Study: Factors Associated With Choice of Infant Sleep Position

22Aug
2017

Factors Associated With Choice of Infant Sleep Position – Pediatrics (free)

Commentaries: Less than half of mothers place sleeping infants supine – 2 Minute Medicine (free) AND Most moms aren’t putting babies to sleep safely, study says – CNN (free) AND Less Than Half of Mothers Report Always Putting Babies to Sleep in Supine Position – Physician’s First Watch (free) AND Parents still failing to put babies to sleep on their backs – Reuters (free)

Placing infants in the supine position for sleep reduces the risk of sudden unexpected infant death and has been recommended by the American Academy of Pediatrics since 2005. Nevertheless, in this survey only 43,7% of mothers placed their infants exclusively in supine position for sleep.

 

Opinion: When surgery is just a stitch-up

22Aug
2017

When surgery is just a stitch-up – The Guardian (RT @Onisillos  see Tweet)

Related article: Use of placebo controls in the evaluation of surgery: systematic review – The BMJ (free)

“With evidence mounting that many minor operations owe their success to the placebo effect, is it time to call a halt to some routine procedures?”

 

Study: Smoking Cessation Pharmacotherapy Among Smokers Hospitalized for Coronary Heart Disease

22Aug
2017

Guideline: Safe Medication Use in the ICU

21Aug
2017

Meta-analysis: Acute Kidney Injury After Computed Tomography

21Aug
2017

Acute Kidney Injury After Computed Tomography: A Meta-analysis – Annals of Emergency Medicine (link to abstract – $ for full-text)

Commentary: When kidneys are injured, CT contrast isn’t the culprit – Health Imaging (free)

Related article: Risk of Acute Kidney Injury After Intravenous Contrast Media Administration – Annals of Emergency Medicine (free)

Source: Hospital Medicine Virtual Journal Club

Compared with noncontrast CT, contrast-enhanced CT was not significantly associated with either acute kidney injury, need for renal replacement therapy, or all-cause mortality.

 

Too much medicine: Mapping the drivers of overdiagnosis to potential solutions

17Aug
2017

A National Implementation Project to Prevent Catheter-Associated Urinary Tract Infection in Nursing Home Residents

17Aug
2017

An Automated, Pharmacist-Driven Initiative Improves Quality of Care for Staphylococcus aureus Bacteremia

16Aug
2017

New, Revised Guidance Documents Cover 35 Radiology Topics

16Aug
2017

Updated: Practice Parameters and Technical Standards – American College of Radiology (free)

News release: New, Revised Guidance Documents Cover 35 Radiology Topics – American College of Radiology, via NewsWise (free)

The American College of Radiology developed 3 new guidance documents and revised 32 others to advance the science of radiology and improve the quality of service to patients

 

FDA Safety Alert: Liquid-filled Intragastric Balloon Systems

16Aug
2017

Association of Previous Cesarean Delivery With Surgical Complications After a Hysterectomy Later in Life

15Aug
2017

Delayed breastfeeding initiation and infant survival

14Aug
2017

Delayed breastfeeding initiation and infant survival: A systematic review and meta-analysis – PLOS One (free)

This systematic review and meta-analysis mostly of observational studies suggests early breastfeeding initiation is associated with increased survival. The authors acknowledge that there are many reasons for delayed breastfeeding initiation that may confound the relationship between breastfeeding initiation and mortality, but remember that randomized trials would not be considered ethical, so we must rely on high quality observational data. Based on their analysis, the authors suggest the implementation of programs that emphasize the importance of early initiation of breastfeeding, in addition to promoting exclusive breastfeeding.

 

Free Online Course: Leading Healthcare Quality and Safety

14Aug
2017

Use of Alternative Medicine for Cancer and Its Impact on Survival

13Aug
2017

What do hypnotics cost hospitals and healthcare?

10Aug
2017

What do hypnotics cost hospitals and healthcare? – F1000 Research (free)

Source: Hospital Medicine Virtual Journal Club

“A best estimate is that U.S. costs of hypnotic harms to healthcare systems are on the order of $55 billion, but conceivably might be as low as $10 billion or as high as $100 billion”.

