Medicine and Health Sciences Commons^™

Perspective On The Utilization And The Outcome Of Digital Tools To Manage Chronic Diseases, Narjodh Singh

Applied Research Projects

The increasing aging population and the prevalence of chronic diseases among lower socioeconomic groups have led to higher healthcare spending on chronic care management. In this paper, the study revolves around the utilization of Information and Communication Technology (ICT) for the management of chronic diseases, with a particular focus on the elderly population. The study examines various digital health interventions, including eHealth, mHealth, electronic health records, remote monitoring, wearable devices, clinical decision support systems, telehealth, and telemedicine, in the context of chronic disease management. The opportunities, strengths, and weaknesses of digital technology are discussed, highlighting the potential benefits of ICT …

The Impact Of Telehealth In Urgent Care Settings, Annie Dong

Applied Research Projects

Telehealth is an emerging modality of patient care and has since expanded to urgent care facilities. Urgent care facilities have been around for decades; however, along with telehealth, it has only grown in popularity in recent years due to the COVID-19 pandemic. However, the implementation and usage of telehealth in urgent care facilities is dependent on the provider being able to use it. This study aimed at looking at the perspective of the provider on the implementation and usage of telehealth in the urgent care setting.

Utilizing Stakeholder Input Within The Tennessee Heart Health Network To Improve Cardiovascular Health Outcomes In Tennessee, Abigail C. Bennett

Longitudinal Scholar's Project

Background: Tennessee ranks sixth nationwide for most deaths related to heart disease. The Tennessee Heart Health Network (TN-HHN), an initiative coordinated by the Tennessee Population Health Consortium (TN-PHC), was created to combat this issue. The TN-HHN is a statewide network of primary care practices, health systems, and academic centers committed to implementing patient-centered outcomes research (PCOR) approaches to demonstrably improve cardiovascular disease (CVD) health outcomes and health equity across Tennessee.

Objective: Evaluate stakeholder experiences in participating in the Network in an effort to assess partner satisfaction and improve the TN-HHN as a whole.

Methods: Eligible stakeholders were invited via …

Medication-Assisted Therapy And First Episode Psychosis: Evaluating Treatment And Readmission Rates: A Scoping Review, Whitney Nichole Trotter Ms, Bsn, Rdn/Ldn, Rn, Margaret Carrie Harvey Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Purpose/Background:

There is limited research aimed at addressing the reoccurrence of admission rates for first-episode psychosis. Research shows that early interventions for first-episode psychosis lead to remissions and prevention of relapses. Research also estimates that approximately one-half of first-episode clients have a history of cannabis abuse or dependence and one-third have a current cannabis use disorder (Wisdom et al., 2011). This study looks to determine whether Medication-assisted therapy (MAT) impacts readmission rates for patients who have substance use disorder and first-episode psychosis within six months of discharge.

Methods:

A comprehensive literature search was conducted using several electronic databases, including PubMed, …

The Noloco Strategy For Essential Hypertension, F. Matthew Mihelic Md

Faculty Publications

Ninety-nine percent of all “essential” hypertension can be controlled by using the NoLoCo strategy, without causing any significant side-effects and without an increase in insulin resistance. NoLoCo stands for Norvasc (amlodipine), Lozol (indapamide), and Cozaar (losartan), but the medicines are considered and used in reverse order.

Early Manual Lymphatic Drainage With Secondary Edema, Tiana Bridges Mot/S, Carly Fallin Mot/S, Emma Hilliard Mot/S, Olivia Holmes Mot/S, Kathryn Mullins Mot/S, Jonathan Richardson Mot/S, Cassie Warlick Mot/S

Master of Occupational Therapy Student Critically Appraised Topics

Implementation of an early manual lymphatic drainage program on post-op head/neck patients to decrease secondary edema.

Modified Vs. Standard Sternal Precautions, Alex Rome Mot/S, Katie Morris Mot/S, Payton Johnston Mot/S, Cheyenne Franklin Mot/S, Rachel Jeneff Mot/S, Hannah Tackett Mot/S

Master of Occupational Therapy Student Critically Appraised Topics

The poster examines standard and modified sternal precautions in pediatrics following a median sternotomy and the impact on developmental outcomes. The question our poster aims to answer includes, do modified sternal precautions improve developmental outcomes in children who underwent (median) sternotomy in a hospital setting compared to those with traditional sternal precautions? Through searching databases, the authors were able to gather articles providing evidence and information regarding modified vs. standard sternal precautions. Through the research, the authors concluded that there is further research needed on this topic in pediatric populations with the recommendation to proceed using caution due to no …

