Medicine and Health Sciences Commons^™

Field Validation Of Multiple Species Distribution Models Shows Variation In Performance For Predicting Aedes Albopictus Distributions At The Invasion Edge, Anna V. Shattuck, Brandon D. Hollingsworth Ph.D., Jared Skrotzki, Scott R. Campbell, Christopher L. Romano, Courtney C. Murdock

Faculty Publications

Background

Climate and land use changes have resulted in range expansion of many species. In this shifting disease landscape, it is important to leverage tools that can predict the distributions of invading vectors to target surveillance and control efforts and identify at-risk populations. Species distribution models (SDMs) are used to predict ranges of invasive species; however, invasive species often violate assumptions of equilibrium and niche conservatism. Moreover, these studies are rarely validated using independent data.

Methods 

We use long-term surveillance data for Aedes albopictus, a highly invasive mosquito capable of transmitting several arboviruses, at its range edge to evaluate a …

Development Of An Evidence-Based Guideline For Nurse-Led Interventions To Improve Medication Adherence In Patients With Severe Mental Illness, Grace Uche Kalu

Walden Dissertations and Doctoral Studies

I conducted this Doctor of Nursing Practice (DNP) project to address medication nonadherence among adults with severe mental illness (SMI) in a psychiatric care setting by developing an evidence-based clinical practice guideline (CPG) for nurse-led interventions. The identified practice gap was the absence of a standardized, evidence-informed framework to guide nurses in enhancing pharmacotherapy adherence, which is a critical issue linked to relapse, rehospitalization, and diminished quality of life in this population. This project was guided by the following practice question: Will an evidence-based guideline on nurse-led interventions to improve medication adherence in patients with SMI be approved by a …

Optimizing Lower Intensity Triplet Therapy In Acute Myeloid Leukemia: A Practical Guide, Wei-Ying Jen, Curtis A Lachowiez, Jennifer Marvin-Peek, Jessica K Altman, Musa Yilmaz, Jacqueline S Garcia, Yasmin Abaza, Nicholas J Short, Joshua F Zeidner, Naval G Daver, Andrew H Wei, Ghayas C Issa, Courtney D Dinardo

Faculty, Staff and Student Publications

Venetoclax-based doublets with azacitidine or low dose cytarabine are the standard of care for the treatment of acute myeloid leukemia (AML) in older patients or those unfit for intensive chemotherapy. However, some patients do not attain complete remission, and over time, most patients relapse. Frontline triplet therapy incorporating a targeted therapy (FLT3, IDH or menin inhibitor) is an emerging treatment concept under investigation for this population. Initial triplet regimens have yielded encouraging composite complete remission and measurable residual disease negativity rates, enabling the transition to allogeneic stem cell transplantation for eligible patients. While effective, triplets are associated with myelosuppression and …

Advances In Artificial Intelligence For Glioblastoma Radiotherapy Planning And Treatment, Reid Master, Nesha Rubin, James Sampson, Kamlesh K Yadav, Shruti Pandita, Aria Sabbagh, Anika Krishnan, Patrick J Silva, Kenneth S Ramos, Vincent Gregoire, Nikos Paragios, Sunil Krishnan, Tej K Pandita

The Brown Foundation: Institute of Molecular Medicine

Glioblastoma is an aggressive central nervous system tumor characterized by diffuse infiltration. Despite substantial advances in oncology, survival outcomes have shown little improvement over the past three decades. Radiotherapy remains a cornerstone of treatment; however, it faces several challenges, including considerable inter-observer variability in clinical target volume delineation, dose constraints associated with adjacent organs at risk, and the persistently poor prognosis of affected patients. Recent advances in artificial intelligence, particularly deep learning, have shown promise in automating radiation therapy mapping to improve consistency, accuracy, and efficiency. This narrative review explores current auto segmentation frameworks, dose mapping, and biologically informed radiotherapy …

