2020 Articles
Using Qualitative Methods to Explore Communication Practices in the Context of Patient Care Rounds on General Care Units
J Gen Intern Med
Poor communication between physicians and nurses is a significant contributor to adverse events for hospitalized patients. Overcoming communication difficulties requires examining communication practices to better understand some of the factors that affect the nurse-physician communication process...
Poor communication between physicians and nurses is a significant contributor to adverse events for hospitalized patients. Overcoming communication difficulties requires examining communication practices to better understand some of the factors that affect the nurse-physician communication process...
Identifying biopsychosocial factors that impact decompressive laminectomy outcomes in veterans with lumbar spinal stenosis: a prospective cohort study
Pain
One in three patients with lumbar spinal stenosis (LSS) undergoing decompressive laminectomy (DL) to alleviate neurogenic claudication do not experience substantial improvement. This prospective cohort study conducted in 193 Veterans aimed to identify key spinal and extra-spinal factors that may contribute to a favorable DL outcome. Biopsychosocial factors evaluated pre-DL and...
One in three patients with lumbar spinal stenosis (LSS) undergoing decompressive laminectomy (DL) to alleviate neurogenic claudication do not experience substantial improvement. This prospective cohort study conducted in 193 Veterans aimed to identify key spinal and extra-spinal factors that may contribute to a favorable DL outcome. Biopsychosocial factors evaluated pre-DL and...
Empiric Antibacterial Therapy and Community-onset Bacterial Co-infection in Patients Hospitalized with COVID-19: A Multi-Hospital Cohort Study
Clin Infect Dis
Antibacterials may be initiated out of concern for bacterial co-infection in patients with COVID-19. We determined prevalence and predictors of empiric antibacterial therapy and community-onset bacterial co-infections in hospitalized patients with COVID-19. Randomly sampled cohort of 1705 patients hospitalized with COVID-19 in 38 Michigan hospitals between 3/13/2020-6/18/2020.
Antibacterials may be initiated out of concern for bacterial co-infection in patients with COVID-19. We determined prevalence and predictors of empiric antibacterial therapy and community-onset bacterial co-infections in hospitalized patients with COVID-19. Randomly sampled cohort of 1705 patients hospitalized with COVID-19 in 38 Michigan hospitals between 3/13/2020-6/18/2020.
An Implementation Framework for the Clinically Indicated Removal Policy for Peripheral Intravenous Catheters
J Nurs Care Qual
Equivalent clinical outcomes, lower costs, and fewer invasive procedures have resulted in revised recommendations for the removal of peripheral intravenous catheters (PIVCs) from the traditional 72- to 96-hourly removal to removal based upon clinical indication. Uptake of this evidence-based innovation to health systems is often delayed, in part due to the lack of a guiding framework for...
Equivalent clinical outcomes, lower costs, and fewer invasive procedures have resulted in revised recommendations for the removal of peripheral intravenous catheters (PIVCs) from the traditional 72- to 96-hourly removal to removal based upon clinical indication. Uptake of this evidence-based innovation to health systems is often delayed, in part due to the lack of a guiding framework for...
Designed to Fail? the Future of Primary Care
J Gen Intern Med
Primary care is widely viewed as being in crisis despite its purported central role in addressing population issues related to healthcare cost, quality, access, and equity. Despite this pivotal role, the nature of the clinical practice today has largely emerged by default. We review the evolution of clinical practice in primary care from its genesis in small practices with paper charts and telephonic patient...
Primary care is widely viewed as being in crisis despite its purported central role in addressing population issues related to healthcare cost, quality, access, and equity. Despite this pivotal role, the nature of the clinical practice today has largely emerged by default. We review the evolution of clinical practice in primary care from its genesis in small practices with paper charts and telephonic patient...
Strategies of Female Teaching Attending Physicians to Navigate Gender-Based Challenges: An Exploratory Qualitative Study
J Hosp Med
Women in medicine experience discrimination, hostility, and unconscious bias frequently and with deleterious effects. While these gender-based challenges are well described, strategies to navigate and respond to them are less understood. This paper sought to explore the lived experiences of female teaching attending physicians emphasizing strategies they use to mitigate...
