scholarly journals Does early antibiotic administration affect disposition or length of stay in patients with cryptic shock? A retrospective pilot study

Critical Care ◽  
2008 ◽  
Vol 12 (Suppl 2) ◽  
pp. P419
Author(s):  
H Chung ◽  
R Otero ◽  
S Rivers ◽  
S Sankey ◽  
E Rivers
Keyword(s):  
Pilot Study ◽  
Length Of Stay ◽  
Antibiotic Administration ◽  
Cryptic Shock

scholarly journals 603. Evaluating the Effects of Centers for Medicare & Medicaid Services Sepsis Core Measure in a Community Hospital

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S364-S364
Author(s):  
So Kim ◽  
Peter Ty
Keyword(s):  
Length Of Stay ◽  
Improve Patient Care ◽  
Prescribing Patterns ◽  
Hospital Length Of Stay ◽  
Antibiotic Prescribing ◽  
Antibiotic Administration ◽  
Negative Consequences ◽  
Treatment Standards ◽  
Core Measure ◽  
Core Measures

Abstract Background Sepsis is the leading cause of morbidity and mortality in hospitals, accounting for 30% of deaths in the emergency department. In 2001, Rivers et al. found that early goal-directed therapy (EGDT) led to significant mortality benefits, which ultimately prompted United States Centers for Medicare and Medicaid Services (CMS) to mandate EGDT in hospitals through its implementation of sepsis core measures. CMS core measures are intended to facilitate the broad implementation of evidence-based treatment standards, and while voluntary, non-compliance is associated with negative consequences to both quality and financial metrics for participating hospitals. However, while quality measures are implemented to ultimately improve patient care, its effects on the healthcare system can also include negative unanticipated consequences. This study seeks to characterize the effect of the CMS sepsis core measure on sepsis identification, antimicrobial utilization, and nd specific prescribing patterns. Methods This is a retrospective cohort review of 175 randomly selected patients greater than and equal to 18 years of age with admitting diagnosis of sepsis, severe sepsis, and septic shock from January 2013 to December 2018. Medical charts were reviewed for relevant data. Results Comparing ED antibiotic prescribing patterns between pre-and post-Sepsis CMS Core Measures, there was no statistical difference in total antibiotics usage and the initiation of broad antibiotics. There was a decreased time to the first antibiotic, an increase in receiving Normal Saline boluses post-Sepsis CMS Core Measures. Conclusion 1. No significant changes were seen in ED antibiotic prescribing behaviors with regard to volume and spectrum 2. ED time to antibiotic administration was significantly faster after the implementation of CMS Core Measures. Also, there was a significant positive shift in time to fluid bolus, fluid selection, and fluid volume 3. Significantly decreased ICU length of stay after implementation of CMS Core Measures possibly associated with above behavior changes 4. No outcomes benefits (mortality, hospital length of stay) realized after implementation of CMS Core Measures Disclosures All Authors: No reported disclosures

Geriatric Inclusive Art and Length of Stay in Acute Care Unit: A Case-Control Pilot Study

2012 ◽  
Vol 60 (8) ◽  
pp. 1585-1587 ◽  
Author(s):  
Olivier Beauchet ◽  
Samantha Remondière ◽  
Micheline Mahé ◽  
Florence Repussard ◽  
Frederic Decavel ◽  
...  
Keyword(s):  
Pilot Study ◽  
Length Of Stay ◽  
Acute Care ◽  
Case Control ◽  
Acute Care Unit

scholarly journals Cost-minimisation analysis alongside a pilot study of early Tissue Doppler Evaluation of Diastolic Dysfunction in Emergency Department Non-ST Elevation Acute Coronary Syndromes (TEDDy-NSTEACS)

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e023920 ◽  
Author(s):  
Vijay S Gc ◽  
Mohamad Alshurafa ◽  
David J Sturgess ◽  
Joseph Ting ◽  
Kye Gregory ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pilot Study ◽  
High Risk ◽  
Length Of Stay ◽  
Cost Saving ◽  
Risk Stratification ◽  
Diagnostic Tool ◽  
Tissue Doppler ◽  
Conventional Care ◽  
St Elevation

