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Postpartum Inpatient Management

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121. Opioid Use and Opioid Use Disorder in Pregnancy

will be required (68). The pain management of intrapartum and postpartum patients on opioid agonist therapies can be challenging because of their increased drug tolerance and hypersensitivity to pain. When resources are available, a consultation with an anesthesiologist can be beneficial in pregnant women with substance use disorder or chronic opioid use to formulate a pain management plan tailored to the individual patient. A multimodal pain control approach with neuraxial analgesia and nonsteroidal (...) , it is essential that screening be universal. Routine screening should rely on validated screening tools, such as questionnaires, including 4Ps, NIDA Quick Screen, and CRAFFT (for women 26 years or younger). For chronic pain, practice goals include strategies to avoid or minimize the use of opioids for pain management, highlighting alternative pain therapies such as nonpharmacologic (eg, exercise, physical therapy, behavioral approaches), and nonopioid pharmacologic treatments. For pregnant women

2017 American College of Obstetricians and Gynecologists

122. Periviable Birth

), potentially modifiable antepartum and intrapartum factors (eg, location of delivery, intent to intervene by cesarean delivery or induction for delivery, administration of antenatal corticosteroids and magnesium sulfate), and postnatal management (eg, starting or withholding and continuing or withdrawing intensive care after birth). Antepartum and intrapartum management options vary depending upon the specific circumstances but may include short-term tocolytic therapy for preterm labor to allow time (...) :617–28. Clinical Considerations and Management What tools are available to obstetrician–gynecologists, other obstetric providers, and families to predict outcomes of periviable birth? Because of the wide range of outcomes associated with periviable birth, counseling should attempt to include accurate information that is as individualized as possible regarding anticipated short-term and long-term outcomes. Nevertheless, it is important to realize that outcomes that have been reported in the medical

2017 American College of Obstetricians and Gynecologists

123. How good is the evidence to support primary care practice?

How good is the evidence to support primary care practice? How good is the evidence to support primary care practice? | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name (...) or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here How good is the evidence to support primary care practice? Article Text Original EBM Research How good is the evidence to support primary care practice? Free Mark H Ebell , Randi Sokol , Aaron Lee , Christopher Simons , Jessica Early Statistics from Altmetric.com Summary box

2017 Evidence-Based Medicine (Requires free registration)

124. Obesity in pregnancy

flyveture på > 4 timer og i forbindelse med kirurgi og traumer. Prægravid BMI = 30 kg/m 2 betragtes som en risikofaktor som medfører let øget risiko, der sammen med andre faktorer indgår i vurderingen af om der skal gives tromboseprofylakse både antepartum og postpartum. Dosering af LMWH (low molecular weight heparin) ved profylaktisk behandling: DSTH (Dansk Selskab for trombose og Hæmostase) anbefaler at dosis ved profylaktisk behandling med LMWH er vægtbaseret: Prægravid vægt: 50-90 kg: 4.500 iE (...) strømper giver formentlig bedst kompliance. I de engelske guidelines (45) anbefales lavere tærskel for profylaktisk behandling.: Man bør overveje at give tromboseprofylakse med LMWH til kvinder med et prækonceptionelt BMI = 30 kg/m 2 , der desuden har to eller flere risikofaktorer for tromboemboliske events. Dette med start så tidligt i graviditeten som muligt. Alle gravide kvinder, der får tromboseprofylakse antepartum, bør fortsætte med profylaktiske doser LMWH til og med 6 uger postpartum. Der bør

2017 Nordic Federation of Societies of Obstetrics and Gynecology

125. HTA of smoking cessation interventions

College Dublin Prof Kathleen Bennett Associate Professor in Biostatistics, Population Health Sciences, Royal College of Surgeons in Ireland (RCSI) Ms Martina Blake National Lead Tobacco Free Ireland Programme, Health Service Executive (HSE) Ms Geraldine Cully Health Promotion & Improvement Tobacco Co- ordinator, Health & Wellbeing Division, HSE Ms Sally Downing Campaign Manager, Communications Division, HSE Prof Michael Drummond Professor of Health Economics, University of York Dr William Flannery (...) ) of smoking cessation interventions Health Information and Quality Authority 8 Ms Dilly O’Brien Assistant Principal Officer, Tobacco & Alcohol Control Unit, Department of Health Mr Kevin O’Hagan Health Promotion Manager, Irish Cancer Society Mr Bernard O’Sullivan President of Cork COPD Support Group and member of COPD Support Ireland Mr Damien Peelo Executive Director, COPD Support Ireland Prof James Raftery Professor of Health Technology Assessment, University of Southampton, UK Dr Máirín Ryan Director

