Health and Medical Administration Commons^™

Implementation Of A Process To Improve Compliance With A Nurse Driven Foley Catheter Removal Protocol In Nursing Staff Of A Medicine Intensive Care Unit, Kendall L. Pfister

DNP Projects

Background: Catheter associated urinary tract infections (CAUTI) are the most prevalent healthcare acquired infection (HAI) in the acute care setting. Unfortunately, CAUTIs can lead to high morbidity and mortality rates, longer length of stay (LOS) and increased healthcare costs. Unfortunately, in critically ill patients which often suffer multi-organ failure/injury, there remains an increased risk for infection and poor outcomes.

Purpose: The purpose of this project is to increase medical intensive care unit (MICU) nursing staffs’ knowledge of existing nurse driven indwelling urinary catheter removal protocol and to implement an electronic medical record (EMR) prompt for removal of unnecessary urinary catheters …

Navigating Sexual And Gender Diversity: A Quality Improvement Project To Increase Provider Cultural Competencies For Sexual And Gender Minorities In Mental Health Outpatient Facilities, Shermeen Chandani

Doctor of Nursing Practice Final Project Abstract

Purpose: Sexual and gender minority (SGM) populations experience healthcare disparities related to stigma, discrimination, and limited provider cultural competency. In outpatient psychiatric settings, non-affirming practices can negatively affect patient engagement, trust, and continuity of care. This quality improvement project aimed to enhance staff sexual and gender minority cultural competency (SGMCC) and strengthen affirming clinical processes.

Background: The project was implemented across two outpatient psychiatric clinics with approximately 28 multidisciplinary staff members. At baseline, no formal SGM cultural competency training or standardized documentation practices for preferred names and pronouns existed.

Methodology: A Plan–Do–Study–Act framework with a pre/post-test design was used. The …

Comparison Of Transversus Abdominis Plane Block Versus Intrathecal Clonidine In Lower Segment Caesarean Section - A Prospective Observational Study, Christy Maria Paul, Dr Somsundar R G Associate Professor, Dr Archana B N Assistant Professor, Dr. Shivakumar G Pofessor And Hod

Digital Journal of Clinical Medicine

Comparison of Transversus Abdominis Plane Block versus Intrathecal Clonidine in Lower Segment Caesarean Section - A Prospective Observational Study

Background and Objective: In the majority of abdominal procedures, transverse abdominis plane block, one of the fascial plane blocks, has been used extensively to treat post-operative pain. Ultrasound has gained popularity in the management of cesarean patients due to its ease of use and reduced adverse effects.To assess the effectiveness of ultrasound guided transverse abdominus plane block with intrathecal clonidine for post surgical pain control in lower segment cesarean patients.

Material and Methods: This prospective observational study was done in …

Factors Affecting The Quality Of Life Of Residents In The United States: Lessons From Virginia, Daniel K. Pryce

Sociology & Criminal Justice Faculty Publications

Evaluating community members' views about their quality of life is important for improving quality of well-being in society, as most societies are interested in the collective well-being of the people. Moreover, quality-of-life research helps public officials to understand how well they are meeting the needs of the electorate. Using the theoretical framework of Maslow's Developmental Perspective, which argues that the higher the need satisfaction of the majority in a given society the greater the quality of life of that society, I explore the effects of multiple variables on quality of life in the Hampton Roads region of Southeast Virginia (this …

Increasing Serious Illness Conversations In Patients At High Risk Of One-Year Mortality Using Improvement Science: A Quality Improvement Study, Kanishk D. Sharma, Sandip A. Godambe, Prachi P. Chavan, Agatha Parks-Savage, Marissa Galicia-Castillo

Department of Family and Community Medicine Faculty Publications

Background: Serious illness conversation (SIC) in an important skillset for clinicians. A review of mortality meetings from an urban academic hospital highlighted the need for early engagement in SICs and advance care planning (ACP) to align medical treatments with patient-centered outcomes. The aim of this study was to increase SICs and their documentation in patients with low one-year survival probability identified by updated Charlson Comorbidity Index (CCI) scores. Methods: This was a quality improvement study with data collected pre- and post-intervention at a large urban level one trauma center in Virginia, which also serves as a primary teaching hospital to …

Improving Mmr Vaccine Administration Among Rubella Non-Immune Postpartum Women – A Quality Improvement Project, Renée Ricci, Erika Olsen, Final Patel, Stephanie Tootle, Dina Linfoot, Anthony Royek, Eric Shaw

South Atlantic Division GME Research Day 2025

No abstract provided.

