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Out Of The Comfort Zone, Patricia Harris Oct 2015

Out Of The Comfort Zone, Patricia Harris

Patricia Harris

Imagine the following experience: Your are a student nurse working with other health care providers in the obstetric unit of your facility. A fifteen-year-old Haitian girl, along with her grandmother, arrives seeking help because her two-day-old, eight-pound baby boy is having difficulty breathing...


Feasibility And Compliance With Daily Home Ecg Monitoring Of The Qt Interval In Heart Transplant Recipients, Erik V. Carter, Kathleen T. Hickey, David M. Pickham, Lynn V. Doering, Belinda Chen, Patricia Harris, Barbara J. Drew Oct 2015

Feasibility And Compliance With Daily Home Ecg Monitoring Of The Qt Interval In Heart Transplant Recipients, Erik V. Carter, Kathleen T. Hickey, David M. Pickham, Lynn V. Doering, Belinda Chen, Patricia Harris, Barbara J. Drew

Patricia Harris

Background: Recent evidence suggests that acute allograft rejection after heart transplantation causes an increased QT interval on electrocardiogram (ECG). The aims of this pilot study were to (1) determine whether heart transplant recipients could achieve compliance in transmitting a 30-second ECG every day for 1 month using a simple ECG device and their home telephone, (2) evaluate the ease of device use and acceptability by transplant recipients, and (3) evaluate the quality of transmitted ECG tracings for QT-interval measurement. Methods: A convenience sample of adult heart transplant recipients were recruited and trained to use the device (HeartOne, Aerotel Medical Systems, …


Prognostic Value Of Heart Rate Turbulence For Risk Assessment In Patients With Unstable Angina And Non-St Elevation Myocardial Infarction, Patricia R.E. Harris, Phyllis K. Stein, Gordon L. Fung, Barbara J. Drew Oct 2015

Prognostic Value Of Heart Rate Turbulence For Risk Assessment In Patients With Unstable Angina And Non-St Elevation Myocardial Infarction, Patricia R.E. Harris, Phyllis K. Stein, Gordon L. Fung, Barbara J. Drew

Patricia Harris

Background: We sought to examine the prognostic value of heart rate turbulence derived from electrocardiographic recordings initiated in the emergency department for patients with non-ST elevation myocardial infarction (NSTEMI) or unstable angina. Methods: Twenty-four-hour Holter recordings were started in patients with cardiac symptoms approximately 45 minutes after arrival in the emergency department. Patients subsequently diagnosed with NSTEMI or unstable angina who had recordings with ≥18 hours of sinus rhythm and sufficient data to compute Thrombolysis In Myocardial Infarction (TIMI) risk scores were chosen for analysis (n = 166). Endpoints were emergent re-entry to the cardiac emergency department and/or death at …


Prevalence And Prognostic Significance Of Long Qt Interval Among Patients With Chest Pain: Selecting An Optimum Qt Rate Correction Formula, Amer A. Hasanien, Barbara J. Drew, Jill Howie-Esquivel, Gordon Fung, Patricia Harris Oct 2015

Prevalence And Prognostic Significance Of Long Qt Interval Among Patients With Chest Pain: Selecting An Optimum Qt Rate Correction Formula, Amer A. Hasanien, Barbara J. Drew, Jill Howie-Esquivel, Gordon Fung, Patricia Harris

Patricia Harris

Background: Little is known about the prevalence and prognostic significance of long QT interval among patients with chest pain during the acute phase of suspected cardiovascular injury. Objectives: Our aim was to investigate the prevalence and prognostic significance of long QT interval among patients presenting to the emergency department (ED) with chest pain using an optimum QT rate correction formula. Methods: We performed secondary analysis on data obtained from the IMMEDIATE AIM trial (N, 145). Data included 24-hour 12-lead Holter electrocardiographic recordings that were stored for offline computer analysis. The QT interval was measured automatically and rate corrected using seven …


Heart Rate Variability Measured Early In Patients With Evolving Acute Coronary Syndrome And 1-Year Outcomes Of Rehospitalization And Mortality, Patricia R.E. Harris, Phyllis K. Stein, Gordon L. Fung, Barbara J. Drew Oct 2015

Heart Rate Variability Measured Early In Patients With Evolving Acute Coronary Syndrome And 1-Year Outcomes Of Rehospitalization And Mortality, Patricia R.E. Harris, Phyllis K. Stein, Gordon L. Fung, Barbara J. Drew

