Medicine and Health Sciences Commons^™

Implementation Of A Surgical Safety Checklist, Nicole Stathatos

Master's Projects and Capstones

Lack of standardization in the perioperative area leads to variations in practice that can cause preventable errors. In a 200-bed hospital in Northern California with eleven operating rooms preforming approximately 11,000 procedures a year, there was an increase incidence in sentinel events such as wrong site surgery (n=1), wrong patient surgery (n=1), and retained foreign body (n=5). Safety checks observed in the operating room (OR) were preformed differently among each surgical team and sometimes did not occur at all. Through the use of a Surgical Safety Checklist (SSC), efforts were aimed to standardize safety practices in the OR. The goal …

Multifarious Interventions To Reduce Falls On The Medical-Surgical Units, Wenjie Ying

Master's Projects and Capstones

The CNL project was conducted on the 56-bed adult medical-surgical units in a trauma center. There were total eight fall incidences from January to February. The SWOT analysis, stakeholder analysis, pre-educational survey, cost-effective analysis and root-cause analysis suggested in-depth training on multifaceted fall prevention. The objectives include reducing falls by 50%, increasing staff’s adherence to fall prevention protocols, boosting staff’s confidence in patient mobility, improving staff responsiveness and communication with meds in HCAHPS, and enhancing knowledge of medications’ side effects by May 14, 2018. The literature reviews indicated that the multicomponent preventative measures to prevent falls along with leadership supports …

Regular Exercise Throughout Pregnancy And Maternal Recovery Postpartum, Rachel Jenkins

Graduate Theses & Dissertations

Abstract

Introduction: The American College of Obstetricians and Gynecologists recommends that “women with uncomplicated pregnancies should be encouraged to engage in aerobic and strength-conditioning exercises before, during, and after pregnancy.”1 Many pregnant mothers seek guidance regarding exercise regimens’ safety and efficacy. This paper is a systematic review of the current literature on the topic of exercise regimens performed throughout pregnancy and maternal postpartum recovery.

Purpose: To determine if following the American College of Obstetricians and Gynecologists recommendation to engage in regular aerobic and strength-conditioning exercises throughout pregnancy contributes to easier deliveries as measured by the number of caesarean sections, time …

The Impact Of Depressive Symptoms On Cognitive Decline And Risk For Dementia, Katheryn Conde

Doctoral Dissertations

As of 2011, the life expectancy for Latinos in the U.S. was 81.6 years, which is higher compared to non-Hispanic Blacks (75.3 years), non-Hispanic Whites (79 years), and Hispanic Black populations (74.9 years; Arias, 2011; Arias, 2015). Latinos have higher age specific prevalence of dementia, which is higher than African Americans and non-Hispanic Whites (Gurland et al.,1999). Latinos experience Alzheimers disease symptoms 6.8 years earlier, with the average onset of 67.6 years which is younger than non-Hispanic Whites (73.1 years; Clark et al., 2005). Furthermore, older Latinos tend to experience depression at a rate of 13% and 35% with the …

Individualizing Care For Pediatric Patients With Autism Spectrum Disorder In Perioperative Services, Erin Scheller

Master's Theses

This research explores solutions for individualizing and improving care for pediatric patients with Autism Spectrum Disorder in the Perioperative Setting of an Outpatient Surgery Center. Specifically, it seeks to determine if providing parent and staff resources on Autism Spectrum Disorder is significantly helpful in increasing confidence in the staff by the parents and the staff themselves. Participants included thirty-five surveyed families who had pediatric patients visiting perioperative services and staff who work on the unit. Methods used include information dissemination with the use of printable and online evidence-based resources, an in-person education event for staff, and a pilot study of …

Assessing The Time Of Completion And Patients’ Perception Of Their Mobility To Accurately Score Fall Risk Assessments, Katherine Jones

