Patient Safety & Quality

Editorial: Cardiopulmonary Resuscitation after Hospital Admission with Covid-19 – The BMJ

“This pandemic has changed the risk-benefit balance for CPR: from “there is no harm in trying” to “there is little benefit to the patient, and potentially significant harm to staff.””


NICE Publishes new COVID-19 Guidelines

6 Apr, 2020 | 01:57h | UTC

COVID-19 Pandemic and Cardiac Imaging

6 Apr, 2020 | 01:35h | UTC

Doctors Need Room to Make the Wrenching Decisions They Face – The New York Times

“New York is granting health care providers civil and criminal immunity during the coronavirus emergency. So should other states.”


How Hospitals Can Protect Frontline Healthcare Workers From COVID-19 – Medium


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N95 Re-Use Instructions

30 Mar, 2020 | 02:06h | UTC

Primary care & Coronavirus (COVID 19): key guidance, information and support – Medium

Related: Coronavirus disease 2019 (covid-19): a guide for UK GPs – The BMJ AND Covid-19: a remote assessment in primary care – The BMJ


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Postacute Care Preparedness for COVID-19: Thinking Ahead – JAMA

“Post-acute care preparedness for COVID19: we need to strengthen capacity in primary and community care to deal with those discharged from hospital.” (via @trishgreenhalgh see Tweet)


Practical Advice: PPE Pearls

26 Mar, 2020 | 01:49h | UTC

Report: N95 Mask Decontamination

25 Mar, 2020 | 02:18h | UTC

Report: N95 mask can be decontaminated without decreasing filtration efficiency – Stanford Medicine

Stanford: N95 masks can be decontaminated without decreasing filtration efficiency using 70C heat for 30 min. Alcohol and bleach should not be used.” (via @CMichaelGibson see Tweet)


Infection Prevention and Control guidance for Long-Term Care Facilities in the context of COVID-19 – World Health Organization (PDF)

Related Study: COVID-19 in a Long-Term Care Facility — King County, Washington, February 27–March 9, 2020 – CDC Morbidity and Mortality Weekly Report (free)

“Introduction of COVID-19 into a long-term residential care facility in Washington resulted in cases among 81 residents, 34 staff members, and 14 visitors; 23 persons died” (from CDC)


Mental Health and Psychosocial Considerations During COVID-19 Outbreak – World Health Organization (free PDF)

Related: The psychological impact of quarantine and how to reduce it: rapid review of the evidence – The Lancet (free) AND Behavioural scientists form new front in battle against coronavirus – The Guardian (free)

“Minimize watching, reading or listening to news that causes you to feel anxious or distressed; seek information only from trusted sources and mainly to take practical steps to prepare your plans and protect yourself and loved ones.”


Coronavirus disease 2019 (covid-19): a guide for UK GPs – The BMJ (free)

See also: Latest Research on the COVID-19 Outbreak (free resources)


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Getting your workplace ready for COVID-19 – World Health Organization (free PDF)

Related Guideline: COVID-19: guidance for employers and businesses – Public Health England (free)

“WHO just published guidance on how to prevent the spread of COVID- 19 in a workplace & protect your customers, contractors & employees. We advise these measures to be taken now, even if coronavirus hasn’t arrived in communities where you operate.” (via @DrTedros see Tweet)


Former CDC director: A coronavirus pandemic is inevitable. What now? – CNN (free)

Related: Opinion on COVID-19 Outbreak – “Past Time to Tell the Public: “It Will Probably Go Pandemic, and We Should All Prepare Now”” (related opinions on the subject)

See also: Novel Coronavirus Disease (COVID-19) Latest Articles, Guidelines, News & Perspectives / 26 February 2020 Edition (free resources on the subject – updated daily)


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Evaluation of a Common Prescribing Cascade of Calcium Channel Blockers and Diuretics in Older Adults With Hypertension – JAMA Internal Medicine (free for a limited period)

Commentary: Antihypertensive Prescribing Cascades as High-Priority Targets for Deprescribing – JAMA Internal Medicine (free for a limited period)


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Should the first rule of medicine be not “Do no harm” but rather “Be kind”? – The BMJ Opinion (free)


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Contact isolation versus standard precautions to decrease acquisition of extended-spectrum β-lactamase-producing Enterobacterales in non-critical care wards: a cluster-randomised crossover trial – The Lancet Infectious Diseases (link to abstract – $ for full-text)


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Identifying adverse events: reflections on an imperfect gold standard after 20 years of patient safety research – BMJ Quality & Safety (free)


