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https://www.readbyqxmd.com/read/29151000/implementing-clinical-practice-changes-in-critical-care-lessons-learned-in-a-national-collaborative-of-over-60-icu-teams
#1
Ruth Kleinpell, Jerry J Zimmerman
Improving care in the intensive care unit (ICU) is a global area of focus for clinicians worldwide. The complexity of the ICU environment, compounded by multiple patient comorbidities and high acuity levels, makes the ICU a unique and challenging area of clinical practice. The essence of quality improvement - designing and implementing strategies to enhance care - fit well with the ICU setting. However, implementing clinical change is challenging, regardless of the clinical setting. A national collaborative targeting ICU settings was initiated which provided a number of lessons learned regarding implementing quality of care initiatives in critical care...
November 18, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29150990/prevalence-of-dry-eye-disease-and-its-association-with-dyslipidemia
#2
Krishnamoorthy Rathnakumar, Kaliaperumal Ramachandran, Durairaj Baba, Venkatachalam Ramesh, Velusamy Anebaracy, Ramachandran Vidhya, Rajamanickam Vinothkumar, Ramamurthy Poovitha, Rajagopalan Geetha
BACKGROUND: Dry eye disease (DED) is a common ocular surface disease significantly affecting the quality of life of patients. The aim of our study is to focus on the prevalence of DED and to determine the relationship between dyslipidemia and DED. METHODS: The study was performed with the age group of 25-70 years, who attended the ophthalmology outpatient department at Sri Lakshmi Narayana Institute of Medical Sciences with complaints of dry eye. A standard questionnaire was taken, and tear film tests were performed to diagnose dry eye...
November 18, 2017: Journal of Basic and Clinical Physiology and Pharmacology
https://www.readbyqxmd.com/read/29150972/patient-level-factors-and-the-quality-of-care-delivered-in-pediatric-emergency-departments
#3
James P Marcin, Patrick S Romano, Parul Dayal, Madan Dharmar, James M Chamberlain, Nanette Dudley, Charles G Macias, Lise E Nigrovic, Elizabeth C Powell, Alexander J Rogers, Meridith Sonnett, Leah Tzimenatos, Elizabeth R Alpern, Rebecca Andrews-Dickert, Dominic A Borgialli, Erika Sidney, T Charles Casper, J Michael Dean, Nathan Kuppermann
OBJECTIVE: Quality of care delivered to adult patients in the emergency department (ED) is often associated with demographic and clinical factors such as a patient's race/ethnicity and insurance status. We sought to determine whether the quality of care delivered to children in the ED was associated with a variety of patient-level factors. METHODS: This was a retrospective, observational cohort study. Pediatric patients (<18 years) who received care between January 2011 and December 2011 at one of twelve EDs participating in the Pediatric Emergency Care Applied Research Network (PECARN) were included...
November 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29150861/cost-effectiveness-of-the-psycho-educational-blended-group-and-online-intervention-hypoaware-compared-with-usual-care-for-people-with-type-1-and-insulin-treated-type-2-diabetes-with-problematic-hypoglycaemia-analyses-of-a-cluster-randomized-controlled-trial
#4
M de Wit, S M P A Rondags, M W van Tulder, F J Snoek, J E Bosmans
AIMS: To evaluate the cost-effectiveness of HypoAware, a blended (group and online) psycho-educational intervention based on the evidence-based Blood Glucose Awareness Training, in comparison with usual care in people with Type 1 and Type 2 diabetes with a high risk of severe hypoglycaemia. METHODS: We performed an economic evaluation, from a societal and healthcare perspective, that used data from a 6-month, multicentre, cluster-randomized controlled trial (n=137)...
