Health and Medical Administration Commons^™

Bedside Shift Report And Patient Satisfaction, Kasandra R. Johnson

Electronic Theses and Dissertations

Each year, millions of deaths worldwide are caused by medication errors in hospitals. Some of these errors are accounted for through miscommunication during the change of the nurse shift report. One of the Joint Commission’s 2019 national patient safety goals for hospital programs was to improve communication effectiveness among caregivers since mistakes in a caregiver’s communication accounted for 37% of severe patient injuries. Safety is threatened by patients not being included. Therefore, adopting the bedside shift report allows patients to be actively engaged, reinforcing nurse-patient communication. The bedside shift report enables nurses to provide safe, high-quality, patient-centered care at the …

Nurses Leading In Bridging The Culture Gap: Communicating With The Deaf Community, Veronica C. Leftridge

Electronic Theses and Dissertations

Nurses provide patient care in clinics, hospitals, homes, churches, schools, communities, and military, as well as on emergency medical helicopters. When a nurse is assigned to care for a patient, the patient expects the nurse to be culturally competent, communicate effectively, and provide safe quality care. However, cultural incompetence is observed when nurses provide care for Deaf patients, but they are unfamiliar with Deaf culture. In addition, communication is a fundamental skill nurses learn in nursing school, but course content in nursing programs rarely touches on how to communicate effectively with Deaf patients. Of the approximately 325 million people in …

The Four Agreements Analysis Los Cuatro Acuerdos De Don Miguel Ruíz, Dulce Morales

Electronic Theses, Projects, and Dissertations

The Toltecs were an indigenous Mexican culture of great warriors and artists with a very unique wisdom on life and behavior, that lived around 1000 years ago. Their extended knowledge on life and behavior certainly can be of help on developing a great leader in any organization based on the four agreements they practiced to better themselves spiritually, emotionally and physically. Therefore, Don Miguel Ruiz did some research of the Toltecs Wisdom and learn more about these four agreements:

1. Be impeccable with your word.
2. Don’t take anything personally.
3. Don’t make assumptions.
4. Always do your best.

After learning how to apply …

Implementing A Stroke Process Improvement Group To Reduce Time To Thrombectomy In Patients With Acute Ischemic Stroke At Greenwich Hospital, Victoria Merrill

DNP Projects

Introduction: Delays in door to skin puncture time for patients with ischemic stroke are associated with worse clinical outcomes. The following quality improvement study was conducted at Greenwich Hospital which aimed to decrease door to skin puncture time for endovascular stroke treatment. Greenwich Hospital began its new stroke program in January 2020 and opened thrombectomy capable interventional radiology (IR) services. Delays to door to skin puncture times existed with average time being 100 minutes with a goal time of 90 minutes or less for 50% or more of patients directly arriving to the hospital and 60 minutes or less for …

Quality Of Care: A Business Case For Us Hospitals, Iwimbong Kum Ghabowen

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Patient Protection and Affordable Care Act present some threats and opportunities to many hospitals across the USA. Under the Value-Based Purchasing Program, acute care hospitals' rewards are tied to incentive payments for the quality of care provided in the inpatient hospital. In the last 20 years, growing research has examined the effects of the quality of care on the financial performance of hospitals. There is a gap in the literature, particularly exploring the relationship between quality and hospital financial performance using national samples. This dissertation investigates the association between patients' experience of care, 30-day readmission rates, and case-mix-index (CMI) …

The Nursing Leader’S Role In Decreasing Implicit Rationing By Improving The Nursing Work Environment, Allison Mchugh

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite all the literature about missed care and its contributing factors, it is prevalent in most hospitals worldwide. Missed care is the result of care that is implicitly rationed. For this paper, implicit rationing is defined as how nurses decide what care is delivered based on the present work environment. Many factors influence implicit rationing. One such factor is the work environment. The association between the nursing work environment and implicit rationing is well described in the literature. The nursing leader is in a formal position responsible for patient outcomes and the nursing practice environment. Therefore, it is important to …

