/29469547/workload-and-severity-of-illness-of-patients-on-intensive-care-units-with-available-intermediate-care-units-a-multicentre-cohort-study
#17
Uwe Hamsen, Rolf Lefering, Christian Fisahn, Thomas A Schildhauer, Chistian Waydhas
BACKGROUND: Intermediate care units (IMCU) are established in many hospitals to better match the requirements of patient care with respect to their personnel, equipment and other resources. This should relieve intensive care unit (ICU) capacities for more severely ill patients and reduce readmissions to ICU. This study was conducted to investigate the effects of IMCU use on ICU populations. METHODS: This is a retrospective analysis of the German National Registry of Intensive Care from the years 2000 to 2010...
February 15, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29461630/factors-affecting-discharge-to-home-of-geriatric-intermediate-care-facility-residents-in-japan
#18
Kojiro Morita, Sachiko Ono, Miho Ishimaru, Hiroki Matsui, Takashi Naruse, Hideo Yasunaga
OBJECTIVES: To investigate factors associated with lower likelihood of discharge to home from geriatric intermediate care facilities in Japan. DESIGN: Retrospective cohort study. SETTING: We used data from the nationwide long-term care (LTC) insurance claims database (April 2012-March 2014). PARTICIPANTS: Study participants were 342,758 individuals newly admitted to 3,459 geriatric intermediate care facilities during the study period...
April 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29452285/risk-factors-for-perioperative-morbidity-in-spine-surgeries-of-different-complexities-a-multivariate-analysis-of-1-009-consecutive-patients
#19
Mazda Farshad, David E Bauer, Cyrill Wechsler, Christian Gerber, Alexander Aichmair
BACKGROUND CONTEXT: There is a broad spectrum of complications during or after surgical procedures, with differing incidences reported in the published literature. Heterogeneity can be explained by the lack of an established evidence-based classification system for documentation and classification of complications in a standardized manner. PURPOSE: The objective of this study was to identify predictive risk factors for perioperative and early postoperative morbidities in spine surgeries of different complexities in a large cohort of consecutive patients...
February 13, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29433853/identifying-the-low-risk-patient-in-surgical-intensive-and-intermediate-care-units-using-continuous-monitoring
#20
Holly N Blackburn, Matthew T Clark, J Randall Moorman, Douglas E Lake, J Forrest Calland
BACKGROUND: Continuous predictive monitoring has been employed successfully to predict subclinical adverse events. Should low values on these models, however, reassure us that a patient will not have an adverse outcome? Negative predictive values of such models could help predict safe patient discharge. The goal of this study was to validate the negative predictive value of an ensemble model for critical illness (using previously developed models for respiratory instability, hemorrhage, and sepsis) based on bedside monitoring data in the intensive care units and intermediate care unit...
April 2018: Surgery
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