Patient Safety Commons^™

Brief Review: Patient Pill Splitting. What Is The Appropriate Advice To Provide Patients In The Emergency Department?, Mohammad Rattu, James Espinosa, Gabriel Meister, Alan Lucerna

Rowan-Virtua Research Day

A number of patients have inquired about the practice of pill splitting. Cutting or splitting of pills can be used by patients to create an intermediate dose or to save on money where a higher dose is priced at relatively the same cost as a lower dose. In this review we discuss a number of issues related to medication safety and table splitting.

Brief Review: Low Frequency Event Charts (G-Charts) In Healthcare, James Espinosa, David Ho, Alan Lucerna, Henry Schuitema

Rowan-Virtua Research Day

The ability to determine if a change in a system is actually an improvement—or worsening in function—is one of the essential desiderata of quality improvement efforts. There are many ways to look at the issue. A special problem occurs when the event being studied is low frequency by nature. By way of example, patient falls in a given hospital or division of a hospital may occur in a way that is low frequency—yet each event is important. Process engineering has developed an approach to low frequency events. Part of this approach may involve specialized charts that look at the “time-between-events”—as …

Addressing The Health Needs Of The (D/D)Eaf And Hard Of Hearing Community, Zainab Krayem, Rachel Jeff-Macauley, Nicolette Falco, Vanesa Pizutelli

Rowan-Virtua Research Day

Merriam-Webster’s dictionary defines deaf to describe an individual who has total or partial hearing loss. However, the term carries much more weight as it breeds its own culture, Deaf culture, to be exact. There’s an emphasis placed on the spelling where deaf, spelled with a lowercase d, refers to individuals who are born deaf and grew up within this deaf culture. Whereas, members who identify as Deaf with a capital D have lost their hearing later on in life, and did not necessarily grow up within deaf culture. There is often a discrepancy whereby members who identify as d/Deaf or …

Release The Kratom: Post-Acute Withdrawal Syndrome In A 70 Year Old Male, Nardin El-Shammaa, Kyle Street, Narshima Pinninti

Rowan-Virtua Research Day

Centuries in Eastern medicine.. Kratom has been commonly used for chronic pain and opiate withdrawal symptoms with first reported cases in the United States in the early 2000s. It is a plant that consists of psychoactive alkaloids that target opioid receptors with different affinity. Effects from Kratom are dose-dependent, at lower doses, it acts as a stimulant, while at higher doses produces analgesia and euphoria. Although Kratom is legal and easily accessible over the counter, there have been increasing reports of potential for addiction and toxicity. Cessation of Kratom can result in withdrawal symptoms similar to opiate withdrawal. Here we …

“I Know My Body Better Than Anyone Else” Perspectives Of People Who Inject Drugs On Antimicrobial Treatment Decision Making For Serious Infections, Amy Eckland, Michael Kohut Phd, Henry Stoddard, Debra Burris, Frank Chessa, Monica Sikka, Daniel Solomon, Colleen Kershaw, Ellen Eaton, Rebecca N. Hutchinson, Peter Friedmann, Thomas Stopka, Kathleen Fairfield, Kinna Thakarar

Costas T. Lambrew Research Retreat 2023

Introduction:

• Few studies have examined the perspectives of patients with lived experience regarding outpatient treatment options for injection drug use (IDU) associated infections.

• We sought to better understand the perspectives of both community partners with lived experience who work with people who inject drugs (PWID) and hospitalized patients with IDU-associated infections on shared treatment decision making.

Therapeutic Approaches To Working With Perinatal Loss Clients: A Grounded Theory Study, Heather H. Olivier

University of New Orleans Theses and Dissertations

Perinatal loss (i.e., miscarriage, stillbirth, termination, and infant death) is commonly referred to in the literature as an invisible loss, non-loss, and even medical event. It is an ambiguous loss exhibiting the dialectical contradiction between the physical absence and psychological presence of the baby accompanied by disenfranchised grief, a reaction to a loss that is unacknowledged by society. Despite the likelihood of mental health clinicians working with clients who have experienced perinatal loss, there has yet to be a therapeutic model designed specifically for the unique grief and trauma reactions presented in this population. Existing grief models do not address …

Medication Errors In Pediatric Care And Preventative Solutions, Tyler Tidwell

Political Science Undergraduate Honors Theses

The research presented extensively examines previous reports covering pediatric medication errors (PMEs). Utilizing specific studies into the frequency and types of medication errors along with public surveys and policy discussion, the data and suggestions here provide commentary on the scope of PMEs, suggested institutional reform, and most importantly, legislative recommended action necessary to stymie the tide of PMEs. A significant portion of the research contained fixates on the literature review to provide ample familiarity with the background and scope of PMEs, but the subsequent sections will discuss their implication. After providing details on the magnitude of the issue, regulatory and …

The Ethical Dilemmas Epigenetic Editing In Utero Presents To Christians, Victoria Hendrix

