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https://www.readbyqxmd.com/read/28738341/unmet-care-needs-in-the-oldest-old-primary-care-patients-with-cognitive-disorders-results-of-the-agecode-and-agequalide-study
#1
Janine Stein, Alexander Pabst, Tobias Luck, Dagmar Lühmann, Kathrin Heser, Frank Jessen, Horst Bickel, Edelgard Mösch, Michael Pentzek, Angela Fuchs, Birgitt Wiese, Silke Mamone, Hans-Helmut König, Christian Brettschneider, Jochen Werle, Martin Scherer, Wolfgang Maier, Siegfried Weyerer, Steffi G Riedel-Heller
BACKGROUND: In the future, an increase in health care needs in the elderly is expected. Reports on unmet care needs of the oldest old with cognitive disorders are pending. This study aims at exploring unmet needs in the oldest old primary care patients with mild cognitive impairment (MCI) and dementia. Furthermore, the association between sociodemographic and clinical factors and unmet needs ought to be analyzed. METHODS: Based on the study "Needs, Health Service Use, Costs and Health-Related Quality of Life in a Large Sample of Oldest-Old Primary Care Patients (85+)" (AgeQualiDe), 749 patients (unimpaired, MCI, and dementia) aged 85 years and older, their relatives (n = 421), and general practitioners (GPs) (n = 607) were assessed...
July 25, 2017: Dementia and Geriatric Cognitive Disorders
https://www.readbyqxmd.com/read/28738035/palliative-care-and-phase-1-trials-intervention-to-improve-quality-of-life-and-provide-education%C3%A2
#2
Betty R Ferrell, Vincent Chung, Marianna Koczywas, Anna Cathy Williams, Denise Gallagher, Patricia Fischer, Thomas J Smith
BACKGROUND: Patients in phase 1 clinical trials often have significant symptom burdens and quality-of-life concerns that increase as they progress along the cancer trajectory and experience drug toxicities from the clinical trial. 
. OBJECTIVES: The interdisciplinary intervention described is aimed at providing optimum palliative care to support patients with solid tumors participating in a phase 1 clinical trial.
. METHODS: The intervention includes a baseline evaluation using quantitative surveys, a comprehensive palliative care assessment by a research nurse based on patient baseline evaluation, and a goals-of-care discussion by the treating oncologist...
August 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28738033/how-can-i-implement-accurate-delirium-screening-and-prevention-practices
#3
Kimberly Sanchez
As a clinical nurse specialist (CNS), I am tasked with improving patient outcomes through collaborative research, evidence-based practice, and process improvement efforts that affect the quality and safety of patient care. However, I have learned over time that it is not enough to simply incorporate the latest evidence into organizational policies and procedures; it has to be followed in practice. 
.
August 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28738029/confronting-compassion-fatigue-assessment-and-intervention-in-inpatient-oncology%C3%A2
#4
Lisa M Zajac, Katherine J Moran, Carla J Groh
BACKGROUND: A notable variation among patient satisfaction scores with nursing care was identified. Contributing factors were examined and revealed significant negative correlations between the unit death rate and surviving patients' satisfaction scores. Compassion fatigue (CF) was hypothesized to be a major contributing factor.
. OBJECTIVES: The objective was to address CF in RNs and oncology care associates (assistive personnel) by developing an intervention to provide bereavement support to staff after patient deaths...
August 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28737998/examination-of-the-patient-focused-impact-of-cancer-telegenetics-among-a-rural-population-comparison-with-traditional-in-person-services
#5
Nan M Solomons, Amanda E Lamb, Frances L Lucas, Eileen F McDonald, Susan Miesfeldt
BACKGROUND: Telecommunication models promise to improve access to cancer genetic counseling. Little is known about their impact among the geographically underserved. This work examined knowledge and emotional outcomes and attitudes/beliefs regarding cancer telegenetic services (via live-interactive videoconferencing) in Maine. MATERIALS AND METHODS: Cancer telegenetic patients seen at two remote sites and control (in-person) patients responded to pre-/postsurveys assessing care impact on hereditary breast and ovarian cancer (HBOC) knowledge and emotional health, ease of access to services, and telegenetics satisfaction/acceptability...
