27392 research outputs found
Sort by
The Chaldean Lived Experience of Hospitalization
No full textAbstract
Nurses are guided by The American Nurses Association Code of Ethics to establish relationships of trust with their patients. For many years, nursing has been identified as the most trusted profession and nurses have been ranked highly regarding their honesty and ethical behavior. The quality of the relationship between nurse and patient is linked by the establishment of trust. The patient who has a trusting relationship with their nurse is more likely to participate in their care process. This hermeneutic phenomenological study explored the lived experience of a Chaldean patient or Chaldean family member during their hospitalization. Individual interviews provided a description of aspects of the participants\u27 lived experiences. Four key themes emerged: navigating communication, needs as a patient, comfort and courtesy, and trust. Through the sharing of their personal hospitalization stories, the ten participants in this study offered insight into their experiences, which were instrumental in shaping the findings of this research
Life in the Fast Lane: Improving Patient Intermittent Fasting Compliance
Full text linkBackground: In the United States, 2 in 5 adults are obese. The U.S. spends approximately $147 billion annually on healthcare related to obesity. Intermittent Fasting (IF) has emerged as an evidence-based, safe, and cost-effective approach to weight loss. When instructed correctly, it has been shown to improve patient BMI and total weight over a short-term duration.
Purpose of the Project: The purpose of this study was to determine the effectiveness of a standardized time-restricted eating (TRE) intermittent fasting education protocol for primary care providers (PCP) and its impact on their confidence levels in managing patients. This project aims to enhance provider confidence in educating and managing patients, resulting in increased patient knowledge, improved compliance, and better weight loss outcomes.
Evidence-Based Intervention: This project was implemented using the Iowa Model. Standardized TRE intermittent fasting education was given to four primary care providers, who then educated a total of 20 patients using a standardized format. Pre- and post-intervention provider surveys were administered to assess changes, and body mass index (BMI) and weight were measured over six months to evaluate improvement and compliance among patients.
Results: Provider survey scores improved from pre-intervention to post-intervention levels, with a 28.57% increase in provider confidence levels. Overall, 56% of patients demonstrated minimal to clinically significant weight loss and changes in BMI. A noticeable association was found between patient compliance and total weight loss or BMI change.
Implications for Clinical Practice: Standardized education on intermittent fasting enhances provider confidence and patient compliance, ultimately leading to improved outcomes. Regular patient follow-up is crucial for monitoring progress and providing positive reinforcement
Decreasing Dermal Filler Adverse Events Using QSEN and Benner Theoretical Frameworks to Assess Competency
Full text linkBackground: Aesthetic nursing is a new branch of nursing practice. Formal nursing education and standards are lacking, making it challenging to assess competency of an aesthetic nurse. Adverse events (AEs) range from minor (bruising) to severe (vascular compromise and blindness) and can be associated with poor technique or lack of knowledge. Standardized practice using evidence-based (EB) protocols is necessary to provide safe, high-quality care. The Institute of Medicine (IOM) and the Joint Commission support the use of the Quality and Safety in Nursing (QSEN) programs to improve outcomes and promote safety. Due to varied training, “experienced” aesthetic nurses may or may not perform these techniques competently. After doubling our staff of “experienced” injectors, dermal filler AEs doubled over one year. AEs in our office are defined as anything that causes a client return visit post injection due to a complaint. Most AEs are lumps, asymmetry, and rarely vascular compromise.
Purpose: The purpose of this evidence-based project was to decrease AEs associated with dermal filler injections by creating a competency-based assessment and training program using existing dermal filler EB protocols, placed in QSEN and Benner\u27s Novice to Expert theoretical frameworks. The IOWA model guided the implementation of this project.
Project Plan Process: QSEN competency statements are divided into categories of Knowledge, Skills, and Attitudes (KSAs). Competency assessment forms using EB protocols and QSEN competencies, structured into Benner’s Novice to Expert framework were developed. All medical staff (n=10) at two separate locations completed the assessment and training within a four-month period. All staff self-evaluated and were objectively evaluated on a Novice to Expert scale. Anything noted as less than Competent in the QSEN KSAs/Benner format was addressed using customized training programs. AEs were monitored monthly.
