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Focus on Integrative Approaches to Pain, Anxiety Management During Adolescent IUD Insertion
On Jan. 1, 2018, The Joint Commission implemented new and revised pain assessment and management standards for accredited hospitals. The additions and revisions require hospitals to “provide at least one non-pharmacological pain treatment modality.” There are several non-pharmacologic approaches to offer adolescents to help manage anxiety and pain related to intrauterine device (IUD) insertions. Such methods include hypnotic language, music, heat therapy, social support (“IUD doula”), acupressure, and aromatherapy.
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Study Examines Effect of Vitamin D, Estradiol Deficiency on Metabolic Syndrome
Menopause is associated with an increased risk for metabolic syndrome, a cluster of risk factors for cardiovascular disease and diabetes. New research indicates that vitamin D and estradiol may help protect against these conditions.
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Research Continues Toward Potential Herpes Vaccine
After promising research for a potential herpes vaccine stalled in 2018, scientists are finding new paths for investigation that may lead to a potential candidate. Recently published research by Yale University investigators may offer clues to an effective vaccine option.
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Medicaid Reimbursement Change Increases Interbirth Intervals Among Teens
After changing its Medicaid policy to provide reimbursement for immediate postpartum long-acting reversible contraception (LARCs) separate from the global labor and delivery payment, South Carolina saw an increase in immediate postpartum LARC initiation and increased birth spacing among young women.
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ACIP Recommends HPV Vaccination for Older Men and Women
The Advisory Committee on Immunization Practices recently approved use of the 9-valent HPV vaccine for persons ages 27-45 years. The recommendation to expand use of the vaccine comes as findings from a large meta-analysis indicate that the HPV vaccine has substantially reduced infections and precancerous lesions. Providers are encouraged to discuss the potential benefits of HPV vaccination with patients in the mid-age category, addressing the reduced efficacy compared to vaccination within the younger target age range, as well as the reduced risk of high-grade disease and cervical cancer.
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No Substantial Difference in Risk of Acquiring HIV in IUD, Implant, Injection Users
Results from a large, randomized trial among African women found no substantial difference in HIV risk using the copper intrauterine device, the levonorgestrel implant, and the depot medroxyprogesterone acetate injection. The data counter research that suggested a potential association between some types of contraceptives and risk of acquiring HIV.
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Appellate Court Rejects Loss-of-Chance Argument for Patient Who Suffered Stroke
This case reveals a potent defense for physicians and care providers: A patient must prove causation when raising a malpractice allegation. A plaintiff must prove that the physician or care provider’s conduct is a substantial factor in causing the harm, which means that it must be more than a remote or trivial factor. However, it does not have to be the only cause of the harm. If the harm would have occurred without the physician or care provider’s conduct, then the conduct was not a substantial factor in causing harm.
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Patient Loses Eye to Improper Sterilization of Surgical Equipment; Awarded $3.5 Million
The lessons from this case include the importance of proper sterilization, as well as the legal procedures and appeal options. The appellate court noted that the hospital did not dispute the possibility that a breach in the sterilization process had occurred; instead, the hospital focused its challenge on the fact that the patient had not presented convincing evidence demonstrating that the breach in sterilization practices had caused the infection.
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Future for Risk Managers Will Require Flexibility, Learning
Risk managers seeking to improve their careers must evolve continually with the changing healthcare landscape. There are new technologies to consider, along with value-based reimbursement models, that are dependent on quality patient outcomes. Healthcare delivery models continue to bring new and sometimes unfamiliar services and exposures to an organization.
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Address Metadata With Protocol for Subpoenas
A strict protocol for responding to subpoenas can reduce the risks that come with inadvertently releasing too much information, or the wrong information. Experts have found that the best practice for responding to subpoenas or authorizations for production of medical records in legal cases is to set up a special department or designate an employee as the legal health information management representative. All requests for records in a legal case would be funneled through a person or persons trained in the legal issues and with ready access to the legal department or outside legal counsel when questions arise.