Digital Commons Network^™

Preventing Pressure Injuries On Patients Undergoing Treatment With Extracorporeal Membrane Oxygenation (Ecmo), Hediyeh Shakeri

Master's Projects and Capstones

One of the top National Patient Safety Goals by The Joint Commission is to prevent hospital-acquired pressure injuries, which is reiterated by Centers of Medicare and Medicaid as a valuable metric in determining the quality of patient care and safety as well as hospital performance. The Agency for Healthcare Research and Quality reports over 2.5 million patients affected by hospital-acquired pressure injuries per year, costing between $9.1-$11.6 billion per year with the cost of individual patient care ranging from $20,900 to 151,700 per pressure injury (Agency for Healthcare Research and Quality, 2014). Approximately 30% of these cases are related to …

Patient Coordinated Care Response Team, Joshua Fox

Master's Projects and Capstones

Section I: Abstract

Problem: Communication between medical professionals and patients is a critical element to patient satisfaction and safety. The 2020 patient overall satisfaction scores for the local Roseville hospital were 73%. These data demonstrated an opportunity to enhance processes and the culture at the local Roseville hospital to meet the communication needs of its patient population.

Context: A patient coordinated care response team was developed to improve communication for newly diagnosed cancer patients or other life-altering diagnosis patients.

Interventions: A survey was completed to establish the current state of patient satisfaction with communication practices with healthcare providers in the …

Standardization Of Bedside Shift Report In Pediatrics, Edwin Tadeo

Master's Projects and Capstones

Problem: In the pediatric setting, the change-of-shift report does not traditionally happen at the bedside. Medical error is a significant health challenge in the healthcare system, with substantial effects on patient safety, including disability or death. Failure of effective communication during the hand-off process contributes to approximately 30% of all malpractice claims. Furthermore, inadequate hand-offs have been shown to contribute to 1,744 deaths and $1.7 billion in malpractice costs over five years (Joint Commission, 2017).

Context: The microsystem setting for this improvement project is a 32-bed pediatric unit in Northern California. It was concluded that the organization could support any …

Enhanced Recovery After Surgery: Effectiveness Of Real Time Data Tracking Tools, Alatia S. Jentons

Master's Projects and Capstones

Enhanced Recovery after Surgery (ERAS) has been proven by evidence to lower both recovery time and postoperative complication rates while also being cost-effective. It is a new recovery process that consists of several bundles in order to meet adherence. The hospital site where this project was conducted was at a Northern California Medical Center which provides care for in-patient postoperative, urgent and non-urgent cases. On our assigned units, we identified the potential for improvement after observing a lack of standardization of real-time charting for ERAS. This resulted in retro data, which is not an effective way to collect data when …

Clabsi Prevention In The Icu-A New Approach, Shannon M. Hicks

Master's Projects and Capstones

Abstract

The Center for Disease Control and Prevention (CDC) emphasizes that the primary cause of preventable deaths and disabilities among hospitalized patients in the United States are hospital-acquired infections (HAIs). Based on the CDC surgical site infection monitoring, common infections include central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia, and catheter-associated urinary tract infections. This paper primarily focuses on the problem of CLABSI, with an aim to reduce the net occurrences of CLABSIs in the intensive care unit (ICU) through the interventional use of SecurePortIV skin adhesive during the insertion of central lines. Although few researchers have examined the implication of …

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 …

Residential Metals Abatement Program Quality Assurance Project Plan (Non-Residential Parcels - Indoor Dust), Environmental Resource Management (Erm), Elsie King, Christopher Berg, Thomas J. Beckman

Silver Bow Creek/Butte Area Superfund Site

No abstract provided.

Financial Facts From The Seed For Oklahoma Kids Child Development Account Experiment, Center For Social Development

Center for Social Development Research

How does a Child Development Account (CDA) opened at a child’s birth shape their access to assets for higher education?

This Fact Sheet highlights findings from Financial Outcomes in a Child Development Account Experiment: Full Inclusion, Success Regardless of Race or Income, and Investment Growth for All (CSD Research Summary 21-06). Products of the SEED for Oklahoma Kids (SEED OK) experiment, both the Fact Sheet and the Research Summary indicate that the automatic CDA in SEED OK greatly increases the likelihood that disadvantaged children have assets for their future education. When given a CDA structure and support for …

Oral Care Experiences Of Palliative Care Patients, Their Relatives/Carers And Healthcare Professionals: A Qualitative Systematic Review, Delgado M Bernardes, Anastasios Plessas, Lorna Burns, Helen Neilens, Sarah Griffiths, Jos Latour

Peninsula Dental School

No abstract provided.

