Digital Commons Network^™

Point Of Care Testing: Best Practice Toolkit For Improving Access To Point Of Care Testing In Mobile Medicine, Michaela Gist

Student Scholarly Projects

Practice Problem: Healthcare for persons experiencing homelessness (PEH) is a complex issue. Chronic and communicable diseases are disproportionately represented within this population. Healthcare spending is 2.5 times more costly in comparison to those who have not experienced homelessness. Although mobile health clinics aim to reduce the concerns with access to care, they do not eliminate barriers if the appropriate tests are not immediately available.

PICO: In the homeless population treated in mobile medicine (P), what is the effect of point of care testing (I) on turnaround time (O) compared with outside laboratory testing (C)?

Evidence: Critical analysis of the literature …

Effects Of Water Access On Childhood Linear Growth In Zimbabwe, Robert Ntozini

Walden Dissertations and Doctoral Studies

No abstract provided.

Nurse Leader Rounding To Provide Fall Prevention Strategies, Kerri Philipbar

Student Scholarly Projects

Practice Problem: Falls while patients are hospitalized are all too common. It was identified that the 300-bed facility in Southeast Georgia had a clinical practice gap with inpatient falls. Inpatient falls cause unnecessary pain and suffering to the patient and families. In addition to the negative effects to the patients, it creates a hardship to the organization. Increased length of stay and additional testing and treatments are charged to the hospital because of a fall.

PICOT: The PICOT question for this project is as follows: In adult patients in an acute care setting (P), does nurse leader rounding to …

Evidence-Based Intervention For Decreasing Chronic Kidney Progression In Patients With Type Ii Diabetes Mellitus, Lynn M. Johnson

Student Scholarly Projects

Practice Problem: The overall management of Type II Diabetes Mellitus (DM II) and the complications that accompany along with comorbidities are debilitating and financially exhausting. The American Diabetes Association dietary recommends a consistent low-carbohydrate diet to maintain optimal blood glucose levels to prevent complications and progression of other comorbidities. Uncontrolled diabetes mellitus leads to the development of chronic kidney disease (CKD) which can lead to the progression to End Stage Renal Disease.

PICOT: In patients in the outpatient setting aged 18 years and older(P), how does the ADA dietary guidelines for patients with type II DM(I) compared with patients self-reported …

Patient Navigational Tool Increase Resource Use In A Latino Population, Kimberly Burrus

Student Scholarly Projects

Practice Problem: The practice problem is a patient navigation tool in a mobile health clinic for the Latino population to help improve utilization of resources within Daviess County, Indiana, and improve overall health literacy and health of those populations?

PICOT: The PICOT question that guided this project was: In a mobile health clinic serving Latino populations (P), does a navigation tool (I) compared to current practices (C) improve utilization of services (O) within a 12-week timeframe (T)?

Evidence: The evidence that guided this project showed patients with limited English proficiency, immigrant families have a disparity of health literacy, and an …

The Effects Of An Influenza Vaccine Education Bundle On Environmental Management Services Workers, Michelle Keister

Student Scholarly Projects

Practice Problem: Environmental Management Service Workers have low vaccination rates. They work around a vulnerable patient population.

PICOT: For Environmental Management Services (EMS) workers (P), does the use of an Influenza Vaccine Education Bundle (I) compared to the current practice (C) impact EMS worker influenza vaccine compliance (O) within a 10-week period (T)?

Evidence: Using an educational vaccine bundle that increases access to the vaccine, provides education regarding the vaccine, and comes from a trusted source will increase flu vaccination rates among Environmental Management Services workers.

Intervention: Implement a vaccine education bundle.

Outcome: After implementation in 2023, vaccination rates …

Improving Cervical Cancer Screening Rates In The Primary Care Setting, Esmeralda Young

Student Scholarly Projects

Practice Problem: Cervical cancer screening with Pap is the recommended standard practice for women aged 21 to 65. The project aimed to increase low cervical cancer screening rates at a primary care clinic.

PICOT: The PICOT question that guided this project was: (P) In women 21 to 65 years old in the primary care setting (I), does proactive pre-scheduling of cervical cancer screenings (C) compared to current standard practice (O) affect cervical cancer screening rates (T) over eight weeks?

