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1.
J Patient Exp ; 10: 23743735231151544, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36698622

RESUMO

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey measures patient perceptions of hospital experience to determine the annual Center for Medicare and Medicaid Services (CMS) reimbursement. This study focuses on the "Quiet at Night" variable and identifies institutions with the highest scores to determine characteristics that facilitate patient sleep. The key findings were as follows: CMS Top Rated Hospitals have a mean score of 5 on the "Quiet at Night" variable.US News Honor Roll Hospitals have a mean score of 2.67, with a statistically significant difference of P < .001 between the groups.The key characteristics of the CMS Hospitals are that they are predominantly privately owned, specialized, surgical facilities with few total hospital beds.Knowing that HCAHPS scores directly impact and reflect patient experience, the objective of this study was to better understand the hospital practices that facilitate a high score on the "Quiet at Night" question to empower low scoring hospitals to improve their sleep practices at night and to score higher on the HCAHPS survey.

2.
STAR Protoc ; 4(3): 102410, 2023 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-37393611

RESUMO

Plasmonic nanoparticles and nanocrystalline materials have broad applicability in catalysis, optoelectronics, sensing, and sustainability. Below, we detail a robust protocol for the synthesis of bimetallic Au-Sn nanoparticles in mild, aqueous conditions. This protocol describes the steps for synthesizing gold nanoparticle seeds, diffusing Sn into the seeds by chemical reduction, and the optical and structural analysis by UV-visible spectroscopy, X-ray diffraction, and electron microscopy. For complete details on the use and execution of this protocol, please refer to Fonseca Guzman et al.1.


Assuntos
Nanopartículas Metálicas , Estanho , Estanho/química , Ouro/química , Ligas de Ouro , Prata/química , Nanopartículas Metálicas/química
3.
J Hosp Med ; 17(8): 633-638, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35854665

RESUMO

The objective of this study was to understand the existing practices and attitudes regarding inpatient sleep at the 2020 US News and World Report (USNWR) Honor Roll pediatric (n = 10) and adult (n = 20) hospitals. Section chiefs of Hospital Medicine from these institutions were surveyed and interviewed between June and August 2021. Among 23 of 30 surveyed physician leaders (response rate = 77%), 96% (n = 22) rated patient sleep as important, but only 43% (n = 10) were satisfied with their institutions' efforts. A total of 96% (n = 22) of institutions lack sleep equity practices. Fewer than half (48%) of top hospitals have sleep-friendly practices, with the most common practices including reducing overnight vital sign monitoring (43%), decreasing ambient light in the wards (43%), adjusting lab and medication schedules (35%), and implementing quiet hours (30%). Major themes from qualitative interviews included: importance of universal sleep-friendly cultures, environmental changes, and external incentives to improve patient sleep.


Assuntos
Hospitais , Pacientes , Adulto , Criança , Humanos , Sono , Inquéritos e Questionários
4.
Microbiol Resour Announc ; 11(2): e0123221, 2022 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-35175117

RESUMO

Here, we report the draft genome sequence of three glutaraldehyde-resistant isolates from produced water from hydraulic fracturing operations. The three strains were identified as Marinobacter sp. strain G11, Halomonas sp. strain G15, and Bacillus sp. strain G16. The genome sequences of these isolates will provide insights into biocide resistance in hydraulic fracturing operations.

5.
Pilot Feasibility Stud ; 7(1): 161, 2021 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-34412696

RESUMO

BACKGROUND: Sleep disturbances in hospitalized patients are linked to poor recovery. In preparation for a future randomized controlled trial, this pilot study evaluated the feasibility and acceptability of a multi-component intervention (I-SLEEP) that educates and empowers inpatients to advocate for fewer nighttime disruptions in order to improve sleep during periods of hospitalization. METHODS: Eligible inpatients received I-SLEEP, which included an educational video, brochure, sleep kit, and three questions patients can ask their team to reduce nighttime disruptions. Following I-SLEEP, inpatients were surveyed on the primary feasibility outcomes of satisfaction with and use of I-SLEEP components. Inpatients were also surveyed regarding empowerment and understanding of intervention materials. Patient charts were reviewed to collect data on nighttime (11 PM-7 AM) vital sign and blood draws disruptions. RESULTS: Ninety percent (n = 26/29) of patients were satisfied with the brochure and 87% (n = 27/31) with the video. Nearly all (95%, n = 36/37) patients felt empowered to ask their providers to minimize nighttime disruptions and 68% (n = 26/37) intended to alter sleep habits post-discharge. Forty-nine percent (n = 18/37) of patients asked an I-SLEEP question. Patients who asked an I-SLEEP question were significantly more likely to experience nights with fewer disruptions due to nighttime vitals (19% vs. 2.1%, p = 0.008). CONCLUSION: This pilot study found that I-SLEEP was well-accepted and enabled hospitalized patients to advocate for less disrupted sleep. Educating patients to advocate for reducing nighttime disruptions may be a patient-centered, low-cost strategy to improve patients' care and in-hospital experience. These results suggest that I-SLEEP is ready to be evaluated against routine care in a future randomized controlled trial. TRIAL REGISTRATION: ClinicalTrials.Gov NCT04151251 .

