Patient Safety Commons^™

Educating Nurses On Frequent Oral Care For Mechanically Ventilated Patients: An Evidence-Based Practice Project Proposal, Grace Alford, Susan Butz, Ruth Chavez, Joy Shoemaker

Doctor of Nursing Practice Scholarly Projects

The final scholarly project proposal is to implement oral care education for nurses in an intensive care unit (ICU). The proposal aims to create a guideline for an investigator to implement oral care recommendations for mechanically ventilated patients in order to reduce ventilator-associated pneumonia (VAP). The proposal consists of obtaining VAP data and oral care charting data for the unit studied, steps for providing oral care education, and analysis recommendations. Oral care involves swabbing the patient’s mouth every two hours with a swab and mouthwash. Oral care education would include handouts and direct teaching. The proposal aims to increase oral …

Dispelling The Malaria-Typhoid Co-Infection Myth In Nigeria. A Literature Review, Olawale Akinola

Dartmouth Library Staff Publications

Malaria and typhoid fever are public health concerns in Nigeria, with high prevalence rates. The perception of a widespread co-infection between these diseases may be misleading, due to limitations in diagnostic methods, particularly the Widal test for typhoid fever. This literature review examines the prevalence of malaria-typhoid co-infection in Nigeria and identifies factors contributing to misdiagnosis, including non-specific symptoms, limited diagnostic resources, and the diagnostic accuracy of tests employed. Additionally, the review discusses the implications of misdiagnosis, such as the overuse of broad-spectrum antibiotics leading to a rising incidence of antimicrobial resistance. Strategies to address this issue are explored, emphasizing …

Implementation Of A Standardized Suicide Screening Process In A University Student Health Clinic: A Quality Improvement Project, Addie Grace Strong, Kathryn Dambrino, R. David Phillippi, Linda Wofford

DNP Projects

Background: Suicide is a leading cause of death among college age students, prompting the need for evidence-based screening tools like the Columbia Suicide Severity Rating Scale (C-SSRS) to enable early detection and timely intervention. Inconsistencies in suicide screening may pose a risk of missed intervention opportunities. This Doctor of Nursing Practice project specifically aimed to improve the quality and consistency of suicide screening in a university student health clinic by implementing the C-SSRS tool into the clinic workflow during mental health appointments. Methods: Employing a quality improvement framework, this scholarly project followed the Institute for Healthcare Improvement Model for Improvement …

A Case Of “Neptune’S Fix Elixir” - The Dangerous Consequences Of Unregulated Use Of Tianeptine In Over-The-Counter Products, Priscilla Lozano, Maya Qutob Do, Eduardo Espiridion

Tower Health Research Day

No abstract provided.

Patient Characteristics Of, And Remedial Interventions For, Complaints And Medico-Legal Claims Against Doctors: A Rapid Review Of The Literature, Timothy J Schultz, Michael Zhou, Jodi Gray, Jackie Roseleur, Richard Clark, Dylan A Mordaunt, Peter D Hibbert, Georgie Haysom, Michael Wright

Faculty, Staff and Student Publications

BACKGROUND: It is uncertain if patient's characteristics are associated with complaints and claims against doctors. Additionally, evidence for the effectiveness of remedial interventions on rates of complaints and claims against doctors has not been synthesised.

METHODS: We conducted a rapid review of recent literature to answer: Question 1 "What are the common characteristics and circumstances of patients who are most likely to complain or bring a claim about the care they have received from a doctor?" and Question 2 "What initiatives or interventions have been shown to be effective at reducing complaints and claims about the care patients have received …

Beyond The Classroom Walls: Stakeholder Experiences With Remote Instruction In Post Rn Baccalaureate Nursing Program During The Covid-19 Pandemic: A Qualitative Inquiry, Laila Akber Cassum, Arusa Mansoor, Saima Sachwani, Zeenar Salim, Ridah Feroz, Shanaz Cassum

