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https://www.readbyqxmd.com/read/28772186/an-evaluation-of-involving-family-caregivers-in-the-self-care-of-heart-failure-patients-on-hospital-readmission-randomised-controlled-trial-the-family-study
#1
Hiba Deek, Sungwon Chang, Phillip J Newton, Samar Noureddine, Sally C Inglis, Ghina Al Arab, Samer Kabbani, Wael Chalak, Nadim Timani, Peter S Macdonald, Patricia M Davidson
BACKGROUND: The prevalence of heart failure is increasing in Lebanon but to date there is no systematic evaluation of a disease management intervention. OBJECTIVE: The aim of this study was to evaluate the effect of involving family caregivers in the self-care of patients with heart failure on the risk of hospital readmission. DESIGN: A multi-site, block randomised controlled trial. SETTINGS: The study was conducted over a 13-month period in three tertiary medical centres in Beirut and Mount Lebanon, Lebanon...
July 25, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28762229/-percutaneous-edge-to-edge-mitral-valve-repair-new-transcatheter-approach-and-nursing-experience-in-patients-with-severe-mitral-regurgitation-and-prohibitive-surgical-risk
#2
Hsiu-Fen Huang, Hui-Yun Yu, Ching-Wei Lee, Hui-Chuang Chang, Mei-Ling Lin, Shin-Huey Wung
Open-heart surgery and conservative medical treatments have been the traditional, mainstay treatments for patients with severe mitral regurgitation (MR). Transcatheter edge-to-edge mitral repair is a novel technique. Using the transcatheter approach allows delivery of the clip into the left ventricle and the clipping of the orifice of the MR. The heart failure symptoms and outcomes of patients improve after this procedure. Compared to open-heart surgery, the mitral clip achieves similar MR reduction results with a significantly lower rate of complications...
August 2017: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/28701596/propofol-versus-ketofol-for-sedation-of-pediatric-patients-undergoing-transcatheter-pulmonary-valve-implantation-a-double-blind-randomized-study
#3
Rabie Soliman, Mohammed Mofeed, Tarek Momenah
OBJECTIVE: The study was done to compare propofol and ketofol for sedation of pediatric patients scheduled for elective pulmonary valve implantation in a catheterization laboratory. DESIGN: This was a double-blind randomized study. SETTING: This study was conducted in Prince Sultan Cardiac Centre, Saudi Arabia. PATIENTS AND METHODS: The study included 60 pediatric patients with pulmonary regurge undergoing pulmonary valve implantation...
July 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28693565/two-year-post-discharge-costs-of-care-among-patients-treated-with-transcatheter-or-surgical-aortic-valve-replacement-in-germany
#4
Klaus Kaier, Frederike von Kampen, Hardy Baumbach, Constantin von Zur Mühlen, Philip Hehn, Werner Vach, Manfred Zehender, Christoph Bode, Jochen Reinöhl
BACKGROUND: This study presents data on post-discharge costs of care among patients treated with transcatheter or surgical aortic valve replacement over a two year period. METHODS: Based on a prospective clinical trial, post-discharge utilization of health services and status of assistance were collected for 151 elderly patients via 2250 monthly telephone interviews, valued using standardized unit costs and analysed using two-part regression models. RESULTS: At month 1 post-discharge, total costs of care are substantially elevated (monthly mean: €3506...
July 11, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28661969/structural-nursing-and-physician-characteristics-and-30-day-mortality-for-patients-undergoing-cardiac-surgery-in-pennsylvania
#5
Meghan B Lane-Fall, Tara S Ramaswamy, Sydney E S Brown, Xu He, Jacob T Gutsche, Lee A Fleisher, Mark D Neuman
OBJECTIVE: Cardiac surgery ICU characteristics and clinician staffing patterns have not been well characterized. We sought to describe Pennsylvania cardiac ICUs and to determine whether ICU characteristics are associated with mortality in the 30 days after cardiac surgery. DESIGN: From 2012 to 2013, we conducted a survey of cardiac surgery ICUs in Pennsylvania to assess ICU structure, care practices, and clinician staffing patterns. ICU data were linked to an administrative database of cardiac surgery patient discharges...
September 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28657948/impact-of-the-hospital-readmission-reduction-program-on-surgical-readmissions-among-medicare-beneficiaries
#6
Andrew M Ibrahim, Hari Nathan, Jyothi R Thumma, Justin B Dimick
OBJECTIVE: To understand the impact of the Hospital Readmission Reduction Program on both future targeted and nontargeted surgical procedures. BACKGROUND: The Hospital Readmission Reduction Program, established under the Affordable Care Act in March of 2010, placed financial penalties on hospitals with higher than expected rates of readmission beginning in 2012 for targeted medical conditions. Multiple studies have suggested a "spill-over" effect into other conditions, but the extent of that effect for specific surgical procedures is unknown...