Senior Honors Theses

The development of CRISPR epigenetic editing technology was initially impactful due to its potential for disease treatment. However, despite the potential benefits of epigenetic technology, there exist ethical dilemmas surrounding its use in utero. The review of the ethical dilemmas of epigenetic editing in utero from a Christian perspective showed that research in epigenetic editing is promising, yet fraught with peril. The basic ethical issues of epigenetic editing in utero stem from its inaccuracy, lack of research concerning its effects on offspring, an incomplete understanding of gene interactions, and its connection to eugenics. The ethical concerns particularly relevant to Christians …

Ohio Forensic Nurse Examiners: Readiness To Care For Victims Of Sexual Assault With Disability, Deanna Nicole Smith

Doctor of Nursing Practice Scholarly Projects

Forensic nurse examiners (FNEs) care for crime victims in acute care settings. These nurses are specifically trained in trauma-informed care and evidence collection in cases of sexual assault, domestic violence, abuse, and human trafficking (RAINN, 2022). The scholarly project focuses on the care of victims of sexual assault living with disability, as this population is three times more likely to be victimized than any other population (NSVRC, 2022). The project literature review reveals a lack of data on preparation standards for FNEs on caring for victims with disability and providing accommodations during forensic examination. Currently, it is unknown if FNEs …

Operationalizing A Medication Safety Gap Assessment For A Large Health System, Carley Warren, Joan Kramer, L Hayley Burgess

HCA Healthcare Journal of Medicine

Background

Medication errors continue to be a leading cause of medical errors. In the United States alone, 7000 to 9000 people die annually due to a medication error, and many more are harmed. Since 2014, the Institute for Safe Medication Practices (ISMP) has advocated for several best practices in acute care facilities derived from reports of patient harm.

Methods

The medication safety best practices chosen for this assessment were based on the 2020 ISMP Targeted Medication Safety Best Practices (TMSBP) and health system-identified opportunities. Each month, for 9 months, select best practices were covered with associated tools to assess the …

Digital Patient Engagement At A Perioperative Surgical Home Implemented Community Hospital, Srinivasan Sridhar, Amy Mount Hunter, Bernadette Mccrory

Patient Experience Journal

Patients in rural areas typically require more perioperative ‘optimization’ for surgery. The rural healthcare systems often overwhelmed with coordinating perioperative services and deliver less than optimal surgical outcomes. This is due to limited supporting microsystems and ability to effectively engage and track patients over the 120-day perioperative period to limit post-surgical complications. The study assessed longitudinal patient engagement within a newly established Perioperative Surgical Home (PSH) at a rural community hospital serving 10+ surrounding counties to identify barriers and best practices for engagement. A digital patient engagement platform was implemented and used to assess longitudinal patient outcomes and engagement from …

Exploring The Experiences Of The Consent Process For Aboriginal And Torres Strait Islander People Having Cardiac Surgery And Participating In Medical Research: A Study Protocol, Julieann Coombes, Keziah Bennett-Brook, Kate Hunter, Tamara Mackean, Edward Litton, Jacquita S. Affandi, Courtney Ryder, Bobby Porykali, Brea Grant, Kenneth Yakubu, Colin Garlett, Camila A. Kairuz Santos

Journal of the Australian Indigenous HealthInfoNet

Background: Gaining informed consent is a critical step before any medical procedure, and before taking part in medical research. Cultural differences in concepts of health and healing, communication, language, and racism, can play a part in forming barriers to gaining informed consent for Aboriginal and Torres Strait Islander people. For Aboriginal and Torres Strait Islander people, a lack of informed consent can worsen distrust and contribute to continuing health disparities. This protocol describes a study aimed at providing a better understanding of informed consent experiences of Aboriginal and Torres Strait Islander people undergoing heart surgery and participating in research. This …

Chewed Versus Swallowed Ticagrelor In P2y12 Inhibitor-Naïve Patients Undergoing Percutaneous Coronary Intervention, Thomas F. Wilson, Muddasir Ashraf, M. Fuad Jan, Tonga Nfor, Louie Kostopoulos, Joaquin Solis, Jayant Khitha, Ahmad Khraisat, Anthony C. Defranco, Tanvir Bajwa, Suhail Q. Allaqaband

Journal of Patient-Centered Research and Reviews

Purpose: Dual antiplatelet therapy is standard for patients undergoing percutaneous coronary intervention (PCI) with stents. Traditionally, patients swallow the loading dose of a P2Y12 inhibitor before or during PCI. Time to achieve adequate platelet inhibition after swallowing the loading dose varies significantly. Chewed tablets may allow more rapid inhibition of platelet aggregation. However, data for this strategy in patients with stable ischemic heart disease or non-ST-elevation acute coronary syndrome (NSTE-ACS) are less robust.

Methods: In this single-center prospective trial, 112 P2Y12-naïve patients with stable ischemic heart disease or NSTE-ACS on aspirin therapy and who received ticagrelor after coronary angiography but …

Implementation Of A Hospital-Wide Surge Plan To Reduce Emergency Department Length Of Stay, Laura Massey

Student Scholarly Projects

Practice Problem: Suboptimal patient flow throughout the hospital has resulted in an increased length of stay (LOS) for emergency department patients and the potential for adverse events.