Layered Architecture For Internet Of Things-Based Healthcare System: A Systematic Literature Review, Somayeh Nasiri, Farahnaz Sadoughi, Afsaneh Dehnad, Mohammad Hesam Tadayon, Hossein Ahmadi

School of Nursing and Midwifery

Internet of Things (IoT), known as a new paradigm, has shown to have a significant role in healthcare domains including remote vital sign monitoring systems, physical activity tracking, early disease diagnosis, and prevention of disease risks. Therefore, designing an integrated healthcare system based on Internet of Things is highly dependent on designing a layered architecture pattern. However, there are no comprehensive studies on Internet of Things layered architecture in the healthcare industry. The purpose of this study was to identify and scrutinize different types of layered architecture of Internet of Things in healthcare in terms of functions, and technologies. We …

Fort Hays State University Tiger Weekly, December 17, 2021, University Relations

Tiger Weekly Newsletters

No abstract provided.

Novel Applications Of Remote Sensing And Gis In Mass Wasting Hazard Assessments For Two Fjords Of South-Central Alaska, Matthew S. Balazs

Geosciences

The fjords of South-Central Alaska are dynamic environments and host to a number of natural hazards that have not received much attention from the research community. The cities of Seward and Whittier are two of Alaska's most important marine transportation hubs, home to commercial fishing fleets, termini of the Alaska Railroad, and home to thousands of residents. This doctoral research focuses on landslides and their associated hazards in these under-studied areas. Chapter 2 involves surficial mapping of the study areas and documents the role of the underlying geologic processes that threaten the safety of people and infrastructure in the Passage …

Steroid Receptor-Coregulator Transcriptional Complexes: New Insights From Cryoem, Ping Yi, Xinzhe Yu, Zhao Wang, Bert W O'Malley

Faculty, Staff and Students Publications

Steroid receptors activate gene transcription through recruitment of a number of coregulators to facilitate histone modification, chromatin remodeling, and general transcription machinery stabilization. Understanding the structures of full-length steroid receptor and coregulatory complexes has been difficult due to their large molecular sizes and dynamic structural conformations. Recent developments in cryo-electron microscopy (cryoEM) technology and proteomics have advanced the structural studies of steroid receptor complexes. Here, we will review the insights we learned from cryoEM studies of the estrogen and androgen receptor transcriptional complexes. Despite similar domain organizations, the two receptors have different coregulator interaction modes. The cryoEM structures now have …

Riding The Wave Of Information: Library Professionals’ Opinion Towards Information Literacy (Il) Program In Academic Libraries Of Pakistan, Shahzadi Humbhi, Munazza Jabeen, Shabbir Tareen, Alia Humbhi

Library Philosophy and Practice (e-journal)

The present study investigated status, strategies to promote the IL programs, contribution of social media, and challenges to provide IL programs in the academic libraries of Pakistan. A concurrent mixed-method technique was used and a structured questionnaire was designed to collect the data and in-depth interviews from 12 academic librarians of the capital cities of four provinces of Pakistan. A systematic sampling technique was used to collect the data from library professionals. The results reveal that academic libraries took imitative to launch IL programs at academic libraries of Pakistan but there is a need for improvement and revamp them. The …

Distribution, Abundance And Natural Enemies Of The Invasive Tomato Leafminer, Tuta Absoluta (Meyrick) In Kenya, G. Kinyanjui, F. M. Khamis, F. L.O. Ombura, E. U. Kenya, S. Ekesi, S. A. Mohamed

All Peer-Reviewed Publications

Tuta absoluta (Meyrick) has become a serious menace to sustainable production of tomato in Kenya. A survey was conducted between April 2015 and June 2016 to determine its distribution, abundance, infestation, and damage levels on tomato, and associated natural enemies. Trap counts of T. absoluta moths were recorded in all surveyed 29 counties, which indicated its nationwide distribution irrespective of altitude. Tuta absoluta was present in both open fields and greenhouses. The highest moth/trap/day was 115.38 ± 15.90. Highest leaf infestation was 92.22% and the highest number of mines and larvae per leaf were 3.71 ± 0.28 and 2.16 ± …

Using Data Mining To Explore Factors That Distinguish Between Students With High And Low Mathematical Literacy Performance — An Example With Socio-Economically Disadvantaged And Advantaged Students In Macao, Wa Kit Sou, Kwok Cheung Cheung, Man Kai Ieong, Soi Kei Mak