Women in medicine experience discrimination, hostility, and unconscious bias frequently and with deleterious effects. While these gender-based challenges are well described, strategies to navigate and respond to them are less understood. This paper sought to explore the lived experiences of female teaching attending physicians emphasizing strategies they use to mitigate...
Peripherally Inserted Central Catheter Thrombosis Following Placement via Electrocardiography vs. Traditional Methods: An Analysis of 42,687 Patients
Am J Med
Peripherally inserted central catheter tip placement at the cavoatrial junction is associated with reduced catheter-related deep vein thrombosis . Electrocardiographic tip confirmation purportedly improves accuracy of tip placement, but whether this approach can reduce deep vein thrombosis is unknown.
Peripherally inserted central catheter tip placement at the cavoatrial junction is associated with reduced catheter-related deep vein thrombosis . Electrocardiographic tip confirmation purportedly improves accuracy of tip placement, but whether this approach can reduce deep vein thrombosis is unknown.
Compassionate Communication Amid the COVID-19 Pandemic
J Hosp Med
The coronavirus disease of 2019 (COVID-19) pandemic is the health crisis of our generation and will inevitably leave a lasting mark on how we practice medicine. It has already rapidly changed the way we communicate with patients, families, and colleagues. From the explosion of virtual care—which has been accelerated by need and new reimbursement policies3—to the physical barriers...
The coronavirus disease of 2019 (COVID-19) pandemic is the health crisis of our generation and will inevitably leave a lasting mark on how we practice medicine. It has already rapidly changed the way we communicate with patients, families, and colleagues. From the explosion of virtual care—which has been accelerated by need and new reimbursement policies3—to the physical barriers...
Targeting Zero Harm: A Stretch Goal That Risks Breaking the Spring
NEJM Catalyst
Despite the well-intentioned aim of eliminating all patient harm, achieving 100% success is literally impossible and in fact creates other types of harm.
Despite the well-intentioned aim of eliminating all patient harm, achieving 100% success is literally impossible and in fact creates other types of harm.
The Michigan Appropriateness Guide for Intravenous Catheters in Pediatrics: miniMAGIC
Pediatrics
Vascular access device decision-making for pediatric patients remains a complex, highly variable process. To date, evidence-based criteria to inform these choices do not exist. The objective of the Michigan Appropriateness Guide for Intravenous Catheters in pediatrics (miniMAGIC) was to provide guidance on device selection, device characteristics, and insertion technique for clinicians...
Vascular access device decision-making for pediatric patients remains a complex, highly variable process. To date, evidence-based criteria to inform these choices do not exist. The objective of the Michigan Appropriateness Guide for Intravenous Catheters in pediatrics (miniMAGIC) was to provide guidance on device selection, device characteristics, and insertion technique for clinicians...
Developing Appropriateness Criteria for Pediatric Vascular Access
Pediatrics
To describe the methodology undertaken to provide guidance on the appropriateness, as well as inappropriateness, of vascular access device selection, characteristics, and insertion technique for pediatric patients.
To describe the methodology undertaken to provide guidance on the appropriateness, as well as inappropriateness, of vascular access device selection, characteristics, and insertion technique for pediatric patients.
Selection and Insertion of Vascular Access Devices in Pediatrics: A Systematic Review
Pediatrics
To critically review the evidence for the selection and insertion of pediatric vascular access devices (VADs).
To critically review the evidence for the selection and insertion of pediatric vascular access devices (VADs).
Developing Pediatric Appropriateness Criteria for Intravenous Catheters
Pediatrics
Consider this scenario: an 8-month-old infant with osteomyelitis needs intravenous (IV) access for 3 weeks of antibiotics; what device will best ensure successful therapy and low risk of complications? Or consider this: a teenager with cystic fibrosis is hospitalized for the third time this year with an acute exacerbation. Despite multiple efforts by experienced clinicians, an IV catheter cannot be...
