Patient Safety Commons^™

An Assessment Of Accessibility And Affordability Of Inpatient Psychiatric Care In Tennessee, Kailee Havrda

Electronic Theses and Dissertations

Introduction: Access to mental health has seen changes over the past decade, but little research and attention have been given to access to inpatient psychiatric facilities. Inpatient psychiatric care is crucial for patients experiencing mental health emergencies who need immediate access to care. Gaps in spatial accessibility, affordability, and the access and assessment process were identified due to a lack of available information in the field.

Methods: Secondary data from the Tennessee Department of Health were used to assess financial accessibility through payer source charges and patient encounters, as well as through mapping of inpatient psychiatric facilities and conducting drive …

Trust As Public Health Infrastructure: Advancing Health Care Safety Through Risk Communication And Community Engagement, Karanvir Bhinder, Sahibpreet Bhinder

HCA Healthcare Journal of Medicine

Background

Preparedness frameworks traditionally emphasize surveillance, laboratory capacity, clinical care and logistics. However, recent public health emergencies have demonstrated that even technically sound interventions may fail when trust is weak, communication is fragmented or misinformation undermines public confidence. Risk communication and community engagement (RCCE) is therefore increasingly recognized as an important component of effective outbreak response.

Perspective

Evidence from COVID-19, Ebola and other public health emergencies demonstrates that trust, communication and community engagement influence adherence to public health guidance, vaccine acceptance, healthcare utilization and the implementation of evidence-based interventions. Despite this, RCCE is frequently operationalized as a support function rather …

Bridging Awareness And Action: A Multilevel Model Of Organizational Learning, Safety Climate, And Sickle Cell Trait Safety Compliance, Kimberly Snowden

Annual DBA Scholars Conference

Despite the existence of NCAA and National Athletic Trainers’ Association guidelines, preventable sickle cell trait (SCT)-related adverse events continue to occur in athletic settings. This study examines how organizational learning capacity, safety climate, leadership commitment, and individual risk perception influence compliance with SCT safety protocols and related safety outcomes. Drawing on Organizational Learning Theory, Safety Climate Theory, and the Health Belief Model, the study proposes a multilevel framework tested through an explanatory sequential mixed-methods design. Findings are expected to identify organizational predictors of compliance and provide practical recommendations to strengthen SCT safety implementation and reduce preventable athlete harm.

Assessment Of Antimicrobial Transition Errors From Hospitals To Skilled Nursing Facilities, Amy Y. Kang, Guarina A. Garcia Delgado, Ashley Nguyen, Maddie Yeh, Tracy Ly, Richard C. Beuttler, Abisay Ortega, Donna Phan Tran, Evelyn Flores, Charis Tjeong, Andrew Bishop, Praneet Kalkat, Loren G. Miller

Pharmacy Faculty Articles and Research

Background More than 1 million Americans reside in skilled nursing facilities (SNFs). Antimicrobial transition errors among patients transferred from hospital to SNFs pose safety risks and may lead to poor outcomes, but data on such errors are limited.   Methods We conducted a retrospective cohort study of infectious diseases clinics from 1 June 2020 through 30 November 2023 at the Los Angeles County Department of Health Services, a large safety-net health system. We performed logistic regression analyses to identify factors associated with antimicrobial transition errors and poor infection outcomes.   Results We screened records of 6865 clinic patients, among whom 112 were …

Prephiral Bacterial Infectious Agent Triggers Neuroinflammatory Responses And Neurobehavioral Impairment In Wild-Type Mice, Hadeer Atalah

Theses and Dissertations

Neurodegenerative diseases, including Alzheimer's and Parkinson's, present an increasing global challenge, with chronic neuroinflammation identified as a principal factor alongside genetic, environmental, and infectious influences (Boyd et al., 2022).  Epidemiological data associate bacterial infections with a 40% heightened risk of Parkinson's disease; however, the mechanisms—especially the direct connection between peripheral sepsis and the silent onset of central nervous system pathology absent acute meningitis—are inadequately investigated (Smeyne et al., 2021), particularly concerning common pathogens like Klebsiella pneumoniae in high-burden areas such as Egyptian ICUs, where it constitutes 30% of cases (Alkompoz et al., 2023). This study filled the gap by creating …

