Medicine and Health Sciences Commons^™

A 3- And 6- Month Follow-Up To A Student-Led Approach To Patient Safety In Pre-Clinical Curriculum, Nelson D. Gonzalez, Sahar Panjwani, Daniel Nwosuocha, Lauren Bayliss, Ayleen Godreau

Research Colloquium

Introduction: Preventable medical errors are currently the third leading cause of death in the United States following heart disease and cancer. In light of this, integration of formal patient safety education into undergraduate medical education has been encouraged by the World Health Organization. This study aimed to assess the change in patient safety knowledge, attitudes, and beliefs in students after early exposure to patient safety during pre-clinical years.

Methods: First and second-year medical students participated in the training and responses were assessed through a pre-test, immediate post-test, 3-month post-test, and 6-month post-test. The survey assessed student knowledge on aspects …

Catheter-Associated Urinary Tract Infections: Patient Characteristics, Treatment, And Clinical Outcomes In One South Texas Acute Care Hospital, Kimberly A. Ambrosini, Jose Campo Maldonado

Research Colloquium

Background: Catheter-associated urinary tract infections (CA-UTIs) account for 40 percent of nosocomial infections worldwide. Their elimination is at the forefront of quality improvement in one South Texas acute care hospital.

Methods: Over a period of 6 months, five CA-UTIs occurred in one South Texas acute care hospital. These cases were identified via regular surveillance by Infection Prevention staff and the Laboratory Department of the hospital. This research reviews patient age, sex, length of stay, bacteria contracted, appropriate antibiotic use, patient characteristics, and overall outcomes.

Results: Between the months of July and December 2021, 5 CAUTIs were contracted. Patients ranged in …

Impact Of Academic Golden Weekend Initiative On Academic Success For An Internal Medicine Clerkship, Elif S. Duran, Maria A. Alvarenga, Stephanie Onyechi, Jose E. Campo Maldonado

Research Colloquium

Background: COVID-19 precautions led to a change in the number of protected weekends for the UTRGV Internal Medicine Clerkship, going from 2 protected weekends to none. The aim of Academic Golden Weekends during a fully inpatient clerkship has been to maximize the student experience by providing enough time to balance all the necessary components of the student experience. Starting April 26, 2021, all cohorts completing their Internal Medicine Clerkship as third-year medical students had 3 protected weekends.

Methods: Two surveys were created to compare the pre-intervention and post-intervention cohorts. The surveys focused on student satisfaction regarding the time they had …

Quality Improvement Project To Increase Hepatitis C Virus Screening For Ambulatory Gme Internal Medicine Clinic Patients, Nghia Nguyen, Karrar Al Gburi, Arturo Suplee, Jarrad Mcadams, Serag Fares, Carol Soler, Ans Albustamy, Jorge Alejandro Bernal, Sumandeep Brar, J. Paredes

Research Symposium

Background: In 2020, CDC established new guideline expanding Hepatitis C virus (HCV) screening to all adults aged 18 to 79 years. Our QI project objective is to enhance HCV screening amongst the UTRGV-DHR IM department by establishing suitable reminders and educational sessions.

Methods: We reviewed HCV screening status of all adult patients 18 to 79 years old from June 1^st 2020 to December 1^st 2020. We then provided one lecture on the new screening recommendation from CDC 2020 guideline. We also encouraged residents to educate patients on the importance of HCV screening, and to identify and overcome barriers …

The Fortify Resilience Initiative, Nausheen Jamal, Deepu George, Maria Hernandez, Evan Garcia, Myrna Ruiz, Salvador Arellano Iii

Research Symposium

Purpose: The Fortify Resilience Initiative focuses on building and sustaining a culture of wellbeing for Residents and Fellows (R/Fs) at The University of Texas Rio Grande Valley (UTRGV) School of Medicine’s (SOM) Graduate Medical Education (GME) residency and fellowship programs. In order to address the multitude of threats to physician wellness and to mitigate the silent, but pernicious effects of burnout on these physician learners serving in the RGV, this Initiative from the Office of GME will strengthen existing wellbeing pathways while expanding additional solutions that will work to sustain wellbeing. Utilizing a combination of prevention, promotion, and intervention strategies …

