Digital Commons Network^™

Healing Wounds Through Nutrition, Deanna Garza

Master's Projects and Capstones

Abstract

The role of nutrition in wound care is often overlooked. The main reasons why wounds fail to heal are malnutrition, infection, impaired organ function due to co-existing diseases such as diabetes, hypertension, renal disease, and peripheral vascular disease to name a few. These factors have contributed to poor patient outcomes and patient satisfaction, as well as an increase in hospital length of stay. To promote wound healing, fuel from macro and micronutrients are necessary to deliver oxygen and energy for cell regeneration. However, nurses must possess knowledge and understanding of these requirements and the effects of nutrition on wound …

Transitions Of Care: Implementing Early Follow-Up Appointment To Help Decrease Readmission Rate, Lualhati Espina Dursun

Master's Projects and Capstones

Abstract

Problem – The rate of readmission in the country is at a severe level. According to CMS, in 2017 the average national readmission rate was 18.4%(CMS, 2018). Hospitals are penalized for unnecessary readmissions (HRRP, 2018). In addition to the financial burden of readmissions, quality of life is decreased with readmission.

Context – Early or timely outpatient follow-up after hospitalization has been projected as a means of decreasing readmission rates.

Interventions – Integrating follow-up appointment to the current care transition - HUB process as a means in reducing readmission rates.

Measures & Results – Identified high-risk patients that need timely …

Making Space For Makerspace: How Adding A Makerspace Can Benefit Art Museum Education Programming, Kaeleigh Thorp

Master's Projects and Capstones

In this capstone project, I advocate for adding makerspaces to art museum education programming. I review the foundational educational concepts of a makerspace which help explain why it is a modern strategy to increasing visitor learning. This includes John Dewey’s theories of experience and education, Howard Gardner’s multiple intelligences theory, George Hein’s studies of museum visitor behavior, and the physiological science of learning. I then propose four key terms essential for visitor learning, and explain how makerspaces successfully incorporate them. The four key terms are: 1. multiple intelligences, 2. direct experience, 3. inquiry based and open ended learning, and 4. …

Watch & Learn - A Teacher's Guidebook For Film-Based Esl Course, Xiaoxue Zhu

Master's Projects and Capstones

Educators in the 21st century are continuously discovering more engaging teaching tools to facilitate language learners. In today's increasingly developing visual world, film stands out from other traditional materials for its unique features, such as the visuality and authenticity. With appropriately designed activities, film could be a valuable resource in teaching English as a second language (TESOL) setting, and also a perfect tool for inspiring cross-cultural communication and promoting critical thinking skills.

However, research has shown that ESL teachers feel reluctant to use film as a significant component in their classrooms even though they have recognized and affirmed the benefit …

Expanding The Definition Of Provenance: Adapting To Changes Since The Publication Of The First Aam Guide To Provenance Research, Katlin Cunningham

Master's Projects and Capstones

In 2001 the American Alliance of Museums (AAM) published The AAM Guide to Provenance Research. However, in the past seventeen years there have been several new developments in the provenanceresearchfield, and an updated guide has yet to be released. I propose that several changes be made to create an updated version. For this project, I tested this guide in two ways: first, to see how our understanding of provenance has changed since 2001 and second, to use a case study to assess whether the recommended basic research guide and principles still apply to today.

In the first …

Health Care Improvement Initiative: Outcomes And Impact Of An Academic-Practice Partnership Between A Large Integrated Health System’S Nurse Scholars Academy And The University Of San Francisco School Of Nursing And Health Professions, Ryan Fuller

Master's Projects and Capstones

By December 2018, a large integrated health system’s Nurse Scholars Academy (NSA) will have financially-sponsored 64 registered nurses to return to school through a strategic academic-practice partnership program at the University of San Francisco (USF). Referred to as ‘Nurse Scholars,' health system employees elected to return-to-school through NSA. As a five-year initiative, NSA was at risk for not receiving additional funding beyond 2020 without a thorough outcomes analysis that articulated the outcomes to executive leadership.

