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https://www.readbyqxmd.com/read/28329414/a-protocol-for-the-development-of-a-critical-thinking-assessment-tool-for-nurses-using-a-delphi-technique
#1
Elisabeth Jacob, Christine Duffield, Darren Jacob
AIM: The aim of this study is to develop an assessment tool to measure the critical thinking ability of nurses. BACKGROUND: As an increasing number of complex patients are admitted to hospitals, the importance of nurses recognising changes in health status and picking up on deterioration is more important. To detect early signs of complication requires critical thinking skills. Registered nurses are expected to commence their clinical careers with the necessary critical thinking skills to ensure safe nursing practice...
March 22, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28327116/a-tailored-online-safety-and-health-intervention-for-women-experiencing-intimate-partner-violence-the-ican-plan-4-safety-randomized-controlled-trial-protocol
#2
Marilyn Ford-Gilboe, Colleen Varcoe, Kelly Scott-Storey, Judith Wuest, James Case, Leanne M Currie, Nancy Glass, Marilyn Hodgins, Harriet MacMillan, Nancy Perrin, C Nadine Wathen
BACKGROUND: Intimate partner violence (IPV) threatens the safety and health of women worldwide. Safety planning is a widely recommended, evidence-based intervention for women experiencing IPV, yet fewer than 1 in 5 Canadian women access safety planning through domestic violence services. Rural, Indigenous, racialized, and immigrant women, those who prioritize their privacy, and/or women who have partners other than men, face unique safety risks and access barriers. Online IPV interventions tailored to the unique features of women's lives, and to maximize choice and control, have potential to reduce access barriers, and improve fit and inclusiveness, maximizing effectiveness of these interventions for diverse groups...
March 21, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28326967/development-and-validation-of-a-remote-home-safety-protocol
#3
Sergio Romero, Mi Jung Lee, Ivana Simic, Charles Levy, Jon Sanford
AIM: Environmental assessments and subsequent modifications conducted by healthcare professionals can enhance home safety and promote independent living. However, travel time, expense and the availability of qualified professionals can limit the broad application of this intervention. Remote technology has the potential to increase access to home safety evaluations. PURPOSE: This study describes the development and validation of a remote home safety protocol that can be used by a caregiver of an elderly person to video-record their home environment for later viewing and evaluation by a trained professional...
March 22, 2017: Disability and Rehabilitation. Assistive Technology
https://www.readbyqxmd.com/read/28326803/when-is-an-alveolar-type-2-cell-an-alveolar-type-2-cell-a-conundrum-for-lung-stem-cell-biology-and-regenerative-medicine
#4
Michael F Beers, Yuben Moodley
Generating mature, differentiated, adult lung cells from pluripotent cells such as induced pluripotent cells (iPS) and embryonic stem cells (ES) offers the hope of both generating disease specific in vitro models and creating definitive and personalized therapies for a host of debilitating lung parenchymal and airway diseases. With the goal of advancing lung regenerative medicine, several groups have developed and reported on protocols utilizing either defined media, co-culture with mesenchymal components, or sequential treatments mimicking lung development, to obtain distal lung epithelial cells from stem cell precursors...
March 22, 2017: American Journal of Respiratory Cell and Molecular Biology
https://www.readbyqxmd.com/read/28325461/neurocritical-care-of-acute-subdural-hemorrhage
#5
REVIEW
Fawaz Al-Mufti, Stephan A Mayer
Although urgent surgical hematoma evacuation is necessary for most patients with subdural hematoma (SDH), well-orchestrated, evidenced-based, multidisciplinary, postoperative critical care is essential to achieve the best possible outcome. Acute SDH complicates approximately 11% of mild to moderate traumatic brain injuries (TBIs) that require hospitalization, and approximately 20% of severe TBIs. Acute SDH usually is related to a clear traumatic event, but in some cases can occur spontaneously. Management of SDH in the setting of TBI typically conforms to the Advanced Trauma Life Support protocol with airway taking priority, and management breathing and circulation occurring in parallel rather than sequence...
