Parkview Health Research Repository
Not a member yet
774 research outputs found
Sort by
Comparing a patient positioning system to an overhead LIFT with pillows for impact on turning effectiveness.
No full textBACKGROUND: Frequent patient handling activities present numerous challenges to healthcare workers. A variety of products are available to assist with in-bed positioning but few comparative studies have been completed to ascertain turning effectiveness.
METHODS: The purpose of this study was to compare two turning devices (air-powered positioning system with wedges versus ceiling lift with pillows) for in-bed repositioning and turning effectiveness. The study took place at a large community hospital in the Midwestern USA and used a prospective, four-group crossover study design to compare devices.
RESULTS: The two turning groups were not significantly different for any of the demographic variables. The use of an air-powered positioning system with wedges achieved a greater degree of turn and maintained that turn after an hour better than the lift device with pillows. There were no hospital acquired pressure injuries in either group.
CONCLUSION: The devices used demonstrated significant differences in turn angle achieved and ability to maintain the turn at one hour. Future studies need to further delineate the ideal method for turning and compare devices to identify best practice and equipment. An effective turning method would integrate ease of use with the ability to achieve an optimal degree of turn in order to prevent hospital acquired pressure injuries while also decreasing caregiver injuries
Involving Patients as Key Stakeholders in the Design of Cardiovascular Implantable Electronic Device Data Dashboards: Implications for Patient Care
Get PDFBackground Data from remote monitoring (RM) of cardiovascular implantable electronic devices (CIEDs) currently are not accessible to patients despite demand. The typical RM report contains multiple pages of data for trained technicians to read and interpret and requires a patient-centered approach to be curated to meet individual user needs. Objective The purpose of this study was to understand which RM data elements are important to patients and to gain design insights for displaying meaningful data in a digital dashboard. Methods Adults with implantable cardioverter–defibrillators (ICDs) and pacemakers (PMs) participated in this 2-phase, user-centered design study. Phase 1 included a card-sorting activity to prioritize device data elements. Phase 2 included one-on-one design sessions to gather insights and feedback about a visual display (labels and icons). Results Twenty-nine adults (mean age 71.8 ± 11.6 years; 51.7% female; 89.7% white) participated. Priority data elements for both ICD and PM groups in phase 1 (n = 19) were related to cardiac episodes, device activity, and impedance values. Recommended replacement time for battery was high priority for the PM group but not the ICD group. Phase 2 (n = 10) revealed that patients would like descriptive, nontechnical terms to depict the data and icons that are intuitive and informative. Conclusion This user-centered design study demonstrated that patients with ICDs and PMs were able to prioritize specific data from a comprehensive list of data elements that they had never seen before. This work contributes to the goal of sharing RM data with patients in a way that optimizes the RM feature of CIEDs for improving patient outcomes and clinical care
Healthy Mom & Baby Innovation Competition: Winner announced!
No full textParkview Health started looking for worldwide solutions to the infant mortality crisis. We called on innovators from around the world to participate in an event called the Healthy Mom and Baby Innovation Competition, which was created in partnership with MATTER, a global healthcare startup based in Chicago. The goal was to discover ideas that could reduce the infant mortality rate in northeast Indiana and around the world
Healthy Moms Event News Brief
Get PDFHealthy moms event June 1
Semifinalists of the Healthy Mom and Baby Innovation Competition, created in collaboration with Parkview Health and Matter, will showcase their ideas to reduce infant mortality rates during a June 1 virtual event. Launched in February, the competition challenged innovators to submit product, software or program solutions with the promise and potential of reducing the rates of infant mortality. Entries were submitted by 57 teams from 14 states and six countries. On June 1, one winner and up to four other semifinalist teams will be selected to participate in a threemonth virtual accelerator program, where they will continue to build and test their solution with leaders from Parkview Health, Matter and Indiana Management Performance Hub. Chicago-based Matter is a health care startup incubator and corporate innovation accelerator. On Sept. 17, finalist teams will pitch their solutions to a community of health care professionals, Parkview leaders and outside investors for potential pilot opportunities and funding. All teams that participate in the final pitch day will receive a one-year global membership at Matter. The June 1 virtual event is free, with the public awards presentation starting at 3:30 p.m. To register for the free virtual event or read more about the 10 semifinalists of the Healthy Mom and Baby Innovation Competition, go to Parkview.com/innovation2020.
original online link: https://www.journalgazette.net/news/local/20200522/brief
Impact of immunotherapy use in patients with stage IV pancreatic carcinoma
Get PDFBackground: Most patients with pancreatic cancer have non-resectable disease at the time of diagnosis and usually die within 6-12 months. Despite indications in other solid tumors, the role of immunotherapy (IO) is unknown for late stage, advanced pancreatic cancer.
Methods: Using the National Cancer Database (NCDB), cases of Stage IV pancreatic cancers diagnosed in the period of 2014-2016 with at least 30-day follow up were retrospectively analyzed. The following clinical demographics were included: age (younger than 70 vs. older than 70), sex (male vs. female), race (whites vs. others), insurance (uninsured vs. insured), type of institution (academic vs. nonacademic), liver metastasis (yes vs. no), lung metastasis (yes vs. no), external beam radiation (yes vs. no), systemic chemotherapy (yes vs. no) and IO (yes vs. no). survival analysis was performed using Kaplan-Meier curves and Log-rank tests. Multivariable Cox proportional hazard models and propensity score matching analysis were also utilized. A P value \u3c0.05 was considered significant.
