Evidence-Based Best Practice Toolkit For Social Determinants Of Health: A Program Evaluation Review, Bryleigh Berry

Student Scholarly Projects

Despite an increase in healthcare expenditure, racial and ethnic disparities remain a substantial concern among adult primary care patients in the United States. This is largely due to the focus on medical intervention and disregard for the underlying factors that contribute significantly to health outcomes such as economic stability, educational access and quality, healthcare access and quality, neighborhood and built environment, and social and community context. The PICOT question that guided this program evaluation review project is: In adult clients seeking care at a primary care clinic (P), how does a SDOH toolkit based on the CDC framework (I) compared …

Asking The Question ‘What Matters To You?’ In A London Intensive Care Unit, Harriet Pittaway, Laura White, Karen Turner, Angelique Mcgillivary

Journal of Patient-Centered Research and Reviews

Purpose: At the heart of the paradigm shift in approach to patient care from paternalism toward shared decision-making lies the international “What Matters To You?” (WMTY) movement. However, WMTY principles are not frequently applied to the critical care setting. The aim of this quality improvement project work was to design and integrate a tool for all patients admitted to the intensive care unit (ICU) that helped answer WMTY.

Methods: Using Plan-Do-Study-Act (PDSA) methodology across 8 cycles, a multidisciplinary team designed and integrated a bedside poster into the ICU. Quantitative and qualitative data were collected via a bedside audit process on …

A Nurse Is To A Patient What A Mother Is To A Child, Farhan S. Imran

Advances in Clinical Medical Research and Healthcare Delivery

A physician's tribute the profession of nursing.

A Survey To Highlight Areas Of Focus For Patient Care In Settings Utilizing Medical Interpretation, Azayzel Deregis

Undergraduate Honors Theses

This thesis recounts my personal experience working as a volunteer medical interpreter for the Language and Culture Resource Center at East Tennessee State University. The result of my time spent volunteering as a medical interpreter, shadowing professional medical interpreters, and witnessing patient-provider interactions during interpreted sessions was an inspiration to study medical interpretation further and delve into the challenges faced by patients who require medical interpreters. During my time researching this topic, I found that the United States is severely lacking in Spanish medical interpreters—with some healthcare facilities employing no medical interpreters—even though the size of the Hispanic population is …

When "First, Do No Harm" Fails: A Restorative Justice Approach To Workgroup Harms In Healthcare, Pedro L. Flores

Dissertations

In healthcare, workgroup mistreatment is a pervasive problem that begins during medical education (medical and nursing school) and becomes embedded in the “hidden curriculum of professionalism,” which dissuades and even punishes learners for talking about abuse they witness. Furthermore, the mistreatment of healthcare providers (HCPs) pervades all disciplines in the healthcare delivery chain due to a combination of cultural factors, systemic pressures, dysfunctional hierarchies, and leadership’s tolerance of intimidating and disruptive behaviors. Not surprisingly, 18% of U.S. HCPs have left the medical field since the start of the COVID-19 pandemic, and burnout, stress, anxiety, and increased workloads have been identified …

Wellness Review 2021, Part 2, Brian A. Ferguson, Martin Huecker

Journal of Wellness

Introduction: This article presents Part 2 of the biannual JWellness Review of literature from 2021 (July – December). We emphasize new science and resilience initiatives published outside of JWellness that seek understanding of burnout and thriving among healthcare professionals (HCPs).

Methods: For the interval of July 1 to December 30, 2021, PubMed was queried for empirical and observational research studies, review articles, guideline summaries, letters, and editorials. Of 93 results, we reviewed methods and salient points to arrive at a final list of 48 articles for inclusion.

Literature in Review: Common themes that emerged included teamwork, EMR optimization, group decompression, …

Full Practice Authority: Determining Readiness Among Nurse Practitioner Students In Mississippi, Betty Hoffman

Doctoral Projects

Full practice authority has been granted to nurse practitioners by many states. These practitioners are educated and trained as full primary providers of health care. Full practice authority for nurse practitioners is not granted in Mississippi, which currently ranks in the lowest positions for health care in the United States. The low ranking can be attributed to a lack of providers and access to services.

