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https://www.readbyqxmd.com/read/28437546/root-cause-analysis-and-actions-for-the-prevention-of-medical-errors-quality-improvement-and-resident-education
#1
Ryan Charles, Brandon Hood, Joseph M DeRosier, John W Gosbee, James P Bagian, Ying Li, Michelle S Caird, J Sybil Biermann, Mark E Hake
The quality of care delivered by orthopedic surgeons continues to grow in importance. Multiple orthopedic programs, organizations, and committees have been created to measure the quality of surgical care and reduce the incidence of medical adverse events. Structured root cause analysis and actions (RCA2) has become an area of interest. If performed thoroughly, RCA2 has been shown to reduce surgical errors across many subspecialties. The Accreditation Council for Graduate Medical Education has a new mandate for programs to involve residents in quality improvement processes...
April 24, 2017: Orthopedics
https://www.readbyqxmd.com/read/28437428/prevalence-of-alcohol-use-disorders-among-under-and-post-graduate-healthcare-students-in-italy
#2
Monica Lamberti, Francesco Napolitano, Paola Napolitano, Antonio Arnese, Vincenzo Crispino, Gianclaudio Panariello, Gabriella Di Giuseppe
A cross-sectional study was carried out on 641 medical students, 359 students attending a degree course in the healthcare professions, and 500 resident physicians, all undergoing health surveillance at the ambulatory of the Division of Occupational Medicine, Second University of Naples, Italy. 76.1% of the participants drank alcohol, with 85.5% of medical students, 77.4% of resident physicians, and 63% of healthcare-professions students reporting regular alcohol use. In the whole sample, the mean Audit-C score was 1...
2017: PloS One
https://www.readbyqxmd.com/read/28436360/prostate-cancer-screening-practices-amongst-physicians-in-the-north-simcoe-muskoka-local-health-integration-network
#3
Thomas Burrows, A Andrew Ray, Cory Hartsburg
INTRODUCTION: The prostate-specific antigen (PSA) screening test is controversial and can result in both over-diagnosis and over-treatment. Recently, the Canadian Task Force on Preventive Health Care (CTFPHC) has recommended against routine screening for prostate cancer. We sought to determine how the CTFPHC has impacted the practice patterns among family physicians in the North Simcoe Muskoka (NSM) Local Health Integration Network (LHIN). MATERIALS AND METHODS: We surveyed all 439 family physicians within the NSM LHIN as well as 21 residents of the Family Medical Teaching Unit...
April 2017: Canadian Journal of Urology
https://www.readbyqxmd.com/read/28436344/inattention-tests-for-delirium
#4
Paul Regal
Voyer and colleagues (2016) report an interesting and important comparison of ten attention/concentration tests for DSM-5 delirium. I have a number of questions and comments as follows: (1) What training did the research assistants have? DSM-5 diagnosis is generally regarded as a decision by medical specialists. When the person has prior dementia, identifying delirium is a high-level medical skill. Behavioral and psychological symptoms of dementia can closely mimic delirium unless the examiner focuses on behavioral triggers and the speed of cognitive decline...
April 24, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28436193/association-between-using-medications-with-anticholinergic-properties-and-short-term-cognitive-decline-among-older-men-a-retrospective-cohort-study-in-taiwan
#5
Yi-Hui Wu, Chih-Jen Wang, Cheng-Hao Hung, Liang-Yu Chen, Ming-Hsien Lin, Pei-Ning Wang, Liang-Kung Chen
AIM: The use of anticholinergic drugs had been strongly linked to adverse health outcomes among older adults, especially in cognitive impairment or dementia. The present study aimed to evaluate the cognitive decline related to the use of anticholinergic drugs among older men living in the veterans' homes in Taiwan. METHODS: This retrospective cohort study was a substudy of The Longitudinal Older Veterans study. A total of 274 residents living in four Taiwan veterans' homes and receiving two consecutive Mini-Mental State Examinations within the interval of 6 months from January 2012 to December 2014 were enrolled in the present study...
