March 2015 Briefing - Critical Care

Here are what the editors at HealthDay consider to be the most important developments in Critical Care for March 2015. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

2015 Match Sees High Proportion of Unmatched Seniors

MONDAY, March 30, 2015 (HealthDay News) -- About 6.1 percent of U.S. allopathic medical school seniors in the National Resident Matching Program (NRMP) were not placed into first-year residency positions, with a higher percentage of unmatched seniors than in 2014, according to a report published by the American Medical Association.

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Innovative Prototype Presented for Post-ICU Patients

FRIDAY, March 27, 2015 (HealthDay News) -- A collaborative care model, the Critical Care Recovery Center (CCRC), represents an innovative prototype aimed to improve the quality of life of intensive care unit (ICU) survivors, according to a report published in the March issue of the American Journal of Nursing.

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Physicians Should Be Aware of Signs of Burnout

THURSDAY, March 26, 2015 (HealthDay News) -- Burnout can be prevented if physicians are aware of the warning signs, according to an article published by the American Medical Association.

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Perception of Crisis Mode Tied to Patient Info Exchange Issues

THURSDAY, March 26, 2015 (HealthDay News) -- Hospital staff members who perceive their unit is trying to do too much too quickly are more likely to also perceive problems in exchanging patient information across units, according to a study published in the March issue of the Journal of Hospital Medicine.

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FDA Approves New Treatment for Anthrax

WEDNESDAY, March 25, 2015 (HealthDay News) -- Anthrasil, Anthrax Immune Globulin Intravenous (Human), has been approved by the U.S. Food and Drug Administration to treat patients with inhalational anthrax in combination with appropriate antibacterial drugs.

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Short Hospital Stays Don't Impair STEMI Outcomes in Seniors

WEDNESDAY, March 25, 2015 (HealthDay News) -- For older patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI), outcomes are similar for discharge after 48 hours versus four to five days, according to a study published in the March 31 issue of the Journal of the American College of Cardiology.

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Outcome Not Affected by Family Presence During Resuscitation

WEDNESDAY, March 25, 2015 (HealthDay News) -- There are no significant differences in outcomes or processes of care for U.S. hospitals with policies allowing for family presence during resuscitation (FPDR) compared with hospitals without this policy, according to a study published online March 24 in Circulation: Cardiovascular Quality and Outcomes.

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Meds Not Stents in Patients With Intracranial Arterial Stenosis

TUESDAY, March 24, 2015 (HealthDay News) -- Using stents rather than medication alone to keep narrowed arteries open in the brain may actually increase patients' risk of stroke, according to the results of a new trial. The report was published in the March 24/31 issue of the Journal of the American Medical Association.

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Patient Status at ICU Discharge, Not Timing, Predicts Survival

THURSDAY, March 19, 2015 (HealthDay News) -- For patients discharged from the intensive care unit (ICU), patient status, particularly the presence of limitations of medical therapy (LOMT) orders, strongly predicts mortality, according to a study published online March 2 in the American Journal of Respiratory and Critical Care Medicine.

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Interventions Up Blood Culture Ordering in Pediatric Pneumonia

WEDNESDAY, March 18, 2015 (HealthDay News) -- Interventions can increase blood culture ordering in children hospitalized with community-acquired pneumonia (CAP), with no effect on length of stay (LOS), according to a study published online March 16 in Pediatrics.

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More Than 16 Million Americans Have Gained Coverage Under ACA

TUESDAY, March 17, 2015 (HealthDay News) -- The Obama Administration reported Monday the largest drop in the number of Americans without health insurance since the Johnson administration expanded health coverage through Medicare and Medicaid 50 years ago.

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Gender-Specific Variation in Medical Specialties

MONDAY, March 16, 2015 (HealthDay News) -- Medical specialties vary by gender, with obstetrics/gynecology and pediatrics dominated by female residents and specialties such as surgery, emergency medicine, and anesthesiology dominated by males, according to a report published by the Association of American Medical Colleges (AAMC).

AAMC 2015 Report on Residents

Tips Provided for Residents Applying to Fellowship Training

MONDAY, March 16, 2015 (HealthDay News) -- The process of selecting and preparing for a fellowship training program, specifically pulmonary and/or critical care medicine, should begin early in residency, according to an article published online March 5 in the Annals of the American Thoracic Society.

