Quality Improvement Commons^™

The Quick Dash Reformed: Increasing The Holisticity And Occupational Nature Of Upper Extremity Therapeutic Evaluation, Lauren E. Garcia

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: The QuickDASH is one of the most common upper extremity (UE) focused patient-reported outcome measures (PROMs) utilized within current practice. Despite its high utilization rate, there are still many concerns surrounding the QuickDASH, including its applicability to certain populations, difficulty with cross-cultural adaptation, and limited psychosocial evaluation. Purpose: The purpose of this study was to develop and implement a reformed version of the QuickDASH, the OT-DASH, that included modernized and occupation-focused language to achieve increased client applicability and yield more accurate comparisons between client perceptions of dysfunction and their true clinical presentations. Theoretical framework: The Person-Environment-Occupation-Performance model was utilized …

Improving Neuromuscular Blockade Surveillance In Anesthesia Care With Quantitative Train Of Four Monitoring, Carley S. Blair

Graduate Theses, Dissertations, and Problem Reports (ETD)

Problem Statement: Despite the availability of quantitative train of four (TOF) monitoring, anesthesia providers more frequently rely on tactile (qualitative) TOF monitoring, which is associated with underestimation of recovery from muscle relaxation. Inadequate recovery from muscle relaxants results in residual weakness and its associated complications in the postoperative period, including compromised respiratory function (Thilen et al., 2023).

Background: Neuromuscular blockade (NMB) drugs are required to facilitate endotracheal intubation and allow for surgical manipulation. When these drugs are used, train of four (TOF) stimulations are used to monitor and assess the depth and recovery from NMB. TwitchView monitors (quantitative monitoring) is …

Nephrocheck Implementation And Its Impact On The Incidence Of Acute Kidney Injury After Coronary Artery Bypass Graft Surgery, Michael Maccourtney

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

NephroCheck Implementation and its Impact on the Incidence of Acute Kidney Injury After Coronary Artery Bypass Graft Surgery

Michael C. MacCourtney

Problem Statement: Acute kidney injury occurs in up to 50% of patients after cardiac surgery (Meersche et al., 2017). This contributes to significant morbidity, mortality, and costs (Helgadottir et al., 2016). At the time of the project implementation, the standard of care involved measuring renal function utilizing serum creatinine (SCr) and urine output (UOP) without NephroCheck. These renal function labs do not represent a timely and accurate assessment of the patient’s current renal status because they do not …

Exploring Patient-Provider Communication In Indian American Populations: A Scoping Review, Pranav S. Nadella

Honors Undergraduate Theses

Effective provider-patient communication directly influences patient satisfaction, treatment adherence, and health outcomes, yet the unique experiences of Indian Americans—one of the fastest-growing U.S. populations—remain underexplored in communication research. This scoping review, following Joanna Briggs Institute guidelines, systematically mapped the existing literature on provider-patient communication involving Indian Americans. Eleven studies met inclusion criteria, with data extracted on methods, populations, and seven coded aspects related to communication.

Findings revealed a narrow focus on first-generation immigrants and women, leaving men’s experiences and second-generation voices largely unexamined. Communication was shaped by language discordance, cultural stigma, family involvement, trust dynamics, and health literacy. No studies …

From Tricare To Medicaid: Dental Insurance Disparities Among U.S. Veterans And Active Duty Service Members, Madeline K. Mcnutt Ms

Honors Undergraduate Theses

Oral health plays a critical role in systemic well-being, yet dental care access in the United States remains deeply unequal, particularly among low-income and historically marginalized populations. Among those significantly affected are military veterans, who frequently experience barriers to oral healthcare due to eligibility restrictions within the Department of Veterans Affairs (VA) system. This study offers a comparative analysis of dental insurance satisfaction between recipients of Medicaid and the TRICARE Active Duty Dental Program (ADDP), two federally funded programs that reflect the divide between civilian and military healthcare access. While TRICARE ADDP provides comprehensive and uniform coverage for Active Duty …