An Analysis Of Diagnostic Metabolomic Profiles Associated With Hepatotoxicity During Childhood All Induction Therapy, Emily J Mason, Anna M Crain, Michael E Scheurer, Philip J Lupo, Karen R Rabin, Olga A Taylor, Marley Roberts, John P Woodhouse, Ashley Chavana, Kathleen Ludwig, Laura Klesse, Kenneth Heym, Timothy Griffin, Rodrigo Erana, Juan Carlos Bernini, M Monica Gramatges, Joanna S Yi, Sandi L Pruitt, M Brooke Bernhardt, Hong Zhu, Steven D Mittelman, Van Huynh, Etan Orgel, Jeremy M Schraw, Austin L Brown

Faculty, Staff and Students Publications

Hepatotoxicity is a well-documented complication of induction chemotherapy for acute lymphoblastic leukemia (ALL), but our understanding of its biological mechanisms is limited. We identified 314 patients with ALL (aged 1-19 years) treated at Texas Children’s Hospital (2008-2019) with diagnostic bone marrow plasma available for metabolomic profiling: 234 for discovery and 80 for replication. Hepatotoxicity during induction was defined as follows: (1) transaminitis: grade ≥3 aspartate aminotransferase or alanine aminotransferase or (2) conjugated hyperbilirubinemia: conjugated bilirubin (c.bili) >3 mg/dL. Untargeted profiling detected 519 metabolites. Adjusted odds ratios (aORs) for each metabolite were calculated with logistic regression, accounting for sex, age, body …

Targeting The Hepatic Circadian Clock Concomitant With Tyrosine Kinase Inhibition Reverses Late-Stage Hepatocellular Carcinoma, Baharan Fekry, Savera Aggarwal, Rachel Van Drunen, Rafael Bravo, Andy Escalante, Constance Atkins, Sheng Pan, Zheng Chen, Kai Sun, David R Hall, Mamoun Younes, Kristin Eckel-Mahan

Faculty, Staff and Student Publications

Hepatocellular carcinoma (HCC) is a leading cause of cancer-related deaths. Most patients present at advanced stages, and the effectiveness of tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors is constrained by limited patient response. A subset of HCC shows elevated expression of the promoter 2 ("P2")-driven hepatocyte nuclear factor 4 alpha (HNF4α) isoform, which directly transcriptionally represses the circadian brain and muscle ARNT-like protein 1 (BMAL1) transcription factor. This subtype of HCC is robustly inhibited by the plant-based flavonoid nobiletin (NOB), a circadian-fortifying compound. Using patient-matched human HCC and serum, we show that BMAL1-deficient HCC shows exaggerated carnitine palmitoyl transferase …

Patient-Reported Outcomes After Ipsilateral Radiation Therapy For N2b Tonsillar Squamous Cell Carcinoma, Chike O Abana, Adam S Garden, G Brandon Gunn, Gregory M Chronowski, Abdallah S R Mohamed, Andrew J Frankart, Natalie Geier, Houda Bahig, Carly E A Barbon, Kate Hutcheson, Vinita Takiar, Clifton D Fuller, Steven J Frank, David I Rosenthal, Jack Phan

Faculty, Staff and Student Publications

Background: Previous studies have reported excellent disease control and survival in patients with well-lateralized, American Joint Committee on Cancer (AJCC)-7 T1-2N2b tonsillar squamous cell carcinoma (SCC). The reduced treatment volume is associated with lower rates of physician-assessed toxicity. Patient-reported outcomes (PROs) have been proposed as a similarly reliable measure, but the body of literature is limited for unilaterally treated patients. Our goal was to review PROs of such patients who had reduced treatment volumes.

Methods: We reviewed PROs of patients with AJCC-7 T1-2N2b disease treated with ipsilateral radiation therapy (RT), with or without surgery or chemotherapy before RT. PROs were …

Coordinated Transfer Of Dna Between Pol Θ And Pol Δ Resets Microhomology Choice During Double-Strand Break Repair, Yuzhen Li, Mark Returan, Adele T Guerin, April M Averill, Dorcas Oladapo, Sylvie Doublié, Richard D Wood

Faculty, Staff and Student Publications

DNA polymerase theta (Pol θ)-mediated end joining (TMEJ) initiates DNA double-strand break repair by using short homologies (microhomologies) between single-stranded DNA tails. This repair process is particularly important in cancer cells defective in homologous recombination. The exonuclease function of DNA polymerase delta (Pol δ) has been identified as an essential component for TMEJ, functioning to remove unpaired bases flanking a microhomology (MH). It is not known if the exonuclease removes all unpaired bases at once and how this removal might affect subsequent MH selection. Here, we reconstituted a functional TMEJ repair process using purified human Pol θ and Pol δ. …

