Medicine and Health Sciences Commons^™

The Influence Of Surgical Stress And Inflammatory Biomarkers On The Occurrence Of Postoperative Delirium, Kirsten Davis, Yulisa Flores

Symposium of Student Scholars

Research focusing on hypothermia has established a relationship between surgical stress and inflammatory biomarkers on delirium incidents in critically ill non-cardiac surgical patients. Unfortunately, postoperative delirium is a common complication after surgery and results in acute brain failure. Though the cause of delirium is still relatively unknown, systemic inflammation with neurological involvement is one of the leading etiologic theories. Another common complication in surgical patients is the occurrence of unplanned hypothermia during non-cardiac surgeries. For our study, we will be looking at two inflammatory biomarkers: C-reactive protein (CRP), and Interleukin 6 (IL-6). CRP is produced in the liver and is …

A Research Appraisal Of How Electronic Health Record Implementation Has Impacted Coding Efficiency​, Madeline Phillips, Jasmine Ware

ATU Scholars Symposium

This research project highlights the ways that coding efficiency has been improved in healthcare over the years, with an emphasis on EHR implementation. This research project references and analyzes trends concerning coding and the revenue cycle from both credible and reliable sources. In this research study, we will reference articles that analyze trends and create a visual understanding of the data collected. This study will highlight a broad spectrum of the impact of electronic health record implementation in the healthcare setting. (Tsai et al., 2020)

The Effectiveness Of Increasing Frequency Of Central-Line Dressing Changes And Monitoring On Clabsi Rates: A Scoping Review, Jacob Schmidt, Bsn, Rn, Ccrn, Georgia Brown, Bsn, Rn, Laura Dickey, Agpcnp-C, Lauren Faulkner, Bsn, Rn, Margaret Harvey, Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Abstract

Purpose/Background

Central lines provide many benefits to critically ill patients; however, there are additional risks with them, including central line-associated bloodstream infections (CLABSIs). CLABSIs place patients at increased risk for morbidity and mortality, longer length of stay, and higher medical costs. Studies evaluating various methods of reducing CLABSIs have been performed. This scoping review was completed to determine the effectiveness of frequent central-line dressing changes and increased monitoring on the incidence of central-line associated blood stream infections in adults with central-lines.

Methods

An extensive database search through the University of Tennessee Health Science Center (UTHSC) Online Library was performed …

The Utilization Of Depression Screening Tools In Patients With Diabetes Type 2, Hanna Book, Kennedy Eldridge, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn, Artangela Henry Dnp, Agacnp-Bc, Fnp-C, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Diabetes and depression are highly prevalent and concerning conditions impacting millions worldwide. Evidence-based guidelines recommend regular depression screening of individuals with type II diabetes (DM2) to appropriately diagnose and treat depression and proactively enhance clinical outcomes. The gold standard for determining depression in patients with chronic disease is the diagnostic clinical interview; however, many clinicians have turned to brief, self-reported screening tools such as the PHQ-2 and the PHQ-9 whose use are recommended by evidence-based guidelines. This study aims to assess the utilization of the PHQ-2 and PHQ-9 versus no screening on DM2 patients in a primary care setting. …

Virtual Visits In Routine Prenatal Care, Katrina K. Wu

MUSC Theses and Dissertations

Problem

One million pregnant persons in the United States do not receive early prenatal care or the recommended number of prenatal visits each year, and this gap in care access disproportionately affects people of color, those with lower incomes, and those living in rural communities. Telemedicine was widely utilized in prenatal care during the COVID-19 pandemic, and optimizing prenatal telemedicine has the potential to improve prenatal care access beyond the pandemic.

Purpose

This dissertation focused on examining the integration of virtual visits in routine prenatal care during the COVID-19 pandemic. The purpose of this dissertation was to:

Aim 1. Explore …

A Hapi Reduction Qi Project: Don't Leave Your Patient In S.H.A.M.B.L.E.S, Anissa Guzman, Ashlee Garcia, Valerie Lindsay

Articles, Abstracts, and Reports

No abstract provided.