November 18, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29150794/shunt-surgery-in-idiopathic-normal-pressure-hydrocephalus-is-cost-effective-a-cost-utility-analysis
#5
Mats Tullberg, Josefine Persson, Jakob Petersen, Per Hellström, Carsten Wikkelsø, Åsa Lundgren-Nilsson
BACKGROUND: The objective was to evaluate the cost-effectiveness of shunt surgery in patients with idiopathic normal pressure hydrocephalus (iNPH). METHODS: Health-related quality of life was evaluated before and 6 months after surgery using the EQ-5D-3 L (EuroQOL group five-dimensions health survey) in 30 patients (median age, 71 years; range, 65-89 years) diagnosed with iNPH. The costs associated with shunt surgery were assessed by a detailed survey with interviews and extraction of register data concerning the cost of hospital care, primary care, residential care, home-care service and informal care...
November 17, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29150473/patient-level-and-practice-level-factors-associated-with-consultation-duration-a-cross-sectional-analysis-of-over-one-million-consultations-in-english-primary-care
#6
Sarah Stevens, Clare Bankhead, Toqir Mukhtar, Rafael Perera-Salazar, Tim A Holt, Chris Salisbury, F D Richard Hobbs
OBJECTIVES: Consultation duration has previously been shown to be associated with patient, practitioner and practice characteristics. However, previous studies were conducted outside the UK, considered only small numbers of general practitioner (GP) consultations or focused primarily on practitioner-level characteristics. We aimed to determine the patient-level and practice-level factors associated with duration of GP and nurse consultations in UK primary care. DESIGN AND SETTING: Cross-sectional data were obtained from English general practices contributing to the Clinical Practice Research Datalink (CPRD) linked to data on patient deprivation and practice staffing, rurality and Quality and Outcomes Framework (QOF) achievement...
November 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29150418/immune-enhancing-formulas-for-patients-with-cancer-undergoing-esophagectomy-systematic-review-protocol
#7
Astrid Naranjo, Elizabeth Isenring, Laisa Teleni
BACKGROUND: Adult patients with an esophageal cancer can potentially be compromised with postoperative leaks or fistulae if patients' nutritional status is in a vulnerable stage. Currently in Australia, there is a growing need for clinicians to know whether use of immune-enhancing formulas (IEFs) containing Arg, omega-3, and RNA are a cost-effective approach compared with isonitrogenous-isocaloric formulas to reduce postoperative infectious complications in esophagectomy patients. Since IEFs may carry higher costs, this has led to inconsistencies in practice among clinicians and hospitals...
November 17, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/29150313/safety-practices-perceptions-and-behaviors-in-radiation-oncology-a-national-survey-of-radiation-therapists
#8
Kristina Demas Woodhouse, David Hashemi, Kathryn Betcher, Abigail Doucette, Allison Weaver, Brian Monzon, Seth A Rosenthal, Neha Vapiwala
PURPOSE: Radiation therapy is complex and demands high vigilance and precise coordination. Radiation therapists (RTTs) directly deliver radiation and are often the first to discover an error. Yet, few studies have examined the practices of RTTs regarding patient safety. We conducted a national survey to explore the perspectives of RTTs related to quality and safety. METHODS AND MATERIALS: In 2016, an electronic survey was sent to a random sample of 1500 RTTs in the United States...
June 15, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/29150233/management-of-first-depression-or-generalized-anxiety-disorder-episode-in-adults-in-primary-care-a-systematic-metareview
#9
Damien Driot, Michel Bismuth, Adrien Maurel, Julie Soulie-Albouy, Jordan Birebent, Stéphane Oustric, Julie Dupouy
CONTEXT: General Practitioners (GPs) are the leading antidepressants prescribers in Europe and in France. Difficulties in implementing existing recommendations in daily practice have been described. OBJECTIVE: The objective of this study was to elaborate two algorithms to guide GPs in the patient management for a first major depressive disorder (MDD) or generalized anxiety disorder (GAD) episode in primary care. DATA SOURCES: PubMed, Cochrane, and ISI Web of Science were explored using mainly the following keywords: depressive disorder, anxiety disorders, antidepressive agents or antidepressant...
