Medicine and Health Sciences Commons^™

Outdoor Recreation For People With Spinal Cord Injuries: An Educational Video Series, Siarra Walker

Student Capstone Papers

More than 15 million people globally are living with spinal cord injury (SCI). Only half of people with SCI engage in leisure activities and approximately 71% of the population reports dissatisfaction in their leisure participation. There are numerous intrinsic and extrinsic barriers that lead to these significant declines in leisure exploration and participation, including lack of knowledge and inaccurate accessible online information. In correlation with these barriers, occupational therapy practitioners underutilize leisure participation during the rehabilitation process for people with SCI and this is an underreported topic in the literature. Occupational therapy practitioners and people with SCI lack knowledge of …

Reducing The Incidence Of Frequent Hospital Readmissions In Veterans Population, Dasari Reddy

Student Scholarly Projects

Practice Problem: Veterans hospital readmission problems are challenging, specifically in the heart failure department, which severely impacts the patient's health, mortality, family, and quality of life. Frequent readmissions increase the usage cost, hospital budget, and loss of time from providers to other veterans, and failure to meet the key guidelines of the Center for Medicare and Medicaid for improvement.

PICOT: The PICOT question that guided this project was, in veterans with heart failure and one or more frequent hospital readmissions discharged in the last 30 days(P), does the appointment of a dedicated discharge nurse practitioner as a coordinator(I), compared to …

Manualized Occupational Therapy Intervention For Children And Adolescents With Post-Traumatic Stress Disorder, Adam Mcmahon

Student Capstone Papers

Post-traumatic stress disorder (PTSD) in children can cause physiological and psychological reactions that can lead to impaired executive functioning and self-regulation skills that interfere with occupational engagement. Occupational Therapy (OT) utilizes an occupational perspective to treat children with PTSD. However, there is an absence of a manualized OT intervention in the literature that incorporates an occupation-based approach, utilizes graded occupation as the primary intervention, and tracks treatment progress and outcomes. The purpose of this capstone project was to create a manualized OT intervention protocol for OT practitioners to treat children with PTSD guided by the model of human occupation and …

Evaluation Of An Advanced Practice Clinician Onboarding Program, Sophia Robinson

Student Scholarly Projects

Practice Problem: This project aimed to evaluate the effectiveness of a mentorship-based onboarding program versus a standard program without mentorship.

PICOT: The PICOT question that guided this project was (P), In newly hired APCs did the inclusion of mentorship in the onboarding process (I) lead to higher levels of general self-efficacy compared to standard orientation practices lacking mentorship (C), within an 8-week timeframe (T)?

Evidence: Nine articles were reviewed, revealing that standardized mentorship, structured orientation, and tailored support for professional development are critical strategies to boost confidence and retention among healthcare professionals.

Intervention: A standardized onboarding program that incorporated …

An Evidence-Based Bundle To Decrease Pressure Injuries (Pis) In Homecare, Esther Owookade

Student Scholarly Projects

Practice Problem: Pressure injuries are a significant problem in healthcare settings. The older adult patients in this home health agency have experienced an increased in incidences of pressure injuries which necessitates intervention.

PICOT: The PICOT question that guided this project was" In older adults 65years and above with pressure injuries in the home healthcare setting(P), does a pressure injury care bundle(I), compared to the current practices of standard care of repositioning alone( C),reduce the incidence of pressure injuries( O ) in 10 weeks (T)?"

Evidence: The evidence used to guide this evidence-based change project was from relevant health …

Occupational Therapy’S Role In The Success And Positive Outcomes Of Youth Within The Foster System, Cassidy Solomon

Student Capstone Papers

This capstone paper will discuss the development of an occupational therapy program to support the needs of youth within the foster system and prepare this population to live independently. Background information including statistics, the need for occupational therapy, and the program specifics such as rationale, significance, and objective are discussed. The development of an occupational therapy program to aid in the success of children within the foster care system helps close a gap in research that will contribute to this population's success and positive outcomes. The purpose of this capstone was to develop a program for children in the foster …

Increasing Operating Room Efficiency Through Decreased Turnover Times, R. Keith Wolfskill

