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Publisher: AHC Media   (Total: 2 journals)   [Sort by number of followers]

Showing 1 - 2 of 2 Journals sorted alphabetically
Healthcare Risk Management     Full-text available via subscription   (Followers: 2)
Hospital Peer Review     Full-text available via subscription  
Journal Cover Hospital Peer Review
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   Full-text available via subscription Subscription journal
   ISSN (Print) 0149-2632
   Published by AHC Media Homepage  [2 journals]
  • Endoscopy Practice Settles Allegations of Medicare Fraud
    • Abstract: The Memorial Hermann Endoscopy and Surgery Center of North Houston, an associated medical practice, and one of their physicians reached an agreement to settle with the Office of Inspector General of the Department of Health and Human Services for $1.5 million to settle allegations of Medicare fraud.
      PubDate: Thu, 16 Nov 2017 00:00:00 -050
       
  • District Court Finds Dynamic Visions Home Health Violated the FCA
    • Abstract: A federal district court judge from the District of Columbia ruled in favor of the United States government in a False Claims Act case against former home health company Dynamic Visions, awarding the government $1.98 million.
      PubDate: Thu, 16 Nov 2017 00:00:00 -050
       
  • CMS Issues Final Rule on 340B Drug Program
    • Abstract: The Centers for Medicare & Medicaid Services (CMS) finalized its rule concerning the amount that hospitals will be paid for delivering drugs to patients in the outpatient setting.
      PubDate: Thu, 16 Nov 2017 00:00:00 -050
       
  • INSYS Therapeutics Founder Charged With Racketeering Related to Fentanyl
    • Abstract: John Kapoor, owner of INSYS Therapeutics, has been charged with conspiracy to profit from the illegal distribution of fentanyl spray, a potent opioid used to treat cancer pain.
      PubDate: Thu, 16 Nov 2017 00:00:00 -050
       
  • New Guidelines Redefine Blood Pressure Targets, Treatment Approaches
    • Abstract: The number of Americans who suffer from high blood pressure could reach nearly 50% under new guidelines released this week by the American Heart Association.
      PubDate: Tue, 14 Nov 2017 10:30:00 -050
       
  • Keep PRN Employees in the Loop
    • Abstract: Keeping PRN employees updated is difficult because of constant changes in the field of patient access. This article provides tips to keep employees informed.
      PubDate: Mon, 13 Nov 2017 15:20:00 -050
       
  • If Patient Access Is Left Out of Big Decisions, Patient Experience Can
           Suffer
    • Abstract: Patient access leadership is sometimes omitted from planning discussions involving staffing, technology, and new service lines. This article discusses steps patient access can take to prevent problems with patient satisfaction.
      PubDate: Mon, 13 Nov 2017 15:14:00 -050
       
  • Patient Access in a ‘Fishbowl,’ Some Assume Registrar Is Doing
           Nothing
    • Abstract: Investigations of complaints claiming registrars are unproductive might reveal that staff were on the phone with payers, experiencing computer downtime, or conversing with patients. This article will discuss steps patient access leaders can take to prevent complaints about delays.
      PubDate: Mon, 13 Nov 2017 15:07:00 -050
       
  • Patient Access Financial Assistance Policies Face Intense Scrutiny: Two
           Lawsuits Already Underway
    • Abstract: Two recent lawsuits in Washington allege that hospitals withheld charity care from thousands of patients. This article will review steps patient access departments can take to comply with state and federal regulations.
      PubDate: Mon, 13 Nov 2017 14:58:00 -050
       
  • Approach to Pediatric Eye Discharge and Periorbital Swelling
    • Abstract: Eye problems, particularly conjunctivitis and periorbital swelling, are very common. The majority are managed easily, but more serious disease processes must be considered. Early recognition and prompt treatment of more serious etiologies, such as gonococcal conjunctivitis and herpes simplex virus, can prevent vision loss.
      PubDate: Mon, 13 Nov 2017 13:35:00 -050
       
  • Healthgrades Analysis Shows Quality, Safety Link
    • Abstract: Thousands of lives could be saved every year if all hospitals performed at a similar level to those rated as five-star facilities, according to a new Healthgrades 2018 analysis of top hospitals.
      PubDate: Mon, 13 Nov 2017 13:23:00 -050
       
  • Hospitals Improve Sharply in Leapfrog Group Safety Grades
    • Abstract: Hospitals in some states continue to show dramatic improvements in the Fall 2017 Leapfrog Hospital Safety Grades, with Rhode Island achieving first place after being 50th in 2012.
      PubDate: Mon, 13 Nov 2017 13:18:00 -050
       
  • ACOs Yield Quality Lessons for Hospitals, May Expand
    • Abstract: Medicare accountable care organizations (ACOs) have yielded valuable lessons about value-based care and positioned some hospitals to be competitive in the future, with the most recent results showing participants improving quality and reaping financial rewards.
      PubDate: Mon, 13 Nov 2017 13:13:00 -050
       
  • Improve ED Quality and Efficiency by Looking Outside the ED
    • Abstract: Fixing ED issues requires looking beyond the confines of the ED.
      PubDate: Mon, 13 Nov 2017 13:05:00 -050
       
  • Update on Postpartum Hemorrhage
    • Abstract: In the United States, postpartum hemorrhage accounts for 11.4% of maternal deaths, the fourth most common cause after cardiovascular diseases, non-cardiovascular diseases, and infection; worldwide, it is the leading cause of maternal mortality. This feature will discuss the latest treatments for managing postpartum hemorrhage.
      PubDate: Mon, 13 Nov 2017 12:59:00 -050
       
  • Antibiotic Timeouts Boost Clinicians’ Confidence
    • Abstract: An antibiotic timeout program can improve provider confidence in making decisions to de-escalate antimicrobial therapy in ambiguous circumstances, according to recent research.
      PubDate: Mon, 13 Nov 2017 12:57:00 -050
       
  • CDC Offers Extensive Resources on Antibiotic Stewardship
    • Abstract: The federal CDC in Atlanta offers a set of key principles to guide efforts to improve antibiotic use and, therefore, advance patient safety and improve outcomes.
      PubDate: Mon, 13 Nov 2017 12:54:00 -050
       
  • Hormone Replacement: Have We Made Progress Since WHI'
    • Abstract: Vaginal estrogen may improve vaginal symptoms of menopause and does not increase the risk for endometrial cancer, stroke, or cardiovascular disease.
      PubDate: Mon, 13 Nov 2017 12:53:00 -050
       
  • Trends in OB/GYN Malpractice Litigation
    • Abstract: In this review of medicolegal claims data from 2005-2014, obstetric and gynecologic surgery had the second highest average indemnity payment compared to other specialties, topped only by neurosurgery. Of the 10,915 claims identified, the majority (60%) were dropped, withdrawn, or dismissed; 31.1% of claims were paid by the defendant (90% before trial); and 7.5% were successfully defended by the physician.
      PubDate: Mon, 13 Nov 2017 12:49:00 -050
       
  • Antibiotic Stewardship Requires Hospitalwide Commitment
    • Abstract: An effective antibiotic stewardship program requires significant commitment from top executive levels down to the bedside.
      PubDate: Mon, 13 Nov 2017 12:47:22 -050
       
  • New Treatment Option for Women at Risk of Fragility Fractures
    • Abstract: A randomized trial demonstrated a reduced risk of fragility fractures in high-risk women with osteoporosis treated monthly with the monoclonal antibody romosozumab compared with weekly alendronate.
      PubDate: Mon, 13 Nov 2017 12:34:00 -050
       
  • Are Organ Transplant Recipients in a Trial Protocol Considered Research
           Subjects'
    • Abstract: Research protocols to extend the viability period of transplant organs are of great interest, but does that mean organ recipients must give informed consent as research subjects' Here we enter an ethical impasse, that if adequately resolved could increase the supply of organs for transplant.
      PubDate: Mon, 13 Nov 2017 10:24:00 -050
       
  • PRIM&R Finds Itself Caught in State Travel Ban Controversy
    • Abstract: The 2017 PRIM&R conference was scheduled for November in San Antonio, TX. All was well until the Texas legislature passed legislation in May 2017 that allows adoption providers to turn away potential parents, including lesbian, gay, bisexual, and transgender families and others, based on the adoption providers’ religious beliefs.
      PubDate: Mon, 13 Nov 2017 10:20:00 -050
       
  • Informed Consent Conundrum: Making the Complex Concise
    • Abstract: New language regarding informed consent in the revised Common Rule seems benign enough at first reading, but actually accomplishing the directives in a scientifically valid manner is a formidable undertaking.
      PubDate: Mon, 13 Nov 2017 10:16:00 -050
       
  • Finding a Path to Informed Consent for the Addicted
    • Abstract: As an opioid epidemic ravages the country, a cutting-edge question on the frontier of neuroscience is: Can addiction be blocked in the brain' Even if it could, the question for IRBs will immediately be: Can an addict give informed consent'
      PubDate: Mon, 13 Nov 2017 10:13:00 -050
       
  • De-identifying Data in Qualitative Research Is Complex, Time-consuming
    • Abstract: One of the more complicated issues social, behavioral, and education research investigators and IRBs might consider involves how to de-identify data for use in qualitative studies.
      PubDate: Mon, 13 Nov 2017 10:05:00 -050
       
  • IRBs Must Prepare for Studies Involving Transgender Populations
    • Abstract: The transgender population has situational vulnerability that should be taken into account when IRBs review studies enrolling these individuals.
      PubDate: Mon, 13 Nov 2017 09:53:00 -050
       
  • Research Shows Link Between Quality and Readmission Rates
    • Abstract: New research using CMS data is confirming the relationship between quality care and lower readmission rates.
      PubDate: Mon, 13 Nov 2017 09:33:00 -050
       
  • Copy-and-Paste Continues to Threaten Documentation Safety
    • Abstract: Copy-and-paste is so easy and time-saving that it can be tempting to overuse it in the medical record, and some electronic medical records encourage clinicians to use blocks of text over and over. However, liberal use of copy-and-paste can diminish the quality and reliability of an electronic medical record.
      PubDate: Mon, 13 Nov 2017 09:29:00 -050
       
  • Communication Failures Let Multidrug-resistant Bug Spread Between Settings
    • Abstract: An outbreak of extremely drug-resistant Acinetobacter baumannii at multiple facilities in Oregon underscores an open secret as bad bugs move across the healthcare continuum: There are disincentives to telling the receiving facility that the patient has a history of a drug-resistant bacteria or other problematic pathogens.
      PubDate: Mon, 13 Nov 2017 09:22:00 -050
       
  • Unit-based Case Management Model Works Best for Organization
    • Abstract: Once upon a time, a hospital’s case manager performed all case management responsibilities and utilization review work. Social workers performed a lot of the discharge planning. All worked fairly well, but something was missing: Case managers were limited in their ability to care for patients.
      PubDate: Mon, 13 Nov 2017 09:10:00 -050
       
  • Q&A With the Nurse Who Wrote the Book on Case Management
    • Abstract: Case Management Advisor asked Catherine M. Mullahy, RN, CCM, president of Mullahy & Associates of Huntington, NY, and author of The Case Manager’s Handbook, Sixth Edition, published in June 2016, to discuss case management tools and strategies.
      PubDate: Mon, 13 Nov 2017 09:05:00 -050
       
  • Study Offers Puzzle Piece to Paying for Integrated Care
    • Abstract: Integrating mental health into primary care practice settings needs both research and a payment structure that works.
      PubDate: Mon, 13 Nov 2017 09:01:00 -050
       
  • Risk Stratification Can Help in Population Health Environment
    • Abstract: Risk-stratified care management can help bridge the distance between providing effective care and finding efficient ways to do so.
      PubDate: Mon, 13 Nov 2017 08:52:00 -050
       
  • NIOSH: Don't Breathe Easy About Airborne Flu
    • Abstract: Another reason for healthcare workers to get flu shot
      PubDate: Fri, 10 Nov 2017 00:00:00 -050
       
  • Take Steam Out of Plaintiff’s Missed Fracture Claim
    • Abstract: About 2% of minor trauma patients presenting to a Belgian ED leave with a missed diagnosis, according to a recent study. Of 56 minor trauma patients with missed diagnoses, the most frequently missed diagnoses were ankle, wrist, and foot fractures.
      PubDate: Thu, 09 Nov 2017 15:23:00 -050
       
  • Excessive ED Waits Are Trigger for Malpractice Lawsuits
    • Abstract: EPs can expect wait times to become an issue in any litigation in which an ED patient was diagnosed with a time-sensitive disease process.
      PubDate: Thu, 09 Nov 2017 15:19:00 -050
       
  • Some Plaintiffs' ‘Experts’ Have Never Worked in ED
    • Abstract: It’s never easy for an EP to listen to an expert witness testify that their care was negligent, but it’s harder to take coming from someone who hasn’t worked in an ED in many years — or ever.
      PubDate: Thu, 09 Nov 2017 15:15:00 -050
       
  • ECG Overload' EP Might Miss Subtle STEMI
    • Abstract: It’s not uncommon for EPs to be presented with dozens of ECGs during a shift. The large number of ECGs performed at triage could lead to an unintended legal consequence: increasing the possibility of missed ST-elevation myocardial infarction (STEMI), especially those that are subtle or atypical presentations.
      PubDate: Thu, 09 Nov 2017 15:10:00 -050
       
  • Surprising New Data on Missed Acute Coronary Syndrome in EDs
    • Abstract: Lack of “typical” symptoms cannot rule out acute coronary syndrome, and “atypical” symptoms should raise the EP’s index of suspicion, according to a recent review of the literature.
      PubDate: Thu, 09 Nov 2017 15:05:00 -050
       
  • Did ED Prescription Spark Opioid Addiction' Causation Tough to Prove
    • Abstract: Plaintiff attorneys may try to link a patient’s addiction to an ED prescription, but linking causation to one specific EP is difficult. EPs can reduce legal risks by checking available registries to identify high-risk patients, posting clear guidelines on prescribing practices in ED waiting rooms, and using caution about referring screening to social workers or behavioral health specialists.
      PubDate: Thu, 09 Nov 2017 15:00:00 -050
       
  • ED Claims Involving High-dose Analgesics Carry Jury Appeal
    • Abstract: Recent successful ED claims involving high-dose analgesics focused on failure to monitor patients and improper discharge. The malpractice lawsuits alleged that a patient was seriously injured because he or she was allowed to leave the ED while sedated, a patient went into respiratory arrest because of unsafe discharge, and the ED failed to monitor a patient adequately, resulting in the patient’s death.
      PubDate: Thu, 09 Nov 2017 14:56:00 -050
       
  • AAAHC’s Updated Standards Include ‘Elements of
           Compliance’
    • Abstract: The AAAHC rewrote its standards to include elements of compliance. The 2018 Accreditation Handbook for Ambulatory Health Care contains revised standards that will be implemented in surveys starting March 1, 2018.
      PubDate: Wed, 08 Nov 2017 10:13:00 -050
       
  • Emergency Preparedness Standards in a World of Endless Disasters
    • Abstract: Many ASC directors and staff were concerned about the federal emergency preparedness final rule after the new federal regulations were published in 2016. Then, events this year put disaster preparation into sharper focus.
      PubDate: Wed, 08 Nov 2017 10:08:00 -050
       
  • Life Safety Compliance Trends, Update, and Look Ahead
    • Abstract: The federal Life Safety Code standards for ambulatory surgery centers (ASCs) will continue to evolve over the next few years. They are moving toward patient safety-centric policies and procedures, and it might not be long before the next big changes arrive.
      PubDate: Wed, 08 Nov 2017 10:04:00 -050
       
  • ‘No One Likes Me’
    • Abstract: Some employees are decision-makers who take their job seriously, seem trustworthy, are motivated, don’t mind sharing the load, and are perceived as working hard. Conversely, those who are not as popular or well liked are often viewed as manipulative, gossipers, conniving, rude, quiet, or possess other traits.
      PubDate: Wed, 08 Nov 2017 09:58:00 -050
       
  • Four Steps to Making ASCs More Efficient
    • Abstract: Surgery centers increasingly are under regulatory scrutiny, and their industry is evolving quickly. One of the more predictable changes is the push for greater efficiency and cost-cutting.
      PubDate: Wed, 08 Nov 2017 09:52:00 -050
       
  • A Few Suggestions for Better Operations
    • Abstract: ASC boards focus on the big picture of a surgery center’s staffing, services, and financing. But they also might pay closer attention to some of the operational details that can help or hinder an organization’s efficiency.
      PubDate: Wed, 08 Nov 2017 09:47:00 -050
       
  • FDA Actions
    • Abstract: In this section: FDA approves new herpes zoster vaccine, greenlights second gene therapy for cancer, and issues warnings to companies marketing cannabidiol.
      PubDate: Wed, 08 Nov 2017 09:46:12 -050
       
  • Rivaroxaban Plus Aspirin for Secondary Prevention
    • Abstract: Among patients with stable cardiovascular disease, those assigned to rivaroxaban plus aspirin in a recent study experienced better cardiovascular outcomes and more major bleeding events than those assigned to aspirin alone. Rivaroxaban alone was no better than aspirin.
      PubDate: Wed, 08 Nov 2017 09:43:27 -050
       
  • Cutting Higher-hanging Fruit to Improve ASC’s Financials
    • Abstract: Minimizing variation is one strategy that can help ASCs improve efficiency and cost.
      PubDate: Wed, 08 Nov 2017 09:43:00 -050
       
  • Monitoring Bleeding Risks Associated With Non-vitamin K Oral
           Anticoagulants
    • Abstract: In a recent trial, among patients taking non-vitamin K oral anticoagulants for atrial fibrillation, concurrent use of amiodarone, fluconazole, rifampin, and phenytoin was associated with increased risk of major bleeding.
      PubDate: Wed, 08 Nov 2017 09:41:07 -050
       
  • A Quick Look at 2018 for ASCs
    • Abstract: What is the biggest issue ASCs will face in 2018' They will be challenged to sustain growth at a time when administrators are focused on lowering costs and raising quality during an era of mergers and acquisitions.
      PubDate: Wed, 08 Nov 2017 09:39:00 -050
       
  • Lowering Dementia Risk in Atrial Fibrillation Patients
    • Abstract: Oral anticoagulants may reduce the risk of dementia in patients with atrial fibrillation, according to a new study from Sweden.
      PubDate: Wed, 08 Nov 2017 09:38:31 -050
       
  • Possible Link Between Acetaminophen Use During Pregnancy and Later ADHD
           Development
    • Abstract: A recent study showed that long-term maternal use of acetaminophen during pregnancy was associated substantially with ADHD, even after adjusting for indications of use, familial risk of ADHD, and other potential confounders. However, given that paternal use of acetaminophen also was associated with ADHD, the causal role of acetaminophen can be questioned.
      PubDate: Wed, 08 Nov 2017 09:36:21 -050
       
  • Tips for Avoiding Huge False Claims Fines
    • Abstract: ASCs can run into regulatory trouble by simply creating a poorly structured business ownership agreement or by paying one owner physician more than another. Two health law experts highlighted common mistakes healthcare professionals make regarding the FCA, Anti-Kickback Statute, and Stark Law.
      PubDate: Wed, 08 Nov 2017 09:33:00 -050
       
  • Stakes High Regarding False Claims Act Compliance
    • Abstract: Ambulatory surgery centers are vulnerable to False Claims Act violations because of their corporate structures and relationships.
      PubDate: Wed, 08 Nov 2017 09:27:00 -050
       
  • Considering Systemic Treatment for Atopic Dermatitis
    • Abstract: A recent panel of eczema experts convened to provide advice about when clinicians should consider systemic treatment.
      PubDate: Mon, 06 Nov 2017 11:00:00 -050
       
  • Cardiorespiratory Fitness and Mortality
    • Abstract: In both men and women in the United States, levels of cardiorespiratory fitness are inversely related to mortality. An encouraging epidemiologic study of women found that even brisk walking for about 30 minutes daily was associated with near maximal cardiovascular health benefits.
      PubDate: Mon, 06 Nov 2017 10:58:00 -050
       
  • Searching for Answers on Knee Osteoarthritis
    • Abstract: Data consistently show that for knee osteoarthritis, weight loss is associated with symptomatic and functional improvement. The mechanism of this is incompletely understood, since weight loss has not been shown to affect the progressive degradation of cartilage typical of osteoarthritis.
      PubDate: Mon, 06 Nov 2017 10:55:00 -050
       
  • New Pharmacologic Direction for Parkinson’s Disease
    • Abstract: Most clinicians are used to thinking about dopamine modulation when considering treatments for Parkinson’s disease. Unfortunately, none of the current treatments can be designated as disease-modifying, even though such treatment provides transient symptomatic relief.
      PubDate: Mon, 06 Nov 2017 10:53:00 -050
       
  • Morphine in Dyspneic Acute Heart Failure
    • Abstract: Based on recent data, clinicians should avoid morphine use in acute heart failure patients.
      PubDate: Mon, 06 Nov 2017 10:50:00 -050
       
