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, …

Application Of Lymphedema Education Toolkit For Nurse Coordinators, Julian K. Miranda

Master's Projects and Capstones

Problem: There is approximately one in five breast cancer survivors affected by breast cancer-related lymphedema (BCRL), a potentially debilitating condition affecting the physical, emotional, social, and financial well-being of individuals. Context: This Quality Improvement (QI) project was conducted at an outpatient facility of Hospital X’s Women’s Cancer Center. Within this microsystem, there are 24 permanent clinical nurse coordinators and advanced practice providers, with 15 nurse coordinators dedicated to care for patients with breast cancer or gynecological conditions. Intervention: The intervention aims to evaluate if a standardized educational tool improves early interventions for patients with lymphedema and knowledge among healthcare providers …

Nursing Students’ Perceptions Of The Impact Of Teamwork And Collaboration On Patient Care, Riana Square

Honors College Theses

Teamwork and communication are two topics that a vast majority of nursing students are introduced to in their first semester of nursing school. Many nursing students have a desire to improve their communication skills and have a better understanding of the inner workings of interdisciplinary collaboration. A study across multiple cohorts of Georgia Southern Nursing students was conducted to explore their perceptions of the correlation between teamwork and patient care outcomes. This study also explores nursing students’ readiness to communicate with other healthcare professionals and the effectiveness of the means to practice these communication skills while in nursing school. It …

Identifying Srnas Individual Learning Preferences Utilizing The Vark Learning Inventory Tool, James Eads

Doctor of Nursing Practice Projects

Abstract

All graduates of a doctoral anesthesiology program are required to successfully pass the National Certifying Exam (NCE). Since 2011, the national average passage rate has decreased from 89.1% to 84.1% in 2021 (NBCRNA, 2023). Yamaguchi’s 2022 study revealed that students are positively impacted academically when they implement individual learning preferences. The purpose of this project was to identify individual learning preferences for students enrolled in the U.S. Army Nurse Anesthesiology program. The hypothesis was that students who recognize their preferred learning and incorporate preferred learning techniques would result in an increased percentage of passage rate scores for the NCE. …

Exploring Available Information On The Gut-Brain Axis And Alzheimer’S Disease For Clinicians Making Dietary Recommendations: A Scoping Review, Megan Gibson

Electronic Theses and Dissertations

Abstract: Alzheimer’s Disease (AD) is a complex neurodegenerative disease that requires interprofessional collaboration. Pharmacological options are currently ineffective, increasing the need for preventative strategies to combat the rise of AD. Considerations of gut-targeted interventions have increased as a key component in the prevention of AD, based on the understanding that the state of the gut microbiome can impact cognitive function through the pathway known as the gut-brain axis.

Methods: This scoping review explored information on the gut-brain axis in persons with AD. A comprehensive search was conducted in November 2023. Forty reviews and 13 human studies were analyzed.

Results: There …

Understanding Medical Students' Perceived Readiness To Serve As Culturally Competent Practitioners, Michel'le Janae Bryant

Seton Hall University Dissertations and Theses (ETDs)

Background: The US population is more culturally diverse than ever. Although advancements have been made in improving the nation’s overall health, health disparities continue among different racial and ethnic groups. To promote person-centered care practices, medical students must be ready to serve diverse patient populations and provide equitable care. Despite their training, some medical students report feeling unprepared to treat diverse patient populations, potentially impacting their clinical practice and patient care outcomes.

Purpose: This study’s purpose was to explore the perceived readiness of final-year medical students in the US to provide culturally competent care utilizing the Readiness Theory and The …

Evaluating The Association Of Influenza Vaccination On Long-Term Covid-19 Symptoms In U.S. Adults, Ratnakar Pingili

Capstone Experience

Objective. To evaluate the association of influenza vaccination in the past 12 months with Long COVID effects and clinical and sociodemographic factors.

