Quality Improvement Commons^™

Bridging The Gap For Hiv Education In Primary Care Setting, Oregon Mcdiarmid, Lindsay Porter

North Texas GME Research Forum 2024

No abstract provided.

Improving The Screening For Abdominal Aortic Aneurysm At Grand Prairie Internal Medicine Clinic ​, Riddhi H. Patel, Danielle Ford

North Texas GME Research Forum 2024

Introduction: An abdominal aortic aneurysm (AAA) is typically defined as aortic enlargement with a diameter of 3.0 cm or larger. The prevalence of AAA has declined over the past 2 decades among screened men 65 years or older in various European countries. The current prevalence of AAA in the United States is unclear because of the low uptake of screening. This QI project will involve MCA residents and Grand Prairie clinic attending to incorporate screening for abdominal aortic aneurysm guidelines used by USPSTF and attempt to encourage all our established and new patients who fit into the criteria for …

Current Trends In School Nursing In Musculoskeletal Injuries And Concussions, Christoffer Amdahl, Hans Drawbert, Sadra Forati, Joshua Allen, Sana Qureshi, Afsha Rais

North Texas GME Research Forum 2024

Background: School nurses are on the front lines of assessing, identifying and treating school age children with a number of health complications. Implementing nursing services in schools have previously demonstrated improved medical care costs for students, less productivity loss for parents, and less productivity loss for teachers. As a result, nursing services in schools provide a cost-beneficial investment of public money, and warrant both financial support from policy makers as well as educational support from local healthcare services. Communicable disease, asthma, musculoskeletal injuries, concussions are common conditions seen in school aged children and a fundamental understanding of these issues …

Resident Gamification Challenge: Unlocking Pocus Proficiency Board Review Through Play, Kevin Bertrand, Emily Macauley, Michael Falgiani

North Florida Division GME Research Day 2024

No abstract provided.

Effect Of The Intern Survival Book Handbook In Medical City Fort Worth Family Medicine Residency Program, Nancy Sang, Harry Pham, Tammy Nguyen, Zara Soomro, Patrick Feng, Ali Al-Nahi

North Texas GME Research Forum 2024

Background: The optimization of medical training is a critical concern amid dynamic shifts in both medical and societal landscapes. Research indicates that a substantial proportion of medical trainees experience stress, anxiety, and depression, with an estimated depression rate of 29% among medical residents, compared to 8% among nonphysicians. Furthermore, the suicide rate among physicians is twice that of the general population. Difficulty in adapting to new environments, responsibilities, and training levels exacerbate these challenges. This study evaluates the efficacy of "The Intern Survival Handbook" in mitigating stressors among new trainees, enhancing their work performance, and promoting overall mental health. Methods: …

Gamification To Improve Ems Knowledge Of Medical Capacity Determination, Ross Sinicrope, Nasim Motaghedi, Zachary Yates, Elliott Richardson, Stephanie Schieffert, Jacob Wright, Abigail Alorda, Jeffrey Katz, Linh Nguyen, Shayne Gue, Christine Van Dillen, Ayanna Walker

North Florida Division GME Research Day 2024

No abstract provided.

Stemi Alert Notification System At Hca Florida Orange Park Hospital: A Quality Improvement Project, Jomel Jacinto, Pranav Bommineni, Steven Goodfriend, Mubbasher Syed

South Atlantic Division GME Research Day 2024

No abstract provided.

A Comparative Analysis Of Costs Associated With Assisted Reproductive Technology; Invitro Fertilization Of Singleton, Twin, And Multiple Gestations Compared To Non-Invitro Fertilization Singleton Gestations, Ruth Arthur-Asmah

MUSC Theses and Dissertations

This study examines IVF and non-IVF costs associated with prenatal, delivery, and postpartum care using claims data from Merative MarketScan Commercial and Encounter data from 2018-2020 to understand the costs associated with respective IVF singleton, twin, and multiple gestations, as compared to non-IVF singleton gestations. These patients identified as females at birth, were continuously enrolled in private insurance, and have not experienced termination of pregnancy. The Student T-test was performed on continuous variables, and logistic regression was performed on binary variables with the overall outcome variables being cost, IVF, and non-IVF, controlling for age. The cost data was gamma log …

Mastering The Ite With Em Mastermind: A Board Game For Board Review, Taylor Cesarz, Stephanie Cohen, Shayne Gue

North Florida Division GME Research Day 2024

No abstract provided.

Enhancing Interprofessional Communication: Strategies For Nurses And Residents At Hca Florida Osceola Hospital, Juan Thomas Del Calvo, Mehuliben Upadhyaya, Sathvik Saineni, Minh Anh Le, Awss Shalhoub, Nima Hosseinian, Ashwini Komarla, Olga Karasik

North Florida Division GME Research Day 2024

No abstract provided.

