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Ambulatory education

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https://www.readbyqxmd.com/read/28542089/patients-confidence-in-methods-of-blood-pressure-assessment-and-their-reported-adherence-to-antihypertensive-medications
#1
Paul Alvarez, Jennifer Zeng, Laura Tuttle, Anthony J Viera
OBJECTIVE: Adherence to antihypertensive medications is often less than optimal. Research suggests that patients have limited confidence regarding whether office blood pressure (BP) assessments represent their 'true' BP, which may further promote poor adherence to BP-lowering medication. We assessed peoples' confidence in the methods of BP assessment and examined the associations between patients' confidence levels and medication adherence comparing office and home BP-monitoring techniques...
May 24, 2017: Blood Pressure Monitoring
https://www.readbyqxmd.com/read/28541965/increasing-health-portal-utilization-in-cardiac-ambulatory-patients-a-pilot-project
#2
Carmen L Shaw, Gayle L Casterline, Dennis Taylor, Maureen Fogle, Bradi Granger
Increasing health portal participation actively engages patients in their care and improves outcomes. The primary aim for this project was to increase patient health portal utilization. Nurses used a tablet-based demo to teach patients how to navigate the health portal. Assigning health videos to the portal was a tactic used to increase utilization. Each patient participant was surveyed about health portal utilization at initial nurse navigator appointment, day of procedure, and 30 days after discharge. Seventy-three percent (n = 14) of the 19 selected patients received the intervention; 36% (n = 4) of patients reported using a health portal feature; meaningful use metric preintervention increased from 12% to 16% after the intervention; 16% and 18% of patients viewed assigned videos in their health portal prior to procedure and after hospital discharge...
May 25, 2017: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/28541137/clinical-use-of-continuous-glucose-monitoring-in-adults-with-type-2-diabetes
#3
Anders L Carlson, Deborah M Mullen, Richard M Bergenstal
Hemoglobin A1c is an excellent population health measure for the risk of vascular complications in diabetes, while continuous glucose monitoring (CGM) is a tool to help personalize a diabetes treatment plan. The value of CGM in individuals with type 1 diabetes (T1D) has been well demonstrated when compared with utilizing self-monitoring of blood glucose (SMBG) to guide treatment decisions. CGM is a tool for patients and clinicians to visualize the important role that diet, exercise, stress management, and the appropriate selection of diabetes medications can have in managing type 2 diabetes (T2D)...
May 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28527684/patient-perceptions-regarding-outpatient-hip-and-knee-arthroplasties
#4
R Michael Meneghini, Mary Ziemba-Davis
BACKGROUND: There has been increasing interest in outpatient total joint arthroplasty (TJA) in the orthopedic community, but how patients feel about outpatient TJA is unknown. The purpose of this study was to understand patient perspectives on hip and knee replacements performed in an outpatient setting. METHODS: We surveyed 110 consecutive patients scheduled for primary TJA in an academic suburban arthroplasty practice regarding their knowledge and perceptions of outpatient TJA...
April 13, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28526039/influences-on-patient-satisfaction-in-healthcare-centers-a-semi-quantitative-study-over-5%C3%A2-years
#5
Ruth D Thornton, Nicole Nurse, Laura Snavely, Stacey Hackett-Zahler, Kenice Frank, Robert A DiTomasso
BACKGROUND: Knowledge of ambulatory patients' satisfaction with clinic visits help improve communication and delivery of healthcare. The goal was to examine patient satisfaction in a primary care setting, identify how selected patient and physician setting and characteristics affected satisfaction, and determine if feedback provided to medical directors over time impacted patient satisfaction. METHODS: A three-phase, semi-quantitative analysis was performed using anonymous, validated patient satisfaction surveys collected from 889 ambulatory outpatients in 6 healthcare centers over 5-years...
May 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28522282/quality-indicators-for-the-use-of-systemic-antibiotics-in-dentistry
#6
Rugzan Jameel Hussein, Robert Krohn, Petra Kaufmann-Kolle, Gerald Willms
BACKGROUND: Risks resulted from using systemic antibiotics such as increasing rates of bacterial resistance, allergy and side effects should be always weighed individually for each patient against any potential benefits. Routine antibiotic prescribing must be therefore discouraged. The Federal Joint Committee ("Gemeinsamer Bundesauschuss", G-BA) commissioned the AQUA-Institute with the development of an external quality assurance procedure, examining systemic antibiotic use in periodontal, conservative and surgical treatments in ambulatory dental health care...
May 15, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28500408/scheduling-internal-medicine-resident-rotations-to-ensure-fairness-and-facilitate-continuity-of-care
#7
Ruben A Proano, Akshit Agarwal
Completing a residency program is a requirement for medical students before they can practice medicine independently. Residency programs in internal medicine must undergo a series of supervised rotations in elective, inpatient, and ambulatory units. Typically, a team of chief residents is charged to develop a yearly rotational schedule. This process is complex, as it needs to consider academic, managerial, regulatory, and legal restrictions while also facilitating the provision of patient care, ensuring a diverse educational experience, balancing the workload, and improving resident satisfaction...
