scholarly journals Survey of resident physician and attending physician feedback perceptions: There is still work to be done

2019 ◽  
Vol 25 (12) ◽  
Author(s):  
Tamar Hajar ◽  
Karolyn A Wanat ◽  
Nicole Fett
Keyword(s):  
Resident Physician ◽  
Attending Physician ◽  
Feedback Perceptions

scholarly journals Improving population health in resident clinics: increasing pneumonia vaccination rates in adults 65 years and older

2020 ◽  
Vol 9 (4) ◽  
pp. e000830
Author(s):  
Sheila McGreevy ◽  
Caylin McGowan ◽  
Kristin Gillenwater ◽  
Rebecca Opole ◽  
Meena Veluri ◽  
...  
Keyword(s):  
Intervention Group ◽  
Bacterial Pathogen ◽  
The Elderly ◽  
Vaccination Rate ◽  
Resident Physician ◽  
Control Group ◽  
Vaccination Rates ◽  
Attending Physician ◽  
And Control ◽  
Verbal Encouragement

Streptococcus pneumoniae is a significant bacterial pathogen, especially in the elderly. There are two types of pneumococcal vaccines, one with polysaccharides from the capsule of 23 serotypes (PPSV23) and one with polysaccharides from 13 serotypes that have been conjugated to a protein (PCV13). Both vaccines decrease the incidence of invasive pneumococcal disease and are recommended for all people ≥65 years of age. We found the vaccination rate against S. pneumoniae in patients ≥65 years of age in our resident physician continuity clinics was 59.85%, which is considerably lower than the vaccination rate of 69.16% in our attending physician clinics. The aim of our study was to double the number of vaccinations given in the resident physician clinics over a 1-month period without compromising workflow or unduly burdening the rooming nurse or resident physicians. For our primary intervention, we assigned a designated nurse with expertise in vaccinations the task of reviewing charts ahead of clinic visits then pending the order for the appropriate pneumococcal vaccine. Our secondary intervention was the education of physicians through pocket cards, verbal encouragement and email reminders. χ² test was conducted to compare the proportion of patients 65 years or older who were vaccinated between the intervention and control groups. The results indicated that the intervention group patients were 2.61 times (95% CI 1.18 to 6.10) more likely to be vaccinated compared with the control group patients (20% vs 8.7%, χ2 (1)=5.16, p=0.02, Cramer’s V=0.16). The intervention resulted in more than doubling the number of vaccinations in the intervention group compared with the control group. Moreover, poststudy interviews and surveys indicated our workflow is sustainable and amendable to wider use within the resident physician clinics.

Nursing Liability and Chain of Command

2009 ◽  
Vol 28 (6) ◽  
pp. 401-402
Author(s):  
Harriett Twiggs Smalls
Keyword(s):  
Candida Albicans ◽  
Night Shift ◽  
Resident Physician ◽  
Cancer Drug ◽  
Chain Of Command ◽  
The Right ◽  
Attending Physician ◽  
Attending Physicians

SCENARIO: A FIVE-DAY-OLD INFANT is diagnosed with systemic Candida albicans (yeast). During rounds, the resident physician is told to start 5FC (flucytosine). When the order is written, it is for 5FU (fluorouracil, a cancer drug). The medication arrives on the unit; the nurse checks it against the order and determines that it is for the right patient, right dose, right route, right time, and, according to the order, right drug. The infant receives the drug from nurses on two shifts. The nurse on the night shift, a new nurse, asks why the infant is receiving a cancer drug. She calls the pharmacy to question it, then calls the resident physician and is told that it was what the attending physician said to order. Despite the nurse’s insistence that this is not the right drug, the resident demands that she give the drug as ordered. She gives the drug. The next morning the infant dies. A lawsuit is brought in which the resident, attending physicians, and hospital are named as defendants. The hospital is sued because of the negligence of its nurses who failed to question the order to give 5FU.

