Digital Commons Network^™

The Flexibility Of The Rule Against Perpetuities As Applied To Mineral Top Leases, John W. Ponder

Oil and Gas, Natural Resources, and Energy Journal

No abstract provided.

From Pore Space To Policy Space: The Costs, Benefits, And Constitutionality Of North Dakota’S Ccs Long-Term Liability Transfer Standard, Lainey Morrow

Oil and Gas, Natural Resources, and Energy Journal

No abstract provided.

Opening The Door: Copyrightability Of Interpreted Seismic Models After Gsi V. Tgs, David Logan

Oil and Gas, Natural Resources, and Energy Journal

No abstract provided.

Beyond Produced Water: Extending Cactus Water To Lithium And Other Oilfield Waste, Louis W. Krivanek Iv

Oil and Gas, Natural Resources, and Energy Journal

No abstract provided.

Beneath The Surface: Addressing The Ownership And Development Rights Of Geothermal Energy Resources Under Oklahoma Property Law, Kobe K. Gipson

Oil and Gas, Natural Resources, and Energy Journal

No abstract provided.

Aesthetic Considerations In Nuisance Claims Against Texas Wind Farms, Ellie Duggan

Oil and Gas, Natural Resources, and Energy Journal

No abstract provided.

Ownership Of Produced Water And The Path To Domestic Lithium And Critical Mineral Commercialization, Emily Davis

Oil and Gas, Natural Resources, and Energy Journal

No abstract provided.

The Eleventh Circuit’S Narrow Interpretation Of Nepa In Alligator Alcatraz, Madison Crow

Oil and Gas, Natural Resources, and Energy Journal

No abstract provided.

Editor's Introduction & Front Pages, Louis W. Krivanek Iv

Oil and Gas, Natural Resources, and Energy Journal

No abstract provided.

Safer Together: One Purpose, One Future, Tara Haines

HCA Healthcare Journal of Medicine

This art quilt is based on the theme that working together creates a safer future for our patients. The patient is at the center and is surrounded by the care team to help them navigate towards health and better outcomes. Our student nurse is on the left with angel wings, supported by their professor, the patient, the care team, and their nurse, all guided by Florence Nightingale's lamp over the often uneven path towards a safer future

Nurses' Week, Sekia Lor

HCA Healthcare Journal of Medicine

I am an academic advisor for nursing students who also happens to be a balloon artist. I created all of these nurse balloon animals during Nurses' Week to represent “better together.” These balloons were then given to staff members on campus to celebrate Nurse’s Week!

Family Tree, Margaret J. Demars

HCA Healthcare Journal of Medicine

I currently work as an intensive care unit nurse and was asked to paint a mural in our break room. I decided to paint a “family tree” symbolizing unity among the departments. I wanted to create something that promoted peace and serenity. Once the tree was completed, the employees were encouraged to print photos of themselves, their pets, or their families to pin to the tree. This project brought everyone together and was a really fun and engaging activity among the nurses and staff. Now, we can take our breaks and admire something other than the same white walls we …

Wave Of Healing, Annemarie Dittmar

HCA Healthcare Journal of Medicine

There is so much hope and healing in nursing. As nurses, we are meant to bring hope and healing to others. To me, the sunrise is symbolic of hope, hope that healing will happen and that there are always things to hope for. The wave of water is symbolic of healing; it is a blue green wave of healing that washes over and provides calming energy and mental clarity. Sunlight and ocean waves bring hope and healing to my own soul. I used a Japanese art form called Kinusaiga, which is a type of painting with fabric. I used …

Trust As Public Health Infrastructure: Advancing Health Care Safety Through Risk Communication And Community Engagement, Karanvir Bhinder, Sahibpreet Bhinder

HCA Healthcare Journal of Medicine

Background

Preparedness frameworks traditionally emphasize surveillance, laboratory capacity, clinical care and logistics. However, recent public health emergencies have demonstrated that even technically sound interventions may fail when trust is weak, communication is fragmented or misinformation undermines public confidence. Risk communication and community engagement (RCCE) is therefore increasingly recognized as an important component of effective outbreak response.

