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 …

Bridging Fiscal Sustainability And Health Equity: A Policy Analysis Of California’S Healthcare Coverage Safeguards, Guadalupe Castaneda Martinez

Master's Projects and Capstones

Without structural policy intervention, approximately 4.6 million Californians remain at risk of being uninsured by 2030, worsening racial and ethnic health disparities and hospital uncompensated care burdens. This policy analysis advocates for a hybrid universal coverage model combining sliding-scale subsidies (California Senate Bill 78) with full-scope Medi-Cal expansion for all income-eligible residents regardless of legal status (California Assembly Bill 133). The framework relies on existing funding mechanisms, including the Managed Care Organization tax and the Health Care Affordability Reserve Fund. Comparative analysis indicates that market-only subsidies leave severe equity gaps, whereas immediate single-payer transitions pose substantial fiscal and administrative risks. …

Clinical Corner: Pearls From Local Dentists

West Michigan District Dental Society Bulletin

"Clinical Corner: Pearls from Local Dentists" is a section of the WMDDS Bulletin where local dentists share clinical wisdom for fellow practitioners. This edition's topics include Behavior Guidance in Pediatric Dentistry, occupational pain, and occupational hearing loss

Comparison Of Selected Supply Chain Management Practices Of Three Major Regional/Metropolitan Hospitals, Alan D. Smith

Atlantic Marketing Association Proceedings

No abstract provided.

Evaluating The Impact Of A Standardized Intimate Partner Violence Screening Tool In A Clinical Setting, Dylan Bogucki

Evidence-Based Practice Project Reports

Intimate partner violence (IPV) is defined as any act of violence, including physical, sexual, stalking, or psychological aggression by an intimate partner, former or current. Despite being preventable, IPV remains a leading nonobstetric cause of morbidity and mortality among women, which highlights the need for systematic screening in clinical settings. The purpose of this quality improvement project is to identify women who have previously experienced or are currently experiencing IPV and to connect them with appropriate resources. Twenty-one studies were identified, all demonstrating moderate to high methodological quality and supporting the need for routine IPV screening in women’s health settings. …

Falling Star Program: A Visual Cue Intervention To Reduce Falls In Long-Term Care, Maggie Shanahan

Evidence-Based Practice Project Reports

Falls among older adults in skilled nursing and long-term care settings remain a leading cause of injury, functional decline, and increased healthcare utilization, contributing significantly to morbidity and mortality in this population (Centers for Disease Control and Prevention [CDC], 2023; Agency for Healthcare Research and Quality [AHRQ], 2022). The primary purpose of this project aimed to implement and evaluate a structured visual cue–based fall prevention intervention to reduce fall rates among high-risk residents in a long-term care facility in Northwest Indiana. The project included 23 participants aged 65 years and older who were identified as high risk for falls. Using …

Staff Educational Impact On School-Based Mental Health Services: A Scoping Review, Daniel J. Kim, Di'yana Fisher, Laura Reed Dnp, Aprn, Fnp-Bc, Cne, Fnap

Doctor of Nursing Practice Projects

Purpose/Background

            Trends are consistently increasing among adolescents in regard to mental health diagnoses and suicide risks, which emphasizes the necessity for early identification via school-based psychiatric screenings. The Patient Health Questionnaire-9 (PHQ-9) has proven effective in uncovering symptoms of depression; variable application and limited staff knowledge continue to be substantial hurdles. This scoping review examined the influence of staff education and training on the efficacy of school-based psychiatric screening.

Methods

            PubMed, CINAHL, Medline, Elsevier, Google Scholar, and JAMA were utilized to conduct this scoping review. Peer-reviewed studies published between 2020 and 2025 were included if they involved adolescents aged 13-18, …

Decreasing Catheter Associated Urinary Tract Infection Through Reinforcement Of Hand Hygiene Compliance In A Rehabilitation Unit, Gloria Ihenwe

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this project is to decrease the CAUTI rate among adult rehabilitation patients with indwelling catheters from 40% to 1% through improved staff hand hygiene (HH) compliance and to increase hand hygiene compliance from 45.24% to 60.47% within 3 months. The secondary aim is that staff will report self-improvement in hand hygiene knowledge and technique.

