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https://www.readbyqxmd.com/read/28198753/mechanical-ventilation-weaning-practices-and-decision-making-in-european-picus
#1
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...
February 14, 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
#2
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)...
January 3, 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
#3
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
#4
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
#5
(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
#6
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
https://www.readbyqxmd.com/read/28134553/using-organizational-and-clinical-performance-data-to-increase-the-value-of-mental-health-care
#7
Eric M Schmidt, Dean D Krahn, Marsden H McGuire, Sara Tavakoli, David M Wright, Hugo E Solares, Sonne Lemke, Jodie Trafton
U.S. health systems, policy makers, and patients increasingly demand high-value care that improves health outcomes at lower cost. This study describes the initial design and analysis of the Mental Health Management System (MHMS), a performance data and quality improvement tool used by the Veterans Health Administration (VHA) to increase the value of its mental health care. The MHMS evaluates access to and quality of mental health care, organizational structure and efficiency, implementation of innovative treatment options, and, in collaboration with management, resource needs for delivering care...
February 2017: Psychological Services
https://www.readbyqxmd.com/read/28125990/an-assessment-of-staffing-needs-at-a-hiv-clinic-in-a-western-kenya-using-the-who-workload-indicators-of-staffing-need-wisn-2011
#8
B Burmen, N Owuor, P Mitei
BACKGROUND: An optimal number of health workers, who are appropriately allocated across different occupations and geographical regions, are required to ensure population coverage of health interventions. Health worker shortages in HIV care provision are highest in areas that are worst hit by the HIV epidemic. Kenya is listed among countries that experience health worker shortages (<2.5 health workers per 1000 population) and have a high HIV burden (HIV prevalence 5.6 with 15.2% in Nyanza province)...
January 26, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/28125473/proposed-regulations-for-long-term-care-omit-nurse-staffing-mandates
#9
Dalia Sofer
Setting staffing ratios would be 'challenging,' says the CMS.
February 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28118657/association-of-intensive-care-unit-patient-to-intensivist-ratios-with-hospital-mortality
#10
Hayley B Gershengorn, David A Harrison, Allan Garland, M Elizabeth Wilcox, Kathryn M Rowan, Hannah Wunsch
Importance: The patient-to-intensivist ratio (PIR) across intensive care units (ICUs) is not standardized and the association of PIR with patient outcome is not well established. Understanding the impact of PIR on outcomes is necessary to optimize senior medical staffing and deliver high-quality care. Objective: To test the hypotheses that: (1) there is significant variation in the PIR across ICUs and (2) higher PIRs are associated with higher hospital mortality for ICU patients...
January 24, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28107348/predicting-length-of-stay-among-patients-discharged-from-the-emergency-department-using-an-accelerated-failure-time-model
#11
Chung-Hsien Chaou, Hsiu-Hsi Chen, Shu-Hui Chang, Petrus Tang, Shin-Liang Pan, Amy Ming-Fang Yen, Te-Fa Chiu
BACKGROUND: Emergency department (ED) crowding continues to be an important health care issue in modern countries. Among the many crucial quality indicators for monitoring the throughput process, a patient's length of stay (LOS) is considered the most important one since it is both the cause and the result of ED crowding. The aim of this study is to identify and quantify the influence of different patient-related or diagnostic activities-related factors on the ED LOS of discharged patients...
2017: PloS One
https://www.readbyqxmd.com/read/28103856/relationship-between-the-presence-of-baccalaureate-educated-rns-and-quality-of-care-a-cross-sectional-study-in-dutch-long-term-care-facilities
#12
Ramona Backhaus, Erik van Rossum, Hilde Verbeek, Ruud J G Halfens, Frans E S Tan, Elizabeth Capezuti, Jan P H Hamers
BACKGROUND: Recent evidence suggests that an increase in baccalaureate-educated registered nurses (BRNs) leads to better quality of care in hospitals. For geriatric long-term care facilities such as nursing homes, this relationship is less clear. Most studies assessing the relationship between nurse staffing and quality of care in long-term care facilities are US-based, and only a few have focused on the unique contribution of registered nurses. In this study, we focus on BRNs, as they are expected to serve as role models and change agents, while little is known about their unique contribution to quality of care in long-term care facilities...
January 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28094649/guidance-on-safe-staffing-shies-away-from-set-ratio
#13
Chris Longhurst
The head of the Safe Staffing Alliance has said new draft guidance on nurse staffing on acute adult inpatient wards in England 'does not go far enough'.
January 4, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28093370/a-comparison-of-locomotor-therapy-interventions-partial-body-weight-supported-treadmill-lokomat%C3%A2-and-g-eo%C3%A2-training-in-persons-with-traumatic-brain-injury
#14
Alberto Esquenazi, Stella Lee, Amanda Wikoff, Andrew Packel, Theresa Toczylowski, John Feeley
BACKGROUND: Literature in the application of gait training techniques in persons with traumatic brain injury is limited. Current techniques require of multiple staff and are physically demanding. The use of a robotic locomotor training may provide improved training capacity for this population. OBJECTIVE: To examine the impact of three different modes of locomotor therapy on gait velocity and spatiotemporal symmetry using: an end effector robot (G-EO™); a robotic exoskeleton (Lokomat®) and manual assisted partial-body weight supported treadmill training (PBWSTT) in participants with traumatic brain injury...
