Background: Urinary catheters, vascular catheters, and wounds such as pressure injuries are often hidden from view under gowns and sheets – out of sight, out of mind – contributing to prolonged catheter use, infections, delayed interventions, and diagnostic errors for symptoms (e.g., fever, delirium) related to catheters and wounds. We developed and pilot tested a […]

Background: Skin, soft tissue, and joint infections are common in pediatric patients and can require invasive procedures to drain purulent fluid. Atypical pathogens (fungal and acid-fast bacilli [AFB]) are important but rare causes of these infections with reported case rates as low as 0.6-1.6 cases/100,000 a year. Despite the rarity of these infections, costly atypical […]

Background: Our institution’s rate of hospital acquired Clostridioides difficile (C. diff) infection (CDI) is higher than expected based on documented severity of illness of our patients. The C. diff testing algorithm at our institution utilizes a multi-step approach. It begins with two tests (antigen EIA and toxin A/B EIA). If the results of these two […]

Background: Digital bedside information displays can alert clinicians about patient safety hazards, but the unintended consequences of these interventions are not well understood. Introducing new digital interventions may have implications for clinician satisfaction with the electronic environment, clinical team communication, and patient-centered care. Toward greater understanding of these unintended consequences, we described the content, form, […]

Background: Hospital at home (HaH) programs have shown efficacy as substitutes for high-cost, traditional hospitalization in patients who are primarily low-acuity and with a range of medical conditions, including community-acquired pneumonia (CAP) and urinary tract infection (UTI). However, wide-spread adoption is minimal as providers and patients are challenged to consider HaH at the time of […]

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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: Peripherally inserted central catheters (PICCs) are associated with an increased risk of central line-associated bloodstream infection (CLABSI) and venous thromboembolism (VTE). Catheters that are coated or impregnated with antimicrobial and/or antithrombotic agents have been developed to prevent these complications. However, their effectiveness in preventing CLABSI and VTE is unclear. Using data from a large […]

Background: Peripherally inserted central catheters (PICCs) are frequently used to deliver intravenous (IV) antibiotic therapy. Infectious disease (ID) physicians are often consulted prior to PICC placement, but whether their engagement influences PICC appropriateness and complications is not known. Methods: Using data from the Michigan Hospital Medicine Safety Consortium on PICCs placed in hospitalized medical patients […]

Background: Between 2007 and 2015, inpatient fluoroquinolone use declined in U.S. Veterans Affairs (VA) hospitals. Whether fluoroquinolone use at discharge has also declined, in particular since antibiotic stewardship programs became mandated at VA hospitals in 2014, is unknown. Methods: In this retrospective cohort study of hospitalizations with infection between January 1, 2014 and December 31, […]