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Publication Implicit Bias in Nursing Care: A Walker and Avant Concept Analysis(University of Pennsylvania, 2023-12) Chris Barnes, MDiv, MSN, RN, CEN, TCRN, CPENNurses address pain and suffering in their daily practice; yet, an underlying problem for nurses is the presence of implicit bias. This paper uses the Walker and Avant (2019) Concept Analysis guidelines to analyze the concept of implicit bias in nursing. The concept analysis reviewed 143 articles of which 21 articles met the inclusion criteria for understanding the impact of implicit bias in current nursing practice. Defining attributes, antecedents, consequences, and empirical referents are identified. Example cases are also offered. The concept analysis highlights the concept of implicit bias and the impact upon nursing care.Publication An Antibiotic Stewardship Program within Telehealth to Decrease Inappropriate Antibiotic Prescriptions in Acute Uncomplicated Bronchitis(University of Pennsylvania, 2023-12) Jordan Burnam, DNP, FNP-CPurpose: Implement and evaluate an antibiotic stewardship program developed by the CDC within the telehealth setting to reduce the rate of antibiotic prescriptions by providers for uncomplicated bronchitis. Methods: A quality improvement study was employed within a telehealth practice platform in the Tampa, Florida area. A pre-intervention assessment of the provider’s antibiotic prescribing rates for bronchitis was conducted. Implementation included utilization of tools provided by the CDC and a presentation on evidence-based antibiotic prescribing practice guidelines. Post-intervention analysis included an audit with feedback method over a span of three months that assessed provider antibiotic prescribing rates for bronchitis. Results: There was a 22.1% decrease from pre-intervention to post-intervention antibiotics prescribed for acute bronchitis. A chi-square test of independence was performed to examine the relationship between antibiotics prescribed for bronchitis and the implementation ofan antibiotic stewardship program. The relation between these variables was significant, X2 (1, N= 175) = 13.8829, p = .000195. Antibiotics were less likely to be prescribed for bronchitis after the implementation of an antibiotic stewardship program in this setting. Discussion: Results demonstrated that when antibiotic stewardship programs guided by the CDC are implemented and followed, decreased use of antibiotics can result. This project was limited due to sample size and implementation period. Conclusions: Implementing an antibiotic stewardship program framed by the CDC within a clinical site that entails provider education and audit with feedback on providers' prescribing practices was shown to accomplish the goal of decreasing the number of inappropriate antibiotics prescribed for bronchitis.Publication Book Review: Cherry, S. M. (2022) Importing care, faithful service: Filipino and Indian American nurses at a veteran’s hospital(University of Pennsylvania, 2023-12) Andre A. Rosario, BSN, RN-BCN/APublication The Patterns and Costs of Services Use among Homeless Families(Journal of Community Psychology, 2011)This study examines families’ use of behavioral health hospitalization and foster care placement prior to, during and following shelter use, comparing families based on shelter pattern and type of housing exit. Results show that inpatient and foster care services use drops in the homelessness period, but rebounds following exit, regardless of pattern of shelter use, and type of housing exit. Results suggest that shelters supplant use of services, but not on a sustained basis. Despite declines in concurrent services use, the homelessness period is overall more costly for episodically and long-term shelter users, primarily owing to the high costs of shelter. High rates of inpatient and foster care services use following the homeless spell suggest that providers of homeless assistance should systematically screen and refer homeless families to on-going community-based service supports. Service use patterns indicate that homeless spells may disrupt continuity of care with community-based health and social services.Publication The Aging of Contemporary Homelessness(Contexts, 2013)Homelessness is currently at a demographic crossroad. This presents a unique opportunity for hastening its demise. In the thirty years since homelessness first manifested itself in American cities in its contemporary form, it has ascended to one of the most prominent American social problems. Despite the current push by advocacy organizations to end homelessness, many expect it will always be with us. In its longevity, however, lies the potential for its decline, provided we do not repeat this cycle with a new generation of homeless.