Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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Medicine procedure services (MPS) increasingly perform bedside procedures, including lumbar punctures (LPs). Success rates and factors associated with LP success performed by MPS have not been well described. ⋯ In a large cohort of patients undergoing LP by an MPS, we identified high success and low complication rates. Trainee participation was associated with increased odds of success, while obesity, prior spinal surgery, and Black race were associated with decreased odds of success. Ultrasound guidance was associated with lower odds of a traumatic LP. Our data may help proceduralists in planning and assist in shared decision-making.
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No standardized summative tools exist to assess competency in bedside procedures or provide residents and programs with summative feedback. ⋯ The PCC provided competency-based assessment of a resident's procedural skills and may be used to assess the impact of curriculum changes.
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In-hospital cardiac arrest (IHCA) with the return of spontaneous circulation (ROSC) is a clinical scenario associated with potentially devastating outcomes. ⋯ Our study demonstrated improved consistency in completing post-ROSC clinical tasks after the introduction of a post-ROSC checklist to our hospital. This work suggests that the implementation of a checklist can have meaningful impacts on task completion in the post-ROSC setting. Despite this, considerable inconsistencies in post-ROSC care persisted after the intervention indicating the limits of checklists in this setting. Future work is needed to identify interventions that can further improve post-ROSC processes of care.
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Stigma surrounding opioid use disorder (OUD) is a barrier to treatment. The use of stigmatizing language may be evidence of negative views toward patients. ⋯ Stigmatizing language was common in this study of patients hospitalized for infectious complications of OUD. Best-practice language was uncommon, but when used was associated with increased odds of addiction treatment and specialty care referrals.