Hospital-at-Home Patient Fall Predictors.

Objective: To evaluate predictors of falls in the hospital-at-home (HaH) setting from a single institution in 3 US states.

Patients And Methods: In this retrospective study of HaH patients residing in Florida, Wisconsin, and Arizona, we identified 51 patients who fell and were matched to 153 patients without fall, between July 2020 and July 2023. Patient demographics and clinical characteristics were collected, including age, sex, race, Charlson Comorbidity Index, geographic location, body mass index, Hester Davis Scale, admission diagnosis, continuous intravenous infusion, polypharmacy, marital status/life partnership, area deprivation index, and use of supplemental oxygen.

Factors leading to escalations in hospital-at-home: a scoping review.

Objective: Hospital-at-Home (H@H) models are safe and cost-effective alternatives for patients with acute or subacute conditions, offering care in the comfort and familiarity of their homes. Escalations, where patients are transferred back to traditional inpatient settings, are key performance metrics but represent significant challenges for H@H programs by interrupting the continuity and advantages of home-based treatment. This scoping review analyzes the factors leading to escalations across H@H programs.

Safety in a hybrid hospital-at-home program versus traditional inpatient care: A pragmatic randomized controlled trial.

Background: Hospital-at-home programs (HaH) in the United States have evolved to include a virtual-hybrid delivery model, where all physician encounters are virtual and partnered with a home care team.

Objective: To examine whether a virtual hybrid HaH program enabled by technology has similar clinical outcomes to traditional brick-and-mortar (B&M) hospital care.

Methods: We conducted a pragmatic trial at three hospitals, randomizing 1150 acutely ill patients requiring hospital care between July 10, 2023, and October 31, 2023 one-to-one into two groups: intervention (HaH) and control (B&M).

Nutrition Optimization in Early Dialysis.

Background: Protein-energy wasting (PEW) syndrome is a common condition among patients suffering from end-stage renal disease (ESRD) receiving intermittent hemodialysis (IHD). Hospital nutrition barriers such as delayed meals and iatrogenic fasting can negatively affect patients' experiences and contribute to long-standing nutritional deficits in at-risk patients. This project aimed to improve nutrition provision to inpatients with early IHD appointments by 50% (relative increase) without increasing IHD start time delays.

Increased Risk and Unique Clinical Course of Patient Safety Indicator-3 Pressure Injuries Among COVID-19 Hospitalized Patients.

Background: The COVID-19 pandemic introduced unique challenges to healthcare systems, particularly in relation to patient safety and adverse events during hospitalization. There is limited understanding of COVID-19's association with some patient safety indicators (PSIs).

Objectives: This study aimed to investigate the impact of COVID-19 infection on the rate of PSI-3 events and its implications on quality metrics.

Artificial Intelligence Support for Informal Patient Caregivers: A Systematic Review.

This study aims to explore how artificial intelligence can help ease the burden on caregivers, filling a gap in current research and healthcare practices due to the growing challenge of an aging population and increased reliance on informal caregivers. We conducted a search with Google Scholar, PubMed, Scopus, IEEE Xplore, and Web of Science, focusing on AI and caregiving. Our inclusion criteria were studies where AI supports informal caregivers, excluding those solely for data collection.

Association of Neutralizing Antispike Monoclonal Antibody Treatment With Coronavirus Disease 2019 Hospitalization and Assessment of the Monoclonal Antibody Screening Score.

Objective: To test the hypothesis that the Monoclonal Antibody Screening Score performs consistently better in identifying the need for monoclonal antibody infusion throughout each "wave" of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant predominance during the coronavirus disease 2019 (COVID-19) pandemic and that the infusion of contemporary monoclonal antibody treatments is associated with a lower risk of hospitalization.

Patients And Methods: In this retrospective cohort study, we evaluated the efficacy of monoclonal antibody treatment compared with that of no monoclonal antibody treatment in symptomatic adults who tested positive for SARS-CoV-2 regardless of their risk factors for disease progression or vaccination status during different periods of SARS-CoV-2 variant predominance. The primary outcome was hospitalization within 28 days after COVID-19 diagnosis.

Pyomyositis presenting as myonecrosis secondary to methicillin-resistant bacteremia in chronic lymphocytic leukemia.

The incidence of pyomyositis in immunocompromised patients with HIV, diabetes, myelodysplastic syndromes, and acute lymphocytic leukemia is well documented. However, there are only a few reports of pyomyositis and myonecrosis in patients with chronic lymphocytic leukemia (CLL). We present a rare case of pyomyositis presenting as myonecrosis secondary to methicillin-resistant eus bacteremia in a 72-year-old patient with CLL.

The Pitfalls of Mining for QuantiFERON Gold in Severely Ill Patients With COVID-19.

Objective: To assess the proportion of indeterminate QuantiFERON-TB Gold Plus (QFT-Plus) results in patients admitted for severe coronavirus disease 2019 (COVID-19) pneumonia and evaluate the factors associated with indeterminate QFT-Plus results.

