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https://www.readbyqxmd.com/read/27933151/improving-asthma-care-in-a-pediatric-resident-clinic
#1
Julia Lee, Albina Gogo, Daniel Tancredi, Erik Fernandez Y Garcia, Ulfat Shaikh
There is variation in pediatric asthma management in the outpatient setting. Adherence to national asthma guidelines provides a systematic standardized approach to asthma management. There is a gap between usual and guideline-consistent asthma care in resident clinics. Practice improvement modules aimed at improving resident physician adherence to asthma care guidelines have not been consistently utilized and have not yet been studied. Our aim was to increase guideline consistent care in our pediatric resident clinic in a twelve-month period via increasing performance on the following measures to 75%: spirometry testing; influenza immunization recommendation; level of control assessed through the use of a standardized questionnaire; appropriate medications per national guideline; and use of written asthma action plans...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27932357/using-quality-assessment-tools-to-critically-appraise-ageing-research-a-guide-for-clinicians
#2
REVIEW
Jennifer Kirsty Harrison, James Reid, Terry J Quinn, Susan Deborah Shenkin
Evidence based medicine tells us that we should not accept published research at face value. Even research from established teams published in the highest impact journals can have methodological flaws, biases and limited generalisability. The critical appraisal of research studies can seem daunting, but tools are available to make the process easier for the non-specialist. Understanding the language and process of quality assessment is essential when considering or conducting research, and is also valuable for all clinicians who use published research to inform their clinical practice...
December 7, 2016: Age and Ageing
https://www.readbyqxmd.com/read/27930963/-teaching-on-the-run-with-australian-midwives-in-a-tertiary-maternity-hospital
#3
Yvonne Hauck, Lucy Lewis, Alissa Pemberton, Caroline Crichton, Janice Butt
Teaching On The Run (TOTR) is an Australian program for health professionals involved in clinical supervision. An amended TOTR program was evaluated with midwives acting as preceptors assisting learners integrate theory with clinical practice. A mixed method study was employed to compare midwives' perceived skills and confidence before and after completion of TOTR workshops. A secondary aim explored midwifery learners' (students and new graduates) perceptions of support from preceptors during the implementation of TOTR...
November 25, 2016: Nurse Education in Practice
https://www.readbyqxmd.com/read/27929082/a-retrospective-study-of-pyogenic-liver-abscess-focusing-on-klebsiella-pneumoniae-as-a-primary-pathogen-in-china-from-1994-to-2015
#4
Yun Qian, Chi Chun Wong, Sanchuan Lai, Huarong Chen, Xingkang He, Leimin Sun, Jiaguo Wu, Jiancang Zhou, Jun Yu, Weili Liu, Daoyang Zhou, Jianmin Si
Pyogenic liver abscess (PLA) is a common intra-abdominal infection in adults. In this study, we aim to explore demographic and clinical characteristics of PLA focusing on Klebsiella pneumoniae (K. pneumoniae) induced PLA (KP-PLA) in mainland China. A retrospective review of medical records from all patients with KP-PLA admitted to a tertiary teaching hospital over a 21-year period (1994-2015) was performed. Among 296 PLA cases with confirmed culture-positive data, K. pneumoniae was revealed as the predominant pathogen (n = 189, 63...
December 8, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27928663/volume-of-hospital-is-important-for-the-prognosis-of-high-risk-patients-with-nonvariceal-upper-gastrointestinal-bleeding-nvugib
#5
Jin Woo Choi, Seong Woo Jeon, Jung Gu Kwon, Dong Wook Lee, Chang Yoon Ha, Kwang Bum Cho, Byung Ik Jang, Jung Bae Park, Youn Sun Park
BACKGROUND AND AIM: Nonvariceal upper gastrointestinal bleeding (NVUGIB) is a potentially life-threatening hospital emergency requiring hemodynamic stabilization and resuscitation. This study is carried out to determine whether hospital volume can influence outcome in patients with NVUGIB. METHOD: This is a retrospective study with a prospective cohort database (KCT 0000514. cris.nih.go.kr). Eight teaching hospitals were divided into two different groups: high-volume centers (HVC, ≥60 NVUGIB patients/year, four clinics) and low-volume centers (LVC, <60 NVUGIB patients/year, four clinics)...
December 7, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27927728/preventability-of-hospital-readmissions-from-skilled-nursing-facilities-a-consumer-perspective
#6
J Mary Lou Jacobsen, John F Schnelle, Avantika A Saraf, Emily A Long, Eduard E Vasilevskis, Sunil Kripalani, Sandra F Simmons
PURPOSE OF THE STUDY: A structured interview was conducted with Medicare patients readmitted to a private, tertiary teaching hospital from skilled nursing facilities (SNFs) to assess their perspectives of readmission preventability and their role in the readmission. DESIGN AND METHODS: Data were collected at Vanderbilt University Medical Center using a 6-item interview administered at the bedside to Medicare beneficiaries with unplanned hospital readmissions from 23 SNFs within 60 days of a previous hospital discharge...
