Optimizing Heparin Quality Assurance Utilizing Electronic Data Abstraction.

Heparin is a high-risk medication with significant variability across patients. Systematic data analysis can help hospitals improve heparin management, ensuring safe and effective anticoagulation. An opportunity exists to create a more efficient data collection process, allowing hospitals to streamline quality assurance programs.

Treatment of atrial fibrillation and venous thromboembolism with factor Xa inhibitors in severely obese patients.

Background: A paucity of data exists to support the use of factor (F)Xa inhibitors in severely obese patients with a weight of ≥150 kg or body mass index (BMI) of ≥50 kg/m.

Objectives: The purpose of this study was to evaluate whether FXa inhibitors are as safe and effective as warfarin for the treatment of atrial fibrillation (AF) and/or venous thromboembolism (VTE) in individuals with a BMI of ≥50 kg/m and/or weight of ≥150 kg.

Methods: This was a multicenter retrospective cohort study of severely obese adult patients with AF and/or VTE treated with a FXa inhibitor or warfarin.

Treatment of during extracorporeal life support: A case report.

With rates of ECMO utilization on the rise, prevention of nosocomial infections is of paramount importance. , an emerging highly pathogenic multidrug resistant fungus, is of particular concern as it is associated with persistent colonization of environmental surfaces, inability to be recognized by many diagnostic platforms, inconsistent laboratory susceptibility results, and high mortality rates. We describe a case of in a VV-ECMO patient successfully managed with a combination of anidulafungin, amphotericin B, and flucytosine.

Venous Thromboembolism Prophylaxis in Low Body Weight Critically Ill Patients.

Objective: To compare bleeding and thromboembolic events in low body weight patients receiving reduced-dose venous thromboembolism (VTE) prophylaxis versus standard-dose VTE prophylaxis.

Design: Multicenter, retrospective, cohort study.

Setting: Five Ascension Health Hospitals.

Efficacy and safety of factor Xa inhibitors in low body weight patients.

Study Objective: The purpose of this study is to provide evidence for the safety and efficacy of factor Xa inhibitors in patients with a weight ≤60 kg or BMI < 18.5 kg/m .

Design: Multicenter, retrospective, cohort study.

Review of Restricted Experiment Requests, Division of Select Agents and Toxins, US Centers for Disease Control and Prevention, 2014-2021.

The US Centers for Disease Control and Prevention Division of Select Agents and Toxins (DSAT) regulates laboratories that possess, use, or transfer select agents and toxins within United States as part of the Federal Select Agent Program. DSAT also mitigates biosafety risks through the review of "restricted experiments," which under the select agent regulations are experiments that pose heightened biosafety risks. In a previous study, we evaluated restricted experimental requests submitted to DSAT for review between 2006 and 2013.

Enteral Sedation in Patients Requiring Mechanical Ventilation During an Intravenous Analgesic and Sedative Shortage.

There is a paucity of data evaluating the use of enteral sedation in mechanical ventilation. A sedative shortage resulted in the use of this approach. To evaluate the feasibility of using enteral sedatives to decrease intravenous (IV) analgesia and sedative requirements.

Hydrocortisone versus vasopressin for the management of adult patients with septic shock refractory to norepinephrine: A multicenter retrospective study.

Study Objective: Significant practice variation exists when selecting between hydrocortisone and vasopressin as second line agents in patients with septic shock in need of escalating doses of norepinephrine. The goal of this study was to assess differences in clinical outcomes between these two agents.

Design: Multicenter, retrospective, observational study.

Monitoring Laboratory Occupational Exposures to .

Background: is a Tier 1 overlap select agent and subject to the select agent regulations (42 CFR §73 and 9 CFR §121). It is a gram-negative, motile, soil saprophyte, and the etiologic agent of melioidosis. infection can produce systemic illness and can be fatal in the absence of appropriate treatment.

Risk of bleeding with factor Xa inhibitors versus unfractionated heparin in patients with acute kidney injury.

Study Objective: To compare bleeding and thromboembolic events in patients receiving therapeutic doses of apixaban or rivaroxaban versus unfractionated heparin (UFH) in patients with acute kidney injury (AKI).

Design: Single-center, retrospective, observational study.

Setting: Ascension St.

Management of Venous Thromboembolism in Morbid Obesity With Rivaroxaban or Warfarin.

Background: Rivaroxaban is a first-line option for the management of venous thromboembolism (VTE). However, limited data are available regarding its effectiveness in morbidly obese patients.

Objective: To evaluate rates of thrombosis and bleeding in morbidly obese patients receiving rivaroxaban or warfarin for VTE.

In-hospital venous thromboembolism: are glucocorticoids a prime suspect?

The objective of the study was to determine whether glucocorticoid use is associated with an increased incidence of in-hospital VTE. We conducted a case-control study of patients with an in-hospital VTE from October 2015 to December 2019. Adult patient cases were identified by ICD-10 codes for acute venous thromboembolism.

Multi-center retrospective study evaluating the efficacy and safety of apixaban versus warfarin for treatment of venous thromboembolism in patients with severe obesity.

Study Objective: Direct oral anticoagulants are the standard of care for venous thromboembolism (VTE) treatment. These agents are recommended regardless of patient weight and body mass index (BMI). However, there remains limited evidence supporting the use of apixaban in patients with severe obesity with a BMI ≥40 kg/m or weight ≥120 kg.

