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Call For Papers! 2025 Special Issue On Tick-Borne Illnesses!

Journal of Maine Medical Center

No abstract provided.

Analysis Of Claims Data Reveals Clinical And Social Factors Associated With Hepatitis C Direct-Acting Antiviral Prescriptions In Maine, Colin Waters, Anya Cutler, Kinna Thakarar, Kathleen Fairfield

Journal of Maine Medical Center

Introduction: There are now several curative options for chronic viral hepatitis C (HCV). We sought to investigate factors associated with prescriptions for direct-acting antiviral therapy in the hopes of informing improved HCV treatment access.

Methods: We conducted a cross-sectional analysis of all-payer claims data for the state of Maine to identify patients with chronic HCV diagnosis codes. Prescription claims were analyzed to determine which patients were prescribed a direct-acting antiviral for HCV treatment. Univariate analysis identified factors associated with prescription status, which were incorporated into a multivariable logistic regression model to Identify factors associated with direct-acting antiviral (DAA) prescribing.

Results: …

Closing The Gap: Using The Echo Model To Improve Access To Hereditary Colorectal Cancer Risk Assessment And Genetic Counseling In The Rural Setting, Stephanie Sharp, Linda Steinmark, Emily Edelman, Kate Reed, Kelly Barnes, Susan Miesfeldt

MaineHealth Maine Medical Center

Background: There is underutilization of colorectal (CRC)-related cancer genetic counseling services nationally, especially in underserved regions. Novel models of cancer genetic care in rural states like Maine are needed to narrow the practice gap, reflected in an improvement in the percentage of individuals meeting genetic testing guidelines referred for cancer genetic counseling. Goal To lower the CRC ca

Smoke Evacuation In The Operating Room, Meghan Holley, Mckenzie Moon

Nurse Residency

In perioperative staff, does mandating the use of smoke evacuation in the surgical setting compared to no smoke evacuation decrease the amount of exposure to toxic byproducts found in surgical plume for each surgical case?

Hepatitis A Cases On The Rise And What Can Be Done About It, Dana Mccarney, Stephen Rawlings

Journal of Maine Medical Center

No abstract provided.

2024 Mite Teaching Awards

Journal of Maine Medical Center

No abstract provided.

Purewick Versus Foley Catheters, Ashleigh Lunt, Grace Tibbetts, Tia Hufstader

Nurse Residency

Background: A Foley catheter is an indwelling urinary drainage device that is placed in a patient's urethra and remains in their bladder, continuously draining urine into a bag. In hospital settings, there are many indications for indwelling catheters such as strict I&O monitoring, incontinence, retention, end of life comfort, surgery, and immobility.

Help Programs Impact On Delirium, Abigail Holt

Nurse Residency

Background: Delirium is a condition that affects 1/3 of patients in the hospital. It is a condition that is preventable and reversible.

The Benefits Of Simulation-Based Training, Brooke Taylor

Nurse Residency

Background: Due to COVID-19, many hospitals shut down their in-person classes and simulated trainings. This has had a negative impact on the education of our new graduate nurses.

Improving Nurse-Provider Communication, Caitlin Martel-Harrington, Martha Mary Lane

Nurse Residency

Background: Ineffective communication among healthcare staff has been shown to cause an increase in errors and decrease in patient satisfaction.

How Environment Of Care Standards Impact Patient Satisfaction, Taylor Tantingco, Raeven Bilugan

Nurse Residency

Background: Environment of Care (EOC) are standards of care that revolve around the safety and well-being of both the staff and the patient.

EOC takes into account variables such as a clean environment, basic standards of care (ADLs), and access to resources/materials.

Improving The Balance Between Patient Satisfaction And Efficient Ed Throughput, Jessica Graham, Izzi Marceau

Nurse Residency

Background: Patients come into the Emergency Department (ED)when they are having an emergent health concern. One role of the ED nurse is balancing the patient expectations of care with ensuring the flow of the department. The studies reviewed here examine the way that ED nurses can help to coordinate realistic expectations for patients as they are waiting to be seen.

Evidence-Based Diabetes Exercise Intervention, Laura Smith

Nurse Residency

Type 2 diabetes mellitus is a chronic, noninfectious disease that affects a large population of adults in the world. Typically, it is associated with obesity, a sedentary lifestyle, and the consumption of undesirable meals (Nakrani et al., 2020/2023). Even with various treatments available for type 2 diabetes, most patients find it challenging to maintain a steady blood glucose level.

