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A large, multicenter clinical trial that compared protocol-based care to usual care for patients presenting to emergency departments with early sepsis and septic shock found no differences in clinical outcomes. However, early recognition and therapy was beneficial and should be the standard of care.
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Compared to manual surveillance methods, an electronic surveillance tool for catheter-associated urinary tract infections had a high negative predictive value but a low positive predictive value.
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Patients on mechanical ventilation who were managed with both conservative fluid administration and aggressive diuresis weaned faster, had significantly more ventilator-free days, and experienced reduced incidences of both ventilator-associated complications and ventilator-associated pneumonia.
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During my final year of interventional cardiology training, a woman in her 60s was brought emergently to the cath lab in cardiogenic shock, with diffuse ST-segment elevations.
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Joint replacement surgery may seem routine, but patients are being readmitted to the hospital for a variety of reasons, including comorbidities, poor outcomes from therapy, and deep venous thrombosis.
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More hospitals than ever before are being penalized by the Centers for Medicare & Medicaid Services for excess readmissions and insurers are starting to develop their own readmission reduction programs.
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1. Look beyond the data.
2. Consult the palliative care team.
3. Reach out to embedded case managers.
4. Facilitate early discharges.
5. Follow up with assisted living residents.
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A team effort at Holzer Health System helped reduce the rate of all-cause readmissions by 20%.
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Transitions from the hospital go smoother and patients are less likely to be readmitted when the providers at the next level of care get detailed and complete information about the patient, says Sandy Merlino, RN, MBA, vice president, integrated delivery systems and hospital market development for Visiting Nurse Service of New York.
