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https://www.readbyqxmd.com/read/29457258/quality-of-prescribing-by-physicians-nurse-practitioners-and-physician-assistants-in-the-united-states
#1
Shiyin Jiao, Irene B Murimi, Randall S Stafford, Ramin Mojtabai, G Caleb Alexander
OBJECTIVE: Nurse practitioners (NPs) and physician assistants (PAs) have increasingly broad prescribing authority in the United States, yet little is known regarding how the quality of their prescribing practices compares to that of physicians. The objective of this study was to compare the quality of prescribing practices of physicians and non-physician providers. METHODS: A serial cross-sectional analysis of the 2006-2012 National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS) was performed...
February 19, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29455708/developing-public-health-initiatives-through-understanding-motivations-of-the-audience-at-mass-gathering-events
#2
Alison Hutton, Jamie Ranse, Matthew Brendan Munn
This report identifies what is known about audience motivations at three different mass-gathering events: outdoor music festivals, religious events, and sporting events. In light of these motivations, the paper discusses how these can be harnessed by the event organizer and Emergency Medical Services. Lastly, motivations tell what kinds of interventions can be used to achieve an understanding of audience characteristics and the opportunity to develop tailor-made programs to maximize safety and make long-lasting public health interventions to a particular "cohort" or event population...
February 19, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29455680/emergency-medical-service-ems-utilization-by-syrian-refugees-residing-in-ankara-turkey
#3
Ali Osman Altıner, Sıdıka Tekeli Yeşil
Introduction Many Syrians have left their country and migrated to other countries since March 2011, due to the civil war. As of March 2016, a total of 2,747,946 Syrian refugees had immigrated to Turkey. Some Syrian refugees have been living in camps, while 2,475,134 have been living in metropolitan areas, such as Ankara. Study Objective This study investigated Emergency Medical Service (EMS) utilization among Syrian refugees residing in Ankara. METHODS: This study was a descriptive, cross-sectional database analysis using data obtained from the Department of EMS of the Ankara Provincial Health Directorate...
February 19, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29454378/do-employees-benefit-from-collaborations-between-out-of-hours-general-practitioners-and-emergency-departments
#4
Elisabeth Sybilla Johanna van Gils-van Rooij, Sjoerd Michael Broekman, Dingenus Herman de Bakker, Berthold Rudy Meijboom, Christoffel Joris Yzermans
BACKGROUND: In an attempt to redirect patients who are inappropriately attending hospital emergency departments (ED) and in doing so provide the right care at the right place, out-of-hours GP (General Practitioner) services and EDs increasingly collaborate in Urgent Care Collaborations (UCCs). Work satisfaction is an important factor in analysing the impact of this organisational change. The objective of this study is, firstly, to discover if there is a difference in the employee experiences between those working in UCCs and those in traditional out-of-hours services in which EDs and out-of-hours GP services operate separately (i...
February 17, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29453296/understanding-the-characteristics-of-recurrent-visits-to-the-emergency-department-by-paediatric-patients-a-retrospective-observational-study-conducted-at-three-tertiary-hospitals-in-korea
#5
Byung-Soo Kim, Jung-Youn Kim, Sung-Hyuk Choi, Young-Hoon Yoon
OBJECTIVES: The number of paediatric patients visiting the emergency department (ED) continues to rise. In South Korea, approximately 25% of the patients who visit the ED are paediatric patients. In the USA, about 20% of the paediatric population were found to have visited the ED in the past year. A recent study demonstrated that 4.5%-8% of patients account for 25% of all ED visits. Therefore, the aim of this study was to identify the characteristics of recurrent visits. METHODS: Design: retrospective observational study...
