Health and Medical Administration Commons^™

May 2023, Swosu Bulldog Wellness Committee

SWOSU BULLDOG WELLNESS

Your Bulldog Wellness Committee is declaring May as “Movement and Mental Health” month. We encourage you to select a way in which you enjoy moving your body (walking, swimming, bicycling, dancing, yoga, etc.) and move for a combined 20 minutes at least five days a week. Physical activity impacts our mental health, sleep habits, stress levels, and mood.

Cms Emergency Preparedness Rule: Examining The Relationship Between Nursing Home Facility Characteristics And Regulatory Deficiencies, Tihara Richardson Sommers

School of Public Service Theses & Dissertations

The effects of Hurricane Katrina and other natural disasters have increased the focus on nursing homes, particularly nursing home emergency preparedness. Nursing home administrators and direct care employees have described the challenges faced when responding to an emergency event. Due to numerous emergency preparedness insufficiencies, requirements were implemented to protect the vulnerable population of older adults who reside in nursing homes. In 2016, the Centers for Medicare & Medicaid (CMS) added specific emergency preparedness requirements to the existing fire safety requirements for regulated nursing homes. These deficiency evaluations are the only routinely collected source of information detailing compliance with the …

Fear Of Recurrence As A Mediator Of Illness Perception And Perceived Stress In Acute Myocardial Infarction Survivors, Sarah E. Zvonar

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose: The primary objective of this study is to evaluate fear of recurrence as a mediator of illness perception and perceived stress. This research will determine how illness perceptions and fear of recurrence affect perceived stress in the acute myocardial infarction (AMI) population. Other aims will observe how demographics predict patients who may experience increased fear of recurrence and stress in the AMI population, how the variables of fear of recurrence change over time, and if fear of recurrence is still a significant mediator after controlling for depression and anxiety.Rational/ Conceptual Basis/ Background: Acute myocardial infarctions (AMIs) are often accompanied …

New-R Intervention For Clients With Severe Mental Illness And Obesity: Grant Writing For Implementation Funds Supporting Occupational Therapy Interventions, Kaitlyn Hoffman

UNLV Theses, Dissertations, Professional Papers, and Capstones

Increasing numbers of people suffer from obesity and severe mental illness co-morbidly. If these conditions remain untreated, they can harm an individual's health and well-being. Unfortunately, there are very few programs currently available that target both management and improvement of these conditions simultaneously. Even so, despite the lack of programming options, it must be noted that the NEW-R program strives to reach those goals, although there hasn't been an abundance of literature supporting the effectiveness of this program. This poses a concern for occupational therapy practitioners who hope to assist their clients in managing these conditions as occupational therapy treatments …

Enhanced Iot-Based Electrocardiogram Monitoring System With Deep Learning, Jian Ni

UNLV Theses, Dissertations, Professional Papers, and Capstones

Due to the rapid development of computing and sensing technologies, Internet of Things (IoT)-based cardiac monitoring plays a crucial role in providing patients with cost-efficient solutions for long-term, continuous, and pervasive electrocardiogram (ECG) monitoring outside a hospital setting. In a typical IoT-based ECG monitoring system, ECG signals are picked up by sensors located on the edge, and then uploaded to the remote cloud servers. ECG interpretation is performed for the collected ECGs in the cloud servers and the analysis results can be made instantly available to the patients as well as their healthcare providers.In this dissertation, we first examine the …

An Analysis Of The Effects Of Certified Electronic Health Records On Organizations And Patients., Picandra Elzie

Electronic Theses and Dissertations

The growing technological advancement of electronic health records can become an issue with quality and electronic patient information exchange if hospitals do not adhere to federal guidelines. It is recommended that hospitals utilize certified electronic health records (EHRs) to receive financial incentives. This certification is supposedly also associated with the quality of the EHR itself. The certification process is criticized for allowing EHR vendors to meet a set of limited functions known in advance. EHRs can affect healthcare quality and electronic health information exchange. This dissertation explored what is known about the effects of certified EHRs on length of stay …

Lesbian, Gay, Bisexual, Transgender, Queer (Lgbtqia+) Health Disparities In Sexual Health And Sexual Education, Cole T. Mcbride

Curriculum and Instruction Undergraduate Honors Theses

Background: Comprehensive sex education instills knowledge and promotes the health of all youth, however, most sex education remains heteronormative. School-based programs in the United States (US) emphasize monogamous, heterosexual relationships. In 2021, only 7.4% of students received sex education that included positive representations of both LGB and transgender people and nonbinary topics, while 72% of programs across the US omit LGBTQ+ topics. Most new HIV diagnoses occur in gay and bisexual men aged 13-34, but the sex education environment for this group is increasingly hostile as more states prohibit addressing these topics in public schools.

