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Full-Text Articles in Medicine and Health Sciences

Improving Mental Health Support For Nursing Students Through Mental Health First Aid (Mhfa) Training Of Clinical Faculty, Amy Sands May 2024

Improving Mental Health Support For Nursing Students Through Mental Health First Aid (Mhfa) Training Of Clinical Faculty, Amy Sands

Graduate Theses, Dissertations, and Capstones

This project aimed to implement a process improvement program at the Louisville campus of Galen College of Nursing to improve the mental health support for nursing students through the training of Clinical Instructors (CIs) in using adult Mental Health First Aid (MHFA) and the ALGEE actions described within that program.


Utilizing Decision Tree Implementation And Provider Education To Improve Colorectal Cancer Screening Orders: A Quality Improvement Project, Alicia Kollar May 2024

Utilizing Decision Tree Implementation And Provider Education To Improve Colorectal Cancer Screening Orders: A Quality Improvement Project, Alicia Kollar

Doctor of Nursing Practice (DNP) Manuscripts

Background and Significance: Colorectal cancer (CRC) is the third most common cancer and the second leading cause of cancer-related deaths (Jain, et al., 2022). Healthy People 2030 objectives include reducing the CRC death rate and increasing the proportion of adults who get screened (Healthy People 2030, n.d.). According to 2021 data, only 58.7% of adults are screened with a Healthy People target of 68.3%. Healthy People states that there are effective screening tools to detect colorectal cancer early, and people are more likely to survive it (Healthy People 2030, n.d.). Purpose: This quality improvement (QI) project aims to implement an …


With Love, ; An Interdisciplinary And Intersectional Look At Why Creativity Is Essential, Theo Starr Gardner May 2024

With Love, ; An Interdisciplinary And Intersectional Look At Why Creativity Is Essential, Theo Starr Gardner

Whittier Scholars Program

My Whittier Scholars Program self-designed major, Teaching Creativity, is a mixture of Art, Literature, and Education classes. My research and praxis classes have been focused on the ‘how?’s and 'why?’s of creativity, so it felt only right that my project should be a constructivist, generative project. The project I have been working on throughout my time at Whittier, and that has just fully come to fruition on April 11th, 2024, was a solo art gallery/open mic event entitled ‘With Love,’. With Love, was conceptually inspired by the research I’ve conducted on creativity and creative arts education over the past few …


Physical Activity Levels In First-Year University Students, Jerealya Cogdell May 2024

Physical Activity Levels In First-Year University Students, Jerealya Cogdell

Honors College Theses

The purpose of this study is to see if physical activity (PA) is affected for students since transitioning from high school to their first semester in college. The study was conducted by asking questions pertaining to PA via an online survey through the platform Qualtrics. It will be administered to students at Georgia Southern University. However, only the data from freshmen students that meet specific criteria will be accounted for in this study. The data will be analyzed using Chi-squared to determine how PA is affected due to this transition. The data will compare the results from high school senior …


Nursing Students’ Perceptions Of The Impact Of Teamwork And Collaboration On Patient Care, Riana Square May 2024

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

Honors College Theses

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


The Hero’S Journey Through Therapy: A Literature Review, Rylee Blake May 2024

The Hero’S Journey Through Therapy: A Literature Review, Rylee Blake

Expressive Therapies Capstone Theses

The Hero’s Journey (Campbell, 1949) is a common narrative structure throughout ancient mythology and modern storytelling which describes the transformation of a hero through a journey of trials and represents the experience of psychological healing throughout various cultures. Because of the ancient and common nature of this structure and the psychological importance of personal narrative and storying even from an early age (Boyd, 2018; Klees, 2016), this thesis hypothesizes that a client’s experience throughout psychotherapy will follow the stages of the Hero’s Journey and that invoking this structure within the therapy room, particularly for drama therapists, will empower clients toward …


Expressive Therapies And Resiliency – Resistance In Mental Health: A Literature Review, Gabrielle Lopez May 2024

Expressive Therapies And Resiliency – Resistance In Mental Health: A Literature Review, Gabrielle Lopez