Improving Safe And Effective Management Of Pain At Home, Alayna V. Olivarez

Honors Undergraduate Theses

Pain is the most common clinical symptom in individuals with a cancer diagnosis. Additionally, home is the preferred place for cancer care which introduces numerous challenges for cancer pain management. The primary purpose of this literature review is to identify support interventions to enhance pain control, prevent exacerbations in pain, and optimize quality of life in individuals with cancer transitioning from the acute care setting to home. The secondary purpose of this review is to analyze patient-specific barriers influencing self-efficacy of pain management and overall health outcomes in the target population. A systematic literature search was conducted using CINAHL, EBSCOhost, …

Development And Validation Of An Accurate And Precise Skin Color Scale, Henry Lim, Christina Guo, Reem Ayoub, Rafael Do Valle, Kristina Kafle, Ysabelle Martinez, Dana Olsen, Marshall Hall, Christian Scheufele, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Introduction: Utilization of the Fitzpatrick scale to describe skin color does not adequately account for variations in pigmentation that are reflective of skin color characteristics of persons from diverse racial and ethnic backgrounds. This study aims to create a better way to describe skin color. Methods: We developed an 11-point color scale. This Skin Color Scale (SCS) was reproduced onto a physical card that could be placed onto a research participant’s inner arms for independent scale interpretation. Participants and two investigators selected the best matching scale interpretation value for each arm. Self-acquired and investigator assessed Fitzpatrick scores were taken. These …

Implementation Of A Process To Improve Compliance With A Nurse Driven Foley Catheter Removal Protocol In Nursing Staff Of A Medicine Intensive Care Unit, Kendall L. Pfister

DNP Projects

Background: Catheter associated urinary tract infections (CAUTI) are the most prevalent healthcare acquired infection (HAI) in the acute care setting. Unfortunately, CAUTIs can lead to high morbidity and mortality rates, longer length of stay (LOS) and increased healthcare costs. Unfortunately, in critically ill patients which often suffer multi-organ failure/injury, there remains an increased risk for infection and poor outcomes.

Purpose: The purpose of this project is to increase medical intensive care unit (MICU) nursing staffs’ knowledge of existing nurse driven indwelling urinary catheter removal protocol and to implement an electronic medical record (EMR) prompt for removal of unnecessary urinary catheters …

Navigating Sexual And Gender Diversity: A Quality Improvement Project To Increase Provider Cultural Competencies For Sexual And Gender Minorities In Mental Health Outpatient Facilities, Shermeen Chandani

Doctor of Nursing Practice Final Project Abstract

Purpose: Sexual and gender minority (SGM) populations experience healthcare disparities related to stigma, discrimination, and limited provider cultural competency. In outpatient psychiatric settings, non-affirming practices can negatively affect patient engagement, trust, and continuity of care. This quality improvement project aimed to enhance staff sexual and gender minority cultural competency (SGMCC) and strengthen affirming clinical processes.

Background: The project was implemented across two outpatient psychiatric clinics with approximately 28 multidisciplinary staff members. At baseline, no formal SGM cultural competency training or standardized documentation practices for preferred names and pronouns existed.

Methodology: A Plan–Do–Study–Act framework with a pre/post-test design was used. The …

Financial Health Literacy Of Community-Dwelling Older Adults: A Qualitative Research Study, Kimberly Davis

Theses and Dissertations

Background: Financial health literacy (FHL) is an emerging concept with unique application to older adults. Multiple complexities converge in older age that create increased financial vulnerability (e.g., retirement, chronic disease). However, low financial and health literacy are common in older adults, impacting their ability to self-manage. The AWV’s focus on prevention offers an opportunity to incorporate a proactive approach to financial-related assessment. This study will explore the perceived value of assessing FHL in primary care settings and the financial-related barriers and facilitators to implementing the personalized prevention plan.

Methods: The conceptual framework was guided by the Individual and Family Self-Management …

Comparison Of Transversus Abdominis Plane Block Versus Intrathecal Clonidine In Lower Segment Caesarean Section - A Prospective Observational Study, Christy Maria Paul, Dr Somsundar R G Associate Professor, Dr Archana B N Assistant Professor, Dr. Shivakumar G Pofessor And Hod

Digital Journal of Clinical Medicine

Comparison of Transversus Abdominis Plane Block versus Intrathecal Clonidine in Lower Segment Caesarean Section - A Prospective Observational Study

Background and Objective: In the majority of abdominal procedures, transverse abdominis plane block, one of the fascial plane blocks, has been used extensively to treat post-operative pain. Ultrasound has gained popularity in the management of cesarean patients due to its ease of use and reduced adverse effects.To assess the effectiveness of ultrasound guided transverse abdominus plane block with intrathecal clonidine for post surgical pain control in lower segment cesarean patients.

