A5063290842- Antibiotic Use and Resistance
- Emergency and Acute Care Studies
- Patient Satisfaction in Healthcare
- Pneumonia and Respiratory Infections
- Bacterial Identification and Susceptibility Testing
- Antimicrobial Resistance in Staphylococcus
- Electronic Health Records Systems
- Dysphagia Assessment and Management
- Streptococcal Infections and Treatments
- COVID-19 Clinical Research Studies
- Urinary Tract Infections Management
- Sepsis Diagnosis and Treatment
- Patient Safety and Medication Errors
- Tracheal and airway disorders
- Esophageal and GI Pathology
- Patient-Provider Communication in Healthcare
- Nosocomial Infections in ICU
- Clinical Reasoning and Diagnostic Skills
- Healthcare Decision-Making and Restraints
- Respiratory viral infections research
- Geriatric Care and Nursing Homes
- Chronic Disease Management Strategies
- Radiology practices and education
- COVID-19 diagnosis using AI
- Ultrasound in Clinical Applications
University of Wisconsin–Madison
2016-2025
Wayne State University
2025
University of Iowa
2025
Oregon Medical Research Center
2024
New York Proton Center
2024
University of Pittsburgh
2024
Communities In Schools of Orange County
2024
Lindsay Unified School District
2024
Walsh University
2020-2023
Werner-Wicker-Klinik
2023
Importance Little is known about incidence of, risk factors for, and harms associated with inappropriate diagnosis of community-acquired pneumonia (CAP). Objective To characterize CAP in hospitalized patients. Design, Setting, Participants This prospective cohort study, including medical record review patient telephone calls, took place across 48 Michigan hospitals. Trained abstractors retrospectively assessed patients treated for between July 1, 2017, March 31, 2020. Patients were eligible...
Coronavirus disease 2019 (COVID-19), caused by novel enveloped single stranded RNA coronavirus (SARS-CoV-2), is responsible for an ongoing global pandemic. While other countries deployed widespread testing as early mitigation strategy, the U.S. experienced delays in development and deployment of organism identification assays. As such, there uncertainty surrounding burden community spread, severely hampering containment efforts. COVID-19 illuminates need a tiered diagnostic approach to...
In this study, we used human factors (HF) methods and principles to design a clinical decision support (CDS) that provides cognitive the pulmonary embolism (PE) diagnostic decision-making process in emergency department. We hypothesised application of HF will produce more usable CDS improves PE decision-making, particular about appropriate pathway.We conducted scenario-based simulation study compare HF-based (the so-called for diagnosis (PE-Dx CDS)) with web-based (MDCalc); 32 physicians...
Abstract Background Limited data have described the testing patterns and outcomes of adults (≥18 years) with acute respiratory illness (ARI) in emergency department setting. Methods This prospective cohort study includes patients ARI from a program sponsored by Centers for Disease Control Prevention entitled Respiratory Virus Laboratory Emergency Department Network Surveillance (RESP-LENS) August 2021 until March 2024 (91 hospitals). Patients ARIs were identified weekly electronic...
Abstract Objective: Skin and soft tissue infections (SSTIs) account for over 2.8 million annual emergency department (ED) visits often result in suboptimal antibiotic therapy. The objective of this study was to evaluate a set interventions minimizing inappropriate prescription antibiotics presumed SSTIs the ED. Design: Case vignette survey. Participants: A national sample medicine (EM) physicians. Methods: Each described clinical scenario SSTI (cellulitis or abscess) included unique...
Abstract Background The COVID-19 pandemic stressed antimicrobial stewardship (AMS) programs with increased workloads and lack of guidance on the treatment COVID-19. Throughout pandemic, patients have received antibiotics for this viral illness despite reported low rates confirmed bacterial co-infections. purpose study was to identify challenges strategies successful antibiotic inpatients. Part 1 Table Methods We utilized Premier Healthcare Database hospitals appropriate prescribing before...
Abstract Background The COVID-19 pandemic was an unprecedented stress test for hospital-based antimicrobial stewardship (AMS) programs. purpose of this study to characterize strategies AMS program resiliency during the pandemic. Methods Using a national dataset, we identified hospitals according three criteria: 1.) significant burden; 2.) appropriate antibiotic prescribing patterns before pandemic; and 3.) maintenance We conducted semi-structured interviews with pharmacists, physicians...
Abstract Background Significant concerns have been raised regarding the overuse of antibiotics among patients hospitalized for coronavirus disease 2019 (COVID-19) and broad impact pandemic on antimicrobial stewardship in acute care. We sought to compare potentially unnecessary antibiotic prescribing over time admitted with symptomatic COVID-19 non–COVID-19 viral respiratory tract infections (ARTIs). Methods conducted a repeated cross-sectional analysis monthly rate from March 2020 December...
The pervasive, often inappropriate, use of antibiotics in healthcare settings has been identified as a major public health threat due to the resultant widespread emergence antibiotic resistant bacteria. In nursing homes (NH), many two-thirds residents receive each year and up 75% these are estimated be inappropriate. objective this study was characterize therapy for NH compare appropriateness based on setting prescription initiation.This retrospective, cross-sectional multi-center that...
Machine learning is increasingly used for risk stratification in health care. Achieving accurate predictive models do not improve outcomes if they cannot be translated into efficacious intervention. Here we examine the potential utility of automated and referral intervention to screen older adults fall after emergency department (ED) visits.This study evaluated several machine methodologies creation a algorithm using electronic record data estimated effects resultant based on performance...
Background Procalcitonin is a biomarker that supports clinical decision-making on when to initiate and discontinue antibiotic therapy. Several cost (-effectiveness) analyses have been conducted Procalcitonin-guided stewardship, but none mainly based US originated data. Objective To compare effectiveness costs of Procalcitonin-algorithm versus standard care guide prescription for patients hospitalized with diagnosis suspected sepsis or lower respiratory tract infection in the US. Methods A...
Abstract Frailty is a complex and multidimensional condition wherein declines in physiologic reserve function place individuals state of heightened vulnerability decreased resiliency. There has been growing interest both research clinical settings to understand how best define, assess characterise frailty older adults. To this end, various models assessment tools have used define measure frailty. While differences exist among these tools, common unifying theme focus on physical activity....
Abstract Background Inappropriate ordering and acquisition of urine cultures leads to unnecessary treatment asymptomatic bacteriuria (ASB). Treatment ASB contributes antimicrobial resistance particularly among hospital-acquired organisms. Our objective was investigate culture collection practices nurses identify key system-level human factor barriers facilitators that affect optimal practices. Methods We conducted two focus groups, one with ED the other ICU nurses. Questions were developed...
Importance Acute respiratory infections (ARIs) account for most outpatient visits. Discriminating bacterial vs viral etiology is a diagnostic challenge with therapeutic implications. Objective To investigate whether FebriDx, rapid, point-of-care immunoassay, can differentiate bacterial- from viral-associated host immune response in ARI through measurement of myxovirus resistance protein A (MxA) and C-reactive (CRP) finger-stick blood. Design, Setting, Participants This study enrolled adults...
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