Medicine and Health Sciences Commons^™

Empowering Caregivers, Protecting Patients: An Ambulatory Central Line Quality Improvement Initiative For Education And Follow-Up, Elizabeth Martinez, Belinda Bordeaux, Stephanie Langevin, Cristina Herrera, Mary Smith, Merissa Doyle, Barbara Stein, Kimberly Poshar, Marissa Dunlap, Allison Silva, Eric Werner

Department of Pediatrics Faculty Publications

Introduction: Preventing ambulatory central line-associated bloodstream infections (A-CLABSIs) is challenging due to inconsistent education, follow-up, and home care practices. Pediatric intestinal failure (IF) patients are particularly vulnerable. This institution aimed to decrease its IF A-CLABSI rate by 25% within 2 years through a standardized, step-by-step central line care education program.

Methods: Using the Toyota problem-solving method, the team reviewed data and performed a root cause analysis of the prioritized problem, implementing a 2-phase education program. Phase 1 delivered in-hospital education using videos, handouts, and hands-on teaching with skill demonstration. The existing pediatric central line skills class was expanded and offered …

The Impact Of Medicaid Policy Limitations On Access To Eating Disorder Treatment: Uncovering The Consequences Of A System Built To Fail, Meghan Frost

DSW Capstone Projects

Individuals who rely on Medicaid face major barriers when trying to access eating disorder (ED) treatment, reflecting broader patterns of structural disadvantage in publicly funded health care. Research shows delayed diagnosis, limited access to ED specialists, and frequent denials for recommended services. These gaps occur because Medicaid policies do not match the needs of evidence based ED care, resulting in delayed or incomplete care for many individuals with eating disorders.

This issue is highly relevant to social work practice because the policies shaping these barriers are complex and difficult for clients and ED providers to navigate. Social workers across clinics, …

Health Literacy/Numeracy-Related Factors Affecting Interpretation In Medical Laboratory Values, Rachel L. Childs

School of Medical Diagnostics & Translational Sciences Publications

Background

Health literacy and numeracy are broad terms that relate to a patient’s understanding of their health information. While there is a substantial amount of research on this topic in a general sense as well as in relation to how deficiencies in these skills impact patients’ understanding of laboratory results, little is known regarding the extent to which underlying factors, which are impacted by health literacy/numeracy, affect how patients interpret their results. This literature review attempts to shed light on the current literature on this more focused and narrow issue, including recommendations to address these barriers.

Content

To perform this …

Maintaining Trust In Uncertain Times: Funding Pauses And The Ethical Cost To Community-Engaged Research, Brynn E. Sheehan

Department Psychiatry & Behavioral Science Faculty Publications

Federal funding pauses, once considered rare, are increasingly disrupting the stability and continuity of community‐engaged research. Even projects with active, awarded grants are experiencing the strain of funding uncertainty, raising substantive concerns among research teams and community partners. These disruptions extend beyond operational delays; they jeopardize the continuity of relationships developed through sustained, collaborative engagement. In the absence of clear information about a project's future, uncertainty undermines trust and challenges the ethical principles that guide human subjects research, particularly beneficence and justice. This paper draws on direct experience and insights from the broader field to examine the practical and ethical …

Improving Pediatric Emergency Department Lethal Means Safety Documentation Rates For Adolescents With Mental Health Concerns, Cassandra L. Stegall, Ana-Maria Mcgill, John Fanton, Paul C. Mullan

Department Psychiatry & Behavioral Science Faculty Publications

Introduction:

Lethal means safety counseling (LMSC) is recommended for children presenting to the emergency department (ED) for a mental health (MH) evaluation. Currently, no gold-standard guidelines exist for documenting LMSC in the ED.

Methods:

This quality improvement project was conducted in the ED of a tertiary children's hospital. Baseline data were analyzed for access to any LMSC documentation (ALD) for "firearms/guns," "sharps," or "medication," and for complete LMSC documentation (CLD) if access to all 3 types was documented. The first intervention period added open-ended screening questions about access to lethal means to the MH-licensed clinical social worker note template. Intervention …

A Quality Improvement Project To Enhance Early And Consistent Prenatal Care In The Spanish Speaking Female Population At The Fqhc West Ashley Fetter Clinic, Ana Martinez Conde, Sophia Zia, Joye Fordham, Dennis Besong

South Atlantic Division GME Research Days 2026

No abstract provided.

