Medicine and Health Sciences Commons^™

Pain Control: Opioid Vs. Nonopioid Analgesia During The Immediate Postoperative Period, Shamsie M. Lumpkin Bsn, Srna, Isaac W. Parrish Bsn, Srna, Austin S. Terrell Bsn, Srna, Dwayne S. Accardo Dnp, Aprn, Crna

Doctor of Nursing Practice Projects

Background Opioid analgesia has become the mainstay for acute pain management in the postoperative setting. However, the use of opioid medications comes with significant risks and side effects. Due to increasing numbers of prescriptions to those with chronic pain, opioid medications have become more expensive while becoming less effective due to the buildup of patient tolerance. The idea of opioid-free analgesic techniques has rarely been breached in many hospitals. Emerging research has shown that opioid-sparing approaches have resulted in lower reported pain scores across the board, as well as significant cost reductions to hospitals and insurance agencies. In addition to …

Blood Transfusion Errors Within A Health System: A Review Of Root Cause Analyses, Elizabeth A. Lancaster, Elizabeth K. Rhodus, Mary B. Duke, Andrew M. Harris

Sanders-Brown Center on Aging Faculty Publications

Introduction
Blood transfusions are lifesaving treatments which require critical attention to processes and details. If processes are not followed, grievous errors can lead to sentinel events. A review of investigations completed due to reported events will show the error trends associated with systems used throughout the blood transfusion process.

Methods
This study employed root cause analyses (RCAs) within the Veterans Health Administration (VHA) to review the events leading to blood transfusion errors. Data was pulled from the RCA databases within the VA National Center for Patient Safety. The time frame was October 2014 to August 2019. A total of 53 …

Factors That Determine Comprehensive Categorical Classification Of Ehr Implementation Levels, Soumya Upadhyay, William Opoku-Agyeman

Healthcare Administration & Policy Faculty Publications

Electronic Health Records (EHRs) have the potential to alleviate patient safety mistakes. Of the various levels of EHR, advanced or higher-level functionalities of EHR are designed to improve patient safety. Certain organizational and environmental factors may pose as barriers toward implementing all of the functionalities, leaving certain hospitals intermediate between basic and comprehensive levels of implementation. This study identifies a comprehensive categorical classification that includes hospitals that have functionalities between basic and comprehensive levels of EHR and determines the organizational and environmental factors that may influence hospitals to implement one or more combinations of these categories. A longitudinal panel design …

Nutrition, A Tenet Of Lifestyle Medicine But Not Medicine?, Leigh A. Frame

Clinical Research and Leadership Faculty Publications

Nutrition is a foundation of health and one of six pillars of Lifestyle Medicine. The importance of nutrition in clinical care is now widely recognized by health care professionals and the public. However, clinicians are not comfortable counselling their patients on nutrition due to inadequate or lack of training, leaving a significant need in patient care. This gap can be closed with evidence-based curricula in medical schools and in the trainings of other health care professionals. This communication presents the current state of nutrition knowledge in health care, emphasizing nutrition education for physicians, and presents a model of how pre- …

Incompatibility Group I1 (Inci1) Plasmids: Their Genetics, Biology, And Public Health Relevance, Steven L. Foley, Pravin R. Kaldhone, Steven C. Ricke, Jing Han

Food and Drug Administration Papers

Bacterial plasmids are extrachromosomal genetic elements that often carry antimicrobial resistance (AMR) genes and genes encoding increased virulence and can be transmissible among bacteria by conjugation. One key group of plasmids is the incompatibility group I1 (IncI1) plasmids, which have been isolated from multiple Enterobacteriaceae of food animal origin and clinically ill human patients. The IncI group of plasmids were initially characterized due to their sensitivity to the filamentous bacteriophage If1. Two prototypical IncI1 plasmids, R64 and pColIb-P9, have been extensively studied, and the plasmids consist of unique regions associated with plasmid replication, plasmid stability/maintenance, transfer machinery apparatus, single-stranded DNA …

Analytics For Hospital Resource Planning: Two Case Studies, Jingui Xie, Weifen Zhuang, Marcus Ang, Mabel C. Chou, Li Luo, David D. Yao

Research Collection Lee Kong Chian School Of Business

Using real data and process flows from two large hospitals (in Singapore and in Chengdu, China) as cases, we illustrate how to apply certain modeling and optimization techniques, along with simulation as a validation tool, to hospital resource planning problems. We demonstrate how these simple analytical tools can help achieve significant improvements in both patient service and resource utilization, and without the need to increase the overall level of existing capacities. Two resource planning problems are studied in detail, one concerns the re-balancing of bed capacities among various wards, and the other addresses the allocation of medical diagnostic resource among …

