Parkview Health Research Repository
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Increasing capacity for nursing research in magnet-designated organizations to promote nursing research.
No full textNursing research is important in order to assure nursing interventions are beneficial and not harmful to patient care. Nurse leaders should encourage and develop a culture of inquiry. An infrastructure is the foundation for nursing research and is essential to facilitate and support clinical nurses conduct of research. Resources including personnel and time are essential. However, the most important element for a successful nursing research program is nursing staff that are inspired, empowered and encouraged to perform their own nursing research
A retrospective evaluation of non-operative use of push dose phenylephrine in critically ill adults
No full textPoster Presentation
Objective: To investigate the efficacy, safety and usage patterns of push-dose phenylephrine in non-operative, critically ill patients
Financial and Labor Benefits of the Individual TB Risk Assessment Model for Annual TB Screening
Get PDFTB rates are at an all time low in the U.S. and serial TB testing is inefficient and burdensome. Here we describe a model to guide TB screening based on occupational and non-occupational risk. Facility-level risk is taken into account only to drive policy. This methodology will reduce the cost and labor burden of TB screening.
This poster was presented at the SHEA Decennial: 6th International Conference on Healthcare Associated Infection
Adolescent Interventions to Manage Self-Regulation in Type 1 Diabetes (AIMS-T1D): randomized control trial study protocol.
Get PDFBACKGROUND: Self-regulation (SR), or the capacity to control one\u27s thoughts, emotions, and behaviors in order to achieve a desired goal, shapes health outcomes through many pathways, including supporting adherence to medical treatment regimens. Type 1 Diabetes (T1D) is one specific condition that requires SR to ensure adherence to daily treatment regimens that can be arduous and effortful (e.g., monitoring blood glucose). Adolescents, in particular, have poor adherence to T1D treatment regimens, yet it is essential that they assume increased responsibility for managing their T1D as they approach young adulthood. Adolescence is also a time of rapid changes in SR capacity and thus a compelling period for intervention. Promoting SR among adolescents with T1D may thus be a novel method to improve treatment regimen adherence. The current study tests a behavioral intervention to enhance SR among adolescents with T1D. SR and T1D medical regimen adherence will be examined as primary and secondary outcomes, respectively.
METHODS: We will use a randomized control trial design to test the impact of a behavioral intervention on three SR targets: Executive Functioning (EF), Emotion Regulation (ER), and Future Orientation (FO); and T1D medical regimen adherence. Adolescents with T1D (n = 94) will be recruited from pediatric endocrinology clinics and randomly assigned to treatment or control group. The behavioral intervention consists of working memory training (to enhance EF), biofeedback and relaxation training (to enhance ER), and episodic future thinking training (to enhance FO) across an 8-week period. SR and treatment regimen adherence will be assessed at pre- and post-test using multiple methods (behavioral tasks, diabetes device downloads, self- and parent-report). We will use an intent-to-treat framework using generalized linear mixed models to test our hypotheses that: 1) the treatment group will demonstrate greater improvements in SR than the control group, and 2) the treatment group will demonstrate better treatment regimen adherence outcomes than the control group.
DISCUSSION: If successful, SR-focused behavioral interventions could improve health outcomes among adolescents with T1D and have transdiagnostic implications across multiple chronic conditions requiring treatment regimen adherence.
TRIAL REGISTRATION: ClinicalTrials.gov: NCT03688919; registered September 28, 2018
Effect of Warming IV Fluids During MICU Transport on Patient Comfort and Temperature
Get PDFThis study is to determine if during the transport of critically ill patients receiving intravenous fluids (IVF), the use of an IVF warmer may increase comfort, reduce pain, and prevent hypothermia.
PI: Jennifer Esslinger BSN, RN, CFRN, CTRN
Contact: [email protected]
Medication Adherence for Atrial Fibrillation Patients: Triangulating Measures from a Smart Pill Bottle, e-prescribing Software, and Patient Communication through the Electronic Health Record
Get PDFObjective: Our primary objectives were to examine adherence rates across two technologies (e-prescribing software and smart pill bottle) with cross-validation from alert-triggered messaging within the patient electronic health record (EHR) portal and to explore the benefits and challenges faced by atrial fibrillation (AF) patients in using a smart pill bottle.
Materials and Methods: We triangulated the rate of oral anticoagulant medication adherence among 160 AF patients over 6 months using an EHR in combination with data from the AdhereTechVC Wireless Smart Pill Bottle and SurescriptsVC . In addition, we collected qualitative feedback on patients’ Smart Pill Bottle usage through structured interviews with 153 participants.
Results: Patients maintained an average adherence rate of 90.0% according to the smart pill bottle; however, when dose misses were calibrated based on patient or provider feedback, the adjusted adherence was 93.6%. Surescripts adherence rates for refills were 92.2%. Participants generally found the bottle easy to operate but suggested that its size and functionality did not fit seamlessly into their existing routine, as many used weekly pill organizers to manage multiple medications.
Discussion: Though each method of tracking adherence has positive and negative attributes, combining them and seeking patient feedback may help capture a more accurate adherence rate than any single technological intervention. Technologies may have different design considerations for research and consumer use.
Conclusion: Overall, these technologies provide useful but imperfect adherence data for research purposes, and smart pill bottles could be improved with patient-centered design.
