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Featured Articles

April 18, 2019

Antibiotics Unnecessary in Coagulase-Negative Staphylococci Catheter-Related BSI

Study findings indicated that withholding antimicrobial therapy in CoNS-CRBSI is neither associated with short-term complications nor with long-term recurrences. Patients not receiving antibiotics for catheter-related bloodstream infections (CRBSI) with coagulase-negative Staphylococci (CoNS) after catheter removal experience similar short-term complications and long-term recurrences to patients receiving ≥5 days of antibiotic therapy, according study results published in Antimicrobial Resistance & Infection Control. Read More

ICU Patients with Non-Brain-Related Injuries May Suffer Undetected Cognitive Dysfunction

Many patients spend time in the ICU for reasons that have nothing to do with a known brain injury, and most health care providers and caregivers don't have any evidence to believe there is an issue with the brain. For example, a patient may have had a traumatic injury that does not involve the brain, yet still requires breathing support to enable surgeons to fix damaged organs, they may have issues with their heart or lungs, they may contract a serious infection, or they may simply be recovering from a surgical procedure like an organ transplant that has nothing directly to do with their brain. Read More

Study Provides Insight Into Use of Critical Care Resources

A study by Massachusetts General Hospital (MGH) investigators has found wide variation in the use of different hospital units—intensive care or general medical units—to deliver a type of advanced respiratory support called non-invasive ventilation. The team's report published in Critical Care Medicine found no differences in length of stay or in-hospital deaths among patients with chronic obstructive pulmonary disease (COPD) receiving this treatment that were associated with whether they were treated on a general medical unit or an intensive care unit (ICU). Read More

Study Says Hospital Acquired Infections Can Make Patients ‘Feel Like Lepers’

Healthcare associated infections such as MRSA cause more than just physical distress for patients, according to a recent analysis. The study, published in the American Journal of Infection Control, a journal of the Association of Professionals in Infection Control and Epidemiology, found many patients had emotional responses to diagnoses of hospital acquired infections, including “feeling dirty,” “having the plague” or “feeling like a leper.” Researchers at Glasgow Caledonian University in Scotland conducted a meta-synthesis of qualitative research, according to a news release on the study. Read More

  • January 17, 2019

    Oral, Gut Decontamination Does Not Reduce Bloodstream Infections in ICU

    Results of a randomized clinical trial showed that selective oral or digestive tract decontamination is not associated with reductions in ICU-acquired bloodstream infections caused by multidrug-resistant gram-negative bacteria among patients receiving mechanical ventilation with moderate to high antibiotic resistance prevalence. Read More

    New Study Compares Performance of Real-Time Infectious Disease Forecasting Models

    In what the authors believe is the first documented comparison of several real-time infectious disease forecasting models by different teams across many seasons, five research groups report this week that a majority of models consistently showed higher accuracy than historical baseline models. Read More

    New AI Can Detect Urinary Tract Infections

    New AI developed at the University of Surrey could identify and help reduce one of the top causes of hospitalisation for people living with dementia: urinary tract infections (UTI). UTI is an infection of any part of the urinary system, from the kidneys to the bladder. The symptoms include pain in the lower part of the stomach, blood in urine, needing to urinate suddenly or more often than usual and changes in mood and behaviour. Read More

    CDC: Flu Cases Hit 7 Million in the United States

    The flu season is picking up steam, with about 7 million Americans having been struck by a strain of the flu virus, health officials said Friday. Almost half of those individuals went to a doctor, while 69,000 to 84,000 people have been hospitalized for flu-related illness, the U.S. Centers for Disease Control and Prevention said in a new release. As of Jan. 5, 15 states and New York City were reporting high flu activity, and it was widespread in 30 states. The influenza A strain H1N1 remains the most common type of flu. This strain has been circulating and was pandemic in 2009 and in 1918. Read More

  • January 10, 2019

    How Common Pain Relievers May Promote Clostridium Difficile Infections

    Clostridium difficile causes the most common and most dangerous hospital-born infections in the United States and around the world. People treated with antibiotics are at heightened risk because those drugs disturb the microbial balance of the gut, but observational studies have also identified a link between severe C. difficile infections and use of NSAIDs, or non-steroidal anti-inflammatory drugs.  Read More

