Medicine and Health Sciences Commons^™

Improving Patient Care Outcomes By Standardizing Change Of Shift Report, Marie Gutierrez Msn, Bsn, Rn

Master's Projects and Capstones

The change of shift is one of the most crucial times during a nurse’s day. It is a time where vital patient information is passed off from one nurse to the next. There is evidence that the root cause of many sentinel events and poor patient outcomes in related to communication breakdown during the change of shift report process. The Joint Commission has identified communication as the primary cause for preventable medical errors with handoffs accounting for 80% of these instances. Change of shift is an elaborate communication process that involves the transition of care between nurses as well as …

Fall Prevention In The Inpatient Setting, Verna Bautista

Master's Projects and Capstones

Fall Prevention in the Inpatient Setting Abstract

This project focuses on patient and family fall prevention education through an educational brochure. 4South is a mixed medical/surgical and medical/surgical-telemetry unit, specializing in dialysis and stroke patients. Since January 2017, there has been eight falls on the unit. The project’s objective is to decrease the number of falls in 4South by 50% by the end of the 4^th quarter 2017.

An identified weakness was inconsistent patient and family education. The CNL roles of data analyst and clinician were utilized. With the feedback from the Fall Task Force committee, an educational brochure …

Novel Influences Of Il-10 On Cns Inflammation Revealed By Integrated Analyses Of Cytokine Networks And Microglial Morphology., Warren D. Anderson, Andrew D. Greenhalgh, Aditya Takwale, Samuel David, Rajanikanth Vadigepalli

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Coordinated interactions between cytokine signaling and morphological dynamics of microglial cells regulate neuroinflammation in CNS injury and disease. We found that pro-inflammatory cytokine gene expression in vivo showed a pronounced recovery following systemic LPS. We performed a novel multivariate analysis of microglial morphology and identified changes in specific morphological properties of microglia that matched the expression dynamics of pro-inflammatory cytokine TNFα. The adaptive recovery kinetics of TNFα expression and microglial soma size showed comparable profiles and dependence on anti-inflammatory cytokine IL-10 expression. The recovery of cytokine variations and microglial morphology responses to inflammation were negatively regulated by IL-10. Our novel …

The Need Of Lactation Consultant For Night Shift, Joyce Fung

Master's Projects and Capstones

Abstract

Breastfeeding can provide many health benefits for both mother and baby. To increase the health benefits for patients, a change project will be implemented to increase the rates of exclusive breastfeeding for postpartum patients. The project will be focusing on teaching and be providing information on health benefits of exclusive breastfeeding. Our project is aiming to increase the rates of exclusive breastfeeding by providing lactation consultants during night shift.

Surveys and interviews were conducted pre-program and found most patients are unaware of the health benefits of breastfeeding and the lactation consultant services provided by the hospital. The method used …

Reduction In Delayed Patient Care On The Medical-Surgical Unit, Lina Tran

Master's Projects and Capstones

The focus of this project is to improve daily bedside rounds through utilizing the BRT, which could enhance patient safety and satisfaction by reducing delayed patient care on 3 North medical-surgical department at CPMC. The data retrieved from nurses in the past 3 months has shown that 30% of the patients had delayed care due to daily bedside rounds. By utilizing late medication as an indicator, my goal is to observe a reduction in late medication documentation due to daily bedside rounds by 10% by the end of August 2017. CPMC Davies campus adult medical-surgical department holds 44 inpatient beds. …

Investing In The Float Pool: A Cost Effective Alternative For Staffing Shortages, Christen Straw

Master's Projects and Capstones

Abstract

Inpatient facilities have historically utilized contract nurses as a short-term solution to staffing shortages. Research suggests that utilizing the float pool provides a cost-effective alternative that has the potential to save the organization millions of dollars per year. This project aims to explore the financial impact of the float pool by increasing the volume of nurses by 50% within six months, individualizing the onboarding process to fit the needs of this complex department, and initiating a shared decision making model for identifying and implementing change. The overarching goal of this project is to provide a cost-saving alternative to staffing …

The Role Of The Clinical Nurse Leader In Reintroducing And Sustaining A Successful Cancer Risk Assessment Program In A Community Hospital Setting, Tiffany Gishizky

Master's Projects and Capstones

Abstract

The goal of implementing a comprehensive cancer risk assessment (CRA) program prompted the evaluation of a community-based breast center microsystem and previous CRA program for feasibility and sustainability. The development of a value proposition by the Clinical Nurse Leader student highlights the role in the advancement of the nursing profession as an interdisciplinary leader. Review of current literature facilitated development of program structure and identification of downstream revenue sources. Data analysis includes historical patient volume, screening and procedural reimbursement rates, population statistics and organization market share, and program financial impacts. Data synthesis reveals a CRA program demonstrates potential revenue …

Medical School Watercooler Newsletter - August 13, 2017, Lindsey Lyle

Watercooler Newsletter

This is the August 13, 2017 edition of the Frederick P. Whiddon College of Medicine's Newsletter - Watercooler.

