Medicine and Health Sciences Commons^™

Interpreting Covid-19 Deaths Among Nursing Home Residents In The Us: The Changing Role Of Facility Quality Over Time, Debasree Das Gupta, Uma Kelekar, Sidney C. Turner, Anupam A. Sule, Taya G. Jerman

Kinesiology and Health Science Faculty Publications

A report published last year by the Centers for Medicare & Medicaid Services (CMS) highlighted that COVID-19 case counts are more likely to be high in lower quality nursing homes than in higher quality ones. Since then, multiple studies have examined this association with a handful also exploring the role of facility quality in explaining resident deaths from the virus. Despite this wide interest, no previous study has investigated how the relation between quality and COVID-19 mortality among nursing home residents may have changed, if at all, over the progression of the pandemic. This understanding is indeed lacking given that …

J Mich Dent Assoc September 2021

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry 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 with “Reports from the Dental School Deans”, Dr. Mert Aksu and Dr. Laurie McCauley.
• A feature article from the Journal’s DEI series, “Building a Culturally Competent Practice”.
• A feature article, “Disability Insurance: 10 Things You Need to Know”.
• News you need, Editorial and regular department articles on MDA Foundation activities, Dentistry and …

Depression, Burnout, And Professional Outcomes Among Pas., Sarah R Blackstone, Aimee K Johnson, Noël E Smith, Timothy C. Mccall, Whitney R Simmons, Ashley W Skelly

Clinical Research and Leadership Faculty Publications

OBJECTIVE: This study examined the effect of depression and burnout on PA professional fulfillment and medical errors.

METHODS: Eight hundred eighty PAs completed an online survey containing the Professional Fulfillment Index, PHQ-2, GAD-7, and demographic questions. Two serial mediation models examined the relationship between depression, burnout, and professional outcomes.

RESULTS: Burnout fully mediated the relationship between depression and outcomes in both models and the present research indicates that burnout plays a stronger role in job satisfaction than symptoms of depression.

CONCLUSIONS: Understanding the underpinnings of professional satisfaction may mitigate clinician turnover, which in turn may lead to cost savings for …

September 2021, Swosu Bulldog Wellness Committee

SWOSU BULLDOG WELLNESS

SWOSU is holding COVID19 Vaccination Clinics on Fridays
through the months of September and October
10 am – 2 pm at the Pioneer Cellular Event Center

• This is open to all students and faculty
• Public walk-ins are welcome
**Appointments are not required, but helpful for vaccine management**
• For questions, call the SWOSU COVID phone line 580-774-3025

Food Addiction And Obesity, Lisa Ling

Electronic Theses and Dissertations

The obesity rate in the U.S. adult population has increased to epidemic levels despite attempts to decrease obesity through evidence-based knowledge, clinical practice guidelines, medical interventions, and individual efforts. For certain individuals, food addiction behaviors such as food cravings, loss of control, and binge eating contribute to obesity and require a different approach to care. Little work has been done on adding the possibility of food addiction to obesity screening and treatment. This study utilized a quasi-experimental quantitative pre- and postsurvey research design based on Lewin’s change theory. Nurse practitioners were surveyed regarding the provider’s perceptions, attitudes, and beliefs about …

Food Deserts: Hungry For Answers, Lawren Cumberbatch

Symposium of Student Scholars

In 2010, the United States Department of Agriculture (USDA) reported that 23.5 million people in the United States live in food deserts. As defined by the USDA, a “food desert” is a neighborhood that lacks healthy food sources. This can be measured by distance to a store, number of stores in an area, individual-level resources such as family income or vehicle availability, and neighborhood-level resources such as availability of public transportation. Past research provides evidence that food deserts are especially likely to occur in communities heavily populated by minorities. As a Black Indian pre-med student aiming to join the world …

Examining The Relationship Between African-Americans And Their Physicians, Genesis Weever

Symposium of Student Scholars

For years, there has been a bad history amongst the relationship between African-Americans and their fellow medical institutions. Many African-Americans do not believe that medical professionals have their best interest at heart. Oftentimes, their white counterparts may receive better care, even when they have the same condition. Many African-Americans may even face barriers that their white counterparts will not experience, and will be denied access to healthcare. This results in more deaths and critical illnesses of African-Americans. In order to discover the underlying problem and a possible solution, a review of the literature was initiated. Using a literature matrix and …