Patricia Harris

Objective: This study sought to examine the prognostic value of heart rate variability (HRV) measurement initiated immediately after emergency department presentation for patients with acute coronary syndrome (ACS). Background: Altered HRV has been associated with adverse outcomes in heart disease, but the value of HRV measured during the earliest phases of ACS related to risk of 1-year rehospitalization and death has not been established. Methods: Twenty-four-hour Holter recordings of 279 patients with ACS were initiated within 45 minutes of emergency department arrival; recordings with �18 hours of sinus rhythm were selected for HRV analysis (number [N] �193). Time domain, frequency …


Insights Into The Problem Of Alarm Fatigue With Physiologic Monitor Devices: A Comprehensive Observational Study Of Consecutive Intensive Care Unit Patients, Barbara J. Drew, Patricia Harris, Jessica K. Zègre-Hemsey, Tina Mammone, Daniel Schindler, Rebeca Salas-Boni, Yong Bai, Adelita Tinoco, Quan Ding, Xiao Hu Oct 2015

Insights Into The Problem Of Alarm Fatigue With Physiologic Monitor Devices: A Comprehensive Observational Study Of Consecutive Intensive Care Unit Patients, Barbara J. Drew, Patricia Harris, Jessica K. Zègre-Hemsey, Tina Mammone, Daniel Schindler, Rebeca Salas-Boni, Yong Bai, Adelita Tinoco, Quan Ding, Xiao Hu

Patricia Harris

Purpose: Physiologic monitors are plagued with alarms that create a cacophony of sounds and visual alerts causing ‘‘alarm fatigue’’ which creates an unsafe patient environment because a life-threatening event may be missed in this milieu of sensory overload. Using a state-of-the-art technology acquisition infrastructure, all monitor data including 7 ECG leads, all pressure, SpO2, and respiration waveforms as well as user settings and alarms were stored on 461 adults treated in intensive care units. Using a well-defined alarm annotation protocol, nurse scientists with 95% inter-rater reliability annotated 12,671 arrhythmia alarms. Results: A total of 2,558,760 unique alarms occurred in the …


A Comparison Of Skills Competency Test Scores Among Philippine-Educated Nursing Students After An Intensive Medical-Surgical Course, Margaret Fink, Debbie Daunt, Patricia Harris, Barbara Mccamish Oct 2015

A Comparison Of Skills Competency Test Scores Among Philippine-Educated Nursing Students After An Intensive Medical-Surgical Course, Margaret Fink, Debbie Daunt, Patricia Harris, Barbara Mccamish

Patricia Harris

Objective: This study examined the effect of a 10-week intensive medical-surgical course on ability to perform 16 common, acute care skills among Philippine educated nursing students seeking licensure in California. The aims of the study were to (1) determine competency in performing skills at the start of the medical-surgical course and (2) evaluate the effectiveness of the medical-surgical course in improving skill competency.

Methods: Twenty-three Philippine educated nursing students participated in a 4-hour skills competency test procedure that involved 4 patient care stations and 16 common acute care skills. During the last week of the 10-week medical-surgical course that included …


A Comparison Of Skills Competency Test Scores Among Philippine-Educated Nursing Students After An Intensive Medical-Surgical Course, Margaret Fink, Debbie Daunt, Patricia Harris, Barbara Mccamish Oct 2015

A Comparison Of Skills Competency Test Scores Among Philippine-Educated Nursing Students After An Intensive Medical-Surgical Course, Margaret Fink, Debbie Daunt, Patricia Harris, Barbara Mccamish

Patricia Harris

Objective: This study examined the effect of a 10-week intensive medical-surgical course on ability to perform 16 common, acute care skills among Philippine educated nursing students seeking licensure in California. The aims of the study were to (1) determine competency in performing skills at the start of the medical-surgical course and (2) evaluate the effectiveness of the medical-surgical course in improving skill competency. Methods: Twenty-three Philippine educated nursing students participated in a 4-hour skills competency test procedure that involved 4 patient care stations and 16 common acute care skills. During the last week of the 10-week medical-surgical course that included …


A Comparison Of Skills Competency Test Scores Among Philippine-Educated Nursing Students After An Intensive Medical-Surgical Course, Margaret Fink, Debbie Daunt, Patricia Harris, Barbara Mccamish Aug 2015

A Comparison Of Skills Competency Test Scores Among Philippine-Educated Nursing Students After An Intensive Medical-Surgical Course, Margaret Fink, Debbie Daunt, Patricia Harris, Barbara Mccamish

Patricia Harris

Objective: This study examined the effect of a 10-week intensive medical-surgical course on ability to perform 16 common, acute care skills among Philippine educated nursing students seeking licensure in California. The aims of the study were to (1) determine competency in performing skills at the start of the medical-surgical course and (2) evaluate the effectiveness of the medical-surgical course in improving skill competency. Methods: Twenty-three Philippine educated nursing students participated in a 4-hour skills competency test procedure that involved 4 patient care stations and 16 common acute care skills. During the last week of the 10-week medical-surgical course that included …