Student Scholarly Projects

The Operating Room (OR) is the financial engine of the modern hospital or surgical center. Over 40% of the hospital's cost is invested in the OR, but the facility recoups a monetary return of around 60-70%. Turnover time is a crucial factor in reducing costs. Uncontrolled, it can inflate operating costs, but when managed effectively, it can boost surgeon, patient, and staff satisfaction, enhance patient safety, and significantly reduce operational costs. The literature underscores the importance of reducing the time between operating room turnovers to improve OR efficiency. A key strategy that research consistently shows to be effective is the …

Implementation Of An Evidence-Based Hospital Acquired Pressure Injury Strategy In The Intensive Care Unit, Tonya C.W. Brigman

Student Scholarly Projects

Practice Problem: Hospital-acquired pressure injuries (HAPI) are a significant concern in healthcare with the most vulnerable group being the adult patients in ICUs leading to increased morbidity, longer hospital stays, and higher healthcare costs.

PICOT: In adult ICU patients (P) does the implementation of daily chlorhexidine gluconate (CHG) baths with post bath barrier cream combined with intentional turning every 2-hours (I) compared to standard skin care practices and nonintentional turning (C) reduce the incidence of hospital-acquired pressure injuries (HAPI) (O) within 10-weeks (T)?

Evidence: The project was based on the analysis of the literature published in the …

Implementing A Patient Education Bundle To Improve Patient Satisfaction, Madison Tyler

Student Scholarly Projects

Practice Problem: Patients on the intervention unit reported via HCAHPS surveys a lack of understanding of the nurse provided education on their medications’ side effects and purpose after discharge home from the hospital. Nurses at the intervention unit’s organization do not use any formal or standardized method of patient education to ensure patient comprehension.

PICOT: Among adult inpatients (18 years or older) on a step-down unit in an acute care facility (P), does implementing an education bundle related to patient medication education (I), compared to current practice of no formal education process (C), increase patient satisfaction as measured by HCAHPS …

Improving Patient Awareness And Compliance With Telephone Follow-Up Calls Post Visit, Ajibola Kutti

Student Scholarly Projects

Practice Problem: In a high-volume clinic without current follow up practices post visit, a telephone follow-up (TFU) intervention was implemented within three days of patient outpatient appointments.

PICOT: The PICOT question that guided this project was: In adult patients in a high-volume clinic (P), does the implementation of telephone follow-up calls by nurses (I) compared to current practices (C) improve patient compliance and post-office follow-up visits (O) over 10-weeks (T)?

Evidence: The literature provided recommendations and evidence that supported the effectiveness of following up with patients within three days of leaving the healthcare clinic. TFU’s are a cost-effective intervention that …

Using Home Telehealth To Reduce Hospital Readmission Rates In Heart Failure Patients In The Emergency Room, Margaret Ashby

Student Scholarly Projects

Practice Problem: In one hospital, the readmission rates and emergency room visit for patients who are diagnosed with heart failure (HF) was increasing.

PICOT: Among veterans who are hospitalized for HF (P) does the enrollment into a care coordination program for these veterans (I) compared to current practices (C), reduce the hospital readmission rates and emergency department visits (O) within 10-weeks (T)?

Evidence: The literature supports the idea that home telehealth as a home monitoring program for patients who have chronic diseases such as heart failure (HF) and has had success in patients with hypertension amongst patients. Transition strategies from …

Reducing Rates Of Blood Culture Contamination In The Emergency Room, Erika Goldberg

Student Scholarly Projects

Practice Problem: In one emergency room (ER) blood cultures (BC) drawn by nurses had a high contamination rate due to lack of collection standards, which lead to poor patient outcomes.

PICOT: The PICOT question that guided this project was; In adult emergency room patients where blood cultures are drawn (P), how does implementation of an evidence-based practice method (I), compared to the standard method of obtaining blood cultures (C), affect blood culture contamination rates (O), within ten weeks. (T)?

Evidence: Based on multiple sources within the literature; best evidence for lowering blood culture contamination rates (BCC) is done using EBP …

Nurse Retention Amid Workplace Adversity: Examining Strategies And Outcomes, Horace Smith

Student Scholarly Projects

Practice Problem: This project aimed to evaluate the effectiveness of nurse retention strategies in enhancing job satisfaction, focusing primarily on Emergency Department (ED) Registered Nurses (RNs). A comprehensive approach was adopted within the ED of a veteran hospital in the Southeast, aimed at promoting staff retention.

