Digital Commons Network^™

Quality Improvement Project Improving Provider Confidence For Medication Adherence Screening Through Use Of The Medication Adherence Rating Scale (Mars), Tamara Cheek

Doctor of Nursing Practice Projects

Medication nonadherence affects 50% to 70% of individuals with serious mental illness. This contributes to symptom relapses, hospitalization, poor treatment outcomes, and higher healthcare costs. The purpose of this quality improvement project was to evaluate the impact of a competency-based Medication Adherence Rating Scale (MARS) training program on provider confidence and standardized adherence screening in a psychiatric clinic, to improve confidence and increase use of a standardized assessment. Guided by Bandura's Self-Efficacy Theory and Lewin's Change Management Model and implemented using the Plan-Do-Study-Act framework, the project used a quantitative quasi-experimental pre-post design with eight psychiatric mental health nurse practitioners. Data …

Quality Improvement Project: Addressing Appointment Non-Adherence Through Social Needs Screening, Dorathy Anderson

Doctor of Nursing Practice Projects

Mental health care access in the US faces systemic barriers that delay treatment and disrupt care, often worsening patient outcomes. Unmet social needs of health, such as transportation, financial, and housing issues, lead to missed appointments and fragmented care, thereby increasing health disparities. This quality improvement project evaluated whether targeted staff education improved the identification and response to social needs that affect appointment adherence. Adult Learning Theory guided the training, while Lewin’s Theory of Change and the Plan-Do-Study-Act framework informed implementation and evaluation. The intervention population consisted of five clinic staff members. A quasi-experimental pretest-posttest design was used to evaluate …

The Impact Of Telephonic Versus Video Platforms On Nurses’ Intrinsic Motivation: An Evidence-Based Practice Project, Brittney Saldierna

Doctor of Nursing Practice Projects

Ambulatory pediatric nurses frequently rely on telephone-only encounters for telehealth triage and patient education despite the availability of video-enabled technology. Literature demonstrates that the inability to visually assess patients limits clinical assessment accuracy, communication effectiveness, and nurse confidence. The purpose of this evidence-based practice project was to evaluate whether educating ambulatory pediatric nurses on the integration of video-enhanced telehealth encounters impacts intrinsic motivation and perceived competence compared with telephone-only encounters. Guided by the Iowa Model of Evidence-Based Practice and the ADKAR Change Management Model, this quantitative, quasi-experimental project was applied utilizing the PDSA cycle implementation framework in ambulatory pediatric specialty …

Quality Improvement Project: The Impact Of Standardized Handoff Communication In A Home Acute Care Setting, Antonius Devon Speed

Doctor of Nursing Practice Projects

Effective nurse-to-nurse handoff communication is essential in hospital-at-home telehealth care, where remote nurses depend on accurate electronic health record documentation and structured shift-to-shift communication. This quality improvement project evaluated whether education and implementation of a standardized Situation, Background, Assessment, Recommendation (SBAR) workflow improved staff-reported handoff quality and reduced communication-related near-miss events over 8 weeks. Lewin's Change Theory, Rogers's Diffusion of Innovations, and the Plan-Do-Study-Act framework guided implementation and sustainability. A quantitative, quasi-experimental one-group pretest-posttest design was used. The intervention included SBAR education, a workflow checklist, and a handoff template. Outcomes were selected Handover Evaluation Scale (HES) responses and aggregate near-miss …

Quality Improvement Project: Implementation Of Trauma-Informed Care Education In An Outpatient Psychiatric Clinic, Ornela Claude Ika

Doctor of Nursing Practice Projects

Trauma-informed care (TIC) is an evidence-based approach that promotes safe, patient-centered care for individuals with a history of trauma. Many patients receiving services in psychiatric settings have experienced trauma, placing them at risk for retraumatization during healthcare encounters. Despite the recognized benefits of TIC, the outpatient psychiatric clinic involved in this project lacked a formal trauma-informed care education program for staff. The purpose of this quality improvement project was to determine whether implementation of a structured trauma-informed care educational intervention improved staff attitudes toward trauma-informed care. Lewin’s Change Theory and the Plan-Do-Study-Act framework guided project implementation. A quantitative pre-intervention and …

Quality Improvement Project: Impact Of Adjunct Clinical Faculty Mentorship On Self-Confidence: A Quality Improvement Project, Fairah Solomon