  • CV Benefits of GLP-1RA Treatment in Type 2 Diabetes
    • Abstract: Among the sodium-glucose cotransporter 2 inhibitor and glucagon-like peptide-1 receptor agonist classes of pharmacotherapy, there appears to be much more similarity than not. Should clinicians consider these salubrious cardiovascular effects a class effect' That is, should all members of the class be anticipated to experience similarly favorable cardiovascular outcomes'
      PubDate: Mon, 06 Nov 2017 10:48:00 -050
       
  • Revised Standards on Pain Assessment and Management Reflect Concerns About
           Opioid Epidemic
    • Abstract: As of Jan. 1, 2018, The Joint Commission will judge accredited hospitals according to newly revised standards for pain assessment and management. The standards are intended to address some of the unintended consequences of a nationwide focus on the under-treatment of pain, reflected in earlier versions. The revised standards push practitioners to offer alternatives to opioids when appropriate, and to engage patients in treatment planning for their pain so that realistic expectations are established.
      PubDate: Fri, 03 Nov 2017 13:47:00 -040
       
  • Two-stage Screening Tool Improves Identification of Young Sepsis Patients
           in ED
    • Abstract: Investigators at Children’s Hospital of Philadelphia have developed a two-stage process to better identify children with sepsis while also minimizing alert fatigue. The approach includes an electronic alert tool that flags children with abnormal vital signs, but includes screening questions that enable clinicians to eliminate patients with no sign of infection. This approach is paired with a sepsis huddle to bring clinician judgment into the equation.
      PubDate: Fri, 03 Nov 2017 13:38:00 -040
       
  • Electronic Tool, Clinical Judgment Replace Electronic Severity Index
           Triage System
    • Abstract: Johns Hopkins Hospital in Baltimore has replaced a widely used triage system with a new decision-support tool that enables nurses at triage in the ED to better differentiate patients based on acuity level. The electronic tool, dubbed e-triage, is able to quickly factor in a patient’s medical history, vital signs, and chief complaint, and compare this information to thousands of other patients.
      PubDate: Fri, 03 Nov 2017 13:33:00 -040
       
  • How Las Vegas Hospitals Responded to Nation’s Deadliest Mass
           Shooting
    • Abstract: Las Vegas medical professionals describe their experience responding to the nation's deadliest mass shooting that occurred in October. These providers also emphasize the importance of developing a versatile emergency response process that can be deployed in any type of mass casualty event.
      PubDate: Fri, 03 Nov 2017 13:26:00 -040
       
  • NIOSH to Focus on Musculoskeletal Injuries
    • Abstract: Healthcare workers are among the occupational groups most at risk for musculoskeletal injuries, the National Institute for Occupational Safety and Health announced in a series of blog posts on these all-too-common harms.
      PubDate: Fri, 03 Nov 2017 11:41:00 -040
       
  • Evidence That Working ‘Bare Below the Elbows’ Protects
           Patients
    • Abstract: Experimental evidence supporting the concept of healthcare workers working “bare below the elbows” to prevent transmission of pathogens to patients via long sleeves was recently presented in San Diego at the IDWeek 2017 conference.
      PubDate: Fri, 03 Nov 2017 11:38:00 -040
       
  • Homicide at Hopkins: Healthcare Workers Seek Solace in Aftermath
    • Abstract: A recent shocking act of violence at Johns Hopkins Hospital in Baltimore quickly underscored the importance of the hospital’s state-of-the art peer responder program: Resilience In Stressful Events (RISE).
      PubDate: Fri, 03 Nov 2017 11:35:00 -040
       
  • The Patient’s Tale: A Victim of Drug Diversion
    • Abstract: The story of Lauren Lollini and Kristen Parker is a cautionary tale that healthcare workers tempted to divert drugs should consider.
      PubDate: Fri, 03 Nov 2017 11:28:00 -040
       
  • CDC: 60,000 Died of Opioid Overdoses in 2016
    • Abstract: The nation’s expanding opioid epidemic has many ramifications for healthcare facilities, including the threat of violence by addicts seeking care, exposure of healthcare workers to powerful narcotics, and the potential for street opioids to exacerbate the longstanding problem of drug diversion by healthcare workers.
      PubDate: Fri, 03 Nov 2017 11:22:00 -040
       
  • Drug Diversion Rampant as Opioid Epidemic Explodes in Communities
    • Abstract: A community opioid addiction problem of such staggering scale certainly adds another permutation to the hidden epidemic of drug diversion by healthcare workers.
      PubDate: Fri, 03 Nov 2017 11:17:00 -040
       
  • Emerging Infectious Disease and Emergency Medicine
    • Abstract: There are many emerging infections for which the emergency physician must remain clinically vigilant. Although many infections may not represent true emergencies, it is important for ED providers to understand the epidemiology, presentation, and treatment of some of today’s common and life-threatening infections.
      PubDate: Fri, 03 Nov 2017 09:20:00 -040
       
  • Factors Keeping Older Patients From Presenting to ED With AMI
    • Abstract: What older patients are most likely to delay seeking emergency care for acute myocardial infarction (AMI)'
      PubDate: Thu, 02 Nov 2017 00:00:00 -040
       
  • One in Five Public ED Patients Visited Another Facility for Same Complaint
    • Abstract: If you work at a public emergency department (ED), chances are that about one in five of your patients have already been seen at another ED for the same complaint. Most of them will undergo duplicate testing because of inadequate information about their past treatment.
      PubDate: Thu, 02 Nov 2017 00:00:00 -040
       
  • Prochlorperazine Combo Better Than Opioid Migraine Relief in ED
    • Abstract: The opioid hydromorphone often is used as first-line treatment for migraine in the emergency department (ED). A new study calls that practice into question, however, suggesting that a better alternative exists.
      PubDate: Thu, 02 Nov 2017 00:00:00 -040
       
  • EDs Play an Increasingly Outsized Role in Providing US Healthcare
    • Abstract: It’s not just your imagination. Emergency departments (EDs) are carrying an increasingly heavy burden in providing healthcare to Americans.
      PubDate: Thu, 02 Nov 2017 00:00:00 -040
       
  • Transitions in Care and the Role of the Case Manager
    • Abstract: Care transitions has become a buzzword in healthcare. In fact, it has become an important component of case management models and the role of the case manager. This month, we will discuss what transitions in care actually means, particularly as it relates to case management.
      PubDate: Tue, 31 Oct 2017 13:58:00 -040
       
  • Are Right-sided Leads Needed'
    • Abstract: The ECG in the figure was obtained from a man in his 50s who presented with new severe chest pain. How would you interpret this tracing' What area(s) of the heart are involved' What is the likely culprit artery'
      PubDate: Tue, 31 Oct 2017 09:35:00 -040
       
  • Clinical Briefs
    • Abstract: In this section: opioid-induced nausea; considering the safety of proton pump inhibitors; and life after bariatric surgery.
      PubDate: Tue, 31 Oct 2017 09:32:00 -040
       
  • Secnidazole Oral Granules (Solosec)
    • Abstract: Secnidazole is indicated for the treatment of bacterial vaginosis in adult women.
      PubDate: Tue, 31 Oct 2017 09:27:00 -040
       
  • Oily Fish Is Associated With Better Sleep
    • Abstract: A study in Ecuador showed a strong positive correlation between dietary oily fish intake and sleep quality.
      PubDate: Tue, 31 Oct 2017 09:20:00 -040
       
  • A Rivaroxaban/Daily Low-dose Aspirin Combination and Cardiovascular Events
    • Abstract: The addition of rivaroxaban to daily low-dose aspirin resulted in fewer cardiovascular outcomes and increased major bleeding compared to aspirin alone in patients with stable cardiovascular disease.
      PubDate: Tue, 31 Oct 2017 09:04:00 -040
       
  • A Cup of Coffee May Help Patients Live Longer
    • Abstract: In a prospective cohort of patients coinfected with HIV and hepatitis C virus, drinking three or more cups of coffee per day halved the all-cause mortality risk.
      PubDate: Tue, 31 Oct 2017 08:59:00 -040
       
  • Systemwide Program Improves Post-discharge Care for Indigent Patients
    • Abstract: Faced with a growing indigent population, Sentara Healthcare developed a comprehensive systemwide program with post-acute providers that agreed to partner with the hospital to care for indigent patients after discharge.
      PubDate: Mon, 30 Oct 2017 09:28:00 -040
       
  • If Discharge Plan A Fails, Maybe Plan B or C Will Work
    • Abstract: Developing a successful discharge plan for patients with a history of drug abuse takes creativity, patience, and flexibility.
      PubDate: Mon, 30 Oct 2017 09:26:00 -040
       
  • Discharge Planning for Opioid Abusers Presents Many Challenges
    • Abstract: Creating a successful discharge plan for patients with opioid abuse issues is a huge challenge for a case manager in the cardiac care unit at Massachusetts General Hospital.
      PubDate: Mon, 30 Oct 2017 09:23:00 -040
       
  • Compatibility Is Key to the Success of Case Manager-Social Worker Teams
    • Abstract: Case management leadership should make sure the teams work well together and understand how to work cohesively and collaboratively.
      PubDate: Mon, 30 Oct 2017 09:16:00 -040
       
  • A Formal Model Helps Eliminate Duplication, Gaps in Care
    • Abstract: Initiatives from CMS make it more important for case management leadership to review the duties, roles, and responsibilities of all disciplines and build an effective model.
      PubDate: Mon, 30 Oct 2017 09:09:00 -040
       
  • Vague Job Descriptions Leave Everyone Confused
    • Abstract: One of the biggest problems case management consultants encounter is the lack of detailed job descriptions for case managers and social workers. Some hospitals don’t have job descriptions at all, while others use almost the same verbiage for RN case managers and social workers.
      PubDate: Mon, 30 Oct 2017 09:05:00 -040
       
  • RN Case Managers, Social Workers Should Work as a Team With Clearly
           Defined Roles
    • Abstract: With increasingly complex patients and changing reimbursement rules, it takes both an RN case manager and a social worker to gather a complete picture of a patient’s situation and create an effective discharge plan.
      PubDate: Mon, 30 Oct 2017 09:01:00 -040
       
  • Science Focuses on Mycoplasma genitalium
    • Abstract: Mycoplasma genitalium, a sexually transmitted infection, is a major cause of urethritis in men and is associated with cervicitis, pelvic inflammatory disease, preterm birth, and spontaneous abortion in women.
      PubDate: Mon, 30 Oct 2017 08:48:00 -040
       
  • New Study Points to Long-term Effectiveness of 9-Valent HPV Vaccine
    • Abstract: Vaccine could prevent 90% of cervical cancer cases worldwide.
      PubDate: Mon, 30 Oct 2017 08:41:00 -040
       
  • HIV Pre-exposure Prophylaxis for Adolescents: A Health Equity and
           Reproductive Justice Issue
    • Abstract: Access to HIV pre-exposure prophylaxis is not just a public health issue, but equally important, an equity and justice issue.
      PubDate: Sun, 29 Oct 2017 16:53:00 -040
       
  • Low Rates of Adherence to PID Guidance Found in Emergency Departments
    • Abstract: Research analyzing trends in the nation’s emergency departments indicates low rates of HIV and syphilis screening among teens diagnosed with pelvic inflammatory disease, despite the high risk for such infections. Data also suggest low rates of adherence to national treatment guidelines.
      PubDate: Sun, 29 Oct 2017 16:44:00 -040
       
  • Clinician Alert: STIs Hit High-water Mark
    • Abstract: More than 2 million cases of chlamydia, gonorrhea, and syphilis were reported in the United States in 2016, the highest number ever, according to the latest surveillance from the Centers for Disease Control and Prevention.
      PubDate: Sun, 29 Oct 2017 16:35:00 -040
       
  • Vending Machines Expand Options for College Health Emergency Contraception
    • Abstract: While age restrictions on levonorgestrel emergency contraceptive pills (ECPs) were removed in 2013, access to pills often is tricky, even for college-age students. Now Stanford University and University of California locations in Santa Barbara and Davis are among the latest campuses that have installed vending machines stocked with ECPs.
      PubDate: Sun, 29 Oct 2017 16:25:00 -040
       
  • U.S. MEC Updates Contraceptive Information for Women With HIV
    • Abstract: The Centers for Disease Control and Prevention is revising its recommendation on the use of the progestin-only contraception injection depot medroxyprogesterone acetate (DMPA) by women at high risk for HIV from Category 1 (no restriction) to Category 2 (benefits outweigh theoretical or proven risks).
      PubDate: Sun, 29 Oct 2017 16:15:00 -040
       
  • Task Force Issues Cervical Cancer Screening Guidance: What Changes Can
           Clinicians Expect'
    • Abstract: Ages 30-65: Cervical cytology every three years or HPV testing every five years.
      PubDate: Sun, 29 Oct 2017 16:08:00 -040
       
  • Hospitals’ Financial Assistance Processes Under Intense Scrutiny
    • Abstract: Hospitals’ processes for charity care are facing intense legal scrutiny, with two highly publicized lawsuits underway.
      PubDate: Fri, 27 Oct 2017 12:20:00 -040
       
  • CDC: More Than 60,000 Opioid OD Deaths in 2016
    • Abstract: Estimated overdose deaths nearly double 2015 total
      PubDate: Fri, 27 Oct 2017 00:00:00 -040
       
  • Migraine With Aura, Stroke Risk, and Biomarkers
    • Abstract: A longitudinal cohort study of twins found no increased stroke risk related to migraine overall, but there was a modestly increased risk for stroke related to migraine with aura. Familial factors and vascular biomarkers associated with migraine with aura may explain its correlation with vascular disease.
      PubDate: Tue, 24 Oct 2017 14:50:00 -040
       
  • Diabetes, HbA1c, and Neuropathy
    • Abstract: The hallmark of neuropathy associated with type 2 diabetes is reduction of sensory nerve action potential amplitude and not a reduction in conduction velocity, supporting the hypothesis that hyperglycemia causes axonal dysfunction and injury.
      PubDate: Tue, 24 Oct 2017 14:47:00 -040
       
  • Noninvasive Vagus Nerve Stimulation for Indomethacin-Sensitive Headaches
    • Abstract: Trigeminal autonomic cephalgias are notoriously difficult to treat and may be responsive to noninvasive vagus nerve stimulation.
      PubDate: Tue, 24 Oct 2017 13:42:00 -040
       
  • Childhood Head Trauma and Risk of Subsequent Diagnosis of Multiple
           Sclerosis
    • Abstract: A large study that reviewed longitudinally collected data from the national Swedish Patient Register found that head trauma in adolescents was associated with an increased risk of subsequent diagnosis of multiple sclerosis.
      PubDate: Tue, 24 Oct 2017 13:39:00 -040
       
  • Exploring Cortical Pathology in Multiple Sclerosis With Routine MRI
    • Abstract: In this MRI and histopathological study, the investigators showed that cortical T1w/T2w ratio was unrelated to myelin density, but had a strong correlation with dendritic density. Furthermore, abnormal values within the posterior cingulate cortex correlated with impairment in cognitive domains.
      PubDate: Tue, 24 Oct 2017 13:36:00 -040
       
  • Pitfalls in the Treatment of Seizures Associated With Brain Tumors
    • Abstract: In this multicenter, observational study, the authors assessed the prevalence of neuropsychiatric side effects from medications in subjects with tumor-related epilepsy. Levetiracetam was found to have the highest prevalence of such side effects.
      PubDate: Tue, 24 Oct 2017 13:33:00 -040
       
  • Management of Skin and Soft Tissue Infections
    • Abstract: Skin and soft tissue infections are encountered commonly in primary care practices, presenting as a range of disorders, from uncomplicated cellulitis, impetigo, folliculitis, erysipelas, and focal abscesses to necrotizing fasciitis. Each year between 1998-2006 in the United States, there were 650,000 hospital admissions for cellulitis, with estimates of 14.5 million cases annually treated as outpatients, accounting for $3.7 billion in ambulatory care costs.
      PubDate: Tue, 24 Oct 2017 12:49:00 -040
       
  • Spiritual Healing: A Randomized Clinical Trial
    • Abstract: A randomized, controlled trial evaluated the effectiveness of Brazilian energy therapy — Spiritist “passé” — in multiple conditions associated with recovery in cardiovascular inpatients.
      PubDate: Tue, 24 Oct 2017 11:35:00 -040
       
  • Vitamin D and Colorectal Cancer: The Plot Thickens
    • Abstract: In a follow-up study, researchers investigated whether single nucleotide polymorphism (SNP) genotypes in the vitamin D and calcium pathways are associated with the authors’ previous findings that daily intake of 1,000 IU vitamin D3 and/or 1,200 mg calcium did not reduce colorectal adenoma risk. The authors concluded that vitamin D3 supplementation benefits in the prevention of advanced colorectal adenomas may vary depending on vitamin D receptor genotype status.
      PubDate: Tue, 24 Oct 2017 11:19:00 -040
       
  • Physician Burnout: A Multi-specialty Perspective
    • Abstract: Although different specialties address the problem of physician burnout, studies suggest the most effect is gained from organizational interventions.
      PubDate: Tue, 24 Oct 2017 11:08:00 -040
       
  • Unintended Consequences: Steps to Fight Sepsis Increase C. diff
    • Abstract: A hospital effort to rapidly identify potential sepsis cases and initiate antibiotic treatment led to an unintended consequence: an increase in Clostridium difficile infections.
      PubDate: Mon, 23 Oct 2017 12:32:35 -040
       
  • IDWeek: Antibiotic Use in Dentistry Driving Up C. diff Rates
    • Abstract: Dentists prescribe a surprising amount of antibiotics, and this can lead to adverse patient consequences in the community.
      PubDate: Mon, 23 Oct 2017 12:26:00 -040
       
  • ‘Mystery Patient Drills’ Test Hospital Readiness
    • Abstract: The New York City Department of Health and Mental Hygiene recently conducted elaborate “mystery patient drills” that used in-house collaborators to evaluate clinical readiness in ED staff.
      PubDate: Mon, 23 Oct 2017 12:17:00 -040
       
  • Communication Failures Let Multidrug-resistant Bug Spread Between Settings
    • Abstract: An outbreak of extremely drug-resistant Acinetobacter baumannii at multiple facilities in Oregon underscores an open secret: There are disincentives to telling the receiving facility that the patient has a history of a drug-resistant bacteria or other problematic pathogens.
      PubDate: Mon, 23 Oct 2017 12:07:00 -040
       
  • H3N2 Flu Strain Mismatch Could Hit Elderly Patients Hard
    • Abstract: Elderly and long-term care staff are all too often the most under-immunized healthcare workers.
      PubDate: Mon, 23 Oct 2017 11:58:00 -040
       
  • Infectious Disease Alert Updates
    • Abstract: Travelers Unaware of the Need for Pre-travel Vaccinations; Fecal Microbiota Testing; Newer Guidelines for Influenza Testing This Season
      PubDate: Mon, 23 Oct 2017 11:15:00 -040
       
  • Chikungunya Locally Acquired in Italy and France
    • Abstract: An outbreak of autochthonously acquired chikungunya infection has affected 298 individuals as of early October 2017, while a small outbreak also has occurred in southeastern France.
      PubDate: Mon, 23 Oct 2017 11:10:00 -040
       
  • Caring for Providers: Mindfulness for Healthcare Practitioners
    • Abstract: Preliminary studies show some promise for use of mindfulness interventions in healthcare practitioners, but the time required for training medical providers in these techniques is identified as a limitation to implementation.
      PubDate: Mon, 23 Oct 2017 11:09:00 -040
       
  • How Many Personnel Are Required for Antimicrobial Stewardship' More
           Than You Have at Your Hospital
    • Abstract: A work group in the Veterans Administration determined that the necessary staffing of antimicrobial stewardship programs dealing with inpatients (including long-term care) is 1.0 clinical pharmacy specialist with infectious disease knowledge and 0.25 physician (preferably trained in infectious disease) per 100 occupied beds. Needs for outpatient stewardship, which is now mandated, were not included in the assessment.
      PubDate: Mon, 23 Oct 2017 11:07:00 -040
       
  • Treatment of Pulmonary Mycobacterium avium Infection: Failure Is Common
    • Abstract: Current treatment regimens for pulmonary Mycobacterium avium infection leave a great deal to be desired.
      PubDate: Mon, 23 Oct 2017 11:03:00 -040
       
  • Immunohistochemistry and Diagnosis of Viral Diseases
    • Abstract: Researchers reviewed five years of cases at an academic medical center’s pathology department for the use of immunohistochemistry to detect CMV, HSV-1, HSV-2, varicella zoster virus, adenovirus, or polyomavirus. Of 957 cases, 134 were positive. Viral cytopathic effect (CPE) was present on hematoxylin and eosin staining in 75% of the IHC+ cases. No changes in clinical care occurred in any of the IHC+ cases in which viral CPE was absent.
      PubDate: Mon, 23 Oct 2017 11:00:00 -040
       
