A video-based educational intervention for providers regarding colorectal cancer screening

Methods: Email sent to providers asking them to complete a 7 question survey regarding knowledge and self-reported comfort in screening for colorectal cancer using a shared decision-making approach.https://jdc.jefferson.edu/patientsafetyposters/1045/thumbnail.jp

Creating Improved Communication Between Nursing and Physicians: Importance of Collaboration within a Hospital System

Background: Optimal communication between all members of the healthcare team is important to ensure safe and efficient patient care.Objective: To improve communication between nurses and resident physicians by developing and implementing a paging protocol.Methods: A resident-led workgroup was assembled to identify opportunities for improving communication. A survey was designed to assess current practices and perceptions related to resident and nurse communication. A facilitated focus group of residents and nurses met on two separate occasions to review the survey results and develop a set of mutually agreeable paging guidelines. The group chose to adopt the ISBARR communication tool and planned educational interventions accordingly. Residents and nurses were resurveyed roughly three months’ post-intervention.Results: The results indicated a 12.8% reduction (p=0.017) in the percentage of nurse respondents that “never” inquire whether or not another nurse on the unit needs to speak with the same physician prior to paging. A 10.3% increase (p=0.033) in resident respondents that “usually” receive grouped pages, and an 11% reduction (p=0.042) in the percentage of resident respondents that “never: receive grouped pages. However, only 53.3% (n=60) of nurse respondents and 44.1% (n=68) of resident respondents felt their ISBARR training was adequate. Moreover, only 38.4% and 30.9% of nurse and resident respondents, respectively felt the paging guidelines and ISBARR had improved overall communications between the two groups.Conclusions: While the follow-up survey results revealed some improvements in paging practices, the need for continued education was clear

Pediatric Hand Treadmill Injuries

The great popularity of physical fitness in modern society has brought many pieces of exercise equipment into our homes for convenience and privacy. This trend has come with an increasing rate of injuries to children who curiously touch moving parts, including treadmill belts. Experience with a recent series of treadmill contact burns to children's hands is described in this article. A retrospective chart review at a tertiary referral center from June 1998 until June 2001 found six children sustaining hand burns from treadmills. The patients' ages at presentation ranged from 15 to 45 months (average of 31 months, three boys and three girls). All injuries occurred in the home while a parent was using the treadmill. Burns involved the palmar aspect of the hand, mostly confined to the fingers, and the severity ranged from partialto full-thickness burns. All patients were initially managed with collagenase and bacitracin zinc/polymyxin B powder dressings to second-and third-degree burns, along with splinting and rangeof-motion exercises. Two patients required skin grafting at 2 weeks and 2 months for full-thickness tissue loss and tight joint contracture, respectively. At an average follow-up of 12 months, all patients had full range of motion and no physical limitation. The rate of children injured by exercise equipment is expected to increase. Friction burns to the hands remain a concern, although early recognition and appropriate management are associated with excellent functional outcomes. Protective modification of exercise machines seems to be the best approach to eliminating these injuries

Higher IL-6 and IL6:IGF Ratio in Patients with Barth Syndrome

Background: Barth Syndrome (BTHS) is a serious X-linked genetic disorder associated with mutations in the tafazzin gene (TAZ, also called G4.5). The multi-system disorder is primarily characterized by the following pathologies: cardiac and skeletal myopathies, neutropenia, growth delay, and exercise intolerance. Although growth anomalies have been widely reported in BTHS, there is a paucity of research on the role of inflammation and the potential link to alterations in growth factors levels in BTHS patients. Methods: Plasma from 36 subjects, 22 patients with Barth Syndrome (0.5 - 24 yrs) and 14 healthy control males (8 - 21 yrs) was analyzed for two growth factors: IGF-1 (bound and free) and Growth Hormone (GH); and two inflammatory cytokines IL-6 and TNF-α using high-sensitivity enzyme-linked immunosorbent assays. Results: The average IL-6 and IL6:IGF ratio levels were significantly higher in the BTHS (p = 0.046 and 0.02 respectively). As for GH, there was a significant group by age interaction (p = 0.01), such that GH was lower for BTHS patients under the age of 14.4 years and higher than controls after age 14.4 years. TNF-α levels were not significantly different, however, the TNF-α:GH was lower in BTHS patients than controls (p = 0.01). Conclusions: Comparison of two anabolic growth mediators, IGF and GH, and two catabolic cytokines, IL-6 and TNF-α, in BTHS patients and healthy age-matched controls demonstrated a potential imbalance in inflammatory cytokines and anabolic growth factors. Higher rates of IL-6 (all ages) and lower GH levels were observed in BTHS patients (under age 14.5) compared to controls. These findings may implicate inflammatory processes in the catabolic nature of Barth Syndrome pathology as well as provide a link to mitochondrial function. Furthermore, interactions between growth factors, testosterone and inflammatory mediators may explain some of the variability in cardiac and skeletal myopathies seen in Barth Syndrome

