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Grants & Research

Publications

2015 Selected Publications

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McGuire R and Moore E. Using a Configurable EMR and Decision Support Tools to Promote Process Integration for Routine HIV Screening in the Emergency Department. Journalof the American Medical Informatics Association 2015. doi: 10.1093/jamia/ocv031

Summary: Given the clinical and public health benefits of routine HIV testing, Maricopa Integrated Health System is the first and, to-date, only hospital in Arizona to implement routine, non-targeted, opt-out, rapid HIV screening in the ED. This case report describes program implementation in the adult ED of an urban safety-net hospital serving under-served populations, including the uninsured and under-insured. Through a controlled and collaborative process, MIHS integrated custom documentation elements specific to HIV screening into the triage/intake process, implemented and utilized clinical decision support tools to guide clinicians in each step of the process, and used electronic data collection and reporting to drive new screening protocols that led to a significant increase in overall HIV testing rates.

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Edmonds A et al. Social Work and the HIV Care Continuum: Assisting HIV Patients Diagnosed in an Emergency Department. Social Work. DOI: 10.1093/sw/swv011

Summary: Social workers have played an integral role in society’s response to the HIV/AIDS pandemic since the discovery of the disease. As the landscape of the epidemic has changed, so has the social work response to it. Social workers are, and have been, central to the success of TEST AZ (Test, Educate, Support, and Treat Arizona), which is a nontargeted, routine opt-out HIV screening program in the emergency department (ED) of Maricopa Medical Center.

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2014 Selected Publications

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Storrow AB et al. Diagnostic performance of cardiac troponin I for early rule-in and rule-out of acute myocardial infarction: results of a prospective multicenter trial. Clinical Biochemistry. DOI: 10.1016/j.clinbiochem.2014.08.018

Summary: The emergency departments at several medical centers, including MIHS, assessed the cardiac protein, troponin, for its accuracy in predicting heart attacks. As troponin values increased, the probability of heart attack also increased, which may prove to be useful for acute care.

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Storrow AB et al. Absolute and relative changes (delta) in troponin I for early diagnosis of myocardial infarction: results from a prospective multicenter trial. Clinical Biochemistry. DOI: 10.1016/j.clinbiochem.2014.09.012

Summary: The emergency departments at several medical centers, including MIHS, assessed the cardiac protein, troponin, for its accuracy in predicting heart attacks. Across three time intervals, absolute changes in troponin levels showed better predictive accuracy than relative changes, which could be used with baseline troponin levels to calculate heart attack probability.


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Lorello DJ et al. Results of a prospective randomized controlled trial of early ambulation of patients with lower extremity autografts. Journal of Burn Care & Research 35; 431-436. DOI: 10.1097/BCR.0000000000000014

Summary: The AZ Burn Center at MIHS studied whether patients who begin walking within one day of autografting will be at greater risk of graft failure vs. patients who are immobile until five days after the procedure. There was not a higher rate of graft loss for patients walking within one day, suggesting that patients can safely walk soon after surgery without fear of graft failure.


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Rimmer RB et al. The reported pain coping strategies of pediatric burn survivors—does a correlation exist between coping style and development of anxiety disorder? Journal of Burn Care & Research. DOI: 10.1097/BCR.0000000000000109

Summary: The AZ Burn Center at MIHS looked for an association between self-reported pain coping skills and anxiety levels in pediatric burn patients. Children who internalize pain could be more likely to experience long-term anxiety, and an anxiety questionnaire could help clinicians identify such children.

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Geren K et al. Identification of Acute HIV Infection Using Fourth Generation Testing in an Opt-out Emergency Department Screening Program. Annals of Emergency Medicine. DOI: 10.1016/j.annemergmed.2014.05.021

Summary: The emergency department at MIHS adopted routine HIV testing. This new way of testing was able to better identify recent infections, enabling earlier treatment and linkage to care.

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Vyles D et al. Predictors of Serious Bacterial Infections in Pediatric Burn Patients with Fever. Journal of Burn Care & Research 35, 291-295.

Summary: The AZ Burn Center at MIHS reviewed records to predict bacterial infections.  Larger total body surface area of burns predicted serious infections, which may allow doctors to better adjust treatment for more severe burns and to improve patient outcomes.

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Rimmer et al. Parent vs. Burn-Injured Child Self-Report: Contributions to a Better Understanding of Anxiety Levels. Journal of Burn Care & Research 35, 296-302.

Summary: The AZ Burn Center at MIHS gave patients and parents an anxiety survey. This showed that parents underestimate the anxiety their children experience during treatment, suggesting that staff should seek both child and parental perspectives to ensure the best outcomes for patients.

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