J. Rush Pierce Jr., MD, MPH Archives

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Does Preoperative Hypercapnia Predict Postoperative Complications in Patients with Obstructive Sleep Apnea?
June 10, 2016
Clinical question: Are patients with obstructive sleep apnea (OSA) and preoperative hypercapnia more likely to experience postoperative complications than those without? Background: Obesity hypoventilation syndrome (OHS) is known to increase medical morbidity in patients with OSA, but its impact
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Rapid Immunoassays for Heparin-Induced Thrombocytopenia Offer Fast Screening Possibilities
June 10, 2016
Clinical question: How useful are rapid immunoassays (RIs) compared to other tests for heparin-induced thrombocytopenia (HIT)? Background: HIT is a clinicopathologic diagnosis, which traditionally requires clinical criteria and laboratory confirmation through initial testing with enzyme-linked im
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Impact of Delayed Discharge Summary Completion on Hospital Readmission
June 8, 2016
Clinical question: Is a delay in completion of hospital discharge summary associated with hospital readmissions? Background: Inpatient discharge summaries serve as a communication tool to future care providers.
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Effects of Assigning Medical Teams to Nursing Units on Patient Care
June 8, 2016
Clinical question: Does assigning a single medical team to a nursing unit (regionalizing) improve communication and prevent adverse events? Background: Many factors impact communication in healthcare delivery. Failures in communication are a known source of adverse events in hospital care.
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Troponin Leak Portends Poorer Outcomes in Congestive Heart Disease Hospitalizations
June 6, 2016
Clinical question: What is the association between detectable cardiac troponin (cTn) levels and outcomes in persons hospitalized with acute decompensated heart failure (ADHF)? Background: There are millions of ADHF hospitalizations per year, and all-cause mortality and readmission rates are high.
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New Guidelines for Cardiovascular Imaging in Chest Pain
June 6, 2016
Clinical question: Which cardiovascular imaging modalities can augment triage of ED patients with chest pain? Background: Because absolute event rates for patients with chest pain and normal initial ECG findings are not low enough to drive discharge triage decisions, and findings that patients wi
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Hospitalist Quality Improvement Initiative Reduces Inpatient Laboratory Costs
June 5, 2016
Clinical question: Will a multifaceted quality improvement initiative targeted at hospitalists reduce inpatient laboratory costs? Background: Routine inpatient laboratory testing is a well-recognized area of healthcare waste and was highlighted by the American Board of Internal Medicine Choosing
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Discharge Planning Reduces Length of Stay in Elderly Patients Admitted with Medical Illnesses
June 5, 2016
Clinical question: Does discharge planning improve length of stay and reduce readmission rates compared to usual care? Background: Discharge planning is accomplished to varying degrees for patients admitted to an acute-care hospital.
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Enhancing Mobility Reduces Length of Stay
June 3, 2016
Clinical question: Can a nurse-driven early ambulation program aimed at all hospitalized adults increase patient mobility and decrease length of stay? Background: Many adults experience decline of functional abilities during their hospitalization.
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Can Sepsis Be Better Defined?
June 3, 2016
Clinical question: Given advances in the understanding and treatment of sepsis, can sepsis be better defined? Background: Definitions of sepsis and septic shock were last revised in 2001.