health personnel

Infectious Diseases Society of America Guidelines on Infection Prevention for Healthcare Personnel Caring for Patients with Suspected or Known COVID-19

Bethie Seay — Tue, 30 Nov 2021 06:00:00 +0000

Date Added:

November 30, 2021

Journal/Publication:

Clinical Infectious Diseases

Publication Date:

November 15, 2021

Type:

Meta-analyses, Reviews, and Guidelines

DOI (1):

10.1093/cid/ciab953

PMID (1):

34791102

Recommendations from the Infectious Disease Society of America regarding prevention of COVID-19 infection in health care professionals.

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Background: Since its emergence in late 2019, SARS-CoV-2 continues to pose a risk to healthcare personnel (HCP) and patients in healthcare settings. Although all clinical interactions likely carry some risk of transmission, human actions like coughing and care activities like aerosol-generating procedures likely have a higher risk of transmission. The rapid emergence and global spread of SARS-CoV-2 continues to create significant challenges in healthcare facilities, particularly with shortages of personal protective equipment (PPE) used by HCP. Evidence-based recommendations for what PPE to use in conventional, contingency, and crisis standards of care continue to be needed. Where evidence is lacking, the development of specific research questions can help direct funders and investigators.

Objective: Develop evidence-based rapid guidelines intended to support HCP in their decisions about infection prevention when caring for patients with suspected or known COVID-19.

Methods: IDSA formed a multidisciplinary guideline panel including frontline clinicians, infectious disease specialists, experts in infection control, and guideline methodologists with representation from the disciplines of public health, medical microbiology, pediatrics, critical care medicine and gastroenterology. The process followed a rapid recommendation checklist. The panel prioritized questions and outcomes. Then a systematic review of the peer-reviewed and grey literature was conducted. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the certainty of evidence and make recommendations.

Results: The IDSA guideline panel agreed on eight recommendations, including two updated recommendations and one new recommendation added since the first version of the guideline. Narrative summaries of other interventions undergoing evaluations are also included.

Conclusions: Using a combination of direct and indirect evidence, the panel was able to provide recommendations for eight specific questions on the use of PPE for HCP providing care for patients with suspected or known COVID-19. Where evidence was lacking, attempts were made to provide potential avenues for investigation. There remain significant gaps in the understanding of the transmission dynamics of SARS-CoV-2 and PPE recommendations may need to be modified in response to new evidence. These recommendations should serve as a minimum for PPE use in healthcare facilities and do not preclude decisions based on local risk assessments or requirements of local health jurisdictions or other regulatory bodies.

Author/s:

Lynch, J. B., Davitkov, P., Anderson, D. J., Bhimraj, A., Cheng, V. C. C., Guzman-Cottrill, J., Dhindsa, J., Duggal, A., Jain, M. K., Lee, G. M., Liang, S. Y., McGeer, A., Varghese, J., Lavergne, V., Murad, M. H., Mustafa, R. A., Sultan, S., Falck-Ytter, Y., Morgan, R. L.

The Management of Type 1 Diabetes in Adults. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)

Bethie Seay — Tue, 05 Oct 2021 05:00:00 +0000

Date Added:

October 5, 2021

Journal/Publication:

Diabetes Care

Publication Date:

September 30, 2021

Type:

Meta-analyses, Reviews, and Guidelines

MeSH

Adult

United States

diabetes mellitus, type 1

insulin

Islets of Langerhans Transplantation

Diabetic Ketoacidosis

self-management

Consensus

Psychiatric Rehabilitation

blood glucose

Blood Glucose Self-Monitoring

Inpatients

follow-up studies

Hypoglycemia

Insulin, Regular, Human

Pancreas

Writing

health personnel

A Consensus statement from the ADA on management of Type 1 diabetes in adults.

