Parkview Health Research Repository
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What bereaved people have found helpful following death of a loved one in a hospital: a survey study
No full textGiven the individual and public health impact of bereavement, discovering what people perceive as helpful after loss can improve interventions. In contrast to national projects, this project focused on two hospitals in a Midwestern hospital system.
A survey was developed to assess the work of chaplains with next of kin following a death, to assess the awareness and helpfulness of persons and organizations in the community, and to ask what people had done, said, or given that was helpful, or what respondents wished people had done. From a list of 283 people invited to respond, 52 completed the survey.
Survey responses indicated that chaplains were perceived as helpful in providing resources and support. Family and friends were the most used sources of support, RNs and physicians were the most helpful. Support from church sources was identified as helpful through unprompted responses. A theme identified as “remembering” emerged in several places, related to remembering the life and dates and stories about the deceased
Endoscopic Submucosal Dissection for Previously Attempted Colorectal Lesions: An International Multicenter Experience.
No full textBACKGROUND & AIMS: Salvage endoscopic submucosal dissection (ESD) has been proposed for previously attempted colorectal lesions (PACLs), yet the extensive submucosal fibrosis impacts procedural difficulty and resection outcomes. The aim of this study was to evaluate the efficacy and safety of salvage ESD for the treatment of PACLs.
METHODS: This international, multicenter study enrolled consecutive patients who underwent ESD to manage PACLs. Rates of en bloc, R0 resection, and local recurrence were assessed for efficacy. Safety was assessed by adverse events (AEs), procedure-related mortality, and the need for surgical management.
RESULTS: Of 415 lesions, en bloc rate was 83.4%, the R0 rate was 76.2%, and the curative resection rate was 73.5%. AEs occurred in 48 (11.8%) patients, the most common being intraprocedural perforation (n = 19 [4.6%]). Two patients required surgical management and 17 were managed endoscopically. Significant intraprocedural bleeding occurred in 3 (0.7%) patients, all managed endoscopically. A total of 25 (6.0%) patients had post-ESD AEs at a median of 5 (interquartile range, 1-24) days, most commonly being delayed bleeding (2.4%). Of 260 patients with follow-up data (median 49 [interquartile range, 25-72] weeks), local recurrence occurred in 18 (6.9%). Surgical referral was made in 25 (6.0%) patients due to noncurative resection (5%), intraprocedural perforation (0.4%), and post-ESD AEs (0.4%; colonic stricture and fistula formation). There was no mortality from procedure-related or colorectal cancer.
CONCLUSIONS: Salvage ESD is highly effective in the treatment of PACLs. When performed by experts, AEs were uncommon and mostly managed endoscopically
Evaluation and Optimization of Outpatient Parenteral Antimicrobial Therapy Laboratory Monitoring for Beta-Lactam Antibiotics.
Get PDFPresented at the ASHP Midyear Clinical Meeting. New Orleans, LA
This evaluation found that among patients who experienced eosinophilia, only one exhibited signs of hypersensitivity, while seven required a change in therapy. This indicates that while eosinophilia is a concern, its direct clinical impact may be limited for the majority of patients. In the cohort experiencing elevated LFTs including AST, ALT, or alkaline phosphatase levels, fewer than 2% necessitated a change in therapy. This low rate suggests that routine LFT monitoring may not always correlate with significant clinical decisions, raising questions about the necessity of frequent lab draws
Association of Early Nutrition with Bronchopulmonary Dysplasia Severity and Magnetic Resonance Imaging Lung Characteristics in Preterm Infants.
No full textINTRODUCTION: Restricted fetal and neonatal growth is a known risk factor for bronchopulmonary dysplasia (BPD) in premature infants. However, the impact of nutrition and infant growth specifically on lung growth in BPD is unknown. Moreover, whether all lung growth in BPD is beneficial is unclear. We hypothesized that lung growth and development and severity of BPD directly relate to caloric and protein intake, weight gain, and linear growth of premature neonates.
METHODS: In this retrospective study, caloric and protein intake for the first 4 weeks of life, growth parameters along with lung volume, mass, density, and BPD severity obtained by ultrashort echo time (UTE) MRI, were analyzed.
RESULTS: The cohort included 95 neonates with mean GA 26.1 weeks and BW 790 g. Infants with grade 2 and 3 BPD had less caloric and protein intake during first 4 weeks of life vs. grade 1 BPD (96/98 vs. 106 kcal/kg/day; 3.79/3.75 vs. 3.99 g protein/kg/day; p \u3c 0.05). UTE MRI showed that lung mass per body surface area increased with increasing BPD severity (237, 311, 384 g/m2 for grade 1, 2, and 3, respectively, p \u3c 0.05). Increased caloric intake was associated with decreased lung mass (p = 0.02) and improved BPD score on MRI (p = 0.04).
