Medicine and Health Sciences Commons^™

Implementation Of An Education Program To Decrease Inpatient Falls, Elizabeth M. Carpenter, Jewyl Gibson

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Inpatient falls are affecting 1 million patients across the United States every year with 25% of fall resulting in injury. Approximately 25% of falls are preventable with accurate assessment and appropriate fall precaution interventions. According to the literature, obtaining an accurate fall risk assessment is the first step in inpatient fall prevention.

LOCAL PROBLEM: Patient falls increased on 2 cardiac stepdown units in a level III trauma center in Knoxville, Tennessee. From 2020- 2022, the combined units experienced a 48% increase in patient falls. Nursing leadership identified staff knowledge deficits and inaccurate scoring of fall assessments as primary contributors …

Prevalence Of Frailty And Pain In Hospitalised Cancer Patients: Implications For Older Adult Care, Heather Lane, Rosemary Saunders, Kate Crookes, Seng G. M. Ang, Caroline Bulsara, Max K. Bulsara, Beverley Ewens, Olivia Gallagher, Karen Gullick, Sue Haydon, Jeff Hughes, Kim-Huong Nguyen, Karla Seaman, Christopher Etherton-Beer

Research outputs 2022 to 2026

A hospital-wide point prevalence study investigated frailty and pain in patients with a cancer-related admission. Modifiable factors associated with frailty in people with cancer were determined through logistic regression. Forty-eight patients (19%) with cancer-related admissions were 2.65 times more likely to be frail and 2.12 more likely to have moderate pain. Frailty and pain were highly prevalent among cancer-related admissions, reinforcing the need for frailty screening and importance of pain assessment for patients with cancer.

Validation Of A Novel, Rapid Sepsis Diagnostic For Emergency Department Use, Hollis R. O'Neal, Roya Sheybani, David R. Janz, Robert Scoggins, Tonya Jagneaux, James E. Walker, Daniel J. Henning, Elizabeth Rosenman, Simon A. Mahler, Hariharan Regunath, Christopher S. Sampson, D. Clark Files, Richard D. Fremont, Michael J. Noto, Erica E. Schneider, Wesley R. Shealey, Matthew S. Berlinger, Thomas C. Carver, Morgan K. Walker, Nathan A. Ledeboer, Ajay M. Shah, Henry T.K. Tse, Dino Dicarlo, Todd W. Rice, Christopher B. Thomas

School of Medicine Faculty Publications

OBJECTIVES: To assess the in vitro IntelliSep test, a microfluidic assay that quantifies the state of immune activation by evaluating the biophysical properties of leukocytes, as a rapid diagnostic for sepsis. DESIGN: Prospective cohort study. SETTING: Five emergency departments (EDs) in Louisiana, Missouri, North Carolina, and Washington. PATIENTS: Adult patients presenting to the ED with signs (two of four Systemic Inflammatory Response Syndrome criteria, where one must be temperature or WBC count) or suspicion (provider-ordered culture) of infection. INTERVENTIONS: All patients underwent testing with the IntelliSep using ethylene diamine tetraacetic acid-anticoagulated whole blood followed by retrospective adjudication for sepsis by …

"Girls Don't Strike Without Provocation.": African American Women, The General Strike, And The Good Samaritan Hospital School Of Nursing, Charlotte, North Carolina, 1956-1959., Francena F.L. Turner

Sociology Department Faculty Working Papers

No abstract provided.

Mitigating Intensive Care Unit Noise: Design-Led Modeling Solutions, Calculated Acoustic Outcomes, And Cost Implications, Emil E. Jonescu, Benjamin Farrel, Chamil E. Ramanayaka, Christopher White, Giuseppe Costanzo, Lori Delaney, Rebecca Hahn, Janet Ferrier, Edward Litton

Research outputs 2022 to 2026

Objectives, Purpose, or Aim: The study aimed to decrease noise levels in the ICU, anticipated to have adverse effects on both patients and staff, by implementing enhancements in acoustic design. Background: Recognizing ICU noise as a significant disruptor of sleep and a potential hindrance to patient recovery, this study was conducted at a 40-bed ICU in Fiona Stanley Hospital in Perth, Australia. Methods: A comprehensive mixed-methods approach was employed, encompassing surveys, site analysis, and acoustic measurements. Survey data highlighted the importance of patient sleep quality, emphasizing the negative impact of noise on work performance, patient connection, and job satisfaction. Room …

