Quality Improvement Commons^™

The Effectiveness Of Botulinum Toxin Injections In The Management Of Chronic Neck And Shoulder Myofascial Pain: A Nursing Perspective, Jia Zhou

Nursing | Student Research Posters

No abstract provided.

The Role Of Sexual Assault Nurse Examiners: Addressing The Shortage And Its Implications For Healthcare, Isabel Mary Mccarthy

Nursing | Student Research Posters

The increasing prevalence of sexual assault cases has highlighted the crucial need for trained healthcare professionals who can effectively provide sensitive care for survivors. Sexual Assault Nurse Examiners (SANE) are registered nurses specifically trained to perform forensic examinations and provide medical and emotional support to sexual assault victims. However, many nursing programs lack formal education on SANE practices, which can hinder students' preparedness to address such cases in their future careers. This study aims to evaluate the effectiveness of a specialized Sexual Assault Nurse Examiner (SANE) training module integrated into an undergraduate nursing curriculum at Dominican University of California. By …

Developing A Nursing Early-Intervention Bundle To Decrease The Prevalence Of Post-Intensive Care Syndrome, Aneesha Biju

Nursing | Student Research Posters

Post-intensive care syndrome (PICS) has become an increasingly recognized challenge in critical care as more patients survive prolonged mechanical ventilation and lengthy ICU stays. Although lifesaving interventions support recovery from the primary illness, many patients develop new or worsened physical, cognitive, or psychological impairments after discharge. These complications often limit independence, slow recovery, and create long-term burdens for both patients and families. Research shows that early, consistent nursing interventions, such as delirium prevention, early mobility, mental health support, and family communication, can reduce the risk of PICS. The absence of a unified and standardized approach results in inconsistent practices and …

Developing An Educational Session And Epic-Based Tools To Help Nurses Provide Culturally Sensitive Care To Their Muslim Patients, Laila Albutmeh

Nursing | Student Research Posters

Islam is currently the fastest growing religion in the world. The chances of nurses getting Muslim patients are on a rise. Islam is not just a religion but a way of life that shapes/guides every aspect of human experience. With religion being such an important part in a Muslim's life, they need nurses to be able to provide them culturally sensitive care. Nurses can do this if they are equipped with the right knowledge and tools. Implementing educational resources on how to provide culturally sensitive care to Muslim patients for nurses to use will help them be able to provide …

Improvement Of Hpv Vaccination Rate In Pediatric Patients In A Clinic Through Implementation Of A Bundle, Macalah Jenschke

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Introduction: Human papillomavirus (HPV) is a major cause of several cancers, and vaccination is a highly effective preventive measure. However, HPV vaccination rates remain suboptimal, particularly in rural pediatric populations. This quality improvement (QI) project aims to enhance HPV vaccination rates through the implementation of a comprehensive vaccination bundle targeting provider education, patient and parent education, appointment reminders, and the use of a vaccine waiver when needed.

Method: This QI project was conducted over twelve weeks in a rural pediatric clinic with approximately 130 patients seen daily. The intervention bundle included provider education on effective communication regarding HPV vaccination, educational …

Improving Glucose Levels In Adults With Type 2 Diabetes, Kaitlin Castillo

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Type 2 diabetes is a growing health crisis, posing significant challenges not only to individual well-being but also to healthcare systems' financial sustainability. The prevalence of type 2 diabetes continues to rise annually, contributing to increased medical costs, hospitalizations, and long-term complications. Houston, Texas, has a diabetes prevalence of 13.5%, exceeding the national average of 10%. A clinical gap exists in providers’ ability to prevent and manage type 2 diabetes. Prioritizing prevention, early intervention, and improved patient monitoring can reduce incidence rates, lower healthcare costs, and enhance overall population health. A Plan Do Study Act model was utilized for the …

“What We Say Matters”: Reducing Drug Use Stigmatization By Healthcare Professionals Through A Narrative-Based Awareness Campaign, Adam M. Traugott

DNP Projects

Background: Stigma towards substance use has been identified as a contributor to poor care and health outcomes amongst people who use drugs (PWUD), a vulnerable population. Healthcare worker stigma negatively affects the outcomes of individual patients and may have greater public health implications. Methods of addressing drug-use stigma have previously been implemented in a variety of clinical settings. Presenting the lived experience of PWUD to healthcare workers via emotionally compelling narratives has been found to be an effective means of stigma reduction.