Methods. Cross-sectional study with data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS), covering 415,132 non-institutionalized U.S. adults with a confirmed COVID-19 diagnosis and influenza vaccination reported within the last 12 months. Logistic regression was conducted between influenza vaccination (exposure) and Long COVID (outcome), controlling for demographic variables, pre-existing health conditions, and socioeconomic status.

Results. Of 120,603 participants, 21.89% reported Long COVID symptoms and 42.04% had received an influenza vaccine. Findings indicate a statistically significant 13% reduction …

Education Of The Effects Of Obesity Medications And A Stepwise Approach To Mitigate Prevalence And Encourage Lifestyle Medicine For Primary Care Physicians, Kiely M. Curran

Department of Nutrition Student Projects

My Capstone project is an Educational Manual that emphasizes a healthcare team approach to the treatment and management of obesity. The Educational Manual consists of a standardized protocol in management of obesity in patients and a document with summarized references for primary care providers; and a simplified document for patient education. There is a growing interest in the usage of obesity medications. The purpose of my Capstone project is to provide a simplified manual for the primary care provider to reference to make knowledgeable and patient-centered decisions in the prescription of obesity medications and decisions in weight-management. My methodology included …

Medicine Men: Medicine Match A Program To Increase Male Participation In Targeted Areas Of The Healthcare Field, Anthony Paul Huffman

Honors Projects

The Medicine Men program addresses the imbalance in gender representation in low and middle-level healthcare careers. The program uses a website named Medicine Match to achieve this goal, which offers shadowing, talking, and additional resources with verified medical professionals. Medicine Match provides an engaging platform for individuals interested in exploring healthcare careers. The program's methodology involves creating connections between aspiring professionals, following the path of role models, fostering a sense of community, and educating and empowering target populations. Through a theoretical test and analysis, Medicine Men seeks to demonstrate its efficacy in increasing interest, knowledge, and comfort among male students …

Prescribing Flavor: Proposal For A Longitudinal Culinary Medicine Curriculum In A Family Medicine Residency Program, Mario F. Jacome Jr

Department of Nutrition Student Projects

Culinary medicine is gaining recognition as an essential component of healthcare, aiming to integrate food and nutrition into medical practice for managing chronic diseases. However, there is a significant gap in nutrition education within medical schools and residency programs, leaving healthcare professionals ill-equipped to address patients' dietary concerns. This proposal presents a comprehensive longitudinal curriculum blueprint for culinary medicine tailored to family medicine residents. The curriculum emphasizes hands-on learning, collaborative cooking opportunities, and practical counseling techniques to empower residents in addressing nutrition-related diseases effectively. Through a structured approach and innovative educational strategies, this initiative aims to enhance resident proficiency and …

Home-Based Virtual Culinary Nutrition Education Sessions For Amyotrophic Lateral Sclerosis Patients: Quantitative Experimental Pilot Study, Ciara N. Reistad, Mauricio Lobo

Department of Nutrition Student Projects

Amyotrophic lateral sclerosis (ALS) impairs voluntary muscular activity and often results in malnutrition. The need for specialized dietary therapy for ALS-related illnesses is highlighted by recent research, but it also draws attention to the lack of targeted care and ongoing nutritional status monitoring. Technological developments like telehealth and chatbots hold potential for ALS patients’ nutritional monitoring. The pilot study examined the feasibility and impact of home-based virtual culinary nutrition education sessions on nutritional knowledge, dietary intake of energy (CHO), protein (PRO) and FAT, body mass index (BMI), and functional status assessed by ALSFRS-R scores in patients with Amyotrophic Lateral Sclerosis …

Best Screening: Introducing The Neonatal Assessment Visual European Grid To Nicus In Tennessee, Gabrielle Sledge

