Medicine and Health Sciences Commons^™

"All Set Togo Home":Improving Discharge Planning For Patient's Safe And Timely Discharge, Jasmin Milana

Master's Projects and Capstones

Abstract

The project focuses on the improvement of the discharge planning for patient’s safe and timely discharge in the medical oncology and telemetry unit at the county hospital. The facility has 54-bed capacity with an average daily census of 35 to 40 specializing in cancer, end-stage diseases, cardiac issues, HIV/AIDS, sepsis, palliative and comfort care, diabetes, respiratory diseases, psychiatric and placement patients. The unit has no discharge coordinator. Nurses are responsible for the quality and safe discharge of patients. These nurses experience frustrations due to fragmented system of the discharge process, nurses’ heavy workload, and prioritizing patients with higher acuity. …

Assessment Of Falls Protocol Use On Medical-Telemetry Units, Fanny Ku

Master's Projects and Capstones

Purpose: The purpose of this quality improvement project is to identify a root cause analysis for an increase in falls at a large, metropolitan hospital and implement interventions designed to reduce the incidence of falls on the medical-telemetry unit.

Background: Falls, regardless of severity, may inflict irreparable consequences on patients, families, and hospitals. Approximately 20-30% of falls result in physical or emotional harm, including minor bruises, emotional trauma, and fractures (“Falls,” 2004). When falls occur, hospitals are generally responsible for all costs incurred from the sentinel event, and do not receive re-imbursement from insurances for services provided. In the large, …

Assessment Of Fall Protocol Use On A Medical-Telemetry Unit, Ashia Mar

Master's Projects and Capstones

Purpose: This quality improvement project serves to implement a fall prevention plan to decrease patient falls on the medical-telemetry unit of a large metropolitan hospital.

Background: Patient falls are a persistent nationwide problem in the acute care setting. Between 700,000 and 1,000,000 falls occur in hospital every year and approximately 30-35% of these falls result in injury and 11,000 falls result in death (Health Research & Educational Trust, 2016). Falls always cause harm to the patient, whether it is emotional or physical; but, falls can also cause harm to the providers, family, and organization. Patient injury, additional hospital expenses, and …

A Roadmap For The Journey Home - A Supplemental Tool Guiding Patients From Hospital To Home, Michelle Basco

Master's Projects and Capstones

Centers for Medicare and Medicaid (CMS) have recognized readmission rates as a public health problem. CMS incentivizes hospitals to reduce readmission rates and reduce payments for hospitals with high readmission rates (Berry et al., 2013). Patient education and discharge planning are associated with decreased readmission rates. I gained fieldwork experience at Children’s Health System of Texas in Dallas. Children’s Health, a pediatric non-profit, is the 8th largest pediatric health care provider in the U.S. Prior to discharge patient education occurs on topics related to their diagnosis, plus patients are provided discharge instructions including their diagnosis, medications, and simple instructions for …

Health Starts In The Home: An Assessment Of Efforts To Improve Occupant Health Through Healthy Building Materials In San Francisco’S Affordable Housing, Staci Hoell

Master's Projects and Capstones

Americans spend 90% of their lives indoors, and much of this time is spent at home, surrounded by building materials that typically have added chemicals like flame retardants, highly fluorinated compounds, and antimicrobials. Recent research has linked these chemicals to adverse health outcomes such as asthma, endocrine disruption, cancer, neurodevelopmental issues, and reproductive problems (Bayer et al., n.d.; Green Science Policy Institute). Furthermore, these chronic health conditions disproportionately affect low-income populations. Fortunately, substantial efforts in research, practice, and policy are working to reduce the use of these potentially harmful chemicals in building materials, particularly in San Francisco’s affordable housing sector. …

The Clinical Nurse Leader: Improving Early Sepsis Identification On Inpatient Units, Denise G. Lopez