February 16, 2018: BMJ Open
https://www.readbyqxmd.com/read/29453155/evaluation-of-the-triage-performed-by-registered-nurses-in-the-hospital-cl%C3%A3-nico-universitario-%C3%A2-lozano-blesa%C3%A2-emergency-service-saragossa-spain
#6
Isabel Viñuales, Araceli Monzón-Fernández, Manuel Viñuales, Teresa Sanclemente
OBJECTIVE: To evaluate nurses' triage quality and adequacy in Saragossa's Hospital Clínico and to compare the main characteristics of "urgent" and "non-urgent" visits to the Hospital Emergency Department (HED). METHOD: This exploratory-retrospective research study was carried out over the last 3 months of 2015 (paediatrics, gynaecological and ophthalmologic emergencies were excluded). Data were obtained from the "Puesto Clínico Hospitalario" programme used in the HED...
February 13, 2018: Enfermería Clínica
https://www.readbyqxmd.com/read/29452962/the-role-of-resiliency-and-coping-strategies-in-occurrence-of-positive-changes-in-medical-rescue-workers
#7
Nina Ogińska-Bulik, Magdalena Zadworna-Cieślak
BACKGROUND: Working in the emergency services entails exposure to traumatic events; however, their effects can be both negative and positive. Among the factors determining posttraumatic growth (PTG) after an experienced trauma are the personal resources and coping strategies. The purpose of the research was to investigate the role of resiliency and coping strategies with stress in posttraumatic growth in a group of medical rescue workers. MATERIALS AND METHODS: Data of 80 male medical rescuers who have experienced traumatic event in their worksite were analyzed...
February 13, 2018: International Emergency Nursing
https://www.readbyqxmd.com/read/29452722/traumatic-lingual-hematoma-resulting-in-bilateral-temporal-mandibular-joint-dislocations
#8
Dhara P Amin, Michael N Cooper, Kim I Newton
BACKGROUND: Lingual hematoma (LH) is a relatively uncommon entity seen after both medical and traumatic etiologies. Regardless of the cause, the feared complication is acute airway obstruction. CASE REPORT: Our case involves a 39-year-old man who presented to the Emergency Department via emergency medical services with an enlarging LH after an unwitnessed fall, suspected to be an alcohol withdrawal seizure. The bleeding was likely exacerbated by previously undiagnosed thrombocytopenia...
February 13, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29452351/impact-of-treatment-delay-on-mortality-in-st-segment-elevation-myocardial-infarction-stemi-patients-presenting-with-and-without-haemodynamic-instability-results-from-the-german-prospective-multicentre-fitt-stemi-trial
#9
Karl Heinrich Scholz, Sebastian K G Maier, Lars S Maier, Björn Lengenfelder, Claudius Jacobshagen, Jens Jung, Claus Fleischmann, Gerald S Werner, Hans G Olbrich, Rainer Ott, Harald Mudra, Karlheinz Seidl, P Christian Schulze, Christian Weiss, Josef Haimerl, Tim Friede, Thomas Meyer
Aims: The aim of this study was to investigate the effect of contact-to-balloon time on mortality in ST-segment elevation myocardial infarction (STEMI) patients with and without haemodynamic instability. Methods and results: Using data from the prospective, multicentre Feedback Intervention and Treatment Times in ST-Elevation Myocardial Infarction (FITT-STEMI) trial, we assessed the prognostic relevance of first medical contact-to-balloon time in n = 12 675 STEMI patients who used emergency medical service transportation and were treated with primary percutaneous coronary intervention (PCI)...
February 14, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29451116/population-tailored-care-for-homeless-veterans-and-acute-care-use-cost-and-satisfaction-a-prospective-quasi-experimental-trial
#10
Thomas P O'Toole, Erin E Johnson, Matthew Borgia, Amy Noack, Jean Yoon, Elizabeth Gehlert, Jeanie Lo
INTRODUCTION: Although traditional patient-centered medical homes (PCMHs) are effective for patients with complex needs, it is unclear whether homeless-tailored PCMHs work better for homeless veterans. We examined the impact of enrollment in a Veterans Health Administration (VHA) homeless-tailored PCMH on health services use, cost, and satisfaction compared with enrollment in a traditional, nontailored PCMH. METHODS: We conducted a prospective, multicenter, quasi-experimental, single-blinded study at 2 VHA medical centers to assess health services use, cost, and satisfaction during 12 months among 2 groups of homeless veterans: 1) veterans receiving VHA homeless-tailored primary care (Homeless-Patient Aligned Care Team [H-PACT]) and 2) veterans receiving traditional primary care services (PACT)...
