Medicine and Health Sciences Commons^™

Improving Patient Outcomes And Nurse Satisfaction By Reducing Avoidable Interruptions During Medication Administrations, Roberta Howard

Master's Projects and Capstones

Medication administration is an important part of nursing duties in acute-care settings. The nurse is responsible for prioritizing safe quality care when administering medications but errors do occur. This project addressed interruptions as one of the challenges of safe medication administration. The aims of this project are 1) to determine a standardized medication administration process 2) to identify perceived and actual interruptions on the unit and 3) to address and reduce the avoidable interruptions of calls, pages and call lights at the nurse station. The purpose of this project is to improve patient outcomes, nurse satisfaction and nurse workflow by …

Minimizing Avoidable Interruptions During Medication Administration, Jaleel Anne Arnado

Master's Projects and Capstones

The objective of this CNL Internship Project is to improve patient outcomes and nurse satisfaction by minimizing the avoidable interruptions that occur during medication administration. The microsystem is a pediatric and adult medical-surgical overflow unit at a large, urban teaching hospital in Northern California. A series of surveys for nurses and patients and observations of medication administrations were conducted to assess barriers during mediation administration. It was determined phone calls interrupt a nurse the most during medication administration. Interruptions leave the medication administration process vulnerable to errors because it disrupts the nurse’s workflow and thought process. Because most pediatric medication …

Improving Birth Outcomes: Women’S Oral Health Project, Dilem Polat

Master's Projects and Capstones

Improving Birth Outcomes: Women’s Oral Health Project is a new project housed within the Child Health and Disability Prevention, CHDP Program. The main goal of the project is to improve the birth outcomes of high-risk pregnant women and their children, by educating participants within the Maternal Child and Adolescent Health Section at the San Francisco Department of Public Health. The educational component will focus on the importance of oral health and the impact of oral disease on perinatal health. Following the educational component, referrals for appropriate dentists will be provided for participants to they may begin improving their oral health. …

Employee Engagement In The Pacu, Michelle Spadaro

Master's Projects and Capstones

A clear vision is a powerful tool that can help advance employee engagement within nursing units. There is a great need for a compelling vision for the operation of a safe, efficient, equitable, effective, and patient centered healthcare delivery system. It is crucial to identify what actions are needed to achieve this vision and what realistic strategies are necessary for success. The purpose of this vision statement is to achieve excellence in nursing by establishing a common identity and direction that responds to an ever-changing healthcare environment. The project was conducted on a 25 bed peri-operative and post anesthesia care …

Improving The Hcahps Score For Pain Well Controlled, Uwaezu J. Umeh

Master's Projects and Capstones

This project took place on a Renal/Endocrine unit of a northern California Hospital. As observed on this unit, pain was not well controlled and this caused the HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) score for ‘pain well controlled’ to be low. Hence, this project sought to address the underlying reasons why pain was not well controlled and to proffer solutions to raise the HCAHPS score to at least 65% from an average of 55%. In order to find the root causes, the nurses were surveyed, the patients and certified nursing assistants (CNAs) were interviewed, and a 24-hour …

Patient Satisfaction Related To Noise In The Coronary Care Unit, Anjanette S. Dominguez

Master's Projects and Capstones

Background The CCU staff recognized a department trend for low patient-satisfaction score related to environmental noise levels. Based on the Press Ganey score, the patient-satisfaction score plummeted in relation to noise level beginning in March 2014.

Purpose To improve patient satisfaction regarding noise level in the CCU to 100% by November 21, 2014.

Methods Senior & Fleming’s Hard System Model of Change guided this literature search of CINAHL and Fusion for articles published from 2009 to 2014. Specific terms used were noise, critical care, and sleep promotion. From September to November 2014, earplugs were offered to all alert/oriented patients entering …

Increasing Compliance Of Personal Protective Equipment S Election And Use For Isolation Precautions Among Rns & Nas On A Med-Surg Unit, Megan R. Alsmeyer

Master's Projects and Capstones

Background: Due to the high potential of transferring infectious diseases and/or organisms among patients, themselves, and the community, healthcare workers (HCWs) must be knowledgeable and confident in selecting the appropriate type of personal protective equipment (PPE), and the use in technique when putting on (donning) and removing (doffing) PPE based on the level of isolation precautions required for the patient being cared for.

