Medicine and Health Sciences Commons^™

Removal Of Ana Language To Increase Access To Vaccination Compliance, Steven G. Pochop Jr.

Doctor of Nursing Practice Final Manuscripts

Background: In 2015, the American Nurses Association (ANA) revised their immunization and vaccine policy statement to address the culture of vaccines that was prevalent in 2015. Due to evolving climate and growth in vaccination noncompliance as evidenced by recent outbreaks of vaccine preventable illnesses.

Purpose of Project: It is my recommendation that the ANA remove their endorsement of religious exemption from vaccinations in their policy statement, considering misapplications for which the exemption was not designed and that compromises the safety of the public. Additionally, annual medical exemption recertification signed by a qualified provider will become the recommended standard of practice. …

Efficacy Of Telehealth Modalities In Medication Adherence For Older Adults, Mitchell Adrian C. Siy

Doctor of Nursing Practice Final Manuscripts

About half of the geriatric population who take at least one medication find medication adherence challenging. Average adherence of an elderly patient taking one medication a day is about 80%. This adherence decreases to about 50% for patients taking medications four times a day. Nonadherence can lead to a myriad of preventable adverse effects that can reduce the quality of life and even result in death. In the United States, $100-300 billion could be saved in health care costs due to adverse effects of poor medication adherence. The purpose of this evidence-based project (EBP) is to improve medication adherence in …

Impact Of Psychotropic Medications On Electrical Cardiac Conduction In The Emergency Department: A Best Practice Review, Juliann Hatt

Doctor of Nursing Practice Final Manuscripts

Abstract Background: The effects of psychotropic drugs on cardiac repolarization have increasingly gained attention in research and clinical practice over the last 2 decades. The absolute risk of cardiac arrhythmia, such as the polymorphic ventricular tachycardia, Torsades de Pointes (TdP), is low (14 per 10,000 patients/year) and sudden cardiac death as a consequence of all cardiac arrhythmias is less frequent (Braillon et al., 2017). TdP can occur at therapeutic doses of second-generation antipsychotics and antidepressants and with a corrected Q-T (QTc) interval >500 ms. Many psychotropic medications can delay cardiac repolarization thereby producing prolonged QTc in the electrocardiogram (ECG). Emergency …

Screening For Postmenopausal Osteoporosis In Women Between Age 30-64 In Primary Care: A Policy Perspective With Recommendations, Shenwan Wang

Doctor of Nursing Practice Final Manuscripts

Osteoporosis is a silent disease leading to osteoporotic fractures and even death. Postmenopausal women are extremely susceptible to osteoporosis because of estrogen deficiency. But less than 1 in 4 women with an osteoporotic fracture was screened or treated for osteoporosis. Postmenopausal women have been proven to benefit from early osteoporosis detection and treatment. However, there is no current national policy on screening for postmenopausal osteoporosis before age 65. Nurse practitioners can play an important role in screening for postmenopausal osteoporosis in primary care to prevent osteoporotic fractures and improve quality of life.

Optimizing Best Telehealth Practices Among Advanced Practice Registered Nurses, Karen Swafford

Doctor of Nursing Practice Final Manuscripts

Abstract

Optimizing best clinical telehealth practices among APRNs

Abstract Title: Optimizing best clinical telehealth practices among APRNs through a survey that gauges their preparedness in core competencies and their recommendations.

Background: In April 2020, about half of all Medicare primary care visits were done through telehealth due to the COVID-19 pandemic. Telehealth evoked a strong positive response among patients, which created a new niche in healthcare. To effectively leverage its value, one of its key goals is the promotion of best clinical practices (Agrawal, 2020). However, very little information was found about programs that address NP training in telehealth. …

The Challenges Of Lagging Diversity And Inclusion In Health Care, Ebony Caldwell, Nananamibia Duffy, Deborah Stamps

Advances in Clinical Medical Research and Healthcare Delivery

The healthcare workforce in the United States (US) does not accurately reflect the future growth of diversity, based on projections of a more racially/ethnically diverse patient population in the US over the next decade. Poor health outcomes, particularly in African Americans, continue to occur, and African Americans continue to be underrepresented in medicine. This signals a continuation of health disparities in marginalized communities. Healthcare organizations must address the low number of Black physicians in communities and support education gaps to strengthen pipelines that will ensure a greater diversity in matriculating medical school students.

