Health and Medical Administration Commons^™

Efficacy Of Various Interventions For Achieving Target Hba1c Levels For Patients With Type Ii Diabetes Mellitus And On Exogenous Insulin, Caitlin S. Welch, Archie Troxel

Longitudinal Scholar's Project

Objective: To learn the rates at which patients at UT Family Medicine–St. Francis (UTFM–SF) with type II diabetes mellitus are being prescribed recommended medications—namely metformin, sodium-glucose cotransporter 2 (SGLT2) inhibitors, and glucagon-like peptide 1 receptor agonists (GLP1RAs)—whether these rates correspond to the severity of hyperglycemia (as indicated by HbA1C level). A secondary goal of the study was to investigate if HbA1C levels are being checked at recommended intervals.

Methods: A retrospective chart review was conducted using records of patients seen at the clinic in the previous four years between the ages of 18 and 65 who had visits with ICD …

Identifying Critical Aging Care Challenges And Opportunities In High-Income Countries: A Cross-Country Comparison Of Denmark, Germany, And The United States, Cassandra Martin

Capstone Collection

Despite the rapid growth in the aging population in the United States, insufficient resources and attention are invested in improving the support systems this population relies on. This discussion explored the question of how the United States as a high-income country fails to operate an aging care support infrastructure that has comparable comprehensiveness, availability, affordability, and overall quality to other high-income countries. Comparing financing structures, long-term care models, and various aging care supports is important for answering this question. This paper approached exploring this question by analyzing specified indicators from publicly available data across the United States, Germany, and Denmark. …

No One Should Have To Give Birth Alone: An Analysis Of The Efficacy Of Community-Based Doula Programs Serving Ethnic Minorities In San Francisco, Maria Margaret Nelson

Master's Projects and Capstones

Adverse birth outcomes for both the parent and the child disproportionately affect people of color. Evidence demonstrates that one of the ways to mitigate these negative consequences is through the utilization of a doula, a trained birth companion that is not a medical provider but whose role it is to physically and emotionally support the patient through pregnancy, birth, and postpartum. Community-based doula programs, where the doula is of the same cultural background as the client, are particularly effective in improving birth outcomes in communities of color by providing culturally competent care and helping to navigate a healthcare system that …

Risk Of Transmission Of Respiratory Viruses During Aerosol-Generating Medical Procedures (Agmps) Revisited In The Covid-19 Pandemic: A Systematic Review, Jenine Leal, Brenlea Farkas, Liza Mastikhina, Jordyn Flanagan, Becky Skidmore, Charleen Salmon, Devika Dixit, Stephanie Smith, Stephen Tsekrekos, Bonita Lee, Joseph Vayalumkal, Jessica Dunn, Robyn Harrison, Melody Cordoviz, Roberta Dubois, Uma Chandran, Fiona Clement, Kathryn Bush, John Conly, Oscar Larios

Faculty, Staff and Student Publications

BACKGROUND: In many jurisdictions healthcare workers (HCWs) are using respirators for aerosol-generating medical procedures (AGMPs) performed on adult and pediatric populations with all suspect/confirmed viral respiratory infections (VRIs). This systematic review assessed the risk of VRIs to HCWs in the presence of AGMPs, the role respirators versus medical/surgical masks have on reducing that risk, and if the risk to HCWs during AGMPs differed when caring for adult or pediatric patient populations.

MAIN TEXT: We searched MEDLINE, EMBASE, Cochrane Central, Cochrane SR, CINAHL, COVID-19 specific resources, and MedRxiv for English and French articles from database inception to September 9, 2021. Independent …

Provider Attitude Towards Postpartum Sexual Health, Katie Shearer, Pallavi Khanna

Longitudinal Scholar's Project

Background: The prevalence of female sexual dysfunction (FSD) worldwide is estimated to be 41%. FSD is even more prevalent in postpartum patients. There are significant barriers to addressing FSD in a busy clinic, and the use of a standardized screening questionnaire could be used to improve outcomes during postpartum appointments.

Methodology: Providers that care for postpartum patients at Regional One Health in Memphis, TN, were asked to complete an anonymous survey online. General knowledge and practices of providers were assessed.