From Trial To The Prescription Pad: Quality Improvement Of Sglt-2 Inhibitor Prescription Prevalence For Patients With Diabetes And Heart Failure, Grace Fawcett, Victoria Blaisdell, Riley King, William Hannah, Eric Shaw

South Atlantic Division GME Research Day 2025

No abstract provided.

Introducing Transitional Care Management In Outpatient Setting For Emergency Department Discharge Follow Ups, Radhika Mohan, Sanket Patel, Deepa Nuthalapati, Michael Smith, Valerie Sinkler, Dennis Besong, Pooja Paunikar

South Atlantic Division GME Research Day 2025

No abstract provided.

Education Interventions Implemented To Increase Lung Cancer Screening Rates, Arpit Arora, Crystal Bharat, Sophia Zia, Pooja Paunikar, Dana Simpson

South Atlantic Division GME Research Day 2025

No abstract provided.

Daily Weights, Better Outcomes: The Positive Impact Of Daily Weight Tracking In Hospitalized Patients On The Telemetry Floor, Sophia Zia, David Ortega, Lailany Agront-Davo, Merid Moqattash, William Lopez, Sirin Khajaviyan, Yagmur Beaman, Michael Craig

South Atlantic Division GME Research Day 2025

No abstract provided.

No Patient Left Behind: Improving Transition Of Care In Coronary Artery Disease And Heart Failure Patients, Rebecca Schuyler, Gunjan Mundhra, Mubbasher Syed

South Atlantic Division GME Research Day 2025

No abstract provided.

Inpatient Vs. Outpatient Management Outcomes Of Ectopic Pregnancy With Methotrexate, Courtney Smith, Taryn Hoffman, Kavya Davuluri, Ashley Brodrick, Taylor Penny, Robyn Meadows, Martin Wegman

South Atlantic Division GME Research Day 2025

No abstract provided.

Improving Usage Of Low-Dose Chest Ct For Lung Cancer Screening Amongst Tobacco Users That Fall Within Certain Criteria Per Uspstf Recommendations - A Quality Improvement Project, Karissa Charles, Evelyn Ogbomoh, Anthony Shadiack

South Atlantic Division GME Research Day 2025

No abstract provided.

Chaos To Calm: Utilizing Checklists In The Icu To Improve Quality During Intubations, J Dunitz, Matthew Daniel, Will Hickman, Sarah Johnson, Erik Porter

South Atlantic Division GME Research Day 2025

No abstract provided.

Enhancing Patient Safety: The Role Of Interdisciplinary Teams In Reducing Blood Culture Contamination, Fady M. Awad, Austin Patrick-Eisenberg, Brian Watson, Mohamed Faris

South Atlantic Division GME Research Day 2025

No abstract provided.

Quality Over Quantity: Doula Perspectives On Equity, Access, And Quality Of Care In Black Maternal Health Outcomes, Terry-Ann E. Lynch

West Chester University Graduate Theses, Dissertations, and Final Projects

Black maternal mortality in the United States is a public health crisis. There are a plethora of reasons as to why maternal and fetal deaths disproportionately impact Black women. From a public health perspective, health disparities are an area of concern in marginalized communities, with Black maternal mortality being a risk factor. “According to the Centers for Disease Control and Prevention (CDC), in 2021, the maternal mortality rate for non-Hispanic Black (subsequently, Black) women was 69.9 deaths per 100,000 live births, 2.6 times the rate for non-Hispanic White (subsequently, White) women (26.6)” Maternal Mortality Rates in the United States, 2021” …

Association Between The Social Vulnerability Index And Adverse Pregnancy Outcomes, Tetsuya Kawakita, Misa Hayasaka, Lindsay Robbins, Juliana Martins, George Saade

Department of Obstetrics & Gynecology Faculty Publications

Objective: To assess the association between the Social Vulnerability Index (SVI) and racial disparities in pregnancy outcomes across U.S. counties and to quantify these racial disparities.

