scholarly journals Choosing Wisely in Healthcare Epidemiology and Antimicrobial Stewardship

2016 ◽  
Vol 37 (7) ◽  
pp. 755-760 ◽  
Author(s):  
Daniel J. Morgan ◽  
Lindsay D. Croft ◽  
Valerie Deloney ◽  
Kyle J. Popovich ◽  
Chris Crnich ◽  
...  
Keyword(s):  
Delphi Method ◽  
Convincing Evidence ◽  
Choosing Wisely ◽  
Research Network ◽  
Individual Member ◽  
Medical Overuse ◽  
Hospital Epidemiology ◽  
Endotracheal Tubes ◽  
Top 40 ◽  
Healthcare Epidemiology

OBJECTIVETo identify Choosing Wisely items for the American Board of Internal Medicine Foundation.METHODSThe Society for Healthcare Epidemiology of America (SHEA) elicited potential items from a hospital epidemiology listserv, SHEA committee members, and a SHEA–Infectious Diseases Society of America compendium with SHEA Research Network members ranking items by Delphi method voting. The SHEA Guidelines Committee reviewed the top 10 items for appropriateness for Choosing Wisely. Five final recommendations were approved via individual member vote by committees and the SHEA Board.RESULTSNinety-six items were proposed by 87 listserv members and 99 SHEA committee members. Top 40 items were ranked by 24 committee members and 64 of 226 SHEA Research Network members. The 5 final recommendations follow: 1. Don’t continue antibiotics beyond 72 hours in hospitalized patients unless patient has clear evidence of infection. 2. Avoid invasive devices (including central venous catheters, endotracheal tubes, and urinary catheters)and, if required, use no longer than necessary. They pose a major risk for infections. 3. Don’t perform urinalysis, urine culture, blood culture, or Clostridium difficile testing unless patients have signs or symptoms of infection. Tests can be falsely positive leading to overdiagnosis and overtreatment. 4. Do not use antibiotics in patients with recent C. difficile without convincing evidence of need. Antibiotics pose a high risk of C. difficile recurrence. 5. Don’t continue surgical prophylactic antibiotics after the patient has left the operating room. Five runner-up recommendations are included.CONCLUSIONSThese 5 SHEA Choosing Wisely and 5 runner-up items limit medical overuse.Infect Control Hosp Epidemiol 2016;37:755–760

Interfacility transfer communication of multidrug-resistant organism colonization or infection status: Practices and barriers in the acute-care setting

2021 ◽  
pp. 1-6
Author(s):  
Katherine D. Ellingson ◽  
Brie N. Noble ◽  
Genevieve L. Buser ◽  
Graham M. Snyder ◽  
Jessina C. McGregor ◽  
...  
Keyword(s):  
Acute Care ◽  
Infection Prevention ◽  
Multidrug Resistant ◽  
Research Network ◽  
Resistant Organism ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Hospital Size ◽  
Academic Affiliation ◽  
Healthcare Epidemiology

Abstract Objective: To describe interfacility transfer communication (IFTC) methods for notification of multidrug-resistant organism (MDRO) status in a diverse sample of acute-care hospitals. Design: Cross-sectional survey. Participants: Hospitals within the Society for Healthcare Epidemiology of America (SHEA) Research Network (SRN). Methods: SRN members completed an electronic survey on protocols and methods for IFTC. We assessed differences in IFTC frequency, barriers, and perceived benefit by presence of an IFTC protocol. Results: Among 136 hospital representatives who were sent the survey, 54 (40%) responded, of whom 72% reported having an IFTC protocol in place. The presence of a protocol did not differ significantly by hospital size, academic affiliation, or international status. Of those with IFTC protocols, 44% reported consistent notification of MDRO status (>75% of the time) to receiving facilities, as opposed to 13% from those with no IFTC protocol (P = .04). Respondents from hospitals with IFTC protocols reported significantly fewer barriers to communication compared to those without (2.8 vs 4.3; P = .03). Overall, however, most respondents (56%) reported a lack of standardization in communication. Presence of an IFTC protocol did not affect whether respondents perceived IFTC protocols as having a significant impact on infection prevention or antimicrobial stewardship. Conclusions: Most respondents reported having an IFTC protocol, which was associated with reduced communication barriers at transfer. Standardization of protocols and clarity about expectations for sending and receipt of information related to MDRO status may facilitate IFTC and promote appropriate and timely infection prevention practices.

scholarly journals The Romanian Society of Internal Medicine’s Choosing Wisely Campaign

2019 ◽  
Vol 57 (2) ◽  
pp. 181-194
Author(s):  
Caterina Delcea ◽  
Camelia Badea ◽  
Ciprian Jurcut ◽  
Adrian Purcarea ◽  
Silvia Sovaila ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Scientific Evidence ◽  
Early Mobilization ◽  
Hemoglobin Concentration ◽  
Diagnostic Procedures ◽  
Bed Rest ◽  
Convincing Evidence ◽  
Choosing Wisely ◽  
Motor Vehicles ◽  
European Federation

Abstract Quality of care in medicine is not necessarily proportional to quantity of care and excess is often useless or even more, potentially detrimental to our patients. Adhering to the European Federation of Internal Medicine’s initiative, the Romanian Society of Internal Medicine (SRMI) launched the Choosing Wisely in Internal Medicine Campaign, aiming to cut down diagnostic procedures or therapeutics overused in our country. A Working Group was formed and from 200 published recommendations from previous international campaigns, 36 were voted as most important. These were submitted for voting to the members of the SRMI and posted on a social media platform. After the two voting rounds, the top six recommendations were established. These were: 1. Stop medicines when no further benefit is achieved or the potential harms outweigh the potential benefits for the individual patient. 2. Don’t use antibiotics in patients with recent C. difficile without convincing evidence of need. 3. Don’t regularly prescribe bed rest and inactivity following injury and/or illness unless there is scientific evidence that harm will result from activity. Promote early mobilization. 4. Don’t initiate an antibiotic without an identified indication and a predetermined length of treatment or review date. 5. Don’t prescribe opioids for treatment of chronic or acute pain for sensitive jobs such as operating motor vehicles, forklifts, cranes or other heavy equipment. 6. Transfuse red cells for anemia only if the hemoglobin concentration is less than 7 g/dL or if the patient is hemodynamically unstable or has significant cardiovascular or respiratory comorbidity. Don’t transfuse more units of blood than absolutely necessary.