Results: 79% of respondents answered that they felt very comfortable assessing for postpartum sexual health, and 88% …

Comparison Of Routine Health Screening Rates Between Two Emr Systems, Lauren M. Cancio, Caleb J. Berta

Longitudinal Scholar's Project

An EMR, electronic medical record, system refers to the software widely adopted by medical practitioners to reduce the use of hard-copy files, and improve the documentation, storage, and retrieval of patient information. Some EMR systems can generate automatic alerts reminding providers when patients are due for certain preventive services or meet the criteria for various screening measures. Epic, one of the leading EMR systems in use today, contains this additional feature. The screening recommendations built into Epic are derived from a committee of USPSTF, U.S. Preventive Services Task Force, medical experts whose focus is to improve patient health across the …

Multicomponent Approach To Delirium Prevention In The Acute Care Setting: An Evidence-Based Quality Improvement Project., Kelley James

Doctor of Nursing Practice Papers

Background: Acutely ill, hospitalized individuals are at an increased likelihood of developing delirium. Between 30-35% of those patients admitted to the hospital will develop delirium, and as a result, these individuals will face an increased risk of mortality, adverse medical events, restraint usage, and incur a more extended hospitalization. The literature supports early screening utilizing the Confusion Assessment Method (CAM) tool and nurse-driven, multicomponent interventions to aid in preventing its development.

Environment: This project was implemented in a long-term, acute care facility specializing in patients requiring long-term mechanical ventilation, advanced wound care, pulmonary and respiratory care, and the rehabilitation of …

The Patient-Centered Medical Home And The Value Of Heightened Care Coordination: A Systematic Literature Review, Garrett L. Vetter

Capstone Experience: Master of Public Health

Health care spending in the United States continues to increase at a pace that far exceeds inflation. Representing a greater proportion of the nation’s gross domestic product (GDP) than any other country, costs associated with health care services in the U.S. lend support to growing concern regarding the sustainability of current systems. Furthermore, the fragmented nature of the current landscape often presents challenges to the provision of high-quality and efficient care. Satisfaction among both patients and health care providers, alike, suffers under the weight of increasing regulatory burden, the lack of integrated medical records systems, and growing complexity among health …

Evaluating Burnout, Secondary Traumatic Stress, And Sleep Disturbances In Healthcare Professionals During A Global Pandemic, Laura K. Miller, Sarah Pehlke

Journal of Wellness

Introduction: For healthcare workers, the COVID-19 pandemic resulted in increased workload, work related stress and patient acuity potentially leading to burnout, secondary traumatic stress (STS), and sleep disruptions. This study aims to assess the prevalence of burnout and STS symptoms, as well as sleep disturbances among healthcare personnel working in the United States during the pandemic.

Methods: Healthcare workers from all disciplines and settings in the United States completed a cross-sectional survey about work and personal characteristics from January 20-March 1, 2021. Participants reported on symptoms of burnout, STS, and sleep disruptions.

Results: A total of 360 participants in the …

Real-World Third Covid-19 Vaccine Dosing And Antibody Response In Patients With Hematologic Malignancies, Michael A. Thompson, Sigrun Hallmeyer, Veronica E. Fitzpatrick, Yunqi Liao, Michael P. Mullane, Stephen C. Medlin, Kenneth Copeland, James L. Weese

Journal of Patient-Centered Research and Reviews

Purpose: This study sought to describe the changes in immune response to a third dose of either Pfizer’s or Moderna’s COVID-19 mRNA vaccine (3V) among patients with hematologic malignancies, as well as associated characteristics

Methods: This retrospective cohort study analyzed pre-3V and post-3V data on 493 patients diagnosed with hematologic malignancies across a large Midwestern health system between August 28, 2021, and November 1, 2021. For antibody testing, S1 spike antigen of the SARS-CoV-2 virus titer was used to determine serostatus.

Results: Among 493 participants, 274 (55.6%) were seropositive both pre- and post-3V (+/+) while 115 (23.3%) seroconverted to positive …

Virtual Behavioral Health Treatment Satisfaction And Outcomes Across Time, Mindy R. Waite, Sara Diab, James Adefisoye

Journal of Patient-Centered Research and Reviews

Purpose: The COVID-19 pandemic continues to have major and long-lasting impacts on health care delivery and mental health. As health care shifted to telehealth, legislation was adjusted to expand telehealth allowances, creating a unique opportunity to elucidate outcomes. The aim of this study was to assess long-term patient and clinician satisfaction and outcomes with virtual behavioral health.

