Analyzing Perceptions of University of Mississippi Pre-Health Students Regarding the Effectiveness of Medical Interpretation Options

This study investigates the perceptions of pre-health students regarding which clinical interpretation options are most effective, while also assessing their personal proficiencies of the Spanish language. Information obtained from the research survey provides a basis of research that may aid in assessing trends of interpretation services, allowing for improvements to be made to these services prior to the influx of Hispanic/Latino residents into Mississippi. This investigation is entirely conducted at the University of Mississippi and includes the ideas of undergraduate pre-medical students, pre-pharmacy students, pre-PA (physician’s assistant) students, pre-PT (physical therapy) students, pre-speech therapy students, and pre-nursing students. After 61 undergraduate students provided responses to the survey via SurveyMonkey, health professionals at the University of Mississippi were asked to provide commentary on the results, indicating preferences for bilingual doctors serving interpreting functions. The most significant results of this study support previous research on Spanish interpreters in the health care professions. Pre-med students at the University of Mississippi are indeed following the norms for the rest of the nation in recognizing a need for Spanish bilingual doctors and professionally trained in-person interpreters in the clinical setting. The surprising results, however, indicate that pre-med students at the University of Mississippi believe that Spanish bilingual doctors and professionally trained in-person interpreters offer more accessible and affordable services than previous research signifies

The evaluation of an evidence-based clinical answer format for pediatricians

<p>Abstract</p> <p>Background</p> <p>Clinicians are increasingly using electronic sources of evidence to support clinical decision-making; however, there are multiple demands on clinician time, and summarised and synthesised evidence is needed. Clinical Answers (CA) have been developed to address this need; the CA is a synthesised evidence-based summary that supports point-of-care clinical decision-making. The aim of this paper is to report on a survey used to test and improve the CA format.</p> <p>Methods</p> <p>An online survey was sent to pediatricians via e-mail and posted on a child health clinical standards website. Quantitative data analysis consisted primarily of descriptive statistics; qualitative data analysis consisted of content analysis.</p> <p>Results</p> <p>Eighty-three pediatricians responded to the survey. Most respondents found the CA useful or very useful (93%) and agreed or strongly agreed that the layout was effective and allowed them to quickly locate critical information (82%). Quantitative and qualitative data suggested that respondents thought there should be less detail in the linked figures and tables (p = 0.0002), but overall respondents seemed to think there was an appropriate level of detail in most sections of the CA.</p> <p>Conclusions</p> <p>Based on the quantitative and qualitative survey responses, major and minor modifications to the CA format were implemented, such as removing forest plots, adding links in each addendum to bring the user back to the front page, and adding an 'Implications for practice' section to the CA. Findings suggest that CAs will be a useful tool for pediatricians; thus, the research team has now begun creating CAs to assist busy clinicians in their day-to-day clinical practice by providing high-quality information for decision-making at the point-of-care.</p

Providing better clinical reference sources at the point of care

Physicians frequently need clinical reference material at the time they are taking care of patients, but despite the widespread availability of seemingly appropriate resources, physicians do not consistently avail themselves. Previous research has shown that the main obstacle to resource use is lack of time to search, followed by inability to find the information even with extended searching. Using a randomly selected sample of previously published questions (Clinical Questions Collection at the National Library of Medicine), current online electronic clinical reference resources were searched. Search times, success rates, and result quality were compared. Retrieval of drug information was dominated by navigation time, whereas searches for other materials were dominated by search time. It was rare that actually reading the material required significant time. Based on the results, an improved interface for accessing clinical reference data is proposed. Key features include a "Fast" interface that minimizes navigation time to easily found resources and a "Flex" interface that minimizes search time for more arcane material.Master of Science in Information Scienc

