Hospital practice (1995)Pub Date : 2024-08-01Epub Date: 2024-05-27DOI: 10.1080/21548331.2024.2359363
Raghad Tambour, Malakeh Z Malak, Hadi Rabee, Zaher Nazzal, Mohammad Gharbeyah, Dina Abugaber, Ibrahim Ghoul
{"title":"A retrospective study of the predictors of mortality among patients in intensive care units at North West-Bank hospitals in Palestine.","authors":"Raghad Tambour, Malakeh Z Malak, Hadi Rabee, Zaher Nazzal, Mohammad Gharbeyah, Dina Abugaber, Ibrahim Ghoul","doi":"10.1080/21548331.2024.2359363","DOIUrl":"10.1080/21548331.2024.2359363","url":null,"abstract":"<p><strong>Objectives: </strong>The intensive care unit (ICU) mortality rate remains high, especially in developing countries, regardless of the advances in critical management. There is a lack of studies about mortality causes in hospitals and particularly ICUs in Palestine.This study evaluated the demographic and clinical characteristics of critically ill patients and determined the predictors of mortality among patients in the ICU.</p><p><strong>Methods: </strong>A retrospective study assessed all patients who stayed in the ICU for more than 24 h from January 2017 to January 2019. Data were collected from the patient's files. Patient characteristics (background, clinical variables, and comorbidities) were recorded.</p><p><strong>Results: </strong>The study included 227 eligible ICU patients. The cases' mean age was 55.5 (SD ± 18.2) years. The overall ICU mortality rate was 31.7%. The following factors were associated with high adjusted mortality odds: admission from inside the hospital (adjusted odds ratio (aOR), 2.1, 95% CI: 1.1-3.9, <i>p</i> < 0.05), creatinine level ≥2 mg/dl on admission (aOR, 2.7, 95% CI: 1.3-5.8, <i>p</i> < 0.01), hematology malignancy patients (aOR, 3.4, 95% CI: 1.6-6.7, <i>p</i> = 0.001), immune-compromised (aOR, 2.5, 95% CI: 1.3-4.7, <i>p</i> < 0.01), septic shock (aOR, 27.1, 95% CI: 7.9-88.3, <i>p</i> < 0.001), hospital-acquired infections (aOR: 13.4, 95% CI: 4.1-57.1, <i>p</i> < 0.001), and patients with multiple-source infection (aOR: 16.3, 95% CI: 6.4-57.1, <i>p</i> < 0.001). Also, high SOFA and APACHE scores predicted morality (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>The mortality rate among ICU patients was high. It was higher among those admitted from the hospital wards, septic shock, hospital-acquired infection, multiple infection sources, and multi-drug resistance infections. Thus, strategies should be developed to enhance the ICU environment and provide sufficient resources to minimize the effects of these predictors.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"105-112"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141089103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Assessment of disease pattern and drug utilization among neurology intensive care unit patients in a developing country: an observational analysis.","authors":"Mamidi Niveditha, Ruby Kasana, Amit Ranjan Barua, Mausumi Barthakur, Krishna Undela","doi":"10.1080/21548331.2024.2358747","DOIUrl":"10.1080/21548331.2024.2358747","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the disease pattern and drug utilization among admitted patients in a tertiary-care hospital's neurology intensive care unit (neuro ICU).</p><p><strong>Methods: </strong>A prospective observational cohort study was conducted between August 2022 and January 2023. Patients of any age and gender admitted to the neuro ICU were included, but those who declined to participate were excluded. Demographics, clinical, and medication details were consistently gathered and maintained until discharge. The World Health Organization (WHO)/International Network of Rational Use of Drugs (INRUD) prescribing indicators and the Anatomical Therapeutic Chemical (ATC) classification/Defined Daily Dose (DDD) system were used to evaluate drug use.</p><p><strong>Results: </strong>A total of 516 patients were included, predominantly male (65.1%), with an average age of 54.62 ± 15.02 years. The most common diagnosis was stroke [72.3%, comprised of hemorrhagic (46.7%) and ischemic (25.6%)], followed by seizure disorders (6.6%), and central nervous system infections (5.4%). Patients received an average of 7.8 medications, 32.3% prescribed by generic name, 16.0% antibiotics, 74.1% injections, and 100% essential drugs. A (28.5%), C (19.2%), N (17.3%), J (19.2%), B (13.5%), and R (2.3%) were commonly prescribed ATC classes of medications. Number of DDDs was maximum for pantoprazole and furosemide. Based on discharged status, 41.0% were discharged on request, 24.8% against medical advice, 23.8% routine, and 10.2% mortality during hospitalization.</p><p><strong>Conclusion: </strong>Our study reveals a high prevalence of hemorrhagic stroke, especially among men, diverging from global ischemic stroke trends. Irregular hypertension treatment is the primary cause, exacerbated by low healthcare knowledge in rural areas, where patients often discharge on request, probably due to poor socio-economic conditions. Urgent public awareness campaigns and further research are needed to address this elevated hemorrhagic stroke incidence.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"77-83"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141089128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hospital practice (1995)Pub Date : 2024-08-01Epub Date: 2024-08-21DOI: 10.1080/21548331.2024.2367955
