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https://www.readbyqxmd.com/read/29762314/effectiveness-of-dexmedetomidine-versus-propofol-on-extubation-times-length-of-stay-and-mortality-rates-in-adult-cardiac-surgery-patients-a-systematic-review-and-meta-analysis
#1
John Nguyen, Noel Nacpil
OBJECTIVE: To determine the effects of dexmedetomidine versus propofol on extubation time, intensive care unit (ICU) length of stay, total hospital length of stay and in-hospital mortality rates in cardiac surgery patients. INTRODUCTION: Recovery from cardiovascular surgery involves weaning from mechanical ventilation. Mechanical ventilation decreases the work of breathing for patients by inhaling oxygen and exhaling carbon dioxide via a ventilator or breathing machine...
May 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29728981/quality-of-life-and-satisfaction-with-inpatient-treatment-in-adolescents-with-psychiatric-disorders-a-comparison-between-patients-parents-and-caregivers-self-assessments-at-admission-and-discharge
#2
Petra Katzenschläger, Rainer Fliedl, Christian Popow, Michael Kundi
OBJECTIVES: The purpose of this study was to compare results of patients', parents', and caregivers' (nursing staff and educators) (self-)assessments of quality of life, treatment outcomes, and satisfaction with inpatient treatment in a child and adolescent psychiatric hospital. In addition, the investigation included a comparison between admission and discharge of the three investigated groups. METHODS: The study considered adolescents at the Department of Child and Adolescent Psychiatry and Psychotherapy, Hinterbruehl, along with their parents and caregivers...
May 4, 2018: Neuropsychiatrie: Klinik, Diagnostik, Therapie und Rehabilitation
https://www.readbyqxmd.com/read/29715257/evaluation-of-richmond-agitation-sedation-scale-rass-in-mechanically-ventilated-in-the-emergency-department
#3
Marianne K Pop, Katelyn R Dervay, Mary Dansby, Carolina Jones
The purpose of this study was to assess Richmond Agitation Sedation Scale (RASS) goal implementation in mechanically ventilated patients sedated in the emergency department (ED), compliance with RASS, and goal achievement. This study was a retrospective chart review at a large Level I trauma academic medical center. Patients who were intubated in the ED or en route to the ED between October 1, 2013, and October 1, 2014, were eligible for inclusion if they met the following criteria: aged 18 years or older, 24 hr or more on mechanically ventilated support receiving continuous sedation and/or analgesia during the first 48 hr of admission, and a hospital stay of 6 days or more...
April 2018: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/29712529/cost-effectiveness-development-for-the-postoperative-care-of-craniotomy-patients-a-safe-transitions-pathway-in-neurological-surgery
#4
Joseph A Osorio, Michael M Safaee, Jennifer Viner, Sujatha Sankaran, Sarah Imershein, Ezekiel Adigun, Gabriela Weigel, Mitchel S Berger, Michael W McDermott
OBJECTIVE The authors' institution is in the top 5th percentile for hospital cost in the nation, and the neurointensive care unit (NICU) is one of the costliest units. The NICU is more expensive than other units because of lower staff/patient ratio and because of the equipment necessary to monitor patient care. The cost differential between the NICU and Neuro transitional care unit (NTCU) is $1504 per day. The goal of this study was to evaluate and to pilot a program to improve efficiency and lower cost by modifying the postoperative care of patients who have undergone a craniotomy, sending them to the NTCU as opposed to the NICU...
May 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29705118/multi-stakeholder-informed-guidelines-for-direct-admission-of-children-to-hospital
#5
JoAnna K Leyenaar, Megan Shevenell, Paul A Rizzo, Vanessa L Hill, Peter K Lindenauer
OBJECTIVES: To develop pediatric direct admission guidelines and prioritize outcomes to evaluate the safety and effectiveness of hospital admission processes. STUDY DESIGN: We conducted deliberative discussions at 1 children's hospital and 2 community hospitals, engaging parents of hospitalized children and inpatient, outpatient, and emergency department physicians and nurses to identify shared and dissenting perspectives regarding direct admission processes and outcomes...
