DSpace collection: PA Graduate Student Conference Papers

Awareness and implementation of sepsis guidelines in Kansas hospitals

title: Awareness and implementation of sepsis guidelines in Kansas hospitals authors: Steadham, Matthew; Nyberg, Sue M.; Copas, Gina; Griffin, Audrey
abstract: In 2002 the Surviving Sepsis Campaign was established by an international consortium of healthcare providers as a collaborative effort to reduce mortality from the life-threatening conditions of severe sepsis and septic shock. Resuscitation and treatment guidelines (“Early Goal-Directed Therapy – EGDT”) were developed based on existing literature. There is very little published data evaluating awareness of these guidelines and the capability to implement them in smaller, rural hospitals. This descriptive study was conducted to assess awareness and capability for implementation of EGDT in rural, Kansas hospitals. Methods: A survey tool was designed and mailed to the medical director of the emergency department (ED) in all 129 Kansas hospitals. Non-responders received a second survey, also by mail. Results: Only 25% of respondents were aware of EGDT. Awareness and implementation of the Surviving Sepsis Campaign early goal-directed treatment recommendations is low while the capability of facilities to perform the individual components of these recommendations is high.
description: Paper presented to the 4th Annual Symposium on Graduate Research and Scholarly Projects (GRASP) held at the Hughes Metropolitan Complex, Wichita State University, April 25, 2008.

Utilization of mid-level providers in trauma centers: a national survey

title: Utilization of mid-level providers in trauma centers: a national survey authors: Helten, Amy M.; Johnston, Angela D.; Nyberg, Sue M.; Berg-Copas, Gina
abstract: The Accreditation Council for Graduate Medical Education recently implemented standards which limits hours worked by resident physicians to no more than 80 hours per week. As a result of these limitations, teaching hospitals throughout the United States may be faced with potential staffing shortages. Recent census data published by professional organizations indicate an upward trend in the number of physician assistants (PAs) working in the subspecialty of trauma. As the roles of hospital based mid-level providers (MLPs), including advanced registered nurse practitioners (ARNPs) and PAs, continue to evolve, a greater understanding of those roles will help to identify future employment trends for these professions. Methods: A survey tool was developed and mailed to 464 major trauma centers in the United States. The survey was designed to determine the prevalence and utilization of MLPs on the trauma service. Results: 246 surveys were returned for a response rate of 53%. Results of this study indicate that the following clinicians utilized in direct care of the trauma patient are as follows: Surgical Resident Physicians (54.1%), PAs (32.9%), and ARNPs (34.6%). In addition, 29% of respondents who do not currently utilize MLPs indicated that they intended to utilize them in the future. Conclusion: Over half of the facilities responding to the survey utilize MLPs on their trauma service. Pearson Chi Square analysis suggests that ACS verified facilities utilize MLPs proportionately more than non-verified facilities and that Level I trauma centers use proportionately more MLPs than Level 2 trauma centers (p < .05). In the majority of the trauma centers, MLPs appear to be utilized to perform traditional duties performed with fewer MLPs performing invasive procedures. Finally, almost 30% of the respondents who do not currently utilize MLPs state that they intend to utilize them in the future. This indicates the potential for continued job growth for MLPs.
description: Paper presented to the 4th Annual Symposium on Graduate Research and Scholarly Projects (GRASP) held at the Hughes Metropolitan Complex, Wichita State University, April 25, 2008.

Extensive arthroscopic release of the stiff total knee to improve range of motion after arthrofibrosis

title: Extensive arthroscopic release of the stiff total knee to improve range of motion after arthrofibrosis authors: Reif, Heather; Day, David
abstract: A retrospective chart review was conducted on patients that had undergone a total knee arthroplasty (TKA) done by the same orthopedic surgeon and subsequently were referred to a different surgeon who performed a diagnostic arthroscopy for debridement of soft tissue problems following the replacement. Twelve patients met criteria for inclusion in the study; however 6 patients were subsequently excluded. All of the hardware used in the first surgery was of appropriate size and position and no revision of hardware was necessary. All of the patients considered for this study suffered from arthrofibrosis following the TKA, resulting in decreased range of motion (ROM) and stiffness. The debridement included lysis of adhesions, release of the lateral retinaculum, fat pad revision, and a synovectomy. Some patients also required manipulation under anesthesia during the arthroscopy. Following the debridement, all patients were referred to physical therapy (PT) to continue increasing ROM and to prevent the formation of additional scar tissue lesions. The mean ROM for pre-operative extension improved from 24 o to a postoperative ROM 3.66o. The average improvement of extension was 25.33 o. The mean improvement in ROM for flexion improved from 88.33 o to 106 o. The average improvement in flexion was 17.66 o. Overall all patients were satisfied with the results. All patients had improvements in range of motion and decreased pain ratings.
description: Paper presented to the 4th Annual Symposium on Graduate Research and Scholarly Projects (GRASP) held at the Hughes Metropolitan Complex, Wichita State University, April 25, 2008.

The perceptions of physician assistants regarding doctorate level PA education

title: The perceptions of physician assistants regarding doctorate level PA education authors: Ohlemeier, Lindsay S.; Muma, Richard D.
abstract: Many mid-level health care professions have implemented the clinical doctorate. The physician assistant (PA) profession has not implemented doctoral-level education. This cross - sectional study was designed to determine the perceptions of practicing PAs regarding the Doctorate of Physician Assistant (DPA). A survey was sent to a randomized sample of United States PAs that were in the database of the American Academy of Physician Assistants (AAPA). The results were analyzed using Chi-Square analysis and descriptive statistics. The response rate for this survey was 23% (n=1,500). The majority of the respondents were not in favor of the DPA (55.8%). The study results reveal a group of practicing PAs in the United States that do not favor the profession moving toward offering a DPA degree.
description: Paper presented to the 4th Annual Symposium on Graduate Research and Scholarly Projects (GRASP) held at the Hughes Metropolitan Complex, Wichita State University, April 25, 2008.