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The American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) convened a writing group to develop a consensus statement on the management of type 1 diabetes in adults. The writing group has considered the rapid development of new treatments and technologies and addressed the following topics: diagnosis, aims of management, schedule of care, diabetes self-management education and support, glucose monitoring, insulin therapy, hypoglycemia, behavioral considerations, psychosocial care, diabetic ketoacidosis, pancreas and islet transplantation, adjunctive therapies, special populations, inpatient management, and future perspectives. Although we discuss the schedule for follow-up examinations and testing, we have not included the evaluation and treatment of the chronic microvascular and macrovascular complications of diabetes as these are well-reviewed and discussed elsewhere. The writing group was aware of both national and international guidance on type 1 diabetes and did not seek to replicate this but rather aimed to highlight the major areas that health care professionals should consider when managing adults with type 1 diabetes. Though evidence-based where possible, the recommendations in the report represent the consensus opinion of the authors.

Author/s:

Holt, R. I. G., DeVries, J. H., Hess-Fischl, A., Hirsch, I. B., Kirkman, M. S., Klupa, T., Ludwig, B., Nørgaard, K., Pettus, J., Renard, E., Skyler, J. S., Snoek, F. J., Weinstock, R. S., Peters, A. L.

Patient Questions Surrounding Mask Use for Prevention of COVID-19 and Physician Answers from an Evidence-Based Perspective: a Narrative Review

Bethie Seay — Fri, 03 Sep 2021 05:00:00 +0000

Date Added:

September 3, 2021

Type:

Patient Education Materials

DOI (1):

10.1007/s11606-020-06324-w

MeSH

Evidence-based answers to patients’ questions about masks to prevent the spread of COVID-19.

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Recent mandates to wear masks in public places across the USA combined with conflicting messaging from the media and government agencies have generated a lot of patient questions surrounding the appropriate use and efficacy of cloth masks. Here, we have organized the evidence in the context of real patient questions and have provided example answers from a physician’s perspective. The purpose of this review is to offer healthcare providers with examples of how to respond to patient questions about masks in a way that encourages responsible decision-making. We conclude, based on the evidence showing a benefit for cloth masks and the recent reports supporting a role for aerosols in the transmission of SARS-CoV-2, that cloth masks will be effective when used correctly. We further assert that stronger public messaging surrounding cloth masks in the community setting is needed, and should specify that 2–3 layer, fitted face masks be worn at all times in public as another layer of protection in addition to social distancing, not just when social distancing cannot be maintained.

Author/s:

Martinez, J. A., Miller, R. H., Martinez, R. A.

How can healthcare professionals provide guidance and support to parents of adolescents? Results from a primary care-based study

Bethie Seay — Thu, 08 Jul 2021 05:00:00 +0000

Date Added:

July 8, 2021

Type:

Clinical Research Results

DOI (1):

10.1186/s12913-021-06200-1

PMID (1):

33743664

MeSH

delivery of health care

health personnel

Humans

Parenting

A list of topics parents of adolescents hope their primary care clinicians will discuss with their child.

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Background: This study explored the rewards and difficulties of raising an adolescent and investigated parents' level of interest in receiving guidance from healthcare providers on parenting and adolescent health topics. Additionally, this study investigated whether parents were interested in parenting programs in primary care and explored methods in which parents want to receive guidance.

Methods: Parents of adolescents (ages 12-18) who attended an outpatient pediatric clinic with their adolescent were contacted by telephone and completed a short telephone survey. Parents were asked open-ended questions regarding the rewards and difficulties of parenting and rated how important it was to receive guidance from a healthcare provider on certain parenting and health topics. Additionally, parents reported their level of interest in a parenting program in primary care and rated how they would like to receive guidance.

Results: Our final sample included 104 parents, 87% of whom were interested in a parenting program within primary care. A variety of parenting rewards and difficulties were associated with raising an adolescent. From the list of parenting topics, communication was rated very important to receive guidance on (65%), followed by conflict management (50%). Of health topics, parents were primarily interested in receiving guidance on sex (77%), mental health (75%), and alcohol and drugs (74%). Parents in the study wanted to receive guidance from a pediatrician or through written literature.

Conclusions: The current study finds that parents identify several rewarding and difficult aspects associated with raising an adolescent and are open to receiving guidance on a range of parenting topics in a variety of formats through primary care settings. Incorporating such education into healthcare visits could improve parents' knowledge. Healthcare providers are encouraged to consider how best to provide parenting support during this important developmental time period.

