Parkview Health Research Repository
Not a member yet
774 research outputs found
Sort by
Association of systolic, diastolic, mean, and pulse pressure with morbidity and mortality in septic ICU patients: a nationwide observational study.
No full textBACKGROUND: Intensivists target different blood pressure component values to manage intensive care unit (ICU) patients with sepsis. We aimed to evaluate the relationship between individual blood pressure components and organ dysfunction in critically ill septic patients.
METHODS: In this retrospective observational study, we evaluated 77,328 septic patients in 364 ICUs in the eICU Research Institute database. Primary exposure was the lowest cumulative value of each component; mean, systolic, diastolic, and pulse pressure, sustained for at least 120 min during ICU stay. Primary outcome was ICU mortality and secondary outcomes were composite outcomes of acute kidney injury or death and myocardial injury or death during ICU stay. Multivariable logistic regression spline and threshold regression adjusting for potential confounders were conducted to evaluate associations between exposures and outcomes. Sensitivity analysis was conducted in 4211 patients with septic shock.
RESULTS: Lower values of all blood pressures components were associated with a higher risk of ICU mortality. Estimated change-points for the risk of ICU mortality were 69 mmHg for mean, 100 mmHg for systolic, 60 mmHg for diastolic, and 57 mmHg for pulse pressure. The strength of association between blood pressure components and ICU mortality as determined by slopes of threshold regression were mean (- 0.13), systolic (- 0.11), diastolic (- 0.09), and pulse pressure (- 0.05). Equivalent non-linear associations between blood pressure components and ICU mortality were confirmed in septic shock patients. We observed a similar relationship between blood pressure components and secondary outcomes.
CONCLUSION: Blood pressure component association with ICU mortality is the strongest for mean followed by systolic, diastolic, and weakest for pulse pressure. Critical care teams should continue to follow MAP-based resuscitation, though exploratory analysis focusing on blood pressure components in different sepsis phenotypes in critically ill ICU patients is needed
Innovative strategy to improve enteral nutrition in prone positioning with patients with COVID-19.
Get PDFBACKGROUND: Enteral nutrition is essential to improve outcomes in patients who are critically ill. Patients in the prone position, including those diagnosed with coronavirus disease 2019 (COVID-19) present additional challenges for enteral nutrition initiation.
METHODS: A novel technique for placing feeding tubes while in the prone position was developed using an electromagnetic placement device and specialty trained clinical nurse specialists. Data were assessed retrospectively to determine effectiveness of this new practice.
RESULTS: Sixty-eight patients had feeding tubes placed while in the prone position; 75% were able to be placed through the postpyloric route, 22% were placed through the gastric route, and 3% unable to be placed. Use of this technique facilitated earlier initiation of feedings by 2 days from time of admission and almost half a day from intubation to feeding. There was no additional radiation exposure from using this technique.
CONCLUSION: Ability to place feeding tubes early while patients were prone reduced delays for starting enteral nutrition. Patients with COVID-19 in the prone position were able to receive effective nutrition support earlier with no additional complications
2023 Student Research Fellowship Program: SERF ABSTRACT Booklet
No full text2024 Student Research Fellowship Program: Abstracts listed
Investigating Post-Operative Refractive Outcomes in Patients Undergoing Cataract Surgery to Assess the Potential Impact of a Concurrent Diagnosis of Dry Eye Disease (DED)
The Effects of Integrative Palliative Oncology on Health System Burden
Comparison of Jump Performance, Movement Quality, and Dynamic Balance Among Male High School Athletes with Varying Levels of Sports Specialization.
SSRI Efficacy in Treating Major Depressive Disorder: Preliminary Findings.
Neutrophil-to-Lymphocyte Ratio (NLR) to Monitor Neuroinflammation Status During Long COVID.
The Impact of Medical Debriefing on Emergency Department Length of Stay in Trauma Patients.
Impact of Comorbidities as Predictors on Hospital Length of Stay and Mortality in Hip Fracture Patients in A Rural Community Area of Northeast Indiana.
Investigating The Functional Impacts of Metabolic Disease Associated Immune-Vascular Interactions in Alzheimer’s Disease.
Heterozygous PAI-1 Deficiency’s Role in Pathological Aging in the Human Cardiovascular System
Interferon Beta Modulation of Brain Endothelial Cell Activation in Ischemic Stroke
Case Duration in Late vs. Early PT Initiation at Parkview Occupational Health: A Retrospective Analysis.
Retrospective Analysis of Suicide Deaths in Allen County Indiana, 2013 – 202
METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS SCREENING OF NEONATAL INTENSIVE CARE UNIT STAFF IN AN OUTBREAK SETTING
Get PDFPresented at 2023 APIC Annual Conference
In December 2020, our infection prevention (IP) department noted an increase in Methicillin-resistant Staphylococcus aureus (MRSA) isolates over baseline in the Neonatal Intensive Care Unit (NICU). Our hospital sees a steady influx of parents colonized with MRSA and our weekly screening process regularly discovers neonates that subsequently become colonized with MRSA. A doubling of the number of cases per month led to deeper investigation. Epidemiologic data were collected on the neonates and matched to their mother’s screening cultures (when obtained). Sensitivity patterns were matched, and staff noted that a single sensitivity pattern predominate
Skin Safety Bootcamp: Empowering Nurses to own HAPI Prevention: A Quality Improvement Initiative
Get PDFPoster presented at Parkview Nursing Research Symposium, 2023
Question: For inpatient cardiovascular nurses, does implementing a skin safety bootcamp improve the use of pressure injury prevention interventions compared to preintervention, resulting in a decrease in hospital-acquired pressure injuries
Ten simple rules for interpreting and evaluating a meta-analysis.
