Medicine and Health Sciences Commons^™

Float Rns: Unit Specific Tools To Promote A More Positive Float Experience, Tarra Abdullah-Grayson

Doctor of Nursing Practice (DNP) Projects

Despite efforts to transition large portions of primary health care services to more community-based outpatient settings, federal projections say the rising complexity of acute care will increase demand for RNs in hospital settings by 36% in 2020 (American Association of Colleges of Nursing [AACN], 2017). Other projections indicate that by 2025, the U.S. registered nursing shortage will expand to more than 260,000 (Buerhaus, Auerbach, & Staiger, 2009). In an effort to address the ongoing challenges of nursing staff shortages, many hospitals have established a core of internal float pool RNs as a practical and cost effective solution to address the …

Increasing Faculty Knowledge And Empathy Related To Nursing Students With Learning Disabilities, Jodi Kushner

Doctor of Nursing Practice (DNP) Projects

The purpose of this paper is to provide a project overview for the implementation of a disability training module and simulation experience offered to university school of nursing faculty to increase faculty knowledge and empathy related to nursing students with learning disabilities. The number of students with learning disabilities in the postsecondary education setting has tripled in the past decade (Orr & Hammig, 2009). This growing student population makes faculty preparation essential in order to effectively meet the needs of these students. The literature indicated that best practices include disability training, faculty support, student support, inclusive strategies such as Universal …

The Development Of A Cardiovascular Competency Checklist For Chinese Nurses, Amy B. Xiong

Doctor of Nursing Practice (DNP) Projects

Cardiovascular disease is a global issue affecting millions of lives around the world. Today, countries like the U.S. and China have joined forces to take on the global issue. In the U.S., the American Heart Association is the largest organization dedicated to reducing the mortality rate of cardiovascular disease by requiring healthcare services to uphold standard cardiovascular guidelines. Astonishingly, within the last 10 years, the U.S. has reduced their cardiovascular mortality rate by 30%.

This quality improvement project sought to determine the gap between the United States and China’s standard nursing education and practices and to help Chinese nurses achieve …

Quality Improvement In Provider Attitudes Towards Adherence To Comprehensive Diabetic Care Hedis Standards, Samantha Taylor

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Healthcare Effectiveness Data and Information Set (HEDIS) is a quality measurement for standard of care used to rate a health plan or provider's ability to demonstrate clinical effectiveness. Medicare Advantage healthcare plan utilizes HEDIS as a guide for standard of care. Adherence to HEDIS is useful in decreasing chronic disease burden through preventative measures. Diabetes, a disease with high burden, has Comprehensive Diabetes Care HEDIS standards that specifically target providers. Increasing adherence to HEDIS measures is shown to significantly improve health outcomes when used with evidence-based guidelines. The literature shows having high HEDIS scores are not an incentive to adhere …

Pilot Of A Randomized Trial Comparing Outcomes Of Three Types Of Peripheral Intravenous Catheters (Pivc): Utilizing The Plan, Do, Study, Act Cycle, Heather Galang

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Peripheral intravenous catheters (PIVC) are used in high volume in acute and ambulatory settings. Due to high volume of use in patient care, complications from a PIVC can significantly impact patient experience. Literature indicates complications such as blood exposure, phlebitis, unplanned removal, infiltration, occlusion, dwell time, pain, and cost have serious consequences in patient care, leading to potential delays in treatment, patient discomfort, patient dissatisfaction, safety concerns, nursing interruptions, increased length of stay, and added costs. Gap analysis indicates additional research can prove beneficial for evidence-based care improvement. The authors propose using the plan, do, study, act to conduct a …

The Effectiveness Of Education And Cognitive Rehearsal In Managing Nurse-To-Nurse Incivility, Deborah B. Kile

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

This project was designed to evaluate the effectiveness of education on nurse-to-nurse incivility and use of cognitive rehearsal techniques on registered nurses' perception of their ability to recognize and confront incivility, along with resulting job satisfaction. Nurse-to-nurse incivility negatively affects nurses, organizations and patients. The Tri-Council for Nursing's proclamation calls nurses to recognize incivility and take steps to eliminate this in practice ("Tri-Council" 2017). A mixed method, quality improvement pilot study was conducted. Participants, (registered nurses employed in a Post-Anesthesia Care Unit in a community hospital in Virginia), received education on incivility and cognitive rehearsal techniques. Data was collected through …

