Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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Comparative Study
Implementation and evaluation of an alpha-numeric paging system on a resident inpatient teaching service.
Numeric pagers are commonly used communication devices in healthcare, but cannot convey important information such as the reason for or urgency of the page. Alphanumeric pagers can display both numbers and text, and may address some of these communication problems. ⋯ We successfully implemented an alphanumeric paging system that reduced disruptive pages on a GM inpatient service.
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The clinical venous thromboembolism (VTE) burden remains high in the United States, despite guidelines recommending that safe and effective VTE prophylaxis be available. This study assesses the real-world rate of appropriate inpatient VTE prophylaxis in hospitalized U.S. medical and surgical patients at risk of VTE, in accordance with the seventh American College of Chest Physicians, (ACCP) guidelines. ⋯ Few medical and surgical patients at high risk of VTE receive appropriate inpatient prophylaxis in accordance with guideline recommendations. It is important for individual hospitals to improve VTE prophylaxis practices to meet national performance initiatives.
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Handoffs are ubiquitous to Hospital Medicine and are considered a vulnerable time for patient safety. ⋯ The systematic review and resulting recommendations provide hospitalists a starting point from which to improve in-hospital handoffs.
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Little is known about the professional help-seeking behavior of residents as they perform procedures in the hospital. ⋯ Resident physicians appear to seek formal assistance appropriately for procedures they perform on sicker patients. Additional research is needed to understand whether overconfidence or poor access to attending physicians is responsible for their failure to seek consultation with urgent and emergent cases.
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Central venous catheter (CVC) insertions are performed frequently by internal medicine residents. Complications, including arterial puncture and pneumothorax, decrease when operators use fewer needle passes to insert the CVC. In this study, we evaluated the effect of simulation-based mastery learning on CVC insertion skill. ⋯ Simulation-based mastery learning increased residents' skills in simulated CVC insertion, decreased the number of needle passes when performing actual procedures, and increased resident self-confidence.