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Inpatient guideline

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https://www.readbyqxmd.com/read/28209276/the-aahks-clinical-research-award-what-are-the-costs-of-knee-osteoarthritis-in-the-year-prior-to-total-knee-arthroplasty
#1
Nicholas A Bedard, Spencer B Dowdle, Christopher A Anthony, David E DeMik, Michael A McHugh, Kevin J Bozic, John J Callaghan
BACKGROUND: Despite American Academy of Orthopaedic Surgeons Clinical Practice Guidelines (CPGs) related to the non-arthroplasty management of osteoarthritis (OA) of the knee, non-recommended treatments remain in common use. We sought to determine the costs associated with non-arthroplasty management of knee OA in the year prior to total knee arthroplasty (TKA) and stratify them by CPG recommendation status. METHODS: The Humana database was reviewed from 2007 to 2015 for primary TKA patients...
January 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28205159/deficits-in-knowledge-attitude-and-practice-towards-blood-culture-sampling-results-of-a-nationwide-mixed-methods-study-among-inpatient-care-physicians-in-germany
#2
Heike Raupach-Rosin, Arne Duddeck, Maike Gehrlich, Charlotte Helmke, Johannes Huebner, Mathias W Pletz, Rafael Mikolajczyk, André Karch
PURPOSE: Blood culture (BC) sampling rates in Germany are considerably lower than recommended. Aim of our study was to assess knowledge, attitudes, and practice of physicians in Germany regarding BC diagnostics. METHODS: We conducted a cross-sectional mixed-methods study among physicians working in inpatient care in Germany. Based on the results of qualitative focus groups, a questionnaire-based quantitative study was conducted in 2015-2016. In total, 706 medical doctors and final-year medical students from 11 out of 16 federal states in Germany participated...
February 15, 2017: Infection
https://www.readbyqxmd.com/read/28193738/incidence-and-survival-after-in-hospital-cardiopulmonary-resuscitation-in-nonelderly-adults-us-experience-2007-to-2012
#3
Sagar Mallikethi-Reddy, Alexandros Briasoulis, Emmanuel Akintoye, Kavyashri Jagadeesh, Robert D Brook, Melvyn Rubenfire, Luis Afonso, Cindy L Grines
BACKGROUND: Survival trends after in-hospital cardiopulmonary resuscitation (ICPR) for cardiac arrest in nonelderly adults is not well known. Influence of cardiopulmonary resuscitation guidelines on nationwide survival after ICPR is yet to be well elucidated. METHODS AND RESULTS: We examined survival trends and factors associated with survival after ICPR in nonelderly adults aged 18 to 64 years, using Healthcare Utilization Project Nationwide Inpatient Sample Database from 2007 through 2012 in the United States...
February 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28192226/use-of-preventive-medication-in-patients-with-limited-life-expectancy-a-systematic-review
#4
REVIEW
Arjun Poudel, Patsy Yates, Debra Rowett, Lisa M Nissen
CONTEXT: Optimal prescribing in patients with limited life expectancy remains unclear. OBJECTIVES: This study systematically reviews the published literature regarding the use of preventive medication in patients with reduced life expectancy. METHODS: A systematic literature search was conducted using three databases (MEDLINE, EMBASE and CINAHL). Articles published in English from January 1995 to December 2015 were retrieved for analysis to identify peer-reviewed, observational studies assessing use of preventive medications in patients with limited life expectancy...
February 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28188399/-erratum-to-guideline-oriented-inpatient-psychiatric-psychotherapeutic-psychosomatic-treatment-of-anxiety-disorders-how-many-personnel-are-need
#5
B Bandelow, U Lueken, J Wolff, F Godemann, C Wolff-Menzler, J Deckert, A Ströhle, M Beutel, J Wiltink, K Domschke, M Berger
No abstract text is available yet for this article.
February 10, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28188268/design-and-rationale-of-a-randomized-trial-of-a-care-transition-strategy-in-patients-with-acute-heart-failure-discharged-from-the-emergency-department-guided-hf-get-with-the-guidelines-in-emergency-department-patients-with-heart-failure
#6
Gregory J Fermann, Phillip D Levy, Peter Pang, Javed Butler, S Imran Ayaz, Douglas Char, Patrick Dunn, Cathy A Jenkins, Christy Kampe, Yosef Khan, Vijaya A Kumar, JoAnn Lindenfeld, Dandan Liu, Karen Miller, W Frank Peacock, Samaa Rizk, Chad Robichaux, Russell L Rothman, Jon Schrock, Adam Singer, Sarah A Sterling, Alan B Storrow, Cheryl Walsh, John Wilburn, Sean P Collins
: GUIDED-HF (Get With the Guidelines in Emergency Department Patients With Heart Failure) is a multicenter randomized trial of a patient-centered transitional care intervention in patients with acute heart failure (AHF) who are discharged either directly from the emergency department (ED) or after a brief period of ED-based observation. To optimize care and reduce ED and hospital revisits, there has been significant emphasis on improving transitions at the time of hospital discharge for patients with HF...
