Arch Intern Med
-
To determine whether internists' attitudes toward the hospitalist model change after implementation of a new inpatient service. ⋯ Following experience with a hospitalist system, physician attitude, including concerns regarding career satisfaction and relationships with patients, toward a voluntary hospitalist model improved. Future research should investigate whether the hospitalist model affects patient satisfaction and quality of care.
-
Do-not-resuscitate (DNR) orders are commonly found in treatment plans for patients near the end of life. Orders for partial resuscitation (eg, "do not intubate") have evolved from DNR orders. Although the ethics of DNR orders have been widely examined in the medical literature, little has been written about the ethics of partial resuscitation. This article explores the ethical implications of partial DNR orders and identifies the need to develop care plans addressing life-threatening conditions for patients with DNR orders.
-
Randomized Controlled Trial Multicenter Study Clinical Trial
The impact of dedicated medication nurses on the medication administration error rate: a randomized controlled trial.
Concerns about hospital medication safety mount as the pace of new drug releases accelerates. ⋯ This trial suggests that use of dedicated medication nurses does not reduce medication error rates. However, subgroup analysis indicates that medication nurses might be useful in some settings. The differences in findings at the 2 hospitals and their differences in medication-use processes reinforce the concept that medication errors are usually related to systems design issues.
-
Randomized Controlled Trial Clinical Trial
Effectiveness of bupropion sustained release for smoking cessation in a health care setting: a randomized trial.
The efficacy of bupropion hydrochloride sustained release (SR) (Zyban) for smoking cessation has been evaluated in clinical trials that included frequent in-person behavioral counseling, but not in actual practice settings. ⋯ In this actual practice setting, the combination of bupropion SR and minimal or moderate counseling was associated with 1-year quit rates of 23.6% to 33.2%. This suggests that existing health care systems can substantially decrease tobacco use rates among their enrollees if they provide these modest interventions.