Medicine and Health Sciences Commons^™

Essential Collaborations Among Case Managers And Providers Regarding Discharge Processes, Lashawnda Richardson

Doctor of Nursing Practice Projects

Communication is vital between case managers and providers when patients need care coordination post-discharge. This includes but is not limited to facilitating home health services, ordering durable medical equipment, sending referrals to rehabilitation facilities, and sponsorship for uninsured or underinsured patients. This gives case managers the opportunity to educate providers on the discharge needs they ordered for their patients. The collaboration between case managers and providers allows for timely discharge planning and providing patients and their families with accurate information regarding their discharge needs.

Improving Triage Accuracy In The Emergency Department, Joselyn Silverman

Master's Projects and Capstones

Problem: High rates of patients being mis-triaged was occurring at Hospital X leading to poor patient outcomes and incorrect staffing levels.

Context: This quality improvement project took place at Hospital X’s emergency department. A stakeholder analysis and a microsystem assessment along with a staff survey was created in order to determine areas of improvement and staff responsiveness.

Interventions: Eight educational seminars were conducted along with Hospital X leadership and students created supplemental materials for the staff to use on a daily basis.

Measures: Two data pulls were conducted over the course of the quality improvement project; one prior to the …

Nurses' Compliance With Central Line Maintenance (Handling) Guidelines At A Tertiary Care Setting In Karachi, Pakistan- A Descriptive Cross-Sectional Study, Alina Amir Ali

Theses & Dissertations

Background: Central venous catheters (CVCs) are integral to modern healthcare, facilitating critical treatments. However, the risk of complications, particularly infections, necessitates strict adherence to central line maintenance protocols. This study explores the compliance of nurses in executing these protocols.
Purpose: In a tertiary care facility in Karachi, Pakistan, this study sought to evaluate nurses' adherence to each item on the central line management checklist as well as the checklist's total adherence in the Special Care Units.
Method: A total of 119 registered nurses were assessed, using a quantitative structured observational design for central line handling in adult medical surgical special …

Prevalence Of Depression In Patients With Cardiovascular Diseases, Faryal Ghafoor

Theses & Dissertations

Background: Approximately 17.3 million individuals across the globe lose their lives to cardiovascular diseases (CVD), with a majority of these cases occurring in low-to-middle-income countries. The incidence of cardiovascular disease in Pakistan is 918 cases per 100,000 individuals. Depression frequently impacts the health, expenses, and prognosis of patients with cardiovascular disease.
Purpose: This study aimed to determine the prevalence of depression among CVD patients at Aga Khan University Hospital, Karachi, and explore the influence of co-morbidities, marital status, age, and educational background on one's status, regarding depression.
Method: A quantitative descriptive cross-sectional study was conducted at the Aga Khan University …

Concept Of Health-Related Quality Of Life Among People With Heart Failure In Karachi, Pakistan, Anny Ashiq Ali

Theses & Dissertations

Background: Non-communicable diseases (NCDs), including cardiovascular diseases, are a leading cause of global mortality. The mortality rate for cardiovascular diseases is on the rise, with 80 % to 86 % of fatalities, particularly in low- and middle-income countries, including Pakistan. Among NCDs, heart failure (HF) is a condition for which there is no cure, and patients rely on supportive treatments to maintain their quality of life. HF not only affects physical well-being but also has far-reaching consequences on the emotional, social, and cognitive aspects of life. In the context of Pakistan, where unique healthcare, sociocultural, and economic factors prevail, the …

Improving The Mental Health Nursing Competencies Of Nurses Caring For Patients With History Of Substance Use Disorder In Long-Term Care Settings, Nancyver Lafleur-Omeler

Doctor of Nursing Practice Projects

Background

While nurses are often on the front lines of working with patients with a history of substance use disorders (SUD), most have limited training in this area. Nurses who work in Long Term Care (LTC) settings are often challenged to resolve the practical issue of needing more competency in caring for SUD patients. Horner et al. (2019) agreed that the deficiency of mental health knowledge and skills in healthcare workers is linked to decreased quality of care, which can diminish patient outcomes. This lack of competency must be addressed (Margoliese & Vandyck, 2019).

