Temple University Hospital (TUH) in Philadelphia, Pennsylvania is an academic medical center in the United States which is a part of the healthcare network Temple Health. It is the chief clinical training site for the Temple University School of Medicine. The hospital currently has a 722-bed capacity that offers comprehensive inpatient and outpatient services to the surrounding community, and highly specialized tertiary services in the Delaware Valley. In 2015, Temple University Hospital had more than 84,000 emergency department and 200,000 outpatient visits.In August 2011, Becker's Hospital Review listed Temple University Hospital as number 10 on the 100 Top Grossing Hospitals in America with $5.9 billion in gross revenue.
Controlling Nutritional Status (CONUT) score has previously been linked to increased mortality following hip fracture. The objective of this study was to evaluate the association between preoperative CONUT score and other postoperative complication rates in patients who underwent surgical hip fracture fixation. This study utilized the TriNetX Research Network to identify patients aged ≥ 65 with a previous history of hip fracture surgery between May 1, 2015, and May 1, 2025. Patients with a documented history of primary malignant neoplasm of the lower limb or secondary bony metastasis were excluded. Next, patients were separated according to calculated CONUT score using laboratory data available within six months of the index procedure. Patients with a CONUT score between 0 and 4 were considered no to low risk whereas those with a value between 5 and 12 represented the moderate to severe risk cohort. Propensity score matching was performed 1:1 based upon demographic characteristics and medical comorbidities. Outcomes were assessed within 30 days of surgery utilizing risk ratios (RR) and 95
Abstract Purpose Venous thromboembolism (VTE) causes mortality in 100,000 patients annually in the United States. The ACCP guidelines proposed giving extended chemoprophylaxis to patients who had a high VTE risk (Caprini score ≥5) undergoing abdominal or pelvic surgery for cancer. However, postmastectomy microsurgical breast free reconstruction was excluded from these recommendations. We aim to compare VTE outcomes and procedure related complications between short and extended postoperative chemoprophylaxis. Methods: A retrospective chart review was performed of patients from our institution who underwent DIEP flap reconstruction and were discharged on either short-term (2 weeks) enoxaparin from January 2017- June 2025. Those with a history of prior VTE, coagulopathy, or anticoagulation use were excluded. Chi-squared analyses independently compared PE and DVT rates before and after the implementation of extended postoperative prophylaxis. Methods A retrospective chart review was performed of patients from our institution who underwent DIEP flap reconstruction and were discharged on either short-term (2 weeks) enoxaparin from January 2017- June 2025. Those with a history of prior VTE, coagulopathy, or anticoagulation use were excluded. Chi-squared analyses independently compared PE and DVT rates before and after the implementation of extended postoperative prophylaxis. Results A total of 358 patients were included: 62 received short-term prophylaxis and 296 received extended prophylaxis, both cohorts received enoxaparin 40 mg daily. DVT and PE rates were 2.48% and 4.9% in the short-term prophylaxis cohort, compared with 1.87% and 0% with extended prophylaxis. Extended prophylaxis was associated with significantly lower rates of PE and DVT (P = 0.04 and P = 0.002, respectively); there was no significant difference in hematoma rates between cohorts (P = 0.76). Conclusion The implementation of extended postoperative chemoprophylaxis was associated with significant reductions in the rates of both DVT and PE, without an increased bleeding risk. Our findings support integration of the described regimen into standardized postoperative prophylaxis protocols.
Abstract Introduction Facing increased patient acuity, the BICU team performed a needs assessment and formed a Procedure Team, introducing specialized RN and PCA roles. The Procedure RN leads advanced wound care and procedures, while the PCA supports workflow and safety. Together, with the primary RN and provider team, they enhance patient outcomes, staff development, RN retention, and satisfaction, aligning with evidence-based practices and supporting continued improvement in high-acuity care settings. Methods Evaluation of efficiency and efficacy over 4 years. The Procedure Team pilot launched in April 2021 to address BICU needs, introducing the Procedure RN role for advanced wound care, multidisciplinary coordination, and staff mentorship. The Procedure PCA role was added to the pilot in 2022 to provide hands-on procedural support and enhance patient safety. Staffing models were adjusted permanently in October 2022 related to the evidence that supported optimal RN-to-patient ratios and resource allocation is evaluated year after year. As patient volume grows, the program continues to expand, onboarding additional RNs and PCAs to support ongoing improvements and workflow efficiency. Results The Procedure Team improved procedural efficiency, patient safety, and staff development in the BICU. With specialized RN and PCA roles, workflows became smoother, infection rates dropped to zero for CLABSI and CAUTI, and RN retention increased. Staffing expanded as patient volumes grew, and documentation quality improved. Continuous evaluation and leadership support ensured sustainability and scalability in high-acuity care. The evidence reflects a strong commitment to growth and continuous improvement to recruit and onboard registered nurses, in 2022 we started with17.10 RN FTE’s in burn specialty to 30.9 RN FTE’s in burn specialty in 2025. Conclusions The creation and implementation of the Procedure Team in the BICU exemplifies a structured, data-driven, and collaborative approach to nursing innovation. The initiative resulted in measurable improvements in procedural efficiency, infection prevention, documentation quality, and staff competency. Continuous evaluation and expansion, supported by senior leadership, ensured the sustainability and scalability of the program, ultimately enhancing patient care in a high-acuity environment. Applicability of Research to Practice The Procedure Team initiative improved procedural efficiency, patient safety, documentation, and staff skills through a structured, data-driven approach. Outcomes align with Evidence-Based Practice and national benchmarks, showing validity and reliability. The scalable model supports ongoing evaluation and adaptation, making it replicable for high-acuity settings and promoting sustainable change in clinical practice. Funding for the study N/A.
