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Inpatient teaching unit

Baiju R Shah, Sakina Walji, Alexander Kiss, Jacqueline E James, Julia M Lowe
OBJECTIVES: We sought to develop the Hypoglycemia During Hospitalization (HyDHo) scoring system, to predict the risk for hypoglycemia during hospitalization in patients with diabetes at the time of admission to a general medical unit. METHODS: We randomly selected 300 patients with diabetes who had been admitted to a medical inpatient unit at a teaching hospital. Hypoglycemia was defined as any point-of-care glucose test result ≤3.9 mmol/L. Demographic and clinical predictors of hypoglycemia were identified through review of the hospitalization record...
August 10, 2018: Canadian Journal of Diabetes
Samaher Sweity, Andrew Finlay, Charlotte Lees, Adam Monk, Toshi Sherpa, Derick Wade
OBJECTIVE: To determine the short-term effects of supplying hospital inpatients with earplugs and eye masks, preparatory to a full-scale trial. DESIGN: A single-centre, open-label, two-arm, parallel group, randomized-controlled trial. SETTING: A total of 13 medical and surgical wards in a large teaching hospital in the United Kingdom. PARTICIPANTS: Everyone admitted to hospital aged 18 years or older, who stayed overnight and had the mental capacity and sufficient understanding of English to give consent, the ability to complete the study questionnaire and the ability to use earplugs and eye masks unaided was considered...
October 15, 2018: Clinical Rehabilitation
Sarah Burm, Lisa Faden, Sandy DeLuca, Kathy Hibbert, Noureen Huda, Mark Goldszmidt
Today's hospitals are burdened with patients who have complex health needs. This is readily apparent in an inpatient internal medicine setting. While important elements of effective interprofessional collaboration have been identified and trialled across clinical settings, their promise continues to be elusive. One reason may be that caring for patients requires understanding the size and complexity of healthcare networks. For example, the non-human 'things' that healthcare providers work with and take for granted in their professional practice-patient beds, diagnostic imaging, accreditation standards, work schedules, hospital policies, team rounds-also play a role in how care is shaped...
October 15, 2018: Journal of Interprofessional Care
Leen Khoury, David A Hill, Melissa Panzo, Melissa Chiappetta, Sachin Tekade, Stephen M Cohn
OBJECTIVE: Upper gastrointestinal (GI) bleeding occurs at a rate of 40-150 episodes per 100,000 persons per year and is associated with a mortality rate of 6%-10%. We sought to determine the need for therapeutic endoscopy or surgical interventions in patients with hematemesis and the association with blood transfusion requirements. METHODS: We queried the database of our large teaching facility for adult patients presenting with obvious upper GI hemorrhage (hematemesis) between 2014 and 2017...
July 23, 2018: Curēus
Michael J Stentz, Mary E Kelley, Craig S Jabaley, Vikas O'Reilly-Shah, Robert F Groff, Vanessa Moll, James M Blum
The use of extracorporeal membrane oxygenation (ECMO) has grown rapidly in recent years. We sought to describe the rate of ECMO use in the United States, regional variation in ECMO use, the hospitals performing ECMO, and the primary payers for ECMO patients. Detailed data were obtained using the Healthcare Cost and Utilization Project (HCUPnet) summaries of State Inpatient Databases from 34 participating states for the years 2011-2014. The ECMO rates over time were modeled, overall and within subcategories of age group, bed size, hospital ownership, teaching status, and payer type...
September 19, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Lorna Renner, Shivani Shah, Nickhill Bhakta, Avram Denburg, Sue Horton, Sumit Gupta
PURPOSE: No published study to date has examined total cost and cost-effectiveness of maintaining a pediatric oncology treatment center in an African setting, thus limiting childhood cancer advocacy and policy efforts. METHODS: Within the Korle Bu Teaching Hospital in Accra, Ghana, costing data were gathered for all inputs related to operating a pediatric cancer unit. Cost and volume data for relevant clinical services (eg, laboratory, pathology, medications) were obtained retrospectively or prospectively...
September 2018: Journal of Global Oncology
Zaid Al-Qurayshi, Sarah M Baker, Meghan Garstka, Christopher Ducoin, Mary Killackey, Ronald L Nichols, Emad Kandil
BACKGROUND: Post-operative infection (POI) is a serious complication in all surgical disciplines and can derail a patient's treatment and recovery course. In this analysis, we examine national trends, risk factors, and costs associated with POI. METHODS: Using the Nationwide Inpatient Sample (NIS) for the years available for data analysis at the time of this study (2003-2010), we performed a cross-sectional study of adult (≥18 years) inpatients with POI and designated Clinical Classification Software (CCS) procedural class codes for the operations performed...
