Public Health Commons^™

The Lived Experience Of Acute Stroke Advanced Practice Registered Nurses (Aprn) Working In Expanded Roles: A Mixed Methods Study, Terri-Ellen Kiernan

Theses and Dissertations (ETD)

Introduction. Nurse practitioners have made credible gains through the six decades since inception to cover the growing need for outpatient family care. Nurse practitioners are now working in all aspects of medicine by continuing to fill gaps with healthcare needs that persist due to physician shortages. Stroke neurology is a medical specialty plagued by a shortage of physician specialists in hospital acute care which can limit acute stroke diagnosis and treatment capabilities. Stroke nurse practitioners (SNP) are vascular neurology trained specialists who fill relatively new hospital roles to assume traditionally physician-based responsibilities in an expanded role. This study aims to …

The Department Of Health Wants To Know What You’Re Up To, Lance Plunkett Jd, Llm

The New York State Dental Journal

On May 3, 2023, Gov. Hochul signed into law, as part of the enacted New York State Budget, a new Article 45-A of the New York State Public Health Law known as the “Material Transactions Law.” The law took effect on Aug. 1, 2023, but it awaited promised guidance on its application and enforcement from the New York State Department of Health. In March, adhering to its usual torpor, the Department of Health finally issued such guidance. The law basically requires reporting certain transactions, like practice acquisitions, mergers and sales, to the Department of Health.

The Impact Of Discretion On Human Service Workers Supporting The Health Of Unaccompanied Minors In Foster Care, Diana M. Clark

Senior Theses

Unaccompanied children (UCs) are a vulnerable population that enters government custody and accesses healthcare via the Office of Refugee Resettlement (ORR)'s system of care. While prior research has focused on generating policy recommendations to improve healthcare services available to UCs both in ORR custody and following release from custody, this thesis will instead expand upon the experiences of staff members working at ORR-contracted agencies. These workers make decisions that have short- and long-term implications on the health and wellbeing of UCs. Drawing from 65 in-depth interviews with human service workers in ORR-contracted voluntary agencies, this thesis uses street-level bureaucracy framework …

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. …

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 …

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 …

Analisis Faktor Penyebab Komplain Pasien Pada Pelayanan Rawat Inap: Studi Kasus Di Rumah Sakit X Tahun 2024, Tasmiati Manzilah, Risky Kusuma Hartono

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Complaints from patients are often used as an indicator of the quality of health services. The causes of complaints from inpatients are related to factors that cause dissatisfaction or discomfort experienced by patients during their hospitalization. This study aims to see the causes of patient complaints about inpatient services. In addition, researchers also examine the relationship between several variables and complaints and analyze further to determine the main factors causing complaints from patients about inpatient services. This study uses a sequential explanatory approach. The study design is cross-sectional for inpatients at Hospital X who are willing to be respondents and …

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 …

Evaluasi Implementasi Manajemen Rumah Sakit Dalam Upaya Peningkatan Rating Google Customer Review Di Rumah Sakit Karisma Cimareme Tahun 2023: Pendekatan Teori Servqual Dan Donabedian, Patriot Haryo Trenggono, Adang Bachtiar

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

This study aims to evaluate the management of Karisma Cimareme Hospital in addressing its low Google Customer Review ratings. Initial data shows that KCH received an average rating of 2.9 stars, lower than two other private hospitals in West Bandung Regency, IMC Hospital with 3.1 stars and Cahya Kawaluyan Hospital with 4.1 stars. Using the SERVQUAL framework, which includes the dimensions of tangibles, empathy, responsiveness, reliability, and assurance, along with Donabedian's theory, this study focuses on improving service quality through the implementation of Standard Operating Procedures (SOP). The research method involved direct observation of hospital services, in-depth interviews with hospital …

Analisis Peran Case Manager Dalam Kendali Mutu Dan Kendali Biaya Pelayanan Rawat Inap Bedah Di Rumah Sakit Universitas Indonesia Tahun 2022, Natasya C. Viano, Purnawan Junadi

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Patient Service Management is carried out by the case manager to create quality services with efficient cost. This study aims to evaluate the role of case managers in quality and cost control of surgical inpatients with JKN assurance at the UI Hospital in 2022. This study uses the concept of Donabedian and KARS guidelines. Quality control is seen from Length of Stay (LOS), patient satisfaction, compliance with clinical pathway, compliance with doctor visits, and delays in elective surgery. Cost control is seen from the difference between INA-CBG's claims and hospital bills and cost formulations. Secondary data were collected from medical …

Analisis Deskriptif Tentang Strategi Mutu Pelayanan Kandungan (Obstetri Dan Ginekologi) Di Rumah Sakit Islam Nu Demak, Akhmad Safi’I, Abdul Aziz

