Implementation of an Evidence-Based Practice Discharge Medication Protocol for Heart Failure Patients to Reduce 30-Day Readmissions

Practice Problem: An estimated 6.5 million American adults ≥20 years of age have heart failure (HF) and worldwide 1 to 2% of the total healthcare budget is spent on HF. To improve outcomes and streamline the treatment of HF patients, The American Heart Association (AHA) joined with the American College of Cardiology (ACC) and created the Get With The Guidelines Program (GWTG). PICOT: The PICOT question that guided this project was in adult HF patients admitted to the cardiovascular unit under the care of the hospitalist service, does implementing an evidence-based practice (EBP) discharge medication protocol for physician use based on the AHA GWTG program’s HF discharge medication protocol, compared to no standardized discharge protocol, improve patients’ 30-day readmission rate, in 12 weeks? Evidence: Evidence from 10 studies supported implementing an evidence-based GDMT tool into a standardized HF discharge medication protocol for this project. Intervention: Education and encouragement of use of the AHA GWTG discharge medication protocol for HF in the electronic health record (EHR) was provided to a group of physicians on a cardiovascular unit. The intervention was over a four-week period and pre- and post-intervention protocol use was observed with specific measures analyzed for observation of improvement. Outcome: The results determined there was minimal statistical significance, however, there was a decrease in the financial measure of the cost of HF readmissions denoting a clinical significance. Conclusion: Continued use of a guideline-based discharge medication protocol, such as the one utilized in this project, is recommended based on the results and evidence provided in this project

The Impact of Virtual Immersion in the E-Learning Environment

Students in post-graduate programs can enhance their learning efficacy and positively impact their interprofessional collaboration skills by participating in a virtual immersion experience within their e-learning course. Students from various healthcare disciplines who participated in a virtual immersion were charged with the task to create a strategic plan for a healthcare organization. Upon completion of the course, they believed the interprofessional collaborative discussions and group dynamics utilized during the virtual immersion enabled them to communicate more effectively in their workplace, thus, improving patient outcomes. The focus of this presentation is to share the impact a virtual immersion has on the student experience and patient outcomes

A genomic catalog of Earth’s microbiomes

The reconstruction of bacterial and archaeal genomes from shotgun metagenomes has enabled insights into the ecology and evolution of environmental and host-associated microbiomes. Here we applied this approach to >10,000 metagenomes collected from diverse habitats covering all of Earth’s continents and oceans, including metagenomes from human and animal hosts, engineered environments, and natural and agricultural soils, to capture extant microbial, metabolic and functional potential. This comprehensive catalog includes 52,515 metagenome-assembled genomes representing 12,556 novel candidate species-level operational taxonomic units spanning 135 phyla. The catalog expands the known phylogenetic diversity of bacteria and archaea by 44% and is broadly available for streamlined comparative analyses, interactive exploration, metabolic modeling and bulk download. We demonstrate the utility of this collection for understanding secondary-metabolite biosynthetic potential and for resolving thousands of new host linkages to uncultivated viruses. This resource underscores the value of genome-centric approaches for revealing genomic properties of uncultivated microorganisms that affect ecosystem processes.</p