Jolene Fox

Intermountain Medical Center, Salt Lake City, Utah, United States

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Publications (11)0 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study was to design and implement a domestic violence (DV) screening protocol. Trauma patients meeting inclusion criteria (hospitalized > 48 hours) were given a four question DV screen. If abuse was found, a comprehensive DV questionnaire followed. Barriers to screening and results were recorded. Compliance during the pilot test showed 23 of 157 (14.6%) admitted patients were screened. In the implementation year, 446 of 721 (61.9%) were screened. During the 10-month follow-up, 499 of 619 (80.6%) patients were screened. Lack of social work resources was the primary barrier to screening, but compliance increased and was maintained after the study period.
    No preview · Article · May 2015 · Journal of trauma nursing: the official journal of the Society of Trauma Nurses
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    ABSTRACT: Red blood cell distribution width (RDW) is a component of the complete blood count (CBC) that is traditionally used to identify iron-deficiency anemia. RDW has been shown to predict mortality in patients with multiple different medical conditions and in general populations. It is unknown whether RDW predicts outcomes in trauma patients. This study tested whether RDW predicts mortality in a trauma population at a Level I trauma center. Trauma patients with a CBC from October 2005 to December 2011 were evaluated. Sex-specific 30-day and 1-year all-cause mortality and RDW were studied using Cox regression adjusted for age, Injury Severity Score (ISS), hospital length of stay, blunt versus penetrating trauma, and other CBC parameters. A total of 3,637 females and 5,901 males were evaluated at 30 days and 1 year. With full adjustment, RDW predicted 30-day mortality in males (for RDW quintiles 1-5: 2.2%, 1.8%, 3.6%, 4.8%, 10.1%, respectively; p < 0.001) but not in females (3.4%, 1.9%, 3.0%, 3.9%, 6.2%; p = 0.036). At 1 year, RDW predicted mortality in both males (p < 0.001; 0.5%, 0.4%, 0.8%, 1.7%, and 8.3%) and females (p < 0.001; 0.5%, 2.1%, 3.0%, 4.2%, and 8.8%). Receiver operating characteristic analysis found c = 0.705 in males and c = 0.625 in females at 30 days and c = 0.820 in males and c = 0.723 in females at 1 year. RDW independently predicted mortality in trauma patients at this single Level I trauma center. RDW may reveal underlying health status and be clinically useful for prognostication. The mechanistic relationship between RDW and mortality in trauma remains unknown and should be further evaluated. Prognostic and epidemiological study, level III.
    No preview · Article · Apr 2013
  • Suzanne Day · Jolene Fox · Kathy Cookman
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    ABSTRACT: Study purpose was to describe trauma registrar job requirements, responsibilities, and recruitment/retention practices. An online survey was used. One-third required a high school diploma; two-thirds required a college degree. Most required skills were medical terminology (66%), database management (65%), anatomy (64%), Word (63%). Data responsibilities included abstracting, entry, coding, and validating. Few employers required certification. Twenty-six percent reported problems with recruitment, and 35% with retention. Salary and lack of advancement were primary reasons for employee turnover. Certifications were less relevant than skills; the primary focus was data management. Recommendations for recruitment/retention include job flexibility, educational opportunities, and recognition as a profession.
    No preview · Article · Jan 2012 · Journal of trauma nursing: the official journal of the Society of Trauma Nurses
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    ABSTRACT: This study examined air medical transport (AMT) personnel's experiences with and opinions about prehospital and AMT research. A Web-based questionnaire was sent to eight randomly selected AMT programs from each of six Association of Air Medical Services (AAMS) regions. Responders were defined by university association (UA) and AMT professional role. Forty-eight of 54 (89%) contacted programs and 536 of 1,282 (42%) individuals responded. Non-UA responders (74%) had significantly more work experience in emergency medical services (EMS) (13.5 +/- 8.5 vs. 10.8 +/- 8.3 years, P = .002) and AMT (8.3 +/- 6.3 vs. 6.8 +/- 5.7 years, P = .008), whereas UA responders (26%) had more research training (51% vs. 37%, P = .006), experience (79% vs. 59%, P < .001), and grants (7% vs. 2%, P = .006). By AMT role, administrators had the most work experience, and physicians had the most research experience. Research productivity of responders was low, with only 9% having presented and 10% having published research; and UA made no difference in productivity. A majority of responders advocated research: EMS (66%) and AMT (68%), program (53%). Willingness to participate in research was high for both EMS research (87%) and AMT research (92%). Although AMT personnel were strong advocates of and willing to participate in research, few had research knowledge. For AMT personnel, disparity exists between advocating for and producing research.
    No preview · Article · Jul 2010 · AirMed
  • Jolene Fox · Suzanne Day · Lisa Reynolds · Frank Thomas