July 21, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28737996/integrating-palliative-and-oncology-care-for-patients-with-advanced-cancer-a-quality-improvement-intervention
#6
Laura C Hanson, Frances Collichio, Stephen A Bernard, William A Wood, Matt Milowsky, Erin Burgess, Crista J Creedle, Summer Cheek, Lydia Chang, Bhisham Chera, Alexandra Fox, Feng-Chang Lin
BACKGROUND: Practice guidelines recommend palliative care for patients with advanced cancer, but gaps in access and quality of care persist. OBJECTIVE: To increase goals-of-care (GOC) communication for hospitalized patients with Stage IV cancer. METHODS: An interdisciplinary team designed a quality improvement intervention to enhance oncology palliative care, including training in communication skills and triggers for palliative care consults...
July 24, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28737990/cost-effectiveness-of-novel-agents-in-medicare-patients-with-multiple-myeloma-findings-from-a-u-s-payer-s-perspective
#7
Ying Chen, David R Lairson, Wenyaw Chan, Jinhai Huo, Xianglin L Du
BACKGROUND: Since multiple myeloma (MM) incurs a substantial economic burden in care management, more and more discussion has been generated in recent years about the costs of novel antimyeloma drugs and their associated value. Because of these costs, economic assessment that quantifies value of care over the long-term is essential. OBJECTIVE: To determine the cost-effectiveness (measured as cost per life-year saved) of front-line novel agent-based therapy use among a cohort of elderly patients with MM in a real-world setting...
August 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28737985/evaluation-of-patient-migration-patterns-and-related-health-care-costs-within-a-national-medicare-advantage-prescription-drug-plan-after-implementation-of-an-oxycodone-hcl-extended-release-access-restriction
#8
Chi-Chang Chen, Ajita P De, Brian Sweet, Rolin L Wade
BACKGROUND: Health plans use formulary restrictions (e.g., prior authorization, step therapy, tier change, nonformulary status) in an effort to control cost and promote quality, safety, and appropriate prescription utilization. Some Medicare payers perceive that the inclusion of certain agents, such as branded oxycodone HCl extended-release tablets (OERs), on their formularies is associated with attracting high-cost members to the plan. OBJECTIVE: To evaluate disenrollment rates, patient migration, and subsequent health care costs among OER users who disenrolled from a national Medicare Advantage Prescription Drug plan (study-MAPD) in the plan year following OER nonformulary restriction...
August 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28737775/fertility-preservation-issues-in-pediatric-hematopoietic-stem-cell-transplantation-practical-approaches-from-the-consensus-of-the-pediatric-diseases-working-party-of-the-ebmt-and-the-international-bfm-study-group
#9
A Balduzzi, J-H Dalle, K Jahnukainen, M von Wolff, G Lucchini, M Ifversen, K T Macklon, C Poirot, T Diesch, A Jarisch, D Bresters, I Yaniv, B Gibson, A M Willasch, R Fadini, L Ferrari, A Lawitschka, A Ahler, N Sänger, S Corbacioglu, M Ansari, R Moffat, A Dalissier, E Beohou, P Sedlacek, A Lankester, C D De Heredia Rubio, K Vettenranta, J Wachowiak, A Yesilipek, E Trigoso, T Klingebiel, C Peters, P Bader
Fertility preservation is an urgent challenge in the transplant setting. A panel of transplanters and fertility specialists within the Pediatric Diseases Working Party of the European Society for Blood and Marrow Transplantation (EBMT) and the International BFM Study Group provides specific guidelines. Patients and families should be informed of possible gender- and age-specific cryopreservation strategies that should be tailored according to the underlying disease, clinical condition and previous exposure to chemotherapy...
