Holly:
Facilitating the translation of basic and clinical research into clinical practice and improved population health has become a major goal of the health related research enterprise. The original emphasis on ? supporting “bench to bedside” translation has been expanded to include facilitating applications of basic and clinical research into practice settings and into broader community environments. Public policies can be impacted by basic and clinical research findings, and research can be impacted by public policy. Informing public policy is a critical and powerful way of improving the health of individuals and of populations. Several ways in which research can impact health related policy making include; accurately ? and objectively documenting the existence of a problem, quantifying the extent of this problem, and demonstrating the correlates of a problem; analyzing the problem to identify what interventions work and which do not, and identifying undesired and unintended consequences of policy decisions; suggesting or proposing options to address the problem; and, debating about health issues to include scholarly evidence as well as biases (Mirvis, 2009). Surgical Smoke Plume in the Perioperative setting. Surgical smoke, or plume, is the byproduct of the use of electrosurgical devices, ultrasonic devices, and laser treatment. These devices vaporize tissue and blood vessels which creates the gaseous material called plume. Approximately 5% of surgical plume is particulate matter consisting of chemical, physical, or biologic material. Exposure to this matter is cumulative much like tobacco smoke (Matthews, 2016). While there are perioperative guidelines regarding surgical smoke in the operating room, and the Occupational Health and Safety Organization (OSHA) states that employers are responsible for providing a safe and healthy workplace, surgical smoke evacuation is not required (York & Autry, 2018). The potential health risks of exposure and inhalation of surgical plume include eye, nose, and throat irritation, headaches, cough, and nasal congestion. Surgical plume has also been linked to acute and chronic inflammatory changes in the respiratory tract such as emphysema, asthma, and bronchitis (Romano, Gusten, De Antonellis, & Joppolo, 2017). The small particulate matter produced by vaporization can travel into the alveoli to the bloodstream and potentially cause cancer. A few of the chemicals present in surgical plume include hydrocarbons, phenol, and benzene, known carcinogens. Biologic material present can include human papilloma virus (HPV) or human immunodeficiency virus (HIV). Surgical plume may cause postoperative complications for patients that include headaches, nausea, vomiting and increased CO2 levels, possible surgical site infections, and potentially cancer metastasis due to the aerosolized particles (Matthews, 2016). To address the issue of the dangers of surgical plume exposure in the operating room drafting and passing legislation has become imperative. In drafting this legislation, partnering with other members of the healthcare team, the Association of Operating Room Nurses (AORN), and the Alabama State Nurses Association (ASNA) will aide in developing the legislation, provide valuable resources regarding data on surgical plume dangers, case studies of those adversely affected due to this exposure, and educational materials for the legislators. Using legislation previously passed in Rhode Island and Colorado and pending legislation in Oregon as a guide for legislation in Alabama will greatly help in the wording of subsequent legislation. Legislation is the best course of action regarding this issue due to the environmental dangers the entire surgical team is exposed to and the lack of governmental oversight to this issue.
References:
Matthews, S. (2016). Preventing harm from surgical plume. Kai Tiaki Nursing New Zealand, 22(6), 26–27. Retrieved from: https://search-ebscohostcom.lopes.idm.oclc.org/login.aspx? direct=true&db=ccm&AN=116867994&site=edslive&scope=site
Mirvis D. M. (2009). From research to public policy: an essential extension of the translation research agenda. Clinical and translational science, 2(5), 379–381. https://doi.org/10.1111/j.1752- 8062.2009.00144.x
Romano, F., Gusten, J., De Antonellis, S., and Joppolo, C. M. (2017). Electrosurgical smoke: Ultrafine particle measurements and work environment quality in different operating theatres. International Journal of Environmental Research and Public Health, 14, (2), 137.