Doctor of Nursing Practice Projects

Novice adjunct clinical faculty transitioning from expert clinicians to nurse educators face many challenges, particularly in understanding their roles, responsibilities, and educational frameworks. Despite an established orientation at the project site, a structured mentorship program to support the role transition is lacking. This quality improvement (QI) project aimed to improve novice adjunct clinical faculty’s self-confidence through the implementation of a structured mentorship intervention. Guided by Lewin's Change Theory and Constructivist Learning Theory, the project utilized a quasi-experimental pre- and post-test design. Implementation was guided by the Plan-Do-Study-Act framework. A purposive sample of seven novice adjunct clinical faculty with less than …

Adaptation Of The Transition Readiness Assessment Questionnaire For Pediatric-Onset Multiple Sclerosis: Protocol For A User-Centered Design Approach, Claudia Gambrah-Lyles, Aaron W Abrams, Sara Loud, Hollie Schmidt, Emily Blosberg, Melissa Wright, Kelsey E Poisson, Kristen S Fisher, Kimberly A O'Neill, Akash Virupakshaiah, John W Rose

Faculty, Staff and Students Publications

Background: Pediatric-onset multiple sclerosis (POMS) is a chronic, progressive neurologic condition requiring lifelong management and coordinated transition from pediatric to adult care. Evidence-based guidelines identify transition readiness assessment as a core component of successful transition; however, most POMS clinics do not formally assess readiness, and existing tools do not address POMS-specific challenges, such as fluctuating disability, complex treatment regimens, and cognitive impairment. This gap underscores the need for a transition readiness measure tailored to POMS.

Objective: This paper aims to describe a stakeholder-engaged, implementation science-guided protocol for adapting the Transition Readiness Assessment Questionnaire (TRAQ) version 6.0 to reflect the unique …

Bridging Gaps In Childhood Systemic Lupus Erythematosus Treated At An Outpatient Clinic, Allen M. Savedra

Walden Dissertations and Doctoral Studies

No abstract provided.

Continuing Medical Education As A Workforce Learning System For Artificial Intelligence In Clinical Practice, Tim Murphy, Rob E. Carpenter

Human Resource Development Faculty Publications and Presentations

Artificial intelligence (AI) is increasingly embedded in clinical decision support, documentation, imaging, predictive analytics, and workflow management. However, the educational systems responsible for preparing practicing physicians to use AI have not fully addressed the interpretive, ethical, and organizational demands of AI-supported care. This qualitative case study examined how continuing medical education (CME) shapes physicians’ readiness to integrate AI into clinical practice. Guided by the Unified Theory of Acceptance and Use of Technology (UTAUT) and human resource development (HRD), the study analyzed semi-structured interviews with 14 physicians from diverse specialties within a large academic health system. Organizational artifacts, including CME announcements, …

Critical Care Nurses’ Self-Efficacy In Responding To Emergency Code Situations, Nesheemah Sabree

Walden Dissertations and Doctoral Studies

No abstract provided.

Qualitative Evaluation Of The Seated Physical Activity Intervention (Spin) Randomized Controlled Trial For Wheelchair Users With Multiple Sclerosis (Ms): Formative Feedback And Future Directions, Angela J Piasecki, Robert W Motl, Katherine Froehlich-Grobe, Stephanie L Silveira

Faculty, Staff and Student Publications

Background/objectives: Wheelchair users with multiple sclerosis (MS) often face barriers that restrict participation in physical activity and exercise training. This manuscript reports on participant feedback to guide evaluating and refining a novel exercise training program, Seated Physical activity INtervention (SPIN). SPIN was adapted from the Guidelines for Exercise in MS (GEMS) approach using a three-step community-engaged research framework based on meeting the needs of wheelchair users with MS.

