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The Role Between Transactive Memory Systems In The Relationship Between Psychological Safety & Quality In Interprofessional Healthcare Teams, Tera L. Webb

All ETDs from UAB

During uncertainty, the optimum solution for work-related problems or patient care cases require the scopes of practice and competencies beyond a single profession. For this reason, the collaborative efforts of interprofessional teams are a widely used approach to patient care and medical decision making. The interdependency between healthcare professionals with varied expertise and input often lead to desired outcomes. Beyond the structure of the team, there are numerous cognitive processes at play that impact knowledge transfer in highly skilled teams that impact outcomes. Therefore, this dissertation will review relevant literature on two cognitive constructs – psychological safety and transactive memory …

Level Ii Fieldwork Educators' Perceived And Experienced Challenges With Using The Collaborative Fieldwork Supervision Model, Oaklee Rogers, Cherie Graves, Tamara Turner, Debra J. Hanson, Marilyn G. Klug

Journal of Occupational Therapy Education

Fieldwork shortages have been noted in the literature for some time. With the ever-changing healthcare system and an increasing number of students in occupational therapy programs, the scarcity of fieldwork placements is dire. Rooted in adult learning principles, the collaborative fieldwork supervision model is one approach to fieldwork education that may alleviate the shortage of placements, while also supporting student learning. This model is designed to have one fieldwork educator supervising two or more students throughout a fieldwork experience. The strengths and challenges of this model are well documented, although it is unclear if the identified challenges are the same …

Changing The Ways Bedside Nursing Staff Think About ‘All Things Urinary Catheters, Angela Foard

Doctor of Nursing Practice Projects

The purpose of this project was to bring attention to the importance of the bedside nursing staff’s "back to the basics" approach to nurse-led interventions to help reduce the number of increasing hospital-acquired infections (HAI), specifically catheter-associated urinary tract infections (CAUTI). The motivation to address this problem was due to the bedside nursing staff under-utilizing best practice interventions to prevent insertions and re-insertions of urinary catheters. A high number of urinary catheter insertions and re-insertions increases the risk of a CAUTI. Evidence-based interventions should be reinforced and utilized by bedside nursing staff to prevent insertions and re-insertions. Evidence-based nurse-led practices …

The Impact Of Mindful Breathing On Stress Of Employees Working From Home, Lindsey Goldberg

Doctor of Nursing Practice Projects

This DNP project was designed to decrease stress among employees working from home (WFH) by educating them on mindful breathing practices. Through the implementation of a mindful breathing activity, the intended project outcome was to improve stress levels of employees working from their homes. Mindful breathing is an evidence-based strategy that has demonstrated decreased stress levels. Mindful breathing was implemented among two companies employing an estimate of 170 WFH employees to improve health and well-being with potential long-term positive impact on sustainability of organizations in the post-COVID, work from home environment. The participants were invited to perform 8-minutes of daily …

A Journey To Finding Space In The Tension: Experience Of Instructors' Relationship With Religion And Spirituality In Doctoral Psychology Programs, Samantha Mcgee

Antioch University Dissertations & Theses

Religion and spirituality, when viewed through a holistic lens, can reflect important aspects of a person’s identity. It can be a source of well-being and also struggle. The fields of religion, spirituality and psychology have had a history of being polarized, with some efforts to integrate the two fields. Tensions exist at multiple ecological levels around the topic of religion and spirituality, which can make it easier to avoid discussing it in classrooms and therapy rooms. It is important to address and create room for discussion of experiences around religion and spirituality in classrooms that are training psychologists so they …

Locating Uncertainty In Hospital Leader Sensemaking And Sensegiving Of Organizational Change: A Single Case Study, Sara E. Barry

Antioch University Dissertations & Theses

Leaders planning strategic change face significant ambiguity and uncertainty due to the complex, fast-paced, and volatile nature of organizational life. What one leader sees as an opportunity, another may view as a threat depending on their past experiences, their existing mental models, and their perceptions of uncertainty. Sensemaking and sensegiving theories provide a framework for how leaders retrospectively make sense of new and disorienting information through recursive cycles of interpretation, action, and learning, and seek to influence the meaning-making of others towards a shared vision of the strategic change. Despite decades of research using these theories, studies have yet to …

