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Purpose: The opioid crisis has contributed to the mortality, morbidity, and rising healthcare costs in the United States. Buprenorphine (BUP) is an effective medication for opioid use disorder. The aims of this quality assurance evaluation of a BUP program were to (a) evaluate the clinic's performance in illicit opioid abstinence and (b) identify patient risk and resilience characteristics to improve patient success in recovery with BUP. Methods: A retrospective chart review of open (n = 35) and closed (n = 21) cases and a cross-sectional survey in open cases were completed. Adults (aged ≥18 years) who completed 6 months of BUP treatment at a psychiatric clinic were included. Clinical performance was measured with percentages of opioid-negative urine and completed monthly urine drug tests (UDTs) for the first 6months. Open cases were surveyed regarding risk and resilience characteristics (frequency of opioid cravings and triggers, therapy participation, and coping skills). Descriptive statistics, t test, and chi-square test were used to analyze data. Results: Average opioid-negative urine was significantly higher in open cases than closed cases (88.57% vs. 74.82%; t = 2. 885, p = .004). There was no significant association between open cases (61.4%) and closed cases (73.8%) in completed monthly UDT. Opening and closing of cases stabilized with mandatory monthly UDT. Most individuals reported therapy participation, minimal opioid cravings, and use of distraction to cope with chronic-pain-induced cravings. Conclusions/Implications: This clinic met benchmarks leading to improved substance recovery. Recommendations include regular evaluations of UDT, cravings, and chronic pain; therapy participation; and continuous quality assurance activities. [ABSTRACT FROM AUTHOR]

Background and purpose Colon cancer is the second leading cause of cancer-related deaths in the United States but is highly treatable when diagnosed early. The purpose of this quality improvement (QI) initiative was to develop, implement, and evaluate a multilevel intervention to raise colon cancer screening rates. Methods A pre- and postintervention design was used with patients who were largely Caucasian and English speaking. Patients were mailed information about the importance of screening, and a phone line was created for patients to select a colonoscopy, fecal immunochemical test, or decline screening. Patients not responding via the phone line received an e-mail or postcard about the importance of screening. Electronic flags were sent to providers on the day of the visit to remind staff to address screening. Uninsured patients received free screening. Conclusions Across three clinics, colon cancer screening rates increased by 6.3%-6.9% through use of a multilevel intervention. Staff satisfaction was moderately high for ease of use, staff education, and perceived success of the QI initiative. Implications for practice Patient education, decision support tools, outreach to patients by mail, phone, e-mail, electronic flags, and free screening for uninsured patients collectively can increase colon cancer screening rates in an at-risk population. [ABSTRACT FROM AUTHOR]

The article presents a literature review which examines studies that implement best practices interventions and the influence of these on instrumental activities of daily living (IADL) and activities of daily living (ADL) for community-dwelling older adults. It states that an electronic search of CINAHL, ISI Web of Science, and Ovid MEDLINE databases is conducted. Results reveal that only one study evaluates ADL/IADL performance.

The article discusses Lyme disease, which is the most common vector-borne illness in the U.S. Accordingly, the disease is caused by the bacteria called borrelia burgdorferi spirochet which is transmitted to human if the ticks carrying such bacteria bites and stays attached for one to two days. The Ixodes genus which has more than 200 potentially disease-carrying species is said to be the most apt to carry the bacteria.

Purpose: The aims of this study were to review predictors of knowledge about human papillomavirus (HPV), HPV vaccine, and factors related to HPV vaccine uptake and report a quality assurance project that evaluated HPV vaccine uptake and three-dose completion rates., Methods: The setting was a small private urban pediatric practice. Chart review was used to describe HPV vaccine uptake and dose completion rates in 2007. The convenience sample included 189 girls aged 12 to 21 years with HPV vaccine uptake., Results: During 2007, 153 girls aged 12 to 17 years and 42 girls aged 18 to 21 years were seen at well-child care visits. HPV vaccine uptake was 72% (n = 110) for the younger group and 79% (n = 33) for the older group. There was no significant difference in HPV vaccine uptake by group. One quarter (24%, n = 46) received the HPV vaccine dose at an episodic visit. The dose completion rate was 64% (n = 120)., Discussion: HPV vaccine uptake and dose completion rates were higher than rates reported by the Centers for Disease Control and Prevention. Effective strategies are needed to promote HPV vaccine uptake and dose completion., (Copyright © 2012 National Association of Pediatric Nurse Practitioners. Published by Mosby, Inc. All rights reserved.)