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A Quality Improvement Project To Determine The Incidence And Prevalence Of Obstructive Sleep Apnea, Best Practice Anesthesia Guidelines, And The Incidence Of Perioperative Cardiac And Respiratory Complications After The Implementation Of The Stop-Bang Questionnaire, Bradly Diamond, Gregory Guerrier, Cody Holliman, Robert Marrero, Tyler Nelson 2019 The University of Southern Mississippi

A Quality Improvement Project To Determine The Incidence And Prevalence Of Obstructive Sleep Apnea, Best Practice Anesthesia Guidelines, And The Incidence Of Perioperative Cardiac And Respiratory Complications After The Implementation Of The Stop-Bang Questionnaire, Bradly Diamond, Gregory Guerrier, Cody Holliman, Robert Marrero, Tyler Nelson

Doctoral Projects

Patients with obstructive sleep apnea (OSA) are at risk for perioperative respiratory and cardiovascular compromise (Opperer et al., 2016). Unfortunately, almost 90% of patients with moderate-to-severe OSA are not diagnosed and unaware of their disorder; however, they remain at increased perioperative risks (Singh et al., 2015). The STOP-BANG questionnaire was developed to meet the need for a reliable, concise, and efficient screening tool for OSA risk. The facility at which this project was conducted did not utilize a prescreening OSA risk tool. The facility not using a prescreening OSA risk tool is especially important because the State of Mississippi currently ...


A Unique Model For Perinatal Palliative Care In A Level Iv Neonatal Intensive Care Unit, Kelstan L. Ellis DO, Megan Tucker MD 2019 Childrens Mercy Kansas City

A Unique Model For Perinatal Palliative Care In A Level Iv Neonatal Intensive Care Unit, Kelstan L. Ellis Do, Megan Tucker Md

Research Days

No abstract provided.


Improved Coordination Of Care For Picu Patients With Newly Diagnosed Anterior Mediastinal Masses, Laura McCarthy 2019 Children's Mercy Hospital

Improved Coordination Of Care For Picu Patients With Newly Diagnosed Anterior Mediastinal Masses, Laura Mccarthy

Presentations

This presentation describes a quality improvement project to develop a multi-disciplinary standardized approach for prompt surgical intervention to establish a diagnosis of anterior mediastinal mass. The aim was to decrease the time from presentation to surgical diagnostic procedure to <24 hours for all patients with newly diagnosed AM masses. An Anterior Mediastinal Mass Recommended Pathway was developed to improve communication and reduce time to diagnosis and treatment.


Short-Interval Self-Learning To Improve Retention Of Resuscitation Skills: A Randomized Controlled Trial, Ryuhei Sato, Chika Nishiyama, Kosuke Kiyohara, Makiko Sano, Tasuku Matsuyama, Tomonari Shimamoto, Toshihiro Hatakeyama, Taku Iwami 2019 Kyoto University

Short-Interval Self-Learning To Improve Retention Of Resuscitation Skills: A Randomized Controlled Trial, Ryuhei Sato, Chika Nishiyama, Kosuke Kiyohara, Makiko Sano, Tasuku Matsuyama, Tomonari Shimamoto, Toshihiro Hatakeyama, Taku Iwami

International Journal of First Aid Education

The optimal interval and methods for cardiopulmonary resuscitation (CPR) retraining remain unclear. We evaluated the difference in CPR skills one year after a 45-minute chest compression-only CPR training among participants receiving short self-learning refresher training at 3-month intervals, those receiving this training at 6-month intervals, and those without the refresher training.

Participants were randomly assigned to the 3-month group, 6-month group, or control group. Resuscitation skills were assessed immediately after the initial training, and at 1 year after the training. The primary endpoint was the number of chest compressions performed with appropriate depth one year after the training. Among 129 ...


Propofol Infusion Syndrome: A Serious Complication With A Commonly Used Drug In The Icu, Hernando Castillo MS, Jaimin Patel DO, Nathan Brewster DO, Swetangini Patel P3, Brian Civic MD 2019 USF MCOM- LVHN Campus

Propofol Infusion Syndrome: A Serious Complication With A Commonly Used Drug In The Icu, Hernando Castillo Ms, Jaimin Patel Do, Nathan Brewster Do, Swetangini Patel P3, Brian Civic Md

Department of Medicine

No abstract provided.


