Medicine and Health Sciences Commons^™

Reducing Medication Barriers Before Patient Check-Out At A Student Run Free Clinic, Jenna D. Reisler, Daniel Bao, Alison Zill, Marysuna Wilkerson

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

Decreasing Blood Culture Contamination At A Children’S Hospital, Taylor Pearl, Brittany Bare, Ricardo Zegarra-Linares, Jessica Lee

South Atlantic Division GME Research Day 2024

No abstract provided.

Quality Improvement Project: Compliance Of Antenatal Testing In Patients With Class Iii Obesity, Isabella L. Sciacca, Timothy Kremer, Nicole Tenzel

North Texas GME Research Forum 2024

The prevalence of obesity in women of reproductive age (20 to 39) in the US is 39.7%. It has been estimated that one-quarter of pregnancy complications are attributable to maternal obesity. Comprehensive prenatal care is imperative to achieving positive health outcomes. This quality improvement (QI) initiative aimed to improve antenatal fetal surveillance rates in patients with class III obesity. Evidence based interventions to test fetal wellbeing were implemented and examined over a 7 month time period to evaluate physician compliance of the standard of care for antenatal surveillance starting at 34 weeks gestation. Following implementation of this initiative, compliance with …

Implementing A Standardized Screening Algorithm For Iron Deficiency Anemia In Pregnancy, Ariel Moskowitz, Nicole Tenzel, Joshua Mangels, Lyndsay Millican

North Texas GME Research Forum 2024

OBJECTIVE: Anemia in pregnancy is a global health problem and complicates >40% of pregnancies. Anemia is associated with significant maternal and fetal complications including low birth weight, preterm delivery, postpartum hemorrhage, ICU admissions, need for blood transfusion, and maternal morbidity. The American College of Obstetricians and Gynecologists (ACOG) and the CDC recommend screening for anemia at the first prenatal visit and again between 24 and 28 weeks gestation. The aim of this quality improvement project is to improve compliance of screening for anemia in pregnancy amongst the providers of Medical City Women's Care. METHODS: Using the Plan-Do-Study-Act (PDSA) quality improvement …

Implementation Of Viz.Ai Augmented Intelligence Software To Reduce Door To Puncture Times And Patient Outcomes At A Comprehensive Stroke Center, Cody Bryant, Brandon Womack, Mason Patel, Sanjay Sharma

North Texas GME Research Forum 2024

Introduction: Endovascular therapy (EVT) in the form of mechanical thrombectomy is the mainstay of treatment for acute large vessel occlusion (LVO) ischemic stroke, but its efficacy is highly time sensitive. It is crucial that stroke centers continue to implement process improvements that aim to streamline stroke workflow. Viz.AI is a platform that uses artificial intelligence to automatically detect LVOs with computed tomography (CT) imaging. It provides immediate access to the CT images as well as a platform for centralized communication through the mobile application. We sought to determine if the implementation of Viz.AI at our comprehensive stroke center improved stroke …

Improving Clostridium Difficile Detection At Medical City Arlington: A Quality Improvement Project, Bremmy Alsbrooks, Nur-Alhuda Shahub, Shabaz Mallick, Jesse Brown

North Texas GME Research Forum 2024

INTRODUCTION: Hospital acquired Clostridium difficile infection are one of the costliest hospital acquired infections. Over the past year, there were 19 C diff cases. Reasons for this uptick in cases from previous years could be waiting too long for collection (where a patient has C diff on admission, but does not receive testing until several days later), antibiotics, environmental (for example, using the same toilet brush to clean bathrooms on the floor as well as the bathroom in a C diff patient's room, cleaning high touch areas less than two times during the day, etc.), or staff education. From our …

Investigating And Addressing Deficiencies In Our Current Urinalysis Reflex Program, Alexander Duggan, Megan Hobbs, Cameron Holsomback

South Atlantic Division GME Research Day 2024

No abstract provided.

Increased Confidence And Knowledge Of Long-Acting Injectable Antipsychotics In Nursing, Improving The Timeliness To Intervention, Barbara Gracious, Marc Macaluso, Haryashpal Bhullar

South Atlantic Division GME Research Day 2024

No abstract provided.

Improving Depression Screening In Primary Care By Implementing A Systematic Annual Screening Protocol: A Quality Improvement Initiative, Trang Nguyen, Ian Whitaker, Danny Tran, Aidan Lum Kong, Nan Crossley

South Atlantic Division GME Research Day 2024

No abstract provided.

Improving Rates Of Postpartum Depression Screening: A Quality Improvement Project, Sarah Chason, Keisha Reddick, Alexis Brown, Cassandra Hensel, Hannah Pittman, Jennifer Brown

South Atlantic Division GME Research Day 2024

No abstract provided.