Telemedicine Visits In An Established Multidisciplinary Central Nervous System Clinic For Radiation Oncology And Neurosurgery (Radians) In A Community Hospital Setting., S C Bowen R, R Gheewala, Wa Paez, B Lucke-Wold, T Mitin, Jn Ciporen

Clinical Research and Leadership Faculty Publications

OBJECTIVE: To determine the impact of telemedicine visits, compared to in-person visits, on patient satisfaction in an established community hospital-based multidisciplinary central nervous system (CNS) clinic.

METHODS: Telemedicine options - virtual visits and teleconferencing - were introduced in July 2020. Both radiation oncologist and neurosurgeon were simultaneously present for the telemedicine visit. Descriptive patient demographics, survey responses, and travel time and distance calculations were analyzed. Satisfaction score was compared to previously published data.

RESULTS: A total of twenty-five telemedicine visits (n=22 video; n=3 phone) were completed since July 2020. Patient demographics are as follows: mean age was 59 years (range=22-81), …

Healthcare Systems Should Be Leaders In Patient-Centered Sustainability, Katherine T. Liu Md, Facp, Lesley B. Gordon Md, Ms

Journal of Maine Medical Center

No abstract provided.

Patient Transport In The Time Of Covid-19: Using Health Care Failure Mode And Effect Analysis With Simulation To Test And Modify A Protocol, John Kwock, Jeffrey Holmes, Shelly Chipman, Erin Siebers, Angela Berry, Sonja Orff, Victoria Boutin, Leah Mallory

Journal of Maine Medical Center

Introduction: In March 2020, in response to the COVID-19 pandemic, an interprofessional, interdisciplinary team at Maine Medical Center used Healthcare Failure Mode and Effect Analysis (HFMEA) and in situ simulation to rapidly identify and mitigate latent safety threats (LST) in patient transport protocols.

Methods: Following HFMEA steps, stakeholders representing a variety of disciplines assembled to address transport of patients with COVID-19. A process map was created to describe the process. With hazard analysis using table-top simulation followed by in situ simulation, we identified, categorized, and scored LSTs. Mitigation strategies were identified during structured debriefing.

Results: Fourteen LSTs were identified in …

Applying The Plan-Do-Study-Act Cycle In Medical Education To Refine An Antibiotics Therapy Active Learning Session, Stacey Rose, Richard Hamill, Andrew Caruso, Nital P Appelbaum

Faculty, Staff and Students Publications

BACKGROUND: Active learning improves learner engagement and knowledge retention. The application of continuous quality improvement methodologies, such as the Plan-Do-Study-Act (PDSA) framework, may be useful for optimizing medical education, including active learning sessions. We aimed to enhance student satisfaction and achievement of learning outcomes by applying the PDSA framework to an antibiotic utilization curriculum for medical students.

METHODS: Guided by the Plan-Do-Study-Act framework, between February 2017 and July 2019, we developed, implemented, and revised an active learning session for medical students, focused on appropriate utilization of antibiotics during their Internal Medicine clerkship.

RESULTS: Across twelve sessions, 367 students (83.4%) completed …

Great (Soft) Power Competition: Us And Chinese Efforts In Global Health Engagement, Michael W. Wissemann

The US Army War College Quarterly: Parameters

Global health engagement, an underutilized strategy rooted in the strengths of soft power persuasion, can lead to more military-to-military cooperation training, help establish relationships that can be relied on when crises develop, stabilize fragile states, and deny violent extremist organizations space for recruiting and operations. Examining Chinese efforts worldwide to curry favor and influence and the challenges posed by the COVID-19 pandemic, this article shows health as a medium is a very compelling and advantageous whole-of-government approach to national security policy concerns.

