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Setting the Truth Free: The Case for Restoring the Central American University of NIcaragua Through the Framework of International Human Rights Law
No full textHaving a Home to Come Home to: How Subsidized Housing Impacts Unhoused Pregnant Women
No full textCommunity based organizations (CBOs) lead the charge in the fight to end housing insecurity and often must make up where local governments fall short. San Francisco is an example of a municipality that has a long history of addressing instances of housing insecurity for its residents, and where CBOs step in to provide housing support for populations with unique and special circumstances. One CBO that operates in San Francisco that I was interested in studying was the Homeless Prenatal Program (HPP), and the Jelani House, a housing subsidy that is funded and operated by the HPP for pregnant women who experience housing insecurity. My interest in this organization led me to ask this question: to what extent do the current supportive housing organizations in San Francisco effectively reduce housing insecurity for marginally housed or homeless pregnant women? After conducting interviews with professional staff with the HPP, I found that the HPP does not directly address housing insecurity for pregnant women. Instead, this organization concomitantly responds to needs expressed by their client population within the means and limitations of the organization, focusing on medical and health-centered care, creating opportunities for their clients to grow their personal and professional development, and building a foundation of trust and community for themselves. My research led me to policy recommendations that impact the HPP, the San Francisco city government, and the state of California. This project is important because it adds to the growing body of literature dedicated to bringing insight on how housing support provided to pregnant women positively impacts the growth of their independence. My study further affirms the work that the HPP does for pregnant unhoused women by demonstrating the impact the organization has on each woman’s pregnancy journey, whatever that may look like for them
Stopping the Slippery Slope: What Happy the Elephant Can Gain from Estrellita the Monkey
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A Quality Improvement Initiative to Streamline Flu Vaccine Documentation and Increase Staff Engagement
No full textObjective: This quality improvement project was implemented in an urban community health clinic primarily serving low-income and Latinx patients. Factors such as demographics, socioeconomic status, health, and transportation contribute to low U.S. influenza vaccination rates (Chen et al., 2020), while EHR training can improve provider satisfaction and efficiency (DiAngi et al., 2019). This microsystem faced inconsistent workflow processes, limited EHR training, and documentation errors that contributed to low staff satisfaction rates and influenza vaccination rates. An average of 11.4% of patients received a flu vaccine in October 2023 and 2024. Medical assistants (MAs) completed a pre-intervention survey indicating that 35% were dissatisfied with the flu vaccine rollout process. Contributing factors include competing MA priorities, unclear EHR training, lack of workflow standardization, limited use of EHR tools, poor vaccine signage, and inconsistent vaccine ordering. Aim: A multimodal intervention was designed to address workflow inefficiencies and MA dissatisfaction. Methods: These interventions included (1) integrating the Immunization Clinic function in EPIC to streamline flu vaccine documentation and administration, (2) MA EHR training, and (3) the distribution of workflow tip sheets to standardize EHR use. Collection of data included pre- and post- MA satisfaction surveys and clinic vaccination reports. Trainings sessions involved MAs, nurse managers, and other clinic staff to standardize workflow. Implementation of the Immunization Clinic EHR function began on October 1, 2025, and ended on November 5, 2025. Results: Post-intervention results showed that patient vaccination rates increased from 11.4% to 19.1% and staff satisfaction increased from 65% to 77%. Conclusions: The intervention proved to be successful as patient vaccination rates and staff satisfaction increased. This showcases the importance of staff trainings and having a consistent standardized EHR workflow
Reducing Hospital-Acquired Pressure Injuries Through Targeted Nurse Education on the Braden Scale and SKINS Bundle
