scholarly journals Implementation of iPads to Increase Compliance with Delivery of New Parent Education in the Newborn Nursery: A Retrospective Study (Preprint)

2020 ◽  
Author(s):  
Haritha Pavuluri ◽  
Alicia Grant ◽  
Alexander Hartman ◽  
Lauren Fowler ◽  
Jennifer Hudson ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Standard Deviation ◽  
Healthcare System ◽  
Parent Education ◽  
Parental Education ◽  
Healthcare Providers ◽  
Hospital Setting ◽  
Educational Video ◽  
Tablet Computers ◽  
Improve Compliance

BACKGROUND Abusive Head Trauma (AHT) is a serious health problem affecting more than 3,000 infants annually in the US. The American Academy of Pediatrics and the CDC recommend that healthcare providers counsel new parents about the dangers of AHT. Previous studies showed that parental education is effective at reducing incidents of AHT. South Carolina law requires hospitals to provide all new parents with a state-produced educational video about AHT. This mandate was met in different ways in the several hospital campuses within a large SC healthcare system, with some using DVD players, others using workstations on wheels, and others allowing parents to view the video on their own personal devices. Frequent technical barriers and workflow inefficiencies resulted in low rates of compliance with this mandate at several campuses. To improve compliance with the state mandate, the healthcare system standardized video viewing protocol across all campuses by implementing the use of iPads for parental education. Existing literature suggests that patient education can be improved in the hospital setting by utilizing tablet computers, but our literature search failed to find an evaluation of tablet computers for the education of parents in the newborn nursery. We used the implementation of an iPad-based parental education delivery protocol to evaluate whether tablet computers can improve compliance with delivering new parent education in the hospital setting. OBJECTIVE To evaluate whether the introduction of iPads in the newborn nursery resulted in improved rates of parents being offered the opportunity to view a state-mandated video about AHT. METHODS We interviewed physicians and nurses from the newborn nurseries to determine what previous protocols were in place to educate new parents before a standardized iPad-based protocol was implemented across six campuses of a large SC healthcare system. A retrospective study was conducted by reviewing EHR of 1,491 patients across the six campuses to determine the pre- and post-intervention compliance rates of offering the AHT educational video to parents in the newborn nurseries. RESULTS Compliance increased overall (p<.001) across sites from an average of 41.93% (standard deviation of 46.24) to 99.73% (standard deviation of 0.26).  Four out of six locations saw a significant increase in compliance rates after introducing the iPad intervention (p <.001). The remaining two locations that showed no difference both had very high rates of pre-intervention compliance. CONCLUSIONS Following the implementation of a standardized iPad-based protocol to deliver new parent education, there was significant improvement in the percentage of new parents who were offered the opportunity to view an educational video about AHT in the newborn nursery. Based on these results, other healthcare providers should consider iPads to be a feasible and effective method for delivering hospital-based education to families in the newborn nursery.

scholarly journals Documentation of Screening for Firearm Access by Healthcare Providers in the Veterans Healthcare System: A Retrospective Study

2021 ◽  
Vol 22 (3) ◽  
Author(s):  
Cynthia Brandt ◽  
T. Elizabeth Workman ◽  
Melissa Farmer ◽  
Kathleen Akgun ◽  
Erica Abel ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Healthcare System ◽  
Healthcare Providers ◽  
System A

scholarly journals 139. Impact of Pharmacist Driven Outpatient Fluoroquinolone Stewardship Initiative in Community Based Setting

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S81-S81
Author(s):  
Sarah Norman ◽  
Sara Jones ◽  
Cara Acklin ◽  
Christian Cheatham
Keyword(s):  
Antimicrobial Stewardship ◽  
Healthcare Providers ◽  
Hospital Setting ◽  
Secondary Outcome ◽  
Quality Improvement Initiative ◽  
Oral Antibiotic ◽  
Ambulatory Care Setting ◽  
Community Based ◽  
Before And After ◽  
Physician Network

