Perception Of Lean Adoption Among Emergency Department Personnel In Public Hospitals In Selangor, Malaysia, Azizul Rahman Mohamad Jamil, Mohd Rizal Abdul Manaf, Sharifa Ezat Wan Puteh, Kiran Ganesh Balakrishnan

Makara Journal of Health Research

Background: This research aims to assess the perceptions of the staff working in emergency departments in Selangor, Malaysia, regarding the adoption of lean management and identify the factors that affect their perceptions.

Methods: A cross-sectional study using the Lean in Healthcare Questionnaire was conducted with 251 respondents, which consisted of doctors, nurses and medical assistants employed in three selected hospitals.

Results: One-way analysis of variance (ANOVA) showed a significant difference in every domain score in accordance with the occupation category. For the domain process, a significant negative correlation was found between age and domain score (r = …

Healthcare Provider Engagement And Its Effects On Patient Rereferral: Insights From Indonesia, Felicia Setiawan

Makara Journal of Health Research

Background: In the highly competitive landscape of healthcare, nurturing strong relationships between referring healthcare providers and healthcare facilities is essential for maintaining patient loyalty. This study explores the factors influencing referring health care provider engagement and its subsequent impact on the willingness to rerefer to healthcare facilities.

Methods: A cross-sectional quantitative survey was conducted with 181 healthcare providers who regularly refer patients to a private hospital in Jakarta. Data were collected through an online structured questionnaire consisting of 29 questions. The following dimensions were covered: specialist characteristics, practice characteristics, healthcare provider–specialist interaction, patient–specialist interaction, returning referral, training opportunity, …

Preventive Strategies For Elder Abuse Within Hospice Care By Healthcare Professionals, Joshua Eason

Nursing | Student Research Posters

Background: Healthcare professionals providing hospice care need to have particular specialized abilities, empathy, and trust. Unfortunately, some of these medical professionals are unable to provide their patients the care they need, so they will instead abuse and ignore them. Elder abuse must be identified and addressed in hospice care settings if older patients are to have their rights and dignity upheld and a standardized, compassionate end-of-life care program is to be provided for each patient.

Purpose: The purpose of this study is to examine the effectiveness and preventative strategies for elder abuse, implemented by healthcare providers within the hospice care …

Educating Nurses On Frequent Oral Care For Mechanically Ventilated Patients: An Evidence-Based Practice Project Proposal, Grace Alford, Susan Butz, Ruth Chavez, Joy Shoemaker

Doctor of Nursing Practice Scholarly Projects

The final scholarly project proposal is to implement oral care education for nurses in an intensive care unit (ICU). The proposal aims to create a guideline for an investigator to implement oral care recommendations for mechanically ventilated patients in order to reduce ventilator-associated pneumonia (VAP). The proposal consists of obtaining VAP data and oral care charting data for the unit studied, steps for providing oral care education, and analysis recommendations. Oral care involves swabbing the patient’s mouth every two hours with a swab and mouthwash. Oral care education would include handouts and direct teaching. The proposal aims to increase oral …

Comparing The Effects Of The Induction Of Anesthesia With Etomidate To The Induction Of Anesthesia With Midazolam On The Incidence Of In-Hospital Mortality: A Scoping Review, Madison Hayes Bsn, Rn, Ashley Lynch Bsn, Rn, Scott Jamison Bsn, Rn, Mary Joiner Bsn, Rn, Gray Seymour Bsn, Rn, Dwayne Accardo Dnp, Aprn, Crna, Tracy Mcclinton, Dnp, Aprn, Agacnp-Bc, Epb-C

Doctor of Nursing Practice Projects

Purpose/Background

The induction of anesthesia using hypnotic sedatives, such as etomidate and midazolam, is common practice. Etomidate and midazolam are commonly employed in the induction of anesthesia in the septic patient population, each with its unique advantages and drawbacks. This scoping review aims to synthesize evidence on the effects of anesthetic induction with etomidate versus midazolam in adult septic patients, focusing on the incidence of mortality and associated adverse effects during hospitalization. The purpose is to establish a standard of care for anesthetic induction in this population.

