Editor's Note Patients with diabetes who had low blood glucose values during the last day of hospitalization had higher rates of 30-day readmission and post discharge mortality, this study finds. Examining 843,978 admissions to the VA health care system over a 14-year period, researchers found that patients with diabetes who…
Editor's Note Compared with preoperative independent functional status, preoperative dependent functional status was independently associated with worse outcomes after primary total hip arthroplasty in this study. Of 43,179 patients analyzed, those who were less able to care for themselves: were 2 to 3 times more likely to have surgical complications…
Editor's Note A new interdisciplinary care protocol for frail elderly trauma patients significantly decreased delirium and 30-day readmission risk in this study. Researchers at Brigham and Women’s Hospital, Boston, compared the care of 125 patients who were treated before the pathway was implemented with 144 patients after the pathway was…
Editor's Note A 12-month targeted initiative to discharge surgical patients earlier was associated with a 50% increase in patients being discharged by noon in this study. The initiative, which included preoperative and inpatient components: increased discharge by noon rates from 14.3% to 21.5% decreased length of stay (LOS) from 2.17…
Editor's Note In this prospective study, nonfrailty and elective surgery were positively associated with functional recovery of older patients after major surgery. Of 754 community-living patients 70 years or older who were analyzed, 266 survived major surgery with increased disability and were monitored for 6 months. A total of 174…
Editor's Note In this study, an ultrarestrictive opioid prescribing strategy was associated with a reduction in the number of pills dispensed without changes in postoperative pain, complications, or increases in prescription refill requests. In this case-control 2-year analysis of 1,231 women having surgery for gynecologic cancer, those having ambulatory or…
Editor's Note In this study, patients in teaching hospitals in Michigan received significantly larger postoperative opioid prescriptions and had higher rates of high-risk prescribing compared with nonteaching hospitals in the state. The amount of opioid prescribed in initial opioid prescriptions varied 4.7-fold across hospitals, from 130 to 616 oral morphine…
Enhanced recovery after surgery (ERAS) led the list of newer patient care models in use at hospitals that employ respondents to the 2018 OR Manager Salary/Career Survey. A total of 42% of hospital-based OR leaders said ERAS had been or would soon be implemented in their facilities, down slightly from…
Editor's Note In this study from the University of Pennsylvania School of Nursing, researchers developed, validated, and tested an algorithm called, “Discharge Referral Expert System for Care Transitions (DIRECT),” which helped clinicians identify patients most in need of post-acute care (PAC) and lowered readmission rates. The researchers conducted a 4-month…
Editor's Note Excessive opioid prescribing was associated with higher postoperative opioid consumption in this study. In this analysis of 2,392 surgical patients, the quantity of opioids prescribed was significantly higher than opioid consumption, with patients reporting using only 27% of the opioids prescribed to them. Prescription size had the strongest…