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Enhancing Documentation Accuracy and Nurse Handoffs Through Virtual Reality in a Pediatric Perianesthesia Unit
No full textSetting: The pediatric perianesthesia unit (pre-operative and post-anesthesia care unit). Problem: Gaps in perianesthesia documentation contribute to poor handoff communication, leading to adverse events and increased hospital costs. Additionally, inconsistent documentation reduces clarity and consistency during handoffs. Context: Staff in the microsystem reported low confidence scores with required OP-Time documentation, inconsistent workflows, and I-PASS handoff expectations. These factors contribute to incomplete charting and a lack of standardization across providers. Interventions: A two-part educational intervention was conducted, consisting of eight sessions. The first component is a Virtual Reality (VR) simulation that demonstrates an accurate perianesthesia I-PASS handoff. The second component is a didactic education related to organizational OP-Time documentation policies and further I-PASS handoff elements. Methods: Pre- and post-intervention documentation audits were conducted to evaluate the accuracy and completeness of required OP-Time documentation elements and handoff components. Results: Documentation compliance increased from 85% to 89% post- intervention, indicating a 4% positive trend towards the target goal. Additionally, staff confidence improved 88% regarding hospital policies and 80% related to required documentation and handoff requirements after the intervention. Conclusion: The VR-based documentation module was an effective strategy to improve documentation accuracy and staff confidence. Although the project did not reach the intended 95% benchmark, the intervention produced meaningful improvements in documentation quality and nurse handoff consistency. Continued integration of education, consistent audits, and reinforcement are recommended to further enhance patient safety in the perianesthesia microsystem and increase compliance
Implementing a Standardized Doula Awareness Tool to Improve Team Collaboration and Patient Understanding
No full textSetting: 22-bed, Labor and Delivery (L&D) unit in the Bay Area serving diverse birthing patients. Problem & Context: The unit lacks a standardized model to introduce doulas, clarify their roles, or communicate their value. Evidence shows that doulas feel unseen by other hospital staff (Kett et al., 2022) and report that their role can be misunderstood, undervalued, or unrecognized, creating barriers to effective partnership (Louis-Jacques et al., 2024). Pre-survey: Only 19.2% of the participating volunteer doulas felt patients understood their role as a doula, and 11.5% felt patients were only slightly knowledgeable. In terms of collaboration, just 15.4% felt consistently understood and supported by staff. Intervention: To address this gap, the team created a standardized doula awareness poster, featuring each doula’s name, photo, brief information, and patient testimonies. The goal was to improve visibility and staff understanding. Methods: A pre- and post-survey assessed doula visibility, role clarity, patient and staff understanding, and perceived support from staff. Descriptive statistics were used to compare pre- and post-intervention responses. Post-survey was collected after four weeks of implementation. Results: Post-intervention responses from the doulas showed increased feelings of visibility, improved perception that patients and staff understood their role, and a strengthened sense of integration within the L&D team. 70% of respondents reported moderate to significant improvement in communication and collaboration. 60% rated their comfort level as moderately to significantly improved after the poster was displayed. After intervention, the percentage of doulas who felt consistently supported doubled from 15.4% to 30%. Rarely feeling supported dropped to 0%. Conclusion: The doula awareness poster effectively enhanced visibility, understanding, and integration of volunteer doulas within the L&D microsystem. Ongoing updates and continued staff education are recommended to maintain these gains
Improving Infusion Workflow Through Standardized Patient Rooming Guideline
No full textAt a pediatric outpatient infusion center located in California, medical assistants (MAs) struggle with the appropriate placement of infusion patients. Inconsistent training and a lack of standardized assessment and education tools are contributing factors toward inefficient infusion placement. Due to the uncertainty of where to place each patient, MAs rely on verbal directions from charge nurses, which hinders workflow efficiency, burdens charge nurses with non-urgent matters, and creates bottlenecks on the unit, ultimately elongating patient wait times and affecting their satisfaction with the services provided. By developing room assignment guidelines and a reference tool, this project will aim to support MAs in confidently making patient placement decisions, while taking away interruptions to nursing staff, which will allocate more time for other critical nursing tasks. Phase 1 of the project sought to streamline patient flow while supporting more consistent care through implementing a standardized room assignment guideline and reference tool for MAs to place patients independently in appropriate rooms at least 80% of the time without charge nurse intervention, improving efficiency and reducing charge nurse interruptions by 30%. Despite the successful development of a standardized guideline and reference tool, the planned pilot implementation could not be executed within the timeframe of the project because of site logistical issues. Therefore, outcome data were not collected, and future evaluation is needed to measure the intervention\u27s effects on workflow efficiencies and patient placement accuracy. Phase 2 entailed monthly training and education to reinforce the standardized guideline and to make necessary changes after feedback from medical assistants and from limitations that might have arisen
