#jhmchat Transcript
Healthcare social media transcript of the #jhmchat hashtag.
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See #jhmchat Influencers/Analytics.
| Profile | Tweet |
|---|---|
 | Society of Hospital Medicine @SocietyHospMed #JHMChat begins NOW! Join the conversation w/ @JHospMedicine @FutureDocs @tony_breu, then claim #CME: https://t.co/fHval4itfN https://t.co/hySjWeZLO1 |
 | Vinny Arora MD MAPP @FutureDocs RT @SHMLive: #JHMChat begins NOW! Join the conversation w/ @JHospMedicine @FutureDocs @tony_breu, then claim #CME: https://t.co/fHval4itfN… |
 | Journal of Hospital Medicine @JHospMedicine Welcome @tony_breu who is also our @jhospmedicine series editor for @TWDFNR who will be tonight's discussant #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Welcome to #JHMChat, I am your moderator @FutureDocs please introduce yourself. |
 | Things We Do For No Reason @TWDFNR Tony Breu, here from Boston MA. Spend all day with my sick 1-year-old. Docusate was unnecessary! No gown, but lots of hand-washing... I'll be participating tonight from the @TWDFNR account. #JHMchat |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: Welcome to #JHMChat, I am your moderator @FutureDocs please introduce yourself. |
 | Med Peds Hospitalist @medpedshosp @SHMLive @JHospMedicine @FutureDocs @tony_breu Here Moises Auron, Cleveland Clinic. Glad to join and learn from others. |
| Things We Do For No Reason @TWDFNR @JHospMedicine @tony_breu Alongside the amazing @DocLennyF #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @TWDFNR: Tony Breu, here from Boston MA. Spend all day with my sick 1-year-old. Docusate was unnecessary! No gown, but lots of hand-wa… |
| @freckledpedidoc Hi Everyone! Anika Kumar, joining from Cleveland. #JHMChat | |
 | GI Pearls @GI_Pearls RT @JHospMedicine: #JHMChat is TONIGHT at 9pET on @TWDFNR with @tony_breu, moderated by @FutureDocs with live sketches by @gracefarris— Con… |
 | Charlie M. Wray, DO, MS @WrayCharles RT @JHospMedicine: Welcome @tony_breu who is also our @jhospmedicine series editor for @TWDFNR who will be tonight's discussant #JHMChat |
 | Jennifer Caputo-Seidler, MD @jennifermcaputo Jen Caputo, joining from Tampa, FL #JHMChat |
| Journal of Hospital Medicine @JHospMedicine @TWDFNR Welcome! Glad you made it @tony_breu and some lessons even when tending to a sick kid. Hope they are on the mend. #jhmchat |
 | Sonya Tang Girdwood 鄧 智佳, MD, PhD @STangGirdwood @JHospMedicine @FutureDocs Sonya, #PedsHM fellow from Cincy! #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @TWDFNR: @JHospMedicine @tony_breu Alongside the amazing @DocLennyF #JHMChat |
| Charlie M. Wray, DO, MS @WrayCharles Charlie Wray, broadcasting from the SF Bay area. Really looking forward to tonights #JHMChat |
| Med Peds Hospitalist @medpedshosp @TWDFNR @JHospMedicine @tony_breu @DocLennyF Dynamic duo!#JHMChat |
| Journal of Hospital Medicine @JHospMedicine @STangGirdwood @FutureDocs Welcome to #JHMChat #PedsHM |
| Things We Do For No Reason @TWDFNR @JHospMedicine @tony_breu Absolutely. 5-hour naps help! #JHMChat |
 | Brian McGillen, MD @BMcGillenMD Brian McGillen joining from Hershey, PA. Hello! #JHMChat |
| Med Peds Hospitalist @medpedshosp #JHMChat |
| @salahq Hello all #JHMChat | |
 | John @jmomdphd John, #PedsHM fellow from FL #jhmchat |
 | Michelle Brooks, MD, SFHM @michellebr00ks Michelle Brooks from VCU Health in Richmond, VA. We got rid of contact precautions in 2008 or 2010 (?) for MRSA/VRE. And I stopped using docusate as of February 2019. #JHMChat |
 | Jen Readlynn, MD, FHM (she/her) @jenreadlynn Jen Readlynn from Rochester, NY #JHMChat |
| Things We Do For No Reason @TWDFNR @michellebr00ks A pro! #JHMChat |
 | Rachel Johnson @DoubleDawgMD #JHMChat PGY-2 from Atlanta. Just put the very new baby to bed; excited for tonight's chat! |
| Vinny Arora MD MAPP @FutureDocs @TWDFNR @JHospMedicine @tony_breu It is #nationalnappingday today #JHMChat since you asked my #sleep tidbit did you |
| Med Peds Hospitalist @medpedshosp @aoglasser @OHSU_DHM @OHSUIMRes Oh, you definitely can! #JHMChat |
| Journal of Hospital Medicine @JHospMedicine T1 In @TWDFNR series, Docusate is not an evidence-based way of treating constipation. Why do we do it? #JHMChat https://t.co/MHbJ8PGz4e |
 | Delia Takagi @dltkgi @JHospMedicine @FutureDocs Geriatrician here. Interesting topics tonight. #JHMChat |
| Charlie M. Wray, DO, MS @WrayCharles @michellebr00ks This reminds me of how people remember just where they were when some huge historical event occurred...but for a hospitalist #jhmchat |
| Sonya Tang Girdwood 鄧 智佳, MD, PhD @STangGirdwood @aoglasser @OHSU_DHM @OHSUIMRes You can do it! I’m working out and trying to outline a candidate statement for a grant! #JHMChat |
 | Dr. Jennifer Chen, MD FAAP 林 明 堯 @DrJenChen4kids @JHospMedicine @FutureDocs Jen, #PedsHM fellow in (rainy!) San Diego #JHMChat |
| Journal of Hospital Medicine @JHospMedicine @dltkgi @FutureDocs Welcome to all specialties on tonight’s #JHMChat @TWDFNR edition! Look forward to discussion T1 coming up |
| Michelle Brooks, MD, SFHM @michellebr00ks @JHospMedicine @TWDFNR A1 - Habit and protocol? It's still in our standard bowel regimen pop-up when I prescribe inpatient opiates. #JHMChat |
 | Kristen Young @kristenyoung @JHospMedicine @FutureDocs Hi, Kristen, current medicine chief resident (@UAPhxIM), one of the co-authors for Discontinuing Contact Precautions TWDFNR... excited to see these two articles discussed! #JHMchat |
| Journal of Hospital Medicine @JHospMedicine RT @JHospMedicine: @dltkgi @FutureDocs Welcome to all specialties on tonight’s #JHMChat @TWDFNR edition! Look forward to discussion T1 comi… |
 | Adam Rodman @AdamRodmanMD #jhmchat -- Adam, an internist from Boston! Sorry I'm a little late, I have diaper duty! |
 | Chris Petrilli, MD, SFHM @PetrilliMD @JHospMedicine @TWDFNR #JHMChat Nostalgia and to make us feel like we are doing something that doesn't sound as aggressive as miraLAX |
 | Eric Soriano, MD @EricLSoriano @JHospMedicine @FutureDocs Eric, IM PGY3 at Yale New Haven! |
| Jennifer Caputo-Seidler, MD @jennifermcaputo @JHospMedicine @TWDFNR A1 At my institution I think it’s tradition. When we implemented EPIC EMR docusate was built in as a default in the admission order set. So each year new interns learn to utilize it. Hard to break cultural habits #JHMChat |
| John @jmomdphd A1: It’s also listed on many references (peds included) as a treatment for constipation #JHMChat |
| Things We Do For No Reason @TWDFNR @JHospMedicine Great question to start us off. Let's add a quick poll. In your estimation, which of the following is the greatest contributor to the continued use of docusate? #JHMchat |
| Journal of Hospital Medicine @JHospMedicine Early adopters are in the house on #JHMchat welcome! |
| Med Peds Hospitalist @medpedshosp @JHospMedicine @TWDFNR T1- the main thing in my perspective is that it has been considered as a “non-toxic” mild laxative. Kind of just the custom of using it. #JHMChat |
| Med Peds Hospitalist @medpedshosp RT @JHospMedicine: T1 In @TWDFNR series, Docusate is not an evidence-based way of treating constipation. Why do we do it? #JHMChat https:/… |
| Jennifer Caputo-Seidler, MD @jennifermcaputo @WrayCharles @michellebr00ks Where were you when docusate was phased out? I like it #JHMChat |
| @ RT @WrayCharles: @michellebr00ks This reminds me of how people remember just where they were when some huge historical event occurred...but… | |
| Vinny Arora MD MAPP @FutureDocs @EricLSoriano @JHospMedicine Welcome to #JHMChat just use our hashtag to get noticed:) |
| Sonya Tang Girdwood 鄧 智佳, MD, PhD @STangGirdwood @aoglasser @OHSU_DHM @OHSUIMRes Clearly, at least one if not all 3 activities will suffer. At least I tried #JHMchat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn A1: Agree with others. It seems to be a habit for people. We joke about it at conferences with our palliative care colleagues yet keep on prescribing. Also, I don't write for it but my APPs/residents do. But I don't discontinue it either. #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: T1 In @TWDFNR series, Docusate is not an evidence-based way of treating constipation. Why do we do it? #JHMChat https:/… |
| @salahq We got rid of contact precautions 3 years ago, no CHG bathing! The emotional attachment to old practices are the “wall” #jhmchat | |
| Charlie M. Wray, DO, MS @WrayCharles @JHospMedicine @TWDFNR #HeirloomMedicine at its best #jhmchat |
| Med Peds Hospitalist @medpedshosp Indeed. Habit. And also as it has been incorporated in the formulary - used along w senna. #JHMChat |
| Society of Hospital Medicine @SocietyHospMed T1 is live! Join the #JHMChat conversation w/ @JHospMedicine @FutureDocs @tony_breu @TWDFNR, then claim #CME! |
| Vinny Arora MD MAPP @FutureDocs RT @SHMLive: T1 is live! Join the #JHMChat conversation w/ @JHospMedicine @FutureDocs @tony_breu @TWDFNR, then claim #CME! https://t.co/pkX… |
| Society of Hospital Medicine @SocietyHospMed RT @TWDFNR: @JHospMedicine Great question to start us off. Let's add a quick poll. In your estimation, which of the following is the gre… |
| Things We Do For No Reason @TWDFNR RT @JHospMedicine: T1 In @TWDFNR series, Docusate is not an evidence-based way of treating constipation. Why do we do it? #JHMChat https:/… |
| Journal of Hospital Medicine @JHospMedicine RT @SHMLive: T1 is live! Join the #JHMChat conversation w/ @JHospMedicine @FutureDocs @tony_breu @TWDFNR, then claim #CME! https://t.co/pkX… |
| @freckledpedidoc @jmomdphd Yes but it generally isn’t 1st line in Pediatrics because there isn’t much data to support it, except in biliary atresia patients (but even that literature isn’t very good). #JHMChat | |
| Dr. Jennifer Chen, MD FAAP 林 明 堯 @DrJenChen4kids @JHospMedicine @TWDFNR #JHMchat T1: I don’t use docusate much - Miralax/PEG is first line, then maybe enema and/or senna. If the kid’s constipation is bad enough to get admitted just for that, they’re probably getting a NGT cleanout anyway |
| Chris Petrilli, MD, SFHM @PetrilliMD @JHospMedicine "It's gotta go because it won't help them go" - #jhmchat fight song/chant / title of powerpoint for Pharmacy and Therapeutics committee to remove it from formulary |