Development And Implementation Of An Educational Prenatal Packet To Improve Obstetric Management And Patient Education Within A Family And Community Medicine Residency Program, Jalicia Sturdivant, Julianna Snow, Esther Piervil, Erica Paulos, Kimberly Mathurin

South Atlantic Division GME Research Day 2024

No abstract provided.

Quality Improvement In Healthcare: A Practical Guide For Providers (Part 2), Jeremy Ellis

Transformative Medicine (T-Med)

No abstract provided.

Non-Clinical Perspectives On Sepsis: A Project For Enhanced Awareness, Anjali Kumari Singh

Master's Projects and Capstones

Problem: This project aimed to enhance non-clinical staff knowledge of sepsis through a targeted awareness campaign, while also seeking to uphold or enhance the organization's sepsis-related performance.

Context: Clinical Nurse Leader students conducted a microsystem assessment in five crucial non-clinical departments of an urban Bay Area hospital, each playing a vital role in the organization's efficiency at different levels.

Intervention: During Sepsis Awareness Month, a sepsis awareness campaign was implemented. This involved a concise presentation on sepsis, its consequences, and the significance of awareness in each department. Additionally, informational fliers detailing sepsis signs and symptoms were distributed.

Measures: A pre-and …

Campaigning Beyond: Sepsis Awareness Among Non-Clinical Staff, Cynthia Wong

Master's Projects and Capstones

Problem: Sepsis stands as the foremost cause of illness and death among hospitalized patients globally, yet a considerable number remain oblivious to this critical condition. Based on the pre-implementation survey among non-clinical staff members of an urban hospital, awareness of sepsis must be heightened to ensure swift recognition and response.

Context: The project conducted takes place in five distinct non-clinical departments at a large hospital organization in Northern California. Each department plays an essential role in the holistic and efficient functioning of the organization to provide quality patient care.

Interventions: A sepsis awareness campaign was implemented throughout the month of …

Evaluation Of A Community Based Teaching Hospital’S Geriatric Emergency Medicine Initiative, Josette Hartnett, Isabel Muronzi-Belfon, Suzanne J. Rose

Journal of Geriatric Emergency Medicine

INTRODUCTION: To accommodate the complex healthcare needs of the rising geriatric population, Stamford Hospital’s (SH) emergency department (ED) began a Geriatric Emergency Medicine Initiative (GEMI) in 2018 to improve our ED environment, practices, and focused assessments for our community-dwelling older adults.

METHODS: This retrospective program evaluation describes SH’s novel ED processes for at-risk older adults and compares GEMI and non-GEMI assessed patient outcomes using aggregate frequencies on throughput metrics such as length of stay (LOS), 72 hour and 30-day re-admission rates, and other outcomes of interest. Chi-square tests and group t-tests were used for all analyses with a p-value of …

Implementation Of Standardized Contraceptive Education To Improve Larc Initiation In Postpartum Individuals, Gracie E Clayton, Melissa M. Hessock, Amanda Flood

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Approximately 50% of pregnancies in the United States are unintended, leading to negative health, psychosocial, and financial outcomes. Supported methods for preventing unintended pregnancies are promoting education and access to highly effective contraceptive methods, including long-acting reversible contraceptives (LARCs). Studies demonstrate counselor knowledge and bias contribute to underutilization of LARCs, highlighting the need for standardized education.

LOCAL PROBLEM: The setting for this practice improvement project was a rural obstetrical unit in Tennessee where there was no standardized postpartum contraceptive education. Rates of contraceptive use at postpartum discharge were low. The purpose of this project was to implement …

Psychosocial Consequences Of Diagnosed Malignant Melanoma, Savanna Eve Smallwood-Corcoran, Mary Johnson, Lindsay Frazier

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Psychosocial consequences frequently accompany the diagnosis of malignant melanoma (MM), such as fear, anxiety, burden, and distress. Patients are not receiving the proper psychiatric care needed to address the psychosocial consequences they are experiencing. Patients diagnosed with MM have expressed a lack of assessment and supportive care by providers to address psychosocial consequences they are experiencing.

LOCAL PROBLEM: The setting for the quality improvement project was a private dermatology clinic in Knoxville, Tennessee. There was no standard procedure for anxiety screening at the site. Comparable to published studies, there is a lack of procedures for screening patients …

Reducing Iatrogenic Opiate Withdrawal In The Picu: An Evidence-Based Practice Improvement Project, Kaitlin Kirk Ogle, Marian Malone, Will Guider

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Current recommendations to reduce pain associated with mechanical ventilation is the administration of opiate and benzodiazepine infusions for Pediatric Intensive Care Unit (PICU) patients. If these infusions are weaned too quickly, iatrogenic withdrawal syndrome (IWS) often occurs. IWS symptoms include tachycardia, hypertension, diaphoresis, fever, irritability, tremors, clonus, hyperactive reflexes, vomiting, and diarrhea. Untreated IWS can lead to life-threatening complications.
LOCAL PROBLEM: The PICU at the project site contains fourteen beds and treats critically-ill pediatric patients. There was no standardized withdrawal assessment tool in practice. The purpose of this project was to implement the Withdrawal Assessment Tool-Version 1 …

Quality & Patient Safety Gazette : Volume 2, Issue 4 - 2023, The Aga Khan University Hospital, Karachi

Quality & Patient Safety - Gazette

• World Quality Day 2023
• Workshop on How to conduct a Root Cause Analysis
• Blast from the Past
• Learn with Fun!
• Stay Tuned with Us…..

