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https://www.readbyqxmd.com/read/27911904/dressing-wear-time-after-breast-reconstruction-a-randomized-clinical-trial
#1
Daniela Francescato Veiga, Carlos Américo Veiga Damasceno, Joel Veiga-Filho, Luiz Francisley Paiva, Fernando Elias Martins Fonseca, Isaías Vieira Cabral, Natália Lana Larcher Pinto, Yara Juliano, Lydia Masako Ferreira
BACKGROUND: The evidence to support dressing standards for breast surgery wounds is empiric and scarce. OBJECTIVE: This two-arm randomized clinical trial was designed to assess the effect of dressing wear time on surgical site infection (SSI) rates, skin colonization and patient perceptions. METHODS: A total of 200 breast cancer patients undergoing breast reconstruction were prospectively enrolled. Patients were randomly allocated to group I (dressing removed on the first postoperative day, n = 100) or group II (dressing removed on the sixth postoperative day, n = 100)...
2016: PloS One
https://www.readbyqxmd.com/read/27909093/barriers-of-pediatric-residents-to-speaking-up-about-patient-safety
#2
Rachel Landgren, Zeinab Alawadi, Caryn Douma, Eric J Thomas, Jason Etchegaray
BACKGROUND AND OBJECTIVES: Medical errors are a leading cause of death in the United States. Effective communication and speaking up are crucial factors in patient safety initiatives. We examined the reasons reported by pediatric residents for not speaking up about safety events when they are observed in practice. We also tested a priori hypotheses of associations between categories of barriers to speaking up with perceptions of safety and teamwork culture. METHODS: Pediatric residents completed an anonymous electronic survey measuring safety and teamwork culture along with an open-ended question asking them to list the top 3 barriers to speaking up about patient safety concerns...
December 2016: Hospital Pediatrics
https://www.readbyqxmd.com/read/27906760/improving-the-quality-of-ward-based-surgical-care-with-a-human-factors-intervention-bundle
#3
Maximilian J Johnston, Sonal Arora, Dominic King, Ara Darzi
OBJECTIVE: This study aimed to explore the impact of a human factors intervention bundle on the quality of ward-based surgical care in a UK hospital. SUMMARY OF BACKGROUND DATA: Improving the culture of a surgical team is a difficult task. Engagement with stakeholders before intervention is key. Studies have shown that appropriate supervision can enhance surgical ward safety. METHODS: A pre-post intervention study was conducted. The intervention bundle consisted of twice-daily attending ward rounds, a "chief resident of the week" available at all times on the ward, an escalation of care protocol and team contact cards...
November 30, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27904743/frontline-worker-perceptions-of-medication-safety-in-india
#4
Sangeeta Sharma, Fauzia Tabassum, Sarbjeet Khurana, Kaveri Kapoor
BACKGROUND: To explore interprofessionals' perceptions about patient safety, particularly medication safety and associated factors and barriers. METHODS: A total of 389 respondents were recruited using convenience sample in the cross sectional survey. RESULTS: Medication safety was perceived as somewhat safe (60%). One-third of respondents witnessed 3-4 or more medication errors (MEs) within the past 1 year. Out of that, one quarter were reportedly, sentinel events...
December 2016: Therapeutic Advances in Drug Safety
https://www.readbyqxmd.com/read/27904592/factors-affecting-the-quality-of-hospital-hotel-services-from-the-patients-and-their-companions-point-of-view-a-national-study-in-iran
#5
Seyed Majid Shirzadi, Pouran Raeissi, Amir Ashkan Nasiripour, Seyed Jamaleddin Tabibi
BACKGROUND: The hospitality design of a hospital is a complex process that depends on careful planning, systematic thinking, and consideration of various factors. This study aimed to determine the viewpoints of patients and their relatives on factors affecting hospital hotel services in Iran in 2015. The results of this study can be used to design a suitable model for the assessment and improvement of hospitality service quality. MATERIALS AND METHODS: In this cross-sectional descriptive study, 10 hospitals of Iran were included...
