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https://www.readbyqxmd.com/read/29785662/the-timing-and-circumstances-of-the-implementation-of-pediatric-palliative-care-in-hungarian-pediatric-oncology
#1
Judit Nyirő, Szilvia Zörgő, Földesi Enikő, Katalin Hegedűs, Péter Hauser
Despite the continuous improvement of pediatric palliative care, medical professionals still face various barriers regarding its implementation; our aim was to investigate this question in Hungarian pediatric oncology practice. Structured interviews were carried out in person with physicians from the Hungarian Pediatric Oncology Group (n = 22). Codes were generated inductively with the aid of Atlas.ti 6.0 software. Most physicians placed the palliative care discussion at the end of curative treatment (n = 21) and preferred to conduct it in a team setting (n = 18), mainly in the presence of a psychologist...
May 21, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29784698/aspects-of-multicomponent-integrated-care-promote-sustained-improvement-in-surrogate-clinical-outcomes-a-systematic-review-and-meta-analysis
#2
REVIEW
Lee Ling Lim, Eric S H Lau, Alice P S Kong, Melanie J Davies, Naomi S Levitt, Björn Eliasson, Carlos A Aguilar-Salinas, Guang Ning, Yutaka Seino, Wing Yee So, Margaret McGill, Graham D Ogle, Trevor J Orchard, Philip Clarke, Rury R Holman, Edward W Gregg, Juan José Gagliardino, Juliana C N Chan
OBJECTIVE: The implementation of the Chronic Care Model (CCM) improves health care quality. We examined the sustained effectiveness of multicomponent integrated care in type 2 diabetes. RESEARCH DESIGN AND METHODS: We searched PubMed and Ovid MEDLINE (January 2000-August 2016) and identified randomized controlled trials comprising two or more quality improvement strategies from two or more domains (health system, health care providers, or patients) lasting ≥12 months with one or more clinical outcomes...
June 2018: Diabetes Care
https://www.readbyqxmd.com/read/29784540/recommendations-for-the-use-of-electroencephalography-and-evoked-potentials-in-comatose-patients
#3
REVIEW
Nathalie André-Obadia, Julie Zyss, Martine Gavaret, Jean-Pascal Lefaucheur, Eric Azabou, Sébastien Boulogne, Jean-Michel Guérit, Aileen McGonigal, Philippe Merle, Véronique Mutschler, Lionel Naccache, Cécile Sabourdy, Agnès Trébuchon, Louise Tyvaert, Laurent Vercueil, Benjamin Rohaut, Arnaud Delval
Predicting the outcome of a comatose or poorly responsive patient is a major issue for intensive care unit teams, in order to give the most accurate information to the family and to choose the best therapeutic option. However, determining the level of cortical activity in patients with disorders of consciousness is a real challenge. Reliable criteria are required to help clinicians in the decision-making process, especially in the acute phase of coma. In this paper, we propose recommendations for recording and interpreting electroencephalography and evoked potentials in comatose patients based on the literature and the clinical experience of a group of neurophysiologists trained in the management of comatose patients...
May 18, 2018: Neurophysiologie Clinique, Clinical Neurophysiology
https://www.readbyqxmd.com/read/29784519/east-african-perceptions-of-barriers-facilitators-for-pediatric-clinical-research-participation-and-development-of-the-inclusive-research-model
#4
M Rebecca O'Connor, Ali Adem, Helene Starks
PURPOSE: This study sought to gain a greater understanding of perceptions related to barriers/facilitators for pediatric (ages 0-17) clinical research participation among East African immigrant community members. DESIGN AND METHODS: Community leader interviews (n = 6) and focus groups with lay members (n = 16) from the three largest East African communities in the Seattle area (Eritrean, Ethiopian and Somali) were conducted. Discussions were semi-structured based on existing barrier/facilitator research and analyzed using directed content analysis to identify major themes...