The Efficacy Of Constraint-Induced Movement Therapy Or Modified Constraint-Induced Movement Therapy In Improving Upper Extremity Motor Function In Adults With Hemiplegia After A Traumatic Brain Injury, Ryan Bizette, Adaire Deblanc, Rachel Ridenour, Lindsey Satterlee, Allyson Smith, Katya Vanausdall

Master of Occupational Therapy Student Critically Appraised Topics

The final portfolio contains 11 research articles from both national and international journals. Study designs include two randomized control trials, one systematic review, four quasi-experimental studies, one case study, two case series, and one pilot case study. All studies relate directly to components of the evidence-based practice question and will be used to draft new practice guidelines for using constraint-induced movement therapy (CIMT) or modified constraint-induced movement therapy (mCIMT) in occupational therapy practice.

Seven articles specifically describe the effectiveness of CIMT or mCIMT for adults with hemiplegia following a traumatic brain injury. The other four articles describe the effectiveness of …

Positioning And Feeding Techniques Effective In Improving Sensorimotor Functions In Infants With Cleft Palate, Skylar Russell Mot/S, Kaitlin Steel Mot/S, Robin Edwards Mot/S, Bri Morgan Mot/S, Danielle Boscaccy Mot/S, Haleigh Black Mot/S, Sydney Young Mot/S

Master of Occupational Therapy Student Critically Appraised Topics

Orofacial clefts are the second most common type of birth defect in the United States and are continuing to grow each year (Nasreddine et al., 2021). Based on the National Birth Defects Prevention Network annual report in 2014, 1 in 1,700 babies were born in the United States with a cleft palate (Mai CT et al., 2019). While there are different types of orofacial clefts, for this research the term cleft palate will be used to determine appropriate interventions within the scope of occupational therapy, such as positioning, bottle modifications, and sensorimotor techniques. The impact of this birth defect can …

Occupational Therapy Strategies For Postural Orthostatic Tachycardia Syndrome, Rachel Geissler, Marjorie Jamerson, Hunter Tockey, Mackenzie Dew, Emily Bennett, Summer Weldon, Laura Mendez

Master of Occupational Therapy Student Critically Appraised Topics

Effectiveness of occupational therapy strategies with adults with postural orthostatic tachycardia syndrome.

Mini-Mental State Examination (Mmse) As Predictor Of On-Road Driving Ability, Erica Bailey Floyd, Katelyn Elizabeth Stewart, Elizabeth Claire Morris, Hayes Elizabeth Franklin, Kristin Elizabeth Mather, Caymen Lynn Starwalt

Master of Occupational Therapy Student Critically Appraised Topics

Students met with a community OT practitioner who specializes in driving rehabilitation. The community practitioner identified a potential gap in referrals for individuals with cognitive impairment and on-road driving assessments. Due to the scarcity of driving rehabilitation practitioners, it is important to provide effective evaluation and interview. By identifying clients who are past the potential for safe on-road driving performance due to their score on a status examination, practitioners can reach more clients in a more efficacious manner. There exists a need for a more accurate screening measure to predict on road driving performance in individuals with cognitive impairment. The …

Studies On The Leukocyte-Associated Ig-Like Inhibitory Receptor-1 Signaling Pathway In T Lymphocytes, Chidi Zacheaus

Theses and Dissertations (ETD)

Inflammation is a natural process in which the immune system concertedly responds to pathogens and abnormal cell growth to protect the host. For an efficient/effective immune response that circumvents tissue atrophy, a delicate balance between stimulatory and inhibitory mechanisms is essential for the proper functioning of the immune system. Immuno-receptor Tyrosine-based Inhibitory Motif (ITIM)-bearing receptors in immune cells, including T lymphocytes, play a major role in preventing autoimmune responses. Leukocyte-associated Ig-like Inhibitory Receptor 1 (LAIR-1) is one of ITIM-bearing receptors. The mechanism by which LAIR-1 attenuates T-cell response has yet to be completely understood. In this study, I investigated a …

The Effects Of Synovial Fluid And Inflammatory Cells On Orthopaedic Implant Alloys, Lisa Phan

Theses and Dissertations (ETD)

Introduction. Total knee arthroplasty (TKA) is a common surgical procedure used to treat end-stage osteoarthritis. The implants used in TKA typically consist of a Cobalt Chromium Molybdenum (CoCrMo) femoral component and a Titanium Aluminum Vanadium (TiAlV) alloy baseplate. These metal alloys are chosen for their mechanical properties, corrosion resistance, high affinity for bone, and biocompatibility. However, they can be susceptible to mechanical and electrochemical wear, leading to the release of metal ions. Osteoarthritis and inflammation can alter the composition of Synovial Fluid (SF), potentially causing implant corrosion and the release of metal ions into the surrounding tissue. These metal ions …

