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Articles 1 - 28 of 28
Full-Text Articles in Medicine and Health Sciences
Metastatic Testicular Cancer Patient With Synchronous Oral Squamous Cell Carcinoma Presented With Gastrointestinal Bleeding: A Case Report, Manar F. Ashour, Sundus Nasim, Hallas M. Kadhim, Maan Faraj, Sylvia E. Eshak
Metastatic Testicular Cancer Patient With Synchronous Oral Squamous Cell Carcinoma Presented With Gastrointestinal Bleeding: A Case Report, Manar F. Ashour, Sundus Nasim, Hallas M. Kadhim, Maan Faraj, Sylvia E. Eshak
Advances in Clinical Medical Research and Healthcare Delivery
Testicular cancer is a curable oncologic disease of males mostly aged 15-44 years. Most of the patients are successfully treated with radical orchiectomy. However, a delayed presentation may lead to a dismal prognosis. There are several risk factors including cryptorchidism, a first-degree relative with testicular cancer, hypospadias, childhood inguinal hernia, and military pollutant exposure, among others. The distant metastasis of testicular carcinoma to the lung, liver, and brain are widely described. We present a unique case of a 28-year-old male who presented with gastrointestinal (GI) bleeding. Later, it was discovered that he had a metastatic testicular carcinoma synchronous with an …
The Safe Stay Program: For Care Of The Pediatric Patient Boarding In The Emergency Department, Kellie Rorke
The Safe Stay Program: For Care Of The Pediatric Patient Boarding In The Emergency Department, Kellie Rorke
Nursing Research and EBP Day 2022
The purpose of this evidence-based project was to explore alternative methods to address the process for admitted patients boarding in the pediatric emergency department. It was hypothesized that creating an intentional program of vigilance for safe care of the boarding pediatric patient via a pediatric admission care RN (PAC-RN), supported by interventions including on time medication administration, monitoring, and admission process education. Could reduce adverse events, total inpatient length of stay, morbidity and mortality and improve overall patient/family satisfaction.
A systematic literature search to review patient boarding in the emergency department was conducted. The literature reviewed supported the implementation of …
Ehealth@Home: Avoiding Readmissions For Heart Failure Patients, Krysta Harrington
Ehealth@Home: Avoiding Readmissions For Heart Failure Patients, Krysta Harrington
Nursing Research and EBP Day 2022
The purpose of this evidence-based project was to reduce readmission rates for congestive heart failure (CHF) patients. It was hypothesized that targeted, nursing led care would reduce readmission rates. To test the hypothesis, we engaged patients post-discharge to enroll in eHealth@Home. eHealth@Home is a program at Rochester Regional Health (RRH) that serves high need CHF patients with frequent acute care utilization. These patients receive intensive monitoring and follow-up from a dedicated eHealth nurse, nurse practitioner and community health worker who work in tandem with a patient’s RRH provider to ensure that seamless and quality care is delivered. Visits were done …
Immune-Related Adverse Event Management For Oncology Patients, Mary Beth Casselbury, Lori Davis, Sharon Wilson
Immune-Related Adverse Event Management For Oncology Patients, Mary Beth Casselbury, Lori Davis, Sharon Wilson
Nursing Research and EBP Day 2022
Rapid advances in cancer immunotherapy using Immune Checkpoint Inhibitors have led to significantly improved survival of patients. Immunotherapy is also associated with multiple immune-related adverse events (irAE’s). The purpose of this research is to determine if reinforced patient education regarding early recognition/management of side effects/adverse events decreases serious immune-related events. It is hypothesized that utilizing a patient education plan may determine if these interventions can manage immune-related adverse events and thereby decrease the severity of these events.
