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https://www.readbyqxmd.com/read/28330452/a-structure-process-and-outcome-evaluation-of-the-geriatric-emergency-department-intervention-model-of-care-a-study-protocol
#1
Elizabeth Marsden, Andrea Taylor, Marianne Wallis, Alison Craswell, Marc Broadbent, Adrian Barnett, Kim-Huong Nguyen, Julia Crilly, Colleen Johnston, Amanda Glenwright
BACKGROUND: Emergency departments are chaotic environments in which complex, frail older persons living in the community and residential aged care facilities are sometimes subjected to prolonged emergency department lengths of stay, excessive tests and iatrogenic complications. Given the ageing population, the importance of providing appropriate, quality health care in the emergency department for this cohort is paramount. One possible solution, a nurse-led, physician-championed, emergency department gerontological intervention team, which provides frontload assessment, early collateral communication and appropriate discharge planning, has been developed...
March 23, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28293996/effective-pain-management-in-patients-in-hospital
#2
Candy McCabe
Chronic pain is experienced by between one third and one half of the UK population. Nurses should ensure that patients' pain is assessed and managed when they present to hospital, including pre-existing chronic pain and acute pain as a result of trauma or surgical interventions. Acute pain that is inadequately managed may result in chronic pain, impeding the patient's return to normal function and daily activities. Depression and increasing age affect the likelihood of patients experiencing chronic pain. Nurses should be familiar with the pain assessment tools available for use with older people and be aware of the potential issues of polypharmacy and altered sensitivity to medication in older people...
March 15, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28284593/nurse-titrated-analgesia-and-sedation-in-intensive-care-increases-the-frequency-of-comfort-assessment-and-reduces-midazolam-use-in-paediatric-patients-following-cardiac-surgery
#3
Grace E Larson, Stephen McKeever
BACKGROUND: Pain and sedation protocols are suggested to improve the outcomes of patients within paediatric intensive care. However, it is not clear how protocols will influence practice within individual units. OBJECTIVES: Evaluate a nurse led pain and sedation protocols impact on pain scoring and analgesic and sedative administration for post-operative cardiac patients within a paediatric intensive care unit. METHODS: A retrospective chart review was performed on 100 patients admitted to a tertiary paediatric intensive care unit pre and post introduction of an analgesic and sedative protocol...
March 8, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28238674/experiences-and-effects-of-structurally-involving-residents-in-the-nursing-home-by-means-of-participatory-action-research-a-mixed-method-study
#4
Lien Van Malderen, Patricia De Vriendt, Tony Mets, Dominique Verté, Ellen Gorus
OBJECTIVES: This study aimed to examine the effects of introducing participatory action research (PAR) within the nursing home (NH) on residents' quality of life (QoL) and NH experience and participation, and to explore their experiences with PAR. DESIGN: A mixed methods design was chosen, including a clustered randomized controlled trial (RCT) and qualitative interviews. SETTING: For the RCT, 3 NHs were randomly allocated to 3 conditions: an intervention (weekly PAR activity), an active control (weekly reminiscence-activity), or passive control (care as usual)...
February 23, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28237735/emergency-medical-dispatch-priority-in-chest-pain-patients-due-to-life-threatening-conditions-a-cohort-study-examining-circadian-variations-and-impact-of-the-education
#5
Araz Rawshani, Nina Rawshani, Carita Gelang, Jan-Otto Andersson, Anna Larsson, Angela Bång, Johan Herlitz, Martin Gellerstedt
BACKGROUND AND AIMS: We examined the accuracy in assessments of emergency dispatchers according to their education and time of the day. We examined this in chest pain patients who were diagnosed with a potentially life-threatening condition (LTC) or died within 30days. METHODS: Among 2205 persons, 482 died, 1631 experienced an acute coronary syndrome (ACS), 1914 had a LTC. Multivariable logistic regression was used to study how time of the call and the dispatcher's education were associated with the risk of missing to give priority 1 (the highest)...