    Plumbing Contamination Linked with Cluster of Infections from Rare Sphingomona Species

    Health care-associated infection (HAI) rates are down overall in the United States but remain a problem in health care settings. In 2015 there were an estimated 687,000 HAIs in US acute care hospitals, and 72,000 hospital patients with HAIs died during their hospitalizations. Although surgical site infections, pneumonia, and Clostridium difficile infections account for most HAIs, the NEJM study detailed a cluster of infections caused by waterborne Sphingomonas species, including S koreensis, an uncommon gram-negative bacterium that was first documented as a human pathogen in a 2015 study. Read More

    Characteristics of Skin, Soft Tissue Infections Requiring High-Level Care

    Data published in the Annals of Emergency Medicine identified a limited number of simple clinical characteristics that appear to identify skin and soft tissue infections that require high-level inpatient services. A noncurrent review of existing records identified emergency department patients treated for skin and soft tissue infections. The presence or absence of select criteria was recorded for each case, along with whether the patient needed high-level care (defined as intensive care unit admission, operating room surgical intervention, or death as the primary outcome). Recursive partitioning was then applied to identify the principal criteria associated with high-level care. Read More

    ICU Stethoscopes Harbor DNA from Nosocomial Bacteria

    Stethoscopes are often used on multiple patients, and have been considered as vectors for hospital-based bacterial contamination. In this study, the authors used molecular methods to investigate the bacterial status of stethoscopes used in medical ICUs, even those that are used only once, and whether conventional methods of cleaning stethoscopes effectively decontaminate them and, if not, what microbes may be found on them. Read More

  • November 8, 2018

    How Hospitals Can Prevent Dementia in ICU Patients

    A checklist that focuses on pain assessment and exercise can help reduce intensive care unit patients' risk of developing long-term mental effects, such as dementia and confusion, NPR reports. Four things to know: 1. Following the checklist can cut a patient's risk of mental impairment after an ICU stay by 25 percent to 30 percent, said Eugene Wesley Ely, MD, professor of medicine at Vanderbilt University School of Medicine in Nashville, Tenn. This post-ICU condition is different than memory problems that may arise after heart surgery and general anesthesia in the elderly. Read More

    Oral, Gut Decontamination Does Not Reduce Bloodstream Infections in ICU

    Results of a randomized clinical trial showed that selective oral or digestive tract decontamination is not associated with reductions in ICU-acquired bloodstream infections caused by multidrug-resistant gram-negative bacteria among patients receiving mechanical ventilation with moderate to high antibiotic resistance prevalence. [Selective decontamination of the digestive tract (SDD)] and [selective oropharyngeal decontamination (SOD)] are routinely used in ICUs in the Netherlands, but their use has not been widely adopted in other countries, mainly because of limited efficacy data in settings with higher levels of antibiotic resistance and concern about emergence of antibiotic resistance, although the latter is not supported by meta-analyses,” Bastiaan H. Wittekamp, MD, PhD, of University Medical Center Utrecht in the Netherlands, and colleagues wrote in JAMA. Read More

    Shoe Sole and Floor Contamination: A New Consideration in the Environmental Hygiene Challenge for Hospitals

    It sounds like the beginnings of a riddle: What do we wear and walk on daily but never truly think about, especially in terms of pathogen transmission? Shoe soles and healthcare facility floors are the workhorses of the environment, and yet their capacity for aiding and abetting infectious agents remains unclear. Recent research seems to confirm what common sense already tells us -- that items which contact the floor are contaminated and could serve as vectors; despite daily cleaning of high-touch surfaces such as floors, it has already been shown that bacterial and viral contamination returns rather quickly. Read More

    Machine-Learning System Could Aid Critical Decisions in Sepsis Care

    Researchers from MIT and Massachusetts General Hospital (MGH) have developed a predictive model that could guide clinicians in deciding when to give potentially lifesaving drugs to patients being treated for sepsis in the ER. Sepsis is one of the most frequent causes of admission, and one of the most common causes of death, in the intensive care unit. But the vast majority of these patients first come in through the ER. Treatment usually begins with antibiotics and intravenous fluids, a couple liters at a time. If patients don’t respond well, they may go into septic shock, where their blood pressure drops dangerously low and organs fail. Then it’s often off to the ICU, where clinicians may reduce or stop the fluids and begin vasopressor medications, such as norepinephrine and dopamine, to raise and maintain the patient’s blood pressure. Read More

