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Missed Nursing Care and Declining Patient Safety

While the immediate effect of the COVID-19 omicron variant on the healthcare workforce is the pressing issue, there were serious concerns about staff shortages and the effect of “missed nursing care” on patients well before the pandemic. Missed nursing care is defined as delaying, omitting, or rationing care by nursing staff.

Worker Safety Is Critical to Patient Safety

As the COVID-19 pandemic exacerbates the national nursing shortage, healthcare workers are finally seen as a valuable commodity that should not be routinely lost to injuries trying to manually lift and mobilize patients. Ultimately, understanding worker safety equals patient safety improves the well-being of an organization.

Are Boosters Prolonging the Pandemic?

Some people have raised the question of whether booster shots are unethical from a global perspective, and even counterproductive to ending the pandemic because highly mutated variants will continue to arise in unvaccinated patients.

Winter of Our Discontent: Omicron Variant Pushes Healthcare to Brink

With omicron causing much higher breakthrough infection rates than previous COVID-19 variants, there is concern infected healthcare workers must isolate amid an ongoing nursing shortage. The previous recommendation for 10 days has been changed to seven, and shorter than that under certain conditions.

The Latest on COVID-19 Vaccination

The COVID-19 pandemic has led to an infodemic of misinformation affecting the ability of the general public to make good decisions about vaccination. Vaccine hesitancy is a byproduct of this infodemic. After reviewing the current available data, the vaccines have an excellent risk/benefit ratio.

Significance of Flail Mitral Leaflet and Wall-Impinging Regurgitant Flow

Using cardiac MRI as a gold standard, the presence of a flail mitral leaflet or a wall-impinging mitral regurgitant jet on transthoracic echocardiography were associated with severe mitral regurgitation, but not diagnostic of it.

Jugular Venous Pressure by Bedside Ultrasound

Using a handheld point-of-care ultrasound device to estimate right atrial pressure from images of the jugular vein resulted in a higher imaging success rate vs. visual inspection and a reasonably accurate estimation, especially in those with elevated right atrial pressures.

Importance of Exercise Testing-Associated Ventricular Ectopy

A study of asymptomatic subjects without known cardiovascular disease undergoing treadmill exercise testing and followed for a mean of 20 years showed high-grade premature ventricular contractions during exercise recovery (but not during exercise) are predictive of subsequent cardiovascular mortality.

Post-TAVR Patients with Atrial Fibrillation Bleed Less on Vitamin K Antagonists vs. Edoxaban

In this randomized trial of post-transcatheter aortic valve replacement patients with atrial fibrillation, edoxaban was noninferior to vitamin K antagonists with regard to a composite of adverse endpoints, but was associated with a higher rate of major bleeding.

New Treatment for Hypertrophic Obstructive Cardiomyopathy

A study of the echocardiographic characteristics of symptomatic patients with obstructive hypertrophic cardiomyopathy treated with mavacamten showed a persistent 30-week improvement in several key pathophysiologic characteristics.