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Enhanced Recovery After Surgery: Necessity Of Real Time Tracking In Quality Measures And Outcomes, Emily Owens

Master's Projects and Capstones

Abstract

A High Reliability Organization (HRO), such as this Northern California Medical Center, holds itself to high standards of performance in the areas of recognition, ranking, and accreditation. The commonality between these high-scored and valuable acknowledgements is the pillars of Quality Outcomes. As benchmarking and reporting allow this facility to measure outcomes against self and other plans, it greatly strengthens the internal focus for continual improvement and goal setting in direct patient care and outcomes. A deeper layer of the Quality Department includes the bundle “ERAS – Enhanced Recovery After Surgery”, which is compiled of principles aiming to minimize opioid …

Reducing Maternal Falls On A Postpartum Unit Through Staff Education, Kathleen Benjamin

Master's Projects and Capstones

There have been 23 documented falls on the maternity unit at Hospital A over the past three years. This fall rate is above the national average, making the reduction of falls on the postpartum unit a priority to maintain the hospital’s Magnet status and improve patient safety. Data analysis related to contributing factors of falls and staff education on best ambulation practices has the potential to decrease the number of maternal falls on the targeted microsystem population of the postpartum unit. This quality improvement project conducted a fall audit on each documented fall case, performed an environmental survey of the …

Evidence Based Repositioning Strategies To Improve Pressure Injury Rates, Ivan E. Dorsey

Master's Projects and Capstones

Pressure injuries (PI) affect approximately 1-3 million people in the United States annually, and amount to 3-11 billion dollars in yearly healthcare costs (Mondragon et al., 2021; Padula & Delarmente, 2019). In veterans who seek care, especially the elderly (>65 y/o), pressure injuries are particularly devastating because they increase hospital costs and lengthen stays (Stroupe et al., 2011). In light of these statistics, the aim of this project was to decrease PI rates in veteran patients through the implementation of evidence-based practice. This project was conducted on a medical/surgical telemetry unit with 18 beds at a Northern California hospital …

Reducing Hospital Readmission Rate In Chf Patients Through Early Individualized Patient Discharge Education, Anthony Ensah

Master's Projects and Capstones

The term congestive heart failure (CHF) is a chronic condition that occurs in a person when the heart stops doing its normal activity of pumping blood to the rest of the body for the body. Heart failure normally occurs when the heart can no longer pump (systolic) or fills (diastolic) pressure adequately to the body. Because heart failure is one of the leading causes of death in the United States this project was conducted on one of the Northern California San Francisco Bay- Area hospitals to assess patients understanding and knowledge on the presenting signs and symptoms of heart failure …

Discharge Nurse Role Implementation: Improving Discharge Timeliness And Patient Outcomes, Diamond Faith Chu

Master's Projects and Capstones

Problem: The Discharge Nurse (DN) Role Implementation project aims to reduce the delay in the discharge process and patient length-of-stay. With the current microsystem discharge process, there are observed barriers to timely discharge related to various discharge tasks and interdisciplinary communication methods.

Context: This project was implemented in a metropolitan hospital within Northern California, on a unit that serves medical-surgical, oncology, and geriatric patients. There are 35 registered nurses (RN’s), eight certified nursing assistants, one charge manager, one assistant charge manager, one clinical nurse leader, and four clinical nurse specialists (oncology).

Interventions: The intended aim of this project is to …

Improving Medical-Surgical Nurses’ Confidence In Initiating The Code Blue Process, Moung Sui A. Lee

Master's Projects and Capstones

Lack of confidence in responding to codes can decrease patient outcomes, for any delay in care reduces the chances of revival. As codes occur less frequently in medical-surgical units, nurses who work in this specialty are not as equipped to respond to codes like their ICU or ER colleagues. To address this concern, a code blue readiness training was implemented in six different medical-surgical units of an East Bay hospital. Pre and post surveys were utilized for data comparison on nurses’ confidence in responding to various steps of a code. The results revealed an overall increase in confidence. For this …

Establishing Quiet Hours In Long-Term Care: A Quality Improvement Project, Heather Battaglia

Master's Projects and Capstones

Problem: Sleep disturbances in long-term care residents are associated with falls, behavioral problems, and increased mortality rates, yet long-term care facilities are traditionally noisy environments at night. Designated quiet hours have been shown to improve patient sleep as well as decrease stress levels in nurses.

Context: In a skilled nursing facility that provides care for military veterans with complex medical and psychosocial needs, signage exists that indicates to be quiet between 10:00 p.m. and 7:00 a.m., but no defined guidelines were available for staff to observe.

