Rapid Naloxone Administration Workshop for Health Care Providers at an Academic Medical Center

Background: In the United States, most deaths occur in hospitals, with approximately 25% of hospitalized patients having palliative care needs. Therefore, the provision of good end-of-life (EOL) care to these patients is a priority. However, research assessing staff preparedness for the provision of EOL care to hospitalized patients is lacking. Objective: To assess health-care professionals’ self-perceived competencies regarding the provision of EOL care in hospitalized patients. Methods: Descriptive study of self-perceived EOL care competencies among health-care professionals. The study instrument (End-of-Life Questionnaire) contains 28 questions assessing knowledge, attitudes, and behaviors related to the provision of EOL care. Health-care professionals (nursing, medicine, social work, psychology, physical, occupational and respiratory therapist, and spiritual care) at a large academic medical center participated in the study. Means were calculated for each item, and comparisons of mean scores were conducted via t tests. Analysis of variance was used to identify differences among groups. Results: A total of 1197 questionnaires was completed. The greatest self-perceived competency was in providing emotional support for patients/families, and the least self-perceived competency was in providing continuity of care. When compared to nurses, physicians had higher scores on EOL care attitudes, behaviors, and communication. Physicians and nurses had higher scores on most subscales than other health-care providers. Conclusions: Differences in self-perceived EOL care competencies were identified among disciplines, particularly between physicians and nurses. The results provide evidence for assessing health-care providers to identify their specific training needs before implementing educational programs on EOL care.

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Defining Legacy: The Perceptions of Pediatric Health Care Providers

Clinical Pediatrics ◽

10.1177/0009922820940808 ◽

2020 ◽

Vol 59 (11) ◽

pp. 1004-1010

Author(s):

Jessika Boles ◽

Maile Jones ◽

Jenna Dunbar ◽

Jessica Cook

Keyword(s):

Health Care ◽

Health Care Providers ◽

Family Relationships ◽

Medical Center ◽

Academic Medical Center ◽

Free Text ◽

Care Providers ◽

Pediatric Health ◽

Pediatric Health Care ◽

Free Text Response

Legacy building interventions like plaster hand molds are offered in most children’s hospitals, yet little is known about how the concept of legacy is understood and described by pediatric health care providers. Therefore, this study explored pediatric health care providers’ perceptions of legacy at an academic medical center to ensure that future legacy interventions are evidence-informed and theoretically grounded. An electronic survey featuring three open-ended questions and two multiple-choice questions with an option for free text response was completed by 172 medical and psychosocial health care providers. Analysis yielded four themes: (1) legacy is intergenerational, enduring, and typically associated with end-of-life; (2) legacies articulate the impacts on others for which one is known and remembered; (3) legacies can be expressed through tangible items or intangible qualities; and (4) legacies are informed and generated by family relationships and work experiences. By understanding legacy as a personally and professionally contextualized experience, health care providers can better assess and meet the legacy needs of hospitalized pediatric patients and families.

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Analysis of an Infectious Diseases Pharmacist on Call Pager Program to Inform Educational Efforts

Journal of Pharmacy Technology ◽

10.1177/8755122517708207 ◽

2017 ◽

Vol 33 (4) ◽

pp. 146-150

Author(s):

Elise M. Gilbert ◽

Nathaniel J. Rhodes ◽

Milena M. McLaughlin ◽

Jessica M. Cottreau ◽

Marc H. Scheetz ◽

...

Keyword(s):