Evidence: The evidence strongly supported improving cervical cancer screening among the targeted population. Studies showed that Pap smear screening reduced the …

The Ethical Data Practices Framework And Its Implications For Data Privacy Relations Between The United States And The European Union, Vasiliki Rahimzadeh

Center for Medical Ethics and Health Policy Staff Publications

No abstract provided.

Flow-Sizing Critical Care Resources, Joseph L Nates, John M Oropello, Neeraj Badjatia, Gregory Beilman, Craig M Coopersmith, Neil A Halpern, Daniel L Herr, Judith Jacobi, Roozehra Kahn, Sharon Leung, Nitin Puri, Ayan Sen, Stephen M Pastores

Staff and Researcher Publications

Objectives: To describe the factors affecting critical care capacity and how critical care organizations (CCOs) within academic centers in the U.S. flow-size critical care resources under normal operations, strain, and surge conditions.

Data sources: PubMed, federal agency and American Hospital Association reports, and previous CCO survey results were reviewed.

Study selection: Studies and reports of critical care bed capacity and utilization within CCOs and in the United States were selected.

Data extraction: The Academic Leaders in the Critical Care Medicine Task Force established regular conference calls to reach a consensus on the approach of CCOs to "flow-sizing" critical care services. …

Improving Research Is A Multipronged Collaborative Approach Reliant On "Expert" Humility And Respect, Philip Cheng, Andrew Bossick, Ashley B. Redding

2023 Patient Advisor Retreat

Our project goal is to bring together Henry Ford health sciences researchers and community members to promote the engagement of diverse patient perspectives. This poster highlights current initiatives pertaining to the integration of diverse perspectives into the research process to enhance our science at the group, system, and NIH level.

Expanding Use Of Sodium-Glucose Cotransporter-2 Inhibitor (Sglt2i) In Managing Patients With Diabetes And Chronic Kidney Disease In Primary Care, Stephanie Wu

Student Scholarly Projects

Practice Problem: In 2022, the addendum of standards of medical care in diabetes management was annotated to recommend the broader use of sodium-glucose cotransporter 2 inhibitors (SGLT2i) to treat patients with Type 2 diabetes mellitus (DM) and diabetic nephropathy. Despite the Department of Veterans Affairs’ (VA) efforts to include SLGT2i as a formulary, non-restrictive prescription in the primary care ordering menu, the overall utilization rates of SGLT2i remained relatively low in primary care.

PICOT: The PICOT question that guided this project was: In patients with DM and chronic kidney disease (CKD) (P), how does an evidence-based guideline algorithm bundle (I) …

Camera Assisted Monitoring Device As A Tool To Reduce Falls In Inpatient Adults: An Integrative Review, Pamela Oriaifo

Doctoral Dissertations and Projects

Background: Adult inpatient falls remain a significant challenge in many hospitals, resulting in poor quality of life and severe financial burden. There have been tremendous efforts to curb the number of falls ranging from environmental modification, clinician education, review of medications, and use of assistive devices. One such assistive device is the use of camera monitoring systems. This systemic review scopes camera/video-assisted fall prevention programs in hospitals. It was hypothesized that camera/video-assisted fall prevention programs would reduce adult inpatient fall and costs significantly. The outcomes of camera or video-assisted fall prevention programs were considered in some hospital settings. Method: The …

Exploration Of Burnout, Emotional Thriving, And Emotional Recovery In An Academic Medical Center: A Mixed Methods Quality Improvement Project, Roxana Naderi, Katherine T. Morrison, Zuzanna Czernik, James E. Carter Jr, Katherine N. Dickerman, Alexandra Gallant, Lara Kirkbride-Romeo, Lauren Mcbeth, Angela Keniston, Kristin M. Jensen

Journal of Wellness

Introduction: Healthcare provider burnout, an indicator of wellbeing, impacts patient safety, provider distress, and employee turnover. In this mixed methods, multi-site quality improvement study conductedpandemic, we assessed employee wellbeing in a large clinical department.