Perspective

Evidence from COVID-19, Ebola and other public health emergencies demonstrates that trust, communication and community engagement influence adherence to public health guidance, vaccine acceptance, healthcare utilization and the implementation of evidence-based interventions. Despite this, RCCE is frequently operationalized as a support function rather …

Advanced Practice Provider-Physician Collaboration And Medical Staff Governance: A Framework For Patient Safety, Nicolas Testa, Kaysha Hervey, Cynthia Borum

HCA Healthcare Journal of Medicine

The growth of advanced practice providers (APPs) is occurring in parallel with persistent and projected physician shortages. One important solution and increasingly visible response to these workforce challenges is the expanding role of APPs. Strong physician-APP partnerships can help distribute workload, improve access, and support sustainable practice with the delivery of safe, quality patient care. The future of clinical care will depend on effective APP-physician collaboration grounded in sound credentialing, clearly defined supervision and practice expectations, and robust medical staff monitoring programs. We describe the governance and oversight processes in a large health care system to assess and support APP …

Creating A Climate Of Safety: Preparing Nursing Students For Responsible Artificial Intelligence Use, Shanti Srinivas, Jennifer L. Stewart

HCA Healthcare Journal of Medicine

Safety is the foundation of high-quality, effective, and efficient health care, requiring intentional dedication from organizations, leaders, educators, providers, and patients alike. The increasing integration of artificial intelligence (AI) into health care settings is outpacing the development of structured safety education designed for its use. As AI tools become increasingly embedded in diagnosis, documentation, and clinical decision-making, a climate of safety must extend to encompass the unique risks these technologies introduce, including algorithmic biases, data privacy vulnerabilities, and the possible erosion of clinical judgment through overreliance on machine-generated outputs.

Equally essential is the promotion of workplace wellbeing, which recognizes that …

From Hired To Hands-On-Deck Status: Solving Delays In Health Care Hiring Processes And Supporting Workforce Safety Across A Large For-Profit Health System, Cynthia Skeens

HCA Healthcare Journal of Medicine

Background

During and after the COVID-19 pandemic, health care staffing shortages and onboarding inefficiencies, specifically delays in employee health clearance, prolonged time to hire, and threatened workplace and patient safety.

Methods

An employee health onboarding workflow at a large health care organization was redesigned across 3 domains: people, process, and technology. Interventions included workflow standardization, elimination of non–value-added steps, optimized tuberculosis screening, increased appointment capacity, and technology integration (electronic health record [EHR]documentation, centralized scheduling and communication, and completion of pre-visit forms). Following a pilot from May to December 2022, the workflow was expanded organization-wide with a structured rollout and ongoing …

Promoting Safety In Alcohol Withdrawal Syndrome: A Proactive Nursing Process Framework, Julie Anne C. Comia, Elizabeth Card

HCA Healthcare Journal of Medicine

Background

Alcohol withdrawal syndrome (AWS) is a potentially life-threatening response to the abrupt cessation or reduction of heavy, prolonged alcohol use. Untreated, it can progress to delirium tremens (DT), a medical emergency historically associated with mortality as high as 40%. Agitation and hallucinations during withdrawal also pose safety risks to the health care team in addition to the patient. Because deterioration follows a predictable course, timely nursing recognition and intervention are central to protecting both the patient and the care team from avoidable harm. The evidence-based framework is intended as an educational tool to help nurses anticipate and avoid harm; …

A Conceptual Framework For Clinical Quality Oversight In Telehealth-Enabled Home-Based Urgent Care, Taylor Spencer, Jason P. Williams

HCA Healthcare Journal of Medicine

Background

Home-based urgent care serving frail older adults should aspire to high-quality clinical care with optimal patient outcomes. However, monitoring and ensuring this quality can be challenging. For example, telemedicine and value-based frameworks introduce substantial complexity to clinical quality monitoring.

Purpose

We describe the conceptual framework for a multidimensional quality monitoring program within a national home-based urgent care model.

Framework Description

Medical care was delivered via a multi-state home-based primary, palliative, and urgent care practice serving medically complex Medicare Advantage (MA) populations. Our model of care incorporated distributed clinical and operational teams delivering 24/7 care via telephonic triage, video-enabled encounters, …

A Safety Framework: Empowering Faculty To Build A Culture Of Safety, Rebekah L. Randall, Sarah Woodward

HCA Healthcare Journal of Medicine

Background

Prelicensure nursing curricula lack a defined safety framework for clinical education, leaving faculty with minimal guidance on how to model and teach foundational safety concepts. Nursing accrediting bodies identify psychological and physical safety as institutional priorities, emphasizing the need to equip future clinicians with foundational safety competencies early in their training.

