Download or read book Future Research Needs for Prevention and Treatment of Clostridium Difficile Infection written by Hussein Z. Noorani and published by . This book was released on 2012 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Clostridium difficile infection (CDI) is a serious healthcare-associated infection and a growing health care problem, especially with the emergence of more virulent strains in the early 2000s. CDI is now the most common cause of nosocomial infectious diarrhea and is increasing in incidence and, in all likelihood, severity. A comparative effectiveness review (CER) was prepared by the Minnesota Evidence-based Practice Center (EPC) on Comparative Effectiveness of Early Diagnosis, Prevention, and Treatment of Clostridium difficile Infection (December 2011). The purpose of the CER was to provide an overarching assessment of the evidence for comparing the accuracy of diagnostic tests and the effectiveness of prevention and treatment interventions on initial and recurrent CDI-related patient outcomes in adults. Limited high-quality evidence was available to support the diagnostic, preventive, and treatment practices for CDI carried out by providers in hospital, long-term care, and outpatient settings. Inconsistency in definitions of diarrhea, severity, resolution of symptoms, recurrence, or cure contributed to the difficulty in drawing conclusions from the evidence. There were a number of important evidence gaps identified in the CER. The objective of this Future Research Needs project was to systematically prioritize evidence gaps on prevention and treatment of CDI, and to develop a list of research questions to address the prioritized gaps. Although different diagnostic methods for toxigenic Clostridium difficile were evaluated in the CER, diagnostic methods were not included in this project primarily because polymerase chain reaction testing is rapidly becoming the standard diagnostic test for the infection.

Download or read book Future Research Needs for Prevention and Treatment of Clostridium Difficile Infection written by U. S. Department of Health and Human Services and published by CreateSpace. This book was released on 2013-04-04 with total page 66 pages. Available in PDF, EPUB and Kindle. Book excerpt: Clostridium difficile infection (CDI) is a serious healthcare-associated infection and a growing health care problem, especially with the emergence of more virulent strains in the early 2000s. Clostridium difficile was first recognized as having the ability to cause pseudomembranous colitis in the late 1970s. CDI is now the most common cause of nosocomial infectious diarrhea. Asymptomatic colonization in healthy adults has been observed in only 3 percent of persons, while the prevalence of such colonization among residents in long-term-care facilities approaches 50 percent. Individuals colonized with Clostridium difficile serve as a reservoir for infection by contaminating the environment with Clostridium difficile spores, thus leading to the spread of the organism on the hands of health care workers or via use of medical equipment. CDI is increasing in incidence and, in all likelihood, severity. The number of cases diagnosed among patients discharged from hospitals increased from 31 per 100,000 persons in 1996 to 84 per 100,000 persons in 2005. Infection due to a relatively new strain of Clostridium difficile, termed “North American pulsed-field gel electrophoresis type 1” (NAP1), is felt to be at least partially responsible for this increased incidence of CDI as well as for the increased severity of clinical illness. The NAP1 strain is capable of producing more than 15 times the quantity of both toxins A and B, which are directly responsible for the damage to the intestinal tract of infected patients. Hence, CDI is not only now more common, but also more severe, leading to an attributable mortality of up to 16 percent of all deaths. A comparative effectiveness review (CER) was prepared by the Minnesota Evidence-based Practice Center (EPC) on Comparative Effectiveness of Early Diagnosis, Prevention, and Treatment of Clostridium difficile Infection (December 2011). The purpose of the CER was to provide an overarching assessment of the evidence for comparing the accuracy of diagnostic tests and the effectiveness of prevention and treatment interventions on initial and recurrent CDI related patient outcomes in adults. Key informants, provided input to the EPC on the scope of the CER, agreed that its greatest contribution to the field could be to have an independent organization provide a comprehensive review of the major concerns of the field for both clinicians and researchers. The major impetus underlying the SR was a concern about the presence of clinical disease, not asymptomatic carriage of the Clostridium difficile organism.1 Molecular epidemiological studies whose main purpose was to identify the strains of Clostridium difficile present in the population were outside the scope of the CER. The CER focused on adult patients as they, particularly elderly adults, carry the most of the morbidity and mortality burden.The CER addressed the following Key Questions (KQs): 1. How do different methods for detection of toxigenic Clostridium difficile to assist with diagnosis of CDI compare in their sensitivity and specificity? a. Do the differences in performance measures vary with sample characteristics? 2. What are effective prevention strategies? a. What is the effectiveness of current prevention strategies? b. What are the harms associated with prevention strategies? c. How sustainable are prevention practices in health care (outpatient, hospital inpatient, extended care) and community settings? 3. What are the comparative effectiveness and harms of different antibiotic treatments? a. Does effectiveness vary by disease severity or strain? b. Does effectiveness vary by patient characteristics: age, gender, comorbidity, hospital versus community-acquired setting? c. How do prevention and treatment of CDI affect resistance of other pathogens? 4. What are the effectiveness and harms of nonstandard adjunctive interventions? a. In patients with relapse/recurrent CDI?

