Medicine and Health Sciences Commons^™

Utilization Of 340b Program In A Rural Hospital, Heath Ashford, Lauren Valli, William K. Willis, Alberto Coustasse

Management Faculty Research

Introduction: The 340B is a federal program that provides eligible rural hospitals, providers, and clinics the capability to purchase medications at reduced prices for outpatient use. Enrollment in the 340B program requires drug manufacturers to supply covered healthcare entities and eligible healthcare organizations medications at substantially reduced prices and has allowed covered entities to extend federal resources by offering more comprehensive services and reaching more of the vulnerable populations. The purpose of this research study was to examine utilization of 340B program within provider based clinics of a university medical school affiliated with a rural hospital to assess the benefits …

Healthcare Of The Uninsured Population In West Virginia And The United States, Leslie Salyers, Mounica Mummaneni, William K. Willis, Alberto Coustasse

Management Faculty Research

Introduction: The uninsured population in the United States has increased dramatically over the past few years. Hospitals and physicians bear the financial burden of the uninsured by compensating for the billions of dollars in bad debt or uncompensated care they incur each year. Emergency rooms and other healthcare facilities are left with billions in uncompensated care due to 47 million uninsured Americans. Uncompensated care in 2006 was $31.2 billion. Majority of individuals accounting for uncompensated care are those living at or below the federal poverty level and those individuals who can afford health coverage but freely choose to forgo purchasing …

Stromal Monocarboxylate Transporter Mct4 Is A Poor Prognostic Factor In Squamous Cell Carcinoma, Mehri Mollaee, Md, P. Cotzia, Patrick Tassone, Md, Adam J. Luginbuhl, Md, Ubaldo E. Martinez-Outshoorn, Md, Tingting Zhan, Joseph M. Curry, Md, Madalina Tuluc, Md

Department of Pathology, Anatomy, and Cell Biology Resident's Posters

ABSTRACT

Introduction:

Monocarboxylate transporter 4 (MCT4) is the main exporter of lactate out of cells. It is also a critical component in the glycolytic metabolism of cancer cells. In this study, stromal MCT4 in oral SCC was correlated with risk of recurrence (ROR), extent of primary tumor (pT) and nodal metastasis (pN), perineural invasion (PNI), lymphovascular invasion (LVI), HPV status, extracapsular extension (ECE) and positive margin.

Methods:

Clinical data were collected for 86 consecutive patients with oral HNSCC. Tissue microarrays (TMA) were constructed from paraffin blocks of resection specimens and stained for MCT4. Immunohistochemistry (IHC) staining was assessed and quantified …

Workflow Modifications And Addition Of Maldi-Tof Technology Significantly Improved Turn-Around-Time To Identification Of Common Urine Pathogens, Dimath Alyemni, Md, Christine M. Lam, Amity L. Roberts, Phd, D(Abmm)

Department of Pathology, Anatomy, and Cell Biology Resident's Posters

Background:

In order to improve the identification of common aerobic urine cultures as well as antimicrobial susceptibility testing (AST) setup at an Academic Medical Center, work-flow modifications and MALDI-TOF technology were incorporated. Previously, the majority of species identification was achieved with conventional identification/antimicrobial susceptibility combo panels. All urine cultures, regardless of laboratory receipt time, were previously read once per day on 1st shift.

Methods:

The initial workflow modification involved addition of a 2nd shift urine culture reading. Urine specimens received from 8:00 AM to 4:00 PM were read on 1st shift, while urine specimens received from 4:00 PM to 8:00 …

Is Myeloproliferative Neoplasm With Splanchnic Vein Thrombosis A Distinct Clinical Entity?, Upasana Joneja, Md, Jerald Z. Gong, Md, Guldeep Uppal, Md

Department of Pathology, Anatomy, and Cell Biology Resident's Posters

Clinical History:

A 29 year-old previously healthy female presented with sub-acute symptoms of weight loss, right upper quadrant pain and nausea.