Consider this scenario: an 8-month-old infant with osteomyelitis needs intravenous (IV) access for 3 weeks of antibiotics; what device will best ensure successful therapy and low risk of complications? Or consider this: a teenager with cystic fibrosis is hospitalized for the third time this year with an acute exacerbation. Despite multiple efforts by experienced clinicians, an IV catheter cannot be...
Quality & safety in the literature: July 2020
Assessment of race and sex as risk factors for colonization with multidrug-resistant organisms in six nursing homes
Infect Control Hosp Epidemiol
The role of demographic characteristics, such as sex and race, as risk factors for colonization with multidrug-resistant organisms, has not been established in the nursing home setting. We demonstrate significantly higher prevalence overall in male patients, and sex differences are dependent on organism of interest and body site.
The role of demographic characteristics, such as sex and race, as risk factors for colonization with multidrug-resistant organisms, has not been established in the nursing home setting. We demonstrate significantly higher prevalence overall in male patients, and sex differences are dependent on organism of interest and body site.
Annals for Hospitalists - 16 June 2020
Transforming use of two catheters: from accessory to hazard
Lancet Infect Dis
In The Lancet Infectious Diseases, Bart J Laan and colleagues examined the effect of a tailored multifaceted intervention in medical wards in seven hospitals in the Netherlands that focused on reducing inappropriate use of two of the most commonly used medical technologies worldwide: short peripheral intravenous catheters and urinary catheters. These catheters are often inserted...
In The Lancet Infectious Diseases, Bart J Laan and colleagues examined the effect of a tailored multifaceted intervention in medical wards in seven hospitals in the Netherlands that focused on reducing inappropriate use of two of the most commonly used medical technologies worldwide: short peripheral intravenous catheters and urinary catheters. These catheters are often inserted...
Use of and Patient-Reported Complications Related to Midline Catheters and Peripherally Inserted Central Catheters
Infect Control Hosp Epidemiol
We conducted a prospective observational study of indications for use and patient experiences with midline catheters (n = 50) compared to peripherally inserted central catheters (n = 63). The primary indication for patients with midline catheters was difficult venous access. Patients with midline catheters reported fewer complications than patients with peripherally inserted central...
We conducted a prospective observational study of indications for use and patient experiences with midline catheters (n = 50) compared to peripherally inserted central catheters (n = 63). The primary indication for patients with midline catheters was difficult venous access. Patients with midline catheters reported fewer complications than patients with peripherally inserted central...
Catheter-Associated Urinary Tract Infection, Clostridioides difficile Colitis, Central Line-Associated Bloodstream Infection, and Methicillin-Resistant Staphylococcus aureus
Med Clin North Am
Hospital-acquired infections increase cost, morbidity, and mortality for patients across the United States and the world. Principal among these infections are central line-associated bloodstream infection, catheter-associated urinary tract infection, Clostridioides difficile, and methicillin-resistant Staphylococcus aureus colonization and infections. This article provides succinct summaries...
Hospital-acquired infections increase cost, morbidity, and mortality for patients across the United States and the world. Principal among these infections are central line-associated bloodstream infection, catheter-associated urinary tract infection, Clostridioides difficile, and methicillin-resistant Staphylococcus aureus colonization and infections. This article provides succinct summaries...
A comparison of international prenatal care guidelines for low-risk women to inform high-value care
Am J Obstet Gynecol
In response to worsening maternal-infant outcomes in the United States (U.S.), key policymakers have called for maternity care reform, including changes to prenatal care.1 However, there is limited evidence linking outcomes to specific aspects of prenatal care, including prenatal education (ie, anticipatory guidance about pregnancy, delivery, and the postpartum period), support services...
In response to worsening maternal-infant outcomes in the United States (U.S.), key policymakers have called for maternity care reform, including changes to prenatal care.1 However, there is limited evidence linking outcomes to specific aspects of prenatal care, including prenatal education (ie, anticipatory guidance about pregnancy, delivery, and the postpartum period), support services...
