by Dan Osterweil, MD, FACP, CMD

I read with interest and some amusement the recent article in Caring for the Ages by Joanne Kaldy and the accompanied Editor's note from Dr. Steinberg.  Citing the Joint Commission alert on "alarm fatigue" which has wisely recommended steps to curb "alarm fatigue" in the hospital setting, this recommendation was based on data related to alarm-related adverse events, 80 of which resulted in death.  Others resulted in permanent loss of function, and  five led to unexpected additional care or an extended stay in hospital.  The editor's note tries to insert a sobering reality into the discussion which was full of opinions and limited evidence. Dr. Steinberg  struck a conciliatory note by pointing out to the value of various interventions and warning against a "black and white" approach to issues in our nursing homes.

by Janice Hoffman, PharmD, CGP, FASCP

SB 493 is a bill that was passed a few weeks ago which allows for pharmacists to be more fully utilized across the care continuum. This bill grants pharmacists in all practice settings certain authority that had been limited to inpatient and integrated health systems and establishes an “Advanced Practice Pharmacist” status. This designation is NOT mandatory and only those pharmacists who meet specific requirements will be eligible.

by Tim Gieseke, MD, CMD

Is it enough for your staff to “Sing Happy Birthday” as they wash their hands?  This article provides your staff with immediate feedback on the effectiveness of their hand washing technique rather than relying on time alone.  If failure occurs, it provides training videos.

I took the test with some concern about “passing”.  I passed, but found I've changed my technique to address the more recalcitrant areas of my hands. I suspect your attending physicians and non-clinical staff might also benefit from this training tool.  Please read on.

by Karl Steinberg, MD, CMD

AMDA was invited to participate in the American Board of Internal Medicine’s Choosing Wisely Campaign, in which numerous medical professional organizations and specialty societies were asked to weigh in on what common practices should be reduced or eliminated.  Many organizations have shared their evidence-based recommendations this year, and they are available at