Methods

A literature review was conducted from September 2022 to March 2023 utilizing …

Referral To In-Person Smoking Cessation Counseling As A Smoking Cessation Aid, Annie Mandrell Bsn, Rn, Matthew Keathley Bsn, Rn, Lewis Linden Bsn, Rn, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Referral to In-Person Smoking Cessation Counseling as a Smoking Cessation Aid

Purpose/Background

Smoking increases an individual’s risk of acute and chronic disease morbidity and mortality, as well as creating a financial burden for the individual and healthcare system. In the United States, tobacco smoking is the leading cause of preventable death. There are an estimated 5 million tobacco-related deaths each year due to tobacco smoking. Additional healthcare costs are also seen due to the need for increased treatments, medical supplies, and staffing. Previous research for smoking cessation resources has primarily focused on traditional primary care offices. Research shows that in-person …

The Impact Of Social Determinants Of Health On Adherence To Urinary Tract Infection Treatment: A Scoping Review, Barrett S. Patel, Ms, Bsn, Rn, Emily A. Gentry, Bsn, Rn, Sally Humphrey Dnp, Aprn, Cpnp-Pc, Bobby Bellflower Dnsc, Nnp-Bc, Faanp, Fnap

Doctor of Nursing Practice Projects

Purpose/Background

Urinary tract infections (UTIs) are a common diagnosis among children. Patients must fully comply with treatment regimens to reduce the risk of recurring UTIs and prevent long-term complications. This scoping review aims to evaluate the literature and examine the association between screening for social determinants of health (SDH) and adherence to UTI treatment.

Methods

A thorough literature search via PubMed, Cochrane Library, Elsevier Clinical Key, CINAHL, and JAMA was conducted with the following keywords: Pediatric UTI, Adherence to Treatment Plans, Social Determinants of Health, Social Needs Screening, and others. Ten articles were appraised for their evidence and quality. The …

Impact Of Ehr On Security Check And Patient Outcomes, Arun Kumar Marumudi

Harrisburg University Dissertations and Theses

This study aims to explore patient perspectives on how electronic health record (EHR) security protocols influence care quality and outcomes. In the context of methodology, an online survey was conducted in March 2024 with 10 participants from the USA who provided informed consent. Questions assessed experience with EHRs, security concerns, perceptions of authentication impacts, satisfaction with balancing priorities, and open-ended feedback. Descriptive analysis was used to identify key themes.

Most respondents had direct EHR exposure, which validated their viewpoints. Universal concerns co-existed with preferring digital records due to facilitated sharing when regulated appropriately. One-third reported occasional access issues correlating with …

Evidenced-Based Strategies To Increase Cervical Cancer Screening Rates, Tuong Cat Vo Bsn-Rn, Nada Salloukh Bsn-Rn, Tatiana Elena Swanson Bsn-Rn, Xiao Mie Cindy Zhu Bsn-Rn, Laura Taylor Reed Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Cervical cancer is the fourth leading cause of cancer affecting women worldwide (Staley et al., 2021). With cervical cancer being a preventable disease, an effective method of reducing healthcare costs and mortality is primary prevention, such as screenings. Financial burdens and barriers to accessing medical care may result due to the lack of proper cervical cancer screenings. Detecting cervical cancer includes screening women 21 to 65 years old with a Papanicolaou (PAP) test every three years. Women aged 30 to 65 years old can extend the screening of cervical cancer by having a Human Papillomavirus (HPV) test along with …

Lai Antipsychotics Vs. Oral Antipsychotics: Treatment Adherence, Relapses, And Readmissions, Natalie N. Lewis Bsn, Rn, Mallory F. Johnson Bsn, Rn-Bc, Tyler N. Halle-Todd Bsn, Rn, Natalie N. Ragland Bsn, Rn, Sharon H. Little Dnp, Aprn, Fnp-Bc, Jacqueline Sharp Dnp, Aprn,Pmhnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Schizophrenia is a lifelong illness with recurrent and often debilitating symptoms that may impair daily functioning, cognition, behaviors, socialization, emotions, and expression. It is recognized as a global mental health burden that affects the individual, their family, and society. Medication nonadherence and resulting relapse detrimentally affect the patient’s physical and mental health and quality of life. They are associated with increased hospitalization and emergency room visits, substance use, suicide, and homelessness. Current guidelines endorse second-generation antipsychotics such as Risperidone and Aripiprazole as the first-line treatment for most cases of psychosis. However, long-acting injectable (LAIs) atypical antipsychotics are a promising …

