Medicine and Health Sciences Commons^™

Improving First Case Starts For A Neurosurgery Or, Tara L. Goodall

Master's Projects and Capstones

Problem: On-time first cases for operating rooms (OR) is a worldwide focus for improvement. OR delays have many adverse effects, including economic costs and patient and facility staff satisfaction.

Context: The site for this improvement project is a medium-sized hospital in Northern California. There are 12 ORs, with an average of 600-700 cases. Neurosurgery was the chosen specialty due to low on-time starts and long delay minutes. The focus was working with one OR to improve first case on-time starts by 20%.

Interventions: A worksheet was created to track room setup, delay reasons, and delay minutes. A visual setup guide …

Derivation And Validation Of A General Predictive Model For Long Term Risks For Mortality And Invasive Cardiovascular Interventions In Congenital Heart Disease, David A. Danford

Capstone Experience

Introduction. Accurate assessment of prognosis is a key driver of clinical decision making in congenital heart disease (CHD), but is complicated because CHD represents such a diverse collection of conditions. The aim of this investigation is to derive, validate, and calibrate multivariable predictive models for time to surgical or catheter-mediated intervention (INT) in CHD and for time to death in CHD. Methods. 4108 unique subjects were prospectively and consecutively enrolled, and randomized to derivation and validation cohorts. Total follow up was 26,578 patient-years, with 102 deaths and 868 INTs. Accelerated failure time multivariable predictive models for the outcomes, based on …

Platelet-Rich Plasma Vs. Traditional Surgical And Nonsurgical Interventions For Rotator Cuff Tendinopathies, Nick Slingerland

Theses and Graduate Projects

Background: Rotator cuff tendinopathies present as one of the most common musculoskeletal injuries of the upper extremity. The rotator cuff consists of four muscles: the supraspinatus, infraspinatus, teres minor, and subscapularis with the supraspinatus the most injured of the group. Over time, variations regarding treatment through surgical or nonsurgical interventions have remained constant. In recent years, the use of platelet-rich plasma (PRP) as an additional alternative has become popular to promote healing and improve functionality of the shoulder. The purpose of this clinical review using various study designs is to assess if the platelet-rich plasma injections are more effective when …

Closing Communication Gaps For Unplanned Surgical Patients: One Pre-Op Checklist At A Time, Seda L. Vash

Master's Projects and Capstones

Problem: Unplanned, inpatient surgical patients were experiencing poor outcomes and dissatisfaction with their overall care. This surgical patient population also lacked communication from their healthcare teams with regard to plans of care throughout their hospital stays.

Context: This was a quality improvement project for the unplanned, inpatient surgical patient population in the Central Valley of California. Approximately 13% of this hospital’s surgical patients required post-surgical care in the inpatient units. These patients, according to unfavorable HCAHPS scores, experienced unsatisfying care and insufficient communication from their healthcare teams, including physicians and nurses.

Intervention: This project implemented an Add-On Communication Tool for …

Perioperative Management Of The Patient With Diabetes Mellitus, Alexa High

Nursing Student Class Projects (Formerly MSN)

Diabetes Mellitus is one of the most prevalent co-morbidities seen in hospitals today. As such, it is extremely important for healthcare providers to be well informed in order to care for their patients properly. This poster will adequately inform healthcare providers on key signs and symptoms, pathophysiology, diagnosis, and treatment for diabetes mellitus. This poster will also include significant information on how to care for the patient with diabetes mellitus during the perioperative period.

Introduction Of Strong For Surgery Pre-Surgical Checklist For Elective Procedures​, Dylan Defauw

Doctor of Nursing Practice Projects

Nearly one-third of hospitalized patients experience preventable harm or adverse effects related to the care they received, often due to preventable surgical complications. Thorough preoperative assessment and management of risk factors can lessen this risk. The purpose of this quality improvement project was to increase knowledge and prepare staff for use of the preoperative tool Strong for Surgery (S4S) in a general surgery clinic in a rural hospital in southern Illinois. Support for each of the key components of the Strong for Surgery pre-surgical checklist was reviewed in the literature; these include nutrition, smoking cessation, glycemic control, medication management, safe …

Correction Of Excessive Gingival Display: Lip Repositioning With/Without Myotomy, Austin Michael Dodge

Master's Theses (2009 -)

Background: Lip repositioning (LR) is a conservative and reversible surgical method for correcting excessive gingival display (EGD). Purpose: The study aims to compare two LR techniques. The objectives include 1) comparing the amount of gingival display reduction (GDR) after LR without (Group 1) and with (Group 2) myotomy, stratified in accordance with the etiology of the EGD 2) Comparing the gingival display rebound (GDRB) 3) compare subject satisfaction and morbidity. Methods: After obtaining IRB approval, 20 human subjects with EGD (measured apical to the CEJ of #9) were randomly allocated for surgery without and with myotomy. Pre-operative, diagnostic information were …