This project seeks to explore attitudes and understanding of nurse practitioner students in the State of Mississippi regarding full practice authority. A survey will be electronically distributed to determine what is already known and understood …

Communicating Comfort In Crisis: A Literature Review On Overcoming The Emergency Room Environment To Foster The Nurse-Patient Relationship, Faith G. Davenport

Senior Honors Theses

The average emergency room patient is not receiving the compassionate nurse-patient communication that patients experience on other hospital floors. Fewer positive nurse-patient interactions prompt patients to state that they feel uncomforted and dissatisfied on hospital exit surveys, inciting hospital management to investigate how to reverse this trend to retain their federal funding. Emergency room nurses cite multiple barriers inherent in their work environment that prevent them from building rapport with their patients, including a layout not conducive to private conversations, strict time constraints, and a fluctuating workload. Working for a prolonged period under these conditions is driving many nurses to …

The Last Conversation, Muhammad Ismail Khalid Yousaf

Journal of Wellness

The brain-death exam is one of the most sensitive undertakings for a physician, especially a neurologist, because of its social and legal implications. It is the vital examination establishing a clear lack of meaningful vitals, allowing a family to mark the end of a journey and a life finally complete. Physicians who perform and establish this death-decision must ensure they are au courant with the family's sentiments and concerns. It would behoove this obligated physician to bear in mind that it is a human being who will go through this invasive and rough exam. This comatose person is a father …

Implementation Of A Drive-Through Covid-19 Mass Vaccination Site: Experiences From Louvax–Broadbent In Louisville, Kentucky, Ruth Carrico, Sarah Beth Hartlage, Valenchia Brown Msn, Aprn, Fnp-C, Sarah M. Bishop, Luanne Didelot, William Hayden, Beverly Williams Coleman, Sarah Tan, Delanor Manson, Kellie Kane, Dawn Balcom, Paul Kern

The University of Louisville Journal of Respiratory Infections

Background: Response to the COVID-19 pandemic has required innovative approaches to vaccination, including methods to rapidly and safely immunize communities. A major challenge to such a response involved access to untapped healthcare worker resources. The Louisville, Kentucky, response involved the use of a large volunteer workforce to supplement local public health employees in planning and implementing a large-scale drive-through vaccination event. The objective of this manuscript was to outline processes involved in training a mass immunization workforce and implementating a large-scale COVID-19 community vaccination.

Approach: Competency-based and standardized training was provided for every volunteer before working their shift. Volunteers worked …

A Call To Create: Poetry As Healing And One Nurse’S Self-Discovery, Kim Cornett Henry, Kim Cornett Henry

English Theses

Florence Nightingale’s vision for nursing has changed greatly in the past one hundred and fifty years, with nursing’s identity replaced with an emphasis on science over caring. The fast-paced, technologically sophisticated environments, designed to meet the declining health of an American public, have resulted in nurses who are being pulled away from nurse-to-patient caring acts and the reasons they felt called to become nurses. These changes have had detrimental psychological and emotional effects on nurses and are especially evident in Intensive Care nurses. Expressive writing as poetry, autoethnography, and participation in vibrant writing communities offer nurses experiences for healing, voice, …

Student Pharmacists’ Emotional Responses And Coping During The Covid-19 Pandemic, Hannah E. Johnson, Deaundre Bumpass, Aric Schadler, Jeffrey Cain

Journal of Wellness

Introduction: Health professions students, including student pharmacists, have been impacted by the coronavirus disease 19 (COVID-19 pandemic) as schools have transitioned to remote learning and cancelled milestone events. During times of crises, media consumption and hobby participation also impact well-being. The adverse emotional responses and coping strategies of student pharmacists amidst the COVID-19 pandemic have not been evaluated, nor have factors that may contribute to emotional responses. The purpose of this study is to determine Doctor of Pharmacy students’ emotional responses and coping precipitated by the COVID-19 pandemic, and the influence of media use, working status, and participation in hobbies. …

Rebuilding A Foundation Of Trust: A Call To Action In Creating A Safe Environment For Everyone, Cynda H. Rushton, Laura J. Wood, Karen Grimley, Jerry Mansfield, Barbara Jacobs, Jason A. Wolf

