Patient Safety Commons^™

Birthing Reimagined: Perceptions Of Safety And Autonomy In Birth Experiences Among Postpartum Individuals During Covid-19, Beldina Orinda

Senior Honors Papers / Undergraduate Theses

Background: Safety during childbirth is a priority for care providers, but patients' perceptions of safety may differ from those of providers, especially in biomedical settings.1–4 This can influence health outcomes and satisfaction with the birth experience.5–7 We hypothesize that autonomy, defined as the ability to make decisions about care during childbirth, may enhance feelings of safety and positive mental health outcomes.9,15

Methods: Surveys via REDCap v11.1.29 captured the experiences and Edinburgh Postnatal Depression Scale (EPDS) scores of pregnant and postpartum women. Participants (n=49) included 15 pregnant and 34 postpartum individuals, aged 18 and older, who had given …

Isolated Temazepam Overdose: A Unique Case Of An Unresponsive Female, Eric Doane

Rowan-Virtua Research Day

Cases of acute overdose presenting to the emergency department pose a great challenge given that history can sometimes be limited or at times be inaccurate. While naloxone is routinely given in the field to help reduce opiate’s sedating effects, the routine use of flumazenil has not been routinely adopted in cases of benzodiazepine overdose. This is because, unlike naloxone, there are many medications that act on the GABA receptor, and flumazenil is only specific for binding to the benzodiazepine/GABA receptor. This can lead to an unmasking of other medications that may be co-ingested that also effect the GABA receptor leading …

Release The Kratom: Post-Acute Withdrawal Syndrome In A 70 Year Old Male, Nardin El-Shammaa, Kyle Street, Narsimha Pinninti

Rowan-Virtua Research Day

Centuries in Eastern medicine.. Kratom has been commonly used for chronic pain and opiate withdrawal symptoms with first reported cases in the United States in the early 2000s. It is a plant that consists of psychoactive alkaloids that target opioid receptors with different affinity. Effects from Kratom are dose-dependent, at lower doses, it acts as a stimulant, while at higher doses produces analgesia and euphoria. Although Kratom is legal and easily accessible over the counter, there have been increasing reports of potential for addiction and toxicity. Cessation of Kratom can result in withdrawal symptoms similar to opiate withdrawal. Here we …

Challenges To Implementing Screening, Brief Intervention, And Referral To Treatment (Sbirt) For Substance Use In Primary Care Settings At Rowan-Virtua, Alissa Hochman, Kristy Straub, Nancy Chase, Samuel Damiri, Jenna Destefano, Allyson Distel, Sana Farhat

Rowan-Virtua Research Day

Background and Purpose: Implementing the SBIRT model for substance use in a primary care setting has many benefits including normalizing conversations about alcohol and other substance use into patients’ visits, thereby reducing harm, reducing consumption and its negative impact, and promoting system changes to overcome barriers to treatment access. The full scope of the current SBIRT project involves the recruitment, hiring, training, and integration of health educators in 9 primary care sites throughout South Jersey, as well as a project supervisor serving as implementation lead and liaison to medical and administrative staff at all 9 primary care sites. Initial barriers …

“I Know My Body Better Than Anyone Else” Perspectives Of People Who Inject Drugs On Antimicrobial Treatment Decision Making For Serious Infections, Amy Eckland, Michael Kohut Phd, Henry Stoddard, Debra Burris, Frank Chessa, Monica Sikka, Daniel Solomon, Colleen Kershaw, Ellen Eaton, Rebecca N. Hutchinson, Peter Friedmann, Thomas Stopka, Kathleen Fairfield, Kinna Thakarar

Costas T. Lambrew Research Retreat 2023

Introduction:

• Few studies have examined the perspectives of patients with lived experience regarding outpatient treatment options for injection drug use (IDU) associated infections.

• We sought to better understand the perspectives of both community partners with lived experience who work with people who inject drugs (PWID) and hospitalized patients with IDU-associated infections on shared treatment decision making.

