Health and Medical Administration Commons^™

Self-Measured Blood Pressure Monitoring: A Patient Empowerment Project, Alison Cusmano

Doctor of Nursing Practice Final Manuscripts

Hypertension is a public health issue estimated to affect 112 million adults by 2030. Primary care patients in an outpatient clinic in Southern California with elevated blood pressure readings in the office did not have an organized system for close follow-up. The purpose of this evidence-based project (EBP) was to educate patients on self-measured blood pressure monitoring (SMBP), Dietary Approaches to Stop Hypertension (DASH), diet interventions, and healthy weight loss to improve hypertension rates. Through these interventions, patients developed an understanding of their systolic and diastolic blood pressure goals. Nurse practitioners, medical assistants, and licensed vocational nurses screened for high …

Barriers To Preoperative Warming: Best Practice Guideline, Tyler Comans, Zachary Hays, Caleb Leach

Doctoral Projects

The lack of preoperative warming has a direct relationship to perioperative hypothermia complications which include, but are not limited to: increased infection rate, coagulopathies, and increased myocardial oxygen consumption; all contributing to poor patient and facility outcomes. Implementation of an evidence-based educational module with visual aid can potentially increase the utilization of active warming techniques in the preoperative setting by perioperative staff. The DNP Project investigated barriers to preoperative warming by perioperative staff at a large teaching hospital in the southeastern United States. Barriers were assessed by a voluntary survey sent to 87 perioperative staff members. Twenty-two surveys were completed …

A Survey Of Delirium Self-Reported Knowledge And Practices Among Emergency Physicians In The United States, Anita N. Chary, Adriane Lesser, Sharon K. Inouye, Christopher R. Carpenter Md, Msc, Amy R. Stuck, Maura Kennedy

Journal of Geriatric Emergency Medicine

Objective: This study aimed to evaluate United States emergency physicians’ self-reported knowledge and practices regarding the detection, prevention, and management of delirium, a common and deadly syndrome that disproportionately affects older emergency department (ED) patients. Knowledge and practices of the broader emergency physician community about these priority topics in geriatric emergency medicine are understudied.

Design: Electronic self-administered online survey

Setting: United States

Participants: One-hundred ninety-seven emergency physicians of the American College of Emergency Physicians Emergency Medicine Practice Research Network

Measures: Descriptive statistics were generated from survey responses.

Results: Of 734 physicians in the research network who were sent the …

It Takes Courage To Pause: Rapid Goals-Of-Care Conversations In The Emergency Department, Anita N. Chary, Aanand D. Naik, Kei Ouchi

Journal of Geriatric Emergency Medicine

n/a

Are Current Pain Assessments Adequate?, Allison Caspersen

MSN Capstone Projects

“Pain is what the patient says it is” has been a big proponent to improve interventions for pain management. But how are we assessing patients’ pain? They have been asked to provide us with a number to rate their pain but what do these numbers mean to the patient? Do they rate according to pain they have experienced in the past or is it based off what they imagine the pain could be? Have we ever distinguished patient preference between unidimensional and multidimensional pain assessment? The use of unidimensional pain assessment the Numerical rating scale (NRS) has been used primarily …

Change Project Using A Fall Prevention Action Program To Decrease Falls On A Behavioral Health Unit, Amy Shuptrine

Student Scholarly Projects

Practice Problem: Fall rates are increasing in the behavioral health units of the East Texas hospital. Due to the worldwide COVID-19 pandemic, the units are short-staffed, which further supports the urgent need for a targeted intervention to reduce fall risk.

PICOT: The PICOT question that guided this project was: “In adult behavioral health patients (P), what is the effect of the Edmonson Psychiatric Fall Risk Assessment Tool (I), compared with previous use of the Morse Fall Risk tool (C), on the fall rate (O), in 8 weeks (T)?”

Evidence: Falls are the most reported incidents in acute care hospitals and …

Transforming Prescription Opioid Practices In Primary Care With Change Theory, Rob E. Carpenter, Dave Silberman, Jody Takemoto

Human Resource Development Faculty Publications and Presentations

The opioid epidemic continues to be an ongoing public health crisis. Many primary health care providers aptly serve as the gate keeper to opioid prescriptions. The opioid epidemic has challenged the primary care profession whilst many of these providers have opted out of opioid prescribing altogether. This unintended consequence affirms erosion to primary care that is vital to the ecosystem of opioid management. The purpose of this study was to understand strategies to deliver opioids safely and effectively. Results indicate primary care providers are uniquely positioned to make a positive opioid impact through focused change initiatives. Five common themes arose …

