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Patient transfer quality

Donna Franklin, Franz E Babl, Luregn J Schlapbach, Ed Oakley, Simon Craig, Jocelyn Neutze, Jeremy Furyk, John F Fraser, Mark Jones, Jennifer A Whitty, Stuart R Dalziel, Andreas Schibler
BACKGROUND: High-flow oxygen therapy through a nasal cannula has been increasingly used in infants with bronchiolitis, despite limited high-quality evidence of its efficacy. The efficacy of high-flow oxygen therapy through a nasal cannula in settings other than intensive care units (ICUs) is unclear. METHODS: In this multicenter, randomized, controlled trial, we assigned infants younger than 12 months of age who had bronchiolitis and a need for supplemental oxygen therapy to receive either high-flow oxygen therapy (high-flow group) or standard oxygen therapy (standard-therapy group)...
March 22, 2018: New England Journal of Medicine
Jennifer Bido, Roya Ghazinouri, Jamie E Collins, Desirée Diez Portela, Luis Alcantara, Thomas S Thornhill, Jeffrey N Katz
BACKGROUND: Medical missions to low and middle-income countries are increasingly frequent, with an estimated 6,000 trips sponsored by U.S. organizations accounting for approximately 200,000 surgical cases and $250 million in costs annually. However, these missions have received little critical evaluation. This paper describes the research program Operation Walk (Op-Walk) Boston, and proposes an evaluation model for similar surgical missions. METHODS: We propose an evaluation model, borrowing from the work of Donabedian and enriched by evidence from our research program...
March 21, 2018: Journal of Bone and Joint Surgery. American Volume
Canan Koksal, Ugur Akbas, Nazmiye Donmez Kesen, Murat Okutan, Hatice Bilge, Gonul Kemikler
PURPOSE: The purpose of this study was to perform pretreatment patient-specific quality assurance (QA) for intracranial irradiation using CyberKnife with an ion chamber. METHODS: Twenty-five intracranial plans created using the ray-tracing algorithm were used for this study. Computed tomography (CT) images of the water-equivalent RW3 slab phantom with PinPoint ionization chamber were acquired with 1-mm slice thickness and transferred to the MultiPlan treatment planning system (TPS)...
January 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Barry A Finegan, Daniel Roblin, Fadi Hammal
Quality problem: For smokers, hospital admission is accompanied by forced involuntary nicotine abstinence due to smoke-free site/grounds policies. An audit of patients admitted to our surgical wards revealed that identification of smoking status was inadequate and that nicotine addiction management (NAM) was infrequently offered. The project aimed to enhance both these metrics by initiating NAM in the post anesthesia care unit (PACU). Initial assessment: Out of 744 patients admitted to our PACU in August 2015, 54% had their smoking status documented...
March 14, 2018: International Journal for Quality in Health Care
Ulviye Günay, Gülsen Kılınç
BACKGROUND: Nursing education contains both theoretical and practical training processes. Clinical training is the basis of nursing education. The quality of clinical training is closely related to the quality of the clinical learning environment. OBJECTIVES: This study aimed to determine the transfer of theoretical knowledge into clinical practice by nursing students and the difficulties they experience during this process. METHODS: A qualitative research design was used in the study...
March 1, 2018: Nurse Education Today
L B Amsden, P T Davidson, H B Fevrier, R Goldfien, L J Herrinton
Purpose To better understand diagnostic delay and doctor-patient communication during the diagnosis of systemic lupus erythematous in patients without malar rash, we conducted a qualitative study of primary care providers' perceptions. Methods We conducted in-depth interviews with a purposive sample of eight primary care physicians in Kaiser Permanente Northern California. Telephone interviews were recorded, transcribed, reviewed, and coded for domains and themes. Results We identified five domains related to diagnosis: initial assessment and tests, initial diagnosis and empiric treatment, timeliness of diagnosis, communicating with the patient, and opportunities for improvement...
January 1, 2018: Lupus
H S Thakkar, I Yardley, D Kufeji
Introduction In 2015, the Royal College of Surgeons of England (RCS) commissioned the East Midlands Clinical Network to develop a set of guidelines for the management of paediatric torsion. Two quality measures identified were the provision of surgery locally where possible and 100% of explorations within three hours. We sought to assess the adherence to these quality measures within our referral network. Materials and methods Retrospective data were collected for all paediatric scrotal explorations performed within our centre between January 2014 and July 2016...
