Feature Channels: Patient Safety

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Johns Hopkins Nursing student helps push alternate strategies to combat infection in pediatric intensive care unit.

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Nationwide, more than one-quarter of hospital-based general practitioners who take over for patients’ primary care doctors to manage inpatient care say their average patient load exceeds safe levels multiple times per month, according to a new Johns Hopkins study. Moreover, the study found that one in five of these physicians, known as hospitalists, reports that their workload puts patients at risk for serious complications, or even death.

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Daily baths with an ordinary antibacterial cleanser can safely reduce the risk of dangerous bloodstream infections in critically ill children, according to a trial conducted in five pediatric hospitals and led by investigators at the Johns Hopkins Children's Center. A report on the findings of the research -- the first of its kind in children and one of the largest infection-prevention trials to date -- will be published online Jan. 26 in The Lancet

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Central line associated bloodstream infections in newborns were reduced by 58 percent in less than a year in hospital neonatal intensive care units participating in an AHRQ patient safety program.

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What cancerous conditions lead to what kinds of bacterial infections? If doctors knew, they could predict which patients would likely benefit from pre-treatment with certain kinds of antibiotics. A University of Colorado Cancer Center study shows the answer: E. coli and Klebsiella pneumoniae are especially prevalent in patients with lung and GI cancers, more so for Klebsiella if these patients have been treated previously with aminopenicillins.

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Technological advancements in medicine have allowed patients suffering from musculoskeletal conditions such as hip and knee pain to regain mobility and live relatively pain-free. But some “high risk” surgical devices that have been approved by the U.S. Food and Drug Administration (FDA) are not required to go through clinical trials, where a product is tested to determine its safety and effectiveness.

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Clever intervention designed by a pharmacologist, a general practitioner and a biostatistician substantially reduced the prescribing of potentially dangerous medications. Reporters' conference call on January 23 at 9:30 EST The study’s three co-authors, Vittorio Maio, PharmD, MS, MSPH (a Jefferson pharmacology expert); Scott Keith, PhD (a Jefferson biostatistician); and Stefano Del Canale, MD, PhD (a practicing physician in Parma) will discuss their work. The dial-in telephone number is: +1-866-818-8556 Access Code: 5430707

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Experts from The Children’s Hospital of Philadelphia were among the leaders of two large national studies showing that extending CPR longer than previously thought useful saves lives in both children and adults after in-hospital cardiac arrest.

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When hospital operating room staff follow a written safety checklist to respond to a medical crisis during surgery, they are nearly 75 percent less likely to miss a critical clinical step.

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A California hospital reported that its vascular access team has gone nearly seven years without a central line-associated bloodstream infection (CLABSI) in any of its peripherally inserted central catheter (PICC) lines.

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Study shows patients who give their doctors high marks in communication more likely to fill prescriptions.

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Infection control experts at The Johns Hopkins Hospital have found that a combination of robot-like devices that disperse a bleaching agent into the air and then detoxify the disinfecting chemical are highly effective at killing and preventing the spread of multiple-drug-resistant bacteria, or so-called hospital superbugs.

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A recent international survey on the global burden of disease identified hypertension (high blood pressure) as the leading “risk factor” for disease around the world. Over 120 members of the American Medical Group Association (AMGA) serving more than 40 million patients have joined together to address this health problem by participating in Measure Up, Pressure Down, a new national healthcare campaign aimed at preventing, detecting and controlling high blood pressure spearheaded by the American Medical Group Foundation (AMGF), AMGA’s nonprofit education and research arm.

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The Univ. of Michigan Health System doesn’t claim to be perfect. But its response to medical errors is a model that other hospitals can and should copy, according to a new study.

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Virginia Tech researchers have discovered how a common diarrhea-causing bacterium sends the body’s natural defenses into overdrive, actually intensifying illness while fighting infection.

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For the fourth year in a row, Hospital for Special Surgery has an infection rate that is significantly lower than the New York State average for hip replacement or revision surgeries, according to the State Department of Health.

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UC San Diego Health System was honored with two separate “A” Hospital Safety Scores by The Leapfrog Group, an independent national nonprofit run by employers and other large purchasers of health benefits.

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Surgical teams at Cedars-Sinai have reduced surgical site infections by more than 60 percent for patients who undergo colorectal procedures by introducing evidence-based protocols that are easy to follow and relatively low in cost.

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Use of a simple disinfection cap can strengthen hospitals’ patient safety efforts, improve disinfection of IV catheters and lower the cost of care.

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The type of IV connector used in vascular access is closely linked to a patient’s chance of getting a dangerous bloodstream infection, according to two new studies.

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Stony Brook University School of Medicine researchers have found that children’s brains are more affected by an inhaled anesthetic than an intravenous anesthetic with increased levels of brain lactate.

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High compliance with hand hygiene and focusing on other simple infection control measures on medical, surgical and neuroscience intensive care units resulted in reduced rates of methicillin-resistant Staphylococcus aureus (MRSA) infection by 95 percent in a nine-year study, according to research findings by Virginia Commonwealth University physicians presented during IDWeek 2012.

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(PHILADELPHIA) – Researchers at Thomas Jefferson University Hospital have shown that combining distal protection devices with the prophylactic use of the drug nicardipine is more effective at preventing life-threatening complications following a percutaneous coronary intervention (PCI) (angioplasty, stenting) on patients who have undergone previous bypass surgery than distal protection devices alone.

