Honoring Veterans’ Wishes: Efficacy Of An Evidence-Based Shared Decision-Making Tool In Va Icu Goals-Of-Care Discussions, Stephanie Alexander, Anna Astashchanka Md, Venktesh Ramnath Md

Doctor of Nursing Practice Final Manuscripts

Abstract

Introduction: This Doctor of Nursing Practice project aimed to enhance the knowledge and confidence of the San Diego Veterans Health Administration’s (VASD) Intensive Care Unit (ICU) medical providers in goals-of-care discussions (GOCD). Additionally, this project aimed to improve the documentation of these discussions.

Background: Delays in GOCD can lead to futile medical and surgical interventions, inappropriate antibiotic use, and higher rates of mental health conditions in patients and their loved ones. Earlier GOCD are associated with lower ventilation and resuscitation rates, earlier hospice enrollment, reduced ICU admissions, lower financial costs, and better patient and caregiver quality of life. However, …

Improving Dental Students' Knowledge And Confidence In Treating Tobacco Use, Victoria Pierce

DNP Projects

Background: Tobacco use can lead to numerous chronic health conditions. Healthcare professionals in the dental field are in a unique position to broach this issue with patients. Research shows that dental students do not feel equipped to provide tobacco cessation care, citing lack of education on the subject among their top reasons for this.

Purpose: The purpose of this project was to evaluate changes in dental students’ knowledge and confidence related to treating tobacco use after participation in an educational intervention about the 5A’s, behavioral counseling, and first-line prescription medications.

Methods: This quality improvement initiative utilized a quasi-experimental survey design …

Racial And Geographic Disparities In The Management And Care Of Sepsis, Luke Dommaschk Burwell

Nursing | Senior Theses

Sepsis, a severe condition triggered by the body's response to infection, requires prompt treatment to prevent tissue damage and organ failure. The SEP-1 Sepsis bundle, developed by Center for Medicare and Medicaid Services (CMS), aims to standardize care, particularly in rural hospitals with limited resources. However, disparities in bundle adherence and mortality rates persist, with rural areas facing more significant challenges. Studies show racial differences in care quality, emphasizing the need for interventions to address systemic biases. While sepsis bundle adherence and simulation training are strong indicators of care improvement, the literature review underscores the need for targeted interventions in …

Neurodiagnostic Program Director Perceptions On Low Enrollments, Daniella Krantz

Student Dissertations

Higher education enrollments have trended downward over the last several years and fallen further due to the impact of the COVID-19 pandemic. The problem addressed in this study was low student enrollment in neurodiagnostic programs in the United States, resulting in an increasing shortage of neurodiagnostic professionals working in the field. The purpose of this descriptive qualitative study was to explore the perceptions of neurodiagnostic program directors and their views on the low enrollments in neurodiagnostic programs in the United States. A descriptive qualitative design was used to understand the perspectives of these program directors. Human capital theory, the theory …

Increasing Medical-Surgical Nurses' Palliative Care Self-Efficacy Using The Cares Tool: A Quality Improvement Project, Rebekkah L. Stanko

Nursing (graduate) Student Scholarship

Background: Over 35% of all deaths in the United States occur in the acute care hospital setting, and 75% of end-of-life (EOL) patients require palliative care. Registered nurses (RNs) with strong palliative care self-efficacy (PCSE) promote positive death experiences for patients and families by minimizing patient suffering and maintaining clinical and ethical standards. Employers can enhance RNs’ PCSE through educational interventions and resources.

Problem: Inpatient acute care hospital RNs lack PCSE because acute care is traditionally curative, and RNs receive limited EOL care education.

Methods: A quality improvement project was conducted. Participants were a convenience sample of RNs …

Implementation Of The Diet Readiness Test To Assess Self-Efficacy And Education Effectiveness In Overweight Women, Tatjana Ilich

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence-based Doctor of Nursing Practice (DNP) project was to assess perceived self-efficacy in overweight women who are participating in a weight loss program and the effectiveness of education being provided using the Diet Readiness Test (DRT).

