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https://www.readbyqxmd.com/read/28523364/-structured-patient-handovers-in-perioperative-medicine-rationale-and-implementation-in-clinical-practice
#1
M J Merkel, V von Dossow, B Zwißler
Clear and consistent communication is pivotal for well-functioning teamwork, in operating theatres as well as intensive care units. However, patient handovers significantly vary between specialties and locations. If communication is not well structured, it might increase the risk for mishaps and malpractice. Therefore, implementing structured handover protocols is pivotal. The perioperative setting is a high-risk environment that is prone to communication failures due to operational design (frequent change of shift due to working time restrictions) and a high work load and multitasking (operating room management, short surgery times, concurrent emergencies)...
May 18, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28522796/effects-of-%C3%AE-adrenoceptor-and-catechol-o-methyl-transferase-comt-polymorphism-on-postoperative-outcome-in-cardiac-surgery-patients
#2
Stefan Dhein, Pascal M Dohmen, Matthias Sauer, Julia Tews, Johannes Weickmann, Anne-Kathrin Funkat, Martin Misfeld, Michael A Borger, Friedrich W Mohr
BACKGROUND There is a long-standing debate about the role of beta-adrenoceptor polymorphisms in the cardiovascular system. We wanted to elucidate whether β1-adrenoceptor-polymorphisms affects the postoperative catecholamine consumption and the length of intermediate care unit stay in patients undergoing cardiac surgery, and whether this might be enhanced or attenuated by catechol-O-methyl-transferase (COMT) polymorphism. MATERIAL AND METHODS We included 116 patients (63±1.2 years; 34% females; 81±1 kg) undergoing cardiac surgery...
May 19, 2017: Medical Science Monitor Basic Research
https://www.readbyqxmd.com/read/28515954/a-prospective-cohort-study-of-thoracic-ultrasound-in-acute-respiratory-failure-the-c3po-protocol
#3
Peter D Wallbridge, Simon A Joosten, Liam M Hannan, Daniel P Steinfort, L Irving, J Goldin, Mark Hew
OBJECTIVES: This study was performed to assess the clinical utility of a standardised thoracic ultrasound examination when added to standard care in patients with acute respiratory failure admitted to an intermediate care unit. This study aimed to assess the impact on clinical diagnosis, clinician confidence and management. Ultrasound has been shown to have utility in patients admitted to intensive care and emergency; however, utility in a ward setting is unknown. DESIGN: Prospective cohort study...
May 2017: JRSM Open
https://www.readbyqxmd.com/read/28504495/early-use-of-continuous-positive-airway-pressure-in-the-treatment-of-moderate-to-severe-acute-lower-respiratory-tract-infections-among-patients-younger-than-2-years-old
#4
Laura Figueroa, Federico Laffaye
OBJETIVE: To analyze the characteristics of patients younger than 2 years old who had a moderate to severe acute lower respiratory tract infection and were treated early with bubble continuous positive airway pressure, and factors associated with a successful intervention. METHOD: Retrospective and descriptive study. Children younger than 2 years old admitted to the Pediatric Intermediate Care Unit of Hospital Provincial Neuquen between June 2009 and December 2010...
June 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28487415/randomized-comparison-of-helmet-cpap-versus-high-flow-nasal-cannula-oxygen-in-pediatric-respiratory-distress
#5
Giovanna Vitaliti, Maria Concetta Vitaliti, Maria Carla Finocchiaro, Vita Antonella Di Stefano, Piero Pavone, Nassim Matin, Nazgol Motamed-Gorji, Riccardo Lubrano, Raffaele Falsaperla
BACKGROUND: The current study aimed to compare the efficacy and safety of 2 noninvasive respiratory support methods, which included helmet CPAP and high-flow nasal cannula (HFNC) in children with respiratory distress admitted to a pediatric intermediate care unit. METHODS: This study was a prospective observational study conducted on children with respiratory distress (age 1-24 months) who were admitted to our acute and emergency operative unit. All included subjects were randomly treated with helmet CPAP or HFNC in a 1:1 fashion until their clinical picture, oxygen saturation, and arterial blood gas (ABG) parameters resolved...
May 9, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28462741/medicines-reablement-in-intermediate-health-and-social-care-services
#6
Kate Gerrish, Sara Laker, Sarah Wright, Wendy Stainrod
Aim To evaluate a medicines reablement initiative involving health and social care, to include consideration of the training package, proportion of patients reabled successfully, and patient and staff perspectives of the service. BACKGROUND: Intermediate care services provide short-term intervention to support patients with chronic conditions transition from hospital to community-based services and involves maximising patients' independence through reablement. The term 'medicines reablement' describes the process of rehabilitating patients to be independent with their medication...