Get PDFThis brief review provides tangible steps readers can take to interpret and evaluate a meta-analysis, particularly when applied to clinical research topics
Respiratory ECMO Survival Prediction (RESP) Score for COVID-19 Patients Treated with ECMO.
No full textVeno-venous extracorporeal membrane oxygenation (VV ECMO) has been used as a life-supporting modality for patients with severe respiratory failure because of coronavirus disease 2019 (COVID-19). We aim to evaluate the performance of the RESP score in predicting the hospital survival of COVID-19 patients undergoing VV ECMO. We performed retrospective analysis of the extracorporeal life support organization (ELSO) dataset for COVID-19 patients requiring ECMO support to evaluate the performance of RESP score in predicting in hospital survival. All adult (age ≥18) COVID-19 patients receiving VV ECMO for acute respiratory failure enrolled in the ELSO database from March to August 2020 were included in the analysis. A total of 1985 patients from the ELSO registry were identified and analyzed based on pre-ECMO variables. Median RESP score of survivors was 3 (IQR 1-5) compared to 2 (IQR 0-4) in deceased. A logistic model including RESP score variables poorly discriminated survival and death with AUC (area under curve) 0.61 (95% confidence interval: 0.59-0.64). In-hospital survival for COVID-19 patients based on RESP score class from I to V was 69.7%, 59.3%, 45.7%, 42.5%, and 32.3%, respectively. Patients with immunosuppression (relative risk = 0.43) and pre-ECMO cardiac arrest (relative risk = 0.48) had lower survival. RESP score is a poor predictor of survival in COVID-19 patients undergoing ECMO. Compared to the original cohort used for RESP score creation, COVID-19 patients in RESP class I-III had worse survival whereas the patients in RESP class IV-V had better survival
Moment-to-Moment Observation of Parental Media Use and Parent-Child Interaction: Quality and Media Multitasking
Get PDFMobile media proliferation throughout society has infused and complicated environments that formerly were interaction rich (e.g., waiting rooms, restaurants, and playgrounds) with the presence of smart devices. Ethnographic studies have indicated that parental use negatively impacts parent-child interaction quality. The current study reviews and expands on previous research through observing systematically parent-child interaction quality throughout the course of an entire meal (30-140 minutes). Utilizing five-minute intervals, across 93 parent-child dyads, we assessed both within- and between-person moment-to-moment changes in parenting quality (i.e., parental positivity, negativity, and engagement) in the context of parental media use. Between-person, only positivity appeared to decrease when comparing low and high parental media use. Within-person findings indicated that when the parent demonstrated higher than their typical media use, we noted a significant decrease in the quality of engagement and positivity. Differing from ethnographic studies, no change in negativity was identified within-person. Utilizing a lagged interval analysis, we identified a pattern of increased parental engagement with their child following intervals with parental media use, identifying a pattern of parental media multitasking heretofore only observed in ethnographic studies. Implications of findings in the context of previous research and future directions are discussed
How to Train a (Bad) Algorithmic Caseworker: A Quantitative Deconstruction of Risk Assessments in Child Welfare
No full textCHI EA \u2722: Extended Abstracts of the 2022 CHI Conference on Human Factors in Computing Systems
Child welfare (CW) agencies use risk assessment tools as a means to achieve evidence-based, consistent, and unbiased decision-making. These risk assessments act as data collection mechanisms and have been further developed into algorithmic systems in recent years. Moreover, several of these algorithms have reinforced biased theoretical constructs and predictors because of the easy availability of structured assessment data. In this study, we critically examine the Washington Assessment of Risk Model (WARM), a prominent risk assessment tool that has been adopted by over 30 states in the United States and has been repurposed into more complex algorithmic systems. We compared WARM against the narrative coding of casenotes written by caseworkers who used WARM. We found significant discrepancies between the casenotes and WARM data where WARM scores did not not mirror caseworkers’ notes about family risk. We provide the SIGCHI community with some initial findings from the quantitative de-construction of a child-welfare risk assessment algorithm
Medical students\u27 perception of what embodies an effective surgeon educator.
No full textBACKGROUND: Effective surgeon educators likely help medical students develop competency and may inspire pursuit of surgical training. We sought to determine the qualities medical students believe embody effective surgical educators.
METHODS: Mixed-methods study of nationally electronically recruited 3rd-year medical students using virtual semi-structured interviews and anonymous quantitative survey to determine the most critical and most frequently encountered qualities of effective surgical educators. Thematic analysis using grounded theory was undertaken.
RESULTS: Data saturation occurred after 9 interviews. Themes of effective surgical educators included: engagement (acknowledging student, knowing their name, talking to the student), fostering a positive learning environment (non-threatening, non-shaming questioning), inclusion (giving responsibility/appropriate autonomy), and understanding how to teach a novice (teaching the student how to learn, adapt to learner). On quantitative analysis of Likert based survey, encouraging, promoting a positive learning climate, timely constructive feedback, and questioning were ranked as most critical.
CONCLUSION: Students highly value positive learning climate and inclusion. Faculty Development to promote these traits may improve clerkship learning and experience