Methods: Data were obtained over 16 months from surveys to patients and clinicians receiving/providing virtual treatment. Outcomes data also were collected from medical records of adults receiving in-person and virtual behavioral health treatment. Data were summarized using descriptive statistics. Groups were compared using …

Asking The Question ‘What Matters To You?’ In A London Intensive Care Unit, Harriet Pittaway, Laura White, Karen Turner, Angelique Mcgillivary

Journal of Patient-Centered Research and Reviews

Purpose: At the heart of the paradigm shift in approach to patient care from paternalism toward shared decision-making lies the international “What Matters To You?” (WMTY) movement. However, WMTY principles are not frequently applied to the critical care setting. The aim of this quality improvement project work was to design and integrate a tool for all patients admitted to the intensive care unit (ICU) that helped answer WMTY.

Methods: Using Plan-Do-Study-Act (PDSA) methodology across 8 cycles, a multidisciplinary team designed and integrated a bedside poster into the ICU. Quantitative and qualitative data were collected via a bedside audit process on …

Abstracts From The 2022 Health Care Systems Research Network (Hcsrn) Annual Conference

Journal of Patient-Centered Research and Reviews

The Health Care Systems Research Network (HCSRN) is comprised of 20 health systems with embedded research units. The network’s annual conference serves as a forum for research teams from member institutions to disseminate scientific findings, explore new collaborations, and share insights about conducting research in real-world care delivery settings. Abstracts accepted for presentation at HCSRN 2022 are published in this supplement of Journal of Patient-Centered Research and Reviews, the official journal of HCSRN’s annual conference proceedings.

Life Matters, Marina Fischer

Dissertations

Problem: One of the challenges facing many primary care providers is managing hypertension. Hypertension contributes to cardiovascular disease events. Consequently, the high occurrence of hypertension related visits signifies a clinical practice gap in hypertension management resulting in substandard blood pressure outcomes. The purpose of this clinical scholarship project was to assess the difference of pre and post Quality of Life Scale (QOLS) scores in a hypertensive population.

Methods: This quality improvement project used a longitudinal, observational design with prospective data collection. The sample included newly diagnosed hypertensive adults ages 21 to 64 years old. The sample was administered the World …

The Mission System: An Electronic Health Record For Medical Treatment In Guatemala, Tawniece M. Curry

Dissertations

Abstract

Problem: The introduction of an electronic health record (EHR) system has become an essential component in monitoring and tracking patient information in most developed countries but are difficult to implement in underdeveloped countries. Guatemala is a country with poor health care and limited resources for patient tracking and monitoring. An organization in Guatemala, Nursing Heart Inc. (NHI), provides care to over 40 underserved rural communities but lacks the ability to monitor and track patient information. In order for NHI to properly monitor and evaluate their programs and track patients’ continuity of care, the introduction of an EHR system is …

Using Community-Based Participatory Research To Assess The Needs Of Hiv-Related Services For Infected Individuals In Rural Communities, Elizabeth Brown, Charles Brown, Owen Johnson, Wendelyn Inman, Revlon Briggs, Wanda Burrell, Rosemary Theriot, Elizabeth Williams, Alexis Heaston

Public Health, Health Administration, and Health Sciences Faculty Research

HIV/AIDS remains a significant health concern in rural communities, which may also experience many disparate issues including reduced access to health services (Department of Health and Human Services, 2015). Community efforts should be increased to improve services to people living with HIV/AIDS (PLWHA), especially in rural communities. In the state of Tennessee, using a community-based participatory research (CBPR) approach, a needs assessment was conducted to identify gaps, barriers, and strategies for improving HIV-related comprehensive care services for people diagnosed with HIV/AIDS in 26 rural counties. The paper describes the CBPR partnership and the needs assessment project that was conducted and …

Evaluating The Extent Of Fall Prevention Knowledge Of Direct Care Clinicians In A Post-Acute Hospital Setting: A Quality Improvement Initiative, Joseph Henry Mitchell Jr

Doctor of Nursing Practice Projects

Background: Events, such as falls, continue to maintain permanence in countless public health settings and organizations, attributing to unnecessary resource utilization. Proven methods for mitigating fall occurrences transpire through reliable fall education and by creating programs that directly impact these incidents. These agendas are essential and can lessen undue stress, obligations, and associated fiscal liability.

Purpose: This DNP project aimed to ascertain and expand unit nurses' fall prevention strategy knowledge in a long-term acute care hospital, bringing awareness of evidence-based practices through a learning addendum.

