Health and Medical Administration Commons^™

Exploring Hapi Incidence In Patients Admitted Through The Ed: A Quality Improvement Initiative, Alexa L. Tietgens

DNP Projects

Each year in the U.S., pressure injuries, or PIs, are responsible for more than 60,000 patient deaths and billions of dollars’ worth of treatment costs. Research shows that roughly 95% of all PIs are preventable by following evidence-based practice guidelines which include early identification of patients at risk, frequent skin assessments, and implementation of prevention strategies. However, the ED environment creates unique risks for PI development due to the routine use of hard surfaces (i.e., stretchers, backboards, exam tables) and frequent hospital overcrowding. Although nurses play a pivotal role in PI prevention, frequent staffing shortages, high patient acuity levels, and …

A Quality Improvement Initiative To Improve Follow-Up Time And Reduce Readmissions And Emergency Department Utilization For Oncology Patients, Delaney Serfling

MUSC Theses and Dissertations

Hospitals across the nation are facing extreme challenges with overcrowding. Unplanned readmissions and emergency department use are two significant contributors to this urgent issue. Historically, oncology patients are high utilizers of emergency department services, and have elevated numbers of unplanned readmissions. This is especially true of gastrointestinal medical oncology patients. In an effort to move the needle in the right direction, an operational quality improvement initiative to decrease emergency department utilization and unplanned readmissions was conducted. This pilot project took place over a three-month period, and consisted of protecting time for advanced practice providers (APPs) and updating inefficient workflows. The …

Improving Diabetes Management For School Health Workers Using A Live, Virtual Training Course, Bonnie Mccann-Crosby, Lisa Setchfield, Yvonne Barham, Dawn Espinosa, Jennifer Bailey, Beth Pali, Amanda Garey, Sarah Lyons, Rona Sonabend

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Background: Type 1 diabetes is one of the most common chronic diseases in childhood. Optimal school nurse and staff education is critical to creating a safe learning environment and influencing long term outcomes of students with type 1 diabetes. The purpose of this project was to develop a virtual continuing education diabetes management course for school health workers to improve their knowledge of diabetes management and evaluate the effectiveness of the learning platform.

Methods: A total of 199 participants completed the live, virtual continuing education course. Participants completed a pre and post-test to assess improvements in the key learning objectives …

Geriatric Depression Screening And Chief Complaint: What Is The Risk For 30- And 90-Day Readmission?, Eric James, Joan Michelle Moccia, Victoria Lucia

Journal of Geriatric Emergency Medicine

Abstract

Background:

Readmission to the hospital within 30-days has a high cost and represents a gap in care for older adults. Older adults are at significant risk for depression, particularly given their medical comorbidities and social factors such as isolation due to SARS-CoV-2. Many patients who screen positive for depression may have no known history of depression. This investigation examines the relationship between a positive geriatric depression screen and chief complaint as a function of 30- and 90-day readmission risk.

Methods:

We examined the electronic medical record of 329 older adults aged 65 and older from February 1, 2020, to …

Developing, Implementing, And Evaluating A Clinical Dashboard To Improve The Efficiency And Ease Of Tracking Institute For Healthcare Improvement Ihi Age-Friendly 4ms Framework Data., Margaret Parniawski Nsn, Ne-Bc, Kenneth Forte, Denis Mohess Md, Ray Wauthier Bsn, Erica Zerl Ssa, Edward Ostrowski Msn

Posters

The purpose of this study was to describe a user-centered development, implementation and preliminary evaluation of clinical dashboards to track Age-Friendly 4M Framework Data.

Reducing Blood Culture Contamination In The Emergency Department: A Multi-Method Quality Improvement Project, Daryn Brauner Msn, Marlene Schmidt Msn, Nikki Campbell Bsn, Anthony Renzoni Pharmd, Keri Bill Msn, April Alfano

Posters

The goal of this quality improvement project is to reduce the monthly percentage of BCC in an academic emergency department (ED) through implementation of a multimethod intervention targeting registered nurses (RN) and patient care technicians (PCT) who perform phlebotomy for blood cultures

Implementing The Fall Tailoring Interventions For Patient Safety (Tips) Program To Increase Nursing Knowledge Of Fall Prevention & Reduce Falls & Falls With Injury In The Medical-Surgical Setting, Anne M. Aquila, Palumbo John Mba, Ms, Mt (Ascp), Karen Bauce Dnp, Mpa, Rn, Nea-Bc

Posters

The purpose of this translational research project was to determine if the reimplementation of the Fall TIPS Program in the medical-surgical setting reduced falls and falls with injury over a 10-week period.

