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https://www.readbyqxmd.com/read/29135348/development-of-a-surgical-infection-surveillance-program-at-a-tertiary-hospital-in-ethiopia-lessons-learned-from-two-surveillance-strategies
#1
Jared A Forrester, Luca Koritsanszky, Benjamin D Parsons, Menbere Hailu, Demisew Amenu, Seifu Alemu, Fekadu Jiru, Thomas G Weiser
BACKGROUND: Surgical site infections (SSIs) are a leading cause of post-operative morbidity and mortality. We developed Clean Cut, a surgical infection prevention program, with two goals: (1) Increase adherence to evidence-based peri-operative infection prevention standards and (2) establish sustainable surgical infection surveillance. Here we describe our infection surveillance strategy. PATIENTS AND METHODS: Clean Cut was piloted and evaluated at a 523 bed tertiary hospital in Ethiopia...
November 14, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29112512/causal-analysis-of-world-health-organization-s-surgical-safety-checklist-implementation-quality-and-impact-on-care-processes-and-patient-outcomes-secondary-analysis-from-a-large-stepped-wedge-cluster-randomized-controlled-trial-in-norway
#2
Arvid Steinar Haugen, Hilde Valen Wæhle, Stian Kreken Almeland, Stig Harthug, Nick Sevdalis, Geir Egil Eide, Monica Wammen Nortvedt, Ingrid Smith, Eirik Søfteland
OBJECTIVE: We hypothesize that high-quality implementation of the World Health Organization's Surgical Safety Checklist (SSC) will lead to improved care processes and subsequently reduction of peri- and postoperative complications. BACKGROUND: Implementation of the SSC was associated with robust reduction in morbidity and length of in-hospital stay in a stepped wedge cluster randomized controlled trial conducted in 2 Norwegian hospitals. Further investigation of precisely how the SSC improves care processes and subsequently patient outcomes is needed to understand the causal mechanisms of improvement...
November 6, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29080067/interventions-targeting-the-prescribing-and-monitoring-of-vancomycin-for-hospitalized-patients-a-systematic-review-protocol
#3
REVIEW
Cameron J Phillips, Alice J Wisdom, Ross A McKinnon, Richard J Woodman, David L Gordon
INTRODUCTION: Vancomycin remains one of our essential antibiotics after fifty years of treating serious infections such as methicillin-resistant Staphylococcus aureus. Vancomycin, unlike many other antibiotic agents, requires individualized dosing and monitoring of serum drug levels to ensure it is efficacious, to minimize toxicity, and to limit the development of antibiotic resistance. These issues have led to numerous vancomycin clinical practice guidelines being published in recent years including several key national guidelines...
October 27, 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/29066020/repeat-gram-negative-hospital-acquired-infections-and-antibiotic-susceptibility-a-systematic-review
#4
REVIEW
Mansi Agarwal, Stephanie Shiau, Elaine L Larson
Repeat HAIs among frequently hospitalized patients may be contributing to the high rates of antibiotic resistance seen in gram-negative bacteria (GNB) in hospital settings. This systematic review examines the state of the literature assessing the association between repeat GNB HAIs and changes in antibiotic susceptibility patterns. A systematic search of English language published literature was conducted to identify studies in peer-reviewed journals from 2000 to 2015. Studies must have assessed drug resistance in repeat GNB infections longitudinally at the patient level...
October 20, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/29058569/surgical-site-infections-after-appendectomy-performed-in-low-and-middle-human-development-index-countries-a-systematic-review
#5
Deshka Foster, Will Kethman, Lawrence Z Cai, Thomas G Weiser, Joseph D Forrester
BACKGROUND: Acute appendicitis is a common surgical emergency worldwide. Early intervention is associated with better outcomes. In low and middle Human Development-Index Countries (LMHDICs), late presentation and poor access to healthcare facilities can contribute to greater illness severity and higher complication rates, such as post-operative surgical site infections (SSIs). The current rate of SSIs post-appendectomy in low- and middle-index settings has yet to be described. METHODS: We performed a systemic review of the literature describing the incidence and management of SSIs after appendectomy in LMHDICs...
