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July 2015 Briefing – Critical Care

Here are what the editors at HealthDay consider to be the most important developments in Critical Care for July 2015. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

AMA Wants Doctor Input on EHRs, Meaningful Use

FRIDAY, July 31, 2015 (HealthDay News) — The American Medical Association (AMA) is encouraging clinicians to share their perspectives on electronic heath records (EHRs) and the meaningful use program.

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U.S. Health Spending Projected to Rise 5.8 Percent By 2024

FRIDAY, July 31, 2015 (HealthDay News) — From 2014 to 2024, U.S. health spending growth is projected to increase by about 6 percent, according to a report published online July 28 in Health Affairs.

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Docs Report Patient Safety Often at Risk in ER to Inpatient Handoff

THURSDAY, July 30, 2015 (HealthDay News) — Physicians report that patient safety is often at risk during the emergency department admission handoff process due to ineffective communication. The findings were published online July 22 in the Journal of Hospital Medicine.

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Early Surgery Tied to Increased Mortality in Polytraumatized

WEDNESDAY, July 29, 2015 (HealthDay News) — For polytraumatized patients, surgery for thoracic spine trauma within 72 hours of trauma is associated with increased mortality, according to a study published in the Aug. 1 issue of The Spine Journal.

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Outcomes Equal for Continuous, Intermittent β-Lactams in Sepsis

WEDNESDAY, July 29, 2015 (HealthDay News) — Continuous and intermittent administration of β-lactam antibiotics are similarly efficacious for patients with severe sepsis, according to a study published online July 22 in the American Journal of Respiratory and Critical Care Medicine.

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RAPID Score Validated for Prognosis of Pleural Infections

WEDNESDAY, July 29, 2015 (HealthDay News) — The recently developed RAPID score, which identifies the risk of mortality in patients with pleural infections based on five clinical factors, has been validated in a diverse patient cohort. The findings have been published online July 20 in the Annals of the American Thoracic Society.

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Routine Dyspnea Severity Assessment Could Aid Care

WEDNESDAY, July 29, 2015 (HealthDay News) — The majority of hospitalists believe that routinely assessing dyspnea severity would enhance their clinical decision making and positively affect patient care, according to a study published online July 20 in the Journal of Hospital Medicine.

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2015 MOC Program Expected to Cost $5.7 Billion Over 10 Years

WEDNESDAY, July 29, 2015 (HealthDay News) — The 2015 version of the American Board of Internal Medicine (ABIM) maintenance-of-certification (MOC) program is expected to generate considerable costs, mainly due to physician time costs, according to research published online July 28 in the Annals of Internal Medicine.

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Patients Report Improved Care Access, Better Health With ACA

TUESDAY, July 28, 2015 (HealthDay News) — Millions more Americans have affordable health insurance, access to a personal doctor, and feel they are in better health following the first two open-enrollment periods of the Affordable Care Act (ACA), a new analysis shows. The results are published in the July 28 issue of the Journal of the American Medical Association.

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2008 Initiative Had Minimal Impact on Pressure Ulcer Charges

TUESDAY, July 28, 2015 (HealthDay News) — The 2008 Hospital-Acquired Conditions Initiative (HACI) payment changes for pressure ulcers have had a minimal effect, according to a study published in the July issue of the Journal of the American Geriatrics Society.

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Neonatal Intensive Care May Be Overused

MONDAY, July 27, 2015 (HealthDay News) — More infants are being treated in neonatal intensive care units at many U.S. hospitals, and the infants are bigger and less premature, suggesting potential overuse of the resource, according to a study published online July 27 in JAMA Pediatrics.

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Delays Noted in the Reporting of Serious Patient Harms to FDA

MONDAY, July 27, 2015 (HealthDay News) — About 10 percent of cases where a drug does serious harm are not reported to the U.S. Food and Drug Administration within the required 15-day period, according to a new analysis published online July 27 as a research letter in JAMA Internal Medicine.

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One-Third of Septic Shock Survivors Readmitted

MONDAY, July 27, 2015 (HealthDay News) — About one-third of survivors of sepsis or septic shock are readmitted within 30 days, according to a study published online July 20 in the Journal of Hospital Medicine.

