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At present, the right of patients to choose providers who will render them home care is based upon three key sources. Despite these requirements there is a lingering perception that hospitals give lip service to patients right to freedom of choice.
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The Center to Advance Palliative Care (CAPC) in New York City has launched a Palliative Care Leadership Center (PCLC) initiative to help health care organizations create programs to more effectively manage advanced chronic illness.
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After the results of the Recombinant Human Activated Protein C Worldwide Evaluation in Severe Sepsis (PROWESS) trial were published in 2001, many institutions established criteria for use of drotrecogin alfa (activated) that were similar to the inclusion criteria used in the trial. Institutions, however, then had to decide how to evaluate the criteria and the outcomes of patients with sepsis. At one institution, a broad, systematic approach to that evaluation was taken.
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Pharmacists now can expect thousands of drugs and biological products to have bar codes on their labels by 2006.
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The federal government announced several new initiatives recently regarding prescription drugs, as well as the final report from the Counterfeit Drug Task Force.
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A number of studies have questioned the dogma of oral contrast administration. Only one, however, was prospective: Staffords study published in 1999 cast doubt on whether oral contrast added any significant data to the evaluation of stable patients. Now, a prospective, non-randomized, cohort study from Salt Lake City with 500 consecutive Trauma I (their highest designation) patients has omitted oral contrast from the routine trauma abdominal CT scan.
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The authors analyzed 965 consecutive patients presenting to any of three European emergency departments between October 2000 and June 2002 with complaints suggestive of pulmonary embolism (PE)sudden or worsening dyspnea, chest pain without another etiology, or syncope.
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The adage the best chest x-ray is an old chest x-ray can be extended to the world of electrocardiography. With the myriad and subtle changes that may occur on the 12-lead surface electrocardiogram, at times the emergency physicians best ally is an old tracing for comparison.
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New research is challenging the current guidelines of how to treat atherosclerotic coronary disease with statin drugs. Current guidelines by the National Cholesterol Education Program have set a therapy target of 100 mg/dL. Two recent head-to-head trials, however, suggest that intensive statin therapy may be of greater benefit.
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Computerized physician order entry (CPOE) may be one way to curb medication errors. The reality, however, is that most health care centers have not implemented such a program and may never will. CPOE systems are expensive, and some professionals fear the technology will be outdated during the time it takes to install the system and teach staff to use it.
