Parkview Health Research Repository
Not a member yet
774 research outputs found
Sort by
2024 Parkview Research Repository Library Report - Infographic
Get PDFA infographic compilation of data regarding readership and metrics of content in the Parkview Research Repository for the year of 2024. The platform, Digital Commons, is provided by Elsevier and the institutional repository is managed by the Parkview Research Library. This institutional repository (IR) was started in 2017 and is accessible worldwide
Outcomes of Mechanical Circulatory Support in STEMI Patients with Cardiogenic Shock: Insights from the National Inpatient Sample
Get PDFBackground Cardiogenic shock has been associated with a high mortality rate despite advances in mechanical circulatory support. Data is inconsistent as the majority of patients in the current trials are SCAI stage E, or data is combined with heart failure and STEMI cardiogenic shock. Methods Data was extracted from the 2020 United States National Inpatient data set. The diagnosis criteria were “STEMI” and “Cardiogenic shock”. The primary outcome of interest was comparing mortality in those patients who received mechanical circulatory support vs. those who did not in STEMI Cardiogenic shock. Results There were 4,302 patients with STEMI and cardiogenic shock, and 65.3% were males. The mean age was 66.7 years (SD 12.3), and the mean length of hospital stay was 7.9 days (SD 10.03). 36% of the patients died during hospital admission. 29% received an intra-aortic balloon pump (IABP), 15.5% had Impella left ventricular support, 3.2% had veno-arterial extracorporeal membrane oxygenation (ECMO), 2.2% had both IABP and Impella, 1.3% had both Impella and ECMO and 1.0% had both IABP and ECMO. The Kaplan-Meier analysis showed that IABP use was associated with decreased in-hospital mortality (p\u3c0.001). In the multivariate analysis, age (OR 1.034, 95% CI 1.028-1.04, p\u3c0.001), female (OR 1.26, 95% CI 1.1-1.45, p\u3c0.001), acute kidney injury (OR 1.96, 95% CI 1.71-2.25, p\u3c0.001), ECMO (OR 1.74, 95% CI 1.22-2.50, p=0.003), and Impella (OR 1.72, 95% CI 1.45-2.06, p\u3c0.001) were associated with increased in-hospital mortality. Conversely, using IABP (OR 0.65, 95% CI 0.56-0.76, p\u3c0.001) was associated with decreased in-hospital mortality. Conclusions Mechanical circulatory support devices are used individually and in combination with each other in patients with cardiogenic shock, with IABP being the most commonly used. However, in-hospital mortality remains high, but using IABP was associated with decreased in-hospital mortality. The patients with IABP were more likely SCAI stage C rather than SCAI stage E; therefore, this could have contributed to the decrease in-hospital mortality
Penicillin Allergy De-labeling: Evaluating a Health System’s Implementation of the PEN-FAST Tool within an Infectious Disease Clinic.
Get PDFPresented at the Great Lakes Pharmacy Residents Conference. West Lafayette, IN: April 2024.
This retrospective, post-implementation study found that 81% of patients with a documented penicillin allergy could be de-labeled, and that the majority could theoretically tolerate a penicillin challenge
Best practices for PGY1 letters of intent: Recommendations from a modified Delphi process.
Get PDFPresented at ACCP Virtual Poster Symposium. Lenexa, KS: May 2024.
This study generated best practices student pharmacists pursuing residency training should employ when preparing a letter of intent
Early vs Late Extracorporeal Membrane Oxygenation (ECMO) for Mechanical Circulatory Support
Get PDFBackground Use of Extracorporeal membrane oxygenation (ECMO) for hemodynamic (HD) support is becoming increasingly prevalent. While potentially life-saving, ECMO use is associated with complications of its own due to widespread immune activation. We aim to compare early (≤1 day) vs late (\u3e1 day) ECMO use for hemodynamic support. Methods The national readmission database (2016-2020) was utilized to identify hospitalizations requiring ECMO. Cohorts were stratified based on ECMO initiation. A Propensity Score Matching (PSM) model matched patients with early vs late ECMO use. Pearson’s x2 test was applied to PSM-2 matched cohorts to compare outcomes. Results Among 40,984 hospitalizations requiring ECMO for HD support; About 21.2% (N: 8,688) had early ECMO initiation. After propensity matching, early ECMO use was found to be associated with a higher incidence of stroke (6.9% vs. 4.6%), sudden cardiac arrest (11.7% vs 8.6%), post-procedural bleeding (5.8% vs 4.8%), vascular complications (2.5% vs 1.9%), acute MI (21% vs 16.2%), AKI (56.7% vs 55.6%), respiratory failure (45.9% vs 36.5%), MACCE (46.4% vs 40.8%) & need for vasopressors (18.4% vs 15.4%) [p\u3c0.001]. Mortality was similar between two cohorts (p\u3e0.05). Mortality in HD unstable patients requiring ECMO has increased from 4.2% in 2016 to 36.6% in 2020 (p-trend \u3c0.001). Early ECMO use was also associated with higher readmission rates at 30-day (14.4% vs 12.4%, p\u3c0.001), 90-day & 180-day intervals but with lower LOS (9 vs 19 days) & cost of hospitalization [p\u3c0.001]. Conclusions Early ECMO use is associated with much higher complication & readmission rates, although mortality is not different
Attachment security and problematic media use in infancy: A longitudinal study in the United States.
