Digital Commons Network^™

Chronic Disease Screening And Detection In Vulnerable Populations, Courtney J. Seman, Hussein Hadid, Tania Jaimes, Robert Walls

Master's Projects and Capstones

This quality improvement project aims to address gaps in chronic disease screening by implementing standardized protocols for diabetes, hypertension, vision impairment, and scoliosis within the University of San Francisco (USF) Nurse-Led Clinic in Orange County. Problem: The clinic identified a lack of screening practices, which limited early detection and intervention for two specific vulnerable populations. Context: The clinic serves two high-risk groups: older adults, including formerly homeless individuals, and children in two local grade schools. These populations face significant healthcare disparities, making early detection of chronic conditions critical. Interventions: Guided by Kotter’s Change Theory, the project developed and implemented evidence-based …

Supporting Well-Being For The Home Visiting Workforce: Organizational Supports For Experiences Of Bias & Discrimination, Beth L. Green, Nicole M. Lauzus, Yumi Lee, Ron Joseph, Erin Gaines, Center For Improvement Of Child And Family Services

School of Social Work Faculty Publications and Presentations

This learning brief is the third in a series to share findings from a 2023 statewide survey of over 700 members of Oregon’s home visiting workforce. This study has provided a wealth of information about Oregon’s home visiting workforce and what could be done to improve and support worker well-being and retention, with a focus on the needs and experiences of home visitors of color and those who speak languages other than English.

Little research has examined the extent to which home visitors experience racism or discrimination on the job, how this may impact their professional and personal well-being, and …

Best Practice Toolkit For Increasing Colorectal Cancer Screenings In At-Risk Adults, Zoe Windfelder

Student Scholarly Projects

Adult individuals at risk for colorectal cancer (CRC) do not have a direct, accessible best-practice toolkit to follow for screening measures. Research showed that at least three guidelines (i.e., American Cancer Society [ACS], American College of Gastroenterology [ACG], and U.S. Preventive Services Task Forces [USPSTF]) are used interchangeably daily by interprofessional staff for individuals with average to high-risk variables. The project was guided by the following PICOT question: For interprofessional staff supporting the at-risk adult population for colorectal cancer (P), how does the development of a best practice for coordination of care toolkit (I) compared to no structured program strategy …

Attachment Styles As Moderators Of Loneliness In Remote Work, Brody Tj Loughlin

Doctoral Dissertations

This dissertation investigates the role of attachment styles in moderating the relationship between remote work and loneliness. Drawing on attachment theory, which posits that early life experiences shape attachment styles and influence social interactions, the study examines whether attachment styles (anxious, avoidant, and secure) moderate the association between remote work and feelings of loneliness. The research targets 394 remote workers, using a quantitative, cross-sectional survey design with proportional stratified sampling to reflect the distribution of hybrid and fully remote work arrangements in the U.S. workforce. The Extent of RemoteWork measure, the Three-Item Loneliness Scale, and the Adult Attachment Scale assess …

Examining Assessment Tools To Predict Burnout Among Healthcare Practitioners And Students, Robin Hilliard Albertson, Lindsay Gietzen

Pacific Journal of Health

The U.S. health system is stretched thin by pressures to expand service delivery and improve outcomes while reducing costs. This pressure is intensified by global health crises and other factors, resulting in further reductions in the healthcare workforce due to burnout. The strain leaves healthcare practitioners at risk of experiencing negative consequences of burnout, even death [1]. This study explored the correlations between three validated assessment tools to determine if early signs of burnout in healthcare practitioners and students can be identified succinctly, thus expanding the current body of evidence on the strengths of environments supporting career retention and healthcare …

Improving Patient Awareness And Compliance With Telephone Follow-Up Calls Post Visit, Ajibola Kutti

Student Scholarly Projects

Practice Problem: In a high-volume clinic without current follow up practices post visit, a telephone follow-up (TFU) intervention was implemented within three days of patient outpatient appointments.

PICOT: The PICOT question that guided this project was: In adult patients in a high-volume clinic (P), does the implementation of telephone follow-up calls by nurses (I) compared to current practices (C) improve patient compliance and post-office follow-up visits (O) over 10-weeks (T)?