  • Mice, Mutations, and Microcephaly: The Evolving Pathogenesis of Congenital
           Zika Syndrome
    • Abstract: Approximately five years ago, a single gene mutation altered Zika virus, making it able to target neuronal progenitor cells and cause what we now know as congenital Zika syndrome with microcephaly and ocular abnormalities.
      PubDate: Mon, 23 Oct 2017 10:57:00 -040
       
  • Angiotensin II Raises Blood Pressure in Patients with Vasodilatory Shock
    • Abstract: The ATHOS-3 trial represents an important proof of concept trial regarding angiotensin II as a new vasopressor in the armamentarium to treat vasodilatory shock.
      PubDate: Mon, 23 Oct 2017 10:55:00 -040
       
  • Antibiotics and Adverse Events: Doctors, Do No Harm
    • Abstract: A retrospective study found that among 1,488 hospitalized patients who received an antibiotic, 298 (20%) experienced at least one antibiotic-associated adverse drug event. Furthermore, 287 (19%) of the antibiotic regimens were not clinically indicated, and 56 (20%) of these were associated with an adverse drug event.
      PubDate: Mon, 23 Oct 2017 10:54:00 -040
       
  • Natriuretic Peptide-guided Therapy Does Not Improve Systolic Heart Failure
           Outcomes
    • Abstract: A recent meta-analysis of 11 trials showed a significant reduction in all-cause mortality with natriuretic peptide-guided therapy, although the individual trial results varied substantially.
      PubDate: Mon, 23 Oct 2017 10:45:00 -040
       
  • Is a Dabigatran Reversal Agent Effective'
    • Abstract: Dabigatran is an attractive oral anticoagulant for patients who demonstrate indications for oral anticoagulation but are at high risk of bleeding.
      PubDate: Mon, 23 Oct 2017 10:30:00 -040
       
  • Defense Verdict in 11-Year Delay-in-Diagnosis Case
    • Abstract: At first blush, this is a relatively straightforward failure-to-diagnose case, but the essence of this case is that the patient’s cancer would not have been cured in 2004 if the physician had made the proper diagnosis and followed up appropriately, resulting in a defense verdict.
      PubDate: Mon, 23 Oct 2017 10:01:00 -040
       
  • $7 Million Verdict: Improper Use of Balloon Device Leads to Death
    • Abstract: A physician's inexperience with a balloon device led to ruptured blood vessels and the patient's death.
      PubDate: Mon, 23 Oct 2017 09:58:00 -040
       
  • OIG Auditing Medicare Payments for Telehealth
    • Abstract: Healthcare organizations offering telehealth services should expect more scrutiny from the federal government now that the Department of Health and Human Services Office of Inspector General has announced plans to review Medicare payments for telehealth services, seeking to confirm the patient was at an eligible originating site and that the statutory conditions for coverage were met.
      PubDate: Mon, 23 Oct 2017 09:52:00 -040
       
  • ASC 606 Standard Requires Proper Reporting of Revenue
    • Abstract: The Department of Justice’s campaign against healthcare fraud puts hospitals and health systems at risk in many ways, and they could find themselves subject to even greater fraud risk as the 2018 compliance deadline for a new standard of revenue reporting fast approaches.
      PubDate: Mon, 23 Oct 2017 09:48:00 -040
       
  • Scathing Results from Police Investigations of Nurse Arrest
    • Abstract: The Salt Lake City Police Department conducted two separate investigations of the arrest of nurse Alex Wubbels, RN, and the results echo the reactions of many who have seen the videos.
      PubDate: Mon, 23 Oct 2017 09:44:00 -040
       
  • Hospital Revises Policy on Police Requests
    • Abstract: The University of Utah Hospital continues to refine its policies for encounters with law enforcement, recently rolling out a new policy that requires police to go through the hospital’s customer service office with any request.
      PubDate: Mon, 23 Oct 2017 09:37:00 -040
       
  • Video Shows Aggressive Arrest of Nurse
    • Abstract: The videos showing the arrest of nurse Alex Wubbels are disturbing to many viewers, but especially to risk managers and other healthcare professionals who understand the dilemma faced by a clinician trying to comply with hospital policy and the law when law enforcement demands otherwise.
      PubDate: Mon, 23 Oct 2017 09:33:00 -040
       
  • Nurse Arrest Puts Focus on Hospital Security, Policies
    • Abstract: The highly publicized arrest of a Utah nurse for refusing to allow a police request to draw blood on an unconscious patient drew attention to how hospital policies and procedures should protect staff in such confrontations, and particularly the role that in-house police and security officers should play.
      PubDate: Mon, 23 Oct 2017 09:27:00 -040
       
  • Early Error Disclosure Training Prepares Residents to Provide Ethical Care
    • Abstract: Role-modeling, a strong patient safety culture, and simulation training provided to interdisciplinary groups facilitate error disclosure, found several recent studies.
      PubDate: Mon, 23 Oct 2017 08:53:00 -040
       
  • Radiation Oncologists Want, but Often Lack, Palliative Care Training
    • Abstract: Residents, practicing radiation oncologists, and program directors believe palliative care training is important, but education is lacking in some areas, according to multiple recent studies.
      PubDate: Mon, 23 Oct 2017 08:49:00 -040
       
  • Patients More Likely to Choose Do Not Resuscitate After Educational Video
    • Abstract: Hospitalized patients who watched a video about code status choices were less likely to choose full code, and more likely to choose do not resuscitate or do not intubate, found a study of 119 patients hospitalized on the general medicine service at Minneapolis Veterans Affairs Health Care System in Minnesota.
      PubDate: Mon, 23 Oct 2017 08:34:00 -040
       
  • Study: Surrogates Sometimes Place Own Wishes Over Patient’s
    • Abstract: Surrogate decision-makers are valuing what they think is best for the patient more than they value patient preferences in the process of making medical decisions for them, found a recent study.
      PubDate: Mon, 23 Oct 2017 08:28:00 -040
       
  • Ethical Debate Continues Over Genetically Modified Human Embryos
    • Abstract: The first-known experiment creating genetically modified human embryos in the U.S. using a gene-editing tool called CRISPR reignited ethical debate on this type of research.
      PubDate: Mon, 23 Oct 2017 08:18:00 -040
       
  • Advance Care Planning Often ‘Useless’: Providers Can’t
           Always Access in EHRs
    • Abstract: With electronic health records, patients’ advance care planning should be only a mouse click away. Too often, this isn’t reality.
      PubDate: Mon, 23 Oct 2017 08:08:00 -040
       
  • Anesthesiology Practice Settles FCA Claims Involving Improper Billing
    • Abstract: Anesthesia group New York Spine and Wellness Center will pay nearly $2 million to resolve allegations that it improperly billed for moderate sedation services.
      PubDate: Mon, 23 Oct 2017 00:00:00 -040
       
  • Vulnerabilities Remain in Medicare Hospital Outlier Payments
    • Abstract: The Department of Health and Human Services Office of Inspector General found that Medicare contractors did not always refer cost reports that qualified for reconciliation of the hospital outlier payments, and the Centers for Medicare & Medicaid Services did not always ensure that the Medicare contractors performed the appropriate reconciliation, according a review of Medicare outlier payments performed between October 2003 and March 2011.
      PubDate: Mon, 23 Oct 2017 00:00:00 -040
       
  • Four Houston Hospitals Resolve Allegations of Kickbacks
    • Abstract: Four Houston-area hospitals affiliated with the Hospital Corporation of America (HCA) will settle allegations that they gave rights to transport Medicare and Medicaid patients to specific ambulance companies that paid to receive this business.
      PubDate: Mon, 23 Oct 2017 00:00:00 -040
       
  • Tachycardia
    • Abstract: The recognition, diagnosis, and treatment of tachycardia is a cornerstone of emergency medicine practice. This article will cover the most commonly seen supraventricular and ventricular tachycardias encountered in the ED, with a focus on their electrocardiographic diagnoses and treatment options.
      PubDate: Fri, 20 Oct 2017 16:24:00 -040
       
  • In-hospital vs. Telephone Availability of an Intensivist at Night
    • Abstract: When overnight shifts were staffed by nighttime intensivists rather than residents with attending intensivists on call remotely, most nurses perceived improvements in clinical care, procedures, efficiency, communication, and job place comfort.
      PubDate: Fri, 20 Oct 2017 13:25:00 -040
       
  • Is There Still a Role for High-frequency Oscillatory Ventilation in
           ARDS'
    • Abstract: In this patient-level meta-analysis of four well-known randomized, controlled trials of high-frequency oscillatory ventilation (HFOV) in acute respiratory distress syndrome (ARDS), the authors found that HFOV increases mortality for most patients with ARDS but may improve survival among patients specifically with severe ARDS.
      PubDate: Fri, 20 Oct 2017 13:21:00 -040
       
  • Hyponatremia in the Critically Ill
    • Abstract: Hyponatremia is the most common electrolyte disorder encountered in hospitalized patients (30-40%) and is present in 17.7% of patients admitted to the ICU. A recent registry demonstrated significant practice variation regarding this common disorder, underlining the frequent diagnostic and therapeutic challenges clinicians face in this area.
      PubDate: Fri, 20 Oct 2017 12:52:00 -040
       
  • Transcatheter Mitral Valve Replacement as an Alternative to Other Surgical
           Options
    • Abstract: A large registry study of transcatheter mitral valve replacement (TMVR) in patients with degenerated mitral valve bioprostheses or failed mitral annuloplasty repairs who were at high risk for repeat surgery showed that TMVR can be performed successfully. However, the initial and long-term results are better in the degenerated bioprothesis group.
      PubDate: Fri, 20 Oct 2017 10:31:00 -040
       
  • Can Medical Therapy Improve Functional Mitral Regurgitation'
    • Abstract: Among patients who presented with heart failure with reduced ejection fraction and severe functional mitral regurgitation, mitral regurgitation improved in 38% of patients with medical management. Improvement in mitral regurgitation was associated with increased survival.
      PubDate: Fri, 20 Oct 2017 10:27:00 -040
       
  • Patent Foramen Ovale Intervention Rises to Occasion in Cryptogenic Stroke
    • Abstract: After years of uncertainty, three large randomized trials have shown a benefit to patent foramen ovale closure in reducing recurrence after cryptogenic stroke in the right patients.
      PubDate: Fri, 20 Oct 2017 10:24:00 -040
       
  • Late-breaking Clinical Trials From the European Society of Cardiology
           Congress, August 2017
    • Abstract: Recent findings of several important clinical trials in atrial fibrillation management were presented as part of the “Hot Line” sessions at this year’s European Society of Cardiology Congress in Barcelona, Spain. A selection particularly relevant to the general cardiology community is presented here.
      PubDate: Fri, 20 Oct 2017 10:19:00 -040
       
  • Research Shows Link Between Quality and Readmission Rates
    • Abstract: Researchers studied readmissions of more than 2.7 million Medicare patients over age 65, treated at more than 4,700 hospitals between 2014 and 2015. Hospitals in the highest performance quartile for quality had significantly lower 30-day readmission rates than those in the lowest quartile.
      PubDate: Tue, 17 Oct 2017 16:21:00 -040
       
  • Promising Time for Careers in Healthcare Quality, Report Says
    • Abstract: A new report says demand for healthcare quality management is likely to increase as a result of government mandates compelling healthcare providers to improve the quality of patient care they offer, the rising volume of unstructured data in the healthcare sector, and the demand for reducing healthcare costs and risk of medical errors.
      PubDate: Tue, 17 Oct 2017 16:15:00 -040
       
  • CMS Offers Guidance on Inpatient Engagement Necessary for Hospital
           Certification
    • Abstract: The new guidance highlights two key factors that surveyors should consider: average length of stay (ALOS) and average daily census (ADC).
      PubDate: Tue, 17 Oct 2017 16:10:00 -040
       
  • ICU Diaries Help Patients, Families Cope With Stress and Aftereffects
    • Abstract: An innovative diary system has helped to reduce the incidence of post-intensive care syndrome (PICS) at a California health system.
      PubDate: Tue, 17 Oct 2017 16:06:00 -040
       
  • AHA Urges CMS to Halt Quality Star Ratings, Calls Them Misleading
    • Abstract: The American Hospital Association's vice president of public policy analysis and development says the ratings program poses a “regulatory burden” that is “substantial and unsustainable” for hospitals.
      PubDate: Tue, 17 Oct 2017 15:56:00 -040
       
  • Avoid Lost Revenue Caused by Insurance Eligibility Mistakes
    • Abstract: Patient access staff can interpret responses from insurance eligibility software incorrectly, causing lost revenue. This article provides tips to help prevent mistakes.
      PubDate: Tue, 17 Oct 2017 15:54:00 -040
       
  • Too Many ‘John Does'’ Tighten Processes for Unidentified
           Patients
    • Abstract: Unidentified patients pose safety concerns because of the possibility of duplicate medical record creation and patient misidentification. Several approaches may help minimize safety concerns.
      PubDate: Tue, 17 Oct 2017 15:49:00 -040
       
  • ‘Floater’ Reduces OT and Burnout
    • Abstract: About 150 hours a year in overtime is no longer needed in the patient access department at one facility because of a new “floater” position created several years ago.
      PubDate: Tue, 17 Oct 2017 15:45:00 -040
       
  • WSJ Casts Doubt on Value of TJC Accreditation
    • Abstract: One quality professional says the Wall Street Journal's new report may have raised some valid concerns, but also misrepresents how TJC accreditation works.
      PubDate: Tue, 17 Oct 2017 15:41:00 -040
       
  • Trust Patient Access Employees With These Important Projects
    • Abstract: Patient access employees appreciate being asked to participate in projects, and the department benefits from their feedback.
      PubDate: Tue, 17 Oct 2017 15:40:00 -040
       
  • Cross-training’s True Return on Investment: A Better Patient
           Experience
    • Abstract: Cross-training registrars improves patient satisfaction with shorter waits and improves employee satisfaction with opportunities to advance.
      PubDate: Tue, 17 Oct 2017 15:34:00 -040
       
  • Physician Skepticism on Satisfaction Can Be Overcome
    • Abstract: The focus on patient satisfaction may be reaching a level that prompts some physicians to rebel.
      PubDate: Tue, 17 Oct 2017 15:28:00 -040
       
  • Have Plan B for Unexpected Call-outs: Reduce OT
    • Abstract: If registration areas are understaffed during peak volumes, patient care, registration quality, and customer service all suffer.
      PubDate: Tue, 17 Oct 2017 15:25:00 -040
       
  • Upfront Collections Increased by $3 Million With Preservice Financial
           Clearance Process
    • Abstract: With a preservice financial clearance process, Cox Health increased annual point-of-service collections to $1.4 million from $800,000; Texas Health Resources’ collections rose from $8 million to $11 million.
      PubDate: Tue, 17 Oct 2017 15:13:00 -040
       
  • Hypersensitivity Reactions in the Pediatric ED: The Tip of the Iceberg
    • Abstract: Hypersensitivity reactions are very common. Understanding the different types, including serum sickness-like reactions, Stevens-Johnson syndrome, toxic epidermolytic necrolysis, and drug reaction with eosinophilia and systemic symptoms, is valuable both for an accurate and timely diagnosis as well as appropriate management.
      PubDate: Tue, 17 Oct 2017 14:16:00 -040
       
  • Management of Chronic Hypertension in Pregnancy
    • Abstract: Chronic hypertension complicates about 5% of pregnancies and has been associated with higher rates of intrauterine growth restriction (IUGR), stillbirth, and, most importantly, superimposed preeclampsia. Although the condition is far from being solved, there have been some major inroads made into its understanding through contemporary investigation.
      PubDate: Tue, 17 Oct 2017 12:00:00 -040
       
  • The LNG IUS and Stress Reactivity: A Mechanism for Mood Effects or False
           Signal'
    • Abstract: Users of the levonorgestrel (LNG) intrauterine system showed an exaggerated response to stress compared to women using a combined LNG pill or those with natural cycles.
      PubDate: Tue, 17 Oct 2017 11:55:00 -040
       
  • Just Which Patients Are at Risk of Developing Uterine Fibroids'
    • Abstract: Uterine fibroids occur commonly and are the most frequent reason for hysterectomy in the United States. Recognizing the risk factors for developing fibroids can help clinicians identify affected individuals and may lead to new approaches to treatment.
      PubDate: Tue, 17 Oct 2017 11:50:00 -040
       
  • Brain Reanimation Investigator Reports Dramatic Results
    • Abstract: Though the findings come with a considerable caveat — they have yet to be published in a peer-reviewed journal — the lead investigator of a controversial brain reanimation study using “living cadavers” is reporting some dramatic results.
      PubDate: Tue, 17 Oct 2017 10:15:00 -040
       
  • HHS to Take Action to Protect Research Whistleblowers
    • Abstract: The Department of Health and Human Services is taking measures to protect whistleblowers who express concern about human research trials, agreeing with a government watchdog report that the current system has a chilling effect due to “fear of reprisal.”
      PubDate: Tue, 17 Oct 2017 10:12:00 -040
       
  • IRBs Could Address Ethical Issues Related to Tracking Devices
    • Abstract: Some IRBs have begun to review studies that use medical devices with tracking technology. These types of mobile devices raise some ethical and regulatory questions.
      PubDate: Tue, 17 Oct 2017 10:08:00 -040
       
  • The Choice: A Decision to Decline a Clinical Trial
    • Abstract: Ten years ago, Rebecca Dresser, MS, JD, faced a life-changing and, quite possibly, life-saving decision. As a bioethicist and IRB member, she was informed of a diagnosis of cancer and offered a difficult choice: She could enter a new clinical trial for treatment, or follow a specific regimen recommended by oncologists on a tumor board.
      PubDate: Tue, 17 Oct 2017 10:04:00 -040
       
  • IRB Collaborations With Tech Companies Could Mean What to the IRB'
    • Abstract: Tech companies increasingly are partnering with research institutions. These partnerships include sharing data and project collaboration. What IRBs will want to know as this trend continues is what it means from a human research protection perspective.
      PubDate: Tue, 17 Oct 2017 09:57:00 -040
       
  • Bypassing an IRB Review, Researchers Held Herpes Vaccine Trial on an
           Island
    • Abstract: The human research protection community recently learned of a troubling clinical trial that involved private funding, a U.S. medical college researcher who died this summer, and a study held on a Caribbean island. The clinical trial was for a live attenuated herpes simplex virus-2 vaccine injected in human participants, and it was never reviewed by an IRB.
      PubDate: Tue, 17 Oct 2017 09:53:00 -040
       
  • Bundled Approach to Handoff Communication Delivers Significant Safety
           Dividends
    • Abstract: With an estimated 80% of the most serious medical errors linked to communication failures, handoff processes are a rich target for improvement. There are numerous tools designed to help providers remember to convey the most important information when transitioning a patient to another provider, but one approach in particular has demonstrated in multiple studies that it can reduce medical errors and preventable adverse events substantially.
      PubDate: Tue, 17 Oct 2017 09:32:00 -040
       
  • Organization Expands Case Management for North Carolina Sickle Cell
           Population
    • Abstract: North Carolina patients with sickle cell disease are a small population that experiences repeated and costly ED visits and hospitalizations. Community Care of North Carolina has 600 care managers statewide, who work primarily with Medicaid patients, matching them with 14 networks and care managers across the state.
      PubDate: Tue, 17 Oct 2017 09:26:00 -040
       
  • Orthopedic Nurse Navigator Helps Surgery Patients Stay Healthy
    • Abstract: The Comprehensive Care for Joint Replacement program helped the University of Pittsburgh Medical Center Passavant reduce the percentage of total joint replacement patients who are discharged to a skilled nursing facility instead of home.
      PubDate: Tue, 17 Oct 2017 09:18:00 -040
       
  • Medicare Payment Codes Related to Care Management
    • Abstract: Starting in 2017, the Centers for Medicare & Medicaid Services provided new Healthcare Common Procedure Coding System codes for care management payment.
      PubDate: Tue, 17 Oct 2017 09:14:00 -040
       
  • Designers of Collaborative Behavioral Health and Primary Care Models See
           Growth in Future
    • Abstract: Recent Medicare funding for care management services, related to integrated behavioral health and primary care, has provided more incentives for healthcare organizations to use this approach.
      PubDate: Tue, 17 Oct 2017 09:10:00 -040
       
  • It’s Not the Stress, It’s the Unhealthy Coping
    • PubDate: Mon, 16 Oct 2017 00:00:00 -040
       
  • Liability Protections for EMTALA Care Elusive for EPs
    • Abstract: Although several states have enacted liability reform legislation for ED care, efforts at the federal level have been less successful. Here is a summary of legislation under consideration in Congress.
      PubDate: Wed, 11 Oct 2017 10:29:00 -040
       
