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Out Of The Darkness And Into The Limelight: How Nurse Jackie Betters The Nursing Image, Shayla M. Holloway

Senior Honors Projects, 2010-2019

Due to the media’s portrayal of nurses, the nursing image has been

misconstrued over the past few years. Although nurses tend to be overlooked in the

media, there are television series out there that help promote the profession. This

essay considers how the television series Nurse Jackie is positively changing

society’s view of the modern day nurse. By analyzing some of the main protagonists

in season one of this controversial late night drama, one can see how Nurse Jackie

dispels popular nursing stereotypes and enhances the nursing image. Although

viewers may not grasp this shows impact on nursing, this show …

Preventing Obesity And Cardiovascular Disease In At-Risk Youth, Allison Patricia Woolf, Nicole Ashley Bauernfeind, Rachel Katharine Civale, Elizabeth Rose Spellman

Senior Honors Projects, 2010-2019

The literature review that was conducted focuses on exploring the most effective way to prevent development of Cardiovascular Disease (CVD) as a late effect of childhood obesity or risk thereof. Our research focused on the 8-10 year old at-risk and obese pediatric populations and whether the use of interactive educational interventions in the community setting can be of use to reduce CVD development and improve overall health status. Our findings determined that interactive educational interventions early in childhood can improve health outcomes for these populations and prevent subsequent development of CVD. We minimized the inclusion of all research whose evidence …

Using Social Narratives To Improve The Healthcare Experiences Of Children Diagnosed With Autism Spectrum Disorder, Margaret Spindel

Senior Honors Projects, 2010-2019

Children with Autism Spectrum Disorder (ASD) often experience significant emotional stress when they visit a healthcare provider. The focus of this research project was to explore the use of social narratives to help reduce stress associated with this environment. Social narratives are short stories designed to walk a child through a potential situation that they will encounter, that they may not be familiar with, or that they are not currently handling properly. As part of an initial literature review, evidence for the need for additional intervention in the healthcare setting for children with ASD was established. Continuing literature review then …

Navigating Culture: An Exploration Of Domestic Violence And Abuse Resource Provision To The Harrisonburg Iraqi Refugee Community, Kaitlin Michelle Holland

Senior Honors Projects, 2010-2019

There are currently 22.5 million refugees worldwide who have been displaced from their home countries due to war, conflict, or persecution. Of this total, only 1% are recommended for resettlement each year. In recent years, many of these resettled refugees have come from Iraq, fleeing conflict stemming from the Iraq war and ISIS. Upon resettlement, refugees face significant acculturation difficulties that can negatively affect mental health. Additionally, experiencing domestic violence and abuse (DVA) can also negatively affect physical and mental health. I researched how the refugee migration experience and domestic violence and abuse affect mental health as well as what …

Improving Adherence To Mental Health Treatment In A Low-Income Clinic, Janice G. Gandy

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

The increasing prevalence of mental illness in the United States presents significant challenges for primary care providers in low-income settings. Integrated Behavioral Health (IBH) programs have resulted in improved general health for low-income participants; however, managing appointment adherence, in which the patient attends appointment as scheduled, is particularly challenging. The purpose of this pilot project was to implement bundled interventions at a low-income primary care clinic to improve patient adherence to behavioral health treatment. The bundle of interventions included: 1) educational interventions emphasizing the benefits of IBH care 2) warm patient handoffs between the primary care provider to a behavioral …

Quality Improvement In Provider Attitudes Towards Adherence To Comprehensive Diabetic Care Hedis Standards, Samantha Taylor

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Healthcare Effectiveness Data and Information Set (HEDIS) is a quality measurement for standard of care used to rate a health plan or provider's ability to demonstrate clinical effectiveness. Medicare Advantage healthcare plan utilizes HEDIS as a guide for standard of care. Adherence to HEDIS is useful in decreasing chronic disease burden through preventative measures. Diabetes, a disease with high burden, has Comprehensive Diabetes Care HEDIS standards that specifically target providers. Increasing adherence to HEDIS measures is shown to significantly improve health outcomes when used with evidence-based guidelines. The literature shows having high HEDIS scores are not an incentive to adhere …

Pilot Of A Randomized Trial Comparing Outcomes Of Three Types Of Peripheral Intravenous Catheters (Pivc): Utilizing The Plan, Do, Study, Act Cycle, Heather Galang