Keywords: Adolescents; Parenting support; Parents; Primary care.

Author/s:

Jones, L. D., Grout, R. W., Gilbert, A. L., Wilkinson, T. A., Garbuz, T., Downs, S. M., Aalsma, M. C.

Rickettsial Disease Diagnostic Testing and Interpretation

Saige Blanchard — Fri, 28 May 2021 05:00:00 +0000

Date Added:

May 28, 2021

Publisher:

Centers for Disease Control and Prevention

Publication Date:

May 25, 2021

URL:

Rickettsial Disease Diagnostic Testing and Interpretation

Type:

Clinical Decision Aids, Public Health Announcements

Format:

Video

Keywords

MeSH

Polymerase Chain Reaction

Rickettsia Infections

Antibodies

health personnel

Fluorescent Antibody Technique, Indirect

A 10 minute you-tube video discussing current testing recommendations for Rickettsial diseases. James W. Mold, MD, MPH

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This video provides information on rickettsial disease diagnostic methods for healthcare providers, including what tests are available and when it is most appropriate to collect samples. This video focuses on the use of polymerase chain reaction (or PCR) tests, and the indirect immunofluorescence antibody (IFA) assay for rickettsial disease diagnosis.

Author/s:

Centers for Disease Control and Prevention

COVID-19 Vaccine: Quick Reference Guide for Healthcare Professionals

Bethie Seay — Tue, 25 May 2021 05:00:00 +0000

Date Added:

May 25, 2021

Type:

Clinical Decision Aids

MeSH

Centers for Disease Control and Prevention, U.S.

delivery of health care

ACIP Reference Guide on COVID Vaccine administration.

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The table below provides basic information on the proper storage, preparation, and administration of the currently authorized COVID-19 vaccine products in the United States. For additional information and detailed clinical guidance go to the manufacturer’s and CDC’s webpages listed.

Author/s:

Centers for Disease Control and Prevention

Contraceptive Challenges in Women With Common Medical Conditions

Brian Desmarais — Sat, 07 Nov 2020 21:17:24 +0000

Date Added:

November 7, 2020

Journal/Publication:

Mayo Clinic proceedings

Publisher:

Mayo Clinic

Publication Date:

November 1, 2020

Issue:

Volume:

Pages:

2525-2534

URL:

Contraceptive Challenges in Women With Common Medical Conditions

Format:

Article

DOI (1):

10.1016/j.mayocp.2020.08.045

MeSH

health personnel

reproduction

Contraceptive Devices

Recommendations for contraception in patients with a variety of medical conditions. James W. Mold, MD, MPH

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Women have the opportunity to meet personal contraceptive goals with convenient, highly reliable, and easily reversible methods. Long-acting reversible contraception represents an increasingly popular option for most women throughout the reproductive lifespan. Nonetheless, many women and their health care providers are challenged by coexisting medical issues. We aim to help clinicians individualize contraception and use shared decision-making to enhance patient satisfaction and continuation with their method.

Author/s:

Gave, C.J., Marnach, M.L., Casey, P.M.

COVID-19–Associated Multisystem Inflammatory Syndrome in Children — United States, March–July 2020

Brian Desmarais — Tue, 11 Aug 2020 16:18:53 +0000

Date Added:

August 11, 2020

Journal/Publication:

Morbidity and Mortality Weekly Report

Publisher:

Centers for Disease Control and Prevention

Publication Date:

August 7, 2020

URL:

COVID-19–Associated Multisystem Inflammatory Syndrome in Children — United States, March–July 2020

Type:

Clinical Research Results

Format:

Article

DOI (1):

http://dx.doi.org/10.15585/mmwr.mm6932e2

MeSH

health personnel

Early Diagnosis

Public Health Practice

A summary from the CDC of what is currently known about COVID-19-related Multisystem Inflammatory Syndrome in Children (MIS-C) in the U.S. James W. Mold, MD, MPH

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Summary

What is already known about this topic?

