Public Health Commons^™

Establishing A Routine Process Of Medication Reconciliation In A Rural Primary Care Clinic To Address Unnecessary Polypharmacy In Patients 65 And Older, Jessica Kirkwood-Harp

Doctor of Nursing Practice Projects

Background: Medication safety by reducing the proportion of older adults who use inappropriate medications is a Healthy People 2030 goal (Office of Disease Prevention and Health Promotion, n.d.(a)). The research for this proposal supported an established medication reconciliation (MR) to reduce errors and adverse drug events (ADEs). Consistent MR is essential for patient safety and positive patient outcomes in rural outpatient primary care clinics, as these patients possess multiple comorbidities.

Purpose: This Doctor of Nursing Practice (DNP) quality improvement project (QIP) established a routine MR process within a rural primary care clinic with reduced unnecessary polypharmacy and decreased risk of …

Kinerja Rumah Sakit Dengan Pendekatan Balanced Scorecard (Bsc): Studi Kasus, Nabella Nabella, Wahyu Sulistiadi

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Regional General Hospitals as hospitals owned by local governments must provide the best service for the community, one way to assess the performance of the services provided is to use the Balanced Scorecard (BSC) method where this assessment does not only look at the financial perspective. but other aspects in the provision of health services to patients in hospitals. This study aims to see the results of the application of the use of the Balanced Scorecard (BSC) in the performance analysis of hospitals in Indonesia. This study uses a literature review method. Based on a study conducted by looking at …

Implementasi Lean Dalam Strategi Pemasaran Di Rumah Sakit Gigi Dan Mulut: Tinjauan Literatur, Arini Cyndwiana Prastiwi, Dumilah Ayuningtyas

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Hospitals as health services must make strategies in developing marketing activities so that they get a good response from the community. Oral and Dental Hospital (RSGM) is a health service that provides dental and oral health services in the form of prevention, treatment and recovery as well as providing emergency, outpatient, and inpatient services. The growing number of RSGM has forced health service management to plan the right marketing strategy to increase and maintain interest in patient visits. In addition, RSGM must also pay attention to service quality and cost efficiency. The benefits of lean in marketing can improve service …

Patient Safety Culture In Public General Hospitals: Literature Review, Rifa Fauziyyah, Masyitoh Basabih

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Background: The global prevalence of preventable adverse events in healthcare is a significant problem, with approximately 42.7 million annual accidents resulting in 23 million DALYs lost. Safety culture plays a crucial role in mitigating or exacerbating these incidents within hospitals. Objectives: To identify the results of the assessment of patient safety culture and the characteristics associated with patient safety culture in public general hospitals in various countries. Methods: This study was conducted between April-July 2021 utilizing a literature review approach using study searches through PubMed, Scopus, ScienceDirect, Google Scholar, and Garuda databases, and it discovered 17 papers from 2011-2021 that …

Pengembangan Sistem Pengajuan Cuti Online Pegawai Di Rumah Sakit Umum Anwar Medika, Eka Yusmanisari, Nur Andini Febrianti, Rhosita Dewi, Ulul Azmi

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The personnel department is the part in charge of handling the employee leave system. The employee leave system at Anwar Medika General Hospital is still done manually, using hardcopy documents or archives and not having a special database. This certainly affects the effectiveness and efficiency of work because officers have to input leave requests from many employees every day, which of course takes a long time to manage the data and adds to the workload of the staffing department. For that we need an information system that can handle these problems. The activities carried out aim to provide an overview …

Analisis Manajemen Risiko Pasien Jatuh Di Instalasi Rawat Inap Rsia Xyz Jakarta Timur, Rani Umina, Vetty Yulianty Permanasari

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The incidence of patients fall is a second big issue after the incidence of medication errors. Reducing the risk of falls is one measure of service quality that is the main focus of the Hospital. This study aims to analyze the risk management of inpatient falls at Woman and Children Hospital SMB in 2020 by using FMEA tool. This research is a qualitative study by using in-depth interviews, observation, document review, and FGD as data collection methods. The results of this study indicate that factors of patient fall which become high priority potential failure modes are found in the structure …

