المؤلفون: Ford, James S, Rouleau, Sam G, Wagner, Jenny L, Adams, Christopher B, May, Larissa S, Parikh, Aman K, Holmes, James F

المصدر: Vaccine. 41(9)

مصطلحات موضوعية: Humans, Vaccination, Emergency Service, Hospital, Electronic Health Records, COVID-19, COVID-19 Vaccines, Emergency Department, Public Health, SARS-CoV-2, Emergency Care, Clinical Research, Health Services, Vaccine Related, Immunization, Prevention, Prevention of disease and conditions, and promotion of well-being, 3.4 Vaccines, Good Health and Well Being, Biological Sciences, Agricultural and Veterinary Sciences, Medical and Health Sciences, Virology

الوصف: BackgroundWe aimed to evaluate the feasibility of implementing an emergency department (ED)-based Coronavirus Disease of 2019 (COVID-19) vaccination protocol in a population of unhoused patients.MethodsOn June 10, 2021, a best practice alert (BPA) was implemented that fired when an ED provider opened the charts of unhoused patients and prompted the provider to order COVID-19 vaccination for eligible patients. We downloaded electronic medical record data of patients who received a COVID-19 vaccine in the ED between June 10, 2021 and August 26, 2021. The outcomes of interest were the number of unhoused, and the total number of patients vaccinated for COVID-19 during the study period. Data were described with simple descriptive statistics.ResultsThere were 25,871 patient encounters in 19,992 unique patients (mean 1.3 visits/patient) in the emergency department during the study period. There were 1,474 (6% of total ED population) visits in 1,085 unique patients who were unhoused (mean 1.4 visits/patient). The BPA fired in 1,046 unhoused patient encounters (71% of PEH encounters) and was accepted in 79 (8%). Forty-three unhoused patients were vaccinated as a result of the BPA (4% of BPA fires) and 18 unhoused patients were vaccinated without BPA prompting. An additional 76 domiciled patients were vaccinated in the ED.ConclusionsImplementing an ED-based COVID-19 vaccination program is feasible, however, only a small number of patients underwent COVID-19 vaccination. Further studies are needed to explore the utility of using the ED as a setting for COVID-19 vaccination.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/6fh61691Test

المؤلفون: Elder, Joshua W, Wu, Evan F, Chenoweth, James A, Holmes, James F, Parikh, Aman K, Moulin, Aimee K, Trevino, Tommie G, Richards, John R

مصطلحات موضوعية: Biomedical and Clinical Sciences, Clinical Sciences, Screening And Brief Intervention For Substance Abuse, Health Services, Clinical Research, Substance Misuse, Alcoholism, Alcohol Use and Health, Emergency Care, Good Health and Well Being, Clinical sciences

الوصف: BackgroundScreening for unhealthy alcohol and drug use in the emergency department (ED) can be challenging due to crowding, lack of privacy, and overburdened staff. The objectives of this study were to determine the feasibility and utility of a brief tablet-based screening method in the ED and if patients would consider a face-to-face meeting with a certified alcohol and drug counselor (CADC) for more in-depth screening, brief intervention, and referral to treatment (SBIRT) helpful via this interface.MethodsA tablet-based questionnaire was offered to 500 patients. Inclusion criteria were age ≥18, Emergency Severity Index 2-5, and English comprehension. Subjects were excluded if they had evidence of acute intoxication and/or received sedating medication.ResultsA total of 283 (57%) subjects were enrolled over a 4-week period, which represented an increase of 183% over the monthly average of patients referred for SBIRT by the CADC prior to the study. There were 131 (46%) who screened positive for unhealthy alcohol and drug use, with 51 (39%) and 37 (28%) who screened positive for solely unhealthy alcohol use and drug use/drug use disorders, respectively. There were 43 (33%) who screened positive for combined unhealthy alcohol and drug use. Despite willingness to participate in the tablet-based questionnaire, only 20 (15%) with a positive screen indicated via the tablet that a face-to-face meeting with the CADC for further SBIRT would be helpful.ConclusionBrief tablet-based screening for unhealthy alcohol and drug use in the ED was an effective method to increase the number of adult patients identified than solely by their treating clinicians. However, only a minority of subjects screening positive using this interface believed a face-to-face meeting with the CADC for further SBIRT would be helpful.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/2s51s722Test

المؤلفون: Richards, John R, Stayton, Taylor L, Wells, Jason A, Parikh, Aman K, Laurin, Erik G

المصدر: Clinical and Experimental Emergency Medicine. 5(4)

مصطلحات موضوعية: Health Services and Systems, Biomedical and Clinical Sciences, Nursing, Health Sciences, Behavioral and Social Science, Prevention, Clinical Research, Good Health and Well Being, Shift work schedule, Emergency medicine, Emergency nursing, Sleep wake disorders, Sleep aids, pharmaceutical, Sleep aids, pharmaceutical