May 18, 2018: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/29784265/don-t-ignore-my-snore-reducing-perioperative-complications-of-obstructive-sleep-apnea
#5
Ludy P Lemus, Betty McMullin, Honorata Balinowski
PURPOSE: Obstructive sleep apnea (OSA), a condition associated with decreased muscle tone in the airway, has been linked to postoperative complications. The purpose of the initiative was to develop and implement a guideline for patients identified as high-risk for OSA to reduce complications related to OSA. DESIGN: A multidisciplinary team developed the guideline utilizing the Iowa Model of Evidence-Based Practice to Promote Quality Care. METHODS: PubMed literature search from 2006-2013 and critique of over 40 articles were completed...
June 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29784263/tertiary-care-referrals-for-fractures-in-children
#6
Jennifer K Marsh, David J Murray, Anshuman Sharma, Kavya Narayana Reddy, Alyssa Naes
PURPOSE: With limited local access to pediatric subspecialty care outside major metropolitan areas, tertiary care hospitals treat many children originally seen at outside facilities for relatively brief but urgent surgical procedures. This referral-based care imposes significant financial and psychological stress on the families. DESIGN: Prospective, survey methodology was used. METHODS: Families of children aged 0-18 years admitted to the St...
June 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29784225/nursing-diagnoses-of-the-homeless-population-in-light-of-self-care-theory
#7
Felicialle Pereira da Silva, Francisco de Assis Siqueira Paiva, Carolina Pereira Guedes, Iracema da Silva Frazão, Selene Cordeiro Vasconcelos, Murilo Duarte da Costa Lima
BACKGROUND: A growing number of people find themselves in conditions of extreme poverty, which often makes living on the streets the only option. Living conditions in this setting exert a direct impact on health and self-care. Health care for the homeless population should be planned in an interdisciplinary and intersectoral manner. In this context, nursing diagnoses constitute an essential part of the systemization of care. OBJECTIVES: The aims of the present study were to identify nursing diagnoses of a homeless population and propose nursing interventions based on the findings in light of the Nursing Outcomes Classification and Nursing Interventions Classification...
June 2018: Archives of Psychiatric Nursing
https://www.readbyqxmd.com/read/29783270/reducing-alarm-fatigue-in-two-neonatal-intensive-care-units-through-a-quality-improvement-collaboration
#8
Kendall R Johnson, James I Hagadorn, David W Sink
OBJECTIVE:  To reduce nonactionable oximeter alarms by 80% without increasing time infants were hypoxemic (oxygen saturation [SpO2 ] ≤ 80%) or hyperoxemic (SpO2  > 95% while on supplemental oxygen). STUDY DESIGN:  In 2015, a multidisciplinary team at Connecticut Children's Medical Center initiated a quality improvement project to reduce nonactionable oximeter alarms in two referral neonatal intensive care units (NICUs). Changes made through improvement cycles included reduction of the low oximeter alarm limit for specific populations, increased low alarm delay, development of postmenstrual age-based alarm profiles, and updated bedside visual reminders...
May 21, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29783091/mind-at-home-streamlined-study-protocol-for-a-randomized-trial-of-home-based-care-coordination-for-persons-with-dementia-and-their-caregivers
#9
Quincy M Samus, Betty Smith Black, Melissa Reuland, Jeannie-Marie S Leoutsakos, Laura Pizzi, Kevin D Frick, David L Roth, Laura N Gitlin, Constantine G Lyketsos, Deirdre Johnston
BACKGROUND: Dementia is associated with high health care costs, premature long-term care (LTC) placement, medical complications, reduced quality of life, and caregiver burden. Most health care providers and systems are not yet organized or equipped to provide comprehensive long-term care management for dementia, although a range of effective symptoms and supportive care approaches exist. The Maximizing Independence at Home-Streamlined (MIND-S) is a promising model of home-based dementia care coordination designed to efficiently improve person-centered outcomes, while reducing care costs...
May 18, 2018: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29782601/patient-centered-medical-home-status-and-preparedness-to-assess-resident-milestones-a-cera-study
#10
Thad Wilkins, Wonsuk Yoo, Ralph A Gillies, Julie Dahl-Smith, Jacqueline Dubose, Joseph Hobbs, Selina Smith, Dean A Seehusen
Purpose: The patient-centered medical home (PCMH) model has been proposed as the ideal model for delivering primary care and is focused on improving patient safety and quality, reducing costs, and enhancing patient satisfaction. The mandated Accreditation Council for Graduate Medical Education educational milestones for evaluation of resident competency represent the skills graduates will utilize after graduation. Many of these skills are reflected in the PCMH model. We sought to determine if residency programs whose main family medicine (FM) practice sites have achieved PCMH recognition are therefore more prepared to evaluate milestones...