Multisystem inflammatory syndrome in children (MIS-C) is a rare but severe condition that has been reported approximately 2–4 weeks after the onset of COVID-19 in children and adolescents.

What is added by this report?

Most cases of MIS-C have features of shock, with cardiac involvement, gastrointestinal symptoms, and significantly elevated markers of inflammation, with positive laboratory test results for SARS-CoV-2. Of the 565 patients who underwent SARS-CoV-2 testing, all had a positive test result by RT-PCR or serology.

What are the implications for public health practice?

Distinguishing MIS-C from other severe infectious or inflammatory conditions poses a challenge to clinicians caring for children and adolescents. As the COVID-19 pandemic continues to expand in many jurisdictions, health care provider awareness of MIS-C will facilitate early recognition, early diagnosis, and prompt treatment.

Author/s:

Godfred-Cato, S., Bryant, B., Leung, J.

Coding for Coronavirus: NEW Guidance Replaces the Rule of 1 Month Ago

Brian Desmarais — Thu, 02 Apr 2020 02:51:06 +0000

Date Added:

April 1, 2020

Journal/Publication:

Medscape Family Medicine

Publication Date:

March 30, 2020

URL:

Coding for Coronavirus: NEW Guidance Replaces the Rule of 1 Month Ago

Type:

Practice Management Reviews and Guidelines

Format:

Web Page

Keywords

MeSH

International Classification of Diseases

health personnel

physicians

Centers for Disease Control and Prevention

U.S.

A new ICD-10 code, U07.1, has been created for confirmed cases of COVID19. Additional codes can be added for complications like pneumonia. James W. Mold, MD, MPH

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Not available.

Author/s:

Nicoletti, B.

N95 Respirators vs Medical Masks for Preventing Influenza Among Health Care Personnel: A Randomized Clinical Trial

John Bayhi — Mon, 23 Mar 2020 22:10:43 +0000

Date Added:

March 23, 2020

Journal/Publication:

JAMA

Publisher:

American Medical Association

Publication Date:

September 3, 2019

Issue:

Volume:

222

Pages:

824-833

URL:

N95 Respirators vs Medical Masks for Preventing Influenza Among Health Care Personnel: A Randomized Clinical Trial

Format:

Article

DOI (1):

10.1001/jama.2019.11645

Keywords

respiratory disease

respiratory infections

PMID (1):

31479137

This large RCT appears to confirm prior studies showing that regular surgical masks work just as well (or poorly) as N95 masks from preventing influenza in front line health care workers. James W. Mold, MD, MPH

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IMPORTANCE:

Clinical studies have been inconclusive about the effectiveness of N95 respirators and medical masks in preventing health care personnel (HCP) from acquiring workplace viral respiratory infections.

OBJECTIVE:

To compare the effect of N95 respirators vs medical masks for prevention of influenza and other viral respiratory infections among HCP.

DESIGN, SETTING, AND PARTICIPANTS:

A cluster randomized pragmatic effectiveness study conducted at 137 outpatient study sites at 7 US medical centers between September 2011 and May 2015, with final follow-up in June 2016. Each year for 4 years, during the 12-week period of peak viral respiratory illness, pairs of outpatient sites (clusters) within each center were matched and randomly assigned to the N95 respirator or medical mask groups.

INTERVENTIONS:

Overall, 1993 participants in 189 clusters were randomly assigned to wear N95 respirators (2512 HCP-seasons of observation) and 2058 in 191 clusters were randomly assigned to wear medical masks (2668 HCP-seasons) when near patients with respiratory illness.

MAIN OUTCOMES AND MEASURES:

The primary outcome was the incidence of laboratory-confirmed influenza. Secondary outcomes included incidence of acute respiratory illness, laboratory-detected respiratory infections, laboratory-confirmed respiratory illness, and influenzalike illness. Adherence to interventions was assessed.