What Quantifies Good Primary Care In The United States? A Review Of Algorithms And Metrics Using Real-World Data, Yun Wang, Jianwei Zheng, Todd Schneberk, Yu Ke, Alexandre Chan, Tao Hu, Jerika Lam, Mary Gutierrez, Ivan Portillo, Dan Wu, Chi-Hung Chang, Yang Qu, Lawrence Brown, Michael B. Nichol

Pharmacy Faculty Articles and Research

Primary care physicians (PCPs) play an indispensable role in providing comprehensive care and referring patients for specialty care and other medical services. As the COVID-19 outbreak disrupts patient access to care, understanding the quality of primary care is critical at this unprecedented moment to support patients with complex medical needs in the primary care setting and inform policymakers to redesign our primary care system. The traditional way of collecting information from patient surveys is time-consuming and costly, and novel data collection and analysis methods are needed. In this review paper, we describe the existing algorithms and metrics that use the …

The Effectiveness Of Disinfection Protocols In Medical School Osteopathic Manipulative Medicine Labs., Harrison A. Patrizio, Riley Phyu, Thomas Boyle, Todd Schachter

Rowan-Virtua School of Osteopathic Medicine Departmental Research

CONTEXT: In light of the COVID-19 pandemic, healthcare-associated infections have taken center stage. Healthcare has adjusted workflows to accommodate for more robust disinfecting regiments to help protect the community. This has resulted in the need for medical institutions to reevaluate the current disinfection protocols down to the student level. The osteopathic manipulative medicine (OMM) laboratory provides an optimal avenue for assessing the effectiveness of medical students' ability to clean examination tables. With OMM laboratories having a high level of interaction, adequate disinfection is important for the health and safety of students and teaching faculties.

OBJECTIVES: This study will evaluate the …

Top 10 Things To Know About Falls In Older Adults, Alexander W. Zirulnik, Shan Liu

Journal of Geriatric Emergency Medicine

No abstract provided.

Feasibility Of Family Focused Obesity Screening In Primary Care, Adrianne Griffiths

Doctor of Nursing Practice Final Manuscripts

Background: Obesity is associated with serious medical conditions including diabetes, hypertension, and heart disease. It also contributes to decreased productivity at work and school, financial strain, and reduced quality of life.

Purpose of Project: To address this problem, a nurse practitioner-led screening and intervention program was piloted at a primary care clinic in southern San Diego. The tool provides a standardized method for screening individuals and their families for nutrition and physical activity deficits associated with obesity, as well as appropriate and effective interventions to prevent and manage obesity.

Methods: The Family Nutrition and Physical Activity (FNPA) screening tool is …

Using Drama Therapy To Foster Peer Support Among Nurse Leaders, Chyela Rowe

Expressive Therapies Dissertations

This study explored the use of drama therapy to support the social-emotional experiences of nurse leaders at a mid-sized regional hospital system in the Southeastern United States. Nurse leaders have experienced profound changes to their work environments in recent years and burnout has been at an all-time high among healthcare workers globally. Organizational supports for nurses and nurse leaders are both inadequate to meet the needs and under-resourced. The research questions explored 1) whether the drama therapy peer support initiative improved outcomes and 2) whether there was a significant relationship between measures, and 3) what nurse leaders described as facilitators …

Exploring The Relationship Between Nurse Supervisor’S Servant Leadership Behavior And Nursing Employee’S Self-Assessment Of Engagement And Burnout In Nigeria, Michael Otuwurunne

Seton Hall University Dissertations and Theses (ETDs)

Burnout is a problem among workers in Nigeria, especially among nurses (Ozumba, & Alabere, 2019). This study examined whether there was a significant relationship between the employee perception of the servant leadership behaviors of the nurse supervisor and the employee’s self-rating of burnout: exhaustion and disengagement, and servant leadership behaviors of the nurse supervisor, and engagement: vigor, dedication, and absorption. Exhaustion refers to an intensive physical, affective, and cognitive strain while disengagement refers to the distancing of oneself from one’s work, and experiencing negative attitudes toward the work object, work content, or one’s work in general (Demerouti et al., 2001). …

How Does Facilitation In Healthcare Work? Using Mechanism Mapping To Illuminate The Black Box Of A Meta-Implementation Strategy, Amy M Kilbourne, Elvin Geng, Ingrid Eshun-Wilson, Shannon Sweeney, Donna Shelley, Deborah J Cohen, Joann E Kirchner, Maria E Fernandez, Michael L Parchman

Faculty, Staff and Student Publications

BACKGROUND: Healthcare facilitation, an implementation strategy designed to improve the uptake of effective clinical innovations in routine practice, has produced promising yet mixed results in randomized implementation trials and has not been fully researched across different contexts.