Methods: Semi-structured interviews were conducted with 9 participants who completed the 16-week SPIN intervention. The key SPIN intervention components were the exercise prescription, exercise equipment, and behavioral coaching grounded in Social Cognitive …

Evaluating The Reproducibility And Verifiability Of Nutrition Research: A Case Study Of Studies Assessing The Relationship Between Potatoes And Colorectal Cancer, Yasaman Jamshidi-Naeini, Colby J Vorland, Pranav Kapoor, Bailey Ortyl, Jocelyn Mineo, Luke Still, Korlu Sorsor, Shelby Rodney, Xander Tooze, Brent Flickinger, Beate Henschel, Stephanie L Dickinson, David B Allison

Faculty, Staff and Students Publications

The credibility of nutritional research is dependent on the rigor with which studies are conducted and the ability for independent assessment to be performed. Despite the importance of these, more work is needed in the field of nutrition to buttress the trustworthiness of nutrition research. To develop and apply a process for evaluating the rigor, reproducibility, and verifiability of nutritional research, using the relationship between potato consumption and Colorectal Cancer (CRC) as a case study. We updated existing systematic reviews to include studies on potatoes and CRC, assessing their design, execution, and reporting quality. We attempted to reproduce and verify …

Self-Perceived Burden And Mental Health Outcomes In Adults With Osteogenesis Imperfecta, Emily R Strouphauer, Camille Villar, Ryan J Mccarty, Danqi Li, Gianna M Colombo, Brendan Lee, Chaya N Murali, Dianne Nguyen, Sarah Sadek, Marie-Eve Robinson, Jocelyn Gomez, Michelle Fynan, V Reid Sutton, Andrew D Wiese, Eric A Storch

Faculty, Staff and Students Publications

Osteogenesis Imperfecta (OI) is a rare disorder causing bone fragility, pain, and functional impairment that causes substantial psychosocial burden. This study examined how self-perceived burden (SPB), or distress from feelings of dependence on caregivers, relates to depression, anxiety, and suicidality in adults with OI. A total of 208 adults (M age = 42.9, predominately White and female) with OI were recruited to complete a cross-sectional survey assessing SPB, psychological symptoms, health, and sociodemographics. Results indicated that SPB was significantly higher among younger individuals, those not living with a partner, those living with adult family members, lower-income groups, and individuals …

From Fly On The Wall To Future Colleagues: Best Practice Recommendations For Medical Student Shadowing Programs, Molly Estes, Danielle Matonis, Mckenna Knych, Brian Barbas, Ronnie Ren, William Dixon, Michael Pasirstein, Xiao C. Zhang, Kaitlin Bowers, Ravi R. Chauhan, Laryssa A. Patti

Department of Emergency Medicine Faculty Papers

BACKGROUND: Physician shadowing is a common component of early medical education and frequently represents students' first exposure to clinical practice. Despite its prevalence, existing guidance primarily targets learners rather than physicians supervising shadowing experiences. This gap is especially relevant in the emergency department (ED), where high patient acuity, workflow demands, and complex clinical environments create challenges for providing safe and meaningful observational learning. We sought to develop consensus-based best practice recommendations for ED faculty supervising medical student shadowing.

METHODS: We conducted a modified Delphi study using an online survey platform to achieve panelist consensus. Ten emergency medicine educators with a …

Intersection Of Pediatric Hypertension And Cardiovascular-Kidney-Metabolic Disease, Jessica O'Keeffe, Christina Kingshill, Jack Tompson, Andrew M. South, Carissa M. Baker-Smith

Department of Medicine Faculty Papers

PURPOSE OF REVIEW: The purpose of this review is to describe the intersection between pediatric hypertension and advancing stages of cardiovascular, kidney metabolic syndrome in children and adolescents.

RECENT FINDINGS: Cardiovascular-kidney-metabolic syndrome is highly prevalent in the pediatric population. The onset of CKM in childhood is influenced by the presence of antenatal risk factors such as maternal hypertensive disorders of pregnancy. Advancing stages of CKM in children and adolescents are strongly influenced by food insecurity and social determinants of health that impact the risk for childhood obesity. Activation of the renin-angiotensin-aldosterone system is a key mediator in the relationship between …

Meeting Report From The 2025 Cure Ocular Melanoma (Cure Om) Global Science Meeting, Amsterdam, The Netherlands, October 2025, Andrew E. Aplin, Katherina Alsina, Allison S. Betof, Joseph Birkett, Marcus O. Butler, George Cole, Rizwan Haq, Florian A. Karreth, Vinit B. Mahajan, Rahul Marpadga, Prithvi Mruthyunjaya, Paul Nathan, Jonas A. Nilsson, Gary Palmer, Joseph J. Sacco, Takami Sato, Sarah Stanhope, Pang-Ning Teng, Kyleigh Lipira

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

The 2025 Cure Ocular Melanoma (CURE OM) Global Science Meeting took place in Amsterdam, The Netherlands on October 25th, 2025. Several promising drug candidates are in development; however, there is still an urgent need for better prevention, detection, and treatment of uveal melanoma. The purpose of this meeting was to promote international collaboration and idea exchange between scientists, industry, and patient advocates.

