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https://www.readbyqxmd.com/read/28624270/implementation-and-evaluation-of-a-navigator-role-to-improve-emergency-department-throughput
#1
Paul Fulbrook, Melanie Jessup, Frances Kinnear
BACKGROUND: Emergency department overcrowding impacts patients, staff, and quality of care, and there is government pressure to optimize throughput and reduce waiting times. One solution for improving patient flow is the emerging 'navigator' role: a nurse that supports staff in care delivery; facilitating efficient and timely patient movement through the emergency department. METHODS: A 20-week project was implemented to evaluate an emergency department nurse navigator role...
June 14, 2017: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/28618914/role-of-the-polypill-for-secondary-prevention-in-ischaemic-heart-disease
#2
José M Castellano, Valentín Fuster, Catriona Jennings, Eva Prescott, Héctor Bueno
In 2011, for the first time in the history of humankind, non-communicable diseases became the leading cause of death worldwide. This change in trend is obviously multifactorial and very complex, as it is the paradoxical result of social, economic and health system growth worldwide. Vaccination and infectious diseases control, changing dietary habits worldwide, sedentary behaviour, globalisation, industrialisation (resulting in a shift from manual to sedentary labour), tobacco and sugary beverage surges in low- and middle-income countries and rapid urbanisation have all played a role in this epidemic transition...
June 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28613398/fetal-and-umbilical-doppler-ultrasound-in-high-risk-pregnancies
#3
REVIEW
Zarko Alfirevic, Tamara Stampalija, Therese Dowswell
BACKGROUND: Abnormal blood flow patterns in fetal circulation detected by Doppler ultrasound may indicate poor fetal prognosis. It is also possible that false positive Doppler ultrasound findings could lead to adverse outcomes from unnecessary interventions, including preterm delivery. OBJECTIVES: The objective of this review was to assess the effects of Doppler ultrasound used to assess fetal well-being in high-risk pregnancies on obstetric care and fetal outcomes...
June 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28608597/perineal-techniques-during-the-second-stage-of-labour-for-reducing-perineal-trauma
#4
REVIEW
Vigdis Aasheim, Anne Britt Vika Nilsen, Liv Merete Reinar, Mirjam Lukasse
BACKGROUND: Most vaginal births are associated with trauma to the genital tract. The morbidity associated with perineal trauma can be significant, especially when it comes to third- and fourth-degree tears. Different interventions including perineal massage, warm or cold compresses, and perineal management techniques have been used to prevent trauma. This is an update of a Cochrane review that was first published in 2011. OBJECTIVES: To assess the effect of perineal techniques during the second stage of labour on the incidence and morbidity associated with perineal trauma...
June 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28600035/predictors-of-perinatal-outcomes-and-economic-costs-for-late-term-induction-of-labour
#5
Daniel Oros, Raquel Garcia-Simon, Jesús Clemente, Ernesto Fabre, Manuel Angel Romero, Antonio Montañes
OBJECTIVE: We aimed to predict the perinatal outcomes and costs of health services following labour induction for late-term pregnancies. MATERIALS AND METHODS: We conducted a cohort study of 245 women who underwent labour induction during their 41st week of gestation. The cervical condition was assessed upon admission using the Bishop score and ultrasound cervical length measurements. We estimated the direct costs of labour induction, and a predictive model for perinatal outcomes was constructed using the decision tree analysis algorithm and a logit model...
June 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28599068/methods-of-term-labour-induction-for-women-with-a-previous-caesarean-section
#6
REVIEW
Helen M West, Marta Jozwiak, Jodie M Dodd
BACKGROUND: Women with a prior caesarean delivery have an increased risk of uterine rupture and for women subsequently requiring induction of labour it is unclear which method is preferable to avoid adverse outcomes. This is an update of a review that was published in 2013. OBJECTIVES: To assess the benefits and harms associated with different methods used to induce labour in women who have had a previous caesarean birth. SEARCH METHODS: We searched Cochrane Pregnancy and Childbirth's Trials Register (31 August 2016) and reference lists of retrieved studies...