| Rachel Johnson @DoubleDawgMD #JHMChat A1: inertia is hard to overcome. Students follow residents who follow attendings who are often not up to date. |
| Chris Petrilli, MD, SFHM @PetrilliMD RT @SHMLive: T1 is live! Join the #JHMChat conversation w/ @JHospMedicine @FutureDocs @tony_breu @TWDFNR, then claim #CME! https://t.co/pkX… |
| Jennifer Caputo-Seidler, MD @jennifermcaputo RT @TWDFNR: @JHospMedicine Great question to start us off. Let's add a quick poll. In your estimation, which of the following is the gre… |
 | Kshitij Thakur, MD, MSc @KshitijThakurMD @JHospMedicine @FutureDocs Kshitij Thakur from University of Kentucky #JHMchay |
| Adam Rodman @AdamRodmanMD #jhmchat T1 docusate SOUNDS like an ideal treatment -- cheap, well-tolerated. It just doesn't work |
| Michelle Brooks, MD, SFHM @michellebr00ks A1 - #JHMChat - looks like surgeons and medicine use docusate with equivalent frequency. It's like the one thing we agree on. |
 | Lakshman Swamy (laxswamy@bsky.social) @laxswamy @michellebr00ks @Dr_Mike_Stevens @TWDFNR @gonzalobearman @mike_edmond @dr_dmorgan @eliowa Yes you often get a single room and far less intrusion. In academic centers, we rarely understand just how many interruptions a patient experiences. It is endless. |
| Charlie M. Wray, DO, MS @WrayCharles @jennifermcaputo @michellebr00ks This should be our goal for every @TWDFNR article @tony_breu & @DocLennyF #JHMChat |
| Charlie M. Wray, DO, MS @WrayCharles RT @jennifermcaputo: @WrayCharles @michellebr00ks Where were you when docusate was phased out? I like it #JHMChat |
| Kshitij Thakur, MD, MSc @KshitijThakurMD @JHospMedicine @FutureDocs Kshitij Thakur from University of Kentucky #JHMchat |
| Med Peds Hospitalist @medpedshosp @PetrilliMD @JHospMedicine @TWDFNR Nostalgia! Poetic laxation :) #JHMChat |
| Society of Hospital Medicine @SocietyHospMed Don't forget to claim #CME after tonight's #JHMChat: https://t.co/zJYslL00dW |
 | luke buchanan @LukeBuchananana RT @JHospMedicine: T1 In @TWDFNR series, Docusate is not an evidence-based way of treating constipation. Why do we do it? #JHMChat https:/… |
| Journal of Hospital Medicine @JHospMedicine RT @WrayCharles: @JHospMedicine @TWDFNR #HeirloomMedicine at its best #jhmchat |
| John @jmomdphd @freckledpedidoc Agree; and I don’t use it as first line either #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @jennifermcaputo: @WrayCharles @michellebr00ks Where were you when docusate was phased out? I like it #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @TWDFNR: @JHospMedicine Great question to start us off. Let's add a quick poll. In your estimation, which of the following is the gre… |
 | Avital Y. O'Glasser, MD FACP SFHM DFPM (she/her) @aoglasser @WrayCharles @jennifermcaputo @michellebr00ks @TWDFNR @tony_breu @DocLennyF #jhmchat I love "remember when"s still remember my first case of takotsubo's as MS4 when attending (@DavidWienerMD) was shocked to see it in the states! |
| Med Peds Hospitalist @medpedshosp RT @freckledpedidoc: @jmomdphd Yes but it generally isn’t 1st line in Pediatrics because there isn’t much data to support it, except in bil… |
| Delia Takagi @dltkgi A1. Habit. Plus, easily available at pharmacy for outpatient use. #JHMChat |
 | Benji Mathews, MD MBA @MDbenji @JHospMedicine @TWDFNR Once an treatment becomes popular it is difficult to disimpact #jhmchat #docusate #TWDFNR |
| Sonya Tang Girdwood 鄧 智佳, MD, PhD @STangGirdwood @JHospMedicine @TWDFNR I don’t think I’ve been the primary prescriber of docusate for #pedsHM patient but have continued it for patients wi/chronic constipation, esp complex care patient, where it was prescribed by GI doc. I feel like a lot of parents prefer over Miralax and senna (cramping). #JHMChat |
| Jennifer Caputo-Seidler, MD @jennifermcaputo @DrJenChen4kids @JHospMedicine @TWDFNR I’ll agree I don’t see nearly as much docusate use from my med-Peds colleagues #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @TWDFNR: @JHospMedicine @tony_breu Alongside the amazing @DocLennyF #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @DoubleDawgMD: #JHMChat A1: inertia is hard to overcome. Students follow residents who follow attendings who are often not up to date. |
| Charlie M. Wray, DO, MS @WrayCharles @gracefarris We're still working on getting our ortho colleagues to flush the docusate #jhmchat |
 | Renee Dversdal @DRsonosRD @JHospMedicine @TWDFNR Belated intro (hi from Oregon, I’m a hospitalist finishing up notes in preop clinic!) & A1: agree re: smart sets & culture, but sometimes because patients think it works & need education as well! #JHMchat |
| Med Peds Hospitalist @medpedshosp Polyethylenglycol with senna is very effective in both adult and children #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @ben_geisler: time for a #SIESTA #jhmchat https://t.co/rvNvyDLWTM |
| Chris Petrilli, MD, SFHM @PetrilliMD @benjikmathews @JHospMedicine @TWDFNR #jhmchat I see what you did there, Benji...and I love it! |
| Kristen Young @kristenyoung @JHospMedicine @TWDFNR T1: Docusate and doc-senna are on the admissions order set, it's easier just to click the doc-senna and move on. More clicks to get to the senna and miralax. #jhmchat |
| Sonya Tang Girdwood 鄧 智佳, MD, PhD @STangGirdwood @JHospMedicine @TWDFNR With the “scare” that Miralax causes psychiatric issues in kids (not true), parents often ask for other constipation meds that are easy to administer. I personally go with lactulose if they refuse Miralax. #JHMchat |
| Med Peds Hospitalist @medpedshosp Indeed! The ENT surgeons use liquid docusate to dissolve cerumen. #JHMChat |
| Michelle Brooks, MD, SFHM @michellebr00ks A1 - when I brought this topic up at Grand Rounds 2 weeks ago, the ICU attendings listed pharmacists as the culprits. But I talked to the pharmacists, and they're on board. EHR needs to change. #JHMChat |
| Things We Do For No Reason @TWDFNR @JHospMedicine Culture is winning in a landslide. So, who did we all learn this from? And how can we change the culture? #jhmchat https://t.co/GWiYNSABUh |
| Med Peds Hospitalist @medpedshosp RT @SHMLive: Don't forget to claim #CME after tonight's #JHMChat: https://t.co/zJYslL00dW |
| @freckledpedidoc A1. In Peds we use PEG as 1st line and then senna/enemas (depending on etiology of constipation). I have seen docusate used for biliary atresia patients in liver failure, but in those patients 1st line is still lactulose. #JHMChat | |
 | Adam K. @Duece430 Adam, from NYP-BMH in Brooklyn here #jhmchat |
| Charlie M. Wray, DO, MS @WrayCharles The pun game is strong in tonights #JHMChat |
| John @jmomdphd @STangGirdwood @JHospMedicine @TWDFNR I’m also a PEG followed by lactulose kind of guy #JHMChat |
 | Rebecca Jaffe, MD @RJmdphilly #jhmchat rebecca here from philly s/p bedtime handoff to husband. |
| Vinny Arora MD MAPP @FutureDocs RT @WrayCharles: The pun game is strong in tonights #JHMChat https://t.co/FbLCe3dYra |
| Med Peds Hospitalist @medpedshosp Indeed. Is “benign” - doesn’t do anything. #JHMChat |
| Chris Petrilli, MD, SFHM @PetrilliMD @TWDFNR @JHospMedicine #jhmchat #1980sPSA :) https://t.co/g6AtjYOel2 |
| Michelle Brooks, MD, SFHM @michellebr00ks A2 - Can we just leave it off the hospital formulary? Making it a non-formulary medication would make it harder to order. #jhmchat |
| Sonya Tang Girdwood 鄧 智佳, MD, PhD @STangGirdwood @JHospMedicine @TWDFNR I know the @TWDFNR article was specific to the adult/geriatric population. Anyone know what studies, if any, have been done in peds? #JHMchat |
| Charlie M. Wray, DO, MS @WrayCharles @TWDFNR @JHospMedicine Do we change culture or do we change formularies...? #jhmchat |
| Michelle Brooks, MD, SFHM @michellebr00ks RT @benjikmathews: @JHospMedicine @TWDFNR Once an treatment becomes popular it is difficult to disimpact #jhmchat #docusate #TWDFNR |
| Jennifer Caputo-Seidler, MD @jennifermcaputo @kristenyoung @JHospMedicine @TWDFNR We also have a shortage of senna, but have senna-docusate available #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @benjikmathews: @JHospMedicine @TWDFNR Once an treatment becomes popular it is difficult to disimpact #jhmchat #docusate #TWDFNR |
| Things We Do For No Reason @TWDFNR @JHospMedicine And, (assuming it was our residents who taught us), did anyone ever say, "show me the evidence?". I certainly didn't. #jhmchat |
| Journal of Hospital Medicine @JHospMedicine T2 up in a moment...#JHMChat |
| Med Peds Hospitalist @medpedshosp It is a though process - have to “clean” all order sets. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @TWDFNR: @JHospMedicine And, (assuming it was our residents who taught us), did anyone ever say, "show me the evidence?". I certainly d… |
| Adam Rodman @AdamRodmanMD Does docusate prescribing in the inpatient setting actually harm anybody? It might if it prevents you from prescribing an effective anti-constipation agent.#jhmchat |
| Chris Petrilli, MD, SFHM @PetrilliMD @WrayCharles @TWDFNR @JHospMedicine #JHMChat formularies first then culture, it's much easier to get people to not order something if they can't |
| Sonya Tang Girdwood 鄧 智佳, MD, PhD @STangGirdwood @AdamRodmanMD @jmomdphd @JHospMedicine @TWDFNR Mag sulfate is definitely something I should get more comfortable prescribing without GI recommendations. Thanks for the reminder! #JHMChat |
| Journal of Hospital Medicine @JHospMedicine @WrayCharles @TWDFNR Stay tuned ....for T2 #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly #JHMChat I'm still on A1 - I have heard pharmacists say "docusate works more as a stool softener if taken daily for someone at risk for constipation" - is there a difference in evidence for prevention vs treatment? |
| Things We Do For No Reason @TWDFNR If you can change the formulary, that is the most durable. But, that's not possible for everyone, immediately. #JHMChat |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn @WrayCharles @TWDFNR @JHospMedicine #jhmchat both! It's probably easier to first change the formulary. |
| Med Peds Hospitalist @medpedshosp @TWDFNR @JHospMedicine By enhancing the knowledge and disseminating this new information. Promoting massive education in a redundant way #JHMChat |