Awareness With Paralysis And Symptoms Of Post-Traumatic Stress Disorder Among Mechanically Ventilated Emergency Department Survivors (Ed-Awareness-2 Trial): Study Protocol For A Pragmatic, Multicenter, Stepped Wedge Cluster Randomized Trial., Brian M Fuller, Brian E Driver, Michael B. Roberts, Christa A Schorr, Kathryn Thompson, Brett Faine, Julianne Yeary, Nicholas M Mohr, Ryan D Pappal, Robert J Stephens, Yan Yan, Nicholas J Johnson, Brian W Roberts

PCOM Scholarly Papers

BACKGROUND: Awareness with paralysis (AWP) is memory recall during neuromuscular blockade (NMB) and can cause significant psychological harm. Decades of effort and rigorous trials have been conducted to prevent AWP in the operating room, where prevalence is 0.1-0.2%. By contrast, AWP in mechanically ventilated emergency department (ED) patients is common, with estimated prevalence of 3.3-7.4% among survivors given NMB. Longer-acting NMB use is a critical risk for AWP, and we have shown an association between ED rocuronium use and increased AWP prevalence. As NMB are given to more than 90% of ED patients during tracheal intubation, this trial provides a …

Mountain West State Health System Rankings, 2023, Julia Salangsang, Ivan Sun, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet presents data from the “2023 Scorecard on State Health System Performance” published by The Commonwealth Fund. The original report includes data from all 50 states and measures health system performance based on health care access, quality, use of services, costs, health disparities, reproductive care and women’s health, and health outcomes.

Camera Assisted Monitoring Device As A Tool To Reduce Falls In Inpatient Adults: An Integrative Review, Pamela Oriaifo

Doctoral Dissertations and Projects

Background: Adult inpatient falls remain a significant challenge in many hospitals, resulting in poor quality of life and severe financial burden. There have been tremendous efforts to curb the number of falls ranging from environmental modification, clinician education, review of medications, and use of assistive devices. One such assistive device is the use of camera monitoring systems. This systemic review scopes camera/video-assisted fall prevention programs in hospitals. It was hypothesized that camera/video-assisted fall prevention programs would reduce adult inpatient fall and costs significantly. The outcomes of camera or video-assisted fall prevention programs were considered in some hospital settings. Method: The …

Trends And Seasonality Of Emergency Department Visits And Hospitalizations For Suicidality Among Children And Adolescents In The Us From 2016 To 2021, Youngran Kim, Trudy Millard Krause, Scott D Lane

Journal Articles

IMPORTANCE: The detection of seasonal patterns in suicidality should be of interest to clinicians and US public health officials, as intervention efforts can benefit by targeting periods of heightened risk.

OBJECTIVES: to examine recent trends in suicidality rates, quantify the seasonality in suicidality, and demonstrate the disrupted seasonality patterns during the spring 2020 COVID-19-related school closures among US children and adolescents.

DESIGN, SETTING, AND PARTICIPANTS: This population-based, descriptive cross-sectional study used administrative claims data from Optum's deidentifed Clinformatics Data Mart Database. Participants included children aged 10 to 12 years and adolescents aged 13 to 18 years who were commercially insured …

Effect Of A Community Hospital’S Sustainable And Enhanced Fall Prevention Quality Improvement Program On Inpatient Falls And Falls With Injury: A Before And After Study, Anne Catino

DNP Scholarly Projects

The frequency of hospital falls is a significant clinical problem and directly related to patient safety. Failure to identify potential risk factors and to implement individualized measures for fall prevention can threaten patients’ safety and lead to increased hospital length of stay, increased hospital cost, and reduced quality of life for patients. The purpose of this project was to enhance an evidence-based, fall prevention program to effect a reduction in falls and falls injury. The project is supported by a multidisciplinary hospital team and builds on a community hospital’s fall reduction program. Falls and falls with injury frequencies for 6 …

Reducing Urinary Catheter Usage In The Intensive Care Unit Setting And Education Related To Preventing Cautis: A Qi Project, Kristina Diurno

DNP Projects

Significance and Background: Catheter-associated urinary tract infections (CAUTIs) are common but preventable hospital-associated infections. The inappropriate and prolonged use of indwelling urinary catheters can pose a significant risk for patients and healthcare organizations. The Centers for Disease Control and Prevention identified that the most important factor related to an increased risk of CAUTI is the length of time an indwelling catheter remains in place. This DNP (Doctor of Nursing Practice) project assessed the barriers to removing indwelling catheters in the intensive care unit (ICU) while providing encouragement of prompt removal.

