Krinsley J.S.,Stamford Hospital
Hospital practice (1995) | Year: 2012
Intensive monitoring of blood glucose levels and treatment of hyperglycemia in critically ill patients has become a standard of care over the past decade. Although diabetes is associated with a large burden of illness in outpatients, the "diabetes paradox" suggests that in patients admitted to intensive care units, the presence of diabetes as a comorbidity is not independently associated with increased risk of mortality. This review article 1) describes prospective trial and observational cohort literature addressing this issue, 2) addresses the potential mechanisms underlying the diabetes paradox, and 3) discusses implications for patient care and future research.
Bhalani V.V.,Stamford Hospital
Connecticut medicine | Year: 2012
Splenosis is the autotransplantation of splenic tissue to abnormal sites, either the abdomen or thorax, following traumatic injury of the spleen. For splenic tissue to reach the thorax, there must be concomitant diaphragmatic injury. Thoracic splenosis is usually discovered incidentally on routine thoracic imaging as single or multiple, indeterminate pleural-based masses limited to the left hemithorax. Traditionally, diagnosis required invasive procedures and/or surgery to acquire tissue samples in order to rule out other causes of lung masses, ie, cancer. We report a case in which nuclear imaging was used to make the diagnosis of thoracic splenosis, thus preventing the need for invasive procedures and avoiding unnecessary patient apprehension.
Krinsley J.S.,Stamford Hospital
Hospital practice (1995) | Year: 2011
Intensive monitoring of blood glucose concentrations in critically ill patients has become a standard of care in intensive care units over the past 10 years, following the publication of a single-center randomized trial targeting euglycemia in postoperative patients. This article summarizes the literature describing the relationship between hyperglycemia and mortality in the critically ill, the main findings of the major interventional trials of intensive insulin therapy, the association between hypoglycemia and increased glycemic variability with adverse outcomes, and the impact of a preexisting diagnosis of diabetes. A framework for understanding dysglycemia in the critically ill, an approach that recognizes disturbances in the "3 domains" of glycemic control--hyperglycemia, hypoglycemia, and increased glycemic variability--is presented. Finally, practical considerations relating to the implementation of glycemic management protocols are discussed.
Simon S.L.,Stamford Hospital
American journal of orthopedics (Belle Mead, N.J.) | Year: 2011
Tenosynovial giant cell tumors (TGCTs) are pigmented villonodular proliferative lesions originating from the synovium, bursa, or joint. TGCTs tend to be locally aggressive, and there is a chance for multiple occurrences, which often lead to impairment of joint function. In this article, we report the case of a diffuse-type extra-articular TGCT found in the thigh of a 36-year-old woman. Surveillance F-18 fluorodeoxyglucose positron emission tomography detected increased activity within the left thigh. This activity was confirmed with magnetic resonance imaging and with surgical excision and histopathologic determination of the tumor. This patient's case suggests that TGCTs may be discovered and followed after resection with positron emission tomography.
Parry M.F.,Columbia University |
Parry M.F.,Stamford Hospital |
Grant B.,Stamford Hospital |
Sestovic M.,Stamford Hospital
American Journal of Infection Control | Year: 2013
Background: Despite using sterile technique for catheter insertion, closed drainage systems, and structured daily care plans, catheter-associated urinary tract infections (CAUTIs) regularly occur in acute care hospitals. We believe that meaningful reduction in CAUTI rates can only be achieved by reducing urinary catheter use. Methods: We used an interventional study of a hospital-wide, multidisciplinary program to reduce urinary catheter use and CAUTIs on all patient care units in a 300-bed, community teaching hospital in Connecticut. Our primary focus was the implementation of a nurse-directed urinary catheter removal protocol. This protocol was linked to the physician's catheter insertion order. Three additional elements included physician documentation of catheter insertion criteria, a device-specific charting module added to physician electronic progress notes, and biweekly unit-specific feedback on catheter use rates and CAUTI rates in a multidisciplinary forum. Results: We achieved a 50% hospital-wide reduction in catheter use and a 70% reduction in CAUTIs over a 36-month period, although there was wide variation from unit to unit in catheter reduction efforts, ranging from 4% (maternity) to 74% (telemetry). Conclusion: Urinary catheter use, and ultimately CAUTI rates, can be effectively reduced by the diligent application of relatively few evidence-based interventions. Aggressive implementation of the nurse-directed catheter removal protocol was associated with lower catheter use rates and reduced infection rates. © 2013 by the Association for Professionals in Infection Control and Epidemiology, Inc.