Point-Of-Care Hrhpv Mrna Detection With Reverse Transcription Recombinase Polymerase Amplification On A Portable Fluorimeter From Provider-Collected Cervical Samples In Maputo, Mozambique, Emilie Newsham Novak, Cannon J Hansen, Zoha Wazir, Ariel Ma, Jennifer Carns, Hira Atif, Jane R Montealegre, Michael E Scheurer, Cesaltina Lorenzoni, Daniel G Rosen, Mila P Salcedo, Kathleen M Schmeler, Rebecca R Richards-Kortum

Faculty, Staff and Students Publications

Background: Cervical cancer is the most common cancer in women in Mozambique, where limited screening infrastructure contributes to high disease burden. While testing for high-risk human papillomavirus (hrHPV) DNA can identify women at risk for cervical cancer, its limited specificity may lead to overtreatment in screen-and-treat programs, straining resources. We performed a pilot study to evaluate preliminary feasibility of a novel, accessible test to detect hrHPV mRNA, a more specific biomarker for cervical cancer risk, from 22 women who previously screened positive for visual inspection with acetic acid at Maputo Central Hospital in Mozambique.

Methods: Cervicovaginal samples were analyzed for …

Advocating For A Care-Based Ethic: Stories Of Pregnancy And Birth From Caregivers Of Children With Down Syndrome, Lydia Ocasio-Stoutenburg, Nayma Sultana Mim

Developmental Disabilities Network Journal

Down syndrome (DS) impacts about 1 in every 640 childbirths in the United States. While quality of life has improved for people with DS, systemic inequities and deficit-based perceptions have persisted throughout history, with material impacts on people with DS and their caregivers. Researchers have documented how caregivers of children with DS have had negative experiences with healthcare providers and genetic counselors, whose biased views about DS translate into subtle and overt pressures. Few studies explicitly focus on the experiences of Caregivers of Color, multilingual families, as well as families with varying economic experiences who have children with DS. This …

Pruritus Associated With Systemic Sclerosis: A Systematic Review Of Treatment-Based Clinical Trials, Kiana Mortezaei, Rishika Pasula, Meryem Nursoy, Amit Syal, Ioannis Panayiotou, Geeta Kumari, Andreas Chatzitoffis, Pavle Milutinovic, Olajumoke O. Fadugba, Chris T. Derk

Student Papers, Posters & Projects

This paper aims to examine the latest research on treatments for itch (pruritus) in people with systemic sclerosis (SSc), identify areas where information is lacking, and propose suggestions for future studies.A comprehensive literature search was performed in PubMed and Scopus in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify studies evaluating therapeutic interventions for pruritus in SSc. Eligible studies included randomized controlled trials, cohort studies, and case series comprising a minimum of three patients. Data extraction encompassed study design, patient demographics, pruritus assessment instruments including validated and non-validated measures, and clinical outcomes. Studies …

Health Management Practices In Chronic Traumatic Brain Injury Rehabilitation: A Scoping Review Protocol, Davina Sharma, Shané J. Gill, Lizbeth Goodman, Amanda Rabinowitz, Louis N. Hunter, Reinhard Schaler, Kirby L. Wycoff

College of Health Professions Faculty Papers

INTRODUCTION: Traumatic brain injury is increasingly recognized as a chronic condition requiring long-term rehabilitation and coordinated care beyond the acute phase. Across Europe, substantial variation exists in healthcare system organization, funding structures, and service delivery models, which may influence access to rehabilitation and long-term functional outcomes for adults with chronic moderate-to-severe traumatic brain injury. The objective of this scoping review protocol is to systematically characterize systemic factors and management practices that shape rehabilitation access, continuity of care, and recovery outcomes across European healthcare systems. This review will map published evidence on health management practices influencing chronic traumatic brain injury rehabilitation …