Bruce C Trapnell
{"title":"Inhaled molgramostim therapy for the treatment of autoimmune pulmonary alveolar proteinosis (aPAP): a plain language summary of the IMPALA trial.","authors":"Bruce C Trapnell","doi":"10.1080/21548331.2024.2367955","DOIUrl":"10.1080/21548331.2024.2367955","url":null,"abstract":"","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"47-63"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hospital practice (1995)Pub Date : 2024-08-01Epub Date: 2024-08-05DOI: 10.1080/21548331.2024.2386924
Hannah Peters, Alex Liaukovich, Nardeen Grace, Christine Ausman, Niki Kiepek
{"title":"Opportunities to improve inpatient services and reduce rates of patient-direct discharge among people who use substances.","authors":"Hannah Peters, Alex Liaukovich, Nardeen Grace, Christine Ausman, Niki Kiepek","doi":"10.1080/21548331.2024.2386924","DOIUrl":"10.1080/21548331.2024.2386924","url":null,"abstract":"<p><strong>Purpose: </strong>Patients who use substances (PWUS) report experiencing stigmatizing encounters and undertreatment of pain and withdrawal symptoms that increase the likelihood of patient-directed discharge (PDD). This scoping review examines North American literature to gain insights about how institutional factors intersect with patient experiences and contribute to PDD.</p><p><strong>Methods: </strong>A scoping review was conducted using MEDLINE, CINAHL, Scopus, and EMBASE databases. Screening was completed by two reviewers. A data extraction tool developed by the research team was used to collect demographic information and explore patients' experiences and reasons for PDD.</p><p><strong>Results: </strong>We present four themes related to PDD: i) effective management of pain and withdrawal symptoms, ii) therapeutic alliance with healthcare providers, iii) hospital policies, protocols, and procedures, and iv) recommendations. Notably, all patients in all qualitative studies reported predominant experiences of uncaring, stigmatizing interactions with healthcare providers.</p><p><strong>Discussion: </strong>Findings suggest that transformations are required at individual and institutional levels. At an individual level, to provide equitable care to all patients, healthcare providers in all practice settings should be competent to effectively and compassionately care for PWUS. At an institutional level, policies need to be re-envisioned to support the implementation of effective practices.</p><p><strong>Conclusion: </strong>Hospitals are faced with the challenges to ensure respectful care environments guided by harm reduction policies that will improve engagement of PWUS in services.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"64-76"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Integrating family caregivers in older adults' hospital stays: a needed cultural shift.","authors":"Chloe Muntefering, Amanda Kastrinos, Natalie S McAndrew, Madelyn Ahrens, Allison J Applebaum, Lauren Bangerter, Beth Fields","doi":"10.1080/21548331.2024.2357510","DOIUrl":"10.1080/21548331.2024.2357510","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to examine perceived barriers and facilitators to caregiver inclusion in the hospital care of older adult family members or friends through the perspectives of (1) hospitalized older adults, (2) caregivers of a hospitalized older adult, (3) healthcare clinicians, and (4) policymakers.</p><p><strong>Methods: </strong>This qualitative descriptive exploratory study utilized semi-structured interviews with <i>N</i> = 24 participants and was analyzed using a framework method.</p><p><strong>Results: </strong>Eight codes arose that were categorized into four domains guided by the Social Ecological Model. Individual-level factors were determined both for the caregiver and for the clinician. Relationship-level factors were revealed pertaining to communication style and method. Hospital-level factors included hospital environment and resources. Societal-level factors included healthcare climate and policies.</p><p><strong>Discussion: </strong>Findings indicated that hospital workflows and policies inadequately support family caregivers. This study highlights potential solutions to caregivers' integration into hospital workflows.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"1-13"},"PeriodicalIF":0.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11579244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141065552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hospital practice (1995)Pub Date : 2024-02-01Epub Date: 2024-03-05DOI: 10.1080/21548331.2024.2321824
