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Failure-to-rescue

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https://www.readbyqxmd.com/read/29407346/associations-between-nurse-education-and-experience-and-the-risk-of-mortality-and-adverse-events-in-acute-care-hospitals-a-systematic-review-of-observational-studies
#1
REVIEW
Li-Anne Audet, Patricia Bourgault, Christian M Rochefort
OBJECTIVES: To provide knowledge from the summarization of the evidence on the: a) associations between nurse education and experience and the occurrence of mortality and adverse events in acute care hospitals, and; b) benefits to patients and organizations of the recent Institute of Medicine's recommendation that 80% of registered nurses should be educated at the baccalaureate degree by 2020. DATA SOURCES: A systematic search of English and French literature was conducted in six electronic databases: 1) Medline, 2) PubMed, 3) CINAHL, 4) Scopus, 5) Campbell, and 6) Cochrane databases...
January 31, 2018: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29401188/hospital-variation-in-mortality-after-emergency-bowel-resections-the-role-of-failure-to-rescue
#2
Ambar Mehta, David Efron, Kent Stevens, Mariuxi C Manukyan, Bellal Joseph, Joseph V Sakran
INTRODUCTION: Hospital variation in failure-to-rescue (FTR) rates has partially explained nationwide differences in mortality after elective surgeries. To examine the role of FTR among emergency general surgery, we compared nationwide risk-adjusted mortality, complications, and FTR rates after emergent bowel resections. METHODS: We identified patients who underwent emergent small or large bowel resections in the 2010-2011 Nationwide Inpatient Sample using the American Association for the Surgery of Trauma criteria...
February 3, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29397102/predictors-of-failure-to-rescue-after-esophagectomy
#3
Douglas Z Liou, Derek Serna-Gallegos, James Mirocha, Vahak Bairamian, Rodrigo F Alban, Harmik J Soukiasian
BACKGROUND: Failure to rescue (FTR), defined as death after a major complication, is a metric increasingly being used to assess quality of care. Risk factors associated with FTR after esophagectomy have not been previously studied. METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was queried for patients who underwent esophagectomy with gastric conduit between 2010 and 2014. Patients with at least one major postoperative complication were grouped according to inhospital mortality (FTR group) and survival to discharge (SUR group)...
January 31, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29389841/emergency-general-surgery-in-geriatric-patients-a-statewide-analysis-of-surgeon-and-hospital-volume-with-outcomes
#4
Ambar Mehta, Linda A Dultz, Bellal Joseph, Joseph K Canner, Kent Stevens, Christian Jones, Elliot R Haut, David T Efron, Joseph V Sakran
INTRODUCTION: Geriatric patients undergoing emergency general surgery (EGS) face significant morbidity and mortality. We assessed how surgeon and hospital volumes affected these outcomes. METHODS: We identified patients at least 65 years old in Maryland's Health Services Cost Review Commission database from 2012-2014 who underwent one of 12 EGS procedures, as defined by the American Association for the Surgery of Trauma, and then calculated four outcomes: mortality rate, the incidence of at least one of eight common in-hospital EGS complications, failure-to-rescue (death after experiencing a postoperative complication), and the 30-day readmission rate...
January 31, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29388457/avoidable-30-day-mortality-analysis-and-failure-to-rescue-in-dysvascular-lower-extremity-amputees
#5
Christian Wied, Nicolai B Foss, Peter T Tengberg, Gitte Holm, Anders Troelsen, Morten T Kristensen
Background and purpose - An enhanced treatment program may decrease 30-day mortality below 20% after lower extremity amputations (LEA). The potential and limitations for further reduction are unknown. We analyzed postoperative causes of 30-day mortality, and assessed failure to rescue (FTR) rate in LEA patients who followed an enhanced treatment program. Patients and methods - Medical charts of 195 primary LEA procedures were reviewed independently by 3 of the authors, and deaths during hospitalization following amputation were classified according to consensus...
February 1, 2018: Acta Orthopaedica
https://www.readbyqxmd.com/read/29355993/relationships-between-army-nursing-practice-environments-and-patient-outcomes
#6
Pauline A Swiger, Lori A Loan, Dheeraj Raju, Sara T Breckenridge-Sproat, Rebecca S Miltner, Patricia A Patrician
Favorable nursing practice environments have been associated with lower patient mortality, failure to rescue, nurse-administered medication errors, infections, patient complaints, and patient falls. Favorable environments have also been associated with higher nurse-reported care quality and patient satisfaction in civilian hospitals. However, limited information exists on the relationship between favorable nursing practice environments and positive outcomes in military facilities. Using 4 years of secondary data collected from 45 units in 10 Army hospitals, generalized estimating equations were used to test the associations between nurses' scores on the Practice Environment Scale of the Nursing Work Index (PES-NWI) and patient outcomes of falls with and without injury, medication administration errors with and without harm, and patient experience...
