Chart of the Day: Nurse Practitioners in Primary Care
A new study in Health Affairs by Hilary Barnes, Matthew McHugh, and colleagues, demonstrates the increasingly important role nurse practitioners (NPs) have in primary care in the United States.
Photo Page: Penn Nursing's National 'Think Tank' on Vulnerable Elder Care
An Afternoon with Atul Gawande at Penn Medicine
Let’s Truly Engage Patients to Drive Health Care Innovation
Tradition can be a great thing, but we need to re-evaluate how the practices and lessons of the past apply to the present. That was one message stressed by Dr. Mark Smith as he delivered Penn LDI’s Charles C. Leighton, MD Memorial Lecture. Dr.
Lower Postsurgical Mortality for Individuals with Dementia with Better-Educated Hospital Workforce
Surgical patients age 65 and over with Alzheimer’s disease and related dementias (ADRD) were more likely to die within 30 days of admission and to die after a complication than those without ADRD. Having better-educated nurses in the hospital improved the likelihood of good outcomes for all surgical patients, but had a much greater effect in individuals with ADRD. Specifically, a 10% increase in the proportion of nurses with a Bachelor of Science in Nursing (BSN) degree or higher was associated with 10% lower odds of death and 10% lower odds of dying after a complication for surgical patients with ADRD.
Moving Beyond Duty-Hours
If you want to start an intense debate within the medical community, just talk about duty-hours – the length of a physician-in-training’s shift.
Physician-Level Variation in Outcomes of Mechanically Ventilated Patients
Meeta Prasad Kerlin, Andrew Epstein, Jeremy M. Kahn, Theodore J. Iwashyna, ...
Abstract [from journal]
Rationale: Physicians are increasingly being held accountable for patient outcomes, yet their specific contribution to the outcomes remains uncertain....
LDI 2018 Leighton Lecture: 'Patient Engagement and 21st Century Health Care'
Education Outcomes in a Duty-Hour Flexibility Trial in Internal Medicine
Sanjay V. Desai, David A. Asch, Lisa M. Bellini, Krisda H. Chaiyachati, Manqing Liu, Alice L. Sternberg, James Tonascia, Alyssa...
Abstract [from journal]
Background
Concern persists that inflexible duty-hour rules in medical residency programs may adversely affect the training of physicians.
Methods
We randomly assigned 63 internal medicine residency programs in the United States to be governed by standard duty-hour policies of the 2011 Accreditation Council for Graduate Medical Education (ACGME) or by more flexible policies that did not specify limits on shift length or mandatory time off...
Video Excerpt: Shreya Kangovi - Update on Community Health Workers Project
Video Excerpt: Ingrid Nembhard - Testing a New Role for Nurses as Care Coordinators
Video Excerpt: Karen Lasater on Improving End-of-Life Care
LDI 2018 Pilot Study Grants Announced
Infants in Drug Withdrawal: A National Description of Nurse Workload, Infant Acuity, and Parental Needs
Jessica G. Smith, Jeannette A. Rogowski, Kathryn M. Schoenauer, ...
In the Journal of Perinatal and Neonatal Nursing, Jessica Smith and colleagues, including Jeannette Rogowski and Eileen Lake, investigate how infants in drug withdrawal compare with nondrug withdrawal infants to inform proper nurse assignments based on infant acuity and parental needs. Though not commonly recognized, a troubling aspect of the opioid epidemic is increased drug use among pregnant women, which has led to an increase in infants who are...
Pennsylvania Declares a State of Emergency for the Opioid Epidemic
Last week Pennsylvania became the sixth state in the country to declare a state of emergency for the heroin and opioid epidemic. With over 4,600 drug overdose deaths in 2016 alone, and over 5,000 deaths estimated for 2017, this declaration comes at a critical time for Pennsylvanians.