Exploring The Relationship Between Burnout And Supervisory Support Among Respiratory Therapists, Ahmad Eissa Alhaykan

Seton Hall University Dissertations and Theses (ETDs)

Background: Respiratory therapists (RTs) provide patient-centered care in diverse clinical settings for various patients. RTs most frequently work with acutely injured and critically ill patients. Working with these populations often takes an emotional toll on the practitioner, resulting in high rates of burnout. A high prevalence of burnout has been detected among health professionals. Even though RTs face unique stresses in the workplace, there is a lack of research addressing burnout among these professionals. Because workplace stressors are not expected to decrease in the near future in healthcare organizations, the search for protecting factors against burnout, such as supervisory …

Caregiver Support In The Emergency Department, Candace Kim, Dawn Butler, Todd C. James

Journal of Geriatric Emergency Medicine

Caregiver support in the emergency department can lead to improved patient care, decreased suffering and lower costs. Identifying caregivers and inviting them onto the healthcare team enhances care. It is useful to document risk factors for caregiver stress and provide resources. The Kingston Caregiver Stress Scale is a tool suitable for assessing needs of caregivers. Multiple health professionals in the emergency department can be utilized to support caregivers.

Operationalizing Culture: Refugees, Migration, And Mental Health In The Wake Of The Vietnam War, Helena Bui

The Yale Undergraduate Research Journal

!e end of the Vietnam War led to the migration of hundreds of thousands of Vietnamese refugees to the United States a"er political and economic upheaval. As another result, the refugees’ years of warfare, trauma, death, and injury began to manifest as unprecedented mental health issues that American physicians and researchers sought to understand. In this paper, I argue that American medical professionals— in good faith—operationalized [Vietnamese] culture to help themselves and their colleagues understand the mental health issues of Vietnamese refugees. Yet this operationalization acted as a double-edged sword. Viewing Western mental health discourse through the lens of Vietnamese …

Unmet Needs And Social Challenges For Older Adults During And After The Covid-19 Pandemic: An Opportunity To Improve Care, Alyssa Elman, Daniel Baek, Elaine Gottesman, Michael E. Stern, Mary R. Mulcare, Amy Shaw, Morgan Pearman, Michelle Sullivan, Sunday Clark, Timothy F. Platts-Mills, Rahul Sharma, Tony Rosen

Journal of Geriatric Emergency Medicine

Many older adults have unmet needs and social challenges that can negatively impact their health and well-being, particularly during and after the COVID pandemic. These include social isolation, inadequate care or assistance with their daily activities, food insecurity, housing insecurity, poverty, and abuse/neglect/exploitation. An ED visit provides a unique and critical opportunity to identify these issues and initiate intervention for these vulnerable older adults. By assessing for unmet needs and social challenges, considering a team-based approach as to how they may be ameliorated, using online tools, and integrating telehealth and EMS, ED providers have the potential to dramatically improve …

Omental Tuberculosis In A Patient With Alcoholic Liver Cirrhosis-The Diagnostic And Treatment Dilemma, Ekta Tirthani, Mina Said

Advances in Clinical Medical Research and Healthcare Delivery

Alcoholic cirrhosis is frequently complicated by spontaneous bacterial peritonitis (SBP) due to the translocation of gut bacteria. However, in immigrants to the USA from parts of the world with high tuberculosis burden, a high degree of clinical suspicion of tuberculous peritonitis should be maintained when a patient presents with symptoms similar to SBP. We describe a case of a 45-year-old Nepali man with a history of alcohol abuse who immigrated to the USA six years prior and presented to the hospital with abdominal pain, night sweats, fevers, and a 10 kg weight loss. A CT scan revealed abdominopelvic ascites, liver …

The Upfront Cost Of Translating Graduate Medical Education Into A Virtual Platform, Ronak Mistry, Alex Glaser

Advances in Clinical Medical Research and Healthcare Delivery

Graduate medical education was drastically disrupted by the COVID-19 pandemic. With a halt on all in-person educational sessions in response to the need for social distancing, residency programs across the country scrambled to develop virtual curricula with some difficulty, given the limited guidance to creating online learning platforms prior to the onset of the pandemic. In-person Socratic discussions have always been the cornerstone of internal medicine training. Here, we discussed our experiences of translating the in-person model and to a virtual platform, highlighting the upfront financial burden that doing so can have. Time will need to pass before we can …

