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https://www.readbyqxmd.com/read/29222135/ambulatory-versus-inpatient-management-of-severe-nausea-and-vomiting-of-pregnancy-a-randomised-control-trial-with-patient-preference-arm
#1
Nicola Mitchell-Jones, Jessica Alice Farren, Aurelio Tobias, Tom Bourne, Cecilia Bottomley
OBJECTIVE: To determine whether ambulatory (outpatient (OP)) treatment of severe nausea and vomiting of pregnancy (NVP) is as effective as inpatient (IP) care. DESIGN: Non-blinded randomised control trial (RCT) with patient preference arm. SETTING: Two multicentre teaching hospitals in London. PARTICIPANTS: Women less than 20 weeks' pregnant with severe NVP and associated ketonuria (>1+). METHODS: Women who agreed to the RCT were randomised via web-based application to either ambulatory or IP treatment...
December 5, 2017: BMJ Open
https://www.readbyqxmd.com/read/29195738/a-perioperative-care-map-improves-outcomes-in-patients-with-morbid-obesity-undergoing-major-surgery
#2
Benjamin D Boodaie, Anthony H Bui, David L Feldman, Michael Brodman, Peter Shamamian, Ronald Kaleya, Meg Rosenblatt, Donna Somerville, Patricia Kischak, I Michael Leitman
BACKGROUND: The surgical management of patients with morbid obesity (BMI ≥ 40) is notable for a relatively high risk of complications. To address this problem, a perioperative care map was developed using precautions and best practices commonly employed in bariatric surgery. It requires additional medical assessments, sleep apnea surveillance, more stringent guidelines for anesthetic management, and readily available bariatric operating room equipment, among other items. This care map was implemented in 2013 at four major urban teaching hospitals for use in patients undergoing all types of non-ambulatory surgery with a BMI greater than 40 kg/m2...
November 28, 2017: Surgery
https://www.readbyqxmd.com/read/29189213/blood-pressure-monitoring-theory-and-practice-european-society-of-hypertension-working-group-on-blood-pressure-monitoring-and-cardiovascular-variability-teaching-course-proceedings
#3
George S Stergiou, Paolo Palatini, Roland Asmar, Grzegorz Bilo, Alejandro de la Sierra, Geoff Head, Kazuomi Kario, Anastasia Mihailidou, Jiguang Wang, Giuseppe Mancia, Eoin O'Brien, Gianfranco Parati
The European Society of Hypertension (ESH) Working Group on Blood Pressure (BP) Monitoring and Cardiovascular Variability organized a Teaching Course on 'Blood Pressure Monitoring: Theory and Practice' during the 2017 ESH Meeting in Milan, Italy. This course performed by 11 international BP monitoring experts covered key topics of BP monitoring, including office BP measurement, ambulatory BP monitoring, home BP monitoring, ambulatory versus home BP, white-coat and masked hypertension, cuff use, and BP variability...
November 17, 2017: Blood Pressure Monitoring
https://www.readbyqxmd.com/read/29167142/creating-a-new-rural-pharmacy-workforce-development-and-implementation-of-the-rural-pharmacy-health-initiative
#4
Mollie Ashe Scott, Stephanie Kiser, Irene Park, Rebecca Grandy, Pamela U Joyner
PURPOSE: An innovative certificate program aimed at expanding the rural pharmacy workforce, increasing the number of pharmacists with expertise in rural practice, and improving healthcare outcomes in rural North Carolina is described. SUMMARY: Predicted shortages of primary care physicians and closures of critical access hospitals are expected to worsen existing health disparities. Experiential education in schools and colleges of pharmacy primarily takes place in academic medical centers and, unlike experiential education in medical schools, rarely emphasizes the provision of patient care in rural U...
December 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29154055/complementary-and-alternative-medicine-use-among-elderly-patients-living-with-chronic-diseases-in-a-teaching-hospital-in-ethiopia
#5
Asnakew Achaw Ayele, Henok Getachew Tegegn, Kaleab Taye Haile, Sewunet Admasu Belachew, Amanual Getnet Mersha, Daniel Asfaw Erku
BACKGROUND: The use of complementary and alternative medicine (CAM) among patients with chronic diseases has grown rapidly worldwide. Yet, little has been known about CAM use by elderly patients with chronic diseases in Ethiopia. This study aimed at assessing the prevalence and reasons for CAM utilization among elderly patients living with chronic diseases in Ethiopia. METHODS: An institution-based quantitative cross-sectional survey was conducted among elderly patients with chronic disease attending outpatient ambulatory clinics of University of Gondar referral and teaching hospital (UoGRTH)...