| Jennifer Caputo-Seidler, MD @jennifermcaputo @michellebr00ks That would be ideal! #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @TWDFNR: If you can change the formulary, that is the most durable. But, that's not possible for everyone, immediately. #JHMChat https:… |
| Charlie M. Wray, DO, MS @WrayCharles @RJmdphilly great question. I've heard the same...Anyone know? #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @gracefarris: T1 we’ve known for such a long time 🧐 #jhmchat https://t.co/sRgIb4steA |
| Med Peds Hospitalist @medpedshosp RT @TWDFNR: @JHospMedicine And, (assuming it was our residents who taught us), did anyone ever say, "show me the evidence?". I certainly d… |
| Michelle Brooks, MD, SFHM @michellebr00ks This is what made me stop ordering it. If it prevents patients from getting correct treatment, it's a dangerous drug. #JHMChat |
| Med Peds Hospitalist @medpedshosp RT @PetrilliMD: @WrayCharles @TWDFNR @JHospMedicine #JHMChat formularies first then culture, it's much easier to get people to not order so… |
| Chris Petrilli, MD, SFHM @PetrilliMD @TWDFNR #jhmchat It should be pretty easy - who can say no with a powerpoint title like my previous tweet? #HaveThemCallMe |
| Avital Y. O'Glasser, MD FACP SFHM DFPM (she/her) @aoglasser RT @michellebr00ks: This is what made me stop ordering it. If it prevents patients from getting correct treatment, it's a dangerous drug.… |
| Sonya Tang Girdwood 鄧 智佳, MD, PhD @STangGirdwood @freckledpedidoc @AdamRodmanMD @jmomdphd @JHospMedicine @TWDFNR Mag Sulfate on ice? Sounds fancy! I’ll have one please! #JHMChat |
| Vinny Arora MD MAPP @FutureDocs @RJmdphilly As is your moderator #JHMchat |
| @freckledpedidoc @STangGirdwood @JHospMedicine @TWDFNR I don’t believe docusate is well-studied in Peds. #JHMChat | |
| Med Peds Hospitalist @medpedshosp @PetrilliMD @WrayCharles @TWDFNR @JHospMedicine That is why formularies must be reviewed and updated routinely.#JHMChat |
| Charlie M. Wray, DO, MS @WrayCharles @TWDFNR Sounds like these formularies need an enema (sorry, couldn't resist) #jhmchat |
| Avital Y. O'Glasser, MD FACP SFHM DFPM (she/her) @aoglasser @michellebr00ks #jhmchat yup, no effectiveness, prevents optimal treatment one of the arguments/themes laid out in "medical reversal" @adamcifu @VPrasadMDMPH |
| Michelle Brooks, MD, SFHM @michellebr00ks @RJmdphilly I think some of the studies in the chart were for prophylaxis. #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @FutureDocs We'll see if it takes. #JHMchat |
| Things We Do For No Reason @TWDFNR @WrayCharles @RJmdphilly The study we're discussing looked at both treatment and prophylaxis. No benefit for either. #JHMChat https://t.co/RiJz6jxbpb |
| Kristen Young @kristenyoung @AdamRodmanMD @JHospMedicine @TWDFNR #JHMchat definitely true - since someone created those admission order sets... This is just my observed practice. It has taken a long time (18years?!) to spread the word, and evidence, that docusate is unhelpful. |
| Sonya Tang Girdwood 鄧 智佳, MD, PhD @STangGirdwood @freckledpedidoc @JHospMedicine @TWDFNR Like most medications...#WhyImAPedsClinicalPharmacologist #JHMChat |
| Vinny Arora MD MAPP @FutureDocs @RJmdphilly huddling downstairs hoping for the best #jhmchat |
| Things We Do For No Reason @TWDFNR This is the exact point made by the authors. But other, more serious, harms have occurred. https://t.co/wQeyEDxwzJ #JHMChat |
| Med Peds Hospitalist @medpedshosp This is when we can see the power of engagement - we can make a difference #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @laxswamy @WrayCharles Because hospital diet? #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @ben_geisler: that'd solve our problem! #nuclearoption #jhmchat https://t.co/h5XJLbdnRs |
 | Omi @Omi_082 RT @TWDFNR: @JHospMedicine Great question to start us off. Let's add a quick poll. In your estimation, which of the following is the gre… |
| Journal of Hospital Medicine @JHospMedicine T2 One of the recommendations from @TWDFNR is to remove docusate from your hospital formulary. Is this feasible? What are other ways we can de-implement this practice? #JHMChat https://t.co/52h3yRWZxH |
| Eric Soriano, MD @EricLSoriano @JHospMedicine @TWDFNR #jhmchat We don't usually see docusate alone, but our formulary does have the very fancy sounding senna-plus which is senna-docusate so it slips in to the bowel regimen all the time! |
| Sonya Tang Girdwood 鄧 智佳, MD, PhD @STangGirdwood @AdamRodmanMD @freckledpedidoc @jmomdphd @JHospMedicine @TWDFNR Our residents do antibiotics tasting - clindamycin is definitely yucky! I also did an AED tasting as an intern, and definitely got giggly afterwards. Should do a constipation med tasting! #JHMChat |
| Chris Petrilli, MD, SFHM @PetrilliMD @WrayCharles @TWDFNR #JHMChat just ask your Pharmacy team how much they spend on docusate every year...I predict it is surprisingly higher than you would think! https://t.co/Lwj9nxOCbQ |
| Med Peds Hospitalist @medpedshosp RT @WrayCharles: @TWDFNR Sounds like these formularies need an enema (sorry, couldn't resist) #jhmchat |
| Rebecca Jaffe, MD @RJmdphilly @FutureDocs https://t.co/KOWstNHrXx |
| Adam Rodman @AdamRodmanMD I wonder if there's any evidence that hospital constipation has gotten worse. The use of opiate pain medication certainly has increased over the last 20 years. Some of those studies are rather old.#jhmchat |
| Med Peds Hospitalist @medpedshosp RT @TWDFNR: @WrayCharles @RJmdphilly The study we're discussing looked at both treatment and prophylaxis. No benefit for either. #JHMChat… |
| Vinny Arora MD MAPP @FutureDocs The question you have all been waiting for.... on #jhmchat |
| Chris Petrilli, MD, SFHM @PetrilliMD RT @TWDFNR: @WrayCharles @RJmdphilly The study we're discussing looked at both treatment and prophylaxis. No benefit for either. #JHMChat… |
| Charlie M. Wray, DO, MS @WrayCharles RT @TWDFNR: This is the exact point made by the authors. But other, more serious, harms have occurred. https://t.co/wQeyEDxwzJ #JHMChat… |
| Kristen Young @kristenyoung RT @TWDFNR: @WrayCharles @RJmdphilly The study we're discussing looked at both treatment and prophylaxis. No benefit for either. #JHMChat… |
| Vinny Arora MD MAPP @FutureDocs RT @PetrilliMD: @WrayCharles @TWDFNR #JHMChat just ask your Pharmacy team how much they spend on docusate every year...I predict it is surp… |
| Charlie M. Wray, DO, MS @WrayCharles RT @TWDFNR: @WrayCharles @RJmdphilly The study we're discussing looked at both treatment and prophylaxis. No benefit for either. #JHMChat… |
| Sonya Tang Girdwood 鄧 智佳, MD, PhD @STangGirdwood @PetrilliMD @WrayCharles @TWDFNR Paging @JCourterPharmD! How much do we spend on docusate at our hospital?? #JHMchat |
| Journal of Hospital Medicine @JHospMedicine RT @FutureDocs: The question you have all been waiting for.... on #jhmchat https://t.co/rPuwk1I93G |
 | Chang Kim, MD PhD @changkim211 RT @JHospMedicine: There are so many 'Things We Do For No Reason' (@TWDFNR), but @FutureDocs we'll be discussing 2: Docusate & Contact Prec… |
| Society of Hospital Medicine @SocietyHospMed There's still time to share your thoughts in tonight's #JHMChat on #ThingsWeDoForNoReason! |
| Michelle Brooks, MD, SFHM @michellebr00ks @RJmdphilly @laxswamy @WrayCharles NPO. All. Day. Long. #JHMChat |
| Chris Petrilli, MD, SFHM @PetrilliMD @STangGirdwood @WrayCharles @TWDFNR @JCourterPharmD #JHMChat #AntiConstipationStewardship |
| Brian McGillen, MD @BMcGillenMD A2. We've reduced PPI use (esp. gtts) via education and aligning with pharmacy...you'd think the same could happen with a little effectiveness / cost data! #JHMChat |
| Avital Y. O'Glasser, MD FACP SFHM DFPM (she/her) @aoglasser @michellebr00ks @RJmdphilly @laxswamy @WrayCharles #JHMchat another #TWDFNR... bring on the "clears until 2 hours"!!! |
 | Zaven Sargsyan @sargsyanz Creating social pressure can be very effective too. My resident showed me a discharge med list with docusate on it, signed with my name. Made me blush. #JHMChat |
| Sonya Tang Girdwood 鄧 智佳, MD, PhD @STangGirdwood @JHospMedicine @TWDFNR Have the EMR suggest other options when docusate is ordered? Prescribers don’t like having to click through several screens and will learn quickly. #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @michellebr00ks @laxswamy @WrayCharles "Except meds" #jhmchat |
| Charlie M. Wray, DO, MS @WrayCharles @PetrilliMD @TWDFNR which gets you to the solution...show admin/pharm how much they are wasting #jhmchat |
| Med Peds Hospitalist @medpedshosp T2- engaging pharmacy, GI, surgery, nutrition, IT - and have a compelling review of order sets. It is feasible - we can demonstrate the cost savings of not using a useless medication. #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @TWDFNR: This is the exact point made by the authors. But other, more serious, harms have occurred. https://t.co/wQeyEDxwzJ #JHMChat… |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn A2: It's certainly feasible after months of going through therapeutics committee and clinical council and getting every specialist to agree. The education as to why is the bigger piece that needs to happen. #JHMChat |
| Michelle Brooks, MD, SFHM @michellebr00ks @aoglasser @PetrilliMD @WrayCharles @TWDFNR Except folate! A penny a pill, right @TWDFNR? #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @aoglasser @michellebr00ks @laxswamy @WrayCharles another #TWDFNR #JHMChat |
| Adam Rodman @AdamRodmanMD @michellebr00ks @RJmdphilly @laxswamy @WrayCharles when I practiced in Botswana, I was initially shocked when they called it starving the patient. But really saying starving rather than NPO is just more intellectually honest. |
| Jennifer Caputo-Seidler, MD @jennifermcaputo A2 Removing from formularies is strongest solution because it will make it easy for us to stop ordering. Next I’d say changing order sets. Increased education and awareness of ineffectiveness a weak solution #JHMChat |
| Chris Petrilli, MD, SFHM @PetrilliMD @gracefarris @WrayCharles @TWDFNR #JHMChat I guess that makes sense since it works :-) |
| Rebecca Jaffe, MD @RJmdphilly RT @jennifermcaputo: A2 Removing from formularies is strongest solution because it will make it easy for us to stop ordering. Next I’d say… |
| Charlie M. Wray, DO, MS @WrayCharles @AdamRodmanMD @michellebr00ks @RJmdphilly @laxswamy NPO does add a sense of gravitas, doesn't it #jhmchat |