ObjectiveTo estimate the cost implications of early angiography for patients with suspected non-ST elevation acute coronary syndrome (NSTEACS) using tissue Doppler imaging (TDI).DesignA decision tree model was used to synthesise data from the pilot study and literature sources. Sensitivity analyses tested the impact of assumptions incorporated into the analysis.SettingEmergency department (ED), Brisbane, Australia.ParticipantsPatients with suspected NSTEACS.InterventionsTDI as a diagnostic tool for triaging patients within 4 hours of presentation in addition to conventional risk stratification, compared with conventional risk stratification alone.Data sourcesResource used for diagnosis and management were recorded prospectively and costed for 51 adults who had echocardiography within 24 hours of admission. Costs for conventional care were based on observed data. Cost estimates for the TDI intervention assumed patients classified as high risk at TDI (E/e’>14) progressed early to angiography with an associated 1-day reduction in length of stay.Primary outcome measuresCosts until discharge from the Australian healthcare perspective in 2016–2017 prices.ResultsFindings suggest that using TDI as a diagnostic tool for triaging patients with suspected NSTEACS is likely to be cost saving by $A1090 (95% credible interval: $A573 to $A1703) per patient compared with conventional care. The results are mainly driven by the assumed reduction in length of stay due to the inclusion of early TDI in clinical decision-making.ConclusionsThis pilot study indicates that compared with conventional risk stratification, triaging patients presenting with suspected NSTEACS with TDI within 4 hours of ED presentation has potential cost savings. Findings assume a reduction in hospital stay is achieved for patients considered to be high risk at TDI. Larger, comparative studies with longer follow-up are needed to confirm the clinical effectiveness of TDI as a diagnostic strategy for NSTEACS, the assumed reduction in hospital stay and any cost saving.

scholarly journals The Infant Cuddler Study: Evaluating the effectiveness of volunteer cuddling in infants with neonatal abstinence syndrome

2019 ◽  
Vol 25 (7) ◽  
pp. 414-418
Author(s):  
Amanda Hignell ◽  
Karen Carlyle ◽  
Catherine Bishop ◽  
Mary Murphy ◽  
Teresa Valenzano ◽  
...  
Keyword(s):  
Pilot Study ◽  
Length Of Stay ◽  
Focus Groups ◽  
Positive Impact ◽  
Surrogate Marker ◽  
Neonatal Abstinence Syndrome ◽  
Control Group ◽  
Abstinence Syndrome ◽  
Study Results ◽  
The Impact

Abstract Objectives St. Michael’s Hospital launched a volunteer cuddling program for all infants admitted into the neonatal intensive care unit in October 2015. The program utilizes trained volunteers to cuddle infants when caregivers are not available. This was a pilot study to assess the impact of a volunteer cuddle program on length of stay (LOS) and feasibility of implementation of the program. Methods A mixed methods approach was utilized to measure both quantitative and qualitative impact. A pilot cohort study with a retrospective control group assessed the feasibility of implementing a volunteer cuddling program for infants with neonatal abstinence syndrome (NAS). Length of stay was used as a surrogate marker to measure the impact of cuddling on infants being treated for Neonatal Abstinence Syndrome. Focus groups using semi-structured interviews were conducted with volunteers and nurses at the end of the pilot study. Results LOS was reduced by 6.36 days (U=34, P=0.072) for infants with NAS in the volunteer cuddling program. Focus groups with both bedside nurses and program volunteers described a positive impact of cuddling programs on infants, families, staff, and volunteers alike. Conclusions The study results suggest that the volunteer cuddling program may reduce LOS in infants with NAS and have potential economic savings on hospital resources. However, larger prospective cohort studies are needed to confirm these results.

Does Timely Antibiotic Administration Decrease Hospital Length of Stay in Chorioamnionitis?

2014 ◽  
Vol 123 ◽  
pp. 47S
Author(s):  
Pooja D. Doehrman ◽  
Laurie Erickson ◽  
Judith Adams ◽  
Melissa Molyneux
Keyword(s):  
Length Of Stay ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Antibiotic Administration

scholarly journals Antibiotic Administration Along with Endodontic Therapy in the Republic of Croatia: a Pilot Study

2020 ◽  
Vol 54 (3) ◽  
pp. 314-321
Author(s):  
Josipa Sović ◽  
Sanja Šegović ◽  
Ivan Tomašić ◽  
Božidar Pavelić ◽  
Ivana Šutej ◽  
...  
Keyword(s):  
Pilot Study ◽  
Antibiotic Administration ◽  
The Republic
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