Therapeutic Approaches To Working With Perinatal Loss Clients: A Grounded Theory Study, Heather H. Olivier

University of New Orleans Theses and Dissertations

Perinatal loss (i.e., miscarriage, stillbirth, termination, and infant death) is commonly referred to in the literature as an invisible loss, non-loss, and even medical event. It is an ambiguous loss exhibiting the dialectical contradiction between the physical absence and psychological presence of the baby accompanied by disenfranchised grief, a reaction to a loss that is unacknowledged by society. Despite the likelihood of mental health clinicians working with clients who have experienced perinatal loss, there has yet to be a therapeutic model designed specifically for the unique grief and trauma reactions presented in this population. Existing grief models do not address …

Physical Activity Among Adults With Psychiatric Illness In Karachi, Pakistan: A Survey Based Research, Aneeta Jevtani, Erum Perveen, Mustafa Uroosa, Nazia Zeya, Farkhanda Emad, Fareeha Kanwal, Mahum Azhaar, Faisal Yamin

Baltic Journal of Health and Physical Activity

Introduction: In Pakistan, psychological wellbeing is still considered a stigma and has limited resources to provide maximum care. Individuals with mental illness struggle with maintaining their sedentary behaviors and have poor wellbeing. The aim of the study is to investigate the physical activity among individuals with a psychiatric illness. Materials and Methods: A sample data of 144 outpatients, diagnosed with a psychiatric illness were collected from the Outpatient Department (OPD) of a public sector psychiatric set-up in Karachi, Pakistan. The participants were assessed with the International Physical Activity Questionnaire (IPAQ). Results: Females with a psychiatric illness were found to be …

Coh 1700: Health Care Coordination Syllabus, Sasha Harry

Open Educational Resources

This is the syllabus for a Health Care Coordination course.

The goal of health care coordination is to improve patient outcomes with better health care services. Care coordinators play a critical role in improving patient care. Students will learn how to effectively advocate for patients and interact with members of the healthcare team in finding solutions to provide high quality, value-based, and efficient care. Effective communication styles, assessing patient’s needs and goals, and helping with patients’ transitions of care are among many topics covered in this course. Upon course completion, students will have acquired basic knowledge and skills to educate, …

History Of Falls, Mild Cognitive Impairment, And The Presence Of Home Environmental Hazards Among Community-Dwelling Older Persons In District V, Manila, Marilou J. Raval, Donald S. Lipardo

Philippine Journal of Physical Therapy

Introduction: It is important to investigate factors that may increase the fall risk in the geriatric population. This study aimed to determine the relationship between: 1) mild cognitive impairments (MCI) and history of falls; 2) home environmental hazards (HEH) and history of falls; and 3) MCI and HEHs among older adults.

Methods: Community-dwelling older persons of District V, Manila were random sampled to participate in this cross-sectional correlational study. The Home Falls and Accidents Screening Tool for Health Professionals (HOMEFAST-HP) and Fall History Questionnaire were used to collect information on the presence of HEH and history of falls, respectively. Chi-Square …

Postpartum Depression For Mothers With Early Fetal Death Or Stillbirths, Callie Goldman

Symposium of Student Scholars

Background: Many times, prevention of early fetus death and stillbirths is possible; however, some mortality events are spontaneous or unavoidable. While existing research reveals the likelihood of postpartum depression for mothers following birth, few studies address the potential for postpartum depression of mothers of stillbirth or demised fetuses. The purpose of this study is to determine how mothers can be better prepared for the hardship of losing a baby during childbirth, while going through common difficulties, such as postpartum depression, following birth. Methods: A mixed method approach will be conducted to gather qualitative (interview) and quantitative (Edinburgh Postnatal Depression Scale …

Substance Use Among Nurses As A Result Of Covid-19, And The Impact Of Rehabilitative Programs On Nurses, Gerome Macaspac

Nursing | Senior Theses

Background: The incidence of substance use among nurses has been a persistent issue for decades. The effects associated with substance misuse depend on what is used, the amount, how often, and how they are taken. Regardless of the substance used, any nurse who enters the workplace using substances puts the lives of others at risk. Due to the widespread effects of the COVID-19 pandemic, there is a risk that the number of nurses resorting to the use of substances may have increased. Therefore, an investigation into drug use among nurses during the pandemic is particularly important.

Objective: To explore the …

Patient Perspectives On Opioid Risk Discussions In Primary Care, Stephanie A. Hooker, Inih J. Essien, Caitlin M. Borgert-Spaniol, Rebecca C. Rossom, Anthony W. Olson, Katrina M. Romagnoli, Leif I. Solberg

Journal of Patient-Centered Research and Reviews

Purpose: Both patients and clinicians have described discussions of potential opioid risks as challenging. This study’s goal was to understand patient perspectives on discussing opioid risks with primary care clinicians (PCCs).

