Journal of Urgent Care Medicine

Development of a Positive Urinalysis Criteria Using a Machine Learning Approach

Urgent Message: There are no consensus definitions for what defines a “positive” urinalysis in the pediatric population. This secondary analysis of data from a quality improvement project in a network of pediatric urgent care centers used a machine learning approach to determine which variables on urinalysis most strongly predict a subsequently positive urine culture. Kari Flicker, BS; Jessica Parrott, DNP, CPNP-PC, CNE; Tammy Speerhas, DNP, FNP-C; Turaj Vazifedan, DHSc; Theresa Guins, MD; Jeffrey Bobrowitz, MD; …

Development and Implementation of a Headache and Migraine Pathway in Pediatric Urgent Care: A Quality Improvement Initiative

Urgent Message: There are an estimated 250,000 visits annually associated with pediatric headaches in the United States, 84% of which are not treated according to best evidence-based practice (EBP). The development of an EBP headache and migraine pathway in a pediatric urgent care improved access to evidence-based guidelines and increased clinician confidence and knowledge regarding the diagnosis and management of headaches in children. Sarah J. Nembu, DNP, APRN, FNP-C, CPNP-AC; Melissa R. Penkalski, DNP, APRN, …

Major Adverse Cardiovascular Events in Patients with Chest Pain And Moderate Heart Risk Scores Who Were Referred For An Expedited Outpatient Cardiology Evaluation: A Multi-Center Descriptive Study

Urgent Message: Patients with a moderate-risk HEART score referred from an urgent care center for an expedited outpatient cardiology evaluation were found to have a very low rate of MACE and no occurrence of ischemic cardiac deaths. Citation: Thomson N, Barbarash S, Lebron-Gallagher D, Julson H, Weinstock M. Major Adverse Cardiovascular Events in Patients with Chest Pain And Moderate Heart Risk Scores Who Were Referred For An Expedited Outpatient Cardiology Evaluation: A Multi-Center Descriptive Study. …

Fast Track Improves Patient Flow and Wait Times in the Pediatric Urgent Care: A Quality Improvement Project

Urgent Message: Fast trackmodels aim to improve patient throughput metrics for low-acuity patients. In this quality improvement project, a process for fast track in the pediatric urgent care significantly improved patient flow. Hayley L. Ross, MD; Sandra P. Spencer, MD; Traci Ertle, MSN, RN, CPEN; Anthony Watkins, MSN, RN, NE-BC; Mark Feldman, MD; Derrek Massanari, MD, MPH; Bernadette Johnson, MD; Alexandria J. Wiersma, MD Citation: Ross HL, Spencer SP, Ertle T, Watkins A, Feldman M, …

Return Visits and Hospitalization Rates of Adult Patients Discharged with Tachycardia After an Urgent Care Visit: A Retrospective Cohort Study

Urgent Message: Patients discharged from an urgent care clinic with tachycardia were found to have significantly higher odds of return visits to the urgent care and emergency department as well as higher odds of being admitted to the hospital within 7 days compared to non-tachycardic patients. Vitoria Regina Nunes Maia, MD; Ryan Loh, PhD; Michael Weinstock, MD; Lindsey E. Fish, MD Citation: Maia VRN, Loh R, Weinstock M, Fish L. Return Visits and Hospitalization Rates …

Influence of Clinical Setting on Antibiotic Prescribing Practices for Acute Otitis Media in Children at an Urban Academic Medical Center

Urgent Message: This retrospective chart review study found that the odds of children receiving an antibiotic prescription for acute otitis media in urgent care and the emergency department were significantly higher compared to a primary care setting. Further research is needed to better understand factors contributing to higher antibiotic prescribing rates in acute care settings. Angelica M. Mangahas, BS; Heather M. Weinreich, MD, MPH; Johanna Wickemeyer, MD; Margaret Schmit MD; Rakhi Thambi, MD, MBA Citation: …

NSAIDs in Urgent Care and Emergency Departments: A Narrative Review

Urgent Message: This narrative review of non-steroidal anti-inflammatory drugs (NSAIDs) characterizes the specific evidence-based indications, previous studies on dosing and route, and side effects of these medications. It supports NSAIDs as an important class of medications in the management of acute pain in urgent care and emergency settings. Campbell Belisle Haley, MD; Andy T. Hsueh, MD; Chih-Hsuan Chen, MD; Ariana M. Nelson, MD Citation: Belisle Haley C, Hsueh AT, Chen CH, Nelson A. NSAIDs in …

Using Urgent-Care-Based Telemedicine to Increase Primary Care Referrals: A Quality Improvement Project

Urgent Message: A quality improvement project demonstrated increased referral rates to primary care from an urgent care telemedicine service line for those who did not have a primary care provider. Brianna Woodruff, DNP, ARNP, FNP-C; Khara’ A. Jefferson, DNP, APRN, FNP-C, CHC Citation: Woodruff B, Jefferson K. Using Urgent-Care-Based Telemedicine to Increase Primary Care Referrals: A Quality Improvement Project. J Urgent Care Med. 2024; 18(5): 40-47. Key words: Effective care, primary care referral, telemedicine, urgent …

Pediatric Knowledge Needs Assessment: A Pilot Study

Urgent Message: Pediatric emergency medicine researchers have an opportunity to enhance collaboration with general emergency medicine and acute care clinicians to bridge the gap between research and dissemination of evidence-based care recommendations. Bashar S. Shihabuddin, MD, MS, FAAP, FACEP; Jessica Fritter, MACPR, ACRP-CP; Charmaine B. Lo, PhD MPH; Rachel Stanley MD, MHSA; Michael Weinstock, MD Citation: Shihabuddin B, Fritter J, Lo C, Stanley R, Weinstock M. Pediatric Knowledge Needs Assessment: A Pilot Study. J Urgent …

Real-World Validation of Rapid PCR Strep Testing in Urgent Care

Urgent Message: The diagnosis of bacterial pharyngitis is often difficult. Rapid polymerase chain reaction testing has potential to improve diagnostic certainty. Despite high accuracy rates, many urgent care providers continue to seek confirmation by throat culture. Justin Bowles, MD, Supreet Ghumman, MS4 Citation: Bowles J, Ghumman S. Real world validation of rapid PCR strep testing in urgent care. J Urgent Care Med. 2023;18(2):15-21 Key Words: bacterial pharyngitis; PCR testing Abstract Introduction: Point-of-care polymerase chain reaction …

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