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Implementing Maternal Fetal Triage Index (MFTI) in a High-Risk Obstetrical Setting
Get PDFProblem: The Maternal Fetal Triage Index (MFTI) for obstetric triage provides a systematic method for assessing and assigning acuity. Data evaluated for February 2024 and March 2024 identified the need for improved response times for triage Priority Two, which averaged 28.75 minutes (goal 15 minutes) for a provider to present to the bedside. The average percentage of patients with documented MFTI scores was 70.65% ( goal \u3e80%).
Context: A high-risk 24-bed obstetrical department in an acute care hospital in Northern California that triages over 600 patients monthly with over 400 deliveries in the same period.
Interventions: Real-time observations and staff feedback were provided using Kamishibai (K) cards. A cause and reaction statement was collected, documented, and discussed for identified unmet objectives. A Pareto chart was used to analyze missing elements and inform additional PDSA cycles to improve the percentage of MFTI completion.
Measures: The primary outcome measure was the time between provider notification and arrival at the bedside for MFTI Priority Two. Process measures included an increase in patients assigned an MFTI score.
Results: Provider time to triage for MFTI Priority Two increased slightly from 28.75 minutes to 28.8 minutes, and the percentage of patients assigned an MFTI score improved slightly from 70.65% to 73%.
Conclusions: MFTI provides a standardized and objective priority-driven process capable of improving triage efficiency and maternal-fetal outcomes; however, experienced clinical staff chose to rely on their clinical judgment, limiting the adoption of the MFTI scoring tool.
Keywords: Maternal-Fetal Triage Index, MFTI, OB triage, Kamishibai cards, K card
Improving Stroke Education Scores At A Primary Stroke Center
Get PDFAbstract
Problem: The COVID-19 pandemic precipitated a significant departure from the nursing profession, leaving healthcare organizations grappling with critical staffing shortages and compromising patient care standards. In 2023, an advanced Primary Stroke Center in a Northern California hospital’s STK-8 scores fluctuated between 80-100%, with an average annual score of 92.8%, putting the facility\u27s primary stroke certification and long-term patient outcomes at risk.
Context: A 24-bed acute stroke and telemetry unit in a Northern California hospital and designated primary stroke center.
Interventions: The following measures were implemented to improve the quality of stroke care and enhance STK-8 compliance, including dot “smart” phrases created within the electronic medical record (EMR) to aid clinical staff with consistent and complete stroke education documentation, staff re-education, and implementation of standardized protocols to foster interdisciplinary collaboration among stroke-certified nurses, physicians, and unit leaders.
Measures: Documentation compliance of at least 95% or greater for stroke measure STK-8 during the implementation period from January 2024 through April 2024.
Results: 100% compliance with the STK-8 measure in the last two months of the four-month intervention period. This success is a promising sign, but it\u27s important to note that more long-term data is needed to ensure ongoing compliance with STK-8 documentation.
Conclusion: The initiative effectively standardized stroke education practices among healthcare providers, enhancing their understanding and application of essential components of stroke education measures.
Keywords: TJC stroke measures, STK-8, stroke education, stroke documentation, primary stroke center, smart phras
From Blood on Stone to Ink on Page: Tiananmen Literature and Art and the Prospect of Change
No full textIn the 1920s, Chinese writer, Lu Xun, championed the idea of change through fiction writing. The use of fiction allows a writer to more candidly critique political oppression, social failure, and historical trauma, while affording the author a thin layer of distance from the dangerous truths they illuminate. Three generations after Lu Xun, a fresh throng of Chinese writers and artists similarly aimed to illuminate the truth through “fiction” and art. They shared their unabridged stories and creative works of an ugly chapter in Chinese history, the Tiananmen Square Massacre. Despite the Chinese government’s attempts to bleach the Square, there yet exists a potent and explosive residue that lingers in these writers’ narratives and artists’ strokes about the blood-soaked tiles of Tiananmen Square. As the 35th anniversary of the Tiananmen Square Massacre approaches, this Capstone Project conducts a multi-data-source synthesis of the narratives that followed the Tiananmen Square Massacre of 1989, and analyzes their impact within the framework of Lu Xun’s idea that literature can create change.