Master's Projects and Capstones

This study aimed to examine the time to complete fall risk assessment tools, Hendrich II Fall Risk Assessment Model (Hendrich II) and Patient Mobility Assessment Tool (PMAT) in a San Francisco Bay Area hospital. In addition, this study examined the efficacy of patients’ perceptions of their own mobility, when asked as part of the fall risk assessment process. Data was collected and analyzed on seventy-four patients across four nursing units, Medical, Surgical, Telemetry, Medical-Surgical/Oncology. The data indicated that, on average, Hendrich II took 00:01:49 minutes and PMAT took 00:04:12 minutes when completed separately. When asked about their own mobility level, …

A Program Evaluation Of A Drug And Alcohol Family Treatment Program, Katrina Ramirez

Doctoral Dissertations

The current study is a program evaluation at John Muir Behavioral Health, Center for Recovery. The research determined the effectiveness of the program at Center for Recovery that is offered to patients that struggle with substance use disorder and their families. The purpose of this study is to assess patients’ behavioral, cognitive and social/environmental factors as it relates to their commitment to sobriety and examine how the involvement of family members influences the patient’s recovery process. I utilized a mixed methodology of quantitative and qualitative interviews of patients and family members. The findings suggest depressive symptoms were negatively correlated with …

Louisiana State University Health Sciences Center - 2018 - 144th Commencement, Office Of The Registrar, Lsu Health Sciences Center-No

Graduation & Commencement Programs

The program for the 144th Commencement of LSU Health Sciences Center - New Orleans held May 17, 2018.

Understanding And Prevention Of Catheter Associated Urinary Tract Infections (Cautis), Ritu Saini

Master's Projects and Capstones

Abstract

The project goal is to reduce and eliminate CAUTI occurrences on the med-surgical unit by increasing staff knowledge on CAUTIs and applying the ANA CAUTI prevention tool to improve patient outcomes. The project objectives are (1) enhanced staff knowledge about CAUTIs, (2) staff adherence to the implemented the ANA CAUTI prevention tool, and (3) maintained CAUTI rate below benchmark. The CNL role in the project is to function as an educator and outcomes manager, which serves as the foundation for the project. The department consists of a 34-bed med-surgical unit with the adult patient population mix of oncology, surgical, …

Hazardous Drug Administration In The Home Setting: Reducing Exposure Risks, Cynthia D. Huff Msn, Rn, Ocn, Crni, Cnl

Master's Projects and Capstones

Hazardous drug (HD) administration used to be contained in controlled-healthcare settings, however, the introduction of HDs for home administration has become a growing area of concern for home health agencies. The objectives of the Clinical Nurse Leader (CNL) project aims to improve homecare nurses' knowledge of HDs and improve competency with personal protective equipment (PPE). The microsystem provides short-term homecare services for acute and chronically-ill patients. One team leader, two home infusion coordinators, and twelve registered infusion nurses participated in learning about exposure risks and PPE use with HD administration. Kotter's 8-step change theory was used to develop behavior change …

Improving Breast Health Care Through The Implementation Of A Nurse Navigator, Maria Watson

Master's Projects and Capstones

Abstract

In a rural Northern California setting, a Clinical Nurse Leader intern was implemented as a designated Nurse Navigator (NN) for a regional breast health population. The global aim of this project is to improve care for potential and actual newly diagnosed breast cancer patients by increasing access to care, decreasing barriers, and improving timeliness of care. Using evidence based on an extensive scholarly literature review, the designated NN will accomplish the aim through care coordination, thereby improving patient outcomes, decreasing outmigration of care, and increasing the financial viability of the breast health program. The ultimate goal of the breast …

Improving Pressure Ulcer Education, Fernando Romeo Zamarripa Guzman

Master's Projects and Capstones

An educational gap exists at the point of care with regards to pressure ulcer prevention for hospice clients. Medical personnel provide oral instructions, but they do not provide sufficient tools for future reference. This project consists of improving pressure ulcer education at the point of care. The nursing staff consists of ten nurses who act as case managers. They are a big part of client care within the hospice setting, which can vary from home care or care in a designated facility. To improve the current practice of providing just oral instructions to patients, an educational tool was created to …