Nivolumab Plus Ipilimumab Induce Hyper-Progression In Renal Medullary Carcinoma: Results Of A Phase Ii Trial And Preclinical Evidence, Melinda Soeung, Xinmiao Yan, Ciro Zanca, Jing Qian, Menuka Karki, Fei Duan, Hania Khan, Li Zhang, David H Peng, Mariah Williams, Rong He, Ziheng Chen, Luigi Perelli, Jianfeng Chen, Rebecca S Tidwell, Pankaj K Chauhan, Courtney N Le, Truong N A Lam, Nirjar Bhattacharya, Rutvi Shah, I-Lin Ho, Jason P Gay, Caroline C Carrillo, Ningping Feng, Kang Le, Guang Gao, Teresa L Perry, Faika Mseeh, Yongying Jiang, Quanyun A Xu, Niki Marie Zacharias, Rahul A Sheth, Tharakeswara K Bathala, Priya Rao, Najat C Daw, Durga N Tripathi, Cheryl L Walker, Mohammad M Mohammad, Jianhua Zhang, Guangchun Han, Yanshuo Chu, Ruiping Wang, Minghao Dang, Enyu Dai, Fuduan Peng, Yunhe Liu, Akshaya Jadhav, Wenhua Lang, Claudio A Arrechedera, Leticia Campos Clemente, Edwin R Parra, Hsinyi Lu, Cara L Haymaker, Ignacio I Wistuba, Andrew Futreal, Andrea Viale, Michael J Soth, Philip Jones, Joseph R Marszalek, Timothy Heffernan, Giulio F Draetta, Nizar M Tannir, Jianjun Gao, Linghua Wang, Giannicola Genovese, Pavlos Msaouel

Faculty, Staff and Students Publications

Therapeutic options for patients with renal medullary carcinoma (RMC) are limited. Here we report the results of a phase II clinical trial (NCT03274258) of anti-PD1 nivolumab plus anti-CTLA4 ipilimumab in patients with RMC, with objective response rate as primary outcome. Enrollment was halted for futility at a prespecified interim analysis as all 10 treated patients experienced rapid disease progression. 5/10 met radiological criteria for hyperprogression and median progression-free survival (secondary outcome) was 1.38 months (95% confidence interval: 1.28, 1.60). In a post-hoc single-cell RNA sequencing analysis, data from patients with RMC before and after nivolumab plus ipilimumab treatment indicated that …

Leaping Between Branches: Hybridisation And The Tangled Evolutionary History Of True Lemurs, Giacomo Mercuri, Giovanni Merici, Kyle Kai-How Farh, Lukas F K Kuderna, Jeffrey Rogers, Tomàs Marques-Bonet, Giuseppe Donati, Riccardo Percudani, Cristian Capelli

Faculty, Staff and Students Publications

The true lemurs (genus Eulemur) are a genetically diverse and spatially widespread group of species inhabiting most of Madagascar's forests. Including 12 recognized species, the genus can be divided into four major evolutionary groups: E. rubriventer, E. mongoz, the Brown Lemur Species Complex (BLSC), and the coronatus-macaco-flavifrons complex (CMFC), although monophyly for the CMFC is not always supported. Recent genome-based studies highlighted topological and chronological differences between nuclear and mitochondrial phylogenies of true lemurs, which could be explained by events of hybridisation. In order to reconstruct the evolutionary history of the genus, we test for gene-flow between Eulemur clades using …

Turning Patients' Open-Ended Narratives Of Chronic Pain Into Quantitative Measures: Natural Language Processing Study, Raquel Norel, Jennifer Gewandter, Zhengwu Zhang, Anika Tahsin, Chadi G Abdallah, John Markman, Zhiyao Duan, Guillermo Cecchi, Paul Geha

Faculty, Staff and Students Publications

Background: Subjective report of pain remains the gold standard for assessing symptoms in patients with chronic pain and their response to analgesics. This subjectivity underscores the importance of understanding patients' personal narratives, as they offer an accurate representation of the illness experience.