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Expansion of High-Deductible Plans to Impact Physician Care

FRIDAY, July 24, 2015 (HealthDay News) — As a result of the increasing popularity of high-deductible health care plans, patients now have more financial responsibility for medical services, which is impacting physician practices, according to an article published in Medical Economics.

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Adherence to Stroke Guidelines Overestimated by Hospitals

THURSDAY, July 23, 2015 (HealthDay News) — Many U.S. hospitals overestimate their ability to provide fast delivery of tissue plasminogen activator (tPA) to stroke patients, according to a study published online July 22 in the Journal of the American Heart Association.

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Pharmacological Prophylaxis Doesn’t Cut VTE in Cirrhosis

THURSDAY, July 23, 2015 (HealthDay News) — Pharmacological thromboprophylaxis does not reduce the risk of venous thromboembolism (VTE) in patients with cirrhosis, according to a study published in the July issue of the Journal of Thrombosis and Haemostasis.

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Fluoroquinolones Halt Multidrug-Resistant-TB in Contacts

THURSDAY, July 23, 2015 (HealthDay News) — For contacts of individuals with multidrug-resistant tuberculosis (MDR-TB), fluoroquinolone (FQN) therapy is associated with health system savings and reduced mortality, according to a study published in the July 15 issue of the American Journal of Respiratory and Critical Care Medicine.

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Targeted Prophylaxis Effective in Post-Prostate Biopsy Sepsis

TUESDAY, July 21, 2015 (HealthDay News) — For patients undergoing transrectal prostate biopsy, targeted prophylaxis is similarly effective to empirical prophylaxis for prevention of post-biopsy sepsis, according to a study published in the August issue of The Journal of Urology.

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Inadequate Adherence for Proper Removal of Protective Gear

TUESDAY, July 21, 2015 (HealthDay News) — Many health care workers do not remove personal protective equipment (PPE) correctly, according to a brief report published in the July 1 issue of the American Journal of Infection Control.

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The Top Five Unnecessary Tests, Treatments in Newborn Medicine

MONDAY, July 20, 2015 (HealthDay News) — The top five unnecessary tests and treatments have been identified in newborn medicine, according to an article published online July 20 in Pediatrics.

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Macrolide-Resistant M. pneumoniae in All U.S. Regions

MONDAY, July 20, 2015 (HealthDay News) — Macrolide-resistant Mycoplasma pneumoniae (MRMP) has a prevalence of 13.2 percent in a sample of M. pneumoniae-positive specimens from six locations in the United States, according to a study published in the August issue of the U.S. Centers for Disease Control and Prevention’s Emerging Infectious Diseases.

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Intervention Can Improve Appropriateness of Telemetry Use

MONDAY, July 20, 2015 (HealthDay News) — A hospitalist-driven intervention to improve appropriate use of telemetry can reduce length of stay and costs, according to a study published online July 7 in the Journal of Hospital Medicine.

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U.S. E. coli O157 Outbreaks Mainly Due to Food

FRIDAY, July 17, 2015 (HealthDay News) — Outbreaks of Shiga toxin-producing bacterium Escherichia coli O157 infection are mainly caused by food, especially beef and leafy vegetables, according to a study published in the August issue of the U.S. Centers for Disease Control and Prevention’s Emerging Infectious Diseases.

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CMS May Adopt Doctors’ Calls for End-of-Life Counseling

FRIDAY, July 17, 2015 (HealthDay News) — A proposed rule from the Centers for Medicare & Medicaid Services (CMS) would implement physicians’ calls to pay for end-of-life counseling, according to a report published by the American Medical Association (AMA).

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Clinicians May Harbor Biases About Sexual Orientation

FRIDAY, July 17, 2015 (HealthDay News) — Clinicians may be biased when it comes to the sexual orientation of patients, new research suggests. The study was published online July 16 in the American Journal of Public Health.

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Choosing Wisely: How to Implement in Clinical Practice

THURSDAY, July 16, 2015 (HealthDay News) — Strategies should be adopted to help with implementation of the Choosing Wisely program, which was designed to address the problem of medical overuse, according to an article published in the July/August issue of Family Practice Management.

