Patient Safety Commons^™

Exploration Of Patient Variables And Characteristics Best Suited For Medical Marijuana Treatment For Anxiety And Depressive Disorders, Corey Gazoo

Dissertations

Individuals with posttraumatic stress, anxiety and depressive disorders are currently being prescribed medical marijuana as a treatment in many states across the United States. However, marijuana is still considered a schedule one narcotic by the Drug Enforcement Administration and federal government, which provides several barriers and challenges to conduct research such as approval from the U.S. Food and Drug Administration and following guidelines from the National Institute on Drug Abuse issued by the DEA. Additionally, individuals prescribed medical marijuana for mental health disorders are not always thoroughly instructed on the type of medical marijuana, the dosage, and how frequently to …

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 …

Prevalencia Mensual De Trastorno De Ansiedad Generalizada Durante La Pandemia Por Covid-19 En México, Pablo Gaitán-Rossi, Víctor Pérez-Hernández, Mireya Vilar-Compte, Graciela Teruel-Belismelis

Department of Public Health Scholarship and Creative Works

Objective. Estimate the prevalence of generalized anxiety disorder (GAD) from April to June 2020. Materials and methods. Repeated cross-sections design based in the Encovid-19, a series of monthly mobile surveys with represen- tative samples of Mexico (N= 833-1 674).The questionnaire includes the GAD-2 scale, and, in July, the GAD-7 scale was added; we examined its internal validity with confirmatory factor analysis and its concurrent validity with sociodemo- graphic variables. Using GAD-7 as criterion, we analyzed the predictive validity of the GAD-2.We estimated the monthly prevalence with the GAD-2. Results. The GAD-7 and the GAD-2 are reliable and valid.The GAD-2 has …

Optimization Of Vaccine Supply Chains In Low- And Middle-Income Countries Utilizing Drones, Maximilian Kolter

Graduate Theses and Dissertations

Despite tremendous efforts from governments and humanitarian organizations, millions of children in low- and low-middle-income countries (LICs and LMICs) are still excluded from the benefits of immunization. The vaccine distribution in LICs and LMICs is challenging for several reasons, such as limited cold chain capacities, vaccine wastage, uncertain demand, and lack of access to immunization services. A promising avenue to address these issues is the utilization of drones for vaccine delivery. Drones can fly at high speed on direct paths and could enable on-demand deliveries to mitigate limited storage capacities. Further, their independence of road networks could allow them reaching …

An Investigation Into Over The Counter Painkiller Use, Shane M. Cusack, Angeline D. Lagali, Andreia Stavrianos

International Undergraduate Journal of Health Sciences

This study comprises a survey to examine the use, risks, and awareness of over-the-counter (OTC) pain medication. The survey was a paper-based survey extended to the general public in Cork, Ireland from February 24^th 2020 to March 14^th 2020. A Microsoft Excel template (16.34 2020) was used to analyse the results of the 106 valid responses that were received. Responses showed that 105/106 individuals had taken an OTC painkiller in their lifetime. Paracetamol was the most used OTC painkiller with 98.1% of people having taken it in the past. The overall majority of individuals were aware of …

Full Issue: The International Undergraduate Journal Of Health Sciences, Volume 1, Issue 1, June 2021, Iujhs Full Issue

International Undergraduate Journal of Health Sciences

The full June 2021 issue (Volume 1, Issue 1) of the International Undergraduate Journal of Health Sciences

A Novel Approach To Explore Safety-I And Safety-Ii Perspectives In In Situ Simulations-The Structured What If Functional Resonance Analysis Methodology., Ralph James Mackinnon, Karin Pukk-Härenstam, Christopher S. Kennedy, Erik Hollnagel, David Slater

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: With ever increasingly complex healthcare settings, technology enhanced simulation (TES) is well positioned to explore all perspectives to enhance patient safety and patient outcomes. Analysis from a Safety-II stance requires identification of human adjustments in daily work that are key to maintaining safety. The aim of this paper is to describe an approach to explore the consequences of human variability from a Safety-II perspective and describe the added value of this to TES.