When The Caregiver Becomes The Victim: Root Cause Analysis Of A Provider Safety Event And Development Of A Quality Improvement Framework, Sadia Akram, Barbara Gracious, Anjali Pathak, Muniza Shah

South Atlantic Division GME Research Days 2026

No abstract provided.

Enhancing Patient Safety: Yellow Gown Strategy For Fall Prevention, Kimberly Nathan, Obumneke Umerah, Lorenna Garcia-Bochas, Nayda Parisio Poldiak, Jilian Sansbury

South Atlantic Division GME Research Days 2026

No abstract provided.

Impact Of Sputum Collection Within 24 Hours Of Admission For Patients Hospitalized With Pneumonia, Sally Baker, Madelaine Duarte, Lauren Kirk, Mohamed Faris

South Atlantic Division GME Research Days 2026

No abstract provided.

Improving Inpatient Colonoscopy Bowel Preparation Quality In A Community Hospital Via Split-Dose Polyethylene Glycol Regimen, Brenden Pearce, Yashaswi Koguru, Schuyler Nebeker, Minh Nguyen, Lauren Roper, Kathleen Raynor

South Atlantic Division GME Research Days 2026

No abstract provided.

Implementing Daily Spontaneous Awakening And Breathing Trials In The Trauma Intensive Care Unit: A Quality Improvement Initiative, Bradley Vaughn, Lina V. Mata-Mcmurry, Eric Shaw, James Dunne

South Atlantic Division GME Research Days 2026

No abstract provided.

A Qi Project: Fostering Methods Of Communication To Promote Hospital Discharge Follow-Up Rate And Access To Primary Care, Radhika Mohan, Sanket Patel, Deepa Nuthalapati, Michael Smith, Valerie Sinkler, Dennis Besong, Pooja Paunikar

South Atlantic Division GME Research Days 2026

No abstract provided.

Leading The Way In Pediatric Oral Health Promotion, Denise C. Mckinney

Dental Hygiene Faculty Publications

[Introduction] Dental hygienists promote oral health and provide preventive services to patients throughout their lifespan. The Commission on Dental Accreditation, Dental Hygiene Standards emphasize that graduates must be competent in providing dental hygiene care for all patient populations, including children.¹ In fact, promoting pediatric oral health begins prior to birth with the expectant mother and/or caregiver. Oral health care to include education is essential during pregnancy; specifically, around the prevention and treatment of dental caries for the mother and the unborn child.² In the U.S., from 2013-2016, roughly 30% of women aged 20-44 years had untreated dental caries.³ Expectant mothers …

Dental Professionalism In A Changing World: Challenges & Opportunities, Robert P. Iovino, Dds, Ma Dds, Ma

Journal of the American College of Dentists

This manuscript examines the erosion of traditional dental professionalism amid rising educational costs, declining membership in professional associations, and the growing influence of corporate ownership and private equity in dentistry. Drawing perspectives from economics, sociology, philosophy, law, and ethics, it traces the historical development of professional licensure and its role in safeguarding clinical autonomy, ethical integrity, and public trust. The analysis highlights how deregulation and profit-driven practice models challenge the profession’s social contract. The manuscript argues that preserving strong civic institutions, restrictive licensure standards, and humanities-informed education is essential to sustaining dentistry as a learned profession rather than a commodified …

J Am Coll Dent 2026 92 4

Journal of the American College of Dentists

The Journal of the American College of Dentists (JACD) publishes scholarly articles, editorials, essays, and reflections addressing the ethical, professional, and social dimensions of dentistry. The Journal serves as a forum for advancing ethics, professionalism, leadership, and excellence within the dental community. By fostering dialogue across disciplines and perspectives, JACD provides readers with insights that encourage ethical, professional practice, lifelong learning, and service to the public, reinforcing dentistry’s commitment to advancing oral healthcare and the common good.

