Health and Medical Administration Commons^™

Improving The Utilization Of Palliative Care Services At Medical City Fort Worth, Gennipher Smith, Shervin Sarji, Maanasa Palani, Samuel Chen, Mary Halm, Kristina Bowman, Morvarid Rezaie

North Texas GME Research Forum 2026

Palliative Care (PC) is a specialized medical care that aims to optimize the quality of life and alleviate the suffering of patients with serious medical illness. Benefits of palliative care include improved symptom management, enhanced quality of life, reduced healthcare utilization, better care alignment, improved communication and support, and financial savings. Hospital Corporation of America (HCA) Medical City Fort Worth (MCFW) has a PC consult service. However, it is underutilized. According to data collected from January 2025 to December 2025, the percentage of PC consults for high risk units, such as oncology and ICU, by day 3 of admission varies …

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

2026

This poster describes a quality improvement initiative that integrated psychiatric resource nurses as subject matter experts (SMEs) into clinical documentation workflows to improve documentation compliance for high-risk behavioral health patients. The intervention resulted in substantial improvements in charting accuracy and compliance, including an increase in emergency department documentation compliance from 28% to 95% over seven months, while enhancing staff education, collaboration, and patient safety.

Responding To Social Isolation: The Tole Of Chaplaincy In Addressing Social Determinants Of Health (Sdoh) In Pediatric Contexts, Adam Lubbers, Forest Melton, Simbarashe Sigauke, Sophie Le

2026

This poster describes a pilot program that integrated chaplaincy services into the care pathway for pediatric patients and families who screened positive for low social support, a key social determinant of health. The findings suggest chaplain-led interventions provide effective emotional, spiritual, and practical support, helping address social isolation, caregiver burden, financial insecurity, and other health equity concerns while offering culturally responsive care.

No One Left Behind: Identification Of Healthcare Needs Through System-Wide Social Determinants Of Health Screenings, Rose Dela Cruz, Amanda Marquez, Madison Lemmons

2026

This poster describes a system-wide quality improvement initiative designed to increase completion rates of Social Determinants of Health (SDOH) screenings by addressing workflow barriers, educating staff, and implementing standardized processes across clinical teams. The project demonstrates how interdisciplinary collaboration, nursing engagement, and structured screening workflows can improve identification of social needs and connect pediatric patients and families with resources that support health equity and better health outcomes.

Scaling Up Health Literacy Practices Through A Champion Program, Cameron Stine, Kelli Williams, Diana Montoya, Leslie Moore, Carol Howe

2026

This poster describes the development and expansion of a Health Literacy Champion Program designed to improve the consistent use of health literacy best practices across a healthcare organization. The program successfully expanded from ambulatory nursing to 13 disciplines, using champion training, newsletters, clinical observations, and peer influence to promote plain language communication, information chunking, and teach-back techniques that support patient understanding and safety.

Improving Nursing Assignment Through Integration Of An Acuity Scoring Tool: A Unit-Based Quality Improvement Project, Daisy Everard Dagohoy, Analyne Gale Roldan

Covenant Nurses Week 2026

No abstract provided.

Hyperglycemia Detection From Sigle - Lead Ecg Using A Hybrid Cnn & Transformer Model, Adam Ayomikun Ogunjembola

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract
Hyperglycemia Detection from Single-Lead ECG using a Hybrid CNN & Transformer Model
Adam Ogunjembola

Diabetes Mellitus is known as high blood glucose. This high blood glucose level happens when the body has a problem with producing or using insulin. Insulin is a very important hormone that the pancreas makes to control how much glucose gets into the bloodstream and cells. Diabetes Mellitus has an effect on the body if it is not treated, such as damaging the blood vessels and nerves which can lead to stroke, kidney failure, heart attack and permanent loss of vision. Since people with diabetes …

Improving Antibiotic Prescribing For Urinary Tract Infections In Urgent Care Centers, Alexis Alastanos

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: Urinary tract infections (UTIs) are one of the most common infections that require antibiotic therapy. Providers working in three urgent care clinics located in Eastern West Virginia diagnosis and treat UTIs based on their clinical judgement. Variability in clinical judgement results in inappropriate antibiotic use which has implications on antibiotic resistance and the financial burden of the patients as well as the entire organization.