Download or read book Effectiveness of Early Diagnosis Prevention and Treatment of Clostridium Difficile Infection written by and published by . This book was released on 2011 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: OBJECTIVES: To conduct a systematic review and synthesize evidence for differences in the accuracy of diagnostic tests, and the effects of interventions to prevent and treat Clostridium difficile infection (CDI) in adult patients. DATA SOURCES: Searching for relevant literature was conducted in MEDLINE, the Cochrane Library, and Allied and Complementary Medicine (AMED). ClinicalTrials.gov and expert consultants provided leads to additional studies. We also manually searched reference lists from relevant literature. REVIEW METHODS: Standard Evidence-based Practice Center methods were employed. Screening of abstracts and full text articles to identify studies meeting inclusion/exclusion criteria was performed by two independent reviewers. High-quality direct comparison studies were used to examine differences in diagnostic tests. Randomized controlled trials (RCTs) were used to examine comparative effectiveness of antibiotic treatment for CDI. Quality of data extraction was checked by separate reviewers. Quality ratings and strength of evidence grading was performed on included studies. Evidence on diagnostic tests was quantitatively synthesized focusing on differences between test sensitivities and specificities. Evidence on antibiotic treatment was quantitatively examined using pooled analysis. Qualitative narrative analysis was used to synthesize evidence from all available study types for environmental prevention and nonstandard prevention and treatment, with the exception of probiotics as primary prevention, for which a forest plot is provided. RESULTS: Overall, literature was sparse and strength of evidence was generally low due to small sample sizes or lack of adequate controls. For diagnostic testing, direct comparisons of commercially available enzyme immunoassays for C. difficile toxins A and B did not find major differences in sensitivity or specificity. Limited evidence suggests that tests for genes related to the production of C. difficile toxins may be more sensitive than immunoassays for toxins A and B while the comparisons of these test specificities were inconsistent. Moderate evidence in favor of antibiotic restriction policies for prevention was found. Environmental preventive interventions such as glove use and disposable thermometers have limited evidence. However, this literature is largely based on controlling outbreaks. Use of multiple component interventions further limits the ability to synthesize evidence in a meaningful way. Numerous potential new forms of treatment are being examined in placebo controlled RCTs, case series, and case reports. For standard treatment, no antimicrobial is clearly superior for the initial cure of CDI. Recurrence is less frequent with fidaxomicin than with vancomycin. Monoclonal antibodies for prevention and fecal flora reconstitution for multiple recurrences appear promising. CONCLUSIONS: Given the frequency and severity of CDI and the fact that future reimbursement policy may withhold payment for hospital-acquired infections, this is an under-researched topic. More precise estimates of the magnitude of differences in test sensitivities and specificities are needed. More importantly, studies have not established that any of the possible differences in test accuracy would lead to substantially different patient outcomes in clinical practice. More research on effective treatment and unintended consequences of treatment, such as resistance, is needed. Gut flora may be important, but improved understanding of healthy gut ecology and the complex interactions is necessary before continuing to pursue probiotics.

