Patient Safety & Quality
Non-health care facility medication errors resulting in serious medical outcomes
13 Jul, 2017 | 20:54h | UTCCommentary: More People Are Making Mistakes With Medicines At Home – NPR (free)
Are There Long-Term Risks to Egg Donors?
11 Jul, 2017 | 16:55h | UTCAre There Long-Term Risks to Egg Donors? – New York Times (10 articles per month are free)
Shared Decision Making: The Importance of Diagnosing Preferences
11 Jul, 2017 | 16:46h | UTCShared Decision Making: The Importance of Diagnosing Preferences – JAMA Internal Medicine (free)
Related: Editorial: Sharing Medicine – A JAMA Internal Medicine Series (free) AND Sharing as the Future of Medicine – JAMA Internal Medicine (free)
Association of delay of urgent or emergency surgery with mortality and use of health care resources
10 Jul, 2017 | 15:09h | UTCCommentary: Patients whose emergency surgery is delayed are at higher risk of death – Canadian Medical Association Journal, via EurekAlert (free)
Source: STAT News Newsletter
“Delayed operating room access for emergency surgery was associated with increased risk of inhospital mortality, longer length of stay and higher costs”.
Medication nonadherence may increase health care costs
8 Jul, 2017 | 20:19h | UTCLongitudinal Patterns of Medication Nonadherence and Associated Health Care Costs – Inflammatory Bowel Diseases (link to abstract – $ for full-text)
Commentary: Taking medications as prescribed important to control health care costs – Cincinnati Children’s Hospital Medical Center, via EurekAlert (free)
In this small study, patients with increasing nonadherence over time demonstrate more than a 3-fold increase in costs compared with adherent patients.
Pictograms, Units and Dosing Tools, and Parent Medication Errors
7 Jul, 2017 | 14:08h | UTCPictograms, Units and Dosing Tools, and Parent Medication Errors: A Randomized Study – Pediatrics (link to abstract – $ for full-text)
Commentaries: Most Parents Give Kids Wrong Doses – MedPage Today (free registration required) AND Proper tools may help prevent medicine errors at home – Reuters (free)
Risk of death among users of Proton Pump Inhibitors
5 Jul, 2017 | 15:31h | UTCCommentaries: Proton pump inhibitors associated with raised mortality – OnMedica (free) AND Longtime use of heartburn drugs linked to increased risk of death – NewsMedical (free) AND People taking heartburn drugs could have higher risk of death, study claims – The Guardian (free) AND Some heartburn drugs linked with higher risk of death – CBS News (free) AND PPIs Linked to Higher Risk for Death – Medscape (free registration required)
In a large observational study, PPI use was associated with increased mortality (HR 1.25; CI 1.23 to 1.28). PPIs were also associated with increased risk compared to H2 blockers (HR 1.24; CI 1.21 to 1.27). See more on the trade-offs of PPI therapy in our July 3rd issue (see #10)
Common ED Medication Errors: Polypharmacy
4 Jul, 2017 | 21:17h | UTCCommon ED Medication Errors: Polypharmacy – emDocs (free)
Related: Current and future perspectives on the management of polypharmacy – BMC Family Practice (free)
Re-designing the pathway to surgery: better care and added value
3 Jul, 2017 | 17:16h | UTCRe-designing the pathway to surgery: better care and added value – Perioperative Medicine (free)
Source: Critical Care Reviews Newsletter
Redesigning Care for High-Cost, High-Risk Patients
3 Jul, 2017 | 13:36h | UTCRedesigning Care for High-Cost, High-Risk Patients – Harvard Business Review (a few articles per month are free) (RT @pash22 see Tweet)
Related: Designing a High-Performing Health Care System for Patients with Complex Needs: Ten Recommendations for Policymakers – The Commonwealth Fund (free) AND Caring for High-Need, High-Cost Patients — An Urgent Priority – New England Journal of Medicine (Free) AND Multimorbidity: clinical assessment and management – NICE Guideline (free) AND Multimorbidity in Older Adults with Cardiovascular Disease – American College of Cardiology, Latest in Cardiology (Free full text) AND Focusing on High-Cost Patients — The Key to Addressing High Costs? – NEJM Catalyst (free) AND Richard Smith: The challenge of high need, high cost patients – The BMJ Blogs (free) AND Playbook: Better Care for People with Complex Needs – Institute for Healthcare Improvement (free)
Delirium Prevention Strategies for Elderly Adults with Hip Fracture
30 Jun, 2017 | 15:18h | UTCSource: PracticalReviews ($)
See related article on the effect of multicomponent nonpharmacologic interventions to prevent delirium in abdominal surgery in our May 25th issue (see #5)
Delirium-friendly preprinted postoperative orders executed by regular nursing staff resulted in a significant reduction in postoperative delirium.
Hospital Visits by Nurse Practitioners Prevent Readmission
28 Jun, 2017 | 22:46h | UTCHospital Visits by Nurse Practitioners Prevent Readmission – Medscape (free registration required)
Contact Precautions for Endemic MRSA and VRE: Time to Retire Legal Mandates
26 Jun, 2017 | 19:41h | UTCViewpoint: Contact Precautions for Endemic MRSA and VRE: Time to Retire Legal Mandates – JAMA (free)
“Contact precautions are easy to use w a single patient, but burdensome when applied to an entire hospital” (RT @JAMA_current see Tweet)
This viewpoint suggests a more selective use of contact precautions for the control of endemic pathogens.