Evaluating The Effectiveness Of Healthcare Competency Training Delivery Methods, Vanessa Jennings

Capstone Projects and Master's Theses

Decades of research express the need to strengthen the trust between minority groups and the healthcare system through addressing and reducing cross-cultural miscommunication. Though Central Coast VNA and Hospice is a well-established organization, the rate at which underrepresented individuals (i.e., LatinX, Asian, African American, Pacific Islander) access their services is low. Issues contributing to the low number of underrepresented individuals include language barriers, a poorly structured system, and a lack of cultural competency training among the staff. The result is an underserved population, a failure to meet the agency’s mission, and a perpetuation of systemic racism. To address this problem, …

Machine Learning Automated Detection Of Large Vessel Occlusion From Mobile Stroke Unit Computed Tomography Angiography, Alexandra L Czap, Mersedeh Bahr-Hosseini, Noopur Singh, Jose-Miguel Yamal, May Nour, Stephanie Parker, Youngran Kim, Lucas Restrepo, Rania Abdelkhaleq, Sergio Salazar-Marioni, Kenny Phan, Ritvij Bowry, Suja S Rajan, James C Grotta, Jeffrey L Saver, Luca Giancardo, Sunil A Sheth

Journal Articles

BACKGROUND: Prehospital automated large vessel occlusion (LVO) detection in Mobile Stroke Units (MSUs) could accelerate identification and treatment of patients with LVO acute ischemic stroke. Here, we evaluate the performance of a machine learning (ML) model on CT angiograms (CTAs) obtained from 2 MSUs to detect LVO.

METHODS: Patients evaluated on MSUs in Houston and Los Angeles with out-of-hospital CTAs were identified. Anterior circulation LVO was defined as an occlusion of the intracranial internal carotid artery, middle cerebral artery (M1 or M2), or anterior cerebral artery vessels and determined by an expert human reader. A ML model to detect LVO …

Biomarkers And Factors Related To Risk Of Acute Kidney Injury, Mary Ann David

Dissertations

Background: Acute kidney injury (AKI) is associated with increased mortality, morbidity, length of hospital stay, and in-hospital cost. Timely intervention is needed to prevent disease progression, but the delay in diagnostic process often results in delayed treatment. Recent studies show a significant increase in novel urine biomarkers (UB), TIMP-2 and IGFBP7, has been linked to an increased risk of AKI.

Objectives: The purpose of this study was to examine the relationships among participants’ sociodemographic and clinical characteristics, including select biomarkers, care management processes, treatments, and patient outcomes in a sample of hospitalized critically ill patients in southern California.

Findings: Study …

Transplantability In Burdened Populations: A Regional Analysis Of The Robotic-Assisted Kidney Transplant Impact On Access Given Socioeconomic And Demographic Factors, Earnest James Davis Jr.

Dissertations

Introduction/Background

The social contract of health (SCOH) in America that governs healthcare interactions has listed toward provider organizations and away from the patient. End stage renal disease treatment provides an explicatory case to examine an unbalanced SCOH. The study evaluates whether the robot-assisted kidney transplantation (RAKT) technique allows for patients with higher body mass indices and of burdened socioeconomic and sociodemographic status improved access to transplant compared to traditional open kidney transplant (OKT).

Methods

The study set combined extant data for patients transplanted at Chicago from two data sets. Investigators used independent t-tests, chi-squared tests, survival analysis, analysis of frequencies, …

Analysis Of Blood Borne Pathogen Exposure Monitoring Protocol Adherence In An Academic Medical Center: A Seven Year Analysis And Literature Review, Natavoot N. Chongswatdi Md, Callie Seaman Md, Diane Harman Rn, Bsn, William Rollyson Md, Adam M. Franks Md

Marshall Journal of Medicine

Introduction

Health care workers (HCW) are at risk for occupational blood borne pathogen exposures (BBPE). Effective prevention and management of BBPEs relies upon reporting and post-exposure follow-up protocol adherence. As post-exposure monitoring completion is largely unexplored, seven years of a university healthcare system’s BBPE exposure data was explored and compared to documented rates.

