The Future of Assessing Frailty in the Patient With Advanced Heart Failure: A Review of Current Literature.

Frailty is becoming an important component of health care outcomes in patients with a diagnosis of heart failure. A literature search was completed to determine whether a best practice guideline existed to assess frailty in patients who were considering ventricular assist device placement. The literature search revealed that best practice guidelines did not exist.

The Challenges of Managing Pain in the Intensive Care Unit.

Pain management in the intensive care unit can be challenging. It is important to assess and reassess the patient for pain using the appropriate pain assessment tool for the patient's condition. It is critical to use these tools for compliance to best practice recommendations by The Joint Commission, the Society of Critical Care Management, and the American Association of Critical Care Nurses.

Using an Institute Model to Reduce the Incidence of Venous Thromboembolism Within a Large Hospital System.

Internal benchmarking showed that the Orthopedic Institute had an above average rate of venous thromboembolism (VTE) along with other institutes. The Orthopedic VTE Quality Team was assigned to investigate opportunities for improvement to share with other institutes. To investigate the issues and barriers to the administration of chemical and mechanical VTE prophylaxis, data collection included real-time point prevalence study, physician and nursing surveys, and electronic medical record audits.

Utilization of Institute for Health Care Improvement Tools to Develop a Mortality Review Process.

Mortality rates have emerged as one of the main metrics determining quality of care within a hospital. In an effort to evaluate cases, this article illustrates the use of the Institute of Healthcare Improvement Global Trigger Tool as well as the implementation of a 3-prong review process in a large, urban teaching facility. In addition, the findings of the evaluation process are shared.

Blood Glucose Management for Reducing Cardiac Surgery Infections.

Stress-induced hyperglycemia can occur after cardiac surgery unless the patient is carefully managed. Postoperative hyperglycemia is typically associated with surgical site infections and mediastinitis, resulting in a longer length of stay and escalated costs for the hospitalization. The American Association of Clinical Endocrinologists recommend keeping the intraoperative and postoperative blood glucose levels below 180 mg/dL to avoid postoperative infections.

Rib Fracture Protocol Advancing the Care of the Elderly Patient.

This article discusses unique factors associated with rib fractures in the elderly patient population and explains the process used in one facility to develop a revised protocol for the management of elderly patients with a rib fracture. The goals were to eliminate gaps in early trauma care management and employ a care routine that would improve outcomes for this vulnerable group of patients with fracture.