Prognostic Value Of Heart Rate Turbulence For Risk Assessment In Patients With Unstable Angina And Non-St Elevation Myocardial Infarction, Patricia R.E. Harris, Phyllis K. Stein, Gordon L. Fung, Barbara J. Drew Aug 2015

Prognostic Value Of Heart Rate Turbulence For Risk Assessment In Patients With Unstable Angina And Non-St Elevation Myocardial Infarction, Patricia R.E. Harris, Phyllis K. Stein, Gordon L. Fung, Barbara J. Drew

Patricia Harris

Background: We sought to examine the prognostic value of heart rate turbulence derived from electrocardiographic recordings initiated in the emergency department for patients with non-ST elevation myocardial infarction (NSTEMI) or unstable angina. Methods: Twenty-four-hour Holter recordings were started in patients with cardiac symptoms approximately 45 minutes after arrival in the emergency department. Patients subsequently diagnosed with NSTEMI or unstable angina who had recordings with ≥18 hours of sinus rhythm and sufficient data to compute Thrombolysis In Myocardial Infarction (TIMI) risk scores were chosen for analysis (n = 166). Endpoints were emergent re-entry to the cardiac emergency department and/or death at …


Prevalence And Prognostic Significance Of Long Qt Interval Among Patients With Chest Pain: Selecting An Optimum Qt Rate Correction Formula, Amer A. Hasanien, Barbara J. Drew, Jill Howie-Esquivel, Gordon Fung, Patricia Harris Aug 2015

Prevalence And Prognostic Significance Of Long Qt Interval Among Patients With Chest Pain: Selecting An Optimum Qt Rate Correction Formula, Amer A. Hasanien, Barbara J. Drew, Jill Howie-Esquivel, Gordon Fung, Patricia Harris

Patricia Harris

Background: Little is known about the prevalence and prognostic significance of long QT interval among patients with chest pain during the acute phase of suspected cardiovascular injury. Objectives: Our aim was to investigate the prevalence and prognostic significance of long QT interval among patients presenting to the emergency department (ED) with chest pain using an optimum QT rate correction formula. Methods: We performed secondary analysis on data obtained from the IMMEDIATE AIM trial (N, 145). Data included 24-hour 12-lead Holter electrocardiographic recordings that were stored for offline computer analysis. The QT interval was measured automatically and rate corrected using seven …


Insights Into The Problem Of Alarm Fatigue With Physiologic Monitor Devices: A Comprehensive Observational Study Of Consecutive Intensive Care Unit Patients, Barbara J. Drew, Patricia Harris, Jessica K. Zègre-Hemsey, Tina Mammone, Daniel Schindler, Rebeca Salas-Boni, Yong Bai, Adelita Tinoco, Quan Ding, Xiao Hu Aug 2015

Insights Into The Problem Of Alarm Fatigue With Physiologic Monitor Devices: A Comprehensive Observational Study Of Consecutive Intensive Care Unit Patients, Barbara J. Drew, Patricia Harris, Jessica K. Zègre-Hemsey, Tina Mammone, Daniel Schindler, Rebeca Salas-Boni, Yong Bai, Adelita Tinoco, Quan Ding, Xiao Hu

Patricia Harris

Purpose: Physiologic monitors are plagued with alarms that create a cacophony of sounds and visual alerts causing ‘‘alarm fatigue’’ which creates an unsafe patient environment because a life-threatening event may be missed in this milieu of sensory overload. Using a state-of-the-art technology acquisition infrastructure, all monitor data including 7 ECG leads, all pressure, SpO2, and respiration waveforms as well as user settings and alarms were stored on 461 adults treated in intensive care units. Using a well-defined alarm annotation protocol, nurse scientists with 95% inter-rater reliability annotated 12,671 arrhythmia alarms.