| Vinny Arora MD MAPP @FutureDocs this would make one helluva @SHMLive workshop or better yet a tweet up @WrayCharles @vineet_chopra @LekshmiMD @gracefarris #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @WolfsonD: T3 #JHMChat We have seen a focus on imaging, labs, antibiotics, telemetry & blood |
 | Mark Shapiro, MD @ETSshow @FutureDocs #JHMChat Mark Shapiro here! Catching up, I’m late, my Twitter feed is very constipated. Anyone have any thoughts? |
| Rebecca Jaffe, MD @RJmdphilly @jenreadlynn Educating the small group of stakeholders more effective than educating all potential orderers... #JHMChat |
| Avital Y. O'Glasser, MD FACP SFHM DFPM (she/her) @aoglasser @WrayCharles @AdamRodmanMD @michellebr00ks @RJmdphilly @laxswamy #jhmchat doesn't anything derived from latin words?? |
| Things We Do For No Reason @TWDFNR @AdamRodmanMD @WrayCharles @PetrilliMD Given how often it is used, there is money to be saved. #JHMChat https://t.co/ZyIDpMmhw3 |
| Vinny Arora MD MAPP @FutureDocs RT @RJmdphilly: @jenreadlynn Educating the small group of stakeholders more effective than educating all potential orderers... #JHMChat |
| Med Peds Hospitalist @medpedshosp RT @SHMLive: There's still time to share your thoughts in tonight's #JHMChat on #ThingsWeDoForNoReason! https://t.co/x9vOhowNDr |
| @salahq A2: it may cause provider-indigestion, but I am sure it is doable. Keep in mind that there are organizational consitpators @sanjaysaint everywhere #JHMChat . | |
| Chris Petrilli, MD, SFHM @PetrilliMD @michellebr00ks @aoglasser @WrayCharles @TWDFNR #JHMChat - yeah but only if the folate is low #JustKiddingLenny @TWDFNR |
| @ RT @WrayCharles: @AdamRodmanMD @michellebr00ks @RJmdphilly @laxswamy NPO does add a sense of gravitas, doesn't it #jhmchat | |
| Journal of Hospital Medicine @JHospMedicine RT @salahq: A2: it may cause provider-indigestion, but I am sure it is doable. Keep in mind that there are organizational consitpators @san… |
| Med Peds Hospitalist @medpedshosp RT @ETSshow: @FutureDocs #JHMChat Mark Shapiro here! Catching up, I’m late, my Twitter feed is very constipated. Anyone have any thoughts? |
| Mark Shapiro, MD @ETSshow @FutureDocs @SHMLive @WrayCharles @vineet_chopra @LekshmiMD @gracefarris @gracefarris has to do a cartoon of everyone’s face as they take a swig of lactulose. Would make for a fine coffee table book #JHMchat |
| Journal of Hospital Medicine @JHospMedicine RT @medpedshosp: T2- engaging pharmacy, GI, surgery, nutrition, IT - and have a compelling review of order sets. It is feasible - we can de… |
| Michelle Brooks, MD, SFHM @michellebr00ks I feel like #organizationalconstipators is my new favorite term for systemic barriers to change. #JHMChat |
| @ @ETSshow @FutureDocs Welcome @ETSshow ! #JHMChat | |
| Journal of Hospital Medicine @JHospMedicine RT @SHMLive: There's still time to share your thoughts in tonight's #JHMChat on #ThingsWeDoForNoReason! https://t.co/x9vOhowNDr |
| Journal of Hospital Medicine @JHospMedicine RT @TWDFNR: If you can change the formulary, that is the most durable. But, that's not possible for everyone, immediately. #JHMChat https:… |
| Charlie M. Wray, DO, MS @WrayCharles @FutureDocs @SHMLive @vineet_chopra @LekshmiMD @gracefarris Sounds fun and gross. I'm in. Wonder if the @SHMLive IRB would approve ...?#jhmchat |
| Med Peds Hospitalist @medpedshosp Indeed - we all are prominent stakeholders - the more people we engage - the higher the likelihood of success #JHMChat |
| Med Peds Hospitalist @medpedshosp RT @TWDFNR: @AdamRodmanMD @WrayCharles @PetrilliMD Given how often it is used, there is money to be saved. #JHMChat https://t.co/ZyIDpMmh… |
| @ RT @ETSshow: @FutureDocs @SHMLive @WrayCharles @vineet_chopra @LekshmiMD @gracefarris @gracefarris has to do a cartoon of everyone’s face a… | |
| Dr. Jennifer Chen, MD FAAP 林 明 堯 @DrJenChen4kids @JHospMedicine @TWDFNR #JHMChat T2: Many peds places got rid of meds w codeine, so removing from formulary is one option. De-implementation still requires education if it’s been entrenched in training/culture |
| Things We Do For No Reason @TWDFNR Order sets are wonderful, until they aren't. #JHMChat |
 | Perpetually behind Medical Student @mara_emm #JHMChat pre-med interested in EBM and currently working at a nursing/rehab facility. During wound care rounds, the doc is annoyed that contact precautions slow him down. He is less likely to see the patient (esp. if something small). |
| Adam Rodman @AdamRodmanMD @ETSshow @FutureDocs @SHMLive @WrayCharles @vineet_chopra @LekshmiMD @gracefarris It doesn't taste that bad! |
| Journal of Hospital Medicine @JHospMedicine RT @DrJenChen4kids: @JHospMedicine @TWDFNR #JHMChat T2: Many peds places got rid of meds w codeine, so removing from formulary is one optio… |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn @RJmdphilly Fair. But I think educating all the current orderers, even a little, needs to happen. No one likes to be told what to do without some background as to why. And again, I'm not the one ordering it. #JHMChat |
| Med Peds Hospitalist @medpedshosp RT @michellebr00ks: I feel like #organizationalconstipators is my new favorite term for systemic barriers to change. #JHMChat https://t.co… |
| Journal of Hospital Medicine @JHospMedicine RT @michellebr00ks: Michelle Brooks from VCU Health in Richmond, VA. We got rid of contact precautions in 2008 or 2010 (?) for MRSA/VRE.… |
| Adam Rodman @AdamRodmanMD @gracefarris @ETSshow @FutureDocs Yeah, hey Mark! |
 | Jonathan Berry @jlberrymd A bit late but wanted to introduce myself: Jonathan, an Internal Medicine resident in Boston. #JHMChat |
| Med Peds Hospitalist @medpedshosp RT @TWDFNR: Order sets are wonderful, until they aren't. #JHMChat https://t.co/DqPZrdAwCP |
| Rebecca Jaffe, MD @RJmdphilly RT @michellebr00ks: I feel like #organizationalconstipators is my new favorite term for systemic barriers to change. #JHMChat https://t.co… |
| Journal of Hospital Medicine @JHospMedicine @mara_emm Hang tight coming up on #JHMChat and welcome to a premed! |
 | Matt Anderson @CCInquisitivist RT @JHospMedicine: T1 In @TWDFNR series, Docusate is not an evidence-based way of treating constipation. Why do we do it? #JHMChat https:/… |
| @ RT @jlberrymd: A bit late but wanted to introduce myself: Jonathan, an Internal Medicine resident in Boston. #JHMChat | |
 | R Logan Jones, MD FACP @rloganjonesmd T1: But you guys, the box says it’s the #1 recommended OTC stool softener and adverts/packaging doesn’t lie...does it? #JHMchat https://t.co/bQSV2MaF37 |
| Things We Do For No Reason @TWDFNR @AdamRodmanMD @WrayCharles @PetrilliMD Maybe. But, I often see docusate used as a "backbone" treatment. Everyone gets it PLUS something else. #JHMchat |
| Michelle Brooks, MD, SFHM @michellebr00ks @jlberrymd Welcome! Fair warning -- lots of poop puns tonight. #JHMChat |
| Med Peds Hospitalist @medpedshosp RT @rloganjonesmd: T1: But you guys, the box says it’s the #1 recommended OTC stool softener and adverts/packaging doesn’t lie...does it? #… |
| Delia Takagi @dltkgi A2. Changing the formulary is a good answer, but it takes a long time to make foundation changes in emr templates. Outpt standpoint, pcps can also educate pts. #JHMChat |
| Jonathan Berry @jlberrymd @sargsyanz I fully agree with this. Having learned of the lack of evidence, while it's easier to just continue a med someone is already on, I hate the idea of seeing my name on a discharge summary for a med I know will not be effective #JHMChat |
| Sonya Tang Girdwood 鄧 智佳, MD, PhD @STangGirdwood @FutureDocs @SHMLive @WrayCharles @vineet_chopra @LekshmiMD @gracefarris Please pick a conference room as close to the restrooms as possible, or better yet, with bathrooms in the room! #JHMChat #somanyinappropriategifs |
| Rebecca Jaffe, MD @RJmdphilly @jenreadlynn Sure - but maybe a "we are removing x from formulary (or orderset, or whatever) and here is why" is a more effective way to get large scale or quick change. Agree though people like to feel engaged. #jhmchat |
| Med Peds Hospitalist @medpedshosp We use it with senna and polyethylenglycol. And sometimes an extra magnesium oxide. #JHMChat |
| @freckledpedidoc @FutureDocs @SHMLive @WrayCharles @vineet_chopra @LekshmiMD @gracefarris Chocolate sennosides are ok... and are OTC I really know too much about the taste of medications 🤦🏾♀️ #JHMChat | |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn @TWDFNR @AdamRodmanMD @WrayCharles @PetrilliMD True. Very few are on docusate alone in the hospital. Maybe only if it's what on their outpatient med rec. #JHMChat |
| Charlie M. Wray, DO, MS @WrayCharles @ben_geisler @JHospMedicine totally agree, Ben. Attribution would be difficult #jhmchat |
| Vinny Arora MD MAPP @FutureDocs RT @michellebr00ks: @jlberrymd Welcome! Fair warning -- lots of poop puns tonight. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine T3 up in a moment...#JHMChat |
| Brian McGillen, MD @BMcGillenMD @freckledpedidoc @FutureDocs @SHMLive @WrayCharles @vineet_chopra @LekshmiMD @gracefarris Chocolate, you say? Hershey likes this idea! #JHMChat |
| Sonya Tang Girdwood 鄧 智佳, MD, PhD @STangGirdwood [REDACTED USER] Does it stop you for ordering the Miralax? If so, the EMR intervention technically works but perhaps with the less-than-ideal outcome. #JHMChat |
 | Steven Chen 陳持威, MD, MPH, MHPEd @DrStevenTChen Sorry, I’ve been lurking on #jhmchat. I should probably introduce myself instead of furtively liking posts.... Steven, dermatologist/internist from Boston. |
| Things We Do For No Reason @TWDFNR @JHospMedicine We're curious. Who has actually succeeded in getting doscusate off their hospital formulary? #jhmchat |
| Adam Rodman @AdamRodmanMD fun unrelated laxative fact. Senna actually appears in the materia Medica.#jhmchat |
| Dr. Jennifer Chen, MD FAAP 林 明 堯 @DrJenChen4kids @STangGirdwood @AdamRodmanMD @freckledpedidoc @jmomdphd @JHospMedicine @TWDFNR Haha, we also do formula taste testing (now some of those are disgusting, esp the hydrolyzed ones! @shortandsnark) #JHMchat |
| Journal of Hospital Medicine @JHospMedicine RT @TWDFNR: @JHospMedicine We're curious. Who has actually succeeded in getting doscusate off their hospital formulary? #jhmchat |
