Digital Commons Network^™

The Effects Of A Surrogate Provider System For Asynchronous Computerized Notifications Of Test Results In A Primary Care Resident Clinic, Michael Louie, Luke Yeager, Angela Dunn

Quality Improvement/Patient Safety Symposium

With the use of Electronic Medical Records (EMRs), there is a growing concern for the quality and safety of patient care among the sheer volume of information distributed and processed daily. Within the Veteran Affairs (VA) system, 37% of primary care providers report at least one patient missed test result within the previous two weeks leading to a diagnostic delay (Wahls and Cram 2007). Termed “view alerts,” these computerized notifications are the primary way information such as test results or nursing concerns are conveyed to the provider asynchronously. One study showed that VA providers received 58 “view alerts” per day …

Providing High Reliability Care For Picu Patients With Pulmonary Hypertension: A Quality Improvement Project, Anjali Subbaswamy, Nicholas Tan, Iric Guthrie, Kelsey Fath, Cole Linzmeyer, Elizabeth Yakes Jimenez

Quality Improvement/Patient Safety Symposium

Providing High Reliability Care for PICU Patients with Pulmonary Hypertension: A Quality Improvement Project

Anjali Subbaswamy, MD; Nicholas Tan, DO; Iric Guthrie, MD; Kelsey Fath, MD; Cole Linzmeyer, DO; Elizabeth Yakes Jimenez, PhD, RDN, LD

Purpose: Pediatric patients with pulmonary hypertension (PHTN) are a high acuity, low frequency population, and are often admitted to the pediatric intensive care unit (PICU). To mitigate the risk of precipitating a potentially life-threatening pulmonary hypertensive crisis, health care staff need to take specific precautions. This quality improvement (QI) project aims to increase the number of inpatient PHTN patients for whom PHTN precautions are applied …

Improving Pneumococcal Vaccination Adherence In Eligible Candidates Over 65 Years Of Age Per Uspft Guidelines At Westside Clinic, Meredith Keller, Ashley Wildman, Julia Howard, Leland Abrams, Erika Jones

Quality Improvement/Patient Safety Symposium

Background

Pneumococcal polysaccharide vaccine (PPSV23) is recommended to all adults 65 years and older, people 2 through 64 years with certain medical conditions and all adults older than 19 years who smoke. This vaccine prevents severe pneumococcal disease, reducing hospital admissions and risk of death. As part of a quality improvement project, a group Internal Medicine resident physicians with continuity clinic at the UNMH Westside Clinic sought to increase our vaccinations rates with PPSV23 in patients older than 65 years.

Methods

A list of 282 patients aged 65 or older receiving primary care at the UNMH Westside Clinic were identified …

Inpatient Prescription Drug Monitoring Program Usage At Unmh: A Pilot Qi Proposal To Decrease Prescription Opioid Misuse, Sally Midani Bs, Isabella Cervantes Ba, Isaac Lira Bs, Krista Dominguez-Salazar Pharmd, Phc3, Adriana R. Carrillo Pharmd, Sergio Huerta Md

Quality Improvement/Patient Safety Symposium

Opioid overdose is a worldwide epidemic, claiming the lives of almost 450,000 people from 1999-2018. Studies show that this number might be even higher, with an estimated 130 people dying daily from prescription opioid overdose as a staggering 11.4 million people currently misuse these potent medications. The implementation of state-based Prescription Drug Monitoring Programs (PDMP) has increased in recent years and may be responsible for the significant decrease in prescription opioid involved death rates in 2018, a 13.5% decline. The PDMP functions as a live online database where a patient’s prescription fill date, medication name, strength, supply, pharmacy and prescriber …

A Provider-Facing Dashboard To Monitor Hydroxychloroquine Dosing Within The Va Healthcare System: The Albuquerque Va Experience, Meredith Keller, David Cisneros, Kimberly Reiter, Gabriela Schmajuk

Quality Improvement/Patient Safety Symposium

Monitoring hydroxychloroquine dosages to avoid retinal toxicity in patients within the VA Healthcare System, a multi-site study

Background

Through the SFVA Measurement Science QUERI led by Principle Investigator Gabriela Schmajuk MD, the Albuquerque VA Healthcare System was enrolled in a multi-site study to identify patients with hydroxychloroquine doses greater than the recommended 5mg/kg to reduce the risk of retinal toxicity.

Methods

Using the Dashboard tool, patients with hydroxychloroquine doses greater than 5mg/kg were identified. Data about these patients, including weight, rheumatologic diagnoses, dosages, and prescribing providers was collected. The prescribing providers were then contacted with dosage recommendations.

