Health Information Technology Commons^™

Anesthesia Services In The Time Of Covid, James Chen, Daisy Sangroula, Katelyn Williams, Sydney Pham, Ozan Akca, Jiapeng Huang, Sean Clifford

The University of Louisville Journal of Respiratory Infections

Our hospital is a 400-bed, Level-1 trauma center with 78 intensive care unit (ICU) beds serving the greater Louisville metropolitan area. The COVID-19 pandemic forced our hospital to re-evaluate our core business operations and to develop a coherent response to a fluid situation. Between March 15 and May 15, 2020, the University of Louisville Hospital admitted more than 100 COVID-19 inpatients; approximately 30 were admitted to the ICU, and most required endotracheal intubation. The following review describes our Department of Anesthesiology \& Perioperative Medicine foci, actions, and rationale during the COVID-19 pandemic. While we hope not to experience another pandemic …

Effective Ultrasound And Neural Mobilization Combinations In Reducing Hand Disabilities In Carpal Tunnel Syndrome Patients, Ni Luh Nopi Andayani, Ari Wibawa, Made Hendra Satria Nugraha

Jurnal Keperawatan Indonesia

Excessive activity in the hands and wrists over a prolonged period of time can cause repetitive strain injury, which leads to the occurrence of carpal tunnel syndrome. The purpose of this study is to determine the differences in the effectiveness of ultrasound therapy and neural mobilization interventions with ultrasound therapy and passive stretching in reducing hand disabilities in patients with carpal tunnel syndrome. It is an experimental study, using the pre-and post-test control group design. The sampling technique employed was simple random sampling, with a study sample comprising 30 people.The difference test with an independent t-test showed a significant difference …

Working Beyond 80: The Meaning Of Work To An Octogenarian In The Workforce, Ma. Mayla Imelda M. Lapa, Laurence L. Gracia, Endrex P. Nemenzo

Jurnal Keperawatan Indonesia

There is an increasing share of people aged 50 years and over in the labor market structure and the rapid aging of the global workforce that supports the latter claim but with a little tank of information on qualitative research describing the experiences of a working octogenarian. An octogenarian is a person who is between 80 and 89 years old. This study aimed to investigate the experiences of a working octogenarian in her fieldwork through a qualitative case study analysis. From the interview, the following three themes were revealed: (a) Work as a legacy, (b) Work as an advocacy, and …

Adaptation To Sexual Dysfunction In Patients With Chronic Renal Failure, Akhyarul Anam, Lestari Sukmarini, Agung Waluyo

Jurnal Keperawatan Indonesia

The prevalence of chronic renal failure in Indonesia tends to increase in the lower age group (45–54 years).Chronic renal failure may lead to impaired sexual function. A descriptive phenomenology study with in-depth interviews was carried out with 12 participants, and thematic content analysis was applied. Six themes were revealed, as follows: 1) adaptation process to sexual dysfunction experienced, 2) sexual dysfunction experience,3)importance of fulfilling sexuality needs,4) behavior in dealing with sexual dysfunction, 5) perception of the cause of sexual dysfunction, and 6) participants’ expectation of health service related to sexual function. The experience of adapting to sexual dysfunction became a …

Job Demands–Resources Model Affects The Performance Of Associate Nurses In Hospital, Khairunnisa Batubara, Bustami Syam, Sri Eka Wahyuni

Jurnal Keperawatan Indonesia

Low nurses’ performance is related with increased job demands and unprofessional job resources. This cross-sectional study aimed to analyze the effects of the job demands–resources model on the performance of associate nurses. The study population was composed of 126 nurses randomly selected. Data were analyzed using the multiple linear regression test. The results showed that job demands and job resources significantly affected the performance of associate nurses. A moderate or heavy level of job demands supported with good job resources will have a positive effect on nurse motivation; thus, nurse’s performance remains good. Job demands must be balanced with job …

Tuberculosis Cases Finding Practice: The Intention Of Cadres, Agnes Pude Lepuen, Cicilia Nony Ayuningsih Bratajaya, Sada Rasmada

Jurnal Keperawatan Indonesia

Tuberculosis (TB) is a difficult health problem to overcome. Active case finding is an important step in managing this infectious disease. However, the prevalence of TB case finding among cadres at the community level is low because of the stigma attached to TB, difficulty in geographical coverage, low public awareness, and social economic barriers. In addition, the empowerment and intention of cadres to perform community-based TB case finding are not optimal yet. This cross-sectional study aimed to determine the intention of TB case finding among 162 public health cadres at one district. Convenient sampling technique was employed in this study. …