Methods

The Marshall Health Occupational Health and Wellness division collected seven years (2012-2018) of BBPE follow-up monitoring adherence rates and demographic data. Data for HCW occupation, exposure incident, and source patient disease status were evaluated. Differences were analyzed with Chi square, Fischer Exact and logistic regression tests. …

Improving Vaccination Rates In Pediatric Primary Care, Lauren E. Osbeck

Doctoral Dissertations

Objectives: In a small, rural pediatric primary care clinic, the effectiveness of electronic patient portal reminders were evaluated at improving vaccination rates for school required immunizations.

Methods: A quality improvement project was initiated utilizing The Social Ecological Model. All pediatric patients were sent reminders who were under-immunized. This QI project evaluated the effectiveness of vaccine reminders on the improvement of immunization rates in the clinic

Results: Total number of fully-vaccinated patients within the practice improved (2%) and patients under-immunized decreased by 1%. 87 immunizations were given to patients were given to patients who were under-immunized and an average of 10% …

May 9, 2022 Hsc Committee Notice, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

Using A Food Insecurity Screening Tool In The Nicu, Emily Coffman Bsn, Rn, Fatina Caldwell Bs, Bsn, Rn, Cpn, Cpen, Mackenzie Box Bsn, Rn, Uche Anani Md, Faap, Christin Fritz Md, Mph, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background: Infants admitted to the NICU are disproportionately born to low-income families. This, combined with unique financial challenges of their long-term stay, may predispose caregivers to food insecurity (FI). FI among caregivers has far reaching implications for the health of infants who are already vulnerable related to comorbidities from their NICU stay.

Methods: Using the Iowa model to successfully engage key stake holders and begin a small pilot study, a randomized preintervention chart audit was performed (n=30) to evaluate if FI was identified by NICU Social Worker (SW). The FI screening tool was administered by nursing to a separate group …

Cancelation: May 3 2022 Hsc Committee Meeting, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

Advantages Of Early Utilization Of Palliative Care In The Pediatric Icu: A Scoping Review, Shelby Noel Cain Bsn, Rn, Cpn, Dana Pabalate Zimmerman Msn, Rn, Charis Elizabeth Oji Msn, Aprn, Cpnp-Pc/Ac, Michelle Rickard Dnp, Cpnp-Ac

Doctor of Nursing Practice Projects

Abstract Purpose/Background Despite the increased use of palliative care in adults, only a tiny percentage of children with life-limiting illnesses or life-threatening conditions receive palliative care before dying. Palliative care has low utilization, and consults are often made late in a child’s hospitalization or diagnosis. Palliative care remains underutilized among hospitalized pediatric patients resulting in unnecessary treatments, costly and lengthy hospitalizations, and deaths occurring in the intensive care unit (ICU) rather than at home. The purpose of this scoping review is to evaluate current literature to determine the use and effect of pediatric palliative care, specifically, whether consultation of palliative …

Long-Acting Antipsychotic Injectables Vs. Oral Antipsychotics: Comparing Compliance, Relapse, And Re-Hospitalization Rates, Latoria Boyland Bsn, Rn, Kara Darretta Bsn, Rn, Ansley Geno Bsn, Rn, Keevia Porter Dnp, Np-C, Rn

