Abstract P85: Diversity of Educational Providers Among Anticoagulation Clinics: Results of a National Survey

2011 ◽  
Vol 4 (suppl_2) ◽  
Author(s):  
Adam Leidal ◽  
Geoffery D Barnes ◽  
Brian Salata ◽  
James B Froehlich ◽  
Scott Kaatz
Keyword(s):  
Patient Education ◽  
General Education ◽  
National Survey ◽  
Warfarin Dose ◽  
The United States ◽  
Dietary Changes ◽  
Ensure Patient Safety ◽  
Anticoagulation Clinics ◽  
Dietary Education ◽  
Almost All

Background: Due to the difficulty and complexity in managing warfarin, anticoagulation clinics must provide adequate patient education to ensure patient safety. Nevertheless, strategies to educate anticoagulation patients vary widely. We intend to describe the self-reported educational practices of anticoagulation clinics across the United States. Methods: A 31-question online survey was sent to all members of the Anticoagulation Forum, a network of healthcare providers who work in the field of thromboembolic disease. 264 unique clinics responded to the survey. Each reported question had at least 244 responses. Descriptive statistics are reported. Results: Most clinics provide general education through reading materials (92%) and in-person interactions (89%). Few clinics educate by means of video (27%), website (17%), and other methods (8%). Pharmacists (PharmDs) and nurses (RNs) combine to provide the majority (80%) of general anticoagulation education. 39% and 24% of clinics reported that PharmDs and RNs, respectively, provide almost all (>90%) of the general education. 36% and 24% of clinics reported that PharmDs and RNs, respectively, provide almost all (>90%) of the dietary education. 3.3% of all clinics reported that dieticians provides more than 30% of all dietary education. 90% of clinics use literature and 84% of clinics use personal teaching methods to educate their patients on diet. The provider is typically PharmDs and RNs, as they combine for 78% of all dietary education provided by the clinics. In addition to dietary education, 71% of clinics reported using dietary changes to control out-of-range INR values. Conclusion: This national survey illustrates the diversity in providers of patient education among anticoagulation clinics. Dietary education was only minimally provided by registered dieticians. Traditional materials are primarily used with few clinics utilizing web-based education. The majority of clinics reported using dietary changes in addition to warfarin dose changes to manage out-of-range INR values. Exploring these differing provider strategies and tools may be useful in developing a more structured and effective anticoagulation educational plan.

scholarly journals ASHP national survey of pharmacy practice in hospital settings: Dispensing and administration—2020

2021 ◽  
Author(s):  
Craig A Pedersen ◽  
Philip J Schneider ◽  
Michael C Ganio ◽  
Douglas J Scheckelhoff
Keyword(s):  
Health Systems ◽  
National Survey ◽  
Workflow Management ◽  
Pharmacy Practice ◽  
Drug Distribution ◽  
Mail Survey ◽  
The United States ◽  
Traditional Role ◽  
Mode Method ◽  
Almost All

Abstract Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose Results of the 2020 ASHP national survey of pharmacy practice in hospital settings are presented. Methods Pharmacy directors at 1,437 general and children’s medical/surgical hospitals in the United States were surveyed using a mixed-mode method of contact by email and mail. Survey completion was online. IQVIA supplied data on hospital characteristics; the survey sample was drawn from the IMS hospital database. Results The response rate was 18.7%. Almost all hospitals (92.5%) have a method for pharmacists to review medication orders on demand. Most hospitals (74.5%) use automated dispensing cabinets (ADCs) as their primary method for drug distribution. A third of hospitals use barcodes to verify doses during dispensing in the pharmacy and to verify ingredients when intravenous medications are compounded. More than 80% scan barcodes when restocking ADCs. Sterile workflow management technology is used in 21.3% of hospitals. Almost three-quarters of hospitals outsource some sterile preparations. Pharmacists can independently prescribe in 21.1% of hospitals. Pharmacist practice in ambulatory clinics in 46.2% of health systems and provide telepharmacy services in 28.4% of health systems. Conclusion Pharmacists continue their responsibility in their traditional role in preparation and dispensing of medications. They have successfully employed technology to improve safety and efficiency in performance of these duties and have employed emerging technologies to improve the safety, timeliness, and efficiency of the administration of drugs to patients. As pharmacists continue to expand their role to all aspects of medication use, new opportunities highlighted in ASHP’s Practice Advancement Initiative 2030 have been identified.