School of Nursing & Midwifery

The COVID-19 pandemic led to the closure of educational campuses and the suspension of conventional classroom teaching globally and locally, and many switched overnight to an online modality. The change was experienced differently by varied audiences, given the availability of resources. The study aimed to examine stakeholders' experiences of emergency remote instructions in the Post-RN Baccalaureate Nursing Program during the COVID-19 pandemic. A qualitative descriptive exploratory design with a purposive sampling technique was used at a private nursing university in Karachi, Pakistan. Focus group discussions with students and faculty were conducted separately, while in-depth interviews with key informants were held …

Respiratory Therapists' Attitudes On Patient Safety And The Use Of Workarounds: A Phenomenological Study, Lee Wisdom

Graduate Theses, Dissertations, and Capstones

Respiratory therapists (RTs) provide cardiopulmonary care and share the essential responsibility of keeping patients safe throughout their healthcare journey. RTs care for patients in various settings and manage mechanical ventilation (life-support), artificial airways, and attend emergencies such as cardiac arrests and other urgent clinical care matters (American Association for Respiratory Care [AARC], n.d.-b). As such, RTs may be exposed to opportunities in their day-to-day routines that influence patient safety. Currently, the literature is limited regarding RTs’ safety attitudes and the use of workarounds in respiratory care in the United States (U.S.). Both safety attitudes and the use of workarounds have …

Everyone Deserves A Dental Home, Loren C. Baim Dds

The New York State Dental Journal

With knowledge and preparation, dental practices should be able to accommodate the growing population of people on the autism spectrum.

Establishing Consent: The Role Of Women Representatives In Passing Informed Consent Laws, Sophia Stockham

Department of Political Science: Dissertations, Theses, and Student Research

What predicts the adoption of informed consent laws for pelvic exams within the United States? As of January 2023, 22 states have adopted informed consent laws for pelvic examinations on women, with eleven being under Democratic control, six being Republican control, and five with divided control between the legislature and gubernatorial level at the time of adoption. Little attention, however, has been given to women’s health mandates outside the issue of abortion and to variation among state partisan adoption regarding informed consent for pelvic exams. This paper examines the impact of partisanship, the percentage of women in the legislature, and …

J Mich Dent Assoc April 2024

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association provides news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. It stands as the primary publication reaching Michigan dentists.

In the April 2024 issue, the Journal focuses on the landscape of practicing in rural settings. Original content includes:

• A cover story highlighting Michigan’s Donated Dental Service Program
• A feature on Michigan’s Revised Kindergarten Oral Health Assessment Law
• A feature article on the origins, future, and use of the CDT Code
• Profiles of the 2024-25 MDA Officer, Trustee and ADA Delegation candidate
• An …

The Mda’S Michigan Donated Dental Services (Dds) Program: How To Serve The Elderly And Disabled In Your Community And Build Your Team (Without Leaving Your Office!), April Stopczynski

The Journal of the Michigan Dental Association

April Stopczynski, MDA Manager of Access and Prevention, sheds light on the Michigan Donated Dental Services (DDS) program, elucidating its impact on individuals through poignant patient narratives and dentist testimonials. The article illustrates how DDS bridges the gap in dental care for the elderly, disabled, and financially compromised individuals in Michigan. The program not only restores smiles but also transforms lives by providing much-needed dental treatment through volunteer dentists and labs. This article presents the value of DDS for patients, providers, dental team members and the greater community. Information is provided on how to participate in this transformative program.

Development Of Solitary Keratoacanthoma From A Cutaneous Wart, Joshua M. Ninan, Veronica Salazar

Research Symposium

Background: Common cutaneous warts, referred to in medicine as verrucae vulgaris, are proliferative lesions caused by human papillomavirus. These lesions are mostly benign and usually resolve without incident, except in the case of the patient mentioned in this report. Our patient developed a solitary keratoacanthoma, currently accepted as a clinical variant of squamous cell carcinoma, as a result of several risk factors and traumatic exposure. The current literature does not have an established association of HPV with solitary keratoacanthomas. This case report explores the presentation and pathogenesis of solitary keratoacanthomas within the setting of HPV.