Background

Catheter-associated urinary tract infections (CAUTIs) are common preventable healthcare-associated infections. Inconsistent HH compliance among direct care staff remains a common challenge and can contribute to infection risks and transmission of microorganisms

Methodology

The Plan-Do-Study-Act (PDSA) quality improvement model guided the implementation …

Can The Implementation Of The Pause Decrease Death Anxiety And Poor Mental Health In Practicing Nurses?, Lilli Meyer

Undergraduate Theses

Practicing nurses are frequently exposed to patient death, placing them at increased risk for death anxiety and compromised mental health. Despite this, there remains a lack of structured, in-the-moment interventions to support emotional processing within clinical settings. This study evaluates whether the implementation of “The Pause,” a brief moment of silence following a patient’s death, may reduce death anxiety and improve mental health outcomes among practicing nurses. A quantitative survey consisting of eight questions was distributed to nurses in the Louisville, Kentucky area over a three-month period, yielding 26 responses. Findings indicated that 80.8% of participants reported no improvement or …

Improving Anesthesia Provider Confidence In The Identification, Management, And Treatment Of Postoperative Delirium, Brittany M. Whistle, Charles Dustin Phelps

Scholars Week

Purpose: Postoperative Delirium (POD) is a potentially devastating complication of anesthesia that is poorly understood by clinical staff leading to poor outcomes for surgical patients. This study is meant to determine if a focused knowledge presentation accompanied by visual aids could increase anesthesia providers confidence in identifying, diagnosing, and treating Postoperative Delirium.

Methodology: Utilizing a statistical model to analyze respondents results on a standardized test administered before and after an informational presentation with visual aids on the topic of Postoperative Delirium.

Results: Results indicated a statistically significant difference between pretest and posttest scores, with a p-value of .002, t(11) = …

Hormonal Birth Control Misinformation On Tiktok: A Content Analysis Of Influencer Narratives, Sarah Bdeir, Jana Hatahet, Liselle Tungol, Khush Hussain, Rumyah Rafique, Raneem Sabbaq, Ragad Almsaddi

Medical Student Research Symposium

Background:

Hormonal birth control is the most common form of reversible contraception. In the U.S., pharmacy data show oral contraceptive pill prescriptions declined 25.6% from March 2021 to October 2023. Meanwhile, patients increasingly seek health information on social media. On TikTok, “hormone hacking” content has surged, often portraying birth control as artificial, harmful, or even carcinogenic, despite a lack of supporting evidence. While accessible information on social media can be valuable, such narratives risk spreading misinformation, fueling mistrust in women’s health.

Methods:

We conducted a qualitative content analysis of 50 TikTok videos (March and September 2025) under #birthcontrol, #hormonehealth, #birthcontroltoxicity, …

Validity And Reliability Of The Wut Hydration System When Assessed In The Afternoon, Peyton A. Hines, Rosie Perez, Rebecca Allen, Shawn Wierick, Xiujing Zhao, Corey Butts, Brendon Mcdermott

2026 Honors Symposium

The WUT (weight, urine color, and thirst) Venn diagram is recommended for individuals to self-assess their hydration status. However, current research is limited to comparisons between morning first-void markers and 24-hour markers. PURPOSE: To examine the validity and reliability of afternoon WUT scores in comparison to 24-hour hydration status. METHODS: Fifty participants (25 ± 8y, 72.2 ± 14.9kg) voluntarily participated in this study. Participants collected afternoon spot urine between 2:00 and 4:00 pm and 24-hour urine samples on three out of seven consecutive days. Body mass (BM), urine color (Ucol), urine osmolality (Uosm), urine specific gravity (USG), and thirst perception …

Incidence Of High Volume Residual Gastric Content In Perioperative Patients Taking Glucagon-Like Peptide-1 Receptor Agonists, And Its Dependence On The Duration Of Preoperative Fasting And Drug Holding: A Prospective Observational Study, Marissa Huggins, Ion Hobai

Cumberland Medica

Background: Glucagon-like peptide-1 receptor agonists (GLP-1RAs), including semaglutide and dulaglutide, are increasingly prescribed for type 2 diabetes mellitus and obesity. These agents delay gastric emptying and have been associated with a higher incidence of unexpected full stomachs in procedural patients. To prevent pulmonary aspiration, current recommendations include extending preoperative fasting (e.g., 24 hours instead of the standard 8 hours) and/or withholding the GLP-1RA medication before surgery (≥1 drug half-lives). However, the efficacy of these strategies have remained unclear and are evaluated in this study.