Trial By Fire: Impact Of Rapid Expansion Of Telemedicine In A Large Community Health System, Scott Stratton-Smith, Cole Nardi, Benjamin Snyder

Advances in Clinical Medical Research and Healthcare Delivery

Background: Our community-based health system transitioned to a largely telehealth-based approach under the pressure of the COVID-19 pandemic. Limited implementation of telehealth had begun in 2018, but provider and patient reluctance and inadequate reimbursement prevented widespread adoption at the time. The pandemic accelerated our system’s telehealth efforts.

Results: In February 2020, video technology was rarely utilized, with the organization averaging fewer than 10 video visits per month. In April 2020, our providers used it for over 30% of all visits in our system, accounting for over 30,000 visits. Before COVID-19, fewer than 20 of our providers had performed a direct-to-patient …

Clinical Presentation Of Covid-19 Disease In Two Rural New York Counties, Richard Terry, Sadaf Mughal, Vidhya Reddy, Tina Burt

Advances in Clinical Medical Research and Healthcare Delivery

Purpose

To analyze the phenotypic expression of Coronavirus infection (COVID-19) among patients residing in the Chemung and Schuyler counties of New York State.

Method

A retrospective review of medical records was performed between March 16, 2020 to April 16, 2020. Sixty- five patients presenting with symptoms of COVID-19 infection were included in this IRB-exempt study. Presence of infection was confirmed using reverse transcriptase polymerase chain reaction (RT- PCR) from nasopharyngeal swab samples, as per Centers for Disease Control and prevention (CDC) guidelines.

Results

Patients varied in age from 13 to 82 years, with nearly equal proportion of females (51%) vs …

Colonic Gallstone Obstruction, Abdoulaziz Toure M.D, Mitchell Witkowski, Vithal Vernenkar D.O, Brian Watkins Md, Ms, Facs, Prasad V. Penmetsa M.D

Advances in Clinical Medical Research and Healthcare Delivery

This report discusses a case of a 79-year-old Caucasian female who presented with large bowel obstruction. A significant CT findings of cholecystocolic fistula and an impacted gallstone at the junction of the descending and sigmoid colon. We present a case of colonic gallstone obstruction that was treated with endoscopic lithotripsy. This interventional approach is effective in stable elderly patients with high surgical risk and in patients with significant comorbidities.

A Rare Case Of Upper Arm Compartment Syndrome In A Patient On Anticoagulant Therapy, Zi Tan, Ammar Ahmed, Amr Khalifa, Roy Trumbo

Advances in Clinical Medical Research and Healthcare Delivery

Background Compartment syndrome is the condition when elevated pressures within an osseofascial compartment cause vascular and neurological compromise, leading to muscle ischemia and possible necrosis if left untreated. It commonly occurs after a traumatic event (e.g., crush injury, fracture, trauma); however, compartment syndrome can still happen spontaneously and in any compartment of the body.

The objective of this case report is to present the signs and symptoms of upper arm compartment syndrome, which is a rare site for compartment syndrome, along with a review of the diagnosis and treatment.

Case Report A 62-year-old man receiving anticoagulant therapy for atrial fibrillation …

Knowing What We Know: Leveraging Community Knowledge Through Automated Text-Mining, Justin Gardner, Jonathan Tory Toole, Hemant Kalia, Garry Spink Jr., Gordon Broderick

Advances in Clinical Medical Research and Healthcare Delivery

No abstract provided.

Why Are We Doing This?, Richard Alweis, Hemant Kalia

Advances in Clinical Medical Research and Healthcare Delivery

The editors of the journal explain the rationale for founding a new journal and the goals of the journal.

A Systematic Review: The Impacts Of Non-Pharmacological Therapy Interventions, Such As Exercise, On Postpartum Depressive Symptoms In Postpartum Women?, Jennifer Rafala, Amanda Kozlowski, Kristin Simons, Madison Rhoad, Courtney Greene

Symposium of Student Scholars

Abstract

Title: A Systematic Review: The impacts of non-pharmacological therapy interventions, such as exercise, on postpartum depressive symptoms in postpartum women?

Background: Postpartum depression is a psychological condition most often seen within six weeks after birth. Often confused with short-term “baby blues”, postpartum depression can be debilitating including excessive crying, insomnia, fatigue, feelings of hopelessness and worthlessness, and other disruptive symptoms that can impede the new mother’s ability to care for herself and her baby. Postpartum depression often goes unrecognized by new mothers; however, when diagnosed, treatment regimens frequently include pharmacological interventions.