January 13, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28069914/survival-analysis-of-weekend-emergency-medical-admissions
#15
Richard Conway, Sean Cournane, Declan Byrne, Deirdre O'Riordan, Bernard Silke
BACKGROUND: We previously reported weekend emergency admissions to have a higher mortality; we have now examined the time profile of deaths, by weekday or weekend admission, in all emergency medical patients admitted between 2002 - 2014. METHODS: We divided admissions by a weekday or weekend (After 17.00 Friday-Sunday) hospital arrival. We examined survival following an admission using Cox proportional hazard models and Kaplan-Meier time to event analysis. RESULTS: 82,368 admissions were recorded in 44,628 patients...
January 9, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28062019/care-delivery-patterns-processes-and-outcomes-for-primary-ovarian-cancer-surgery-a-population-based-review-using-a-national-administrative-database
#16
Saad Shakeel, Laurie Elit, Noori Akhtar-Danesh, Laura Schneider, Christian Finley
OBJECTIVES: In this pan-Canadian study, we sought to elucidate the current state of surgical care for primary ovarian cancers and factors influencing selected short-term outcomes; these were in-hospital mortality (IHM), major complications (MCs), failure-to-rescue (FTR), and hospital length of stay (LOS). METHODS: We created a population cohort using inpatient admission records from the Canadian Institute of Health Information data set (2004-2012). Multilevel logistic regression and flexible parametric survival analyses, adjusted for hospital clustering effect, were conducted to determine the effect of patient-specific factors (i...
January 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28059837/complications-risk-factors-and-staffing-patterns-for-noncardiac-surgery-in-patients-with-left-ventricular-assist-devices
#17
Michael R Mathis, Subramanian Sathishkumar, Sachin Kheterpal, Matthew D Caldwell, Francis D Pagani, Elizabeth S Jewell, Milo C Engoren
BACKGROUND: Patients with left ventricular assist devices presenting for noncardiac surgery are increasingly commonplace; however, little is known about their outcomes. Accordingly, the authors sought to determine the frequency of complications, risk factors, and staffing patterns. METHODS: The authors performed a retrospective study at their academic tertiary care center, investigating all adult left ventricular assist device patients undergoing noncardiac surgery from 2006 to 2015...
March 2017: Anesthesiology
https://www.readbyqxmd.com/read/28051772/characterizing-teamwork-in-cardiovascular-care-outcomes-a-network-analytics-approach
#18
Matthew B Carson, Denise M Scholtens, Conor N Frailey, Stephanie J Gravenor, Emilie S Powell, Amy Y Wang, Gayle Shier Kricke, Faraz S Ahmad, R Kannan Mutharasan, Nicholas D Soulakis
BACKGROUND: The nature of teamwork in healthcare is complex and interdisciplinary, and provider collaboration based on shared patient encounters is crucial to its success. Characterizing the intensity of working relationships with risk-adjusted patient outcomes supplies insight into provider interactions in a hospital environment. METHODS AND RESULTS: We extracted 4 years of patient, provider, and activity data for encounters in an inpatient cardiology unit from Northwestern Medicine's Enterprise Data Warehouse...
November 2016: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28045351/primary-care-mental-health-integration-in-the-va-health-system-associations-between-provider-staffing-and-quality-of-depression-care
#19
Debra S Levine, John F McCarthy, Brittany Cornwell, Laurie Brockmann, Paul N Pfeiffer
OBJECTIVES: The study examined whether staffing of Primary Care-Mental Health Integration (PCMHI) services in the Department of Veterans Affairs (VA) health system is related to quality of depression care. METHODS: Site surveys and administrative data from 349 VA facilities for fiscal year 2013 were used to calculate PCMHI staffing (full-time equivalents) per 10,000 primary care patients and discipline-specific staffing proportions for PCMHI psychologists, social workers, nurses, and psychiatric medication prescribers...
January 3, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28017895/mobbing-among-care-workers-in-nursing-homes-a-cross-sectional-secondary-analysis-of-the-swiss-nursing-homes-human-resources-project
#20
Myriam Tong, René Schwendimann, Franziska Zúñiga
BACKGROUND: As a category of bullying, mobbing is a form of violence in the workplace that damages the employing organization as well as the targeted employee. In Europe, the overall prevalence of mobbing in healthcare is estimated at 4%. However, few studies have explored mobbing among long-term care workers. OBJECTIVES: This study aims to examine the frequency of mobbing in Swiss nursing homes and its relationships with care workers' (i.e. registered nurse, licensed practical nurse, assistant nurse, nurse aide) health status, job satisfaction, and intention to leave, and to explore the work environment as a contributing factor to mobbing...
December 15, 2016: International Journal of Nursing Studies
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