Infectious Diseases ◽

Health Care Providers ◽

Medical Center ◽

Academic Medical Center ◽

Temporal Trends ◽

Question Type ◽

Care Providers ◽

Educational Initiatives ◽

Academic Medical ◽

Secondary Objective

Background: An on call infectious diseases (ID) pharmacist may be used as a resource for physicians, pharmacists, and other health care providers to help answer questions regarding anti-infective agents. Objective: To assess type, requestor, resources dedicated, and temporal trends of questions received through an ID pharmacist on call pager program. A secondary objective was to gather insight as to how this information was utilized to inform educational initiatives. Methods: This was a retrospective study of questions received by the ID pharmacist on call via pager at a large academic medical center. Question data were documented in a central database and analyzed to assess temporal trends and question type, and qualitatively analyzed to determine areas for targeted educational efforts. Results: The ID pharmacist on call recorded 545 questions during the 1-year study period; questions were composed of various antimicrobial agent–related queries, including antibiotic spectrum and selection (n = 251, 46.1%), dosing of antimicrobials (n = 195, 35.8%), and drug monitoring (n = 26, 4.8%). Targeted educational initiatives secondary to questions received included pharmacist education regarding the use of polymyxin antibiotics and antibiotic dosing protocol updates. Conclusions: An ID pharmacist on call pager program was utilized to inquire about antibiotic spectrum and selection for the majority of questions. Records of questions received may be utilized to direct educational efforts and create or revise targeted resources for pharmacists and other clinicians.

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An Academic Medical Center’s Learners’ Perceptions of Health Disparities

PRiMER ◽

10.22454/primer.2018.867250 ◽

2018 ◽

Vol 2 ◽

Author(s):

Joyce E. Balls-Berry ◽

Eddie Greene ◽

Jennifer McCormick ◽

Onelis Quirindongo-Cedeno ◽

Karen Weavers ◽

...

Keyword(s):

Health Disparities ◽

Health Care Providers ◽

Medical Center ◽

Academic Medical Center ◽

Care Providers ◽

Unequal Treatment ◽

Medical Centers ◽

Academic Medical ◽

Significant Difference ◽

Patient Groups

Introduction: Lack of health equity ultimately leads to unequal treatment of diverse patients and contributes to the growing disparities seen in national health. Academic medical centers should consider providing health care providers and biomedical researchers training on how to identify and address health disparities. Methods: The authors led an introductory health disparities course for graduate students and research and clinical fellows at an academic medical center in the Midwest. We compared pre/postcourse assessments to determine changes in learners’ perceptions and knowledge of health disparities using an unpaired analysis to permit inclusion of responses provided only at baseline. Results: Sixty-two learners completed preassessment, with 56 completing the postassessment (90%). In the postcourse assessment, learners reported an increase in knowledge of disparities and had changes in their perceptions of health disparities linked to treatment of different patient groups based on demographic characteristics. There was a statistically significant difference in learners’ perceptions of how patients are treated based on gender identity (P=0.02) and sexual orientation (P=0.04). Conclusions: The results detail how an academic medical center can provide training on health disparities for diverse learners. This study underscores the influence of health disparities from the perspective of learners who conduct biomedical research and patient care. This course serves a model for introductory-level health disparities courses.

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Patient Perceptions of Open, Laparoscopic, and Robotic Gynecological Surgeries

BioMed Research International ◽

10.1155/2016/4284093 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 8

Author(s):

Mohamad Irani ◽

Cheruba Prabakar ◽

Sepide Nematian ◽

Nitasha Julka ◽

Devika Bhatt ◽

...

Keyword(s):

Health Care Providers ◽

Medical Center ◽

Academic Medical Center ◽

Surgical Approaches ◽

Care Providers ◽

Institutional Review ◽

Academic Medical ◽

History Of ◽

The Difference ◽

Gynecological Care

Objective. To investigate patient knowledge and attitudes toward surgical approaches in gynecology. Design. An anonymous Institutional Review Board (IRB) approved questionnaire survey. Patients/Setting. A total of 219 women seeking obstetrical and gynecological care in two offices affiliated with an academic medical center. Results. Thirty-four percent of the participants did not understand the difference between open and laparoscopic surgeries. 56% of the participants knew that laparoscopy is a better surgical approach for patients than open abdominal surgeries, while 37% thought that laparoscopy requires the surgeon to have a higher technical skill. 46% of the participants do not understand the difference between laparoscopic and robotic procedures. 67.5% of the participants did not know that the surgeon moves the robot’s arms to perform the surgery. Higher educational level and/or history of previous abdominal surgeries were associated with the highest rates of answering all the questions correctly (p<0.05), after controlling for age and race. Conclusions. A substantial percentage of patients do not understand the difference between various surgical approaches. Health care providers should not assume that their patients have an adequate understanding of their surgical options and accordingly should educate them about those options so they can make truly informed decisions.