Methods: Patients identified to be at elevated risk for problems with opioids (ie, opioid use disorder [OUD] diagnosis, taking a medication for OUD, or having ≥ 3 opioid prescriptions in the last year) were recruited from an integrated, Upper Midwest health system to participate in semi-structured qualitative interviews. Interview questions aimed to better understand patient views on conversations about opioid risks with PCCs and perceptions of OUD screening and …

Emergency Care For Youth Who Experience Suicidality And Identify As Lesbian Gay Bisexual Transgender Queer/Questioning (Lgbtq+): An Interpretive Phenomenology, Theresa Schultz

Electronic Theses and Dissertations

Purpose: Suicide is a leading cause of death in children; youth who identify as LGBTQ+ are at an exponentially higher risk of suicide. The purpose of this study was to explore the lived experiences of young adults who identify as LGBTQ+ and sought emergency care for suicidality when they were adolescents.

Methods: Heideggerian hermeneutics phenomenology is the research method used in this study. Youth, ages 18-25 years, who identify as LGBTQ+ and sought emergency treatment for suicidality when they were adolescents (13-17 years) were recruited to participate;fifteen youth enrolled. Individuals ranged in age from 20 to 25 years. Participants described …

Can Variables From The Electronic Health Record Identify Delirium At Bedside?, Ariba Khan, Kayla Heslin, Michelle Simpson, Michael L. Malone

Journal of Patient-Centered Research and Reviews

Delirium, a common and serious disorder in older hospitalized patients, remains underrecognized. While several delirium predictive models have been developed, only a handful have focused on electronic health record (EHR) data. This prospective cohort study of older inpatients (≥ 65 years old) aimed to determine if variables within our health system’s EHR could be used to identify delirium among hospitalized patients at the bedside. Trained researchers screened daily for delirium using the 3-minute diagnostic Confusion Assessment Method (3D-CAM). Patient demographic and clinical variables were extracted from the EHR. Among 408 participants, mean age was 75 years, 60.8% were female, and …

Discharged Against Medical Advice In The Postpartum Period: Why Should We Care?, Gurbani Bedi Bs, Mariam Ayyash Md, Mscr, Monique Swain Md

Medical Student Research Symposium

Objective: To understand reasons and events surrounding postpartum discharges against medical advice (AMA) in an urban population in Detroit, Michigan.

Methods: A retrospective chart review was conducted looking at women who left AMA in the postpartum period from Henry Ford Hospital in Detroit, Michigan between 2013 and 2021.

Results: 111 women (0.18%) left AMA in the postpartum period between 2013 and 2021. 35.1% of women were Black, 53% were White, 11.7% were of other races. 4.5% of women had home births and were brought in by EMS shortly after delivery. 44.1% of women had preterm births. 35.1% delivered via cesarean …

Utilizing Primary Care To Engage Patients On Opioids In A Psychological Intervention For Chronic Pain, Sikander Chohan, Lyuba Gavrilova Bs, Leah Hect, Kristi Autio, Erin Tobin, Brian K. Ahmedani, Lisa R. Miller-Matero

Medical Student Research Symposium

Introduction: Chronic pain is commonly encountered in primary care. It is often treated with opioids, which can cause overdose and death. Psychological interventions are an effective alternative, yet difficulty engaging patients with opioid prescriptions has led to their underutilization. Offering these interventions in primary care settings may alleviate this barrier.

Objective: Determine whether opioid prescriptions are related to patients engaging in a brief psychological intervention for chronic pain management in primary care.

Study Design: Secondary analysis of a pilot randomized clinical trial (RCT) of a 5-session psychological intervention for chronic pain. Patients with chronic pain (N= 220) were approached to …

Investigation Of Emergency Department Visits And Hospitalization Rates Of Child Physical Abuse At Cooper University Hospital Prior To And During The Covid-19 Pandemic, Afeerah Ahmad, Rachel Silliman Cohen, Laura Brennan

Rowan-Virtua Research Day

The COVID-19 pandemic has been detrimental for children. Many families have experienced stressors, including unemployment, financial hardship, and familial illness. These factors all pose increased risk for child physical abuse. Limitations in child welfare services affected investigations and provision of services to high-risk families. The extent to which the rates of physical abuse in NJ have been affected is unknown. We sought to answer the question of whether the COVID-19 pandemic affected the severity of physical abuse and the incidence of physical abuse presenting to Cooper University Hospital.

We hypothesized that there would be a higher proportion of severe child …

Understanding The State Of Lgbtqia+ Healthcare And Support In Camden County, Sayan Basu, Sana Farhat, Cindy Capps, Ali Harb

Rowan-Virtua Research Day

4.5% of American adults identify as lesbian, gay, or bisexual and about 1.4 million adults identify as transgender.

This demographic is impacted by many social determinants of health and health disparities, particularly for transgender patients.

33% of LGBTQIA+ patients ranging from a pool of 28,000 surveyed patients have had a negative experience with their health providers, and 8% of them had to educate their physicians about their needs due to physicians’ lack of knowledge about this demographic.