RESULTS:

Among 2862 randomized participants (mean [SD] age, 43 [11.5] years; 2369 [82.8%]) women), 2371 completed the study and accounted for 5180 HCP-seasons. There were 207 laboratory-confirmed influenza infection events (8.2% of HCP-seasons) in the N95 respirator group and 193 (7.2% of HCP-seasons) in the medical mask group (difference, 1.0%, [95% CI, -0.5% to 2.5%]; P = .18) (adjusted odds ratio [OR], 1.18 [95% CI, 0.95-1.45]). There were 1556 acute respiratory illness events in the respirator group vs 1711 in the mask group (difference, -21.9 per 1000 HCP-seasons [95% CI, -48.2 to 4.4]; P = .10); 679 laboratory-detected respiratory infections in the respirator group vs 745 in the mask group (difference, -8.9 per 1000 HCP-seasons, [95% CI, -33.3 to 15.4]; P = .47); 371 laboratory-confirmed respiratory illness events in the respirator group vs 417 in the mask group (difference, -8.6 per 1000 HCP-seasons [95% CI, -28.2 to 10.9]; P = .39); and 128 influenzalike illness events in the respirator group vs 166 in the mask group (difference, -11.3 per 1000 HCP-seasons [95% CI, -23.8 to 1.3]; P = .08). In the respirator group, 89.4% of participants reported "always" or "sometimes" wearing their assigned devices vs 90.2% in the mask group.

CONCLUSIONS AND RELEVANCE:

Among outpatient health care personnel, N95 respirators vs medical masks as worn by participants in this trial resulted in no significant difference in the incidence of laboratory-confirmed influenza.

TRIAL REGISTRATION:

ClinicalTrials.gov Identifier: NCT01249625.

Author/s:

Radonovich, LJ Jr, Simberkoff, MS, Bessesen, MT, Brown, AC, Cummings, DAT, Gaydos, CA, Los, JG, Krosche, AE, Gibert, CL, Gorse, GJ, Nyquist, AC, Reich, N.G., Rodriguez-Barradas, MC, Price, CS, Perl, TM, ResPECT investigators

Screening for Alcohol Use and Brief Counseling of Adults — 13 States and the District of Columbia, 2017

John Bayhi — Sat, 14 Mar 2020 20:31:53 +0000

Date Added:

March 14, 2020

Journal/Publication:

MMWR Morbidity and Mortality Weekly Report

Publisher:

Centers for Disease Control and Prevention

Publication Date:

March 13, 2020

Issue:

Volume:

Pages:

265-270

URL:

Screening for Alcohol Use and Brief Counseling of Adults — 13 States and the District of Columbia, 2017

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.15585/mmwr.mm6910a3

Keywords

alcohol use

screening and brief intervention

alcohol SBI

binge drinking

PMID (1):

32163383

MeSH

Behavioral Risk Factor Surveillance System

Fetal Alcohol Spectrum Disorders

Public Health Practice

health personnel

Evidence-Based Medicine

insurance coverage

Telephone

Centers for Disease Control and Prevention

U.S.

Longitudinal Studies

The CDC recommends screening all adults for binge drinking with a single question and recommending reduction to those who screen positive. James W. Mold, MD, MPH

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What is already known about this topic?

Binge drinking increases the risk for adverse health conditions and death. Alcohol screening and brief intervention (SBI), recommended by the U.S. Preventive Services Task Force (USPSTF) for all adults in primary care, is effective in reducing binge drinking.

What is added by this report?

In 2017, 81% of survey respondents were asked by their health care provider about alcohol consumption and 38% about binge drinking at a checkup in the past 2 years. Among those asked about alcohol use and who reported current binge drinking, 80% received no advice to reduce their drinking.

What are the implications for public health practice?

Implementation of alcohol SBI as recommended by USPSTF, coupled with population-level evidence-based interventions, can reduce binge drinking among U.S. adults.