Formal Ethics Education In Speech-Language Pathology Graduate Students, Jennifer N. Gaylord

Murray State Theses and Dissertations

Ethical service provision is an essential foundational skill for speech-language pathologists (SLPs) and is fundamental for maintaining the integrity of the profession of speech-language pathology. While practicing speech-language pathologists are required to complete formal ethics training during each certification maintenance interval, there are no guidelines set forth as to the amount and type of training for graduate students in speech-language pathology. This quasi-experimental investigation compared the effect of ethics training embedded within a curriculum to formal ethics training on the ethics knowledge and self-reported comfort levels of first-year graduate students in speech-language pathology. Two equal, non-randomized groups of participants completed …

How To "Start Small And Just Keep Moving Forward": Mixed Methods Results From A Stepped-Wedge Trial To Support Evidence-Based Processes In Local Health Departments, Rebekah R Jacob, Renee G Parks, Peg Allen, Stephanie Mazzucca, Yan Yan, Sarah Kang, Debra Dekker, Ross C Brownson

2020-Current year OA Pubs

BACKGROUND: Local health departments (LHDs) in the United States are charged with preventing disease and promoting health in their respective communities. Understanding and addressing what supports LHD's need to foster a climate and culture supportive of evidence-based decision making (EBDM) processes can enhance delivery of effective practices and services.

METHODS: We employed a stepped-wedge trial design to test staggered delivery of implementation supports in 12 LHDs (Missouri, USA) to expand capacity for EBDM processes. The intervention was an in-person training in EBDM and continued support by the research team over 24 months (March 2018-February 2020). We used a mixed-methods approach …

Implementation Barriers To Integrating Exercise As Medicine In Oncology: An Ecological Scoping Review, Mary A. Kennedy, Sara Bayes, Robert U. Newton, Yvonne Zissiadis, Nigel Spry, Dennis Taaffe, Nicolas H. Hart, Daniel A. Galvao

Research outputs 2014 to 2021

Purpose

While calls have been made for exercise to become standard practice in oncology, barriers to implementation in real-world settings are not well described. This systematic scoping review aimed to comprehensively describe barriers impeding integration of exercise into routine oncology care within healthcare systems.

Methods

A systematic literature search was conducted across six electronic databases (since 2010) to identify barriers to implementing exercise into real-world settings. An ecological framework was used to classify barriers according to their respective level within the healthcare system.

Results

A total of 1,376 results were retrieved; 50 articles describing implementation barriers in real-world exercise oncology …

Building The Plane While It’S Flying: Implementation Lessons From Integrating A Co-Located Exercise Clinic Into Oncology Care, Mary A. Kennedy, Sara Bayes, Robert U. Newton, Yvonne Zissiadis, Nigel A. Spry, Dennis R. Taaffe, Nicolas H. Hart, Daniel A. Galvão

Research outputs 2022 to 2026

Background:

Despite its therapeutic role during cancer treatment, exercise is not routinely integrated into care and implementation efforts are largely absent from the literature. The aim of this study was to evaluate a strategy to integrate the workflow of a co-located exercise clinic into routine care within a private oncology setting in two clinics in the metropolitan region of Western Australia.

Methods:

This prospective evaluation utilised a mixed methods approach to summarise lessons learned during the implementation of an integrated exercise workflow and supporting implementation plan. Data collection was informed by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. Reports …

The Resilience Vaccine, Sara Horton-Deutch T. Duffy

Master's Projects and Capstones

Healthcare workers have been working in unprecedented circumstances since the declaration of the COVID-19 pandemic. Caregivers have been taxed with burnout. A large healthcare organization’s 26-bed, medical-surgical, telemetry, COVID-19 overflow unit was significantly impacted. Many healthcare organizations have adopted advocacy for attaining joy in work as an extra dimension of the Institute for Health Improvement’s Triple Aim. Adding this fourth aim supports averting caregiver burnout (CBO) while promoting joy in work.

This quality improvement project examined nurse leaders’ interventions that address CBO, promote healthy work environments, and promote joy in work. From June through August 2021, an 8-week resilience program …

Implementation Of An Agitation Scale In Three Emergency Departments In An Urban Area Of Northern California, Adam Pelzl

Doctor of Nursing Practice (DNP) Projects

Background. Behavioral health patients in the emergency department are customarily treated without an objective assessment of agitation at presentation and throughout their hospital stay.

