Quality Improvement Commons^™

Quality Improvement Protocol: Improving The Use Of Nonpharmacological Pain Management Strategies Within The Inpatient Hospital Setting, Katherine Salamon, Christina Russell, Dara Devinney, Catherine M Soprano

Department of Medicine Faculty Papers

Background: There are many nonpharmacological pain management services available to hospitalized youth; however, not all youth are offered these services. Lack of knowledge about resources, difficulty with the referral process, and lack of understanding about nonpharmacological pain management services and when to refer patients are among the main reasons for lack of utilization. Quality improvement (QI) initiatives have grown within hospital settings and can serve to create change in fast-paced environments. Methods: The current QI project aimed to pilot an educational program to increase the use of nonpharmacological pain management interventions. Staff located on one floor of a pediatric hospital …

Quality Improvement In Public-Private Partnerships In Low- And Middle-Income Countries: A Systematic Review, Cassandra Iroz, Rohit Ramaswamy, Zulfiqar Bhutta, Paul Barach

College of Population Health Faculty Papers

BACKGROUND: Public-private partnerships (PPP) are often how health improvement programs are implemented in low-and-middle-income countries (LMICs). We therefore aimed to systematically review the literature about the aim and impacts of quality improvement (QI) approaches in PPP in LMICs.

METHODS: We searched SCOPUS and grey literature for studies published before March 2022. One reviewer screened abstracts and full-text studies for inclusion. The study characteristics, setting, design, outcomes, and lessons learned were abstracted using a standard tool and reviewed in detail by a second author.

RESULTS: We identified 9,457 citations, of which 144 met the inclusion criteria and underwent full-text abstraction. We …

An Educational Intervention Differentiating Pressure Injuries From End-Of-Life Wounds, Alicia Perez Varela, Annette Callis

Providence Nursing Research Conference 2023 – Present

Background

End-of-life (EOL) wounds are identified in the literature as Kennedy Terminal Ulcers (KTU), Skin Failure (SF), Trombley-Brennan Terminal Tissue Injury (TB-TTI), and SCALE (Skin Changes at Life’s End). EOL wounds have a similar appearance to pressure injuries (PIs) with a fundamentally different etiology. The misclassification of EOL wounds as PIs results in increased Hospital Acquired Pressure Injuries (HAPI), hospital fines, and less-than-optimal EOL wound management.

Purpose

To examine the effectiveness of an educational intervention on EOL wounds in increasing nurse confidence in providing End-of-Life Care (EOLC) and differentiating PIs from EOL wounds.

Methods

This quasi-experimental study used the 28-item …

Fall Prevention Quality Initiative: Implementation Of Fall Ambassador Safety Team (Fast), Jerome Codilla, Joanna Arraiza

Providence Nursing Research Conference 2023 – Present

Background

Patient falls are the most common adverse events reported in hospitals and represent a persistent patient safety issue. Annually, roughly 700,000 to 1 million patient falls occur in United States hospitals, resulting in around 250,000 injuries and up to 11,000 deaths (LeLaurin et al., 2019). Nurses are responsible for the identification of high fall risk patients and development of a plan of care to minimize risk. Multifactorial strategies have been shown to reduce falls, but evidence of a sustainability team (fall champions) is lacking. Review of the National Database of Nursing Quality Indicators (NDNQI) data on a 33-bed progressive …

A Quality Improvement Project To Decrease New Or Worsening Pressure Ulcers In A Skilled Nursing Facility (D-Pus Snf), Shaune Mattsson

Providence Nursing Research Conference 2023 – Present

Background:

Pressure ulcers (PU) are a "localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or shear/friction". PU are an urgent problem in the United States (U.S.). Residents in skilled nursing facilities (SNF) are disproportionately affected, with 9.2% of residents estimated to suffer a PU nationally. The Braden Scale is gold standard for identifying individuals at risk for PU in healthcare settings across the continuum and grades PU risk in 6 categories: sensory perception, moisture, activity, mobility, nutrition, and friction/shear. To protect against PU, a Braden Scale must be documented on …

A Quality Improvement Project To Reduce Hospital Acquired Pressure Injuries In Patients With Darker Pigmented Skin, Ma Fe Chase, Travis Scott, Renee Hoeskel, Yolanda Rodriquez

Providence Nursing Research Conference 2023 – Present

Purpose: This quality improvement (QI) project aims to improve the accuracy and effectiveness of skin assessments for patients with darker skin tones in preventing hospital-acquired pressure injuries (HAPIs) by implementing an evidence-based, standardized skin assessment protocol and training program.