Project Purpose: The purpose of this project is to determine whether assessing the knowledge and actual practice with observing, and utilizing an innovative approach of video and educational tools to isolation precautions would improve the consistency of …

Improving Patient Outcomes Through Use Of The Teach-Back Method In The Post Anesthesia Care Unit, Kathleen Osullivan

Master's Projects and Capstones

The setting for this Clinical Nurse Leader (CNL) project was the Post Anesthesia Care Unit (PACU) at a level I trauma center in the Bay Area. The goal was to improve the discharge education performed by the PACU nurses to improve patient safety and decrease the chance of complications or readmissions to this hospital. With no clear instructions for how discharge teaching should be done, the nurses have many differing styles which leaves room for gaps in discharge planning. This influenced the implementation of the teach-back method during discharge planning in order to ensure proper education and increased patient understanding. …

Safe Patient Handling & No Lift Policy: Reducing The Incidence Of Work-Related Injuries Among Nursing Staff, Marissa N. Scanlon

Master's Projects and Capstones

Background: Patient handling is a major risk factor for work-related injuries among nurses. Inadequate and inappropriate safe patient handling practices contribute to increased work-related injuries, lost/restricted work days, and hospital costs.

Purpose: The focus of this study was to increase the use of mechanical lift equipment and Lift Team to reduce the incidence of work-related injuries among nursing staff involved in patient handling activities on the Medical-Cardiac IICU.

Methodology: The theoretical framework employed for this project was Lippitt’s change theory. Pre-and post-survey self-report evaluations were conducted prior to and following the implementation of the Bedside Mobility Assessment Tool (BMAT) and …

Oligomerization, Conformational Stability And Thermal Unfolding Of Harpin, Hrpzpss And Its Hypersensitive Response-Inducing C-Terminal Fragment, C-214-Hrpzpss., Pradip K Tarafdar, Lakshmi Vasudev Vedantam, Rajeshwer S Sankhala, Pallinti Purushotham, Appa Rao Podile, Musti J Swamy

Department of Biochemistry and Molecular Biology Faculty Papers

HrpZ-a harpin from Pseudomonas syringae-is a highly thermostable protein that exhibits multifunctional abilities e.g., it elicits hypersensitive response (HR), enhances plant growth, acts as a virulence factor, and forms pores in plant plasma membranes as well as artificial membranes. However, the molecular mechanism of its biological activity and high thermal stability remained poorly understood. HR inducing abilities of non-overlapping short deletion mutants of harpins put further constraints on the ability to establish structure-activity relationships. We characterized HrpZPss from Pseudomonas syringae pv. syringae and its HR inducing C-terminal fragment with 214 amino acids (C-214-HrpZPss) using calorimetric, spectroscopic and microscopic approaches. Both …

Berkeley Youth Alternatives Fieldwork Summary Report: Assessing Social Determinants To Improve The Physical Health And Academic Development For Youth In Berkeley, California, Alane M. Cruz

Master's Projects and Capstones

The following paper summarizes the three hundred hour fieldwork experience at Berkeley Youth Alternatives (BYA), a non-profit community-based organization located in Southwest Berkeley that is committed to combating the social determinants that contribute to the prevalent health disparities within their community. The fieldwork internship is a major requirement in completing the Master’s of Public Health (MPH) program at the University of San Francisco (USF), and allows the education and experience gained over the duration of the program to be applied in a real public health setting.