This health system employs more than 23,000 registered nurses in Northern California (NCAL). The NSA is a region-wide effort to accelerate academic progression, leadership development, …

Accessing Mental Health Services As An Undocumented Individual: Policy Recommendations For The State Of California, Lorena Mosqueda

Master's Projects and Capstones

Undocumented individuals are subject to stressors that may exacerbate existing mental health problems or proliferate new mental health illnesses. Due to unjust historical and current institutional and systemic policies the undocumented population accesses mental health services at a rate far below the general population. As a result, this vulnerable community is left with untreated mental health conditions and is further entrenched in a cycle of inequity. In an effort to address this alarming reality we based a review of relevant literature to identify recommendations to increase access to mental health services among the United States undocumented population. Additionally, a simulation …

Building Engagement Through Developing Students’ Sense Of Self-Control, Natalia Sanchez Gonzalez

Master's Projects and Capstones

Students who enter public schools in the United States in the latter part of their academic career may lack the English language proficiency or capital necessary to successfully participate in mainstream content courses. Students such as these, known as late arrivals, face even greater difficulties when they enter academic institutions that or not equipped to provide language supports that ensure students can access content. Arriving at a later age and grade level, places additional pressure on educators and students to enter mainstream language classrooms. With little control or access to be active participants in the new academic settings, these students …

Renouncing The Universal Museum’S Imperial Past: A Call To Return The Rosetta Stone Through Collaborative Museology, Anna Volante

Master's Projects and Capstones

In colonial times, Western empires used orientalism to justify and perpetuate colonialism and imperialism over countries that they believed inferior to their own. These imperial powers plundered cultural heritage artifacts from the nations they oppressed and took these objects back to their national museums to be displayed as trophies of subjugation. The ownership of cultural heritage remains a point of contention throughout the field of museum studies. Despite cries for repatriation, these artifacts continue to be housed in universal museums today. One of the most well-known cases is that of the Rosetta Stone, stripped from the city of Rashid, Egypt …

Under Pressure: Tailored Cpr With Stress Management For Formerly Incarcerated Individuals, Amanda Lee

Master's Projects and Capstones

Purpose: The purpose of this study was to increase rates of Cardiopulmonary Resuscitation (CPR) training and bystander response to Sudden Cardiac Arrest (SCA). This was accomplished by providing a short, one hour adapted CPR course with a stress management component targeting common barriers (e.g. psychological concerns) to bystander response for formerly incarcerated individuals at the Delancey Street Foundation.

Methods: The CPR course was adapted based off a literature review on the learning needs and preferences of this population. Data collection included:1) instructor evaluation of skills based on oral and simulation examination by students (adapted from the standard American Heart Association …

Defying The Gravity Of Falls On Msu, Alvin Joseph Abad

Master's Projects and Capstones

Falls are a leading cause of injury and death for adult males in the United States and have been an ongoing problem on the Medical Surgical Unit (MSU). Therefore, the aim of this project is to increase fall prevention education and communication on MSU in order to ultimately improve fall rates. Although there are currently fall prevention processes already in place, these may not be sufficient as demonstrated by recent fall metrics. Many RNs on MSU are fairly new nurses; and their enthusiasm and adaptability may be an advantage for this evidence-based project. Furthermore, the management team seems to be …

Cnl As Outcomes Manager: Improving Communication During The Er To Icu Handoff, Amy Ho

Master's Projects and Capstones

Emergency room (ER) to Intensive care unit (ICU) handoff reports are often ineffective because the lack of an standardized guideline. The aim of the Clinical Nurse Leader (CNL) improvement project was to improve the nurse satisfaction survey scores in the ER and ICU microsystems within a mid-sized community hospital in northern California. Participates included registered nurses, and ER and ICU managers. The failure mode and effect analysis (FMEA), Strength, weaknesses, opportunities, and threats (SWOT) analysis, and the Plan-Do-Study-Act (PDSA) cycle were used for this project. Literature reviews were conducted to identify effective theories, patterns, and tools for handoff reports. Nurse …

