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Critical access hospitals

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https://read.qxmd.com/read/30760326/achieving-ethnic-equality-in-the-israel-trauma-healthcare-system-the-case-of-the-elderly-population
#1
Nura Abdel-Rahman, Nechemia Yoffe, Maya Siman-Tov, Irina Radomislensky, Kobi Peleg
OBJECTIVE: To determine if ethnic disparities exist with regard to the risk of injury and injury outcomes among elderly hospitalized casualties in Israel. METHODS: A retrospective study based on data from the Israeli National Trauma Registry between 2008 and 2017. Data included demographic, injury and hospitalization characteristics. Descriptive statistics and adjusted logistic regression were used to examine the differences between Jewish and Arab casualties, aged 65 and older...
February 13, 2019: Israel Journal of Health Policy Research
https://read.qxmd.com/read/30759492/physician-perceptions-of-the-electronic-problem-list-in-pediatric-trauma-care
#2
Bat-Zion Hose, Peter L T Hoonakker, Abigail R Wooldridge, Thomas B Brazelton Iii, Shannon M Dean, Ben Eithun, James C Fackler, Ayse P Gurses, Michelle M Kelly, Jonathan E Kohler, Nicolette M McGeorge, Joshua C Ross, Deborah A Rusy, Pascale Carayon
OBJECTIVE:  To describe physician perceptions of the potential goals, characteristics, and content of the electronic problem list (PL) in pediatric trauma. METHODS:  We conducted 12 semistructured interviews with physicians involved in the pediatric trauma care process, including residents, fellows, and attendings from four services: emergency medicine, surgery, anesthesia, and pediatric critical care. Using qualitative content analysis, we identified PL goals, characteristics, and patient-related information from these interviews and the hospital's PL etiquette document of guideline...
January 2019: Applied Clinical Informatics
https://read.qxmd.com/read/30741611/burden-of-large-vessel-occlusion-stroke-and-the-service-gap-of-thrombectomy-a-population-based-study-using-a-territory-wide-public-hospital-system-registry
#3
Anderson C O Tsang, Jia You, Lai Fung Li, Frederick C P Tsang, Pauline P S Woo, Eva L H Tsui, Philip Yu, Gilberto K K Leung
BACKGROUND: Ischemic stroke due to large vessel occlusion can be effectively treated with thrombectomy but access to this treatment is limited in many parts of the world. Local incidence of large vessel occlusion is critical in determining the development of thrombectomy service, but reliable data from Asian countries are lacking. AIMS: We performed a population-based study to estimate the burden of large vessel occlusion and the service gap for thrombectomy in Hong Kong...
February 11, 2019: International Journal of Stroke: Official Journal of the International Stroke Society
https://read.qxmd.com/read/30741244/ehr-usage-problems-a-preliminary-study
#4
Clément Wawrzyniak, Romaric Marcilly, Nicolas Baclet, Arnaud Hansske, Sylvia Pelayo
Electronic health record (EHR) systems were initially developed to improve health care delivery by facilitating the healthcare professionals' access to electronically-stored patient information, but problems are regularly reported in the literature. We present here a preliminary study conducted at a 950-bed university hospital. They have implemented an EHR in 2012 to remove their paper-based system. After few years, physicians complain that the EHR is "too complex", "too slow", "unsatisfying", and "which interacts with too many health software"...
2019: Studies in Health Technology and Informatics
https://read.qxmd.com/read/30740796/caregivers-and-community-perceptions-of-blood-transfusion-for-children-with-severe-anaemia-in-uganda
#5
A Dhabangi, R Idro, C C John, W H Dzik, R Opoka, G E Siu, F Ayebare, M B van Hensbroek
OBJECTIVE: To describe local perceptions of blood transfusion for children with severe anaemia in Uganda. BACKGROUND: Blood transfusion is a common emergency treatment for children with severe anaemia and saves millions of lives of African children. However, the perceptions of transfusion recipients have not been well studied. A better understanding of the perceived risk may improve transfusion care. METHODS: A qualitative study based on 16 in-depth interviews of caregivers of transfused children, and six focus group discussions with community members was conducted in three regions of Uganda between October and November 2017...