June 9, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28592237/labour-management-guidelines-for-a-tanzanian-referral-hospital-the-participatory-development-process-and-birth-attendants-perceptions
#7
Nanna Maaløe, Natasha Housseine, Jos van Roosmalen, Ib Christian Bygbjerg, Britt Pinkowski Tersbøl, Rashid Saleh Khamis, Birgitte Bruun Nielsen, Tarek Meguid
BACKGROUND: While international guidelines for intrapartum care appear to have increased rapidly since 2000, literature suggests that it has only in few instances been matched with reviews of local modifications, use, and impact at the targeted low resource facilities. At a Tanzanian referral hospital, this paper describes the development process of locally achievable, partograph-associated, and peer-reviewed labour management guidelines, and it presents an assessment of professional birth attendants' perceptions...
June 7, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28571213/the-effect-of-metoclopramide-addition-to-lidocaine-on-pain-of-patients-with-grades-ii-and-iii-post-episiotomy-repair
#8
Sheida Shabanian, Sara Kalbasi, Gholamreza Shabanian, Bahram Khoram, Forozan Ganji
INTRODUCTION: Episiotomy is the most common procedure used for dilatation of the vaginal opening for giving birth. Although episiotomy is associated with benefits for the mother, it may lead to short term and long term disabilities, including postpartum perineal pain that is secondary to perineal tearing. AIM: The aim of this study was to investigate the effect of subcutaneous lidocaine compared with lidocaine and metoclopramide on pain after episiotomy. MATERIALS AND METHODS: In this clinical trial study, the patients (83 for control group and 83 for case group) with episiotomy Grades II and III were enrolled and were asked to express their postpartum episiotomy pain as a number, from zero (no pain) to 10 (severest pain) Visual Analogue Scale (VAS score) at 0, 30 minute, 1 hour, 2 hour, 4 hour, 6 hour and 12 hour postpartum...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28539008/position-in-the-second-stage-of-labour-for-women-without-epidural-anaesthesia
#9
REVIEW
Janesh K Gupta, Akanksha Sood, G Justus Hofmeyr, Joshua P Vogel
BACKGROUND: For centuries, there has been controversy around whether being upright (sitting, birthing stools, chairs, squatting, kneeling) or lying down (lateral (Sim's) position, semi-recumbent, lithotomy position, Trendelenburg's position) have advantages for women giving birth to their babies. This is an update of a review previously published in 2012, 2004 and 1999. OBJECTIVES: To determine the possible benefits and risks of the use of different birth positions during the second stage of labour without epidural anaesthesia, on maternal, fetal, neonatal and caregiver outcomes...
May 25, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28528578/a-cluster-randomized-trial-to-reduce-caesarean-delivery-rates-in-quebec-cost-effectiveness-analysis
#10
Mira Johri, Edmond S W Ng, Clara Bermudez-Tamayo, Jeffrey S Hoch, Thierry Ducruet, Nils Chaillet
BACKGROUND: Widespread increases in caesarean section (CS) rates have sparked concerns about risks to mothers and infants and rising healthcare costs. A multicentre, two-arm, cluster-randomized trial in Quebec, Canada assessed whether an audit and feedback intervention targeting health professionals would reduce CS rates for pregnant women compared to usual care, and concluded that it reduced CS rates without adverse effects on maternal or neonatal health. The effect was statistically significant but clinically small...
May 22, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28515516/changes-in-cardiac-index-during-labour-analgesia-a-double-blind-randomised-controlled-trial-of-epidural-versus-combined-spinal-epidural-analgesia-a-preliminary-study
#11
Stephanie Yacoubian, Corrina M Oxford, Bhavani Shankar Kodali
BACKGROUND AND AIMS: Combined spinal-epidural (CSE) analgesia for labour and delivery is occasionally associated with foetal bradycardia. Decreases in cardiac index (CI) and/or uterine hypertonia are implicated as possible aetiological factors. No study has evaluated CI changes following combined spinal analgesia for labour and delivery. This prospective, double-blind, randomised controlled trial evaluates haemodynamic trends during CSE and epidural analgesia for labour. METHODS: Twenty-six parturients at term requesting labour analgesia were randomised to receive either epidural (E) or CSE analgesia...
