OBJECTIVESTo evaluate the pediatric prescription medication discharge delivery and counseling program, implemented at an 186-bed children's hospital integrated within a larger academic medical center, and its effectiveness on reducing hospital readmissions.METHODS This study was a retrospective chart review of existing data in the electronic medical record from patients <21 years of age who were discharged from our institution between September 1, 2014, and November 30, 2014. Patients who participated in the pediatric discharge program were compared to non-participants. The primary objective was to determine if the patient was readmitted within 30 days. Secondary objectives included time until readmission, diagnosis at discharge, and hospital unit at discharge. RESULTSIn total, 1804 patients were assessed. After exclusions, 932 subjects were included in the analysis. In total, 393 (42.2%) patients participated in the pediatric medication discharge and counseling program, and 539 did not participate. Of the patients who participated in the program, 52 were readmitted within 30 days (13.2%), compared with 67 patients (12.4%) who did not participate in the discharge program, p = 0.717. Patients with the diagnoses of malignancy and kidney injury were more likely to be readmitted within this time frame, and those with the diagnoses of heart defects or cardiology disorders and malignancy were more likely to participate in the pediatric prescription medication discharge program.CONCLUSION Participation in the pediatric discharge medication delivery and counseling program did not reduce hospital readmission rate within 30 days.ABBREVIATIONS EMR, electronic medical record; PCICU, pediatric cardiac intensive care unit; PPMDP, pediatric prescription medication discharge program; RSV, respiratory syncytial virus
Context Best practice guidelines indicate the need for suicide prevention training for athletic trainers. However, no resources exist that address suicide prevention programs that are specifically designed for athletic trainers and their roles working with student-athletes and mental health crisis teams. Objective To describe an introductory model for implementing suicide prevention training into an athletic training curriculum. Background Current Commission on Accreditation of Athletic Training Education standards identify suicidal ideation as one of the behavioral health conditions that need to be addressed within athletic training curricula. Introducing educational models for implementing suicide prevention training and mental health emergency action plans (EAPs) into curricula will assist educators in preparing athletic training students to recognize and assist student-athletes who are in a suicidal crisis. Description An introductory educational model for implementing suicide prevention training into an athletic training curriculum that highlights gatekeeper training, appropriate suicide terminology, recognition of suicidal ideation in student-athletes, proper responses to student-athletes in crisis, use of experiential exercises, and development of a mental health—suicide-specific EAP. Clinical Advantage(s) Within this educational model, a threefold benefit exists for athletic training students: (1) engagement in meaningful experiential exercises to enhance their readiness to enter clinical practice with the skills and knowledge needed to recognize, assist, and refer student-athletes dealing with suicidal ideation; (2) skill development in the design, development, and implementation of a mental health—suicide-specific EAP; (3) interdisciplinary collaboration with mental health professionals that enhances appreciation for their expertise and promotes the value of each professional's role on the mental health crisis team. Conclusion(s) This introductory model for implementing suicide prevention training within an athletic training curriculum offers an instructional strategy that supports the Commission on Accreditation of Athletic Training Education standards, professional readiness for athletic training students, and interdisciplinary collaboration among mental health and athletic training professionals.
Background: Cancer patients who self-report tobacco use within the past 30 days are at high risk for relapse and benefit from cessation support. However, there is little data on whether assessment of tobacco use within the past 30 days increases referral rates to a cessation program across cancer disease sites. Methods: Structured tobacco assessments were administered to 426 new adult patients in a Radiation Oncology clinic at a single institution. Multiple logistic regression was used to assess if clinical aspects of cancer diagnosis (age, gender, race, disease site [head/neck or thoracic {HNT} vs. other], stage [advanced vs. early], and purpose [curative vs. palliative]) affected cessation service referral rates identified using assessment of tobacco use within the past 30 days. Results: Complete medical and tobacco use data were compiled for 387 adult cancer patients (91%). Of these, 147 (38%) were women, 259 (67%) were Caucasian, 115 (30%) were black, 177 (46%) were diagnosed with HNT cancer, and 289 (74%) were being considered for curative cancer treatment. Ever smoking was reported in 273 patients (71%), and 83 (21%) reported current smoking everyday or some days. In 180 former smokers who reported time since last cigarette, 21 (12%) reported smoking within with past 30 days and 9 (7%) of these reported smoking within the past day or week. In 21 patients who were identified for cessation support through evaluation of smoking within the past 30 days, 6 (29%) were women, 7 (33%) were black, 15 (71%) were being considered for curative treatment, and 15 (71%) were diagnosed with a HNT cancer. Multiple logistic regression identified that younger age (10 yr OR 2.41, 95% CI 1.47 - 3.98) and HNT cancer (OR 8.13, 95% CI 2.2-30.3) but not gender, race, stage, and purpose were significantly associated with referral based on assessment of tobacco use within the past 30 days. Identification of smoking within the past 30 days increased cessation referrals by 25% from 83 to 114 patients. Conclusions: Assessment of tobacco use within the past 30 days increased referrals to a smoking cessation program from a Radiation Oncology clinic using a standardized tobacco assessment. In clinical trials and practice, including this question has particular benefit for younger patients and patients with head/neck or thoracic tumors. Citation Format: Samuel Lewis Cooper, Katherine Hoover, Elizabeth Garrett-Mayer, Kenneth Michael Cummings, Matthew J. Carpenter, Kelly Crowley, David T. Marshall, Graham W. Warren. Assessment of tobacco use within 30 days increases referral for cessation support. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 3736. doi:10.1158/1538-7445.AM2015-3736
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