Patient Safety & Quality
Randomized trial: Admission Avoidance Hospital at Home + Geriatric Assessment led to similar outcomes compared to hospital admission for older persons
3 May, 2021 | 05:13h | UTCIs Comprehensive Geriatric Assessment Admission Avoidance Hospital at Home an Alternative to Hospital Admission for Older Persons? A Randomized Trial – Annals of Internal Medicine (link to abstract – $ for full-text)
Related: Pandemic Boosts an Old Idea—Bringing Acute Care to the Patient
Ethics Commission Position Statement: Admission criteria and management of critical care patients in a pandemic context – “Age cannot be used as the sole criterion for admission nor denial of access to ICU settings”
29 Apr, 2021 | 08:36h | UTC
Pre-post study: A hospital quality improvement intervention significantly reduced the rates of cesarean delivery for nulliparous, term, singleton, vertex births
29 Apr, 2021 | 08:21h | UTCHospital Quality Improvement Interventions, Statewide Policy Initiatives, and Rates of Cesarean Delivery for Nulliparous, Term, Singleton, Vertex Births in California – JAMA (free for a limited period)
Editorial: Initiatives to Reduce Cesarean Delivery Rates for Low-risk First Births – JAMA
Commentary on Twitter (thread – click for more)
"Rates of cesarean delivery for NTSV births in California decreased [from 26% to 22.8%] in the setting of a coordinated hospital-level collaborative and statewide initiatives designed to support vaginal birth.
"The rest of the US had no change."https://t.co/jwKkQZ4nix @cmqcc
— Ben Harder #BlackLivesMatter (@benharder) April 27, 2021
Study in nursing homes shows rapid antigen testing could be a useful tool to identify contagious people at risk for transmitting SARS-CoV-2
27 Apr, 2021 | 08:35h | UTCEditorial: Utility of Rapid Antigen Tests in Nursing Homes
Commentary on Twitter
💥🆕 Despite lower positive agreement compared with RT-PCR, antigen test positivity had higher agreement with shedding of replication-competent virus. These results suggest that antigen testing could be a useful tool to rapidly identify contagious people. https://t.co/Dlw7ttLlSL pic.twitter.com/sGmfVIy02H
— Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟 (@ABsteward) April 26, 2021
Guideline: Prevention of Positioning Injuries During Gynecologic Surgery
25 Apr, 2021 | 20:50h | UTC
Guide to Enhanced Recovery for Cancer Patients Undergoing Liver Surgery
25 Apr, 2021 | 20:53h | UTCSee also: Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations – World Journal of Surgery AND Enhanced Recovery After Surgery (ERAS) Society Guidelines
Financial Toxicity in Advanced and Metastatic Cancer: Overburdened and Underprepared
22 Apr, 2021 | 08:24h | UTCRelated: Opinion – The high price of anticancer drugs: origins, implications, barriers, solutions AND Tackling the High Cost of Cancer Care AND Study: Clinician Engagement Regarding Financial Toxicity After Diagnosis of Cancer AND
Opportunities and Challenges for the Next Phase of Enhanced Recovery After Surgery
22 Apr, 2021 | 08:28h | UTCOpportunities and Challenges for the Next Phase of Enhanced Recovery After Surgery: A Review – JAMA Surgery (free for a limited period)
See also: Enhanced Recovery After Surgery (ERAS) Society Guidelines
RCT: Effect of infusion set replacement intervals on catheter-related bloodstream infections – “Infusion set use can be safely extended to 7 days with resultant cost and workload reductions”
20 Apr, 2021 | 05:37h | UTCEffect of infusion set replacement intervals on catheter-related bloodstream infections (RSVP): a randomised, controlled, equivalence (central venous access device)–non-inferiority (peripheral arterial catheter) trial – The Lancet (link to abstract – $ for full-text)
Commentaries on Twitter
If you're an #RN👩⚕️or #infection preventer & it makes you crazy🤯that different hospitals🏥use infusion sets for different durations⏰- READ this massive #RCT in @TheLancet from @AVATAR_grp @UQHealth @UQMedicine @MetroNorthHHS @MenziesHealth & large team https://t.co/lpz1C6ceM2
— Prof Claire Rickard (@Claire_AVATAR) April 18, 2021