Andrew J Quinn, Hannah Saven, Rozina Haile, Seung Jae Moon, April Lee, Savanna Thor
{"title":"Inappropriate use of proton pump inhibitors in hospitalized patients with lower gastrointestinal bleeding.","authors":"Andrew J Quinn, Hannah Saven, Rozina Haile, Seung Jae Moon, April Lee, Savanna Thor","doi":"10.1080/21548331.2024.2321824","DOIUrl":"10.1080/21548331.2024.2321824","url":null,"abstract":"<p><strong>Objectives: </strong>Use of proton pump inhibitors (PPIs) is a mainstay in treating upper gastrointestinal bleeding (UGIB). However, the beneficial effects of PPIs are not anticipated to extend beyond the duodenum and may actually contribute to the risk of lower gastrointestinal bleeding (LGIB). However, in practice, PPIs are often used for inpatients with LGIB where no benefit exists.</p><p><strong>Methods: </strong>A retrospective chart review was performed on inpatients during a 2-year period at an urban academic teaching hospital. Inpatients with consults to the gastroenterology (GI) service with confirmed or highly suspected LGIB were included. Outcomes regarding PPI use and the GI consulting service recommendations in these 225 patients were evaluated.</p><p><strong>Results: </strong>About 37.8% of patients were started on a PPI during their inpatient course. Of those, 46% patients started on a PPI had no indication for PPI and 85% had no recommendation by the GI consultants to start a PPI. Of the 85 patients started on PPI, the GI consultants recommended stopping it in two (2.3%) patients. Lastly, 20 patients (9%) were discharged on PPI without an indication for PPI.</p><p><strong>Conclusion: </strong>To our knowledge, this is the first study that looked at the inappropriate utilization of PPIs in patients admitted for LGIBs utilizing GI consultant recommendations. Given the large proportion of patients started on PPI without a clinical indication and continued at discharge and the paucity of GI recommendations to discontinue inappropriate use, we found that clinical care may be improved with formal GI recommendations regarding use of PPI.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"19-22"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139973816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hospital practice (1995)Pub Date : 2024-02-01Epub Date: 2024-03-04DOI: 10.1080/21548331.2024.2320069
Steven G Chrysant
{"title":"Effects of physical activity on sleep quality and wellbeing.","authors":"Steven G Chrysant","doi":"10.1080/21548331.2024.2320069","DOIUrl":"10.1080/21548331.2024.2320069","url":null,"abstract":"<p><p>Physical activity (PA) has pluripotential beneficial effects on body functions. These benefits include reduction in the incidence of cardiovascular disease (CVD), coronary heart disease (CHD), hypertension, type 2 diabetes mellitus (T2DM), and death. In addition to these effects, PA exerts significant beneficial effects on sleep onset, duration and quality, which add to its beneficial effects. In contrast, lack of sleep has been associated with increased incidence of CVD complications and death. In this regard, PA serves as a non-pharmacologic means for sleep improvement especially in older people, who frequently have difficulties in falling asleep. Regarding the timing of exercise and its effect on sleep, there has been no difference between morning and evening exercise on the onset and quality of sleep. With respect the beneficial cardiovascular effects of PA on sleep, there has been a debate among several investigators with some reporting significant beneficial effects of PA, and others reporting not significant beneficial effects. In order to get a better perspective on the effects of PA on quality of sleep, and its cardiovascular beneficial effects, a Medline search of the English literature was conducted between 2017 and 2023 using the terms exercise, sleep, cardiovascular disease, death and 36 pertinent papers were selected (Figure 1). The findings from these papers together with collateral literature will be discussed in this review.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"13-18"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139973815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hospital practice (1995)Pub Date : 2024-02-01Epub Date: 2024-05-07DOI: 10.1080/21548331.2024.2348990