February 16, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28222751/planning-to-be-routine-habit-as-a-mediator-of-the-planning-behaviour-relationship-in-healthcare-professionals
#6
Sebastian Potthoff, Justin Presseau, Falko F Sniehotta, Marie Johnston, Marko Elovainio, Leah Avery
BACKGROUND: Gaps in the quality of care provided to people with type 2 diabetes are regularly identified. Healthcare professionals often have a strong intention to follow practice guidelines during consultations with people with type 2 diabetes; however, this intention does not always translate into action. Action planning (planning when, where and how to act) and coping planning (planning how to overcome pre-identified barriers) have been hypothesised to help with the enactment of intentions by creating mental cue-response links that promote habit formation...
February 21, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28214194/orthogeriatric-activity-in-a-general-hospital-of-castilla-la-mancha-spain
#7
J M Fernández-Ibáñez, M C Morales-Ballesteros, E Crespo-Romero, S Gómez-Gómez, M D Fraga-Fuentes, J Cruz-Tejado, P A Hernández-Zegarra, Á Arias-Arias, M M García-Baltasar
AIM: To describe the orthogeriatric activity in the elderly with hip fractures in the Hospital Mancha Centro, based on the recommendations of the main guidelines. MATERIAL AND METHOD: Observational prospective study, comprising all patients over 65 years of age admitted to the Traumatology Unit with a hip fracture between April 2015 and December 2015. Patients were admitted under the care of the Traumatology Unit with cross-consultation carried out with the Geriatrics Department, which then carried out a pre-operative geriatric assessment and the post-operative follow-ups...
February 14, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28191498/a-prospective-study-of-patient-safety-incidents-in-gastrointestinal-endoscopy
#8
Manmeet Matharoo, Adam Haycock, Nick Sevdalis, Siwan Thomas-Gibson
Background and study aims Medical error occurs frequently with significant morbidity and mortality. This study aime to assess the frequency and type of endoscopy patient safety incidents (PSIs). Patients and methods A prospective observational study of PSIs in routine diagnostic and therapeutic endoscopy was undertaken in a secondary and tertiary care center. Observations were undertaken within the endoscopy suite across pre-procedure, intra-procedure and post-procedure phases of care. Experienced (Consultant-level) and trainee endoscopists from medical, surgical, and nursing specialities were included...
January 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28163786/changes-in-safety-climate-and-teamwork-in-the-operating-room-after-implementation-of-a-revised-who-checklist-a-prospective-interventional-study
#9
Sofia Erestam, Eva Haglind, David Bock, Annette Erichsen Andersson, Eva Angenete
BACKGROUND: Inter-professional teamwork in the operating room is important for patient safety. The World Health Organization (WHO) checklist was introduced to improve intraoperative teamwork. The aim of this study was to evaluate the safety climate in a Swedish operating room setting before and after an intervention, using a revised version of the WHO checklist to improve teamwork. METHODS: This study is a single center prospective interventional study. Participants were personnel working in operating room teams including surgeons, anesthesiologists, scrub nurses, nurse anaesthetists and nurse assistants...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28152685/optimizing-discharge-teaching-process-to-increase-the-efficiency-and-effectiveness-of-the-follow-up-call
#10
Gina Aranzamendez, Beverly A Hayes, Kavita Pathak, Duke Rohe, Valerie Haywood
226 Background: Patients undergoing complex oncologic operations are at high risk for perioperative complications associated with adverse effects on quality of life, costs and overall outcomes. Complications within 30 days of discharge are most commonly identified during first 48-72 hours post-discharge. Telephone follow-up can provide a safety net and is part of a larger discharge teaching process. Initial review of the current follow up processes underscored many variations. An interdisciplinary team was tasked to optimize discharge processes across the continuum of care which leads to a more efficient follow-up call encounter...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28135658/an-exploration-of-australian-psychologists-role-in-assessing-women-considering-risk-reducing-or-contralateral-prophylactic-mastectomy
#11
Lucy Braude, Rebekah Laidsaar-Powell, Jemma Gilchrist, Laura Kirsten, Ilona Juraskova
OBJECTIVES: Given increasing rates of risk-reducing mastectomies (RRM) and contralateral prophylactic mastectomies (CPM), and the potentially significant psychological sequelae of this irreversible procedure, health professionals (HPs) regularly refer patients to psychologists for pre-operative assessment and support. This is the first study to provide qualitative insights from HPs into the role of psychologists who are working with women considering RRM or CPM. MATERIALS AND METHODS: 24 HPs (psychologists, surgeons, breast care nurses and genetic counsellors) experienced in treating patients before or after RRM/CPM completed semi-structured interviews (n = 15) or participated in a focus group (n = 10)...
