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Featured Articles

October 15, 2019

New Test Assists Physicians with Quicker Treatment Decisions for Sepsis

A new test to determine whether antibiotics will be effective against certain bacterial infections is helping physicians make faster and better prescription treatment choices. "Randomized Clinical Trial Evaluating Clinical Impact of RAPid Identification and Antimicrobial Susceptibility Testing for Gram-Negative Bacteremia (RAPIDS-GN)," is the largest study to evaluate the clinical impact of rapid blood culture diagnostics in the management of patients with Gram-negative bacilli bloodstream infections.  Read More

Severe Allergic Reactions Identified with Peripherally Inserted Central Catheters

Peripherally inserted central catheters (PICCs) that use a magnetized tip to guide insertion were associated with serious allergic reactions in patients, according to a study published today in Infection Control & Hospital Epidemiology, the journal for the Society for Healthcare Epidemiology of America. Severe adverse reactions occurred in patients within minutes of PICC insertion. Read More

Happy International Infection Prevention Week!

Each of us—patients, families, and healthcare personnel—has an important role to play in keeping patients safe from infection. First and foremost, know the basics of infection prevention. Do your part—and hand hygiene is key! Whether you’re in a healthcare facility or in the community, there are things healthcare professionals, patients, and family members can do to stay safe from infections. Read More

  • October 8, 2019

    Some ICU Admissions May Be Preventable, Saving Money and Improving Care

    Many admissions to the intensive care unit may be preventable, potentially decreasing health care costs and improving care, according to new research published online in the Annals of the American Thoracic Society.  Read More

    Study: Personalized Decision Support Affects Intensive Care

    For patients in pediatric intensive care who are at high risk for AKI, giving clinicians automated decision support during the electronic order entry process increased the rate of blood testing for AKI by 9 percent. The study by researchers at Vanderbilt University Medical Center appears in the journal Pediatric Research.  Read More

    Conflicts and Duplications When Applying More Than One Clinical Practice Guideline to a Patient

    Researchers in WMG at the University of Warwick have developed a new method that could solve the problem of how to automate support of managing the complexities of care when applying multiple clinical practice guidelines, to patients with more than one medical issue. Read More

  • October 1, 2019

    3D-Printed Models Can Drop Operating Room Times, Bolster Bottom Line

    Deploying 3D-printed, anatomical patient models and surgical guides has the potential to dramatically drop both time spent in the operating room and healthcare costs. That’s according to a new study published last week in Academic Radiology. Based on a review of several past analyses, researchers estimate that such anatomical models could save more than $3,700 per case by reducing time spent in the OR, and surgical guides could save nearly $1,500.  Read More

    IV Iron Does Not Increase Risk for Infection, Mortality

    Findings published in International Urology and Nephrology suggest that the use of high-dose parenteral iron is not associated with a higher risk for infection, all-cause mortality, increased hospitalization or increased cardiovascular events. According to the study, effective production of red cells and optimization of hemoglobin among patients with end-stage renal disease require continuing monthly iron infusion, but the safety of iron has been extensively debated.   Read More

    Unexpected Microbiome Collapse After Admission to Intensive Care

    Research published in the journal Microbial Genomics assessed how the diversity and makeup of the gut microbiome varied during patients' time in the intensive care unit (ICU). The gut microbiome is the complex community of bacteria and other microbes that reside in the gut, and plays an important role in health and wellbeing. Read More

  • September 24, 2019

    Tailored 'Cell Sheets' to Improve Post-Operative Wound Closing and Healing

    Scientists have designed a new method for post-operative wound closing and healing that is both fast and effective. This strategy revolves around engineered "cell sheets"—or layers of skin-based cells. The procedure culminates in a wound dressing that is custom made for a specific cut or lesion that can be used to effectively treat open skin areas after surgeries.  Read More

    Exercise Physiologists Aid Early Mobilization in ICU Patients

    Exercise physiologists can provide safe and effective early mobilization in intensive care units (ICUs), according to a study published in the September issue of the American Journal of Critical Care.  Read More

