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https://www.readbyqxmd.com/read/28725789/improving-american-healthcare-through-clinical-lab-2-0-a-project-santa-fe-report
#1
James M Crawford, Khosrow Shotorbani, Gaurav Sharma, Michael Crossey, Tarush Kothari, Thomas S Lorey, Jeffrey W Prichard, Myra Wilkerson, Nancy Fisher
Project Santa Fe was established both to provide thought leadership and to help develop the evidence base for the valuation of clinical laboratory services in the next era of American healthcare. The participants in Project Santa Fe represent major regional health systems that can operationalize laboratory-driven innovations and test their valuation in diverse regional marketplaces in the United States. We provide recommendations from the inaugural March 2016 meeting of Project Santa Fe. Specifically, in the transition from volume-based to value-based health care, clinical laboratories are called upon to provide programmatic leadership in reducing total cost of care through optimization of time-to-diagnosis and time-to-effective therapeutics, optimization of care coordination, and programmatic support of wellness care, screening, and monitoring...
January 2017: Acad Pathol
https://www.readbyqxmd.com/read/28722141/failure-to-rescue-as-a-nurse-sensitive-indicator
#2
Jane Mushta, Kathy L Rush, Elizabeth Andersen
PROBLEM: The aim of this concept analysis was to clarify failure to rescure as a nurse-sensitive indicator. Although the concept of failure to rescue as a nurse-sensitive outcome has appeared in the nursing literature for over a decade, conceptual clarity is needed to address its variable and ambiguous use in health care. METHODS: Walker and Avant's eight-stage method of concept analysis was used to explore the concept of failure to rescue in nursing practice. Twenty-one papers were retrieved from Cumulative Index of Nursing and Allied Health Literature (CINAHL) and MEDLINE databases and selected for review and synthesis...
July 19, 2017: Nursing Forum
https://www.readbyqxmd.com/read/28719249/applying-sensory-modulation-to-mental-health-inpatient-care-to-reduce-seclusion-and-restraint-a-case-control-study
#3
Charlotte Andersen, Anne Kolmos, Kjeld Andersen, Volkmar Sippel, Elsebeth Stenager
BACKGROUND: Clinical training in managing conflicts and preventing violence seldom contains sensory modulation (SM) as a method to de-escalate and prevent restraint and seclusion. Sensory-based interventions promote adaptive regulation of arousal and emotion. SM is a complementary approach that is associated with reduced rates of seclusion and restraint in mental healthcare, but there is need for more research in this area. AIMS: Using SM to reduce restraint and seclusion in inpatient mental health care...
July 18, 2017: Nordic Journal of Psychiatry
https://www.readbyqxmd.com/read/28716050/working-for-patient-safety-a-qualitative-study-of-women-s-help-seeking-during-acute-perinatal-events
#4
Nicola Mackintosh, Susanna Rance, Wendy Carter, Jane Sandall
BACKGROUND: Women and their relatives can play an important role in early detection and help seeking for acute perinatal events. Recent UK reports indicate that patient-professional partnership in 'working for safety' can be difficult to achieve in practice, sometimes with catastrophic consequences. This research explored the experiences of women and relatives who had experienced early warning signs about their condition and sought help in escalating care. METHODS: Secondary analysis of case study data which included qualitative interviews with 22 women purposively sampled on account of experiencing a step up in care and 4 of their relatives from two NHS Trusts in England during 2010...
July 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28715794/an-introduction-to-the-emergency-department-adult-clinical-escalation-protocol-ed-ace
#5
Eoin Coughlan, Una Geary, Abel Wakai, Ronan O'Sullivan, John Browne, Eilish McAuliffe, Marie Ward, Fiona McDaid, Conor Deasy
PURPOSE OF THE STUDY: This study demonstrates how a participatory action research approach was used to address the challenge of the early and effective detection of the deteriorating patient in the ED setting. The approach enabled a systematic approach to patient monitoring and escalation of care to be developed to address the wide-ranging spectrum of undifferentiated presentations and the phases of ED care from triage to patient admission. This paper presents a longitudinal patient monitoring system, which aims to provide monitoring and escalation of care, where necessary, of adult patients from triage to admission to hospital in a manner that is feasible in the unique ED environment...
November 14, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28712978/local-radiotherapy-intensification-for-locally-advanced-non-small-cell-lung-cancer-a-call-to-arms
#6
REVIEW
Noah S Kalman, Elisabeth Weiss, Paul R Walker, Julian G Rosenman
Chemoradiotherapy, the standard of care for locally advanced non-small-cell lung cancer (NSCLC), often fails to eradicate all known disease. Despite advances in chemotherapeutic regimens, locally advanced NSCLC remains a difficult disease to treat, and locoregional failure remains common. Improved radiographic detection can identify patients at significant risk of locoregional failure after definitive treatment, and newer methods of escalating locoregional treatment may allow for improvements in locoregional control with acceptable toxicity...