Core Standards For Leadership In Oral Healthcare, Sir Nairn H.F. Wilson Cbe Dsc(H.C.) Ddent(H.C.) Phd Msc Bds Fcgdent Fds Rcs Edin, Eng(Hon) & Rcps Glasg(Hon) Ffd Rcsi(Hon) Fcdshk(Hon) Fracds(Hon) Drd Fhea Facd Ficd Fadm Fpfa Frsm Fkc

Journal of the American College of Dentists

This article introduces the American College of Dentists’ core standards for leadership in oral healthcare, grounded in well-established ethical principles and in response to ever-increasing expectations for patient-first care. It is suggested that the new standards must be consistently upheld to maintain patient trust and professional credibility. Effective leadership, in contrast to management, improves patient engagement and outcomes, team performance, and resilience. The article calls for more leadership training in dentistry, beginning in dental schools, and highlights the need for effective leadership in oral healthcare to strengthen the profession’s standing and status.

Standards For Leadership In Oral Health Care. A Project Of The Board Of Regents Of The American College Of Dentists, Robert A. Faiella Dmd, Mmsc., Mba, Teresa A. Dolan Dds, Mph, Facd, N. Karl Haden Phd, Facd, Sreenivas Koka Dds, Ms, Phd, Mba, Mas, Facd, Sir Nairn H.F. Wilson Cbe Dsc(H.C.) Ddent(H.C.) Phd Msc Bds Fcgdent Fds Rcs Edin, Eng(Hon) & Rcps Glasg(Hon) Ffd Rcsi(Hon) Fcdshk(Hon) Fracds(Hon) Drd Fhea Facd Ficd Fadm Fpfa Frsm Fkc

Journal of the American College of Dentists

This section of the Journal of the American College of Dentists presents professional conference proceedings and/or published guidelines relevant to dentistry, ethics, education, leadership, policy, or clinical care. Conference proceedings may also include documents from affiliate organizations in dentistry.

Empathy And Human-Centered Leadership In Community Health Center Dental Clinics, Pamela S. Alston Dds, Mpp, Facd

Journal of the American College of Dentists

A person-centered approach, with empathy toward patients, can improve satisfaction among both patients and dental health professionals. A dental director with a human-centered leadership style can improve the well-being of oral health team members. This article describes the role that empathy, a core value of humanism and professionalism, plays in accomplishing these improvements in community health center dental clinics. This article also describes the risks of empathy, as experienced by the author in her role as a dental director and practitioner, as well as documented in the literature. It further focuses on dental directors’ human-centered approaches to supporting oral health …

Visit Complexity Differs Between Scarring And Nonscarring Alopecia: A 5-Year Dataderm Analysis, Ian Noel Encarnacion, Noelle Desir, Nicholas Schell, Apoorva Mehta, Temitayo Ogunleye, Susan Taylor

Department of Medicine Faculty Publications

[Introduction] Accurate coding is a critical component of dermatologic practice, influencing reimbursement and documentation of clinical complexity. Although alopecia has significant psychosocial and financial burdens, Current Procedural Terminology (CPT) coding patterns in alopecia management remain largely understudied. Our population-level study using the American Academy of Dermatology's DataDerm clinical registry¹ evaluates alopecia CPT coding trends, pre-2021 and post-2021 evaluation and management (E/M) CPT coding updates,² aiming to inform coding practices and visit complexity, which have significant reimbursement implications.

Criterion Validity Of The Functional Status And Pain Assessment Scale Versus Pain And Length Of Stay In Hospitalized Adults With Scd, Wally R. Smith, Daniel M. Sop, Yue May Zhang, Margaret S. Guy, Rehan Qayyum

Department of Medicine Faculty Publications

Objectives

In prior research we demonstrated face, construct, discriminant, and preliminary convergent validity of the newly developed, 10-item Functional Status Pain Assessment (FSPA) scale (0-50) in adult SCD patients hospitalized with VOC. We aimed in this study to further demonstrate criterion validity of the FSPA.