March 15, 2018: Annals of the Royal College of Surgeons of England
Alexander Trumpp, Johannes Lohr, Daniel Wedekind, Martin Schmidt, Matthias Burghardt, Axel R Heller, Hagen Malberg, Sebastian Zaunseder
BACKGROUND: Camera-based photoplethysmography (cbPPG) is a measurement technique which enables remote vital sign monitoring by using cameras. To obtain valid plethysmograms, proper regions of interest (ROIs) have to be selected in the video data. Most automated selection methods rely on specific spatial or temporal features limiting a broader application. In this work, we present a new method which overcomes those drawbacks and, therefore, allows cbPPG to be applied in an intraoperative environment...
March 14, 2018: Biomedical Engineering Online
Dorothee Boehm, Konstantin Bergmeister, Emre Gazyakan, Thomas Kremer, Ulrich Kneser, Volker J Schmidt
AIMS: Reconstruction of breasts and chest wall deformities in female patients after severe burn injury is a challenge for reconstructive surgeons. In these patients, neither implant-based procedures nor standard free flaps are sometimes applicable because of limited skin quality and unavailability of donor sites at the abdomen, back, buttock, or medial thigh. METHODS: We present a case of a young female patient with a history of 80 % total body surface area burn after electric high-voltage injury...
March 13, 2018: Annals of Plastic Surgery
Rikinkumar S Patel, Priya Patel, Kaushal Shah, Mandeep Kaur, Zeeshan Mansuri, Ramkrishna Makani
Objective To determine the impact of cannabis use disorder (CUD) on the inpatient outcomes of attention deficit hyperactivity disorder (ADHD) in adolescents Background Previous studies have evaluated the impact of CUD on the health-related quality of life in ADHD patients. Methods We used the nationwide inpatient sample (NIS) from the Healthcare Cost and Utilization Project (HCUP) from years 2010--2014. We identified ADHD and cannabis use (CU) as the primary and the other diagnosis, respectively, using validated International Classification of Diseases, 9th Revision, and Clinical Modification (ICD-9--CM) codes...
January 7, 2018: Curēus
Cristian A Linte, Jon J Camp, Maryam E Rettmann, Dieter Haemmerich, Mehmet K Aktas, David T Huang, Douglas L Packer, David R Holmes
In spite of significant efforts to improve image-guided ablation therapy, a large number of patients undergoing ablation therapy to treat cardiac arrhythmic conditions require repeat procedures. The delivery of insufficient thermal dose is a significant contributor to incomplete tissue ablation, in turn leading to the arrhythmia recurrence. Ongoing research efforts aim to better characterize and visualize RF delivery to monitor the induced tissue damage during therapy. Here, we propose a method that entails modeling and visualization of the lesions in real-time...
April 2018: Journal of Medical Imaging
R Poverini, R Lisi, F Lisi, V Berlinghieri, W Bielli, P Carfagna, A Costantino, D Iacomino, G Nicodemo
Granulocyte-macrophage colony-stimulation factor plays different crucial roles during embryo implantation and subsequent development. Here we aimed to evaluate the effects of embryo cell culture medium, with the inclusion of granulocyte-macrophage colony-stimulation factor (GM-CSF), on embryo development and pregnancy rate. To this end, we took advantage of our retrospective observational study to correlate the outcomes from two different culture media. We included in this study 25 unselected patient from our IVF Center that underwent heterologous IVF cycle with crypreserved oocytes...
December 2018: Cell Death Discovery
Sadikah Behbehani, Stefano Polesello, Joseph Hasson, Justin Silver, Weon-Young Son, Michael Dahan
OBJECTIVE: Asses clinical pregnancy rates and live birth rates in the presence of non-cavity deforming intramural fibroids in single fresh blastocyst transfer cycles DESIGN CLASSIFICATION: Canadian Task Force classification II-2 SETTING SETTING: Academic fertility center. PATIENT(S): 929 fresh single blastocyst transfer cycles were included; 94 with only non cavity distorting intramural fibroids and 764 without fibroids. Cleavage embryo transfers were excluded to reduce bias based on embryo quality INTERVENTION(S): none MAIN OUTCOME MEASURE(S): Live birth rate (LBR) and clinical pregnancy rate (CPR) RESULT(S): There were no differences noted in gravity, parity, or body mass index in patients with and without fibroids...