 

Alternatives to hospital admission for people aged over 65 years

9Aug
2017

A systematic review to identify and assess the effectiveness of alternatives for people over the age of 65 who are at risk of potentially avoidable hospital admission – BMJ Open (free) (RT @NIHR_DC)

Alternatives to hospital admission for people aged over 65 years can be safe and reduce costs across a range of acute and chronic conditions.

 

Too Many Meds?

5Aug
2017

Too Many Meds? America’s Love Affair With Prescription Medication – Consumer Reports (free)

See more on “Deprescribing” in our May 8th issue (see #7), May 9th issue (see #4) and May 15th issue (see #2), and also a related article on Current and future perspectives on the management of polypharmacy

“Yes. Way Too Many Meds. Think De-prescribe”. (RT @EricTopol see Tweet)

 

Design Thinking for Doctors and Nurses

5Aug
2017

Discover and defeat your diagnostic errors

3Aug
2017

Discover and defeat your diagnostic errors – ACP Internist (free) (RT @acpinternist  see Tweet)

“Experts explain the causes and solutions for common mistakes in diagnosis”.

 

Oral fluoroquinolones and risk of secondary pseudotumor cerebri syndrome

3Aug
2017

New Issue: Iatrogenesis in Pediatrics – AMA Journal of Ethics

3Aug
2017

Iatrogenesis in Pediatrics – AMA Journal of Ethics (free) (RT @JournalofEthics)

New issue with series of articles exploring strategies clinicians need to know to respond to adverse outcomes.

 

Medication errors in anesthesia: unacceptable or unavoidable?

3Aug
2017

Surgical Informed Consent Process in Neurosurgery

28Jul
2017

Risk Factors for Emergency Department Visits After Hysterectomy for Benign Disease

25Jul
2017

Risk Factors for Emergency Department Visits After Hysterectomy for Benign Disease – Obstetrics & Gynaecology (free PDF)

Commentaries: Emergency Visits Common After Hysterectomy, Study Finds – Medscape (free registration required) AND ~10 Percent Present to ER After Hysterectomy for Benign Disease – Physician’s Briefing (free)
“Risk factors include younger age, higher parity, Medicare or self-pay insurance, postoperative pain” (from Physician’s Briefing)

 

Enhanced recovery pathway for colorectal surgical patients improves outcomes, reduces cost

25Jul
2017

American College of Surgeons (ACS) 2017 Quality and Patient Safety Conference: Enhanced recovery pathway for colorectal surgical patients improves outcomes, reduces cost – ACS, via EurekAlert (free)

Related guideline: Clinical Practice Guidelines for Enhanced Recovery After Colon and Rectal Surgery From the American Society of Colon and Rectal Surgeons and Society of American Gastrointestinal and Endoscopic Surgeons (free)

See other Enhanced Recovery After Surgery (ERAS) Guidelines and Reviews in our collection and in the ERAS Society Website.

“Successful protocol shortens hospital stays, reduces patients’ risk of complications, and cuts costs up to $11,000 per procedure”

 

Witch Metrics in Hospital Quality Should Patients Pay Attention To?

25Jul
2017

Sharing Knowledge for Health Care

25Jul
2017

Reducing Smoking Rates for Patients Facing Surgery

25Jul
2017

2017 ACS Quality and Safety Conference: “Strong for Surgery” Shows Promise in Reducing Smoking Rates for Patients Facing Surgery – American College of Surgeons, via NewsWise (free)

“Study suggests big drop in smoking rates when surgeons help patients quit before their operations”.

 

Prescription Smoking Cessation Medications After Myocardial Infarction Underused

25Jul
2017

Fluoroquinolone restriction to control fluoroquinolone-resistant Clostridium difficile

24Jul
2017

Effects of control interventions on Clostridium difficile infection in England: an observational study – The Lancet Infectious Diseases (free)

Invited Commentary: Fluoroquinolone restriction to control fluoroquinolone-resistant Clostridium difficile (free)

“Very important finding! Restricting fluoroquinolones more important than infection control measures to prevent CDI” (RT @sanjaysaint see Tweet)

 

Cardiovascular implantable electronic devices: a review of the dangers and difficulties in MR scanning and attempts to improve safety

23Jul
2017

The Evolving Story of Overlapping Surgery

23Jul
2017

Viewpoint: The Evolving Story of Overlapping Surgery – JAMA (free) (RT @pash22 see Tweet)

Commentary: 3 steps to restore patient trust in overlapping surgeries – FierceHealthcare (free)

This interesting viewpoint discusses the practice of scheduling overlapping surgeries, in which a qualified practitioner finishes noncritical parts of the first operation while the primary surgeon moves to the next surgery.