Inclusion Of Family Planning Within The National Health Insurance Benefits Package In Ghana: A Health Facility Assessment, Population Council, Ministry Of Health, Ghana Health Service, National Health Insurance Authority, Marie Stopes International Ghana

Reproductive Health

In Ghana, National Health Insurance Act 852 of 2012 ensures that health-care benefits include family planning (FP) services, however people continue to pay for FP services because the policy is yet to be implemented in practice. Under the leadership of the Ministry of Health, the National Health Insurance Authority in collaboration with the Ghana Health Service, Marie Stopes International-Ghana and the Population Council implemented a pilot project to remove FP service out-of-pocket costs. All modern clinical FP methods were added to national health insurance and expensed by health facilities through the national health insurance claims process. The intervention significantly increased …

Developing A Practical Application Of The Isometric Squat And Surface Electromyography, David Phillips, Angelic Rose Del Vecchio, Kevin Carroll, Evan L. Matthews

Department of Exercise Science and Physical Education Scholarship and Creative Works

Electromyography (EMG) is a research tool used in gait analysis, muscle coordination evaluation, clinical evaluation and sports techniques. Electromyography can provide an insight into neural adaptations, cross education effects, bilateral contraction deficiencies, and antagonist activity in exercise-related movements. While there are clear benefits to using EMG in exercise-related professions, accessibility, cost, and difficulty interpreting the data limit its use in strength and clinical settings. We propose a practical EMG assessment using the isometric squat to identify compensatory activation patterns and report early observations. Ten healthy participants were recruited. Participants performed a 2-min isometric handgrip protocol and an isometric squat protocol. …

Communication In Interventional Radiology: Addressing The Challenges Of Complexity And The Impact Of Secure Text-Message Communications, Aakriti Mishra, Daniel Harwood, William Schaeffer, Anna Fabre, Emily Ochmanek, Paul Vantine, Sean Biggs, Ryan Lebaron

Quality Improvement/Patient Safety Symposium

Background: The utilization of smartphone-based technology to improve multidisciplinary communication and patient care provides an exciting opportunity for quality improvement research. In our institution, consult requests have traditionally been responded to verbally, in person or over the phone. Unfortunately, this is prone to communication errors and duplication of work. Approximately three years ago, our division developed a uniform consultation note that could easily be placed in the patient record. Additionally, we analyze the impact of a HIPAA compliant messaging system (“Tiger Connect™”) on communication inside and outside the interventional radiology (IR) department.

Methods and materials: The electronic health record (EHR) …

Present Anesthesiology Practices In The Context Of Patent Foramen Ovale: Pfo Anesthesiology Survey, Hank M. Spellman Ms, Huynh (Wendy) Nguyen Md, Ricardo Falcon Md, Tim Petersen Phd, Codruta Soneru Md

Quality Improvement/Patient Safety Symposium

Institutions around the US often have no defined standard of care (SOC) measures concerning perioperative management of posterior spinal fusion (PSF) surgery patients with a patent foramen ovale (PFO). There is a tacit risk for paradoxical air embolism (PAI) for patients who undergo PSF (1,2,3). The sequelae of PAI include stroke, myocardial infarction, splanchnic infarction, cardiovascular collapse, and death. Upon IRB approval of our survey, data was gathered from 350 pediatric anesthesiologists. There were 49 responses; 46 of whom completed the survey. 81% of respondents practice in surgical settings and 92% provide anesthesia for PSF. 63% had 10-years or more …

Effects Of Social Determinants Of Health In Progression To Type 2 Diabetes, Folabi I. Ariganjoye

Applied Research Projects

The prevalence of prediabetes and diabetes in the United States and around the world has increased faster than expected in the last 30 years. The economic burden this costs a nation can be astronomic both in terms of expense and loss in productivity. One-third of U.S. adults, 86 million people, have prediabetes. Effective management is needed that can reach these 86 million, and others at high risk, to reduce their progression to diagnosed Type 2 diabetes. After the literature review, there was not enough literature to support how these led to the progression to diabetes. The abundant literature is centered …

114 Years And Counting – An Updated History Of The University Of South Dakota Sanford School Of Medicine, H Bruce Vogt, William J. Dendinger, Evelyn Schlenker, Janet C. Linderman