2017 Health Information and Quality Authority

126. Quality measures in high-risk pregnancies: Executive summary of a cooperative workshop of SMFM, NICHD, and ACOG

Force on Hypertension in Pregnancy (Table 2; footnote a). Hypertension/preeclampsia treatment (inpatient) Magnesium sulfate for prevention of eclampsia in delivering or postpartum women with preeclampsia with severe features Yes Signi?cant cause of maternal morbidity and death. Yes Studies indicate decreased rate of seizures with prophylaxis. Yes Yes Chart abstraction or electronic health records Yes SMFM Publications Committee. Quality measures in high-risk pregnancies. Am J Obstet Gynecol 2017 (...) and Human Development, and American College of Obstetri- cians and Gynecologists (ACOG) convened a “Quality Measures in High-Risk Pregnancies Workshop.” The goals were to (1) review the current landscape regarding quality measures in obstetric conditions with increased risk for adverse maternal or fetal outcomes, (2) evaluate the avail- able evidence for management of common obstetric con- ditionstoidentifythosethatmaydrivethehighestimpacton outcomes, quality, and value, (3) propose measures for high

2017 Society for Maternal-Fetal Medicine

127. Guidance addressing all aspects of the care of people with schizophrenia and related disorders. Includes correct diagnosis, symptom relief and recovery of social function

Guidance addressing all aspects of the care of people with schizophrenia and related disorders. Includes correct diagnosis, symptom relief and recovery of social function First published in Australian and New Zealand Journal of Psychiatry 2016, Vol. 50(5) 1-117. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders Cherrie Galletly 1,2,3 , David Castle 4 , Frances Dark 5 , Verity Humberstone 6 , Assen (...) Jablensky 7 , Eóin Killackey 8,9 , Jayashri Kulkarni 10,11 , Patrick McGorry 8,9,12 , Olav Nielssen 13 and Nga Tran 14,15 Abstract Objectives: This guideline provides recommendations for the clinical management of schizophrenia and related disorders for health professionals working in Australia and New Zealand. It aims to encourage all clinicians to adopt best practice principles. The recommendations represent the consensus of a group of Australian and New Zealand experts in the management

2016 Royal Australian and New Zealand College of Psychiatrists

128. Safe midwifery staffing for maternity settings

complications (e.g. managing fetal distress, complicated birth) Managing Managing complications complications (e.g. postpartum haemorrhage, difficulty establishing infant feeding) Additional time for the following: Additional time for the following: Consider Consideration of preferred ation of preferred place of birth place of birth (e.g. home birth) Pro Providing care for women viding care for women needing specialist input needing specialist input ( (e.g.female genital mutilation) Managing specific (...) and free-standing). It aims to improve maternity care by giving advice on monitoring staffing levels and actions to take if there are not enough midwives to meet the needs of women and babies in the service. Who is it for? Midwives and other healthcare professionals Hospital managers and service managers Heads and directors of nursing and midwifery Commissioners, trust boards and policy decision-makers Women and babies who use maternity services Other national documents There are other national

2015 National Institute for Health and Clinical Excellence - Clinical Guidelines

130. Intrapartum care for healthy women and babies

1.16 Care of the woman after birth 74 Putting this guideline into practice 80 Context 82 More information 83 Recommendations for research 84 1 Models of midwifery-led care 84 2 Effect of information giving on place of birth 84 3 Long-term consequences of planning birth in different settings 85 4 Education about the latent first stage of labour 85 5 Postpartum haemorrhage 86 Appendix A: Adverse outcomes 87 Intrapartum care for healthy women and babies (CG190) © NICE 2019. All rights reserved (...) %) 585 (13.3%) Meconium staining 432 (12.2%) 301 (12.2%) 538 (12.2%) Retained placenta 250 (7.0%) 179 (7.3%) 203 (4.6%) Repair of perineal trauma 386 (10.9%) 184 (7.5%) 369 (8.4%) Neonatal concerns (postpartum) 180 (5.1%) 63 (2.6%) 5 (0.0%) Other 711 (20.1%) 396 (16.2%) 676 (16.3%) * Main reason for transfer to an obstetric unit for each woman (there may be more than 1 reason). 1.1.8 If further discussion is wanted by either the midwife or the woman about the choice of planned place of birth, arrange