March 9, 2018: Journal of Minimally Invasive Gynecology
E Mangoli, M A Khalili, A R Talebi, S Ghasemi-Esmailabad, A Hosseini
The main goal was to evaluate the correlation between sperm parameters and chromatin quality with embryo kinetics via time-lapse monitoring system (TLM). A total of 40 couples involved in the ICSI program as a result of male infertility. For assessment of sperm chromatin and DNA quality, we used aniline blue, toluidine blue, chromomycin A3, acridine orange and terminal transferase-mediated deoxyuridine triphosphate biotin end labelling assays. All mature oocytes were injected, and the generated zygotes (2PNs) were cultured in TLM...
March 12, 2018: Andrologia
Muhammad M Fareed, Rizwan Ishtiaq, Thomas J Galloway
Overall radiation treatment time has long been recognized as an important factor in head and neck tumor control. The concern of tumor growth in waiting time either before starting radiotherapy or during treatment is substantial given its negative impact on clinical outcome. There is an overwhelming evidence that increasing the time to initiate treatment increases the tumor burden and worsens the prognosis. This effect is more pronounced especially in patients with an early stage cancer disease. Delay in treatment initiation is contributed by both health care- and patient-related factors...
March 12, 2018: Current Treatment Options in Oncology
Simon J Craddock Lee, Stephen J Inrig, Bijal A Balasubramanian, Celette Sugg Skinner, Robin T Higashi, Katharine McCallister, Wendy Pechero Bishop, Noel O Santini, Jasmin A Tiro
The colorectal cancer (CRC) screening process involves multiple interfaces (communication exchanges and transfers of responsibility for specific actions) among primary care and gastroenterology providers, laboratory, and administrative staff. After a retrospective electronic health record (EHR) analysis discovered substantial clinic variation and low CRC screening prevalence overall in an urban, integrated safety-net system, we launched a qualitative analysis to identify potential quality improvement targets to enhance fecal immunochemical test (FIT) completion, the system's preferred screening modality...
March 2018: Preventive Medicine Reports
Karen Wain
The genetic counseling profession continues to expand and respond to the changing landscape of genomic medicine. "Non-traditional" genetic counseling roles have become more commonplace and the transferability of the genetic counselor skill set has been widely acknowledged, particularly in genetic laboratory settings. As these expanding roles continue to mature, all genetic counselors can benefit by learning and adopting clinically relevant skills, such as genomic variant interpretation, which can be applied to direct patient care...
March 10, 2018: Journal of Genetic Counseling
Michael K Xu, Kathleen G Dobson, Lehana Thabane, Alison E Fox-Robichaud
BACKGROUND: Rapid response teams have been widely adopted across the world. Although evidence for their efficacy is not clear, they remain a popular means to detect and react to patient deterioration. This may in part be due to there being no standardized approach to their usage or implementation. A key component of their ability to be effective is the speed of response. OBJECTIVE: The objective of this review is to evaluate the effect of delayed response by rapid response teams on hospital mortality (primary), cardiac arrest, and intensive care transfer rates (secondary)...
March 9, 2018: Systematic Reviews
Christian I Penaloza, Maryam Alimardani, Shuichi Nishio
EEG-based brain computer interface (BCI) systems have demonstrated potential to assist patients with devastating motor paralysis conditions. However, there is great interest in shifting the BCI trend toward applications aimed at healthy users. Although BCI operation depends on technological factors (i.e., EEG pattern classification algorithm) and human factors (i.e., how well the person can generate good quality EEG patterns), it is the latter that is least investigated. In order to control a motor imagery-based BCI, users need to learn to modulate their sensorimotor brain rhythms by practicing motor imagery using a classical training protocol with an abstract visual feedback...
March 2018: IEEE Transactions on Neural Systems and Rehabilitation Engineering
Diana-Alexandra Ertl, Andreas Gleiss, Katharina Schubert, Caroline Culen, Peer Hauck, Johannes Ott, Alois Gessl, Gabriele Haeusler
BACKGROUND: Previous studies have shown that only a minority of patients with Turner syndrome (TS) have adequate medical care after transfer to adult care. AIM OF THIS STUDY: To assess the status of medical care and quality of life (QoL) in adult women diagnosed with TS and followed-up until transfer. To compare the subjective and objective view of the medical care quality and initiate improvements based on patients' experiences and current recommendations. METHODS: 39 adult women with TS out of 64 patients contacted were seen for a clinical and laboratory check, cardiac ultrasound, standardized and structured questionnaires (SF-36v2 and Beck depression inventory)...
March 7, 2018: Endocrine Connections
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