Medicine and Health Sciences Commons^™

College Students’ Perceptions Of Instructors Whose Primary Language Is Not English, Takiyah A. Clay

Honors Theses

It is common to see instructors at universities in America who are foreign born and, as a result, have a foreign accent. Since foreign accents can influence the perceptions of people, the researcher designed this study to discover any perceptions that college students may have toward instructors with foreign accents. In addition, the researcher wanted to discover if those perceptions influenced the students’ actions in class. In order to reveal these perceptions, the researcher surveyed 205 students both in-person and online. The researcher determined that although a majority of the participants had difficulty comprehending the lectures of instructors with foreign …

Validation Of An Inertial-Measurement-Unit System For Calculating Hip And Knee Flexion Angles During Gait, Joonsun Park

Master's Theses

Technological advances regarding Inertial Measurements Units (IMUs) have positioned this type of sensor as an alternative for camera-based motion capture. This study introduces a new IMU based system (IMU_sys) to measure hip and knee flexion angles. PURPOSE: To validate the use of a five-sensor IMU_sys for the measurement of knee and hip flexion angles during gait in adults and pediatrics at two different time points. METHODS: Bilateral hip and knee flexion patterns (LH, RH, LK, and RK) of twenty-two healthy participants (12 adults and 10 pediatric) between the ages of 8 – 35 years were investigated. Participants …

A Look Into The Relationship Between Socioeconomic Status And Health, Hunter L. Howell

Honors Theses

Disparities in health have always been present, and major steps have been made to narrow this gap in healthcare. With that said, socioeconomic status still plays a significant role in access to healthcare. This study looks into how socioeconomic factors such as age, race, and income affect access to healthcare while also studying avenues as to why these disparities exist.

Traits Of Character That Facilitate Formation Of Exemplary Nurses In Bachelor Of Science Nursing Programs, Jean Marks

Dissertations

Constructivist grounded theory methods were applied in this study to explore traits of character that facilitate the formation of exemplary nurses in Bachelor of Science Nursing (BSN) programs. Interest in this study was prompted by a desire to examine attributes beyond academics alone that contribute to the formation of excellent nurses. The intent was to promote clarity in describing these attributes for further scholarly discussion.

Framing this study was Aristotle’s doctrine of the golden mean (Aristotle, 350 B.C.E./1934). Operational definitions consistent with this doctrine were created for the concepts of character, character traits, and exemplary nursing practice. The concept …

Childbirth And Control Behind Bars: A Descriptive Qualitative Analysis Of The Maternal Perception Of Control In Women Who Have Given Birth While Incarcerated, Lorin Raines

Dissertations

The perception of control during childbirth has been widely studied in various setting and groups. Many factors have been found to aid or impede the perception of control for birthing women. Significance of that perception of control during childbirth has also been measured in past studies. This descriptive qualitative study advances the knowledge of the perception of control during childbirth and examines a population that has thus far been excluded. Four previously incarcerated women participated in semi-structured interviews about their experience of giving birth while incarcerated and their perception of control during that time. The women were from diverse backgrounds …

Apneic Oxygenation: An Adjunctive Therapy For Laryngoscopy During Anesthesia Induction, Yaro Hoffman

Doctoral Projects

Endotracheal intubation is an essential component within the skill set of anesthesia providers. Rapid arterial desaturation remains a primary risk factor during laryngoscopy and intubation. The risk for hypoxemia exists because during endotracheal intubation, patients are apneic or hypo-ventilating (Wong et al., 2017). Apneic oxygenation (AO) has been advocated to attenuate hypoxemia during endotracheal intubation (Pavlov et al., 2017).

The aim of this project was to assess for any knowledge deficits regarding AO among anesthesia providers and assess the willingness of these providers to include AO into their current practice. The project investigator conducted an education session involving the …

Clinical Application: A Cost-Benefit Analysis Of Sugammadex Versus Neostigmine For A North Mississippi Delta Hospital, Donald Carver, Andrew Bundt

Doctoral Projects

As the cost of health care continues to rise and insurance reimbursements have decreased, organizations have to find avenues to cut costs and increase profits. A goal of this project is to help prepare anesthesia providers with the best evidence-based knowledge about sugammadex and neostigmine and allow providers to make a sound, cost-efficient decision when choosing a reversal method. A needs assessment was conducted with the chief certified registered nurse anesthetist (CRNA) at a north delta Mississippi facility. The needs assessment demonstrated that cost was the main concern and reason for choosing neostigmine over sugammadex. Further, providers at the chosen …

