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https://www.readbyqxmd.com/read/28398697/effects-of-targeting-lower-versus-higher-arterial-oxygen-saturations-on-death-or-disability-in-preterm-infants
#1
REVIEW
Lisa M Askie, Brian A Darlow, Peter G Davis, Neil Finer, Ben Stenson, Maximo Vento, Robin Whyte
BACKGROUND: The use of supplemental oxygen in the care of extremely preterm infants has been common practice since the 1940s. Despite this, there is little agreement regarding which oxygen saturation (SpO₂) ranges to target to maximise short- or long-term growth and development, while minimising harms. There are two opposing concerns. Lower oxygen levels (targeting SpO₂ at 90% or less) may impair neurodevelopment or result in death. Higher oxygen levels (targeting SpO₂ greater than 90%) may increase severe retinopathy of prematurity or chronic lung disease...
April 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28388827/relationships-between-nurse-staffing-and-patients-experiences-and-the-mediating-effects-of-missed-nursing-care
#2
Sung-Hyun Cho, Barbara A Mark, George Knafl, Hyoung Eun Chang, Hyo-Jeong Yoon
PURPOSE: The aims of this study were to examine the relationships between nurse staffing and patients' experiences, and to determine the mediating effects of patient-reported missed care on the relationship between nurse staffing and patients' experiences. DESIGN: The study included 362 nurses and 208 patients from 23 nursing units of six hospitals in South Korea. METHODS: Nurse staffing was measured by patient-to-nurse ratios and by nurse- and patient-perceived staffing adequacy...
April 7, 2017: Journal of Nursing Scholarship
https://www.readbyqxmd.com/read/28380716/dietary-service-staffing-impact-nutritional-quality-in-nursing-homes
#3
Kelly M Smith, Kali S Thomas, Shanthi Johnson, Hongdao Meng, Kathryn Hyer
OBJECTIVE: To examine the relationship between dietary service staff and dietary deficiency citations in nursing homes (NHs). METHOD: 2007-2011 Online Survey and Certification and Reporting data for 14,881 freestanding NHs were used to examine the relationship between dietary service staff and the probability of receiving a dietary service-related deficiency citation. An unconditional logit model with random effects was employed. RESULTS: Findings suggest that higher staffing levels for dietitians (odds ratio [OR] = ...
January 1, 2017: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
https://www.readbyqxmd.com/read/28376546/association-of-nursing-overtime-nurse-staffing-and-unit-occupancy-with-health-care-associated-infections-in-the-nicu
#4
Marc Beltempo, Régis Blais, Guy Lacroix, Michèle Cabot, Bruno Piedboeuf
Objective This study aims to assess the association of nursing overtime, nurse staffing, and unit occupancy with health care-associated infections (HCAIs) in the neonatal intensive care unit (NICU). Study Design A 2-year retrospective cohort study was conducted for 2,236 infants admitted in a Canadian tertiary care, 51-bed NICU. Daily administrative data were obtained from the database "Logibec" and combined to the patient outcomes database. Median values for the nursing overtime hours/total hours worked ratio, the available to recommended nurse staffing ratio, and the unit occupancy rate over 3-day periods before HCAI were compared with days that did not precede infections...
April 4, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28375852/postoperative-complications-and-outcomes-associated-with-a-transition-to-24-7-intensivist-management-of-cardiac-surgery-patients
#5
Marc A Benoit, Sean M Bagshaw, Colleen M Norris, Mohamad Zibdawi, Wu Dat Chin, David B Ross, Sean van Diepen
OBJECTIVES: Nighttime intensivist staffing does not improve patient outcomes in general ICUs. Few studies have examined the association between dedicated in-house 24/7 intensivist coverage on outcomes in specialized cardiac surgical ICUs. We sought to evaluate the association between 24/7 in-house intensivist-only management of cardiac surgical patients on postoperative complications and health resource utilization. DESIGN: Before-and-after propensity matched cohort study...
