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https://www.readbyqxmd.com/read/28938300/enhancing-the-quality-and-safety-of-the-perioperative-patient
#1
Sven Staender, Andrew Smith
PURPOSE OF REVIEW: Many possible hazards bedevil the perioperative patient. This review focuses on a number of aspects of perioperative management where the patient's quality and safety can be enhanced. RECENT FINDINGS: Our understanding of the relationship between preoperative preparation and postoperative outcomes has improved. There have also been recent developments in our understanding of how to construct useful cognitive aids and make the best use of checklists by understanding the cultural environment supporting their use...
September 21, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28938281/tranexamic-acid-in-orthopaedic-trauma-surgery-a-meta-analysis
#2
Elizabeth B Gausden, Rameez Qudsi, Myles D Boone, Brian OʼGara, Joseph J Ruzbarsky, Dean G Lorich
AIM: To systematically review and quantify the efficacy of tranexamic acid (TXA) use in reducing the risk of receiving a blood transfusion in patients undergoing orthopaedic trauma surgery, in reducing blood loss, and risk of thromboembolic events. METHODS: A systematic literature search was performed using MEDLINE, Embase, ClinicalTrials.gov, and conference proceeding abstracts from 2014 to 2016. A minimum of 2 reviewers screened each study and graded quality. The primary outcome measure was the risk of receiving a blood transfusion in the TXA group versus control...
October 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28938234/is-early-total-care-a-safe-and-effective-alternative-to-staged-protocol-for-the-treatment-of-schatzker-iv-vi-tibial-plateau-fractures-in-patients-older-than-50-years
#3
Amrut Borade, Harish Kempegowda, Raveesh Richard, Jove Graham, Michael Suk, Daniel S Horwitz
OBJECTIVES: To compare "Early Total Care" (ETC) with "Staged Protocol" (SP) for the treatment of Schatzker IV-VI tibial plateau fractures in patients older than 50 years regarding safety and effectiveness. DESIGN: Retrospective cohort study. SETTING: An academic level 1 US trauma center. PATIENTS/PARTICIPANTS: Eighty-one patients older than 50 years with Schatzker grade IV-VI tibial plateau fractures were included. INTERVENTION: Fifty-three patients were treated under SP with immediate external fixation followed by definitive internal fixation...
September 19, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28938218/late-life-suicide-prevention-strategies-current-status-and-future-directions
#4
REVIEW
Kim Van Orden, Charlene Deming
Late life suicide prevention differs from suicide prevention for other age groups: first, the number of older adults worldwide is on the rise; second, late-life suicide receives much less attention in all societal spheres, from the media, to federal funding agencies, to healthcare initiatives. Recent findings indicate an association between internalized ageist stereotypes and reduced will to live. Recent research also addresses the role of cognitive control as a contributor to risk and as an intervention target (e...
September 8, 2017: Current Opinion in Psychology
https://www.readbyqxmd.com/read/28936910/modulation-of-the-gut-microbiota-a-focus-on-treatments-for-irritable-bowel-syndrome
#5
Lucinda A Harris, Noemi Baffy
Irritable bowel syndrome (IBS), which is characterized by recurrent abdominal pain and disordered bowel habits, is one of the most common functional bowel disorders. IBS is a substantial burden on both patient health-related quality of life and health care costs. Several pathophysiologic mechanisms have been postulated for the occurrence of IBS, including altered gastrointestinal motility, visceral hypersensitivity, changes in gut permeability, immune activation, gut-brain dysregulation, autonomic nervous system dysfunction, and changes in the gut microbiota...