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) in Demak Regency are still high. In 2023, the MMR was 13 cases or 67 per 100,000 live births with a delivery rate of 18,784. The 2023 IMR data reached 7.2 per 1000 live births. The still high MMR and IMR and the socio-cultural market conditions of Demak, which are religious, are very relevant to the need for integrated superior services. Especially in Obgyn, perinatal, and child services. The Islamic Hospital (RSI) NU Demak is present through comprehensive, superior Obgyn services with a trend in patient visits that continues to …

Strengthening Legal Frameworks And Patient Safety: A Narrative Review Of Medical And Dental Malpractice In Indonesia, Ghulam Mustafa, Ede Surya Darmawan

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Many cases of medical and dental malpractice in Indonesia are still related to patient safety and healthcare quality. This narrative review aims to identify solutions that can be implemented. The main focus is to compare the incidence of malpractice in clinical medical and dental practice, emphasizing legal implications, coverage, and internal organizational issues. A systematic literature search was conducted through databases such as Pubmed, ScienceDirect, Google Scholar, Springer, Garuda, and other online databases. Articles published no later than 2024. Eleven studies were selected that discussed the problem of malpractice in Indonesia. Independent screening and critical appraisal were carried out to …

Acute Care For Elders Unit Implementation At Banner Health: A Quality Improvement Analysis, Jacob Lahti, Tony Gaidici, Shreya Bharath, Esha Saraswat, Nimit Agarwal

Annual Research Symposium

There is an increasing need to optimize hospital care for older adults as Age Friendly Health Systems (AFHS) become increasingly popular. Geriatric patients may often be subject to extended hospital stays, which can result in functional decline, increases in hospital-acquired injury, infections, and neurocognitive deterioration. Early acute inpatient rehabilitation (IRF) is known to improve functional optimization of older adults as compared to therapy in a skilled nursing facility (SNF). In this study we demonstrate the effect of a structured program based on the 4Ms of AFHS in our newly established Acute Care for Elders (ACE) unit, a first in Arizona. …

The Opportunities And Barriers Surrounding The Use Of Digital Health And Telemedicine In Sub-Saharan Africa, Aveline Langmead, Afua Osei-Wusu, Erica Tutuwan, Sara Mcmahon, Porter Biggs

Annual Research Symposium

No abstract provided.

One Center's Experience Of Pulmonary Embolism After Covid-19: Impact Of Vaccination Status, Cara Gose, Kaylee Dixon, Andrea M. Bodine Md

Advances in Clinical Medical Research and Healthcare Delivery

Background: The incidence of pulmonary embolism (PE) has increased since the outbreak of the COVID-19 pandemic and may be due to the observed hypercoagulable state. There is conflicting evidence that thromboembolism risk increases after vaccination and that vaccines decrease the probability of having a thromboembolic event. This study aimed to explore how vaccination status impacts occurrence of PE after a positive COVID-19 test. The hypothesis was that vaccinated, immunocompetent patients have a lower incidence of PE after COVID-19 compared to unvaccinated patients.

Methods: This was a retrospective chart review at a teaching hospital in New England from 1/01/2021 to 3/31/2023 …

Clinician Attitudes And Experiences In Screening Patients For Social Determinants Of Health Using Prapare, Pranav Rane, Mathew B. Weimer M.D., Adam Baus

Journal of Appalachian Health

Introduction: Social Determinants of Health (SDOH) are the conditions in which people are born, grow, live, work, and age. SDOH significantly influence health outcomes; as such, healthcare systems should screen for patients’ social needs. PRAPARE is standardized screening tool designed to assess and address patients’ social needs.

Purpose: This study examines SDOH screening at Valley Health Systems, a federally qualified health center based in Huntington, West Virginia. The aim of this research is to assess clinician attitudes and experiences in using the PRAPARE tool to screen for SDOH.

Methods: A self-administered online survey was conducted from April to May 2022 …

Implementation Of Endometriosis Toolkit: A Quality Improvement Project To Enhance Nurse Practitioners’ Knowledge And Management, Hasbun Rachel

DNP Qualifying Manuscripts

Abstract

Background: Endometriosis, characterized by the ectopic growth of endometrial-like tissue, affects approximately 11% of reproductive-aged women in the United States. Diagnosing endometriosis is challenging due to its diverse clinical presentations, reliance on laparoscopic procedures, absence of biomarkers, and limited awareness among healthcare providers and patients.

Local Problem: The diagnostic complexity of endometriosis, compounded by reduced provider awareness and a lack of comprehensive resources, leads to delayed and suboptimal care for affected women.