National Survey of Pediatricians' Opinions about and Practices for Acute Otitis Media and Xylitol Use

2010 ◽  
Vol 21 (05) ◽  
pp. 329-346 ◽  
Author(s):  
Jeffrey L. Danhauer ◽  
Carole E. Johnson ◽  
Suzanne N. Rotan ◽  
Tasha A. Snelson ◽  
Jennifer S. Stockwell
Keyword(s):  
United States ◽  
Side Effects ◽  
American Academy ◽  
Otitis Media ◽  
National Survey ◽  
Acute Otitis Media ◽  
The United States ◽  
Physician Visits ◽  
Attitudes And Practices ◽  
Almost All

Background: Acute otitis media (AOM) is the main reason for physician visits and antibiotic prescriptions in children. Pediatricians (Peds) are gatekeepers for services and sources of information for families. The 2004 American Academy of Pediatrics/American Academy of Family Physicians (AAP/AAFP) Clinical Practice Guideline: Diagnosis and Management of Acute Otitis Media recommended preventative and management measures for Peds' practice. Treatments for AOM (antimicrobial therapy and surgery) sometimes have questionable effectiveness, risks, and high costs. Thus, Peds should consider using prophylactics for AOM that are easy to administer, cost-effective, and have minimal side effects. Xylitol, a naturally occurring sugar alcohol, is widely used to prevent AOM and for other health conditions in Europe, and as a dental caries prophylaxis in the United States. It would be helpful to know Peds' attitudes and practices to identify barriers to xylitol's use as a prophylaxis for AOM in the United States. Purpose: To conduct a national survey of Peds in the United States to evaluate how closely they adhered to the AAP/AAFP guideline, and their knowledge and opinions about xylitol use. Research Design: A randomized, national postal survey. Method: A 48-item questionnaire developed for this study was mailed to a random sample of 506 Peds within the United States during spring 2009. It assessed Peds' demographics, adherence to the guideline, and knowledge and opinions about and use of xylitol as a prophylaxis for AOM in children. Results: The questionnaire response rate was 22% (98 useable/506 mailed − 63 returned undeliverable). Participants were about equal for gender, and almost all were in private practice for over 10 yr. Most had pediatric patients with at least one bout of AOM annually. The majority adhered to the guideline (e.g., almost all routinely assessed and managed patients' pain for AOM and encouraged prevention by recommending that families reduce risk factors). Most used and were comfortable with otoscopy for diagnosing AOM, but not tympanometry. Almost all believed that conductive hearing loss could hinder speech-language and academic development, and AOM could reduce quality of life of children. They also believed that those under 6 mo of age with AOM should receive antibacterial therapy beginning with amoxicillin but did not use complementary and alternative medicine (CAM). Only about half knew about medical uses for xylitol, but of those, most were aware of its use in chewing gum to prevent AOM but had not used it with patients. They were not sure of xylitol's effectiveness or appropriate dosages but cited stomach cramping and diarrhea as possible side effects. Most would use xylitol if evidence supported it and wanted information about it via reprints or electronically. Few agreed that audiologists are important in diagnosing/managing AOM. Conclusions: Most of these Peds adhered to the AAP/AAFP guideline. They were not using CAMs like xylitol for preventing AOM in children. Future research should focus on prevention and the use of xylitol as a possible prophylaxis regimen for AOM in patients.

Hiring Practices of Exercise Physiologist in Cardiac Rehabilitation Programs among Mid-Atlantic States in the United States

2016 ◽  
Vol 5 (3) ◽  
pp. 32-36 ◽  
Author(s):  
Allison Hope Bowersock ◽  
William Alexander Breeding ◽  
Carmel Alexander Sheppard
Keyword(s):  
United States ◽  
Patient Education ◽  
Cardiac Rehabilitation ◽  
Science Curriculum ◽  
Exercise Physiology ◽  
Clinical Skill ◽  
The United States ◽  
Hiring Practices ◽  
Clinical Settings ◽  
Rehabilitation Programs

