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https://www.readbyqxmd.com/read/29606163/the-impact-of-isolation-on-healthcare-worker-contact-and-compliance-with-infection-control-practices-in-nursing-homes
#1
Lisa Pineles, Chris Petruccelli, Eli N Perencevich, Mary-Claire Roghmann, Kalpana Gupta, Jose Cadena, Gio Baracco, Christopher D Pfeiffer, Graeme Forrest, Suzanne F Bradley, Chris Crnich, Heather Reisinger, Daniel J Morgan
OBJECTIVETo directly observe healthcare workers in a nursing home setting to measure frequency and duration of resident contact and infection prevention behavior as a factor of isolation practiceDESIGNObservational studySETTING AND PARTICIPANTSHealthcare workers in 8 VA nursing homes in Florida, Maryland, Massachusetts, Michigan, Washington, and TexasMETHODSOver a 15-month period, trained research staff without clinical responsibilities on the units observed nursing home resident room activity for 15-30-minute intervals...
April 2, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29575978/decreasing-dialysis-catheter-rates-by-creating-a-multidisciplinary-dialysis-access-program
#2
Patricia M Rosenberry, Silke V Niederhaus, Eugene J Schweitzer, David B Leeser
INTRODUCTION: Centers for Medicare and Medicaid Services have determined that chronic dialysis units should have <12% of their patients utilizing central venous catheters for hemodialysis treatments. On the Eastern Shore of Maryland, the central venous catheter rates in the dialysis units averaged >45%. A multidisciplinary program was established with goals of decreasing catheter rates in order to decrease central line-associated bloodstream infections, decrease mortality associated with central line-associated bloodstream infection, decrease hospital days, and provide savings to the healthcare system...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29570362/verbal-test-of-practical-judgment-vpj-a-new-test-of-judgment-that-predicts-functional-skills-for-older-adults
#3
William E Mansbach, Melissa A Tanner, Francis Schindler
OBJECTIVES: The clinical assessment of older adults' judgment is important for mitigating safety risks that often precipitate loss of independence. Our national survey of geriatric healthcare providers (N = 496; M years of experience = 17.11 ± 10.60) indicated that formal judgment tests are underutilized in clinical practice. We developed the Verbal Test of Practical Judgment (VPJ) as a new test of judgment for older adults intended to identify difficulty performing instrumental activities of daily living (IADL)...
March 23, 2018: Aging & Mental Health
https://www.readbyqxmd.com/read/29555709/venous-thromboembolism-quality-measures-fail-to-accurately-measure-quality
#4
REVIEW
Brandyn D Lau, Michael B Streiff, Peter J Pronovost, Elliott R Haut
Venous thromboembolism (VTE) is 1 of the most common causes of preventable harm for patients in hospitals. Consequently, the Joint Commission, the Centers for Medicare and Medicaid Services, the Agency for Healthcare Research and Quality, the United Kingdom Care Quality Commission, the Australian Commission on Safety and Quality in Health Care, the Maryland Health Services Cost Review Commission, and the American College of Surgeons have prioritized measuring and reporting VTE outcomes with the goal of reducing the incidence of and preventable harm from VTE...
March 20, 2018: Circulation
https://www.readbyqxmd.com/read/29553339/carbapenem-nonsusceptible-acinetobacter-baumannii-8-us-metropolitan-areas-2012-2015
#5
Sandra N Bulens, Sarah H Yi, Maroya S Walters, Jesse T Jacob, Chris Bower, Jessica Reno, Lucy Wilson, Elisabeth Vaeth, Wendy Bamberg, Sarah J Janelle, Ruth Lynfield, Paula Snippes Vagnone, Kristin Shaw, Marion Kainer, Daniel Muleta, Jacqueline Mounsey, Ghinwa Dumyati, Cathleen Concannon, Zintars Beldavs, P Maureen Cassidy, Erin C Phipps, Nicole Kenslow, Emily B Hancock, Alexander J Kallen
In healthcare settings, Acinetobacter spp. bacteria commonly demonstrate antimicrobial resistance, making them a major treatment challenge. Nearly half of Acinetobacter organisms from clinical cultures in the United States are nonsusceptible to carbapenem antimicrobial drugs. During 2012-2015, we conducted laboratory- and population-based surveillance in selected metropolitan areas in Colorado, Georgia, Maryland, Minnesota, New Mexico, New York, Oregon, and Tennessee to determine the incidence of carbapenem-nonsusceptible A...