Improving Hand-Off Communication Between The Skilled Nursing Facility And The Emergency Department, Dubravka Labovic

Master's Projects and Capstones

Abstract

The purpose of this project is to improve hand-off procedure between Skilled Nursing Facility (SNF) and Emergency Department (ED). Patient population consists of all retired veterans who currently reside in California Department of Veterans Affairs, Veterans Home of California (CalVet) – the state long-term care facility for elderly. The problem occurs when continuation of care is compromised due to poor exchange of information at the time of transfer to ED. Nurses in SNF need a step-by-step procedure that will improve the process of transfer and the intention of this project is to create a process that will become daily …

Health Policy & Management News, Georgia Southern University

Health Policy & Community Health: News & Publications (2011-2018)

• Leadership for Health Professionals: Theory, Skills, and Applications

Reduing Hospital Readmissions: Ideal Discharge Planning For Heart Failure Management, Chun Mei Chen, Chun Mei Chen

Master's Projects and Capstones

Abstract

The objectives during this project were to achieve by the end of 2018 an overall reduction of 25% in HF readmissions within 30 days. By identifying root causes of readmissions and using needs assessment within the microsystem, literature highlights the elements defining interventions that can be used to improve transitions of care and reduce avoidable HF hospital readmissions. A plan was developed for integrating an evidence-based practice, IDEAL Discharge Planning, along with engaging patients and families at bedside from the first day of admission until discharge to more effectively assist staff in providing patient-centered education and self-care skills. The …

Exploring Direct And Indirect Effects Of English Proficiency On Access, Utilization, And Health Status Among Californian Adults With Limited English Proficiency (Lep), Renee E. Pierre-Louis

Seton Hall University Dissertations and Theses (ETDs)

Background and Study Purpose: Findings from previous studies suggest that, in a health care delivery context, individuals with limited English proficiency (LEP) are adversely impacted by lack of patient-provider language concordance. Yet, the concept of LEP has been mostly studied in the context of cultural competence and language has been generally considered a demographic or cultural characteristic. There is a growing body of research concerning LEP and health status; however, it is limited. This study sought to evaluate the effects of LEP on access, utilization, and self-rated health status (SRHS) among LEP respondents to a large health interview survey …

Confirmatory Factor Analysis Of The Causal Illness Attribution Scale In Chinese Patients With Multiple Somatic Symptoms, Ling Zhang, Jeanine Schwarz, Maria Kleinstäuber, Kurt Fritzsche, Wiebke Hannig, Jing Wei, Jianzhong Yang, Lan Zhang

Psychology Faculty Publications

Causal illness attributions influence how individuals cope with somatic symptoms and illnesses. Dimensions of causal symptom attributions have been examined in Western cultures with the subscale ‘causes’ of the revised Illness Perception Questionnaire (IPQ-R). Some previous studies have identified a stronger somatic attribution style in Asian patients. In this study it was examined if the factorial structure of causal attributions identified in Western populations can be identified in a large Chinese sample of patients presenting with somatic symptoms. We recruited 665 patients aged at least 18 who were visiting the hospital for reasons of treatment from departments of traditional Chinese …

Improving The Use Of The Integrative Healing Approach, Kristina Horak

Master's Projects and Capstones

The Integrative Healing Approach (IHA) is an initiative that promotes holistic healing and includes the use of essential oils, deep breathing techniques, and therapeutic touch. Its purpose is to relieve pain, anxiety, insomnia, and depression among patients, and stress among staff. The IHA pilot initiative was implemented on the Acute Rehabilitation Unit (ARU) and faced barriers to implementation after the first round of staff education. By rounding with staff and conducting surveys, it was identified that the staff are not using IHA interventions as often due to time constraints. Additionally, there is an identifiable rift between Registered Nurses (RNs) and …

