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Continuation of Antibiotics for UTI Often Inappropriate

Posted on Sun, Nov 22, 2015
Continuation of Antibiotics for UTI Often Inappropriate

Antibiotics frequently initiated inappropriately in ER; continuation after admission inappropriate for 68%

For patients with urinary tract infections (UTIs), initiation of antibiotics in the emergency department is frequently inappropriate, as is continuation of antibiotics after admission, according to a study published online Nov. 12 in the Journal of Hospital Medicine.

Dmitry Kiyatkin, M.D., from the Johns Hopkins Bayview Medical Center in Baltimore, and colleagues reviewed the medical records for all patients admitted to the hospital who initiated treatment for a UTI in the emergency department during a four-week period.

The researchers found that antibiotic initiation was inappropriate for 59 percent of 94 patients. Continuation of antibiotics after admission was inappropriate for 68 percent of 80 patients.

"In conclusion, we found a high rate of inappropriate antibiotic administration for UTIs that began in the emergency department and continued after admission," the authors write. "Specific guidelines should be developed and validated to direct diagnosis and treatment of UTIs in the emergency department and hospital."

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Docs Report Patient Safety Often at Risk in ER to Inpatient Handoff

Posted on Sat, Aug 01, 2015
Docs Report Patient Safety Often at Risk in ER to Inpatient Handoff

Both ER, inpatient physicians say patient safety is at risk during handoff

THURSDAY, July 30, 2015 (HealthDay News) -- Physicians report that patient safety is often at risk during the emergency department admission handoff process due to ineffective communication. The findings were published online July 22 in the Journal of Hospital Medicine.

Christopher J. Smith, M.D., from the University of Nebraska Medical Center College of Medicine in Omaha, and colleagues surveyed resident, fellow, and faculty physicians directly involved in admission handoffs from emergency medicine and five medical admitting services at a 627-bed tertiary care academic medical center.

Based on responses from 94 admitting and 32 emergency medicine physicians, the researchers found that admitting physicians reported that vital clinical information was communicated less frequently for all content areas (P < 0.001), compared to emergency medicine physicians. Nearly all (94 percent) of emergency medicine physicians felt defensive at least "sometimes." Just under one-third of all respondents (29 percent) reported handoff-related adverse events, most frequently related to ineffective communication. Sequential handoffs were commonly reported for both emergency medicine and admitting services, and 78 percent of physicians reported that these handoffs negatively impact patient care.

"We identified several perceived barriers to safe inter-unit handoff from the emergency department to the inpatient setting. Handoff-related adverse events, a pattern of conflicting physician perceptions, and frequent sequential handoffs were of particular concern," the authors write. "Our findings support the need for collaborative efforts to improve interdisciplinary communication."

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