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Unraveling Sex Trafficking through Screening and Referrals
Get PDFAbstract
Human trafficking is a form of modern-day slavery; sex trafficking is one form of human trafficking. Previous research has demonstrated that most trafficking victims encounter the healthcare system at some point during their trafficking experience. Patients who have been sex trafficked may experience profound psychological and physical trauma. Healthcare personnel are in key positions to screen for trafficking and to provide appropriate referrals; if an awareness of the problem exists. The purpose of this project was to increase OB/Gyn office staff confidence with sex trafficking screening and to complete appropriate referrals to address the identified needs. The project began with a review of warning signs, screening process and then addressed sex trafficking myths. The program concluded with the introduction of a sex trafficking resource binder and review of the referral process. Staff feedback was overwhelmingly positive, with an immediate impact being improved patient privacy during screening. The predominate limitations were staff turnover and persistent uncertainty regarding the referral process
Popliteal Blocks for the Treatment of Distal Injuries in the Lower Extremity in the Emergency Department
Get PDFOpioid addiction in the United States has increased, and interventions needs to be put into place to manage pain with fewer opioids. Alternatives like peripheral nerve blocks can be used to aid in pain management for acute injuries like ankle and wrist fractures. The purpose of this project is to develop and create a regional anesthesia protocol for acute upper and lower extremity fractures in the emergency department (ED) at Passavant Hospital in Jacksonville, Illinois, with the long-term goal of a reduction in opioid administration. An educational Power Point presentation was provided for the ED and the anesthesia personnel on July 17, 2018. A survey was distributed for the evaluation of the protocol and the presentation. The results of the survey revealed the following: over eighty percent of the participants believed that the protocols contained information necessary to perform or assist in a block procedure, and over ninety percent of participants suggested incorporating the use of both the supraclavicular and popliteal block protocols into daily practice. Utilization of both the supraclavicular and popliteal block protocol will likely lead to future reductions of opioid administration for pain control for this patient population, which would improve patient satisfaction scores and reduce the length of hospital stays
Supraclavicular Blocks for the Treatment of Distal Injuries in the Upper Extremity in the Emergency Department
Get PDFOpioid addiction in the United States has increased, and interventions needs to be put into place to manage pain with fewer opioids. Alternatives like peripheral nerve blocks can be used to aid in pain management for acute injuries like ankle and wrist fractures. The purpose of this project is to develop and create a regional anesthesia protocol for acute upper and lower extremity fractures in the emergency department (ED) at Passavant Hospital in Jacksonville, Illinois, with the long-term goal of a reduction in opioid administration. An educational Power Point presentation was provided for the ED and the anesthesia personnel on July 17, 2018. A survey was distributed for the evaluation of the protocol and the presentation. The results of the survey revealed the following: over eighty percent of the participants believed that the protocols contained information necessary to perform or assist in a block procedure, and over ninety percent of participants suggested incorporating the use of both the supraclavicular and popliteal block protocols into daily practice. Utilization of both the supraclavicular and popliteal block protocol will likely lead to future reductions of opioid administration for pain control for this patient population, which would improve patient satisfaction scores and reduce the length of hospital stays
Conducting a Root Cause Analysis to Improve Patient Selection Process
No full textOffice-based gastrointestinal (GI) facilities care for a high volume of outpatients undergoing quick endoscopic procedures. Over the past three decades, the number of outpatient GI procedures has dramatically increased and is projected to continue to rise. Given the rising number of outpatient GI procedures, it is essential to maximize the safety of such practice. The aging population and rising number of individuals with multiple co-morbidities increase the risk for complications during anesthesia. Limited resources also make it more difficult to treat complications that may arise during the anesthetic. A gastrointestinal office, located in a relatively small, southern Illinois city, elected to evaluate their current practice in selecting patients they provide upper and lower GI procedures under conscious sedation. The goal of this project was to enhance patient safety by improving the current preoperative assessment and patient selection process based on current guidelines and research. Currently there is no uniform practice guidelines to help guide the selection of patients with various comorbidities undergoing office-based procedures receiving office-based sedation. However, recommendations have been made based upon expert opinion and best practice
Patient Experiences with Compounded Medications
No full textObjectives: There is little data directly from patients on their experiences with compounded prescriptions (CRx). The purposes of the study were to determine how patients initiated CRx use and how they perceived their CRx therapy.
