GrandRounds DOH-Orange Offers Free STD Testing on Wednesdays in April April is Sexually Transmitted Disease Awareness month. On Wednesdays during the month, the Florida Department of Health in Orange County’s Sexually Transmitted Disease (STD) Clinic in downtown Orlando will conduct free STD testing during clinic hours. The address is 832 W. Central Boulevard, Orlando, FL 32805. The free testing is only for the month of April and only on Wednesdays. This effort is to encourage more clients to get tested and bring awareness of the subject. For further information on testing or the program, you can contact the STD program at 407-858-1445.
The STD Program works to control transmission through four major avenues: • Education of at-risk persons on the modes of disease transmission and the means for reducing the risk of transmission by changing sexual behaviors • Detection of infection in persons without symptoms, and those who are who are unlikely to seek diagnostic and treatment services. • Diagnosis and treatment of persons who are infected. • Evaluation, treatment and counseling of sex partners of persons with a Sexually Transmitted Disease (STD).
AdventHealth, UCF Collaborate on Suicide-prevention Initiative AdventHealth is collaborating with the University of Central Florida to address a growing suicide crisis across the nation. The effort is modeled after the Zero Suicide Initiative, a national program to reduce suicide deaths, which have risen dramatically in recent years. Rates of suicide have increased by more than 25 percent across the U.S. since 1999, according to the Centers for Disease Control and Prevention. In Florida, the rate of increase is more than 10 percent. The program also addresses a need raised by AdventHealth’s Community Health Needs Assessment, which consistently finds access to mental-health treatment is lacking across Central Florida. The UCF-AdventHealth collaboration will focus on patients who come into the emergency rooms at AdventHealth Kissimmee and AdventHealth Orlando exhibiting signs of suicidal thoughts or behaviors. Currently, those patients might be held in the ER for up to 12 hours waiting for a spot to become available in a psychiatric facility. Or they might be discharged, only to return to the ER in the following weeks. If a patient shows warning signs for suicide, social workers will call and check in with them to monitor suicide risk, provide psychosocial education and support, and to make linkages to community supports on a regular basis for up to 90 days. “The idea is to establish a relationship with the patient, so if the patient goes into an acute crisis, they have a point person who has a psychiatric background and clinical training in suicide prevention,” said Robert Geissler, director of emergency services at AdventHealth Kissimmee. “That point person can connect them with appropriate resources, rather than having them go back to the ER.”
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In addition to the social-worker support, the program involves training ER staff and chaplains to recognize and treat patients who may be dealing with suicidal thoughts or feelings. Kim Gryglewicz of UCF’s College of Health Professions and Sciences is leading the research effort in conjunction with the AdventHealth Research Institute. “From a research perspective, we’re trying to answer two major questions: How do we improve safety measures and practices? And how do we use outcome measures to track what we’re doing to improve suicide care?” Gryglewicz said. “We will be working to implement best practices in the ED setting using a comprehensive strategy for screening, suicide risk assessment and safety planning, and then tracking what happens post-discharge, with the ultimate goal of preventing suicides and attempts from happening.” In the long term, the same practices and procedures could be implemented at other care sites throughout Central Florida, with the potential to expand statewide and across the nation. Available data on young people shows similar support services allowed 80 percent to be discharged from follow-up care no longer at risk for suicide, with the remaining 20 percent needing follow-up care. Gryglewicz expects that researchers might find similar benefits among adult patients after the 90-day program. She hopes to have preliminary data after about six months. The program is funded by a three-year grant from the U.S. Substance Abuse and Mental Health Services Administration.
Health Scholars Introduces VR Training App to Combat ACLS Skills Decay Health Scholars has launched the first headset-based VR training simulation to provide clinicians repeatable ACLS refresher training. In-hospital cardiac arrest survival rates average 26 percent and patients in which clinical staff reported adequate resuscitation training have greater than 3-fold odds of higher survival rates than patients where adequate training programs are lacking. In fact, the rate of survival after cardiac arrest increased by 28.3 percent with implementation of ACLS training courses. However, knowledge of this life saving competency decays within months of certification for those who work in non-critical care areas (majority of the hospital). Health systems have struggled to implement costeffective and adequate refresher training due to the volume of individuals needing training and limited numbers of clinical educators. With ACLS Virtual Reality Simulation organizations are able to provide critical refresher training at scale and for 50 percent less than the cost of physical simulation. “Health Scholars’ virtual reality training prevents ACLS skills decay by enabling learners to physically engage in code situations at an appropriate frequency. It’s realistic, clinically accurate and can be completed at the convenience of the learner,” said Daniel Katz Anesthesiologist, ACLS Instructor. The app was designed in accordance with American Heart Association (AHA) guidelines to complement AHA’s HeartCode® training as well as the new Resuscitation Quality Improvement (RQI) program, utilizing state-of-the-art voice recognition and motion capture technologies. According to a recent AHA scientific statement, “Resuscitation Education Science: Educational Strategies to Improve Outcomes from Cardiac Arrest”: • The current massed approach to resus-
citation training should be replaced or supplemented with a spaced practice. • The duration and design of each training session, the interval between sessions, and the number of repetitions should be tailored to context, learner type, objectives, and prior experiences. • Techniques such as debriefing after real resuscitation events and in situ simulation can be used to provide spaced training experiences. • Technology-enhanced simulators and learning management systems should be used to collect individual learner data during training to determine the interval of training.4 ACLS Virtual Reality Simulation can meet all of these needs without bulky equipment or high coordination overhead. It immerses learners in a VR simulation that allows them to provide voice-directed commands and show they understand the core rhythms as well as how to address them while using proper communication skills. Its features allow it to: • Train to all of the AHA core rhythms including return of spontaneous circulation (ROSC) • Place the learner in the role of the team lead, as required by AHA, and recreate the stress of a mega code situation • Provide standardized practice, assessment and skills validation • Debrief on failed waveform identification and on general code management principals needing improvement • Be completed without having to schedule an entire team – extending the reach of training • Be used 24/7, at the convenience of the learner, encouraging increased training frequency
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