February 15, 2018: Preventing Chronic Disease
https://www.readbyqxmd.com/read/29450470/incidence-of-delayed-intracranial-hemorrhage-in-older-patients-after-blunt-head-trauma
#11
James A Chenoweth, Samuel D Gaona, Mark Faul, James F Holmes, Daniel K Nishijima
Importance: Current guidelines conflict on the management of older adults who have blunt head trauma taking anticoagulant and antiplatelet medications. This is partially due to the limited data comparing patients who are taking these medications with those who are not. Objective: To investigate the incidence of delayed traumatic intracranial hemorrhage in older adults with head trauma, including those taking anticoagulant and antiplatelet medications. Design, Setting, and Participants: This prospective observational cohort study included patients 55 years and older who had blunt head trauma and were transported via emergency medical services between August 1, 2015, and September 30, 2016...
February 14, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29447489/compulsory-use-of-the-backboard-is-associated-with-increased-frequency-of-thoracolumbar-imaging
#12
Brian M Clemency, Christopher T Tanski, Jennifer Gibson Chambers, Michael O'Brien, Andrew S Knapp, Alexander J Clark, Patrick McGoff, Johanna Innes, Heather A Lindstrom, David Hostler
BACKGROUND: Backboards have been shown to cause pain in uninjured patients. This may alter physical exam findings, leading emergency department (ED) providers to suspect a spinal injury when none exists resulting in additional imaging of the thoracolumbar spine. New York had previously employed a "Spinal Immobilization" protocol that included compulsory backboard application for all patients with suspected spinal injuries. In 2015, New York instituted a new "Spinal Motion Restriction" protocol that made backboard use optional for these patients...
February 15, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29445882/procedure-rates-performed-by-emergency-medicine-residents-a-retrospective-review
#13
Joshua T Bucher, Christopher Bryczkowski, Grant Wei, Renee L Riggs, Anoop Kotwal, Brian Sumner, Jonathan V McCoy
BACKGROUND: The purpose of our study is to investigate rates of individual procedures performed by residents in our emergency medicine (EM) residency program. Different programs expose residents to different training environments. Our hypothesis is that ultrasound examinations are the most commonly performed procedure in our residency. METHODS: The study took place in an academic level I trauma center with multiple residency and fellowship programs including surgery, surgical critical care, trauma, medicine, pulmonary/critical care, anesthesiology and others...
February 14, 2018: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29444733/medically-attended-catheter-complications-are-common-in-patients-with-outpatient-central-venous-catheters
#14
Steven S Spires, Peter F Rebeiro, Mickie Miller, Katie Koss, Patty W Wright, Thomas R Talbot
OBJECTIVE Outpatient central venous catheters (CVCs) are being used more frequently; however, data describing mechanical complications and central-line-associated bloodstream infections (CLABSI) in the outpatient setting are limited. We performed a retrospective observational cohort study to understand the burden of these complications to elucidate their impact on the healthcare system. METHODS Data were retrospectively collected on patients discharged from Vanderbilt University Medical Center with a CVC in place and admitted into the care of Vanderbilt Home Care Services...
February 15, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29444640/cancer-screening-in-koreans-a-focus-group-approach
#15
Shin-Young Lee, Eunice E Lee
BACKGROUND: Cancer is the greatest disease burden in Korea. Cancer screening can reduce the burden of cancer but cancer screening rates among Koreans remain low. The purposes of this study were to a) understand Koreans' beliefs and knowledge about cancer screening, and b) explore preferred strategies for increasing cancer screening utilization. METHODS: We conducted a descriptive, qualitative study using eight face-to-face focus groups with a total of 64 Koreans aged 40 and over...
