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https://www.readbyqxmd.com/read/27919244/surgical-antibiotic-prophylaxis-in-children-a-mixed-method-study-on-healthcare-professionals-attitudes
#1
Angela Giusti, Stefania Spila Alegiani, Marta Luisa Ciofi Degli Atti, Sofia Colaceci, Roberto Raschetti, Pasquale Arace, Raffaele Spiazzi, Massimiliano Raponi
BACKGROUND: Qualitative and quantitative research investigating determinants of adherence to clinical guidelines (GLs) on surgical antibiotic prophylaxis (SAP) are scarce. We conducted a mixed-method study aimed at investigating barriers and at describing attitudes of healthcare professionals (HCPs) regarding SAP in three Italian children's hospitals. METHODS: The study comprised two sequential phases: 1) collection of qualitative data through focus groups; 2) conduction of a survey on HCPs attitudes towards SAP...
December 5, 2016: BMC Pediatrics
https://www.readbyqxmd.com/read/27912757/the-sydney-triage-to-admission-risk-tool-start-to-predict-emergency-department-disposition-a-derivation-and-internal-validation-study-using-retrospective-state-wide-data-from-new-south-wales-australia
#2
Michael M Dinh, Saartje Berendsen Russell, Kendall J Bein, Kris Rogers, David Muscatello, Richard Paoloni, Jon Hayman, Dane R Chalkley, Rebecca Ivers
BACKGROUND: Disposition decisions are critical to the functioning of Emergency Departments. The objectives of the present study were to derive and internally validate a prediction model for inpatient admission from the Emergency Department to assist with triage, patient flow and clinical decision making. METHODS: This was a retrospective analysis of State-wide Emergency Department data in New South Wales, Australia. Adult patients (age ≥ 16 years) were included if they presented to a Level five or six (tertiary level) Emergency Department in New South Wales, Australia between 2013 and 2014...
December 3, 2016: BMC Emergency Medicine
https://www.readbyqxmd.com/read/27899440/the-elimination-of-transfer-distances-is-an-important-part-of-hospital-design
#3
Sauli Karvonen, Isto Nordback, Jussi Elo, Jouni Havulinna, Heikki-Jussi Laine
OBJECTIVE: The objective of the present study was to describe how a specific patient flow analysis with from-to charts can be used in hospital design and layout planning. BACKGROUND: As part of a large renewal project at a university hospital, a detailed patient flow analysis was applied to planning the musculoskeletal surgery unit (orthopedics and traumatology, hand surgery, and plastic surgery). METHOD: First, the main activities of the unit were determined...
November 29, 2016: HERD
https://www.readbyqxmd.com/read/27884753/cell-free-dna-induced-apoptosis-of-granulosa-cells-by-oxidative-stress
#4
Yichun Guan, Wenjuan Zhang, Xingling Wang, Pengfei Cai, Qi Jia, Wenjie Zhao
BACKGROUND: Cell-free DNA is a DNA fragment that is produced by cell apoptosis which can affect the micro-environment of cell apoptosis. The levels of Cell-free DNA have been associated with successful rate of in vitro fertilization-embryo transfer (IVF-ET) and embryonic development. Our aim is to determine the relationship between cell-free DNA and embryo quality. The mechanisms of cell-free DNA in granulose and the apoptosis will be determined also. METHODS: The study enrolled patients who were undergone IVF for the first time and grouped the patients as pregnant (n=130) and non-pregnant (n=59)...
November 21, 2016: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/27865367/circulating-tumor-stem-like-cells-in-oral-squamous-cell-carcinoma-an-unresolved-paradox
#5
Shanaya Patel, Kavan Shah, Sheefa Mirza, Kanisha Shah, Rakesh Rawal
OBJECTIVE: Circulating tumor cells (CTCs) are increasingly gaining importance due to their immense potential in enhancing diagnosis, prognosis and response to therapy in solid malignancies. Therefore, we aimed to comprehend the molecular diversity and critical role of this disseminated tumor population in OSCC. METHODOLOGY: CD44+ subpopulation was isolated using immuno-magnetic cell separation and their purity was validated using flow cytometry. Characterisation of self renewal potential and resistance to chemotherapy was assessed using tumor sphere forming and cytotoxicity assay...
