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https://www.readbyqxmd.com/read/28328390/the-efficacy-of-telemedicine-supported-discharge-within-an-in-home-model-of-care
#1
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
#2
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
#3
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
#4
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
#5
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
#6
(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
#7
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
#8
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
https://www.readbyqxmd.com/read/28141882/integrative-review-of-admission-factors-related-to-associate-degree-nursing-program-success
#9
Jeanette M Olsen
BACKGROUND: High attrition in associate degree nursing (ADN) programs contributes to the nursing shortage and causes hardship for students, families, faculty, colleges, and taxpayers. The purpose of this integrative literature review is to identify admission criteria related to ADN program success to inform evidence-based admission policies and reduce attrition. METHOD: Integrative review methodology, suggested by Whittemore and Knafl, was used. A systematic search of existing professional literature was conducted using five databases and key word searches...
February 1, 2017: Journal of Nursing Education
https://www.readbyqxmd.com/read/28107269/actualization-of-a-seamless-nursing-program-licensed-practical-nurse-to-baccalaureate-registered-nurse
#10
Andrea Wallen, Linda McKay, Ellen Santos, Holly LaFrance, Rose M Veith
Upward educational mobility of licensed practical nurses (LPNs) is important for their professional development. For the nursing profession, this upward mobility increases workforce diversity. To address the paucity of programs accepting the LPN's education, a team of 6 BSN and LPN nurse educators, backed by 2 universities, developed a seamless LPN-BSN program. This article documents the process, including a needs assessment, curriculum development, admission criteria, implementation, lessons learned, and outcomes...
January 20, 2017: Nurse Educator
https://www.readbyqxmd.com/read/28054925/the-wound-trend-scale-a-retrospective-review-of-utility-and-predictive-value-in-the-assessment-and-documentation-of-lower-leg-ulcers
#11
Noreen A Campbell, Donna L Campbell, Andrea Turner
Wound assessment is essential to manage wound care. The Wound Trend Scale (WTS) is a paper-and-pen instrument comprised of 14 parameters designed to guide assessment of findings relevant to lower leg ulcer management and includes an infection screen and cues for physician consultation. To determine its clinical utility, predictive value, and reliability, data were retrospectively analyzed from a random sampling of medical records of patients seen at a Foot and Leg Clinic between January 1, 2007 and December 31, 2008...
December 2016: Ostomy/wound Management
https://www.readbyqxmd.com/read/27936113/preoperative-csf-melatonin-concentrations-and-the-occurrence-of-delirium-in-older-hip-fracture-patients-a-preliminary-study
#12
Rikie M Scholtens, Sophia E J A de Rooij, Annelies E Vellekoop, Bart C Vrouenraets, Barbara C van Munster
BACKGROUND: Delirium is characterized by disturbances in circadian rhythm. Melatonin regulates our circadian rhythm. Our aim was to compare preoperative cerebrospinal fluid (CSF) melatonin levels in patients with and without postoperative delirium. METHODS: Prospective cohort study with hip fracture patients ≥ 65 years who were acutely admitted to the hospital for surgical treatment and received spinal anaesthesia. CSF was collected after cannulation, before administering anaesthetics...
2016: PloS One
https://www.readbyqxmd.com/read/27911889/using-a-holistic-preadmission-assessment-to-help-predict-second-degree-nursing-student-success
#13
Lisette Barton, Angela Willis, Hsin-Hui Lin
The purpose of this study was to identify a profile of noncognitive preadmission characteristics that were associated with academic failure in a cohort of second-degree nursing students who applied to an urban school of nursing. Preadmission testing data for 86 students from a suite of assessments that predict performance in high-stress environments yielded unique characteristics that were associated with vulnerability to attrition. The findings support the use of holistic admissions criteria to promote success...
January 2017: Nurse Educator
https://www.readbyqxmd.com/read/27862664/neonatal-outcomes-in-a-level-ii-regional-neonatal-intensive-care-unit
#14
Raid Mr Umran, Asjad Al-Jammali
BACKGROUND: Improvement of neonatal mortality is a challenge in developing countries such as Iraq due to increased demand and overload of maternity services. The aim of this study was to document the number, disease patterns and outcome of admitted newborns and the improvement after implementation of clinical protocols, and to identify possible future target measures. METHOD: A descriptive study was conducted at the neonatal intensive care unit (NICU) of a regional hospital from 2011 to 2013...