April 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28348492/hospital-resource-intensity-and-cirrhosis-mortality-in-united-states
#6
Amit K Mathur, Apurba K Chakrabarti, Jessica L Mellinger, Michael L Volk, Ryan Day, Andrew L Singer, Winston R Hewitt, Kunam S Reddy, Adyr A Moss
AIM: To determine whether hospital characteristics predict cirrhosis mortality and how much variation in mortality is attributable to hospital differences. METHODS: We used data from the 2005-2011 Nationwide Inpatient Sample and the American Hospital Association Annual survey to identify hospitalizations for decompensated cirrhosis and corresponding facility characteristics. We created hospital-specific risk and reliability-adjusted odds ratios for cirrhosis mortality, and evaluated patient and facility differences based on hospital performance quintiles...
March 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28340503/risk-factors-for-lymph-node-metastases-in-women-with-endometrial-cancer-a-population-based-nation-wide-register-study-on-behalf-of-the-swedish-gynecological-cancer-group
#7
K Stålberg, P Kjølhede, M Bjurberg, C Borgfeldt, P Dahm-Kähler, H Falconer, E Holmberg, C Staf, B Tholander, E Åvall-Lundqvist, P Rosenberg, T Högberg
The role of lymphadenectomy in the management of early endometrial cancer remains controversial. In the recent ESMO-ESGO-ESTRO guidelines, lymphadenectomy is recommended for patients with endometrioid adenocarcinoma Grade 3 with deep myometrial invasion, but complete agreement was not achieved. In Sweden, DNA aneuploidy has been included as a high-risk factor. The aim of our study was to evaluate the impact of tumor histology, FIGO grade, DNA ploidy and myometrial invasion (MI) on occurrence of lymph node metastasis (LNM) in patients with endometrial cancer...
March 24, 2017: International Journal of Cancer. Journal International du Cancer
https://www.readbyqxmd.com/read/28336014/clinical-significance-of-fibrinogen-degradation-product-among-traumatized-patients
#8
Kouhei Ishikawa, Kazuhiko Omori, Kei Jitsuiki, Hiromichi Ohsaka, Hiroshi Ito, Katsuhito Shimoyama, Toru Fukunaga, Norikazu Urabe, Souichirou Kitamura, Youichi Yanagawa
OBJECTIVE: We retrospectively analyzed trauma patients who were transported by a physician-staffed helicopter (doctor helicopter) to investigate the clinical significance of the fibrinogen degradation product (FDP) level on arrival. METHODS: From February 2011 to July 2016, a medical chart review was retrospectively performed for all patients with trauma who were transported by the doctor helicopter. The subjects were divided into 2 groups: a survival group and a fatal group...
March 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28294028/only-mandated-ratios-will-enable-proper-workforce-planning
#9
Susan Osborne
On 7 February, NHS staff were asked by Unison to record nurse-to-patient ratios as part of the union's sixth annual safe staffing survey.
March 15, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28288172/the-impact-of-an-intervention-to-introduce-malaria-rapid-diagnostic-tests-on-fever-case-management-in-a-high-transmission-setting-in-uganda-a-mixed-methods-cluster-randomized-trial-prime
#10
Clare I R Chandler, Emily L Webb, Catherine Maiteki-Sebuguzi, Susan Nayiga, Christine Nabirye, Deborah D DiLiberto, Emmanuel Ssemmondo, Grant Dorsey, Moses R Kamya, Sarah G Staedke
BACKGROUND: Rapid diagnostic tests for malaria (mRDTs) have been scaled-up widely across Africa. The PRIME study evaluated an intervention aiming to improve fever case management using mRDTs at public health centers in Uganda. METHODS: A cluster-randomized trial was conducted from 2010-13 in Tororo, a high malaria transmission setting. Twenty public health centers were randomized in a 1:1 ratio to intervention or control. The intervention included training in health center management, fever case management with mRDTs, and patient-centered services; plus provision of mRDTs and artemether-lumefantrine (AL) when stocks ran low...