Administration

If those who founded the USD Sanford School of Medicine in 1907 were to drop in on the school today, what would they find most surprising? Would the time travelers marvel at the modern teaching facilities, our amazing ability to cure previously deadly diseases, or would they be puzzled by the complexities of medical practice in the modern era of technology and regulation? The first century of the medical school’s existence brought immense change as the school evolved. As advances in medical science and medical practice accelerated, the school kept pace. The first century resulted in a well-established medical school …

Detect Adverse Events And Medication Errors Using Technology, Kenneth Maxik, Craig Kimble, Alberto Coustasse

Pharmacy Practice & Administration

Technology has changed the practice of pharmacy. Many systems are now part of an ever increasingly interfaced or integrated health care system allowing the electronic exchange of prescriptions from electronic health records (EHRs) to the pharmacy information system and bidirectional data exchange for many items, such as lab results and test information. With meaningful use of automated distribution cabinet databases, EHR efforts, electronic data exchange, and smart pump technology, the availability of data to use for addressing and preventing adverse medication events has grown. Use of these systems has allowed a data-rich environment to store and retrieve reporting. Mining data …

The Use Of A Peanut Ball During Labor In Nulliparous Term Singleton Vertex Pregnancies To Decrease The Primary Cesarean Rate: An Evidence-Based Practice Improvement Project, Megan Elizabeth Honaker

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Current statistics indicate cesarean section rates in nulliparous term singleton vertex (NTSV) pregnancies, a singleton first pregnancy > 37 weeks’ gestation in a vertex position, of 32.8% and rising. A peanut ball, a tool used to optimize pelvic opening and fetal head rotation, can decrease labor length and cesarean section rates. The aim of this evidence-based practice improvement project was to reduce the cesarean rate in NTSV pregnancies by 1% within three months. The project occurred in an urban 12-bed labor and delivery unit in Middle Tennessee. Participants included laboring women meeting NTSV criteria. METHOD: Plan- do- study- act cycles …

Temporal Trends And Predictors Of Surgical Ablation For Atrial Fibrillation In A Large Western Us Healthcare System, Scott Brancato, Mansen Wang, Kateri Spinelli, Alison Leiataua, James Brevig, Zachary M Deboard, Torin P. Fitton, Maheer Gandhavadi, Jonathan P. Piccini, Neil Worrall, Tyler J Gluckman

Articles, Abstracts, and Reports

No abstract provided.

05-04-21 Hsc Committee Meeting Agenda Revised, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

Effectiveness Of Ehr-Depression Screening Among Adult Diabetics In An Urban Primary Care Clinic, Filipina C. Schnabel Md, Mph, Msn, Fnp-Bc, Danielle Aldridge Msn, Fnp-C, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Background Diabetes mellitus (DM) and depression are important comorbid conditions that can lead to more serious health outcomes. The American Diabetes Association (ADA) supports routine screening for depression as part of standard diabetes management. The PHQ2 and PHQ9 questionnaires are good diagnostic screening tools used for major depressive disorders in Type 2 diabetes mellitus (DM2). This quality improvement study aims to compare the rate of depression screening, treatment, and referral to behavioral health in adult patients with DM2 pre and post-integration of depression screening tools into the electronic health record (EHR).

Methods We conducted a retrospective chart review on patients …

05-04-21 Hsc Committee Meeting Notice, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

Dnp Final Report: The Impact Of The Care Coordination Management Tool On Children With Special Health Care Needs, Keisia N. Sobers-Butler, Ms, Bsba, Rn, Cmcn

DNP Final Reports

Children with Special Health Care Needs (CSHCN) population, account for 30% of spending or $233.5 billion of the costs (Bui et al., 2017). Identifying barriers to care in the CSHCN population can be multi-faceted and complex incorporating high utilization of time, and clinical resources. This project aims to evaluate the impact of care coordination, and utilization on the CSHCN population through a Patient-centered Medical Home, use of embedded case management assessing this population through using the evidence-based Care

Coordination Management Tool (CCMT). CSHCN (N=117) and families were assessed using the CCMT at every interaction from September 1, 2020 – November …

Assessment Of Knowledge, Attitude, Perception Of Pharmacy Students Towards Telepharmacy, Komal Patel

Applied Research Projects

Telemedicine is one of the fastest growing area in health care technology and COVID-19 pandemic has changed the way of practicing Telemedicine. Telepharmacy is a part of telemedicine where pharmacy use this technology to provide patient care services. Success of any technology depends on users’ willingness to learn and attitude towards technology. Early assessment of students’ attitude during pharmacy school is important to know in order to assess how receptive students are to accept Telepharmacy in their work setting currently or in future. That will also help to determine success of Telepharmacy implementation. This study will focus on assessing knowledge, …

Rising Above The Challenge: Using An Enhanced Staffing Model To Improve Care For Covid-19 Patients, Anne Rabert Mhsa, Rn, Ccrn, Ne-Bc, Sandra Derbyshire Rn, Ccrn, Pamela Sellars Bsn, Rn, Ccrn

Posters

No abstract provided.

