Pressure Injury and Restraint Prevalence Surveys: Saving Time and Dollars for Patient Care by Automating Manual Chart Abstraction

Bronson Healthcare Group performs quarterly pressure injury and restraint audits as part of the National Database of Nursing Quality Indicators (NDNQI). The chart abstraction portion of the audit previously required nurses to manually abstract 31 data points. To save time and cost, we used Lean and PDSA process improvement tools to automate the chart abstraction portion of the audit, reducing the number of data points requiring manual abstraction to 2. We validated the automated abstraction by comparing it to abstractions done manually by the audit nurses. We found that an automated process has the potential to reduce the impact of human error inherent in manual abstraction

Experience in Implementing Inpatient Clinical Note Capture via a Provider Order Entry System

Care providers' adoption of computer-based health-related documentation ("note capture”) tools has been limited, even though such tools have the potential to facilitate information gathering and to promote efficiency of clinical charting. The authors have developed and deployed a computerized note-capture tool that has been made available to end users through a care provider order entry (CPOE) system already in wide use at Vanderbilt. Overall note-capture tool usage between January 1, 1999, and December 31, 2001, increased substantially, both in the number of users and in their frequency of use. This case report is provided as an example of how an existing care provider order entry environment can facilitate clinical end-user adoption of a computer-assisted documentation tool—a concept that may seem counterintuitive to som

Investigation into the Medical, Developmental, and Adaptive Behavior Phenotype of Infants and Toddlers with Williams Syndrome

Williams syndrome (WS) is a neurodevelopmental disorder that causes cardiac abnormalities, difficulties eating and sleeping, cognitive delays, and hypersociability. Although researchers have conducted characterizations of children and adults with WS, less is known about younger children with this disorder. This study will characterize the medical, developmental, and adaptive behavior features of infants and children with WS aged 3 months - 5 years. Data for this project was obtained from 16 infants and toddlers who came to the Nationwide Children’s Hospital/Nisonger Center Williams Syndrome Clinic from 2007-2014, including parent reported developmental history, medical data, and standardized developmental testing. Thirty-one percent (31.3%) of parents reported that their infant/toddler with WS had sleeping problems and 58.3% reported feeding difficulties. Delays were noted in the acquisition of developmental milestones, particularly in language development. Levels of adaptive behavior were in the Mildly Delayed range. Within the Practical domain of adaptive behavior (Home Living, Community Use, Health and Safety, Self Care), Community Use skills were significantly stronger than Self Care skills. A significant main effect was also found between the three composite scores on the Bayley Scales of Infant and Toddler Development (Motor, Cognitive, and Language), with lower scores appearing in the Motor Domain. The data collected thus far highlights the need for early intervention in these young children.No embargoAcademic Major: Neuroscienc

Understanding Visualization: A formal approach using category theory and semiotics

This article combines the vocabulary of semiotics and category theory to provide a formal analysis of visualization. It shows how familiar processes of visualization fit the semiotic frameworks of both Saussure and Peirce, and extends these structures using the tools of category theory to provide a general framework for understanding visualization in practice, including: relationships between systems, data collected from those systems, renderings of those data in the form of representations, the reading of those representations to create visualizations, and the use of those visualizations to create knowledge and understanding of the system under inspection. The resulting framework is validated by demonstrating how familiar information visualization concepts (such as literalness, sensitivity, redundancy, ambiguity, generalizability, and chart junk) arise naturally from it and can be defined formally and precisely. This article generalizes previous work on the formal characterization of visualization by, inter alia, Ziemkiewicz and Kosara and allows us to formally distinguish properties of the visualization process that previous work does not

Preventing Emergency Department Overutilization for Florida’s Seasonal Resident Population

Background/Local Problem: Seasonal migration of elderly patients to Lee County, Florida result in overcrowding and prolonged wait times in emergency departments. Many of these seasonal residents dissociate the management of their chronic health conditions with a local provider, therefore utilizing the emergency department for non-urgent needs. Purpose: The Seasonal Resident Navigator Program was intended to enhance the coordination of primary care services for elderly seasonal residents by establishing appointments with local primary care providers (PCP) in order to reduce the overutilization of emergency services and improve patient throughput. Methods: A residency and provider assessment tool was incorporated into the Healthpark Medical Center Emergency Department (ED) nurse triage workflow between November 2017-February 2018 in order to identify seasonal residents, age 65 or greater, without an assigned local provider and facilitate proper follow up appointments. Interventions: The percentage of all seasonal resident encounters at Healthpark Medical Center ED pre-and-post intervention were evaluated as well as the percentage of all seasonal residents that maintained their assigned PCP follow up appointment. Open commentary from patients was evaluated to identify perceived barriers from outpatient follow up. Results/Conclusion: The Seasonal Resident Navigator program will contribute to future trends in emergency department utilization and seasonal resident access to care through enhanced coordination between the acute care and primary care sector

Mythology in the Middle Ages: Heroic Tales of Monsters, Magic, and Might

Myths of gods, legends of battles, and folktales of magic abound in the heroic narratives of the Middle Ages. Mythology in the Middle Ages: Heroic Tales of Monsters, Magic, and Might describes how Medieval heroes were developed from a variety of source materials: Early pagan gods become euhemerized through a Christian lens, and an older epic heroic sensibility was exchanged for a Christian typological and figural representation of saints. Most startlingly, the faces of Christian martyrs were refracted through a heroic lens in the battles between Christian standard-bearers and their opponents, who were at times explicitly described in demonic terms.The book treats readers to a fantastic adventure as author Christopher R. Fee guides them on the trail of some of the greatest heroes of medieval literature. Discussing the meanings of medieval mythology, legend, and folklore through a wide variety of fantastic episodes, themes, and motifs, the journey takes readers across centuries and through the mythic, legendary, and folkloric imaginations of different peoples. Coverage ranges from the Atlantic and Baltic coasts of Europe, south into the Holy Roman Empire, west through the Iberian peninsula, and into North Africa. From there, it is east to Byzantium, Russia, and even the far reaches of Persia. [From the publisher]https://cupola.gettysburg.edu/books/1065/thumbnail.jp

Outlook Magazine, Summer 2018

https://digitalcommons.wustl.edu/outlook/1204/thumbnail.jp