METHODS: The reader is guided through a novel application of functional resonance analysis methodology (FRAM), a method to analyse how a system or activity is affected …

Allergy And Anaphylaxis From The Prehospital Perspective, Anthony E. Conrardy

Dissertations and Theses

Anaphylaxis is considered a severe, potentially fatal, systemic allergic reaction that occurs suddenly after contact with an allergy causing substance. It is estimated that up to 5% of the population has experienced anaphylaxis, with 1% of hospitalizations and 0.1% of emergency department patients having fatal outcomes. We characterized the population of patients encountered by the EMS agency (786 patients) that had a provider impression of “allergic reaction” and then utilized logistic regression models to estimate associations with the administration of epinephrine in the prehospital setting. Additionally, we used incident location data for all patient encounters of the EMS agency …

Migration As A Determinant Of Childhood Obesity In The United States And Latin America, Mireya Vilar-Compte, Arturo V. Bustamante, Nancy López-Olmedo, Pablo Gaitán-Rossi, Jaqueline Torres, Karen E. Peterson, Graciela Teruel, Rafael Pérez-Escamilla

Department of Public Health Scholarship and Creative Works

International migration has economic and health implications. The acculturation process to the host country may be linked to childhood obesity. We use the Community Energy Balance (CEB) framework to analyze the relationship between migration and childhood obesity in Mexican households with international migrants. Using longitudinal data from the Mexican Family Life Survey (MxFLS), we examine how migrant networks affect childhood obesity in origin communities. We also review binational health programs that could be effective at tackling childhood obesity in migrant households from Mexico. Children embedded in migrant networks are at greater risk of developing overweight or obesity, suggesting a significant …

Implementation Of Childhood Obesity Prevention And Control Policies In The United States And Latin America: Lessons For Cross-Border Research And Practice, Rafael Perez-Escamilla, Mireya Vilar-Compte, Elizabeth Rhodes, Olga L. Sarmiento, Camila Corvalan, Rachel Sturke, Susan Vorkoper

Department of Public Health Scholarship and Creative Works

Progress has been made in the development and widespread implementation of effective interventions to address childhood obesity, yet important challenges remain. To understand how the United States and Latin American countries achieved success in implementing obesity policies and programs (PAPs) and identify improvement opportunities using implementation science principles. We identified three comparative case studies: (1) front-of-food package labeling (Mexico and Chile); (2) Open Streets/play streets (Colombia and the United States); and (3) the Baby-Friendly Hospital Initiative (Brazil and the United States). Information from multiple sources (e.g., scientific and gray literature and key informant interviews) was synthesized to describe barriers, facilitators, …

Improving Identification Of Seniors At Risk Tool Adherence To Identify Emergency Department Readmissions In Older Adults, Joy Gao

Doctor of Nursing Practice Final Manuscripts

The purpose of this evidence-based project (EBP) is to improve the emergency department (E.D.) staff adherence in completing the Identifying Seniors at Risk (ISAR) screening tool. The specific aim is to improve electronic health record (EHR) data collection to enhance the identification of older adults that are frequent utilizers of the E.D. at a local community hospital in Southern California. Based upon the most recent National Hospital Ambulatory Medical Care Survey, patients ages 65 and older make up 32% of all E.D. admissions. These patients also represent 50% of the moderate to severely ill patients seen in the E.D. …

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 …

Identifying Causes Of Readmission At Unm Hospital, Jewel Meyer-Hagen Ms3, Justine Yang Ms3, Christopher Bartlett Md, Avanika Mahajan Ms3, Susie Pham Ms3, Ishan Shah Do, Harsh Sharma Md, Jessie Rogers Md, Brianna Muller Md, Julia Howard Do, Radha Denmark Np, Gabriel Palley Md, Anthony Worsham Md

Quality Improvement/Patient Safety Symposium

Background/Introduction:

Inadequate coordination of care and poor transition of care quality are known contributors to hospital readmission. Patient readmission is a known risk factor for poor patient outcomes. Department of Internal Medicine (DOIM) readmission rate was 13.18% during fiscal year (FY) 2020, and is 13.58% to date during FY21. The objective of this study is to identify system-based drivers of readmission, understand why the readmission rate has increased from FY20 to FY21, and design interventions to address identified gaps.

Methods:

Developed a survey using RedCap. Retrospective chart review of 104 randomly selected patients discharged from UNMH during fiscal year 2020 …

Improving Surface Cleaning And Hand Hygiene Using Fluorescent Markers, Taryn Whitman

Master's Projects and Capstones

Problem: Compared to inpatient units, ambulatory care clinics have differences in staffing available and frequency to perform room turnover (RTO). Pre-intervention data revealed poor Hand hygiene (HH) and high-touch surface cleaning (HTSC) knowledge and low RTO compliance reliability. Currently, there is no process for objectively monitoring RTO compliance and staff self-evaluation of HH, HTSC, and RTO performance is incongruent with observations.