Evaluation/Results: AEs associated with dermal filler injections decreased by 65% (n=34) compared to the same period the prior year (n=97). Four of the ten providers participated in customized training sessions. Implementation cost was 12,000 in six months, associated with time saved managing AEs.
Conclusions: Assessing competency and addressing deficiencies in KSAs using a QSEN and Benner based program decreased AEs in dermal filler clients.
Implications for Practice: All aesthetic providers will be assessed, trained and annually evaluated using this program to promote safety, improve outcomes and decrease cost associated with AEs. Ensuring competency of aesthetic nurses will promote the goals of the IOM to promote consumer safety
Optimizing Warfarin Management in Cardiovascular Care
Full text linkBackground: Maintaining a therapeutic International Normalized Ratio (INR) is essential to reduce bleeding and thromboembolic risks in patients on warfarin therapy. In a rural outpatient cardiac clinic serving a predominantly underserved population, many patients face financial and access barriers that preclude the use of newer non-vitamin K antagonist oral anticoagulants (NOACs). Patients with atrial fibrillation (AF) or mechanical valve replacements who rely on warfarin require consistent monitoring and management, which can be challenging in settings with limited resources and staffing.
Purpose: The purpose of this evidence-based pilot project was to improve therapeutic INR outcomes through the implementation of a standardized warfarin management protocol. The protocol included provider education, an EHR-based warfarin flowsheet, a physical binder for reference, and standardized follow-up intervals. The intervention was designed to promote safety and consistency in anticoagulation management for patients with atrial fibrillation or mechanical valve replacement.
Methods: Two nurse practitioners, one physician, and one medical assistant were educated on warfarin dosing protocols, INR thresholds (2–3 for AF, 2.5–3.5 for mechanical valves), and best practices for monitoring. INR data were tracked over six months using EHR queries and binder logs. The medical assistant assisted with patient follow-up, documented bleeding complications, and coordinated INR monitoring using the standardized protocol.
Evaluation of Outcomes/Results: Post-intervention chart reviews suggested an overall improvement in INR management. The frequency of in-range INR values appeared to increase over time. No adverse events such as major bleeding or thromboembolic complications were documented during the implementation period. These findings may reflect improved consistency in monitoring, enhanced provider awareness, and better patient follow-up, particularly in a rural setting with limited resources.
Conclusion: The implementation of a standardized warfarin management protocol appeared to improve INR control and patient safety within a rural cardiology clinic. This model is sustainable, clinically relevant, and adaptable for other resource-limited settings. Emphasizing workflow structure, provider education, and support staff involvement may enhance anticoagulation outcomes across underserved populations
When is Free Speech “Beyond” the Constitution?
No full textThe constitution of a nation without a state action doctrine might limit private restriction or compulsion of speech just as it limits the state. In such a nation, “free speech beyond the constitution” might not be a particularly meaningful concept. In the United States, however, the First Amendment’s free speech clause limits only what the federal, state, and local governments may do. As a nonconstitutional policy matter, it might or might not be a good idea for the government to impose First Amendment- like restrictions on private actors or for private actors to voluntarily impose First Amendment-like restrictions on themselves. We might also ponder the acceptable scope of informal social sanctions on others for their speech activity.
Why, though, does our Constitution have a fairly strict state action/private action line? And, related, how does the Court police that line? These are big questions of constitutional law (and political theory) that span across rights. I will touch on them only briefly here. More to the point of this conference, might we relax the state action line in the free speech setting if private actors take on attributes of the state or if they possess power similar enough to that of the state to warrant imposition of First Amendment (or First Amendment-like) speech rules? And may we analogize this to a flip-side question: when do we properly alter duties and protections for state actors if they take on attributes of (or act as) private actors?