February 10, 2019: Transfusion Medicine
https://read.qxmd.com/read/30739245/utilisation-of-critical-care-services-for-surgical-patients-in-a-model-three-hospital
#6
Amy Lee Fowler, Orla Cullivan, Shomik Sibartie, Aidan O'Shea, Ronan Waldron, Iqbal Khan, Waqar Khan, Kevin M Barry
BACKGROUND: The demand for intensive care unit (ICU) beds in the surgical population has increased in recent years. This is due to increased complexity of operative interventions, development of critical care services and improved availability of technologies. The number of beds in ICUs nationwide remains limited. In model three hospitals, this is further impacted by a lack of high dependency unit (HDU) facilities and difficulty with transfer of patients to tertiary centres. AIM: To assess utilisation of ICU resources amongst general surgical patients admitted for elective and emergency procedures to Mayo University Hospital...
February 9, 2019: Irish Journal of Medical Science
https://read.qxmd.com/read/30735100/telehealth-decreases-rural-emergency-department-wait-times-for-behavioral-health-patients-in-a-group-of-critical-access-hospitals
#7
Roseanne Moody Fairchild, Shiaw-Fen Ferng-Kuo, Stephanie Laws, Hicham Rahmouni, Daniel Hardesty
BACKGROUND: Telehealth has been proposed as an important care delivery strategy to increase access to behavioral health care, especially in rural and medically-underserved settings where mental health care provider shortage areas predominate, to speed access to behavioral health care, and reduce health disparities. INTRODUCTION: This study was conducted to determine the effects of telehealth-based care delivery on clinical, temporal, and cost outcomes for behavioral health patients in rural emergency departments (EDs) of four Midwestern critical access hospitals (CAHs)...
February 8, 2019: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://read.qxmd.com/read/30710037/peripheral-intravenous-access-applying-infusion-therapy-standards-of-practice-to-improve-patient-safety
#8
Barb Nickel
The most common invasive procedure performed in the hospital setting worldwide is the insertion of a peripheral intravenous catheter. Although use of peripheral intravenous access is common, its presence is far from benign, with a reported 35% to 50% failure rate, even in facilities with a dedicated infusion team. Significant complications related to the presence of a peripheral intravenous site include localized infection, bacteremia, phlebitis, and infiltration or extravasation. Consistent application of evidence-based standards of practice in all aspects of peripheral intravenous catheter care is essential to provide infusion therapy that delivers safe and quality care...
February 2019: Critical Care Nurse
https://read.qxmd.com/read/30691443/what-contraception-do-women-use-after-experiencing-complications-from-abortion-an-analysis-of-cohort-records-of-18-688-postabortion-care-clients-in-tanzania
#9
Colin Baynes, J Kahwa, G Lusiola, F Mwanga, J Bantambya, L Ngosso, M Hiza
BACKGROUND: The family planning component of postabortion care (PAC) is critical, as it helps women to prevent unintended pregnancies and reduce future incidence of life-threatening unsafe abortion. In Tanzania, PAC was recently decentralized from tertiary-level district hospitals to primary health care dispensaries in four regions of the country. This analysis describes interventions used to improve access to high quality PAC services during decentralization; examines results and factors that contribute to PAC clients' voluntary uptake of contraception; and develops recommendations for improving postabortion contraceptive services...
January 28, 2019: BMC Women's Health
https://read.qxmd.com/read/30691435/risky-sexual-practice-and-associated-factors-among-hiv-positive-adults-visiting-art-clinics-in-public-hospitals-in-addis-ababa-city-ethiopia-a-cross-sectional-study
#10
Wondimagegne Belay Tadesse, Abebaw Addis Gelagay
BACKGROUND: Sexual behavior of HIV positive individuals visiting anti- retroviral clinics is a neglected issue. With access to anti-retroviral treatment, HIV positive individuals experience improved health and are able to reintegrate into their social life and many of them engage in sexual activities. In the context of Ethiopia, safer sex practices among people living with HIV is critical in terms of preventing the acquisition of another strain of HIV and helping address the epidemic...