Our team reviewed literature addressing follow-up care for Oncology patients receiving Immunotherapy. To promote efficient management of immune-related adverse events several major oncology …
Rn Managed Warfarin Therapy Improves Patient Outcomes, Beth Ormsby, Stacee Marvin, Viktoria Leblanc, Ashley Harris
Rn Managed Warfarin Therapy Improves Patient Outcomes, Beth Ormsby, Stacee Marvin, Viktoria Leblanc, Ashley Harris
Nursing Research and EBP Day 2022
Warfarin, an oral anticoagulant, is a “high-risk” medication with narrow therapeutic range and risks for serious complications if not carefully managed. Therapeutic effect is determined using a blood test called the International Normalized Ratio (INR). Evidence shows a higher percentage of Time in Therapeutic Range (TTR) decreases the risk of adverse events including bleeding, hemorrhagic stroke, and death. An optimal TTR is 60 – 70% or higher. Improving TTR by 2.5 - 5% could significantly impact outcomes.
It was hypothesized that an algorithm based approach to Warfarin management by a consistent team of RN’s would improve TTR and outcomes.
To …
Assessing Primary Care Rns Impact On Quality Patient Care, Elizabeth Carreira
Assessing Primary Care Rns Impact On Quality Patient Care, Elizabeth Carreira
Nursing Research and EBP Day 2022
The purpose of this work was to examine how a large multi-site primary care based organization established an organizational structure that supported the determination, definition, measurement, and reporting of nursing sensitive indicators (NSIs) specific to ambulatory care nursing. NSIs capture the value of care provided by nurses and are a critical component of ANCC Magnet designation. The organization considered that successful pursuit of Magnet designation in an all ambulatory organization would involve establishing a framework to report NSIs that included defining nursing units and NSIs meaningful to the organization.
A multidisciplinary team led by nursing was established to examine and …
Licensed Practical Nurses Working To Maximum Scope Of Practice, Lindsey Sippel, Lauren Sicker, Jessie Schiffhauer, Kristee Aliten
Licensed Practical Nurses Working To Maximum Scope Of Practice, Lindsey Sippel, Lauren Sicker, Jessie Schiffhauer, Kristee Aliten
Nursing Research and EBP Day 2022
BACKGROUND: Nurses on 4800, a medical-surgical unit, were feeling overwhelmed by an increasing patient load due to Registered Nurse (RN) vacancies. No not only was staff morale at a low, but the staff was concerned about the impact on patient care. Nursing staff on 4800 consists of RNs as well as Licensed Practical Nurses (LPNs). As the team contemplated the high nurse:patient ratio, they identified that LPNs were not working to the full scope of their practice. The team began to wonder if ensuring that LPNs could work at the highest level of their scope of practice if this would …
Experiences Of Nurses And Nurse Leaders During The First Year Of The Covid-19 Pandemic: An Integrative Review, Jessica Powell
Experiences Of Nurses And Nurse Leaders During The First Year Of The Covid-19 Pandemic: An Integrative Review, Jessica Powell
Nursing Research and EBP Day 2022
This research aimed to examine the experiences of nurses and nursing leadership who worked through the COVID-19 pandemic. Understanding their experiences will help better support those suffering from burnout. An integrative review was done by searching three databases in February 2022. Search terms included: burnout, compassion fatigue, Nurs*, leadership, and COVID-19. A total of 288 studies were retrieved, with 11 eligible for review. Seven themes were identified: information, safety, psychological and physical impacts on nurses, patient needs vs. pandemic needs, acknowledgment, protective factors and positive things from their experience, and changes in responsibilities. Understanding the nurses’ and nurse leaders’ experiences …
Lost In Translation: Mitigating The Effects Of Language Barriers On Patient Outcomes, Megan R. Van Dorp
Lost In Translation: Mitigating The Effects Of Language Barriers On Patient Outcomes, Megan R. Van Dorp
Nursing Research and EBP Day 2022
The purpose of this research was to describe the development, implementation, timeline, and future evaluation of an evidence-based initiative to improve the outcomes of limited English proficiency patients. It was hypothesized that bridging the communication gap between patients of lesser English proficiency and their healthcare providers would increase patients' participation and understanding of their hospital stay. Improving discharge instructions and ensuring comprehension would promote well-being and health as patients are adequately equipped at discharge to assume their own healthcare needs. To test the hypothesis, a literature search was conducted of professional databases. Fifteen scholarly articles contributed to the research base …
Development And Implementation Of An Ambulatory Nursing Shared Governance Council, Patricia K. Fioravanti, Maria Larner
Development And Implementation Of An Ambulatory Nursing Shared Governance Council, Patricia K. Fioravanti, Maria Larner
Nursing Research and EBP Day 2022
The purpose of this work was to research, develop, and implement an ambulatory nursing shared governance council (ANSGC) to support the pursuit of Magnet designation within the Primary Care and Specialty Institute (PCASI) ambulatory care nursing environment at Rochester Regional Health. PCASI is comprised of over 115 practices located throughout 8 counties. Literature supports shared governance as a mechanism to increase nurse engagement, nurse retention, improve patient outcomes and promotes partnership between front line nurses and administration. Nursing Shared Governance is a pillar of the American Nurses Credentialing Center (ANCC) Magnet culture and a critical component of Magnet designation.