Exploring The Impact Of Adverse Childhood Experiences On Preventive Healthcare Utilization In Rural Georgia, Ryan R. Traylor

College of Graduate Studies: Theses & Dissertations

This study examines the relationship between Adverse Childhood Experiences (ACEs) and preventive healthcare use among adults in Georgia, specifically within rural populations facing structural barriers. Using 2023 Georgia Behavioral Risk Factor Surveillance System (BRFSS) data, the research analyzes associations between ACE exposure, rural residence, and preventive care outcomes, including physical exams and flu vaccinations. Guided by an intersectionally adapted version of Andersen’s Behavioral Model of Health Services Use, the study evaluates how predisposing factors, enabling resources, and perceived barriers relate to healthcare engagement. Logistic regression analyses assess the correlation of ACE exposure, cost barriers, provider access, and sociodemographics with preventive …

A Quality Improvement Initiative To Streamline Flu Vaccine Documentation And Increase Staff Engagement, Carla E. Giron

Master's Projects and Capstones

Objective: This quality improvement project was implemented in an urban community health clinic primarily serving low-income and Latinx patients. Factors such as demographics, socioeconomic status, health, and transportation contribute to low U.S. influenza vaccination rates (Chen et al., 2020), while EHR training can improve provider satisfaction and efficiency (DiAngi et al., 2019). This microsystem faced inconsistent workflow processes, limited EHR training, and documentation errors that contributed to low staff satisfaction rates and influenza vaccination rates. An average of 11.4% of patients received a flu vaccine in October 2023 and 2024. Medical assistants (MAs) completed a pre-intervention survey indicating that 35% …

Psychological Treatment Behind The Walls:Insights From The Inside, Rogelio Serrano

Psychology Division Scholarship

Repeated eras of mass incarceration, criminalization of marginalized communities, and substance use policies have created a revolving door of justice involved populations. The ever-increasing prison population has repeatedly become the largest contingency of mental health clientele for an overburdened mental health system. Those who work with formerly incarcerated individuals in the community often don’t know the unique set of challenges faced by practitioners within the system. Increased understanding and coordination of care can offer opportunities for sustained recovery and reduced levels of recidivism. In this presentation participants will learn about the unique insights on mental health treatment that can be …

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 …

Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi

Social Work Dissertations - Archive

This study investigated the lived experiences of individuals living with HIV (PLWH) in the Dallas-Fort Worth (DFW) area of Texas during the COVID-19 pandemic, using an Interpretative Phenomenological Analysis (IPA) framework. The research examined the intersection of health, social dynamics, and psychological resilience among PLWH, who faced compounded vulnerabilities due to systemic inequities and the dual public health crises of HIV and COVID-19. Through semi-structured interviews with ten participants from diverse backgrounds, the study captured the profound impacts of disrupted healthcare systems, heightened stigma, and social isolation on this marginalized population. The findings reveal that the pandemic exacerbated existing inequities …

Investigating The Impact Of Phthalate Exposures From Personal Care Products On Uterine Fibroid Incidence And Prevalence In Us-Born Black Women, Ella Brissett

CMC Senior Theses

Uterine fibroids are benign tumors composed of smooth muscle cells and connective tissue that develop within or on the walls of the uterus. Despite being non-cancerous, they can severely affect quality of life by causing heavy bleeding, chronic pain, and reproductive complications. Fibroids are typically found in women of reproductive age, but they disproportionately affect Black women, who experience higher incidence and severity. The underlying causes of this disparity is poorly understood; however, an emerging body of research is highlighting the role of phthalates, endocrine-disrupting chemicals found in many personal care products, in exacerbating fibroid development. Through a critical analysis …

The Impact Of State-Mandated Certification Of Surgical Technologists On Surgical Site Infection Rates: Evaluating Policy, Practice, And Patient Outcomes, Katherine E. Geiger

Graduate Student Theses, Dissertations, & Professional Papers

Abstract

Chairperson: Matthew Schertz, Ph.D.

Committee Member: Morgen J Alwell, Ph.D.

Committee Member: Jill Davis, M.Ed.