CBC results: WBC-11.7, Hb- 12.5, Platelet- 286, MCV- 90, MCV- 26.8, RDW- 18%.

Imaging: Ultrasound and MRI of the abdomen were suggestive of Budd-Chiari syndrome that was supported by a liver biopsy showing features of hepatic outflow obstruction(Figure 1). There was no clinical or radiological evidence of splenomegaly. The hypercoagulable work-up was negative. An underlying Myeloproliferative Neoplasm (MPN) was suspected.

Identifying Cases Of Undiagnosed, Clinically Significant Copd In Primary Care: Qualitative Insight From Patients In The Target Population, Nancy K. Leidy, Katherine Kim, Elizabeth D. Bacci, Barbara P. Yawn, David M. Mannino, Byron M. Thomashow, R. Graham Barr, Stephen I. Rennard, Julia F. Houfek, Meilan K. Han, Catherine A. Meldrum, Barry J. Make, Russ P. Bowler, Anna W. Steenrod, Lindsey T. Murray, John W. Walsh, Fernando Martinez, High-Risk-Copd Screening Study Group

Journal Articles: Pulmonary & Critical Care Med

BACKGROUND: Many cases of chronic obstructive pulmonary disease (COPD) are diagnosed only after significant loss of lung function or during exacerbations.

AIMS: This study is part of a multi-method approach to develop a new screening instrument for identifying undiagnosed, clinically significant COPD in primary care.

METHODS: Subjects with varied histories of COPD diagnosis, risk factors and history of exacerbations were recruited through five US clinics (four pulmonary, one primary care). Phase I: Eight focus groups and six telephone interviews were conducted to elicit descriptions of risk factors for COPD, recent or historical acute respiratory events, and symptoms to inform the …

How Do Perceived Gender Roles Influence The Number Of Attempted Medical Interventions Of Infertile Couples?, Erin Aiello

Theses and Dissertations--Family Sciences

Infertility affects 1 in 8 couples and the literature discusses the emotional effects infertility has on an individual. One option for infertility is to attempt medical interventions and the literature in the field does not explain why some people attempt more interventions than others. Using data from the 2002 National Survey of Family Growth (NSFG), Cycle 6, this quantitative study aims to understand the relationship between traditional gender roles and values and the attempted number of medical interventions by individuals within a relationship experiencing infertility. The results from this study indicate that both males and females that are in relationship …

Ncaa Fencing Championship, Zachary Moss

Master of Arts in Sport Management

This paper examined the many aspects of planning, organizing, and managing a sporting event. Specifically, it focused on the management of the 2019 NCAA Fencing Championships utilizing Welsh-Ryan Arena at Northwestern University as the host site. Every aspect of the event is examined beginning with the organization responsible for it, going through the structure of the event itself, outlining a marketing plan for the event, analyzing the management of employees and volunteers, discussing of potential risks associated with the facility for this event, analyzing ethical concerns of the event itself, and concluding with personal reflection from the paper's author. Included …

The Twenty-Four Three Study Plan: Increasing Hispanic And Latino Student Nurse Success, Virginia Montez-Ochoa

Regis University Student Publications (comprehensive collection)

Executive Summary
In Latino nursing students, the implementation of the Twenty-Four-Three Study plan demonstrated at least one letter grade increase in their overall grades within a midterm time frame. As our nation’s Latino populations are exploding, this has given rise to challenges that the profession of nursing faces. Latino populations are experiencing high levels of health care disparities which are compounded by a low national Latino RN representation of 3.9%. This is further compounded by an unusually high Latino student nurse attrition rates which can reach up to 80% by some estimates.