Contents Include:

USA Lions Club Hosting Kickoff Run for Sight

USA Welcomes Dr. Amelia Hewes

Strada Patient Care Center Flagpole Ceremony Honors Late Paul Parker

Free Football Tickets, Tailgate for USA Health Employees, Volunteers

USA Neurology to Host Epilepsy Support Group

Linking Kindling To Increased Glutamate Release In The Dentate Gyrus Of The Hippocampus Through The Stxbp5/Tomosyn-1 Gene, Seth R. Batten, Elena A. Matveeva, Sidney W. Whiteheart, Thomas C. Vanaman, Greg A. Gerhardt, John T. Slevin

Psychology Faculty Publications

Introduction: In kindling, repeated electrical stimulation of certain brain areas causes progressive and permanent intensification of epileptiform activity resulting in generalized seizures. We focused on the role(s) of glutamate and a negative regulator of glutamate release, STXBP5/tomosyn-1, in kindling.

Methods: Stimulating electrodes were implanted in the amygdala and progression to two successive Racine stage 5 seizures was measured in wild-type and STXBP5/tomosyn-1^−/− (Tom^−/−) animals. Glutamate release measurements were performed in distinct brain regions using a glutamate-selective microelectrode array (MEA).

Results: Naïve Tom^−/− mice had significant increases in KCl-evoked glutamate release compared to naïve wild type as …

Understanding The Blogging Practices Of Women Undergoing In Vitro Fertilization (Ivf): A Discourse Analysis Of Women’S Ivf Blogs, Elizabeth Orr, Susan M. Jack, Wendy Sword, Sandra Ireland, Lois Ostolosky

The Qualitative Report

Infertility and its associated treatments, including in vitro fertilization (IVF), can have a profound impact on the emotional health and well-being of women desiring to become mothers. Researchers have measured the impact of infertility and described the experience of infertility and its treatment, leaving the rich descriptions of the IVF experience as captured in women’s blogs to be explored. This discourse analysis describes the blogging practices of women undergoing IVF, exploring both the content and function of the IVF blog discourse. Data were collected from the text of seven women’s blogs (n=1,149 blog posts) and resulted in four main functions …

Creating A Culture Of Mobility: A Quality Improvement Project, Vincent K. Samuel

Master's Projects and Capstones

Abstract title: Creating A Culture of Patient Mobility in An Acute Care Setting.

Unit: Medical Surgical unit.

Author: Vincent Samuel RN, BSN

Institution: University of San Francisco; Kaiser Permanente Nurse Scholar Academy; Kaiser Permanente Hospital, San Francisco (CNL practicum site).

Background Information

The medical/surgical unit had the average ambulation score of 54% in the year 2015, much below the benchmark of 65% set for the year. The direct impact of low ambulation score was the increase in patient’s length of stay. The micro-system analysis revealed various factors that contributes to this problem such as, inadequate staffing, unit culture, unavailability of …

Encountering Disenfranchised Grief: A Pilot Investigation Of The Clinical Lived Experiences In Dance/Movement Therapy, Kate M. Dominguez

Creative Arts Therapies Theses

This study employed a transcendental phenomenological methodology to understand how clients’ lived experiences of disenfranchised grief are present within the clinical therapeutic relationship in dance/movement therapy. Data was collected through individual semi-structured interviews from four dance/movement therapists who have worked with clients experiencing disenfranchised grief. Moustakas’ (1994) adaptation of the Stevick-Colaizzi-Keen method of data analysis was used concurrently with data collection. Data analysis resulted in four textural themes: a) Disenfranchised grief can be described as disconnecting, overwhelming, complex, unrecognized, and pervasive; b) It is distinguished by exacerbated grief; c) It is recognized as a distinct form of grief; and d) …

You, Me, And We: An Artistic Inquiry Exploring Embodied Self-Awareness, Peter Navarro

Creative Arts Therapies Theses

Heuristic research methodology was used to engage in a creative and systematic process of self-exploration with a goal of fostering embodied self-awareness. I answered the following research question: How will engaging in embodied self-awareness influence and inform the relationships I create with others and myself? Additionally, I explored my use of Effort time and its influence on my embodied self-awareness. As the sole-researcher and participant, data were collected for 4 weeks in 8 sessions by self-reflecting on intuitively felt meaningful experiences between myself and another person(s), in addition to self-reflecting on my individual experience amidst those interactions. Movement narratives, embodied …

Early Progressive Mobility In The Intensive Care Unit Adult Patient Population, Kimberly Henry

Master's Projects

No abstract provided.

