Background: Prescription opioids have come under increasing scrutiny in recent years due to the rise in use and misuse which has resulted in significant morbidity and mortality. There have been several efforts by government agencies to address this such as the FDA issuing a Risk Evaluation Mitigation Strategy (REMS) for extended release/long acting (ERLAs) opioids [...]

Background: Pulmonary embolism (PE), refers to obstruction of the pulmonary artery or one of its branches by material (thrombus, tumor, air or fat) that originated elsewhere in the body.Wells criteria must be part of the clinical assessment for PE. With these criteria, we can classify patients as high probability (>6 pts), moderate (2 to 6 [...]

Background: Patients with cancer require reliable venous access for therapy. Although peripherally inserted central catheters (PICCs) and implanted ports are often used to meet infusion needs, risk of complications between these devices is unknown. We did a systematic review and meta-analysis to compare the risk of deep vein thrombosis (DVT), exit-site complications and central line-associated [...]

Background: Diagnostic error is commonly defined as a missed or delayed diagnosis and has been described as among the most important patient safety hazards. Diagnostic errors also account for the largest category of medical malpractice high severity claims and total payouts. Despite a large literature on the incidence of inpatient adverse events, no systematic review [...]

Background: New Mexico has a long-standing history of implementing harm reduction strategies for the prevention of opioid overdose. Most recently, on June 14, 2019, SB221 added language to the New Mexico Pain Relief Act requiring health care providers prescribing opioid analgesics for 5 days or longer to co-prescribe an opioid antagonist along with written information [...]

Background: Central line-associated bloodstream infection (CLABSI) is a morbid and potentially lethal complication. National policies related to CLABSI mandate public reporting of this adverse event, with hospitals receiving penalties based on their CLABSI rates. Contemporary data suggest that peripherally inserted central catheters (PICCs) placed outside critical care settings are a large contributor to hospital CLABSI [...]

Background: Availability of acute medical services (e.g., emergency department, intensive care unit) has been associated with adverse clinical outcomes. The association between acute psychiatric inpatient beds and suicide has not been well described. In the Veterans Health Administration (VHA), suicide rates among veterans have increased despite mental health care investments. Our objective was to examine [...]

Background: With the advancement of technology and medical care, more critically ill patients are surviving the medical intensive care unit (ICU) and are transferred to the general wards, where they spend the majority of their hospitalization. While there are guidelines that address common complications in the ICU (delirium and functional decline), once patients are transferred [...]

Background: Diagnostic errors in hospitalized patients are difficult to identify and quantify: error rates range from 4.8 to 49.8%. Though chart review tools, like the Safer Dx instrument, have been developed to assess the presence of diagnostic error in ambulatory settings, they have yet to be validated for acute care. A key issue is identifying [...]

Background: Hospital discharges due to psychotropics poisoning whether intentional, unintentional, prescription errors or related side effects have been increasing nationally. Hospital costs are also increasing subsequently. We compared the annual rate of hospital discharges in 4 regions of United States (West, Midwest, South, and Northeast) while incorporating the number of the mental health providers in [...]