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Digital Scribes: A Possible Solution for Provider Burnout by Reducing Provider Workload
Get PDFBackground: Provider burnout is continuing to be a massive problem for our healthcare industry. One major contributor to provider burnout is burdensome administrative tasks associated with documentation of electronic medical records (EMR). This review aims to uncover the applications for artificially intelligent digital scribes as a solution to reduce EMR documentation burden. Purpose: Provider burnout has shown to increase the incidence of major mistakes and decreased patient safety grades. Digital scribes could be a solution in reducing provider burnout by reducing the administrative burden of EMR documentation. Methods: A comprehensive literature review was conducted using articles from PubMed using search phrases “AI digital scribes, digital scribe in practice . An advanced search was conducted through PubMed searching for article titles using key phrases “digital scribes” and “automatic speech recognition”. Exclusion criteria included systematic reviews, any articles published prior to 2019, and any articles that did not contain any variation of the key words above in their titles. Conclusions: Early trials of current digital scribe technology have shown the ability to reduce provider workload by accurately documenting pertinent summaries from the patient-provider encounter into EMR systems. Digital scribe technology is only in its infancy stages and still requires extensive trialing to allow for seamless integration into provider practice
The Status of Abortion Care Training for Medical Providers Amidst the Current Abortion Access Crisis: a Literature Review
Get PDFBackground: While a common, safe, and essential aspect of reproductive healthcare, abortions have been subject to countless legal restrictions and bans in the United States, especially after the overturn of Roe v. Wade. This has also exacerbated the current shortage of abortion providers. Within this crisis of worsening abortion access, it is imperative to appropriately train future clinicians to provide abortion care. Purpose: This literature review will investigate the status of abortion training in medical schooling. It will explore physician-specific education in abortion and look specifically at the impact of recent legal threats on the availability of this training. Finally, the review will discuss the role of non-physician clinicians in the area of abortion care, especially as this relates to expanding abortion access. Methods: A comprehensive literature review was conducted using PubMed and Google Scholar. Search terms included “abortion training,” “abortion + medical school,” “abortion + physician assistant,” and “abortion + nurse practitioner.” Major studies that contributed to this review were published after 2018 in the United States and present original survey research, observational, or prospective studies. Results: Both physicians and advanced practice clinicians (APCs) are often inadequately prepared to provide abortion care. Up to 40% of medical students and more than one in three OB-GYN residents do not receive routine abortion training, which is likely to worsen as legal bans disrupt access to this care. Research demonstrates that APCs can provide high-quality abortion care; however, limited studies reveal their training in abortion needs improvement. Conclusion: To expand abortion access and confront current abortion provider shortages, it is imperative to better equip future clinicians to provide abortions. Future research should focus on the status of abortion training for APCs, providers who may be uniquely able to expand abortion care access in their communities
It’s More than Skin Deep: Evaluating Mental Health Care in Dermatology Settings
Get PDFBackground: There is a high prevalence of mental health comorbidities in those with dermatologic conditions given the visible nature of many conditions. However, mental health often fails to be addressed due to lack of mental health education, stigma around mental health, and lack of mental health resources for patients. Purpose: This research study aims to assess how patients and providers experience and address mental health in dermatology settings. Methods: A systematic literature review was performed analyzing the relationship between dermatologic conditions and mental health. Additionally, a survey was conducted to assess how dermatology providers approach mental health in dermatology settings. Results: The survey found that conversations surrounding mental health, screening for mental health symptoms, treating mental health issues, and referring patients to mental health services, rarely occur in dermatology settings. The research suggests that the topic of mental health needs to continue to be discussed to reduce the stigma surrounding it, specifically in the specialty of dermatology, given the high correlation between dermatologic diseases and mental health conditions. Conclusion: Findings suggest that mental health is underappreciated in dermatology settings. Additionally, barriers to mental health services remain prevalent and add difficulty to treating dermatologic patients with mental health comorbidities. Continued efforts to improve medical education to include holistic evaluation of patients, along with the implementation of mental health screening and increased utilization of mental health providers will be beneficial to ensure that mental health is adequately addressed in dermatology settings
Queering PA School: An Audit of Augsburg University’s Physician Assistant Program Regarding LGBTQ+ Related Health Topics
Get PDFBackground: Historically LGBTQ+ people have encountered discrimination in the world of medicine, and often providers are sometimes unaware of how to manage medical issues of these patients. In order to best serve queer and trans patients, a more coherent, consistent curriculum needs to be established so that all medical professions are capable of giving high quality treatment to these patients. Physician assistants (PAs) are advanced practice providers who take care of LGBTQ+ patients on a daily basis and are trained under a similar model as physicians. PA programs must also be up to date on the most culturally sensitive ways to care for the queer community to help increase access to these patients.
