scholarly journals Nurse adaptability: Implementing clinical trials in the midst of a pandemic

2020 ◽  
Vol 11 (4) ◽  
pp. 30
Author(s):  
Sarah J. Mendez ◽  
Brian Raimondo ◽  
Patricia Hughes

Working in Manhattan, the center of the nations’ outbreak of the novel coronavirus-19 virus truly demonstrated how adaptable nurses are. During this time, multiple clinical research trials began at our academic medical center, NYU Langone Health, as researchers attempted to learn what medical interventions worked best to treat critically-ill COVID-19 patients. In designing and implementing these trials, the researchers had little familiarity with the workings of inpatient hospital units. They did not understand how nursing staff provided care to patients on these units. Likewise, many bedside nurses had never assisted researchers in conducting clinical research on their patients. Therefore, a nursing operations team (NOT) was needed to assist both the research teams and the inpatient nurses. NOT met with the researchers to review proposed clinical research trials and determine how nursing staff would be utilized to complete the required research tasks such as specimen and data collection, study intervention administration, and patient monitoring. Toward that end, NOT developed education and training materials on all of the research trials that were implemented at NYU Langone Health for our bedside nurses. This education included tip sheets, safety huddle rounds with the involved units, and “just in time” education to any nurse whose patient was urgently enrolled in a trial. In this way, NOT helped bedside nurses quickly adapt to their role in assisting the research team conduct their studies on our COVID positive inpatients.


2020 ◽  
Vol 41 (S1) ◽  
pp. s168-s169
Author(s):  
Rebecca Choudhury ◽  
Ronald Beaulieu ◽  
Thomas Talbot ◽  
George Nelson

Background: As more US hospitals report antibiotic utilization to the CDC, standardized antimicrobial administration ratios (SAARs) derived from patient care unit-based antibiotic utilization data will increasingly be used to guide local antibiotic stewardship interventions. Location-based antibiotic utilization surveillance data are often utilized given the relative ease of ascertainment. However, aggregating antibiotic use data on a unit basis may have variable effects depending on the number of clinical teams providing care. In this study, we examined antibiotic utilization from units at a tertiary-care hospital to illustrate the potential challenges of using unit-based antibiotic utilization to change individual prescribing. Methods: We used inpatient pharmacy antibiotic use administration records at an adult tertiary-care academic medical center over a 6-month period from January 2019 through June 2019 to describe the geographic footprints and AU of medical, surgical, and critical care teams. All teams accounting for at least 1 patient day present on each unit during the study period were included in the analysis, as were all teams prescribing at least 1 antibiotic day of therapy (DOT). Results: The study population consisted of 24 units: 6 ICUs (25%) and 18 non-ICUs (75%). Over the study period, the average numbers of teams caring for patients in ICU and non-ICU wards were 10.2 (range, 3.2–16.9) and 13.7 (range, 10.4–18.9), respectively. Units were divided into 3 categories by the number of teams, accounting for ≥70% of total patient days present (Fig. 1): “homogenous” (≤3), “pauciteam” (4–7 teams), and “heterogeneous” (>7 teams). In total, 12 (50%) units were “pauciteam”; 7 (29%) were “homogeneous”; and 5 (21%) were “heterogeneous.” Units could also be classified as “homogenous,” “pauciteam,” or “heterogeneous” based on team-level antibiotic utilization or DOT for specific antibiotics. Different patterns emerged based on antibiotic restriction status. Classifying units based on vancomycin DOT (unrestricted) exhibited fewer “heterogeneous” units, whereas using meropenem DOT (restricted) revealed no “heterogeneous” units. Furthermore, the average number of units where individual clinical teams prescribed an antibiotic varied widely (range, 1.4–12.3 units per team). Conclusions: Unit-based antibiotic utilization data may encounter limitations in affecting prescriber behavior, particularly on units where a large number of clinical teams contribute to antibiotic utilization. Additionally, some services prescribing antibiotics across many hospital units may be minimally influenced by unit-level data. Team-based antibiotic utilization may allow for a more targeted metric to drive individual team prescribing.Funding: NoneDisclosures: None



2021 ◽  
pp. e1-e5
Author(s):  
Somnath Bose ◽  
Akiva Leibowitz

The sudden surge in cases of novel coronavirus disease 2019 (COVID-19) has presented unprecedented challenges in the care of critically ill patients with the disease. A disease-focused checklist was developed to supplement and streamline the existing structure of rounds during a time of significant resource constraint. A total of 51 critical care consultants across multiple specialties at a tertiary academic medical center were surveyed regarding their preference for a structured checklist. Among the respondents, 82% were in favor of a disease-focused checklist. Mechanical ventilation parameters, rescue ventilation strategies, sedation regimens, inflammatory markers specific to COVID-19, and family communication were the elements most commonly identified as being important for inclusion in such a checklist.



