A pilot study evaluating the effects of Magtrace for sentinel biopsy regarding care process optimization, reimbursement, surgical time and patient comfort compared to standard Technetium

2020 ◽  
Author(s):  
S Shams ◽  
K Lippold ◽  
R Roehle ◽  
S Paepke ◽  
JU Blohmer ◽  
...  
BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e030268
Author(s):  
Tobias Ingo Stacke ◽  
Johannes Michael Bergmann ◽  
Armin Michael Ströbel ◽  
René Müller-Widmer ◽  
Daniel Purwins ◽  
...  

IntroductionRegardless of the healthcare setting, person-centred care and its implementation in caring for older people are a central issue for those who are responsible as professional caregivers and for those in need of care within the care process. Both aspects encompass the possibility of recognising personal preferences. To provide person-centred care, professional caregivers need to know about the individual preferences of the persons being cared for. Therefore, the PELI (an acronym for ‘Preferences for Everyday Living Inventory’) instrument was developed at the Polisher Research Institute (USA) for the systematic recording of individual preferences of older people in need of care. There is currently no comparable instrument available in the German language.MethodsAs part of the proposed project PELI-D, all versions of the original PELI instrument (nursing home version) were (1) culture-sensitively translated into German and will be (2) examined in a pilot study for their reliability, feasibility and practicability. For the project PELI-D, we worked together with our practice partners in Germany (Diaconia and Caritas in North Rhine-Westphalia) and collaborated with our partners in the USA who developed the PELI instrument. This study protocol focuses on the pilot study, which will be conducted by the German Center for Neurodegenerative Diseases (DZNE) (site Witten).Ethics and disseminationThis study was approved by the internal quality control committee of the DZNE (ID number: WI029 PELI-D) and by the ethics committee of the German Society of Nursing Science Duisburg branch office (ID number: 18-010). All personal information will be deidentified with a specific identification code and stored in a secured location apart from the rest of the study data. Only qualified and study-related staff will be allowed access to the data. The results of the study will be distributed nationally and internationally through peer-reviewed journals, conferences and journals for nursing care practice.


Author(s):  
Sina Shams ◽  
Kai Lippold ◽  
Jens Uwe Blohmer ◽  
Robert Röhle ◽  
Friedrich Kühn ◽  
...  

Abstract Background Sentinel lymph node biopsy after technetium-99 (Tc99) localization is a mainstay of oncologic breast surgery. The timing of Tc99 injection can complicate operating room schedules, which can cause increasing overall costs of care and patient discomfort. Methods This study compared 59 patients who underwent breast cancer surgery including sentinel lymph node biopsy. Based on the surgeon’s choice, 29 patients were treated with Tc99, and 30 patients received the iron-based tracer, Magtrace. The primary outcomes were time spent on the care pathway and operating time from commissioning of the probe to removal of the sentinel node. The secondary outcomes were patient pain levels and reimbursement. Results The mean time spent on the preoperative breast cancer care pathway was significantly shorter for the Magtrace group (5.4 ± 1.3 min) than for the Tc99 group (82 ± 20 min) (p < 0.0001). The median time from probe usage to sentinel node extirpation was slightly but not significantly shorter in the Magtrace group (5 min; interquartile range [IQR], 3–15 min vs 10 min; IQR, 7–15 min; p = 0.151). Reimbursement and pain levels remained unchanged, and the hospital length of stay was similar in the two groups (Magtrace: 5.1 ± 2.3 days vs Tc99: 4.5 ± 3.2 days). Conclusions Magtrace localization shortened the preoperative care pathway and did not affect surgical time or reimbursement. Once established, it could allow for cost reduction and improve patient comfort.


2020 ◽  
Vol 5 (2) ◽  
pp. 55-59
Author(s):  
Souza MC ◽  
Luiz Amaro do Nascimento Neto ◽  
Lucas Afonso Barbosa Saraiva ◽  
Caio Vinicius Afonso Barbosa Saraiva ◽  
Ariosto Afonso de Morais ◽  
...  

Goal: Describe the use of a cardiological instrument developed by medicine and nursing with the use of information technology to assist terminally ill elderly patients. Introduction: The use of interventional medical technology in cardiac and terminally ill elderly patients needs to be associated with palliative care as clinical support measures in intensive care. This resource assists in decisions at the end of the patient's life and directs the attention of the health team to ensure patient comfort and family satisfaction. In this regard, information and communication technology assist the entire care process. Method: It is a descriptive and exploratory study of quantitative and statistical character. Based on the innovative methodology of the current times, using uniform and ethical parameters for the elaboration of assistance based on auxiliary technology and the knowledge of medical and nursing professionals. Results and Discussion: 99 articles were analyzed, discussed and quantified, showing experiences of palliative care in intensive care units using the variables of technology and cardiologic instruments and the participation of medicine and nursing. Conclusion: The theme “palliative care” should be further investigated in order to improve the relationship between patients, their families and the health team. Considering the increase in the number of elderly people in intensive care, it is essential to improve the training of health professionals to face the challenges that involve the end of life and cardiology.