November 2016: Oral Oncology
https://www.readbyqxmd.com/read/27862986/analysing-the-emergency-department-patient-journey-discovery-of-bottlenecks-to-emergency-department-patient-flow
#6
Sankalp Khanna, Justin Boyle, Norm Good, Anthony Bell, James Lind
OBJECTIVE: Despite significant workflow reform to comply with the federally mandated National Emergency Access Target (NEAT), Australian public hospitals continue to face significant barriers in achieving good ED patient flow. This study was undertaken to identify and analyse the impact of individual waypoints on an ED patient's journey and identify which waypoints act as bottlenecks to a hospital's 4 h ED disposition performance. METHODS: This study involves retrospective analysis and simulation employing 2 years of ED administrative data from a sample of two major and two large metropolitan hospitals in Queensland, Australia...
November 8, 2016: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/27858961/performance-of-mrna-and-dna-based-high-risk-human-papillomavirus-assays-in-detection-of-high-grade-cervical-lesions
#7
Elina Virtanen, Ilkka Kalliala, Tadeusz Dyba, Pekka Nieminen, Eeva Auvinen
INTRODUCTION: The aim was to assess the performance of two commercial assays for the detection of high-risk human papillomavirus (hrHPV): Aptima HPV Assay (Hologic, Inc., Marlborough, MA, USA) which detects mRNA of 14 different hrHPV types, and Hybrid Capture 2 HPV DNA test (HC2; Qiagen, Gaithersburg, MD, USA), which detects the DNA of 13 different hrHPV types. Test performance was compared in the settings of a standard colposcopy clinic, among the regular patient flow. MATERIAL AND METHODS: Two separate cervical cell samples for Aptima and HC2 testing were collected from women referred to colposcopy or a cervical follow-up visit...
October 13, 2016: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/27851703/a-multidisciplinary-initiative-to-increase-inpatient-discharges-before-noon
#8
Marlena Kane, Ann Weinacker, Rudolph Arthofer, Timothy Seay-Morrison, Wesley Elfman, Mark Ramirez, Neera Ahuja, David Pickham, James Hereford, Mark Welton
OBJECTIVE: The aim of this study is to evaluate the effect of 2 hospital-wide interventions on achieving a discharge-before-noon rate of 40%. BACKGROUND: A multidisciplinary team led by administrative and physician leadership developed a plan to diminish capacity constraints by minimizing late afternoon hospital discharges using 2 patient flow management techniques. METHODS: The study was a preintervention/postintervention retrospective analysis observing all inpatients discharged across 19 inpatient units in a 484-bed, academic teaching hospital measuring calendar month discharge-before-noon percentage, patient satisfaction, and readmission rates...
December 2016: Journal of Nursing Administration
https://www.readbyqxmd.com/read/27847339/analytical-evaluation-of-a-new-point-of-care-system-for-measuring-cardiac-troponin-i
#9
Danielle Wm Kemper, Veronique Semjonow, Femke de Theije, Diederick Keizer, Lian van Lippen, Johannes Mair, Bernadette Wille, Michael Christ, Felicitas Geier, Pierre Hausfater, David Pariente, Volkher Scharnhorst, Joyce Curvers, Jeroen Nieuwenhuis
OBJECTIVES: Point-of-care cardiac troponin testing with adequate analytical performances has the potential to improve chest pain patients flow in the emergency department. We present the analytical evaluation of the newly developed Philips Minicare cTnI point-of-care immunoassay. DESIGN & METHODS: Li-heparin whole blood and plasma were used to perform analytical studies. The sample type comparison study was performed at 4 different hospitals. The 99th percentile upper reference limit (URL) study was performed using Li-heparin plasma, Li-heparin whole blood and capillary blood samples from 750 healthy adults, aging from 18 to 86years...