OBJECTIVE: Using mechanism mapping, which applies directed acyclic graphs that decompose an effect of interest into hypothesized causal steps and mechanisms, we propose a more concrete description of how healthcare facilitation works to inform its further study as a meta-implementation strategy.

METHODS: Using a modified Delphi consensus process, co-authors developed the mechanistic map based on a three-step process. First, they developed an initial …

Health Disparities: Ranking Horry County's Most Disadvantaged Communities, Stephen Borders, Jacob Bradley, Mackenzie Cannon, William Hall

Public Health

Horry County is a rapidly growing region in South Carolina, with a diverse population of over 300,000 residents. Despite this growth, the county faces significant health challenges, including high rates of chronic diseases, such as diabetes and obesity, and a shortage of healthcare providers in certain areas. These challenges are exacerbated by the county's socio-economic disparities, with many low-income residents lacking access to basic health services. Our approach is to address these challenges by identifying the areas within the county with the greatest unmet needs, also known as disadvantaged communities. By identifying the needs of Horry County’s most disadvantaged communities, …

A Systematic Literature Review Of Telehealth For Health Equity In Pediatric And Women's Health Care: Promise Vs Reality, Sharanya Chandu

Honors Scholar Theses

Background: Telehealth interventions can transform the healthcare system to improve accessibility, quality of care, and outcomes for women’s obstetric health.

Objective: This literature review seeks to summarize current research to understand the effect of telehealth on women’s obstetrics and gynecology outcomes.

Methods: A literature review was conducted following the PRISMA methodology to identify a set of papers containing information related to obstetrics and maternal health. The search terms used identified telehealth or telemedicine interventions used for obstetric, maternal, or prenatal care from the period 2013-2023. 19 articles were identified and reviewed.

Results: The literature review considered three primary aspects from …

Ethical Considerations Of Clinical Research In Emergency Care Settings: A Review, Adith Velavan

Honors Scholar Theses

Emergency and acute care settings are some of the most volatile and high intensity areas of any healthcare operation. Better understanding of systems and treatments in these spaces are critical to improving outcomes for the high risk patients that are treated there. Clinical research serves as a cornerstone of modern medical research, and is critical to the further improvement of clinical care in these settings. This thesis serves to explore the ethicality of such research given the constraints of emergency medicine settings. Not only does this thesis provide a strong foundation regarding the history and current practices of clinical research, …

Medical Interpreters' Work Impact On Their Lives: Understanding Medical Interpreters' Work Experience, Nicholas M. Herrarte Smith

Senior Honors Projects, 2020-current

Medical interpreters in the US are crucial health workers that specialize in facilitating communication between non-English-speaking patients and English medical professionals. Although much research has been done regarding the positive impact of professional medical interpreters on LEP (limited English proficient) patients' health, it is less known how medical interpreters’ lives are impacted in this line of work. Thus, this study was aimed at gaining a better understanding on the impact that this line of work has on the lives of medical interpreters. For this study, a survey was created with questions regarding demographics, interpretation’s certification process, interpreter’s satisfaction/experience, and mental …

Developing A Management And Finance Training For Future Public Health Leaders, Kristy T. Hayes, Harry J. Heiman, Peggy A. Honoré

School of Public Health Faculty Publications

Public health leaders are increasingly being asked to address adaptive challenges in the context of finite and often limited resources. Budgets and their associated resources create the financial framework within which public health agencies and organizations must operate. Yet, many public health professionals expected to undertake roles requiring this foundational knowledge and skills are not trained in the fundamentals of public finance and are ill-equipped for managing and monitoring funds. Graduate courses in schools of public health most often are focused on health care management and finance or private sector finance. To meet the needs of future public health leaders, …

How Medical Cannabis Took Root In Mississippi, Loral Winn

Honors Theses

How Medical Cannabis Took Root in Mississippi

(Under the direction of Dr. Iveta Imre)