Background: Obesity is a rapidly growing public health problem affecting an increasing number of countries worldwide because of its prevalence, costs, and health effects. Among women between the ages of 40 and 60, more than 80% report that they are either trying to lose weight or trying to maintain weight. The overall prevalence of obesity was similar among men …

Improving Timely Sepsis Care Through Staff Education Within The Emergency Department, Spencer Forest

Master's Projects and Capstones

Problem: This quality improvement project aims to increase SEP-1 sepsis bundle compliance among nursing staff at a 16-bed emergency department through targeted continual staff education on sepsis screening and best practices. Currently, the unit is experiencing cases of sepsis fallout and is not meeting the 90% threshold on three treatment metrics as defined by the institutional sepsis bundle time goals. Bundle compliance that adheres to the time goals decreases incidences of sepsis fallout and overall days in the hospital, while increasing positive patient health outcomes.

Context: A microsystem assessment was completed along with a staff gap survey to determine areas …

Support Their Sleep: Enhancing Nurses' Knowledge And Implementation Of Non-Pharmacological Sleep Protocols To Improve Patient Rest, Recovery, And Reduce Cognitive Impairment., David C. Barry

Master's Theses and Capstones

Background: Sleep and rest play an influential role in promoting recovery and healing in humans. Hospitalized patients are at risk for altered sleep from hospitalization, illness, and stimulation from a hospital environment. Non-pharmacologic interventions preformed by nurses can help to improve sleep and sleep environment for patients.

Local problem: There was no protocol or available information regarding patient sleep promotion for nurses to references when caring for patients.

Methods: Nurses in the microsystem (n=8) were administered a pre/post questionnaire containing Likert scales and a short quiz containing knowledge-based questions. Questionnaires were distributed to nurses prior to and after …

The Relationship Between Self-Efficacy And Informed Decision-Making On Primiparous Women During The Birthing Process, Morgan R. Fillipo

Nursing | Senior Theses

Childbirth is a very intense and vulnerable experience, especially for first-time mothers. Across the globe, the prevalence of traumatic and unsatisfying births has become an increasingly troublesome issue for women. There is extensive evidence of maltreatment, and a large portion of the problem has to do with the client’s medical team. To combat this dilemma, the best course of action would be to prepare women for this possibility by increasing the client’s self-efficacy and decision-making abilities. Self-efficacy, also known as confidence in one’s skills, is an important trait to have when it comes to patients being able to advocate for …

Utilizing Podcast Education To Improve Nurse Knowledge, Confidence, And Behaviors Related To Palliative Care Conversations In The Intensive Care Unit, Brittany Estridge

DNP Projects

Background: The personal connection that Registered Nurses (RNs) build with patients and their families puts them at the forefront of many conversations during the patient’s stay in the intensive care unit (ICU). Some of the most difficult conversations are related to palliative care (PC). It can be challenging to know how to respond to the complex questions posed in palliative care conversations (PCC) when patients and their caregivers are making decisions that will alter the course of the patient’s treatment, as well as affect the quality and length of their life.

Purpose: Nurses receive inadequate training in PCC. The purpose …

Nurse-Led Education On Oral Chemotherapy Medications, Carmen Lucia Glick Alonso

Master's Projects and Capstones

Problem: Breast cancer is one of the leading causes of cancer death among women in the United States. Annually, around 264,000 breast cancer cases are diagnosed in women and 2,400 in men (Centers for Disease Control and Prevention, 2022). According to the American Cancer Society, the risk of a woman in the United States being diagnosed with breast cancer in their life is around 13% (2022).

Context: Along with a cancer diagnosis comes the need to introduce patient education about new oral chemotherapy treatments. As a treatment team member, the oncology nurse plays a vital role in this …

Postpartum And Pediatric Education Program For Mothers, Lacie T. Ellithorpe

Department of Occupational Therapy Entry-Level Capstone Projects

My capstone experience included the focus area(s) of Clinical Practice Skills and Education. The aim of this capstone project was to create an ergonomic education program to address new motherhood and their occupations of health management and maintenance, sleep and rest, breastfeeding and other baby care, community mobility, and leisure. My Capstone Mentor was Dr. Kari Rasmussen, OTD, OTR/L. Becoming a new mother is considered a major life event, due to significant role changes that impact a mother’s everyday occupations. The population I served was new and expectant mothers in order to provide ergonomic education as they relate to the …

Genetics And Genomics Education Among Physician Assistants, Wesley Patterson

All Dissertations

This dissertation comprises five chapters to describe genetics and genomics education among physician assistant/associate (PA) students and practicing PAs. Chapter I introduces the gap in supply and demand of genetic services, the need for non-genetics healthcare providers to fill the gap, and the PA profession as a solution.

