January 2009

Antimicrobial stewardship teams look at how individual cases fit into hospital-wide trends of infection and resistance

Teaming up to fight superbugs

Antimicrobial stewardship teams ramp up the fight against “superbugs.” The battle with drug-resistant bacteria has evolved into an all-out war in many hospitals, and fighting back with newer drugs no longer seems like the best defensive strategy. Instead, hospitals are deploying multidisciplinary teams to spread the word about prevention through judicious use of antibiotics.

Letter from the editor

Overprescribing of antibiotics is often cited as a chief culprit behind the rising threat of “superbugâ€ï¿½ infections, such as Methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile.

Managing confusion in the hospitalized elderly

Key to halting cognitive decline is recognizing red flags and acting early. Delirium in hospitalized patients, including those with dementia, can be prevented in most cases if hospital staff is trained to recognize symptoms and act quickly.

Breaking the fall: Preventing fractures after discharge

Hospitalization is a risk factor for falls, but also an opportunity for prevention. Recent research suggests that hospitalization is a risk factor for post-discharge fracture in elderly patients, prompting some hospitalists to consider what measures they can take to reduce fracture risk before these patients leave the hospital.

Statin use in the acute care setting

An expert summarizes best practices.

Mindful medicine: Challenges of treating the physician-patient

Jeffrey Cohn, ACP Member, told us about a case he had seen as a hematology/oncology fellow while at Emory University.

Measure of the month: Stroke and stroke rehabilitation

In accordance with a law passed by Congress late in 2006, physicians and other eligible professionals are able to receive bonus payments of 1.5% of their total allowed Medicare charges, subject to a cap, by submitting information for defined quality measures.

Just for the record

A computer crash prompts reflection on EHRs.

What's new on ACP Internist's blog

The hits keep coming on ACP Internist’s blog, launched last May. Daily updates provide readers with the latest news relevant to internal and hospital medicine.

Billing and coding

Specific documentation helps optimize payments for heart failure.

Recalls of syringes, AXP bags, generic drugs

Recalls, warnings, and approvals.

Delirium, treating drug resistance, fall prevention

A 75-year-old woman with a long history of chronic obstructive pulmonary disease is evaluated in the intensive care unit for delirium... and other cases.

Journal watch: recent studies of note

Recent studies about C. diff. infections, antibiotic use at teaching hospitals, and other topics.

In the News

IOM favors more limits on resident hours, and other medical updates.