Purpose: The purpose …

Assessment Of Saudi Arabians' Awareness Of Oral Health And Oral Hygiene In A Group Of 200 Dental Clinic Participants, Mahmoud Al Ankily, Mohamed Shamel, Sara Abdel Wahed, Mohamed Mansy

Dentistry

Oral mucosa lesions cause oral sores, discoloration, and anomalies. Oral mucosa genetic and developmental disorders may affect anybody. Oral cavity carcinoma causes 4% of all malignancies worldwide. Early detection of oral cancer improves survival rates. Oral precancerous diseases include color, abnormalities, surface texture, and location that predict malignancy. The goal of this study was to examine the Saudi Arabians' awareness of oral health and oral hygiene. An observational, cross-sectional approach was adopted for the study. Individuals with a probable malignant oral disease who visited an OPD at a dental hospital and had relevant behaviors were recruited in the study. In …

Interaction Between Fluoxetine And Risperidone And Its Association With Clinical Outcomes In Schizophrenic Patients, Fitri Rachmaini, Dian Ayu Juwita, Rahmad Abdillah, Rezy Dwi Afrianti, Fatma Sri Wahyuni

Pharmaceutical Sciences and Research

The concurrent use of fluoxetine and risperidone to treat schizophrenia may result in drug interactions. This study aims to analyse the clinical outcomes of fluoxetine-risperidone therapy and the possibility of their interaction in schizophrenic patients. The clinical outcomes are patient status at the time of hospital discharge, the length of hospitalisation and the Positive and Negative Syndrome Scale- Excitement Component (PANSS-EC). This study was conducted prospectively in psychiatric ward of HB Saanin Mental Hospital from May to October 2021 and study subjects were selected using consecutive sampling technique with inclusion criteria. Forty-three patients were eligible for this study. Research data …

Demonstration Of The Managing For Daily Improvement Quality Improvement Methodology In An Alcohol Withdrawal Protocol Audit, Alex Stephens, Diana Hoot, Amy Cain

HCA Healthcare Journal of Medicine

Background

The Clinical Institute Withdrawal Assessment for Alcohol, Revised (CIWA-Ar) is an assessment tool designed to standardize care and minimize the risk of complications in patients experiencing alcohol withdrawal. After discovering an increase in medication errors and late assessments under this protocol, pharmacists at a 218-bed community hospital performed an audit of protocol compliance using a performance improvement methodology known as Managing for Daily Improvement (MDI).

Methods

A daily audit of CIWA-Ar protocol compliance was performed across all hospital units, followed by discussions with frontline nurses regarding barriers to compliance. The daily audit included assessments of appropriate monitoring frequency, medication …

Operationalizing A Medication Safety Gap Assessment For A Large Health System, Carley Warren, Joan Kramer, L Hayley Burgess

HCA Healthcare Journal of Medicine

Background

Medication errors continue to be a leading cause of medical errors. In the United States alone, 7000 to 9000 people die annually due to a medication error, and many more are harmed. Since 2014, the Institute for Safe Medication Practices (ISMP) has advocated for several best practices in acute care facilities derived from reports of patient harm.

Methods

The medication safety best practices chosen for this assessment were based on the 2020 ISMP Targeted Medication Safety Best Practices (TMSBP) and health system-identified opportunities. Each month, for 9 months, select best practices were covered with associated tools to assess the …

An Innovative Model For Graduate Medical Education Faculty Development Through Physician In Training Delivery, Daniel A. Nguyen, Christopher Wong, Christian Scheufele, Michael Carletti, Stephen Weis

North Texas GME Research Forum 2023

BACKGROUND/INTRODUCTION: Faculty development is an important component for ACGME accreditation of residency programs. 1-3 There are multiple strategies for faculty development with methods including workshops, lunch-ins, and online modules. 10-12 Having successful approaches to develop faculty has lead to self-reported improvement in teaching and clinical skills, intrapersonal and interpersonal growth with faculty given more positive ratings by learners. 8,9 Beyond the individual faculty, there can be system wide cultural shifts supportive of scholarly teaching. 10 Delivering content that is convenient and valuable to the faculty can be challenging. 3,4 If resident physicians can deliver effective convenient faculty development programs then …

Does Brief Intervention In The Form Of A Lecture Improve Resident Knowledge About Hep C Screening?, Mary Dacosta, Evelyn Chicas, Kiana Clem, Shelby Collymore

North Texas GME Research Forum 2023

The prevalence for hepatitis C during 2013-2016 was about ~2.4 million. Screening helps to prevent chronic hepatitis C or start early curative treatment. USPSTF recently changed their guidelines in 2021 for Hepatitis C screening to now include all asymptomatic patients from ages from 18-79 years old without liver disease. Screening usually includes the Hepatitis C Antibody test. Further testing includes Hepatitis C mRNA PCR if screening test is positive. High risk patients should have periodic screening. Since the change, this project was done to ensure the appropriate screening and testing thereafter was done, as well as appropriate communication and documentation. …

Monitoring Concordance In The Management Of Transfusing Blood Components In Cirrhotic Patients For Paracentesis With Evidence-Based Guidelines, Joseph Kim, Gregory Moses

