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https://www.readbyqxmd.com/read/28524414/complementary-medicine-use-among-general-internal-medicine-inpatients-in-a-swiss-university-hospital
#1
Isabelle Ducrest, Pedro Marques-Vidal, Mohamed Faouzi, Bernard Burnand, Gérard Waeber, Pierre-Yves Rodondi
BACKGROUND: Complementary Medicine (CM) is frequently used by the general population, but data about prevalence among hospitalised patients are scarce. We evaluated the prevalence and determinants of CM use by inpatients, lifetime, 2 months before and during their hospitalisation in a general internal medicine ward. METHODS: Cross-sectional survey conducted in September 2014 among adult (≥18 years) patients hospitalised for at least 1 day in the general internal medicine ward of the Lausanne University Hospital, Switzerland...
May 19, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28523476/impact-of-a-patient-navigator-program-on-hospital-based-and-outpatient-utilization-over-180%C3%A2-days-in-a-safety-net-health-system
#2
Richard B Balaban, Fang Zhang, Catherine E Vialle-Valentin, Alison A Galbraith, Marguerite E Burns, Marc R Larochelle, Dennis Ross-Degnan
BACKGROUND: With emerging global payment structures, medical systems need to understand longer-term impacts of care transition strategies. OBJECTIVE: To determine the effect of a care transition program using patient navigators (PNs) on health service utilization among high-risk safety-net patients over a 180-day period. DESIGN: Randomized controlled trial conducted October 2011 through April 2013. PARTICIPANTS: Patients admitted to the general medicine service with ≥1 readmission risk factor: (1) age ≥ 60; (2) in-network inpatient admission within prior 6 months; (3) index length of stay ≥ 3 days; or (4) admission diagnosis of heart failure or (5) chronic obstructive pulmonary disease...
May 18, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28514976/working-despite-having-influenza-like-illness-results-of-an-anonymous-survey-of-healthcare-providers-who-care-for-transplant-recipients
#3
Sherif B Mossad, Abhishek Deshpande, Sarah Schramm, Xiaobo Liu, Michael B Rothberg
OBJECTIVE To compare the rates of and reasons for presenteeism associated with influenza-like illness (ILI) among healthcare professionals (HCPs) caring for hospitalized inpatient transplant recipients and internal medicine patients. DESIGN We designed a 10-question anonymous survey in which ILI was defined as fever (>37.8°C) and cough and/or sore throat and ILI B was defined as fever (>37.8°C) or cough or sore throat; both definitions were considered in the absence of another known cause. SETTING Tertiary-care center...
May 18, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28509435/inpatient-iron-deficiency-detection-and-management-how-do-general-physicians-and-gastroenterologists-perform-in-a-tertiary-care-hospital
#4
Muhammad Waqas Fazal, Jane Andrews, Josephine Thomas, Eliana Saffouri
BACKGROUND: Iron deficiency (ID) is often an indicator of underlying pathology. Early detection and treatment avoids long term morbidity, and allows for prompt iron repletion avoiding ID anaemia (IDA) and need for blood transfusion. AIM: We aimed to evaluate the management of ID in two internal medicine units [General Medical (GM) & Gastroenterology (GE)] in a large metropolitan hospital and compare it to international guidelines.(3,4) METHOD: All consecutive inpatient admissions under GM & GE units were retrospectively reviewed until 40 patients in each service were identified with anaemia and/or microcytic hypochromic blood counts...
May 16, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28506546/a-model-for-electronic-handoff-between-the-emergency-department-and-inpatient-units
#5
Leon D Sanchez, David T Chiu, Larry Nathanson, Steve Horng, Richard E Wolfe, Mark L Zeidel, Kirsten Boyd, Carrie Tibbles, Shelley Calder, Jane Dufresne, Julius J Yang
BACKGROUND: Patient handoffs between units can introduce risk and time delays. Verbal communication is the most common mode of handoff, but requires coordination between different parties. OBJECTIVE: We present an asynchronous patient handoff process supported by a structured electronic signout for admissions from the emergency department (ED) to the inpatient medicine service. METHODS: A retrospective review of patients admitted to the medical service from July 1, 2011 to June 30, 2015 at a tertiary referral center with 520 inpatient beds and 57,000 ED visits annually...