Objectives: This systematic review aimed to determine the …

How Various Exercise Modalities Impact Quality Of Life, Physical Activity, And Program Adherence In Patients With Copd, Hannah Brookshire, Sarah Barnes, Natalie Cagle, Nancy Starnes, Elia Schaefer

Symposium of Student Scholars

How Various Exercise Modalities Impact Quality of Life, Physical Activity, and Program Adherence in Patients with COPD

Background: Chronic obstructive pulmonary disease (COPD) is a group of diseases that causes breathing difficulty due to airway obstruction. Adherence to physical activity recommendations for those with COPD is often problematic and leads to worsening dyspnea and quality of life. Due to the prevalence of COPD, it is important to understand how different exercise modalities impact quality of life and adherence to physical activity.

Objective: The purpose of this systematic review was to determine if patients with COPD have a better quality of …

Creating A Protein Chimera To Study Regulation Of Muscle Diversity, Shannon Scarboro

Symposium of Student Scholars

Creating a protein chimera to study regulation of muscle diversity.

Body muscles are made of many individual super-cells, called muscle fibers, that have distinct properties and determine every individual’s strength and endurance. Initially all muscle fibers have identical characteristics, but become differentiated into specific types in adults. The mechanism of such transition is not well understood, despite its obvious importance for shaping human physicality.

Remarkable conservation of the muscle tissue enables us to use fruit flies to study the mechanisms of muscle fiber diversity. We hypothesized that the transcription factor Mef2 acts as a molecular switch that activates structural genes …

A Systematic Review: The Impact Of Social Support Programs On Caregiver Burnout For Caregivers Of Children With Cancer, Vanessa Otamendi, Jalaya Graves, Autumn Whitley, Joanna Juarez, Helena Walker

Symposium of Student Scholars

Title: A Systematic Review: The Impact of Social Support Programs on Caregiver Burnout for Caregivers of Children with Cancer

Background: In addition to children diagnosed with cancer, their caregivers may also experience hardship. While caregivers handle their own personal responsibilities, they also provide emotional, physical, and financial support to their children. In addition to the likely stress that occurs from caring for a child with a long-term illness, lack of social support, educational resources, or support programs may lead to caregiver burnout.

Objective: The purpose of the systematic review was to review published research focused on caregiver burnout for caregivers …

A Systematic Review: The Effect Of Social Support On Emotional Burden Of Alzheimer’S Caregivers, Jessica Monahan, Julia Samuel, Guadalupe Perez, Cristiana Seixas, Adanech Jones

Symposium of Student Scholars

Background: Alzheimer’s disease is a degenerative form of dementia that affects not only patients but also their caregivers. Various social support interventions have been shown to benefit caregivers by decreasing stress, depression, anxiety, and other physical and psychological issues.

Objective: The purpose of the systematic review was to determine the effect of social support on emotional burden for caregivers of patients with Alzheimer’s disease.

Methods: Research was conducted using the databases PubMed and CINAHL to identify eligible studies. Specific inclusion and exclusion criteria were used when screening studies. After evaluation and assessment of the studies, a total of eight …

Fr247 Budesonide Vs. Mesalamine In Microscopic Colitis: A Systematic Review And Meta-Analysis Of Efficacy And Adverse Events, Adnan Malik Md, Hermant Goyal Md, Abhilash Perisetti Md, Mahum Nadeem, Mahesh Gajendran, Gregory Enders, Aman Ali, Benjamin Tharian

Other Specialties

Poster Presentation: BUDESONIDE VS. MESALAMINE IN MICROSCOPIC COLITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF EFFICACY AND ADVERSE EVENTS

Identifying Causes Of Readmission At Unm Hospital, Jewel Meyer-Hagen Ms3, Justine Yang Ms3, Christopher Bartlett Md, Avanika Mahajan Ms3, Susie Pham Ms3, Ishan Shah Do, Harsh Sharma Md, Jessie Rogers Md, Brianna Muller Md, Julia Howard Do, Radha Denmark Np, Gabriel Palley Md, Anthony Worsham Md

Quality Improvement/Patient Safety Symposium

Background/Introduction:

Inadequate coordination of care and poor transition of care quality are known contributors to hospital readmission. Patient readmission is a known risk factor for poor patient outcomes. Department of Internal Medicine (DOIM) readmission rate was 13.18% during fiscal year (FY) 2020, and is 13.58% to date during FY21. The objective of this study is to identify system-based drivers of readmission, understand why the readmission rate has increased from FY20 to FY21, and design interventions to address identified gaps.

