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Improving Patient Care of Adults Experiencing Alcohol Withdrawal: A Quality Improvement Project
Get PDFBackground: Alcohol use disorder is on the rise in the United States (Esser, et al., 2024). Alcohol-related accidents greatly contribute to costs and expenditures within the healthcare sector. Clinicians need to have adequate screening and assessment skills as well as knowledge when treating patients experiencing withdrawal from alcohol in the hospital. Standardization of protocols and early administration of benzodiazepines decreases morbidity and mortality.
Objective: The project identified evidence-based practice screening and assessment strategies utilized for the care of adults experiencing withdrawal from alcohol. Protocols at the hospital were updated to reflect new information. The project included an education module provided to staff nurses to increase confidence and knowledge and introduce the new policy.
Methods: Staff nurses watched an education module online and answered questions regarding perceived confidence before and after watching the module. They also answered three open-ended questions and two knowledge-based questions.
Results: There was an increased perception of confidence after staff nurses viewed the education module. There was also an increase in correct answers to the knowledge-based questions. Short term answers revealed that staff nurses were aware that alcohol use was on the rise. They also acknowledged that alcohol withdrawal has physical and emotional consequences for which they felt needed great empathy and compassion.
Implications: Standardizing protocols, screening tools, assessment strategies and medication administration for treatment of patients experiencing alcohol withdrawal led to safer patient outcomes. Annual education modules increase confidence and knowledge amongst staff members
Improving Integrated Care through an Interprofessional Communication Education Module using TeamSTEPPS®
Get PDFBackground: Despite spending the most money on healthcare per capita (World Health Organization, 2020), the United States (US) has the worst health outcomes for birthing persons and newborns, measured by maternal mortality, infant mortality, and preterm birth rates. These outcomes are attributed to inadequate access to care and errors in interprofessional communication. Intervention: This quality improvement initiative implements early intervention of an interprofessional communication training using an evidence-based interprofessional collaboration frame called TeamSTEPPS®. Measures: Effectiveness of this intervention was evaluated using pre- and post- qualitative survey data gathered from participants. Outcomes: Of the 8 survey participants, 100% of participants related the importance of TeamSTEPPS® communication tools. On a 5-point Likert scale, the education module effectiveness received a rating of 4 or higher from all participants. Conclusions: This quality improvement initiative underscores the significance of interprofessional education and highlights the need for broader, nationwide efforts to improve collaborative care and patient health outcomes. Further study is warranted across diverse healthcare settings and with larger sample sizes to establish a clearer correlation between interprofessional education on communication and patient care outcomes
Designing a Community-Level Hypertension Management Program for Rural Vietnam
Get PDFBackground: This paper outlines the design of a hypertension management program aimed to be piloted in a rural commune in Vietnam. The program is in collaboration with a nonprofit organization based in the U.S. and emphasizes grassroots solutions to improve healthcare access and enhance patient outcomes at the community level.
Objectives: To determine the prevalence of elevated blood pressure and associated risk factors in Ca Dy\u27s population, examine the commune health workers\u27 experiences at the commune health station, and design a program to manage hypertension
Method: Mixed-method analysis results informed the design of a HMP for this project. Phase I comprised a retrospective quantitative analysis of data from 2019 and 2023 mobile clinics in Ca Dy, along with qualitative data collected from a focus group discussion with commune health workers. These findings guided the program design in phase II.
Results: About one-third of adults in Ca Dy have experienced elevated BP, with prevalence on the rise since 2019 and age being the only statistically significant risk factor. For the local population, accessing care is hindered by distance and financial constraints, while the CHWs face challenges in providing care due to limited healthcare resources and financial support.