April 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28436184/delaying-cognitive-and-physical-decline-through-multidomain-interventions-for-residents-with-mild-to-moderate-dementia-in-dementia-care-units-in-taiwan-a-prospective-cohort-study
#6
Chih-Kuang Liang, Ming-Yueh Chou, Liang-Yu Chen, Kuei-Yu Wang, Shih-Yi Lin, Liang-Kung Chen, Yu-Te Lin, Tsung-Yun Liu, Ching-Hui Loh
AIM: To develop experimental multi-domain interventions for older people with mild-to-moderate dementia, and to evaluate the effect of delaying cognitive and physical decline, and improvement or prevention of geriatric syndromes during 1-year follow up. METHODS: Participants aged 65 years and older with mild-to-moderate dementia (clinical dementia rating [CDR] 1 or 2) were grouped as intervention in Jia-Li Veterans Home and usual care model in the community (Memory clinic)...
April 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28435509/usmle-scores-predict-success-in-abem-initial-certification-a-multicenter-study
#7
Elie Harmouche, Nikhil Goyal, Ashley Pinawin, Jumana Nagarwala, Rahul Bhat
INTRODUCTION: There are no existing data on whether performance on the United States Medical Licensing Examination (USMLE) predicts success in American Board of Emergency Medicine (ABEM) certification. The aim of this study was to determine the presence of any association between USMLE scores and first-time success on the ABEM qualifying and oral certification examinations. METHODS: We retrospectively collected USMLE Step 1, Step 2 Clinical Knowledge (CK) scores and pass/fail results from the first attempt at ABEM qualifying and oral examinations from residents graduating between 2009 and 2011 from nine EM programs...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435508/a-novel-collaboration-to-reduce-the-travel-related-cost-of-residency-interviewing
#8
Eric Shappell, Abra Fant, Benjamin Schnapp, Jill P Craig, James Ahn, Christine Babcock, Michael A Gisondi
INTRODUCTION: Interviewing for residency is a complicated and often expensive endeavor. Literature has estimated interview costs of $4,000 to $15,000 per applicant, mostly attributable to travel and lodging. The authors sought to reduce these costs and improve the applicant interview experience by coordinating interview dates between two residency programs in Chicago, Illinois. METHODS: Two emergency medicine residency programs scheduled contiguous interview dates for the 2015-2016 interview season...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28434885/early-performance-on-an-eye-surgery-simulator-predicts-subsequent-resident-surgical-performance
#9
Ramak Roohipoor, Mehdi Yaseri, Amir Teymourpour, Carolyn Kloek, John B Miller, John I Loewenstein
OBJECTIVE: To examine early performance on an eye surgery simulator and its relationship to subsequent live surgical performance in a single large residency program. DESIGN: Retrospective study. SETTING: Massachusetts Eye and Ear, Harvard Medical School, Department of Ophthalmology. METHODS: In a retrospective study, we compared performance of 30 first-year ophthalmology residents on an eye surgery simulator to their surgical skills as third-year residents...
April 20, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28434754/-patient-safety-culture-in-family-practice-residents-of-galicia
#10
Manuel Portela Romero, Rosendo Bugarín González, María Sol Rodríguez Calvo
OBJECTIVE: To determine the views held by Family practice (FP) residents on the different dimensions of patient safety, in order to identify potential areas for improvement. DESIGN: A cross-sectional study. LOCATION: Seven FP of Galicia teaching units. PARTICIPANTS: 182 FP residents who completed the Medical Office Survey on Patient Safety Culture questionnaire. MEASUREMENTS: The Medical Office Survey on Patient Safety Culture questionnaire was chosen because it is translated, validated, and adapted to the Spanish model of Primary Care...