June 27, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28649851/avoidance-of-urinary-catheterization-to-minimize-in-hospital-complications-after-transcatheter-aortic-valve-implantation-an-observational-study
#7
Sandra B Lauck, Jae-Yung Kwon, David A Wood, Jennifer Baumbusch, Tone M Norekvål, Nay Htun, Leo Stephenson, John G Webb
BACKGROUND: Contemporary transcatheter aortic valve implantation (TAVI) devices and approach present opportunities to review historical practices initially informed by early treatment development and cardiac surgery. The avoidance of urinary catheterization in the older TAVI population is a strategy to minimize in-hospital complications. The purpose of the study was to explore elimination-related complications following the phased implementation of a default strategy of avoiding urinary catheterization in patients undergoing transfemoral (TF) TAVI...
June 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28601334/variation-in-readmission-expenditures-after-high-risk-surgery
#8
Bruce L Jacobs, Chang He, Benjamin Y Li, Alex Helfand, Naveen Krishnan, Tudor Borza, Amir A Ghaferi, Brent K Hollenbeck, Jonathan E Helm, Mariel S Lavieri, Ted A Skolarus
BACKGROUND: The Hospital Readmissions Reduction Program reduces payments to hospitals with excess readmissions for three common medical conditions and recently extended its readmission program to surgical patients. We sought to investigate readmission intensity as measured by readmission cost for high-risk surgeries and examine predictors of higher readmission costs. MATERIALS AND METHODS: We used the Healthcare Cost and Utilization Project's State Inpatient Database to perform a retrospective cohort study of patients undergoing major chest (aortic valve replacement, coronary artery bypass grafting, lung resection) and major abdominal (abdominal aortic aneurysm repair [open approach], cystectomy, esophagectomy, pancreatectomy) surgery in 2009 and 2010...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28412109/reengineering-valve-patients-postdischarge-management-for-adapting-to-bundled-payment-models
#9
Michael S Koeckert, Patricia A Ursomanno, Mathew R Williams, Michael Querijero, Elias A Zias, Didier F Loulmet, Kevin Kirchen, Eugene A Grossi, Aubrey C Galloway
BACKGROUND: Bundled Payments for Care Improvement (BPCI) initiatives were developed by Medicare in an effort to reduce expenditures while preserving quality of care. Payment model 2 reimburses based on a target price for 90-day episode of care postprocedure. The challenge for valve patients is the historically high (>35%) 90-day readmission rate. We analyzed our institutional cardiac surgical service line adaptation to this initiative. METHODS: On May 1, 2015, we instituted a readmission reduction initiative (RRI) that included presurgical risk stratification, comprehensive predischarge planning, and standardized postdischarge management led by cardiac nurse practitioners (CNPs) who attempt to guide any postdischarge encounters (PDEs)...
July 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28064245/conservative-management-of-migrated-percutaneous-endoscopic-colostomy-tube
#10
Thomas J G Chase, Joshua Luck, Lauren S Harris, Gareth Bashir
A 68-year-old male nursing home resident presented following dislodgement of a percutaneous endoscopic colostomy (PEC) tube originally sited to prevent recurrent sigmoid volvulus. Computed tomography demonstrated tube migration into the lumen of the recto-sigmoid junction, where it remained for 12 days before passing spontaneously. During this period, the patient remained asymptomatic; the residual colocutaneous fistula functioned as a decompressive valve. Originally, the patient was due to be discharged with early flexible sigmoidoscopy follow-up...
January 6, 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28056819/quality-of-care-assessment-and-improvement-in-aortic-stenosis-rationale-and-design-of-a-multicentre-registry-impulse
#11
Norbert Frey, Richard P Steeds, Antonio Serra, Eberhard Schulz, Stephan Baldus, Matthias Lutz, Christiane Pohlmann, Jana Kurucova, Peter Bramlage, David Messika-Zeitoun
BACKGROUND: Severe aortic stenosis (AS) is a common, serious valve disease in which no effective medical therapy is available and, if not treated by intervention, has a 5-year survival of only 40-60%. Despite the availability of guidelines supporting the effective use of surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI) to treat the majority of these patients, adherence to these guidelines in clinical practice is still unsatisfactory. Several recent studies have emphasised the necessity for improved communication between multidisciplinary teams, with the aim to ensure that severe AS patients receive appropriate treatment...