| Chris Petrilli, MD, SFHM @PetrilliMD RT @TWDFNR: @JHospMedicine We're curious. Who has actually succeeded in getting doscusate off their hospital formulary? #jhmchat |
| Zaven Sargsyan @sargsyanz How would a pharmacy/therapeutics committee feel about adding other homeopathic stuff to the formulary? Then let’s subtract one. #JHMChat |
| Benji Mathews, MD MBA @MDbenji @JHospMedicine @TWDFNR Evaluate major drivers of overuse (culture of healthcare consumption, provider attitudes/biases/past interactions, patient unawareness of no evidence etc). For providers: Education, reflection, feedback, role-modeling. For patients: educate! Have them partner in DX/TX #JHMChat |
| @freckledpedidoc @bmcgillen26 @FutureDocs @SHMLive @WrayCharles @vineet_chopra @LekshmiMD @gracefarris Brian, it’s chocolate Ex-lax and comes in a rectangular bar like Hershey’s chocolate with squares that can be broken off. | |
| Charlie M. Wray, DO, MS @WrayCharles RT @TWDFNR: @JHospMedicine We're curious. Who has actually succeeded in getting doscusate off their hospital formulary? #jhmchat |
| Society of Hospital Medicine @SocietyHospMed RT @TWDFNR: @JHospMedicine We're curious. Who has actually succeeded in getting doscusate off their hospital formulary? #jhmchat |
| Chris Petrilli, MD, SFHM @PetrilliMD @DrStevenTChen Welcome to #jhmchat - it's a pleasure to have you! Just remember to post with #JHMChat each time so everyone can see your post! Enjoy! |
| Vinny Arora MD MAPP @FutureDocs A+ #jhmchat |
| Mark Shapiro, MD @ETSshow @AdamRodmanMD @gracefarris @FutureDocs Hey everyone! Adam! You’re still awake!? You must be tired, every patient says it awful! #JHMchat |
| Chris Petrilli, MD, SFHM @PetrilliMD @ben_geisler https://t.co/CFpIC7guo4 #JHMChat |
| Sonya Tang Girdwood 鄧 智佳, MD, PhD @STangGirdwood @DrJenChen4kids @AdamRodmanMD @freckledpedidoc @jmomdphd @JHospMedicine @TWDFNR @shortandsnark A GI doc did that once for a lecture. I was surprised how gross Pedialyte tastes and we recommend it all the time on #PedsHM and outpatient! #JHMChat |
| Adam Rodman @AdamRodmanMD @ETSshow @gracefarris @FutureDocs I told Tony I would stay up for this. |
| Adam Rodman @AdamRodmanMD @ETSshow @gracefarris @FutureDocs Got a baby hanging off my chest right now. |
| Journal of Hospital Medicine @JHospMedicine ⚠️ warning! we are about to switch gears from constipation to contact precautions. Hang on to your seats on #JHMChat @TWFNR editions @tony_breu |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn @RJmdphilly Absolutely agree. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine T3 In @TWDFNR, Contact isolation for MSRA and VRE was described as ineffective & potentially harmful. @TWDFNR recommends discontinuing this practice in hospitals with low endemic rates & high hand hygiene rates (>90%). Can anyone try this? #JHMChat https://t.co/XNZ9iDZh7Z |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: ⚠️ warning! we are about to switch gears from constipation to contact precautions. Hang on to your seats on #JHMChat @TW… |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: ⚠️ warning! we are about to switch gears from constipation to contact precautions. Hang on to your seats on #JHMChat @TW… |
| Dr. Jennifer Chen, MD FAAP 林 明 堯 @DrJenChen4kids @JHospMedicine @TWDFNR I also got extra wary of docusate after the Burkholderia contamination issues https://t.co/4P4pwDSyPR #JHMChat |
| Med Peds Hospitalist @medpedshosp [REDACTED USER] Guillherme! Welcome! This is Moises! We don’t use bisacodyl that much at Cleveland Clinic. #JHMChat |
| Jennifer Caputo-Seidler, MD @jennifermcaputo A3 we’ve just this month implemented physician ability to discontinue droplet precautions (most commonly placed when patient gets flu swab in ED) so it will be an uphill battle to remove mrsa/vre precautions #JHMChat |
| Michelle Brooks, MD, SFHM @michellebr00ks @JHospMedicine @TWDFNR Our hospital was progressive in this, and the ID folks have #donetheirresearch on this. We got rid of contact precautions for MRSA and VRE I think over 10 years ago. #JHMChat |
| Med Peds Hospitalist @medpedshosp At @CleClinicMD we do not isolate for MRSA or VRE #JHMChat |
| R Logan Jones, MD FACP @rloganjonesmd @JHospMedicine @TWDFNR T3 : Hey @TWDFNR, we're taking step in this direction #jhmchat --> https://t.co/ppv4mBODiC |
| Journal of Hospital Medicine @JHospMedicine Our #tweetiatricians game is strong tonight on #JHMChat ! |
| Adam Rodman @AdamRodmanMD my institution doesn't have contact precautions for MRSA. But our satellite hospitals do. I just ignore them. That's probably not the right way to go about it. #jhmchat |
| @salahq #JHMChat contact precautions for these organisms is a waste of healthcare dollars | |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn A3: We did a few years ago and it's been great. The problem we run into is that not all of the nursing homes locally have moved to this, so we're unknowingly waiting for private rooms for discharge because they're not on precautions as inpatient. #JHMChat |
| Things We Do For No Reason @TWDFNR RT @rloganjonesmd: @JHospMedicine @TWDFNR T3 : Hey @TWDFNR, we're taking step in this direction #jhmchat --> https://t.co/ppv4mBODiC |
| Journal of Hospital Medicine @JHospMedicine RT @michellebr00ks: @JHospMedicine @TWDFNR Our hospital was progressive in this, and the ID folks have #donetheirresearch on this. We got r… |
| Jennifer Caputo-Seidler, MD @jennifermcaputo @michellebr00ks @JHospMedicine @TWDFNR Incredible! |
| Omi @Omi_082 RT @JHospMedicine: T3 In @TWDFNR, Contact isolation for MSRA and VRE was described as ineffective & potentially harmful. @TWDFNR recommen… |
| Sonya Tang Girdwood 鄧 智佳, MD, PhD @STangGirdwood @JHospMedicine @TWDFNR Our hospital still requires contact isolation for both...however, @RebeccaSteuart is part of a QI project at our institution that has providers review PPE orders everyday to take patients out ASAP. Could definitely implement something similar for this issue. #JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: T3 In @TWDFNR, Contact isolation for MSRA and VRE was described as ineffective & potentially harmful. @TWDFNR recommen… |
| Rachel Johnson @DoubleDawgMD #JHMChat. If the well controlled environments in RCTs show contact isolation to be ineffective...how much less effective is it in real community hospitals where doctors, techs, visitos haphazardly toss the gown over their head and blaze in? |
| Journal of Hospital Medicine @JHospMedicine @michellebr00ks @TWDFNR Any thoughts on how and why this was successful @michellebr00ks ?#jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @rloganjonesmd: @JHospMedicine @TWDFNR T3 : Hey @TWDFNR, we're taking step in this direction #jhmchat --> https://t.co/ppv4mBODiC |
| Med Peds Hospitalist @medpedshosp Go Peds and Med-Peds! #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @DoubleDawgMD: #JHMChat. If the well controlled environments in RCTs show contact isolation to be ineffective...how much less effective… |
| Kristen Young @kristenyoung @JHospMedicine @TWDFNR In the process, initially the idea of Discontinuing CP for MRSA and VRE was a resident/hospitalist led project, working with ID & IP/IC. In 2017, we discontinue historical MRSA CP, and followed rates. Now following a systematic approach, looking to further reduce. #JHMchat |
| Chris Petrilli, MD, SFHM @PetrilliMD RT @JHospMedicine: T3 In @TWDFNR, Contact isolation for MSRA and VRE was described as ineffective & potentially harmful. @TWDFNR recommen… |
| Jonathan Berry @jlberrymd @AdamRodmanMD Having had MRSA/VRE precautions in med school and at other hospitals we rotate at, I love their absence at our hospital -- one less barrier to checking in on patients throughout the day #JHMChat |
| Charlie M. Wray, DO, MS @WrayCharles RT @DoubleDawgMD: #JHMChat. If the well controlled environments in RCTs show contact isolation to be ineffective...how much less effective… |
| Things We Do For No Reason @TWDFNR I'm already sensing a lot of "No Precautions" sentiment. What drives this? Though there is more than one issue, what's the biggest? #jhmchat |
| Rebecca Jaffe, MD @RJmdphilly ugh in case anyone is wondering the bedtime TOC did not work. Success is way worse than my readmission rate for what it's worth #JHMChat @FutureDocs |
| Dr. Jennifer Chen, MD FAAP 林 明 堯 @DrJenChen4kids @JHospMedicine @TWDFNR #JHMchat T3: Fortunately don’t get much VRE in #PedsHM (yet) but we do contact precautions for MRSA and ESBL. Unfortunately we’re seeing more of both, so not sure we fall under “low endemic” category. |
| Vinny Arora MD MAPP @FutureDocs RT @DoubleDawgMD: #JHMChat. If the well controlled environments in RCTs show contact isolation to be ineffective...how much less effective… |
| Adam Rodman @AdamRodmanMD sometimes I wish we could just get everybody from JHM chat together and open our own hospital. #jhmchat |
| Michelle Brooks, MD, SFHM @michellebr00ks @JHospMedicine @TWDFNR We had some great leadership. @mike_edmond @gonzalobearman And they've shown that there was no increase in infectious complications related to MRSA/VRE (several of the citations in the article are from these guys). |
| Zaven Sargsyan @sargsyanz Retweeting an old sentiment for #JHMchat . And correction: depending on the indication, indeed unnecessary. |
| Med Peds Hospitalist @medpedshosp Systematic continuous improvement projects w trainees can lead big changes in the healthcare system #JHMChat |
| Journal of Hospital Medicine @JHospMedicine Local experts do tip the scales #JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @TWDFNR: I'm already sensing a lot of "No Precautions" sentiment. What drives this? Though there is more than one issue, what's the big… |
| Things We Do For No Reason @TWDFNR @AdamRodmanMD You'd make us use the old René Laennec stethoscopes! #JHMChat |
| Rebecca Jaffe, MD @RJmdphilly @TWDFNR You know I wonder whether people react to this one on a logical level or gut/emotional level...and then retrofit the logic. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @kristenyoung: @JHospMedicine @TWDFNR In the process, initially the idea of Discontinuing CP for MRSA and VRE was a resident/hospitalist… |