A Content Analysis Of Media Coverage Of Telehealth In Mississippi, Hailey Layne

Honors Theses

Telehealth’s utilization within healthcare has expanded and changed areas of healthcare delivery. In rural states like Mississippi barriers to accessing healthcare services exist due to demographic factors, socioeconomic factors, or geographic distance. This study was meant to look at the literature related to telehealth that was being disseminated to Mississippians through online news sources. It was noted whether these articles viewed telehealth utilization in a positive or negative way. Utilizing a cross-sectional media analysis, the news articles were screened using a coding form that acknowledged different themes in the literature. Frequency analyses were conducted to aid in interpreting the common …

Increasing Colorectal Cancer Screening Uptake Among Hispanic/Latino Patients: A Quality Improvement Initiative, Erick Hernandez Campos, Elizabeth Morse, David Phillippi

DNP Projects

Background: In 2021, cancer (CRC) screening rates for Latino men (42%) and women (47.5%) remain well below the Health People 2020 target (70.5%). Extensive documentation of barriers for screening include language, insurance status, and other sociocultural barriers which contribute to delays in diagnosis and/or diagnosis at advanced stages of the disease, and worse health outcomes. Latinos need culturally and linguistically appropriate health promotion interventions aimed to increase CRC screening rates with any modality (FIT, Cologuard, or Colonoscopy).

Methods: The Donabedian Structure-Process-Outcome (S-P-O) Model for quality improvement was used to develop and target a provider-driven, language-concordant communication interventions for …

Patient And Provider Experience With Artificial Intelligence Screening Technology For Diabetic Retinopathy In A Rural Primary Care Setting, Brian M. Nolan, Emma R. Daybranch, Kerri Barton, Neil Korsen

Journal of Maine Medical Center

Introduction: The development of autonomous artificial intelligence for interpreting diabetic retinopathy (DR) images has allowed for point-of-care testing in the primary care setting. This study describes patient and provider experiences and perceptions of the artificial intelligence DR screening technology called EyeArt by EyeNuk during implementation of the tool at Western Maine Primary Care in Norway, Maine.

Methods: This non-randomized, single-center, prospective observational study surveyed 102 patients and 13 primary care providers on their experience of the new screening intervention.

Results: All surveyed providers agreed that the new screening tool would improve access and annual screening rates. Some providers also identified …

An Inflection Point To Improve Emergency Care For Older Adults, Jonny Macias Tejada, Michael Malone, Kevin Biese

Journal of Geriatric Emergency Medicine

Not applicable.

The Effects Of Hospital-Mandated Nurse To Patient Ratios On Patient Care, Vince Latorre

Nursing | Student Research Posters

Background Nurse to patient ratios or nurse staffing is a controversial topic that is often discussed and argued in the medical field for its pros and cons. Nonetheless, the nurse to patient ratio plays a vital role on how nurses’ deliver quality care and provide safety to patients in a hospital setting. In 1999, California’s legislation passed a mandated nurse to patient ratio (AB 394) that requires all hospitals in California to have a set amount of patients a nurse can have depending on the unit the nurse works for. In 2023, California is still the only state that has …

The History Of Geriatric Emergency Medicine, Teresita M. Hogan Md, Lowell Gerson Phd, Aurthur B. Sanders Md

Journal of Geriatric Emergency Medicine

Abstract: Excellent emergency care does not happen by chance. The standard emergency approach that excels in the young, fails in older patients. Older adults experience unnecessary morbidity and excess mortality in our emergency departments. This article describes the pursuit of excellent emergency care in the historically challenging older adult population. A pivotal point occurred once emergency physicians recognized older patients as a distinct population in need of unique evaluation and treatment.

In the early 1990s a group of geriatricians, philanthropists, and emergency physicians joined forces to improve older patient care. Geriatric Emergency Medicine (GEM) emerged as a subspecialty as these …

Pectoralis Nerve Block Compared To Thoracic Paravertebral Nerve Block In The Mastectomy Patient: Evidence-Based Practice Recommendations, Eric Boyer

Doctor of Nursing Practice Scholarly Projects

Patients undergoing a mastectomy are at increased risk of becoming opioid dependent. Most patients undergoing a mastectomy are diagnosed with breast cancer, and the use of opioids is known to aid in cancer metastasizing due to the suppression of the body's natural killer cells. In addition, regional anesthesia, also known as a nerve block, has long provided a reduction in sensation by blocking the nerve pathway, thus numbing the feeling of pain in the operative area. The Pectoralis nerve block (PECS) and the Thoracic Paravertebral block (TPVB) are used in patients undergoing a mastectomy to help reduce the severity of …

Exploring Hapi Incidence In Patients Admitted Through The Ed: A Quality Improvement Initiative, Alexa L. Tietgens

