Health and Medical Administration Commons^™

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 …

Evidenced-Based Strategies To Increase Cervical Cancer Screening Rates, Tuong Cat Vo Bsn-Rn, Nada Salloukh Bsn-Rn, Tatiana Elena Swanson Bsn-Rn, Xiao Mie Cindy Zhu Bsn-Rn, Laura Taylor Reed Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Cervical cancer is the fourth leading cause of cancer affecting women worldwide (Staley et al., 2021). With cervical cancer being a preventable disease, an effective method of reducing healthcare costs and mortality is primary prevention, such as screenings. Financial burdens and barriers to accessing medical care may result due to the lack of proper cervical cancer screenings. Detecting cervical cancer includes screening women 21 to 65 years old with a Papanicolaou (PAP) test every three years. Women aged 30 to 65 years old can extend the screening of cervical cancer by having a Human Papillomavirus (HPV) test along with …

The Impact Of Patient And Provider Education On Statin Therapy Initiation And Adherence In Type Ii Diabetics, Jane Harlan Bsn-Rn, Lindsey Jacobsen Bsn-Rn, Emily Easterly Bsn-Rn, Mitch King Bsn-Rn, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Purpose/Background

Type 2 diabetes mellitus (T2DM) is a common, chronic disease that increases the risk of coronary artery disease and stroke fourfold, which makes protecting cardiac function a priority. The American Diabetes Association (ADA) and American Heart Association (AHA) recommend the prescription of statins to reduce cardiovascular complications. Unfortunately, provider and patient adherence to this recommendation is poor.This study aimed to determine if shared-decision making and patient follow-up within a 6 month period of being newly diagnosed with T2D has an effect on the initiation rate of statin therapy.

Methods

In this retrospective study we requested data from the University …

Implementation Of A Standardized Suicide Screening Process In A University Student Health Clinic: A Quality Improvement Project, Addie Grace Strong, Kathryn Dambrino, R. David Phillippi, Linda Wofford

DNP Scholarly Projects

Background: Suicide is a leading cause of death among college age students, prompting the need for evidence-based screening tools like the Columbia Suicide Severity Rating Scale (C-SSRS) to enable early detection and timely intervention. Inconsistencies in suicide screening may pose a risk of missed intervention opportunities. This Doctor of Nursing Practice project specifically aimed to improve the quality and consistency of suicide screening in a university student health clinic by implementing the C-SSRS tool into the clinic workflow during mental health appointments. Methods: Employing a quality improvement framework, this scholarly project followed the Institute for Healthcare Improvement Model for Improvement …

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 …

Antibiotic Stewardship In Patients With Viral Upper Respiratory Illness: Improving Quality Measures In Retail Health, Meredith A. Nolan, Robin Harris, Clay Smith

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

BACKGROUND: Millions of people will die from antibiotic-resistant bacterial infections in the next 30 years. Retail health providers are pivotal in this global epidemiological problem.

LOCAL PROBLEM: Setting included 15 retail health clinics operated by Vanderbilt University Medical Center in Middle Tennessee. Project examined provider education, patient engagement, and commitment to antibiotic stewardship, components of the CDC's Core Elements of Outpatient Antibiotic Stewardship framework. Specific aims were that providers would have a significant reduction in the percentage of antibiotics prescribed for viral illness over the study period.

METHODS: Using the Evidence-Based Practice Improvement Model, a Quality Improvement …

Reducing Copd Readmissions Through The Implementation Of A Guideline-Based Clinical Pathway: An Evidence-Based Practice Improvement Project, Hannah F. Hall, Allyson Neal, Samantha Bauer

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

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide. It is characterized by airway inflammation and damage that inhibits appropriate airflow. Exacerbations of COPD (ECOPD) hasten disease progression and have profound impacts on the patients.

Local Problem: East Tennesseans experience higher rates of COPD than the rest of the state. Community members at the project site identified that the inpatient management of ECOPD is inconsistent and discordant with the 2023 Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. The purpose of this project was to reduce readmissions and increase guideline concordance by developing an algorithm …

Effect Of Certified Diabetes Clinical Education Specialists On Adults With Type 2 Diabetes, Rachel Faller, Tracy Gregory, Michelle Jones, Peyton Barnett, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Purpose/Background