Evidence Review: A total of 10 articles were evaluated to support the implementation of antibiotic stewardship initiatives that provide guidance in caring for this population. Interventions include electronic health record enhancements, provider education, and tracking …

Iron Deficiency And Iron Deficiency Anemia: Inconsistent Screening Practices And Delayed Result Processing In Children 12-18 Months, Madonna J. Mahoney Marshall

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Introduction:

Iron deficiency and iron deficiency anemia in children aged 12 to 18 months are prevalent conditions that, if not identified and treated early, are associated with adverse neurodevelopmental outcomes.

Purpose:

This quality improvement project evaluated the impact of a standardized screening and follow-up protocol on laboratory result retrieval, provider review, and caregiver follow-through in a military pediatric clinic.

Method:

A pre-post intervention design guided by the Plan-Do-Study-Act framework was implemented over 11 weeks and included staff education, standardized workflows, and caregiver outreach.

Results:

The intervention improved laboratory completion and caregiver follow-up rates; however, sustainability was limited by staffing constraints …

Efficacy Of A Vertically Integrated, Module-Based Small Group Discussion And Virtual Patient Simulation Model To Enhance Cardiology Knowledge And Clinical Reasoning In Medical Students, Kumar Abhishek, Pratyush Kumar, O Puri, M Pathania

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Time To Safe Chest Tube Removal After Water-Seal Trial, Rahul Pawa, Joshua Gazzetta, Leo A. Benedict, Sean Nix, Phillip Jones, Yoon Cho, Alyssa Fesmire

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Opioid Prescribing Patterns Following Isolated Trigger Finger Release: A Single-Institution Quality Improvement Study, Brandalynn Mathis, Robert Garner, Cameron Sprong, Mark Gamadia, Alan Cornett, Steven Smith

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Interventions To Reduce 30-Day Re-Hospitalization Rates In Skilled Nursing Facilities: A Systematic Review, Pradeep Rajbhandari, Karl E. Minges, Lawrence San Jose, Michael Waxman

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Implementation Of A Pressure Injury Prevention Bundle To Reduce Hospital-Acquired Pressure Injuries In The Intensive Care Unit, Xibo Lan

Doctor of Nursing Practice Final Project Abstract

Purpose

The goal of this quality improvement project was to utilize the SKINSAFE pressure injury prevention bundle during 12 weeks of implementation to increase evidence-based pressure injury prevention practices adherence and decrease risk of hospital-acquired pressure injury (HAPI) in the intensive care units (ICU).

Background

ICU patients experience high risk for hospital acquired pressure injuries (HAPIs) secondary to immobility and device related pressure. Initial adherence to SKINSAFE bundle was 55-56%. There was inconsistent use of heel offloading devices, wound photography and documentation. Prevention bundles were affected by staffing fluctuations and leadership turnovers.

Methodology

The Plan-Do-Study-Act cycle for this project included …

Empowered Choices: A Quality Improvement Women’S Health Initiative In Faith-Based Nursing For Women Recovering From Substance Use Disorder, Jennifer Mewshaw

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: Women with substance use disorder (SUD) face higher rates of unplanned pregnancy, reproductive infections, and delayed prenatal care. Faith community nurses (FCNs) often already serve within this community and have a long history of promoting public health interventions. However, they lack the knowledge and confidence in sexual and reproductive health (SRH) education.