Interdisciplinary Integrated Primary And Behavioral Healthcare (I2pbh) Initiative, John Ronnau, Deepu George, Maria Hernandez, Evan Garcia, Myrna Ruiz

Research Symposium

Purpose: The Interdisciplinary Integrated Primary and Behavioral Healthcare (I²PBH) initiative will train University of Texas Rio Grande Valley (UTRGV) mental health graduates to deliver high quality, evidence-based Integrated Behavioral Health (IBH) services in the Rio Grande Valley (RGV) – a high-need, high-demand, medically underserved Hispanic region along the US-Mexico border. Specifically, the I²PBH initiative will train 24 UTRGV mental health graduates annually to deliver high-quality Integrated Behavioral Health (IBH) clinical services through the evidence based Primary Care Behavioral Health (PCBH) model. With a training emphasis on basic/advanced theory and clinical skills in the PCBH model, students …

Primary Care Behavioral Health Partnerships Advancing & Transforming Health Sciences (Pcbh Paths), Kristan Diaz-Rios, Deepu George, Maria Hernandez, Evan Garcia, Myrna Ruiz, Salvador Arellano Iii

Research Symposium

Purpose: Primary Care Behavioral Health Partnerships Advancing & Transforming Health Sciences (PCBH PATHS) is a workforce development pipeline project aimed at permanently augmenting UTRGV’s institutional capacity to address shortage of an Integrated Behavioral Health (IBH) competent workforce locally, regionally and nationally. Our initiative, aligned with UTRGV strategic priorities and key initiatives, will integrate basic(model specific strategy and operational elements), mid-level (role identity and profession specific behavioral competencies specific to each health profession), and advanced (behavioral medicine clinical skills) applications of the evidence based PCBH model of delivery. A PCBH focused delivery system (clinical and educational), in which primary care providers …

Qi In Resident Leadership Workshop, Heidi Y. Pareja, Chelsea H. Chang, Daniel Aragon, Deepu George

Research Symposium

Background: Many residency programs provide some type of leadership training for chief residents. As these emerging leaders transition into their role, it is imperative to provide them with skills and knowledge to help them develop their leadership style. UTRGV’s department of Graduate Medical Education (GME) organized their first “Resident Leader Workshop” for all rising Chiefs and GME Resident Leadership Council (RLC) members. Using a pre and post survey, participants provided feedback on the effectiveness of knowledge and skills presented during the workshop.

Methods: All residency and fellowship rising Chiefs and GME RLC members were invited. The workshop took place …

Quality Improvement In A Hospital Setting: Central Line-Associated Bloodstream Infections At An Acute Care Hospital In South Texas, Hoang Anh T. Nguyen, Jose E. Campo Maldonado

MEDI 9331 Scholarly Activities Clinical Years

Background: Central line-associated infections (CLABSI) are life-threatening nosocomial infections that are associated with significant increase in healthcare expenditure, prolonged stays, and risk of mortality.

Objective: To identify outcome trends and risk factors that contribute to incidence of CLABSI at an 866-bed acute care hospital in South Texas.

Methods: A retrospective chart review was conducted on 38 patients who met the National Healthcare Safety Network criteria for CLABSI during the period of January 2021 to March 2022

Results: There was a total of thirty-two CLABSIs in 2021. Hospital-wide CLABSI rate was 1.76 hospital-wide per 1,000-line days. Half of cases were COVID-19 …

Catheter-Associated Urinary Tract Infections: Patient Characteristics, Treatment, And Clinical Outcomes In One South Texas Acute Care Hospital, Kimberly A. Ambrosini, Jose Campo Maldonado

MEDI 9331 Scholarly Activities Clinical Years

Background: Catheter-associated urinary tract infections (CA-UTIs) account for 40 percent of nosocomial infections worldwide. Their elimination is at the forefront of quality improvement in one South Texas acute care hospital.