Improving The Early Detection And Management Of Peripheral Artery Disease In Patients With Diabetes Within The Primary Care Setting, Julyssa Amanda Rodriguez

Doctor of Nursing Practice

Background. Diabetes is a significant risk factor for peripheral artery disease. Individuals with diabetes, greater than 50 years of age, having at least one other risk factor should be screened for peripheral artery disease with an ankle brachial index. Purpose. Improve detection and management of peripheral artery disease in persons with diabetes within primary care. Evidence. Individuals with diabetes and peripheral artery disease have an increased risk of adverse cardiac and limb events, impairing the patient’s quality of life and causing long-term disability (Berger & Newman, 2020). Methods. During a 10-week period, these processes were implemented: (a) screening all patients …

J Mich Dent Assoc December 2021

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• Two cover stories presenting perspectives from both ends of the practice life continuum: “Starting Your Practice Life” and “Preparing for Retirement”.
• A feature article, “What Happened in Vegas Became ADA Policy”.
• A feature article, “An Oversight Corrected: 2020 MDA Life Members Recognized”.
• The 2021 Author/Title Index to the Journal of the Michigan Dental Association. …

The Emergence Of A Texas Collaboration To Improve Well-Being In Learning Health Systems, Toi B Harris, Anil Nanda, Lilit A Sargsyan, Wei-Jung A Chen, Jennifer G Christner

Faculty, Staff and Students Publications

Prior models of well-being have focused on resolving issues at different levels within a single institution. Changes over time in medicine have resulted in massive turnover and reduced clinical hours that portray a deficit-oriented system. As developments to improve purpose and professional satisfaction emerge, the Texas Medical Association Committee on Physician Health and Wellness (PHW) is committed to providing the vehicle for a statewide collaboration and illuminating the path forward.To describe the existing health and wellness resources in Texas academic medical centers and understand the gaps in resources and strategies for addressing the health and wellness needs in the medical …

The Impact Of A Crisis Intervention Team Program On Psychiatric Boarding, Kurtis Hooks

Counseling & Human Services Theses & Dissertations

Psychiatric boarding is the phenomenon of housing individuals in emergency departments while awaiting access to mental health services in the community. The expansion of psychiatric boarding is attributed to continued deinstitutionalization and under-resourcing of mental health services. Psychiatric boarding is also associated with deleterious outcomes for individuals in need of access to behavioral health services, facilities. There is limited research on programmatic efforts to reduce psychiatric boarding as it pertains to Crisis Intervention Team programs colocated in medical settings. Crisis Intervention Team (CIT) programs are community-based, multi-stakeholder partnerships that include dedicated assessment centers crisis response and referral. This study utilized …

The Relationship Of Hospital Ceo Gender And The Patient Experience: The Role Of The Mediating Effects Of Hospital Characteristics, Lanean M. Lang

Electronic Theses and Dissertations

In this quantitative study, I investigated CEO gender and the patient experience in acute care hospitals in Texas for 2019. As the patient-experience has been the metric for quality patient care and hospital reimbursements, hospital CEOs play an important role in promoting positive patient experience as they lead the organization in strategic goals. The study is relevant as a shortage of experienced and qualified healthcare leaders is expected as baby-boomers retire. The lack of women leaders remains a challenging issue. The purpose of the study was to assess the gender differences of the CEO on the impact of patient experience …

Impact Of Central Line Bundle Care On Reduction Of Central Line Associated-Infections: A Scoping Review, Alisha James-Scott Msn, Fnp-C, Rachel Savoy Msn, Fnp-Bc, Donna Lynch-Smith Dnp, Acnp-Bc, Apn, Ne-Bc, Cnl, Tracy Mcclinton Dnp, Ag-Acnp-Bc, Apn

Doctor of Nursing Practice Projects

Purpose/Background Central venous catheters (CVC) are typical for critically ill patients in the intensive care unit (ICU). Due to the invasiveness of this procedure, there is a high risk for central line-associated bloodstream infection (CLABSI). These infections have been known to increase mortality and morbidity, medical costs, and reduce hospital reimbursements. Evidenced-based interventions were grouped to assemble a central line bundle to decrease the number of CLABSIs and improve patient outcomes. This scoping review will evaluate the literature and examine the association between reduced CLABSI rates and central line bundle care implementation or current use.

