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Implementation of a Transitional Psychiatric Process in a Psychiatric Inpatient Facility
No full textBackground: Intensive Outpatient and Partial Hospitalization programs help build the transitional gap inpatient facilities\u27 experience by using patient-centered approaches in cross-continuum teams. A transitional psychiatric checklist was designed based on the psychiatric inpatient facility’s needs to improve inpatient screenings and to increase transitional care admissions to the outpatient units. The project coordinator developed eligibility algorithms designed to complement the transitional care that the hospital has in place. Aims of the Project: Reduce inpatient re-hospitalizations, increase outpatient admissions, and provide a smooth outpatient transition for inpatients who are being discharged; by evaluating patients using a transitional psychiatric checklist. Purpose: Using a transitional psychiatric checklist, implement a process to improve inpatient screenings, increase transitional care admissions to the facility’s outpatient clinic, and decrease adult patient readmission rates. Methods: Using a site-specific checklist that allowed staff to screen eligible patients and refer them to the facility’s outpatient clinic based on specific criteria. This project created algorithms to guide nurses and case managers on the checklist. Based on the checklist responses, the staff made appropriate referrals to the outpatient clinic. Outcomes: This year, the outpatient behavioral clinic increased its eligible admissions by 67% compared to last year. They raised their referrals from the inpatient unit by 25% compared to the previous year. Out of 74 admitted patients, readmission rates were 0%. Implications for Practice: Providers should be able to identify premature discharges and coordinate transitional care accordingly within the facility. Providers will determine treatment based on the checklist and the American Psychological Association guidelines
A Reactivation of Ocular Toxoplasmosis during Pregnancy
Get PDFBackground: Toxoplasma gondii is a parasite estimated to affect over 500 million people worldwide. The feline is the definitive host for the parasite and infection may be acquired or congenital via maternal transmission. Humans may acquire the infection by ingestion of raw or undercooked meats and vegetables, contaminated water, or exposure to infected cat feces. The infection is often benign, self-limiting, and asymptomatic for humans, but potentially life threatening to infants or the immunocompromised patient.
Case Report: A 22 year-old Caucasian female, pregnant at 12 weeks gestation, presented to the optometry service with acute symptoms of hazy vision and a new gray stationary blind-spot in the inferior field of vision of the right eye. Clinical picture led to diagnosis of reactivated ocular toxoplasmosis.
Conclusion: Ocular toxoplasmosis primarily affects the retina, producing a retinochoroiditis with resultant scarring and potential blindness. Treatment with a combination of antibiotics and steroid may be required. Allergy history and current pregnancy were important factors to consider when determining treatment of our patient
Emotional Whirlwind
Get PDFThis is a narrative about my emotional experience with the COVID-19 Pandemic. It entails how I adapted to the new lifestyle that was ahead
Addressing Obstacles in Following Prescribed Medication Regimens in Patients With Type 2 Diabetes Mellitus
Get PDFBackground. Type 2 diabetes is the ninth leading cause of death in the United States. Micro/macro vascular complications are common in diabetes. Purpose. To implement an evidence-based protocol addressing obstacles for patients with type 2 diabetes in following their prescribed medication regimens to reduce glycosylated hemoglobin levels. Evidence. Failure to follow treatment plans increases diabetes complications. Perceptions and complexities of treatment plans, side effects of therapies, and cost contribute to patients not taking their medications as prescribed. Goals. To increase the number of patients with type 2 diabetes who follow their prescribed medication regimen and reach their targeted glycosylated hemoglobin. To increase referrals for patients with glycosylated hemoglobin greater than 8.4 g/dL to the optimization clinic. Methods. Patients with diabetes were asked to complete a medication adherence and diabetes knowledge questionnaire identifying obstacles to taking prescribed medications. Providers adjusted treatments according to clinical practice guidelines to address the identified obstacles. Results. A total of 61 patients completed the questionnaire and received educational information. All 22 patients with glycosylated hemoglobin’s above 8.4% were referred to the optimization clinic. Common barriers reported were cost (14%), side effects (31%), and forgetfulness (55%). Patient advocates were used to address cost, alternative therapies were provided for side effects, and mail-in delivery services were offered for forgetfulness. The project ended before three-month follow-up glycosylated hemoglobin levels were obtained. Practice Implications. Early recognition of obstacles that interfere with patients taking their medication providesan opportunity to address these barriers thereby reducing the risk of complications from diabetes
