Notes

Identification associated with an Alveolar Macrophage-Related Central Gene Set in Intense Breathing Hardship Affliction.
CONCLUSIONS Intertrigo is a common skin condition in care homes and home care. Obese and diabetic subjects, and subjects needing help with hygiene and getting dressed are at particular high risk. Adequate skin care strategies might be helpful to prevent this skin problem. INTRODUCTION Remote wireless monitoring is a new technology that allows the continuous recording of ward patients' vital signs, supporting nurses by measuring vital signs frequently and accurately. A case series is presented to illustrate how these systems might contribute to improved patient surveillance. METHODS AND RESULTS Five hospitals in three European countries installed a remote wireless vital signs monitoring system on medical or surgical wards. Heart rate, respiratory rate and temperature were measured by the system every 2 min. Four cases of (paroxysmal) atrial fibrillation are presented, two cases of sepsis and one case each of pyrexia, cardiogenic pulmonary edema and pulmonary embolisms. All cases show that the remote monitoring system revealed the first signs of ventilatory and circulatory deterioration before a change in the trends of the respective values became obvious by manual vital signs measurement. DISCUSSION This case series illustrates that a wireless remote vital signs monitoring system on medical and surgical wards has the potential to reduce time to detect deteriorating patients. BACKGROUND Mobilizing hospital patients is associated with improved outcomes and shorter length of stay. Safe patient handling and mobility programs that include mechanical lift use facilitate mobilizing patients and reduce the likelihood of musculoskeletal disorders in staff. However, there is little information on the prevalence of lift use or why some patients are more likely to have a lift used than others. Such information is needed to inform public policy, benchmark lift use over time, and contextualize barriers for lift use. OBJECTIVE To determine the percentage of patients that had a lift used during care in US acute care facilities, identify attributes related to the patient and their hospital stay that affect the lift use, examine whether state legislation increased lift use, and determine whether lift use was correlated with more frequent mobilization out of bed. DESIGN Retrospective analysis of the 2018 International Pressure Ulcer Prevalence ™ data. PARTICIPANTS 40,856 patients in 642 US acute care likely to be observed in a bedside chair and less likely to be observed in bed, as compared to patients that never had a lift used. CONCLUSIONS Despite the benefits to patients and caregivers, US acute care facilities are largely not using lifts to safely mobilize patients. Results suggested that safe patient handling and mobility legislation has increased the rate of lift use. Finally, lift use was correlated with patients being mobilized out of bed. BACKGROUND General practitioners experience a high workload during out-of-hours care. A possible solution is the shifting of care to nurse practitioners. OBJECTIVES To provide insight into patient- and care characteristics, safety, efficiency, and patient satisfaction of substituting general practitioners with nurse practitioners for home visits by out-of-hours primary care services. DESIGN Quasi-experimental non-randomised study comparing home visits by nurse practitioners (intervention group; one out-of-hours care service) with home visits by general practitioners (control group; two out-of-hours care services) for 24 protocolised health problems. SETTING Three out-of-hours primary care services in the East of the Netherlands. PARTICIPANTS 1601 patients who received a home visit by a nurse practitioner (N = 386) or a general practitioner (N = 1215). Of these patients, 639 gave informed consent to be included in the protocol adherence assessment and follow-up record review (nurse practitioner N = 358; generamore often appropriate (93.7% versus 79.5%). There were no differences in the number of missed diagnoses and complications. The number of follow-up contacts was also similar in both groups. Patient satisfaction was generally high and significantly higher for nurse practitioners on several items. JTE 013 mw CONCLUSIONS Nurse practitioners with experience in ambulance care can safely, efficiently, and satisfactorily perform low complex out-of-hours primary care home visits. It is recommended to study the safety and efficiency of nurse practitioners' home visits in other regions and with nurse practitioners with different educational levels and different specialisations. In addition, we recommend to evaluate the cost-effectiveness and if it leads increased quality of care. BACKGROUND The demand for total knee arthroplasty is increasing worldwide. Optimising results and meeting patients' expectations are more challenging than before, because the length of hospitalisation has markedly reduced and the standard care processes have been accelerated. We incorporated an interactive patient infotainment system into the standard clinical pathway for total knee arthroplasty in the hope of improving patients' length of stay. OBJECTIVES To analyse whether incorporation of an interactive infotainment system reduced the length of stay and improved the quality of medical care (in terms of number of medical orders and emergency room returns). DESIGN A prospective, quasi-randomised controlled trial. PARTICIPANTS AND SETTING Data of 86 patients hospitalised for a unilateral total knee arthroplasty at a medical centre in Taiwan were analysed. METHODS From January 2017 to July 2017, 86 patients who underwent unilateral total knee arthroplasty and were cared for under a standard clinical pathway we being significantly lower than that in the control group ($144 vs. $163, MD = -21.7, 95% CI -41.0 to -2.25, p = 0.007). CONCLUSIONS The incorporation of a patient infotainment system into the standard clinical pathway for total knee arthroplasty can efficiently reduce the length of hospital stay and maintain the quality of medical care. Further studies on improvement of patient medical literacy with the help of the infotainment system would be of interest in order to improve clinical practice and patient satisfaction. REGISTRATION NUMBER NCT03788798 TWEETABLE ABSTRACT A patient infotainment system can reduce hospital stay and maintain medical quality for total knee arthroplasty.
Website: https://www.selleckchem.com/products/jte-013.html