Hospital Volunteer at Dayton Children’s

My experience as a clinical hospital volunteer at Dayton Children’s Hospital in the summer of 2017 critically influenced my career trajectory. For the duration of the summer, I trained to assist doctors, nurses, and patients in the Surgery Department as well as the Emergency Department.

In the Surgery Department, I reported to the recovery area for patients undergoing an outpatient procedure before they were released to the care of their parents. In this role, I often prepped the rooms for a new patients, wheeled the unconscious patients in their beds into a recovery room, checked in when the doctors were not present, transported the patients out of the hospital to their cars via wheelchair after discharge, and then cleaned their room and any toys they may have used during their stay.

While assisting in the Emergency Department, my roles were largely the same though less defined. I would often spend my time sterilizing toys for the rooms and in the waiting room, directed patients to their rooms and from the emergency room to other departments or the pharmacy, and observed the interactions of doctors or nurses with the patients. Different from the surgical duties, I frequently entertained the kids and their parents alike while they waited for the doctors’ attention, which we all know can be a testy task in a crowded emergency room. Because of the high turnover of ill individuals in this facility, I felt that even my work to sterilize equipment was well received and necessary for optimal patient care.

When I am home during the school year and over the various breaks, I spend a few hours at the hospital to remind myself of the unseen work that contributes critically to the operation of healthcare.

Denman Undergraduate Research Forum 2018

One of the many advantages of the culture of research at The Ohio State University is the bounty of opportunities to present research in a professional, respected setting. Principally, the largest undergraduate research event of the year, and one the largest in the country is the Denman.

Throughout an all-day event, undergraduates engaged in any discipline of research present posters or speaking presentations to at least two judges as well as a number of peers, faculty, and staff. I presented a poster about the research that I conducted in the summer of 2017 about a clinical intervention to enhance surgical recovery for patients of adolescent scoliosis, which can you read deeply about in another post which I have attached a link to below.

For the first time, I faced the challenge of demonstrating my expertise on a topic that many individuals have dedicated their entire professional careers to studying. I felt at first intimidated to present to these judges, but quickly realized that they were equally as excited about new discoveries in their field as I was.

Learn more about my research here.

Link to research information: Denman-1gvqm34

Research Assistant at Dayton Children’s Hospital

Research Poster-r2gcgj

In the summer of 2017, I engaged with the Orthopedic Center in Dayton Children’s Hospital to participate in a clinical research project. Our study focused on enhanced recovery after surgery (ERAS) methods for patients undergoing a posterior spinal fusion for adolescent idiopathic scoliosis (AIS). AIS is the most common type of spinal deformity for pediatrics in the world, thus constant innovations in its treatment and diagnosis is required.

We retroactively compared a novel analgesic pain management regiment against the traditional pain pathway. Our primary outcome of measurement was the length of stay in the hospital, and secondarily we monitored post operative complications and opiate consumption. Traditionally, an intra-operative injection of morphine was given with a variable regiment of pain medications. In our novel pathway, the intra-operative injection was eliminated, and all patients were given the exact same medications for congruent time frames after surgery: IV opioids, muscle relaxants, anti-nausea and bowel stimulating regiment, non-opiate analgesics, anti-inflammatory, and oral opioids.

Typically patients spend 5-6 days of recovery in the hospital, until their mobility has improved, diet remains consistent, self reported pain scores have improved, and serious infections and complications are ruled out. We compared 22 cases of the traditional pain pathway and 15 of the accelerated pathway, and found that those patients in the novel cohort spent 3.3 days in the hospital on average while the traditional patients spent 5.0, a statistically significant reduction in LOS by 1.7 days. Additionally, there was less variation in the length of stay for APP compared to the TPP (0.6 days compared to 1.9 days). There was no statistical difference in self-reported pain scores between the two groups.  Between groups, there was no significant difference seen in absolute opioid consumption during hospitalization. When accounting for effect sizes, we found evidence that the 2nd and 3rd day after surgery, opioid consumption was indeed decreasing on these days alone, though not overall during the hospital stay.

Preliminary results of our ongoing study indicate that the APP implementation results in a decreased LOS without significant difference in in-patient opioid usage or sacrifice to patient comfort. Length of stay indicates postoperative satisfaction, as patients achieved mobility and controlled pain more rapidly to be able to be sent home. Additionally, this study has worked to decrease opioid consumption in surgical patients. Although there was no decrease in usage while the patients were in hospital, getting them out of the hospital sooner relieves them of that extra two days of opioid consumption and through pain control programs more quickly. Lastly, our patient satisfaction was increased by decreasing their hospital costs and returning them to their home environment sooner. With the opioid epidemic having a major influence in the prescription pain drug market, we believe that interventions like ours may help control the dissemination of these narcotics.

At the present, about 10 more cases have been added to the APP group. Next summer, the study will add an additional drug to be administered just after closure, which in preliminary literature has been shown to further reduce LOS, opioid consumption, and cost.

Attached is the link to our research poster.