Finding The Narrative In Incident Reports, La'eeqa Aslam

Master's Projects and Capstones

The Progress Foundation, as licensed by the state of California and the Community Care Licensing, is required to use incident reports for internal audits and remain in compliance as a health facility. Incident reports are used to record events or accidents that have occurred within an organization. Often times, reports are made, handed off, and given from the residence home to the Community Care Licensing with little to no information of how an incident was managed. The Progress Foundation is working towards tracking information from the incident reports to improve internal management and understand the trends in the reports.

In …

Creating A Culture Of Learning: Improving Patient Mobility In A Medical-Surgical Unit, Camille Cabalsa

Master's Projects and Capstones

Abstract

PROBLEM: Hospitalization, especially among older adults aged 65 or over, can result in decreased mobility and functional decline. This decreased mobility can lead to accelerated bone loss, falls, increased length of stay, and delirium. In this medical-surgical unit, a pattern reflecting lack of adequate patient mobility has persisted over one year.

CONTEXT: Northwest (NW), a 42-bed community hospital medical-surgical unit- part of an integrated regional health care delivery system, has not been maximizing the mobilization of their patients for the past year based on internal data.The improvement project described in this paper focused on creating a culture of continuous …

Improving Knowledge And Attitude Of Primary Healthcare Givers Towards Vulnerable Populations: A Quality Improvement Project, Kimberly Shankel

Master's Projects and Capstones

Improving Knowledge and Attitude of Primary Healthcare

Givers Towards Vulnerable Populations

Kimberly Shankel

University of San Francisco

Abstract

Problem

This project aims to improve patient satisfaction for vulnerable population patients while in hospital, namely transgender and gender non-conforming people. A major roadblock for this population in seeking medical care is their fear of discrimination when accessing healthcare, resulting in a delay, or avoidance of medical care. Multiple studies agree there is a need for nursing education on cultural competence to improve care and satisfaction for vulnerable populations.

Context

The site for this quality improvement project is a small suburban hospital …

Combining Patient-Centered-Care And Technology To Reduce Falls In A Medical/Telemetry Unit, Megan Mira

Master's Projects and Capstones

Abstract

PROBLEM: From October 2017 through June 2018 there were 25 patient falls recorded on the 5^th floor medical surgical telemetry unit. Top factors contributing to this high fall rate include: poor patient-centered-care planning, and inadequate set-up for use of technology.

CONTEXT: According to the Joint Commission, 2015, each fall with injury costs $14,000. This estimate doesn’t include the potential indirect costs that account for the long-term effects of injuries such as disability, dependence on others, lost time from work, household duties, and reduced quality of life.

INTERVENTIONS: Staff education was introduced and focused on using a new mindfulness …

The Destruction Of Unesco World Heritage Sites Aleppo And Palmyra In Syria Due To Civil War: Accessioning And Cataloging The Satellite And Drone Imagery Into A Museum Collection, Colette P. Militello

Master's Projects and Capstones

This Museum Studies capstone will discuss the civil war inside Syria, and the destruction of UNESCO World Heritage Sites Aleppo and Palmyra. This paper will examine the historical importance of these sites, and the drone and satellite imagery data used to confirm the destruction. This paper will argue that for full preservation of these cultural heritage sites that this imagery data should be accessioned into a museum collection with the use of professionally-trained registrars. This paper will explore this idea further by arguing that this imagery data collected by companies and governments should be handed over with full copyright to …

Mdr Matters! Improving Primary Nurse Participation In Multidisciplinary Rounds, Alma Alcantara

Master's Projects and Capstones

Abstract

Problem: The current model of multidisciplinary rounds (MDR) in a 40-bed medical-surgical unit within a Northern California community hospital has demonstrated low participation rates from primary nursing. The primary nurse attendance in MDRs is consistently at 50% participation, below the target goal of 80%. This lack of engagement leads to ineffective communication and fragmented care coordination resulting in suboptimal quality care and cost outcomes.