PICOT: The PICOT question guiding this project is as follows: In a veteran hospital's Emergency Room (ER) located in the southeast (P), how does the implementation of nurse retention strategies (I) compared to current standards (C) increase their job satisfaction (O) over a period of ten weeks (T)?

Evidence: This project …

Using An Evidence-Based Practice Nurse Recognition Practice To Improve Job Satisfaction, Hali Bianchi

Student Scholarly Projects

Practice Problem: The project targeted low job satisfaction and high nurse turnover in a Central Florida bone marrow transplant unit, impacting patient care and costs.

PICOT: (P) For registered nurses (RNs) on the bone marrow transplant unit, (I) does implementing an evidence-based practice employee recognition program (C) compared to no employee recognition program, (O) lead to an increase in job satisfaction (T) over 10 weeks?

Evidence: The evidence supported the effectiveness of meaningful recognition programs, such as personalized verbal acknowledgment from leadership, in boosting job satisfaction among nurses.

Intervention: The intervention involved nurse managers using a weekly employee recognition …

Policy Review And Recommendation: Full Practice Authority For Psychiatric Mental Health Nurse Practitioners In Georgia, Shantelle Coe

Student Scholarly Projects

Citizens of the state of Georgia, particularly those in rural or underserved communities, experience a lack of mental health resources. Extensive research evidence underscores the urgent need for enhanced access to mental health services, especially in rural areas where individuals face significant barriers such as limited provider availability and long travel distances. Through a thorough review of existing policy related to scope of practice, this scholarly work advocates for policy changes related to the practice authority of Psychiatric Mental Health Nurse Practitioners (PMHNPs). Advancement of legislative priorities to promote full practice authority for PMHNPs in the state of Georgia empowers …

Decreasing Influenza Vaccination Disparity Rates By Utilization Of Hotspot Deployments Of A Mobile Health Vehicle, Geneveve Deasis Tejada

Student Scholarly Projects

Practice Problem: Influenza vaccination for Black/African American patients is historically lower than White patients across all healthcare organizations (Quinn, 2018). In the organization’s 2022 performance, only 13.98% of Black/African American patients ages 19 and older were vaccinated compared to 27.81% of White/Caucasian patients.

PICOT: The PICOT question that guided this project was for Black/African American patients ages 19 and older receiving care from primary care clinics in Southeast San Diego (P), what is the impact of adding access to influenza vaccinations through hotspot-driven MHV deployments (I) compared to usual vaccination delivery in the medical office building (MOB) (C) on influenza …

Evidence Based Practice Change To Incorporate A Standardized Process Checklist For Fecal Microbiota Therapy (Fmt) To Increase Staff Adherence, Alicia Gomez

Student Scholarly Projects

Practice Problem: Staff adherence to new procedures is crucial for ensuring patient safety, maintaining quality care, reducing risks and liabilities, and fostering a positive organizational culture that supports continuous improvement. Having a procedure done safely for patients infected with C.diff provides an overall benefit to the healthcare system.

PICOT: In an endoscopy lab staffed with nurses and surgical technicians (P), does the implementation of a new standardized process of administering FDA approved Fecal Microbiota Transplant Therapy (I) compared to the current process (C), increase staff adherence to the process (O) over 12 weeks(T)?

Evidence: Leadership, supervision, and organizational culture are …

Social Participation Program For Older Adults With Dementia Residing In Long Term Care Facilities, Keri Mcclelland

Student Capstone Papers

Social participation is characterized by activities that involve social interaction with others and supports social interdependence; individuals engage in this occupation through a variety of contexts including with their community, family, friends, and peers (American Occupational Therapy Association, 2020). Social participation has been discovered to influence general health and well-being, cognitive health, risk of dementia, and stress (Sommerlad et al., 2023). Dementia is a prevalent disease affecting approximately 50 million individuals worldwide (Sommerlad et al., 2023) causing increased dependence and disability among the older adult population and is shown to be growing as the aging population increases in number (Wang …

Diabetic Coaching Program To Improve African American Patients Glycemic Control, Shonda Moore

Student Scholarly Projects

Practice Problem: The purpose of the practice problem was to find out if, among African Americans with type II diabetes who are over 18, adopting a diabetic coaching program that emphasizes diet management can result in better glycemic control over 10 weeks than for those who do not receive coaching.

