Health and Medical Administration Commons^™

Ultrasound-Guided Epidural Placement Vs. Conventional Technique - Evaluating Effectiveness: A Scoping Review, Skylar R. Kuehn, Bsn, Rn, Ccrn-Cmc, Jacob B. Morphis, Bsn, Rn, Sarah D. Price, Bsn, Rn, Katherine E. Pritchard, Msn, Rn, Jordan Isaac Dnp, Crna, Sharon Little Dnp, Aprn, Fnp-Bc, Tracy Mcclinton

Doctor of Nursing Practice Projects

Purpose/Background

Epidural anesthesia is a cornerstone of perioperative pain management, offering effective analgesia and reduced opioid dependency. However, traditional landmark-based epidural placement (EP) techniques often result in variable first-pass success rates (FPSR) and increased risks of complications. Ultrasound-guided (USG) EP has emerged as an alternative, providing real-time anatomical visualization to improve accuracy and safety. This scoping review synthesizes evidence on the comparative efficacy of USG EP and conventional techniques in adult patients undergoing perioperative epidural anesthesia.

Methods

This review commenced September 2023 and included full-access, peer-reviewed journal articles published in English between 2014-2023. Databases searched included PubMed, CINAHL, Cochrane Library, …

Assessing The Efficacy Of Remimazolam Vs. Midazolam In Short-Duration Gastrointestinal Endoscopy Procedures And How They Affect Patient Recovery Time: A Scoping Review, Kelsey Gray, Bsn, Rn, Ccrn, Shannon Guthrie, Bsn, Rn, Ana Grace Holder, Bsn, Rn, Will Howard, Bsn, Rn, Dwayne Accardo Dnp, Crna, Faana, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose

The purpose of this scoping review is to evaluate and compare the efficacy of Remimazolam and Midazolam as sedatives in short-duration gastrointestinal endoscopy procedures.

Efficacy Of Aprepitant And Ondansetron In Managing Postoperative Nausea And Vomiting In Perioperative Obese Patients, Jada Stewart, Reagan Revon, Samantha Castellaw, Ashlee Roberts, Dwayne Accardo Dnp, Crna, Faana, Bobby Belflower Dnsc, Nnp-Bc, Faanp, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Postoperative nausea and vomiting (PONV) is a common adverse event that occurs during the recovery period following anesthesia. PONV has been reported to affect nearly 80% of patients, leading to prolonged hospitalization, increases in cost of care, patient dissatisfaction, dehydration, electrolyte imbalances, acute kidney injury, and pulmonary aspiration. Certain risk factors, including obese patients, female gender, and nonsmoker status, increase the risk of PONV. Traditionally, for all patients going under anesthesia, a prophylactic antiemetic regimen is administered; however, since obese and other high-risk patients are at increased risk of experiencing PONV despite traditional regimens, anesthesia providers should administer multiple …

Social Determinants Of Health Screening – Evaluating Its Influence On Glycated Hemoglobin Levels In The Pediatric Population: A Scoping Review, Lindsay Gibson, Victoria Hutchison, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Ebp-C, Sally Humphrey Dnp, Aprn, Cpnp-Pc

Doctor of Nursing Practice Projects

Purpose/Background

Social determinants of health (SDOH) have a significant impact on health outcomes. Pediatric patients with type one diabetes mellitus (T1DM) with adverse SDOH have inferior glycemic control, higher healthcare utilization, and increased risks of complications. SDOH screenings are not standard practice in pediatric T1DM care despite literature demonstrating that screening can improve outcomes. This scoping review aims to summarize existing evidence surrounding SDOH screenings and their impact on pediatric T1DM outcomes.

