Kimberly G. Fulda, DrPH
Permanent URI for this communityhttps://hdl.handle.net/20.500.12503/31224
Associate Professor, Family Medicine and Osteopathic Manipulative Medicine
Executive Director, North Texas Primary Care-Based Research Network
Email: Kimberly.Fulda@unthsc.edu
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Browsing Kimberly G. Fulda, DrPH by Author "Espinoza, Anna M."
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Item A Multisite Qualitative Analysis of Perceived Roles in Medication Safety: Older Adults' Perspectives(Cleveland Clinic, 2023-03-04) Jallow, Fatoumata; Stehling, Elisa; Sajwani-Merchant, Zara; Daniel, Kathryn M.; Fulda, Kimberly G.; Espinoza, Anna M.; Gurses, Ayse P.; Arbaje, Alicia I.; Xiao, YanOlder adults and caregivers play an essential role in medication safety; however, self-perception of their and health professionals' roles in medication safety is not well-understood. The objective of our study was to identify the roles of patients, providers, and pharmacists in medication safety from the perspective of older adults. Semi-structured qualitative interviews were held with 28 community-dwelling older adults over 65 years who took five or more prescription medications daily. Results suggest that older adults' self-perceptions of their role in medication safety varied widely. Older adults perceived that self-learning about their medications and securing them are critical to avoiding medication-related harm. Primary care providers were perceived as coordinators between older adults and specialists. Older adults expected pharmacists to inform them of any changes in the characteristics of medications to ensure medications were taken correctly. Our findings provide an in-depth analysis of older adults' perceptions and expectations of their providers' specific roles in medication safety. Educating providers and pharmacists about the role expectations of this population with complex needs can ultimately improve medication safety.Item Primary care clinics can be a source of exposure to virulent Clostridium (now Clostridioides) difficile: An environmental screening study of hospitals and clinics in Dallas-Fort Worth region(PLOS, 2019-08-15) Simecka, Jerry W.; Fulda, Kimberly G.; Pulse, Mark; Lee, Joon-Hak; Vitucci, John; Nguyen, Phung; Taylor, Patricia; Filipetto, Frank; Espinoza, Anna M.; Sharma, SushmaC. difficile is an endospore-forming pathogen, which is becoming a common cause of microbial health-care associated gastrointestinal disease in the United States. Both healthy and symptomatic patients can shed C. difficile spores into the environment, which can survive for long periods, being resistant to desiccation, heat, and disinfectants. In healthcare facilities, environmental contamination with C. difficile is a major concern as a potential source of exposure to this pathogen and risk of disease in susceptible patients. Although hospital-acquired infection is recognized, community-acquired infection is an increasingly recognized health problem. Primary care clinics may be a significant source of exposure to this pathogen; however, there are limited data about presence of environmental C. difficile within clinics. To address the potential for primary care clinics as a source of environmental exposure to virulent C. difficile, we measured the frequency of environmental contamination with spores in clinic examination rooms and hospital rooms in Dallas-Fort Worth (DFW) area of Texas. The ribotypes and presence of toxin genes from some environmental isolates were compared. Our results indicate primary care clinics have higher frequencies of contamination than hospitals. After notification of the presence of C. difficile spores in the clinics and an educational discussion to emphasize the importance of this infection and methods of infection prevention, environmental contamination in clinics was reduced on subsequent sampling to that found in hospitals. Thus, primary care clinics can be a source of exposure to virulent C. difficile, and recognition of this possibility can result in improved infection prevention, potentially reducing community-acquired C. difficile infections and subsequent disease.