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Inpatient Communication Networks: Leveraging Secure Text-Messaging Platforms to Gain Insight into Inpatient Communication Systems

Applied Clinical Informatics ◽

10.1055/s-0039-1692401 ◽

2019 ◽

Vol 10 (03) ◽

pp. 471-478 ◽

Cited By ~ 1

Author(s):

Philip A. Hagedorn ◽

Eric S. Kirkendall ◽

S. Andrew Spooner ◽

Vishnu Mohan

Keyword(s):

Communication Network ◽

Network Analysis ◽

Health Care Providers ◽

Text Messaging ◽

Communication Systems ◽

Medical Center ◽

Academic Medical Center ◽

Care Providers ◽

Academic Medical ◽

The Impact

Objective This study attempts to characterize the inpatient communication network within a quaternary pediatric academic medical center by applying network analysis methods to secure text-messaging data. Methods We used network graphing and statistical software to create network models of an inpatient communication system with secure text-messaging data from physicians, nurses, and other ancillary staff in an academic medical center. Descriptive statistics about the network, users within the network, and visualizations informed the team's understanding of the network and its components. Results Analysis of messages exchanged over approximately 23 days revealed a large, scale-free network with 4,442 nodes and 59,913 edges. Quantitative description of user behavior (messages sent and received) and network metrics (i.e., importance of nodes within a network) revealed several operational and clinical roles both sending and receiving > 1,000 messages over this time period. While some of these nodes represented expected “dispatcher” roles in our inpatient system, others occupied important frontline clinical roles responsible for bedside clinical care. Conclusion Quantitative and network analysis of secure text-messaging logs revealed several key operational and clinical roles at risk for alert fatigue and information overload. This analysis also revealed a communication network highly reliant on these key roles, meaning disruption to these individuals or their workflows could lead to dysfunction of the communication network. While secure text-messaging applications play increasingly important roles in facilitating inpatient communication, little is understood about the impact these systems have on health care providers. Developing methods to understand and optimize communication between inpatient providers might help operational and clinical leaders to proactively prevent poorly understood pitfalls associated with these systems and build resilient and effective communication structures.

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Educational Intervention to Improve Delirium Recognition by Nurses

American Journal of Critical Care ◽

10.4037/ajcc2018851 ◽

2018 ◽

Vol 27 (4) ◽

pp. 270-278 ◽

Cited By ~ 5

Author(s):

Cheri S. Blevins ◽

Regina DeGennaro

Keyword(s):

Health Care ◽

Intensive Care Unit ◽

Intensive Care ◽

Health Care Providers ◽

Educational Intervention ◽

Medical Intensive Care Unit ◽

Medical Center ◽

Academic Medical Center ◽

Care Providers ◽

Medical Intensive Care

Background Delirium poses increased morbidity and mortality risks for hospitalized patients. Underrecognition by health care providers contributes to poor outcomes for patients. Little has been published about methods used to teach health care providers how to screen for delirium using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Objective To evaluate the effectiveness of a multimodal educational intervention for nurses in the medical intensive care unit to improve their knowledge and skills regarding delirium and delirium recognition. Methods An educational intervention was done in the medical intensive care unit of an academic medical center. Effectiveness was evaluated via a quasi-experimental design and using preintervention and postintervention assessments. Procedural correctness of performing the CAM-ICU delirium screening also was measured. Results Nurses participated in 1 small-group session (n = 34). Fifteen sessions were conducted from June to September 2016, and assessments were completed before and after the intervention. The sample consisted of predominantly nurses with a bachelor’s degree (56%) who had 1 to 5 years’ experience (59%). Mean scores overall and on the knowledge subscale differed significantly (P < .001) from before to after the intervention. No correlation was found between demographic groups and score differences. Seventy-nine percent of participants used the tool correctly after the intervention. Conclusions The educational intervention provided for these nurses further validated published reports of the benefits of an educational program about delirium. The content of the educational intervention should be targeted for the setting, the risk factors for the patient population in question, and the specific delirium screening tool used.

