Emergency Medicine Commons^™

Academic Detailing As A Health Information Technology Implementation Method: Supporting The Design And Implementation Of An Emergency Department-Based Clinical Decision Support Tool To Prevent Future Falls, Hanna J Barton, Apoorva Maru, Margaret A Leaf, Daniel J Hekman, Douglas A Wiegmann, Manish N Shah, Brian W Patterson

Faculty, Staff and Student Publications

BACKGROUND: Clinical decision support (CDS) tools that incorporate machine learning-derived content have the potential to transform clinical care by augmenting clinicians' expertise. To realize this potential, such tools must be designed to fit the dynamic work systems of the clinicians who use them. We propose the use of academic detailing-personal visits to clinicians by an expert in a specific health IT tool-as a method for both ensuring the correct understanding of that tool and its evidence base and identifying factors influencing the tool's implementation.

OBJECTIVE: This study aimed to assess academic detailing as a method for simultaneously ensuring the correct …

An Educational Intervention Differentiating Pressure Injuries From End-Of-Life Wounds, Alicia Perez Varela, Annette Callis

Providence Nursing Research Conference 2023 – Present

Background

End-of-life (EOL) wounds are identified in the literature as Kennedy Terminal Ulcers (KTU), Skin Failure (SF), Trombley-Brennan Terminal Tissue Injury (TB-TTI), and SCALE (Skin Changes at Life’s End). EOL wounds have a similar appearance to pressure injuries (PIs) with a fundamentally different etiology. The misclassification of EOL wounds as PIs results in increased Hospital Acquired Pressure Injuries (HAPI), hospital fines, and less-than-optimal EOL wound management.

Purpose

To examine the effectiveness of an educational intervention on EOL wounds in increasing nurse confidence in providing End-of-Life Care (EOLC) and differentiating PIs from EOL wounds.

Methods

This quasi-experimental study used the 28-item …

The Utility Of Interventional Anesthesia, Kylie Daguio, Kiley Jackson, Samantha Boever, Andrew Chang, James Keane, Leonard B. Goldstein

SOMA Faculty Publications

no abstract

" Does Educational Level Affect The Outcome Of Myocardial Infarction? ", Ahmed Magdy Ahmed Elsayed

Theses and Dissertations

Background: Heath awareness plays a major role in determining the outcomes of serious medical conditions specially when response time is crucial. STEMI patients are prone to serious compilations if they didn’t receive the appropriate treatment on time. Raising the health awareness of the community would result in seeking medical help at earlier stage of the disease. Earlier presentation to the medical center would result in better health outcomes. Certain factors form the health awareness of the community. This includes educational level, previous exposure to similar situations, and exposure to health awareness materials.

Methods: This is a cohort study in …

Advancing Virtual At-Home Care For Community Health Center Patients Using Patient Self-Care Tools, Technology, And Education [Letter], Cheryl Modica, Joy H. Lewis, Curtis Bay

SOMA Faculty Publications

Abstract

Introduction

Health centers are community-based, patient directed primary care providers that offer accessible, high-quality primary care within medically underserved communities. Screening for cancer and managing complex chronic conditions such as diabetes, hypertension, obesity, and depression are vital services for the vulnerable populations seen by community health centers. Delivering care for complex chronic conditions and preventive services using virtual models that integrate self-care tools and technology is an important approach to increasing access for hard-to-reach patients served by health centers.

Objective

This study aimed to explore the use of a virtual care model, applied using a systems approach and patient-driven …

The Interrai Ed Tool For Screening Older Patients In The Emergency Department: “What Am I Supposed To Do With This?”, Michael L. Malone

Journal of Geriatric Emergency Medicine

not applicable for Collective Wisdom/ Editorial per JGEM author guidelines.