Type 2 diabetes mellitus affects 13.1% of adults living in Shelby County and over 30 million adults in the United States. This chronic disease creates a higher risk of macrovascular and microvascular complications for this population resulting in poor outcomes if not properly managed. Improving glycemic control can help to improve the quality of life for people living with diabetes and reduce healthcare costs. Currently 20% of funds spent in the United States on healthcare is utilized for diabetic care. Certified Diabetes Care and Education Specialists (CDCES) primarily educate patients about managing their diabetes, including health promotion that can …

Initiating Culturally-Directed Education For Hispanic Adults With Type 2 Diabetes Mellitus, Marie Davis, Jennifer Smith, Mandy Horner

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

BACKGROUND:

The U.S. Hispanic population has the highest rate of Type 2 diabetes mellitus (T2DM), which is influenced by socio-economic status and language barriers. Current evidence suggests that the delivery of culturally-directed Diabetes Self-Management Education (DSME) with the use of an interpreter can reduce diabetes-associated complications.

LOCAL PROBLEM:

The project took place at a free clinic in North Carolina. The purposes of this project was to create a culturally-directed DSME bundle for Hispanic adults with the use of a Spanish interpreter to improve understanding of T2DM management.

METHODS:

The Johns Hopkins Nursing Evidence-Based Practice Model (JHNEBP) was …

How Soon Is Too Soon? A Quality Improvement Approach To Postoperative Length Of Stay Following Transcatheter Aortic Valve Replacement, David Brian Jones, Robin Harris, Paul N. Fiorilli Md, Allyson Neal

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

BACKGROUND: Heart valve disease prevalence is expected to rapidly increase over the next twenty years. Aortic stenosis, the most common valvular disorder, is a significant cause of heart failure hospital admissions and high mortality if left untreated. Treatment options include surgical aortic valve replacement (SAVR) and the more popular transcatheter aortic valve replacement (TAVR). The rapid increase of TAVR procedures generates hospital bed capacity issues, and there is no recommendation defining the minimum length of stay (LOS) following TAVR.

LOCAL PROBLEM: The setting was a 1,100-bed academic medical center in southeastern Pennsylvania with an average annual TAVR volume …

A Systematic Review: Mirror Neurons & Schizophrenia, Yashesvi Sharma, Surajit Dey

Annual Research Symposium

This research project establishes a link between Mirror Neuron System (MNS) activity and this information's implications in treating and understanding schizophrenia, specifically, schizophrenic patients with negative symptoms.

Governmental Affairs Update: Dental Medicaid, Neema Katibai Jd

The Journal of the Michigan Dental Association

The MDA spearheads an initiative to enhance Medicaid anesthesia services reimbursement, aiming to address the disparity between current rates and commercial standards. Despite recent improvements in Medicaid dental benefits, access to care remains hindered by low anesthesia reimbursement rates. The MDA advocates for a substantial investment to increase reimbursement to 85% of commercial rates, garnering support from various medical associations. This collaborative effort marks a significant stride towards achieving equitable Medicaid reimbursement. Grassroots advocacy is pivotal in influencing state budget decisions, urging constituents to engage with legislators via MDA text alerts.

An Educational Intervention Differentiating Pressure Injuries From End-Of-Life Wounds, Alicia Perez Varela, Annette Callis

Providence Nursing Research Conference 2023 – Present

Background

End-of-life (EOL) wounds are identified in the literature as Kennedy Terminal Ulcers (KTU), Skin Failure (SF), Trombley-Brennan Terminal Tissue Injury (TB-TTI), and SCALE (Skin Changes at Life’s End). EOL wounds have a similar appearance to pressure injuries (PIs) with a fundamentally different etiology. The misclassification of EOL wounds as PIs results in increased Hospital Acquired Pressure Injuries (HAPI), hospital fines, and less-than-optimal EOL wound management.

Purpose

To examine the effectiveness of an educational intervention on EOL wounds in increasing nurse confidence in providing End-of-Life Care (EOLC) and differentiating PIs from EOL wounds.

Methods

This quasi-experimental study used the 28-item …

Revolutionizing Denture Excellence: An Invigorating In-Vitro Exploration Of Organic Products In Prosthetic Rehabilitation, Nighila Ravindran, Sneha Joseph, Aswani Surya K

Annual Research Symposium

The denture base comes into contact with diverse substances in the oral cavity, acting as a reservoir for microorganisms like corynebacterium, streptococcus, lactobacillus, and candida. This colonization elevates the risk of complications such as denture stomatitis and candidiasis. Commercial denture cleaners have explored the use of natural ingredients, less commonly employed but offering various advantages. These ingredients aim to mitigate the potential issues associated with microbial colonization on denture surfaces, contributing to improved oral hygiene for denture wearers. The exploration of natural elements reflects a nuanced approach to denture care, considering both efficacy and less conventional alternatives.