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Clostridium difficile infections are becoming more common and more severe in hospitalized children and the elderly, in large part due to greater use of antibiotics, Mayo Clinic researchers report in studies being presented at the American College of Gastroenterology annual meeting.

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An ongoing program is developing new tools for assessing health care quality from the most important viewpoint—that of the patient receiving care, according to a special supplement to Medical Care. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

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In a pilot study assessing the effect of different levels of chloride in intravenous fluids administered to critically ill patients in an intensive care unit, restricting the amount of chloride administration was associated with a significant decrease in the incidence of acute kidney injury and the use of renal replacement therapy.

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Study shows surgical proficiency levels are achieved at variable rates and suggests current protocols insufficiently evaluate residents’ skills.

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A computerized checklist system designed to help physicians identify and use the best methods of preventing potentially deadly blood clots in hospitalized trauma patients dramatically reduced the number of these dangerous venous thromboembolisms (VTEs), new Johns Hopkins research suggests.

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Screening practices for multidrug-resistant organisms (MDROs) in intensive care units (ICUs) vary widely from hospital to hospital, according to a new study by researchers at Columbia University School of Nursing and published in the October 2012 issue of the American Journal of Infection Control.

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Four experts in anesthesiology, infectious disease and pain medicine discussed the recent U.S. meningitis outbreak in the Late-Breaking Education Panel, “The Fungal Meningitis Crisis,” on Sunday, Oct. 14.

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Reducing preventable harm in hospitals often starts with small, low-tech steps: brushing the teeth of patients on ventilators; using low-rise beds and socks with safety treads on both sides; completing a surgical time out before mounting a blade on a scalpel.

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IV connectors, through which intravenous medication and nutrition are provided to a patient, can play a crucial role in protecting patients from life-threatening infections and other complications.

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Although patients with chronic conditions who do not take medications as prescribed tend to have poorer health outcomes and higher health care costs than those who adhere to medication regimens, a new report sheds light on the potential for multiple interventions to improve medication adherence.

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A unique nationwide patient safety project reduced by 40 percent the rate of central line-associated bloodstream infections (CLABSIs) in intensive care units. The project used the CUSP toolkit.

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A published study conducted by researchers at West Virginia University has found that doctor and pharmacy shoppers are at a greater risk for drug-related death.

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Johns Hopkins patient safety experts quantify the incidence of fatal and non-fatal diagnostic errors in the intensive care unit. Researchers report a diagnostic error was found in more than one in four critically ill adults at death.

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A neutral-pressure IV needleless connector was associated with complete elimination of catheter-related bloodstream infections (CRBSI) in a successful device trial at a large cancer center in the six-month period following implementation of the device.

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Many people have probably heard of off-label drug use, but they may not know when that applies to prescriptions they are taking, a Mayo Clinic analysis found. Off-label drug use occurs when a physician prescribes medication to treat a condition before that use has been approved by the Food and Drug Administration. In a newly published article in Mayo Clinic Proceedings, researchers pose and answer 10 questions about off-label drug use.

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A major international study led by University of Adelaide researchers aims to prevent death and serious illness caused by one of the most common infections contracted by patients in hospitals.

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A patient safety team including researchers in the Johns Hopkins Armstrong Institute for Patient Safety and Quality reported a one-third cut in the rate of costly and potentially lethal surgical site infections (SSIs) following colorectal operations after requiring use of a simple safety checklist and urging caregivers to speak up if they see potentially unsafe practices.

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A study of more than 500 patients admitted to, and discharged from, a big-city medical center suggests that nurse-pharmacist teams trained to track down discrepancies between lists of drugs patients are taking at home and those they are scheduled to take in the hospital might substantially reduce such potentially harmful conflicts.

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An IV connector known as an intraluminal protection device (IPD) significantly outperformed two widely used negative-pressure IV connectors in research performed at Methodist Extended Care Hospital.

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Physicians don’t do as much as they could to ensure that patients adhere to their medication regimens, highlighting the need to develop better methods for doctors to identify non-adherence and to change that behavior.

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A new tool to guide decisions about safe and effective medication use has been developed at the University of Illinois at Chicago College of Pharmacy.

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The FDA’s Risk Evaluation and Mitigation Strategies (REMS) for extended release/long-acting (ER/LA) opioids, announced on July 9, is consistent with the American Pain Society’s strong belief that competency-based educational programs will benefit both primary care and specialty prescribers of ER/LA opioids and ultimately improve patient safety and decrease diversion while still assuring access to these medications for patients who need them.

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A disinfection cap used in IV therapy was the subject of an award-winning, multi-site study at a four-hospital, Chicago-area hospital system.

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In a study of more than 18,000 patients having surgery for hip fracture, researchers at the Perelman School of Medicine at the University of Pennsylvania found that the use of regional anesthesia versus general anesthesia, was associated with a significant reduction in major pulmonary complications and death. The new study will be published in the July issue of the journal Anesthesiology.

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Concern about overexposure to radiation due to excessive use of medical imaging has come to the fore in recent years. Now, a study led by researchers at the University of California, San Francisco (UCSF) and Group Health Research Institute, shows that medical imaging is increasing even in health maintenance organization systems (HMOs), which don’t have a financial incentive to conduct them.

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In a recently approved position statement, the American Association of Physicists in Medicine (AAPM) affirms that computed tomography (CT) scans are important diagnostic tools for children and adults when used appropriately. AAPM encourages parents to discuss the need for any diagnostic medical procedures for their children with their physician.