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Opportunities to prevent complications

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4 papers 0 to 25 followers
Lona Mody, Sarah L Krein, Sanjay Saint, Lillian C Min, Ana Montoya, Bonnie Lansing, Sara E McNamara, Kathleen Symons, Jay Fisch, Evonne Koo, Ruth Anne Rye, Andrzej Galecki, Mohammed U Kabeto, James T Fitzgerald, Russell N Olmsted, Carol A Kauffman, Suzanne F Bradley
IMPORTANCE: Indwelling devices (eg, urinary catheters and feeding tubes) are often used in nursing homes (NHs). Inadequate care of residents with these devices contributes to high rates of multidrug-resistant organisms (MDROs) and device-related infections in NHs. OBJECTIVE: To test whether a multimodal targeted infection program (TIP) reduces the prevalence of MDROs and incident device-related infections. DESIGN, SETTING, AND PARTICIPANTS: Randomized clinical trial at 12 community-based NHs from May 2010 to April 2013...
May 2015: JAMA Internal Medicine
Judith Tanner, Wendy Padley, Ojan Assadian, David Leaper, Martin Kiernan, Charles Edmiston
BACKGROUND: Care bundles are a strategy that can be used to reduce the risk of surgical site infection (SSI), but individual studies of care bundles report conflicting outcomes. This study assesses the effectiveness of care bundles to reduce SSI among patients undergoing colorectal surgery. METHODS: We performed a systematic review and meta-analysis of randomized controlled trials, quasi-experimental studies, and cohort studies of care bundles to reduce SSI. The search strategy included database and clinical trials register searches from 2012 until June 2014, searching reference lists of retrieved studies and contacting study authors to obtain missing data...
July 2015: Surgery
Tammy T Hshieh, Jirong Yue, Esther Oh, Margaret Puelle, Sarah Dowal, Thomas Travison, Sharon K Inouye
IMPORTANCE: Delirium, an acute disorder with high morbidity and mortality, is often preventable through multicomponent nonpharmacological strategies. The efficacy of these strategies for preventing subsequent adverse outcomes has been limited to small studies to date. OBJECTIVE: To evaluate available evidence on multicomponent nonpharmacological delirium interventions in reducing incident delirium and preventing poor outcomes associated with delirium. DATA SOURCES: PubMed, Google Scholar, ScienceDirect, and the Cochrane Database of Systematic Reviews from January 1, 1999, to December 31, 2013...
April 2015: JAMA Internal Medicine
Vineet Chopra, Sushant Govindan, Latoya Kuhn, David Ratz, Randy F Sweis, Natalie Melin, Rachel Thompson, Aaron Tolan, James Barron, Sanjay Saint
BACKGROUND: Complications associated with central venous catheters (CVCs) increase over time. Although early removal of unnecessary CVCs is important to prevent complications, the extent to which clinicians are aware that their patients have a CVC is unknown. OBJECTIVE: To assess how often clinicians were unaware of the presence of triple-lumen catheters or peripherally inserted central catheters (PICCs) in hospitalized patients. DESIGN: Multicenter, cross-sectional study...
October 21, 2014: Annals of Internal Medicine
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