Methods

This was a prospective observational study of 561 daily functional and pain assessments from 91 hospitalized adults with SCD from January 2018 to June of 2019. Principal Component Analysis (PCA) Partial Least Squares (PLS) models determined the relationship between LOS, pain intensity, and FSPA. A Generalized Linear Model (GLM) to quantified the impact of …

Frequent Emergency Department Utilization And Syphilis Case Profiles In The Sentara Healthcare System: A Retrospective Cross-Sectional Analysis In Hampton Roads, Martina Zamponi, Grace M. Tillotson, Chandler F. Knox, Mackenzie Tardif-Kunk, Thomas R. Campbell, Peter A. Mollica

Department of Medicine Faculty Publications

Background

Syphilis rates have increased substantially nationwide, disproportionately affecting marginalized populations and individuals with differing patterns of healthcare utilization. The Hampton Roads region of Virginia and North Carolina includes multiple jurisdictions with syphilis rates above the CDC screening threshold, with 7 of its 9 independent cities meeting this criterion. However, no prior study has examined the relationship between emergency department (ED) utilization patterns and documented syphilis diagnoses in this region.

Methods

A retrospective cross-sectional analysis of the Sentara Healthcare network was conducted using aggregate data from the TriNetX platform. Patients diagnosed with syphilis between 2023 and 2024 were stratified by …

Determinants Of Patient Satisfaction In An Academic Primary Care Setting: A Cross-Sectional Study Of The Postpandemic Era, Alvin Maliakal, Rajita Kanapareddy, Zooha Altaf, Janani Anbazhagan, Kristin Olson, Cynthia Avila, Rehan Qayyum

Department of Medicine Faculty Publications

Background

Patient satisfaction, a key indicator of healthcare quality, is associated with improved adherence, continuity, and outcomes. However, limited evidence describes determinants of patient satisfaction in contemporary primary care settings reflecting the postpandemic era, when care delivery models and patient expectations have evolved substantially.

Objective

To evaluate the sociodemographic and clinical factors associated with patient satisfaction in an academic primary care setting following the postpandemic era.

Methods

We conducted a cross-sectional survey of adult patients (≥18 years) attending a primary care clinic. Participants completed a self-administered questionnaire including the Visit-Specific Satisfaction Questionnaire (VSQ-9) and measures of sociodemographic and clinical characteristics. …

Clinical Challenges Associated With Enhancing Hypertension Among The Underserved African American Population, Ashley Richardson

Doctor of Nursing Practice (DNP) Scholarly Projects

Background 

African Americans face a significantly higher prevalence of hypertension, tend to develop complications at younger ages, and have disproportionately higher mortality rates. Key social determinants of health (SDoH)—including food deserts, unequal access to healthcare, and geographic disparities in healthcare resources—contribute to these ongoing inequities. Addressing both systemic and individual barriers is crucial for effective hypertension management.

Objective

This study aims to assess the effectiveness of a culturally relevant, community-based intervention designed to reduce both systolic and diastolic blood pressure among Black adults with uncontrolled hypertension.

Methods 

Quality improvement (QI) initiatives typically employ multicomponent, equity-focused models. The primary components of …

Navigating An Uncharted Path: Chief Diversity Officer Challenges In Creating And Implementing A Dei Strategy Plan Within Major Hospital Systems, Diane Shines Mcdaniel

Antioch University Dissertations & Theses

This qualitative phenomenological study investigated the major challenges Chief Diversity Officers (CDOs) face when creating and implementing DEI strategy plans within major hospital systems in the United States. The study was guided by one research question: What are the major challenges that Chief Diversity Officers face in creating and implementing a DEI strategy plan within major U.S. hospital systems? A phenomenological design was used to examine the challenges of six Chief Diversity Officers serving in major U.S. hospitals as they led DEI strategy planning and implementation. Data were generated through semi-structured interviews consisting of eight open-ended questions designed to elicit …

Exploring Management Strategies To Reduce Workplace Violence: Perceptions Of Illinois Healthcare Professionals, Mary Mack

All Student Theses and Dissertations

This qualitative study examined how managers of nonprofit healthcare facilities in the Chicago metropolitan area implement strategies to reduce workplace violence, what these strategies are and how they are carried out, and what organizational factors facilitate or impede their implementation. Semi-structured interviews were conducted with seven healthcare professionals in management or safety-oriented roles across seven facilities, purposefully sampled through the researcher's professional network. Findings revealed four recurring patterns across the sample. Prevention infrastructure was installed reactively, following specific triggering incidents rather than anticipating documented risk. Facilities consistently favored lower-cost mitigation measures over more resource-intensive prevention strategies. Reliance on short-tenure contract …

