Quality Improvement Commons^™

Improving The Rates Of Sexually Transmitted Infection Diagnosis By Increasing Provider Knowledge About Testing, Lauren Cunningham

Student Scholarship & Creative Works

There has been a significant increase in sexually transmitted infection (STI) rates since 2021. Though this issue is nationwide, rural providers require education regarding testing, screening, and transmission of disease processes. The infections with the most significant increase are gonorrhea, chlamydia, and syphilis. The purpose of this project was to provide education to providers regarding local STI statistics, in addition to when to and not to test for sexually transmitted STI infections. Education was provided to three Advance Practice Nurse Practitioners about disease signs and symptoms, transmission, and local STI statistic rates. STI testing rates were observed three months prior …

The Impact Of Hyperglycemia On Post-Reperfusion Outcomes In Patients With Hyperacute Ischemic Stroke, Nicole Schumacher

Theses and Dissertations (ETD)

Stroke is a major contributor to disability in the United States, with ischemic stroke accounting for approximately 87% of all cases. The use of approved reperfusion therapies, including intravenous thrombolysis with tissue plasminogen activator (tPA) and mechanical thrombectomy, has significantly improved functional outcomes for ischemic stroke patients. However, hyperglycemia at the time of hospital arrival is associated with worse outcomes, including increased infarct growth, higher rates of disability, and elevated mortality. Despite this, current stroke guidelines neither exclude hyperglycemic patients from receiving reperfusion therapy nor recommend glucose management during the hyperacute phase of care. While recent studies suggest that mild …

Using Ehr Reminders To Control Hypertension, Umme Kulsoom Ghous, Logan Mcculley, Danielle C. Hall, Linda Katherine Lambert, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Purpose/Background

Hypertension is a significant risk factor for cardiovascular and kidney diseases but is often under-diagnosed and poorly managed. Electronic Health Records (EHR) can help by providing automated reminders to recheck elevated blood pressure (BP) readings, ensuring accurate measurements, and guiding clinical interventions. This study aims to determine if EHR-based reminders improve BP control in adult patients aged 21 and older, focusing on hypertension diagnosis accuracy and timely management.

Methods

After a literature review, the study took place in a primary care clinic and only included patients with an existing diagnosis of hypertension. Thirty patients were included in the study. …

Patterns And Outcomes In Urotrauma: An Analysis Of Fatality Trends And Contributing Factors, Neharika Penmetcha, Aun Bangash, Kelsey Baker

Research Symposium

Background: Urotrauma, involving injuries to the kidneys, ureters, and bladder, represents a critical subset of trauma cases, significantly impacting patient morbidity and mortality. Renal and urogenital injuries account for 10–20% of abdominal trauma in adults and children. Understanding urotrauma's epidemiology is vital for improving care protocols and resource allocation. Despite its impact, data on injury mechanisms, intent, and care modalities specific to urotrauma remain limited. This study investigates patterns in injury mechanisms, intent, transport modalities, and facility transfer status to identify factors influencing patient outcomes and inform trauma care improvements.

Methods: A retrospective review analyzed 3,492 trauma cases, filtered for …

A New Paradigm In Hospital Medicine: Evaluating The Effects Of Geographical Cohorting On Health Care Delivery, Vasu Gupta, Bhupinder Singh, Kanishk Aggarwal, Ayushi Garg, Rhea Kanwar, Fnu Anamika, Inder Preet Kaur, Rohit Jain

HCA Healthcare Journal of Medicine

Background

Geographical cohorting in hospital settings represents a significant shift from traditional patient rounding practices and aims to enhance the efficiency of health care delivery. This model assigns hospitalists to a particular inpatient unit, where most of their patients are located. While this model has several benefits, including streamlining health care procedures, optimizing resource allocation, and fostering better provider communication, its implementation is not without its challenges.

Methods

Our methodology for researching geographical cohorting involved a comprehensive literature review of peer-reviewed studies, surveys, and retrospective analyses. We utilized academic databases, such as PubMed, JSTOR, and Google Scholar, to identify relevant …

A Narrative Review Of Barriers To Utilization Of Surgical Risk Assessment Calculators, Jacob Lahti, Kaiya A. Noe, Abigail Veenstra, Sarah Gallitto, Victoria I. De Leon, Thomas C. Varkey, Nimit Agarwal

Annual Research Symposium

Over the last several decades, it has become the desire of surgical and medical teams to decrease risk levels involved for patients undergoing surgery. However, despite the advent of risk assessment calculators to help physicians obtain more accurate and objective judgements for postoperative complications, these tools are underutilized in standard clinical practices in comparison to other methods of risk assessment. This is likely due at least in part to certain barriers that decrease their functionality and ease of use. This review discusses the major barriers to the utilization of current risk calculators so as to allow for a better understanding …

Acute Care For Elders Unit Implementation At Banner Health: A Quality Improvement Analysis, Jacob Lahti, Tony Gaidici, Shreya Bharath, Esha Saraswat, Nimit Agarwal

