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Abstract Number: 171
SHM Converge 2023
Background: Diagnostic errors (DEs) are common and can lead to preventable harm in hospitalized patients.[1] To address this problem as part of our AHRQ-funded Patient Safety Learning Laboratory, we characterized diagnostic process failures that contribute to DEs.[2,3] Next, we refined three interventions (Figure 1) that addressed common process failures and were embedded into our electronic […]
Abstract Number: 172
SHM Converge 2023
Background: CMS launched the Hospital Value-Based Purchasing (VBP) Program in 2010 as part of their initiatives to incorporate healthcare quality into Medicare payment structures. Participating hospitals are assessed according to four domains: Clinical Care, Person and Community Engagement, Safety, and Efficiency and Cost Reduction. Interventions to improve patient safety such as hand hygiene, contact precautions, […]
Abstract Number: 173
SHM Converge 2023
Background: In-hospital venous thromboembolism (VTE) remains an important preventable cause of morbidity/mortality. Multiple risk assessment models (RAMs) for VTE in hospitalized medical patients have been developed, validated, and endorsed by several national societies. Despite evidence and guidelines supporting risk stratification for VTE prevention, data suggest that prophylactic measures are not appropriately utilized. In a nation-wide […]
Abstract Number: 174
SHM Converge 2023
Background: Hospitalized patients may require central venous access devices (CVADs) for inadequate intravenous (IV) access. CVADs have known complications, including peri-procedural trauma and central line associated bloodstream infections (CLABSI). CLABSI is of concern for patients and hospital systems, as it is largely preventable and used as a quality measure. A CVAD alternative is a short […]
Abstract Number: 175
SHM Converge 2023
Background: The Michigan PICC-DVT Risk Score (MRS) identified five predictors for deep venous thrombosis (DVT) associated with peripherally inserted central catheters (PICCs): presence of another central venous catheter (CVC) when device is placed, white blood cell (WBC) count at time of insertion, active cancer, number of catheter lumens, and history of venous thromboembolism (VTE)1. We […]
Abstract Number: 176
SHM Converge 2023
Background: Medicine procedure services (MPS) increasingly perform bedside procedures such as lumbar puncture (LP). While rates of major complications are low, success rates in the literature are widely variable and dependent on patient body habitus, patient positioning, operator experience, and use of ultrasound guidance.1 Many trainees report discomfort with their skill in performing and supervising […]
Abstract Number: 177
SHM Converge 2023
Background: Gabapentinoids (gabapentin and pregabalin) are commonly prescribed medications typically used to treat neuropathic pain. They are often prescribed off label with varying degrees of evidence to treat a variety of other conditions such as non-neuropathic pain, post-operative pain, and alcohol use disorder. Due to emerging evidence, in 2019 the FDA put out a warning […]
Abstract Number: 178
SHM Converge 2023
Background: Hypoglycemia is common and potentially life-threatening for diabetic patients, often iatrogenic from diabetes treatments. It is important to be able to accurately study rates of hypoglycemia when evaluating the inpatient treatment of diabetes at a systems-level. Discharge diagnosis codes show promise as a tool in the surveillance of hypoglycemic events in large administrative databases […]
Abstract Number: 179
SHM Converge 2023
Background: Poorly controlled pain in hospitalized patients is common and may lead to excessive opioid administration and adverse events. Ketamine is a reversible, non-competitive NMDA receptor antagonist which blocks glutamate excitatory transmission and provides analgesia with minimal respiratory effects. Dosing for procedural sedation and induction of general anesthesia ranges from 1-4.5 mg/kg. Consensus guidelines for […]
Abstract Number: 180
SHM Converge 2023
Background: Almost three-quarters of hospitals with 50 or more beds have a palliative care program, and the percentage of annual hospital admissions receiving an initial palliative care consultation is more than 5%. Methylnaltrexone (MNTX) is a peripherally acting µ-opioid receptor antagonist indicated for opioid-induced constipation (OIC) in patients with advanced illness who are receiving palliative […]