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Perspective: CPR, by Default

2 Feb, 2020 | 19:45h | UTC

CPR, by Default – The New York Times (10 articles per month are free)


Eliminating Medication Overload: A National Action Plan – Lown Institute (free PDF)

Press Release: Millions of Older Americans Harmed by Too Many Medications – Lown Institute (free)

Commentary: ‘Small’ tactics to counter Big Pharma’s influence on medication overload – STAT (free)

Related: Reducing Inappropriate Medication Use & Polypharmacy (several articles and commentaries on the subject)


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Adapting Lean methods to facilitate stakeholder engagement and co-design in healthcare – The BMJ (free)

See also: Full BMJ Collection on Quality Improvement (free articles)


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Artificial Intelligence Is Rushing Into Patient Care – And Could Raise Risks – Scientific American (a few articles per month are free)

“AI systems are not as rigorously tested as other medical devices, and have already made serious mistakes.”


Evaluating a digital sepsis alert in a London multisite hospital network: a natural experiment using electronic health record data – Journal of the American Medical Informatics Association (free)

Commentary: Digital monitoring system helps improve hospital care of sepsis patients – OnMedica (free) AND Sepsis digital alert ‘led to faster treatment with antibiotics’ – BBC (free)


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Intensivist Burnout: Running on Empty?

18 Nov, 2019 | 00:26h | UTC

UPDATE: The FDA Warns that Biotin May Interfere with Lab Tests: FDA Safety Communication – U.S Food and Drug Administration (free)

Commentary: FDA Updates Warning on Biotin Interfering with Lab Results – NEJM Journal Watch (free)

“…the FDA is particularly concerned about biotin interference causing a falsely low result for troponin, a clinically important biomarker to aid in the diagnosis of heart attacks, which may lead to a missed diagnosis and potentially serious clinical implications. The FDA continues to receive adverse events reports indicating biotin interference caused falsely low troponin results.”


Early Palliative Care Consultation in the Medical ICU: A Cluster Randomized Crossover Trial – Critical Care Medicine (link to abstract – $ for full-text)

Source: EvidenceAlerts


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Offline: Touch—the first language – The Lancet (free)

Related: Of Slide Rules and Stethoscopes: AI and the Future of Doctoring – The Hastings Center Report (free)


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Are zombie doctors taking over America? – TEDMED (free)

Source: MedPage Today

“Physician Zubin Damania, Director of Healthcare Development for Downtown Project Las Vegas, has a plan to fight back against a system that can dehumanize doctors and patients alike.”


Disappointment in the Value-Based Era: Time for a Fresh Approach? – JAMA (free for a limited period)

Related: Designing a High-Performing Health Care System for Patients with Complex Needs: Ten Recommendations for Policymakers – The Commonwealth fund (free) AND Effective Care for High-Need Patients: Opportunities for Improving Outcomes, Value, and Health – National Academy of Medicine (free PDF) AND Focusing on High-Cost Patients — The Key to Addressing High Costs? – NEJM Catalyst (free) AND  Systematic review of high-cost patients’ characteristics and healthcare utilization – BMJ Open (free) AND Effectiveness of interventions for managing multiple high-burden chronic diseases in older adults: a systematic review and meta-analysis – Canadian Medical Association Journal (free) AND Multimorbidity: a priority for global health research – The Academy of Medical Sciences (free) AND The global burden of multiple chronic conditions: A narrative review – Preventive Medicine Reports (free) AND Redesigning Care for High-Cost, High-Risk Patients – Harvard Business Review (a few articles per month are free) AND Multimorbidity: clinical assessment and management – NICE Guideline (free) AND Multimorbidity in Older Adults with Cardiovascular Disease – American College of Cardiology, Latest in Cardiology (free) AND  Richard Smith: The challenge of high need, high cost patients – The BMJ Blogs (free) AND Playbook: Better Care for People with Complex Needs – Institute for Healthcare Improvement (free)


NCCN Guideline: Distress Management

10 Oct, 2019 | 09:06h | UTC

I’ve noticed a change in my colleague’s behaviour. What should I do? – The BMJ (free) (via @brhospitalist)


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World Health Organization Campaign on World Patient Safety Day (free resources)

News Release: WHO calls for urgent action to reduce patient harm in healthcare (free)

See also: Patient Safety Fact Sheet (free) 10 facts on patient safety (free) AND The Lancet Editorial: Patient safety: too little, but not too late (free)


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How to start an antimicrobial stewardship programme in a hospital – Clinical Microbiology and Infection (free)


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