Southern medical journal
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Southern medical journal · Feb 2021
Maternity Units in Rural Hospitals in North Carolina: Successful Models for Staffing and Structure.
Almost 15% of all US births occur in rural hospitals, yet rural hospitals are closing at an alarming rate because of shortages of delivering clinicians, nurses, and anesthesia support. We describe maternity staffing patterns in successful rural hospitals across North Carolina. ⋯ Innovative staffing models, including family physicians, nurse midwives, and nurse anesthetists, are critical for the survival of rural hospitals that provide vital maternity services in underserved areas.
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Southern medical journal · Feb 2021
Supporting Trainees by Addressing Inappropriate Behaviors by Patients.
Physicians in training may be particularly vulnerable to the negative effects of discrimination and inappropriate behaviors by patients. We sought to determine the frequency of inappropriate behaviors by patients toward Internal Medicine (IM) residents, residents' confidence to manage the behaviors, and differences among demographic characteristics, including race, sex, and level of clinical experience. ⋯ Our study highlights that macro- and microaggressions by patients toward IM residents are common. Curricula are needed to equip trainees with tools to appropriately respond during such encounters.
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Southern medical journal · Feb 2021
Using a Resident-Led School Outreach Program to Improve Knowledge of All-Terrain Vehicle Safety.
During the past decade, all-terrain vehicle (ATV)-related injuries treated in US emergency departments decreased by 33%, down to approximately 100,000 injuries in 2016. In comparison, the number of children evaluated for ATV injuries in the Children's of Alabama emergency department more than doubled between 2006 and 2016, counter to the national trend. The American Academy of Pediatrics guidelines state that ATV operators should be at least 16 years old; however, children younger than 16 continue to represent almost one-third of all ATV-related injuries nationwide, and nearly all of the injuries to children in Alabama. ⋯ The STARs program dramatically improved short-term ATV safety knowledge, and many participants reported they were likely to subsequently use the safe practices presented. School-based programs, such as STARs, may help increase ATV safety awareness and change behaviors in high-risk age groups. This training may be successfully provided by various motivated individuals, including medical residents.
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Southern medical journal · Feb 2021
Improving Fecal Immunochemical Testing Rates for Colon Cancer Screening in the Outpatient Setting.
The amount of colorectal cancer (CRC) screening using the noninvasive fecal immunochemical test (FIT) at a federally qualified health center, Five Rivers Health Clinic (Dayton, Ohio), has been low historically. Our quality improvement (QI) project aimed to improve CRC screening adherence in eligible patients who opted for FIT. ⋯ The compliance rate for FIT completion and return more than doubled among our clinic patients after using a three-component QI intervention. Except for a difference in race, the lack of association between demographic and clinical characteristics with either pre-I/post-I group or return/no return of the FIT card leads us to conclude that our QI program for increasing FIT compliance is effective. Other settings where CRC screening is a prominent component of preventive care may benefit from adopting a similar QI intervention.
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To evaluate the willingness of young adult males to use male hormonal contraception and to determine the most desirable formulation. ⋯ There is significant interest among young adult males in using various forms of MHC, especially in injectable form. Differences in views of MHC were seen in two distinct male populations. Specifically, males who achieved a higher level of education, were employed, or in a relationship were found to more frequently be willing to use MHC. With further research and funding, MHC may serve as a significant way to decrease unintended pregnancies in the future.