Medical Education Commons^™

From The Editor: Context Creates Meaning For Evidence, James Peter Meza

Clinical Research in Practice: The Journal of Team Hippocrates

Introducing "Informed Consent" manuscripts and an expanded remit for the Journal.

Control Of Hypertension Among Diabetic Patients In A Referral Hospital In Tanzania: A Cross-Sectional Study, Semvua B. Kilonzo, Daniel W. Gunda, Fatma Bakshi, Fredrick Kalokola, Henry A. Mayala, Hollo Dadi

Faculty of Health Sciences, East Africa

Background:

Hypertension is common among diabetic patients. The co-existence of two conditions carries an excessive risk of severe complications and mortalities. Limited information exists on the determinants of poor hypertension control among these patients. We aimed at determining the prevalence and factors associated with poor hypertension control in these patients.

Methods:

Data of diabetic patients who were also hypertensive attending an outpatient clinic from 1 August 2015 to 31 December 2015 at Bugando Medical Centre were retrospectively analyzed. Uncontrolled hypertension was defined as a blood pressure of ≥130mmHg and/or ≥80mmHg systolic and diastolic respectively. A designed questionnaire was used …

Refugee-Centered Medical Home:A New Approach To Care At The University Of Louisville Global Health Center, Rahel Bosson, Ruth M. Carrico, Anupama Raghuram, Paula Peyrani, William A. Mattingly, Rebecca Ford, Stephen P. Furmanek, Julio A. Ramirez

Journal of Refugee & Global Health

Refugees arrive to the United States with a full spectrum of health conditions, many of which involve intense case management requiring significant financial investments and use of healthcare resources. Kentucky receives more than 3,000 new refugees each year and ranked 10th in the nation for numbers of new arrivals resettled during 2015. These refugees arrive from diverse countries representing different cultures and speaking different languages. In addition, they arrive with diverse health conditions and medical needs. The aims of this paper are to share experiences from the University of Louisville Global Health Center regarding conceptualization, implementation and evaluation of a …

Strategies To Improve Interdisciplinary Communication In An Acute Care Inpatient Pediatric Unit, Sarah Thompson, Haley Pelletier, Barbara Bush Children's Hospital-Inpatient, Maine Medical Center, Suneela Nayak, Ruth Hanselman, Stephen Tyzik

MaineHealth Maine Medical Center

Interdisciplinary patient rounding has been shown to improve patient and family satisfaction as well as reduce patient length of stay and readmission rates. In an acute care inpatient pediatric unit, baseline metrics demonstrated that 100% of the time, nursing was not included in these rounds thus resulting in sub optimal communication.

The goal of this performance improvement project was to attain increased nursing participation. Data collection demonstrated several reasons for lack of participation and corrective actions were instituted. After undertaking this KPI goal and utilizing operational excellence, 95% of the time, nurses were called to morning rounds with the medical …

Improving Type And Screen Specimen Collection Prior To Elective Surgery, Nordx Blood Bank Staff, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman

MaineHealth Maine Medical Center

To avoid delays in the availability of compatible blood for elective surgery patients requiring transfusion, a type and screen specimen should be completed at least 24 hours prior to surgery. Baseline metrics in an acute care inpatient blood bank demonstrated a significant number of cases with no type or screen completed.

The objective of this KPI was to prevent any delays in providing compatible blood products to scheduled surgical patients. Several internal and external system issues were identified as a result of a root cause analysis and a number of actions were initiated.

Outcomes have been positive. Data collection post …

Delirium Reduction Strategies For The Critically Ill, June Chaves, Sam Canonico, Will Cheney, Tammy Corey, Gil Fraser, Alex Kowalewski, Jen Low, Cardiac Intensive Care Unit, Haley Pelletier, Cathy Palleschi, Stephen Tyzik, Suneela Nayak, Ruth Hanselman

MaineHealth Maine Medical Center

Delirium, an acute and fluctuating disturbance of consciousness and cognition, is a common manifestation of acute brain dysfunction in critically ill patients. Patients with delirium have longer hospital stays and a lower 6-month survival rate than do patients without delirium. Preliminary research suggests that delirium may be associated with cognitive impairment that persists months to years after discharge.

