Patient Safety Commons^™

Quality Of Icu Discharge Summaries Produced By Pediatric Residents: The Memorial Health University Medical Center Experience, Jessica M. Lee, James Ryden, Emma Meehan, Eric Shaw, Mary C. Lytle, Andrew Stack, Ashley Shearman

HCA Healthcare Journal of Medicine

Background

Discharging intensive care unit (ICU) patients directly home is becoming more common. High-quality ICU discharge summaries are crucial in the transition of patient care. Currently, at Memorial Health University Medical Center (MHUMC), there exists no standardized ICU discharge summary template or consistency when discharge documentation is completed. Investigators evaluated the timeliness and completeness of ICU discharge summaries at MHUMC produced by pediatric residents.

Methods

A single-center retrospective chart review of pediatric patients discharged directly from a 10-bed Pediatric ICU to home was conducted. Charts were evaluated pre- and post-intervention. The intervention included the implementation of a standardized ICU discharge …

History Of Falls, Mild Cognitive Impairment, And The Presence Of Home Environmental Hazards Among Community-Dwelling Older Persons In District V, Manila, Marilou J. Raval, Donald S. Lipardo

Philippine Journal of Physical Therapy

Introduction: It is important to investigate factors that may increase the fall risk in the geriatric population. This study aimed to determine the relationship between: 1) mild cognitive impairments (MCI) and history of falls; 2) home environmental hazards (HEH) and history of falls; and 3) MCI and HEHs among older adults.

Methods: Community-dwelling older persons of District V, Manila were random sampled to participate in this cross-sectional correlational study. The Home Falls and Accidents Screening Tool for Health Professionals (HOMEFAST-HP) and Fall History Questionnaire were used to collect information on the presence of HEH and history of falls, respectively. Chi-Square …

Postpartum Depression For Mothers With Early Fetal Death Or Stillbirths, Callie Goldman

Symposium of Student Scholars

Background: Many times, prevention of early fetus death and stillbirths is possible; however, some mortality events are spontaneous or unavoidable. While existing research reveals the likelihood of postpartum depression for mothers following birth, few studies address the potential for postpartum depression of mothers of stillbirth or demised fetuses. The purpose of this study is to determine how mothers can be better prepared for the hardship of losing a baby during childbirth, while going through common difficulties, such as postpartum depression, following birth. Methods: A mixed method approach will be conducted to gather qualitative (interview) and quantitative (Edinburgh Postnatal Depression Scale …

Alternative Precautionary Measures Yielding Lower C. Diff Infection Rates In Healthcare Facilities, Matthew Kramer

Symposium of Student Scholars

Background: An international healthcare concern is the persistent spread of Clostridium difficile, a Gram-positive spore forming bacterium that is responsible for the most common hospital-acquired infection, amongst patients.

Objective: A systematic review was performed to summarize evidence that the interventions utilized in healthcare facilities which indicate a patient’s precautionary status are insufficient, outdated, and commonly lead to infection in neighboring patient rooms. Databases such as PubMed, NCBI, Google Scholar, and APHA’s Medical Care were searched, covering the period from 2017-2022. Studies were included if their focus concentrated on C. diff and the precautionary measures taken by employees at healthcare …

Identifying Cultural Biases And Understanding Health Care Disparities For Lgtbq+ Patients, Jevon Nelson

Nursing | Senior Theses

Understanding the health disparities within the LGBTQ+ population, will consist of educating Nurses and other healthcare providers cultural competence for this population, along with proposing certain educational training programs for all the medical professionals. There’s not only an implicit bias but also lack in quality of healthcare due to the personal reasons that healthcare providers may have, along with certain stigmas that creates an infringement on healthcare for this specific population. Members of the LGBTQ+ community will continue to have one of the highest amounts of health care disparities due to the lack of cultural incompetence if nothing is done.

Substance Use Among Nurses As A Result Of Covid-19, And The Impact Of Rehabilitative Programs On Nurses, Gerome Macaspac

Nursing | Senior Theses

Background: The incidence of substance use among nurses has been a persistent issue for decades. The effects associated with substance misuse depend on what is used, the amount, how often, and how they are taken. Regardless of the substance used, any nurse who enters the workplace using substances puts the lives of others at risk. Due to the widespread effects of the COVID-19 pandemic, there is a risk that the number of nurses resorting to the use of substances may have increased. Therefore, an investigation into drug use among nurses during the pandemic is particularly important.