Improving The Blood Product Administration Process At Hcaflorida Osceola Hospital, Neha Meda, Kar Shun Constant Mak, Parasto Asnaashari, Natalia Irina Tejada, Joshua Sutarwan, Olga Karasik, Sarah Tinsley

North Florida 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 …

Improving Safety And Increasing Timeliness, A Quality Improvement Study, Haylee M. Durand

Athletic Training Case Studies

St. Xavier High School has approximately 900 student-athletes and two certified athletic trainers. On any given day the athletic trainers may see between 50 and 60 student-athletes. The high volume of athletes results in some smaller tasks being forgotten. One task that has not been done as frequently as necessary is cleaning treatment tables after each use. According to the CDC, patient tables should be cleaned between each patient. With the current model of tables only being cleaned one to two times consistently throughout the day, CDC standards are not being met. To combat this problem, we decided to talk …

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 …

Promoting Inpatient Mobility To Improve Patient Outcomes: A Quality Improvement Project In A Rural Critical Access Hospital, Chantal Laplante

Master's Theses and Capstones

Background: Although beneficial to patient outcomes, inpatient ambulation is not a prioritized care intervention, and a task often deferred to physical therapy. Patient immobility is a complex problem that requires a multifaceted approach.

Local Problem: In a rural, critical access hospital, on an 18-bed medical surgical unit, nursing staff lacked ownership of patient mobility. There was no standardized process to document ambulation and mobility tasks were not scheduled, falling to the end of the nursing work list. Many patients did not have activity orders upon admission and nurses lacked resources for ambulation assessment and daily goal setting. There was no …

Improving Spiritual Care Competency Among Intensive Care Unit Nurses: Promoting Holistic Patient Care Towards End-Of-Life, Joanne Nguyen, Dana Bagis

Nursing | Senior Theses

Intensive care unit (ICU) nurses play a crucial role in providing physiological stabilizing care in a dynamic and fast-paced environment, often marked by constant changes and variability in complex patients. Despite their specialization, the aspect of spiritual care tends to be overlooked, particularly in the context of end-of-life care. This is significant because previous studies have shown that a lack of spiritual care leads to poorer health outcomes, decreased coping, increased depression, and diminished quality of life for patients. This research proposal aims to investigate the spiritual care competency among ICU nurses who partake in spiritual care-based training, with the …

Optimizing Ventilator-Associated Pneumonia Prevention And Education: In Adult Icu Settings, Danielle Gonzalez

Nursing | Senior Theses

Background: Ventilator associated pneumonia (VAP) in adult intensive care patient units (ICU) is one of the most common and deadly nosocomial infections today. Studies have identified a gap in intensive care nurse ventilator education and compliance with hospital protocols. Overall increasing the rates of VAP and morbidity. Hospitals worldwide have shown a decrease in VAP rates after inheriting "VAP-bundles''. This includes nurse specific interventions and assessments as a preventative measure. However, studies failed to demonstrate which bundle interventions directly correspond to the prevention of VAP. Purpose: Address all components of education, a nurse’s ability to properly identify and understand the …

Enhancing Mental Health Support And Reducing Burnout In Nursing: A Holistic Approach, Alexa Miller, Andrea Quintela

Nursing | Senior Theses

Urgent action is needed to strengthen mental health support for nurses experiencing burnout. This thesis examines the stigma surrounding burnout in the nursing community and implements holistic approaches to alleviate burnout of those affected. Integrating mental health awareness, mindfulness-based interventions, personal self-care, and supportive hospital practice can decrease nurse burnout. By first coming to terms with nurse turnover and further prioritizing nurses' physiological, emotional, and social welfare, leadership and organization can implement holistic strategies to address these diverse challenges nurses face. Through a deep dive into existing literature, relevant studies, and a blend of critical findings, this thesis emphasizes the …

Screening For Food And Nutrition Insecurity In The Healthcare Setting: A Cross-Sectional Survey Of Non-Medicaid Insured Adults In An Integrated Healthcare Delivery System, Carmen Byker Shanks, Nancy P Gordon

Faculty, Staff and Student Publications

OBJECTIVES: Healthcare screening identifies factors that impact patient health and well-being. Hunger as a Vital Sign (HVS) is widely applied as a screening tool to assess food security. However, there are no common practice screening questions to identify patients who are nutrition insecure or acquire free food from community-based organizations. This study used self-reported survey data from a non-Medicaid insured adult population approximately one year after the start of the COVID-19 pandemic (2021). The survey examined the extent to which the HVS measure might have under-estimated population-level food insecurity and/or nutrition insecurity, as well as under-identified food and nutrition insecurity …

Creating The New Normal: A Historical Approach To Understanding Marketing Agility And Its Implications Across Business, Healthcare, And Social Welfare In A Post Pandemic World, Elan Burton, Delancy Bennett, Linda Burton

Atlantic Marketing Journal

The purpose of this article is to expand our understanding of how marketing agility shapes business, healthcare, and social welfare policy and societal responses to global pandemics. We set the stage for this discussion by presenting an historical exemplar case of marketing agility during the 1918 Influenza pandemic in the US. Next, we outline a necessary conceptual revision and update to previous treatments of marketing agility relative to historical pandemics considering the recent COVID-19 pandemic. Our novel conceptualization focuses on a firm’s (business, healthcare, social welfare) prompt response to dynamic and turbulent circumstances beyond the control of the firm (Araújo …

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.