Methods: Wellbeing surveys were sent electronically to Department of Medicine clinicians, researchers, administrators, and staff from August-September 2019 assessing perceptions of Burnout, Emotional Thriving (ET), and Emotional Recovery (ER). Qualitative responses were reviewed for themes using mixed inductive-deductive analysis. The initial coding was done by small teams with consensus obtained through large group discussions. This study was IRB-approved as non-human subjects research.

Results: Of the 671 …

Association Of Parental Status And Gender With Burden Of Multidisciplinary Tumor Boards Among Oncology Physicians, Brittney L Chau, Jonnby S Laguardia, Sungjin Kim, Samuel C Zhang, Eric Pletcher, Nina N Sanford, Ann C Raldow, Lisa Singer, Jun Gong, Sukhmani K Padda, Mitchell Kamrava, Tara Cohen, Devarati Mitra, Katelyn M Atkins

Faculty, Staff and Student Publications

IMPORTANCE: Tumor boards are integral to the care of patients with cancer. However, data investigating the burden of tumor boards on physicians are limited.

OBJECTIVE: To investigate what physician-related and tumor board-related factors are associated with higher tumor board burden among oncology physicians.

DESIGN, SETTING, AND PARTICIPANTS: Tumor board burden was assessed by a cross-sectional convenience survey posted on social media and by email to Cedars-Sinai Medical Center cancer physicians between March 3 and April 3, 2022. Tumor board start times were independently collected by email from 22 top cancer centers.

MAIN OUTCOMES AND MEASURES: Tumor board burden was measured …

Multilevel Community Engagement To Inform A Randomized Clinical Trial, Kirby L. Wycoff, Jabina G. Coleman, Christine M. Santoro, Leah L. Zullig, Niesha Darden, Porsche M. Holland, Jane F. Cruice, Shukriyyah Mitchell, Michelle Smith, Saleemah J. Mcneil, Sharon J. Herring

Counseling and Behavioral Health Faculty Papers

OBJECTIVE: To explore how patients, community-based perinatal support professionals, and health system clinicians and staff perceived facilitators and barriers to implementation of a randomized clinical trial (RCT) designed to optimize Black maternal heart health.

METHODS: This article describes the formative work that we believed needed to occur before the start of the Change of H.E.A.R.T (Here for Equity, Advocacy, Reflection and Transformation) RCT. We used a qualitative, descriptive design and community-based, participatory approach, the latter of which allowed our team to intentionally focus on avoiding harm and equalizing power dynamics throughout the research process. Data were collected between November 2021 …

Implementation Of A Pcp Referral In Urgent Care For Patients With Hypertension, Teri Alesha Scott

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Adult patients with uncontrolled hypertension at Saluda Pointe Urgent Care (SPUC) do not have an established primary care provider (PCP) for follow-up.

Purpose: To improve access to care by establishing patients with uncontrolled hypertension (>140/90) with a PCP.

Method: Implement a PCP referral at SPUC for patients with uncontrolled hypertension. The Primary Care Connection Center (PCCC) contacted the referred patients within 72 hours to schedule an appointment. An Organizational Change Management (OCM) Solutions survey measured provider attitude and readiness for change before and after implementation.

Inclusion Criteria: Adult patients 18 and older, without an …

Assessing Organizational Readiness For Evidence-Based Practice (Ebp) Change For The Implementation Of A Postoperative Neuropathic Mastalgia (Pnm) Scale Among General Surgery Ambulatory Practices, Jessica Terry Gonzalez

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Assessing postoperative neuropathic mastalgia (PNM) among oncology breast surgical patients is not commonly performed using a surgery specific pain scale at large South Carolina healthcare organization and is historically misdiagnosed, mismanaged, despite representing a common and significant complication (Gong et al., 2020; Humble et al., 2015; Mejdahl et al., 2019). Studies show that early identification of patients with neuropathic-specific pain following breast cancer-related surgery facilitates better pain management and patient outcomes (Pereira et al., 2017; Sipilä et al., 2012). Assessing organizational readiness to adopt Evidence-Based Practice change is recommended to facilitate the identification of potential barriers to implementation …

Evaluation Of A Revised Clinical Ladder Program In Addressing Clinical Competence And Performance, Accountability, Professional Growth, Rewards And Benefits, Job Satisfaction And Engagement, And Autonomy And Decision Making, Vaughn Hansen Msn, Rn, Ne-Bc

Doctor of Nursing Practice Projects

Background: The surge of nurses leaving the profession has increased in recent years raising concerns that unless systemwide changes are implemented this trend will increase exponentially for years to come. Healthcare organizations struggle to retain an experienced, competent nursing workforce and seek ways to keep them from leaving. A clinical ladder program is one potential method being implemented in which healthcare organizations mitigate the exodus of nurses and create a healthier work environment.