Context: An intervention strategy to standardize the MDR model was implemented over three months. A literature review revealed that effective and consistent MDR practices can directly influence primary nurse participation. This change management project focus …

Keep The Beat With Heart Failure Education: A Quality Improvement Project, Brenda L. Peterson

Master's Projects and Capstones

Abstract

Problem: Heart failure (HF), also known as congestive heart failure (CHF), is the number one diagnosis-related group (DRG) for people 65 years of age and older in the United States. This disease group is complicated and debilitating, requiring frequent hospitalizations with high mortality rates. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has identified CHF as an area for improvement in hospitals.

Context: This was a quality improvement project for an integrated medical center in the Central Valley, California with over 19,000 HF patients. In 2018, for patients 65 years and older, HF is the third-most admitted DRG …

Raising Oas Cahps Scores: Using Patient Education, Katrina Pangilinan

Master's Projects and Capstones

At the Golden Gate Endoscopy Center (GGEC), the Consumer Assessment of Healthcare Providers and Systems Outpatient and Ambulatory Surgery (OAS CAHPS) survey results on patient satisfaction have been below the 50th percentile for the last three quarters of 2018. Patient satisfaction scores are a quality measure for the patient care experience and important for the success of the organization and its providers. Based on patient comments from previous surveys, patients feel that the center does not explain the possible side effects of the anesthesia in a way they can understand. Other patient comments and concerns included confusion regarding dietary restrictions …

Reducing Inpatient Readmissions Through Early Follow-Up Appointment Planning: A Quality Improvement Project, Isabella Cuenco

Master's Projects and Capstones

Problem: Inpatient readmissions have a highly negative impact on healthcare systems. Not only do these hospitalizations have a detrimental effect on patient outcomes they also are accompanied by a prohibitive financial burden to the hospitals.

Context: Follow-up appointment with a primary care provider after discharge has been demonstrated as a viable strategy to reduce the risk of readmissions.

Interventions: Create a volunteer program to schedule patient appointments with a primary care provider within seven days of discharge.

Measures and Results: Compare the number of patients that were discharged with a follow-up appointment after the intervention to before the intervention, and …

Improving The Staff Responsiveness By Bundling Care, Practicing Proactive Authentic Hourly Visits, And Using The Four P’S, Robert Vega

Master's Projects and Capstones

Abstract

Problem

Staff responsiveness is an important Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Star Rating composite tool that hospitals monitor because it is consumer-driven information. The intent is that the HCAHPS composite promotes patient satisfaction, contributes to the prevention of harm, and can save millions of dollars (Danaf et al., 2017). On admission, the patient is orientated to their room, provided a nurse call light button to use, and told not to get out of bed alone and to wait for their nurse (Mitchell et al., 2014). On Three North, a gap exists in the delay it …

Employing Natural History Collections In The Aid Of Conservation: Streamlining An Approach To Model Species Distributions En Masse For The Preservation Of Biodiversity, Alice Fornari

Master's Projects and Capstones

Using species distribution models (SDMs) in Natural History Collections (NHCs) can influence how humans implement conservation changes in flora and fauna communities and ecosystems. Through the use of legacy data (old NHCs and their associated locality/collection information), data correction (background data or pseudo absences added to presence-only data), and the SDM software, Maxent (and its associated geographic information systems or GIS projected models), it has been shown that it is feasible to create a low budget protocol/setup to project the past, present and future of species population changes. This has been done in the past few decades as more collections …

Music Education And Its Impact On L2 Learning, Johanna Nilsson

Master's Projects and Capstones

English Language Learners are disproportionately underrepresented in secondary music classes in the United States. They are systematically excluded due to overly restrictive schedules, high emphasis on test scores and academic remediation, real and perceived cost of participation, and the types of courses that are offered at most secondary schools. At the same time, musical intervention research has revealed that musical ability is linked to literacy, pronunciation, and vocabulary retention, all aspects of second language acquisition. By excluding English Language Learners from music education, we could be denying them a tool that could positively impact their language acquisition. However, most of …