Patient Experience Journal

Well before the COVID-19 pandemic, incivility and physical threats directed toward healthcare employees and often registered nurses was a growing concern by Chief Nurse Executive (CNE) leaders. In 2019, conversations initiated by The Beryl Institute’s Nurse Executive Council (NEC) to consider how best to achieve a much-needed balance between patient/family and staff safety have now become a critical priority to ensure the safety of everyone receiving and providing health care services. The heart of this work was organized around a set of newly developed ethical precepts designed to guide the exploration of key concepts. A call to action grounded in …

Demographics, Activities, And Environmental Factors Impact Burnout In A National Survey Of Emergency Medicine Residents, Nicole Battaglioli, Tim P. Moran, Simiao Li-Sauerwine

Journal of Wellness

Introduction: Burnout in emergency medicine and in residency training has been well-described. The impact of demographic, individual, and programmatic factors on burnout have not previously been determined in a national survey of emergency medicine residents. This study aimed to identify personal and environmental factors impacting resident burnout in a national sample of emergency medicine residents.

Methods: A prospective Emergency Medicine Resident Wellness Survey was administered in 2017. We surveyed respondents on demographic, personal, and environmental factors; each respondent also completed the Maslach Burnout Inventory - Human Services Survey. Linear regressions were used to identify variables associated with the Maslach Burnout …

The Ways In Which Women’S Suffrage Affected Healthcare, Madison M. Weber

The Review: A Journal of Undergraduate Student Research

The 19th Amendment had and continues to have a major impact on women’s healthcare in the United States. Prior to suffrage, women had little to no ability to voice their thoughts on and change policies that regarded their own health. This essay addresses the way in which the vote both directly and indirectly impacted healthcare; including workplace conditions, maternal and reproductive rights, racial disparities, political advocacy and healthcare, the different waves of feminism, and how this has all affected modern healthcare for women. From progressive articles being published in women's magazines, to the establishment of marital rape, to the availability …

Use Of Ecomaps In Qualitative Health Research, Veena Manja, Ananya Nrusimha, Harriet Macmillan, Lisa Schwartz Dr, Susan Jack

The Qualitative Report

Qualitative health research plays a central role in exploring individuals’ experiences and perceptions of wellness, illness, and healthcare services. Visual tools are increasingly used for data elicitation. An ecomap is a visual tool that applies ecosystems theory to human communities and relationships to provide an illustration of the quality of relationships. We describe the use of ecomaps in qualitative health research. Searches across eight databases identified 407 citations. We screened them in duplicate to identify 129 publications that underwent full text review and included 73 in the final synthesis. We classified and summarized data based on iterative comparisons across sources. …

Revealing Meaning From Story: The Application Of Narrative Inquiry To Explore The Factors That Influence Decision Making In Relation To The Withdrawal Of Life-Sustaining Treatment In The Intensive Care Unit, Fiona Foxall, Deborah Sundin, Amanda Towell-Barnard Phd, Mnursing, Beverly Ewens, Vivien Kemp, Davina Porock

Research outputs 2014 to 2021

This paper considers the effectiveness of narrative inquiry as a research method in collecting and analyzing stories from a purposive sample of intensive care nurses and doctors, regarding their perceptions of the factors that influence decision-making in relation to the withdrawal of life sustaining treatment. Delaying the withdrawal of treatment when it is clearly indicated, may result in unnecessary patient suffering at the end of life, distress for the family as well as moral distress for staff. In narrative inquiry participants’ first-hand accounts of their experiences are told through story; the focus of analysis is the story, with the story …

Cultural Competency Training For U.S. Army Security Force Assistance Brigade (Sfab) Brigade Medical Teams, Jacob Blount

Doctor of Nursing Practice Projects

The United States Army began standing up Security Force Assistance Brigades (SFAB) in February 2018. The Brigade Medical Team (BMT) is an 11-person, interdisciplinary Army National Guard team. National Guard Soldiers only have one weekend per month and two weeks of annual training per year to develop/maintain cultural competence. The researcher investigated the efficacy of the Cross-Cultural Competence Trainer (3CT) V2 course to develop and maintain cultural competency in BMT personnel. Pre-test results were obtained from three military medical personnel and a post-test immediately after the course. Participants completed a longitudinal test 28-31 days after the post-test. There was a …