May 2, 2017: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/28403334/patient-safety-incidents-and-nursing-workload
#7
Katya Cuadros Carlesi, Kátia Grillo Padilha, Maria Cecília Toffoletto, Carlos Henriquez-Roldán, Monica Andrea Canales Juan
Objective: to identify the relationship between the workload of the nursing team and the occurrence of patient safety incidents linked to nursing care in a public hospital in Chile. Method: quantitative, analytical, cross-sectional research through review of medical records. The estimation of workload in Intensive Care Units (ICUs) was performed using the Therapeutic Interventions Scoring System (TISS-28) and for the other services, we used the nurse/patient and nursing assistant/patient ratios...
April 6, 2017: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/28380151/hammock-position-and-nesting-comparison-of-physiological-and-behavioral-effects-in-preterm-infants
#8
Kassandra Silva Falcão Costa, Ludmylla de Oliveira Beleza, Lissandra Martins Souza, Laiane Medeiros Ribeiro
Objective: To compare the effects of the use of hammocks versus nesting in preterm infants, after diaper changing. Methods: quasi-experimental study, a cross-over trial with 30 preterm newborns in an intermediate care nursery (ICN) in a public hospital in Brasilia-DF, conducted from November 2011 to March 2012. The effects of the two interventions (nesting and hammock) after diaper changing were assessed. Student's t test with a confidence level of 95% (p <0...
March 30, 2017: Revista Gaúcha de Enfermagem
https://www.readbyqxmd.com/read/28336082/-social-and-health-resources-in-catalonia-current-situation
#9
Ingrid Bullich-Marín, Pau Sánchez-Ferrín, Concepció Cabanes-Duran, Antoni Salvà-Casanovas
The network of social and health care has advanced since its inception. Furthermore, news services have been created and some resources have been adapted within the framework of respective health plans. This article presents the current situation of the different social and health resources in Catalonia, as well as the main changes that have occurred in recent years, more specifically in the period of the Health Plan 2011-2015. This period is characterised by an adaptation of the social and health network within the context of chronic care, for which the development of intermediate care resources has become the most relevant aspect...
March 20, 2017: Revista Española de Geriatría y Gerontología
https://www.readbyqxmd.com/read/28318554/decubitus-ulcers-in-patients-undergoing-vascular-operations-do-not-influence-mortality-but-affect-resource-utilization
#10
J Hunter Mehaffey, Amani D Politano, Castigliano M Bhamidipati, Margaret C Tracci, Kenneth J Cherry, John A Kern, Irving L Kron, Gilbert R Upchurch
BACKGROUND: While it is anticipated that decubitus ulcers are detrimental to outcomes after vascular operations, the contemporary influence of perioperative decubitus ulcers in vascular surgery remains unknown. METHODS: Using the National Impatient Survey, all adult patients who underwent vascular operation were selected. Patients were stratified by the presence or absence (non-decubitus ulcers) of decubitus ulcer. Case-mix adjusted hierarchical mixed-models examined in-hospital mortality, the occurrence of any complication, and discharge disposition...
June 2017: Surgery
https://www.readbyqxmd.com/read/28315116/evaluating-the-prevalence-of-potentially-inappropriate-prescribing-in-older-adults-in-intermediate-care-facilities-a-cross-sectional-observational-study
#11
Anna Millar, Carmel Hughes, Cristín Ryan
Background Potentially inappropriate prescribing (PIP) [encompassing potentially inappropriate medicines (PIMs) and potential prescribing omissions (PPOs)], is prevalent amongst older adults in primary and secondary care. However, PIP prevalence in intermediate care (IC) is unknown. Objective To determine the prevalence of PIMs/PPOs and associated patient factors. Setting Three IC facilities in Northern Ireland. Method The Screening Tool of Older People's Prescriptions and the Screening Tool to Alert doctors to Right Treatment were used to identify PIP over 8 weeks...
