Quality Improvement Commons^™

Perinatal Mood And Anxiety Disorders (Pmads): A Scoping Review, Christina Willis Bsn, Rn, Nia Wells Bsn, Rn, Miranda Smith Bsn, Rn, Kate Fouquier Cnm, Phd, Facnm

Doctor of Nursing Practice Projects

Purpose/Background Perinatal Mood and Anxiety Disorders (PMADs), including postpartum depression, anxiety, and psychosis, significantly impact maternal and infant health. This scoping review consolidates current literature on PMADs, emphasizing prevalence, risk factors, screening, and treatment. The primary aim is to identify research gaps and inform clinical guidelines to enhance perinatal care.

Methods A literature search followed PRISMA guidelines from August 2022 to November 2024. Databases searched included PubMed, CINAHL, Scopus, and Google Scholar, using terms such as "perinatal mood disorders" and "maternal mental health." Inclusion criteria were English-language studies from the past decade addressing PMADs during pregnancy and up to one …

The Importance Of Well-Being For College Students, Benjamin Williamson, Dr. Mary Jan Greer, Phd, Otr

Spring 2025 OTD Capstone Symposium

Provided education on well-being, enabled independence, and improved quality of life, specifically for college students in this setting.

Advocate for Sustainable Programs:

Advocated for more programs to address the needs of college students and integrated all 8 dimensions of wellness into their current lifestyle

Support Academic Advancement:

Addressed college students' needs for overcoming occupational adversities which affects the longevity and academic success of college students

Motivate College Students:

Provided accessible and occupation-based resources that supported participating college students in independently improving their occupational roles

Advance Holistic Based Strategies:

Incorporated holistic based strategies that apply to each occupational role affecting participating …

Challenging Race-Based Health Care Discrimination: A New Private Right Of Action, Aaron Pinkett

Northwestern University Law Review

The Hippocratic Oath calls on doctors to “do no harm.” Yet we know from extensive public health research that clinicians repeatedly cause harm to Black patients by dismissing their medical concerns, misdiagnosing them, and undertreating their pain. These practices of differential treatment for Black patients have led to steadily increasing racial disparities in health care outcomes throughout the United States. Title VI of the Civil Rights Act of 1964 prohibits this type of disparate impact, but modern Supreme Court jurisprudence forecloses opportunities for affected parties to seek legal relief—despite the clearly established legislative intent of Title VI. However, another legal …

Indeterminate Benefit Of Long-Term Beta-Blocker Use After Acute Myocardial Infarction For Some Patients, Logan S. Thayer, Khush Hussain, Nicholas Apostolakis, Gretchen Swift, Arifbillah Sarowar, Mohammad Al-Hadidi, Scott Yaekle

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Yndigegn T, Lindahl B, Mars K, et. al., Beta-blockers after myocardial infarction and preserved ejection fraction. N Engl J Med. April 7 2024;390:1372-1381. https://doi.org/10.1056/NEJMoa2401479

for a patient showing 55% left ventricular ejection fraction after myocardial infarction.

Impact Of Cde Referral On A1c Control In Adult Type 2 Dm Patients., Alivia Watts Bsn, Rn, Yesica Sanchez Bsn, Rn, Morgan Hilliard Bsn, Rn, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Type II Diabetes Mellitus is a chronic health condition impacting many adults in Tennessee. Certified Diabetic Educators (CDEs) are specifically trained in educating and addressing the health care needs of patients with diagnoses of Type I or Type II Diabetes. Research has shown that education conducted by CDEs leads to improved outcomes and self- care in those with diabetes (Bowen, et al., 2016, King et al., 2019). Not only are CDEs cost effective services leading to a decrease in healthcare costs, but they also aid in the improvement of hemoglobin A1C (Hgb A1C) levels and decrease complications associated with Type …

Expanded Patient Reach At New Student Run Free Medical Clinic Location, Olivia Krol, Hana Warmflash, Alex Foster

OHSU-PSU School of Public Health Annual Conference

Background: Critical to modern medical education, student run free medical clinics (SRFCs) are present at more than 75% of AAMC member institutions. SRFCs educate students while providing low-barrier, free healthcare to underserved populations. SRFCs provide unique leadership and health systems management opportunities not traditionally emphasized in training, including leading logistical and operational changes.

In this project, we highlight the impact of a student-led operational initiative that transitioned our clinic from the River District Navigation Center (RDNC) to the Resource Center (RC), improving accessibility.