Methods

A scoping literature review was conducted from August 2022 to November 2024 via CINAHL, Cochrane, EBSCO, Elsevier, and PubMed. Inclusion criteria included peer-reviewed articles, English language, publication …

Dental Utilization Pre- And Post-Covid-19 Pandemic Shutdown Across Different Birth Cohorts, Anirudh Agaram, Jeff Johnston Dds, Ms, Stephen A. Eklund Drph, Dds, Mhsa

The Journal of the Michigan Dental Association

Given the disruptions to dental practice because of COVID-19 in 2020, the question arose as to how dental patients would return to dental care in the following years, and if treatment patterns would be different, or would return to the previous patterns. Further, it was desired to understand whether patients of different ages would return to dental practices and use dental services differently. In order to assess these questions, utilization patterns among commercial enrollees within Delta Dental of Michigan, Ohio, and Indiana were explored. The analysis, spanning from 2018 to 2023, focused on diagnostic, preventative, and restorative procedures across diverse …

Examining The Impact Of The Executive Healthcare Leadership Institute On Faculty Readiness To Lead, Blythe Eggleston

Graduate Theses and Dissertations

Americans living in rural communities face significantly poorer health outcomes compared to those in urban areas. Academic medical centers (AMCs), such as the University of Arkansas for Medical Sciences (UAMS), play a critical role in addressing these disparities by incorporating rural health improvement into their mission. UAMS has committed to mitigating adverse health outcomes through targeted initiatives. However, AMCs operate within highly complex environments, balancing their tripartite mission of teaching, research, and clinical care, which demands exceptional leadership. These institutions also face unique organizational and economic challenges, compounded by personal and professional pressures on faculty members. To enhance leadership capacity …

Joint Modelling Of Longitudinal Egfr Trajectory And Time To Acute Kidney Injury In Lung Transplant Patients, Samiha Zakir

Theses and Dissertations

Progressive declines in estimated glomerular filtration rate (eGFR) often precede acute kidney injury (AKI), yet the relationship between eGFR trends and AKI risk remains unclear. This study investigates longitudinal eGFR changes and their association with AKI in 459 lung transplant patients followed for up to 7 years (n = 6419). We applied a piecewise linear mixed-effects model to evaluate eGFR trajectories and a Cox proportional hazards model to assess time to AKI. A joint model was used to explore the interplay between longitudinal and survival processes. Key covariates included gender, age at transplantation, antibody-mediated rejection (AMR), and pre-transplant eGFR. Males …

05-20-25 Bor Hsc Committee Meeting Minutes, Patricia Serna

HSC Committee (A subcommittee of the UNM Board of Regents)

05-20-25 BOR HSC Committee Meeting Minutes

Implementation Of Houdini Guidelines Nurse-Driven Protocol To Lower Catheter-Associated Urinary Tract Infections And Foley Utilization Days, Tammie N. Collins

Electronic Theses and Dissertations

Catheter-associated urinary tract infections are a common issue in healthcare settings. These issues contribute to hospital-acquired infections and can lead to complications and increased healthcare costs. The quality project evaluated the impact of the HOUDINI guidelines nursedriven protocol to reduce infection rates and Foley utilization days. A structured guideline for Foley catheter safe removal was implemented using a quantitative method. Catheter-associated urinary tract infection rates and Foley utilization days pre- and postintervention were tracked. Data were collected using the electronic health records, infection control data sheets, and the HOUDINI checklists. A baseline assessment of catheter-associated urinary tract infections rates was …

Portable Head Computed Tomography Protocol For Trauma, Christian Quinones, Alexander Bolufer, Cory Hewitt, Sagun Tuli

HCA Healthcare Journal of Medicine

The use of portable computed tomography (CT) scanners has been shown to reduce risks associated with intrahospital transport and to expedite imaging in critically ill patients. While their use is established in intensive care units, their utility on intraoperative trauma patients remains underexplored. This paper reviews existing literature on portable CT use, defines appropriate clinical indications, outlines contraindications, and identifies quality metrics and implementation challenges. It also presents a proposed protocol for integrating portable head CT imaging into trauma workflows, focusing on early identification of intracranial or spinal injuries in the operating room. The development and analysis of standardized protocols …

Hope Experience Essentials: The Next Generation Of Service Standards At Mayo Clinic, Jennifer Packard, Richard M. Elias, Thomas J. (Tripp) Welch, Karee A. Munson, Jonathan A. Leighton

