Decreasing Perioperative Medication Errors with Standardized Labeling Education

BACKGROUND: Medication errors are prevalent within the perioperative setting (Wahr et al., 2017). The anesthesia provider is the sole professional in charge of the medication process in the operating room, which results in fewer safety checks than in other healthcare settings (Nanji et al., 2016). LOCAL PROBLEM: The proposed scholarly project aimed to reduce medication errors at an academic medical center in the Southeast using an educational module focused on standardized narcotic syringe labeling. The participants were anesthesia providers in the operating room at the project site. METHODS: The Evidence-Based Practice Improvement model was used to guide the development, implementation, and evaluation of the scholarly project. INTERVENTIONS: The project team used an education module created by the Phase I team and disseminated the module to the project participants in three Plan-Do-Study-Act cycles. The outcomes of the project were assessed by counting properly labeled fentanyl and hydromorphone syringes pre-and post-intervention. RESULTS: Data was analyzed and evaluated through the International Business Machines Corporation’s Statistical Package for the Social Sciences Version 29 software application using Chi-Square tests to evaluate for statistical significance. Statistically significant improvements in standardized narcotic syringe labeling were found after implementation. Results showed statistically significant increases in patient and fentanyl concentration labeling compliance. Statistically significant increases in hydromorphone patient labeling compliance also occurred. There was no change in hydromorphone concentration labeling because the syringes were prefilled. CONCLUSION: Improving standardized narcotic syringe labeling led to a reduction in medication errors. Recommendations for sustainability include continued surveillance of syringe labeling compliance by the pharmacy department, including the educational module as a yearly education requirement, and continued communication of compliance rates with anesthesia providers

Trauma Prevalence and Desire for Trauma-Informed Coaching in Collegiate Sports: A Mixed Methods Study

This study investigated trauma prevalence amongst collegiate student-athletes and openness towards trauma-informed coaching practices among athletes and coaches at two small Division III colleges. Surveys gathered quantitative data from athletes (n = 91) and coaches (n =18) and qualitative data from athletes (n = 33). Quantitative results indicated that 52.7% of athletes experienced at least one potentially traumatic event during their lifetime. The most prevalent trauma was unwanted sexual contact. Additionally, 50.5% of athletes experienced sport-based harassment or abuse during their lifetime, with 21.7% of affected athletes experiencing said abuse in college sports. Athletes reported that 8 out of 10 trauma-informed coaching techniques included in the study were already implemented or desired for implementation at rates between 73.2–93.1% on their teams. Coaches also showed support for trauma-informed coaching, with 88.2% indicating they believed the practice was necessary in college athletics and a large majority of coaches agreeing or strongly agreeing with 8 out of 10 techniques. Qualitative results highlighted the variety of impacts that traumatic experiences have on athletes. The most reported themes were negative psychological and performance effects. Findings support the idea that trauma-informed coaching is necessary and desired in collegiate athletics

The Vehicle, Spring 1998

Vol. 39, No. 2 Table of Contents The MarriageStephanie Kavanaughpage 10 UntitledKyla Anthonypage 11 Behind the Old Farmhouse FieldJacob Tolbertpage 12 decomposing tearsDavid Moutraypage 13 brookBrooke Tidballpage 14 Sacred CircleJacob Tolbertpage 15 without discretionMandy Watsonpage 16 HAIRCUTStephanie Kavanaughpage 17 Slave for a DayLizz Lampherepage 18 Taco HellEric Dolanpage 19 Who Am I?Sara Cizmarpage 20 XXJason Brownpage 21-22 Torn PaperJacob Tolbertpage 23-24 Fat GirlsKim Hunterpage 24 UntitledMaureen Rafterypage 25 LegosA. Fijakiewiczpage 26 Black Shoes in JuneErin Maagpage 27 UntitledMaureen Rafterypage 28 TicklishLizz Lampherepage 29 of naiveteMandy Watsonpage 30 The Geology of WaterfallsStephanie Kavanaughpage 31 GratitudeJeanette McCainpage 32 AnswersKim Hunterpage 33 Cornfield MeetDaniel G. Fitzgeraldpage 39https://thekeep.eiu.edu/vehicle/1071/thumbnail.jp

Guidelines of the American Society of Mammalogists for the use of wild mammals in research

Guidelines for use of wild mammal species are updated from the American Society of Mammalogists (ASM) 2007 publication. These revised guidelines cover current professional techniques and regulations involving mammals used in research and teaching. They incorporate additional resources, summaries of procedures, and reporting requirements not contained in earlier publications. Included are details on marking, housing, trapping, and collecting mammals. It is recommended that institutional animal care and use committees (IACUCs), regulatory agencies, and investigators use these guidelines as a resource for protocols involving wild mammals. These guidelines were prepared and approved by the ASM, working with experienced professional veterinarians and IACUCs, whose collective expertise provides a broad and comprehensive understanding of the biology of nondomesticated mammals in their natural environments. The most current version of these guidelines and any subsequent modifications are available at the ASM Animal Care and Use Committee page of the ASM Web site (http://mammalsociety.org/committees/index.asp).American Society of Mammalogist

Human-correlated genetic HCC models identify combination therapy for precision medicine [Pre-print]

Hepatocellular carcinoma (HCC), the most common form of primary liver cancer, is a leading cause of cancer related mortality worldwide. HCC occurs typically from a background of chronic liver disease, caused by a spectrum of predisposing conditions. Tumour development is driven by the expansion of clones that accumulated progressive driver mutations, with hepatocytes the most likely cell of origin. However, the landscape of driver mutations in HCC is independent of the underlying aetiologies. Despite an increasing range of systemic treatment options for advanced HCC outcomes remain heterogeneous and typically poor. Emerging data suggest that drug efficacies depend on disease aetiology and genetic alterations. Exploring subtypes in preclinical models with human relevance will therefore be essential to advance precision medicine in HCC. We generated over twenty-five new genetically-driven in vivo and in vitro HCC models. Our models represent multiple features of human HCC, including clonal origin, histopathological appearance, and metastasis to distant organs. We integrated transcriptomic data from the mouse models with human HCC data and identified four common human-mouse subtype clusters. The subtype clusters had distinct transcriptomic characteristics that aligned with histopathology. In a proof-of-principle analysis, we verified response to standard of care treatment and used a linked in vitro-in vivo pipeline to identify a promising therapeutic candidate, cladribine, that has not been linked to HCC treatment before. Cladribine acts in a highly effective subtype-specific manner in combination with standard of care therapy