Objective: To explore the …

Psychometric Properties Of The Sindhi Version Of The Mood And Feelings Questionnaire (Mfq) In A Sample Of Early Adolescents Living In Rural Pakistan, Janavi Shetty, Florence Perquier, Susan C. Campisi, Yaqub Wasan, Madison Aitken, Daphne J. Korczak, Suneeta Monga, Sajid Bashir Soofi, Peter Szatmari, Zulfiqar Ahmed Bhutta

Centre of Excellence in Women and Child Health

There is a need for reliable and valid screening tools that assess depressive symptoms in adolescents in Pakistan. To address this need, the present study examined the psychometric properties and factor structure of a Sindhi-translated and adapted version of the child-report Mood and Feelings Questionnaire (MFQ-C) and the Short Mood and Feelings Questionnaire (SMFQ-C) in a community sample of adolescents living in Matiari, Pakistan. Questionnaires were translated into Sindhi and administered by study psychologists to 1350 participants (52.3% female) 9.0 to 15.9 years old. Measurement structure was examined using confirmatory factor analysis. Internal consistency was estimated, and convergent and divergent …

Public Satisfaction With Covid-19 Vaccination Program In Saudi Arabia, Muhammad Waseem Shahzad, Adel Al-Shabaan, Ammar Mattar, Bilal Salameh, Eman M. Alturaiki, Waleed A. Alqarni, Khalid A. Alharbi, Turki M. Alhumaidany

Patient Experience Journal

The challenges posed by the ongoing COVID-19 pandemic have required the introduction of new care delivery models and procedures. For the foreseeable future, vaccine administration will be a key part of the patient experience journey. It is important therefore to understand and evaluate experiences of individuals taking the vaccination, an area which requires considerable attention. To address this, the COVID-19 Vaccination Satisfaction survey was developed and administered at several healthcare facilities across Saudi Arabia. Between January 2021 and end of December 2021, a total of 1,699,177 completed surveys were collected. The survey results suggest high satisfaction among participants taking the …

Cost Analysis Of Implementing An Exercise Program For Fall And Fracture Prevention In Older Adults On Proton Pump Inhibitor Therapy, Thomas Adam Wichelmann, Nhan Dang, David H. Kruchko, Sufyan Abdulmujeeb, Eli D. Ehrenpreis

Journal of Patient-Centered Research and Reviews

Purpose: Falls have significant financial impact. Proton pump inhibitor (PPI) therapy is associated with an increased risk of falls and fractures. Exercise programs have been shown to decrease risk of falls in the elderly population and are recommended by the U.S. Preventive Services Task Force for patients over age 65 to reduce falls. Our study aimed to explore the potential financial benefit of implementing three different Centers for Disease Control and Prevention-recommended exercise-based interventions for fall prevention (Tai Chi, Stepping On, and Otago Exercise Program) in ≥ 65-year-old patients on PPI therapy.

Methods: A Markov model was developed to predict …

Patient Perspectives On Opioid Risk Discussions In Primary Care, Stephanie A. Hooker, Inih J. Essien, Caitlin M. Borgert-Spaniol, Rebecca C. Rossom, Anthony W. Olson, Katrina M. Romagnoli, Leif I. Solberg

Journal of Patient-Centered Research and Reviews

Purpose: Both patients and clinicians have described discussions of potential opioid risks as challenging. This study’s goal was to understand patient perspectives on discussing opioid risks with primary care clinicians (PCCs).