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Peripheral intravenous catheters (PIVC) are used in high volume in acute and ambulatory settings. Due to high volume of use in patient care, complications from a PIVC can significantly impact patient experience. Literature indicates complications such as blood exposure, phlebitis, unplanned removal, infiltration, occlusion, dwell time, pain, and cost have serious consequences in patient care, leading to potential delays in treatment, patient discomfort, patient dissatisfaction, safety concerns, nursing interruptions, increased length of stay, and added costs. Gap analysis indicates additional research can prove beneficial for evidence-based care improvement. The authors propose using the plan, do, study, act to conduct a …

The Effectiveness Of Education And Cognitive Rehearsal In Managing Nurse-To-Nurse Incivility, Deborah B. Kile

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

This project was designed to evaluate the effectiveness of education on nurse-to-nurse incivility and use of cognitive rehearsal techniques on registered nurses' perception of their ability to recognize and confront incivility, along with resulting job satisfaction. Nurse-to-nurse incivility negatively affects nurses, organizations and patients. The Tri-Council for Nursing's proclamation calls nurses to recognize incivility and take steps to eliminate this in practice ("Tri-Council" 2017). A mixed method, quality improvement pilot study was conducted. Participants, (registered nurses employed in a Post-Anesthesia Care Unit in a community hospital in Virginia), received education on incivility and cognitive rehearsal techniques. Data was collected through …

Improving Nursing Adherence To Pediatric Pain Management Bundle Using The Pdsa Cycle, Stephen W. Lovern

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Given the current standards, pediatric post-operative pain management can be a distressing outcome to the patient and family. Adequate management of post-op pain in this population is a challenge despite the availability of evidence-based interventions combined to form care bundles. Tonsillectomies are common procedures in the pediatric population and often include moderate to severe pain with ineffective pain relief. Inadequate pain management leads to unplanned admissions, longer post anesthesia care unit (PACU) stays, slower oral intake, and longer recovery periods. In this project, two interventions were tested using the plan-do-study-act (PDSA) model for rapid cycle improvements. The first intervention was …

Identifying Ways That Institutional Staffing And Scheduling Committees Engage Nursing Staff In Resource Allocation At The Unit And Institutional Levels, Kevin M. Shimp

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

The American Nurses Association (ANA) recommends that at least fifty percent direct care providers are involved in staffing and scheduling decisions at the institutional level (ANA Staffing, 2015). This recommendation coincides with Magnet recommendations for the staff most impacted by staffing levels. Magnet organizations are recognized for superior nursing processes and quality patient care, which lead to the highest levels of safety, quality, and patient satisfaction (ANCC, 2015). Existing research, largely at the unit level, shows that registered nurses in acute care environments have higher general work satisfaction and morale when they are engaged in decision making around staffing (Ellerbe …

New Nurse Huddle Pilot To Improve New Graduate Nurse Retention, Timothy Craddock

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Purpose: With the continued nursing shortage, it has become increasingly important for healthcare organizations to focus on nurse retention to maintain quality of care standards and maintain fiscal responsibility. The purpose of this project was to pilot a new graduate nurse huddle to improve retention of new graduate nurses.

Method: A new graduate nurse huddle was developed using past nurse residency cohort Casey-Fink Graduate Nurse Experience Survey data to focus on areas of poor performance. Mixed methods surveys were administered pre-huddle and post-huddle to measure participant intent to stay and perception of huddle value. Descriptive statistics were used to evaluate …

Improve Readmissions And Patient Satisfaction Scores With A Revised Discharge Education Plan, Michele M. Hughes

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Problem: Payers of health insurance are tracking key performance measures and are limiting payments to hospitals. With this threat to financial reimbursement hospital systems have increased emphasis on tracking and improving outcomes. The purpose of this project is to reduce all-cause 30-day readmissions and improve patient satisfaction scores in the care transitions domain after a total hip or total knee replacement by revising the discharge materials and education.