OTD Capstone Projects

Blind Early Services Tennessee (BEST) is an early intervention agency that serves children ages 0-5 with visual impairments across Tennessee. BEST serves over 200 children and families across the state offering early intervention (BEST Start), parent empowerment (BEST Advocate), and family support (BEST Together) programming. The purpose of this project was to assist in the implementation of an early identification initiative (BEST Screening) using the Neonatal Assessment Visual European Grid (NAVEG). The NAVEG is a newborn vision screening shown to identify neurological risk for visual impairments. The long-term goal of this program is to promote the screening and early identification …

Exploring The Prevalence Of Mental Illness And Mental Health Issues Amongst Adults Diagnosed With Type One Diabetes During Their Adolescence: A Nursing Perspective, Sara J. Taylor

Honors Capstones

While every individual experiences and copes with their illness in different fashions, it is important to equip everyone with resources they need for any direct or potential complications. Type One Diabetes is a chronic illness that is always ever changing. Treatment and care for it is constant and can cause burnout, frustration, increased stress, and many other mental health issues for the patient. If left untreated and poorly managed, these feelings can develop into far more serious complications such as depression, PTSD, eating disorders, etc. While a cure for Type One Diabetes is not currently an option, providing preventative education …

A Multiple-Site Case Inquiry To Identify The Attributes Of Socio-Academic Culture In Successful Entry-To-Practice Respiratory Therapy Programs, Thomas D. Jones

Doctor of Education (Ed.D)

Background: Organizational structure and culture have been explored extensively in higher education. Nonacademic factors influence student engagement, motivation, and success. Research describing socio-academic culture in health professions programs is limited. Achievement of fundamental social-emotional learning (SEL) competencies empowers students to learn and achieve educational goals. SEL has not been established as a theoretical framework in health professions education. SEL competencies closely align with respiratory therapy (RT) learner needs and essential professional skills. Attributes of socio-academic culture in successful RT programs and their impact on student success are unknown. Objective: To identify the attributes of socio-academic culture in successful entry-to-practice respiratory …

From Cough To Crip: The Development Of Codeine From A Purely Medical Substance Into A Popular Recreational Drug, Rhett C. Vaughn

Senior Theses

The research that was conducted aimed to elicit the influence that pop culture has on recreational drug consumption. Specifically, the usage of the drug codeine has become very popular in social media among many influencers. The research focuses on the prevalence of this drug across several media platforms, alongside the growing rate of consumption globally. Research was conducted primarily through combining various databases at various organizations and this study aims to compile the data into one coherent paper regarding codeine in pop culture. While, it cannot be solely attributed to one specific outlet or influence, this study found that alongside …

Comparison Of Perceived Stress In First-Year Pre-Med Students And First-Year Medical Students At Usd, Maggie Derner

Honors Thesis

Stress can be caused by many factors, including money, relationships, promotions, grades, and responsibilities. In college, these stressors can be exacerbated. This research dives into stress in both undergraduate students as well as medical students. Previous literature has indicated that high levels of stress are present in students, and it is likely to have negative effects on the students, whether that is their mental or physical well-being. Schools have put interventions in place to help combat the stress levels present in their students. At the University of South Dakota (USD) and USD Sanford School of Medicine (USD SSOM), perceived stress …

Coping Strategies And Stress Of The Undergraduate Nursing Student In The Clinical Setting: An Evidence Based Practice Quantitative Study, Ashley Calverley

Electronic Theses and Dissertations

The assessment of perceived stress and coping behaviors related to first-semester clinical might benefit students in nursing education. The assessment of most common coping behaviors and perceived stress related to the clinical setting is essential due to difference in personalities, learning abilities, and coping behaviors among nursing students today. Previous research has suggested the initial clinical period results in adverse outcomes, such as poor academic performance, elevated burnout levels, and diminished personal well-being. These factors are detrimental to academic success in nursing programs. Evidence supports that helping students develop positive stress/coping abilities will aid in adapting in both the academic …

The Effect Of Nursing Education On The Utilization Of Kangaroo Mother Care And Weight Gain Of Preterm And Low Birth Weight Infants, Jhenalynn Valete

Nursing | Senior Theses

Aim: The goal of this quantitative study is to investigate if educating nurses about the significance of KMC will increase its utilization and promote weight gain in low birthweight and preterm infants. Additionally, it aims to find the optimal duration of KMC required to maximize health outcomes for the infant. This research proposal aims to provide nursing professionals with valuable insights, allowing them to effectively educate parents on practices that promote maximal weight gain in neonates.