PCASI …
A Depression Screening Protocol For Acute Stoke Patients: A Quality Improvement Project, Celia Mcintosh
A Depression Screening Protocol For Acute Stoke Patients: A Quality Improvement Project, Celia Mcintosh
Nursing Research and EBP Day 2022
Background: Depression after stroke is common and is associated with poor functional recovery, suicidal ideation, decreased quality of life, and increased mortality. Despite this knowledge, poststroke depression (PSD) is often underdetected and thus undertreated. PSD is clinically important for the caregiver, the family, and the stroke survivor. Inconsistencies in screening and treatment practices may further contribute to these negative outcomes.
Purpose: The purposes of this evidence-based clinical scholarship project were to (1) determine the efficacy of an evidence-based depression screening protocol in improving early detection and treatment of PSD and (2) identify if there were any relationships between the protocol …
Evidence-Based Practice Liaisons: Supporting Ebp Across The Health System, Tami A. Hartzell, Susan Stell
Evidence-Based Practice Liaisons: Supporting Ebp Across The Health System, Tami A. Hartzell, Susan Stell
Nursing Research and EBP Day 2022
No abstract provided.
Reducing Intubation Time In Adult Cardiothoracic Surgery Patients: A Review Of Data Under The Direction Of A Board Certified Critical Care Intensivist, Rebecca Gooch, Lauren Grip, Chance Nadritch, Kimberly Vent
Reducing Intubation Time In Adult Cardiothoracic Surgery Patients: A Review Of Data Under The Direction Of A Board Certified Critical Care Intensivist, Rebecca Gooch, Lauren Grip, Chance Nadritch, Kimberly Vent
Nursing Research and EBP Day 2022
Background: Prolonged intubation after cardiac surgery increases the risk of morbidity and mortality and lengthens hospital stays. Factors that influence the ability to extubate patients with speed and efficiency include the type of operation, the patient’s baseline physiological condition, and provider practice patterns. The purpose of this research was to prove that the change of practice patterns that followed the addition of an intensivist lessened extubation times in cardiac surgery patients. It was hypothesized that the interventions brought on by the introduction of an intensivist would greatly reduce the amount of time a patient is intubated while in the intensive …
Development Of Share: Supportive Holistic Anxiety Reducing Experience In Critical Care, Benjamin Lindsay, Judith V. Treschuk
Development Of Share: Supportive Holistic Anxiety Reducing Experience In Critical Care, Benjamin Lindsay, Judith V. Treschuk
Nursing Research and EBP Day 2022
The purpose of this research/EBP was to develop an evidence-based Interdisciplinary Family-Centered Communication and Support Program in the Surgical/Neuro Intensive Care Unit intended to provide the support that family members and patients need when admitted to the Surgical/Neuro Intensive Care Unit.