الوصف: OBJECTIVE:Determine differences between faculty, residents, and nurses regarding night shift preparation, performance, recovery, and perception of emotional and physical health effects. METHODS:Survey study performed at an urban university medical center emergency department with an accredited residency program in emergency medicine. RESULTS:Forty-seven faculty, 37 residents, and 90 nurses completed the survey. There was no difference in use of physical sleep aids between groups, except nurses utilized blackout curtains more (69%) than residents (60%) and faculty (45%). Bedroom temperature preference was similar. The routine use of pharmacologic sleep aids differed: nurses and residents (both 38%) compared to faculty (13%). Residents routinely used melatonin more (79%) than did faculty (33%) and nurses (38%). Faculty preferred not to eat (45%), whereas residents (24%) preferred a full meal. The majority (>72%) in all groups drank coffee before their night shift and reported feeling tired despite their routine, with 4:00 a.m. as median nadir. Faculty reported a higher rate (41%) of falling asleep while driving compared to residents (14%) and nurses (32%), but the accident rate (3% to 6%) did not differ significantly. All had similar opinions regarding night shift-associated health effects. However, faculty reported lower level of satisfaction working night shifts, whereas nurses agreed less than the other groups regarding increased risk of drug and alcohol dependence. CONCLUSION:Faculty, residents, and nurses shared many characteristics. Faculty tended to not use pharmacologic sleep aids, not eat before their shift, fall asleep at a higher rate while driving home, and enjoy night shift work less.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/1gt9k9g3Test

المؤلفون: Richards, John R., Mefford, Jason M., Patel, Jaymin J., Parikh, Aman K., Eder, Anke Z., Elder, Joshua W.

المصدر: Toxicology Communications ; volume 4, issue 1, page 18-24 ; ISSN 2473-4306

الإتاحة: https://doi.org/10.1080/24734306.2020.1752536Test

المؤلفون: Elder, Joshua W., Wu, Evan F., Chenoweth, James A., Holmes, James F., Parikh, Aman K., Moulin, Aimee K., Trevino, Tommie G., Richards, John R.

المصدر: Emerg Med Int

مصطلحات موضوعية: Research Article, demo, psy

الوصف: BACKGROUND: Screening for unhealthy alcohol and drug use in the emergency department (ED) can be challenging due to crowding, lack of privacy, and overburdened staff. The objectives of this study were to determine the feasibility and utility of a brief tablet-based screening method in the ED and if patients would consider a face-to-face meeting with a certified alcohol and drug counselor (CADC) for more in-depth screening, brief intervention, and referral to treatment (SBIRT) helpful via this interface. METHODS: A tablet-based questionnaire was offered to 500 patients. Inclusion criteria were age ≥18, Emergency Severity Index 2–5, and English comprehension. Subjects were excluded if they had evidence of acute intoxication and/or received sedating medication. RESULTS: A total of 283 (57%) subjects were enrolled over a 4-week period, which represented an increase of 183% over the monthly average of patients referred for SBIRT by the CADC prior to the study. There were 131 (46%) who screened positive for unhealthy alcohol and drug use, with 51 (39%) and 37 (28%) who screened positive for solely unhealthy alcohol use and drug use/drug use disorders, respectively. There were 43 (33%) who screened positive for combined unhealthy alcohol and drug use. Despite willingness to participate in the tablet-based questionnaire, only 20 (15%) with a positive screen indicated via the tablet that a face-to-face meeting with the CADC for further SBIRT would be helpful. CONCLUSION: Brief tablet-based screening for unhealthy alcohol and drug use in the ED was an effective method to increase the number of adult patients identified than solely by their treating clinicians. However, only a minority of subjects screening positive using this interface believed a face-to-face meeting with the CADC for further SBIRT would be helpful.

العلاقة: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7382715Test/

الإتاحة: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7382715Test/

المؤلفون: Richards, John R., Singh, Gagan D., Parikh, Aman K., Venugopal, Sandhya

المصدر: The American Journal of Emergency Medicine ; volume 37, issue 5, page 1007.e1-1007.e4 ; ISSN 0735-6757

مصطلحات موضوعية: Emergency Medicine, General Medicine

الإتاحة: https://doi.org/10.1016/j.ajem.2019.02.017Test
https://api.elsevier.com/content/article/PII:S0735675719300956?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S0735675719300956?httpAccept=text/plainTest

المؤلفون: Costantino, Thomas G., Parikh, Aman K., Satz, Wayne A., Fojtik, John P.

المصدر: Annals of Emergency Medicine ; volume 46, issue 5, page 456-461 ; ISSN 0196-0644

الإتاحة: https://doi.org/10.1016/j.annemergmed.2004.12.026Test
https://api.elsevier.com/content/article/PII:S0196064405000570?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S0196064405000570?httpAccept=text/plainTest