Interventions: Standards for quiet hours were established and posted throughout the microsystem. Lecture-style teaching …

Joint Management Of Upland & Aquatic Habitat For The California Red-Legged Frog & California Tiger Salamander, Kyle E. Verblaauw

Master's Projects and Capstones

As federally and state protected amphibians, the California tiger salamander (Ambystoma californiense) and the California red-legged frog (Rana draytonii) are recipients of ample management focus. Both species face a variety of threats, including habitat loss and alteration, introduction of non-native species, spread of disease, and effects of climate change. While management plans for the California tiger salamander and California red-legged frog exist, they frequently do not consider both species in tandem and often contain multiple shortcomings. This document aims to address the shortfalls of current management by providing practical recommendations for jointly managing the upland and …

Motivating Poetry In The Adult Esl Classroom, Lenore Marin Myers

Master's Projects and Capstones

Current research into motivation in second language acquisition, including Dörnyei (2005, 2009, 2015), offers compelling evidence that adult language learners who develop and habitually strengthen a vision of their future, linguistically capable selves using concrete, sensory imagery are more likely to sustain the necessary motivation to achieve their personal language-learning goals. My thesis proposes that poetry writing can be an effective medium for language learners to build facility in developing concrete, sensory imagery (tactile, visual, kinesthetic, olfactory, and auditory), including creating a motivating vision of their future, linguistically capable selves. Because poetry can directly support and build learner motivation, it …

Mindfulness In Early Childhood Education, Madalyn L. Coss

Honors Projects

The following work identifies the need for mindfulness in early childhood education. It explains what mindfulness is, what the benefits of it are, and how it can be used in early childhood classrooms. A podcast episode is included with the intent of it being used to inform educators on the subject.

Perceived Exercise Habits Of Individuals With Parkinson’S Disease Living In The Community, Jordana Lockwich, Kate Schwartzkopf-Phifer, Camille L. Skubik-Peplaski, Richard D. Andreatta, Patrick H. Kitzman

Communication Sciences and Disorders Faculty Publications

Context

Exercise has been shown to improve gait in individuals with Parkinson’s disease (PD). Stepping practice at higher intensity levels has been suggested as a beneficial treatment option to improve gait in the neurological population. Unfortunately, this mode is poorly understood and underutilized within the PD population. Information on what individuals with PD are doing for exercise would be beneficial to help tailor exercise programs to improve gait and provide exercise options in the community for intensity-based exercise.

Objective

To investigate the current exercise habits of individuals living with PD in the community aimed at improving walking and to understand …

Building A New Model Of Church-State Collaboration On Environmental Care In Ghana Based On Catholic Social Teaching And African Theological Traditions, Emmanuel Abbey-Quaye

Electronic Theses and Dissertations

Abstract

The care of the environment has always been considered by the Ghana Catholic Church as an important aspect of her pastoral care and evangelizing mission in Ghana. Hence, in their various teachings in communiqués and other pastoral documents from 1965 till now, the Ghana Catholic Bishops’ Conference has consistently addressed the major environmental challenges confronting Ghana such as deforestation, mining, pollution, etc., applying the principles of stewardship and care of creation, intergenerational solidarity, integral ecology, etc., to ground these teachings.

Besides, in acknowledging that neither the Catholic Church nor the Ghanaian Government alone can resolve the various ecological crises …

Heavenly Clothing Liturgically Worn: The Clothing Metaphor In The Book Of Revelation As Exegetically Performed In The Byzantine Liturgical Rite, Elias Issa

Electronic Theses and Dissertations

Problem

The subject of these hermeneutical and performative approaches to the biblical texts and the liturgical dimensions and metaphors in the Book of Revelation are of particular interest to this dissertation, whose ultimate goal is to ask how the Byzantine rites, as practiced in the Orthodox Church, actualize the liturgical dimensions of the Book of the Revelation. The question will focus on a case study of the clothing metaphor as used in Revelation and related apocalyptic texts.