Case Presentation: 48-year-old Caucasian female …

Close Contacts Of Xenograft Recipients: Ethical Considerations Due To Risk Of Xenozoonosis, Daniel J Hurst, Luz Padilla, Daniel Rodger, Tamar Schiff, David K C Cooper

Rowan-Virtua School of Osteopathic Medicine Departmental Research

With decades of pre-clinical studies culminating in the recent clinical application of xenotransplantation, it would appear timely to provide recommendations for operationalizing oversight of xenotransplantation clinical trials. Ethical issues with clinical xenotransplantation have been described for decades, largely centering on animal welfare, the risks posed to the recipient, and public health risks posed by potential spread of xenozoonosis. Much less attention has been given to considerations relating to potentially elevated risks faced by those who may care for or otherwise have close contact with xenograft recipients. This paper examines the ethical and logistical issues raised by the potential exposure to …

The Acceptance And Use Of Digital Technologies For Self-Reporting Medication Safety Events After Care Transitions To Home In Patients With Cancer: Survey Study, Yun Jiang, Misun Hwang, Youmin Cho, Christopher R Friese, Sarah T Hawley, Milisa Manojlovich, John C Krauss, Yang Gong

Faculty, Staff and Student Publications

BACKGROUND: Actively engaging patients with cancer and their families in monitoring and reporting medication safety events during care transitions is indispensable for achieving optimal patient safety outcomes. However, existing patient self-reporting systems often cannot address patients' various experiences and concerns regarding medication safety over time. In addition, these systems are usually not designed for patients' just-in-time reporting. There is a significant knowledge gap in understanding the nature, scope, and causes of medication safety events after patients' transition back home because of a lack of patient engagement in self-monitoring and reporting of safety events. The challenges for patients with cancer in …

Governmental Affairs Update, Neema Katibai Jd

The Journal of the Michigan Dental Association

The article presents the American Dental Association's federal advocacy achievements during the first half of the 118th Congress. The ADA has made significant strides in influencing policy and regulations across various categories, including workforce issues, dental insurance reform, access to care, student loan debt, Medicaid, practice management, veterans' affairs, health information technology, and public health. Their efforts span from urging legislative action to collaborating with federal agencies and Congress members. These accomplishments showcase the ADA's commitment to advancing dental profession interests nationally.

News You Need, David Foe Ma

The Journal of the Michigan Dental Association

The 2024 MDA Annual Session promises a range of valuable events and courses, including a free keynote by Joe Johnson, PhD, addressing career fulfillment. Additional highlights include the Gordon Christensen session, new dentist track, leadership courses, and an expansive exhibit hall. Meanwhile, the MDA House of Delegates Nominating Committee announced its candidate slate for the upcoming administrative year. The MDA also offers a free webinar on suicide prevention and celebrates communities awarded for water fluoridation quality. Additionally, ADA news covers a clinical guideline on managing dental pain, the ADA Academy's teaching program, and World Oral Health Day initiatives. Lastly, local …

Utilization Of The System Engineering Design Process To Design And Test A Low-Cost Infectious Aerosol Control Mechanism For Patient Aeromedical Evacuation, Sara Shaghaghi

Theses and Dissertations

The aeromedical evacuation of military patients is a critical component of care for Armed Forces members. The Air Force’s ability to transport patients relies on the technology and systems available. A vital transport responsibility is keeping the patient and medical personnel safe during transport. The historical and legacy systems provide reliable transport mechanisms for the Armed Forces’ patients infected with high-level biological agents, but drawbacks must be considered. This dissertation will discuss the development, conceptual design, and initial evaluation of a new low-cost, litter-mounted patient transport system, Biological-Mitigation in Patient Transport (B-MIPT), using the “V” model of the system engineering …

Practical Considerations For Navigating Withdrawal From The Federal Select Agent Program, Scott J Patlovich, Kristin G King, Robert J Emery, Zackary B Becker, Rebecca B Kairis

