Patient Safety Commons^™

Too Much Of A Good Thing: Case Of Fluoride Toxicity, Swet Patel, John Polunin, James Espinosa, Alan Lucerna, Trent Malcolm

Rowan-Virtua Research Day

Overall, the beneficial role of fluoride for the maintenance of proper dental hygiene has been known for many decades which has been corroborated by a plethora of research. Media and culture have further highlighted how using fluoride supplementation can help with dental cavities. It is clear that just as there are benefits to fluoride usage, there also risks. Further awareness needs to be made that showcases the downfalls of excess fluoride use. Labels need to be placed on fluoride products that emphasizes the dosing. It is imperative that people are educated on the toxicity of fluoride as too much of …

The Role Of Physiologic Vision Deficits In Elderly Self Dispensing Medication Errors, Harrison Patrizio

Rowan-Virtua Research Day

Elderly populations are more prone to self-dispensing medication errors. Although some of these errors can be attributed to a patient’s disease, many errors are preventable with behavioral modification. As we age, the lens of the eye becomes yellow. This tints all light that passes through it causing deficits in color distinguishability.(Andreasen, 1980) Additionally, the lens of the eye hardens over time. This results in presbyopia, an inability to focus close objects.(Wolffsohn, 2018) These changes can cause elderly patients to misread labels or dispensed incorrect medication due to color shade similarities.(Cardarelli, 2011) Although these visual changes are well documented, current research …

Literature Review: Incidentalomas In Emergency Medicine - How Often Are They Reported And Are Patients Informed?, Mohammad Rattu, James Espinosa, Alan Lucerna, James Lee

Rowan-Virtua Research Day

The purpose of this proposed study is to look at the rate of incidental findings on CT scan in a community hospital setting, as well as to look at the rate of documentation of communication of the findings to the patient and referral for follow-up to primary care or to a specialty follow-up.

America’S History Of Health Disparities: How Does This Affect The Future Of Healthcare In Mississippi?, Zuri O. Dixon Omere, Jazmin King

Honors Theses

America’s healthcare system runs rampant with healthcare inequalities that have an alarming effect on minorities and people of color. In order for people of color and marginalized groups to receive proper care and treatment, more attention needs to be brought to these inequalities. For example, Covid-19 reflected the health inequalities that are present in this country; minorities were more likely to become hospitalized due to Covid-19 than other non-minorities. In addition, minorities in women’s health, specifically black women, have been affected in various ways that are related to the inequalities in medicine like dying during childbirth and improper care. This …

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 …

Civility And Communication Interventions To Improve Patient Outcomes, Lane Denney

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Communication in health care is vital for the successful care of patients and their outcomes while they are hospitalized. Healthcare workers are responsible for communicating patient information whether it is between change of shifts or reporting to a patient’s provider. It is important that this information is communicated effectively. This review evaluates how nurses communicate in shift- report and how this affects patient outcomes and civility between nursing units and teams. Overall, bedside shift reports promoted the best patient outcomes and increased teamwork on hospital units.

Peer Review/Ethics: How Can Our Office Be More Inclusive Of Transgender Patients?, Debra Peters Dds

The Journal of the Michigan Dental Association

In this professional ethics article, Dr. Debra Peters of the ADA’s Council on Ethics, Bylaws and Judicial Affairs addresses the need for dental teams to be more inclusive of transgender patients, emphasizing the challenges faced by transgender and gender non-conforming (TGNC) individuals in accessing dental care. The article recommends providing training and resources for dental teams, highlighting the importance of first impressions and effective communication during patient interactions. Practical suggestions include incorporating affirmed name and gender options in registration forms, ensuring appropriate language in interactions, and addressing insurance claim discrepancies. The column promotes creating a respectful environment and cites the …

U.S. Army Medical Command’S Medical Treatment Facilities’ Response To Sars-Cov-2 (Covid-19), Seyedmohammad Ahmadshahi

All Theses

Starting in December 2019 to the current time in May 2022, COVID-19 was a devastating pandemic with approximately 440 million cases and 6 million deaths worldwide (Centers for Disease Control and Prevention [CDC], 2021). The United States (US) with roughly 90 million cases and 1 million deaths (CDC, 2021) was one of the epicenters of the outbreak since the beginning. The pandemic has significantly impacted the health systems across the US with unpredictable surges of highly infectious patients with uncertain symptomology and acuity levels, requiring isolation and critical level of care (Brambilla et al., 2021).