Expressive Therapies Capstone Theses

This review evaluates the current literature on psychological resistance amongst human service professionals experiencing burnout and the effect of Expressive Arts interventions on resiliency. Concepts include identifying the main symptoms, risk factors, causes, and treatments for burnout in education faculty, medical staff, and clinicians. Qualitative, quantitative, and meta-analysis studies are included to identify the most prevalent intervention frameworks for reducing stress including Arts-Based and Mindfulness-compassion based techniques. The effectiveness of Arts-based tools on strengthening identity, self-esteem, emotional regulation, and meaning-making in combating burnout is presented. Based on analysis of the literature, the author proposes a three-step intervention framework for utilizing …


Neuroqueering Art Therapy: Bringing Neurodivergent Gender Diversity Into The Creative Arts Therapy Room: A Literature Review, Avital Eisen May 2024

Neuroqueering Art Therapy: Bringing Neurodivergent Gender Diversity Into The Creative Arts Therapy Room: A Literature Review, Avital Eisen

Expressive Therapies Capstone Theses

Recent research across disciplines has established the significance of the overlap between neurodivergence and gender diversity, a truth long espoused by the community. Acting on this research, some mental health disciplines have begun addressing neurodivergent transgender and gender diverse people as a unified population in their research, but the field of art therapy has not yet followed suit. Theoretical frameworks of intersectionality, queer theory, and disability justice highlight the importance of centering the unique experiences and needs of neurodivergent gender diversity. Using these frameworks, this literature review synthesizes community knowledge with art therapy research on both neurodivergence and gender diversity, …


Method Acting As A Therapeutic Intervention For Trauma Recovery, Remi Moses May 2024

Method Acting As A Therapeutic Intervention For Trauma Recovery, Remi Moses

Expressive Therapies Capstone Theses

While considered controversial by some, Method acting as popularized by Lee Strasberg is a technique that elicits powerful and authentic results on stage and screen. The foundational Method acting techniques, the Relaxation Exercise (RE) and the Sense Memory Exercise (SME), share similarities to bottom-up therapeutic processes like Somatic Experiencing and Eye Movement Desensitization and Reprocessing. By implementing a trauma-informed drama therapy framework with these two exercises, the RE and SME were restructured as a therapeutic intervention for people in trauma recovery. The author implemented a study of three consecutive group therapy sessions for people healing from trauma where clients participated …


The Relationship Between Sun Protective Behavior, Health Beliefs, Attitudes, And Norms Of Sun Exposure Among College Athletes, Avery B. Snyder May 2024

The Relationship Between Sun Protective Behavior, Health Beliefs, Attitudes, And Norms Of Sun Exposure Among College Athletes, Avery B. Snyder

Honors Theses

The purpose of this study was to access the relationship between sun protective behavior, health beliefs, attitudes, and norms of sun exposure among college athletes. An electronic survey was provided to student athletes for about two weeks in October of 2023. Prior to student participation the Institutional Review Board approved the protocol and data collection. The survey was sent to the students by the athletic director through an app called Teamworks that connects to all the athletes at Coastal Carolina. The majority of students who took the survey reported they did not wear sunscreen in past games/practices. Of those who …


Development, Validation, And Diagnostic Performance Of A Novel Radiomic Model For Predicting Prostate Cancer Recurrence, Linda M. Huynh May 2024

Development, Validation, And Diagnostic Performance Of A Novel Radiomic Model For Predicting Prostate Cancer Recurrence, Linda M. Huynh

Theses & Dissertations

Multi-parametric magnetic resonance imaging (MP-MRI)-derived radiomics have been shown to capture sub-visual patterns for the quantitative characterization of prostate cancer (PC) phenotypes. The present dissertation seeks to develop, evaluate, and compare the performance of an MRI-derived radiomic model for the prediction of PC recurrence following definitive treatment with radical prostatectomy (RP).