Patient Experience Journal

Engaging employees in providing exemplary patient experience has been challenging for healthcare leaders in recent years given the pressures of the regulatory environment, increases in staff burnout and rising patient expectations. Amid these challenges, addressing patient experience remains a top priority for healthcare organizations. A novel intervention has been applied at Mayo Clinic with the goal of improving both employee engagement and patient experience. Previous efforts to teach service excellence involved customer service trainings, sometimes purchased through outside vendors. This new initiative is based on our organizational culture and values, input from our employees and patients, and considers the changing …

Cancer Partnerships Hub (Cph) Model: Implementing An Organizational Innovation To Enhance Engagement Of Patient-Partner In Cancer Care Services, Deborah Pascale, Sandie Oberoi, Charlotte Gélinas-Gagné, Pegah Torabi, Ludovic Tamaro, Karine Bilodeau

Patient Experience Journal

Patient partnership is rapidly becoming a cornerstone of effective care, with healthcare professionals recognizing the immense value of collaboration. This case study delves into the innovative Cancer Partnership Hub (CPH) model implemented at the Integrated University Health and Social Services Center of East Montreal Island (CIUSSS-EMTL) in Quebec, Canada. The CPH model exemplifies the integration of patients as active agents within the cancer program. The CPH Model is designed to offer comprehensive support and information services, providing a diverse array of resources crafted ``by and for'' people living with and beyond cancer (PLC). Rooted in the project's motto ``Engage. Share. …

What Makes A Hospital Gown Functional? A Comparative Case Study Of Effective Patient-Centered Design Practices In Four (N = 4) Hospital Gowns, Robmarie Lopez

Patient Experience Journal

A hospital gown is essentially a patient uniform. Yet, the typical ``tie in the back'' hospital gown, standard garb for routine medical procedure, can have great influence over key intervention factors like receptiveness to treatment and patient self-esteem. Thus, the goals of this study are two-fold: 1) To understand patient perceptions of the standard hospital gown, and 2) To understand which principles and elements of design underpin effectively functional hospital gown redesign. Aim 1 was assessed via a comprehensive literature review of n = 5 qualitative or mixed-methods studies which surveyed or interviewed patients on their experience with the standard …

Adolescents With Cystic Fibrosis Expressing Their Possible Selves Through Photovoice: A Longitudinal Interpretative Phenomenological Analysis To Prepare A Peer Support Intervention For Healthcare Transition, Maxime Morsa, Adélaïde Vincent-Lardy, Julie Haesebaert, Catherine Llerena, Lucie Pelz, Philippe Reix, Rémi Gagnayre, Quitterie Reynaud

Patient Experience Journal

While the transition from pediatric to adult care has become a field of study and practice focused on preparing the adolescent to ``become an adult with a chronic condition'', we are conducting participatory research to develop, implement, and evaluate a peer-support intervention aimed at supporting transition from pediatric to adult care for adolescents living with cystic fibrosis within two hospital centers in France. In preparation for this intervention, we would like to better understand how peer support could support identity self-determination of the adolescents. We conducted a longitudinal qualitative research using photovoice technique. For one year, 8 French adolescents (15–18 …

Understanding The Care Experiences And Support Needs Of Uk Adults Treated In Hospital For Meningitis, Harriet Hay, Amy Tallett Dr, Bec Aeddi, Beverley Corbett, Claire Donovan, Jane Blewitt, Juan Abad Madroñero

Patient Experience Journal

Background: Meningitis often results in ongoing and multifaceted after-effects, which can impact many aspects of people's lives, yet relatively little support and follow-up is offered. This study explored post-treatment care experiences of UK adults aged 16 and over following a recent stay in hospital for meningitis. Methods: A survey was designed to ask about hospital discharge, recovery, information provision and aftercare support. The research involved 5 semi-structured, in-depth interviews and a 15-participant online asynchronous focus group. The themes arising from this qualitative stage informed the development of a quantitative 32-item questionnaire which was hosted and promoted online between September 2022 …