Based on the findings from …

Assessing The Potential Effectiveness Of Diffuse Reflectance Spectroscopy For Quantifying Neonatal Skin Properties Using Tissue Phantoms, Jack Murphy

Biomedical Engineering Undergraduate Honors Theses

Diffuse reflectance spectroscopy (DRS) has previously been shown to be effective at analyzing the optical characteristics of a wide variety of biological tissues, including the skin. In addition to being sensitive to the amount of blood and its oxygenation, DRS can be used to extract bilirubin levels and assess jaundice, a common complication in newborn infants. To assess its potential for being utilized in applications involving neonatal skin, we evaluated the utility of DRS for extracting hemoglobin and bilirubin concentrations from tissue phantoms. Phantom sets were created by including a known amount of scattering and by varying known concentrations of …

Understanding Patient Experiences Before And During The Covid-19 Pandemic: A Quasi-Experimental Comparison Of In-Person And Virtual Cancer Care, Linda Watson, Claire Link, Siwei Qi, Eclair Photitai, Lindsi Chmielewski, Diane Fode, Andrea Deiure

Patient Experience Journal

The COVID-19 pandemic prompted the immediate widespread implementation of virtual care appointments in Cancer Care Alberta (CCA). This study aimed to compare patient experiences and satisfaction with in-person care provided prior to the pandemic and virtual care provided after the COVID-19 outbreak. Surveys were conducted to compare patient satisfaction, using the Your Voice Matters (YVM) experience survey, between patients in the pre-pandemic in-person (baseline) and post-outbreak (virtual) cohorts. Generalized Linear Models (GLMs) with an ordinal logistic link were used, adjusting for self-reported health status and other covariates, to investigate the association between cohort type and patient satisfaction. Despite having higher …

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, …

Family’S Sufferings From Asymptomatic Covid: Clinicians’ Perspective, Neha Joshi Dr, Jitender Nagpal Dr, Anand Sinha Dr

Patient Experience Journal

Anticipating dire consequences, in 2020 the world braced itself for the unparalleled pandemic by resorting to unprecedented measures including stringent lockdowns, unforeseen social isolations, spotlight focus, resource diversions besides reorganized healthcare systems to name the quintessential few. Such unifocal convergence enhanced the vulnerabilities of patients dependent on non-COVID healthcare assistance. For a nation with a meagre allocation of 0.7 hospital beds per 1000 people and a lopsided doctor-population ratio of 1:1800, COVID-centric measures created unintended complications. Ironically, many succumbed in myriad ways, not due to the pandemic but due to the attributes of the survival measures. While such consequences cannot …

Infant Car Seat Safety Education And Confidence Measure For Maternal-Child Nursing Students, Mariah A. Arnett

Honors College Theses

Studies have shown that nursing students experience a greater-than-normal amount of anxiety and decreased clinical confidence when in settings involving infants and children, which is said to have a negative impact on the learning experience (Lassche, 2013; Moscaritolo, 2009). Patient education is a vital aspect of nursing, but one that the student nurse may not feel comfortable taking part in, either because of their lack of nursing experience or because of a lack of experience with infants and infant safety (Potter, 2020; Lassche, 2013). This project attempts to assess for a change in clinical confidence after providing a subject specific …

Advancements In Left Ventricular Assist Devices To Prevent Pump Thrombosis And Blood Coagulopathy, Grainne Malone, Gerges Abdelsayed, Fianait Bligh, Fatma Al Qattan, Saifullah Syed, Prateepan Varatharajullu, Augustin Msellati, Daniela Mwipatayi, Maimoona Azhar, Saulat Hasnain Fatimi

Section of Cardiothoracic Surgery

Mechanical circulatory support (MCS) devices, such as left ventricular assist devices (LVADs) are very useful in improving outcomes in patients with advanced-stage heart failure. Despite recent advances in LVAD development, pump thrombosis is one of the most severe adverse events caused by LVADs. The contact of blood with artificial materials of LVAD pumps and cannulas triggers the coagulation cascade. Heat spots, for example, produced by mechanical bearings are often subjected to thrombus build-up when low-flow situations impair washout and thus the necessary cooling does not happen. The formation of thrombus in an LVAD may compromise its function, causing a drop …

Anakinra Treatment Efficacy In Reduction Of Inflammatory Biomarkers In Covid-19 Patients: A Meta-Analysis, Zunaira Naveed, Musharraf Sarwar, Zahid Ali, Danish Saeed, Khadija Choudhry, Azza Sarfraz, Zouina Sarfraz, Miguel Felix, Ivan Cherrez-Ojeda

Department of Paediatrics and Child Health

Introduction: Anakinra is being empirically considered for the treatment of COVID-19 patients. The aim is to assess the efficacy of anakinra treatment on inflammatory marker reduction, including c-reactive protein (CRP) concentrations, serum ferritin, and serum d-dimer levels.
Methods: Adhering to PRISMA 2020 statement guidelines, a systematic search was conducted across the following databases from December 2019 until January 10, 2022: PubMed/MEDLINE, Cochrane Central, Web of Science, Scopus, and EMBASE. The following keywords were employed: Anakinra, COVID*, SARS-CoV-2, inflammatory, CRP, D-dimer, Ferritin, hematological, laboratory, clinical, trials. The findings were collated and presented in a tabulated manner, and statistically analyzed using Review …