Chinese/English Journal of Educational Measurement and Evaluation | 教育测量与评估双语期刊

Using Macao-PISA 2012 data collected from socio-economically disadvantaged and advantaged students, this study identified two sets of important learning factors that distinguished between low- and high-performing disadvantaged students, and between low- and high-performing advantaged students, respectively. The findings of this research contribute to a better understanding of the reasons for Macao’s high-quality and equitable education as compared to other regions with high mathematical literacy performance while also revealing the crux of small inequities in its education system. The analysis method used in this paper provides a paradigm for data mining research using large-scale assessment data and helps researchers better grasp …

Revitalizing The Ban On Conversion Therapy: An Affirmation Of The Constitutionality Of Conversion Therapy Bans, Logan Kline

University of Cincinnati Law Review

No abstract provided.

Challenging Solitary Confinement Through State Constitutions, Alison Gordon

University of Cincinnati Law Review

Eighth Amendment jurisprudence has resulted in limited scrutiny of solitary confinement despite the known harms associated with the practice. The two-part test established by the federal courts to evaluate Eighth Amendment claims and limitations on challenging prison conditions under the Prison Litigation Reform Act can make it difficult to establish that solitary confinement is cruel and unusual punishment.

State constitutional challenges to solitary confinement are underexplored. Nearly all state constitutions contain an equivalent provision to the Eighth Amendment’s prohibition on cruel and unusual punishment. State courts need not be bound by federal jurisprudence in interpreting the scope of the state …

Authority, Obedience, And Justification, Michelle Madden Dempsey

University of Cincinnati Law Review

We have a duty to think for ourselves. The law claims authority over us. We have a duty, at least sometimes, to obey the law. Alone, each of these premises is fairly uncontroversial. Combined, they create some intriguing puzzles. Can law’s claim of authority be justified? If so, does justified legal authority entail an obligation to obey the law? If not, are we nonetheless justified, and perhaps even obligated, to act as if such an obligation exists? While this essay is hardly the first to address these questions, it is the first to do so by combining elements of Joseph …

Sustainable Irrigation Based On Co-Regulation Of Soil Water Supply And Atmospheric Evaporative Demand, Jingwen Zhang, Kaiyu Guan, Bin Peng, Ming Pan, Wang Zhou, Chongya Jiang, Hyungsuk Kimm, Trenton E. Franz, Robert F. Grant, Yi Yang, Daran R. Rudnick, Derek M. Heeren, Andrew E. Suyker, William L. Bauerle, Grace L. Miner

School of Natural Resources: Faculty Publications

Irrigation is an important adaptation to reduce crop yield loss due to water stress from both soil water deficit (low soil moisture) and atmospheric aridity (high vapor pressure deficit, VPD). Traditionally, irrigation has primarily focused on soil water deficit. Observational evidence demonstrates that stomatal conductance is co-regulated by soil moisture and VPD from water supply and demand aspects. Here we use a validated hydraulically-driven ecosystem model to reproduce the co-regulation pattern. Specifically, we propose a plant-centric irrigation scheme considering water supply-demand dynamics (SDD), and compare it with soil-moisture-based irrigation scheme (management allowable depletion, MAD) for continuous maize cropping systems in …

Creating Positive Impact: The Power Of Greater Purpose And Consciousness Of Connectedness, Joseph Leah, Chris Laszlo

Engaged Management ReView

As the idea of business as a positive force in society continues to grow, we ask: Under what conditions do business leaders transform their companies into organizations that create positive value for all stakeholders, generate above-average economic returns, and serve personal well-being, community health, a fair and inclusive society, and a thriving natural environment?

This study aims to explore the underlying factors and motivations of business as a force for good, and to identify practical guidance for business leaders wishing to create a positive impact through their organizations. Our prior research led us to hypothesize that a leader’s mindset—or consciousness—is …

Creating Cautionary Tales: Institutional, Judicial, And Societal Indifference To The Lives Of Incarcerated Individuals, Nicole B. Godfrey

Arkansas Law Review

It has long been said that a society’s worth can be judged by taking stock of its prisons. That is all the truer in this pandemic, where inmates everywhere have been rendered vulnerable and often powerless to protect themselves from harm. May we hope that our country’s facilities serve as models rather than cautionary tales. Justice Sonia Sotomayor, joined by Justice Ruth Bader Ginsburg, issued the above-quoted clarion call to protect the lives of incarcerated people on May 14, 2020. At that point, the COVID-19 pandemic had brought American society to a standstill for a little more than two months, …