2017: PloS One
https://www.readbyqxmd.com/read/28275860/parameters-affecting-length-of-stay-in-a-pediatric-emergency-department-a-retrospective-observational-study
#11
Kevin D Hofer, Rotraud K Saurenmann
Prolonged emergency department (ED) length of stay (LOS) is used as a proxy for ED overcrowding and is associated with adverse outcomes of patients requiring therapy and reduced patient satisfaction. Our aim was to identify and quantify variables which affect ED-LOS. Patients admitted to the pediatric ED of a large regional Swiss hospital during a 1-year period were analyzed for LOS (in minutes). Predictor variables included patient-associated parameters (time of admission and discharge, ED occupancy, triage score, diagnosis, and demographic data) and external factors (weekday, time, and season)...
March 8, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28269339/a-novel-system-to-tackle-hospital-acquired-pressure-ulcers
#12
B S Renganathan, S P Preejith, Sridhar Nagaiyan, Jayaraj Joseph, Mohanasankar Sivaprakasam
Hospital acquired pressure ulcers (HAPUs) is a major problem that affects around one in twenty patients who are admitted in hospital with sudden illness. These ulcers often occur when patients have limited mobility and cannot change positions in bed on their own. Traditionally, the occurrence of HAPUs has been minimized by turning the patient every 2 hours to alternating lateral and supine positions, and by using pressure redistributing mattresses. In many healthcare facilities, such a patient repositioning schedule is not always maintained owing to low caregiver compliance to turning protocols...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28263363/changes-in-emergency-department-geriatric-services-in-quebec-and-correlates-of-these-changes
#13
Jane McCusker, Alain Vadeboncoeur, Sylvie Cossette, Nathalie Veillette, Francine Ducharme, Thien Tuong Minh Vu, Antonio Ciampi, Deniz Cetin-Sahin, Eric Belzile
BACKGROUND/OBJECTIVES: To describe changes in geriatric emergency department (ED) services from 2006 (T1) to 2013/14 (T2), associated factors, and outcomes. DESIGN: Two-wave survey design. SETTING: Province of Quebec, Canada. PARTICIPANTS: Lead nurses and physicians at 57 EDs that participated in both the T1 and T2 surveys. INTERVENTION: Changes over time in ED geriatric services, observed naturalistically...
March 6, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28227581/a-novel-system-to-tackle-hospital-acquired-pressure-ulcers
#14
B S Renganathan, S P Preejith, Sridhar Nagaiyan, Jayaraj Joseph, Mohanasankar Sivaprakasam, B S Renganathan, S P Preejith, Sridhar Nagaiyan, Jayaraj Joseph, Mohanasankar Sivaprakasam, S P Preejith, B S Renganathan, Sridhar Nagaiyan, Jayaraj Joseph, Mohanasankar Sivaprakasam
Hospital acquired pressure ulcers (HAPUs) is a major problem that affects around one in twenty patients who are admitted in hospital with sudden illness. These ulcers often occur when patients have limited mobility and cannot change positions in bed on their own. Traditionally, the occurrence of HAPUs has been minimized by turning the patient every 2 hours to alternating lateral and supine positions, and by using pressure redistributing mattresses. In many healthcare facilities, such a patient repositioning schedule is not always maintained owing to low caregiver compliance to turning protocols...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28198753/mechanical-ventilation-weaning-practices-and-decision-making-in-european-picus
#15
Lyvonne N Tume, Martin C J Kneyber, Bronagh Blackwood, Louise Rose
OBJECTIVES: This survey had three key objectives: 1) To describe responsibility for key ventilation and weaning decisions in European PICUs and explore variations across Europe; 2) To describe the use of protocols, spontaneous breathing trials, noninvasive ventilation, high-flow nasal cannula use, and automated weaning systems; and 3) To describe nurse-to-patient staffing ratios and perceived nursing autonomy and influence over ventilation decision making. DESIGN: Cross-sectional electronic survey...