November 12, 2016: Clinical Biochemistry
https://www.readbyqxmd.com/read/27843036/acute-medical-units-the-way-to-go-a-literature-review
#10
L S van Galen, E M J Lammers, L J Schoonmade, N Alam, M H H Kramer, P W B Nanayakkara
BACKGROUND: Acute healthcare chains in the Netherlands are increasingly under pressure because of rising emergency department (ED) admissions, relative bed shortages and government policy changes. In order to improve acute patient flow and quality of care through hospitals, an acute medical unit (AMU) might be a solution, as demonstrated in the UK. However, limited information is available concerning AMUs in the Netherlands. Therefore, the aims of this study were to METHODS: A systematic literature search was performed searching 3 electronic databases: PubMed, Cochrane and EMBASE...
November 11, 2016: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/27832465/ethnographic-analysis-on-the-use-of-the-electronic-medical-record-for-clinical-handoff
#11
Philippa Nelson, Anthony J Bell, Larry Nathanson, Leon D Sanchez, Jonathan Fisher, Philip D Anderson
The objective of this study was to understand the social elements of clinical and organizational interactions of the key stakeholders in the specific context of an electronic dashboard used by the emergency department (ED) and inpatient medicine teams at the time of clinical referral and handover. An electronic handover function is utilised at the ED-inpatient interface at this institution and has given clinicians the ability to better communicate, monitor the department and strive to improve patient safety in streamline the delivery of care in the acute phase...
November 10, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27831655/emergency-department-crowding-and-hospital-bed-shortage-is-lean-a-smart-answer-a-systematic-review
#12
S Bucci, A G de Belvis, S Marventano, A C De Leva, M Tanzariello, M L Specchia, W Ricciardi, F Franceschi
OBJECTIVE: Emergency Departments (EDs) worldwide face the challenges of crowding, waiting times, and cost containment. This review aims to provide a synthesis of the current literature focused on how Lean Thinking Principles and tools can be applied in an ED to address overcrowding and hospital admissions. MATERIALS AND METHODS: Primary studies showing Lean interventions and implementation in ED visits, not requiring additional resources measuring specific outcomes (i...
October 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27830937/mass-vaccinations-at-the-united-states-naval-academy
#13
Chrysanthy Ha, Christopher Taylor, Jitendrakumar R Modi
We analyzed the mass influenza vaccination clinic process at the United States Naval Academy to identify gaps and implement changes for improvement. The Lean Six Sigma methodology was employed. Total number of staff members working the clinic and total hours worked were measured at baseline in August 2013 and after implementation in August 2014 to determine improvement. The clinic was moved from a hallway to an auditorium, and a linear patient flow was established. Staff members wore vests for easy identification, and the supply box was reorganized...
November 10, 2016: Health Security
https://www.readbyqxmd.com/read/27821867/impaired-t-cell-dependent-humoral-immune-response-associated-with-juvenile-onset-recurrent-respiratory-papillomatosis-progression
#14
Xunyao Wu, Guoliang Wang, Xi Chen, Jie Zhang, Jing Zhao, Jun Wang, Yang Xiao, Jun Tai, Shengcai Wang, Guixiang Wang, Hua Wang, Lina Bai, Jingang Gui, Xin Ni
Whether humoral immunity plays a role in HPV type 6 or 11 virus-mediated Juvenile-onset Recurrent Respiratory Papillomatosis (JORRP) remains unknown. In the present study, serum total IgG level in 44 JORRP patients was significantly decreased compared with that in 40 healthy controls. Moreover, expanded CD3(-)CD19(+) B cells with down-regulation of CD23, CD40, HLA-DR and up-regulation of CD86 expression were found in the peripheral blood of JORRP patients. Flow cytometry analysis of B-cell compartment showed that the frequency of both CD19(+)CD27(hi) plasma cells and CD19(+)CD27(+) memory B cells were decreased in JORRP patients...
November 8, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27800746/nuffield-trust-report-highlights-problems-faced-by-hospitals-in-meeting-4-hour-a-e-target
#15
(no author information available yet)
NHS trusts and health systems need to rethink how they manage patient flow to free up capacity and meet emergency department targets, the Nuffield Trust says.