Reducing Inter-Unit Patient Report Delays And Transfer Times, Natalya Marinov

Master's Projects and Capstones

Inter-unit coordination is essential in preventing a bottleneck in patient flow and its resultant stresses to staff, hindering quality patient care, and wasting time. The Medical-Surgical Unit (MSU) and Post Anesthesia Care Unit (PACU) struggle to establish efficient patient report times and transfers. Preliminary data demonstrated report delays attributed to an arduous workload and overburdened MSU nursing staff. The project’s objective focuses on reducing nurse-related report time delays by 10%, increasing understanding and teamwork, promoting proactive thinking to manage workflow efficiently, improving patient flow, and improving the inter-unit relationship between MSU and PACU. Increasing awareness and reducing transfer times are …

Admission Criteria For The Pediatric Acute Care Unit To Reduce Length Of Stay In The Emergency Department, Peter G. Campbell

Master's Projects and Capstones

Abstract

The primary objective as outlined in this prospectus is to develop pediatric admission criteria to reduce length of stay (LOS) in the emergency department for patients being admitted to the pediatric acute care unit. The pediatric acute care unit is a 25-bed licensed bed at a tertiary hospital in San Francisco serving patients from 1 day to 21 years of age. Methods included both qualitative and quantitative data to determine relevance of quality improvement project related to LOS, patient safety, patient satisfaction, and nurse to physician communication. Data collected indicated that average LOS in the ED was significantly higher …

The Clinical Nurse Leader As Outcomes Manager: Optimizing Screening Mammography In An Outpatient Breast Center, Yao Luo

Master's Projects and Capstones

The Clinical Nurse Leader as Outcomes Manager: Optimizing Screening Mammography in an Outpatient Breast Center

Abstract

This clinical nurse leader (CNL) practice improvement project was conducted in an outpatient breast center that is part of a community safety-net hospital. The patient population consists of a large proportion of disadvantaged, low income, low English literacy, and high-risk women over 445 years of age. Recent observations and baseline data from the breast center and the mobile mammography van indicated that five to eight radiologic views were taken during a routine mammogram in a subset of screening patients which exceeds the standard set …

Stress Urinary Incontinence In Collegiate Female Athletes: Prevalence And Impact, Marie Bouchard

Master's Projects and Capstones

Abstract

Introduction, definition: Urinary incontinence is the involuntary leaking of urine (a few drops to a few milliliters). It can happen while exercising with no urge to urinate (stress urinary incontinence), with a sudden urge to urinate (overactive bladder or urgency urinary incontinence), or a combination of the two (mixed urinary incontinence). This issue is very common among female athletes. However, because of the reluctance to discuss this problem, it remains underdiagnosed and undertreated.

Methods:An anonymous and confidential survey was distributed to the 90 University of San Francisco female student athletes from seven different varsity sports in December 2017. …

An Active Efficient Coding Model Of The Development Of Amblyopia, Samuel Eckmann, Lukas Klimmasch, Bertram Shi, Jochen Triesch

MODVIS Workshop

No abstract provided.

Systematic Pan-Cancer Analysis Of Somatic Allele Frequency., Liam Spurr, Muzi Li, Nawaf Alomran, Qianqian Zhang, Paula Restrepo, Mercedeh Movassagh, Chris Trenkov, Nerissa Tunnessen, Tatiyana Apanasovich, Keith A Crandall, Nathan Edwards, Anelia Horvath

Pharmacology and Physiology Faculty Publications

Imbalanced expression of somatic alleles in cancer can suggest functional and selective features, and can therefore indicate possible driving potential of the underlying genetic variants. To explore the correlation between allele frequency of somatic variants and total gene expression of their harboring gene, we used the unique data set of matched tumor and normal RNA and DNA sequencing data of 5523 distinct single nucleotide variants in 381 individuals across 10 cancer types obtained from The Cancer Genome Atlas (TCGA). We analyzed the allele frequency in the context of the variant and gene functional features and linked it with changes in …

A Combined Positron Emission Tomography (Pet)-Electron Paramagnetic Resonance Imaging (Epri) System: Initial Evaluation Of A Prototype Scanner, Mark Tseytlin, Alexander V. Stolin, Priyaankadevi Guggilapu, Andrey A. Bobko, Valery V. Khramtsov, Oxana Tseytlin, Raymond R. Raylman

