scholarly journals Implementing an Evidence-Based Practice Change for Alcohol Withdrawal in an Acute Care Hospital

2021 ◽  
Author(s):  
◽  
Theresa Carroll
Keyword(s):  
At Risk ◽  
Acute Care ◽  
Alcohol Withdrawal ◽  
Acute Care Hospital ◽  
The United States ◽  
Withdrawal Symptoms ◽  
Evidence Based ◽  
Care Hospital ◽  
Standard Facility ◽  
Patients At Risk

Practice Problem: Alcohol Use Disorders (AUD) affects a significant portion of the population in the United States. When AUD is either unrecognized or inadequately treated in the acute care setting it can lead to medical complications, increased length or stay (LOS), increased healthcare expense, and increased patient mortality. PICOT: In a population of adult patients admitted to an acute care hospital progressive care unit (P), how does applying an initial evidence-based screening tool to detect risk for moderate to severe alcohol withdrawal, the PAWSS (I), compare to no standard screening or assessment for potential alcohol withdrawal symptoms (C) affect the occurrence of patient deterioration for acute alcohol withdrawal symptoms (O) within an eight week timeframe (T)? Intervention: The PAWSS tool was utilized to screen all patients admitted to the progressive care unit. Patients identified at moderate to severe risk by a score of ≥4 were treated according to the standard facility practice with included CIWA-Ar monitoring and medication management with benzodiazepine medication. Outcome: The project was able to demonstrate a significant decrease in the mean LOS for those patients identified at risk and treated for AWS, with an average decrease of 50 hours in length of stay for those patients treated during the project implementation. Conclusion: Early recognition of patients at risk for AWS is an important component of effective management and treatment. Further study is needed into best practices for treatment of patients at risk, and internal compliance measures within the organization.

scholarly journals Estimated annual numbers of US acute-care hospital patients at risk for venous thromboembolism

2007 ◽  
Vol 82 (9) ◽  
pp. 777-782 ◽  
Author(s):  
Frederick A. Anderson ◽  
Maxim Zayaruzny ◽  
John A. Heit ◽  
Dogan Fidan ◽  
Alexander T. Cohen
Keyword(s):  
At Risk ◽  
Venous Thromboembolism ◽  
Acute Care ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Hospital Patients ◽  
Patients At Risk

Clean or sterile technique when inserting indwelling urinary catheter: An evaluation of nurses’ and assistant nurses’ interpretations of a guideline at an acute-care hospital in Sweden

2018 ◽  
Vol 39 (2) ◽  
pp. 92-97
Author(s):  
Aysel Kulbay ◽  
Ann Tammelin
Keyword(s):  
Urinary Bladder ◽  
Acute Care ◽  
Urinary Catheter ◽  
Acute Care Hospital ◽  
Evidence Based ◽  
Urinary Catheterization ◽  
Care Hospital ◽  
Urinary Catheters ◽  
Sterile Technique ◽  
Assistant Nurses

Insertion of indwelling urinary catheters should be performed in a way that minimizes the risk of introducing bacteria to the urinary bladder. Nurses and assistant nurses from three departments at an acute-care hospital in Sweden answered a questionnaire about their insertion of urinary catheterization. Of the 563 nurses, 92% answered the questionnaire. Among the 492 who performed catheterization, 58% ( n = 287) said that they followed the hospital guideline. Two-thirds of those following the hospital guideline said that they used clean technique and one-third sterile technique. In all, 82% considered the catheter should be kept sterile while inserted but only 16% described all the prerequisites to achieve this. Over 90% of the respondents performed catheterization less than once a week. Our conclusion is that a guideline should describe every step of catheterization in detail and that an evidence-based process for implementation of the guideline is necessary to achieve uniformity in performance.

scholarly journals Epidemiology of Clostridium difficile Infection

2013 ◽  
Vol 26 (5) ◽  
pp. 464-475 ◽  
Author(s):  
Daryl D. DePestel ◽  
David M. Aronoff
Keyword(s):  
Clostridium Difficile ◽  
Acute Care ◽  
Clostridium Difficile Infection ◽  
Hospital Setting ◽  
Acute Care Hospital ◽  
Disease Recurrence ◽  
The United States ◽  
Care Hospital ◽  
Term Care ◽  
Populations At Risk