Inaugural Research Symposium, The University Of Texas Rio Grande Valley. School Of Medicine

School of Medicine Publications

Inaugural Research Symposium 2017

Evidence-Based Protocol: Decreasing Falls And Falls With Injury In A Nsdu, Jennifer J. Komm

Master's Projects

Patient falls in acute care tend to be the most common adverse events reported. The Centers for Medicare and Medicaid Services report that fall-related injuries are classified as hospital-acquired conditions and no longer reimburses for the diagnosis and treatment of injuries incurred from falls during hospitalization. Falls are decreasing at too slow a rate even with a variety of fall prevention guidelines being available. Falls are a complex problem within hospitals and the prevention of falls is challenging. Literature supports the individualization of fall prevention interventions based on the risk factors exhibited by a patient. Tailoring interventions to specific fall …

Business Intelligence Competencies: Making Healthcare Data Come Alive, Christina Bivona-Tellez

Doctor of Nursing Practice (DNP) Projects

Business Intelligence Competencies: Making Healthcare Data Come Alive While a wealth of healthcare related data exists, nurse leaders (NL) have yet to understand its implications and adopt analytical skills to lead in the transformation of care delivery. Information science is at a new frontier for nursing to embrace. It is critical for nursing leadership to advance and support business intelligence (BI) and interactive data visualization (IDV) skills across the organization and advocate for greater engagement of nurses in health system decision making. With these new tools and competencies, nursing and other health professions can innovate best practices, providing enhanced quality, …

Cultivating A Culture Of Compassion Among Newly Graduated Registered Nurses: An Evidence-Based Mobile Learning Toolkit, Benson Yeung

Doctor of Nursing Practice (DNP) Projects

Empathy, kindness, and compassion are some of the humanistic values essential to nursing practice particularly in today’s patient and family-centric healthcare environment. A genuinely empathetic and caring relationship between a nurse and a patient not only enhances the quality and safety of care but also contributes to patient satisfaction, compliance to treatment, and overall health outcomes. Debate amongst educators and researchers continues to grow as to whether these uniquely humanistic values are innate or if they can be taught. How do nurses acquire the knowledge, skills, and attitudes towards the delivery of compassionate patient care? What strategies are best suited …

Mountain Biking As A Means To Encourage Public Health And Wellbeing, Scott C. Dillard

Master of Public Health Program Student Publications

Mountain biking is a popular form of outdoor exercise. There are 8.3 million riders in the U.S., 2.8% of the population (The Outdoor Foundation, 2016). The National Survey on Recreation and the Environment (https://www.srs.fs.usda.gov/trends/nsre-directory/) places the number of participants much higher at 42.7 million riders, but their definition is less restrictive (Cordell, 2012). The National Survey includes anyone who has ridden a mountain or hybrid bicycle in the last twelve months, regardless of riding surface, while Outdoor Recreation Participation Top Line Report (The Outdoor Foundation, 2016) estimates are based on riding surface. Therefore, to avoid confirmation bias, the lower Outdoor …

Stress Increases Peripheral Axon Growth And Regeneration Through Glucocorticoid Receptor-Dependent Transcriptional Programs, Jessica K. Lerch, Jessica K. Alexander, Kathryn M. Madalena, Dario Motti, Tam Quach, Akhil Dhamija, Alicia Zha, John C. Gensel, Jeanette Webster Marketon, Vance P. Lemmon, John L. Bixby, Phillip G. Popovich

Physiology Faculty Publications

Stress and glucocorticoid (GC) release are common behavioral and hormonal responses to injury or disease. In the brain, stress/GCs can alter neuron structure and function leading to cognitive impairment. Stress and GCs also exacerbate pain, but whether a corresponding change occurs in structural plasticity of sensory neurons is unknown. Here, we show that in female mice (Mus musculus) basal GC receptor (Nr3c1, also known as GR) expression in dorsal root ganglion (DRG) sensory neurons is 15-fold higher than in neurons in canonical stress-responsive brain regions (M. musculus). In response to stress or GCs, adult …

The Fight Against Breast Cancer: A Policy And Programmatic Approach, Nandi Robinson

