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https://www.readbyqxmd.com/read/28525923/a-national-implementation-project-to-prevent-catheter-associated-urinary-tract-infection-in-nursing-home-residents
#1
Lona Mody, M Todd Greene, Jennifer Meddings, Sarah L Krein, Sara E McNamara, Barbara W Trautner, David Ratz, Nimalie D Stone, Lillian Min, Steven J Schweon, Andrew J Rolle, Russell N Olmsted, Dale R Burwen, James Battles, Barbara Edson, Sanjay Saint
Importance: Catheter-associated urinary tract infection (UTI) in nursing home residents is a common cause of sepsis, hospital admission, and antimicrobial use leading to colonization with multidrug-resistant organisms. Objective: To develop, implement, and evaluate an intervention to reduce catheter-associated UTI. Design, Setting, and Participants: A large-scale prospective implementation project was conducted in community-based nursing homes participating in the Agency for Healthcare Research and Quality Safety Program for Long-Term Care...
May 19, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28456075/associations-between-pain-and-depression-in-nursing-home-patients-at-different-stages-of-dementia
#2
Ane Erdal, Elisabeth Flo, Geir Selbaek, Dag Aarsland, Sverre Bergh, Dagrun D Slettebo, Bettina S Husebo
BACKGROUND: Pain is associated with depression in nursing home patients with dementia. It is, however, unclear whether pain increases depression. Therefore we evaluated the prospective associations between pain and depressive symptoms in nursing home patients at different stages of cognitive impairment. METHODS: Two longitudinal studies were combined, including 931 patients (≥65 years) from 65 nursing homes. One study assessed patients at admission, with 6-month follow-up (2012-2014)...
April 24, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28433247/outpatient-laparoscopic-appendectomy-feasible-in-a-public-county-hospital
#3
David R Rosen, Kenji Inaba, Paul J Oh, Adam C Gutierrez, Aaron M Strumwasser, Subarna Biswas, Melody Cala, Glenn T Ault
BACKGROUND: Outpatient laparoscopic appendectomy is being used increasingly as a treatment option for acute, uncomplicated appendicitis. This was a prospective validation study in a large, urban, public safety-net hospital. STUDY DESIGN: From 2014 to 2016, all patients undergoing laparoscopic appendectomy for acute, uncomplicated appendicitis were enrolled in a prospective observational trial. Standard baseline perioperative practice (control group) was documented for 1 year...
March 13, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28431908/implementation-of-a-person-centered-medical-care-model-in-a-skilled-nursing-facility-a-pilot-evaluation
#4
Kathleen Abrahamson, Jaclyn Myers, Arif Nazir
OBJECTIVES: The objective of this study was to evaluate the feasibility and impact of implementing a person-centered medical care model for post-acute care residents within a skilled nursing facility (SNF). DESIGN: A mixed-method (qualitative and quantitative) pilot evaluation. SETTING: An 89-bed SNF located within a large midwestern city. PARTICIPANTS: Forty SNF post-acute patients admitted to the facility during a 6-month period were enrolled in the pilot evaluation...
April 18, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28416016/variation-in-rates-of-icu-readmissions-and-post-icu-in-hospital-mortality-and-their-association-with-icu-discharge-practices
#5
Nelleke van Sluisveld, Ferishta Bakhshi-Raiez, Nicolette de Keizer, Rebecca Holman, Gert Wester, Hub Wollersheim, Johannes G van der Hoeven, Marieke Zegers
BACKGROUND: Variation in intensive care unit (ICU) readmissions and in-hospital mortality after ICU discharge may indicate potential for improvement and could be explained by ICU discharge practices. Our objective was threefold: (1) describe variation in rates of ICU readmissions within 48 h and post-ICU in-hospital mortality, (2) describe ICU discharge practices in Dutch hospitals, and (3) study the association between rates of ICU readmissions within 48 h and post-ICU in-hospital mortality and ICU discharge practices...
April 17, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28405254/risk-of-falls-associated-with-antiepileptic-drug-use-in-ambulatory-elderly-populations-a-systematic-review
#6
REVIEW
Mira Maximos, Feng Chang, Tejal Patel
BACKGROUND: Falls are a major cause of morbidity and mortality in older adults. About a third of those aged 65 years or older fall at least once each year, which can result in hospitalizations, hip fractures and nursing home admissions that incur high costs to individuals, families and society. The objective of this clinical review was to assess the risk of falls in ambulatory older adults who take antiepileptic drugs, medications that can increase fall risk and decrease bone density...
March 2017: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
https://www.readbyqxmd.com/read/28398988/protected-mealtimes-for-adults-with-cancer-in-a-hematology-oncology-setting-an-evidence-based-implementation-project
#7
Benazir Naseer, Solano S G Tan, Seri S Ramli, Emily Ang
BACKGROUND: Patients with cancer are often at risk or suffer from some form of malnutrition, which could be attributed to their disease progression or the adverse effects of cancer treatment. Protected mealtime and offering assistance during mealtime may not improve their nutritional status but would allow them to enjoy their meal and improve patient satisfaction. OBJECTIVES: The aim of this project was to promote best practice in protecting mealtimes in hematology-oncology patients...