Optimizing Ventilator-Associated Pneumonia Prevention And Education: In Adult Icu Settings, Danielle Gonzalez

Nursing | Student Research Posters

Background: Ventilator associated pneumonia (VAP) in adult intensive care patient units (ICU) is one of the most common and deadly nosocomial infections today. Studies have identified a gap in intensive care nurse ventilator education and compliance with hospital protocols. Overall increasing the rates of VAP and morbidity. Hospitals worldwide have shown a decrease in VAP rates after inheriting "VAP-bundles''. This includes nurse specific interventions and assessments as a preventative measure. However, studies failed to demonstrate which bundle interventions directly correspond to the prevention of VAP. Purpose: Address all components of education, a nurse’s ability to properly identify and understand the …

Evaluating The Impact Of Simulation On Perceived Knowledge And Confidence Of New Graduate Nurses (Ngns) In Maternal-Newborn Care, Disa Seymour

DNP Scholarly Projects

Abstract

Background: Nursing education worldwide varies in duration and training process, with nurses often facing rapid immersion into patient care complexities when entering the workforce. While new nurses contribute significantly to the nursing community with contemporary knowledge, their transition to practice can be daunting, necessitating support for both competence and retention. As specialty care settings integrate more new graduate nurses (NGNs) to address workforce shortages, collaboration between leaders and educators becomes crucial. Simulation emerges as a vital tool in building confidence while learning, offering a safe space for skill development and growth of confidence.

Purpose: This project’s objective was to …

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. …

Creation Of A Structured Rapid Response Team And Early Rrt Activation, Elizabeth Amaka Azie

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Cardiac arrest, unanticipated admissions to the intensive care unit (ICU), and mortality account for about 50% of serious inpatient adverse events (Ko et al., 2020). Efforts to prevent in-hospital cardiopulmonary resuscitation (CPR) require a system to identify deteriorating patients and include an appropriate interventional response, such as a rapid response team (Andersen et al., 2019). A well-structured rapid response team (RRT) has five categories that include team structure, organizational culture, expertise, communication, and teamwork (Jackson, 2017). A community hospital in Texas has been challenged in its attempts to have a well-structured RRT and had an increase in cardiac arrest. A …

Impact Of A Discharge Bundle On Boarding Hours In Acute Care Hospitals, Monica L. Herrera

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

The national epidemic of boarding hours in the emergency departments prompted the implementation of a discharge bundle in an acute care hospital. This bundle included an ADT nurse, discharge orders written prior to 11AM, and EVS shifting employee hours. Initial findings indicated a reduction in boarding time by 126 minutes.

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. …

Developing Toolkit For Adults With Autism Spectrum Disorder In An Oncology Outpatient Clinic, Brittany J. Johnson Dnp, Fnp-C

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Autistic adults are at higher risk of being diagnosed with co-occurring health conditions, and yet they are a vulnerable group for disparities in access and outcomes. One of the key barriers to better outcomes is poor patient-provider communication. This study the use of AASPIRE’s AHAT communication toolkit as a channel between healthcare workers and autistic adults to facilitate their appointments within the outpatient oncology department, as well as assessing healthcare providers’ knowledge and self-efficacy in caring for the patients. Sixteen healthcare providers (12 registered nurses and four patient care assistants) completed pre and post intervention surveys and utilized the AHAT …

Impact Of Repeated Reimbursement Penalties On Hospital Total Quality Scores, Alice Brewer, M. Courtney Hughes, Kunal N. Patel

Faculty Articles, Papers, and Other Scholarship

Objectives

The incidence of hospital-acquired conditions (HACs) is a serious public health issue with implications ranging from patient morbidity and mortality to negative financial impacts on patients and health care systems. Despite substantial efforts to address and reduce HACs, research into the effect of quality improvement programs is inconclusive. This study seeks to better understand the relationship between repeated reimbursement penalties and improvement in HAC quality scores.

Methods

A quantitative comparative analysis of U.S. health care data was conducted. Data on quality outcomes and hospital characteristics were sourced from the Hospital-Acquired Condition Reduction Program from fiscal years 2018 and 2019 …

Ob-Pdcds Chinese, Marianne E. Weiss, Lili Wei

Post-Discharge Coping Difficulty Scale (PDCDS)

The Readiness for Hospital Discharge Scale, Quality of Discharge Teaching Scale, and Post-Discharge Coping Difficulty Scale were developed by Dr. Marianne Weiss to measure nurse-sensitive discharge care processes and patient outcomes. Three versions of the scales were developed concurrently for different patient populations – Adult medical-surgical patients, Parents of hospitalized children, and Postpartum Patient mothers (see Weiss & Piacentine, 2006, Weiss et al., 2007, and Bobay et al., 2018 for description of the development and initial testing). Additional scales and information about translation rights are located at Marquette Nursing.

PERMISSION TO USE

The Readiness for Discharge Scale, Quality of Discharge …