2014 National Institute for Health and Clinical Excellence - Clinical Guidelines

131. The Association of Coloproctology of Great Britain and Ireland Consensus Guidelines in Surgery for Inflammatory Bowel Disease

friends and colleagues. Copy URL Share a link - there are areas of practice that are not covered in detail. The British Society of Gastroenterology (BSG) have taken the view that there should be an expanded and updated version of the guidelines for medical management that is particularly relevant to a UK audience. These BSG guidelines will have some input from the surgical community but there was an opportunity to expand the surgical component. The Inflammatory Bowel Disease (IBD) Clinical Advisory (...) Group of the Association of Coloproctology of Great Britain and Ireland (ACPGBI) have therefore commissioned a set of guidelines focusing specifically on surgery for adults and adolescents with IBD. The guidelines are procedure‐based and are intended to dovetail with the BSG's comprehensive medically focused guidelines. The primary objective here is to provide detailed evidence‐based guidelines on the surgical management of IBD for the target audience of colorectal surgeons practising in Great

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2018 Association of Coloproctology of Great Britain and Ireland

132. Better Mental Health for All: A Public Health Approach to Mental Health Improvement

and the three shortlisted award entries from Torbay, Motherwell and Somerset who agreed to be interviewed on film about their work. Liz Skinner project managed the delivery of this report. Professor Simon Capewell (FPH’s Vice President for Policy), Professor Chris Packham (Chair of FPH’s Health Services Committee) and members of the FPH’s Health Policy and Advocacy Committee acted as reviewers and suggested additional content. Suggested Citation Better Mental Health for All: A Public Health Approach (...) and less therapeutic and more custodial institutions. It was against this background that the therapeutic optimism of the post Second World War, twenty first century phase began, following the discovery of antidepressants and major tranquillisers which revolutionised the management of the major psychoses. However, this was oversold and the resources for proper community care were never forthcoming. We have witnessed a mental health service in increasing disarray, unable to deliver for children

2016 Faculty of Public Health

133. 10 priorities for integrating physical and mental health

and five times more unplanned inpatient admissions than a matched control group drawn from the general population. Eighty per cent of these admissions were for physical rather than mental health problems. While this cannot be attributed to shortcomings in primary care exclusively, effective primary care will be critical in addressing these inequalities. What would a more integrated approach look like? Responsibility for monitoring and managing the physical health of people with severe mental illnesses (...) as a predictive factor for longer hospital stays and higher institutionalisation rates. Patients with dementia often experience delays in discharge, even when there is no substantive medical reason for delay. There is evidence linking untreated or under-treated mental health problems among general hospital inpatients to higher rates of re-attendance at A&E after discharge. Self-harm accounts for more than 150,000 A&E attendances per year in England and can require significant staff time to manage. What would

2016 The King's Fund

134. Expert Opinion on neuraminidase inhibitors for prevention and treatment of influenza (Feb 2016)

all ILI cases, including cases not confirmed in laboratory. Intention to treat - infected Analysis of only laboratory -confirmed, influenza-infected participants of influenza trials. Isolation The separation of infected persons to prevent transmission to susceptible ones. Isolation refers to separation of ill persons; quarantine refers to separation of potentially exposed but well persons. Long-term care facility Health care facility for inpatients that require a long term stay. Morbidity Disease

2016 European Centre for Disease Prevention and Control - Expert Opinion

135. Guideline supplement: Hypertensive disorders of pregnancy

practice management during pregnancy, labour and postpartum 2.3 Clinical questions The following clinical questions were generated to inform the guideline scope and purpose: • How is hypertension in pregnancy classified and described? • How is preeclampsia diagnosed? • What measures reduce risks of HDP or limit disease progression (if any)? • What is considered best practice management with regard to: o Initial investigations o Target BP o Antihypertensive therapy o Model of care o Antenatal (...) surveillance • What is best practice management with regard to planning birth and intrapartum and postpartum care? • What are the longer term consequences of HDP? 2.4 Exclusions The following exclusions were identified in the guideline scope: • Management of anaesthesia • Routine antenatal, intrapartum and postpartum care Queensland Clinical Guideline Supplement: Hypertensive disorders of pregnancy Refer to online version, destroy printed copies after use Page 5 of 13 2.5 Search strategy A search

