News
Discontinuation of Beta Blockers Increases Risk of Postoperative Myocardial Infarction and Death
October 27, 2014
Clinical question: Does perioperative beta-blocker discontinuation affect postoperative myocardial infarction (MI) in low-risk patients undergoing joint arthroplasty? Background: Recent trials show no benefit of perioperative beta blockers in reducing the incidence of perioperative myocardial inf
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Cancer Guideline for VTE Prophylaxis for Inpatients and Long-Term Treatment With Low-Molecular-Weight Heparin for Acute VTE
October 27, 2014
Clinical question: On what aspects of VTE management in cancer patients are there consensus among the major guideline panels? Background: VTE is a common and serious complication of cancer.
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Trauma Patients with Pulmonary Embolism Might Not Have DVT on Imaging of Lower Extremities
October 27, 2014
Clinical question: What is the relationship between acute DVT and pulmonary embolism (PE) in trauma patients? Background: Major trauma is associated with an increased risk of acute DVT and PE. It is assumed that the majority of PEs arise from DVTs in the lower extremities.
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Eliminating Adverse Events and Redundant Tests Could Generate U.S. Healthcare Savings
October 27, 2014
Clinical question: Using available data, what is the estimated cost savings of eliminating adverse events and avoiding redundant tests? Background: Reimbursement schemes are changing such that hospitals are reimbursed less for some adverse events.
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High Perioperative Oxygen Fraction Does Not Improve Surgical-Site Infection Frequency after Abdominal Surgery
October 27, 2014
Clinical question: Does the use of 80% oxygen perioperatively in abdominal surgery decrease the frequency of surgical-site infection within 14 days without increasing the rate of pulmonary complications? Background: Low oxygen tension in wounds can negatively impact immune response and healing.
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News
Short Course of Oral Antibiotics Effective for Acute Osteomyelitis and Septic Arthritis in Children
October 27, 2014
By Mark Shen, MD Reviewed by Pediatric Editor Mark Shen, MD, medical director of hospital medicine at Dell Children’s Medical Center, Austin, Texas. Clinical question: Is a short course (less than four weeks) of antibiotics effective for the treatment of acute osteomyelitis and septic arthritis?
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Computer-Based Reminders Have Small to Modest Effect on Care Processes
October 27, 2014
Clinical question: Do on-screen, computer-based clinical reminders improve adherence to target processes of care or clinical outcomes? Background: Gaps between practice guidelines and routine care are caused, in part, by the inability of clinicians to access or recall information at the point of
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Patient Participation in Medication Reconciliation at Discharge Helps Detect Prescribing Discrepancies
October 27, 2014
Clinical question: Does the inclusion of a medication adherence counseling session during a hospital discharge reconciliation process reduce discrepancies in the final medication regimen? Background: Inadvertent medication prescribing errors are an important cause of preventable adverse drug even
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Negative D-Dimer Test Can Safely Exclude Pulmonary Embolism in Patients at Low To Intermediate Clinical Risk
October 27, 2014
Clinical question: In patients with symptoms consistent with pulmonary embolism (PE), can evaluation with a clinical risk assessment tool and D-dimer assay identify patients who do not require CT angiography to exclude PE? Background: D-dimer is a highly sensitive but nonspecific marker of VTE, a
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Patient Signout Is Not Uniformly Comprehensive and Often Lacks Critical Information
October 27, 2014
Clinical question: Do signouts vary in the quality and quantity of information, and what are the various factors affecting signout quality? Background: Miscommunication during transfers of responsibility for hospitalized patients is common and can result in harm.