June 16, 2017: Clinical Lung Cancer
https://www.readbyqxmd.com/read/28709439/enhanced-antimicrobial-de-escalation-for-pneumonia-in-mechanically-ventilated-patients-a-cross-over-study
#7
Tracy Trupka, Kristen Fisher, Scott T Micek, Paul Juang, Marin H Kollef
BACKGROUND: Antibiotics are commonly administered to hospitalized patients with infiltrates for possible bacterial pneumonia, often leading to unnecessary treatment and increasing the risk for resistance emergence. Therefore, we performed a study to determine if an enhanced antibiotic de-escalation practice could improve antibiotic utilization in mechanically ventilated patients with suspected pneumonia cared for in an academic closed intensive care unit (ICU). METHODS: This was a prospective cross-over trial comparing routine antibiotic management (RAM) and enhanced antimicrobial de-escalation (EAD) performed within two medical ICUs (total 34 beds) at Barnes-Jewish Hospital, an academic referral center...
July 15, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28705675/use-of-evidence-based-recommendations-in-an-antibiotic-care-bundle-for-the-intensive-care-unit
#8
Nico T Mutters, Giulia De Angelis, Giovanni Restuccia, Francesca Di Muzio, Jeroen Schouten, Marlies Hulscher, Massimo Antonelli, Evelina Tacconelli
PURPOSE: To drive decisions on antibiotic therapy in the intensive care unit (ICU), we developed an antibiotic care bundle (ABC-Bundle) with evidence-based recommendations (EBRs) for antibiotic prescriptions. METHODS: We conducted a 3-step prospective study. First, a systematic review of the literature reporting EBRs for antibiotic usage in the ICU was performed. Second, we developed an ABC-Bundle through a 2-round, RAND-modified Delphi method with an international expert panel, including the most relevant EBRs on a 9-point Likert scale...
July 10, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28701290/using-new-and-emerging-technologies-to-identify-and-respond-to-suicidality-among-help-seeking-young-people-a-cross-sectional-study
#9
Frank Iorfino, Tracey A Davenport, Laura Ospina-Pinillos, Daniel F Hermens, Shane Cross, Jane Burns, Ian B Hickie
BACKGROUND: Suicidal thoughts are common among young people presenting to face-to-face and online mental health services. The early detection and rapid response to these suicidal thoughts and other suicidal behaviors is a priority for suicide prevention and early intervention efforts internationally. Establishing how best to use new and emerging technologies to facilitate person-centered systematic assessment and early intervention for suicidality is crucial to these efforts. OBJECTIVE: The aim of this study was to examine the use of a suicidality escalation protocol to respond to suicidality among help-seeking young people...
July 12, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28700284/prevalence-of-financial-fraud-and-scams-among-older-adults-in-the-united-states-a-systematic-review-and-meta-analysis
#10
David Burnes, Charles R Henderson, Christine Sheppard, Rebecca Zhao, Karl Pillemer, Mark S Lachs
BACKGROUND: The financial exploitation of older adults was recently recognized by the Centers for Disease Control and Prevention as a serious public health problem. Knowledge of the prevalence of elder financial exploitation is mostly limited to the category of financial abuse, which occurs in relationships involving an expectation of trust. Little is known about the other major category of elder financial exploitation-elder financial fraud and scams, which is perpetrated by strangers...
August 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28693625/a-role-for-antimicrobial-stewardship-in-clinical-sepsis-pathways-a-prospective-interventional-study
#11
John Burston, Suman Adhikari, Andrew Hayen, Heather Doolan, Melissa L Kelly, Kathy Fu, Tomas O Jensen, Pamela Konecny
OBJECTIVE To evaluate the impact of early infectious diseases (ID) antimicrobial stewardship (AMS) intervention on inpatient sepsis antibiotic management. DESIGN Interventional, nonrandomized, controlled study. SETTING Tertiary-care referral hospital, Sydney, Australia. PATIENTS Consecutive, adult, non-intensive care unit (non-ICU) inpatients triggering an institutional clinical sepsis pathway from May to August 2015. INTERVENTION All patients reviewed by an ID Fellow within 24 hours of sepsis pathway trigger underwent case review and clinic file documentation of recommendations...
July 11, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28693596/prioritising-responses-of-nurses-to-deteriorating-patient-observations-pronto-protocol-testing-the-effectiveness-of-a-facilitation-intervention-in-a-pragmatic-cluster-randomised-trial-with-an-embedded-process-evaluation-and-cost-analysis
#12
Tracey K Bucknall, Gill Harvey, Julie Considine, Imogen Mitchell, Jo Rycroft-Malone, Ian D Graham, Mohammadreza Mohebbi, Jennifer Watts, Alison M Hutchinson
BACKGROUND: Vital signs are the primary indicator of physiological status and for determining the need for urgent clinical treatment. Yet, if physiological signs of deterioration are missed, misinterpreted or mismanaged, then critical illness, unplanned intensive care admissions, cardiac arrest and death may ensue. Although evidence demonstrates the benefit of early recognition and management of deteriorating patients, failure to escalate care and manage deteriorating patients remains a relatively frequent occurrence in hospitals...