Background: This is a cost-effective and natural way to enhance health outcomes such as temperature regulation, weight gain, respiratory function, pain mitigation, …

Nutrition Counseling Practices Among Psychologists, Wibecke Stromsnes

University of the Pacific Theses and Dissertations

There is a lack of treatment guidelines for how to address the impact of nutrition on clients’ mental health. Prior research is limited regarding psychologists’ practices of nutrition counseling and has mostly focused on practices of dieticians and medical doctors. The purpose of this study was to examine psychologists’ beliefs and attitudes about nutrition counseling, amount of training and use of nutrition counseling, self-rated knowledge in the use of nutrition counseling and perceived benefits and barriers to using nutrition counseling. Data was collected using an online survey of 76 licensed psychologists’ training in nutrition and use of nutrition counseling. Findings …

Improving Spiritual Care Competency Among Intensive Care Unit Nurses: Promoting Holistic Patient Care Towards End-Of-Life, Joanne Nguyen, Dana Bagis

Nursing | Senior Theses

Intensive care unit (ICU) nurses play a crucial role in providing physiological stabilizing care in a dynamic and fast-paced environment, often marked by constant changes and variability in complex patients. Despite their specialization, the aspect of spiritual care tends to be overlooked, particularly in the context of end-of-life care. This is significant because previous studies have shown that a lack of spiritual care leads to poorer health outcomes, decreased coping, increased depression, and diminished quality of life for patients. This research proposal aims to investigate the spiritual care competency among ICU nurses who partake in spiritual care-based training, with the …

Reimagining Equitable Care: Simulation-Based Education And The Dismantling Of Implicit Bias And Stigma Of Vulnerable Populations In Hospitals, Vanessa Smith

Nursing | Senior Theses

Background: Simulation-based education consists of using high-fidelity mannequins and equipment to provide a safe space for healthcare professionals to practice crucial skills within healthcare. Used within hospitals and schools, simulation most commonly surrounds practicing hands-on skills such as central line insertion, IV insertion, Ultrasound-guided procedures, code blue response, etc. However, a large portion of healthcare that is overlooked is tackling issues within patient-provider relationships. Simulation can help dismantle the negative behaviors and feelings providers push onto patients through the use of standardized patients and role-playing. By using these methods, simulation can reduce providers’ personal implicit biases and the stigma associated …

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 …

Evaluating Healthcare Workers’ Knowledge, Attitudes, And Practices Regarding Language Access Services In The Clinical Setting, Rachel Archibald

DNP Projects

Background: Barriers to accessing and understanding healthcare can place patients with low English proficiency at an increased risk of poor health outcomes. Language-based inequities in healthcare exist due to lack of interpretation and translation services available, lack of healthcare workers’ knowledge of resources, and/or perceptions that these services require too much time or effort. Failing to address barriers affecting this population leaves them vulnerable in the healthcare setting.

Purpose: The purpose of this DNP project was to educate nurses, providers, and staff on an inpatient unit at a rural hospital of the language interpretation resources available, best practices for implementation, …

Scares: A Clinician Guide To Spinal Cord Awareness, Response, And Emergency Support Creation And Implantation Of Scares Protocol Among Hospitalist Advanced Practice Providers, Brittany Biega

DNP Scholarly Projects

While they are more common in patients with oncological disease and trauma, SCE still exist among patients without these comorbidities. Less has been established regarding care protocols in this population. The absence of standardized procedures has been linked to preventable, adverse patient outcomes, including cases of permanent damage due to delayed treatment. This project employs Lean Six Sigma methodologies and Johns Hopkins Evidence- Based Practice to devise a robust SCE protocol, aimed at standardizing care and improving patient outcomes. A multidisciplinary team including general medicine, neurology, neurosurgery, and neuroradiology developed “Spinal Emergency Management Guidelines” protocol, which was implemented within the …