There has been dramatic change in the epidemiology of Clostridium difficile infection (CDI) since the turn of the 21st century noted by a marked increase in incidence and severity, occurring at a disproportionately higher frequency in older patients. Historically considered a nosocomial infection associated with antibiotic exposure, CDI has now also emerged in the community in populations previously considered low risk. Emerging risk factors and disease recurrence represent continued challenges in the management of CDI. The increased incidence and severity associated with CDI has coincided with the emergence and rapid spread of a previously rare strain, ribotype 027. Recent data from the United States and Europe suggest that the incidence of CDI may have reached a crescendo in the recent years and is perhaps beginning to plateau. The acute care direct costs of CDI were estimated to be US$4.8 billion in 2008. However, nearly all the published studies have focused on CDI diagnosed and treated in the acute care hospital setting and fail to measure the burden outside the hospital, including recently discharged patients, outpatients, and those in long-term care facilities. Enhanced surveillance methods are needed to monitor the incidence, to identify populations at risk, and to characterize the molecular epidemiology of strains causing CDI.

Sharp-Device Injuries to Hospital Staff Nurses in 4 Countries

2007 ◽  
Vol 28 (4) ◽  
pp. 473-478 ◽  
Author(s):  
Sean P. Clarke ◽  
Maria Schubert ◽  
Thorsten Körner
Keyword(s):  
United States ◽  
Acute Care ◽  
Acute Care Hospital ◽  
Hospital Staff ◽  
The United States ◽  
Staff Nurses ◽  
Care Hospital ◽  
Injury Rates ◽  
The Past ◽  
Hospital Staff Nurses

Objective.To compare sharp-device injury rates among hospital staff nurses in 4 Western countries.Design.Cross-sectional survey.Setting.Acute-care hospital nurses in the United States (Pennsylvania), Canada (Alberta, British Columbia, and Ontario), the United Kingdom (England and Scotland), and Germany.Participants.A total of 34,318 acute-care hospital staff nurses in 1998-1999.Results.Survey-based rates of retrospectively-reported needlestick injuries in the previous year for medical-surgical unit nurses ranged from 146 injuries per 1,000 full-time equivalent positions (FTEs) in the US sample to 488 injuries per 1,000 FTEs in Germany. In the United States and Canada, very high rates of sharp-device injury among nurses working in the operating room and/or perioperative care were observed (255 and 569 injuries per 1,000 FTEs per year, respectively). Reported use of safety-engineered sharp devices was considerably lower in Germany and Canada than it was in the United States. Some variation in injury rates was seen across nursing specialties among North American nurses, mostly in line with the frequency of risky procedures in the nurses' work.Conclusions.Studies conducted in the United States over the past 15 years suggest that the rates of sharp-device injuries to front-line nurses have fallen over the past decade, probably at least in part because of increased awareness and adoption of safer technologies, suggesting that regulatory strategies have improved nurse safety. The much higher injury rate in Germany may be due to slow adoption of safety devices. Wider diffusion of safer technologies, as well as introduction and stronger enforcement of occupational safety and health regulations, are likely to decrease sharp-device injury rates in various countries even further.

Admission Surveillance for Carbapenamase-Producing Enterobacteriaceae at a Long-Term Acute Care Hospital

2013 ◽  
Vol 34 (8) ◽  
pp. 832-834 ◽  
Author(s):  
Jessica D. Lewis ◽  
Matthew Bishop ◽  
Brenda Heon ◽  
Amy J. Mathers ◽  
Kyle B. Enfield ◽  
...  
Keyword(s):  
United States ◽  
Prospective Study ◽  
Acute Care ◽  
Acute Care Hospital ◽  
Acute Care Hospitals ◽  
The United States ◽  
Routine Screening ◽  
Care Hospital ◽  
High Prevalence

Carbapenemase-producing Enterobacteriaceae (CPE) are of increasing prevalence worldwide, and long-term acute care hospitals (LTACHs) have been implicated in several outbreaks in the United States. This prospective study of routine screening for CPE on admission to a LTACH demonstrates a high prevalence of CPE colonization in central Virginia.

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