Acceptability, Usability, And Clinical Integration Of A Clinic-Based Digital Game For Hpv Education: Qualitative Perspectives From Adolescents, Parents, And Healthcare Providers, Elizabeth Reifsnider, Satya Subedi, Nouran Ghonaim, Megan Whaley, Angela Chia-Chen Chen

Ellmer School of Nursing Faculty Publications

Background/Objectives: HPV vaccination is safe, effective, and recommended at ages 11–12, yet uptake remains suboptimal. Serious video games may offer an innovative strategy to deliver brief, engaging education during clinic visits. This qualitative paper, embedded within a mixed-methods study, examined adolescents’, parents’, and healthcare providers’ (HCPs’) perceptions of the acceptability, usability, and perceived clinical applicability of HPV Detective, a tablet-based digital game designed to provide HPV-related education to parent–child dyads during pediatric clinic wait times. Methods: Eight adolescent–parent dyads (N = 16) and three HCPs from university-affiliated pediatric clinics participated in 30–60-min semi-structured Zoom interviews. Interviews were audio-recorded, transcribed, and …

Identifying The Physical Activity Promotion Practices Of Obstetricians And Gynecologists: Patients With Endometriosis And Polycystic Ovary Syndrome, Allison P. Herman

Theses and Dissertations (Comprehensive)

Despite efforts to promote physical activity, many females in Canada do not meet recommended physical activity guidelines. For individuals with gynecological conditions such as endometriosis and polycystic ovary syndrome (PCOS), physical activity may aid in symptom management and improve daily functioning. Healthcare settings, including obstetrics and gynecology, represent an area of opportunity to promote physical activity among this population. This thesis aims to understand the physical activity promotion practices of Ontario-based Obstetricians and Gynecologists (OBGYNs) to patients with endometriosis and/or PCOS. A cross-sectional online survey was conducted to explore OBGYNs promotional practices and perceived factors influencing their engagement in physical …

Diagnosing The Discourse: How The Academy Of Breastfeeding Medicine Constructs And Constrains Treatment Of Tethered Oral Tissues, Mary E. Miller

Antioch University Dissertations & Theses

While breastfeeding is recognized as fundamental to global public health, oral restrictions that can affect infant latch, milk transfer, and feeding efficiency warrant further examination within policy frameworks. This dissertation proposes an expanded conceptualization of tethered oral tissues (TOTs) that encompasses not only anatomical frenal restrictions but also fascial tensions, neuromuscular limitations, and other conditions restricting orofacial function that may be congenital or acquired. The purpose of this study was to critically examine how this clinical guidance document shapes understandings and responses to TOTs. Using Carol Bacchi’s “What’s the Problem Represented to Be?” approach, a critical discourse analysis of the …

An Investigation Of Federated Gnns Under Aggregation, Data Poisoning, And Differential Privacy For Icu Length-Of-Stay Prediction, Shakib Mahmud Dipto, Soumya Banerjee, Sandip Roy, Ahmad F. Al Musawi, Preetam Ghosh, Sachin Shetty, Pratip Rana

Computer Science Faculty Publications

Accurate prediction of ICU Length of Stay (LoS) is essential for clinical decision-making and healthcare resource management. Graph Neural Networks (GNNs), such as GraphSAGE, offer a natural fit by capturing patient data from Electronic Health Records (EHRs) through graph structures. However, the distributed and sensitive nature of this data raises both privacy and legal concerns regarding the aggregation and training of GNN models. This additionally leads to issues with data imbalance and model robustness. In this study, we perform an analysis of the Federated Graph Neural Network (GNN-FL) framework to enable decentralized learning on EHRs derived from the MIMIC-III dataset. …

Review Of Outcomes: Quality Improvement Of Upper-Extremity Necrotizing Soft Tissue Infections, Cailey A. England Bs, Ryan A. Reinhart Bs, Tien Do Do, Maame A. Effirim Bs, Dylan Bezzini Md

Summer Research Program Abstracts

No abstract provided.