Master's Projects and Capstones

CNL students were invited to a large metropolitan hospital in an effort to create a quality improvement project related to sepsis in order to decrease cost, the length of stay, and improve patient outcomes. CNL students shadowed nurses in order to better un derstand the nursing culture and assess the microsystem. Chart audits were reviewed to determine whether nurses at the assigned units were completing sepsis screenings on time and used the appropriate vital signs and labs. Nurses’ questionnaires were provi ded to assess sepsis knowledge and their understanding of sepsis. Results showed a lack in compliance in completing sepsis …

Improving Early Sepsis Identification On Inpatient Units, Monica Schurle

Master's Projects and Capstones

Sepsis is a serious complication, which is initiated by the body’s extreme response to an infection. If sepsis is not identified and treated promptly, it can rapidly lead to tissue damage, organ failure and death. In order to reduce the number of patients who decline to sepsis in hospital, an efficient sepsis protocol needs to be implemented. Nursing practices, knowledge, and early recognition of systemic inflammatory response syndrome (SIRS) were assessed and measured in order to implement effective interventions. A root cause analysis was conducted to identify any discrepancies with compliance performing the sepsis screening in a timely manner, identify …

Assessment Of Falls On A Medical-Telemetry Unit, Andie Reed

Master's Projects and Capstones

The purpose of this quality improvement project aimed at reducing falls on a medical-telemetry unit in a large metropolitan Magnet hospital. It was important for the MSN/CNL students to focus on falls because it is not just a concern for this institution, it is a national dilemma that needs to be addressed. Due to the complexities and intricate details of the IRB process, the MSN/CNL students were unable to collect data or further advance their project into the microsystem. Instead, information was attained from the University of San Francisco database to allow the MSN/CNL students to continue with the steps …

Fall Prevention Protocol In Acute Care Setting, Allie Di Angelo

Master's Projects and Capstones

Purpose:

Purpose: The purpose of this quality improvement project is to implement a falls intervention to improve falls on the Medical Telemetry unit in the large metropolitan hospital.

Background: Between 700,000 and 1,000,000 falls occur in hospitals every year. Furthermore, approximately 30-35% of these falls result in injury and 11,000 falls result in death (Health Research & Educational Trust, 2016). Falls harm patients, families, and providers. They are also a high cost, as many insurance companies will not reimburse care when a patient falls. As a hospital organization it is important to ensure funds are going to the appropriate places. …

Assessment Of Falls On A Medical-Telemetry Unit, Sahar Taravati

Master's Projects and Capstones

Purpose: The purpose of this quality improvement project is to implement a falls intervention to improve falls on the Medical-Telemetry unit.

Background: Between 700,000 and 1,000,000 falls occur in hospitals every year. Furthermore, approximately 30-35% of these falls result in injury and 11,000 falls result in death (Health Research & Educational Trust, 2016). Falls harm patients, families, and providers. They are also a high cost, as many insurance companies will not reimburse care when a fall occurs. As a hospital organization, it is important to ensure funds are going to the appropriate places. Currently the metropolitan hospital had …

Development Of A Formalized Mentorship Program, Rozlyn Bauer

Master's Projects and Capstones

The purpose of this project is to help increase retention of newly licensed registered nurses (NLRN) at a large community medical center. The medical center loses approximately 20 NLRNs per year which is costly for the medical center. The loss of NLRN can be attributed to decreased job satisfaction, poor nursing competence and lateral violence between the nursing staff. Evidence shows that mentorship is a proven, evidence-based approach to solving these issues and more (Hodgson & Scanlan, 2013).

Not only can mentorship help increase retention, address lateral violence, increase job satisfaction and nursing competence but, it can also help enhance …

Development Of A Formalized Mentorship Program For Newly Licensed Registered Nurses At A Large Community Medical Center, Javier Moreno

Master's Projects and Capstones

With mentorship being a key to addressing several issues at a large community medical center, the leadership of the institution engaged with students of a Clinical Nurse Leader (CNL) Program to conduct a thorough assessment. This paper addresses the charge for a standardized and formalized evidence-based approach to a nurse mentorship program to address key areas that enhance not only the work environment but also the quality of care. These key areas include the 1) promotion of professional development and engagement via 2) acquisition of skills necessary to achieve nursing competence, 3) address lateral violence, 4) increase in staff retention …

