Try a new search

Format these results:

Searched for:

person:violaj01

in-biosketch:true

Total Results:

23


Implementation of a Preoperative Anemia Clinic Utilizing a Minimal Staffing Model

Mabry, Christian; Perelman, Seth; Kim, Jung T; Blitz, Jeanna D
We present a process map for the implementation of a program to treat preoperative anemia utilizing 1 existing anesthesiologist in the preoperative evaluation clinic. In the first 7 months postimplementation, 342 patients were screened for anemia, 166 were diagnosed, and 107 were treated. The mean increase in hemoglobin in treated patients was ~2 g/dL (range 0-4.9 g/dL). Two patients' surgeries were delayed in favor of treatment and 3 surgical patients, who had received 2 complete iron infusions, received an intraoperative transfusion. The total revenue generated for the institution was enough to subsidize the cost of an additional anesthesiologist.
PMID: 31770131
ISSN: 2575-3126
CID: 4215882

Preoperative Assessment and Management of Patients with Pain and Anxiety Disorders

Doan, Lisa V; Blitz, Jeanna
Purpose of Review/UNASSIGNED:This review summarizes selected recent evidence on issues important for preoperative pain evaluation. Recent Findings/UNASSIGNED:Opioids, though a mainstay of postoperative pain management, are associated with both short and increasingly recognized long-term risks, including persistent opioid use. Risk factors for high levels of acute postoperative pain as well as chronic postsurgical pain may overlap, including psychological factors such as depression, anxiety, and catastrophizing. Tools to predict those at risk for poor postoperative pain outcomes are being studied. Summary/UNASSIGNED:Preoperative pain and psychological factors can affect postoperative pain outcomes. More work is needed in the future to develop practical interventions in the preoperative period to address these factors.
PMCID:7222996
PMID: 32435161
ISSN: 1523-3855
CID: 4442672

Expansion of a geriatric and pre-admission testing partnership to improve recognition of postoperative delirium in older adults undergoing elective spine surgery [Meeting Abstract]

Zweig, Y; Blitz, J D; Perskin, M
Background: Postoperative delirium occurs in 11-53% of older hospitalized patients, and is associated with cognitive and functional decline, increase in hospital associated complications, prolonged hospital stay, and a greater mortality. Delirium is often unrecognized which delays interventions that can reduce the burden on patients and caregivers. We report on a partnership between geriatrics and pre-admission testing (PAT) now expanded to improve recognition of preoperative cognitive impairment in patients undergoing spine surgery to proactively address modifiable delirium risks.
Method(s): This project was initiated in March 2018 and is ongo-ing. A trained RN in PAT conducted a Mini-COG screen on patients aged >=65. The inpatient geriatric consult service (GCS) and spine surgical team were notified if the patient had a positive screening result (<=3/5). GCS identified any high-risk deliriogenic medications in the EMR and searched the controlled substance registry in NY and surrounding areas. GCS collaborated with the surgical team day 1 post-operatively to consider a proactive geriatric consultation for delirium prevention.
Result(s): 150 patients over the age of 65 with planned elective spine surgery completed a Mini-COG screening test in PAT from March-November 2018. Eleven patients had a positive Mini-COG screen. Of the 11 patients, 1 did not have surgery and 2 developed delirium postoperatively. GCS was consulted for both patients who developed delirium and saw 1 patient proactively who did not go on to have delirium. One of the patients who developed delirium was on a high risk medication preoperatively and 2 patients were on high risk medications and did not go on to develop delirium.
Conclusion(s): This unique collaboration between PAT and geriat-rics suggests a framework can be established to increase surveillance for delirium in the perioperative period. This population of patients over 65 years old with planned elective spine surgery are a particularly high risk group due to deliriogenic medications used in the preopera-tive period to manage pain and muscle spasms, along with the poten-tial need for benzodiazepenes for muscle spasms in the postoperative period. We plan to continue to evaluate trends in delirium occurrence in patients with abnormal preoperative cognitive screening and work towards interventions that can be tailored to this population
EMBASE:627352302
ISSN: 1532-5415
CID: 3831842