Type 2 Neural Progenitor Cell Activation Drives Reactive Neurogenesis After Binge-Like Alcohol Exposure In Adolescent Male Rats, Chelsea Rhea Geil Nickell, Hui Peng, Dayna M. Hayes, Kevin Y. Chen, Justin A. Mcclain, Kimberly Nixon

Pharmaceutical Sciences Faculty Publications

Excessive alcohol consumption during adolescence remains a significant health concern as alcohol drinking during adolescence increases the likelihood of an alcohol use disorder in adulthood by fourfold. Binge drinking in adolescence is a particular problem as binge-pattern consumption is the biggest predictor of neurodegeneration from alcohol and adolescents are particularly susceptible to the damaging effects of alcohol. The adolescent hippocampus, in particular, is highly susceptible to alcohol-induced structural and functional effects, including volume and neuron loss. However, hippocampal structure and function may recover with abstinence and, like in adults, a reactive burst in hippocampal neurogenesis in abstinence may contribute to …

Coping With Labor Education For Nurses, Donna Vo

Master's Projects and Capstones

The “Coping With Labor Education for Nurses” education plan is substantiated by data from the California Maternal Quality Care Collaborative (CMQCC) vaginal birth initiative toolkit and other research. Evidence-based data from multiple sources indicates that improving how labor support is offered at the bedside for the laboring patient can potentially decrease cesarean rates, reduce expenses, and increase savings. The objectives of this plan are to improve patient advocacy and the level of labor support interventions labor and delivery nurses will provide for patients to improve patient satisfaction score above 80%, decrease or maintain cesarean rates below 24.9%, and improve patient …

Aim High, Win Big: Optimizing The Or Nurse's Skills To Improve Surgical Outcomes, Ammie Rose Agbuya-Gates

Master's Projects and Capstones

Abstract

Operating room nurses are constantly challenged with new surgical procedures and technology that affect the delivery of safe patient care. A deficiency in skill sets was identified among 50% of OR nurses in this microsystem. A structured scrub training program will improve the performance of novice and advanced beginner nurses to prevent the occurrence of adverse events. This program includes 320 hours of exposure to scrub the top ten procedures of two specialty services after the nurse learns how to circulate. The ability to circulate and scrub is an indication of high performance. It is expected that the OR …

Reducing Intraventricuar Hemorrhage, Nakia Green

Master's Projects and Capstones

Abstract

Global Aim:

Between September 2017 and September 2018 we aim to reduce the rate of grade III and grade IV intraventricular hemorrhage (IVH) in infants less than or equal to 32 weeks gestation, or less than or equal to 1500 grams from 11% to 5%.

Project Aim:

Develop a best practice bundle for the Prevention of Intraventricular Hemorrhage with implementation of best practice of midline head positioning for infants less than or equal to 32 weeks gestation or less than or equal to 1500 grams by October 2017.

Setting:

Level III, 64 bed Neonatal Intensive Care Unit

Quality …

Improving Oral Care Practices And Aspiration Risk Assessment To Mitigate Risk Of Hospital Acquired Pneumnia, Jeniffer Baker

Master's Projects and Capstones

Abstract

The aim of Improving Oral Care Practices and Aspiration Risk Assessment to Mitigate Risk of Hospital Acquired Pneumonia is to decrease rates of hospital acquired pneumonia (HAP) on a 16 bed Transitional Care Unit (TCU) with a mixed skill staff. The theme of the project is risk reduction with improved patient outcomes and cost reduction as reasons for implementation. Fourteen cases of HAP were reported in the last 5 quarters which accounts for 48% of all in-patient acquired infections. Through policy development, standardization of oral care technique, and improved risk factor assessment, the project goal is to decrease rates …

Discharge By 11:00 Am And The Effects On Throughput, Gena Bravo

Master's Projects and Capstones

This Clinical Nurse Leader project aims to improve the discharge process to increase the percentage of patients discharged before 11:00 AM on the Progressive Care Unit (PCU). One evidence-based approach to help alleviate capacity constraints in the hospital is to create an effective and timely discharge process. The goal of this project is to educate the front line staff, care coordinators, and providers to a standardized discharge process. The PCU is a cardiac telemetry unit with 30 private rooms. The patients on the PCU are post-cardiac surgery with some overflow medical patients throughout the unit. Kotter’s theoretical framework was chosen …