Methods: This was a cross-sectional study using restricted Centers for Disease Control and Prevention data sets, including natality data sets, fetal death data sets, and all-cause mortality data sets from 2016 to 2021. We limited analyses to Black or White individuals aged 15-44 years from 3,114 U.S. counties. Participants were categorized into quartiles based on county-level SVI. The primary outcome was maternal mortality rate while pregnant or within 42 days of the end of …

Exploring Lgbtq+ Competency In Healthcare, Jordan Whiteman

Honors College Theses

Marginalized groups such as the LGBTQ+ community are known to face healthcare disparities that negatively affect their process of navigating healthcare systems. This project explores the perceived lack of representation and understanding of the LGBTQ+ community within healthcare settings, exposing the deficits in knowledge for unique challenges and inequalities these patients may face. By viewing the literature, a myriad of complications faced by LGBTQ+ people in clinical settings can be identified. They possess a generalized feeling of mistrust towards the healthcare system. Healthcare staff overall describe low confidence with caring for this demographic. Heteronormativity’s presence in the field of healthcare …

Exploring The Perception Of Learning Environment Among Undergraduate Medical Students In South India – A Cross-Sectional Study, Suba A, Suma S, Shobana R, Abeetha S, Chitra M, Shruthy K M

Health Professions Education

Purpose: The term "learning environment" refers to the combined social, physical, and psychological context in which the students learn. While a dismissive environment can lead to stress and burnout, a supportive environment enhances professionalism and academic success. Students' perceptions of the medical school learning environment might vary significantly depending on their age, gender, kind of institution and based on their academic year. Comprehending the disparities in perceptions towards the educational setting related to the above said variations may aid in devising interventions that promote favourable experiences for medical students. This study aimed to assess perception of learning environment by South …

Evaluating The Impact Of Epic Integration And Dual Registered Nurse Check-Off On Pressure Injury Prevention Workflow Compliance, Darlene Y. Olowu

Doctor of Nursing Practice Final Project Abstract

Background

Hospital-acquired pressure injuries (HAPIs), particularly sacral and heel injuries, remain a persistent challenge in critical care settings, leading to increased morbidity, mortality, and healthcare costs.

Purpose

This quality improvement project aimed to improve compliance with a pressure injury prevention (PIP) workflow by integrating a dual RN check-off system within EPIC, thereby reducing sacral and heel pressure injuries. The project sought to enhance accountability, standardize documentation, and optimize compliance with evidence-based PIP measures.

Methodology

A Plan-Do-Study-Act (PDSA) framework guided the project implementation in an oncologic intensive care unit (ICU). Key interventions included: (1) EPIC integration of a dual RN check-off …

Closing Racial And Ethnic Disparity Gaps In Pediatric Asthma Follow Up Care - A Quality Improvement Initiative, Ayodele Ayeko

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Closing racial and ethnic disparity gaps in pediatric asthma follow up care - A quality improvement initiative

Ayodele Ayeko

Introduction/Background: Inadequate management of asthma significantly contributes to poor asthma control, poor quality of life (QOL), and high hospitalization rates among pediatric patients. The Global Initiative for Asthma (GINA) guidelines offer recommendations designed to enhance asthma control and improve the quality of life for those affected (2015), including recommendations for close follow up care. At WVU Medicine Children’s Hospital (WVUMCH), insufficient asthma control has been associated with lower clinic follow-up rates and an increase in hospitalization. Although educational initiatives …

Increasing Special Pathogen Preparedness At A Frontline Hospital: A Quality Improvement Project, Mckenna Freed, Christa Arguinchona, Barbara Bennett-Wolcott

Articles, Abstracts, and Reports

No abstract provided.

The Quick Dash Reformed: Increasing The Holisticity And Occupational Nature Of Upper Extremity Therapeutic Evaluation, Lauren E. Garcia

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: The QuickDASH is one of the most common upper extremity (UE) focused patient-reported outcome measures (PROMs) utilized within current practice. Despite its high utilization rate, there are still many concerns surrounding the QuickDASH, including its applicability to certain populations, difficulty with cross-cultural adaptation, and limited psychosocial evaluation. Purpose: The purpose of this study was to develop and implement a reformed version of the QuickDASH, the OT-DASH, that included modernized and occupation-focused language to achieve increased client applicability and yield more accurate comparisons between client perceptions of dysfunction and their true clinical presentations. Theoretical framework: The Person-Environment-Occupation-Performance model was utilized …

Improving Neuromuscular Blockade Surveillance In Anesthesia Care With Quantitative Train Of Four Monitoring, Carley S. Blair

Graduate Theses, Dissertations, and Problem Reports (ETD)

Problem Statement: Despite the availability of quantitative train of four (TOF) monitoring, anesthesia providers more frequently rely on tactile (qualitative) TOF monitoring, which is associated with underestimation of recovery from muscle relaxation. Inadequate recovery from muscle relaxants results in residual weakness and its associated complications in the postoperative period, including compromised respiratory function (Thilen et al., 2023).