PICOT: In African Americans with type II diabetes over 18 years of age (P), does a diabetic coaching program on diet management (I), compared to no coaching program (C), improve glycemic control (O) over 10 weeks (T)?

Evidence: The evidence used to guide this project came from databases, including PubMed, …

Preoperative Warming To Improve Patient Outcomes: Implementation Of A Warming Protocol, Tiara Switzer-Houston

Student Scholarly Projects

Practice Problem: Inadvertent perioperative hypothermia (IPH) is noted to be the most common surgical complication. IPH is associated with a variety of complications which are known to impact the well-being of the patient, family, and healthcare system.

PICOT: The PICOT question that guided this scholarly project was scheduled for total hip and knee arthroplasty surgical procedures under general or neuraxial anesthesia greater than 60 minutes (P), how effective is the implementation of an evidence-based pre-surgical warming protocol including forced-air warming (FAW) (I) compared to current practices (C) in improving normothermia readings within 15 minutes of arriving to the PACU, …

Implementation Of The Dynamic Appraisal Of Situational Aggression (Dasa) Tool On Inpatient Mental Health Unit, Maira Rodriguez

Student Scholarly Projects

Practice Problem: Inpatient mental health units are vulnerable to aggression and violence, which may lead to physical injuries. It is essential to implement proactive measures to prevent violence before it escalates.

PICOT: In an adult inpatient mental health unit (P), does the use of the Dynamic Appraisal of Situational Aggression (DASA) (I), compared to no screening for aggression (C) decrease restraints and seclusion, provide early detection and awareness of aggressive behaviors (O) within ten weeks.

Evidence: The DASA assessment tool has been tested in various settings, such as forensic and general adult mental health units. It has also been found …

The Impact Of Telecritical Care On Length Of Stay In A Critical Care Setting, Mallory Oberts

Student Scholarly Projects

Practice Problem: At a major metropolitan VA hospital, there was a lack of adherence by the nursing staff to the TeleCritical Care program for adult patients in the critical care setting.

PICOT: The PICOT question guiding this project was: In adult patients admitted to critical care (P), does the implementation of TeleCritical Care (I) compared to standard critical care without telemedicine (C) decrease length of stay (O) within 8 weeks (T)?

Evidence: The literature review identified improved quality of care delivery, decreased length of stay, and reduced mortality rates as key benefits of implementing TeleCritical Care in …

Evidence-Based Practice For Terminal Extubation: A Guideline Development For Critical Care, Heather Marica

Student Scholarly Projects

Practice Problem: In the critical care unit it was identified that providers utilized various practices in managing patients who were to be terminally extubated (TE). The variations in TE practice resulted in healthcare providers engaging in the TE process feeling unsure of the care they were providing and questioning if best practice measures were being implemented.

PICOT: The PICOT question guiding this project was: “In acute care adult patients who are to be TE (P), how does the development of an evidence-based TE guideline (I) compared to current TE practices (C) improve critical care healthcare workers perception and ability to …

Actions To Improve In-Patient Communication On Medication Teaching, Tracy Wei

Student Scholarly Projects

Practice Problem: Medication education is a national and global patient safety challenge. Healthcare organizations often lack consistent and effective medication teaching policies. Studies have found that the teach-back method is an effective interactive communication practice of medication teaching to achieve optimal patient outcomes.

PICOT: In direct care nursing staff (P), How does an evidence-based medication teaching bundle (I) compared to the current medication teaching practice(C) affect staff adherence to the dissemination of medication teaching to hospitalized patients (O) in 12 weeks (T)?