Purpose: Three aims were developed for this quality improvement project: …

Prehospital Stroke Care Part 2: On-Scene Evaluation And Management By Emergency Medical Services Practitioners, Christopher T Richards, J Adam Oostema, Sherita N Chapman, Lauren E Mamer, Ethan S Brandler, Anne W Alexandrov, Alexandra L Czap, Juan Carlos Martinez-Gutierrez, Christian Martin-Gill, Ashish R Panchal, Jason T Mcmullan, Kori S Zachrison

Journal Articles

The prehospital phase is a critical component of delivering high-quality acute stroke care. This topical review discusses the current state of prehospital acute stroke screening and transport, as well as new and emerging advances in prehospital diagnosis and treatment of acute stroke. Topics include prehospital stroke screening, stroke severity screening, emerging technologies to aid in the identification and diagnosis of acute stroke in the prehospital setting, prenotification of receiving emergency departments, decision support for destination determination, and the capabilities and opportunities for prehospital stroke treatment in mobile stroke units. Further evidence-based guideline development and implementation of new technologies are critical …

Outcomes Of Completed Quality Activities In An Australian Tertiary Hospital, 2015-2019, Qun Catherine Li, Jonathan Karnon, Jim Codde

IHR Papers and Journal Articles

Quality activities including quality assurance and quality improvement are an integral part of safety and quality governance for hospitals. Previous studies identified that (i) majority are for quality assurance and knowledge-acquiring purposes and (ii) adherence to the quality cycle as well as impact on patient-related outcomes at the hospital level are unclear, neither associated with costs. This study aims to (i) assess adherence to the quality cycle for quality activities in a large Australian tertiary hospital; (ii) report outcomes of quality activities at the hospital level, including impact on patient-related outcomes measured by the occurrence of hospital-acquired complications; and (iii) …

Best Strategies To Address Burnout Among Healthcare Professionals: An Integrative Review, Kimberly Ann Delbo

Doctoral Dissertations and Projects

The purpose of this integrative literature review (ILR) is to provide a comprehensive summary and analysis of past empirical and theoretical literature related to the phenomenon of burnout while sharing a synthesis of literature. This ILR explores, critiques, summarizes, and analyzes best practices and interventions to address burnout and promote engagement and well-being among health care workers within acute care hospitals. The scientific basis for this ILR was the premise that a relationship exists between burnout interventions and organizational cultures which can be positively influenced by relational and social leadership styles that reduce work-related stressors and create positive, professional, healthy …

Reducing Suicide Reattempts With A Telephone Follow Up Program, Bailey Breaux

MSN Capstone Projects

Suicide is one of the leading causes of death in the United States. Most people can say they know at least one person who has committed suicide or has considered suicide. The number of deaths continues to rise, and they aren’t stopping anytime soon. Many of these patients visit emergency rooms around the country seeking help for their depression and suicidal ideation. Some are brought into the emergency department following a suicide attempt and their visit only predicts another one happening in the near future. Some hospitals around the globe has tried to stop this recurrence of suicide reattempts by …

The Global, Regional, And National Burden Of Benign Prostatic Hyperplasia In 204 Countries And Territories From 2000 To 2019: A Systematic Analysis For The Global Burden Of Disease Study 2019, Atalel Fentahun, Hannah Han, Behzad Abbasi, Mohsen Abbasi-Kangevari, Muktar Beshir Ahmed, Ismaeel Yunusa Ph. D., Et Al.

Faculty Publications

Background Benign prostatic hyperplasia is a common urological disease affecting older men worldwide, but comprehensive data about the global, regional, and national burden of benign prostatic hyperplasia and its trends over time are scarce. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we estimated global trends in, and prevalence of, benign prostatic hyperplasia and disability-adjusted life-years (DALYs) due to benign prostatic hyperplasia, in 21 regions and 204 countries and territories from 2000 to 2019.

Methods This study was conducted with GBD 2019 analytical and modelling strategies. Primary prevalence data came from claims from …

Executive Summary: Driving The Southern Nevada Health Economy Forward, Tripp Umbach

Policy Briefs and Reports

The University of Nevada, Las Vegas (UNLV) plans to develop an integrated academic health center within the Las Vegas Medical District (LVMD).1 The academic health center includes UNLV’s five health science schools and mental and behavioral health, which is distributed among several colleges (medicine, liberal arts, urban affairs, and education) in the university. University Medical Center (UMC), a major teaching hospital, will also be an important driver of the academic health center. For the purposes of this report, UNLV’s medical and health science entities along with UMC are referred to collectively as the UNLV Academic Health Center.

