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Report from the 2023 American Diabetes Association Scientific Sessions
At the 2023 American Diabetes Association Scientific Sessions, experts presented key updates, advances, and best practices for patient care. A selection of presentations relevant to the internal medicine and primary care community is presented here.
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Donislecel-jujn Allogenic Pancreatic Islet Cellular Suspension (Lantidra)
Lantidra can be prescribed to adults with type 1 diabetes who cannot approach target HbA1c levels because of current repeated episodes of severe hyperglycemia despite intensive diabetes management and education.
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What Kind of Bundle Branch Block?
Assuming QRS widening in a supraventricular rhythm is not the result of hyperkalemia or other toxicity, and assuming the patient has not been diagnosed with Wolff-Parkinson-White syndrome, classification of 12-lead ECG conduction disturbances can be simplified into one of three basic categories. The tracing in the figure illustrates this concept.
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A Component of Tea to Promote Sleep: A Review of L-theanine as Treatment for Insomnia
This review of eight studies encompassing 417 patients assesses the effectiveness of L-theanine on sleep disorders. Results were inconsistent, but avenues of future study were identified.
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A Closer Look at the Effects of Screen Time on Adolescent Mental Health
This systematic review of 50 studies reveals a correlation between increased social media usage and decreased mental well-being in adolescents of both genders, more significant depression in girls, and an association of high weekday smartphone usage with reduced mental well-being across both sexes. However, the inconsistency of the findings necessitates additional studies before generalization.
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Case Managers Could Use Z Codes More for Patient Care and QI
Case managers, providers, and health systems underuse ICD-10 Z codes eight years after they were introduced. These codes could provide a wealth of data to researchers and case management quality improvement projects. They still hold promise to be a way for providers to collect reimbursement for their work to help patients with their social determinants of health.
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Screening and Documenting Cases of Human Trafficking Are Important, But Carry Risks
Human trafficking is a critical issue from a public health perspective. It has lasting psychological and physical effects on victims. There is too little information about how prevalent human trafficking is in the United States and how often the victims are seen in healthcare settings. Case managers, hospitals, and ambulatory providers could improve the data by documenting suspected or confirmed human trafficking cases via Z codes.
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How Case Managers Can Help Victims of Trafficking
Case managers can learn skills and tactics for helping patients who have been trafficked. For example, investigators used an online training module to educate ED staff about human trafficking. Participants reported more confidence in identifying a possible human trafficking victim, noting they were more likely to screen patients for human trafficking.
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Stroke Patient Navigator Prevents 30-Day Readmissions
A stroke nurse navigator team can prevent 30-day readmissions in stroke patients treated with thrombolysis, investigators found. A health system’s 30-day readmission rate was 13.6% before it began to use a stroke nurse navigator. The rate declined to 6.9%. Patients with the stroke nurse implementation were 67.6% less likely to be readmitted within 30 days compared to patients without the navigator.
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International Discharges Create Chaos and Inspire Creativity for Case Managers
Case managers and discharge planners in every state sometimes encounter the most challenging and frustrating of cases: the international discharge. Hospital Case Management asked Judith R. Sands, RN, MSL, BSN, CPHRM, CPHQ, CCM, ARM, a clinical consultant and author of Home Hospice Navigation: The Caregiver’s Guide, to answer a few questions about best practices in handling these unique care transition cases.