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Clinical Issues - Patient Safety

 

ICU patients need to be seen as well as heard

Determining the floor plan of a hospital is usually the responsibility of an architect, but a recent study shows doctors should care about design, too. More

Stickers, candy help reduce drug errors

Auckland City Hospital in New Zealand reduced medication errors due to inaccurate recording of patients' medications. More

Putting MRSA to the test

Screening patients may keep infection from taking hold. More

Fewer catheters … fewer infections

The Michigan Health & Hospital Association reduced unnecessary use of catheters and thereby catheter-associated UTIs. More

System catches codes before they’re called

Mercy Hospital Anderson in Cincinnati used a scoring system to reduce the number of code blues called outside the ICU. More

Is it observation or inpatient?

Three new ways to answer the age-old question

The question of “observation or inpatient” has perplexed hospital physicians for some time, but it’s recently acquired greater financial significance. Recovery audit contractors paid by Medicare will be looking at hospitals’ one-day admissions to determine whether patients were appropriately admitted or should have been under observation status. More

Q&A: Dennis M. Manning, FACP, and A. Scott Keller, FACP

I-MOVE gets elderly patients on the move

A new tool developed by hospitalists helps assess mobility

The I-MOVE sounds like a state-of-the-art electronic gadget, but it’s actually the simplest of medical tools. Developed by clinicians at Mercy Hospital of Pittsburgh and the Mayo Clinic in Minnesota, the Independent Mobility Validation Examination, or I-MOVE, is a 12-point scale that could help hospitalists assess their patients’ mobility. More

Lost in transition

Medication discrepancies between hospitals and skilled nursing facilities are common. Learn why and what you can do about it. More

Are your patients at risk?

Dr. Peraino discusses four common causes of medical mistakes and offers tips on preventing them. More

Improving handoffs through better communication

Research has shown that speakers systematically overestimate how well their messages are understood by listeners, and assume a listener has all the same knowledge they do. Verbal updates and read-backs can help. More

Get the germs where they live —in the hospital

An expert delivers good news and bad news about hospital-acquired infections. More

Creating a better discharge summary

Is standardization the answer?

The discharge summary is a vital tool for transferring information between the hospitalist and primary care physician, but it isn’t always given the priority it deserves.
More

War on bugs

Antimicrobial stewardship teams ramp up the fight against "superbugs"
The battle with drug-resistant bacteria has evolved into an all-out war in many hospitals, and fighting back with newer drugs no longer seems like the best defensive strategy. Instead, hospitals are deploying multidisciplinary teams to spread the word about prevention through judicious use of antibiotics.
January '09

Breaking the fall
Hospitalization is a risk factor for falls, but also an opportunity for prevention
Recent research suggests that hospitalization is a risk factor for post-discharge fracture in elderly patients, prompting some hospitalists to consider what measures they can take to reduce fracture risk before these patients leave the hospital.
January '09

To err is human … to not plan for it is trouble

Hospitals should always work to prevent serious or fatal medical errors, but they also need to have a plan in place for what to do if an error occurs. Chances are, it will happen eventually.
December '08

Calling for backup before it’s needed

Failure to rescue, the failure to identify patients with critical abnormalities and provide the resources necessary to prevent harm, was one of the top three preventable errors found in hospitals in 2004-2006, accounting for 17% of total errors. Experts offer their solutions.
November '08

Closing the loop on medication errors

Barcodes were supposed to prevent problems, but instead, staff developed workarounds to speed care. Ferret out the problems before fatalities occur.
November '08

Delivery (of a shock) in two minutes or less

Assessing and improving cardiac arrest response times
Recent research has found that hospitalized patients with ventricular fibrillation or ventricular tachycardia don't always receive defibrillation within the recommended window, and that the delay has a detrimental effect on outcomes and survival. Cardiologists and other experts trying to improve these times say that hospitalists are in the perfect spot to take charge of the problem and lead improvement efforts.
August '08

Wiping out falls
Systemic interventions help reduce patient risk
August '08

Quick response, teamwork protected patients during heparin recall
As pharmacists monitored hospital supplies, physicians and nurses monitored patients
July '08

Keeping track of mistakes that don’t happen
Near-miss tracking project for residents aims to improve hospital care
April '08

MKSAP primer: Health care-associated infections
Adapted from ACP's latest Medical Knowledge Self-Assessment Program
April '08

Test yourself: Health care-associated infections
April '08

Dedicated MRSA unit cuts hospital costs and length of stay
March '08

Doctor, don't be a hero: Getting VAP to zero takes teamwork
September '07

Wiping out surgical site infections
Protocols and preparation are key
August '07

Eliminating drug errors
Hospitals adopt medication reconciliation to improve patient safety
May '07

Treating chest pain in 90 minutes or less
Hospitals work to apply best practices for acute MI
April '07

Hospitals put rapid response systems into play
March '07

Aiming for zero
Hospitals work to eliminate catheter-related bloodstream infections
June '07

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ACP Hospitalist Weekly

From the July 28, 2010 edition

• After general surgery, sepsis and septic shock far more common than PE, MI
• Opt-out tests in ED detect slightly more patients with HIV

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ACP Hospitalist provides news and information for internists about the practice of medicine and reports on the policies, products and activities of ACP. All published material, which is covered by copyright, represents the views of the contributor and does not reflect the opinion of the American College of Physicians or any other institution unless clearly stated