Investigating Racial And Ethnic Healthcare Disparities In Screenable Ob/Gyn-Related Cancers, Lara Laughrey

Annual Research Symposium

This is a scoping review of peer-reviewed literature addressing healthcare inequity based on race and ethnicity with a specific focus on Ob/Gyn-related management and treatment of screenable cancers.

Assessment Of Emotional Intelligence Among Students In Dental College, Gowri Nandana S Final Year Student, Sudeep C. B Professor And Head Of The Department Of Public Health Dentistry

Annual Research Symposium

Over an extended period, the examination of intelligence predominantly centered on the adaptive deployment of cognitive abilities. In more recent times, scholars such as Gardner (1983) and Sternberg (1988) have proposed comprehensive frameworks for comprehending intelligence. Pioneering the concept of "emotional intelligence," Salovey and Mayer (1990) posited that emotional intelligence encompasses three distinct categories of adaptive capabilities: the evaluation and expression of emotions, the regulation of emotions, and the utilization of emotions in problem-solving. The objective is to evaluate emotional intelligence among dental students across various educational institutions.

Quality Of Life In Orthodontics, Claudia Eisenhuth, Gabriel Eisenhuth, Connor Schwartz, Amir Mohajeri, Man Hung, Tiffany Nelson, Ryann Glenn

Annual Research Symposium

Orthodontic treatment goes beyond mere cosmetic enhancement; it significantly impacts various aspects of an individual's quality of life. Beyond the physical benefits of improved oral function and prevention of dental issues, orthodontics also yields profound psychological benefits. Aligned teeth enhance self-confidence, reduce social anxiety, and contribute to better relationships and professional opportunities. Moreover, addressing dental concerns through orthodontic treatment reduces psychological distress and promotes overall happiness and satisfaction. Real-life case studies vividly illustrate the transformative effects of orthodontic interventions, emphasizing the importance of considering quality of life outcomes in dental care.

Exploring The Interconnected Role Of The Oral Microbiome And Periodontal Disease In The Development And Progression Of Oral Squamous Cell Carcinoma, Malak Al-Regib, Claudia M. Tellez Freitas

Annual Research Symposium

This comprehensive review explores the complex linkage among the oral microbiome, periodontal disease, and the onset and progression of oral squamous cell carcinoma (OSCC).

Investigating The Role Of Chaos In Minimizing Tumor Growth, Maxwell Geiger

Annual Research Symposium

Chaos is a type of motion found in mathematical systems that is highly sensitive to initial conditions. While many biological systems described in literature have been analyzed for the presence of chaotic dynamics, there are still many that are yet to be discovered. The goal of this project is to reassess Itik and Banks’ discovery of chaotic behavior in their population dynamics model of cancer growth. Once chaotic behavior is confirmed, we want to investigate how chaos could possibly be controlled to minimize tumor growth and discover novel treatments for cancer patients.

The National Status Of Pharmacists’ Ability To Prescribe Hormonal Contraceptives, Aleese Smith, Urvi Patel, Alexandra Arledge, Josie Young, Erin Johanson

Annual Research Symposium

The scope of practice for pharmacists first expanded in California and Oregon with the ability to prescribe hormonal contraceptives to patients in their communities. Since 2016, over 33 states now allow for pharmacist prescribing of birth control in their pharmacy practice laws.

90% of Americans live within 5 miles of a retail pharmacy, making community pharmacies an accessible resource who may otherwise be unable to access contraceptives. The gap in care experienced by certain patient populations is now being filled by pharmacists with their ability to prescribe birth control.

" Does Educational Level Affect The Outcome Of Myocardial Infarction? ", Ahmed Magdy Ahmed Elsayed

Theses and Dissertations

Background: Heath awareness plays a major role in determining the outcomes of serious medical conditions specially when response time is crucial. STEMI patients are prone to serious compilations if they didn’t receive the appropriate treatment on time. Raising the health awareness of the community would result in seeking medical help at earlier stage of the disease. Earlier presentation to the medical center would result in better health outcomes. Certain factors form the health awareness of the community. This includes educational level, previous exposure to similar situations, and exposure to health awareness materials.