MP-MRI was obtained from 339 patients who had a minimum of 2 years follow-up following RP at three institutions. The prostate was manually delineated as the region of interest and 924 radiomic features were extracted. All features were evaluated for stability via intraclass correlation coefficient (ICC) and image normalization …


Promoting Wakefulness To Increase Occupational Engagement In Military Service Members Experiencing Insomnia Following Mtbi, Leah N. Myers May 2024

Promoting Wakefulness To Increase Occupational Engagement In Military Service Members Experiencing Insomnia Following Mtbi, Leah N. Myers

Occupational Therapy Capstone Presentations

Sustaining a traumatic brain injury of any severity is associated with an extremely high prevalence of insomnia. Military service members, being exposed to hazardous equipment and conditions, are one of the most likely populations to sustain sleep concerns following TBI. This student capstone project aimed to support military service members experiencing sleep disturbances due to TBI through direct advanced clinical skill attainment, Light Therapy program development, and by initiating research and clinic resource creation relating to shift work and sleep. To target this population, the project was completed at the Fort Carson Intrepid Spirit Center in Colorado where outpatient concussion …


Occupational Therapy’S Role As A Member Of An Interdisciplinary Feeding Team For Children With Sensory Processing Differences, Emily G. Bruinsma May 2024

Occupational Therapy’S Role As A Member Of An Interdisciplinary Feeding Team For Children With Sensory Processing Differences, Emily G. Bruinsma

Occupational Therapy Capstone Presentations

Considering the high prevalence of pediatric feeding disorders and the increased need for occupational therapists trained to work with children with feeding challenges, this project sought to provide a better understanding of the key components of a feeding therapy program. These components include caregiver involvement, use of an interdisciplinary team, interventions aimed at sensory integration, and the inclusion of family-centered and motivating interventions. The Sensory Integration theory was used to guide this project by providing an understanding of the various ways individuals can receive and respond to sensory information. There were three primary goals for this capstone project, including developing …


An Eye-Opening Capstone: A New Perspective On Occupation-Based Treatments For Neurologic-Based Visual Deficits, Katlyn J. Knakmuhs May 2024

An Eye-Opening Capstone: A New Perspective On Occupation-Based Treatments For Neurologic-Based Visual Deficits, Katlyn J. Knakmuhs

Occupational Therapy Capstone Presentations

The purpose of this 14-week capstone experience was to gain hands on in depth clinical experience working with individuals post neurologic injury, specifically post-concussion, who were experiencing a visual perceptual deficit. Additionally, the focus of this capstone was to implement occupation-based skills and activities into therapy sessions for individuals experiencing those visual perceptual deficits post-concussion. This capstone experience took place at the Sanford Outpatient Rehabilitation Clinic in Sioux Falls, South Dakota and was completed under the supervision of a licensed occupational therapist who is a certified brain injury specialist. Eight individuals post-concussion with visual perceptual deficits who were patients of …


Improving Collection Of Second Blood Pressure For Patients In Primary Care Who Present With An Elevated Reading, Jordan Sieh, Elizabeth Sundberg, Tania Arreguin May 2024

Improving Collection Of Second Blood Pressure For Patients In Primary Care Who Present With An Elevated Reading, Jordan Sieh, Elizabeth Sundberg, Tania Arreguin

Doctor of Nursing Practice Projects: College of Nursing

Purpose: Early diagnosis of hypertension is critical to prevent complications such as renal and cardiovascular diseases. Many healthcare facilities do not have a blood pressure training program educating appropriate staff on importance of accurate blood pressure readings and techniques. The purpose of this project is to improve the number of patients with elevated blood pressure reading at the OneWorld Quick Sick Clinic.

Methods: Health aides/Health Assistants/Medical assistants at OneWorld Quick Sick will receive blood pressure training to review proper techniques. During this training they will also be educated on appropriate follow-up blood pressure readings and a new technique to document …


Heart Failure Zone Tool: A Quality Improvement Project, Emily Scahill, Cindy Driggers, Angelica Marquez May 2024

Heart Failure Zone Tool: A Quality Improvement Project, Emily Scahill, Cindy Driggers, Angelica Marquez

Doctor of Nursing Practice Projects: College of Nursing

Purpose

Heart failure is the leading cause of hospital admissions among adults over 65 years old and lack of patient knowledge regarding the self-management of heart failure is a key factor in rising readmission rates. This project enhances inpatient heart failure education using a laminated heart failure zone tool handout to guide heart failure education. The intent was to increase patients’ confidence regarding heart failure self-management and positively impact patients’ knowledge regarding the management of heart failure.