May 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28504012/inpatient-glycemic-management-in-internal-medicine-an-observational-multicenter-study-in-nanjing-china
#6
Shujie Hao, Ning Zhang, Anne Folta Fish, Xiaodan Yuan, Lin Liu, Fan Li, Zhaohui Fang, Qingqing Lou
Aims To evaluate the prevalence of hyperglycemia among inpatients in internal medicine, and specifically, to assess the glycemic management of inpatients in non-endocrinology departments in three large urban hospitals in China. Methods A multicenter observational study was conducted using electronic health records, and a survey of 1939 patients who were admitted to internal medicine units and followed until discharge. Those with previously diagnosed diabetes, newly diagnosed diabetes, or impaired fasting glucose were included...
May 13, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28500408/scheduling-internal-medicine-resident-rotations-to-ensure-fairness-and-facilitate-continuity-of-care
#7
Ruben A Proano, Akshit Agarwal
Completing a residency program is a requirement for medical students before they can practice medicine independently. Residency programs in internal medicine must undergo a series of supervised rotations in elective, inpatient, and ambulatory units. Typically, a team of chief residents is charged to develop a yearly rotational schedule. This process is complex, as it needs to consider academic, managerial, regulatory, and legal restrictions while also facilitating the provision of patient care, ensuring a diverse educational experience, balancing the workload, and improving resident satisfaction...
May 12, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28499421/patterns-of-use-and-appropriateness-of-antibiotics-prescribed-to-patients-receiving-haemodialysis-an-observational-study
#8
Katrina Hui, Michelle Nalder, Kirsty Buising, Aspasia Pefanis, Khai Y Ooi, Eugenie Pedagogos, Craig Nelson, Carl M J Kirkpatrick, David C M Kong
BACKGROUND: There are limited published data on the types and appropriateness of oral and intravenous (IV) antibiotics prescribed to patients receiving haemodialysis. This information is critical to optimise antibiotic prescribing. Therefore this study aims to describe the patterns of use and the appropriateness of oral and IV antibiotics prescribed to patients receiving haemodialysis. METHODS: This was a prospective, observational study across four community and two hospital inpatient haemodialysis units in Melbourne, Australia...
May 12, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28497983/promoting-responsible-electronic-documentation-validity-evidence-for-a-checklist-to-assess-progress-notes-in-the-electronic-health-record
#9
Jennifer A Bierman, Kathryn Kinner Hufmeyer, David T Liss, A Charlotta Weaver, Heather L Heiman
Construct: We aimed to develop an instrument to measure the quality of inpatient electronic health record- (EHR-) generated progress notes without requiring raters to review the detailed chart or know the patient. BACKGROUND: Notes written in EHRs have generated criticism for being unnecessarily long and redundant, perpetuating inaccuracy and obscuring providers' clinical reasoning. Available assessment tools either focus on outpatient progress notes or require chart review by raters to develop familiarity with the patient...
May 12, 2017: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/28487461/the-impact-of-duty-cycle-workflow-on-sign-out-practices-a-qualitative-study-of-an-internal-medicine-residency-program-in-maryland-usa
#10
Soo-Hoon Lee, Sanjay V Desai, Phillip H Phan
OBJECTIVES: Although JCAHO requires a standardised approach to handoffs, and while many standardised protocols have been tested, sign-out practices continue to vary. We believe this is due to the variability in workflow during inpatient duty cycle. We investigate the impact of such workflows on intern sign-out practices. DESIGN: We employed a prospective, grounded theory mixed-method design. SETTING: The study was conducted at a residency programme in the mid-Atlantic USA...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28474132/what-type-of-food-can-older-adults-masticate-evaluation-of-mastication-performance-using-color-changeable-chewing-gum
#11
Shinichi Wada, Nobuyuki Kawate, Masazumi Mizuma
This study determines if older adults can masticate regular foods via a simple test conducted using a color-changeable chewing gum. Seventy-nine consecutive inpatients of our clinic receiving rehabilitation and general medicine were assessed for eligibility. The inclusion criterion was >65 years. Thirty patients consented to participate. The main outcome variable was the food bolus texture at the swallowing threshold for five regular foods. The main explanatory variable was the a* value of the color-changeable chewing gum after 120 s of chewing (a* represents the degree of color between red and green, and a positive a* value indicates red)...