November 12, 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/27807908/home-based-vs-inpatient-education-for-children-newly-diagnosed-with-type-1-diabetes
#15
H Clapin, L Hop, E Ritchie, R Jayabalan, M Evans, K Browne-Cooper, S Peter, J Vine, T W Jones, E A Davis
BACKGROUND: Initial management of children diagnosed with type 1 diabetes (T1D) varies worldwide with sparse high quality evidence regarding the impact of different models of care. AIM: To compare the inpatient model of care with a hybrid home-based alternative, examining metabolic and psychosocial outcomes, diabetes knowledge, length of stay, and patient satisfaction. SUBJECTS AND METHODS: The study design was a randomized-controlled trial...
November 3, 2016: Pediatric Diabetes
https://www.readbyqxmd.com/read/27769209/study-protocol-a-randomized-controlled-trial-evaluating-the-effect-of-family-based-behavioral-treatment-of-childhood-and-adolescent-obesity-the-fabo-study
#16
Hanna F Skjåkødegård, Yngvild S Danielsen, Mette Morken, Sara-Rebekka F Linde, Rachel P Kolko, Katherine N Balantekin, Denise E Wilfley, Pétur B Júlíusson
BACKGROUND: The purpose of the FABO-study is to evaluate the effect of family-based behavioral social facilitation treatment (FBSFT), designed to target children's family and social support networks to enhance weight loss outcomes, compared to the standard treatment (treatment as usual, TAU) given to children and adolescents with obesity in a routine clinical practice. METHODS: Randomized controlled trial (RCT), in which families (n = 120) are recruited from the children and adolescents (ages 6-18 years) referred to the Obesity Outpatient Clinic (OOC), Haukeland University Hospital, Norway...
October 21, 2016: BMC Public Health
https://www.readbyqxmd.com/read/27766672/validating-the-4a-s-test-in-screening-for-delirium-in-a-culturally-diverse-geriatric-inpatient-population
#17
Jayita De, Anne P F Wand, Peter I Smerdely, Glenn E Hunt
OBJECTIVE: To measure the diagnostic accuracy of the 4A's test in screening for delirium in geriatric inpatients from culturally diverse backgrounds. METHODS: A prospective study was conducted with patients admitted to the geriatric and orthogeriatric services of a tertiary teaching hospital. Consenting participants aged 65 years and over were screened for delirium with the 4AT by nursing staff within 72 h of admission. The diagnosis of delirium was made separately by expert assessors, responsible for the participant's clinical care, blinded to the 4AT score, within 30 min of the 4AT assessment using the DSM 5 criteria and the Confusion Assessment Method...
October 20, 2016: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27755328/families-readiness-for-discharge-of-their-pre-term-infant-a-best-practice-implementation-project
#18
Lei Cheng, Yuxia Zhang, Ying Gu, Chunmei Lu, Qing Liu, Hao Yuan
BACKGROUND: Supporting and involving the families of pre-term infants' in the discharge process provides them with confidence in caring for their infants at home. In an effort to facilitate families' readiness for discharge, the neonatal unit (NU) of the Children's Hospital of Fudan University has implemented a best practice project. OBJECTIVES: The aim of this project was to integrate the best available evidence on facilitating families' readiness for discharge into the nursing practice of the Children's Hospital of Fudan University...
September 2016: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/27752319/-the-constipation-conundrum-improving-recognition-of-constipation-on-a-gastroenterology-ward
#19
Robert Jackson, Philip Cheng, Sarah Moreman, Nicola Davey, Lisa Owen
Constipation is a common and often overlooked problem, but it can cause serious complications for patients including pain, nausea, urinary retention, and prolonged hospital admission. There are no recognised criteria for the diagnosis of constipation in the acute hospital setting, and it is often the role of the ward doctor to identify and manage this problem. Completion and monitoring of "stool charts" by nursing and medical staff is key to proper recognition and management of constipation. A baseline study found that while charts were completed well, they were only monitored by doctors 17...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27749704/a-patient-centered-transitional-care-case-management-program-taking-case-management-to-the-streets-and-beyond
#20
Derenda Lovelace, Diane Hancock, Sabrina S Hughes, Phyllis R Wyche, Claire Jenkins, Cindy Logan
BACKGROUND: In 2011, the Hunter Holmes McGuire Veterans Administration Medical Center (VAMC) in Richmond, VA, had a cumulative readmission rate and emergency department (ED) revisits for discharged Veterans of 1 in 5. In 2012, a transitional care program (TCP) was implemented to improve care coordination and outcomes among Veterans, with an emphasis on geriatric patients with chronic disease. This TCP was created with an interdisciplinary approach using intensive case management interventions, with a goal of reducing Veteran ED and hospital revisits by 30%...
November 2016: Professional Case Management
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