Responding To Sexual Abuse In Health Care: Development Of A Guide For Patients, Tristan Mcintosh, Heidi Walsh, Meredith Parsons, Erin D. Solomon, Jessica Mozersky, James M. Dubois

Journal of Patient-Centered Research and Reviews

This report details the development of a stakeholder- and evidence-informed online resource guide for patients that provides information to raise awareness about sexual abuse in health care, the value of chaperones, and options for responding to sexual abuse. The guide was developed to reflect lessons learned from 10 years of researching physician wrongdoing (ie, sexual violations, improper prescribing, and unnecessary invasive procedures), a 5-year National Institutes of Health-funded mixed-methods study of 280 cases of egregious wrongdoing in medicine, and an expert working group. Focus groups were conducted with 22 patients from diverse backgrounds to obtain feedback on the acceptability of …

Understanding Travel For Families With A Physically Disabled Child Through The Occupational Therapy Lens, Dinah Adams, Karen Park, Susan Macdermott

Spring 2022 Virtual OTD Capstone Symposium

Travel is a complex occupation that involves interactions between body function, activity participation, and the environment. For families traveling with a physically disabled child this occupation becomes even more complex. The available literature on the lived experiences of these families is significantly limited. This project aims to determine participants’ experiences of commercial airline travel with a child who has a physical disability. Through the participants experiences, barriers and needs of this population can be identified. Through identification of barriers, the needs of this population are highlighted as well as ways they can be supported and advocated for.

The Efficacy Of Low-Dose Aspirin In Pregnancy Among Women In Malaria-Endemic Countries, Melissa Bauserman, Sequoia I. Leuba, Jennifer Hemingway-Foday, Tracy L. Nolen, Janet Moore, Elizabeth M. Mcclure, Adrien Lokangaka, Antoinette Tsehfu, Sarah Saleem, Saleem Jessani

Community Health Sciences

Background: Low dose aspirin (LDA) is an effective strategy to reduce preterm birth. However, LDA might have differential effects globally, based on the etiology of preterm birth. In some regions, malaria in pregnancy could be an important modifier of LDA on birth outcomes and anemia.
Methods: This is a sub-study of the ASPIRIN trial, a multi-national, randomized, placebo controlled trial evaluating LDA effect on preterm birth. We enrolled a convenience sample of women in the ASPIRIN trial from the Democratic Republic of Congo (DRC), Kenya and Zambia. We used quantitative polymerase chain reaction to detect malaria. We calculated crude prevalence …

Quality Reporting On Dialysis Water Testing And Dialysis Machine Disinfection, Jennifer Boquiren Quitevis

Student Scholarly Projects

Practice Problem: Kidney failure affects 0.1% - 0.2% of the general population, yet the dialysis expenditure is 5%-7% of total healthcare budget spending. The increased incidence of chronic disease will result in more End Stage Renal Disease patients on dialysis along with more comorbidities. Thus, it is imperative for health organizations to have well established protocols and guidelines to manage the care of the dialysis patient.

PICOT: The PICOT question that guided this project was: in patients receiving dialysis at an acute care dialysis unit (P), does utilizing a Standardized Policy for Quality Reporting on Dialysis Water Testing and …

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 …

Lower The Risk For Medical Emergencies, Christopher J. Smiley Dds

The Journal of the Michigan Dental Association

Clinicians focus on health and safety for our patients. The editorial highlights the importance of cultural competence in dentistry to mitigate the risk of medical emergencies. Reflecting on a recent CE program, Dr. Smiley underscores the need for proactive emergency preparedness, emphasizing detailed protocols and hands-on training. The article advocates for thorough patient screening, incorporating three questions presented by Dr. Mitchel Gardiner in an article in this month’s issue, addressing patient-specific health considerations and consulting with healthcare providers. The editorial concludes by stressing the significance of risk reduction through comprehensive assessments, team training, and preparedness.

J Mich Dent Assoc April 2022

The Journal of the Michigan Dental Association

Monthly, The Journal of the Michigan Dental Association brings news, information, and feature articles to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this April 2022 issue, the reader will find the following original content:

• A cover feature “Protect Your Patients and Yourself: The Complete and Honest Medical History”
• A feature article “The Foundation for Dental Care: The Patient Interview and Dental/Medical Health History”
• A 10-Minute EBD “The Preferred Analgesia for Orthodontic Tooth Movement: Acetaminophen or NSAIDs?”
• News you need: an Editorial, a "Reminder about Antitrust Law", and regular department articles, …

Succinic Semialdehyde Dehydrogenase Deficiency (Ssadhd): Qualitative Needs Assessment For Patients With A Rare Neurological Disorder, Cassandra Bovee, Kayla Woodring

Annual Research Symposium

No abstract provided.

