Research Priorities For Therapeutic Plasma Exchange In Critically Ill Patients, Sascha David, Lene Russell, Pedro Castro, Andry Van De Louw, Lara Zafrani, Tasneem Pirani, Nathan D. Nielsen, Eric Mariotte, Bruno L. Ferreyro, Jan T. Kielstein, Luca Montini, Anne C. Brignier, Matthias Kochanek, Joan Cid, Chiara Robba, Ignacio Martin-Loeches, Marlies Ostermann, Nicole P. Juffermans

Pathology Research and Scholarship

Therapeutic plasma exchange (TPE) is a therapeutic intervention that separates plasma from blood cells to remove pathological factors or to replenish deficient factors. The use of TPE is increasing over the last decades. However, despite a good theoretical rationale and biological plausibility for TPE as a therapy for numerous diseases or syndromes associated with critical illness, TPE in the intensive care unit (ICU) setting has not been studied extensively. A group of eighteen experts around the globe from different clinical backgrounds used a modified Delphi method to phrase key research questions related to "TPE in the critically ill patient". These …

Increasing Nutritional Assessment For Inpatient Adolescents: A Quality Improvement Project, Karen Abich Carracedo, Kelsey Soppet, Melissa Sanchez

Quality Improvement/Patient Safety Symposium

Eating disorders are a group of conditions characterized by severe disturbances in eating behaviors and associated with distressing emotions and thoughts. There are many subtypes with specific diagnostic thresholds. Major risk factors include female sex, age, low self-esteem, perfectionism, depression, anxiety, and genetic dysregulations. Prevalence data for American Adolescents is variable.

Currently, our institution does not have a consistent method for asking questions regarding nutrition and eating behaviors. The first step in identifying suspicious behaviors that could clue a provider into disordered eating is to ask questions regarding nutrition and eating behaviors in a standardized assessment.

For this quality improvement …

Medication For Opioid Use Disorder During Pregnancy - Maternal And Infant Network To Understand Outcomes Associated With Use Of Medication For Opioid Use Disorder During Pregnancy (Mat-Link), 2014-2021, Kathryn Miele, Shin Y. Kim, Rachelle Jones, Juneka H. Rembert, Elisha M. Wachman, Hira Shrestha, Michelle L. Henninger, Teresa M. Kimes, Patrick D. Schneider, Vaseekaran Sivaloganathan, Katherine A. Sward, Vikrant G. Deshmukh, Pilar M. Sanjuan, Jessie R. Maxwell, Neil S. Seligman, Sarah Caveglia, Judette M. Louis, Tanner Wright, Carolyne Cody Bennett, Caitlin Green, Nisha George, Lucas Gosdin, Emmy L. Tran, Dana Meaney-Delman, Suzanne M. Gilboa

Pediatrics Research and Scholarship

PROBLEM: Medication for opioid use disorder (MOUD) is recommended for persons with opioid use disorder (OUD) during pregnancy. However, knowledge gaps exist about best practices for management of OUD during pregnancy and these data are needed to guide clinical care.

PERIOD COVERED: 2014-2021.

DESCRIPTION OF THE SYSTEM: Established in 2019, the Maternal and Infant Network to Understand Outcomes Associated with Medication for Opioid Use Disorder During Pregnancy (MAT-LINK) is a surveillance network of seven clinical sites in the United States. Boston Medical Center, Kaiser Permanente Northwest, The Ohio State University, and the University of Utah were the initial clinical sites …

Saving The Microbiome One Phlegm At A Time: Sputum Collection In The Ed For Patients Admitted With Pneumonia, Joanna Watterson, Jessica Mitchell, Elyse Sheehan, Meghan Brett