Purpose: All PA programs differ in the level of teachings about queer healthcare as there are no nationally established standards for this professional school. It is important to begin the conversation about standardizations so that all PA schools are equipping their students to be able to treat people in the LGBTQ+ community. This study hopes to create a conversation about queer healthcare through the lens of PAs and challenge other medical professional programs to query their own curriculum on the matter.
Methods: This study performed an audit of the Augsburg University PA program’s LGBTQ+ related content compared to national competencies 4 created for medical schools. Each competency was analyzed and ranked as “met,” “partially met,” or “not met.” The results were then compiled onto a document for the PA program to utilize and improve their current curriculum. Results: It was discovered that the Augsburg PA program learning objectives fully fulfilled 12 competencies, partially fulfilled 14 competencies, and did not fulfil 4 competencies. Many of the competencies that were partially met or not met were related to the field of pediatric queer medicine, differences in sex development (DSD), or queer policy change in healthcare. The literature revealed there is little known about the current teachings of queer health in PA schools. Additionally, the nationally recognized organizations for PA schools have very broad recommendations for gender and sexual minority (GSM) content, leaving the possibility of programs to include as much or as little as they choose in their curriculum.
Conclusion: A call for more specific and measurable competencies for PA schools to follow for LGBTQ+ health topics is being made so that each school has a way to audit themselves. Actions that fellow PA educators can take include performing an audit of their curriculum, developing updated competencies specific to PA school, or discussing the intricacies of their curriculum with LGBTQ+ students and staff. This could help ensure that more PAs in this generation will have the confidence and competence to handle the needs of queer and trans patients
Barriers to Healthcare Faced by Individuals With Autism Spectrum Disorder and their Families
Get PDFBackground: Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that is characterized by impairments in social interaction and communication as well as repetitive behaviors or interests that can affect daily functioning. ASD individuals are also more likely to experience poor physical and mental health along with reduced life expectancy compared to non-autistic people. Thus, it is crucial that those with ASD are able to obtain adequate healthcare. However, there is limited research on the barriers to medical care access faced by those with ASD and their families.
Purpose: Due to the lack of autism awareness in the general population and medical community along with limited research on ASD healthcare access barriers, the aim of this study was to examine healthcare access challenges faced by individuals with ASD and their families. The goal of this research is to contribute to the limited research on this topic in order to educate current and future healthcare providers so that they can better serve their ASD patients.
Methods: The literature review portion of this study was performed using Augsburg University’s Lindell Library EBSCO Host search engine, Google Scholar and PubMed to find articles on barriers to healthcare access faced by those with ASD and their families. The interview portion of the research was performed using purposeful sampling with three parents of children with ASD. Interviews were conducted virtually via Zoom through 30-minute interviews with each parent. Participants were recruited through snowball sampling and an informed consent process was used by pre-administration of signed consent forms prior to the interviews. This class-based project was designated IRB-Exempt from Augsburg University IRB, #2023-06-04.
Conclusions: Results of the literature review revealed that barriers faced by ASD patients include feelings of judgment/dismissal from providers, anxiety around appointments, and communication problems. The literature review and interviews both showed that challenges faced by caregivers involve healthcare system navigation, insurance coverage and provider competence. Both studies highlight existing gaps at the medical provider level and at the healthcare system level
Surgical Equity for People Experiencing Homelessness
No full textHealth care disparities among marginalized populations, particularly individuals experiencing homelessness, present significant challenges within surgical care. A quality improvement project highlights critical issues stemming from assumptions of stable housing status presurgery, that result in potential missed intervention opportunities and inadequate patient care. The intersection of homelessness and surgical services emphasizes the need for targeted education and the implementation of tailored interventions. Drawing on Jean Watson’s Human Caring Theory to advocate for holistic patient care, this quality improvement project proposes a presurgery checklist and educational initiatives at a Midwest medical center. These efforts aim to enhance surgical care staff awareness and improve outcomes for PEH undergoing surgical procedures, addressing systemic barriers and fostering equitable care practices. It is essential for nurses to advocate for inclusive strategies that ensure comprehensive care delivery across diverse patient populations
Unveiling Healthcare Disparities by Addressing Historical Traumas to Build Inclusive Spaces for Marginalized Communities: An Autoethnographic Study
Get PDFThis paper delves into the pervasive disparities within the healthcare system, rooted in historical injustices that are perpetuated by systemic biases, particularly affecting Black, Indigenous, and People of Color (BIPOC) communities, as well as the LGBTQIA2S+ community. Through a comprehensive literature review and autoethnographic study, the paper examines the deep-seated issues faced by these marginalized groups, including access barriers, discrimination, mistrust of healthcare providers, and the enduring impact these have on health outcomes. Historical traumas such as the Tuskegee Syphilis Study and the use of HeLa cells underscore the enduring impact of past injustices on present-day healthcare experiences. Moreover, the paper explores the intersecting factors of race, ethnicity, gender identity, and sexual orientation that contribute to healthcare disparities. The autoethnographic study will expand upon the experiences of a plus-sized, Black, queer woman when navigating the healthcare system. The research and study emphasize the importance of creating safe spaces within healthcare settings and fostering cultural competence amongst all clinicians to address the unique needs of marginalized communities. This paper emphasizes the need for healthcare providers to be educated on the historical context of discrimination and for systemic reforms to foster empathy, respect, equity, and inclusivity. By acknowledging past wrongs and working towards equity through culturally competent care, the healthcare system can begin to rebuild trust and improve patient outcomes for marginalized groups
Beneficial and Detrimental Health Effects of Gilbert’s Syndrome: A Systematic Literature Review
No full textBackground: Gilbert’s syndrome (GS), typically considered a benign genetic condition, is signified by some transient episodes of mild hyperbilirubinemia. Evidence suggests that it may increase risk of cholelithiasis. At the same time the antioxidant and anti-inflammatory properties of bilirubin seem to provide protection against lifestyle diseases.