April 2018: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/29461992/healthcare-s-future-strategic-investment-in-technology
#6
Michael A Franklin
Recent and rapid advances in the implementation of technology have greatly affected the quality and efficiency of healthcare delivery in the United States. Simultaneously, diverse generational pressures-including the consumerism of millennials and unsustainable growth in the costs of care for baby boomers-have accelerated a revolution in healthcare delivery that was marked in 2010 by the passage of the Affordable Care Act.Against this backdrop, Maryland and the Centers for Medicare & Medicaid Services entered into a partnership in 2014 to modernize the Maryland All-Payer Model...
April 2018: Frontiers of Health Services Management
https://www.readbyqxmd.com/read/29411541/exploring-an-alternative-approach-to-lyme-disease-surveillance-in-maryland
#7
H Rutz, B Hogan, S Hook, A Hinckley, K Feldman
In Maryland, Lyme disease (LD) is a reportable disease and all laboratories and healthcare providers are required to report to the local health department. Given the volume of LD reports and effort required for investigation, surveillance for LD is burdensome and subject to underreporting. We explored the utility of International Classification of Diseases, 9th Revision, Clinical Modification (administrative) codes for use with LD surveillance. We aimed to collect the administrative codes for a 10% sample of 2009 LD reports (n = 474) from 292 facilities stratified by case classification (confirmed, probable, suspected and not a case)...
February 6, 2018: Zoonoses and Public Health
https://www.readbyqxmd.com/read/29397800/electronically-available-comorbid-conditions-for-risk-prediction-of-healthcare-associated-clostridium-difficile-infection
#8
Anthony D Harris, Alyssa N Sbarra, Surbhi Leekha, Sarah S Jackson, J Kristie Johnson, Lisa Pineles, Kerri A Thom
OBJECTIVE To analyze whether electronically available comorbid conditions are risk factors for Centers for Disease Control and Prevention (CDC)-defined, hospital-onset Clostridium difficile infection (CDI) after controlling for antibiotic and gastric acid suppression therapy use. PATIENTS Patients aged ≥18 years admitted to the University of Maryland Medical Center between November 7, 2015, and May 31, 2017. METHODS Comorbid conditions were assessed using the Elixhauser comorbidity index. The Elixhauser comorbidity index and the comorbid condition components were calculated using the International Classification of Disease, Tenth Revision, Clinical Modification (ICD-10-CM) codes extracted from electronic medical records...
March 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29316451/an-innovative-model-to-coordinate-healthcare-and-social-services-for-people-with-serious-mental-illness-a-mixed-methods-case-study-of-maryland-s-medicaid-health-home-program
#9
Emma E McGinty, Alene Kennedy-Hendricks, Sarah Linden, Seema Choksy, Elizabeth Stone, Gail L Daumit
OBJECTIVE: We conducted a case study examining implementation of Maryland's Medicaid health home program, a unique model for integration of behavioral, somatic, and social services for people with serious mental illness (SMI) in the psychiatric rehabilitation program setting. METHOD: We conducted interviews and surveys with health home leaders (N=72) and front-line staff (N=627) representing 46 of the 48 total health home programs active during the November 2015-December 2016 study period...