The Crossroads Of Wellness And Second Victim Syndrome: Identifying Factors That Alter The Pathway Of Caregiver Recovery Following An Unanticipated Adverse Patient Outcome, Kimia Zarabian, A. Katharine Hindle, Ivy Benjenk, Anita Vincent, Jamil M. Kazma, Benjamin Shambon, Raymond Pla, Eric Heinz

Journal of Wellness

Introduction: Second Victim Syndrome (SVS) describes the phenomenon in which a caregiver experiences a traumatic psychological and emotional response to an adverse patient event or medical error. Using quantitative survey analysis, we aim to better understand the personal factors that affect SVS development and recovery.

Methods: Caregivers at a small urban academic medical center who had experienced an adverse patient event in the past six months were invited to take part in this institution-wide, voluntary, quantitative, cross-sectional study. Three surveys were administered; the Holmes-Rahe Life Stress Inventory (HRLSI) was used as a surrogate to measure stressful life events. The …

Promoting Recognition And Rescue: Human Trafficking Screening, Erin E. Pittman

MSN Capstone Projects

The exploitation of human beings is a serious public health concern (Centers for Disease Control [CDC] 2018). The United States Department of Justice (2018) defines human trafficking as an act of coercing a person’s labor services or commercial sex acts. Family Nurse Practitioners play a significant role in the identification of victims, especially those practicing in emergency departments. A majority of healthcare providers have yet to establish a standardized screening tool and there is little evidence regarding the impact these screening tools have in recognizing victims of human trafficking (Emergency Nurses Association, 2018). This alarming information brings about the clinical …

An Appraisal Of Nursing Informatics Research And The Influence Of The Unified Theory Of Acceptance And Use Of Technology, Diodemise Ovwasa

Library Philosophy and Practice (e-journal)

Abstract

The study recognized the importance of healthcare informatics in today’s dynamic health systems, and narrows down to how nursing informatics, a component of healthcare informatics, can provide efficient and effective healthcare delivery. Hence, underpinned by the unified theory of acceptance and use of technology (UTAUT), the study aimed at situating research activities on nursing informatics within existing studies that have applied the theory to investigate healthcare informatics in general. The study adopted a systematic review of literature to explored online databases: Google Scholar and Ebscohost from 2014 to 2019. The search returned a total of 205 articles for the …

Defining And Characterizing Frequent Attenders: Systematic Literature Review And Recommendations, Dip Shukla, Erik Faber, Brian Sick

Journal of Patient-Centered Research and Reviews

Purpose: To decrease cost and improve efficiency, health care organizations have focused on frequent attenders — patients with high health care utilization. Prior studies have investigated singular health care settings, used varying definitions of frequent attendance, and inconsistently identified factors correlated with frequent attendance. The purpose of this article is to suggest a uniform definition of frequent attenders for different health care settings and to determine factors correlated with frequent attendance.

Methods: This systematic review of three databases identified 2761 unique articles; 174 met inclusion criteria. Studies were analyzed for their definition of frequent attenders and factors associated with frequent …

Solutions To Address Frequent Hospital Attendance, Glenda Sundberg

Journal of Patient-Centered Research and Reviews

In this editorial, practical solutions and considerations in helping the most complex and at-risk patients in our health systems are discussed. These patients, sometimes referred to as health care “super-utilizers” in the literature, tend to be frequently seen and cared for in costly hospital and emergency department settings. Innovative care models that aim to bridge system gaps, achieve better health outcomes, and improve the well-being of both patients and providers are needed and should continue to be explored.

Optimist Prime- Emergency Medicine Residents Are An Optimistic Group, Nicole Battaglioli, Sarah Mott, Tim P. Moran, Simiao Li-Sauerwine, Matt Melamed

Journal of Wellness

Introduction: No study before has been conducted looking at the level of optimism and pessimism in emergency medicine residents and how it may be linked to resident burnout. This is the first national- level assessment of these personality factors.