Using Collaborative Objective Simulation Clinical Evaluation With Undergraduate Nursing Students And Nurse Anesthesia Students Labor Epidural Placement In An Active Labor Patient, Chaka K. Jackson, Aisha Pierre

Doctoral Projects

Developing interdisciplinary teamwork and patient communication skills are essential for the student registered nurse anesthetist (SRNA) to provide quality patient care when administering epidural anesthesia. The synthesis of the evidence revealed limited available information on simulation use for SRNA epidural administration and collaboration. This doctoral project examined the effectiveness of learning through traditional simulation to enhance communication and collaboration between the Bachelor of Science in Nursing (BSN) and the Nurse Anesthesia Program (NAP) students. The BSN and NAP students were provided with a simulation environment to care for a laboring patient while improving patient safety and quality outcomes. The project …

Cultural Competence Objective Structured Clinical Examination For Student Nurse Anesthetists, Ashley Nicole Minor, Loryn Elise Jamison

Doctoral Projects

The landscape of ethnicity is growing increasingly diverse. In 2017, the U.S. Census Bureau estimated that by the time the 2020 Census is conducted, over half of the nation’s children will be of a minority group (U.S. Census Bureau, 2017). With this evolution in cultural variety comes a necessity to incorporate exposure and training of cultural competency into professional health programs. Student registered nurse anesthetists (SRNAs) are a key demographic to professional growth within the realms of cultural competence as related to the field of nurse anesthesia. Along with clinical skills and advanced knowledge, cultural competence should be equally developed. …

Uniform Clinical Evaluation For Video Laryngoscopy In Nurse Anesthesia Training: A Policy Proposal, Kristen Yelverton

Doctoral Projects

At The University of Southern Mississippi’s (USM) Nurse Anesthesia Program (NAP), no standardized clinical evaluation for video laryngoscopy (VL) use exists. To address the gap in standardized evaluation of VL, an evidence-based, objective structured clinical examination (OSCE) will be developed and proposed to the USM NAP. The intervention to this need is the evaluation of the OSCE and supporting documents by the panel of experts. The aim of the OSCE would be to teach SRNAs in a step-by-step process how to properly handle a video laryngoscope and the necessary techniques to ensure both patient and student safety (Wunder et al., …

Evaluating The Effectiveness Of Adverse Childhood Experiences And Trauma Informed Care Training For Mental Health Nurses, Felicia Gathings

Doctoral Projects

Adverse Childhood Experiences (ACEs) are traumatic events that happened to a person at a young age, and when untreated they have a higher risk of developing a mental illness. ACEs are associated with social problems, illnesses, and physiological issues. ACEs are related to increased health risks and an increase in high-risk behaviors. Despite increase evidence relating ACEs to physical and mental issues, nurses lack training in ACEs and trauma-informed care (TIC). The overall goal of this project was to increase knowledge of ACEs and TIC in mental health nurses when caring for mentally ill patients. Pre-test and Post-test surveys were …

A Best Practice Recommendation: Decreasing Perioperative Fentanyl Used Through The Utilization Of Dexmedetomidine Prior To Surgical Incision, Shelby Harriel, Amy Houck

Doctoral Projects

Upon anesthesia induction, patients often receive fentanyl, an opioid medication that is linked to addiction, dependence, morbidity, and mortality (Stanley, 2014). The goal of this practice recommendation was to propose an alternative way of managing pain and the increased sympathetic response in the perioperative setting, specifically during the induction phase, through evaluating published research. A possible substitute for fentanyl is a drug called dexmedetomidine (Precedex™). Through a comparison of pharmacology, indications, risks, and benefits, one can conclude that if Precedex™ is given prior to induction, in the place of large doses of fentanyl, it can potentially achieve a smoother intraoperative …

Improving Door To Transfer Times For St Segment Elevation Myocardial Infarction In Small Emergency Departments: A Quality Performance Improvement Project, Amber Ryals

Doctoral Projects

Heart disease is a leading cause of death in the United States (Centers for Disease Control [CDC], 2020). ST-elevation myocardial infarctions are around 38% of all coronary syndrome patients that present to the emergency department (Akbar et al., 2020). Smaller, outlying facilities can be at a disadvantage due to the lack of readily available specialties and services, such as a cardiac catheterization laboratory, which has the potential to cause a delay in inpatient care. With standardized cardiac protocols in place at many facilities, initial identification and treatment of myocardial infarctions are begun long before a patient enters a facility, often …