Implementation Of A Standardized Suicide Screening Process In A University Student Health Clinic: A Quality Improvement Project, Addie Grace Strong, Kathryn Dambrino, R. David Phillippi, Linda Wofford

DNP Projects

Background: Suicide is a leading cause of death among college age students, prompting the need for evidence-based screening tools like the Columbia Suicide Severity Rating Scale (C-SSRS) to enable early detection and timely intervention. Inconsistencies in suicide screening may pose a risk of missed intervention opportunities. This Doctor of Nursing Practice project specifically aimed to improve the quality and consistency of suicide screening in a university student health clinic by implementing the C-SSRS tool into the clinic workflow during mental health appointments. Methods: Employing a quality improvement framework, this scholarly project followed the Institute for Healthcare Improvement Model for Improvement …

The Financial Impact Of Correct Status Within Health Systems, Davin Evanson, Arveen Asghar, Eugene York, Michael S. Weingarten, Walter Bohnenblust

Tower Health Research Day

No abstract provided.

Implementation Of Mindfulness & Stress Reduction Training For Medical Students, Jill Berenato

SACAD: Scholarly Activities

Abstract

This proposal advocates for implementing mandatory mindfulness and stress reduction training sessions for surgical students at Philadelphia College of Osteopathic Medicine (PCOM). It is well-documented that medical students, particularly those in surgical disciplines, experience high levels of stress, which can negatively impact their mental health, academic performance and overall well-being. Mindfulness-based interventions have shown promise in reducing stress and enhancing resilience among medical students. By integrating mindfulness training into the surgical curriculum, PCOM aims to equip students with essential coping skills to effectively manage stress, thereby promoting their mental health and academic success. This handout serves to accompany the …

Use Of A Primary Care Dataset To Describe ‘The Real Picture’ Of Diabetes In Kimberley Aboriginal Communities, Caitlyn S. White, Kimberley Seear, Lorraine Anderson, Emma Griffiths

Journal of the Australian Indigenous HealthInfoNet

Objective
Aboriginal communities are impacted by high rates of diabetes, however these are currently underestimated by national data sources used by policy and decision makers to inform allocation of health resources. We aimed to estimate diabetes prevalence and screening coverage using primary care electronic medical record data.

Methods
A cross-sectional audit was conducted using primary care data from Aboriginal regular Aboriginal Community Controlled Health Service (ACCHS) clinic attendees aged 15 years and over (n=1763) in five remote communities in the Kimberley region. Main outcome measures were overall diabetes prevalence; age-specific diabetes prevalence; prevalence of pre-diabetes; and screening rates among patients …

Quality Improvement In Public-Private Partnerships In Low- And Middle-Income Countries: A Systematic Review, Cassandra Iroz, Rohit Ramaswamy, Zulfiqar Bhutta, Paul Barach

College of Population Health Faculty Papers

BACKGROUND: Public-private partnerships (PPP) are often how health improvement programs are implemented in low-and-middle-income countries (LMICs). We therefore aimed to systematically review the literature about the aim and impacts of quality improvement (QI) approaches in PPP in LMICs.

METHODS: We searched SCOPUS and grey literature for studies published before March 2022. One reviewer screened abstracts and full-text studies for inclusion. The study characteristics, setting, design, outcomes, and lessons learned were abstracted using a standard tool and reviewed in detail by a second author.

RESULTS: We identified 9,457 citations, of which 144 met the inclusion criteria and underwent full-text abstraction. We …

Assessing The Types Of Juvenile Detention Medical Issues: A Focus On Florida, De’Angelo L. Dean

MUSC Theses and Dissertations

The justice system for young people in the United States has been a source of worry as more people acknowledge the possible adverse outcomes of involvement in the justice system during adolescence. Involvement with law enforcement can lead to various difficulties for young people, such as heightened susceptibility to psychological problems, interruptions in their education, and reduced prospects for achievement in the future. Hence, it is crucial to understand the interplays between the health care for juveniles referred by courts or law enforcement for hospital care to identify opportunities for process and outcome improvements. The interaction between juveniles and the …

