Background: Nonabsorbable disaccharides such as lactulose and poorly absorbed antibiotics such as neomycin and rifaximin are commonly used in the treatment of hepatic encephalopathy (HE). Although several studies have examined the efficacy of rifaximin in patients with HE, results of such trials has been inconsistent. We therefore performed a meta‐analysis of randomized controlled trials to […]

Background: Hospitalist programs are increasingly prevalent in teaching hospitals. Consequently, internal medicine and pediatrics trainees may receive much of their inpatient education from hospitalists. The objective of this study was to characterize the effects of hospitalists on trainee education. Methods: We searched MEDLINE, DARE, NHS EED, HTA, and Cochrane (last searched 11/2007) using the term […]

Background: Interdisciplinary communication is critically important for safe and effective patient care. Little is known about patterns of communication between nurses and physicians caring for hospitalized medical patients. Our objective was to characterize nurse‐physician communication and agreement on the plan of care (POC). Methods: During the 1‐month study period, 342 randomly selected hospitalized medical patients […]

Background: Studies demonstrate discrepant attitudes about teamwork among nurses and physicians in operating rooms and intensive care units. Little is known about teamwork attitudes on general medical services. Our objective was to assess ratings of teamwork by providers on inpatient medical units and barriers to collaboration. Methods: During a 1‐month study period, all nurses, primary […]

Background: Patients cared for in the hospital today meet numerous new physicians including hospitalists, house staff, and consultants. The relationship of each provider to the care of the patient is often confusing. We proposed that the distribution of personalized business cards with the physician name, title with description, central contact number, and a photo to […]

Background: The initial clinical assessment of patients with suspected pulmonary embolism (PE) is an essential part of the current diagnostic algorithm. Standardized prediction rules can be used to determine a general pretest probability of PE that substantially improves the predictive value of diagnostic modalities such as CT angiography and ventilation‐perfusion scanning. The modified Wells criteria, […]

Background: Hip surgery (either total hip arthroplasty or repair of the fracture) is the most common noncardiac surgical procedure performed in patients 65 years or older. Most postoperative complication reports have focused on cardiac events and their prevention, but little is known about stroke after hip surgery or interventions to reduce such events. The objectives […]

Background: Non‐ST‐segment elevation acute coronary syndrome (NSTEACS) patients are managed either with a routine invasive strategy (RIS), in which all patients undergo coronary artery angiography, or with selective invasive strategy (SIS), in which only patients with refractory or inducible ischemia undergo coronary angiography. To evaluate whether the benefit of RIS or SIS is sex specific […]

Background: In our 1000‐bed tertiary medical center, codes are run by ACLS‐certified internal medicine residents who have variable clinical experience in managing a Code Blue response. Daily physician and nurse changes in the code team composition make the development of consistent skills difficult. We established a mock Code Blue program as a quality control on […]

Background: Most patients in the ICU obtain excellent glycemic control with the use of an insulin drip protocol. How best to transition patients to a subcutaneous regimen and maintain adequate glycemic control is less well established. We evaluated how effectively glycemic control was maintained during transition from IV to subcutaneous insulin in 2 ICUs at […]