Abstract:
BACKGROUND:Experts and national regulatory bodies have deemed femoral vein catheterization (FVC) unsafe, and recommend avoiding it whenever possible. OBJECTIVE:To assess rates of catheter-related bloodstream infections (CRBI) and deep venous thrombosis (DVT) complicating FVC. DESIGN:Prospective observational cohort study. SETTING:Medical intensive care unit (MICU) of a 350-bed community teaching hospital. PATIENTS:Consecutive admissions to the MICU during 7 months. METHODS:Demographic, laboratory and Doppler ultrasound studies were collected on patients receiving large vein catheters (VC) in our MICU. Ultrasound examinations were systematically performed on the day of and 5 to 7 days after removal of FVC. RESULTS:VC were inserted in 238 (35% of) patients. Of that total, 217 catheters were in large veins (49% FVC, 38% internal jugular and 13% subclavian) for an average of 2.7 days for femoral, 5.7 days for internal jugular and 3.6 days for subclavian vein catheters. During 1200 catheter-days, no central VC CRBI was identified. Of 107 FVC, initial and follow-up Doppler studies were performed in 50 patients. A total of 97% of patients received routine thromboprophylaxis and none had a DVT. Of the 57 patients with initial but no Doppler follow-up at 5 to 7 days following removal, no patient developed clinically detected venous thromboembolism (VTE). CONCLUSION:Short-term FVC was used safely in our MICU in the setting of thromboprophylaxis. In light of its favorable safety profile for initial resuscitation of critically ill patients, it may be premature to strongly discourage FVC.
journal_name
J Hosp Medjournal_title
Journal of hospital medicineauthors
Casanegra AI,Brannan S,Dadu R,Ong P,Berner M,Spinning K,Hughes T,Marrinan G,Zinn K,Manthous Cdoi
10.1002/jhm.696subject
Has Abstractpub_date
2011-01-01 00:00:00pages
33-6issue
1eissn
1553-5592issn
1553-5606journal_volume
6pub_type
杂志文章abstract:BACKGROUND:Patient-centered care has been identified as 1 of the 6 aims for the 21st century healthcare system. The notepad is a simple tool for reminders and personal interactions. We introduced Dear Doctor (DD) notes, a bedside notepad designed to prompt patient questions and improve patient satisfaction. OBJECTIVE:...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2073
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:Mycoplasma pneumoniae is a common cause of community-acquired pneumonia in childhood. Few studies have addressed the association of antimicrobial treatment and outcomes. OBJECTIVE:To determine whether macrolide therapy is associated with improved outcomes among children hospitalized with M. pneumoniae pneum...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,多中心研究
doi:10.1002/jhm.1904
更新日期:2012-04-01 00:00:00
abstract::The objective of this study was to measure internal medicine resident engagement with an electronic medical record-based dashboard providing feedback on their use of routine laboratory tests relative to service averages. From January 2016 to June 2016, residents were e-mailed a snapshot of their personalized dashboard...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2811
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:Increased recognition of ionizing radiation risks has placed an emphasis on the appropriate use of myocardial perfusion imaging (MPI). Hospitalists frequently order MPI in the evaluation of chest pain and are thus at the forefront of its inpatient utilization. METHODS:We collected baseline figures for a gro...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2288
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:Specialty hospitals are a subset of acute-care hospitals that provide a narrower set of services than general medical hospitals (GMHs), predominantly in areas such as cardiac disease and surgery. Although specialty hospitals also advertise high patient satisfaction, this has not been examined using national ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2225
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Hospitalized patients with diabetes have experienced a disproportionate reduction in mortality over the past decade. OBJECTIVE:To examine whether this differential decrease affected all patients with diabetes, and to identify explanatory factors. DESIGN:Serial, cross-sectional observational study. SETTING...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2321
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:Sepsis, the most expensive cause of hospitalization in the United States, is associated with high morbidity and mortality. However, healthcare utilization patterns following sepsis are poorly understood. OBJECTIVE:To identify patient-level factors that contribute to postsepsis mortality and healthcare utili...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,多中心研究
doi:10.1002/jhm.2197
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:Unplanned (unexpected) transfers to the intensive care unit (ICU) are typically preceded by physiologic instability. However, trends toward instability may be subtle and not accurately reflected by changes in vital signs. The shock index (SI) (heart rate/systolic blood pressure as an indicator of left ventri...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.779
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:The National Acute Medicine Programme (NAMP) was established to address the unsatisfactory management of acutely ill medical patients in Ireland. It aimed to improve quality of care and patient safety, streamline access to healthcare, and reduce cost through efficiency gains. METHOD:A model of care was deve...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2443
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:The recent intense attention to hospital readmissions and their implications for quality, safety, and reimbursement necessitates understanding specific subsets of readmitted patients. Frequently admitted patients, defined as patients who are admitted 5 or more times within 1 year, may have some distinguishin...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2375
更新日期:2015-09-01 00:00:00
abstract::The growth of hospital medicine has led to new challenges, and recent graduates may feel unprepared to meet the expanding clinical duties expected of hospitalists. At our institution, we created a resident-inspired hospitalist curriculum to address the training needs for the next generation of hospitalists. Our progra...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2590
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Hospital leaders have had mixed success reducing readmissions Little is known about the readmitted patient's perspective. METHODS:A cross-sectional 36-item survey was administered to 1084 readmitted inpatients of The Hospital of the University of Pennsylvania (an urban academic medical center) and Penn Pres...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.1966
更新日期:2012-11-01 00:00:00
