News
Trauma Patients with Pulmonary Embolism Might Not Have DVT on Imaging of Lower Extremities
October 27, 2014
Clinical question: What is the relationship between acute DVT and pulmonary embolism (PE) in trauma patients? Background: Major trauma is associated with an increased risk of acute DVT and PE. It is assumed that the majority of PEs arise from DVTs in the lower extremities.
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Eliminating Adverse Events and Redundant Tests Could Generate U.S. Healthcare Savings
October 27, 2014
Clinical question: Using available data, what is the estimated cost savings of eliminating adverse events and avoiding redundant tests? Background: Reimbursement schemes are changing such that hospitals are reimbursed less for some adverse events.
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High Perioperative Oxygen Fraction Does Not Improve Surgical-Site Infection Frequency after Abdominal Surgery
October 27, 2014
Clinical question: Does the use of 80% oxygen perioperatively in abdominal surgery decrease the frequency of surgical-site infection within 14 days without increasing the rate of pulmonary complications? Background: Low oxygen tension in wounds can negatively impact immune response and healing.
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News
Short Course of Oral Antibiotics Effective for Acute Osteomyelitis and Septic Arthritis in Children
October 27, 2014
By Mark Shen, MD Reviewed by Pediatric Editor Mark Shen, MD, medical director of hospital medicine at Dell Children’s Medical Center, Austin, Texas. Clinical question: Is a short course (less than four weeks) of antibiotics effective for the treatment of acute osteomyelitis and septic arthritis?
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Computer-Based Reminders Have Small to Modest Effect on Care Processes
October 27, 2014
Clinical question: Do on-screen, computer-based clinical reminders improve adherence to target processes of care or clinical outcomes? Background: Gaps between practice guidelines and routine care are caused, in part, by the inability of clinicians to access or recall information at the point of
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Patient Participation in Medication Reconciliation at Discharge Helps Detect Prescribing Discrepancies
October 27, 2014
Clinical question: Does the inclusion of a medication adherence counseling session during a hospital discharge reconciliation process reduce discrepancies in the final medication regimen? Background: Inadvertent medication prescribing errors are an important cause of preventable adverse drug even
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Negative D-Dimer Test Can Safely Exclude Pulmonary Embolism in Patients at Low To Intermediate Clinical Risk
October 27, 2014
Clinical question: In patients with symptoms consistent with pulmonary embolism (PE), can evaluation with a clinical risk assessment tool and D-dimer assay identify patients who do not require CT angiography to exclude PE? Background: D-dimer is a highly sensitive but nonspecific marker of VTE, a
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Patient Signout Is Not Uniformly Comprehensive and Often Lacks Critical Information
October 27, 2014
Clinical question: Do signouts vary in the quality and quantity of information, and what are the various factors affecting signout quality? Background: Miscommunication during transfers of responsibility for hospitalized patients is common and can result in harm.
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Emergency Department Signout via Voicemail Yields Mixed Reviews
October 27, 2014
Clinical question: How does traditional, oral signout from emergency providers to inpatient medicine physicians compare to dictated, voicemail signout? Background: Communication failures contribute to errors in care transition from ED to inpatient medicine units.
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Emergency Department “Boarding” Results in Undesirable Events
October 27, 2014
Clinical question: What is the frequency and nature of undesirable events experienced by patients who “board” in the ED? Background: Hospital crowding results in patients spending extended amounts of time—also known as “boarding”—in the ED as they wait for an inpatient bed.
