Medicine and Health Sciences Commons^™

Improving Health Outcomes In Children And Adolescents With Asthma, Elizabeth Kate Coffey Moore

Theses and Dissertations (ETD)

Asthma is among the most prevalent chronic illnesses found in the United States, affecting millions of people under the age of 18 each year. The disease burden for affected children, adolescents, their families, and the healthcare system is immense. Finding ways to mitigate its impact is critical to improving the lives of affected children, adolescents, and their families. The three chapters included in this dissertation aimed to document the asthma triggers that children and adolescents are exposed to and strategies for reducing them and to demonstrate using Imogene King’s conceptual framework to guide nursing practice to care for and nursing …

Real-World Pharmacological Anticoagulation And Clinical Outcomes Of Venous Thromboembolism In Adults With Sickle Cell Disease, Ming Chen

Theses and Dissertations (ETD)

Sickle cell disease (SCD) is an inherited disease characterized by sickle-shaped red blood cells that can slow or block blood flow. It affects about 100,000 people in the United States, and occurs more commonly in people of African descent. SCD is considered as a hypercoagulable state and venous thromboembolism (VTE) is a serious disease-specific complication. However, there have been limited real-world studies on VTE in SCD patients. This work aims to provide a comprehensive assessment of the risk factors and treatment of VTE in adults with SCD by using longitudinal real-world data. First, a retrospective cohort study on 30-day readmission …

The Validity And Reliability Of Ultrasound As A Tool For Assessing Skeletal Muscle Characteristics In The Pediatric Population, Elizabeth Seewer

Theses and Dissertations (ETD)

Annually, around 5 million people in the U.S. are admitted to Intensive Care Units (ICU) due to critical conditions, with pediatric patients comprising 21% of these admissions. Approximately 40% of pediatric ICU (PICU) patients require mechanical ventilation and extended stays, and about 6% result in death. Survivors often face long-term disabilities, including loss of skeletal muscle mass (SMM), a risk factor for morbidity and mortality. Abdominal computed tomography (CT) scans, often performed during PICU admissions, can assess muscle mass but pose risks of increased cost and radiation exposure. While CT and Magnetic Resonance Imaging (MRI) are gold standards for muscle …

Improving Lesion Diameter Reporting On Skin Biopsy Requisition Forms: A Quality Improvement Project, Christopher Wong, Christian Scheufele, Marshall Hall, Henry Lim, Daniel A. Nguyen, Stephen Weis, Michael Carletti, Dustin Wilkes

North Texas GME Research Forum 2024

Background: Skin biopsy requisition forms (SBRFs) are the primary communication tool between dermatologists and dermatopathologists. Diameters of biopsied skin lesions are frequently omitted on SBRFs. This quality improvement project aimed to increase the rate of reporting diameters of neoplasms on SBRFs from an academic dermatology outpatient clinic to greater than 65% within three years. Methods: The Plan-Do-Study-Act model was utilized. An initial audit was performed for SBRFs of biopsies obtained between July 1, 2021, and February 4, 2022 (“Cycle 1”). On February 4, 2022, the authors discussed societal guidelines for lesion diameter reporting on SBRFs (“Intervention A”). Cycle 2 prospectively …

Utilizing The Stop-Bang Questionnaire To Assess Risk Of Obstructive Sleep Apnea In Hospitalized Patients With Heart Failure To Facilitate Sleep Medicine Referrals Upon Discharge, Chelsea Mitchell

DNP Projects

Background: Obstructive sleep apnea (OSA) is the most common sleep-breathing disorder. Undiagnosed OSA is highly prevalent in the population, especially in those with heart failure. OSA and heart failure combined create a negative feedback loop that can lead to poor clinical outcomes. Unfortunately, many cardiac patients are never screened for OSA.

Purpose: The purpose of this project is to improve screening rates for OSA via the STOP-Bang questionnaire and establish an efficient and effective process for referrals to sleep medicine for heart failure patients screening high-risk.

Methods: The design was a quality improvement project with pre- and post-testing and a …

Improving Dental Students' Knowledge And Confidence In Treating Tobacco Use, Victoria Pierce

DNP Projects

Background: Tobacco use can lead to numerous chronic health conditions. Healthcare professionals in the dental field are in a unique position to broach this issue with patients. Research shows that dental students do not feel equipped to provide tobacco cessation care, citing lack of education on the subject among their top reasons for this.

Purpose: The purpose of this project was to evaluate changes in dental students’ knowledge and confidence related to treating tobacco use after participation in an educational intervention about the 5A’s, behavioral counseling, and first-line prescription medications.