April 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28131545/comparative-analysis-implementation-of-a-pre-operative-educational-intervention-to-decrease-anxiety-among-parents-of-children-with-congenital-heart-disease
#12
Silvio Simeone, Gianluca Pucciarelli, Marco Perrone, Teresa Rea, Gianpaolo Gargiulo, Grazia Dell'Angelo, Assunta Guillari, Giuseppe Comentale, Gaetano Palma, Carlo Vosa
PURPOSE: The present study evaluated the efficacy of a nursing educational intervention in alleviating the level of parental anxiety in the parents of children who required heart surgery for the first time. DESIGN AND METHODS: A comparative study was used to explore the parents of children who had to undergo cardiac surgery. Parents of children were randomized into 2 groups: 1) control group and 2) experimental group or parents that received the educational intervention about PICU stay...
January 25, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28125964/effect-of-admission-fascia-iliaca-compartment-blocks-on-post-operative-abbreviated-mental-test-scores-in-elderly-fractured-neck-of-femur-patients-a-retrospective-cohort-study
#13
Peter M Odor, Irina Chis Ster, Iain Wilkinson, Frederic Sage
BACKGROUND: Post-operative cognitive impairment is common in elderly patients following surgery for hip fracture, with undertreated pain being an important etiological factor. Non-opioid based analgesic techniques, such as nerve blocks, may help reduce the risk of cognitive complications. The aim of this study was to investigate whether receiving a fascia iliaca compartment block (FICB) as part of a pre-operative analgesic regime increased the odds of high post-operative abbreviated mental test scores (AMTS) when compared with conventional analgesia without a nerve block...
January 5, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28116797/a-multidisciplinary-infection-control-bundle-to-reduce-the-number-of-spinal-cord-stimulator-infections
#14
Erlangga Yusuf, Sven Bamps, Bénédicte Thüer, Jan Mattheussen, Jean-Paul Ursi, Elke Del Biondo, Kris de Smedt, Raf Van Paesschen, Dirk Berghmans, Kaat Hofkens, Jef Van Schaeren, Tony van Havenbergh, Bruno Van Herendael
OBJECTIVE: To investigate the effect of a quality improvement project that resulted in an infection control bundle to reduce the number of spinal cord stimulator (SCS) infections. MATERIALS AND METHODS: The study was performed in a single center for neuromodulation from January 1, 2014, through May 31, 2016. In response to a high number of surgical site infections (SSIs) after SCS surgery, a multidisciplinary team analyzed the surgical process and developed an infection prevention bundle consisting of five items: 1) showering and decolonization for five days prior to surgery and showering in the hospital on the morning of surgery; 2) performing the SCS implantation as the first in the daily operating room (OR) program; 3) maintaining a minimal number of people in the OR; 4) providing home care nurses with a folder with SCS wound care instructions including pictures; 5) giving oral specific wound care instructions to patients...
January 24, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28115491/development-and-external-validation-of-a-nomogram-and-online-tool-to-predict-bowel-dysfunction-following-restorative-rectal-cancer-resection-the-polars-score
#15
Nick J Battersby, George Bouliotis, Katrine J Emmertsen, Therese Juul, Rob Glynne-Jones, Graham Branagan, Peter Christensen, Søren Laurberg, Brendan J Moran
OBJECTIVE: Bowel dysfunction is common following a restorative rectal cancer resection, but symptom severity and the degree of quality of life impairment is highly variable. An internationally validated patient-reported outcome measure, Low Anterior Resection Syndrome (LARS) score, now enables these symptoms to be measured. The study purpose was: (1) to develop a model that predicts postoperative bowel function; (2) externally validate the model and (3) incorporate these findings into a nomogram and online tool in order to individualise patient counselling and aid preoperative consent...