Improving Early Sepsis Identification On Inpatient Units, Eva M. Diaz

Master's Projects and Capstones

Sepsis is a medical emergency resulting from an infection. Its systemic effects can quickly lead to death if it is left untreated. The condition is extremely costly in regard to human life and national healthcare costs. In an effort to combat rising rates of sepsis effective protocols must be implemented into hospitals. Assessments were performed to ascertain the level of nursing knowledge regarding sepsis criteria, treatment, and hospital protocol. A microsystem assessment was performed using the Five Ps Assessment Tool, which addresses purpose, patients, professionals, processes, and patterns. A root cause analysis (RCA) helped identify factors affecting adherence to the …

Improving Early Sepsis Identification On Inpatient Units, Courtney Sumanqui

Master's Projects and Capstones

Sepsis is a medical emergency that if left untreated can rapidly cause death for many patients due to effects that this systemic infection has on the human body. Millions of Americans nationwide are affected by sepsis on an annual basis. To reduce the number of patients who decline to sepsis in the hospital, efficient sepsis protocols must be effectively implemented throughout the hospital. Healthcare organizations must dedicate themselves to providing high quality patient care from the time of admission to discharge. This quality improvement project focused on improving early sepsis identification on inpatient units.

Nurse practices, knowledge, understanding related to …

Improving Early Sepsis Identification On Inpatient Units, Leslie Virtudazo

Master's Projects and Capstones

Sepsis is a life-threatening condition that arises from a complication of severe infection characterized by a systemic inflammatory response (SIRS). As a time critical illness requiring early identification and treatment, delayed recognition of sepsis can lead to organ failure and death. Effective sepsis protocols need to be established and implemented to reduce the number of patients declining to sepsis in the hospital setting. For this project, nursing practice and knowledge of SIRS and sepsis protocol were assessed to obtain a baseline measure of the nurses’ knowledge.

A root cause analysis was used to identify existing barriers to performing timely sepsis …

The Future Of Nuclear Security: A Medical Physicist’S Perspective, Katharine E. Thomson

International Journal of Nuclear Security

Planning for the future of nuclear security is a vital and complex task, requiring cooperation and contribution from many disciplines and industries. This diversity of expertise should include the medical sector, which faces many of the same challenges as the nuclear industry: controlling access to dangerous material, creating a strong security culture, cooperating with the wider world and engaging the public.

Medical physicists, of which the author is one, oversee all aspects of small-scale radiation use. This paper discusses three key areas increasingly important to both medical and nuclear uses of radioactive materials: public engagement, prevention of nuclear and radiological …

Self-Efficacy For Symptom Management In Adult Hematopoietic Stem Cell Transplant Patients, Lynn White

Theses & Dissertations

Hematopoietic stem cell transplant (HSCT) is a treatment for hematologic cancers and other hematologic conditions that causes severe treatment-related symptoms. The first 30 days after HSCT, or the acute phase, is when symptoms are most intense. During this time, the ability of patients to manage their symptoms, in collaboration with their health care providers, is crucial to reduce the distress caused by the symptoms. Self-efficacy is the person’s confidence in their ability to perform a behavior, such as symptom management. This body of work describes the concept of self-efficacy for symptom management (SESM), presents an integrated literature review on self-efficacy …

Cpap-Mad Combination Therapy For Cpap Intolerant Patients With Moderate To Severe Osa, Jacob Stadiem

Theses & Dissertations

The treatment of obstructive sleep apnea (OSA) allows for a multidisciplinary approach between dentistry and medicine. Continuous positive airway pressure (CPAP) is the gold standard for OSA treatment, but the non-adherence rates are high. The mandibular advancement device (MAD) has a higher acceptance rate than the CPAP, however the efficacy is much lower in cases of moderate to severe OSA. This thesis attempted to evaluate if there was a change in compliance when a MAD was added as a combination therapy to moderate to severe OSA subjects that were currently non-compliant with their CPAP. In addition, the change in air …

