Addressing Prognosis in Serious Illness
Publication date: July 2017 Source:Hospital Medicine Clinics, Volume 6, Issue 3 Author(s): Julia Ragland, Kosha Thakore, Wendy G. AndersonTeaser Patients with serious illness deserve information about their prognosis to make informed decisions about the medical care they receive and how they wish to approach personal goals at the end of life. Hospitalizations present an opportunity to reassess prognosis and goals of care. Estimating and discussing prognosis are core competencies for hospitalists and should be offered to patients with serious illness. Ask–tell–ask is a practical approach for discussing prognosis (a...
Source: Hospital Medicine Clinics - June 30, 2017 Category: Internal Medicine Source Type: research
Recognition and Management of Preeclampsia
Publication date: July 2017 Source:Hospital Medicine Clinics, Volume 6, Issue 3 Author(s): Christine M. CombsTeaser Preeclampsia is a multisystem disorder of new-onset hypertension in the second half of pregnancy associated with abnormalities in several organ systems. Manifestations of maternal vascular endothelial dysfunction include proteinuria, thrombocytopenia, microangiopathic hemolysis, pulmonary edema, hepatic ischemia, hypercoagulability, stroke, and seizure. Preeclampsia is common, with a worldwide prevalence of 2% to 8%, and 3% to 5% of all US pregnancies, with prevalence in primiparous pregnancies approximate...
Source: Hospital Medicine Clinics - June 30, 2017 Category: Internal Medicine Source Type: research
Monitoring and Reversal of Oral Anticoagulation in Hospitalized Patients
This article seeks to review the mechanisms, dosing, and safety concerns of oral anticoagulants and strategies for reversal in hospitalized patients. (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - June 30, 2017 Category: Internal Medicine Source Type: research
Consequences of Falls in Older Patients
Publication date: July 2017 Source:Hospital Medicine Clinics, Volume 6, Issue 3 Author(s): Cynthia A. Korzelius, Lien LeTeaser Ground-level falls are the most common type of trauma in older patients. These injuries may be unrecognized because of vulnerability to injury from apparently minor mechanisms, susceptibility to less common injuries, distracting injuries, altered pain perception, and sometimes impaired cognition. Physiologic changes associated with aging and medical comorbidities may obscure clinical instability. Hospitalists must be familiar with common injuries, such as pelvic fractures. Given the increase in...
Source: Hospital Medicine Clinics - June 30, 2017 Category: Internal Medicine Source Type: research
Historical Review and Current Controversies in Sepsis Diagnosis and Management
Publication date: July 2017 Source:Hospital Medicine Clinics, Volume 6, Issue 3 Author(s): Michael D. GibbonsTeaser Sepsis is a common condition that has been recognized throughout history. Currently, sepsis accounts for a large portion of our health care spending and, more important, a high degree of morbidity and mortality. The defining criteria of sepsis and our treatment approaches have undergone recent alteration, which has not been unanimously adopted. This review analyzes the shift in definition and its implications, as well as providing a brief comment on the current understanding of best treatment and a discuss...
Source: Hospital Medicine Clinics - June 30, 2017 Category: Internal Medicine Source Type: research
Telemetry Monitoring
This article outlines the conditions where telemetry use is indicated, where it may be used, and where it is not needed. Overuse of telemetry leads to alarm fatigue. Reducing telemetry overutilization and decreasing alarm fatigue can be accomplished by hospitalists as part of process improvement efforts in conjunction with nursing leadership and hospital administration. (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - June 30, 2017 Category: Internal Medicine Source Type: research
Pushing the Comfort Zone: Realities of Hospitalist Practice in 2017
Publication date: July 2017 Source:Hospital Medicine Clinics, Volume 6, Issue 3 Author(s): Steven B. Pestka (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - June 30, 2017 Category: Internal Medicine Source Type: research
Forthcoming Issue
Publication date: July 2017 Source:Hospital Medicine Clinics, Volume 6, Issue 3 (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - June 30, 2017 Category: Internal Medicine Source Type: research
Evaluation and Management of the Hospitalized Patient with Interstitial Lung Disease
Publication date: Available online 23 June 2017 Source:Hospital Medicine Clinics Author(s): Aamir Raza, Justin M. OldhamTeaser Interstitial lung diseases (ILDs) are a relatively rare, yet highly morbid group of pulmonary abnormalities. Individual ILDs have heterogeneous natural histories and responses to therapy, underscoring the importance of prompt recognition and accurate diagnosis. In this review, the authors highlight ILDs most likely to be encountered by hospital-based physicians, including idiopathic pulmonary fibrosis, chronic hypersensitivity pneumonitis, and ILD associated with connective tissue disease. They...
Source: Hospital Medicine Clinics - June 23, 2017 Category: Internal Medicine Source Type: research
Hospital Medicine: Twenty Years Later
Publication date: April 2017 Source:Hospital Medicine Clinics, Volume 6, Issue 2 Author(s): Chi-Cheng Huang (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - March 1, 2017 Category: Internal Medicine Source Type: research
Management of Upper Gastrointestinal Bleeding
This article outlines the general approach to management of these patients. In addition, this article explores the multiple causes of upper gastrointestinal bleeding from the esophagus, stomach, and small bowel, and the recommended treatment of these respective sources of bleeding. (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - January 28, 2017 Category: Internal Medicine Source Type: research
Endocarditis
This article reviews epidemiology, clinical features, diagnosis, management, and prophylaxis guidelines that are useful in hospital medicine practice. (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - January 27, 2017 Category: Internal Medicine Source Type: research
Electronic Health Records
This article provides a foundation and guidance for initial installation and maintenance of EHR systems specifically designed to improve medication safety relating to 3 domains: (1) foundational concepts in medication alerting and clinical knowledge bases, (2) examples of medication decision support failures and successes, and (3) human factors considerations in designing alerts that clinicians will find useful, including avoidance of alert fatigue. (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - January 26, 2017 Category: Internal Medicine Source Type: research
Interventions and Strategies to Reduce 30-day Readmission Rates
Publication date: Available online 12 January 2017 Source:Hospital Medicine Clinics Author(s): Daniela Urma, Chi-Cheng HuangTeaser The transition from inpatient to outpatient environment is a complex and vulnerable process in which teamwork developed around and with the patient is essential to provide effective medical care. Standardizing the process with a designated task and action plan for responsible parties improves patient compliance and decreases readmissions. For chronic medical patients, family involvement and continued education support via portals, health care providers, and community resources are a needed ...
Source: Hospital Medicine Clinics - January 12, 2017 Category: Internal Medicine Source Type: research
Update on Direct Oral Anticoagulants and Their Uses
Publication date: Available online 3 January 2017 Source:Hospital Medicine Clinics Author(s): Vigyan Bang, Russell S. Zide, Chi-Cheng HuangTeaser New oral anticoagulants (NOACs), now termed direct oral anticoagulants (DOACs) offer an alternative to warfarin for several thrombotic conditions, including nonvalvular atrial fibrillation (AF) and venous thromboembolism (VTE). Their unique properties allow more predictable dosing and ease of use, avoid the need for perioperative bridging anticoagulation, and have similar or improved efficacy and reduced side effect risk compared with warfarin. Although they have now become ...
Source: Hospital Medicine Clinics - January 3, 2017 Category: Internal Medicine Source Type: research