The Interdisciplinary Curriculum for Oncology Palliative Care Education (iCOPE): Meeting the Challenge of Interprofessional Education

Abstract Background: Interprofessional education is necessary to prepare students of the health professions for successful practice in today's health care environment. Because of its expertise in interdisciplinary practice and team-based care, palliative care should be leading the way in creating educational opportunities for students to learn the skills for team practice and provision of quality patient-centered care. Multiple barriers exist that can discourage those desiring to create and implement truly interdisciplinary curriculum. Design: An interdisciplinary faculty team planned and piloted a mandatory interdisciplinary palliative oncology curriculum and responded to formative feedback. Setting/Subjects: The project took place at a large public metropolitan university. Medical, nursing, and social work students and chaplains completing a clinical pastoral education internship participated in the curriculum. Measurements: Formative feedback was received via the consultation of an interdisciplinary group of palliative education experts, focus groups from students, and student evaluations of each learning modality. Results: Multiple barriers were experienced and successfully addressed by the faculty team. Curricular components were redesigned based on formative feedback. Openness to this feedback coupled with flexibility and compromise enabled the faculty team to create an efficient, sustainable, and feasible interdisciplinary palliative oncology curriculum. Conclusion: Interdisciplinary palliative education can be successful if faculty teams are willing to confront challenges, accept feedback on multiple levels, and compromise while maintaining focus on desired learner outcomes

Knowledge, attitudes, and fear of COVID-19 during the Rapid Rise Period in Bangladesh

The study aims to determine the level of Knowledge, Attitude, and Practice (KAP) related to COVID-19 preventive health habits and perception of fear towards COVID-19 in subjects living in Bangladesh. Design: Prospective, cross-sectional survey of (n = 2157) male and female subjects, 13–88 years of age, living in Bangladesh. Methods: Ethical approval and trial registration were obtained before the commencement of the study. Subjects who volunteered to participate and signed the informed consent were enrolled in the study and completed the structured questionnaire on KAP and Fear of COVID-19 scale (FCV-19S). Results: Twenty-eight percent (28.69%) of subjects reported one or more COVID-19 symptoms, and 21.4% of subjects reported one or more co-morbidities. Knowledge scores were slightly higher in males (8.75± 1.58) than females (8.66± 1.70). Knowledge was significantly correlated with age (p < .005), an education level (p < .001), attitude (p < .001), and urban location (p < .001). Knowledge scores showed an inverse correlation with fear scores (p < .001). Eighty-three percent (83.7%) of subjects with COVID-19 symptoms reported wearing a mask in public, and 75.4% of subjects reported staying away from crowded places. Subjects with one or more symptoms reported higher fear compared to subjects without (18.73± 4.6; 18.45± 5.1). Conclusion: Bangladeshis reported a high prevalence of self-isolation, positive preventive health behaviors related to COVID-19, and moderate to high fear levels. Higher knowledge and Practice were found in males, higher education levels, older age, and urban location. Fear of COVID-19 was more prevalent in female and elderly subjects. A positive attitude was reported for the majority of subjects, reflecting the belief that COVID-19 was controllable and containable