December 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/29068819/an-innovative-shared-decision-making-curriculum-for-internal-medicine-residents-findings-from-the-university-of-pittsburgh-medical-center
#6
Jennifer Rusiecki, Jane Schell, Scott Rothenberger, Sarah Merriam, Melissa McNeil, Carla Spagnoletti
PURPOSE: Shared decision making (SDM) is a core competency in health policy and guidelines. Most U.S. internal medicine residencies lack an SDM education curriculum. A standardized patient (SP)-based curriculum teaching key concepts and skills of SDM was developed. METHOD: This curriculum consisted of an innovative seven-step SDM model and a skills-focused SP case, integrated into the ambulatory rotation for senior medicine residents at the University of Pittsburgh Medical Center in 2015...
October 24, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28970040/-the-private-pediatrician-in-the-clinical-care-pathway-for-children-affected-by-specific-learning-disorders-in-france
#7
T-N Willig, J P Blanc, R Assathiany
The clinical care pathway for children presenting specific learning disorders, including language, motor coordination, and attention disorders is based on different levels of assessment by the professionals involved. In France, a first step of organization was established in 2002 by founding of a network of structures devoted to clinical assessment of complex cases, research, and teaching for the professionals involved. Although this organization proved to contribute an essential service, the demand largely exceeded the availability of access...
November 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28953296/effective-learning-in-an-ambulatory-family-medicine-clerkship-a-qualitative-study-of-medical-student-midpoint-feedback
#8
Melissa K Bradner, Sharon Kaufer Flores, Judy S Gary, Sharon Zumbrunn
BACKGROUND AND OBJECTIVES: There is substantial research on the effectiveness of ambulatory medical preceptors' teaching skills, but less is known about the student perspective on what contributes most to effective learning in a busy clinical practice. METHODS: As part of a formative midpoint assessment during the third-year clerkship in family medicine, students were asked to respond to the following open-ended reflective prompt: "My preceptor contributed to my learning by...
September 2017: Family Medicine
https://www.readbyqxmd.com/read/28891855/patient-satisfaction-with-propofol-for-outpatient-colonoscopy-a-prospective-randomized-double-blind-study
#9
RANDOMIZED CONTROLLED TRIAL
Anantha Padmanabhan, Christoforos Frangopoulos, Lynn E T Shaffer
BACKGROUND: Previous literature has shown that propofol has ideal anesthetic properties for patients undergoing colonoscopy, a common procedure at outpatient surgery centers. However, there is a paucity of information regarding patient satisfaction with propofol. OBJECTIVE: The aim of this study was to evaluate patient satisfaction with propofol compared with nonpropofol (fentanyl/midazolam) anesthesia for outpatient colonoscopies. Safety and complications were secondary end points...
October 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28834845/primary-care-residents-in-teaching-health-centers-their-intentions-to-practice-in-underserved-settings-after-residency-training
#10
Zohray Talib, Mariellen Malloy Jewers, Julia H Strasser, David K Popiel, Debora Goetz Goldberg, Candice Chen, Hayden Kepley, Fitzhugh Mullan, Marsha Regenstein
PURPOSE: To describe the residents who chose to train in teaching health centers (THCs), which are community-based ambulatory patient care sites that sponsor primary care residencies, and their intentions to practice in underserved settings. METHOD: The authors surveyed all THC residents training in academic years 2013-2014, 2014-2015, and 2015-2016, comparing their demographic characteristics with data available for residents nationally, and examined THC residents' intentions to practice in underserved settings using logistic regression analysis...
August 22, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28830868/efficient-and-effective-precepting-of-pharmacy-students-in-acute-and-ambulatory-care-rotations-a-delphi-expert-panel-study
#11
Robert Ignoffo, Lucinda Chan, Katherine Knapp, Emily Chan, Eric Ip, Jason Bandy, Kathleen Besinque, James Colbert, Jeremiah J Duby, Joseph S Galanto, Mark Gloudeman, Patty Havard, Grant Lackey, Eric Lozano, James Scott, Tania L Stewart
PURPOSE: Using the Delphi process, a panel of experienced preceptors achieved consensus on best practices to increase preceptor efficiency and effectiveness. METHODS: The Delphi panelists completed 3 survey rounds and a face-to-face meeting. Survey questions covered several topics, including preparation of students for rotations, preceptor efficiency and effectiveness, potential resident contributions to precepting, methods of developing critical-thinking skills and providing assessment and feedback, precepting time metrics, and barriers to preceptor effectiveness...
August 22, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28794119/trends-and-outcomes-after-same-day-discharge-after-percutaneous-coronary-interventions
#12
Shikhar Agarwal, Badal Thakkar, Kimberly A Skelding, James C Blankenship
BACKGROUND: Despite the demonstrated safety of the same-day discharge (SDD) after percutaneous coronary intervention (PCI), uptake of this program has been relatively poor in the United States. We evaluated the temporal trends and variations in the utilization of SDD after PCI during the contemporary era. In addition, we evaluated the predictors of SDD (compared with next-day discharge) and the causes of readmission in these 2 patient cohorts. METHODS AND RESULTS: Data were extracted from State Ambulatory Surgical Database and State Inpatient Database from Florida and New York ranging from 2009 to 2013...