6.
Hosp Pediatr ; 11(4): 327-333, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33731336

RESUMO

OBJECTIVES: Hospitalized children experience frequent nighttime awakenings. Oral medications are commonly administered around the clock despite the comparable efficacy of daytime administration schedules, which promote sleep. With this study, we evaluated the effectiveness of a quality improvement initiative to increase the proportion of sleep-friendly antibiotic administration schedules. METHODS: Interprofessional stakeholders modified computerized provider order entry defaults for 4 oral antibiotic medications, from around the clock to administration occurring exclusively during waking hours. Additionally, care-team members received targeted education. Outcome measures included the proportion of sleep-friendly administration schedules and patient caregiver-reported disruptions to sleep. Pre- and posteducation surveys were used to evaluate education effectiveness. Balancing measures were missed antibiotic doses and related escalations of care. RESULTS: Interrupted time series analysis revealed a 72% increase (interceptpre: 18%; interceptpost: 90%; 95% confidence interval: 65%-79%; P < .001) in intercept for percentage of orders with sleep-friendly administration schedules (orders: n pre = 1014 and n post = 649). Compared with preeducation surveys, care-team members posteducation were more likely to agree that oral medications scheduled around the clock cause sleep disruption (resident: 71% pre, 90% post [P = .01]; nurse: 63% pre, 79% post [P = .03]). Although sleep-friendly orders increased, patient caregivers reported an increase in sleep disruption due to medications (pre 28%, post 46%; P < .001). CONCLUSIONS: A simple, low-cost intervention of computerized provider order entry default modifications and education can increase the proportion of sleep-friendly oral antibiotic administration schedules for hospitalized children. Patient perception of sleep is impacted by multiple factors and often does not align with objective data. An increased focus on improving sleep during hospitalization may result in heightened awareness of disruptions.


Assuntos
Pacientes Internados , Melhoria de Qualidade , Cuidadores , Criança , Criança Hospitalizada , Humanos , Sono
7.
J Am Geriatr Soc ; 67(1): 21-28, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30586155

RESUMO

The mission of the Patient-Centered Outcomes Research Institute (PCORI) is to fund the production of high-quality evidence that will enable patients and clinicians to make informed, personalized healthcare decisions. Since 2012, the PCORI has invested $177 million in patient-centered comparative effectiveness research (CER) that specifically targets the health needs of older adults, with additional relevant studies in its broader portfolio. Developing the PCORI's research portfolio has provided us with significant insights into what factors to consider when conducting CER in older adult populations. When comparing the net benefit of two or more interventions for older adults, investigators should consider the following: absolute risk difference, competing risks, life expectancy, the difference between chronologic and physiologic age, the importance of patient preferences, and other potential drivers of variable treatment effects. Investigators should also engage older adults and their caregivers as partners throughout the research process. Their input helps to identify key outcomes of interest and insights about the conduct of the research. As the PCORI continues to support research that addresses the healthcare decisions of the rapidly growing older adult population, it needs to partner with patients and researchers to identify the most important questions to address. J Am Geriatr Soc 67:21-28, 2019.


Assuntos
Pesquisa Comparativa da Efetividade/métodos , Geriatria/métodos , Avaliação de Resultados da Assistência ao Paciente , Assistência Centrada no Paciente , Academias e Institutos , Idoso , Idoso de 80 Anos ou mais , Tomada de Decisões , Feminino , Humanos , Masculino , Pesquisadores , Estados Unidos
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