Results or expected …

The Role Of Comorbidities And Social Determinants Of Health In Patients With Covid-19 In New Mexico, Lauren Epler, Tenzin Desel, Ariana Thompson, Samantha Paltrow-Krulwich, Susie Pham, Diamone Gathers Md, Krystal Chan Md

Quality Improvement/Patient Safety Symposium

Introduction

Comorbidities are associated with higher levels of morbidity and mortality in patients with COVID-19 infection. Minorities have been disproportionately affected by COVID-19. Additionally, minorities have high rates of comorbidities.

Methods

Students surveyed consented patients on RedCap who tested positive for COVID-19 infection and were seen in the UNM COVID-Follow up Clinic between April-October 2020 via telephone.

Results

125 patients. 52% Hispanic/Latino, 23% American Indian/Alaska Native, 16% white, 3% African American, 1% Asian, and 5% multiple race/ethnicities. 16% had vaped nicotine, 15% had vaped marijuana or cannabis, and 33% had smoked at least 100 cigarettes in their lifetime. 23% had …

Anal Cancer Screening At Truman Health Services, Peter D. Tran, Harshdeep Babbar

Quality Improvement/Patient Safety Symposium

Anal Papanicoloau Screening at Truman Clinic

Anal cancer is a squamous cell cancer associated with human papillomavirus (HPV), the same virus that is associated with cervical cancer. Although vaccination against HPV has been shown to be effective in reducing overall rates of infection, the number of new anal cancer cases has been rising for many years. In HIV-infected men and women, the incidence is even higher of anal cancer than in the general population. Current rates in an HIV-infected MSM population have been estimated to be as high as 70-144 per 100,000, with some studies of HIV-infected individuals showing that …

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) …

Enhanced Arthrocentesis Of The Flexed Knee With Pneumatic Compression, Sumir Brahmbhatt, Maheswari Muruganandam, Ahsan Iqbal, David Cisneros, Adnan Kiani, Nicole Suzanne Emil, Sharon Nunez, William Hayward, Philip Band, Wilmer Sibbitt Jr.

Quality Improvement/Patient Safety Symposium

Background/Objective: To explore an alternative to standard extended knee arthrocentesis using pneumatic compression of the flexed knee.

Methods: Using a paired sample design, 41 consecutive effusive knees underwent arthrocentesis in the flexed knee position first without and then with pneumatic compression of suprapatellar bursa. Arthrocentesis success and fluid yield in milliliters (ml) were measured. For comparison 41 consecutive patients who had undergone extended knee arthrocentesis without and with compression were also studied.

Results: Successful diagnostic arthrocentesis (≥ 3 ml) of the effusive flexed knee was 85% (35/41) without compression and increased significantly to 100% (41/41) with pneumatic compression (p=0.027). Synovial …

20210521_Hslic Welcomes George Hernandez, Sally Bowler-Hill

HSLIC Blog Post

No abstract provided.

Pediatric Residency Academic Rotation Improves Self-Rated Proficiency In Quality Improvement Skills, Maria Heubeck, Rebecca Craig, Taylor Ford, Lanier Lopez, Grace Mccauley, Elizabeth Yakes Jimenez

Quality Improvement/Patient Safety Symposium

Category: In-progress research

Title: Pediatric Residency Academic Rotation Improves Self-Rated Proficiency in Quality Improvement Skills

Maria Heubeck, MD; Rebecca Craig, MD; Taylor, Ford, MD; Lanier Lopez, MD; Grace McCauley, MPH; Elizabeth Yakes Jimenez, PhD, RDN, LD

Introduction: As of July 2020, all second-year pediatric residents participate in a one-month academic rotation. The rotation focuses on quality improvement (QI), research, education and leadership skills and experience. This project aims to assess the impact of the rotation on residents’ self-reported QI proficiency, self-rated motivation to pursue scholarly activities, and competency based on ACGME milestones.

Methods: Pediatric residents participating in the academic rotation …

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 …

20210520_Global Accessibility Day, Kelleen Maluski

HSLIC Blog Post

No abstract provided.