Driving The Southern Nevada Health Economy Forward: Benefits Of A Transformational Unlv Academic Health Center, Tripp Umbach

Policy Briefs and Reports

The University of Nevada, Las Vegas (UNLV) plans to develop an integrated academic health center within the Las Vegas Medical District (LVMD). The academic health center includes UNLV’s five health science schools and mental and behavioral health, which is distributed among several colleges (medicine, liberal arts, urban affairs, and education) in the university. University Medical Center (UMC), a major teaching hospital, will also be an important driver of the academic health center. For the purposes of this report, UNLV’s medical and health science entities along with UMC are referred to collectively as the UNLV Academic Health Center. Additional academic health …

2021 Saem Consensus Conference Proceedings: Research Priorities For Developing Emergency Department Screening Tools For Social Risks And Needs, Jacqueline Furbacher, Callan Fockele, Ben Del Buono, Laura Janneck, Cooper March, Melanie Molina, Herbet C Duber, Kelly M Doran, Michelle P Lin, Richelle J Cooper, Payal Modi

Journal Articles

INTRODUCTION: The Emergency Department (ED) acts as a safety net for our healthcare system. While studies have shown increased prevalence of social risks and needs among ED patients, there are many outstanding questions about the validity and use of social risks and needs screening tools in the ED setting.

METHODS: In this paper, we present research gaps and priorities pertaining to social risks and needs screening tools used in the ED, identified through a consensus approach informed by literature review and external expert feedback as part of the 2021 SAEM Consensus Conference -- From Bedside to Policy: Advancing Social Emergency …

Differential Patterns And Outcomes Of 20.6 Million Cardiovascular Emergency Department Encounters For Men And Women In The United States., Zahra Raisi-Estabragh, Ofer Kobo, Ayman Elbadawi, Poonam Velagapudi, Garima Sharma, Renee P Bullock-Palmer, Steffen E Petersen, Laxmi S Mehta, Waqas Ullah, Ariel Roguin, Louise Y Sun, Mamas A Mamas

Division of Cardiology Faculty Papers

Background We describe sex-differential disease patterns and outcomes of >20.6 million cardiovascular emergency department encounters in the United States. Methods and Results We analyzed primary cardiovascular encounters from the Nationwide Emergency Department Sample between 2016 and 2018. We grouped cardiovascular diagnoses into 15 disease categories. The sample included 48.7% women; median age was 67 (interquartile range, 54-78) years. Men had greater overall baseline comorbidity burden; however, women had higher rates of obesity, hypertension, and cerebrovascular disease. For women, the most common emergency department encounters were essential hypertension (16.0%), hypertensive heart or kidney disease (14.1%), and atrial fibrillation/flutter (10.2%). For men, …

Predicting At-Risk Opioid Use Three Months After Ed Visit For Trauma: Results From The Aurora Study, Brittany E. Punches, Uwe Stolz, Caroline E. Freiermuth, Rachel M. Ancona, Samuel A. Mclean, Stacey L. House, Francesca L. Beaudoin, Xinming An, Jennifer S. Stevens, Donglin Zeng, Thomas C. Neylan, Gari D. Clifford, Tanja Jovanovic, Sarah D. Linnstaedt, Laura T. Germine, Kenneth A. Bollen, Scott L. Rauch, John P. Haran, Alan B. Storrow, Christopher Lewandowski, Paul I. Musey Jr., Phyllis L. Hendry, Sophia Sheikh, Christopher W. Jones, Michael C. Kurz, Nina T. Gentile, Meghan E. Mcgrath, Lauren A. Hudak, Jose L. Pascual, Mark J. Seamon, Erica Harris, Anna M. Chang, Claire Pearson, David A. Peak, Roland C. Merchant, Robert M. Domeier, Niels K. Rathlev, Brian J. O'Neil, Leon D. Sanchez, Steven E. Bruce, Robert H. Pietrzak, Jutta Joormann, Deanna M. Barch, Diego A. Pizzagalli, Jordan W. Smoller, Beatriz Luna, Steven E. Harte, James M. Elliott, Ronald C. Kessler, Kerry J. Ressler, Karestan C. Koenen, Michael S. Lyons

Department of Emergency Medicine Faculty Papers

OBJECTIVE: Whether short-term, low-potency opioid prescriptions for acute pain lead to future at-risk opioid use remains controversial and inadequately characterized. Our objective was to measure the association between emergency department (ED) opioid analgesic exposure after a physical, trauma-related event and subsequent opioid use. We hypothesized ED opioid analgesic exposure is associated with subsequent at-risk opioid use.

