Mathews Journal of Emergency Medicine最新文献

{"title":"Effect of a Statewide Opioid Monitoring Program on a Community Emergency Department Opioid Prescribing Patterns","authors":"N. Caltabiano, Ashley Keifer, J. Espinosa, A. Lucerna, Nicholas Tomasello, R. Mordecai, Henry Schuitema, V. Scali","doi":"10.30654/mjem.10043","DOIUrl":"https://doi.org/10.30654/mjem.10043","url":null,"abstract":"Purpose of the Study: The purpose of this study was to determine if emergency physician’s opioid prescribing habits in three emergency departments of a three hospital community healthcare system changed following the revision of a state Prescription Monitoring Program (NJPMP). Materials Methods: retrospective time series analysis A random sample of 50 days was be chosen from the year period prior to revised NJPMP) and a random sample of 50 days was chosen from the following two years. Data Retrospective data from an emergency department information system. Setting: Three average number of day’s supply decreased from a mean of 4.512 (StDev 0.736) in the pre-intervention period to a mean of 3.845 (StDev 0.758 in the post intervention period. This difference was highly significant (p < 0.001). There was a statistically significant decrease in all three measures when the pre-prescription monitoring program period and the post-prescription monitoring period were compared. This difference is evidence of a strong temporal relationship to the NJ-RX program, but does not prove causality. Other factors may have contributed. However, the temporal relationship is very statistically powerful and was certainly in the intended direction of effect of the reduction in opiate prescriptions. Conclusions: There was a statistically significant decrease in all three measures when the pre-prescription monitoring program period and the post-prescription monitoring period suggests that the monitoring system was likely causal.","PeriodicalId":128320,"journal":{"name":"Mathews Journal of Emergency Medicine","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127497397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare Documents: How Readable? A Study of Simple Strategies to Decrease Reading Grade Level and Increase Reading Ease of Healthcare Documents","authors":"J. Espinosa, A. Lucerna, Henry Schuitema","doi":"10.30654/mjem.10044","DOIUrl":"https://doi.org/10.30654/mjem.10044","url":null,"abstract":"Background: The field of healthcare is becoming more aware of the need for patients to be able understand the consent forms we provide. Health literacy is often defined as the ability to read, understand, and act correctly on health information. Health literacy surveys have consistently shown that about 24% of the population cannot read at the 5th grade level. About 66% of the population can read at the 6 th grade level. It is for this reason that the target grade level for most newspapers and lay periodicals is set at a goal of a 6 th grade reading level. [1-2] How can one study the reading level and reading ease of a document? A well-known formula for determining the reading grade level of a document is the Flesch-Kincaid Grade Score (FKGS). The Flesch Reading Ease Score (FRES) is a well-known formula for determining reading ease. One advantage of these two tests is that they are both available on a widely-available word processing platform. Methods: The purpose of project was to identify a random sample of consent forms, open source, from the internet. The Flesch-Kincaid Grade Level and Flesch Reading Ease effect of decreasing the reading grade level as expressed in the FKGS and of increasing reading ease as expressed in the FRES. These effects were highly statistically significant. Future directions could include a study of other literacy indicators. Hospital-based documents could be assessed for possible literacy intervention. Comparisons of reductions in FKGS and FRES could be compared to outcomes in other reading scores. Lastly, outcomes of patient comprehension pre and post literacy interventions, such as reductions in FKGS and increases in FRES, could be made.","PeriodicalId":128320,"journal":{"name":"Mathews Journal of Emergency Medicine","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129537134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of Vancomycin Dosing in the Emergency Department: Two Dosage Sizes do Not Fit All","authors":"Melissa J. Reeves, Karina Gotliboym, J. Espinosa, V. Scali, A. Lucerna, R. Mordecai, Henry Schuitema","doi":"10.30654/mjem.10041","DOIUrl":"https://doi.org/10.30654/mjem.10041","url":null,"abstract":"Copyright: Espinosa J, et al. © (2021). This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. James Espinosa Department of Emergency Medicine, Rowan University, SOM/Jefferson Stratford, NJ, USA, 18 East Laurel Road, Stratford, NJ 08084 E-mail: jim010@aol.com ABSTRACT","PeriodicalId":128320,"journal":{"name":"Mathews Journal of Emergency Medicine","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114351450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential Impact of Choosing Wisely-- ED Coagulation Study (PT-PTT-INR): Utilization and Economic Modeling","authors":"Victoria McElroy, J. Espinosa, V. Scali, Henny Schuitema, A. Lucerna","doi":"10.30654/MJEM.10040","DOIUrl":"https://doi.org/10.30654/MJEM.10040","url":null,"abstract":"Purpose of the study: The purpose of this study was to look at ED compliance with the Schuur et al, Choosing Wisely recommendations for ED coagulation study utilization and to create an economic model for the relationship of specific reasons for coagulation testing in the ED to potential savings. Materials and Methods: The setting was the three emergency departments of a community-based, university-affiliated hospital system. The study design was a retrospective chart review utilizing data from laboratory and emergency departments. One hundred charts in which a PT/INR and or PTT had been ordered were randomly selected. Laboratory data included specific costs of the tests and the overall number of tests ordered for years 2015 and 2016. An economic model for system-wide and national potential savings was created based on the resulting utilization data. Results: The overall compliance of