November 14, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/29150180/family-centre-bereavement-practices-in-danish-intensive-care-units-a-cross-sectional-national-survey
#10
Ingrid Egerod, Gudrun Kaldan, Maureen Coombs, Marion Mitchell
BACKGROUND: Mortality in Danish intensive care units (ICUs) continues at 27%, resulting in a large number of bereaved family members being cared for in the ICU. OBJECTIVES: To investigate the provision of bereavement care and follow-up services for bereaved families in Danish ICUs. METHODOLOGY: Self-administered computerized cross-sectional nation-wide survey of Danish ICUs. RESULTS: Nurses at 46 of 48 (96%) ICUs in Denmark responded...
November 14, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29150163/the-management-of-diagnosed-heart-failure-in-older-people-in-primary-care
#11
REVIEW
Nicholas R Jones, F D Richard Hobbs, Clare J Taylor
Heart failure (HF) is a common condition affecting predominantly older people. Symptoms include breathlessness and fatigue, and can significantly reduce quality of life. HF rarely occurs in isolation, with most patients having several co-existing diseases requiring multiple medications. There is a large evidence base for treatment of HF with reduced ejection fraction, or HFrEF; however, many of the trials did not include older people with multimorbidity so their findings should be applied to this group with some caution...
December 2017: Maturitas
https://www.readbyqxmd.com/read/29150148/-family-socioeconomic-status-and-health-services-clues-to-health-care-in-diabetic-patients-with-lower-limb-amputations-in-andalusia-a-qualitative-study
#12
Gabriel Jesús Rodríguez, Juan Antonio Córdoba-Doña, Antonio Escolar-Pujolar, Manuel Aguilar-Diosdado, Isabel Goicolea
AIM: To examine the experience of diabetic care in patients undergoing lower limb amputation. DESIGN: A qualitative study using the phenomenological approach. SETTING: Cadiz Health District. PARTICIPANTS: A total of 16 patients (11 men and 5 women) diagnosed with diabetes mellitus type 2 and with non-traumatic lower limb amputation. METHODS: Semi-structured interviews were performed, followed by a content analysis according Graneheim and Lundman...
November 14, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/29150102/evaluation-of-criteria-of-manual-blood-smear-review-following-automated-complete-blood-counts-in-a-large-university-hospital
#13
Samuel Ricardo Comar, Mariester Malvezzi, Ricardo Pasquini
BACKGROUND: There is great interest in reducing the number of automated complete blood counts requiring manual blood smear reviews without sacrificing the quality of patient care. This study was aimed at evaluating and establishing appropriate screening criteria for manual blood smear reviews to improve the performance in a hematology laboratory. METHOD: A total of 1977 consecutive samples from the daily workload were used to evaluate four sets of screening criteria for manual blood smear reviews to identify samples with positive smear findings...
October 2017: Revista Brasileira de Hematologia e Hemoterapia
https://www.readbyqxmd.com/read/29149880/analytical-performance-of-envisia-a-genomic-classifier-for-usual-interstitial-pneumonia
#14
Yoonha Choi, Jiayi Lu, Zhanzhi Hu, Daniel G Pankratz, Huimin Jiang, Manqiu Cao, Cristina Marchisano, Jennifer Huiras, Grazyna Fedorowicz, Mei G Wong, Jessica R Anderson, Edward Y Tom, Joshua Babiarz, Urooj Imtiaz, Neil M Barth, P Sean Walsh, Giulia C Kennedy, Jing Huang
BACKGROUND: Clinical guidelines specify that diagnosis of interstitial pulmonary fibrosis (IPF) requires identification of usual interstitial pneumonia (UIP) pattern. While UIP can be identified by high resolution CT of the chest, the results are often inconclusive, making surgical lung biopsy necessary to reach a definitive diagnosis (Raghu et al., Am J Respir Crit Care Med 183(6):788-824, 2011). The Envisia genomic classifier differentiates UIP from non-UIP pathology in transbronchial biopsies (TBB), potentially allowing patients to avoid an invasive procedure (Brown et al...