Research suggests that there is a reluctance to access mental health services in the LGBTQIA+ community due to homophobia,, difficulties disclosing sexual and …

Health Disparities In Adults With Developmental And Intellectual Disabilities, Tulsi Patel

Nursing | Senior Theses

This paper reviews literature pertaining to the treatment of people with developmental disabilities. It will emphasize the inadequacies of health care in this population. The literature that will be discussed focuses on disparities in care via proxy, sociodemographic and clinical factors associated with disparities, assessing the needs of this population, the prevalence of disabilities in rural and urban settings, and the comparison of health disparities between adults with and without developmental disabilities.

For the purpose of this paper, a few terms will be defined. Developmental disabilities (DD) will be defined as “a group of conditions due to an impairment in …

An Exploration Of Psychological Trauma And Positive Adaptation In Adults With Congenital Heart Disease During The Covid-19 Pandemic, Liza Morton Dr, Calum Calderwood, Nicola Cogan, Claire Murphy, Evan Nix, Jacek Kolacz Dr

Patient Experience Journal

The growing population of adults with congenital heart disease (CHD) often have lifelong experience of dealing with potentially traumatic health crises and medical uncertainty whilst facing increased vulnerability to post-traumatic stress disorder (PTSD). The COVID-19 pandemic presents additional challenges for this population including increased risk of health complications, shielding and strict social distancing, changes to medical care provision and social stigma. Despite such challenges, adults with CHD have the potential to also experience positive changes, yet little is known as to what helps cultivate positive adaptation and post-traumatic growth (PTG) within this context. The current study comprised a cross-sectional, anonymous, …

Protect Your Patients And Yourself: The Complete And Honest Medical History, Mitchell Gardiner Dmd

The Journal of the Michigan Dental Association

This feature article emphasizes the critical role of obtaining a complete and honest medical history in dental practice. Reflecting on the evolution of clinicians' diligence since dental school, the article underscores the potential risks associated with inadequate medical histories. The legal and ethical responsibilities in gathering comprehensive patient information are highlighted, emphasizing the impact on patient well-being and the dentist's vulnerability to legal challenges. The complexities of patients' truthfulness, especially regarding sensitive topics, are discussed, urging clinicians to establish trust for accurate disclosures. The article concludes with practical recommendations, stressing the ongoing need for thorough medical history reviews and the …

The Foundation For Dental Care: The Patient Interview And Dental/Medical Health History, Richard W. Panek Dds, George Georgiev Dds

The Journal of the Michigan Dental Association

This feature article emphasizes the pivotal role of patient interviews and medical history assessments in establishing the foundation for dental care. Delving into the essential components of a patient's medical history, the article underscores the significance of gathering comprehensive information, including medications, allergies, and lifestyle factors. The patient interview is explored as a dynamic process aimed at building rapport, understanding the chief complaint, and addressing potential health risks. The article navigates through various scenarios, from adapting questions for specific patient situations to handling challenging topics such as substance abuse and behavioral health issues. Ultimately, the integration of total medical assessment …

A Qualitative Analysis Of The Impact Of Electronic Health Records (Ehr) On Healthcare Quality And Safety: Clinicians’ Lived Experiences, Soumya Upadhyay, Han-Fen Hu

Healthcare Administration and Policy Faculty Research

Purpose: There have been mixed findings of clinicians’ perceptions of Electronic Health Record (EHR). This study aims to explore the lived experiences of clinicians, to assess the role of EHR in improving the quality and safety of healthcare.

Basic Procedures: A qualitative study design was used. We collected the opinions from different groups of clinicians (physicians, hospitalists, nurse practitioners, nurses, and patient safety officers) using semi-structured interviews. Organizations represented were trauma hospitals, academic medical centers, medical clinics, home health centers, and small hospitals.

Main findings: Our study found clinicians’ ambivalent assessments toward EHR, which confirms extant literature. …

Self-Measured Blood Pressure Monitoring: A Patient Empowerment Project, Alison Cusmano

Doctor of Nursing Practice Final Manuscripts

Hypertension is a public health issue estimated to affect 112 million adults by 2030. Primary care patients in an outpatient clinic in Southern California with elevated blood pressure readings in the office did not have an organized system for close follow-up. The purpose of this evidence-based project (EBP) was to educate patients on self-measured blood pressure monitoring (SMBP), Dietary Approaches to Stop Hypertension (DASH), diet interventions, and healthy weight loss to improve hypertension rates. Through these interventions, patients developed an understanding of their systolic and diastolic blood pressure goals. Nurse practitioners, medical assistants, and licensed vocational nurses screened for high …