Objective: In this pilot study involving 20 patients with chronic low back pain (CLBP), we applied emerging tools from natural language processing (NLP) to derive quantitative measures that captured patients' pain narratives.

Methods: Patients' narratives were collected during recorded semistructured interviews in which they spoke about their lives in general and their experiences with CLBP. Given that NLP …

Botulinum Toxin Combined With Robot-Assisted Therapy For Post-Stroke Spasticity: A Systematic Review, Salvatore Facciorusso, Stefania Spina, Mirko Filippetti, Rajiv Reebye, Gerard E Francisco, Andrea Santamato

Faculty, Staff and Student Publications

Background: Post-stroke spasticity limits motor recovery and independence. Combining botulinum toxin type-A (BoNT-A) injection with intensive, task-specific robot-assisted therapy (RAT) might enhance neuroplasticity and functional gains, but its additive effect and optimal timing are uncertain. (

Methods: We systematically searched major medical databases and trial registries up to April 2025 for randomized controlled trials in adults with post-stroke spasticity comparing botulinum toxin type-A injection plus RAT with toxin injection plus conventional therapy, or RAT alone with RAT combined with toxin injection. Risk of bias was assessed using the RoB 2 tool, and findings were synthesized narratively.

Results: Seven trials ( …

Improving Dynamic Balance And Gait Adaptation With Ischemic Conditioning Post-Stroke, Stephanie Christine Wolfe

Dissertations (1934 -)

The purpose of this dissertation was to quantify the benefits of ischemic conditioning on reactive balance responses and gait adaptation during treadmill walking in chronic stroke survivors. Reactive balance and gait adaptations are believed to be limited in this population. Ischemic conditioning is an emerging adjunct to physical therapy that improves motor function post-stroke via improvements in strength, voluntary muscle activation, walking speed, and fatigability. Here, we quantified how ischemic conditioning could impact performance of a more complex task: altering gait to meet various perturbing conditions. Specifically, we quantified mediolateral margin of stability in response to lateral cable pulls (both …

Prospective Sars-Cov-2 Additional Vaccination In Immunosuppressant-Treated Individuals With Autoimmune Diseases In A Randomized Controlled Trial, Meggan Mackay, Alfred Hj Kim, Et Al.

2020-Current year OA Pubs

BACKGROUND: Individuals with autoimmune diseases (AD) on immunosuppressants often have suboptimal responses to COVID-19 vaccine. We evaluated the efficacy and safety of additional COVID-19 vaccines in those treated with mycophenolate mofetil/mycophenolic acid (MMF/MPA), methotrexate (MTX), and B cell-depleting therapy (BCDT), including the impact of withholding MMF/MPA and MTX.

METHODS: In this open-label, multicenter, randomized trial, 22 participants taking MMF/MPA, 26 taking MTX, and 93 treated with BCDT who had suboptimal antibody responses to initial COVID-19 vaccines (2 doses of BNT162b2 or mRNA-1273 or 1 dose of AD26.COV2.S) received an additional homologous vaccine. Participants taking MMF/MPA and MTX were randomized (1:1) …

Cpx-351 Vs. Conventional Chemotherapy Cardiotoxicity In High-Risk Aml: A Post Hoc Phase Iii Trial Analysis, Joshua D Mitchell, Michael Pfeiffer, John Boehmer, John Gorcsan, Shunsuke Eguchi, Yoshiyuki Orihara, Nalina Dronamraju, Sonja Dhani, Stefan Faderl, Tara L Lin, Geoffrey L Uy, Jeffrey E Lancet, Jorge E Cortes

2020-Current year OA Pubs

BACKGROUND: CPX-351, a dual-drug liposomal encapsulation of daunorubicin and cytarabine in a synergistic 1:5 molar ratio, has demonstrated significantly improved overall survival in acute myeloid leukemia (AML) compared with 7 + 3, but its impact on cardiac function remains unclear. In a post hoc analysis of the pivotal clinical trial, we sought to determine the relative cardiotoxicity of CPX-351 vs. 7 + 3 in high-risk AML.

