This “CME” series of articles from JAMA Internal Medicine (Apr 22) concludes, “This simple prediction model identifies before discharge the risk of potentially avoidable 30-day readmission in medical patients. This score has potential to easily identify patients who may need more intensive transitional care interventions. Click here to read full-text.
News You Can Use
concludes: “Nonemergency PCI procedures performed at hospitals in Massachusetts without on-site surgical services were noninferior to procedures performed at hospitals with on-site surgical services with respect to the 30-day and 1-year rates of clinical events.” (NEJM, April 18) Click here to read full-text
This “Perspective” article explains that the shortages that were projected have not materialize; rather, there appears to be a surge. Contributing factors include a combination of growing interest in nursing careers and the dynamic response of the educational sector has improved long-term workforce projections. If demand for nurses continues to expand at historical rates through 20300, entry into nursing must continue to grow over the next 2 decades at a rate of 20% per decade in order to meet that demand. A second uncertainty involves the uneven distribution of the workforce. The per capita RN supply in the Western and Northeast regions of the US has fallen behind that in the rest of the country because these regions are home to a greater number of older RNs who are retiring.. A third undertainty is the lingering effect of the recession. A final uncertainty concerns the demand for RNS. The ACA (Affordable Care Act) may stimulate additional demand for RNs, with its increase in nurse managed health centers and reform of the care delivery system. Click here to read full article.
Breaking News: Looser guidelines issued on prostate screening. Early detection of prostate cancer: AUA Guidelineby jmiller on May 10, 2013
As reported in the New York Times on May 3rd, the American Urological Association has issued new guidelines concerning the early detection of prostate cancer. The Panel recommends against PSA screening in men under age 40 years; the Panel does not recommend routine screening in men between ages of 40 to 54 years at average risk. For men ages 55 to 69 years the Panel recognizes that the decision to undergo PSA screening involves weighing the benfits of preventing prostat cancer mortality in 1 man for every 1,000 men screened over a decade against known potential harms associated with screening and treatment. For this reason, the Panel strongly recommends shared decision-making for men age 55 to 69 years that are considering PSA screening, and proceed based on a man’s values and preferences. To reduce the harms of screening, a routine screening interval of two years or more may be preferred over annual screening. The Panel does not recommend routine PSA screening in men over age 70 years of age or any man with less than a 10 to 15 year life expectancy. Any questions about the new guidelines should be directed to Dr. Barry Meisenberg or Dr. Robert Hanley. Click here to read full guideline.
This is a new device used right here at AAMC… This article, appearing in this week’s (April 25th) issue of the NEJM, states, “Patients with gastroesophageal reflux disease who have a partial response to proton-pump inhibitors often seek alternative therapy. We evaluated the safety and effectiveness of a new magnetic device to augment the lower esophageal sphincter.” The article concludes “In this single-group evaluation of 100 patients before and after sphincter augmentation with a magnetic device, exposure to esophageal acid decreased, reflux symptoms improved, and use of proton-pump inhibitors decreased.” Click here to read full-text.
“PubMed Clinic” – Learn how to use our intranet electronic medical library and tie it into PubMed searchingby jmiller on April 16, 2013
Dr. Eddie McDevitt and Joyce Miller, Medical Librarian, are going to team up once again to offer a Category 1 CME class on PubMed searching and tie it in with our own electronic databases. Mark your calendars for Wed., August 28th at 6:00 pm. for a planned dinner meeting to hone your skills and to learn our new databases and what they have to offer. In order to plan for the room, we need a very general headcount..so if you are interested, could you please send either a reply (below) or an email to : email@example.com Thank you!
From the April 13th issue of Modern Healthcare, “For nearly four decades, Maryland’s “all payer” system has set hospital prices for the state’s 53 hospitals. The state regulates prices for every insurer, incuding Medicaid, Medicare and patients who pay their own bills. The new proposal underscores a shift toward more aggressive attempts to curb the rise in healthcare costs ahead of an expansion of health insurance coverage next year under the Patient Protection and Affordable Care Act. If approved by federal officials, Maryland would join Massachusetts as a state that seeks to tie health spending to growth in the state economy.” Click here to read full-text.
“The guidelines are intended to provide practitioners with a standardized approach to the rational, safe, and efective use of antimicrobial agents for the prevention of surgical-site infections (SSIs) based on currently available clinical evidence and emerging issues. (Surg Infections, Feb) Click here to read full-text.