| Charlie M. Wray, DO, MS @WrayCharles @DoubleDawgMD Great point. Can't tell you how many times I've seen this happen right after I walked out of CP room all gowned up (usually to be a "good attending" and follow the rules) to see someone else waltz right in. Frustrating to say the least #jhmchat |
| Renee Dversdal @DRsonosRD @rloganjonesmd @JHospMedicine @TWDFNR A3: I have nothing helpful to add beyond this excellent @OHSUIMRes resident thread, so proud! #JHMchat https://t.co/kHQ4lJQdkU |
| Adam Rodman @AdamRodmanMD The reason that contact precautions Russell my Jimmy's is that patients get poor care with them. I can't even see on my own floor that nurses and CNAs are less likely to go into the rooms let alone the medical teams. #jhmchat |
| @Dr_Mike_Stevens @michellebr00ks @JHospMedicine @TWDFNR Key is strong #InfectionPrevention support locally w/ a great horizontal IP platform. Some of our thoughts on this can be found here: https://t.co/vxbr9vx2Ux https://t.co/FDaNN9gWOb | |
| @salahq We took an aggressive approach in eliminating contact precautions in a 9-hospital health system for MDRO. The majority of physicians jumped on board easily #JHMChat | |
| Med Peds Hospitalist @medpedshosp @AdamRodmanMD Would be really cool! #JHMChat |
| Vinny Arora MD MAPP @FutureDocs @RJmdphilly im feeling you - if you only knew what was going on here #jhmchat |
| Med Peds Hospitalist @medpedshosp RT @JHospMedicine: Local experts do tip the scales #JHMChat https://t.co/IqoMxobrd0 |
| R Logan Jones, MD FACP @rloganjonesmd @JHospMedicine @tony_breu I think this is the phrase you meant to go for....@aoglasser #JHMchat https://t.co/PMGmdcU7d7 |
| Charlie M. Wray, DO, MS @WrayCharles @AdamRodmanMD Count me in #jhmchat |
| Kristen Young @kristenyoung @michellebr00ks @JHospMedicine @TWDFNR VCU is one of the 30+ systems who don't isolate! Any follow up data from your system? |
| Jennifer Caputo-Seidler, MD @jennifermcaputo RT @TWDFNR: I'm already sensing a lot of "No Precautions" sentiment. What drives this? Though there is more than one issue, what's the big… |
| Perpetually behind Medical Student @mara_emm Happens ALL the time #jhmchat |
| Vinny Arora MD MAPP @FutureDocs i am crying laughing #jhmchat #toddlerlife #bedtime #DaylightSavingsTime |
| @Dr_Mike_Stevens @michellebr00ks @JHospMedicine @TWDFNR @mike_edmond @gonzalobearman Also, here are some of our local data on discontinuing CP for MRSA/ VRE: https://t.co/e4GMa1IWxm, https://t.co/ECzCXnPSXv, https://t.co/p2nbWyA6kq #JHMChat @ICHEJournal @SHEA_Epi | |
| Rebecca Jaffe, MD @RJmdphilly @FutureDocs haha - fun to imagine anyway... (where is the pulling my hair out emoji?) |
| Michelle Brooks, MD, SFHM @michellebr00ks One metaanalysis of the data - favors stopping contact precautions. #JHMChat https://t.co/Nc4iNmxQQh |
| Med Peds Hospitalist @medpedshosp Contact precautions lead to patient isolation. Damage the overall quality of care. #JHMChat |
| Things We Do For No Reason @TWDFNR @gracefarris @RJmdphilly @FutureDocs I'm currently on the "daddy, can I work in the office with you?" square. [I love that square]. #JHMChat |
| Mark Shapiro, MD @ETSshow @FutureDocs @SHMLive @WrayCharles @vineet_chopra @LekshmiMD @gracefarris Before I forget, someone in this auspicious #JHMchat makes their Explore The Space podcast debut tomorrow morning! Stay tuned, it’s really good! |
 | Jamee Walters, MD @jamee_walters @FutureDocs @SHMLive @WrayCharles @vineet_chopra @LekshmiMD @gracefarris Our pharmacist does this every year with the residents. |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: Local experts do tip the scales #JHMChat https://t.co/IqoMxobrd0 |
| Vinny Arora MD MAPP @FutureDocs RT @sargsyanz: Retweeting an old sentiment for #JHMchat . And correction: depending on the indication, indeed unnecessary. https://t.co/zzB… |
| Michelle Brooks, MD, SFHM @michellebr00ks @kristenyoung @JHospMedicine @TWDFNR Welcome @Dr_Mike_Stevens to supply you with the laundry list. Please say hi to one of the experts everyone! #JHMChat |
| Adam Rodman @AdamRodmanMD @TWDFNR @gracefarris @RJmdphilly @FutureDocs I am wearing mine while I pace around my living room. |
| Rebecca Jaffe, MD @RJmdphilly @medpedshosp We are still solidly in the "trying to improve adherence rates" stage of change on this issue. #JHMChat |
| Med Peds Hospitalist @medpedshosp RT @Dr_Mike_Stevens: @michellebr00ks @JHospMedicine @TWDFNR @mike_edmond @gonzalobearman Also, here are some of our local data on discontin… |
| Med Peds Hospitalist @medpedshosp RT @michellebr00ks: One metaanalysis of the data - favors stopping contact precautions. #JHMChat https://t.co/Nc4iNmxQQh |
| R Logan Jones, MD FACP @rloganjonesmd @michellebr00ks @JHospMedicine @TWDFNR You've got @gonzalobearman with you out there at VCU. He's really trying to move the needle to evidence based and rational contact isolation #JHMchat |
| Journal of Hospital Medicine @JHospMedicine T4. Horizontal strategies to prevent infection spread include chlorhexidine gluconate (CHG) bathing, which has been associated with reduced C diffe. What are some important considerations for implementing daily CHG bathing for all patients? #JHMChat |
 | Nathan Varady @nathanvarady RT @JHospMedicine: T3 In @TWDFNR, Contact isolation for MSRA and VRE was described as ineffective & potentially harmful. @TWDFNR recommen… |
| @ RT @FutureDocs: i am crying laughing #jhmchat #toddlerlife #bedtime #DaylightSavingsTime https://t.co/LsgDyuoAUh | |
| Med Peds Hospitalist @medpedshosp @ETSshow @FutureDocs @SHMLive @WrayCharles @vineet_chopra @LekshmiMD @gracefarris Can’t wait! #JHMChat |
| Things We Do For No Reason @TWDFNR What are some of the "rational" uses of contact precautions that people see? #JHMChat https://t.co/lvGSbVoiPN |
| Dr. Jennifer Chen, MD FAAP 林 明 堯 @DrJenChen4kids @jennifermcaputo Oh yes, it’s annoying when a patient automatically gets precautions just because a certain test was ordered (eg airborne for TB even if low on differential). If clinical suspicion is there, sure, add the precautions to protect staff/other patients #JHMChat |
| Michelle Brooks, MD, SFHM @michellebr00ks @Dr_Mike_Stevens @JHospMedicine @TWDFNR @mike_edmond @gonzalobearman @ICHEJournal @SHEA_Epi Hey @Dr_Mike_Stevens - when did we discontinue precautions? I feel like I was still a resident. #solongago #idontrememberwhen #JHMChat |
| Michelle Brooks, MD, SFHM @michellebr00ks RT @rloganjonesmd: @michellebr00ks @JHospMedicine @TWDFNR You've got @gonzalobearman with you out there at VCU. He's really trying to move… |
| Vinny Arora MD MAPP @FutureDocs @AdamRodmanMD my husband has had a similar joke - collect all the hospitalists you love and take out an ad saying hospitalist group for hire #jhmchat (he's a health economist) |
| Things We Do For No Reason @TWDFNR @ben_geisler @AdamRodmanMD brings them on rounds... #JHMChat |
| Michelle Brooks, MD, SFHM @michellebr00ks @rloganjonesmd @JHospMedicine @TWDFNR @gonzalobearman He chimed in prior to #JHMChat! |
| Journal of Hospital Medicine @JHospMedicine #JHMChat |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: T4. Horizontal strategies to prevent infection spread include chlorhexidine gluconate (CHG) bathing, which has been ass… |
| Rebecca Jaffe, MD @RJmdphilly @salahq Silly question - what are JC standards around contact precautions? Is it a "set your own policy and stick by it" kind of issue, or are there basic standards that must be met? #JHMChat |
| Jonathan Berry @jlberrymd @TWDFNR @ben_geisler @AdamRodmanMD Can confirm. #JHMChat |
| Vinny Arora MD MAPP @FutureDocs RT @TWDFNR: What are some of the "rational" uses of contact precautions that people see? #JHMChat https://t.co/lvGSbVoiPN |
| @salahq A4: skin, skin, skin! #JHMChat | |
| Med Peds Hospitalist @medpedshosp T4- this is mostly used in the ICU on patients w central lines #JHMChat |
| Vinny Arora MD MAPP @FutureDocs @michellebr00ks @kristenyoung @JHospMedicine @TWDFNR @Dr_Mike_Stevens welcome to #JHMChat great to have experts in the house! |
| Michelle Brooks, MD, SFHM @michellebr00ks @rloganjonesmd - #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @FutureDocs: @michellebr00ks @kristenyoung @JHospMedicine @TWDFNR @Dr_Mike_Stevens welcome to #JHMChat great to have experts in the hous… |
| Brian McGillen, MD @BMcGillenMD A4. We have had big issues with patients doing daily CHG baths for #PICCs. Many tend to not like them after the first 1 or 2! Course, could also be in how we do/don't set expectations... #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @michellebr00ks: @kristenyoung @JHospMedicine @TWDFNR Welcome @Dr_Mike_Stevens to supply you with the laundry list. Please say hi to on… |
| Sonya Tang Girdwood 鄧 智佳, MD, PhD @STangGirdwood @TWDFNR Working with kids who cough and sneeze in your face and put their drool-covered hands all over your clothes and stethoscope, sometimes having a barrier just makes me feel better. Is that rational or irrational? #JHMChat |
| Eric Soriano, MD @EricLSoriano @JHospMedicine @TWDFNR We are behind...we require 3 negative MRSA surveillance swabs before contact can be discontinued and even then it is very hard to remove from the chart. We do have an initiative to swab outpatients in an attempt to remove the precautions! #jhmchat |
| @ RT @FutureDocs: @michellebr00ks @kristenyoung @JHospMedicine @TWDFNR @Dr_Mike_Stevens welcome to #JHMChat great to have experts in the hous… | |
| Dr. Jennifer Chen, MD FAAP 林 明 堯 @DrJenChen4kids @TWDFNR I think contact + for concern C diff or norovirus is reasonable. We had a nasty norovirus outbreak a couple years ago w lots of kids vomiting 🤢🤮 #JHMChat |
| @salahq A4: did I hear C. diff? Am I missing something? Are we back to poop? #jhmchat | |
| @Dr_Mike_Stevens @TWDFNR Also have to consider opportunity costs for your system's #InfectionPrevention program. CP focuses $$$ and time on individual pathogens-when there is likely more bang for your $ focusing on interventions that affect multiple pathogens simultaneously (like hand hygiene) #JHMChat | |
| Michelle Brooks, MD, SFHM @michellebr00ks @AdamRodmanMD Then we'd all be in the same time zone too! #JHMChat https://t.co/ro6KffEDxP |