  • Visit Volume Linked to Being Named in Claim
    • Abstract: One in 11 EPs was named in malpractice claims during a 4.5 year period, according to a recent study. Total number of years in practice and visit volume were the only factors associated with being named as a defendant.
      PubDate: Wed, 11 Oct 2017 10:24:00 -040
       
  • When Psychiatric Patient Comes to ED, Consider Entire Hospital’s
           Capabilities
    • Abstract: An attorney who worked on the case provides detailed information about a recent record-breaking EMTALA settlement.
      PubDate: Wed, 11 Oct 2017 10:19:00 -040
       
  • Inspector General Sets Sights on ED Psychiatric Boarding Practices
    • Abstract: Psychiatric patients are held routinely in EDs for hours, days, or even weeks due to lack of available facilities. Few would argue it’s a high-risk situation for the patient, EPs, and the hospital; yet, the dangerous practice continues.
      PubDate: Wed, 11 Oct 2017 09:58:00 -040
       
  • Non-prudent Limits on Patient Visits: Overcoming Barriers to Provide
           Necessary Care
    • Abstract: Since EMTALA requires medical professionals to provide care to their patients, big insurance companies see no reason to provide payment for care they do not feel like covering. While some argue that on the surface this is their right to pay only for necessary services, the decision to retrospectively deny coverage is a fundamental assault on the rights of patients to seek emergency care and providers to bill for legitimate services rendered. Using the “retrospectoscope” to lecture patients and providers about care for serious health threats is a disservice to all medical professionals. It is unconscionable, immoral, illegal, and potentially unconstitutional.
      PubDate: Wed, 11 Oct 2017 09:51:00 -040
       
  • Clinical Briefs
    • Abstract: In this section: A better definition for celiac disease; shedding light on a vaccine; and treating asthma.
      PubDate: Wed, 11 Oct 2017 09:22:00 -040
       
  • Meropenem and Vaborbactam Injection (Vabomere)
    • Abstract: The FDA has approved a new combination antibacterial for the treatment of complicated urinary tract infections.
      PubDate: Wed, 11 Oct 2017 09:16:00 -040
       
  • Is a Dabigatran Reversal Agent Effective'
    • Abstract: A pragmatic clinical study of idarucizumab for counteracting the effects of the oral anticoagulant dabigatran showed rapid and complete reversal of its effects in patients with major bleeding or urgent surgery, without any adverse safety concerns.
      PubDate: Wed, 11 Oct 2017 09:08:29 -040
       
  • Mother Was Right: You Are What You Eat
    • Abstract: In a study of simplified enterotypes as prognostic markers for successful body fat loss on two different diets, participants with a greater ratio of Prevotella to Bacteroides appeared more susceptible to lose body fat on diets high in fiber and whole grains.
      PubDate: Wed, 11 Oct 2017 09:05:00 -040
       
  • Diet High in Carbohydrates, Not Fats, Drives Mortality
    • Abstract: A prospective epidemiological cohort study of people 35-70 years of age in 18 countries showed that a higher intake of carbohydrates increased total mortality, while the intake of fats of all kinds did not. A higher intake of saturated fat reduced stroke mortality.
      PubDate: Wed, 11 Oct 2017 08:59:00 -040
       
  • Emerging Fungus Can Colonize Skin for Months
    • Abstract: Employee health professionals should be aware of an emerging new multidrug-resistant fungal “superbug,” Candida auris. This pathogen spreads more like bacteria than fungi and can colonize the skin for prolonged periods, the CDC reports.
      PubDate: Tue, 10 Oct 2017 15:44:00 -040
       
  • If You Have a Needle Safety Device, Activate It
    • Abstract: In 56% of needlesticks involving safety devices, the protective mechanism was not activated, the International Safety Center's Exposure Prevention Information Network reports.
      PubDate: Tue, 10 Oct 2017 15:32:00 -040
       
  • Flu Immunization Rates Level Off in Healthcare Workers
    • Abstract: While hospital rates remain high, flu immunization rates of healthcare workers overall have leveled off and remain particularly low in long-term care, the CDC reports.
      PubDate: Tue, 10 Oct 2017 15:26:00 -040
       
  • Patient Mobility Forum Founded
    • Abstract: A new safe patient handling forum is now online for employee professionals to ask questions or share ideas and policies with colleagues and industry. 
      PubDate: Tue, 10 Oct 2017 15:24:00 -040
       
  • Severe Flu Season in Australia Could Herald U.S. Woes
    • Abstract: The annual attempt to match the seasonal influenza vaccine with mutating flu viruses always is a bit of a gamble, and this year is no different. In particular, the U.S. vaccine may not provide complete immunity to an H3N2 strain that has caused serious infections during the summer season in Australia.
      PubDate: Tue, 10 Oct 2017 15:19:00 -040
       
  • Evacuate: When Hurricane Sandy Forced HCWs to Flee
    • Abstract: Five years ago Hurricane Sandy battered and inundated the Northeast, forcing the evacuation and shutdown of New York University’s Langone Medical Center in New York City. Hospital researchers recently published an analysis of how NYU nurses were affected by the event, suggesting planning strategies for hospitals affected by major storms and disasters.
      PubDate: Tue, 10 Oct 2017 15:15:00 -040
       
  • Employee Health Steps Up as Hurricanes Hit Hospitals
    • Abstract: Employee health professionals hunkered down with their hospital colleagues recently as hurricanes Harvey and Irma hit the contiguous United States and Hurricane Maria subsequently devastated Puerto Rico. While relief efforts were still underway in Puerto Rico as this issue went to press, Hospital Employee Health talked to employee health professionals who were on hospital duty in the path of Harvey and Irma.
      PubDate: Tue, 10 Oct 2017 15:09:00 -040
       
  • The Pediatric Airway and Rapid Sequence Intubation in Trauma
    • Abstract: This article will discuss in detail the approach to the pediatric trauma patient, with a strict focus on the pediatric airway.
      PubDate: Mon, 09 Oct 2017 15:32:00 -040
       
  • A Link Between Demodex Mites and Rosacea
    • Abstract: The role of Demodex in rosacea appears to be well demonstrated. Since eradication of Demodex is insufficient to resolve rosacea, other pathophysiologic pathways also must be involved.
      PubDate: Mon, 09 Oct 2017 13:55:00 -040
       
  • More Good News for GLP-1 RA in Type 2 Diabetes
    • Abstract: Since 2008, the FDA has required all new diabetes medications to provide evidence of cardiovascular (CV) safety. The good news is that several classes of agents have demonstrated not only CV safety, but even efficacy in reducing CV events and (in some cases) all-cause mortality.
      PubDate: Mon, 09 Oct 2017 13:51:00 -040
       
  • Menopausal Hormone Replacement
    • Abstract: For women who use or have used hormone replacement for menopausal symptoms, new data should be reassuring that their symptom relief does not come at a cost of increased total or cancer-related mortality.
      PubDate: Mon, 09 Oct 2017 13:49:00 -040
       
  • Is It Safe to Use PPIs Long Term'
    • Abstract: Proton pump inhibitors (PPIs) are among the most widely used medications in the United States, thanks to a generally favorable combination of efficacy, tolerability, and safety. Because such a large portion of the adult population uses PPIs, even if a small fraction experiences an adverse effect, it becomes a potentially important issue.
      PubDate: Mon, 09 Oct 2017 13:47:00 -040
       
  • The Long-term Picture After Bariatric Surgery
    • Abstract: While often viewed as a last-resort treatment of obesity, bariatric surgery actually is the only intervention demonstrated to improve obesity-related mortality. Strict criteria for payment by insurers and costs that are inaccessible to most of the uninsured have restricted the population who could benefit from bariatric surgery.
      PubDate: Mon, 09 Oct 2017 13:45:00 -040
       
  • Opioid-induced Nausea and Vomiting
    • Abstract: Opioids are highly effective when administered for appropriate indications. Unfortunately, opioid-induced nausea and/or vomiting (OINV) can limit opioid effectiveness. In the immediate postoperative period, OINV can stress wound integrity and prolong hospital stay. In the outpatient setting, some patients are faced with the dilemma of accepting lesser levels of pain control in exchange for less OINV as they consider whether they should decrease their opioid dosing schedule.
      PubDate: Mon, 09 Oct 2017 13:43:00 -040
       
  • FDA Actions
    • Abstract: In this section: The FDA unveils new adverse events dashboard tool, announces intent to hasten generic drug approvals, greenlights a generic drug to treat multiple sclerosis, greenlights biosimilar to treat multiple types of cancers, gives go ahead to leukemia treatment, and approves updated herpes zoster vaccine.
      PubDate: Mon, 09 Oct 2017 13:23:00 -040
       
  • Possible Adverse Cardiovascular Events Slow Osteoporosis Drug Approval
           Process
    • Abstract: Romosozumab appears to outperform alendronate for fracture prevention in women with osteoporosis, but an increase in cardiovascular adverse events has derailed FDA approval.
      PubDate: Mon, 09 Oct 2017 13:16:00 -040
       
  • Comparing Two Important Hormone Therapy Treatments
    • Abstract: New data from the Women’s Health Initiative may be reassuring for women on postmenopausal hormone therapy. The data show no higher mortality rate with hormone use after long-term follow-up.
      PubDate: Mon, 09 Oct 2017 13:14:00 -040
       
  • What Is the Appropriate Length of Opioid Prescriptions After Routine
           Surgeries'
    • Abstract: Postsurgical opioid prescriptions often lead to extra pills stored in unsecured locations in homes. This represents a potential source for non-medical opioid use and associated morbidity and mortality for patients and their families.
      PubDate: Mon, 09 Oct 2017 13:12:00 -040
       
  • Making the Most of a High-deductible Plan Environment
    • Abstract: It was just in one summer month, but Bluffton Okatie Surgery Center in Bluffton, SC, logged a cash collection rate of 100.2%.
      PubDate: Fri, 06 Oct 2017 15:42:00 -040
       
  • For Your Consideration: A Few Interesting FAQs and Answers
    • Abstract: Stephen Earnhart answers reader questions on communication, investing, and electronic medical records.
      PubDate: Fri, 06 Oct 2017 15:38:00 -040
       
  • Surgery Center Finds Success With High-acuity Spine Cases
    • Abstract: ASCs that are expanding their services might find that high-acuity spine cases can work well. Some strategies for expanding into spine cases are similar to expanding into total joint cases.
      PubDate: Fri, 06 Oct 2017 15:33:00 -040
       
  • Follow These Steps for Analysis in Infection Investigations
    • Abstract: Because ASCs experience high patient volumes, any lapse in infection control best practices at an ASC can create major problems. The way to prevent a post-surgery infection outbreak is to follow quality improvement steps in surveillance, detection, analysis, and process changes.
      PubDate: Fri, 06 Oct 2017 15:23:00 -040
       
  • Learn More About Payers to Improve Collections Success
    • Abstract: Learning more about the payer market can help surgery centers reduce denials and improve collections.
      PubDate: Fri, 06 Oct 2017 15:20:00 -040
       
  • After Entering Into a Joint Venture, Here’s What an ASC Can Do
    • Abstract: When considering a joint venture with a health system, know which questions to ask and what type of agreement will work.
      PubDate: Fri, 06 Oct 2017 15:15:00 -040
       
  • Are Joint Ventures With Hospitals Beneficial to Surgery Centers'
    • Abstract: Ambulatory surgery centers can benefit from a joint venture with a health system, depending on how it is structured.
      PubDate: Fri, 06 Oct 2017 15:10:00 -040
       
  • Shocking Nurse Arrest Prompts Discussions About Working With Police
           Officers
    • Abstract: Hospital workers and law enforcement officers often drill together, and they generally work cooperatively to ensure safety and security. Consequently, while disputes are not unheard of, the well-publicized arrest of a Utah nurse who refused to comply with a police detective’s request for a blood sample is a reminder that frontline providers must be well-versed in how to handle such requests.
      PubDate: Fri, 06 Oct 2017 08:35:00 -040
       
  • Detailed Preparation Helped Miami Hospital Staff Withstand Hurricane Irma
    • Abstract: While Hurricane Harvey was submerging much of southeast Texas with flood waters, another monster storm was aiming for Florida, and hospitals there were preparing for what forecasters said would be a historic hurricane in terms of size and the potential for damage.
      PubDate: Fri, 06 Oct 2017 08:29:00 -040
       
  • Hurricane Harvey Pushed Southeast Texas Hospitals to the Limit
    • Abstract: With several medical facilities in southeast Texas affected by the historic storm, Franklin, TN-based IASIS Healthcare pooled its resources, shuttled in relief staff from hospitals in other states, and found creative ways to reach hospitals surrounded by flood waters.
      PubDate: Fri, 06 Oct 2017 08:26:00 -040
       
  • Hemodynamic Monitoring Modalities in the Emergency Department
    • Abstract: Hemodynamic monitoring is a very important component in effectively resuscitating critically ill patients. Various methods of hemodynamic monitoring not only give the physician an idea of the patient’s overall pathophysiology, but can alert the physician to acute changes.
      PubDate: Thu, 05 Oct 2017 16:14:00 -040
       
  • Flu Immunization Rates Level Off in Healthcare Workers
    • Abstract: Hospitals on board, long-term care workers lagging.
      PubDate: Wed, 04 Oct 2017 00:00:00 -040
       
  • Secondary Heart Failure Affects Readmissions
    • Abstract: Heart failure that develops or worsens during a hospital stay can affect outcomes, costs, and readmissions, so hospitals are advised to identify patients at risk for secondary heart failure.
      PubDate: Tue, 03 Oct 2017 07:49:00 -040
       
  • Improved Patient Handoffs Require Comprehensive Approach
    • Abstract: Hospitals are paying more attention to patient handoffs as a crucial element in quality and patient safety, with an evolution toward seeing them as not just a distinct task, but more as a comprehensive strategy.
      PubDate: Tue, 03 Oct 2017 07:47:00 -040
       
  • They're Back! CMS Audits Are Ratcheting Up
    • Abstract: Hospitals have had a reprieve from record requests, denials, and appeals, but that’s about to change as CMS ramps up its auditing programs.
      PubDate: Tue, 03 Oct 2017 07:43:00 -040
       
  • For Better Patient Care, Communicate Early and Often
    • Abstract: In today’s healthcare world, communicating with other clinicians in the hospital and in post-acute provider organizations is essential to ensure patients receive the care they need to stay out of the hospital and the ED.
      PubDate: Tue, 03 Oct 2017 07:40:00 -040
       
  • No Crystal Ball Needed to Know Where CMS May Focus
    • Abstract: To get a good idea of what diagnoses CMS will add to the readmission reduction program or other value-based purchasing programs, look no further than the Hospital Inpatient Quality Reporting Program components.
      PubDate: Tue, 03 Oct 2017 07:37:00 -040
       
  • Under New Leadership, CMS Continues Emphasis on Quality
    • Abstract: Despite all of the changes in Washington, DC, the Centers for Medicare & Medicaid Services remains committed to providing high-quality, efficient, and cost-effective care.
      PubDate: Tue, 03 Oct 2017 07:33:00 -040
       
  • Here’s When EDs Should Increase Usage of Antibiotics
    • Abstract: Emergency clinicians are under a lot of pressure to reduce antibiotic prescribing, so it is news when a study suggests the medications aren’t being used enough in a specific situation.
      PubDate: Tue, 03 Oct 2017 00:00:00 -040
       
  • Less Long-term Use When Opioids Initially Prescribed at ED
    • Abstract: Despite efforts in the past to blame emergency medicine for the nation’s opioid epidemic, a new study finds that patients who are prescribed opioids for the first time in the emergency department (ED) are much less likely to become long-term narcotics users.
      PubDate: Tue, 03 Oct 2017 00:00:00 -040
       
  • General EDs More Likely to Use CT to Diagnose Pediatric Abdominal Pain
    • Abstract: Computed tomography (CT) scans are more likely to be used in a general emergency department (ED) to diagnosis children with nontraumatic abdominal pain than in an ED specializing in pediatrics, according to a new study.
      PubDate: Tue, 03 Oct 2017 00:00:00 -040
       
  • ED Visits at Record High Since Affordable Care Act Implementation
    • Abstract: After implementation of the Affordable Care Act (ACA) visits to emergency departments (EDs) shot up, climbing to a record high of 141.4 million patient visits in 2014, the most recent data available.
      PubDate: Tue, 03 Oct 2017 00:00:00 -040
       
  • Aberrant Conduction or Ventricular Bigeminy'
    • Abstract: How would you interpret the tracing' Are these multifocal (multiform) premature ventricular contractions'
      PubDate: Mon, 02 Oct 2017 08:53:00 -040
       
  • Clinical Briefs
    • Abstract: In this section: managing diabetes; elective surgery; and nephrolithiasis patients.
      PubDate: Mon, 02 Oct 2017 08:49:00 -040
       
  • Tisagenlecleucel Suspension (Kymriah)
    • Abstract: Kymriah is indicated for the treatment of patients up to 25 years of age with B-cell precursor acute lymphoblastic leukemia that is refractory or in second or later relapse.
      PubDate: Mon, 02 Oct 2017 08:45:00 -040
       
  • What Is the Ideal Target for Blood Pressure Control'
    • Abstract: Researchers organized a study to address quality-of-life outcomes based on recent blood pressure recommendations.
      PubDate: Mon, 02 Oct 2017 08:36:00 -040
       
  • Do Antibiotics Reduce Hormonal Contraceptive Effectiveness'
    • Abstract: Researchers conducted a systematic review of studies that evaluated the effect of concomitant non-rifamycin antibiotic use on hormonal contraceptive effectiveness. Although data are limited, there was no evidence to support the existence of drug interactions.
      PubDate: Mon, 02 Oct 2017 08:33:00 -040
       
  • Screening for Prostate Cancer May Offer Survival Benefits
    • Abstract: Using a mathematical model to account for differences in implementation and baseline screening, researchers reassessed mortality data from two major studies and discovered that screening led to a 25-30% reduction of prostate cancer death in both.
      PubDate: Mon, 02 Oct 2017 08:28:00 -040
       
  • Medicaid Waivers Pose New Threats to Reproductive Health
    • Abstract: State policymakers around the country are pursuing changes to Medicaid that could have serious implications for healthcare access.
      PubDate: Wed, 27 Sep 2017 17:06:00 -040
       
  • Vaginal Estrogen Found to Be Safe, Effective Option During Menopause
    • Abstract: Results of recent research indicate that vaginal estrogen is effective and safe for the treatment of genitourinary symptoms. Such low-dose vaginal estrogen options keep blood levels within the normal postmenopausal range.
      PubDate: Wed, 27 Sep 2017 16:59:00 -040
       
  • Condoms: Report Showcases Usage Trends
    • Abstract: A recent analysis of national data indicates that from 2011-2015, 23.8% of women and 33.7% of men ages 15-44 used a condom at last sexual intercourse. Of those who used condoms, about 60% of men and 56% of women relied on condoms alone for pregnancy prevention.
      PubDate: Wed, 27 Sep 2017 16:54:00 -040
       
  • More Parents Choosing the HPV Shot for Teens
    • Abstract: Six of 10 U.S. parents now are choosing to have their teens vaccinated against HPV.
      PubDate: Wed, 27 Sep 2017 16:49:00 -040
       
  • Postpartum Placement of Hormonal IUD Does Not Affect Breastfeeding
           Outcomes
    • Abstract: Women can avoid unintended pregnancy and successfully breastfeed.
      PubDate: Wed, 27 Sep 2017 16:39:00 -040
       
  • Tribulus: An RCT Supporting Its Use for Erectile Dysfunction
    • Abstract: This double-blind, randomized, controlled trial in 180 men showed that a standardized extract of Tribulus terrestris improved erectile function after 12 weeks of treatment.
      PubDate: Wed, 20 Sep 2017 15:08:00 -040
       
  • Acupuncture Decreases the Perception of Stress in a College Population
    • Abstract: A verum acupuncture group led to a greater reduction in the perception of stress when compared to a sham acupuncture group.
      PubDate: Wed, 20 Sep 2017 15:04:00 -040
       
  • Oily Fish Is Associated With Better Sleep
    • Abstract: A study in Ecuador showed a strong positive correlation between dietary oily fish intake and sleep quality.
      PubDate: Wed, 20 Sep 2017 15:00:00 -040
       
  • Caring for Providers: Mindfulness for Healthcare Practitioners
    • Abstract: A review of studies regarding brief mindfulness interventions for healthcare providers found an association with improved measures of provider well-being and no evidence of behavioral changes.
      PubDate: Wed, 20 Sep 2017 14:55:00 -040
       
  • Acupuncture and Neuromodulation in the Treatment of Migraine
    • Abstract: Individuals suffering with migraine often use complementary and integrative therapies to treat migraine symptoms. Acupuncture has moderate evidence in reducing the frequency of migraine attacks, and neuromodulation is a promising treatment on the horizon for those suffering with migraine.
      PubDate: Wed, 20 Sep 2017 14:50:00 -040
       
