scholarly journals Potential Impact of Antibiotic Stewardship Programs on Overall Antibiotic Use in Adult Acute-Care Hospitals in the United States

2018 ◽  
Vol 39 (3) ◽  
pp. 373-376 ◽  
Author(s):  
Sarah Kabbani ◽  
James Baggs ◽  
Lauri A. Hicks ◽  
Arjun Srinivasan
Keyword(s):  
United States ◽  
Acute Care ◽  
Antibiotic Stewardship ◽  
Acute Care Hospitals ◽  
Antibiotic Use ◽  
The United States ◽  
Potential Impact

Preparation of Children for Hospitalization in Acute Care Hospitals in the United States

PEDIATRICS ◽  
1981 ◽  
Vol 68 (3) ◽  
pp. 361-368
Author(s):  
Pat Azarnoff ◽  
Patricia D. Woody
Keyword(s):  
United States ◽  
Acute Care ◽  
Group Discussion ◽  
Acute Care Hospitals ◽  
The United States ◽  
Pediatric Care ◽  
Children's Hospitals ◽  
General Hospitals ◽  
Psychological Preparation ◽  
Children’S Hospitals

To study the prevalence and nature of psychological preparation for pediatric care, children's hospitals and acute care general hospitals were surveyed, and 24 hospitals were visited. Of 1,427 hospitals responding, 468 (33%) provided regular, planned preparation services. Prior to hospitalization, group tours and group discussion were the two most frequently used methods. During hospitalization, children learned informally as events occurred, usually through conversations.

Pressure Ulcers and Prevention Among Acute Care Hospitals in the United States

2013 ◽  
Vol 39 (9) ◽  
pp. 404-414 ◽  
Author(s):  
Sandra Bergquist-Beringer ◽  
Lei Dong ◽  
Jianghua He ◽  
Nancy Dunton
Keyword(s):  
United States ◽  
Acute Care ◽  
Pressure Ulcers ◽  
Acute Care Hospitals ◽  
The United States

Simulation Use in Acute Care Hospitals in the United States

2018 ◽  
Vol 34 (5) ◽  
pp. 242-249 ◽  
Author(s):  
Mary G. Harper ◽  
Gregory E. Gilbert ◽  
Marie Gilbert ◽  
Linda Markey ◽  
Krista Anderson
Keyword(s):  
United States ◽  
Acute Care ◽  
Acute Care Hospitals ◽  
The United States

scholarly journals 2070. Assessing Primary Care Physicians’ Attitudes and Perceptions Toward Antibiotic Resistance and Outpatient Antibiotic Stewardship: A National Survey

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S698-S698
Author(s):  
Rachel M Zetts ◽  
Andrea Garcia ◽  
Jason Doctor ◽  
Jeffrey Gerber ◽  
Jeffrey A Linder ◽  
...  
Keyword(s):  
United States ◽  
Primary Care ◽  
Antibiotic Resistance ◽  
National Survey ◽  
Antibiotic Stewardship ◽  
Primary Care Physicians ◽  
Antibiotic Use ◽  
The United States ◽  
Incentive Program ◽  
Data Feedback

Abstract Background At least 30% of outpatient antibiotic prescriptions are unnecessary. Outpatient antibiotic stewardship can improve prescribing and minimize the threat of antibiotic resistance. We assessed primary care physicians’ (PCPs) perceptions of antibiotic resistance, inappropriate antibiotic use, and the need for and impact of antibiotic stewardship activities. Methods We conducted a national survey of 1,550 internal and family medicine physicians and pediatricians recruited from a medical market research panel. Quotas were established to recruit participants by geographic region and specialty. For sample representativeness, survey weights were generated according to these characteristics using the American Medical Association’s Masterfile. Results Among respondents, 94% agreed that resistance is a problem in the United States, but only 55% felt it was a problem for their practice; 65% of respondents agreed they had seen an increase in resistant infections in their patients over the past 5 years. Responses about inappropriate antibiotic use were similar: 91% agreed that it was a problem, but 37% agreed that it is a problem in their practice. Additionally, 60% felt they prescribed antibiotics more appropriately than their peers. For antibiotic stewardship, 91% felt it was appropriate for office-based practices, but 53% believed that discussions with patients on the appropriate use of antibiotics is sufficient to address the problem. The majority of respondents indicated they were likely, very likely, or extremely likely to implement stewardship interventions in response to feedback or incentives from payers or health departments. The activities with the strongest likelihood to spur stewardship adoption included the state health department publishing local resistance patterns (82%), a payer creating a stand-alone incentive program for stewardship (80%), or a payer including it in a broader quality incentive program (76%). Conclusion PCPs feel that antibiotic resistance, inappropriate prescribing, and stewardship are important in the United States, but not for their own practices. This disconnect poses a challenge for the success of outpatient stewardship programs. Incentive or data feedback activities may help encourage stewardship uptake. Disclosures All authors: No reported disclosures.