Method: The total joint replacement discharge education materials were revised to address the common causes of readmissions. The documents were reformatted to improve literacy level, readability, and patient learning. Nurses were educated …

Rat Hind Limb Nociceptive Withdrawal Response To Heat And Mechanical Stimuli Depends On Initial Position Of The Paw But Not Stimulus Location, Giavanna Verdi

Senior Honors Projects, 2010-2019

Mammals rapidly withdraw their hind limb in response to noxious stimulation, which is a protective movement known as the nociceptive withdrawal response (NWR). The NWR has been previously studied in spinalized, decerebrated and anesthetized non-human and human mammals; however, there is minimal information on the NWR in intact, unanesthetized non-human mammals.

The first specific aim was to identify the factors that determine the direction and magnitude of the NWR in intact, unanesthetized rats. Based on previous studies, we hypothesized that the location of stimulation and the initial position of the paw preceding the NWR will influence the direction and magnitude …

Interdisciplinary Skill Development During Summer Autism Clinic, Rachel F. Kagle

Senior Honors Projects, 2010-2019

The present paper focuses on the interdisciplinary skill development of speech-language pathology graduate student clinicians and occupational therapy graduate student clinicians in the treatment of children with Autism Spectrum Disorder. This paper explains the significance of these disciplines in the treatment of Autism before giving the results of the study. For the present study, data was collected at James Madison University’s Summer Autism Camp over a four-week period. There were ten speech-language pathology (SLP) clinicians that received the survey and eleven children with Autism that were enrolled in the program. It was hypothesized that the SLP clinicians would display skill …

The Relationship Between Fundamental Frequency Variation And Articulation In Healthy Speech Production, Casey Behre

Senior Honors Projects, 2010-2019

Fundamental Frequency (F0) and articulation are two factors of speech production that impact speech perception, and yet the potential interactions of these two factors are not well understood. Their relationship has potential theoretical as well as clinical implications. This Honors Project aims to better understand this relationship by examining changes in fundamental frequency (F0) and the acoustic vowel space as an index of articulatory behaviors with a within-speaker approach. Specifically, F0 variations were examined in relation to the acoustic vowel space for 10 male native speakers of American English. Two sets of acoustic measures were made to evaluate F0 and …

The Quadriciser’S Effect On Range Of Motion And Upper Body Motor Control In Children With Mixed Quadriplegia Due To Chromosomal Disorders, Jillian P. Serigano

Senior Honors Projects, 2010-2019

PURPOSE: The purpose of this experiment is to determine the effects that the quadriciser has on range of motion and upper body motor control in children with mixed quadriplegia due to chromosomal deletion disorders. METHODS: Two subjects with different chromosomal deletion disorders participated in this study. They completed a 10-week passive exercise intervention using the quadriciser. Range of motion of the elbow and shoulder were taken pre and post quadriciser use for both subjects. For one subject, hip and knee measurements were also taken. Both subjects also completed a timed reach task pre and post quadriciser use to test motor …

Impacts Of Birth Plans On Maternal Satisfaction A Literature Review And Focus Group Study, Kaylyn Brooks

Senior Honors Projects, 2010-2019

Purpose: The purpose of this research paper is to investigate existing research for the relationship between birth plans and maternal satisfaction of the labor and birth experience.

Design: The research found and utilized in this paper is formulated into a literature review format and includes research obtained from a focus group of midwives.

Population/Sample: The population of the research obtain for this literature review consisted of pregnant women (at various stages of their pregnancy, labor, and birth) and post-partum women whom had prepared written birth plans.

Variables Studied: Maternal satisfaction of expectant mothers with their personal labor and birth experience …

Characterization Of Neuronal Specific Responses To Induced Misfolded Protein Stress In Caenorhabditis Elegans, Claire Gormley

Senior Honors Projects, 2010-2019

Abstract

Misfolded protein stress has been associated with many types of disease,

including neurodegenerative disorders like Alzheimer’s, Parkinson’s and Huntington’s

disease. When a cell accumulates misfolded proteins in the endoplasmic reticulum,

misfolded protein stress occurs and the unfolded protein response (UPR) is triggered to

induce mechanisms that will allow the cell to either survive or undergo cell death. The

nascent polypeptide associated complex (NAC) is a co-translational chaperone and α/β

heterodimer that manages protein folding and localization, and protects against misfolded

protein stress; changes in NAC function have been linked to both neurodegeneration and

cancer. In these studies, I depleted …

A Meta-Analysis Of The Aftermath Of South Africa’S Apartheid On Its Health Care System, Caitlin Jaeckel

