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Evaluating the Impact of the Bedside Mobility Assessment Tool (BMAT) on Nursing Staff Confidence in Patient Mobilization: A Pre and Post Implementation Study
No full textBackground Hospitalized patients are at high risk for functional decline due to immobility. Despite the benefits of early mobility, consistent assessment and promotion of mobility remain challenging, partly due to low nursing confidence. The Bedside Mobility Assessment Tool (BMAT) has shown promise in addressing these issues. The purpose of this project was to evaluate the impact of BMAT education and unit-wide implementation on nursing staff confidence in assessing patient mobility among adult inpatients on an acute care unit at a level one trauma center in Seattle, Washington.
Methods This quality improvement project included BMAT education (a one-hour Zoom session on BMAT use and early mobility benefits, in-service huddles, flyers summarizing key points, and bedside signage to support clinical use) and surveys measuring nursing staff’s confidence in mobility assessment at pre-education, two weeks post-education, and one-month post-education. Descriptive statistics and paired t-tests assessed changes in confidence. A subgroup analysis examined the relationship between years of experience and confidence in mobilizing unfamiliar patients.
Results Thirty-eight nurses completed the pre-education survey, 21 completed the two-week post-survey and 20 completed the one-month post-survey. The largest proportion of participants (34.2%) had two to three years of experience. Mean confidence level was increased by 14.7% at two weeks and 14.4% at one-month post-education. No relationship was found between years of experience and self-reported confidence.
Conclusion BMAT education had a practical impact in increasing nurses’ confidence level. Future studies should explore broader implementation to assess its effect on nursing confidence and mobility practices
Stock Albuterol Programs in Public Schools: A Scoping Review and Qualitative Study
No full textAsthma remains a leading cause of school absenteeism, emergency room visits, and 911 calls among school-aged children in the United States. Despite clinical guidelines recommending the availability of rescue inhalers in schools, significant barriers such as limited access, inconsistent policies, and insufficient nursing staff continue to hinder effective asthma management. This Doctor of Nursing Practice (DNP) project employed a scoping review to examine the implementation strategies and outcomes of stock albuterol programs across various U.S. school systems. Using the PRISMA-ScR methodology, peer-reviewed literature from 2014 to 2024 was analyzed to identify facilitators, barriers, and clinical outcomes associated with these programs.
The PRECEDE-PROCEED framework guided the assessment of policy gaps and stakeholder readiness. Findings suggest that stock albuterol programs can significantly reduce emergency interventions and school absences, particularly when supported by clear protocols, staff training, and stakeholder engagement. The results provide a foundation for improving asthma emergency preparedness and equity in school health services, particularly in underserved communities.
A qualitative analysis revealed five key themes related to asthma management in schools and the perceived need for stock albuterol programs: controlled asthma management, limitations in student self-management, insufficient access to school nurses, limited staff training, and financial challenges. These findings bring to light the systemic barriers surrounding asthma management and student safety within schools
Infectious Disease Response Preparedness: Survey of Small to Medium Residential Universities
No full textObjective: To improve the understanding of strategies implemented by institutions of higher education (IHE) during the COVID-19 pandemic, including how those experiences and resulting knowledge influenced staff confidence and preparedness for future infectious disease events.
Participants: Small to medium undergraduate residential IHE in CA, OR, and WA.
Methods: A Qualtrics survey collected data 1/26/25 – 2/24/25.
Results: Over 50% of respondents identified 7 of 9 preparedness needs as a major to critical need of their IHE. Statistically significant associations were found between IHE conducting a review of actions during COVID-19 and both self-confidence (ρ 0.46, p=0.018) and confidence in IHE preparedness (ρ 0.56, p=0.004). Other associations with self-confidence were knowledge of pandemic preparedness (ρ 0.45, p=0.011) and IHE size (ρ -0.47, p=0.008).
Conclusions: Although many IHE were unprepared for the COVID-19 pandemic, it is important to take the experience and lessons learned to be ready for the next emerging infectious disease threat
Identifying Barriers to Breast Cancer Screening in Asian American Women
No full textBackground: Breast cancer is the most diagnosed cancer among Asian American women, yet have lower screening rates than non-Hispanic Americans.
Objective: This project evaluated mammogram rates among Asian American women at a Federally Qualified Health Center, assessed demographic factors affecting screening, and identified perceived barriers through a survey.
Methods: A chart review was conducted to assess rates of mammogram screenings rates, the percent difference between planned and actual screenings, and patient demographics that may affect screening rates. A 13-question quantitative survey was developed and completed by participants to assess common barriers and identify potential strategies to reduce barriers to screening.
Results: Fifty-seven percent (n=745) of Asian American women received a mammogram, compared to the overall clinic rate of 68.8% (n=1,196), falling short of the FQHC’s 74% target. The most commonly screened age group was 61–65, with Vietnamese being the most frequently identified ethnicity. Women living in Seattle had both the highest screening rate and the highest proportion overdue (43.9%). A 13-question survey of clinical staff revealed that fear and discomfort were the most commonly reported barriers to screening.
Conclusion: To improve screening rates, culturally sensitive educational tools addressing fear and discomfort are needed, along with expanded access through mobile mammography services in underserved regions
Self-reported Prevalence of Traumatic Brain Injury Among Law Enforcement Officers
No full textTraumatic brain injuries (TBIs) have been extensively studied in sports, military, and criminal contexts, revealing significant prevalence rates and impacts on cognitive function, emotional regulation, and behavioral outcomes. However, the prevalence, patterns, and implications of TBI within law enforcement populations remain unexplored, presenting a gap in occupational health research. This gap is notable given that law enforcement officers face unique occupational hazards including physical confrontations, vehicle pursuits, and training-related exposures that may elevate their risk for neurological injury. While extensive research documents the impact of TBI on decision-making, executive function, and emotional processing, all critical competencies for effective policing, limited research has examined TBI in law enforcement populations. Initial studies conducted in the United Kingdom (UK), suggest that law enforcement officers have higher prevalence rates of TBIs than the general population, but this phenomenon has not been investigated in the United States. This thesis addresses this gap by examining the lifetime prevalence of self-reported TBI among commissioned law enforcement officers in Washington State using an electronically adapted version of the Ohio State University TBI Identification Method. The study investigated patterns of TBI occurrence across different life stages, mechanisms of injury specific to law enforcement duties, and the relationship between career progression and TBI exposure. The results reveal TBI prevalence of 67.3% beginning in childhood and continuing through professional careers. Additionally, 70.8% of adult TBI incidents occurred on-duty. Vehicle TBI exposure escalated from 0.0% among new officers to 88.9% among veterans with 25+ years of service. The thesis concludes by discussing the empirical and practical implications of these findings