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Scripted Communication

Variables related to scripted communication and patient satisfaction was studied. Patients who were admitted to the hospital and had inpatient status considered for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction survey. Inclusion criteria for the study population were if the patient was not a newborn, deceased, a ward of the state, or a No Publicity patient. The HCAHPS survey was only sent every 90 days per The Agency for Healthcare Research and Quality (CRMC, 2012). The independent variable was scripted communication with the use of AIDET (Acknowledge, Introduce, Duration, Explanation, Thanking) measured by the HCAHPS survey. The dependent variable was patient satisfaction. This Capstone project increased physicians, nurses, and hospital awareness of patient centered communication directly impacts patient satisfaction

Investigating the attitudes and perceptions of pharmacy technicians in the dispensing of naloxone in pharmacies across Massachusetts

The number of opioid-related overdose deaths in the United States has quadrupled since 1999. For this reason, in October 2017 President Donald Trump declared the opioid epidemic a public health emergency. Massachusetts is particularly affected by the opioid epidemic as evident in an opioid-related death rate that is double the national rate. Naloxone is a prescription medication that works antagonistically to bind opioid receptors and rapidly reverses and blocks the effects of opioids. This drug is widely used to revive patients who are experiencing an opioid overdose. Prior research on the topic of attitudes toward naloxone prescriptions and dispensing has focused primarily on three groups of people: patients, prescribers, and pharmacists. However, in recent years there has been an expansion of the role of the pharmacy technician in healthcare administration, such as in the administration of vaccines. Thus, there is a lack of research centered on the role of pharmacy technicians in the dispensing of naloxone. The aim of this study was to investigate the attitudes and perceptions of pharmacy technicians in the dispensing of naloxone across Massachusetts. This goal was accomplished by purposively sampling CVS pharmacies in 13 municipalities across the state, with 7 municipalities having an opioid-related death rate per 100,000 people greater than the state average and 6 municipalities having an opioid-related death rate per 100,000 people less than the state average. These municipalities were termed High-Risk Municipalities and Low-Risk Municipalities, respectively. Three CVS pharmacies were sampled within each municipality, yielding a total sample size of 39 CVS pharmacies with 21 from High-Risk Municipalities and 18 from Low-Risk Municipalities. Pharmacy technicians working in each pharmacy were administered a survey pertaining to their attitudes and perceptions on naloxone dispensing. The results of this study demonstrated that there was a significant difference between technicians working in High-Risk Municipalities and Low-Risk Municipalities regarding the percentage of patients who they believed could benefit from naloxone. Specifically, 67% of participants in Low-Risk Municipalities indicated that less than 25% of patients could benefit from having a naloxone kit available whereas 67% of participants in High-Risk Municipalities indicated that greater than 50% of patients could benefit (Mann-Whitney U significance level = 0.001). This result is critical, especially considering the fact that there was no significant difference between both groups of technicians on their perceptions of patients who used illicit opioids or prescription opioids. In addition, unsolicited feedback from participants revealed several common themes among technicians working in both groups, including the belief that patients could benefit from a reduced cost of naloxone and that both technicians and patients may be unaware that naloxone can benefit individuals taking prescription opioids rather than just people who inject drugs. Future studies could investigate whether participant characteristics, such as years of experience working in the pharmacy may have influenced the results. Also, future research could be directed toward determining if there might be a relationship between syringe sales and naloxone sales in High-Risk Municipalities

A Retrospective Comparative Analysis of a CMS Nursing Home Compare Five-Star Quality Measure: Are We Improving Care?