September 5, 2018: Surgical Infections
Adam E M Eltorai, Grayson L Baird, Joshua Pangborn, Ashley Szabo Eltorai, Valentin Antoci, Katherine Paquette, Kevin Connors, Jacqueline Barbaria, Kimberly J Smeals, Barbara Riley, Shyam A Patel, Saurabh Agarwal, Terrance T Healey, Corey E Ventetuolo, Frank W Sellke, Alan H Daniels
Despite largely unproven clinical effectiveness, incentive spirometry (IS) is widely used in an effort to reduce postoperative pulmonary complications. The objective of the study is to evaluate the financial impact of implementing IS. The amount of time nurses and RTs spend each day doing IS-related activities was assessed utilizing an online survey distributed to the relevant national nursing and respiratory therapists (RT) societies along with questionnaire that was prospectively collected every day for 4 weeks at a single 10-bed cardiothoracic surgery step-down unit...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
Teresa Caya, Mary Jo Knobloch, Jackson Musuuza, Emily Wilhelmson, Nasia Safdar
BACKGROUND: Many studies investigating daily chlorhexidine gluconate (CHG) bathing as an infection control intervention to decrease health care-associated infections have focused on reduction of infection and colonization; few studies have assessed CHG bathing compliance, work system factors, facilitators, and barriers to implementation. METHODS: This is a combination retrospective/prospective pilot study conducted at a large academic teaching hospital that implemented daily CHG bathing across all inpatient units...
August 30, 2018: American Journal of Infection Control
Xian-Liang Liu, Karen Willis, Chiung-Jung Jo Wu, Yan Shi, Maree Johnson
OBJECTIVE: To describe, from the perspectives of health professionals, the health education currently being provided from hospital admission to discharge to home to patients who present with acute coronary syndrome who also have type 2 diabetes mellitus (T2DM). METHODS: A qualitative study using semistructured interviews was undertaken in the coronary care unit (CCU) of a major hospital in Shanghai, China. Fifteen health professionals (nine registered nurses and six physicians) from the CCU who delivered health education to patients with acute coronary syndrome and T2DM participated...
August 23, 2018: BMJ Open
Erin Muladore, Jill A Brown, Judy Haefner, Barbara Kupferschmid
WHAT IS KNOWN ON THE SUBJECT?: Many psychiatric inpatients use tobacco, but most psychiatric hospital units prohibit tobacco use. Psychiatric nurses do not receive adequate education about how to teach patients to best manage tobacco withdrawal symptoms. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: Psychiatric nurses who receive a brief educational intervention about tobacco withdrawal symptoms and best practices for using nicotine gum may be more prepared to teach patients about these topics. In turn, patients may use nicotine gum more often during their hospitalization, leading to improved outcomes for them as well as for staff...
August 21, 2018: Journal of Psychiatric and Mental Health Nursing
Sarah Burm, Kaitlyn Boese, Lisa Faden, Sandy DeLuca, Noureen Huda, Kathy Hibbert, Mark Goldszmidt
BACKGROUND: While the concept of collaboration is highly touted in the literature, most descriptions of effective collaboration highlight formal collaborative events; largely ignored are the informal collaborative events and none focusing on the frequent, 'seemingly' by chance communication events that arise and their role in supporting patient safety and quality care. OBJECTIVE: To identify the types of informal communication events that exist in the inpatient setting and better understand the barriers contributing to their necessity...
August 18, 2018: BMJ Quality & Safety
Flávia de Oliveira Motta Maia, Diná de Almeida Lopes Monteiro da Cruz, Gilceria Tochika Shimoda, Karina Sichieri, Luciana Inaba Senier Iida
OBJECTIVES: The main objective of this project was to reduce the incidence and harm from falls that occur among patients admitted in the acute Internal Medicine Unit and Intensive Care Unit in a public teaching hospital in São Paulo, Brazil. INTRODUCTION: Falls are a challenge for health professionals and healthcare services as they may result in high-impact outcomes for patients, such as functional decline, increase in length of hospital stay, increase in the cost of healthcare services, and death...