Hypothesis: GLP-1RA use in surgical patients is associated with increased incidence and volume of residual gastric …

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 …

Improving Structured Handoff Documentation In A Pediatric Emergency Department, Deborah Hammett, Rebecca Matta, Jody Kieffer, Jillian Savage, Courtney Nelson

Department of Pediatrics Faculty Papers

INTRODUCTION: The I-PASS handoff tool guides provider handoffs and reduces adverse events in the inpatient setting. Transitions of care occur frequently in the emergency department (ED), and the unpredictable environment can lead to less structured handoffs. Our goal was to increase the percentage of handoff notes that include all 4 I-PASS components by 20% within 6 months.

METHODS: We developed a handoff note template for the pediatric ED that included 4 key I-PASS elements: illness severity, patient care summary, action list, and situational awareness/contingency planning. Our primary outcome measure was the percentage of handoff notes that contained all 4 I-PASS …

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 …

A Pilot Study Evaluating Child Resistant Closures In Pharmaceuticals In The Developing Nation Of Ghana: Informing Global Paediatric Safety And Usability Standards, Samuel Ofosu, Kojo Agyapong Afrifah, Laura Bix

Journal of Applied Packaging Research

Despite their proven effectiveness in preventing unintentional paediatric medication poisoning in high-income countries, the performance and usability of Child Resistant Closures (CRCs) remain underexplored in low and middle-income countries (LMICs).

To provide pilot data regarding the potential efficacy of using CRCs in LMICs, we conducted a study of the approach in a low-resourced region (Ghana, West Africa) by adapting testing protocols utilized in the United States (16 CFR Part 1700.20). The study utilized a convenience sample of children (n=50; 42-51 months) and adults (n=50; 50-70 years) to develop preliminary data related to the efficacy of a single design of CRC …

Evaluating The Dispensing Of Non-Prescription Antibiotics In Baghdad's Community Pharmacies: A Public Health Concern., Ali Azeez Ali Al-Jumaili, Yusr Burhan Ahmed, Hasan Ali Hasan Shubbar, Mina Mohammed Jabbar

Maaen Journal for Medical Sciences

Background: Despite existing regulatory restrictions from the Iraqi Ministry of Health and global guidance from the World Health Organization, the practice of dispensing antibiotics without prescriptions remains prevalent.

Objectives: This study aimed to assess the prevalence of non-prescription antibiotic dispensing in community pharmacies across Iraq and to evaluate pharmacy personnel’s perceptions and practices concerning antimicrobial use.

Methods: A cross-sectional survey was conducted between January and February 2025, targeting 63 pharmacists working in independent pharmacies across Baghdad and other Iraqi governorates. Data were obtained through a predefined questionnaire administered both in person and online. Descriptive statistics summarized participant demographics and responses, …

Intimate Partner Violence Experience, Support Seeking And Coping Strategies Among Pregnant Women In Southwestern Uganda, Eve Katushabe, John Baptist Asiimwe, John Bosco Ndinawe, Editor Abeneitwe, Agnes Katusiime, Gladys Nakidde, Vincent Batwala

School of Nursing & Midwifery, East Africa

Intimate partner violence (IPV) during pregnancy remains a global health challenge. This study aimed to explore pregnant women’s experiences of IPV, support seeking, and coping strategies in Southwestern Uganda. Pregnant women who had experienced IPV during pregnancy were purposively selected and completed in-depth interviews, with data saturation reached after 25 participants. Guided by the feminist theory, data were analyzed deductively and inductively using thematic analysis. Participating pregnant women were exposed to physical violence (e.g., the gravid abdomen being stepped on), psychological violence (e.g., verbal abuse), sexual violence (e.g., being forced into uncomfortable sexual positions), and financial control and manipulation (e.g., …

Your Healthcare Rights & Resources In Ice Detention: A Bilingual (English-Spanish) Resource For Detained People, Vineeth R. Vaidyula B.S.*, Shivani Kulkarni B.A.*, Jai Mehrotra-Varma B.S.*, Elizabeth R. Kolod M.D., M.P.H.