Opinion: Natural health products should be sold separately from drugs
26 Jun, 2017 | 18:54h | UTCEditorial: Natural health products should be sold separately from drugs – Canadian Medical Association Journal (free)
“Separate “natural” products from drugs to protect consumers, says @drstanbrook” (RT @CMAJ see Tweet)
Monitoring Medical Devices: Missed Warning Signs Within Existing Data
26 Jun, 2017 | 21:27h | UTCViewpoint: Monitoring Medical Devices: Missed Warning Signs Within Existing Data – JAMA (free)
Related: The lap band for weight loss is a tale of medicine gone wrong – VOX (free) Reoperation and Medicare Expenditures After Laparoscopic Gastric Band Surgery – JAMA Surgery (link to abstract – $ for full-text) AND Safety, Effectiveness of Gastric Banding Called Into Question – Medscape (free registration required) AND 1 In 5 Gastric Band Surgeries Require Corrective Operations – American Council on Science and Health (free)
The authors use the example of gastric band surgery to discuss how available data may be used more appropriately for earlier detection of problems in the safety of medical devices.
Timely Use of Probiotics in Hospitalized Adults Prevents Clostridium difficile Infection
26 Jun, 2017 | 17:52h | UTCSource: EvidenceAlerts (free resource to find articles of interest)
In this meta-analysis including 19 randomized trials, probiotics given within 2 days of the first antibiotic dose (more effective than if started later) reduced the risk of Clostridium difficile infection (CDI) by >50% in hospitalized adults. 1 case of CDI would be prevented for every 23−144 patients treated with probiotics when antibiotics are started. “There was no convincing evidence of superior efficacy for any of the tested probiotic formulations, delivery methods (drink or capsule), or probiotic doses”.
Point of view: Generalists key to improved hospital outcomes
26 Jun, 2017 | 17:26h | UTCPoint of view: Generalists key to improved hospital outcomes – MJA Insights (free)
Adverse Events Reported to the US Food and Drug Administration for Cosmetics and Personal Care Products
26 Jun, 2017 | 17:15h | UTCEditorial: Cosmetics, Regulations, and the Public Health – Understanding the Safety of Medical and Other Products (free)
The JAMA Network – For the Media: How Many Adverse Events Are Reported to FDA for Cosmetics, Personal Care? (free)
Commentaries: More Health Problems Reported With Hair And Skin Care Products – NPR (free) AND The Hidden Dangers of Makeup and Shampoo – TIME (a few articles per month are free)
Interesting initiative for improving quality and reducing readmissions from skilled nursing facilities
25 Jun, 2017 | 14:24h | UTCNecessity is the mother of invention: an innovative hospitalist-resident initiative for improving quality and reducing readmissions from skilled nursing facilities – Journal of Community Hospital Internal Medicine Perspectives (free) (RT @HMVJC see Tweet)
In this model of care, a hospitalist-led team, including the resident on the geriatrics rotation, followed patients discharged from the hospital to the skilled nursing facility, leading to significant decrease in readmission rates.
Benchmarking study helps hospitals improve measurement of adverse events
23 Jun, 2017 | 00:58h | UTCBenchmarking study helps hospitals improve measurement of adverse events – NIHR Signal (free)
Original report: Measuring harm and informing quality improvement in the Welsh NHS: the longitudinal Welsh national adverse events study – Health Services and Delivery Research (free PDF)
This study compared two different approaches to measure adverse events, the “Trigger Tool system” and the “Two-stage review”
Value-Based Care Alone Won’t Reduce Health Spending and Improve Patient Outcomes
22 Jun, 2017 | 16:32h | UTCValue-Based Care Alone Won’t Reduce Health Spending and Improve Patient Outcomes – Harvard Business Review (a few articles per month are free) (RT @pash22 see Tweet)
“We believe that value-based care, implemented using lean principles and in conjunction with an ongoing, community-wide effort to address social determinants of health, can reduce health spending and deliver on the promise of better health”
Cardiopulmonary resuscitation – 30:2 or just keep going?
22 Jun, 2017 | 15:30h | UTCCardiopulmonary resuscitation – 30:2 or just keep going? – by Scott Munro, in Evidently Cochrane (free) (RT @NIHR_DC see Tweet)
“Untrained bystander CPR had better outcomes when given telephone advice from EMS services to perform continuous CPR, rather than interrupted CPR with rescue breaths”. For trained EMS professionals, “it is possible that there is little or no difference between the two approaches”.
Every Newborn Action Plan – World Health Organization
22 Jun, 2017 | 01:55h | UTCEvery Newborn Action Plan – World Health Organization (free) (RT @WHO see Tweet with infographic)
Related report from UK: Each Baby Counts – Royal College of Obstetricians and Gynaecologists (free PDF) Each Baby Counts Homepage (free resources) AND Reducing baby deaths and brain injuries during childbirth – BBC News (free)
Every year, 2.7 million babies die in the first 28 days of life. 75% of these deaths are preventable.
Performance Improvement: Phenytoin Toxicity
22 Jun, 2017 | 00:02h | UTCPerformance Improvement: Phenytoin Toxicity – JAMA (free)
Interesting case of medication error and prevention of subsequent adverse events (RT @JAMA_current see Tweet)
Which patients with advanced respiratory disease die in hospital?
21 Jun, 2017 | 21:07h | UTCAn end of life strategy probably improved choice of where to die for people with severe respiratory disease – NIHR Signal (free)
Original article: Which patients with advanced respiratory disease die in hospital? A 14-year population-based study of trends and associated factors – BMC Medicine (free)