August 2018: JBI Database of Systematic Reviews and Implementation Reports
Sarah Armenia, Loka Thangamathesvaran, Akia D Caine, Neil King, Anastasia Kunac, Aziz M Merchant
Introduction  High-fidelity team-based simulation has been identified as an effective way of teaching and evaluating both technical and nontechnical skills. Several studies have described the benefits of this modality in a variety of acute care settings, but a lack of standardized methodologies has resulted in heterogeneous findings. Few studies have characterized high fidelity simulation across a broad range of acute care settings and integrated the latest evidence on its educational and patient impact. Methods  The MEDLINE, EMBASE, Cochrane Library, and PsycINFO databases were searched for empirical studies from the last 10 years, investigating high fidelity team-based simulation in surgical, trauma, and critical care training curricula...
July 2018: Surgery Journal
Jo Hill, Adam Gerace, Candice Oster, Shahid Ullah
Objective The aims of the present study were to establish rates of resuscitation order documentation of patients aged ≥65 years from both psychogeriatric and general medical units and to compare patients on predictors of resuscitation status, particularly examining the effect of depression. Methods A retrospective case note audit of psychogeriatric (n = 162) and general medical (n = 135) unit admissions within a tertiary teaching hospital was performed. Multivariate logistic regression was used to determine significant clinical and demographic predictors of resuscitation status...
August 14, 2018: Australian Health Review: a Publication of the Australian Hospital Association
Shanan Mahal, Sorabh Datta, Virendrasinh Ravat, Priya Patel, Bipin Saroha, Rikinkumar S Patel
Objective This study aimed to determine the differences in hospitalization outcomes among patients admitted for congestive cardiac failure (CCF) with underlying subclinical hypothyroidism (SCH). Methods This retrospective case-control study used data from the nationwide inpatient sample (NIS) for the years 2012-2014. We identified cases with CCF as the primary diagnosis and SCH as the secondary diagnosis using validated ICD-9-CM codes and controls with CCF only. The differences in hospitalization outcomes and hospital characteristics were quantified using the multinomial logistic regression model (adjusted odds ratio (aOR))...
June 8, 2018: Curēus
Carlin Callaway, Craig Cunningham, Shawna Grover, Kenneth R Steele, Andrea McGlynn, Vorachai Sribanditmongkol
BACKGROUND: Bedside handoffs, the teach-back method, and discharge bundles have been shown to contribute to empowering patients to actively engage in their treatment. OBJECTIVES: The objectives were to identify patient activation scores, patient readmission rates, and nursing staff satisfaction before and after implementing bedside handoffs, the teach-back method, and discharge bundles on an inpatient oncology unit at a large military treatment facility. METHODS: A series of three cycles using the Plan-Do-Study-Act framework guided implementation of the multifaceted approach...
August 1, 2018: Clinical Journal of Oncology Nursing
Larrie Greenberg
The challenging and changing face of medicine over the last 45 years of the author's career has dictated where faculty members' primary interaction with patients occurs, how they teach trainees, and how they measure educational outcomes. The transfer of patient care from the inpatient to the ambulatory setting in the late 20 century was instrumental in creating a "new' model for faculty; that is, the clinician educator (CE). This individual has been defined as a faculty member whose primary responsibility as part of the academic mission is patient care and whose focus is on the theoretical constructs that inform excellent teaching and effective learning, applying these to create and inform educational scholarship...
July 17, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Tiffany P Baugh, C W David Chang
Objectives The purpose of this study is to describe the demographics of children undergoing inpatient management of epistaxis and recognize the clinical circumstances that may necessitate embolization or ligation for epistaxis management. Study Design and Setting Cross-sectional analysis of a national database. Subjects and Methods A review of data reported by hospitals in the United States to the Healthcare Cost and Utilization Project Kids' Inpatient Database with a diagnosis of epistaxis was conducted ( International Classification of Diseases, Ninth Revision [ ICD-9] code 784...
October 2018: Otolaryngology—Head and Neck Surgery
C Alix Timko, Tiffanie J Goulazian, Kathleen Kara Fitzpatrick, Daniel Rodriguez
Background: Anorexia nervosa (AN) is a severe psychiatric condition characterized by low body weight, fear of weight gain/becoming fat and/or behavior that interferes with weight gain, and body disturbance. Though there have been recent advances in the treatment of AN, there continues to be an urgent need to increase treatment options. Cognitive remediation therapy (CRT) has been successfully used as an adjunctive treatment for individuals with AN. In this study, we pilot the use of CRT plus an innovative parent involvement component as a pre-treatment intervention on a medical unit...
2018: Pilot and Feasibility Studies
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