Improving Hand Hygiene Adherence in Healthcare Workers Before Patient Contact: A Multimodal Intervention in Four Tertiary Care Hospitals in Japan
J Hosp Med
Hand hygiene is key to preventing healthcare-associated infection and the spread of respiratory viruses like the novel coronavirus that causes COVID-19. Unfortunately, hand hygiene adherence of healthcare workers (HCWs) in Japan is suboptimal according to previous studies.
Hand hygiene is key to preventing healthcare-associated infection and the spread of respiratory viruses like the novel coronavirus that causes COVID-19. Unfortunately, hand hygiene adherence of healthcare workers (HCWs) in Japan is suboptimal according to previous studies.
The Relationship of Loneliness to End-of-Life Experience in Older Americans: A Cohort Study
J AM Geriatr Soc
Little is known about the relationship between loneliness and end‐of‐life (EOL) experience including symptom burden, intensity of care, and advance care planning among older adults.
Little is known about the relationship between loneliness and end‐of‐life (EOL) experience including symptom burden, intensity of care, and advance care planning among older adults.
Is It Time to More Fully Address Teaching Religion and Spirituality in Medicine?
Ann Intern Med
About a century ago, Sir William Osler, one of the most distinguished physicians of the day, observed that “Nothing in life is more wonderful than faith…. Faith has always been an essential factor in the practice of medicine” (1). Doctors and patients shared this belief in faith, and much more...
About a century ago, Sir William Osler, one of the most distinguished physicians of the day, observed that “Nothing in life is more wonderful than faith…. Faith has always been an essential factor in the practice of medicine” (1). Doctors and patients shared this belief in faith, and much more...
Nurse staffing and healthcare-associated infections in a national healthcare system that implemented a nurse staffing directive: Multi-level interrupted time series analyses
Int J Nurs Stud
Background: In 2010, the Veterans Health Administration Office of Nursing Services (VHA ONS) issued a Staffing Methodology (SM) Directive, standardizing the method of determining appropriate nurse staffing for VHA facilities. Objectives: To assess associations between the Directive, nurse staffing trends, and healthcare-associated infections.
Background: In 2010, the Veterans Health Administration Office of Nursing Services (VHA ONS) issued a Staffing Methodology (SM) Directive, standardizing the method of determining appropriate nurse staffing for VHA facilities. Objectives: To assess associations between the Directive, nurse staffing trends, and healthcare-associated infections.
Patient Preferences for Physician Attire: A Multicenter Study in Japan
J Hosp Med
Previous studies have shown that patients have specific expectations regarding physician dress. Japan has a cultural background that is in many ways distinct from western countries. Thus, physician attire may have a different impact in Japan.
Previous studies have shown that patients have specific expectations regarding physician dress. Japan has a cultural background that is in many ways distinct from western countries. Thus, physician attire may have a different impact in Japan.
Mentoring Millennials
JAMA
The surgical case was straightforward: a young man had experienced a radial nerve injury from a broken humerus, now without neurological recovery. Tendon transfers to restore wrist and finger extension were planned. The surgeon, resident, and medical student approached the scrub sink together to review major teaching points, potential pitfalls, and contingency plans in case...
The surgical case was straightforward: a young man had experienced a radial nerve injury from a broken humerus, now without neurological recovery. Tendon transfers to restore wrist and finger extension were planned. The surgeon, resident, and medical student approached the scrub sink together to review major teaching points, potential pitfalls, and contingency plans in case...
A Jaw-Dropping Diagnosis
J Hosp Med
Clinical Care Conundrum. A 73-year-old man presented to primary care for an annual examination. Four days prior, he noted right-sided sharp jaw pain such that he could not open his mouth nor chew solid food; it radiated from the right mandible to the ipsilateral temple. He also noted bilateral aching hip pain for several years that increased in severity in the prior 2 months. He reported...
Clinical Care Conundrum. A 73-year-old man presented to primary care for an annual examination. Four days prior, he noted right-sided sharp jaw pain such that he could not open his mouth nor chew solid food; it radiated from the right mandible to the ipsilateral temple. He also noted bilateral aching hip pain for several years that increased in severity in the prior 2 months. He reported...