February 14, 2018: BMC Public Health
https://www.readbyqxmd.com/read/29441840/the-ethics-of-real-time-ems-direction-suggested-curricular-content
#16
Jay M Brenner, Andrew L Aswegan, Laura E Vearrier, Jesse B Basford, Kenneth V Iserson
Ethical dilemmas can create moral distress in even the most experienced emergency physicians (EPs). Following reasonable and justified approaches can help alleviate such distress. The purpose of this article is to guide EPs providing Emergency Medical Services (EMS) direction to navigate through common ethical issues confronted in the prehospital delivery of care, including protecting privacy and confidentiality, decision-making capacity and refusal of treatment, withholding of treatment, and termination of resuscitation (TOR)...
February 14, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29440802/patients-with-end-stage-oncologic-and-nononcologic-disease-in-emergency-service-of-an-urban-tertiary-hospital
#17
Jose P Amado, Rolando Vasquez, Roberto W Huari, Andrea S Sucari, Teodoro J Oscanoa
Context: In the last decades, patients with chronic terminal diseases have had more frequent visits to emergency services. Aims: This study aims to determine the proportion of terminal illness in patients readmitted to emergency room, to evaluate the use of this service and rate of death. Settings and Design: A cross-sectional study in a tertiary hospital with 120 stretchers which annually reports 160 thousand attentions and 22 thousand admissions...
January 2018: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/29440798/rural-palliative-care-in-north-india-rapid-evaluation-of-a-program-using-a-realist-mixed-method-approach
#18
Daniel F Munday, Erna Haraldsdottir, Manju Manak, Ann Thyle, Cathy M Ratcliff
Context: Palliative care has not developed widely in rural North India. Since 2010, the Emmanuel Hospitals Association (EHA) has been developing a model of palliative care appropriate for this setting, based on teams undertaking home visits with the backup of outpatient and inpatient services. A project to further develop the model operated from 2012 to 2015 supported by funding from the UK. Aims: This study aims to evaluate the EHA palliative care project. Settings and Design: Rapid evaluation method using a mixed method realist approach at the five project hospital sites...
January 2018: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/29440236/the-consequences-of-patient-charges-for-prescription-drugs-in-canada-a-cross-sectional-survey
#19
Michael R Law, Lucy Cheng, Ashra Kolhatkar, Laurie J Goldsmith, Steven G Morgan, Anne M Holbrook, Irfan A Dhalla
BACKGROUND: Many Canadians face substantial out-of-pocket charges for prescription drugs. Prior work suggests that this causes some patients to not take their medications as prescribed; however, we have little understanding of whether charges for prescription medicines lead patients to forego basic needs or to use more health care services. Our study aimed to quantify the consequences of patient charges for medicines in Canada. METHODS: As part of the 2016 Canadian Community Health Survey, we designed and fielded cross-sectional questions to 28 091 Canadians regarding prescription drug affordability, consequent use of health care services and trade-offs with other expenditures...
February 5, 2018: CMAJ Open
https://www.readbyqxmd.com/read/29440127/ethics-and-patient-and-public-involvement-with-children-and-young-people
#20
Sarah Jane Mitchell, Anne-Marie Slowther, Jane Coad, Shazaan Akhtar, Elizabeth Hyde, Dena Khan, Jeremy Dale
Patient and public involvement (PPI) is important both in research and in quality improvement activities related to healthcare services . While PPI activities do not require formal ethical approval, they can raise a number of ethical concerns, through the introduction of complex technical medical concepts, challenging language or sensitive subject areas. There is very little published literature to guide ethical practice in this area. We have been conducting PPI with children and young people throughout a research study in paediatric palliative care...
February 9, 2018: Archives of Disease in Childhood. Education and Practice Edition
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