Unveiling Patient Satisfaction: Exploring Demographics, Interactions, And Health-Seeking Behavior, Vanessa B. Crowther, Cassandra Shaw-Johnson, Robbya R. Green-Weir, Pia S. Woodley, Marilyn A. Weatherspoon, Errick D. Farmer, Arlesia L. Mathis

Patient Experience Journal

Objective: This study examined the social context of the patient visit (demographics, waiting room experience, patient-provider interaction) and their relationship to satisfaction with the quality of care when seeking medical treatment. It also examined satisfaction as a predictor variable for its effect on three patient behavioral outcomes. Methods: The study was implemented using a cross-sectional quantitative design among adults aged 18 and older. One hundred fifty-eight participants responded to the survey, and the final sample size was n = 147. We employed advanced data analysis, hierarchical regression, three-way ANOVA, linear regression, and logistic regression to examine four outcome variables. Results: …

Effectiveness Of Incident Reporting Tools In Ensuring Patient Safety: A Systematic-Narrative Hybrid Review, Valentina Cerrone, Vincenzo Andretta, Angela Prendin, Bernadette Ilardi, Carloluigi Bonetti, Mario Capunzo, Marco Cascella

Patient Experience Journal

Background: Ensuring Patient Safety in healthcare is essential and requires efficient methods to reduce risks and improve the quality of care. Although incident reporting tools are commonly used to identify possible and actual care failures, their efficacy differs among various environments. The aim is to evaluate the effectiveness of incident reporting tools in enhancing patient safety. Methods: This review employed a combined methodology that integrates systematic and narrative approaches to gain a thorough understanding of incident reporting practices. In accordance with PRISMA guidelines, databases including PubMed, Embase, and Cochrane Library were systematically searched for studies published from January 2013 to …

Patient Perspectives On Implementing A Person-Centered Care System: Experiences From The U.S. Veterans Health Administration's Whole Health System Of Care, Ekaterina Anderson, Renda S. Wiener, Brianne Molloy-Paolillo, Megan Mccullough, Bo Kim, J. Irene Harris, Seppo T. Rinne, Barbara G. Bokhour

Patient Experience Journal

Objectives. Replacing the disease-centered, paternalistic approach in healthcare with a person-centered model has become a widely recognized imperative. However, patients' perspectives on and experiences with real-life efforts to implement this approach to care are rarely studied. We examined this issue at a health system with a prominent record of commitment to implementing person-centered care on the system level – the U.S. Veterans Health Administration (VHA). For over a decade, VHA has been transforming itself into a Whole Health (WH) system of care that is person-centered, holistic, and empowering. Methods. We conducted semi-structured qualitative interviews with 19 patients recruited from a …

My Life, My Story And Life Recovery Among Veterans With Substance Use Problems, Grace Chang Md, Mph, Martha J. Duffy Md, Susan Nathan Md

Patient Experience Journal

Objective: The United States Veterans Health Administration My Life, My Story (MLMS) program is a patient-centered care intervention where veterans are interviewed about their life story and may grant permission to include it in their electronic health record (EHR). Our purpose was to focus on a sample of MLMS narratives from veterans with self-disclosed substance use (SU) from our institution, and to evaluate the potential relationship between their content and a life change for the better, and to compare their content with the EHR. Methods: The narratives were reviewed on 4 domains (past challenge, substance use, experience of a turning …

The Impact Of Learners On Patient Satisfaction In The Orthopedic Setting, Sydney Boike, Kevin Hodge, Lynsey Malin, Timothy Nyangacha, Rebekah Kleinsmith, Megan Reams, Julia Stumpf, Bradley Nelson

Patient Experience Journal

This investigation evaluates the impact of learners and their post-graduate year (PGY) levels on patient satisfaction in the orthopedic outpatient clinic, an area with limited prior research. A retrospective cohort study was conducted using data from July 2020 to December 2022, involving 2,484 patients, with a 39% response rate. Satisfaction was measured via NRC Health surveys, focusing on the likelihood of recommending the provider or clinic based on the presence of learners, categorized as none, present in the clinic, or involved in patient care. Non-parametric statistical analysis revealed significant reductions in satisfaction when learners were involved in care, with top-box …