STEVEN KREIN, MD

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The conference studied how to improve nursing care for veterans, focusing on key areas like preventing pressure injuries, coordinating care, and better nurse working conditions. Researchers identified five main topics needing more attention and created recommendations to enhance nursing practices within the Veterans Health Administration. This matters because improving nursing can lead to better health outcomes for the 9 million veterans who rely on their care. Who this helps: Veterans and the nurses who care for them.

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This study focused on creating recommendations to prevent hospital-onset urinary tract infections (HOUTIs), particularly highlighting non-catheter-associated UTIs, which haven’t had well-established prevention methods. The expert panel reached strong consensus on 37 key statements related to monitoring and preventing these infections, with at least 88% agreement on most topics. This is important because improving prevention strategies can significantly reduce the number of infections that patients acquire in hospitals, leading to better health outcomes and lower healthcare costs. Who this helps: This benefits patients in hospitals and healthcare providers who care for them.

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This study looked at older adults with dementia in the U.S. who were taking three or more medications that affect the brain, known as CNS-active polypharmacy. Out of nearly 1 million people studied, 14.3% were affected by this polypharmacy, with 63% of the medications prescribed by primary care doctors. Understanding how these medications are prescribed is important because it can help improve safety and care for patients with dementia. Who this helps: This helps patients with dementia and their doctors.

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This study looked at how nurses at a Veterans Affairs facility experienced the change from an old electronic health record (EHR) system to a new one. It involved interviews with 26 nurses and surveys from 317 others, which highlighted issues like difficulty using the new system and the need for better training and support. The findings showed that improving EHR functionality and ensuring training aligns with nursing practices are important for maintaining safety and efficiency in patient care. Who this helps: This helps nurses and healthcare organizations improve how they manage patient information.

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This study looked at how healthcare providers who go to patients' homes make decisions about using antibiotics. Researchers interviewed 22 of these home-based primary care doctors and learned that specialists like infectious disease doctors and pharmacists play important roles in helping them choose the right antibiotics. The findings show that local programs can improve antibiotic prescribing decisions and highlight the need for better support tailored to home care challenges. Who this helps: This helps doctors and healthcare providers working in home-based care deliver better treatment for their patients.

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This study looked at chronic low back pain in older veterans, specifically how nociplastic pain—pain linked to changes in the brain and nervous system—affects their everyday function. Out of 342 veterans surveyed, 36% showed signs of fibromyalgia, a condition often linked to nociplastic pain, while almost all reported pain in multiple areas of their bodies. The research found that higher levels of fibromyalgia symptoms were associated with worse physical and mental health, indicating that more than just the physical pain is impacting these veterans’ lives. Who this helps: This benefits aging veterans struggling with chronic pain, their healthcare providers, and anyone working to improve their treatment options.

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This study looked at how people with inflammatory bowel disease (IBD) use Reddit to share their experiences and find support. Researchers analyzed 659 posts from specific subreddits and found that 31% of these were original posts while the rest were replies. They discovered that patients often seek information, advice, and emotional support on topics like symptoms, medication, healthcare challenges, diets, and mental health issues, highlighting the need for better care in traditional healthcare settings. Who this helps: This research benefits patients with IBD by showing how they can use social media for support and understanding.

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This study looks at ways to improve the safety of hemodialysis treatments for patients with end-stage kidney disease, which can sometimes cause low blood pressure during treatment. Researchers tested two approaches: one aimed at training healthcare providers and the other focused on educating and mentoring patients. The goal is to reduce the occurrence of low blood pressure during treatments, which can lead to complications, by implementing these interventions across 20 dialysis centers. Who this helps: This benefits patients undergoing hemodialysis and the healthcare providers who treat them.

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This study looked at how using implementation science can improve the ways hospitals manage and use antibiotics. The researchers found that by incorporating methods from implementation science, healthcare facilities can better promote and adopt effective antibiotic practices, leading to more consistent and sustainable results in everyday care. This is important because better management of antibiotics helps reduce resistance and improve patient outcomes. Who this helps: This benefits patients and healthcare providers by ensuring safer and more effective use of antibiotics.

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This study explored a program where pharmacists checked antibiotic prescriptions before patients left the hospital to ensure they weren't being overprescribed. Out of 288 reviews, pharmacists recommended changing antibiotics in 25% of cases, and hospital doctors accepted 70% of those recommendations. Although the program was well-received and easy to implement, it didn't significantly change the overall use of antibiotics after discharge. Who this helps: This helps patients by reducing the risk of unnecessary antibiotic use.