| Sonya Tang Girdwood 鄧 智佳, MD, PhD @STangGirdwood @TWDFNR But also when we have babies under 28 days who will get tapped if they get a fever, I also feel like wearing gloves or something will protect them from whatever is floating around in the hospital. #JHMChat #pedsproblems |
| Charlie M. Wray, DO, MS @WrayCharles @ben_geisler you had me at hawthorne effect, Ben #jhmchat |
| Rebecca Jaffe, MD @RJmdphilly @michellebr00ks @kristenyoung @JHospMedicine @TWDFNR @Dr_Mike_Stevens what do you guys isolate for? #JHMChat |
| Sonya Tang Girdwood 鄧 智佳, MD, PhD @STangGirdwood @freckledpedidoc @TWDFNR And vomited on! Sometimes pooped on too! #JHMChat |
| Charlie M. Wray, DO, MS @WrayCharles RT @Dr_Mike_Stevens: @TWDFNR Also have to consider opportunity costs for your system's #InfectionPrevention program. CP focuses $$$ and tim… |
 | Michael Sinha @DrSinhaEsq #JHMChat A bit late checking in, but lurking in Boston. Mostly here for the @gracefarris cartoons... 😀 |
| Dr. Jennifer Chen, MD FAAP 林 明 堯 @DrJenChen4kids @STangGirdwood @TWDFNR After having many kids cough/sneeze into my face, in winter I’ll often wear a mask even in non-droplet precaution rooms 😅 #JHMChat #PedsHM |
| Med Peds Hospitalist @medpedshosp RT @Dr_Mike_Stevens: @TWDFNR Also have to consider opportunity costs for your system's #InfectionPrevention program. CP focuses $$$ and tim… |
| Journal of Hospital Medicine @JHospMedicine @salahq You saw what we did there #JHMChat https://t.co/sO7Umi7fRJ |
| Adam Rodman @AdamRodmanMD @RJmdphilly @michellebr00ks @kristenyoung @JHospMedicine @TWDFNR @Dr_Mike_Stevens C diff for sure |
| Things We Do For No Reason @TWDFNR @ben_geisler This meta-analysis included quasi-experimental studies where they looked at rates of hospital-acquired MRSA/VRE after CPs were discontinued. #JHMChat |
| Michelle Brooks, MD, SFHM @michellebr00ks A4 - patients don't like the sticky feeling. #JHMChat |
| Vinny Arora MD MAPP @FutureDocs @DrJenChen4kids @STangGirdwood @TWDFNR but do you wear a mask at home? #jhmchat I give up. |
| Journal of Hospital Medicine @JHospMedicine RT @michellebr00ks: A4 - patients don't like the sticky feeling. #JHMChat https://t.co/GwGBTgxSK9 |
| Things We Do For No Reason @TWDFNR @jennifermcaputo Don't bring scabies into the #JHMChat |
| Med Peds Hospitalist @medpedshosp @DrJenChen4kids @STangGirdwood @TWDFNR I wear the mask all the time! (In Peds, winter time). #JHMChat |
| Adam Rodman @AdamRodmanMD this is going off on a tangent a bit, what does anyone still insist on using soap in water after leaving a C diff room?#jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @DrSinhaEsq: #JHMChat A bit late checking in, but lurking in Boston. Mostly here for the @gracefarris cartoons... 😀 |
| Journal of Hospital Medicine @JHospMedicine RT @ben_geisler: so true! if hawthorne effect from trial (cohort study) gone - effect size even smaller? #jhmchat https://t.co/nFKRkbVRzW |
| Journal of Hospital Medicine @JHospMedicine RT @michellebr00ks: One metaanalysis of the data - favors stopping contact precautions. #JHMChat https://t.co/Nc4iNmxQQh |
| Dr. Jennifer Chen, MD FAAP 林 明 堯 @DrJenChen4kids @FutureDocs @STangGirdwood @TWDFNR Don’t have kids at home so no mask therr, but you’re right, many ppl who spend a lot of time around potentially sick kids (eg teachers) don’t usually have masks #JHMChat |
| Kristen Young @kristenyoung @WrayCharles @DoubleDawgMD I studied this, we only have about a 60% compliance with posted signage - which is near what other studies have cited (50-60%). Dismal. Worse the hand hygiene rates plummet once the CP sign goes up. #JHMchat |
| Michelle Brooks, MD, SFHM @michellebr00ks @RJmdphilly @kristenyoung @JHospMedicine @TWDFNR @Dr_Mike_Stevens C diff, resistant GNRS - ESBL and KPC-producing, MDR Pseudomonas & Burkholderia. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @Dr_Mike_Stevens: @TWDFNR Also have to consider opportunity costs for your system's #InfectionPrevention program. CP focuses $$$ and tim… |
| Jen Readlynn, MD, FHM (she/her) @jenreadlynn @STangGirdwood @TWDFNR We're required to glove for every adult patient in our hospital. Peds was exempt due to low Cdiff rates. #washglovewash #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @salahq: A4: did I hear C. diff? Am I missing something? Are we back to poop? #jhmchat https://t.co/6O0y2qm9gO |
| Journal of Hospital Medicine @JHospMedicine RT @DrJenChen4kids: @TWDFNR I think contact + for concern C diff or norovirus is reasonable. We had a nasty norovirus outbreak a couple ye… |
| Rebecca Jaffe, MD @RJmdphilly @TWDFNR I'm sort of assuming C diff and flu. And since we seem to go full on hazmat disseminated zoster...suspected meningococcus, TB (though these are airborn/strict precaution) #JHMChat |
| Adam Rodman @AdamRodmanMD @michellebr00ks @RJmdphilly @kristenyoung @JHospMedicine @TWDFNR @Dr_Mike_Stevens I had an acinetobacter that was resistant to literally everything. I use contact precautions for that patient. |
| Med Peds Hospitalist @medpedshosp @TWDFNR CRAB, ESBL. Scabies. #JHMChat |
| Kshitij Thakur, MD, MSc @KshitijThakurMD @JHospMedicine We were successful in implementing this for our malignant Hematology cohort... needs a lot of reinforcement from the hospitalist at rounds. #jhmchat |
| Kristen Young @kristenyoung @DrJenChen4kids @STangGirdwood @TWDFNR Same, and I think this speaks to the "rational" contact precautions and patient centered CP. #JHMchat |
| Journal of Hospital Medicine @JHospMedicine RT @drkshitijthakur: @JHospMedicine We were successful in implementing this for our malignant Hematology cohort... needs a lot of reinforce… |
| Michelle Brooks, MD, SFHM @michellebr00ks #JHMChat - for the tweetiatricians in the house! |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: @salahq You saw what we did there #JHMChat https://t.co/sO7Umi7fRJ |
| Vinny Arora MD MAPP @FutureDocs @DrSinhaEsq @gracefarris aren't we all ? #jhmchat |
| @Dr_Mike_Stevens @michellebr00ks @JHospMedicine @TWDFNR @mike_edmond @gonzalobearman @ICHEJournal @SHEA_Epi April 2013! Time flies! #JHMChat | |
| Med Peds Hospitalist @medpedshosp @TWDFNR Also Cdiff, KPC. #JHMChat |
| Med Peds Hospitalist @medpedshosp RT @michellebr00ks: #JHMChat - for the tweetiatricians in the house! https://t.co/s5dQXW4UOX |
| Journal of Hospital Medicine @JHospMedicine T4 #JHMChat Please add closing thoughts on @TWDFNR with @tony_breu on constipation & contact precautions. |
| Rebecca Jaffe, MD @RJmdphilly @AdamRodmanMD @michellebr00ks @kristenyoung @JHospMedicine @TWDFNR @Dr_Mike_Stevens Assuming there's no data for that ;) Sometimes good sense and paranoia win out begs the question - maybe contact precautions would have been useful if the MRDA/VRE prevalence was lower? #JHMChat |
| Mark Shapiro, MD @ETSshow @medpedshosp @FutureDocs @SHMLive @WrayCharles @vineet_chopra @LekshmiMD @gracefarris It’s not @gracefarris #JHMChat |
| Michelle Brooks, MD, SFHM @michellebr00ks @RJmdphilly @TWDFNR We have a pathogen-specific isolation chart to refer to. #JHMChat |
| @salahq Great question. My answer is “fear” and protection of own #microbiome #JHMChat | |
| Dr. Jennifer Chen, MD FAAP 林 明 堯 @DrJenChen4kids @freckledpedidoc @JHospMedicine #JHMChat T4: adding to this, might be aggravating for many kids w sensitive skin too, especially complex ones w hardware like ostomies or Gtubes. Not sure how costs would compare to the contact precaution gowns |
| Rebecca Jaffe, MD @RJmdphilly RT @FutureDocs: @AdamRodmanMD my husband has had a similar joke - collect all the hospitalists you love and take out an ad saying hospitali… |
| Rebecca Jaffe, MD @RJmdphilly @FutureDocs @AdamRodmanMD #dreamjob #jhmchat |
| Society of Hospital Medicine @SocietyHospMed Share your final #JHMChat thoughts, then claim #CME! https://t.co/zJYslL00dW |
| Vinny Arora MD MAPP @FutureDocs For a brief moment I thought you were taking vitals during the CHG bath (baths are often done in the middle of the night) but then I realized you talking bedtime! 😂😂😂🤣 #jhmchat |
| Michelle Brooks, MD, SFHM @michellebr00ks @Dr_Mike_Stevens @JHospMedicine @TWDFNR @mike_edmond @gonzalobearman @ICHEJournal @SHEA_Epi Hahaha. Much later than I thought! I thought it was 2010. #JHMChat |
| Sonya Tang Girdwood 鄧 智佳, MD, PhD @STangGirdwood @TWDFNR I do take the time when we’re gowning up to teach. Lots of people say there’s no time to teach our rounds when it’s high census in winter but I remind them that when the entire team is crowded around one closet and putting on equipment, you have their attention! #JHMChat #meded |
| Eric Soriano, MD @EricLSoriano @ben_geisler #jhmchat same with a viral respiratory PCR panel because it means everyone gowns and masks for 24-48 hours while waiting to see if the patient has rhinovirus... |
| Med Peds Hospitalist @medpedshosp RT @SHMLive: Share your final #JHMChat thoughts, then claim #CME! https://t.co/zJYslL00dW https://t.co/wUqgL1nNej |
| R Logan Jones, MD FACP @rloganjonesmd @salahq A4: if the title of this paper doesn't strike fear in your heart, then I don't know what could "The Potential for Airborne Dispersal of Clostridium difficile from Symptomatic Patients. " #jhmchat https://t.co/Va5PTp0msb |
| Things We Do For No Reason @TWDFNR @RJmdphilly @AdamRodmanMD @michellebr00ks @kristenyoung @JHospMedicine @Dr_Mike_Stevens This is partly the argument made by @dr_dmorgan in this wonderful article. #JHMChat https://t.co/gvqT4sQRve https://t.co/lCzlR24wQQ |
| Renee Dversdal @DRsonosRD @JHospMedicine T4: Seems like that would have pretty significant nursing time requirements? #JHMchat |
| Med Peds Hospitalist @medpedshosp And toilets in hospital rooms have no cover! #JHMChat |
| @ @FutureDocs Haha! I’m filing these parenting outpouches under #JHMchat bc #WorkLifeBalance | |
| Things We Do For No Reason @TWDFNR @ben_geisler @CDCgov And the CDC still suggests the use of contact precautions. #JHMChat |
| Charlie M. Wray, DO, MS @WrayCharles @JHospMedicine @TWDFNR @tony_breu Another great chat tonight! Love the broad participation -- with a strong showing from our #tweetrians (pediatricians). Overall: Reaffirmed my distaste of docusate and contact precautions #jhmchat |
| @freckledpedidoc @JHospMedicine @TWDFNR @tony_breu It’s nice to have these discussions. Sometimes the medicine we practice in #PedsHM is an extrapolation from what our adult colleagues do. I appreciate the candid, literature-based discussions so we can understand how our adult colleagues approach similar concerns. #JHMChat | |