Master's Projects and Capstones

Abstract

Breast cancer continues to remain a significant health issue for women. Previously thought to only occur among postmenopausal women, breast cancer has impacted women of different ages; and rates of breast cancer have various impacts among different ethnic groups. For women living in a toxic environment, many of them have become the new wave of breast cancer cases. Screening and detection have succeeded in decreasing mortality rates. However, more research is needed in finding an efficient method of treatment. In the effort to assist in the fight against breast cancer through a policy and programmatic angle, I am fulfilling …

A Study Of The Integration Of Biomedical Devices With Information Technology Systems With An Emphasis On Information Quality, James A. Mcginnis, Jr

Theses and Dissertations

The cost of Information Technology in the US per year is estimated at 1.7 trillion of dollars with an estimated 7.6 billion in healthcare (Hillestad, et al., 2005). While this seems to be a large investment that should produce substantial returns regarding quality care, patient safety, and improved healthcare, there appears to be a distrust of data between Information Technology (IT) and the medical industry/systems (Holden & Karsh, 2009), (Holden & Karsh, 2010). The distrust of the data that can arise from data shared between biomedical devices, IT systems can become evident when proper policies, and procedures are not in …

Research Brief: "Creating Hope: Assisting Veterans With Job Search Strategies Using Cognitive Information Processing Theory", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This study highlights research on common challenges veterans face during their career search, and presents recommendations for meaningful change. The employment needs of veterans can be addressed through cognitive information processing, a career problem solving and decision making theory that involves defining goals, understanding options, ranking options, making a choice, and reflecting on the decided choice. In practice, considering entering the civilian job market after military service can have challenges, and veterans should consider discussing their employment seeking experiences with other veterans who are experiencing similar struggles or who have successfully entered the civilian job market. In practice, the Department …

Chest Pain Protocol Order Set, Andrey Kulikov

Master's Projects and Capstones

The goal of this project is to implement a chest pain protocol order set in order to increase the nurse-initiated chest pain protocol by 50%. The project was implemented in a Emergency Department (ED) that has problems with understaffing and patient crowding. RN-initiated chest pain orders are implemented 11% of the time and 89% by physicians. RNs initiated orders in less than 10 minutes while 50% of physician orders are initiated over 30 minutes. This results in delayed care and decreases patient flow. A chest pain protocol order set was designed based on the approved nursing protocol policy. 90% of …

Going Online With Telemedicine: What Barriers Exist And How Might They Be Resolved, Pierron Tackes

Oklahoma Journal of Law and Technology

No abstract provided.

Decluttering The Mind: A Creative Approach Towards Becoming, Jessica Ann Lochte

Creative Arts Therapies Theses

The purpose of this research was to explore the researcher’s mind, as defined within the field of interpersonal neurobiology (IPNB), and concept of self in the context of professional development as a dance/movement therapist. An embodied artistic inquiry methodology was chosen to support this in-depth reflective exploration, utilizing visual art making and movement as methods of data collection and analysis. Primary research questions were inspired by Rogers’ (1961) views of psychotherapy, asking “Who am I as a therapist?” and “How may I become myself as a therapist?” The process was further structured through Siegel’s (2010a) nine domains of integration: consciousness, …

2016-2017 Academic Year In Review, Dugoni School Of Dentistry

Dugoni Academic Year in Review

Highlights of academic programs, clinical services, research, community outreach and other areas of University of the Pacific's Arthur A. Dugoni School of Dentistry.

Abl Kinase Regulation By Braf/Erk And Cooperation With Akt In Melanoma, Aditi Jain, Rakshamani Tripathi, Courtney P. Turpin, Chi Wang, Rina Plattner

Pharmacology and Nutritional Sciences Faculty Publications

The melanoma incidence continues to increase, and the disease remains incurable for many due to its metastatic nature and high rate of therapeutic resistance. In particular, melanomas harboring BRAF^V600E and PTEN mutations often are resistant to current therapies, including BRAF inhibitors (BRAFi) and immune checkpoint inhibitors. Abl kinases (Abl/Arg) are activated in melanomas and drive progression; however, their mechanism of activation has not been established. Here we elucidate a novel link between BRAF^V600E/ERK signaling and Abl kinases. We demonstrate that BRAF^V600E/ERK play a critical role in binding, phosphorylating and regulating Abl localization and Abl/Arg activation …

Hypertensive Urgency, Jed Grant

Physician Assistant Faculty & Staff Presentations

No abstract provided.

The Fundoscopic Exam In Clinical Practice, Jed Grant

Physician Assistant Faculty & Staff Presentations

No abstract provided.