April 25, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29698354/a-systematic-review-of-early-warning-systems-effects-on-nurses-clinical-performance-and-adverse-events-among-deteriorating-ward-patients
#6
Ju-Ry Lee, Eun-Mi Kim, Sun-Aee Kim, Eui Geum Oh
OBJECTIVE: Early warning systems (EWSs) are an integral part of processes that aim to improve the early identification and management of deteriorating patients in general wards. However, the widespread implementation of these systems has not generated robust data regarding nurses' clinical performance and patients' adverse events. This review aimed to determine the ability of EWSs to improve nurses' clinical performance and prevent adverse events among deteriorating ward patients. METHOD: The PubMed, CINAHL, EMBASE, and Cochrane Library databases were searched for relevant publications (January 1, 1997, to April 12, 2017)...
April 25, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/29656714/epidemiology-of-sepsis-in-intensive-care-units-in-turkey-a-multicenter-point-prevalence-study
#7
Nur Baykara, Halis Akalın, Mustafa Kemal Arslantaş, Volkan Hancı, Çiğdem Çağlayan, Ferda Kahveci, Kubilay Demirağ, Canan Baydemir, Necmettin Ünal
BACKGROUND: The prevalence and mortality of sepsis are largely unknown in Turkey, a country with high antibiotic resistance. A national, multicenter, point-prevalence study was conducted to determine the prevalence, causative microorganisms, and outcome of sepsis in intensive care units (ICUs) in Turkey. METHODS: A total of 132 ICUs from 94 hospitals participated. All patients (aged > 18 years) present at the participating ICUs or admitted for any duration within a 24-h period (08:00 on January 27, 2016 to 08:00 on January 28, 2016) were included...
April 16, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29628451/assessing-rehabilitation-eligibility-of-older-patients-an-ethical-analysis-of-the-impact-of-bias
#8
Josephine Najem, Priscilla Lam Wai Shun, Maude Laliberté, Vardit Ravitsky
Hospitalized older patients are more vulnerable to physical or cognitive functional decline. Inpatient rehabilitation programs improve significantly their functional status and may prevent their admission to nursing homes. While inpatient rehabilitation institutions have established admission criteria that can be seen as objective, the risk of bias remains and raises the question of equitable access for more vulnerable populations such as older patients. This paper reviews some established eligibility criteria for inpatient rehabilitation by examining a framework used in Montreal, Québec, Canada for assessing rehabilitation eligibility and by applying this framework to a case study...
2018: Kennedy Institute of Ethics Journal
https://www.readbyqxmd.com/read/29622722/inpatient-quality-improvement-interventions-for-asthma-a-meta-analysis
#9
REVIEW
Kavita Parikh, Susan Keller, Shawn Ralston
CONTEXT: Despite the availability of evidence-based guidelines for the management of pediatric asthma, health care utilization remains high. OBJECTIVE: Systematically review the inpatient literature on asthma quality improvement (QI) and synthesize impact on subsequent health care utilization. DATA SOURCES: Medline and Cumulative Index to Nursing and Allied Health Literature (January 1, 1991-November 16, 2016) and bibliographies of retrieved articles...
May 2018: Pediatrics
https://www.readbyqxmd.com/read/29603405/short-and-long-term-cost-and-utilization-of-health-care-resources-in-parkinson-s-disease-in-the-uk
#10
Sharada Weir, Mihail Samnaliev, Tzu-Chun Kuo, Travis S Tierney, Silke Walleser Autiero, Rod S Taylor, Anette Schrag
BACKGROUND: There is currently no robust long-term data on costs of treating patients with Parkinson's disease. The objective of this study was to report levels of health care utilization and associated costs in the 10 years after diagnosis among PD patients in the United Kingdom. METHODS: We undertook a retrospective population-based cohort study using linked data from the UK Clinical Practice Research Datalink and Hospital Episode Statistics databases. Total health care costs of PD patients were compared with those of a control group of patients without PD selected using 1:1 propensity score matching based on age, sex, and comorbidity...
March 30, 2018: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/29595549/fathers-stress-in-the-neonatal-intensive-care-unit-a-systematic-review
#11
Paula M Prouhet, Mary R Gregory, Cynthia L Russell, Lauren H Yaeger
BACKGROUND: Admission to the neonatal intensive care unit (NICU) is stressful for parents. Nurses often focus on maternal well-being and fail to acknowledge the stress of fathers. Research on fathers' psychological stress is limited. PURPOSE: A systematic review of the literature was completed to examine the extent of psychological stress and types of stressors in fathers with infants admitted to the NICU. METHODS/SEARCH STRATEGY: A search of Ovid MEDLINE, Cochrane Library, PsycINFO, CINAHL, and EMBASE was conducted to identify descriptive and observational studies reporting father-specific stress in the NICU...