Methods: This quality improvement initiative utilized a quasi-experimental survey design …

The Impact Of Lung Cancer Screening Education On Knowledge And Screening Rates In A Kentucky Cancer Survivorship Clinic, Alexandra Isler

DNP Projects

Background: Lung cancer is a significant problem in Kentucky, which ranks fourth in the nation in adults who currently smoke. Early detection, through lung cancer screening, can prevent untimely deaths. Several barriers to screening exist including lack of knowledge and awareness among patients regarding lung cancer screening. By increasing knowledge, at risk patients can take the necessary steps to decrease incidence of late stage diagnoses.

Purpose: The purpose of this project was to evaluate patients’ knowledge of lung cancer screening and referral and screening rates before and after one-on-one patient education.

Methods: This was a quality improvement project that used …

Ada Report: Ada Board Discusses Membership, Looks Ahead To 2024, Michele Tulak-Gorecki Dds

The Journal of the Michigan Dental Association

The ADA Board of Trustees' annual retreat prioritized board development, emphasizing individual strengths and effective communication. Key topics included the Tripartite Membership Model Pilot, a dental school collaboration strategy, and sponsorship for the National Academies of Medicine Oral Health Project. Updates from ADA leaders highlighted initiatives like the Lessons in a Lunchbox program, ADA app improvements, legislative support for young dentists, and workforce solutions. The report concludes with a call to share the ADA story and promote collaboration.

The Pacesetter Style Of Leadership, Michelle C. Dziurgot Dds

The Journal of the Michigan Dental Association

This editorial explores the pacesetter leadership style, likening it to a marathon "rabbit" setting a fast pace. Pacesetters, exemplified by figures like Jack Welch and James Cameron, set ambitious goals, driving themselves and their teams relentlessly. While effective in achieving short-term goals and maximizing team potential, drawbacks include employee stress, lack of feedback, and a "rat race" atmosphere. The author, a self-identified pacesetter with a compassionate approach, emphasizes the importance of balancing high standards with employee well-being for sustained success.

Human Rights, Informed Consent, And The Influence Of Gender In Compulsory Vaccination: A Qualitative Analysis To Mediate Public Policy In A Protracted Social Conflict, Shannon Christine Rowles-Mcgighan

Department of Conflict Resolution Studies Theses and Dissertations

This research study sought to understand the perspectives and experiences related to theCompulsory Vaccination Policy and the Vaccine Injury Compensation Program. The research objective was to mediate the conflict between the public and the medical community by presenting what William Ury called the “third side.” Uri (1999) studied conflict and found another way to perceive conflict from a larger perspective that emphasizes a fair solution that meets both sides’ needs and the surrounding communities. This study involved qualitative analysis to triangulate the concerns in the conflict through an evaluation of vaccine injury cases, vaccine injury data collection methods, the influence …

Clinical Outcomes Associated With Mrsa Naat Utilization., Shannon B. Leighton, Pharmd, Emily Fox, Greg Tallman

Books, Presentations, Posters, Etc.

Abstract: A recent analysis by the Oregon Regional Antimicrobial Stewardship Program demonstrated that across the Oregon region, MRSA NAAT from the nares have a high negative predictive value (NPV) of 99.4%. These findings were consistent when stratified by culture site. The high NPV suggests that MRSA NAAT nasal swabs can be useful in promoting de-escalation (e.g., discontinuation) of anti-MRSA treatment. Few studies have evaluated if use of the MRSA NAAT influences anti-MRSA treatment de-escalation, and even fewer have assessed important clinical outcomes related to MRSA NAAT utilization and de-escalation. The goal of this study is to evaluate the frequency of …

Impact Of Repeated Reimbursement Penalties On Hospital Total Quality Scores, Alice Brewer, M. Courtney Hughes, Kunal N. Patel

Faculty Articles, Papers, and Other Scholarship

Objectives

The incidence of hospital-acquired conditions (HACs) is a serious public health issue with implications ranging from patient morbidity and mortality to negative financial impacts on patients and health care systems. Despite substantial efforts to address and reduce HACs, research into the effect of quality improvement programs is inconclusive. This study seeks to better understand the relationship between repeated reimbursement penalties and improvement in HAC quality scores.

