Highly Effective Model for Implementation of In-House Platelets in a Tertiary Veteran Hospital Setting Without a Trauma Center

2020 ◽  
Vol 51 (5) ◽  
pp. e51-e58
Author(s):  
Jeffrey M Petersen ◽  
Vijal Patel ◽  
Darshana Jhala
Keyword(s):  
Trauma Center ◽  
Hospital Setting ◽  
Tertiary Hospital ◽  
System Model ◽  
Expiration Date ◽  
Highly Effective ◽  
Veteran Hospital ◽  
Innovative System ◽  
One Year ◽  
New System

Abstract Background Platelet products have a limited shelf life and are costly. Therefore, to balance clinical usage/availability and wastage in a tertiary hospital setting without a trauma center, an innovative system model was established. This system reduced wastage by transferring platelet unit approaching their expiration date to a nearby facility (with the same blood supplier and a trauma center) before expiration, when there is no anticipated need for the product at the original location. Methods A review of data to determine the degree of platelet wastage and wastage costs one year before implementation of this measure in October 2017 and one year after implementation of this measure. Results Since the implementation of this measure, no platelet units have expired on the shelf. In contrast, from October 2016 to October 2017, before implementation of platelet transfer, platelet products expired regularly. Conclusion This new system model is highly effective in maintaining platelet inventory without wastage.

Highly Effective Model for Implementation of In-House Platelets in a Tertiary Hospital Setting Without a Trauma Center: Corporal Michael J. Crescenz Veterans Affairs Medical Center (CMCVAMC) Experience

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S154-S155
Author(s):  
Vijal Patel ◽  
Jeffrey Petersen ◽  
Darshana Jhala
Keyword(s):  
Trauma Center ◽  
Medical Center ◽  
Hospital Setting ◽  
Cost Savings ◽  
Cost Effective ◽  
Tertiary Hospital ◽  
Effective Model ◽  
System Model ◽  
Effective Measure ◽  
Highly Effective

Abstract Introduction Platelet products have a limited shelf life and are costly. Hence, it remains crucial to balance clinical usage and wastage in a tertiary hospital setting without a trauma center. Considering this, an innovative system model was established to reduce wastage: the CMCVAMC—starting October 2017—arranged to transfer the platelet unit to a nearby facility with a trauma center when product has a short expiration date and there is no anticipated need for the product. This is a cost-effective measure to reduce platelet wastage and ensure the appropriate blood product availability. Method QA/QI data were reviewed to determine the degree of platelet wastage both a year prior to the implementation of this platelet transfer to another facility and after the past implementation of this transfer to February 2019. The cost of each platelet product was determined from the blood supplier (American Red Cross). From these comparisons prior to and after implementation, a determination of reduction of product wastage and cost savings was made. Results Since the implementation of this platelet transfer, there have been no platelets expiring on the shelf. In contrast, from October 2016 to October 2017 prior to implementation of platelet transfer, platelet products were often wasted or expired. In contrast, from October 2017 to February 2019, there has been no wastage of platelets. Conclusion This is a highly effective model for a tertiary hospital without a trauma center to bring in house platelets without wastage of a costly product while maintaining appropriate availability of the product. This quality improvement system study demonstrates that the measure resulted in significant savings and this serves as a model for other similar facilities. This is an innovative, easy to implement, and cost-effective system model that can be used in other tertiary facilities without a trauma center.

scholarly journals Persistently Elevated PTH After Parathyroidectomy at One Year: Experience in a Tertiary Referral Center

2019 ◽  
Vol 104 (10) ◽  
pp. 4473-4480
Author(s):  
Marie Caldwell ◽  
Jeff Laux ◽  
Marshall Clark ◽  
Lawrence Kim ◽  
Janet Rubin
Keyword(s):  
North Carolina ◽  
Hospital Setting ◽  
Tertiary Hospital ◽  
Tertiary Referral Center ◽  
Gland Weight ◽  
Clinical Difference ◽  
One Year ◽  
Persistent Elevation