scholarly journals The Perceived Knowledge of Fall Prevention in Nurses Working in Acute Care Hospitals in China and the United States

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Lin Wang ◽  
Li Zhang ◽  
Elizabeth Roe ◽  
Sally Decker ◽  
Gwen Howard ◽  
...  
Keyword(s):  
United States ◽  
Acute Care ◽  
Fall Prevention ◽  
Acute Care Hospitals ◽  
The United States ◽  
Perceived Knowledge

scholarly journals Urinary Catheter Indications in the United States: Results from a National Survey of Acute Care Hospitals

2014 ◽  
Vol 35 (S3) ◽  
pp. S96-S98 ◽  
Author(s):  
M. Todd Greene ◽  
Hiroko Kiyoshi-Teo ◽  
Heidi Reichert ◽  
Sarah Krein ◽  
Sanjay Saint
Keyword(s):  
United States ◽  
Urinary Incontinence ◽  
Acute Care ◽  
National Survey ◽  
Urinary Catheter ◽  
Outlet Obstruction ◽  
Acute Care Hospitals ◽  
The United States ◽  
Urinary Catheters ◽  
Appropriate Use

In a survey of acute care hospitals across the United States, we found that many hospitals use indwelling urinary catheters for reasons that are not medically necessary (eg, urinary incontinence without outlet obstruction and patient/family requests). Our findings highlight an opportunity to reduce unnecessary catheter use through promoting awareness of appropriate use.

scholarly journals Association of Hospital-Onset Clostridium difficile Infection Rates and Antibiotic Use in US Acute Care Hospitals, 2006–2012: An Ecologic Analysis

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S1-S1 ◽  
Author(s):  
Sophia Kazakova ◽  
James Baggs ◽  
Lawrence McDonald ◽  
Sarah Yi ◽  
Kelly Hatfield ◽  
...  
Keyword(s):  
Acute Care ◽  
Inpatient Treatment ◽  
Acute Care Hospitals ◽  
Antibiotic Use ◽  
Estimating Equation ◽  
The United States ◽  
Fourth Generation ◽  
Days Of Therapy ◽  
Facility Level ◽  
Hospital Characteristics

Abstract Background This study investigated the association between facility-level rates of hospital-onset CDI (HO-CDI) and inpatient antibiotic use (AU) in a large group of U.S. acute care hospitals over a 7-year period. Methods We used adult discharge and antibiotic use data from 552 acute care hospitals participating in the Truven Health MarketScan Hospital Database from January 1, 2006 to December 31, 2012 to determine facility-level CDI rates and AU. HO-CDI was defined as a discharge with a secondary ICD-9-CM diagnosis code for CDI (008.45) and inpatient treatment with metronidazole or oral vancomycin. The relationship between facility-level HO-CDI (HO-CDI per 10,000 patient-days (PD)) and AU (days of therapy (DOT) per 1,000 PD) was examined through multivariate general estimating equation models that accounted for the correlation between annual HO-CDI rates within a hospital. The models controlled for hospital characteristics and a facility-level rate of community-onset CDI (CO-CDI), defined as a discharge with a primary ICD-9-CM code for CDI and inpatient treatment. Results During 2006 to 2012, the mean HO-CDI rate was 11 per 10,000 PD (interquartile range (IQR): 5.7–14.7) and mean AU was 811 DOT/1,000 PD (IQR: 710–932). After controlling for facility-level CO-CDI and other hospital characteristics, overall AU was significantly associated with facility-level HO-CDI rate; for every 50 DOT/1,000 PD increase in AU, there was a 4.4% increase in the HO-CDI rate. Similarly, the only antibiotic classes significantly associated with HO-CDI were third- and fourth-generation cephalosporins (P < 0.0001) and carbapenems (P = 0.0011) with respective increases of 2.1% and 2.4% of HO-CDI per 10 DOT/1,000 PD increase. Fluoroquinolones and β-lactam/β-lactamase inhibitor combinations were not significantly associated with HO-CDI. Conclusion In this ecologic analysis of over 500 hospitals, overall antibiotic use was associated with increased rates of HO-CDI. In contrast to recent patient-level analyses in the United States and national observations in England, only third- and fourth-generation cephalosporins and carbapenems were associated with HO-CDI. Disclosures All authors: No reported disclosures.

scholarly journals Association Between State Medicaid Expansion and Emergency Access to Acute Care Hospitals in the United States

2020 ◽  
Vol 3 (11) ◽  
pp. e2025815
Author(s):  
David J. Wallace ◽  
Julie M. Donohue ◽  
Derek C. Angus ◽  
Lindsay M. Sabik ◽  
Billie Davis ◽  
...  
Keyword(s):  
United States ◽  
Acute Care ◽  
Acute Care Hospitals ◽  
The United States ◽  
Medicaid Expansion
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