Sexual Abuse Assessment on Admission by Nursing Staff in General Hospital Psychiatric Settings.

OBJECTIVE: Clinicians should have information about patients\u27 sexual abuse history as early as possible, because a history of sexual abuse may affect psychiatric patients\u27 presentation of symptoms and response to treatment. The authors surveyed a nationwide sample of acute inpatient psychiatric facilities to determine whether a history of sexual abuse was completed on admission. METHODS: A survey questionnaire about current practices relating to assessment of patients\u27 history of sexual abuse was sent to nurse managers at every general hospital in the U.S. that offered inpatient psychiatric services (N = 1,410). RESULTS: Although respondents at 69 percent of the 466 facilities that participated in the survey believed that the admission assessment of psychiatric patients should always include a history of sexual abuse, only 43 percent of responding facilities included such histories in the admission assessment. Reasons for not including the history included patients\u27 and staff members\u27 unwillingness to discuss sexual abuse, lack of staff competence in discussing the issue, and duplication of data collection that occurs later in the patient\u27s hospital stay. CONCLUSIONS: Nurse managers of inpatient psychiatric services in general hospitals recognize the importance of including an assessment of patients\u27 history of sexual abuse in the admission assessment but report several obstacles to implementing this procedure

Embolization for the treatment of large, complex fibroids in an outpatient setting: A report of 2 cases

Uterine leiomyomas are the most common benign pelvic tumors in premenopausal women, causing significant morbidity. Uterine fibroid embolization is a minimally invasive alternative to traditional open or laparoscopic surgeries for the management of symptomatic uterine leiomyoma. For large fibroids, hospitalization after treatment is often required. However, there are limited data on patients with large, complex uterine leiomyomas treated by embolization. This report of 2 cases describes 2 females with large, complex fibroids causing pain and decreased quality of life who were evaluated and treated with embolization in the outpatient setting. Each patient underwent transradial cannulation and uterine artery embolization under local anesthesia or conscious sedation and returned home without complication. For women wishing to preserve their uterus, uterine fibroid embolization is an effective nonsurgical alternative to hysterectomy and myomectomy in an outpatient setting. If standard protocols are followed, embolization by way of transradial artery catheterization is safe for the treatment of large, complex, symptomatic fibroids in the outpatient setting; however, additional studies with larger cohorts are warranted. Accessing the uterine arteries transradially reduces the risk of intra- and post-operative complications for patients, reduces their time spent in a hospital, and minimizes operating costs

Artificial Differences in Clostridium difficile Infection Rates Associated with Disparity in Testing.

In 2015, Clostridium difficile testing rates among 30 US community, multispecialty, and cancer hospitals were 14.0, 16.3, and 33.9/1,000 patient-days, respectively. Pooled hospital onset rates were 0.56, 0.84, and 1.57/1,000 patient-days, respectively. Higher testing rates may artificially inflate reported rates of C. difficile infection. C. difficile surveillance should consider testing frequency