Opioid Prescribing Rate for Nonoperative Distal Radius Fractures and Clinician Response to a Clinical Decision Support Alert.

Background: Opioids are commonly prescribed for the management of acute orthopedic trauma pain, including nonoperative distal radius fractures.

Objectives: This prospective study aimed to determine if a clinical decision support intervention influenced prescribing decisions for patients with known risk factors. We sought to quantify frequency of opioid prescriptions for acute nonoperative distal radius fractures treated.

Patients with glenohumeral arthritis are more likely to be prescribed opioids in the emergency department or urgent care setting.

Objective: The objective is to quantify the rate of opioid and benzodiazepine prescribing for the diagnosis of shoulder osteoarthritis across a large healthcare system and to describe the impact of a clinical decision support intervention on prescribing patterns.

Design: A prospective observational study.

Setting: One large healthcare system.

Adherence to legislation limiting opioid prescription duration following musculoskeletal injury.

Objectives: North Carolina had implemented legislation (Strengthen Opioid Misuse Prevention (STOP) Act) limiting opioid prescriptions to 5 days for acute pain and 7 days for post-operative pain. This study aimed to identify patient, prescriber, and facility characteristics associated with STOP Act adherence for patients with acute or post-surgical musculoskeletal (MSK) conditions.

Design: A three-level hierarchical logistic regression model was used to predict odds of adherence with STOP Act duration limits, accounting for fixed and random effects at the patient, prescriber, and facility levels.

Implementation of required sedation assessment in nursing workflow to address naloxone utilization.

Objective: Opioid-related adverse drug events continue to occur. This study aimed to characterize the patient population receiving naloxone to inform future intervention efforts.

Design: We describe a case series of patients who received naloxone in the hospital during a 16-week time frame in 2016.

Correcting for digital image correlation speckle inversion at high temperature using color cameras.

Digital image correlation (DIC) is a popular, noncontacting technique to measure full-field deformation by using cameras to track the motion of an applied surface pattern. Because it is noncontacting, DIC can be performed for extreme temperature applications (e.g.

Balancing Safety, Comfort, and Fall Risk: An Intervention to Limit Opioid and Benzodiazepine Prescriptions for Geriatric Patients.

Introduction: This study reports on the impact of a clinical decision support tool embedded in the electronic medical record and characterizes the demographics, prescribing patterns, and risk factors associated with opioid and benzodiazepine misuse in the older adult population.

Significance: This study reports on prescribing patterns for patients ≥65 years-old who presented to Emergency Departments (ED) or Urgent Care (UC) facilities across a large healthcare system following a fall (n = 34,334 encounters; n = 25,469 patients). This system implemented a clinical decision support intervention which provides an alert when the patient has an evidence-based risk factor for prescription drug misuse; prescribers can continue, amend or cancel the prescription.

Opioid Prescribing Risk Factors in Nonoperative Ankle Fractures: The Impact of a Prospective Clinical Decision Support Intervention.

Opioids are frequently used for acute pain management of musculoskeletal injuries, which can lead to misuse and abuse. This study aimed to identify the opioid prescribing rate for ankle fractures treated nonoperatively in the ambulatory and emergency department setting across a single healthcare system and to identify patients considered at high risk for abuse, misuse, or diversion of prescription opioids that received an opioid. A retrospective cohort study was performed at a large healthcare system.

Prevalence of Prescription Opioids for Nonoperative Treatment of Rotator Cuff Disease Is High.

Purpose: To quantify the prevalence of opioid and benzodiazepine prescriptions for patients with rotator cuff disease across a large health care system and to describe evidence-based risk factors for opioid use within this population.

Methods: We conducted a retrospective cohort study at a major health care system of all patients with qualifying diagnostic codes. Emergency department, urgent care, and outpatient encounters between January and December 2016 for an acute rotator cuff tear, listed as the primary diagnosis, were included.

Opioid Prescribing and Patient Satisfaction Scores Across Practice Types.