Purpose: The purpose of this survey was to identify factors that may be influencing the appreciation of exercise physiology as a discipline as demonstrated by hiring practices in regional clinical settings. Methods: A telephone survey was administered to 33 cardiac rehabilitation programs in 5 states in the Mid-Atlantic region of the United States (Kentucky, North Carolina, Tennessee, Virginia, and West Virginia). Results: The distribution of nurses and exercise physiologists (EPs) employed by the 33 facilities varied by state, but overall there were 86 nurses and 55 EPs working among the surveyed facilities. Of the 33 surveyed facilities, 12 (36%) reported a preference for hiring nurses over EPs; only 4 (12%) reported a preference for hiring EPs over nurses. The remaining facilities (n = 17; 52%) reported no preference (n = 12; 36%) or that the decision depends on a variety of factors (n = 5; 15%). Several common themes were identified from respondents. These included that, compared to nurses, EPs have greater expertise in exercise prescription and better understanding of safe exercise progression for patients. However, nurses were believed to possess greater assessment and clinical skill with an emphasis on emergency response preparedness and greater general patient education skills. Conclusion: Academic programs that prepare students for careers as EPs employed in clinical settings may benefit from additional coursework and internship site selection that focus on clinical assessment skills, emergency preparedness, and patient education to reinforce their work in an exercise science curriculum.

scholarly journals What Lies Beneath: The Role of Self-Efficacy, Causal Attribution Habits, and Gender in Accounting for the Success of College Students

2021 ◽  
Vol 11 (7) ◽  
pp. 333
Author(s):  
Kerstin Hamann ◽  
Maura A. E. Pilotti ◽  
Bruce M. Wilson
Keyword(s):  
General Education ◽  
Self Efficacy ◽  
Causal Attribution ◽  
The United States ◽  
Female Students ◽  
Male Students ◽  
Course Grades ◽  
Success In Higher Education ◽  
And Gender

Existing research has identified gender as a driving variable of student success in higher education: women attend college at a higher rate and are also more successful than their male peers. We build on the extant literature by asking whether specific cognitive variables (i.e., self-efficacy and causal attribution habits) distinguish male and female students with differing academic performance levels. Using a case study, we collected data from students enrolled in a general education course (sample size N = 400) at a large public university in the United States. Our findings indicate that while students’ course grades and cumulative college grades did not vary by gender, female and male students reported different self-efficacy and causal attribution habits for good grades and poor grades. To illustrate, self-efficacy for female students is broad and stretches across all their courses; in contrast, for male students, it is more limited to specific courses. These gender differences in cognition, particularly in accounting for undesirable events, may assist faculty members and advisors in understanding how students respond to difficulties and challenges.

scholarly journals Mathematical pattern of Kessler psychological distress distribution in the general population of the U.S. and Japan

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shinichiro Tomitaka ◽  
Toshiaki A. Furukawa
Keyword(s):  
United States ◽  
General Population ◽  
National Survey ◽  
Goodness Of Fit ◽  
Quadratic Function ◽  
The United States ◽  
Depression Screening ◽  
Distribution Model ◽  
Epidemiological Surveys ◽  
Screening Scale

Abstract Background Although the 6-item Kessler psychological scale (K6) is a useful depression screening scale in clinical settings and epidemiological surveys, little is known about the distribution model of the K6 score in the general population. Using four major national survey datasets from the United States and Japan, we explored the mathematical pattern of the K6 distributions in the general population. Methods We analyzed four datasets from the National Health Interview Survey, the National Survey on Drug Use and Health, and the Behavioral Risk Factor Surveillance System in the United States, and the Comprehensive Survey of Living Conditions in Japan. We compared the goodness of fit between three models: exponential, power law, and quadratic function models. Graphical and regression analyses were employed to investigate the mathematical patterns of the K6 distributions. Results The exponential function had the best fit among the three models. The K6 distributions exhibited an exponential pattern, except for the lower end of the distribution across the four surveys. The rate parameter of the K6 distributions was similar across all surveys. Conclusions Our results suggest that, regardless of different sample populations and methodologies, the K6 scores exhibit a common mathematical distribution in the general population. Our findings will contribute to the development of the distribution model for such a depression screening scale.

scholarly journals Effects of B.1.1.7 and B.1.351 on COVID-19 Dynamics: A Campus Reopening Study

2021 ◽  
Author(s):  
Kevin Linka ◽  
Mathias Peirlinck ◽  
Amelie Schäfer ◽  
Oguz Ziya Tikenogullari ◽  
Alain Goriely ◽  
...  
Keyword(s):  
Online Education ◽  
The United States ◽  
Wild Type ◽  
Seir Model ◽  
Population Mixing ◽  
Santa Clara County ◽  
Increased Risk ◽  
Controversial Topic ◽  
Almost All ◽  
Local Reproduction