  • Joint Arthrocentesis in the Emergency Department
    • Abstract: The ability to rapidly recognize infection, as well as distinguish inflammatory arthropathy from infection, crystal arthropathy, and osteoarthritis, makes arthrocentesis a valuable and sometimes essential emergency medicine procedure.
      PubDate: Wed, 20 Sep 2017 14:18:00 -040
       
  • What Is the Ideal Target for Blood Pressure Control'
    • Abstract: Patient-reported outcomes in a recent trial of subjects who received intensive treatment with a target systolic blood pressure of < 120 mmHg were similar to those who received standard care, supporting the recommendations of SPRINT.
      PubDate: Wed, 20 Sep 2017 12:24:00 -040
       
  • Cerebrolysin Is Unproven as a Neuroprotectant for Acute Ischemic Stroke
    • Abstract: The routine use of Cerebrolysin in acute stroke is not justified.
      PubDate: Wed, 20 Sep 2017 12:17:00 -040
       
  • Idarucizumab for Reversal of the Anticoagulant Effects of Dabigatran
    • Abstract: The administration of idarucizumab is effective and safe for the reversal of the direct thrombin inhibitor, dabigatran, and should be used in appropriate clinical situations.
      PubDate: Wed, 20 Sep 2017 12:14:00 -040
       
  • Sudden Prehospital Death From Subarachnoid Hemorrhage
    • Abstract: Based on recent nationwide data reported from Finland, one-fourth of those experiencing their first ever subarachnoid hemorrhage died suddenly before being admitted to a hospital.
      PubDate: Wed, 20 Sep 2017 12:08:00 -040
       
  • Infectious Disease Alert Updates
    • Abstract: Corporate Antibiotic Stewardship; Hypervirulence Meets Antibiotic Resistance — A Lethal Combination; Glue Masquerading as an Aortic Root Abscess; Molecular Diagnostic Coup
      PubDate: Wed, 20 Sep 2017 12:03:00 -040
       
  • California and Coccidioidomycosis: Be Careful About the Air You Breathe
    • Abstract: Cases of coccidioidomycosis significantly increased in 2016.
      PubDate: Wed, 20 Sep 2017 11:54:00 -040
       
  • Polyneuropathy and Nutrition
    • Abstract: Other than the identification of a specific vitamin or essential element deficiency, overall nutritional status does not appear to play any role in the development of idiopathic neuropathies in adults.
      PubDate: Wed, 20 Sep 2017 11:47:00 -040
       
  • Delafloxacin (Baxdela®)
    • Abstract: Delafloxacin is a new broad-spectrum fluoroquinolone that was approved by the U.S. Food and Drug Administration in June 2017 for acute bacterial skin and skin structure infections.
      PubDate: Wed, 20 Sep 2017 11:45:00 -040
       
  • Lamotrigine for Myotonia
    • Abstract: SYNOPSIS: In a randomized, double-blind, placebo-controlled treatment trial of patients with non-dystrophic myotonia, those treated with lamotrigine experienced significant improvement.
      PubDate: Wed, 20 Sep 2017 11:44:00 -040
       
  • REM Sleep, Not Slow-wave Sleep, Decreases Dementia Risk
    • Abstract: In a series of clinical studies of cognitively normal people older than 60 years of age, disruption of REM sleep and reduced quantity of REM sleep increased the risk of developing Alzheimer-type dementia.
      PubDate: Wed, 20 Sep 2017 11:40:00 -040
       
  • Tau as a Biomarker of Acute and Chronic Traumatic Brain Injury
    • Abstract: The ongoing search for reliable biomarkers of traumatic brain injury repeatedly has demonstrated the reliability of using plasma phosphor-tau levels to help distinguish injury from normal, and severe injury from mild injury.
      PubDate: Wed, 20 Sep 2017 11:37:00 -040
       
  • Fungal Endophthalmitis: Another Risk Associated With Intravenous Drug Use
    • Abstract: A retrospective cohort study found that endogenous fungal endophthalmitis is associated with intravenous drug use and frequently results in poor visual outcomes despite appropriate surgical and antifungal therapy.
      PubDate: Wed, 20 Sep 2017 11:36:00 -040
       
  • Taste, Smell, and the Insular Cortex
    • Abstract: Olfaction and taste appear to be localized in the insular cortex with bilateral representation.
      PubDate: Wed, 20 Sep 2017 11:30:00 -040
       
  • Rheumatic Heart Disease — The Global Situation
    • Abstract: With advances in access to good medical care, the global burden of rheumatic heart disease is declining. However, there still is significant disease in resource-limited regions of the world.
      PubDate: Wed, 20 Sep 2017 11:21:00 -040
       
  • Chagas Seroprevalence in Military Personnel in Texas
    • Abstract: A cross-sectional study of military trainees and instructors who spend significant time in field conditions was performed at Joint Base San Antonio to determine the prevalence of Trypanosoma cruzi infection. None tested positive by polymerase chain reaction nor by enzyme-linked immunosorbent assay or indirect immunofluorescent antibody.
      PubDate: Wed, 20 Sep 2017 11:12:00 -040
       
  • Extreme Weather and Infectious Diseases: What Will Follow Hurricanes
           Harvey and Irma'
    • Abstract: Among the dangers faced after a severe weather event is an increased risk of various infections.
      PubDate: Wed, 20 Sep 2017 11:05:00 -040
       
  • Zika Virus Disease: A Primer for the Primary Care Physician
    • Abstract: Zika virus disease is a global issue, but with the recent hurricanes and flooding in Texas and Florida, mosquito-borne illnesses may become more prevalent. This article discusses the latest recommendations for the prevention of Zika viral disease, the populations and regions still at increased risk, and the latest and most promising research being conducted to develop a Zika virus vaccine and treatment.
      PubDate: Wed, 20 Sep 2017 08:58:00 -040
       
  • Conversation Increases Blood Pressure Medication Adherence for Some
           Low-income Patients
    • Abstract: Physicians uncertain how to help low-income patients follow their blood pressure medication regimens are advised to take this approach: Just discuss it with them.
      PubDate: Wed, 20 Sep 2017 00:00:00 -040
       
  • Program Successfully Combines Primary Care, Substance Abuse Treatment
    • Abstract: Sending patients away for substance abuse treatment might not always be the best way for primary care providers to deal with those problem, a new study shows.
      PubDate: Wed, 20 Sep 2017 00:00:00 -040
       
  • EHRs Eat Up Half of Physician Time, But Help Could Be on the Way
    • Abstract: If you feel like you are spending half your time entering information into your practice’s electronic health record, you are not alone.
      PubDate: Wed, 20 Sep 2017 00:00:00 -040
       
  • Survey: Fear of Malpractice Drives Most Overuse of Healthcare Resources
    • Abstract: Most of wasted healthcare resources and costs in the United States are related to unnecessary medical services, according to a new study. The price tag' About $210 billion a year.
      PubDate: Wed, 20 Sep 2017 00:00:00 -040
       
  • ‘Ever-Expanding Options’ Prolong Life, but Spark Conflicts
    • Abstract: Surrogates may be struggling to let go of a loved one, may not understand clinical realities, or may have religious or cultural beliefs about withdrawal or withholding of life-sustaining medical interventions. Regardless of the reason, families sometimes want to “do everything” when the clinical team feels it’s time to stop.
      PubDate: Tue, 19 Sep 2017 09:44:00 -040
       
  • Study: Only About One-third of Adults Completed Advance Directives
    • Abstract: Only about one-third (37%) of U.S. adults had completed any type of advance directive, found a recent review of studies.
      PubDate: Tue, 19 Sep 2017 09:40:00 -040
       
  • Revised Common Rule Is Changing Informed Consent
    • Abstract: The recently updated Federal Policy for the Protection of Human Subjects, also called the Common Rule, is changing informed consent practices in two important ways.
      PubDate: Tue, 19 Sep 2017 09:36:00 -040
       
  • Can Intoxicated Patients Provide Informed Consent for Research'
    • Abstract: It’s not uncommon for ED patients to present with acute intoxication. This complicates not only their clinical care, but also the informed consent process. A recent study set out to determine to what extent acute alcohol intoxication affects capacity to assent, consent, or refuse research participation.
      PubDate: Tue, 19 Sep 2017 09:33:00 -040
       
  • Unethical Marketing Practices for Stem Cell Treatments Continue
    • Abstract: Recently passed legislation allows Texas clinics to bypass FDA approval for investigational stem cell treatments for patients with certain severe chronic diseases or terminal illnesses. The law alarmed ethicists who have been monitoring these practices.
      PubDate: Tue, 19 Sep 2017 09:28:00 -040
       
  • Patients Without Surrogates Pose Ethical Challenges at End of Life
    • Abstract: The issue of incapacitated patients lacking surrogates has received growing attention, resulting in a newly updated position statement and several case studies.
      PubDate: Tue, 19 Sep 2017 09:22:00 -040
       
  • Mylan to Pay $465 Million in False Claims Act Settlement
    • Abstract: Pharma giant Mylan will pay $465 million to resolve False Claims Act allegations that Mylan misclassified EpiPen as a generic drug to avoid paying Medicaid rebates owed to it under the Medicaid Drug Rebate Program, according to the United States Attorney’s Office of the District of Massachusetts.
      PubDate: Tue, 19 Sep 2017 00:00:00 -040
       
  • CMS Cancels Two Mandatory Payments Models
    • Abstract: The Centers for Medicare and Medicaid Services recently announced a proposed rule to change the structure of the Comprehensive Care for Joint Replacement model, and cancel the Episodic Payment Model, and Cardiac Rehabilitation incentive payment model.
      PubDate: Tue, 19 Sep 2017 00:00:00 -040
       
  • Medicare Overhauling the Fraud Audit Process
    • Abstract: The Centers for Medicare & Medicaid Services announced changes to the way it audits claims for fraud, by selecting claims that pose the greatest financial risk.
      PubDate: Tue, 19 Sep 2017 00:00:00 -040
       
  • Aetna May Have Breached HIV Privacy
    • Abstract: Health insurance giant Aetna was accused of revealing the HIV status of a large group of people living with HIV in multiple states via mailings to Aetna members.
      PubDate: Tue, 19 Sep 2017 00:00:00 -040
       
  • Defendants Prevail on Negligent Postoperative Care Claim
    • Abstract: A jury found that defendant physician followed standard of care following a patient's knee surgery.
      PubDate: Mon, 18 Sep 2017 10:00:00 -040
       
  • Physician, Hospital Negligence Found After Hypoxic Brain Damage to Infant
    • Abstract: Failure to monitor fetal vital signs led to infant's hypoxia and cerebral palsy after birth.
      PubDate: Mon, 18 Sep 2017 09:56:00 -040
       
  • One-third Have Experienced Cybersecurity Incidents with Medical Devices
    • Abstract: More than one-third of medical device professionals reported that their organizations have experienced a cybersecurity incident in the past year, according to a recent survey.
      PubDate: Mon, 18 Sep 2017 09:50:00 -040
       
  • Risk Analysis Tool Available for Specialties
    • Abstract: A healthcare professional liability insurer released a risk analysis tool for free, with data drawn from closed malpractice claims to identify the greatest malpractice risks by specialty.
      PubDate: Mon, 18 Sep 2017 09:47:00 -040
       
  • Study: Pathologists Want More Active Role in Error Disclosure
    • Abstract: Pathologists want to play a more active role in conversations about errors with patients, instead of turning to the treating physician to handle it, according to a recent study.
      PubDate: Mon, 18 Sep 2017 09:43:00 -040
       
  • American Hospital Association Calls for Reducing Regulatory Burden on
           Hospitals
    • Abstract: The American Hospital Association calls on Congress to reduce the regulatory burden on hospitals and health systems, calling the burden “substantial and unsustainable.”
      PubDate: Mon, 18 Sep 2017 09:39:00 -040
       
  • Nurses Suspended for Viewing Patient’s Genitals
    • Abstract: Denver Health Medical Center suspended five nurses for three weeks after confirming they intentionally viewed a patient’s genitals without cause, including opening his body bag to view the deceased man’s body parts.
      PubDate: Mon, 18 Sep 2017 09:36:15 -040
       
  • Copy-and-Paste Brings Compliance Risks
    • Abstract: Physicians can create compliance risks by overusing copy-and-paste in electronic medical records. The records can result in upcoding and the loss of reimbursement.
      PubDate: Mon, 18 Sep 2017 09:34:00 -040
       
  • Hospital Loses Tax-exempt Status Over 501(r)
    • Abstract: The IRS has revoked the tax-exempt status of a hospital for noncompliance with section 501(r) of the Internal Revenue Code, following the lead of state tax courts that have been increasingly harsh when scrutinizing tax-exempt hospitals.
      PubDate: Mon, 18 Sep 2017 09:29:00 -040
       
  • Family Sues Nurse and Hospital After Newborn Death
    • Abstract: An Oregon woman is suing Portland Adventist Medical Center and an individual nurse after her four-day-old son died. Monica Thompson is seeking $3.5 million from the nurse and $5.1 million from the hospital.
      PubDate: Mon, 18 Sep 2017 09:25:00 -040
       
  • Smothered Newborn Shows Patient Safety, Liability Risks
    • Abstract: A tragic newborn death illustrates the patient safety risks posed by simply leaving an infant to sleep in the arms of its mother, risks that are increasing with the emphasis on more physical contact between the mother and child.
      PubDate: Mon, 18 Sep 2017 09:21:00 -040
       
  • Anomalous Coronary Arteries Discovered in Middle-aged Individuals
    • Abstract: Anomalous origin of coronary arteries from the opposite sinus are encountered more frequently in middle-aged subjects evaluated for coronary artery disease using CT angiography.
      PubDate: Mon, 18 Sep 2017 08:51:01 -040
       
  • Natriuretic Peptide-guided Therapy Does Not Improve Systolic Heart Failure
           Outcomes
    • Abstract: Among high-risk patients with heart failure and reduced ejection fraction, a strategy of titrating medical therapy to a target natriuretic peptide level was not associated with improvements in hospitalization or survival.
      PubDate: Mon, 18 Sep 2017 08:47:41 -040
       
  • Rate-controlled Atrial Fibrillation as a Reversible Cause of
           Cardiomyopathy
    • Abstract: In patients with persistent but rate-controlled atrial fibrillation and left ventricular systolic dysfunction of otherwise uncertain etiology, catheter ablation to restore sinus rhythm can result in significant improvement or normalization of ejection fraction.
      PubDate: Mon, 18 Sep 2017 08:44:00 -040
       
  • Is a Dabigatran Reversal Agent Effective'
    • Abstract: A pragmatic clinical study of idarucizumab for counteracting the effects of the oral anticoagulant dabigatran showed rapid and complete reversal of its effects in patients with major bleeding or urgent surgery, without any adverse safety concerns.
      PubDate: Mon, 18 Sep 2017 08:41:00 -040
       
  • RE-DUAL Deals Another Blow to Triple Therapy
    • Abstract: In this trial of post-percutaneous coronary intervention patients with atrial fibrillation, dual antithrombotic therapy with dabigatran and a P2Y12 inhibitor showed lower rates of bleeding but similar ischemic and thrombotic outcomes compared to a triple therapy regimen with warfarin.
      PubDate: Mon, 18 Sep 2017 08:37:00 -040
       
  • “Avoidable” ED Visits Tend to Fall Into Mental Health, Dental
           Categories
    • Abstract: A study looking at more than 400 million visits to U.S. emergency departments (EDs) over a six-year period determined that 3.5% of them were “avoidable.”
      PubDate: Fri, 15 Sep 2017 00:00:00 -040
       
  • ED Visits, Healthcare Costs Increase When Spouses of Disabled Are
           Suffering
    • Abstract: The statistics will come as no surprise to emergency department (ED) staff, but some percentage of visits by disabled older patients might have more to do with their caregivers’ physical or mental state than their own.
      PubDate: Fri, 15 Sep 2017 00:00:00 -040
       
  • Racial, Ethnic Differences Found in Pediatric Antibiotic Prescribing at
           EDs
    • Abstract: Antibiotics are prescribed to non-Latino white children seeking treatment for viral respiratory tract infections about twice as often in emergency departments (EDs) compared with non-Latino black children.
      PubDate: Fri, 15 Sep 2017 00:00:00 -040
       
  • Study Argues Against Prehospital Antiplatelet Therapy in STEMI
    • Abstract: A new study finds that providing antiplatelet therapy to patients with ST-elevation myocardial infarction (STEMI) provides no significant advantages over in-hospital treatment.
      PubDate: Fri, 15 Sep 2017 00:00:00 -040
       
  • Study: Readmissions More Common After Observation Stays
    • Abstract: Patients often are readmitted to the hospital after an observation stay, according to recent research which suggests hospitals may want to target this population.
      PubDate: Thu, 14 Sep 2017 10:18:01 -040
       
  • Program Offers Psychological First Aid, Support to HCWs Following
           Traumatic Events
    • Abstract: When an adverse outcome occurs, support rightfully flows to the affected patients and families. However, the clinicians involved with such cases often suffer, too, and the resulting stress and anguish can lead to decreased productivity, time away from work, depression, and other serious mental health effects.
      PubDate: Thu, 14 Sep 2017 10:15:00 -040
       
  • Expert: Health Systems Should Emphasize Value-based Care Management
    • Abstract: Since health insurers first developed case management programs in the 1980s, the marketplace for case management has evolved and changed across the continuum of care, with one possible exception: hospital settings.
      PubDate: Thu, 14 Sep 2017 10:11:00 -040
       
  • Recent CMS Payment Model Cancellations Could Affect Case Management
    • Abstract: Case management programs could see some effects from the recent canceling of advanced care coordination through episode payment by the Centers for Medicare & Medicaid Services.
      PubDate: Thu, 14 Sep 2017 10:09:00 -040
       
  • Case Management Program Cuts Heart Failure Readmissions in Half
    • Abstract: A case management program targeted health improvements among congestive heart failure patients and succeeded in cutting readmission rates to half the national average.
      PubDate: Thu, 14 Sep 2017 10:04:00 -040
       
  • Angiotensin II Raises Blood Pressure in Patients with Vasodilatory Shock
    • Abstract: Infusion of recombinant angiotensin II improved blood pressure control in patients with vasodilatory shock already receiving conventional vasopressors.
      PubDate: Thu, 14 Sep 2017 09:59:21 -040
       
  • Spontaneous Breathing Trials and Occam’s Razor
    • Abstract: Different ventilator modes used for a spontaneous breathing trial affected a patient’s work of breathing (WOB) variously and differed regarding WOB measured after extubation. The clinical relevance of these differences is uncertain.
      PubDate: Thu, 14 Sep 2017 09:55:46 -040
       
  • Intensive Care Enteral Nutrition in 2017
    • Abstract: Enteral nutrition (EN), defined as any method of feeding that uses the gastrointestinal (GI) tract (including oral feeding), usually refers to the delivery of nourishment to the GI tract through a tube. Nutrition is of utmost importance for patients suffering from a critical illness, and EN is a mainstay of nutrition in the ICU. Malnutrition and nutritional risk are common in patients admitted to the ICU. The presence of critical illness causes the body to enter a catabolic state, putting patients at risk of development or worsening of malnutrition. The Society of Critical Care Medicine and the American Society for Parenteral and Enteral Nutrition have published and revised joint guidelines to offer evidence-based recommendations for how best to feed critically ill patients.
      PubDate: Thu, 14 Sep 2017 09:51:30 -040
       
  • Study: Trial Results for New Neurological Drugs Often Go Unpublished
    • Abstract: Results of clinical trials for “stalled” neurological drugs — those which had at least one completed Phase III trial but failed to receive FDA approval — are heavily underreported, found a new study.
      PubDate: Thu, 14 Sep 2017 09:42:00 -040
       
  • AllTrials Seeks Transparency in Big Pharma Studies
    • Abstract: The AllTrails campaign, striving to achieve full disclosure of all results in clinical trials, recently conducted an audit of the transparency policies of pharmaceutical companies, finding them open enough on the surface — but beset with devils in the details.
      PubDate: Thu, 14 Sep 2017 09:37:00 -040
       
  • Broad Consent Issues raised by SACHRP and Others
    • Abstract: With broad consent, patients would have an easy and speedy opportunity to opt out of future research uses of their biospecimens. But if they didn’t opt out — and most people probably would agree to the research use of their specimens — then scientific progress could proceed without the consent roadblock.
      PubDate: Thu, 14 Sep 2017 09:31:00 -040
       
  • FDA Lowers the Boom on Stem Cell Clinics
    • Abstract: The FDA recently cracked down on two stem cell clinics for questionable research practices, including one clinic that was using smallpox vaccine as part of a treatment protocol.
      PubDate: Thu, 14 Sep 2017 09:26:00 -040
       
  • NIH Considers Action on Pay-to-Participate Trials
    • Abstract: Recent action by federal authorities against stem cell clinics charged with questionable practices appear to validate concerns raised by bioethicists like Leigh Turner, PhD, who recently warned that some stem cell clinics are charging research subjects exorbitant fees for participation in experimental treatments marketed as clinical trials on ClinicalTrials.gov.
      PubDate: Thu, 14 Sep 2017 09:22:00 -040
       