Quality Improvement Project The Impact Of The Interact “Stop And Watch Tool” In A Skilled Nursing Facility, Lorraine Hicks

Doctor of Nursing Practice Projects

Avoidable hospitalizations from skilled nursing facilities (SNF) contribute to increased healthcare costs, resident distress, and adverse health outcomes. Many readmissions result from delays in identifying and communicating early signs of resident deterioration. The purpose of this project was to implement an evidence-based intervention to recognize early changes in residents’ conditions, empower nursing staff to detect and promptly communicate concerns, and impact 30-day hospital readmission rates. Problems identified included delayed recognition of early changes in residents’ conditions, fragmented staff communication, and the absence of standardized reporting practices, which were associated with preventable hospital readmissions. A quasi-experimental pre-/post-intervention design guided by Jean …

Microglial Swell1 Deficiency Drives Male-Specific Seizure Vulnerability But Paradoxical Neuroprotection Through Impaired Phagocytosis, Abhijeet S Barath, Aastha Dheer, Laura Montier, Mekenzie M Peshoff, Emily Dale, Flavia Goche, Thanh Thanh Le Nguyen, Mastura Akter, Fangfang Qi, Dimitrios Kleidonas, Lauren Harris, Sarah A Jewanee, Anthony D Umpierre, Dale B Bosco, Koichiro Haruwaka, Rajan Sah, Long-Jun Wu, Rongzhuo Hua, Tejaswani Datla

The Brown Foundation: Institute of Molecular Medicine

The discovery of genes encoding the volume-regulated anion channel (VRAC) has enabled detailed exploration of its cell type-specific roles in the brain. LRRC8A (SWELL1) is the essential VRAC subunit. We observed seizure-induced, subunit-specific changes in microglial VRAC expression and investigated its function using conditional KO (cKO) of LRRC8A in microglia. SWELL1 cKO mice exhibited a male-specific increase in kainate-induced seizure severity, yet showed paradoxical neuroprotection against seizure-associated neuronal loss. Mechanistically, SWELL1 deletion led to a cell-autonomous reduction in microglial density and decreased release of VRAC-permeable neuroactive metabolites, including taurine, GABA, and glutamate in culture. Additionally, impaired phagocytic kinetics and reduced …

An Inf2-Dependent Actin-Mediated Step In Inositol 1,4,5-Trisphosphate Receptor Cluster Formation And Activity, Maite R. Zavala, Amrapali Ghosh, Suresh K. Joseph, Rajarshi Chakrabarti

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Intracellular calcium signaling plays a vital role in regulating various cellular processes including gene regulation, motility, metabolism, and cell death. Inositol 1,4,5-trisphosphate receptors (IP3Rs) on the endoplasmic reticulum (ER) are a major cation channel that regulates stimulus-induced calcium release from the ER. While several molecular players regulate the activity of IP3R, its regulation by actin filaments was uncharacterized. Here, we show that actin filaments polymerized by the specific actin nucleator INF2 facilitate agonist-induced IP3R activity. Our results demonstrate that INF2-mediated actin filaments regulate the formation and/or stability of IP3R clusters on the ER that have been previously shown to be …

Toolkit For Multistate Disease Progression Simulation And Treatment Decision-Making Aid, Can Xie, Ruosha Li, Wael Saber, Jorge E Cortes, Nicholas J Short, Xuelin Huang

Faculty, Staff and Student Publications

Background: The optimal timing of a treatment within therapy lines can maximize its benefit while minimizing risks and side effects. Because patients differ in clinical and biological characteristics, personalized treatment planning can support physicians' decision-making. However, multistate disease progression complicates the comparison of treatment strategies, motivating the development of a user-friendly web tool for multistate disease progression simulation and treatment decision support. Microsimulation is a natural approach for comparing prespecified treatment-timing strategies, where it generates disease trajectories for a large number of virtual patients matched to an individual patient's observed data. In our framework, microsimulation is performed using a multistate …

Enhancing Sleep Quality Through Sleep Hygiene Education Among Adults In A Faith-Based Community, Denielle Earle-Thompson

Doctor of Nursing Practice Projects

Background

Adults between 18 and 64 years of age require at least seven hours of sleep per night; however, many adults do not meet this recommendation, contributing to increased risks for chronic disease, impaired functioning, mood disturbances, and reduced quality of life. Poor sleep quality has been associated with weakened immunity, cardiovascular disease, diabetes, obesity, anxiety, depression, and decreased daytime performance. Obtaining adequate, good-quality sleep is essential for maintaining overall health and well-being. In faith-based communities, combining health education with spiritual support may provide a holistic approach that addresses both physical and emotional contributors to poor sleep.