US physicians prescribe opioids at a high rate relative to other countries. Of the US physicians surveyed, almost half report having prescribed an inappropriate opioid due to concerns about patient satisfaction scores. We investigated patterns in controlled substance prescribing practices, patient risk factors, and associated Press Ganey patient satisfaction scores at a sample of orthopaedic surgery and primary care clinics over a 6month time period.

Establishing an Antimicrobial Stewardship Collaborative Across a Large, Diverse Health Care System.

Unlabelled: Alarming trends in antibiotic resistance sparked a National Action Plan endorsing antimicrobial stewardship programs (ASPs) in health care facilities. Atrium Health consists of 28 acute care facilities with varying levels of ASP maturity. The organization sought to establish an ASP collaborative across a diverse network by uniting local resources with a central advisory team.

Prescribing of Opioids and Benzodiazepines Among Patients With History of Overdose.

Objectives: Addiction and overdose related to prescription drugs continues to be a leading cause of morbidity and mortality in the United States. We aimed to characterize the prescribing of opioids and benzodiazepines to patients who had previously presented with an opioid or benzodiazepine overdose.

Methods: This was a retrospective chart review of patients who were prescribed an opioid or benzodiazepine in a 1-month time-period in 2015 (May) and had a previous presentation for opioid or benzodiazepine overdose at a large healthcare system.

Opioid Prescribing in the Pediatric Orthopaedic Trauma Population.

The purpose of this article is to describe opioid prescribing patterns for children with orthopaedic injuries. A retrospective chart review was conducted on pediatric orthopaedic trauma patients (n = 124) who were discharged from the hospital or emergency department or had a clinic visit during a 1-month period. Patient demographics, prescription specifics, injury details, and fracture fixation information were collected.

Blood flow patterns during incremental and steady-state aerobic exercise.

Background: Endothelial shear stress (ESS) is a physiological stimulus for vascular homeostasis, highly dependent on blood flow patterns. Exercise-induced ESS might be beneficial on vascular health. However, it is unclear what type of ESS aerobic exercise (AX) produces.

The Importance of Team Sex Composition in Team-Training Research Employing Complex Psychomotor Tasks.

Objective: The relationship between team sex composition and team performance on a complex psychomotor task was examined because these types of tasks are commonly used in the lab-based teams literature.

Background: Despite well-documented sex-based differences on complex psychomotor tasks, the preponderance of studies-mainly lab based-that use these tasks makes no mention of the sex composition of teams across or within experimental conditions.

Method: A sample of 123 four-person teams with varying team sex composition learned and performed a complex psychomotor task, Steal Beasts Pro PE.

Biosimilars Are Here: A Hospital Pharmacist's Guide to Educating Health Care Professionals on Biosimilars.

Background: Pharmacists are the recognized experts in pharmacotherapy. With the recent introduction of biosimilar agents into the US market, pharmacists are poised to play a pivotal role in evaluating their risks versus benefits within the framework of cost containment.

Purpose: This article provides hospital pharmacists with the necessary information on the principles surrounding the development, approval process, and use of biosimilars.

Optimizing smart pump technology by increasing critical safety alerts and reducing clinically insignificant alerts.

Background: Alerts generated by intravenous (IV) infusion pump safety software prevent life-threatening situations that might otherwise go unnoticed. However, when alerts are often clinically insignificant, health care workers may become desensitized and discount their importance, resulting in potentially dangerous situations. Little research has been devoted to visual alert desensitization.

Comparative evaluation of three situational judgment test response formats in terms of construct-related validity, subgroup differences, and susceptibility to response distortion.

As a testing method, the efficacy of situational judgment tests (SJTs) is a function of a number of design features. One such design feature is the response format. However, despite the considerable interest in SJT design features, there is little guidance in the extant literature as to which response format is superior or the conditions under which one might be preferable to others.

Using smart pumps to understand and evaluate clinician practice patterns to ensure patient safety.

Background: Safety software installed on intravenous (IV) infusion pumps has been shown to positively impact the quality of patient care through avoidance of medication errors. The data derived from the use of smart pumps are often overlooked, although these data provide helpful insight into the delivery of quality patient care.

Objective: The objectives of this report are to describe the value of implementing IV infusion safety software and analyzing the data and reports generated by this system.