January 23, 2017: Gut
https://www.readbyqxmd.com/read/28062529/a-mixed-reality-simulator-concept-for-future-medical-emergency-response-team-training
#16
Robert J Stone, R Guest, P Mahoney, D Lamb, C Gibson
The UK Defence Medical Service's Pre-Hospital Emergency Care (PHEC) capability includes rapid-deployment Medical Emergency Response Teams (MERTs) comprising tri-service trauma consultants, paramedics and specialised nurses, all of whom are qualified to administer emergency care under extreme conditions to improve the survival prospects of combat casualties. The pre-deployment training of MERT personnel is designed to foster individual knowledge, skills and abilities in PHEC and in small team performance and cohesion in 'mission-specific' contexts...
January 6, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28027419/a-retrospective-cohort-study-of-the-influence-of-lifestyle-factors-on-survival-of-patients-undergoing-surgery-for-colorectal-cancer
#17
Dayna Alexander, Gwen M Allardice, Susan J Moug, David S Morrison
AIM: Several modifiable and non-modifiable health related behaviours are associated with the incidence of Colorectal Cancer (CRC), but there is little research on their association with survival. The project aimed to investigate possible relationships between modifiable behavioural factors and outcomes on a study cohort of CRC patients undergoing potentially curative surgery. METHOD: A retrospective cohort study was carried out of patients diagnosed with non-metastatic CRC undergoing elective curative surgery (January 2011 - December 2012), residing in the NHS Greater Glasgow & Clyde (NHSGGC) area, UK...
December 27, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/27915314/programs-for-detecting-and-treating-retinopathy-of-prematurity-role-of-the-neonatal-team
#18
Sudhanshu Grover, Deeksha Katoch, Mangat R Dogra, Praveen Kumar
High quality perinatal-neonatal care can prevent severe Retinopathy of Prematurity (ROP) in most cases. Preterm infants who do develop retinopathy can also have good visual outcomes if screening and treatment are done timely. National Neonatology Forum published clinical practice guidelines for timely screening and treatment of ROP in neonatal care units in the country in 2010. It is also listed as one of the condition under Rashtriya Bal Swasthya Karyakram for early identification and early intervention, and is currently a focus area under the National Program for Control of Blindness...
November 7, 2016: Indian Pediatrics
https://www.readbyqxmd.com/read/27897432/low-skeletal-muscle-radiation-attenuation-and-visceral-adiposity-are-associated-with-overall-survival-and-surgical-site-infections-in-patients-with-pancreatic-cancer
#19
David P J van Dijk, Maikel J A M Bakens, Mariëlle M E Coolsen, Sander S Rensen, Ronald M van Dam, Martijn J L Bours, Matty P Weijenberg, Cornelis H C Dejong, Steven W M Olde Damink
BACKGROUND: Cancer cachexia and skeletal muscle wasting are related to poor survival. In this study, quantitative body composition measurements using computed tomography (CT) were investigated in relation to survival, post-operative complications, and surgical site infections in surgical patients with cancer of the head of the pancreas. METHODS: A prospective cohort of 199 patients with cancer of the head of the pancreas was analysed by CT imaging at the L3 level to determine (i) muscle radiation attenuation (average Hounsfield units of total L3 skeletal muscle); (ii) visceral adipose tissue area; (iii) subcutaneous adipose tissue area; (iv) intermuscular adipose tissue area; and (v) skeletal muscle area...
October 26, 2016: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/27888199/risk-factors-for-decreased-cardiac-output-after-coronary-artery-bypass-grafting-a-prospective-cohort-study
#20
Eduarda Ribeiro Dos Santos, Camila Takao Lopes, Vera Lucia Regina Maria, Alba Lucia Bottura Leite de Barros
BACKGROUND: No previous study has investigated the predictive risk factors of the nursing diagnosis of risk for decreased cardiac output after coronary artery bypass grafting (CABG). AIMS: This study aimed to identify the predictive risk factors of the nursing diagnosis of risk for decreased cardiac output after CABG. METHODS: This was a prospective cohort study performed at a cardiac university hospital in São Paulo, Brazil and 257 adult patients undergoing CABG were included...
November 25, 2016: European Journal of Cardiovascular Nursing
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