North Texas GME Research Forum 2023

Initiative to decrease unnecessary hemostatic agent transfusion in cirrhotic patients undergoing paracentesis: a resident-led approach quality improvement project to prevent transfusion overuse. Currently, there is no official guideline placed in the hospital for the administration of a hemostatic agent such as fresh frozen plasma in the setting of an elevated international normalized ratio, which paradoxically is an anticipated finding in cirrhotic patients. This process leads to unnecessarily prolonging the duration of the hospital course due to delays in performing the interventional procedures and interruptions in scheduling. The goal of this project is to educate and provide physicians with the most …

Nurses’ Perception Of Work-Environment Uncertainty And Readiness For Organizational Change, Aishah Alsolami, Hanan Alkorashy, Mysara Alfaki, Ahmed Alkarani

Makara Journal of Health Research

Background: Healthcare organizations have a dynamic work-environment that changes constantly. This study aimed to explore whether there is a relationship between work-environment uncertainty and nurses’ readiness to participate in organizational change.

Methods: A cross-sectional study was conducted at two tertiary hospitals. The sample size was 222 nurses. A self-report questionnaire was adopted, translated to Arabic, and used for collecting data; it consists of three scales, personal data sheet, organizational readiness for implementing change scale, and perceived environmental uncertainty in hospitals scale. Descriptive statistics t-test and analysis of variance were used to analyze the data.

Results: The level …

Lesion Size Inclusion On Dermatopathology Requisition Forms: A Quality Improvement Project, Christopher M. Wong, Henry Lim, Christian Scheufele, Daniel A. Nguyen, Ashleigh E. Hermann, Michael Carletti, Stephen Weis

North Texas GME Research Forum 2023

Introduction: Dermatopathology requisition forms (RFs) are a critical communication tool between dermatologists and dermatopathologists. Including detailed information on RFs improves the diagnostic accuracy of the consulting dermatopathologist. However, the diameter of the biopsied lesion is often omitted on RFs. This study aimed to increase the rate of reporting lesion diameters on RFs from an academic outpatient dermatology clinic to greater than 65% through education, reinforcement, and evaluation. Methods: This quality improvement project retrospectively and prospectively analyzed the inclusion rate of lesion diameters on dermatopathology RFs from a single institution. In Phase 1, data was collected from all skin biopsies performed …

Post-Thrombotic Syndrome: Assessing Medical City Weatherford Resident Physicians’ Knowledge In Diagnosis, Treatment, And Prevention, Hiral Thakkar, Aaron Kolar

North Texas GME Research Forum 2023

Post-thrombotic syndrome (PTS) is a relatively understudied sequelae of deep vein thrombosis (DVT). PTS typically presents with similar signs and symptoms as chronic venous insufficiency (CVI) and treatment modalities also mirror each other with the use of compression therapy, emollients, and topical steroids. The contrast is PTS is a direct result of a DVT, and DVTs can be prevented. Thus, it is essential that physicians are able to differentiate and effectively treat both PTS and CVI. Since PTS is widely understudied, the goal of our project is educate residents and other medical professionals on the full scope of PTS including …

Decreasing Rate Of Clabsi At Medical City North Hills With Implementation Of A “Central Line Cart”, William Mangin, Hong Lou, David Maldonado

North Texas GME Research Forum 2023

Central line associated blood stream infections (CLABSI) impart both a significant increase in mortality but also a substantial financial burden onto hospitals. Several processes have been shown to reduce the rate of CLABSIs, most of which have already been implemented at Medical City North Hills (MCNH) Hospital. Key areas of improvement are in those of compliance; namely, the implementation of a dedicated central line cart and a reminder check list to help staff. The project involved implementation of a dedicated line cart at MCNH Hospital. The cart contains supplies for placement of central lines, including trialysis catheters, and arterial lines. …

Phq -9 Utilization In The Primary Care Setting, Michael Armstrong, Ramisa Rahman, Ceferino Cruz Iv, Afsha Rais Kaisani

North Texas GME Research Forum 2023

INTRODUCTION: The Patient Health Questionnaire-9 (PHQ-9) is a tool used to help diagnose depression and assess a patient’s response to treatment. Quality metric (QM) 371 is a measure of PHQ-9 utilization in patients with depression, and Medical City Family Medicine tracks QM 371 in order to improve the quality of care provided to our patients. This project sought to assess utilization of the PHQ-9 in our clinical practice. At the time of this QI project’s inception, QM 371 was reporting at 0%.

METHODS: Our intervention was to give an educational presentation regarding depression, the PHQ-9, as well as how to …

Improving Utilization Of Clinical Pharmacy Services In A Health Professional Shortage Area, Samantha E. Tallman

Masters Projects

Background: Integration of clinical pharmacy specialists (CPS) into primary care has increased over the last decade. CPS are highly educated advanced practice providers and specialize in chronic disease and medication management, and offer additional support to both patients and PCPs. Despite their extensive training and expertise, the role of CPS is often unknown or misunderstood amongst PCPs and results in the underutilization of CPS services. As a result, referrals to their service remain low. The purpose of this quality improvement project is to increase referrals to embedded CPS and identify encounter types by associated diagnoses.

Objectives: Develop and implement a …