METHODS: We evaluated cardiotoxicity in 102 patients with AML (CPX-351, n = 57; 7 + 3, n = 45) who had normal baseline left ventricular ejection fraction (LVEF) ≥ 53% and at least one …

Deep Learning Reveals How Cells Pull, Buckle, And Navigate Fibrous Environments, Abinash Padhi, Arka Daw, Atharva Agashe, Medha Sawhney, Maahi M Talukder, Mehran M H Pour, Mohammad Jafari, Guy M Genin, Farid Alisafaei, Sohan Kale, Anuj Karpatne, Amrinder S Nain

2020-Current year OA Pubs

Cells in tissues navigate fibrous environments fundamentally differently than they do on flat substrates, but the establishment of cell forces in physiological fibrous settings remains poorly understood. Although factors such as the stiffness of the extracellular matrix (ECM) are known to drive behaviors, including cell motility on flat nonfibrous substrates, the interplay between fiber architecture and stiffness in fibrous ECM is not known. Here, we find that in fibrous environments, the directionality of mechanical forces overrides ECM stiffness as the primary regulator of contractility in migrating cells. Using an approach combining phase microscopy with deep learning to map forces in …

Mitochondrial Iron Transport Via Mfrn1 Is Required For Erythroid Cell Cycle Progression, Mark Perfetto, Aidan Danoff, Muhammad Ishfaq, Heidi Monroe, Aiden Mohideen, Meilin Chen, Jesus Tejero, Amber N Stratman, Satoshi Okawa, Yvette Y Yien

2020-Current year OA Pubs

Iron metabolism drives key erythropoietic processes, including hemoglobinization, survival, and proliferation. Here, we developed in vivo methods to interrogate how iron regulates erythropoiesis and report that mitochondrial iron transport via mitoferrin-1 (MFRN1) is essential for erythroid cell cycle progression. mfrn1 embryos had severely decreased erythroid cell number caused by cell cycle arrest at G2/M. They had enlarged nuclei, suggesting a mitotic defect. Iron supplementation rescued the cell cycle defect, implicating mitochondrial iron deficiency as its cause. In contrast, fpn1 mutants, anemic from systemic iron deficiency, had less severe decreases in erythroid mitochondrial iron than mfrn1 mutants and no proliferative defects. …

Analyzing The Global Happiness Index, Victoria Hernandez, Christy W. Wachira

SMU Data Science Review

This study explores the Global Happiness Index using data compiled from the OECD and Our World in Data to identify key factors contributing to societal well-being. Six primary predictors were analyzed: GDP per capita, social support, healthy life expectancy, freedom to make life choices, generosity, and perceptions of corruption. Regression and clustering techniques were employed to uncover patterns among countries. By expanding the analytical scope beyond conventional economic and social indicators, this study helps identify new pathways for improving well-being across diverse cultural and economic landscapes. Additional variables such as perceived safety, political engagement, and values related to family and …

Intouch Week Of November 24, 2025, New York Medical College

InTouch

• NYMC Marks 150 Year Academic Affiliation with NYC Health+Hospitals/Metropolitan with Celebration Symposium
• BioInc@NYMC Welcomes Dair Capture
• SOM Class of 2029 Comes Together for Friendsgiving Celebration
• NYMC and TU Hosted Webinar Series: “Ninety Minutes: The Medical Magazine of the Web”
• Third Volume of Medical Halachah Annual Links Halachah and Modern Medical Ethics
• Feature Your Artwork on the Chironian Back Cover
• TCDM Students Volunteer at Pop-Up Dental Clinic
• Free Ground Shipping on Merch
• In The Community: Students Lead Community Health Fair Offering Wide-Ranging Health Resources
• Student Spotlight: From Medical Student to Ironman

Advancing Cardiorespiratory Care In The Heart Center: Development Of A Specialized Cardiac Curriculum For Respiratory Therapists, Alexandra Birely, Andrea Torzone, Jill Kleiber, Elysia Harshman, Melinda Cory