In a large acute care hospital, the cardiac intensive care staff became interested in mitigating their unit’s high delirium rate of ventilated patients. At baseline, many members of the healthcare team did not believe that delirium could be prevented and the predominant …

Improving Cardiology Patient Flow In Nuclear Medicine, Kelly Haar, Hannah Sullivan, Kathryn Laverdiere, Nuclear Medicine Department, Haley Pelletier, Stephen Tyzik, Suneela Nayak, Ruth Hanselman

MaineHealth Maine Medical Center

At baseline, a nuclear medicine department found it difficult to complete cardiac stress tests within scheduled times. Using the performance improvement process, a nuclear medicine department looked to improve patient experience related to wait times for this test.

Two goals were identified and a root cause analysis was initiated. After identifying some process issues, two KPIs were developed to address them.

A root cause analysis identified some processing issues and two KPIs were instituted to address them.

As a result, one outcome was to hire an additional physician assistant to address the barrier of inadequate cardiology coverage. Next steps include …

Interdepartmental Rounding, Peggy Anderson, Carrie Strick, R3 Med-Surg Unit, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman, Maine Medical Center Operational Excellence

MaineHealth Maine Medical Center

STRATEGIES FOR IMPROVING COMMUNICATION BETWEEN DOCTORS AND NURSES IN AN ACUTE CARE HOSPITAL

Effective interdisciplinary communication is imperative for safe patient care in an acute care hospital environment.

A surgical unit used their HCAHPs scores to assess how often patients perceived there was good communication between different doctors and nurses during their hospital stays. The data demonstrated that this occurred 22% less often than the national average.

As a result of a root cause analysis, a number of countermeasures were initiated with the goal of achieving scores greater than the national average. Post KPI inception in the second quarter of …

Communication Of Medication Side Effects In An Acute Care Hospital, Deb Bachand, Rachel Caiola, R6 Neurology Med-Surg Unit, Haley Pelletier, Brendan Lilley, Suneela Nayak, Ruth Hanselman, Stephen Tyzik

MaineHealth Maine Medical Center

COMMUNICATION OF MEDICATION SIDE EFFECTS IN AN ACUTE CARE HOSPITAL

Effective patient education of prescribed medication side effects improves patient safety and reduces overall risk. On an acute care hospital unit, nursing staff felt previous attempts at this education had been ineffective as demonstrated by their HCAHPs scores for communication about medications.

A root cause analysis demonstrated some flaws and several countermeasures were instituted. The goal of this KPI project was to attain a higher than national average for the specific HCAHPs score.

Post KPI inception, the unit’s HCAHPs data showed steady improvement. Within one month, the goal of an …

Aligning Opioid Prescribing Pathways, Andrea Lai, Outpatient Pharmacy, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman

MaineHealth Maine Medical Center

There is a drug epidemic sweeping the State of Maine and it continues to worsen each passing year. In 2017, the Maine legislature passed Public Law Chapter 488 to strengthen the controlled substance prescription monitoring program. An outpatient pharmacy, located in a large acute care hospital, created a performance improvement project to clarify opioid prescription and resolve any non-compliance with Chapter 488.

After a root cause analysis, several KPIs were established to include tracking the number of phone calls made by pharmacists to non-compliant providers to clarify scripts, provide one on one education and ultimately resolve non-compliance. Repeat offenders were …

Week Of August 21, 2017, New York Medical College

InTouch

• Eduardo Lopez, M.D., is the Inaugural the Catherine and Ladislav P. Hinterbuchner Endowed Chair in Rehabilitation Medicine
• Sixth Annual STAR Student Research Forum Showcases Impressive Summer Investigative Works
• SHSP Students Join LEND at WIHD
• SHSP Hosts Special Public Health Practice Council Meeting

Implementing The Weefim System In Outpatient Pediatric Rehabilitation, Chelsea Ratilainen

Master's Projects and Capstones

Abstract

This project was designed to achieve an unmet criteria in the accreditation process for the outpatient pediatric rehabilitation program at a local, community hospital in the greater Bay Area. The clients range from 6 months old to 20 years old with functional disabilities. The Commission of Accreditation of Rehabilitation Facilities (CARF) requires that applicants demonstrate outcome measure data over a 6 month time period. During the self-evaluation process this was noted to be a deficiency in the department’s efforts. The WeeFIM system was chosen as the first tool to implement in the department. This is a functional improvement measurement …