Faculty, Staff and Student Publications

INTRODUCTION: Clear guidance is provided by the Federal Select Agent Program (FSAP) to assist registered entities in nearly all facets of compliance with the Federal select agent regulations (7 CFR Part 331; 9 CFR Part 121; 42 CFR Part 73). If a registered entity chooses to discontinue its registration, detailed instructions for registration withdrawal are deeply embedded within a document entitled "eFSAP Form 1 Amendment Instructions," which is found on the FSAP website within the electronic Federal Select Agent Program (eFSAP) Resource Center.

METHODS: Using the information found within the eFSAP Form 1 Amendment Instructions, as well as extensive written …

A Pharmacist’S Central Role In Improving Hormonal Contraceptive Access, Aleese Smith, Urvi Patel, Alexandra Arledge, Josie Young, Erin Johanson

Annual Research Symposium

In 2019, the roles of Utah pharmacists grew with the implementation of a statewide standing order allowing prescribing abilities for hormonal contraceptives. With the rates of unplanned pregnancies in Utah up to 1 in every 5; pharmacists have a new role in birth control distribution. Pharmacists and pharmacy interns across the state of Utah are able to prescribe self-administered hormonal contraceptive medications including: oral pills, vaginal insertion medications, and birth control patches. Pharmacists are entrusted with the responsibility to evaluate the patient and their needs to ensure all women receiving birth control are educated about the risks and side effects …

Patient Education On Naloxone And Fentanyl Testing, Monika Baranek, Kyra Dockstader

Annual Research Symposium

To educate patients on the importance of naloxone use to prevent unintended opioid overdoses and deaths. To provide community resources for fentanyl testing and destigmatize their use.

Medication Errors Among Als Providers In The Prehospital Setting, Cody Vaughn Gibson, Victor Jimenez Jr

Annual Research Symposium

EMS providers administer a variety of medications to patients in the prehospital environment, and while there are numerous published studies on medication errors pertaining to the hospital environment, there are comparatively fewer studies which focus on the prehospital environment. Therefore, the purpose of this survey is to investigate the type and frequency of medication errors occurring in the prehospital environment.

The Mrna-Lnp Vaccines - The Good, The Bad And The Ugly?, Botond Z. Igyártó, Zhen Qin

Department of Microbiology and Immunology Faculty Papers

The mRNA-LNP vaccine has received much attention during the COVID-19 pandemic since it served as the basis of the most widely used SARS-CoV-2 vaccines in Western countries. Based on early clinical trial data, these vaccines were deemed safe and effective for all demographics. However, the latest data raise serious concerns about the safety and effectiveness of these vaccines. Here, we review some of the safety and efficacy concerns identified to date. We also discuss the potential mechanism of observed adverse events related to the use of these vaccines and whether they can be mitigated by alterations of this vaccine mechanism …

The Primary Care Np's Guide To Prevention And Management Of Falls In Older Adults, Janice Mark

Nursing and Health Professions Faculty Research and Publications

Falls are a growing health concern affecting older adults (defined as ages 65 years and older) that can lead to devastating consequences. NPs in primary care settings play an important role in the prevention and management of older adult falls. Methods and resources to screen for fall risk, assess risk factors, and manage falls in older adults are discussed.

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. …

Invisible Hand Of Socioeconomic Factors In Rising Trend Of Maternal Mortality Rates In The U.S., Disha Kanada

Dissertations, Theses, and Capstone Projects

Maternal death is a tragedy with devastating effect on families and serves as an important indicator of the quality of a health system. Worldwide, the maternal mortality rate has fallen; however, the maternal mortality rate is increasing in the United States in comparison to other wealthy developed countries. The United States spends a lot of resources on healthcare funds and therefore, the increasing maternal mortality rate is alarming. Apart from this, the birth rates are decreasing, so, it is hard to understand the relationship between declining birth rates (and fertility rates) and inclining mortality rates – logically, this does not …

