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Flux Crystal Growth of a Series of Calcium Rare Earth Silicate Chlorides Calnsio\u3csub\u3e4\u3c/sub\u3eCl (Ln = Pr, Nd, Sm, Eu, Gd, and Tb): Mixed Anion Materials with a Spodiosite-Type Structure
No full textA series of calcium rare earth silicate chlorides, CaLnSiO4Cl (Ln = Pr, Nd, Sm, Eu, Gd, and Tb), was obtained as single crystals from flux crystal growth. The structures were determined by single crystal X-ray diffraction and were found to be related to the spodiosite/Wagnerite mineral structure, Ca2PO4F. The obtained compositions are variations of the spodiosite structure that result from two simultaneous elemental substitutions. Replacing one calcium for one rare earth element and the simultaneous replacement of one VO43− or PO43− with one SiO44−. CaEuSiO4Cl was found to luminesce, and its photoluminescence spectrum is reported
Tailored Interventions to Reduce Patient Falls
No full textProblem: Medical-surgical Units A and B at a midsize southeastern regional hospital accounted for 28.9% of total facility falls from June to August of 2024. Unit A had a fall rate of 1.77 with 66.7% falls related to toileting, and Unit B had a fall rate of 4.93 with 12.5% toileting falls. Purpose: This quality improvement project aimed to implement a tool, Tailored Interventions for Patient Safety (TIPS) to direct individualized patient care plans for toileting patients with elevated risk for falls according to Morse Fall Scale (MFS). Method: Using the MFS, this quality improvement project assessed patients for high fall risk upon admission or transfer to Medical Units A or B. If deemed high risk, the TIPS tool was utilized to create an individualized toileting plan, and documented in the EMR under the “care hand-off” tab. Laminated copies of the plan were posted in the room, and a verbal report was given to nurses and patient care technicians. Analysis: Data were processed by using Wilcoxon, and ANOVA test statistical analysis. At project conclusion, the fall rate for Unit A decreased to 1.08, with 0% falls related to toileting. By comparison, the overall fall rate for Unit B decreased to 3.71, and the percentage of falls related to toileting increased to 37.5%. Implications: The TIPS fall assessment tool, in combination with the MFS, led to a decrease in fall rates by developing an individualized toileting care plan for high fall risk patients; however, the results did not reach statistical significance
Standardizing Heart Failure Discharges: Reducing 30-Day Readmission Rates
Get PDFProblem Statement: Patients readmitted with heart failure (HF) suffer increased mortality, reduced quality of life, and heightened medical expenses, though most readmissions are preventable with a consistent HF discharge regimen.
Purpose: To determine if a consistent HF discharge regimen using an evidence-based HF discharge checklist tool, including standardized HF education and a scheduled follow-up appointment with their cardiologist within 7-10 days post-discharge, impacted HF 30-day readmission rates.
Methods: An evidence-based HF discharge checklist tool was placed on participants’ charts on the Progressive Care Unit (PCU) and utilized by the PCU nurses to standardize HF discharges.
Inclusion Criteria: The study included participants with a primary diagnosis of HF upon admission and patients from a local cardiology practice. The intervention standardized HF discharges on the PCU through an evidence-based HF discharge checklist tool.
Analysis: A Wilcoxon signed-rank test was used to compare pre-intervention and post-intervention HF readmission rates. The number of patients admitted to the PCU included in the HF readmission data, the percentage of HF discharge checklist tools completed compared to HF admissions, the percentage of patients that received standardized HF education, and the percentage of patients who were scheduled and kept follow-up appointments were measured.
Implications for Practice: Standardizing HF discharges through a discharge checklist tool can reduce HF readmissions, minimize hospital expenditures, reduce patient mortality, and increase the quality of life for patients with HF
Passive Remote Monitoring Technologies’ Influence on Home Care Clients’ Ability to Stay Home: Multiprovincial Randomized Controlled Trial
Get PDFBackground: Researchers in Nova Scotia and Ontario, Canada, implemented a passive remote monitoring (PRM) model of home care unique to their health system contexts. Each PRM model integrated tailored PRM devices (eg, motion sensors, cameras, and door alarms) into home care patients’ residences with the aim of linking patients, family and friend caregivers, and health care providers to support older adults’ aging in place. Objective: The purpose of this study was to examine the use of PRM technologies in the home to support older adults’ safe aging in place and avoidance or delay of higher levels of care. Methods: This multiprovincial pragmatic randomized controlled trial examined how PRM technologies support older adults to safely remain in their home and avoid or delay admission to higher levels of care. Pairs of home care patients and their family and friend caregivers were recruited in Ontario and Nova Scotia. Participant pairs were randomly assigned to one of two conditions: (1) standard home care (ie, control) or (2) standard home care plus study-provided PRM (ie, intervention). Participants provided their provincial health insurance numbers to link with provincial health administrative databases and identify if patients were admitted to higher levels of care after 1 year. Cox proportional hazards models were used to evaluate the primary outcome in each province. Results: In total, 313 patient-caregiver pairs were recruited: 174 pairs in Ontario (intervention: n=60; control: n=114) and 139 pairs in Nova Scotia (intervention: n=45; control: n=94). Results indicate PRM was associated with a nonsignificant 30% reduction in risk of patients being admitted to higher levels of care in Ontario (hazard ratio 0.7, 95% CI 0.3-1.4) and no reduction in risk in Nova Scotia (hazard ratio 1.1, 95% CI 0.3-3.7). Adjusting for patient sex had no impact on model estimates for either province. Conclusions: Limitations related, in part, to the impact of the COVID-19 pandemic may have contributed to the effectiveness of the intervention. While our study did not yield statistically significant results (P=.30 and P=.90) regarding the effectiveness of the PRM model in prolonging home stays, the observed trends suggest that technology-assisted aging in place may be a valuable goal for older adults. Further study is required to understand if longer follow-up time allows more effects of PRM on patients’ avoidance of higher levels of care to be detected
Opioid Treatment Matters: an Analysis of District Attorney Non-Prosecution
Get PDFDrug use and drug overdose have become an overriding concern both for civic order and due to the raw death toll from the opioid epidemic. One reform push in the late 2010s/early 2020s, county-level District Attorneys signalling that they would not prose- cute drug use and related crimes, aimed to reduce overdose by reducing criminalization and stigma as a barrier to opioid treatment. At its peak, the policy covered between twenty and thirty million Americans. Using hand-collected data on District Attorney policies and Augmented Synthetic Control for causal identification, I estimate null ef- fects of non-prosecution policies on an urban area’s opioid overdose rates. I hypothesize my findings reflect that non-prosecution policies likely did not affect drug overdose once controlling for the increase in drug overdose in the late 2010s