Abstract Context/Objective Increased PTH after successful parathyroid surgery represents a clinical conundrum. We aimed to determine the prevalence of persistently elevated PTH (PePTH) postsurgery, along with predisposing factors. Design and Setting: Patients ≥ age 18 with parathyroidectomy performed at University of North Carolina Hospitals for primary hyperparathyroidism (PHPT) over a 12-year period were identified from the Carolina Data Warehouse. Clinical and demographic characteristics were collected, transformed, and analyzed. Results Five hundred seventy patients met initial criteria for PHPT, and of those 407 had postoperative values. One hundred forty-four had laboratory results within 3 to 18 months post operatively. There was no clinical difference between those with and without long-term laboratory follow-up. Presurgery, patients had average calcium of 11 mg/dL and PTH 125.4 pg/mL. Ninety-seven percent of patients had normalized calcium after surgery, but 30% had PePTH, which can be predicted at 3 months. Patients with PePTH (persistent elevation of PTH) after surgery did not differ from those with normalized PTH in terms of sex, age, body mass index, or excised gland weight; presurgery 25-vitamin D was slightly lower, but not abnormal (26 ± 15 vs 36 ± 11). The presurgical PTH was significantly higher (P < 0.001) in those with PePTH (156.5 pg/mL compared with presurgical level of 102.5 in those whose PTH normalized). Conclusions Nearly one-third of PHPT patients have elevated PTH levels postsurgery in a tertiary hospital setting. At presentation, patients with PePTH tend to have higher PTH relative to calcium levels. Whether PePTH after surgical treatment of PHPT has pathological consequences is unknown.

Adult’s Total Parenteral Nutrition: Initiative and Implementation of Standardized Formulation in Saudi Arabia

2018 ◽  
Vol 4 (3) ◽  
pp. 483-487
Author(s):  
Yousef Ahmed Alomi ◽  
Hussam Saad Almalki ◽  
Aisha Omar Fallatah ◽  
Awatif Faraj Alshammari ◽  
Nahedh Rashed Alotaibi
Keyword(s):  
Saudi Arabia ◽  
Parenteral Nutrition ◽  
Pharmacy Practice ◽  
International Standards ◽  
Kingdom Of Saudi Arabia ◽  
Parental Nutrition ◽  
International Regulations ◽  
One Year ◽  
New Formulation ◽  
New System

The general administration of pharmaceutical care started potential pharmacy practice program. The program is part of accreditation professional’s process of national and international regulations. The adult’s parenteral nutrition was one of the critical programs. The most healthcare professionals are not familiar with the new system. The new initiatives system adult’s standardized concentration formulation of total parental nutrition as complementary to the previous one. The new formulation consisted of all parental nutrition requirements based on national and international standards. The new system can be converted as computerized physician orders. The new initiatives may implement as project management model over one year or less than that’s. The new system prevents nutrition-related problems, and medication errors, and improve clinical outcomes of the adults’ population in the Kingdom of Saudi Arabia.

Diabetes admissions in a tertiary hospital: A one year review

2016 ◽  
Author(s):  
Olubukola Ojo ◽  
Olalekan Ojo ◽  
Adebola Omosehin ◽  
Kayode Oluwatusa ◽  
Sulaeman Okoro ◽  
...  
Keyword(s):  
Tertiary Hospital ◽  
One Year

scholarly journals A Mental Health Drop-In Centre Offering Brief Transdiagnostic Psychological Assessment and Treatment in a Paediatric Hospital Setting: A One-Year Descriptive Study

2021 ◽  
Vol 18 (10) ◽  
pp. 5369
Author(s):  
Matteo Catanzano ◽  
Sophie D Bennett ◽  
Marc S Tibber ◽  
Anna E Coughtrey ◽  
Holan Liang ◽  
...  
Keyword(s):  
Mental Health ◽  
Young People ◽  
Psychological Assessment ◽  
Mental Health Problems ◽  
Hospital Setting ◽  
Considerable Proportion ◽  
Paediatric Hospital ◽  
Cognitive Behaviour ◽  
Assessment And Treatment ◽  
One Year