Five Questions Every Mentee Should Have an Answer To
J Hosp Med
When we began forming a mentor-mentee relationship in academic medicine a decade ago, it became clear that both structure and expertise was necessary for success. Structure—in the form of expectations that outlined who was responsible for what, how often we should meet, and how best to communicate—made explicit that which is usually implicit...
When we began forming a mentor-mentee relationship in academic medicine a decade ago, it became clear that both structure and expertise was necessary for success. Structure—in the form of expectations that outlined who was responsible for what, how often we should meet, and how best to communicate—made explicit that which is usually implicit...
Preventing healthcare-associated infection in Switzerland: Results of a national survey
Infect Control Hosp Epidemiol
We assessed infection prevention in Swiss hospitals via a national survey focusing on infection prevention practices prior to a large national infection prevention initiative. Of the 59 hospitals that responded (77%), 98% had infection prevention teams and 40% very good or excellent leadership support. However, a minority of hospitals used recommended infection prevention practices...
We assessed infection prevention in Swiss hospitals via a national survey focusing on infection prevention practices prior to a large national infection prevention initiative. Of the 59 hospitals that responded (77%), 98% had infection prevention teams and 40% very good or excellent leadership support. However, a minority of hospitals used recommended infection prevention practices...
Making MAGIC: how to improve the use of peripherally inserted central catheters
BMJ Qual Saf
At this very moment, somewhere in the world, an intravenous catheter is being placed in a hospitalised patient.
At this very moment, somewhere in the world, an intravenous catheter is being placed in a hospitalised patient.
Physicians' Perceptions of Proton Pump Inhibitor Risks and Recommendations to Discontinue: A National Survey
Am J Gastroenterol
Objective: To provide contemporary estimates of internists' perceptions of adverse effects associated with proton pump inhibitors (PPIs) and self-reported clinical use.
Objective: To provide contemporary estimates of internists' perceptions of adverse effects associated with proton pump inhibitors (PPIs) and self-reported clinical use.
How Should U.S. Hospitals Prepare for Coronavirus Disease 2019 (COVID-19)?
Ann Intern Med
Coronavirus disease 2019 (COVID-19) is on the verge of being declared a pandemic. As of 7 March 2020, a total of 423 cases and 19 deaths, including several non–travel-related cases, areas of sustained community transmission, and a nursing home outbreak, have been reported. Best-case estimates suggest that COVID-19 will stress bed capacity, equipment, and health care personnel in U.S. hospitals in ways not previously experienced.
Coronavirus disease 2019 (COVID-19) is on the verge of being declared a pandemic. As of 7 March 2020, a total of 423 cases and 19 deaths, including several non–travel-related cases, areas of sustained community transmission, and a nursing home outbreak, have been reported. Best-case estimates suggest that COVID-19 will stress bed capacity, equipment, and health care personnel in U.S. hospitals in ways not previously experienced.
Stopping the spread of COVID-19
JAMA
What Is COVID-19? COVID-19 is a respiratory infection caused by the virus SARS-CoV-2, which was recently discovered after an outbreak began in Wuhan, China, in December 2019. SARS-CoV-2 is a type of coronavirus, which is a large family of viruses that cause illnesses ranging from the common cold to more severe infections in humans.
What Is COVID-19? COVID-19 is a respiratory infection caused by the virus SARS-CoV-2, which was recently discovered after an outbreak began in Wuhan, China, in December 2019. SARS-CoV-2 is a type of coronavirus, which is a large family of viruses that cause illnesses ranging from the common cold to more severe infections in humans.
Facilitators and Barriers to Recruiting Ambulatory Oncology Practices Into a Large Multisite Study: Mixed Methods Study
JMIR Cancer
Practice-based research is essential to generate the data necessary to understand outcomes in ambulatory oncology care. Although there is an increased interest in studying ambulatory oncology care, given the rising patient volumes and complexity in those settings, little guidance is available on how best to recruit ambulatory oncology practices for research.