Background: Nursing staff play a vital role in preventing HAPIs. Nearly 2.5 million patients develop HAPIs annually in the United States increasing their risk of prolonged hospitalization, increased readmission, infections, and severe pain. Preventing HAPIs continues to be top priority in acute care facilities. Recent audits at a large urban Pacific Northwest hospital revealed high HAPI rates with a staff …

Uda To Rda: A Pathway To Greater Success, Margaret Gingrich Dds

The Journal of the Michigan Dental Association

UDA to RDA: A Pathway to Greater Success" by Margaret Gingrich, DDS, explores the advantages of transitioning unlicensed dental auxiliaries (UDAs) to registered dental assistants (RDAs). The article emphasizes the benefits for both practitioners and staff, citing increased efficiency, improved patient care, and expanded practice capabilities. Dr. Gingrich shares personal experiences from her rural practice, highlighting the challenges of workforce shortages and the strategic adoption of RDAs to address these issues. She outlines a pathway for UDAs to attain RDA status through targeted training programs and contractual agreements, enhancing career satisfaction and practice productivity. The article underscores the importance of …

Coping Strategies And Stress Of The Undergraduate Nursing Student In The Clinical Setting: An Evidence Based Practice Quantitative Study, Ashley Calverley

Electronic Theses and Dissertations

The assessment of perceived stress and coping behaviors related to first-semester clinical might benefit students in nursing education. The assessment of most common coping behaviors and perceived stress related to the clinical setting is essential due to difference in personalities, learning abilities, and coping behaviors among nursing students today. Previous research has suggested the initial clinical period results in adverse outcomes, such as poor academic performance, elevated burnout levels, and diminished personal well-being. These factors are detrimental to academic success in nursing programs. Evidence supports that helping students develop positive stress/coping abilities will aid in adapting in both the academic …

Assessing The Types Of Juvenile Detention Medical Issues: A Focus On Florida, De’Angelo L. Dean

MUSC Theses and Dissertations

The justice system for young people in the United States has been a source of worry as more people acknowledge the possible adverse outcomes of involvement in the justice system during adolescence. Involvement with law enforcement can lead to various difficulties for young people, such as heightened susceptibility to psychological problems, interruptions in their education, and reduced prospects for achievement in the future. Hence, it is crucial to understand the interplays between the health care for juveniles referred by courts or law enforcement for hospital care to identify opportunities for process and outcome improvements. The interaction between juveniles and the …

Lessons From Hospitality: Towards A Hybrid Model Of Senior Living Communities, Yunying Zhong, Tingting Zhang

Rosen Research Review

Old age gets most of us, and how we spend it should be meaningful. The hospitality sector could play a vital role in this regard. Senior living communities are big business in the U.S., but they face demands from residents, and the family and friends who visit them, for more than the traditional focus on healthcare. UCF Rosen College of Hospitality Management researchers, Dr. YunYing Zhong, Dr. Tingting Zhang, and their co-author understand the connection between the senior living community and hospitality sectors; their research is giving impetus to a hybrid model that could benefit both.

A Hospitality-Inspired Approach To Understanding Patient Experience, Maksim Godovykh, Abraham Pizam

Rosen Research Review

Patient experience is the individual's perception of how a healthcare institution treats them on their journey through illness or injury. Research shows that patient-centered care not only improves the quality of healthcare services, but also the patient's wellbeing and health outcomes, and this has resulted in an increased focus on patient experience. Despite its established importance, accurate measurement of patient experience remains a challenge. Applying their experience and knowledge of the hospitality industry, Dr. Maksim Godovykh and Dr. Abraham Pizam at UCF Rosen College of Hospitality Management are developing a broader and more scientific approach to measuring patient experience.

" Does Educational Level Affect The Outcome Of Myocardial Infarction? ", Ahmed Magdy Ahmed Elsayed

Theses and Dissertations

Background: Heath awareness plays a major role in determining the outcomes of serious medical conditions specially when response time is crucial. STEMI patients are prone to serious compilations if they didn’t receive the appropriate treatment on time. Raising the health awareness of the community would result in seeking medical help at earlier stage of the disease. Earlier presentation to the medical center would result in better health outcomes. Certain factors form the health awareness of the community. This includes educational level, previous exposure to similar situations, and exposure to health awareness materials.

Methods: This is a cohort study in …

Measures Of Function In Physical Therapy Assessment Of Children With Cerebral Palsy: A Clinical Audit, Marvin D. Zotomayor

Philippine Journal of Physical Therapy

Introduction: The assessment of outcomes in children with cerebral palsy (CP) is important for monitoring their progress, evaluating interventions, and guiding health policies. This study aimed to (1) identify the most common outcome measures used in the clinics to assess function in children with CP, and (2) determine whether the outcome measures used in the clinics meet the current standards of assessment for the purpose of improving patient care decisions, research, and quality assurance.

Methodology: A retrospective record audit study design was used to determine if the current practice in the clinics on the assessment of function in children with …

Characteristics And Patterns Of Diagnoses For Patients Admitted From And Discharged To Court Or Law Enforcement In The State Of Florida, Christopher Bridgeman

MUSC Theses and Dissertations

OBJECTIVE: The role of prison healthcare is to provide safe, high-quality, and timely healthcare for prisoners. This study examines the characteristics of patients discharged from healthcare in the nation’s third-largest prison system, the state of Florida.