2025

INNOVATION & LEADERSHIP

Background: As innovations advance the outcomes and survival of pediatric patients with heart disease, an evolving patient population is increasing the complexity of inpatient heart care. The Heart Center at Children’s Health Dallas has seen a twofold increase in ventilator dependent tracheostomy patients since 2022, illustrating just one example of the shifting acuity profile of patients being cared for on the Acute Care Cardiology Unit (ACCU). Providing safe and high-quality care within a pediatric Heart Center requires enhanced resources and expertise across the entire multidisciplinary team. The need for increased respiratory therapy support was identified on …

Advancing Health Equity Through Comprehensive Haircare Training To Reduce Pediatric Hospital-Acquired Pressure Injuries, Afra Evans, Adrienne Johnson, Adrienne Davis

2025

QUALITY IMPROVEMENT

Background: Increased awareness of health equity and a rise in hospital-acquired pressure injuries (HAPIs) to the scalp and head—particularly among pediatric patients with textured hair—prompted a comprehensive initiative at a pediatric healthcare organization. Environmental scanning revealed that while new haircare products had been introduced into clinical areas, staff lacked the training and resources to use them effectively. A current-state analysis survey of 133 staff members (86% clinical) revealed significant gaps: 69% had never received training in diverse haircare, 51% did not feel equipped to provide appropriate care, and 36% felt nervous or intimidated when caring for hair …

Elevating Nursing Leadership: How Nurse Managers Empower Unit Practice Councils, Katie Fields

2025

EBP

Literature Review: Utilizing OVID and databases CINAHL and PubMed, a comprehensive review of 22 articles, including integrative reviews and qualitative studies, was conducted to examine leadership behaviors that support NPG and UPCs. Across the literature, empowerment, accountability, and presence are consistently highlighted as essential leadership behaviors for effective shared governance that strengthens engagement and professional growth. Clavelle and Tarasenko (2024) emphasized accountability as critical to advancing NPG, while Rollins et al. (2024) underscored the importance of adaptable leadership styles to meet the evolving needs of frontline nurses and practice councils.

PICO: What are the best practices and leadership behaviors …

From Competence To Confidence: Fostering A Culture Of Certification In Nursing, Derhonda Dossett, Sunni Fleming, Amanda Grantham, Johanna Muller

2025

INNOVATION & LEADERSHIP

Background: Nursing certifications help promote excellence in nursing and support the professional identity of nurses. In an urban academic pediatric hospital system, nursing leaders were tasked with increasing professional nursing certification rates within their departments. One team has excelled in increasing their professional certification rate. The team went from 8 to 35 certified nurses which was a 33.75% increase from July 2022 to July 2025. This has elevated the confidence and knowledge base of the nurses and leaders in the Variable Staffing department. Objectives included increasing knowledge and awareness of professional certification, providing resources available to …

Planting Seeds Of Success: Cultivating Cpen Certification In Pediatric Emergency Nursing, Shelby Flusche, Johanna Muller

2025

INNOVATION & LEADERSHIP

Background: Children’s Health Plano campus has faced challenges in supporting nurses preparing for the Certified Pediatric Emergency Nurse (CPEN) exam, with limited resources available for study and preparation. To encourage certification, a certification champion was identified to provide leadership and guidance. However, it soon became evident that additional support was needed, as many nurses were unsure how to obtain a test voucher and reported low confidence levels regarding exam success. In fact, 75% of nurses initially rated themselves as neutral to not confident in their ability to pass the CPEN exam, highlighting a significant gap in …

We Float So You Don’T Sink: Implementation Of Float Nurse Support Role, Amanda Anderson, Caroline Kelley, Mary Moore, Carlie Phillips, Krista Westbrook

2025

INNOVATION & LEADERSHIP

Background: Critical care float pool nurses possess broad clinical expertise and flexibility to support a wide range of patient care areas across the organization. Their familiarity with multiple units, patient populations, and

established relationships with provider teams helps them to facilitate timely and effective clinical support. Acute care staff regard critical care nurses’ judgment with high respect, enhancing interdisciplinary collaboration and trust. Because of a rising patient acuity and census, there is risk for failures in escalation of care, with 16% of serious pediatric adverse events linked to delays is escalation (Sosa et al., 2022). Critical …

A Quality Attack On Hacs, Chasity Tyree-Lee, Krystan Smith, William Gaines, Samantha Frederick, Kendel Richards

2025

QUALITY IMPROVEMENT

Background: Hospital-acquired conditions (HACs) pose a dual challenge to pediatric organizations, compromising patient safety while creating substantial financial burdens, with a single central line-associated bloodstream infection (CLABSI) costing an estimated $48,108 and delaying discharge (Forrester, 2022; Li, 2024). While prior studies have focused on reducing individual HACs through standardized rounding, our pediatric intensive care unit (PICU) adopted a broader, integrated approach.

