Admission Medication Reconciliation Discrepancies in Trauma Patients: Consistent Nursing Care May Not Be the Answer.

Inadvertent medication reconciliation discrepancies are common among trauma patient populations. We conducted a prospective study at a level 1 trauma center to assess incidence of inadvertent medication reconciliation discrepancies following decreased reliance on short-term nursing staff. Patients and independent sources were interviewed for home medication lists and compared to admission medication reconciliation (AMR) lists. Of the 108 patients included, 37 patients (34%) never received an AMR. Of the 71 patients that had a completed AMR, 42 patients (59%) had one or more errors, with total 154 errors across all patients, for a rate of 3.7 per patient with any discrepancy. Patients taking ≥ 5 medications were significantly more likely to have an incomplete or inaccurate AMR than those taking <5 medications (89% vs 41%, P < .0001). Decreased reliance on short-term nursing staff did not decrease inadvertent admission medication reconciliation discrepancies. Additional interventions to decrease risk of medication administration errors are needed.

Monotherapy Antibiotic Prophylaxis of Lower Extremity Long Bone Type III Open Fractures.

Gustilo type III open fractures involve extensive soft tissue damage and wound contamination that pose significant infection risks. The historical standard for antibiotic prophylaxis has been cefazolin and gentamicin. We conducted a retrospective cohort study of lower extremity type III open fractures treated with ceftriaxone alone for prophylaxis. Eighty-six patients were identified. Nearly all (98%) were managed with appropriate antibiotics, but only 55 (64%) received prophylaxis within 1 hour. Overall, there were 12 infections. This infection rate was not statistically different than the reported literature (14% vs 19%, P = .20). The infection rate between those who received antibiotics within 1 hour was not statistically different from those who got it beyond 1 hour (15% vs 13%, P = .98). In conclusion, the use of ceftriaxone as monotherapy for antibiotic prophylaxis in lower extremity type III open fractures is not statistically different than the use of historic prophylactic regimens.

Early Pandemic Improvements in Diet Quality Are Associated with Increased Physical Activity and Weight Loss in US Adults.

In March 2020, the COVID-19 pandemic led to restricted vocational (Voc-PA) and recreational physical activity (Rec-PA) outside of the home. We conducted a nation-wide survey in the United States (US) during the mitigation peak of the pandemic (June 2020) to assess health-related changes from the previous year. A diet quality (DQ) assessment tool weighted the relative healthfulness of eating occasions from foods prepared-at-home (Home) and away-from-home (Away). Previously-validated instruments assessed PA and demographic variables; height/weight were self-reported to calculate body mass index (BMI). T-tests explored longitudinal, between-sex, and obesity status differences in DQ, PA, and BMI; Pearson correlations explored associations. Of 1648 respondents, 814 valid responses (56.8% female, 81.7% white) were analyzed. Overall and Home DQ was higher for females than males in 2020 (p < 0.001 for both). Respondents increased DQ from 2019 to 2020, primarily from Away (p < 0.001 for both sexes). Total Rec-PA and Voc-PA was higher in males (p = 0.002, p < 0.001) than females in 2020; females reported higher other PA (p = 0.001). Change in BMI was inversely associated with change in both DQ and PA (p < 0.001 for both). In this sample of US adults, early adaptations to the COVID-19 pandemic included improved DQ and BMI. Whether these short-term improvements were maintained warrant further investigation.