May 2018: PRiMER: peer-review reports in medical education research
https://www.readbyqxmd.com/read/29782212/national-impact-of-the-epec-pediatrics-enhanced-train-the-trainer-model-for-delivering-education-on-pediatric-palliative-care
#11
Kimberley Widger, Joanne Wolfe, Stefan Friedrichsdorf, Jason D Pole, Sarah Brennenstuhl, Stephen Liben, Mark Greenberg, Eric Bouffet, Harold Siden, Amna Husain, James A Whitlock, Myra Leyden, Adam Rapoport
BACKGROUND: Lack of pediatric palliative care (PPC) training impedes successful integration of PPC principles into pediatric oncology. OBJECTIVES: We examined the impact of an enhanced implementation of the Education in Palliative and End-of-Life Care for Pediatrics (EPEC® -Pediatrics) curriculum on the following: (1) knowledge dissemination; (2) health professionals' knowledge; (3) practice change; and (4) quality of PPC. DESIGN: An integrated knowledge translation approach was used with pre-/posttest evaluation of care quality...
May 21, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29781978/mixed-methods-evaluation-of-real-time-safety-reporting-by-hospitalized-patients-and-their-care-partners-the-mysafecare-application
#12
Sarah A Collins, Brittany Couture, Ann DeBord Smith, Esteban Gershanik, Elizabeth Lilley, Frank Chang, Cathy Yoon, Stuart Lipsitz, Aziz Sheikh, James Benneyan, David W Bates
OBJECTIVE: The aims of the study were to evaluate the amount and content of data patients and care partners reported using a real-time electronic safety tool compared with other reporting mechanisms and to understand their perspectives on safety concerns and reporting in the hospital. METHODS: This study used mixed methods including 20-month preimplementation and postimplementation trial evaluating MySafeCare, a web-based application, which allows hospitalized patients/care partners to report safety concerns in real time...
April 27, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/29781923/going-beyond-clinical-care-to-reduce-health-care-spending-findings-from-the-j-chip-community-based-population-health-management-program-evaluation
#13
Shannon M E Murphy, Douglas E Hough, Martha L Sylvia, Melissa Sherry, Linda J Dunbar, Raymond Zollinger, Regina Richardson, Scott A Berkowitz, Kevin D Frick
BACKGROUND: Addressing both clinical and nonclinical determinants of health is essential for improving population health outcomes. In 2012, the Johns Hopkins Community Health Partnership (J-CHiP) implemented innovative population health management programs across acute and community environments. The community-based program involved multidisciplinary teams [ie, physicians, care managers (CM), health behavior specialists (HBS), community health workers, neighborhood navigators] and collaboration with community-based organizations to address social determinants...
May 17, 2018: Medical Care
https://www.readbyqxmd.com/read/29781915/childhood-asthma-disparities-in-chicago-developing-approaches-to-health-inequities
#14
Molly A Martin, Melissa Gutierrez Kapheim, Kim Erwin, Stacy Ignoffo, Kate McMahon, Amy OʼRourke, Lynn B Gerald, Meredith Barrett, Valerie G Press, Houshang Darabi, Jerry A Krishnan
We conducted a needs assessment to develop an evidence-based, locally tailored asthma care implementation plan for high-risk children with asthma in Chicago. Our team of health policy experts, clinicians, researchers, and designers included extensive stakeholder engagement (N = 162) in a mixed-methods community needs assessment. Results showed the lines of communication and collaboration across sectors were weak; caregivers were the only consistent force and could not always manage this burden. A series of recommendations for interventions and how to implement and measure them were generated...