Conclusion: Given the high prevalence and increasing trend of elevated BP among adults in Ca Dy, addressing the HTN burden is critical. Empowering commune health workers with resources at a centralized commune health station may decrease the distance traveled by local residents to access care and increase preventative blood pressure management among the communit
A literature review of finding the associated risks for developing deep vein thrombosis using peripherally inserted central catheters (PICC) with vascular ultrasound
Get PDFObjective: Peripherally inserted central catheters (PICC) lines are becoming more widely used in hospitalization for usage of chemotherapy, blood transfusion, and accessibility through the upper extremity venous system. This literature review aims to look at how vascular ultrasound can find risk factors with the incidence of PICC line related thromboembolism.
Materials & Methods: A systematic literature review was aimed through PubMed, ClinicalKey, and CINAHL for the association between upper extremity deep venous thrombosis (DVT) development after the usage of a peripherally inserted catheter (PICC) in controlled examinations. The reviewed studies ranged from the year 2010 to 2023, publications searched included terms of “deep venous thrombosis” and “peripherally inserted central catheterization.”
Results: Correlations between usage of a PICC line and developing upper extremity and lower extremity deep venous thrombosis were confirmed. Risk factors to developing PICC line related DVT have been identified to duration of placement, catheter diameter, site of access
Conclusion: Ultrasound Doppler can be used to improve patient outcome by sonographically evaluating early risk factors for deep venous thrombosis, such as venous wall diameter and location of the deep venous system before PICC insertion. By using prior ultrasound exam findings, criteria, and patient history, anticipation of the patient developing thrombosis due to PICC insertion can be expected and possibly avoided
Analyzing Possible Predictors in Police Use of Force Incidents
Get PDFAcross the country, social justice advocates and federal investigators alike report unconstitutional and excessive police use of force (UOF) that particularly targets minoritized communities. While some thorough investigations into individual municipalities have been made, certain issues unique to UOF data create barriers to conducting large-scale analysis. Notably, there is no standardized national system of data acquisition and treatment; how UOF incidents are recorded and investigated vary substantially between cities. Though not amending the problem of how data is collected by police, this project explores analysis tools for comparing possible predictors of outcome in police use of force incidents, or what level of force is used. Publicly available UOF datasets are utilized to compare three cities of different population sizes: New Orleans, Seattle, and Chicago. Census data from these cities is also used to provide additional demographic information. Results show that race may be used as a strong indicator of what level of force police use in a given incident, meaning that there is a strong correlation between high levels of force and minoritized racial groups. Black residents are overrepresented in UOF incidents overall. While finding ways to recognize and analyze such patterns in the data can be helpful in the initial steps of deconstructing systemic racism and violence, future work is needed to uncover, address, and prevent the causes of such patterns
Metals Matter for Mosses: Pollution Effects on Invertebrate Communities
Get PDFMosses are ubiquitous yet understudied components of Pacific Northwest ecosystems; they play a role in the nitrogen cycle by housing nitrogen-fixing cyanobacteria, insulating against temperature and humidity fluctuations, and are a perfect habitat for a wide array of invertebrates. While previous studies have identified heavy metal hotspots in moss tissue collected from the Duwamish Valley, little research has compared biodiversity across moss communities. This study aimed to characterize the macrofaunal and microfaunal biodiversity in the moss species, Orthotrichium lyelli, across multiple sites in South Seattle. Specifically, we compared mosses from high-pollutant urban sites in the Duwamish Valley to mosses from Seattle Parks. Moss samples were collected from 30 sites in South Seattle, comprising 15 urban and 15 park samples. Invertebrates were extracted from the moss using Baermann and Berlese funnels, then identified via DNA sequencing or morphospecies assignment. Heavy metal concentrations were determined using inductively coupled plasma mass spectrometry (ICP-MS). Our findings reveal notable differences in heavy metal concentrations and invertebrate community composition in moss samples from urban vs. park sites. Microinvertebrate communities in urban sites with low heavy metal levels resemble those in parks more closely than other urban sites. Park sites exhibited higher invertebrate abundance and richness compared to urban sites. These metrics could serve as critical biological indicators of ecosystem health, warranting further investigation into potential human health implications, particularly for low-income communities
