Self-Reported Time-at-Bedside and Its Association with In-Training Examination Scores of Residents in Japan.

Background: Time-at-bedside plays a central role in clinical medicine. However, the amount of time Japanese clinical residents spend at patients' bedsides remains unexplored.

Objective: To quantify time-at-bedside and examine its association with in-training examination scores during clinical residency in Japan.

Enhancing provider-patient connection through low-effort interventions: a scoping review protocol.

Introduction: Nudges, or low-effort interventions aimed at influencing behaviour, can improve provider medical decision-making through promoting adherence to practice guidelines. Strengthening provider-patient humanistic connection through nudges may increase provider satisfaction, mitigate burnout and improve patient satisfaction and outcomes. This scoping review aims to map the literature investigating provider-directed, low-effort interventions aimed at enhancing the provider-patient connection.

What Drives Clinicians to Teach While Caring for Patients?

Past medical education scholarship has explored what to teach, how to teach it better, and the evaluation of what these efforts provide learners. Missing from this dialogue has been the question of what clinician-educators gain from teaching. In this Invited Commentary on Frija-Gruman and colleagues' article "Learning Through Teaching: How Physicians Learn Medicine in Authentic Clinical Contexts," the authors go beyond how and what clinician-educators learn through teaching to what drives clinicians to teach while caring for patients.

Midline vs Peripherally Inserted Central Catheter for Outpatient Parenteral Antimicrobial Therapy.

Importance: Little is known about the safety of midline catheters vs peripherally inserted central catheters (PICCs) for outpatient parenteral antimicrobial therapy (OPAT).

Objective: To compare outcomes from midline catheters vs PICCs for OPAT.

Design, Setting, And Participants: This retrospective cohort study included patients who received antimicrobial therapy through a midline catheter or PICC between January 2017 and November 2023 across 69 Michigan hospitals.

Implementation of a bundle to improve diagnosis in hospitalized patients: lessons learned.

Objectives: The inpatient setting is a challenging clinical environment where systems and situational factors predispose clinicians to making diagnostic errors. Environmental complexities limit trialing of interventions to improve diagnostic error in active inpatient clinical settings. Informed by prior work, we piloted a multi-component intervention designed to reduce diagnostic error to understand its feasibility and uptake.

Survey on nurse-physician communication gaps focusing on diagnostic concerns and reasons for silence.

Diagnosis improvement requires physician-nurse collaboration. This study explored nurses' concerns regarding physicians' diagnoses and how they were communicated to physicians. This cross-sectional study, employing a web-based questionnaire, included nurses registered on Japan's largest online media site from June 26, 2023, to July 31, 2023.

Establishing a paediatric critical care core quality measure set using a multistakeholder, consensus-driven process.

Introduction: Monitoring healthcare quality is challenging in paediatric critical care due to measure variability, data collection burden, and uncertainty regarding consumer and clinician priorities.

Objective: We sought to establish a core quality measure set that (i) is meaningful to consumers and clinicians and (ii) promotes alignment of measure use and collection across paediatric critical care.

Design: We conducted a multi-stakeholder Delphi study with embedded consumer prioritisation survey.

Awareness of peripheral IV catheters among nurses, physicians, and trainees: A prospective cohort study.

Background: Peripheral intravenous catheters (PIVs) are the most frequently used invasive device in hospitalized patients. These devices are not benign and are associated with complications. However, clinician awareness of them is variable and poorly understood.

Improving Appropriate Use of Peripherally Inserted Central Catheters Through a Statewide Collaborative Hospital Initiative: A Cost-Effectiveness Analysis.

Background: Quality improvement (QI) programs require significant financial investment. The authors evaluated the cost-effectiveness of a physician-led, performance-incentivized, QI intervention that increased appropriate peripherally inserted central catheter (PICC) use.

Methods: The authors used an economic evaluation from a health care sector perspective.

Practices to prevent central line-associated bloodstream infection: A 2021 survey of infection preventionists in US hospitals.

Objective: To determine prevalence of technical and behavioral interventions aimed at preventing central line-associated bloodstream infection (CLABSI) following the COVID19 pandemic.