METHODS: This was a study of adults (18-64) admitted from or discharged to law enforcement agencies in Florida in 2018 for healthcare in Florida hospitals. Patients were divided among distinguishable characteristics of gender, zip code, income quartile, rural/urban locality, and insurance type. Data was collected within the Office of Data Collection & Quality Assurance (DCQA) within the Florida Agency for Health Care Administration (Florida …

The Interrai Ed Tool For Screening Older Patients In The Emergency Department: “What Am I Supposed To Do With This?”, Michael L. Malone

Journal of Geriatric Emergency Medicine

not applicable for Collective Wisdom/ Editorial per JGEM author guidelines.

Effectiveness Of Antibiotic Stewardship For Healthcare Providers At Urgent Care Clinics, Helen T. Adewole

Electronic Theses and Dissertations

Antibiotics have revolutionized modern medicine; however, the overuse in urgent care and primary care significantly contributes to the global burden of infections resistant to available antimicrobial medicines. Approximately 30% of the antimicrobials prescribed in acute care settings are unnecessary. Patient demand for antibiotics has seemingly skyrocketed following the recent COVID-19 pandemic. Practitioners must be knowledgeable about antibiotic stewardship initiatives, such as the wait-and-see approach, to reduce antibiotic overuse and improve the trajectory of antibiotic resistance and patient health outcomes. The gap in practice was the limited awareness of scientific evidence-based tools to partner with patients and improve antibiotic prescription patterns. …

Boarding Of Older Adults: A Concerning Trend In The Emergency Department, Julie Van Baardwijk, Eric Tharmathurai, Ariba Khan

Journal of Geriatric Emergency Medicine

Emergency department (ED) boarding (EDB) is the practice of holding admitted patients in the ED due to a lack of hospital beds. We identified one ED in our health system with a high rate of EDB. We sought to identify factors associated with EDB in this hospital by comparing it to a similar hospital in our health care system.

Methods: We conducted a retrospective study comparing two community hospitals in our healthcare system. Boarding was defined as a patient waiting ≥8 hours in ED for disposition. One hospital, located in a rural area with 55beds was chosen as it was …

A Case Study To Investigate Factors Influencing The Santa Clara County Getting To Zero Initiative’S Collective Impact Model, Harit Agroia, Rebecca Reno, Jenette Spezeski, Leyla Mousli, Richard Sarabia, Erin Starzyk

Journal of Social, Behavioral, and Health Sciences

Our objective was to explore how factors, such as backbone organization changes and COVID-19, affected a collective impact (CI) initiative’s progression through the five CI phases and its components of success. We conducted a case study using semistructured interviews with 17 representatives from the action committee, community-based organization, and health department between January and February 2023 in Santa Clara County, California. Participants were asked how internal and external factors affected their engagement and experiences with the CI initiative. We analyzed the data using structural and holistic coding. Results showed that the initiative’s progression was impacted by intersecting factors; overall findings …

Enhancing The Safety Of Medication Administration: The Synergistic Role Of Closed Loop Electronic Medication Management And Iv Medication Administration, Kelly Goetz, Angela Schoenung, Lauren Daugherty, Kaitlyn Hornsby

Posters-at-the-Capitol

The high acuity of patients in the ICU results in numerous medications being administered, increasing the risk of medication errors. The purpose of this project is to investigate the impact of integrating consistent closed loop electronic medication management (CLEMM) to decrease medication errors in the ICU for bedside nurses who use electronic health records (EHRs). The project type is a comprehensive literature review, with studies that included a single prospective cohort study, case report, single non-randomized trial, quasi experimental study, single cross-sectional studies, and systematic reviews. The importance of this project is to address the break in the loop of …

Digital Phobia: An Inquiry For Mapping The Unseen Dimension Of New Digital Anxiety, The ‘Digiphobia’, Amarjit Kumar Singh ,Library Assistant, Md. Arshad Ali , Professional Assistant, Dr. Pankaj Mathur, Deputy Librarian,

Library Philosophy and Practice (e-journal)

Background: As technology continues to advance, individuals' interactions with digital platforms have become integral to daily life. Amidst this technological evolution, a novel concern emerges—Digital Phobia, hereafter referred to as “Digiphobia.” This phenomenon, although not previously explored in scholarly literature, necessitates an in-depth investigation due to its potential impact on individuals' well-being. Our research employs a two-step methodology to investigate its existence, implications, and manifestations.

Introduction: This research paper introduces and proposes the term "Digiphobia" as a comprehensive conceptualization of anxiety arising from interactions with digital spaces, applications, and environments. The proliferation of digital technologies has led to the emergence …