2016 Queensland Health

136. Maternity shared care

into account individual circumstances, may be appropriate. This document does not address all elements of standard practice and accepts that individual clinicians are responsible for: • Providing care within the context of locally available resources, expertise, and scope of practice • Supporting consumer rights and informed decision making in partnership with healthcare practitioners, including the right to decline intervention or ongoing management • Advising consumers of their choices in an environment (...) /teleconference if necessary) • Document inpatient care provided during the antenatal, intrapartum and postnatal period Labour and birth • Care of the woman and baby during labour and birth • The PMC may or may not be involved Discharge summary • Provide a discharge summary to the PMC preferably within 5 days of birth to enable prompt and appropriate follow up (and to the GP if the GP is not the PMC) and where appropriate, the community child health service • Offer a copy of the PHR and the discharge summary

2016 Queensland Health

137. Perinatal substance use: maternal

assessment • Consider anaesthetic review in third trimester to discuss: o Optimum modes of analgesia for labour, birth and postpartum o Venous access • Potential crisis situations 34 Late presentations 34 • Women presenting for the first time in third trimester or labour are at increased risk of pregnancy complications due to inadequate antenatal care • Preferred management: o Admit to hospital (regardless of drugs used) o Undertake comprehensive assessment including history of drug and alcohol use o (...) from the guideline, taking into account individual circumstances may be appropriate. This guideline does not address all elements of standard practice and accepts that individual clinicians are responsible for: • Providing care within the context of locally available resources, expertise, and scope of practice • Supporting consumer rights and informed decision making in partnership with healthcare practitioners including the right to decline intervention or ongoing management • Advising consumers

2016 Queensland Health

138. Hypertensive disorders of pregnancy

risk factor for venous thromboembolism (VTE) occurring in pregnancy or the puerperium 1 • Refer to the Queensland Clinical Guideline VTE prophylaxis in pregnancy and the puerperium 27 Fluid management • Administration of large volumes of intravenous fluids before or after birth may cause pulmonary oedema or worsen peripheral oedema 1 • In the immediate postpartum period, oliguria is common and physiological and does not require fluid therapy unless the serum plasma creatinine is rising • Strict (...) be appropriate. This guideline does not address all elements of standard practice and accepts that individual clinicians are responsible for: • Providing care within the context of locally available resources, expertise, and scope of practice • Supporting consumer rights and informed decision making in partnership with healthcare practitioners including the right to decline intervention or ongoing management • Advising consumers of their choices in an environment that is culturally appropriate and which

2016 Queensland Health

139. Diagnosis of Right Lower Quadrant Pain and Suspected Acute Appendicitis

must disclose any financial conflicts of interest greater than $10,000 and any other relevant business or professional conflicts of interest. Because of their role as end-users, individuals with potential conflicts may be retained. The TOO and the EPC work to balance, manage, or mitigate any conflicts of interest. The list of Key Informants who provided input to this report follows: Anthony Chow, M.D. Division of Infectious Diseases University of British Columbia Vancouver Hospital Vancouver, BC (...) business or professional conflicts of interest. Because of their unique clinical or content expertise, individuals with potential conflicts may be retained. The TOO and the EPC work to balance, manage, or mitigate any potential conflicts of interest identified. The list of Technical Experts who provided input to this report follows: Anthony Chow, M.D. Division of Infectious Diseases University of British Columbia Vancouver Hospital Vancouver, BC, Canada Tyler Hughes, M.D. McPherson Hospital McPherson

2016 Effective Health Care Program (AHRQ)

140. Collaboration in Practice: Implementing Team-Based Care

Medicare beneficiary visits two primary care providers and five specialists per year, as well as health care providers of diagnostic, pharmacy, and other services. This figure is several times larger for x Introduction people with multiple chronic conditions (4). In order to manage large amounts of information and multiple handoffs, seamless communication and transitions among health care providers (within a team or among teams) are required to support wellness and care for patients with complex health (...) to function to the full extent of their education, certification, and experience. In order to manage large amounts of information and multiple handoffs, seamless communication and transitions among health care providers (within a team or among teams) are required to support wellness and to care for patients with complex health conditions. These transitions require a shift to interprofessional collaboration that entail a necessary evolution away from single-provider care to a team-based approach, which

2016 American College of Obstetricians and Gynecologists

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