Context: HH and HTSC are a crucial component of preventing healthcare-associated infections (HAIs). Estimated loss of revenue for one northern California tertiary university hospital system (HCO) campus was nearly $1.8 million dollars in Medicare penalties for 2018.

Intervention: …

Impactful Interactions With Medical Interpretation, Alyssa L. Reinschmidt

Honors Thesis

The purpose of this paper is to examine the quality of healthcare that one can receive when the language barrier is a factor, looking specifically at the collaboration of interpreters and physicians in the delivery of care. To carry out this study, I have analyzed the presence of the language barrier in South Dakota, the current methods of interpretation in clinical settings, and how physicians and interpreters work together to provide care to Limited English Proficiency (LEP) patients. Data has been collected from scholarly articles, journals, presentations, and videos.

Ultimately, with my committee’s help, I have created a physician-interpreter training …

Reducing Alarm Burden By Promoting Judicious Ordering Of Continuous Pulse Oximetry, Kathleen Berg, David Johnson, Ginny Nyberg, Andrew Ausmus, Christine Claeys, Emily Wilkinson, Nicholas Clark

Presentations

Background: Overutilization of continuous pulse oximetry (CPO) contributes to overdiagnosis and prolonged supplemental oxygen utilization. It may also negatively impact patient sleep, mobility, length of stay (LOS), and cost. Response times to actionable alarms increase with the number of non-actionable alarms. Our baseline data revealed an average of 29.6 pulse oximetry monitor alarms sounded for each admitted patient each day of their hospitalization. Most notably, 38.7% of pulse oximetry alarms were for ≥88% which is generally considered non-actionable.

Objective: We aimed to decrease both total pulse oximetry alarms per patient day and alarms for ≥88% per patient day by 20%, …

Assessing The Effects Of Social Determinants On Serious Safety Events, Lisa L. Schroeder, Jessi Van Roekel, John Cowden

Posters

Background: We have long known that various social determinants of health (SDH) such as race, gender, socioeconomic status and others can affect health outcomes, such as readmission rates and mortality. To our knowledge, the impact of SDH on safety events has not been studied.


Objective: We sought to understand the role that social determinants may play in contributing to safety events at our institution and to incorporate this information into the creation of corrective action items following the serious safety event.


Design/Methods: The Clinical Safety team partnered with the Office of Equity and Diversity to develop a standard question regarding …

The Migration Of Carbapenem-Resistant Acinetobacter Baumannii From The Battlefields Of Iraq And Afghanistan To The Healthcare Facilities Of The Veterans Health Administration, Jeffery Rogers

Capstone Experience: Master of Public Health

Multidrug-resistant organisms (MDRO) pose a great threat to health across the globe. That threat is also felt in the Veterans Health Administration (VHA). Wounded warriors returning home from the battlefields of Iraq and Afghanistan may have brought with them MDROs, such as the bacterium Acinetobacter baumannii, as they have transitioned from military service into the VHA facilities. This study investigates the interconnectedness of military service in the Department of Defense (DoD) and a lifetime of care at VHA through a longitudinal tracking of a linked cohort of combat veterans with battlefield injuries and subsequent MDR infections of A. baumannii. …

Examining The Effect Of Provider Bias On Pain Management In Black Patients: A Systematic Literature Review, John Massey, Monica Gambilado

Thinking Matters Symposium

Black Americans face unequal treatment for pain management when seeking care. The aim of this systematic literature review is to examine the impact of provider bias on Black patients receiving appropriate pain management interventions in the clinical setting. This review followed the Preferred Reporting Items for Systematic Literature Reviews and Meta-Analysis guidelines. CINAHL and PubMed were searched with the following key search terms: Black/African American, bias, prejudice, discrimination, unconscious bias, pain management, pain reduction, pain control and analgesic. A self-developed Critical Appraisal Tool was used for quality assessment of the studies included in the review. A total of 101 probable …

Supply, Demand, And Quality: A Three-Pronged Approach To Blood Product Management In Developing Countries, Kyle L. Gress, Karina Charipova, Ivan Urits, Omar Viswanath, Alan D. Kaye

Journal of Patient-Centered Research and Reviews

While transfusion of blood and blood products is instinctively linked to the provision of emergent care, blood and blood products are also routinely used for the treatment of subacute and chronic conditions. Despite the efforts of the World Health Organization and others, developing countries are faced with a three-part problem when it comes to access to and delivery of transfusions: insufficient supply, excessive demand, and inadequate quality of available supply. Developing countries rely heavily on replacement and remunerated donors rather than voluntary nonremunerated donors due to concerns regarding donation- and transfusion-transmitted infection as well as local and cultural beliefs. While …