Synthesis And Electrical Properties Of Copolymers Containing 3-Phenyl[5]Ferrocenophane-1,5-Dimethylene And Vinylimidazole, Muteb H. Alshammari

Electronic Theses & Dissertations

Ferrocene is a well-known organometallic compound and its structure consists of an iron atom sandwiched between two cyclopentadienyl rings. Ferrocene has unique properties such as redox chemistry, high electron density, thermal stability and aromaticity. In addition, the ferrocene can be incorporated into polymers either into the backbone or on the side chains. Ferrocene incorporated polymers have received considerable attention in the areas of electro-catalysis, electrode coating, and battery applications. Therefore, the main purpose of this study is to characterize the electrochemical behavior of copolymers of 3-phenyl[5]ferrocenophane-1,5-dimethylene with vinyl imidazole in aqueous solutions with various electrolytes: sodium perchlorate, zinc perchlorate, cadmium …

Acquisition Of Aquatic Motor Skills Through Children’S Motor Stories, Juan Antonio Moreno Murcia, Elisa Huescar Hernandez, Jose Antonio Richart Parra

International Journal of Aquatic Research and Education

An increasing interest in the renewal of traditional recreational content and the use of the aquatic environments as educational resources is supported by very few empirical, evidence-based studies that link the two. This quasi-experimental study analyzed the role of stories in influencing perceived motor competence and real motor skills in seventy-eight children ages between 4 and 5 years through the administration of two questionnaires on aquatic motor ability and aquatic motor competence. Differences were found in aquatic motor competence (p < .01) and aquatic motor ability (p < .05) for the experimental group, where higher means values were obtained after the intervention. We present this methodological proposal as a useful educational tool for early childhood stimulation with achievements that go beyond motor progress itself.

In Memoriam 2017, Stephen J. Langendorfer Ph.D.

International Journal of Aquatic Research and Education

In Memoriam 2017 - Adolph Kiefer, Louise Priest, Terry Laughlin

Effects Of Aquatic And Land Plyometrics On Athletic Performance: A Systematic Review, Alissa Rhode, David C. Berry

International Journal of Aquatic Research and Education

The purpose of this study was to systematically review literature to determine whether aquatic plyometric training (APT) increases athletic performance compared to land-based plyometric training (LPT). We identified 6 articles from PubMed, CINAHL, MEDLINE, and single-citation matching from January, 1995 through January, 2017 using search words “aquatic plyometric training OR aquatic plyometric OR aquatic plyometrics.” After screening (title, abstract), 6 articles were reviewed for inclusion criteria: (1) full-report/abstract, (2) peer-reviewed RCTs/clinical trials, (3) English language, (4) focused on healthy individuals (free of current, lower-extremity, musculoskeletal injuries) ages 16-30 years, and (6) included strength, power, and/or vertical jump [VJ] dependent …

‘Swansong’ And ‘ Losing Yourself’: Meditations On Life, Death And The Liminal, Cristal Duhaime

RadioDoc Review

This article considers two very personal audio documentaries that reflect on love and identity via the liminal space between life and death. Swansong, by award-winning UK radio producer Hana Walker-Brown, is set in a hospital, as Hana and her father bear witness to her grandmother’s dying and celebrate her joyful life. Losing Yourself, by US producer Ibby Caputo, is a revelatory account of dealing with a cancer diagnosis.