Methodology: In 2022, we launched a nursing-led initiative to reduce multiple HACs—catheter-associated urinary tract infections (CAUTI), CLABSI, hospital-acquired pressure injuries (HAPI), and peripheral intravenous catheter infiltration and extravasations (PIVIE)—simultaneously. The program empowered Quality Champions (QCs), …

Precision In Practice: Subject Matter Expert Integration To Support Excellence In Population-Specific Documentation, Sara Pump, Lauren Spain, Virginia Kasenic, Meagan Talent, Alivia Stewart, Carrin Shaw, Chad Gautreaux, Dori Cousin, Ronesea Allen, Jonathan Rowe

2025

QUALITY IMPROVEMENT

Background: An initial internal pilot audit of patient charts, performed by the Plano psych RN team within the Emergency department in November 2024 revealed significant gaps in documentation compliance for behavioral health patients. Many areas of required charting were found to be incomplete, partially completed, or inconsistently documented across disparate sections of the electronic medical record. This fragmentation not only impedes the ability to efficiently locate critical information but also fails to meet the documentation standards outlined in Children’s Health organizational policies. These deficiencies pose risks to continuity of care, clinical decision-making, regulatory compliance, patient and staff …

Community Health Worker (Chw) Initiative To Address Low Acuity Pediatric Emergency Department Utilization, Jana Neal, Danielle Hayle

2025

INNOVATION & LEADERSHIP

Background: A Medicaid payor-funded collaborative was initiated in partnership with Children’s Health System of Texas to reduce low-acuity emergency department (ED) visits—defined as triage levels 4 or 5—among Medicaid patients, who account for the largest share of ED use, with nearly 50% of visits considered low acuity. To address this, certified Community Health Workers (CHWs) were deployed in the Dallas and Plano EDs to engage eligible caregivers. CHWs provide education on insurance benefits, assist with establishing primary care provider (PCP) relationships, and promote appropriate healthcare utilization. They also work to identify barriers preventing the use of …

Engaging The Night Shift To Sustain A Healthy Work Environment, Kelsey Walsh, Delaney Dewolf, Annie Tolliver

2025

INNOVATION & LEADERSHIP

Background: Night shift nurses often feel overlooked, leading to disengagement and higher turnover. The common question, “What about for the night shift?” highlights gaps in recognition, communication, and collaboration. In 2024, a large pediatric health system launched a Night Shift Forum (NSF) to improve the work environment for this critical group. Results from the AACN Healthy Work Environment Assessment Tool (HWEAT) showed true collaboration (3.41) and meaningful recognition (3.73) as the lowest-scoring areas. Recent studies show that night-shift nurses consistently report lower scores on healthy work environment domains, while organizations with dedicated night councils demonstrate stronger …

A Nurse-Led Investigation Into Rising Cardiology Clinic Admission Holds And A Multidisciplinary Strategy To Reduce Them, Jennifer Dickson, Haley Byrne, Katherine Harris, Leah K. Toombs

2025

INNOVATION & LEADERSHIP

Background: The Dallas Cardiology Clinic, the only hospital-based clinic within the Heart Center’s outpatient network, serves specialized, high-acuity cardiac patients who often require direct admission. Due to inpatient bed constraints in the Acute Care Cardiology Unit and Cardiac ICU, rising patient complexity, patients are increasingly held in the ambulatory space, not intended for, or equipped for prolonged care. In 2024, average admission wait times rose to 118 minutes (often taking 200+ minutes) up from 97 minutes in 2022. Long admit wait times can lead to treatment delays, raise nursing concerns about safety, and disrupt outpatient flow. …