Purpose: This study utilized two psychometrically validated tools to measure (1) the baseline prevalence of drug use stigma …

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

Department of Family and Community Medicine Faculty Publications

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

Improving Safe And Effective Management Of Pain At Home, Alayna V. Olivarez

Honors Undergraduate Theses

Pain is the most common clinical symptom in individuals with a cancer diagnosis. Additionally, home is the preferred place for cancer care which introduces numerous challenges for cancer pain management. The primary purpose of this literature review is to identify support interventions to enhance pain control, prevent exacerbations in pain, and optimize quality of life in individuals with cancer transitioning from the acute care setting to home. The secondary purpose of this review is to analyze patient-specific barriers influencing self-efficacy of pain management and overall health outcomes in the target population. A systematic literature search was conducted using CINAHL, EBSCOhost, …

How Do Patient-Provider Relationships Affect Patient Satisfaction?, Rose D. Lightspeed

Anthós

This article reviews studies on patient satisfaction within the U.S. healthcare system to investigate how physicians’ behavior influences patients’ reported quality of care. Medical negligence, neglect, and cognitive biases are identified from the reviewed literature as physician behaviors that affect the patient-provider relationship and patient satisfaction. Emphasizing patient satisfaction and involvement in their care as important considerations when evaluating patient-provider relationships, Lightspeed underscores how the complex dynamic between patient and provider–including physicians’ reported feeling of inadequate interpersonal skills and patients’ sensitivity to dismissive communication–contributes to reduced satisfaction rates. Lightspeed argues that increasing physician awareness of these factors that influence patient …

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 Patient-Provider Communication In Indian American Populations: A Scoping Review, Pranav S. Nadella

Honors Undergraduate Theses

Effective provider-patient communication directly influences patient satisfaction, treatment adherence, and health outcomes, yet the unique experiences of Indian Americans—one of the fastest-growing U.S. populations—remain underexplored in communication research. This scoping review, following Joanna Briggs Institute guidelines, systematically mapped the existing literature on provider-patient communication involving Indian Americans. Eleven studies met inclusion criteria, with data extracted on methods, populations, and seven coded aspects related to communication.

Findings revealed a narrow focus on first-generation immigrants and women, leaving men’s experiences and second-generation voices largely unexamined. Communication was shaped by language discordance, cultural stigma, family involvement, trust dynamics, and health literacy. No studies …

From Tricare To Medicaid: Dental Insurance Disparities Among U.S. Veterans And Active Duty Service Members, Madeline K. Mcnutt Ms

Honors Undergraduate Theses

Oral health plays a critical role in systemic well-being, yet dental care access in the United States remains deeply unequal, particularly among low-income and historically marginalized populations. Among those significantly affected are military veterans, who frequently experience barriers to oral healthcare due to eligibility restrictions within the Department of Veterans Affairs (VA) system. This study offers a comparative analysis of dental insurance satisfaction between recipients of Medicaid and the TRICARE Active Duty Dental Program (ADDP), two federally funded programs that reflect the divide between civilian and military healthcare access. While TRICARE ADDP provides comprehensive and uniform coverage for Active Duty …

Iimproving Discharges Within The Monitored Pod Units Of A Regional Health Center In Bryan, Tx, Paul R. Russell Iii

Doctor of Nursing Practice Final Project Abstract

IMPROVING DISCHARGE RATES WITHIN THE MONITORED POD UNITS OF A REGIONAL HEALTH CENTER IN BRYAN, TX

Purpose

The purpose of this scholarly project was to improve discharges by 11:00 a.m. within the Monitored Pod Units located in a regional hospital in Bryan, Texas.

Background

The current discharge rate by 1100 for the monitored pod units at the regional health center was below the health system goal of 50%. The impacts of delayed discharges are broad and can be seen throughout the regional health center. Delayed discharges have a direct effect on staff satisfaction, patient satisfaction, and decreased revenue.

Methodology

This …

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

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

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

Michael C. MacCourtney

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

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

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

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

Ayodele Ayeko

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

A New Electronic Handoff Tool To Facilitate Patient Transfer From The Or To Sicu: A Quality Improvement Initiative, Kaylan Jean Kerrigan

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction/Background: Transfer of care is a vulnerable time for patients. Continuity of care depends on good communication from the transferring team to the receiving team. Communication failures contribute to frustration among medical staff and poor patient outcomes. Purpose: The purose of this project was to improve handoff communication and satisfaction between the anesthesia team in the operating room (OR) and the receiving surgical intensive care unit (SICU) nurses. Intervention: A new electronic handoff tool was developed for the Epic electronic health record (EHR) to provide SICU nurses with patient information (name, age, allergies), procedure and diagnosis, intubation status, reversal status, …

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 …

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

Graduate Theses, Dissertations, and Problem Reports (ETD)

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

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

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

Graduate Theses, Dissertations, and Problem Reports (ETD)

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

Initiation Of Sterile Vaginal Preps Prior To Cesarean Sections: A Quality Improvement Project, Diane Gilbertson, Timothy Kremer, Kimberly Udell

North Texas Research Forum 2025

OBJECTIVE: Research on patients undergoing routine gynecological procedures with a vaginal preparation has demonstrated a significant reduction in post-operative infections by decreasing the burden of vaginal bacteria. Despite this research, as well as evidence that they reduce postpartum endometritis, especially in labor patients or those with ruptured membranes (Lui), vaginal preparations prior to cesarean section are not standard practice. Prior to the initiation of this quality improvement project, no patients delivering at Medical City Arlington received a vaginal preparation prior to a cesarean delivery. The goal of this quality improvement project is to improve clinical care, patient safety, and healthcare …

Assessing The Effectiveness Of A Rapid Response Training Course, Nasima Mehraban, Caroline Brooke, Vivek Punjabi, Veeranna Vibhuti