Purpose

The goal of this project …

Medical Interpreters' Work Impact On Their Lives: Understanding Medical Interpreters' Work Experience, Nicholas M. Herrarte Smith

Senior Honors Projects, 2020-current

Medical interpreters in the US are crucial health workers that specialize in facilitating communication between non-English-speaking patients and English medical professionals. Although much research has been done regarding the positive impact of professional medical interpreters on LEP (limited English proficient) patients' health, it is less known how medical interpreters’ lives are impacted in this line of work. Thus, this study was aimed at gaining a better understanding on the impact that this line of work has on the lives of medical interpreters. For this study, a survey was created with questions regarding demographics, interpretation’s certification process, interpreter’s satisfaction/experience, and mental …

How Medical Cannabis Took Root In Mississippi, Loral Winn

Honors Theses

How Medical Cannabis Took Root in Mississippi

(Under the direction of Dr. Iveta Imre)

How Medical Cannabis Took Root in Mississippi is a multimedia journalism piece that follows the timeline of medical cannabis’ legalization in Mississippi through the lives and lenses of characters from each sector of the medical marijuana industry. Written in a journalistic style with hints of narrative methods, the article tells the story of medical cannabis advocates, current patients, state registered practitioners, dispensary owners and employees, and a family-owned cultivation facility while also providing concrete evidence and facts about the legislation and regulations included in the state’s …

Health Insurance Education And Advocacy, Jacob Robante

Capstone Projects and Master's Theses

This capstone aims to highlight the benefits of health insurance for individuals and communities. Currently, at my internship at Salinas Valley Health Orthopedics, we face a large number of uninsured patients. As a result, these patients are left with extensive medical bills that may be difficult to pay since they do not have adequate health insurance to assist with some of the costs. The project's purpose is to educate the community about the importance of health insurance coverage, provide information on available options and resources, and increase enrollment in healthcare plans. The project was implemented through an outreach and educational …

Patient Frailty: A Review, Lakshmi Sailaja Kodavati

Dissertations and Theses

According to Geriator (2011), frailty is a common clinical syndrome in older adults that carries an increased risk for poor health outcomes such as falls, incident disability, hospitalization, and mortality. An operational definition of frailty is the existence of at least three out of five observable criteria indicating compromised energetics: low grip strength; low energy; slowed walking speed; low physical activity; and unintentional weight loss (Fried, et al. 2001).

According to Dubois and Charpillet (2017), most transitions into frailty are due to unintentional weight loss which, in turn, impacts gait performance and subsequent general mobility. In this literature review, the …

Implementing The Use Of The Emergency Severity Index Triage Tool In Urgent Care, Sakeena Spencer

Doctor of Nursing Practice Projects

Background: The urgent care sector has quickly grown in the last decade. Patients who visit healthcare facilities seeking treatment for exacerbations of chronic conditions or episodic illnesses such as asthma without scheduled appointments receive healthcare services from Urgent Care Centers (UCC) or Emergency Departments (E.D.s). Upon visiting the UCC, these patients report life-threatening symptoms; hence require immediate medical attention. UCC healthcare workers should distinguish between non-acute and acute patients to prioritize providing healthcare to patients, ensuring they are not at risk for fatal outcomes. Using the Emergency Severity Index (ESI) triage tool while delivering healthcare services to these patients has …

The Future Of American Primary Care, Julianne M. Johnsonwall

Classical Conversations

Historically, primary care has been delivered by physicians in private practices. However, pre-medical and medical students considering primary care should consider that market trends and physician preferences are changing the delivery methods of primary care. This thesis aims to predict the future delivery methods of primary care in America. By analyzing current studies, articles, and physician polls, it asserts that private practices are not a financially viable practice model and that medical systems will dominate primary care. Firstly, it identifies low insurance reimbursement rates, increasing quality documentation requirements, and an unhealthy work-life balance as the primary obstacles to private practice …

Reducing Patient Falls Through Purposeful Hourly Rounding, Amanda Savage

Student Scholarly Projects

Practice Problem: Falls significantly affect patients, resulting in temporary or permanent harm, even death. In a large acute care facility, patient falls increased from 444 in 2016 to 556 falls in 2019.

