Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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Despite the significant burden of delirium among hospitalized adults, critical appraisal of systematic data on delirium diagnosis, pathophysiology, treatment, prevention, and outcomes is lacking. ⋯ Delirium is an acute, preventable medical condition with short- and long-term negative effects on a patient's cognitive and functional states.
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Multicenter Study Comparative Study
Pediatric observation status: are we overlooking a growing population in children's hospitals?
Inpatient administrative datasets often exclude observation stays, as observation is considered to be outpatient care. The extent to which this status is applied to pediatric hospitalizations is not known. ⋯ Children admitted under observation status make up a substantial proportion of acute care hospitalizations. Analyses of inpatient administrative databases that exclude observation stays likely result in an underestimation of hospital resource utilization for children.
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Pain, dyspnea, and anxiety are common among patients with cancer, heart failure (HF), and chronic obstructive pulmonary disease (COPD), yet little is known about the severity of symptoms over time. ⋯ The majority of inpatients with chronic illness reported high severity of symptoms. Symptoms improved over time but many patients, particularly those with COPD, had high symptom severity at follow-up.
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Comparative Study
Hospitalist-led medicine emergency department team: associations with throughput, timeliness of patient care, and satisfaction.
Admitted patients boarding in the emergency department (ED) leads to hospital diversion. Active bed management and care for boarded patients can improve throughput. We developed a hospital medicine ED (HMED) team to participate in active bed management, and to care for boarded patients, to decrease diversion and improve throughput. ⋯ An HMED team can improve patient flow and decrease ED diversion while providing more timely care to patients boarded in the ED.
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Enteroviral meningitis is a common cause of meningitis in children which requires only supportive care. ⋯ In-house EVPCR testing reduced test turnaround time, increased test utilization, and reduced both length of stay and duration of parenteral antibiotics for children with a positive result. Clinicians caring for children with meningitis should have access to in-hospital EVPCR testing.