Patient Safety Commons^™

Utilization Of Acupuncture Services In The Emergency Department Setting: A Quality Improvement Study, John R. Burns, Jessica J. F. Kram, Vashir Xiong, Jeanne M. Stark Casadont, Tiffany A. Mullen, Nancy Conway, Dennis J. Baumgardner

Jessica Kram, MPH

Purpose: Patients often present to the emergency department (ED) for pain. As opioid fatalities rise, alternative treatments are warranted for pain management. Acupuncture, a nonpharmacological treatment involving the insertion of needles into skin or tissue at specific points within the body, may help to decrease acute pain. Our study aimed to assess the utilization and impact of acupuncture in the ED for acute pain management.

Methods: We conducted a retrospective analysis of purposefully collected quality improvement data. Patients who were ≥18 years old and who presented to the ED at an urban medical center in Wisconsin during 2017 were offered …

Framework For Algorithmically Optimizing Longitudinal Health Outcomes: Examples In Cancer Radiotherapy And Occupational Radiation Protection, Lydia Joyce Wilson

LSU Doctoral Dissertations

Background: Advancements in the treatment of non-infectious disease have enabled survival rates to steadily increase in recent decades (e.g., diabetes, heart disease, and cancer). Epidemiological studies have revealed that the treatments for these diseases can have life-threatening and/or life–altering effects. Thus, realizing the full beneficial potential of advanced treatments necessitates new tools to algorithmically consider all major components of the health outcome, including benefit and detriment. The goal of this dissertation was to develop a framework for improving projected health outcomes following planned radiation exposures in consideration of all beneficial and detrimental, early and late, and fatal and non-fatal …

Effects Of Social Media On Patient Perceptions And Compliance, Annmarie Butare, Adarsh Gupta

Rowan-Virtua Research Day

It is the physician’s responsibility to ensure that their patients are collecting credible and accurate information. Considering the significant proportion of patients using social media to assist with medical decision making, physicians should incorporate this into their patient education in order to ensure patient understanding of the information gathered both outside and inside the medical office, thereby improving compliance and outcomes.

The goals of this study were to examine the influence of social media on patient perceptions of healthcare and use this infomration to improve physician understanding of patient health information-seeking behaviors to improve patient compliance. The three-part survey included …

Postoperative Cholecystitis From Nathanson Liver Retractor During Robotic-Assisted Laparoscopic Partial Nephrectomy, Lauren D. Gleich, Mihir G. Thaker, Gordon A. Brown

Rowan-Virtua Research Day

Proper visualization of the surgical field during any procedure is one of the most imperative elements of surgery. The tools used to obtain this goal come with their own set of risks. This report describes a patient who developed postoperative acalculous cholecystitis (PAC) after use of a Nathan liver retractor. PAC is a rare complication of urologic surgery and is often more severe than acalculous cholecystitis (AC), leading to significant morbidity.

The Teen Vaping Crisis, Jayavignesh Ganesan '21, Cynthia Mu '21, Carolina Seoane '21

Student Leadership Exchange (SLX)

In today’s society, many teens have the idea that is is cool to vape. This has led to an exponential increase in the number of teenagers addicted to nicotine. This increase is directly caused by nicotine companies, specifically vape companies, presenting their products with appealing and misleading packaging. Indeed, nicotine packages are required to have a warning. However, the warning is usually not taken into consideration, as the warning is not eye-catching. Because of this, we propose that all products containing nicotine, including e-cigarettes, must follow plain packaging regulations. Under plain packaging regulations, companies would be required to have the …

Safe Injection Facilities, Timothy Kwong

Honors Theses

According to the Center of Disease Control and Prevention (CDC), “In 2016, a total of 63,632 persons in the United States died from drug overdoses; the age-adjusted rate was 19.8 deaths per 100,000 persons.” There have been countless programs with the sole purpose of reducing the amount of drug related deaths. Some with positive outcomes and others with negative outcomes. Since there is no feasible method of eradicating the problem as a whole, the next logical thing to do would to be creating effect prevention programs.

Safe Injection Facilities (SIFs) have been around for over three decades. They are widespread …

Demographic Factors, Bmi And Diagnosis That Affect The Administration Of Emergency Treatment Orders In Psychiatric Units, France Leandre Md, Liang Hong, Sarah Fayad Md

Psychiatry

Emergency Treatment Orders (ETOs) are defined by Florida Law as an immediate administration of rapid response psychotropic medications to a person with the purpose of expeditiously treat symptoms that if left untreated, present an immediate danger to the safety of the person or others. Current literature have revealed the effectiveness of psychotropic drugs in treating agitation, however epidemiological studies on this practice are still very lacking.