November 17, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29149872/process-quality-of-decision-making-in-multidisciplinary-cancer-team-meetings-a-structured-observational-study
#15
Pola Hahlweg, Sarah Didi, Levente Kriston, Martin Härter, Yvonne Nestoriuc, Isabelle Scholl
BACKGROUND: The quality of decision-making in multidisciplinary team meetings (MDTMs) depends on the quality of information presented and the quality of team processes. Few studies have examined these factors using a standardized approach. The aim of this study was to objectively document the processes involved in decision-making in MDTMs, document the outcomes in terms of whether a treatment recommendation was given (none vs. singular vs. multiple), and to identify factors related to type of treatment recommendation...
November 17, 2017: BMC Cancer
https://www.readbyqxmd.com/read/29149634/patient-participation-in-nursing-bedside-handover-a-systematic-mixed-methods-review
#16
REVIEW
Georgia Tobiano, Tracey Bucknall, Ishtar Sladdin, Jennifer A Whitty, Wendy Chaboyer
BACKGROUND: Numerous reviews of nursing handover have been undertaken, but none have focused on the patients' role. OBJECTIVES: To explore how patient participation in nursing shift-to-shift bedside handover can be enacted. DESIGN: Systematic mixed- methods review. DATA SOURCES: Three search strategies were undertaken in July-August 2016: database searching, backwards citation searching and forward citation searching...
October 24, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29149507/registered-nurse-and-midwife-experiences-of-using-videoconferencing-in-practice-a-systematic-review-of-qualitative-studies
#17
REVIEW
Robyn A Penny, Natalie K Bradford, Danette Langbecker
AIM: To synthesise evidence of registered nurses' and midwives' experiences with videoconferencing and identify perceptions of the appropriateness, meaningfulness and feasibility of this technology in professional and clinical practice. BACKGROUND: Videoconferencing is a form of telehealth that can facilitate access to high quality care to improve health outcomes for patients and enable clinicians working in isolation to access education, clinical supervision, peer support and case review...
November 17, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29149485/factors-influencing-the-delivery-of-the-fundamentals-of-care-perceptions-of-nurses-nursing-leaders-and-healthcare-consumers
#18
Tiffany Conroy
AIM AND OBJECTIVES: To explore the factors described by nurses and consumer representatives influencing the delivery of the fundamentals of care. BACKGROUND: An ongoing challenge facing nursing is ensuring the 'basics' or fundamentals of care are delivered optimally. The way nurses and patients perceive the delivery of the fundamentals of care, had not been explored. Once identified, the factors that promote the delivery of the fundamentals of care may be facilitated ...
November 17, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29149478/hospital-quality-patient-risk-and-medicare-expenditures-for-cancer-surgery
#19
Sarah P Shubeck, Jyothi R Thumma, Justin B Dimick, Hari Nathan
BACKGROUND: Surgical resection is a cornerstone of curative-intent therapy for patients with solid organ malignancies. With increasing attention paid to the costs of surgical care, there is a new focus on variations in the costs of cancer surgery. This study evaluated the potential interactive effect of hospital quality and patient risk on expenditures for cancer resections. METHODS: With 100% Medicare claim data for 2010-2013, patients aged 65 to 99 years who had undergone cancer resection were identified...
November 17, 2017: Cancer
https://www.readbyqxmd.com/read/29149462/a-multi-institutional-study-of-the-perceived-barriers-and-facilitators-to-implementing-evidence-based-practice
#20
Daphne C Duncombe
AIMS AND OBJECTIVES: The study aims were to examine perceived barriers and facilitators to implementing evidence-based practice among nurses working in psychiatric, geriatric, hospital and community settings in The Bahamas. BACKGROUND: It is evident from previous studies that a number of factors exist which either obstruct or promote the utilization of research evidence in nursing practice. Identifying these factors is vital to the successful uptake of evidence-based practice in nursing...
November 17, 2017: Journal of Clinical Nursing
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