Lay Summary: Medication adherence is very important for those with chronic health issues. For those with heart disease, medication adherence not only offers opportunities for improving quality of life, but it also can be life-saving. Nonetheless, many patients with heart disease, including those with atrial fibrillation (the target group for this study) do not take their medications regularly. As technologies advance, there is unprecedented opportunity to track patients’ medication adherence through various methods, which might provide motivation and information to patients as they make daily choices about medication use. In this study, we cross-referenced the results of two of these measures over 6 months—a smart pill bottle, which we used to track pill bottle openings, and e-prescribing software, which we used to track medication refills. We also supplemented these measures with nurse-patient communication via the EHR messaging portal to record exceptions (eg, travel and medication changes) and interviewed patients about their medication use during the 6-month trial. Overall, the tracking technologies worked relatively well to track patient (n ¼ 160) medication behavior; however, they did not capture exceptions. Hence, triangulating data from different sources, with a patient feedback loop, appears critical for gathering accurate data on medication adherence
Scope of Artificial Intelligence in Screening and Diagnosis of Colorectal Cancer
Get PDFGlobally, colorectal cancer is the third most diagnosed malignancy. It causes significant mortality and morbidity, which can be reduced by early diagnosis with an effective screening test. Integrating artificial intelligence (AI) and computer-aided detection (CAD) with screening methods have shown promising results for colorectal cancer screening. AI could provide a “second look” for endoscopists to decrease the rate of missed polyps during a colonoscopy. It can also improve detection and characterization of polyps by integration with colonoscopy, various advanced endoscopic modalities like magnifying narrow-band imaging, endocytoscopy, confocal endomicroscopy, laser-induced fluorescence spectroscopy, and magnifying chromoendoscopy. In this review, we have discussed various AI and CAD applications in CRC screening, polyp detection, and characterization
How Parents and Their Children Used Social Media and Technology at the Beginning of the COVID-19 Pandemic and Associations with Anxiety.
No full textIn this study, we examined parents\u27 (n = 260) perceptions of their own and their children\u27s use of social media and other types of communication technologies in the beginning stages of coronavirus disease 2019 (COVID-19) related sanctions (e.g., social distancing) in the United States. We also examined associations between social media and technology use and anxiety. On average, parents reported that both they and their children (especially teenagers aged 13-18) had increased technology and social media use since the beginning of social distancing. Moreover, even after controlling for demographic factors, structural equation models showed that parents and children with higher levels of anxiety (as reported by parents) were more likely to increase their technology use and use social media and phones to connect. Among parents, higher anxiety was related to using social media for both social support and information seeking. Based on these results, we advocate for the utilization of social media by public health officials for collecting, collating, and dispersing accurate crisis-related information. As social media use is widespread, and there is potential for false rumors to cause erroneous behavioral action and/or undue stress and anxiety, we also suggest that social media campaigns be thoughtfully designed to account for individual differences in developmental stages and psychological vulnerabilities
Nothing New Under the Sun: How Existing Screening Programs can Inform the Design of Social Determinants of Health Screening in Health Care.
No full textResearch Objective Up to 80% of the factors contributing to an individual’s health status are social determinants of health (SDOH). As healthcare systems transition to value-based payment models which compensate providers for patient health outcomes, many have called for healthcare organizations to screen patients for SDOH-related social needs and for providers to consider them when providing medical care. Screening for social needs is expected to involve collecting information that may make patients feel vulnerable, creating a need to develop screening methods that emphasize patient comfort. Similarly, social needs screening may place burdens on providers that have limited training and time to conduct screening or act on the results. Yet, it is underacknowledged that providers, especially in oncology, obstetrics and gynecology, and population health, may already routinely collect sensitive data from patients, including social needs — suggesting that understanding existing screening programs may help to inform the design of expanded social needs screening practices. With a goal of identifying lessons learned in practice, we describe case studies of existing social needs screening in three clinical areas
Perceptions on Tailored Educational Messaging to Patients with Atrial Fibrillation: Towards Increased Patient Engagement and Medication Adherence
No full textBackground The risk of stroke is high among elderly patients with Atrial Fibrillation (AF) and is associated with inadequate adherence to oral anticoagulation (OAC) therapy. Reasons for non-adherence may include patients\u27 lack of knowledge about their disease. Research suggests that health education could increase patient engagement. Prior interventions to increase engagement were directed at promoting good health behaviors, such as regular checkups and medication adherence. Objectives In this study, the multi-platform technology intervention delivered regular personalized education to AF patients to increase their engagement. Educational messages included tailored text content as well as topic-specific videos featuring both health system cardiologists or pharmacists and patients. In this presentation, we share participants\u27 perceptions of these educational messages. Methods Participants included AF patients (N = 160, M = 71 years, range = 42-97) on OAC therapy, who were randomized into control and intervention groups for a six-month study. Both groups received a smart pill bottle for OAC medication to track adherence. In addition, the intervention group received tailored educational messages through a patient portal. Experience sampling (5-point Likert scale, 1 = strongly disagree to 5 = strongly agree) was used to evaluate participants\u27 perception of the messages. Results Preliminary results showed that information shared in educational messages was useful (4.3/5), easy to understand (4.4), and helpful (4.1). Videos helped participants better understand the shared information (4.0). Perhaps because this information was not new to participants (they neither agreed or disagreed that information was new to them; 3.0), most disagreed that they wanted more information than what was provided (2.4). Most participants disagreed that the educational messages made them feel more worried about their health condition (2.8). Participants were neutral that the messaging impacted how they managed their disease (3.4) and that the messaging prompted them to further explore their health condition (3.5). Conclusions Overall, although patients may view the information shared in educational messages as useful, they are neutral regarding its impact on their own disease management and health behaviors