Evaluating the success of an inpatient PA and NP program through trends in ED consults.

Objective: We investigated the effect of an inpatient physician associate/assistant (PA) and NP program on consult volume, length of stay (LOS), and ED returns.

Methods: A retrospective observational study of 4,118 orthopedic ED consults was conducted from January 2017 to March 2022. Univariate statistics were used to evaluate outcomes between cohorts and multivariate regression to evaluate the odds of an LOS of less than 24 hours.

Proteomic examination of Cornus officinalis stimulated 1.1B4 human pancreatic cells reveals activation of autophagy and Keap1/Nrf2 pathway.

Type 1 diabetes (T1D) is an autoimmune disease initiated by genetic predisposition and environmental influences culminating in the immunologically mediated destruction of pancreatic β-cells with eventual loss of insulin production. Although T1D can be accurately predicted via autoantibodies, therapies are lacking that can intercede autoimmunity and protect pancreatic β-cells. There are no approved interventional modalities established for this purpose.

Outcomes of a National Training Curriculum to Advance Generalist Level Palliative Care.

The adoption of palliative care as an integral component of health care has led to the need for generalist level providers, especially important in serious illnesses such as cancer. The goals of this National Cancer Institute-funded training program were to (1) identify the eight domains of quality palliative care applied to oncology practice, (2) demonstrate skills for oncology advanced practice registered nurses (APRNs) in the domains of palliative care, and (3) develop goals for implementing the skills training in practice through process improvement, staff education, and clinical care. The training program led by the End of Life Nursing Education Consortium (ELNEC) project included oncology APRNs in a three-day training course with one-year follow-up for ongoing support and to assess impact.

Improving Real-World Innovation and Problem Solving in Clinical Ethics: Insights from the First Clinical Ethics Un-Conference.

Despite an abundance of academic conferences, clinical ethicists lacked a forum to share innovative practices with peers and to generate solutions to common challenges. Organizers of the first Clinical Ethics Un-Conference developed a working event centered on active participation and problem solving through peer learning, with the goal of improving real-world practice. Registrants included 95 individuals from 64 institutions.

A Series of Tattoo-associated Infections.

is a rapidly growing mycobacterium known to spread through many sources, including tap water. This organism can have variable presentation between patients which can lead to a delay in diagnosis. Here, we report a series of eight cases of tattoo-associated infections that presented between December 2010 and January 2011, which were later linked to a single tattoo provider using gray tattoo ink made by diluting black ink with nonsterile tap water.

Evaluating a New Contrast Media Injection System in Coronary CT Angiography.

Purpose: To evaluate a new contrast media (CM) injection system in patients undergoing coronary computed tomography angiography (CCTA).

Methods: Seventy-one consecutive patients (33 men and 38 women, mean age 59.0 ± 14.

The impact of adjunctive tomosynthesis on screening mammography outcomes in two widely diverse radiology practices.

To determine the effect of adjunctive digital breast tomosynthesis screening on dissimilar mammography practices. We compared the outcomes of breast cancer screening with digital mammography versus digital mammography combined with tomosynthesis in two independent breast imaging practices from June 1, 2015, to May 31, 2016. Institution one was a hospital-based academic practice of breast imaging specialists and institution two was a community-based practice with academic affiliation served by general radiologists.

Driving high-functioning clinical teams: An advanced practice registered nurse and PA optimization initiative.

Background: Rapid changes in the healthcare marketplace are driving healthcare systems to modify operations by which advanced practice registered nurses (APRNs) and physician assistants (PAs) serve patients. By identifying more effective and efficient utilization workflows, organizations can meet these demands, resulting in high-functioning clinical teams.

Local Problem: With the growing number of APRNs and PAs in a large academic medical center, there was a recognized need to establish effective and efficient utilization practices for these healthcare providers.

Health and Economic Burden of Nonalcoholic Fatty Liver Disease in the United States and Its Impact on Veterans.

NAFLD is a leading cause of chronic liver disease and cirrhosis in the US and is associated with metabolic syndrome, type 2 diabetes, cardiovascular disease, and all-cause mortality.