Methods: This Doctor of Nursing Practice quality improvement project aimed to enhance nurse practitioners’ (NPs) knowledge and management of endometriosis through a 1-hour educational session at the …

Lessons Learned From The Covid-19 Pandemic Crisis Management In The Gaza Strip: A Qualitative Study., Belal Aljamal

Journal of the Arab American University مجلة الجامعة العربية الامريكية للبحوث

Aims of the study: The main aim of this study was to discover the lessons learned from the COVID-19 pandemic crisis management from health policymakers' perspective in the Gaza Strip. Methods: The researcher used a qualitative design, targeting 25health policymakers using a purposeful sampling technique and face-to-face semi-structured interviews to collect data. To analyze the interview data, the directed qualitative content analysis approach was used.

Results: All interviewees agreed that the Palestinian Ministry of Health (MoH) managed the COVID-19pandemic well despite the insufficient resources and lack of experience. More specifically, the average of most participants’ assessments of Palestinian MoH “Preparedness” …

Factors Associated With Std Hospital Admissions In South Carolina Hospitals (2020-2024), Darrell Holmes, Dennis Besong

South Atlantic Division GME Research Day 2025

No abstract provided.

Sistemas De Salud Público Y Privado En El Salvador, Ana Ledford

World Languages and Cultures Senior Capstones

This paper analyzes El Salvador’s healthcare system, divided into public and private sectors. The public system, managed by the government, provides accessible healthcare for most of the population, though it faces issues like long wait times. In contrast, the private sector offers faster, specialized services for those who can afford them. The study discusses the strengths and weaknesses of each system, highlighting the need to enhance public healthcare and address access disparities. Solutions include increasing healthcare facilities in underserved areas and fostering collaboration with national and international organizations to improve overall healthcare quality for Salvadorians.

Poner En Práctica Las Regulaciones Federales: Habilitando A Los Pacientes Dominio Limitado Del Inglés, Caitlyn Gailey

World Languages and Cultures Senior Capstones

This paper examines the gaps in the U.S. healthcare system that affect the Hispanic community, focusing on language barriers and cultural competence. It highlights the challenges faced by Limited English Proficiency (LEP) patients, who may struggle with medical terminology, leading to misdiagnosis and improper treatment. The paper advocates for culturally sensitive language services, including qualified interpreters, translated documents and signage in order to improve communication, patient satisfaction, and reduce medical errors. It calls for systemic changes to ensure equitable care for all patients, regardless of language or cultural background.

Burnout In The Emergency Room: Corrective Measures Vs. The Absence Of Solutions, Zane Walters, Zachary Woodall

Theses, Dissertations and Capstones

Introduction: Physician burnout has become an increasingly prevalent and critical issue in healthcare systems worldwide, particularly among emergency room physicians who face high-stress, high-demand working conditions. Burnout manifests as emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment, leading to negative outcomes for physicians’ mental health, job satisfaction, and overall career longevity. This phenomenon not only threatens the well-being of physicians but also compromises patient care quality and contributes to costly turnover within healthcare organizations.

Purpose of the Study: The aim of this study was to systematically investigate the impact of burnout interventions on emergency room physicians. …

Evaluating The Effectiveness Of Teledermatology For Undeserved Populations During And Post-Covid-19, Jakob Gibbs, Sean Hanshaw

Theses, Dissertations and Capstones

Introduction: Teledermatology, a subset of telemedicine, has gained prominence as a means to increase access to dermatologic care while reducing costs and improving patient satisfaction. The swift expansion of teledermatology during the COVID-19 pandemic was driven by the necessity to limit physical contact and adapt to public health restrictions. This technological shift aimed to address longstanding disparities in dermatology access, especially in rural and underserved populations, and to respond to the rising demand for dermatologic services amid provider shortages.

Purpose of the Study: The purpose of this study was to analyze the effects that teledermatology following the COVID-19 pandemic had …

Addressing The Opioid Epidemic Across The United States And In West Virginia, Kailyn Smith, Addison Hughes

Theses, Dissertations and Capstones

Introduction: The opioid crisis had a profound impact on public health across the United States and West Virginia, with overdose deaths reaching unprecedented levels by 2021. Traditional abstinence-only rehabilitation programs demonstrated limited success, largely due to high relapse rates and insufficient mental health support. These programs often overlooked the complex relationship between opioid addiction and co-occurring mental health disorders such as depression and anxiety, which are common among those with substance use disorders. In contrast, Medication-Assisted Treatment (MAT), when supplemented with behavioral therapies and antidepressant medications, has shown greater success in improving recovery outcomes and reducing relapse rates. This …