Evaluating A1c Reduction In Patients With Diabetes Receiving Pharmacy Intervention, Christopher R. Evans, Kirsten Held, Stephanie Thomas, Jeanne Spencer

Advances in Clinical Medical Research and Healthcare Delivery

Introduction: Diabetes affects 34 million Americans and is the 7th leading cause of death in the United States. According to the American Diabetes Association (ADA) the A1c goal for most patients is less than 7%; however, in patients at risk for hypoglycemia or with complications that goal can be increased up to less than 8%. Management of diabetes with diet and exercise is essential, but insufficient for most patients and pharmacologic intervention is necessary to achieve therapeutic goals. Reducing A1c is associated with lower cardiovascular risk and a reduction in diabetes-associated complications. Previous studies have shown that pharmacist management of …

Management Of Fall Patients – What Should Be Done For Emergency Department Fall Patients?, Katherine Selman, Christine Binkley, Katherine Davenport, Shan W. Lliu, Maura Kennedy

Journal of Geriatric Emergency Medicine

Falls are the leading cause of injury-related emergency visits in older adults, translating into an estimated 3 million ED visits and 32,000 deaths from fall-related injuries annually in the United States. Falls subsequently result in diminished functional ability and higher risk for future falls and mortality. Despite this, ED clinicians focus primarily on injuries that result from a fall and often defer the modifiable causes of the fall and future fall prevention to outpatient providers. We review two articles that address the feasibility of performing interventions from the ED and the efficacy of a multifactorial fall intervention program.

Clinical Executive Healthcare Leadership At Ohiohealth, Ladan Barnes

Masters Theses/Capstone Projects

OhioHealth’s Riverside Methodist Hospital with the site supervisor, Chief of Medical Affairs, Dr. Thomas Harmon.

The residency focused on executive health care leadership and the principles, skillsets, and experiences needed to perform the duties of the Vice President of Medical Affairs and Chief of Medical Affairs positions.

The residency provided opportunities to work on projects regarding goal deployment for Women’s Health Services.

Throughout the experience safety, and quality were guiding pinnacles OhioHealth values to excel in all areas in the clinical enterprise.

The residency allowed for in-depth evaluation of healthcare executive leadership with a large focus on clinical health executive …

Behavioral Health At Nationwide Nationwide Children's Hospital Practicum Experience, Muna Sharif

Masters Theses/Capstone Projects

The mission of this practicum experience is to provide the highest quality of care to all children and their families regardless of their ability to pay.

From this experience I was able to develop a comprehensive understanding of the Behavioral Health programs and services at Nationwide Children's Hospital. Additionally, I facilitated the Eating Disorder Intake Process Team Discussion. I attended daily huddles and engaged in discussion while learning from professional leaders. This also included regularly being hands-on in activities and attending all meetings, providing feedback, and debriefing with the site-supervisor.

Integrating Digital Health Technology To Alleviate Caregiver Burden, Patricia Ann Hunt

Applied Research Projects

The elder population in our country is growing at an exponential pace. Studies have shown that elders who are aged 80 years and older are projected to suffer from age related issues such as Alzheimer’s, dementia, and osteoporosis and will need assistance with Long Term Services and Support (LTSS). Additionally, many elders are also projected to suffer from more severe chronic illnesses such as diabetes, cancer, and heart related illnesses. Because many of these elders are aging in place, residing in their own homes, they will require the services of at home assistance, which high probability will be a neighbor, …

Using The 4m Model To Screen Geriatric Patients In The Emergency Department, Martinus Megalla, Roopa Avula, Christopher Manners, Portia Chinnery, Lindsey Perrella, Douglas Finefrock

Journal of Geriatric Emergency Medicine

Several models of specialized geriatric care in the Emergency Department (ED) have been developed since the American College of Emergency Physicians (ACEP) began accrediting geriatric EDs in 2018. There is considerable variability in terms of both design and efficacy in regard to screening older patients in the ED and determining proper interventions The John A. Hartford Foundation and Institute for Healthcare Improvement (IHI) have developed the 4M Model for Creating Age-Friendly Health Systems which aims to provide high quality care to older patients by addressing four critical elements: Mentation, Mobility, Medication, What Matters. This article describes a screening tool for …