March 17, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28292582/-profile-and-evolution-of-chronic-complex-patients-in-a-subacute-unit
#12
Neus Gual, Anna Yuste Font, Belen Enfedaque Montes, Carles Blay Pueyo, Remedios Martín Álvarez, Marco Inzitari
OBJECTIVE: To improve the management of geriatric pluripathologic patients in Catalonia, the identification of chronic complex patient (PCC) or patients with advanced chronic disease (MACA) has been promoted. Patients with exacerbated chronic diseases are promoted to be admitted in subacute units (SG) located in intermediate hospitals and specialized in geriatric care, as an alternative to acute hospital. The results of the care process in patients identified as PCC/MACA in SG have not been evaluated...
March 11, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28288577/elevated-prevalence-of-multidrug-resistant-gram-negative-organisms-in-hiv-positive-men
#13
Claudia Reinheimer, Oliver T Keppler, Christoph Stephan, Thomas A Wichelhaus, Imke Friedrichs, Volkhard A J Kempf
BACKGROUND: Routes of transmission of multidrug-resistant gram-negative organisms (MDRGN) are not completely understood. Since sexual transmission of MDRGN might represent a potential mode that has not been noticed so far, this study evaluated transmission of MDRGN in HIV positive men. METHODS: Between November 2014 and March 2016, we retrospectively investigated the MDRGN prevalence in rectal swabs of n = 109 males tested positive for HIV (HP). These findings were compared to the MDRGN prevalence in n = 109 rectal swabs in age-matched males tested negative for HIV (HN) within the same period...
March 13, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28279073/end-of-life-care-and-discussions-in-japanese-geriatric-health-service-facilities
#14
Asako Kanoh, Yoshiyuki Kizawa, Satoru Tsuneto, Shoji Yokoya
BACKGROUND: Geriatric health service facilities (GHSFs) play important roles as intermediate care facilities for elderly individuals temporarily when they need rehabilitation before returning home. However, the number of residents spending their end-of-life (EOL) period in such facilities is increasing. To improve the quality of EOL care, end-of-life discussions (EOLDs) are recommended by some guidelines and studies. AIM: This study aimed to clarify the current practice of EOL care and EOLDs in GHSFs in Japan...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28258020/lower-extremity-bypass-surgery-on-patients-transferred-from-other-hospitals-is-associated-with-increased-morbidity-and-mortality
#15
Faisal Aziz, Youngmin Chu, Erik B Lehman
BACKGROUND: Despite advances in endovascular surgery, lower extremity arterial bypass remains the gold standard treatment for severe, symptomatic peripheral arterial disease (PAD). Patients who are transferred to other hospitals have generally complex medical problems compared to those patients who are directly admitted from home. The purpose of this study is to identify factors associated with an interfacility transfer in patients with PAD and compare the postoperative outcomes of these patients to those who are directly admitted to the hospital...
May 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28256935/high-on-walking
#16
Bente Martinsen, Anita Haahr, Pia Dreyer, Annelise Norlyk
The aim of this study is to discuss the meaning of walking impairment among people who have previously been able to walk on their own. The study is based on findings from three different life situations: older people recovering after admission in intermediate care, people who have lost a leg, and people who live with Parkinson's disease. The analysis of the data is inspired by Paul Ricoeur's philosophy of interpretation. Four themes were identified: (a) I feel high in two ways; (b) Walking has to be automatic; (c) Every Monday, I walk with the girls in the park; and (d) I dream of walking along the street without sticks and things like that...
January 1, 2017: Western Journal of Nursing Research
https://www.readbyqxmd.com/read/28242766/understanding-the-models-of-community-hospital-rehabilitation-activity-mocha-a-mixed-methods-study
#17
John Gladman, John Buckell, John Young, Andrew Smith, Clare Hulme, Satti Saggu, Mary Godfrey, Pam Enderby, Elizabeth Teale, Roberto Longo, Brenda Gannon, Claire Holditch, Heather Eardley, Helen Tucker
INTRODUCTION: To understand the variation in performance between community hospitals, our objectives are: to measure the relative performance (cost efficiency) of rehabilitation services in community hospitals; to identify the characteristics of community hospital rehabilitation that optimise performance; to investigate the current impact of community hospital inpatient rehabilitation for older people on secondary care and the potential impact if community hospital rehabilitation was optimised to best practice nationally; to examine the relationship between the configuration of intermediate care and secondary care bed use; and to develop toolkits for commissioners and community hospital providers to optimise performance...
February 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28198758/medication-reconciliation-failures-in-children-and-young-adults-with-chronic-disease-during-intensive-and-intermediate-care
#18
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...
April 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28148613/delirium-in-trauma-patients-prevalence-and-predictors
#19
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
#20
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
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