Download or read book Guideline for Isolation Precautions in Hospitals written by Julia S. Garner and published by . This book was released on 1983 with total page 80 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Effectiveness of Early Diagnosis Prevention and Treatment of Clostridium Difficile Infection written by U. S. Department of Health and Human Services and published by CreateSpace. This book was released on 2013-04-06 with total page 266 pages. Available in PDF, EPUB and Kindle. Book excerpt: Clostridium difficile infection (CDI) is a serious healthcare-associated infection and a growing health care problem. C. difficile is a Gram-positive, spore-forming, anaerobic bacterium that, when ingested, can cause CDI if it is a toxigenic strain. CDI symptoms include varying levels of diarrhea severity, as well as pseudomembranous colitis and toxic megacolon. CDI incidence is estimated at 6.5 cases per 10,000 patient days in hospital. About 250,000 hospitalizations were associated with CDI in 2005. Direct attributable mortality from CDI has been reported to be as high as 6.9 % of cases. Elderly people in hospitals account for the vast majority of severe morbidity and mortality. Residents of long-term care facilities are also at higher risk. Incidence rates may increase by fourfold or fivefold during outbreaks. In addition to institutional care environments, C. difficile is also common in the community, being easily isolated from soil and water samples. Community-associated CDI rates are generally much lower, accounting for 27 % of all CDI cases in a recent prevalence study, but are also on the rise. However, the source of the C. difficile organisms responsible for cases of CDI in the community is not well understood. In order for CDI to develop, a person must be infected with a strain of C. difficile capable of making toxin in the person's colon. Approximately 1–2 % of healthy individuals are colonized with C. difficile. If these people have usual, healthy colonic flora, the risk of CDI is very low. There is a small risk of CDI if the colon flora becomes disturbed, commonly through antibiotic use, while the person is colonized with a toxigenic strain. Antibiotics that disturb colon flora enough to allow CDI to develop must get into the colon, and they are associated with alterations in relative amounts of colon bacterial constituents. The immune status of the patient also contributes to the risk of developing CDI and the experienced severity. Other risk factors include increasing age, female gender, comorbidities, gastrointestinal procedures, and use of gastric acid suppression medications. Risk profiles for recurrent CDI are similar. One study, which statistically modeled CDI within the hospital setting, suggested that reducing patient susceptibility to infection is more effective in reducing CDI cases than lowering transmission rates. The purpose of this systematic review was to provide an overarching assessment of the evidence for comparing the accuracy of diagnostic tests and the effectiveness of prevention and treatment interventions on initial and recurrent CDI-related patient outcomes in adult patients. The major impetus of this review is the presence of clinical disease, not asymptomatic carriage of the C. difficile organism. The review focuses on adult patients because adults, and particularly elderly adults, carry the large majority of the morbidity and mortality burden. The following Key Questions (KQs) form the basis for this review: KQ 1. How do different methods for detection of toxigenic C. difficile to assist with diagnosis of CDI compare in their sensitivity and specificity? Do the differences in performance measures vary with sample characteristics? KQ 2. What are effective prevention strategies? What is the effectiveness of current prevention strategies? What are the harms associated with prevention strategies? How sustainable are prevention practices in health care (outpatient, hospital inpatient, extended care) and community settings? KQ 3. What are the comparative effectiveness and harms of different antibiotic treatments? Does effectiveness vary by disease severity or strain? Does effectiveness vary by patient characteristics: age, gender, comorbidity, hospital- versus community-acquired setting? How do prevention and treatment of CDI affect resistance of other pathogens? KQ 4. What are the effectiveness and harms of nonstandard adjunctive interventions? In patients with relapse/recurrent CDI?

Download or read book Probiotics and Child Gastrointestinal Health written by Stefano Guandalini and published by Springer. This book was released on 2019-06-17 with total page 150 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book shows the huge impact the gut microbiota has on the gastrointestinal health of humans with a particular focus on children. It also highlights the potential use of probiotic microorganisms to protect or improve children’s gastrointestinal health. Humans are not single organisms: We are a multi-organism structure composed of ourselves and our microbiota, living in close symbiosis since birth and even before. The huge impact that the billons of microscopic cells living in our gut have on our gastrointestinal and systemic health cannot be overestimated. The enormous progress that has been made in the past decade in our still very incomplete understanding of the gut microbiota is opening the door to potential applications in human health that were simply unthinkable before. One of the most interesting aspects of this new scientific horizon is the fact that we may identify (or even create in the laboratory) and utilize many of these “friendly bacteria” to protect, or improve our health. Thus, strains of probiotic microorganisms are being identified and studied in a vast array of clinical scenarios. Among the most investigated areas for probiotics is the gastrointestinal health of children. The topics addressed in this book are spanning from the development of the gut microbiota in the fetus and newborn all the way to current and potential applications in disparate conditions such as necrotizing enterocolitis, or infectious, or inflammatory conditions affecting the child. The book is written in a rigorous, evidence based manner by an international group of outstanding experts in these fields and is aimed at pediatric gastroenterologists, pediatricians and physician scientists alike.