May 4, 2017: Dysphagia
https://www.readbyqxmd.com/read/28472701/optical-coherence-tomography-findings-in-patients-with-bipolar-disorder
#12
Mohamed A Khalil, Alia A Saleh, Sherif M Gohar, Dalia Hamed Khalil, Mohamed Said
BACKGROUND: Research in bipolar disorder suggests the presence of structural brain abnormalities. It is not clear whether these findings are trait markers or operate with the onset and progress with disease severity and duration. Optical coherence tomography (OCT) is a non-invasive technique that detects degenerative changes in the retina reflecting brain degeneration. This study aimed at detecting these changes and relating them to disease severity and clinical characteristics. METHODS: A case-control study conducted in Psychiatry and Addiction Medicine hospital, Faculty of Medicine at Cairo University...
April 28, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28469901/use-of-electronic-clinical-decision-support-and-hard-stops-to-decrease-unnecessary-thyroid-function-testing
#13
Sonia Dalal, Siddharth Bhesania, Steven Silber, Parag Mehta
NewYork-Presbyterian Brooklyn Methodist Hospital embarked on a Zero Unnecessary Study (ZEUS) initiative, whereby all aspects of clinical care were evaluated and strategies were implemented to mitigate waste. An opportunity was found in regards to thyroid function testing. It has been shown that certain TFTs are ordered far more often than clinically indicated. Free T3 (fT3) and Free T4 (fT4) are only indicated when the TSH is abnormal in the inpatient setting, with rare exceptions. Thus, a clinical algorithm for Clinical Decision Support (CDS) and Hard Stops (HS) were incorporated into the Electronic Medical Record (EMR) to prevent fT3 or fT4 to be ordered without an abnormal TSH, with certain predefined exceptions...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28466398/factors-associated-with-adverse-drug-reactions-in-older-inpatients-in-teaching-hospital
#14
Tácita Pires de Figueiredo, Ronara Camila de Souza Groia, Soraya Coelho Costa Barroso, Mariana Martins Gonzaga do Nascimento, Adriano Max Moreira Reis
Background Adverse drug reactions (ADRs) occur frequently during hospital stays and are an important public health problem, particularly in the care of the older. Objectives This study aimed to determine the prevalence of ADRs among older inpatients and the factors associated with their occurrence. Setting Brazilian teaching hospital. Methods This was a cross-sectional study with older inpatients in the internal medicine ward of a teaching hospital. The dependent variable was the occurrence of an ADR during hospitalization...
May 2, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28465710/do-children-with-neurological-disabilities-use-more-inpatient-resources-an-observational-study
#15
Jin-Xi Yuan, Marian McGowan, Irene Hadjikoumi, Buddhi Pant
BACKGROUND: Advances in healthcare have improved the survival of children with neurological disabilities (ND). Studies in the US have shown that children with ND use a substantial proportion of resources in children's hospitals, however, little research has been conducted in the UK. We aimed to test the hypothesis that children with neurological disabilities use more inpatient resources than children without neurological disabilities, and to quantify any significant differences in resource use...
