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Perspectives on Safety > Perspective
Quality and Safety Challenges in Critical Care: Preventing and Treating Delirium in the Intensive Care Unit
with commentary by Eduard E. Vasilevskis, MD; E. Wesley Ely, MD, MPH; Robert S. Dittus, MD, MPH, Delirium as a Safety Target, December 2012
This piece details a number of evidenced-based practices to help detect, prevent, and treat delirium, which is now seen as a patient safety hazard.
Journal Article > Study
Volpp KG, Rosen AK, Rosenbaum PR, et al. J Gen Intern Med. 2009;10:1149-1155.
The safety impact of the ACGME trainee work hour restrictions remains controversial due to contrasting findings that have suggested benefit, harm, and no significant impact. This observational study analyzed all Medicare patients admitted to acute care facilities with a predefined set of primary diagnoses to estimate the 30-day mortality among high-severity medical admissions and the failure to rescue in postoperative surgical admissions. Investigators found no significant harm or benefit to patients with higher-severity illness compared with those with lower risk among both the medical and surgical patients. A past AHRQ WebM&M perspective discussed the impact of fatigue and extended shifts among trainees on the incidence of medical errors.
Cases & Commentaries
- Web M&M
S. Andrew Josephson, MD; April 2008
A man hospitalized for acute intracranial hemorrhage and cerebral edema was continued too long on an intravenous diuretic. He developed severe dehydration, hypernatremia, and renal failure.