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My COVID Experience in Retrospect
Get PDFMy reflection of my COVID experience and how it impacted me mentally, emotionally, socially, and occupationally, from the retrospective viewpoint
Improving Human Papillomavirus Vaccination Rates in a Primary Care Clinic
No full textAn estimated 85% of unvaccinated sexually active individuals will acquire Human Papillomavirus (HPV) in their lifetime (Chesson et al., 2014). HPV vaccination rates remain low in the United States. Provider-based interventions are associated with increased acceptance of vaccination. This project aims to promote initial HPV vaccinations for patients aged nine to 45 through education, eligibility, provider prompts, follow-up appointments, and provider recommendations in accordance with the Centers for Disease Control and Prevention (CDC) guidelines. This quality improvement project aims to increase the initial HPV vaccination rate in a primary care clinic for patients nine to 45. Before project implementation, clinic staff was educated about HPV vaccination and provider recommendations. Patient education incorporated the CDC HPV vaccination information sheet and discussion by the provider. Immunization cards were used as provider prompts to remind providers to discuss vaccination recommendations.
Data was gathered using the patient electronic medical record, which provided documentation of the administration of HPV vaccines, provider prompts, patient education, and provider recommendations. Results show an overall percentage increase in Gardasil® 9 doses administered, resulting in an increase of 318.2% for the first dose, 140% for the second dose, and 200% for the third dose. There were opportunities to increase the HPV vaccination rate at this clinic, as only 1% of the 675 vaccine-eligible patients seen during the three-month pre-implementation period had received an initial HPV vaccination
Bilateral Optic Disc Drusen with Neuroretinitis
Get PDFBackground: Neuroretinitis is an inflammation of the posterior pole of the eye, resulting in optic disc edema and macular star formation. Systemic conditions associated with these findings include tuberculosis, toxoplasmosis, syphilis, lyme disease, toxocariasis, mumps, herpes simplex, and cat scratch disease. This case illustrates diagnosis and treatment for a patient with neuroretinitis complicated by preexisting vision loss.
Case Report: A Caucasian male in his 40’s presented to the eye clinic for an emergency appointment with complaints of constant blurry vision, especially inferiorly upon awakening, in his right eye for the past two weeks. His ocular history included optic disc drusen in both eyes with profound peripheral vision loss in the left eye. The patient’s systemic history included cluster headaches and sleep apnea. Entering visual acuities were 20/150- OD and 20/20 OS. Additional medical history questioning revealed the recent adoption of a kitten.
Conclusion: This case describes the diagnosis and treatment for the rare condition of neuroretinitis secondary to a Toxocara infection. While cat scratch disease was initially suspected, detailed laboratory testing identified the true, and more rare, causative infectious agent. A variety of differential diagnoses were ruled out through laboratory and imaging studies. Consultations with neuro-ophthalmology and infectious disease specialists were exceedingly valuable in contributing to a positive outcome for this patient. This patient’s preexisting ODD with vision loss heightened the concern to preserve the patient’s remaining vision and further added to the complexity of this challenging case. The importance of medical history questions regarding animal contact also proved vital for accurate diagnosis and treatment of this sight threatening condition
Book Review: The Ophthalmic Laser Handbook
Get PDFBook Review: Freisberg L, Lighthizer N, Skorin, Jr. L, Stonecipher K, and Zimmerman A. The Ophthalmic Laser Handbook. First Edition. Wolters Kluwer Health; 2021. $102.00, 350 pages, Paperback ISBN: 978-1975170172, e-book ISBN: 978-197517021
COVID’s Impact in My Life
Get PDFIn this narrative I describe the emotional, intellectual, social, and physical dimensions in which COVID has had an impact in my life
Nursing Students\u27 Knowledge of and Attitudes Towards Near-Death Experiences
Get PDFIncidence of reported near-death experiences (NDEs) has increased over decades; however, they continue to be inappropriately pathologized or dismissed. These types of responses to disclosures of NDEs by patients can potentially lead to them having problems integrating the experience into their lives. The purpose of this study was to assess undergraduate nursing students’ levels of accurate knowledge of and attitudes towards NDEs and to determine the predictors of nursing students’ knowledge of and attitudes toward NDEs. Additionally, I explored the sources in which nursing students acquire NDE knowledge. I accomplished this by using a cross-sectional, correlational research study design. I obtained data from students enrolled in an undergraduate BSN program at a 4 year university using an online questionnaire to gather quantitative and qualitative data. I selected nursing students as the focus of this study due to the proximity and interaction these students will have with patients when they become nurses.
Study participants had a low level of accurate NDE knowledge. In addition to the low knowledge level, just under two-thirds of participants could not identify at least one strategy to use when caring for patients who have or are suspected of having an NDE. The lack of sufficient knowledge and inability to identify appropriate strategies indicates a lack of preparedness to provide proper care to NDErs. Furthermore, participants had neutral to positive leaning attitudes towards NDEs. These positive leaning attitudes were evident in participants’ expressed desire to learn more about NDEs and their belief that the topic should be included in nursing education. The consensus among participants was a lack of formal education on NDEs within their nursing program. I concluded that the identified lack of preparedness has the potential to have a negative impact on patients’ NDE disclosures and overall care
An Autoethnograpy of a Baby Boomer in Higher Education: Challenges and Catalysts for Change
Get PDFHigher education as a baby boomer brings mental, physical, and economic adjustments, concerns, and insecurities. Additionally, life delivers unexpected challenges and barriers which can cause hardships requiring various types of motivation. Fortunately, there are also catalysts which can contribute toward successes. Literature from four major elements were the focus in this study: motivation, adult learning, challenges, barriers, and catalysts. Theorists and theories included Vroom’s expectancy theory of motivation with the added factor of cost, and Ryan and Deci’s theory on self-determination; Mezirow’s transformative learning and Knowles’s self-directed learning; Cross’s theory on educational barriers—situational, dispositional, and institutional; and Cobb’s social support theory. This research study is qualitative; specifically, evocative autoethnography. Data for analysis consisted of written narratives, white boards, posters, sketches, and verbal conversations. Sensemaking and memory work were utilized in reflective analysis. Through the autoethnographic process, I recognized the following salient themes: (1) this “do over” time was enabled by my owning the advantage of longevity in my encore years; (2) I was motivated in various ways, especially when my fears met my faith; (3) my higher educational experience that I have accomplished up and to this point was instigated and supported by Honey and influential others; and (4) the accretion through learning proved transformative. The purpose of this research study is intended to bring into focus, awareness, and understanding to the challenges being faced by baby boomers, adult learners and nontraditional students, as well as to the educational institutions of higher education and their administrators and faculties