 

Effectiveness of Pharmacist Intervention to Reduce Medication Errors and Health-Care Resources Utilization After Transitions of Care

22Jul
2017

Effectiveness of Pharmacist Intervention to Reduce Medication Errors and Health-Care Resources Utilization After Transitions of Care: A Meta-analysis of Randomized Controlled Trials – Journal of Patient Safety (link to abstract – $ for full-text)

Source: Hospital Medicine Virtual Journal Club (free resource to find articles of interest)

Pharmacist transition of care intervention seems to be an effective strategy to reduce medication errors after hospital discharge and to reduce subsequent emergency room visits.

 

Poor-Quality Medicine: A Global Pandemic

22Jul
2017

Poor-Quality Medicine: A Global Pandemic – Devex (free)

“Each year, the proliferation of substandard and falsified medicines puts the lives of millions of people – particularly those living in developing countries – at risk”

 

Venous Thromboembolism Prophylaxis in Major Orthopedic Surgery: Systematic Review Update

22Jul
2017

Venous Thromboembolism Prophylaxis in Major Orthopedic Surgery: Systematic Review Update. Comparative Effectiveness Review – Agency for Healthcare Research and Quality (free report and summary)

See also: Executive summary (free PDF)

Source: ACP Journal Wise ($ resource to find articles of interest)

Comprehensive review on the evidence regarding thromboembolism prophylaxis in major orthopedic surgery.

 

Laminar airflow in surgery might not reduce surgical site infections

21Jul
2017

The Aging Physician and the Medical Profession: A Review

21Jul
2017

Use of antibiotics during pregnancy and the risk of major congenital malformations

21Jul
2017

Use of antibiotics during pregnancy and the risk of major congenital malformations: A population based cohort study – British Journal of Pharmacology (link to abstract – $ for full-text)

Commentary: New study finds link between certain antibiotics during pregnancy and risk for birth defects – News Medical (free)

Related article: Use of antibiotics during pregnancy and risk of spontaneous abortion – Canadian Medical Association Journal (free)

In this large cohort clindamycin, doxycycline, quinolones, macrolides, and phenoxymethylpenicillin were associated with congenital malformations. Amoxicillin, cephalosporins, and nitrofurantoin were not associated with birth defects.

 

Comprehensive geriatric assessment and optimization in vascular surgery

20Jul
2017

Randomized clinical trial of comprehensive geriatric assessment and optimization in vascular surgery – British Journal of Surgery (link to abstract – $ for full-text)

Source: ACP Journal Club ($ resource to find articles of interest)

In this RCT, a comprehensive preoperative geriatric assessment and optimization before vascular surgery was associated with shorter length of hospital stay, lower incidence of complications, and patients were less likely to be discharged to a higher level of dependency.

 

Predicting all-cause risk of 30-day hospital readmission using artificial neural networks

18Jul
2017

Physicians need to openly discuss medical mistakes and near misses

16Jul
2017

Threats to Information Security: Public Health Implications

16Jul
2017

Clinical Practice Guidelines for Enhanced Recovery After Colon and Rectal Surgery

16Jul
2017

Non-health care facility medication errors resulting in serious medical outcomes

13Jul
2017

Are There Long-Term Risks to Egg Donors?

11Jul
2017

Shared Decision Making: The Importance of Diagnosing Preferences

11Jul
2017

Association of delay of urgent or emergency surgery with mortality and use of health care resources

10Jul
2017

Medication nonadherence may increase health care costs

8Jul
2017

Longitudinal Patterns of Medication Nonadherence and Associated Health Care Costs – Inflammatory Bowel Diseases (link to abstract – $ for full-text)

Commentary: Taking medications as prescribed important to control health care costs – Cincinnati Children’s Hospital Medical Center, via EurekAlert (free)

In this small study, patients with increasing nonadherence over time demonstrate more than a 3-fold increase in costs compared with adherent patients.

