Background: Health care‐acquired infections (HAIs) represent a far too common risk and cost of hospitalization. Urinary catheter‐associated urinary tract infection is the most common cause of HAIs, with prolonged catheter use conferring a relative risk of 5.1‐6.8. Ventilator‐associated pneumonia (VAP) is the leading cause of death among patients with HAIs with an attributable mortality as […]

Background: Methylnaltrexone, a quaternary derivative of naltrexone, is being developed for the treatment of opioid‐induced constipation in patients with advanced illness and postoperative ileus. GI transit, slowed by morphine, is reversed by intravenous, subcutaneous, or oral methylnaltrexone. In previous studies involving opioid users on chronic methadone maintenance treated with intravenous or oral methylnaltrexone laxated within […]

Background: Subcutaneous (SC) administration of human recombinant hyaluronidase (rHuPH20) temporarily increases connective tissue permeability by degrading hyaluronan. Because this technique enhances dispersion of coadministered molecules, we evaluated whether rHuPH20 coadministered with SC morphine enhances morphine absorption. Methods: Two placebo‐controlled, double‐blind, crossover trials, one with 13 palliative care patients and the other with 18 healthy volunteers, […]

Background: Subcutaneous (SC) administration of human recombinant hyaluronidase (rHuPH20) temporarily increases the permeability of connective tissues by degrading hyaluronan and facilitating dispersion of coinjected molecules. SC administration of morphine + rHuPH20 in healthy volunteers and palliative care patients has been shown to enhance morphine absorption, resulting in phar‐macokinetics (PK) that favorably compared with intravenous (IV) […]

Background: As hospitalist groups grow larger, it is important for every member of the team to be on the same page with new developments and in‐house rules and regulations. Exchanging e‐mails has the limitation of not providing a central resource for information that can be easily accessed and searched by all group members at the […]

Background: Incorporating continuing medical education for hospital medicine programs is an important component of practice development. This can be particularly challenging for practices that do not have access to grand rounds and the usual calendar of educational events traditionally available on academic campuses. Recognizing the relevance of the Society of Hospital Medicine's The Core Competencies […]

Background: The resident duty‐hour limitations mandated by theACGME increases the number of handoffs of patient responsibility, raising concerns about discontinuity of care and patient safety (Charap, Ann Intern Med. 2004). Meanwhile, the handoff process is left to interns alone in more than one third of training programs (Horwitz et al., Arch Intern Med. 2006). We […]

Background: A number of studies reported in the literature suggest there is overuse of proton pump inhibitor (PPI) medications in hospitalized patients. Purpose: The goals of the study were to implement a computerized physician order entry (CPOE) order set for intravenous (IV) PPIs and to anlayze use patterns following this change. Description: A multidisciplinary committee […]

Background: Since the advent of hospitalist programs, multiple studies reported in the literature have compared readmission rates on hospitalist and nonhospitalist services. However, specific reasons for readmission are often not available. Purpose: To describe the experience of a recently established hospital medicine program at a large academic medical center with regard to 7‐day readmissions and […]

Background: A hospitalist program serves numerous stakeholders: patients, hospital administration, primary care physicians, and nursing staff, to name a few. It is imperative to gauge hospitalist performance as evaluated by these stakeholders. Although surveying patients and primary care physicians is now the established norm, there was a need to create a nursing satisfaction survey. This […]