Materials and Methods

The process included identifying hospitalized patients who had been flagged as a heart failure core measure or had been identified …


Mental Health Among Collegiate Athletes, Stella Elise Fairbanks May 2024

Mental Health Among Collegiate Athletes, Stella Elise Fairbanks

Honors Thesis

Mental health has become increasingly more linked with athletics, especially collegiate athletics. There has been an increase in public acknowledgment of the presence of mental health in sports, specifically, more athletes are speaking about their mental health struggles as well as more research is being conducted in order to gain a greater understanding of the relationship between mental health and athletics. This literature review discusses athletes’ personal experiences of their mental health struggles, the presence of stigma associated with mental health and athletics, and the results of the recent NCAA, National Collegiate Athletic Association, research. This thesis aims to uncover …


Implementing The Copm To Create Occupation-Based Interventions In Outpatient Adult Rehabilitation, Kelcee A. Bacon May 2024

Implementing The Copm To Create Occupation-Based Interventions In Outpatient Adult Rehabilitation, Kelcee A. Bacon

Occupational Therapy Capstone Presentations

Worldwide, people continue to live longer, with the number of people over the age of 60 predicted to double by 2050; many of those people also have chronic diseases that could benefit from rehabilitation services. Outpatient rehabilitative services, including occupational therapy, have increased occupational performance, strength, mobility, and coordination for those diagnosed with musculoskeletal or neurological conditions. This capstone focused on three components: 1) in-depth clinical practice using occupation-based assessments and interventions with the adult population, 2) understanding the administrative roles of private practice therapists, and 3) creating educational materials to increase knowledge and skills surrounding outpatient occupational therapy for …


Multimodal Investigations For The Identification Of Surgically Relevant Brain Areas, Kevin Tyner May 2024

Multimodal Investigations For The Identification Of Surgically Relevant Brain Areas, Kevin Tyner

Theses & Dissertations

Epilepsy is a neurological disease leading to recurrent and unpredictable seizures. Patients can be diagnosed as focal onset, where the seizure focus resides in one hemisphere; generalized onset, where seizure foci reside in both hemispheres; or unknown onset. Anti-seizure medications are the first line of treatment, and those whose seizures cannot be controlled with medication are diagnosed with drug-resistant epilepsy (DRE). For patients diagnosed with focal onset epilepsy to achieve seizure freedom, surgical resection of the epileptogenic zone (EZ), the region of the brain that is both necessary and sufficient for initiating seizures, is required. The EZ is a theoretical …


Incorporating A High Fidelity Transgender Simulation Into Undergraduate Nursing Curriculum, Kacee Child, Jenniepearl Spencer May 2024

Incorporating A High Fidelity Transgender Simulation Into Undergraduate Nursing Curriculum, Kacee Child, Jenniepearl Spencer

Doctor of Nursing Practice Projects: College of Nursing

Purpose

The purpose of this study was to evaluate the knowledge and attitudes of nursing students participating in a high-fidelity transgender patient simulation. The aims were to increase student knowledge and confidence to improve communication and provide more inclusive and equitable care.

Healthcare providers are not adequately prepared to manage the unique health needs of the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community. Nurses are ideally positioned to address gaps in LGBTQ healthcare by providing culturally competent care. Yet, LGBTQ health education is lacking in most undergraduate nursing school curriculums.

Methods

62 undergraduate nursing students participated in a post-surgical …


Facilitating Community Integration Following Inpatient Rehabilitation: The Importance Of Caregivers, Alysa N. Jensen May 2024

Facilitating Community Integration Following Inpatient Rehabilitation: The Importance Of Caregivers, Alysa N. Jensen

Occupational Therapy Capstone Presentations

Community integration (CI) is a significant benchmark for successful rehabilitation following traumatic brain injury (TBI). The purpose of this capstone was to utilize occupational therapy assessments, interventions, and resources to support patients and their caregivers during the transition from the clinical setting to the community. Methods included assessment and intervention for patient function, cognition as it relates to burden of care, patient discharge statistics, development and implementation of caregiver resources, and semi-structured caregiver interviews. The outcomes of this project indicate that although TBI survivors are discharging home, they continue to require substantial caregiver support. Outcomes also indicate that there is …


Empowering Pregnancy And Postpartum: Supporting Motherhood Through Occupational Therapy Education, Alison Drexler May 2024