A Refractory Case Of Severely Uncontrolled Eosinophilic Asthma On Maximal Therapy, William Ueng MPH, Jaimin Patel DO, Nathan Brewster DO, Swetangini Patel P3, Andres Zirlinger MD 2019 USF MCOM- LVHN Campus

A Refractory Case Of Severely Uncontrolled Eosinophilic Asthma On Maximal Therapy, William Ueng Mph, Jaimin Patel Do, Nathan Brewster Do, Swetangini Patel P3, Andres Zirlinger Md

Department of Medicine

No abstract provided.


An Uncommon Complication Of A Common Medication: Diffuse Alveolar Hemorrhage Secondary To Supratherapeutic Inr, Nathan Brewster DO, Christopher Lenivy DO, Kareem Godil MD, Andres Zirlinger MD 2019 Lehigh Valley Health Network

An Uncommon Complication Of A Common Medication: Diffuse Alveolar Hemorrhage Secondary To Supratherapeutic Inr, Nathan Brewster Do, Christopher Lenivy Do, Kareem Godil Md, Andres Zirlinger Md

Department of Medicine

No abstract provided.


The Influence Of Body Mass Index On Survival And Length Of Stay In Patients With Septic Shock, Yasir Jawaid, Waseem Ahmed, Damir Kusmic, Aman Ajmeri, Kanaan Mansoor, Cristie Mannino, Thomas Judge, Larry E. Carter, Akash V. Ajmera 2019 Marshall University

The Influence Of Body Mass Index On Survival And Length Of Stay In Patients With Septic Shock, Yasir Jawaid, Waseem Ahmed, Damir Kusmic, Aman Ajmeri, Kanaan Mansoor, Cristie Mannino, Thomas Judge, Larry E. Carter, Akash V. Ajmera

Akash Ajmera

Background: Obesity is one of the most widespread epidemics of our time. In fact, currently 65.7% of US adults age 20 and older are overweight, while 30.6% are obese. It has been well-established that obesity has numerous adverse effects on long-term health, however the specific effect on patients treated for sepsis and septic shock is unclear. Body Mass Index (BMI) is a measure of total body fat content and surrogate marker for obesity. In our study, we aimed to identify if BMI was an independent risk factor for poor survival or increased length of stay (LOS) in patients ...


Stressed Out With Sepsis., Robert Hilton, Michael Baram 2019 Thomas Jefferson University

Stressed Out With Sepsis., Robert Hilton, Michael Baram

Division of Pulmonary and Critical Care Medicine Faculty Papers

No abstract provided.


Icatibant Is Not Helpful For The Treatment Of Ace Inhibitor-Induced Angioedema, Samantha R. Schwartz 2019 Wayne State University School of Medicine

Icatibant Is Not Helpful For The Treatment Of Ace Inhibitor-Induced Angioedema, Samantha R. Schwartz

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Sinert R, Levy P, Bernstein JA, et al. Randomized trial of icatibant for angiotensin-converting enzyme inhibitor-induced upper airway angioedema. J Allergy Clin Immunol Pract. 2017; 5(5): 1402-1409. doi: 10.1016/j.jaip.2017.03.003.


Bova Is Superior To Spesi In Identification Of High Risk Pulmonary Embolism Patients, J. DiBello, P. Khaing, E. Gupta, C. Au, T. Chengsupanimit, B. K. Awsare, M. Baram, F. M. West, G. C. Kane 2019 Thomas Jefferson University

Bova Is Superior To Spesi In Identification Of High Risk Pulmonary Embolism Patients, J. Dibello, P. Khaing, E. Gupta, C. Au, T. Chengsupanimit, B. K. Awsare, M. Baram, F. M. West, G. C. Kane

Phase 1

Introduction: Prognostic models exist for the purpose of stratifying patients with acute pulmonary embolism. Of these, the Pulmonary Embolism Severity Index (PESI) and the simplified PESI (sPESI) are the most well-known, although more recent composite models, like the BOVA score, are now being studied and implemented. Comparative efficacy of these scores to predict long term mortality is not well established.

Methods: We performed a retrospective analysis of all consecutive patients diagnosed with PE using computed tomography scan from 2014-2016 at an urban tertiary-referral medical center. Cox proportional hazard analyses were performed to compare the performance of two prognostic models – sPESI ...