April 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/29579571/identifying-reliable-predictors-of-protein-energy-malnutrition-in-hospitalized-frail-older-adults-a-prospective-longitudinal-study
#12
Gianfranco Sanson, Luca Bertocchi, Eugenia Dal Bo, Carmen Luisa Di Pasquale, Michela Zanetti
BACKGROUND: Decreased food intake is a risk factor for relevant complications (e.g. infections, pressure ulcers), longer hospital stays, higher readmission rates, greater health care costs and increased patient mortality, particularly in frail hospitalized older adults who are malnourished or at risk of malnutrition. Nurses are called to improve this criticality, starting from accurately identify patients for malnutrition at hospital admission and effectively monitoring their food intake...
March 7, 2018: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29559308/the-association-of-frailty-with-post-icu-disability-nursing-home-admission-and-mortality-a-longitudinal-study
#13
Lauren E Ferrante, Margaret A Pisani, Terrence E Murphy, Evelyne A Gahbauer, Linda S Leo-Summers, Thomas M Gill
BACKGROUND: Frailty is a strong indicator of vulnerability among older persons, but its association with ICU outcomes has not been evaluated prospectively (i.e., with objective measurements obtained prior to ICU admission). Our objective was to prospectively evaluate the relationship between frailty and post-ICU disability, incident nursing home (NH) admission, and death. METHODS: The parent cohort included 754 adults aged ≥70, who were evaluated monthly for disability in 13 functional activities and every 18 months for frailty (1998-2014)...
March 17, 2018: Chest
https://www.readbyqxmd.com/read/29552746/evaluation-of-the-present-on-admission-indicator-among-hospitalized-fee-for-service-medicare-patients-with-a-pressure-ulcer-diagnosis-coding-patterns-and-impact-on-hospital-acquired-pressure-ulcer-rates
#14
Lee Squitieri, Daniel A Waxman, Carol M Mangione, Debra Saliba, Clifford Y Ko, Jack Needleman, David A Ganz
OBJECTIVES: To evaluate national present-on-admission (POA) reporting for hospital-acquired pressure ulcers (HAPUs) and examine the impact of quality measure exclusion criteria on HAPU rates. DATA SOURCES/STUDY SETTING: Medicare inpatient, outpatient, and nursing facility data as well as independent provider claims (2010-2011). STUDY DESIGN: Retrospective cross-sectional study. DATA COLLECTION/EXTRACTION METHODS: We evaluated acute inpatient hospital admissions among Medicare fee-for-service (FFS) beneficiaries in 2011...
January 25, 2018: Health Services Research
https://www.readbyqxmd.com/read/29533523/prior-work-and-educational-experience-are-not-associated-with-successful-completion-of-a-master-s-level-distance-education-midwifery-program
#15
Nancy A Niemczyk, Alison Cutts, Dana B Perlman
INTRODUCTION: In order to increase and diversify the midwifery workforce, admissions criteria for midwifery education programs must not contain unnecessary barriers to entry. Once accepted, students need to successfully complete the program. Many admissions criteria commonly used in midwifery education programs in the United States are not evidence based and could be unnecessary barriers to education. The primary objective of this study was to identify factors known during the admission process that were related to successful completion or failure to complete a midwifery program educating both student nurse-midwives (SNMs) and student midwives (SMs); a secondary objective was to quantify reasons for program noncompletion...