Promising Flex Program Initiatives To Support Critical Access Hospitals During The Covid-19 Pandemic, Celia Jewell Rn, Mph, Sara Kahn-Troster Mph, John Gale Ms

Rural Hospitals (Flex Program)

This brief reports on promising State Flex Program (SFP) strategies to support Critical Access Hospitals during the COVID-19 pandemic. SFPs adapted existing initiatives and implemented new activities to address the emerging needs of CAHs during the pandemic. With approval from the Federal Office of Rural Health, the SFPs redirected funds and activities to address the evolving COVID-19 needs of CAHs while maintaining fidelity to Flex Program goals. Based on qualitative interviews with seven SFPs, the authors, members of the Flex Monitoring Team, discuss initiatives such as resiliency training for frontline staff; packaging and dissemination of COVID-19 information; public health messaging; …

The Use Of Dmaic To Improve Quality Vaccination Recommendations In Chain Community Pharmacies, Urvi Patel

Applied Research Projects

Community pharmacies provide the convenience and ease of administrating vaccinations outside traditional settings. Vaccinations are health initiatives that protect communities and improve health outcomes in all populations. Despite their accessibility and supporting clinical data, various influential factors contribute to the current suboptimal rates of vaccine administration. Given the common barriers to vaccine administration, this research narrows down to address a specific barrier and attempts to implement a method that focuses on improving vaccine rates in community pharmacies. This research is a case study that utilizes the DMAIC model of lean six sigma and aims to use this quality improvement process …

Physician Burnout: Stress Within The Health Care System, Aidan Hauser

English Department: Research for Change - Wicked Problems in Our World

As our nation’s healthcare system expands, more stress and responsibility are placed on our physicians and frontline healthcare workers. The pressures of the daily job often prove extremely damaging to the employee’s mental and physical health. Physician and worker burnout is a growing epidemic that is damaging our care providers more and more every day. Burnout effects not only workers, but all of those surrounding them as well. This plague is not going to be repaired by one single change, but it is clear that many adjustments must be made to reform our healthcare system.

Laboratory Techniques In Public Health: Bi-520 Introduction To Public Health Lab Manual, Anuradha Srivastava

Open Educational Resources

This laboratory manual for a foundations course Public Health is unique in the sense that very rarely, a foundations course in the field has a lab component offered with the lecture. This lab manual provides basic laboratory exercises that could be useful to introduce undergraduate students to the basics of public health laboratory practices.

Macra And Accountable Care Organizations: Is It Working?, Bukola Abodunde, Chelsea Slater, Alberto Coustasse

Management Faculty Research

The purpose of this study was to examine how the Medicare Access and CHIP Reauthorization Act (MACRA) has improved health care delivery and to determine its impact on Accountable Care Organization (ACO) goals. ACOs have provided quality care through the reduction in readmission rates, coordinated care, and cost savings. With the passage of the MACRA, it has been estimated that it would further decrease Medicare spending on physician and hospital services. Also, ACOs have had a positive impact on improving health care delivery and have played a significant role in providing exceptional quality of care while also managing to increase …

Successful Distancing: Telemedicine In Gastroenterology And Hepatology During The Covid-19 Pandemic., Abhilash Perisetti M.B.B.S, M.D., Hemant Goyal

Other Specialties

Telemedicine involves delivering healthcare and preventative care services to patients without the need for in-person encounters. Traditionally, telemedicine has been used for acute events (e.g., stroke, used to relay essential information to the emergency department) and chronic disease management (e.g., diabetes and chronic kidney disease management). Though the utilization of telemedicine in gastroenterology and hepatology has been modest at best, especially for inflammatory bowel diseases and chronic liver disease management, since the onset of coronavirus disease 2019 (COVID-19) pandemic, utilization of telemedicine in gastroenterology increased by 4000% in the first two weeks, equivalent to the last six years of growth …

04-06-2021 Hsc Committee Agenda - Revised, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

04-06-21 Hsc Committee Agenda, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

04-06-21 Hsc Committee Notice, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.