Supporting Struggling Trainees with Performance Issues: Lessons from a UK Model.

Approximately 6-9% of trainees will have performance issues of variable degrees with 3-5% of trainees struggling to complete their training and requiring additional targeted time or an extension of training. Some even leave the profession. The environment is complex, often chaotic and overstretched, and, now, made more difficult due to the impact of COVID-19 on medical training.

Assessing Outcomes Between Risperidone Microspheres and Paliperidone Palmitate Long-Acting Injectable Antipsychotics Among Veterans.

Background: Long-acting injectable antipsychotics (LAIAs) are integral for managing schizophrenia, schizoaffective disorder, and bipolar I disorder among veterans. Studies comparing LAIAs, such as risperidone microspheres and paliperidone palmitate, are limited. The primary objective of our study was to compare the number of psychiatric hospitalizations among veterans initiated on risperidone microspheres and those taking paliperidone palmitate pre- and post-LAIA initiation.

Delirium in Intensive Care Units: Perceptions of Physicians and Nurses.

Delirium is an indicator of morbidity and mortality in intensive care unit (ICU) patients. It can lead to negative outcomes and longer hospital stays, thus increasing hospital costs. Despite national recommendations for daily assessment of delirium, it remains underdiagnosed.

Essential Care Needs for Patients' Family Members at the Intensive Care Units in Palestine.

Background: Understanding the needs of families of hospital patients, especially those in intensive care units is key to providing comprehensive, effective support. The aim of this study is to determine the needs of families of Intensive Care Unit (ICU) patients in four Palestinian hospitals.

Materials And Methods: This was a cross-sectional, analytic study including 240 participants selected using convenience sampling.

Efficacy and renal outcomes of SGLT2 inhibitors in patients with type 2 diabetes and chronic kidney disease.

Objective: To review glucose-lowering efficacy and changes in renal function associated with sodium-glucose co-transporter 2 (SGLT2) inhibitors among patients with chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM).

Data Sources: A literature search of MEDLINE and Cochrane databases was performed from 2000 to August 2018 using search terms: SGLT2 inhibitors, sodium glucose co-transporter 2, canagliflozin, empagliflozin, dapagliflozin, ertugliflozin, and chronic kidney disease. References of identified articles were also reviewed.

Impact of a Multidisciplinary Infection Prevention Initiative on Central Line and Urinary Catheter Utilization in a Long-term Acute Care Hospital.

Background: Prolonged central line (CL) and urinary catheter (UC) use can increase risk of central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI).

Methods: This interventional study conducted in a 76-bed long-term acute care hospital (LTACH) in Southeast Michigan was divided into 3 periods: pre-intervention (January 2015-June 2015), intervention (July-November 2015), and postintervention (December 2015-March 2017). During the intervention period, a multidisciplinary infection prevention team (MIPT) made weekly recommendations to remove unnecessary CL/UC or switch to alternate urinary/intravenous access.

Cleaning the air with ultraviolet germicidal irradiation lessened contact infections in a long-term acute care hospital.

Background: This study was designed to determine whether removing bacteria from the air with ultraviolet germicidal irradiation (UV-C) at the room level would reduce infection rates.

Methods: We reviewed infection data for 12 months before and after UV-C installation in the special care unit (SCU) of a long-term acute care hospital. All patients admitted to the SCU during the study time frame were included.

Implementing an antibiotic stewardship program at a long-term acute care hospital in Detroit, Michigan.

Background: The objective of the study was to assess health care providers' (HCPs) knowledge and attitude toward antimicrobial resistance (AMR) and implement an antimicrobial stewardship program (ASP) in a long-term acute care hospital (LTACH).

Methods: A questionnaire on antibiotic use and resistance was administered to HCP in an LTACH in Detroit, Michigan, between August 2011 and October 2011. Concurrently, a retrospective review of common antibiotic prescription practices and costs was conducted.

Feasibility and Safety of Flexible Bronchoscopy Performed Via Tracheal Tubes in Patients With Tracheostomies: A Retrospective, Single-Center Experience.

Background: Flexible bronchoscopy (FB) is commonly performed to assess, diagnose, and treat patients with respiratory disease, and is typically performed via transnasal or transoral approaches. FB can be performed via tracheal tubes in patients with tracheostomies; however, the safety and technical feasibility has not been established. The present study evaluates the safety and feasibility of performing FB via tracheal tubes.