Thomas Edmiston, Kittane Vishnupriya, Arjun Chanmugam
{"title":"Recurrent acute pancreatitis: a harbinger for irreversible chronic pancreatitis.","authors":"Thomas Edmiston, Kittane Vishnupriya, Arjun Chanmugam","doi":"10.1080/21548331.2024.2348990","DOIUrl":"10.1080/21548331.2024.2348990","url":null,"abstract":"<p><p>Recurrent acute pancreatitis is beginning to be recognized as an intermediary stage in the continuous spectrum between acute and chronic pancreatitis. It is crucial to identify this disease stage and intervene with diagnostic and therapeutic modalities to prevent the painful and irreversible condition of chronic pancreatitis. We review the recent advances in diagnosing and managing this important 'call for action' condition.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"5-12"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Implementation of a multi-modal intervention adopting new technologies, clinical services, and feedback improves catheter-associated urinary tract infections.","authors":"Lauren Fish, Rachael Heathers, Micah Litherland, Molly Jung, Kalvin Yu","doi":"10.1080/21548331.2024.2335099","DOIUrl":"10.1080/21548331.2024.2335099","url":null,"abstract":"<p><strong>Objectives: </strong>Catheter-associated urinary tract infections (CAUTI) are a significant cause of morbidity and financial burden to healthcare systems. The aim of this study was to develop and implement a program designed to reduce Foley catheter use days and associated CAUTI rates.</p><p><strong>Methods: </strong>A retrospective evaluation of a multi-modal program aimed toward reducing Foley catheter use days and associated CAUTI rates across the Indiana University Health (IUH) system was conducted. IUH is comprised of 16 hospitals and 2,703 available beds. The program included the adoption of new technologies with evidence-based clinical training materials based on change management and feedback from clinicians. National Healthcare Safety Network Standardized Infection Ratio (SIR), Standardized Utilization Ratio (SUR), and Incidence Density Ratio (IDR) rates were assessed.</p><p><strong>Results: </strong>Implementation of the multi-modal program resulted in a significant reduction in SIR, SUR, and IDR in the post-implementation compared to the baseline periods.</p><p><strong>Conclusions: </strong>Through CAUTI bundle workflow assessments, education, and interventions designed to standardize practice variation, the program was successfully implemented and resulted in a significant decrease in Foley Catheter use days, and associated CAUTI rates.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"34-38"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140207746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hospital practice (1995)Pub Date : 2024-02-01Epub Date: 2024-03-14DOI: 10.1080/21548331.2024.2329043
Melisa Mehmed, Ben Walters, Heather Keys, Pann Ei Hnynn Si, Nandkishor Athavale, Ahmed H Abdelhafiz
{"title":"Spontaneous retropharyngeal abscess presenting as delirium in a frail older woman: a case-based review.","authors":"Melisa Mehmed, Ben Walters, Heather Keys, Pann Ei Hnynn Si, Nandkishor Athavale, Ahmed H Abdelhafiz","doi":"10.1080/21548331.2024.2329043","DOIUrl":"10.1080/21548331.2024.2329043","url":null,"abstract":"<p><strong>Introduction: </strong>Retropharyngeal abscess (RPA) is an uncommon infection in older people, which usually presents with localized upper airway symptoms.</p><p><strong>Case presentation: </strong>We present a case of RPA in a 69-year-old frail woman with co-morbidities, who presented atypically with delirium. She initially complained of general symptoms of malaise, body aches and general decline. Her symptoms progressed to hypoactive delirium before she started to localize her complaints to the upper airway. The delirium presentation of RPA is not commonly reported in the literature. Co-morbidities and frailty are likely to be the underlying risk factors for delirium presentation in this case. Most of the RPA cases reported in older people in the literature presented typically with localized symptoms, however these cases had lower burden of morbidities and reported no frailty. In our case report, poor mouth hygiene and dental caries were thought to be the source of infection. Early intervention with antibiotic treatment for total of four weeks resulted in a full recovery.</p><p><strong>Conclusion: </strong>RPA may present with delirium in older people with frailty and co-morbidities. Poor oral hygiene and dental caries, if left untreated, may progress into serious deep space neck infection.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"39-45"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}