Chapter II is a rapid literature review that summarizes the available literature regarding genetics and genomics education for PAs. A paucity of literature exists to describe the current state of PA genetics-genomics education. The few studies retrieved describe content being taught in PA programs, the number of genetics-genomics contact hours PA students …

Prenatal Education For Black Mothers And Their Support Persons As An Intervention For Improving Initiation Of Breastfeeding, Sandra King

Doctor of Nursing Practice Projects

Background: The benefits of breastfeeding are commonly known; however, the rates of exclusive breastfeeding among the Black community are less than those of other ethnic groups. Providing breastmilk or formula to an infant is an individual decision. Influential factors such as cultural background, employment status, socioeconomic status, level of education, and availability of support from family members and health care providers correlate with the method a mother chooses to feed her infant. Increasing breastfeeding initiation immediately after birth is a necessary precedent for uptake in the exclusivity of breastfeeding.

Purpose: This Doctor of Nursing Practice project aims to improve prenatal …

Lgbtq+ Health Disparities: Healthcare Intervention, Kara Steinbrecher

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The lesbian, gay, bisexual, transgender, and queer (LGBTQ+) community has carried the burden of countless health disparities throughout its history tied to discrimination, bias, prejudice, and stigma. LGBTQ+ individuals are disproportionately at higher risk for substance abuse, sexually transmitted diseases, cardiovascular disease, mental illness, suicide, and unequal access to healthcare, related to social stigma and bias that exists in healthcare itself. The purpose of this systematic literature review is to analyze existing health disparities among the LGBTQ+ population in the United States and the efficacy of various interventions of health care professionals to reduce them. Twenty-one articles from multiple online …

Doctors & Diets: The Return Of Nutrition To American Medical Education, Luke Hollingsworth

Senior Theses

The purpose of this honors graduation thesis is to analyze the role of nutrition in the prevention, management, and treatment of chronic diseases and to argue that clinical nutrition should be reintegrated into American medical education as a high priority subject. The thesis begins with a historical review of clinical nutrition beginning in the fifth century B.C. with Hippocrates in Classical Greece and ending in 21st century America. Following the historical review, five of some of the most prevalent chronic diseases in America are examined through a nutritional lens. This thesis concludes with a discussion of the outlook of American …

The Relationship Between The Educational Experiences Of Senior Dental Students And Their Attitudes Towards Intellectual And Developmental Disabilities, Alya Sarkhouah

University of the Pacific Theses and Dissertations

This research explores final year dental students’ knowledge and attitudes towards the treatment and management of patients with Intellectual and Developmental Disabilities (I/DD) as related to variations in the dental practices in Special Health Care Needs (SHCN) training they received. A quantitative, non-experimental study was conducted, employing survey data collection methods, to address descriptive, comparative, and correlational questions. One cohort, Class 2020, attended extramural rotations in specialized clinics for patients with I/DD and in-person lecture concerning this topic. However, due to the COVID-19 pandemic and its health-related restrictions, another cohort, Class 2021, did not have the same opportunity as rotations …

Ophthalmic Nursing Education: The Key To Unlocking Patient Access To Retina Services, Jacob P. Mcginnis

Master's Theses and Capstones

Background: Ophthalmology, the medical field dedicated to the human eye and visual system infrequently uses nurses due to a lack of nursing knowledge about ophthalmology.

Local Problem: An ophthalmic microsystem in the Northeastern United States is experiencing increased demand for services and decreased access to their retina section. The microsystem does not utilize nurses in the clinic because of education and training barriers. The specific aim of this quality improvement (QI) project is to increase nursing knowledge about ophthalmology from baseline to an overall passing score of 80%.