Severity Of Disease And Mortality For Hospitalized Patients With Community-Acquired Viral Pneumonia Compared To Patients With Community-Acquired Bacterial Pneumonia, Richard Y. Kim, Thomas Chandler, Stephen P. Furmanek, Timothy Lee Wiemken, Rodrigo Cavallazzi 2019 University of Louisville

Severity Of Disease And Mortality For Hospitalized Patients With Community-Acquired Viral Pneumonia Compared To Patients With Community-Acquired Bacterial Pneumonia, Richard Y. Kim, Thomas Chandler, Stephen P. Furmanek, Timothy Lee Wiemken, Rodrigo Cavallazzi

The University of Louisville Journal of Respiratory Infections

Background: There exists a large body of literature to help identify, diagnose, treat, and manage community-acquired pneumonia (CAP). Despite this, there is little data that directly compares the clinical syndromes and complications of pure bacterial pneumonia to pure viral pneumonia. Our study compares the clinical presentation, morbidity and mortality of viral vs. bacterial etiologies of CAP.

Methods: This was a secondary data analysis of the Community-Acquired Pneumonia Organization (CAPO) international study database. Data was collected concerning patient demographics, physical examination findings, laboratory findings, radiological findings, severity of illness, and clinical outcomes and stratified according to the two study groups, CAVP ...


Kangaroo Mother Care And Traditional Care, Arianna Smola, Kirsten Lawson 2019 The University of Akron

Kangaroo Mother Care And Traditional Care, Arianna Smola, Kirsten Lawson

Williams Honors College, Honors Research Projects

Prematurity and low birth weight are leading causes of infant death. Throughout recent years care methods for this population have evolved from incubator care to Kangaroo Mother Care (KMC). The purpose of this systematic review was to answer the following PICO question: in the case of preterm and low birth weight (LBW) infants, how does the technique of Kangaroo Mother Care (KMC) compare to traditional incubator use, regarding long and short-term outcomes of preterm and LBW infant recovery. Methods of this study included the selection of twenty peer-reviewed articles that studied the effect of incubators and KMC on premature and ...


General Philippine Hospital, Manila, Philippines, Cara Cecil 2019 Chlldren's Mercy Hospital

General Philippine Hospital, Manila, Philippines, Cara Cecil

Posters

Describes her experience working in the Philippine General Hospital/University of the Philippines providing care in the pediatric ICU, neonatal ICU, and emergency department.


Analgesia And Sedation Medication Use In Infants With Congenital Diaphragmatic Hernia Is Associated With Adverse Outcome, Mark Weems, Theresa Grover, Robert DiGeronimo, Jason Gien, Ruth Seabrook, Sarah Keene, Natalie Rintoul, Beverly Brozanski, John Daniel, Rachel Chapman, Burhan Mahmood, Yvette Johnson, Yigit Guner, Holly Hedrick, Isabella Zaniletti, Karna Murthy 2019 Children's Mercy Hospital

Analgesia And Sedation Medication Use In Infants With Congenital Diaphragmatic Hernia Is Associated With Adverse Outcome, Mark Weems, Theresa Grover, Robert Digeronimo, Jason Gien, Ruth Seabrook, Sarah Keene, Natalie Rintoul, Beverly Brozanski, John Daniel, Rachel Chapman, Burhan Mahmood, Yvette Johnson, Yigit Guner, Holly Hedrick, Isabella Zaniletti, Karna Murthy

Posters

This study describes the use and variation of sedation and analgesic medications as well as short-term clinical outcomes in infants with congenital diaphragmatic hernia.


"Sterile Cockpit": How Utilizing Aviation Regulations Can Reduce Errors In Ecmo Procedures, Sarah P. Jimenez, Johanna I. Orrick, Kari L. Davidson, Debra E. Newton 2019 Children's Mercy Hospital

"Sterile Cockpit": How Utilizing Aviation Regulations Can Reduce Errors In Ecmo Procedures, Sarah P. Jimenez, Johanna I. Orrick, Kari L. Davidson, Debra E. Newton

Posters

The "Sterile Cockpit Rule," developed in 1981 as an aviation regulation, was adapted by the ECMO core team to promote a distraction-free environment during critical ECMO procedures. Upon review of the data including tracking of interruptions, errors, and staff experience, it is evident that the concept of Sterile Cockpit has streamlined procedure efficiency, as well as safety.