 

Pictograms, Units and Dosing Tools, and Parent Medication Errors

7Jul
2017

Risk of death among users of Proton Pump Inhibitors

5Jul
2017

Common ED Medication Errors: Polypharmacy

4Jul
2017

Re-designing the pathway to surgery: better care and added value

3Jul
2017

Redesigning Care for High-Cost, High-Risk Patients

3Jul
2017

Delirium Prevention Strategies for Elderly Adults with Hip Fracture

30Jun
2017

Hospital Visits by Nurse Practitioners Prevent Readmission

28Jun
2017

Monitoring Medical Devices: Missed Warning Signs Within Existing Data

26Jun
2017

Viewpoint: Monitoring Medical Devices: Missed Warning Signs Within Existing Data – JAMA (free)

Related: The lap band for weight loss is a tale of medicine gone wrong – VOX (free) Reoperation and Medicare Expenditures After Laparoscopic Gastric Band Surgery – JAMA Surgery (link to abstract – $ for full-text) AND Safety, Effectiveness of Gastric Banding Called Into Question – Medscape (free registration required) AND 1 In 5 Gastric Band Surgeries Require Corrective Operations – American Council on Science and Health (free)

The authors use the example of gastric band surgery to discuss how available data may be used more appropriately for earlier detection of problems in the safety of medical devices.

 

Contact Precautions for Endemic MRSA and VRE: Time to Retire Legal Mandates

26Jun
2017

Viewpoint: Contact Precautions for Endemic MRSA and VRE: Time to Retire Legal Mandates – JAMA (free)

“Contact precautions are easy to use w a single patient, but burdensome when applied to an entire hospital” (RT @JAMA_current see Tweet)

This viewpoint suggests a more selective use of contact precautions for the control of endemic pathogens.

 

Opinion: Natural health products should be sold separately from drugs

26Jun
2017

Editorial: Natural health products should be sold separately from drugs – Canadian Medical Association Journal (free)

“Separate “natural” products from drugs to protect consumers, says @drstanbrook” (RT @CMAJ see Tweet)

 

Timely Use of Probiotics in Hospitalized Adults Prevents Clostridium difficile Infection

26Jun
2017

Timely Use of Probiotics in Hospitalized Adults Prevents Clostridium difficile Infection: A Systematic Review With Meta-Regression Analysis – Gastroenterology (free)

Source: EvidenceAlerts (free resource to find articles of interest)

In this meta-analysis including 19 randomized trials, probiotics given within 2 days of the first antibiotic dose (more effective than if started later) reduced the risk of Clostridium difficile infection (CDI) by >50% in hospitalized adults. 1 case of CDI would be prevented for every 23−144 patients treated with probiotics when antibiotics are started. “There was no convincing evidence of superior efficacy for any of the tested probiotic formulations, delivery methods (drink or capsule), or probiotic doses”.

 

Point of view: Generalists key to improved hospital outcomes

26Jun
2017

Adverse Events Reported to the US Food and Drug Administration for Cosmetics and Personal Care Products

26Jun
2017

Interesting initiative for improving quality and reducing readmissions from skilled nursing facilities

25Jun
2017

Necessity is the mother of invention: an innovative hospitalist-resident initiative for improving quality and reducing readmissions from skilled nursing facilities – Journal of Community Hospital Internal Medicine Perspectives (free) (RT @HMVJC see Tweet)

In this model of care, a hospitalist-led team, including the resident on the geriatrics rotation, followed patients discharged from the hospital to the skilled nursing facility, leading to significant decrease in readmission rates.

 

Benchmarking study helps hospitals improve measurement of adverse events

23Jun
2017

Benchmarking study helps hospitals improve measurement of adverse events – NIHR Signal (free)

Original report: Measuring harm and informing quality improvement in the Welsh NHS: the longitudinal Welsh national adverse events study – Health Services and Delivery Research (free PDF)

This study compared two different approaches to measure adverse events, the “Trigger Tool system” and the “Two-stage review”

 

Value-Based Care Alone Won’t Reduce Health Spending and Improve Patient Outcomes

22Jun
2017

Value-Based Care Alone Won’t Reduce Health Spending and Improve Patient Outcomes – Harvard Business Review (a few articles per month are free) (RT @pash22 see Tweet)

“We believe that value-based care, implemented using lean principles and in conjunction with an ongoing, community-wide effort to address social determinants of health, can reduce health spending and deliver on the promise of better health”

 

Cardiopulmonary resuscitation – 30:2 or just keep going?