Method

The question of this dissertation is framed within this context of the liturgical performative exegesis. The question will be approached in its …

Understanding Snow Leopard (Panthera Uncia) Population Structure, Diet, And Human-Wildlife Dimensions Using Noninvasive Genetic Approaches, Charlotte Hacker

Electronic Theses and Dissertations

Snow leopards (Panthera uncia) are a large cat endemic to the mountains of Central Asia. Despite their status as a flagship species, there are numerous knowledge gaps surrounding their population status, dietary ecology, and relationship with humans. Such knowledge gaps are prohibitive for effective conservation action for the species. Snow leopards are threatened by habitat loss, decreased prey availability, retaliatory killings, and large-scale negative impacts associated with climate change. In order to help bridge these gaps, noninvasive genetic methodologies were deployed in this work across several disciplines. Population genetic metrics were garnered at local, regional, and range-wide scales, …

2021-12-17_Michiganoverview_Covidsymptoms, Michigan Department Of Health & Human Services

Michigan COVID-19 Syndromic Surveillance System Data

The Syndromic Surveillance System Data report was obtained from Michigan's COVID-19 dashboard, from under the link "​Coronavirus Symptoms": https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated three times a week on Mondays, Wednesdays and Fridays.

Syndromic Surveillance System data is obtained from approximately 216 facilities participating in syndromic surveillance (139 Emergency Departments (ED), 77 Urgent Care) across the State of Michigan. The reporting is based on individuals who present at EDs and may not be representative of the overall population. The coronavirus-like symptoms query searches visit free-text (chief complaint, …

November / December 2021, Lisa Friesen

The CETL Correspondent

CETL will be launching Blackboard Ally...

Dr. Mapopa Sanga, CETL Teaching and Learning Coordinator, will be leading the faculty/staff training over the new quizzing tool in Canvas.

LinkedIn Learning offers many training videos for faculty, staff, and students.

Fouad Elected To Prestigious National Dentistry Advisory Council, Staff

Browse All News

No abstract provided.

3t3-L1 Adipocytes As A Model Of Glut4 Translocation, Aline Collin

Chemistry and Biochemistry

Type 2 diabetes (T2D), a lethal disease, reveals an alarming increase of epidemic proportions and, by 2050, an estimated 1 in 3 adults in the US will suffer from it. Persistent and systemic inflammatory and oxidative stress in adipose tissue and skeletal muscle are recognized as key players in the progression of T2D. T2D is characterized by insulin resistance, the inability of cells to respond to standard circulating levels of insulin, resulting in hyperglycemia. In adipocytes and skeletal muscle, glucose uptake, a vital step in blood glucose regulation, predominantly occurs via the glucose transporter 4 (Glut4) in an insulindependent recruitment …

Age Related Dementias, Shahab Soltani

Chemistry and Biochemistry

During the last few decades, the average life expectancy has dramatically increased in the U.S.A. and globally. As a result, the diseases associated with age, such as dementia, significantly impact families, society, and government. Dementia is a broad term describing memory loss, cognitive dysfunctions, and limited social skills caused by many factors such as aging, stroke, and genetic background. Although the primary etiology remains unclear but inflammatory reactions, neurodegeneration, vascular abnormalities play an important role in the progression of these disorders. Therefore, treatment is mainly supportive to relieve the symptoms of dementia and not to cure dementia or slow down …

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 …

Preparing Nurses In Management Positions For Bedside Care During Times Of Crisis, Trevor Murray

Doctor of Nursing Practice (DNP) Projects

Background

The purpose of this quality improvement project was to increase perceived self-efficacy in performing bedside skills among nurse leaders. As the demand for nurses increased, these leaders anticipated a direct role in providing patient care in the event of a patient surge due to COVID-19.

Problem

Due to the COVID-19 pandemic and Delta variant, hospital nursing leaders were and still are concerned with the challenge of providing enough competent nurses to deliver care. The DNP project prepared nurses who work in leadership roles to take or assist in taking a patient assignment.

Methods

Nurse leaders attended a skills lab …

Designing And Implementing A De-Escalation Toolkit To Improve Staff Education And Competency On De-Escalation Within A Mental Health Outpatient Setting, Balraj Bajwa

Doctor of Nursing Practice (DNP) Projects

Background: The purpose of this study is to develop and implement a de-escalation toolkit to help improve memory, retention, and utility of de-escalation techniques within an outpatient mental health crisis stabilization unit.

Problem: The aforementioned crisis stabilization unit has elevated rates of patient aggression/violence and staff present with difficulty recalling de-escalation techniques due to the lapse in memory and/or retention.

Methods: The project was introduced to the stakeholders of the crisis stabilization unit and input was obtained on the design and components of the toolkit. Various analyses were conducted to ensure the appropriate implementation of the project.