Practice-based research is essential to generate the data necessary to understand outcomes in ambulatory oncology care. Although there is an increased interest in studying ambulatory oncology care, given the rising patient volumes and complexity in those settings, little guidance is available on how best to recruit ambulatory oncology practices for research.
Condom Catheters versus Indwelling Urethral Catheters in Men: A Prospective, Observational Study
J Hosp Med
To assess complications of condom catheters compared with indwelling urethral catheters, we conducted a prospective cohort study in two Veterans Affairs hospitals. Male patients who used a condom catheter or indwelling urethral catheter during their hospital stay were followed for one month by interview and medical record review. Participants included 36 men who used condom catheters...
To assess complications of condom catheters compared with indwelling urethral catheters, we conducted a prospective cohort study in two Veterans Affairs hospitals. Male patients who used a condom catheter or indwelling urethral catheter during their hospital stay were followed for one month by interview and medical record review. Participants included 36 men who used condom catheters...
Contamination of Common Area and Rehabilitation Gym Environment with Multidrug‐Resistant Organisms
J Am Geriatr Soc
Objectives: To quantify the multidrug‐resistant organism (MDRO) burden of high‐touch common area and rehabilitation gym surfaces, and to assess microorganism transfer potential during rehabilitation sessions. Design: Prospective study of environmental contamination.
Objectives: To quantify the multidrug‐resistant organism (MDRO) burden of high‐touch common area and rehabilitation gym surfaces, and to assess microorganism transfer potential during rehabilitation sessions. Design: Prospective study of environmental contamination.
Inpatient and Discharge Fluoroquinolone Prescribing in Veteran's Affairs HospitalsBetween 2014 and 2017
Open Forum Infect Dis
Between 2007 and 2015, inpatient fluoroquinolone use declined in US Veterans Affairs (VA) hospitals. Whether fluoroquinolone use at discharge also declined, in particular since antibiotic stewardship programs became mandated at VA hospitals in 2014, is unknown.
Between 2007 and 2015, inpatient fluoroquinolone use declined in US Veterans Affairs (VA) hospitals. Whether fluoroquinolone use at discharge also declined, in particular since antibiotic stewardship programs became mandated at VA hospitals in 2014, is unknown.
Multistate programme to reduce catheter-associated infections in intensive care units with elevated infection rates
BMJ Qual Saf
Preventing central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) remains challenging in intensive care units (ICUs). The Agency for Healthcare Research and Quality Safety Program for ICUs aimed to reduce CLABSI and CAUTI in units with elevated rates.
Preventing central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) remains challenging in intensive care units (ICUs). The Agency for Healthcare Research and Quality Safety Program for ICUs aimed to reduce CLABSI and CAUTI in units with elevated rates.
Leadership & Professional Development: Make a Friend Before You Need One
J Hosp Med
To succeed in a hospital, leaders need a generous supply of social and political capital. House officers learn this very quickly, especially when they are relying on other members of the healthcare team to obtain tests and studies for their patients and calling for specialty consultations. To be successful and efficient, building relationships and trust is key. Such capital, unfortunately, takes time to develop.
To succeed in a hospital, leaders need a generous supply of social and political capital. House officers learn this very quickly, especially when they are relying on other members of the healthcare team to obtain tests and studies for their patients and calling for specialty consultations. To be successful and efficient, building relationships and trust is key. Such capital, unfortunately, takes time to develop.
Annals for Hospitalists - 19 May 2020
Mindful Mentorship
Healthcare
Mentorship – a dynamic relationship between a protégé and an incumbent aimed at the reciprocal development of both – is foundational to academic success. Although mentors play varying roles in the evolution of mentees, some have greater impact and influence than others. What distinguishes these “uber” mentors from their counterparts?
Mentorship – a dynamic relationship between a protégé and an incumbent aimed at the reciprocal development of both – is foundational to academic success. Although mentors play varying roles in the evolution of mentees, some have greater impact and influence than others. What distinguishes these “uber” mentors from their counterparts?