As a surgical technology instructor, I have witnessed firsthand the impact that certified surgical technologists (CSTs) have on patient safety, particularly in the prevention of surgical site infections (SSIs). This professional paper investigates the relationship between state-mandated certification of surgical technologists and SSI rates, with a focus on how standardized education and credentialing influence clinical outcomes. SSIs remain a significant concern in surgical environments, contributing to increased morbidity, longer hospital stays, and greater healthcare costs. The research presented here examines certification requirements across various …

Patient Education On Naloxone And Fentanyl Testing, Monika Baranek, Kyra Dockstader

Annual Research Symposium

To educate patients on the importance of naloxone use to prevent unintended opioid overdoses and deaths. To provide community resources for fentanyl testing and destigmatize their use.

Reimagining Equitable Care: Simulation-Based Education And The Dismantling Of Implicit Bias And Stigma Of Vulnerable Populations In Hospitals, Vanessa Smith

Nursing | Senior Theses

Background: Simulation-based education consists of using high-fidelity mannequins and equipment to provide a safe space for healthcare professionals to practice crucial skills within healthcare. Used within hospitals and schools, simulation most commonly surrounds practicing hands-on skills such as central line insertion, IV insertion, Ultrasound-guided procedures, code blue response, etc. However, a large portion of healthcare that is overlooked is tackling issues within patient-provider relationships. Simulation can help dismantle the negative behaviors and feelings providers push onto patients through the use of standardized patients and role-playing. By using these methods, simulation can reduce providers’ personal implicit biases and the stigma associated …

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 …

Evaluating A High School Mrsa Prevention Program: A Case Study, Jamie Henning

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

MRSA poses a significant health risk to athletes nationwide. This case study examines the application of an online training module to address knowledge gaps regarding Methicillin-resistant Staphylococcus aureus (MRSA) among key decision-makers for high school athletes. It reviews the development and initial evaluation of a web-based training program designed to empower decision-makers with the knowledge to prevent MRSA infection and respond to suspected cases. Program evaluation recommended expanding the training module to wrestling staff with improved evaluation methods while continuing implementation and effectiveness assessment for the football staff. Despite initial data quality limitations, the online training module evaluation offered valuable …

Exploration Of The Implementation Of An Integrated Electronic Laboratory Information Management System On Quality Diagnostics Service Indicators At A County Level Public Hospital In Western Kenya., Kelly Allen

Capstone Collection

Underinvestment in pathology and laboratory capacity caused by low visibility in research and in prioritization by public health leaders results in limited effective healthcare coverage and an estimated 1.1 million premature deaths annually in Low-and-Middle-Income Countries. Kenya’s public health laboratories provide a median 41% of the Essential Diagnostic List to their patients and in Kisumu County, as much as 44.2% of the population has little to no access to essential diagnostics. The government of Kisumu implemented the county Health Laboratory Strategic Plan 2018-2022 to address this public health challenge. Little information exists on the effectiveness of these initiatives and the …

Calculating Risk: A Scoping Review Of Ncaa D1 Football Players’ Motivations To Play And The Correlation To Demographic Characteristics And Injury Experiences, Kathleen D. Walsh

Honors Theses

The purpose of this research was to investigate the motivations of National Collegiate Athletic Association (NCAA) Division 1 (D1) football players for playing the game and how these motivations are associated with their socioeconomic status (SES). Further, the research aimed to investigate how the uncovered motivations were linked to injury experiences. The original project was designed as a survey-based mixed methods study on a national scale. However, issues with participant recruitment led to sidelining of that primary research. The research presented is a scoping review of the available literature pertaining to the research question: What is known from existing literature …

Fixing The System: A Comparative Review Of The United Kingdom, Germany, And United States’ Healthcare Systems And Lessons Learned For Potential Improvements In The United States, Jessica Goddard

Senior Theses

In an effort to provide recommendations to the United States’ considerations of a universal healthcare system, this thesis analyzes the United States healthcare system alongside the sophisticated systems of the United Kingdom and Germany. Literature review and an analysis of 10 health outcomes and indicators guided the framework for a set of interview questions to be asked of healthcare professionals in all three countries. The interview response data was then organized and used to guide the suggested recommendations to the United States in its path towards universal healthcare. While a limited number of solutions could be provided given the time …

Coh 1700: Health Care Coordination Syllabus, Sasha Harry

Open Educational Resources

This is the syllabus for a Health Care Coordination course.