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Perceptions of Adult Arkansans Regarding Trusted Sources of Information about the COVID-19 Pandemic (Preprint)

10.2196/preprints.30992 ◽

2021 ◽

Author(s):

Rachel S Purvis ◽

Don E Willis ◽

Ramey Moore ◽

Cari Bogulski ◽

Pearl A McElfish

Keyword(s):

Health Care ◽

Mixed Methods ◽

Health Care Providers ◽

News Media ◽

Online Survey ◽

Medical Center ◽

Academic Medical Center ◽

Local Health ◽

Care Providers ◽

Sources Of Information

BACKGROUND The US leads the world in confirmed COVID-19 cases; Arkansas ranks fifth in average daily cases per 100,000. Historically, Americans relied on health communications from governmental sources and the news media. However, there has been a documented decline of trust in these sources. OBJECTIVE This study seeks to understand trusted sources of information about COVID-19 to improve health messaging because research shows the level of trust is associated with adherence to recommendations. METHODS A mixed methods concurrent triangulation design was used. Data were collected using an online survey and interview instrument from participants (N=1,221) who were 18 years of age or older and residing, employed, or accessing health care in Arkansas. RESULTS Two primary themes related to participants’ perceptions of sources of information about COVID-19 are reported: 1) trusted sources of information and 2) distrust or lack of trust in sources of information. Several subthemes emerged within each primary theme. Results showed high trust in the academic medical center, federal and state public health agencies, and local health care providers. The study also documents diverging voices of distrust and uncertainty in making sense of contradictory information. Participants reported the main reason for their lack of trust was the rapidly changing information and the lack of consistency in information provided across sources. CONCLUSIONS This finding provides insight into the importance of coordination between national, state, and local communications to bolster trust. This study makes a significant contribution as the largest mixed methods study on trusted sources of information for COVID-19.

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Measuring the awareness of health care providers at Benghazi Medical Center for Health Informatics

Proceedings of the 6th International Conference on Engineering & MIS 2020 ◽

10.1145/3410352.3410733 ◽

2020 ◽

Author(s):

Zinab Salah Ali Albayood ◽

Ehab A. Omar Elfallah ◽

Abdelbaset Elghriani

Keyword(s):

Health Care ◽

Health Care Providers ◽

Health Informatics ◽

Medical Center ◽

Care Providers

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Pharmacists’ Perceptions on Their Role, Activities, Facilitators, and Barriers to Practicing in a Post-Intensive Care Recovery Clinic

Hospital Pharmacy ◽

10.1177/0018578718823740 ◽

2019 ◽

Vol 55 (2) ◽

pp. 119-125

Author(s):

Antoinette B. Coe ◽

Rebecca E. Bookstaver ◽

Andrew C. Fritschle ◽

Michael T. Kenes ◽

Pamela MacTavish ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Health Care Providers ◽

Medical Center ◽

Academic Medical Center ◽

Direct Patient Care ◽

Care Providers ◽

Medication Regimen ◽

Medication Reviews ◽

Facilitators And Barriers

Background: Complex medication regimen changes burden intensive care unit (ICU) survivors and their caregivers during the transition to home. Intensive care unit recovery clinics are a prime setting for pharmacists to address patients’ and their caregivers’ medication-related needs. The purpose of this study was to describe ICU recovery clinic pharmacists’ activities, roles, and perceived barriers and facilitators to practicing in ICU recovery clinics across different institutions. Methods: An expert panel of ICU recovery clinic pharmacists completed a 15-item survey. Survey items addressed the pharmacists’ years in practice, education and training, activities performed, their perceptions of facilitators and barriers to practicing in an ICU recovery clinic setting, and general ICU recovery clinic characteristics. Descriptive statistics were used. Results: Nine ICU recovery clinic pharmacists participated. The average number of years in practice was 16.5 years (SD = 13.5, range = 2-38). All pharmacists practiced in an interprofessional ICU recovery clinic affiliated with an academic medical center. Seven (78%) pharmacists always performed medication reconciliation and a comprehensive medication review in each patient visit. Need for medication education was the most prevalent item found in patient comprehensive medication reviews. The main facilitators for pharmacists’ successful participation in an ICU recovery clinic were incorporation into clinic workflow, support from other health care providers, and adequate space to see patients. The ICU recovery clinic pharmacists perceived the top barriers to be lack of dedicated time and inadequate billing for services. Conclusions: The ICU recovery clinic pharmacists address ICU survivors’ medication needs by providing direct patient care in the clinic. Strategies to mitigate pharmacists’ barriers to practicing in ICU recovery clinics, such as lack of dedicated time and adequate billing for pharmacist services, warrant a multifaceted solution, potentially including advocacy and policy work by national pharmacy professional organizations.

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