Download or read book Early Diagnosis Prevention and Treatment of Clostridium Difficile written by Mary Butler and published by . This book was released on 2016 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: OBJECTIVE: Update a 2011 review of differences in accuracy of diagnostic tests and the effects of interventions to prevent and treat Clostridium difficile infection (CDI) in adults. DATA SOURCES: Medline(r), the Cochrane Clinical Trials Registry, and Embase(r) from 2010 through April 2015 plus reference lists of included studies and recent systematic reviews. METHODS: Two investigators screened abstracts and full texts of identified references for eligibility. Eligible studies included studies of sensitivity and specificity for diagnostic tests in patients at risk for CDI. We included randomized controlled trials or high-quality cohort studies enrolling adult patients with CDI or suspected CDI for treatment interventions. Prevention studies also included adult patients at risk for CDI and observational study designs. Two investigators extracted data, assessed individual study risk of bias, and evaluated the strength of evidence for each comparison and outcome. Pooled estimates were analyzed to assess the efficacy and comparative effectiveness of a variety of treatments. RESULTS: We identified 37 diagnostic studies and 56 studies evaluating prevention or treatment interventions to update the review. High-strength evidence showed that nucleic amplification tests were sensitive and specific for CDI when using culture as the reference standard. Low-strength evidence was found that some institutional prevention interventions, such as antibiotic prescribing practices and transmission interruption (terminal room cleaning with hydrogen peroxide vapor and handwashing campaigns), reduce CDI incidence. Low-strength evidence also suggested that prevention programs can be sustained over several years. For CDI treatment, vancomycin is more effective than metronidazole (high-strength evidence), and the effect does not vary by severity (moderate-strength evidence). Fidaxomicin remains noninferior to vancomycin for the initial cure of CDI (moderate-strength evidence) but is superior to vancomycin for prevention of recurrent CDI (now high-strength evidence). Although both fecal microbiota transplantation (FMT) and probiotics were the subject of a significant number of new studies, the overall high risk of bias of many of these studies necessitated ratings of low strength of evidence. Specifically, low-strength evidence suggests that FMT may have a significant effect on reducing recurrent CDI. Similarly, low-strength evidence suggests that lactobaccilus strains and multiorganism probiotics also can reduce recurrent CDI. However, Saccharomyces boulardii was no more effective than placebo in preventing recurrent CDI. Evidence for FMT for refractory CDI was insufficient. Few studies reported adverse events; when reported, few events were noted. CONCLUSIONS: Research on diagnostic testing for and interventions to treat CDI expanded considerably in 4 years. Nucleic acid amplification tests have high sensitivity and specificity for CDI. Vancomycin is more effective than metronidazole for initial CDI, while fidaxomicin is more effective than vancomycin for the prevention of recurrent CDI. FMT and lactobacillus probiotics to restore colonic biodiversity and improve patient resistance to CDI or recurrence have low-strength but relatively consistent positive evidence for efficacy.

Download or read book Clostridium Difficile Infection in Long Term Care Facilities written by Teena Chopra and published by Springer Nature. This book was released on 2019-11-14 with total page 80 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book aims to fill knowledge gap among healthcare workers about Clostridium difficile (also known as C.difficile and CDI) among aging patients, especially those in long-term care facilities (LTCFs). Written by experts in infectious diseases and geriatric medicine, this book provides comprehensive information on all aspects of CDI pertaining to LTCF settings, including epidemiology, diagnosis, prevention, management and the unique challenges faced by LTCFs with regards to the CDI problem. The book begins by introducing the topic as it relates to aging patients before delving into the various aspects of CDI management. Topics include infection control and prevention, treatment of CDI, and the establishment of antibiotic stewardship programs to reduce inappropriate antibiotic use and reduce CDI rates. The book also features a chapter on probiotics for the prevention of CDI and new strategies to monitor environmental cleaning practices of CDI patient rooms that do not appear in any other resource. Clostridium Difficile Infection in Long-Term Care Facilities is an excellent resource for geriatricians, infectious diseases specialists, long-term care administrators, nurses, pharmacists, researchers, and all clinicians working with infections in long-term care settings.