Patients And Methods: Data on COVID-19 admissions at Mayo Clinic in Florida were extracted between October 13, 2020, and September 20, 2021, and data from a prepandemic cohort were extracted between October 13, 2018, and September 20, 2019. A secondary analysis of the COVID-19 cohort was performed using gradient boosting modeling to generate variable importance and SHapley Additive exPlanations plots.

The association of acute COVID-19 infection with Patient Safety Indicator-12 events in a multisite healthcare system.

Background: Patient Safety Indicator (PSI)-12, a hospital quality measure designed by Agency for Healthcare Research and Quality (AHRQ) to capture potentially preventable adverse events, captures perioperative venous thromboembolism (VTE). It is unclear how COVID-19 has affected PSI-12 performance.

Objective: We sought to compare the cumulative incidence of PSI-12 in patients with and without acute COVID-19 infection.

Clinical and laboratory profiles of the SARS-CoV-2 Delta variant compared with pre-Delta variants.

Objectives: The emergence of SARS-CoV-2 variants of concern has led to significant phenotypical changes in transmissibility, virulence, and public health measures. Our study used clinical data to compare characteristics between a Delta variant wave and a pre-Delta variant wave of hospitalized patients.

Methods: This single-center retrospective study defined a wave as an increasing number of COVID-19 hospitalizations, which peaked and later decreased.

Low antispike antibody levels correlate with poor outcomes in COVID-19 breakthrough hospitalizations.

Background: While COVID-19 immunization programs attempted to reach targeted rates, cases rose significantly since the emergence of the delta variant. This retrospective cohort study describes the correlation between antispike antibodies and outcomes of hospitalized, breakthrough cases during the delta variant surge.

Methods: All patients with positive SARS-CoV-2 polymerase chain reaction hospitalized at Mayo Clinic Florida from 19 June 2021 to 11 November 2021 were considered for analysis.

Coronavirus Disease 2019 Vaccine-Breakthrough Infections Requiring Hospitalization in Mayo Clinic Florida Through August 2021.

We characterized coronavirus disease 2019 (COVID-19) breakthrough cases admitted to a single center in Florida. With the emergence of delta variant, an increased number of hospitalizations was seen due to breakthrough infections. These patients were older and more likely to have comorbidities.

Goal-Directed Achievement Through Geographic Location (GAGL) Reduces Patient Length of Stay and Adverse Events.

This prospective cohort study aimed to improve hospital outcomes through geographic location of hospitalist patients and conducting daily multidisciplinary team rounds-Goal-directed Achievements through Geographic Location (GAGL). Patients were admitted to a geographic (GAGL) study unit where daily multidisciplinary rounds took place among nursing, case management, a hospitalist, pharmacy, physical and occupational therapy, respiratory therapy, and nutrition services. A total of 985 (56.

Pharmacogenomics of Cytochrome P450 of Nimodipine Metabolism After Aneurysmal Subarachnoid Hemorrhage.

Introduction: Aneurysmal subarachnoid hemorrhage (aSAH) is a type of stroke that is life threatening with high rates of mortality, and many survivors are left with permanent neurologic deficits. Nimodipine is the treatment of choice for aSAH with the goal of reduction of delayed cerebral ischemia. It is the only evidence-based medication that has been shown to have improved outcomes for delayed cerebral ischemia; therefore, it is important for neuroscience nurses to be knowledgeable of the pharmacology and pharmacogenomics properties of this medication, including cytochrome P450 (CYP450) enzymes.

Pregnancy and Parenting During Cardiology Fellowship.

Background An increasing number of residents and fellows have children during training. However, little is known about the specific experience of cardiology fellows who become parents during training. Methods and Results A 66-question Internet-based survey about experiences of pregnancy during graduate medical training was administered between May 1 and July 15, 2013, to all trainees (N=1516) in the Mayo School of Graduate Medical Education across 3 academic sites.

A 32-year-old man with hypoxemia and bilateral upper-lobe predominant ground-glass infiltrates on chest imaging.

Diffuse alveolar hemorrhage (DAH) is a rare, but potentially fatal, complication of antiphospholipid syndrome, and may present with acute and fulminant symptoms. We report a case of DAH presenting as sudden onset dyspnea in a gentleman with known antiphospholipid syndrome. Chest computed tomography angiography with pulmonary embolism protocol showed right lower lobe segmental filling defects, upper-lobe predominant diffuse ground-glass opacities, and centrilobular nodules bilaterally.

Concurrent Spontaneous Pneumomediastinum and Pneumorrhachis.

Background: Spontaneous pneumomediastinum with concurrent pneumorrhachis (air in the spinal canal) and subcutaneous emphysema can be an alarming presentation, both clinically and radiographically. These clinical entities often require only conservative measures after ruling out any worrisome underlying causes. Management often involves appropriate imaging, hospital admission, and sub-specialty consultation as needed to help determine any potential causes for the presentation that may require anything more than a period of medical observation.