Methods: Patients identified to be at elevated risk for problems with opioids (ie, opioid use disorder [OUD] diagnosis, taking a medication for OUD, or having ≥ 3 opioid prescriptions in the last year) were recruited from an integrated, Upper Midwest health system to participate in semi-structured qualitative interviews. Interview questions aimed to better understand patient views on conversations about opioid risks with PCCs and perceptions of OUD screening and …

Eye Safety In Dentistry, Marie T. Fluent Dds, Cdipc

The Journal of the Michigan Dental Association

In this article, Dr. Fluent underscores the importance of eye safety from vision loss that ended her clinical dental career. The article emphasizes the prevalence of ocular injuries in occupational settings, with about 2,000 U.S. workers suffering job-related eye injuries daily. Dental professionals face multiple eye hazards, including flying debris, chemicals, and infectious materials. Protective eyewear is crucial, with the CDC and OSHA recommending its use.

A significant concern is the "bottom gap" in protective eyewear, which exposes dental personnel to risks. The article introduces a new ANSI standard, ANSI/ISEA Z87.62-2021, to standardize eye and face protection against bloodborne pathogens …

Dentistry And The Law: Dealing With Patients Who Have Been Using Marijuana, Dan Schulte Jd

The Journal of the Michigan Dental Association

When dealing with patients who emit a strong marijuana odor, it's crucial to focus on their capacity to provide informed consent and the ability to deliver treatment up to the standard of care. Judging their level of intoxication solely by appearance and smell can be unreliable, so it's best to avoid making such judgments. Instead, inform patients that you may refuse treatment if their odor or other factors hinder your ability to provide care. To prevent last-minute issues, communicate this policy in advance, particularly to patients with a history of marijuana odor. Dismissing such patients from your practice may also …

Mda At Your Service: What Is The Recommendation Regarding Prescribing Clindamycin?, Eric Tye Dds, Angela Kanazeh Ms, Cmp

The Journal of the Michigan Dental Association

The MDA at Your Service Column addresses member resources available from the MDA. This month presents guidance in prescribing practices, particularly regarding clindamycin. Clindamycin’s association with an increased risk of antibiotic-associated diarrhea, including Clostridioides difficile (C. diff) infection, has increased. The report highlights how to access an ADA clinical guideline, its preference for azithromycin over clindamycin, and the warning associated with prescribing clindamycin. Further reference is available in the August 2020 MDA Journal article "Antibiotic Guidelines for Dentistry: Who, When, What, Why and How to Prescribe,” by Elaine Bailey, PharmD, and Marie Fluent, DDS. Additional member resources discussed in this …

J Mich Dent Assoc October 2022

The Journal of the Michigan Dental Association

Monthly, The Journal of the Michigan Dental Association brings news, information, and feature articles to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• A cover story on eye safety to reduce occupational risk of eye injury in clinical dentistry.
• A feature story on a dentist’s journey with Bell’s Palsy.
• A department reports on legal issues caring for patients suspected of being under the influence of marijuana.
• Department article on workforce and employees quietly quitting.
• Articles on MDA Public Relations Grant Recipients …

Quantifying And Predicting Real-World Iatrogenic Severe Hypoglycemia In Adults With Type 1 Or 2 Diabetes Mellitus (The Inphorm Study, United States), Alexandria A. Ratzki-Leewing

Electronic Thesis and Dissertation Repository

Clinical outpatient strategies to accurately predict diabetes-related iatrogenic severe hypoglycemia (SH) are lacking. To redress this gap, we conducted the first-ever prognosis investigation of guideline-defined (Level 3) SH in the United States (US) (iNPHORM).

Chapter 4 details the design and implementation of iNPHORM: a prospective 12-wave panel survey (2020–2021). N=1206 adults with type 1 or insulin- and/or secretagogue-treated type 2 diabetes mellitus (T1DM or T2DM) were recruited from a US-wide, probability-based internet panel. For one-year, we collected monthly data on SH occurrence (frequencies, detection methods, symptoms, causes, and treatments) and related factors (anthropometric, sociodemographic, clinical, environmental/situational, behavioural, and psychosocial).

iNPHORM …

Frequency Of Bystander Exposure To Antibiotics For Enteropathogenic Bacteria Among Young Children In Low-Resource Settings, Elizabeth T. Rogawski Mcquade, Stephanie A. Brennhofer, Sarah E. Elwood, Timothy L. Mcmurry, Joseph A. Lewnard, Estomih R. Mduma, Sanjaya Shrestha, Najeeha Talat Iqbal, Pascal O. Bessong, Gagandeep Kang