February 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28182155/clinical-audit-of-copd-in-outpatient-respiratory-clinics-in-spain-the-epoconsul-study
#7
Myriam Calle Rubio, Bernardino Alcázar Navarrete, Joan B Soriano, Juan J Soler-Cataluña, José Miguel Rodríguez González-Moro, Manuel E Fuentes Ferrer, José Luis López-Campos
BACKGROUND: Chronic obstructive pulmonary disease (COPD) outpatients account for a large burden of usual care by respirologists. EPOCONSUL is the first national clinical audit conducted in Spain on the medical care for COPD patients delivered in outpatient respiratory clinics. We aimed to evaluate the clinical interventions and the degree of adherence to recommendations in outpatients of current COPD clinical practice guidelines. METHODOLOGY: This is an observational study with prospective recruitment (May 2014-May 2015) of patients with a COPD diagnosis as seen in outpatient respiratory clinics...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28174033/acute-hypotonia-in-an-infant
#8
Jimme Sierakowski, Jason Arthur, Todd Wylie
BACKGROUND: Acute flaccid myelitis (AFM) is increasing in incidence in the United States and presenting to emergency departments (EDs) across the country. This clinical entity presents as acute paralysis, with magnetic resonance imaging changes in the gray matter only in children younger than 21 years of age. The etiology is unknown, although preceding viral illnesses are common. There are no consensus guidelines regarding treatment. CASE REPORT: A 4-month-old girl presented with decreased bilateral arm movement...
February 4, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28173888/current-state-of-antimicrobial-stewardship-in-children-s-hospital-emergency-departments
#9
Rakesh D Mistry, Jason G Newland, Jeffrey S Gerber, Adam L Hersh, Larissa May, Sarah M Perman, Nathan Kuppermann, Peter S Dayan
BACKGROUND Antimicrobial stewardship programs (ASPs) effectively optimize antibiotic use for inpatients; however, the extent of emergency department (ED) involvement in ASPs has not been described. OBJECTIVE To determine current ED involvement in children's hospital ASPs and to assess beliefs and preferred methods of implementation for ED-based ASPs. METHODS A cross-sectional survey of 37 children's hospitals participating in the Sharing Antimicrobial Resistance Practices collaboration was conducted. Surveys were distributed to ASP leaders and ED medical directors at each institution...
February 8, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28173823/effectiveness-of-a-clinical-practice-change-intervention-in-increasing-the-provision-of-nicotine-dependence-treatment-in-inpatient-psychiatric-facilities-an-implementation-trial
#10
Paula M Wye, Emily A Stockings, Jenny A Bowman, Chris Oldmeadow, John H Wiggers
BACKGROUND: Despite clinical practice guidelines recommending the routine provision of nicotine dependence treatment to smokers in inpatient psychiatric facilities, the prevalence of such treatment provision is low. The aim of this study was to examine the effectiveness of a clinical practice change intervention in increasing clinician recorded provision of nicotine dependence treatment to patients in inpatient psychiatric facilities. METHODS: We undertook an interrupted time series analysis of nicotine dependence treatment provision before, during and after a clinical practice change intervention to increase clinician recorded provision of nicotine dependence treatment for all hospital discharges (aged >18 years, N = 4175) over a 19 month period in two inpatient adult psychiatric facilities in New South Wales, Australia...
February 7, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28168967/-patient-s-own-medications-in-a-swiss-regional-hospital-where-are-we-and-where-should-we-go
#11
O Michel, J Beney, P Turini, M Desmedt, L Roulet
OBJECTIVE: The use of patient's own medications (POMs) during inpatient admissions may represent a risk if not adequately supervised. The objective of this work was: (i) to assess the management of POMs in our hospital, and (ii) to identify actions to assure this practice. METHODS: A questionnaire survey was conducted among caregivers of the medical, surgery and geriatric units of a Swiss regional hospital. Six criteria for appropriate management of POMs were identified from the literature and internal consensus...
February 3, 2017: Annales Pharmaceutiques Françaises
https://www.readbyqxmd.com/read/28167005/acute-care-revisits-after-adenotonsillectomy-in-a-pediatric-medicaid-population-in-ohio
#12
Dmitry Tumin, Hina Walia, Vidya T Raman, Joseph D Tobias
INTRODUCTION: Guidelines for inpatient admission after pediatric tonsillectomy have been proposed to improve the safety of this procedure. This study examined the association between performing adenotonsillectomy in an inpatient setting and acute care revisits within 30 days among children enrolled in a Medicaid Accountable Care Organization in Ohio. METHODS: The Accountable Care Organization's claims database was queried for adenotonsillectomies performed in children ages 0-18 years in 2008-2014...
March 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28166598/scoring-systems-for-estimating-risk-of-venous-thromboembolism-in-hospitalized-medical-patients
#13
Sofia Barbar, Paolo Prandoni
Deep vein thrombosis and pulmonary embolism are associated with considerable morbidity and mortality in hospitalized patients, accounting for up to 10% of hospitalization-related deaths in both surgical and medical patients. Pharmacologic thromboprophylaxis has been demonstrated to be effective, safe, and cost-effective in preventing hospital-acquired venous thromboembolism (VTE) among medical inpatients, and clinician awareness of thrombotic risk promotes prescription of thromboprophylaxis. Guidelines recommend stratification of thrombotic risk for all patients and, unless contraindicated, administration of VTE prophylaxis...
