Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Optimizing A Clostridium Difficile Screen For Intensive Care Unit Admissions, Mary Katherine V. Natour, Jennifer Smith

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: Clostridium difficile infection is one of the most common healthcare-associated infections. Careful screening upon hospital admission enables clinicians to mitigate the spread and sequelae of this illness through early intervention and isolation but this screening must be accurate and highly sensitive to maximize benefit.

Local problem: The site for this project, an ICU in Tennessee, currently employs a highly sensitive but nonspecific tool to detect CDI. This has resulted in low accuracy, low staff compliance, low patient morale, and unnecessarily high personal protective equipment (PPE) costs.

Methods: Levin’s evidence-based practice improvement model was chosen to guide this project from …

Thermoregulation In Colorectal Patients: Heating Co2 Insufflation Gas, Alejandro Conde, Alieu Jawara, Laura Savage, James Alberding Dnp, Michael Godbold

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: 600,000 colorectal surgeries are performed annually in the United States, with 26-90% experiencing some form of unintended hypothermia. Consequences of hypothermia include surgical site infections (SSIs), delayed wound healing, cardiac dysrhythmias, and increased hospital length of stay. Utilization of the laparoscopic approach to intra-abdominal colorectal surgery uses un-warmed CO₂ gas. Multiple studies demonstrate the addition of heated CO₂, for insufflation, reduces intraoperative hypothermia.

LOCAL PROBLEM: This project was implemented at a facility in Tennessee. On average, 250 laparoscopic colorectal cases are performed at this facility annually. Participants were adult colorectal surgical patients, 18 years …

Implementation Of Standardized Patient Education To Improve Adherence With Colonoscopy For Colorectal Cancer Screening, Melissa Leal Hearn, Melissa M. Hessock, Tara L. Hahn

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Colorectal cancer (CRC) is the third leading cause of cancer deaths among men and women in the U.S. CRC is preventable and manageable when detected early. Approximately 30% of average-risk Americans are overdue for colonoscopy screening. Colonoscopy screenings can reduce death by 67%. Current evidence suggests CRC screening education improves screening uptake among men and women at average-risk age.

LOCAL PROBLEM: The setting of this practice improvement project was a private colorectal surgery practice in South Texas, serving primarily Hispanic/Latino and Caucasian patients. Cancellation rates before colonoscopy were 16.8%, and there was no standardized education for CRC …

Decreasing Perioperative Medication Errors With Standardized Labeling Education, Stephanie Mccain, Emily Almond, Anna Wong, Julie Bonom

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Medication errors are prevalent within the perioperative setting (Wahr et al., 2017). The anesthesia provider is the sole professional in charge of the medication process in the operating room, which results in fewer safety checks than in other healthcare settings (Nanji et al., 2016).

LOCAL PROBLEM: The proposed scholarly project aimed to reduce medication errors at an academic medical center in the Southeast using an educational module focused on standardized narcotic syringe labeling. The participants were anesthesia providers in the operating room at the project site.

METHODS: The Evidence-Based Practice Improvement model was used to guide the development, implementation, …

Implementation Of A Single-Patient-Use Airway Taping Product In The Operating Room, Savannah Sierra Nicole Craig, Kaitlin D. Burrell, Jennifer Patrick

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Anesthesia providers use adhesive tape to secure advanced airway devices. Rolls of adhesive tape serve as reservoirs for pathogens. Rolls of tape do not have instructions on how they are to be reused, cannot be disinfected, and should not be repurposed. The re-use of rolls of tape poses a risk to patient safety.

LOCAL PROBLEM: The project facility was an academic medical center in the Southeast region of the United States. The facility does not have taping practice guidelines in place. Rolls of tape are handled without gloves, used by several providers, placed on multiple patients’ faces, and stored …

A Machine Learning Approach For Predicting Clinical Trial Patient Enrollment In Drug Development Portfolio Demand Planning, Ahmed Shoieb