April 20, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28434273/development-of-distinct-body-mass-index-trajectories-among-children-before-age-5-years-a-population-based-study
#11
Brian A Lynch, Lila J Finney Rutten, Jon O Ebbert, Seema Kumar, Barbara P Yawn, Debra Jacobson, Jennifer St Sauver
The prevalence of childhood obesity has increased over the past 3 decades. This study was designed to understand how childhood body mass index (BMI) influences later risk of obesity. We calculated BMIs for children residing in Olmsted County, Minnesota, between January 1, 2005 and December 31, 2012 using medical records data. We defined homogenous BMI trajectory clusters using a nonparametric hill-climbing algorithm. Overall, 16,538 (47%) children had >3 weight assessments at least 1 year apart and were included in the analyses...
April 1, 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/28433827/a-comparison-of-medication-administration-errors-from-original-medication-packaging-and-multi-compartment-compliance-aids-in-care-homes-a-prospective-observational-study
#12
Julia Fiona-Maree Gilmartin-Thomas, Felicity Smith, Rory Wolfe, Yogini Jani
BACKGROUND: No published study has been specifically designed to compare medication administration errors between original medication packaging and multi-compartment compliance aids in care homes, using direct observation. OBJECTIVES: Compare the effect of original medication packaging and multi-compartment compliance aids on medication administration accuracy. DESIGN: Prospective observational. SETTING: Ten Greater London care homes...
March 28, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28433523/association-of-preresidency-peer-reviewed-publications-with-radiation-oncology-resident-choice-of-academic-versus-private-practice-career
#13
Shearwood McClelland, Charles R Thomas, Lynn D Wilson, Emma B Holliday, Jerry J Jaboin
INTRODUCTION: The decision of radiation oncology residents to pursue academic versus private practice careers plays a central role in shaping the present and future of the field, but factors that are potentially predictive of this decision are lacking. This study was performed to examine the role of several factors publicly available before residency on postresidency career choice, including preresidency peer-reviewed publications (PRPs), which have been associated with resident career choice in comparably competitive subspecialties such as neurosurgery...
April 5, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28433453/attending-documentation-contribution-to-billing-at-an-academic-emergency-department-with-an-electronic-health-record
#14
Brian J Yun, Stephen C Dorner, Brian M Baccari, John Brennan, Karen Smith, Ali S Raja, Benjamin A White
INTRODUCTION: In emergency medicine (EM), patient care documentation serves many functions, including supporting reimbursement. In addition, many electronic health record systems facilitate automatically populating certain data fields. As a result, in the academic model, the attending's note may now more often recapitulate many of the same elements found in the resident's or physician assistant's (PA) note. We sought to determine the value of additional attending documentation, and how often the attending documentation prevented a downcoding event...
April 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28433120/additional-cost-because-of-pneumonia-in-nursing-home-residents-results-from-the-incidence-of-pneumonia-and-related-consequences-in-nursing-home-resident-study
#15
Nadège Costa, Emiel O Hoogendijk, Michael Mounié, Robert Bourrel, Yves Rolland, Bruno Vellas, Laurent Molinier, Matteo Cesari
OBJECTIVES: Pneumonia is a frequent condition in older people. Our aim was to examine the total healthcare cost related to pneumonia in nursing home (NH) residents over a 1-year follow-up period. DESIGN: This was a prospective, longitudinal, observational, and multicenter study that was a part of the Incidence of Pneumonia and related Consequences in Nursing Home Resident study. SETTING: Thirteen NHs located in Languedoc Roussillon and Midi-Pyrénées regions in France were included...
May 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28431908/implementation-of-a-person-centered-medical-care-model-in-a-skilled-nursing-facility-a-pilot-evaluation
#16
Kathleen Abrahamson, Jaclyn Myers, Arif Nazir
OBJECTIVES: The objective of this study was to evaluate the feasibility and impact of implementing a person-centered medical care model for post-acute care residents within a skilled nursing facility (SNF). DESIGN: A mixed-method (qualitative and quantitative) pilot evaluation. SETTING: An 89-bed SNF located within a large midwestern city. PARTICIPANTS: Forty SNF post-acute patients admitted to the facility during a 6-month period were enrolled in the pilot evaluation...
