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Benchmark Study: Impact of Electronic Health Records vs. Paper-based Records
Get PDFMedical documentation is an essential part of healthcare and conducted at the highest standard; documentation ensures the delivery of safe and high-quality healthcare services (Noureldin et al., 2014). Performance Improvement team reports the same poor outcomes each quarter that may be a result of the paper-based documentation system. These outcomes include patient safety, patient satisfaction and cost-effectiveness. This narrative review’s purpose is to determine whether the implementation of an electronic health record (EHR) system could improve outcomes. Evidence-based guidelines for the implementation of an EHR need special consideration to have a successful transition. Further studies may need to be reviewed that reflect the Ambulatory Surgery Center (ASC) setting.
Keywords: electronic health records, EHR, paper charting, ambulatory surgery centers; electronic medical records, EMR, paper documentation, patient satisfaction, patient preference, patient safety, cost, cost-effectivenes
DNP Final Report: IMPLEMENTATION OF A PRENATAL ELECTRONIC EDUCATION PROGRAM TO IMPROVE EXCLUSIVE BREASTFEEDING INITIATION RATES IN NEW MOTHERS
Get PDFBreastfeeding is accepted as the best source of infant nutrition exclusively for the first six months of life. Because it is important to both mother and infant for long-term health benefits, exclusive breastfeeding at discharge has been a CMS Perinatal Core Measure since 2015. It is essential that hospitals have personnel and programs in place to support breastfeeding mothers to support the Healthy People 2030 goal of exclusive breastfeeding for the first six months of life. COVID-19 changed how the world interacted and medical staff had to use innovative techniques to engage and educate patients virtually since social distancing prohibited normal in-person appointments and interactions that would have normally occurred. Younger clientele may actually prefer online or virtual exchanges over in-person interactions according to literature. Therefore, the question was, how do you improve exclusive breastfeeding rates in facilities during a pandemic when normal interactions are not allowed due to social distancing requirements? Practice question: Does a prenatal electronic education program improve exclusive breastfeeding rates in new mothers prior to discharge? The literature supports any education, specifically, electronic methods, can improve exclusive breastfeeding rates
DNP Final Report: Vascular Access in Burn Patients: An Evidence-Based Practice Project
Get PDFVascular access in burn patients is a challenging aspect of care that affects the healthcare team and patients daily. The goal in this evidence-based practice project at a southern United States burn center was to improve the quality of the vascular access process by reducing the use of Central Venous Lines (CVL) and unsuccessful venipuncture attempts. The following practice question was formed: In hospitalized burn patients (P), how does a vascular access team with ultrasound-guided peripheral IV capability (I) compared with no vascular access team and standard IV insertion (C) affect central line days (O1) or patient experience (O2) during patient hospitalization (T)? Based on systematic review of the literature and evidence appraisal, the recommendation was made to implement an early Vascular Access Team (VAT) consult for burn patients. A 45% reduction in CVL device days (DD) and a 35% improvement in patient experience were anticipated with implementation based on the evidence. The project was implemented in January through March 2022. The results included that there was a 12.8% reduction in CVL DD, an 89% reduction in the number of times more than two vascular access attempts was required, and a 138% improvement in patient experience. Although the CVL DD decreased, the evidence based anticipated outcome was not reached, most likely due to the specialized population of burn patients; however, the improvement in patient experiences far exceeded the evidence-based expectation. Early vascular access consult was successfully implemented in this burn center
TO STUDY HEART RATE DYNAMICS OF PRETERM INFANTS USING LSTM BASED DEEP LEARNING MODEL
Get PDFBabies born prematurely are more likely to experience serious medical problems called Bradycardia, where their heart rate drops below 100 beats per minute(bpm). Bradycardia can decrease cerebral blood velocities by 10-50% from their normal level [6], potentially harming the infant\u27s developing brain and other vital organs. Healthcare professionals working in Neonatal Intensive Care Units (NICUs) face challenges evaluating the likelihood of these events occurring in preterm babies based on their physiological signals. Forecasting and tracking bradycardia events before time will help save thousands of preterm infants from losing their lives. While time series analysis of heart rate data is one possible solution, creating a separate model for each infant is time-consuming and complex too. This thesis aims to test the hypothesis that the heart rate dynamics of preterm infants have unique system characteristics. We can study and track bradycardia events using only one infant, reducing the necessity of designing a specific model for each infant.