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This study focused on a new method for finding a specific artery in dogs and cats called the dorsal pedal artery using a portable ultrasound device. Researchers tested this technique on 27 pets under general anesthesia and found that they successfully accessed the artery 70% of the time and placed a catheter 37% of the time. This matters because it provides a potentially better way to monitor blood pressure directly in pets, especially in cases where their pulse is weak or hard to find. Who this helps: This helps veterinarians and critically ill pets who need accurate blood pressure measurements.

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This study looked at how well healthcare providers connect and work together to care for patients with inflammatory bowel diseases (IBD). It found that patients treated at centers where providers have strong teamwork and collaborate frequently with others had better health outcomes; specifically, these patients were less likely to experience disease flare-ups or need surgery. This matters because improving how care teams work together could lead to better patient experiences and health results. Who this helps: Patients with inflammatory bowel diseases.

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This study looked at how doctors and nurses communicate in hospitals, especially using one-way tools like pagers and phones. Researchers found that these tools led to issues such as "pager fatigue" and interruptions in patient care, increasing the risk of errors. By understanding these problems, the study emphasizes the need for better communication methods, like two-way technologies, to improve patient safety. Who this helps: This benefits patients and healthcare providers by enhancing communication and reducing errors in care.

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This study looked at how well hospitals in the Netherlands are following recommended practices to prevent infections associated with catheters and ventilators. Out of 72 hospitals surveyed, 65% responded, revealing that while most hospitals (95%) used proper techniques for inserting urinary catheters, practices for preventing urinary tract infections and ventilator-associated pneumonia were not always used as often as they should be. This matters because improving these practices can lead to fewer infections, which keeps patients safer and healthier. Who this helps: Patients in hospitals who are at risk of serious infections.

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This study looked at how changes in nurse staffing guidelines affected rates of infections in VA hospitals from 2008 to 2014. After the new staffing method was put in place, the amount of nursing hours per patient increased, but not significantly. However, there was a notable drop in bloodstream infections, with a decrease of 0.05 infections for every additional hour of nursing care provided per patient per day. This is important because it shows that better nurse staffing can lead to fewer infections, improving patient safety and health outcomes. Who this helps: Patients receiving care in VA hospitals.

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This study explored how patients on hemodialysis define a difficult treatment session—referred to as a "bad run." Researchers found that 25 patients described these challenging experiences as involving severe discomfort like cramping or low blood pressure, which they attributed to factors such as their own fluid intake and the staff's handling of their treatment. Addressing these issues is important because improving patients' experiences during sessions can lead to better health outcomes and enhance their overall well-being. Who this helps: This benefits patients undergoing hemodialysis and their care teams.

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This study looked at a new method called video reflexive ethnography (VRE) to improve communication between doctors and nurses in hospitals. Researchers found that video recording these interactions was not only doable but also well-received by the staff, which could help enhance communication and ultimately improve patient safety. The process led to better reflection from both nurses and doctors, suggesting it could be an effective tool for enhancing teamwork in healthcare settings. Who this helps: This benefits hospital staff, particularly nurses and doctors, and ultimately supports better patient care.

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This study focuses on how to reduce the unnecessary use of antibiotics for patients who have asymptomatic bacteriuria (ASB), a condition where bacteria are present in the urine without causing symptoms. The researchers are testing a new approach across four different Veterans Health Administration facilities, using a simple guideline and feedback system to help doctors choose the right treatment. The aim is to improve care and cut down on antibiotic overuse, which can lead to resistance issues. Who this helps: This benefits patients by ensuring they receive appropriate treatment and avoids unnecessary antibiotics.

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This study looked at how medical trainees diagnose patients in teaching hospitals and what challenges they face. Researchers observed 29 healthcare workers across four teams for 168 hours and found four main issues: diagnosing is a team effort, important data is often scattered, distractions disrupt the process, and time limits make it hard to make good decisions. Improving these aspects, like team discussions and scheduled breaks, could lead to better diagnoses for patients. Who this helps: This helps patients and healthcare providers in teaching hospitals.

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This study looked at how to effectively prevent bloodstream infections caused by catheters in hospitals across Europe. Researchers found that to be successful, hospitals needed to align their own goals with the project's objectives, have enough resources, and support from dedicated staff. For example, having a dedicated study nurse was crucial for success, and influential individuals helped bridge gaps between departments to prioritize the intervention. Who this helps: This benefits hospital staff and patients by improving infection prevention practices and enhancing patient safety.

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This study looked at how a new team approach in doctors' offices can help people with ongoing pain. Researchers found that using this method improved pain management for many patients. This matters because it offers a better way to support those suffering from chronic pain, leading to a higher quality of life. Who this helps: Patients with chronic pain.