Methods

A quantitative comparative analysis of U.S. health care data was conducted. Data on quality outcomes and hospital characteristics were sourced from the Hospital-Acquired Condition Reduction Program from fiscal years 2018 and 2019 …

Assessing Providers’ Readiness To Integrate Mat Services In A Primary Care Setting, Carmen Ingram-Thorpe

Theses and Dissertations

Opioid use disorder is a growing concern in the United States. Despite medication-assisted treatment (MAT) being a more effective treatment option than behavioral treatment alone, primary care providers’ rate of adoption and utilization of MAT has not matched the demand of the opioid crisis. The largest barrier facing our local community is the availability of organizations and providers that can and will actually provide MAT services. The purpose of this study was to identify factors that impact primary care providers’ readiness to treat individuals with opioid use disorder (OUD) using MAT. This study used the ADKAR model as framework, which …

The Relationship Between Outcomes Associated With Patient Blood Management Programs And Transfusion Safety Officers, Gary Morral

Theses and Dissertations

BACKGROUND: Patient Blood Management (PBM) has become the standard of care for transfusion services in hospitals. Transfusion Safety Officers (TSOs) have been identified by some as being a crucial part of a successful PBM program; however, no studies have been done to show their effectiveness, or if there is even a relationship between having a TSO and outcomes associated with PBM programs. The purpose of this study was to describe and test the relationship between having a TSO and six outcomes associated with PBM programs including blood product wastage (red blood cells, plasma, and platelets), hospital lengths of stay, rates …

J Mich Dent Assoc January 2024

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

The January issue sets the foundation for Children’s Dental Health Month in February, the reader will find the following original content:

• A cover commentary on Pediatric Dentistry
• A feature article on “Silver Diamine Fluoride as a Caries Management Option for the Young Child”.
• A feature on “Considerations Concerning Obesity-Related Education for Parents of Young Children”.
• Professional advice commentary on “Staying Focused on a Moving Target: Coping …

Adherence To Personal Protective Equipment Practices During The Covid-19 Pandemic: A Pilot Study, Taryn Amos, Cameron Griffin, Joshua K. Schaffzin, Andrea Ankrum, Felicia Scaggs Huang

Psychology Faculty Publications

A direct observational pilot project of healthcare personnel (HCP) was conducted to validate a tool that measures personal protective equipment (PPE) adherence at a large pediatric institution. Overall unit PPE adherence for all moments ranged from 50-61%. Masking was the most adhered to PPE moment (100%); hand hygiene prior to donning PPE had the lowest adherence (13%). Using data from this standardized tool, researchers can evolve PPE standards to maximize their adherence, effectiveness, and ease of utilization.

Comparative Analysis Of Machine Learning Models For Predicting Healthcare Traffic: Insights For Optimized Emergency Response, Shadman Mahmood Khan Pathan, Sakan Binte Imran, M. M. Shabab Iqbal, Muhammad Enayetur Rahman, Md. Nurul Absar Siddiky, Muhammad Rezaur Rahman, Md Rafid Hasan, Nondon Lal Dey, Md Sobuj Hossain

Electrical & Computer Engineering Faculty Publications

Efficient management of healthcare traffic is crucial for ensuring timely access to medical services, particularly in emergency situations where delays can have severe consequences. This study presents a comparative analysis of three widely used machine learning models—Linear Regression, Decision Trees, and Random Forests—aimed at predicting healthcare-related traffic volumes. A large dataset from a metropolitan traffic system was used to train and evaluate the models based on key performance indicators, including Mean Squared Error (MSE), R² Score, and computational efficiency. The results reveal that the Random Forest model offers the best performance, achieving higher predictive accuracy and faster execution times compared …

Victory Out Of Tragedy: Organ Donation, Ali Salim, Bryan A Cotton

Faculty, Staff and Student Publications

Major improvements in trauma care during the last decade have improved survival rates in the severely injured. The unintended consequence is the presentation of patients with non-survivable injuries in a time frame in which intervention is considered and often employed due to prognostic uncertainty. In light of this, discerning survivability in these patients remains increasingly problematic. Evidence-based cut-points of futility can guide early decisions for discontinuing aggressive treatment and use of precious resources in severely injured patients arriving in extremis.