The aims of this project were to:

1) improve RNs’ and PCTs’ Fall TIPS knowledge

2) reduce patient falls and falls with injury

Bedside Safety Nurses: A Novel Approach To Reducing Patient Harm, Kenneth Forte, Corinne Booth Bsn, Rn, Nikki Campbell Bsn, Rn, Danielle Jimenez Msn, Rn, Alexandra Mingolello Bsn, Rn, Heather Nachilo Msn, Rn, Heidi Steller Msn, Rn, Joubin Bavarian Rn, Mary Christoffersen Dnp, Rn, Morine Cebert Phd, Aprn

Posters

The purpose of this longitudinal interventional pre-and post-intervention study was to assess the ability of Bedside Patient Safety Nurses to Identify and intervene in patient safety issues before they reach the patient.

A Critical Analysis Of Discrepancies In Behavioral Health Program Ratings By Evidence-Based Practice Registers For Behavioral Health, Miranda Jade Lee-Easton

Dissertations

Decision makers in the behavioral health disciplines are under increasing pressure to identify and implement evidence-based practices (EBPs). These decision makers often do not have the time or expertise to assess primary studies of program efficacy or effectiveness. They could benefit from tools to assist them in identifying and implementing EBPs. One tool is an evidence-based practice register (EBPR). Prior studies have documented that when multiple EBPRs rate a given program, they may come to seemingly conflicting program ratings. The prior research concerning the reason for these conflicts is sparse. The purpose of the present study is to understand how …

Covid-19 Vaccine Hesitancy And Vaccination Rate Among The Latino Population In South Carolina, Brynn E. Lynagh

Senior Theses

It is common knowledge that COVID-19 disproportionately impacts racial and ethnic minorities in the United States. Furthermore, these sects of the population exhibit increased vaccine hesitancy and lower vaccination rates as compared to the aggregated population of the United States, furthering the risk posed by COVID-19 to these communities. In particular, this study focuses on the Latino population in South Carolina, the vaccination rate among this community, and the perspectives which contributed to their vaccination decision. Two hundred Spanish and Portuguese speaking residents of South Carolina were interviewed using a paper survey conducted by pre-trained interviewers. The survey gathered data …

Root Cause Analysis, Victor Warr, Tom Sant, Carly Riehl, Rahib Bashir

Articles, Abstracts, and Reports

No abstract provided.

Qi Project: Clopidogrel In Nstemi, Amanda Sams, Erin Kaya, Carsten Kirby, Ester Peters, Michael Stewart (Faculty Advisor)

Articles, Abstracts, and Reports

No abstract provided.

Identifying Gaps In Interpretive Services To Improve Patient Care: A Root Cause Analysis, Christiane Phillips, Reed Ritterbusch, Ken Scott, Jenny Wickens

Articles, Abstracts, and Reports

No abstract provided.

Preventable Tacrolimus Toxicity, Brooke Parker, Jessica Sterner, John Mele, Laura Dewald, Cassidy Johnston

Articles, Abstracts, and Reports

No abstract provided.

Implementation Of A Patient Satisfaction Survey At A Free Community Clinic: A Quality Improvement Project, Nora O'Sullivan

DNP Projects

Background: The uninsured, underinsured, and underserved populations in the US are impacted by health disparities and have unique experiences with healthcare. Yet, settings which serve these populations – the “safety net”- are not adequately supported to gather patient experience data. In Connecticut, Fairfield County has a higher percentage of uninsured people than the overall state. Additionally, this population has demonstrated higher frequency of emergency department utilization than the overall population. Therefore, processes to measure the barriers to accessing quality care and patient experience and satisfaction with care are needed in safety net clinics to promote elimination of health disparities and …

Use Of A Worksite Physical Activity To Improve Subjective Daytime Sleepiness Among Night Shift Healthcare Workers: A Quality Improvement Project, Marthe Sooh Nkongo

DNP Projects

Background and Significance: Shift work including work schedules beyond the typical "nine-to-five," causes the disruption of sleep-wake behaviors (Healy et al., 2021). The circadian misalignment is a potential pathway for the development of metabolic diseases, excessive daytime sleepiness, sleep deprivation, and declines in alertness and performance among night shift workers (James et al., 2017; McHugh et al., 2020; Parry et al., 2018). Emerging evidence suggests that physical activity synchronizes the sleep-wake cycles (Healy et al., 2021).

