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Easing the Grieving Process for Families of Patients Dying in the ICU
October 29, 2015
Clinical question: Can we dignify death in the ICU and ease the grieving process by soliciting wishes from patients, families, and care team members? Background: The death of the critically ill patient in the ICU can be dehumanizing and overwhelming for the patient’s family and friends, leading t
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Pediatric Trigger Tool Helps Identify Inpatient Pediatric Harm
October 29, 2015
Clinical question: Can a trigger tool identify harms for hospitalized children? Background: An estimated 400,000 people die annually in the United States as a result of hospital-associated harm.
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Left Atrial Appendage Closure Favorable Over Warfarin for Atrial Fibrillation
October 29, 2015
Clinical question: Is there a favorable risk-benefit ratio for left atrial appendage closure (LAAC) compared to warfarin for prevention of stroke, systemic embolism, and cardiovascular death in nonvalvular atrial fibrillation? Background: LAAC with the WATCHMAN device was shown to be noninferior
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Urinalysis Is Reliable Infection Predictor in Infants
October 6, 2015
Clinical question: In infants younger than three months of age with bacteremic urinary tract infection (UTI), how sensitive and specific are urinalysis (UA) findings? Background: Infants are commonly hospitalized with UTIs. The gold standard for diagnosis is considered to be urine culture.
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High-Flow Nasal Oxygen Therapy Noninferior to BiPAP in Post-Operative Respiratory Failure
October 6, 2015
Clinical question: In post-operative cardiothoracic surgery patients, is high-flow nasal oxygen therapy inferior to BiPAP for resolution of acute respiratory failure? Background: Acute respiratory failure is common following cardiothoracic surgery, and noninvasive ventilation often is used to avo
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Supplemental Oxygen During STEMI Might Increase Myocardial Injury
October 6, 2015
Clinical question: Does routine oxygen supplementation in patients with STEMI increase myocardial injury? Background: Because of physiologic and clinical studies conducted before the era of acute coronary intervention, supplemental oxygen routinely is administered to patients with STEMI, regardle
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Thrombectomy Within Eight Hours of Stroke Onset Reduces Post-Stroke Disability
October 6, 2015
Clinical question: Does thrombectomy, in conjunction with medical therapy, improve functional independence in patients with an acute proximal anterior stroke? Background: Revascularization of proximal anterior strokes with alteplase alone occurs less than 50% of the time.
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Interdisciplinary Team Care on General Medical Units Does Not Improve Patient Outcomes
October 6, 2015
Clinical question: Does interdisciplinary care on general medical wards improve patient outcomes? Background: Patients on general medical wards might experience errors and/or preventable deaths.
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Patient Satisfaction Scores, Objective Measures of Surgical Quality Have Positive Association
October 6, 2015
Clinical question: Is there an association between objective measures of surgical quality and patient satisfaction as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey? Background: The Centers for Medicare and Medicaid Services (CMS) has tied financi
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Extended Anticoagulation Therapy and Recurrent Rates of Venous Thromboembolism
October 6, 2015
Clinical question: Among patients with a first episode of unprovoked pulmonary embolism (PE), what are the benefits and harms of extending the duration of anticoagulation for secondary prophylaxis against recurrent VTE? Background: Optimal duration of anticoagulation after initial unprovoked PE i