2021 ◽  
Author(s):  
Dawei Wang ◽  
Rhoann Kerh ◽  
Sungbum Jun ◽  
Seokcheon Lee ◽  
Roy Mayega2 ◽  
...  

Abstract Background The Electronic tracking system for healthcare commodities (E+TRA Health) is an all-in-one out- of-box solution for supply chain management system of healthcare commodities for lower-level health facilities in rural areas. It aims to support real-time monitoring and decision-making to (1) reduce the time needed to prepare orders, (2) reduce stockout and overstock cases of targeted medical supplies, (3) help improve patient outcomes. In this study, we adopted an integrated approach to analyze the process of information flow, identify and address critical paths of essential supplies associated with maternal health in the Ugandan health system. Methods We apply system engineering principles and work with community partners in hospitals to develop care process workflow charts (based on essential services) for the lifecycle of maternal health continuum of care. Based on this chart, we develop a local cloud-based offline-compatible smart sync platform named “E+TRA Health” to triangulate 1) patient admission, diagnoses, delivery information, testing reports from laboratories, 2) inventory information from main store, stores in Maternal Child Health (MCH) unit, and 3) lab, to identify the critical list of medical and laboratory supplies, their lead times for procurement and then generate reports and suggested procurement plans for real time decision-making. Results The E+TRA Health platform was piloted in two Healthcare Center IV facilities in Uganda over a period of 6 months. The system collected more than 5,000 patient records and managed more than 500 types of medicines. The pilot study demonstrated the functionalities of E+TRA Health and its feasibility to sense demand from point of care. Conclusion E+TRA Health is the first to triangulate supply and demand data from three different departments (main store, lab, and MCH) to forecast and generate orders automatically to meet patient demands. It is capable of generating reports required by MOH in real time compared to one-week lead-time using paper-based systems. This prompts frontline stakeholders to generate efficient, reliable and sustainable strategic healthcare plans with real time data. This system improves patient outcomes through better commodity availability by sensing true patient demands.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fei Huang ◽  
Minxue Wang ◽  
Huixin Chen ◽  
Nan Cheng ◽  
Yanling Wang ◽  
...  

Abstract Background Uvulopalatopharyngoplasty(UPPP) is the most prevalent surgical treatment of obstructive sleep apnea, but postoperative pharyngeal pain may affect patient comfort. The enhanced recovery after surgery pathway has been proved beneficial to many types of surgery but not to UPPP yet. The aim of this pilot study was to preliminarily standrize an enhanced recovery after surgery protocol for UPPP, to assess whether it has positive effects on reducing postoperative pharyngeal pain and improving patient comfort, and to test its feasibility for an international multicentre study. Methods This randomised controlled study analysed 116 patients with obstructive sleep apnoea (OSA) who were undergoing UPPP in a single tertiary care hospital. They were randomly divided according to treatment: the ERAS group (those who received ERAS treatment) and the control group (those who received traditional treatment). Ninety-five patients completed the assessment (ERAS group, 59 patients; control group, 36 patients). Pharyngeal pain and patient comfort were evaluated using a visual analogue scale (VAS) at 30 min and at 6, 12, 24 and 48 h after UPPP. Complications, hospitalisation duration, and hospital cost were recorded. Results The VAS scores for resting pain and swallowing pain were significantly lower in the ERAS group than those in the control group at 30 min and at 6, 12, 24 and 48 h after surgery. Patient comfort was improved in the ERAS group. The hospitalisation duration and cost were comparable between the groups. The incidence of complications showed an increasing trend in the ERAS group. Conclusion The ERAS protocol significantly relieved pharyngeal pain after UPPP and improved comfort in patients with OSA, which showed the prospect for an larger study. Meanwhile a potential increase of post-operative complications in the ERAS group should be noticed. Trial registration Chinese Clinical Trial Registry (23/09/2018, ChiCTR1800018537)


Author(s):  
B. Frerich ◽  
F. Schiefke ◽  
M. Förster ◽  
H. Weidenbach ◽  
A. Hemprich

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