Department of Paediatrics and Child Health

Children in low-resource settings carry enteric pathogens asymptomatically and are frequently treated with antibiotics, resulting in opportunities for pathogens to be exposed to antibiotics when not the target of treatment (i.e., bystander exposure). We quantified the frequency of bystander antibiotic exposures for enteric pathogens and estimated associations with resistance among children in eight low-resource settings. We analyzed 15,697 antibiotic courses from 1,715 children aged 0 to 2 y from the MAL-ED birth cohort. We calculated the incidence of bystander exposures and attributed exposures to respiratory and diarrheal illnesses. We associated bystander exposure with phenotypic susceptibility of E. coli isolates in …

Menstrual Irregularities Following Covid-19 Vaccination: A Global Cross-Sectional Survey, Azza Sarfraz, Zouina Sarfraz, Muzna Sarfraz, Zainab Nadeem, Miguel Felix, Ivan Cherrez-Ojeda

Department of Paediatrics and Child Health

Introduction: The coronavirus disease 2019 (COVID-19) vaccination generates protective immunity against SARS-CoV-2 infection. There is no clear evidence of COVID-19 vaccine-induced menstrual irregularities.
Objective: To identify potential menstrual irregularities following COVID-19 vaccine among females.
Methods: A worldwide cross-sectional survey study was conducted from June 10, 2021, to July 10, 2021 using online mediums. The survey consisted of 15 questions divided into baseline characteristics, vaccination status and dosage, menstruation and relate factors, and thoughts and knowledge about menstrual irregularities. Non-probability convenience sampling method was used including 510 responses. The results were tabulated, with bivariate analysis and chi-square test results. The sensitivity …

“High Spending, Poor Productivity Gains!” Assessing Public Health System (In)Efficiency And Hospital Performance In The State Of Kuwait: Would More Private Delivery Improve Healthcare?, Aljawhara Alsabah

NYMC Student Theses and Dissertations

The healthcare sector in the State of Kuwait has been nurtured for many decades by the government, where the majority of health services in the country are controlled by the Ministry of Health (MoH). Although healthcare services in public sector hospitals are at highly subsidized rates, causing private sector involvement in healthcare to be considerably low, the growing demands for private delivery of care burgeoned participation of private hospitals in Kuwait, and improving hospital efficiency and productivity is more critical and timelier than ever. This dissertation aims to analyze public health system efficiency and hospital performance in the State of …

Omicron Spike Function And Neutralizing Activity Elicited By A Comprehensive Panel Of Vaccines, John E. Bowen, Amin Addetia, Ha V Dang, Cameron Stewart, Jack T. Brown, William K. Sharkey, Kaitlin R. Sprouse, Kumail Ahmed, Asefa Shariq Ansari, Najeeha Talat Iqbal

Department of Paediatrics and Child Health

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant of concern comprises several sublineages, with BA.2 and BA.2.12.1 having replaced the previously dominant BA.1 and with BA.4 and BA.5 increasing in prevalence worldwide. We show that the large number of Omicron sublineage spike mutations leads to enhanced angiotensin-converting enzyme 2 (ACE2) binding, reduced fusogenicity, and severe dampening of plasma neutralizing activity elicited by infection or seven clinical vaccines relative to the ancestral virus. Administration of a homologous or heterologous booster based on the Wuhan-Hu-1 spike sequence markedly increased neutralizing antibody titers and breadth against BA.1, BA.2, BA.2.12.1, BA.4, and …

Emergency Care For Youth Who Experience Suicidality And Identify As Lesbian Gay Bisexual Transgender Queer/Questioning (Lgbtq+): An Interpretive Phenomenology, Theresa Schultz

Electronic Theses and Dissertations

Purpose: Suicide is a leading cause of death in children; youth who identify as LGBTQ+ are at an exponentially higher risk of suicide. The purpose of this study was to explore the lived experiences of young adults who identify as LGBTQ+ and sought emergency care for suicidality when they were adolescents.