The overall goal of the internship experience was to assess the social determinants of …

Relocation Of Orc To Or2, Svetlana N. Schopp

Master's Projects and Capstones

The goal of this Clinical Nurse Leader (CNL) internship project was to maintain safety and quality of care of obstetric (OB) patients undergoing Cesarean Sections (C/S) after operating room for cesarean sections (ORC) is relocated from obstetric unit to the main operating room (OR). The microsystem will accomplish this through effective teamwork, clear interdisciplinary communication, collaboration, and standardization of processes involved. The institution is a not for profit rural health care facility and is a designated Critical Access Hospital; it is located in Northern California. A general obligation bond was passed in 2007 to fund seismic upgrades. Old OB unit …

Gender, Smoking And Tobacco Reduction And Cessation: A Scoping Review, Joan L. Bottorff, Rebecca Haines-Saah, Mary T. Kelly, John L. Oliffe, Iris Torchalla, Nancy Poole, Lorraine Greaves, Carole A. Robinson, Mary H. H. Ensom, Chizimuzo T.C. Okoli, J. Craig Phillips

Nursing Faculty Publications

Considerations of how gender-related factors influence smoking first appeared over 20 years ago in the work of critical and feminist scholars. This scholarship highlighted the need to consider the social and cultural context of women's tobacco use and the relationships between smoking and gender inequity. Parallel research on men's smoking and masculinities has only recently emerged with some attention being given to gender influences on men's tobacco use. Since that time, a multidisciplinary literature addressing women and men's tobacco use has spanned the social, psychological and medical sciences. To incorporate these gender-related factors into tobacco reduction and cessation interventions, our …

Genome-Wide Analysis Of Drosophila Circular Rnas Reveals Their Structural And Sequence Properties And Age-Dependent Neural Accumulation, Sarah Olson, Brenton R. Graveley

UCHC Articles - Research

Circularization was recently recognized to broadly expand transcriptome complexity. Here, we exploit massive Drosophila total RNA-sequencing data, >5 billion paired-end reads from >100 libraries covering diverse developmental stages, tissues, and cultured cells, to rigorously annotate >2,500 fruit fly circular RNAs. These mostly derive from back-splicing of protein-coding genes and lack poly(A) tails, and the circularization of hundreds of genes is conserved across multiple Drosophila species. We elucidate structural and sequence properties of Drosophila circular RNAs, which exhibit commonalities and distinctions from mammalian circles. Notably, Drosophila circular RNAs harbor >1,000 well-conserved canonical miRNA seed matches, especially within coding regions, and coding …

Physical Therapy Management Of A Patient After A Subacromial Decompression With Acromioplasty And Bursectomy: A Case Report, Brianne Landholt

Case Report Posters

Background: Subacromial impingement results from repetitive trauma to structures underneath the subacromial arch which can lead to: A decrease in the subacromial space, impingement of the soft tissue, a decrease in functional abilities. Conservative treatment can include: Physical therapy, nonsteroidal anti-inflammatory drugs (NSAIDS), corticosteriod injections, surgical option includes a subacromial decompression (SAD). There is conflicting evidence on the benefits of surgery. Literature is lacking supportive evidence of SAD without RTC repair or performing SAD with both an acromioplasty and bursectomy. Purpose: The purpose of this case report was to investigate the functional outcomes of a patient after SAD with an …

Physical Therapy Management Of A Manual Laborer With Chronic Rotator Cuff Tendinopathy: A Case Report, Samuel Lasher

Case Report Papers

Background and Purpose: Rotator cuff tendinopathy (RCT) is a chronic tendon injury that can have significant impact on an individual’s occupation, recreation and personal life. Currently there is a paucity of information detailing physical therapy (PT) interventions for individuals with RCT, who must continue working. The purpose of this case report was to report a clinical experience detailing the PT management of a patient with RCT, who secondary to occupational obligations must continue to participate in activities harmful to her condition. Case Description: The patient was a 44 year-old, female, who worked as a manual laborer. She was diagnosed with …

Physical Therapy Management Of A Patient With Stroke Utilizing Muscular Facilitation Techniques In A Skilled Nursing Facility: A Case Report, Erin Bayne

Case Report Papers

Background and Purpose: Stroke is the leading cause of long term disability in the United States. Hemiparesis is an impairment following stroke, however trunk musculature asymmetry is also common and is often overlooked when assessing a patient’s muscular control. Trunk musculature is an essential link between the upper and lower extremities during activities of daily living and impairments in trunk musculature can result in decreased safety and balance. The purpose of this case report is to provide the framework for treatment and an overview of the care plan for a patient following stroke, with special attention to trunk musculature facilitation. …