abstract::Current hospital readmission measures are part of the Centers for Medicare & Medicaid Services Five-Star Quality Rating System but are inadequate for reporting hospital quality. We review potential biases in the readmission measures and offer policy recommendations to address these biases. Hospital readmission rates a...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2799
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Academic medical centers (AMCs) have a constrained resident work force. Many AMCs have increased the use of nonresident service hospitalists to manage continued growth in clinical volume. To optimize their time in the hospital, it is important to understand hospitalists' work flow. DESIGN:We performed a tim...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.613
更新日期:2010-07-01 00:00:00
abstract::Outcomes for patients hospitalized on weekends are often worse for adults-the so-called "weekend effect." Less is known about the weekend effect for children. We examined 55,383 hospitalizations at a tertiary care children's hospital. We used logistic regression to examine the associations of weekend admission and wee...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2426
更新日期:2015-11-01 00:00:00
abstract:WHAT'S NEW:This is the first study of a pediatric hospitalist preoperative clinic. Pediatric hospitalists frequently make significant recommendations for patients with neuromuscular scoliosis prior to spinal surgery, especially those with medical complexity. Certain clinical criteria are statistically significantly ass...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2101
更新日期:2013-12-01 00:00:00
abstract::As the field of hospital medicine expands, internal medicine residency programs can play a role in preparing future hospitalists. To date, little is known of the prevalence and characteristics of hospitalist-focused resident rotations. We surveyed the largest 100 Internal Medicine Residency Programs to better understa...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2952
更新日期:2018-09-01 00:00:00
abstract::Registry data indicate a gap between evidence-based guidelines and current management of patients with acute decompensated heart failure (ADHF). Bridging this gap is crucial given the frequency and cost of hospitalization for this disorder. Patients with ADHF require rapid assessment to determine appropriate treatment...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
doi:10.1002/jhm.395
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:Hip fractures typically occur in frail elderly patients. Preoperative specialty consults, in addition to hospitalist comanagement, are often requested for preoperative risk assessment. OBJECTIVE:Determine if preoperative specialty consults meaningfully influence management and outcomes in hip fracture patie...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.3264
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Emergency department (ED) ward admissions subsequently transferred to the intensive care unit (ICU) within 24 hours have higher mortality than direct ICU admissions. DESIGN, SETTING, PATIENTS:Describe risk factors for unplanned ICU transfer within 24 hours of ward arrival from the ED. METHODS:Evaluation of...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.1979
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Obtaining blood cultures (BCs) for patients hospitalized with community-acquired-pneumonia (CAP) has been recommended by experts and used as a measure of quality of care. However, BCs are infrequently positive in these patients and their effect on clinical management has been questioned. PURPOSE:We performe...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
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更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:The affordability of prescription medications continues to be a major public health issue in the United States. Estimates of cost-related medication underuse come largely from surveys of ambulatory patients. Hospitalized patients may be vulnerable to cost-related underuse and its consequences, but have been ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.948
更新日期:2012-02-01 00:00:00
abstract::Esophageal variceal bleeding (EVB) is a frequent complication in cirrhotic patients resulting in considerable mortality and morbidity. The aim of this study was to investigate the occurrence, impact, and trends of EVB in hospitalized cirrhotic patients on a nationwide level in the United States. We interrogated data f...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2360
更新日期:2015-07-01 00:00:00
abstract::Depressive symptoms during a medical hospitalization may be an overlooked prognostic factor for adverse events postdischarge. Our aim was to evaluate whether depressive symptoms predict 30-day readmission or death after medical hospitalization. We conducted a systematic review of studies that compared postdischarge ou...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1002/jhm.2547
更新日期:2016-05-01 00:00:00
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journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.311
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:Approximately 83% of hospitalist groups around the country utilize advanced practice providers; however, the demand for hospitalists continues to exceed the supply, and this has led to increased utilization of advanced practice providers in hospital medicine. Advanced practice providers receive very limited ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.3183
更新日期:2019-06-01 00:00:00
abstract::Many hospitalists are routinely granted hospital privileges to perform invasive bedside procedures, but criteria for privileging are not well described. We conducted a survey of 21 hospitalist procedure experts from the Society of Hospital Medicine Point-of-Care Ultrasound Task Force to better understand current privi...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2837
更新日期:2017-10-01 00:00:00
abstract::Dr. Pham, a practicing general internist and health policy researcher, recalls her experience, as a granddaughter, of how patients, families, and physicians are often complicit in foiling the good coordination of care. ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.410
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Increasing use of testing among hospitalized patients has resulted in an increase in radiologic incidental findings (IFs), which challenge the provision of high-value care in the hospital setting. OBJECTIVE:To understand impact of radiologic incidental findings on resource utilization in patients hospitaliz...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2722
更新日期:2017-05-01 00:00:00
abstract::Gallstone ileus is a rare etiology of small bowel obstruction, occurring typically in the elderly population. The delay in diagnosis often results in significant morbidity and mortality. Here, we describe a case of 67 year old woman who presented with non specific abdominal symptoms and on evaluation was found to have...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.582
更新日期:2010-02-01 00:00:00