    Moral Distress and Moral Strength Among Clinicians in Health Care Systems

    Nurse burnout impacts both nurses and patients, and significantly influences the retention of nurses in the healthcare setting, research shows. But could burnout be a symptom of something larger? Read More

  • September 17, 2019

    Focus on the Value, Rewards of Physician-Patient Relationships

    Studies of burnout, depression and dissatisfaction among physicians share one common theme – the problem arises from the environment in which modern medicine is practiced. The studies imply that simply changing the environmental demands of a physician may stave off feelings that the physician no longer practices in a noble profession, but rather just completes daily job requirements. A breakdown of the physician-patient relationship arises from today’s health care system. We are pressured for time and challenged to run a business with decreasing reimbursement offset by strategies to make up for the deficits.  Read More

    Private Patient Rooms May Reduce Rates of Some Infections

    Moving patients from a hospital with mostly ward-type rooms to a new hospital with exclusively private rooms appeared to be associated with a sustained decrease in the rates of new MRSA colonization and vancomycin-resistant enterococci, or VRE, colonization and infection, according to findings published in JAMA Internal Medicine. However, researchers reported that the move was not associated with a reduction in MRSA infection or Clostridioides difficile infection.  Read More

    Current Method of Calculating SSIs is Underestimates Rates of Some Procedures

    Jessica L. Seidelman, MD, MPH, a medical instructor in the division of infectious diseases at Duke University School of Medicine, and colleagues from the Duke Infection Control Outreach Network (DICON) help hospitals submit data to the National Healthcare Safety Network (NHSN). “In our process of reviewing SSIs, we realized that hospitals were calculating denominators differently and this prompted us to take a deeper look at SSI denominators,” Seidelman explained to Infectious Disease News. Read More

    Slowing Brain Rhythms Can Serve as a Marker for Delirium and Its Clinical Outcomes

    An EEG (electroencephalogram) can provide a valuable biomarker for detecting delirium, a serious mental disturbance that is often underrecognized, as well as predicting poor clinical outcomes, researchers from Massachusetts General Hospital (MGH) have found. In a paper published in Neurology, the team reported that the generalized slowing of brain rhythms were associated with longer patient hospitalizations, worse functional outcomes and increased mortality.  Read More

  • September 11, 2019

    Research Shows 80% Drop in ICU Bloodstream Infections

    Bloodstream infections acquired in UK Intensive Care Units (ICUs) reduced by 80% between 2007 and 2012, according to research funded by the NIHR Guy's and St Thomas' Biomedical Research Centre. The findings are based on data collected from over 1 million patients admitted to 276 NHS adult ICUs across England, Wales and Northern Ireland.  Read More

    Slowing Brain Rhythms Can Serve as a Marker for Delirium and Its Clinical Outcomes

    An EEG (electroencephalogram) can provide a valuable biomarker for detecting delirium, a serious mental disturbance that is often underrecognized, as well as predicting poor clinical outcomes, researchers from Massachusetts General Hospital (MGH) have found. In a paper published in Neurology, the team reported that the generalized slowing of brain rhythms, shown as abnormal theta or delta waveforms on a routine clinical EEG, were associated with longer patient hospitalizations, worse functional outcomes and increased mortality.  Read More

    Compassion Fatigue: When Helping Hurts

    Since I graduated from college, I have worked at non-profits and have had jobs where my goal is to improve the lives of others. For me, I love having jobs where I can help others and I feel like it is what I am here to do. Here’s the thing, though, those of us that work in helping professionals are prone to compassion fatigue. Read More

    More Than 70% of UTIs Are Non-Device Associated

    “Over the past few decades substantial efforts have been made to reduce the incidence of catheter-associated urinary tract infections (CAUTIs) in the United States, with great success. However, these interventions mainly focus on the placement, maintenance, removal and properties of indwelling urinary catheters,” Paula D. Strassle, PhD, MSPH, assistant professor in the department of epidemiology at the University of North Carolina at Chapel Hill, told Infectious Disease News.  Read More

