Articles: patient-care.
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Recognizing and managing pain is especially challenging for vulnerable populations who cannot communicate their discomfort. Because there is no valid and reliable objective measure of pain, the American Society for Pain Management Nursing advocates for comprehensive assessment practices articulated in a Hierarchy of Pain Assessment. These practices must gather relevant information to infer the presence of pain and evaluate a patient's response to treatment. Nurses and other healthcare providers must be advocates for those who cannot communicate their pain experience.
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Recognizing and managing pain is especially challenging for vulnerable populations who cannot communicate their discomfort. Because there is no valid and reliable objective measure of pain, the American Society for Pain Management Nursing advocates for comprehensive assessment practices articulated in a Hierarchy of Pain Assessment. These practices require gathering relevant information to infer the presence of pain and evaluate a patient's response to treatment. Nurses and other healthcare providers must be advocates for those who cannot communicate their pain experience.
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Diagnostic errors, often due to biases in clinical reasoning, significantly affect patient care. While artificial intelligence chatbots like ChatGPT could help mitigate such biases, their potential susceptibility to biases is unknown. ⋯ It seems that, while ChatGPT is not sensitive to bias when biasing information is situational, it is sensitive to bias when the biasing information is part of the patient's disease history. Its utility in diagnostic support has potential, but caution is advised. Future research should enhance AI's bias detection and mitigation to make it truly useful for diagnostic support.
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Editorial
Decoding Homelessness: Z-Codes and the Recognition of Homelessness as a Comorbid Condition.
There are an estimated 653,100 people across the United States experiencing homelessness. Homelessness is an important social determinant of health associated with increased morbidity and mortality. ⋯ Here, we review the historical purpose and utilization of codes to identify SDOH ("Z-codes"); describe how the recent CMS policy change elevates the importance of homelessness within medical care and impacts reimbursement; analyze the potential risks and benefits of this change to patients, clinicians, and health systems; and assess barriers to implementation. We conclude by calling for health systems to move beyond simply documenting homelessness to meaningfully addressing health inequities in PEH.
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Anesthesia and analgesia · Nov 2024
The Association Between Perioperative Red Blood Cell Transfusions and 1-Year Mortality After Major Cancer Surgery: An International Multicenter Observational Study.
Packed red blood cell (pRBC) transfusions in patients undergoing surgery for cancer are given to treat anemia or acute hemorrhage. Evidence indicates that pRBC transfusions are associated with poor perioperative and oncological outcomes. The ARCA-1 (Perioperative Care in the Cancer Patient-1) study was designed to test the association between perioperative pRBC transfusions and postoperative morbidity and mortality in patients undergoing cancer surgery. The primary hypothesis of our study was that perioperative pRBC transfusions have a negative impact on postoperative morbidity and 1-year mortality. ⋯ This international, multicenter observational study showed that perioperative pRBC transfusion was associated with an increased mortality risk.