September 22, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28936819/-the-scope-quality-and-safety-requirements-of-drug-abuse-testing
#6
Tuncay Küme, Çiğdem Karakükcü, Aslı Pınar, Hakan Coşkunol
The aim of this review is to inform about the scopes and requirements of drug abuse testing. Drug abuse testing is one of the tools for determination of drug use. It must fulfill the quality and safety requirements in judgmental legal and administrative decisions. Drug abuse testing must fulfill some requirements like selection of the appropriate test matrix, appropriate screening test panel, sampling in detection window, patient consent, identification of the donor, appropriate collection site, sample collection with observation, identification and control of the sample, specimen custody chain in preanalytical phase; analysis in authorized laboratories, specimen validity tests, reliable testing METHODS, strict quality control, two-step analysis in analytical phase; storage of the split specimen, confirmation of the split specimen in the objection, result custody chain, appropriate cut-off concentration, the appropriate interpretation of the result in postanalytical phase...
2017: Türk Psikiyatri Dergisi, Turkish Journal of Psychiatry
https://www.readbyqxmd.com/read/28936475/surgical-data-science-the-new-knowledge-domain
#7
S Swaroop Vedula, Gregory D Hager
Healthcare in general, and surgery/interventional care in particular, is evolving through rapid advances in technology and increasing complexity of care with the goal of maximizing quality and value of care. While innovations in diagnostic and therapeutic technologies have driven past improvements in quality of surgical care, future transformation in care will be enabled by data. Conventional methodologies, such as registry studies, are limited in their scope for discovery and research, extent and complexity of data, breadth of analytic techniques, and translation or integration of research findings into patient care...
April 2017: Innov Surg Sci
https://www.readbyqxmd.com/read/28935359/disparities-by-sex-tracked-in-the-2015-national-healthcare-quality-and-disparities-report-trends-across-national-quality-strategy-priorities-health-conditions-and-access-measures
#8
Jennifer E Moore, Atlang Mompe, Ernest Moy
INTRODUCTION: Established by the Affordable Care Act, the National Quality Strategy (NQS) is the national policy goals aimed at improving the quality of health care for all Americans. The NQS established six priorities to provide better, more affordable care for individuals and communities. This is the first analysis of data on the NQS and access measures that focus on sex differences, health conditions, trends, and disparities. METHODS: Measures from the 2015 National Healthcare Quality and Disparities Report (QDR) for the four National Quality Strategy priorities (Patient Safety, Person Centered Care, Effective Treatment and Healthy Living), access to care, and health conditions for women were compared to measures for men...
September 19, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/28935036/inferior-vena-cava-filters-to-prevent-pulmonary-embolism-systematic-review-and%C3%A2-meta-analysis
#9
Behnood Bikdeli, Saurav Chatterjee, Nihar R Desai, Ajay J Kirtane, Mayur M Desai, Michael B Bracken, Frederick A Spencer, Manuel Monreal, Samuel Z Goldhaber, Harlan M Krumholz
BACKGROUND: Inferior vena cava (IVC) filters are widely used for prevention of pulmonary embolism (PE). However, uncertainty persists about their efficacy and safety. OBJECTIVES: The authors conducted a systematic review and meta-analysis of the published reports on the efficacy and safety of IVC filters. METHODS: The authors searched PubMed, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov through October 3, 2016, for randomized controlled trials (RCTs) or prospective controlled observational studies of IVC filters versus none in patients at risk of PE...
September 26, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28934995/quality-improvement-primer-part-2-executing-a-quality-improvement-project-in-the-emergency-department
#10
Lucas B Chartier, Antonia S Stang, Samuel Vaillancourt, Amy H Y Cheng
The topics of quality improvement (QI) and patient safety have become important themes in health care in recent years, particularly in the emergency department setting, which is a frequent point of contact with the health care system for patients. In the first of three articles in this series meant as a QI primer for emergency medicine clinicians, we introduced the strategic planning required to develop an effective QI project using a fictional case study as an example. In this second article we continue with our example of improving time to antibiotics for patients with sepsis, and introduce the Model for Improvement...