To test the hypothesis, a Long Short-Term Memory (LSTM) based deep learning network has been proposed for time series analysis of the heart rate of preterm infants using only heart rate as the input. Bradycardias are an important part of preterm infant cardiac dynamics due to which they are significant in this study. The LSTM model was trained using the heart rate data of a single infant and then tested on other infants having test segments of 10 minutes with at least 5 seconds of bradycardia event. Bradycardia events were categorized into three cases according to their nature of severity, severe, moderate, and mild. The developed model performed one-step, five steps, and ten-step time series prediction using three different sliding window scenarios, i.e., 30, 60, and 120 sec on the test data. The model was tested for severe, moderate, mild, and normal case scenarios for all three-time steps prediction, i.e., one-step, five-step, and ten-step, using sliding window sizes of 30, 60, and 120 seconds. The model performed well when tested on novel data, with a low average RMSE value.
After thoroughly analyzing the output data, it can be concluded that the proposed hypothesis about distinct system characteristics in each infant is accurate since the designed model can detect instances of bradycardia in each infant with a lower average root-mean-square error (RMSE). This could aid in efficiently managing and treating preterm infants in the neonatal intensive care unit (NICU)
PEROXISOME PROLIFERATOR-ACTIVATED RECEPTOR GAMMA (PPAR-γ) REGULATION OF INDUCTION OF INFLAMMATORY MEDIATORS BY ORGANIC DUST IN THP-1 MACROPHAGE CELLS
Get PDFInhalation of organic dust is associated with the development of respiratory diseases such as bronchitis, hypersensitivity pneumonitis, asthma, and chronic obstructive pulmonary disease (COPD). Chronic inflammation due to increased cytokine production has been linked to the development and progression of respiratory diseases. Peroxisome proliferator-activated receptor gamma (PPAR-γ), a transcription factor belonging to the nuclear hormone receptor family, is known to modulate inflammatory responses. In this study, we investigated the involvement of PPAR-γ in the regulation of organic dust induction of inflammatory mediators in THP-1 macrophages. THP-1 monocytic cells were differentiated into macrophages using phorbol myristate acetate. The effects of PPAR-γ agonists and antagonists on the induction of IL-6 and TNF-a expression by poultry organic dust extract were investigated by ELISA and real-time qRT-PCR. The effects of PPAR-γ agonist 15d-PGJ2 on ROS production and activation of MAPKs and NF-kB and STAT-3 activation were investigated by DCFDA labeling and western blotting respectively. We found that PPAR-γ agonist 15d-PGJ2 potently inhibited dust extract induction of TNF-α and IL-6 proteins by reducing mRNA expression. 15d-PGJ2 inhibited ROS levels and NF-κB and STAT-3 activation while concomitantly activating MAPKs. These data indicated that the inhibitory effects of 15d-PGJ2 on TNF-α and IL-6 may be mediated via reduced ROS and NF-κB and STAT-3 activation, suggesting that PPAR-γ could be targeted to attenuate organic dust-induced lung inflammation
The Hispanic Community is Growing in Presence and Relevance in Texas, and East Texas is no Exception
Get PDFThis issue of the Hibbs Brief is dedicated to the Hispanic Community in observance of the Hispanic Heritage Month
BlueFMCW: random frequency hopping radar for mitigation of interference and spoofing
Get PDFRadars form a central piece in a variety of emerging applications requiring higher degrees of localization. However, two problems are anticipated as more radars are deployed: viz., (i) inter-radar interference and (ii) security attacks. While many prior proposals have addressed the problems, no work in the radar literature addressed them simultaneously. In this context, we introduce a novel frequency-modulated continuous-wave (FMCW) radar scheme (namely, BlueFMCW) that aims to alleviate the damage from interference and active attacks (e.g., spoofing). The technique designs that the waveform randomly hops across multiple frequencies to dilute the damage at a certain frequency. Moreover, we propose a phase alignment algorithm to remove the phase discontinuity while combining the beat signals from the randomly-hopped chirps. The simulation results show that the proposed technique can efficiently mitigate the interference and spoofing signals in various scenarios without costing its resolution
Obesity and the Development of Lung Fibrosis