The Comparison Between Chlorhexidine And Providone-Iodine Antiseptics In The Operating Rom To Prevent Surgical Site Infections, Eleanor Decarolis

Nurse Residency

Background: Surgical site infections (SSI's) are one of the most common and costly complications from surgery. Chlorhexidine gluconate (CHG) and Povidione-Iodine (PVI) are the most common antiseptics used in surgery. The efficacy and uses of these surgical preps have been studied to determine the most effective in preventing surgical site infections.

Roommates And Privacy: An Evaluation Of Patient Satisfaction With Shared Rooms In Medical-Surgical Units, Michelle Tope, James Wiesen

Nurse Residency

BACKGROUND: Two patients often share a hospital room on medical-surgical floors. However, this arrangement does not consider the patients’ subjective sense of privacy, comfort, or quality of sleep. When those needs are unmet, patients are less satisfied with their hospital stay. There is some research on patient’s preference for private rooms versus shared rooms.

Fall Rates In Patient Populations With Remote Video Monitoring Compared To Companions, Alexandra Volpe, Catherine Close

Nurse Residency

Background: Healthcare facilities are constantly searching for new and improved interventions to minimize injury and fall rates within their units. 1:1 companions, or ‘sitters’, have been used to provide the patient with close monitoring in order to accomplish these goals. However, companions are not always a liable option for facilities due to poor staffing and increased expense in order to staff a ratio of 1 companion to 1 patient. Research has started to develop on the benefits of remote video monitoring, or ‘telesitting’, as an intervention to minimize fall risk and injury.

The Impact Of Prone Ventilation Among Patients Diagnosed With Acute Respiratory Distress Syndrome, Mary Steward, Kimberly Loomis

Nurse Residency

Background Mechanical ventilation is a commonICU intervention for patients in respiratory distress. Proning is a form of mechanical ventilation that has been recently studied which improves gas exchange and lung perfusion among patients specifically diagnosed with ARDS.

In Patients Aged 70 And Above, Male And Female, How Does The Length Of Stay After Treatment Compared To Early Discharge Impact The Patient's Level Of Orientation?, Amanda Ames, Caitlin Chasse, Jamie Beaupre

Nurse Residency

Background: The length of stay after treatment can put patients’ health and well-being at a disadvantage. Length of stay can not only cause delirium but can also have detrimental impacts on pre-existing comorbidities. By decreasing a patient's length of stay following the completion of treatment, there are lower levels of adverse outcomes that not only benefit the patient but also those around them.

Use Of Language-Adapted Resources In The Non-English Speaking Patient Population, Jenny Lansing, Emma Dubois

Nurse Residency

Background: Across the healthcare field, it is essential that patients and families can both communicate and understand the care they receive. A lack in this can lead to delays in care, missed findings, unnecessary care and costs, and even preventable emergencies. Limited research surrounds the impact that language barriers pose as well as methods to address this.

Pbpa Creating Pathways To Ensure Patients Are Using Their Inhaled Medications Effectively, Suzan Michelle Collins, Heather Blake, Chandler Blodgett, Sue Vermette, Martine Eon

Operations Transformation

Problem: Patients do not consistently know how to prepare, use and/or clean their inhalers effectively.

Impact: When patients do not consistently know how to prepare, use and/or clean their inhalers effectively they are in fact, not receiving the benefit from their prescribed medication.

They experience poor patient outcomes and overall poor patient experience.

• Increased calls to provider offices for unresolved, worsening symptoms and/or complications. (Thrush, hoarseness, cardiac symptoms etc.)
• Increased same day office visits.
• Patient crowding in Urgent Care and/or Emergency Department.
• Hospital Admissions.
• Increase in emotional and financial stress from missing school and/or work.
• Increase in referrals to specialists …

Thank You - Jmmc Reviewers 2023 And Early 2024

Journal of Maine Medical Center

No abstract provided.

Educating Ourselves About Substance Use Disorder, Kristen Silvia

Journal of Maine Medical Center

No abstract provided.

Chylous Ascites As A Contributor To Severe Malnutrition In Advanced Cirrhosis: A Case Report, Catherine M. Call, Michael Gilleo, Zhyldyz Kabaeva

Journal of Maine Medical Center

Introduction: Chylous ascites is the accumulation of chyle, a triglyceride and calorie-rich fluid, in the peritoneal cavity. It develops when the intra-abdominal lymphatics that contain chyle are damaged. It is a rare complication of liver cirrhosis that affects less than 1% of patients with this condition. Prompt identification may allow for treatment of associated caloric wasting.