Improvement In Patients’ Ability To Care For Anxiety And Impaired Body Image: A Case Report Of Acceptance And Commitment Therapy And Family Psychoeducation, Rasmawati Rasmawati, Budi Anna Keliat, Herni Susanti

Jurnal Keperawatan Indonesia

Heart failure and hypertension are non-communicable diseases that are responsible for 70% of deaths world wide and cause anxiety and impaired body image. Nursing interventions(therapy in general) and acceptance and commitment therapy increase patients’ acceptance of the disease and commitment to alleviate anxiety and improve impaired body image. Meanwhile, family psychoeducation improves the family’s ability to care for the patient. This case report presents two patients with heart failure and hypertension. The two patients experienced a decrease in symptoms on the cognitive aspects(difficulty concentrating, focusing on self, and decline body changes), affective aspects (worry, shame, and despair), physiological aspects(sleep disorders …

Nurses’ Awareness On Patient Safety Culture In A Newly Established University Hospital, Mohd Said Nurumal, Najwa Madinah Sabran, Siti Hazariah Abdul Hamid, Muhammad Kamil Che Hasan

Jurnal Keperawatan Indonesia

As a vital part of patient care delivery, patient safety culture contributes to the quality of care provided by nurses. Safe patient care is positively linked to the attitudes of nurses. This study aimed to assess the perception of nurses working in a newly established teaching hospital. A cross-sectional study involving 194 nurses from three different units was conducted by using a 24-item Hospital Survey of Patient Safety Culture. Data on gender, working unit, age, years of working, and attendance in workshops on patient safety were also collected. The majority of the nurses had a positive total score of patient …

Valsalva Maneuver To Decrease Pain Intensity During Arteriovenous Fistula Insertion In Hemodialysis Patients, Mahruri Saputra, Ikhsanuddin Ahmad Harahap, Sutomo Kasiman

Jurnal Keperawatan Indonesia

AV fistula allows external vascular access for hemodialysis patients. Because hemodialysis patients experience puncture wounds and stabbing pain approximately 300 times a year, development of methods to decrease pain intensity are of great importance. Some techniques, such as the Valsalva maneuver, are known to reduce pain. This study aims to assess the effect of the Valsalva maneuver on decreasing the intensity of AV fistula pain in patients receiving hemodialysis. The quasi-experimental research of pre and post without control applying consecutive sampling to get as many as 63 respondents. Pain intensity was measured by using the Numerical Pain Rating Scale (NPRS). …

Severe Covid-19, Arpan H. Chawala, Shivam Gulati, Bettina Sinanova, Jose Bordon

The University of Louisville Journal of Respiratory Infections

Introduction: There is substantial variation in the clinical characteristics and outcomes of severe coronavirus disease (COVID-19), making it difficult to do an optimal assessment of this condition. We reviewed the current English literature to identify the findings concerning the baseline characteristics and health outcomes of patients with severe COVID-19, primarily those with acute respiratory distress syndrome (ARDS).

Methods: We examined only studies that assessed patients with confirmed COVID-19 by reverse transcription-polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) with at least one of the following severity criteria: treated in the intensive care unit (ICU), ARDS, and/or invasive …

Is Sars-Cov-2 A Neurotropic Virus And A Potential Facilitator Of Cns Infection For Other Pathogens?, Jose Bordon

The University of Louisville Journal of Respiratory Infections

No abstract provided.

The Importance Of Cycle Threshold Values In The Evaluation Of Patients With Persistent Positive Pcr For Sars-Cov-2: Case Study And Brief Review, Jose Bordon, Donghoon Chung, Priya Krishnan, Ruth Carrico, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Some patients recover from COVID-19, but their reverse transcription-polymerase chain reaction (RT-PCR) for SARS-CoV-2 remains persistently positive. In the evaluation of these patients, it is important to define the cycle threshold (Ct) value of the RT-PCR test. This article will present a case study, address relevant findings and interpretation of the RT-PCR test, and explain the use of Ct values in defining when a healthcare worker may return to work. Our current approach is to allow health care workers with persistently positive RT-PCR to return to work if the Ct value is greater than 35.