Purpose

The purpose …

Disclosing Hunger: Predictors And Screening Strategies For Food Insecurity In Undergraduate University Students And Adults Contexts, Jocelyn Emily Jarvis

USF Tampa Graduate Theses and Dissertations

Food insecurity is a growing public health concern among college students in the United States, with prevalence estimates exceeding those of the general population. Despite the availability of campus, community, and federal food assistance resources, utilization remains low, suggesting that barriers extend beyond structural access. This dissertation examines the psychosocial, behavioral, and institutional factors that shape food insecurity disclosure and help-seeking behaviors among undergraduate students, guided by the Social Ecological Model (SEM).

This work includes three complementary studies. Study One presents a scoping review synthesizing 16 U.S.-based studies to identify psychosocial determinants of food assistance utilization among food-insecure adults. Findings …

A Scoping Review Of Preventive Interventions To Reduce Violence Against Women And Girls In The Islamic Republic Of Iran, Wahiba Abu-Ras, Leena Babiker Idris, Shahira Amin, Ashley Butler, Patricia J. Kelly, Basil H. Aboul-Enein

College of Nursing Faculty Papers & Presentations

In Iran, violence against women (VAWG) remains highly prevalent, with reported rates ranging from 22.9% to 66%, underscoring the need for effective, contextually grounded interventions.   This scoping review aimed to systematically identify, map, and critically appraise intervention strategies addressing VAWG in Iran.   Guided by PRISMA-ScR and the PICOS framework, comprehensive searches were conducted across nine databases from 2000 to September 2024. Eligible studies included intervention-based research conducted in Iran that reported outcomes related to violence reduction, psychological well-being, or empowerment. Thirteen studies met the inclusion criteria.   The included studies demonstrated heterogeneous designs, theoretical frameworks, and outcome measures. Four interventions targeted …

Where Evidence-Based Medicine Meets Ai: Promise, Pitfalls, And Practice, Sangil Lee, Joshua Davis, Ken Milne, Christina Shenvi, Lars K. Beattie, Martin Wegman, Laura Melville, Richard D. Shih, Bryan Kane

Department of Emergency Medicine Faculty Papers

No abstract provided.

Integration Of Intraoperative Data In Interpretable Machine Learning Models To Predict Postoperative Aki In Noncardiac Surgery Patients, Justin Do, Karan H. Shah, Melissa Xu, Andrew Hyunwoo Kim, Vivaswat Suresh, Nidhir Guggilla, Michael Li, Rishi Kothari

Department of Anesthesiology Faculty Papers

OBJECTIVES: We aimed to (1) quantify changes in discrimination when adding intraoperative data to preoperative data and (2) compare tabular machine learning with feature engineering against a time-aware LSTM-based model.

MATERIALS AND METHODS: Retrospective cohort of 46 204 adults undergoing 57 055 eligible noncardiac surgery in the INSPIRE database. We extracted 38 preoperative and 49 intraoperative variables; acute kidney injury (AKI) was defined by KDIGO serum creatinine criteria and modeled as stage 2/3 postoperative AKI. Models were trained on preoperative-only and combined pre- and intraoperative data. Intraoperative series were summarized using eight statistical features for tabular models or integrated directly …

Quality Improvement Project: The Impact Of A Safety Coach Program In A Pediatric Intensive Care Unit, Royanne Lickliter

Doctor of Nursing Practice Projects

Patient safety remains a critical concern in healthcare, with hospital-acquired conditions (HACs) contributing to preventable harm, mortality, and increased costs, particularly in high-acuity settings such as Pediatric intensive care units (PICUs). A recent safety culture survey at a tertiary pediatric hospital identified gaps in proactive safety behaviors, communication, and psychological safety. The primary problem identified was inconsistent engagement in proactive safety practices and limited frontline empowerment to identify and mitigate risks in real time. The purpose of this quality improvement (QI) project was to evaluate the impact of implementing a structured Safety Coach Program in the PICU on HAC rates, …