April 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28511452/the-effect-of-entonox-on-labour-pain-relief-among-nulliparous-women-a-randomized-controlled-trial
#12
Parisa Parsa, Nafiseh Saeedzadeh, Ghodratallah Roshanaei, Fatameh Shobeiri, Faryar Hakemzadeh
INTRODUCTION: Labour pain is one of the most severe pain in humans. Fear of labour pain is the most dreadful reason for Caesarean Section (CS). Entonox (a mixture of nitrous oxide+oxygen) is a safe inhalational analgesia during labour pain. AIM: This study investigated the effect of entonox on pain relief and length of labour in nulliparous women. MATERIALS AND METHODS: A clinical trial study was conducted among 120 nulliparous women (60 in intervention and 60 in control group) in 2015 in Atieh Hospital, Hamadan city, Iran...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28486938/barriers-and-facilitators-related-to-the-uptake-of-four-strategies-to-prevent-neonatal-early-onset-group-b-haemolytic-streptococcus-disease-a-qualitative-study
#13
Diny G E Kolkman, Margot A H Fleuren, Maurice G A J Wouters, Christianne J M de Groot, Marlies E B Rijnders
BACKGROUND: Actions to prevent early onset disease in neonates are based on different strategies including administering antibiotic prophylaxis during labour in case of 1) maternal GBS colonisation (screening strategy), 2) identified risk factors (risk-based strategy) or 3) a combination of these two conditions (maternal GBS colonisation and identified risk factors: combination strategy and the Dutch guideline). Low adherence to guidelines preventing EOGBS has been reported. Each strategy has drawbacks and clinical outcomes are affected by care providers' and women's adherence...
May 9, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28472859/lifestyle-interventions-for-the-treatment-of-women-with-gestational-diabetes
#14
REVIEW
Julie Brown, Nisreen A Alwan, Jane West, Stephen Brown, Christopher Jd McKinlay, Diane Farrar, Caroline A Crowther
BACKGROUND: Gestational diabetes (GDM) is glucose intolerance, first recognised in pregnancy and usually resolving after birth. GDM is associated with both short- and long-term adverse effects for the mother and her infant. Lifestyle interventions are the primary therapeutic strategy for many women with GDM. OBJECTIVES: To evaluate the effects of combined lifestyle interventions with or without pharmacotherapy in treating women with gestational diabetes. SEARCH METHODS: We searched the Pregnancy and Childbirth Group's Trials Register (14 May 2016), ClinicalTrials...
May 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28464006/antenatal-small-class-education-versus-auditorium-based-lectures-to-promote-positive-transitioning-to-parenthood-a-randomised-trial
#15
Vibeke Koushede, Carina Sjöberg Brixval, Lau Caspar Thygesen, Solveig Forberg Axelsen, Per Winkel, Jane Lindschou, Christian Gluud, Pernille Due
Prospective parents widely use education to gain information about, e.g., labour and parenting skills. It is unknown if antenatal education in small classes is more beneficial for parenting stress and parenting alliance compared with other types of antenatal education. In the present randomised trial, we examined the effect of antenatal education in small classes versus auditorium-based lectures on perceived stress, parenting stress, and parenting alliance. A total of 1,766 pregnant women were randomised to receive: antenatal education in small classes three times in pregnancy and one time after delivery, each session lasted 2...
2017: PloS One
https://www.readbyqxmd.com/read/28458123/the-motivation-and-capacity-to-go-above-and-beyond-qualitative-analysis-of-free-text-survey-responses-in-the-m-ngo-randomised-controlled-trial-of-caseload-midwifery
#16
Jyai Allen, Sue Kildea, Donna L Hartz, Mark Tracy, Sally Tracy
OBJECTIVE: to explore whether women allocated to caseload care characterise their midwife differently to those allocated to standard care. DESIGN: multi-site unblinded, randomised, controlled, parallel-group trial. SETTING: the study was conducted in two metropolitan teaching hospitals across two Australian cities. POPULATION: women of all obstetric risk were eligible to participate. Inclusion criteria were: 18 years or older, less than 24 week's gestation with a singleton pregnancy...