Clinical and Translational Science Institute

The advent of hybrid scanners, combining complementary modalities, has revolutionized the application of advanced imaging technology to clinical practice and biomedical research. In this project, we investigated the melding of two complementary, functional imaging methods: positron emission tomography (PET) and electron paramagnetic resonance imaging (EPRI). PET radiotracers can provide important information about cellular parameters, such as glucose metabolism. While EPR probes can provide assessment of tissue microenvironment, measuring oxygenation and pH, for example. Therefore, a combined PET/EPRI scanner promises to provide new insights not attainable with current imagers by simultaneous acquisition of multiple components of tissue microenvironments. To explore the …

Energy Expenditure Performing Hands-Only Cardiopulmonary Resuscitation During Average Emergency Response Times, Johnathan Valdez, Savanna Edson, Micha Emmel, Jesus Rivera-Macias, Benjamin Adams, Mary Casilla

2018 Symposium

Early cardiopulmonary resuscitation (CPR) by civilian responders is a critical aspect in the survival of cardiac arrest patients. According to the American Red Cross (ARC), the average response time to a 911 call is 8-12 min. High-quality CPR performed as soon as possible following cardiac arrest considerably increases a person’s chances of survival and recovery. It is possible that fatigue may decrease CPR quality, and to date no data exists on the metabolic cost of preforming hands-only CPR. PURPOSE: To determine the energy expenditure of performing hands-only CPR during the average emergency response time. METHODS: Eight college-aged participants (23.6 ± …

What Obstacles Prevent Students From Engaging In Environmentally Friendly Behaviors?, Carrie Cutler, Loretta Sohappy

2018 Symposium

According to the Environmental Protection Agency (EPA)the United States generated 33 million tons of plastic waste in 2014 of which only 9.5% was recycled. In addition Americans use over 17 million barrels of oil a year to meet demands for plastic water bottles. Any reusable plastic that gets thrown away creates the need to harvest new raw materials contributing to pollution and energy consumption. If Americans consumed 50% fewer plastic water bottles per year they would save enough oil to power one million cars for six months. The purpose of this study was to identify college students’ attitudes barriers and …

Notice Of 06-05-2018 Hsc Committee Meeting, Patrice Martin

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

Design Of A Distributed Real-Time E-Health Cyber Ecosystem With Collective Actions: Diagnosis, Dynamic Queueing, And Decision Making, Yanlin Zhou

Department of Electrical and Computer Engineering: Dissertations, Theses, and Student Research

In this thesis, we develop a framework for E-health Cyber Ecosystems, and look into different involved actors. The three interested parties in the ecosystem including patients, doctors, and healthcare providers are discussed in 3 different phases. In Phase 1, machine-learning based modeling and simulation analysis is performed to remotely predict a patient's risk level of having heart diseases in real time. In Phase 2, an online dynamic queueing model is devised to pair doctors with patients having high risk levels (diagnosed in Phase 1) to confirm the risk, and provide help. In Phase 3, a decision making paradigm is proposed …

The Effect Of Diabetes Self-Management Education On Hba1c And Quality Of Life In African-Americans: A Systematic Review And Meta-Analysis., Amy T. Cunningham, Denine R. Crittendon, Neva White, Geoffrey D. Mills, Victor Diaz, Marianna Lanoue

Department of Family & Community Medicine Faculty Papers

BACKGROUND: Type 2 diabetes presents a major morbidity and mortality burden in the United States. Diabetes self-management education (DSME) is an intervention associated with improved hemoglobin A1c(HbA1c) and quality of life(QOL), and is recommended for all individuals with type 2 diabetes. African-Americans have disproportionate type 2 diabetes morbidity and mortality, yet no prior meta-analyses have examined DSME outcomes exclusively in this population. This systematic review and meta-analysis examined the impact of DSME on HbA1c and QOL in African-Americans compared to usual care.

METHODS: Randomized controlled trials, cluster-randomized trials, and quasi-experimental interventions were included. 352 citations were retrieved; 279 abstracts were …