Quality Improvement/Patient Safety Symposium

Problem Identification

Patients brought into the Emergency Department (ED) with pneumonia who require admission often receive broad-spectrum antibiotics, due to high acuity and desire to cover an array of possible pathogens. While this is reasonable, broad-spectrum antibiotics come with potential harms to both the individual patient and the community at large, and efforts should be made to narrow coverage as soon as possible, usually informed by culture data and sensitivities. To this end, IDSA guidelines for hospital acquired pneumonia currently recommend antibiotic treatment based on culture data, over empiric treatment[i]. However, culture data takes time. Therefore, antibiotic stewardship …

Referral Triage To Improve Neurology Access, Melinda Mata

Doctor of Nursing Practice Scholarly Projects

The demand for neurology consultation far outweighs the number of specialists, thus causing long wait-times for consultation. Other contributing factors to obtaining timely consultation include, quality of information sent with the referral, insurance authorization, triage process, and appointment availability. This retrospective quality improvement study explored the effects of a referral triage process on reducing appointment wait time. All referrals were sent to one fax number and a new standard referral and triage process was implemented with specific operators with defined roles and responsibilities. The initial results following intervention implementation did not show improvement in wait times. Comparing the new triage …

Increasing Utilization Of Free Prescription Vouchers Among Native American Patients, Heather Yerdon, Gina Giazzoni, Joseph Schripsema, Radha Denmark, Trevor Olsen

Quality Improvement/Patient Safety Symposium

INTRODUCTION The Sandia and Manzano mountains were inhabited by the Pueblos as far back as the 1300s 1. In 1932 the US government built a tuberculosis sanatorium for Native Americans on the land next to the current University of New Mexico (UNM) Hospital, eventually becoming the US Government Indian Hospital, a regional medical center for Native Americans. However, as the population of Bernalillo County grew, the county wanted to operate a hospital to serve non-Native patients on this land. In 1952 the Pueblo Native American governors agreed to give up their land encompassing the Indian Hospital for the government-funded construction …

Racial And Ethnic Influence On Diabetes Mellitus Prevalence In Uranium Miners, Laila Lobo, Kevin Vlahovich, Maria Johana Zambrano, Sher Ali Khan, Asma Qamruddin, Hossein Azadi

Quality Improvement/Patient Safety Symposium

Background: Uranium (U) exposure may increase risk of developing Diabetes Mellitus (DM). U-miners may be at increased risk of DM due to occupational U exposure. American Indians (AI) are a vulnerable population with a high rate of DM and may be at greater risk of developing DM due to U exposure than are U-miners of other races/ethnicities. Our aim is to assess DM prevalence in U-miners among different races/ethnicities.

Methods: This was a retrospective cohort study using survey data from former U-Miners in the Radiation Exposure Screening & Education Program at University of New Mexico (UNM) from 4/1/2005-9/30/2022. Age, …

One Size Does Not Fit All: Increasing Access To Specialized Growth Curves For Pediatric Populations, Mikayla Pulliam, Kelsey Soppet, Crystal C. Avila-Schroder, Justin Hessinger, Jennifer Garcia

Quality Improvement/Patient Safety Symposium

Background/gap

Assessing the growth pattern of pediatric patients using standardized growth curves is the gold standard for monitoring nutritional status of children. The CDC and WHO growth curves are reference tools available in the Cerner EMR system currently used at UNMH. These tools are used to plot the height, weight and head circumference of children to ensure appropriate growth throughout development.

There are pediatric populations in which the CDC or WHO standardized growth curves may not be ideal. Some pediatric conditions present with unique growth patterns and require assessment of growth on both standardized and specialized charts. We have identified …

Reducing The Environmental Impact Of Cbp Surgery: Economic And Environmental Considerations Of Desflurane Replacement, Bethany Sanchez, Joseph Freeman, Angela Akbarpour, Ranjani Venkataramani, Karyn Nunez

Quality Improvement/Patient Safety Symposium

INTRODUCTION: Atmospheric concentrations of inhaled anesthetic gasses are estimated to be 100,000 times lower than carbon dioxide, but responsible for an estimated 10-15% of anthropogenic forcing of climate. Desflurane is a particularly potent greenhouse gas, with each kg of desflurane heating the atmosphere as much as 3,714 kgs of CO₂. Isoflurane is also a potent greenhouse gas, but has a lower environmental impact, is more widely used for cardiac surgeries around the United States, and costs less than desflurane. Additionally, healthcare costs can be reduced by making small changes without sacrificing high value care.