Annual Research Symposium

There is an increasing need to optimize hospital care for older adults as Age Friendly Health Systems (AFHS) become increasingly popular. Geriatric patients may often be subject to extended hospital stays, which can result in functional decline, increases in hospital-acquired injury, infections, and neurocognitive deterioration. Early acute inpatient rehabilitation (IRF) is known to improve functional optimization of older adults as compared to therapy in a skilled nursing facility (SNF). In this study we demonstrate the effect of a structured program based on the 4Ms of AFHS in our newly established Acute Care for Elders (ACE) unit, a first in Arizona. …

The Opportunities And Barriers Surrounding The Use Of Digital Health And Telemedicine In Sub-Saharan Africa, Aveline Langmead, Afua Osei-Wusu, Erica Tutuwan, Sara Mcmahon, Porter Biggs

Annual Research Symposium

No abstract provided.

One Center's Experience Of Pulmonary Embolism After Covid-19: Impact Of Vaccination Status, Cara Gose, Kaylee Dixon, Andrea M. Bodine Md

Advances in Clinical Medical Research and Healthcare Delivery

Background: The incidence of pulmonary embolism (PE) has increased since the outbreak of the COVID-19 pandemic and may be due to the observed hypercoagulable state. There is conflicting evidence that thromboembolism risk increases after vaccination and that vaccines decrease the probability of having a thromboembolic event. This study aimed to explore how vaccination status impacts occurrence of PE after a positive COVID-19 test. The hypothesis was that vaccinated, immunocompetent patients have a lower incidence of PE after COVID-19 compared to unvaccinated patients.

Methods: This was a retrospective chart review at a teaching hospital in New England from 1/01/2021 to 3/31/2023 …

Clinician Attitudes And Experiences In Screening Patients For Social Determinants Of Health Using Prapare, Pranav Rane, Mathew B. Weimer M.D., Adam Baus

Journal of Appalachian Health

Introduction: Social Determinants of Health (SDOH) are the conditions in which people are born, grow, live, work, and age. SDOH significantly influence health outcomes; as such, healthcare systems should screen for patients’ social needs. PRAPARE is standardized screening tool designed to assess and address patients’ social needs.

Purpose: This study examines SDOH screening at Valley Health Systems, a federally qualified health center based in Huntington, West Virginia. The aim of this research is to assess clinician attitudes and experiences in using the PRAPARE tool to screen for SDOH.

Methods: A self-administered online survey was conducted from April to May 2022 …

Implementation Of Endometriosis Toolkit: A Quality Improvement Project To Enhance Nurse Practitioners’ Knowledge And Management, Hasbun Rachel

DNP Qualifying Manuscripts

Abstract

Background: Endometriosis, characterized by the ectopic growth of endometrial-like tissue, affects approximately 11% of reproductive-aged women in the United States. Diagnosing endometriosis is challenging due to its diverse clinical presentations, reliance on laparoscopic procedures, absence of biomarkers, and limited awareness among healthcare providers and patients.

Local Problem: The diagnostic complexity of endometriosis, compounded by reduced provider awareness and a lack of comprehensive resources, leads to delayed and suboptimal care for affected women.

Methods: This Doctor of Nursing Practice quality improvement project aimed to enhance nurse practitioners’ (NPs) knowledge and management of endometriosis through a 1-hour educational session at the …

Factors Associated With Std Hospital Admissions In South Carolina Hospitals (2020-2024), Darrell Holmes, Dennis Besong

South Atlantic Division GME Research Day 2025

No abstract provided.

Sistemas De Salud Público Y Privado En El Salvador, Ana Ledford

World Languages and Cultures Senior Capstones

This paper analyzes El Salvador’s healthcare system, divided into public and private sectors. The public system, managed by the government, provides accessible healthcare for most of the population, though it faces issues like long wait times. In contrast, the private sector offers faster, specialized services for those who can afford them. The study discusses the strengths and weaknesses of each system, highlighting the need to enhance public healthcare and address access disparities. Solutions include increasing healthcare facilities in underserved areas and fostering collaboration with national and international organizations to improve overall healthcare quality for Salvadorians.

Poner En Práctica Las Regulaciones Federales: Habilitando A Los Pacientes Dominio Limitado Del Inglés, Caitlyn Gailey

World Languages and Cultures Senior Capstones

This paper examines the gaps in the U.S. healthcare system that affect the Hispanic community, focusing on language barriers and cultural competence. It highlights the challenges faced by Limited English Proficiency (LEP) patients, who may struggle with medical terminology, leading to misdiagnosis and improper treatment. The paper advocates for culturally sensitive language services, including qualified interpreters, translated documents and signage in order to improve communication, patient satisfaction, and reduce medical errors. It calls for systemic changes to ensure equitable care for all patients, regardless of language or cultural background.

Improving Knowledge And Confidence Of Family Nurse Practitioners In Offering The Hpv Vaccine, Leni Terano Fisher

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Introduction

Despite the recommendations of the United States Advisory Committee on Immunization Practices, HPV immunization lags behind other routine vaccines by up to 31%. Although there are many reasons for the low vaccine rate, provider hesitancy and lack of confidence significantly contribute to suboptimal HPV vaccine uptake.