Results: A total of 2,558,760 unique alarms occurred in the …


Alarm Management In Intensive Care – Ucsf Study: Lessons Learned And Future Challenges, Patricia Harris May 2015

Alarm Management In Intensive Care – Ucsf Study: Lessons Learned And Future Challenges, Patricia Harris

Patricia Harris

No abstract available


Integrating Monitor Alarms With Laboratory Test Results To Enhance Patient Deterioration Prediction, Yong Bai, Duc H. Do, Patricia Harris, Daniel Schindler, Noel G. Boyle, Barbara J. Drew, Xiao Hu Jan 2015

Integrating Monitor Alarms With Laboratory Test Results To Enhance Patient Deterioration Prediction, Yong Bai, Duc H. Do, Patricia Harris, Daniel Schindler, Noel G. Boyle, Barbara J. Drew, Xiao Hu

Patricia Harris

Patient monitors in modern hospitals have become ubiquitous but they generate an excessive number of false alarms causing alarm fatigue. Our previous work showed that combinations of frequently co-occurring monitor alarms, called SuperAlarm patterns, were capable of predicting in-hospital code blue events at a lower alarm frequency. In the present study, we extend the conceptual domain of a SuperAlarm to incorporate laboratory test results along with monitor alarms so as to build an integrated data set to mine SuperAlarm patterns. We propose two approaches to integrate monitor alarms with laboratory test results and use a maximal frequent itemsets mining algorithm …


Patient Characteristics Associated With False Arrhythmia Alarms In Intensive Care [Abstract 19717], Patricia Harris, Jessica K. Zègre-Hemsey, Tina Mammone, Daniel Schindler, Xiao Hu, Yong Bai, Steven M. Paul, Barbara J. Drew Nov 2014

Patient Characteristics Associated With False Arrhythmia Alarms In Intensive Care [Abstract 19717], Patricia Harris, Jessica K. Zègre-Hemsey, Tina Mammone, Daniel Schindler, Xiao Hu, Yong Bai, Steven M. Paul, Barbara J. Drew

Patricia Harris

Introduction: A high rate of false arrhythmia alarms leads to clinical alarm fatigue, i.e. desensitization and inappropriate silencing of alarms.


False Ventricular Tachycardia Alarm Suppression In The Icu Based On The Discrete Wavelet Transform In The Ecg Signal, Rebeca Salas-Boni, Yong Bai, Patricia Harris, Barbara J. Drew, Xiao Hu Oct 2014

False Ventricular Tachycardia Alarm Suppression In The Icu Based On The Discrete Wavelet Transform In The Ecg Signal, Rebeca Salas-Boni, Yong Bai, Patricia Harris, Barbara J. Drew, Xiao Hu

Patricia Harris

Over the past few years, reducing the number of false positive cardiac monitor alarms (FA) in the intensive care unit (ICU) has become an issue of the utmost importance. In our work, we developed a robust methodology that, without the need for additional non-ECG waveforms, suppresses false positive ventricular tachycardia (VT) alarms without resulting in false negative alarms. Our approach is based on features extracted from the ECG signal 20 seconds prior to a triggered alarm. We applied a multi resolution wavelet transform to the ECG data 20seconds prior to the alarm trigger, extracted features from appropriately chosen scales and …


Analysis Of Patient Alarms In Adult Intensive Care Units, Patricia Harris Mar 2014

Analysis Of Patient Alarms In Adult Intensive Care Units, Patricia Harris

Patricia Harris

...Our study aims were pretty straight-forward. We concentrated quite a bit on arrhythmia alarms, which is a little different than the parameter alarms we've been talking about so far today. We decided we were going to assess the alarm prevalence of patient's physiological monitor alarms. We'll identify the alarm burden, analyze a select high priority number of arrhythmia alarms and determine patient characteristics that may be associated with the frequent alarms.


Heart Rate Turbulence In Patients With Respiratory Failure. [Abstract], Patricia Harris, Barbara Drew Oct 2013

Heart Rate Turbulence In Patients With Respiratory Failure. [Abstract], Patricia Harris, Barbara Drew

Patricia Harris

We sought to determine the feasibility of measuring heart rate turbulence (HRT) derived from electrocardiographic (ECG) bedside monitors in critically ill respiratory failure patients, receiving mechanical ventilation. In addition, we aimed to determine whether or not a normal HRT response was associated with patients' successful return to spontaneous breathing, also called ventilator weaning, and survival to discharge.


Heart Rate Turbulence In Patients With Respiratory Failure [Poster], Patricia Harris Mar 2013

Heart Rate Turbulence In Patients With Respiratory Failure [Poster], Patricia Harris

Patricia Harris

No abstract available


Prelimimary Findings From The “Analysis Of Patient Bedside Monitor Alarms” Study, Patricia Harris Dec 2012

Prelimimary Findings From The “Analysis Of Patient Bedside Monitor Alarms” Study, Patricia Harris

Patricia Harris

No abstract available


Heart Rate Turbulence In Patients With Acute Respiratory Failure [Poster], Patricia Harris Dec 2012

Heart Rate Turbulence In Patients With Acute Respiratory Failure [Poster], Patricia Harris