  • IRBs Share Strategies to Prepare for New Common Rule
    • Abstract: Some IRBs have been preparing for months for the Jan. 19, 2018, implementation of the new Common Rule. Others have taken a more casual, wait-and-see-if-it’s-delayed approach. IRBs that are preparing for a January rollout have found that preparation is time-consuming and resource-intensive.
      PubDate: Thu, 14 Sep 2017 09:18:00 -040
       
  • FDA’s Informed Consent Change Is Step Toward Harmonizing
    • Abstract: The FDA’s recent move to allow a waiver of informed consent for studies involving minimal risk could be a first step toward harmonization with the existing Common Rule.
      PubDate: Thu, 14 Sep 2017 09:14:00 -040
       
  • Future Patient Access Leaders Learn on the Job
    • Abstract: Creating on-the-job experiences can build leadership skills of patient access employees.
      PubDate: Wed, 13 Sep 2017 16:57:42 -040
       
  • Scanning Palm Veins or Irises' Patients Will Come to Expect It
    • Abstract: Registration areas increasingly are using iris or palm vein scanning. This article provides items to consider before implementing this technology.
      PubDate: Wed, 13 Sep 2017 16:53:00 -040
       
  • Stop Surprise Bills With One Pre-reg Call
    • Abstract: Patient access departments are moving financial discussions earlier in the process with preregistration phone calls.
      PubDate: Wed, 13 Sep 2017 16:49:00 -040
       
  • Did Payer Coverage Change' Communicate to Patient Access Quickly
    • Abstract: Updating patient access employees on payer coverage changes is a top challenge for patient access leaders.
      PubDate: Wed, 13 Sep 2017 16:44:00 -040
       
  • Don’t Make Patients Come to You: Find Them
    • Abstract: Some patient access departments are tracking patients’ locations in registration areas to provide better service, with plastic tracking badges, wristbands, or the patient’s own smart phone.
      PubDate: Wed, 13 Sep 2017 16:39:00 -040
       
  • Prior Authorizations: ‘Top Issue Within the Revenue Cycle’
    • Abstract: A growing number of states have passed prior authorization legislation to combat payer requirements resulting in delayed care, lost revenue, and dissatisfied patients.
      PubDate: Wed, 13 Sep 2017 16:31:00 -040
       
  • Virulent, Drug-resistant Pneumonia Bug Emerges in China ICU
    • Abstract: In particularly unwelcome news from China, researchers report they have isolated a strain of Klebsiella pneumoniae that is both hypervirulent and highly drug-resistant. A worse combination is difficult to imagine. Usually, hypervirulent K. pneumoniae remains susceptible to drugs, but acquiring resistance apparently through genetic transfer in nature means this is a bug that could possibly infect heathy people in the community, let alone frail hospital patients.
      PubDate: Wed, 13 Sep 2017 16:08:41 -040
       
  • Poor Oral Care During Hospitalization May Lead to Pneumonia
    • Abstract: Ventilator-associated pneumonia is a commonly tracked healthcare-associated infection, and frequently the target of interventions to protect patients. On the other hand, non-ventilator healthcare-associated pneumonia falls into a gray area, where it often remains unreported in surveillance systems.
      PubDate: Wed, 13 Sep 2017 16:07:24 -040
       
  • CMS, Joint Commission Are Citing for ‘Flash’ Sterilization
    • Abstract: The abiding principle is that if you must rapidly sterilize an instrument — usually in an effort to return it to the sterile field — you must immediately use it.
      PubDate: Wed, 13 Sep 2017 16:06:27 -040
       
  • SSIs: A Common and Costly Infection
    • Abstract: The CDC has issued new guidelines for the prevention of the most common and costly healthcare-associated infection: surgical site infections.
      PubDate: Wed, 13 Sep 2017 16:02:39 -040
       
  • Highly Drug-resistant C. auris Continues to Emerge in U.S.
    • Abstract: The CDC is urging infection preventionists and their clinical colleagues to have a high index of suspicion for emerging Candida auris, a fungus that spreads more like bacteria, can be highly drug-resistant, and survives on skin and environmental surfaces for prolonged periods.
      PubDate: Wed, 13 Sep 2017 15:56:00 -040
       
  • Subclinical Hypothyroidism: What Is It and When Should We Treat It'
    • Abstract: The current diagnosis and treatment of subclinical hypothyroidism in women of reproductive age is controversial and may well change as new studies become available.
      PubDate: Wed, 13 Sep 2017 15:46:00 -040
       
  • Antenatal Steroids for Very Early PTB
    • Abstract: A large European multicenter study has shown that antenatal corticosteroid administration in patients at risk for imminent very early preterm birth (24 to 31 weeks) will decrease perinatal mortality and morbidity substantially, even after only three hours of exposure.
      PubDate: Wed, 13 Sep 2017 15:43:00 -040
       
  • Irritable Bowel Syndrome, Constipation, and Quality of Life in Women
    • Abstract: Irritable bowel syndrome has a negative effect on women’s quality of life and affects one-third of women who present for care with fecal incontinence.
      PubDate: Wed, 13 Sep 2017 15:39:00 -040
       
  • Do Antibiotics Reduce Hormonal Contraceptive Effectiveness'
    • Abstract: This is a systematic review of studies evaluating the effect of concomitant non-rifamycin antibiotic use on hormonal contraceptive effectiveness. Although data are limited, there is no evidence to support the existence of drug interactions.
      PubDate: Wed, 13 Sep 2017 15:33:00 -040
       
  • Pediatric Airway Management
    • Abstract: Pediatric patients frequently present with respiratory complaints. Fortunately, most children respond well to simple medical interventions. Understanding a child's anatomic and physiologic differences is critical to effectively preventing respiratory failure and stabilizing a child when it occurs.
      PubDate: Wed, 13 Sep 2017 13:52:00 -040
       
  • Functional Outcomes After Receiving Life-sustaining Therapy in the ICU
    • Abstract: Among patients who have spent at least three days in an ICU and required even brief mechanical ventilation and/or vasopressor support, almost half are dead and only one-third return to their baseline at six months. Several factors present on the first day of admission are associated with not returning to baseline status.
      PubDate: Wed, 13 Sep 2017 12:01:00 -040
       
  • Frailty as a Patient Assessment Tool Prior to Aortic Valve Replacement
    • Abstract: Assessment of frailty adds important prognostic information about risk of death and disability following both surgical aortic valve replacement and transcatheter aortic valve replacement. Among the available instruments for assessing frailty, a scale known as the Essential Frailty Toolkit demonstrated the best correlation with outcomes.
      PubDate: Wed, 13 Sep 2017 12:00:16 -040
       
  • Percutaneous Coronary Interventions in Nonagenarians
    • Abstract: Nonagenarians can undergo percutaneous coronary interventions with low in-lab complication rates, but 30-day and one-year mortality is considerably higher than in younger patients.
      PubDate: Wed, 13 Sep 2017 11:59:14 -040
       
  • Palliative Care-based Intervention Improves Quality of Life in Chronic
           Heart Failure
    • Abstract: Among patients with advanced heart failure, implementation of an interdisciplinary palliative care intervention was associated with improved quality of life.
      PubDate: Wed, 13 Sep 2017 11:57:42 -040
       
  • Advance Care Planning Must Advance Forward
    • Abstract: In a systematic review of 795,909 people in 150 studies, researchers found many Americans have not completed an advance directive.
      PubDate: Wed, 13 Sep 2017 11:55:28 -040
       
  • Secondary Heart Failure Affects Readmissions
    • Abstract: Heart failure that develops or worsens during a hospital stay can affect outcomes, costs, and readmissions, so hospitals are advised to identify patients at risk for secondary heart failure.
      PubDate: Wed, 13 Sep 2017 10:54:42 -040
       
  • Hartford Healthcare Launching Quality Initiatives
    • Abstract: Hartford HealthCare, a healthcare network in Connecticut, is launching a series of quality initiatives aimed at getting patients the care they need quickly and safely.
      PubDate: Wed, 13 Sep 2017 10:52:53 -040
       
  • Copy-and-Paste Continues to Threaten Documentation Safety
    • Abstract: Copy-and-paste is so easy and time saving that it can be tempting to overuse it in the medical record, and some electronic medical records encourage clinicians to use blocks of text over and over. Liberal use of copy-and-paste can diminish the quality and reliability of an electronic medical record, however.
      PubDate: Wed, 13 Sep 2017 10:52:06 -040
       
  • Staffing Grid Improves Satisfaction for Patients and Nurses, Reduces Falls
    • Abstract: A new staffing grid focused on improving patient, nurse and staff satisfaction contributed to reducing patient falls by 50% and staff injuries by 81% over approximately one year at Sharp Memorial Hospital in San Diego.
      PubDate: Wed, 13 Sep 2017 10:50:27 -040
       
  • Improved Patient Handoffs Require Comprehensive Approach
    • Abstract: Hospitals are paying more attention to patient handoffs as a crucial element in quality and patient safety, with an evolution toward seeing them as not just a distinct task, but more as a comprehensive strategy.
      PubDate: Wed, 13 Sep 2017 10:48:56 -040
       
  • Clinical Briefs
    • Abstract: In this section: diagnosing pulmonary embolism; tackling early prostate cancer; and treating urinary tract symptoms.
      PubDate: Mon, 11 Sep 2017 13:49:00 -040
       
  • Glecaprevir and Pibrentasvir Tablets (Mavyret)
    • Abstract: The FDA has approved a dual fixed-dose combination of glecaprevir, a NS3/4A protease inhibitor, and pibrentasvir, a NS5A inhibitor, for the treatment of all major genotypes (1-6) of chronic hepatitis C infections.
      PubDate: Mon, 11 Sep 2017 13:42:39 -040
       
  • Genital HPV in Men: How Common Is It'
    • Abstract: In this U.S. cross-sectional survey, the prevalence of genital human papillomavirus (HPV) infection in adult men was 45%, of which 25% were high-risk subtypes. The overall rate of HPV vaccination among those who were eligible was 11%.
      PubDate: Mon, 11 Sep 2017 13:37:00 -040
       
  • Dual Antibiotic Therapy Is Not Routinely Necessary for Uncomplicated
           Cellulitis
    • Abstract: A randomized, multicenter, placebo-controlled clinical trial that enrolled patients presenting to emergency departments with uncomplicated cellulitis found the addition of trimethoprim-sulfamethoxazole to cephalexin did not lead to better outcomes.
      PubDate: Mon, 11 Sep 2017 13:32:32 -040
       
  • EP Defendants Need Forensic IT Experts to Explain EMRs
    • Abstract: A recent malpractice lawsuit against an EP alleged that a patient coded and spent two weeks in an ICU because he received a medication to which he was allergic. Since the electronic medical record (EMR) clearly documented the patient’s allergy to the medication, at first glance, it looked as though the EP had made a colossal mistake. However, this was not the case.
      PubDate: Mon, 11 Sep 2017 13:12:00 -040
       
  • Missed Compartment Syndrome in the ED Often Leads to Litigation
    • Abstract: Compartment syndrome is one of the few true orthopedic emergencies seen in the ED, and the consequences can be dire.
      PubDate: Mon, 11 Sep 2017 13:06:00 -040
       
  • Do State Damage Caps Apply to EMTALA'
    • Abstract: A recent case is a good example of how a delay in implementing an order can expose EDs to EMTALA and medical malpractice claims.
      PubDate: Mon, 11 Sep 2017 13:01:00 -040
       
  • Expanded tPA Criteria Means Many More Potential Plaintiffs
    • Abstract: Did a stroke patient experience a bad outcome in the ED' If tissue plasminogen activator (tPA) wasn’t administered in the ED, without a good reason documented in the chart, a malpractice lawsuit is likely.
      PubDate: Mon, 11 Sep 2017 12:52:00 -040
       
  • Informed Consent: Beyond Signing a Form
    • Abstract: The informed discussion is critical to the informed consent process and meeting the applicable standard of care for obtaining informed consent. Thus, the content of that discussion is more important than a signature on a form, which frequently doesn’t include enough details about the information shared with the patient. The concept of shared decision-making adds complexity to the idea of informed consent.
      PubDate: Mon, 11 Sep 2017 12:42:00 -040
       
  • Separating Celiac Disease From Non-celiac Gluten Sensitivity
    • Abstract: As there is no diagnostic test to confirm any patient’s 'non-gluten celiac sensitivity,' debate on the issue continues.
      PubDate: Mon, 11 Sep 2017 08:56:52 -040
       
  • Azithromycin Reduces Asthma Exacerbations
    • Abstract: Asthma exacerbations essentially are induced exclusively by viral infections (as well as thermal and atopic stimuli). Is it time to reconsider that posture'
      PubDate: Mon, 11 Sep 2017 08:53:37 -040
       
  • BCG Vaccinations and the False-positive Effect
    • Abstract: Clinicians should consider that the bacille Calmette-Guerin vaccination effect could influence tuberculin testing responsivity for an essentially indefinite period.
      PubDate: Mon, 11 Sep 2017 08:51:32 -040
       
  • Measuring Urine Calcium in Nephrolithiasis Patients
    • Abstract: High sodium content in the diet increases calcium excretion in the urine, so sodium restriction may be beneficial. Thiazide diuretics reduce urinary calcium excretion and are useful when dietary and hydration steps are insufficient.
      PubDate: Mon, 11 Sep 2017 08:49:04 -040
       
  • Managing Diabetes: First Things First, or Vice Versa
    • Abstract: Certain attributes suggest glucagon-like peptide-1 receptor agonists might be an appropriate initial treatment for type 2 diabetes mellitus, supplanting metformin.
      PubDate: Mon, 11 Sep 2017 08:46:16 -040
       
  • Routine Preoperative Lab Tests for Elective Surgery
    • Abstract: Historically, there have been an excessive number of pre-op tests performed that not only provide no benefit for patient outcomes, but actually may cause harm because of unnecessary expense as well as need for follow-up of incidental (usually irrelevant) abnormal findings.
      PubDate: Mon, 11 Sep 2017 08:43:21 -040
       
  • Senate Investigation Reveals Damaging Information About Pharma Company
    • Abstract: Recording allegedly captures sales rep distorting facts about a powerful painkiller to fast-track approval.
      PubDate: Fri, 08 Sep 2017 15:15:00 -040
       
  • FDA Actions
    • Abstract: In this section: The agency approves fixed-dose combination hepatitis C treatment, greenlights first U.S. gene therapy, and approves new urinary tract infection drug.
      PubDate: Thu, 07 Sep 2017 08:48:42 -040
       
  • Treating Pain and PTSD with Cannabis
    • Abstract: There is insufficient evidence today to draw conclusions about the benefits and harms of plant-based cannabis preparations in patients with PTSD.
      PubDate: Thu, 07 Sep 2017 08:44:21 -040
       
  • Canagliflozin Reduces Cardiovascular Events in Diabetic Patients
    • Abstract: Canagliflozin resulted in a lower risk of cardiovascular disease in type 2 diabetics who were at high cardiovascular risk. However, there was a higher risk of amputation, which is a new finding.
      PubDate: Thu, 07 Sep 2017 08:41:01 -040
       
  • New Data Show Liraglutide Improves Renal Outcomes in Type 2 Diabetes
           Patients
    • Abstract: In a recent trial, when added to usual care for type 2 diabetes, investigators concluded that liraglutide resulted in lower rates of the development and progression of diabetic kidney disease than placebo.
      PubDate: Thu, 07 Sep 2017 08:36:28 -040
       
  • Evaluation of Bradycardia in the Emergency Department
    • Abstract: In this article, the normal anatomy and pathophysiology of bradydysrhythmias in adults will be reviewed, followed by the latest recommendations in evaluation and management.
      PubDate: Wed, 06 Sep 2017 13:29:00 -040
       
  • Under Pressure: Multiple Factors Driving Nurse Burnout
    • Abstract: We frequently hear of rampant stress and resulting burnout in nurses. What causes it' Employee health professionals are well aware of the threats of occupational injury and illness, but other factors in the work environment require considerable resilience to withstand daily. 
      PubDate: Wed, 06 Sep 2017 10:26:00 -040
       
  • Is Complacency Setting in on Sharps Injury Prevention'
    • Abstract: Although incremental gains continue, needlestick and sharps injury prevention efforts overall have plateaued and there is a risk of complacency in healthcare settings due to the perceived diminished threat of the major bloodborne pathogens, according to an expert on the issue.
      PubDate: Wed, 06 Sep 2017 10:21:00 -040
       
  • NIOSH Looks to Expand Use of Elastomeric Respirators
    • Abstract: The National Institute for Occupational Safety and Health is seeking input to develop procedures for decontamination of reusable elastomeric respirators, which could be an important and sustainable resource in times of high PPE demand.
      PubDate: Wed, 06 Sep 2017 09:48:00 -040
       
  • Exposures to Opioid Patients Endanger Healthcare Workers
    • Abstract: Citing the lack of national guidelines for nurses and other healthcare workers, National Nurses United is developing personal protective equipment recommendations to prevent opioid exposures.
      PubDate: Wed, 06 Sep 2017 09:39:00 -040
       
  • HITECH Incentives Made a Difference in Hospital EHR Adoption
    • Abstract: Here is proof that, when it comes to hospitals, the carrot works as well as, or better than, the stick.
      PubDate: Wed, 06 Sep 2017 00:00:00 -040
       
  • Little Difference Between PCI Outcomes at Safety Net Hospitals vs. Others
    • Abstract: Who fares better: patients undergoing percutaneous coronary intervention (PCI) at safety net hospitals, or non-safety net hospitals'
      PubDate: Wed, 06 Sep 2017 00:00:00 -040
       
  • NICU Antibiotic Use Guidelines Reduce Late-onset Sepsis in Infants
    • Abstract: While hospitals increasingly have antibiotic stewardship guidelines for various departments, those remain rare in neonatal ICUs (NICUs), according to a new study.
      PubDate: Wed, 06 Sep 2017 00:00:00 -040
       
  • Hospital Admissions Elevated for Weeks After Natural Disasters
    • Abstract: Hospitals in the areas affected by the devastating hurricane Harvey will likely be full even longer than they expect during the disaster’s aftermath.
      PubDate: Wed, 06 Sep 2017 00:00:00 -040
       
  • Bundled Approach to Handoff Communication Delivers Significant Safety
           Dividends
    • Abstract: Users note that the I-PASS handoff bundle offers structure for communications as well as guidance on implementation, feedback, and sustainability.
      PubDate: Tue, 05 Sep 2017 10:40:10 -040
       
  • Education, Training Needed to Combat Human Trafficking
    • Abstract: Experts note there is plenty of crossover between the opioid epidemic and what healthcare providers see in terms of trafficking, further complicating rescue.
      PubDate: Tue, 05 Sep 2017 10:29:51 -040
       
  • Hospitals Use Aggressive Tactics to Combat Clostridium Difficile
           Infections
    • Abstract: Although there is some evidence that the incidence of such infections finally may be leveling off nationally, one analysis shows that treatment-resistant forms of the infection have risen sharply.
      PubDate: Tue, 05 Sep 2017 10:19:00 -040
       
  • What U.S. Healthcare Workers Learned From the Ebola Crisis
    • Abstract: With a global pandemic still posing a serious threat to American lives, frontline providers must prepare and drill constantly to
      protect themselves and the public health.
      PubDate: Tue, 05 Sep 2017 10:11:23 -040
       
  • Outpatient Surgery on Steroids
    • Abstract: Feeding on chum-churned water, vendors are adding to the mix the availability of lower cost for the necessary equipment to perform a growing list of procedures outside the mothership. While the mainstream vendors are slow to lower costs, the secondary markets are jumping in with both feet to capture a piece of the expanding pie.
      PubDate: Fri, 01 Sep 2017 11:37:18 -040
       
  • Tips for Preventing Staff Stress, Burnout
    • Abstract: Leaders can take various steps to prevent employees’ healthy stress from turning into counterproductive, or even destructive, stress and burnout.
      PubDate: Fri, 01 Sep 2017 11:31:26 -040
       
  • Preventing Nurse Burnout Starts with Understanding Causes
    • Abstract: There are multiple factors that can contribute to nurse stress and burnout, including job frustration and overwork, poor work-life balance, substance use issues, emotional/family problems, and workplace bullying.
      PubDate: Fri, 01 Sep 2017 11:28:04 -040
       
  • It Takes an ASC to Cultivate Moral Resilience in Staff
    • Abstract: The American Nurses Association recently published a draft call to action on cultivating moral resilience as an antidote to nurses’ and other clinicians’ 'moral suffering and distress.'
      PubDate: Fri, 01 Sep 2017 11:23:00 -040
       
  • Pharmacist Offers Tips on How ASCs Can Prevent Drug Diversion
    • Abstract: Amid a nationwide opioid epidemic, ASCs are not immune to problems related to misuse of controlled substances. Drug diversion should be a chief concern.
      PubDate: Fri, 01 Sep 2017 11:13:00 -040
       