Methods: Heideggerian hermeneutics phenomenology is the research method used in this study. Youth, ages 18-25 years, who identify as LGBTQ+ and sought emergency treatment for suicidality when they were adolescents (13-17 years) were recruited to participate;fifteen youth enrolled. Individuals ranged in age from 20 to 25 years. Participants described …

Esophageal Carcinoma And Associated Risk Factors: A Case-Control Study In Two Tertiary Care Hospitals Of Kabul, Afghanistan, Ramin Saadaat, Jamshid Abdul-Ghafar, Ahmed Maseh Haidary, Nooria Atta, Tazeen Saeed Ali

Community Health Sciences

Purpose: Esophageal cancer (EC) is the most common cancer among males in Afghanistan, thus we aimed to conduct a case-control study to determine the associated risk factors with EC in two tertiary care hospitals of Kabul, Afghanistan.
Patients and methods: We enrolled 132 EC cases and 132 controls and used conditional logistic regression to estimate the odds ratio (OR) with consideration of 95% confidence interval (CI).
Results: The results of our study revealed that esophageal squamous cell carcinoma (ESCC) was the predominant type of EC constituting 75.8% of the cases. The results of the multivariate logistic analysis showed that males …

Effect Of Wearing Masks In The Hospital On Patient-Provider Interaction: “They (Providers) Need To Stay Safe For Their Family And Keep Us Safe.”, Jana L. Wardian, Mikayla Peralta, Chad Vokoun, Sarah E. Richards

Patient Experience Journal

Since March 2020 when the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic was widespread in the U.S., masks became a primary form of protection for healthcare workers when caring for patients. While wearing masks was not a new phenomenon in the health field, there is little known on how the use of them affects the patient-provider relationship. This study explored the experience of wearing masks on the patient-provider relationship in the hospital. This qualitative study involved interviews with both providers and patients at an academic hospital in the Midwest. At the time of this study, in July 2021, hospital …

Multicomponent Approach To Delirium Prevention In The Acute Care Setting: An Evidence-Based Quality Improvement Project., Kelley James

Doctor of Nursing Practice Papers

Background: Acutely ill, hospitalized individuals are at an increased likelihood of developing delirium. Between 30-35% of those patients admitted to the hospital will develop delirium, and as a result, these individuals will face an increased risk of mortality, adverse medical events, restraint usage, and incur a more extended hospitalization. The literature supports early screening utilizing the Confusion Assessment Method (CAM) tool and nurse-driven, multicomponent interventions to aid in preventing its development.

Environment: This project was implemented in a long-term, acute care facility specializing in patients requiring long-term mechanical ventilation, advanced wound care, pulmonary and respiratory care, and the rehabilitation of …

Case Report: Axilla Fibroadenoma - An Atypical Presentation, Safna Naozer Virji, Lubna Mushtaque Vohra, Syeda Sakina Abidi, Romana Idress

Department of Surgery

No abstract provided.

The Impact Of The Covid-19 Pandemic On Patients With Chronic Liver Disease: Results From The Global Liver Registry, Zobair M. Younossi, Yusuf Yilmaz, Mohamed El-Kassas, Ajay Duseja, Saeed Hamid, Gamal Esmat, Nahum Méndez-Sánchez, Wah Kheong Chan, Ashwani K. Singal, Brian Lam

Department of Medicine

Patients with preexisting chronic liver disease (CLD) may experience a substantial burden from both coronavirus 2019 (COVID-19) infection and pandemic-related life disruption. We assessed the impact of the COVID-19 pandemic on patients with CLD. Patients enrolled in our Global Liver Registry were invited to complete a COVID-19 survey. As of June 2021, 2500 patients (mean age ± SD, 49 ± 13 years; 53% men) from seven countries completed the survey. Of all survey completers, 9.3% had COVID-19. Of these patients, 19% were hospitalized, 13% needed oxygen support, but none required mechanical ventilation. Of all patients including those not infected with …

A Retrospective Analysis Of Endocrine Disease In Sphingosine-1-Phosphate Lyase Insufficiency: Case Series And Literature Review, Avinaash Maharaj, Ruth Kwong, Jack Williams, Christopher Smith, Helen Storr, Ruth Krone, Debora Braslavsky, Maria Clemente, Nanik Ram, Indraneel Banerjee