Change through literature and art is possible, even if it has not yet been fully realized in this case. The contributions of literature toward the prospects of political or social transformation are indispensable. Nevertheless, it is unlikely that one great work alone can achieve such lofty aims. Only through the collective endeavor of many voices can the full story of what transpired, and what must be prevented in the future, be conveyed and understood. I rely heavily on interviews with individuals whose lives or experiences intersected with the Square, both original interviews and existing publicly available ones, to evaluate the impact of this collective voice, while parsing out distinctive motivations and mediums each person used for memory, calls for change, or dissent. This project analyzes the concept of political or social transformation through specific means other than open revolution or other violent actions. The question then is whether the pen, or the brush, can produce the desired results. Other research does not specifically answer whether Tiananmen literature and art actually affected change, or still has the latent power to do so. This research helps fill that gap
EMERGENCE: SOCIAL MOVEMENTS, LAW ENFORCEMENT, AND DEFENDING THE SANCTITY OF LIFE
Get PDFThis study examines the aftermath of national social movements advocating for police reforms and accountability, with San Francisco emerging as a pivotal city at the forefront of criminal justice and policing transformations. Rebuilding community trust and implementing substantive police reforms aimed at preserving lives has proven to be a formidable challenge. The convergence of interests among all stakeholders, driven by a shared commitment to dismantling institutional racism and implementing reforms that fostered trust with communities of color and law enforcement, played a pivotal role.
A significant aspect of this reform process has been the development of social movement convergence, where diverse groups with varying motivations and perspectives united towards a common goal. This convergence was marked by the collaboration of community activists, policymakers, law enforcement officials, and community members, all advocating for systemic changes. Their shared objective—to effect substantial organizational changes that embody critical dimensions in protecting the sanctity of life—served as a powerful catalyst for collective action.
While the motivations for altering police department practices varied among key stakeholders, the unified commitment to justice and community well-being provided the foundation for a comprehensive and collective effort. This shared goal underscored the potential for positive change through collaborative initiatives. San Francisco\u27s police reform journey thus stands as a testament to the power of social movement convergence, illustrating how collaborative efforts and an unwavering commitment to justice can drive substantive transformations in policing and community relations
The Cost of Free Black Thought
No full textIn December of 2022 I published on our university library website a research guide consisting of a bibliography of black writers with heterodox views on a wide variety of topics. By May of 2023—five months later—I had been labelled a racist, placed on administrative leave, and targeted for firing.
Transcript and video presentation of a lightning talk given at the Spring 2024 HxLibraries Symposium: Curiosity, Controversy, and Intellectual Courage. Sponsored by Heterodox Academy
Máscaras de Fe: Espiritualidades Queer y Estrategias de Anonimato en la Argentina Posdictatorial
No full textThis article proposes that —in risk contexts marked by institutional violence and religious exclusion— anonymity is not absence but a radical spiritual and political practice. Adopting pseudonyms, masks, or disguises is interpreted as a form of faith in life, pleasure, and community. These strategies subvert binaries between truth and falsehood, authenticity and disguise, proposing a queer ethics of presence. The analysis focuses on pride marches as rites of passage where anonymity is re-signified as collective consecration: the street becomes a temple, the disguise a sacrament, and the mask a spiritual icon
El Susurro del Espíritu en Clave Queer: Arte, Liturgia y Trascendencia
No full textThe evolution of liturgy, preaching, and religious architecture has accompanied the officialization of Christianity, giving rise to complex buildings and artistic expressions, such as basilicas. This process, though historically met with resistance, continues to this day and becomes especially relevant from queer perspectives. The article highlights the importance of the arts — music, theater, dance, poetry, and visual arts — in liturgy and preaching, not merely as embellishment, but as vehicles for opening up new spiritual languages. These queer liturgical practices affirm marginalized LGBTIQ+ identities and heal historical memories, engaging with their realities and struggles