Empowering Pregnancy And Postpartum: Supporting Motherhood Through Occupational Therapy Education, Alison Drexler

Occupational Therapy Capstone Presentations

During pregnancy and postpartum, women are at increased risk for physical and psychological health concerns due to the changes and challenges that come with the transition. The purpose of this 14-week capstone was to develop and implement educational sessions using occupational therapy concepts and integrate them into a community parenting program to ease the transition during the perinatal period. It also aimed to advocate for the role of occupational therapy in pregnancy and postpartum. Methods included preparing and sharing supplemental educational materials, developing and implementing occupation-based sessions, creating a folder of resources, and developing a manuscript advocating for occupational therapy …


Patient-Centered Preimplant Education Session And Bi-Weekly Text Message Adherence Reminders In Patients With A Newly Implanted Cardiomems® Device: A Quality Improvement Study, Elizabeth M. Miller, Alicia Abboud, Audrey Cooper May 2024

Patient-Centered Preimplant Education Session And Bi-Weekly Text Message Adherence Reminders In Patients With A Newly Implanted Cardiomems® Device: A Quality Improvement Study, Elizabeth M. Miller, Alicia Abboud, Audrey Cooper

Doctor of Nursing Practice Projects: College of Nursing

Rationale

Heart failure is a deadly disease, affecting over 6.2 million individuals and costing the United States an estimated 30.7 billion dollars (Virani et al., 2020). By 2023, heart failure costs in the United States are estimated to grow to 70 billion dollars with 75-80% of these costs attributed to inpatient hospitalizations (Heidereich et al., 2022). The CardioMEMs® is a small device placed in the patient’s pulmonary artery via a minimally invasive procedure by an interventional cardiologist. The use of remote patient data from the CardioMEMs® device has been shown to reduce hospital re-admissions, facilitate tailored medication management, detect increased …


Promoting Social, Emotional, And Behavioral Development For Children In A School Setting Using Targeted Occupational Therapy Intervention, Mykenzie N. Hall May 2024

Promoting Social, Emotional, And Behavioral Development For Children In A School Setting Using Targeted Occupational Therapy Intervention, Mykenzie N. Hall

Occupational Therapy Capstone Presentations

Children who have experienced trauma often have poor emotional regulation skills which can lead to peer rejection, decline in engagement at school, and poor academic performance. Occupational therapists have the knowledge and skills to create a client-centered approach when working with children who have experienced trauma. This emotional regulation program is guided by a trauma-informed care approach and a public health approach to mental health. The program consisted of 59 students between transitional kindergarten and 5th grade meeting in small groups once a week for 30 minutes over 11 to 12 weeks. The sessions included activities related to emotional regulation …


Filling The Gap: Educating Caregivers And Patients Post Stroke In An Acute Care Setting, Gabrielle A. Blecke May 2024

Filling The Gap: Educating Caregivers And Patients Post Stroke In An Acute Care Setting, Gabrielle A. Blecke

Occupational Therapy Capstone Presentations

Background: According to the U.S. Department of Health and Human Services (2022), every 40 seconds someone in the United States experiences a cerebrovascular accident (CVA), also known as stroke. A recent study suggests that 63% of these individuals will need informal caregiving from family, friends, or loved-ones throughout their rehabilitation process in order to safely transition home. Research suggests that patients and caregivers post stroke are not receiving enough education to prevent concerns such as caregiver burden, decreased caregiver wellness, and decreased patient outcomes, all which are within the scope of occupational therapy. Methods: Experiences at MyMichigan Midland Hospital drove …


Identifying Phytoremediation Performing Plant Species That Can Be Utilized In The Improvement Of Heavy Metal Contaminated Soils, Ashley Clark*, Samuel Mutiti May 2024

Identifying Phytoremediation Performing Plant Species That Can Be Utilized In The Improvement Of Heavy Metal Contaminated Soils, Ashley Clark*, Samuel Mutiti