April 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28393724/clinical-characteristics-and-outcome-of-healthcare-associated-pneumonia-in-turkey
#8
Canan Gündüz, Mehmet Sezai Taşbakan, Abdullah Sayıner, Aykut Çilli, Oğuz Kılınç, Ayşın Şakar Coşkun
Introduction: Pneumonia in cases with preceding hospitalization, hemodialysis, intravenous therapy, wound care, or chemotherapy within the prior 30 days and residence in nursing homes are defined as healthcare associated pneumonia (HCAP). The aim of this study was to compare the demographic and laboratory data, isolated causative agents and prognosis of patients with community-acquired pneumonia (CAP) and HCAP in a large population in Turkey. Materials and Methods: The data of 785 cases (average age 65...
September 2016: Tüberküloz Ve Toraks
https://www.readbyqxmd.com/read/28368550/home-or-foster-home-care-versus-institutional-long-term-care-for-functionally-dependent-older-people
#9
REVIEW
Camilla Young, Amanda M Hall, Daniela C Gonçalves-Bradley, Terry J Quinn, Lotty Hooft, Barbara C van Munster, David J Stott
BACKGROUND: Changing population demographics have led to an increasing number of functionally dependent older people who require care and medical treatment. In many countries, government policy aims to shift resources into the community from institutional care settings with the expectation that this will reduce costs and improve the quality of care compared. OBJECTIVES: To assess the effects of long-term home or foster home care versus institutional care for functionally dependent older people...
April 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28366150/-clinical-characteristics-and-outcome-of-healthcare-associated-pneumonia-in-turkey
#10
Canan Gündüz, Mehmet Sezai Taşbakan, Abdullah Sayıner, Aykut Çilli, Oğuz Kılınç, Ayşın Şakar Coşkun
Introduction: Pneumonia in cases with preceding hospitalization, hemodialysis, intravenous therapy, wound care, or chemotherapy within the prior 30 days and residence in nursing homes are defined as healthcare associated pneumonia (HCAP). The aim of this study was to compare the demographic and laboratory data, isolated causative agents and prognosis of patients with community-acquired pneumonia (CAP) and HCAP in a large population in Turkey. Materials and Methods: The data of 785 cases (average age 65...
September 2016: Tüberküloz Ve Toraks
https://www.readbyqxmd.com/read/28364517/an-integrative-review-on-standardized-exams-as-a-predictive-admission-criterion-for-rn-programs
#11
Julie E Twidwell, Kathie Records
Nursing programs reject qualified applicants due to limited clinical placements and faculty. By admitting the strongest candidates, schools of nursing will reduce attrition rates, increase NCLEX-RN pass rates, and speed the entry into practice of well-prepared nurses to help stem the nursing shortage. This integrative review identified the standardized admission exams most predictive of student success. Included were articles published between 2005 and 2016 that focused on admission criteria, RN programs, specific exams (e...
April 1, 2017: International Journal of Nursing Education Scholarship
https://www.readbyqxmd.com/read/28338533/sepsis-patients-in-the-emergency-department-stratification-using-the-clinical-impression-score-predisposition-infection-response-and-organ-dysfunction-score-or-quick-sequential-organ-failure-assessment-score
#12
Vincent M Quinten, Matijs van Meurs, Anna E Wolffensperger, Jan C Ter Maaten, Jack J M Ligtenberg
OBJECTIVE: The aim of this study was to compare the stratification of sepsis patients in the emergency department (ED) for ICU admission and mortality using the Predisposition, Infection, Response and Organ dysfunction (PIRO) and quick Sequential Organ Failure Assessment (qSOFA) scores with clinical judgement assessed by the ED staff. PATIENTS AND METHODS: This was a prospective observational study in the ED of a tertiary care teaching hospital. Adult nontrauma patients with suspected infection and at least two Systemic Inflammatory Response Syndrome criteria were included...
May 8, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28328390/the-efficacy-of-telemedicine-supported-discharge-within-an-in-home-model-of-care
#13
Edwin P Greenup, Melissa McCusker, Boyd A Potts, Andrew Bryett
OBJECTIVE: To determine if mobile videoconferencing technology can facilitate the discharge of low-acuity patients receiving in-home care without compromising short-term health outcomes. METHODS: A 6-month trial commenced in July 2015 with 345 patients considered unsuited to Criteria Led Discharge (CLD) receiving in-home care included as participants. Nurses providing clinical support to patients in their homes were supplied with a tablet computer (Apple iPad) with Internet connectivity (Telstra 4G Network) and videoconferencing software (Cisco Jabber for Telepresence)...
February 22, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28268067/application-of-the-third-international-consensus-definitions-for-sepsis-sepsis-3-classification-a-retrospective-population-based-cohort-study
#14
John P Donnelly, Monika M Safford, Nathan I Shapiro, John W Baddley, Henry E Wang
BACKGROUND: The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) present clinical criteria for the classification of patients with sepsis. We investigated incidence and long-term outcomes of patients diagnosed with these classifications, which are currently unknown. METHODS: We did a retrospective analysis using data from 30 239 participants from the USA who were aged at least 45 years and enrolled in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort...