Evidence: The literature provided recommendations and evidence that supported the effectiveness of following up with patients within three days of leaving the healthcare clinic. TFU’s are a cost-effective intervention that …

Transitions Of Care And The Prevention Of Readmissions, Beatriz Granado

Student Scholarly Projects

Unplanned hospital readmissions often result from poor discharge planning and challenges during the transition from hospital to home, including medication errors and weak communication with primary care providers. A well-organized and personalized discharge plan can significantly reduce hospital stays, lower readmission rates, minimize medication errors, and improve patient outcomes, all while decreasing healthcare costs. In post-discharge Medicare-eligible patients (P), how does transitional care coordination through organized, personalized, and patient-focused discharge planning (I), compared with standard or no transitional care coordination provided (C), affect readmissions (O) within the 30-day post-discharge phase monitored over a 10–12-week period (T)? A search was conducted …

Exploring Negotiated Autonomy In The Physician–Physician Assistant Collaborative Dyad, Stephen Robie

Doctor of Philosophy in Translational Health Sciences Dissertations

Physician Assistants (PAs) are integral members of multidisciplinary medical care teams who practice medicine legally under the supervision of physicians. During medical care, supervision is a dynamic process of collaboration wherein a PA who displays competence is granted increasing independence by the supervising physician. This process has been referred to as negotiated autonomy. Despite being noted in work-force literature, the mechanics of how negotiated autonomy operates in real-time have not been described. As organizations increasingly work to integrate PAs into practice, new-hire training programs called ‘on-boarding’ have been implemented to accelerate PA professional development with a goal of increased efficiency …

Primary Care In The University Setting After Covid-19: A Multiple Case Study Of Student Health Services In Oregon, D. Chad Johnson

Dissertations and Theses

In 2020, the COVID-19 pandemic disrupted operations across the settings of primary care and higher education institutions (HEI). HEIs faced sudden decreases in revenue because of reduced enrollments and external pressures to rapidly adapt delivery methods to accommodate the inability to provide in-person classes. Similarly, most primary care settings experienced major reductions to in-person visits and fee-for-service revenues. Student health services (SHS) exist within both primary care and higher education settings and are a unique and poorly understood aspect of primary care. This research set out to explore this under-studied primary care setting by answering the question: "How has COVID-19 …

Well-Being Behaviors And Outcomes In Arkansas Teachers: A Qualitative Analysis Of Teachers In Arkansas During The Covid-19 Pandemic, Ashton Elizabeth Human

Graduate Theses and Dissertations

Introduction: The COVID-19 pandemic introduced new challenges to teachers and emphasized those already existing in the education system. The increased reliance upon technology and lack of administrative support perceived during distance learning led to lower levels of commitment to teaching and increased levels of teacher burnout. Burnout risk is associated with an increased workload, exhaustion from job demands, cynicism toward the professional community and has been shown to have a negative relationship with well-being. Teachers experiencing burnout are unable to establish positive relationships with students, understand students’ needs, stay in contact with trends in the education field, or provide pedagogically …

Trilogies: Lessons From 50 Years Facilitating Community-Based Health Assessments And Planning In Appalachia, Bruce Behringer

Journal of Appalachian Health

Involvement of community and organizational groups is fundamental to most public ventures. Most social, health, economic, and educational improvements in Appalachia have been characterized by successfully integrating community input and finding ways to encourage organizational change and collaboration.

Managing group process and related facilitation skills are fundamental competencies for public health professionals and others guiding change efforts. Groups from communities and organizations can get stalled in their deliberations; a facilitator frequently must think quickly to diagnose the situation and propose alternative approaches. Creative and flexible approaches, learned through practice experiences, can blend with theories and frameworks learned in academic preparation …

Refining Successful Implementation Strategies For The Surgical Safety Checklist In High-Income Contexts: Results Of An International Mixed Methods Study, Meagan E. Elam, Christopher J. Louis, Jonathan Woodson, Nathan Turley, Denisa Urban, Mary E. Brindle, Jacey A. Greece

Patient Experience Journal

The WHO Surgical Safety Checklist (SSC) continues to show inconsistent success in reducing surgical complications in high-income settings. Previous implementation research identified potential barriers and facilitators to success, but it primarily consists of qualitative studies with small sample sizes in limited geographic areas. We conducted a multi-country mixed-methods study of barriers and facilitators to SSC implementation to better inform policies and practices for improving SSC buy-in and use to maximize its impact. This convergent parallel mixed-methods study utilized survey and interview data from surgical team members practicing in five countries. Survey data were analyzed using χ² analysis or Fisher’s …

Spatial-Temporal Variation Of Diarrhea And Associated Sociobehavioral Factors Between 2010-2020 In Rwanda, Amans Ntakarutimana

Walden Dissertations and Doctoral Studies

No abstract provided.