Swansong is a picture of a person fondly remembered but Hana elevates it beyond eulogy into a multi-layered meditation. Her grandmother Joan’s voice flutters in and out of ethereal recreations of …

Evaluation Of Iowa’S Anti-Bullying Law, Marizen Ramirez, Patrick Ten Eyck, Corinne Peek-Asa, Joseph E Cavanaugh, Angela Onwuachi-Willig

Angela Onwuachi-Willig

Background Bullying is the most common form of youth aggression. Although 49 of all 50 states in the U.S. have an anti-bullying law in place to prevent bullying, little is known about the effectiveness of these laws. Our objective was to measure the effectiveness of Iowa’s anti-bullying law in preventing bullying and improving teacher response to bullying. Methods Sixth, 8th, and 11th grade children who completed the 2005, 2008 and 2010 Iowa Youth Survey were included in this study (n = 253,000). Students were coded according to exposure to the law: pre-law for 2005 survey data, one year post-law for …

Let’S Make A Change: Implementing A Standardized Training Orientation In The Immunology Department, Inda Nunez

Inda Nunez

Postmodern Social Control: Dividuals And Surveillance, Ernest M. Oleksy

The Downtown Review

As a society's foundational philosophy changes, so, too, will its forms of social control. By using the works of thinkers like Deleuze and Foucault as pivot points, the dynamic nature of social interactions and the agents to mediate those actions shall be investigated. This article includes findings from archival analysis written in a journalistic prose for simplicity of consumption.

The Appearance And Effects Of Music Therapy In The Solid Organ Transplant Unit, Tracey J. Elliott

The Downtown Review

Patients admitted to the solid-organ transplant unit face a plethora of physical, emotional, and psychological challenges. Risk of infection, perception of pain, depression, surgery complications, and exhaustion are just a few hardships that a patient may face while hospitalized. Patient need areas thus serve as goal areas for the hospital support staff. While intervention is provided to patients in a variety of forms, music therapy is an effective means of treatment due to its multi-faceted nature; a music therapist can address a variety of goal areas with any given patient. The first section of this paper will briefly outline the …

Fabrication And Modification Of Titania Nanotube Arrays For Harvesting Solar Energy And Drug Delivery Applications, Ahmed El Ruby Abdel Rahman Mohamed

Electronic Thesis and Dissertation Repository

The fast diminishing of fossil fuels in the near future, as well as the global warming caused by increasing greenhouse gases have motivated the urgent quest to develop advanced materials as cost-effective photoanodes for solar light harvesting and many other photocatalytic applications. Recently, titania nanotube arrays (TNTAs) fabricated by anodization process has attracted great interest due to their excellent properties such as: high surface area, vertically oriented, highly organized, one-dimensional, nanotubular structure, photoactivity, chemical stability and biocompatibility. This unique combination of excellent properties makes TNTAs an excellent photoanode for solar light harvesting. However, the relatively wide band gap energy of …

Carbohydrates And Fungal Toxin Exposure Influence The Vaginal Microbiota, Metabolome, And Reproductive Health Of Women, Stephanie L. Collins

Electronic Thesis and Dissertation Repository

The reproductive health of women is influenced by microorganisms and their metabolites, namely those representing the vaginal microbiota and those producing toxins that are ingested. To manipulate the vaginal microbiota toward a health-associated, Lactobacillusdominant state, an approach adopting prebiotic lactulose was taken. Using batch culture, lactulose supported Lactobacillus maintenance and positively altered metabolites, while not disrupting indigenous L. crispatus epithelial adherence. The vagina also harbours abundant glycogen, but initial assumptions that lactobacilli utilize it were incorrect. I have now shown that glycogen selectively stimulates organisms associated with dysbiosis and L. iners in a self-limiting manner. Other compounds such as environmental …

Timing And Amount Of Physical Therapy Treatment Are Associated With Length Of Stay In The Cardiothoracic Icu, Audrey M. Johnson, Angela N. Henning, Peter E. Morris, Alejandro G. Villasante Tezanos, Esther E. Dupont-Versteegden

Physical Therapy Faculty Publications

Significant variability exists in physical therapy early mobilization practice. The frequency of physical therapy or early mobilization of patients in the cardiothoracic intensive care unit and its effect on length of stay has not been investigated. The goal of our research was to examine variables that influence physical therapy evaluation and treatment in the intensive care unit using a retrospective chart review. Patients (n = 2568) were categorized and compared based on the most common diagnoses or surgical procedures. Multivariate semi-logarithmic regression analyses were used to determine correlations. Differences among patient subgroups for all independent variables other than age and …