Tcf4 Is A Key Mediator Of Cell Identity And Oncogenesis In Neuroblastoma, Nour Aljouda

Theses and Dissertations (ETD)

Neuroblastomas (NB) are embryonal childhood tumors that derive from the multipotent neural crest cells (NCCs) of the peripheral nervous system. NB accounts for more than 15% of all childhood cancer-related deaths. Despite the most intensive multimodal therapy, more than 50% of patients with high-risk NB relapse with often fatal, resistant disease. Novel therapies are desperately needed to improve cure rates. Previous studies proposed that the deregulation of normal neural crest developmental programs contributes to NB oncogenesis by retaining the highly migratory and proliferative traits of NCCs. Thus, activation or repression of neural crest developmental pathways have been implicated in NB …

Patient Compliance With Colorectal Cancer Screening: A Scoping Review, Peyton Jackson Bsn, Rn, Brandon Crocker Bsn, Rn, Ne-Bc, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Purpose/Background

Colorectal cancer (CRC) is a leading cause of cancer deaths for women and men. Routine screening based on current national guidelines can decrease morbidity and mortality. Unfortunately, patient compliance with CRC screening remains low. This scoping review will evaluate the literature and examine the association between colorectal cancer screening modality and patient compliance.

Methods

Individual searches within PubMed, EBSCO, and Medline were completed using MeSh with the following key words: colorectal cancer screening, patient compliance, stool-based screening, direct visualization, and others. A literature review was completed for 10 critically appraised articles published between 2010 and 2020. The association of …

Pkpd-Model Based Preclinical Characterization Of The Activity Of Spectinamide 1599 Against Mycobacterial Subpopulations. And The Identification Of Potential Partners For Combination Therapy, Zaid Hanif Temrikar

Theses and Dissertations (ETD)

Tuberculosis is one of the top 10 causes of death worldwide and the leading cause of death from a single infectious agent prior to COVID19. Mycobacterium tuberculosis (Mtb) is the causative agent of TB. The interaction between Mtb and the immune system leads to development of diverse environmental niches and physiology within the lung of the TB patients. Mtb is thought to adapt and thrive in such an environment by transforming to different phenotypic variants. Such variants are difficult to kill and are thought to prolong TB pharmacotherapy. Spectinamide 1599 is a synthetic modification of spectinomycin that has demonstrated excellent …

Extubation And Weaning: Implementing A Standard Weaning Protocol, Anna T. Wilhaucks, Caleb J. Fresh, Mohamed N. Khalil, Victoria K. Johnson, Tracy H. Mcclinton Dnp, Ag-Acnp-Bc

Doctor of Nursing Practice Projects

Purpose The purpose of this project is to determine if implementation of a standardized weaning protocol on mechanically ventilated patients affects reintubation rates and decreases adverse outcomes.

Esmolol Compared To Fentanyl For Hemodynamic Attenuation During Intubation: A Scoping Review, Carlie King, Robert Kirby, Mitchell Groome, Cassidy Gubin, Tracy Mcclinton Dnp, Aprn, Agacnp, Ebp-C, Dwayne Accardo Dnp, Crna, Faana

Doctor of Nursing Practice Projects

Purpose/Background

Endotracheal intubation and laryngoscopy potentiate the cardiovascular response in the form of hypertension, tachycardia, and ventricular arrhythmias. Suppression of this adrenergic response is necessary to ensure patient safety. Currently, anesthesia providers employ many methods to attenuate the sympathetic response without established guidelines. As such, our project aimed to determine the effectiveness of fentanyl compared to esmolol in attenuating the hemodynamic response during laryngoscopy and endotracheal intubation within the first five minutes and throughout the intraoperative period.