Handbooks or mentors? The role of a resident physician manual in resident education

2005 ◽  
Author(s):  
Danny Ho ◽  
Yan Xiao ◽  
F. Jacob Seagull ◽  
Amy Sisley ◽  
Richard Dutton ◽  
...  
Keyword(s):  
Resident Education ◽  
Resident Physician

The Impact of Primary Care Resident Physician Training on Patient Weight Loss at 12 Months

Obesity ◽  
2012 ◽  
Author(s):  
Melanie R. Jay ◽  
Colleen C. Gillespie ◽  
Sheira L. Schlair ◽  
Stella M. Savarimuthu ◽  
Scott E. Sherman ◽  
...  
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Resident Physician ◽  
Physician Training ◽  
Primary Care Resident ◽  
Patient Weight ◽  
The Impact

Comparison of Fluorine(18)-fluorodeoxyglucose and Gallium(68)-citrate PET/CT in patients with tuberculosis

2019 ◽  
Vol 58 (05) ◽  
pp. 371-378
Author(s):  
Alfred O. Ankrah ◽  
Ismaheel O. Lawal ◽  
Tebatso M.G. Boshomane ◽  
Hans C. Klein ◽  
Thomas Ebenhan ◽  
...  
Keyword(s):  
Tracer Uptake ◽  
Pet Ct ◽  
The Mean ◽  
18F Fdg ◽  
Definition Of ◽  
Gallium 68 ◽  
Attending Physician ◽  
Pet Scans ◽  
The Brain

Abstract 18F-FDG and 68Ga-citrate PET/CT have both been shown to be useful in the management of tuberculosis (TB). We compared the abnormal PET findings of 18F-FDG- and 68Ga-citrate-PET/CT in patients with TB. Methods Patients with TB on anti-TB therapy were included. Patients had a set of PET scans consisting of both 18F-FDG and 68Ga-citrate. Abnormal lesions were identified, and the two sets of scans were compared. The scan findings were correlated to the clinical data as provided by the attending physician. Results 46 PET/CT scans were performed in 18 patients, 11 (61 %) were female, and the mean age was 35.7 ± 13.5 years. Five patients also had both studies for follow-up reasons during the use of anti-TB therapy. Thirteen patients were co-infected with HIV. 18F-FDG detected more lesions than 68Ga-citrate (261 vs. 166, p < 0.0001). 68Ga-citrate showed a better definition of intracerebral lesions due to the absence of tracer uptake in the brain. The mean SUVmax was higher for 18F-FDG compared to 68Ga-citrate (5.73 vs. 3.01, p < 0.0001). We found a significant correlation between the SUVmax of lesions that were determined by both tracers (r = 0.4968, p < 0.0001). Conclusion Preliminary data shows 18F-FDG-PET detects more abnormal lesions in TB compared to 68Ga-citrate. However, 68Ga-citrate has better lesion definition in the brain and is therefore especially useful when intracranial TB is suspected.

A retrospective audit of antibiotic prescriptions in a Lebanese Hospital

2019 ◽  
Vol 15 (1) ◽  
Author(s):  
Mohamad Ibrahim ◽  
Zeinab Bazzi
Keyword(s):  
Epidemiological Data ◽  
Antibiotic Use ◽  
Antibiotic Prescribing ◽  
Team Approach ◽  
Strong Correlations ◽  
Prescribing Practices ◽  
Antimicrobial Drugs ◽  
Stewardship Program ◽  
Retrospective Audit ◽  
Attending Physician

Despite the frequent alarms that have been published about the adverse effects of antibiotic use and misuse, physicians prescribe to patients approximately fifty percent of unnecessary antimicrobials. In an attempt to decrease the emergence of antimicrobial resistance and increase awareness, a team approach is required to address this prescribing phenomenon in a feasible manner. A retrospective study was done at a one-hundred-forty-bed hospital with a representative sample size of 368 patients. Patient data was collected and analyzed by a stewardship team. The overall antibiotic inappropriate rate was 45.8%, which is relatively high and consistent with the findings of other studies mentioned in the literature. This study aimed to provide baseline epidemiological data on the use of antibiotics in a Lebanese hospital and has revealed several notable patterns of antibiotic prescribing practices among Lebanese physicians such as the use of antimicrobial drugs example penicillin was consistently high. Strong correlations were identified between the type of attending physician and antibiotic appropriateness. These findings will be important in constructing an antimicrobial stewardship program to reduce antibiotic misuse.