Methods: This program, based on a descriptive, quasi-experimental, pre-, and post-analysis, strategically …

Sepsis: Do The Clinical Criteria Support The Medical Coding?, April M. Insco

Theses and Dissertations (ETD)

Background: Sepsis is a condition that can be very costly and very deadly. Diagnosing sepsis can be challenging as there is not one specific test that will identify whether a patient has sepsis and there are varying opinions as to the true definition of sepsis. The definition of sepsis used for this research is a combination of System Inflammatory Response Syndrome (SIRS) with an identified infection. Medical Coders must review the documentation provided in a medical record to accurately assign an ICD-10-CM code. Administrative data is then used to provide statistical information for research purposes. When coded data is not …

J Mich Dent Assoc July 2022

The Journal of the Michigan Dental Association

Monthly, The Journal of the Michigan Dental Association brings news, information, and feature articles to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists! In this July 2022 issue, the reader will find the following original content:

• A cover feature on negotiating reimbursement rates with PPO contracts.
• A cover feature on guarding against employee embezzlement.
• A 10-Minute EBD on rampant caries management and prevention with ADHD patients taking stimulant medications.
• A Back Page look at the 2022 MDA award winners.
• News you need: an Editorial, guidance on dental practice cybersecurity, and regular department …

Care Alert Program In Chronic Recurrent Ed Utilizing Patients, Kaitlyn Phelps, Jonathan Bryan, Jonathan Leggett, Erica Gibbons, Brian Griggs

HCA Healthcare Journal of Medicine

The Care Alert program is designed to help navigate encounters with patient populations that are high utilizers of emergency department (ED) resources. These populations often have chronic medical conditions, have a poor understanding of their conditions, are unfamiliar with the EDs’ role in the management of these conditions, and commonly lack outpatient resources. The Care Alert program intends to address the needs of this challenging patient population by designing individualized care plans that are approved through a multidisciplinary committee. Data from this study showed a 37% decrease in ED visits and a 47% decrease in hospitalizations during the initial 8 …

Health Equity In Medicine, Tracy Macintosh, Barbara L. Gracious, Jeremy R. Brooks, Graig Donini

HCA Healthcare Journal of Medicine

Healthcare disparities exist when, due to racial, ethnic, or gender identity differences linked to social, economic or environmental factors, certain populations lack equitable access to quality healthcare and insurance coverage. Such disparities across history carry profound future implications that we have only begun to contemplate as a profession. This special issue of the HCA Healthcare Journal of Medicine examines the critical issue of health equity in medicine and how the medical community can advance health equity through inclusive behavior and interactions in clinical and educational settings, and our communities.

Analisis Resume Medis Rawat Inap Tidak Lengkap Dengan Menggunakan Konsep Masaaki: Sort, Straighten, Scrub, Systematize, Sustain (5s) Di Rsu Parama Sidhi Singaraja Bali, Idn Yunita Pratiwi, Adik Wibowo

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The quality of the hospital’s medical resume is one of hospital’s services quality indicator, which Parama Sidhi General Hospital still have figure of 17,1% for the incompleteness of medical record data (KLPCM). The goal of this research is to improve the attending physician medical resume’s completion through Sort, Straighten, Scrub, Systematize, and Sustain concept (5S) by acknowledged connection between 5S concept and medical resume completeness efforts based on continues improvement. This research is a mixed method analysis, by using primary and secondary data. The secondary data showed 26,80% among 1362 medical resume files were not completed. Univariate analysis of the …

Analisis Produk Katering Sehat Di Rumah Sakit Izza Menggunakan St (Segmenting, Targeting, Positioning) Dan 4p (Product, Price, Place, Promotion), Helmi Agustian

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The food industry (culinary business) is an industry that is always in demand by the public. During the current COVID-19 pandemic, public awareness of adopting a healthy lifestyle is increasing. Choosing a healthier diet is one way. Izza Hospital is one of the private hospitals in the Cikampek area, which has its Nutrition Installation Unit. As a hospital where most patients are BPJS, there has never been any development of new service products related to patient nutrition. The research conducted is descriptive. The primary data is collected by distributing questionnaires to 100 patients receiving treatment at outpatient care. The results …

Evaluation Of Medical Waste Management Before And During The Covid-19 Pandemic At Sentra Medika Hospital Cikarang, Enny Mar’Atus Sholihah, Amal Chalik Sjaaf

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

One of important things in managing Coronavirus Disease 2019 (COVID-19) pandemic is managing medical waste production. Medical waste management start from waste sort until waste manage by licensed parties, both of patients’ waste and health workers’ waste. Sentra Medika Hospital Cikarang is one of the referral hospitals that handles COVID-19. This research is a descriptive analytic study. Researchers analyze hazardous and toxic waste management before and during a pandemic by conducting interviews with the nursing unit and using secondary data. Secondary data was obtained from the hospital environmental health unit. There is no significant differences medical waste before and during …