Effect Of Russian Current Expert Modes On Quadriceps Muscle Torque In Healthy Adults: A Single-Blinded Randomized Controlled Trial, Ansam Hasan, Ibrahim Moustafa, Tamer Shousha

Faculty, Staff and Student Publications

BACKGROUND: Russian current (RC), a well-known neuromuscular electrical stimulation operating at 2500 Hz, has demonstrated significant strength improvement over traditional exercises due to its high tolerance and low pain provocation. Despite extensive NMES parameter research, the specific effects of expert modes, particularly ON2 and Rest, remain unexplored. This study investigates the direct effect of these expert modes on quadriceps muscle strength in healthy adults.

METHODS: This is a single-blind, randomization-controlled trial. Forty-eight healthy university students (31 females, 17 males) were assigned in two randomized experimental groups either the ON2 or Rest mode for a 15-minute electrical stimulation session. Quadriceps maximum …

Early Immersion In Team-Based Event Review: Experiential Patient Safety Education For Pgy 1 Internal Medicine Residents, Michelle Perkons, Alexis Wickersham, Sonia Bharel, Timothy Kuchera, Rebecca Jaffe

Department of Medicine Faculty Papers

INTRODUCTION: In recent years, there has been a national push to incorporate high-fidelity quality improvement and patient safety (QIPS) education into physician training programs. In fact, integration of robust patient safety education became an Accreditation Council for Graduate Medical Education (ACGME) Common Program Requirement for residency programs in 2017. We developed a curriculum to not only fulfill the ACGME's requirement but also provide PGY 1 internal medicine residents with the skills needed to become active participants in ongoing patient safety work throughout their training and careers.

METHODS: Our patient safety curriculum was woven into residents' existing protected educational time and …

The Association Between Early Exposure To Antibiotics And Childhood Asthma Incidence, Victoria Fischer

Soaring: A Journal of Undergraduate Research

This review examines the association between early exposure to antibiotics and the incidence of asthma in childhood, highlighting significant public health concerns related to antibiotic overuse. The misuse of antibiotics not only contributes to antibiotic resistance but may also impact long-term health outcomes, particularly respiratory diseases like asthma. Emerging evidence suggests that early antibiotic exposure may disrupt gut microbiota, altering immune responses and increasing the risk of asthma development. A systematic review of twenty-seven studies identified a significant correlation between antibiotic use in infancy and subsequent asthma diagnoses. However, there remains a need for further research to delineate the extent …

Reimagining Equitable Care: Simulation-Based Education And The Dismantling Of Implicit Bias And Stigma Of Vulnerable Populations In Hospitals, Vanessa Smith

Nursing | Senior Theses

Background: Simulation-based education consists of using high-fidelity mannequins and equipment to provide a safe space for healthcare professionals to practice crucial skills within healthcare. Used within hospitals and schools, simulation most commonly surrounds practicing hands-on skills such as central line insertion, IV insertion, Ultrasound-guided procedures, code blue response, etc. However, a large portion of healthcare that is overlooked is tackling issues within patient-provider relationships. Simulation can help dismantle the negative behaviors and feelings providers push onto patients through the use of standardized patients and role-playing. By using these methods, simulation can reduce providers’ personal implicit biases and the stigma associated …

Knowledge And Perception Of Hand Hygiene And Associated Factors Among Final Year Medical And Nursing Students In Dar Es Salaam Tanzania, Anthony Baltazary Ngowi

Master of Obstetrics and Gynecology

Hand hygiene, when practiced correctly and consistently is a simple and effective

method to prevent healthcare associated infections. These infections are acquired during a patients’ hospital stay and pose a major worldwide public health problem. The knowledge and practices related to hand hygiene among health workers need to be instilled early on during their training to develop a culture of correct and consistent practice. Existing literature has explored hand hygiene among health workers but very few studies have looked at it amongst medical and nursing students, who are the healthcare workers of tomorrow. This study aimed to assess hand hygiene …