Masters Theses

One of the biggest challenges the clinical research industry currently faces is the accurate forecasting of patient enrollment (namely if and when a clinical trial will achieve full enrollment), as the stochastic behavior of enrollment can significantly contribute to delays in the development of new drugs, increases in duration and costs of clinical trials, and the over- or under- estimation of clinical supply. This study proposes a Machine Learning model using a Fully Convolutional Network (FCN) that is trained on a dataset of 100,000 patient enrollment data points including patient age, patient gender, patient disease, investigational product, study phase, blinded …

Improving Patient Outcomes One Warm Patient At A Time, Lindsey King, Marcus Austin Robison, Julie Bonom Dnp, Michael Godbold Md

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Patient Temperature measurement postoperatively reveals that hypothermia occurs in surgical patients 25-90% of the time. Unintended perioperative hypothermia can be linked to many negative patient outcomes such as increased incidence of surgical site infection (SSI), delayed wound healing and increased length of hospital stay, to mention a few. Any single or combination of the aforementioned issues can eventually lead to an increase in patient morbidity and mortality. The purpose of this proposed quality practice improvement project is to increase the compliance of hypothermia prevention strategies, specifically forced air warming, at the implementation site. The targeted practice improvement is aimed at …

Anesthesia-To-Post Anesthesia Care Unit Handoff Standardization, Cassie Lee Bivens, Mark Timothy Cresap, Steven Michael Halcomb, Maureen Essie Taylor

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Abstract

The exchange of medical information from one medical professional to another is known as the handoff. Communication errors during the transition period of handoffs can lead to medication errors, delays in care, high stress within the work environment, and increased burnout of the nursing staff. Approximately 1,744 deaths and a total of $1.7 billion in malpractice costs were related to healthcare communication failures from 2012 to 2017. One of the areas of the hospital where effective handoffs are critically important, given the high frequency, is in the post-anesthesia care unit (PACU). Major organizations such as the Joint Commission, the …

Quality Improvement: Education And Implementation Of Proper Narcotic Handling Practices By Nurse Anesthetists, Shelby Stevenson, Anne Hendershott, Alexis Asprah

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Medication errors are estimated to occur once in every 150-300 surgeries (Wahr et al., 2017, p. 36). Unsafe injection practices can lead to increased morbidity and mortality, diminish the overall quality of life for patients, and contribute to substantial increases in healthcare costs. A large majority of unsafe injection practices are caused by a lack of education or mistaken beliefs regarding safe injection practices. Educational reinforcement of safe narcotic handling techniques has significant potential to increase the appropriate use of narcotic syringes among nurse anesthesia providers. The long-standing impact of this project could lead to a reduced number of ‘never …

An Investigative Study Into Alzheimer’S Disease (Ad): Development, Pathway And Progression, And Novel Treatment, Aruha Khan

Chancellor’s Honors Program Projects

No abstract provided.

Locked Nucleic Acid Aptamer And 10 Nm Gold Nanoparticles Increases The Sensitivity Of A Prion Protein Detection Assay, Haley Channell

Chancellor’s Honors Program Projects

No abstract provided.

Failure Of Passive Transfer In Camel Calves: 4 Cases (2010-2019), Amanda James, Joseph Smith, Julie Sheldon, Ricardo Videla

Faculty Publications and Other Works -- Large Animal Clinical Sciences

Failure of passive transfer is a management concern for all ruminant species, but is not well described in the literature for camel calves. This case series presents four camel calves (Camelus dromedarius and Camelus bactrianus) referred to a North American veterinary teaching hospital for diagnosis and management of failure of passive transfer. Diagnostics utilized included hematology, serum biochemistry, and immunologic methods as described for crias. Management included antimicrobial, anti-inflammatory, and plasma transfusion therapies. Three of the four calves survived to discharge, and common diagnostic practices such as evaluation of total solids, total protein, immunoglobulin G, and sodium sulfite appear to …

Investigative Study Into Huntington's Disease: Development, Diagnosis, And Therapeutic Treatment, Allison N Mathews

Chancellor’s Honors Program Projects

No abstract provided.

Supplement: A Field Trial Of 2 Point Of Care Glucometers In Healthy Calves, Joseph Smith, Lisa Ebner, Haley Cremerius, Channing Cantrell, Windy Soto-Gonzalez, Rebecca Rahn, Jon P. Mochel, Jeff Olivarez, Amanda Kreuder

Faculty Publications and Other Works -- Large Animal Clinical Sciences

No abstract provided.