22Jun
2017

Cardiopulmonary resuscitation – 30:2 or just keep going? – by Scott Munro, in Evidently Cochrane (free) (RT @NIHR_DC see Tweet)

“Untrained bystander CPR had better outcomes when given telephone advice from EMS services to perform continuous CPR, rather than interrupted CPR with rescue breaths”. For trained EMS professionals, “it is possible that there is little or no difference between the two approaches”.

 

Every Newborn Action Plan – World Health Organization

22Jun
2017

Every Newborn Action Plan – World Health Organization (free) (RT @WHO see Tweet with infographic)

Related report from UK: Each Baby Counts – Royal College of Obstetricians and Gynaecologists (free PDF) Each Baby Counts Homepage (free resources) AND Reducing baby deaths and brain injuries during childbirth – BBC News (free)

Every year, 2.7 million babies die in the first 28 days of life. 75% of these deaths are preventable.

 

Performance Improvement: Phenytoin Toxicity

22Jun
2017

Performance Improvement: Phenytoin Toxicity – JAMA (free)

Interesting case of medication error and prevention of subsequent adverse events (RT @JAMA_current see Tweet)

 

Which patients with advanced respiratory disease die in hospital?

21Jun
2017

Opinion: The practice of radiology needs to change

21Jun
2017

Giles Maskell: The practice of radiology needs to change – The BMJ Opinion (free)

“The practice of radiology is unsafe and needs to change says, Giles Maskell” (RT see Tweet)

 

Lean: Targeted Therapy for Care Delivery

21Jun
2017

Lean: Targeted Therapy for Care Delivery –  Journal of the National Comprehensive Cancer Network (free)

The possible benefits of applying the “Lean” approach to oncology care delivery.

 

Therapeutic Patient Education Interventions to Promote Cardiovascular Patient Self-Management

20Jun
2017

Antibiotic stewardship reduces the incidence of antibiotic-resistant bacteria

20Jun
2017

Surgeon Variation in Complications With Minimally Invasive and Open Colectomy

20Jun
2017

Surgeon Variation in Complications With Minimally Invasive and Open Colectomy: Results From the Michigan Surgical Quality Collaborative – JAMA Surgery (free) (RT @MaryDixonWoods see Tweet)

Surgeon-level variation in complications among surgeons was nearly twice as great for Minimally Invasive Colectomy than for Open Colectomy, implying a need for improved training in adoption of minimally invasive techniques.

 

Why overtreatment and overdiagnosis can be bad for your health

20Jun
2017

Why overtreatment and overdiagnosis can be bad for your health – CBC Radio (free text and audio)

See more on the Choosing Wisely initiative in our April 5 issue, see #6.

“Choosing Wisely on CBC Sunday about overdiagnosis & importance of speaking with your doc about tests/treatments” (RT @ChooseWiselyCA see Tweet)

 

Why Providers May Fail to Reduce Wait Times

20Jun
2017

The tyranny of excessive medical hierarchy

20Jun
2017

Guideline for the Perioperative Management of Antirheumatic Medication in Patients With Rheumatic Diseases Undergoing Elective Total Hip or Total Knee Arthroplasty

19Jun
2017

Hundreds died while taking an arthritis drug, but nobody alerted patients

19Jun
2017

Perspectives on the Use of Clinical Pathways in Oncology Care

16Jun
2017

Using the New ASCO Clinical Practice Guideline for Palliative Care Concurrent With Oncology Care Using the TEAM Approach

16Jun
2017

Pain and Opioids in Cancer Care: Benefits, Risks, and Alternatives

16Jun
2017

Hand hygiene: facilitators and barriers

16Jun
2017

American Society of Health-System Pharmacists – Five Things Physicians and Patients Should Question

16Jun
2017

New Choosing Wisely List: American Society of Health-System Pharmacists – Five Things Physicians and Patients Should Question (free)

See more on the Choosing Wisely initiative in our April 5 issue, see #6.