  • September 4, 2019

    Nurse-Led Quality Initiative Cuts Hypoglycemia in ICU Patients

    Krista E. Shea, M.S.N., from Stamford Hospital in Connecticut, and colleagues conducted real-time analysis of each episode of hypoglycemia (blood glucose level <60 mg/dL) occurring at a 16-bed critical care unit of a university-affiliated teaching hospital. The interdisciplinary team also evaluated patient risk factors and nursing interventions once root cause analysis was incorporated into daily practice.  Read More

    Method to Calculate Central Line Infections Flawed

    Jesse Couk, M.D., from Emory University in Atlanta, and colleagues compared CLABSI rates using standard National Healthcare Safety Network (NHSN) measures (a patient could only have one central line day for a given patient day) to rates accounting for multiple concurrent central lines (number of central lines in one patient in one day count as number of line days). Analysis included all adult patients with central lines at two academic medical centers during an 18-month period.  Read More

    Could Artificial Intelligence Prevent Sepsis in Hospital Patients?

    In the background of all the beeping and gadgetry, an electronic medical record contains thousands of bits of information about your medical history, vital signs and laboratory results. Sentara Healthcare is now deploying artificial intelligence to use that data to stop patients from contracting life-threatening sepsis. Earlier this year the system launched a sepsis prediction tool that alerts doctors and nurses when a patient is at risk of developing the deadly infection.Read More

    Rutgers-Developed Model for ICU Pharmacists Addresses Common Dilemma for Hospitals

    A new team-based model for intensive care unit (ICU) pharmacists, developed by Rutgers and RWJBarnabas Health System, resolves a common dilemma for hospitals and improves care for critically ill patients.Many ICUs include a team of general practice pharmacists, supplemented by one who specializes in critical care.  Read More

  • August 6, 2019

    New AF May Signal Sepsis Onset

    Links between new-onset atrial fibrillation and mortality suggest that the condition may serve as a measure of cardiac dysfunction during sepsis, according to a study published in the Annals of the American Thoracic Society. The Sepsis-3 task force defines sepsis as life-threatening organ dysfunction in response to infection, which is evaluated using the Sequential Organ Failure Assessment (SOFA) score. Currently, the SOFA score measures cardiac dysfunction using blood pressure and vasopressor dose only.  Read More

    Physician Burnout: Why Legal and Regulatory Systems May Need to Step in

    Electronic health record systems are adding extra pressure to physicians, causing burnout. A career as a physician has traditionally been considered to be among the best vocations that talented students can pursue. That may no longer be the case. All too many doctors report that they are unhappy, frustrated and even prepared to leave the profession. That should worry all of us. The physician burnout crisis is likely to affect our quality of care and our access to health care providers.  Read More

    Detection, Treatment of Dyspnea Inconsistent in ICU

    Although the prevalence of dyspnea was at least as high as that of pain, the detection and treatment of moderate to severe dyspnea were more inconsistent than for pain among critically ill patients in the ICU, according to data published in the American Journal of Respiratory and Critical Care Medicine. This study was undertaken as a result of concerns harbored by directors of the medical ICU at NewYork-Presbyterian Hospital about the lack of detection and proper management of dyspnea in the ICU. Read More

    The Dangers of Restraining Someone With Dementia

    Because dementia can trigger some challenging behaviors such as aggression and catastrophic reactions, restraints have been used at times in the past to help prevent injuries to that person or others around them. Fortunately, as a society and medical community, we've become more aware of the anxieties and agitation that restraints produce, as well as the increased risk of injuries with their use. In facilities, restraint use now is extremely limited.  Read More

  • July 2, 2019

    Acupuncture Training May Lessen Burnout Symptoms

    Researchers found a link between acupuncture training and decreased physician depersonalization, according to findings reported in the Journal of the American Board of Family Medicine. “Primary care physicians seek to practice acupuncture as a way to provide options for their patients, to focus on patients’ whole-person health, and to expand their knowledge and skills,” Paul F. Crawford III, MD, of the department of family medicine at the Uniformed Services University of the Health Services, and colleagues wrote.  Read More