Evidence Review: A literature review identified barriers to SRH care for women with SUD and the role of FCNs in community and public health interventions. Evidence supports providing FCNs with the knowledge and skills to deliver SRH education and support for women with SUD using trauma-informed and …

Leading The Way In Pediatric Oral Health Promotion, Denise C. Mckinney

Dental Hygiene Faculty Publications

[Introduction] Dental hygienists promote oral health and provide preventive services to patients throughout their lifespan. The Commission on Dental Accreditation, Dental Hygiene Standards emphasize that graduates must be competent in providing dental hygiene care for all patient populations, including children.¹ In fact, promoting pediatric oral health begins prior to birth with the expectant mother and/or caregiver. Oral health care to include education is essential during pregnancy; specifically, around the prevention and treatment of dental caries for the mother and the unborn child.² In the U.S., from 2013-2016, roughly 30% of women aged 20-44 years had untreated dental caries.³ Expectant mothers …

The Connection Between Medicaid And Obesity In Northeast Ohio, Emmie Kelley, Sophie Kheder

Williams Honors College, Honors Research Projects

Obesity is a major public health concern in the United States that is projected to increase exponentially over the next few years. Obesity is commonly associated with a lower socioeconomic status. Lower-income individuals tend to be supported by Medicaid, a federal insurance program for low-income Americans. Prior studies have shown a positive correlation between income status and obesity prevalence. Our goal was to find if there was a correlation between Medicaid patients and obesity in Northeast Ohio, to provide physicians with a set of characteristics to better combat obesity, since preventative and treatment guidelines are tailored to national trends. We …

Feasibility Of Telehealth-Delivered Gut-Directed Hypnotherapy For Managing Gastrointestinal Health: Exploring Specific Vs. Nonspecific Effects, Sabrina Romero

Honors Undergraduate Theses

This randomized controlled trial evaluated the feasibility and efficacy of telehealth-delivered Gut-Directed Hypnotherapy (GDH) compared to General Hypnotherapy (GH) for managing gastrointestinal symptoms associated with disorders of gut–brain interaction (DGBI). Eleven adults were randomized to receive four 1-hour hypnotherapy sessions over a 14-day period via Zoom (GH n = 5; GDH n = 6). Primary outcomes included PROMIS GI Belly Pain T-scores and Abdominal Pain Ratings assessed at baseline and post-treatment. Follow-up assessments were conducted at three months (n = 8). At post-treatment, participants receiving GDH demonstrated significantly lower PROMIS GI Belly Pain T-scores compared to GH, F(1, …

Acceptability, Usability, And Clinical Integration Of A Clinic-Based Digital Game For Hpv Education: Qualitative Perspectives From Adolescents, Parents, And Healthcare Providers, Elizabeth Reifsnider, Satya Subedi, Nouran Ghonaim, Megan Whaley, Angela Chia-Chen Chen

Ellmer School of Nursing Faculty Publications

Background/Objectives: HPV vaccination is safe, effective, and recommended at ages 11–12, yet uptake remains suboptimal. Serious video games may offer an innovative strategy to deliver brief, engaging education during clinic visits. This qualitative paper, embedded within a mixed-methods study, examined adolescents’, parents’, and healthcare providers’ (HCPs’) perceptions of the acceptability, usability, and perceived clinical applicability of HPV Detective, a tablet-based digital game designed to provide HPV-related education to parent–child dyads during pediatric clinic wait times. Methods: Eight adolescent–parent dyads (N = 16) and three HCPs from university-affiliated pediatric clinics participated in 30–60-min semi-structured Zoom interviews. Interviews were audio-recorded, transcribed, and …

Confessions In Cases Of Child Physical Abuse - A Capnet Study, Margaret R. Russell, Antoinette L. Laskey, Henry T. Puls, Suzanne P. Starling, Joanne N. Wood, Daniel M. Lindberg, Nancy S. Harper, Caitlin R. Mcnamara, Angela N. Bachim, Farah W. Brink, Lori D. Frasier, James D. Anderst, Porcia Vaughn, Kristine A. Campbell

Department of Pediatrics Faculty Publications

Objective

Prior research on confessions of physical abuse (PA) has explored mechanisms of injury. Little is known about conditions supporting a confession of abuse or how confessions may influence case outcomes.

Methods

This cross-sectional study of suspected PA in children age < 10 years at 10 centers participating in CAPNET, a multicenter child PA research network, included children with in-person Child Abuse Pediatrics (CAP) consultations between Feb 2021-Dec 2022 and excluded children without injury. Our focus was a confession of inflicted injury known to the CAP during clinical involvement. We compared child and clinical characteristics, out-of-home (OOH) placements, and arrests between cases with and without confessions. Multivariable models using generalized estimating equations (GEE) produced adjusted predicted probabilities (APP) clustering by CAPNET site.

