Telehealth through the pandemic at a safety net hospital: observations and next steps for cancer care delivery.

The COVID-19 pandemic revolutionized cancer care delivery leading to rapid adoption of digital technology for telehealth in the United States. In this study, we describe telehealth utilization trends across the three largest waves of the pandemic at a safety net academic center. We also provide a perspective on lessons learnt and our vision for cancer care delivery using digital technology in the near future. The integration of interpreter services within the video platform and its integration within the electronic medical record system is crucial for safety net institutes that service a diverse patient population. Pay-parity for telehealth, especially ongoing support for audio-only visits, will be critical in overcoming health disparities for patients without access to smartphone technology. Use of telehealth in clinical trials, widespread adoption of hospital at home programs, electronic consults for rapid access, and structured telehealth slots in clinic templates will be crucial in making cancer care more equitable and efficient.

Evaluation of a Nurse-Initiated Routine HIV Testing Pilot on a Medical-Surgical Unit.

National guidelines recommending a shift from risk-based to routine HIV testing for persons ages 13-64 are described. The role of nurses, particularly medical-surgical nurses, in increasing the number of people screened is discussed.

Implementation of routine HIV testing in an acute care hospital in Rhode Island: a nurse-initiated opt-out pilot project.

The Centers for Disease Control and Prevention (CDC) expanded HIV screening of adults ages 13-64 years in 2006 from risk based to routine. Early detection and treatment improve patient outcomes and prevent disease transmission. This article describes a pilot program in which nurses in an adult inpatient unit at an acute care hospital offer HIV testing to all patients ages 18-64 upon admission through standing orders. The pilot, Standing Orders for Routine Testing (SORT), is a response to changes in state law and regulations in the majority of states including Rhode Island, which have occurred following the CDC policy change. The SORT pilot involves collaboration with interdisciplinary partners and education of unit nurses.

Impact of lower extremity strengthening exercises and mobility on fall rates in hospitalized adults.

Preventing falls in acute care hospitals is a major challenge, and achieving positive outcomes has remained elusive. The purpose of this study was to examine the impact of lower extremity strengthening exercises and mobility on fall rates and fall rates with injury. A nonequivalent control group design was used. Subjects on the intervention unit received targeted lower extremity strengthening exercises and ambulation using a nurse-driven mobility protocol; subjects on the control unit received ambulation alone. One assisted fall occurred on the intervention unit.

Race and sex associations to weight concerns among urban African American and Caucasian smokers.

This study compared general weight concerns (Drive for Thinness, Body Dissatisfaction, and Cognitive Restraint) and smoking-specific weight concerns among adult African American and Caucasian women and men smokers enrolled in a smoking cessation clinical trial. Participants were 119 African Americans (73 female) and 182 Caucasians (90 female). Results revealed that general weight concerns were higher in Caucasians versus African Americans, and in women compared with men but there were no race by sex interactions. Drive for Thinness and Body Dissatisfaction was higher in women compared with men, and Cognitive Restraint was highest in Caucasian women. Finally, smoking-specific weight concerns were higher in Caucasian women than both Caucasian and African American men, with African American women intermediate. Results indicate that while Caucasian women preparing to quit smoking exhibited the highest levels of concern about weight, smoking-specific weight concerns, and certain sub-components of general weight concerns were also prevalent among African Americans and Caucasians. Future research is needed to elucidate how race and sex differences in weight concerns may impact smoking cessation.