Meeting report on the NIDDK/AUA Workshop on Congenital Anomalies of External Genitalia: challenges and opportunities for translational research.

Congenital anomalies of the external genitalia (CAEG) are a prevalent and serious public health concern with lifelong impacts on the urinary function, sexual health, fertility, tumor development, and psychosocial wellbeing of affected individuals. Complications of treatment are frequent, and data reflecting long-term outcomes in adulthood are limited. To identify a path forward to improve treatments and realize the possibility of preventing CAEG, the National Institute of Diabetes and Digestive and Kidney Diseases and the American Urological Association convened researchers from a range of disciplines to coordinate research efforts to fully understand the different etiologies of these common conditions, subsequent variation in clinical phenotypes, and best practices for long term surgical success.

No. 292-Abnormal Uterine Bleeding in Pre-Menopausal Women.

Background: Abnormal uterine bleeding is the direct cause of a significant health care burden for women, their families, and society as a whole. Up to 30% of women will seek medical assistance for this problem during their reproductive years. This guideline replaces previous clinical guidelines on the topic and is aimed to enable health care providers with the tools to provide the latest evidence-based care in the diagnosis and the medical and surgical management of this common problem.

How to set up and administer an enteral feed via a nasogastric tube.

Rationale and key points Nasogastric tube feeding is a method of enteral feeding commonly administered by nurses. Feed can be administered either using a volumetric enteral feeding pump (pump feeding) or via an enteral syringe (bolus feeding). This article explains how nurses can safely undertake these two methods of nasogastric tube feed administration at the patient's bedside.

Analysis of Origins of Admission for Solid Tumor Oncology Inpatients: Disease Severity and Outcomes.

Purpose: Hospital transfers may affect clinical outcomes. Evaluation of admission by source of transfer, time of admission, and provider type may identify opportunities to improve inpatient outcomes.

Methods: We reviewed charts of patients admitted to the solid tumor oncology service between July and December 2014 from the Cleveland Clinic Foundation (CCF) Main Campus emergency department (ED), CCF Regional EDs, outside hospital (OSH) ED, OSH inpatient services, and CCF outpatient clinics.

A Comparison of Health-Related Quality of Life of Women Awaiting Pelvic Organ Prolapse Surgery versus Hip or Knee Replacement.

Objective: Pelvic organ prolapse (POP) can significantly decrease the health-related quality of life (HRQOL) of women. In 2005, provincial and territorial wait time benchmarks were set in areas such as hip and knee replacement, but such efforts were lagging for urogynaecological surgeries. This study aimed to compare wait times and HRQOL scores of females awaiting surgery for POP with those of women awaiting hip or knee replacement.

Improving the Management of Patients With Low-Risk Neutropenic Fever at the Cleveland Clinic Taussig Cancer Institute.

Purpose: Neutropenic fever (NF) is an oncologic emergency and has resulted historically in inpatient management. The Multinational Association for Supportive Care in Cancer (MASCC) score can be used to identify patients with NF at a low risk of complications who can be managed safely as outpatients. Despite established guidelines supporting outpatient management of low-risk neutropenic fever (LRNF), provider awareness is low, and inpatient admission for intravenous antibiotics continues to be standard of care.

Short-term Uresta efficacy (SURE) study: a randomized controlled trial of the Uresta continence device.

Introduction And Hypothesis: An intravaginal device (Uresta) is currently available for the treatment of stress urinary incontinence (SUI). Case-series data on its effectiveness exist; however, controlled data are lacking. The objective of this study is to determine the short-term efficacy of the Uresta device using a randomized placebo controlled trial.

How to insert a nasogastric tube and check gastric position at the bedside.

Rationale and key points A nasogastric tube (NG tube) can be used to aspirate stomach contents or to administer feed, medication or fluid into the stomach. ▶ A blind technique is used to insert the NG tube through the nostril, along the nasopharynx, through the oesophagus and into the stomach. ▶ It is important for nurses to be able to recognise problems that may arise when inserting a NG tube blindly, and to know what actions to take if it is suspected that the distal tip of the NG tube is not sitting in the stomach, or they are unable to identify its location.

Reducing Unplanned Medical Oncology Readmissions by Improving Outpatient Care Transitions: A Process Improvement Project at the Cleveland Clinic.

Purpose: Reducing 30-day unplanned hospital readmissions is a national policy priority. We examined the impact of a quality improvement project focused on reducing oncology readmissions among patients with cancer who were admitted to palliative and general medical oncology services at the Cleveland Clinic.