  • CMS Makes Regulatory Changes; ASCs Might Benefit From Trend
    • Abstract: The Centers for Medicare & Medicaid Services proposed several surgery payment changes in recent months, suggesting that Department of Health and Human Services Secretary Tom Price is following through on his stated goals of rolling back regulatory burdens for doctors.
      PubDate: Fri, 01 Sep 2017 11:10:26 -040
       
  • FDA Chief: ‘We Are Entering a New Frontier in Medical
           Innovation’
    • Abstract: Agency greenlights groundbreaking gene therapy tool to help fight the war against cancer.
      PubDate: Fri, 01 Sep 2017 09:00:00 -040
       
  • Older Adults at Suicide Risk Less Likely to Get ED Mental Health Referral
    • Abstract: The demographic group with the highest rate of suicide is men over the age of 70, according to the World Health Organization. In the United States, nearly 8,000 older adults committed suicide in 2015, with the proportion of suicides higher among the elderly than the young.
      PubDate: Fri, 01 Sep 2017 00:00:00 -040
       
  • New Blueprint Helps EDs End Use of CK-MB Testing for Diagnosing Heart
           Attack
    • Abstract: Several studies have found that creatine kinase-myocardial band (CK-MB) testing can no longer be considered an effective biomarker for detecting damaged heart muscle, and the American College of Cardiology issued a statement more than a decade ago saying the assay can be safely eliminated from practice.
      PubDate: Fri, 01 Sep 2017 00:00:00 -040
       
  • Initiating Buprenorphine for Addiction, Not Just Referrals, Most Cost
           Effective
    • Abstract: Many EDs refer patients for opioid addiction for additional treatment or maybe offer a brief intervention with the referral.
      PubDate: Fri, 01 Sep 2017 00:00:00 -040
       
  • Sedation Medication Influences Adverse Effects in Children Treated at EDs
    • Abstract: The choice of sedation medication has the greatest influence on whether adverse events are likely to occur in pediatric emergency departments and to require significant interventions, according to a new study.
      PubDate: Fri, 01 Sep 2017 00:00:00 -040
       
  • On Overdose Awareness Day, Ninety People Could Die From Opioids
    • Abstract: Misuse of opioids is found in 21 to 29 percent of patients prescribed the drugs for chronic pain.
      PubDate: Thu, 31 Aug 2017 00:00:00 -040
       
  • Is This 4:1 Flutter'
    • Abstract: The rhythm in the figure was diagnosed as atrial flutter with 4:1 AV conduction. Do you agree' How would you confirm your answer'
      PubDate: Wed, 30 Aug 2017 09:03:00 -040
       
  • Clinical Briefs
    • Abstract: In this section: treating hypothyroidism in seniors; revisiting penicillin allergies; and new diverticulitis guidance.
      PubDate: Wed, 30 Aug 2017 08:57:00 -040
       
  • Sofosbuvir, Velpatasvir, and Voxilaprevir Tablets (Vosevi)
    • Abstract: Vosevi is indicated for the treatment of adult patients with chronic hepatitis C infection without cirrhosis or with compensated cirrhosis who are infected with genotype 1, 2, 3, 4, 5, or 6, and have been treated previously with a hepatitis C regimen containing an NS5A inhibitor.
      PubDate: Wed, 30 Aug 2017 08:54:38 -040
       
  • Chondroitin Is as Effective as Celecoxib for Knee Arthritis
    • Abstract: Six months of 800 mg of pharmaceutical-grade chondroitin sulfate daily relieved knee pain as much as 400 mg of celecoxib.
      PubDate: Wed, 30 Aug 2017 08:49:00 -040
       
  • Eat Right, and Live
    • Abstract: An improvement in diet over 12 years in middle-aged nurses and other health professionals resulted in a decreased risk of death.
      PubDate: Wed, 30 Aug 2017 08:44:22 -040
       
  • Glucose Self-monitoring Not Helpful for Non-insulin-treated Type 2
           Diabetes
    • Abstract: In this pragmatic randomized trial, self-monitoring blood glucose did not lead to lower hemoglobin A1c levels or improvement in health-related quality-of-life measures.
      PubDate: Wed, 30 Aug 2017 08:40:22 -040
       
  • What’s Old Is New Again: The History of Case Management
    • Abstract: This month, we will review case management’s long and rich history from a community-based model to an acute care model and beyond.
      PubDate: Tue, 29 Aug 2017 10:07:00 -040
       
  • High-needs Patients Require Focus to Avoid Readmissions
    • Abstract: Hospitals can make significant headway in reducing readmissions by addressing high-needs patients, according to a new National Academy of Medicine special publication, which notes that nearly half of the nation’s spending on healthcare is driven by just 5% of patients.
      PubDate: Tue, 29 Aug 2017 09:54:00 -040
       
  • CMS Cuts Bundled Payment Program, Tweaks Quality Initiatives
    • Abstract: The Centers for Medicare & Medicaid Services proposed sweeping changes in three bundled payment initiatives, and tweaked some of the pay-for-performance measures that affect hospital reimbursement.
      PubDate: Tue, 29 Aug 2017 09:47:00 -040
       
  • Collaboration Moves Long-stay Patients to Next Level of Care
    • Abstract: When NYC Health+Hospitals’ acute care hospitals and post-acute facilities began collaborating in a pilot project, they were able to place challenging patients in the appropriate level of care — a program that is on track to save the public hospital system $3.5 million per year when it is rolled out systemwide.
      PubDate: Tue, 29 Aug 2017 09:43:00 -040
       
  • Got Challenging Patients' Try These Discharge Tips
    • Abstract: Every case management leader should be educating their teams on how to deal with complex and difficult-to-discharge patients so the case managers will know what to do when they face a specific issue.
      PubDate: Tue, 29 Aug 2017 09:36:00 -040
       
  • Refer Difficult-to-place Patients to a Discharge Planning Specialist
    • Abstract: The changes in healthcare reimbursement and the increase in patients with complex needs and inadequate or no funding have created a huge workload for case managers and social workers.
      PubDate: Tue, 29 Aug 2017 09:32:34 -040
       
  • Start Early to Overcome the Challenges of Complex Patients
    • Abstract: Timely and safe discharges are more important than ever in today’s healthcare world, but an increase in complex patients makes creating a discharge plan a challenge.
      PubDate: Tue, 29 Aug 2017 09:28:00 -040
       
  • Contraceptive Research: Science Heads to New Frontiers
    • Abstract: Funding recently has been awarded to scientists around the globe through the Grand Challenges Explorations program, an initiative funded by the Bill & Melinda Gates Foundation. The program seeks to foster concepts for contraceptive discovery platforms that can contribute to the development of new methods suitable for women and men living in limited resource settings.
      PubDate: Mon, 28 Aug 2017 16:12:00 -040
       
  • Increased Focus on Preventing Preeclampsia
    • Abstract: Cases of preeclampsia in the United States have increased since 1980 from 2.4% of all pregnancies to 3.8% in 2010. This increase is cause for concern: Preeclampsia accounts for more than $2.18 billion of the healthcare expenditure in the first 12 months after birth.
      PubDate: Mon, 28 Aug 2017 16:08:00 -040
       
  • ‘Talk. Test. Treat.’ Aimed at Syphilis
    • Abstract: There are more reported cases of primary and secondary syphilis in the United States now than there have been in more than 20 years. The Centers for Disease Control and Prevention has issued a call to action to reverse the trend.
      PubDate: Mon, 28 Aug 2017 16:02:00 -040
       
  • Task Force Issues Draft Guidance on Ovarian Screening
    • Abstract: The U.S. Preventive Services Task Force has issued a draft recommendation statement on ovarian screening, finding that the potential harms of screening outweigh the benefits.
      PubDate: Mon, 28 Aug 2017 15:54:00 -040
       
  • Vasectomy Poses Minimal Prostate Cancer Risk
    • Abstract: A new systematic review and meta-analysis of three decades of evidence concludes that vasectomies are associated with minimal risk of prostate cancer.
      PubDate: Mon, 28 Aug 2017 15:44:00 -040
       
  • Research Finds Many Women Who Receive IUD for Emergency Contraception
           Continue Use
    • Abstract: Sixty-seven percent of women offered long-acting option were using it at one year.
      PubDate: Mon, 28 Aug 2017 15:37:00 -040
       
  • Per-record Cost of Data Breaches Increasing
    • Abstract: The cost of healthcare data breaches continue to remain the highest out of any industry, with an average cost of $380 per record, according to a recent report from the Ponemon Institute.
      PubDate: Tue, 22 Aug 2017 13:30:00 -040
       
  • New Breach Reporting Tool Helps With HIPAA Response
    • Abstract: A new breach reporting tool should be useful for HIPAA compliance, partly because it can help providers stay on top of what is currently trending in cyberattacks and other types of breaches.
      PubDate: Tue, 22 Aug 2017 13:27:00 -040
       
  • Myriad State Requirements Complicate Breach Response
    • Abstract: When you realize there has been a breach of protected health information, your first thought is of HIPAA and how to satisfy federal requirements for responding. But that is far from the end of your obligation, as state requirements can be just as onerous.
      PubDate: Tue, 22 Aug 2017 13:24:00 -040
       
  • Medical Malpractice Case Disguised as Fraud Dismissed
    • Abstract: News: In 2011, a woman presented to a Missouri medical clinic for treatment relating to her inflamed gallbladder. During a diagnostic scan, the patient was injected with substances that ultimately caused her tremendous discomfort and psychological trauma. She filed suit against the medical clinic, claiming that alleged representations made by unidentified medical professionals amounted to fraud. The trial court granted the defendant’s motion to dismiss, finding the patient to have filed the petition untimely.
      PubDate: Mon, 21 Aug 2017 17:17:12 -040
       
  • Misdiagnosis Leads to Sepsis, Amputations, and $16.5 Million Verdict
    • Abstract: News: In Wisconsin in mid-2011, a woman suffered gangrene, resulting in the amputation of her four extremities. The cause of the gangrene was a septic infection resulting from an untreated infection that was not disclosed to the patient, or treated. At trial, the jury awarded the patient $15 million, and her husband $1.5 million for loss of consortium.
      PubDate: Mon, 21 Aug 2017 17:15:42 -040
       
  • Survey: Most Health Providers Use No Cybersecurity Software
    • Abstract: Most healthcare providers do not use any software for information security governance or risk management to protect against cyberattacks, according to a recent survey, which also found providers fear their own employees the most.
      PubDate: Mon, 21 Aug 2017 17:14:18 -040
       
  • Carolina Healthcare System to Pay $6.5 Million for False Claims
    • Abstract: Carolinas Healthcare System (CHS) has agreed to pay the federal government $6.5 million to resolve allegations that the company violated the False Claims Act by up-coding claims for urine drug tests to receive higher payment than allowed for the tests.
      PubDate: Mon, 21 Aug 2017 17:13:20 -040
       
  • Lawyer Reprimanded for Penis Amputation Lawsuit
    • Abstract: A lawyer who represented a client in a case that gained national media attention has been reprimanded by the court for not reviewing medical records to determine if his client’s case was viable.
      PubDate: Mon, 21 Aug 2017 17:12:23 -040
       
  • Factor Consumerism Into Risk Management
    • Abstract: Consumerism is a growing force in healthcare and should be incorporated into a hospital or health system’s risk management strategy, says Jane Harper, CISSP, CRISC, CRCMP, ISA, PCIP, CISA, ITIL, director of privacy and security risk manager at Henry Ford Health System in Detroit.
      PubDate: Mon, 21 Aug 2017 17:11:28 -040
       
  • OR Fire Safety Improving With More Drills, Less Alcohol Prep
    • Abstract: Hospitals are taking fire safety in the OR seriously but still must conduct frequent reviews and update policies as necessary, says Solveig Dittmann, RN, BA, BSN, CPHRM, senior risk specialist with Coverys, a medical professional liability insurer in Boston.
      PubDate: Mon, 21 Aug 2017 17:10:42 -040
       
  • Health System Cuts Workers’ Comp With Best Docs
    • Abstract: Health systems can significantly reduce their workers’ compensation expenses by identifying and using high-performing physicians in medical networks, according to the experience of operators of one system in California, which saw overall claims costs reduced by almost 20%.
      PubDate: Mon, 21 Aug 2017 17:09:29 -040
       
  • Prescribing Opioids: Physicians Must Assess Carefully, Document Rigorously
           to Avoid Liability
    • Abstract: The human toll of the opioid crisis is enormous, with millions of Americans suffering from addiction and more than 90 people dying each day from opioid overdoses. It is widely recognized that a significant part of the problem is the overprescription of pain medications, such as oxycodone and fentanyl. For physicians who prescribe such medications, this presents important challenges.
      PubDate: Mon, 21 Aug 2017 17:07:00 -040
       
  • DOJ Launches Opioid Fraud Unit With Big Data
    • Abstract: Soon after its largest-ever bust of healthcare providers involved in the fraudulent distribution of opioids, the Department of Justice announced a new Opioid Fraud and Abuse Detection Unit that draws on healthcare data analytics to find misuse of controlled substances.
      PubDate: Mon, 21 Aug 2017 17:06:17 -040
       
  • Medicare Fraud Bust Sends Warning to Healthcare Providers
    • Abstract: The huge federal crackdown on Medicare fraud opioid abuse is a loud alarm bell for risk managers in all healthcare settings, signaling that the Department of Health and Human Services and the Department of Justice are not fooling around. They’re charging people by the hundreds, and for the first time a large proportion are healthcare professionals.
      PubDate: Mon, 21 Aug 2017 16:38:00 -040
       
  • Increased Hospice Length of Stay for Children Receiving Palliative Care
    • Abstract: Children who receive palliative care have increased hospice length of stay, according to a recent study.
      PubDate: Mon, 21 Aug 2017 15:56:00 -040
       
  • More Than 90% of POLST Forms Correct and Complete
    • Abstract: Researchers reviewed resuscitation (Section A) and level of medical intervention (Section B) orders in 268,386 forms in the Oregon POLST Registry, and 10,122 forms in the West Virginia e-Directive Registry.
      PubDate: Mon, 21 Aug 2017 15:52:00 -040
       
  • New Tool Assesses Families’ Satisfaction With End-of-life Care
    • Abstract: A new tool is available to assess family members’ satisfaction with end-of-life care in long-term care.
      PubDate: Mon, 21 Aug 2017 15:48:00 -040
       
  • Survey: Device Industry Reps in OR Viewed Positively by Surgeons
    • Abstract: Many orthopedic trauma surgeons may see some significant ethical concerns if a drug company representative wanted to be present during all of their procedures.
      PubDate: Mon, 21 Aug 2017 15:45:00 -040
       
  • Ethics of Using Family Members as Egg Donors or Surrogates
    • Abstract: “The ethical considerations surrounding intrafamilial gamete donation and gestational surrogacy focus on the well-being of those who offer to provide reproductive services, those who receive those services, and the offspring born of any such donation,” says Judith Daar, JD, chair of ASRM’s ethics committee.
      PubDate: Mon, 21 Aug 2017 15:42:00 -040
       
  • Value-based Payments and Primary Care
    • Abstract: Over the past two decades, Medicare and commercial payers have increasing linked healthcare payments to quality. These new payment models are broadly referred to as value-based, as payers primarily focus on clinical and financial outcomes of patients rather than simply paying for services in an unsustainable fee-for-service model. This shift provides a unique opportunity for primary care to recapture its place in healthcare delivery as the original advocate for patient-centered care and the center of value. Primary care clinicians can be rewarded with additional revenue for creating efficient care delivery by developing the skill sets to manage value-based care.
      PubDate: Mon, 21 Aug 2017 15:40:00 -040
       
  • Consult Service Created for Moral Distress
    • Abstract: When ICU nurses at the University of Virginia Health System were experiencing a serious issue with moral distress, they asked Ann B. Hamric, PhD, RN, for help.
      PubDate: Mon, 21 Aug 2017 15:39:25 -040
       
  • Study: Pathologists Want More Active Role in Error Disclosure
    • Abstract: Pathologists want to play a more active role in conversations about errors with patients, instead of turning to the treating physician to handle it, according to a recent study.1
      PubDate: Mon, 21 Aug 2017 15:37:00 -040
       
  • Do Concierge Practices Indicate Medicine ‘Needs to Be
           Fixed'’
    • Abstract: The continued growth of concierge medicine is spurred, in part, by a strong desire for longer, more meaningful visits. This is true for both patients and physicians.
      PubDate: Mon, 21 Aug 2017 15:34:00 -040
       
  • Case of Terminally Ill Infant Sparks Ethical Debate Over Autonomy
    • Abstract: The highly-publicized case of Charlie Gard, a terminally ill British infant, ignited a recent global ethical controversy. The case involved a court battle between the hospital, who wanted to remove the infant from life support, and the child’s parents, who wanted their son transferred to the U.S. for an experimental treatment.
      PubDate: Mon, 21 Aug 2017 15:30:00 -040
       
  • Capsaicin for Painful Diabetic Peripheral Neuropathy
    • Abstract: An 8% capsaicin patch relieves pain and improves sleep in patients with painful diabetic peripheral neuropathy.
      PubDate: Mon, 21 Aug 2017 14:05:00 -040
       
  • Helping Women at Risk for Breast Cancer to Exercise More and Lose Weight
    • Abstract: A web- and phone-based intervention led to significant weight loss and a modest increase in moderate-to-vigorous activity in women at risk of breast cancer.
      PubDate: Mon, 21 Aug 2017 13:54:00 -040
       
  • High-intensity Interval Training in Older and Younger Adults
    • Abstract: High-intensity interval training performed over 12 weeks reversed age-related differences of mitochondrial proteins in adults 65 to 80 years of age, as well as increased insulin sensitivity and VO2 peak, and decreased fat free mass in adults 18 to 30 years of age and 65 to 80 years of age.
      PubDate: Mon, 21 Aug 2017 13:06:00 -040
       
  • The Great Mimicker: Thyroid Emergencies
    • Abstract: Thyroid disease is relatively common, but most often is a benign disease with little clinical significance in the emergency setting. However, even a small insult can disrupt this system and throw the regulation out of control, resulting in the secretion of too much or too little thyroid hormone. Both of these situations can result in the thyroid emergencies thyroid storm and myxedema coma.
      PubDate: Mon, 21 Aug 2017 13:01:00 -040
       
  • Active Children: Do Higher Levels of Activity Help Prevent Depression'
    • Abstract: This prospective study found moderate to vigorous physical activity in early childhood correlated with a decreased number of depressive symptoms in later years.
      PubDate: Mon, 21 Aug 2017 12:59:00 -040
       
  • Optimizing Electromyography in ALS
    • Abstract: In the appropriate clinical setting, electromyography studies of multiple, distal muscle groups in three separate spinal regions showing acute and chronic denervation, are pathognomonic for the diagnosis of amyotrophic lateral sclerosis.
      PubDate: Mon, 21 Aug 2017 11:42:58 -040
       
  • EEG-based Metrics After Severe Brain Injury
    • Abstract: In this cohort study of 104 patients with disorders of consciousness, the authors demonstrated a strong correlation between EEG-based metrics and clinical diagnosis using quantitative behavioral scales, brain metabolism as measured by PET, and clinical outcomes at one year.
      PubDate: Mon, 21 Aug 2017 11:39:00 -040
       
  • Risk Factors for Seizures in Critically Ill Patients Monitored by
           Continuous EEG
    • Abstract: Investigators prospectively analyzed 72-hour continuous electroencephalograms to identify clinical and electroencephalogram risk factors for having seizures and developed a model for “time-dependent” seizure risk. Electrographic seizures occurred in 23% of all patients. The only significant clinical predictors of seizures were presence of coma and prior clinical seizure history.
      PubDate: Mon, 21 Aug 2017 11:35:00 -040
       
  • P-syn in Nerve Fibers on Skin Biopsy May Help Diagnose Dementia with Lewy
           Bodies
    • Abstract: This study compared 18 subjects diagnosed with dementia with Lewy bodies (DLB), 23 with nonsynucleinopathy dementia, and 25 healthy controls and demonstrated that phosphorylated alpha-synuclein was found only in the skin nerve fibers of DLB subjects, helping distinguish this type of dementia from other types.
      PubDate: Mon, 21 Aug 2017 11:31:00 -040
       
  • Infectious Disease Alert Updates
    • Abstract: Immediate Improvement in Childhood Vaccination; A Better Mosquito Trap; Can FMT Restore Gut Flora and Eliminate Resistant Pathogens'
      PubDate: Mon, 21 Aug 2017 11:30:00 -040
       
  • Is Sleep a Clue to a Modifiable Risk Factor for Alzheimer’s
           Disease'
    • Abstract: Evidence is accumulating that disruptions in sleep patterns, particularly slow-wave and REM sleep, alter amyloid-β production and clearance through the cerebrospinal fluid pathways and may play a role in the development of Alzheimer’s disease.
      PubDate: Mon, 21 Aug 2017 11:26:00 -040
       