Improving Staff Satisfaction and Flu Vaccine Uptake Through Standardized Workflow Tools
No full textObjective: Insufficient workflows can cause documentation to be confusing, which ultimately
limits staff engagement. This has led to staff dissatisfaction and a low vaccination uptake in
outpatient clinics. The implementation of a standardized workflow tool and proper staff
education and training can improve staff satisfaction and vaccination adherence, as indicated by
a review of literature. Aim: The purpose of this quality improvement project is to implement a
change in workflow in the electronic health record and staff training in an urban community
health clinic primarily serving low income and Latino patients. This intervention seeks to
increase medical assistant user satisfaction by 15% and increase the clinic vaccination rate by
5%. Methods: The intervention includes an initial assessment of baseline data of patient flu
vaccination in the years 2023 and 2024, along with staff satisfaction rates. Then, the
implementation of a standardized workflow within the electronic health record is produced, with
a step-by-step tip sheet provided to staff that is addressed during an educational meeting.
Evaluation measures include pre- and post- intervention staff satisfaction rates along with data
on influenza uptake that can be analyzed and compared before and after implementation.
Results: Total staff satisfaction in regards to workflow processes improved from 65% to 77%. In
addition, influenza vaccination rates increased from 11.4% to 19.1%, which demonstrates
consistent growth within the past three years. Conclusions: Small structured interventions, such
as implementing staff training and workflow improvements, have led to increased staff
satisfaction and vaccination uptake in patients. This underscores the need for the clinic to sustain
an organized workflow in order for positive outcomes to persist
Bridging Gaps in Safety: A Team-Based Approach to Reducing Falls Among Older Adults
No full textA skilled nursing facility in the San Francisco Bay Area is experiencing fall rates surpassing the national average throughout the year. Falls among elderly residents lead to multi-level complications, from minor bruising to major injuries such as fractures, head injuries and hospital transfer, and in the most severe cases, higher mortality rates. To address the issue of high fall rates at the nursing facility, the post-fall huddle protocol was developed on the unit. The team intends to reduce the facility\u27s fall rate by 25% over the next five weeks, from October 1 through November 5, 2025, along with improving the current post-fall prevention protocol, to enhance staff communication and increase staff awareness regarding falls. Methods, including a pre-survey, SWOT analysis, and Root Cause Analysis, were conducted to assess the microsystem. Education sessions on post-fall huddles were provided to staff, a guideline binder was created for educational purposes, and tip sheets were posted around the unit to reinforce staff understanding of post-fall huddles. The results showed that post-fall huddles did not reduce fall rates within the short project timeline, though the intervention improved communication, teamwork, and staff engagement around fall prevention protocols
Evaluation of Remote Sensing Technologies for Bull Kelp Detection in the Greater Farallones National Marine Sanctuary
No full textThe Greater Farallones National Marine Sanctuary (GFNMS), located off the coast of Northern California contains approximately 90% of the region’s bull kelp. Bull kelp is a foundational species that provides food and shelter supporting diverse marine ecosystems, but due to recent anthropogenic stressors, 90% of kelp forests along the California coast have been lost. The Greater Farallones Association (GFA) is actively working on restoration efforts, where monitoring is essential for assessing recovery success. My research addresses GFA’s need to reduce reliance on intensive, time-consuming Unmanned Aerial Systems (UAS) surveys by identifying accurate, cost-effective, and scalable remote sensing technologies for kelp canopy monitoring. I began by conducting a literature synthesis of the current state of the field, to familiarize myself with the various tools and weigh their pros and cons. I then performed a local and regional GIS analysis to assess the accuracy of PlanetScope data. I compared PlanetScope imagery against high-resolution UAS data (local scale), LandSat imagery (regional scale), and contextualized the findings using marine heat wave data. The analysis revealed that PlanetScope imagery, despite its relatively coarse 3m spatial resolution, provides sufficient spatial and temporal detail to effectively monitor nearshore and emerging kelp forests. My research validates that GFA can reliably adopt PlanetScope as a primary imaging source for their restoration sites. Additionally, the processing algorithms used to process PlanetScope imagery for kelp should be made publicly available to facilitate broader adoption and standardized monitoring