Effectiveness Of Antibiotic Stewardship For Healthcare Providers At Urgent Care Clinics, Helen T. Adewole

Electronic Theses and Dissertations

Antibiotics have revolutionized modern medicine; however, the overuse in urgent care and primary care significantly contributes to the global burden of infections resistant to available antimicrobial medicines. Approximately 30% of the antimicrobials prescribed in acute care settings are unnecessary. Patient demand for antibiotics has seemingly skyrocketed following the recent COVID-19 pandemic. Practitioners must be knowledgeable about antibiotic stewardship initiatives, such as the wait-and-see approach, to reduce antibiotic overuse and improve the trajectory of antibiotic resistance and patient health outcomes. The gap in practice was the limited awareness of scientific evidence-based tools to partner with patients and improve antibiotic prescription patterns. …

Boarding Of Older Adults: A Concerning Trend In The Emergency Department, Julie Van Baardwijk, Eric Tharmathurai, Ariba Khan

Journal of Geriatric Emergency Medicine

Emergency department (ED) boarding (EDB) is the practice of holding admitted patients in the ED due to a lack of hospital beds. We identified one ED in our health system with a high rate of EDB. We sought to identify factors associated with EDB in this hospital by comparing it to a similar hospital in our health care system.

Methods: We conducted a retrospective study comparing two community hospitals in our healthcare system. Boarding was defined as a patient waiting ≥8 hours in ED for disposition. One hospital, located in a rural area with 55beds was chosen as it was …

De-Implementation Of Fecal Occult Blood Testing In The Emergency Department And Hospital Units: A Quality Improvement Project, Adewale Ajumobi, Joline De Castro, Ammar Qureshi

Journal of Community Hospital Internal Medicine Perspectives

Background: Fecal occult blood tests (FOBT) are inappropriately used in patients with melena, hematochezia, coffee ground emesis, iron deficiency anemia, and diarrhea. The use of FOBT for reasons other than screening for colorectal cancer is considered low-value and unnecessary. Methods: Quality Improvement Project that utilized education, Best Practice Advisory (BPA) and modification of order sets in the electronic health record (EHR). The interventions were done in a sequential order based on the Plan-Do-Study-Act (PDSA) method. An annotated run chart was used to analyze the collected data. Results: Education and Best Practice Advisory within the EHR led to significant reduction in …

Implementation Of Common Emergency Department Procedure Checklists To Improve Resident Provider Efficiency Background, Abigail Alorda, Alexa Ragusa, Natalie Diers, Taylor Cesarz, Shayne Gue, Latha Ganti

North Florida Division GME Research Day 2024

No abstract provided.

The Pit Crew Card Game: A Novel Gamifications Exercise To Improve Ems Performance In Critical Care Scenarios, Danielle Dicesare, Bridget Scheveck, Jeffrey Adams, Maria Tassone, Vanessa I. Diaz-Cruz, Christine Van Dillen, Latha Ganti, Shayne Gue, Ayanna Walker

North Florida Division GME Research Day 2024

No abstract provided.

Heart Of Medicine: Simulation To Educate Pre-Clinical Med Students In Basic Life Support (Bls) And Advanced Cardiac Life Support (Acls), Taylor Cesarz, Rachel Shi, Adrien Thokalath, Madison Morris, Shayne Gue, Noe Navarro, Rebecca Beiler, Stephanie Cohen

North Florida Division GME Research Day 2024

No abstract provided.

Impact Of Vertical Zone Redesign: One Hospitals Experience, Zachary Shields, Enrique Alvarez-Ventura, Curtis Johnson

North Texas GME Research Forum 2024

Background: Crowding in the emergency department has been a prevalent issue for decades, however, over the last few years, crowding and the number of patient visits in EDs have been higher than normal. Many factors influenced this, including the COVID-19 pandemic. Emergency departments around the country have been at a loss in improving patient flow and time in the ER. Literature has demonstrated some possible methods with varying results, but there has not been significant research on the subject.

Methods: After reviewing the literature, we designed a system where patients were stratified between different groups using the triage system. …

Utilization Of An Activity-Based Journal Club To Deliver Pediatric Education To Prehospital Providers, Lauren Bolton, Ratna Acharya, Jeffrey Katz, Linh Nguyen, Ariel Vera, Ayanna Walker

North Florida Division GME Research Day 2024

No abstract provided.