Abstract Background Antimicrobial stewardship initiatives and efforts have historically had a greater emphasis in the inpatient hospital setting. There is a need for outpatient stewardship, and additionally, accreditation standards are starting to require antimicrobial stewardship efforts in the ambulatory care setting. Fluoroquinolones are a target for antimicrobial stewardship based on their broad-spectrum activity, pharmacokinetics/pharmacodynamics, safety profile, downstream resistance, and risk of super infections. The objective of this study was to compare outpatient fluoroquinolone prescribing rates before and after pharmacist led initiative. Methods This was a prospective, quality improvement initiative between October 1, 2019 to June 1, 2020 at a community-based physician network across Indiana. The pharmacist initiative incorporated a live, educational presentation with intervention 1 and an informational letter to healthcare providers across the outpatient physician network with intervention 2. Data was collected from a computer-generated, prescription report. The primary outcome was fluoroquinolone prescribing rates at Central Indiana (CI) sites before and after pharmacist led interventions. Rate of fluoroquinolone prescribing was defined as total number of fluoroquinolone prescriptions per month. The secondary outcome included percentage of fluoroquinolone use at CI sites. Percentage of fluoroquinolone use was defined as monthly number of fluoroquinolones prescriptions compared to monthly number of all oral antibiotic prescriptions. Results There was a 29.8% decrease (382 vs 268 prescriptions) in outpatient fluoroquinolone prescriptions at CI sites after intervention 1 compared to same month of previous year. There was a 43.7% decrease (428 vs 241 prescriptions) in outpatient fluoroquinolone prescriptions at CI sites after intervention 2. There was an overall 2.4% decrease (4.9% vs 2.5%) in percentage of fluoroquinolone use compared to all oral antibiotics at CI sites after intervention 2 compared to same month of previous year. Conclusion These findings suggest the pharmacist led outpatient antimicrobial stewardship initiative successfully decreased fluoroquinolone prescribing rates across the network. Disclosures Christian Cheatham, PharmD, BCIDP, Antimicrobial Resistance Solutions (Shareholder)

scholarly journals A Retrospective Review of 589 Percutaneous Tracheostomies in a Canadian Community Teaching Hospital

2021 ◽  
pp. 014556132110257
Author(s):  
Dongho Shin ◽  
Andrew Ma ◽  
Yvonne Chan
Keyword(s):  
Retrospective Study ◽  
Teaching Hospital ◽  
Intraoperative Complications ◽  
Percutaneous Tracheostomy ◽  
Hospital Setting ◽  
Complication Rates ◽  
Safe Alternative ◽  
Neck Extension ◽  
Intraoperative Complication ◽  
Community Teaching

Objective: The primary objective of this study was to review the complication rate of percutaneous tracheostomies performed by a single surgeon in a community teaching hospital. Methods: This retrospective study reviewed the patients who underwent percutaneous tracheostomy with bronchoscopic guidance in a community hospital setting between 2009 and 2017. Patients older than the age of 18 requiring percutaneous tracheostomy were chosen for this retrospective study. Patients who were medically unstable, had no palpable neck landmarks, and inadequate neck extension were excluded. Indications for percutaneous tracheostomy included patients who had failed to wean from mechanical ventilation, required pulmonary toileting, or in whom airway protection was required. Results: Of the 600 patients who received percutaneous tracheostomy, 589 patients were included in the study. Intraoperative complication (2.6%) and postoperative complication rates (11.4%) compared similarly to literature reported rates. The most common intraoperative complications were bleeding, technical difficulties, and accidental extubation. Bleeding, tube obstruction, and infection were the most common postoperative complications. Overall burden of comorbidity, defined by Charlson Comorbidity Index, and coagulopathy were also found to be associated with higher complication rates. The decannulation rate at discharge was 46.3%. Conclusion: Percutaneous tracheostomy is a safe alternative to open tracheostomies in the community setting for appropriately selected patients.

scholarly journals Motivational Application of Standardized Antimicrobial Administration Ratios Within a Healthcare System

2020 ◽  
Vol 41 (S1) ◽  
pp. s321-s321
Author(s):  
Stephanie Shealy ◽  
Joseph Kohn ◽  
Emily Yongue ◽  
Casey Troficanto ◽  
Brandon Bookstaver ◽  
...  
Keyword(s):  
Patient Care ◽  
Healthcare System ◽  
Antimicrobial Stewardship ◽  
Broad Spectrum ◽  
Healthcare Providers ◽  
The United States ◽  
Antimicrobial Use ◽  
Gram Positive ◽  
Specific Patient ◽  
Antimicrobial Administration