Parents’ Feelings About School Reopening During Covid-19: Survey Results From Northeast Indiana, Mindy Flanagan Phd, Brandon T. Mcdaniel Phd, Michelle Drouin Phd, Jessica Pater Phd, Tammy Toscos Phd

Health Services and Informatics Research

A report compiled by a team from the Health Services and Informatics Research Group. Assess concerns and attitudes related to child(ren)’s return to school amid the COVID-19 pandemic among parents in Northeast Indiana. Method, results, and conclusion of survey results.

Covid-19 Surveillance Testing Of Healthcare Personnel Drives Universal Masking Practice, Paul S. Schulz, Ashley M. Wilde, Steve T. Hester, Jim Frazier, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Health care professionals (HCP) are at increased risk of COVID-19 infection due to the unpredictable clinical presentation of COVID-19 disease, limited SARS-CoV-2 testing, personal protective equipment (PPE) shortages, and the inherent inability to distance from patients. Infected HCP may infect others, including coworkers, leading to a simultaneous increase in the number of infections and decrease in the availability of HCP in a community. Due to PPE shortages, many healthcare systems have faced difficult decisions regarding utilization of PPE to protect HCP, patients, and the communities they serve. We describe Norton Healthcare’s success utilizing surveillance COVID-19 testing of HCP to inform …

Why Every Hospital Needs A Covid-19 Clinical Case Review Team, Ashley M. Wilde, Paul Schulz, Brian C. Bohn, Sarah E. Moore, Matthew Song, Clayton J. Patross, Bryan Denham, Jim Frazier, Steve T. Hester, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

A hospital’s response to a global pandemic requires a coordinated effort to provide consistent guidance as information rapidly changes. In the early months of the COVID-19 pandemic, diagnosis and subsequent containment was challenging due to unfamiliarity with disease presentation, unknown reverse transcription-polymerase chain reaction sensitivity, and inconsistent access to testing supplies. A centralized COVID-19 clinical case review team can provide guidance on test interpretation, isolation, resource coordination and more.

The Nurse Practitioner In The Time Of Covid, Julie Marfell, Lynn Kelso

The University of Louisville Journal of Respiratory Infections

No abstract provided.

An Overview Of Current Clinical Trials Of Agents For The Treatment And Prevention Of Covid-19 In The United States, Kenneth Schot Hannan, William P. Mckinney

The University of Louisville Journal of Respiratory Infections

Introduction: Given the rapid worldwide spread of SARS-CoV-2 and the attendant risks for severe complications and mortality, numerous clinical trials for its treatment and prevention have been generated in a short period. This report focuses on the categories of the wide spectrum of agents being studied in the United States and the intensity of effort involved with each so that clinicians may consider whether suggesting enrollment may be appropriate for their patients.

Methods: A search was completed of the ClinicalTrials.gov database on May 28, 2020, for all such trials underway as of that date in the US. A total 190 …

Untold Stories In User-Centered Design Of Mobile Health: Practical Challenges And Strategies Learned From The Design And Evaluation Of An App For Older Adults With Heart Failure., Victor Philip Cornet, Tammy Toscos Phd, Davide Bolchini, Romisa Rohani Ghahari, Ryan Ahmed, Carly Daley, Michael J. Mirro Md, Richard J Holden

Health Services and Informatics Research

BACKGROUND: User-centered design (UCD) is a powerful framework for creating useful, easy-to-use, and satisfying mobile health (mHealth) apps. However, the literature seldom reports the practical challenges of implementing UCD, particularly in the field of mHealth.

OBJECTIVE: This study aims to characterize the practical challenges encountered and propose strategies when implementing UCD for mHealth.

METHODS: Our multidisciplinary team implemented a UCD process to design and evaluate a mobile app for older adults with heart failure. During and after this process, we documented the challenges the team encountered and the strategies they used or considered using to address those challenges.

RESULTS: We …

Covid-19 Spread In Europe: The Soccer Connection, Bibodh J. Karki, Raghava S. Ambadapoodi, Zahid Imran, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Introduction: Mass gatherings, such as sports events, are potential causes of the rapid spread of COVID-19 infection. Millions of soccer fans travel across Europe every week. With the world’s most popular leagues continuing play until the second week of March 2020, we hypothesize that a correlation exists between the number of people attending the soccer league games in Spain, Italy, France, Germany, and the UK and the increasing number of cases of COVID-19 in these countries during the ongoing epidemic.