Biomedical Research Careers Pipeline In A Southern Hispanic-Serving Institution (Hsi): Perspectives Of Faculty And Students On Efficacy Of Mentoring Workshops, Ming-Tsan P. Lu, Stacey Lee Gonzalez, Yuridia Munoz, Luis V. Colom

Teaching and Learning Faculty Publications

The purpose of the study was to investigate the efficacy of the Mentoring Workshops for students and faculty. College student and faculty participants’ perceptions of competencies, abilities, beliefs, and attitudes through the study university’s mentoring workshops were reported. The studies were exploratory in nature, leading the investigators to conduct pre-post surveys. Findings suggested that students and faculty had a positive perception of the mentoring workshops’ effectiveness. Faculty provided suggestions, such as making the workshops longer, providing case studies, and holding future mentoring workshops, were reported for enhancing the effectiveness of the mentoring workshops.

Methods To Reduce Fall Risk, Christin Klineman

Grace Peterson Nursing Research Colloquium

Background: The reinforcement of patient, family, and staff education in addition to traditional fall risk interventions is critical to reduce the rates of falls in hospitalized patients.

Objectives: The purpose of this integrative literature review is to analyze whether or not performing initial falls risk assessments combined with patient and family education could potentially reduce the number of falls in hospitalized patients.

Method: An integrative literature review guided by Whittemore & Knafl was conducted using Cumulative Index of Nursing and Allied Health (CINAHL) Complete, ProQuest, PubMed and Google Scholar. A search was conducted using these terms: hospital, falls, fall prevention, …

Effective Methods For Domestic Violence Screening In The Emergency Department, Megan Bryan

Grace Peterson Nursing Research Colloquium

Abstract

Background: The CDC reports that one in four women and one in ten men will experience some form of domestic violence in their lifetime that will have either a short-term or long-term impact on their well-being. Often the first place these victims are seen where they can receive help is the emergency department. Objectives: The goal of this systematic integrative literature review was to explore existing literature on domestic violence screening methods used in the emergency department and determine which methods prove most effective. Concurrently, this review examined the barriers to effective domestic violence screening and how nursing education …

Engaging Medical Students In Problem-Based Search And Study Of The Biomedical Literature., Zhiyong Han, Samantha L Margulies, Divya Kurian, Joshua M Jabaut, Akshita Mehta, Ramzi Dudum, Huberta Koudoro, Ria S Roberts, Jay Lee, Jonathan Li, Hieu T Nguyen, Mark Elliott

Biochemistry and Molecular Medicine Faculty Publications

No abstract provided.

Development Of Physics Curriculum For Pre-Health Students, Elliot Eckman Mylott

Dissertations and Theses

Many pre-health students are required to take introductory physics as undergraduates, though they often struggle to see the relationship between medicine and what they learn in these courses. In order to help students make that connection, reformed curriculum was adopted that teaches physics through the context of biomedicine. This dissertation will discuss the development, implementation, and assessment of the reformed curriculum for the introductory and intermediate level physics courses that targets the needs of pre-health students.

The curriculum created during this project include laboratory activities, multimedia content, and other instructional materials all of which present physics in biomedical contexts. The …

Improving Access And Utilization Of Data To Support Research And Programs Intended To Eliminate Disparities And Promote Health Equity, Rosaly Correa-De-Araujo

Journal of Health Disparities Research and Practice

Numerous Federal initiatives are addressing health and health care disparities. The ultimate goal is to achieve “a nation free of disparities in health and health care.” Social determinants of health remain mostly responsible for health/health care disparities among population groups within and between countries. In the United States, there is little evidence that disparities associated with such determinants are decreasing, with only 10% of those associated with race/ethnicity and income having demonstrated improvement in recent years. A variety of data sources are available from the Federal and private sectors to support research on disparities, but no single national survey seems …

2017 August 15 - Medical Student Education Committee Minutes, Medical Student Education Committee, East Tennessee State University

Medical Student Education Committee Minutes

No abstract provided.

August 2017, Randy Curry, Cindy Brooks

RURAL ROCKS

Rural Rocks, the Rural Health Network newsletter by the SWOSU College of Pharmacy