March 2018: General Hospital Psychiatry
https://www.readbyqxmd.com/read/29299815/older-adults-perceptions-of-the-causes-and-consequences-of-healthcare-overuse-a-qualitative-study
#10
Ariel R Green, Monica Tung, Jodi B Segal
BACKGROUND: Overuse of healthcare is pervasive in the United States, often exposing patients to harm with little likelihood of benefit. Older Americans are particularly vulnerable to overuse and impacted by it, yet it is unknown whether older patients perceive overuse as a consequential problem. OBJECTIVE: To explore the experiences and perspectives of older adults with respect to healthcare overuse in order to develop a framework for understanding and reducing overuse in older adults...
January 3, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29189477/remaining-financially-viable-in-a-time-of-healthcare-transition
#11
Barry P Ronan
In an unstable healthcare environment, Western Maryland Health System has been demonstrating stability. We have responded to the many challenges that hospitals face and managed to thrive in the new, value-based world.We made the transition to value-based payment and care delivery models through innovations in Maryland's payment system. In 2010, we recognized that becoming a demonstration project for value-based care would benefit our health system as we dealt with an aging and shrinking regional population...
January 2017: Frontiers of Health Services Management
https://www.readbyqxmd.com/read/29188069/simultaneous-isolation-of-chryseobacterium-gleum-from-bloodstream-and-respiratory-tract-first-case-report-from-india
#12
Vidhi Jain, Nayani Amrin Fatema Afzal Hussain, Tasneem Siddiqui, Chinmoy Sahu, Malay Ghar, Kashi Nath Prasad
Introduction. Species of the genus Chryseobacterium are emerging healthcare-associated pathogens, often colonizing the hospital environment. There are no clear guidelines available for antimicrobial susceptibility of this organism. In this report we present the first case, to our knowledge, of simultaneous central-line-associated bloodstream infection (CLABSI) and ventilator-associated pneumonia (VAP) due to Chryseobacterium gleum from India. Case presentation. A 62 years old man with a history of a road traffic accident 1 month previously was referred to our center for further management...
October 2017: JMM Case Reports
https://www.readbyqxmd.com/read/28968409/a-brief-intervention-for-preparing-icu-families-to-be-proxies-a-phase-i-study
#13
Alison E Turnbull, Caroline M Chessare, Rachel K Coffin, Dale M Needham
BACKGROUND: Family members of critically ill patients report high levels of conflict with clinicians, have poor understanding of prognosis, struggle to make decisions, and experience substantial symptoms of anxiety, depression, and post-traumatic stress regardless of patient survival status. Efficient interventions are needed to prepare these families to act as patient proxies. OBJECTIVES: To assess a brief "patient activation" intervention designed to set expectations and prepare families of adult intensive care unit (ICU) patients to communicate effectively with the clinical team...
2017: PloS One
https://www.readbyqxmd.com/read/28917951/a-spatial-analysis-of-race-local-health-promoting-resources-and-preventable-hospitalizations
#14
Caryn N Bell, Janice V Bowie, Roland J Thorpe, David M Levine
INTRODUCTION: Preventable hospitalizations (PHs) for chronic conditions could have been avoided if treated with primary healthcare. PH rates are higher among African Americans, and in areas with less healthcare. Little is known about the effects of non-healthcare local health-promoting resources (LHPRs). The objective of this study is to determine associations between LHPRs and chronic PH rates in Maryland, and to assess spatial clustering of areas with high PH rates. METHODS: Hospitalizations in 2010 were obtained from the Maryland Health Services Cost Review Commission by zip code of residence...
December 2017: Preventive Medicine
https://www.readbyqxmd.com/read/28858967/applying-decision-science-to-the-prioritization-of-healthcare-associated-infection-initiatives
#15
Terry H Tsai, Michael D Gerst, Cyrus Engineer, Harold P Lehmann
OBJECTIVES: Improving patient quality remains a top priority from the perspectives of both patient outcomes and cost of care. The continuing threat to patient safety has resulted in an increasing number of options for patient safety initiatives, making choices more difficult because of competing priorities. This study provides a proof of concept for using low-cost decision science methods for prioritizing initiatives. METHODS: Using multicriteria decision analysis, we developed a decision support model for aiding the prioritization of the four most common types of healthcare-associated infections: surgical site infections, central line-associated bloodstream infections, ventilator-associated events, and catheter-associated urinary tract infections...