No More Baby Steps: Preventing Unintended Pregnancies Of Los Angles Minorities And Adolescents, Rachel Bass

Master's Projects and Capstones

Previous studies have identified pregnancy intention to correlate with both maternal and fetal health. Though unintended pregnancy rates are dropping in America, they remain high among minority and young women. Contraceptive usage, a leading protective factor for unintended pregnancies, has been found to vary greatly by age and ethnicity. These two projects aimed to decrease unintended pregnancy rates through increasing patient knowledge of contraceptive options and correct usage. The first project focused on creating a comprehensive, oral contraceptive pill instructional handout for research participants of the birth control pill study. This handout was created through the analysis of compliance errors …

Improving Early Sepsis Identification On Inpatient Units, Monica Schurle

Master's Projects and Capstones

Sepsis is a serious complication, which is initiated by the body’s extreme response to an infection. If sepsis is not identified and treated promptly, it can rapidly lead to tissue damage, organ failure and death. In order to reduce the number of patients who decline to sepsis in hospital, an efficient sepsis protocol needs to be implemented. Nursing practices, knowledge, and early recognition of systemic inflammatory response syndrome (SIRS) were assessed and measured in order to implement effective interventions. A root cause analysis was conducted to identify any discrepancies with compliance performing the sepsis screening in a timely manner, identify …

Assessment Of Falls On A Medical-Telemetry Unit, Andie Reed

Master's Projects and Capstones

The purpose of this quality improvement project aimed at reducing falls on a medical-telemetry unit in a large metropolitan Magnet hospital. It was important for the MSN/CNL students to focus on falls because it is not just a concern for this institution, it is a national dilemma that needs to be addressed. Due to the complexities and intricate details of the IRB process, the MSN/CNL students were unable to collect data or further advance their project into the microsystem. Instead, information was attained from the University of San Francisco database to allow the MSN/CNL students to continue with the steps …

The Role Of Yes-Associated Protein 1 In Ovarian Physiology And Pathology, Xiangmin Lv

Theses & Dissertations

Ovarian granulosa cells are the major somatic components of the ovarian follicle. Proper proliferation and differentiation of ovarian granulosa cells are essential for successful follicle development. Accumulating evidence indicates that the Hippo-YAP signaling pathway plays critical roles in both development and tumorigenesis of several organs. The present study aims to investigate the role of Yes-associated protein 1 (YAP) in ovarian granulosa cell proliferation, differentiation, and malignant transformation. At first, we found that nuclear YAP (active) was highly expressed in proliferative granulosa cells, whereas cytoplasmic YAP (inactive) was detected mainly in terminally-differentiated luteal cells. Further studies suggested that endogenous YAP activity …

Risk Of Post-Ercp Pancreatitis In Liver Transplant Patients: Single Center Experience, Shailender Singh

Theses & Dissertations

Introduction: Acute pancreatitis remains the most common severe complication of endoscopic retrograde cholangiopancreatography (ERCP). The exact cause of post-ERCP pancreatitis (PEP) is unclear. Regardless of the mechanism that initiates PEP, the pathways of inflammation are similar to other forms of acute pancreatitis and include the activation of various inflammatory cytokines, released from the acinar cells and subsequently from helper T lymphocytes and macrophages. Liver transplants (LTx) patients on immunosuppressive medications have impaired T-cell response and hence decreased ability to generate these cytokines. The aim of this study was to review incidence rates and risk factors of PEP in this …

Cpap-Mad Combination Therapy For Cpap Intolerant Patients With Moderate To Severe Osa, Jacob Stadiem

Theses & Dissertations

The treatment of obstructive sleep apnea (OSA) allows for a multidisciplinary approach between dentistry and medicine. Continuous positive airway pressure (CPAP) is the gold standard for OSA treatment, but the non-adherence rates are high. The mandibular advancement device (MAD) has a higher acceptance rate than the CPAP, however the efficacy is much lower in cases of moderate to severe OSA. This thesis attempted to evaluate if there was a change in compliance when a MAD was added as a combination therapy to moderate to severe OSA subjects that were currently non-compliant with their CPAP. In addition, the change in air …