The Need For A Sepsis Screening Tool In An Outpatient Facility, Michael C. Ciccarone

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Sepsis is an exaggerated inflammatory response generated by the immune system secondary to the presence of septicemia, or pathogens within the bloodstream. An average of 270,000 individuals die from sepsis each year, while a total of 1.7 million cases occur annually. Research has shown that the early identification of sepsis prior to hospital admission is associated with decreased lengths of stay, hospital-associated costs, and overall mortality. To demonstrate this research, 26 healthcare staff members in an outpatient clinic were provided with a pre-survey, qSOFA sepsis screening tool, and a post survey to determine if these materials
increased participant confidence when …

Use Of A Smartphone Ecg Monitor To Identify Electrocardiogram Abnormalities Due To Hyperkalemia From Urinary Obstruction In A Jacob’S Sheep, Joseph Smith

Faculty Publications and Other Works -- Large Animal Clinical Sciences

Smartphone-based ECGS present a diagnostic opportunity for large animal practice. A two year old Jacob’s sheep presented with severe hyperkalemia secondary to a urinary obstruction. Collection of an electrocardiogram from a smart-phone based device demonstrated altered waveforms typical of severe hyperkalemia. The patient was successfully managed with medical and surgical therapies. This case presents that the method of collecting a smartphone-based ECG as determined for other large animal species, may be applicable to sheep. Additionally, this report demonstrates that the smartphone-based device may be sensitive enough to detect the absence of a P wave as commonly encountered with cases of …

Oncolytic Viruses: Cancer Treatment Going Viral, Rhianna N. Bronson

Chancellor’s Honors Program Projects

No abstract provided.

The Comparison Of Verbalized Feedback In Human To Computer Interfacing Versus Human To Human Interaction, Kea Francis

EURēCA: Exhibition of Undergraduate Research and Creative Achievement

The project evaluates response to social robots for purposeful tasks. The study uses a social robot, Rapiro, along with a smartphone that serves as a visual interface for the robot system. My role was to design a program on a Raspberry Pi that allows simultaneous control of Rapiro’s actions and a response from a phone application. The phone app is downloaded to an Android phone and designed using MIT App Inventor software. This allows pre-programmed and real-time control of the robot. The user inputs what they want the robot to say through the terminal of the Raspberry Pi. Through serial …

Design And Development Of A Quartz Crystal Microbalance Immunosensor For Exosomes, Wesley Cox

Chancellor’s Honors Program Projects

No abstract provided.

Policy Of Current Hospital Translation Services And Recommendations For Future Adjustments For Spanish-Speaking Patients, Isidora Rose Beach

Baker Scholar Projects

It is a seldom-discussed fact that English-speakers in America enjoy a quality of health care that is not necessarily afforded to non-native speakers receiving care at the same facilities. Policy regarding what is required of health institutions in terms of translation services is exceedingly vague, and implementation of this policy is inconsistent. This lack of guidance makes it possible for many patients needing interpreters to fall through the cracks. This project will examine current policy guiding interpretive services in the U.S., and will recommend more specific guidelines that would improve quality of care for limited English proficiency individuals. This project …

Policy Of Current Hospital Translation Services And Recommendations For Future Adjustments For Spanish-Speaking Patients, Isidora Rose Beach

Chancellor’s Honors Program Projects

No abstract provided.

Investigating The Regulation Of Indole-3-Acetic Acid Production By The Plant Associated Microbe Pantoea Sp. Yr343, Kasey Noel Estenson

Doctoral Dissertations

The auxin indole-3-acetic acid (IAA) plays a central role in plant growth and development and many plant-associated microbes produce IAA. Several IAA biosynthetic pathways have been identified in microbes which use the precursor tryptophan. Pantoea sp. YR343, which was isolated from the Populus deltoides rhizosphere, is a robust plant root colonizer that produces IAA. Using genomic and metabolomics analyses, we predicted that the indole-3-pyruvate (IPA) pathway is the major pathway in Pantoea sp. YR343 for IAA production. To better understand IAA biosynthesis and the effects of IAA exposure on cell physiology, we performed proteomics on Pantoea sp. YR343 grown in …

Development Of A Patient Machine Time Model To Evaluate Dose Perturbation By Respiratory Tumor Motion In Pencil Beam Scanning Proton Radiation Therapy, Mark Artz

Doctoral Dissertations

The pencil beam scanning (PBS) modality for delivering intensity modulated proton radiation therapy is being adopted quickly. Drawing from the dosimetric advantages provided by the Bragg Peak, PBS proton therapy has been shown to produce dose distributions with improved healthy tissue sparing.