Graduate Research Showcase

Heavy metal pollution is a problem associated with industrialization and development. Two major metals that are commonly mined and can enter the environment, which can jeopardize communities’ health, are copper (Cu) and lead (Pb). There are different options for reducing heavy metal pollution in the environment via remediation efforts, including physical, chemical, and biological methods. However, physical and chemical remediation can be costly and labor-intensive, making them unsuitable for regions that do not have the funds to utilize these practices. Biological remediation is a more cost-conservative practice that has been shown in many studies to be effective in the gradual …


Implementation Of A Doula-Supported Postpartum Wellness Toolkit In A Black Community-Based Maternal Wellness Program, Janice Luethje, Leslie Torres May 2024

Implementation Of A Doula-Supported Postpartum Wellness Toolkit In A Black Community-Based Maternal Wellness Program, Janice Luethje, Leslie Torres

Doctor of Nursing Practice Projects: College of Nursing

Objective: The objective of this project was to expand the areas of focus within a maternal wellness program at a Black community center and to evaluate the satisfaction levels of the doulas who utilized the material during postpartum home visits. The toolkit covers a range of postpartum topics in the areas of nutrition, exercise, sexual health, mindfulness, and social support as well as a postpartum mental health screening tool.

Design: This quality improvement project included three distinct phases: The pre-implementation phase, the implementation phase, and the post-implementation phase.

Setting: The project location was a Black community center in Lincoln, Nebraska. …


Implementing A Standardized Protocol For Early Detection Of Undiagnosed Hypertension Patients, Jenscena Hansen, Chris Bell May 2024

Implementing A Standardized Protocol For Early Detection Of Undiagnosed Hypertension Patients, Jenscena Hansen, Chris Bell

Doctor of Nursing Practice Projects: College of Nursing

Introduction: Hypertension is a preventable disease that frequently goes unrecognized and undertreated. Early diagnosis can prevent further comorbidities such as heart disease, stroke, and chronic kidney disease. Implementation of this protocol aims to decrease the number of patients with undiagnosed hypertension and increase the identification of patients with elevated blood pressure who did not have a pre-existing diagnosis of hypertension. The goal of implementing a standardized protocol would help eliminate the number of patients who go undiagnosed.

Methods: This quality improvement design had clinical staff flag patients with elevated blood pressure. Identified patients without a diagnosis of hypertension were educated …


Effects Of An Educational Evidence-Based Website To Improve Breast Health Knowledge And Self-Efficacy Of Breast Self-Examination: Interim Analysis, Mackenzie Koch, Jennifer Cera, Brooke Hancock, Elizabeth Graham May 2024

Effects Of An Educational Evidence-Based Website To Improve Breast Health Knowledge And Self-Efficacy Of Breast Self-Examination: Interim Analysis, Mackenzie Koch, Jennifer Cera, Brooke Hancock, Elizabeth Graham

Doctor of Nursing Practice Projects: College of Nursing

Purpose and Aims

Breast disease, whether benign or malignant, encompasses a wide array of diagnoses. Breast self- examination (BSE) is a simple screening assessment that improves early recognition and diagnosis. With changes in the 2021 ACOG practice guidelines from mandatory to optional provider-performed clinical breast examinations (CBE), it is imperative for patients to possess basic breast health knowledge and accurate BSE techniques. Current standard patient education is provided via brochures or pamphlets. An educational multimedia website was created using ACOG guidelines to impart knowledge and demonstrate proper BSE techniques. Aims were to evaluate changes in participant’s (1) breast health knowledge …


Reduction Of Hospital-Acquired Pressure Injuries In The Acute Care Setting, Bailey Rasmussen, Taylor Bacon, Andrew Gross May 2024

Reduction Of Hospital-Acquired Pressure Injuries In The Acute Care Setting, Bailey Rasmussen, Taylor Bacon, Andrew Gross

Doctor of Nursing Practice Projects: College of Nursing

Background: Hospital-acquired pressure injuries (HAPIs) have been a longstanding problem in hospitals nationwide. HAPIs cause significant financial strain to a healthcare system and complications can be devastating to the patient.

Purpose: The purpose of this project was to implement the Standard Pressure Injury Prevention Protocol (SPIPP) 2.0 Checklist for patients in the Intensive Care Unit (ICU). The primary aim of this study was to determine if implementing the checklist would reduce the number of HAPIs.

Methods: This project took place over a four-week period at a Midwest hospital in the ICU. Data were collected via patient chart …