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

This resource provides a concise, practical overview of healthcare rights and medical access for people held in U.S. Immigration and Customs Enforcement (ICE) detention. It outlines basic health, dental, mental health, and reproductive care rights; expected medical processes during the initial period of detention; and common barriers such as delayed care, limited access to specialists, and language challenges. The guide also offers strategies for self-advocacy and documentation, including tracking medications, medical encounters, and requests for care, and identifies legal and advocacy resources for additional support. Designed for use by detained individuals and their advocates, this resource aims to promote informed …

Exploring Dominican University Nursing Students’ Perceptions Of Economic Barriers To Accessing Essential Women’S Health Products, Annabelle E. Burke

Nursing | Senior Theses

Period poverty is defined as inconsistent or inadequate access to feminine hygiene products, and it has been shown to negatively impact physical and mental health, academic performance, and dignity across diverse populations. Existing research highlights financial strain, social stigma, and insufficient support as key barriers to menstrual equity among individuals experiencing homelessness, adolescents living in low-resource environments, low-income women, and general undergraduate students (Brinkley & Niebuhr, 2023; Dave et al., 2022; Gruer et al., 2021; Lahme et al., 2018; Parkinson et al., 2024; Gilchrist et al., 2024). However, no studies have examined these issues amongst Dominican University nursing students who …

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 …

The Utilization Of Uv-C Devices To Improve Cleaning And Disinfection In The Operating Room For Reduction Of Infection Rates: An Integrative Research Review (Irr), Kathrina Joyce L. Manalo

Covenant Nurses Week 2026

No abstract provided.

Decreasing Hospital Acquired Pressure Injuries Through A Multi-Intervention Approach: A Quality Improvement Project, Kendra D. Crawford

DNP Scholarly Projects

BACKGROUND: Hospital acquired pressure injuries (HAPIs) continue to plague hospitals across the country. HAPIs are an indication of the quality of care delivered by the hospital’s nursing workforce. These injuries are costly to organizations and can lead to increased length of stay (LOS). The development of a HAPI, depending on severity, is a reportable injury and is classified as patient harm. Patients who suffer from HAPIs can experience significant pain and at times, permanent disfigurement. This project’s focus is a community hospital that has seen a steady increase in HAPIs over the last 2 years. During 2025, 28% of the …

Developing An Educational Session And Epic-Based Tools To Help Nurses Provide Culturally Sensitive Care To Their Muslim Patients, Laila Albutmeh

Nursing | Senior Theses

Background: Islam is currently the fastest growing religion in the world and the chances of nurses having a Muslim patient is exceptionally high yet many nurses lack the knowledge and resources on how to accurately provide culturally sensitive care to Muslim patients. Hospitals lack educational sessions/training as well as Epic tools to help nurses provide culturally sensitive care to Muslim patients which leads to a knowledge deficit in cultural sensitivity of Islamic beliefs, values, and practices. Purpose: This thesis paper proposes a research design for a nurse education/training program on Islamic beliefs, values, and practices along with an implementation of …

No Pass Culture Lowers Patient Fall Incidence, Marie Camille Austria

Covenant Nurses Week 2026

No abstract provided.

Improving Patient Outcomes Through Structured Nursing Surveillance In Acute Stroke And Transient Ischemic Attack (Tia): An Integrative Research Review (Irr), Sheeba Everard Matthew

Covenant Nurses Week 2026

No abstract provided.

Improving Patient Outcomes Through Structured Nursing Safety Huddles In Acute Care Settings: An Integrative Research Review (Irr), Brandon Everard Thomas

Covenant Nurses Week 2026

No abstract provided.

Higher Nurse-To-Patient Staffing Ratios Affect Patient Safety Outcomes: An Integrative Research Review (Irr), Kimberly Everard Martinez

Covenant Nurses Week 2026

No abstract provided.

Hapi Heroes Initiative: Innovating Patient Turn Strategies Utilizine The Braden Scale To Prevent Hospital Acquired Pressure Injuries (Hapi) In The Cardiac Telemetry Unit-A Reposition Disposition Quality Improvement Project, Kenn Everard Lachenal, Kimberlea Gale Hiett-Gonzales, Charmaine Capili, Jelly Jacob, Melissa Fallorina, Dillon Mckee

Covenant Nurses Week 2026

No abstract provided.