Technology
As patient census rises, so does your number of messages
What’s the correlation between morning census and the number of secure texts doctors send and receive in the hospital every day? Researchers writing in the Journal of Hospital Medicine tracked the number of secure messages that rounding hospitalists working days in one academic center sent and received during one month in 2023. The results: The number of messages averaged 130 per day, with 13 messages sent or received every hour. On average, secure chats were accessed only 39 seconds after they were sent. Moreover, the authors found a statistically significant correlation between morning census and the number of secure chats sent and accessed per hour, as well as the number of conversations that clinicians had during the day. As for the number of conversations: Hospitalists averaged 22 of those per day in addition to secure messages.
Neurology
Top 10 mistakes in treating neurological emergencies in the hospital
When approaching neurological emergencies in the hospital, what do hospitalists get wrong? At a conference this fall, S. Andrew Josephson, MD, chair of the UCSF department of neurology, described the top 10 mistakes he sees hospitalists make. Treating migraine with opiates is one of those, given that “opiates make head pain worse due to rebound phenomena,” he explained. Other common problems included assuming all jerks are due to seizure, not starting the right empiric therapy for meningitis, not looking for a neurologic etiology in patients with a history of falls and not ordering the right test for patients with bilateral weakness. For more common mistakes in inpatient neurologic emergencies, see Today’s Hospitalist conference coverage.
Conserve
A look at how hospitals are handling the IV fluid shortage
Faced with a continued shortage of IV fluids, hospital administrators are taking steps to conserve fluids and in some cases changing how they approach hydration. A Fierce Healthcare report said that since a Baxter production facility that supplied 60% of IV fluids used in the U.S. was damaged during Hurricane Helene in September, some hospitals have seen their facility’s use of IV fluids drop 55%. Health systems are struggling to accommodate a typical year-end rush to complete elective procedures (because of insurance coverage) and the impending peak of flu season. One health system is considering retooling its EHR to ask clinicians to consider whether patients really need IV fluids.
Increased Risk
One in four nursing home residents getting covid vax
Despite a higher risk of getting covid, just four in 10 U.S. nursing home residents got a vaccine or an updated shot in the winter of 2023-24. A KFF Health News report said that CDC data from April found that during covid’s peak, nursing home residents were hospitalized at a rate eight times higher than that of U.S. adults 70 and older. The CDC recommends that adults 65 and older get an additional dose of the covid vaccine if they had received their previous shot more than four months ago. In addition to growing skepticism about vaccines, one obstacle to vaccinations is cost. While the vaccine is free to patients, the government is no longer paying for it. That means providers must bill insurance companies for every shot, which makes vaccinating a large group like residents of a nursing home a time-consuming exercise. About 1.2 million people live in 15,000 nursing homes in the United States.