  • Infections Associated With Adventure Travel
    • Abstract: Some adventure travel is associated with exposure to infectious pathogens. Some adventure-related illnesses can be prevented. Understanding the details of an adventure trip can help focus a differential diagnosis for ill returned travelers.
      PubDate: Mon, 21 Aug 2017 11:21:00 -040
       
  • Mild Traumatic Brain Injury Induces Altered Sleep and Impaired Memory
    • Abstract: Traumatic brain injury may induce a chronic state of altered sleep with impaired memory consolidation and mood disorders.
      PubDate: Mon, 21 Aug 2017 11:19:00 -040
       
  • Autochthonous Crimean-Congo Hemorrhagic Fever in Europe
    • Abstract: Two patients with Crimean-Congo hemorrhagic fever acquired in Spain are reported. The index patient acquired infection from a tick bite, and the second patient was a nurse who cared for the index patient. The first patient died in the hospital with multi-system organ failure and was diagnosed at autopsy. The second patient recovered with supportive care and was treated with ribavirin, but it was unclear whether the use of ribavirin was helpful.
      PubDate: Mon, 21 Aug 2017 11:09:00 -040
       
  • Microbiology of Hidradenitis Suppurativa: New Evidence That Anaerobes
           Predominate
    • Abstract: Using metagenomic techniques, investigators determined that two Gram-negative anaerobes, Prevotella and Porphyromonas, predominate in hidradenitis suppurativa lesions. Two others, Fusobacterium and Parvimonas, correlate with disease severity.
      PubDate: Mon, 21 Aug 2017 10:49:00 -040
       
  • CDC Update of Notifiable Infectious Diseases
    • Abstract: CDC has updated the available information regarding reportable infectious diseases in the United States.
      PubDate: Mon, 21 Aug 2017 10:42:00 -040
       
  • Does Celecoxib Pose Greater Cardiovascular Risks Than NSAIDs'
    • Abstract: A controlled trial that included patients with arthritis on nonsteroidal anti-inflammatory drug (NSAID) therapy who were randomized to continuing NSAIDs or switching to celecoxib showed that cardiovascular and gastrointestinal event rates are low and not different on the two therapies.
      PubDate: Fri, 18 Aug 2017 10:26:00 -040
       
  • Palliative Care-based Intervention Improves Quality of Life in Chronic
           Heart Failure
    • Abstract: Among patients with advanced heart failure, implementation of an interdisciplinary palliative care intervention was associated with improved quality of life.
      PubDate: Fri, 18 Aug 2017 10:22:00 -040
       
  • Frailty as a Patient Assessment Tool Prior to Aortic Valve Replacement
    • Abstract: Assessment of frailty adds important prognostic information about risk of death and disability following both surgical aortic valve replacement and transcatheter aortic valve replacement.
      PubDate: Fri, 18 Aug 2017 10:19:00 -040
       
  • Percutaneous Coronary Interventions in Nonagenarians
    • Abstract: Nonagenarians can undergo percutaneous coronary interventions with low in-lab complication rates, but 30-day and one-year mortality is considerably higher than in younger patients.
      PubDate: Fri, 18 Aug 2017 10:17:00 -040
       
  • How Much Might the Ejection Fraction Improve' Predicting Response to
           Premature Ventricular Complex Ablation
    • Abstract: Several echocardiographic and electrocardiographic features were identified that can help predict if a cardiomyopathy is caused purely by frequent premature ventricular complexes and whether left ventricular function will normalize with ablative therapy.
      PubDate: Fri, 18 Aug 2017 10:12:00 -040
       
  • Safe Treatment Recommendations for Benzodiazepine Dependence
    • Abstract: SYNOPSIS: There are clear, evidence-based treatment withdrawal regimens for benzodiazepine-dependent patients.
      PubDate: Fri, 18 Aug 2017 09:25:00 -040
       
  • Maternal Mortality, Postpartum Hemorrhage, and Tranexamic Acid: The WOMAN
           Study
    • Abstract: SYNOPSIS: A multicenter study involving patients in 193 countries has shown a decrease in maternal mortality in women with postpartum hemorrhage who were given tranexamic acid once the diagnosis was made.
      PubDate: Fri, 18 Aug 2017 09:22:00 -040
       
  • Requiem for Beta-blockers Post-Myocardial Infarction'
    • Abstract: SYNOPSIS: A propensity score analysis of all hospital survivors of acute myocardial infarction in the United Kingdom from 2007-2013 showed that one-year survival in hospital patients without heart failure or left ventricular dysfunction treated with beta-blockers did not differ from survival in those patients not so treated.
      PubDate: Fri, 18 Aug 2017 09:21:00 -040
       
  • Early Diuretic Administration Associated With Improved Survival in Acute
           Heart Failure Patients
    • Abstract: SYNOPSIS: Among patients presenting to the ED with acute heart failure, those who received the first dose of intravenous furosemide within 60 minutes of arrival demonstrated lower in-hospital mortality compared to those receiving the first dose after 60 minutes.
      PubDate: Fri, 18 Aug 2017 09:14:00 -040
       
  • Cefazolin Leads to Better Outcomes for Methicillin-susceptible
           Staphylococcus aureus Bacteremia Than Nafcillin or Oxacillin
    • Abstract: SYNOPSIS: A retrospective study that included patients from 119 Veterans Affairs hospitals found lower mortality and a similar recurrence rate for methicillin-susceptible Staphylococcus aureus bacteremia treated with cefazolin compared to nafcillin and oxacillin.
      PubDate: Fri, 18 Aug 2017 09:12:00 -040
       
  • CDC Updating Measles Guidelines for HCWs
    • Abstract: The CDC is preparing to review its guideline for measles and healthcare workers, as the once-eradicated childhood infection spreads in ongoing outbreaks in the U.S. and Europe.
      PubDate: Fri, 18 Aug 2017 09:09:19 -040
       
  • High-risk Patients, High-risk Infections
    • Abstract: If there is a worst-case scenario in infection control, it likely involves a life-threatening infection spreading in a vulnerable patient population. They don’t get much more vulnerable than babies in a neonatal ICU, or adults undergoing bone marrow transplant. With their frail immune systems compromised, central line-associated bloodstream infections (CLABSIs) pose a serious threat warranting an immediate infection control response.
      PubDate: Fri, 18 Aug 2017 09:08:35 -040
       
  • Twin Peaks: A Persistent Norovirus Outbreak
    • Abstract: A nasty, easily transmitted bug
      that has ruined many a cruise vacation, norovirus can cause chaotic, labor-intensive outbreaks in hospitals. In that regard, an infection preventionists recently described a norovirus outbreak that kept reigniting in different locations in a situation somewhat akin to fighting a forest fire in high wind.
      PubDate: Fri, 18 Aug 2017 09:07:58 -040
       
  • Resistance to Change' Try Motivational Interviewing
    • Abstract: How do you get someone to change behavior when simply telling them to do so is met with resistance — the “righting reaction” as APIC closing plenary speaker Sanjay Saint, MD, terms it. One approach is called “motivational interviewing,” which first demonstrated efficacy in the addiction field, said Saint, director of the University of Michigan Patient Safety Enhancement Program.
      PubDate: Fri, 18 Aug 2017 09:07:15 -040
       
  • Novel Approaches to Change Behavior and Protect Patients
    • Abstract: Much of infection control work — a frustrating portion to many IPs — is trying to change human behavior. One need look no further than the historic struggle with hand hygiene and the various carrots and sticks that have been dangled and cracked in the name of compliance for decades.
      PubDate: Fri, 18 Aug 2017 09:04:30 -040
       
  • Cancer Drug Manufacturer Settles Three-year Court Battle Over Alleged FCA
           Violations
    • Abstract: The Department of Justice announced that the pharmaceutical manufacturer Celgene has agreed to pay $280 million to settle allegations that the company fraudulently promoted two cancer treatment drugs for uses not approved by the FDA.
      PubDate: Thu, 17 Aug 2017 00:00:00 -040
       
  • Medicare Updates for the Payments to Hospitals for FY 2018 Released
    • Abstract: The Centers for Medicare & Medicaid Services recently issued its final rule on the Hospital Inpatient Prospective Payment System and Long-Term Acute Care Hospital Prospective Payment System.
      PubDate: Thu, 17 Aug 2017 00:00:00 -040
       
  • CMS Announces 2018 Physician Payment and Policy Updates
    • Abstract: The Centers for Medicare & Medicaid Services recently announced a proposed rule to update payment information and other policies related to physicians and other clinicians.
      PubDate: Thu, 17 Aug 2017 00:00:00 -040
       
  • DOJ Executes Largest Healthcare Fraud Enforcement in History
    • Abstract: In July, the Department of Justice and the Department of Health and Human Services announced that they had charged more than 400 defendants from across the country in the largest healthcare fraud scheme ever uncovered by the agencies.
      PubDate: Thu, 17 Aug 2017 00:00:00 -040
       
  • Medical School Quality Affects Opioid Prescribing by Physicians
    • Abstract: PRINCETON, NJ – Better training for physicians, especially general practitioners, could be a meaningful step to controlling the nation’s opioid epidemic, according to a new study.
      PubDate: Thu, 17 Aug 2017 00:00:00 -040
       
  • Change in Physician Attitudes Can Help Obese Patients Lose Weight
    • Abstract: Helping patients lose weight might require a change in world view – by physicians, according to research from Touro University College of Osteopathic Medicine. Similar to the transition that occurred with mental illness, study authors are seeking to alter physician thinking so that they consider obesity a treatable condition and not just individual responsibility.
      PubDate: Thu, 17 Aug 2017 00:00:00 -040
       
  • Extra Support Staff Shores Up Physician Practice Bottom Lines
    • Abstract: Physician practices with a higher non-physician provider (NPP) to physician ratio are more financially successful than those with fewer NPPs. Specialty doesn’t seem to matter, according to the 2017 MGMA DataDive Cost and Revenue Survey.
      PubDate: Thu, 17 Aug 2017 00:00:00 -040
       
  • Patient Empowerment Tool Improves Handwashing Despite Physician Opposition
    • Abstract: Physicians might not have been happy hearing constant reminders to wash their hands, but a new initiative improved their hand hygiene compliance rates anyway, according to a recent report.
      PubDate: Thu, 17 Aug 2017 00:00:00 -040
       
  • ACA-Related Medicaid Expansion Slightly Increased ED Visits
    • Abstract: One of the benefits touted for expanding Medicaid eligibility under the Affordable Care Act (ACA) was a reduction in pricey emergency department visits. But did that really occur'
      PubDate: Thu, 17 Aug 2017 00:00:00 -040
       
  • Immediate Immune Response Could Signal Subsequent Multiple Organ Failure
    • Abstract: One of the challenges in providing emergency care to critically injured patients is determining which ones are more likely to develop multiple organ failure.
      PubDate: Thu, 17 Aug 2017 00:00:00 -040
       
  • Head Injury Decision Support Tool Modestly Lowers CT Use in EDs
    • Abstract: The Canadian CT Head Rule (CCHR) was developed to help physicians determine which minor head injury patients require expensive computed tomography imaging.
      PubDate: Thu, 17 Aug 2017 00:00:00 -040
       
  • Delirium Diagnosis in ED Could Affect Advanced Cancer Patient Survival
    • Abstract: Delirium often is missed in overcrowded emergency departments, and diagnosing the condition in advanced cancer patients is especially important, according to a new study.
      PubDate: Thu, 17 Aug 2017 00:00:00 -040
       
  • Clinical Briefs
    • Abstract: In this section: blood pressure readings for high-risk hypertension patients; Omega-3 fatty acids and diabetic retinopathy; and long-term diabetes control.
      PubDate: Wed, 16 Aug 2017 09:03:00 -040
       
  • Betrixaban Capsules (Bevyxxa)
    • Abstract: Betrixaban is indicated for the prophylaxis of venous thromboembolism (VTE) in adult patients hospitalized for an acute medical illness who are at risk for thromboembolic complications because of moderate or severe restricted mobility and other risk factors for VTE.
      PubDate: Wed, 16 Aug 2017 08:59:00 -040
       
  • Omega-3 Polyunsaturated Fatty Acid Supplementation and Cognitive Decline
    • Abstract: As the first large randomized, placebo-controlled trial studying the efficacy of a lifestyle intervention with a nutraceutical compound (polyunsaturated fatty acid), the Multidomain Alzheimer Preventive Trial is a landmark study.
      PubDate: Wed, 16 Aug 2017 08:51:00 -040
       
  • B-type Natriuretic Peptide Is Less Useful in Elderly Patients With Dyspnea
    • Abstract: Among patients ≥ 80 years of age presenting with acute dyspnea, B-type natriuretic peptide level was not useful for differentiating cardiac vs. respiratory etiologies when added to a model of clinical predictors.
      PubDate: Wed, 16 Aug 2017 08:47:00 -040
       
  • Advance Care Planning Must Advance Forward
    • Abstract: Advance care planning is a continual process of preparing for future medical care in case patients are unable to make his or her own decisions. It includes engaging patients and families to reflect on patients’ personal goals, values, and belief systems, which ultimately translate into informing medical care. This process helps prepare the patient for current and future decisions regarding medical treatment. Data show that Americans have fallen behind on this process.
      PubDate: Wed, 16 Aug 2017 08:43:00 -040
       
  • Changes to Readmissions Rule Will Help, But No Panacea
    • Abstract: A significant number of hospitals are set to benefit from changes in how CMS calculates penalties under the value-based Hospital Readmissions Reduction Program (HRRP), but the proposed rule won’t solve all their problems related to readmissions, says Bill Bithoney, MD, formerly CEO, CCO, and CMO at Sisters of Providence Health System in Springfield, MA, and now a managing director at BDO International consulting in New York City.
      PubDate: Tue, 15 Aug 2017 17:44:31 -040
       
  • Initiating Medication-assisted Treatment for Patients Presenting With
           Opioid Withdrawal
    • Abstract: With a new report showing dramatic surges in both ED visits and hospital admissions because of problems related to opioid misuse, it’s clear that current approaches to the problem are not sufficient.
      PubDate: Tue, 15 Aug 2017 17:43:17 -040
       
  • Look to Social Determinants of Health When Building Post-acute Ties in
           ACOs
    • Abstract: Accountable care organizations (ACOs) that involve case management in the entire care continuum often build post-acute care relationships to help their teams find solutions to patients’ social determinants of health issues.
      PubDate: Tue, 15 Aug 2017 17:42:21 -040
       
  • Opioid Overutilization Management Program Paves Way for Success
    • Abstract: Healthcare organizations could learn a great deal about developing an opioid management program by following some of the best practices created as a result of the federal Medicare mandate for health plan sponsors.
      PubDate: Tue, 15 Aug 2017 17:40:00 -040
       
  • Pain Management in Workers’ Comp Has Evolved to a Holistic Approach
    • Abstract: Psychosocial aspects of chronic pain are much better understood today than a generation ago. What healthcare organizations now know is that each person’s pain after an injury or surgery is different.
      PubDate: Tue, 15 Aug 2017 17:21:06 -040
       
  • Case Management’s Role in Curbing Opioid Epidemic Increases
    • Abstract: Opioid addiction resulted in more than 33,000 U.S. overdose deaths in 2015, making drug overdose the No. 1 cause of accidental death in the nation. The overdose death rate has quadrupled since the 1990s, as have sales of prescription painkillers, according to the American Society of Addiction Medicine.
      PubDate: Tue, 15 Aug 2017 17:17:18 -040
       
  • Medical Marijuana Inc. Moves Forward With Proof of Concept Study
    • Abstract: Medical Marijuana Inc. announced it is working with an Israel-based contract research organization to begin a clinical proof of concept study with its cannabidiol and gabapentin chewing gum product to treat restless leg syndrome in patients.
      PubDate: Tue, 15 Aug 2017 17:01:31 -040
       
  • Pregnant Pause: Time to Push ‘Play’ on Trials With Expectant
           Mothers
    • Abstract: There are many obstacles to including pregnant women in research, and IRBs may understandably err on the side of caution when it comes to expectant mothers in clinical trials.
      PubDate: Tue, 15 Aug 2017 16:58:00 -040
       
  • Gene Expert: IRBs Should Prepare for Somatic Cell Trials
    • Abstract: With somatic gene cell editing already underway in some trials, IRBs should prepare to deal with protocols involving noninheritable genetic changes.
      PubDate: Tue, 15 Aug 2017 16:55:00 -040
       
  • The Single IRB: One Board to Rule Them All
    • Abstract: The National Institutes of Health recently delayed the effective date of its requirement to designate a single IRB in research involving multiple boards, but NIH officials have lost none of their enthusiasm for the idea.
      PubDate: Tue, 15 Aug 2017 16:48:00 -040
       
  • Community Research Training Helps Subjects Become Investigators
    • Abstract: A new social-behavioral research model IRBs might encounter is one in which researchers include people who also could be participants, or their guardians, for the same studies.
      PubDate: Tue, 15 Aug 2017 16:44:27 -040
       
  • Finding the Best Role for Community Members: A Look at Two Strategies
    • Abstract: IRB questions sometimes arise about the role and responsibility of community members/nonscientists on review boards. Should their — and other nonaffiliated members’ — contributions be limited' Do they have enough training to be primary or secondary reviewers'
      PubDate: Tue, 15 Aug 2017 16:42:00 -040
       
  • Newest Oncology Studies Raise Ethical, Other Questions for IRBs
    • Abstract: Clinical research — especially involving oncology trials — is evolving with the introduction of new therapies and therapeutic mechanisms. These raise new and sometimes challenging questions for IRBs reviewing the study protocols.
      PubDate: Tue, 15 Aug 2017 16:37:00 -040
       
  • Fungus Week' The Serious Threat Behind CDC Action
    • Abstract: A multidrug resistant strain of Candida auris is emerging globally.
      PubDate: Tue, 15 Aug 2017 00:00:00 -040
       
  • Failure to Wean From the Ventilator: Is Pleural Effusion the Culprit'
    • Abstract: The authors of a multicenter, prospective cohort study did not find an association between the presence of moderate or large pleural effusion and ventilator weaning failure.
      PubDate: Mon, 14 Aug 2017 14:14:00 -040
       
  • Functional Outcomes After Receiving Life-sustaining Therapy in the ICU
    • Abstract: Among patients who have spent at least three days in an ICU and required even brief mechanical ventilation and/or vasopressor support, almost half are dead and only one-third return to their baseline at six months. Several factors present on the first day of admission are associated with not returning to baseline status.
      PubDate: Mon, 14 Aug 2017 14:10:00 -040
       
  • Thrombocytopenia in the Critically Ill
    • Abstract: Thrombocytopenia is not only a pathologic entity, but the severity of thrombocytopenia and the recovery time of the platelets often predicts outcome, including overall mortality of ICU patients. Critically ill patients with moderate and severe thrombocytopenia demonstrate higher ICU and hospital mortality. If the recovery is delayed beyond day four, several studies have demonstrated higher morbidity and mortality.
      PubDate: Mon, 14 Aug 2017 14:01:00 -040
       
  • Reproductive Rights in 2017: Follow-up and Call for Advocacy
    • Abstract: The Trump administration has made good on a number of promises to roll back reproductive rights. As clinicians, we need to fight back to ensure access for our patients to essential services. This article seeks to document where we stand as of summer 2017, and present opportunities for engagement.
      PubDate: Mon, 14 Aug 2017 12:34:00 -040
       
  • Is Bariatric Surgery the Antidote for Female-associated Cancers'
    • Abstract: This study investigated gastric surgery as a prevention for female-associated cancers. Women with a body mass index of ≥ 38 kg/m2 who had surgery had an average of 28 kg of weight loss compared to the control group. This resulted in a statistically significant decrease in endometrial cancer.
      PubDate: Mon, 14 Aug 2017 12:27:00 -040
       
  • Video Colposcopy: Does It Reduce Patient Anxiety'
    • Abstract: This German randomized, controlled trial of 225 women naïve to colposcopy found that video colposcopy did not reduce patient anxiety during the procedure. However, the authors found that the real-time video feed increased participants’ understanding of their disease.
      PubDate: Mon, 14 Aug 2017 12:23:00 -040
       
  • 17 P vs. Vaginal Progesterone
    • Abstract: A recent randomized study suggested that vaginal progesterone is at least as good as, and may be superior to, intramuscular 17 alpha-hydroxy progesterone caproate in preventing recurrent preterm birth, but shortcomings in the study indicate that more investigation is needed.
      PubDate: Mon, 14 Aug 2017 12:18:00 -040
       
  • Quickly Update Patient Access About Changes
    • Abstract: Patient access frequently needs to update all employees across the entire department quickly. This article discusses strategies for time-sensitive training.
      PubDate: Mon, 14 Aug 2017 10:37:00 -040
       
 
 
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