Use for 7 vs. 4 days = similar outcomes. Effect of infusion set replacement intervals on catheter-related bloodstream infections (RSVP): a randomised, controlled, equivalence (CV access device)–non-inferiority (peripheral arterial catheter) trial https://t.co/6qaJczu1Cr
— Skeptical Scalpel (@Skepticscalpel) April 16, 2021
Catheter-related bloodstream infections (CRBSIs) account for around 70% of all health care associated bloodstream infections. New trial indicates that 7-day replacement of infusion sets is safe, with resultant cost and workload reductions. https://t.co/ua633FkA3K pic.twitter.com/LfaC6lZYMv
— The Lancet (@TheLancet) April 19, 2021
M-A: Prevalence of depression, anxiety and post-traumatic stress disorder in health care workers during the COVID-19 pandemic
20 Apr, 2021 | 06:00h | UTC
Ten scientific reasons in support of airborne transmission of SARS-CoV-2
18 Apr, 2021 | 21:51h | UTCTen scientific reasons in support of airborne transmission of SARS-CoV-2 – The Lancet
Animated Videos: Aerosols and making spaces safe – University of Oxford
Commentary on Twitter (thread – click for more)
Just out in @TheLancet what experts have said for a year
SARS-CoV2 spreads PRIMARILY via airborne route
Failure to act on this has hampered efforts to prevent spread of COVID
Thank you @trishgreenhalgh @linseymarr @kprather88 @j_g_allen, others who stuck to the evidence https://t.co/uuJcUIKWHE
— Ashish K. Jha, MD, MPH (@ashishkjha) April 16, 2021
Viewpoint | Implementing Measurement Science for Electronic Health Record Use – “Clinicians trained in patient care are locked into hours of screen time to complete mandatory clerical and documentation tasks, often unrelated to the quality of the care”
18 Apr, 2021 | 21:09h | UTCImplementing Measurement Science for Electronic Health Record Use – JAMA (free for a limited period)
Related: Opinion – “The EMR has changed the doctor-patient duet into a ménage-à-trois” (resources on the subject) AND Study: Association Between Perceived Electronic Health Record Usability and Professional Burnout (study and commentaries) AND The future of electronic health records – Nature
Commentaries on Twitter
To optimize #EHR design, implementation, and regulation, EHR use measures must be developed that are trustworthy, clinically important, scientifically sound, transparent, and feasible for implementation.
A recent paper by @JAMA_current @JAMANetwork https://t.co/IN3ZxcON9m pic.twitter.com/kOVQGI1OGl
— Eugenio Santoro (@eugeniosantoro) April 11, 2021
"Drawing attention to the EHR user experience with empirical measurements could add visibility and transparency to what is happening—the hours wasted and the risks incurred—that could stimulate usability improvements." https://t.co/WCzuo288Bp
— Janos Kalman (@kalman_jl) April 9, 2021
A guideline to limit indoor airborne transmission of COVID-19
18 Apr, 2021 | 21:47h | UTC
Indoor Air Changes and Potential Implications for SARS-CoV-2 Transmission
18 Apr, 2021 | 21:49h | UTCIndoor Air Changes and Potential Implications for SARS-CoV-2 Transmission – JAMA
Commentary on Twitter (thread – click for more)
https://twitter.com/j_g_allen/status/1383073549380882438
Study: Double masking improves protection from Covid-19 mostly by eliminating any gaps or poor-fitting areas of a mask
18 Apr, 2021 | 21:37h | UTCFitted Filtration Efficiency of Double Masking During the COVID-19 Pandemic – JAMA Internal Medicine
Commentaries: Fit matters most when double masking to protect yourself from COVID-19 – University of North Carolina Health Care AND Check your fit on that double mask if you want it to work against Covid, study says – CNN
RCT: An Enhanced Recovery After Surgery (ERAS) program in laparoscopic distal gastrectomy provided a faster recovery, a shorter postoperative hospitalization length, and lower medical costs without increasing complication and readmission rates
16 Apr, 2021 | 06:16h | UTCRelated: Consensus guidelines for enhanced recovery after gastrectomy – British Journal of Surgery AND Current status of the “enhanced recovery after surgery” program in gastric cancer surgery – Annals of Gastroenterological Surgery