Local Problem. Behavioral health patients presenting with agitation in three emergency departments in Northern California are customarily treated with activation of a Code Grey emergency alert, use of physical restraints, or emergent sedation medication administration to manage the situation, prevent escalation, and protect the staff.

Context. Agitation in patients that is not recognized can lead to emergent sedation medication administration, physical restraints placed, and Code Greys activated to support the clinical staff.

Interventions. An evidenced-based agitation …

Nurse Practitioner-Led Care Pods: A Team Communication Enhancement Model, Miranda Saint-Louis, Miranda Saint Louis

Doctor of Nursing Practice (DNP) Projects

Background: Communication has become a key performance measure in the shift to value-based healthcare. Given the impact of communication failures on patient harm, length of stay, and dissatisfaction with care, new models of care with better communication through structured teamwork and interdisciplinary collaboration are needed.

Problem: In a 16-bed geriatric medical/surgical unit of a New York City multispecialty community hospital, the workflow structure unintentionally created inconsistent handoff communication, gaps in continuity of care, missed care events, and inattention to the patient’s priorities in the care plan. A gap analysis identified communication deficiencies that impacted team effectiveness and patient care …

Inpatient Observation Safety Assistant Practices, Jennifer Knight

Doctor of Nursing Practice Projects

Abstract

Introduction. Sitter usage is a patient safety practice used across healthcare organizations and the world. Sitters go by many other names, such as patient safety assistants, patient care assistants, care partners, and observation partners. There is literature that supports different variations of practices in healthcare facilities. A scoping review of the literature revealed multiple initiatives to reduce sitter cost and observation through nurse empowerment.

Purpose of Root Cause Analysis. The purpose of this root cause analysis is to determine why personnel inconsistently use the sitter policy. The appraised data will be used to improve the sitter process at this …

Improving Access To Reproductive Life Planning Following Implementation Of One Key Question® In Practice, Ashley Wittler

Doctor of Nursing Practice Projects

Abstract

Inadequate reproductive life planning (RLP) education is a widespread problem for women in the United States. This deficit leaves women without necessary guidance regarding contraceptive choices and maximizing pre-conception health. Use of RLP is endorsed by the American College of Obstetricians & Gynecologists (ACOG) and the Center for Disease Control (CDC). Lack of use of an RLP tool in a large, multi-site obstetrical and gynecological practice located in the Metro East is an issue that greatly impacts the patient population. The goal was to initiate the use of an evidence-based RLP tool, known as One Key Question®. The use …

Aidet And Commit To Sit Implementation In The Outpatient Surgical Setting, Olivia V. Meehan

Master's Projects and Capstones

Problem: This quality improvement project implements AIDET and commit to sit to improve communication and increase the patient satisfaction of an outpatient surgery microsystem. The microsystem’s patient satisfaction is assessed, and it is currently scoring below the reach goal of 85^th percentile. The detractors from their overall score mainly stem from the patient not feeling listened to, informed, or updated on the timeline. AIDET and commit to sit are ideal tools for addressing those deficits.

Context: The microsystem being addressed is an outpatient surgery unit that specialized in general surgery for the pediatric population. The pediatric population that the …

Improving Medication Administration Safety In A Correctional Facility With An Electronic Medication Administration System, Rosalinda Salazar

Master's Projects and Capstones

Problem: According to the World Health Organization (2020), medication errors are one of the leading causes of injury and avoidable harm in health care globally.

Context: The county jail houses approximately 700 inmates/patients on a daily basis, and the potential for error when administering medications is high as medications are prepared manually using a paper medication administration record.

Interventions: The jail began using an electronic health record/barcode administration system on October 19, 2020.

Measures: Unusual occurrence reports related to medication errors were reviewed. The time frame included 6 months before electronic implementation, and 6 months after implementation.