Neurosurgical Praxis Guidelines During The Covid-19 Outbreak. Consensus-Based On Currently Available Literature., José Antonio Soriano Sánchez, Bárbara Nettel Rueda, José Alberto Israel Romero Rangel, Armando Alpizar Aguirre, Miguel Ángel Andrade-Ramos, Ulises García Dr., Diego Mendez Rosito, Jorge A. Santos, Sara Patricia Pérez Reyes, Julian Eduardo Soto Abraham, Jose E. Valerio Pascua, Marco Antonio Barajas Romero, Eduardo Díaz Juárez, Alma Griselda Ramírez Reyes, Maria Elena Gonzalez, Claudia Katiutska González Valdez, Félix Domínguez Cortinas, Noé Santiago Ramírez, Tenoch Herrada Pineda, Manuel Eduardo Soto García, Edgar Nathal Vera, Gustavo Melo Guzmán

Archives of Neurosurgery

INTRODUCTION: The World Health Organization recommended several strategies to contain the COVID-19 pandemic, including optimization of care for all patients, especially the seriously ill. Given the strain, the pandemic has posed on healthcare systems around the world, many neurosurgical associations have provided triage recommendations for patients to save resources for the pandemic. We aimed to provide practical recommendations based on specific illnesses requiring surgical procedures commonly performed by neurosurgeons on a life-threatening basis of patient illness. We consider this guideline will help neurosurgeons for the appropriate triage of patients on a daily-situation basis during this pandemic.

METHODS: The Mexican Society …

Systemic Challenges In Pediatric Healthcare: Exploring Reimbursement Disparities And Their Impact On Healthcare Equity, Jessica Ford-Davis, Alexandra Gillette

Theses, Dissertations and Capstones

Introduction: Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP) have provided health coverage for over 135 million Americans, with Medicaid playing a significant role in financing pediatric healthcare. Medicaid covers a wide range of services for children, particularly those from low-income families or with special healthcare needs, including preventive care, immunizations, vision and dental services, and mental health treatments. However, Medicaid reimbursement rates are lower compared to Medicare and private insurance, in some cases 30.6% lower, and have often been insufficient to cover the full cost of care, contributing to financial losses for children's hospitals. Despite these challenges, nearly …

Improving Knowledge And Confidence Of Family Nurse Practitioners In Offering The Hpv Vaccine, Leni Terano Fisher

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Introduction

Despite the recommendations of the United States Advisory Committee on Immunization Practices, HPV immunization lags behind other routine vaccines by up to 31%. Although there are many reasons for the low vaccine rate, provider hesitancy and lack of confidence significantly contribute to suboptimal HPV vaccine uptake.

Objectives

This project aimed to utilize evidence-driven interventions to increase family nurse practitioners' (FNPs) knowledge and confidence in offering the HPV vaccine.

Methods

Participants were given pre- and post-questionnaire surveys. The Wilcoxon Rank Test was used to compare, quantify, and measure the results of the eight-week data collection.

Results

The subjects were …

A Quality Improvement Approach To Reducing Post-Surgical Acute Care Falls, Tiffany C. Mitchell

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Inpatient falls remain one of the most preventable adverse events in hospitals. Falls result in serious injuries and increasing healthcare costs. This quality improvement project evaluates the implementation of Fall TIPS to reduce fall incidence and promote sustainable safety practices.

Improvement In Prenatal Education And Involvement In Patient Care, Miranda Ibrahim, Christelle Reeves, Timothy Kremer

North Texas Research Forum 2025

BACKGROUND: While the attempt is to educate the patient (and their family members) and empower them in their medical decision making, integration of birth plans and discussion of such plans is not routinely implemented by most obstetrical providers. There is currently no standardized approach to the education and birth plan development/or the obstetrical patients. The goal of this project, therefore, is to develop a standardized approach to discussion of birth plans and, albeit indirectly, allow for an opportunity for education for obstetrical patients. METHODS: On a daily basis, through birth plan discussions with patients during routine obstetrical visits, and via …

Increasing Pediatric Asthma Follow-Up Visits And Decreasing Emergency Department Visits In A Primary Care Setting, Rima M. Basal

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

The implementation of the asthma follow-up visits bundle in the pediatric primary care setting is an evidence-based practice project aimed at improving pediatric asthma management. This manuscript discusses the deployment of the bundle, which includes pre- and post- knowledge assessment for parents/caregivers, asthma education through a short video and handout, administration of the asthma control test (ACT), completion of a written asthma action plan (WAAP), and education about the patient portal and telehealth. The goal is to improve parent/caregiver knowledge, treatment adherence, follow-up visit compliance (in-person or virtual) and reduce emergency department (ED) utilization. Parent/caregiver knowledge increased by 23%, ACT …