Patricia Harris

No abstract available


Living With Significant Other Is Associated With Lower Risk For Emergency Readmission After Unstable Angina & Non-St Elevation Myocardial Infarction. [Abstract], Patricia Harris, Barbara J. Drew Nov 2012

Living With Significant Other Is Associated With Lower Risk For Emergency Readmission After Unstable Angina & Non-St Elevation Myocardial Infarction. [Abstract], Patricia Harris, Barbara J. Drew

Patricia Harris

Patients who are diagnosed with unstable angina (UA) or non-ST elevation myocardial infarction (non-STEMI) are at risk for repeated acute cardiac episodes resulting in emergent rehospitalization. American Heart Association/American College of Cardiology practice guidelines recommend use of risk stratification prior to hospital discharge; however, the importance of identifying patients’ social support for follow-up planning is not emphasized.


Living With Significant Other Is Associated With Lower Risk For Emergency Readmission After Unstable Angina & Non-St Elevation Myocardial Infarction [Poster 12064], Patricia Harris, Barbara J. Drew Nov 2012

Living With Significant Other Is Associated With Lower Risk For Emergency Readmission After Unstable Angina & Non-St Elevation Myocardial Infarction [Poster 12064], Patricia Harris, Barbara J. Drew

Patricia Harris

Introduction: Patients who are diagnosed with unstable angina (UA) or non-ST elevation myocardial infarction (non-STEMI) are at risk for repeated acute cardiac episodes resulting in emergent rehospitalization. American Heart Association/American College of Cardiology practice guidelines recommend use of risk stratification prior to hospital discharge; however, the importance of identifying patients’ social support for follow-up planning is not emphasized.
Hypothesis: UA and non-STEMI patients who live with significant others are less likely to return to the Emergency Department (ED) for acute cardiac-related events within one year. Methods: Secondary analysis was conducted of data from a prospective clinical trial (IMMEDIATE AIM Study, …


Comparison Of 1-Year Survival And Heart Rate Variability In Acute Coronary Syndrome. [Abstract], Patricia R.E. Harris, Phyllis K. Stein, Barbara J. Drew Oct 2010

Comparison Of 1-Year Survival And Heart Rate Variability In Acute Coronary Syndrome. [Abstract], Patricia R.E. Harris, Phyllis K. Stein, Barbara J. Drew

Patricia Harris

Numerous studies support the use of heart rate variability (HRV) for risk stratification in the post–myocardial infarction (MI) population. However, little is known about the prognostic value of HRV measured during the acute phase of MI and unstable angina (ie, acute coronary syndrome, or ACS).


Heart Rate Turbulence And Risk Stratification In Acute Coronary Syndrome Patients. [Abstract 0153], Patricia Harris, P. K. Stein, Barbara J. Drew Dec 2009

Heart Rate Turbulence And Risk Stratification In Acute Coronary Syndrome Patients. [Abstract 0153], Patricia Harris, P. K. Stein, Barbara J. Drew

Patricia Harris

Abnormal heart rate turbulence (HRT) is a significant risk for adverse outcomes after myocardial infarction (MI). Less is known about HRT measured during acute coronary syndrome, i.e. ST-elevation MI (STEMI), non-ST-elevation MI (non-STEMI), and unstable angina (UA).


Heart Rate Turbulence And Risk Stratification In Acute Coronary Syndrome Patients [Poster], Patricia Harris Dec 2009

Heart Rate Turbulence And Risk Stratification In Acute Coronary Syndrome Patients [Poster], Patricia Harris

Patricia Harris

No abstract available


Comparison Heart Rate Variability And One-Year Survival In Acute Coronary Syndrome [Poster], Patricia Harris Dec 2009

Comparison Heart Rate Variability And One-Year Survival In Acute Coronary Syndrome [Poster], Patricia Harris

Patricia Harris

No abstract available


Preliminary Comparison Of Exercise Reporting Between Electronic And Paper Logs [Abstract], D. Donesky-Cuenco, P. R.E. Harris, H. Nguyen, S. Wolpin, V. Carrieri-Kohlman Dec 2008

Preliminary Comparison Of Exercise Reporting Between Electronic And Paper Logs [Abstract], D. Donesky-Cuenco, P. R.E. Harris, H. Nguyen, S. Wolpin, V. Carrieri-Kohlman

Patricia Harris

No abstract available


Doctoral Forum Presenter On The Doctoral Program’S Research Residency, Patricia Harris Dec 2008

Doctoral Forum Presenter On The Doctoral Program’S Research Residency, Patricia Harris

Patricia Harris

No abstract available


Presenter For New Doctoral Student Orientation, Patricia Harris Dec 2007

Presenter For New Doctoral Student Orientation, Patricia Harris

Patricia Harris

No abstract available