2017: Emerging Themes in Epidemiology
https://www.readbyqxmd.com/read/28463183/personalized-risk-scoring-for-critical-care-prognosis-using-mixtures-of-gaussian-processes
#16
Ahmed M Alaa, Jinsung Yoon, Scott Hu, Mihaela van der Schaar
In this paper, we develop a personalized real-time risk scoring algorithm that provides timely and granular assessments for the clinical acuity of ward patients based on their (temporal) lab tests and vital signs; the proposed risk scoring system ensures timely intensive care unit (ICU) admissions for clinically deteriorating patients. METHODS: The risk scoring system is based on the idea of sequential hypothesis testing under an uncertain time horizon. The system learns a set of latent patient subtypes from the offline electronic health record data, and trains a mixture of Gaussian Process (GP) experts, where each expert models the physiological data streams associated with a specific patient subtype...
April 27, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28462140/effectiveness-and-safety-of-combination-treatment-of-herbal-medicines-and-oral-antihistamines-for-atopic-dermatitis-a-retrospective-chart-review
#17
Younghee Yun, Jaewoong Son, Kyuseok Kim, Bo-Hyeong Jang, Inhwa Choi, Seong-Gyu Ko
BACKGROUND: Patients with atopic dermatitis (AD) exhibit various symptoms, especially itching. Recently, herbal medicines (HMs) are being used in combination with antihistamines for the treatment of AD in Korea. While oral antihistamines can alleviate itching, HMs appear to exert anti-inflammatory effects with minimal side effects. However, there is little evidence regarding the effectiveness and safety of using HMs in combination with antihistamines for AD. METHODS: To observe the effectiveness and safety of combination treatment with HMs and antihistamines, we performed a retrospective chart review of inpatients with AD who received this combination treatment for at least 7 days in a hospital...
March 2017: Integr Med Res
https://www.readbyqxmd.com/read/28459909/inpatient-management-of-opioid-use-disorder-a-review-for-hospitalists
#18
REVIEW
Jesse Theisen-Toupal, Matthew V Ronan, Amber Moore, Elana S Rosenthal
The United States is experiencing an epidemic of nonmedical opioid use and opioid overdose-related deaths. As a result, there have been a number of public health interventions aimed at addressing this epidemic. However, these interventions fail to address care of individuals with opioid use disorder during hospitalizations and, therefore, miss a key opportunity for intervention. The role of hospitalists in managing hospitalized patients with opioid use disorder is not established. In this review, we discuss the inpatient management of individuals with opioid use disorder, including the treatment of withdrawal, benefits of medication-assisted treatment, and application of harm-reduction strategies...
May 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28459904/planning-and-designing-the-improving-addiction-care-team-impact-for-hospitalized-adults-with-substance-use-disorder
#19
Honora Englander, Melissa Weimer, Rachel Solotaroff, Christina Nicolaidis, Benjamin Chan, Christine Velez, Alison Noice, Tim Hartnett, Ed Blackburn, Pen Barnes, P. Todd Korthuis
People with substance use disorders (SUD) have high rates of hospitalization and readmission, long lengths of stay, and skyrocketing healthcare costs. Yet, models for improving care are extremely limited. We performed a needs assessment and then convened academic and community partners, including a hospital, community SUD organizations, and Medicaid accountable care organizations, to design a care model for medically complex hospitalized patients with SUD. Needs assessment showed that 58% to 67% of participants who reported active substance use said they were interested in cutting back or quitting...
May 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28459902/it-all-just-clicks-development-of-an-inpatient-e-consult-program
#20
Nader Najafi, James D Harrison, Jonathan Duong, Anya Greenberg, Hugo Quinny Cheng
Although the use of electronic consultations (e-consults) in the outpatient setting is commonplace, there is little evidence of their use in the inpatient setting. Often, the only choice hospitalists have is between requesting a time-consuming in-person consultation or requesting an informal, undocumented "curbside" consultation. For a new, remote hospital in our healthcare system, we developed an e-consult protocol that can be used to address simple consultation questions. In the first year of the program, 143 e-consults occurred; the top 5 consultants were infectious disease, hematology, endocrinology, nephrology, and cardiology...
May 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
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