April 18, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28431853/transmission-of-methicillin-resistant-staphylococcus-aureus-to-health-care-worker-gowns-and-gloves-during-care-of-residents-in-veterans-affairs-nursing-homes
#17
Lisa Pineles, Daniel J Morgan, Alison Lydecker, J Kristie Johnson, John D Sorkin, Patricia Langenberg, Natalia Blanco, Alan Lesse, John Sellick, Kalpana Gupta, Luci Leykum, Jose Cadena, Nickie Lepcha, Mary-Claire Roghmann
BACKGROUND: This was an observational study designed to estimate the frequency of methicillin-resistant Staphylococcus aureus (MRSA) transmission to gowns and gloves worn by health care workers (HCWs) interacting with Veterans Affairs Community Living Center (VA nursing home) residents to inform MRSA prevention policies. METHODS: Participants included residents and HCWs from 7 VA nursing homes in 4 states and Washington, DC. Residents were cultured for MRSA at the anterior nares, perianal skin, and wound (if present)...
April 18, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28431532/residents-satisfaction-with-primary-medical-and-health-services-in-western-china
#18
Weinan Dong, Qingyu Zhang, Chunsheng Yan, Wanling Fu, Linlin Xu
BACKGROUND: Currently, China is in the process of medical and health care reform, and the establishment of primary medical and health services covering urban and rural residents is an important aspect of this process. Studying the satisfaction of residents of underdeveloped areas with their primary medical and health services and identifying the factors that can increase the satisfaction of different groups may improve patient compliance and ultimately improve health. Moreover, such research may provide a reference for the development of medical and health undertakings in similarly underdeveloped areas...
April 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28431426/anesthesiologists-and-disaster-medicine-a-needs-assessment-for-education-and-training-and-reported-willingness-to-respond
#19
Heather K Hayanga, Daniel J Barnett, Natasha R Shallow, Michael Roberts, Carol B Thompson, Itay Bentov, Gozde Demiralp, Bradford D Winters, Deborah A Schwengel
BACKGROUND: Anesthesiologists provide comprehensive health care across the emergency department, operating room, and intensive care unit. To date, anesthesiologists' perspectives regarding disaster medicine and public health preparedness have not been described. METHODS: Anesthesiologists' thoughts and attitudes were assessed via a Web-based survey at 3 major academic institutions. Frequencies, percentages, and odds ratios (ORs) were used to assess self-reported perceptions of knowledge and skills, as well as attitudes and beliefs regarding education and training, employee development, professional obligation, safety, psychological readiness, efficacy, personal preparedness, and willingness to respond (WTR)...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28431420/generative-retrieval-improves-learning-and-retention-of-cardiac-anatomy-using-transesophageal-echocardiography
#20
Amanda M Kleiman, Katherine T Forkin, Allison J Bechtel, Stephen R Collins, Jennie Z Ma, Edward C Nemergut, Julie L Huffmyer
BACKGROUND: Transesophageal echocardiography (TEE) is a valuable monitor for patients undergoing cardiac and noncardiac surgery as it allows for evaluation of cardiovascular compromise in the perioperative period. It is challenging for anesthesiology residents and medical students to learn to use and interpret TEE in the clinical environment. A critical component of learning to use and interpret TEE is a strong grasp of normal cardiovascular ultrasound anatomy. METHODS: Fifteen fourth-year medical students and 15 post-graduate year (PGY) 1 and 2 anesthesiology residents without prior training in cardiac anesthesia or TEE viewed normal cardiovascular anatomy TEE video clips; participants were randomized to learning cardiac anatomy in generative retrieval (GR) and standard practice (SP) groups...
May 2017: Anesthesia and Analgesia
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