Best Practices For Point Of Care Ultrasound: An Interdisciplinary Expert Consensus, Brandon Oto, Robert Baeten, Leon Chen, Puja Dalal, Ria Dancel, Steven Fox, Carl William Lange Iv, Cameron Baston, Paul Bornemann, Siddharth Dugar, Andrew Goldsmith, Meghan Kelly Herbst, James N Kirkpatrick, Abhilash Koratala, Michael J Lanspa, Viveta Lobo, Jason T Nomura, Aliaksei Pustavoitau, Mourad H Senussi, Vincent L Sorrell, Frances Mae West, Aarti Sarwal

Faculty, Staff and Students Publications

Despite the growing use of point of care ultrasound (POCUS) in contemporary medical practice and the existence of clinical guidelines addressing its specific applications, there remains a lack of standardization and agreement on optimal practices for several areas of POCUS use. The Society of Point of Care Ultrasound (SPOCUS) formed a working group in 2022 to establish a set of recommended best practices for POCUS, applicable to clinicians regardless of their training, specialty, resource setting, or scope of practice. Using a three-round modified Delphi process, a multi-disciplinary panel of 22 POCUS experts based in the United States reached consensus on …

Patient Satisfaction Informs Improvement Strategies In Emergency Department, Esmat Swallmeh

Doctoral

Recently, patient satisfaction has become one of the key performance indicators used to measure the performance of healthcare institutions and has emerged as a primary strategic indicator of quality and efficacy within the healthcare system. Inadequate care of patient experience in acute hospitals may negatively impact patients’ adherence, readmission rates and mortality. This dissertation critically evaluates over 2,000 peer-reviewed papers relevant to patient satisfaction within the emergency department (ED) environment. It describes the theories, tools, determinants, and methods to increase patient satisfaction. Despite growing attention to patient satisfaction, the academic literature still lacks a comprehensive overview. In addition, the literature …

Screening For Food And Nutrition Insecurity In The Healthcare Setting: A Cross-Sectional Survey Of Non-Medicaid Insured Adults In An Integrated Healthcare Delivery System, Carmen Byker Shanks, Nancy P Gordon

Faculty, Staff and Student Publications

OBJECTIVES: Healthcare screening identifies factors that impact patient health and well-being. Hunger as a Vital Sign (HVS) is widely applied as a screening tool to assess food security. However, there are no common practice screening questions to identify patients who are nutrition insecure or acquire free food from community-based organizations. This study used self-reported survey data from a non-Medicaid insured adult population approximately one year after the start of the COVID-19 pandemic (2021). The survey examined the extent to which the HVS measure might have under-estimated population-level food insecurity and/or nutrition insecurity, as well as under-identified food and nutrition insecurity …

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 …

Analyzing The Relationship Between Socioeconomic Deprivation And Outpatient Medicare Part D Fluoroquinolone Claim Rates In Texas, Mayar Al Mohajer, Edgar Samarasundera, Judite Gonçalves, Alicia Heath

Faculty, Staff and Students Publications

INTRODUCTION: Only a few studies have assessed the relationship between deprivation and excessive antibiotic use. In Texas, antimicrobial prescription rates are particularly high compared with the rest of the US. This study analyzed the association between local area socioeconomic deprivation and providers' fluoroquinolone claim rates among beneficiaries 65 years and older in Texas.

METHODS: This ecological study utilized provider- and area-level data from Medicare Part D Prescribers and the Social Deprivation Index (SDI) repositories. Negative binomial regression models were employed to evaluate the relationship between provider- and area-level characteristics (prescriber's gender, specialty, rural-urban community area, beneficiaries' demographics, area-level population, and …

Implementation Of A Pilot Quality Improvement Project To Guide The Administration Of Intraoperative Dexamethasone For Postoperative Nausea And Vomiting Prophylaxis In Patients With Diabetes Undergoing Orthopedic Procedures, Brittany W. Hall

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: At a local tertiary care hospital, there was no recommendation to guide anesthesia providers in the administration of intraoperative dexamethasone to patients with diabetes. While dexamethasone is a highly effective antiemetic, it may promote hyperglycemia in patients with diabetes.

Purpose: The purpose of this project was to guide and educate about current recommendations for the administration of dexamethasone for PONV prophylaxis in patients with diabetes.

Intervention: 1) Examined pre-intervention practices of dexamethasone administration. 2) Educated about current and best practices to anesthesia staff. 3) Developed badge buddy cards outlining the guideline. 4) Examined post-intervention practices. 5) Evaluated the effect …

Implementation Of The Academic Autistic Spectrum Partnership In Research And Education (Aaspire)-Based Guidelines To Improve Perioperative Care Of Patients With Autism Spectrum Disorder, Kayleigh Brink

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Implementation of the Academic Autistic Spectrum Partnership in Research and Education (AASPIRE)-based Guidelines to Improve Perioperative Care of Patients with Autism Spectrum Disorder

Kayleigh Brink

Introduction: Autism Spectrum Disorder (ASD) is becoming more prevalent with an increasing need to identify and eliminate barriers to care. Healthcare Providers (HCP) have shown limited knowledge and confidence when managing patients with ASD. The inability to provide specialized care and recognize symptoms of pain or discomfort could result in behavioral difficulties.

