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medical rounds

Sara L Ackerman, Gato Gourley, Gem Le, Pamela Williams, Jinoos Yazdany, Urmimala Sarkar
OBJECTIVE: The aim of the study was to develop standards for tracking patient safety gaps in ambulatory care in safety net health systems. METHODS: Leaders from five California safety net health systems were invited to participate in a modified Delphi process sponsored by the Safety Promotion Action Research and Knowledge Network (SPARKNet) and the California Safety Net Institute in 2016. During each of the three Delphi rounds, the feasibility and validity of 13 proposed patient safety measures were discussed and prioritized...
March 14, 2018: Journal of Patient Safety
Jijun Xu, Christopher Herndon, Samantha Anderson, Philip Getson, Victor Foorsov, Peter Moskovitz, R Norm Harden
Objective: To find and reach a consensus on the usage of ketamine in the treatment of complex regional pain syndrome and to determine a reference protocol for future studies. Design: Three hundred fifty-one medical professionals participated in our survey on practice procedures, with 104 respondents providing information on their usage of ketamine for treating the pain associated with complex regional pain syndrome. Respondents answered questions about inpatient treatment, outpatient treatment, children vs adults, safety, and basic demographic information...
March 9, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Pierre Antoine Brown, Swapnil Hiremath, Edward G Clark, Edmund S H Kwok, Christopher McCudden, Ayub Akbari
BACKGROUND: Morbidity and Mortality Conferences (M&MCs) have for generations been part of the education of physicians, yet their effectiveness remains questionable. The Ottawa M&M Model (OM3) was developed to provide a structured approach to M&MCs in order to maximize the quality improvement impact of such rounds. STUDY DESIGN: We conducted a retrospective assessment of the impact of implementing nephrology-specific M&MCs using the OM3. SETTING AND PARTICIPANTS: All physicians, residents and fellows from the division of nephrology at a large academic medical center were invited to participate...
March 12, 2018: International Urology and Nephrology
Driss Berdaï, Florence Thomas-Delecourt, Karine Szwarcensztein
Early market access of health products is associated with a larger number of requests for information by the health authorities. Compared with these expectations, the growing expansion of health databases represents an opportunity for responding to questions raised by the authorities. The computerised nature of the health system provides numerous sources of data, and first and foremost medical/administrative databases such as the French National Inter-Scheme Health Insurance Information System (SNIIRAM) database...
December 30, 2017: Thérapie
Rebekah Laidsaar-Powell, Phyllis Butow, Frances Boyle, Ilona Juraskova
OBJECTIVE: Family caregivers regularly attend medical consultations and are often involved in decision-making; however, there are few practical strategies to guide effective communication for the clinician-patient-family trio. We aimed to develop and evaluate the first comprehensive guidelines for oncology physicians and nurses, on how to positively and effectively involve family caregivers of adult patients in consultations and patient care (TRIO Guidelines-1) and how to manage challenging interactions with family caregivers (TRIO Guidelines-2)...
January 31, 2018: Patient Education and Counseling
Rebekah Laidsaar-Powell, Phyllis Butow, Frances Boyle, Ilona Juraskova
OBJECTIVE: Family caregivers can, at times, add complexity to clinical encounters. Difficult family caregivers and dynamics may: derail consultation communication, reduce patient autonomy, and compromise effective clinical care. A paucity of practical strategies guiding effective clinician-family communication exists. This study aimed to develop and evaluate the first comprehensive, evidence-based guidelines (the TRIO guidelines) for oncology physicians and nurses to better manage several complex/challenging situations involving family members...
February 2, 2018: Patient Education and Counseling
Jonathan S Wald, Saira N Haque, Stephanie Rizk, Jennifer R Webb, Stephen Brown, Shellery Ebron, Christoph U Lehmann, Mark Frisse, Vanessa A Shorte, Edwin A Lomotan, Barbara A Dailey, Kevin B Johnson
Electronic health record (EHR) use throughout the United States has advanced considerably, but functionality to support the optimal care of children has been slower to develop and deploy. A previous team of experts systematically identified gaps in EHR functionality during collaborative work from 2010 to 2013 that produced the Children's EHR Format (Format), funded under the Children's Health Insurance Program Reauthorization Act of 2009, Public Law 111-3. After that, a team of practitioners, software developers, health policy leaders, and other stakeholders examined the Format's exhaustive list of 547 EHR functional requirements in 26 topic areas and found them to be valuable but in need of further refinement and prioritization...