Purpose: This quality improvement project (QI) aimed to improve night-shift nurses ‘subjective daytime sleepiness by incorporating a 4-week worksite walking activity during working hours. …

Implementation Of A Daily Central Line Maintenance Audit Form In An Outpatient Infusion Center: A Quality Improvement Project, Sarah E. Christiana

DNP Projects

Significance and Background: Best evidence supports central venous access device (CVAD) dressing changes occur every 7 days or sooner, if indicated. At a community hospital in New England, patients receive outpatient antimicrobial therapy via CVADs. It is vital that nurses adequately maintain CVAD dressings according to evidence-based protocols to reduce the risk of central line-associated bloodstream infection (CLABSI). CLABSIs, associated with increased morbidity, mortality, and health care costs, are largely preventable through proper CVAD maintenance. At the project site, a review identified that dressing changes were frequently changed beyond the 7-day parameter. Documentation and surveillance processes were identified as opportunities …

Sunscreen Is Not Just For White People: Church-Based Sunscreen Education For Black Women, Lauren Mitchell

DNP Projects

Significance and Background: African American women are an undeserved population in healthcare, particularly regarding skin cancer prevention. The lack of education and misinformation surrounding skin cancer has resulted in general mistrust of the healthcare system amongst African Americans. Proper education on sunscreen use and skin cancer screening is essential to prevent late diagnosis of skin cancer and to promote prevention efforts.

Purpose: This quality improvement project utilized evidence-based practice to provide education on the proper use of sunscreen and skin cancer screening to African American women in a faith-based setting in Southern Connecticut.

Methods: A pre-survey was conducted to assess …

A Comparison Of The Ways In Which The United States And European Nations Treat Chronic Kidney Disease, Robert W. Pokora Iii

Senior Theses

European nations and the United States of America have vastly different outcomes in their treatment of end-stage renal disease (ESRD) patients, specifically when considering survival rate and patient satisfaction level. Unfortunately, no study has ever detailed the reasons why this is the case. This thesis explores and compares the methods by which the United States and European nations treat chronic kidney disease (CKD) and ESRD patients. A literature review aimed to determine factors contributing to the varying outcomes between the two nations, and a Healthcare Provider Survey was crafted and administered to United States healthcare providers in order to determine …

Improving Employee Engagement Scores With Strategically Focused Improvement Coaching, Suneela Nayak, Natalia Johnson, Rebecca Brookes, Jessica Ladd, Meghan Flaherty, Mark Parker

Operations Transformation

Every three years, Maine Medical Center releases a Strategic Plan outlining high level priorities. This guides decision making, resource allocation and invited a call to action for engaged participation from providers and staff. Operational Excellence at MMC is leveraging a stable Daily Management System to strengthen strategy deployment by coaching teams and leaders to link local improvement initiatives with high level strategic priorities.

A Diagnostic Dilemma: Qips, Ryan Carlisle, Paulina Giacomelli, Kyler Wyer, Julia Nyiro, Nolan Weinstein, Judy Swanson (Faculty Advisor)

Articles, Abstracts, and Reports

No abstract provided.

Crna Decision-Making Within The Anesthesia Care Team, Cindi L. Dabney

Theses and Dissertations (ETD)

This research focused on Certified Registered Nurse Anesthesiologists’ (CRNAs’) perspectives on the value placed on their decision-making skills within the Anesthesia Care Team (ACT). The emphasis of the study was to examine CRNA’s perspectives on the strengths, challenges, conflict resolutions, and any other information they were willing to divulge when working with physician anesthesiologists in the ACT model. An electronic survey questionnaire was sent to practicing CRNAs, primarily in the southeast region of the United States, with 171 informants completing the questionnaire. Data analysis included demographic information of the convenience sample that included age, gender, initial educational preparation as a …

Multimorbidity In Diverse Populations: Stratified Analysis Of Race/Ethnicity, Age, Obesity, And Healthcare Costs, Manal Alshakhs

Theses and Dissertations (ETD)

This research aims to fill an essential gap in understanding how Body Mass Index (BMI) cutoffs relate to multimorbidity across races in the United States (US). Given the significant and growing rates of obesity and multimorbidity, as well as the known differences in healthy fat distribution among different races, this is an important area of research. BMI is a widely used but imperfect measure of obesity, as it does not account for differences in body composition. However, it is still used as a diagnostic tool. It is vital to ensure that the cutoffs used to define obesity are appropriate for …

Improving Metabolic Monitoring During Transfers Of Care For Psychiatric Patients Discharged From The Inpatient Psychiatric Residency Service On An Antipsychotic Medication – Part 2, Allison Cohen, Anisha Boetel

View All Graduate Medical Education Content

No abstract provided.

