Patient Safety & Quality

Use of Peripherally Inserted Central Catheters in Patients With Advanced Chronic Kidney Disease: A Prospective Cohort Study – Annals of Internal Medicine (link to abstract – $ for full-text)

Commentaries: Peripherally inserted central catheters often used in CKD – HealthDay (free) AND Too Many CKD Patients Get Central Catheters Despite Warnings – Medscape (free registration required)

 

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An Implementation Guide to Promote Sleep and Reduce Sedative-Hypnotic Initiation for Noncritically Ill Inpatients – JAMA Internal Medicine (free for a limited period)

 

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Is It Time for Safeguards in the Adoption of Robotic Surgery? – JAMA (free for a limited period)

Related: FDA Cautions Patients, Providers About Using Robotically-assisted Surgical Devices for Mastectomy and Other Cancer-related Surgeries (free safety alert and commentary)

“To date, most studies demonstrating potential benefits of robotic-assisted surgery have been small, single-centered reports without rigorous controls.”

 


Why you should be a “medical conservative” – Lown Institute (free)

Original Article: Perspective: The Case for Being a Medical Conservative (free article and twitter thread)

“being a medical conservative means being skeptical about new medical advances until unbiased and high-quality evidence shows a clear benefit”

 


Evaluation of the Collaborative Use of an Evidence-Based Care Bundle in Emergency Laparotomy – JAMA Surgery (free)

 

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Bundled Payments Are Moving Upstream – NEJM Catalyst (free)

“For bundled payments to fulfill their promise of delivering greater value to patients, bundling must shift toward the condition or person level rather than the procedure level”

 


Association of Overlapping Surgery With Perioperative Outcomes – JAMA (link to abstract – $ for full-text)

Podcast: Is It Safe? What Happens When Your Surgeon Is Not Actually Doing Some of Your Operation? – JAMA (free)

Commentaries: How Safe Are Overlapping Surgeries? – Harvard Medical School (free) AND Double-Booked Surgeons: Study Raises Safety Questions For High-Risk Patients – NPR (free) AND ‘Overlapping surgery’ is safe for most patients, but not all – STAT (free)

 

Related Commentary on Twitter (Thread)

 


Humanizing the intensive care unit – Critical Care (free)

 

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PSA’s Medicine Safety: Take Care – Pharmaceutical Society of Australia (free PDF)

News Release: Problems with medicines behind 250,000 hospital admissions annually (free)

“The report reveals that 250,000 Australians are hospitalised each year, with another 400,000 presenting to emergency departments, as a result of medication errors, inappropriate use, misadventure and interactions. At least half of this could have been prevented.”

 


Patient-reported complications related to peripherally inserted central catheters: a multicentre prospective cohort study – BMJ Quality & Safety (free)

 

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Performing an Inadvertent Procedure – JAMA (free for a limited period)

 


Effectiveness of SIESTA on Objective and Subjective Metrics of Nighttime Hospital Sleep Disruptors – Journal of Hospital Medicine (free)

Commentary: Hospital SIESTA project reduces inpatient sleep interruptions – University of Chicago Medical Center (free)

 

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Update: Patient Engagement in Safety

10 Jan, 2019 | 21:28h | UTC

International variation in radiation dose for computed tomography examinations: prospective cohort study – The BMJ (free)

 

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Why Hospitals Should Let You Sleep – The New York Times (10 articles per month are free)

“Frequent disruptions are more than just annoying for patients. They can also cause harm.”

 


Investigation: The Implant Files

30 Nov, 2018 | 02:01h | UTC

Perspective: What the Tests Don’t Show

11 Oct, 2018 | 20:11h | UTC

What the tests don’t show – The Washington Post (a few articles per month are free)

“Many doctors are surprisingly bad at reading test results and/or fail to grasp how false positives work. This is putting patients at risk” (via @pash22 see Tweet)

 


Association between physician US News & World Report medical school ranking and patient outcomes and costs of care: observational study – The BMJ (free)

“Overall, little or no relation was found between the USNWR ranking of the medical school from which a physician graduated and subsequent patient mortality or readmission rates.”