AIM: This …

A Retrospective Chart Review Of Causes Of Mortality Following Pci: The University Of New Mexico Hospital Experience, Yusra Azhar, Kenneth Matt Zabel, James Blankenship

Quality Improvement/Patient Safety Symposium

Background

Recent advances in coronary interventional practice have decreased complication rates and improved procedural success rates. Despite this, mortality after coronary intervention remains a problem.

Clinical databases such as the American College of Cardiology, National Cardiovascular Data CathPCI Registry do not contain enough information to determine the specific cause of death after PCI

AIM

• To identify primary cause of death after PCI at the University of New Mexico (UNM).
• Identify complications from PCI and their contribution to death.
• Identify opportunities for improvement in care of patients undergoing PCI at (UNM) .

Methods

• Chart Review: The University of New Mexico electronic …

Implementing A New Patient Flow Management System At The Addiction And Substance Abuse Program (Asap), Ali Nakip, Mario Cruz, Jordie Martin, Juhee Patel, Neil Alessio, Steve Montoya, John Ngo, Zeynep Behjet

Quality Improvement/Patient Safety Symposium

No abstract provided.

A Simple Method Of Improving Retention-In-Care For Persons Living With Hiv, Ana-Alicia Leonso

Quality Improvement/Patient Safety Symposium

HIV, retention in care, Truman Health Services, CD 4, viral transmission, contact information, preferred contact method, text message

Fall Risk Reduction Qi At The Senior Health Clinic, Alexander Deradke, Louise Leduc, Debra Waters, Matthew Schlough

Quality Improvement/Patient Safety Symposium

Background

Falls in older adults are a major source of morbidity and mortality. In 2020, 33.4% of New Mexican patients over the age of 65 reported a fall in the last year which ranked as the third highest rate in the United States. Given the shortage of primary care physicians in New Mexico preventing falls and falls-related injuries is key to serving our aging population.

Objectives

Patients registering at the Senior Health Clinic have been asked for years if they have had a fall in the last year. Although this data is recorded, it has not been used to implement …

Improved Tracking And Referrals For Vision And Dental Care For Patients With Hiv, Kory Tillery, Michelle Iandiorio

Quality Improvement/Patient Safety Symposium

BACKGROUND

Regular vision and dental care are important components of healthcare for persons with HIV (PWH). HIV infection is associated with a wide array of complications for both ocular and oral health regardless of severity of HIV disease. Ocular disease can range from opportunistic or associated infections (i.e cytomegalovirus retinitis, ocular syphilis); to inflammatory or degenerative disease (i.e retinal vasculopathy, optic neuropathy), or drug effects. Oral disease similarly encompasses infectious and noninfectious etiologies, including opportunistic infections (i.e., candidiasis, oral hairy leukoplakia), comorbid infections (i.e. herpes simplex virus, human papilloma virus, periodontitis/gingivitis), or inflammatory conditions (i.e. salivary gland disease). The Health …

Standardization Of The Workflow For Collecting And Intervening On Social Determinant Of Health Data In A Community-Based Ambulatory Clinic, Tenzin Yangchen, Hamza Altaie, Ashten Duncan

Quality Improvement/Patient Safety Symposium

Problem identification: Social determinants of health (SDOH) are community-related social, economic, and physical conditions that influence patients’ health far in excess of what the direct provision of health care can achieve. Although the Joint Commission (TJC) recently published requirements for universal SDOH screening and intervention for accreditation purposes, many medical practices in New Mexico still have very low rates of screening and intervention, leading to suboptimal health outcomes for our patients. At CHRISTUS St. Vincent Family Medical Center in Santa Fe, the rates of SDOH screening and intervention have been around 2-3% based on current workflow processes and competing …