Maternal Life Course Adversity: The Intersection Of Psychosocial And Biobehavioral Adaptive Response In Pregnancy, Crystal Modde Epstein

Theses & Dissertations

The link between life course adversity and adverse health outcomes is well established, particularly early life adversity (ELA). There is also evidence that the physiologic adaptations associated with stress, depression and ELA can be transmitted intergenerationally via long-term set-point changes within the maternal hypothalamic-pituitary-adrenal axis (HPA). It is unknown how the type and timing of maternal stress and adversity influences HPA regulation during pregnancy and whether maternal coping attenuates this relationship. Manuscript 1 was an integrative review of studies examining the association between maternal ELA and HPA regulation during pregnancy. In manuscripts 2 and 3 the findings of the dissertation …

Occupational Therapy Treatment Of Distal Radius Fractures: Best Practices, Erika Schleis

Honors Theses

This paper describes information on best practices for occupational therapy treatment of distal radius fractures including current information about etiology, incidence and prevalence, diagnostic criteria, comorbidities, associated client factors involved in this injury and the effects of this condition on occupational performance. Two hypothetical case studies are presented using evidence-based treatment information. Discussion of additional research necessary to continue to determine best practice approaches is presented.

December 2017, Randy Curry, Cindy Brooks

RURAL ROCKS

Rural Rocks, the Rural Health Network newsletter by the SWOSU College of Pharmacy

Serum Amyloid A3 Is A High Density Lipoprotein-Associated Acute-Phase Protein, Lisa R. Tannock, Maria C. De Beer, Ailing Ji, Preetha Shridas, Victoria P. Noffsinger, Laura Den Hartigh, Alan Chait, Frederick C. De Beer, Nancy R. Webb

Internal Medicine Faculty Publications

Serum amyloid A (SAA) is a family of acute-phase reactants. Plasma levels of human SAA1/SAA2 (mouse SAA1.1/2.1) can increase ≥ 1,000-fold during an acute-phase response. Mice, but not humans, express a third relatively understudied SAA isoform, SAA3. We investigated whether mouse SAA3 is an HDL-associated acute-phase SAA. Quantitative RT-PCR with isoform-specific primers indicated that SAA3 and SAA1.1/2.1 are induced similarly in livers (∼2,500-fold vs. ∼6,000-fold, respectively) and fat (∼400-fold vs. ∼100-fold, respectively) of lipopolysaccharide (LPS)-injected mice. In situ hybridization demonstrated that all three SAAs are produced by hepatocytes. All three SAA isoforms were detected in plasma of LPS-injected mice, although …

Invited Article: Bridging The Gap – Supporting The Transition From High School To College, Julie A. Frischmann, Kelly S. Moor

Administrative Issues Journal

Idaho State University’s Bengal Bridge is a summer program designed to help students successfully transition from high school to their first year of college at Idaho State University. All Bridge students at ISU take two general education courses, plus an additional credit of supplemental instruction focused on academic strategies specific to the disciplines represented by those general education courses, as well as a First Year Transition (ACAD) course to facilitate engagement with and acculturation to the university community—a total of nine to 10 credits in just seven weeks. Bridge students are also supported by one-to-one academic coaching, supplemental tutoring, peer …

Classical Literature Gives Life To Business Paradox And Systems Integration, Robert A. Page, Samuel K. Andoh, Robert A. Smith

Administrative Issues Journal

Professors bemoan the great difficulty students have understanding the complexity of their disciplines or functional specializations. Many non-traditional students have work and family commitments that limit the time needed to reflect professionally and to master these concepts. This disconnect has persisted despite decades of work developing more integrated, interdisciplinary curricula. One potential, partial solution is to simply start sooner and partner with liberal arts courses to introduce business students to complexity and paradox before they arrive at the business school. Grounding these concepts in the Classics embeds them in great stories of passion, betrayal, commitment, and emotion normally absent in …

Authentic Leadership—Is It More Than Emotional Intelligence?, Phyllis Duncan, Mark Green, Esther Gergen, Wenonah Ecung

Administrative Issues Journal

One of the newest theories to gain widespread interest is authentic leadership. Part of the rationale for developing a model and subsequent instrument to measure authentic leadership was a concern that the more popular theory, the full range model of leadership and its instrument, the Multifactor Leadership Questionnaire (MLQ) (Bass & Avolio, 1985), did not sufficiently emphasize aspects of leader emotional intelligence (EI), such as self-awareness (Avolio & Gardner, 2005).

