Relationships Between Perceived Importance of Chaplain Presence and Health Professionals' Emotional Well-Being in the United States.

Hospital-based chaplains receive specialized training to provide spiritual support to patients and healthcare staff during difficult health transitions. However, the impact of perceived chaplain importance on healthcare staff's emotional and professional well-being is unclear. Healthcare staff (n = 1471) caring for patients in an acute care setting within a large health system answered demographic and emotional health questions in Research Electronic Data Capture (REDCap).

A Randomized Pilot Study Assessing if SEDLine Monitoring During Induction of Surgical Patients is Associated With Reduced Dosage of Administered Induction Agents.

. Intubations, especially in emergent settings, carry a high risk of hemodynamic instability with potentially catastrophic outcomes. Weight-based dosing of induction drugs can be inappropriately high for elective or emergent intubations and lead to hemodynamic instability.

Do buprenorphine doses and ratios matter in medication assisted treatment adherence.

Introduction: Buprenorphine (BUP), generally prescribed as buprenorphine/naloxone, is a key component of medication-assisted treatment (MAT) to manage opioid use disorder. Studies suggest higher doses of BUP increase treatment adherence. Routine urine drug screens (UDS) assist in monitoring MAT adherence via measurement of excreted BUP and its metabolite, norbuprenorphine (NBP).

Surgical Site Infection in Thoracic Surgery Is Not Associated With Perioperative Hypothermia.

Introduction: The Surgical Care Improvement Project (SCIP) added the SCIP-Inf-10 measure to mandate that all surgical patients have perioperative temperature management to reduce surgical site infection. While the basis of this measure originated in colorectal surgery, we hypothesized that this would also apply to thoracic surgery patients.

Methods: This was a retrospective single-center pilot study reviewing two years of thoracic surgery cases for the incidence and duration of hypothermia during the operation and surgical site infection occurring within 30 days.

Phenobarbital and/or benzodiazepines for recurrent alcohol withdrawal: A self-controlled, retrospective cohort study.

Background: While there is ample data supporting the use of barbiturates and benzodiazepines (BZDs) for the treatment of alcohol withdrawal, there is a paucity of information on treating recurrent withdrawal among high healthcare utilizing patients. The purpose of this study was to assess the efficacy and safety of phenobarbital (PB), with or without adjuvant BZDs, for treatment of acute alcohol withdrawal in the emergency department (ED) in patients with high rates of recurrent withdrawal.

Methods: This non-matched, self-controlled, retrospective cohort study evaluated patients seen in the ED of an urban trauma center and safety-net teaching hospital between July 1st, 2018, and July 31st, 2019.

A heart-team hybrid approach for atrial fibrillation: a single-centre long-term clinical outcome cohort study.

Objectives: The Cox-maze IV is the gold standard for surgical ablation of atrial fibrillation (AF). A heart-team hybrid approach using selected epicardial thoracoscopic surgical ablations and completion endocardial ablations to replicate the Cox-maze IV lesion set has gained popularity and early results have been promising. We herein report our single-centre long-term clinical outcomes using the heart-team hybrid approach with 455 patients.

Key articles and guidelines for the emergency medicine clinical pharmacist: 2011-2018 update.

Purpose: To summarize recently published research reports and practice guidelines on emergency medicine (EM)-related pharmacotherapy.

Summary: Our author group was composed of 14 EM pharmacists, who used a systematic process to determine main sections and topics for the update as well as pertinent literature for inclusion. Main sections and topics were determined using a modified Delphi method, author and peer reviewer groups were formed, and articles were selected based on a comprehensive literature review and several criteria for each author-reviewer pair.

Does early physical therapy intervention reduce opioid burden and improve functionality in the management of chronic lower back pain?

Introduction: Chronic lower back pain is a leading cause of disability in US adults. Opioid use continues to be controversial despite the Centers for Disease Control and Prevention guidance on chronic pain management to use nonpharmacologic and nonopioid pharmacologic interventions. The objectives of the study were to assess the impact of early physical therapy (PT) intervention on improving functionality and reducing opioid burden in patients with chronic lower back pain.

Role of Gender in Dual Antiplatelet Therapy After Acute Coronary Syndrome.

Purpose Of Review: The effect of gender on use of dual antiplatelet therapy (DAPT) in treatment of acute coronary syndrome (ACS) is not well established. The purpose of this review is to understand gender-based differences in response to DAPT, so that treatment of ACS can be optimized in women to prevent ischemic events while minimizing bleeding risk.