August 30, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28820507/hematopoietic-stem-cell-transplantation-recipient-and-caregiver-factors-affecting-length-of-stay-and-readmission
#16
Thiruppavai Sundaramurthi, Leslie Wehrlen, Erika Friedman, Sue Thomas, Margaret Bevans
PURPOSE/OBJECTIVES: To evaluate the contributions of patient and caregiver factors to length of stay (LOS) and 30-day readmission status for recipients of allogeneic hematopoietic stem cell transplantation (HSCT).
. DESIGN: Secondary data analysis from a phase 2 clinical trial.
. SETTING: National Institutes of Health Clinical Center in Bethesda, Maryland.
. SAMPLE: 68 dyads (N = 136) comprised of patients receiving HSCT and their caregivers...
September 1, 2017: Oncology Nursing Forum
https://www.readbyqxmd.com/read/28780533/nursing-home-facebook-reviews-who-has-them-and-how-do-they-relate-to-other-measures-of-quality-and-experience
#17
Jennifer Gaudet Hefele, Yue Li, Lauren Campbell, Adrita Barooah, Joyce Wang
BACKGROUND: The growing use of social media creates opportunities for patients and families to provide feedback and rate individual healthcare providers. Whereas previous studies have examined this emerging trend in hospital and physician settings, little is known about user ratings of nursing homes (NHs) and how these ratings relate to other measures of quality. OBJECTIVE: To examine the relationship between Facebook user-generated NH ratings and other measures of NH satisfaction/experience and quality...
February 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28770189/racial-disparities-in-emergency-department-utilization-for-dental-oral-health-related-conditions-in-maryland
#18
Natalia I Chalmers
OBJECTIVES: Hospital emergency departments (EDs) are a place where many Americans seek treatment of dental conditions. Racial and ethnic minorities consistently have higher rates of ED utilization than whites for dental conditions. The reasons for these disparities and significant public health concerns are investigated less often. In this paper, we measure trends in racial disparities in ED discharges for dental conditions in Maryland from 2010 to 2013. To understand these disparities, we also describe differences between racial groups in age, gender, income, location, payer, comorbidities, and the availability of dental care...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28736796/longitudinal-research-on-aging-drivers-longroad-study-design-and-methods
#19
Guohua Li, David W Eby, Robert Santos, Thelma J Mielenz, Lisa J Molnar, David Strogatz, Marian E Betz, Carolyn DiGuiseppi, Lindsay H Ryan, Vanya Jones, Samantha I Pitts, Linda L Hill, Charles J DiMaggio, David LeBlanc, Howard F Andrews
BACKGROUND: As an important indicator of mobility, driving confers a host of social and health benefits to older adults. Despite the importance of safe mobility as the population ages, longitudinal data are lacking about the natural history and determinants of driving safety in older adults. METHODS: The Longitudinal Research on Aging Drivers (LongROAD) project is a multisite prospective cohort study designed to generate empirical data for understanding the role of medical, behavioral, environmental and technological factors in driving safety during the process of aging...
December 2017: Injury Epidemiology
https://www.readbyqxmd.com/read/28735371/identifying-symptoms-of-distress-in-youth-living-with-neurofibromatosis-type-1-nf1
#20
Lori Wiener, Haven Battles, Sima Zadeh Bedoya, Andrea Baldwin, Brigitte C Widemann, Maryland Pao
Children and adolescents with Neurofibromatosis type 1 (NF1) are at increased risk for wide-ranging behavioral, developmental, and cognitive impairments and decreased quality of life. To date, no psychosocial screening tool has been developed to quickly assess the symptoms that 1) can be addressed during routine medical appointments in children with NF1, 2) can produce interpretable and actionable results, 3) can be integrated into medical care, and 4) can quickly identify patients at risk in order to better address that the provision of appropriate care are available...
July 23, 2017: Journal of Genetic Counseling
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