Methods A literature review was …

Leadership Rounding To Improve Patient Satisfaction In Pediatric Ambulatory Care, Tara J. Haskell

Student Scholarly Projects

Practice Problem: Low patient satisfaction has been linked to poor treatment compliance, patients leaving the practice, staff decreased job satisfaction, and high staff turnover (Haskard Zolnierek & DiMatteo, 2009; Prakash, 2010). Magnet reporting has identified wide discrepancies in ambulatory clinics, with some clinics reporting below benchmark patient satisfaction ratings.

PICOT: In pediatric ambulatory and primary care services, how will the implementation of leader-led customer service rounding, compared to current practice, increase family and/or patient satisfaction over 4 weeks?

Evidence: Key findings are that the rounding needs to be population-specific, intentional, and swiftly followed up when problems are identified. The body …

11-30-2021 Hsc Committee Agenda, Hsc Committee

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

No abstract provided.

Medicated-Assisted Treatment And 12-Step Programs: Evaluating The Referral Process, Candace S. Brown, Chudney Williams, Ryan E. Stephens, Jacqueline Sharp, Bobby Bellflower, Martinus T. Zeeman

Doctor of Nursing Practice Projects

Purpose/Background Overdose deaths in the U.S. from opioids have dramatically increased since the COVID-19 pandemic. Although medicated-assisted treatment (MAT) programs are widely available for sufferers of opiate addiction, many drop out of treatment prematurely. Twelve-step programs are considered a valuable part of treatment, but few studies have examined the effect of combining these approaches. We aimed to compare abstinence rates among patients receiving MAT who were referred to 12-step programs to those only receiving MAT.

Methods In this prospective study, a cohort of participants from a MAT clinic agreeing to attend a 12-step program was compared to 15 controls selected …

Toward A More Strategic National Stockpile, Troy Rule

Texas A&M Law Review

The COVID–19 pandemic exposed major deficiencies in the United States’ approach to stockpiling for emergencies. States, cities, and hospitals across the country had meager inventories of critical medical items on hand when the pandemic first reached U.S. soil, and the federal government’s Strategic National Stockpile proved far too small to serve the country’s needs in the first several months of the crisis. As nationwide shortages spread, many state governments were compelled to bid against each other to procure scarce medical supplies—a distribution approach that disadvantaged low-income and minority communities and left countless healthcare professionals and staff ill-equipped to protect themselves …

Polypharmacy And High-Risk Medications In Older Veterans Presenting For Emergency Care, Paige Morizio, Vinita Mistry, Ashley Mcknight, Marc Pepin, William Bryan, Ryan Owenby, Laura Previll, Luna Ragsdale

Journal of Geriatric Emergency Medicine

Background: Guidelines suggest screening for polypharmacy and documentation of high-risk medications in the geriatric Emergency Department (ED) setting. The purpose of this quality improvement initiative was to describe high-risk medications and polypharmacy in older Veterans presenting to the ED in order to inform the workflow of a Geriatric ED pharmacist.

Methods: This was a retrospective, quality improvement project that included patients age 65 years or older who presented to the ED between 10/1/2017 and 9/30/2019. The endpoints included the number of patients with at least one high-risk medication and the mean number of medications on the outpatient medication list. The …

Improving Patient Flow In The Urgent Care Setting, Stephanie Carpenter

Student Scholarly Projects

Practice Problem: Urgent care clinics provide care to patients with non-life-threatening illnesses or injuries and are found to be less expensive and more convenient than emergency departments. As urgent care clinics are growing in popularity so are the patient wait times and overall length of stay times.

PICOT: The PICOT question that guided this project was in urgent care clinic patients (P), how does utilizing the Emergency Severity Index (ESI) as a patient triage tool (I) compared to using no patient triage tool (C) affect the patient flow and patient wait times (O) within 13 weeks.

Evidence: Evidence search with …

Intermediate Care Technicians-A Novel Workforce For Veterans Affairs Geriatric Emergency Departments, Kristina T. Snell, Thomas Edes, Colleen M. Mcquown

Journal of Geriatric Emergency Medicine

No abstract provided.

Geriatric Emergency Medicine Fellowship Journal Club: Frailty, Sarah Keene, Rebecca Fisher, Lauren Cameron-Comasco

Journal of Geriatric Emergency Medicine

No abstract provided.

