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Wheat Ridge, CO, United States

Adams J.,Exempla Lutheran Medical Center | Cymbala A.A.,Kaiser Permanente | Cymbala A.A.,Aurora Pharmaceutical | Delate T.,Kaiser Permanente | And 9 more authors.
Population Health Management | Year: 2015

Optimal management of patients with cardiovascular disease (CVD) includes evaluation of risk factors using a team-based approach. Tobacco use often receives less attention than other CVD risk factors; therefore, utilization of nonphysician health care providers may be valuable in addressing tobacco use. The purpose of this trial was to assess the impact of brief, structured, telephone tobacco cessation counseling (BST) delivered by clinical pharmacists on tobacco cessation attempts compared to usual care. The BST consisted of 1 to 5 minutes discussing 3 key counseling points, including a recommendation to quit and education about cessation aids. This was a cluster-randomized trial of tobacco-using patients with CVD who were enrolled in a clinical pharmacist-managed, physician-directed, CVD disease state management service. Clinical pharmacists were randomized to provide usual care (control) or BST (intervention) to their tobacco-using patients during a 4-month period. Patients were surveyed 3 months later to assess their tobacco cessation attempts, use of tobacco cessation aids, and self-reported cessation. One hundred twenty patients were enrolled. Subjects were predominately white males, aged ≥65 years, with a history of myocardial infarction. One hundred and four subjects completed the follow-up survey. No differences were detected between the 36.2% and 38.6% of control and intervention subjects, respectively, reporting a tobacco cessation attempt (P=0.804) or in the other outcomes (all P>0.05). A BST delivered by clinical pharmacists may not adequately affect patient motivation enough to increase tobacco cessation attempts in tobacco-dependent patients with CVD. Future research is needed to evaluate other team-based strategies that can decrease tobacco use in patients with CVD. (Population Health Management 2015;18:300-306) © 2015, Mary Ann Liebert, Inc. 2015. Source

Davis J.,Wheat Ridge | Cardona J.,Exempla Lutheran Medical Center
Hospital Pharmacy | Year: 2012

Purpose: Computerized provider order entry (CPOE) has been shown to reduce medication error rates by as much as 55%. The purpose of this study was to examine the effect of CPOE on the rate of medication errors at a not-for-profit community hospital.Methods: A prospective, observational study was conducted utilizing a pharmacist-driven concurrent data collection tool to evaluate all medication errors intercepted by each pharmacist. The survey was conducted for 3 separate 1-week periods: once prior to CPOE implementation and twice post CPOE implementation. The primary outcome was the rate of medication errors reported via the pharmacist concurrent data collection tool pre and post CPOE. The secondary outcomes included the errors reported through a hospitalwide, self-reported adverse medication event system, the types of errors, and error severity.Results: A statistically significant 41% reduction (P < .01) in the rate of errors 3 months following CPOE implementation was observed. The secondary outcome of self-reported medication errors per adjusted patient day decreased significantly with a 25% reduction (P < .05). The type of errors reported by the pharmacists changed notably pre and post CPOE implementation; however the severity of the reported errors did not change.Conclusion: CPOE decreased the rate of medication errors at our community hospital 3 months post CPOE implementation. Errors were increased at 1 month post CPOE implementation, but not significantly. The types of errors changed post CPOE implementation, but distribution of error severity was unchanged. © 2012 Thomas Land Publishers, Inc. Source

Wolfson M.,The Cancer Center | Granstrom P.,The Cancer Center | Pomarico B.,The Cancer Center | Reimanis C.,Exempla Lutheran Medical Center
Medsurg nursing : official journal of the Academy of Medical-Surgical Nurses | Year: 2013

The noninvasive temporal artery thermometer offers a way to measure temperature when oral assessment is contraindicated, uncomfortable, or difficult to obtain. In this study, the accuracy and precision of the temporal artery thermometer exceeded levels recommended by experts for use in acute care clinical practice. Source

Belkin A.,Autoimmune Lung Center and Interstitial Lung Disease Program | Fier K.,Autoimmune Lung Center and Interstitial Lung Disease Program | Albright K.,University of Colorado at Denver | Baird S.,Participation Program for Pulmonary Fibrosis P3F | And 9 more authors.
BMC Pulmonary Medicine | Year: 2014

Background: Little is known about whether or how supplemental oxygen affects patients with pulmonary fibrosis. Methods/Design: A mixed-methods study is described. Patients with pulmonary fibrosis, informal caregivers of pulmonary fibrosis patients and practitioners who prescribe supplemental oxygen will be interviewed to gather data on perceptions of how supplemental oxygen impacts patients. In addition, three hundred pulmonary fibrosis patients who do not use daytime supplemental oxygen will be recruited to participate in a longitudinal, pre-/post- study in which patient-reported outcome (PRO) and activity data will be collected at baseline, immediately before daytime supplemental oxygen is initiated, and then once and again 9-12 months later. Activity data will be collected using accelerometers and portable GPS data recorders. The primary outcome is change in dyspnea from before to one month after supplemental oxygen is initiated. Secondary outcomes include scores from PROs to assess cough, fatigue and quality of life as well as the activity data. In exploratory analyses, we will use longitudinal data analytic techniques to assess the trajectories of outcomes over time while controlling for potentially influential variables. Discussion: Throughout the study and at its completion, results will be posted on the website for our research program (the Participation Program for Pulmonary Fibrosis or P3F) at http://www.pulmonaryfibrosisresearch.org. Source

Davis Y.,Exempla Lutheran Medical Center | Perham M.,Exempla Lutheran Medical Center | Jagersky R.,Exempla Lutheran Medical Center | Gorman W.J.,Exempla Lutheran Medical Center | And 2 more authors.
Journal of Perianesthesia Nursing | Year: 2014

Purpose: The purpose of this study was to determine the needs and experiences of patients and family members throughout the entire perioperative experience. Design and Methods: Using a descriptive study design, a convenience sample of patients and family members were surveyed about their needs and how well those needs were met during the perioperative period. Survey questions were adapted from valid and reliable patient and family needs surveys. Rank order of patient and family needs were determined based on average item scores. Findings: A total of 68 patients and 63 family members were surveyed over an 8-month period. Patient needs with the highest scores were related to pain and/or nausea management, having information about the condition after surgery, and treatment with respect and dignity. Family member needs with the highest scores were related to communication with the surgeon after the procedure, opportunities to ask questions and address concerns with hospital staff, and receiving information about the surgical procedure itself before coming to the hospital. Patients and family members perceived that their needs were met most of the time. Conclusions: Results of this survey identify the needs of patients and family members throughout the perioperative time period. © 2014 American Society of PeriAnesthesia Nurses. Source

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