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 …

Working Conditions Of Perfusionists In North America: A Scoping Review, James Strong

Student Works

Perfusionists face significant challenges, including long hours, high workloads, burnout, and workplace risks like sleep deprivation and discrimination, which impact both their well-being and patient outcomes. Despite these concerns, no comprehensive review has mapped workforce trends, and the lack of widespread American Society of Extracorporeal Technology (AmSECT) guideline implementation worsens the situation. This scoping review highlights these issues, emphasizing the need for standardized assessments, better enforcement of guidelines, and proactive strategies to improve perfusionist well-being and patient safety. This scoping review aims to describe the working conditions of North American Certified Clinical Perfusionists (CCPs).

The Effectiveness Of Gad-7 Screening In High School Students, Tamara L. Smith, Allison Darnell, Margaret Harvey, Phd, Acnp-Bc, Chfn, Jacqueline Sharp Dnp, Aprn, Pmhp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Adolescent mental health is a growing concern, with anxiety disorders being particularly prevalent among high school students. Left untreated, anxiety can significantly impact academic performance, social functioning, and long-term mental health. The COVID-19 pandemic exacerbated these challenges, highlighting the critical need for effective screening and intervention strategies. The Generalized Anxiety Disorder 7-item scale (GAD-7) is a validated tool for identifying anxiety disorders, yet its application in high school settings is limited. This scoping review explores the effectiveness of GAD-7 in increasing mental health referrals and improving anxiety outcomes in high school students.

Methods

A comprehensive search was conducted across …

Evaluating The Efficacy Of Predischarge Referrals In Preventing Emergency Mental Health Hospital Readmissions: A Scoping Review, Pretia Carpenter Bsn, Rn, Stephanie Mays Bsn, Rn, Jacqueline Sharp Dnp, Aprn, Pmhp-Bc, Sharon H. Little, Dnp, Fnp-Bc, Aprn

Doctor of Nursing Practice Projects

Background

Emergency mental health hospital readmissions present significant challenges to healthcare systems, often resulting in increased costs, prolonged hospital stays, and poor patient outcomes. Continuity of care through predischarge referrals to outpatient mental health services, psychosocial support, and community resources has been proposed as a strategy to reduce readmissions. However, the effectiveness of these interventions remains inconsistent across different populations and settings.

Objective

This scoping review aims to evaluate the effectiveness of predischarge referrals in reducing 30-day emergency mental health hospital readmissions, identify key components of successful programs, and assess the influence of demographic factors on readmission rates.

Methods

A …

Provider-Nurse Rounding Checklist: A Qi Project, Danielle Ursone Rn, Bsn, Jennifer O'Neil Bsn, Rn, Ccrn, Susan Penque Ph.D, Anp-Bc, Ne-Bc, Nc-C

Posters

• Communication between healthcare providers and nurses is an essential component for a good working relationship.
• Increased collaboration has been shown to improve staff attitudes and job satisfaction.
• Interprofessional rounds with a rounding checklist provide an organized way to perform rounds to increase satisfaction with teamwork and decrease miscommunication.
• At the DNP project site, a rounding checklist is not being used, resulting in a disconnect between the nurses and healthcare providers.

Dnp Final Report: An Evidence-Based Initiative To Improve Bowel Preparation Quality For Colonoscopy, Jennifer L. Gassett

DNP Final Reports

Good colonic bowel preparation (CBP) is an important component of colonoscopy but is often inadequate. Improving CBP can help increase detection of precancerous polyps, prevent procedures from being canceled or repeated, and decrease medical expenses. A quality improvement project was implemented to increase adequate CBP rates at an ambulatory surgery center specializing in endoscopy. Several factors correlate with suboptimal CBP, but the practice question focused on patient education. The PICOT question guiding evidence synthesis was posed: In adult patients preparing for outpatient colonoscopy, how do revised instructions with visual aids compared to written instructions affect CBP adequacy and patient satisfaction? …

Integrating Workplace Violence Prevention Into Nursing Curriculum: Preparing Future Nurses For Safer Practice ​, Noah Briere, Sarah Kegerreis, Molly Lasyone, Savannah Orris