Krinsley J.S.,Stamford Hospital
Hospital practice (1995) | Year: 2014
The monitoring of blood glucose and treatment of hyperglycemia has been a standard of care in intensive care units since the publication of a single-center randomized controlled trial (RCT) of intensive insulin therapy in 2001 that demonstrated marked improvements in mortality. Professional societies created guidelines based on the results of this investigation, and revised them based on the results of a very small group of RCTs that followed. This commentary reviews the weight of evidence provided by the RCTs in comparison to the large body of evidence from observational studies regarding glycemic control of the critically ill, and suggests that the totality of evidence should be considered in the formulation of clinical practice paradigms.
Krinsley J.,Stamford Hospital |
Preiser J.-C.,Erasme University Hospital
Critical Care | Year: 2010
The major interventional trials of intensive insulin therapy in critically ill patients have reached divergent results. The present viewpoint article explores some of the potential reasons, including differences in monitoring technology and protocol design and performance, the occurrence of severe hypoglycemia and changes in the standard of care since publication of the landmark single-center trial. Recently published data detailing the deleterious effect of hypoglycemia are discussed, as is the emerging body of literature describing the important impact of glycemic variability on the risk of mortality in heterogeneous populations of acutely ill and severely ill patients. These new findings have important implications for the design of future interventional trials of intensive insulin therapy in the intensive care unit setting. © 2010 BioMed Central Ltd.
News Article | February 22, 2017
STAMFORD, Conn., Feb. 22, 2017 /PRNewswire/ -- The Competency & Credentialing Institute (CCI) announced Stamford Hospital of Stamford, CT as the 2017 TrueNorth Award winner. Competency & Credentialing Institute (CCI) is a leader in credentialing, nursing competency assessment and...
News Article | February 22, 2017
The Competency & Credentialing Institute (CCI) announced Stamford Hospital of Stamford, CT as the 2017 TrueNorth Award winner. Competency & Credentialing Institute (CCI) is a leader in credentialing, nursing competency assessment and education for the perioperative nursing community. Its ultimate goal is to improve quality patient care in the surgical setting. The award recognizes facilities whose “true north” guides their operating room nursing staff to be lifelong learners, models of competent practice, and advocates for excellence in patient safety. Stamford Hospital was selected as the winner after being carefully considered along many other competitive facilities. The hospital supports operating room nurses through the entire process of becoming Certified Perioperative Nurses (CNOR-certified). This includes having a CNOR Coach available to all staff, free on-site CNOR prep courses conducted annually, a lending library, and programs that offer free contact hours that may be used towards recertification. Cheryl Petrarca, Clinical Operations Director Perioperative Services, Tully Center expressed the honor that the group effort achieved by exclaiming “perhaps my greatest professional achievement had been obtaining my MSN, until this past week when my organization was the recipient of the 2017 True North Award; truly an honor!” Craig Andrews, Director of Public Relations, Stamford Health expressed appreciation for the honor when she stated “Thank you so much for the honor – I know the periop[operative] team is over the moon receiving this recognition (as they should!)” “Stamford Hospital truly sets the standard for support of nursing certification. It is both a pleasure and an honor to see this facility bring to life the best practices we have seen to support the professional development of perioperative nurses,” said Dr. Jim Stobinski, acting chief executive officer of CCI. “The enthusiasm and dedication of the entire staff to include the most senior nursing leadership is very inspiring.” CCI developed the TrueNorth Award program primarily based on the organization’s firm beliefs in the role specialty nursing certification plays in quality patient care. Registered nurses are required to validate their specialized knowledge through the rigorous CNOR certification exam process. Certification in many ways acts as a compass directing a nurse's clinical practice towards industry accepted standards. It is this empowerment that CCI seeks to foster in certified nurses. Not only is there a link between CNOR certification and improved outcomes in surgical patients, certified nurses are also more confident in their skills. Previous winners include Doernbecher Children's Hospital in Portland, OR, St. Clare Hospital in Lakewood, WA, and Memorial Hermann The Woodlands Hospital, The Woodlands, TX. Established in 1978, the Competency and Credentialing Institute provides the CNOR® and CSSM® credentials to more than 37,000 registered nurses. As the only certification body for perioperative nurses, CCI is one of the largest specialty nursing credentialing organizations. The mission of CCI is to lead competency credentialing that promotes safe, quality patient care and lifelong learning.
