Interprofessional Education: TeamSTEPPS® and Simulation With Respiratory Therapy and Nursing Students in Their Final Year.

TeamSTEPPS is a curriculum designed to improve team communication to reduce medical errors and improve patient safety. This exploratory study used a questionnaire to explore differences in attitudes of 130 nursing and respiratory therapy students using a TeamSTEPPS-based interprofessional education seminar and simulation. Results support that students' attitudes regarding the principles Team Structure, Leadership, Situation Monitoring, Mutual Support, and Communication improved from Time 1 (preseminar) to Time 2 (postseminar; p < .05). This improvement was sustained at Time 3 (postsimulation) in all principles except for Mutual Support. Participation in a TeamSTEPPS seminar and simulation can influence attitudes among health care professional students.

Provider Perspectives on Analgesic Use in Intrauterine Device Insertion Procedures: A Mixed Methods Analysis.

CONTEXT: The intrauterine device (IUD) is one type of long-acting reversible contraceptive that is becoming increasingly popular among patients and healthcare providers alike, though many are deterred from using this option due to pain or fear of pain with IUD insertion. While the IUD insertion process itself is standardized, the use of pain medication is not. There is a lack of research regarding provider preference in analgesic use for IUD insertion procedures, which analgesics are being provided to patients, and under which circumstances. This study aims to explore which analgesics are being used routinely in clinical settings, which patient populations are more likely to receive or benefit from these treatments, and why. Secondarily, this study aims to evaluate the impacts of provider characteristics such as location of training and practice, length of practice, and type of training in analgesic administration. METHODS: Various national organizations were contacted via email and asked to distribute the "IUD Pain Management" survey via discussion board or email newsletter. This survey was developed to gather demographic information on providers of IUD placement procedures and evaluate trends in analgesic methods used based on provider and patient characteristics. Additionally, the survey included an opportunity for participants to agree to participate in a brief interview to further elaborate on their responses via phone. Survey responses were collected and evaluated on the secure QuestionPro platform. Results from the interview were qualitatively assessed by coding recurrent themes between participant interviews. RESULTS: Survey respondents represented physicians from family medicine and OB-GYN specialties, as well as nurse practitioners, registered nurses, physician assistants, and OB-GYN resident physicians. The average length of clinical practice is 6.7 years. The majority of respondents reported offering some sort of analgesic for IUD insertion procedures, with nonsteroidal anti-inflammatory drugs being the most commonly used. Participants also reported an increased likelihood of prescribing analgesics for adolescent and nulliparous patients. Participant interviews included themes such as patient perception of pain, provider training, barriers to access, and alternative analgesic options. CONCLUSIONS: Our study has identified a significant amount of variation in practices regarding analgesic use for IUD insertion procedures and highlighted some underlying causes of these inconsistencies. Future studies should further investigate trends in analgesic administration in IUD insertion procedures with a larger sample size and delve into factors such as provider education and barriers to access.

Use of a discussion provoking board game for revealing privilege.

The article discusses the use of a board game, Reality Check: The Game of Privilege, as a tool to promote dialogue and understanding of privilege among medical students and faculty. The game was played in groups of 5-6 participants, and each player assumed the role of a character with specific socioeconomic, sexual orientation, race, and gender identity. Debriefing sessions and anonymous surveys were conducted after each play session, and the findings were reviewed to identify themes and refine future play sessions. The results of the study showed that the game was effective in promoting discussion and reflection on the impact of privilege and bias on healthcare. The debriefing sessions and feedback from participants highlighted the complexity of privilege and circumstance and its impact on patients' care. The study's authors suggest that the game can be used to create a more inclusive and equitable healthcare system that meets the needs of all patients by recognizing and understanding privilege.

Applying the Pit Crew Resuscitation Model to the Inpatient Care Setting.

The Pit Crew Resuscitation model for team performance was designed to facilitate emergency team performance. This article documents observations during model implementation to the in-hospital setting. Low-fidelity simulations were evaluated on medical-surgical nursing units. Six significant findings were obtained: finder confusion, first responder chaos, leaderless teams, equipment disorder, limited space, and disjointed integration. Recommendations were developed and tested. Research is needed to develop training methods for in-hospital application.

A diagnostic dilemma of appendicular mass in an elderly patient: a case report and literature review.

Primary appendicular adenocarcinoma is a rare tumor, mucinous variety, being most common. The case presentation highlights the unusual appearance and diagnostic dilemma of an appendicular adenocarcinoma. Our elderly patient presented with an ill-defined tender lump which later was diagnosed as a perforated appendicular adenocarcinoma, responsive to single-staged surgery and adjunct chemotherapy. We considered the single-staged surgery since the appendix was perforated and right colectomy would not aid the prognosis. High index of clinical suspicion for malignancy should be kept in mind for elderly patients presenting with an appendicular lump. Every effort should be made during the elective surgery to remove the mass during the single-staged surgery.

Cured by Da Vinci Xi: meticulous dissection of an infected urachal cyst presenting with lower urinary tract symptoms in an adult.

An unusual finding in an adult patient with an infected urachal cyst, was treated surgically using the Da Vinci robot. A 26-year-old woman was admitted to our hospital with complaints of lower abdominal pain and burning sensation with urination. She was diagnosed with lower urinary tract infection, treatment did not help her symptoms and further evaluation of CT revealed complex enhancing mass superior to the urinary bladder. The differentials included inflammatory cause such as an abscess, neoplastic mass, urachal cyst, vitello intestinal fistula and urachal sinus. Da Vinchi robotic diagnostic laparoscopy was performed to obtain an accurate assessment and treatment. After cystoscopy followed by laparoscopic exploration of the abdominal and pelvic cavity further helped to narrow down a diagnosis of remnants of urachus. Pathology of the excised specimen showed inflammation without evidence of malignancy and confirmed Urachal cyst. The patient had an uneventful post-operative course.