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October 2015 Briefing – Critical Care

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Here are what the editors at HealthDay consider to be the most important developments in Critical Care for October 2015. This roundup includes the...
For patients with acute myocardial infarction

Part D Enrollment Doesn’t Improve Outcomes After AMI

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Half of AMI patients enrolled in Part D by hospital discharge; outcomes no better than non-enrollees
Patients' reasons for returning to the emergency department after discharge from an internal medicine unit include being discharged too soon and feeling weak

Patients’ Reasons for Returning to ER Differ From Predicted

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Reasons differ from those predicted by the liaison nurse clinician's evaluation
A checklist-based bedside physical examination in the intensive care unit is suggested as clinically useful in spite of a lack of evidence demonstrating this

Value of Bedside Exam for ICU Patients Discussed

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Despite lack of evidence, authors recommend use of checklist-based bedside examination
Markets with greater increases in physician-hospital integration show greater increases in spending for outpatient care

Outpatient Spending Higher With Physician-Hospital Integration

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Authors say increased spending attributable to price increases, not utilization changes
The application of failure mode and effective analysis correlates with increased awareness of medical errors in the pediatric intensive care unit

‘Failure Mode and Effective Analysis’ Ups Error Awareness

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Increase in reported errors, reduction in severity of errors with application of FMEA in PICU
For patients with poor-prognosis cancer

Time-Limited Strategies Feasible for ICU Critical Cancer Care

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For patients with poor-prognosis solid tumors, trial duration of one to four ICU days may be sufficient
Intrinsic qualities of safety-net hospitals

Safety-Net Hospitals Have Higher Costs, Worse Outcomes

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Found to have higher mortality, readmission, surgical costs after controlling for patient factors
More nurses and electronic medical records can help hospitals overcome the "weekend effect" associated with urgent general surgery procedures performed on weekends

Hospital Factors Can Overcome ‘Weekend Effect’

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Improved staffing; electronic records; additional inpatient, aftercare resources help
Newborns with neonatal abstinence syndrome are more likely to be readmitted to the hospital than those without the condition

Hospital Readmissions Up in Neonatal Abstinence Syndrome

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Withdrawal most common reason for infants' readmission to the hospital