No full textObjective: Hospital-acquired pressure injuries (HAPIs) continue to rise nationally despite overall reductions in other hospital-acquired conditions. This project sought to address gaps in nurse knowledge, inconsistent prevention practices, and workflow barriers contributing to HAPI development on a Trauma Medical-Surgical Unit (Unit A). Aim: This project aims to decrease the number of HAPIs on the Trauma Medical Surgical Unit by 11%, from nine HAPIs to eight HAPIs, following implementation of nurse education on the proper use of the Braden Scale and the SKINS Bundle from October 6, 2025, to November 14, 2025. Methods: A pre-intervention survey was administered to identify baseline knowledge gaps among nurses on Unit A. The intervention included focused education on the Braden Scale and the SKINS Bundle, supplemented with patient-centered case studies to evaluate practical application. A post-intervention survey was then completed to measure improvements in knowledge following the training. Results: Following implementation of the intervention, comparison of pre-intervention survey results and post-intervention survey results revealed that there was a 9% increase (100%) in reported confidence in the utilization of the Braden Scale, as well as a 23% increase (88%) in reported confidence in the utilization of the SKINS Bundle order set. Additionally, audits performed on the unit showed a 32% increase in the utilization of the SKINS Bundle itself. Furthermore, Unit A has reported zero HAPIs from September to November 2025. Conclusion: The targeted nurse education increased the nurses’ confidence in utilizing both the Braden Scale and the SKINS Bundle order set. Strengthening staff knowledge, clarifying prevention workflows, and improving access to resources show promise in reducing HAPI incidence and support long-term quality improvement efforts
Standardizing Care: Strengthening DKA Protocol Implementation Among Emergency Department Nurses
No full textObjective: The objective of this project was to address the inconsistent understanding and utilization of the Diabetic Ketoacidosis (DKA) protocol in a high-acuity emergency department within a large hospital system, where baseline survey results showed that 84% of nurses found the DKA order set confusing and only 15% felt “very comfortable” applying it.
Aim: The aim was to improve nurse clarity, confidence, and consistency in using the DKA protocol to support timely, evidence-based management of this high-risk, time-sensitive condition.
Methods: The intervention consisted of brief, targeted education delivered during pre-shift huddles across day and night shifts, focusing on the correct use of the DKA order set, role clarification, insulin and electrolyte management, hourly glucose monitoring requirements, equipment access, and admission workflow. A pre- and post-shift survey measured changes in protocol familiarity, perceived barriers, and self-reported comfort.
Results: Results demonstrated increased staff familiarity with key components of the protocol, decreased reported confusion with the order set, and improved confidence applying the DKA workflow, including a clearer understanding of insulin ordering, glucose monitoring expectations, and the correct sequence of management steps.
Conclusions: These findings suggest that a brief, structured educational intervention can strengthen protocol adherence and support safer, more consistent DKA management in the emergency department
California Water Reuse: State of the Industry as Direct Potable Reuse Comes Online
No full textSince the early 1900’s, California has found ways to reuse its wastewater, and in 2023 the state added a new method, Direct Potable Reuse (DPR), to its toolkit. DPR allows for advanced treated wastewater to be sent directly to a drinking water system, without an environmental buffer. Through a synthesis of the literature and related government documents of the state\u27s water reuse history, an analysis of regional water recycling trends, and a survey of water utility professionals, this paper aims to understand DPR\u27s future role in securing California\u27s water supply. Historically, public perception has delayed adoption and development of California\u27s potable reuse industry. Current reuse trends suggest regional differences in how successful these efforts have been. Water managers expressed positive views about the future of DPR, though funding for new infrastructure and governance structures of the wastewater industry may be the latest roadblocks. Ultimately, California may benefit by prioritizing the expansion of its non-potable recycling efforts, as infrastructure costs for new projects may be more difficult to come by in the current political climate. Regional approaches, as opposed to state-wide initiatives, will also help cater to the needs of different hydrologic areas, each with unique physical and climate characteristics that have, up until now, created divergent paths within California’s water reuse journey
¡El Cielo es una Habitación Llena de Mujeres Gordas Riendo!
No full textThis article examines a pervasive yet often overlooked form of abuse against women: the lifelong regulation of bodily size and shape. While acknowledging the horrific rise in domestic physical violence during the United Kingdom’s lockdown, the focus shifts to the normalized pressures of patriarchal control that women internalize from an early age. Such control disguises itself as concern or benefit, yet inflicts profound personal and spiritual harm. Approaching the issue from a Western perspective, the article argues that, within an incarnational faith, the disciplined body becomes the very site of resistance where transformative divine power is located in human experience