Patient Safety & Quality
11 Drugs You Should Seriously Consider Deprescribing
11 Sep, 2017 | 00:24h | UTC11 Drugs You Should Seriously Consider Deprescribing – Medscape Slideshow (free registration required)
Related: Canadian Deprescribing Network (CaDeN) (free) AND CaDeN Deprescribing Guidelines and Algorithms (free) AND Deprescribing guidelines for the elderly – Ontario Pharmacy Evidence Network (free) AND Deprescribing proton pump inhibitors: Evidence-based clinical practice guideline – Canadian Family Physician (free) AND Too Many Meds? America’s Love Affair With Prescription Medication – Consumer Reports (free) AND Patient often prescribed potentially futile drugs in their final months of life – Science Daily AND The Challenge of Polypharmacy: From Rhetoric to Reality – Royal Pharmaceutical Society and Royal College of General Practitioners Partnership (free PDF) Current and future perspectives on the management of polypharmacy – BMC Family Practice (free)
Should kids be sedated for dental work?
9 Sep, 2017 | 17:18h | UTCShould kids be sedated for dental work? – The New York Times (10 articles per month are free)
Related guideline: Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures: Update 2016 (free)
Study: Impact of early in-hospital medication review by clinical pharmacists on health services utilization
8 Sep, 2017 | 02:16h | UTCSource: Hospital Medicine Virtual Journal Club
Viewpoint: Public Reporting of Surgical Outcomes: Surgeons, Hospitals, or Both?
8 Sep, 2017 | 02:29h | UTCPublic Reporting of Surgical Outcomes: Surgeons, Hospitals, or Both? – JAMA Forum (free)
Comprehensive geriatric assessment may reduce risk of delirium after hip fracture
6 Sep, 2017 | 18:34h | UTCComprehensive assessment may reduce risk of delirium after hip fracture – NIHR Signal (free)
Original article: Comprehensive Geriatric Assessment for Prevention of Delirium After Hip Fracture: A Systematic Review of Randomized Controlled Trials – Journal of The American Geriatrics society (link to abstract – $ for full-text)
“Comprehensive geriatric assessment reduced the risk of delirium by 20% in patients having hip fracture surgery” (RT @NIHR_DC see Tweet)
Study: A fast and frugal algorithm to strengthen diagnosis and treatment decisions for catheter-associated bacteriuria
4 Sep, 2017 | 14:36h | UTCSource: Hospital Medicine Virtual Journal Club
Viewpoint: Diagnostic Errors and Diagnostic Calibration
1 Sep, 2017 | 20:54h | UTCDiagnostic Errors and Diagnostic Calibration – JAMA (free)
Study: Factors Associated With Choice of Infant Sleep Position
22 Aug, 2017 | 13:07h | UTCFactors 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
22 Aug, 2017 | 13:03h | UTCWhen 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
22 Aug, 2017 | 13:02h | UTCCommentaries: Smokers hospitalized for heart attacks often don’t get cessation drugs – Reuters (free) AND Smokers Hospitalized for CHD Rarely Receive Cessation Pharmacotherapy During Hospitalization – American College of Cardiology, Latest in Cardiology (free)
Guideline: Safe Medication Use in the ICU
21 Aug, 2017 | 01:44h | UTCClinical Practice Guideline: Safe Medication Use in the ICU – Critical Care Medicine (free)
See also: Executive Summary (free)
Meta-analysis: Acute Kidney Injury After Computed Tomography
21 Aug, 2017 | 01:41h | UTCAcute 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
17 Aug, 2017 | 21:37h | UTCAnalysis – Too much medicine: Mapping the drivers of overdiagnosis to potential solutions – The BMJ (free)
Related: Overdiagnosis, ethics, and trolley problems: why factors other than outcomes matter – The BMJ (free) AND The overdiagnosis community targets solutions – The BMJ (free) AND Are expanding disease definitions unnecessarily labelling women with polycystic ovary syndrome? – The BMJ (free) AND When technology creates uncertainty: pulse oximetry and Overdiagnosis of hypoxaemia in bronchiolitis – The BMJ (free)