March 2018: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/29524917/efficacy-of-a-tool-to-predict-short-term-mortality-in-older-people-presenting-at-emergency-departments-protocol-for-a-multi-centre-cohort-study
#16
Magnolia Cardona, Ebony T Lewis, Robin M Turner, Hatem Alkhouri, Stephen Asha, John Mackenzie, Margaret Perkins, Sam Suri, Anna Holdgate, Luis Winoto, Chan-Wei Chang, Blanca Gallego-Luxan, Sally McCarthy, Mette R Kristensen, Michael O'Sullivan, Helene Skjøt-Arkil, Anette A Ekmann, Hanne H Nygaard, Jonas J Jensen, Rune O Jensen, Jonas L Pedersen, Dorothy Breen, John A Petersen, Birgitte N Jensen, Christian Backer Mogensen, Ken Hillman, Mikkel Brabrand
BACKGROUND: Prognostic uncertainty inhibits clinicians from initiating timely end-of-life discussions and advance care planning. This study evaluates the efficacy of the CriSTAL (Criteria for Screening and Triaging to Appropriate aLternative care) checklist in emergency departments. METHODS: Prospective cohort study of patients aged ≥65 years with any diagnosis admitted via emergency departments in ten hospitals in Australia, Denmark and Ireland. Electronic and paper clinical records will be used to extract risk factors such as nursing home residency, physiological deterioration warranting a rapid response call, personal history of active chronic disease, history of hospitalisations or intensive care unit admission in the past year, evidence of proteinuria or ECG abnormalities, and evidence of frailty to be concurrently measured with Fried Score and Clinical Frailty Scale...
May 2018: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29500239/risk-of-12-month-mortality-among-hospital-inpatients-using-the-surprise-question-and-spict-criteria-a-prospective-study
#17
Alison M Mudge, Carol Douglas, Xanthe Sansome, Michael Tresillian, Stephen Murray, Simon Finnigan, Cheryl Ruth Blaber
OBJECTIVES: People with serious life-limiting disease benefit from advance care planning, but require active identification. This study applied the Gold Standards Framework Proactive Identification Guidance (GSF-PIG) to a general hospital population to describe high-risk patients and explore prognostic performance for 12-month mortality. METHODS: Prospective cohort study conducted in a metropolitan teaching hospital in Australia. Hospital inpatients on a single day aged 18 years and older were eligible, excluding maternity and neonatal, mental health and day treatment patients...
March 2, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29498182/use-of-the-malnutrition-screening-tool-by-non-dietitians-to-identify-at-risk-patients-in-a-rehabilitation-setting-a-validation-study
#18
Paulina Wester, Rebecca Angus, Dayle Easlea, Michelle Lin, Benjamin Chen, Leanne Bisset
AIM: Malnutrition is highly prevalent in rehabilitation patients, and screening is important to allow for timely intervention to reduce the incidence of adverse clinical outcomes. We aimed to determine the reliability and validity of the commonly employed malnutrition screening tool by non-dietitian staff in categorising patients at risk of malnutrition in the rehabilitation setting. METHODS: This prospective observational cohort study recruited 100 participants on admission to a rehabilitation ward...
March 2, 2018: Nutrition & Dietetics: the Journal of the Dietitians Association of Australia
https://www.readbyqxmd.com/read/29497830/screening-for-dysphagia-in-adult-patients-with-stroke-assessing-the-accuracy-of-informal-detection
#19
Victoria Sherman, Heather Flowers, Moira K Kapral, Gordon Nicholson, Frank Silver, Rosemary Martino
Early identification of dysphagia by screening is recommended best practice for patients admitted to hospital with acute stroke. Screening can reduce the risk of pneumonia and promote stroke recovery, yet some institutions do not utilize a formal screening protocol. This study assessed the accuracy of informal dysphagia detection prior to implementation of a formal screening protocol. We conducted a secondary analysis of data captured between 2003 and 2008 from a sample of 250 adult stroke survivors admitted to a tertiary care centre...
March 1, 2018: Dysphagia
https://www.readbyqxmd.com/read/29435802/measuring-health-related-quality-of-life-hrqol-in-community-and-facility-based-care-settings-with-the-interrai-assessment-instruments-development-of-a-crosswalk-to-hui3
#20
John P Hirdes, Julie Bernier, Rochelle Garner, Philippe Finès, Micaela Jantzi
BACKGROUND: Health-related quality of life (HRQoL) measures are of interest because they can be used to describe health of populations and represent a broader health outcome for population health analyses than mortality rates or life expectancy. The most widely used measure of HRQoL for deriving estimates of health-adjusted life expectancy is the Health Utilities Index Mark 3 (HUI3). The HUI3 is available in most national surveys administered by Statistics Canada, and has been used as part of a microsimulation model to examine the impact of neurological conditions over the life course...
May 2018: Quality of Life Research
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