January 22, 2018: Research in Nursing & Health
https://www.readbyqxmd.com/read/29298221/evaluating-an-art-based-intervention-to-improve-practicing-nurses-observation-description-and-problem-identification-skills
#7
Beth M Nease, Tina S Haney
Astute observation, description, and problem identification skills provide the underpinning for nursing assessment, surveillance, and prevention of failure to rescue events. Art-based education has been effective in nursing schools for improving observation, description, and problem identification. The authors describe a randomized controlled pilot study testing the effectiveness of an art-based educational intervention aimed at improving these skills in practicing nurses.
January 2018: Journal for Nurses in Professional Development
https://www.readbyqxmd.com/read/29285642/association-of-delivery-system-integration-and-outcomes-for-major-cancer-surgery
#8
Jonathan Li, Zaojun Ye, James M Dupree, Brent K Hollenbeck, Hye Sung Min, Deborah Kaye, Lindsey A Herrel, David C Miller, Chad Ellimoottil
BACKGROUND: Integrated delivery systems (IDSs) are postulated to reduce spending and improve outcomes through successful coordination of care across multiple providers. Nonetheless, the actual impact of IDSs on outcomes for complex multidisciplinary care such as major cancer surgery is largely unknown. METHODS: Using 2011-2013 Medicare data, this study identified patients who underwent surgical resection for prostate, bladder, esophageal, pancreatic, lung, liver, kidney, colorectal, or ovarian cancer...
December 29, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29273370/is-there-a-weekend-effect-in-emergency-general-surgery
#9
David Metcalfe, Manuel Castillo-Angeles, Arturo J Rios-Diaz, Joaquim M Havens, Adil Haider, Ali Salim
BACKGROUND: Weekend admission is associated with increased mortality across a range of patient populations and health-care systems. The aim of this study was to determine whether weekend admission is independently associated with serious adverse events (SAEs), in-hospital mortality, or failure to rescue (FTR) in emergency general surgery (EGS). METHODS: An observational study was performed using the National Inpatient Sample in 2012-2013; the largest all-payer inpatient database in the United States, which represents a 20% stratified sample of hospital discharges...
February 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29194321/variability-in-management-of-blunt-liver-trauma-and-contribution-of-level-of-acs-cot-verification-status-on-mortality
#10
Christopher J Tignanelli, Bellal Joseph, Jill L Jakubus, Gaby A Iskander, Lena M Napolitano, Mark R Hemmila
BACKGROUND: Patients who sustain blunt liver trauma and are treated at an ACS-COT verified level 1 trauma center have an overall lower risk of mortality compared with patients admitted to a level 2 trauma center. However, elements contributing to these differences are unknown. We hypothesize that practice variation exists between trauma centers in management of blunt liver injury. Our objective is to identify practice variations and their effect on clinical outcomes. METHODS: Data from a statewide collaborative quality initiative for trauma was utilized...
December 1, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29187110/experience-with-an-acuity-adaptable-care-model-for-pediatric-cardiac-surgery
#11
John M Costello, Elizabeth Preze, Nguyenvu Nguyen, Mary E McBride, James W Collins, Osama M Eltayeb, Michael C Mongé, Barbara J Deal, Michelle M Stephenson, Carl L Backer
BACKGROUND: We describe the implementation of and outcomes associated with an acuity adaptable care model for pediatric patients undergoing cardiac surgery. METHODS: Consecutive patients undergoing an index cardiac operation between July 2007 and June 2015 were included. From July 2007 through June 2010, a conventional model existed in which patients moved among units and care teams based on age, severity of illness, and operative status (conventional group). A transitional period existed between July 2010 and June 8, 2012 (transitional group)...
November 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29153941/the-impact-of-readmission-hospital-on-failure-to-rescue-rates-following-major-urologic-cancer-surgery
#12
Jasmir G Nayak, Sarah K Holt, Jonathan L Wright, Matthew Mossanen, Atreya Dash, John L Gore
PURPOSE: Patients readmitted to secondary hospitals rather than the primary hospital where their surgery took place may be at risk for poorer outcomes. We sought to evaluate the effect of site of readmission on failure-to-rescue complication rates following urologic cancer surgery. MATERIALS AND METHODS: Retrospective review of major urologic cancer surgeries in the Washington State Comprehensive Hospital Abstract Reporting System between 1998 and 2013. Failure-to-rescue (FTR) rates, defined as inpatient death after a complication requiring hospital readmission, were compared between patients readmitted to their primary hospital with those readmitted to a secondary hospital...
November 16, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/29133291/watcher-initiative-associated-with-decrease-in-failure-to-rescue-events-in-pediatric-population
#13
Melanie McClain Smith, Maryanne Chumpia, Lindsey Wargo, Julie Nicol, Mark Bugnitz
BACKGROUND AND OBJECTIVES: Improved situation awareness may prevent unplanned ICU transfers. Transfers with serious safety issues may be classified as unrecognized situation awareness failure events (UNSAFE) and are associated with intubation, vasopressors, or >3 fluid boluses within 1 hour before or after ICU arrival. Our aim was to decrease the proportion of unplanned ICU transfers that met UNSAFE criteria by 50% in 1 year. METHODS: We adapted a previously described huddle-based intervention...