Evaluation Of An Intervention To Maintain Therapeutic Pressure Of The Endotracheal Tube Cuff During Intraoperative Surgery, Jamare Reed

Doctoral Projects

The current practice of intraoperatively assessing the cuff pressure of the endotracheal tube (ETT) is arbitrary and potentially leads to negative impacts on patients. This best practice project aimed to review and synthesize the existing evidence-based literature on measuring ETT cuff pressure and to establish a policy guideline for anesthesia providers to measure ETT cuff pressure in the intraoperative environment. Based on the star model of the knowledge transformation framework model provided by the Academic Center for Evidence-Based Practice (ACE), the creation of evidence-based policy on ETT cuff measurement is expected to potentially prevent poor patient outcomes, patient expenses, and …

Developing An Interdisciplinary Team Checklist To Assess Readiness For Appropriate Medical Removal Of Central Venous Catheter (Cvc), Miranda Harper

Doctoral Projects

Healthcare-associated infections are not a new concept in health care. Many different health-care-associated infections have been established over the years including but not limited to healthcare-associated pneumonia, catheter-associated urinary tract infection, and central line-associated bacterial infection. While these infections are common in healthcare facilities, the rates of these infections are still prevalent in hospitals across the United States. This DNP project focused on central line-associated bacterial infections.

An interdisciplinary team checklist to assess readiness for appropriate medical removal of central venous catheter (CVC) was developed to assess intensive care unit patients for early appropriate medical CVC removal. The interdisciplinary team …

Educating Student Registered Nurse Anesthetist On Malignant Hyperthermia Using An Objective Structured Clinical Examination, Ednita Street Fountain, Faith Sherman

Doctoral Projects

Malignant hyperthermia (MH) is a low-frequency, high-impact event that many student registered nurse anesthetists (SRNA) may be unprepared to manage due to limited exposure in clinical practice (Hackl et al., 1990). Lack of preparation for dealing with such low frequency, high impact events can lead to unfortunate adverse events resulting in death (Hackl et al., 1990). Thus, students should be are prepared to handle these situations if an event should occur.

An objective structured clinical examination (OSCE) is a structured method used to assess certain skills and underpinning knowledge required for practice (Harden & Gleeson, 1979). Students are allowed to …

Ultrasound-Guided Peripheral Venous Access: An Objective Structured Clinical Examination (Osce), Christopher Smith

Doctoral Projects

Intravenous (IV) access is essential to anesthetic practice as it allows the provider to administer fluids, sedative agents, and resuscitation medications. There is, however, a large subset of patients in which IV access can be difficult to obtain due to confounding factors such as preexisting disease, body habitus, and volume status (Sabado & Pittiruti, 2019). Bedside ultrasonography is an effective tool that can be used to gain IV access in these difficult patient populations. The downside to this technology is that there is a learning curve associated with its use, and proper training in ultrasound-guided venous access techniques is crucial …

Optimizing The Impact Of Quality Healthcare Improvements Within A Federally Qualified Health Clinic (Fqhc), Felicia Keys, Ladonna Phillips, Lashundra Speights

Doctoral Projects

This doctoral project’s purpose was geared toward strengthening quality healthcare outcomes documentation by constructing an updated policy and procedure manual specific to quality measures identified above, identifying attitudes and barriers to documenting, and assessing administration willingness to change. The project included a retrospective chart review of three populations and seven healthcare topics. Each diagnosis was researched utilizing specific ICD-10 (see Appendix A). A focus group/Pre-Implementation Questionnaire was administered to a panel of experts consisting of three nurse practitioners with one to nine years of experience employed at the FQHC. Afterward, a focus group was held to discuss barriers and attitudes …

Effect Of Unilateral Lower-Limb Amputation On Intact Limb Biomechanics: A Systematic Review, Amanda Boyd

Master's Theses

The United States will perform 30,000-40,000 amputations this year (Ertl et al., 2019). As a common medical intervention, there is extensive research regarding rehabilitation strategies and post-operative care. Many studies have explored the effects of the affected limb and prosthetic intervention yet have neglected that of the contralateral limb (De Asha et al., 2014; Jones et al., 2006; Winter & Sienko, 1988). Studies have reported an increase in secondary musculoskeletal conditions among unilateral lower-limb amputees, particularly in the intact limb, indicating the need for additional research (Gailey et al., 2008). The purpose of this systematic review was to investigate the …