Methods: We calculated the total number of attendees in the five major soccer leagues from the popular sports websites and …

Automatic Recognition, Segmentation, And Sex Assignment Of Nocturnal Asthmatic Coughs And Cough Epochs In Smartphone Audio Recordings: Observational Field Study, Filipe Barata, Peter Tinschert, Frank Rassouli, Claudia Steurer-Stey, Elgar Fleisch, Milo Puhan, Martin Brutsche, David Kotz, Tobias Kowatsch

Dartmouth Scholarship

Background: Asthma is one of the most prevalent chronic respiratory diseases. Despite increased investment in treatment, little progress has been made in the early recognition and treatment of asthma exacerbations over the last decade. Nocturnal cough monitoring may provide an opportunity to identify patients at risk for imminent exacerbations. Recently developed approaches enable smartphone-based cough monitoring. These approaches, however, have not undergone longitudinal overnight testing nor have they been specifically evaluated in the context of asthma. Also, the problem of distinguishing partner coughs from patient coughs when two or more people are sleeping in the same room using contact-free audio …

Computer-Assisted Coding: Post Icd-10 Implementation, Teresa C. Allen

Applied Research Projects

Computer-assisted coding (CAC) has been around since the 1950s and is projecting to reach $4.75 Billion by 2022. However, it has not been on the hospitals’ priority list until 2014 before the implementation of ICD-10 in 2015. Computer-assisted coding is a technology software that helps streamline the coding workflow, reduce backlogs by increasing productivity, and help coders navigate through more extended, more complex charts more quickly. The technology is a type of artificial intelligence. The idea of computer-assisted became more front-line with the implementation of electronic health records (EHRs) and the demands of a more restrictive reimbursement from payers. Accuracy, …

Projecting The Covid-19 Weekly Deaths And Hospitalizations For Jefferson County, Kentucky, Seyed Karimi, Natalie Dupre, W. Paul Mckinney, Bert B. Little, Naiya Patel, Sarah Moyer

The University of Louisville Journal of Respiratory Infections

Introduction: The trends in the numbers of active hospitalizations and fatalities caused by the COVID-19 in Jefferson County, Kentucky, were projected over the period May 7 to August 20, 2020.

Methods: The projections provided in this report are from a susceptible-exposed-infectious-recovered (SEIR) model. The model was calibrated using the COVID-19 transmission dynamics parameters from relevant literature and clinical dynamics parameters from the county’s data. The model was used to measure the impact of public health policy interventions designed to contain the infection. The policy was modeled by its intervention day and impact on the transmission of the virus such that …

Increasing Cms Sepsis Core Measure Adherence Rates Through Virtual Consultation, Angela Cann

Dissertations

Problem: According to the Centers of Disease Control and Prevention (CDC, 2016), it is estimated that sepsis affects around 1.5 million individuals in the United States annually, causing the death of 250,000 individuals and being responsible for one out of three hospital deaths. One-fourth of patients who develop severe sepsis will die during their hospital stay. Delays in sepsis treatment contribute significantly to increased morbidity, mortality, and length of stay in the hospital. The Centers for Medicare and Medicaid (CMS) sepsis bundle guideline adherence rate in the Emergency Department of a Level III Trauma Center was stagnant at 55% through …

The Role Of Parent Self-Regulation In Youth Type 1 Diabetes Management., Katherine W Bauer, Marisa E Hilliard, Dana K. Albright Phd, Sharon L Lo, Emily M. Fredericks, Alison L Miller

Health Services and Informatics Research

PURPOSE OF REVIEW: Youth with strong self-regulation (SR), or the ability to manage thoughts, emotions, and behaviors, engage in more effective type 1 diabetes (T1D) management. However, while parent support and engagement are critical to ensuring positive youth T1D outcomes, it is rarely considered that parents' SR may also influence youth T1D management. If this is the case, novel interventions to improve parents' SR or ensure adequate support for parents with SR challenges offer great potential to improve family functioning and youth T1D management.

RECENT FINDINGS: Theoretical and preliminary empirical evidence suggests that parental SR impacts family processes that support …

False-Negative Sars-Cov-2 Reverse Transcriptase Polymerase Chain Reaction (Rt-Pcr) Is An Important Consideration For Patient Management And Infection Prevention: A Case Report From The Louisville Covid-19 Epidemiology Study, Matthew Song Pharmd, Bcidp, Ashley M. Wilde, Sarah E. Moore Pharmd, Brian C. Bohn Pharmd, Clayton J. Patross, Bryan Denham, Paul Schulz, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

We report a case of false-negative SARS-CoV-2 reverse transcriptase-polymerase chain reaction (RT-PCR) on a nasopharyngeal swab. Treating clinicians and infection preventionists should maintain a high suspicion for COVID-19 in the appropriate clinical setting despite negative test results. Utilization of chest computed tomography (CT) should be strongly considered in the diagnostic work-up for suspected COVID-19, particularly in areas with limited RT-PCR availability.