Memory Care Approaches To Better Leverage Capacity Of Dementia Specialists: A Narrative Synthesis, Jenny Lam, Soeren Mattke

Project ECHO Bibliography

Prior research suggests that a scarcity of dementia specialists could hamper access to disease-modifying Alzheimer’s treatments. We describe alternative approaches on how to leverage specialist time for memory care in this narrative synthesis based on 17 semi-structured interviews and a targeted literature review on memory care approaches that leverage specialist time. We identified four types of approaches: community primary care practices empowered with better tools and training; primary care memory clinics; specialty memory clinics and; specialty memory centers. Several approaches to use specialist time efficiently have been implemented and some but not all evaluated. The optimal approach may depend on …

Efficacy Of As04-Adjuvanted Vaccine Against Human Papillomavirus (Hpv) Types 16 And 18 In Clearing Incident Hpv Infections: Pooled Analysis Of Data From The Costa Rica Vaccine Trial And The Patricia Study, Joseph E. Tota, Frank Struyf, Allan Hildesheim, Paula Gonzalez, Martin Ryser, Rolando Herrero, John Schussler, Naveen Karkada, Ana Cecilia Rodriguez, Nicolas Folschweiller, Carolina Porras, Mark Schiffman, John T. Schiller, Wim Quint, Aimée R. Kreimer, Matti Lehtinen, Cosette M. Wheeler, Joshua N Sampson

Pathology Research and Scholarship

Clinical trial data and real-world evidence suggest that the AS04-adjuvanted vaccine targeting human papillomavirus types 16 and 18 (AS04-HPV-16/18) vaccine provides nearly 90% protection against cervical intraepithelial neoplasia grade 3 or higher irrespective of type, among women vaccinated before sexual debut. This high efficacy is not fully explained by cross-protection. Although AS04-HPV-16/18 vaccination does not affect clearance of prevalent infections, it may accelerate clearance of newly acquired infections. We pooled data from 2 large-scale randomized controlled trials to evaluate efficacy of the AS04-HPV-16/18 vaccine against clearance of nontargeted incident infections. Results of our analysis do not suggest an effect in …

20210518_Asian Pacific American Heritage Month & Action From The Health Sciences Library, Kelleen Maluski

HSLIC Blog Post

No abstract provided.

Iina Dziil Be’At’Iin (On The Path Of A Strong Life): Dine (Navajo) Perceptions Of Self-Care And Social Support With Diabetes Management, Chenoa Bah Stilwell-Jensen

Communication ETDs

ABSTRACT

Managing diabetes requires a detailed self-care regimen of physical activity, eating well, testing glucose, healthy weight maintenance, and positive emotional outlook in order to maintain health outcomes. Education, clear communication, and sufficient support are needed to address challenging aspects of daily self-care at the onset of diagnosis and throughout the management of the illness. However, many people diagnosed with diabetes are unable to successfully manage their condition. Native Americans are twice as likely to have diabetes than Whites. Although diabetes-related kidney failure and other negative health effects remain a concern among Native Americans, rates of kidney failure in this …

Satisfaction And Willingness To Recommend: Patient Experience In A Southwestern Healthcare Organization, Judy A. Sanchez

Nursing ETDs

This descriptive study examined perceptions of hospital care in a minority majority state within adult Hispanic white, American Indian, and non-Hispanic white patients using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. This secondary analysis of de-identified 2016-2018 data involved 10,181 patients discharged from two urban and five rural hospitals. Demographic variables included: race/ethnicity, preferred language, and hospital location. HCAHPS variables included: overall satisfaction, willingness to recommend, nurse communication, physician communication, responsiveness of hospital staff, pain management, medication communication, cleanliness and quietness, discharge information, and transition of care. Chi-square and loglinear analyses demonstrated that Hispanic whites, and …

Unm Hslic Organizational Chart 2021, Sally Bowler-Hill

HSLIC Organizational Charts

No abstract provided.

Exploring The Role Of Core Positive Selves With Men Convicted Of Child Sexual Offenses: A Character Strengths Initiative, Tiffany A. Miner

Individual, Family, and Community Education ETDs

The aim of this study was to help men convicted of child sexual offenses learn to recognize and engage their character strengths over 12 months. Participants were six men convicted of contact and noncontact (internet) child sexual offenses. All participants were members of a community-based reintegration group for registered citizens. In the first weeks of the study, participants received the Values in Action Inventory of Strengths survey. The survey, containing 240 questions—10 items for each of the 24 character strengths outlined—helped participants identify their top character strengths. The study explored (a) how the men could use their character strengths to …

The Impacts Of Disturbance On Submerged Aquatic Macrophytes Populations Of The Jemez Mountains, New Mexico, Virginia Frances Thompson

Biology ETDs

This dissertation investigates the effects of disturbance (a catastrophic forest fire and decadal-level multi-day flood) on populations of submerged aquatic macrophytes (SAMs) in the streams and rivers of the Jemez Mountains of northern New Mexico, USA. Research conducted and reported in this dissertation addresses the following research questions: 1.) What factors influence the presence or absence of SAMs in Jemez Mountain streams? 2.) How does disturbance (catastrophic wildfire and decadal-level flood) change the amount of aboveground SAM biomass? and 3.) How does that disturbance change the nutrient content (%C, %N, %P) and nutrient stoichiometry of SAMs? These disturbance events had …

Health Impacts Of Wildfire Smoke As A Consequence Of Climate Change And Recommendations For Public Health Officials And The General Public In The Albuquerque Metropolitan Area, Jegason Diviant

Climate Change and Public Health Preparedness

No abstract provided.