The purpose of this quality improvement project was to develop the ABCs of Prevention (Awareness, Body, Communication) and 4Rs of Intervention (Remove, Report, Record, Reflect) safety framework for clinical nursing education, provide faculty education and resources to support its application in teaching, and assess the impact of the …

Integrating The Icare Compassionately Model Into Disaster Simulation, Chelsea Baker

HCA Healthcare Journal of Medicine

While global efforts to increase access to health care have been successful, the provision of high-quality, safe care remains a critical priority as adverse events continue to impact patient outcomes. To combat this issue, nurse educators need to address gaps in both technical and relational domains of care, including compassion. Despite being identified as a core competency to safe practice, compassionate care principles remain inconsistently taught and practiced within nursing curriculum. This study examined the integration of the iCare (inclusivity, character, accountability, respect, excellence) Compassionately model into a simulated disaster scenario to provide students with an opportunity to apply emotional …

Thermal Skin Burns Following Infrared Vein Finder Application In Pediatric Patients: A Report Of 2 Cases And Protocol Revision, Sujata S. Rawlani, Nandini Banad, Jenil Sheth, Raja Narsingrao

HCA Healthcare Journal of Medicine

Background

Peripheral venous cannulation remains a cornerstone of pediatric anesthesia practice. Infrared vein finder devices have gained popularity as aids to improve venous visualization in children with difficult access. However, the thermal hazards associated with certain device types, particularly pocket flashlight-based models, remain underappreciated among clinical staff.

Case Presentation

We report 2 pediatric patients who sustained grade 2 thermal burns at peripheral venous access sites following the use of a pocket flashlight-based infrared vein finder during ophthalmic surgical procedures. The first patient, an 8-month-old girl born at term with appropriate developmental milestones undergoing congenital cataract surgery, developed a ruptured blister …

Assessment Of Hypoglycemia Management In Acute Care Hospitals, Carley Warren, Christina Wing, Chenette Burks, Brooke Schmidt, Adam Hasse

HCA Healthcare Journal of Medicine

Background

Hypoglycemia is a common and potentially preventable complication among hospitalized patients, particularly those receiving insulin or other glucose-lowering therapies. Delayed recognition and inconsistent management can increase adverse outcomes. Although protocols exist, variability in treatment selection and timing may influence the likelihood of returning to normoglycemia. Understanding these patterns is critical to optimizing patient safety in acute care settings.

Methods

This retrospective review evaluated hypoglycemia management in adult inpatients across acute care hospitals within a large health system. Patients were included if they were aged 18 years or older, were hospitalized within the health system, and experienced a hypoglycemic event, …

Yellow Gowns For Fall Prevention: A Quality Improvement Initiative To Enhance Patient Safety, Kimberly Nathan, Obumneke Umerah, Lorenna C. Garcia-Bochas, George A. Helmrich Sr, Nayda Parisio Poldiak, Jilian R. Sansbury

HCA Healthcare Journal of Medicine

Background

Falls, with and without harm, are monitored as a quality metric for inpatient units and are an important component of patient safety. Across the medical-surgical (Med-Surg) units at our facility, fall rates have shown some variability over time, prompting further evaluation of fall-prevention practices and opportunities for improvement. From quarter 1 (Q1) of 2022 through Q2 of 2025, several units reported fall rates ranging between 4.0 and 7.0 falls per 1000 patient days. A review of contributing factors highlighted opportunities to strengthen consistency in fall-prevention practices, enhanced education around alarm use, and improve visibility of patients at higher risk …

Time To Antibiotic Administration In The Treatment Of Sepsis: A Retrospective Cohort Study, Dennis Anthony Cardriche, Grayson Carter, Thomas Matese

HCA Healthcare Journal of Medicine

Background

The 2026 Surviving Sepsis Campaign (SSC) guidelines recommend antimicrobial therapy within 1 hour for probable septic shock, while the Centers for Medicare and Medicaid Services (CMS) mandates a 3-hour window. Current literature presents conflicting evidence on whether these universal time thresholds yield a definitive survival benefit. This study aims to evaluate the real-world impact of delayed antibiotic administration on patient mortality and length of stay (LOS).