DNP Projects

Each year in the U.S., pressure injuries, or PIs, are responsible for more than 60,000 patient deaths and billions of dollars’ worth of treatment costs. Research shows that roughly 95% of all PIs are preventable by following evidence-based practice guidelines which include early identification of patients at risk, frequent skin assessments, and implementation of prevention strategies. However, the ED environment creates unique risks for PI development due to the routine use of hard surfaces (i.e., stretchers, backboards, exam tables) and frequent hospital overcrowding. Although nurses play a pivotal role in PI prevention, frequent staffing shortages, high patient acuity levels, and …

The Impact Of County Level Characteristics On Type 2 Diabetes Related Ed Utilization, Jessica Wilson

MUSC Theses and Dissertations

Approximately 90-95% of the more than 37 million American adults who are living with diabetes have type 2 diabetes. Additionally, those living in rural areas face poor health outcomes related to chronic diseases such as diabetes. The impact of factors related to social determinants of health such as the role of rurality and social vulnerability were described by examining county diabetes related Emergency Department (ED) visit rates for adults aged 18-25 living in North Carolina. No difference in county level diabetes related ED visits were observed between rural counties vs. nonrural counties in the state. However, patterns did emerge in …

A Quality Improvement Initiative To Improve Follow-Up Time And Reduce Readmissions And Emergency Department Utilization For Oncology Patients, Delaney Serfling

MUSC Theses and Dissertations

Hospitals across the nation are facing extreme challenges with overcrowding. Unplanned readmissions and emergency department use are two significant contributors to this urgent issue. Historically, oncology patients are high utilizers of emergency department services, and have elevated numbers of unplanned readmissions. This is especially true of gastrointestinal medical oncology patients. In an effort to move the needle in the right direction, an operational quality improvement initiative to decrease emergency department utilization and unplanned readmissions was conducted. This pilot project took place over a three-month period, and consisted of protecting time for advanced practice providers (APPs) and updating inefficient workflows. The …

South Michigan Food Bank Food Insecurity Dashboard, Mackenzie Cannon

Undergraduate Research Competition

Food insecurity is a multidimensional problem. This research project aims to use geographic information systems to reduce food insecurity in the eight-county service area by the South Michigan Food Bank. We collected and analyzed data on various factors that contribute to food insecurity: such as poverty, education, employment, transportation barriers, and access to supermarkets and grocery stores. By mapping these data at the census tract level and visualizing the results through an interactive dashboard, we identified areas with the highest levels of need while recognizing some of the root causes behind food insecurity throughout the region. In addition, we created …

Improving Diabetes Management For School Health Workers Using A Live, Virtual Training Course, Bonnie Mccann-Crosby, Lisa Setchfield, Yvonne Barham, Dawn Espinosa, Jennifer Bailey, Beth Pali, Amanda Garey, Sarah Lyons, Rona Sonabend

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Background: Type 1 diabetes is one of the most common chronic diseases in childhood. Optimal school nurse and staff education is critical to creating a safe learning environment and influencing long term outcomes of students with type 1 diabetes. The purpose of this project was to develop a virtual continuing education diabetes management course for school health workers to improve their knowledge of diabetes management and evaluate the effectiveness of the learning platform.

Methods: A total of 199 participants completed the live, virtual continuing education course. Participants completed a pre and post-test to assess improvements in the key learning objectives …

02-07-23 Hsc Committee Minutes, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

Geriatric Depression Screening And Chief Complaint: What Is The Risk For 30- And 90-Day Readmission?, Eric James, Joan Michelle Moccia, Victoria Lucia

Journal of Geriatric Emergency Medicine

Abstract

Background:

Readmission to the hospital within 30-days has a high cost and represents a gap in care for older adults. Older adults are at significant risk for depression, particularly given their medical comorbidities and social factors such as isolation due to SARS-CoV-2. Many patients who screen positive for depression may have no known history of depression. This investigation examines the relationship between a positive geriatric depression screen and chief complaint as a function of 30- and 90-day readmission risk.

Methods:

We examined the electronic medical record of 329 older adults aged 65 and older from February 1, 2020, to …

Implementation Of A Hospital-Wide Surge Plan To Reduce Emergency Department Length Of Stay, Laura Massey

Student Scholarly Projects

Practice Problem: Suboptimal patient flow throughout the hospital has resulted in an increased length of stay (LOS) for emergency department patients and the potential for adverse events.

PICOT: In admitted and discharged emergency room patients (P), how does a hospital-wide surge plan (I) compared to current throughput plan (C) affect the length of stay (O) within 8 weeks?

Evidence: The literature evidence reviewed supported the implementation of a hospital-wide surge plan approach positively impacts the emergency room length of stay and patient outcomes.