Objectives: This doctoral project aimed to measure the perceptions of how well a revised clinical ladder program influenced the nursing workforce satisfaction in the following areas: clinical …

Preparing Students For The National Physical Therapist Examination (Npte): One Program’S Experience With Using The Practice Exam And Assessment Tool (Peat) As A Graduation Requirement, Sandra Campbell, Kripa Dholakia, Lynne Sturgill, Robert Wellmon

Internet Journal of Allied Health Sciences and Practice

Purpose. Factors related to National Physical Therapist Examination (NPTE) performance have been widely reported in the literature, yet no strong predictors emerge offering faculty guidance on how to determine student readiness for the NPTE .The Practice Exam and Assessment Tool (PEAT) as a graduation requirement may give insight into readiness for the NPTE. Widener University transitioned from a faculty generated comprehensive examination (FGCE) to the PEAT using Lewin’s Planned Change Model. The purposes of this study were to (1) describe one program’s transition away from a FGCE to the PEAT, (2) present findings of a data driven process to assess …

Discrimination Against Hispanic And African American Women And Interventions To Improve Patient Outcome: An Integrative Review, Sandi Daneri Cruz Rivera

Doctoral Dissertations and Projects

Racial discrimination in health care has been a heavy topic of discussion on social media. Discrimination against women of color such as those of African American and Hispanic descent has been found to have negative health effects. The aim of this project was to identify how racial discrimination influenced African-American and Hispanic women’s health and current interventions that have been implemented to help address these issues. The findings showed that women who experienced discrimination not only in health care but in everyday life did experience negative health outcomes including cardiovascular disparities, obesity, increasing inflammatory markers, and mental health disparities. Implementations …

Innovations In Health-Care Service Delivery During The Pandemic, Taryn Vian, Ankita Meghani Phd

Nursing and Health Professions Faculty Research and Publications

The COVID-19 pandemic disrupted health service delivery as countries implemented lockdowns and issued stay-at-home orders. Despite attempts to make essential health services available throughout, the pandemic strained health systems and resulted in rampant shortages of health commodities, beds and health-care staff. There were concomitant declines in tuberculosis screening, HIV testing, and maternal and child health services.2 However, the global pandemic also accelerated the pace of innovation. Some initiatives served as stopgap measures implemented to maintain health services, whereas others helped leapfrog progress in the areas of health information systems, telemedicine, and regulatory policy, bringing efficiencies that could be applied even …

Opportunities For Competency Support Of Virginia Cooperative Extension Professionals At The Colleague Stage, Karen A. Vines, Ruth E. Wallace, Cynthia Gregg, Neil Clark, Jane Henderson, Lonnie Johnson, Dickson Otieno, Sarah Baughman

Journal of Human Sciences and Extension

This study focused on the professional development needs of Cooperative Extension agents and specialists with between four and seven years of experience, placing them roughly within the colleague career stage. Data were collected through focus groups and validated through member checking and the use of a modified World Café approach. A research team collaborated, increasing the reliability of the findings through intentional reflection in the development of the findings. Areas of competency strength and weakness vary for agents and specialists, and specific topic areas within competencies vary. While many of the emergent competencies identified in this study fit within the …

Unit-Based Onboarding Program For New Graduates On A Medical-Surgical Unit, Racquel A. Brewster

Electronic Theses and Dissertations

Nurse turnover is prevalent among new graduate nurses. Many new graduate nurses feel unsupported by their peers, lack self-confidence, or feel overburdened due to the workload assigned to them. New graduate nurses with support systems are more likely to stay with an organization. Research suggests the creation of a supportive environment for new graduate nurses to help increase nurse retention in this demographic. A unit-based transition onboarding program was launched to create a supportive environment to help retain new graduate nurses on a medical-surgical unit. New graduate nurses with at least 1 to 3 years of experience completed a Likert-type …

Doctor Of Nursing Practice Transformative Leadership Ai Assignment, Elizabeth Gotay

AI Assignment Library

Assignment Overview: In this assignment, students will delve into the complex realm of transformative leadership in nursing practice through a comprehensive case study analysis. Students will examine real-world scenarios and apply their knowledge of leadership theories, ethical considerations, and advanced nursing concepts to critically analyze the role of transformative leadership in achieving positive patient outcomes and fostering organizational change.