Culturally Sensitive Care For Hispanic Americans, Christopher Dodson, Courtney Hall

Scholars Week

The number of individuals that speak another language that is not English as their primary language is at an all time high in the United States, and this can make healthcare harder to access for this portion of the population. This research examines what barriers are present for those who do not speak English as their primary language, such as miscommunications, reduced trust in their provider related to being unable to speak directly with them, parts of their cultural practices and alternative medicines being ignored or misunderstood by healthcare providers, and not feeling secure enough to reveal sensitive information to …

Ten Clinical Tips In The Assessment Of Genitourinary Emergencies Of An Older Adult, Nicole Soria, Danya Khoujah

Journal of Geriatric Emergency Medicine

Osteopathic Medical Students’ Perceptions Of Their Medical Education Due To Covid19, Kaitlyn Thomas, Richard Terry

Advances in Clinical Medical Research and Healthcare Delivery

Objective: The SARS-CoV-2 (COVID19) pandemic has led to unprecedented changes in medical education globally. Published reports on these changes have given some insight as to both positive and negative effects for specific medical schools though none have looked at osteopathic education. Our study attempts to examine the effect of COVID19 more formally on osteopathic medical students’ perception of their medical education in the third and fourth years of medical training.

Methods: Third- and fourth-year medical students at Lake Erie College of Osteopathic Medicine (LECOM) completed electronic surveys regarding their experiences with changes in medical education due to the COVID19 …

Managing Covid-19: Legal And Institutional Issues, Yon-Shik Lee

Minnesota Journal of Law, Science & Technology

No abstract provided.

11-30-2021 Hsc Committee Notice, Hsc Committee

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

No abstract provided.

Improving Patient Satisfaction By Utilizing A Chief Experience Officer, Kathleen G. Spangler

Graduate Theses, Dissertations, and Capstones

With the rapid changes in healthcare and rising costs, improving the patient experience has emerged as a vital healthcare priority among all nations. Many healthcare organizations have responded by creating positions such as the Chief Experience Officer (CXO). This person can play a crucial role as the system champion to lead initiatives to help hospital staff, administrators, and executive leaders focus on patient satisfaction, thus leading to improved patient outcomes/experiences. A descriptive nonexperimental survey design was used to evaluate this project, with the aim of validating the positive influence of the CXO in improving patient satisfaction and experience within the …

November 2021, Swosu Bulldog Wellness Committee

SWOSU BULLDOG WELLNESS

November is American Diabetes Month®
Approximately 373,824 people in Oklahoma have diagnosed diabetes.

An estimated 1,040,000 people in Oklahoma have prediabetes. Take the following survey to find your risk for type 2 diabetes. You will also be given the opportunity to request to be contacted by the SWOSU College of Pharmacy Rural Health Diabetes Prevention Program for upcoming group classes.
Type 2 Diabetes Risk Test: https://swosu.formstack.com/forms/prescreening_questionnaire_dpp

"More Accessible And Easier To Deal With": A Qualitative Inquiry Of Leaders' Perceptions Of The Evolving Roles And Responsibilities Of Advanced Practice Providers At Texas Medical Center, Athena Krasnosky Msn, Aprn, Cpnp, Jessie Marcet-Gonzalez Msn, Aprn, Cpnp, Jordan Rodriguez Bs, Natalie Cormier Smith Msn, Aprn, Np-C, Brenda Chesley Msn, Aprn, Cpnp-Ac/Pc, Linda Brock Msn, Aprn, Cpnp, Heena Narsi Prasla Msn, Aprn, Cpnp, Geran Barton

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Background. With over 10 million patient encounters a year at Texas Medical Center (TMC), Advanced Practice Providers (APPs) are being incorporated into health care delivery models. Moving beyond the narrow “scope of practice” debates that frequently surface when talking about APPs, this inquiry instead seeks to broaden the discussion and take a more comprehensive view of how APPs are being incorporated into health care delivery models that span across several TMC institutions.

Methods. This study uses a thematic analysis study design to analyze structured interviews collected from a small convenience sample of Advance Practice Provider Program Directors at Texas Medical …

Using A Multidisciplinary Data Approach To Operationalize An Experience Framework, Kevin Spera, Garrett Holmes, Sunni Barnes

Patient Experience Journal

Like many healthcare organizations, Baylor Scott & White Health (BSWH) is awash with data. Often, this data is used in siloed departments to monitor safety and quality, make local business decisions, and motivate staff to improve processes to achieve sustained excellence and market share. As margins get thinner and competition from various disrupters increases, organizations have tried to improve the patient experience to remain viable as part of a calculated strategy. Nevertheless, these entities have struggled to focus limited resources for sustained improvement in patient experience. This article details how a large Texas-based healthcare system "operationalized" The Beryl Institute's Experience …