Methods:

Deidentified patient data from medical clinics from January 2024 to February 2025 were analyzed using RStudio …

Evaluating The Effectiveness Of A Non-Pharmacological Sleep Bundle For The Prevention Of Delirium In Geriatric Patients In The Intensive Care Unit: A Scoping Review, Morgan Wilkins Bsn, Rn, Vanessa D'Amico Bsn, Rn, Alyssa Goyda Bsn, Rn, Seema Janga Bsn, Rn, Kaylin Story Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Delirium is an acute disorder yielding cognitive deficits, such as disruption in attention and awareness. It impacts approximately 50% of individuals over the age of 65 who are admitted to the hospital and is prevalent with patients in the intensive care unit (ICU). ICU delirium is associated with adverse outcomes, including higher morbidity, prolonged hospital stays, and chronic neurocognitive deficits. Research demonstrates that implementation of a non-pharmacological sleep bundle can reduce the overall occurrence of delirium. The purpose of this scoping review is to examine the efficacy of a non-pharmacological sleep bundle on the incidence of ICU delirium in …

Improving The Rates Of Sexually Transmitted Infection Diagnosis By Increasing Provider Knowledge About Testing, Lauren Cunningham

Student Scholarship & Creative Works

There has been a significant increase in sexually transmitted infection (STI) rates since 2021. Though this issue is nationwide, rural providers require education regarding testing, screening, and transmission of disease processes. The infections with the most significant increase are gonorrhea, chlamydia, and syphilis. The purpose of this project was to provide education to providers regarding local STI statistics, in addition to when to and not to test for sexually transmitted STI infections. Education was provided to three Advance Practice Nurse Practitioners about disease signs and symptoms, transmission, and local STI statistic rates. STI testing rates were observed three months prior …

Working Conditions Of Perfusionists In North America: A Scoping Review, James Strong

Student Works

Perfusionists face significant challenges, including long hours, high workloads, burnout, and workplace risks like sleep deprivation and discrimination, which impact both their well-being and patient outcomes. Despite these concerns, no comprehensive review has mapped workforce trends, and the lack of widespread American Society of Extracorporeal Technology (AmSECT) guideline implementation worsens the situation. This scoping review highlights these issues, emphasizing the need for standardized assessments, better enforcement of guidelines, and proactive strategies to improve perfusionist well-being and patient safety. This scoping review aims to describe the working conditions of North American Certified Clinical Perfusionists (CCPs).

The Effectiveness Of Gad-7 Screening In High School Students, Tamara L. Smith, Allison Darnell, Margaret Harvey, Phd, Acnp-Bc, Chfn, Jacqueline Sharp Dnp, Aprn, Pmhp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Adolescent mental health is a growing concern, with anxiety disorders being particularly prevalent among high school students. Left untreated, anxiety can significantly impact academic performance, social functioning, and long-term mental health. The COVID-19 pandemic exacerbated these challenges, highlighting the critical need for effective screening and intervention strategies. The Generalized Anxiety Disorder 7-item scale (GAD-7) is a validated tool for identifying anxiety disorders, yet its application in high school settings is limited. This scoping review explores the effectiveness of GAD-7 in increasing mental health referrals and improving anxiety outcomes in high school students.

Methods

A comprehensive search was conducted across …

Evaluating The Efficacy Of Predischarge Referrals In Preventing Emergency Mental Health Hospital Readmissions: A Scoping Review, Pretia Carpenter Bsn, Rn, Stephanie Mays Bsn, Rn, Jacqueline Sharp Dnp, Aprn, Pmhp-Bc, Sharon H. Little, Dnp, Fnp-Bc, Aprn

Doctor of Nursing Practice Projects

Background

Emergency mental health hospital readmissions present significant challenges to healthcare systems, often resulting in increased costs, prolonged hospital stays, and poor patient outcomes. Continuity of care through predischarge referrals to outpatient mental health services, psychosocial support, and community resources has been proposed as a strategy to reduce readmissions. However, the effectiveness of these interventions remains inconsistent across different populations and settings.

Objective

This scoping review aims to evaluate the effectiveness of predischarge referrals in reducing 30-day emergency mental health hospital readmissions, identify key components of successful programs, and assess the influence of demographic factors on readmission rates.

Methods

A …

Provider-Nurse Rounding Checklist: A Qi Project, Danielle Ursone Rn, Bsn, Jennifer O'Neil Bsn, Rn, Ccrn, Susan Penque Ph.D, Anp-Bc, Ne-Bc, Nc-C

Posters

• Communication between healthcare providers and nurses is an essential component for a good working relationship.
• Increased collaboration has been shown to improve staff attitudes and job satisfaction.
• Interprofessional rounds with a rounding checklist provide an organized way to perform rounds to increase satisfaction with teamwork and decrease miscommunication.
• At the DNP project site, a rounding checklist is not being used, resulting in a disconnect between the nurses and healthcare providers.

Dnp Final Report: An Evidence-Based Initiative To Improve Bowel Preparation Quality For Colonoscopy, Jennifer L. Gassett

DNP Final Reports

Good colonic bowel preparation (CBP) is an important component of colonoscopy but is often inadequate. Improving CBP can help increase detection of precancerous polyps, prevent procedures from being canceled or repeated, and decrease medical expenses. A quality improvement project was implemented to increase adequate CBP rates at an ambulatory surgery center specializing in endoscopy. Several factors correlate with suboptimal CBP, but the practice question focused on patient education. The PICOT question guiding evidence synthesis was posed: In adult patients preparing for outpatient colonoscopy, how do revised instructions with visual aids compared to written instructions affect CBP adequacy and patient satisfaction? …