Initiation Of A Roundtable Meeting To Determine Safety Hazards And Provide Education To Range Bison Herd Workers, Lucia Finocchiaro

Capstone Experience

This capstone project serves as an important piece of greater project studying bison handling. Bison production is both a growing and dangerous industry. As a new enterprise in many parts of the country and on tribal lands, significant numbers of untrained employees may be hired. This project undertakes methods to better understand the risks associated with bison handling and to thereby improve handling procedures and increase safety. Herd managers (from tribal and non-tribal sites), researchers, safety experts, and stakeholders were brought together for a roundtable meeting in Omaha. This meeting was designed to provide stakeholders a forum to discuss common …

Decreasing Unplanned Extubations By Taping Technique & Creating A Culture Of Safety, Karishma Rao, Beckie Palmer, Christopher R. Nitkin, Christian Anthony Schneider, Brandy Huitt, Molly Terhune, Ashley Orwick, Dianne Wilderson, Sarah Carboneau, Jenny Mckee, Kerrie A. Meinert, Eugenia K. Pallotto

Presentations

Describes strategies used to decrease the unplanned extubation rate in the Level IV neonatal intensive care unit to less than 1.0 event per 100 ventilator days by December 2018.

Utilization Of Acupuncture Services In The Emergency Department Setting: A Quality Improvement Study, John R. Burns, Jessica J. F. Kram, Vashir Xiong, Jeanne M. Stark Casadont, Tiffany A. Mullen, Nancy Conway, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Purpose: Patients often present to the emergency department (ED) for pain. As opioid fatalities rise, alternative treatments are warranted for pain management. Acupuncture, a nonpharmacological treatment involving the insertion of needles into skin or tissue at specific points within the body, may help to decrease acute pain. Our study aimed to assess the utilization and impact of acupuncture in the ED for acute pain management.

Methods: We conducted a retrospective analysis of purposefully collected quality improvement data. Patients who were ≥18 years old and who presented to the ED at an urban medical center in Wisconsin during 2017 were offered …

Why Doula Services Should Become An Essential Health Benefit In New York State, Jalisha Hanshaw, Amy White

Publications and Research

Doulas are birth workers who assist expecting mothers through pregnancy, birth and postpartum using holistic techniques. Techniques include: prenatal yoga, birth affirmations and induction acupuncture. Doulas are underrated healthcare providers who deserve the same respect as clinical and non-clinical providers. Doulas are well-rounded alternative care providers who focus on mental, emotional, and physical well being of mothers. Also, they know special alternative medical techniques that prevent mothers from maternal mortality among other negative health outcomes. The amount of time and effort doulas perform with expecting mothers are equal or more than the average medical healthcare provider and should be a …

Identifying Challenges Different Provider Group Encounter In Managing Opioid Use Disorder, Chinonye Anumaka

Muskie School Capstones and Dissertations

The Centers for Disease and Control (CDC) describes opioid use disorder (OUD) also known as opioid addiction as the problematic pattern of opioid use leading to clinically significant impairment or distress. In 2016, about 2.1 million people were diagnosed of OUD in the US. In Maine, York County has the third highest drug overdose response and had 166 deaths occurring between 2012-2016. York County is a designated medically underserved area and has a shortage of provider workforce and limited treatment infrastructure. To further understand the challenges providers in York County encounter in managing patients with OUD, 6 focus groups was …

The Use Of Turn Assistance Features On Hospital Beds For Prevention Of Caregiver Injury, Trenton Tucker, Barbara Mcclaskey

Posters

In the world of nursing, caregiver injury is still a major problem. It has been reported that 44% of healthcare workers have lower back musculoskeletal pain. The purpose of this study was to examine ways to decrease injury to care providers. The methodology was a literature review focusing on turn assist technology. Education alone cannot always prevent a musculoskeletal injury, and thus the use of turn assistance features on beds is implemented. These turning functions have shown great success in helping prevent caregiver muscle strain, and in helping decrease caregiver injury. As general technology has increased, so has medical technology …

A Framework To Reveal Clandestine Organ Trafficking In The Dark Web And Beyond, Michael P. Heinl, Bo Yu, Duminda Wijesekera