The purpose of this study was to provide …

Rapid Response Team Education In Improving Bedside Nurses` Knowledge And Skills, Cherry Lynn Maglangit

Regis University Student Publications (comprehensive collection)

Rapid response system (RRS) is considered a powerful tool in patient safety (Simmes, et al., 2013). It is a process where critical care expertise is brought to the patient`s bedside. It is an initiative designed to prevent patient deaths and to improve patient outcomes (Institute of Healthcare Improvement, 2011). The practice issue is, at the medical-surgical floors at a large medical center in one hospitals of Northeastern New York, there is a failure to rescue on their medical-surgical patients secondary to issues concerning delays in activating the rapid response team and delays in recognizing patients` signs and symptoms of deterioration …

Improving The Education Gap For Patients With Chronic Kidney Disease, Donna L. Bobo

Regis University Student Publications (comprehensive collection)

Executive Summary
Improving the Education Gap for Patients with Chronic Kidney Disease
Problem
According to the Center for Disease Contol and Prevention, 26 million adults have chronic kidney disease, which is progressive, mostly silent, and unrecognized (CDC, 2009). Education Education Education Education can enhance knowledge and facilitate selfcan enhance knowledge and facilitate selfcan enhance knowledge and facilitate self can enhance knowledge and facilitate self can enhance knowledge and facilitate selfcan enhance knowledge and facilitate self can enhance knowledge and facilitate selfcan enhance knowledge and facilitate self can enhance knowledge and facilitate self can enhance knowledge and facilitate selfcan enhance knowledge …

Prick Testing In Children, Elizabeth Ann Esterl

Regis University Student Publications (comprehensive collection)

Executive Summary
Capstone Project Title Reducing Variability Among Multiple Operators Using a Single Technique and Device for Skin Prick Testing in Children
Problem
The variability in performance among skin prick test (SPT) operators who performed the twist technique versus the prick technique was raised within the Pediatric Program at the Study Site. Confidence in the SPT results was threatened, treatment plans were delayed and diets remained restricted.
Purpose
This Doctor of Nursing Practice (DNP) Capstone Project was designed to identify a single device and technique that could be used at the facility to reduce variability, increase reliability, and standardize the …

Use Of An Evidence-Based Practice Model To Improve The Quality Of The Hospital Discharge Process, Joni Vaughn

Regis University Student Publications (comprehensive collection)

Problem
“Readmission of Medicare patients within 30 days of discharge from the hospital is nearly 1 in 5” (Naylor, 2012). The older adult has become vulnerable to the ever present breakdowns in the healthcare system creating serious gaps in services. Society and social services have not maintained the continual rapid steady growth of services to the older adult to match the increased life span of Americans. As Rennke (2013) reports, “Patients are vulnerable to a wide range of adverse events after discharge, with more than 20% of medical patients sustaining a preventable adverse event within three weeks of discharge” (p.433). …

Prenatal Nutrition Counseling Designed To Reduce The Intake Of Moderate And High Glycemic Index Foods Among Selected Normal, Overweight, And Obese Patients From A Nonprofit Faith-Based Patient Medical Care Home, Debra T. Gogatz

Regis University Student Publications (comprehensive collection)

Executive Summary

Prenatal Nutrition Counseling Designed to Reduce the Intake of Moderate and High Glycemic Index Foods Among Selected Normal, Overweight, and Obese Patients from a Nonprofit Faith-based Patient Medical Care Home

Problem

Minority and economically disadvantaged clients at a faith based nonprofit patient medical care home were identified as needing dietary counseling in the first trimester of pregnancy. There has existed a preponderance of evidence linking excessive weight gain in pregnancy to multiple complications for mother and child with a suggested relationship specific to the inflammatory processed initiated within the human body related to the ingestion of excessive calories …

Comparison Of Home Medication Adherence In Adults Age 65 And Older After Completion Of Standardized Discharge Medication Education Or Non-Standardized Discharge Medication Education, Jill Weller

Regis University Student Publications (comprehensive collection)

Executive Summary

Comparison of Home Medication Adherence in Adults Age 65 and Older After Completion of Standardized Discharge Medication Education or Non-Standardized Discharge Medication Education
Problem
The older patient (age 65 and older) is at higher risk of medication induced illness because of numerous co-morbid conditions treated with multiple medications, a standardized approach to medication education at hospital discharge can reduce adverse medication events for this at risk population (Esposito, 1995; Jack et al., 2009). The primary driving force for this project is the limited number of research studies published to date that include this specific age bracket and setting. …