Say No To Drugs: Nonpharmacologic Interventions For Preventing Delirium In Critically Ill Patients Intubated & Sedated In A Pediatric Icu, Jessica C. Ellzey

DNP Projects

Background. Delirium is an acute clinical syndrome that is characterized by features of disrupted arousal, attention, cognition, sleep, and perception. Delirium is a well-documented phenomenon in critical care settings in both adult and pediatric populations, particularly among patients with length of stay greater than or equal to 48 hours. Delirium has multiple adverse effects, including increased mortality rate, prolonged duration of mechanical ventilation, higher reintubation rates, prolonged intensive care unit (ICU) admission, prolonged hospital admission, short- and long-term cognitive impairment, and posttraumatic stress disorder. There are currently no accepted guidelines or FDA approved medications to treat ICU delirium in the …

Variability In Perceptions Of Complementary Health Approaches Among Graduate Student Trainees, Delaney C. Bilodeau

Theses and Dissertations

Complementary Health Approaches (CHAs) encompass a diverse range of practices which are often used both independently and alongside conventional medical treatments. Understanding how graduate students training in different fields perceive CHAs is important because these professional trainees will go on to occupy roles as healthcare practitioners, researchers, policy makers, and consumers. This study used sequential rank agreement methods (Ekstrøm, Gerds, & Jensen, 2019) to investigate variations in perceptions of CHAs in a sample of graduate students (N = 416) from 140 possible training programs. Ratings of CHA familiarity, perceptions of CHA legitimacy, and willingness to recommend CHAs were compared …

Pediatric Vaccination Adherence: Enhancing Compliance Among First-Generation Asian American Parents, Katelyn Leong

Nursing | Senior Theses

Background: Vaccine adherence in the pediatric population refers to receiving vaccines as per the recommended schedule, which significantly reduces vaccine-preventable diseases and enhances community immunity. Vaccine hesitancy, driven by concerns such as safety, misinformation, or cultural beliefs can affect adherence. National coverage of state-mandated vaccines among kindergarteners declined from 95% to around 93% between 2019 and 2022, varying across different vaccines. Objective: This research proposal’s focus is to determine if an educational intervention targeting first-generation Asian Americans, who have adopted their immigrant parents' misinformation about vaccines, will effectively increase vaccination rates among their children. The study aims to assess the …

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 …

Navigating Asynchronous Online Learning: The Impacts Of Active Learning And Assigned Group Work On Student Motivation, Belonging, And Inclusion, Shea Elisabeth Carr

Theses and Dissertations--Biology

Motivation, belonging, and inclusion are all critical factors for student success but can be difficult to support in asynchronous online courses. Active learning and required group work have been shown to increase student motivation in in-person and synchronous online courses, but little is known about their impact in online asynchronous settings. This dissertation aimed to 1) evaluate the effect of active learning on student motivation in an online asynchronous setting and 2) evaluate the impact of assigned group work on student motivation and perceptions of belonging and inclusion within the context of an online, asynchronous physiology laboratory course. It was …

Instructional Practices To Foster The Development Of Autonomy: A Qualitative Phenomenological Study Of The Resident Experience, Rachelle Musgrave Aker

Theses and Dissertations--Education Sciences

A growing concern in graduate medical education (GME), research indicates that some graduating residents are unprepared to enter unsupervised practice. The aim of this qualitative phenomenological study is to illuminate the resident experience surrounding the development of autonomy in clinical decision making relative to teaching practices. Research questions include: (1) What is the dual role of learner/teacher like for residents as they attend to their own and others’ development of autonomy in clinical reasoning and decision making? (2) Which teaching methods do they commonly experience as the learner and practice as the teacher relative to this development, and which methods …