METHODS: Participants were enrolled in AURORA, a prospective cohort study of adult patients in 29 U.S., urban EDs receiving care for a traumatic event. Exclusion criteria were hospital admission, persons reporting any non-medical opioid use (e.g., opioids without prescription or taking more than prescribed …

Hospital Nursing Factors Associated With Decreased Odds Of Mortality In Older Adult Medicare Surgical Patients With Depression, Aparna Kumar, Douglas Sloane, Linda Aiken, Matthew Mchugh

College of Nursing Faculty Papers & Presentations

Background: Depression is common, costly, and has deleterious effects in older adult surgical patients. Little research exists examining older adult surgical patient outcomes and depression and the potential for nursing factors to affect these outcomes. The purpose of this study was to determine the relationship between hospital nursing resources, 30-day mortality; and the impact of depression on this relationship.

Methods: This was a retrospective cohort study employing a national nurse survey, hospital data, and Medicare claims data from 2006-2007. The sample included: 296,561 older adult patients, aged 65-90, who had general, orthopedic, or vascular surgery in acute care general hospitals …

Emergency Department Communication In Persons Living With Dementia And Care Partners: A Scoping Review, Christopher R Carpenter, Jesseca Leggett, Fernanda Bellolio, Marian Betz, Ryan M Carnahan, David Carr, Michelle Doering, Jennie Chin Hansen, Eric D Isaacs, Deborah Jobe, Kathleen Kelly, Nancy Morrow-Howell, Beth Prusaczyk, Bob Savage, Joe Suyama, Allan S Vann, Kristin L Rising, Ula Hwang, Manish N Shah

Department of Emergency Medicine Faculty Papers

OBJECTIVES: To synthesize published research exploring emergency department (ED) communication strategies and decision-making with persons living with dementia (PLWD) and their care partners as the basis for a multistakeholder consensus conference to prioritize future research.

DESIGN: Systematic scoping review.

SETTINGS AND PARTICIPANTS: PLWD and their care partners in the ED setting.

METHODS: Informed by 2 Patient-Intervention-Comparison-Outcome (PICO) questions, we conducted systematic electronic searches of medical research databases for relevant publications following standardized methodological guidelines. The results were presented to interdisciplinary stakeholders, including dementia researchers, clinicians, PLWD, care partners, and advocacy organizations. The PICO questions included: How does communication differ for …

Impact Of Risk-Based Sexually Transmitted Infection Screening In The Emergency Department, Fahd A Ahmad, Kayleigh Fischer, Hongjie Gu, Thomas C Bailey, Donna B Jeffe, Christopher R Carpenter, Philip R O Payne

Journal Articles

OBJECTIVES: Sexually transmitted infections (STIs), including chlamydia, gonorrhea, and human immunodeficiency virus (HIV) pose a significant health burden in adolescents. Many adolescents receiving care in the emergency department (ED) are in need of testing, regardless of their chief complaint. Our objective was to determine whether an electronic, risk-based STI screening program in our ED was associated with an increase in STI testing among at-risk adolescents.

METHODS: We conducted a retrospective cohort analysis of patient outcomes in our pediatric ED after integrating an Audio-enhanced Computer-Assisted Self-Interview (ACASI) as standard of care. It obtained a focused sexual history and generated STI testing …

Comparison Of Hemodynamic Responses Between Conventional And Virtual Reality Therapies In Patients With Heart Failure Admitted To An Emergency Room, Angélica Bologna Raposo, Alice Haniuda Moliterno, João Pedro Lucas Neves Silva, Rafael Varago Favri, Ana Paula Coelho Figueira Freire, Francis Lopes Pacagnelli

All Faculty Scholarship for the College of Education and Professional Studies

This study aimed to evaluate and to compare the acute response, due to semi-immersive virtual reality (VR) and conventional therapies (CT), of hemodynamic parameters in hospitalized individuals admitted to an emergency unity for heart failure (HF). This is a viability study with 11 individuals subjected to sessions with and without VR. At CT, stretching, active or active-assisted exercises, and fractional inspiration were performed. In VR therapy (VRT), VR box glasses were used to promote VR relaxation associated with CT. The hemodynamic parameters evaluated were heart rate, systolic and diastolic blood pressure, oxygen saturation, and double product. To analyze them, Student’s …