Results

Confessions were known to CAPs in 115/4297 (2.7%) cases, with significant site variability. In a multivariable GEE model, confessions were more likely in cases with injuries with high-specificity for abuse (APP 6.0% vs 1.5%, p< 0.001), near-fatality (APP 5.5% vs 2.3%, p< 0.001), and older children (APP 4.8% vs 2.5%, p = 0.025). OOH placements and arrests were more common in cases with confessions. CAP awareness of confessions, OOH placements, and arrests did not follow racial or ethnic patterns seen in the US child welfare system. Lower socioeconomic status was associated with OOH placements and arrests but not CAP awareness of confessions.

Conclusions

Our findings highlight differences in case characteristics and outcomes where a confession is known to the CAP and raise questions about agency …

Empowering Caregivers, Protecting Patients: An Ambulatory Central Line Quality Improvement Initiative For Education And Follow-Up, Elizabeth Martinez, Belinda Bordeaux, Stephanie Langevin, Cristina Herrera, Mary Smith, Merissa Doyle, Barbara Stein, Kimberly Poshar, Marissa Dunlap, Allison Silva, Eric Werner

Department of Pediatrics Faculty Publications

Introduction: Preventing ambulatory central line-associated bloodstream infections (A-CLABSIs) is challenging due to inconsistent education, follow-up, and home care practices. Pediatric intestinal failure (IF) patients are particularly vulnerable. This institution aimed to decrease its IF A-CLABSI rate by 25% within 2 years through a standardized, step-by-step central line care education program.

Methods: Using the Toyota problem-solving method, the team reviewed data and performed a root cause analysis of the prioritized problem, implementing a 2-phase education program. Phase 1 delivered in-hospital education using videos, handouts, and hands-on teaching with skill demonstration. The existing pediatric central line skills class was expanded and offered …

Transition To Home Guideline For Patients With Diabetes, Kathleen R. Burgner

Doctor of Nursing Practice (DNP) Scholarly Projects

Background: Diabetes is a leading contributor to preventable hospital readmissions. These hospital readmissions often result from fragmented discharge planning, poor care coordination, and limited post-discharge support. At a 915-bed academic medical center in Southern California, the diabetes-related readmission rate was 13.3%, compared with 11.4% among patients without diabetes. This project aimed to develop an evidence-based Transition-to-Home (TTH) guideline for hospitalized patients with diabetes and evaluate the strength of its recommendations through multidisciplinary stakeholder review.

Methods: An evidence-based guideline development project was conducted over 8 weeks. A comprehensive literature search in CINAHL, MEDLINE, PubMed, and ScienceDirect identified current evidence on transitional …

Continuum Of Care Zine, Natanya Dewar

Open Educational Resources

No abstract provided.

Timelines Of Care: Analyzing Treatment Access For Women With Ongoing Reproductive Health Needs, Nyla M. Keith

Honors Undergraduate Theses

Mandates in the United States created pressure on an already strained healthcare system post-COVID-19 pandemic. With new regulations placed upon abortion care forcing the closing of low-cost health clinics such as Planned Parenthood, legislation that has made health insurance more expensive, and rising pharmaceutical prices, women’s OB/GYN care in America has struggled to meet patient needs. A cross-sectional survey was developed and distributed to four clinics in the Orlando area to assess patients' perceived access to care and identify barriers to receiving OB/GYN care. The survey took approximately 10 – 15 minutes to complete, was available in print and online …

Exploring The Link Between Hospice Setting And Caregiver-Reported Quality Scores, Aidan J. John

Honors Undergraduate Theses

Access to high quality hospice care largely varies across different care environments and regions within the United States. This can shape the experiences of family caregivers who support patients at the end of life. As hospice enrollment expands nationwide, understanding how care delivery changes between home-based services and more skilled inpatient and outpatient services has become integral for examining overall performance.  There are many noticeable differences in provider availability and resources between different programs that can influence the level of support families receive, including timeliness of symptom management and effectiveness of communication with hospice staff. This study evaluated whether hospice …