Methods: This QI project sought to see if registered nurses could …

Increasing Staff Compliance With Routine Hcv Screening And Improving Linkage To Care Among Patients Testing Hepatitis C Positive In The Emergency Department, Carson G. Swartz

DNP Projects

Background: Hepatitis C virus (HCV) is a blood-borne pathogen that can cause severe liver disease, cancer, and death and is a significant source of morbidity and mortality in the United States. Several academic medical centers including University of Kentucky Healthcare have implemented routine HCV screening for patients presenting to the emergency department (ED) and have discovered a large viral burden amongst patients who are often symptomatic.

Purpose: The purpose of this doctoral project is to increase staff compliance, confidence, and education regarding the HCV screening process in an urban, Level I emergency department, as well as to evaluate whether an …

Preparing For Professional Programs: Strategies And Practices For Pre-Medical Education, April Elayne Curry

Theses and Dissertations

This study examines the preparation process for students in professional programs and highlights strategies and practices for pre-medical education. The COVID-19 pandemic has highlighted elements of the healthcare system that explore how critical physicians are that can lead with both a global perspective and with compassionate patient care. In order to understand the competencies required for this leadership process, it is critical to consider the medical school lifecycle from the undergraduate education to residency. Working from the admissions process, we consider what competencies are required for medical school success and physician preparedness and we use that to shape a solid …

Best Practices In Ipe Throughout Literature: Identifying Common Supports, Barriers, And Recommendations For Future Program Development, Megan E. Byrne

Department of Occupational Therapy Entry-Level Capstone Projects

Interprofessional education (IPE) is defined by AOTA (2015) as an “occasion by which students from two or more professions learn about, from, and with each other to improve collaboration and quality of care”. IPE is closely related to and often overlaps with interprofessional collaboration (IPC) within healthcare settings. IPC “occurs when multiple health workers from different professional backgrounds work together with patients, families, [caregivers], and communities to deliver the highest quality of care” (World Health Organization [WHO], 2010, p. 7). The overall aim of IPE is to promote and develop effective IPC thereby improving patient outcomes (Khan, 2016).

Current research …

An Exploration Of Effective Patient Education With An Emphasis On Concussion, Kayla M. Ruopp

Health, Human Performance and Recreation Undergraduate Honors Theses

Concussion is a prevalent healthcare issue in the US, with approximately 1.6-3.8 million sports and recreation-related concussions each year in all ages. A concussion can be defined as a traumatic brain injury caused by biomechanical forces. When an athlete sustains a concussion, a physiologic cascade of events occurs. The most common signs and symptoms of a concussion include: loss of balance, disorientation, headache and confusion. Concussion assessments are important in order to determine the presence of an impairment and there are a multitude of tests that clinicians can use in order to isolate each type of damage. Studies have shown …

A Multimodal Educational Approach For Caregivers Of A Febrile Child: A Quality Improvement Project, Claire Catherine Jones

Nursing (graduate) Student Scholarship

Background: Insufficient caregiver knowledge regarding the physiology and correct management of fever in children contributes to adverse health outcomes in children.

Problem: Lack of multimodal education and resources for caregivers on the management of febrile children leads to medication dosing errors, overutilization of medical resources, and caregiver ambiguity when caring for their child.

Methods: A multimodal educational approach (MEA) on discharge education for the care of a febrile child directed towards caregivers who presented to a pediatric emergency room in Eastern PA, was implemented, and caregiver knowledge and caregiver’s perception of preparedness at time of discharge was measured.

Intervention: The …

Improving Patient Outcomes With Post-Op Education For Nurses Caring For Patients Undergoing Total Joint Replacement, Amanda Collier

Doctor of Nursing Practice Projects

Background: Surgical site infections (SSI) are the third most reported nosocomial infection causing an increased length of stay, increased healthcare cost, and a substantial increase in morbidity. A SSI is an infection developing within 30 days of surgery without using an implant and within one year of surgery utilizing any form of implant. Typically SSI occurs at the time of incision. However, poor postoperative wound care can lead to an SSI.

