Quality Improvement Commons^™

Dexmedetomidine (Precedex) Versus Propofol: In Patients Requiring Sedation While Mechanically Ventilated,, How Does The Use Of Dexmedetomidine (Precedex) Compared To Propofol, Affect Reintubation Within 48 Hours Post Extubation?, Kimberly Barbee, Markela Albright, Malak Amro, Evelyn Caty-Pletcher, Margaret Havey Phd, Aprn, Acnp-Bc, Chfn, Fhrs, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C

Doctor of Nursing Practice Projects

Keywords: dexmedetomidine, propofol, reintubation, sedation2

Abstract Assignment

Background

Sedation management in the ICU plays a key role in extubation readiness and post-extubation outcomes in mechanically ventilated patients. Although both propofol and dexmedetomidine are commonly used in critical care, there is limited evidence comparing their impact on early reintubation. This quality improvement (QI) project examined whether sedative choice was associated with reintubation within 48 hours of extubation.

Methods

A retrospective QI analysis was conducted in a cohort of 38 mechanically ventilated adult patients. Patients received either propofol (n = 31) or dexmedetomidine (n = 7) prior to extubation. Reintubation within …

Educating Nurses On Caring For Patients With Intellectual And Developmental Disabilities – An Evidence-Based Practice Project, Amyela Adarlo

Loma Linda University Electronic Theses, Dissertations & Projects

Intellectual and developmental disabilities (IDD) refer to a range of conditions that begin before age 18 and impact physical, cognitive, and socioemotional development. Patients with IDD often experience poorer health outcomes due to healthcare providers’ limited training in effective communication strategies. This evidence-based project aims to evaluate whether educating nurses on effective communication with IDD patients improves nurse self-efficacy and confidence in communication and enhances caregiver perceptions of nursing care.

Optimizing Communication In The Periprocedural Area: Implementing Sbar: A Quality Improvement Project, Autumn Chang

Loma Linda University Electronic Theses, Dissertations & Projects

The primary aim of this project is to improve standardized nurse-to-nurse communication at the electrophysiology lab of a large Los Angeles hospital. By providing nursing education on a unit-specific, structured handoff communication framework (SBAR) and incorporating a procedure-specific handoff form for electrophysiology (EP) across pre-, intra-, and post-procedure units, this project aims to improve nurses’ perceptions of the handoff process and the effectiveness of handoff education across the periprocedural units. The project further aims to assess nursing incorporation of the training four weeks post-education and changes in patient satisfaction related to nursing teamwork and communication.

Evaluation Of Pinhole Castration Techniques Compare With Traditional Method For Castration In Rabbits, Wakash Oad, Faiz Muhammad Khand, Habibullah Janyaro, Muhammad Mohsen Rahimoon, Muhammad Ramzan, Dilpat Rai Menghwar, Benazir Sahito

Journal of Bioresource Management

Castration is a routine surgical intervention used to sterilize animals. Among the different conventional methods, the pinhole castration provides offer significant advantages. This study was conducted on 12 healthy male domestic rabbits at Shaheed Benazir Bhutto University of Veterinary and Animal Sciences, Sakrand, to evaluate the physiological impacts of traditional versus pinhole castration techniques. The rabbits were randomly divided into group A and group B with six rabbits per group. Key parameters included preoperative vital signs, intraoperative monitoring at 5, 10, and 15 minutes, intra- and postoperative complications, serum cortisol levels (preoperative, 24 hours, 5 and 10 days post-surgery) and …

Utilizing Proactive Rounding With Nursing Leadership To Improve Patient Satisfaction Scores In An Adult Medical-Surgical Unit, Lily A. Bogyah

Student Scholarly Projects

Practice Problem: Patient satisfaction is a key quality indicator that reflects patients’ perceptions of care and the healthcare system’s performance. Patient satisfaction scores at the project site were significantly lower than the national benchmark, particularly on the adult medical-surgical unit.

PICOT: The PICOT question that guided this project was: In patients on an adult medical-surgical unit (P), how does the use of proactive patient rounding conducted by nurse leaders (I) versus current practices alone without such rounding (C) affect patient satisfaction scores over an eight-week period (T)?

Evidence: A literature review of multiple studies found that implementing daily nurse leader …

Strategic Planning Time Horizons And Hospital Performance Outcomes, David Meyer

MUSC Theses and Dissertations

Background: Despite widespread adoption of strategic planning in healthcare, empirical evidence linking strategic planning time horizons to hospital financial and quality performance outcomes remains limited. Healthcare executives invest substantial resources in strategic planning processes, yet lack evidence-based guidance on whether longer or shorter planning horizons yield enhanced financial and quality-related results.