PICOT: In an adult inpatient hospital setting, does purposeful hourly rounding (PHR), compared to no rounding, reduce patient falls over a period of 30 days during the same time period from the previous year?

Evidence: Of the 360 articles reviewed, 12 articles, varying from evidence levels two (1), level three (4), and level five (7), supported PHR as effective in reducing harm from falls in adult …

Factors Associated With Patients Who Leave Emergency Departments Without Being Seen, Eva E. Koci

Walden Dissertations and Doctoral Studies

AbstractPatients leaving an emergency department (ED) without being seen by a provider are a significant problem in United States for patient health. Research on leaving without being seen (LWBS) has been conducted; but very few researchers have examined patients with Tricare or military members. This quantitative study explored the association between patients’ social demographic characteristics (age, gender, race, ethnicity), triage levels, visit characteristics (hour of arrival, day of the arrival), and LWBS rates. The theoretical framework for this study was the Donabedian theory. Secondary data from Agency for Healthcare Administration located in Florida were examined. The research questions explored whether …

Assessing Egyptians' Knowledge, Perceptions, And Attitudes Towards Generic Medicines, Radwa Ahmed Elmoneer

Theses and Dissertations

Medicines are vital component of any health system worldwide, and ensuring accessibility of affordable, effective and safe medications is a critical public policy goal considered by every country. Egypt has, recently, faced aggravated challenges in ensuring the availability of medications countrywide. In response, the Egyptian government has adopted a number of pharmaceutical policies and interventions, mainly, targeting the supply side of the market. Promoting the use of generic medicines is an effective policy intervention that addresses the demand side, a highly recommended intervention given other countries’ experiences. As the main users of medications, patients are a crucial source of knowledge …

Enhancing Health Literacy Using Teach Back Method To Increase Patient Adherence To, Tram Mendoza

Doctor of Nursing Practice (DNP) Projects

Background: Health literacy is a complicated and perplexing topic for those not trained in the medical field. Patients possess pieces of health literacy to some degree, while some have none at all. Limited health literacy can pose a very threatening risk on a patient’s well-being, interfering with their self-care and health maintenance, possibly creating more obstacles for the patient if health instructions and education are not clearly understood. This can lead to increased health expenditures due to treating the effects of poor health maintenance in addition to emergency room visits that may have not been necessary had the patient understood …

Identifying Predictors Of Racial Disparity In Treatment And Mortality Among Patients Diagnosed With Breast Cancer In South Carolina, Oluwole Adeyemi Babatunde

Theses and Dissertations

Introduction: Despite a lower incidence of breast cancer (BrCA) among Black women in the U.S. compared to White women, Black women experience consistently higher mortality rates. The aims of this study were 1) to assess the relationship between race and diagnosis-to-treatment times 2) to assess racial disparity in mortality among Black and White BrCA patients in SC and 3) assessment of the validity of the Mortality-to- incidence ration (MIR) as a proxy for survival and geospatial investigation of racial disparity among breast cancer (BrCA) patients.

