Comparative Effectiveness of Vancomycin and Metronidazole for the Prevention of Recurrence and Death in Patients With Clostridium difficile Infection.

Importance: Metronidazole hydrochloride has historically been considered first-line therapy for patients with mild to moderate Clostridium difficile infection (CDI) but is inferior to vancomycin hydrochloride for clinical cure. The choice of therapy may likewise have substantial consequences on other downstream outcomes, such as recurrence and mortality, although these secondary outcomes have been less studied.

Objective: To evaluate the risk of recurrence and all-cause 30-day mortality among patients receiving metronidazole or vancomycin for the treatment of mild to moderate and severe CDI.

Advancing interprofessional patient safety education for medical, nursing, and pharmacy learners during clinical rotations.

Clinical errors are common and can lead to adverse events and patient death. Health professionals must work within interprofessional teams to provide safe and effective care to patients, yet current curricula is lacking with regards to interprofessional education and patient safety. We describe the development and implementation of an interprofessional course aimed at medical, nursing, and pharmacy learners during their clinical training at a large academic medical centre.

Frequency of Adverse Events Before, During, and After Hospital Admission.

Objectives: Adverse events (AEs) are unintended physical injuries resulting from or contributed to by medical or surgical care. We determined the frequency and type of AEs before, during, and after hospital admission.

Methods: We conducted a cohort study of 296 adult hospital patients.

Perceptions of Gown and Glove Use to Prevent Methicillin-resistant Staphylococcus aureus Transmission in Nursing Homes.

Objectives: To explore current use and perceptions of glove and gown use in nursing homes.

Design: Qualitative study using focus groups and semi-structured interviews.

Setting: Three community-based nursing homes in Maryland.

Improving Incident Reporting Among Physician Trainees.

Background: Preventable medical harm is a leading cause of death in the United States. Incident reporting systems have been identified as the primary method to capture medical error and harm. Incidents are rarely reported, particularly among physician trainees.

Choosing Wisely in Healthcare Epidemiology and Antimicrobial Stewardship.

OBJECTIVE To identify Choosing Wisely items for the American Board of Internal Medicine Foundation. METHODS The Society for Healthcare Epidemiology of America (SHEA) elicited potential items from a hospital epidemiology listserv, SHEA committee members, and a SHEA-Infectious Diseases Society of America compendium with SHEA Research Network members ranking items by Delphi method voting. The SHEA Guidelines Committee reviewed the top 10 items for appropriateness for Choosing Wisely.

The Effect of Contact Precautions on Frequency of Hospital Adverse Events.

Objective: To determine whether use of contact precautions on hospital ward patients is associated with patient adverse events

Design: Individually matched prospective cohort study

Setting: The University of Maryland Medical Center, a tertiary care hospital in Baltimore, Maryland

Methods: A total of 296 medical or surgical inpatients admitted to non-intensive care unit hospital wards were enrolled at admission from January to November 2010. Patients on contact precautions were individually matched by hospital unit after an initial 3-day length of stay to patients not on contact precautions. Adverse events were detected by physician chart review and categorized as noninfectious, preventable and severe noninfectious, and infectious adverse events during the patient's stay using the standardized Institute for Healthcare Improvement's Global Trigger Tool.

The Importance of Colonization with Clostridium difficile on Infection and Transmission.

Clostridium difficile infections (CDI) are the most common cause of healthcare-associated infections (HAI) in the USA, accounting for 12 % of all HAIs [1]. Reasons for such an increase are unknown but may relate to antibiotic use and evolution of a new, pathogenic strain, NAP1/BI/027. The Centers for Disease Control and Prevention (CDC) identifies C.

Lessons learned from hospital Ebola preparation.

Background: Hospital Ebola preparation is underway in the United States and other countries; however, the best approach and resources involved are unknown.

Objective: To examine costs and challenges associated with hospital Ebola preparation by means of a survey of Society for Healthcare Epidemiology of America (SHEA) members.

Design: Electronic survey of infection prevention experts.

The Effect of Universal Glove and Gown Use on Adverse Events in Intensive Care Unit Patients.

Background: No randomized trials have examined the effect of contact precautions or universal glove and gown use on adverse events. We assessed if wearing gloves and gowns during all patient contact in the intensive care unit (ICU) changes adverse event rates.

Methods: From January 2012 to October 2012, intervention ICUs of the 20-site Benefits of Universal Gloving and Gowning cluster randomized trial required that healthcare workers use gloves and gowns for all patient contact.

Risk factors for surgical site infections after pediatric spine operations.

Study Design: Matched case-control study.

Objective: To identify modifiable risk factors for surgical site infections (SSIs) after pediatric spinal fusion.

Summary Of Background Data: The number of SSIs after pediatric spinal fusions increased.

Marital status and optimism score among breast cancer survivors.

Purpose: There are an increasing number of breast cancer survivors, but their psychosocial and supportive care needs are not well-understood. Recent work has found marital status, social support, and optimism to be associated with quality of life, but little research has been conducted to understand how these factors relate to one another.

Methods: Survey data from 722 breast cancer survivors were analyzed to estimate the association between marital status and optimism score, as measured using the Life Orientation Test-Revised.

Factors associated with treatment failure in vertebral osteomyelitis requiring spinal instrumentation.

Patients with vertebral osteomyelitis may require instrumentation for spinal stabilization. Determining the optimal duration and type of antimicrobial therapy for these patients is challenging. The aim of this study was to examine risk factors for treatment failure, in particular antimicrobial duration, in a cohort of patients requiring spinal instrumentation for vertebral osteomyelitis.

Effects of contact precautions on patient perception of care and satisfaction: a prospective cohort study.

Objective: Contact precautions decrease healthcare worker-patient contact and may impact patient satisfaction. To determine the association between contact precautions and patient satisfaction, we used a standardized interview for perceived issues with care.

Design: Prospective cohort study of inpatients, evaluated at admission and on hospital days 3, 7, and 14 (until discharged).