Background: Hospitals in the United States have been encouraged to report antimicrobial use (AU) to the CDC NHSN since 2011. Through the NHSN Antimicrobial Use Option module, health systems may compare standardized antimicrobial administration ratios (SAARs) across specific facilities, patient care locations, time periods, and antimicrobial categories. To date, participation in the NHSN Antimicrobial Use Option remains voluntary and the value of reporting antimicrobial use and receiving monthly SAARs to multihospital healthcare systems has not been clearly demonstrated. In this cohort study. we examined potential applications of SAAR within a healthcare system comprising multiple local hospitals. Methods: Three hospitals within Prisma Health-Midlands (hospitals A, B, and C) became participants in the NHSN Antimicrobial Use Option in July 2017. SAAR reports were presented initially in October 2017 and regularly (every 3–4 months) thereafter during interprofessional antimicrobial stewardship system-wide meetings until end of study in June 2019. Through interfacility comparisons and by analyzing SAAR categories in specific patient-care locations, primary healthcare providers and pharmacists were advised to incorporate results into focused antimicrobial stewardship initiatives within their facility. Specific alerts were designed to promote early de-escalation of antipseudomonal β-lactams and vancomycin. The Student t test was used to compare mean SAAR in the preintervention period (July through October 2017) to the postintervention period (November 2017 through June 2019) for all antimicrobials and specific categories and locations within each hospital. Results: During the preintervention period, mean SAAR for all antimicrobials in hospitals A, B, and C were 0.69, 1.09, and 0.60, respectively. Notably, mean SAARs at hospitals A, B, and C in intensive care units (ICU) during the preintervention period were 0.67, 1.36, and 0.83 for broad-spectrum agents used for hospital-onset infections and 0.59, 1.27, and 0.68, respectively, for agents used for resistant gram-positive infections. After antimicrobial stewardship interventions, mean SAARs for all antimicrobials in hospital B decreased from 1.09 to 0.83 in the postintervention period (P < .001). Mean SAARs decreased from 1.36 to 0.81 for broad-spectrum agents used for hospital-onset infections and from 1.27 to 0.72 for agents used for resistant gram-positive infections in ICU at hospital B (P = .03 and P = .01, respectively). No significant changes were noted in hospitals A and C. Conclusions: Reporting AU to the CDC NHSN and the assessment of SAARs across hospitals in a healthcare system had motivational effects on antimicrobial stewardship practices. Enhancement and customization of antimicrobial stewardship interventions was associated with significant and sustained reductions in SAARs for all antimicrobials and specific antimicrobial categories at those locations.Funding: NoneDisclosures: None

P20 Parental understanding of concussion in youth rugby is significantly improved by viewing the RFU concussion education video

2019 ◽  
Vol 90 (3) ◽  
pp. e31.1-e31
Author(s):  
T Samuel ◽  
K Aquilina ◽  
W Dawes
Keyword(s):  
Parental Education ◽  
Cross Sectional Study ◽  
Educational Video ◽  
Sectional Study ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Parental Experience ◽  
Increased Risk ◽  
Significant Difference ◽  
Composite Scores

ObjectivesTo investigate the current understanding parents have of concussion in their rugby-playing children aged 9–17.DesignCross-sectional studySubjects86 parents from four clubs completed an online questionnaireMethodsAreas covered (1) Parental experience of concussion (2) Rate of viewing of the RFU concussion educational video (RFUCEV), (3) Identification of symptoms of concussion (4) Understanding of the risk of concussion. Each participant was given a composite score, out of 19, based on their performance in symptom identification and true/false questions. Independent-sample two-tailed t-tests were conducted to analyse scores, primarily controlling for viewing of the RFUCEVResultsThere was a significant difference in the scores between the group that had viewed the RFUCEV (n=32, M=14.75, SD=2.55) and those who had not (n=54, M=13.05, SD=2.87); t(84)=2.75, p=0.00721. Additionally, over 25% of parents reported that their child had suffered a concussion, and this was also found to significantly improve the awareness score (p=0.04678)ConclusionsStatistically significant improvement in composite scores after viewing the RFUCEV makes it reasonable to require compulsory parental education prior to signing up a child to play rugby. This would build on the protocol changes made by the RFU in 2014 and further progress the safety of the sport. We suggest the video be improved to emphasise the areas highlighted as inadequately understood, including the increased risk of concussion in under-18s compared to adults.

A HIPAA Security and Privacy Compliance Audit and Risk Assessment Mitigation Approach

2021 ◽  
Vol 3 (2) ◽  
pp. 28-45
Author(s):  
Young B. Choi ◽  
Christopher E. Williams
Keyword(s):  
Healthcare System ◽  
Information Assurance ◽  
Healthcare Providers ◽  
Security And Privacy ◽  
Privacy Requirements ◽  
Security Controls ◽  
The Us ◽  
Compliance Audit ◽  
And Control ◽  
Health Laws

Data breaches have a profound effect on businesses associated with industries like the US healthcare system. This task extends more pressure on healthcare providers as they continue to gain unprecedented access to patient data, as the US healthcare system integrates further into the digital realm. Pressure has also led to the creation of the Health Insurance Portability and Accountability Act, Omnibus Rule, and Health Information Technology for Economic and Clinical Health laws. The Defense Information Systems Agency also develops and maintains security technical implementation guides that are consistent with DoD cybersecurity policies, standards, architectures, security controls, and validation procedures. The objective is to design a network (physician's office) in order to meet the complexity standards and unpredictable measures posed by attackers. Additionally, the network must adhere to HIPAA security and privacy requirements required by law. Successful implantation of network design will articulate comprehension requirements of information assurance security and control.

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