See also: Enhanced Recovery After Surgery (ERAS) Society Guidelines
Editorial: Covid-19 has redefined airborne transmission
16 Apr, 2021 | 06:26h | UTCCovid-19 has redefined airborne transmission – The BMJ
Commentaries: Future attempts to reduce Covid-19 spread should focus on tackling airborne transmission – News Medical AND Open the windows to curb COVID spread: experts – MedicalXpress
Related: CDC Updated Guidance: “It is possible for people to be infected through contact with contaminated surfaces or objects, but the risk is generally considered to be low” (CDC Guidance and more) AND Deep Cleaning Isn’t a Victimless Crime – The Atlantic
8 Tips to Improve Radiologist Communication
16 Apr, 2021 | 06:09h | UTC8 Tips to Improve Radiologist Communication – Diagnostic Imaging
Original study: Talking Points: Enhancing Communication Between Radiologists and Patients – Academic Radiology ($)
Systematic review: Excessive nurse work hours is associated with increased adverse patient outcomes
15 Apr, 2021 | 06:19h | UTCRelationships between comprehensive characteristics of nurse work schedules and adverse patient outcomes: A systematic literature review – Journal of Clinical Nursing (link to abstract – $ for full-text)
Study shows U.S. women nurses are at increased risk of death by suicide compared to physicians and the general population
15 Apr, 2021 | 06:23h | UTCAssociation of US Nurse and Physician Occupation With Risk of Suicide – JAMA Psychiatry (free for a limited period)
Author Interview: Suicide Risk Among US Nurses and Physicians
Commentary: Suicide among female nurses is double that of the general female population – University of Michigan
Commentary on Twitter (thread – click for more)
https://twitter.com/ChrisFriese_RN/status/1382348713641848832
Pandemic Boosts an Old Idea—Bringing Acute Care to the Patient
15 Apr, 2021 | 06:51h | UTCPandemic Boosts an Old Idea—Bringing Acute Care to the Patient – JAMA
Related studies: Cohort Study: Selected patients with Covid-19 can be safely discharged on home oxygen, with low mortality and readmission rates AND Association of a Bundled Hospital-at-Home and 30-Day Postacute Transitional Care Program With Clinical Outcomes and Patient Experiences – JAMA Internal Medicine
Guidance: Using Ventilation and filtration to reduce aerosol transmission of COVID-19 in long-term care homes
15 Apr, 2021 | 06:54h | UTC
Commentary on Twitter
PHAC guidance updated yesterday emphasizes aerosol transmission (including fecal aerosol via toilet traps) and need for adequate ventilation and/or air cleaners (HEPA). We are getting there.@jljcolorado @linseymarr @kprather88 https://t.co/8hi77846cY
— David Fisman (@DFisman) April 14, 2021
Study: Protocoled time-limited trials among critically ill patients with advanced medical illnesses were associated with reduction of nonbeneficial ICU treatments
13 Apr, 2021 | 05:16h | UTCEvaluation of Time-Limited Trials Among Critically Ill Patients With Advanced Medical Illnesses and Reduction of Nonbeneficial ICU Treatments – JAMA Internal Medicine (free for a limited period)
Commentary: Time-Limited Trials and Potentially Nonbeneficial Treatment in the ICU—Willing to Wait for It – JAMA Internal Medicine AND Time-limited trials may decrease the length of stay of critically ill patients in the intensive care unit – 2 Minute Medicine
Author interview: Time-Limited Trials Among Patients With Advanced Illness to Reduce Nonbeneficial ICU Treatments
Related review: Time-limited trial of intensive care treatment: an overview of current literature – Intensive Care Medicine
Cohort study: Postoperative in-hospital mortality of patients with COVID-19 infection was more than double that in patients without COVID-19
13 Apr, 2021 | 05:21h | UTCRelated: Guideline: SARS‐CoV‐2 infection, COVID‐19 and timing of elective surgery AND Study from 116 countries suggests surgery should be delayed for at least seven weeks following a COVID-19 diagnosis to reduce mortality risk
Viewpoint | Reducing Low-Value Care and Improving Health Care Value
9 Apr, 2021 | 03:23h | UTCReducing Low-Value Care and Improving Health Care Value – JAMA (free for a limited period)