Denver, CO, United States
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Jean-Pierre P.,University of Miami | Fiscella K.,University of Rochester | Winters P.C.,University of Rochester | Paskett E.,Ohio State University | And 9 more authors.
Supportive Care in Cancer | Year: 2012

Background: Patient satisfaction (PS), a key measure of quality of cancer care, is a core study outcome of the multisite National Cancer Institute-funded Patient Navigation Research Program. Despite large numbers of underserved monolingual Spanish speakers (MSS) residing in USA, there is no validated Spanish measure of PS that spans the whole spectrum of cancer-related care. The present study reports on the validation of the Patient Satisfaction with Cancer Care (PSCC) measure for Spanish (PSCC-Sp) speakers receiving diagnostic and therapeutic cancer-related care. Methods: Original PSCC items were professionally translated and back translated to ensure cultural appropriateness, meaningfulness, and equivalence. Then, the resulting 18- item PSCC-Sp measure was administered to 285 MSS. We evaluated latent structure and internal consistency of the PSCC-Sp using principal components analysis (PCA) and Cronbach coefficient alpha (?). We used correlation analyses to demonstrate divergence and convergence of the PSCC-Sp with a Spanish version of the Patient Satisfaction with InterpersonalRelationshipwithNavigator (PSN-I-Sp)measure and patients' demographics. Results: The PCA revealed a coherent set of items that explicates 47% of the variance in PS. Reliability assessment demonstrated that the PSCC-Sp had high internal consistency (?=0.92). The PSCC-Sp demonstrated good face validity and convergent and divergent validities as indicated by moderate correlations with the PSN-I-Sp (p=0.003) and nonsignificant correlations with marital status and household income (all ps>0. 05). Conclusion: The PSCC-Sp is a valid and reliable measure of PS and should be tested in other MSS populations. © Springer-Verlag 2011.


Price L.C.,Kaiser Permanente | Price L.C.,University of Colorado at Denver | Price L.C.,Regis University | Wobeter B.,Denver Health Hospital and Authority | And 5 more authors.
Journal of Pain and Symptom Management | Year: 2014

Context. There are few studies that describe cardiac adverse events in patients prescribed methadone for pain management. Objectives. To describe incident cardiac adverse events and risk factors for cardiac adverse events in primary care patients prescribed methadone for pain. Methods This was a retrospective, descriptive, cohort study in patients 18 years or older receiving methadone for pain management during 2010. Patients were followed for 12 months and were categorized as "chronic" or "non-chronic" methadone users. The primary outcomes were a cardiac event, at risk for an event, or neither. Patients were grouped on their outcome and were compared on risk factors and methadone monitoring. Results. A total of 1246 patients were included. Thirty (2.4%), 628 (50.4%), and 588 (47.2%) patients had a cardiac event, were at risk for an event, or had neither an event nor a risk factor, respectively. Overall, the rate of QTc prolongation was 49.4% and the rate of adherence to recommended cardiac monitoring was 39.0%. Similar percentages of chronic and non-chronic users had a cardiac event (P > 0.05). Among the patients who had a cardiac event and were at risk for an event, factors independently associated with having had an event included age (odds ratio = 1.06; 95% CI = 1.03-1.09) and a dose 100 mg/day or higher (odds ratio = 6.18; 95% CI = 1.08-35.45). Conclusion. Few cardiac adverse events resulting from methadone use for pain were detected. However, a large proportion of patients were at risk for an adverse event, especially patients who were older and had received ≥100 mg/day of methadone. © 2014 American Academy of Hospice and Palliative Medicine.


Kim F.J.,University of Colorado at Denver | da Silva R.D.,University of Colorado at Denver | Gustafson D.,University of Colorado at Denver | Nogueira L.,University of Colorado at Denver | And 2 more authors.
Patient Safety in Surgery | Year: 2015

Current surgical safety guidelines and checklists are generic and are not specifically tailored to address patient issues and risk factors in surgical subspecialties. Patient safety in surgical subspecialties should be templated on general patient safety guidelines from other areas of medicine and mental health but include and develop specific processes dedicated for the care of the surgical patients. Safety redundant systems must be in place to decrease errors in surgery. Therefore, different surgical subspecialties should develop a specific curriculum in patient safety addressing training in academic centers and application of these guidelines in all practices. Clearly, redundant safety systems must be in place to decrease errors in surgery, in analogy to safety measures in other high-risk industries. Specific surgical subspecialties are encouraged to develop a specific patient safety curriculum that address training in academic centers and applicability to daily practice, with the goal of keeping our surgical patients safe in all disciplines. The present review article is designed to outline patient safety practices that should be adapted and followed to fit particular specialties. © 2015 Kim et al.


PubMed | Denver Health Hospital and Authority, University of Colorado at Denver and University of Denver
Type: | Journal: Patient safety in surgery | Year: 2015

Current surgical safety guidelines and checklists are generic and are not specifically tailored to address patient issues and risk factors in surgical subspecialties. Patient safety in surgical subspecialties should be templated on general patient safety guidelines from other areas of medicine and mental health but include and develop specific processes dedicated for the care of the surgical patients. Safety redundant systems must be in place to decrease errors in surgery. Therefore, different surgical subspecialties should develop a specific curriculum in patient safety addressing training in academic centers and application of these guidelines in all practices. Clearly, redundant safety systems must be in place to decrease errors in surgery, in analogy to safety measures in other high-risk industries. Specific surgical subspecialties are encouraged to develop a specific patient safety curriculum that address training in academic centers and applicability to daily practice, with the goal of keeping our surgical patients safe in all disciplines. The present review article is designed to outline patient safety practices that should be adapted and followed to fit particular specialties.


Moreira M.,Denver Health Hospital and Authority | Moreira M.,Aurora University | Buchanan J.,Denver Health Hospital and Authority | Buchanan J.,Rocky Mountain Poison and Drug Center | And 4 more authors.
American Journal of Emergency Medicine | Year: 2011

Often, patients are brought in to the emergency department after ingesting large amounts of cocaine in an attempt to conceal it. This act is known as body stuffing. The observation period required to recognize potential toxic adverse effects in these patients is not well described in the literature. We sought to validate a treatment algorithm for asymptomatic cocaine body stuffers using a 6-hour observation period by observing the clinical course of cocaine body stuffers over a 24-hour period. A retrospective chart review was performed on all patients evaluated for witnessed or suspected stuffing over 2 years using a standardized protocol. One hundred six patients met final inclusion criteria as adult cocaine stuffers. No patients developed life-threatening symptoms, and no patients died during observation. In our medical setting, stuffers could be discharged after a 6-hour observation period if there was either complete resolution or absence of clinical symptoms. © 2011 Elsevier Inc. All rights reserved.

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