  • October 31, 2018

    Predicting C. difficile: Researchers Identify Cluster of Factors

    A cluster of factors may help predict which patients are likely to develop Clostridioides difficile, a potentially life-threatening disease commonly known as C. difficile or C. diff, a new study has found. And that could help in efforts to prevent infection, according to the researchers. Read More

    Facebook 'Viable Method' for Implementing Critical Care Ultrasound Curriculum

    Critical care ultrasound (CCUS) is an important skill for all critical care physicians to understand. However, currently there is no standard approach to how to teach CCUS. Researchers aimed to investigate the feasibility of implementing a CCUS curriculum via a social platform in order to evaluate the impact it has on fellow's self-perceived competency. Results found that utilizing a social media platform, like Facebook, provides benefits such as spaced learning, active participation, and an informal and personal learning environment.  Read More

    Using Positive Deviance to Achieve Efficacy, Clarity in HAI Prevention

    The literature is replete with attempts to design and promote customized guidelines to reduce infections during the care continuum. Paradoxically, these efforts sometimes result in gray areas where many staff members are unaware of what is required of them, which then leads to confusion, frustration and uncertainty. Gesser-Edelsburg, et al. (2018) coined the phrase “gray areas” in this context to encompass the variety of situations on the care continuum that are not addressed in the accepted guidelines, and where staff members are unsure of how to proceed. Read More

    10 Hospital Objects That Breed Infection-Causing Bacteria

    Reader's Digest compiled a list of hospital objects that can hold large amounts of bacteria and other microbes, including elevator buttons, faucets and patient privacy curtains. Here are 10 hospital objects that have been found to breed infection-causing bacteria: 1. Privacy curtains. The privacy curtains that surround patients' beds can be contaminated with methicillin-resistant Staphylococcus aureus bacteria, according to a recent study. The researchers tracked the contamination of 10 freshly cleaned curtains. Within two weeks, about 90 percent of the curtains were colonized by MRSA bacteria. Read More

  • October 18, 2018

    Sink Traps are Surprising Source of Antibiotic-Resistant Bacteria in ICU

    During a nationwide outbreak of healthcare-associated infections of an antibiotic-resistant bacteria, an Israeli hospital traced repeated infections of patients in its intensive care unit (ICU) to an unexpected source--sink traps, according to a study published today in Infection Control & Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America. Read More

    New Studies Illustrate Need for Rigorous Review of Infection Preventionist Staffing Models Across Healthcare Systems

    Severe gaps in staffing and outdated coverage benchmarks point to the critical need for evaluating and updating standards for infection preventionist (IP) staffing levels, according to two new studies that explored infection prevention and control resourcing across a variety of healthcare settings. The studies were published in the American Journal of Infection Control (AJIC), the journal of the Association for Professionals in Infection Control and Epidemiology (APIC).  Read More

    C. difficile Survives Commercial Laundering of Hospital Bedsheets

    Commercial washing and drying under United Kingdom health care laundry policy failed to remove all Clostridium difficile, also known as Clostridioides difficile, spores on hospital bedsheets, according to study results published in Infection Control & Hospital Epidemiology. Our research found that standard laundering methods in U.K. hospitals failed to remove all traces of C. difficile, suggesting that linens could be another source of infection among patients and even other hospitals,” Katie Laird, PhD, head of the infectious disease research group in the school of pharmacy at De Montfort University, told Infectious Disease News. “These findings are significant because they could provide an explanation for otherwise unknown C. difficile outbreaks.” Read More

    Sepsis Surveillance Limited by Variations in Claims Data

    An analysis of records from nearly 200 hospitals showed that variations in the completeness and accuracy of claims data makes it difficult to compare sepsis rates and outcomes, according to findings presented at IDWeek. Researchers said meaningful comparisons may require the use of objective clinical data to facilitate improved sepsis surveillance. Read More

  • October 11, 2018

    Impact of a Nurse Intervention to Improve Sleep Quality in Intensive Care Units: Results from a Randomized Controlled Trial