It was hypothesized that there is a way to support patients and their family members during their admission to the RGH SICU/NCCU through evidence-based practice decreasing their anxiety and dissatisfaction with communication with the interdisciplinary team. To test the hypothesis, an electronic literature review was completed in March 2021 and May 2021 for the most current research on family-centered …
Nicu Discharge Readiness, Sarah Kiley, Megan Adams, Jennifer Pacheco-Leyva, Paula Sedita, Brooke Swinton, Michele Wells
Nicu Discharge Readiness, Sarah Kiley, Megan Adams, Jennifer Pacheco-Leyva, Paula Sedita, Brooke Swinton, Michele Wells
Nursing Research and EBP Day 2022
After days, weeks or months in the neonatal intensive care unit (NICU), families can be overwhelmed by the discharge preparation and the transition to home. Literature supports that inadequate preparation for discharge from the NICU increases family anxiety, risk for hospital readmission and emergency room visits, as well as infant care issues at home such as feeding difficulty. This quality improvement project was identified to improve and enhance discharge readiness in the NICU.
The project started with the development of a discharge readiness committee. After reviewing the literature, the committee met to identify areas in need of improvement which included …
Early Mobilization For Critically Ill Adults: An Integrative Review, Jarvis Mcgrath
Early Mobilization For Critically Ill Adults: An Integrative Review, Jarvis Mcgrath
Nursing Research and EBP Day 2022
Objectives: Despite emerging evidence on the health benefits of early mobilization (EM) among critically ill patients, immobility and perceived barriers to EM persists. This integrative review aimed to summarize existing data on nurse-led EM, including how EM is defined, how EM protocols were developed, and key components of their protocol.
Methods: The protocol for this integrative review was developed in consultation with a trained librarian. A comprehensive search was conducted using the databases CINAHL, Embase, and ProQuest Nursing and Allied Health in April 2021. 6% of results were independently screened by 2 reviewers and the remaining were screened by a …
Nurse Driven Early Mobility In The Intensive Care Unit: Mobility Protocol And A Designated Mobility Champion, Intensive Care Unit, Newark-Wayne Community Hospital, Newark, Ny
Nurse Driven Early Mobility In The Intensive Care Unit: Mobility Protocol And A Designated Mobility Champion, Intensive Care Unit, Newark-Wayne Community Hospital, Newark, Ny
Nursing Research and EBP Day 2022
Decreased mobility in hospitalized patients can lead to various health consequences, including increased morbidity and mortality. In the Intensive Care Unit (ICU), patients are not mobilized as frequently or as often as possible. Barriers to mobilization include limited resources such as time and staffing, perceived risk, and insufficient training in safe patient handling. This quality improvement initiative aimed to increase out-of-bed mobility in ICU patients, address activity orders at interdisciplinary rounds, and trial a designated mobility champion. The America Association of Critical-Care Nurses (AACN) Early Progressive Mobility (EPM) protocol and Bedside Mobility Assessment Tool (BMAT) were adopted and used to …
Peer Review, Robert Ferguson
Monkey Pox: Ignored Or Emerging Pathogen, Karoll J. Cortez
Monkey Pox: Ignored Or Emerging Pathogen, Karoll J. Cortez
CHED Talks
No abstract provided.
Shared Language Builds A Foundation For Health Equity, Deborah Stamps, Ebony Caldwell, Ajda Ince
Shared Language Builds A Foundation For Health Equity, Deborah Stamps, Ebony Caldwell, Ajda Ince
Advances in Clinical Medical Research and Healthcare Delivery
Achieving Health Equity requires developing a shared language that allows people to understand diversity in various contexts. For instance, shared language allows us to discuss diversity issues concerning gender identity, just as much as it allows us to discuss diversity issues concerning citizenship, race, or sexual attraction. This article sets out five key terms that form the foundation of a shared language: Diversity, Equity, Inclusion, Cultural Humility, and Cultural Responsiveness. The five key terms provide a solid foundation for efforts to further expand our shared language around diversity, such as a glossary defining terms like gender identity, race.