SPARK Symposium Presentations

Nurses are under attack. 80% of nurses have experienced some form of workplace violence (WPV), which is seen as “part of the job.” Unfortunately, the agency responsible for protecting nurses, the Occupational Safety and Health Administration (OSHA), only offers voluntary guidelines. We have determined that nursing students are the best group to educate about WPV prevention in healthcare. Including this teaching to fit within their pre-clinical requirements, only needing one faculty to teach with an average salary of $80k, to further help set what should be foundational skills. By adding WPV de-escalation techniques and adequately preparing students prior to graduation. …

Duty To Care And Job Turnover Intention In The Post-Pandemic Nursing Workforce, Cathleen A. Lopez

Nursing Theses and Dissertations

Natural and human-made disasters are increasing in number and intensity. In 2020, approximately 688.3 million people required assistance from disaster response personnel. During a disaster or pandemic, nurses must weigh their personal and/or family safety against the ethical code of caring for others. The purpose of this convergent mixed-methods study was to examine duty to care and job turnover intention of registered nurses working in patient-facing roles. A convergent mixed method design was used to address research questions by employing the Nash Duty to Care Scale (NDCS) and the Turnover Intent Scale (TIS-6). Open-ended survey questions were used to explore …

Severe Hypertension In Postpartum: How A Nurse Driven Protocol Can Be Used To Decrease A Delay In Treatment, Kayleigh Momme

Doctor of Nursing Practice (DNP) Scholarly Project

Problem: The problem at the practicum site is a delay in the treatment of severe range hypertension in postpartum patients due to IV push antihypertensives being administered by resident physicians who are clinically stationed in another building as opposed to the primary nurse.

Aim of the Project: The overall aim is to institute a protocol that will prevent a time delay for the treatment of severe range blood pressures in postpartum patients.

Review of Evidence: Hypertensive disorders during pregnancy and the immediate postpartum period are the leading cause of maternal morbidity and mortality. Obstetric related governing bodies have come to …

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 …

Worldwide Trends In The Quality And Breadth Of Clinical Investigations Of Medical Devices Over The Past Decade: A Scoping Review And Evidence Map, Elaine Harris, David F. Keane, Mathew Cherian, Ryan Longley, Rosie Dunne, Thomas Matthew, Paddy Gillespie, Abhay Pandit, Matthew D. Griffin

Articles

682 studies from 2012 and 1682 studies from 2022 were included. Around a quarter of studies were interventional and the remainder being observational and primary outcomes of effectiveness were more common than efficacy. Key study design aspects were frequently unreported, including sample size justification, registration, randomisation technique and funders. Our evidence map demonstrated that predominantly, investigations were of implants and were in a cardiovascular setting. Clinical investigations were broadly similar between 2012 and 2022, though there was a reduction in the proportion of cardiovascular studies, a move in the share of studies coming out of Europe and North America towards …

Cyber Threats In Healthcare: The Ransomware Epidemic, Mackenzie Dotson, Kasi Gorli, Alberto Coustasse

Management Faculty Research

In this presentation, we will delve into the growing ransomware crisis in healthcare, examining how these cyber threats disrupt hospital operations, jeopardize patient safety, and impose significant financial burdens. From understanding how ransomware infiltrates hospital systems to exploring real-world case studies, we will uncover the devastating impact of these attacks. Our discussion will also focus on mitigation strategies, cybersecurity best practices, and policy recommendations to safeguard healthcare institutions from future threats.

Colorectal Cancer Screening And Correlating Gender Disparities, Kara Marr, Megan Janssen, Margaret Payne, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Purpose/Background

In 2023, colorectal cancer (CRC) was the second leading cause of cancer-related deaths in the US, equating to approximately 50,000 total deaths (National Cancer Institute, 2024). Further, it is estimated that an additional 1.4 million Americans are living with CRC (National Cancer Institute, 2024). Early detection screening modalities remain imperative since the NIH has released a combined survival rate of 70% when utilized (National Cancer Institute, 2024). Different derivatives of CRC develop from pre-cancerous polyps and are often without signs or symptoms of disease progression; this asymptomatic period emphasizes the importance of early detection and prevention of colorectal cancer …

Unveiling The Stigma: Doctor Mental Health And Intervention Strategies, Joseph Heirigs