July 11, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28692557/response-to-re-escalation-of-care-in-surgery-a-systematic-risk-assessment-to-prevent-avoidable-harm-in-hospitalized-patients
#13
Maximilian J Johnston, Sonal Arora, Ara Darzi
No abstract text is available yet for this article.
August 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28692556/escalation-of-care-in-surgery-a-systematic-risk-assessment-to-prevent-avoidable-harm-in-hospitalized-patients
#14
Richard Stevenson, Joyce Ngai, Katrin Gudlaugsdottir, David Mansouri, Andrew Haslett, Laura Smith, Karen Stevenson, Andrew Jackson, Raymond Oliphant
No abstract text is available yet for this article.
August 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28685393/side-effects-of-long-term-continuous-intra-arterial-nimodipine-infusion-in-patients-with-severe-refractory-cerebral-vasospasm-after-subarachnoid-hemorrhage
#15
Martin Kieninger, Julia Flessa, Nicole Lindenberg, Sylvia Bele, Andreas Redel, André Schneiker, Gerhard Schuierer, Christina Wendl, Bernhard Graf, Vera Silbereisen
BACKGROUND: Long-term continuous intra-arterial nimodipine infusion (CIAN) is a rescue therapy option in cases of severe refractory cerebral vasospasm (CV) following acute non-traumatic subarachnoid hemorrhage (SAH). However, CIAN therapy can be associated with relevant side effects. Available studies focus on intracerebral complications, whereas extracerebral side effects are rarely examined. Aim of the present study was to generate descriptive data on the clinical course during CIAN therapy and expectable extracerebral side effects...
July 6, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28682734/families-living-well-with-chronic-illness-the-healing-process-of-moving-on
#16
Carole A Robinson
Chronic illness is a global issue of escalating importance. While prevention, control, and management of chronic disease are imperative, it is also critical to shift our focus away from illness and toward living. In particular, attention needs to focus on living well despite illness. This article reports a grounded theory study with 43 members from 17 families who perceived they were managing well with serious chronic illnesses. The theory that captures the circular, iterative healing process of moving on is comprised of five phases: the fight, accepting, living with the chronic illness, sharing the experience, and reconstructing life...
March 2017: Qualitative Health Research
https://www.readbyqxmd.com/read/28675190/feasibility-of-a-respiratory-nurse-specialist-led-sleep-disorder-service-in-a-district-general-hospital
#17
D M Comer
Aim The burden of referrals to investigate sleep disorders has escalated considerably. In order to address this, the feasibility of a nurse-led sleep disorder clinic was investigated. Methods Sleep referrals were stratified on the basis of information contained within the primary care referral, and appropriate home-based sleep studies arranged if obstructive sleep apnoea was considered the most likely working diagnosis. Selected patients were started on continuous positive airway pressure treatment if deemed appropriate...
June 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28673539/trial-designs-and-results-supporting-treatment-de-escalation-and-escalation
#18
Meredith M Regan, William T Barry
Trials for escalation and de-escalation of treatment aim to improve patient care, but from different sides of the same coin with respect to disease control and burdens of treatment. De-escalation of therapy is inherently a non-inferiority question. A design with random assignment to standard of care versus de-escalated therapy is typically implemented but ordinarily will require a large sample size. Some research questions of treatment de-escalation might be asked in select patient populations using single-arm designs...
June 30, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28671539/a-blueprint-for-innovation-to-achieve-health-system-transformation
#19
Anne W Snowdon
Global health systems are challenged by escalating costs and growing demands for care created by the demands of aging populations and rising rates of chronic illness which place unsustainable pressure on health systems to meet population health needs. To overcome these challenges, transformational change is needed to strengthen health system performance and sustainability. Innovation is widely viewed as the strategy to drive transformational change in health systems; yet to date, innovation has lacked a clearly defined focus or agenda to achieve transformation...
2017: HealthcarePapers
https://www.readbyqxmd.com/read/28671522/molecular-epidemiology-of-beta-lactamase-producing-nosocomial-gram-negative-pathogens-from-north-and-south-indian-hospitals
#20
Surbhi Khurana, Purva Mathur, Arti Kapil, Chithra Valsan, Bijayini Behera
PURPOSE: Resistant Gram-negative bacterial (GNB) infections, apart from tremendously escalating the cost of treatment, are a cause for substantial morbidity and mortality among hospitalized patients. Such bacteria are rapidly acquiring resistance to many antimicrobial agents, especially the beta-lactams which are the most frequently prescribed antimicrobials in hospital and community patient care settings, and now also to colistin; a last-line drug to treat infections with such bacteria...
July 3, 2017: Journal of Medical Microbiology
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