Articles: hospitals.
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Multicenter Study
[Results of ENDORSE-2-HUNGARIA study. Repeated assessment of the prevalence of venous thromboembolism risk and prophylaxis in acute hospital care setting].
ENDORSE (Epidemiologic International Day for the Evaluation of Patients at Risk for Venous Thromboembolism in the Acute Hospital Care Setting) study in 2006, was a multinational cross-sectional survey designed to assess the prevalence of venous thromboembolism (VTE) risk in the acute hospital care setting, and to determine the proportion of at-risk patients who receive appropriate prophylaxis. From the 358 randomly selected hospitals across 32 countries in the global registry, 9 Hungarian centers were included. According to the Hungarian results, the use of appropriate prophylaxis was more common in surgical patients but much less common in medical patients comparing to the worldwide average. ⋯ The rate of appropriate prophylaxis use in at-risk patients did not changed significantly in surgical patients, however, a significant, 43.9% increase was found in medical patients (p=0.002), that proves the success of lectures presenting the facts and focusing to increase medical prophylaxis during the time period between the two studies. 59.7% of at-risk medical patients and 15.6% of surgical patients were unprotected against thrombosis in 2009. We should further increase the rate of at-risk patients receiving appropriate prophylaxis. We should reinforce the rationale for the increase of awareness of VTE risk in hospitalized medical patients, and to enhance the prophylaxis practice among healthcare professionals.
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J. Thorac. Cardiovasc. Surg. · May 2010
Multicenter StudyCenter variation and outcomes associated with delayed sternal closure after stage 1 palliation for hypoplastic left heart syndrome.
There is debate whether primary or delayed sternal closure is the best strategy after stage 1 palliation for hypoplastic left heart syndrome. We describe center variation in delayed sternal closure after stage 1 palliation and associated outcomes. ⋯ Use of delayed sternal closure after stage 1 palliation varies widely. These observational data suggest that more frequent use of delayed sternal closure is associated with longer length of stay and higher postoperative infection rates. Further evaluation of the risks and benefits of delayed sternal closure in the management of these complex infants is necessary.
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Multicenter Study
[Care of adolescents in Spanish hospitals: the invisible patients].
The general aim of this work was to address the current models of non-psychiatric hospitalization received by adolescents in Spanish hospitals. Specifically, we wished to determine whether Spanish hospitals have specific non-psychiatric admittance units for adolescent patients, what are the age limits used by such units, what diseases are cared for, and what educational and leisure services are provided for hospitalised patients. If the hospitals do not have specific admittance units for adolescent patients, we wished to find out the age limit at which minors are admitted into the paediatric unit, and where they are they admitted when they are not admitted in paediatrics, and whether alternative educational and leisure activities are provided to minor patients who are admitted in units other than paediatrics. ⋯ The treatment of adolescents within the Spanish hospital system has a series of deficiencies as regards international quality parameters.
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Multicenter Study
Supervising the supervisors--procedural training and supervision in internal medicine residency.
At teaching hospitals, bedside procedures (paracentesis, thoracentesis, lumbar puncture, arthrocentesis and central venous catheter insertion) are performed by junior residents and supervised by senior peers. Residents' perceptions about supervision or how often peer supervision produces unsafe clinical situations are unknown. ⋯ Residents report low levels of comfort and experience with procedures, and frequently report supervising prior to feeling comfortable. Our findings suggest a need to examine best practices for procedural supervision of trainees.
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Southern medical journal · Apr 2010
Multicenter StudyCommunity-based application of mild therapeutic hypothermia for survivors of cardiac arrest.
To demonstrate that the application of therapeutic hypothermia is technically feasible in a community-based setting. ⋯ A simple protocol of mild therapeutic hypothermia using locally available resources is technically feasible and safe in a community-based setting.