    Deep Learning Can Make Reliable Coma Outcome Prediction

    After cardiac arrest and resuscitation, part of the patients will be in a coma and treated at an intensive care unit. Their prospects are uncertain. What is needed to get an outcome prediction that is reliable? Researchers of the University of Twente and the 'Medisch Spectrum Twente' hospital, both in Enschede, The Netherlands, developed a learning network that is capable of interpreting EEG-patterns. It can make a reliable outcome prediction, and thus forms a valuable extra source of information. The researcher present their approach in Critical Care Medicine journal. In The Netherlands, about one third of the people that had a cardiac arrest followed by resuscitation, will have to be treated at the ICU. These patients, about 7000 each year, are in a coma. More than half of them will not regain consciousness.  Read More

    A Hidden Truth: Hospital Faucets Are Often Home to Slime and Biofilm

    Sinks and faucets tested at the University of Michigan Health System revealed slime and biofilm.Hand hygiene is a critical component of infection prevention in hospitals, but the unintended consequences include water splashing out of a sink to spread contaminants from dirty faucets according to new research presented last week in Philadelphia at the 46th Annual Conference of the Association for Professionals in Infection Control and Epidemiology (APIC). Read More

    Penn Finds a Way to Reduce ICU Doctor Burnout

    Cutting the length of rotations in medical intensive care units in half also cut rates of physician burnout in half while additionally improving feelings of fulfillment, according to a new pilot study from Penn Medicine.The results were strong enough that Penn has changed rotations for critical-care doctors on its medical intensive care units (MICUs) at Hospital of the University of Pennsylvania, Penn Presbyterian Medical Center, and Corporal Michael J. Crescenz VA Medical Center.   Read More

  • June 25, 2019

    Hospital Insects Harbour Drug-Resistant Bacteria 

    More than 50 percent of bacteria recovered from flying insects in a group of English hospitals were resistant to one or more antibiotics, posing a potential infection risk to patients, according to a new study. The Aston University study collected almost 20,000 insect samples—including houseflies, 'filth flies' such as bluebottles and greenbottles and a variety of 'drain flies' - from seven NHS hospital sites in England.  Read More

    Risk for Death After Discharge Increases with Hospital-Acquired MRSA

    Researchers found that MRSA bacteremia did not increase the risk for death in hospitalized children compared with methicillin-susceptible Staphylococcus Aureus, or MSSA. However, MRSA infections acquired in the hospital were associated with an increased risk for mortality 1 year after discharge. Oren Gordon, MD, PhD, a pediatric infectious disease fellow at the Johns Hopkins University School of Medicine, and colleagues wrote that two meta-analyses conducted in the early 2000s examined mortality rates of patients with MRSA compared with those with MSSA. However, they wrote that the baseline mortality risk varied considerably in the studies, as did the researchers’ attempts to adjust for potential confounders. Additionally, few pediatric cases were included in these analyses. Read More

    Patients of Surgeons with Unprofessional Behavior More Likely to Suffer Complications

    Patients of surgeons with higher numbers of reports from co-workers about unprofessional behavior are significantly more likely to experience complications during or after their operations, researchers from Vanderbilt University Medical Center (VUMC) reported today in JAMA Surgery. "Surgical teams require every team member to perform at their highest level. Read More

    Flu Virus Coinfection Occurs More Often Than Previously Thought

    A case-control study conducted in southern Brazil described the first case of triple influenza virus infection, and researchers said their findings indicate that “influenza virus coinfections probably occur more often than has been previously documented.” “The clinical implications of coinfections with distinct influenza viruses in the respiratory tract is not well understood,” Ana B. G. Veiga, PhD, from the Federal University of Health Sciences of Porto Alegre, Brazil, and colleagues wrote. “Moreover, [influenza A virus] and [influenza B virus] coinfections have been reported only occasionally. The factors that are responsible for mixed influenza virus infection have not been determined; they can be associated with the host’s immune system, virus properties, and other factors.”  Read More