Antibiotic Stewardship Teams and Clostridioides difficile Practices in United States Hospitals: A National Survey in The Joint Commission Antibiotic Stewardship Standard Era
Infect Control Hosp Epidemiol
Clostridioides difficile infection (CDI) can be prevented through infection prevention practices and antibiotic stewardship. Diagnostic stewardship (ie, strategies to improve use of microbiological testing) can also improve antibiotic use. However, little is known about the use of such practices in US hospitals, especially after multidisciplinary stewardship programs became a requirement for US...
Clostridioides difficile infection (CDI) can be prevented through infection prevention practices and antibiotic stewardship. Diagnostic stewardship (ie, strategies to improve use of microbiological testing) can also improve antibiotic use. However, little is known about the use of such practices in US hospitals, especially after multidisciplinary stewardship programs became a requirement for US...
Trends in Health Care-Associated Infection Prevention Practices in US Veterans Affairs Hospitals From 2005 to 2017
JAMA Net Open
Health care-associated infection (HAI) is associated with substantial harm. To reduce HAI, the largest integrated health care system in the United States-the Veterans Health Administration-was an early adopter of infection prevention policies and initiatives. Whether these efforts translated into increased use of practices to prevent HAI in Veterans Affairs (VA) hospitals is unknown.
Health care-associated infection (HAI) is associated with substantial harm. To reduce HAI, the largest integrated health care system in the United States-the Veterans Health Administration-was an early adopter of infection prevention policies and initiatives. Whether these efforts translated into increased use of practices to prevent HAI in Veterans Affairs (VA) hospitals is unknown.
Cramping, crashing, cannulating, and clotting: a qualitative study of patients’ definitions of a “bad run” on hemodialysis
BMC Nephrol
Hemodialysis sessions frequently become unstable from complications such as intradialytic hypotension and untoward symptoms. Previous patient safety initiatives promote prevention of treatment complications; yet, they have placed little specific focus on avoidable session instability. A patient-centered definition of session instability grounded in patient experiences, and an...
Hemodialysis sessions frequently become unstable from complications such as intradialytic hypotension and untoward symptoms. Previous patient safety initiatives promote prevention of treatment complications; yet, they have placed little specific focus on avoidable session instability. A patient-centered definition of session instability grounded in patient experiences, and an...
Epidemiology of Vancomycin-Resistant Enterococcus faecium and Enterococcus faecalis Colonization in Nursing Facilities
Open Forum Infect Dis
Vancomycin-resistant Enterococcus faecium and Enterococcus faecalis frequently colonize nursing facility (NF) residents, creating opportunities for vancomycin-resistant Enterococcus (VRE) transmission and dissemination of mobile genetic elements conferring antimicrobial resistance. Most VRE studies do not speciate; our study addresses this lack and compares the epidemiology of...
Vancomycin-resistant Enterococcus faecium and Enterococcus faecalis frequently colonize nursing facility (NF) residents, creating opportunities for vancomycin-resistant Enterococcus (VRE) transmission and dissemination of mobile genetic elements conferring antimicrobial resistance. Most VRE studies do not speciate; our study addresses this lack and compares the epidemiology of...
Several Roads Lead to Rome: Operationalizing Antibiotic Stewardship Programs in Nursing Homes
J Am Geriatr Soc
Despite being primarily known for his poetry, Geoffrey Chaucer also composed and compiled the Treatise on the Astrolabe, which is believed to be the oldest known technical manual in the English language. An astrolabe was a medieval instrument primarily used by astronomers to estimate the altitude of celestial bodies.
Despite being primarily known for his poetry, Geoffrey Chaucer also composed and compiled the Treatise on the Astrolabe, which is believed to be the oldest known technical manual in the English language. An astrolabe was a medieval instrument primarily used by astronomers to estimate the altitude of celestial bodies.