Approaches to Modifying the Behavior of Clinicians Who Are Noncompliant With Antimicrobial Stewardship Program Guidelines.

Antimicrobial stewardship programs (ASPs) are a key national initiative to promote appropriate use of antibiotics and to reduce the burden of resistance. The dilemma of managing the outlier physician is especially complex. We outline strategies to establish a successful ASP that reviews appropriate efforts to achieve the goal of modifying outlier physicians' behavior.

Yoga Influences Recovery During Inpatient Rehabilitation: A Pilot Study.

Purpose: The purpose of this study was to add yoga therapy to inpatient rehabilitation and assess whether patients chose to engage in yoga therapy in addition to other daily therapies, to describe patients' perceptions of how yoga therapy influenced recovery, and to assess and describe patient satisfaction with the program.

Methods: This was a single-arm pilot study, adding yoga therapy to ongoing inpatient rehabilitation. Yoga therapy was offered as group yoga or individual yoga twice a week.

Arrhythmias in the epilepsy monitoring unit: watching for sudden unexpected death in epilepsy.

Nurses who work with patients at risk for seizures should be informed that both adult and pediatric patients are at risk for sudden unexpected death in epilepsy (SUDEP). Although the exact pathophysiology of SUDEP is not determined, patients with mesial temporal lobe epilepsy represent an at-risk population because of autonomic dysregulation. With prompt treatment, patients with near-SUDEP can continue to lead normal productive lives.

Ileal pouch anal anastomosis: an overview of surgery, recovery, and achieving postsurgical continence .

Ileal pouch anal anastomosis (IPAA) is a two- or three-stage surgical procedure performed to treat patients with ulcerative colitis (UC) or familial adenomatous polyposis (FAP). Following ileostomy closure and anastomosis, patient goals of care typically include obtaining continence and preventing complications. Nursing interventions to achieve these goals may include developing a skin care regimen, pelvic muscle floor exercises (PFME), diet changes, medication use and coping strategies.

Acoustic pressure wound therapy to facilitate granulation tissue in sacral pressure ulcers in patients with compromised mobility: a case series.

Electrical stimulation and other modalities are recommended for treatment of pressure ulcers in spinal cord injury patients but their use may be limited by clinical contraindications such as necrosis and infection. Acoustic pressure wound therapy can be used to address infection and has no known contraindications related to wound status. A retrospective nonconsecutive study was conducted involving five inpatients with sacral pressure ulcers and compromised mobility (spinal cord injury, ventilator/mobility dependency, or persistent vegetative state) treated with acoustic pressure wound therapy three times per week, 4 to 6 minutes per session, for 5 weeks to 5.

Rehabilitation of the older adult with stroke.

Stroke is an increasing public health concern throughout the world as the leading cause of long-term disability. It is well known that there exist differences related to epidemiology, pathophysiology, comorbidity, and functional outcome of stroke patients with advanced age compared with the young. Factors that have been suggested to influence this disparity include age-related complications, availability of resources, lack of aggressive management, and possible diminished capacity for neuroplasticity.

Re-admissions to inpatient paediatric pulmonary rehabilitation.

Objective: To describe re-admission rates, identify reasons for re-admission and examine characteristics of children requiring re-admission to inpatient pulmonary rehabilitation.

Methodology: Retrospective record review of infants and toddlers (less than three years of age) requiring oxygen or ventilator support discharged from an inpatient paediatric pulmonary rehabilitation programme between 1992 and 1999.

Results: Forty-one initial admissions resulted in 45 readmissions with a mean re-admission rate of 1.

Development and implementation of the Clinical Privileges for Dietitian Nutrition Order Writing program at a long-term acute-care hospital.

A patient nutrition care plan is of little value unless it is quickly and efficiently implemented. Recognition of the value of appropriate and timely medical nutrition intervention in improving patients' nutritional status led to the development of the Clinical Privileges for Dietitian Nutrition Order Writing (CPD NOW) program at a long-term, acute-care hospital. CPD NOW is a formalized approach specifying the types of nutrition care orders that may be written by a registered dietitian (RD), allowing nutrition recommendations to be implemented immediately.