Methods: This study employed an exploratory sequential mixed-methods design combining executive survey data with archival performance data. A REDCap survey was administered to 22 hospital CEOs, CFOs, and other C-suite executives between January and February 2026. Survey responses were matched to publicly available financial and quality performance data from …

Hybrid Diabetes Coaching Model: Integrating In-Person And Telemedicine Strategies To Improve Glycemic Outcomes, Sandis A. Mundackal

Student Scholarly Projects

Practice Problem: In patients with type 2 diabetes, poor glycemic control among adults remains a significant challenge in primary care settings, particularly within federally qualified health centers (FQHCs) that serve underserved populations. At the FQHC practice site, patients were managed using standard care with quarterly follow- up visits, without a structured hybrid coaching approach. This inconsistency contributed to a high number of patients with hemoglobin A1c (HgbA1c) levels ≥ 9%, placing them at increased risk for diabetes-related complications.

PICOT Question: In adults with poorly controlled type 2 diabetes (HgbA1c ≥ 9%) (P), does monthly hybrid coaching delivered through in-person and/or …

Redesigning Outpatient Chemotherapy Scheduling: A Management Approach To Site-Integrated Operations, Dominick J. Morrone

MUSC Theses and Dissertations

Outpatient infusion centers face persistent scheduling complexity driven by variable treatment durations, coordination between clinics, pharmacy lead times, and constrained staffing. This doctoral project develops and reviews a comprehensive framework for infusion scheduling transformation that integrates workforce role redesign, site‑level communication pathways, and data‑informed workqueue governance. Using a multi‑phase case at a large cancer center as an anchor, the framework specifies responsibilities across central schedulers, on‑site teams, medical coordinators, and nursing; details communication and escalation design (secure messaging and in‑basket use); and outlines training and proficiency tiers. The project synthesizes evidence from scheduling science and time-driven activity-based costing principles to …

Synchronizing Success: Interprofessional Teamwork In Optimizing Throughput Management, Deborah Nimick, Eran Wilkerson

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Evaluating The Impact Of A Nurse-Driven Oxygen Titration & Weaning Guidelines On Length Of Stay And Costs Of Care: Qi, Stephanie Zarate

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Creating A Culture Change Around Stroke: Integrating Process Improvement To Reduce Door-To-Needle Time, Shayna Brewer, Benedict Pereira, Rose Bisellach, Jason Greenspan

Providence Nursing Research Conference 2023 – Present

No abstract provided.

A Qi: Implementing Pawss And Ciwa Adherence Challenge In The Psychiatric Emergency Department, Bailey Poler

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Pedaling Through Discomfort: A Feasibility Study Of Faculty-Led Spin Classes And Their Impact On Student Engagement, Resilience, And Faculty-Student Relationships, Gabriela Baza, Elizabeth Hathaway

Pursuit - The Journal of Undergraduate Research at The University of Tennessee

This study explored the feasibility and impact of faculty-led Spin classes on college students’ engagement, well-being, and connection with faculty. Offered twice weekly at 7 AM during Fall 2024, the classes aimed to promote physical activity, resilience, and faculty-student relationships. Twenty-six students attended at least one class, with a median attendance of 4.5 sessions. Post-semester surveys (88% response rate) assessed perceived exertion, interest, enjoyment, challenge, improvement, and instructor encouragement. Students reported high levels of engagement and positive challenge (RPE = 15.3; challenge = 6.4/7). Those attending 7 or more sessions reported significantly greater perceived improvement than those attending fewer sessions …

Rural Georgia Hospital Covid-19 Virus Patient Outcomes, Susan P. Smith, Neeraj Dayama, Morgan E. House, Debra Flores, Sharon Hunt, April Dukes, Steven Gautney

Journal of the Georgia Public Health Association

Background: The Coronavirus disease 2019 (COVID-19) has led to over 1.2 million deaths in the United States. Given the staggering scale of the pandemic, rural hospitals faced heightened challenges due to limited resource availability and underlying patient characteristics.

