2012 Articles
Peripheral venous catheter care in the emergency department: Education and feedback lead to marked improvements.
Am J Infect Control
Peripheral venous catheters (PVCs) can be associated with serious complications. We evaluated the effect of education and feedback on processes related to PVC placement.
Peripheral venous catheters (PVCs) can be associated with serious complications. We evaluated the effect of education and feedback on processes related to PVC placement.
Value-based insurance design in cardiology: using "clinical nuance" to improve quality of care and contain costs.
J Am Coll Cardiol
The past several decades have produced remarkable technological and therapeutic innovations in the prevention and treatment of cardiovascular disease, resulting in impressive reductions in cardiovascular-related morbidity and mortality.
The past several decades have produced remarkable technological and therapeutic innovations in the prevention and treatment of cardiovascular disease, resulting in impressive reductions in cardiovascular-related morbidity and mortality.
Predictors of hospital-acquired urinary tract-related bloodstream infection.
Infect Control Hosp Epid
Bloodstream infection (BSI) secondary to nosocomial urinary tract infection (UTI) is associated with substantial morbidity, mortality and additional financial costs. Our objective was to identify predictors of nosocomial urinary tract-related BSI.
Bloodstream infection (BSI) secondary to nosocomial urinary tract infection (UTI) is associated with substantial morbidity, mortality and additional financial costs. Our objective was to identify predictors of nosocomial urinary tract-related BSI.
Higher rates of Clostridium difficile infection among smokers.
PLoS ONE
Cigarette smoking has been shown to be related to inflammatory bowel disease. We investigated whether smoking affected the probability of developing Clostridium difficile infection (CDI).
Cigarette smoking has been shown to be related to inflammatory bowel disease. We investigated whether smoking affected the probability of developing Clostridium difficile infection (CDI).
Effect of non-payment for hospital-acquired catheter-associated urinary tract infection: a statewide analysis.
Ann Int Med
Most (59% to 86%) hospital-acquired urinary tract infections (UTIs) are catheter-associated urinary tract infections (CAUTIs). As of 2008, claims data are used to deny payment for certain hospital-acquired conditions, including CAUTIs, and publicly report hospital...
Most (59% to 86%) hospital-acquired urinary tract infections (UTIs) are catheter-associated urinary tract infections (CAUTIs). As of 2008, claims data are used to deny payment for certain hospital-acquired conditions, including CAUTIs, and publicly report hospital...
Clostridium difficile ribotype does not predict severe Clostridium difficile infection.
Clin Infect Dis
Studies of Clostridium difficile outbreaks suggested that certain ribotypes (eg, 027 and 078) cause more severe disease than other ribotypes. A growing number of studies challenge the validity of this hypothesis.
Studies of Clostridium difficile outbreaks suggested that certain ribotypes (eg, 027 and 078) cause more severe disease than other ribotypes. A growing number of studies challenge the validity of this hypothesis.
Blood culture contamination: a randomized trial evaluating the comparative effectiveness of three skin antiseptic interventions.
Infect Control Hosp Epid
To determine relative rates of blood culture contamination for 3 skin antisepsis interventions—10% povidone iodine aqueous solution (PI), 2% iodine tincture (IT), and 2% chlorhexidine gluconate in 70% isopropyl alcohol (CHG)—when used by dedicated phlebotomy...
To determine relative rates of blood culture contamination for 3 skin antisepsis interventions—10% povidone iodine aqueous solution (PI), 2% iodine tincture (IT), and 2% chlorhexidine gluconate in 70% isopropyl alcohol (CHG)—when used by dedicated phlebotomy...
Recipes for checklists and bundles: one part active ingredient, two parts measurement.
BMJ Qual Saf
Central venous catheter-related bloodstream infection (CVC-BSI) is common, costly and potentially fatal. For decades, conventional wisdom regarded these infections as inevitable complications of care. This view changed following landmark studies that...
Central venous catheter-related bloodstream infection (CVC-BSI) is common, costly and potentially fatal. For decades, conventional wisdom regarded these infections as inevitable complications of care. This view changed following landmark studies that...
Perceived strength of evidence supporting practices to prevent healthcare-associated infection: results from a national survey of infection prevention personnel.
Am J Infect Control
Limited data exist describing the perceived strength of evidence behind practices to prevent common health care-associated infections (HAIs). We conducted a national survey of infection prevention personnel to assess perception of the evidence for various...
Limited data exist describing the perceived strength of evidence behind practices to prevent common health care-associated infections (HAIs). We conducted a national survey of infection prevention personnel to assess perception of the evidence for various...
Comparison of four methods for deriving hospital standardised mortality ratios from a single hierarchical logistic regression model.