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28325206/improving-glycemic-control-safely-in-non-critical-care-patients-a-collaborative-systems-approach-in-nine-hospitals
#6
Gregory A Maynard, Diana Childers, Janet Holdych, Heather Kendall, Tom Hoag, Karen Harrison
BACKGROUND: Practice variations in insulin management and glycemic adverse events led nine Dignity Health hospitals to initiate a collaborative effort to improve hypoglycemia, uncontrolled hyperglycemia, and glycemic control. METHODS: Non-critical care adult inpatients with ≥4 point-of-care blood glucose (BG) readings in a ≥2-day period were included. Balanced glucometric goals for each hospital were individualized to improve performance by 10%-20% from baseline or achieve top performance derived from Society of Hospital Medicine (SHM) benchmarking studies...
April 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28321321/associations-between-fluid-balance-and-outcomes-in-critically-ill-children-a-protocol-for-a-systematic-review-and-meta-analysis
#7
Rashid Alobaidi, Catherine Morgan, Rajit K Basu, Erin Stenson, Robin Featherstone, Sumit R Majumdar, Sean M Bagshaw
BACKGROUND: Fluid therapy is a mainstay during the resuscitation of critically ill children. After initial stabilization, excessive fluid accumulation may lead to complications of fluid overload, which has been independently associated with increased risk for mortality and major morbidity in critically ill children. OBJECTIVES: Perform an evidence synthesis to describe the methods used to measure fluid balance, define fluid overload, and evaluate the association between fluid balance and outcomes in critically ill children...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28320459/risk-factors-for-pressure-injury-development-in-critically-ill-patients-in-the-intensive-care-unit-a-systematic-review-protocol
#8
Fiona Coyer, Nahla Tayyib
BACKGROUND: Pressure injuries (PIs) create a significant burden in the health care system. Up to 49% of critically ill patients develop PIs. Identifying and understanding potential risk factors is essential to the provision of effective targeted prevention strategies to mitigate risk. The objectives of this review are to identify patient-centred clinical factors that may be associated with PI development in the adult intensive care environment and to determine the effect size of the relationship between identified factors and PI development in this unique population...
March 20, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28318674/organ-donor-management-eight-common-recommendations-and-actions-that-deserve-reflection
#9
C Chamorro-Jambrina, M R Muñoz-Ramírez, J L Martínez-Melgar, M S Pérez-Cornejo
Despite major advances in our understanding of the physiopathology of brain death (BD), there are important controversies as to which protocol is the most appropriate for organ donor management. Many recent reviews on this subject offer recommendations that are sometimes contradictory and in some cases are not applied to other critically ill patients. This article offers a review of the publications (many of them recent) with an impact upon these controversial measures and which can help to confirm, refute or open new areas of research into the most appropriate measures for the management of organ donors in BD, and which should contribute to discard certain established recommendations based on preconceived ideas, that lead to actions lacking a physiopathological basis...
March 16, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28315043/the-intensive-care-medicine-clinical-research-agenda-in-paediatrics
#10
REVIEW
Mark J Peters, Andrew Argent, Marino Festa, Stéphane Leteurtre, Jefferson Piva, Ann Thompson, Douglas Willson, Pierre Tissières, Marisa Tucci, Jacques Lacroix
BACKGROUND: Intensive Care Medicine set us the task of outlining a global clinical research agenda for paediatric intensive care (PIC). In line with the clinical focus of this journal, we have limited this to research that may directly influence patient care. METHODS: Clinician researchers from PIC research networks of varying degrees of formality from around the world were invited to answer two main questions: (1) What have been the major recent advances in paediatric critical care research? (2) What are the top 10 studies for the next 10 years? RESULTS: (1) Inclusive databases are well established in many countries...
March 17, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28306558/monitoring-of-the-physical-exam-in-sepsis
#11
Radu Postelnicu, Laura Evans
PURPOSE OF REVIEW: Monitoring of mental status and peripheral circulatory changes can be accomplished noninvasively in patients in the ICU. Emphasis on physical examination in conditions such as sepsis have gained increased attention as these evaluations can often serve as a surrogate marker for short-term treatment efficacy of therapeutic interventions. Sepsis associated encephalopathy and mental status changes correlate with worse prognosis in patients. Evaluation of peripheral circulation has been shown to be a convenient, easily accessible, and accurate marker for prognosis in patients with septic shock...