The goal of health care coordination is to improve patient outcomes with better health care services. Care coordinators play a critical role in improving patient care. Students will learn how to effectively advocate for patients and interact with members of the healthcare team in finding solutions to provide high quality, value-based, and efficient care. Effective communication styles, assessing patient’s needs and goals, and helping with patients’ transitions of care are among many topics covered in this course. Upon course completion, students will have acquired basic knowledge and skills to educate, …

Emergency Care For Youth Who Experience Suicidality And Identify As Lesbian Gay Bisexual Transgender Queer/Questioning (Lgbtq+): An Interpretive Phenomenology, Theresa Schultz

Electronic Theses and Dissertations

Purpose: Suicide is a leading cause of death in children; youth who identify as LGBTQ+ are at an exponentially higher risk of suicide. The purpose of this study was to explore the lived experiences of young adults who identify as LGBTQ+ and sought emergency care for suicidality when they were adolescents.

Methods: Heideggerian hermeneutics phenomenology is the research method used in this study. Youth, ages 18-25 years, who identify as LGBTQ+ and sought emergency treatment for suicidality when they were adolescents (13-17 years) were recruited to participate;fifteen youth enrolled. Individuals ranged in age from 20 to 25 years. Participants described …

Unearthing Historical Trauma To Advance Health Equity For Survivors Of Human Trafficking, Sandy Woo-Cater

HCA Healthcare Journal of Medicine

In the last decade, the public health field has grown a strong interest in responding to issues related to human trafficking. This specific concentration in healthcare has made efforts to ensure this work includes culturally appropriate tools to serve patients. While curricula to guide health professionals in areas such as cultural competency, cultural responsiveness, or cultural humility exist, historical trauma is not often integrated in the understanding of health outcomes for patients experiencing human trafficking. This paper asserts that advancing health equity for these patients necessitates a deeper historical perspective.

The Impact Of Covid-19 In The Latinx Community, Laura Pedraza, Ricardo Villela, Vikki Kamatgi, Kaitlyn Cocuzzo, Ricardo Correa, Miriam Zylberglait Lisigurski

HCA Healthcare Journal of Medicine

The COVID-19 pandemic has intensified the existing health and social disparities that affect minority groups in the United States (US), including the Latinx community. This situation has been reflected in many aspects of health, including increased morbi-mortality and reduced adherence to medical and scientific recommendations. Limited access to health care, financial challenges, migrant status, and health literacy, or lack thereof, have all hampered the Latinx community's ability to seek aid quickly and to be tested or treated effectively for this disease. This pandemic has shown that the Latinx community's socioeconomic status correlates with greater mortality rates when compared to other …

Book Review: Urban Health | Emerging Public Health Perspectives, Demi Miriam

Journal of Research Initiatives

Book Review

Book Title: Urban Health | Emerging public health perspectives

Editors: Fernandes & Grewal, 2021

Publisher: Global South Strategies

Publication: 02 September 2021

City: Mangalore, India

Total No. of Pages: 341

Price (in INR): 950 (Paperback)

ISBN-13: 978-8195336418

Family’S Sufferings From Asymptomatic Covid: Clinicians’ Perspective, Neha Joshi Dr, Jitender Nagpal Dr, Anand Sinha Dr

Patient Experience Journal

Anticipating dire consequences, in 2020 the world braced itself for the unparalleled pandemic by resorting to unprecedented measures including stringent lockdowns, unforeseen social isolations, spotlight focus, resource diversions besides reorganized healthcare systems to name the quintessential few. Such unifocal convergence enhanced the vulnerabilities of patients dependent on non-COVID healthcare assistance. For a nation with a meagre allocation of 0.7 hospital beds per 1000 people and a lopsided doctor-population ratio of 1:1800, COVID-centric measures created unintended complications. Ironically, many succumbed in myriad ways, not due to the pandemic but due to the attributes of the survival measures. While such consequences cannot …

Surgeons And Ethical Challenges In Operating Room, Nazim Syed Muhammad, Syed Shahabuddin