  • June 18, 2019

    Rapidly Removing Fluid from ICU Patients in Kidney Failure Linked to Increased Death Risk

    The faster fluid is removed using continuous dialysis from patients with failing kidneys, the higher the likelihood they will die in the next several months, according to a study published today in JAMA Network Open by University of Pittsburgh School of Medicine researchers.Nearly two-thirds of critically ill patients with acute kidney injury have extra fluid accumulating in their bodies, which can put pressure on their lungs and cause injury to other organs. To relieve that pressure, clinicians routinely remove the excess fluid from the blood while performing dialysis in the intensive care unit. Read More

    Using Facial Recognition Technology to Continuously Monitor Patient Safety in the ICU

    A team of Japanese scientists has used facial recognition technology to develop an automated system that can predict when patients in the intensive care unit (ICU) are at high risk of unsafe behaviour such as accidentally removing their breathing tube, with moderate (75%) accuracy. The new research, being presented at this year's Euroanaesthesia congress (the annual meeting of the European Society of Anaesthesiology) in Vienna, Austria (1-3 June), suggests that the automated risk detection tool has the potential as a continuous monitor of patient's safety and could remove some of the limitations associated with limited staff capacity that make it difficult to continuously observe critically-ill patients at the bedside.  Read More

    AI Gives Reliable Coma Outcome Prediction

    After cardiac arrest and resuscitation, some patients will still be in a coma and treated at an intensive care unit. Their prospects are uncertain. Clinicians seek a reliable method to predict their outcomes. Researchers of the University of Twenty and the Medisch Spectrum Twenty hospitals have developed a learning network that is capable of interpreting EEG patterns. Artificial intelligence (AI) can give a reliable outcome prediction, providing a valuable extra source of information for decision-making. The researchers present their approach in Critical Care Medicine. Read More

    Pressure Injuries at Time of ICU Admission Tied to Longer Stays

    William T. McGee, M.D., from the Baystate Medical Center in Springfield, Massachusetts, and colleagues retrospectively analyzed inpatient data from 2,723 adult patients in a 24-bed medical-surgical intensive care unit in a large level I trauma center from 2010 to 2012. The authors sought to evaluate the association between pressure injuries and length of stay and mortality.The researchers found that 6.6 percent of patients had a pressure injury at admission. Compared with patients without a pressure injury at admission, patients with a pressure injury had a longer mean unadjusted stay (15.6 versus 10.5 days) and higher in-hospital mortality rate (32.2 percent versus 18.3 percent). The association between pressure injuries and mean increase in length of stay remained with adjustment for other variables (mean difference, 3.1 days).  Read More

  • June 12, 2019

    Sedation and Controlled Paralysis Do Not Improve Survival of ICU Patients with ARDS

    Reversibly paralyzing and heavily sedating hospitalized patients with severe breathing problems do not improve outcomes in most cases, according to a clinical trial conducted at dozens of North American hospitals. The trial -- which was stopped early due to futility -- settles a long-standing debate in the critical care medicine community. Read More

    Patients Give More ‘5-Star’ Ratings to Hospitals with Fewer Services

    Compared to smaller facilities, hospitals that provide complex care for critical illness or serious injury may find it harder to make patients happy, a U.S. study suggests. Patients may be more likely to give top ‘5-star’ ratings to hospitals that don’t offer many commonly sought-after services like emergency rooms and intensive care units, the study found. In an effort to help patients find high quality care, the U.S. Centers for Medicare and Medicaid Services (CMS) publishes hospital rankings based on patients’ experiences, on a website called Hospital Compare. Research to date hasn’t offered a clear picture of how much patients’ ratings, on a scale of 1 to 5, might help people find the best place to go for care, researchers note in JAMA Internal Medicine.  Read More