Doctor of Nursing Practice Projects

Purpose/Background Psychosis is a psychiatric disorder characterized by hallucinations and delusions. These symptoms not only negatively impact a patient’s quality of life but can also make treatment compliance difficult. This lack of treatment compliance ultimately leads to higher relapse and re-hospitalization rates among this population. Thus, it is imperative that effective treatments are developed, utilized, and made readily available for patients. Antipsychotics are medications that block dopamine D2 receptors. These medications are used for psychosis to help to improve patient outcomes. Currently, two routes of antipsychotic administration are available, oral antipsychotics or long-acting antipsychotic injections (LAIs). Oral antipsychotic administration requires …

Engaging Patients And Families In Developing, Implementing, And Evaluating Hospital At Home: A Canadian Case Study, Sean P. Spina Bsc(Pharm), Acpr, Pharmd, Fcshp, Taylor Hainstock Bhsc, Ma, Rounak Haddadi Bsc, Bhsc, Beth Bourke Bscn, Rn, Lisa Thompson Bsc, Elizabeth Borycki Rn Phd Facmi, Fcahs, Fiahsi, Jennifer Cartwright, David Forbes Bsc(Pharm), Mpa, Acpr, Bcps, Cte, Curtis K. Harder Bsc(Pharm), Acpr, Pharmd, Fcshp, Andre Kushniruk Phd, Facmi, Fcahs, Fiahsi, Tasha Mckelvey Bscn, Mha, Rn, Tara Mcmillan Bsc, Stephanie Menz Bsc, Bsp, Acpr, Katy Mukai Ba, Mpa, Michelle Riddle, Shauna Tierney Md, Ccfp, Melinda Zeron Mullins Md, Phd, Ccfp

Patient Experience Journal

The Hospital at Home (HaH) care model is naturally patient-centred, with improved patient and family experiences and outcomes firmly anchoring the innovative approach to care. Existing literature focuses largely on the health care and patient care outcomes of HaH; however, to date, none of the identified literature has reported on engaging patients and families in the development, implementation, or evaluation of the HaH model of care. A multi-stakeholder, Patient-Oriented Research team in Victoria, British Columbia, Canada engaged patients and family/friend caregivers (PFCs) across all components of the HaH program. Guided by best practices in patient and public engagement, the team …

Showcasing Patient And Public Involvement: Using Consultation, Collaboration And Co-Design To Shape A Respiratory Programme, Kate Strong, Elizabeth Williams, Jude Hancock Dr

Patient Experience Journal

The NHS is committed to working with patient groups and the public to co-design health services to ensure that lived experience is used to optimise service design and delivery. This case study describes and considers methodologies used by commissioners to meaningfully engage and collaborate with patient groups to co-design respiratory services in a region of England. Stakeholders agreed a two-stage approach to the patient and public involvement (PPI) for this specific project; an initial consultation with patient groups on existing services, to inform a collaborative co-design process for the new pathway. The full pathway was not commissioned, but elements of …

From Liability To Asset: A Large Health System’S Approach To Transforming Hospital Food, Sven Gierlinger, Bruno Tison, Nicole Giammarinaro

Patient Experience Journal

Historically, hospitals are infamous for poor food quality. Valuing food as a tenant of health and well-being, Northwell Health, New York’s largest healthcare system, is transforming its hospital food program to become an asset and market competition differentiator. By focusing on structure, workforce, procurement and process, Northwell has improved patient experience performance “Quality of Food” by 61 percentile rank points within three years with minimal impact on budgetary cost.

Experience Framework

This article is associated with the Environment & Hospitality lens of The Beryl Institute Experience Framework (https://www.theberylinstitute.org/ExperienceFramework).