CONCLUSION: Decreased nutritional intake during the first 4 weeks of life appears to be associated with more severe BPD, increased lung mass and more severe lung disease on MRI
Operation Honor: Honoring our Veterans in the Medical Intensive Care Unit
No full textPresented at the 2025 Parkview Nursing Research Symposium.
A coworker had an impressionable conversation with a patient and their family regarding end of life. During this conversation she found out the patient was a veteran. This conversation made her aware of a care gap we could fill. She approached the NCAT chair to brainstorm ideas. After months of discussion and research, Operation Honor was born.
Two goals of this project: 1)To honor veterans and their families
To improve staff morale surrounding the loss of a patient as well as providing the patient with a “good death
Navigating Challenges in Palliative Care: A Survey on ASCO Guideline Adherence Among Health Care Providers in Low- and Middle-Income Countries.
No full textPURPOSE: Integrating palliative care into oncology is essential, yet disparities in access and quality persist, particularly in low- and middle-income countries (LMICs). The ASCO guidelines advocate for early, routine, interdisciplinary palliative care for patients with advanced cancer. Barriers to implementing these recommendations include resource limitations, inadequate training, and cultural perceptions. Recognizing these challenges is essential for improving equitable access to palliative care worldwide.
METHODS: This prospective survey assessed adherence to ASCO recommendations for palliative care integration among LMIC health care providers (HCPs). Participants were recruited via e-mail, social media, and a list of members involved in the ASCO Palliative Care Communities of Practice from February to May 2024. The survey included sections on sociodemographic information, self-perceived adherence to ASCO guidelines on a 5-point Likert scale, and open-ended questions on implementation barriers. Data were collected using Research Electronic Data Capture system. Participants were grouped by WHO regions. Descriptive statistics were used to summarize characteristics and adherence scores, and chi-square tests were used to evaluate regional differences. Thematic analysis identified key themes from open-ended responses.
RESULTS: One hundred eighty HCPs participated; 62% was female, and 51.1% was age 35-44 years. Most were physicians (66%), and 50% lacked palliative care specialization. Adherence to ASCO guidelines varied, with early palliative care referrals ranging from 50% in the Americas region to 0% in the Western Pacific region. Key barriers included lack of policy support (25%), unmet educational needs (22%), and accessibility constraints (19%).
CONCLUSION: Addressing identified barriers through evidence-based advocacy, comprehensive policy changes, training, and continuing education programs is essential for integrating palliative care into oncology services across LMICs, promoting health equity for patients with cancer
Forecasting the impact of artificial intelligence on clinical pharmacy practice
Get PDFThere is a need to understand contemporary scientific advances as clinical pharmacy evolves. One rapidly expanding area is artificial intelligence (AI), which has grown significantly over the past year because of the public availability of large language models. This commentary reviews published literature describing and evaluating applications of AI to each aspect of the medication use process and forecasts potential future roles for AI in pharmacy practice. Potential challenges in implementation are also described
Pro: The Use of Sugammadex Does Not Preclude the Need for Objective Neuromuscular Monitoring.
Get PDFBased on strong evidence, optimal management of neuromuscular block should incorporate objective (or quantitative) neuromuscular monitoring with appropriately dosed antagonists such as sugammadex. Sugammadex has the unique ability to antagonize aminosteroidal-induced neuromuscular block at any level; however, neostigmine is a reasonable alternative at minimal levels. Blind or excessive administration of sugammadex does not eliminate the risk of patients having postoperative residual neuromuscular block. Significant variability exists in how patients respond both to neuromuscular blocking agents and their antagonists
Nursing Professional Liability: Bridging RN & APRN Perspectives on Risk, Coverage & Evolving Practice Authority
No full textPresented at the 2025 Parkview Nursing Research Symposium.
The purpose of this literature review is to explore professional liability for RNs and APRNs. Specific objectives include:
• Identify patterns in malpractice claims for RNs and APRNs
• Compare employer-provided and personal malpractice coverage
• Examine the impact of scope-of-practice laws on APRN liability
• Clarify principles of vicarious liability
• Recommend lifelong strategies for education, risk management, and professional practic
Provider Perspectives on Produce Prescription Programs in a Rural Community
No full textThis poster was presented at the 2025 Nursing Research Symposium.
Purpose: To evaluate healthcare provider perspectives on PPPs in a rural community To identify barriers and facilitators to implementing a PPP To lay the groundwork for the successful implementation of a PPP in the Coun