April 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28162827/infectious-diseases-specialist-management-improves-outcomes-for-outpatients-diagnosed-with-cellulitis-in-the-emergency-department-a-double-cohort-study
#16
Shilpa R Jain, Seyed M Hosseini-Moghaddam, Philip Dwek, Kaveri Gupta, Sameer Elsayed, Guy W Thompson, Robert Dagnone, Kelly Hutt, Michael Silverman
Three hospital emergency rooms (ERs) routinely referred all cases of cellulitis requiring outpatient intravenous antibiotics, to a central ER-staffed cellulitis clinic. We performed a retrospective cohort study of all patients seen by the ER clinic in the last 4months preceding a policy change (ER management cohort [ERMC]) (n=149) and all those seen in the first 3months of a new policy of automatic referral to an infectious disease (ID) specialist-supervised cellulitis clinic (ID management cohort [IDMC]) (n=136)...
April 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28154162/outcomes-of-physician-staffed-versus-non-physician-staffed-helicopter-transport-for-st-elevation-myocardial-infarction
#17
Sverrir I Gunnarsson, Joseph Mitchell, Mary S Busch, Brenda Larson, S Michael Gharacholou, Zhanhai Li, Amish N Raval
BACKGROUND: The effect of physician-staffed helicopter emergency medical service (HEMS) on ST-elevation myocardial infarction (STEMI) patient transfer is unknown. The purpose of this study was to evaluate the characteristics and outcomes of physician-staffed HEMS (Physician-HEMS) versus non-physician-staffed (Standard-HEMS) in patients with STEMI. METHODS AND RESULTS: We studied 398 STEMI patients transferred by either Physician-HEMS (n=327) or Standard-HEMS (n=71) for primary or rescue percutaneous coronary intervention at 2 hospitals between 2006 and 2014...
February 2, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28152745/prospectively-measuring-the-acuity-of-outpatient-chemotherapy-treatment-regimens-for-staffing-allocation
#18
Cheryl A Steele
48 Background: UPMC CancerCenter is a large outpatient medical oncology network of 25 locations, located within a 200 mile radius of Pittsburgh, PA. Covering all of these centers with a limited pool of float nurses was a daily challenge. The literature describes many attempts to quantify nursing workload retrospectively based upon complexity, hours of nursing time, etc. The ability to schedule staff equitability in advance is critical to managing staff. New targeted therapies and complicated treatment regimens which impact patient acuity bring to light the need for accurate acuity measurement...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152699/development-of-an-infusion-nurse-staffing-model-for-outpatient-chemotherapy-centers
#19
(no author information available yet)
103 Background: Nursing roles and responsibilities within ambulatory oncology infusion suites across our health system are not clearly defined and it is not understood what the appropriate staffing ratio should be per site. It is not clear if employees are working to the highest level of their licensure or skill, and if the appropriate activities are performed by the correct department. A standard staffing model to provide efficiency of clinical services and patient safety does not exist, and nursing roles are variable between the sites...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28145766/an-official-american-thoracic-society-systematic-review-the-effect-of-nighttime-intensivist-staffing-on-mortality-and-length-of-stay-among-intensive-care-unit-patients
#20
Meeta Prasad Kerlin, Neill K J Adhikari, Louise Rose, M Elizabeth Wilcox, Cassandra J Bellamy, Deena Kelly Costa, Hayley B Gershengorn, Scott D Halpern, Jeremy M Kahn, Meghan B Lane-Fall, David J Wallace, Curtis H Weiss, Hannah Wunsch, Colin R Cooke
BACKGROUND: Studies of nighttime intensivist staffing have yielded mixed results. GOALS: To review the association of nighttime intensivist staffing with outcomes of intensive care unit (ICU) patients. METHODS: We searched five databases (2000-2016) for studies comparing in-hospital nighttime intensivist staffing with other nighttime staffing models in adult ICUs and reporting mortality or length of stay. We abstracted data on staffing models, outcomes, and study characteristics and assessed study quality, using standardized tools...
February 1, 2017: American Journal of Respiratory and Critical Care Medicine
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