How Medical Cannabis Took Root in Mississippi is a multimedia journalism piece that follows the timeline of medical cannabis’ legalization in Mississippi through the lives and lenses of characters from each sector of the medical marijuana industry. Written in a journalistic style with hints of narrative methods, the article tells the story of medical cannabis advocates, current patients, state registered practitioners, dispensary owners and employees, and a family-owned cultivation facility while also providing concrete evidence and facts about the legislation and regulations included in the state’s …

Differences Between Complementary And Alternative Medicine Use Among Chinese Immigrants, Emily Wang, Heet Patel, Jiexi Hu

Rowan-Virtua Research Day

Among Asian-American patients, complementary and alternative medicine is utilized at an exceedingly high rate alongside conventional medicine, due to it being more readily accessible and affordable. It is also a form of medicine that Asian people are more attuned to due to having been used for generations in their culture.1 Surveys conducted by Mackenzie et al., demonstrate that complementary and alternative medicine (CAM) is reportedly used at a higher rate in females of Asian descent and amongst uninsured patients as well as with patients of a lower educational status. 2 In addition, multiple studies have also demonstrated that patients suffering …

Is There An Association Between Preeclampsia/Eclampsia And Congenital Heart Disease Among The Neurodivergent Population?, Jasmine Emanuel, Venkateswar Venkataraman, Jennifer Lecomte, Andrea Iannuzzelli

Rowan-Virtua Research Day

Preeclampsia and eclampsia are very common gestational conditions among pregnant individuals worldwide. These individuals are diagnosed with high blood pressure (after 20 weeks of gestation), proteinuria/end-stage organ disease, and may include seizures. These conditions can put the mother and fetus at risk. A review of literature has shown that there is an association between cardiovascular defects among the neurodivergent population, where these individuals have a higher risk of developing atrial septal defects and ventricular septal defects. The Rowan-Virtua Integrated Special Needs (RISN) Center patient population will be used to investigate whether preeclampsia/eclampsia in mothers is indicative of higher congenital heart …

Isolated Temazepam Overdose: A Unique Case Of An Unresponsive Female, Eric Doane

Rowan-Virtua Research Day

Cases of acute overdose presenting to the emergency department pose a great challenge given that history can sometimes be limited or at times be inaccurate. While naloxone is routinely given in the field to help reduce opiate’s sedating effects, the routine use of flumazenil has not been routinely adopted in cases of benzodiazepine overdose. This is because, unlike naloxone, there are many medications that act on the GABA receptor, and flumazenil is only specific for binding to the benzodiazepine/GABA receptor. This can lead to an unmasking of other medications that may be co-ingested that also effect the GABA receptor leading …

Effects Of Income And Language On Health Literacy: A Study Between A Student-Run Free Clinic And A Family Medicine Office, Sahil Parikh, Emily Forester, Alisha Basak, Arpan Bhagat, Leah Cliatt, Usmaan Al-Shehab, Rebecca Moore

Rowan-Virtua Research Day

Background: Over one-third of the US population exhibit limited health literacy, leading to negative health outcomes and lifestyle choices. By employing the NVS assessment, RCHC sought to compare the health literacy levels of uninsured patients at their facility with those of insured patients at the Rowan Family Medicine office in Hammonton, NJ. This study aimed to assess specific factors that may influence health literacy levels.

Methods: This is an IRB-approved study which surveyed patients enrolled at the RCHC and Rowan Family Medicine Office between February 2021 and March 2023. Patients were given a nutrition label and verbally answered the NVS …

The Correlation Between Serum C-Reactive Protein Level And Risk Of Future Cardiovascular Disease: A Neurodivergent Population Dilemma, Brandon Cunha, Andrea Iannuzzelli, Venkateswar Venkataraman

Rowan-Virtua Research Day

Extensive research on neurotypical (NT) populations has demonstrated that a chronically elevated level of serum C Reactive Protein (CRP) is a strong predictor of future cardiovascular disease (CVD). Interestingly, many neurodivergent (ND) populations experience chronically elevated CRP levels higher than NT controls. Current research is concerned with establishing the significance of this relationship to accurately predict CVD risk for potentially at risk ND patients. To contribute to this gap in knowledge, the Rowan-Virtua Regional Integrated Special Needs (RISN) Center patient population will be studied to identify trends in baseline serum CRP levels across a multitude of ND conditions. A clinical …