Escape The Music Festival - Disaster Day With A Twist, Drake Dixon, Alexa Ragusa, Maria Tassone, Shayne Gue

North Florida Division GME Research Day 2024

No abstract provided.

Resident Gamification Challenge: Unlocking Pocus Proficiency Board Review Through Play, Kevin Bertrand, Emily Macauley, Michael Falgiani

North Florida Division GME Research Day 2024

No abstract provided.

Gamification To Improve Ems Knowledge Of Medical Capacity Determination, Ross Sinicrope, Nasim Motaghedi, Zachary Yates, Elliott Richardson, Stephanie Schieffert, Jacob Wright, Abigail Alorda, Jeffrey Katz, Linh Nguyen, Shayne Gue, Christine Van Dillen, Ayanna Walker

North Florida Division GME Research Day 2024

No abstract provided.

Mastering The Ite With Em Mastermind: A Board Game For Board Review, Taylor Cesarz, Stephanie Cohen, Shayne Gue

North Florida Division GME Research Day 2024

No abstract provided.

Nursing Care During Natural Disasters, War Zones, And Mass Casualty Incidents: Implications For An Educational And Professional Overhaul, Erin N. White

Undergraduate Honors Theses

Emergency situations around the world are inevitable. Any nurse who practices for any period of time is sure to encounter situations like these. Their hospital may be flooded with traumatic and severely life-threatening patient cases where supplies can become scarce. In these situations, a nurse and all other healthcare personnel are expected to act effectively, efficiently and in a highly organized way. Despite this need, many hospitals fail to implement effective disaster preparedness programs and plans. This leaves healthcare workers at a loss for how to treat patients, communicate within and outside of the hospital, coordinate transport, and all the …

Ed Procedural Supply And Operations, Alex Teshon, Konner Cue, Logan Prewitt, Anita Datta

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

Targeted Procedure Lab To Improve Self-Identified Deficiencies Among Graduating Emergency Medicine Residents, Stephanie Cohen, Andrew Bobbett, Shayne Gue, Jeffrey Thompson

North Florida Division GME Research Day 2024

No abstract provided.

Single Question Survey Vs The Ongoing Violence Assessment Tool For Intimate Partner Violence Screening In The Ed, Zhengqiu Zhou, Donna Carden, Mariel Michaels, Gretchen Nonawzki, Saria Slowey, Maureen Mohan, Robyn Hoelle

North Florida Division GME Research Day 2024

No abstract provided.

Come One, Come All: Carnival Themed Gamification Of Emergency Medicine Board Review, Shayne Gue, Taylor Cesarz, Maria Tassone

North Florida Division GME Research Day 2024

No abstract provided.

Multiple Casualty Simulation Scenario Secondary To Natural Disaster At A Music Festival, Stephanie Cohen, Robert Pell, Casey Mcgillicuddy, Nidhi Sahi, Ariel Vera, Steven Nazario, Andrew Bobbett, Rebecca Beiler, Noe Navarro, Latha Ganti, Shayne M. Gue

North Florida Division GME Research Day 2024

No abstract provided.

Learning Mass Casualty Incident Triage Via Role Play Simulation, Martin Morales-Cruz, Ayanna Walker, Drake Dixon, Latha Ganti, Shayne Gue

North Florida Division GME Research Day 2024

No abstract provided.

Implementation Of Viz.Ai Augmented Intelligence Software To Reduce Door To Puncture Times And Patient Outcomes At A Comprehensive Stroke Center, Cody Bryant, Brandon Womack, Mason Patel, Sanjay Sharma

North Texas GME Research Forum 2024

Introduction: Endovascular therapy (EVT) in the form of mechanical thrombectomy is the mainstay of treatment for acute large vessel occlusion (LVO) ischemic stroke, but its efficacy is highly time sensitive. It is crucial that stroke centers continue to implement process improvements that aim to streamline stroke workflow. Viz.AI is a platform that uses artificial intelligence to automatically detect LVOs with computed tomography (CT) imaging. It provides immediate access to the CT images as well as a platform for centralized communication through the mobile application. We sought to determine if the implementation of Viz.AI at our comprehensive stroke center improved stroke …