• Access other PXJ articles related to this lens.
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When Healthcare Leadership And Philanthropy Lead To An Improved Patient Experience: The Paul Lepsoe Music Initiative, Sara Olivier Rn Bscn Mn, Corianne Bell Ba Mus, Cheryl Jones Registered Psychotherapist, Mta, Phd, Jerry M. Maniate Md, M.Ed, Frcpc, Facp

Patient Experience Journal

Through an unprecedented collaboration between an academic acute tertiary care hospital (The Ottawa Hospital (TOH) and a community-based professional orchestra (Ottawa Symphony Orchestra (OSO), the Paul Lepsoe Music Initiative represented an innovative partnership focused on improving patient care via (a) the integration of live music in waiting areas of the hospital’s Cancer Center and (b) the creation of individualized music therapy interventions on the inpatient Palliative Care Unit. Patient, family, and volunteer/staff feedback further refined the intervention throughout the duration of the Initiative; a qualitative process that provided insight into the overall patient experience and opportunities for patients and families …

The Use Of Patient Experience Data For Quality Improvement In Hospitals: A Scoping Review, Lauren Cadel, Michelle Marcinow, Harprit Singh, Kerry Kuluski

Patient Experience Journal

In this paper we identified what was reported in the literature on qualitative and quantitative approaches used to capture and improve patient experiences in a hospital setting. For inclusion, articles were required to describe an embedded strategy for capturing patient experiences that was used to inform quality improvement in a hospital setting. Articles also had to be published in English between January 2004 and December 2020. Six databases (MEDLINE, EMBASE, PsycINFO, CINAHL, Health and Psychosocial Instruments and Cochrane Library) and grey literature (relevant hospital and government websites) were searched. All articles were screened by two reviewers and any disagreements were …

Beyond Hcahps: Analysis Of Patients’ Comments Provides An Expanded View Of Their Hospital Experiences, Andrew S. Gallan, Rakesh Niraj, Awanindra Singh

Patient Experience Journal

An important concern for health care professionals is that standardized patient surveys may not fully capture all the topics that are important to patients. As a result, health care professionals may not have a complete picture of what their patients experience. The purpose of this research is to utilize a state-of-the-art Natural Language Processing technique to make sense of patients’ solicited, unstructured comments to gain a deeper and broader understanding of their experiences in the hospital. We analyzed a large dataset of inpatient survey responses (48,592 patients generating 65,998 comments) by a patient experience survey vendor for an eleven-hospital health …

Patient Reported Experience In A Radiation Oncology Department, Demetra Yannitsos, Petra Grendarova, Abdulla Al-Rashdan, Linda Watson, Wendy Smith, Fiona Lochray, Jackson Wu, Lisa Barbera

Patient Experience Journal

Understanding patient experience is essential to providing high quality, person-centered care. A real-time baseline cross-sectional study was completed to identify gaps in patient experience that can be targeted for quality improvement (QI). This study is part of PROSE (Person-centered Radiation Oncology Service Enhancement), a QI initiative developed to improve patient experience at a tertiary cancer centre Radiation Oncology (RO) Department. Data was collected using the Your Voice Matters (YVM) questionnaire. The YVM captures information on the patient’s last visit, and questions are organized based on dimensions of person-centered care. Recruitment occurred between May and August 2019 in the radiation department. …

Resource Utilization Among Informal Caregiver Of Lung Cancer Patients Undergoing Treatment, Charlotte T. Lee, Clarelle L. Gonsalves, Jenny Gao-Kang, Wyatt G. Pickrell, Ruth F. Barker

Patient Experience Journal

The objective of this study is to explore patient and caregiver factors that shape the use of available resources to support caregiving for lung cancer patients undergoing treatment. A mixed-method study was conducted at one regional cancer centre within the Province of Ontario, Canada, using concurrent triangulation design. Adult patients with lung cancer (n=46) and their caregivers (n=42) (37 patient-caregiver dyads) were invited to complete a one-time study survey. Informal caregivers (n=20) also participated in a one-time semi-structured interview. Descriptive statistics and Pearson’s correlation were used to examine patterns of resource utilization and associations among study variables. Content analysis was …

Adapting And Responding To A Pandemic: Patient And Family Advisory Councils In Children's Hospitals During Covid-19, Pam Dardess, Deborah L. Dokken, Ndidi I. Unaka, Jesse Hsu, Mindy Hoang, Andrew F. Beck, Beverley H. Johnson