In its current configuration, the Authentic Leadership Questionnaire (ALQ) (Walumba, Avolio, Gardner, Wernsing & Peterson, 2008) measures four dimensions of leadership: relational transparency, internal moral perspective, balanced processing, and self-awareness. …

Addressing Uncertainty During Workplace Change: Communication And Sense-Making, Rich Parsells

Administrative Issues Journal

Change is a commonplace occurrence in today’s organizations. A number of scholars suggest that communication strategies during organizational change are an important element to the success of a change initiative, yet such strategies are not given primacy in the research literature. The purpose of this paper is to add to the discourse on communication and workplace change initiatives by reporting on a research project that explored communication actions which were employed and viewed as useful by those experiencing a change in the workplace. This paper presents the findings that emanated from the study and explore their meaning in relation to …

The Effect Of Mechanical Vibration On Pain And Rate Of Tooth Movement During Initial Orthodontic Alignment, Leslie Ellingson

Theses & Dissertations

Purpose: The purpose of this investigation was to evaluate the effect of mechanical vibration on pain experienced and rate of tooth movement (OTM) during the initial alignment phase of orthodontic treatment.

Materials and Methods: Participants were randomly allocated to control, low frequency or high frequency. An electric toothbrush was modified to provide high frequency vibration. A low frequency vibration device was acquired from a commercial vendor. Experimental groups applied vibration to the dentition for 20 minutes daily. All participants completed questionnaires using visual analog scales at five time points. Pain experience was measured in millimeters (mm) with the scale measuring …

A Roadmap For The Journey Home - A Supplemental Tool Guiding Patients From Hospital To Home, Michelle Basco

Master's Projects and Capstones

Centers for Medicare and Medicaid (CMS) have recognized readmission rates as a public health problem. CMS incentivizes hospitals to reduce readmission rates and reduce payments for hospitals with high readmission rates (Berry et al., 2013). Patient education and discharge planning are associated with decreased readmission rates. I gained fieldwork experience at Children’s Health System of Texas in Dallas. Children’s Health, a pediatric non-profit, is the 8th largest pediatric health care provider in the U.S. Prior to discharge patient education occurs on topics related to their diagnosis, plus patients are provided discharge instructions including their diagnosis, medications, and simple instructions for …

Synthesis And Electrical Properties Of Copolymers Containing 3-Phenyl[5]Ferrocenophane-1,5-Dimethylene And Vinylimidazole, Muteb H. Alshammari

Electronic Theses & Dissertations

Ferrocene is a well-known organometallic compound and its structure consists of an iron atom sandwiched between two cyclopentadienyl rings. Ferrocene has unique properties such as redox chemistry, high electron density, thermal stability and aromaticity. In addition, the ferrocene can be incorporated into polymers either into the backbone or on the side chains. Ferrocene incorporated polymers have received considerable attention in the areas of electro-catalysis, electrode coating, and battery applications. Therefore, the main purpose of this study is to characterize the electrochemical behavior of copolymers of 3-phenyl[5]ferrocenophane-1,5-dimethylene with vinyl imidazole in aqueous solutions with various electrolytes: sodium perchlorate, zinc perchlorate, cadmium …

Improving Nursing Adherence To Pediatric Pain Management Bundle Using The Pdsa Cycle, Stephen W. Lovern

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

Given the current standards, pediatric post-operative pain management can be a distressing outcome to the patient and family. Adequate management of post-op pain in this population is a challenge despite the availability of evidence-based interventions combined to form care bundles. Tonsillectomies are common procedures in the pediatric population and often include moderate to severe pain with ineffective pain relief. Inadequate pain management leads to unplanned admissions, longer post anesthesia care unit (PACU) stays, slower oral intake, and longer recovery periods. In this project, two interventions were tested using the plan-do-study-act (PDSA) model for rapid cycle improvements. The first intervention was …