Molecular Characterization Of A Unique Population Of Human Cortical Interneurons; Implications For Primate-Specific Development, Crina Peterson

Biomedical Sciences ETDs

The human brain consists of 86 billion neurons compared to rodent brain, which consists of 75 million neurons, and the underlying mechanisms for the increased complexity of the primate cortex are not fully elucidated. However, an increase in specific cell populations, including calretinin-expressing (CALB2/CR) interneurons (INs), has been identified. In my thesis work, I demonstrate that human pluripotent stem cells (hPSCs) differentiated to neurons by default patterning give rise to this CR population in vitro, providing a method to study their development.

Chapter I reviews cortical development and hPSCs as an appropriate proxy for studying human cortical development. Chapter …

Exploring The Relationship Between Vehicular Emissions And Traffic Operations At Isolated Signalized Intersections, Abiral Dulal

Civil Engineering ETDs

Most roadway transportation modes still run on petroleum fuels. Petroleum fuels are major sources of air pollutants, including hydrocarbons (HC), carbon monoxide (CO), carbon dioxide (CO₂), nitrogen oxides (NO and NO₂, which are together called NOx), Volatile Organic Compounds (VOCs), and particulate matter of size(PM10) and2 and BC). Mitigating pollution is a serious issue, and therefore, it is the engineers' and planners' responsibility to study and reduce emissions as much as possible. Emission levels are generally high at street intersections, which are places where vehicles tend to accelerate, decelerate, and idle. Emission levels at intersections are …

20210514_Your Library - At A Glance, Tamara Wheeler

HSLIC Blog Post

No abstract provided.

Effects Of Environmental Change On Ancestral Pueblo Fishing In The Middle Rio Grande, Jonathan William Dombrosky

Anthropology ETDs

It has long been assumed that fishes were unimportant in the diet of past Pueblo people in the U.S. Southwest. Yet, small numbers of fish remains are consistently recovered from Late pre-Hispanic/Early Historic archaeological sites in the Middle Rio Grande of New Mexico. The end of drought conditions may have impacted food choice and fishing decisions during this time. I use behavioral ecology to understand how fishing could have been an optimal food-getting strategy for Ancestral Pueblo farmers. Stable isotope analysis offers a way to account for environmental change. I provide a refined ¹³C Suess correction model to support …

Women’S Resilience Through Bullying Vernaculars: A Visual Vernacular Discourse Analysis, Karla Ibet Ochoa

Communication ETDs

This study shows the importance of understanding the vernaculars of resilience in relationship to bullying. In this thesis, I explore the public expressions of resilience from three women of color who experienced bullying and have become anti-bullying activists. I explore how the women construct public vernaculars of resilience and perform resilience. I drew on Feminist Standpoint Theory to conduct a visual vernacular discourse analysis of public expressions. The vernaculars discovered through analyzing the public expressions were resilience, self-expression, activism, and all voices matter. These vernaculars and performances reveal women’s feminist standpoints through the work that they do and release to …

20210512_Celebrating Nurses, Ingrid C. Hendrix

HSLIC Blog Post

No abstract provided.

Biopsychosocial Multidisciplinary Treatment Impact On Risk Of Opioid Misuse, Michael A. Palacio

Doctor of Nursing Practice Scholarly Projects

From 1999 to 2014, over 165,000 persons in the United States died from an overdose related to prescription opioids (Centers for Disease Control and Prevention [CDC], 2016). In response, the CDC released guidelines that propose nonpharmacologic and nonopioid pharmacologic therapy as preferred methods for chronic pain control (Dowell et al., 2016). The purpose of this project was to examine the biopsychosocial multidisciplinary treatment impact on risk of opioid medication misuse among adult chronic opioid-dependent noncancer pain clinic patients with and without a psychiatric disorder. Engel’s (1977) biopsychosocial model was used to evaluate whether multidisciplinary treatment impacted the risk of opioid …

Integrating Library-Related Competencies Into Residency Curricula, Deborah J. Rhue, Jonathan Eldredge

Posters and Presentations

No abstract provided.