Values-Based Behavioral Frameworks As Contributors To Organizational Culture In Higher Education: A Literature Review, David J. Park Do

Posters

Colleges and universities almost universally publish statements of institutional values, yet a gap often persists between those stated values and the regularly observed behaviors. This review examines how that gap relates to culture in higher education institutions and specifically explores how translating values into observable behaviors contributes to organizational culture. This literature review used a structured, criteria-guided approach to source identification, selecting sources against three constructs: 1) institutional adoption of values-based behavioral frameworks, 2) organizational culture in higher-education settings, and 3) the perceptions through which organizational members perceive culture. The resulting corpus of 40 sources spans organizational culture scholarship, virtue …

Legislating Equity: A Qualitative Policy Analysis Of Healthcare Access And Health Literacy In Medically Underserved Communities In New Jersey, Korlu Y. Howard

West Chester University Graduate Theses, Dissertations, and Final Projects

Access to healthcare has always been a major policy challenge in the United States and contributes to ongoing disparities. Reform efforts have focused on expanding insurance coverage, yet less attention has been focused on whether the healthcare system is navigable. This study examines three New Jersey statutes using Kingdon’s Multiple Streams Framework and the Health Equity Framework. The purpose of this examination is to better understand how statutory language shapes healthcare access. The findings show that access is primarily structured through coverage requirements, procedural protections, and established legal rights. At the same time, these systems often involve added complexity, requiring …

Evaluating The Impact Of Telemedicine-Based Medication Education On Glycemic Control In Adult Male Veterans With Type 2 Diabetes Mellitus, Megan N. Calter

West Chester University Graduate Theses, Dissertations, and Final Projects

Veterans experience disproportionately high rates of type 2 diabetes mellitus (20.5% vs 11.6% nationally), driven by military-related factors such as PTSD, deployment-related obesity, and service-connected disabilities. At a large urban primary care clinic, 28% (40/141) of veterans with type 2 diabetes mellitus had persistently elevated HbA1c levels of ≥8%, indicating a high risk for diabetes-related complications. This quality improvement project aimed to reduce the proportion of veterans with HbA1c of ≥8% by implementing tailored telemedicine-based medication education, leveraging underutilized virtual care infrastructure to address access barriers and improve diabetes self-management. Participants received two 30-minute telemedicine medication and disease management education …

Unintentional Medication Discrepancies In Outpatient Cardiac Procedures: Identifying Modifiable Barriers, Julie M. Turner

DNP Projects

Background: Medication reconciliation (MR) reduces medication errors during care transitions; however, unintentional medication discrepancies (UMDs) remain common due to variable practices and lack of standardization. Patients undergoing elective cardiac procedures are particularly vulnerable given complex medication regimens.

Purpose: This quality improvement project evaluated implementation of a Medication Reconciliation Barrier Identification Checklist (MRBIC) in the cardiac catheterization laboratory to identify patient, staff, and system-level contributors to UMDs.

Methods: A quasi-experimental pre–post design was conducted at a large academic medical center. During a six-week intervention, nurses and providers completed the MRBIC during pre-procedure MR. Barrier scores were compared with …

Improving Nursing Compliance With Pain Reassessment Documentation After Analgesic Administration, Dorcas Okunola

Doctor of Nursing Practice Final Project Abstract

Improving Nursing Compliance with Pain Reassessment Documentation After Analgesic Administration

PURPOSE: This quality improvement project aimed to increase registered nurse (RN) compliance with documenting pain reassessment within 30–60 minutes after analgesic administration in an adult medical–surgical trauma unit at a large academic medical center.

BACKGROUND: Timely pain reassessment is essential for evaluating treatment effectiveness and ensuring safe, patient-centered care. Baseline audits showed inconsistent documentation and compliance below institutional expectations. Evidence supports the use of electronic health record (EHR) prompts combined with targeted nursing education to improve adherence.

METHODOLOGY: A 12-week quality improvement initiative was conducted to reinforce adherence to the …