Download or read book Orphans and Incentives written by Institute of Medicine and published by National Academies Press. This book was released on 1997-10-30 with total page 112 pages. Available in PDF, EPUB and Kindle. Book excerpt: Infectious diseases remain a leading cause of prolonged illness, premature mortality, and soaring health costs. In the United States in 1995, infectious diseases were the third leading cause of death, right behind heart disease and cancer. Mortality is mounting over time, owing to HIV/AIDS, pneumonia, and septicemia, with drug resistance playing an ever-increasing role in each of these disease categories. This book, a report from a Forum on Emerging Infections workshop, focuses on product areas where returns from the market might be perceived as being too small or too complicated by other factors to compete in industrial portfolios with other demands for investment. Vaccines are quintessential examples of such products. The lessons learned fall into four areas, including what makes intersectoral collaboration a reality, the notion of a product life cycle, the implications of divergent sectoral mandates and concepts of risk, and the roles of advocacy and public education. The summary contains an examination of the Children's Vaccine Initiative and other models, an industry perspective on the emerging infections agenda, and legal and regulatory issues.

Download or read book Emerging Transplant Infections written by Michele I. Morris and published by Springer. This book was released on 2021-06-22 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The field of transplant medicine has evolved significantly since the first kidney transplant was performed in 1954. Innovations in transplant immunosuppression have lowered the risk of organ rejection so that infectious complications are now the leading cause of hospitalization and mortality after solid organ transplant. Infection is also cited as the leading cause of non-relapse mortality after stem cell transplantation. As transplant centers have recognized the importance of transplant specific expertise in patient outcomes, the field of transplant infectious diseases has expanded into a recognized and highly valued subspecialty. International growth in solid organ and stem cell transplantation has outpaced access to such expertise, with some centers employing microbiology laboratory directors and transplant nephrologists as their lead infectious diseases consultants. This has been a particular challenge as the use of novel immunosuppressive regimens in new geographic and immigrant populations have fueled the emergence of new infection syndromes, with the initial presentation sometimes occurring in this most vulnerable patient population. This digital-first book is designed to meet the needs of practitioners engaged in transplant infectious disease practice who need more depth than they are able to find in UpToDate. It provides an overview of emerging infectious disease challenges with clinically relevant information regarding the epidemiology, diagnosis, management, and prevention of infections in solid organ and stem cell transplant recipients. Each chapter focuses on a clinical syndrome or pathogen with new or emerging implications for transplant patients. Given the rapidly evolving nature of emerging infections and topics in transplant infections, no resource has been published on these increasingly notorious issues; this this text is written by top, global experts who regularly update the material to ensure that readers will always have access to the most cutting edge material available. The editorial team consists of three experienced leaders in the field, all of whom have a strong record of scholarship and publication, as well as an international reputation. All three have focused their academic careers on emerging infectious diseases in transplantation, including a current and a past president of various infectious diseases and transplantation societies. The editors are also experienced reviewers and authors who have collaborated on multiple previous projects. All are committed to this project as a unique opportunity to make an important contribution to their field.

Download or read book The Most Common Inpatient Problems in Internal Medicine E Book written by John C. Sun and published by Elsevier Health Sciences. This book was released on 2007-04-04 with total page 432 pages. Available in PDF, EPUB and Kindle. Book excerpt: Here's an extremely handy pocket reference to assist the student, resident, house officer, and busy hospitalist address issues related to the 20 most common disorders seen in the inpatient setting. This brief, small-sized handbook offers you evidence-based information presented in an easy to reference, consistently presented outline and table format. Problem based for quick solutions in diagnosis and therapy in the limited timeframe typical of seeing patients on the wards. Provides a brief presentation of 20 most common inpatient disorders. Provides reliabile diagnosis and treatment options with evidence based recommodations. Handy, pocket book that takes up minimal pocket real estate.