Senior Honors Projects, 2010-2019

The objective of the study was to access the possible problems of the quality of health care that whites and non-whites receive in South Africa. The research question was specific to how the residual effects of apartheid are affecting South Africa’s health care today and if citizens still feel the presence of apartheid in health care. Prior to the start of the study the researcher hypothesized that access, quality, and funding of South Africa’s health care system has not been able to recover from the effect of apartheid and South Africans still observe the effects of apartheid on an individual …

A Survey-Based Study Of The Changes To Self-Efficacy, Trust In Coaching, Goal Orientation, And State Anxiety That Occur During A Marathon Training Taper, Erica A. Witoslawski

Senior Honors Projects, 2010-2019

Throughout a sport season, athletes’ physiological systems are constantly broken down and strengthened due to repeated practices and competitions. However, not just the physiological benefits of tapering impact performance. The purpose of this study was to extend the current literature that has found connections between self-efficacy, trust in coaching, state anxiety, goal orientation, and sport performance by assessing these variables during a marathon training taper period. The study analyzed included 29 subjects who were enrolled in a general-education health and fitness course focusing on marathon training through a series of surveys electronically administered 3 times (baseline, pre-taper, and post-taper) throughout …

Effect Of Biofeedback And Exercise Type On Neural Swallowing Control, Rachel J. Rinehart

Senior Honors Projects, 2010-2019

The clinical efficacy of swallowing exercises is well established in swallowing literature, and biofeedback has been shown to augment cortical hemodynamic response (HDR) during normal swallowing. This study compared HDR during swallowing exercises with and without biofeedback to HDR during normal swallows with and without biofeedback. Healthy adult participants (n=6, mean age=50.83 male=2) were recruited and trained on the following conditions: normal swallowing, swallowing exercise in which a specific physiological target was given (skilled), and swallowing exercises in which no specific physiological target had to be achieved (non-skilled). Biofeedback consisted of submental surface electromyography (sEMG) signals displayed visually. HDR were …

Outcomes And Solutions For Children And Families Affected By Type 1 Diabetes Mellitus, Melissa A. Gray

Senior Honors Projects, 2010-2019

Caring for children with chronic medical conditions, such as type 1 diabetes mellitus (T1DM) has negative implications for the psychosocial wellbeing of the family. Through this project, the negative affects of T1DM on the family were addressed by the formation of the Life’s Too Sweet: A Workshop for a Brighter Future With Type 1 Diabetes (LTS) event, which creates community support for affected families. During LTS workshops, parents collaborated with each other, while the children participated in fun, educational activities about nutrition, fitness, and overall health in relation to T1DM. Supporting interdisciplinary professionals, such as nurses, social workers, registered dietitians, …

Promoting Independent Movers: The Effect Of The Quadriciser On Range Of Motion (Rom), Kristen N. Frank

Senior Honors Projects, 2010-2019

Exercise and movement are pivotal in promoting optimal function for the human body. For individuals with severe orthopedic impairments, attaining the required minimum of 30 minutes of daily exercise is seemingly difficult. The Quadriciser (the “Q”) serves as an alternative method to therapy in attaining daily exercise through promoting passive-active movement of all four limbs. Five middle school and high school subjects with cerebral palsy, severe orthopedic impairments, and multiple disabilities are analyzed to determine if the Q produces increased range of motion (ROM) outcomes for the knee and shoulder joints. A single case AB, pre-post design was utilized where …

Maladaptive Behavior And Communication Disorders Following Tbi: Survivor, Caregiver And Speech-Language Pathologists' Perspectives, Marena S. Jones

Senior Honors Projects, 2010-2019

Following traumatic brain injury (TBI), individuals often face neurobehavioral challenges (e.g., aggression) that hinder treatment. Research on the relationship between communication disorders and maladaptive behaviors is limited. Participants from a convenience sample of two survivors of TBI, a caregiver, and a speech-language pathologist were interviewed about their experiences and perspectives. The interviews reflected focused questions that were congruent across participants. Interviews were recorded, transcribed, and coded. Each coder coded the transcriptions individually, they were then compared using consensus coding for reliability, and finally analyzed for emergent themes. The two most referenced themes were “Communication challenges” and “Changes through rehab”. “Communication …