Information Behavior Factors Related to Satisfaction with Treatment Decisions in Parents of Children with Cancer (Preprint)

2018 ◽  
Author(s):  
Makiko Watanabe
Keyword(s):  
Health Literacy ◽  
Information Sources ◽  
Information Behavior ◽  
Treatment Decision ◽  
Treatment Decisions ◽  
Medical Institution ◽  
Information Utilization ◽  
Critical Health Literacy ◽  
Satisfaction With Treatment ◽  
Attending Physician

BACKGROUND Information behavior studies in modern medicine are indispensable not only for medical professionals but also in considering health outcomes for patients and health consumers. However, quantitative surveys do not provide sufficient information, and the medical information available on the Internet has not been analyzed in detail. OBJECTIVE The purpose of this study was to examine the relationship between information behavior and satisfaction with treatment decisions in patients and their family members and explore the characteristics of information behavior involved in treatment decisions. METHODS A retrospective, cross-sectional survey was conducted using a questionnaire (58 respondents, response rate 59.2%) for 105 parents of children with cancer at a children’s hospital in Japan. Multiple regression analysis was performed to determine whether information behavior influenced satisfaction with treatment decisions, and correlation analysis was performed to examine the relationships between information behaviors. The analysis included 15 information sources and information behavior measured as the communicative health literacy, critical health literacy, and Shared Decision Making measured using the Functional, Communicative and Critical Health Literacy Scale and the Treatment Decision Satisfaction Scale consisting of 6 items. RESULTS The results regarding the RQ1 showed that the attending physician (P = .044), medical institution websites (P = .038), medical books/scientific papers (including those published in English; P = .020), and communicative health literacy (which reflects information utilization capability; P = .048), influenced satisfaction with treatment decisions. The results regarding the RQ2 showed that parents who used the attending physician as an information source did not receive information from other sources apart from a hospital medical professional. On the other hand, parents who used medical institution websites as information sources received various descriptive information. CONCLUSIONS We identified Internet-based information sources that influenced satisfaction with treatment decisions. We identified that the parent's information behavior tended to have a positive influence on the treatment decision when the attending physician and the medical institution’s Health Practitioner, HP, were the information sources, or when they recognized that there was a high communicative HL and utilized the information. Furthermore, the variables used to measure information behavior were divided into several groups based on association. Regarding satisfaction with treatment decisions correlating with each other, information behavior reflected the possibility of establishing links with information sources with direct influence, related information sources, and information utilization capability.

The Esophageal Detector Device: Accuracy and Reliability in Difficult Airway Settings

1996 ◽  
Vol 11 (1) ◽  
pp. 60-62 ◽  
Author(s):  
Christopher E. Kapsner ◽  
David C. Seaberg ◽  
Charles Stengel ◽  
Kaveh Ilkhanipour ◽  
James Menegazzi
Keyword(s):  
Emergency Medicine ◽  
Pulmonary Edema ◽  
Difficult Airway ◽  
Laboratory Investigation ◽  
Respiratory Arrest ◽  
Tube Placement ◽  
Mainstem Bronchus ◽  
Anatomic Location ◽  
The Right ◽  
Attending Physician

AbstractIntroduction:The esophageal detector device (EDD) recently has been found to assess endotracheal (ET) tube placement accurately. This study describes the reliability of the EDD in determining the position of the ET tube in clinical airway situations that are difficult.Methods:This was a prospective, randomized, single-blinded, controlled laboratory investigation. Two airway managers (an emergency-medicine attending physician and a resident) determined ET-tube placement using the EDD in five swine in respiratory arrest. The ET tube was placed in the following clinical airway situations: 1) esophagus; 2) esophagus with 1 liter of air instilled; 3) trachea; 4) trachea with 5 ml/kg water instilled; and 5) right mainstem bronchus. Anatomic location of the tube was verified by thoracotomy of the left side of the chest.Results:There was 100% correlation between the resident and attending physician's use of the EDD. The EDD was 100% accurate in determining tube placement in the esophagus, in the esophagus with 1 liter of air instilled, in the trachea, and in the right mainstem bronchus. The airway managers were only 80% accurate in detecting tracheal intubations when fluid was present.Conclusions:The EDD is an accurate and reliable device for detecting ET-tube placement in most clinical situations. Tube placement in fluid-filled trachea, lungs, or both, which occurs in pulmonary edema and drowning, may not be detected using this device.

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