Opioid Use Disorder: A Crisis Of Concern, Evangella Harville

Electronic Theses and Dissertations

According to a statement from the U.S. Centers for Disease Control and Prevention, between 2000 and 2017, approximately 700,000 people died from drug overdoses in the United States. Approximately 128 persons lose their life each day from an opioid overdose. The data for this study were collected by the vice president of operations at the study site from a preexisting database for 2019 and 2020. The participants were inpatient patients, 18 and older, both male and female, and were from all ethnicities. The study facility was located in Western New York and offered a 30-bed inpatient treatment center with 24-hour …

Physician Burnout Among West Virginia Primary Care Providers, Kevin S. Mccann, Adam Baus, Joanna Bailey, Laura Boone, Jennifer Boyd, Martha Cook-Carter, Dan Doyle

Marshall Journal of Medicine

Introduction

Work related burnout is highly prevalent in US physicians and linked to adverse effects on patients, providers and organizations. This study measures burnout in West Virginia (WV) primary care providers, allowing for comparison of results to a similar, recent study of US physicians.

Methods

Anonymous survey through email that included Maslach Burnout Inventory, demographic, workload, and practice characteristics. Responses were analyzed using JMP Pro 13. Analysis used JMP Pro 13 for descriptive statistics, chi-square and regression modeling.

Results

Subjects = 110, female/male ratio 1.4, all primary care physicians (PCP), or advanced practice registered nurses or physician assistants (APRN/PA). PCP …

Exploring The Therapeutic Relationship As A Central Focus Through Expressive Arts Therapy In Oncology, Akshata Parekh

Expressive Therapies Capstone Theses

The treatment for cancer can be physically, mentally, emotionally and socially challenging. These treatments have side effects like physical body pain, hair loss, changes in weight, energy, nausea and more. These physical changes impact the social, mental and emotional well-being of the patient and makes this journey of the life-threating prognosis of cancer very tough to confront. Expressive arts therapy provides a safe space for the patients to address their mental health concerns as a result of this treatment. The Capstone Thesis Project explored expressive arts therapy interventions with 95 patients through single or multiple sessions while going through their …

More Than A Myth: The Benefits Of Incorporating Holistic Healing Methods From Native American And Mexican Cultures To Approach Opioid Use Disorder (Oud) Treatment, Juliana Favela

CMC Senior Theses

Opioid Use Disorder (OUD) is a substance use disorder that characterizes a dependence on and an addiction to opioids. Opioids attack the prefrontal cortex, the dopaminergic reward system, and the hypothalamic-pituitary-adrenal (HPA) axis which is responsible for the body’s stress response. Opioids constantly shift one’s “set point” to the point where normal actions that cause joy and excitement no longer cause those feelings, resulting in craving and dependence. The opioid epidemic is currently ravaging the United States and has disproportionately affected Native American populations specifically in the rural areas (Tipps, et.al, 2018). The current methods for addressing OUD include medicine …

Supporting Academic Primary Care Teams Serving Refugees: A Qualitative Study, Gabrielle Waclawik Md Mph, Fabiana Kotovicz, Devin Walsh-Felz Md Mph, Savitri Tsering Mssw, Nancy Pandhi Md Mph Phd

Journal of Refugee & Global Health

Introduction: Primary care providers continue to experience significant challenges when caring for refugee patients, yet they are often refugees’ initial point of contact with the U.S. health care system. The purpose of this qualitative study is to expand our understanding of the experiences of academic primary care team members during clinical encounters with refugee patients.

Methods: This multi-perspective, qualitative study included physicians (faculty and residents), nurse practitioners, pharmacists, nurses, and medical assistants (n=10), who have been working with refugee patients for at least one year at two family medicine residency clinics and/or a community health center. Semi-structured in-person interviews were …

Factors Associated With Binge Drinking During The Transition Into Adulthood: Exploring Associations Within Two Distinct Young Adult Age Ranges, Tamara Leech, Sarah Jacobs, Denis Watson

Department of Public Health Scholarship and Creative Works

Background:

Binge drinking among young adults aged 18-21 years has declined over the past decade, but binge drinking rates among people 22-25 years old have remained largely the same. This steady trend in later years represents a departure from the traditional course of maturing out of risky alcohol use, perhaps because young adults are delaying the transition into adulthood.

Aims:

This paper explores the relationship between binge drinking and aspects of the transition into adulthood that could inform interventions targeting these two distinct groups of young adults.

Methods:

We use survey data on 1,081 young adults aged 18-25 living in …