Mother’S Perceptions Of Their Personal Impact On Infant Language Development, Miranda Steinbeck

Senior Honors Projects, 2010-2019

During the early months of a child’s language development, their ability to perceive and process language is very fluid and the language input they receive can have a large impact on their language later in life. From the beginning, children need to be able to differentiate the sounds of speech from the rest of the sounds that occur in their environment (Golinkoff, Can, Soderstrom, Hirsh-Pasek, 2015). In other words, children are exposed to the different sounds in their environment and they begin to pick up on the speech sounds, such as conversation-like interactions, with their parents (Golinkoff et al., 2015). …

The Community 911 System: Sources Of Strain And Relief, Elizabeth Zulauf

Senior Honors Projects, 2010-2019

This thesis will identify best practices from other localities around the country and propose a set of possible solutions for Harrisonburg EMS. Because non-emergency 911 calls use resources, finances, equipment and time that contribute to the burden that the emergency system faces, communities have adopted programs that aim to ease this burden by limiting the amount of ambulance responses to calls that turn out to be non-emergency. It is not only in Harrisonburg, but across the country that “providers are overwhelmed with evaluation, treatment and transportation of patients who have minor medical conditions but who have nowhere else to turn …

Alzheimer’S Disease And The Impact Of Music Therapy A Systematic Literature Review, Hayley Guess

Senior Honors Projects, 2010-2019

Currently ranked as the sixth leading cause of death in the United States, Alzheimer’s disease (AD) has become the most prevalent form of dementia, a term commonly associated with memory loss and other progressive cognitive deficits that compromise patients’ lives. What may begin as a mindlessly misplaced object or momentary inability to recall newly learned information will eventually advance to a loss of personal identity, forgotten loved ones, and utter misperception of reality. Although a cure for AD has yet to be discovered, there are several non-pharmacological treatments that can improve patients’ quality of life and provide temporary relief from …

Crossing The Bridge: A Descriptive Pilot Study Of Sensory Tricks And Related Variables To Musician’S Dystonia Onset, Jamie Agee

Senior Honors Projects, 2010-2019

Silencing music across the globe, musician’s dystonia, a neurological condition with an unknown etiological basis, has played an integral role in terminating professional musician’s careers. While limited research has been conducted into internal/external factors which may potentially influence musician’s focal dystonia onset, this pilot study sought to identify specific instrumentalists’ behaviors and traits which may exhibit a potential relationship with disease onset and, consequently, the ability to utilize sensory tricks. This specifically included examination of practice approach, auditory/kinesthetic feedback, years played, personality, and approach to practice among the musicians being studied. To assess these characteristics within the dystonic musician population …

Repeatability Of Impedance Cardiography In The Measurement Of Cardiovascular Hemodynamics During Exercise, Lindsey Marie Rodriguez

Senior Honors Projects, 2010-2019

Repeatability of Impedance Cardiography Hemodynamic Variables During Treadmill Exercise

Purpose To analyze the day to day repeatability of cardiac hemodynamic measurements using a Physio Flow 07 Enduro during treadmill submaximal exercise.

Methods 21 male subject ages 18 and older were studied. Two graded treadmill exercise tests consisting of two 5-minute steady state stages (Moderate and Vigorous intensity) were performed using the PhysioFlow device at least 48 hours apart. Cardiac hemodynamic measurements were compared between stages and trials using repeated measures ANOVA, intraclass correlations, and Bland-Altman plots.

Results Oxygen consumption (VO₂) and respiratory exchange ratio (RER), were not different …

Effects Of Age, Timbre, Pitch Contour, And Background Noise On Melodic Contour Identification And Sentence Recognition By Children, Lindsey M. Seyfried, Sarah A. Troy

Senior Honors Projects, 2010-2019

The researchers collaborated together with the help of Dr. Yingjiu Nie in the Lab of Auditory Perception in Children and Adults on the four research studies completed there. Through these projects, they were involved in all areas of the research process. While they cannot claim the research project as their own, by assisting the graduate students and Dr. Nie, they exposed themselves to how research is conducted in this field and gained valuable knowledge in the process. To conclude the project, they each wrote individual personals reflection to summarize and review the experience.