A Quality Improvement Project To Evaluate Auditor Satisfaction With Different Data Collection Methods For Auditing Compliance With Catheter Associated Urinary Tract Infection (Cauti) Prevention Standards, Andrea S. Balzer

Regis University Student Publications (comprehensive collection)

Executive Summary A Quality Improvement Project to Evaluate Auditor Satisfaction with Different Data Collection Methods for Auditing Compliance with (CAUTI) Prevention Standards Problem Catheter-associated urinary tract infections (CAUTIs) are among the most common healthcare-associated infection (HAI) in the United States, representing about 40% of all HAIs (Palmer, Lee, Dutta-Linn, Wroe & Hartmann, 2013). Approximately 25% of indwelling urinary catheters are unnecessary and may potentially lead to CAUTIs if not maintained, cleaned, and cared for appropriately (Nazarko, 2012). Literature suggests that preventing CAUTIs is possible by implementing evidence based prevention standards. The PICO research question for CAUTI prevention and prevention standard …

Perspectives Of Associate Degree Nursing Students At Risk For Academic Problems, Phyllis H. Horton

Regis University Student Publications (comprehensive collection)

This quality improvement project focused on associate degree nursing students (ADN) at risk for academic problems in the community college setting. Understanding the supply, distribution, and educational requirements for registered nurses (RNs) is an important factor to ensure quality avenues for nursing programs to ultimately provide competent nurses to support the US health care system. The purpose of this project was to identify themes and patterns from the perspectives of ADN students as to what places him or her at risk for academic problems and how faculty could best intervene to help them become successful. Objectives for this project included: …

The Intervention Of Active Learning Strategies To Increase Nursing Student Self-Directed Learning, Janelle A. Patterson

Regis University Student Publications (comprehensive collection)

Executive Summary

Problem
Undergraduate nursing students at a Midwestern community college struggled to understand and retain content presented in long lecture format courses. The Population, Intervention, Comparison, and Outcomes (PICO) for the program are as follows: P—Nursing students at a Midwestern community college in terms 1, 2, 4, and 5 of the LPN and ADN program; I—Use of guided practice as an active learning teaching strategy in the lab setting to enhance nursing student self-directed learning readiness in terms 1 and 4; C— Nursing students in term 2 and term 5 at a Midwestern community college who did not have …

Evaluating Development Of Critical Thinking Skills In Simulation Learning, Cynthia J. Helgesen

Regis University Student Publications (comprehensive collection)

Executive Summary
Evaluating Development of Critical Thinking Skills in Simulation Learning Problem
Critical thinking is the key to nurses' ability to make sound decisions in clinical practice. It was determined nurses, hired within the last three years at an Intermediate Care Facility for the Mentally Retarded (ICFMR), required additional education and practice to manage high-risk low frequency events, specifically respiratory emergencies. Project questions for this quality improvement initiative included: Will a high fidelity simulation session improve critical thinking skills for registered nurses hired within the last three years, at the ICFMR? And, will the introduction of simulation learning to develop …

Evaluation Of The Impact Of Teamstepps Training On Perceptions Of Teamwork And Resilience In The Intensive Care And Perioperative Units In A Tertiary Care Hospital, Belinda Shaw

Regis University Student Publications (comprehensive collection)

Executive Summary
Evaluation of the Impact of TeamSTEPPS Training on Teamwork and Resilience in the Intensive Care Unit (ICU) and Perioperative Units in a Tertiary Care Hospital
Problem
The ICU and perioperative areas are stressful work environments. Nurses are a vulnerable population experiencing exposure to workplace stress, verbal and physical aggression, burn-out, moral distress, circadian rhythm disruption and depression. The stressful work environment leads to lower quality of patient care and nursing turnover. Teamwork and collaboration prevents errors and promotes healthy work environments (HWE) (Zaccagnini & White, 2014). To achieve the goals of the Affordable Care Act, it will be …

