Sanjay K Saint

..CONCLUSIONS: Far from replacing the duties of frontline physicians and nurses assigned to care for the patient, we believe that a PSP will strengthen the safety net for hospitalized patients and serve as an expert resource...

..Concomitant with this re-examination have been reports showing variability in the use of specific blood components. This investigation was designed to assess hospital variation in blood use and outcomes in cardiac surgery patients...

..We evaluated whether physician profiling affects physician satisfaction and hospital length of stay, and assessed physicians' views concerning hospital cost containment and the quality of care they provide...

..Many hospitalizations for residents of skilled nursing facilities are potentially avoidable. Factors that could prevent hospitalization for urinary tract infection (UTI) were investigated, with focus on patient mobility...

..Using these methods, urinary catheter-associated UTI can often be prevented for weeks, but not longer terms...

..Risk factors for bacteremia in patients with hospital-acquired bacteriuria are largely unknown. Given the morbidity and costs associated with nosocomial bacteremia, determining risk factors could enhance the safety of hospitalized patients...

..To compare condom and indwelling urinary catheters in terms of infection risk and patient satisfaction...

..Future research should focus on additional methods for preventing this common infection...

..e., internists who spend less than 50% of their clinical time caring for inpatients), what effect does time spent in the hospital have on physician satisfaction, stress, and burnout?"..

..We also were curious whether variability would exist in the hand hygiene rates despite the close proximity of the units...

..A qualitative study was conducted to determine the barriers to implementing evidence-based practices to prevent HAI, with a specific focus on the role played by hospital personnel...

..We conclude by providing guidance on the appropriate use of summary measures derived from meta-analyses for cost-effectiveness studies...

..We sought to determine the beliefs of both older male patients and nursing staff about the relative merits and problems of condom and indwelling catheters...

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..A recent meta-analysis concluded that silver alloy catheters reduce the incidence of UTI by 3-fold; however, clinicians must decide whether the efficacy of such catheters is worth the extra per unit cost of $5.30...

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..We conclude that internists, regardless of training in epidemiology, rely heavily on abstracts and prescreening of articles by editors...

..Health care payers increasingly expect that the results of evidence-based economic evaluations will guide practitioners in their choice of cost-effective interventions...

..More than 80% of hospitals in the United States use critical pathways for at least some of their patients. Unfortunately, critical pathway effectiveness in improving clinical efficiency is unclear...

..The slight increase in infectious risk when using multilumen catheters is likely offset by their improved convenience, thereby justifying the continued use of multilumen vascular catheters...

..It remains unclear whether minocycline/rifampin catheters are cost-effective for all high-risk patients or only those requiring longer-term catheterization...

..Interventions beneficial to the prevention of ventilator-associated pneumonia would therefore have a significant impact on the care of these patients...

..Ventilator-associated pneumonia (VAP) is the most common nosocomial infection in critically ill patients. The clinical and economic consequences of VAP are unclear, with a broad range of values reported in the literature..

..Because allogeneic blood transfusions are more common in women and have been associated with immunomodulation, the impact of transfusion on sex differences in infection and mortality was examined...

..Therefore, learning how to implement these findings is critically important to promoting high-quality care and a safe health care environment...

..Ideally, a successful hospital-based clinical research program will need to partner hospitalists with specialists...

..To summarize the effect of urinary catheter reminder systems on the rate of CAUTI, urinary catheter use, and the need for recatheterization, we performed a systematic review and meta-analysis...

..To assess the knowledge of recommended urinary catheter care practices among nursing home (NH) healthcare workers (HCWs) in southeast Michigan...

..To determine what practices are used by hospitals to prevent ventilator-associated pneumonia (VAP) and, through qualitative methods, to understand more fully why hospitals use certain practices and not others...

..Leadership support and staff receptivity play a significant role in its adoption...

..To obtain nationally representative estimates of the additional time, and related cost, of unpaid family caregiving (informal caregiving) associated with chronic lung disease among older Americans...

..Strategies to optimize antibiotic use for such patients are discussed and include implementing a process whereby a urine culture is automatically performed if a urinalysis result suggests infection...

..Results of recent studies from high-volume academic centers suggest that coronary artery bypass grafting (CABG) is becoming safer to perform in octogenarians. Similar data from community-based facilities do not exist...

..Because preliminary data indicated that hospital leadership played an important role, we sought better to understand which behaviors are exhibited by leaders who are successful at implementing HAI prevention practices in US hospitals...

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..To examine the results of a multi-institution, hospitalist-centered consortium designed to disseminate knowledge of best practices relevant to patient safety and to facilitate institutional innovation around such practices...

..Attention toward prevention of CAUTI will likely increase as Center for Medicare and Medicaid Services and other third-party payers no longer reimburse for hospital-acquired UTI...

..If this strategy is effective, similar strategies can be studied and implemented for other high-risk groups...

..Just as healthcare epidemiology has emerged as a paradigm for patient safety, infection prevention may serve as a clinical model for implementation researchers...

..The group also includes a consumer representative. Critical issues are addressed through rigorous case discussion, literature review, and expert consultation...

..To obtain nationally representative estimates of the additional time, and related cost, of informal caregiving associated with urinary incontinence in older individuals...

..Moreover, our findings provide important insights about how and why different quality improvement strategies might perform across organizations with differing contextual characteristics...

..We thus conducted a multicenter study to understand better how US hospitals approach the prevention of hospital-acquired UTI...

..To assess use of urinary collection devices (external, intermittent, and indwelling catheters; pads or briefs) and examine predictors of indwelling catheters in skilled nursing facilities (SNFs)...

..Identifying children at risk for readmission is challenging. Children who did not require supplemental oxygen may be at greater risk because they are progressing in their illness...

..Use of chlorhexidine gluconate in place of the current standard solution for vascular catheter site care is a simple and cost-effective method of improving patient safety in the hospital setting...

..Although previous meta-analyses have concluded that acetylcysteine is beneficial, the recent availability of additional trials calls for reassessment of current evidence...

..While we believe the available evidence does support the use of maximal sterile barriers during routine insertion of central venous catheters, prospective studies and economic analyses would better clarify its value...

..To examine the extent to which elderly individuals use various skilled care facilities after coronary artery bypass grafting (CABG)...

..A synopsis of comments made during the morning practice panel and empirical support for the themes and subthemes identified by panelists are provided in this article...

..Catheter-related bloodstream infections are common, costly, and morbid. Randomized controlled trials indicate that antiseptic-coated central venous catheters reduce infection rates...

..In addition, we hope that this article will stimulate increased interest and research in identifying strategies that will successfully move evidence from the peer-reviewed literature to the patient's bedside...

..Explanations for this sex difference are controversial. The objective of this study was to assess whether infection contributes to the increased risk of mortality in women...

..Since approximately 40% of elderly Americans will enter a nursing home at some point, identification of those at risk of infection could have considerable health, quality of life, and economic consequences. ..