Malaria Risk On Ancient Roman Roads: A Study And Application To Assessing Travel Decisions In Asia Minor By The Apostle Paul, Daniel C. Browning Jr

Master's Theses

This study models malaria risks for travelers on ancient Roman roads with the goal of providing a tool for historical assessment of travel accounts from antiquity. The project includes: identification of malaria risk factors and associated spatial datasets, malaria risk model construction, verification and validation against available pre-eradication data, overlay of ancient Roman road data, and an initial case-study application to the journeys of the Apostle Paul, as narrated in the New Testament book, Acts of the Apostles (Acts). The project is intentionally cross-disciplinary in bringing the technical capabilities of GIS to the task of evaluating nuanced textual sources for …

Whole Word Vs Phoneme Error Scoring For Audiological Word Recognition Testing, Jennifer C. Arnoult

Honors Theses

The purpose of this study was to investigate a possible alternative method of scoring for word recognition testing. The current whole word scoring method is inefficient and often inconsistent with a client’s pure tone average scores, and previous research has suggested that phoneme error scoring may be a more effective and accurate scoring method. This project analyzed the audiogram and word recognition test scores of seventeen adult clients. The test used was the standard twenty-five-word list NU-6 test. The researchers analyzed the results from whole word scoring and phoneme error scoring of the same tests and compared the results to …

Perspectives Relating To Multicultural Training With Speech-Language Pathologists, Evy Jewell Hayes

Honors Theses

The goal of this project is to assess whether Speech-Language Pathologists (SLPs) feel adequately prepared and comfortable interacting with multicultural clients. To assess if an SLP feels prepared to interact with, to assess, to teach, or to treat a multicultural client, a 25-question survey was developed. The survey included questions pertaining to the SLPs’ experiences with other cultures, both professional and personal, if the SLP speaks more than one language, and if the SLP has received any formal training on how to interact with multicultural clients. The survey was sent out via email to 814 licensed SLPs practicing in pre-school, …

Impulsivity As A Trait Predictor In Baccalaureate Nursing Students, Jennifer Bertucci

Dissertations

Impulsive personality traits have been linked to pathological decision making in individuals who possess the trait. Impulsive pathological decision making may include acts of aggression, divergence, risky behavior, lack of self-care, etc. The purpose of this study was to examine impulsive personality traits among nursing students. Traditional students are defined by the following characteristics: earns a high school diploma, enrolls full time immediately after finishing high school, are financially dependent on parents, and either do not work during the school year or works part-time (the exception to the rule) (Choy, 2002). A non-traditional nursing student is defined as students who …

Implementing A Practice Strategy In Primary Care Using An Assessment Tool To Screen For Depression, Donna Snow

Doctoral Projects

Increased efforts are being made to move individuals with co-morbid medical and psychiatric diagnoses toward integrated care. Lack of consistent screening in primary care has caused missed opportunities to identify depression during a routine healthcare provider visit. This project sought to implement a practice strategy in primary care using an assessment tool to screen for depression. Interviews were used to ask patients to answer two questions related to the frequency of depressed mood in the last two weeks. The project was seeking to show by screening patients in primary care for depression, the number of referrals to behavioral health would …

Improving Medication Adherence In African American Adult Females With Hypertension, Donald Welch

Doctoral Projects

The World Health Organization (WHO) reported that adherence among patients with chronic diseases averages nearly 50% in developed countries (Lam & Fresco, 2015). Medication non-adherence is recognized as a significant public health issue that leads to poor health outcomes and added healthcare costs. Multiple African American adult females with hypertension have a high prevalence of non-adhering to their treatment plan. Numerous factors lead to poor medication adherence, including socioeconomic factors, therapy-related factors, patients-related factors, condition-related factors, and health system/healthcare team-related factors (Lam & Fresco, 2015). Medication adherence can lead to a decreased risk of adverse outcomes such as stroke and …

Assessment Of Intrapartum Nurses' Beliefs Related To Birth Practices, Janice Scaggs

Doctoral Projects

Intrapartum nurses’ beliefs influence nursing behavior and nursing interventions during labor and birth. Assessing these beliefs in a regional hospital in the Southeastern United States was the focus of the doctoral project. Before the project, there was no objective data that assessed individual nurse’s beliefs and birth practices in the labor and delivery unit, or among the nursing staff as a whole. A knowledge gap existed in understanding if the nursing culture valued, promoted, and supported intended vaginal birth. Nursing leadership recognized that the overall cesarean birth rate and primary cesarean birth rate in the hospital were similar to State …