Background: Delirium is associated with high morbidity and mortality in hospitalized older adults. Sleep is a modifiable risk factor for delirium. Eye masks (EMs) and earplugs (EPs) have been shown to improve sleep and effective reduce delirium in the ICU. This study examines the clinical usability of this intervention component in general medicine patients. We [...]

Background: The role of aspirin in primary prevention of cardiovascular events remains controversial, Especially in diabetic patients. We have conducted a meta-analysis of all randomized controlled trials (RCTs) to evaluate the efficacy and safety of aspirin for primary prevention in diabetic patients. Methods: Literature search of Pubmed, MEDLINE, Cochrane Library and Clinicaltrials.gov for related RCTs [...]

Background: Clostridioides difficile infection (CDI) can be prevented through infection prevention practices and antibiotic stewardship. We found in a 2013 national survey (571 hospitals, 71% response rate) that while infection prevention practices for CDI were common in U.S. hospitals, only 52% had an antibiotic stewardship program (ASP). On 1 January 2017, The Joint Commission required [...]

Background: Pressure injuries are tissue damage caused by pressure and shear. Susceptible patients are the elderly, acute, critically ill and malnourished. Pressure injuries severely deplete hospital performance measures in the U.S. Currently, over 2.5 million patients develop pressure injuries at a national cost of about $25 billion each year and are implicated in 50,000 deaths. [...]

Background: Delirium is an acute change in mental status affecting 10-64% of hospitalized patients, and may be preventable in 30-40% cases. There was no standardized protocol for delirium at our hospital prior to 2014. In October 2013, we formed a task force for delirium prevention and early identification across 18 medical-surgical units in our hospital. [...]

Background: Patients evaluated after sexual assault may require non-occupational post-exposure prophylaxis (nPEP) to prevent infection with human immunodeficiency virus (HIV), depending on the assessed risk of HIV transmission in each case1-4. Access to nPEP medications, patient counseling, and follow-up care should be offered in a systematic, comprehensive, and compassionate setting. Unfortunately, multiple barriers may impede [...]

Background: Ventilator associated pneumonia (VAP) is the leading cause of death from nosocomial infections in critically-ill patients. The CDC recommends maintaining Head-of-Bed (HOB) elevation at a target recumbency range of 30º-45º due to evidence that a semi-recumbent position significantly reduces VAP. Current methods for evaluating patient recumbency utilize “eyeballing” or built-in HOB protractors, which are [...]

Case Presentation: A 56 y/o African American male with a history of paroxysmal atrial fibrillation presented with “pounding” chest pain after being assaulted. On presentation, the patient was afebrile and normotensive but significantly tachycardic (heart rate 140). Physical exam revealed an irregular rhythm with a s3 gallop and a 2/6 systolic murmur in the left [...]