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This study looked at how to use computer software to find information about urinary catheters in hospital patients by analyzing doctors' notes. The researchers created a system that can accurately identify if a patient has a catheter or is experiencing related symptoms, achieving a recall rate of 75% to 72% in tests, meaning it correctly identified about three-quarters of cases, and a very high accuracy of almost 99% for correctly predicting catheter presence. This is important because it can help healthcare workers quickly find relevant information, which is especially useful for preventing infections related to catheters. Who this helps: This benefits doctors and infection preventionists.

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This study focused on creating an easier-to-use report for monitoring catheter-associated urinary tract infections (CAUTIs). Researchers found that different healthcare providers had varying needs for the information presented, showing that it’s important to know who will be using the reports before creating them. Making this reporting system more efficient can help improve patient care by ensuring providers get the information they need in a usable format. Who this helps: Healthcare providers and their patients.

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This study looked at whether certified and noncertified specialists who insert peripherally inserted central catheters (PICC) have different practices and views. Of the 1,450 vascular access specialists surveyed, 69% were certified. The study found that certified inserters had more experience, with 78% having practiced for over five years, and reported using certain best practices, like ultrasound for insertion, more often than noncertified inserters. Understanding these differences is important for improving patient care and ensuring safer procedures. Who this helps: This helps patients and healthcare providers by promoting higher standards in vascular access care.

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This study looked at ways to prevent catheter-associated urinary tract infections (CAUTIs) and pressure ulcers in veterans' hospitals. The results showed a significant decrease in CAUTI rates from 2.37 to 1.06 infections per 1,000 catheter days, and pressure ulcer rates dropped from 1.80 to 0.99 in participating units. These findings are important because they demonstrate effective strategies to reduce preventable infections and injuries in hospitalized patients. Who this helps: This benefits patients in veterans' hospitals by reducing the risk of infections and ulcers.

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This study looked at the rate and causes of bloodstream infections related to peripherally inserted central catheters (PICC) in patients at a hospital. Out of 966 PICCs placed in 747 patients, a number of factors were linked to a higher risk of infection: patients in the ICU had over three times the odds of getting an infection, and those with double or triple-lumen PICCs were significantly more likely to develop infections earlier. Addressing these risk factors could help improve patient safety and reduce complications related to PICCs. Who this helps: Patients receiving long-term treatment through PICCs, especially those in critical care.

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This study looked at the risks of deep vein thrombosis (DVT) in patients who had peripherally inserted central catheters (PICCs) placed between June 2009 and June 2012. Out of 966 patients, 33 developed DVT related to the PICC and 9 had DVT in their legs, totaling 42 cases. The research found that patients recently diagnosed with cancer and those with certain types of larger PICCs were more likely to develop DVT, suggesting that better guidelines are needed to prevent these complications in vulnerable patients. Who this helps: This research helps patients with cancer and healthcare providers managing their care.

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This study looked at how often hospitals in the U.S. use urinary catheters and found that many of these catheters are used when they aren’t really needed. For example, some hospitals use them for patients with urinary incontinence when no blockage is present, and sometimes they are used simply because patients or their families ask for them. Reducing unnecessary catheter use can help prevent avoidable complications and infections. Who this helps: Patients who are at risk for catheter-related infections.

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This study looked at the experiences of infection preventionists in Thailand, focusing on their job satisfaction and the challenges they face in implementing infection control measures. While many reported being happy in their roles, they also pointed out key issues such as not having enough doctors to support their efforts and struggling to keep up with the latest guidelines. This matters because improving infection control is crucial for patient safety and overall healthcare quality. Who this helps: This helps healthcare workers and ultimately improves care for patients.

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This study looked at how hospital doctors in Michigan feel about and use peripherally inserted central catheters (PICCs), which are tubes used for delivering medications or fluids to patients. Of the doctors surveyed, 81% thought PICCs were safer than other catheter types, and 74% believed patients preferred them. However, 47% acknowledged that many PICCs inserted might not be necessary, and many doctors had gaps in their knowledge about potential complications, which suggests a need for better training and practices. Who this helps: This benefits patients who rely on PICCs for treatment, ensuring safer and more appropriate use.

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This study surveyed 356 nurses and aides working in long-term care facilities to understand their views on using isolation precautions to prevent the spread of infections. Most of the healthcare workers agreed that isolation helps reduce the risk of spreading infections that are resistant to antibiotics, but they also worried that it might harm residents' mental health by causing feelings of depression and loneliness. This research is important because it highlights the need to balance infection control with the emotional well-being of patients in these facilities. Who this helps: This helps healthcare workers, facility administrators, and long-term care residents.

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This study looked at how a Medicare policy that stopped extra payments to hospitals for costly, preventable infections has affected efforts to prevent such infections. The researchers found that 81% of infection prevention specialists noticed hospitals paying more attention to infections targeted by the policy, while one-third of them spent less time on other types of infections. However, only 15% reported getting more money for infection control, and most saw no change in funding. This focus on specific infections led to faster removal of some catheters but didn’t increase routine testing for infections. Who this helps: This benefits patients by improving hospital practices related to certain infections.

