Background: Use of dexamethasone in pediatric patients with asthma exacerbations in the emergency department and ambulatory care settings has been supported in the literature as an alternative to prednisone with equivalent efficacy and potential benefits of increased compliance and decreased side effects. However, there is limited understanding of its efficacy in patients with status asthmaticus [...]

Background: Nosocomial infections contribute significantly to morbidity and increase health care costs for both pediatric and adult patients in the United States.(1) Intravenous access remains a main source of nosocomial infections from environmental and (non-intentional) aseptic technique violations by healthcare providers via contact with stopcocks, IV tubing, and syringes.(2,3) Stopcock contamination and repeated syringe strokes [...]

Background: Family-centered rounds on our pediatric hospital medicine teaching service, which cares for patients in multiple units throughout the hospital, are often prolonged with unpredictable progression. This contributes to inconsistent nursing participation, inefficiencies in patient care, and variable end times. Through the implementation of scheduled-based rounding, our aims were to: 1) start 90% of rounds [...]

Background: Delirium is a well know post-operative complication that has been shown to increase mortality, length of stay, and post-operative complications. Despite extensive study, there is limited treatment for delirium once it occurs. Emphasis on preventing delirium and identifying patients at risk is an important part of reducing its impact on the individual and the [...]

Background: Intravenous (IV) low molecular weight iron dextran is a safe and effective treatment for iron deficiency anemia (1). However, oral (PO) iron supplementation remains a preferred mode of iron repletion due to low cost and ease of administration. Unfortunately, the efficacy of PO iron varies due to differences in drug absorption and patient adherence. [...]

Background: Current guidelines recommend preoperative stress testing for patients whose predicted risk of a major adverse cardiac event exceeds 1%, whose functional status is poor or unknown, and when stress testing would change clinical management. However, each of those three decision points likely vary by provider, and real-world use is unclear. In order to understand [...]

Background: The Society of Hospital Medicine (SHM) is the academic professional home for more than 16,000 hospitalists around the world [1]. The SHM Quality Improvement (QI) Special Interest Group (SIG), which currently has 813 members including residents and medical students, known as QI enthusiasts, uses an online platform, Hospital Medicine Exchange (HMX), to share project [...]

Background: Despite the consistently proven benefits of cardioprotective medications, medication adherence (MA) remains a challenge in coronary artery disease (CAD) patients. Studies suggest that up to 50% of patients with CAD are nonadherent to medications, with patient knowledge, beliefs, and expectations playing a vital role. We aimed to assess patient-related medication non-adherence (MNA) factors in [...]

Background: Risk assessment for venous thromboembolism (VTE) is a part of every hospital admission. The workflow of who completes the assessment varies between hospitals, but often it is carried out by trainees. VTE risk assessment is further complicated by the variety of methods to identify those patients who are appropriate for chemoprophylaxis, mechanical prophylaxis, or [...]

Background: Hematopoietic stem cell transplantation (HSCT) can be a life-saving and curative therapy in hematological malignancies. Pre-transplant evaluation for HSCT is a multidisciplinary process that can be complicated, time-consuming, and expensive for patients to navigate. The process requires coordination between several medical subspecialties including pulmonary, cardiology, and mental health, in addition to social workers and [...]