Date of Graduation

Fall 12-12-2025

Document Access

Restricted Project/Capstone - USF access only

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

Department/Program

Public Health

Program

MSN project

First Advisor

Beth Koser Schwartz

Second Advisor

Ana Martinez

Abstract

Cool & Connected OC (Abstract )

Laura Germano, Valentin Huerta, Thaomi Pham, & Manar Sahalam

University of San Francisco | School of Nursing and Health Professions

NURS 660 B: Practicum Part II- Quality Improvement & Outcomes Management

Professor Schwartz

November 30, 2025

Abstract

Objective: Climate change has increased the frequency and severity of extreme heat events, placing older adults, particularly those in small board-and-care homes in inland Orange County, at elevated risk of heat-related illnesses and emergency department (ED) visits. Many of these facilities lack structured emergency protocols, adequate cooling infrastructure, and culturally appropriate education, all of which contribute to preventable hospitalizations. Problem: Data indicate that approximately 4% of heat-related ED visits among older adults originate from residents of these board and care facilities, particularly in “heat island” zones such as Santa Ana, Anaheim, and Garden Grove, areas characterized by high population density, limited access to cooling centers, and socioeconomic vulnerability. Methods/Interventions: The Cool & Connected OC quality improvement initiative aimed to reduce heat-related ED visits by 25% by September 30, 2026, through a multi-component intervention guided by Kotter’s 8-Step Change Model and the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) framework. Implementation could be carried out in collaboration with public health stakeholders and agencies and includes the distribution of culturally tailored cooling kits, multilingual caregiver education, GIS mapping to identify high-risk heat zones, deployment of mobile cooling centers, and coordinated transportation services. Results: Early outcomes demonstrated increased caregiver knowledge, stronger facility-level preparedness, and greater utilization of cooling resources among vulnerable seniors. Conclusions: These preliminary findings suggest that nurse-led, community-based interventions can play a critical role in reducing climate-related health risks and promoting system-wide resilience. Ongoing evaluation through summer 2026 will assess the program's sustainability and impact on reducing preventable ED visits among at-risk older adults.

Supplemental Files
QI Poster for Cool & Connected OC final*.pdf (2471 kB)
Cool & Connected OC Poster
QI_presentation_Zoom _in_slides final.pdf (3575 kB)
Cool & Connected OC Slides
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