Download or read book Pouchitis and Ileal Pouch Disorders written by Bo Shen and published by Academic Press. This book was released on 2018-11-05 with total page 570 pages. Available in PDF, EPUB and Kindle. Book excerpt: Pouchitis and Ileal Pouch Disorders: A Multidisciplinary Approach for Diagnosis and Management provides much needed information on the evolution of pouch surgery, pouch surgery techniques, and surgery-associated complications, including inflammatory, functional, neoplastic, and metabolic complications. The book provides information on the anatomy of the pouch, pathogenesis of pouchitis and other pouch disorders, proper diagnostic modalities, and medical, endoscopic and surgical options for those disorders. The information has been compiled from a panel of national and international leading experts in the field, including basic scientists, gastrointestinal (GI) pathologists, GI radiologists, gastroenterologists, and more. Features never-before-published information and technology from the vast experience of the contributors and editors in diagnosis and medical, endoscopic, and surgical management of pouchitis and other pouch disorders Contains easy to access recommendations from experts Provides access to an accompanying website with videos of endoscopic demonstrations of various configurations of the pouch, endoscopic evaluation of pouch disorders, and endoscopic treatment of pouch strictures, fistula, and anastomotic leaks/sinuses

Download or read book Caring for People who Sniff Petrol Or Other Volatile Substances written by National Health and Medical Research Council (Australia) and published by . This book was released on 2011 with total page 33 pages. Available in PDF, EPUB and Kindle. Book excerpt: These guidelines provide recommendations that outline the critical aspects of infection prevention and control. The recommendations were developed using the best available evidence and consensus methods by the Infection Control Steering Committee. They have been prioritised as key areas to prevent and control infection in a healthcare facility. It is recognised that the level of risk may differ according to the different types of facility and therefore some recommendations should be justified by risk assessment. When implementing these recommendations all healthcare facilities need to consider the risk of transmission of infection and implement according to their specific setting and circumstances.

Download or read book Microbiome and Metabolome in Diagnosis Therapy and other Strategic Applications written by Joel Faintuch and published by Academic Press. This book was released on 2019-01-03 with total page 506 pages. Available in PDF, EPUB and Kindle. Book excerpt: Microbiome and Metabolome in Diagnosis, Therapy, and Other Strategic Applications is the first book to simultaneously cover the microbiome and the metabolome in relevant clinical conditions. In a pioneering fashion, it addresses not only the classic intestinal environment, but also the oral, gastric, lung, skin and vaginal microbiome that is in line with the latest investigations. Nonbacterial microbiomes, such as fungi and viruses are not overlooked, and the plasma microbiome is also discussed. As plasma, brain, placenta, tumor cells, and other sterile fluids and tissues, are increasingly recognized to potentially host a microbiome, albeit a limited one, this is a timely resource. The book's editors were fortunate to have the input of renowned collaborators from nearly all continents. This is truly an international effort that brings the latest in the field to students and professionals alike. Provides comprehensive coverage on diagnosis, therapy, pharmacotherapy and disease prevention in context of the microbiome and metabolome Focuses on the proposed physiological or pathological conditions Presents an up-to-date, useful reference

Download or read book Manual of Childhood Infections written by Mike Sharland and published by Oxford University Press, USA. This book was released on 2011-04-07 with total page 913 pages. Available in PDF, EPUB and Kindle. Book excerpt: This manual gives information on the causative organisms, epidemiology and clinical features of all important childhood infections. It includes guidance on the clinical management of the infections and on steps to be taken to prevent future cases.

Download or read book Infectious Diseases in the Intensive Care Unit written by Manish Soneja and published by Springer. This book was released on 2021-08-02 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Infections in intensive care is a very broad topic, and this book provides concise yet comprehensive coverage. It focuses on the appropriate and judicious use of microbiological, radiological and point-of-care tests in diagnostic work-ups and evidence-based management protocols. Moreover, it offers essential information on the diagnosis and management of commonly encountered infections in the intensive care unit, making it a handy ready-reference manual for intensivists.

Download or read book Patient Safety and Quality written by Ronda Hughes and published by Department of Health and Human Services. This book was released on 2008 with total page 592 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/