Patient-Centered Care: Disease Vs. Illness, Frantz Duffoo
Patient-Centered Care: Disease Vs. Illness, Frantz Duffoo
CHED Talks
No abstract provided.
“Hiccups” With Covid-19 Management, Yong W. Lee, Jacob Psomiadis, Sarah Akbani, Marvin Lopez-Medal, Aisha Miller
“Hiccups” With Covid-19 Management, Yong W. Lee, Jacob Psomiadis, Sarah Akbani, Marvin Lopez-Medal, Aisha Miller
Advances in Clinical Medical Research and Healthcare Delivery
Hiccups, medically referred as singultus, is a condition that results from involuntary contraction of the diaphragm and intercostal muscles. Singultus is usually a self-limiting condition which typically lasts less than 48 hours but in rare cases, can persist greater than 48 hours. This is a case of a 48 year-old male who was prescribed dexamethasone for COVID-19 but developed intractable singultus for two weeks. Patient was unable to tolerate diet due to intractable singultus leading to vomiting. He underwent various non-pharmacological maneuvers and pharmacotherapy without resolution. Dexamethasone- induced hiccups have been reported as an under recognized side effect of dexamethasone. …
Emergency Medicine Journal Club, David Gibbs, Dylan Norton, Kyle Barbour
Emergency Medicine Journal Club, David Gibbs, Dylan Norton, Kyle Barbour
Advances in Clinical Medical Research and Healthcare Delivery
In this column, we provide a brief review of important papers recently published that relate to the field of Emergency Medicine. The goal is to provide the busy clinician a bullet-like summary of the study, focusing on the research question, methods, results, limitations and bottom line interpretation.
Physician And Patient Moves In The Hospital Do Not Move Patient Satisfaction: A Single-Center Retrospective Analysis, Basil George Verghese, Nagesh Jadhav, Walter A. Polashenski, Carl H. Reynolds
Physician And Patient Moves In The Hospital Do Not Move Patient Satisfaction: A Single-Center Retrospective Analysis, Basil George Verghese, Nagesh Jadhav, Walter A. Polashenski, Carl H. Reynolds
Advances in Clinical Medical Research and Healthcare Delivery
Background. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a standardized survey for measuring patient's experiences at US hospitals. There is a shift towards geographically assigning patients and physicians. However, its impact on patient satisfaction scores has not been studied.
Objective: Examine the correlation between patient experience and overall hospital rating with the number of physicians seen and the number of times the patient was moved during a hospitalization.
Methods: A retrospective observational study was performed using select HCAHPS & Press Ganey survey questions to assess physician satisfaction scores and overall hospital rating and recommendation scores.
Results: There …
Building A Culture Of Research In Your Program, Richard Alweis
Building A Culture Of Research In Your Program, Richard Alweis
CHED Talks
This presentation describes potential interventions to create a culture of research in a community health system department or program that does not have that culture (but needs to develop it).
Hallway Medicine: Hospital Overcrowding And The Impact On Patient Care, Patrick Corey
Hallway Medicine: Hospital Overcrowding And The Impact On Patient Care, Patrick Corey
CHED Talks
Goals:
- Examine how ED metrics have been affected with overcrowding.
- Discuss how boarding affect patient care outcomes.
- Identify potential solutions.
When #Playaparttogether Takes A Dark Turn, Richard Alweis
When #Playaparttogether Takes A Dark Turn, Richard Alweis
CHED Talks
This is an M&M style presentation involving a case of internet gaming disorder. It focuses on the neurology and pathology of internet addictions, as well as screening tools.
Trauma Induced Coagulopathy, Patrick Corey
Trauma Induced Coagulopathy, Patrick Corey
Rochester General Hospital Grand Rounds
Goals:
- Discuss how traumatic events affect coagulation of patient
- Steps ED doctor can take to prevent and treat coagulopathy
- New technology and how it can help guide trauma care