February 6, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28164359/off-label-drug-use-in-oncology-a-systematic-review-of-literature
#14
REVIEW
M M Saiyed, P S Ong, L Chew
WHAT IS KNOWN AND OBJECTIVE: The off-label use of medicines is widespread in several diseases. This type of prescribing practice is particularly more acute in oncology. However, the suitability of anticancer medications for off-label use remains an issue of controversy, due to uncertainty around the clinical benefits and potential toxicities, limited evidence to support clinical decision-making, increased out-of-pocket costs for patients and ethical concerns around the lack of informed consent...
February 5, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28156571/disparities-in-the-availability-of-and-access-to-antiemetics-recommended-by-the-international-antiemetic-guidelines-in-serbia-japan-and-nepal
#15
Ana Zilic, Bishal Gyawali
: 117 Background: Guideline-consistent antiemetic therapy requires 4 classes of antiemetics (AEs) to be available and accessible for the optimal prevention of chemotherapy induced nausea and vomiting (CINV): serotonin3 receptor antagonists (5HT3RAs), neurokinin 1 receptor antagonists (NK1RAs), dopamine receptor antagonists (DOPRAs) and dexamethasone. To evaluate disparities in the availability and accessibility of AEs recommended by the international antiemetic guidelines for the prevention of CINV inpatients treated in governmental hospitals in Nepal (low), Serbia (upper-middle) and Japan (high-income)...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28153020/what-do-we-think-we-are-doing-how-might-a-clinical-information-network-be-promoting-implementation-of-recommended-paediatric-care-practices-in-kenyan-hospitals
#16
Mike English, Philip Ayieko, Rachel Nyamai, Fred Were, David Githanga, Grace Irimu
BACKGROUND: The creation of a clinical network was proposed as a means to promote implementation of a set of recommended clinical practices targeting inpatient paediatric care in Kenya. The rationale for selecting a network as a strategy has been previously described. Here, we aim to describe network activities actually conducted over its first 2.5 years, deconstruct its implementation into specific components and provide our 'insider' interpretation of how the network is functioning as an intervention...
February 2, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/28152733/trends-in-cancer-care-with-the-affordable-care-act
#17
Robert Clell Miller
: 46 Background: Accountable Care Organizations (ACO), as proposed by the Affordable Care Act, will change the delivery of health care in the United States. ACO serve as a network of providers with primary care providers (PCP) set up as gate-keepers for referrals to specialists. Within the next several years, many trends will emerge and drive progress of change, requiring oncologist to take a lead role to adapt to the evolving landscape of health care. METHODS: Literature search of internet-based and academic sources for oncology and the Affordable Care, with a focus on ACO formation...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152727/a-prospective-study-of-an-inpatient-febrile-neutropenia-clinical-practice-guideline-in-oncology-patients
#18
Tanya Thomas, Joshua Reuss, Gina Degennaro, Elizabeth Daniels, Jin Li, Mark Smolkin, Michael Kenneth Keng
: 114 Background: Febrile neutropenia (FN) is a common complication in oncology patients and is associated with significant morbidity and mortality if untreated. Because of this, it is regarded as a medical emergency. FN treatment guidelines universally recommend the prompt initiation ( < 60 minutes) of intravenous antibiotic therapy. We hypothesized that a quality initiative project creating a new FN clinical practice guideline (CPG) would reduce the time to antibiotic administration (TTA) for inpatient oncology patients with FN...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152703/clinical-pathways-an-emerging-tool-for-quality-improvement
#19
Francesca Pirog
: 222 Background: Clinical pathways have emerged as a tool for payers to encourage provider adherence to evidence-based care. Avalere sought to understand how oncology pathways are incorporated into broader organizational quality improvement initiatives and what impact they have on care quality. METHODS: Avalere conducted white and grey literature searches to assess pathways used in quality improvement initiatives. The research was augmented by interviews with leading pathways organizations...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152702/improving-the-treatment-of-patients-with-low-risk-neutropenic-fever-a-quality-improvement-project-at-the-cleveland-clinic-taussig-cancer-institute-tci
#20
Jessica Lau, Erika M Gallagher, Machelle Moeller, Carolyn Best, James Stevenson
: 101 Background: NF is an oncologic emergency and has historically resulted in inpatient (inpt) management. The Multinational Association for Supportive Care in Cancer (MASCC) score can be used to identify NF pts at LR for complications who can be safely managed in the outpatient (outpt) setting. Despite established guidelines supporting outpt management of LRNF, provider awareness is low and inpt admission for intravenous antibiotics (abx) continues to be standard of care. METHODS: A multidisciplinary team performed a QI project to improve management of LRNF (baseline cohort of LRNF pts treated from Jan - Mar 2014, N = 13)...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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