Methods

A literature review was completed of ten critically appraised articles from the years 2011-2022. Articles in the review included randomized control studies, …

Impact Of Opioid-Free Anesthesia On Postoperative Nausea & Vomiting: A Scoping Review, Madison Scholl, Miranda Morrison, Abbey Ramsey, Alexandria Sawicki, Dwayne Accardo Dnp, Crna, Aprn

Doctor of Nursing Practice Projects

Purpose The purpose of this DNP Scoping Review is to compare the current literature regarding the incidence of postoperative nausea and vomiting (PONV) in adult patients who underwent general anesthesia when opioids are used intraoperatively versus a multimodal non-opioid-based intraoperative general anesthetic plan Specific Aims: Incidence of postoperative nausea & vomiting Postoperative rescue antiemetic administration Length of stay in postoperative anesthesia care unit (PACU) Incidence of intraoperative adverse events

Decreasing Postop Delirium With Dexmedetomidine Vs Propofol, Isabel Bannister, Rn, Bsn, Srna, Abigail Kurtz, Rn, Bsn, Srna, Abigail Banko, Rn, Bsn, Srna, Reid Blaylock, Rn, Bsn, Srna, Tracy Mcclinton, Dnp, Aprn, Agacnp-Bc, Epb-C, Caitlan Bradford, Rn, Bsn, Srna

Doctor of Nursing Practice Projects

Postoperative delirium (POD) is a common complication that contributes to increased length of hospital stay, impaired recovery, and can affect long-term outcomes. Recently, research has been conducted to determine if certain anesthetic agents decrease the likelihood of developing POD. However, no clear protocol for prevention exists. This scoping review aimed to analyze the current literature to determine the efficacy of dexmedetomidine versus propofol at preventing POD.

Bi-Weekly Follow-Up Of Adult Patients Diagnosed With Schizophrenia To Increase Treatment Adherence: A Scoping Review, Garrett L. Seaton, Bsn, Rn, Michelle A. Conteh, Bsn, Rn, Shelia L. Jackson, Msn, Bsn, Rn, Sharon H. Little, Dnp, Fnp-Bc, Aprn

Doctor of Nursing Practice Projects

Purpose/Background

Schizophrenia is a complex psychiatric disorder that can significantly affect a patient’s psychological state. Because of this, medication nonadherence is reported as one of the most common causes of relapse and rehospitalization in patients diagnosed with schizophrenia. Although long-acting injectable (LAI) antipsychotics can help provide more continuous treatment, they do not address other factors that affect treatment adherence. This scoping review will evaluate existing literature to assess if a multimodal approach, such as increased patient follow-ups in addition to scheduled, current-practice LAI treatment and management, may increase treatment adherence in adult patients diagnosed with schizophrenia.

Methods

A database search …

Icu Delirium: Detection With And Without Cam-Icu Screening, Kiara Nicole Felix, Anita Larkin, Kathryn Lynn, Latoya Reed, Tracy Mcclinton Dnp, Ag-Acnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Delirium is a form of brain malfunction marked by abnormalities in cognition, disorientation, memory, and awareness. This scoping review's aim is to examine bodies of research on the effects of length of stay (LOS) in the ICU using Confusion Assessment Method-Intensive Care Unit (CAM-ICU).

Methods

Adults age 18 and older admitted to the ICU, of any race or ethnicity, and any gender were all included in the study articles. Nine articles satisfied the search criteria after publications underwent rapid critical appraisal. Results were evaluated for ICU LOS, hospital LOS, mortality, restraint use, medication use, delirium screening tool use, and …

Suicide Screening Among Adolescents With A History Of Mental Or Physical Abuse- Evaluating The Effectiveness Of Suicide Screening: A Scoping Review, Tiffany Nicole Jackson Bsn, Rn, Cody Tyler Cottrell Bsn, Rn, Allison Tucker Mcculley Bsn, Rn, Cen, Sharon Little Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose The purpose of this scoping review is to gather evidence on best practice for the administration of pediatric suicide screening in a variety of healthcare settings.

Long-Acting Injectable Antipsychotics Vs. Oral Antipsychotics In Treatment Adherence: Efficacy And Equity Of Care, Jason P. Peter Msn, Aprn, Fnp-Bc, Ashley F. Walker Bsn, Rn, Sharon Little Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Summary

Background: Compliance with oral antipsychotic medications (OAP) in the treatment of patients with schizophrenia has been a challenge. Challenges to OAP include medication side effects, lack of ability to obtain medications, and missing doses, among other factors. As a result of this non-compliance, those taking oral antipsychotic medication are at greater risk for exacerbation of their illness. The consequence of relapse carries considerable risks with each psychotic event. The study aims to compare if medication treatment adherence is greater in clients with schizophrenia using oral antipsychotics (OAPs) vs. long-acting injectable (LAI) antipsychotic medications.

Methods: In this scoping review, 15 …

How Does School-Based Depression Education Effect Depression Scores: A Scoping Review, Hannah Kliewer Bsn, Rn, Grayson Sheley Bsn, Rn, Sally Humphrey Dnp, Aprn, Cpnp-Pc

Doctor of Nursing Practice Projects

Purpose:

The purpose of this scoping review is to provide a detailed look into depression education courses among adolescents, ages 10-19 years old, and determine if the adolescents’ knowledge, attitudes, and beliefs regarding depression are impacted.