    Post-ICU Depressive Symptoms Correlate With Income, Education, and Function

    Researchers of a study published in CHEST found that moderate to severe depressive symptoms after a stay in an intensive care unit (ICU) are associated with decreased income, lower education, and higher functional dependence. Moreover, age correlates curvilinearly with symptom severity. Read More

    Reducing Inpatient Falls and Injury Rates by Integrating New Technology with Workflow Redesign

    By integrating a novel patient-observer technology into a redesigned clinical workflow, the neuroscience unit at Mission Hospital in Asheville, North Carolina, achieved a 23% reduction in falls and a 12% reduction in fall-related injuries over a 1-year pilot period. Furthermore, the technology and clinical workflow was scaled to two additional units and, collectively, the three units achieved a 40% reduction in fall-related injuries. These results supported scaling the solution to a total of five inpatient units, effectively expanding the number of patients capable of being monitored from six (during the pilot period) to 164.  Read More

  • June 5, 2019

    Placards Do Not Improve Hand Hygiene Adherence

    Hand hygiene placards posted in a Denver hospital — including one that featured an image of two eyes looking directly at the viewer with a reminder to clean their hands — did not result in measurable improvements in hand hygiene adherence among health care workers, researchers reported. “Hospitals around the country are struggling to address hand hygiene adherence, but there are no nationally adopted standards for hand hygiene measurement and improvement, and an optimal combination of elements in hand hygiene ‘bundles’ remains unclear,” Sarah A. Stella, MD, associate professor of medicine and hospital medicine at the University of Colorado School of Medicine, told Infectious Disease News. “Infection preventionists often utilize visual cues and reminders in an attempt to influence behavior without evidence that they are effective.” Read More

    In-Hospital Delirium Increases Postoperative Cognitive Dysfunction Risk in Older

    New research indicates that older patients who develop delirium— an acute attentional deficit that waxes and wanes —right after surgery are more likely to show signs of postoperative cognitive dysfunction one month later. But the study, published in the Online First edition of Anesthesiology, the peer-reviewed medical journal of the American Society of Anesthesiologists (ASA), also found that the number of patients still showing signs of postoperative cognitive dysfunction decreased steadily and significantly at two and six months after surgery. Delirium is a common postoperative complication in older surgical patients and has been associated with cognitive decline, increased risk of dementia, and a host of other negative outcomes. Additionally, delayed or incomplete cognitive recovery can complicate recuperation for older surgical patients.   Read More

    Intelligent ICU for Autonomous Patient Monitoring Using Pervasive Sensing and Deep Learning

    Currently, many critical care indices are not captured automatically at a granular level, rather are repetitively assessed by overburdened nurses. In this pilot study, we examined the feasibility of using pervasive sensing technology and artificial intelligence for autonomous and granular monitoring in the Intensive Care Unit (ICU). As an exemplary prevalent condition, we characterized delirious patients and their environment. We used wearable sensors, light and sound sensors, and a camera to collect data on patients and their environment. We analyzed collected data to detect and recognize patient’s face, their postures, facial action units and expressions, head pose variation, extremity movements, sound pressure levels, light intensity level, and visitation frequency. Read More

    Long-Term Mortality Risk Highest Among Young Patients After ICU Discharge

    Although aging was associated with an increased risk for mortality in the 3 years following hospital ICU discharge, long-term mortality was highest among young patients after standardizing for age and sex, according to a study published in JAMA Network Open. “The benefit of ICU admission for elderly patients has been questioned because it may lead to unnecessary invasive care and avoidable health care expenditure,” Alice Atramont, MD, MSc, of Caisse Nationale d’Assurance Maladie (CNAM) in Paris, France, and colleagues wrote. “In France, the number of ICU beds per 100,000 population is at the European mean, with no financial barriers to access ICU care because of a national health insurance system offering universal coverage for the French population. However, there are few wide-scale population-based studies that document short-term and long-term outcomes of adult patients after ICU discharge across all age strata.  Read More