Methods: A cross-sectional mailed national survey design was used. Participating pharmacies distributed questionnaires to their patients when dispensing CRx. The questionnaire contained items relating to patient demographics, previous use of CRx, how the patient came to use CRx, how the pharmacy was chosen, and satisfaction with the CRx.
Results: A total of 494 usable responses were received. Respondents were predominantly female (82.3%) with an average age of 60.5 years. Most respondents received their CRx via mail or delivery service (78.2%). The average duration of CRx use was 30 months. Patients with insurance paid an average of 116.20. Hormone replacement therapy (HRT) (50.1%) and pain management (23.1%) were the most frequent indications for CRx therapy. CRx were primarily used to replace (68.1%) rather than supplement (31.9%) previous medications. The prescriber was the first person to suggest CRx therapy (78.9%) and the prescriber’s recommendation was important in choosing the compounding pharmacy (89.6%) for most patients. More than 95% of patients were satisfied with all aspects of CRx therapy except cost. Patients judged CRx as equally good or better than previous medications they had used for their medical condition.
Conclusion: Respondents used CRx for HRT, pain treatment, and a variety of medical conditions. CRx were used primarily to replace other medications due to treatment failure or intolerable side effects. Respondents were satisfied with all aspects of CRx therapy with the exception of out-of-pocket cost. The prescriber’s recommendation was the single most important factor in a patient choosing to use CRx and in choosing a compounding pharmacy
Student Perceptions of Teaching Effectiveness and Learning Achievement: A Comparative Examination of Online and Hybrid Course Delivery Format
Get PDFAlthough a good deal of research has been published that compares the effectiveness of communication courses delivered in face-to face and online formats, much less is known about the comparative effectiveness of fully online versus hybrid (a.k.a. blended, mixed mode) courses. Thus, this research project examined student perceptions of teaching effectiveness and learning achievement efficacy in online and hybrid basic communication courses. This two-part study assessed student perceptions (N = 136) about halfway through the semester and again after finishing the course (N = 156). The examination revealed several key conclusions. First, technology constraints must be overcome pedagogically for students to feel prepared in terms of course content comprehension, as well as formal speech construction and delivery. Second, when students enroll in hybrid courses unaware of the technology-enhanced delivery format, they may perceive an expectancy violation that reduces their motivation to attend to the material. Finally, although students value the opportunity to take fully online and hybrid courses, they desire more interactio
Development and Evaluation of a Malignant Hyperthermia Computer Based Learning Project
Get PDFMalignant hyperthermia (MH) is a potentially fatal, inherited disorder of muscle hypermetabolism that occurs after a person is exposed to commonly used volatile anesthetic agents (sevoflurane, desflurane, isoflurane) and/or the depolarizing muscle relaxant, succinylcholine (Diu & Mancuso, 2012). The MH mortality rate has decreased from 80% in the 1960s to less than 5% in 2006 due to increased clinical awareness of manifestations, pathophysiology, and improvement in perioperative monitoring (Rosenberg, Pollock, Schiemann, Bulger, & Stowell, 2015). Therefore,continuing education of perioperative staff is an integral part of proper MH preparedness. Computer-based learning (CBL) modules have been shown to be efficient, inexpensive forms of education which can lead to greater knowledge retention than instructor-led courses (Harrington & Walker, 2004). A discordance with the Centers for Medicare and Medicaid Services (CMS) interpretive guidelines, 482.25(b)(8) in reference to drug interactions and treatment therapy provided the motivation for this project.A CBL module on MH was developed for a tertiary care center in central Illinois, and the effectiveness of the CBL on perioperative staff knowledge was evaluated. The CBL provided online education and training on the prevention, preparation, diagnosis, and treatment of MH. After one month, the CBL was taken by 124 participants with an average pretest score of 70% and an average post-test score of 93%. The results of this project suggested the CBL was effective in increasing perioperative staff knowledge on MH, which may help decrease morbidity and mortality should an MH reaction occur
Transitioning Pediatric Patients with Special Needs