Honors Program: Senior Projects (Public)

Background

The mental health of physicians is a pressing issue that has received increasing attention in recent years. The alarmingly high suicide rates for physicians underscores the critical need to address the mental health challenges that doctors face. Physicians are exposed to stressors that are unique to their profession, including high-stakes decision making, long work hours, traumatic patient situations, and the emotional toll of patient care. These challenges contribute to high rates of anxiety, depression, burnout, and other mental health issues. However, despite these factors, physicians are often reluctant to seek mental health treatment due to fears of professional repercussions, …

Primary Care Physicians' Perspectives On Clinical Integration And Performance Metrics In A Medically Underserved Area., Kern Kumar

MUSC Theses and Dissertations

With the national movement toward improving population health and helping combat the rising costs in healthcare, there are still assumed challenges and barriers concerning performance among healthcare organizations that impact costs and health outcomes. The Physician Hospital Organization (PHO) site within this study has been plagued with poor performance with assumed challenges and barriers for years. In this mixed-methods study leveraging the qualitative approach to support existing data, all primary care physicians within the PHO under study were interviewed, and by following the inductive approach and thematic analysis, valuable themes arose. It was found that due to patient education lacking …

Operating Room Acquired Pressure Injury Prevention, Audrey E. Dillon, Lexi K. Johnston, Grace L. Johnston, Amy N. Cochran

SPARK Symposium Presentations

Our change project focuses on preventing pressure injuries in OR patients using an alternating pressure overlay and gel pad system during surgery and recovery. Pressure injuries cost the healthcare system upwards of $26 billion annually, and surgery patients are at high risk due to prolonged immobility, constant pressure on one area, hemodynamic changes, and excessive moisture. Nurses can play a critical role in reducing healthcare costs and improving patient outcomes by utilizing proper training and outcome tracking. The estimated cost of implementing this system is $37,000, significantly lower than the long-term cost of pressure injuries. Key
stakeholders include nurse managers, …

Written Reminders For Mammogram Compliance, Kristine Cholly, Marcus Barksdale, Rachel Gates, Mabel Olaya, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Purpose/Background

Breast cancer remains the second leading cause of cancer death among women in the United States, with a median age of mortality at 68 years old. Mammography has been shown to improve early detection and reduce mortality rates. Current United States Preventive Services Task Force (USPSTF) recommends biennial mammograms for women aged 50-74. However, compliance with biennial mammogram screenings remains inconsistent. This project aims to evaluate the effectiveness of written reminder letters in improving mammogram compliance among women aged 50-74 years old. The study focuses on comparing mammogram adherence rates among patients who received reminder letters compared to those …

Hospital Re-Admission, Length Of Stay, And Chief Complaints Of Patients Experiencing Housing Instability, Andrew S. Leavitt, Jainaha K. Srikumar, Rizwan M. Siddiqui, Luke R. Siedhoff, Jennifer Liu, Jenenne Geske

EMET Projects

No abstract provided.

Hospital Admissions Of Patients Experiencing Housing Instability, Rizwan M. Siddiqui, Jainaha K. Srikumar, Andrew S. Leavitt, Luke R. Siedhoff, Jenenne Geske, Jennifer Liu

EMET Projects

No abstract provided.

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. …

Shorter Surveys, Better Insights: The Role Of Patient Reported Outcome Surveys In Value-Based Care, Paul Bonilla, Anesu Karen Murambadoro, Victoria Elizondo, Juan Pablo Flanagan

Research Symposium

Background: Patient-reported outcomes (PROs) are essential for tracking patient progress, but lengthy surveys, such as the 40 question Knee Injury and Osteoarthritis Outcome Score (KOOS), create time and cost challenges for private practice. Starting July 2024, the Centers for Medicare and Medicaid (CMS) now require hospitals to collect pre surgery and one year post surgery (9-15 months) HOOS JR and KOOS JR scores for total replacement surgeries, with public reporting set for 2027. Non-reporting carries financial penalties, underscoring the need for streamlined solutions. As value-based care becomes a priority, practical strategies are needed to reduce the burden on providers …

Assessing Patient Satisfaction: The Role Of Net Promoter Scores In Healthcare, Paul Bonilla, Victoria Elizondo, Juan Pablo Flanagan