This paper is part of a Symposium on “Free Speech Beyond The Constitution” published in 27 Journal of Contemporary Legal Issues (2025)
Copley Connects | Spring/Summer 2025
No full textMessage From the Dean | 2
Research and Scholarship Recognition | 3
Featured Collection: Southern Cross | 4
2025 Holleman Scholarship Winners | 6
AI Comes for Digital USD | 7
Pontem Partnership Marks Five Years | 8
Spotlight Jordan Kobayashi | 9
New Faculty at Copley | 9
ACRL Conference in Minneapolis | 10
American Society for Engineering Education (ASEE) Conference | 10
Copley Recognizes Graduating Seniors with Bookplates | 11
Top 10 Digital USD Downloads for the 2024–2025 Academic Year | 12
New Resources for Fall 2025 | 13
Seguimos Creando Enlaces Conference | 13
Copley Reads | 14
Building Community Connections | 15
Student Success Symposium | 16https://digital.sandiego.edu/copley_connects/1024/thumbnail.jp
Archival Articulations of Belonging: Resistance, Reimagination, and Resilience in School and in Incarceration
No full textBelonging is a universal desire, providing purpose and comfort, that supports our ability to survive and triumph through difficulty. A lack of belonging can impact one’s likelihood of becoming incarcerated. In turn, incarceration stigmatizes individuals and disrupts connections with family, friends, and community members. This study of individual’s experiences of belonging analyzed reflective written accounts created during incarceration. This phenomenological qualitative examination of belonging for formerly and currently incarcerated individuals, disproportionately people of color and individuals with disabilities, sought to deepen our understanding of belonging as a force in their lives. In the United States, high rates of incarceration impact not only currently and formerly incarcerated individuals, but their loved ones as well. This study, which examined the American Prison Writing Archive writings of formerly and currently incarcerated individuals and their experiences of belonging during K-12 school and incarceration, used a socio-ecological lens, highlighting the reciprocal relationship between individual and environment. This study found that dysfunctional home environments caused emotional dysregulation at school which resulted in more negative interactions creating barriers to belonging and that incarceration plays a significant role in disrupting belonging, separating individuals from their families and daily routines. For some, belonging served as a protective factor for navigating school and prison. This study implies that creating schools which are trauma-informed could improve students’ sense of belonging, potentially disrupting the school to prison pipeline. It also makes a case for reducing suffering in carceral institutions through improving access to interpersonal relationships and education
Exercise and Nervous System Capacity for Neurodiverse Youth (Infographic)
No full textTraditional environments often reward conformity over difference, making it harder for neurodiverse children to thrive. Instead of asking the child to change, we should adapt the environment to support their nervous systems and help them flourish. Educators, parents, administrators, and advocates can bridge the gap between the challenges and strengths of neurodivergence by using movement and the mind–body connection to build nervous system capacity.https://digital.sandiego.edu/ceen-hmba/1002/thumbnail.jp
Elliott’s Embodied Inclusion 360 Framework: A Holistic Approach to Supporting Neurodiverse Individuals
No full textThe embodied inclusion (EI) 360 framework asserts that authentic inclusion requires adapting environments in support of neurodiverse learners. The EI 360 model offers an urgently needed synthesis of intersecting theories and practices that are too often addressed in silos: educational neuroscience, trauma-informed teaching, social–emotional learning, inclusive education, and culturally responsive pedagogy. The framework identifies five core domains (i.e., physiological, relational, environmental, instructional, and transcendental) that form a cohesive lens through which to understand and respond to learner needs. Each domain contributes valuable insight into neurodiverse learner neurobiology, replacing fragmented, incomplete support plans with an integrated, individualized profile of a learner’s strengths, challenges, and needs. The EI 360 framework offers an integrated lens that empowers educators to design learning experiences that honor the full complexity of neurodiverse learners.https://digital.sandiego.edu/ceen-neuroinclusion/1000/thumbnail.jp
Arts&Sciences Magazine Fall 2025
No full text02 | Messages from the Dean
03 | Rooted in Community
06 | Center Staging Connection
08 | A Look Inside the Honors Program
10 | Preparing Tomorrow\u27s Health Leaders
20 | Awards and Honors
24 | Centerpiece
35 | Spotlights
42 | Off the Shelf
43 | Flashbackhttps://digital.sandiego.edu/casmagazine/1000/thumbnail.jp