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Considerable Burden for Community-Acquired Pneumonia

WEDNESDAY, July 15, 2015 (HealthDay News) — The annual incidence of community-acquired pneumonia requiring hospitalization is 24.8 cases per 10,000 adults, according to a study published online July 14 in the New England Journal of Medicine.

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High Doses of Antibiotic Ups Risk of Over-Anticoagulation

WEDNESDAY, July 15, 2015 (HealthDay News) — Among hospitalized patients, high-dose amoxicillin/clavulanate correlates with increased risk of over-anticoagulation when combined with warfarin, according to a study published online July 2 in the Journal of Clinical Pharmacology.

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Arts Observation Curriculum May Be Beneficial for Medical Students

TUESDAY, July 14, 2015 (HealthDay News) — Use of an arts observation curriculum can help students learn to observe objectively and articulate their observations, which are important traits for clinical practice, according to an article published online July 3 in Academic Medicine.

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Progress in Reporting Conflict of Interest Among IRB Members

TUESDAY, July 14, 2015 (HealthDay News) — Among institutional review board (IRB) members, there has been positive progress in the reporting and management of conflicts of interest, according to a study published online July 13 in JAMA Internal Medicine.

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Weekend Discharge Not Linked to Increased Readmission

FRIDAY, July 10, 2015 (HealthDay News) — For patients with acute myocardial infarction (AMI), congestive heart failure (CHF), and pneumonia, weekend discharge is not associated with 30-day readmission, according to a study published online June 30 in the Journal of Hospital Medicine.

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Uric Acid Therapy Improves Stroke Outcomes in Women

FRIDAY, July 10, 2015 (HealthDay News) — Uric acid (UA) therapy, administered in combination with thrombolysis, is more effective in cutting stroke-related disability in women than in men, according to a study published online July 9 in Stroke.

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ECG Metrics May Predict Cardiac Deaths in CKD Patients

FRIDAY, July 10, 2015 (HealthDay News) — Certain electrocardiographic (ECG) measures may improve prediction of cardiovascular death in patients with chronic kidney disease (CKD), according to research published online July 9 in the Journal of the American Society of Nephrology.

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Court Upholds Medical Liability Damages Cap

TUESDAY, July 7, 2015 (HealthDay News) — The non-economic damages cap under the Medical Injury Compensation Reform Act (MICRA) has been upheld again in a California court of appeal, according to a report published by the American Medical Association.

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Despite Risk to Patients, Health Providers Often Work While Sick

MONDAY, July 6, 2015 (HealthDay News) — Many health care professionals work when they are sick, putting their patients at risk for serious illness or even death, according to a study published online July 6 in JAMA Pediatrics.

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Health Professionals May View Family-Witnessed CPR Negatively

THURSDAY, July 2, 2015 (HealthDay News) — Jordanian health care professionals are against family-witnessed resuscitation in adult critical care settings, according to a study published online June 22 in the Journal of Clinical Nursing.

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Regional Variation in Treatment of Ischemic Stroke

THURSDAY, July 2, 2015 (HealthDay News) — There is considerable regional variation in thrombolysis treatment for ischemic stroke, according to a study published online June 2 in Stroke.

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IOM: Make CPR Mandatory High School Requirement

WEDNESDAY, July 1, 2015 (HealthDay News) — Far too few Americans are surviving cardiac arrest, and a new report issued Tuesday by the Institute of Medicine (IOM) offers strategies to boost survival rates.

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Residents’ Knowledge of High-Value Care Varies

WEDNESDAY, July 1, 2015 (HealthDay News) — U.S. internal medicine (IM) residents report varying knowledge and practice of high-value care (HVC), according to research published online June 16 in Academic Medicine.

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Public Opinion Sought on New Licensure for Assistant Physicians

WEDNESDAY, July 1, 2015 (HealthDay News) — New classification of licensure for assistant physicians has been created, and public opinion is being sought by the Missouri State Board of Registration for the Healing Arts prior to filing these rules with the Secretary of State’s Office and the Joint Committee on Administrative Rules.

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