Hospital practice (1995)
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Hospital practice (1995) · Jan 2015
Multicenter StudyCeftaroline fosamil for the treatment of hospital-acquired pneumonia and ventilator-associated pneumonia.
Ceftaroline fosamil is a novel cephalosporin with bactericidal activity against common pathogens associated with hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP). Ceftaroline is inactive against extended-spectrum β-lactamase-producing or AmpC-overexpressing Enterobacteriaceae and has limited activity against Pseudomonas aeruginosa. CAPTURE is a multicenter, retrospective study designed to collect information on contemporary clinical use of ceftaroline fosamil in the USA. Data on off-label use of ceftaroline fosamil for the treatment of patients with HAP/VAP between September 2013 and March 2014 are presented. ⋯ The CAPTURE study data support further evaluation of ceftaroline fosamil as an effective treatment option for HAP and VAP when a ceftaroline susceptible etiologic pathogen is identified, including MRSA, or as a concurrent therapy when resistant Gram-negative pathogens are suspected.
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Hospital practice (1995) · Dec 2014
Multicenter StudyAbility of nurse clinicians to predict unplanned returns to hospital within thirty days of discharge.
To evaluate the ability of nurse clinician discharge flow coordinators (DFCs) to identify medical patients at risk of unplanned return to the hospital emergency department within 30 days of discharge and whether a higher predicted risk of return was correlated with preventability. ⋯ In a large urban center, experienced nurse clinician DFCs were able to predict 30-day emergency department returns with reasonable accuracy. They were also able to identify the returns to the hospital that were most likely to be preventable. Our data suggests that DFCs can be used to target patients identified as having an increased probability of return with interventions that may be able to reduce the burden of return to hospital.
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Hospital practice (1995) · Apr 2012
Multicenter StudyEvaluation of the IDSA/ATS minor criteria for severe community-acquired pneumonia.
Our aim was to evaluate the minor criteria recommended by the 2007 Infectious Diseases Society of America (IDSA)/American Thoracic Society (ATS) as predictors of 30-day mortality, the need for invasive mechanical ventilation, and/or the need for vasopressor support as markers of severity in patients hospitalized with community-acquired pneumonia (CAP). ⋯ Our results show that hypoxemia, multilobar infiltrates, and leukopenia were the most predictive minor criteria for 30-day mortality. In contrast, hypoxemia and confusion/disorientation were the 2 individual minor severe criteria that were more likely to require invasive mechanical ventilation and/or vasopressor support. At least 3 2007 IDSA/ATS minor severe criteria were associated with 30-day mortality and need for invasive mechanical ventilation and/or vasopressor support.
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Hospital practice (1995) · Feb 2011
Multicenter StudyAdvance care planning in the skilled nursing facility: what do we need for success?
Despite the established benefits of advance care planning (ACP) in the geriatric population, documentation of ACP counseling in the skilled nursing facility (SNF) setting remains poor. The primary aim of this study was to identify key barriers to ACP completion among SNF providers. A secondary aim was to identify ACP practice-based differences between SNF physicians and midlevel providers. ⋯ The survey demonstrated that systems-based barriers contribute to poor ACP documentation in the SNF setting. Key differences in attitudes about the impact of ACP on loved ones were identified between provider groups. Strategies aimed at mitigating practice-level barriers, such as standardizing a location for ACP documentation and formalizing workflow, are needed for increased ACP completion rates in SNFs.