Changes in US Nursing Home Infection Prevention and Control Programs From 2014 to 2018
J Am Med Dir Assoc
Burgeoning rates of antibiotic resistance have resulted in a shift in national focus to improve infection prevention and control programs in US nursing homes (NHs). We sought to evaluate the changes in nursing home infection prevention and control programs over time.
Burgeoning rates of antibiotic resistance have resulted in a shift in national focus to improve infection prevention and control programs in US nursing homes (NHs). We sought to evaluate the changes in nursing home infection prevention and control programs over time.
The I-DECIDED clinical decision-making tool for peripheral intravenous catheter assessment and safe removal: a clinimetric evaluation
BMJ Open
Objective: To describe the clinimetric validation of the I-DECIDED tool for peripheral intravenous catheter assessment and decision-making. Design and setting: I-DECIDED is an eight-step tool derived from international vascular access guidelines into a structured mnemonic for device assessment and decision-making. The clinimetric evaluation process was conducted in three distinct phases.
Objective: To describe the clinimetric validation of the I-DECIDED tool for peripheral intravenous catheter assessment and decision-making. Design and setting: I-DECIDED is an eight-step tool derived from international vascular access guidelines into a structured mnemonic for device assessment and decision-making. The clinimetric evaluation process was conducted in three distinct phases.
A Process for Assessing Products for Infection Prevention in Health Care Settings: A Framework From the Healthcare Infection Control Practices Advisory Committee of the Centers for Disease Control and Prevention
Ann Intern Med
Infection control is a complex task that spans people, products, and practices in diverse settings. For years, the Healthcare Infection Control Practices Advisory Committee (HICPAC) has provided advice and guidance to the Centers for Disease Control and Prevention (CDC) on how best to prevent infections. These recommendations have focused largely on health care delivery practices...
Infection control is a complex task that spans people, products, and practices in diverse settings. For years, the Healthcare Infection Control Practices Advisory Committee (HICPAC) has provided advice and guidance to the Centers for Disease Control and Prevention (CDC) on how best to prevent infections. These recommendations have focused largely on health care delivery practices...
Infection Prevention Practices in the Netherlands: Results From a National Survey
Antimicrob Resist Infect Control
To examine the extent to which acute care hospitals in the Netherlands have adopted recommended practices to prevent catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP), and Clostridioides difficile infection (CDI).
To examine the extent to which acute care hospitals in the Netherlands have adopted recommended practices to prevent catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP), and Clostridioides difficile infection (CDI).
A Deeper Dive into Antibiotic Stewardship Needs: A multi-hospital survey
Open Forum Infect Dis
In a 2016 survey of 46 Michigan hospitals, we identified four key needs for antibiotic stewardship: clinically-relevant antibiotic data, monitoring compliance, syndrome-specific interventions, and discharge stewardship. A stewardship initiative now addresses these needs within the Michigan Hospital Medicine Safety Consortium.
In a 2016 survey of 46 Michigan hospitals, we identified four key needs for antibiotic stewardship: clinically-relevant antibiotic data, monitoring compliance, syndrome-specific interventions, and discharge stewardship. A stewardship initiative now addresses these needs within the Michigan Hospital Medicine Safety Consortium.
Psychological Safety and Infection Prevention Practices: Results From a National Survey
Am J Infect Control
Psychological safety is a critical factor in team learning that positively impacts patient safety. We sought to examine the influence of psychological safety on using recommended health care-associated infection (HAI) prevention practices within US hospitals.
Psychological safety is a critical factor in team learning that positively impacts patient safety. We sought to examine the influence of psychological safety on using recommended health care-associated infection (HAI) prevention practices within US hospitals.
Using Democratic Deliberation to Engage Veterans in Complex Policy Making for the Veterans Health Administration
Fed Pract
A democratic deliberation panel of veterans providing insight into veteran perspectives on resource allocation and the Veterans Choice Act showed the importance and feasibility of engaging veterans in the policy-making process.
A democratic deliberation panel of veterans providing insight into veteran perspectives on resource allocation and the Veterans Choice Act showed the importance and feasibility of engaging veterans in the policy-making process.