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Handoff Tool Alone Insufficient to Handle Nighttime Clinical Issues

MONDAY, March 16, 2015 (HealthDay News) -- A handoff tool, which has been widely adopted in hospitals, seems not to be sufficient for addressing nighttime clinical issues, according to research published in the March issue of the Journal of Hospital Medicine.

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Real-Time Decision Support Tool Aids ER Pneumonia Patients

MONDAY, March 16, 2015 (HealthDay News) -- For emergency department patients with pneumonia, a real-time electronic clinical decision support tool could be beneficial, according to a study published online Feb. 26 in the Annals of Emergency Medicine.

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Hospitalist Continuity Doesn't Appear to Greatly Affect AEs

FRIDAY, March 13, 2015 (HealthDay News) -- Measures of hospitalist physician continuity do not show a consistent or significant association with the incidence of adverse events (AEs), according to research published in the March issue of the Journal of Hospital Medicine.

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HHS Wants to Help Restore Joy of Medicine

FRIDAY, March 13, 2015 (HealthDay News) -- The U.S. Department of Health and Human Services (HHS) is listening to physicians and wants to address the regulatory burdens they face, according to a report published by the American Medical Association (AMA).

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Patients Say Pain Control Is Key to Quality of Care in Hospitals

FRIDAY, March 13, 2015 (HealthDay News) -- Management of pain is an important component in improving the quality of care in hospitals from a patient's perspective, according to research published in the March issue of Pain Practice.

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Getting Heard May Be Key to Getting New Job

FRIDAY, March 13, 2015 (HealthDay News) -- Your voice may be the key to landing a new job, researchers report in an upcoming issue of Psychological Science.

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Clinical Trial Data Often Not Reported in Timely Manner

THURSDAY, March 12, 2015 (HealthDay News) -- Researchers are not promptly reporting the results of clinical trials to ClinicalTrials.gov, according to an article published in the March 12 issue of the New England Journal of Medicine.

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Restrictive Transfusion Threshold No Better Post Cardiac Surgery

WEDNESDAY, March 11, 2015 (HealthDay News) -- For patients undergoing nonemergency cardiac surgery, a postoperative restrictive transfusion threshold is not superior to a liberal threshold, according to a study published in the March 12 issue of the New England Journal of Medicine.

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Patients With Multiple Conditions Need Early Outpatient Follow-Up

WEDNESDAY, March 11, 2015 (HealthDay News) -- The timeliness of outpatient follow-up after discharge matters most for patients with multiple chronic conditions and a greater than 20 percent baseline risk of readmission, according to research published in the March/April issue of the Annals of Family Medicine.

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Physicians Should Plan Exit Strategy in Advance

WEDNESDAY, March 11, 2015 (HealthDay News) -- Physicians should begin planning their exit strategy three to five years in advance, according to the American Medical Association.

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Frustrated by Regulations, Doctors Increasingly Miserable

WEDNESDAY, March 11, 2015 (HealthDay News) -- The nationwide Physician Misery Index is 3.7 out of 5, with the vast majority of physicians reporting that the business and regulation of health care has worsened the practice of medicine, according to a report published by Geneia.

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Persistent EHR Nonadoption Could Mean Lower Payment

WEDNESDAY, March 11, 2015 (HealthDay News) -- Persistent nonadopters of electronic health records (EHRs) tend to be older, and are employed in smaller practices, according to a letter published in the March 3 issue of the Annals of Internal Medicine.

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Hospitalizations After Sepsis Resolution Often Preventable

TUESDAY, March 10, 2015 (HealthDay News) -- When patients survive sepsis, it's common for them to be readmitted to the hospital within a few months, but this can often be avoided, according to research published in the March 10 issue of the Journal of the American Medical Association.

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AAMC: Significant Shortfall of Physicians Projected for 2025

TUESDAY, March 10, 2015 (HealthDay News) -- The expected shortfall of physicians is projected to reach about 46,000 to 90,000 by 2025, according to a study conducted by IHS Inc. for the Association of American Medical Colleges (AAMC).

