Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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GUIDELINE TITLE: (1) Measles (Rubeola): For Healthcare Professionals and (2) Interim Infection Prevention and Control Recommendations for Measles in Healthcare Settings RELEASE DATE: (1) February 5, 2018, and (2) July 2019 PRIOR VERSION(S): n/a DEVELOPER: Centers for Disease Control and Prevention (CDC) FUNDING SOURCE: CDC TARGET POPULATION: Children and adults with suspected or confirmed measles.
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Previous local quality improvement focused on discharging patients with inhaled corticosteroids (ICS) "in-hand" decreased healthcare reutilization after hospitalization for an asthma exacerbation. However, as a result of these new processes, some patients admitted for an asthma exacerbation received more than one ICS inhaler during their admission, contributing to medication waste and potential patient confusion regarding their discharge medication regimen. We sought to decrease this waste. ⋯ Our process change to use the outpatient pharmacy to dispense and verify insurance coverage for ICS medication was associated with a reduction in medication waste during admission for an asthma exacerbation.
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Physicians often consider various nonmedical factors in hospital admission decision-making and may admit socially tenuous patients despite low-acuity medical needs. Evidence showing whether these patients are subject to the same risks of hospitalization as those considered definitely medically appropriate is limited. ⋯ We found no difference in the percentage of admissions with AEs between the two groups (27.3% vs 29.3%; risk ratio 0.93, 95% CI 0.65-1.34, P = .70) nor in AEs per 1,000-patient days (76.8 vs 70.4; incidence rate ratio = 1.09, 95% CI 0.77-1.55, P = .61). Thus, the number of AEs experienced during hospitalization does not appear to be related to the appropriateness of admission based on the level of medical acuity.