Section of Diabetes, Endocrinology and Metabolism

Sphingosine-1-phosphate lyase (SGPL1) insufficiency syndrome (SPLIS) is an autosomal recessive multi-system disorder, which mainly incorporates steroid-resistant nephrotic syndrome and primary adrenal insufficiency. Other variable endocrine manifestations are described. In this study, we aimed to comprehensively annotate the endocrinopathies associated with pathogenic SGPL1 variants and assess for genotype-phenotype correlations by retrospectively reviewing the reports of endocrine disease within our patient cohort and all published cases in the wider literature up to February 2022. Glucocorticoid insufficiency in early childhood is the most common endocrine manifestation affecting 64% of the 50 patients reported with SPLIS, and a third of these individuals have additional …

Association Of U.S. Birth, Duration Of Residence In The U.S., And Atherosclerotic Cardiovascular Disease Risk Factors Among Asian Adults, Mahmoud Al Rifai, Sina Kianoush, Vardhmaan Jain, Parag H. Joshi, Miguel Cainzos-Achirica, Khurram Nasir, Anwar T. Merchant, Sunita Dodani, Sally S. Wong, Zainab Samad

Section of Cardiology

Introduction: Prior studies have shown a direct association between U.S. birth and duration of residence with atherosclerotic cardiovascular disease (ASCVD) though, few have specifically focused on Asian Americans.
Methods: We utilized cross-sectional data from the 2006 to 2015 National Health Interview Survey. We compared prevalent cardiovascular risk factors and ASCVD among Asian American individuals by U.S. birth and duration of time spent in the U.S.
Results: The study sample consisted of 18,150 Asian individuals of whom 20.5 % were Asian Indian, 20.5 % were Chinese, 23.4 % were Filipino, and 35.6 % were of other Asian ethnic groups. The mean …

Estimating The Pre- And Post-Diagnosis Costs Of Tuberculosis For Adults In Pakistan: Household Economic Impact And Costs Mitigating Strategies, Shama Razzaq, Aysha Zahidie, Zafar Fatmi

Community Health Sciences

Background: Despite free tuberculosis (TB) care in Pakistan, patients still have to bear high costs, which push them into poverty. This study estimated the pre- and post-diagnosis costs households bear for TB care, and investigated coping mechanisms among adults ≥ 18 years in Karachi, Pakistan.
Methods: We conducted a cross-sectional study comprising of 516 TB patients identified with completion of at least one month intensive treatment from four public sector health facilities from two institutes in Karachi, Pakistan. A standardized questionnaire to estimate patient's costs was administered. The study outcomes were direct medical and non-medical costs, and indirect costs. The …

Can Variables From The Electronic Health Record Identify Delirium At Bedside?, Ariba Khan, Kayla Heslin, Michelle Simpson, Michael L. Malone

Journal of Patient-Centered Research and Reviews

Delirium, a common and serious disorder in older hospitalized patients, remains underrecognized. While several delirium predictive models have been developed, only a handful have focused on electronic health record (EHR) data. This prospective cohort study of older inpatients (≥ 65 years old) aimed to determine if variables within our health system’s EHR could be used to identify delirium among hospitalized patients at the bedside. Trained researchers screened daily for delirium using the 3-minute diagnostic Confusion Assessment Method (3D-CAM). Patient demographic and clinical variables were extracted from the EHR. Among 408 participants, mean age was 75 years, 60.8% were female, and …

Is Home Blood Pressure Monitoring Effective At Controlling Hypertension In African American Patients? A Clin-Iq, Rebecca Nye, Wilhelm Lehmann, Deborah Simpson

Journal of Patient-Centered Research and Reviews

African Americans are disproportionately affected by hypertension, a modifiable contributor to multiple chronic diseases and premature death. Primary care physicians play an important role in hypertension control. Home blood pressure monitoring (HBPM) is an evidence-based method for confirming diagnosis and monitoring hypertension over time. Some studies have found that HBPM may lead to clinically relevant reductions in blood pressure when combined with additional interventions, but few studies have focused specifically on African American populations. Evidence of effectiveness could increase clinical recommendation of HBPM. This clinical inquiry examined whether HBPM improves blood pressure control in African Americans with uncontrolled hypertension. Reviewed …