Patient Safety
Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/29937
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Browsing Patient Safety by Author "Lindsley, Joshua"
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Item North Texas Cellphone Contamination Initiative: Validation of a Novel Survey Tool for Cellphone Use by Healthcare Workers(2020) Reynolds, Conner; Jowitt, Janet; Ingram, Aubrey; Li, Jeffrey; Sankar, Aparna; Perez, Aaron; Wolstein, Austin; Williams, Trevor; Gelinas, Lillee; Lindsley, JoshuaPreventable medical errors are the third leading cause of death in the United States, accounting for 251,000 lives annually. Healthcare-acquired infections (HAIs) account for nearly 40% of this population, costing the healthcare system $28.4-33.8 billion each year. Current efforts monitoring sources of HAI have set their focus on device-associated infections. Yet, in a recent Multistate Point Prevalence Survey of Health Care-Associated Infections, device-associated HAI only accounted for 25.6% of instances detected. The rising prevalence of cellphone usage by health professionals has prompted researchers to target cellphones as potential vectors for infectious transmission in healthcare. In Phase 1 of the North Texas Cellphone Contamination Initiative (NTCCI), we surveyed 169 health professional students about their cellphone use behavior and swabbed 101 cellphones using EnSURE ATP Luminometer. Our findings demonstrated that health professional students are utilizing their cellphones in the restroom and washing their hands afterwards, but often neglect to clean their phones. This behavior leads to an overall contamination level exceeding previously established cleanliness benchmarks for healthcare environments by 3-to-17 fold. To begin NTCCI Phase 2, we piloted a new survey with 69 healthcare workers to establish a baseline for cellphone use in clinics. This survey was then validated using principal components analysis (PCA) and measures of internal consistency. Our next steps will include increasing the sample size of healthcare workers, as well as ATP Luminometry and bacterial culturing of cellphone surfaces.Item Postoperative Lithium Toxicity after Total Hip Arthroplasty in Patient with Acute Kidney Injury(2020) Roberts, Tyler; Wagner, Russell; Lindsley, JoshuaWe document the first case of lithium toxicity in a 62-year-old female with schizoaffective disorder following total hip arthroplasty. Pre-operatively, the patient had subtherapeutic levels of lithium (0.5 mEq/L; normal range, 0.6 and 1.5 mEq/L) stable on maintenance dosing. She continued receiving this regimen post-operatively. On post-operative day 3, she was found to have an acute kidney injury (Creatinine 1.2 mg/dl, up from .5 mg/dl baseline), supratherapeutic lithium levels (2.5 mEq/L; normal range, 0.6 and 1.5 mEq/L), and signs of acute lithium toxicity. Immediate discontinuation of lithium and initiation of supportive care lead to full recovery. This report demonstrates the need for orthopedic surgeons to actively surveil post-operative lithium levels in patients with concomitant mood disorders, paying special attention to renal function and avoiding of nephrotoxic agents.