2016: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/27903769/education-for-the-next-frontier-in-patient-safety-a-longitudinal-resident-curriculum-on-diagnostic-error
#6
Emily Ruedinger, Maren Olson, Justin Yee, Emily Borman-Shoap, Andrew P J Olson
Diagnostic error is a common, serious problem that has received increased attention recently for its impact on both patients and providers. Presently, most graduate medical education programs do not formally address this topic. The authors developed and evaluated a longitudinal, multimodule resident curriculum about diagnostic error and medical decision making. Key components of the curriculum include demystifying the medical decision-making process, building skills in critical thinking, and providing strategies for diagnostic error mitigation...
November 29, 2016: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/27902947/what-factors-affect-implementation-of-early-rehabilitation-into-intensive-care-unit-practice-a-qualitative-study-with-clinicians
#7
Selina M Parry, Louisa Remedios, Linda Denehy, Laura D Knight, Lisa Beach, Thomas C Rollinson, Sue Berney, Zudin A Puthucheary, Peter Morris, Catherine L Granger
PURPOSE: To identify the barriers and enablers that influence clinicians' implementation of early rehabilitation in critical care. MATERIALS AND METHODS: Qualitative study involving 26 multidisciplinary participants who were recruited using purposive sampling. Four focus groups were conducted using semistructured questions to explore attitudes, beliefs, and experiences. Data were transcribed verbatim and thematic analysis was performed. RESULTS: Six themes emerged, as follows: (1) the clinicians' expectations and knowledge (including rationale for rehabilitation, perceived benefits, and experience), (2) the evidence for and application of rehabilitation (including beliefs regarding when to intervene), (3) patient factors (including prognosis, sedation, delirium, cooperation, motivation, goals, and family), (4) safety considerations (including physiological stability and presence of devices or lines), (5) environmental influences (staffing, resources, equipment, time, and competing priorities), and (6) culture and teamwork...
November 12, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27900338/the-bridge-enhanced-anterior-cruciate-ligament-repair-bear-procedure-an-early-feasibility-cohort-study
#8
Martha M Murray, Brett M Flutie, Leslie A Kalish, Kirsten Ecklund, Braden C Fleming, Benedikt L Proffen, Lyle J Micheli
BACKGROUND: This study assessed the safety of the newly developed bridge-enhanced anterior cruciate ligament (ACL) repair (BEAR), which involves suture repair of the ligament combined with a bioactive scaffold to bridge the gap between the torn ligament ends. As the intra-articular environment is complex in its response to implanted materials, this study was designed to determine whether there would be a significant rate of adverse reaction to the implanted scaffold. HYPOTHESIS: The primary hypothesis was that the implanted scaffold would not result in a deep joint infection (arthrocentesis with positive culture) or significant inflammation (clinical symptoms justifying arthrocentesis but negative culture)...
November 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/27894030/fatigue-in-hospital-nurses-supernurse-culture-is-a-barrier-to-addressing-problems-a-qualitative-interview-study
#9
Linsey M Steege, Jessica G Rainbow
BACKGROUND: Fatigue in hospital nurses is associated with decreased nurse satisfaction, increased turnover and negative patient outcomes. Addressing fatigue in nurses has been identified as a priority by many organizations worldwide in an effort to promote both a culture of patient safety and a healthy nursing workforce. OBJECTIVES: The overall aim of this study was to explore barriers and facilitators within the hospital nurse work system to nurse coping and fatigue...
November 21, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/27893508/best-practices-for-pressure-ulcer-prevention-in-the-burn-center
#10
Julia Warner, Mary Ann Raible, Gina Hajduk, Jacqueline Collavo
The State of Pennsylvania Hospital Engagement Network, in collaboration with a hospital system in Southwestern Pennsylvania, established a goal of reducing hospital-acquired pressure ulcers by 20%. A 6-month unfavorable trend of nurse-sensitive clinical indicators called for immediate process improvement. A retrospective chart review resulted in identification of predominant risk factors placing the burn patient at high risk for pressure ulcer formation. Implementations of pressure ulcer prevention measures were inconsistent...
January 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27892625/progress-at-the-intersection-of-patient-safety-and-medical-liability-insights-from-the-ahrq-patient-safety-and-medical-liability-demonstration-program
#11
M Susan Ridgely, Michael D Greenberg, Michelle B Pillen, James Bell
OBJECTIVE: To identify lessons learned from the experience of the Agency for Healthcare Research and Quality (AHRQ) Patient Safety and Medical Liability (PSML) Demonstration Program. DATA SOURCES/STUDY SETTING: On September 9, 2009, President Obama directed the Secretary of Health and Human Services to authorize demonstration projects that put "patient safety first" with the intent of reducing preventable adverse outcomes and stemming liability costs. Seven demonstration projects received 3 years of funding from AHRQ in the summer of 2010, and the program formally came to a close in June 2015...