Specific Aims: •Determine the impact of a school-based depression education program •Evaluate programs for early knowledge and prevention of depression •Compare the current school curriculum with the addition of depression education

Enhanced Recovery After Surgery (Eras) For Cardiothoracic Surgery, Emile Shaw, Samantha Schultz, Taylor Woods, Emma Zollmann, Dwayne Accardo Dnp, Crna, Faana

Doctor of Nursing Practice Projects

Background/Purpose

Enhanced Recovery After Surgery (ERAS) protocols are multi-disciplinary approaches that optimize recovery and reduce surgical outcome variability. This scoping review compares surgical outcomes associated with traditional perioperative care to outcomes associated with an ERAS protocol for patients undergoing cardiothoracic surgery.

Methods

A literature review evaluating traditional perioperative care versus ERAS protocols in cardiothoracic surgical patients was performed to set inclusion and exclusion criteria based on current peer-reviewed journal articles for qualitative data. Group members selected 14 articles based on inclusion criteria and relevance to the PICOT question for review and placed findings in a synthesis table. Findings included compliance …

Effectiveness Of Perioperative Ketorolac Versus Opioids: A Scoping Review, Jamie Smith Bsn, Srna, Ashley Warner Bsn, Srna, Oran Tubre Bsn, Srna, Sherman Stauffer Bsn, Srna, Dwayne Accardo Dnp, Crna

Doctor of Nursing Practice Projects

Abstract

Purpose

The purpose of this project will compare the effectiveness of ketorolac over opioids alone for pain management of patients 72 hours postoperatively.

Background

In recent years, there has been overwhelming evidence of opioid abuse and its adverse effects on patients’ lives. To combat this, significant attention has been paid to multimodal analgesia throughout the perioperative period to decrease patients’ exposure to opioids. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ketorolac, are being administered intraoperatively to reduce the need for opioids in patients' post-surgical procedures.

Methods

A literature review was done on articles that evaluated perioperative adult human patients undergoing …

Impact Of Mobile Text Reminders On Medication Compliance, Paul Weatherly, Haley Russell, Michelle Rickard Dnp, Cpnp-Ac

Doctor of Nursing Practice Projects

Purpose/Background

Patient noncompliance with medication leads to longer and more frequent infections and health issues. Using mobile reminders, patients can be prompted to take their medication, schedule their followup appointments, or fill their prescription to encourage compliance and better overall health.

Methods

A search of PubMed, LibKey, and EBSCO was conducted. Articles reviewed included meta-analysis, randomized controlled trials, and systematic reviews in the use of mobile reminders on patient compliance, specifically in medication adherence. Then, we reviewed the article methods and outcomes across various health issues addressed. The articles were then reviewed for criteria such as population size, length of …

Telehealth By Certified Psychiatric Providers Compared To Emergency Department Healthcare Providers On Psychiatric Patient Outcomes: A Scoping Review, Lekisha C. Pride, Taylor B. Bradley, Michelle R. Porter, Sharon Little Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Background: Emergency department visits for mental health disorders have increased over the years due to insufficient mental health resources. The number of ED visits for mental health disorders rose from 1.4 to 2.5 million per year in the US. Therefore, mental health patients being seen by ED physicians are more likely to have longer lengths of stay, an increase in hospital admission, and high recidivism rates. Purpose: In this scoping review, we wanted to determine the role of telehealth on ED mental health patients. outcomes regarding how telehealth can reduce the number of admissions, length of stay in the ED, …

Teach-Back Method To Reduce Chf Readmissions: A Scoping Review, Briyanna Evans Bsn, Rn, Bre'yocha Dewalt Bsn, Rn, Ccrn, Jessica Mabry Bsn, Rn, Kailee Garrett Bsn, Rn, Crystal Stephens Bsn, Rn, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

Purpose/Background

The purpose of this scoping review is to evaluate the effectiveness of the teach-back method on education as it relates to congestive heart failure readmission rates. Congestive heart failure (CHF) is the most common cause of hospitalizations among those 65 years and older in the United States. CHF readmission rates in Tennessee are higher than the already elevated national average. The current literature suggests a need to reduce 30-day readmissions, improve patient outcomes, and enhance self-efficacy in patients with CHF. The research proposes a correlation between high readmission rates and poor knowledge retention of patients with CHF, but small …