Objectives

This project aimed to utilize evidence-driven interventions to increase family nurse practitioners' (FNPs) knowledge and confidence in offering the HPV vaccine.

Methods

Participants were given pre- and post-questionnaire surveys. The Wilcoxon Rank Test was used to compare, quantify, and measure the results of the eight-week data collection.

Results

The subjects were …

A Quality Improvement Approach To Reducing Post-Surgical Acute Care Falls, Tiffany C. Mitchell

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Inpatient falls remain one of the most preventable adverse events in hospitals. Falls result in serious injuries and increasing healthcare costs. This quality improvement project evaluates the implementation of Fall TIPS to reduce fall incidence and promote sustainable safety practices.

Improvement In Prenatal Education And Involvement In Patient Care, Miranda Ibrahim, Christelle Reeves, Timothy Kremer

North Texas Research Forum 2025

BACKGROUND: While the attempt is to educate the patient (and their family members) and empower them in their medical decision making, integration of birth plans and discussion of such plans is not routinely implemented by most obstetrical providers. There is currently no standardized approach to the education and birth plan development/or the obstetrical patients. The goal of this project, therefore, is to develop a standardized approach to discussion of birth plans and, albeit indirectly, allow for an opportunity for education for obstetrical patients. METHODS: On a daily basis, through birth plan discussions with patients during routine obstetrical visits, and via …

Increasing Pediatric Asthma Follow-Up Visits And Decreasing Emergency Department Visits In A Primary Care Setting, Rima M. Basal

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

The implementation of the asthma follow-up visits bundle in the pediatric primary care setting is an evidence-based practice project aimed at improving pediatric asthma management. This manuscript discusses the deployment of the bundle, which includes pre- and post- knowledge assessment for parents/caregivers, asthma education through a short video and handout, administration of the asthma control test (ACT), completion of a written asthma action plan (WAAP), and education about the patient portal and telehealth. The goal is to improve parent/caregiver knowledge, treatment adherence, follow-up visit compliance (in-person or virtual) and reduce emergency department (ED) utilization. Parent/caregiver knowledge increased by 23%, ACT …

Rwanda's Natural Remedies: A Fresh Look At The Fight Against Malaria, Leandre Nsabimana Ndisanze

Pomona Senior Theses

Malaria remains one of the most devastating parasitic diseases globally, disproportionately affecting sub-Saharan Africa, where Rwanda continues to face high transmission rates and rising resistance to conventional interventions. Despite decades of control efforts, the emergence of drug-resistant Plasmodium falciparum and insecticide-resistant Anopheles mosquitoes threatens to reverse recent gains. This research responds to the urgent need for sustainable and culturally relevant alternatives by exploring the therapeutic potential of Rwandan traditional medicinal plants. These indigenous remedies, long used by local healers, offer an underexplored reservoir of bioactive compounds that may provide the basis for novel antimalarial drugs.

The central hypothesis of this …

Culturally Sensitive Nursing Care And Its Impact On Abuse Disclosure Among Immigrant-Origin Populations​, Jaspal Uppal

Nursing | Student Research Posters

Background: Immigrant-origin patients often face many systemic barriers when accessing healthcare. Factors such as language barriers, fear of deportation, limited trust in healthcare providers, and lack of culturally sensitive care make it hard for patients to disclose abuse. These challenges contribute to poor health amongst vulnerable populations which highlights the importance of using culturally sensitive and trauma-informed care. Objective: This research aims to test whether culturally adapted, trauma-informed nursing care improves disclosure of abuse and access to support services. The objective is to strengthen safety and trust between healthcare providers and patients through culturally sensitive care. Method: A quantitative quasi-experimental …

Financial Health Literacy Of Community-Dwelling Older Adults: A Qualitative Research Study, Kimberly Davis

Theses and Dissertations

Background: Financial health literacy (FHL) is an emerging concept with unique application to older adults. Multiple complexities converge in older age that create increased financial vulnerability (e.g., retirement, chronic disease). However, low financial and health literacy are common in older adults, impacting their ability to self-manage. The AWV’s focus on prevention offers an opportunity to incorporate a proactive approach to financial-related assessment. This study will explore the perceived value of assessing FHL in primary care settings and the financial-related barriers and facilitators to implementing the personalized prevention plan.

Methods: The conceptual framework was guided by the Individual and Family Self-Management …

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 …

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.

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 …

Generation Z’S Perception Of Skin Cancer And How It Relates To Climate Change, Piercen Bogolea

Honors Undergraduate Theses

Skin cancer is the most common cancer worldwide, and climate change has been identified as a significant contributor. Preventative action early on can help reduce occurrence, but it is unknown if Generation Z is aware of this and is taking the necessary action now to protect themselves. This research aims to gauge the perception of Generation Z on the severity of skin cancer, the relationship between climate change and skin cancer, and the prevalence of preventative measures being taken. A survey was distributed to students aged 18 to 27 enrolled at the University of Central Florida through mixed sampling. The …

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 …

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, …