Quality Improvement Initiative to Reduce Nighttime Noise in a Transplantation and Cellular Therapy Unit.

Sleep is an essential biologic function vital for physiologic rest, healing, and emotional well-being. Sleep disruption is commonly seen in patients and caregivers with lengthy hospital stays such as patients undergoing hematopoietic stem cell transplantation and cellular therapy (TCT). Sleep disruption can lead to increased stress and fatigue, affecting caregivers' ability to support their loved one. The global aim of our quality improvement initiative was to improve sleep quality in TCT patients and caregivers. The smart aim of our project was to decrease nighttime hallway noise from 47 dB to 43 dB and decrease the number of overnight noise peaks greater than 60 dB from 865 to 432 in 6 months. Through a cross-sectional quantitative and qualitative evaluation of sleep we had previously identified poor sleep quality, and with a cross-sectional focus group analysis of patients, caregivers, and medical staff we identified the factors associated with poor sleep. Hallway noise was a major factor. A simplified failure mode analysis identified 4 main key drivers; unobtrusive nighttime cleaning process, nighttime awareness maintenance system, quiet nighttime nursing system, and reliable nighttime awareness system. Several plan-do-study-act interventions took place and were adopted. From January to June 2018 the overnight mean decibel level decreased from 47 dB to 44 dB (6% reduction). Overnight noise spikes above 60 dB decreased from a mean of 865 spikes to a mean of 463 spikes (46% reduction). With a quality improvement initiative, we identified the causes of hallway nighttime hospital unit noise that negatively impact sleep and through a team-based approach performed interventions that successfully mitigated these factors.

Increasing dental student diversity through the UNLV Dental Prospects Program.

Adequately providing for the health care of the growing minority population in the United States requires increased racial and ethnic diversity of the health care workforce. Long-term diversity in the dental profession depends on a more diverse student population in dental schools. The University of Nevada, Las Vegas School of Dental Medicine's (UNLV SDM) Dental Prospects Club is a predental education program that has increased the number of underrepresented minority and disadvantaged students in the school by concentrating on outreach, recruitment, and retention initiatives. The approaches used by the club members and faculty advisors to increase the number of underrepresented minority students recruited to and enrolled in the UNLV SDM are discussed in this report. Also described are the strategies, methods, internal infrastructure, and organizational support used to increase the number of underrepresented minority students at the school.

The declining number of practicing African American dentists in Cuyahoga County, Ohio, 1970 through 2010.

BACKGROUND: The authors tracked the declining number of practicing African American dentists and its relationship to the migratory patterns of the black community in Cuyahoga County, Ohio, from Jan. 1, 1970, through Dec. 31, 2010. METHODS: The authors conducted a longitudinal study in which they used the Geographic Information System (Environmental Systems Research Institute, Redlands, Calif.) to plot the location of each black-owned dental practice in Cuyahoga County in conjunction with the black population. They calculated the ages of the dentists by using birth dates posted on the Ohio State Dental Board's Web site and divided the dentists into five age groups. RESULTS: The study results showed that dental practice distributions followed the migratory pattern of the black population from Cleveland to the surrounding suburbs. The number of black dentists in practice decreased from 1986 through 2010 in the Cleveland metropolitan area (Cuyahoga County), and 46.3 percent of the black dentists were projected to retire by 2020. CONCLUSIONS: These results underscore the need to increase the number of black dentists in Cuyahoga County and nationwide. On the basis of the demographic data they found, the authors expect the number of black dentists to continue to decrease if no intervening circumstances occur. Practice Implications. There were 48.8 percent fewer black dentists in Cuyahoga County in 2010 than there were in 1985. If this pattern continued until 2020, there could be a critical shortage of black dentists in Cuyahoga County.

Shade-matching abilities of dental laboratory technicians using a commercial light source.

