Journal of evaluation in clinical practice
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To investigate the current status of stigma in patients with rheumatoid arthritis (RA), and its correlation with treatment adherence and quality of life. ⋯ Stigma affects RA patients' treatment adherence and quality of life negatively. Healthcare workers are advised to develop comprehensive intervention programs that address the current status of stigma, with the aim of controlling disease progression, reducing disability rates, and improving the quality of life for RA patients.
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The World Health Organization Surgical Safety Checklist (SSC), now used by healthcare providers worldwide, has proved to be useful in the improvement of patients' health through the reduction of mortality and morbidity after surgery. In the Emilia-Romagna region in Italy the SSC is accompanied by a document that registers any non-conformity (NC) identified during SSC completion. This study aimed to investigate the association between surgical complications and checklist compliance, in terms of incompleteness and presence of NCs, using data from the Modena Local Health Unit (LHU). ⋯ Improving checklist compliance can reduce the risk of surgical complications. In particular, NCs are a risk factor that must be further investigated to better understand their relationship with complications. We believe that NCs data recording is helpful for both researchers in the scope of surgical complications, and healthcare professionals in the operating room.
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The objective of this study was to assess the impact of the Enhanced Recovery After Surgery (ERAS) programme implementation on treatment costs at a university-type centre, using the DRG scheme. ⋯ The implementation of the ERAS principles resulted in a number of significant positive economic impacts-reduction in the LOS and a corresponding increase in bed capacity for new patients. Additionally, direct treatment costs, including those related to antibiotic use or laboratory testing were reduced. The Czech Republic's acute healthcare system, like the majority of European healthcare systems, is financed by the DRG system. This flat-rate payment per patient encourages hospital management to seek cost-reduction strategies. The results of our study indicate that fast-track protocols represent a potential viable approach to reducing the cost of treatment while simultaneously meeting the recommendations of evidence-based medicine.
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With absence of a cure, the mainstay of management for patients with motor neurone disease (MND) is holistic supportive care and symptom control. Non-invasive ventilation (NIV) can provide relief from distressing dyspnoea which often accompanies progressive respiratory muscle weakness. Some patients using NIV will become dependent on it, with a small proportion of these patients going on to request withdrawal. Despite being legal in the UK, elective withdrawal of NIV can be emotionally and ethically challenging for the staff involved. To guide the process of symptom-controlled withdrawal, in 2015 the Association for Palliative Medicine (APM) released clinical guidance. The aim of this study is to explore the experiences of the multi-disciplinary team (MDT) involved in elective withdrawal of NIV in an MND cohort following the publication of this guidance. ⋯ Elective withdrawal is highly emotive, simultaneously positively and negatively influencing staff well-being. By addressing the potential mitigating factors, the overall impact on staff's mental health and well-being maybe improved and thus, subsequently, patient care.