Case Report: Epinephrine-Containing Topical Anesthetic Gel Inducing Systemic Epinephrine Toxicity, Md Fateha, Philip Willsie

Rowan-Virtua Research Day

Systemic epinephrine toxicity is a rare complication following inadvertent or excessively large or rapid subcutaneous, intramuscular or intravenous administration. Signs and symptoms of epinephrine toxicity include rapid onset of transient agitation, hypertension, tachycardia, lactic acidosis, and dysrhythmias with potentially fatal consequences. In this case report, we present a 33-year-old female who experienced epinephrine toxicity following the use of a topical anesthetic cream containing lidocaine and epinephrine. The patient had multiple applications to her chest before and during tattoo placement which led to tachycardia, elevated blood pressure, headache, chest pain, nausea, vomiting, and anxiety. The patient was brought into the ED …

Chemical Restraints In The Emergency Department, Nicholas Noffsinger

Rowan-Virtua Research Day

Chemical restraint is a critical intervention used in emergency departments to manage acutely agitated or violent patients. It involves the administration of medication to induce sedation and control behavior, with the goal of ensuring patient and staff safety while allowing necessary medical interventions to be performed. However, the use of chemical restraints necessitates close observation of vital signs and any potential side effects, as well as careful consideration of patient-specific considerations.

Addressing The Health Needs Of The (D/D)Eaf And Hard Of Hearing Community, Zainab Krayem, Rachel Jeff-Macauley, Nicolette Falco, Vanesa Pizutelli

Rowan-Virtua Research Day

The term deaf refers to individuals with total or partial hearing loss. However, it encompasses much more, representing a culture—Deaf culture. The distinction in spelling is important: "Deaf," with an uppercase "D," refers to individuals born Deaf who have been raised within Deaf culture, while "deaf," with a lowercase "d," typically refers to those who lost their hearing later in life and may not have grown up in Deaf culture. People who identify as deaf, Deaf, or hard of hearing (d/D/hoh) are often mistakenly assumed to have cognitive impairments or are broadly categorized as disabled. However, many in the community …

The Effectiveness Of Cleaning Protocols In Medical School Omm Labs By Medical Students, Harrison Patrizio, Riley Phyu, Thomas Boyle, Todd Schachter

Rowan-Virtua Research Day

In light of the COVID-19 pandemic, disinfection in healthcare has taken center stage. Healthcare has adjusted workflows to accommodate for more robust cleaning regimens to help protect the community. This has resulted in the need for medical institutions to reevaluate the current cleaning protocols down to the student level. Osteopathic Manipulative Medicine (OMM) lab provides an optimal avenue for assessing medical student’s examination table cleaning effectiveness. With OMM labs being an activity with a high level of interaction, the quality of examination table cleaning is important for the health and safety of students and teaching faculties. Our study highlights that …

A Clinician's Guide To 23andme: A Survey-Based Study On People’S Attitudes And Actions Towards Direct-To-Consumer Genetic Testing, Julia Kiffel, Rifke Anolik, Alexander Kowalski

Rowan-Virtua Research Day

Background: While direct-to-consumer (DTC) at-home genetic testing like 23andMe provides users with potentially valuable information about their genetics and health risks, consumers might not have the background or knowledge to fully comprehend and interpret the results. This concept is a pressing issue because of the rise in popularity of these DTC genetic tests.

Purpose: The goal of this study is to elucidate the beliefs and attitudes of 23andMe users and determine the relationship between their test results and likelihood for taking medical action. The results from the study will give clinicians and primary care providers (PCPs) insight into how to …

The Blurred Lines Between Medicine And Wellness: A Historical Approach Comparing Osteopathic Physicians, Chiropractors, And Physical Therapists, Heather Soled, Dylan Trawinski, Sonya Priven, Sheam Jahan

Rowan-Virtua Research Day

In modern society, there stands a large number of medical titles with nuances that complicate the layperson’s ability to differentiate standard of care and capabilities. As the world evolves, new job opportunities in the medical and related fields are being constructed to provide positions with various levels of certifications that qualify many caregivers to provide similar and often coexisting levels of care. Some disciplines may agree or disagree on principle; this is just one point of confusion for the mass. Furthermore, disciplines that disagree on principle may still apply analogous treatment models. Such confusion has yielded several challenges for less …