Methods: In this context, we examined patient and hospital-related factors associated with inpatient mortality due to COVID-19. This study is a retrospective chart review of patient outcomes of patients who were hospitalized in a Southwest Georgia rural hospital with COVID-19 during the initial onset of the outbreak and over the following 23 months of the pandemic. Patient demographics, other characteristics, …

Impact Of Acute Flight Training Stress On Cardiovascular Health, Toni Butler, Noah Robbins, Sophia Vaden, Bryan Hinton

Student Research Symposium (SRS)

Student pilots face a unique set of stressors that are a part of their flight training. These acute stressors can have immediate and long-term impacts on their physiological and psychological well-being. Using near-infrared spectroscopy (NIRS) to measure vascular endothelial function (a marker of cardiovascular health), this investigation will help us understand how the stressors involved in acute flight training affects the cardiovascular health of student pilots. We will test the hypothesis that acute flight training stress obtained from a single bout of flight training reduces cardiovascular function as shown by a reduced post-occlusive reactive hyperemic (PORH) response. Cardiovascular health will …

Diagnostic Trends And Service Enhancements In Deaf Mental Health: A Longitudinal Analysis, Kent Schafer, Steve Hamerdinger, Frank Wu, Rie Sakai Bizmark, Charlene Crump

JADARA

A longitudinal study investigated mental health diagnostic trends and patterns among Deaf and Hearing individuals using a comprehensive dataset from Alabama Department of Mental Health spanning 2004-2024 (Deaf=4,547; Hearing=2,056,188). Chi-square analysis revealed significant proportional differences in diagnoses between the groups. Deaf individuals showed significantly higher proportions of psychotic (12.93% vs. 8.33% Hearing), mood (20.76% vs. 18.84% Hearing), and personality (0.58% vs. 0.43% Hearing) disorders. These findings suggest that increased access to specialized and competent mental health services for individuals who are Deaf, particularly following the increase of staffing patterns for the Office of Deaf Services in 2015,contributed to more accurate …

Expanding Waste Segregation Initiatives To Reduce Regulated Medical Waste: A Multi-Departmental Quality Improvement Project, Emily M. Su, Anuja L. Sarode, Mohammed Sami, David R. Nehring, Erica L. Laipply, Mustafa Culcuoglu

HCA Healthcare Journal of Medicine

Background

Regulated medical waste (RMW) drives up health care costs, largely due to misclassification of general waste, especially in operating rooms (ORs), intensive care units (ICUs), and obstetrics and gynecology (OBGYN) departments. This study aimed to reduce RMW volume and costs at Akron City Hospital (ACH) through department-specific interventions aligning with Occupational Safety and Health Administration (OSHA) and Ohio Environmental Protection Agency guidelines.

Methods

Periodic analyses compared hospital-wide aggregate RMW volume, pick-up frequency, and disposal costs before and after interventions. The ORs initiated interventions in October 2022, expanding to ICUs and OBGYN by February 2024. Strategies included staff education, flyers …

A Reflection On What Pharmacists In Different Countries Can Learn From One Another, Aaryaman Khurana, Patricia Darbishire

Purdue Journal of Service-Learning and International Engagement

What would be the first words that come to mind if you were asked about the US health care system? I asked that question to several of my friends and pharmacy peers and received mixed responses such as “expensive,” “confusing,” “hard to navigate,” and “best in the world.” This was not surprising considering the many options and the varying quality of medical procedures, medical devices, and pharmaceuticals available. I wondered how responses might differ if I posed the same question about their health care to those in a third-world country. So, I asked the same question of friends and family …

Operational Factors Influencing Branch Revenue In Multi-Branch Child Therapy Services, Muhammad Luthfi

Jurnal Administrasi Bisnis Terapan

The management of multi-branch child therapy services requires a strong understanding of operational factors that contribute to revenue performance. This study aims to analyze the relationship between operational days, occupancy rate, service attendance, and the number of practitioners in relation to branch revenue within a child therapy service organization operating in urban areas in Indonesia. A quantitative cross-sectional design was employed using operational data collected from 24 child therapy services. This study employed a quantitative cross-sectional design using branch-level operational data collected in December 2025 from 24 child therapy service branches. Multiple linear regression analysis was conducted to examine the …

Analisis Pengaruh Patient-Perceived Hospital Service Quality Terhadap Customer Satisfaction Dan Behavioral Intention Pelayanan Rawat Inap, Launa Inayati Arlina, Dwiky Yuanasika, Mochammad Bagus Qomaruddin, Djazuly Chalidyanto

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The Bed Occupancy Rate (BOR) of inpatient rooms at Mitra Sehat Mandiri Hospital Sidoarjo during 2019-2023 has not reached the ideal standard. The BOR values were 22%, 28%, 37%, 25%, and 20%, with an average of 26.4%, remaining below the ideal range of 60-85%. One of the most influential factors contributing to the low BOR is suboptimal service quality. This study aims to analyze the relationship between Patient-Perceived Hospital Service Quality, customer satisfaction , and behavioral intention among inpatients at Mitra Sehat Mandiri Hospital Sidoarjo. This study employed a quantitative method with an analytical approach and a cross-sectional design. The …