Disruption Of Library Services Due To Hospital Cyberattack: A Case Study, Alice Stokes

University Libraries Faculty and Staff Publications

Cyberattacks on healthcare organizations increased dramatically in 2020 and 2021. The University of Vermont Medical Center suffered an attack in October 2020, during the second wave of the COVID-19 pandemic. The disruption to hospital computer systems had wide ranging impacts, including loss of online access to the medical library for nearly three months. Library staff worked to reduce impacts and increase access for hospital employees until full access was restored. This case study offers lessons learned and resources for health sciences libraries planning for a potential cyberattack.

Promotion Of Covid-19 Va(X)Ccination In The Emergency Department-Procovaxed: Study Protocol For A Cluster Randomized Controlled Trial., Robert M Rodriguez, Kelli O'Laughlin, Stephanie A Eucker, Anna Marie Chang, Kristin L. Rising, Graham Nichol, Alena Pauley, Hemal Kanzaria, Alexzandra Gentsch, Cindy Li, Herbie Duber, Jonathan Butler, Vidya Eswaran, Dave Glidden

Department of Emergency Medicine Faculty Papers

Background: We conducted in-depth interviews to characterize reasons for COVID-19 vaccine hesitancy in emergency department (ED) patients and developed messaging platforms that may address their concerns. In this trial, we seek to determine whether provision of these COVID-19 vaccine messaging platforms in EDs will be associated with greater COVID-19 vaccine acceptance and uptake in unvaccinated ED patients.

Methods: This is a cluster-randomized controlled trial (RCT) evaluating our COVID-19 vaccine messaging platforms in seven hospital EDs (mix of academic, community, and safety-net EDs) in four US cities. Within each study site, we randomized 30 1-week periods to the intervention and 30 …

Knowledge And Practices Regarding Standard Precautions For Infection Control Among Nurses Working At A Public, Tertiary Care Hospital Islamabad, Pakistan, Samina Yasmeen, Tazeen Saeed Ali, Wardah Khalid, Zohra Kurji, Shair Muhammad Hazara, Shahzad Bashir

School of Nursing & Midwifery

Introduction: To protect patients and healthcare providers from healthcare-associated infections (HAIs), standard precautions have been promoted universally. Nurses are the forefront force in patient care; therefore, evidence-based and up to date knowledge and practices can play a vital role in helping nurses apply standard precautions (SPs).
Methods: The analytical cross-sectional study design was used. Through purposive sampling, the data were collected from 320 nurses, via, a self-administered questionnaire, from April to May 2017, from a public tertiary level hospital in Islamabad. The validity and reliability of each section was established. Mean and standard deviation were computed for continuous variables’ whereas; …

Sleep Disruptions Within The Hospital, Faith Walls

Senior Honors Theses

The circadian rhythm is a complex and interwoven system within each human being that creates an internal clock each day. However, patients in all hospital settings continue to have their sleep disrupted by many factors. Seep being disrupted in the hospital patients can develop serious complications. To this day, the issues causing have not been adequately assessed and therapeutically intervened with consistency within nursing practice. Using the Whittemore and Knalf Framework, this integrative review will examine the literature on aspects of inpatient care that contribute to circadian disruptions within hospitals. By doing so, the research can be built upon with …

Performance Improvement For Rural Hospitals: Front Line-Driven Change To Decrease Transfer Time From Ed To Inpatient Admission, Chasatie Whitley, Eddie Perez-Ruberte, Linda Kimsey, Bettye Apenteng

Research & Practice Briefs

Highlights: A recent performance improvement project undertaken by a Georgia Critical Access Hospital (CAH) demonstrates the potential for use of Plan-Do-Study-Act (PDSA) techniques to improve operations in the area of patient transfers from Emergency Department (ED) to Inpatient Ward. Implemented process improvement, including visual tracking of inpatient hold in the ED and bedside handoff led to reductions in admission decision to ED departure time and delayed or omitted ED admission orders.

Background: The Georgia Southern Flex Team, funded by the Georgia State Office of Rural Health, assists the state’s CAHs in pursuing financial and operational excellence. Under an ongoing grant, …