July 2018: Family & Community Health
https://www.readbyqxmd.com/read/29781780/physical-therapists-know-function-an-opinion-on-mobility-and-level-of-activity-during-hospitalization-for-adult-inpatients
#15
Audrey M Johnson, Janice Kuperstein, Dana Howell, Esther E Dupont-Versteegden
Negative consequences of immobility during hospitalization are widely known and remain undisputed. Evidence of low mobility for general medicine adult inpatients persists. Patients who experience hospital acquired functional decline due to low mobility require costly post-acute care services. The impact of immobility on post-acute care physical function and quality of life is directly at odds with value-based care. New Medicare payment models emphasize value-based care to promote care improvement and better patient outcomes...
May 21, 2018: Hospital Topics
https://www.readbyqxmd.com/read/29781699/conceptualisation-of-african-primal-health-care-within-mental-health-care
#16
Neo E Nare, Abel J Pienaar, Ditaba D Mphuthi
BACKGROUND:  It is believed by western education systems that the first contact should be with the nurse in primary health care. However, it is not the case. Therefore, the researcher attempts to correct this misconception by conceptualising the correct beginning of health seeking behaviour in an indigenous African community, namely African Primal Health Care (APHC). 'Primal' was coined during a colloquium by Dr Mbulawa and Seboka team members; however no formal conceptualisation took place, only operational definition...
March 22, 2018: Curationis
https://www.readbyqxmd.com/read/29780963/the-cochlear-implant-and-possibilities-for-narrowing-the-remaining-gaps-between-prosthetic-and-normal-hearing
#17
Blake S Wilson
Background: The cochlear implant has become the standard of care for severe or worse losses in hearing and indeed has produced the first substantial restoration of a lost or absent human sense using a medical intervention. However, the devices are not perfect and many efforts to narrow the remaining gaps between prosthetic and normal hearing are underway. Objective: To assess the present status of cochlear implants and to describe possibilities for improving them...
December 2017: World Journal of Otorhinolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29779623/educating-emergency-department-staff-on-the-identification-and-treatment-of-human-trafficking-victims
#18
Steven Donahue, Michael Schwien, Danielle LaVallee
INTRODUCTION: Hospitalization is one of the few circumstances in which the lives of trafficking victims intersect with the general population. Based on survivor testimonies, the majority of human trafficking victims may receive medical treatment in a hospital's emergency department while in captivity. With evidenced-based training, ED personnel have a better opportunity to screen persons who are being trafficked and intervene on their behalf. METHODS: This project examined the efficacy of an innovative, evidence-based online training module (HTEmergency...
May 17, 2018: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/29779553/social-work-student-and-practitioner-roles-in-integrated-care-settings
#19
Erin P Fraher, Erica Lynn Richman, Lisa de Saxe Zerden, Brianna Lombardi
INTRODUCTION: Social workers are increasingly being deployed in integrated medical and behavioral healthcare settings but information about the roles they fill in these settings is not well understood. This study sought to identify the functions that social workers perform in integrated settings and identify where they acquired the necessary skills to perform them. METHODS: Master of social work students (n=21) and their field supervisors (n=21) who were part of a Health Resources and Services Administration-funded program to train and expand the behavioral health workforce in integrated settings were asked how often they engaged in 28 functions, where they learned to perform those functions, and the degree to which their roles overlapped with others on the healthcare team...
June 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29778659/sepsis-3-septic-shock-criteria-and-associated-mortality-among-infected-hospitalized-patients-assessed-by-a-rapid-response-team
#20
Shannon M Fernando, Peter M Reardon, Bram Rochwerg, Nathan I Shapiro, Donald M Yealy, Andrew J E Seely, Jeffrey J Perry, Douglas P Barnaby, Kyle Murphy, Peter Tanuseputro, Kwadwo Kyeremanteng
BACKGROUND: Rapid Response Teams (RRTs) respond to deteriorating hospitalized patients, and help determine subsequent management, including Intensive Care Unit (ICU) admission. In such patients with sepsis and septic shock, the Sepsis-3 clinical criteria have a potential role in detection, risk-stratification, and prognostication, though their accuracy in comparison to the Systemic Inflammatory Response Syndrome (SIRS)-based septic shock criteria are unknown. We sought to evaluate prognostic accuracy of the Sepsis-3 criteria for in-hospital mortality among infected hospitalized patients with acute deterioration...
May 17, 2018: Chest
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