Design: Cross-sectional survey.

Setting: US acute care hospitals.

Inappropriate Diagnosis of Pneumonia Among Hospitalized Adults.

Importance: Little is known about incidence of, risk factors for, and harms associated with inappropriate diagnosis of community-acquired pneumonia (CAP).

Objective: To characterize inappropriate diagnosis of CAP in hospitalized patients.

Design, Setting, And Participants: This prospective cohort study, including medical record review and patient telephone calls, took place across 48 Michigan hospitals.

Peripheral intravenous catheter infection and failure: A systematic review and meta-analysis.

Background: Peripheral intravenous catheters are the most frequently used invasive device in nursing practice, yet are commonly associated with complications. We performed a systematic review to determine the prevalence of peripheral intravenous catheter infection and all-cause failure.

Methods: The Cochrane Library, PubMed, CINAHL, and EMBASE were searched for observational studies and randomised controlled trials that reported peripheral intravenous catheter related infections or failure.

The role of hospital-based vascular access teams and implications for patient safety: A multi-methods study.

Background: Peripherally inserted central catheters (PICCs) and midline catheters are often placed by nurse-led vascular access teams (VATs). While some data regarding the effectiveness of these teams exists, less is known about their structure and function.

Objectives: To examine the roles, functions, and composition of VATs related to the use and management of PICC and midline catheters.

The impact of a structured assessment and decision tool (I-DECIDED®) on improving care of peripheral intravenous catheters: A multicenter, interrupted time-series study.

Background: Peripheral intravenous catheters are the most widely used invasive device in hospitals but have serious risks.

Objective: To determine if a structured assessment and decision tool (I-DECIDED®) improves daily peripheral intravenous catheter assessment and care decisions.

Design: Prospective, interrupted time-series study.

Midline catheters in patients with advanced chronic kidney disease.

Background: Midline catheters (midlines) are increasingly used in patients with advanced chronic kidney disease (CKD).

Objective: This study describes current practice and acute complications associated with midlines in CKD patients.

Designs, Setting, And Participants: Trained abstractors at 66 hospitals from the Michigan Hospital Medicine Safety (HMS) Consortium collected data on a sample of patients who received a midline during hospitalization.

Biomarkers Associated with Thrombosis in Patients with Peripherally Inserted Central Catheter: A Systematic Review and Meta-Analysis.

Background: The measurement and identification of plasma biomarkers can support the estimation of risk and diagnosis of deep vein thrombosis (DVT) associated with the use of a peripherally inserted central catheter (PICC).

Objectives: This systematic review and meta-analysis aimed to identify the association between the levels of potential biomarkers that reflect the activation of the blood system, long-term vascular complications, inflammatory system, and the occurrence of PICC-related DVT.

Methods: Seven electronic databases (Embase, Web of Science, Medline, Scopus, Cinahl, Cochrane Central Register of Controlled Trials, and ERIC) were searched to identify literature published until December 2022.

The Association of Vasopressor Administration through a Midline Catheter with Catheter-related Complications.

Little is known about the safety of infusing vasopressors through a midline catheter. To evaluate safety outcomes after vasopressor administration through a midline. We conducted a cohort study of adults admitted to 39 hospitals in Michigan (December 2017-March 2022) who received vasopressors while either a midline or peripherally inserted central catheter (PICC) was in place.

Promoting appropriate midline catheter and PICC placement through implementation of an EHR-based clinical decision support tool: An interrupted time-series analysis.

Background: Inappropriate use of peripherally inserted central catheters (PICCs), including multilumen PICCs, may increase the risk of patient complications.

Objective: Implement computerized decision support to: (a) increase the use of midline catheters over PICCs when appropriate and (b) decrease PICC lumens when a PICC is necessary.

Designs: Quasi-experimental, interrupted time series.

Comparing Complication Rates of Midline Catheter vs Peripherally Inserted Central Catheter. A Systematic Review and Meta-analysis.

Background: Peripherally inserted central catheters (PICCs) and midlines are commonly used devices for reliable vascular access. Infection and thrombosis are the main adverse effects of these catheters. We aimed to evaluate the relative risk of complications from midlines and PICCs.