Effectiveness Of Antibiotic Stewardship For Healthcare Providers At Urgent Care Clinics, Helen T. Adewole

Electronic Theses and Dissertations

Antibiotics have revolutionized modern medicine; however, the overuse in urgent care and primary care significantly contributes to the global burden of infections resistant to available antimicrobial medicines. Approximately 30% of the antimicrobials prescribed in acute care settings are unnecessary. Patient demand for antibiotics has seemingly skyrocketed following the recent COVID-19 pandemic. Practitioners must be knowledgeable about antibiotic stewardship initiatives, such as the wait-and-see approach, to reduce antibiotic overuse and improve the trajectory of antibiotic resistance and patient health outcomes. The gap in practice was the limited awareness of scientific evidence-based tools to partner with patients and improve antibiotic prescription patterns. …

A Case Study To Investigate Factors Influencing The Santa Clara County Getting To Zero Initiative’S Collective Impact Model, Harit Agroia, Rebecca Reno, Jenette Spezeski, Leyla Mousli, Richard Sarabia, Erin Starzyk

Journal of Social, Behavioral, and Health Sciences

Our objective was to explore how factors, such as backbone organization changes and COVID-19, affected a collective impact (CI) initiative’s progression through the five CI phases and its components of success. We conducted a case study using semistructured interviews with 17 representatives from the action committee, community-based organization, and health department between January and February 2023 in Santa Clara County, California. Participants were asked how internal and external factors affected their engagement and experiences with the CI initiative. We analyzed the data using structural and holistic coding. Results showed that the initiative’s progression was impacted by intersecting factors; overall findings …

Digital Phobia: An Inquiry For Mapping The Unseen Dimension Of New Digital Anxiety, The ‘Digiphobia’, Amarjit Kumar Singh ,Library Assistant, Md. Arshad Ali , Professional Assistant, Dr. Pankaj Mathur, Deputy Librarian,

Library Philosophy and Practice (e-journal)

Background: As technology continues to advance, individuals' interactions with digital platforms have become integral to daily life. Amidst this technological evolution, a novel concern emerges—Digital Phobia, hereafter referred to as “Digiphobia.” This phenomenon, although not previously explored in scholarly literature, necessitates an in-depth investigation due to its potential impact on individuals' well-being. Our research employs a two-step methodology to investigate its existence, implications, and manifestations.

Introduction: This research paper introduces and proposes the term "Digiphobia" as a comprehensive conceptualization of anxiety arising from interactions with digital spaces, applications, and environments. The proliferation of digital technologies has led to the emergence …

A Quality Improvement Study On Increasing Rates Of Lung Cancer Screening, Arpit Arora, Crystal Bharat, Sophia Zia, Pooja Paunikar, Dana Simpson

South Atlantic Division GME Research Day 2024

No abstract provided.

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. A …

Answering The “Now What?”: The Development Of A Transdisciplinary Breast Cancer Survivorship Nonprofit Organization, Vir-Iaesta Maniquiz Vergel De Dios

CGU Theses & Dissertations

Although patients are living longer or are surviving breast cancer, the side effects of treatment still leave patients struggling with quality-of-life issues. The lack of whole-person care leaves patients unequipped after treatment is complete, searching for answers and a way to survive on their own. The unintended consequence becomes a dramatic shift from the weekly/daily medical appointments during active treatment to a silence that can be daunting for many to navigate. Living Your Truth Empowered, shortened to LYTE Foundation, is an antiauthoritarian minded and anti-hierarchal nonprofit created to address the needs of the growing breast cancer survivor population. LYTE is …

Wellness In Motion: A Quality Improvement Initiative To Support Resident Mobility And Reduce Falls., San N. Pham

Master's Theses and Capstones

Background: Falls are a significant concern in community living centers for older adult veterans. Promoting physical activity and resident engagement is crucial for reducing fall risk among this population.

Local Problem: A specific microsystem within this setting has a fall rate of 3 falls per month. This discrepancy underscores the need for targeted interventions to effectively address this issue.

Methods: This study measured key metrics related to falls and resident engagement in mobility programs both before and after the implementation of an exercise program within the microsystem.