Intervention: The primary intervention for this project was the implementation of a hospital-wide surge policy. Targeted …

Pre-Transplant Evaluation Period Efficiency Through The Use Of An Electronic Scheduling Template, Christy Dawn Byrd

Student Scholarly Projects

Practice Problem: Candidacy for transplant evaluation is a complex and lengthy evaluation process. Delays in National Organ Registry have significant unfavorable impacts on patient outcomes as 22 people a day die awaiting a lifesaving treatment. Operational efficiencies can improve the pre-transplant evaluation period and significantly improve patient outcomes.

PICOT: In an outpatient transplant clinic (P), will leveraging an evidence-based scheduling template (I) compared to the current practice of first available appointment (C) reduce the evaluation period by 66% from a 3–4-week evaluation to a 1-week evaluation resulting in expedited listing on the National Organ Registry (O), when applied over …

04-07-23 Hsc Committee Agenda, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

Improving Metabolic Monitoring During Transfers Of Care For Psychiatric Patients Discharged From The Inpatient Psychiatric Residency Service On An Antipsychotic Medication – Part 2, Allison Cohen, Anisha Boetel

View All Graduate Medical Education Content

No abstract provided.

The Lived Experiences Of Icu, Med-Surg, And Er Nurses In The United States Attempting To Breastfeed During The Covid-19 Pandemic, Amy Seay

Dissertations

Breastfeeding is important to promote the health of both mothers and babies (Centers for Disease Control and Prevention [CDC], 2021). Many mothers experience workplace barriers and stress which negatively impact breastfeeding duration (McCardel & Padilla, 2020; Nagel et al., 2022). However, a gap in the literature exists surrounding specific barriers and the impact of stress on U.S. nurses who breastfeed. Specifically, workplace challenges and stress among nurses resulting from the COVID-19 pandemic lack exploration.

This interpretive phenomenological study explored the lived experiences of ICU, Med-Surg, and ER nurses who attempted to breastfeed during the COVID-19 pandemic. Roy’s adaptation model was …

Developing, Implementing, And Evaluating A Clinical Dashboard To Improve The Efficiency And Ease Of Tracking Institute For Healthcare Improvement Ihi Age-Friendly 4ms Framework Data., Margaret Parniawski Nsn, Ne-Bc, Kenneth Forte, Denis Mohess Md, Ray Wauthier Bsn, Erica Zerl Ssa, Edward Ostrowski Msn

Posters

The purpose of this study was to describe a user-centered development, implementation and preliminary evaluation of clinical dashboards to track Age-Friendly 4M Framework Data.

Reducing Blood Culture Contamination In The Emergency Department: A Multi-Method Quality Improvement Project, Daryn Brauner Msn, Marlene Schmidt Msn, Nikki Campbell Bsn, Anthony Renzoni Pharmd, Keri Bill Msn, April Alfano

Posters

The goal of this quality improvement project is to reduce the monthly percentage of BCC in an academic emergency department (ED) through implementation of a multimethod intervention targeting registered nurses (RN) and patient care technicians (PCT) who perform phlebotomy for blood cultures

Implementing The Fall Tailoring Interventions For Patient Safety (Tips) Program To Increase Nursing Knowledge Of Fall Prevention & Reduce Falls & Falls With Injury In The Medical-Surgical Setting, Anne M. Aquila, Palumbo John Mba, Ms, Mt (Ascp), Karen Bauce Dnp, Mpa, Rn, Nea-Bc

Posters

The purpose of this translational research project was to determine if the reimplementation of the Fall TIPS Program in the medical-surgical setting reduced falls and falls with injury over a 10-week period.

The aims of this project were to:

1) improve RNs’ and PCTs’ Fall TIPS knowledge

2) reduce patient falls and falls with injury

Bedside Safety Nurses: A Novel Approach To Reducing Patient Harm, Kenneth Forte, Corinne Booth Bsn, Rn, Nikki Campbell Bsn, Rn, Danielle Jimenez Msn, Rn, Alexandra Mingolello Bsn, Rn, Heather Nachilo Msn, Rn, Heidi Steller Msn, Rn, Joubin Bavarian Rn, Mary Christoffersen Dnp, Rn, Morine Cebert Phd, Aprn

Posters

The purpose of this longitudinal interventional pre-and post-intervention study was to assess the ability of Bedside Patient Safety Nurses to Identify and intervene in patient safety issues before they reach the patient.

Root Cause Analysis, Victor Warr, Tom Sant, Carly Riehl, Rahib Bashir

Articles, Abstracts, and Reports

No abstract provided.