Material and Methods: This prospective observational study was done in …

Factors Affecting The Quality Of Life Of Residents In The United States: Lessons From Virginia, Daniel K. Pryce

Sociology & Criminal Justice Faculty Publications

Evaluating community members' views about their quality of life is important for improving quality of well-being in society, as most societies are interested in the collective well-being of the people. Moreover, quality-of-life research helps public officials to understand how well they are meeting the needs of the electorate. Using the theoretical framework of Maslow's Developmental Perspective, which argues that the higher the need satisfaction of the majority in a given society the greater the quality of life of that society, I explore the effects of multiple variables on quality of life in the Hampton Roads region of Southeast Virginia (this …

Increasing Serious Illness Conversations In Patients At High Risk Of One-Year Mortality Using Improvement Science: A Quality Improvement Study, Kanishk D. Sharma, Sandip A. Godambe, Prachi P. Chavan, Agatha Parks-Savage, Marissa Galicia-Castillo

Department of Family and Community Medicine Faculty Publications

Background: Serious illness conversation (SIC) in an important skillset for clinicians. A review of mortality meetings from an urban academic hospital highlighted the need for early engagement in SICs and advance care planning (ACP) to align medical treatments with patient-centered outcomes. The aim of this study was to increase SICs and their documentation in patients with low one-year survival probability identified by updated Charlson Comorbidity Index (CCI) scores. Methods: This was a quality improvement study with data collected pre- and post-intervention at a large urban level one trauma center in Virginia, which also serves as a primary teaching hospital to …

Improving Mmr Vaccine Administration Among Rubella Non-Immune Postpartum Women – A Quality Improvement Project, Renée Ricci, Erika Olsen, Final Patel, Stephanie Tootle, Dina Linfoot, Anthony Royek, Eric Shaw

South Atlantic Division GME Research Day 2025

No abstract provided.

From Trial To The Prescription Pad: Quality Improvement Of Sglt-2 Inhibitor Prescription Prevalence For Patients With Diabetes And Heart Failure, Grace Fawcett, Victoria Blaisdell, Riley King, William Hannah, Eric Shaw

South Atlantic Division GME Research Day 2025

No abstract provided.

Introducing Transitional Care Management In Outpatient Setting For Emergency Department Discharge Follow Ups, Radhika Mohan, Sanket Patel, Deepa Nuthalapati, Michael Smith, Valerie Sinkler, Dennis Besong, Pooja Paunikar

South Atlantic Division GME Research Day 2025

No abstract provided.

Education Interventions Implemented To Increase Lung Cancer Screening Rates, Arpit Arora, Crystal Bharat, Sophia Zia, Pooja Paunikar, Dana Simpson

South Atlantic Division GME Research Day 2025

No abstract provided.

Daily Weights, Better Outcomes: The Positive Impact Of Daily Weight Tracking In Hospitalized Patients On The Telemetry Floor, Sophia Zia, David Ortega, Lailany Agront-Davo, Merid Moqattash, William Lopez, Sirin Khajaviyan, Yagmur Beaman, Michael Craig

South Atlantic Division GME Research Day 2025

No abstract provided.

No Patient Left Behind: Improving Transition Of Care In Coronary Artery Disease And Heart Failure Patients, Rebecca Schuyler, Gunjan Mundhra, Mubbasher Syed

South Atlantic Division GME Research Day 2025

No abstract provided.

Inpatient Vs. Outpatient Management Outcomes Of Ectopic Pregnancy With Methotrexate, Courtney Smith, Taryn Hoffman, Kavya Davuluri, Ashley Brodrick, Taylor Penny, Robyn Meadows, Martin Wegman

South Atlantic Division GME Research Day 2025

No abstract provided.