Integrating Workplace Violence Prevention Into Nursing Curriculum: Preparing Future Nurses For Safer Practice ​, Noah Briere, Sarah Kegerreis, Molly Lasyone, Savannah Orris

SPARK Symposium Presentations

Nurses are under attack. 80% of nurses have experienced some form of workplace violence (WPV), which is seen as “part of the job.” Unfortunately, the agency responsible for protecting nurses, the Occupational Safety and Health Administration (OSHA), only offers voluntary guidelines. We have determined that nursing students are the best group to educate about WPV prevention in healthcare. Including this teaching to fit within their pre-clinical requirements, only needing one faculty to teach with an average salary of $80k, to further help set what should be foundational skills. By adding WPV de-escalation techniques and adequately preparing students prior to graduation. …

Duty To Care And Job Turnover Intention In The Post-Pandemic Nursing Workforce, Cathleen A. Lopez

Nursing Theses and Dissertations

Natural and human-made disasters are increasing in number and intensity. In 2020, approximately 688.3 million people required assistance from disaster response personnel. During a disaster or pandemic, nurses must weigh their personal and/or family safety against the ethical code of caring for others. The purpose of this convergent mixed-methods study was to examine duty to care and job turnover intention of registered nurses working in patient-facing roles. A convergent mixed method design was used to address research questions by employing the Nash Duty to Care Scale (NDCS) and the Turnover Intent Scale (TIS-6). Open-ended survey questions were used to explore …

The Impact Of Hyperglycemia On Post-Reperfusion Outcomes In Patients With Hyperacute Ischemic Stroke, Nicole Schumacher

Theses and Dissertations (ETD)

Stroke is a major contributor to disability in the United States, with ischemic stroke accounting for approximately 87% of all cases. The use of approved reperfusion therapies, including intravenous thrombolysis with tissue plasminogen activator (tPA) and mechanical thrombectomy, has significantly improved functional outcomes for ischemic stroke patients. However, hyperglycemia at the time of hospital arrival is associated with worse outcomes, including increased infarct growth, higher rates of disability, and elevated mortality. Despite this, current stroke guidelines neither exclude hyperglycemic patients from receiving reperfusion therapy nor recommend glucose management during the hyperacute phase of care. While recent studies suggest that mild …

Worldwide Trends In The Quality And Breadth Of Clinical Investigations Of Medical Devices Over The Past Decade: A Scoping Review And Evidence Map, Elaine Harris, David F. Keane, Mathew Cherian, Ryan Longley, Rosie Dunne, Thomas Matthew, Paddy Gillespie, Abhay Pandit, Matthew D. Griffin

Articles

682 studies from 2012 and 1682 studies from 2022 were included. Around a quarter of studies were interventional and the remainder being observational and primary outcomes of effectiveness were more common than efficacy. Key study design aspects were frequently unreported, including sample size justification, registration, randomisation technique and funders. Our evidence map demonstrated that predominantly, investigations were of implants and were in a cardiovascular setting. Clinical investigations were broadly similar between 2012 and 2022, though there was a reduction in the proportion of cardiovascular studies, a move in the share of studies coming out of Europe and North America towards …

Cyber Threats In Healthcare: The Ransomware Epidemic, Mackenzie Dotson, Kasi Gorli, Alberto Coustasse

Management Faculty Research

In this presentation, we will delve into the growing ransomware crisis in healthcare, examining how these cyber threats disrupt hospital operations, jeopardize patient safety, and impose significant financial burdens. From understanding how ransomware infiltrates hospital systems to exploring real-world case studies, we will uncover the devastating impact of these attacks. Our discussion will also focus on mitigation strategies, cybersecurity best practices, and policy recommendations to safeguard healthcare institutions from future threats.

Colorectal Cancer Screening And Correlating Gender Disparities, Kara Marr, Megan Janssen, Margaret Payne, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Purpose/Background

In 2023, colorectal cancer (CRC) was the second leading cause of cancer-related deaths in the US, equating to approximately 50,000 total deaths (National Cancer Institute, 2024). Further, it is estimated that an additional 1.4 million Americans are living with CRC (National Cancer Institute, 2024). Early detection screening modalities remain imperative since the NIH has released a combined survival rate of 70% when utilized (National Cancer Institute, 2024). Different derivatives of CRC develop from pre-cancerous polyps and are often without signs or symptoms of disease progression; this asymptomatic period emphasizes the importance of early detection and prevention of colorectal cancer …

Unveiling The Stigma: Doctor Mental Health And Intervention Strategies, Joseph Heirigs

Honors Program: Senior Projects (Public)

Background

The mental health of physicians is a pressing issue that has received increasing attention in recent years. The alarmingly high suicide rates for physicians underscores the critical need to address the mental health challenges that doctors face. Physicians are exposed to stressors that are unique to their profession, including high-stakes decision making, long work hours, traumatic patient situations, and the emotional toll of patient care. These challenges contribute to high rates of anxiety, depression, burnout, and other mental health issues. However, despite these factors, physicians are often reluctant to seek mental health treatment due to fears of professional repercussions, …