Recent Findings: There are innate gender differences in platelet reactivity and response.

Implementation of an integrated computerized prescriber order-entry system for chemotherapy in a multisite safety-net health system.

Purpose: The development of a computerized prescriber order-entry (CPOE) system for chemotherapy in a multisite safety-net health system and the challenges to its successful implementation are described.

Summary: Before CPOE for chemotherapy was first implemented and embedded in the electronic medical record system of Harris Health System (HHS), pharmacy personnel relied on regimen-specific preprinted order sets. However, due to differences in practice styles and workflow logistics, the paper orders across the 3 facilities were mostly site specific, with varying clinical content.

A Case of Metastatic Atypical Neuroendocrine Tumor with Translocation and Diffuse Brain Metastases.

Unlabelled: A challenge in precision medicine requires identification of actionable driver mutations. Critical to such effort is the deployment of sensitive and well-validated assays for mutation detection. Although identification of such alterations within the tumor tissue remains the gold standard, many advanced non-small cell lung cancer cases have only limited tissue samples, derived from small biopsies or fine-needle aspirates, available for testing.

Fly rounds: Validation and pilot of a novel epidemiologic tool to guide infection control response to an infestation of Sarcophagidae flies in a community hospital's perioperative department.

During an outbreak of Sarcophagidae, or flesh flies, in a community hospital's perioperative department, the infection prevention and control (IPC) department developed, validated, and piloted a novel epidemiologic tool to track hourly fly prevalence by room. Interrater reliability of the tool was measured as 0.88 and hourly point prevalence counts were superimposed on floor plans to create heat maps.

Prevention of Ventilator-Associated Pneumonia in the Intensive Care Unit: Beyond the Basics.

Ventilated-associated pneumonia (VAP) is a major concern for hospitals and a major problem for ventilated patients in the intensive care unit. Included in the basics are hand hygiene, wearing gloves, endotracheal tube suctioning, head of bed at 30°, stress ulcer prophylaxis, turning patient side to side at least every two hours, and giving the patient a sedation vacation each morning. Beyond the basics included here are oral hygiene, oral suctioning, endotracheal tube cuff pressure, artificial humidification, the difference in practice between registered nurses and respiratory therapists, using the beach chair position and early mobilization, and the VAP bundle.

Integration of internationally educated nurses into the U.S. Workforce.

This study describes the integration experiences of internationally educated nurses, managers, and educators working in Northern California. The purpose of this qualitative pilot study was to explore the experiences of internationally educated nurses and the nurse managers and educators working with them, to understand the issues, and to highlight potential solutions for addressing integration challenges. Through interviews and qualitative analysis, successful strategies and persistent challenges were identified.

Update on pressure ulcer management and deep tissue injury.

Objective: To review recent literature regarding therapeutic management of pressure ulcers and to discuss the potential implications of the newly recognized entity, deep tissue injury (DTI).

Data Sources: A MEDLINE search was conducted of pressure ulcer therapy published between January 2001 and October 2009. Key search terms included pressure ulcers, deep tissue injury, nutrition, antibiotics, and therapy.

Expectations, perceptions, and management of labor in nulliparas prior to hospitalization.

This ethnographic qualitative study was designed to explore the phenomenon of prehospitalization labor from the perspective of nulliparous women. Twenty-three women were interviewed in the early postpartum period using a semistructured interview guide. The participants recounted their experiences with labor onset recognition and management before being admitted to the hospital for birthing.

Strike a balance with decentralized housekeeping.

Housekeeping staff join patient-care teams to improve patient care, but the transition can cause problems of its own. Read how one hospital minimized the negative effects and improved staff productivity and patient satisfaction.

The new entrepreneurial foundation for the nurse executive.

Nurse executive are well positioned to be the entrepreneurial spirit needed to help their organization adapt to a rapidly changing health care industry. The article suggests a foundation to help nurse executives expand their entrepreneurial role. Areas for consideration and development include awareness, environment, education, characteristics and principles.

Effects of fixation and tissue processing on immunohistochemical demonstration of specific antigens.

Identification of biomarkers in archival tissues using immunochemistry is becoming increasingly important for determining the diagnosis and prognosis of tumors, for characterizing preinvasive neoplastic changes in glandular tissues such as prostate, for evaluating the response of tumors and preinvasive neoplastic changes to certain therapies (i.e., as a surrogate intermediate end point), for selecting patients who are candidates for specific therapies (e.