 


Perspective: Good Documentation

6 Sep, 2018 | 02:52h | UTC

Good Documentation – JAMA (free for a limited period)

“In this narrative medicine essay, the author, who transitioned from paper and pen to computer-generated electronic health record keeping wonders whether the self-select menu items ultimately dehumanizes both the patient and the physician.” (via @JAMA_current see Tweet)

 


Abraar Karan: Changing the way we communicate about patients – The BMJ Opinion (free) (via @NUNESDOC)

“Father of 2, retired car salesman and keen on football NOT the colon cancer in Bed 4 – social history brings humanity back to the bedside” (via @hospicedoctor see Tweet)

 


Report: Improving Health Care Worldwide

31 Aug, 2018 | 02:09h | UTC

Using a New EHR System to Increase Patient Engagement, Improve Efficiency, and Decrease Cost – NEJM Catalyst (free)

“Another solution might be to capitalize on patients’ vested interest in their own health care by actively engaging them in the entry of their own medical history information into the EHR.”

 


Opinion: Lessons for physicians from ‘The Bleeding Edge’: If you see something, say something – STAT (free)

“…physicians must act decisively when they identify the rare outlier in their midst. To do anything less would risk our credibility. Worse still, it could risk the lives of the people we took an oath not to harm.”

 


A Multicenter Study of Patient-Reported Infectious and Noninfectious Complications Associated With Indwelling Urethral Catheters – JAMA Internal Medicine (free)

Commentary: Foleys Aren’t Fun: Patient Study Shows Catheter Risks – University of Michigan, via NewsWise (free)

“More than half of patients surveyed while they had a urinary catheter, and again weeks later, reported a complication – and infections were only part of the problem” (from NewsWise)

 


Out-of-hours discharge from intensive care, in-hospital mortality and intensive care readmission rates: a systematic review and meta-analysis – Intensive Care Medicine (free)

Source: Critical Care Reviews Newsletter

“Out-of-hours discharge from an ICU is strongly associated with both in-hospital death and ICU readmission. Whether these increases in mortality and readmission result from patient differences, differences in care, or a combination remains unclear”.

 


A sleep prescription for medicine – The Lancet (free registration required)

“Junior doctors working a 34 h shift will make 460% more diagnostic mistakes than when well rested. Matthew Walker asks how can we change the culture of sleep within medicine?” (via @TheLancet see Tweet)

 


Rapid Recommendations: Atraumatic (pencil-point) versus conventional needles for lumbar puncture: a clinical practice guideline – The BMJ (free)

We issue a strong recommendation for use of atraumatic needles in all patients (adults and children) undergoing lumbar puncture because they decrease complications and are no less likely to work than conventional needles”

 


Trying to Put a Value on the Doctor-Patient Relationship – The New York Times (10 articles per month are free)

“In its push for profits, the U.S. health care system has made it difficult for patients to get personal attention from doctors. But what if hands-on medicine actually saves money — and lives?”

 


WHO Campaign: Clean Your Hands

10 May, 2018 | 17:34h | UTC

SAVE LIVES: Clean Your Hands 5 May 2018 – World Health Organization Campaign (free guidelines, implementation tools, infographics, videos and more)

“It’s in your hands – prevent sepsis in health care”

 



A prescription for medication errors

30 Mar, 2018 | 02:44h | UTC

New Guide to Infection Control in The Hospital – International Society for Infectious Diseases (free)

A free, online resource on the principles and interventions needed to reduce healthcare associated infections, with suggested control measures across different resource levels.

 


Opioid Wisely – Choosing Wisely Canada (free)

Related Guideline: Guideline for opioid therapy and chronic noncancer pain – Canadian Medical Association Journal (free)

See complete lists from Choosing Wisely U.S. / Choosing Wisely UKChoosing Wisely Australia AND Choosing Wisely Canada

This campaign encourages thoughtful conversation between clinicians and patients to reduce harms associated with opioid prescribing, with recommendations relevant to different specialties.

 


Patterns and Predictors of Short-Term Peripherally Inserted Central Catheter Use: A Multicenter Prospective Cohort Study – Journal of Hospital Medicine (free PDF)

Commentary: Short-term use of IV devices is common — and risky — study shows – University of Michigan, via ScienceDaily (free)

“Intravenous devices known as PICCs should be reserved for long-term use, but a new study shows 1 in 4 are used for 5 days or less” (from ScienceDaily)

 


Compassionate leadership has a pivotal role in tackling bullying in healthcare – The BMJ Opinion (free)

“Negative staff experiences are often a precursor for negative patient experiences”.

 


Editor’s Choice: There but for the grace of God . . . – The BMJ (free)

About liability and error in medical practice.