Evaluating The Efficacy Of Medication-Assisted Treatment For First Episode Psychosis: A Scoping Review, Chanel Thomas Msn, Aprn, Fnp-Bc, Rn-Bc, Alexandra Wittenberg Bsn, Rn-Bc, Anttrenika Anderson Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Ebp-C

Doctor of Nursing Practice Projects

Purpose/Background

The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends that individuals with substance use disorder (SUD) receive medicated-assisted treatment (MAT), as a complete approach to substance use treatment (SAMHSA, 2019). However, treatment measures using combination treatment for SUD in individuals experiencing first episode psychosis (FEP) are seldom used. This scoping review assesses the efficacy of MAT in conjunction with antipsychotics compared to the use of antipsychotic monotherapy for FEP individuals on hospital readmission rates.

Methods

The authors conducted a literature review utilizing PubMed, EBSCO, Elsevier, Google Scholar, PsychINFO, and Medline from August 2020 to November 2022. Key phrases …

Language Barriers In Healthcare: Consequences & Impact On Cultural Competency, With Focus On Vietnamese-American Patient Populations, Dylan Ta

Senior Theses

Language barriers in healthcare produce a wide range of negative effects that diminish healthcare quality and delivery. One consequence in particular is the diminished degree of cultural competence and consideration in the field of medicine. This thesis provides a review of past literature on significant adverse problems caused by the presence of language barriers in healthcare, as well as a detailed perspective into how language barriers damage and decrease the degree of cultural competence utilized by healthcare professionals when providing care for the specific Vietnamese-American ethnic group. Through the interpretation, language barriers are reasonably concluded to be a significant obstacle …

Institutional Strategies To Maintain And Grow Imaging Research During The Covid-19 Pandemic, Mai-Lan Ho, Corey W Arnold, Summer J Decker, John D Hazle, Elizabeth A Krupinski, David A Mankoff

Faculty, Staff and Student Publications

Understanding imaging research experiences, challenges, and strategies for academic radiology departments during and after COVID-19 is critical to prepare for future disruptive events. We summarize key insights and programmatic initiatives at major academic hospitals across the world, based on literature review and meetings of the Radiological Society of North America Vice Chairs of Research (RSNA VCR) group. Through expert discussion and case studies, we provide suggested guidelines to maintain and grow radiology research in the postpandemic era.

Leveraging The Operational Excellence Platform For Improvement: Strengthening Culture Of Safety, Rebecca Brookes, Suneela Nayak, Natalia Johnson, Risk And Patient Safety

Operations Transformation

Senior leaders drive the culture change by demonstrating their own commitment to safety and providing the resources to achieve results. Their consistent and sustained messages about safety help advance a culture of safety ¹. Even with many efforts to improve patient safety, harm events continue to occur, challenging us to innovate additional ways to safeguard patients in our care. The Operational Excellence (OpEx) platform for improvement at Maine Medical Center (MMC) is well positioned to strengthen the Culture of Safety at Maine Medical Center (MMC) by leveraging the mechanism of established Daily Gemba Walks. During each Gemba Walk, leaders …

Magnet Hospitals: An Update On The Impact On Nursing Burnout, Jonathan Settle, Michael Davis, Alberto Coustasse

Management Faculty Research

Nurse burnout has been associated with worsened outcomes for nurses, such as increased turnover or quitting and lower job satisfaction. The purpose of this research was to examine Magnet-designation status in U.S. hospitals, specifically shared governance and structural empowerment, and its effects on nurse burnout, nurse turnover, and job satisfaction of nurses. This study utilized a literature review complemented by two semi-structured interviews. The results showed that Magnet hospitals kept lower levels of burnout, better job satisfaction, and less turnover than non-Magnet hospitals, but this was only the case for some studies of Magnet hospitals. Some outcomes could be attributed …

Screening For Social Determinants Of Health In The Primary Care Setting: A Quality Improvement Project, Winifred Ann Shouse

Graduate Theses, Dissertations, and Capstones

Social determinants of health are the conditions in which individuals are born, age, work, and live that affect health status and outcomes (Rivich et al., 2019). These social and environmental factors can create barriers to patients being able to access and adhere to recommendations for chronic disease management (Gold, et al., 2019). Communication gaps between patients and primary care providers make it challenging for healthcare providers to be completely aware of the financial burdens their patients encounter (Patel et al., 2016). Research supports that identifying and addressing the barriers related to social determinants of health can improve the management of …