North Texas Research Forum 2025

Introduction: Rapid response teams are crucial in healthcare settings for managing clinical emergencies. To enhance the preparedness of interns in handling such situations, we developed a rapid response training course. This study aimed to evaluate the course's effectiveness by examining changes in residents' self-reported confidence levels before and after completing the training. Methods: A group of interns participated in five simulated rapid response scenarios. Before the training, participants rated their confidence level on a scale from 1 (not confident in running a rapid response) to 10 (very confident). Following the training, they reassessed their confidence level. Pre- and post-training ratings …

Improving Communication And Follow Up For Incidental Findings From Panscan Imaging, Makenzie Morrissey, Kristen Payne, Randall Rittmann, Chris Robert, Joseph Lim, Danielle Pigneri

North Texas Research Forum 2025

OBJECTIVE: Incidental findings in medical imaging pose a significant challenge in healthcare due to the potential for missed follow-ups, which can lead to adverse outcomes for patients. These findings, which are unrelated to the primary purpose of the imaging study, are increasingly common due to advances in imaging technology and its widespread use. The consequences of missed follow-ups can be severe. For instance, the rate of malignancy in incidental pulmonary nodule id about 5% and follow up fails in 30-70% of cases. This means for every 120 CT chest scans ordered, 1 lung cancer is missed (McWilliams et al., 2013). …

Assessment Of Patient Satisfaction Through The Introduction Of A Post-Procedure Pamphlet In An Outpatient Clinic, Mohammad Rashik, James Aston, Sajid Surve

North Texas Research Forum 2025

This quality improvement project aimed to create a patient pamphlet for the Osteopathic Manipulative Medicine (OMM) clinic at the University of North Texas Health Science Center. The pamphlet provides important post-procedure information for patients who undergo treatments like joint injections, platelet-rich plasma therapy, prolotherapy, hydrodissection, botulinum toxin injection, and nerve blocks. These procedures can lead to potential side effects, some of which patients may not be aware of. To address this, the pamphlet includes information on common symptoms, their causes, recommended next steps, and guidance on when to contact the OMM clinic or visit the Emergency Department. The pamphlet was …

Optimization Of Venous Thromboembolism (Vte) Prophylaxis In Pregnancy And The Postpartum Period, Sereena Jivraj, Isabella Sciacca, Sherrie Dixon, Timothy Kremer

North Texas Research Forum 2025

Background: Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolisms (PE) continues to be a leading cause of maternal mortality (MM) in the United States. VTE accounts for roughly 9-10% of all maternal deaths. Other countries have adopted anticoagulation protocols to reduce MM rates, but the US has yet to follow suit. The American College of Obstetricians and Gynecologists (ACOG), the American College of Chest Physicians (CHEST), and the Royal College of Obstetricians and Gynaecologists (RCOG) all vary in their guidelines for thromboembolism prophylaxis. Patients who deliver by Cesarean section (C-section) have higher incidences of MM due …

Bridging Knowledge And Practice: Exploring The Medical City Arlington Internal Medicine Handbook, Laura Montoya, Evangelista Ezenduka, Shivani Agarwal, Mike Nguyen, Fatima Safi, Nikhil Madhav, Dallin Beus, George Yeung, Hayan Kundi

North Texas Research Forum 2025

Internal medicine residents face a wide range of challenging medical conditions during their training and need to be equipped with both the knowledge and flexibility to handle whatever comes their way. As part of a collaborative initiative, we present the Medical City Arlington Internal Medicine Handbook, a practical resource built by residents, for residents. This handbook brings together practical insights, evidence-based practices, and specialized clinical expertise, all with the goal of enhancing the diagnostic and treatment skills of internal medicine practitioners. It covers a broad spectrum of conditions, from common ailments to rare and complex diseases, and provides in-depth management …

Under-Utilization Of Non-Selective Beta-Blocker In Patients With Clinically Significant Portal Hypertension & Esophageal Varices, Sohaib Ahmed, Ana Moraga, Syed Usman Mumtaz, Varun Mehta, Boran Mao, Juan Pablo Meruvia, Amar Mandalia, Shamol Williams

North Florida Division GME Research Day 2025

No abstract provided.

Clinical Outcomes And 30-Day Readmission Following Heart Failure Hospitalization In Patients Previously Treated For Obesity With Glp-1 Agonist Versus Bariatric Surgery, Nameer Ascandar, Bobby Malik, Waqas Qureshi, Aysu Erdemir, Eduardo J. Lazaro, Olu Oyesanmi, Sabry Omar, Robert J. Subbiondo, Michael Schandorf-Lartey

West Florida Division GME Research Day 2025

No abstract provided.

Pre And Post-Distribution Outcomes Of The Intern Guidebook, Joyce Smith, Sam Mellits

West Florida Division GME Research Day 2025

No abstract provided.

Breaking The Blockade: A Retrospective Analysis Of Pediatricconstipation In Hospitalized Patients, Yenamala Reddy, Jaicy Pottokaran, Eric K. Shaw, Aimee Behnke, Jean B. Wiggins, Lauren Hebert, Norman Taylor Parks

South Atlantic Division GME Research Day 2025

No abstract provided.