Results: Unusual occurrence …

Staff Perceptions On Organizational Change And Its Impact On Occupational Participation In Institutional Settings, Shelby Pearce, Susan Macdermott, Karen Park

Fall 2021 Virtual OTD Capstone Symposium

Background: Organizational change, primarily in institutional settings, is necessary to prevent institutionalization as well as to reach the goals of the organizations. To support these goals, institutional settings, such as correctional facilities, often use restrictive measures including occupational deprivation. As a profession, occupational therapy recognizes the importance of occupational participation for all persons in society, however there is a gap in knowledge on the importance of how to promote and/or educate other entities on successful change management in different institutional settings.

Purpose: The purpose of this study is to understand how organizational culture impacts occupational participation in institutional settings and …

Lung Cancer Screening: An Evidence-Based Practice Change Project, Robert Bland

Student Scholarly Projects

Practice Problem: Lung cancer is the leading cause of global cancer deaths and is a significant health issue in the US, claiming more than 155,000 lives each year. Lung cancer screening through low dose computed tomography (LDCT) can reduce lung cancer mortality by 20 percent but unfortunately, lung cancer screening is underutilized.

PICOT Question: The PICOT question that guided this project was: in a patient population eligible for LDCT lung screening (P), how does auditing of practice with feedback to the providers (I), compared to not doing the interventions as mentioned above (C), increase LDCT lung cancer screenings in the …

Ventilator-Associated Pneumonia Bundle Care, Jeemole Kattezham Binnichan

MSN Capstone Projects

Ventilator-associated pneumonia (VAP) is one of the most significant nosocomial infections in intensive care units (ICU) worldwide. Patients who have this infection due to lengthy hospital stays face excessive hospital expenditures and are forced to spend more time away from their families than is necessary. VAP is a prominent cause of morbidity and mortality in ICUs, prompting plenty of studies. The most crucial target is its prevention. Understanding how to reduce VAP would help patients live longer, have a better quality of life, and reduce hospital liability. Ventilator-associated pneumonia bundle (VAPB) has been shown in numerous studies to be an …

Implementing A Shared Governance Program, Mayra Elizondo

MSN Capstone Projects

Aim: To see the relationship between nursing satisfaction and patient safety outcomes through the implementation of a shared governance program.

Background: The adoption of shared governance in hospitals across the country would enable more nurses to have more resources, more autonomy in their practice, and thus higher satisfaction in their work environments which would improve patient outcomes.

Implications for future research, clinical practice and policy development: The following paper summarizes that shared governance programs increase the amount of satisfied nurses and improve patient outcomes. Further research is needed to develop effective guides for implementation of shared governance in healthcare facilities …

Bridging Mental Healthcare, Kristin L. White

MSN Capstone Projects

Nurses have an important role in the care given to mental health patients presenting to the emergency department (ED). Without expectations or encouragement toward growth or continued education, the quality of care and the therapeutic ability for care are crippled, as evidenced by nurses' knowledge/competency deficits and negative attitudes. Through ongoing/continued education, the cultivation of a therapeutic culture toward patients that present to the ED for mental health complaints could result. Additionally, these improvements in care, in turn, could promote not only the closure of gaps that exist for quality mental healthcare but may also lead to an increase in …

Impact Of Nurse Residencies On A Graduate Nurse’S First Year, Melinda R. Fox

MSN Capstone Projects

The purpose of this presentation is to highlight the importance of the graduate nurses first year in their clinical role and highlight the positive impact of nurse residency programs. The target audience for this presentation includes, but is not limited to, the University of Texas at Tyler students and professors enrolled in NURS 5382: Capstone. The observers of this presentation will be able to describe the rationale behind the importance of Nurse Residency Programs, discuss the current literature recommendations, and understand the overview of the change process proposed.

Reducing Surgical Site Infections Through Combination Skin Preparation: A Benchmark Study, Jennifer Schacherer

MSN Capstone Projects

Reducing surgical site infections allows for a tremendous reduction in healthcare costs, reduces length of hospital stay, decreases hospital readmissions, and promotes patient safety. The Centers for Disease Control and Prevention estimates that surgical site infections have a 3% mortality rate and 75% of all surgical site infection-related deaths are directly attributable to the surgical site infection (Centers for Disease Control and Prevention [CDC], 2020). With millions of surgeries being performed every year, the reduction of surgical site infections enhances patient safety and ensures the protection of the public. Currently, no standard protocol exists for skin preparation beyond the parameters …