MDPI AG. Retrieved from http://dx.doi.org/10.3390/ijerph14020137
York, K. and Autry, M. (2018), Surgical smoke: Putting the pieces together to become smoke free. AORN J, 107: 692-703. Retrieved from https://doi.org/10.1002/aorn.12149
Ryan:
Translational research has been identifying evidence-based health behaviors, screenings, and immunizations for decades in public health issues (e.g., smoking cessation, physical activity, mammography, colonoscopy) (Woolf, et. al., 2015). All implemented due to translational research on how to help adopting healthier lifestyles for the public knowledge; health services research helps health systems improve uptake of clinical preventive services; and policy research helps communities assimilate the evidence-based policies. However, public health (i.e. medicine) is disappointingly incomplete and slow on the uptake of research evidence. There were several enacted policies for public health in Arizona that was passed for 2018. Examples of these are the Opioid Epidemic Interventions, Dental Therapy, Fresh Produce for SNAP Benefit, Tribal Exemption from Future AHCCCS Work Requirements, Recess in Schools (to address child obesity), Drug Overdose Review Teams, Asthma Management, HIV Needs Assessment, and Healthcare Workforce Data (Humble, 2018). All have been proven by research that for example the Opioid Epidemic Interventions – Opioid pill prescribing limits for opioid naïve patients, morphine equivalent unit limits (with certain exemptions), limitations on physician direct dispensing, requires E-prescribing, requires pharmacists to check the controlled substances monitoring database, requires continuing medical education for prescribers, better regulation of “pill mills,” informed consent and discharge planning at health care institutions, implementation underway via rule writing etc. This policy also goes along with the Drug Overdose Review Teams – requires law enforcement agencies to provide unredacted reports to the chairperson of a local Drug Overdose Fatality Review Team. Data will be used by the Team to develop standards and protocols for local drug overdose fatality review teams and provide training and technical assistance
References Humble, W. (2018). Arizona’s 2018 legislative session: Victories, losses & missed opportunities. Retrieved from https://static1.squarespace.com/static/56ec8d2562c… 6/1526515992805/Arizona%E2%80%99s+2018+Legislative+Session.pdf Woolf, S., Purnell, J., Simon, S., Zimmerman, E., Camberos, G., Haley, A., & Fields, R. (2015). Translating Evidence into Population Health Improvement: Strategies and Barriers. Annual Review of Public Health,36(1), 463-482. doi:10.1146/annurev-publhealth-082214-110901
Lisa:
According to the article, sustaining diabetes prevention and care interventions….by Garst, L’Heveder, Siminerio, Motala, Gabbay, Chaney, & Cavan (2017), “In context of translational research sustainability is defined as the continued use of program components and activities for the continued achievement of desirable program & population outcomes. “In the article eleven research projects of the International Diabetes Federation were investigated for sustainability. Translational Research projects categories to include preventing type 2 diabetes, improving diabetes care and management, protecting women’s health, and preventing diabetes complications. The interviews and surveys conducted were focused on planned sustainable goals, factors influence planning of these goals and sustainability achieved (Garst et al., 2017)
Sustainability of outcomes as a research objective to include three main areas, 1) sustainability, 2) diffusion, & 3) replication (Garst et al., 2017). Sustainability also requires strategy like anticipating limited healthcare budget. Monitoring of the progress also important to sustainable intervention. Main enablers are stakeholder involvement, community ownership which are important to diffusion. With their involvement health authorities will include the determined intervention in regional and national policies (Garst et al., 2017). Media coverage will help to disseminate activities. Due to the media coverage policy makers will recognize the importance of the investigated health issue and more resources may become available. Replication of the intervention to other sites require evaluation and reports of intervention.
Translational research bridges the gap between science and public health action but requires multidisciplinary efforts and a multilevel approach for sustainability. Barriers/ enablers are to be anticipated and more research needed on how to monitor and measure sustainability (Garst et al., 2017) for successful outcomes.
Eliminating Disparities in Diabetes Prevention, Access, and Care Act (H.R. 2651). This act sought to enhance research efforts of the NIH on cause and effects of diabetes in minority populations. CDC will work on effective diabetes treatment, focus on prevention and targeted education. Also, work to strengthen the public health workforce in particular areas (DeGette & Reed, nd). This act died in congress, Health Equity and Accountability Act 2016 (HR 5475) sponsored by Representative R.Kelly also did not make it.
The American Diabetes Association, has The Health Equity Bill of Rights Docket #OMB-2021-0005. Set of principles to guide ADA effort to take action through policy, barriers to health & healthcare today. No person with diabetes or with risk for diabetes to lack resources they need for health & safety. ADA submitted perspective to US Office of Management and Budget on its Request for information: Methods and Leading Practices for Advocacy Equity and support for underserved communities through government.
Reference:
American Diabetes Association. (2021). Advocacy Overview. https://www.diabetes.org/sites/default/files/2021-07/OMB%20Equity%20RFI%20Response_American%20Diabetes%20Association%20final.pdf
DeGette, D., & Reed, T. (nd). Congressional Caucus on Diabetes Legislation: Diabetes Legislation Introduced by Caucus Leadership. http//diabetescaucus-degette.house.gov/legislation
Garst, J., L’Heveder,R., Siminerio, L., Motala, A., Gabbay, R., Chaney, D., & Cavan, D. (2017). Sustaining diabetes prevention and care interventions: a multiple case study of translational research projects. https://www-sciencedirect-com.lopes.idm.oclc.org/science/article/pii/50168822716302145?via%3Dihub
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