How Covid-19 Changed Us: Compassion, Leadership, And Policy, The Lincy Institute

Lincy Institute Events

Nevada was one of the hardest hit states during the COVID-19 pandemic. Over the past three years, researchers at The Lincy Institute and other institutions collected interviews from 80 Nevada leaders across sectors including elected officials, leaders in education, community organizations, government agencies, and the business community. Four years after the onset of the COVID-19 pandemic, our communities continue to build a resilient and healthy Nevada. This forum discusses how the crisis prompted us to rethink how we lead and how we can prepare for future challenges. Following a presentation of the project and its deliverables, leaders across sectors discuss …

Efficiency In Hr: Lean Management With E-Sep And Auto Closing System In Pasar Minggu Hospital, Melanie Husna, Prima Syahputra

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The study focuses on enhancing efficiency in outpatient transactions at Pasar Minggu Hospital, which, in 2019, experienced a high volume of visits primarily covered by national health insurance. With 299,041 outpatient visits using national health insurance that year, the hospital's transition to a COVID-19 referral facility in 2020 underscored the urgency of streamlining operations. Presently, outpatient transactions are manually closed by three staff members, led by the financial administrator, who handles Participant Eligibility Letter files, resolves transaction issues, and finalizes services. Given the imperative for digitization accelerated by the pandemic, the study adopts lean thinking, employing a value stream map …

The Influence Of The Green Hospital Implementation Policy On The Energy Saving Behavior Of Xyz Hospital Employees Using The Theory Of Planned Behavior Approach, Dika Asmawati, Wiku Bakti Bawono Adisasmito, Masyitoh Basabih

Journal of Indonesian Health Policy and Administration

This research uses the Theory of Planned Behavior as the theoretical framework to analyze the relationship between the implementation of green hospital policy and energy-saving behaviors of employees in the hospital environment. The study's sample consists of 150 permanent employees, and the statistical data are analyzed using the Structural Equation ModelingPartial Least Square (SEM-PLS) technique. The analysis results indicate that implementing the green hospital policy influences the supportive factors of behavior: attitudes, subjective norms, and perceived behavioral control. However, the tests also reveal that subjective norms do not positively correlate with the energy-saving behaviors of employees at the hospital. The …

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

Étude De La Gestion De La Crise Sanitaire Liée À La Covid-19 Pour Soutenir La Transition Vers De Nouvelles Organisations Du Travail Dans Le Secteur De L’Administration Publique, Bénédicte Calvet, Martin Chadoin, Maud Gonella, Élise Ledoux, Denys Denis, Isabelle Berger

Rapports de recherche scientifique

La pandémie de la COVID-19 a surpris la population générale et a largement touché les milieux de travail qui ont dû se réorganiser. De nombreuses personnes se sont retrouvées en situation de télétravail imposé alors que d’autres, les travailleurs et travailleuses dits « essentiels » ont dû se conformer à de nombreuses restrictions sanitaires sur leur lieu de travail. Face à l’urgence, plusieurs guides et outils ont été diffusés auprès des entreprises de plusieurs secteurs d’activité économique, afin de les soutenir dans la mise en place de mesures en santé et en sécurité du travail (SST) conformes au contexte pandémique, …

Improving Black Maternal Outcomes In Christian County, Ky: A Social Marketing Approach To Perinatal Provider Change, Ariel A. Arthur

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Compared to other states in the country, Kentucky has historically poor population health outcomes. While the statewide maternal mortality rate is 16.1 per 100,000 live births, this statistic belies the stark racial disparities that exist. In 2018, the pregnancy-related death rate for Black women was 40.2 per 100,000 live births compared to 13.1 for White women. This pattern is persistent even after controlling for socioeconomic status, prenatal care, and other protective factors. Research shows that institutional and interpersonal racism when receiving obstetric care contributes to poor childbirth and postpartum outcomes for Black women. Additionally, geography and rural status may compound …

Answering The “Now What?”: The Development Of A Transdisciplinary Breast Cancer Survivorship Nonprofit Organization, Vir-Iaesta Maniquiz Vergel De Dios

CGU Theses & Dissertations

Although patients are living longer or are surviving breast cancer, the side effects of treatment still leave patients struggling with quality-of-life issues. The lack of whole-person care leaves patients unequipped after treatment is complete, searching for answers and a way to survive on their own. The unintended consequence becomes a dramatic shift from the weekly/daily medical appointments during active treatment to a silence that can be daunting for many to navigate. Living Your Truth Empowered, shortened to LYTE Foundation, is an antiauthoritarian minded and anti-hierarchal nonprofit created to address the needs of the growing breast cancer survivor population. LYTE is …

Enhancing Safety Surveillance During Clinical Trials: The Development Of A Safety Data Review Handbook To Support Pharmacovigilance Clinicians, Lauren Wilson

DNP Scholarly Projects

Abstract

BACKGROUND: Pharmacovigilance (PV) Sciences include activities related to safety surveillance of pharmaceutical products, and is critical for developing safe and effective medications, vaccines and medical devices. Safety monitoring starts with preclinical research and continues through clinical trial and post marketing phases. PV scientists ensure patient safety during clinical trials through regular review and analysis of safety data. Regulations have become increasingly complex, leading to inadequately defined methods for reviewing large clinical trial safety datasets. Inconsistent safety data review (SDR) practices can result in delayed detection of adverse drug reactions (ADRs) or safety signals.

