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A collaborative and multidisciplinary shared responsibility with providing discharge information to pediatric patients/families can support successful reassimilation to life posthospitalization.

An analysis of the current discharge process at an urban pediatric hospital identified variations in discharge practices and instructions.

A multidisciplinary taskforce used the Plan-Do-Study-Act methodology to standardize the discharge process including creating a discharge template, adopting a new education platform, enhancing the electronic health record, and implementing strategies to improve discharge.

There was a reduction in 7-day readmission rate from preintervention 4.58 to postintervention for 4 consecutive quarters of 3.92, 4.20, 3.44, and 3.41, respectively. Percentile ranking and top box scores of the patient satisfaction measure of discharge preparation increased from 12th-62nd to 65th-95th percentile postimplementation and 81% to 88%, respectively.

A local improvement initiative related to standardization of the discharge process resulted in a reduction in 7-day readmission rate and improved patient satisfaction scores.

A local improvement initiative related to standardization of the discharge process resulted in a reduction in 7-day readmission rate and improved patient satisfaction scores.

Nursing care rationing has been a widespread problem in everyday nursing practice for many years.

The aim of this research study was to assess the prevalence of care rationing among nurses working in Poland.

The study was conducted among a population of 1310 nurses. GW806742X molecular weight To examine the dependencies between the sociodemographics and unfinished nursing care, the Polish adaptation of the Perceived Implicit Rationing of Nursing Care questionnaire and an investigator-developed questionnaire were used.

The mean level of missed care was 1.16 (SD = 0.7). The significant predictors of care rationing were associated with the quality of patient care (βstd = -.43, P < .001) and general work satisfaction (βstd = -.15, P < .001).

Job satisfaction and the quality of nursing care should be constantly monitored as these factors are significantly associated with the levels of care rationing.

Job satisfaction and the quality of nursing care should be constantly monitored as these factors are significantly associated with the levels of care rationing.

With the increase in Black nursing home residents, racial and ethnic disparities in quality of care have been raised.

The purpose of this study was to evaluate racial disparities in care and outcomes over 12 months.

This was a secondary data analysis using data from the Evidence Integration Triangle for Behavioral and Psychological Symptoms of Dementia study. A total of 553 residents, 24% Black residents and 76% White residents, from 55 nursing homes were included.

Differences favoring Black resident were noted in agitation, quality of life, inclusion of person-centered care approaches in care plans, and fewer falls and hospitalizations. Differences in quality-of-care interactions favored White residents. There were no differences in depression, resistiveness to care, function, pain, or transfers to the emergency department.

Disparities in clinical outcomes were small and generally favored Black versus White residents except for quality-of-care interactions.

Disparities in clinical outcomes were small and generally favored Black versus White residents except for quality-of-care interactions.

Limited studies have synthesized evidence on nurses' perceptions of recommended fall prevention strategies and potential differences between those and the practiced strategies.

To synthesize evidence about nurses' perceptions of recommended fall prevention strategies for hospitalized adults.

Using PubMed, 50 records underwent abstract and full-text screening, and 10 studies were retained. Narrative synthesis was conducted to identify common themes across studies. Quality assessment was not performed.

Nurses are aware of effective fall prevention strategies but identified unit-level barriers and facilitators to implementing these in their practice. Unit culture and policies, educational offerings, nursing interventions, and style of communication and collaboration were seen to influence fall prevention.

Nurses recognize falls as a multifactorial issue suggesting that prevention efforts be tailored to the unit and involve all employees. We recommend that future research emphasize identifying and understanding the combination of factors that produce successful unit-level fall prevention strategies.

Nurses recognize falls as a multifactorial issue suggesting that prevention efforts be tailored to the unit and involve all employees. We recommend that future research emphasize identifying and understanding the combination of factors that produce successful unit-level fall prevention strategies.

Second victims (SVs) are health care workers traumatized by unanticipated, adverse patient events. These experiences can have personal and professional effects on SVs. Research indicates that SVs experience inadequate support following adverse events.

To determine the prevalence of nurses who identified as SVs and their awareness and use of supportive resources.

A convenience sample of nurses was surveyed, and SV responses were compared with those who did not identify as a SV. Responses were analyzed using nonparametric methods.

One hundred fifty-nine (44.3%) of 359 participants identified as SVs. There was a significant relationship between work tenure and SVs (P = .009). A relationship was found between SVs and awareness and use of support resources, with debriefing being the preferred method after an event.

Adverse events trigger emotional trauma in SVs who require administrative awareness, support, and follow-up to minimize psychological trauma in the clinical nurse.

Adverse events trigger emotional trauma in SVs who require administrative awareness, support, and follow-up to minimize psychological trauma in the clinical nurse.