March 8, 2018: Pediatrics
Jennifer O'Rourke, Joanna Abraham, Lee Ann Riesenberg, Jeff Matson, Karen Dunn Lopez
AIM: To identify the core components of nurse-nurse handoffs. BACKGROUND: Patient handoffs involve a process of passing information, responsibility and control from one caregiver to the next during care transitions. Around the globe, ineffective handoffs have serious consequences resulting in wrong treatments, delays in diagnosis, longer stays, medication errors, patient falls and patient deaths. To date, the core components of nurse-nurse handoff have not been identified...
March 8, 2018: Journal of Advanced Nursing
Nienke Elske Dijkstra, Carolina Geertruida Maria Sino, Eibert Rob Heerdink, Marieke Joanna Schuurmans
BACKGROUND: Home care patients often use many medications and are prone to drug-related problems (DRPs). For the management of problems related to drug use, home care could add to the multidisciplinary expertise of general practitioners (GPs) and pharmacists. The home care observation of medication-related problems by home care employees (HOME)-instrument is paper-based and assists home care workers in reporting potential DRPs. To facilitate the multiprofessional consultation, a digital report of DRPs from the HOME-instrument and digital monitoring and consulting of DRPs between home care and general practices and pharmacies is desired...
March 7, 2018: JMIR Human Factors
Yuewei Wu-Fienberg, Mary K Henzel, Mary Ann Richmond, Devra B Becker
CONTEXT/OBJECTIVE: Multiple medical specialties are often involved in the management of patients with both spinal cord injuries (SCI) and pressure injuries (PIs), sometimes leading to inadequate communication. Our Veterans Affairs (VA) hospital has an interdisciplinary team for PI patients in the SCI unit. This team conducts monthly bedside rounds and journal clubs; there is no similar team for patients with PIs outside the SCI unit. This pilot study aims to determine whether such an interdisciplinary team improves care coordination among practitioners...
March 6, 2018: Journal of Spinal Cord Medicine
Emil Ter Veer, L Bengt van Rijssen, Marc G Besselink, Rosa M A Mali, Jordan D Berlin, Stefan Boeck, Franck Bonnetain, Ian Chau, Thierry Conroy, Eric Van Cutsem, Gael Deplanque, Helmut Friess, Bengt Glimelius, David Goldstein, Richard Herrmann, Roberto Labianca, Jean-Luc Van Laethem, Teresa Macarulla, Jonathan H M van der Meer, John P Neoptolemos, Takuji Okusaka, Eileen M O'Reilly, Uwe Pelzer, Philip A Philip, Marcel J van der Poel, Michele Reni, Werner Scheithauer, Jens T Siveke, Chris Verslype, Olivier R Busch, Johanna W Wilmink, Martijn G H van Oijen, Hanneke W M van Laarhoven
Variations in the reporting of potentially confounding variables in studies investigating systemic treatments for unresectable pancreatic cancer pose challenges in drawing accurate comparisons between findings. In this Review, we establish the first international consensus on mandatory baseline and prognostic characteristics in future trials for the treatment of unresectable pancreatic cancer. We did a systematic literature search to find phase 3 trials investigating first-line systemic treatment for locally advanced or metastatic pancreatic cancer to identify baseline characteristics and prognostic variables...
March 2018: Lancet Oncology
Xiaohong Li, Wenchao Li, Wuning Mo, Zheng Yang
RATIONALE: Both acute lymphoblastic leukemia (ALL) and Ewing sarcoma (ES) are small round cell tumors, and it is difficult to differential diagnose them because of overlapping clinical, radiographic, histologic, and immunophenotypic features. PATIENT'S CONCERNS: A 5-year-old boy was admitted to our hospital because of pains in his left leg without obvious inducement and lameness worsening with walking over a two 2-month period. DIAGNOSES: Based on the comprehensive analysis of radiography, magnetic resonance imaging (MRI), pathology biopsy and immunohistochemistry, the lesion was confirmed to be ES...
January 2018: Medicine (Baltimore)
Takao Orii
 In the collaboration between community pharmacies and hospitals or clinics, the use of electronic medicine notebook may allow information sharing, including among out-of-network hospitals, clinics, and community pharmacies. For risk minimization, mobile or smart phones, which patients always carry with them, should be used as a tool allowing drug information to be accessed at any time. An advantage of the electronic conversion of patient drug information is that it allows patients not only to obtain round-the-clock information on drugs, etc...