Methods: Breast cancer cases diagnosed between 2002-2010 were obtained retrospectively from the SC Central Cancer …

Educating Staff Nurses For Successful Patient Discharge, Julie First-Williams

Walden Dissertations and Doctoral Studies

The definition of a successful discharge is a discharge that results in patients successfully managing a chronic disease for at least 30 days without requiring an acute inpatient hospitalization. Many chronic disease readmissions are preventable. Successful discharge planning takes a multidisciplinary team that includes nurses who assess the discharge plan and provide additional education where needed. The purpose of this project was to determine staff nurses' understanding of their role in discharge education. Dorothea Orem's self-care deficit theory guided the project and root cause analysis was used in the development of the problem statements. Staff nurses (n=12) from evening and …

Price Transparency In The United States Healthcare System, Gurlivleen (Minnie) Ahuja

USF Tampa Graduate Theses and Dissertations

The study explores price transparency in the healthcare system. With the increase in healthcare spending resulting in the advent of high deductible plans, consumers have been exposed to high healthcare cost. Despite being burdened with outrageous and extravagant bills, studies have shown that the consumers are not using price transparency tools to their benefit.

The literature review reveals that the major stakeholders in the healthcare industry have never been studied together to understand the research question on ‘Why is there lack of price transparency in the healthcare system?’ moreover, there is no theory to explains this phenomenon.

This study undertakes …

Factors Contributing To 30-Day Readmission In Postsurgical Patients: A Reevaluation Of Hospital Policies And Proposal For Change, Miriam Morgan-Skinner

Doctor of Nursing Practice Projects

Background

Readmission can cause much frustration for patients and families. The Center for Medicare and Medicaid Services (CMS) has emphasized the importance of finding ways to decrease readmissions within 30 days of discharge. In the southwest healthcare organization studied, the 30-day readmission rate for abdominal surgeries was 10%. The goal of the study was to identify the causative factors for the readmissions and make appropriate suggestive changes. This project identified the factors contributing to the 30-day readmission rate in selected abdominal surgeries between January 2016-July 2017 and developed a policy to address the predominant factor.

Method

After receiving institutional review …

Influence Of Depression On Treatment And Survival: A Population-Based Study In Patients With Breast Cancer In Kentucky, Feitong Lei

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

This capstone project describes the results of a consultative experience in biostatistics.

Self-Disclosure, Gender, And Patient Satisfaction In The Doctor-Patient Relationship, Khadiza Tul Jannat

All Graduate Theses, Dissertations, and Other Capstone Projects

It has been well established that the doctor-patient relationship is integral for providing quality health care and sustaining patient satisfaction. Additionally, research has indicated that doctors' self-disclosure is considered as an essential interpersonal component of relational development. In terms of the doctor-patient interaction, previous research has produced numerous studies investigating the relationship between doctors' communication behaviors and patient satisfaction. Scholars have also explored how communication styles are associated with doctors' gender, and patient satisfaction. However, there is still a gap in the existing research concerning the connections between doctors' self-disclosure, gender, and patient satisfaction in doctor-patient interactions. My qualitative study …

The Impact Of Adjuvant Chemotherapy On Survival For Patients With Stage Ii Colon Cancer Portfolio, Li Ding

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

This capstone project describes the results of a consultative experience in biostatistics.

A Bridge Too Far? Risks And Benefits Of Perioperative Bridging Therapy, Jordan Buchholz

Physician Assistant Scholarly Project Papers

The long-term use of oral anticoagulants is common among certain high-risk patient populations for the prevention of thromboembolic events such as stroke, pulmonary embolism (PE), and other systemic events. According to Garwood et al. (2017) it is estimated that 15-20% of chronically anticoagulated patients will undergo a surgery or procedure that will require anticoagulation interruption annually. During this interruption period, “bridging” anticoagulant therapy is often utilized with unfractionated heparin or low-molecular weight heparin to ensure adequate anticoagulation is achieved (Ayoub et al., 2016). However, there has been an ongoing debate whether or not the benefits of perioperative anticoagulant bridging therapy …

Implementation Of A Depression Screening Tool For Cardiovascular Patients In The Primary Care Setting, Amber Nicole Ballentine

Theses and Dissertations

Background: Patients with cardiovascular disease (CVD) have a two-fold increased risk of depression as compared to patients without CVD. According to the American Heart Association (AHA, 2016), there is no gold-standard procedure for screening for depression in cardiovascular patients. Screening for depression varies greatly across specialties and practices, often leaving a gap for detection and treatment of depression in cardiac patients. There are many depression screening tools available; however, the AHA recommends use of the patient health questionnaire (PHQ) screening tool. The PHQ-2 and PHQ-9 questionnaires are the most brief, sensitive, and specific depression screening tool for patients with …