December 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29120929/risk-factors-for-opioid-induced-respiratory-depression-and-failure-to-rescue-a-review
#14
Kapil Gupta, Arun Prasad, Mahesh Nagappa, Jean Wong, Lusine Abrahamyan, Frances F Chung
PURPOSE OF REVIEW: The primary objective of this review is to identify the risk factors for opioid-induced respiratory depression (OIRD) in the postoperative period. RECENT FINDINGS: In the postoperative period, OIRD has often been reported resulting in morbidity and mortality. The risk factors which predispose surgical patients to increased risk of OIRD are not clearly defined. A literature search was performed for adult surgical patients who were prescribed opioids during their hospital stay and any available reports on postoperative respiratory depression/respiratory events...
February 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29116490/impact-of-sarcopenic-obesity-on-failure-to-rescue-from-major-complications-following-pancreaticoduodenectomy-for-cancer-results-from-a-multicenter-study
#15
Nicolò Pecorelli, Giovanni Capretti, Marta Sandini, Anna Damascelli, Giulia Cristel, Francesco De Cobelli, Luca Gianotti, Alessandro Zerbi, Marco Braga
BACKGROUND: Failure to rescue (FTR) is a quality-of-care indicator in pancreatic surgery, but may also identify patients who may not tolerate major postoperative complications despite being treated with best available care. Previous studies found that high visceral adipose tissue-to-skeletal muscle ratio is associated with poor outcomes following pancreaticoduodenectomy (PD). The aim of the study is to assess the impact of sarcopenic obesity on occurrence of FTR from major complications in cancer patients undergoing PD...
January 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29074117/intensive-care-unit-admission-after-endovascular-aortic-aneurysm-repair-is-primarily-determined-by-hospital-factors-adds-significant-cost-and-is-often-unnecessary
#16
Caitlin W Hicks, Husain N Alshaikh, Devin Zarkowsky, Ian C Bostock, Besma Nejim, Mahmoud B Malas
BACKGROUND: A large proportion of endovascular aortic aneurysm repair (EVAR) patients are routinely admitted to the intensive care unit (ICU) for postoperative observation. In this study, we aimed to describe the factors associated with ICU admission after EVAR and to compare the outcomes and costs associated with ICU vs non-ICU observation. METHODS: All patients undergoing elective infrarenal EVAR in the Premier database (2009-2015) were included. Patients were stratified as ICU vs non-ICU admission according to location on postoperative day 0...
October 23, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29044631/frailty-hospital-volume-and-failure-to-rescue-after-head-and-neck-cancer-surgery
#17
Carrie L Nieman, C Matthew Stewart, David W Eisele, Peter J Pronovost, Christine G Gourin
OBJECTIVES/HYPOTHESIS: We previously reported that high-volume hospital head and neck cancer (HNCA) surgical care is associated with decreased mortality, largely explained by reduced rates of failure to rescue. Frailty is an independent predictor of mortality, but is significantly less likely in patients receiving high-volume care. We investigate whether differences in frailty rates explain the relationship between volume and outcomes in HNCA patients and whether frailty confounds the relationship between failure to rescue and mortality...
October 17, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28973498/failure-to-rescue-and-mortality-following-resection-of-intracranial-neoplasms
#18
Hani Malone, Michael Cloney, Jingyan Yang, Dawn L Hershman, Jason D Wright, Alfred I Neugut, Jeffrey N Bruce
BACKGROUND: There is growing recognition that perioperative complication rates are similar between hospitals, but mortality rates are lower at high-volume centers. This may be due to differences in the ability to rescue patients from major complications. OBJECTIVE: To examine the relationship between hospital caseload and failure to rescue from complications following resection of intracranial neoplasms. METHODS: We identified adults in the Nationwide Inpatient Sample diagnosed with glioma, meningioma, brain metastasis, or acoustic neuroma, who underwent surgical resection between 1998 and 2010...
August 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28938300/enhancing-the-quality-and-safety-of-the-perioperative-patient
#19
Sven Staender, Andrew Smith
PURPOSE OF REVIEW: Many possible hazards bedevil the perioperative patient. This review focuses on a number of aspects of perioperative management where the patient's quality and safety can be enhanced. RECENT FINDINGS: Our understanding of the relationship between preoperative preparation and postoperative outcomes has improved. There have also been recent developments in our understanding of how to construct useful cognitive aids and make the best use of checklists by understanding the cultural environment supporting their use...
December 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28877805/increased-age-predicts-failure-to-rescue
#20
Galinos Barmparas, Matthew J Martin, Douglas A Wiegmann, Ken R Catchpole, Bruce L Gewertz, Eric J Ley
Failure to rescue (FTR), defined as any death after the development of in-hospital complications, is an important quality measure, but the relationship with age after a traumatic injury, has not been well defined. We sought to examine whether older trauma patients are at higher risk for FTR. The National Trauma Databank (NTDB) research datasets 2007 to 2011 were queried for patients ≥16 years who had any reported complication. Those who survived (non-FTR) were compared with those who did not (FTR) using a forward logistic regression model...
November 1, 2016: American Surgeon
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