Background: Reduced payments from Medicare related to high rates of hospital-acquired pressure injuries has prompted hospitals to invest in new technologies and strategies to improve wound care and prevention. While many hospitals have increased the purchase of skin care products such as prophylactic dressings, little is known about the association between these products and reductions [...]

Background: Reduced payments from Medicare related to high rates of hospital-acquired pressure injuries has prompted hospitals to invest in new technologies and strategies to improve wound care and prevention. While many hospitals have increased the purchase of skin care products such as prophylactic dressings, little is known about the association between these products and reductions [...]

Background: Sickle cell disease (SCD) affects about 100,000 people in the US. The disease causes significant mortality, morbidity and frequent hospitalizations secondary to primary manifestations of the disease and its complications. We conducted a retrospective, single institution study in adult patients (pts), ≥ 18 years with SCD to assess factors associated with health care utilization [...]

Background: Previous studies suggest that the type of healthcare is associated with distinct clinical characteristics and outcomes,  but there are few studies addressing this in patients with a ST-elevation myocardial infarction (STEMI) in our country.  Methods: Patients presenting to our center from December 2009 to December 2014 were prospectively and consecutively included. The main inclusion [...]

Background: Hospitals are incentivized to reduce 30-day readmissions under the Affordable Care Act. Medicare payments can be reduced when inpatient readmissions are excessive. The Centers for Medicare & Medicaid Services (CMS) readmission measure is defined among encounters classified with only an inpatient status. At this time, observation encounters are not included in this measure. This [...]

Background: A documented penicillin allergy is associated with increased length of hospital stay and an increased incidence of Clostridium difficile, methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterocci. These findings are attributed to use of broader-spectrum ‘second-line’ antibiotics.  No clinical intervention has been shown to affect the above clinical outcomes to date. Hospitalization is an opportunity to [...]

Background: Acute kidney injury (AKI) following cardiac surgery occurs in 30% of cases with 1% requiring dialysis resulting in significant morbidity and mortality.  HMG-CoA Reductase Inhibitors (“statins”) have been postulated to be of benefit in this population, however results from existing clinical studies have been inconsistent. Since there is abundance of evidence showing that short-term [...]

Background: The Center for Disease Control and Prevention estimates that 1.7 million patients per year develop hospital-associated infections (HAI), of whom 99,000 die. HAIs financially impact the United States healthcare system with an estimated cost of $6 billion per year. At Platte Valley Medical Center (PVMC) in 2013, the urinary catheter utilization ratio and rates [...]

Background: The Modified Early Warning Score (MEWS) is a physiological scoring system developed to identify patients in early stages of clinical deterioration and prevent delays in proper care. It consists of systolic blood pressure, heart rate, respiratory rate, temperature and level of consciousness. Higher MEWS are associated with greater mortality and need for intensive care. [...]

Background: In 2011, sepsis accounted for more than $20 billion (5.2%) of total US hospital costs.  The CDC estimates that hospitalizations for sepsis or septicemia increased from 621,000 to 1,141,000 in 2000 and 2008 respectively.  Severe sepsis has an in-hospital mortality rate of 28.6-37.7%, and those who survive may face a difficult recovery including long-term [...]