March 3, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28243074/delirium-in-405-articles-of-medical-non-surgical-or-icu-inpatients-unproven-speed-of-onset-and-recovery
#15
Paul Jay Regal
PURPOSE: There is agreement in the medical literature that delirium is of sudden or rapid onset. Although the speed of recovery cannot be used for initial diagnosis, recovery speed provides a test of diagnostic criteria. The aim of this study was to determine whether articles on delirium among medical inpatients proved sudden onset and rapid recovery. METHODS: The literature was searched for studies with at least 50 patients on medical or geriatric wards. Excluded were postoperative, critical care, and nursing home studies...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28196751/-hospital-emergencies-arising-from-nursing-homes-in-a-region-evolution-characteristics-and-appropriateness
#16
Inma Sánchez-Pérez, Nuri Comes Garcia, Lola Romero Piniella, Gemma Prats Martos, Gemma Arnau Bataller, Jordi Coderch
OBJECTIVE: Hospital emergencies (HE) arising from nursing homes (NH) are on the rise. We analyse the evolution, characteristics and appropriateness of HE of NH residents in a region, as well as resulting hospital admissions. METHOD: Retrospective descriptive study between 2010 and 2013 of institutionalised residents of 11 NH located in Baix Empordà (704 beds) and Palamós Hospital. VARIABLES: Gender, age, morbidity and relative weight according to clinical risk groups (CRG), NH, length of stay, diagnosis of the emergency, appropriateness of HE according to Bermejo's criteria and the HE appropriateness protocol (HEAP), and appropriateness of hospitalisations according to the Appropriateness Evaluation Protocol (AEP)...
February 10, 2017: Gaceta Sanitaria
https://www.readbyqxmd.com/read/28196328/adherence-to-a-nurse-driven-feeding-protocol-in-a-pediatric-intensive-care-unit
#17
Carmen A Cunningham, Lindsay B Gervais, Vera C Mazurak, Vijay Anand, Daniel Garros, Katelynn Crick, Bodil M K Larsen
BACKGROUND: Patients admitted to pediatric intensive care units (PICUs) often experience prolonged periods without nutrition support, which may result in hospital-induced malnutrition and longer length of stay. Nurse-driven feeding protocols have been developed to prevent unnecessary interruptions or delays to nutrition support. The primary objective of this study was to identify compliance and reasons for noncompliance to a feeding protocol at a tertiary care hospital PICU in Canada...
February 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28156581/the-extended-care-unit-a-feasible-economic-solution-for-longer-term-palliative-inpatients
#18
(no author information available yet)
143 Background: Many inpatient palliative care units (PCUs) in Australia require patients who cannot go home, but remain stable after 2 weeks, to be discharged to nursing homes (NHs). This involves moving between 5 locations (home, acute hospital, PCU, NH transition bed, NH), in the final weeks of life. We propose an "Extended Care Unit" (ECU) to avoid unnecessary moves for such patients. This study aimed to investigate the feasibility of the proposed ECU, including identifying demand, admission criteria, length of stay, and hospital costs...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152860/using-information-technology-to-power-an-integrated-community-based-oncology-palliative-care-model
#19
Andrew Allan Hertler, Lianne Matthews, RaeLynn Carr
166 Background: There is a need to improve palliative care program access for patients with cancer. The identification of candidates for palliative care at the point of diagnose can improve care and reduce costs. This pilot program was launched in July 2015 by four stakeholders: Health plan; Regional palliative care provider; Community oncology practice; and Oncology quality management provider. METHODS: Objectives are to increase patient satisfaction, reduce unnecessary utilization and costs...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152791/improving-venous-thromboembolism-vte-prophylaxis-for-hospitalized-malignant-hematology-bone-marrow-transplant-heme-bmt-patients
#20
John Dzundza, Archana Ajmera, Ashley Gustafson, Mimi Lo, Richard Fong, Larissa Graff, Bao Dao, Rebecca Young, Lloyd Earl Damon, Thomas G Martin, Rebecca Leah Olin
79 Background: Hospitalized patients on the heme/BMT service at our academic cancer center have historically not received pharmacologic VTE prophylaxis (VTEP) due to concerns regarding thrombocytopenia and bleeding risk. However, a retrospective review of heme/BMT admissions from 2009 to 2013 revealed that 59% of hospital-acquired VTE cases occurred at a platelet count > 50 x 10E9/L, suggesting missed opportunities for VTE prevention. METHODS: To implement VTEP on the heme/BMT service, a multidisciplinary quality improvement team developed a pilot intervention with 5 strategies: 1) identification of heme/BMT-specific contraindications to VTEP, 2) standardized use of VTEP for all heme/BMT patients unless contraindications are present, 3) hold parameter for platelet count < 50 x 10E9/L within the VTEP order, 4) note template to document VTEP plan, and 5) provider, nurse, pharmacist, and patient education...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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