Author/s:

McKnight-Eily, LR, Okoro, CA, Turay, K, Acero, C, Hungerford, D

Aspirin in the Treatment and Prevention of Migraine Headaches: Possible Additional Clinical Options for Primary Healthcare Providers

Brian Desmarais — Mon, 11 Nov 2019 15:09:25 +0000

Date Added:

November 11, 2019

Journal/Publication:

The American Journal of Medicine

Publication Date:

October 12, 2019

URL:

Aspirin in the Treatment and Prevention of Migraine Headaches: Possible Additional Clinical Options for Primary Healthcare Providers

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

https://doi.org/10.1016/j.amjmed.2019.10.023

Keywords

MeSH

While the full article is not available for free, I though the abstract might be of interest and value. James W. Mold, MD, MPH

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Migraine headaches are among the most common and potentially debilitating disorders encountered by primary healthcare providers. In the treatment of acute migraine as well as prevention of recurrent attacks there are prescription drugs of proven benefit. For those without health insurance or high co-pays, however, they may be neither available nor affordable and, for all patients, they may be either poorly tolerated or contraindicated.

The totality of evidence, which includes data from randomized trials, suggests that high-dose aspirin, in doses from 900 to 1300 milligrams, taken at the onset of symptoms, is an effective and safe treatment option for acute migraine headaches. In addition, the totality of evidence, including some, but not all, randomized trials, suggests the possibility that daily aspirin in doses from 81 to 325 milligrams, may be an effective and safe treatment option for the prevention of recurrent migraine headaches.

The relatively favorable side effect profile of aspirin and extremely low costs compared with other prescription drug therapies may provide additional options for primary healthcare providers treating acute as well as recurrent migraine headaches.

Author/s:

Biglione, B., Gitin, A., Gorelick, P., Hennekens, C.

Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices - United States, 2019-20 Influenza Season

Brian Desmarais — Mon, 30 Sep 2019 13:16:17 +0000

Date Added:

September 30, 2019

Journal/Publication:

Morbidity and Mortality Weekly Report

Publication Date:

August 23, 2019

Issue:

Volume:

Pages:

1-21

URL:

Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices - United States, 2019-20 Influenza Seaso

Type:

Public Health Announcements

Format:

Article

DOI (1):

10.15585/mmwr.rr6803a1

Keywords

Flu vaccines

vaccination recommendations

Centers for Disease Control and Prevention

MeSH

vaccines, inactivated

Hemagglutinins

Influenza A Virus, H1N1 Subtype

Influenza A Virus, H3N2 Subtype

united states food and drug administration

centers for disease control and prevention (U.S.)

Contraindications

This year’s flu vaccine recommendations from the CDC. James W. Mold, MD, MPH

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Abstract

This report updates the 2018-19 recommendations of the Advisory Committee on Immunization Practices (ACIP) regarding the use of seasonal influenza vaccines in the United States (MMWR Recomm Rep 2018;67[No. RR-3]). Routine annual influenza vaccination is recommended for all persons aged ≥6 months who do not have contraindications. A licensed, recommended, and age-appropriate vaccine should be used. Inactivated influenza vaccines (IIVs), recombinant influenza vaccine (RIV), and live attenuated influenza vaccine (LAIV) are expected to be available for the 2019-20 season. Standard-dose, unadjuvanted, inactivated influenza vaccines will be available in quadrivalent formulations (IIV4s). High-dose (HD-IIV3) and adjuvanted (aIIV3) inactivated influenza vaccines will be available in trivalent formulations. Recombinant (RIV4) and live attenuated influenza vaccine (LAIV4) will be available in quadrivalent formulations.Updates to the recommendations described in this report reflect discussions during public meetings of ACIP held on October 25, 2018; February 27, 2019; and June 27, 2019. Primary updates in this report include the following two items. First, 2019-20 U.S. trivalent influenza vaccines will contain hemagglutinin (HA) derived from an A/Brisbane/02/2018 (H1N1)pdm09-like virus, an A/Kansas/14/2017 (H3N2)-like virus, and a B/Colorado/06/2017-like virus (Victoria lineage). Quadrivalent influenza vaccines will contain HA derived from these three viruses, and a B/Phuket/3073/2013-like virus (Yamagata lineage). Second, recent labeling changes for two IIV4s, Afluria Quadrivalent and Fluzone Quadrivalent, are discussed. The age indication for Afluria Quadrivalent has been expanded from ≥5 years to ≥6 months. The dose volume for Afluria Quadrivalent is 0.25 mL for children aged 6 through 35 months and 0.5 mL for all persons aged ≥36 months (≥3 years). The dose volume for Fluzone Quadrivalent for children aged 6 through 35 months, which was previously 0.25 mL, is now either 0.25 mL or 0.5 mL. The dose volume for Fluzone Quadrivalent is 0.5 mL for all persons aged ≥36 months (≥3 years).This report focuses on the recommendations for use of vaccines for the prevention and control of influenza during the 2019-20 season in the United States. A brief summary of these recommendations and a Background Document containing additional information are available at https://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/flu.html. These recommendations apply to U.S.-licensed influenza vaccines used within Food and Drug Administration-licensed indications. Updates and other information are available from CDC's influenza website (https://www.cdc.gov/flu). Vaccination and health care providers should check this site periodically for additional information.