Reducing Urinary Tract Infections In Adult Hospitalized Patients During The Covid-19 Pandemic: A Quality Improvement Project, Margie Martin, Catherina Chang Martinez, Dayana Kowalski, Courtney Willard, Yessenia Muniz, Gabriela Flores, Laura Budnechky, Joy Mitts, Hollie Gow

Nursing & Health Sciences Research Journal

Background: Catheter-associated urinary tract infections (CAUTIs) remain among the most common healthcare-associated infections, leading to increased morbidity and mortality in hospitalized adult patients. Methods: An interdisciplinary team initiated a quality improvement project to help reduce CAUTIs in a South Florida hospital. The project included using a CAUTI bundle consisting of indwelling catheter protocols, electronic bladder management order sets, nursing staff education, and implementation of external urinary catheters during the years 2020 through 2022. Results: The CAUTI bundle demonstrated positive outcomes in decreasing CAUTI rates. During our fiscal year 2022, there were 63% fewer CAUTIs (n = 23) compared to 2020 …

Enhancing The Rates Of Advance Directive Documentation To Improve The Quality Of Patient Care, Sydney Sheppard, Katie Salyers, Carolyn Curtis, Adam Franks Franks, Courtney Wellman

Marshall Journal of Medicine

Introduction

Advance Directives (AD) allow patients to maintain autonomy during incapacitation. Patients and their caregivers benefit from these documents in times of crisis. Overcoming barriers to AD completion and documentation can improve patient care quality.

Methods

A retrospective chart review was performed initially, after consolidation of the electronic health record (EHR) and after alteration of the EHR, to evaluate the availability of a patient’s medical power of attorney (MPOA), living will (LW), and code status.

Results

Baseline documentation of MPOA (7.33%), LW (6.00%), and code status (5.33%) within the outpatient EHR was low. After 2 cycles, this improved to 13.10%, …

A 3- And 6- Month Follow-Up To A Student-Led Approach To Patient Safety In Pre-Clinical Curriculum, Nelson D. Gonzalez, Sahar Panjwani, Daniel Nwosuocha, Lauren Bayliss, Ayleen Godreau

Research Colloquium

Introduction: Preventable medical errors are currently the third leading cause of death in the United States following heart disease and cancer. In light of this, integration of formal patient safety education into undergraduate medical education has been encouraged by the World Health Organization. This study aimed to assess the change in patient safety knowledge, attitudes, and beliefs in students after early exposure to patient safety during pre-clinical years.

Methods: First and second-year medical students participated in the training and responses were assessed through a pre-test, immediate post-test, 3-month post-test, and 6-month post-test. The survey assessed student knowledge on aspects …

Proactively Preventing Medical Errors: A Student-Led Approach To Patient Safety In Pre-Clinical Curriculum, Sahar Panjwani, Daniel Nwosuocha, Nelson D. Gonzalez, Ayleen Godreau

Research Symposium

Introduction: Preventable medical errors are currently the third leading cause of death in the United States following heart disease and cancer (1). This study was designed to assess the change in knowledge from earlier education of medical students during pre-clinical years.

Methods: Patient safety trainings have been conducted for two years for interested first and second-year medical students and responses are assessed through a pre-test, immediate post-test, 3-month post-test, and 6-month post-test. The survey assesses student knowledge on aspects of patient safety and has Likert scale questions assessing if the training influenced students’ desire to learn about patient safety. …

Quality Improvement In Healthcare: A Practical Guide For Providers, Jeremy Ellis

Transformative Medicine (T-Med)

No abstract provided.