    No preview · Article · Feb 2010 · AirMed
  • Frank Thomas · Jolene Fox
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    ABSTRACT: The purpose of this study was to quantify the value of current and future Air Medical Physician Association (AMPA) membership services. Three-hundred-ninety-eight AMPA members were contacted by e-mail to participate in ranking AMPA membership services by a perceived numeric value (10 = highest to 1 = lowest), using a web-based survey. One-hundred-eighteen AMPA members completed the survey. The percentage of respondents having attended the conference and their AMPA-related Conference ranked-value scores were as follows: Air Medical Transport Conference (AMTC), 43%, 9.6 +/- 1.9; AirMed International Conference, 9%, 7.8 +/- 4.2; AMTC Pre-conference, 65%, 7.6 +/- 2.5; Critical Care Transport Medicine Conference (CCTMC), 47%, 6.6 +/- 2.6; CCTMC Pre-conference, 37%, 6.6 +/- 2.6; the Association of Air Medical Services (AAMS) Mid-Year Conference, 6%, 6.4 +/- 4.9; and General Membership meeting, 63%, 5.6 +/- 2.4. Current AMPA Benefit/Service ranked-value scores were as follows: textbook, 8.4 +/- 1.8; voice for physicians, 8.0 +/- 2.3; position papers, 7.9 +/- 1.8; Air Medical Journal subscription, 7.8 +/- 2.1; networking with others, 7.7 +/- 2.4; newsletter, 7.3 +/- 1.9; means to enhance professional credibility, 7.1 +/- 2.5; web site, 7.0 +/- 2.1; voice on Commission on Accreditation of Medical Transport Systems (CAMTS), 7.0 +/- 2.7; continuing medical education (CME) credits, 6.6 +/- 3.0; conference discounts, 6.4 +/- 2.9; and curriculum vitae builder, 4.9 +/- 2.9. Future AMPA Benefits/Services ranked-value scores were as follows: evidence-based guidelines, 8.6 +/- 1.7; transport database, 7.7 +/- 2.1; malpractice repository, 7.6 +/- 2.2; DVD lectures, 7.4 +/- 2.0; medical director certification, 7.2 +/- 2.9; lobbying, 7.1 +/- 2.4; photo library, 6.4 +/- 2.3; salary and benefits surveys, 6.4 +/- 2.6; speaker's bureau, 6.2 +/- 2.4; and consulting service list, 6.2 +/- 2.4. This AMPA survey was useful in prioritizing membership services.
    No preview · Article · Mar 2009 · AirMed
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    ABSTRACT: Our goal was to identify strategies that would reduce risks and improve patient safety during registration of trauma patients and subsequent electronic data linkage. Recently, the health care industry and the Joint Commission on Accreditation of Healthcare Organizations have supported failure mode effects analysis (FMEA) as a tool for proactively reducing risk to patients. We utilized FEMA for a comprehensive evaluation of our trauma patient registration process for system weaknesses. We found several areas of our processes that placed patients at risk. On the basis of our findings, we implemented changes that included education of staff, role clarification, task reallocation, and established a list of personnel authorized to request the electronic data linkage process. Further recommendations were made for information system changes, which are under review. FMEA helped us to systematically identify and prioritize risks to patient safety. Our findings directed changes, which, in turn, reduced potential errors. We recommend this method of evaluation to other health care personnel interested in improving patient safety.
    No preview · Article · Oct 2007 · Quality management in health care
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    ABSTRACT: Performance improvement (PI) in the multiple systems injured patient frequently highlights areas for improvement in overall hospital care processes. Failure mode effects analysis (FMEA) is an effective tool to assess and prioritize areas of risk in clinical practice. Failure mode effects analysis is often initiated by a "near-miss" or concern for risk as opposed to a root cause analysis that is initiated solely after a sentinel event. In contrast to a root cause analysis, the FMEA looks more broadly at processes involved in the delivery of care. The purpose of this abstract was to demonstrate the usefulness of FMEA as a PI tool by describing an event and following the event through the healthcare delivery PI processes involved. During routine chart abstraction, a trauma registrar found that an elderly trauma patient admitted with a subdural hematoma inadvertently received heparin during the course of a dialysis treatment. Although heparin use was contraindicated in this patient, there were no sequelae as a result of the error. This case was reviewed by the trauma service PI committee and the quality improvement team, which initiated FMEA. An FMEA of inpatient dialysis process was conducted following this incident. The process included physician, nursing, and allied health representatives involved in dialysis. As part of the process, observations of dialysis treatments and staff interviews were conducted. Observation revealed that nurses generally left the patient's room and did not involve themselves in the dialysis process. A formal patient "pass-off" report was not done. Nurses did not review dialysis orders or reevaluate the treatment plan before treatment. We found that several areas of our current practice placed our patients at risk. 1. The nephrology consult/dialysis communication process was inconsistent. 2. Scheduling of treatments for chronic dialysis patients could occur without a formal consult or order. 3. RNs were not consistently involved in dialysis scheduling, setup, or treatment. 4. Dialysis technicians may exceed scope of practice (taking telephone orders) when scheduling of treatment occurred before consult and written orders. Near-miss events may be overlooked as opportunities for improvement in cases where no harm has come to the patient. As a result of our FMEA investigation, the following recommendations were made to improve hospital care delivery in those trauma patients who require inpatient dialysis: 1. Education of RNs about the dialysis process. 2. Implementation of a formal reporting process between the RN and the dialysis technician before the procedure is initiated. 3. RN supervision of dialysis treatments. 4. Use of a preprinted inpatient dialysis form. 5. Education of dialysis technicians regarding their scope of practice. 6. Improve notification process for scheduling dialysis procedures between units and dialysis coordinator (similar to x-ray scheduling). Our performance improvement focus has broadened to include all reported "near-miss" events in order to improve our healthcare delivery process before an event with sequelae occurs. We have found that using FMEA has greatly increased our ability to facilitate change across all services and departments within the hospital.
    No preview · Article · Jul 2006 · Journal of trauma nursing: the official journal of the Society of Trauma Nurses
  • Teresa Reading · Jolene Fox · Suzanne Day

    No preview · Article · Dec 2004 · Journal of healthcare risk management: the journal of the American Society for Healthcare Risk Management
  • Article: MANUSCRIPT
    Suzanne Day · Jolene Fox · Teresa Reading

    No preview · Article · Oct 2004 · Journal of trauma nursing: the official journal of the Society of Trauma Nurses
  • Suzanne Day · Jolene Fox · Teresa Reading

    No preview · Article · Sep 2004 · Journal of trauma nursing: the official journal of the Society of Trauma Nurses