Audit and Feedback Processes Among Antimicrobial Stewardship Programs: A Survey of the Society for Healthcare Epidemiology of America Research Network

2016 ◽  
Vol 37 (6) ◽  
pp. 704-706 ◽  
Author(s):  
D. J. Livorsi ◽  
B. Heintz ◽  
J. T. Jacob ◽  
S. L. Krein ◽  
D. J. Morgan ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Interquartile Range ◽  
Infect Control Hosp ◽  
Audit And Feedback ◽  
Research Network ◽  
Hospital Beds ◽  
Healthcare Epidemiology ◽  
Optimal Implementation

Optimal implementation of audit-and-feedback is an important part of advancing antimicrobial stewardship programs. Our survey demonstrated variability in how 61 programs approach audit-and-feedback. The median (interquartile range) number of recommendations per week was 9 (5–19) per 100 hospital-beds. A major perceived barrier to more comprehensive stewardship was lack of resources.Infect Control Hosp Epidemiol 2016;37:704–706

scholarly journals Policies and practices of SHEA Research Network hospitals during the COVID-19 pandemic

2020 ◽  
Vol 41 (10) ◽  
pp. 1127-1135 ◽  
Author(s):  
Michael S. Calderwood ◽  
Valerie M. Deloney ◽  
Deverick J. Anderson ◽  
Vincent Chi-Chung Cheng ◽  
Shruti Gohil ◽  
...  
Keyword(s):  
The United States ◽  
Research Network ◽  
Healthcare Personnel ◽  
Personal Protection Equipment ◽  
Healthcare Facilities ◽  
Hospital Policies ◽  
Healthcare Epidemiology ◽  
Personnel Policies ◽  
Individual Healthcare ◽  
Policies And Practices

AbstractTo understand hospital policies and practices as the COVID-19 pandemic accelerated, the Society for Healthcare Epidemiology of America (SHEA) conducted a survey through the SHEA Research Network (SRN). The survey assessed policies and practices around the optimization of personal protection equipment (PPE), testing, healthcare personnel policies, visitors of COVID-19 patients in relation to procedures, and types of patients. Overall, 69 individual healthcare facilities responded in the United States and internationally, for a 73% response rate.

scholarly journals Surveillance practices and air-sampling strategies to address healthcare-associated invasive mold infections in Society for Healthcare Epidemiology of America (SHEA) Research Network hospitals—United States, 2020

2021 ◽  
pp. 1-4
Author(s):  
Jeremy A. W. Gold ◽  
Brendan R. Jackson ◽  
Janet Glowicz ◽  
Kenneth R. Mead ◽  
Karlyn D. Beer
Keyword(s):  
United States ◽  
Acute Care ◽  
Air Sampling ◽  
Acute Care Hospitals ◽  
Research Network ◽  
Sampling Strategies ◽  
Case Definitions ◽  
Healthcare Associated ◽  
Healthcare Epidemiology ◽  
Invasive Mold Infections

Abstract With this survey, we investigated healthcare-associated invasive mold infection (HA-IMI) surveillance and air sampling practices in US acute-care hospitals. More than half of surveyed facilities performed HA-IMI surveillance and air sampling. HA-IMI surveillance was more commonly performed in academic versus nonacademic facilities. HA-IMI case definitions and sampling strategies varied widely among respondents.

Healthcare Epidemiology is the Paradigm for Patient Safety

2002 ◽  
Vol 23 (1) ◽  
pp. 47-51 ◽  
Author(s):  
William E. Scheckler
Keyword(s):  
Patient Safety ◽  
The United States ◽  
Lessons Learned ◽  
Institute Of Medicine ◽  
Hospital Epidemiology ◽  
Making A Difference ◽  
Control And Prevention ◽  
Quality Of Medical Care ◽  
Healthcare Epidemiology

I was honored to receive the 2001 Lectureship Award from the Society for Healthcare Epidemiology of America (SHEA). It was my intent during the talk to review our field and implications that some of the new initiatives called “patient safety” have for our expertise. This article is based on the SHEA Lectureship that was given April 1, 2001, at the SHEA Annual Meeting in Toronto, Ontario, Canada.This article consists of four sections. First, I review lessons learned from colleagues during the 33 years that I have been associated with the field of hospital epidemiology and infection control, since my first days at the Centers for Disease Control and Prevention (CDC). Second, I explore issues raised by the Institute of Medicine (IOM) report on patient safety, adverse events, and medical errors, evaluating research that went into the extrapolation of the numbers of preventable deaths that this report highlighted. Those deaths gained everyone's attention. Third, I review the field of healthcare epidemiology, highlighting the three decades of success in our field in enhancing the safety of patients, improving their outcomes, and making a difference in the quality of medical care received in the United States. Finally, I discuss the challenges that hospital epidemiology currently faces and the opportunities that come with the expertise we have developed during more than 30 years.

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