October 23, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29056853/evaluation-of-risk-minimization-activities-for-cyproterone-acetate-2%C3%A2-mg-ethinylestradiol-35%C3%A2-%C3%A2%C2%B5g-a-cross-sectional-physician-survey
#6
Kimberly H Davis, Alex Asiimwe, Laurie J Zografos, David J McSorley, Elizabeth B Andrews
BACKGROUND: Cyproterone acetate 2 mg/ethinylestradiol 35 µg, an estrogen/progestogen treatment with anti-androgenic properties, shares a thromboembolism risk with combined hormonal contraceptives. Educational materials (i.e., direct healthcare professional communication, patient information card, prescriber checklist) were distributed to physicians to increase risk awareness. OBJECTIVE: The objective of this study was to measure physician knowledge of thromboembolism risk of cyproterone acetate 2 mg/ethinylestradiol 35 µg and ascertain whether physicians received the educational materials...
2017: Pharmaceutical Medicine
https://www.readbyqxmd.com/read/29038828/using-the-who-surgical-safety-checklist-to-direct-perioperative-quality-improvement-at-a-surgical-hospital-in-cambodia-the-importance-of-objective-confirmation-of-process-completion
#7
Naomi Y Garland, Sokhavatey Kheng, Michael De Leon, Hourt Eap, Jared A Forrester, Janice Hay, Palritha Oum, Socheat Sam Ath, Simon Stock, Samprathna Yem, Gerlinda Lucas, Thomas G Weiser
BACKGROUND: The WHO surgical safety checklist (SSC) is known to prevent postoperative complications; however, strategies for effective implementation are unclear. In addition to cultural and organizational barriers faced by high-income countries, resource-constrained settings face scarcity of durable and consumable goods. We used the SSC to better understand barriers to improvement at a trauma hospital in Battambang, Cambodia. METHODS: We introduced the SSC and trained data collectors to observe surgical staff performing the checklist...
October 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28981722/the-economic-evaluation-of-an-antibiotic-checklist-as-antimicrobial-stewardship-intervention
#8
Frederike V van Daalen, Brent C Opmeer, Jan M Prins, Suzanne E Geerlings, Marlies E J L Hulscher
Objectives: An antibiotic checklist was introduced in nine Dutch hospitals to improve appropriate antibiotic use. We estimated the cost-effectiveness of checklist use. Methods: We compared 853 patients treated with an antibiotic before checklist introduction (usual care group) with 1207 patients treated after introduction (checklist group). We calculated the change of costs between these groups per unit effect [incremental cost-effectiveness ratio (ICER)]: per extra patient receiving appropriate treatment; and per day reduction in length of hospital stay (LOS)...
November 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28959778/improving-the-care-of-patients-with-cystic-fibrosis-cf
#9
Ahsan Aftab Khan, Edward F Nash, Joanna Whitehouse, Rifat Rashid
BACKGROUND: The West Midlands Adult Cystic Fibrosis (CF) Centre based at Birmingham Heartlands Hospital provides care for adults with CF in the West Midlands. People with CF are prone to pulmonary exacerbations, which often require inpatient admission for intravenous antibiotics. We observed that the admission process was efficient during working hours (9:00-17:00, Monday-Friday) when the CF team are routinely available, but out-of-working hours, there were delays in these patients being clerked and receiving their first antibiotic dose...