PURPOSE: The purpose of this study was to evaluate dental laboratory technicians' abilities to match shades using a light-corrective device under conventional laboratory conditions. The variables measured were years experience, gender, and light source. MATERIALS AND METHODS: A 14-item shade-matching quiz (SMQ) was field-tested and deemed adequate. Information included age, gender, number of years experience, and Ishihara's Colour-Blindness Assessment. Forty-two dental technicians from five northeast Ohio laboratories were invited to participate. The SMQ was administered twice: under the lighting conditions in the individual laboratories (SMQ-Lab) and with a light-corrective source (SMQ-LC). For each item, the technicians were to select the matching Vita shade tab from five preselected shade tabs. SMQ scores equaled the number of correct matches. Statistical analysis included calculation of means, standard deviations, correlation coefficients, and independent and paired t-tests. Significance was set at p

Comparison of the shade matching ability of dental students using two light sources.

STATEMENT OF PROBLEM: Shade selection is affected by a host of variables, including lighting. PURPOSE: The purpose of this study was to assess the ability of dental students to match shades under natural lighting and using a light-correcting device, specifically to determine whether there are differences based on: (1) year in school, (2) gender of student, and (3) light source. MATERIAL AND METHODS: A 14-item shade matching quiz (SMQ) and a questionnaire were field tested. No major modifications were made to SMQ or questionnaire. Demographic information included year in school, age, gender, previous experience, and Ishihara's Tests for Color-Blindness. The SMQ was administered on separate occasions during the spring and summer, under natural light (SMQ-NL) and using the light-correcting device (SMQ-CL). For each of the 14 items, students (n=216) were to select the matching shade tab from 5 preselected tabs. Statistical analyses included ANOVAs, paired t tests, and independent t tests (alpha=.05). RESULTS: A total of 165 male and 51 female students participated, with an average age of 26 years. SMQ scores of 10 color-deficient students were excluded. There were no significant differences in SMQ-NL and SMQ-CL among the first through fourth year students (ANOVA), nor between men and women (t tests). The SMQ scores were significantly higher with the light-correcting device than with natural light: 11.4 +/- 1.9 and 10.4 +/- 2.0, respectively (paired t test, P<.001). With and without the light-correcting device, the Vita C shades were less likely to be matched than the Vita A or B shades (paired t tests, P<.001). CONCLUSIONS: Dental students' shade matching abilities were better with a light-correcting source than under natural light. Gender and experience were not found to be factors in matching shades. The Vita C shades were least likely to be matched.

An analysis of current analgesic preferences for endodontic pain management.

A descriptive, cross sectional survey was developed to determine the preferences of endodontists when prescribing analgesics. Eleven clinical scenarios describing common endodontic diagnoses or procedures with specified severity of pain were provided. A survey was sent to 310 AAE members and 63 responded, providing a 20% response rate. Respondents were given various choices for analgesic prescription including various dosages of ibuprofen or acetaminophen (APAP), or combination narcotic medications. Data were analyzed by chi2 tests. Non-narcotics were preferred over narcotics for all clinical situations. Significantly more respondents selected ibuprofen 600 mg (4x a day) regardless of the severity of preoperative or postoperative pain (p<0.001). Educators and board-certified AAE members were less likely than nonboard certified AAE members to manage their patient's perceived severe pain with narcotic analgesics.

Electric pulp tester conductance through various interface media.

A conducting media is necessary when using an electric pulp tester (EPT). The objective of this study was to observe differences in conductance through various media. We hypothesized that variations in current conductance through different media exist. The pulp chamber of a freshly extracted premolar was exposed, and the cathode of a voltmeter was inserted into the pulpal tissue. The anode was coupled to the EPT handpiece. The measurement taken during dry (no interface media) EPT tip-to-tooth contact was 0 V, which served as negative control. EPT tip directly touching the cathode measured 3.9V and served as positive control. A number of media readily available in the dental office were tested. Data was analyzed using single factor ANOVA. Listerine (3.3) conducted the most voltage (p<0.5). Of nonliquids, K-Y Brand UltraGel and Crest Baking Soda & Peroxide Whitening Tartar Control toothpaste recorded significantly (p<0.05) higher voltage readings (1.4 V).