Designing and Running a Preoperative Clinic

Blitz, Jeanna D; Mabry, Christian
Value in health care has been described as quality divided by cost, where quality is the sum of patient outcomes and experience. A well-run preoperative evaluation clinic (PEC) offers many opportunities to improve the value of the care delivered to patients by reducing the associated costs and improving the quality of care. Certain patient education and medical optimization strategies initiated in the PEC clinic are linked to an improvement in patients' long-term health outcomes. When designing a PEC, it is important to address the PEC's mission and scope with all stakeholders early in the process.
PMID: 30390773
ISSN: 1932-2275
CID: 3429202

Comparison of Noninvasive Hemoglobin Analysis to Invasive Hemoglobin Analysis [Meeting Abstract]

Mabry, Christian; Blitz, Jeanna; Hadley, Graham
ISI:000460104600034
ISSN: 0003-2999
CID: 3727522

Correlation of Preoperative Anemia to Transfusion Rates in Spine Deformity Surgeries at a Major Academic Medical Center [Meeting Abstract]

Mabry, Christian; Blitz, Jeanna
ISI:000460104600041
ISSN: 0003-2999
CID: 3727502

A retrospective study of opioid prescribing patterns at hospital discharge in surgical patients with obstructive sleep apnea

Kendale, Samir M; Wang, Jing; Blitz, Jeanna D; Calvino, Steven; Cuff, Germaine; Barone, Nicholas; Rosenberg, Andrew D; Doan, Lisa
PURPOSE/OBJECTIVE:Obstructive sleep apnea (OSA) is a risk factor for complications with postoperative opioid use, and in those patients with known or suspected OSA, minimization of postoperative opioids is recommended. We hypothesize that despite these recommendations, surgical patients with known or suspected OSA are prescribed postoperative opioids at hospital discharge at similar doses to those without OSA. METHODS:This was a retrospective analysis of the electronic health records of surgical patients from 1 November 2016 to 30 April 2017 at a single academic institution. Patients with a known diagnosis of OSA or a STOP-Bang score ≥ 5 were compared with those without OSA for the amount of postoperative discharge opioid medication using multivariable linear regression. RESULTS:Of the 17,671 patients analyzed, 1,692 (9.6%) had known or suspected OSA with 1,450 (86%) of these patients discharged on opioid medications. Of the 15,979 patients without OSA, 12,273 (77%) were discharged on opioid medications. The total median [interquartile range (IQR)] oral morphine equivalents (OME) for all patients was 150 [0-338] mg and for patients with known or suspected OSA was 160 [0-450] mg, an unadjusted comparison showing an 18% difference in OME (95% confidence interval [CI], 3% to 35%; P = 0.02). The analysis, after adjusting for confounders, showed no significant difference in the amount of opioids prescribed to OSA or non-OSA patients (8% difference in total OME; 95% CI, -6% to 25%; P = 0.26). CONCLUSION/CONCLUSIONS:This study shows that surgical patients at risk for OSA or confirmed OSA are prescribed opioids at similar rates and doses upon discharge despite guidelines that recommend minimizing opioid use in OSA patients. These findings indicate a need to implement different strategies to reduce the prescription of opioids to patients with OSA.
PMID: 29777388
ISSN: 1496-8975
CID: 3120822

A Novel Geriatric/Cardiothoracic Surgery/Pre-Admission Testing Partnership to Assess Preoperative Cognition to Improve Postoperative Delirium Outcomes [Meeting Abstract]

D'souza, C.; Thant, A.; Perskin, M.; Zweig, Y.; Cunningham, C.; Turton-Thompson, T.; Blitz, J.; Buttar, A.
ISI:000430468400595
ISSN: 0002-8614
CID: 3084922

End stage renal disease on dialysis

Chapter by: Blitz, J
in: Preoperative Assessment and Management by
pp. 271-274
ISBN: 9781496368447
CID: 3652002

Chronic kidney disease

Chapter by: Blitz, J
in: Preoperative Assessment and Management by
pp. 265-270
ISBN: 9781496368447
CID: 3652132