AbstractThe timing and sequence of safe campus reopening has remained the most controversial topic in higher education since the outbreak of the COVID-19 pandemic. By the end of March 2020, almost all colleges and universities in the United States had transitioned to an all online education and many institutions have not yet fully reopened to date. For a residential campus like Stanford University, the major challenge of reopening is to estimate the number of incoming infectious students at the first day of class. Here we learn the number of incoming infectious students using Bayesian inference and perform a series of retrospective and projective simulations to quantify the risk of campus reopening. We create a physics-based probabilistic model to infer the local reproduction dynamics for each state and adopt a network SEIR model to simulate the return of all undergraduates, broken down by their year of enrollment and state of origin. From these returning student populations, we predict the outbreak dynamics throughout the spring, summer, fall, and winter quarters using the inferred reproduction dynamics of Santa Clara County. We compare three different scenarios: the true outbreak dynamics under the wild-type SARS-CoV-2, and the hypothetical outbreak dynamics under the new COVID-19 variants B.1.1.7 and B.1.351 with 56% and 50% increased transmissibility. Our study reveals that even small changes in transmissibility can have an enormous impact on the overall case numbers. With no additional countermeasures, during the most affected quarter, the fall of 2020, there would have been 203 cases under baseline reproduction, compared to 4727 and 4256 cases for the B.1.1.7 and B.1.351 variants. Our results suggest that population mixing presents an increased risk for local outbreaks, especially with new and more infectious variants emerging across the globe. Tight outbreak control through mandatory quarantine and test-trace-isolate strategies will be critical in successfully managing these local outbreak dynamics.

scholarly journals The Effect of Vaccination Rates on the Infection of COVID-19 under the Vaccination Rate below the Herd Immunity Threshold

2021 ◽  
Vol 18 (14) ◽  
pp. 7491
Author(s):  
Yi-Tui Chen
Keyword(s):  
Infection Rate ◽  
Herd Immunity ◽  
The United States ◽  
Vaccination Rate ◽  
Infection Rates ◽  
Vaccination Rates ◽  
The United Kingdom ◽  
The World ◽  
Almost All ◽  
The Impact

Although vaccination is carried out worldwide, the vaccination rate varies greatly. As of 24 May 2021, in some countries, the proportion of the population fully vaccinated against COVID-19 has exceeded 50%, but in many countries, this proportion is still very low, less than 1%. This article aims to explore the impact of vaccination on the spread of the COVID-19 pandemic. As the herd immunity of almost all countries in the world has not been reached, several countries were selected as sample cases by employing the following criteria: more than 60 vaccine doses per 100 people and a population of more than one million people. In the end, a total of eight countries/regions were selected, including Israel, the UAE, Chile, the United Kingdom, the United States, Hungary, and Qatar. The results find that vaccination has a major impact on reducing infection rates in all countries. However, the infection rate after vaccination showed two trends. One is an inverted U-shaped trend, and the other is an L-shaped trend. For those countries with an inverted U-shaped trend, the infection rate begins to decline when the vaccination rate reaches 1.46–50.91 doses per 100 people.

scholarly journals Examining Variations in Surfactant Administration (ENVISION): A Neonatology Insights Pilot Project

Children ◽  
2021 ◽  
Vol 8 (4) ◽  
pp. 261
Author(s):  
Priya Patel ◽  
Andrew Houck ◽  
Daniel Fuentes
Keyword(s):  
Clinical Practice ◽  
Nurse Practitioners ◽  
Pilot Project ◽  
The United States ◽  
Institution Type ◽  
Respiratory Therapists ◽  
Respiratory Management ◽  
Surfactant Administration ◽  
Practice Variations ◽  
Almost All

Variability in neonatal clinical practice is well recognized. Respiratory management involves interdisciplinary care and often is protocol driven. The most recent published guidelines for management of respiratory distress syndrome and surfactant administration were published in 2014 and may not reflect current clinical practice in the United States. The goal of this project was to better understand variability in surfactant administration through conduct of health care provider (HCP) interviews. Questions focused on known practice variations included: use of premedication, decisions to treat, technique of surfactant administration and use of guidelines. Data were analyzed for trends and results were communicated with participants. A total of 54 HCPs participated from June to September 2020. In almost all settings, neonatologists or nurse practitioners intubated the infant and respiratory therapists administered surfactant. The INSURE (INtubation-SURrfactant-Extubation) technique was practiced by 83% of participants. Premedication prior to intubation was used by 76% of HCPs. An FiO2 ≥ 30% was the most common threshold for surfactant administration (48%). In conclusion, clinical practice variations exist in respiratory management and surfactant administration and do not seem to be specific to NICU level or institution type. It is unknown what effects the variability in clinical practice might have on clinical outcomes.

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