Trauma-Informed Care: A Therapeutic Approach in Communication
No full textAs medical providers, it is crucial to use therapeutic communication when building relationships with patients. Bias, stigma, and judgment often manifest through a provider’s body language and choice of words, exacerbating patient trauma and leading to health disparities. Trauma-informed care (TIC) addresses these issues by emphasizing respect, compassion, and empathy. TIC has been extensively studied in high-income regions such as Australia, Europe and the United States, but its application in low- and middle-income countries (LMIC) such as Kenya, is less understood. The aim of this study was to assess the knowledge, attitudes, and skills of nurses working in a rural community clinic in Chogoria, Kenya. Objectives were achieved through pre- and post-workshop surveys and exploratory qualitative interviews conducted after an in-service workshop on Trauma-Informed Care (TIC). Healthcare workers demonstrated a 3% increase in knowledge, attitudes, and skills in postsurvey results following an in-service workshop on TIC. Analysis of focus group narrative data revealed three themes: relevance, cultural stigma and bias, and additional needs in the community. TIC’s therapeutic communication helps to mitigate biases and stigma, foster empathy, and address patient trauma, ultimately reducing health disparities. The findings of this study indicate further research regarding TIC should be conducted in LMIC to identify ways in which providers can enhance the quality of health care delivery and promote holistic healing.
Keywords: adult trauma, adverse childhood events, harm reduction, trauma-informed car
Queer Rights Learning through Transnational, Digital Communities of Practice
Get PDFTraditional human rights education (HRE), and education writ-large, often depends on and reinforces binary hierarchies. The Society of Gender Professionals (SGP) reflects on how its trans-national, digital communities of practice (“Gender Circles”) are actively “queering” traditional HRE. This article shares reflections and learnings from 14 one-on-one interviews with Gender Circle participants, most notably from the Breaking Gender/Sex Binaries Circles. By facilitating spaces that co-create knowledge, build community, and center lived experiences of people with diverse sexual orientations, gender identities and expressions, and sex characteristics (SOGIESC,) SGP disrupts and queers binaries and hierarchies in education and other constructs, such as with Global South/North dynamics and in gender work (traditionally focused on cisgender women and girls). Key findings include: SGP’s impact on participant learning; participants’ assessment of the Circles’ learning environment; participants’ assessment of to what extent SGP centers marginalized voices (e.g. queer/trans, Global South); and challenges in participating in the Circle
Literacies of the Rainbow Corn Mother: A Queer Indigenous Eye for DEI
Get PDFThe landscape of Diversity, Equity, and Inclusion (DEI) work is currently undergoing a critical evaluation and facing attacks, revealing the limitations of performative initiatives entrenched in colonial frameworks. These initiatives often fail to acknowledge and address the erasure of Indigenous and queer identities, alongside the need for genuine representation within institutional settings. This approach may lead to creating inclusivity shaped by colonial law rather than fostering the true inclusivity and belonging that communities seek.
Advocates are calling for a shift towards a more comprehensive and inclusive approach to DEI work, urging organizations to move beyond performative gestures and toward meaningful change. As organizations and institutions continue to navigate the complexities and challenges of DEI work, it is imperative to acknowledge the historical injustices and systemic barriers that have marginalized certain communities and continue to influence programming through power dynamics and organizational needs. By embracing a holistic approach that integrates queerness and decoloniality, we have the opportunity to transcend performative gestures and pave the way for substantive progress in creating inclusive environments. In this article, we explore the vital need of a commitment to a Queer Indigenous Eye for DEI allowing us to challenge colonial legacies, promote authentic belonging for all individuals, and lay the foundation for a more just and inclusive future
Mycelium, Lotus Flowers, and the Future We Gon’ Create: The Cypher
Get PDFIn this track, we, the producers, cypher with Dr. David Stovall, connecting ecology to the current times through the lenses of abolition and fugitivity. We lay the groundwork for volume three and think through how to equip ourselves to disrupt old ways of thinking about education to collectively create futures in which Black communities can access liberation. By linking the historical impacts of desegregation, acts of subversion, and methods of refusal, Dr. David Stovall and the producers invite readers to commune with our stories, knowings, and musings