Attenuated familial adenomatous polyposis is characterised by low number (≤ 100) and delayed development of colorectal adenomas. Various definitions have been used, and genotype-phenotype correlations suggested.

We aim to evaluate phenotypic and genotypic correlation in patients with presumed attenuated familial adenomatous polyposis and assess familial variability.

This is a retrospective study.

This study was conducted at a tertiary polyposis registry.

Individuals with attenuated familial adenomatous polyposis were identified. Phenotypic group was defined as ≤ 100 adenomas at age 25 years and genotypic group was defined as a variant in the Adenomatous polyposis coli region associated with attenuated familial adenomatous polyposis. Pathology polyp count was used for patients who had undergone surgery and endoscopic polyp count for those with intact colon.

We evaluated phenotypic and genotypic correlation in patients with presumed attenuated familial adenomatous polyposis and familial variability.//links.lww.com/DCR/B775.

Phenotype in familial adenomatous polyposis lies on a spectrum - being determined in part by genotype and age at adenoma count. Diagnosis of attenuated familial adenomatous polyposis should be based on phenotype; genotype is not a reliable indicator. Management should be personalized according to the phenotype of each individual. See Video Abstract at http//links.lww.com/DCR/B775.

Clinical complete responders after chemoradiation for rectal cancer are increasingly being managed by a watch-and-wait strategy. Nonetheless, a significant proportion will experience a local regrowth, and the long-term oncological outcomes of these patients is not totally known.

The purpose of this study was to analyze the outcomes of patients who submitted to a watch-and-wait strategy and developed a local regrowth, and to compare these results with sustained complete clinical responders.

This was a retrospective study.

Single institution, tertiary cancer center involved in alternatives to organ preservation.

Patients with a biopsy-proven rectal adenocarcinoma (stage II/III or low lying cT2N0M0 at risk for an abdominoperineal resection) treated with chemoradiation who were found at restage to have a clinical complete response.

Rectal cancer patients treated with chemoradiation who underwent a watch-and-wait strategy (without a full thickness local excision) and developed a local regrowth were comcción-Dr. Fidel Ruiz Healy).

Readmission after ileostomy creation continues to be a major cause of morbidity with rates ranging from 15-30% due to dehydration and obstruction. Rural environments pose an added risk of readmission due to larger travel distances and lack of consistent home health services.

To reduce ileostomy-related readmission rates in a rural academic medical center.

Rapid cycle quality improvement study.

Single center study, rural academic medical center.

Colorectal surgery patients receiving a new ileostomy.

Improvement initiatives identified through Plan-Do-Study-Act cycles (Enhanced team continuity, standardized rehydration, nursing/staff education).

Thirty-day readmission, average length of stay, average time to readmission.

Roughly equal rates of ileostomy were created in each time point, consistent with a tertiary care colorectal practice. The pre-implementation readmission rate was 29%. Over the course of the entire quality improvement initiative, re-admission rates decreased by over 50% (29% to 1 from these types of targeted interventions in order to decrease readmission rates. See Video Abstract at http//links.lww.com/DCR/B771.

Implementation of initiatives targeting enhanced team continuity, the standardization of rehydration therapies, and improved patient education decreased readmission rates in patients with new ileostomies. Rural centers, where outpatient resources are not as readily available or accessible, stand to benefit the most from these types of targeted interventions in order to decrease readmission rates. See Video Abstract at http//links.lww.com/DCR/B771.

Low anterior resection syndrome has a significant impact on the quality of life in rectal cancer survivors. Previous studies comparing laparoscopic to open rectal resection have neglected bowel function outcomes.

To assess if there is a difference in the functional outcome between patients undergoing laparoscopic versus open resection for rectal adenocarcinoma.

Cross-sectional prevalence of low anterior resection syndrome was assessed in a secondary analysis of the multi-center phase 3 randomized clinical trial, Australasian Laparoscopic Cancer of the Rectum Trial (ACTRN12609000663257).

Seven study subsites across New Zealand and Australia.

Participants were adults with rectal cancer who underwent anterior resection and had bowel continuity.

Postoperative bowel function was evaluated using the validated LARS score and Bowel Function Instrument.

The Australasian Laparoscopic Cancer of the Rectum Trial randomized 475 patients with T1-T3 rectal adenocarcinoma less than 15cm from the anal verge. 257wel dysfunction affects a majority of rectal cancer patients for a significant time after the operation. In this secondary analysis of a randomized trial, surgical approach does not appear to influence the likelihood or severity of low anterior resection syndrome. See Video Abstract at http//links.lww.com/DCR/B794.