A Matter of Conscience: Examining the Law and Policy of Conscientious Objection in Health Care.

Conscientious objection refers to refusal by a health care provider (HCP) to provide certain treatments, including the standard of care, to a patient based upon the provider's personal, ethical, or religious beliefs. Federal and state rules regarding conscientious objection have expanded the scope of legal protections that HCPs and institutions can invoke in support of refusal. Opponents of these rules argue that allowing refusal of care deprives patients of care that conforms to professionally established guidelines, contradicts long-standing principles related to informed consent, interferes with the ability of health care facilities to provide safe and efficient care, and leaves the patient without means of redress for injury.

Colistin plus meropenem for carbapenem-resistant Gram-negative infections: in vitro synergism is not associated with better clinical outcomes.

Objectives: In vitro models showing synergism between polymyxins and carbapenems support combination treatment for carbapenem-resistant Gram-negative (CRGN) infections. We tested the association between the presence of in vitro synergism and clinical outcomes in patients treated with colistin plus meropenem.

Methods: This was a secondary analysis of AIDA, a randomized controlled trial comparing colistin with colistin-meropenem for severe CRGN infections.

Population pharmacokinetics of colistin and the relation to survival in critically ill patients infected with colistin susceptible and carbapenem-resistant bacteria.

Objectives: The aim was to analyse the population pharmacokinetics of colistin and to explore the relationship between colistin exposure and time to death.

Methods: Patients included in the AIDA randomized controlled trial were treated with colistin for severe infections caused by carbapenem-resistant Gram-negative bacteria. All subjects received a 9 million units (MU) loading dose, followed by a 4.

Research translation for military and veteran health: research, practice, policy.

Military service presents unique challenges and opportunities for health care and public health. In the USA, there are over 2 million military servicemembers, 20 million veterans, and millions more military and veteran family members. Military servicemembers and eligible family members, many veterans, and retirees receive health care through the two largest learning health care systems in the USA, managed and delivered through the Departments of Defense (DoD), Veterans Affairs (VA), and contracted health care organizations.

Risk Factors for Postpartum Depression: An Umbrella Review.

Introduction: A deeper understanding of risk factors for postpartum depression (PPD) is essential to better target prevention and screening. An umbrella review was conducted to summarize and synthesize previously published systematic reviews and meta-analyses.

Methods: Eight databases were searched in October of 2016, including PubMed, CINAHL, MEDLINE, PsycINFO, Embase, SCOPUS, PsycEXTRA, and Cochrane.

Providing Access: Differences in Pediatric Portal Activation Begin at Patient Check-in.

Background: The patient portal interface with individual electronic health records (EHR) was introduced as a tool to enhance participatory medicine. Recent studies suggest adults from racial and ethnic minorities as well as non-English speakers face disproportionate barriers to adoption; however, little data are available for pediatric patients.

Objective: The purpose of this study was to examine patient portal offers and activation patterns among pediatric urology patients at two geographically diverse tertiary pediatric hospitals.

Inappropriate Use of Public Hospitals Emergency Departments in Greece: Magnitude and Associated Factors.

The aim of this study was to evaluate the appropriateness of use of the Emergency Departments (EDs) and to identify the reasons for inappropriate use. A study with 805 patients visiting the EDs of four large-scale public hospitals in Athens was conducted using the Hospital Urgencies Appropriateness Protocol (HUAP). 38.

Robotic Systems in Operating Theaters: New Forms of Team-Machine Interaction in Health Care.

Background: Health information systems have developed rapidly and considerably during the last decades, taking advantage of many new technologies. Robots used in operating theaters represent an exceptional example of this trend. Yet, the more these systems are designed to act autonomously and intelligently, the more complex and ethical questions arise about serious implications of how future hybrid clinical team-machine interactions ought to be envisioned, in situations where actions and their decision-making are continuously shared between humans and machines.

Patient Survival and Length of Stay Associated With Delayed Rapid Response System Activation.

The objective of this study was to investigate the difference in mortality and length of stay between patients who experienced a delay in rapid response system (RRS) activation and those who did not. A retrospective comparative cohort study investigated all adult inpatient cases that experienced an RRS activation from January 1, 2017, through January 1, 2018. Cases experiencing a delay in RRS activation were compared with cases without delay.

Adjusting to the transition into assisted living: Opportunities for nurse practitioners.

Background And Purpose: Transition from an independent living residence to assisted living (AL) is challenging. The study purpose was to understand such a transition from the perspective of older women.

Methods: A hermeneutic phenomenological approach was used to explore how 17 older women living in a Continuing Care Retirement Community, many of whom were recently widowed, experienced this transition.

"Learning How to Teach" in Nursing: Perspectives of Clinicians After a Formal Academy.

Background: The nursing faculty shortage is expected to persist throughout the next decade. Understanding what influences transition from clinician to educator and retention can improve approaches used in nursing programs for those aspiring to careers in nursing education.

Purpose: This qualitative study elicited the experiences of participants who completed a structured program to prepare clinicians to become clinical faculty for prelicensure students.

Chart It to Stop It: Failure Modes and Effect Analysis for the Reporting of Workplace Aggression.

The purpose of this quality improvement study was to describe the process for workplace aggression (WPA) reporting and the potential failures for this process in a pediatric emergency department. Interviews were conducted with 10 interdisciplinary employees. Findings yielded 7 tasks following WPA: contact security, contact police, contact clinical manager, notify emergency department director, call safety hotline, complete electronic safety form, and complete paper safety form.

Reducing Opioid Prescriptions in Outpatient Pediatric Urological Surgery.

Purpose: We assessed the impact of a 2-phase Plan-Do-Study-Act cycle to decrease opioid prescriptions following pediatric urological surgery.

Materials And Methods: Parents of children undergoing outpatient urological procedures were given questionnaires to assess opioid dosing and pain scores using the Parents' Postoperative Pain Measure scale. Age, procedure and opioid prescription data were recorded, as well as volume of medication administered.

Examining the Beliefs of Skilled Nursing Facility Directors of Nursing Regarding BSN Completion and the Impact of Nurse Leader Education on Patient Outcomes.

Research suggests that acute care patients cared for by baccalaureate-educated nurses have better outcomes. Directors of nursing (DONs) in skilled nursing facilities (SNFs) have lower rates of baccalaureate attainment than acute care nurses for unclear reasons. To understand the interest in advancing education, researchers surveyed SNF DONs in Connecticut to examine their beliefs about academic advancement and the impact of DON education on resident outcomes.

Predictors of glycemic management among patients with type 2 diabetes.

Aims And Objectives: To identify correlates of glycemic control among people with type 2 diabetes mellitus.

Background: Approximately 28.8 million adults have type 2 diabetes mellitus in the United States with $245 billion spent on disability and lost productivity.