March 16, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28302179/balanced-crystalloids-versus-saline-in-the-intensive-care-unit-study-protocol-for-a-cluster-randomized-multiple-crossover-trial
#12
Matthew W Semler, Wesley H Self, Li Wang, Daniel W Byrne, Jonathan P Wanderer, Jesse M Ehrenfeld, Joanna L Stollings, Avinash B Kumar, Antonio Hernandez, Oscar D Guillamondegui, Addison K May, Edward D Siew, Andrew D Shaw, Gordon R Bernard, Todd W Rice
BACKGROUND: Saline, the intravenous fluid most commonly administered to critically ill adults, contains a high chloride content, which may be associated with acute kidney injury and death. Whether using balanced crystalloids rather than saline decreases the risk of acute kidney injury and death among critically ill adults remains unknown. METHODS: The Isotonic Solutions and Major Adverse Renal Events Trial (SMART) is a pragmatic, cluster-level allocation, cluster-level crossover trial being conducted between 1 June 2015 and 30 April 2017 in five intensive care units at Vanderbilt University Medical Center in Nashville, TN, USA...
March 16, 2017: Trials
https://www.readbyqxmd.com/read/28302101/preventing-diabetes-in-obese-latino-youth-with-prediabetes-a-study-protocol-for-a-randomized-controlled-trial
#13
Erica G Soltero, Yolanda P Konopken, Micah L Olson, Colleen S Keller, Felipe G Castro, Allison N Williams, Donald L Patrick, Stephanie Ayers, Houchun H Hu, Matthew Sandoval, Janiel Pimentel, William C Knowler, Kevin D Frick, Gabriel Q Shaibi
BACKGROUND: Obese Latino adolescents are disproportionately impacted by insulin resistance and type 2 diabetes. Prediabetes is an intermediate stage in the pathogenesis of type 2 diabetes and represents a critical opportunity for intervention. However, to date, no diabetes prevention studies have been conducted in obese Latino youth with prediabetes, a highly vulnerable and underserved group. Therefore, we propose a randomized-controlled trial to test the short-term (6-month) and long-term (12-month) efficacy of a culturally-grounded, lifestyle intervention, as compared to usual care, for improving glucose tolerance and reducing diabetes risk in 120 obese Latino adolescents with prediabetes...
March 16, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28297813/-clinical-application-and-evaluation-of-an-early-non-sedation-protocol-for-critically-ill-respiratory-patients
#14
J B Huang, C Q Lan, H Y Li, L Chen, J G Pan, L L Chen, H Weng, Y M Zeng
Objective: To study the value of an early (mechanical ventilation after 24 h) non-sedation protocol for intubated, mechanically ventilated patients in the respiratory intensive care unit (RICU). Methods: Seventy intubated, mechanically ventilated patients were prospectively enrolled and randomly assigned to management with early non-sedation (intervention group; n=35) or with daily interruption of sedation (DIS) (control group; n=35). The duration of mechanical ventilation, length of the RICU and hospital stay, RICU and hospital mortality, drug consumption, RICU and hospitalization expenses, incidence of complications and adverse events and serum levels of vital organ damage and inflammatory markers after mechanical ventilation for 48 h were recorded and compared...
March 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28296670/intraoperative-feeding-improves-calorie-and-protein-delivery-in-acute-burn-patients
#15
David E Varon, Gil Freitas, Neha Goel, Jennifer Wall, Deepak Bharadia, Erin Sisk, Joshua C Vacanti, Bohdan Pomahac, Indranil Sinha, Vihas M Patel
Enteral nutrition support is a critical component of modern burn care for severely burned patients. However, tube feeds are frequently withheld during the perioperative period because of aspiration concerns. As a result, patients requiring multiple operative procedures risk accumulating significant protein-calorie deficits. The objective of this study was to describe our American Burn Association-certified burn center's experience implementing an intraoperative feeding protocol in severely burned patients defined as a cutaneous burn ≥20% TBSA...