News Article | December 8, 2016
ALBANY, N.Y.--(BUSINESS WIRE)--In response to the critical need for better healthcare environments for children, EYP Inc., national leader in sustainability and comprehensive high-performance design, announced its intent to acquire Atlanta-based Stanley Beaman & Sears, an award-winning architecture and interior design firm and pioneer in the design of children’s hospitals. This union brings an additional specialization to EYP’s healthcare practice and specifically addresses the global need for high-quality, innovative pediatric care facilities. Both parties have signed a letter of intent with anticipation of closing by Dec. 31, 2016. Stanley Beaman & Sears was the first to integrate technology for education and entertainment into children’s hospitals to enhance young patients’ journey to health and wellness. Sharing EYP’s commitment to expertise driven design, Stanley Beaman & Sears has worked on pediatric care facilities for renowned clients, including St. Jude Children’s Research Hospital, Nemours Children’s Hospital, Children’s Healthcare of Atlanta, University of Chicago Comer Children’s Hospital, Children’s Hospital of New Orleans, and University of Virginia Medical Center, among others. Additionally, the pediatric firm is involved with a range of philanthropic work in support of child health in Africa. The addition of Stanley Beaman & Sears continues to grow EYP’s international healthcare presence. In 2014, EYP acquired WHR Architects to lead its healthcare practice, which is consistently ranked No.1 in healthcare renovation by Health Facilities Management Magazine. The group has seen continuous success and recognition for their deep expertise in evidence-based design, patient-centered care and behavioral healthcare in both new and renovation projects, such as Stamford Hospital, Jersey Shore University Medical Center, Fulton State Psychiatric Hospital, and Denmark’s Bispebjerg Somatic Hospital. As the premier pediatric design firm practice in the U.S., Stanley Beaman & Sears complements the expertise of the group and expands EYP’s team of experts in healthcare design, client-focused care and biomedical research. The combined resources of WHR Architects and Stanley Beaman & Sears now places EYP among the largest healthcare design practices in the country. Stanley Beaman & Sears also brings added expertise in experiential graphic design and interior design to EYP, complementing EYP’s offerings for the government, higher education, healthcare, science & technology and corporate industries. Stanley Beaman & Sears has provided these areas of expertise for such clients as Georgia Institute of Technology, University of Virginia, Children’s Healthcare of Atlanta, Children’s Hospital of Philadelphia, the Georgia Museum of Art and the new Mercedes Benz Stadium in Atlanta. “We design for clients who recognize that the fulfillment of their mission is directly linked to the performance of their facilities. For over 40 years, we have helped those clients—institutions of higher education, federal agencies, corporations and healthcare providers—advance their vision and goals by providing environments that are informed by deep, relevant knowledge,” said Tom Birdsey, AIA, President and CEO of EYP. “EYP and Stanley Beaman & Sears are united by passion and purpose, fueled by innovation, and focused on furthering our clients’ missions. Together with Stanley Beaman & Sears, we will continue to advance new methods of delivery that respond to the ever-changing needs of pediatric facilities nationwide. Expertise-driven design is our mission—it’s how we help our clients realize their vision.” “It’s hard to imagine a better fit for our culture than EYP,” said Kimberly Stanley, AIA, principal of Stanley Beaman & Sears, “and the benefits to our clients are outstanding. Both firms see design as a collaborative journey of discovery with our clients. We’re excited about having in-house engineers and energy specialists on our project teams as well as being able to offer EYP clients new expertise and services.” ABOUT STANLEY BEAMAN & SEARS: Stanley Beaman & Sears, based in Atlanta, Georgia, is an award-winning architecture, interiors and graphic design firm with a focus on healthcare, higher education and the arts. The firm has designed projects for notable universities and academic medical centers nationwide, and is a national leader in the design of healthcare facilities for children. For more information about Stanley Beaman & Sears Architects, visit www.stanleybeamansears.com. ABOUT EYP: EYP is a renowned global provider of high-performance building design, research, and consulting services for higher education, government, healthcare, and corporate clients. EYP is the only firm to have twice been ranked #1 for Energy & Sustainability by Architect Magazine. More than 650 professionals in architecture, engineering, energy, and interior design collaborate across 16 offices in the U.S. and Europe to deliver expertise-driven design. For more information, visit www.eypae.com.