OASIS Clinic

After implementing a comprehensive fall program, a critical process for investigating patient fall events, the post-fall huddle form (PFHF), was identified as an opportunity to collect extensive data to promote fall prevention. However, the PFHF was a manual process in paper format only and consisted of approximately 50 questions. The process was deemed laborious and wasn't consistently completed. The aim was to promote completion rates and evaluate the impact on direct care nurses in a neurosciences unit. The quality improvement project included designing an electronic PFHF, education for entering and validating the data, routine feedback, and pre- and postimplementation surveys. Supportive features included force functions, deidentification, electronic health record interoperability, and automated leader notification. Completion rates improved from 11.1% to an overall average of 99.6%. There was statistical significance related to decreased time to complete the form electronically for the initiator (P = .035) and the validator (P = .003). Frustrations and concerns expressed during the preimplementation survey decreased upon using the electronic PFHF. Utilizing technology, the electronic PFHF increased completion rates, enhanced data collection, and improved staff satisfaction. In addition, health care leaders increased the valuable data needed to promote patient safety and cost-savings.

Abstract This chapter explores the success of the Oasis Intergenerational Tutoring Program over a span of thirty-five years. Established in 1989 as a community engagement opportunity, the tutoring program has grown to be the primary volunteer program of the Oasis Institute. Older adult volunteers are paired with children who benefit from assistance with reading and literacy. The caring, supportive relationships that the Oasis tutors form with the students offer a mentoring component as the children regularly interact with an adult role model. How the program continues to be relevant for school staff, children, and older adults is highlighted through both qualitative and quantitative data combined with information gleaned from interaction with the program’s stakeholders. Challenges to implementation and continued expansion of the Oasis Tutoring Program are also delved into.

Compulsory treatment has decades of history in Iran; both before and after the Islamic Revolution, but there are many debates regarding its efficacy and effectiveness. Retention Rate is one of the best indices to estimate the efficacy of treatment. This study will compare Retention Rate among people referred from compulsory treatment centers and volunteer participants. This was a retrospective (historical) cohort study that has been conducted among people who were taking methadone maintenance treatment (MMT). The study sample was selected from the MMT centers that admit both referral patients from compulsory centers and voluntary patients. All newly admitted patients from March 2017 to March 2018 were enrolled and followed up until March 2019. A total of 105 participants were recruited for the study. All were males with a mean age of 36.6 ± 7.9 years. Fifty-six percent of individuals were referred from compulsory residential centers. The total one-year retention rate of participants in this study was 15.84%. The one-year retention rate for the patients referred from compulsory residential centers and the non-referred patients was 12.28 and 20.45%, respectively (value of p = 0.128). Among the other studied factors, only marital status was significantly associated with MMT retention (p = 0.023). Although the average treatment adherence time for non-referred patients was about 60 days higher than those referred from compulsory residential centers, this study found no significant differences in retention days and a one-year retention rate. Further studies with larger sample sizes and longer follow-ups are needed to explore the efficacy of compulsory treatment methods in Iran.

Practices regarding recovery after mastectomy vary significantly, including overnight stay versus discharge same day. Expanded use of Enhanced Recovery After Surgery (ERAS) algorithms and the recent COVID pandemic have led to increased number of patients who undergo home recovery after mastectomy (HRAM). The Patient Safety Quality Committee of the American Society of Breast Surgeons created a multispecialty working group to review the literature evaluating HRAM after mastectomy with and without implant-based reconstruction. A literature review was performed regarding this topic; the group then developed guidance for patient selection and tools for implementation. Multiple, retrospective series have reported that patients discharged day of mastectomy have similar risk of complications compared with those kept overnight, including risk of hematoma (0-5.1%). Multimodal strategies that improve nausea and analgesia improve likelihood of HRAM. Patients who undergo surgery in ambulatory surgery centers and by high-volume breast surgeons are more likely to be discharged day of surgery. When evaluating unplanned return to care, the only significant factors are African American race and increased comorbidities. Review of current literature demonstrates that HRAM is a safe option in appropriate patients. Choice of method of recovery should consider patient factors, such as comorbidities and social situation, and requires input from the multidisciplinary team. Preoperative education regarding pain management, drain care, and after-hour access to medical care are crucial components to a successful program. Additional investigation is needed as these programs become more prevalent to assess quality measures such as unplanned return to care, complications, and patient satisfaction.

Article Johann Georg Sulzer – Johann Jakob Bodmer, Briefwechsel. Kritische Ausgabe. Hg. von Elisabeth Décultot und Jana Kittelmann unter Mitarbeit von Baptiste Baumann. 2 Bde. (Johann Georg Sulzer, Gesammelte Schriften 10) Schwabe, Basel 2020. LI/1994 S., CHF 340,–. was published on April 1, 2022 in the journal Arbitrium (volume 40, issue 1).

PurposeChild marriage is associated with multiple adverse health and social outcomes. Although evidence suggests that child marriage is associated with reduced participation in personal and household decisions for women, less is known about the association between age at marriage and decision-making among married adolescent girls. This study assesses associations between adolescents' age at marriage and two dimensions of decision-making (participation and satisfaction) in the high early marriage prevalence settings of Niger. MethodsCross-sectional data from a cluster-randomized control trial of a community-level program to increase the use of modern contraceptives among married adolescents in the Dosso region of Niger were analyzed. Multiple logistic regression models were used to determine the association of age at marriage with married girls' participation in and satisfaction with decision-making processes. ResultsMore than half of married adolescents (N = 796) were married before reaching the age of 15 years. Older age at marriage was associated with adolescents' increased participation in decisions related to economics (adjusted odds ratio: 1.23; 95% confidence interval: 1.05–1.43) and health-care access (adjusted odds ratio: 1.18; 95% confidence interval: 1.01–1.40), but not with greater reported satisfaction with their control over these decisions. ConclusionsThe study suggests that marrying as a very young adolescent places girls in even more disadvantaged positions regarding decision-making. These findings indicate the need to design programs targeted at addressing inequitable gender norms to reduce early child marriage and increase participation in decision-making. Further study of satisfaction with participation in decision-making is recommended, including consideration of whether it is related to gender norms for participation in decisions rather than actual participation.