Stat Methods Med Res
There is interest in deriving case-mix adjusted standardised mortality ratios so that comparisons between healthcare providers, such as hospitals, can be undertaken in the controversial belief that variability in standardised mortality ratios reflects quality of care.
There is interest in deriving case-mix adjusted standardised mortality ratios so that comparisons between healthcare providers, such as hospitals, can be undertaken in the controversial belief that variability in standardised mortality ratios reflects quality of care.
The problem with peripherally inserted central catheters.
JAMA
Central venous catheters (CVCs) provide reliable venous access for tasks as diverse as delivery of medication, laboratory testing, and hemodynamic monitoring and occupy a fundamental role in the management of seriously ill patients. However, despite their many...
Central venous catheters (CVCs) provide reliable venous access for tasks as diverse as delivery of medication, laboratory testing, and hemodynamic monitoring and occupy a fundamental role in the management of seriously ill patients. However, despite their many...
Case-mix adjusted hospital mortality is a poor proxy for preventable mortality: a modelling study.
BMJ Qual Saf
Risk-adjustment schemes are used to monitor hospital performance, on the assumption that excess mortality not explained by case mix is largely attributable to suboptimal care. We have developed a model to estimate the proportion of the variation in...
Risk-adjustment schemes are used to monitor hospital performance, on the assumption that excess mortality not explained by case mix is largely attributable to suboptimal care. We have developed a model to estimate the proportion of the variation in...
National survey of Thai infection preventions in the era of patient safety.
Am J Infect Control
A national survey of infection preventionists was conducted in Thailand to assess career satisfaction, perceived barriers to implementing infection control practices and current sources of continuing education. Despite positive career satisfaction, several...
A national survey of infection preventionists was conducted in Thailand to assess career satisfaction, perceived barriers to implementing infection control practices and current sources of continuing education. Despite positive career satisfaction, several...
Identifying patients with severe sepsis using administrative claims: Patient-level validation of the Angus Implementation of the International Consensus Conference Definition of Severe Sepsis.
Med Care
Severe sepsis is a common and costly problem. Although consistently defined clinically by consensus conference since 1991, there have been several different implementations of the severe sepsis definition using ICD-9-CM codes for research. We conducted a...
Severe sepsis is a common and costly problem. Although consistently defined clinically by consensus conference since 1991, there have been several different implementations of the severe sepsis definition using ICD-9-CM codes for research. We conducted a...
Sustained reductions in urinary catheter use over 5 years: Bedside nurses view themselves responsible for evaluation of catheter necessity.
Am J Infect Control
Multiple approaches are needed to improve urinary catheter use and sustain compliance with the appropriate indications for catheter use.
Multiple approaches are needed to improve urinary catheter use and sustain compliance with the appropriate indications for catheter use.
Review of evidence for alcohol-based skin preparation agents.
Infect Control Hosp Epidemiol
We report that surgical site infections (SSIs) remain a major problem despite nearly a decade of national efforts to implement various practice-based recommendations targeting SSIs. According to a 2012 US Department of Health and Human Services news release...
We report that surgical site infections (SSIs) remain a major problem despite nearly a decade of national efforts to implement various practice-based recommendations targeting SSIs. According to a 2012 US Department of Health and Human Services news release...
Cardiac risk is not associated with hypertension treatment intensification.
Am J Manag Care
Considering cardiovascular (CV) risk could make clinical care more efficient and individualized, but most practice guidelines focus on single risk factors. We sought to determine if hypertension treatment intensification (TI) is more likely in patients with elevated CV risk.
Considering cardiovascular (CV) risk could make clinical care more efficient and individualized, but most practice guidelines focus on single risk factors. We sought to determine if hypertension treatment intensification (TI) is more likely in patients with elevated CV risk.
Physician assessments of medication adherence and decisions to intensify medications for patients with uncontrolled blood pressure: still no better than a coin toss.
BMC Health Serv Res
Many patients have uncontrolled blood pressure (BP) because they are not taking medications as prescribed. Providers may have difficulty accurately assessing adherence. Providers need to assess medication adherence to decide whether to address...
Many patients have uncontrolled blood pressure (BP) because they are not taking medications as prescribed. Providers may have difficulty accurately assessing adherence. Providers need to assess medication adherence to decide whether to address...
Preoperative topical antimicrobial decolonization in head and neck surgery
Laryngoscope
Surgical site infections (SSIs) are an important cause of morbidity and mortality after head and neck surgery. Our primary objective was to determine the efficacy of preoperative topical antimicrobial decolonization before head and neck surgery.
Surgical site infections (SSIs) are an important cause of morbidity and mortality after head and neck surgery. Our primary objective was to determine the efficacy of preoperative topical antimicrobial decolonization before head and neck surgery.
Bloodstream infection, venous thrombosis, and peripherally inserted central catheters: reappraising the evidence.