coagulation utilization with the Choosing Wisely recommendation was 27%. Inversely, the overall non-compliance of coagulation utilization was 73%. There were no cases in which there was a clinically significant abnormal coagulation result. The system average for utilization of PT/INR for the two years studied was 28%.The system average for utilization of PTT for the two years studied was 27% .There was some variation by campus. For PT/INR the range was 24% to 30%. For PTT the range was 23% to 29%. Economic Modeling Results: 3 hospital system model. The 3 hospital system charge for a PT/INR is $53.00 The 3 hospital system charge for a PTT is $64.00 Using the base year, the total charge for PT/INR testing was approximately 2.3 million dollars and the total charge for PTT testing was approximately 2.7 million dollars. PT/INR potential savings: A 10% reduction in PT/INR use translates to over 230,000 dollars in savings. A 20% reduction is double that— approximately 460,000 dollars. If the maximal overutilization rate of 73% was decreased to a minimum, the savings would be over 1.6 million dollars. PTT potential savings: A 10% reduction in PTT could save over 270,000 dollars in savings. A 20% reduction is double that—approximately 540,000 dollars. If the maximal overutilization rate of 73% was decreased to a minimum, the savings would be over 1.9 million dollars. Economic Modeling Results: National model. Exact national data for coagulation use is not readily available. However, some modeling is possible given the assumptions of the system rates of 28% utilization of PT/INR and 27% PTT, as well as the system charges applied into the model. As a model, based on CDC data from the index year (136 million ED visits) the results *Corresponding Author: E-mail: jim010@aol.com","PeriodicalId":128320,"journal":{"name":"Mathews Journal of Emergency Medicine","volume":"233 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114531415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical Skills Mannequin Training for Cricothyrotomy","authors":"V. Scali, J. Espinosa","doi":"10.30654/MJEM.10038","DOIUrl":"https://doi.org/10.30654/MJEM.10038","url":null,"abstract":"The purpose of this study was to assess whether the low frequency/critically high skill set of cricothyrotomy can be taught to emergency medicine residents at various levels of training. Our study was prospective in design, involving a brief survey concerning years of training, prior experience with cricothyrotomy, sense of comfort with procedure and number witnessed. Participants were emergency medicine residents PGY 2-5. After the survey, participants watched a demonstration video. Cricothyrotomy was then performed by participants on a mannequin using a preassembled cricothyrotomy kit, up to a maximum of 10 attempts. Successful performance was defined as 40 seconds or less as per the training model of Wong et al. When participants were pooled by attempt, the overall reduction in time performance reached a plateau by the 5th attempt. This plateau is identical to the plateau described by Wong in his study of cricothyrotomy training in anesthesiologists. When success was operationally defined as less than or equal to 40 seconds per attempt, the success threshold was definitely reached by the 2nd attempt and reached a plateau by the 5th attempt. Statistical significance of less than p= 0.01 was reached by the second attempt and reached a plateau (p=0.001) by the 5th attempt.","PeriodicalId":128320,"journal":{"name":"Mathews Journal of Emergency Medicine","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121711148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Conflict Between Formel and İnformel Structures of the Emergency Departments That Effect the Occupational Satisfaction of Staff","authors":"O. Derman","doi":"10.30654/mjem.10033","DOIUrl":"https://doi.org/10.30654/mjem.10033","url":null,"abstract":"This study addresses the factors that effect the occupational satisfaction of staff working at the emergency department of hospital in Ankara, Turkey. Five differenct district hospital joined to the study. We make face to face interview with 110 participants to the study. As high occupational satisfaction directly reflects work gratification this will then directly increase the satisfaction of the patients that apply to the emergency department of the hospitals. Making the emergency department more functional in the health system leads to the formation of an ordered and more compatible sub-system. Everywhere around the World emergency departments are the most difficult to administer hospital services. At these centers the satisfaction level is ususally below that of the hospitals average.","PeriodicalId":128320,"journal":{"name":"Mathews Journal of Emergency Medicine","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125719764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Connection of Normal Blood Oxygen Level and Eye Blinking","authors":"M. Qadir, Muhammad Tanveer","doi":"10.30654/mjem.10032","DOIUrl":"https://doi.org/10.30654/mjem.10032","url":null,"abstract":"Oxygen saturation is the part of oxygen that is wet with hemoglobin with respect to total hemoglobin in blood. There must be accurate equilibrium of oxygen in the human body because body need exact balance of oxygen. 95-100% blood oxygen level is considered as normal in humans. If the oxygen level will be below than 90% it is considered as low level and give result in hypoxemia a disease. Continuously lowering of oxygen level lead to respiratory and cardiac problem. Oxygen level can be arising by oxygen therapy. When oxygen come into tissues oxygenation begin. Oxygen saturation in the medicine field also known as “sats”. When the partial pressure of oxygen is low then most of the hemoglobin is deoxygenated. Hemoglobin an element that carry oxygen to the body parts by binding with oxygen. Four hemoglobin molecules are present in each of red blood cells. Oxygen level can be measured by pulse oximeter a device.","PeriodicalId":128320,"journal":{"name":"Mathews Journal of Emergency Medicine","volume":"387 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114008146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}