December 7, 2016: Gerontologist
https://www.readbyqxmd.com/read/27927175/a-pilot-randomized-controlled-trial-of-a-tailored-cognitive-behavioural-therapy-based-intervention-for-depressive-symptoms-in-those-newly-diagnosed-with-multiple-sclerosis
#7
Litza A Kiropoulos, Trevor Kilpatrick, Alex Holmes, Jennifer Threader
BACKGROUND: To examine the effectiveness and acceptability of an 8-week individual tailored cognitive behavioural therapy (CBT) intervention for the treatment of depressive symptoms in those newly diagnosed with multiple sclerosis. METHODS: The current study presents a pilot, parallel group randomized controlled trial (RCT) with an allocation ratio of 1:1 conducted in a large research and teaching hospital in Melbourne, Australia. 30 individuals with a mean age of 36...
December 7, 2016: BMC Psychiatry
https://www.readbyqxmd.com/read/27926974/pregnant-patient-knowledge-and-behavior-regarding-perinatal-oral-health
#8
Bernard Gonik, Eline Wilson, Melanie Mayberry, Bushra Yuki Joarder
Objective Perinatal oral health is important to obstetric practice, with significant implications for maternal, fetal, and infant health. This study sought to describe and compare knowledge and behavior related to perinatal oral health in two distinct populations of pregnant women. Methods An anonymous 13-question survey was distributed at two patient centers (urban teaching clinics and suburban referral center), examining patient knowledge and behaviors pertaining to oral health. Descriptive statistics were tabulated...
December 7, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27925381/doctors-use-of-mobile-devices-in-the-clinical-setting-a-mixed-methods-study
#9
Arany Nerminathan, Amanda Harrison, Megan Phelps, Karen M Scott
AIM: To explore how doctors use mobile devices in the clinical setting and understand drivers for use. METHODS: A mixed methods study was used with doctors in a paediatric and adult teaching hospital in 2013. A paper based survey examined mobile device usage data by doctors in the clinical setting. Focus groups explored doctors' reasons for using or refraining from using mobile devices in the clinical setting, and their attitudes about others' use. RESULTS: The survey, completed by 109 doctors, showed that 91% owned a smartphone and 88% used their mobile devices frequently in the clinical setting...
December 7, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27925145/the-oldest-old-in-the-emergency-department-impact-of-renal-function
#10
T Brünnler, M Drey, G Dirrigl, C Weingart, F Rockmann, C Sieber, U Hoffmann
OBJECTIVES: The ageing population implicates an increasing numbers of older adults attending Emergency Departments (ED). We assessed the effect of estimated glomerular filtration rate as a predictor of clinical outcomes in oldest-old patients ≥ 85 years attending the ED in an university teaching hospital. DESIGN: Within three years, 81831 patient contacts were made in our ED. 7799 (9.5%) were older than 85 years, in whom we analyzed the impact of renal function on various outcome parameters...
2016: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/27925078/factors-associated-with-the-occurrence-of-adverse-events-in-critical-elderly-patients
#11
Maria Cecilia Toffoletto, Ricardo Luis Barbosa, Rafaela Andolhe, Elaine Machado de Oliveira, Adriana Janzantte Ducci, Katia Grillo Padilha
Objective: to identify the factors associated with the occurrence of adverse events in critical elderly patients admitted to intensive care unit according to demographic and clinical characteristics. Method: a retrospective cohort study was conducted in nine units of a teaching hospital. Data were collected from medical records and from monitoring of nursing shift change. We used the t-test/Mann-Whitney, chi-square and logistic regression to test associations. Significance level of 5% was used...
November 2016: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/27925055/lung-protection-an-intervention-for-tidal-volume-reduction-in-a-teaching-intensive-care-unit
#12
Arturo Briva, Cristina Gaiero
Objective: To determine the effect of feedback and education regarding the use of predicted body weight to adjust tidal volume in a lung-protective mechanical ventilation strategy. Methods: The study was performed from October 2014 to November 2015 (12 months) in a single university polyvalent intensive care unit. We developed a combined intervention (education and feedback), placing particular attention on the importance of adjusting tidal volumes to predicted body weight bedside...
December 1, 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/27922922/a-sleep-hygiene-and-relaxation-intervention-for-children-with-acute-lymphoblastic-leukemia-a-pilot-randomized-controlled-trial
#13
Sue Zupanec, Heather Jones, Lyndsey McRae, Efrosini Papaconstantinou, Julie Weston, Robyn Stremler
BACKGROUND: Sleep disturbance and fatigue are common and distressing pediatric cancer-related outcomes. Sleep hygiene education and relaxation techniques are recommended to improve sleep in healthy children and adult cancer survivors. No studies have tested these interventions to improve sleep and fatigue for children with acute lymphoblastic leukemia (ALL) in the home setting. OBJECTIVES: The aim of this study is to establish the feasibility and acceptability of a sleep hygiene and relaxation intervention to improve sleep and fatigue for children receiving maintenance chemotherapy for ALL...