Journal of Digital Forensics, Security and Law

Due to the scarcity of transplantable organs, patients have to wait on long lists for many years to get a matching kidney. This scarcity has created an illicit market place for wealthy recipients to avoid long waiting times. Brokers arrange such organ transplants and collect most of the payment that is sometimes channeled to fund other illicit activities. In order to collect and disburse payments, they often resort to money laundering-like schemes of money transfers. As the low-cost Internet arrives in some of the affected countries, social media and the dark web are used to illegally trade human organs. This …

An Iterative Process For Training Design And Implementation Increased Health Workers' Knowledge For Taking Nutrition Behavior Change To Scale, Wendy Gonzalez, Anabelle Bonvecchio Arenas, Armando García-Guerra, Mireya Vilar-Compte, Alejandría Villa De La Vega, Laura Quezada, Cynthia Rosas, Ana Lilia Lozada-Tequeanes, Amira Hernández

Department of Public Health Scholarship and Creative Works

The shortage of skilled, motivated, and well-supported health workers is a major barrier to scaling up nutrition interventions and services. Objective: The objective of this study is to describe the process for developing and implementing a training of health personnel for the delivery of the Integrated Strategy for Attention to Nutrition (EsIAN), an evidence-based strategy for promoting infant and young child feeding through primary health care in Mexico. The specific objective is to provide a case study and highlight challenges, as well as elements to successfully mitigate these, and discuss potential applications of findings beyond the Mexican context. Methods: The …

Determinants Of Severe Maternal Morbidity And Its Racial/Ethnic Disparities In New York City, 2008–2012, Renata E. Howland, Meghan Angley, Sang Hee Won, Wendy Wilcox, Hannah Searing, Sze Yan Liu, Emily White Johansson

Department of Public Health Scholarship and Creative Works

Objectives Severe maternal morbidity (SMM) is an important indicator for identifying and monitoring efforts to improve maternal health. Studies have identified independent risk factors, including race/ethnicity; however, there has been limited investigation of the modifying effect of socioeconomic factors. The study aims were to quantify SMM risk factors and to determine if socioeconomic status modifies the effect of race/ethnicity on SMM risk. Methods We used 2008–2012 NYC birth certificates matched with hospital discharge records for maternal deliveries. SMM was defined using an algorithm developed by the Centers for Disease Control and Prevention. Mixed-effects logistic regression models estimated SMM risk by …

Implementation Of A Chronic Pain Functional Assessment Tool In Primary Care Practice, Jude Emerson Stevens

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Background

An estimated 20% of patients with non-cancer pain symptoms or pain-related diagnoses receive an opioid prescription. Current guidelines advocate use of a functional assessment as a strategy to improve the efficacy and safety of chronic pain management using opioids. This project aimed to integrate functional assessments into patient care visits for chronic pain and optimize safe and effective prescribing.

Methods

This quality improvement project was conducted at a primary care clinic in Burlington, VT. Baseline data on current functional assessment utilization and barriers amongst providers were collected. The validated Pain, Enjoyment, and General Activity (PEG) scale was administered from …

Evaluating Ways To Reduce Errors In Medication Reconciliations Performed By Nurses In A Rural Hospital Setting, Kalen T. Freeman

MPA/MPP/MPFM Capstone Projects

Medication reconciliation, also known as “med recs”, are an important part of a patient’s care during their hospitalization. A med rec is when hospital personnel generate a list of the medications the patient takes at home. Med recs are vital in the hospital admission process because home medications need to be restarted at appropriate times to fully care for the patient. Also, mistakes in a home medication list can lead to serious consequences in the patient’s health. This study focuses on med recs being performed at Marcum and Wallace Hospital in Irvine, Kentucky. More specifically, the study explores the different …

Factors Associated With Hospital Readmissions Among United States Dialysis Facilities, Amber B. Paulus

Theses and Dissertations

Hospital readmissions are a major burden for patients with end stage renal disease (ESRD). On average, one in three hospital discharges among patients with ESRD are followed by a readmission within 30 days. Currently, dialysis facilities are held accountable for readmissions via the ESRD Quality Incentive Program standardized readmission ratio (SRR) clinical measure. However, little is known about facility-level factors associated with readmission. Additionally, unlike other standardized measures of quality in the dialysis setting, incident patients within their first 90-days of dialysis are included in the performance calculation. This study analyzed CMS Dialysis Facility Report data from 2013 to 2016 …

Racial Variations Of The Injection Route Of Administration Among Injection Drug Users In The United States: A Comparative Trend Analysis, Philip Danquah

Graduate & Professional Student Association Research Forum

The objective of this research is to address the variations in the injection route of administration among racial groups who are injection drug users in the United States and how that contributes to their vulnerability to HIV/AIDS behaviors and hospital admissions.