Get PDFMedia use during childhood has quickly become a norm across the United States and in other countries. One area still not well understood is the development of problematic (or maladaptive and disruptive) media use in children. This research examines the role of attachment security as a central component in the development of problematic media use over time in a sample of 248 parent-child dyads (9.50% African American, 20.66% Hispanic, 62.81% White, 2.07% Asian, 4.96% other ethnicities). We examined the relationship between attachment security and problematic media use one and 2 years later. We then constructed a mediation model examining parent responsiveness while jointly engaging in media use and during play as mediators between infant attachment security and problematic media use over time. Results suggest that while infant attachment security may be protective against developing problematic media use patterns, this relationship does not seem to be mediated by parent-child interactions while engaging in media or during play
Comparing cardiometabolic monitoring and side effect management in a pharmacist-led ambulatory clozapine clinic versus standard care.
Get PDFPresented at the ASHP Midyear Clinical Meeting. New Orleans, LA
This study found that cardiometabolic monitoring rates were significantly higher in the pharmacist group compared to standard care, and that clozapine-related side effects were screened more frequently
Candida auris screening in the acute care setting: An infection control partnership between hospitals and skilled nursing facilities
Get PDFPresented at 2023 APIC Annual Conference
Background: Candida auris (C. auris) is a drug-resistant fungus that can spread easily between hospitalized patients and nursing home residents. To mitigate risk of C. auris spread, a nine-hospital healthcare system developed a C. auris screening tool in January 2020. Infection Preventionists (IPs) use the screening tool to determine which patients qualify for C. auris screening, looking specifically at the facility type where the patient came from. The IP then initiates the isolation and testing protocol with the bedside nurse and provider.
Methods: Over the course of three years, the hospital epidemiologist collected data on all screening events, such as date of lab testing and results, location of residence, and history of other multidrug resistant organisms (MDROs) to evaluate, educate, and report on the screening process. Epidemiological surveillance data were evaluated using pivot tables to identify possible epidemiological trends.
Results: Data analysis revealed three out of the thirty-five facilities had residents who tested positive for C. auris. Of the three facilities, all were skilled nursing facilities (SNFs), two of which provide ventilator care (v). The SNFs were de-identified with new labels – vSNF1, vSNF2, and SNF. Of the three facilities found to have C. auris positive residents (n=88), 3.4% (3/88) came from vSNF1, 5.7% (5/88) and 2.3% (2/88) were from vSNF2 and SNF, respectively. Outbreak clusters emerged from the pivot table using screening dates, which were organized into yearly quarters. The first two clusters occurred at the SNF and vSNF2 facilities during the same timespan from 2021Q2 to 2021Q4. No additional screens resulted positive in 2022 for both facilities. The third cluster occurred between 2022Q3 to 2022Q4 at vSNF1.
Conclusion: Receiving a positive C. auris result allows the IP department to promptly reach out to the facility where the patient came from and begin assisting with intervention needs and staff education, if requested. Additionally, all positive results are reported to the state department of health, who also duly assists with control measures necessary to mitigate risk and prevent future outbreaks
Enhancing Diabetes Care with Peer Mentorship and Support Groups
Get PDFPoster presented at the Parkview Nursing Research Symposium, 2023.
Continued increase in prevalence of type 2 diabetes indicates need for more effective interventions to support lifestyle and behavior changes (ADA 2018).
• Evidence indicates attending diabetes self management education programs can improve diabetes outcomes, unfortunately they are often under referred and underutilized (Powers et al. 2015, Boakye et al. 2018).
• Limited class times, locations, and capacities can make attendance for all patients difficult and vulnerable populations are less likely to participate (Boakye et al. 2018).
• Diabetes education programs often lack culturally and individually relevant guidance, provide no long-term support, and most insurance policies only cover up to 10 hours of education (Boakye et al. 2018).
• Despite these shortcomings in diabetes education and support, our communities still have patients that have found success in disease management.
• Successful patients are a potential resource for new and chronic patients struggling to understand and control their disease.
• The purpose of this review is to collect and examine existing literature on the use of peer support or mentorship programs as a treatment adjunct for adult type 2 diabetics to establish the need for local program development and implementation
Community Acquired Pneumonia Order Set Utilization Evaluation: A Retrospective Chart Review
Get PDFPresented at the ASHP Midyear Clinical Meeting. December 2023.
This poster evaluated adherence of antimicrobial regimen selection using a community acquired pneumonia (CAP) order set updated to Infectious Disease Society of America/American Thoracic Society guidelines