This paper is a retrospective analysis of the pre- and post-implementation of a CMS quality measure designed for its Nursing Home Compare Five-Star Quality Rating System. The measure, Percentage of short-stay residents who have had an outpatient emergency room visit (Medicare claims-based) introduced in 2016, was added due to the increasing rates of resident transfers to acute-care facilities. The skilled nursing facility’s performance outcomes of this measure will determine payment by CMS as part of the new skilled nursing facility value-based purchasing program (SNF VBP), which is set to be implemented in 2019. Methods: Information found in the Skilled Nursing Facility records within the Medicare 5% national sample data set comprised the data for the study. Time frames for the applicable data were from January through December of 2015 and January through December 2016. Data was selected for all nursing home residents with a nursing home stay of 30 days or less (short-stay residents). Results: A total of 126,098 patients were examined within the dataset, 63,546 discharges were included for 2015 and 62,552 discharges for 2016. A total of 39,275 patients were transferred from a SNF to the hospital with 20,248 (31.86%) transferred in the pre-quality measure implementation year, and 19,027 (30.42%) in the post quality improvement year. The percent of patients who were transferred to a hospital declined from 31.9% in 2015 to 30.4% in 2016. Conclusion: The rate of transfer of short-stay SNF residents was reduced in the post-quality measure implementation year 2016. It is unknown if the reduction in transfers was a direct result of the implementation of the quality measure or due to other causes. Answering this question warrants the need for future research

Evidence-based medicine among internal medicine residents in a community hospital program using smart phones

BACKGROUND: This study implemented and evaluated a point-of-care, wireless Internet access using smart phones for information retrieval during daily clinical rounds and academic activities of internal medicine residents in a community hospital. We did the project to assess the feasibility of using smart phones as an alternative to reach online medical resources because we were unable to find previous studies of this type. In addition, we wanted to learn what Web-based information resources internal medicine residents were using and whether providing bedside, real-time access to medical information would be perceived useful for patient care and academic activities. METHODS: We equipped the medical teams in the hospital wards with smart phones (mobile phone/PDA hybrid devices) to provide immediate access to evidence-based resources developed at the National Library of Medicine as well as to other medical Websites. The emphasis of this project was to measure the convenience and feasibility of real-time access to current medical literature using smart phones. RESULTS: The smart phones provided real-time mobile access to medical literature during daily rounds and clinical activities in the hospital. Physicians found these devices easy to use. A post-study survey showed that the information retrieved was perceived to be useful for patient care and academic activities. CONCLUSION: In community hospitals and ambulatory clinics without wireless networks where the majority of physicians work, real-time access to current medical literature may be achieved through smart phones. Immediate availability of reliable and updated information obtained from authoritative sources on the Web makes evidence-based practice in a community hospital a reality

Practical Strategies for Pharmacist Integration with Primary Care: A Workbook.

This workbook is a practical set of tips and resources to assist pharmacists in providing clinical pharmacy services to primary care providers and their patients. The content was written based on experiences in Vermont in 2014, however the topics should generalize to pharmacists in other areas

Emergency care practitioner students’ satisfaction with simulation across two universities in South Africa

Background Simulation learning is an educational strategy that has been used in South African Emergency Care Practitioner training for at least a decade. No authors had previously measured the satisfaction of South African ECP students with simulation learning. Objective The objectives of this study were to explore the simulation satisfaction of students from two universities in South Africa, and to describe the simulation satisfaction using descriptive statistics. Methods This cross-sectional, descriptive, quantitative study used an English, electronic version of the SSES with one item from the tool deleted. Results A total of 81 students participated in the study - 32 from Nelson Mandela University (NMU) (39.5%) and 49 (60.5%) from the University of Johannesburg (UJ). Statistically significant differences were noted between the two groups in all three factors between the students from NMU and UJ: debriefing and reflection (median = 3.5 vs median = 4.2; p = 0.000; r = 0.5), clinical reasoning (median = 3.6 vs median = 4.0; p=0.002; r = 0.3.) and clinical learning (median = 3.7 vs median = 4.0; p=0.005; r = 0.3). Conclusions Students from both universities have had an overall positive experience of simulation learning, the students from UJ reported higher levels of satisfaction with simulation. These data provide important information for ECP student educators and highlight areas of satisfaction as well as dissatisfaction with simulation learning. This study also indicates that further research is required into the ECP student experiences of simulation learning in South Africa