2017: BMJ Open Qual
https://www.readbyqxmd.com/read/28932266/risk-factors-for-surgical-site-infections-in-obstetrics-a-retrospective-study-in-an-ethiopian-referral-hospital
#10
Teshager Mamo, Tilaye Workneh Abebe, Tesfaye Yitna Chichiabellu, Antehun Alemayehu Anjulo
BACKGROUND: Pregnant women are at risk of infection during labor and delivery. Infection in obstetrics accounts for the second most common cause of maternal mortality next to post partum hemorrhage. Knowing the prevalence and associated risk factors would help to undertake optimal precautions and standard surgical techniques to reduce surgical site infection which poses increased hospital cost and total hospital stay of the patients. METHOD: Facility based retrospective observational study design was carried out purposively to assess the prevalence of surgical site infections and associated risk factors among mothers who had delivery related surgery at obstetric ward of Assela teaching referral hospital from April, 23, 2015 to September 5, 2015...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28925508/the-cost-effectiveness-of-oral-health-interventions-a-systematic-review-of-cost-utility-analyses
#11
Ruvini M Hettiarachchi, Sanjeewa Kularatna, Martin J Downes, Joshua Byrnes, Jeroen Kroon, Ratilal Lalloo, Newell W Johnson, Paul A Scuffham
OBJECTIVES: To assess the usage of cost-utility analysis (CUA) in oral health interventions and to evaluate the methods used and the reporting quality of CUA in publications on oral health interventions. METHODS: A systematic review was performed on literature published between 2000 and 2016 where cost-utility analyses of oral health interventions were included. The reporting quality of these oral health CUAs was assessed against the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist...
September 19, 2017: Community Dentistry and Oral Epidemiology
https://www.readbyqxmd.com/read/28921938/prostate-cancer-treatment-in-renal-transplant-recipients-a-systematic-review
#12
REVIEW
Giancarlo Marra, Ettore Dalmasso, Marco Angello, Stefania Munegato, Andrea Bosio, Omidreza Sedigh, Luigi Biancone, Paolo Gontero
BACKGROUND: The majority of kidney transplants are performed in recipients (RTR) over 50; simultaneously their life expectancy is improving. The increasing age and number of RTR is likely to be paralleled by an increase of prostate cancer (PCa) incidence. However, little is known on the optimal management of these patients who represent a therapeutic challenge due to medical and anatomical graft-related issues. METHODS: AMED, Medline and Embase were searched until November 17(th) , 2016 adhering to the PRISMA guidelines and the AMSTAR checklist to investigate oncological and functional outcomes of PCa treatment in RTR...
September 18, 2017: BJU International
https://www.readbyqxmd.com/read/28846138/eras-safety-checklists-antibiotics-and-vte-prophylaxis
#13
REVIEW
Susan D Moffatt-Bruce, Brian Hilligoss, Iahn Gonsenhauser
The concept rested on several components that many of us have now tried to adopt or improve on, inclusive of a multidisciplinary team, a multimodal approach to anesthesia and preoperative preparedness, evidence-based approach to care protocols; and a change in management using interactive and continuous audit prior to and post-procedure. This article describes the development of ERAS protocols relative to checklist implementation, antibiotic use, and venous thromboembolism (VTE) prevention, how these ideas are developed and operationalized as well as how they are evolving and spreading across the care continuum to achieve sustained outcome improvements...
October 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28780302/systematic-assessment-reveals-lack-of-understandability-for-prostate-biopsy-online-patient-education-materials
#14
Kimberly A Maciolek, David F Jarrard, E Jason Abel, Sara L Best
OBJECTIVE: To evaluate the accuracy, readability, understandability, and actionability of Internet patient education materials (PEM) about transrectal ultrasound-guided prostate biopsy. METHODS: A comprehensive Internet search was performed to find PEM with pre- or postbiopsy instructions. PEM that were duplicates, government affiliated, international, or video based were excluded. Biopsy instructions were evaluated for accuracy and presence of essential topics...
November 2017: Urology
https://www.readbyqxmd.com/read/28771478/patients-in-palliative-care-development-of-a-predictive-model-for-anxiety-using-routine-data
#15
Sonja Hofmann, Stephanie Hess, Carsten Klein, Gabriele Lindena, Lukas Radbruch, Christoph Ostgathe
INTRODUCTION: Anxiety is one of the most common psychological symptoms in patients in a palliative care situation. This study aims to develop a predictive model for anxiety using data from the standard documentation routine. METHODS: Data sets of palliative care patients collected by the German quality management benchmarking system called Hospice and Palliative Care Evaluation (HOPE) from 2007 to 2011 were randomly divided into a training set containing two-thirds of the data and a test set with the remaining one-third...
