Implementing a Peer Support Program for Second Victims.

The second victim phenomenon describes the distress frequently experienced by health care providers after an unintentional medical error or unexpected adverse event. However, few health care institutions have initiatives that proactively address this phenomenon. The pilot project discussed in this article aimed to create a peer support program for health care providers experiencing the second victim phenomenon.

Sleep and substance use disorder treatment: A preliminary study of subjective and objective assessment of sleep during an intensive outpatient program.

Background And Objectives: Characteristics of sleep concerns and their relationship to mental health in heterogeneous substance use disorder (SUD) treatment settings are not well understood. The purpose of this preliminary study was to assess sleep using subjective and objective measures at two time points during SUD treatment and compare sleep changes to changes in mental health measures.

Methods: Treatment-seeking participants completed an assessment battery at the beginning of treatment (Time 1, N = 30) and again upon treatment completion (Time 2, approximately 4 weeks later, N = 22).

Veiled Truths: Iranian Women and Risky Sexual Behavior in the Context of Substance Use.

Background: Substance use disorders and risky sexual behavior coexist for some women. Explanatory models of women's sexuality in the context of substance use are under study. This study aimed to explore how women's sexual behavior can become risky in the context of substance use.

Appointment Reminders to Decrease 30-Day Readmission Rates to Inpatient Psychiatric Hospitals.

Purpose Of Project: The purpose of this quality improvement project was to reduce 30-day readmission rates to inpatient psychiatric hospitals by standardizing discharge processes by including scheduling outpatient psychiatric appointments for all patients at discharge and also to include the mailing postal reminders to prompt patients to attend their first outpatient mental health appointment following treatment.

Primary Practice Setting: Inpatient psychiatric hospital.

Methodology And Sample: The project design was an analysis of readmission data obtained both 3 months before and after implementation of the postal reminder letters.

Achieving High Reliability Through Cultural Mindfulness.

Healthcare has enthusiastically embraced quality and safety improvement. Yet, more radical transformation is clearly needed to make a more significant impact on error reduction and to ensure consistent quality. This need for transformation is leading healthcare to examine how other industries, such as nuclear power and aviation, improve safety to achieve a high degree of reliability and avoid potential catastrophes.

A progressive pruritic rash with blisters.

This article describes a patient with a progressive pruritic rash and fluid-filled blisters. A punch biopsy later confirmed the diagnosis of bullous pemphigoid, an inflammatory condition that most commonly occurs in older adults and is treated with corticosteroids.

Epilepsy update, part 2: nursing care and evidence-based treatment.

As new research has increased our understanding of epilepsy and the challenges patients with epilepsy face, the role of the nurse as an educator and advocate has grown. This article, the second in a two-part series, addresses the most important aspects of assessing and caring for patients with epilepsy-highlighting the seizure first-aid instructions that all family members of a patient with epilepsy should have; the teaching points to share with parents of young children with epilepsy; and online epilepsy resources for patients, family members, and health care professionals. The authors also discuss current medical, surgical, neurostimulatory, and dietary approaches to epilepsy treatment.

CE: Epilepsy Update, Part 1: Refining Our Understanding of a Complex Disease.

Epilepsy is a serious, common neurologic disease that affects people of all ages. As underscored in the 2012 Institute of Medicine report Epilepsy Across the Spectrum: Promoting Health and Understanding, the millions of people living with epilepsy in the United States face the challenges of seeking out high-quality, coordinated health care and community services; overcoming epilepsy misinformation and stigma; and finding understanding and support in their communities. This article, the first in a two-part series, discusses new research that has increased our understanding of epilepsy's etiology and pathophysiology, new definitions that are changing the ways we evaluate and treat this disease, conditions that frequently present with epilepsy, and psychosocial challenges faced by people with epilepsy.

Dermatology diagnoses among rural and urban physician assistants.

Objectives: Dermatology is not heavily covered in the curricula of physician assistant (PA) programs or on the certification examination, even though patient visits to PAs for skin complaints are very common. If significant on-the-job training is thus required for dermatology care, then practice setting differences likely impact the quality of that informal training. This study sought to identify differences in the ability of rural and urban PAs to diagnose skin disorders.

Improving oversight of the graduate medical education enterprise: one institution's strategies and tools.

Accreditation organizations, financial stakeholders, legal systems, and regulatory agencies have increased the need for accountability in educational processes and curricular outcomes of graduate medical education. This demand for greater programmatic monitoring has placed pressure on institutions with graduate medical education (GME) programs to develop greater oversight of these programs. Meeting these challenges requires development of new GME management strategies and tools for institutional GME administrators to scrutinize programs, while still allowing these programs the autonomy to develop and implement educational methods to meet their unique training needs.