    Researchers conducted this pilot randomized controlled trial in Spain to assess the effect a brief nurse intervention on sleep quality in patients in the intensive care unit (ICU). For this investigation, 40 patients admitted in hospital for valve cardiac surgery were randomly allocated to the control group (n=20), receiving usual care, and to the experimental group (n=20), receiving a nurse intervention the day before surgery and admission in the ICU. The investigators found that patients’ sleep quality was not improved by nurse intervention prior to ICU admission. Read More

    Digital Tool Quantifies Nurses’ Intuition and Predicts Potential Critical Situations

    Nurses often talk about having a sixth sense. A gut feeling says something is wrong with a patient, but putting that intuition into words and validating it can be hard. Perhaps a patient isn’t eating or drinking as much as the day before or the texture of their skin changed slightly. Maybe yesterday their mind was clear and today they are confused. These subtle changes could be early signs of a person’s health deteriorating, and they are picked up by a digital tool called the Rothman Index.  Read More

    Complexity of Work Environment Limits Nurses from Achieving a Healthy Lifestyle

    Research among nurses reports fewer than 10 percent meet physical activity guidelines and eat a healthy diet. The American Nurses Association underscored this issue by declaring 2017 as the Year of the Healthy Nurse. A new study published in the Journal of Nutrition Education and Behavior found that despite providing pedometers, a smartphone app, and access to a Facebook group, study participants were unable to change their diet and physical activity levels at the same time. Read More

    Early Dialysis Not Better for Septic Shock Patients with Acute Kidney Injury

    Early renal replacement therapy for patients in the initial phase of septic shock who have severe acute kidney injury is no better than delayed therapy, according to a French study of 488 patients that was stopped early for futility. After 90 days, 58% in the early treatment group had died vs 54% among patients whose treatment was delayed 48 hours to see if renal recovery would occur. In many cases, kidney function returned spontaneously. Results of the study, a multicenter, randomized trial known as IDEAL-ICU, were published online October 10 in the New England Journal of Medicine. Read More

  • October 3, 2018

    Severe Infections Rising Among Americans with Diabetes

    The number of Americans with diabetes who wind up in hospitals with serious infections, or who develop them while in the hospital, is on the rise. Between 2010 and 2015, the number of diabetics hospitalized for infections rose 52 percent (from 16 per 1,000 people to 24 per 1,000), according to researchers from the U.S. Centers for Disease Control and Prevention. "People with diabetes are more susceptible to in-hospital infections as compared with people without diabetes, and this risk is increasing," said lead researcher Jessica Harding, from the CDC's Division of Diabetes Translation. Read More

    Opt-Out Testing for HIV, Hepatitis C Could Improve Diagnoses in the ED

    A new study from screening results performed at a pair of Oakland-based hospital systems found that automated, routine testing for HIV and hepatitis C virus (HCV) conducted in integration with standard nursing workflow could increase the prevalence of caught diagnoses for both diseases. The obvious end-result would be more timely care for patients unlikely to be tested outside of an emergency department (ED) setting—namely, younger patients. Read More

    Study Explores Impact of Hand-Drying Method on Contamination and Bacteria Levels in Hospital Washrooms

    Laboratory and in situ studies have demonstrated that some hand drying methods are associated with a greater risk of dissemination of residual microbes from hands after (especially suboptimal) handwashing. In this latest study, supported by a grant from ETS, two toilets per hospital were observed – each had paper towel dispensers and jet air hand dryers, but only one of these was available to use at any given time – the hand drying method was changed every four weeks. The toilets were frequented by patients, visitors and staff. Bacterial contamination levels were measured over 12 weeks. Target bacteria included methicillin susceptible (MSSA) and resistant Staphylococcus aureus (MRSA), enterococci and enterobacteria, including ESBL (extended-spectrum β-lactamase) bacteria. Read More

  • September 25, 2018

    Recent Developments in Surgical Sepsis

    It is almost a century since Moynihan famously noted that, “every surgical operation is an experiment in bacteriology.” While the basic components of that experiment (the host, the bacterial flora and the factors which alter the balance between bacterial capacity for invasion and host resistance) have not changed, the outcome of surgical procedure, even when complicated by infection, has improved markedly. Read More

    Cath Lab Pre-Activation Beneficial But Not Routine in STEMI

    Fewer than half of patients with STEMI who were transported by emergency medical services had catheterization laboratory pre-activation before they arrived at the hospital, despite a suggestion of mortality benefit from cath lab pre-activation, according to a study published in JACC: Cardiovascular Interventions. Read More

    Hospitals Could Reduce HAIs by up to 55%

    A large systematic review and meta-analysis showed that hospitals could reduce health care-associated infections, or HAIs, by 35% to 55% with systematic implementation of evidence-based infection prevention and control measures.
    The findings were published in Infection Control & Hospital Epidemiology.
    Read More

    Biomarker-Guided Antimicrobial Stewardship: The Next Target, or Missing the Mark?