Am J Med
The widespread use of peripherally inserted central catheters (PICCs) has transformed the care of medical and surgical patients. Whereas intravenous antibiotics, parenteral nutrition, and administration of chemotherapy once necessitated prolonged...
The widespread use of peripherally inserted central catheters (PICCs) has transformed the care of medical and surgical patients. Whereas intravenous antibiotics, parenteral nutrition, and administration of chemotherapy once necessitated prolonged...
Is statin use associated with reduced mortality after pneumonia? A systematic review and meta-analysis.
Am J Med
The objective of this study was to perform a systematic review and meta-analysis of the effects of statins on mortality following pneumonia.
The objective of this study was to perform a systematic review and meta-analysis of the effects of statins on mortality following pneumonia.
Intensive care unit admitting patterns in the Veterans Affairs health care system.
Arch Intern Med
Critical care resource use accounts for almost 1% of US gross domestic product and varies widely among hospitals. However, we know little about the initial decision to admit a patient to the intensive care unit (ICU).
Critical care resource use accounts for almost 1% of US gross domestic product and varies widely among hospitals. However, we know little about the initial decision to admit a patient to the intensive care unit (ICU).
Does nonpayment for hospital-acquired catheter-associated urinary tract infections lead to overtesting and increased antimicrobial prescribing?
Clin Infect Dis
On 1 October 2008, in an effort to stimulate efforts to prevent catheter-associated urinary tract infection (CAUTI), the Centers for Medicare & Medicaid Services (CMS) implemented a policy of not reimbursing hospitals for hospital-acquired CAUTI.
On 1 October 2008, in an effort to stimulate efforts to prevent catheter-associated urinary tract infection (CAUTI), the Centers for Medicare & Medicaid Services (CMS) implemented a policy of not reimbursing hospitals for hospital-acquired CAUTI.
Evaluating the effect of a national collaborative: a cautionary tale.
BMJ Qual Saf
Improving the efficiency and quality of care that hospitalised patients receive is clearly important. The study by Glasgow and colleagues in this issue of BMJ Quality and Safety provides interesting insights into the summative outcomes of a large, national...
Improving the efficiency and quality of care that hospitalised patients receive is clearly important. The study by Glasgow and colleagues in this issue of BMJ Quality and Safety provides interesting insights into the summative outcomes of a large, national...
Higher rates of Clostridium difficile infection among smokers.
PLoS One
Cigarette smoking has been shown to be related to inflammatory bowel disease. We investigated whether smoking affected the probability of developing Clostridium difficile infection (CDI).
Cigarette smoking has been shown to be related to inflammatory bowel disease. We investigated whether smoking affected the probability of developing Clostridium difficile infection (CDI).
Nurse-physician relationships in ambulatory oncology settings.
J Nurs Scholarsh
The purpose of this study was to explore nurses’ perceptions of nurse-physician relationships in ambulatory oncology settings, which are linked to patient safety.
The purpose of this study was to explore nurses’ perceptions of nurse-physician relationships in ambulatory oncology settings, which are linked to patient safety.
A hybrid Centers for Medicaid and Medicare service mortality model in 3 diagnoses.
Med Care
Reliance on administrative data sources and a cohort with restricted age range (Medicare 65 y and above) may limit conclusions drawn from public reporting of 30-day mortality rates in 3 diagnoses [acute myocardial infarction (AMI), congestive heart failure...
Reliance on administrative data sources and a cohort with restricted age range (Medicare 65 y and above) may limit conclusions drawn from public reporting of 30-day mortality rates in 3 diagnoses [acute myocardial infarction (AMI), congestive heart failure...
Triggers of hospitalization for venous thromboembolism.
Circulation
The rate of hospitalization for venous thromboembolism (VTE) is increasing in the United States. Although predictors of hospital-acquired VTE are well-known, triggers of VTE before hospitalization are not as clearly defined. The objective of this study was to...
The rate of hospitalization for venous thromboembolism (VTE) is increasing in the United States. Although predictors of hospital-acquired VTE are well-known, triggers of VTE before hospitalization are not as clearly defined. The objective of this study was to...
Medicare's public reporting initiative on hospital quality had modest or no impact on mortality from three key conditions.
Health Aff
Hospital Compare, Medicare’s public reporting initiative, began reporting measures of hospital quality for almost all US acute care hospitals in 2005. The impact of this public reporting initiative on patient mortality is unknown.
Hospital Compare, Medicare’s public reporting initiative, began reporting measures of hospital quality for almost all US acute care hospitals in 2005. The impact of this public reporting initiative on patient mortality is unknown.
What's it worth? Public willingness to pay to avoid mental illnesses compared with general medical illnesses.