Demonstrating advanced practice provider value: Implementing a new advanced practice provider billing algorithm.

Background: Rapid changes in healthcare are driving the adjustment of work flow by which providers serve patients in team-based care. Specifically, there is a need to develop more effective and efficient utilization with accurate attribution of advanced practice providers' (APPs) productivity.

Local Problem: The directors of the APP-Best Practice Center conducted assessments of each clinical area at the Medical University of South Carolina (MUSC) Health, a large academic medical center.

Can state-supported interprofessional coalitions cure preceptor shortages?

The shortage of clinical preceptors compromises the current and future supply of healthcare providers and patient access to primary care. This article describes how an interprofessional coalition in South Carolina formed and sought government support to address the preceptor shortage. Some states have legislated preceptor tax credits and/or deductions to support the clinical education of future primary care healthcare providers.

A Retrospective Analysis of Surveillance Adherence of Patients after Treatment of Primary Cutaneous Melanoma.

Melanoma surveillance serves to identify new primary melanomas and curable locoregional or early distant recurrences. Although an optimal melanoma surveillance strategy has not been determined, several clinical guidelines exist. The aim of this study was to identify demographic and clinico-pathologic variables associated with poor adherence to National Comprehensive Cancer Network (NCCN) melanoma surveillance guidelines.

Reaching Latino families through pediatric primary care: Outcomes of the CANNE parent training program.

The lack of culturally adapted parenting programs for Latinos contributes to low engagement in effective parenting programs. (CANNE), a culturally adapted program, improves family dynamics by decreasing problematic child behavior and helping parents manage stress. CANNE was delivered with 12 Latino parents of children (age 3-7).

Right Paraduodenal Hernia.

Clinical suspicion is necessary to prevent possible complications and mortality from paraduodenal hernias, a rare cause of small bowel obstruction.

Postoperative Patient-Controlled Analgesia in the Pediatric Cardiac Intensive Care Unit.

Background: High rates of uncontrolled pain in critically ill patients remain common. Patient-controlled analgesia is more effective than traditional intravenous as-needed dosing regimens for managing postoperative pain in older children and adults.

Objective: To determine whether pain-related clinical outcomes in patients from age 10 years to adult following cardiac surgery are improved by using patient-controlled analgesia as a pain management strategy.

Adherence to evidence-based treatment guidelines for bipolar depression in an inpatient setting.

Objective: The purpose of this study is to determine whether patients with a discharge diagnosis of bipolar depression were prescribed medications that are in accordance with evidence-based treatment guidelines and are FDA-approved for bipolar depression.

Methods: A retrospective study was conducted to assess prescribing of evidence-based therapies for patients discharged between November 2007 and August 2010 with a diagnosis code of BPD at the time of discharge. The primary objective of the study was to determine if evidence-based medications were prescribed at the time of discharge.

A Program Module to Supplement the Clinical Psychiatry Rotation for Physician Assistant Students.

A recent blog article aimed at prospective physician assistants (PAs) identified psychiatry as a series of Diagnostic and Statistical Manual of Mental Disorders, 5th edition, diagnoses supplemented by empathy and medication. It suggested that there were ample opportunities for PAs to practice psychiatry, although a recent survey showed that only 1% of PA graduates were employed in psychiatric clinical practices. While this is only one perspective, it suggests that PAs' understanding of psychiatric practice is limited by the patient population they see during their clinical rotations as students.

Rapid HIV Testing in a New Orleans Emergency Department is Effective in Identifying New HIV Diagnoses and in Linking Patients to Care.

A retrospective chart review of patients who agreed to a rapid HIV test in the emergency department in the initial year of institution of the rapid test was conducted. Out of 8,204 patients, 99 were newly diagnosed with HIV in the first year of the institution of the rapid HIV test (1.2%).

Prevention of stroke in sickle cell anemia.

The risk of stroke for a child with SCD is many times greater than that of a healthy child without SCD or heart disease. There is a technique that allows the identification of the children with SCD who have high risk even within this relatively high-risk group. And there is a highly effective preventive treatment.