January 5, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28043434/aortic-root-surgery-does-high-surgical-volume-and-a-consistent-perioperative-approach-improve-outcome
#12
Rajdeep Bilkhu, Pouya Youssefi, Gopal Soppa, Rajan Sharma, Anne Child, Mark Edsell, Jean-Pierre van Besouw, Marjan Jahangiri
There is evidence that high surgical volume and team consistency improve outcomes. Mortality of 4%-12% for aortic root surgery has been reported in the United States and UK. We aim to assess outcomes of patients undergoing aortic root surgery by a consistent, high-volume team. Data on patients undergoing elective or urgent aortic root replacement (ARR) were collected prospectively. Patients undergoing emergency surgery were excluded. A standardized perioperative approach was maintained and was achieved by delivering training to team members, including surgical trainees, anesthetic, nursing, and perfusion staff, whenever there was a change of team...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28034845/thirty-day-readmissions-after-transcatheter-aortic-valve-replacement-in-the-united-states-insights-from-the-nationwide-readmissions-database
#13
Dhaval Kolte, Sahil Khera, M Rizwan Sardar, Neil Gheewala, Tanush Gupta, Saurav Chatterjee, Andrew Goldsweig, Wilbert S Aronow, Gregg C Fonarow, Deepak L Bhatt, Adam B Greenbaum, Paul C Gordon, Barry Sharaf, J Dawn Abbott
BACKGROUND: Readmissions after cardiac procedures are common and contribute to increased healthcare utilization and costs. Data on 30-day readmissions after transcatheter aortic valve replacement (TAVR) are limited. METHODS AND RESULTS: Patients undergoing TAVR (International Classification of Diseases-Ninth Revision-CM codes 35.05 and 35.06) between January and November 2013 who survived the index hospitalization were identified in the Nationwide Readmissions Database...
January 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27890544/persistent-hydrocephalus-due-to-postural-activation-of-a-ventricular-shunt-anti-gravity-device
#14
Claudia L Craven, Ahmed K Toma, Laurence D Watkins
The ever present need to balance over drainage with under drainage in hydrocephalus has required innovations including adjustable valves with antigravity devices. These are activated in the vertical position to prevent siphoning. We describe a group of bedridden patients who presented with unexplained under drainage caused by activation of antigravity shunt components produced by peculiar head/body position. Retrospective single centre case series of hydrocephalus patients, treated with ventriculo-peritoneal (VP) shunt insertion between April 2014 - February 2016...
March 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27803362/toward-optimal-decision-making-among-vulnerable-patients-referred-for-cardiac-surgery-a-qualitative-analysis-of-patient-and-provider-perspectives
#15
Ryan A Gainer, Janet Curran, Karen J Buth, Jennie G David, Jean-Francois Légaré, Gregory M Hirsch
OBJECTIVES: Comprehension of risks, benefits, and alternative treatment options has been shown to be poor among patients referred for cardiac interventions. Patients' values and preferences are rarely explicitly sought. An increasing proportion of frail and older patients are undergoing complex cardiac surgical procedures with increased risk of both mortality and prolonged institutional care. We sought input from patients and caregivers to determine the optimal approach to decision making in this vulnerable patient population...
July 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/27616189/fast-track-cardiac-care-for-adult-cardiac-surgical-patients
#16
REVIEW
Wai-Tat Wong, Veronica Kw Lai, Yee Eot Chee, Anna Lee
BACKGROUND: Fast-track cardiac care is a complex intervention involving several components of care during cardiac anaesthesia and in the postoperative period, with the ultimate aim of early extubation after surgery, to reduce length of stay in the intensive care unit and in the hospital. Safe and effective fast-track cardiac care may reduce hospital costs. This is an update of a Cochrane review first published in 2003, updated in 2012 and updated now in 2016. OBJECTIVES: To determine the safety and effectiveness of fast-track cardiac care compared with conventional (not fast-track) care in adult patients undergoing cardiac surgery...