Results: Among 25,596 eligible cases, 163 patients were treated with IO. A significant association between the use of IO and several clinical demographics (age \u3c70, academic institution, adenocarcinoma, lung metastasis, radiation, chemotherapy) was noted. Chemotherapy was administered in 133 (82%) and 16,342 (64%) of cases in the IO and non-IO groups, respectively. Use of IO was associated with improved overall survival (OS) in both univariate and multivariate analyses (P\u3c0.0001 for each). Median OS (in months) was 12.2 in the IO group vs. 5.8 in the non-IO group. Landmark analysis in the IO group showed 12 and 24-month survival of 51.0% and 20.0% respectively, as compared with 28.2% and 11.9% in the non-IO group. Propensity score matching analysis also demonstrated a trend toward improved OS in IO group (P=0.0753). Median survival was 12.2 and 8.9 months, respectively.
Conclusions: This retrospective data analysis using a large cancer database suggests that use of IO could improve survival in patients with advanced pancreatic cancer. More studies will be needed in the future to validate these results
Improving Social Determinants of Health Screening Implementation Through Collaboration: Leveraging a Clinical-Academic Partnership.
No full textProblem Addressed and Project Purpose Motivated by the transition to value-based payment models, 1 there are growing efforts to capture information about patients’ social determinants of health (SDOH) in United States (US) healthcare and provide subsequent services targeted at those health-related social risk factors. The collection of data about social risk factors creates opportunities for healthcare providers to make referrals to social service agencies to address individual patients’ needs and to tailor treatment plans to individuals’ specific needs, a goal of precision health2,3. Hence, by accurately and appropriately collecting SDOH data from patients and actionably displaying these data to providers, healthcare systems may provide resources and effective patient-centered treatment, working towards the goal of achieving better health outcomes for patients who are disadvantaged2 . While healthcare organizations are beginning to screen patients for numerous social needs using a variety of tools, no standard or universally-used screening tools or processes exist. At the same time, varied screening policies tailored to the needs of specific patient populations may be necessary to ensure accurate and appropriate data collection1 . There is limited evidence on how social risk data collection is currently carried out both formally and informally in different clinical settings, suggesting open research questions such as what types of screening are offered, which types of providers or staff performs screening, when are patients screened, how are patients screened, and what is the impact of standardized screening practices on patients and providers? We have formed a partnership between Parkview Health and the University of Michigan to address these questions
Implementation of a Pediatric Pharmacy Education Program at a Community Regional Medical Center.
No full textOBJECTIVES: This study aimed to implement a web-based pediatric education program designed for pharmacists who participate in neonatal and pediatric order verification at a community-based health system and to evaluate the success through measuring outcomes related to both comfort and competence of pharmacists in pediatric and neonatal pharmacotherapy.
METHODS: This prospective quality improvement study assessed changes in confidence and competence from before to after education. Eight educational modules were designed to provide education based on the needs of this institution. All pharmacists who participate in neonatal and pediatric order verification were eligible for inclusion throughout the health system. Time in the verification queue for pediatric and neonatal medication orders was compared for before to after education as an objective surrogate marker for comfort and competence. A provider survey was conducted before and after education to assess the providers\u27 perspective of the quality and necessity of pharmacist-provider interactions.
RESULTS: All confidence scores showed statistical improvement from before to after education (p \u3c 0.001). Before to after education competency scores significantly improved (median 77% [IQR, 69%-85%] to 100% [IQR, 92%-100%]; p \u3c 0.01). The module with the lowest mean score (87%) was module 4 (Antibiotics Part 1), and the one with highest number of retakes (24 retakes from 16 different pharmacists) was module 5 (Antibiotics Part 2).
CONCLUSIONS: Targeted web-based education effectively improved both confidence and competence among health-system pharmacists to provide pediatric and neonatal care in a community hospital
Impact of Extended Interval INR Testing During the COVID-19 Pandemic
No full text2020 ASHP Midyear Clinical Meeting
Objective: To determine if extended INR interval monitoring during the COVID-19 pandemic would significantly impact TTR or be associated with emergency department (ED) visits and hospitalizations with bleeding or clotting events
Evaluation of a pharmacy managed vancomycin dosing protocol for critically ill adult patients requiring continuous renal replacement therapy (CRRT) at a community hospital
No full text2020 ASHP Midyear Clinical Meeting / Virtual Meeting/ Poster
Objective: The purpose of this medication use evaluation (MUE) was to evaluate a pharmacy managed vancomycin dosing protocol for patients on CRRT patients in a community hospital
Evaluation of beta-lactam allergy classification and carbapenem use in patients admitted to the medical-surgical floors of a large, community hospital
No full textBackground and Objective
Background • CDC reports half of patients admitted to the hospital received at least 1 dose of antibiotics from 2006-2012 • Approximately 32 million people in the United States have a documented allergy to a beta-lactam (BL) antibiotic • Approximately 10% of all US patients report having an allergic reaction to a BL in their lifetime • Fewer than 1% has a true IgE (immunoglobulin E) mediated allergy to a BL • Over 80% of those patients with an IgE-mediated allergy lose sensitivity after 10 years • Penicillin-skin testing cost: ~$220 • Per the CDC, carbapenem use increased by 37% from 2006-2012 • Carbapenems are rarely first line antibiotics, but are frequently used when first line agents are excluded due to the patient\u27s drug-allergies • Carbapenem use is associated with increased healthcare costs and promotion of antibiotic resistance Objective • Determine the beta-lactam (BL) allergy-risk stratification for patients at Parkview Regional Medical Center with a documented allergy to a BL