December 2016: Health Services Research
https://www.readbyqxmd.com/read/27890714/a-randomized-trial-of-the-amikacin-fosfomycin-inhalation-system-for-the-adjunctive-therapy-of-gram-negative-ventilator-associated-pneumonia-iasis-trial
#12
Marin H Kollef, Jean-Damien Ricard, Damien Roux, Bruno Francois, Eleni Ischaki, Zsolt Rozgonyi, Thierry Boulain, Zsolt Ivanyi, Gál János, Denis Garot, Firas Koura, Epaminondas Zakynthinos, George Dimopoulos, Antonio Torres, Wayne Danker, A Bruce Montgomery
BACKGROUND: Clinical failures in ventilator-associated pneumonia (VAP) caused by Gram-negative bacteria are common and associated with substantial morbidity, mortality, and resource utilization. METHODS: We assessed the safety and efficacy of the amikacin fosfomycin inhalation system (AFIS) for the treatment of Gram-negative bacterial VAP in a randomized double-blind, placebo-controlled, parallel group, phase 2 study between May 2013 and March 2016. We compared standard of care in each arm plus 300 mg amikacin/120 mg fosfomycin or placebo (saline), delivered by aerosol twice daily for 10 days (or to extubation if <10 days) via the investigational eFlow Inline System (PARI GmbH, Germany)...
November 24, 2016: Chest
https://www.readbyqxmd.com/read/27888550/mesenchymal-stem-stromal-cells-biology-and-preclinical-evidence-for-therapeutic-potential-for-organ-dysfunction-following-trauma-or-sepsis
#13
Michael A Matthay, Shibani Pati, Jae-Woo Lee
Several experimental studies have provided evidence that bone-marrow derived mesenchymal stem (stromal) cells (MSC) may be effective in treating critically ill surgical patients who develop traumatic brain injury, acute renal failure, or the acute respiratory distress syndrome. There is also preclinical evidence that MSC may be effective in treating sepsis-induced organ failure, including evidence that MSC have anti-microbial properties. This review considers preclinical studies with direct relevance to organ failure following trauma, sepsis or major infections that apply to critically ill patients...
November 26, 2016: Stem Cells
https://www.readbyqxmd.com/read/27886626/describing-clinical-faculty-experiences-with-patient-safety-and-quality-care-in-acute-care-settings-a-mixed-methods-study
#14
Linda Roney, Catherine Sumpio, Audrey M Beauvais, Eileen R O'Shea
BACKGROUND: A major safety initiative in acute care settings across the United States has been to transform hospitals into High Reliability Organizations. The initiative requires developing cognitive awareness, best practices, and infrastructure so that all healthcare providers including clinical faculty are accountable to deliver quality and safe care. OBJECTIVE: To describe the experience of baccalaureate clinical nursing faculty concerning safety and near miss events, in acute care hospital settings...
November 18, 2016: Nurse Education Today
https://www.readbyqxmd.com/read/27884844/medication-reconciliation-as-a-medication-safety-initiative-in-ethiopia-a-study-protocol
#15
Alemayehu B Mekonnen, Andrew J McLachlan, Jo-Anne E Brien, Desalew Mekonnen, Zenahebezu Abay
INTRODUCTION: Medication related adverse events are common, particularly during transitions of care, and have a significant impact on patient outcomes and healthcare costs. Medication reconciliation (MedRec) is an important initiative to achieve the Quality Use of Medicines, and has been adopted as a standard practice in many developed countries. However, the impact of this strategy is rarely described in Ethiopia. The aims of this study are to explore patient safety culture, and to develop, implement and evaluate a theory informed MedRec intervention, with the aim of minimising the incidence of medication errors during hospital admission...