Autonomic Dysreflexia: An Educational Intervention For First Responders To Recognize This Medical Emergency, Jennifer J. Wahl

Regis University Student Publications (comprehensive collection)

Executive Summary
This knowledge enhancement capstone project regarding Autonomic Dysreflexia (AD) was an evidence based practice educational intervention project performed in a variety of emergency health care provider organizations in a large metropolitan Midwestern city.
Problem
Approximately 265,000 persons in the United States are living with a spinal cord injury (SCI). Of this population, 16-24% (The National SCI Statistical Center, 2011), are at risk of developing Autonomic Dysreflexia (AD) a potentially life threatening condition unique to spinal cord injured (SCI) persons.
Purpose
The purpose of this evidence-based practice project was to examine the impact of an educational program aimed at …

Relationships Between Activation Level, Knowledge, Self-Efficacy, And Self-Management Behavior In Heart Failure Patients Discharged From Rural Hospitals., Van Do, Lufei Young, Sue Barnason, Hoang Tran

Journal Articles: Health Services Research & Administration

Non-adherence to self-management guidelines accounted for 50% of hospital readmissions in heart failure patients. Evidence showed that patient activation affects self-management behaviors in populations living with chronic conditions. The purpose of this study was to describe patient activation level and its relationship with knowledge, self-efficacy and self-management behaviors in heart failure patients discharged from rural hospitals. Our study populations were recruited from two hospitals in rural areas of Nebraska. We found that two-thirds of the participants reported low activation levels (e.g., taking no action to manage their heart failure condition). In addition, low patient activation levels were associated with inadequate …

Research Ethics Training Of Trainers: Developing Capacity Of Bolivian Health Science And Civil Society Leaders, Annette Aalborg, Jacqueline Cortez, Sarah Sullivan, Oscar Lanza, Armando Basagoitia, Adriana Valencia, Roxane Modares

Program/Project Purpose: The University of San Andres, Faculty of Medicine in La Paz, Bolivia in collaboration with Touro University California, Public Health Program was awarded a NIH Research Ethics Planning Grant in June, 2013 to develop strategies and processes for implementation of a comprehensive national research ethics program for Bolivia. Although the importance of scientific research based on ethical principles is highlighted in the Bolivian constitution and national health legislation, few Bolivian academics, researchers and health professionals have received formal training in the principles and practices of research ethics. A principle aim of the Planning Grant is to develop …

From Ideas To Efficacy: The Orbit Model For Developing Behavioral Treatments For Chronic Diseases, Susan M. Czajkowski, Lynda H. Powell, Nancy Adler, Sylvie Naar-King, Kim D. Reynolds, Christine M. Hunter, Barbara Laraia, Deborah H. Olster, Frank M. Perna, Janey C. Peterson, Elissa Epel, Josephine E. Boyington, Mary Charlson

CGU Faculty Publications and Research

Objective: Given the critical role of behavior in preventing and treating chronic diseases, it is important to accelerate the development of behavioral treatments that can improve chronic disease prevention and outcomes. Findings from basic behavioral and social sciences research hold great promise for addressing behaviorally based clinical health problems, yet there is currently no established pathway for translating fundamental behavioral science discoveries into health-related treatments ready for Phase III efficacy testing. This article provides a systematic framework for developing behavioral treatments for preventing and treating chronic diseases. Method: The Obesity-Related Behavioral Intervention Trials (ORBIT) model for behavioral treatment development features …

Auditory Hallucinations Interview Guide: Promoting Recovery With An Interactive Assessment Tool, Louise Nigh Trygstad, Robin Kay Buccheri, Martha D. Buffum, Dau-Shen Ju, Glenna A. Dowling