September 22, 2017: CJEM
https://www.readbyqxmd.com/read/28934785/1-year-results-of-a-randomized-controlled-trial-of-conservative-management-vs-minimally-invasive-surgical-treatment-for-sacroiliac-joint-pain
#11
Julius Dengler Dengler, Djaya Kools, Robert Pflugmacher, Alessandro Gasbarrini, Domenico Prestamburgo, Paolo Gaetani, Eddie van Eeckhoven, Daniel Cher, Bengt Sturesson
BACKGROUND: Low back pain (LBP) emanating from the sacroiliac joint (SIJ) is a common finding. Devices to fuse the SIJ are now commercially available, but high-quality evidence supporting their effectiveness is limited. OBJECTIVES: To compare the safety and effectiveness of conservative management (CM) to minimally invasive sacroiliac joint fusion (SIJF) in patients with chronic LBP originating from the SIJ. STUDY DESIGN: Prospective, multicenter randomized controlled trial...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28934783/serious-adverse-events-associated-with-readmission-through-one-year-after-vertebral-augmentation-with-either-a-polyetheretherketone-implant-or-balloon-kyphoplasty
#12
Douglas P Beall, Jeffrey D Coe, Mark McIlduff, Daniel Bloch, John Hornberger, Christopher Warner, Sean Tutton
BACKGROUND: The KAST (Kiva Safety and Efficacy) investigation device exempt (IDE) study indicated that the majority of patients responded equally well to vertebral augmentation using either an implant-based approach or balloon kyphoplasty (BK). Additional investigation has suggested that a subset of patients may benefit further by avoiding repeated readmissions due to serious adverse events (SAEs) if they receive one vertebral augmentation approach over another. OBJECTIVES: The primary aim was to assess the effect of 2 different augmentation procedures on readmission rates for SAEs...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28934402/a-world-health-organization-field-trial-assessing-a-proposed-icd-11-framework-for-classifying-patient-safety-events
#13
Alan J Forster, Burnand Bernard, Saskia E Drösler, Yana Gurevich, James Harrison, Jean-Marie Januel, Patrick S Romano, Danielle A Southern, Vijaya Sundararajan, Hude Quan, Saskia E Vanderloo, Harold A Pincus, William A Ghali
Objective: To assess the utility of the proposed World Health Organization (WHO)'s International Classification of Disease (ICD) framework for classifying patient safety events. Setting: Independent classification of 45 clinical vignettes using a web-based platform. Study participants: The WHO's multi-disciplinary Quality and Safety Topic Advisory Group. Main outcome measure(s): The framework consists of three concepts: harm, cause and mode...
August 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28934265/comparative-effectiveness-of-different-transarterial-embolization-therapies-alone-or-in-combination-with-local-ablative-or-adjuvant-systemic-treatments-for-unresectable-hepatocellular-carcinoma-a-network-meta-analysis-of-randomized-controlled-trials
#14
Konstantinos Katsanos, Panagiotis Kitrou, Stavros Spiliopoulos, Ioannis Maroulis, Theodore Petsas, Dimitris Karnabatidis
BACKGROUND: The optimal transcatheter embolization strategy for patients with unresectable hepatocellular carcinoma (HCC) remains elusive. We conducted a systematic review and network meta-analysis (NMA) of different embolization options for unresectable HCC. METHODS: Medical databases were searched for randomized controlled trials evaluating bland transarterial embolization (TAE), conventional TACE, drug-eluting bead chemoembolization (DEB-TACE), or transarterial radioembolization (TARE), either alone or combined with adjuvant chemotherapy, or local liver ablation, or external radiotherapy for unresectable HCC up to June 2017...
2017: PloS One
https://www.readbyqxmd.com/read/28933708/statewide-longitudinal-progression-of-the-whole-patient-measure-of-safety-in-south-carolina
#15
Christine B Turley, Jordan Brittingham, Aunyika Moonan, Dianne Davis, Hrishikesh Chakraborty
Meaningful improvement in patient safety encompasses a vast number of quality metrics, but a single measure to represent the overall level of safety is challenging to produce. Recently, Perla et al. established the Whole-Person Measure of Safety (WPMoS) to reflect the concept of global risk assessment at the patient level. We evaluated the WPMoS across an entire state to understand the impact of urban/rural setting, academic status, and hospital size on patient safety outcomes. The population included all South Carolina (SC) inpatient discharges from January 1, 2008, through to December 31, 2013, and was evaluated using established definitions of highly undesirable events (HUEs)...