Assessment of factors affecting practice towards COVID-19 among health care workers in health care facility of West Guji Zone, South Ethiopia, 2020.

Introduction: health care workers are at greatest risk to being infected with COVID-19 in health care facilities. This study is focused on assessing the level of practice and factors affecting practice towards COVID-19 among health care workers in health care facility of West Guji Zone, Oromia region, Ethiopia.

Methods: health facility based cross-sectional study design was carried out from December 1 to 30 2020 among health care providers in West Guji Zone.

Cisplatin-induced nephrotoxicity in an outpatient setting.

Background: The use of cisplatin is limited by the development of nephrotoxicity, with an incidence approaching 30%. It is unclear if a risk prediction score can effectively predict the development of nephrotoxicity throughout all cycles of cisplatin therapy among outpatients.

Methods: Retrospective, observational study evaluating adult patients receiving cisplatin in outpatient infusion centers from January 2009 to November 2019 (n = 186).

Impact of a clinical decision support tool targeting QT-prolonging medications.

Purpose: To evaluate the impact of a newly implemented clinical decision support (CDS) tool targeting QT interval-prolonging medications on order verification and provider interventions.

Methods: A multicenter, retrospective quasi-experimental study was conducted to evaluate provider response to CDS alerts triggered during ordering of QT-prolonging medications for adult patients. The primary outcome was the proportion of orders triggering QTc alerts that were continued without intervention during a specified preimplementation phase (n = 49) and during a postimplementation phase (n = 100).

Health System Resilience: What Are We Talking About? A Scoping Review Mapping Characteristics and Keywords.

Background: Health systems are based on 6 functions that need to work together at all times to effectively deliver safe and quality health services. These functions are vulnerable to shocks and changes; if a health system is unable to withstand the pressure from a shock, it may cease to function or collapse. The concept of resilience has been introduced with the goal of strengthening health systems to avoid disruption or collapse.

Review of Requests to Exclude Attenuated Strains of Select Agents and Modified Select Toxins, Division of Select Agents and Toxins, Centers for Disease Control and Prevention, 2003-2017.

The Centers for Disease Control and Prevention's Division of Select Agents and Toxins (DSAT) regulates the possession, use, and transfer of select agents and toxins throughout the United States as part of the Federal Select Agent Program. The Department of Health and Human Services (HHS) select agent regulations also include criteria for the exclusion of select agents and toxins from the requirements of the regulations (42 CFR § 73.3 and 73.

Assessment of Anticoagulation in Patients Receiving Ultrasound-Assisted Catheter-Directed Thrombolysis for Treatment of Pulmonary Embolism.

Background: Ultrasound-assisted, catheter-directed thrombolysis (USAT) has emerged as a popular treatment option for submassive pulmonary embolism (PE). The optimal strategy for transitioning patients from full-intensity to reduced-intensity heparin during the procedure has yet to be established.

Objective: The goal of this study was to evaluate the anticoagulation management in patients receiving catheter-directed thrombolysis with USAT.

Regadenoson versus Dipyridamole: A Comparison of the Frequency of Adverse Events in Patients Undergoing Myocardial Perfusion Imaging.

Study Objective: To compare the frequency of adverse events in patients undergoing myocardial perfusion imaging (MPI) with either regadenoson or dipyridamole.

Design: Single-center, retrospective cohort study.

Setting: Large community teaching hospital.

The pattern and magnitude of "in vivo thrombin generation" differ in women with preeclampsia and in those with SGA fetuses without preeclampsia.

Objective: We aimed to determine the differences in the pattern and magnitude of thrombin generation between patients with preeclampsia (PE) and those with a small-for-gestational-age (SGA) fetus.

Methods: This cross-sectional study included women in the following groups: (1) normal pregnancy (NP) (n = 49); (2) PE (n = 56); and (3) SGA (n = 28). Maternal plasma thrombin generation (TGA) was measured, calculating: (a) lag time (LT); (b) velocity index (VI); (c) peak thrombin concentration (PTC); (d) time-to-peak thrombin concentration (TPTC); and (e) endogenous thrombin potential (ETP).

Can a Short Video Improve Apixaban Knowledge in an Inpatient Setting?

Purpose: To increase patient knowledge about apixaban (Eliquis, Bristol-Myers Squibb) using an educational video delivered in an urban inpatient setting.

Methods: This prospective, quasi-experimental study evaluated knowledge gain and retention in patients receiving apixaban after viewing a short educational video. Knowledge was assessed with a questionnaire immediately before, immediately after, and one month following the educational video.

Assessment of Postoperative Pain Control with an Elastomeric Pain Pump Following Cardiothoracic Surgery.

Objective: To assess the effectiveness of local anesthesia, delivered via elastomeric pump to manage pain in patients undergoing cardiothoracic surgery.

Methods: A retrospective, comparative analysis evaluating adult cardiothoracic surgery patients (by median sternotomy) who received continuous infusion bupivacaine + traditional methods of pain control (N = 100) or traditional pain control alone (N = 100) from July 2011-October 2013. The primary efficacy end point was total postoperative opioid requirements for 96 hours following surgery.