(2014) Supporting Mandated Child Abuse And Neglect Reporters, Krystal Vaughn, Allison B. Boothe

Louisiana Journal of Counseling

No abstract provided.

(2014) Entire Issue, Meredith Nelson, Peter Emerson

Louisiana Journal of Counseling

No abstract provided.

Sustainable Development For Mobile Health Apps Using The Human-Centered Design Process, Qingfan An, Marjorie M Kelley, Audra Hanners, Po-Yin Yen

2020-Current year OA Pubs

Well-documented scientific evidence indicates that mobile health (mHealth) apps can improve the quality of life, relieve symptoms, and restore health for patients. In addition to improving patients' health outcomes, mHealth apps reduce health care use and the cost burdens associated with disease management. Currently, patients and health care providers have a wide variety of choices among commercially available mHealth apps. However, due to the high resource costs and low user adoption of mHealth apps, the cost-benefit relationship remains controversial. When compared to traditional expert-driven approaches, applying human-centered design (HCD) may result in more useable, acceptable, and effective mHealth apps. In …

Impact Of Fall Education To Nursing Staff On Oncology Patient Fall Rates, Danni Nina Sloane

Doctoral Dissertations and Projects

Falls and fall-related injuries impact patients' health outcomes and are the most commonly reported adverse event in hospitals for patients over 65 years of age. This scholarly project was conducted to evaluate the effect of evidence-based education to the Registered Nurses and Certified Nursing Assistance in the medical and surgical oncology inpatient on reducing the number of patients falling. Retrospective reviews of patient fall rates, were conducted two months before the fall educational sessions, and prospective reviews were conducted after implementing fall education. Patient falls also affect reimbursement rates and, on average, increase a patient’s length of stay by about …

Utilization Of Wellness Practices For Burnout And Stress During Covid-19 Among An Interdisciplinary Cohort Of Emergency Healthcare Workers, Michael J. Zdradzinski, Sheri-Ann O. Kaltiso, Roslyn Seitz, Timothy P. Moran, Jennifer Clements, Sheryl L. Heron, Michelle D. Lall

Journal of Wellness

Introduction: The Coronavirus Disease (COVID-19) introduced additional stress to the baseline occupational stressors of emergency care workers. The objectives of this study were to evaluate perceived stress and burnout and the utilization and perceived benefit of wellness practices among emergency healthcare workers (EHCWs), including: emergency physicians, advanced practice providers (APPs), nurses, and departmental administrative staff during the COVID-19 pandemic.

Methods: A cross-sectional 28-item electronic survey of EHCWs at three hospitals in a major United States city was used to measure participants’ utilization and perceived benefit of wellness practices, burnout (2-item measure), overall stress (perceived stress scale), and stress …

Acceptability, Appropriateness, And Feasibility Of Rural School Support Strategies For Behavioral Interventions: A Mixed Methods Evaluation Over Two Years Of A Hybrid Type 3 Implementation-Effectiveness Trial, Hannah G. Calvert, Michaela Mcquilkin, Ashley Havlicak, Teri Lewis, Lindsey Turner

Public and Population Health Faculty Publications and Presentations

Background: Positive Behavioral Interventions and Supports (PBIS) is a framework for implementing evidence-based interventions for preventing behavioral issues and improving climate in schools. The implementation of school-wide PBIS with fidelity is complex, requiring leadership commitment, teaming, and coordination of systems for tracking behaviors and consequences. Putting these components in place while ensuring alignment with the values and needs of the school community can be difficult for schools with fewer resources, such as rural schools. Implementation supports are needed, including strategies such as technical assistance, but it is unclear whether lower-cost modalities such as virtual support are acceptable, appropriate, and feasible …