Background: The initiation or withdrawal of artificial nutrition, via nasogastric and gastrostomy tubes, is a common and difficult issue in medical practice. Resident physicians and hospitalists frequently involve families in making these decisions, as the patients are generally hospitalized and often too ill to decide for themselves. However, little is known about the attitudes of […]

Background: Poor glycemic control in hospitalized patients is strongly associated with increased length of stay, mortality, infections, and other undesirable outcomes. Poor glycemic control and suboptimal insulin regimens are the rule in inpatient ward settings, in part because of the fear of inducing hypoglycemia. We sought to improve glycemic control while reducing hypoglycemia in hospitalized […]

Background: Although there are some data on the effect of hospitalist‐run teaching services at academic institutions, there is very little data about the effect of nonteaching hospitalist services compared with traditional house staff‐associated teaching services at academic medical centers. Many academic centers across the country have employed or are starting to employ nonteaching hospitalist services […]

Background: The addition of a clinical nurse specialist (CNS) to an inpatient medical team has been shown to reduce length of stay (LOS) and improve patient satisfaction. Many hospitalists practice in nonteaching settings and without the assistance of other dedicated team members. The purpose of this study was to evaluate the effect of a hospitalist‐CNS […]

Background: Postoperative ileus (POI) occurs in patients undergoing bowel resection and can lead to prolonged hospitalization. Methylnaltrexone, a quaternary derivative of naltrexone, avoids the peripheral effects of opioids while sparing their central analgesic effects. It is thought that mu‐opioid receptors in the gastrointestinal tract may play a role in the pathogenesis of POI. We hypothesized […]

Background: Hyponatremia is a common electrolyte disorder in hospitalized patients often resulting from elevated arginine vasopressin (AVP) levels. Conivaptan (CNV) is a novel AVP‐receptor antagonist that produces aquaresis, the solute‐free, electrolyte‐sparing excretion of water, by ing AVP V2 receptors. The efficacy and safety of using CNV in the treatment of euvolemic and hypervolemic hyponatremia of […]

Background: Detection of geriatric syndromes is a critical step in caring for older patients and determining eligibility for post‐acute care services. Geriatric syndromes, notably delirium and malnutrition, are often undiagnosed and untreated in hospitalized elderly patients; and a history of falls, often overlooked, identifies patients at high risk for future preventable falls. We hypothesized that […]

Background: Postoperative bariatric surgery (BS) infection rates (IRs) of 1%‐16.5% have been reported, with a mortality rate of up to 21.7%. This study investigated the 30‐day postoperative IR and mortality rate at our institution. It also examined epidemiologic risk factors for postoperative bariatric surgery infections. Methods: Nosocomial infections that occurred less than 30 days post‐BS […]

Background: Catheter‐associated bloodstream infection (CA‐BSI) causes significant morbidity and mortality. Yet there are no national data describing the extent to which American hospitals are using proven strategies to prevent CA‐BSI, nor are there data assessing the facilitators of or barriers to using proven preventive practices. We were also curious how a centralized system of health […]

Background: Inpatient hyperglycemia is common and associated with adverse patient outcomes. Current guidelines recommend treatment to achieve glucose levels below 180 mg/dL in the inpatient non‐ICU setting. The best ways to achieve this glucose target are unknown. Methods: We developed a multifaceted intervention to improve inpatient glycemic control consisting of: (1) a detailed subcutaneous insulin […]