Get PDFTransitional care, which encompasses both the sending and receiving aspects, is essential for pediatric patients with complex care needs.A provider in a small, Midwest pediatric primary care clinic agrees with researchers that transitional guidelines are needed for consistency among pediatric and adult providers. This clinic currently has no process in place to guide the transition of patients with special needs. The primary goal of this project was to develop a communication tool that aids in the transition of patients with special needs into the adult primary care setting. The literature reviewed provided a variety of tools used to communicate healthcare information to providers. Barriers, gaps, and recommendations identified in transition of pediatric patients into the adult care setting were also reviewed. Pediatric and adult providers, parents of a pediatric patient with complex needs, a social worker, and a special needs teacher in a clinic setting were consulted in development of the tool.The tool was designed to provide important health information and goals of the patient and family in order to facilitate deliberate transition of care. Expert feedback from pediatric and adult providers and a S.W.O.T Analysis were utilized to help identify implementation challenges. Implementation of the communication tool will likely provide a smoother transition for the patient, family, and providers
Managing Chronic Back Pain in a Rural Primary Care Setting
Get PDFChronic back pain management is complex and is often challenging for Primary Care Providers (PCPs). Rural PCPs are managing chronic back pain despite limited training and availability of pain management specialists. Pharmacological interventions are often used to treat chronic back pain despite current evidence suggesting physical therapy and aquatic therapy are first-line treatments. A directory of local therapy facilities offering physical and aquatic therapy and a review of clinical practice guidelines (CPG) were provided to three PCPs in a rural clinic in the Midwest. Use of the directory and the CPG was intended to help decrease reliance on pharmacological options and increase reliance on non-pharmacologic options when treating chronic back pain. There were 595 encounters pre-implementation and 641 post implementation for the complaint of chronic back pain reflecting the six most frequent diagnoses. Comparison of pre and post physical and aquatic therapy referrals for chronic back pain indicated that there was not a statistically significant increase in therapy referrals but rather a clinically relevant increase of post implementation referrals (5.88 to 8.58%, an additional 20 referrals). This project impacted the clinic by heightening awareness of the use of non-pharmacological interventions, such as physical and aquatic therapy, for chronic back pain management. Barriers to adaption included patient-oriented reasons, insurance limitations, and provider reluctance
Improving Allergy Immunotherapy Adherence
Get PDFAllergen Immunotherapy (AIT) is an effective treatment for allergic rhinitis. However, at a Midwest teaching clinic, patients tend to not complete the entire course of immunotherapy. AIT adherence is suboptimal due to a multitude of reasons. The purpose of this project is to increase adherence to AIT by implementing the following evidence based interventions; a text message reminder, a communication/education template, and through increasing clinic accessibility. Initial implementation involved working with clinic personnel to develop the content of the reminder texts and of additional educational materials. Subsequently, the changes were executed at the beginning of fall. Over the following three months, the project goals were evaluated through a convenience sample of patients from age 5 to adults who are currently receiving subcutaneous immunotherapy (SCIT) in the outpatient setting. Patients were given a Likert-scale survey after project completion to measure satisfaction with the text message reminder. At the beginning of the project, there were 172 SCIT patients and 67 were non-adherent (39%). During the project, 2 patients moved, 2 patients had insurance changes and could no longer come to the clinic, and 12 patients dropped out completely. Fourteen of the remaining 51 non-adherent patients completed the protocol. Overall, AIT adherence increased 12% in the clinic. Patients indicated satisfaction with text message reminders. However, they would prefer them sent 1-2 days prior to their scheduled injection appointment. AIT adherence improved for SCIT patients. Text message reminders, communication/education template, and increased clinic accessibility can improve AIT adherence in a clinically relevant way