Section of Urology

Ethics lie in the heart of professionalism. In surgery, it represents an essential element, with surgeons facing ethical challenges in their routine practice. The rapid expansion of surgical technology and innovation along with the use of resources and consideration of conflict of interest have brought up the need for the development of current surgical code of ethics. Operating room represents a stressful environment where patients' lives depend upon careful preparation, planning and execution. The progression of surgery within the operating room must be done in harmony and in line with the ethical principles of autonomy, beneficence, non-maleficence and justice. Discussion …

Mathematical Models Of Infection Prevention Programs In Hospital Settings, Kelly A. Reagan

Theses and Dissertations

Hospitals play a vital role in providing for the healthcare needs of a community. Patients can develop hospital-acquired infections (HAIs) during their hospitalization due to exposure to foreign bacteria, viruses, and fungi. Infection prevention programs target and reduce HAIs, but implementing the infection prevention programs often comes with a cost. The goal of my research is to use mathematical models to quantify the impact of infection prevention programs on cases of HAIs and total healthcare costs. First, I use a Markov chain model to quantify how one infection prevention program reduces general HAIs in the hospital. Then, I calculate the …

The Yearly Financing Need Of Providing Paid Maternity Leave In The Informal Sector In Indonesia, Adiatma Y. M. Siregar, Pipit Pitriyan, Donny Hardiawan, Paul Zambrano, Mireya Vilar-Compte, Graciela Ma Teruel Belismelis, Meztli Moncada, David Tamayo, Grace Carroll, Rafael Perez-Escamilla, Roger Mathisen

Department of Public Health Scholarship and Creative Works

Background: The economic cost of not breastfeeding in Indonesia is estimated at US$1.5–9.4 billion annually, the highest in South East Asia. Half of the 33.6 million working women of reproductive age (WRA) in Indonesia (15–49 years) are informal employees, meaning they are working as casual workers or they are self-employed (small scale business) and assisted by unpaid/family worker(s). No specific maternity protection entitlements are currently available for WRA working informally in Indonesia. This study aims to estimate the financing need of providing maternity leave cash transfer (MCT) for WRA working in the informal sector in Indonesia. Method: The costing methodology …

Breastfeeding Media Coverage And Beliefs During The Covid-19 Pandemic In Mexico: Implications For Breastfeeding Equity, Mireya Vilar-Compte, P. Gaitán‐Rossi, E. C. Rhodes, V. Cruz‐Villalba, R. Pérez‐Escamilla

Department of Public Health Scholarship and Creative Works

Background: Because breastfeeding offers short- and long- term health benefits to mothers and children, breastfeeding promotion and support is a public health priority. Evidence shows that SARS-CoV-2 is not likely to be transmitted via breastmilk. Moreover, antibodies against SARS-CoV-2 are thought to be contained in breastmilk of mothers with history of COVID-19 infection or vaccination. WHO recommends direct breastfeeding as the preferred infant feeding option during the COVID-19 pandemic, even among women with COVID-19; but conflicting practices have been adopted, which could widen existing inequities in breastfeeding. This study aims to describe how information about breastfeeding was communicated in Mexican …

Impact Of The Covid-19 Pandemic On Loneliness And Social Isolation: A Multi-Country Study, Roger O’Sullivan, Annette Burns, Gerard Leavey, Iracema Leroi, Vanessa Burholt, James Lubben, Julianne Holt-Lunstad, Christina Victor, Brian Lawlor, Mireya Vilar-Compte, Carla M. Perissinotto, Mark A. Tully, Mary Pat Sullivan, Michael Rosato, Joanna Mchugh Power, Elisa Tiilikainen, Thomas R. Prohaska

Department of Public Health Scholarship and Creative Works

The COVID-19 global pandemic and subsequent public health social measures have challenged our social and economic life, with increasing concerns around potentially rising levels of social isolation and loneliness. This paper is based on cross-sectional online survey data (available in 10 languages, from 2 June to 16 November 2020) with 20,398 respondents from 101 different countries. It aims to help increase our understanding of the global risk factors that are associated with social isolation and loneliness, irrespective of culture or country, to support evidence-based policy, services and public health interventions. We found the prevalence of severe loneliness was 21% during …