Concomitant Invasive Pneumococcal Disease In A Patient With Covid-19 – A Case Report From The Louisville Epidemiology Study, Clayton J. Patross, Brian C. Bohn Pharmd, Sarah E. Moore Pharmd, Paul Schulz, Matthew Song Pharmd, Bcidp, Ashley M. Wilde, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

A 60-year-old male presented to the emergency department (ED) with a 1–2 day history of confusion, headache, and subjective fever. Because he had met with a contact two days prior to admission who had recently traveled from the Bahamas, a COVID-19 nasopharyngeal (NP) and oropharyngeal (OP) polymerase chain reaction (PCR) test was ordered. He was diagnosed with bacterial meningitis based on presenting neurologic symptoms and the identification of Streptococcus pneumoniae from blood cultures. The COVID-19 NP and OP test returned positive, although he never developed shortness of breath, cough, other respiratory symptoms, diarrhea, abdominal pain, nausea, vomiting, or any change …

Assessing Mobile Phone Access, Usage, And Willingness Among Women To Receive Voice Message-Based Mobile Health Intervention To Improve Antenatal Care Attendance In District Thatta, Sindh, Pakistan, Anam Shahil Feroz, Naureen Akber Ali, Sarah Saleem

Community Health Sciences

Background: Pakistan has one of the highest maternal mortality ratios worldwide at 276/100,000 live births and only 51% percent of women receive four or more ANC visits. This means that there are missed opportunities for almost half of the women who were not able to seek the recommended antenatal visits. In Thatta district, the maternal mortality ratio is estimated at 313/100,000 live births. Various studies reported that mHealth interventions have proven to be effective to improve antenatal care and postnatal care services. However, the feasibility and effectiveness of mobile health interventions to increase uptake of preventive maternal healthcare services among …

It Governance For Balancing Evolveability And Standardization In Health Information System Implementation In Ethiopian Context, Birkinesh Lagebo, Birkinesh Lagebo, Mark Gaynor Prof., Temtim Assefa Dr

African Conference on Information Systems and Technology

Failing to balance standardization and evolveability in IS design and implementation process results sustainability failure which is common in developing country. IS research provides various IS design solution including layered modular architecture to address both evolveability and standardization simultaneously. However, this design solution requires appropriate IT governance mechanisms which lacks both theoretical and empirical explanation in IS research. The core of this research is understanding IT governance mechanism design that can balance standardization and evolveability in the course of IS design and implementation. The research uses the case of District Health Information System-2 (DHIS-2), layered modular architecture, design and implementation …

Strengthening The Evidence Base For Telehealth For Abortion Service Delivery, Nadi Kaonga

Journal of Maine Medical Center

Telehealth – which is the use of information and communication technology to provide clinical services to patients remotely – provides an opportunity to extend safe abortion services to women. A recent review article on telehealth for abortion service delivery found it to be acceptable, feasible and safe when compared to in-person service delivery. Despite the promising findings, the evidence base can and should be strengthened to optimize the impact of such services for women. Areas for improvement include evaluating the efficacy and effectiveness of telehealth implementations in more remote settings and with women across variable levels of technoliteracy, conducting cost-effectiveness …

Comparison Of Sars-Cov-2 To Sars-Cov, Mers, And Influenza A: A Systematic Review, Debbie Calabrese

Health Informatics Student Papers and Projects

Differences and similarities are examined among SARS-CoV-2, SARS-CoV-1, MERS and influenza A, in the context of transmissibility. Characteristics specific to the respective pathogens prove invaluable as they set the stage for intervention and management. SARS-CoV-2 bears similarities to other recently emerged infectious diseases in basic virologic ways, yet is distinctly different in terms of viral transmission dynamics. These differences arise from genomic qualities and properties specific to the virus. As ACE2 receptors are determinants for attachment and spread of the virus, and their role throughout tissues in the body is vast, an understanding of organ-level pathogenesis of SARS-CoV-2 is crucial …