Self-Medication Practices In Medical Students During The Covid-19 Pandemic: A Cross-Sectional Analysis, Farah Yasmin, Muhammad Sohaib Asghar, Unaiza Naeem, Hala Najeeb, Hamza Nauman, Muhammad Nadeem Ahsan, Abdullah Khan Khattak

Medical College Documents

Background and objectives: During the pandemic, the growing influence of social media, accessibility of over-the-counter medications, and fear of contracting the virus may have led to self-medication practices among the general public. Medical students are prone to such practices due to relevant background knowledge, and access to drugs. This study was carried out to determine and analyze the prevalence of self-medication practices among medical students in Pakistan.
Materials and methods: This descriptive, cross-sectional study was conducted online in which the participants were asked about the general demographics, their self-medication practices and the reasons to use. All participants were currently enrolled …

Increasing The Knowledge Of Opioid Use Disorder (Oud) And Medication Assisted Treatment (Mat) In Advanced Practice Registered Nurses (Aprns) In Georgia, Angela Queen Roberts, Jennifer Goldsberry Dnp, Msn, Fnp-Bc, Aprncne,, Gail Godwin Ph.D. Pmhnp-Bc,Cne, Sallie Coke Ph.D., Aprn, C-Pnp, C-Fnp, Pmhs

Graduate Research Showcase

The national opioid crisis has had devastating effects on the United States (US) healthcare system with the financial burden totaling more than $2 trillion from 2015 to 2018 (White House Government, 2020) and the physical burden of 128 overdose-related deaths daily (Centers for Disease Control, 2020). According to the Centers for Disease Control (CDC), some of these deaths are the result of deficits in education to healthcare providers about pain management treatment (CDC, 2020). Improved education for healthcare providers has resulted in a significant decline in the total number of opioid prescriptions from 2016-2019 which suggests that successful containment of …

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. …

Perspective On Newborn Screening (Nbs): Evidence Sharing On Conditions To Be Included In Nbs In Pakistan, Hafsa Majid, Lena Jafri, Sibtain Ahmed, Khadija Humayun, Salman Kirmani, Natasha Bahadur Ali, Bushra Moiz, Aysha Habib, Bushra Afroze

Department of Pathology and Laboratory Medicine

Newborn screening aims at detecting treatable disorders early so that the treatment can be initiated to prevent mortality and morbidity. Such programmes are well established in most developed countries, and all newborns are screened for selected metabolic, endocrine and other disorders based on disease epidemiology, testing and treatment availability, efficiency and cost-effectiveness. Even in developing countries, such screening programmes are initiated using heel prick capillary blood collected on filter paper. The current narrative review was planned to provide a perspective with evidence in favour of starting newborn screening for different disorders. The programme project should be initiated nationwide, taking one …

Residual Symptoms And The Quality Of Life In Individuals Recovered From Covid-19 Infection: A Survey From Pakistan, Mohammad Aadil Qamar, Russell Seth Martins, Rubaid Azhar Dhillon, Areeba Tharwani, Omar Irfan, Qosain Fatima Suriya, Wajiha Rizwan, Javaid Ahmed Khan, Ali Bin Sarwar Zubairi

Medical College Documents

Background: There remains scarcity of literature regarding the patient's health status post-COVID-19 infection. This study analyzes the prevalence of residual symptoms and quality of life (QoL) after COVID-19.
Methods: An anonymous online survey was administrated in Pakistan from November 2020 to April 2021 in COVID-19 survivors. The questionnaire used the 12-Item Short Form Health Survey (SF-12) to assess mental and physical QoL. Multivariate linear regression was used to explore factors associated with mental and physical QoL scores.
Results: A total of 331 COVID-19 survivors participated in our survey. Around 42.0% of the cohort reported within 1-3 months of diagnosis of …

Male Breast Cancer: The Three Decades' Experience Of A Tertiary Care Hospital In A Lower-Middle Income Country, Sana Zeeshan, Muhammad Tayyab, Fatima Shaukat, Muhammad Usman Tariq, Nargis Khan, Lubna Vohra

Section of General Surgery

Introduction Male breast cancer is uncommon and managed on the guidelines of female breast cancer due to tumor rarity. We sought to identify the incidence, clinicopathological features, and survival of all male breast cancer patients managed in our hospital. Methods A retrospective cross-sectional study was conducted at Aga Khan University Hospital (AKUH), Karachi, Pakistan, from January 1986 to December 2018. Demographic data, treatment records, and follow-up data of all male breast cancer patients who were treated at AKUH was reviewed. Results Thirty-eight out of 42 patients who presented over a period of 32 years were included. The mean age was …