Patient Experience Journal

This mixed-methods study investigated the effects of the COVID-19 pandemic on Patient and Family Advisory Councils (PFACs) within children’s hospitals in the United States. Specifically, the study sought to understand how PFACs adapted operations as a result of the COVID-19 pandemic, how patient and family advisors (PFAs) were engaged in the response to COVID-19, and the intersection of the COVID-19 pandemic with PFAC diversity, equity, and inclusion. The study consisted of a survey distributed to 228 children’s hospitals, with a 73% response rate, and in-depth interviews with selected survey respondents (n=12). While COVID-19 temporarily disrupted PFAC operations and forced rapid …

The Impact Of Patient-Centered Care On Health Outcomes In Adolescents Living With Diabetes, Rashida Farhad Vasanwala Dr, Amos Lim, Lim Soo Ting, Lim Pei Kwee, Hui Yuen Ching, Tan Xiang Feng

Patient Experience Journal

There is increasing evidence from research studies that suggest patient-centered care has a relationship with good clinical outcomes. In Singapore, there are no studies done to assess and address the issue of patient-centered care and its association with the adolescent’s ability to manage their chronic medical condition, such as Type 1 Diabetes Mellitus. The relationship between the patient and clinicians has changed from a paternalistic form to a position which aims to foster patient-centered care. More importantly, this study aims to show the adolescent’s readiness and ability to assume a more mature role in management of their own medical condition. …

Understanding Both Sides Of The Blood Draw: The Experience Of The Pediatric Patient And The Phlebotomist, Julie R. Piazza, Sandra Merkel, Brooke Rothberg, Joan Gargaro, Kristin Kullgren

Patient Experience Journal

A phlebotomist’s words and actions play a crucial role in success of a blood draw and in providing a supportive patient experience. This study examined use of comfort measures during a pediatric blood draw. The phlebotomist’s use of soft words, positioning, distraction, coaching/support were observed with sixty children between 3-14 years of age during a blood draw. The level of fear /anxiety before and during the blood draw was recorded by an RA. The child’s level of fear/anxiety was observed and reported by the parent/caregiver after the procedure. Comfort measures provided by phlebotomists, the parent/caregiver’s report of their child’s usual …

Evaluating Healthcare Leaders: A Competency Assessment Of Rural Healthcare Management Within The Midwest, Heather Winkler

Dissertations, Theses, and Projects

Rural healthcare facilities, which include critical access hospitals, are vulnerable to closure due to workforce shortages, low patient volumes, challenging payer and patient populations, and geographic isolation. Additionally, many rural communities entered the COVID-19 pandemic understaffed, under-serviced, facing inadequate healthcare infrastructures, and with limited clinical resources and equipment. This exploratory research aimed to measure the leadership competencies identified by the American College of Healthcare Executives (ACHE) of healthcare leaders working in rural hospitals and clinics within the Midwest. Having expert leadership skills and competencies can significantly impact how an organization succeeds, both for the patients, staff, and community. In contrast, …

Prevention Of Diabetes-Related Hospital Readmission Following Initial Diagnosis Of Diabetes In Patients Over The Age Of Fifty: A Scoping Review, Nathan Miller Dnp, Agacnp, Fnp, Jasmine Harris Dnp, Fnp, Michael Clardy Dnp, Agacnp, Diana Dedmon Dnp, Acnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background: By reviewing multiple studies related to the treatment of patients with new diagnoses of diabetes, this scoping review will endeavor to determine which interventions, when implemented for patients over 50 years old which are newly diagnosed with type 2 diabetes, can decrease the likelihood of hospital readmission related to diabetes within 90 days when compared with those patients who did not receive or participate in follow-up.

Methods: For resources to be eligible to review they had to be from 2015 or after. Studies selected included patients over the age of 50 newly diagnosed with type 2 diabetes subject to …