December 5, 2016: Cancer Nursing
https://www.readbyqxmd.com/read/27921321/from-paperwork-to-parenting-experiences-of-professional-staff-in-student-support
#14
Wendy C Y Hu, Eleanor Flynn, Rebecca Mann, Robyn Woodward-Kron
CONTEXT: For academic staff, responding to student concerns is an important responsibility. Professional staff, or non-academic staff who do administrative work in medical schools, are often the first to be approached by students, yet there is little research on how they manage student issues. Informed by the conceptual framework of emotional labour, we examined the experiences of professional staff, aiming to identify theoretical and practical insights for improving the provision of student support...
December 5, 2016: Medical Education
https://www.readbyqxmd.com/read/27920966/an-evaluation-of-positional-prompts-for-teaching-receptive-identification-to-individuals-diagnosed-with-autism-spectrum-disorder
#15
Justin B Leaf, Joseph H Cihon, Donna Townley-Cochran, Kevin Miller, Ronald Leaf, John McEachin, Mitchell Taubman
In this study, we evaluated the effects of positional prompts on teaching receptive identification to six children diagnosed with autism spectrum disorder (ASD). The researchers implemented a most-to-least prompting system using a three level hierarchy to teach receptive picture identification. Within the prompting hierarchy, only positional prompts were used. The most assistive prompt was placing the target stimulus 12 in. closer to the participant, the less assistive prompt was placing the target stimulus 6 in...
December 2016: Behavior Analysis in Practice
https://www.readbyqxmd.com/read/27920962/recommendations-for-detecting-and-addressing-barriers-to-successful-supervision
#16
Tyra P Sellers, Linda A LeBlanc, Amber L Valentino
Behavior analysts who supervise staff are responsible for establishing a healthy supervisory relationship and for teaching basic behavior analytic skills (e.g., verbal repertoires, technical repertoires, clinical decision-making). In addition, supervisors should prepare their supervisees to succeed in their subsequent professional activities by developing their interpersonal skills and professionalism repertoires. Difficulties in the supervisor relationship and problematic personal and professional skills often become the focus of targeted supervision efforts after the effects of deficits (e...
December 2016: Behavior Analysis in Practice
https://www.readbyqxmd.com/read/27919373/improving-the-effectiveness-of-drug-safety-alerts-to-increase-adherence-to-the-guideline-for-gastrointestinal-prophylaxis
#17
Soufiane Lilih, Marieke Pereboom, Ruud T M van der Hoeven, Aukje K Mantel-Teeuwisse, Matthijs L Becker
OBJECTIVE: Gastrointestinal bleedings are the most frequently occurring reason for medication-related hospital admissions, which are potentially preventable. We implemented a clinical decision support system that recommends to prescribe gastrointestinal prophylaxis in patients with an increased risk according to the Dutch guideline. Our primary objective was to determine whether the implementation resulted in improved compliance with this guideline for gastrointestinal prophylaxis. A secondary objective was to determine whether implementation resulted in a reduction of the number of drug safety alerts...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27919251/a-randomised-controlled-trial-of-sensory-awareness-training-and-additional-motor-practice-for-learning-scalpel-skills-in-podiatry-students
#18
Ryan S Causby, Michelle N McDonnell, Lloyd Reed, Susan L Hillier
BACKGROUND: The process of using a scalpel, like all other motor activities, is dependent upon the successful integration of afferent (sensory), cognitive and efferent (motor) processes. During learning of these skills, even if motor practice is carefully monitored there is still an inherent risk involved. It is also possible that this strategy could reinforce high levels of anxiety experienced by the student and affect student self-efficacy, causing detrimental effects on motor learning...
December 5, 2016: BMC Medical Education
https://www.readbyqxmd.com/read/27918867/case-based-interprofessional-learning-for-undergraduate-healthcare-professionals-in-the-clinical-setting
#19
Jamal Nasir, Julie Goldie, Annabel Little, Debasish Banerjee, Scott Reeves
Interprofessional learning (IPL) within the healthcare setting has well documented positive outcomes for patients, yet it is not widely offered at the undergraduate level, particularly in a clinical setting. We set up case-based teaching scenarios involving a real patient, aimed at small groups of four students representing two or more healthcare professions. The aim of the sessions was to give students a greater awareness of the roles of all the different healthcare professions involved in patient care in a hospital setting...
December 5, 2016: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/27918336/resident-physicians-improve-nontechnical-skills-when-on-operating-room-management-and-leadership-rotation
#20
Devon C Cole, Christopher R Giordano, Terrie Vasilopoulos, Brenda G Fahy
BACKGROUND: Anesthesiology residency primarily emphasizes the development of medical knowledge and technical skills. Yet, nontechnical skills (NTS) are also vital to successful clinical practice. Elements of NTS are communication, teamwork, situational awareness, and decision making. METHODS: The first 10 consecutive senior residents who chose to participate in this 2-week elective rotation of operating room (OR) management and leadership training were enrolled in this study, which spanned from March 2013 to March 2015...
December 1, 2016: Anesthesia and Analgesia
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