November 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27881101/knowledge-barriers-and-facilitators-of-exercise-in-dialysis-patients-a-qualitative-study-of-patients-staff-and-nephrologists
#16
Manisha Jhamb, Mary L McNulty, Gerald Ingalsbe, Julie W Childers, Jane Schell, Molly B Conroy, Daniel E Forman, Andrea Hergenroeder, Mary Amanda Dew
BACKGROUND: Despite growing evidence on benefits of increased physical activity in hemodialysis (HD) patients and safety of intra-dialytic exercise, it is not part of standard clinical care, resulting in a missed opportunity to improve clinical outcomes in these patients. To develop a successful exercise program for HD patients, it is critical to understand patients', staff and nephrologists' knowledge, barriers, motivators and preferences for patient exercise. METHODS: In-depth interviews were conducted with a purposive sample of HD patients, staff and nephrologists from 4 dialysis units...
November 24, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27878228/lithium-carbonate-and-coenzyme-q10-reduce-cell-death-in-a-cell-model-of-machado-joseph-disease
#17
C M Lopes-Ramos, T C Pereira, D B Dogini, R Gilioli, I Lopes-Cendes
Machado-Joseph disease (MJD) or spinocerebellar ataxia type 3 (SCA3) is an autosomal dominant neurodegenerative disorder caused by expansion of the polyglutamine domain of the ataxin-3 (ATX3) protein. MJD/SCA3 is the most frequent autosomal dominant ataxia in many countries. The mechanism underlying MJD/SCA3 is thought to be mainly related to protein misfolding and aggregation leading to neuronal dysfunction followed by cell death. Currently, there are no effective treatments for patients with MJD/SCA3. Here, we report on the potential use of lithium carbonate and coenzyme Q10 to reduce cell death caused by the expanded ATX3 in cell culture...
November 21, 2016: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/27875383/predictors-of-hospital-nurses-safety-practices-work-environment-workload-job-satisfaction-and-error-reporting
#18
Hui-Ying Chiang, Ya-Chu Hsiao, Huan-Fang Lee
Nurses' safety practices of medication administration, prevention of falls and unplanned extubations, and handover are essentials to patient safety. This study explored the prediction between such safety practices and work environment factors, workload, job satisfaction, and error-reporting culture of 1429 Taiwanese nurses. Nurses' job satisfaction, error-reporting culture, and one environmental factor of nursing quality were found to be major predictors of safety practices. The other environment factors related to professional development and participation in hospital affairs and nurses' workload had limited predictive effects on the safety practices...
November 21, 2016: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/27868070/adaptation-and-feasibility-study-of-a-digital-health-program-to-prevent-diabetes-among-low-income-patients-results-from-a-partnership-between-a-digital-health-company-and-an-academic-research-team
#19
Valy Fontil, Kelly McDermott, Lina Tieu, Christina Rios, Eliza Gibson, Cynthia Castro Sweet, Mike Payne, Courtney R Lyles
Background. The feasibility of digital health programs to prevent and manage diabetes in low-income patients has not been adequately explored. Methods. Researchers collaborated with a digital health company to adapt a diabetes prevention program for low-income prediabetes patients at a large safety net clinic. We conducted focus groups to assess patient perspectives, revised lessons for improved readability and cultural relevance to low-income and Hispanic patients, conducted a feasibility study of the adapted program in English and Spanish speaking cohorts, and implemented real-time adaptations to the program for commercial use and for a larger trial of in multiple safety net clinics...
2016: Journal of Diabetes Research
https://www.readbyqxmd.com/read/27863436/chemotherapy-plus-dendritic-cells-co-cultured-with-cytokine-induced-killer-cells-versus-chemotherapy-alone-to-treat-advanced-non-small-cell-lung-cancer-a-meta-analysis
#20
Cuiling Zhou, Donglan Liu, Jie Li, Huanhuan Sun, Xiaobin Zheng, Shuncong Wang, Guobin Hong, Saradhi Mallampati, Hongliu Sun, Xiuling Zhou, Zhibin Cheng, Hongyu Zhang, Haiqing Ma
This study was aimed to investigate the efficacy and safety of the combination treatment of dendritic cells co-cultured with cytokine-induced killer cells and chemotherapy for patients with advanced non-small-cell lung cancer (NSCLC). Literatures were searched from the Cochrane Library Central, PubMed, Web of Science and EMBASE. The primary endpoint of interest was overall survival (OS), and secondary endpoints were disease control rate (DCR) and progression free survival (PFS). Finally 7 trials published between January 2005 and March 2016 met inclusion criteria and totally 610 patients were enrolled...
November 16, 2016: Oncotarget
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