Psychiatr Serv
Allocation of resources for the treatment of mental illness is low relative to the burden imposed by these illnesses. The reason for this discrepancy has not been established. Few studies have directly and systematically compared public evaluations of the importance...
Allocation of resources for the treatment of mental illness is low relative to the burden imposed by these illnesses. The reason for this discrepancy has not been established. Few studies have directly and systematically compared public evaluations of the importance...
Implementation challenges in the intensive care unit: the why, who, and how of daily interruption of sedation
J Crit Care
Despite strong medical evidence and policy initiatives supporting the use of daily interruption of sedation in mechanically ventilated patients, compliance remains suboptimal. We sought to identify new barriers to daily interruption of sedation.
Despite strong medical evidence and policy initiatives supporting the use of daily interruption of sedation in mechanically ventilated patients, compliance remains suboptimal. We sought to identify new barriers to daily interruption of sedation.
Antigenic challenge in the etiology of autoimmune disease in women.
J Autoimmun
Infection has long been implicated as a trigger for autoimmune disease. Other antigenic challenges include receipt of allogeneic tissue or blood resulting in immunomodulation. We investigated antigenic challenges as possible risk factors for autoimmune disease in...
Infection has long been implicated as a trigger for autoimmune disease. Other antigenic challenges include receipt of allogeneic tissue or blood resulting in immunomodulation. We investigated antigenic challenges as possible risk factors for autoimmune disease in...
Health care worker opinions on use of isolation precautions in long-term care facilities.
Am J Infect Control
To address controversies surrounding contact isolation precautions in skilled nursing facilities (SNF), we surveyed 356 nurses and nurses' aides from 7 SNFs on their opinions regarding benefits and harms of contact isolation precautions. Whereas a majority of...
To address controversies surrounding contact isolation precautions in skilled nursing facilities (SNF), we surveyed 356 nurses and nurses' aides from 7 SNFs on their opinions regarding benefits and harms of contact isolation precautions. Whereas a majority of...
Effect of perioperative statins on death, myocardial infarction, atrial fibrillation, and length of stay: A systematic review and meta-analysis.
Arch Surg
To assess the influence of perioperative statin treatment on the risk of death, myocardial infarction, atrial fibrillation, and hospital and intensive care unit length of stay in statin-naive patients undergoing cardiac or noncardiac surgery.
To assess the influence of perioperative statin treatment on the risk of death, myocardial infarction, atrial fibrillation, and hospital and intensive care unit length of stay in statin-naive patients undergoing cardiac or noncardiac surgery.
Health care cost and value: the way forward.
JAMA
The increasing cost of health care has been a focal policy issue since the 1970s. During this period, many interventions aimed at moderating health care costs, including the managed-care movement and reforms in hospital and physician payment, have failed.
The increasing cost of health care has been a focal policy issue since the 1970s. During this period, many interventions aimed at moderating health care costs, including the managed-care movement and reforms in hospital and physician payment, have failed.
Spurious inferences about long-term outcomes: The case of severe sepsis and geriatric conditions.
Am J Respir Crit Care Med
Survivors of critical illness suffer significant limitations and disabilities. Ascertain whether severe sepsis is associated with increased risk of so-called geriatric conditions (injurious falls, low body mass index [BMI], incontinence, vision loss, hearing loss, and chronic...
Survivors of critical illness suffer significant limitations and disabilities. Ascertain whether severe sepsis is associated with increased risk of so-called geriatric conditions (injurious falls, low body mass index [BMI], incontinence, vision loss, hearing loss, and chronic...
Physician practices and readiness for medical home reforms: policy, pitfalls, and possibilities.
Health Serv Res
To determine the proportion of physician practices in the United States that currently meets medical home criteria.
To determine the proportion of physician practices in the United States that currently meets medical home criteria.
Enhancing the safety of hospitalized patients: who is minding the antimicrobials?
Arch Intern Med
Guidelines have long recommended against using antimicrobials in hospitalized patients who have bacteriuria but no symptoms of a urinary tract infection (UTI). Asymptomatic bacteriuria is commonly found in hospitalized patients, often when urine cultures are...
Guidelines have long recommended against using antimicrobials in hospitalized patients who have bacteriuria but no symptoms of a urinary tract infection (UTI). Asymptomatic bacteriuria is commonly found in hospitalized patients, often when urine cultures are...
Reducing inappropriate urinary catheter use: a statewide effort.
Arch Intern Med
Indwelling urinary catheters may lead to both infectious and non-infectious complications and are often used in the hospital setting without an appropriate indication. The objective of this study was to evaluate the results of a statewide quality improvement effort to...
Indwelling urinary catheters may lead to both infectious and non-infectious complications and are often used in the hospital setting without an appropriate indication. The objective of this study was to evaluate the results of a statewide quality improvement effort to...