July 24, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28737744/delivering-advanced-therapies-the-big-pharma-approach
#10
REVIEW
J Tarnowski, D Krishna, L Jespers, A Ketkar, R Haddock, J Imrie, S Kili
After two decades of focused development and some recent clinical successes, cell and gene therapy (CGT) is emerging as a promising approach to personalized medicines. Genetically engineered cells as a medical modality are poised to stand alongside or in combination with small molecule and biopharmaceutical approaches to bring new therapies to patients globally. Big pharma can play a vital role in industrializing CGT by focusing on diseases with high un-met medical need and compelling genetic evidence. Pharma should invest in manufacturing and supply chain solutions that deliver reproducible, high quality therapies at a commercially viable cost...
July 24, 2017: Gene Therapy
https://www.readbyqxmd.com/read/28737635/reducing-length-of-stay-direct-cost-and-readmissions-in-total-joint-arthroplasty-patients-with-an-outcomes-manager-led-interprofessional-team
#11
Melissa Arana, Licia Harper, Huanying Qin, Jay Mabrey
The purpose of this quality improvement project was to determine whether an outcomes manager-led interprofessional team could reduce length of stay and direct cost without increasing 30-day readmission rates in the total joint arthroplasty patient population. The goal was to promote interprofessional relationships combined with collaborative practice to promote coordinated care with improved outcomes. Results from this project showed that length of stay (total hip arthroplasty [THA] reduced by 0.4 days and total knee arthroplasty [TKA] reduced by 0...
July 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28737634/noise-reduction-to-reduce-patient-anxiety-during-cast-removal-can-we-decrease-patient-anxiety-with-cast-removal-by-wearing-noise-reduction-headphones-during-cast-saw-use
#12
Susan T Mahan, Marie S Harris, Anneliese M Lierhaus, Patricia E Miller, Rachel L DiFazio
BACKGROUND: Noise reduction headphones decrease the sound during cast removal. Their effectiveness in decreasing anxiety has not been studied. PURPOSE: Compare pediatric patients' anxiety levels during cast removal with and without utilization of noise reduction headphones combined with use of a personal electronic device. METHODS: Quality improvement project. Patients randomly assigned to noise reduction headphone group or standard care group during cast removal...
July 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28737630/first-in-the-nation-one-unit-s-journey-to-achieving-fragility-fracture-certification
#13
Audry McDonald, Samantha Church, Laura Hixon, Linda Vo, Martha Sleutel
Osteoporosis is related to more than 2 million fractures and $19 billion in healthcare costs each year (). A fragility fracture (FF) is a low-energy fracture of the distal radius, proximal humerus, ankle, or proximal femur (hip) from minimal trauma such as a fall from a standing height. In addition to cost, FFs often result in the loss of independence and productivity (). In 2015, our orthopaedic unit received the first certification ever awarded for FFs. Fragility fracture certification is a new certification demonstrating that a healthcare facility complies with national patient care standards and uses evidence-based practice guidelines to deliver quality outcomes...
July 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28737617/management-of-acetabular-fractures-in-the-elderly
#14
Nicholas B Antell, Julie A Switzer, Andrew H Schmidt
The incidence of acetabular fractures in the elderly population is increasing. Fractures in this population differ from those in younger patients, with more frequent involvement of the anterior column, more comminution, and more severe articular impaction in elderly patients. Although acetabular fractures in geriatric patients are more likely the result of low-energy trauma, outcomes are generally poorer than those in young patients. Multiple management options have been proposed, but no intervention has become the standard of care for these fractures in the elderly...
August 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28737600/an-interprofessional-quality-improvement-initiative-to-standardize-pediatric-extubation-readiness-assessment
#15
Samer Abu-Sultaneh, Acrista J Hole, Alvaro J Tori, Brain D Benneyworth, Riad Lutfi, Christopher W Mastropietro
OBJECTIVES: Establishing protocols to wean mechanical ventilation and assess readiness for extubation, with the goal of minimizing morbidity associated with extubation failure and prolonged mechanical ventilation, have become increasingly important in contemporary PICUs. The aim of this quality improvement initiative is to establish a respiratory therapist-led daily spontaneous breathing trial protocol to standardize extubation readiness assessment and documentation in our PICU. DESIGN: A quality improvement project...