Research Symposium

Background: The Net Promoter Score (NPS) is a widely used tool for measuring customer satisfaction and loyalty through a simple question: “How likely are you to recommend [company name] to a friend or colleague?” Responses categorize individuals as Promoters (9–10), Passives (7–8), or Detractors (0–6), with the final score calculated by subtracting the percentage of Detractors from Promoters. Introduced in 2003, NPS has become popular across industries for its simplicity, predictive value, and benchmarking capabilities. In healthcare, NPS adoption is increasing as hospitals seek concise, standardized tools to assess patient satisfaction—an essential metric in the shift toward value-based care. …

Analyzing The Impact Of Surgery On Reducing Missed Workdays, Paul Bonilla, Victoria Elizondo, Juan Pablo Flanagan

Research Symposium

Background: Managing patient expectations before surgery is essential to improving the surgical experience. A key aspect of this is understanding the impact of surgery on work attendance. While patient-reported outcomes (PROs) are commonly used to assess health conditions, less attention has been given to how work attendance, both before and after surgery, can inform preoperative counseling. This is especially relevant for patients concerned about taking time off work. Analyzing work attendance can reveal patterns that help patients make informed decisions, improve long-term outcomes, and enhance satisfaction by setting achievable recovery timelines. This study aims to explore how this data can …

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 …

Guardians Of The Catheters, Interprofessional Collaboration Reduced Cauti Rates At Phfh, Dawn Doud, Angie Shemwell, Stephanie Brown, Tobi Bryan, Georgia Gauron, Tasha Anisimov, Peter Weitzman, Emma Peterson, Tiffanie Rampley

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Intraoperative Imaging In Orthopedic Settings: An Assessment Of Changes In Adherence To Imaging Guidelines, Emmanuel Franco, Tabitha Abraham, Zayd Ayas, Frank Gerold

Research Symposium

Background: High-quality intraoperative photography is vital for treatment planning, patient counseling, and surgical education. Inconsistencies in image quality are prevalent in orthopedic literature due to the absence of formalized criteria specific to orthopedic settings. In 2014, "Medical Photography: Principles for Orthopedics" introduced guidelines intending to standardize protocols for capturing clinical images. By comparing the quality of images taken both before and after these proposed guidelines, this project aims to evaluate whether this has influenced a trend toward standardization and consistency in intraoperative orthopedic photography.

Methods: To assess quality differences in orthopedic images before and after the 2014 guidelines, 60 intraoperative …

Impact Of Proviq Process Confirmations And Daily Management Systems On Catheter Associated Urinary Tract Infection Rates, Missy Thingelstad, Caitie Van Eerden, Travis Scott, Tiara L. Benson, Allison Engle, Shih-Ting Chiu, Ma Fe Chase, Melissa Scheck, Cecilia Malama, Brooke Higgins

Articles, Abstracts, and Reports

Problem Statement: Our 539-bed tertiary care center observed an increase in the Catheter Associated Urinary Tract Infection (CAUTI) Standardized Infection Ratio (SIR) from 0.88 to 1.28 when comparing October to December of 2023 to 2024. CAUTIs are associated with increased patient discomfort, mortality, morbidity, length of stay, and cost. Methods: Using ProvIQ methodology, process confirmation cards were introduced in eight pilot units, including critical care, medical-surgical, and maternal-child specialties, from October to December 2024. ProvIQ is an evidence-based quality improvement methodology including a basket of measures from Lean, Six Sigma, and change management. This program was developed by Quality Management …

Preserving Privacy In Senior Care At Home Monitoring Systems, Sam Russel, Ryan Benton, Amy Campbell, Scott Sittig

Shelby Hall Graduate Research Forum Posters

Many seniors prefer to live at home which necessitates research into the application of technologies to provide a safer environment with less caregiver resources. However, the application of home health care (HHC) monitoring for seniors is still in an evolutionary stage. Present HHC systems are produced by private companies with general regulatory guidelines lacking specific care of the elderly. As such, each company that produces such a system claims to have better safety, privacy, and security that their competitors. A pressing issues is devising and applying a general framework for the application of technologies that delivers safety while preserving privacy. …

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 …