Author/s:

Grohskopf, L.A., Alyanak, E., Broder, K.R., Walter, E.B., Fry, A.M., Jernigan, D.B.

Physician Stress and Burnout

John Bayhi — Wed, 18 Sep 2019 16:49:32 +0000

Date Added:

September 18, 2019

Journal/Publication:

The American Journal of Medicine

Publisher:

Elsevier Inc

Publication Date:

September 11, 2019

URL:

Physician Stress and Burnout

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1016/j.amjmed.2019.08.034

Keywords

PMID (1):

31520624

MeSH

burnout, professional

A review of physician burnout and what can be done about it. James W. Mold, MD, MPH

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Tens (or hundreds) of thousands of Americans die each year as a result of preventable medical errors. Changes in the practice and business of medicine have caused some to question whether burnout among physicians and other healthcare providers may adversely affect patient outcomes. A clear consensus supports the contention that burnout affects patients, albeit with low quality objective data. The psychological and physical impact on physicians and other providers is quite clear however, and the impact on the physician workforce (where large shortages are projected) is yet another cause for concern. We have all heard the airplane safety announcement remind us to "please put on your own oxygen mask first before assisting others." But, like many airline passengers (very few of whom use oxygen masks correctly when they are needed), physicians often do not recognize symptoms of burnout or depression, and even less often do they seek help. We detail causes and consequences of physician burnout and propose solutions to increase physician work satisfaction.

Author/s:

Yates, SW

Assessment and Management of Patients at Risk for Suicide: Synopsis of the 2019 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guidelines.

Brian Desmarais — Wed, 28 Aug 2019 19:36:58 +0000

Date Added:

August 28, 2019

Journal/Publication:

Annals of Internal Medicine

Publication Date:

August 27, 2019

URL:

Assessment and Management of Patients at Risk for Suicide: Synopsis of the 2019 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guidelines.

Format:

Article

DOI (1):

10.7326/M19-0687

Keywords

MeSH

evidence-based practice

DESCRIPTION:

In May 2019, the U.S. Department of Veterans Affairs (VA) and U.S. Department of Defense (DoD) approved an update to the 2013 joint clinical practice guideline for assessing and managing patients who are at risk for suicide. This guideline provides health care providers with a framework by which to screen for, evaluate, treat, and manage the individual needs and preferences of VA and DoD patientswho may be at risk for suicide.

METHODS:

In January 2018, the VA/DoD Evidence-Based Practice Work Group convened to develop a joint VA/DoD guideline including clinical stakeholders and conforming to the National Academy of Medicine's tenets for trustworthy clinical practice guidelines. The guideline panel drafted key questions, systematically searched and evaluated the literature through April 2018, created algorithms, and advanced 22 recommendations in accordance with the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system.

RECOMMENDATIONS:

This synopsis, which includes 3 clinical practice algorithms, summarizes the key recommendations of the guideline related to screening and evaluation, risk management and treatment, and other management methods. Risk management and treatment recommendations address both pharmacologic and nonpharmacologic approaches for patients with suicidal ideation and behavior. Other management methods address lethal means safety (such as restricting access to firearms, poisons, and medications and installing barriers to prevent jumping from lethal heights) and population health strategies.

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These guidelines produced by the VA apply equally well to all adults. James W. Mold, MD, MPH

Author/s:

Sall, J., Brenner, J., Bell, A.M.M., Colston, M.J.