English For Baking: Lessons For Kitchen Workers Using On-Site Learning, Christopher Torossian

Master's Projects and Capstones

Today, the back of house staff in culinary kitchens is comprised largely by migrant workers whose native language is something other than English. At times this can create issues among workers due to communication errors or complete lack of communication all together, posing issues for not only cooking, but it can also be a threat to kitchen safety as well. Additionally, due to native speaker stigma surrounding non-native speakers of English, many workers are often denied the chance at a higher position in the workplace simply because of their low communicative competence, despite their actual talents and skills in the …

Improving Nursing Communication Outcomes Through The Tell-Us Card, Jeffrey Salao, Nina Park, Laura Le, Brittney Pilker, Jillian Cule, Maricarmen Reyes

Master's Projects and Capstones

Abstract

Nursing communication plays a pivotal role in patient-centered care. However, statistics have shown that failures in communication exist in more than 20% of all hospital settings (Sethi & Rani, 2017). Within the explored microsystem, a gap in patient communication was identified through the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys. Reports revealed that the microsystem was performing at 69%, which is 11% below the national average for nursing communication (Centers for Medicare and Medicaid Services [CMS], 2018). After performing a microsystem assessment, there was a measurable communication opportunity between the patients and nurses. It was determined …

Improving Nursing Communication Outcomes Through The Tell-Us Card, Brittney Pilker, Jillian Cule, Laura Le, Nina Park, Jeffrey Salao, Maricarmen Reyes

Master's Projects and Capstones

Nursing communication plays a pivotal role in patient-centered care. However, statistics have shown that failures in communication exist in more than 20% of all hospital settings (Sethi & Rani, 2017). Within the explored microsystem, a gap in patient communication was identified through the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys. Reports revealed that the microsystem was performing at 69%, which is 11% below the national average for nursing communication (Centers for Medicare and Medicaid Services [CMS], 2018). After performing a microsystem assessment, there was a measurable communication opportunity between the patients and nurses. It was determined that …

Power In Plain Sight: Exploring The Class Privilege At In Curriculum At Wealthy High Schools, Miriam Gross

Master's Projects and Capstones

While secondary education has moderately improved in its approach of racial and gender issues in the classroom, social class remains an undiscussed topic, especially in school communities serving students of the highest social classes where financial privilege often intersects with racial privilege. The lack of discussion of social class is considered against the role schooling is meant to play in creating good citizens and the different ways that is construed. Taking into account research into the identity formation of wealthy adolescents, the hidden curriculum in secondary schools that supports the current social order, and pedagogical practices that could be used …

Multilingual Museums: A Proposal To Increase Linguistic Diversity In Contemporary Art Museums, Jennifer Cha

Master's Projects and Capstones

The U.S. population is becoming more ethnically, racially, and linguistically diverse. It is estimated that by the year 2050, the U.S. will shift to a majority-minority population, meaning that the total minority population will become the majority of the U.S. population. But while the U.S. is diversifying, the current museum visitorship demographic is not representative of or on track to measure up to these changes in the future. If museums are valuable civic spaces with several associated health, social, and educational benefits, and a large percentage of the population have low-English proficiency and cannot access the information, then there is …

Using Games To Teach English In Chinese High School Classroom, Wenyu Zhu

Master's Projects and Capstones

In the 20th century, English played an important role in international communication as an international language. English is a bridge between countries' economies, cultures, and trade. However, current English education in Chinese high schools is still test-oriented which is ineffective, and students are tired of it. Moreover, teachers also have trouble engaging students in the class. The purpose of this project is to create a curriculum for high school English teachers in China to use games to teach English language skills. Krashen’s (1982) Theory of Second Language Acquisition contains five main hypotheses which support this project. The project includes twenty-three …