March 29, 2017: Midwifery
https://www.readbyqxmd.com/read/28440898/comparing-induction-of-labour-with-oral-misoprostol-or-foley-catheter-at-term-cost-effectiveness-analysis-of-a-randomised-controlled-multi-centre-non-inferiority-trial
#17
Mieke L G Ten Eikelder, Gert-Jan van Baaren, Katrien Oude Rengerink, Marta Jozwiak, Jan Willem de Leeuw, Gunilla Kleiverda, Inge Evers, Karin de Boer, Josien Brons, Kitty W M Bloemenkamp, Ben W Mol
OBJECTIVE: To assess the costs of labour induction with oral misoprostol compared to Foley catheter. DESIGN: Economic evaluation alongside a randomised controlled trial. SETTING: Obstetric departments of six tertiary and 23 secondary care hospitals in the Netherlands. POPULATION: Women with a viable term singleton pregnancy in cephalic presentation, intact membranes, an unfavourable cervix (Bishop score <6) without a previous caesarean section, had been randomised for labour induction with oral misoprostol (n = 924) or Foley catheter (n = 921)...
April 25, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28426160/assessment-and-support-during-early-labour-for-improving-birth-outcomes
#18
REVIEW
Shinobu Kobayashi, Nobutsugu Hanada, Masayo Matsuzaki, Kenji Takehara, Erika Ota, Hatoko Sasaki, Chie Nagata, Rintaro Mori
BACKGROUND: The progress of labour in the early or latent phase is usually slow and may include painful uterine contractions. Women may feel distressed and lose their confidence during this phase. Support and assessment interventions have been assessed in two previous Cochrane Reviews. This review updates and replaces these two reviews, which have become out of date. OBJECTIVES: To investigate the effectiveness of assessment and support interventions for women during early labour...
April 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28416501/protocol-for-a-placebo-controlled-within-participants-crossover-trial-evaluating-the-efficacy-of-intranasal-oxytocin-to-improve-pain-and-function-among-women-with-chronic-pelvic-musculoskeletal-pain
#19
Joshua A Rash, Kirsti Toivonen, Magali Robert, Maryam Nasr-Esfahani, John F Jarrell, Tavis S Campbell
INTRODUCTION: This protocol presents the rationale and design for a trial evaluating the efficacy of intranasal oxytocin in improving pain and function among women with chronic pelvic musculoskeletal pain. Oxytocin is a neuropeptide traditionally recognised for involvement in labour, delivery and lactation. Novel evidence suggests that oxytocin decreases pain sensitivity in humans. While oxytocin administration has been reported to lower pain sensitivity among patients experiencing chronic back pain, headache, constipation and colon pain, no research has evaluated the association between intranasal oxytocin and chronic pelvic musculoskeletal pain...
April 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28414983/a-randomised-controlled-trial-in-comparing-maternal-and-neonatal-outcomes-between-hands-and-knees-delivery-position-and-supine-position-in-china
#20
Hongyu Zhang, Shurong Huang, Xiaolan Guo, Ningning Zhao, Yujing Lu, Min Chen, Yingxia Li, Junqin Wu, Lihua Huang, Fenglan Ma, Yuhong Yang, Xiaoli Zhang, Xiaoyu Zhou, Renfei Guo, Wenzhi Cai
BACKGROUND: the supine position is the most frequently offered for birth delivery in China and many other countries, but the hands-and-knees position is now gaining prominence with doctors in China. This study aims to examine the differences in maternal and neonatal outcomes among low-risk women who gave birth either in the hands-and-knees position or the supine position. METHODS: a randomised controlled trial was conducted in 11 hospitals in China from May to December in 2012...
March 31, 2017: Midwifery
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