Methods

A retrospective cohort study was conducted analyzing 62 153 adult encounters with severe sepsis or septic shock at emergency departments (EDs) between December 31, 2023, and December 31, 2025. Time to first …

A Heuristic Tool To Enable Root Cause Analysis Of Safety Events, William D. Porter, Kianca Joseph, Demitria Stafford, Kurt Larson, John Mier, Michelle Butler-Jackson, Musaddiq Waheed

HCA Healthcare Journal of Medicine

Background

Hospitals routinely collect wide-ranging data related to quality, efficiency, and clinical practice. As part of these efforts, patient safety event data are collected, compiled, and analyzed to drive process improvement.

Methods

We present a novel adaptation and application of the Department of Defense Human Factors Analysis and Classification System (HFACS) as a heuristic tool to improve the conduct of root cause analysis (RCA) sessions that follow serious patient safety events. To assess individual knowledge improvement after reviewing the heuristic tool, a 1-page summary (including a graphical image of the tool) was developed and provided to a convenience sample of …

The Use Of Infra-Red Spectroscopy To Assess Intact Skin Of Various Skin Tones, Mary Lee A. Potter, Stacie Sosa, Charlott Polm, Sherry Campton, Wisam Salameh, Ronnie Klein, Yaniv Cohen

HCA Healthcare Journal of Medicine

Background

Pressure injuries (PI) continue to be a serious medical complication in the acute care setting. Industry leaders advocate for the use of objective technologies to provide accurate and quantifiable skin assessments for all patients across diverse skin tones. The Infra-Red Spectroscopy Scanner (IRSS) is a novel non-invasive decision support system (DSS) electro-optic technology that uses near infra-red spectroscopy to examine and assess physical and chemical changes prior to visual skin breakdown in real-time.

Methods

A 2-phase prospective open-label pilot device study was launched under protocol IRM-02-1123 (USA version 3.0, November 1, 2023). In both Phase 1 and Phase 2, …

Building A Culture Of Safety Through Faculty Mentorship: The Peer Pairing Framework For Clinical Nurse Educators, Clare A. Chambers

HCA Healthcare Journal of Medicine

Background

Clinical nurse educators often transition from bedside practice to clinical education in high-risk settings without structured support. Limited or absent mentorship during this transition may affect educator confidence, student learning outcomes, patient outcomes, and the ability to sustain a culture of safety. Although mentorship is widely recommended in nursing education, implementation strategies remain limited. The Peer Pairing Framework was developed as a staged mentorship approach to support clinical nurse educators and inform a comprehensive mentorship model.

Methods

The Peer Pairing Framework was informed by a voluntary onboarding survey of 914 clinical faculty, of whom 73.52% expressed interest in having …

Critical Care Catalyst: The Impact Of Trauma Nurse Leads On Mortality, Patient Outcomes, And Throughput, Danielle Brady, Jessica L. Brady, Hannah Dice, Parker Hu

HCA Healthcare Journal of Medicine

Background

Trauma is the leading cause of years of life lost in the United States. Dedicated trauma nurse leaders (TNLs) coordinate resuscitation and streamline care, but data evaluating their clinical impact at level I trauma centers are limited. We evaluated the association between a newly implemented dedicated TNL program and patient outcomes.

Methods

This single-center, preimplementation and postimplementation observational study at an urban level I trauma center compared adult tier 1 and tier 2 trauma activations from the pre-TNL period (January 1, 2017, through April 30, 2020) with the post-TNL period (May 1, 2020, through December 31, 2023; 8 dedicated …

Retrospective Exploratory Pre And Post Evaluation Of Waste Anesthetic Gas Scavenging System And Association With Post Anesthesia Care Unit (Pacu) Nurse Health, Jessica Garibay, Dina A. Krenzischek, Ryan Macdonald, Elizabeth Card

HCA Healthcare Journal of Medicine

Background

The Occupational Safety and Health Administration (OSHA) recognizes the negative health impact of occupational exposure to anesthetic gases in the operating room. As a result, OSHA has implemented regulations, engineering controls, and regular air quality surveillance programs to protect surgical staff. However, immediate postoperative patients exhale waste anesthetic gases (WAGs) into the Post Anesthesia Care Unit (PACU) environment, exposing nurses to occupational health risks, including headaches, fatigue, organ damage, cancer, and reproductive complications. The PACU lacks any regulations or even recognition of this safety issue; in fact, most nurses and leadership are unaware. One potential solution, a scavenging oxygen …