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Bridging During Anticoagulation Interruptions Is Associated with Worse Outcomes
Despite the routine nature of discontinuing atrial fibrillation (AF) patients’ long-term oral anticoagulation (OAC) for procedures and “bridging” them with another agent, there is remarkably little data on the safety and benefit of this practice. Guidelines detailing when and how to initiate bridging therapy have been published, but data supporting why we should bridge at all are limited.1 To help fill this void, Steinberg and colleagues used a national, community-based registry of outpatients with AF (ORBIT-AF) to examine current practices around periprocedural OAC management and associated outcomes. Outcomes evaluated included rates of major bleeding, as well as myocardial infarction, stroke or systemic embolism, cause-specific hospitalization, and death within 30 days.
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Intravenous Fluids in Patients With Acute Heart Failure
MONOGRAPH: Volume overload is a hallmark of acute heart failure. In hospitalized patients, intravenous loop diuretics are the most common treatment for decongestion.
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Only 1 HCW confirmed as occupationally infected with HIV in last 15 years, with 12 ‘possible’ cases
In the 1990s, tragic cases of healthcare workers who acquired AIDS and hepatitis on the job helped propel the movement for sharps safety. The evidence now shows the success of safer devices, standard precautions and post-exposure prophylaxis: In the past 15 years, only one health care worker developed HIV in a confirmed occupational exposure, according to a report from the Centers for Disease Control and Prevention.1
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Nurses report bullying, disrespectful behavior by other nurses similar to ‘hazing’
A common perception is that a lot of the bullying and disrespect that can create a toxic work culture in healthcare settings is directed by physicians toward nurses. Surprisingly, nurses appear to observe a hierarchy within their own ranks that may be just as mean-spirited, says Elaine Larson, PhD, RN, FAAN, CIC, associate dean for research at the Columbia School of Nursing in New York.
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Use screening tools, partnerships to improve identification, care of victims of IPV
With all the problems that emergency providers face on a daily basis, it can be especially difficult to identify and manage patients who may be victims of intimate partner violence (IPV). Some of these individuals are reluctant to share that they are in danger at home, and providers are often hesitant to push for this information — either because they lack ready access to resources to respond, or they aren’t sure what the next steps should be.
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Palliative care options increase as CMs look for end-of-life care
After more than two decades, the concept of palliative care is gaining traction among case managers and other healthcare providers, partly in response to acceptance for this type of end-of-life care under the Affordable Care Act. Advocates of palliative care cite its benefit of filling in gaps in symptom management for patients undergoing procedures at the end of life.
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New study highlights CM demographics
The Commission for Case Manager Certification (CCMC) of Mount Laurel, NJ, conducts a thorough survey of case managers every five years, providing a snapshot of where the profession stands.
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Experts: Market Case Management to Younger Professionals
Case management faces a brain drain in the next decade as the bulk of its membership heads toward retirement.
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ED Push - February 2015 Second Issue
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Hospital Consult - February 2015