May 12, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28498074/an-analysis-from-the-quality-outcomes-database-part-1-disability-quality-of-life-and-pain-outcomes-following-lumbar-spine-surgery-predicting-likely-individual-patient-outcomes-for-shared-decision-making
#8
Matthew J McGirt, Mohamad Bydon, Kristin R Archer, Clinton J Devin, Silky Chotai, Scott L Parker, Hui Nian, Frank E Harrell, Theodore Speroff, Robert S Dittus, Sharon E Philips, Christopher I Shaffrey, Kevin T Foley, Anthony L Asher
OBJECTIVE Quality and outcomes registry platforms lie at the center of many emerging evidence-driven reform models. Specifically, clinical registry data are progressively informing health care decision-making. In this analysis, the authors used data from a national prospective outcomes registry (the Quality Outcomes Database) to develop a predictive model for 12-month postoperative pain, disability, and quality of life (QOL) in patients undergoing elective lumbar spine surgery. METHODS Included in this analysis were 7618 patients who had completed 12 months of follow-up...
May 12, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28497471/clinician-perspectives-on-symptom-and-quality-of-life-experiences-of-patients-during-cancer-therapies-implications-for-ehealth
#9
Donna L Berry, Manan M Nayak, Janet L Abrahm, Ilana Braun, Michael S Rabin, Mary E Cooley
OBJECTIVES: The purpose of this study was to explore clinician experiences with cancer symptom and quality of life (SQL) management from diagnosis throughout therapy in the ambulatory setting, plus identify preferences for a future SQL decision support system. METHODS: Eligible clinicians worked in ambulatory cancer care with responsibility for direct patient care. Focus groups (FG) were conducted to discuss symptom management throughout the treatment experience and features desired in a future decision support system...
May 12, 2017: Psycho-oncology
https://www.readbyqxmd.com/read/28495909/pulse-wave-velocity-is-associated-with-cognitive-impairment-in-hemodialysis-patients
#10
Susanne Angermann, Marcus Baumann, Siegfried Wassertheurer, Christopher Clemens Mayer, Dominik Steubl, Christine Hauser, Yana Suttmann, Anna-Lena Reichelt, Robin Satanovskij, Georg Lorenz, Moritz Lukas, Bernhard Haller, Uwe Heemann, Timo Grimmer, Christoph Schmaderer
BACKGROUND: Cognitive impairment in hemodialysis patients is common and associated with adverse outcomes. So far, the underlying pathogenesis remains unclear. Therefore, we examined the potential relationship between cognitive impairment and three different categories of risk factors with particular focus on arterial stiffness measured by Pulse Wave Velocity (PWV). METHODS: A total of 201 chronic hemodialysis patients underwent cognitive testing under standardized conditions using the Montreal Cognitive Assessment (MoCA)...
May 11, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28489227/using-quality-improvement-in-resident-education-to-improve-transition-care
#11
Sofija D Volertas, Rita Rossi-Foulkes
The importance of a specific transition process is recognized by many health organizations. Got Transition, a cooperative endeavor aimed at improving the transition from pediatric to adult health care, developed Six Core Elements defining the basic components of health care transition support. In this article, we review the Six Core Elements by presenting a model that combines resident quality improvement and transition care training. In this Internal Medicine-Pediatrics residency program, ambulatory training for residents takes place in a combined adult and pediatric clinic...
May 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28486877/effects-of-the-mental-health-parity-and-addictions-equality-act-on-depression-treatment-choice-in-primary-care-facilities
#12
Daniel M Goldberg, Hsien-Chang Lin
Objective The Mental Health Parity and Addictions Equality Act (MHPAEA) of 2010 in the United States sought to expand mental health insurance benefits on par with medical benefits. As primary care facilities are often the first step in identifying mental health concerns, it is essential to examine the association of this policy with primary care physicians' choice on depression treatment. Method A retrospective cross-sectional study was conducted using data from the 2007-2012 National Ambulatory Medical Care Survey, including a weighted total of 162,699,930 depression patients...
January 2017: International Journal of Psychiatry in Medicine
https://www.readbyqxmd.com/read/28486632/a-quality-improvement-project-using-statistical-process-control-methods-for-type-2-diabetes-control-in-a-resource-limited-setting
#13
David Flood, Kate Douglas, Vera Goldberg, Boris Martinez, Pablo Garcia, MaryCatherine Arbour, Peter Rohloff
Quality issue: Quality improvement (QI) is a key strategy for improving diabetes care in low- and middle-income countries (LMICs). This study reports on a diabetes QI project in rural Guatemala whose primary aim was to improve glycemic control of a panel of adult diabetes patients. Initial assessment: Formative research suggested multiple areas for programmatic improvement in ambulatory diabetes care. Choice of solution: This project utilized the Model for Improvement and Agile Global Health, our organization's complementary healthcare implementation framework...