Nursing and Health Professions Faculty Research and Publications

Auditory Hallucinations Interview Guide: Promoting Recovery with an Interactive Assessment Tool Abstract The Auditory Hallucinations Interview Guide (AHIG) is a 32-item tool to help psychiatric-mental health nurses assess the past and current experience of each voice hearer so they can provide more individualized care. This tool was developed as a research tool but has been found clinically useful in both inpatient and outpatient settings to help voice hearers and nurses develop a shared terminology of auditory hallucinations. Using the AHIG, voice hearers are able to tell their story in a structured and safe environment that encourages recovery. Through respect and …

A Feasibility Pilot Study On The Use Of Complementary Therapies Delivered Via Mobile Technologies On Icelandic Surgical Patients' Reports Of Anxiety, Pain, And Self-Efficacy In Healing, Margaret M. Hansen Edd, Msn, Rn

Nursing and Health Professions Faculty Research and Publications

Background Complementary therapies (CT), such as relaxation technique, massage, guided imagery, and accupuncture have shown to benefit patients undergoing surgery. The aim of this study was to determine the feasibility of using audio relaxation technique (ART), music intervention (MI), nature video application with music (NVAM), and nature video application without music (NVA) delivered via mobile technologies in a clinical setting. Secondary, the effects of ART, MI, NVAM and NVA on patients’ state anxiety, pain perception, and perceived self-efficacy in healing were determined. Methods A randomized clinical trial (RCT) involving 105 same day surgery (SDS) patients, who were assigned to an …

Utilization Of Clinical Practice Guidelines: Barriers And Facilitators, Melanie R. Keiffer

Nursing and Health Professions Faculty Research and Publications

Key points

• Clinical practice guidelines are tools used to assist health care professionals in clinical decision making with the ultimate goal of improving patient care.

• Promoting the implementation of clinical practice guidelines at the point of care delivery is a hurdle to translating scientific findings into practice.

• As access to electronic evidence sources increase, the amount of evidence available to clinicians for clinical decision support is overwhelming.

• Increased adoption of electronic health records and clinical decision support tools will move clinical practice guidelines more rapidly to the patient encounter.

The Association Between Self-Rated Mental Health Status And Total Health Care Expenditure: A Cross-Sectional Analysis Of A Nationally Representative Sample, Muoi T. Nguyen, Winnie Y. Chan, Courtney Keeler

Nursing and Health Professions Faculty Research and Publications

Both clinical diagnoses and self-rated measures of mental illness are associated with a variety of outcomes, including physical well-being, health utilization, and expenditure. However, much of current literature primarily utilizes clinically diagnosed data.

This cross-sectional study explores the impact of mental illness and health care expenditure using 2 self-rated measures: self-rated measured of perceived mental health status (SRMH) and Kessler Screening Scale for Psychological Distress (K6).

Data from the 2011 Medical Expenditure Panel Survey Household Component, a nationally representative sample of noninstitutionalized individuals (n = 18,295), were analyzed using bivariate χ² tests and a 2-part model (logistics regression and …

Pilot Data: Are Vertical And Lateral Hop Tests Appropriate For Patients Post-Ankle Fracture?, Jeff Houck, R. Spaulding, T. Weiss, T. Dewilde

Student-Faculty Research - College of Physical Therapy

Ankle fractures effect 5 out of 10,000 individuals (van Staa, 2001). A recent study shows rapid functional gains over the first 6 months after an ankle fracture, but there are little or no gains 18-24 months into the recovery cycle (Beckenkamp, 2014). Similarly, other studies have shown that ankle fracture patients are categorized as having good recovery outcomes on popular measures such as the modified Olerud Molander scale (Egol, 2006), yet are unable to return to previous level of sport (Hong, 2013), indicating there may be persisting higher level performance deficits. This brings up the issue of whether there are …

Tuberculosis As A Metaphor For Isolation: An Interdisciplinary Examination Of Tuberculosis, Stefanie Pavlick 15

Honor Scholar Theses

No abstract provided.