Factors for Success of International Female Doctoral Students in Science in the United States
Get PDFFactors for Success of International Female Doctoral Students in Science in the United States
Many international doctoral female students in the sciences in the United States do not obtain a degree despite their large investment in time, effort, and financial resources. The loss of highly prepared and credentialed international female doctoral students, who have a genuine interest in science but who choose not to pursue their studies to graduation or switch careers due to real or perceived barriers, signifies such a loss not just for the women themselves and their families but for their countries of origin, their hosts universities, the scientific professions, and society in general (Castillo et al., 2014). The purpose of this qualitative transcendental descriptive phenomenological study was to explore the lived experiences of international female doctoral students who succeeded in their doctoral programs in the United States in science, technology, engineering, and mathematics (STEM), or completed a professional program in the health sciences.
I utilized a transcendental descriptive phenomenological approach to explore, describe, and understand how international female doctoral students succeeded in their doctoral programs in the United States in the sciences. To improve the methodological validity of the study, triangulation of data sources and data methods were used. Through multiple methods and multiple sources, I gathered data which provided a rich description of the phenomenon investigated (Bloomberg & Volpe, 2016). I utilized Arts Based Research and testimonios to arrive at key findings.
Key findings explained the what, the why, and how these participants overcame insurmountable barriers and succeeded in their doctoral science programs in the United States. Families provided what was needed in terms of finances, resources, and support. Regardless of specific traditional religions or spirituality, faith gave strength and provided endurance to all participants during crisis. Support from academic advisors, research supervisors, faculty, and mentors were the number one factor for retention and student success for female international STEM and doctoral health science students in the United States. The role of peers was important. Balance also played an important role in the success of international doctoral females in the sciences. The most resilient group was high risk students. The participants persevered due to personal, social, and institutional factors. Participants underwent a process of transformation to create their new doctoral and scientific identities. Findings from Testimonios revealed that participants contributed human capital, and suffered cultural dissonance, discrimination, sexual harassment, and gender, cultural, and class microaggressions.
Universities in the United States can provide “safe spaces” on their campuses to serve as refuge centers that deliver a sense of belonging and support for those international female doctoral science students who suffer from discrimination, alienation, and/or microaggressions. Universities must provide safe methods, formal and informal, to report sexual harassment and provide fair and equitable access to resources for all employees and doctoral students. They must create policies that support faculty and doctoral students during times when family and personal life demands are overwhelming, specifically for raising young children, taking care of an ill or disabled family member, caring for elderly parents, or when in a personal crisis
Diagnosis and Excision of a Solitary Trichoepithelioma
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Background: Solitary trichoepithelioma is a rare benign tumor of hair follicle origin. Although trichoepithelioma has a predilection for the face and neck, it is not usually found on the eyelids. It has similar clinicopathological features to basal cell carcinoma. Surgical excision and histopathologic analysis is helpful for correct diagnosis.
Case Report: A 59-year-old Caucasian female presented with a raised, reddish oval mass on the right lower eyelid. The mass had telangiectatic blood vessels on its surface, was non-pigmented and slightly umbilicated. It was in close approximation of the eyelid margin causing distortion and poor apposition of the lid to the globe. The mass was completely removed under local anesthesia using the tissue-sparing surgical technique known as shave biopsy. Histopathologic analysis confirmed the mass to be a trichoepithelioma.
Conclusion: Optometrists should be able to differentiate benign trichoepithelioma from basal cell carcinoma
Growth Through COVID
Get PDFHow COVID impacted my emotional and occupational wellness in a positive manner in order to develop a new outlook on life