May 9, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28486615/effort-reward-imbalance-at-work-and-the-prevalence-of-unsuccessfully-treated-hypertension-among-white-collar-workers
#14
Xavier Trudel, Alain Milot, Mahée Gilbert-Ouimet, Caroline Duchaine, Line Guénette, Violaine Dalens, Chantal Brisson
We examined the association between effort-reward imbalance (ERI) exposure at work and unsuccessfully treated hypertension among white-collar workers from a large cohort in Quebec City, Canada. The study used a repeated cross sectional design involving three waves of data collection (2000-09). The study sample was composed of 474 workers treated for hypertension, accounting for 739 observations. At each time, ERI was measured using validated scales and ambulatory blood pressure (BP) was measured every 15 minutes during the working day...
May 9, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28482992/barriers-to-use-of-family-planning-methods-among-heterosexual-mexican-couples
#15
María Luisa Flores Arias, Jane Dimmitt Champion, Norma Elva Sáenz Soto, Marlene Tovar, Sandra Paloma Esparza Dávila
BACKGROUND: Family planning has become increasingly important as a fundamental component of sexual health and as such is offered via public health systems worldwide. Identification of barriers to use of family planning methods among heterosexual couples living in Mexico is indicated to facilitate access to family planning methods. METHODS: Barriers to family planning methods were assessed among Mexican heterosexual, sexually active males and females of reproductive age, using a modified Spanish version of the Barriers to the Use of Family Planning Methods scale (Cronbach's alpha = ...
May 1, 2017: Research and Theory for Nursing Practice
https://www.readbyqxmd.com/read/28474589/use-of-snapps-model-for-pediatric-outpatient-education
#16
Anju Kapoor, Anil Kapoor, Ashish Kalraiya, Sheela Longia
OBJECTIVE: To assess and compare the educational effectiveness of SNAPPS model with traditional method in developing reasoning skills of Pediatric residents in Out-patient department. METHODS: 40 case presentations with 4 residents (20 each with traditional and SNAPPS methods) were audiotaped and compared with respect to making differentials, reasoning for analyzing differentials, raising uncertainties by probing preceptor, and selecting case-related issues for self study...
April 15, 2017: Indian Pediatrics
https://www.readbyqxmd.com/read/28458577/ambulatory-anesthetic-care-in-children-undergoing-myringotomy-and-tube-placement-current-perspectives
#17
REVIEW
Hal Robinson, Thomas Engelhardt
PURPOSE: Myringotomy and tube placement is one of the most frequently performed ear, nose and throat (ENT) surgeries in the pediatric population. Effective anesthetic management is vital to ensuring successful ambulatory care and ensuring child and parental satisfaction. RECENT FINDINGS: This review summarizes recently published studies about the long-term effects of general anesthesia in young children, novel approaches to preoperative fasting and simplified approaches to the assessment and management of emergence delirium (ED) and emergence agitation (EA)...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28457296/the-role-of-occult-hypertension-in-retinal-vein-occlusions-and-diabetic-retinopathy
#18
Nataly Pesin, Efrem D Mandelcorn, Tina Felfeli, Richard I Ogilvie, Michael H Brent
OBJECTIVE: The aim of the study was to investigate whether individuals who develop retinal vein occlusion (RVO) or sudden-onset activity in otherwise quiescent diabetic retinopathy (DR) and those who have normal blood pressure (BP) or controlled hypertension according to their family physician show evidence of occult hypertension on 24-hour BP monitoring. METHODS: Patients with a new-onset RVO or DR that led to vitreous hemorrhage after a period of quiescence were identified...
April 2017: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
https://www.readbyqxmd.com/read/28439357/resident-dyads-providing-transition-care-to-adolescents-and-young-adults-with-chronic-illnesses-and-neurodevelopmental-disabilities
#19
Richard J Chung, Joan Jasien, Gary R Maslow
BACKGROUND: Youth with special health care needs often experience difficulty transitioning from pediatric to adult care. These difficulties may derive in part from lack of physician training in transition care and the challenges health care providers experience establishing interdisciplinary partnerships to support these patients. OBJECTIVE: This educational innovation sought to improve pediatrics and adult medicine residents' interdisciplinary communication and collaboration...
April 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28439353/improving-timely-resident-follow-up-and-communication-of-results-in-ambulatory-clinics-utilizing-a-web-based-audit-and-feedback-module
#20
Joel C Boggan, Aparna Swaminathan, Samantha Thomas, David L Simel, Aimee K Zaas, Jonathan G Bae
BACKGROUND: Failure to follow up and communicate test results to patients in outpatient settings may lead to diagnostic and therapeutic delays. Residents are less likely than attending physicians to report results to patients, and may face additional barriers to reporting, given competing clinical responsibilities. OBJECTIVE: This study aimed to improve the rates of communicating test results to patients in resident ambulatory clinics. METHODS: We performed an internal medicine, residency-wide, pre- and postintervention, quality improvement project using audit and feedback...
April 2017: Journal of Graduate Medical Education
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