January 28, 2019: BMC Public Health
https://read.qxmd.com/read/30691354/pharmaceutical-interventions-to-improve-safety-of-chemotherapy-treated-cancer-patients-a-cross-sectional-study
#11
Johanne Daupin, Germain Perrin, Chloe Lhermitte-Pastor, Marie-Caroline Loustalot, Simon Pernot, Virginie Savoldelli, Constance Thibault, Bruno Landi, Brigitte Sabatier, Eric Caudron
PURPOSE: Cancer chemotherapy is a high-risk process. To improve patient safety, a systematic pharmaceutical analysis of chemotherapy prescriptions is performed in our institution. The aim of this study was to assess the impact of pharmaceutical interventions (PIs) on the safety of patient chemotherapy prescriptions. METHODS: This prospective cross-sectional study was conducted in an 800-bed university hospital with oncology departments. All chemotherapy prescriptions were included and PIs were collected prospectively during one month...
January 28, 2019: Journal of Oncology Pharmacy Practice
https://read.qxmd.com/read/30689893/the-impact-of-mobile-technology-on-teamwork-and-communication-in-hospitals-a-systematic-review
#12
Guy Martin, Ankur Khajuria, Sonal Arora, Dominic King, Hutan Ashrafian, Ara Darzi
Objectives: Effective communication is critical to the safe delivery of care but is characterized by outdated technologies. Mobile technology has the potential to transform communication and teamwork but the evidence is currently uncertain. The objective of this systematic review was to summarize the quality and breadth of evidence for the impact of mobile technologies on communication and teamwork in hospitals. Materials and Methods: Electronic databases (MEDLINE, PsycINFO, EMBASE, CINAHL Plus, HMIC, Cochrane Library, and National Institute of Health Research Health Technology Assessment) were searched for English language publications reporting communication- or teamwork-related outcomes from mobile technologies in the hospital setting between 2007 and 2017...
January 25, 2019: Journal of the American Medical Informatics Association: JAMIA
https://read.qxmd.com/read/30685676/comparison-of-the-change-in-heart-failure-readmission-and-mortality-rates-between-hospitals-subject-to-hospital-readmission-reduction-program-penalties-and-critical-access-hospitals
#13
Alexander T Sandhu, Paul A Heidenreich
BACKGROUND: The Hospital Readmission Reduction Program (HRRP), announced in 2010, penalizes hospitals with high readmissions for multiple conditions including heart failure. METHODS: We compared heart failure readmission and mortality rates in hospitals exposed to HRRP financial penalties with critical access hospitals (CAHs) not subject to the penalty between 2005 and 2016 using 3-year moving averages from Hospital Compare. RESULTS: After HRRP introduction, CAHs experienced a 0...
December 7, 2018: American Heart Journal
https://read.qxmd.com/read/30682499/impact-evaluation-of-a-critical-pathway-for-patients-with-clostridium-difficile-infection-a-pre-post-analysis-in-a-third-level-referral-center
#14
Antonio Giulio de Belvis, Andrea Barbara, Gabriele Giubbini, Serena Traglia, Carmen Angioletti, Gianluca Janiro, Luca Masucci, Maurizio Sanguinetti, Patrizia Laurenti, Andrea Cambieri, Antonio Gasbarrini, Walter Ricciardi, Giovanni Cammarota
BACKGROUND: Clostridium Difficile Infections (CDIs) have been increasing both in incidence and in severity, representing a big public health concern. AIM: The aim of this study was to evaluate the impact of a recently implemented Critical Pathway (CP) focused on patients with CDI in an Italian Teaching Hospital. METHODS: The CP implementation consisted of intervention aimed to: faster diagnosis and appropriateness in admission and discharge point of care; activation of a multidisciplinary team; staff training; information to patients and caregivers...
January 22, 2019: International Journal of Infectious Diseases: IJID
https://read.qxmd.com/read/30682138/outcomes-and-challenges-of-a-kidney-transplant-programme-at-groote-schuur-hospital-cape-town-a-south-african-perspective
#15
Bianca Davidson, Tinus Du Toit, Erika S W Jones, Zunaid Barday, Kathryn Manning, Fiona Mc Curdie, Dave Thomson, Brian L Rayner, Elmi Muller, Nicola Wearne
INTRODUCTION: Access to dialysis and transplantation in the developing world remains limited. Therefore, optimising renal allograft survival is essential. This study aimed to evaluate clinical outcomes and identify poor prognostic factors in the renal transplant programme at Groote Schuur Hospital [GSH], Cape Town.     . METHOD: Data were collected on all patients who underwent a kidney transplant at GSH from 1st July 2010 to the 30 June 2015. Analyses were performed to assess baseline characteristics, graft and patient survival, as well as predictors of poor outcome...