    Sepsis is a common and serious condition that can lead to significant morbidity and mortality. Because early and effective antibiotic therapy is a critical component of treatment, there is ongoing interest in increasingly rapid and reliable diagnosis. In conjunction with clinical evaluation, biomarkers have emerged as potentially useful diagnostic tools and may additionally have a role later in therapy to evaluate clinical response and guide cessation of antibiotics. Read More

  • September 13, 2018

    Clinical Education On-Demand! "Stressing the Dressing: Reducing Vascular Access Device Complications"

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    Vasopressors May Contribute to ICU-Related Weakness

    Treatment with vasopressor medications was associated markedly increased risk for developing intensive care unit (ICU)-associated weakness among critically ill patients on mechanical ventilation, researchers said. Read More

    Men Place Less Value on Care-Oriented Careers Like Nursing

    Men assign less importance to care-oriented careers than women do, possibly because men internalize different values than women, suggests new research from the University of British Columbia. While women are significantly underrepresented in science, technology, engineering and math (STEM) fields, making up just nine to 16 per cent of engineers and 21 per cent of computer programmers in the U.S., men are even more markedly underrepresented in healthcare, early education, and domestic (HEED) careers. They make up only 10 per cent of nurses and four per cent of preschool and kindergarten teachers in the U.S., according to the U.S. Bureau of Labor Statistics. Read More

    Caffeine Consumption May Extend Life Expectancy for People with Kidney Disease

    A new study in Nephrology Dialysis Transplantation indicates that consuming more caffeine may help reduce the risk of death for people with chronic kidney disease. An inverse relationship between coffee consumption and mortality has been reported in the general population. However, the association between caffeine consumption and mortality for people with chronic kidney disease remains uncertain. The researchers hypothesized that caffeine consumption might be associated with lower mortality among participants with chronic kidney disease. Read More

    Guidance for Preventing C. difficile in Neonatal Intensive Care

    Newborns require special diagnosis and treatment considerations for an infectious diarrhea known as Clostridioides difficile (C. difficile) infection, according to a new evidence-based white paper published today in Infection Control & Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America. The publication is in conjunction with the release of a companion review by the Centers for Disease Control and Prevention's Healthcare Infection Control Practices Advisory Committee (HICPAC) and recommends against routine testing for C. difficile in neonatal patients and suggests evaluating first for more common causes of diarrhea. Read More

  • August 29, 2018

    Certain Antibiotic-Resistant Infections on the Rise

    Nearly six percent of urinary tract infections analyzed by a California emergency department were caused by drug-resistant bacteria in a one-year study period, according to new research in Annals of Emergency Medicine. The bacteria were resistant to most of the commonly used antibiotics. And, in many cases, patients had no identifiable risk for this kind of infection, the study found. Read More

    Therapeutic Algorithm May Guide Empiric Therapy in Pneumonia

    An algorithm based on risk factors for resistant pathogens and illness severity can simplify pneumonia treatment, improve the accuracy of empiric therapy, reduce mortality, and help avoid overusing broad spectrum therapy in some patients, according to new findings published in Clinical Infectious Diseases. Read More

    Investigating an Elizabethkingia anophelis Cluster in a Pediatric ICU

    Intensive care units (ICUs) are the last place infection preventionists want to see an outbreak. There is no “good” location for an outbreak, but an ICU is perhaps one of the worst, as the sickest, most vulnerable patients are cared for in such units. Like an oncology unit, an ICU experiencing cases of infection with an unusual organism can represent a canary in the coal mine. Elizabethkingia bacteria are found in soil, river water, and reservoirs; however, they tend to only cause disease for those with weakened immune systems. The most common manifestations are meningitis and respiratory infections. Read More

    Discharging Patients Home from ICU Poses No Added Risk

    Direct discharge home from the ICU does not increase health care utilization or mortality, according to research published in JAMA Internal Medicine. Read More

  • August 22, 2018

    TODAY - August 22nd Complimentary Clinical Education Webcast: "Stressing the Dressing: Reducing Vascular Access Device Complications" Featuring, Russel Nassof, JD - Space is limited! Register for the live event or to receive a recorded copy of the presentation.