Transformasi Digital Sebagai Bagian Dari Strategi Pemasaran Di Rumah Sakit Siloam Palangka Raya Tahun 2020, Kevin Chrisanta Budiyatno

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Digital transformation in healthcare is implemented through a technology-based approach to improve patient-centered care. In relation to marketing strategic planning, digital transformation is included within the marketing mix of product, promotion, and place. Assessment of healthcare technology development can be based on seven major areas, which are 1) Integrated management of information technology in health; 2) Medical images; 3) Electronic Medical Record; 4) Information technology and portable devices in health; 5) Access to e-Health; 6) Telemedicine; and 7) Privacy of medical data. Digital transformation in Siloam Hospitals Palangka Raya has shown to improve cost efficiency and work process flow, although …

Faktor Pada Perawat Yang Berhubungan Dengan Persepsi Melaporkan Kejadian Tidak Diharapkan (Ktd) Di Rumah Sakit Prima Medika Denpasar Tahun 2020, I Putu Wirama, Adik Wibowo

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Hospital is complex and full of risk medical facility. Adverse events reporting is one part of the patient safety system that has an important roles to improve the hospital’s quality. Nurses have the longest contact's time with patients so they become the most important component in reporting the Adverse Event Reporting. This study aims to determine the factors that affects perception in adverse event reporting at Prima Medika Hospital Denpasar 2020. Prima MedikaHospitalis a type C private hospital.This studies quantitative study using a cross- sectional design with 140 nurses as samples and conducted in June 2020. The nurses’s perception who …

Language Preference Impact On The Outcomes Of Those Lost To Follow-Up After A Diagnosis Of Pregnancy Of Unknown Location, Erin A. Leestma, Mayra A. Shafique, Megan Mcnitt, Annmarie Vilkins

Medical Student Research Symposium

Pregnancy of unknown location (PUL) is a temporary diagnosis when there is a positive pregnancy test but an intrauterine gestational sac and/or fetal pole are not visualized with ultrasonography. The three potential outcomes for such a pregnancy are failed pregnancy, an early intrauterine pregnancy or an ectopic/abnormal pregnancy. Given the serious associated morbidity of ectopic pregnancy, these PUL require strict follow up of bHCG levels to help the clinician determine the likely outcome of the PUL (failed vs early vs ectopic) and choose the best intervention (expectant management, surgical management or medical management). One potential barrier to follow-up identified in …

Emerging Trends In Healthcare Driven By The Covid-19 Pandemic: A Review From Health Informatics Perspective., Venugopal Mudgundi, Bhargav Desai, Farhad Nasar

Advances in Clinical Medical Research and Healthcare Delivery

The COVID-19 pandemic is the first of its kind to hit the world in the modern information age. People working in healthcare across the globe have harnessed technological advances and modern digital tools in innovative new ways. This has brought specific, more recent trends in healthcare delivery to the forefront. In this review, we present a collection of articles that highlight some of the emerging trends in healthcare driven by the COVID-19 pandemic and that have the potential to transform healthcare in the coming decades. We provide a brief commentary on the opportunities and challenges for each trend.

Feasibility And Effectiveness Of A Prehabilitation Program Prior To Breast Cancer Surgery: A Critically Appraised Topic, Emma Choi, Alissa Lee, Kayla Woods, Morgan Mills, Carol Houston

Master of Occupational Therapy Student Critically Appraised Topics

The purpose of our project is to determine the feasibility and effectiveness of a prehabilitation (prehab) program for patients undergoing breast cancer surgery as compared to only receiving post-surgical rehabilitation. Our clinical mentor has recently obtained certification as a lymphedema specialist and is assisting with the opening of an outpatient mastectomy clinic through the Methodist University systems. Through our research process, we critically appraised two Level II articles, two Level III articles, and one Level IV article. Positive outcomes related to the feasibility were identified, however there is limited significant evidence supporting the effectiveness of the intervention. We recommend using …

Group Therapy For Adults With Hip Replacements, Riley Burford Mot/S, Hillary Talley Mot/S, Elizabeth Seals Mot/S, Alishah Pirwani Mot/S, Tylan Wakefield Mot/S

Master of Occupational Therapy Student Critically Appraised Topics

The purpose of our critically appraised topic is to synthesize the best current evidence regarding the feasibility of group occupational therapy and outcomes related to ADL performance. The final portfolio contains a total of four research articles. Study designs include two randomized control trials, one cohort design, and one systematic review. All studies related directly to the PICO question and were used to determine best evidence for the feasibility of group therapy of the older adult population who have hip replacements in a rehabilitation setting.