2018: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
Umair Masood, Anuj Sharma, Zabeer Bhatti, Jessica Carroll, Amit Bhardwaj, Devamohan Sivalingam, Amit S Dhamoon
Stress ulcer prophylaxis (SUP) is often inappropriately utilized, particularly in critically ill patients. The objective of this study is to find an effective way of reducing inappropriate SUP use in an academic medical intensive care unit (ICU). Medical ICU patients receiving SUP were identified over a 1-month period, and their charts were reviewed to determine whether American Society of Health-System Pharmacists guidelines were followed. Inappropriate usage was calculated as inappropriate patient-days and converted to incidence per 100 patient-days...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
Gaby Danan, Rolf Teschke
Launched in 1993 and partially based on the results of an international consensus meeting organized under the auspices of the Council of International Organizations of Medical Sciences (CIOMS), the Roussel Uclaf Causality Assessment Method (RUCAM) is the most used causality assessment tool worldwide for the diagnosis of drug-induced liver injury (DILI) and herb-induced liver injury (HILI) in a large number of epidemiological studies, case reports, and case series. The 25-year experience of RUCAM use confirmed that the success was due to its objective, standardized, and liver-injury-specific approach structured with defined key elements derived from a series of DILI cases with positive rechallenge...
March 3, 2018: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
Lindsay H Dewa, Kevin Murray, Bethan Thibaut, Sonny Christian Ramtale, Sheila Adam, Ara Darzi, Stephanie Archer
OBJECTIVE: Physical healthcare has dominated the patient safety field; research in mental healthcare is not as extensive but findings from physical healthcare cannot be applied to mental healthcare because it delivers specialised care that faces unique challenges. Therefore, a clearer focus and recognition of patient safety in mental health as a distinct research area is still needed. The study aim is to identify future research priorities in the field of patient safety in mental health...
March 3, 2018: BMJ Open
Noelia Vicente Oliveros, Covadonga Pérez Menéndez Conde, Ana María Álvarez Díaz, Teresa Bermejo Vicedo, Sagrario Martín-Aragón Álvarez, Beatriz Montero Errasquín, José Luis Calleja López, María Angeles Gálvez Múgica, Gema Nieto Gómez, Gemma García Menéndez, Sonia Chamarro Rubio, Eva Delgado Silveira
OBJECTIVE: The aim of this study was to stratify medications used in hospital  care according to their potential risk. METHOD: The RAND/UCLA Appropriateness Method was used. Anatomical Therapeutic Chemical subgroups were classified according to their potential risk. A literature search, bulletins, and alerts issued by patient safety organizations were used to identify the potential safety risk of  these subgroups. Nine experts in patient/medication safety were selected to score the subgroups for their appropriateness in the classification...
March 1, 2018: Farmacia Hospitalaria
Lauren Clack, Simone Passerini, Tanja Manser, Hugo Sax
OBJECTIVE To elicit expert consensus on the likelihood of infectious outcomes (patient colonization or infection) following a broad range of infectious risk moments (IRMs) from observations in acute care. DESIGN Expert consensus study using modified Delphi technique. PARTICIPANTS Panel of 40 international experts including nurses, physicians and microbiologists specialized in infectious diseases and infection prevention and control (IPC). METHODS The modified Delphi process consisted of 3 online survey rounds, with feedback of mean ratings and expert comments between rounds...
March 2018: Infection Control and Hospital Epidemiology
J C T Lau, A C Leong
The C-MAC® video monitor attachment is suitable for all otolaryngological scenarios, including post-operative follow up and difficult airway examination. Currently, there are no studies looking at the effectiveness of C-MAC® portable monitor with portable flexible nasoendoscopy. Our study demonstrates that the C-MAC® monitor with portable flexible nasoendoscopy is an excellent tool in terms of medical education, improving patient-doctor communication, efficiency of ward rounds and for medico-legal documentation, with distinct advantages over traditional direct flexible nasoendoscopy...
March 1, 2018: Clinical Otolaryngology
Edward C Kuan, Kevin A Peng, Lyndon O Gonzalez, Joel A Sercarz
We report a rare case of squamous cell carcinoma (SCC) of the nasal cavity arising in a patient with granulomatosis with polyangiitis (GPA). The patient was a 35-year-old man who had been diagnosed 15 years earlier with GPA and treated medically for sinonasal, pulmonary, and renal involvement. He presented to us with left-sided orbital and cheek pain and nasal obstruction. Endoscopy detected a friable, exophytic mass that involved the left lateral nasal wall and septum. Biopsy analysis identified the mass as an SCC...
January 2018: Ear, Nose, & Throat Journal
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