Aim: This study was part of a broader project to examine the acceptability, feasibility and impact of a transdiagnostic mental health drop-in centre offering brief psychological assessment and treatment for children and young people and/or their families with mental health needs in the context of long-term physical health conditions (LTCs). The aims of this investigation were to characterise: (i) the use of such a centre, (ii) the demographics and symptoms of those presenting to the centre, and (iii) the types of support that are requested and/or indicated. Methods: A mental health “booth” was located in reception of a national paediatric hospital over one year. Characteristics of young people with LTCs and their siblings/parents attending the booth were defined. Emotional/behavioural symptoms were measured using standardised questionnaires including the Strengths and Difficulties Questionnaire (SDQ). Participants subsequently received one of four categories of intervention: brief transdiagnostic cognitive behaviour therapy (CBT), referral to other services, neurodevelopmental assessment or signposting to resources. Results: One hundred and twenty-eight participants were recruited. The mean age of young people was 9.14 years (standard deviation: 4.28); 61% identified as white and 45% were male. Over half of young people recruited scored in the clinical range with respect to the SDQ. Presenting problems included: anxiety (49%), challenging behaviour (35%), low mood (22%) and other (15%). Conclusions: A considerable proportion of young people with LTC in a paediatric hospital scored in the clinical range for common mental health problems, indicating a potential for psychological interventions.

scholarly journals 2054. Hospital-initiated Antibiotics in Nursing Homes

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S692-S692
Author(s):  
Jon P Furuno ◽  
Brie N Noble ◽  
Vicki Nordby ◽  
Bo Weber ◽  
Jessina C McGregor ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Hospital Setting ◽  
Antibiotic Prescribing ◽  
Administration Route ◽  
Electronic Health Record Data ◽  
For Profit ◽  
Duration Of Therapy ◽  
Record Data ◽  
One Year ◽  
The One

Abstract Background Nursing homes (NHs) are required by the Centers for Medicare and Medicaid Services to maintain antimicrobial stewardship programs. Hospital-initiated antibiotics may pose a barrier to optimizing antibiotic prescribing in this setting. Our objective was to characterize hospital-initiated antibiotic prescriptions among NH residents. Methods We collected electronic health record data on antibiotic prescribing events within 60 days of residents’ admission to 17 for-profit NHs in Oregon, California, and Nevada between January 1, and December 31, 2017. We characterized antibiotics prescribed, administration route, and proportion initiated in a hospital setting. Results Over the one-year study period, there were 4350 antibiotic prescribing events among 1633 NH residents. Mean (standard deviation) age was 77 (12) years and 58% were female. Approximately 45% (1,973/4,350) of antibiotics prescribed within 60 days of NH admission were hospital-initiated. The most frequently prescribed hospital-initiated antibiotics were cephalosporins (27%; 1st gen: 54%, 2nd gen: 6%, 3rd gen: 34%, 4th gen: 5%, 5th gen: 1%), fluoroquinolones (20%), and penicillins (14%; natural penicilins: 4%, semisynthetic penicillins: 3%, aminopenicillans: 57%, β-lactam/β-lactamase inhibitors: 21%, and antipseudomonal penicillins: 15%). Additionally, 24% of antibiotics were parenteral and the median (interquartile range) duration of therapy was 6 (3–10) days. Over 15% of residents with hospital-initiated antibiotics were readmitted to the hospital within 30 days. Conclusion Approximately 45% of antibiotic prescribing in a multistate sample of NHs were hospital-initiated, of which roughly 40% was broad-spectrum. Interventions specifically targeting antibiotic prescribing during and following the transition from hospitals to NHs are needed. Disclosures All authors: No reported disclosures.

A Novel Recurrent Generalized Congruence Neural Network Measure for Objective Speech Quality Evaluation

2012 ◽  
Vol 433-440 ◽  
pp. 2282-2287
Author(s):  
Tian Yun Yan
Keyword(s):  
Neural Network ◽  
Quality Evaluation ◽  
Speech Quality ◽  
System Model ◽  
The Novel ◽  
Training Time ◽  
Network Measure ◽  
Comparison Results ◽  
Objective Speech Quality ◽  
New System

A new system model for objective speech quality evaluation based on the improved recurrent generalized congruence neural network (RGCNN/OSQE) is proposed. The performance of the RGCNN model is compared with the most commonly used RBFNN (radial basis function neural network) model in objective speech quality evaluation. Comparison results show that the RGCNN model has higher correlation coefficient, less deviation, and saves about half training time, i.e., the RGCNN model has obvious advantages over the RBFNN model. Therefore, the novel RGCNN model for objective speech quality evaluation is feasible and effective.

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