Methods: Over a period of 6 months, five CA-UTIs occurred in one South Texas acute care hospital. These cases were identified via regular surveillance by Infection Prevention staff and the Laboratory Department of the hospital. This research reviews patient age, sex, length of stay, bacteria contracted, appropriate antibiotic use, patient characteristics, and overall outcomes.

Results: Between the months of July and December 2021, 5 CAUTIs were contracted. Patients …

Potential Perioperative Complications Due To Difference In Timing Of Systemic Heparinization During Ruptured Aneurysm Coiling, Rouzbeh Kotaki, Ameer E. Hassan, Wondwossen G. Tekle

MEDI 9331 Scholarly Activities Clinical Years

Potential Perioperative Complications Due To Differences in Timing Of Systemic Heparin Distribution During Ruptured Aneurysm Coiling

Introduction:

In general, systematic heparin anticoagulation is standard in regards to neurovascular intervention. When coiling ruptured aneurysms, many neurointerventionalists have their own protocol as to timing of systemic heparinization. There is ample research and literature reviewing the frequency of perioperative events, predictors and outcomes, as well as the efficacy in the use of anticoagulants and/or antiplatelets before, during, and after neurovascular procedures to prevent adverse outcomes. However, there currently exists a dearth of research in regards to timing of distribution of heparin intraoperatively and …

Mortality Outcomes In Therapeutic Versus Prophylactic Anticoagulation In Obese Patients In Predominantly Hispanic Population, Dave Patel, Moktar Ahmed Sheikh-Salah, Raul Garcia, Jewel Udenwagu, Jose Campo Maldonado, Christopher Romero

MEDI 9331 Scholarly Activities Clinical Years

Introduction: As of January 26, 2021, there have been 1,988,063 confirmed cases with 34,701 fatalities from COVID-19 in the state of Texas. As the fatalities increased in Rio Grande Valley, there was overwhelming evidence that showed that obesity, an already hypercoagulable state, was a risk factor that contributed to the severity of COVID-19 infection (Sanchis-Gomar, et. Al. 2020). The prevalence of obesity amongst the population in in the RGV presents an opportunity to correlate trends in outcomes with the obese population that are admitted for inpatient management of COVID-19.

Materials and Methods: This retrospective cohort study looks at patient’s electronic …

End Tidal Carbon Dioxide Monitoring (Capnography) In The Cardiac Intensive Care Unit, Madeline Elaine Huff, Kenneth T. Shelton

School of Medicine Publications and Presentations

Background: Carbon dioxide levels can be monitored throughout the respiratory cycle via capnography. In this way, capnography allows healthcare professionals to follow several respiratory factors in real-time, including respiratory depression, apnea, and hypercapnia. Postoperative patients are subjected to significant harm while receiving sedating medications without appropriate monitoring and intervention. Earlier detection of alterations to ventilation status will better enable providers to more accurately dose medications during procedures, especially in high-risk patient populations.

Methods: Patient selection included post-operative patients in the intensive care unit that were receiving sedation/analgesia, high dose or high frequency opioids, epidural or intrathecal pain management, patients that …

An Integrated Lean Supply Chain Framework For U.S. Hospitals, Subhajit Chakraborty, Jorge A. Gonzalez

Management Faculty Publications and Presentations

We apply a lean supply chain framework to the healthcare industry in the U.S., drawing support from lean systems philosophy. We conceptualize a view of the U.S. healthcare ecosystem that places a hospital and its admitted patients at the center and describes how all entities inside and outside the hospital work can implement lean principles to improve patients' quality care. This application depicts how a holistic consideration of hospital resources available in both the internal and external supply chain would increase the optimal use of such resources and ultimately serve patients. We offer propositions suggesting that an integrated supply chain …