Methods: This was a prospective survey study leveraging data obtained through the 2017 National Emergency Medicine Resident Wellness Survey, which included the Life Orientation Test-Revised (LOT-R). The Life Orientation Test-Revised (LOT-R) is a 10-item tool that measures levels of optimism versus pessimism.

Results: We found that the majority of our resident respondents scored in the moderate category of the LOT-R. Additionally, …

An Autoethnography Of A Registered Nurse Living With Chronic Undiagnosed Illness, Frances M. Ricker

Nursing ETDs

Abstract

This autoethnographic study examines a registered nurse’s experience living with chronic undiagnosed illness. The number living with undiagnosed illness is unknown and little is understood about living with chronic undiagnosed illness.

This analytic autoethnography (Anderson, 2006) used multiple data sources: my journal, medical history narrative, and artifacts including my handwork, examples of my father’s handwriting, and family photographs. Narrative analysis, thematic analysis, and visual analysis were conducted.

My experience of living with chronic undiagnosed illness was characterized by three themes that reinforced isolation: not knowing, loss, and hidden secret self. Family context evidenced diverse themes of not being believed, …

Finding Common Threads: How Patients, Physicians And Nurses Perceive The Patient Gown, Christy M. Lucas, Cheryl Dellasega

Patient Experience Journal

Evidence-based care is standard practice in medicine, but the patient gown has fallen outside the scope of scholarly research. The current gown renders a patient vulnerable, diminishing patients’ sense of identity, agency, and dignity with its one-size-fits-none design. The impact on providers is similarly neglected. Our objective was to explore how patients and providers derive meaning from patient gowns. A convenience sample at an academic medical center was interviewed utilizing a standardized framework developed by a medical student and two PhD-prepared researchers with experience in qualitative methods. The study was inductive in nature, seeking to understand perceptions of the patient …

Ethical Imperatives Critical To Effective Disease Control In The Coronavirus Pandemic: Recognition Of Global Health Interdependence As A Driver Of Health And Social Equity, George A. Gellert Md, Mph, Mpa

Journal of Health Ethics

Ethical imperatives critical to effective disease control in the coronavirus pandemic: Recognition of global health interdependence as a driver of health and social equity

George A. Gellert MD, MPH, MPA

ABSTRACT

Decades into the era of emerging infectious diseases, the 2019-2020 coronavirus pandemic has caught the world, and the United States in particular, poorly prepared to engage effective public health disease prevention and control measures. In part, this reflects poor public health planning, response, logistical preparation and pandemic readiness, and complacency by governments and disease control agencies. In terms of future responses to emerging infection pandemics, these deficiencies can be …

Assessment Of Structural Competency In Baccalaureate Nursing Students: A Descriptive Study, Elle J. Del Gallo

Senior Honors Projects, 2010-2019

Cultural competence has been investigated extensively in nursing education to better prepare nurses to care for individuals of diverse backgrounds. While developing cultural competence is important to address individual care needs, it may not address the social and structural factors that influence health. Structural competency describes the ability to assess not only cultural factors that affect health disparities, but also structural inequalities and stigmas that can alter a patient’s presenting symptoms and risk for certain diseases.

Wellness Review 2019, Part 1, Martin Huecker, Brian A. Ferguson

Journal of Wellness

Welcome to the first Journal of Wellness review of recent literature. Wellness leaders are aware that a literature search yields thousands of articles on burnout, less on wellness, and no consistent, reliable source of publication. This validates the mission of JWellness, to collect editorials and research in one location, free for all to read and publish, allowing dissemination to all healthcare professionals.

House Calls Are Reaching The Tipping Point — Now We Need The Workforce, Thomas Cornwell

Journal of Patient-Centered Research and Reviews

Home-based primary care (HBPC) improves the lives of high-cost, frail, homebound patients and their caregivers while reducing costs by keeping patients at home and reducing the use of hospitals and nursing homes. Several forces are behind the resurgence of HBPC, including the rapidly aging population, advancements in portable medical technology, evidence showing the value of HBPC, and improved payments for HBPC. There are 2 million to 4 million patients who could benefit from HBPC, but only 12% are receiving it. The number of these patients is expected to double over the next two decades. This requires a larger and better …