November 1, 2016: Nursing Management (Harrow)
https://www.readbyqxmd.com/read/27799448/use-of-telehealth-to-treat-and-manage-chronic-viral-hepatitis-in-regional-queensland
#16
Kandice Keogh, Paul Clark, Patricia C Valery, Steven M McPhail, Candise Bradshaw, Melany Day, Anthony C Smith
For regional and rural Queenslanders, chronic viral hepatitis treatment is a major unmet health need, with restricted access to specialists outside of tertiary, largely metropolitan hospitals. To increase treatment of chronic viral hepatitis in regional Queensland, a team-based telehealth model was expanded. This expansion embedded an initial nursing consultation prior to specialist telehealth consultation. We conducted a retrospective audit of the introduction and expansion of hepatology telehealth services...
December 2016: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/27788918/comparison-of-outcomes-of-patients-with-acute-appendicitis-between-an-acute-care-surgery-model-and-traditional-call-coverage-model-in-the-same-community
#17
Shaina Schaetzel, Rachel Dirks, James Davis
BACKGROUND: This study compared outcomes, patient flow, and cost between an acute care surgery (ACS) and traditional call model (TRAD) for acute appendicitis in the same community and time period. METHODS: Patients who underwent appendectomy from 7/1/2012 to 6/30/2014 were retrospectively reviewed. An ACS and TRAD were compared. Demographic data, outcomes, cost, and time intervals were compared. RESULTS: Of the 945 patients reviewed, the ACS group had more perforated appendicitis on preoperative computed tomography scan (9% vs 3%, P < ...
October 3, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27788015/transcriptomic-analysis-reveals-significant-b-lymphocyte-suppression-in-corticosteroid-treated-hosts-with-pneumocystis-pneumonia
#18
Yang Hu, Dong Wang, Kan Zhai, Zhaohui Tong
Pneumocystis pneumonia (PCP) is an opportunistic infectious disease that is prevalent in immunosuppressed hosts. Corticosteroid treatment is the most significant risk factor for HIV-negative patients with PCP, although little is known about how corticosteroids alter the host defense against Pneumocystis infection. In the present study, we used transcriptome analysis to examine the immune response in the lungs of corticosteroid-treated PCP mice. The results showed downregulation in the genes related to both native immunity, such as antigen processing and presentation, inflammatory response, and phagocytosis, as well as B and T lymphocyte immunity...
October 27, 2016: American Journal of Respiratory Cell and Molecular Biology
https://www.readbyqxmd.com/read/27783800/characteristics-and-functional-demands-of-patients-at-a-local-rehabilitation-network-analysis-from-first-contact
#19
Mariana Angélica Peixoto de Souza, Jane Fonseca Dias, Fabiane Ribeiro Ferreira, Marisa Cotta Mancini, Renata Noce Kirkwood, Rosana Ferreira Sampaio
The cross sectional study aims to create the patients' profile and understand their demands for seeking public rehabilitation services from Belo Horizonte. Data were analyzed from 516 patients who gained entry into the health care system by means of the Protocol for Identification of Problems for Rehabilitation (PLPR). It allows for gathering information related to one's health and the social context, including a brief functional description (BFD) with 25 items. Most patients were females, mean age of 57 years, and 54% declared to be responsible for the family income...
October 2016: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/27773335/nurse-staffing-and-hospital-characteristics-predictive-of-time-to-diagnostic-evaluation-for-patients-in-the-emergency-department
#20
Judith Shindul-Rothschild, Catherine Y Read, Kelly D Stamp, Jane Flanagan
: In the 2014 Emergency Department Benchmarking Alliance Summit, for the first time, participants recommended tracking nursing and advanced practice nurse hours. Performance data from the Centers for Medicare and Medicaid Services provides an opportunity to analyze factors associated with delays in emergency care. The purpose of this study was to investigate hospital characteristics associated with time to a diagnostic evaluation in 67 Massachusetts emergency departments from 2013 to 2014...
October 20, 2016: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
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