Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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Inpatient hyperglycemia in adult patients with and without a history of diabetes is a predictor of poor clinical outcome. No previous studies, however, have examined the association of hyperglycemia and clinical outcome in children admitted to a community pediatric hospital. ⋯ Hyperglycemia is present in one-fourth of children admitted to the hospital, most of them without a history of diabetes prior to admission. Hyperglycemia was associated with a greater need for ICU care and longer ICU stay but not with increased in-hospital mortality.
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The use of specialized orthopedic surgery (SOS) units in total knee arthroplasty (TKA) patients is well established. The number and costs of arthoplasty surgeries continue to increase, requiring institutions to reexamine their existing practices for financial sustainability. ⋯ Patients on SOS units following elective TKA have a reduced LOS and decreased total and hospital costs. Our results should encourage hospitals to reevaluate postoperative patient flow to optimize resource utilization.
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The "Swiss cheese model" of systems accidents is commonly applied to patient safety, implying that many "holes" must align before an adverse event occurs. The Accreditation Council for Graduate Medical Education (ACGME) instituted work hour limitations to fill one such hole by reducing resident fatigue. ⋯ Our focus group participants perceived that the ACGME work hour limitations had minimized the impact of resident fatigue on patient care errors. Other contributors to errors remained and were often exacerbated by methods to maintain compliance with the rules.
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The purpose of the study was to investigate the prevalence of smoking among health care workers (HCWs) at King Hussein Medical Center (KHMC), the biggest tertiary-care center in Jordan. ⋯ Our results showed a very high percentage of cigarette smoking among HCWs at KHMC. Smoking cessation programs should be introduced among Jordanian physicians.
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Specialist care has been shown to improve outcomes for several complex medical conditions. For patients with ischemic stroke, prior studies have suggested that admission to the care of neurologists is associated with better outcomes, but these studies may have incompletely controlled for confounding prognostic differences. ⋯ Differences in ischemic stroke outcomes between neurologists and generalists may be a result of differences in initial prognosis because outcomes are no better at hospitals that admit patients to the care of neurologists more frequently.