Differences In Length Of Stay (Los) For The Adult General Medicine Population Compared To Patients With Social Determinants Of Health For The University Of New Mexico Hospital (Unmh), Vanessa Krajeck, Joshua M. Garcia

Quality Improvement/Patient Safety Symposium

Introduction:

The University of New Mexico Department of Internal Medicine Office of Quality & Safety evaluated the differences in length of stay (LOS) for the adult general medicine population compared to patients with social determinants of health (specific ICD-10 z-codes) for the University of New Mexico Hospital (UNMH). The hypothesis was patients with documented social determinants of health had a longer LOS index compared to patients that did not have social determinants of health. A LOS >1 index indicates a higher than expected LOS based on risk models. A LOS >1 indicates an opportunity for documentation or system process changes. …

Improving Patient Safety With A Pressure Injury Prevention Bundle In A Urban Intensive Care Unit, Radha Denmark, Cassie Belzer, Christopher Bartlett

Quality Improvement/Patient Safety Symposium

Gap Identification/Background

About 2.5 million Americans in acute care facilities develop a hospital-acquired pressure injury (HAPI) each year, with an incidence up to 45% in intensive care settings (ICUs)¹ costing $75,000-$150,000 per patient². They are painful, reduce quality of life, and increase morbidity and mortality, resulting in 60,000 deaths annually in the United States.²

Guideline recommendations are that HAPI prevention begins with a comprehensive risk assessment that is not dependent on a single risk tool since no single tool is comprehensive. However, a chart audit conducted in a 24-bed trauma-surgical intensive care unit (TSICU) of a …

Difficult Conversations: Practicing Delivering Bad News With Pediatric Residents Through Simulation Curriculum, Morgan Day, Jodi Mayfield, Justin Hessinger, Lanier Lopez

Quality Improvement/Patient Safety Symposium

Problem (Gap) Identification/Background

Students, residents, and attendings report that delivering bad news is stressful.¹ In a study of pediatric residents, only 27% reported that they felt comfortable delivering bad news to parents of a seriously ill child, though 90% perceived this to be a very important skill.² Given that up to 10% of children can be expected to have a moderate or severe long-term health problem, this is a skill that should be developed during training.² Additionally, reports have indicated that initial communication of bad news can negatively³ or positively⁴ affect adjustment to the diagnosis. …

Examining Interprofessional Communication In Healthcare, Devin Alexander Maez

Quality Improvement/Patient Safety Symposium

INTRODUCTION

Interprofessional communication is an essential tool for providing strong patient care in healthcare settings, particularly in large public hospitals like University of New Mexico Hospital. Several care teams are often involved in the care of one patient (physicians, nurses, PT/OT, pharmacy, etc.). When communication breaks down between care teams, patient care can be greatly diminished or compromised. Lack of coordination and communication amongst different care teams can either affect the patients both directly or indirectly in many ways, potentially leading to extended hospital stays and various poor health outcomes. Several challenges specifically within healthcare settings exist that best exemplify …

Aging And Learning: Community Engagemente And Self-Efficacy In L2 Teaching To Elderly Learners, Leticia Rinaldi Souza

Spanish and Portuguese ETDs

The elderly population (60 years or older) has been increasing during the past decades around the world and is expected to reach two billion by 2050 (Scult, Haime, et al 2015). However, the misconception that elderly people are uncapable, or incompetent is still part of the imaginary constructed around such populations (Minichiello and Coulson, 2005). Older adults present powerful functional capacities and social activities lead to better performance and slower decreases in their memory and executive function (Scott, Masser, & Pachana, 2020). Thus, second language learning plays an effective role in enabling active and regular engagement in social and psychological …

The Bias Of New Mexico Nurses In A Residency Program Toward People Experiencing Homelessness, Tolulope Kabir Fijabi