September 12, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27604617/12th-winfocus-world-congress-on-ultrasound-in-emergency-and-critical-care
#17
Yahya Acar, Onur Tezel, Necati Salman, Erdem Cevik, Margarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-Bordomás, Mustafa Z Mahmoud, Abdelmoneim Sulieman, Abbas Ali, Alrayah Mustafa, Ihab Abdelrahman, Mustafa Bahar, Osama Ali, H Lester Kirchner, Gregor Prosen, Ajda Anzic, Paul Leeson, Maryam Bahreini, Fatemeh Rasooli, Houman Hosseinnejad, Gabriel Blecher, Robert Meek, Diana Egerton-Warburton, Edina Ćatić Ćuti, Stanko Belina, Tihomir Vančina, Idriz Kovačević, Nadan Rustemović, Ikwan Chang, Jin Hee Lee, Young Ho Kwak, Do Kyun Kim, Chi-Yung Cheng, Hsiu-Yung Pan, Chia-Te Kung, Ela Ćurčić, Ena Pritišanac, Ivo Planinc, Marijana Grgić Medić, Radovan Radonić, Abiola Fasina, Anthony J Dean, Nova L Panebianco, Patricia S Henwood, Oliviero Fochi, Moreno Favarato, Ezio Bonanomi, Ivan Tomić, Youngrock Ha, Hongchuen Toh, Elizabeth Harmon, Wilma Chan, Cameron Baston, Gail Morrison, Frances Shofer, Angela Hua, Sharon Kim, James Tsung, Isa Gunaydin, Zeynep Kekec, Mehmet Oguzhan Ay, Jinjoo Kim, Jinhyun Kim, Gyoosung Choi, Dowon Shim, Ji-Han Lee, Jana Ambrozic, Katja Prokselj, Miha Lucovnik, Gabrijela Brzan Simenc, Asta Mačiulienė, Almantas Maleckas, Algimantas Kriščiukaitis, Vytautas Mačiulis, Andrius Macas, Sharad Mohite, Zoltan Narancsik, Hugon Možina, Sara Nikolić, Jan Hansel, Rok Petrovčič, Una Mršić, Simon Orlob, Markus Lerchbaumer, Niklas Schönegger, Reinhard Kaufmann, Chun-I Pan, Chien-Hung Wu, Sarah Pasquale, Stephanie J Doniger, Sharon Yellin, Gerardo Chiricolo, Maja Potisek, Borut Drnovšek, Boštjan Leskovar, Kristine Robinson, Clara Kraft, Benjamin Moser, Stephen Davis, Shelley Layman, Yusef Sayeed, Joseph Minardi, Irmina Sefic Pasic, Amra Dzananovic, Anes Pasic, Sandra Vegar Zubovic, Ana Godan Hauptman, Ana Vujaklija Brajkovic, Jaksa Babel, Marina Peklic, Vedran Radonic, Luka Bielen, Peh Wee Ming, Nur Hafiza Yezid, Fatahul Laham Mohammed, Zainal Abidin Huda, Wan Nasarudin Wan Ismail, W Yus Haniff W Isa, Hashairi Fauzi, Praveena Seeva, Mohd Zulfakar Mazlan
A1 Point-of-care ultrasound examination of cervical spine in emergency departmentYahya Acar, Onur Tezel, Necati SalmanA2 A new technique in verifying the placement of a nasogastric tube: obtaining the longitudinal view of nasogastric tube in addition to transverse view with ultrasoundYahya Acar, Necati Salman, Onur Tezel, Erdem CevikA3 Pseudoaneurysm of the femoral artery after cannulation of a central venous line. Should we always use ultrasound in these procedures?Margarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-BordomásA4 Ultrasound-guided supraclavicular subclavian vein catheterization...
September 2016: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/27573519/neonatal-ventilation-with-a-manikin-model-and-two-novel-peep-valves-without-an-external-gas-source
#18
Monica Thallinger, Hege Langli Ersdal, Colin Morley, Carolyn Purington, Øystein Gomo, Estomih Mduma, Joar Eilevstjønn, Ketil Størdal
OBJECTIVE: Positive end expiratory pressure (PEEP) is beneficial when ventilating preterm newborns. The aim was to study whether inexperienced providers were able to generate PEEP during simulated neonatal ventilation, using two novel prototype PEEP valves, on a self-inflating bag without an external gas source. DESIGN: Forty-six nursing students in Tanzania were trained in ventilation with a new Laerdal Upright resuscitator and mask on a NeoNatalie manikin with a newborn resuscitation monitor...
May 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/27510178/identifying-the-position-of-the-right-atrium-to-align-pressure-transducer-for-cvp-spirit-level-or-3d-electromagnetic-positioning
#19
S Avellan, I Uhr, D McKelvey, Soren Sondergaard
The central venous pressure, CVP, is an important variable in the management of selected perioperative and intensive care cases and in clinical decision support systems, CDSS. In current routine, when measuring CVP the health care provider may use anatomical landmarks and a spirit level, SL, to adjust the pressure transducer to the level of the tricuspid valve, i.e. the phlebostatic axis. The aim of the study was to assess the agreement in the postoperative setting between the SL method and electromagnetic 3D positioning (EM)...
August 10, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27508481/stressors-perceived-by-patients-in-the-immediate-postoperative-of-cardiac-surgery
#20
Carina Aparecida Marosti Dessotte, Hélen Francine Rodrigues, Rejane Kiyomi Furuya, Lidia Aparecida Rossi, Rosana Aparecida Spadoti Dantas
OBJECTIVE: to investigate stressors perceived by patients in the immediate postoperative of cardiac surgery and their association with sociodemographic and clinical characteristics. METHOD: a prospective correlational study conducted in a city in São Paulo, between August 2013 and December 2014. A non-probabilistic sample included patients submitted to their first coronary artery bypass graft or mitral valve surgery. The "Environmental Stressor Questionnaire" adapted to Portuguese was used...
July 2016: Revista Brasileira de Enfermagem
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