A National Implementation Project to Prevent Catheter-Associated Urinary Tract Infection in Nursing Home Residents
17 Aug, 2017 | 15:57h | UTCA National Implementation Project to Prevent Catheter-Associated Urinary Tract Infection in Nursing Home Residents – JAMA Internal Medicine (link to abstract – $ for full-text)
Commentaries: Study Shows 54 Percent Drop in CAUTIs Among Nursing Home Residents – Infection Control Today (free) AND AHRQ safety program helps cut catheter infections by more than 50% among nursing home patients, JAMA study shows – Healthcare Finance (free) AND Implementing technical and socioadaptive bundles may decrease catheter-associated urinary tract infections in nursing homes – 2 Minute Medicine (free) AND Nursing homes cut urinary tract infections in half through focused effort on catheter care – Michigan University, via EurekAlert (free)
Related: Toolkit for Reducing Catheter-Associated Urinary Tract Infections (CAUTI) – Agency for Healthcare Research and Quality (free resources)
An Automated, Pharmacist-Driven Initiative Improves Quality of Care for Staphylococcus aureus Bacteremia
16 Aug, 2017 | 15:11h | UTCAn Automated, Pharmacist-Driven Initiative Improves Quality of Care for Staphylococcus aureus Bacteremia – Clinical Infectious Diseases (link to abstract – $ for full-text)
Commentaries: Automating antimicrobial stewardship – ACP Hospitalist (free) AND Automated intervention aids treatment of Staph aureus bacteremia – CIDRAP (free)
New, Revised Guidance Documents Cover 35 Radiology Topics
16 Aug, 2017 | 14:28h | UTCUpdated: 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
16 Aug, 2017 | 13:46h | UTCFDA Safety Alert: Liquid-filled Intragastric Balloon Systems: Letter to Healthcare Providers – Potential Risks (free)
Commentaries: Five People Die After Using Weight Loss Balloons for Obesity – Time (free) AND FDA Warns of Gastric Balloon Deaths – MedPage Today (free registration required) AND Five Deaths Tied to Intragastric Balloons, FDA Says – Medscape (free registration required)
Association of Previous Cesarean Delivery With Surgical Complications After a Hysterectomy Later in Life
15 Aug, 2017 | 20:31h | UTCCommentaries: C-Section Delivery Associated with Increased Risk of Complications from Hysterectomy – The JAMA Network (free) AND C-Section Now, Hysterectomy Complications Later? – MedPage Today (free registration required)
Delayed breastfeeding initiation and infant survival
14 Aug, 2017 | 15:23h | UTCThis 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
14 Aug, 2017 | 00:14h | UTCStarts Today! Free Online Course: Leading Healthcare Quality and Safety – The George Washington University and Coursera
Use of Alternative Medicine for Cancer and Its Impact on Survival
13 Aug, 2017 | 21:58h | UTCUse of Alternative Medicine for Cancer and Its Impact on Survival – Journal of the National Cancer Institute (link to abstract – $ for full-text)
Commentary: Use of alternative medicine hastens death of cancer patients – Edzard Ernst (free) AND Cancer Survival Takes a Hit with Alternative Medicine – MedPage Today (free) AND Using Alternative Medicine Only for Cancer Linked to Lower Survival Rate – Yale Cancer Center, via NewsWise (free) AND ‘Alternative Medicine’ for Cancer Ups Death Risk – Medscape (free registration required)
What do hypnotics cost hospitals and healthcare?
10 Aug, 2017 | 17:16h | UTCWhat 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
9 Aug, 2017 | 17:58h | UTCA 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?
5 Aug, 2017 | 20:02h | UTCToo 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
5 Aug, 2017 | 14:52h | UTCDesign Thinking for Doctors and Nurses – New York Times (10 articles per month are free)