Doctor of Nursing Practice Scholarly Projects

ABSTRACT

There is growing evidence that healthcare workers do not provide equivalent levels of care to patients of different social groups. This group includes the population of people experiencing homelessness and the number continues to grow simultaneously across U.S. Studies have also shown that the poor and the marginalized experiences disappointment in the healthcare industry due to negative attitudes such as stereotyping, bias, and prejudice from healthcare providers limiting them from accessing care when necessary. With growing research on the influence of the experience of trauma among people experiencing homelessness, there is a lack of trauma-informed services as it relates …

Civility Intervention In A Private Ambulatory Clinic, Steve D. Fusselman

Doctor of Nursing Practice Scholarly Projects

Healthcare workers commonly face incivility in the workplace. This quality improvement project aimed to employ evidence-based practices to help improve self-perception about workplace civility using Dr. Cynthia Clark’s Workplace Civility Index (WCI)© 20-item Likert questionnaire and an educational intervention on civility. The impact of incivility in the workplace is undeniable, contributing to lower morale, absenteeism, decreased productivity, impaired communication, job burnout, and resignations. An exploratory factor analysis confirmed the reliability of WCI© as a beneficial instrument for measuring a company's capacity for civility. Finally, this project revealed that incorporating the WCI© with an educational intervention had a significant impact and …

Telehealth Monitoring For Non-Hospitalized Covid-19 Positive Patients In A Rural Setting, Rebekah Leann French

Doctor of Nursing Practice Scholarly Projects

Purpose

This quality improvement project evaluates the efficacy of an outpatient COVID-19 telehealth monitoring program intended to increase access to care, decrease emergency room/urgent care visits, and hospital admissions among telehealth observed adult patients in a rural area while providing safe home monitoring during acute illness.

Rationale/Background

Prior to COVID-19 pandemic, healthcare systems within the United States encountered several challenges including healthcare inequality and decreased healthcare access, particularly in rural communities. These gaps became more apparent when a novel COVID-19 pandemic emerged straining healthcare systems in the United States and throughout the world. Challenges ranged from overwhelmed emergency room (ER) …

Key Takeaways For Knowledge Expansion Of Early-Career Scientists Conducting Transdisciplinary Research In Energetics And Cancer (Trec): A Report From The Trec Training Workshop 2022, Che-Pei Kung, Meghan B. Skiba, Erika J. Crosby, Jessica Gorzelitz, Mary A. Kennedy, Bethany A. Kerr, Yun Rose Li, Sarah Nash, Melanie Potiaumpai, Amber S. Kleckner, Dara L. James, Michael F. Coleman, Ciaran M. Fairman, Gloria C. Galván, David O. Garcia, Max J. Gordon, Mathilde His, Lyndsey M. Hornbuckle, So-Youn Kim, Tae-Hyung Kim, Amanika Kumar, Mélanie Mahé, Karen K. Mcdonnell, Jade Moore, Sangphil Oh, Xinghui Sun, Melinda L. Irwin

Pathology Research and Scholarship

The overall goal of the annual Transdisciplinary Research in Energetics and Cancer (TREC) Training Workshop is to provide transdisciplinary training for scientists in energetics and cancer and clinical care. The 2022 Workshop included 27 early-to-mid career investigators (trainees) pursuing diverse TREC research areas in basic, clinical, and population sciences. The 2022 trainees participated in a gallery walk, an interactive qualitative program evaluation method, to summarize key takeaways related to program objectives. Writing groups were formed and collaborated on this summary of the 5 key takeaways from the TREC Workshop. The 2022 TREC Workshop provided a targeted and unique networking opportunity …

20230503_Choose Privacy Every Day, Robyn Gleasner

HSLIC Blog Post

No abstract provided.

05-09-2023 Hsc Committee Agenda, Hsc Committee

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

No abstract provided.

