Background: Neonatal intensive care unit (NICU) patients are at increased risk for handoff communication failures due to complexity and prolonged length of stay. We report a quality initiative aimed at reducing avoidable interruptions during neonatal handoffs while monitoring handoff duration and provider satisfaction.
Methods: Observational time series between August 2015 and March 2018 in an academic level IV NICU. NICU I-PASS and process changes were implemented using plan-do-study-act cycle, and statistical process control charts were used in the analysis. Unmatched preintervention and postintervention satisfaction surveys were compared using Mann-Whitney U tests.
Results: There was special cause variation in the mean number of avoidable interruptions per handoff from 4 to 0.3 (92% reduction). The mean duration of handoff was reduced ~1 min/patient. Provider satisfaction with the quality of handoffs also improved from a mean of 3.36 to 3.75 on a 1-5 Likert scale (p=0.049).
Conclusions: Standardisation of NICU handoff with NICU I-PASS and process changes led to the sustained reduction in avoidable interruptions with the added benefit of reduced handoff length and improved provider satisfaction.
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http://dx.doi.org/10.1136/bmjoq-2020-001014 | DOI Listing |
AME Case Rep
October 2024
Department of Oncology, Wenzhou Traditional Chinese Medicine Hospital of Zhejiang Chinese Medical University, Wenzhou, China.
Background: Hyperammonemic encephalopathy caused by high-dose infusion of 5-fluorouracil (5-FU) is a rare adverse reaction in rectal cancer patients with an incidence rate of 5.7%. Although the patient could be restored to normal after supportive treatments, the occurrence of this side effect was still inevitable.
View Article and Find Full Text PDFResuscitation
January 2025
Department of Medicine, University of Washington, Seattle, WA; King County Emergency Medical Services, Seattle-King County Department of Public Health, Seattle, WA.
Background: Prior studies have proposed defibrillator biosignal algorithms which characterize cardiac arrest rhythm and physiologic status. We evaluated whether a novel, individualized resuscitation strategy that integrates multiple ECG and impedance-based algorithms could reduce CPR interruptions and better align rescuer actions with patient-specific physiology.
Methods: In a retrospective cohort of ventricular fibrillation out-of-hospital cardiac arrests, observed rescuer actions (rhythm analysis, shock delivery, pulse checks, and drug therapy) were compared to hypothetical actions recommended by the proposed individualized strategy.
J Clin Med
January 2025
College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11461, Saudi Arabia.
Owing to the growing use of immune checkpoint inhibitors (ICIs) in the treatment of cancer, a wide spectrum of toxicity has arisen among cancer patients. Yet, limited ICI toxicity-related research is currently conducted in our region. This is a retrospective observational study conducted on adult cancer patients who received at least one cycle of ICI single therapy.
View Article and Find Full Text PDFClin Adv Periodontics
January 2025
Department of Periodontology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo, Japan.
Background: Various surgical techniques have recently been developed for periodontal tissue regeneration, especially those do not involve any incisions in the interdental papillae at the regeneration site. These techniques have significant advantages for obtaining clinical attachment gain with least amount of gingival recession, however, may also have disadvantages such as limited field of surgical view, difficulty in debridement, and limited access only from the buccal side. This case report addresses a 2-year follow-up with a novel surgical approach to achieve periodontal regeneration that overcomes these limitations: the flexible tunnel technique (FTT).
View Article and Find Full Text PDFActa Dermatovenerol Croat
November 2024
Constantin A. Dasanu MD, PhD, Lucy Curci Cancer Center, Eisenhower Health, 39000 Bob Hope Dr, Rancho Mirage, CA 92270 , USA;
Erlotinib, an epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI), is currently used in the therapy of several solid malignancies. This agent has been associated with several dermatological side-effects, the most common being papulo-pustular acneiform rash. Herein we describe a unique skin effect in a patient treated with erlotinib for non-small cell lung cancer.
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