The Role And Impact Of Student Leadership On Participants In A Healthy Eating And Physical Activity Programme, Lila Gutuskey, Nate Mccaughtry, Bo Shen, Erin Centeio, Alex Garn

Kinesiology, Health and Sport Studies

Objective: In the USA there are rising rates of obesity among children, at least in part due to unhealthy eating and physical inactivity. Implementing school-based health interventions with elementary school children focused on youth empowerment could lead to improved health environments and behaviours. The purpose of the present study was to examine elementary students’ perceptions of participating in a student-led school health improvement team. Empowerment theory guided the research, specifically the concept of including participants in programming to identify possible individual-level outcomes. Design: Qualitative research. Setting: One US elementary school formed a student-led school health improvement team, …

P53 And Cancer-Associated Sialylated Glygans Are Surrogate Markers Of Cancerization Of The Bladder Associated With Schistosoma Haematobium Infection, Julio Santos, Elisabete Fernandes, Jose Alexandre Ferreira, Luis Lima, Ana Tavares, Andreia Peixoto, Beatriz Parreira, Jose Manuel Correia Da Costa, Paul J. Brindley, Carlos Lopes, Lucio L. Santos

Microbiology, Immunology, and Tropical Medicine Faculty Publications

Background

Bladder cancer is a significant health problem in rural areas of Africa and the Middle East where Schistosoma haematobium is prevalent, supporting an association between malignant transformation and infection by this blood fluke. Nevertheless, the molecular mechanisms linking these events are poorly understood. Bladder cancers in infected populations are generally diagnosed at a late stage since there is a lack of non-invasive diagnostic tools, hence enforcing the need for early carcinogenesis markers.

Methodology/Principal Findings

Forty-three formalin-fixed paraffin-embedded bladder biopsies of S. haematobium-infected patients, consisting of bladder tumours, tumour adjacent mucosa and pre-malignant/malignant urothelial lesions, were screened for bladder …

The Public Health Exposome: A Population-Based, Exposure Science Approach To Health Disparities Research, Paul D. Juarez, Patricia Matthews-Juarez, Darryl B. Hood, Wansoo Im, Robert S. Levine, Barbara J. Kilbourne, Michael A. Langston, Mohammad Z. Al-Hamdan, William L. Crosson, Maurice G. Estes, Sue M. Estes, Vincent K. Agboto, Paul Robinson, Sacoby Wilson, Maureen Y. Lichtveld

Sociology Faculty Research

The lack of progress in reducing health disparities suggests that new approaches are needed if we are to achieve meaningful, equitable, and lasting reductions. Current scientific paradigms do not adequately capture the complexity of the relationships between environment, personal health and population level disparities. The public health exposome is presented as a universal exposure tracking framework for integrating complex relationships between exogenous and endogenous exposures across the lifespan from conception to death. It uses a social-ecological framework that builds on the exposome paradigm for conceptualizing how exogenous exposures “get under the skin”. The public health exposome approach has led our …

Examination Of Capital Murder Jurors’ Deliberations: Methods And Issues, Keith Price, Susan Coleman, Gary R. Byrd

Administrative Issues Journal

The study of capital juries remains a subject of critical interest for the public and for legislative and judicial policy makers as well as legal scholars and social scientists. Cowan, Thompson, and Ellsworth established one of the standard methodologies for examination of this topic in their 1984 seminal study by observing the subjects’ debate about conviction in a death penalty case utilizing mock juries; other scholars employed different techniques to add more information in the late 1990s. Yet, the question of death qualification and prosecutorial bias remains open to inquiry. This preliminary study found evidence to support bias toward conviction …

Physical Therapy Management Of A Manual Laborer With Chronic Rotator Cuff Tendinopathy: A Case Report, Samuel Lasher