Comparative Analysis Of Machine Learning Models For Predicting Healthcare Traffic: Insights For Optimized Emergency Response, Shadman Mahmood Khan Pathan, Sakan Binte Imran, M. M. Shabab Iqbal, Muhammad Enayetur Rahman, Md. Nurul Absar Siddiky, Muhammad Rezaur Rahman, Md Rafid Hasan, Nondon Lal Dey, Md Sobuj Hossain

Electrical & Computer Engineering Faculty Publications

Efficient management of healthcare traffic is crucial for ensuring timely access to medical services, particularly in emergency situations where delays can have severe consequences. This study presents a comparative analysis of three widely used machine learning models—Linear Regression, Decision Trees, and Random Forests—aimed at predicting healthcare-related traffic volumes. A large dataset from a metropolitan traffic system was used to train and evaluate the models based on key performance indicators, including Mean Squared Error (MSE), R² Score, and computational efficiency. The results reveal that the Random Forest model offers the best performance, achieving higher predictive accuracy and faster execution times compared …

The Validity And Reliability Of Ultrasound As A Tool For Assessing Skeletal Muscle Characteristics In The Pediatric Population, Elizabeth Seewer

Theses and Dissertations (ETD)

Annually, around 5 million people in the U.S. are admitted to Intensive Care Units (ICU) due to critical conditions, with pediatric patients comprising 21% of these admissions. Approximately 40% of pediatric ICU (PICU) patients require mechanical ventilation and extended stays, and about 6% result in death. Survivors often face long-term disabilities, including loss of skeletal muscle mass (SMM), a risk factor for morbidity and mortality. Abdominal computed tomography (CT) scans, often performed during PICU admissions, can assess muscle mass but pose risks of increased cost and radiation exposure. While CT and Magnetic Resonance Imaging (MRI) are gold standards for muscle …

Best Practices For Point Of Care Ultrasound: An Interdisciplinary Expert Consensus, Brandon Oto, Robert Baeten, Leon Chen, Puja Dalal, Ria Dancel, Steven Fox, Carl William Lange Iv, Cameron Baston, Paul Bornemann, Siddharth Dugar, Andrew Goldsmith, Meghan Kelly Herbst, James N Kirkpatrick, Abhilash Koratala, Michael J Lanspa, Viveta Lobo, Jason T Nomura, Aliaksei Pustavoitau, Mourad H Senussi, Vincent L Sorrell, Frances Mae West, Aarti Sarwal

Faculty, Staff and Students Publications

Despite the growing use of point of care ultrasound (POCUS) in contemporary medical practice and the existence of clinical guidelines addressing its specific applications, there remains a lack of standardization and agreement on optimal practices for several areas of POCUS use. The Society of Point of Care Ultrasound (SPOCUS) formed a working group in 2022 to establish a set of recommended best practices for POCUS, applicable to clinicians regardless of their training, specialty, resource setting, or scope of practice. Using a three-round modified Delphi process, a multi-disciplinary panel of 22 POCUS experts based in the United States reached consensus on …

Describing And Predicting Trajectories Of Healthcare Utilization Among Older Adults Presenting To An Emergency Department Using The Interrai Emergency Department Screener, Matthew B. Downer, Kristina Kokorelias, Andrew P. Costa, Don Melady, Samir K. Sinha

Journal of Geriatric Emergency Medicine

Introduction: Although older adults visit emergency departments (EDs) more than any other age group, the trajectories of healthcare utilization older adults experience post-ED are not well described. Further, whether rapid ED assessment tools can predict trajectories and discharge destinations remains unclear.

Methods: Older adults (≥65 years) who presented to an ED at a large Canadian urban academic hospital were recruited (January 2018-April 2019). The interRAI ED Screener (EDS) was completed on presentation. Patients were categorized by EDS risk score (1/2=low, 3/4=moderate, 5/6=high) and had their discharge destinations tracked. Patients admitted to hospital were tracked until their final discharge destination. …