S279 S290
LATE-BREAKING ABSTRACTS
The criteria for late-breaking abstracts was research that was new and
of sufficient scientific importance to merit special consideration after
the standard abstract deadline. All abstracts were reviewed by the
AAPM&R Evidence Committee.
CATEGORY: QUALITY IMPROVEMENT
Poster 460:
Medication Discrepancies During In-Patient Transfers
Ilana Etelzon, MD (Kingsbrook Jewish Medical Center, Edgewater, New
Jersey, United States), Amarin Suriyakhamhaengwongse, MD,
Swathy Sreekumar, MD, Todd R. Lefkowitz, DO
Disclosures:
Ilana Etelzon: I Have No Relevant Financial Relationships
To Disclose
Objective:
To analyze medication discrepancies in patients trans-
ferred from acute care hospital to inpatient rehabilitation facility.
Design:
This is a retrospective study. We gathered discharge sum-
maries of patients admitted to inpatient rehabilitation facility from an
acute care hospital from October 2016 to November 2016. We analyzed
time the discharge summary was completed at the acute care hospital
and recorded missing medications on the rehabilitation admission
notes. Medications were categorized based on drug class.
Setting:
Inpatient rehabilitation facility at an inner-city hospital.
Participants:
Our study involved 57 cases, 24 males and 33 females.
Interventions:
Not applicable.
Main Outcome Measures:
We investigated the time of discharge
summary documentation, type of medication missing, and the location
the medication was initiated.
Results:
Fifty-one percent of the patients did not have any discrep-
ancies in medications during patient hand-off. Of the 49% of patients
with medication discrepancies, the three most common medications
missing were anti-coagulants, diabetes medications, and anti-hyper-
tensives. We also analyzed the location at which the missing medica-
tion was started and found that 41% of cases with missing medications
were started in the acute care hospital and 59% of the medications
were home medications. The majority of medication discrepancies
were found on discharge summaries written at 5:00 pm.
Conclusions:
Medication discrepancies during patient hand-off is a
serious mistake that leads to poor patient care. In this study, 49% of
patients were found to have medication discrepancies. We hypothe-
size that the discrepancies can be attributed to the heavy workload of
inpatient residents towards the end of the work day. Further investi-
gation is needed to confirm this hypothesis. We would like to imple-
ment a patient checklist that is incorporated into discharge summary
document on electronic medical record (EMR), as well as involving
pharmacologist earlier in-patient management to further ease the
transition of care.
Level of Evidence:
Level III
CATEGORY: MSK & SPORTS MEDICINE
Poster 461:
In-Hospital Designed and 3D Printed Myo-Electric
and Body-Driven Prosthesis for Adults and Children with Upper
Extremity Limb Deficiencies
e
A Functional and Cost Effective
Approach for Usage in First and Third World Countries
Vishal Chandel, MD (Montefiore Medical Center/Albert Einstein,
Bronx, NY, United States), Yuxi Chen, MD, FAAPMR, C. Glenn Hutnick,
FAAOP, CPO, CTP, FAAOP, Stephanie E. Rand, DO, Anna Rozman, DO,
MBA, Neel Chandel, MD, Jeanette D. Perry, Jewelry CAD Designer,
Matthew N. Bartels, MD, MPH, FAAPMR
Disclosures:
Vishal Chandel: I Have No Relevant Financial Relation-
ships To Disclose
Objective:
To create a cost effective and functional myo-electric and
body driven prosthesis for adults and children with upper extremity limb
deficiencies in first world and third world setting which are designed, 3D
printed and assembled in hospital and are yet practical and cost effective.
Design:
Proof of concept feasibility pilot.
Setting:
Academic medical center and third world environment.
Participants:
Five.
Interventions:
We designed, printed, assembled and delivered one
myo-electric and four body driven 3D printed prosthetic devices for
children and adults with upper extremity limb deficiencies using open
source prototypes with our own modifications on designs and electronic
circuits to reach a certain functional goal based on patient’s needs.
Main Outcome Measures:
1. Successful delivery, acceptance and
usage by the patient. 2. Compliance. 3. Measures of Cost. 4. Time for
development of the devices.
Results:
Three body driven upper extremity prosthesis were success-
fully delivered to three children in our medical center in NY. One body
driven left extremity prosthesis and one myo-electric right extremity
prosthesis were successfully delivered to one adult patient in Kingston
(Jamaica) during our mission work. Patient acceptance was 100%. Every
patient is using it so far. Cost on an average for body driven prosthesis
was $50 (compared to minimum $1000 and up in market). Time to create
one device on an average ranges from two days to one week. Cost on an
average for onemyo-electric prosthesis was $500 (compared to $20,000-
$50,000 available in market). Time to create one myo-electric upper
extremity device on an average ranges from two weeks to one month.
Conclusions:
Using open source Arduino circuit boards and 3D printing
software along with commercially available printers, we can create
inexpensive and highly acceptable upper extremity prosthesis which can
be printed in both first and third world environments in patients who
have upper extremity limb deficiencies in a very cost effective manner.
Level of Evidence:
Level III
CATEGORY: NEUROLOGICAL REHABILITATION
Poster 462:
Efficacy of Intrathecal Baclofen Therapy Compared to
Conventional Oral Treatment in Post-Stroke Spasticity: An
International Multicenter Randomized Controlled Trial (SISTERS)
Michael J. Creamer, DO (Central Florida Pain Relief Centers,
Orlando, USA, Maitland, FL, United States), Geoffrey C. Cloud, MB BS
BSC FRCP, Peter PK. Kossmehl, MD, Michael R. Yochelson, MD, FAAPM&R,
Gerard E. Francisco, MD, FAAPMR, Anthony B. Ward, BSc, MD, FRCPEd,
FRCP, Joerg H. Wissel, MD FRCP, Mauro Zampolini, MD,
Meghann M. Loven, MS, Nathalie Berthuy, RN, Abdallah Abouihia, Master
in Statistics, Alessandra Calabrese, Leopold LS. Saltuari, MD, Prof
Disclosures:
Michael Creamer: I Have No Relevant Financial
Relationships To Disclose
Objective:
SISTERS compared the efficacy of intrathecal baclofen (ITB)
therapy with oral anti-spastic medications (conventional medical man-
agement, CMM) in managing severe spasticity of post-stroke patients.
Design:
Randomized, controlled study.
Setting:
Eighteen rehabilitation facilities.
Participants:
Sixty stroke patients with spasticity in at least two ex-
tremities and an Ashworth Scale (AS) score 3 in a minimum of two
affected muscle groups in the lower limbs were randomly assigned to
the ITB (N
¼
31) or CMM (N
¼
29) groups.
Interventions:
Patients randomized to the ITB arm received ITB
therapy and physiotherapy. Patients randomized to CMM arm were
prescribed oral antispastic medication and physiotherapy.
S279
Abstracts / PM R 9 (2017) S131-S290