September 4, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28933516/anti-il5-therapies-for-asthma
#16
REVIEW
Hugo A Farne, Amanda Wilson, Colin Powell, Lynne Bax, Stephen J Milan
BACKGROUND: This review is the first update of a previously published review in The Cochrane Library (Issue 7, 2015). Interleukin-5 (IL-5) is the main cytokine involved in the activation of eosinophils, which cause airway inflammation and are a classic feature of asthma. Monoclonal antibodies targeting IL-5 or its receptor (IL-5R) have been developed, with recent studies suggesting that they reduce asthma exacerbations, improve health-related quality of life (HRQoL) and lung function...
September 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28933123/-meta-analysis-of-yinzhihuang-oral-liquid-in-treatment-of-intrahepatic-cholestasis-of-pregnancy
#17
Jing-Jing Yan, Xiao-Ping Xia, Na Bu
To systematically review the clinical efficacy and safety of Yinzhihuang oral liquid in the treatment of intrahepatic cholestasis of pregnancy(ICP). Literatures published by June 2016 were searched in databases, such as Medline, Pubmed, Cochrane Library, China National Knowledge Infrastructure(CNKI), Chinese Scientific Journals Full-text Database(VIP), Chinese biomedical literature database(CBM), and Wanfang Database. Randomized controlled trials(RCT) of Yinzhihuang oral liquid were collected according to the inclusion criteria, and the methodological quality of selected literatures was evaluated...
December 2016: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
https://www.readbyqxmd.com/read/28932765/informed-strangers-witnessing-and-responding-to-unethical-care-as-student-nurses
#18
Joyce Engel, Jenn Salfi, Samantha Micsinszki, Andrea Bodnar
Nursing students occupy a unique perspective in clinical settings because they are informed, through education, about how patient care ought to happen. Given the brevity of placements and their "visiting status" in clinical sites, students are less invested in the ethos of specific sites. Subsequently, their perspectives of quality care are informed by what should happen, which might differ from that of nurses and patients. The purpose of this study was to identify predominant themes in patient care, as experienced by students, and the influence that these observations have on the development of their ethical reasoning...
January 2017: Global Qualitative Nursing Research
https://www.readbyqxmd.com/read/28932092/systematic-review-and-meta-analysis-of-colon-cleansing-preparations-in-patients-with-inflammatory-bowel-disease
#19
Sophie Restellini, Omar Kherad, Talat Bessissow, Charles Ménard, Myriam Martel, Maryam Taheri Tanjani, Peter L Lakatos, Alan N Barkun
AIM: To performed a systematic review and meta-analysis to determine any possible differences in terms of effectiveness, safety and tolerability between existing colon-cleansing products in patients with inflammatory bowel disease. METHODS: Systematic searches were performed (January 1980-September 2016) using MEDLINE, EMBASE, Scopus, CENTRAL and ISI Web of knowledge for randomized trials assessing preparations with or without adjuvants, given in split and non-split dosing, and in high (> 3 L) or low-volume (2 L or less) regimens...
August 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28930372/efficacy-and-safety-of-blood-transfusion-in-obstetric-patients-systematic-review-of-the-literature
#20
Celso Módolo, Arnav Agarwal, Mariana Floriano Luiza Piva, Andresa Graciutti Botan, Samira Esteves Afonso Camargo, Nermeen Gawish, Norma Sueli Pinheiro Módolo, Regina El Dib
OBJECTIVES: To evaluate the efficacy of blood transfusion compared to no intervention in obstetric patients. MATERIAL AND METHODS: A systematic review was performed with Cochrane Database of Clinical Trials, PubMed, EMBASE and LILACS databases searched as of September, 2016. Two authors independently selected relevant clinical trials, assessed their methodological quality and extracted data, using the GRADE approach. RESULTS: Five studies within a total of 6,297 met the inclusion criteria, with women generally aged 20-40 years...
2017: Ginekologia Polska
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