| Things We Do For No Reason @TWDFNR RT @WrayCharles: @JHospMedicine @TWDFNR @tony_breu Another great chat tonight! Love the broad participation -- with a strong showing from o… |
| Vinny Arora MD MAPP @FutureDocs wow that was fast #JHMChat. thank you for participating in this rapid fire @TWDFNR chat with @tony_breu on Constipation and Contact Precautions. Lots of food for thought on de-implementation by partnering with our pharmacy/infection control colleagues. |
| Michelle Brooks, MD, SFHM @michellebr00ks CT - I didn't realize ditching the CP would be so controversial, since our hospital switched relatively easily. I feel like people will hang onto docusate longer than those blue (at our institution) or yellow gowns. #jhmchat |
| Mark Shapiro, MD @ETSshow @AdamRodmanMD In! #JHMchat |
| @salahq Thank you @SMcGrathICP .. #JHMChat | |
| Charlie M. Wray, DO, MS @WrayCharles @TWDFNR @RJmdphilly @AdamRodmanMD @michellebr00ks @kristenyoung @JHospMedicine @Dr_Mike_Stevens @dr_dmorgan Dan usually says smart things like this... #jhmchat |
| Journal of Hospital Medicine @JHospMedicine RT @TWDFNR: @RJmdphilly @AdamRodmanMD @michellebr00ks @kristenyoung @JHospMedicine @Dr_Mike_Stevens This is partly the argument made by @dr… |
| Charlie M. Wray, DO, MS @WrayCharles RT @FutureDocs: wow that was fast #JHMChat. thank you for participating in this rapid fire @TWDFNR chat with @tony_breu on Constipation and… |
| Journal of Hospital Medicine @JHospMedicine RT @WrayCharles: @JHospMedicine @TWDFNR @tony_breu Another great chat tonight! Love the broad participation -- with a strong showing from o… |
| Charlie M. Wray, DO, MS @WrayCharles RT @freckledpedidoc: @JHospMedicine @TWDFNR @tony_breu It’s nice to have these discussions. Sometimes the medicine we practice in #PedsHM i… |
| Journal of Hospital Medicine @JHospMedicine RT @FutureDocs: wow that was fast #JHMChat. thank you for participating in this rapid fire @TWDFNR chat with @tony_breu on Constipation and… |
| Adam Rodman @AdamRodmanMD great conversation! Thank you so much @tony_breu for moderating!#jhmchat |
| Things We Do For No Reason @TWDFNR Thank you @FutureDocs for a wonderful #JHMchat! |
| Mark Shapiro, MD @ETSshow @FutureDocs @TWDFNR @tony_breu I love that, after those topics, you went with “food!” #nothungry! See you all at @SHMLive in a few weeks! #JHMchat |
| Journal of Hospital Medicine @JHospMedicine Thank you to our partners @SHMLive @CostsofCare and @ABIMFoundation for supporting #JHMChat! @TWDFNR edition |
| Journal of Hospital Medicine @JHospMedicine Thanks for a great #JHMchat. Don't forget to claim your #CME here https://t.co/7vP3slGkXR |
| Med Peds Hospitalist @medpedshosp Many thanks to @FutureDocs @tony_breu @DocLennyF @TWDFNR for the excellent #JHMChat tonight! Learned a lot and enjoy the interaction! |
| Kshitij Thakur, MD, MSc @KshitijThakurMD @DRsonosRD @JHospMedicine It can work in certain cohorts of patients with a favorable nurse to patient ratio. #jhmchat |
| Michelle Brooks, MD, SFHM @michellebr00ks RT @FutureDocs: wow that was fast #JHMChat. thank you for participating in this rapid fire @TWDFNR chat with @tony_breu on Constipation and… |
| Journal of Hospital Medicine @JHospMedicine RT @bmcgillen26: A4. We have had big issues with patients doing daily CHG baths for #PICCs. Many tend to not like them after the first 1 or… |
| Jonathan Berry @jlberrymd @michellebr00ks Making it my mission this month to deprescribe docusate left and right...but yes on a broader culture I think it will be here for a while #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @DRsonosRD: @JHospMedicine T4: Seems like that would have pretty significant nursing time requirements? #JHMchat |
| Journal of Hospital Medicine @JHospMedicine RT @jlberrymd: @michellebr00ks Making it my mission this month to deprescribe docusate left and right...but yes on a broader culture I thin… |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: Thank you to our partners @SHMLive @CostsofCare and @ABIMFoundation for supporting #JHMChat! @TWDFNR edition |
| Journal of Hospital Medicine @JHospMedicine RT @TWDFNR: Thank you @FutureDocs for a wonderful #JHMchat! |
| Journal of Hospital Medicine @JHospMedicine @TWDFNR @FutureDocs Thank you @tony_breu #jhmchat |
| Sonya Tang Girdwood 鄧 智佳, MD, PhD @STangGirdwood What a fun #JHMChat tonight! Can’t wait for #PHMFellowJC tom. night on another topic that impacts adult HM, #PedsHM and subspecialities! Adult hospitalists: love to hear from you since the study was done on adult medicine rounds. @DrStevenTChen: were you involved w/this study? |
| Journal of Hospital Medicine @JHospMedicine RT @michellebr00ks: CT - I didn't realize ditching the CP would be so controversial, since our hospital switched relatively easily. I feel… |
| R Logan Jones, MD FACP @rloganjonesmd @aoglasser @medpedshosp I think there are some questions best left unanswered #jhmchat |
| Michelle Brooks, MD, SFHM @michellebr00ks So fun everyone! See you guys soon!! #JHMChat #HospMed19 |
| @salahq I suggest that we form a panel to discuss the PCR panels added burden of precautions in healthcare #JHMChat | |
| Rebecca Jaffe, MD @RJmdphilly @michellebr00ks Its funny - before reading @rloganjonesmd tweetorial i actually didn't realize that CP was controversial. I mean we are TRYING SO HARD to get people to wear the damn things. Didn't know it was an option to opt out. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @SHMLive: Share your final #JHMChat thoughts, then claim #CME! https://t.co/zJYslL00dW https://t.co/wUqgL1nNej |
 | The Curbsiders @thecurbsiders We hear @KashlakHospital is hiring! #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @michellebr00ks: #JHMChat - for the tweetiatricians in the house! https://t.co/s5dQXW4UOX |
| Avital Y. O'Glasser, MD FACP SFHM DFPM (she/her) @aoglasser @michellebr00ks #jhmchat got to start my day with @michellebr00ks and @RJmdphilly, got to end my day with them!! I love #medtwitter |
| Kristen Young @kristenyoung @JHospMedicine @TWDFNR @tony_breu Thank you again for covering both of these topics, even better to see the vast opinions of both CP and docusate. #JHMchat |
| Vinny Arora MD MAPP @FutureDocs love THIS #JHMChat meets #womeninmedicine #timesuphc |
| Rebecca Jaffe, MD @RJmdphilly @gracefarris @FutureDocs Yeah I keep not tagging #JHMChat when I get too off topic, but maybe I should just lump it all in because it's all part and parcel... |
| Michelle Brooks, MD, SFHM @michellebr00ks @aoglasser @RJmdphilly #besties #JHMChat https://t.co/1eUKiVrhws |
| @salahq Thanks #jhmchat team al. for a great chat https://t.co/PMvlOvPISe | |
| Vinny Arora MD MAPP @FutureDocs @RJmdphilly @gracefarris if its any consolation, as the moderator I feel like the side convo are an important capture of the purpose of #JHMchat - learn and support each other. |
| @DrEricStrong @AdamRodmanMD The biggest barrier to ignoring MRSA CP requirements is the fact that 90% of those around you will think you are just being too lazy to care about protecting patients. That's honestly my major motivation for continuing to gown and glove for this indication. | |
| Vinny Arora MD MAPP @FutureDocs @aoglasser @michellebr00ks @RJmdphilly i need to get on this schedule #jhmchat |
| Rebecca Jaffe, MD @RJmdphilly @SMcGrathICP @salahq I know I can ask my infection control folks, but out of curiosity - are there generally accepted guidelines for local epi and determining facility risk? Seems like a worthwhile addition to a general #TWDFNR discussion (ie - for no reason, except in these situations...) #JHMChat |
| Avital Y. O'Glasser, MD FACP SFHM DFPM (she/her) @aoglasser @FutureDocs @michellebr00ks @RJmdphilly #jhmchat file this under "has #medtwitter or #JHMchat ever led to any scholarly collaborations?" :) |
| Journal of Hospital Medicine @JHospMedicine Look forward to seeing everyone at #HospMed19 #jhmchat details on tweetup coming soon.... |
| R Logan Jones, MD FACP @rloganjonesmd @medpedshosp @aoglasser A3: a research question always had : does the floor cleaning machine that goes down the hall ACTUALLY make the hospital MORE dirty/prone to spread of infection compared to old fashion mop (via aerosolized particulate matter on hard floors) #jhmchat #InfectionPrevention https://t.co/ePe3GqJAP8 |
| Vinny Arora MD MAPP @FutureDocs RT @ben_geisler: thanks @JHospMedicine @TWDFNR @tony_breu @FutureDocs @WrayCharles for tonight's #JHMchat - good times! now #SIESTA https:/… |
| Vinny Arora MD MAPP @FutureDocs RT @JHospMedicine: Look forward to seeing everyone at #HospMed19 #jhmchat details on tweetup coming soon.... |
| Rebecca Jaffe, MD @RJmdphilly @aoglasser @michellebr00ks ...and @MargMChapman about whom we learned that her phone was named loosely after 80s-90s rap star who will go unnamed (for now) #jhmchat (taking all my self control not to add a gif!) |
| Society of Hospital Medicine @SocietyHospMed RT @JHospMedicine: Look forward to seeing everyone at #HospMed19 #jhmchat details on tweetup coming soon.... |
| Michelle Brooks, MD, SFHM @michellebr00ks @RJmdphilly @aoglasser @MargMChapman HAHAHAHAHA!! She can't hotspot. #JHMChat |
| Journal of Hospital Medicine @JHospMedicine RT @kristenyoung: @JHospMedicine @TWDFNR @tony_breu Thank you again for covering both of these topics, even better to see the vast opinions… |
| Avital Y. O'Glasser, MD FACP SFHM DFPM (she/her) @aoglasser @michellebr00ks @RJmdphilly @MargMChapman #jhmchat yes, it was a very good monday!! https://t.co/U7d4ou2s4j |
| Michelle Brooks, MD, SFHM @michellebr00ks @RJmdphilly @aoglasser @MargMChapman https://t.co/bXlf6aPGx2 |
| Kristen Young @kristenyoung @Dr_Mike_Stevens @michellebr00ks @JHospMedicine @TWDFNR 100% this, at my hospital there was no support initially from the local IP, and I had to go to other hospitals in the system to get support from their IP, eventually was able to gain support from the system IP admin. IP is key. #JHMchat |
| Sonya Tang Girdwood 鄧 智佳, MD, PhD @STangGirdwood @AdamRodmanMD @pccm_doc @freckledpedidoc @jmomdphd @JHospMedicine @TWDFNR Haha, I blame asthma on the brain. #JHMchat |
#jhmchat content from Twitter.