Although PBS proton therapy is very promising, lung cancer treatment is not without its challenges. Rapid tissue density changes and respiratory tumor motion present a particularly difficult treatment geometry. The tumor moves continuously within the lung as the patient breathes.

In this project, the dose perturbation of a PBS proton therapy lung plan is evaluated and time based …

Cognitive Functioning Of Drumming And Rhythm Therapy For Neurological Disorders, Logan James Deyo

Chancellor’s Honors Program Projects

No abstract provided.

Icloudecg: A Mobile Cardiac Telemedicine System, David S. Clifford

Masters Theses

With rising healthcare costs and a substantially growing number of patients 65 or over, the benefits of telemedicine and patient self-monitoring systems are becoming increasingly evident. Patients, physicians, hospitals, and even insurance providers benefit from vigilant, cost-effective patient monitoring systems. This thesis describes the development of a portable, smart-phone connected system for continuous cardiac monitoring. The system is capable of continuously monitoring the conditions of the heart, automated detection of cardiac arrhythmias, and real-time notifying patients and physicians of the detected abnormalities. The system consists of four main subsystems: 1) a Bluetooth capable chest-strap ECG, 2) an Android-enabled mobile device, …

Fiber Optic Bandage, Logan Mcneil, Cameron Pilkey, Brittani Erwin, Adam Wojnar

Faculty Publications and Other Works -- Biomedical and Diagnostic Sciences

The purpose of this document is to show the report for the Fiber optic device formulated through the biomedical engineering department with a senior design group. A growing issue in medical technology is open wound care. Particularly prevalent in diabetics, open wound care is expensive and time consuming. Certain wavelengths of light have not only shown to have germicidal properties, but also allow cell growth and regeneration. The following design was founded around these ideas, and an initial design was developed. The design centered around using fiber optics as a means of replacing a wet bandage in a normal wound …

The Characterization Of Amyloid Fibrils And Novel Synthetic Heparin-Binding Peptides Binding To Cell Surfaces, Nicole Marie Hackenbrack

Chancellor’s Honors Program Projects

No abstract provided.

Fiber Optic Bandage, Logan Mcneil

Chancellor’s Honors Program Projects

No abstract provided.

Dynamic Simulation And Neuromuscular Control Of Movement: Applications For Predictive Simulations Of Balance Recovery, Misagh Mansouri Boroujeni

Doctoral Dissertations

Balance is among the most challenging tasks for patients with movement disorders. Study and treatment of these disorders could greatly benefit from combined software tools that offer better insights into neuromuscular biomechanics, and predictive capabilities for optimal surgical and rehabilitation treatment planning. A platform was created to combine musculoskeletal modeling, closed-loop forward dynamic simulation, optimization techniques, and neuromuscular control system design. Spinal (stretch-reflex) and supraspinal (operational space task-based) controllers were developed to test simulation-based hypotheses related to balance recovery and movement control. A corrective procedure (rectus femoris transfer surgery) was targeted for children experiencing stiff-knee gait and how this procedure …

A Computational, Topological Approach To Icu Mortality Rate Prediction With Data Relationship Realization, Adam Michael Aaron

Masters Theses

The objective of this work is to predict the mortality of intensive care unit patients based on their physiological data and understand the relationships between physiological data. Such a model may be used to prioritize care when resources are limited or identify patients that will need significant care in the immediate future. This effort will take a novel approach applying computational topological analysis to classify patients. The algorithm predicting the patient outcomes is trained using an evolutionary algorithm. The dataset used is from the 2012 PhysioNet Computing in Cardiology Challenge. A set containing 4000 records with outcomes was used to …