Patient Safety Workshop: A Graduate Medical Education Interprofessional Simulation Half-Day, Ans Albustamy, Roque Mifuji, Michelle Lopez, Teresa Villagomez, Chelsea Chang

Research Symposium

Introduction: As per the National Academy of Medicine, patient safety is considered indistinguishable from the delivery of quality health care, and is referred to as the foundation upon which all other aspects of quality care are built. Throughout the years, graduate medical education (GME) across the world has evolved to ensure the training of future medical professionals includes exposure to many of the elements that compose patient safety, such as implementing root cause analysis, systems thinking, and disclosing adverse events. University of Texas Rio Grande Valley (UTRGV) is the sponsoring institution for 19 GME programs across different specialties. As part …

Enhancing Appropriate Statin Therapy In Type 2 Diabetic Patients Aged Between 40-75 Years At Graduate Medical Education (Gme) Internal Medicine Clinic, Adriana Betancourth Alvarenga, Ans Albustamy, Ayesha Khan, Steffi Sathiyaraj, Nghia Nguyen, Martha Solis, Rodolfo Garza-Morales, Oscar Lopez, Yilen Karen Ng-Wong, Hector Arredondo, Andres R. Suarez Parraga

Research Symposium

Background: The prevalence of type 2 diabetes mellitus (T2DM) is significantly higher in Rio Grande Valley than the rest of the United States. T2DM patients have an elevated risk of Atherosclerotic cardiovascular disease (ASCVD), and clinical trials have demonstrated the beneficial effects of statin therapy on ASCVD. A quality-improvement project was implemented in the GME Internal Medicine (IM) Clinic at Doctors Hospital at Renaissance to improve statin therapy appropriateness.

Methods: T2DM patients aged 40-75 were selected from the GME IM Clinic visits from July 2021 to October 2021 for baseline data and from January 2022 to April 2022 after implementing …

Measuring Blood Pressure In Primary Care For Accurate Diagnosis And Decision Making: Implementing Evidence-Based Protocols Across A Health System, Gertrude W. Manchester, Deirdre C. Donahue, Catarina I. Kiefe, Lori Pelletier, Marie A. Sosa, Sheri A. Keitz

The Lahey Journal

Abstract

Background: Evidence-based blood pressure (BP) measurement is required for optimal clinical decision-making while improper measurement risks daily diagnostic and therapeutic errors.

Objective: To implement and sustain an evidence-based BP measurement protocol without extra resources and disseminate the protocol across a primary care network.

Design, Setting, and Participants: A Plan-Do-Study-Act (PDSA) framework for quality improvement was used to design a standardized BP measurement protocol including a 5-minute rest period only for patients with persistently elevated blood pressure. The protocol was developed using Goldratt’s Theory of Constraints and Layers of Resistance to ensure multidisciplinary buy-in and was implemented in 3 groups …

Perioperative Team-Based Morbidity And Mortality Conferences: A Systematic Review Of The Literature, Aubrey Samost-Williams, Roni Rosen, Alexander Hannenberg, Melis Lydston, Garrett M Nash, Mary Brindle

Journal Articles

OBJECTIVE: This systematic review aimed to identify key elements of perioperative team-based morbidity and mortality conferences (TBMMs) and their impact on patient safety, education, and quality improvement outcomes.

BACKGROUND: Patient safety in the perioperative period is influenced by system, team, and individual behaviors. However, despite this recognition, single-discipline morbidity and mortality conferences remain a mainstay of educational and quality improvement efforts.

METHODS: A structured search was conducted in MEDLINE Complete, Embase, Web of Science, ClinicalTrials.gov, Cochrane CENTRAL, and ProQuest Dissertations and Theses Global in July 2022. Search results were screened, and the articles meeting inclusion criteria were abstracted.

RESULTS: Seven …

Retrospective Evaluation Of The Covid-19 Contact Tracing Program At The Maine Center For Disease Control And Prevention, Elisabeth Brewington Mha, Mph, Ben K. Greenfield Phd, Jessica Purser Phd

Journal of Maine Medical Center

Introduction: Despite the widespread use of contact tracing efforts throughout the COVID-19 pandemic, there are limited findings available about best practices and recommendations. The Maine Center for Disease Control and Prevention contracted staff to conduct COVID-19 contact tracing from August 2020 through February 2022. A retrospective evaluation of this program was conducted to share lessons learned with public health and health care leaders for future use.

Methods: Contracted contact tracing staff participated in facilitated discussions structured by the Strengths, Weaknesses, Opportunities, and Threats analysis framework. Three sessions were recorded and transcribed, and qualitative analysis through thematic review and evaluation coding …

Video Documentation As A Measure Of Written Documentation Accuracy In Emergency Medical Service Field Intubations, Christopher S. Keller, Christopher Dilger, Shih-Chin Chou, Rasheed Lawal, Shane Jenks

HCA Healthcare Journal of Medicine

Introduction

Quality improvement (QI) is a major focus of all departments and fields of health care, including emergency medical services. The chaotic and rapidly evolving atmosphere in which paramedics must practice can lead to inconsistency between what is documented and the actual events. This leads to difficulty when trying to evaluate the practitioners and when implementing a QI program. In this study, we evaluated the prevalence of discrepancy between the video and written record for Rapid Sequence Intubation (RSI) performed in the field as a demonstration of the utility of video documentation in QI.

Methods

We used a systematic retrospective …