Methods:

Developed a survey using RedCap. Retrospective chart review of 104 randomly selected patients discharged from UNMH during fiscal year 2020 …

2021-05-21_Michiganoverview_Covidbedppe, Michigan Department Of Health & Human Services

Michigan COVID-19 Hospital Data

Contains the tables Statewide Hospital Capacity Report for COVID-19, COVID-19 Metrics, Statewide Hospital Available PPE Tracking for COVID-19, as well as the tables PPE Days On Hand and Patient Census.

2021-05-21_Michigandaily_Covidmap, Michigan Department Of Health & Human Services

Daily Michigan COVID-19 Update

The "WHERE WE STAND WITH COVID-19" map was obtained from Michigan's main COVID-19 page: https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily at 3p.m., Monday - Saturday.

The State of Michigan is working around the clock to test and treat COVID-19 patients. Below is the most recent data healthcare experts across the state have compiled.

The image contained a map, indicating total cases by county, and also provides statistics on Total Confirmed Cases, Total COVID-19 Deaths, Daily Confirmed Cases, and Daily COVID-19 Deaths. There …

2021-05-21_Michiganoverview_Covidvaccinestats, Michigan Department Of Health & Human Services

Michigan COVID-19 Vaccine Data

The COVID Vaccine Dashboard page was obtained from Michigan's main COVID-19 page: https://www.michigan.gov/coronavirus/0,9753,7-406-98178_103214-547150--,00.html.

Data is updated Monday through Saturday. Previously reported numbers of administered vaccine doses may change as new data are received. A possible lag in reporting vaccine doses will result in increases in numbers previously reported.

This report is created by the Michigan Department of Health and Human Services Division of Immunization from data reported to the Michigan Care Improvement Registry (MCIR).

The dashboard contained the tabs Vaccines Delivered, Delivery Trend, Doses Administered, Doses by Vaccine, Doses Metrics, Coverage, Coverage Metrics …

Development Of An Ehealth Harm Reduction Resource To Address Opioid Use Among Youth In Rural Northern California, Carolyn Perrotti Lake

Doctor of Nursing Practice (DNP) Projects

Problem: Opioid use and misuse is a leading cause of injury and death among adolescents and young adults in the United States, with a three-fold increase in opioid overdoses since 2000 (Carney et al., 2018; Hudgins et al., 2019). Opioid misuse correlates with misuse of other substances, which exponentially increases health risks over time. The most effective treatment for opioid use disorder (OUD) among adolescence is through effective prevention interventions that either prevent the development of the OUD or enable timely diagnosis and treatment in order to prevent poor health outcomes.

Context: The use of eHealth technology, which has …

2021-05-21_Michiganoverview_Covidstats, Michigan Department Of Health & Human Services

Cumulative Michigan COVID-19 Data

The COVID Overview page was obtained from Michigan's main COVID-19 page: https:/www.michigan.gov/coronavirus/0,9753,7-406-98163-520743--,00.html.

The State of Michigan is working around the clock to test and treat COVID-19 patients. Below is the most recent data healthcare experts across the state have compiled. It is updated Monday - Saturday.
This report is provisional and subject to change. City of Detroit and Wayne County are reported separately. MDHHS began tracking probable cases April 5, 2020. FCI indicates federal correctional institute. MDOC indicates Michigan Department of Corrections. Diagnostic tests, including nucleic acid amplification/real-time polymerase chain reaction (NAAT/RT-PCR) and rapid virus antigen detection point of …

Stability Of Plasma Glucose In Whole Blood Samples Collected In Sodium Fluoride Tube Vs. Sodium Heparin Plasma Separator Tubes, Ryan C. Braunberger, Magen Martinez, David G. Grenache

Quality Improvement/Patient Safety Symposium

Background: The concentration of plasma glucose is influenced by preanalytical variables such as delayed processing of whole blood. Glucose concentrations decrease by 5-7% per hour in whole blood due to glycolysis. This preanalytical loss decreases the diagnostic sensitivity of glucose when used to diagnose diabetes mellitus or gestational diabetes mellitus. Sodium fluoride (NaF) is commonly used to inhibit glycolysis in samples collected during oral glucose tolerance tests, but is inadequate as it does not stop glycolysis for two or more hours. Guidelines recommend blood samples be immediately immersed in an ice slurry and analyzed within 30 minutes of collection, but …

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 …

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 …

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) …