March 6, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28292331/the-ghent-psychotherapy-study-gps-on-the-differential-efficacy-of-supportive-expressive-and-cognitive-behavioral-interventions-in-dependent-and-self-critical-depressive-patients-study-protocol-for-a-randomized-controlled-trial
#16
Reitske Meganck, Mattias Desmet, Claudi Bockting, Ruth Inslegers, Femke Truijens, Melissa De Smet, Rosa De Geest, Kimberly Van Nieuwenhove, Vicky Hennissen, Goedele Hermans, Tom Loeys, Ufuoma Angelica Norman, Chris Baeken, Stijn Vanheule
BACKGROUND: Major depressive disorder is a leading cause of disease burden worldwide, indicating the importance of effective therapies. Outcome studies have shown overall efficacy of different types of psychotherapy across groups, yet large variability within groups. Although patient characteristics are considered crucial in understanding outcome, they have received limited research attention. This trial aims at investigating the interaction between therapeutic approach (pre-structured versus explorative) and the personality style of patients (dependent versus self-critical), which is considered a core underlying dimension of depressive pathology...
March 14, 2017: Trials
https://www.readbyqxmd.com/read/28291783/oesophageal-heat-exchangers-with-a-diameter-of-11mm-or-14-7mm-are-equally-effective-and-safe-for-targeted-temperature-management
#17
Daniel C Schroeder, Maria Guschlbauer, Alexandra C Maul, Daniel A Cremer, Ingrid Becker, David de la Puente Bethencourt, Peter Paal, Stephan A Padosch, Wolfgang A Wetsch, Thorsten Annecke, Bernd W Böttiger, Anja Sterner-Kock, Holger Herff
BACKGROUND: Targeted temperature management (TTM) is widely used in critical care settings for conditions including hepatic encephalopathy, hypoxic ischemic encephalopathy, meningitis, myocardial infarction, paediatric cardiac arrest, spinal cord injury, traumatic brain injury, ischemic stroke and sepsis. Furthermore, TTM is a key treatment for patients after out-of-hospital cardiac-arrest (OHCA). However, the optimal cooling method, which is quick, safe and cost-effective still remains controversial...
2017: PloS One
https://www.readbyqxmd.com/read/28290956/multidisciplinary-in-situ-simulation-based-training-as-a-postpartum-hemorrhage-quality-improvement-project
#18
Monica A Lutgendorf, Carmen Spalding, Elizabeth Drake, Dennis Spence, Jason O Heaton, Kristina V Morocco
BACKGROUND: Postpartum hemorrhage is a common obstetric emergency affecting 3 to 5% of deliveries, with significant maternal morbidity and mortality. Effective management of postpartum hemorrhage requires strong teamwork and collaboration. We completed a multidisciplinary in situ postpartum hemorrhage simulation training exercise with structured team debriefing to evaluate hospital protocols, team performance, operational readiness, and real-time identification of system improvements...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28290933/leveraging-the-partnership-for-patients-initiative-to-improve-patient-safety-and-quality-within-the-military-health-system
#19
Heidi B King, Kimberly Kesling, Carmen Birk, Theodore Walker, Heather Taylor, Michael Datena, Brittany Burgess, Lyndsay Bower
INTRODUCTION: Partnership for Patients (PfP) was a national initiative sponsored by the Department of Health and Human Services, Centers for Medicare and Medicaid Services, to reduce preventable hospital acquired conditions (HACs) by 40% and readmissions (within 30 days) by 20%, by the end of 2013 (as compared to the baseline of CY2010). Along with partners across the nation, the Assistant Secretary of Defense for Health Affairs, Dr. Jonathan Woodson, pledged to support PfP in June 2011...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28289049/kids-in-communities-study-kics-study-protocol-a-cross-sectional-mixed-methods-approach-to-measuring-community-level-factors-influencing-early-child-development-in-australia
#20
Sharon Goldfeld, Karen Villanueva, Robert Tanton, Ilan Katz, Sally Brinkman, Geoffrey Woolcock, Billie Giles-Corti
INTRODUCTION: Healthy childhood development in the early years is critical for later adult health and well-being. Early childhood development (ECD) research has focused primarily on individual, family and school factors, but largely ignored community factors. The Kids in Communities Study (KiCS) will test and investigate community-level influences on child development across Australia. METHODS AND ANALYSIS: Cross-sectional mixed-methods study exploring community-level effects in 25 Australian local communities; selection based on community socioeconomic status (SES) and ECD using the Australian Early Development Census (AEDC), a population measure of child development, to create a local community 'diagonality type', that is, those performing better or worse (off-diagonal), or as expected (on-diagonal) on the AEDC relative to their SES...
March 13, 2017: BMJ Open
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