Does a 1-Hour Sepsis Bundle Save Lives?
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Among patients with suspected sepsis in the ED, the implementation of a 1-hour sepsis bundle was not associated with significant difference in in-hospital mortality.
Source
Effect of the 1-h bundle on mortality in patients with suspected sepsis in the emergency department: a stepped wedge cluster randomized clinical trial. Intensive Care Med. 2024 Jul;50(7):1086-1095. doi: 10.1007/s00134-024-07509-1. Epub 2024 Jun 24. PMID: 38913098.
Administering Harm – A Deep Dive into Hospital Headaches
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There are significant administrative burdens faced by hospitalists and administrative leaders, which negatively impact efficiency, well-being, and job satisfaction. The findings highlight the importance of systematically identifying and measuring administrative burdens as a critical step towards creating healthier work environments, thereby optimizing healthcare delivery.
A Path to U.S. Health Insurance Reform?
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To fulfill a societal obligation to provide healthcare to all, two things must be done: healthcare insurance must be universal, basic, and free, while also providing supplemental care in a healthcare market.
Source
A Blueprint for U.S. Health Insurance Reform. Ann Intern Med. 2024 May 14. doi: 10.7326/M24-0091. Online ahead of print. PMID: 38739923
Pay to Play – Telehealth and Inappropriate Antibiotics
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Using online telemedicine platforms, the authors found that it was appallingly easy to rapidly obtain inappropriate antibiotic prescriptions for symptoms of viral URIs by paying a nominal fee. This highlights the need for increased education and regulations around inappropriate prescribing of antibiotics to safeguard the public and uphold good medical practices.
Source
Antibiotics on Demand: Advances in Asynchronous Telemedicine Call for Increased Antibiotic Surveillance. Clin Infect Dis. 2024 Feb 17;78(2):308-311. doi: 10.1093/cid/ciad472.
Inequities in Hallway Bed Placement
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In the absence of a standardized approach, patients placed in hallway beds were more likely to be male, have Medicaid/self-pay payer status, and elope in this single health system study.
Source
Inequities among patient placement in emergency department hallway treatment spaces. Am J Emerg Med. 2024 Feb;76:70-74. doi: 10.1016/j.ajem.2023.11.013. Epub 2023 Nov 11.
Comparing Intubation of Critically Ill Children between APRNs and Physicians
Dr. Amal Mattu and friends have a new video course you don't want to miss. Take a look!
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Review of tracheal intubations (TIs) performed in pediatric ICUs found advanced practice registered nurses (APRNs) had a lower first attempt success compared to doctors and respiratory therapists.
Private Equity Acquisition May Be Dangerous for Patients
JournalFeed and Dr. Amal Mattu's Top Picks Video Series is LIVE!
Take a look!
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In a self-described “quasi-experimental” analysis of Medicare claims data, private equity owned hospitals were associated with a 25% increase in hospitalization-acquired adverse events when compared with non-private equity hospitals. Notably, there was a 27% increase in falls, a 38% increase in the volume of central line-associated infections, despite the placement of 16% fewer central lines, and a doubling of surgical site infections despite 8% fewer surgical procedures being performed (underpowered assertion).
Source
Changes in Hospital Adverse Events and Patient Outcomes Associated With Private Equity Acquisition. JAMA. 2023 Dec 26;330(24):2365-2375. doi: 10.1001/jama.2023.23147.
A Solution to Burnout – More Vacation?
Exciting news! JournalFeed and Dr. Amal Mattu's Top Picks Video Series is set to GO LIVE this week! It's free for Gold Spoon members or you can just get the video series. Watch this trailer and get excited!
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This survey of US physicians found taking more than 3 weeks of vacation per year was associated with lower rates of burnout, while spending 30 minutes or more per vacation day on patient-related work was associated with increased burnout.
Source
Vacation Days Taken, Work During Vacation, and Burnout Among US Physicians. JAMA Netw Open. 2024 Jan 2;7(1):e2351635. doi: 10.1001/jamanetworkopen.2023.51635.
Making PROGRESS – Pediatric Emergencies and Healthcare Disparities
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This systematic review and meta-analysis identified multiple social determinants of health that were related to increased utilization of ED services by children from racial minority and lower socioeconomic status (SES) groups.
Source
Social Determinants of Health and Pediatric Emergency Department Outcomes: A Systematic Review and Meta-Analysis of Observational Studies. Ann Emerg Med. Published online December 6, 2023. doi:10.1016/j.annemergmed.2023.10.010
Does Contact Precaution for MRSA Really Matter?
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Contact precaution (CP) for patients with MRSA infection or colonization is listed as an "essential practice" for all U.S. hospitals, but should it be?