Keep The Beat With Heart Failure Education: A Quality Improvement Project, Brenda L. Peterson 2018 University of San Francisco

Keep The Beat With Heart Failure Education: A Quality Improvement Project, Brenda L. Peterson

Master's Projects and Capstones

Abstract

Problem: Heart failure (HF), also known as congestive heart failure (CHF), is the number one diagnosis-related group (DRG) for people 65 years of age and older in the United States. This disease group is complicated and debilitating, requiring frequent hospitalizations with high mortality rates. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has identified CHF as an area for improvement in hospitals.

Context: This was a quality improvement project for an integrated medical center in the Central Valley, California with over 19,000 HF patients. In 2018, for patients 65 years and older, HF is the third-most admitted ...


Vitamin C In The Treatment Of Septic Shock, Alyson O. Shaughnessy, Matthew Tieszen 2018 James Madison University

Vitamin C In The Treatment Of Septic Shock, Alyson O. Shaughnessy, Matthew Tieszen

Physician Assistant Capstones

Objective:To assess the efficacy of improving outcomes of septic shock treatment with the addition of Vitamin C to standard treatment compared to standard therapy alone. To assess whether or not Vitamin C has a favorable outcome in the treatment of septic shock in terms of decreasing duration of vasopressor usage, reducing duration of intensive care unit (ICU) stay, and improving mortality.

Design: Systematic literature review.

Methods: Searches were conducted in PubMed and Google Scholar using the terms ascorbic acid, sepsis, septic shock, and vasopressors. In PubMed the following filters were used: humans only, clinical trials, studies within the past ...


Defining Electronic-Prescribing And Infusion-Related Medication Errors In Paediatric Intensive Care - A Delphi Study., Moninne Howlett, Brian J. Cleary, Cormac V. Breatnach 2018 Royal College of Surgeons in Ireland

Defining Electronic-Prescribing And Infusion-Related Medication Errors In Paediatric Intensive Care - A Delphi Study., Moninne Howlett, Brian J. Cleary, Cormac V. Breatnach

School of Pharmacy Articles

BACKGROUND: The use of health information technology (HIT) to improve patient safety is widely advocated by governmental and safety agencies. Electronic-prescribing and smart-pump technology are examples of HIT medication error reduction strategies. The introduction of new errors on HIT implementation is, however, also recognised. To determine the impact of HIT interventions, clear medication error definitions are required. This study aims to achieve consensus on defining as medication errors a range of either technology-generated, or previously unaddressed infusion-related scenarios, common in the paediatric intensive care setting.

METHODS: This study was conducted in a 23-bed paediatric intensive care unit (PICU) of an ...


Should We Use The Impact-Model For The Outcome Prognostication Of Tbi Patients? A Qualitative Study Assessing Physicians' Perceptions, Jesse Moskowitz, Thomas Quinn, Muhammad W. Khan, Lori Shutter, Robert J. Goldberg, Nananda Col, Kathleen M. Mazor, Susanne Muehlschlegel 2018 University of Massachusetts Medical School

Should We Use The Impact-Model For The Outcome Prognostication Of Tbi Patients? A Qualitative Study Assessing Physicians' Perceptions, Jesse Moskowitz, Thomas Quinn, Muhammad W. Khan, Lori Shutter, Robert J. Goldberg, Nananda Col, Kathleen M. Mazor, Susanne Muehlschlegel

Kathleen M. Mazor

Introduction. Shared Decision-Making may facilitate information exchange, deliberation, and effective decision-making, but no decision aids currently exist for difficult decisions in neurocritical care patients. The International Patient Decision Aid Standards, a framework for the creation of high-quality decision aids (DA), recommends the presentation of numeric outcome and risk estimates. Efforts are underway to create a goals-of-care DA in critically-ill traumatic brain injury (ciTBI) patients. To inform its content, we examined physicians' perceptions, and use of the IMPACT-model, the most widely validated ciTBI outcome model, and explored physicians' preferences for communicating prognostic information towards families. Methods. We conducted a qualitative study ...


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