July 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28737598/epidemiology-and-outcomes-of-cardiac-arrest-in-pediatric-cardiac-icus
#16
Jeffrey A Alten, Darren Klugman, Tia T Raymond, David S Cooper, Janet E Donohue, Wenying Zhang, Sara K Pasquali, Michael G Gaies
OBJECTIVES: In-hospital cardiac arrest occurs in 2.6-6% of children with cardiac disease and is associated with significant morbidity and mortality. Much remains unknown about cardiac arrest in pediatric cardiac ICUs; therefore, we aimed to describe cardiac arrest epidemiology in a contemporary multicenter cardiac ICU cohort. DESIGN: Retrospective analysis within the Pediatric Cardiac Critical Care Consortium clinical registry. SETTING: Cardiac ICUs within 23 North American hospitals...
July 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28737572/european-society-for-paediatric-gastroenterology-hepatology-and-nutrition-guidelines-for-the-evaluation-and-treatment-of-gastrointestinal-and-nutritional-complications-in-children-with-neurological-impairment
#17
Claudio Romano, Myriam van Wynckel, Jessie Hulst, Ilse Broekaert, Jiri Bronsky, Luigi Dall'Oglio, Nataša F Mis, Iva Hojsak, Rok Orel, Alexandra Papadopoulou, Michela Schaeppi, Nikhil Thapar, Michael Wilschanski, Peter Sullivan, Frédéric Gottrand
OBJECTIVES: Feeding difficulties are frequent in children with neurological impairments and can be associated with undernutrition, growth failure, micronutrients deficiencies, osteopenia, and nutritional comorbidities. Gastrointestinal problems including gastroesophageal reflux disease, constipation, and dysphagia are also frequent in this population and affect quality of life and nutritional status. There is currently a lack of a systematic approach to the care of these patients. With this report, European Society of Gastroenterology, Hepatology and Nutrition aims to develop uniform guidelines for the management of the gastroenterological and nutritional problems in children with neurological impairment...
August 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28737270/hospital-ownership-status-and-cesareans-in-the-united-states-the-effect-of-for-profit-hospitals
#18
Theresa Morris, Kelly McNamara, Christine H Morton
BACKGROUND: Given the increasing proportion of United States hospitals that are for-profit, we examined whether women who give birth in for-profit hospitals are more likely to have cesareans than women who give birth in not-for-profit hospitals. We hypothesized that cesareans are more likely to occur in for-profit hospitals because of the organizational emphasis on short-term financial indicators, including payment of shareholder dividends. METHODS: We used logistic regression and difference of means tests to analyze data from the Listening to Mothers III survey of women who gave birth in the United States in 2011 and 2012...
July 24, 2017: Birth
https://www.readbyqxmd.com/read/28737045/pharmacist-s-demand-for-optimal-primary-care-service-delivery-in-a-community-pharmacy-the-optipharm-study
#19
Mark A Munger, Michael Walsh, Jon Godin, Michael Feehan
BACKGROUND: The US population continues to expand providing the need for primary health care services. Community pharmacies integrated with medicine may provide greater access while providing high quality care. OBJECTIVE: To gauge pharmacists' demand for primary health care services delivered through community pharmacies. METHODS: An online survey was administered to determine community pharmacists' preferences for varying primary care services that could be offered in the community pharmacy setting...
July 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28736789/spiritual-distress-and-spiritual-care-in-advanced-heart-failure
#20
REVIEW
Ronald Gillilan, Sameena Qawi, Audrey J Weymiller, Christina Puchalski
As patients face serious and chronic illness, they are confronted with the realities of dying. Spiritual and existential issues are particularly prominent near the end of life and can result in significant distress. It is critical that healthcare professionals know how to address patients' and families' spiritual concerns, diagnose spiritual distress and attend to the deep suffering of patients in a way that can result in a better quality of life for patients and families. Tools such as the FICA spiritual history tool help clinicians invite patients and families to share their spiritual or existential concerns as well as sources of hope and meaning which can help them cope better with their illness...
July 24, 2017: Heart Failure Reviews
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