Perceptions Of Nursing Staff On Restraint Alternatives, Adelia S. Perea

Doctor of Nursing Practice Scholarly Projects

Physical restraint is often used as a nursing intervention for patients with behavioral issues despite current evidence that indicates their use is actually more harmful than helpful. Nursing staff at UNMH are required by policy to use other methods such as restraint alternatives before placing patients in restraint. However, they do not have the necessary resources or tools to comply with the policy. The NPCU conducted a quality improvement project that introduced 5 restraint alternatives followed by a survey focused on nursing perceptions. The results revealed 2 alternatives (Gamewright GoPOP sensory toy & Playtivity sensory disc) were perceived by nursing …

Determinants Of Demand Response Program Participation, Janie M. Chermak, Jesse Ian Kaczmarski, Benjamin A. Jones

SMART Grid Center (NM EPSCoR RII V)

Survey instrument and codebook for the analysis reported in:

Kaczmarski, Jesse, Benjamin Jones, and Janie Chermak. 2022. "Determinants of Demand Response Program Participation: Contingent Valuation Evidence from a Smart Thermostat Program" Energies 15, no. 2: 590. https://doi.org/10.3390/en15020590

The survey instrument can be accessed via the "Download" link.

Accompanying files include a README. Information from the README file is also included below.

Per the consent language in the included survey instrument, raw data from the reported study are not publicly available.

GENERAL INFORMATION

Title of Dataset: Determinants of Demand Response Program Participation

Principal Investigator Information Name: Janie Chermak, ORCID: N/A, Institution: …

Heterogeneity Of Treatment Effects Of Hydrocortisone By Risk Of Bronchopulmonary Dysplasia Or Death Among Extremely Preterm Infants In The National Institute Of Child Health And Human Development Neonatal Research Network Trial: A Secondary Analysis Of A Randomized Clinical Trial, Samuel J. Gentle, Matthew A. Rysavy, Lei Li, Matthew M. Laughon, Ravi M. Patel, Erik A. Jensen, Susan Hintz, Namasivayam Ambalavanan, Waldemar A. Carlo, Kristi Watterberg, National Institute Of Child Health And Human Development Neonatal Research Network

Pediatrics Research and Scholarship

IMPORTANCE: Extremely preterm infants who develop bronchopulmonary dysplasia (BPD) are at a higher risk for adverse pulmonary and neurodevelopmental outcomes. In the National Institute of Child Health and Human Development Neonatal Research Network (NICHD NRN) Hydrocortisone Trial, hydrocortisone neither reduced rates of BPD or death nor increased rates of neurodevelopmental impairment (NDI) or death.

OBJECTIVE: To determine whether estimated risk for grades 2 to 3 BPD or death is associated with the effect of hydrocortisone on the composite outcomes of (1) grades 2 to 3 BPD or death and (2) moderate or severe NDI or death.

DESIGN, SETTING, AND PARTICIPANTS: …

Assessment Of Corticosteroid Therapy And Death Or Disability According To Pretreatment Risk Of Death Or Bronchopulmonary Dysplasia In Extremely Preterm Infants, Erik A. Jensen, Laura Elizabeth Wiener, Matthew A. Rysavy, Kevin C. Dysart, Marie G. Gantz, Eric C. Eichenwald, Rachel G. Greenberg, Heidi M. Harmon, Matthew M. Laughon, Kristi L. Watterberg, Michele C. Walsh, Bradley A. Yoder, Scott A. Lorch, Sara B. Demauro, Eunice Kennedy Shriver National Institute Of Child Health And Human Development Neonatal Research Network

Pediatrics Research and Scholarship

IMPORTANCE: Meta-analyses suggest that corticosteroids may be associated with increased survival without cerebral palsy in infants at high risk of bronchopulmonary dysplasia (BPD) but are associated with adverse neurologic outcomes in low-risk infants. Whether this association exists in contemporary practice is uncertain because most randomized clinical trials administered corticosteroids earlier and at higher doses than currently recommended.

OBJECTIVE: To evaluate whether the pretreatment risk of death or grade 2 or 3 BPD at 36 weeks' postmenstrual age modified the association between postnatal corticosteroid therapy and death or disability at 2 years' corrected age in extremely preterm infants.

DESIGN, SETTING, AND …