Patient Reported Outcomes In Sickle Cell Disease Examined Within A Conceptual Model, Swapandeep Mushiana, Marsha Treadwell Phd, Sherif M. Badawy Md, Ms, Liliana Preiss Phd, Allison King Md Mph Phd, Barbara Kroner Phd, Yumie Chen Bs, Jeffrey Glassberg, Victor Gordeuk Md, Nirmish Shah Md, Angie Snyder Phd Mph, Theodore Wun Md

Doctoral Dissertations

Objective: To examine the relations between patient reported outcomes (PROs) within a conceptual model for adults with sickle cell disease (SCD) ages 18 – 45 years enrolled in the Sickle Cell Disease Implementation Consortium (SCDIC) registry. We hypothesized that patient and SCD related factors and barriers to care would independently contribute to functioning as measured using the PRO domains. Additionally, pain and other SCD related complications are expected to impact the relation between the variables. Methods: Participants completed a 48-item survey that included socio-demographics and PRO measures, such as social functioning, pain impact emotional distress, and cognitive functioning. …

The Use Of Isbared/Ishaped And Elimination Of Reviewing Patients’ Chart Before Handoff To Decrease Incremental Overtime, Sheila Bucao

Master's Projects and Capstones

Problem: Incremental overtime was found to majorly impact the financial well-being of a stroke unit. From an allocated budget of 22 hours per pay period, the unit’s incremental overtime averaged 40 hours. The stroke unit had skilled-mix competencies, further complicating handoffs. The absence of a standard reporting method means that reviewing patients’ charts takes approximately 10 to 15 minutes, extending what should be a quick, but thorough nurse knowledge exchange.

Context: The body of evidence reviewed indicated that pertinent information to patient care is not left out or missed when a standardized tool is used during handoff. Based on Lean …

Improvement Cycles In Medical Education: From Quality Improvement To Patient Care And Clinical Research, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

No abstract provided.

“I’M Not Staying In The Hospital Tonight”: How Emergency Departments Can Leverage Health And Social Services At Home To Support Care Transitions For Older Patients, Emily Franzosa, Ula Hwang, Maya Genovesi, Orna Intrator, Thomas Edes, Michael Malone

Journal of Geriatric Emergency Medicine

When hospital admission is less than desirable and sending a patient home alone feels unsafe, connecting patients to health and social services at home are a valuable third option for emergency providers. Coordinating home support services from the ED is effective care delivery and aligns with health systems’ goals of decreasing avoidable admissions, and developing capacity to assess and refer patients to home support from the ED is part of good emergency care. Change also doesn’t have to happen overnight. Taking small steps now to improve older patients' transitions to home can help EDs build toward high-quality, patient-centered care for …

Nurse Retention In Workplace Adversity, Deborah Lewis

Student Scholarly Projects

Practice Problem: Nurse turnover rate and lack of retention are issues that have an impact on safe patient care, patient mortality, quality outcomes, and patient experiences in the acute care units at the identified project setting. Turnover leads to excess labor utilization of overtime and increased hospital costs.

PICOT: The PICOT question that guided this project was (P) In acute care hospital nurses, how do (I) nurse retention strategies (C) compared with no nurse retention strategies (O) reduce nurses’ intention to leave and increase job satisfaction over (T) eight weeks?

Evidence: Twenty-one articles were reviewed that identified autonomy, recognition, …

Building Patient Participation In Quality Of Care Through The Healthcare Stories Project: A Demonstration Program In New York State Hiv Clinics, Abigail Baim-Lance, Freda Coren, Margaret Brown, Hazel Lever, Daniel Tietz, Bruce Agins

Patient Experience Journal

There is growing recognition that patients should play a central role in defining, assessing, and improving the quality of healthcare, thereby enhancing patient experiences. Healthcare organizations struggle to meet these goals, which require becoming more patient-centered and patient-involved. The Healthcare Stories Project (HCSP), a demonstration program of the NYS Department of Health AIDS Institute, aimed to address this. HCSP comprises three, stepwise activities to: 1) Capture how patients define and experience ‘quality of care’ in the clinic; 2) Engage patients and providers as equal partners in understanding and improving the quality of care; and through partnerships, 3) Support the building …