2019: PloS One
https://read.qxmd.com/read/30673294/cell-phone-usefulness-to-improve-the-skin-cancer-screening-preliminary-results-and-critical-analysis-of-mobile-app-development
#16
Carlos Eduardo Goulart Silveira, Cristiane Carcano, Edmundo C Mauad, Humberto Faleiros, Adhemar Longatto-Filho
INTRODUCTION: The high incidence of skin cancer in Brazil has resulted in an urgent need for more efficient methods of reducing the time between initial diagnosis and therapy. Such delays are significant in large countries like Brazil, where a considerable proportion of the population live in remote areas with limited access to specialized medical care. To address this problem the use of mobile phones as screening devices for suspicious skin lesions has been incorporated as long-distance teledermatology services...
January 2019: Rural and Remote Health
https://read.qxmd.com/read/30672974/quality-of-life-in-survivors-after-a-period-of-hospitalization-in-the-intensive-care-unit-a-systematic-review
#17
Paula Caitano Fontela, Franciele Aline Norberto Branquinho Abdala, Soraia Genebra Ibrahim Forgiarini, Luiz Alberto Forgiarini
OBJECTIVE: To assess the long-term, health-related quality of life of intensive care unit survivors by systematic review. METHODS: The search for, and selection and analysis of, observational studies that assessed the health-related quality of life of intensive care unit survivors in the electronic databases LILACS and MEDLINE® (accessed through PubMed) was performed using the indexed MESH terms "quality of life [MeSH Terms]" AND "critically illness [MeSH Terms]"...
October 2018: Revista Brasileira de Terapia Intensiva
https://read.qxmd.com/read/30667612/drivers-of-health-information-exchange-use-during-postacute-care-transitions
#18
Dori A Cross, Jeffrey S McCullough, Julia Adler-Milstein
OBJECTIVES: To characterize the drivers of the use of electronic health information exchange (HIE) by skilled nursing facilities (SNFs) to access patient hospital data during care transitions. STUDY DESIGN: Explanatory, sequential mixed-methods study. Quantitative data from an audit log captured HIE use by 3 SNFs to retrieve hospitalization information for the 5487 patients discharged to their care between June 2014 and March 2017, along with patient demographic data...
January 1, 2019: American Journal of Managed Care
https://read.qxmd.com/read/30665441/best-practice-advice-on-pre-hospital-emergency-anaesthesia-advanced-airway-management
#19
Kate Crewdson, David Lockey, Wolfgang Voelckel, Peter Temesvari, Hans Morten Lossius
BACKGROUND: Effective and timely airway management is a priority for sick and injured patients. The benefit and conduct of pre-hospital emergency anaesthesia (PHEA) and advanced airway management remains controversial but there are a proportion of critically ill and injured patients who require urgent advanced airway management prior to hospital arrival. This document provides current best practice advice for the provision of PHEA and advanced airway management. METHOD: This best practice advice was developed from EHAC Medical Working Group enforced by pre-hospital critical care experts...
January 21, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://read.qxmd.com/read/30664478/a-web-based-recovery-program-icutogether-for-intensive-care-survivors-protocol-for-a-randomized-controlled-trial
#20
Beverley Ewens, Helen Myers, Lisa Whitehead, Karla Seaman, Deborah Sundin, Joyce Hendricks
BACKGROUND: Those who experience a critical illness or condition requiring admission to an intensive care unit (ICU) frequently experience physical and psychological complications as a direct result of their critical illness or condition and ICU experience. Complications, if left untreated, can affect the quality of life of survivors and impact health care resources. Explorations of potential interventions to reduce the negative impact of an ICU experience have failed to establish an evidence-based intervention...
January 17, 2019: JMIR Research Protocols
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