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General interest items edited by Janice Flahiff

Patients with learning disabilities become ‘invisible’ in hospitals, says study

Patients with learning disabilities become ‘invisible’ in hospitals, says study.

From the 17th January 2014 ScienceDaily article

Hospital patients with learning disabilities face longer waits and mismanaged treatment due to a failure to understand them by nursing staff, says a new report.

In one case, a patient who had problems making herself understood was accused of being drunk by hard pressed hospital staff.

It is estimated that one in 50 people in England have some form of learning disabilities such as Down’s syndrome.

Dr Irene Tuffrey-Wijne, senior research fellow in nursing at St George’s, University of London and Kingston University, said: “People with learning disabilities are largely invisible within the hospitals, which meant that their additional needs are not recognised or understood by staff.

“Our study found many examples of good practice, but also many examples where the safety of people with learning disabilities in hospitals was at risk.”

Dr Tuffrey-Wijne, a co-author of the study who works at the Faculty of Health, Social Care and Education, a partnership between the two universities, added: “The most common safety issues were delays and omissions of care and treatment.

“Some examples come down to basic nursing care like providing enough nutrition but other serious consequences were also seen in our study.

It found that the main barrier to better and safer care was a lack of effective flagging systems, leading to a failure to identify patients with learning disabilities in the first place.

 

Read entire article here

 

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January 21, 2014 Posted by | health care | , , , , , | Leave a comment

[Repost] Most Frequent Procedures Performed in U.S. Hospitals, 2011

From Statistical Brief #165 at Healthcare Cost and Utilization Project (HCUP)

Anne Pfuntner, Lauren M. Wier, M.P.H., and Carol Stocks, R.N., M.H.S.A.

Introduction

When hospitalized, patients may undergo procedures for surgery, treatments (e.g., blood transfusions), or for diagnostic purposes (e.g., biopsy). The principal procedure is the procedure performed for definitive treatment. Hospitalizations usually involve multiple procedures, which together constitute the all-listed procedures performed during a hospital stay. Data on inpatient hospital procedures can help hospital administrators, health practitioners, researchers, and others understand how hospital care, including care related to diagnosis and treatment, is currently provided and what changes or consistencies in care delivery have occurred over time.

The present Statistical Brief presents 2011 data on the most common all-listed procedures performed during hospital stays in the United States, overall and by patient age. Changes between 1997 and 2011 in the number of stays and in the rate of hospitalizations with these procedures are also presented. All differences between estimates noted in the text are statistically significant at the .001 level or better.

Findings

Most frequent all-listed procedures performed during hospital stays, 2011
Table 1 shows the all-listed procedures that were performed most commonly during hospital stays in 2011, as well as the change in the rate of hospitalizations with these procedures since 1997. Procedures were performed in 63 percent of hospital stays in 2011. The hospitalization rate for stays with procedures remained stable since 1997 at 780 per 10,000 population.

Blood transfusion was the most common procedure performed during hospitalizations in 2011 (12 percent of stays with a procedure); the rate of hospitalizations with blood transfusion more than doubled since 1997.

Respiratory intubation and mechanical ventilation was the third most common procedure performed, occurring in 7 percent of stays with a procedure in 2011. The hospitalization rate for stays involving respiratory intubation and mechanical ventilation increased 56 percent since 1997.

Highlights
    • Procedures were performed in 63 percent of hospital stays in 2011.The hospitalization rate for stays with procedures remained stable since 1997 at 780 per 10,000 population.
    • Between 1997 and 2011, the hospitalization rate for stays with hemodialysis increased 68 percent.
    • The hospitalization rates for stays with a blood transfusion increased 129 percent for adults aged 18-44 years and 45-64 years, 111 percent for adults aged 65-84 years, and 97 percent for adults aged 85 years and older.
    • The hospitalization rate for stays with Cesarean section increased 39 percent between 1997 and 2011.
    • Between 1997 and 2011, the most rapidly growing procedure was indwelling catheter—the rate of hospitalization for stays with this procedure more than tripled.
  • Adults aged 65-84 years accounted for more than half of the total number of stays with knee arthroplasty in 2011; their hospitalization rate increased 59 percent since 1997.
Six of the most frequent procedures performed were associated with pregnancy, childbirth, and newborns. When combined, they accounted for 30 percent of stays with a procedure in 2011: prophylactic vaccinations and inoculations, repair of current obstetric laceration, Cesarean section, circumcision, artificial rupture of membranes to assist delivery, and fetal monitoring. Cesarean section was the most common major operating room procedure performed in 2011 (41 stays per 10,000 population); the hospitalization rate for stays with Cesarean section increased 39 percent since 1997.

Four cardiovascular procedures also were among the most frequently performed in 2011, constituting almost 15 percent of all stays with a procedure: diagnostic cardiac catheterization, coronary arteriography; hemodialysis; diagnostic ultrasound of the heart (echocardiogram); and percutaneous transluminal coronary angioplasty (PTCA). Between 1997 and 2011, the hospitalization rate for stays with hemodialysis increased 68 percent, but the rate fell 24 percent for stays with diagnostic cardiac catheterization.

Table 1. Number of stays, stays per 10,000 population, and percentage change in rate of the most frequent all-listed procedures for hospital stays, 1997 and 2011
All‐listed Clinical Classifications Software (CCS) procedures Number of stays with the procedure in thousands Number of stays with the procedure per 10,000 population Change in rate, %
1997 2011 1997 2011 1997-2011
All stays (with and without procedures) 34,679 38,591 1,272 1,239 -3
All stays with any procedure 21,257 24,312 780 780 0
Stays with a procedure, % 61 63
Blood transfusion* 1,097 2,929 40 94 134
Prophylactic vaccinations and inoculations 567 1,860 21 60 187
Respiratory intubation and mechanical ventilation 919 1,635 34 52 56
Repair of current obstetric laceration 1,137 1,315 42 42 1
Cesarean section 800 1,272 29 41 39
Diagnostic cardiac catheterization, coronary arteriography 1,461 1,261 54 40 -24
Upper gastrointestinal endoscopy, biopsy 1,105 1,225 41 39 -3
Circumcision 1,164 1,108 43 36 -17
Artificial rupture of membranes to assist delivery 747 948 27 30 11
Hemodialysis 473 909 17 29 68
Diagnostic ultrasound of heart (echocardiogram) 632 869 23 28 20
Fetal monitoring 1,002 780 37 25 -32
Arthroplasty knee 329 718 12 23 91
Enteral and parenteral nutrition 277 586 10 19 85
Percutaneous transluminal coronary angioplasty (PTCA) 581 560 21 18 -16
Colonoscopy and biopsy 531 525 19 17 -13
Laminectomy, excision intervertebral disc 425 525 16 17 8
Spinal fusion 202 489 7 16 112
Incision of pleura, thoracentesis, chest drainage 349 476 13 15 19
Hip replacement, total and partial 291 467 11 15 40
* The number of stays with blood transfusion does not reflect the number of units of blood transfused.
Source: Agency for Healthcare Research and Quality (AHRQ), Center for Delivery, Organization, and Markets, Healthcare Cost and Utilization Project (HCUP), Nationwide Inpatient Sample (NIS), 1997 and 2011

 

 

 

 

Read the entire report here

 

October 24, 2013 Posted by | health care | , , , , | Leave a comment

   

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