Case Report Posters

Background: Tendinopathy is characterized by tendon thickening, localized pain and chronic degeneration reflective of failed healing. 38% of manual laborers who participate in daily moderate to heavy lifting will experience Rotator Cuff Tendinopathy(RCT). There is a lack of research investigating the PT management of manual laborers who have RCT, but must continue to participate in harmful activities to fulfill occupational responsibilities. Purpose: The purpose of this case report was to describe the PT management of a patient with rotator cuff tendinopathy who, due to work requirements continued to participate in activities detrimental to the health of the supraspinatus and function …

Expression Of Suppressor Of Cytokine Signaling 1 (Socs1) Impairs Viral Clearance And Exacerbates Lung Injury During Influenza Infection., Keer Sun, Sharon Salmon, Vijaya Kumar Yajjala, Christopher Bauer, Dennis W. Metzger

Journal Articles: Pathology and Microbiology

Suppressor of cytokine signaling (SOCS) proteins are inducible feedback inhibitors of cytokine signaling. SOCS1-/- mice die within three weeks postnatally due to IFN-γ-induced hyperinflammation. Since it is well established that IFN-γ is dispensable for protection against influenza infection, we generated SOCS1-/-IFN-γ-/- mice to determine whether SOCS1 regulates antiviral immunity in vivo. Here we show that SOCS1-/-IFN-γ-/- mice exhibited significantly enhanced resistance to influenza infection, as evidenced by improved viral clearance, attenuated acute lung damage, and consequently increased survival rates compared to either IFN-γ-/- or WT animals. Enhanced viral clearance in SOCS1-/-IFN-γ-/- mice coincided with a rapid onset of adaptive immune …

Exploring The Intersection Between Folk And Conventional Medicine In Albany, Kentucky, Chloe J. Brown

Mahurin Honors College Capstone Experience/Thesis Projects

Approximately 60% of patients surveyed (in Albany, KY) practice folk medicine, which suggests that a significant segment of the population may practice folk medicine. Patients typically use folk medical treatments concurrently with conventional medical treatments; while the interaction of these treatments is generally innocuous or positive, folk medical treatments can sometimes be harmful, lead to negative interactions with other drugs prescribed by a conventional medical professional. Since folk medicine and conventional medicine frequently interact, it is important for medical professionals to be aware of and address folk medical practices in a conventional medical environment. In order to better address folk …

Hip Fracture Evaluation With Alternatives Of Total Hip Arthroplasty Versus Hemiarthroplasty (Health): Protocol For A Multicentre Randomised Trial, Mohit Bhandari, P. J. Devereaux, Thomas A. Einhorn, Lehana Thabane, Emil H. Schemitsch, Kenneth J. Koval, Frede Frihagen, Rudolf W. Poolman, Kevin Tetsworth, Ernesto Guerra-Farfán, Kim Madden, Sheila Sprague, Gordon Guyatt, Ali Oliasharazi, Franklin D. Shuler, Jonathon Salva, James Day, Tigran Garabekyan, Felix Cheung, Linda Morgan, Timothy Wilson-Byrne Md, Mary Beth Cordle

Orthopaedics

Introduction: Hip fractures are a leading cause of mortality and disability worldwide, and the number of hip fractures is expected to rise to over 6 million per year by 2050. The optimal approach for the surgical management of displaced femoral neck fractures remains unknown. Current evidence suggests the use of arthroplasty; however, there is lack of evidence regarding whether patients with displaced femoral neck fractures experience better outcomes with total hip arthroplasty (THA) or hemiarthroplasty (HA). The HEALTH trial compares outcomes following THA versus HA in patients 50 years of age or older with displaced femoral neck fractures.