Intervention: A de-escalation …

Implementation Of An Acute Care For The Elderly (Ace) Unit In A Community Hospital, Kimberly A. Colonnelli

Doctor of Nursing Practice (DNP) Projects

Background: “Baby boomers” (born between 1946 and 1964) represent 15% of the total population of the United States (Population Reference Bureau, 2019), but 50% of its total healthcare expenses (Mattison, 2021). Growth of this population will have a corresponding rise in demand on healthcare resources. Replication of a geriatric inpatient care model (Palmer et al., 1994) was introduced in a large geographically and ethnically diverse integrated care delivery system.

Problem: The demographic for this small community hospital located in Northern California has a larger percentage of patients over the age of 65 compared to other facilities within this …

Implementation Of A Mental Health Environmental Risk Assessment Tool, Alan Le

Doctor of Nursing Practice (DNP) Projects

Background: Patient suicide is a serious safety issue, especially in mental health settings since suicides disproportionately affect psychiatric patients. Environmental hazards are a primary contributing factor in patient suicide cases.

Problem: Mental health staff may lack tools and training to perform proper environmental risk assessments, which is the case at a psychiatric crisis residential center in northern California that utilized no environmental risk assessment tool.

Methods: An environmental risk assessment tool was implemented at the site for four months to increase staff confidence, ability to identify hazards and decrease risk of patient suicides.

Interventions: The Suicide and …

Regulatory Orientation To Support Transition To Academic Leadership, Annmarie Munana

Doctor of Nursing Practice (DNP) Projects

Background: As pre-licensure nursing education is burdened by levels of regulations and standards, it is important the academic leader understand regulatory compliance and the applicable federal, state, and local rules and laws. At a multi-campus university, the leader’s ability to address regulatory issues is critical to the program’s success.

Local Problem: The university’s campus leader regulatory orientation lacks consistency and standardization of content and resources. This situation results in campus leaders having varying degrees of knowledge and competency ensuring academic regulatory compliance.

Context: Regulatory compliance stems from external influences and multiple layers of regulations and accreditation. The university provides onboarding …

Building Excellence Through Shared Governance And Continuous Process Improvement, Deborah Reitter

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Nursing shared governance in the hospital setting is a well-established structure for shared decision-making between staff nurses and nurse leaders to improve nursing practice, quality of care, and patient safety. Establishing effective, shared governance can take several years: new skills must be acquired, new behaviors accepted, and new professional commitments made. Newcomers to shared governance require support, education, and the opportunity to acquire requisite skills; otherwise, interest, commitment, and achievement of desired outcomes cannot be sustained.

Local Problem: A large hospital in California established a shared governance structure in 2018. Performance gaps between two high-performing Nursing Unit Councils …

Targeting Pre-Operative Booking Processes To Decrease Risks Of "Never Events", Rebecca Lynn Poths, Rebecca Lynn Poths

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem: Wrong patient, wrong procedure, wrong site, and wrong side surgeries are such egregious errors that are known as “never events.” Root cause analyses can pinpoint a failure yet do little to determine if corrective action has reduced the risk of recurrence.

Context: Monitoring surgical cases prospectively to identify weaknesses that could help identify specific risk factors to avert and move toward zero defects. The setting for this quality improvement project is a >300-bed Level III trauma hospital, where the risk of wrong-site surgeries and lack of standardized processes in the surgical pre-operative booking process was of concern to …

Manager Onboarding To Improve Knowledge And Confidence To Lead, Christine (Tina) K. Asiimwe

Doctor of Nursing Practice (DNP) Projects

Background: Primary care (PC) is increasingly the setting for affordable, coordinated, end-to-end patient care, with PC managers in charge of organizational performance. While PC managers are central to high-functioning teams, they often receive inadequate onboarding.

Local Problem: Primary care onboarding competes with other operational priorities and faces time constraints, lack of mentorship, and cost.

Context: At an integrated healthcare system, a need was identified to develop structured, role-specific onboarding for newly hired PC managers to improve knowledge and confidence to lead.

Interventions: Bauer’s Four Cs framework for onboarding guided the development of a manager onboarding program for 12 new PC …

Creating A Pipeline To Increase Diversity In Executive Leadership Positions, Trarina Harris

Doctor of Nursing Practice (DNP) Projects

Background: Minority nurse leader presence at the executive leadership level is suboptimal, with insufficient pathways to increase representation. The lack of diversity in executive leadership threatens efforts to improve patient care and reduce disparities (Jerome Harris, 2021).

Local Problem: Practices to increase the diversity of executive nurse leaders at a pediatric medical center have had very little to no impact. Frontline nurses and nurse executives are not racially or ethnically representative of the increasingly minority patient populations served.

Context: As a commitment to increasing workforce diversity, the medical center developed an executive-level Racial Equity Taskforce, which aligned with the …

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 …