Evidence: A review and appraisal of 12 research studies demonstrated that the teach-back method was …

An Evidence-Based Approach For Decreasing Burnout In Health Care Workers, Leonor T. Salalila

Student Scholarly Projects

Practice Problem: Health care worker (HCW) burnout is a pervasive phenomenon within the healthcare industry, affecting professionals across various disciplines. Emotional exhaustion is a prominent feature, leading to feelings of being emotionally drained, overwhelmed, and unable to cope effectively with the demands of the job. Additionally, burnout often results in a significant lack of motivation among HCWs, who may struggle to find meaning and purpose in their work, exacerbating feelings of frustration and disillusionment. Consequences extend beyond individual well-being, impacting healthcare organizations with reduced work efficacy, low productivity, increased absenteeism, and high turnover rates. Addressing burnout requires a multifaceted approach, …

The Positive Impact Of Reducing Polypharmacy On The Quality Of Life For Older Adults With Serious Illness, Stephanie Orlando

Student Scholarly Projects

Practice Problem

The rising prevalence of chronic health conditions, the aging of the population, and advances in healthcare technology have contributed to the rampant over-prescribing of medications and the prescribing of potentially inappropriate medicines (PIMS) in community-dwelling older adults. Additionally, reluctance by the medical community to deprescribe and resistance among patients and their caregivers due to misperceptions about withdrawing treatment has further perpetuated the problem.

PICOT

The PICOT question for this project was, in community-dwelling older adults over age 60 receiving palliative care, does the implementation of an interprofessional deprescribing intervention compared to standard care by a home-based medical care …

Policy Review And Recommendation: Full Practice Authority For Nurse Practitioners In The Southwestern United States, Sara J. Rowe

Student Scholarly Projects

This policy analysis investigates the benefits of full practice authority (FPA) for Nurse Practitioners (NPs) in the Southwestern United States, using Arizona as an FPA model and California and Tennessee as comparison states. The PICO question that directed the project is: for NPs practicing as advanced practice nurse practitioners within the Southwestern United States region (P), does a comprehensive policy recommendation for FPA for NP-led clinics in the secondary education space (I) compared to existing variable approaches within the region (C) improve access to care and direct or indirect patient outcomes as endorsed by the literature (O)? A comprehensive literature …

Effect Of Acute Care Discharge Delays On Inpatient Rehabilitation Facility (Irf) Utilization, Eric Garrard

Student Dissertations

Discharge delays present hospitals with challenges in managing costs for Medicare admissions. Meanwhile, Inpatient Rehabilitation Facilities (IRF) are subject to strict pre-admission requirements that can complicate efficient transitions of care for patients with intensive rehabilitation needs. The purpose of this retrospective quantitative correlational study was to examine any relationship between acute care discharge delays and IRF utilization. This study investigated whether length of stay (LOS) and Medicare Advantage prior authorization requirements impact IRF referrals by reviewing 3,747 medical records of acute stroke patients aged 65 years and older at a regionally integrated healthcare system over a 3-year period (2020- 2022). …

Policy Review And Recommendation For Secondary Education Np-Led Clinics In The Southeastern United States, Shiney Alex Jacob

Student Scholarly Projects

Secondary-level education involves adolescent children aged 11-12 years to 18-19 with unique healthcare needs. Their healthcare is of significant importance as they are transitioning to adulthood, and a majority of them lack access to primary healthcare needs. Advanced Practice Registered Nurses/Nurse Practitioners (APRNs/NPs) provide high-quality, cost-effective, and evidence-based care to people across the lifespan, and there is minimal utilization of their services in meeting the primary care needs of adolescents at the secondary school level. The purpose of the policy project was to determine if current policies and practices related to school health services in three southeastern states of the …

Palliative Care Referral Protocol: Best Practice Toolkit For Improving Early Referral Rate For Adult Cancer Patients, Linda Dinh Nguyen

Student Scholarly Projects

Despite the benefits of palliative care being well-documented in studies and early palliative care services being strongly recommended by reputable organizations, such as the American Society of Clinical Oncology, many patients did not receive or received late referrals (Pigni et al., 2022). This mainly occurs because oncologists commonly base their referrals on perceived needs and clinical judgment (Smith et al., 2017). Thus, this program development project aimed to create a toolkit to improve early identification and referral to palliative care for adult patients who would benefit from palliative care services. The PICO question that guides this program is: In ambulatory …