Methods and …

Functional Lung Avoidance For Individualized Radiotherapy (Flair): Study Protocol For A Randomized, Double-Blind Clinical Trial., Douglas A Hoover, Dante Pi Capaldi, Khadija Sheikh, David A Palma, George B Rodrigues, A Rashid Dar, Edward Yu, Brian Dingle, Mark Landis, Walter Kocha, Michael Sanatani, Mark Vincent, Jawaid Younus, Sara Kuruvilla, Stewart Gaede, Grace Parraga, Brian P Yaremko

Medical Biophysics Publications

BACKGROUND: Although radiotherapy is a key component of curative-intent treatment for locally advanced, unresectable non-small cell lung cancer (NSCLC), it can be associated with substantial pulmonary toxicity in some patients. Current radiotherapy planning techniques aim to minimize the radiation dose to the lungs, without accounting for regional variations in lung function. Many patients, particularly smokers, can have substantial regional differences in pulmonary ventilation patterns, and it has been hypothesized that preferential avoidance of functional lung during radiotherapy may reduce toxicity. Although several investigators have shown that functional lung can be identified using advanced imaging techniques and/or demonstrated the feasibility and …

Ifn-Γ Causes Aplastic Anemia By Altering Hematopoietic Stem/Progenitor Cell Composition And Disrupting Lineage Differentiation, Fan Ching Lin, Megan Karwan, Bahara Saleh, Deborah L. Hodge, Tim Chan, Kimberly C. Boelte, Jonathan R. Keller, Howard A. Young

United States Public Health Resources

Aplastic anemia (AA) is characterized by hypocellular marrow and peripheral pancytopenia. Because interferon gamma (IFN-γ) can be detected in peripheral blood mononuclear cells of AA patients, it has been hypothesized that autoreactive T lymphocytes may be involved in destroying the hematopoietic stem cells. We have observed AA-like symptoms in our IFN-γ adenylate-uridylate-rich element (ARE)-deleted (del) mice, which constitutively express a low level of IFN-γ under normal physiologic conditions. Because no T-cell autoimmunity was observed, we hypothesized that IFN-γ may be directly involved in the pathophysiology of AA. In these mice, we did not detect infiltration of T cells in bone …

An Evidence-Based Approach To A Replacement Hospital Training Curriculum, Mark D. Beck

Doctor of Nursing Practice (DNP) Projects

Creation of a training and educational curriculum for a new or replacement facility is daunting in its own right, but without a repository of organizational knowledge cataloging the transfer of tacit to explicit knowledge from the organizations previous library of facility openings, the task becomes Herculean, with as many tasks and cast of characters as the original myths. Navigating the shoals, eddies and tides of the various aspects of this project revealed the need for a comprehensive knowledge management solution to training that is coupled with healthcare design principles and initiatives. This purpose of the DNP project is about the …

Onsite Integrative Clinics: Acupuncture, Positive Patient Outcomes, And Frequency Of Provider Office Visits, Sherry Shoemaker Phd

Dissertations

Purpose and Aims. There is limited information about outcomes of care, resource utilization, and associated costs for patients who receive acupuncture in integrative health settings. The purpose of this study was to address this gap through the following aims: To examine: (1) changes in patient pain levels pre/post acupuncture treatments; (2) relationships between receiving acupuncture treatments (number of treatments, length of time, select demographic factors, (age, gender), pain level pre and post acupuncture treatments; (3) relationships between number of treatments, length of time, age, gender, pain level (pre/post acupuncture treatments) and provider visits (pre/post acupuncture treatments); and (4) relationship between …

Effect Of Hydrogen Peroxide On The Biosynthesis Of Heme And Proteins: Potential Implications For The Partitioning Of Glu-TrnaGlu Between These Pathways, Carolina Farah, Gloria Levicán, Michael Ibba, Omar Orellana

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Glutamyl-tRNA (Glu-tRNA^Glu) is the common substrate for both protein translation and heme biosynthesis via the C5 pathway. Under normal conditions, an adequate supply of this aminoacyl-tRNA is available to both pathways. However, under certain circumstances, Glu-tRNA^Glu can become scarce, resulting in competition between the two pathways for this aminoacyl-tRNA. In Acidithiobacillus ferrooxidans, glutamyl-tRNA synthetase 1 (GluRS1) is the main enzyme that synthesizes Glu-tRNA^Glu. Previous studies have shown that GluRS1 is inactivated in vitro by hydrogen peroxide (H₂O₂). This raises the question as to whether H₂O₂ negatively affects …