Background: Neuromuscular blockade (NMB) drugs are required to facilitate endotracheal intubation and allow for surgical manipulation. When these drugs are used, train of four (TOF) stimulations are used to monitor and assess the depth and recovery from NMB. TwitchView monitors (quantitative monitoring) is …

Nephrocheck Implementation And Its Impact On The Incidence Of Acute Kidney Injury After Coronary Artery Bypass Graft Surgery, Michael Maccourtney

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

NephroCheck Implementation and its Impact on the Incidence of Acute Kidney Injury After Coronary Artery Bypass Graft Surgery

Michael C. MacCourtney

Problem Statement: Acute kidney injury occurs in up to 50% of patients after cardiac surgery (Meersche et al., 2017). This contributes to significant morbidity, mortality, and costs (Helgadottir et al., 2016). At the time of the project implementation, the standard of care involved measuring renal function utilizing serum creatinine (SCr) and urine output (UOP) without NephroCheck. These renal function labs do not represent a timely and accurate assessment of the patient’s current renal status because they do not …

The Role Of Social Health Insurance In Achieving Universal Health Coverage In Asia: A Systematic Review, Afaf Jauhar, Mardiati Nadjib

Jurnal Ekonomi Kesehatan Indonesia

Universal Health Coverage (UHC) aims to ensure that all individuals have access to essential health services without financial hardship. Social Health Insurance (SHI) is critical in achieving this goal, especially in low- and middle-income countries. This systematic review explores the role of SHI systems in advancing UHC across 14 Asian countries, focusing on healthcare access, financial protection, and equity. A comprehensive search across PubMed, Scopus, and ScienceDirect identified 768 articles, and 37 studies were selected after screening, following the PRISMA guidelines. The chosen studies cover countries with varying SHI models across Asia. The findings reveal that high-income countries such as …

Priorities To Care Within The Military Health System: A Mixed Methods Study On Military Spouse Access To Care During Covid-19 On Okinawa, Elayne L. Wilson

Theses & Dissertations

Military spouses in Okinawa experienced denial of care at military treatment facilities and off base Japanese healthcare facilities during the COVID-19 pandemic. Over two years of travel restrictions further contributed to difficulties accessing healthcare while stationed on the island with their active-duty spouse. This study examined the implications of a priority-based access system through the TRICARE program implemented due to limited resources during COVID-19 and its impact on military spouses in a scarce medical resource environment. This concurrent mixed-methods research used a survey tool developed by Community First Hawaii to quantify access to healthcare and in-depth interviews to further explore …

Does Physician-Hospital Vertical Integration Affect Hospital Output?, Soumya Upadhyay, Neeraj Bhandari

Healthcare Administration and Policy Faculty Research

Background: Physician-hospital vertical integration is gaining steam but it is unclear how they affect hospital output.

Objective: To examine the direct impact of vertical integration on hospital output.

Design: A pooled design with 6-year data using linear regressions was used. Then, panel data design with hospital fixed effects was used.

Methods: We linked American Hospital Association data (2016-2021) with AHRQ Comparative Health System Performance Initiative’s Compendium (2018, 2020, 2021; 34 987 hospital-year observations) to develop new measures of vertical integration and assess its relationship with several measures of hospital output including annualized total admissions, total number of inpatients days, …

Advanced Practice Clinician Outcomes: Pre/Post Implementation Of An Advanced Practice Clinician Council, Jeannine M. Moss

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Improving access to quality, affordable, and timely healthcare is a national priority. Health systems across the United States are utilizing Advanced Practice Clinicians (APCs) to fill the void in healthcare delivery. As provider shortages continue and the demand for APCs increases, organizations must develop robust structures to support APC engagement, retention, job satisfaction, and professional growth. Currently, 44% of the provider workforce within a large urban health system are APCs, yet despite substantial APC provider labor pool representation, the organization had little infrastructure to support APC professional growth and no mechanism for organizational involvement. This quality improvement (QI) project aimed …

Reducing No-Shows In A Behavioral Health Setting: A Program Evaluation, Meagan Evans

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Mental healthcare in America faces many significant challenges; this is especially true in rural regions like Southwest Virginia. When patients miss their scheduled appointments, it represents a lost opportunity to deliver the critical mental health services that other individuals in need could have benefited from. A significant access issue presents itself when patients are not able to get the mental health support they need. The lack of outpatient access leads to patients utilizing emergency rooms inappropriately for what could have been routine care visits. A multitude of factors can contribute to patients failing to attend their scheduled appointments, including transportation …