Transforming Prescription Opioid Practices In Primary Care With Change Theory, Rob E. Carpenter, Dave Silberman, Jody Takemoto

Human Resource Development Faculty Publications and Presentations

The opioid epidemic continues to be an ongoing public health crisis. Many primary health care providers aptly serve as the gate keeper to opioid prescriptions. The opioid epidemic has challenged the primary care profession whilst many of these providers have opted out of opioid prescribing altogether. This unintended consequence affirms erosion to primary care that is vital to the ecosystem of opioid management. The purpose of this study was to understand strategies to deliver opioids safely and effectively. Results indicate primary care providers are uniquely positioned to make a positive opioid impact through focused change initiatives. Five common themes arose …

The Relationship Of Hospital Ceo Gender And The Patient Experience: The Role Of The Mediating Effects Of Hospital Characteristics, Lanean M. Lang

Electronic Theses and Dissertations

In this quantitative study, I investigated CEO gender and the patient experience in acute care hospitals in Texas for 2019. As the patient-experience has been the metric for quality patient care and hospital reimbursements, hospital CEOs play an important role in promoting positive patient experience as they lead the organization in strategic goals. The study is relevant as a shortage of experienced and qualified healthcare leaders is expected as baby-boomers retire. The lack of women leaders remains a challenging issue. The purpose of the study was to assess the gender differences of the CEO on the impact of patient experience …

Quality Improvement Project: Communication Guidance During And Following Maternal Hemorrhage, Kathleen Giramur

Doctor of Nursing Practice

Background. Maternal hemorrhage is a significant cause of worsening maternal morbidity and mortality in the United States. If timely, effective, and compassionate communication is not provided during and following traumatic birth events, negative mental health problems may result that affect maternal well-being, bonding with the baby, and family relationships. A gap analysis carried out at the clinical site showed that a written, evidence-based guidance on communication with patients and families during and after a maternal hemorrhage event was needed. Compliance through documentation is required by the Joint Commission. Trauma-Informed Care is an evidence-based communication approach that incorporates principles of safety, …

Strategies To Prevent Hospital Acquired Pressure Injuries In The Intensive Care Unit, Theresa Ann Pomerleau

Doctor of Nursing Practice

Background. Despite prevention strategies, hospital acquired pressure injuries continue to occur, especially in intensive care units. This led to an impetus for nurses to have a robust knowledge of pressure injuries to promulgate prevention strategies in their practice. Significance of the Problem. The hospital acquired pressure injury rate in the medical surgical intensive care unit for the year 2019 at Hospital X was greater than the national benchmark. Purpose. The global aim statement was to improve the quality of patient care by developing an evidence based educational suite in collaboration with interdisciplinary team members for prevention of hospital acquired pressure …

The Emergence Of A Texas Collaboration To Improve Well-Being In Learning Health Systems, Toi B Harris, Anil Nanda, Lilit A Sargsyan, Wei-Jung A Chen, Jennifer G Christner

Faculty, Staff and Students Publications

Prior models of well-being have focused on resolving issues at different levels within a single institution. Changes over time in medicine have resulted in massive turnover and reduced clinical hours that portray a deficit-oriented system. As developments to improve purpose and professional satisfaction emerge, the Texas Medical Association Committee on Physician Health and Wellness (PHW) is committed to providing the vehicle for a statewide collaboration and illuminating the path forward.To describe the existing health and wellness resources in Texas academic medical centers and understand the gaps in resources and strategies for addressing the health and wellness needs in the medical …

College Students’ Well-Being During The Covid-19 Pandemic: A Systematic Review Of The Literature, Michaela Q. Iglesia, Ming-Tsan Lu

School of Medicine Publications

Studies have shown increased levels of distress during the coronavirus disease-19 (COVID-19) pandemic, and college students are becoming more recognized as a vulnerable population. This narrative systematic review aims to synthesize the current understanding of mental health, lifestyle, and socioeconomic impacts that the pandemic had on college students in the United States. A search was conducted on PubMed, PsycInfo, and Web of Science. A total of 34 observational studies were included which examined aspects of college students’ health and experiences during the COVID-19 pandemic in the United States. A great deal of students was shown to experience a moderate level …