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FDA Approves New CPR Devices

MONDAY, March 9, 2015 (HealthDay News) -- A new cardiopulmonary resuscitation (CPR) system designed to increase the chance of survival in people experiencing cardiac arrest has been approved by the U.S. Food and Drug Administration.

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Educational Intervention Can Cut Inappropriate PPI Prescriptions

MONDAY, March 9, 2015 (HealthDay News) -- A monthly educational intervention paired with a web-based quality improvement tool is feasible for increasing the proportion of inappropriate proton pump inhibitor (PPI) prescriptions discontinued at hospital discharge, according to a study published online Feb. 24 in the Journal of Hospital Medicine.

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Changes Being Made to Med School Applicant Assessment

FRIDAY, March 6, 2015 (HealthDay News) -- In accordance with the changes in graduate medical education to better prepare doctors for a changing health care system, changes are being made to medical school applicant evaluation, according to an article published Feb. 19 by the American Medical Association (AMA).

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Confidence Gap Between Male and Female Med Students

FRIDAY, March 6, 2015 (HealthDay News) -- Female medical students perform at the same or higher level as men, but they lack confidence compared with men, according to a letter published in the March 3 issue of the Annals of Internal Medicine.

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National Hospital Rating Systems Rarely in Agreement

FRIDAY, March 6, 2015 (HealthDay News) -- National hospital rating systems are rarely in agreement, according to a study published in the March issue of Health Affairs.

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FDA Launches First App to Identify Drug Shortages

THURSDAY, March 5, 2015 (HealthDay News) -- A mobile phone application (app) has been released to identify current drug shortages, resolved shortages, or discontinuations of drug products, according to a press release published by the U.S. Food and Drug Administration.

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One-Third of U.S. More Than Hour Away From Stroke Center

THURSDAY, March 5, 2015 (HealthDay News) -- One-third of Americans can't be transported by ambulance to a stroke center within one hour, according to research published online March 4 in Neurology.

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Study Examines Palliative Care in Cardiac Intensive Care Units

THURSDAY, March 5, 2015 (HealthDay News) -- Increased palliative care education and training among clinicians who are involved in cardiac critical care could benefit care, according to a study published in the March 1 issue of The American Journal of Cardiology.

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Rush University Adds Patient Scores to Doctor Profiles

WEDNESDAY, March 4, 2015 (HealthDay News) -- Rush University Medical Center's website has started adding the results of patient surveys to individual physician profiles, according to a report published by the medical center.

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Anemia Linked to Adverse Outcomes in Atrial Fibrillation

WEDNESDAY, March 4, 2015 (HealthDay News) -- For patients with atrial fibrillation receiving anticoagulant treatment, the presence of anemia is associated with increased risk of thromboembolic events, bleeding complications, and mortality, according to research published online Feb. 13 in the Journal of Thrombosis and Haemostasis.

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Research Measures Perceptions of Physician Compassion

TUESDAY, March 3, 2015 (HealthDay News) -- Patients prefer physicians who convey a more optimistic message, and perceive in them a higher level of compassion, according to a study published online Feb. 26 in JAMA Oncology.

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ACP Issues Recommendations for Management of Pressure Ulcers

TUESDAY, March 3, 2015 (HealthDay News) -- Recommendations have been developed for the prevention and management of pressure ulcers, and published as two American College of Physicians (ACP) clinical practice guidelines in the March 3 issue of the Annals of Internal Medicine.

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Resistance to Common Antimicrobials Increasing

TUESDAY, March 3, 2015 (HealthDay News) -- Resistance to commonly used antimicrobials is increasing in Salmonella and Campylobacter, according to a report published Feb. 26 by the European Food Safety Authority (EFSA).

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U.S. Nurse Who Contracted Ebola Sues Employer

MONDAY, March 2, 2015 (HealthDay News) -- An American nurse who contracted Ebola is suing her employer.

Health Highlights: March 2, 2015

Hospital Design Has Little Effect on Patient Satisfaction

MONDAY, March 2, 2015 (HealthDay News) -- Hospital design has little effect on patient satisfaction, according to a study published online Feb. 5 in the Journal of Hospital Medicine.

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Physician's Briefing