Evaluation of Empiric Coverage of Previously Cultured Multidrug Resistant Organisms in Critically Ill Patients Admitted for Sepsis.

Purpose: Multidrug-resistant organisms (MDROs) are associated with an increased length of stay and a higher risk of mortality in hospitalized patients. A lack of literature exists that evaluates the need to empirically cover patients for historic MDROs upon readmission. Methods: A retrospective, single-center, cohort study was conducted to evaluate the impact of empiric MDRO antibiotic coverage in patients with a history of MDROs. Differences in length of stay were assessed between two groups of patients: those empirically treated for their historic MDRO and those not. Secondary outcomes included in-hospital mortality, ICU length of stay, need for antibiotic escalation, need for antibiotic de-escalation, and antibiotic duration. Results: Seventy-two patients with historic MDRO(s) were readmitted to the hospital and met inclusion criteria for this study. Hospital length of stay was similar between those empirically covered and those not (11 days vs 15.1 days; P = 0.149). When analyzed in a population only including Gram-negative MDROs, hospital length of stay was shorter in those who received empiric coverage (10.7 days vs 17.2 days; P = 0.032). Conclusion: In the total study population, empiric coverage of historic MDROs failed to significantly reduce hospital length of stay. When analyzed in a population of only Gram-negative MDROs, empiric coverage of historic organisms reduced hospital length of stay by 6.5 days. This suggests that in patients readmitted to the ICU for sepsis, empiric coverage of historic Gram-negative MDROs may be beneficial.

Social Media in Nurse Anesthesia: A Model of a Reproducible Educational Podcast.

Social media and specifically podcasting are available to the field of nurse anesthesia as potential educational tools. This article outlines key concepts in social media, including free open access medical education and literature supporting the use of podcasting in higher, medical, and nursing education. The authors provide an educational model useful for developing social media tools and a logic model for producing an educational podcast. These tools were used in the production of the authors' educational anesthesia podcast, and key steps are outlined. The goal of this article is to provide an overview of social media and relevant resources so that other educational podcasts may be developed for the nurse anesthesia community.