Rosemccleary1647
The implementation of robot-assisted radical cystectomy (RARC) with intracorporeal urinary diversion (ICUD) for management of patients with muscle-invasive or high-risk noninvasive bladder cancer has increased in utilization over the last decade. Here, we seek to describe institutional opioid prescription and utilization patterns following implementation of a nonopioid (NOP) perioperative pain management protocol in patients who received RARC with ICUD.
The records of all patients who underwent RARC that utilized a NOP perioperative pain management protocol at a single academic institution from 2016 to 2020 were retrospectively reviewed. Descriptive statistical analyses were performed. For comparison, we included 74 consecutive patients who received the same NOP protocol with extracorporeal urinary diversion (ECUD).
A total of 116 patients who received ICUD were included in our analysis. The median operation time for the ICUD group was 305 minutes (interquartile range [IQR] 262-352). 12.1% (n = 14) of p acceptable complication and readmission rates.
The implementation of a NOP protocol for patients undergoing RARC with ICUD allows for both decreased postoperative narcotic use and reduced need for narcotic prescriptions at discharge with acceptable complication and readmission rates.
With the current movement toward treating oligometastatic hormone sensitive prostate cancer (OMPC), we design a study with the objective of gathering opinions regarding what would be considered a clinically significant benefit from such treatments.
Data was collected from physicians of the Society of Urologic Oncology using a self-administered questionnaire using SurveyMonkey. The questionnaire was designed to obtain characteristics on clinical practice of the respondents, definitions used for OMPC and also what would be considered a clinically significant benefit according to the respondents. We present a descriptive analysis of the responses obtained.
We obtained 119 responses (response rate of 12.6%) after sending the questionnaire twice with one month apart. Most of them being staff/faculty (89%) practicing in the United States of America (84.87%). Most of the responders referred that a significant proportion of their practice comes from PC patients. Most defined OMPC <3 bone/lymph node metastasignificant and this should be used for estimating the sample size in future clinical trials.
Several immune checkpoint inhibitors (ICIs) are FDA approved for treatment of genitourinary (GU) malignancies. We aim to determine demographic and clinicopathologic characteristics that significantly affect clinical outcomes in patients with advanced stage GU malignancies treated with ICIs.
We performed a single-center, consecutive, retrospective cohort analysis on patients with metastatic or unresectable GU malignancies who were treated with ICIs at the University of Michigan. Immune-related adverse events (irAEs), putative immune-mediated allergies, and overall response rates (ORR) were assessed. Comorbidity index scores were calculated. Survival analysis was performed to evaluate progression-free survival (PFS) and overall survival (OS), stratifying and controlling for a variety of clinicopathologic baseline factors including site of metastases.
A total of 160 patients were identified with advanced renal cell carcinoma (RCC) or urothelial carcinoma. selleck kinase inhibitor Median PFS and OS were 5.0 and 23.6 months for RCC,rowing body of literature that seeks to understand the clinicopathologic variables and outcomes associated with ICI therapy.
To identify the risks in automated dispensing cabinet use in order to improve routine procedure safety.
We used the Failure Mode Effect Analysis (FMEA) methodology. A multidisciplinary team identified potential failure modes of the procedure through a brainstorming session. We assessed the impact associated with each failure mode with the Risk Priority Number (RPN), which involves three variables occurrence, severity, and detectability. Improvement measures were established for failure modes with RPN>100 considered critical. The final RPN (theoretical) that would result from the proposed measures was also calculated.
The process was divided into five sub-processes automatic delivery of order replacement, to prepare order in a pyramidal cart, transport of the pyramidal cart from the pharmacy service to the automated dispensing cabinet, replacement of the automated dispensing cabinet by the pharmacy technician and dispensing/returning by nursing staff. Twenty-two failure modes, with 25 cases and with varying effects (severity 2-8) were evaluated. The sub-process with more failure modes with NPR>100 was dispensing/returning by nursing staff.
The FMEA methodology was a useful tool when applied to automated dispensing cabinet system use. The implementation of improvement actions significantly reduced the risk.
The FMEA methodology was a useful tool when applied to automated dispensing cabinet system use. The implementation of improvement actions significantly reduced the risk.
The implantation of hospital information systems (HISs) has grown dramatically in recent years. Understanding the success rate of HIS is key in health organizations. In this study, a validated questionnaire for HISs evaluation based on the Information System Success Model (ISSM) has been provided. In addition, the HIS success rate was determined.
The current study was conducted at one of the largest teaching hospitals in eastern Iran. The 44-items questionnaire was developed for data gathering. The questionnaire covered ISSM dimensions, which include analysis of quality system, quality of information, quality service, system use, usefulness, satisfaction, and net benefits. Content validity, constructs validity, and reliability of the ISSM questionnaire was measured. HIS success rate has been determined and categorized based on users' perspective as follows appropriate (75%≤HIS success rate), moderate (50%≤HIS success rate<75%), low coverage (25%≤HIS success rate<50%), and poor (coverage rate<25%).
In total, 253 users participated in the study. The ISSM questionnaire was validated by an expert panel with CVI 85.12% and CVR 88.22%. The overall Cronbach's alpha value of the instrument was determined as 92.2%. Nine factors with eigenvalues greater than 1.00 were identified, jointly accounting for 66.91% of the total variance. The value of KMO was.866 showed that the sample size was adequate for factor analysis. The highly significant Bartlett's test (p<0.000) indicated that variables were correlated and the factor analysis was appropriate. Our results demonstrated that the total mean of HIS success was "moderate" base on the users' point of view.
The findings of the current study, provide valuable scientific evidence for key affecting factors on hospital EHR in Iran as a developing country.
The findings of the current study, provide valuable scientific evidence for key affecting factors on hospital EHR in Iran as a developing country.