“Great choosing wisely list from @ASHPOfficial. Great doctoring tips for physicians & trainees” (RT @AnilMakam see Tweet)

 

Non–Vitamin K Antagonist Oral Anticoagulant Dosing in Patients With Atrial Fibrillation and Renal Dysfunction

15Jun
2017

Non–Vitamin K Antagonist Oral Anticoagulant Dosing in Patients With Atrial Fibrillation and Renal Dysfunction – Journal of The American College of Cardiology (link to abstract – $ for full-text)

Commentary: NOAC Doses: Just Stick to the Label – MedPage Today (free registration required)

“Among the 1,473 patients with a renal indication for dose reduction, 43.0% were potentially overdosed, which was associated with a higher risk of major bleeding”

 

Association of Adverse Events With Antibiotic Use in Hospitalized Patients

14Jun
2017

Association of Adverse Events With Antibiotic Use in Hospitalized Patients – JAMA Internal Medicine (link to abstract – $ for full-text)

Commentary: Antibiotic-Associated Adverse Events Common – Medscape (free registration required)

“20% of hospitalized patients receiving antibiotics had adverse drug event. Of those, 20% of regimens inappropriate” (RT @PeterPronovost see Tweet)

 

It’s time to get serious about the safety of medical devices

13Jun
2017

Leading Quality in Changing Times

11Jun
2017

Leading Quality in Changing Times – NEJM Catalyst (free)

“4 principles for quality leaders in brave new world of population health” (RT @nejmcatalyst see Tweet)

 

Practice Guidelines for Preoperative Fasting

9Jun
2017

Things the Health Care Sector Must Do to Improve Cybersecurity

8Jun
2017

Management of polypharmacy

8Jun
2017

Handshake-free zones to prevent infections?

8Jun
2017

#ASCO2017 – Survival in a Trial Assessing Patient-Reported Outcomes for Symptom Monitoring During Cancer Treatment

5Jun
2017

#ASCO2017 – Overall Survival Results of a Trial Assessing Patient-Reported Outcomes for Symptom Monitoring During Routine Cancer Treatment – JAMA (free)

Commentaries: Quickly reporting cancer complications may boost survival – STAT News (free) AND If This Were a Drug, the Price Would Be $100,000 – Medscape (free registration required) AND How a simple tech tool can help cancer patients live longer – The Washington Post (free)

“For surveillance of cancer, digital tracking of patient-generated data improves survival”. “The cost of digital tracking is very low and > 5 months median survival improvement is more than cancer drugs that cost > $100,000” (RT @EricTopol see Tweets and Answers)

 

Changing the narratives for patient safety – World Health Organization

5Jun
2017

Perspectives: Changing the narratives for patient safety – World Health Organization (free)

“No simple solutions to patient safety: why we have to change the narratives” (RT @MaryDixonWoods See Tweet)

 

Engaging Patients in Patient Safety – a Canadian Guide

5Jun
2017

Prevention of Catheter-Associated Urinary Tract Infection in Nursing Home Residents

4Jun
2017

Prophylactic Acid-Suppressive Therapy in Hospitalized Adults

2Jun
2017

Diabetes – Injection and Infusion Technique Recommendations

1Jun
2017

The lap band for weight loss is a tale of medicine gone wrong

25May
2017

Effect of a Modified Hospital Elder Life Program on Delirium and Length of Hospital Stay in Patients Undergoing Abdominal Surgery

25May
2017

Effect of a Modified Hospital Elder Life Program on Delirium and Length of Hospital Stay in Patients Undergoing Abdominal Surgery: A Cluster Randomized Clinical Trial – JAMA Surgery (free) (RT @PreetiNMalani see Tweet)

Commentary: Anti-delirium strategy reduces after-surgery confusion in elderly – Reuters Health (free)

Multicomponent nonpharmacologic interventions, including orienting communications, oral and nutritional assistance, and early mobilization reduced postoperative delirium by 56% and length of stay by 2 days.

 

Factors Associated with Pediatric Mortality from Motor Vehicle Crashes

25May
2017
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