METHODS: This quality improvement project used …

Home Blood Pressure Monitoring Bundle For Hypertension Outcomes In Adult Patients Receiving Care In Public Health Clinics, Christine Jennifer Victorian

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Hypertension (HTN) that is not adequately controlled leads to cardiovascular disease, stroke, and heart disease. It affects 116 million adults (47%) in the United States (U.S.). The HTN compliance rate in a South Texas public health clinic was 64%, below the national benchmark of 76%. Home blood pressure monitoring (HBPM) was recommended in a joint statement by the American Heart Association (AHA) and the American Medical Association (AMA). Literature evidence revealed that the HBPM bundle increased BP control (< 140/90 mmHg) compliance.

Methods: A quality improvement (QI) bundle was initiated to address the low HTN compliance rate from a quality management perspective. …

Clinical Practice Guideline For The Management Of Depression In Primary Care, Estrella Catherine Villarreal

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: The prevalence of depression poses a significant challenge in primary care, emphasizing the urgent need to address this issue during patient visits. Primary care providers are at the forefront of managing depression, yet they encounter difficulties in screening, diagnosing, assessing, and treating this complex condition. Clinical guidelines serve as valuable tools for primary care providers and practices, offering support in identifying and addressing depression effectively. An evidence-based approach to treating depression in primary care, with a focus on collaborative interventions with behavioral health to enhance depression management for American Indian/Alaskan Native (AI/AN) communities.

Methods: The descriptive analysis was conducted …

Work Characteristics, Workplace Support, And Mental Ill-Health In A Canadian Cohort Of Healthcare Workers During The Covid-19 Pandemic, Nicola Cherry, Anil Adisesh, Igor Burstyn, Quentin Durand-Moreau, Jean-Michel Galarneau, France Labrèche, Shannon Ruzycki, Tanis Zadunayski

Études primaires

Objective The aim of the study was to identify determinants of mental health in healthcare workers (HCW) during the COVID-19 pandemic. Methods A cohort of Canadian HCW completed four questionnaires giving details of work with patients, ratings of workplace supports, a mental health questionnaire, and substance use. Principal components were extracted from 23 rating scales. Risk factors were examined by Poisson regression. Results A total of 4854 (97.8%) of 4964 participants completed ratings and mental health questionnaires. Healthcare workers working with patients with COVID-19 had high anxiety and depression scores. One of three extracted components, 'poor support,' was related to …

The Anatomy Of Physician Fulfillment: Strategies Beyond Burnout, Brook Hale

Antioch University Dissertations & Theses

The persistent tension and power struggle between healthcare executives and physicians is a prevalent issue in healthcare organizations, often leading to a culture of organizational mistrust. This dynamic stems from perceived conflicting goals: executives are frequently seen as primarily focused on financial outcomes, while physicians are viewed as resistant to change. This study explored how physician fulfillment is experienced at work, with the ultimate goal of identifying potential interventions to bridge the gap between these groups. There is vast research and literature available regarding burnout in healthcare; this research focused on understanding what physicians find fulfilling in their work and …

Wellness Review 2023, Part 1, Brian A. Ferguson, Martin Huecker

Journal of Wellness

Introduction: The 2023 Part 1 summary reviews research on wellness in healthcare professionals published outside of JWellness from January 1, 2023 to June 30, 2023.

Methods: Editors conducted a Boolean search of titles and abstracts in PubMed utilizing keyword identifiers pairing healthcare personnel (providers, nurses, and other staff) with a well-being metric. Of 416 relevant articles, an intriguing and innovative 30 were selected for inclusion, with two additional articles manually curated.

Literature in Review: This sample of the recent literature into healthcare professional wellness included multiple targeted interventions and studies of resilience. Main themes that emerged include: positive systematic healthcare …

Organizational Change In Saudi Healthcare Settings: Evaluating Organizational And Individual Readiness For Change, And The Mediating Role Of Readiness For Change Between Management Support And Commitment To Change., Sultan Alsaif

Electronic Theses and Dissertations

BACKGROUND: To respond to the constantly changing environment and developments of healthcare, leaders of healthcare organizations have been trying to introduce and implement transformations that allow their organizations to be able to operate effectively and efficiently to meet the shifts in healthcare demand and to deal with new patterns of health issues, comply with the new policies, and to enhance their present in the market. Thus, it is important for managers to determine the level of readiness for implementing organizational changes from to perspectives. These perspectives include organizational readiness for change and individual readiness for change. METHOD: This first manuscript …

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.

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 …