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    Effectively Expressing Empathy to Improve ICU Care

    In nearly every intensive care unit (ICU) at every pediatric hospital across the country, physicians hold numerous care conferences with patients' family members daily. Due to the challenging nature of many these conversations -- covering anything from unexpected changes to care plans for critically ill children to whether it's time to consider withdrawing life support -- these talks tend to be highly emotional. Read More

    New Elective Gives UAH Students Preview of the Ups and Downs of Critical Care Transport Nursing

    If the idea of trying to save someone’s life isn’t panic-inducing enough, try doing it in mid-air with limited room to maneuver and the whir of helicopter blades drowning out any chance of direct communication. For Ron Bolen (MSN, RN, CCRN, CEN, CFRN), however, it’s all in a day’s work. And now he’s imparting that knowledge to a new generation of nursing students in his undergraduate-level Critical Care Transport Nursing course at The University of Alabama in Huntsville (UAH).  Read More

    Trust, Access Confer Success in Community-Based Hypertension Management

    Hypertension is a well-established, powerful risk factor for CVD and stroke, especially in black individuals, but the challenge lies in identifying and deploying the most efficient strategy to prevent and control BP. According to the CDC, 1 in 3 U.S. adults has hypertension, defined as 140 mm Hg over 90 mm Hg or above or use of antihypertensive medication, and nearly half of those with hypertension have not achieved control. In addition, an estimated 13 million U.S. adults with hypertension do not know that they have the condition and, thus, are not receiving treatment. Read More

    If You’re a Nurse, You’re a Patient Advocate

    Most nurses don’t wear nursing caps any longer, but we still wear many hats. And the advocate hat is one we never take off. At times, the work we do is routine. At other times it is complex and critical. But it always is patient-centered. We are assessors, planners, providers and care evaluators. We are technicians and researchers, managers, leaders and educators. And we are nurse advocates. Read More

  • August 16, 2018

    Clinical Education Webcast: "Stressing the Dressing: Reducing Vascular Access Device Complications" Featuring, Russel Nassof, JD - Space is limited!

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    The Intensivist Shortage: Is There a Way Around It?

    In the ICU, the numbers just don't add up. There is a significant shortage of intensive care specialists, and despite efforts by hospitals to recruit more intensivists, there are not enough to provide quality care to intensive care unit patients. And according to one study, “the shortage of full-time intensivists is most likely 5-10 times more pronounced” than it is generally considered to be - because “the bulk of CCM board certificates are allocated to part-time physicians.” While a part-time intensivist is better than none, it is far from an ideal situation. Read More

    UCLA Pilot Project Fulfills Patient Wishes to Improve End-of-Life Experience

    Researchers at UCLA have launched a pilot project designed to fulfill small wishes from critically ill patients in hopes of improving their end-of-life experience. The program — offered to patients in the ICU — will expand later this year to include the oncology unit at UCLA Santa Monica Hospital.  Read More

    Engaging Leaders in CAUTI Prevention Efforts

    Including senior leaders in CAUTI prevention is a critical aspect of the design and implementation of infection prevention programs. Implementing a program to successfully reduce catheter-associated urinary tract infections requires a multipronged approach, dedicated resources, and leadership support from the highest levels of an organization. Senior leaders of healthcare organizations are responsible for navigating the constantly changing landscape of healthcare quality, financial, and regulatory issues. Read More

    Very Empty (and Very Full) Hospitals Have Lowest C. Diff Risk

    Patients are three times likelier to contract the dangerous infection when a hospital is at midlevel occupancy, a new way of tracking the data finds. Hospitals spend a lot of time and effort to protect their patients from developing new infections — especially dangerous ones that can pose a greater health threat than whatever brought that person in for care. But this massive effort has been missing a key element, according to University of Michigan and Rand Corp. researchers. Read More