PICOT: In admitted and discharged emergency room patients (P), how does a hospital-wide surge plan (I) compared to current throughput plan (C) affect the length of stay (O) within 8 weeks?

Evidence: The literature evidence reviewed supported the implementation of a hospital-wide surge plan approach positively impacts the emergency room length of stay and patient outcomes.

Intervention: The primary intervention for this project was the implementation of a hospital-wide surge policy. Targeted …

Migrants Sans Papiers: The Impact Of Cantonal Program And Policy Discrepancies On Undocumented Migrant Healthcare Utilization In Switzerland, Denise Peng

Independent Study Project (ISP) Collection

While Switzerland houses what is generally considered one of the best healthcare systems globally, regional policy discrepancies leave undocumented migrants (UDM) in precarious conditions that threaten the nation’s claim to universal health coverage. Critical analyses of existing UDM-catering structures in different cantons, the Swiss Confederation member states, reveal that local discrepancies in healthcare utilization are functional gradients of cantonal support and public endorsement. Relationships with these authorities are instrumental in steering health outcomes not only with program funding and outreach but also management of studies to better understand UDM health determinants and inform future preventative measures.

UDM services and initiatives …

Language Services For Populations With Limited English Proficiency (Lep) And The Necessity For Proper Medical Interpretation With A Focus In South Carolina, Elizabeth Pung

Senior Theses

Linguistically appropriate healthcare is a cornerstone of providing quality patient care. Provider-patient communication is imperative to achieving linguistically appropriate healthcare; unfortunately, language barriers introduced by different spoken languages of patients to their providers hinders this communication. Patients with limited English proficiency (LEP) are ensured accessible healthcare under federal regulations such as the National Standards for Culturally and Linguistically Appropriate Services (CLAS standards); however, a gap between patients with LEP and the healthcare system remains. Not only is there a gap in communication for patients with LEP to their providing physician, but there is a nationwide epidemic resulting in poor health …

Fixing The System: A Comparative Review Of The United Kingdom, Germany, And United States’ Healthcare Systems And Lessons Learned For Potential Improvements In The United States, Jessica Goddard

Senior Theses

In an effort to provide recommendations to the United States’ considerations of a universal healthcare system, this thesis analyzes the United States healthcare system alongside the sophisticated systems of the United Kingdom and Germany. Literature review and an analysis of 10 health outcomes and indicators guided the framework for a set of interview questions to be asked of healthcare professionals in all three countries. The interview response data was then organized and used to guide the suggested recommendations to the United States in its path towards universal healthcare. While a limited number of solutions could be provided given the time …

Sexual Knowledge And Wellness Of College Students, Aubrey Parker

Undergraduate Research Conference

Abstract: The purpose of this research project is to conduct further research on the use of a questionnaire developed by the fall 2022 FSC 330 class to assess sexual health knowledge of W students. I plan to study their use as a potential educational tool to provide sexual health knowledge to W students in addition to assessing their sexual health knowledge. The revised survey consists of topics that cover: contraceptives, women’s/ men’s sexual health and anatomy, gender/ sexual orientation, sexual coercion, STI’s, and lastly love/ communication. The survey we are currently making will have three different versions that are: feedback …

Physical Activity Among Adults With Psychiatric Illness In Karachi, Pakistan: A Survey Based Research, Aneeta Jevtani, Erum Perveen, Mustafa Uroosa, Nazia Zeya, Farkhanda Emad, Fareeha Kanwal, Mahum Azhaar, Faisal Yamin

Baltic Journal of Health and Physical Activity

Introduction: In Pakistan, psychological wellbeing is still considered a stigma and has limited resources to provide maximum care. Individuals with mental illness struggle with maintaining their sedentary behaviors and have poor wellbeing. The aim of the study is to investigate the physical activity among individuals with a psychiatric illness. Materials and Methods: A sample data of 144 outpatients, diagnosed with a psychiatric illness were collected from the Outpatient Department (OPD) of a public sector psychiatric set-up in Karachi, Pakistan. The participants were assessed with the International Physical Activity Questionnaire (IPAQ). Results: Females with a psychiatric illness were found to be …

The Current Youth Sport Culture And Its Impact On Sport Participation Experiences Of Low Socioeconomic Status Families, Mayrena I. Hernandez, Elena C. Miller, Laura A. Prieto, Luis Columna, Kevin M. Biese, David R. Bell

Internet Journal of Allied Health Sciences and Practice

Purpose: The rise of sport specialization can jeopardize the opportunities for families of low socioeconomic status (SES) to participate in organized sport. However, obtaining an athletic scholarship may be a motivating factor for low SES youth to sport specialize. Yet, the experiences of low SES athletes in sport participation are not well known. Method: We used an Interpretative phenomenological analysis (IPA) to explore experiences of low SES families with children participating in sport and how this may be impacted by the current youth sport culture that promotes sport specialization. We engaged in semi-structured interviews with 12 low SES parents. Results: …