Purpose: This project aims to educate nursing staff on care of the total joint replacement (TJR) patient to reduce readmission rates for postoperative SSI.

Design Methods: This …

Preserving Safety While Upholding The Integrity Of Medical Education And Practical Skills: The Impact Of Covid-19 On Teaching Human Anatomy, Anna Cowan

Undergraduate Honors Theses

The global pandemic caused by COVID-19 placed constraints on several aspects of normal life, especially those of higher level education. While many programs moved to teaching in a strictly online format, there are some courses in which this structure was not appropriate. This study observed the outcome of the adapted course structure employed at Quillen College of Medicine during their Gross Human Anatomy course. Through a voluntary survey and multiple independent t-tests, it was demonstrated that the students who took the adapted course performed, on average, 2 points lower on each exam than previous classes. Also, this study showed that …

Attitudes And Actions Of Genetic Counseling Program Directors Regarding Standards For Accreditation Of Genetic Counseling Training Programs, Ben Newsum

Human Genetics Theses

Academic accreditation is a common feature of higher education, with a moderate body of literature. Previous studies largely focus on factors that are crucial to the implementation or acceptance of standards. This study explored how education standards of genetic counseling are perceived and interacted with by program directors. We performed semi-structured interviews with current program directors, assistant directors, and associate directors to gain insight into their perspectives on current accreditation standards and the standards’ revision process. Interview transcripts were analyzed via thematic analysis to identify common themes related to program directors’ perceptions of the standards and accreditation as a whole. …

A Capstone In Education: Current Challenges For Occupational Therapist Clinicians Transitioning To Role Of Academician, Jacie Schneider

Department of Occupational Therapy Entry-Level Capstone Projects

The doctoral capstone I participated in for my entry-level Doctor of Occupational Therapy program was in a focus area of education with a mentor who was a professor in a master’s program. I supported my mentor in her role as a professor of a physical dysfunction intervention course and had the opportunity to present a module to students on wheelchair seating interventions. Using experience gained during my capstone as well as information learned during the review of literature, I created a guide for OTs interested in making the transition into academia to meet the capstone project requirement.

Disruptive Communication Among The Interdisciplinary Team: Gaining Insight And Providing Nurse Education, Kristen Marie Anderson

Doctor of Nursing Practice Scholarly Project

The purpose of this study is to identify what types of disruptive behavior nurses are experiencing, discuss outcomes of disruptive behavior, and educate healthcare providers and administrators of disruptive communication. Understanding the consequences of disruptive communication can help educators articulate the need for training in conflict management and therapeutic communication methods. It can also aid healthcare providers to be more conscious of their behavior in the professional setting. Seven research questions related to communication were developed and analyzed in this study. The author developed a pre-education survey that included demographics, multiple-choice questions, and open-ended questions to assess the nurses' knowledge …

Social Media And Mental Health In Adolescents And Young Adults: A Systematic Review, Dawn Ritter, Kimberly Ray, Celia Keefe

Williams Honors College, Honors Research Projects

The goal of our project is to increase understanding of the link between social media use and mental illness in teens and young adults. Our objective is to write a systematic review of the literature to answer the PICOT questions: (1) In teens and adults, younger than 25 years, what is the relationship between social media use and mental illness? (2) In teens and adults, younger than 25 years, what is the effect of interventions, such as social media as a resource, on mental health promotion and well-being? The motivation for our project comes from the increased use of social …

Evaluating The Effect Of An Electronic Health Record Patient Portal On The Management Of Hypertension, Ashley Hall

DNP Projects

Background: Hypertension is the leading cause of cardiovascular disease and affects individuals globally, nationally, and locally. Consequences of uncontrolled hypertension include atherosclerosis, heart failure, stroke, and renal disease. The electronic health portal is a patient-specific, interactive tool that has been shown to promote adherence to provider recommendations and improve chronic disease management.

Purpose: The purpose of this project was to determine the effects of education via an electronic healthcare portal on the blood pressure management of adults at a primary care clinic in a small town in Kentucky.

Methods: This study was a one-group pre/post intervention designed to evaluate provider …