Purpose: The purpose of this project was to improve confidence among HCPs to identify ASD characteristics and to improve the use of …

Dismantling Pervasive Gender Stereotypes In Healthcare Leadership Contexts With An Ecological Systems Theory Approach, Andrei A. Lux, Nasim Salehi, Diarmuid Hurley, Elizabeth Emanuel

Research outputs 2022 to 2026

Leadership emergence is fraught with pervasive gender stereotypes, and women remain underrepresented in senior leadership roles, particularly in healthcare organisations. We apply ecological systems theory to explain how environmental factors enable or inhibit women’s leadership emergence in healthcare settings. We interviewed 17 senior female leaders in the Australian healthcare sector to explore how gender-related perceptions affected their leadership journeys. Five themes emerged that challenge existing narratives: men supported women’s advancement; women impeded other women’s progress; vulnerability was a leadership strength; ambitious women were ostracised; and women were ‘given’ leadership opportunities rather than actively pursuing them. By situating these findings within …

Using Noninvasive Clinical Parameters To Predict Mortality And Morbidity After Cardiac Interventions In Patients With Cirrhosis: A Systematic Review, Christo Mathew, Ankur Patel, George Cholankeril, Avegail Flores, Ruben Hernaez

Faculty, Staff and Students Publications

BACKGROUND: Cardiovascular disease commonly affects advanced liver disease patients. They undergo cardiac interventions to improve cardiac outcomes. Cirrhosis increases complication risk, including bleeding, renal and respiratory failure, and further decompensation, including death, posing a clinical dilemma to proceduralists. Predicting outcomes is crucial in managing patients with cirrhosis. Our aim was to systematically review clinical parameters to assess the mortality and complication risk in patients with cirrhosis undergoing cardiac interventions.

METHODS: We searched cirrhosis and cardiovascular intervention terminology in PubMed and Excerpta Medica Database (EMBASE) from inception to January 8, 2023. We included studies reporting clinical scores (e.g. Model for End-stage …

Utilizing Ai Integrated Neuroimaging Technology To Expand Upon Machine Learning In Positron Emission Tomography Technology With The Aim Of Detecting Amyloid Beta Biomarkers Early In The Onset Of Alzheimer's., Ethan S. Terman

Undergraduate Research Posters

Early intervention in Alzheimer's is vital for treatment. The earlier a professional can detect symptoms and make a diagnosis the earlier a prognosis can be implemented. With the prevalence of data in our day-to-day world combined with Artificial intelligence (AI), utilizing both for machine learning can pave the way for more accurate and efficient detection of Alzheimer's and other neurodegenerative diseases. AI combined with Machine learning (ML) increases diagnostic efficiency and reduces human errors, making it a valuable resource for physicians and clinicians alike. With the increasing amount of data processing and image interpretation required, the ability to use AI …

Reducing Food Scarcity: The Benefits Of Urban Farming, S.A. Claudell, Emilio Mejia

Journal of Nonprofit Innovation

Urban farming can enhance the lives of communities and help reduce food scarcity. This paper presents a conceptual prototype of an efficient urban farming community that can be scaled for a single apartment building or an entire community across all global geoeconomics regions, including densely populated cities and rural, developing towns and communities. When deployed in coordination with smart crop choices, local farm support, and efficient transportation then the result isn’t just sustainability, but also increasing fresh produce accessibility, optimizing nutritional value, eliminating the use of ‘forever chemicals’, reducing transportation costs, and fostering global environmental benefits.

Imagine Doris, who is …

Engaging Chief Medical Officers To Improve Multidisciplinary Rounds, Gregory Mccormack, Pranav C. Mehta

HCA Healthcare Journal of Medicine

Background

Multidisciplinary rounds (MDRs), a model of care in which multiple members of the care team, representing different disciplines, come together to discuss the care of a patient in real-time. MDRs are a valuable tool for clinical teams to improve patient length of stay (LOS), reduce healthcare-associated infections, and increase care coordination. HCA Healthcare’s data science and performance improvement teams created a data visualization tool called Next-gen Analytics for Treatment and Efficiency (NATE) Tempo to support care teams in managing rounds and barriers.

Methods

A pilot implementation of MDRs using the NATE Tempo tool was initiated in 10 hospitals, accompanied …