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This study looked at how Thai hospitals prevent three common infections related to healthcare: catheter-associated urinary tract infections (CAUTI), central line-associated bloodstream infections (CLABSI), and ventilator-associated pneumonia (VAP). Out of 256 hospitals surveyed, 80% participated, and while most (93%) used alcohol-based hand sanitizers regularly, many specific prevention practices were used infrequently: only 47% of hospitals used condom catheters for CAUTI, 85% avoided routine changes for CLABSI, and 84% practiced proper positioning for VAP. This is important because improving these practices can help reduce infections that patients might acquire during their hospital stay. Who this helps: Patients in hospitals and healthcare professionals working to prevent infections.

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This study focused on how nurses and doctors communicate in three intensive care units (ICUs) at a Veterans Affairs Medical Center. Researchers found significant differences in how communication and safety culture were perceived across the units, with nurses in the unit that reported the weakest safety culture also feeling less satisfied with their communication with doctors. These findings are important because better communication can improve patient care and safety in critical settings. Who this helps: This benefits patients and healthcare workers in ICUs.

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This study looked at how financial problems affect the ability of people with diabetes and chronic pain to stick to their medication plans. Out of 245 patients surveyed, 9% reduced their medications for both conditions, 13% cut back on diabetes medications only, and another 9% trimmed down on pain medications only. Key findings include that patients earning less than $20,000 a year are five times more likely to skip medications due to cost, and those with more depression are also more inclined to neglect their diabetes treatments. Who this helps: This benefits patients who struggle to afford their medications and may need additional support.

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This study looked at how the Veterans Health Administration (VHA) is improving diabetes care for veterans using their electronic health records. They found that a focused approach, which includes doctors actively involved in the research and systems that track health performance, leads to better outcomes. For example, a quarter of the veterans they serve have diabetes, and the findings show that simply using technology isn't enough without strong leadership and a focus on overall health management. Who this helps: This helps veterans who have diabetes, ensuring they receive better treatment and care.

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This study looked at how trust between patients and their doctors affects whether patients can afford and stick to their prescribed medications. Researchers found that among 912 diabetic patients, those with a low level of trust in their doctors were more likely to skip medications when faced with high costs. For example, patients with low trust were not only more affected by their out-of-pocket costs but also had a higher chance of report medication issues related to cost, especially if they had depression. Who this helps: This benefits patients dealing with chronic illnesses and their healthcare providers.

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This research examined how many people in rural areas are signing up for different types of managed health care plans, like HMOs for commercial insurance, Medicaid, and Medicare. It found that even though most rural counties have access to at least one type of HMO, very few people are actually enrolling—particularly for Medicaid and Medicare plans. This is important because changes in laws and HMO services could lead to more rural residents getting health care coverage in the future. Who this helps: This helps rural patients seeking better access to health care options.

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The study looked at enrollment in MinnesotaCare, a subsidized health insurance program aimed at helping rural residents who are uninsured. It found that as of October 1995, about 91,140 people were enrolled, making up roughly 2.1% of Minnesota's total population. Areas with higher enrollment were generally in central Minnesota, while lower enrollment was seen in southern counties, especially in places with fewer minorities and lower population density. Who this helps: This benefits rural residents in Minnesota who are struggling to afford health insurance.

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This study looked at how imaging technologies, like MRI and CT scanners, and their interpretation services changed in rural hospitals in the northwestern United States between 1991 and 1994. The findings show that while the number of imaging machines generally increased, many rural hospitals still struggled with access to radiology services; by 1994, 11.5% lacked any on-site radiology staff, and only 18% had daily services. This matters because improved access to imaging is crucial for timely diagnosis and treatment, especially in rural areas where medical resources can be limited. Who this helps: This benefits patients in rural areas who need imaging services for their health care.

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This study looked at the availability of obstetric care, like prenatal services, in rural Minnesota. It found that most rural doctors (69%) and all obstetricians and certified nurse midwives are still providing care, despite 67 rural doctors stopping and 55 new ones starting in the past year. While some counties struggle with limited healthcare providers, the overall situation in Minnesota is not as serious as once feared, even though certain areas do have challenges. Who this helps: This information benefits rural patients and healthcare providers as they understand the state of obstetric services in their communities.

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This study looked at how drinking alcohol affects brain responses when people have to decide whether a traffic signal is red or green. Researchers tested 10 participants at three different alcohol levels: none, a little (0.06%), and fairly high (0.13%). They found that at the highest alcohol level, it took longer for the brain to respond to the traffic signals, meaning that drinking can slow down your ability to process important information on the road. Who this helps: This research benefits drivers and public safety officials.