Intervention: The "GIMME 10" exercise program, grounded in evidence-based practices and emphasizing resident-centric …

Home Blood Pressure Monitoring Bundle For Hypertension Outcomes In Adult Patients Receiving Care In Public Health Clinics, Christine Jennifer Victorian

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Hypertension (HTN) that is not adequately controlled leads to cardiovascular disease, stroke, and heart disease. It affects 116 million adults (47%) in the United States (U.S.). The HTN compliance rate in a South Texas public health clinic was 64%, below the national benchmark of 76%. Home blood pressure monitoring (HBPM) was recommended in a joint statement by the American Heart Association (AHA) and the American Medical Association (AMA). Literature evidence revealed that the HBPM bundle increased BP control (< 140/90 mmHg) compliance.

Methods: A quality improvement (QI) bundle was initiated to address the low HTN compliance rate from a quality management perspective. …

Implementation Of Prognosticator Algorithm For Initiation Of Serious Illness Discussions And Improving The Rate Of Palliative And Hospice Referrals, Joy Isebor

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Context: Early serious illness conversations related to end-of-life and goals of care with seriously ill patients have been associated with improving patients' outcomes and quality of care (Bernacki et al., 2015). However, initiating these serious illness discussions has been challenging in the home-based primary care setting.

Objectives: To train and support home-based primary care clinicians in integrating best practices in serious illness discussions and decision-making engagement among patients sixty-five and older with serious illnesses, optimize the alignment between patient goals and the medical care they receive, improving their quality of life and the rate of palliative care and hospice referrals. …

Enhancing Breast Cancer Screening In Kims Clinic: A Quality Improvement Initiative, Daniel J. Avila Castillo, Crystal Ike, Mina Choudhry

Gulf Coast Division GME Research Symposium 2024

No abstract provided.

Empirical Insights Into Survivorship Care: A Cross-Sectional Study Of Coc Accredited Hospitals In Kentucky, Amanda M. Beckett

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

ABSTRACT

Background:

Cancer survivorship care programs play a vital role in supporting cancer survivors and improving their quality of life. Understanding the landscape of survivorship and the potential barriers is key to optimizing care delivery.

Methods:

The primary purpose of this cross-sectional study was to explore existing cancer survivorship care programs offered by Commission on Cancer (CoC) accredited hospitals in Kentucky. Data from the Markey Cancer Affiliate Network (MCCAN) from 2022 through 2023 was analyzed. Variables included hospital characteristics such as rural code, types of survivorship services offered, and reported barriers to these services.

Results:

Analysis of n=19 CoC facilities …

Social Determinants Of Health: Evaluation Using Rates Of Vision Screening And Follow-Up Examinations, Madeline Dyer

Williams Honors College, Honors Research Projects

Vision care is essential to the quality of life of young children, impacting them over the course of their lives. Social Determinants of Health (SDOH) affect the likelihood of a child having access to appropriate care specified by the Bright Futures. The aim of this study was to assess the impact of SDOH on the completion of vision screening and the rate of follow-up with an eye care provider when applicable. In addition, rates of instrument-based vision screening and recommended ophthalmology follow-up were compared with COI, a metric assessing the quality of resources available and the conditions that matter for …

Improving Dental Students' Knowledge And Confidence In Treating Tobacco Use, Victoria Pierce

DNP Projects

Background: Tobacco use can lead to numerous chronic health conditions. Healthcare professionals in the dental field are in a unique position to broach this issue with patients. Research shows that dental students do not feel equipped to provide tobacco cessation care, citing lack of education on the subject among their top reasons for this.

Purpose: The purpose of this project was to evaluate changes in dental students’ knowledge and confidence related to treating tobacco use after participation in an educational intervention about the 5A’s, behavioral counseling, and first-line prescription medications.

Methods: This quality improvement initiative utilized a quasi-experimental survey design …

Preparing Healthcare Education For An Ai-Augmented Future, Jiajie Zhang, Susan H Fenton

Faculty, Staff and Student Publications

Artificial intelligence (AI) fundamentally transforms healthcare education as a knowledge enterprise, creating a distributed cognitive system composed of the human brain, which remains relatively unchanged, and AI-based knowledge and cognitive functions, which have accelerated exponentially in scale and power. Education must focus on developing skills to collaborate with AI and on achieving outcomes like problems solved and discoveries made. Curriculum and education policies also need to adapt to this transformation.