Strategies to Enhance Patient Care and Compliance with Pain Order Duplications and Gaps.

According to the Joint Commission every patient has a right to pain management. Due to multimodal pain management, pain orders have the potential for duplication as well as gaps in therapy. At our institution, we evaluated pain orders and implemented strategies that aimed to reduce those gaps.

Hemodialysis Access Maintenance in the Medicare Population: An Analysis Over a Decade of Trends by Provider Specialty and Site of Service.

Purpose: To evaluate annual national trends in hemodialysis access maintenance procedures in the Medicare population by specialty and setting.

Methods: Medicare Physician Supplier Procedure Summary Master Files between 2005 and 2015 were analyzed for procedure codes of hemodialysis access angiography and percutaneous thrombectomy. Using physician specialty codes, component procedure volume for endovascular services were queried for radiology, medicine, and surgery.

ACR Appropriateness Criteria Imaging of Deep Inferior Epigastric Arteries for Surgical Planning (Breast Reconstruction Surgery).

Breast cancer is the most common malignancy in women in the United States. Breast reconstruction surgery is a commonly used therapy for patients with breast cancer. The technique for the deep inferior epigastric perforator flap uses a preserved rectus muscle, which decreases donor site morbidity.

Role of albumin in cirrhosis: from a hospitalist's perspective.

Albumin, a negatively charged globular protein encoded on chromosome 4, is one of the most abundant proteins in the plasma and accounts for approximately 75% of plasma oncotic pressure. The role of albumin in the management of various disease states has shown to be beneficial historically. Low serum albumin is a predictor of mortality and poor outcomes.

ACR Appropriateness Criteria Vascular Claudication-Assessment for Revascularization.

Vascular claudication is a symptom complex characterized by reproducible pain and weakness in an active muscle group due to peripheral arterial disease. Noninvasive hemodynamic tests such as the ankle brachial index, toe brachial index, segmental pressures, and pulse volume recordings are considered the first imaging modalities necessary to reliably establish the presence and severity of arterial obstructions. Vascular imaging is consequently used for diagnosing individual lesions and triaging patients for medical, percutaneous, or surgical intervention.

Community need for university-based mental health services: identifying the top 5.

The purpose of this study was to determine the community need for mental health and health promotion services provided by advanced practice nursing faculty at a small university in the midwestern United States. Fifty participants from a three-county service area were selected to complete a needs assessment survey. Survey results indicated strong community need for primary mental health services for low-income residents, older adults, pregnant women, and families with children.

Toxic shock syndrome: an opportunity for nursing intervention.

Toxic Shock Syndrome (TSS) is a potentially fatal illness caused by a particular strain of Staphylococcus aureus. The clinical presentation is similar to that of septic shock. The incidence of TSS peaked in the late 1970s and early 1980s, probably as a result of availability of super absorbent tampons.

Human intradiscal levels with cefazolin.

The administration of prophylactic antibiotics for the prevention of discitis is common in the field of spinal surgery. The purpose of this study was to determine 1) whether cefazolin administered intravenously would result in detectable intradiscal levels; and 2) if so, what the proper timing of the antibiotic bolus should be to achieve optimal intradiscal concentrations. Forty human lumbar discs were obtained during the study period.