2017: PloS One
https://www.readbyqxmd.com/read/28741229/inhaled-antimicrobials-for-ventilator-associated-pneumonia-practical-aspects
#16
Garyphallia Poulakou, Dimitrios K Matthaiou, David P Nicolau, Georgios Siakallis, George Dimopoulos
Positive experience with inhaled antibiotics in pulmonary infections of patients with cystic fibrosis has paved the way for their utilization in mechanically ventilated, critically ill patients with lower respiratory tract infections. A successful antibiotic delivery depends upon the size of the generated particle and the elimination of drug impaction in the large airways and the ventilator circuit. Generated droplet size is mainly affected by the type of the nebulizer employed. Currently, jet, ultrasonic, and vibrating mesh nebulizers are marketed; the latter can deliver optimal antibiotic particle size...
July 24, 2017: Drugs
https://www.readbyqxmd.com/read/28663774/infection-prophylaxis-for-breast-implant-surgery-could-we-do-better
#17
Julia R Henderson, Sandhir Kandola, Susan P Hignett, Rebecca L Teasdale, Ashley R Topps, Mandana Pennick, Meiju Hwang, Nicola Barnes, Cliona C Kirwan
Objective: Infective complications following breast implant surgery may result in implant removal. This causes patient distress and is costly to treat. A range of precautions is undertaken at the time of surgery to reduce infection, with varying levels of supporting evidence. This study aimed to determine how frequently and consistently infection prevention precautions are used during breast implant surgery. Methods: Multicenter observational study of surgical practice with real-time data collection during breast implant surgery...
2017: Eplasty
https://www.readbyqxmd.com/read/28662709/interval-follow-up-of-a-4-day-pilot-program-to-implement-the-who-surgical-safety-checklist-at-a-congolese-hospital
#18
Michelle C White, Jennifer Peterschmidt, James Callahan, J Edward Fitzgerald, Kristin L Close
BACKGROUND: The World Health Organisation Surgical Safety Checklist (SSC) improves surgical outcomes and the research question is no longer 'does the SSC work?' but, 'how to make the SSC work?' Evidence for implementation strategies in low-income countries is sparse and existing strategies are heavily based on long-term external support. Short but effective implementation programs are required if widespread scale up is to be achieved. We designed and delivered a four-day pilot SSC training course at a single hospital centre in the Republic of Congo, and evaluated the implementation after one year...
June 29, 2017: Globalization and Health
https://www.readbyqxmd.com/read/28482011/narrative-feedback-from-or-personnel-about-the-safety-of-their-surgical-practice-before-and-after-a-surgical-safety-checklist-intervention
#19
Shehnaz Alidina, Hye-Chun Hur, William R Berry, George Molina, Guy Guenthner, Anna M Modest, Sara J Singer
Objective: To examine narrative feedback to understand surgical team perceptions about surgical safety checklists (SSCs) and their impact on the safety of surgical practice. Design: We reviewed free-text comments from surveys administered before and after SSC implementation between 2011 and 2013. We categorized feedback thematically and as positive, negative or neutral. Setting: South Carolina hospitals participating in a statewide collaborative on checklist implementation...
August 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28470579/does-probiotic-supplementation-affect-pulmonary-exacerbation-and-intestinal-inflammation-in-cystic-fibrosis-a-systematic-review-of-randomized-clinical-trials
#20
REVIEW
Zeinab Nikniaz, Leila Nikniaz, Nemat Bilan, Mohammad Hossein Somi, Elnaz Faramarzi
BACKGROUND: Patients with cystic fibrosis (CF) usually have abnormal intestinal microbiota due to massive exposure to antibiotics. Probiotics could modify the gut microbiota and hence may affect CF management. So the aim of present systematic review was evaluation of the efficacy and safety of probiotic supplementation for the management of cystic fibrosis. DATA SOURCES: We searched PubMed, Science Direct, Google Scholar, Springer Cochrane Library Databases until January 2016 for randomized controlled trials (RCTs) performed in pediatric or adult populations related to the study aim...
August 2017: World Journal of Pediatrics: WJP
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