Methods: Baseline rates of readmissions were gathered during the period from January 2013 to April 2014.

The nurse's role in patient nutrition and hydration.

Abstract Evans L, Best C (2015) Meeting patients' nutrition and hydration needs. The Nursing and Midwifery Council's new code was introduced in March 2015. For the first time, nutrition and hydration are mentioned specifically within the code.

Improving nutrition in older people in acute care.

Older people have an increased risk of becoming malnourished when they are ill. Admission to hospital may affect their nutritional intake and nutritional status. Nutrition screening and implementation of nutrition care plans can help minimise the risk of malnutrition in acute care settings, if used effectively.

Managing malnutrition in patients with dementia.

As dementia progresses, an individual may experience increasing difficulties in eating and drinking safely. Evidence suggests that admission to hospital may exacerbate these problems. This article aims to familiarise readers with some of the issues associated with providing good nutritional care for a patient with dementia in hospital.

Hospital nurses' comfort in and frequency of delivering heart failure self-care education.

Background: Nurses are expected to deliver pre-discharge heart failure education in 8 content areas: what heart failure means, medications, diet, activity, weight monitoring, fluid restriction, signs/symptoms of worsening condition and signs/symptoms of fluid overload.

Aims: To examine nurses' comfort in and frequency of delivering heart failure education to hospitalized patients.

Methods: A multicenter, descriptive, correlational design and questionnaire methods were used.

Accurate assessment patient weigh.

Measuring patient weight is considered a routine assessment that is frequently delegated to unregistered staff. Yet patient weight is a fundamental part of nutrition assessment and may be used to calculate drug dosages and assess fluid balance. It is vital that staff carrying out this measurement are trained and have access to appropriate equipment that is regularly calibrated.

Patient and family views of nutritional status.

Providing adequate food in hospitals remains a concern for those involved in healthcare as well as patients and relatives. We conducted a small-scale survey to explore relatives' and patients' perceptions about the risk of developing malnutrition in hospital and to gauge whether further more in-depth audit was required.

Guidelines for routine gastrostomy tube replacement in children.

Endoscopic placement of a gastrostomy is the safest method of inserting a gastrostomy in children who are going to require full or supplemental enteral feeding for more than six weeks. Once a stoma tract has formed successfully following initial placement of a gastrostomy tube, the device can be changed to a balloon, button or non-balloon type. Community nursing teams often support a number of children with gastrostomies and their families, replacing the devices as necessary.

Nasogastric feeding in the community: safe and effective practice.

A small percentage of patients receiving enteral tube feeding in the community receive feed via a nasogastric tube. There are risks associated with this method if the correct procedures for monitoring tube displacement are not in place. Guidance for checking tube position has been provided by the National Patient Safety Agency (NPSA).

Maintaining hydration in enteral tube feeding.

Although recognition of the importance of hydration is increasing, there is little research relating to hydration in enterally fed patients. An online survey found a lack of evidence-based guidance and a need for a greater understanding of this area.

Abnormal uterine bleeding in pre-menopausal women.

Background: Abnormal uterine bleeding is the direct cause of a significant health care burden for women, their families, and society as a whole. Up to 30% of women will seek medical assistance for this problem during their reproductive years. This guideline replaces previous clinical guidelines on the topic and is aimed to enable health care providers with the tools to provide the latest evidence-based care in the diagnosis and the medical and surgical management of this common problem.

Obstetric anal sphincter injuries: a survey of clinical practice among Canadian obstetricians.

Objective: To describe the current practice, experience, and confidence of Canadian obstetricians in the management of obstetric anal sphincter injuries (OASIS) and to explore the need for national practice guidelines on this topic.

Methods: We conducted a cross-sectional, Internet-based survey between December 2010 and March 2011. The survey was initially tested among a sample population and then distributed electronically to 665 Canadian obstetricians.

Feeding hospital patients: a multiprofessional approach.

Nurses have a key role in ensuring that inpatients receive adequate nutrition and hydration. This article gives practical advice on helping patients during mealtimes.

Administration of medicines via an enteral feed tube.

In 2007, the National Patient Safety Agency raised concerns about the administration of medicines through enteral feeding tubes. This article outlines safe practice when administering medication by this route. Considerations should include whether the patient can take the medicine orally and what interactions may occur with other drugs, the feed or the tube itself.