Purpose: This systematic review aims to comprehensively analyze the existing literature to evaluate detrimental effects of GS, particularly its association with cholelithiasis. Additionally, it explores whether elevated bilirubin levels associated with GS provide protective effects against atherosclerosis, cardiovascular diseases, type 2 diabetes mellitus (T2DM) and its complications, and assesses the overall impact on morbidity and mortality.
Methods: Articles published between 2018 and 2024 were reviewed using PubMed. The review included studies examining the relationship between GS and elevated bilirubin levels with cholelithiasis, atherosclerosis, coronary artery disease, T2DM, lipid metabolism, and obesity. Articles that were systematic reviews, editorials, meta-analyses, animal studies, and non English-language articles were excluded.
Results: The review found that the beneficial effects of GS, attributed to the antioxidant, anti-inflammatory, and anti-atherogenic properties of bilirubin, outweigh its harmful aspects, despite its association with cholelithiasis. Elevated bilirubin levels were found to provide protection against various lifestyle diseases. Conclusion: GS may offer a natural advantage due to its protective effects against lifestyle diseases. However, the impact of GS varies based on individual factors. More large-scale, multicenter prospective studies are needed to elucidate the mechanisms of bilirubin\u27s effects and establish the long-term impacts on lifestyle diseases and overall morbidity and mortality
Nurse Closure Visits in Consultative Medicine
No full textThe Consultative Medicine practice at a major Midwestern teaching hospital specializes in diagnosing and developing care plans for adults across the United States who have struggled to receive accurate diagnoses for their complex or rare conditions. Recognizing that patients often face challenges implementing these care plans upon returning to their local healthcare settings, the health care team within the Consultative Medicine practice developed Nurse Closure Visits based on Margaret Newman’s theory of Health as Expanding Consciousness. The Nurse Closure Visits consist of two sessions: an in-person meeting immediately following the physician’s consultation and a virtual follow-up within one to two weeks. These visits aim to reinforce diagnoses, address patient concerns, and proactively identify and resolve any barriers to implementing the care plan locally, ultimately empowering patients to manage their health and follow-up care effectively. The project will be deemed effective by seeing a decrease in patients’ electronic messages after receiving a 30-day closure of care letter and an increase in patient satisfaction scores
Optimizing Nutrition Status and Patient Outcomes in Adults Receiving Post-ICU Care
Get PDFBackground: Nutrition interventions for hospitalized patients can provide meaningful benefit on patient recovery outcome, length of hospital admission, and overall healthcare costs. Preventing and treating malnutrition is one aspect of optimizing patient outcomes following a prolonged clinical course, including stays in the intensive care unit (ICU).
Purpose: This literature review aims to address how nutrition status can be maximized for a patient’s post intensive care unit clinical course. While early enteral nutrition (EN) when appropriate is accepted as optimal care, there is little standardization for removal of devices to provide artificially administered nutrition and hydration (AANH).
Methods: A comprehensive literature review was conducted using PubMed and Google Scholar, using the search terms post extubation dysphagia, malnutrition, post ICU rehab, post ICU nutrition, ICU nutrition, feeding tube in the ICU, post extubation rehab phase, and dysphagia and feeding tube. Inclusion criteria were studies that were published in 2018 or later. Systematic reviews, case studies and research prior to 2018 was excluded unless it was needed to provide appropriate historical background or context for discussion.
Conclusions: In order to best time the removal of artificially administered nutrition and hydration devices to optimize patient rehabilitation and minimize determinate outcomes related to malnutrition, further research is warranted. Research should focus on assessing outcoming randomized control trials, with defined malnutrition criteria across institutions