August 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28734046/effect-of-a-community-based-service-learning-experience-in-geriatrics-on-internal-medicine-residents-and-community-participants
#13
Rachel K Miller, Jennifer Michener, Phyllis Yang, Karen Goldstein, Jennine Groce-Martin, Gala True, Jerry Johnson
Community-based service learning (CBSL) provides an opportunity to teach internal medicine residents the social context of aging and clinical concepts. The objectives of the current study were to demonstrate the feasibility of a CBSL program targeting internal medicine residents and to assess its effect on medical residents and community participants. internal medicine residents participated in a CBSL experience for half a day during ambulatory blocks from 2011 to 2014. Residents attended a senior housing unit or center, delivered a presentation about a geriatric health topic, toured the facility, and received information about local older adult resources...
September 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28708356/-what-remains-of-our-balints
#14
Régis Marion-Veyron, Konstantinos Tzartzas, Michael Saraga
In addition to providing psychiatric care to patients with somatic diseases, liaison psychiatry plays a role in the teaching of the relational aspects of medical practice. This series of three articles offers a critical reflection on this topic and examples of educational programs developed at Lausanne University Hospital. In the Department of Ambulatory Care and Community Medicine, an intervention inspired by Balint groups offers to residents in general internal medicine the possibility of working through their clinical experiences and their evolving professional identity...
February 8, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28602709/factors-associated-with-the-use-of-potentially-inappropriate-medications-by-older-adults-with-cancer
#15
Cristiane Moreira Reis, Andrezza Gouvêa Dos Santos, Paula de Jesus Souza, Adriano Max Moreira Reis
OBJECTIVES: To determine the frequency and the factors associated with the use of potentially inappropriate medications (PIMs) by older adults with cancer at an onco-haematology ambulatory clinic of a teaching hospital in Brazil. MATERIAL AND METHODS: Patients aged 60years or older (n=160) subjected to parenteral antineoplastic chemotherapy from May to December 2015 and treated with one or more medications in the ambulatory clinic were interviewed. Data on medications, comorbidities, oncological diagnosis, and functional status were recorded...
July 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28541965/increasing-health-portal-utilization-in-cardiac-ambulatory-patients-a-pilot-project
#16
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/28527552/postoperative-instructions-preoperatively-evaluating-the-effectiveness-of-a-teaching-model-on-patient-satisfaction-regarding-instructions-for-home-care
#17
Jennifer Hovsepian, Cheryl McGah, Claire O'Brien
Patients in the ambulatory setting often receive home care instructions, primarily in the postoperative phase. Patient's retention and understanding of these instructions is one determinant of postoperative outcomes. This article highlights how we designed and implemented a teaching strategy to better prepare patients for discharge from an ambulatory surgical setting. Our methods included developing a day of surgery plan for teaching patients their discharge instructions upon arrival, creating on-line teaching videos, and revising post discharge pain medication instructions...
June 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28474589/use-of-snapps-model-for-pediatric-outpatient-education
#18
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/28473306/using-a-medical-intranet-of-things-system-to-prevent-bed-falls-in-an-acute-care-hospital-a-pilot-study
#19
Henri U Balaguera, Diana Wise, Chun Yin Ng, Han-Wen Tso, Wan-Lin Chiang, Aimee M Hutchinson, Tracy Galvin, Lee Hilborne, Cathy Hoffman, Chi-Cheng Huang, C Jason Wang
BACKGROUND: Hospitalized patients in the United States experience falls at a rate of 2.6 to 17.1 per 1000 patient-days, with the majority occurring when a patient is moving to, from, and around the bed. Each fall with injury costs an average of US $14,000. OBJECTIVE: The aim was to conduct a technology evaluation, including feasibility, usability, and user experience, of a medical sensor-based Intranet of things (IoT) system in facilitating nursing response to bed exits in an acute care hospital...
May 4, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28434459/becoming-parent-and-nurse-high-fidelity-simulation-in-teaching-ambulatory-central-line-infection-prevention-to-parents-of-children-with-cancer
#20
Carol E Heiser Rosenberg, Mary F Terhaar, Judith A Ascenzi, Anna Walbert, K Michelle Kokoszka, Julianne S Perretta, Marlene R Miller
BACKGROUND: Ambulatory central-line infections in children with cancer are life-threatening. Infections are two to three times more frequent in outpatients than inpatients, for whom evidence-based bundles have decreased morbidity. Most cancer care now takes place at home, where parents perform many of the same tasks as nurses. However, parents often feel stressed and unprepared. To address this, high-fidelity simulation, which has been effective for teaching novice nurses, was evaluated for parent central-line education...
May 2017: Joint Commission Journal on Quality and Patient Safety
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