Clinical Findings: A 52-year-old woman with alcohol-related cirrhosis and refractory transudative ascites presented for her second scheduled revision of a transjugular intrahepatic portosystemic shunt. She had confusion, constipation, worsening ascites, and severe malnutrition with muscle wasting (body mass index 12.6). The procedure was deferred, …

Identifying Overdose Risk Factors For People Hospitalized With Injection Drug Use-Associated Infections In Maine, Melanie Mait, Kim Murray, Tania D. Strout, Kinna Thakarar

Journal of Maine Medical Center

Introduction: The overdose crisis continues to be a significant problem, particularly in rural states such as Maine. The objectives of this study were to: 1) describe demographic and health characteristics and 2) identify overdose risk factors among people in Maine hospitalized with injection drug use (IDU)-associated infections.

Methods: We performed descriptive analysis of demographics, health characteristics, and injection practices, stratified by lifetime history of overdose. We conducted an exploratory logistic regression analysis, controlling for gender, homelessness, having experienced an emergency department (ED) visit in the past 3-months, and endorsement of injecting alone in the past 30 days to examine …

Let’S Go! 2022-2023 Educational Programs: Developing A Standardized Obesity Medicine Curriculum Through A Realist Evaluation, Isaac Stickney, Peter Amann, Victoria Rogers, Austin Steward, Kayla Bronzo, Alec Luro, Robert Bing-You

Journal of Maine Medical Center

Problem: Obesity is linked to more than 200 chronic conditions, lower quality of life, and worse outcomes for patients. Let’s Go! is a community engagement initiative that works with communities to create environments that support healthy behaviors that impact obesity. Let’s Go! provides educational programming for all medical learners and providers throughout Maine and Carroll County, New Hampshire. The goal of Let’s Go! is to address the health outcomes of obesity and the stigma associated with it, including its impact on patients’ mental health and clinicians’ unconscious biases.

Approach: We used a realist evaluation, a framework in which the social …

Intravenous Iron In Patients Hospitalized With Bacterial Infections: Utilization And Outcomes, Nicolette Centanni, Jennifer Hammond, Joshua Carver, Wendy Craig, Stephanie Nichols

Journal of Maine Medical Center

Introduction: Given the uncertainties with IV iron therapy and potential risk of infection, there may be hesitation to treat hospitalized patients with bacterial infections with this preparation even if clinically indicated. The aim of this study was to examine patterns of prescribing IV iron in hospitalized patients being treated for a bacterial infection and associated clinical outcomes in those with severe infections.

Methods: This retrospective chart review evaluated adult patients who received both IV iron sucrose and antibiotics during the same admission at Maine Medical Center during 2019. Data collected included iron studies and IV iron prescribing practices. Clinical outcomes …

Ultrasound Guided Piv Insertion Implementation, Blake Hotchkiss, Beth O'Donnell, Miles Merwin, Billie Jo Senecal, Ronica Smith, Eric Alan, Bryan Tavary, Chelsea Harkins, Taylor Archard, Leslie Geissinger, Lauren Remington

Operations Transformation

Observed high number of unsuccessful peripheral IV insertion attempts. This increases waste (cost and time) and decreases patient satisfaction.

Mainehealth Medical Group Report Inventory, Holly Ward, Robin Lozinski, Stephanie Lepine, Shawn Mcglaughlin White, Tracey Shaw, Sheila Adell

Operations Transformation

Variation of Epic Quality Reports being used across MHMG following the merge of Coastal, Mountain and Southern region quality departments resulting in inconsistent workflows and processes. This can lead to inconsistent care and outcomes of Quality Data we report.

Enhancing The Therapeutic Activity Of An Immune Checkpoint Inhibitor, Mainehealth, Peter C. Brooks, Jennifer M. Caron, Liangru Contois

MaineHealth Patents

The present invention provides antagonists and methods of use thereof in the treatment of cancer and abnormal immune suppression diseases.

Improving The Utilization Of Lunch Breaks For Nursing Staff, Norma Dawson, Kelsey Robinson, Bridget Miller, Deborah Monck, Beth Kessler

Operations Transformation

The Med-Surg Unit at LincolnHealth has a high number of nursing staff missing lunch breaks, despite encouragement and existing efforts to promote taking breaks. In addition, there are many instances where staff are not accounting for the breaks they have taken on their time sheets.