Community-Based Asthma Intervention Programs And Their Impact On Childhood Health Outcomes And Burdens On The Healthcare System, Danika Ng

Master's Projects and Capstones

Since 1997, asthma prevalence rates have increased by 3% annually, leading to a current rate of 18.4 million adults and 6.2 million children with asthma, high hospitalization and emergency department visit rates, and an overall healthcare spending of 50 billion dollars. However, this increase in prevalence is disproportionately impacting children. Asthma is the third leading cause for hospitalization in children, have higher proportions of children being hospitalized with asthma symptoms, and have higher rates of asthma attacks. Recent literature shows that perceived lack of adequate education in areas such as medication adherence, medical device usage, asthma trigger avoidance, lack of …

The Linkage Between Hpa Axis Dysregulation And Metabolic Syndrome, Brianna Godlewski

Honors Theses

A diagnosis of Metabolic Syndrome (MSX) requires patients to present with three or more of the following symptoms: elevated fasting blood glucose levels, elevated serum triglyceride levels, low serum HDL levels, elevated blood pressure, and truncal obesity. This pathology shares many similarities with Cushing’s Syndrome (CS) but a diagnosis of CS requires hypercortisolemia. This similarity has led our lab and others to hypothesize that MSX may be a Cushingoid-like state caused by hypersensitivity of the glucocorticoid receptor (GR), a nuclear hormone receptor that is activated when cortisol binds, and or hyperactivity of the enzyme 11beta-hydroxysteroid dehydrogenase (11?- HSD) type 1, …

Comparing The Effectiveness Of Using Educational Booklet Or Brief Video On Patients’ Knowledge, Perceptions And Willingness To Participate In Placebo-Controlled Clinical Trials, Khalid F. Almoaikel, Dennis Raisch, Matthew Borrego, Mike Sather, Mark Holdsworth

Pharmaceutical Sciences ETDs

Background and Objectives: Limited knowledge about clinical trials can influence a patient’s willingness to participate in medical research. For placebo-controlled clinical trials, it is more difficult to recruit patients compared to clinical trials without a placebo arm. Thus, educating individuals about clinical trials and placebos can potentially improve their perceptions about clinical trials and might increase their willingness to enroll in them. The study objectives include:

1) To design educational interventions (a booklet and a video) to improve a patient’s knowledge of placebo controlled clinical trials.

2) To compare the impact of the educational interventions (booklet, video or both) on …

Fall Prevention In A Neurological Care Unit, Claudeth Jeffrey

Walden Dissertations and Doctoral Studies

Patient falls are an ongoing concern for health systems in the US and in the setting where this project took place. Inpatient falls affect consumers and health providers because falls often result in patient morbidity and mortality, legal risk, increased length of stay, and increased costs. The purpose of this project was to evaluate the existing fall prevention protocol at the site where this project took place and to make recommendations for an evidenced-based fall prevention protocol. The professional practice model was the conceptual model that guided the exploratory descriptive project. A review of the site's fall prevention policies and …

Managerial Strategies For Improving Employee Engagement: A Single Case Study, Ann-Marie Alcala

Walden Dissertations and Doctoral Studies

In 2013, 1% of Medicare reimbursements were withheld from U.S. hospitals, with a

proposed cap of 2% in 2017 for redistribution to those hospitals that improve overall care and patient satisfaction. The purpose of this single case study was to explore the engagement strategies that some hospital middle managers used to improve employee performance to increase patient satisfaction. The sample included 4 health care middle managers in 1 hospital in northeast Connecticut. The conceptual framework that grounded this study was Kahn's personal engagement theory. Data were collected via semistructured interviews, participant observations, and review of hospital and public government documents. …