Background: The nature of the Advanced Practice Provider (APP) and attending physician (MD) relationship is that of trust, mutual respect, and delegation. In U.S. territories where MD supervision or oversight of APP practice is required by law, MDs are left to trust and delegate patient care tasks and authority to their collaborating APPs while sharing [...]

Background: Portable Orders for Life-Sustaining Treatment (POLST) forms are an integral patient-centered care tool which facilitate conversation about and documentation of patients’ preferences for life-sustaining treatment. As the proportion of hospitalized patients with serious progressive illness increases over time, advanced care planning has become paramount. Within the adult acute care population, however, POLST form completion [...]

Background: Patient safety assistants (PSAs), or “sitters,” observe patients at bedside considered at “high risk” for in-hospital events [1] such as falls or elopements. While studies suggest PSAs do not impact safety outcomes,[2-4] they are widely utilized without formal guidelines.[2, 5, 6] With increasing healthcare costs and limited resources, efficient care models are sought.[1, 2, [...]

Background: Osteoporosis is a major comorbidity of the elderly. With a high prevalence of primary disease as well as disease-related complications, early diagnosis and treatment is paramount. Medical therapy is available to decrease the rate of bone loss and reduce the rate of fractures. Methods: Using a poster consisting of a simple checklist and prescriptive [...]

Background: Studies have shown that early exposure to statins preoperatively have been associated with significant reductions in perioperative mortality and improved post-operative outcomes [1]. Despite guideline recommendations, use of statin therapy remains sub-optimal [2]. A retrospective study at our institution revealed over 40% of patients that presented to our preoperative optimization clinic were not on [...]

Background: D-dimer is one of the most commonly used tests because of its high sensitivity, but a high false positive rate prevents healthcare providers from efficiently diagnosing pulmonary embolism (PE). This leads to many patients unnecessarily undergoing CT pulmonary angiography (CTPA) scans in the emergency department (ED). This study sought to determine if there is [...]

Background: Naloxone is a medication that reverses opioid overdose in emergency situations and prevents deaths. A group of 55 Eastern Virginia Medical School (EVMS) medical students were trained by REVIVE!, a program that educates on how to recognize and respond to an opioid overdose emergency with the administration of naloxone. We evaluated whether there is [...]

Background: Proper hand hygiene is a cornerstone of infection control [1,2]. Despite this, compliance remains a challenge, averaging only 50% across healthcare systems nationwide [1].Several interventions have been trialed to improve compliance, including audit and feedback [3]. Traditionally, hand hygiene audits have occurred through direct observation. Unfortunately, this approach can capture fewer than 1-3% of [...]

Background: Physician shortage and healthcare access is a serious issue especially in a rural state like Arkansas and the dearth of physicians has further worsened during the COVID-19 pandemic. Many US trained International Medical Graduates (IMGs) serve the underserved communities of Arkansas to fill in the physician gap. However, the uncertainties surrounding immigration policies, especially [...]

Background: Hospital-Associated Disability (HAD) is a life-altering condition that can lead to readmissions and is associated with increased risk for death. Physical therapy (PT) is an invaluable tool to help prevent HAD but, studies have shown that even under normal circumstances, there are a multitude of barriers to adequate PT in hospitalized patients. The COVID-19 [...]