2016 ◽  
Vol 46 (3) ◽  
pp. 146-153 ◽  
Author(s):  
Jennifer McElroy ◽  
Cheryl A. Smith-Miller ◽  
Catherine K. Madigan ◽  
Yin Li


1993 ◽  
Vol 36 (6) ◽  
pp. 741-749 ◽  
Author(s):  
Mary E. Charlson ◽  
John P. Allegrante ◽  
James P. Hollenberg ◽  
Ted P. Szatrowski ◽  
Margaret G. E. Peterson ◽  
...  


PLoS ONE ◽  
2015 ◽  
Vol 10 (10) ◽  
pp. e0140768 ◽  
Author(s):  
Erica Rose Denhoff ◽  
Carly E. Milliren ◽  
Sarah D. de Ferranti ◽  
Sarah K. Steltz ◽  
Stavroula K. Osganian


Author(s):  
Kevin B. Read

Background: Librarians and researchers alike have long identified research data management (RDM) training as a need in biomedical research. Despite the wealth of libraries offering RDM education to their communities, clinical research is an area that has not been targeted. Clinical RDM (CRDM) is seen by its community as an essential part of the research process where established guidelines exist, yet educational initiatives in this area are unknown.Case Presentation: Leveraging the author’s academic library’s experience supporting CRDM through informationist grants and REDCap training in our medical center, we developed a 1.5 hour CRDM workshop. This workshop was designed to use established CRDM guidelines in clinical research and address common questions asked by our community through the library’s existing data support program. The workshop was offered to the entire medical center 4 times between November 2017 and July 2018. This case study describes the development, implementation, and evaluation of this workshop.Conclusions: The 4 workshops were well attended and well received by the medical center community, with 99% stating that they would recommend the class to others and 98% stating that they would use what they learned in their work. Attendees also articulated how they would implement the main competencies they learned from the workshop into their work. For the library, the effort to support CRDM has led to the coordination of a larger institutional collaborative training series to educate researchers on best practices with data, as well as the formation of institution-wide policy groups to address researcher challenges with CRDM, data transfer, and data sharing.



2020 ◽  
Vol 4 (4) ◽  
pp. 331-335
Author(s):  
Marissa Stroo ◽  
Kirubel Asfaw ◽  
Christine Deeter ◽  
Stephanie A. Freel ◽  
Rebecca J. N. Brouwer ◽  
...  

AbstractIntroduction:A new competency-based job framework was implemented for clinical research professionals at a large, clinical research-intensive academic medical center. This study evaluates the rates of turnover before and after implementation of the new framework. Turnover in this workforce (as with most) is costly; it contributes to wasted dollars and lost productivity since these are highly specialized positions requiring extensive training, regardless of experience in the field.Methods:Trends in employee turnover for 3 years prior to and after the implementation of competency-based job framework for clinical research positions were studied using human resources data. Employee demographics, turnover rates, and comparisons to national statistics are summarized.Results:Employee turnover within the clinical research professional jobs has decreased from 23% to 16%, a 45% reduction, since the implementation of competency-based job framework.Conclusion:The new jobs and career ladders, both of which are centered on a competency-based framework, have decreased the overall turnover rate in this employee population. Since little is known about the rates of turnover in clinical research, especially in the academic medical setting, the results of this analysis can provide important insights to other academic medical centers on both employee turnover rate in general and the potential impact of implementing large-scale competency-based job changes.



Stroke ◽  
2014 ◽  
Vol 45 (1) ◽  
pp. 271-273 ◽  
Author(s):  
Eric E. Adelman ◽  
William J. Meurer ◽  
Dorinda K. Nance ◽  
Mary Jo Kocan ◽  
Kate E. Maddox ◽  
...  


SLEEP ◽  
2019 ◽  
Vol 42 (Supplement_1) ◽  
pp. A251-A251 ◽  
Author(s):  
Francis Christian ◽  
Kalyan Muppavarapu ◽  
Christopher Aston ◽  
Chee Yoon Bauer ◽  
Viral Doshi


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