Get PDFObesity is an epidemic worldwide and the obese people suffer from a range of respiratory complications including fibrotic changes in the lung. The influence of obesity on the lung is multifactorial, which is related to both mechanical injury and various inflammatory mediators produced by excessive adipose tissues, and infiltrated immune cells. Adiposity causes increased production of inflammatory mediators, for example, cytokines, chemokines, and adipokines, both locally and in the systemic circulation, thereby rendering susceptibility to respiratory diseases, and altered responses. Lung fibrosis is closely related to chronic inflammation in the lung. Current data suggest a link between lung fibrosis and dietinduced obesity, although the mechanism remains incomplete understood. This review summarizes findings on the association of lung fibrosis with obesity, highlights the role of several critical inflammatory mediators (e.g., TNF-α, TGF-β, and MCP-1) in obesity related lung fibrosis and the implication of obesity in the outcomes of idiopathic pulmonary fibrosis patients
Panel Presentation: Research, Innovation, Entrepreneurship in the Business World
No full textKerri Camp, PhD - Federal Funding Opportunities for Entrepreneurship in East Texas
Jeff Howlett - Entrepreneurship and Technology Commercialization Innovations in East Texas
Paul Nichols, PhD - Enabling the Next Generation’s New Venture
The Impact of Cognitive Rehabilitation Therapy on Alzheimer\u27s Disease
Get PDFThe number of people suffering from Alzheimer’s disease (AD) rises daily. This is a devastating disease for the patients, significant others, and families to have to experience. “Epidemiological data confirm what retirees have observed: about 30-50% of those living to their mid-80’s will have suffered a marked loss of cognitive ability, a harbinger of advanced AD, or will have suffered advanced AD. Further, the tragedy of AD affecting loved partners takes an enormous toll on their healthier partners” (Reid et al., 2017).
The current treatment regimen for Alzheimer’s disease includes medication therapy. Evidence has shown that there are only small benefits from medication regimens. Memantine has shown a small clinical benefit for patients with moderate-to-severe Alzheimer’s disease (McShane et al., 2019). Donepezil has demonstrated that patients with mild, moderate, and severe dementia due to Alzheimer’s disease experience small benefits in cognitive function and activities of daily living (Birks & Harvey, 2003). Optimal medication treatment involves multiple medications and increases the risk for polypharmacy and adverse effects. More treatment options for Alzheimer’s disease that can provide patients with greater benefits should be available.
For Alzheimer’s disease patients to maintain their cognitive function and ability to carry out activities of daily living, the brain must be exercised through multimodal non-drug therapies and cognitive rehabilitation therapy (Luttenberger et al., 2012). Cognitive rehabilitation therapy is a form of nonpharmacological interventions that is modified to each individual (Forstmeier et al., 2015). Cognitive rehabilitation therapy is a collection of treatment strategies that are individualized to each patient and is designed to work on improving problems that are identified by the patient. It works to improve activities of daily living, cognition, attention, perception, learning, judgement, mood, and perception. When there is an improvement in activities of daily living, cognition, and mood, there is also an improvement in quality of life. The focus of this project is on the outcome of improving activities of daily living.
This change project involves the implementation of adding cognitive rehabilitation therapy to the treatment regimen for patients with Alzheimer’s disease for 6 weeks. Throughout this time, the outcomes of cognitive rehabilitation therapy in addition to medication therapy are compared to the outcomes of medication therapy alone. The project discusses the effects that these treatment regimens have on activities of daily living in the lives of patients with Alzheimer’s disease. Positive outcomes are projected to be seen and include an improvement of activities of daily living after implementing cognitive rehabilitation therapy. Other positive outcomes that are projected to be seen throughout this project include improved memory and a prolonged quality of life.
Caregivers have a vital role in the life of a patient with Alzheimer’s disease. With cognitive rehabilitation therapy, caregivers can gain advice, support, and hope with handling the day-to-day challenges of Alzheimer’s disease. Results of the project are valuable to the Alzheimer’s disease community and those caring for patients with Alzheimer’s disease. Evidence-based research was performed and evaluated vigorously to conclude the projected results. A variety of high-level articles with a high quality of evidence were identified and applied throughout this project