Methods: This is a cohort study in …

Ligaplant: Recreating Natural From Artificial, Disha Kamavisdar

Annual Research Symposium

Missing teeth can be substituted by the use of the dental implants. The most widely used implants in the current scenario are the osseointegrated implants with various shortcomings and the most prominent one is the lack of the periodontal ligament. To overcome this, implants with periodontal ligaments can be procured and this can be possible by the application of the tissue engineering concept along with suitable implant material.

Application Of In-Silico Computational Biology Strategies To Demonstrate Mechanism Of Oral Cancer Cell Death By Natural Peptide, Dr Dominic Augustine

Annual Research Symposium

This research work is designed to identify biomolecules from Earthworm Coelomic Fluid (ECF) of Eudrilus Eugeniae (EE) that can inhibit oral cancer cells from proliferating. The study aims to construct a homology model of the 18 kDa protein from ECF of EE (18-ECFP) with molecular dynamics simulation (MDS) to enable its molecular docking with pro-apoptotic caspase receptors with determination of binding energy scores. The study also evaluates the anti-cancer potential of 18-ECFP on SCC-9 cells in vitro by wet lab techniques.

Pathogenic Implications Of Candidal Species In Both Oral Cancer And Oral Potentially Malignant Disorders - A Review, Dr Dominic Augustine, Sowmya Sv, Kuntala Mondal

Annual Research Symposium

Oral squamous cell carcinoma (OSCC) is the 6th most common cancer in worldwide. Cigarette smoking, alcohol consumption, and betel quid chewing are its major risk factors other factors that can lead to OSCC include excessive sun exposure, viral or fungal infection, poor nutrition, and poor oral hygiene. The carcinogenesis of OSCC occurs gradually and oral epithelial dysplasia is considered a potential histologic precursor of OSCC. Most OSCC cases are preceded by clinically evident oral potentially malignant disorders (OPMDs). The aim of this review is to correlate the association between Candida species and oral potentially malignant disorders and its possible mechanisms …

Immunohistochemical Expression Of Cyclin D1 In Dentigerous Cyst, Odontogenic Keratocyst And Unicystic Ameloblastoma- An In-Vitro Study, Kuntala Mondal, Sv Sowmya, Dominic Augustine

Annual Research Symposium

Cyclin D1, a G1 cyclin member, regulates the transition of the cell cycle from the G1 phase to the S phase. The uncontrolled and elevated expression of cyclin D1 has been associated with rapid growth, heightened proliferative activity and increased histologic aggressiveness. Unicystic ameloblastoma pertains to cystic lesions that present clinical, radiographic, or gross features akin to jaw cysts. Nevertheless, upon histological scrutiny, these lesions display a distinctive ameloblastomatous epithelium lining the cystic cavity, with or without luminal or mural proliferation. This cystic variant of tumor bears substantial resemblances to dentigerous cysts, and occasionally, both entities can become indistinguishable upon …

An Immunohistochemical Panel For The Accurate Differentiation Between Mucoepidermoid Carcinoma And Pleomorphic Adenoma, Kuntala Mondal, Sv Sowmya, Dominic Augustine

Annual Research Symposium

Salivary Gland Tumors (SGTs) are a diverse group of neoplasms, with a wide range of histological subtypes, some of which can exhibit overlapping features. Amongst this group of tumors, Pleomorphic Adenoma (PA) and Mucoepidermoid Carcinoma (MEC) stand out as prevalent entities originating from the salivary glands. The accurate differentiation between these two entities is crucial for treatment planning, as it influences decisions regarding the extent of surgical resection. Because of the overlapping histopathological features, it is difficult to differentiate these two lesions with the help of conventional Hematoxylin & Eosin (H& E). The evaluation of Immunohistochemical (IHC) markers holds pivotal …

Cheiloscopic Characteristics Detection And Pattern Classification By Machine Learning Technique, Dr Dominic Augustine, Sowmya Sv

Annual Research Symposium

Machine Learning (ML) is a field enhancing the rapid growth of technology. Though use of digital softwares for cheiloscopic investigations have been attempted with limited success, the use of ML based techniques are scarce and seldom have been employed in forensic odontology. The present study aimed to identify cheiloscopic patterns through machine learning based methods and to correlate the segmented patterns with age and gender of individuals.

Association Between Abo Blood Grouping And Odontometry: An Unexplored Evidence In Forensics, Dr Dominic Augustine, Sowmya Sv

Annual Research Symposium

Recent research has exhibited a strong association between ABO blood groups and susceptibility to diseases. Extraoral and intraoral hard tissue landmarks provide a stable and reliable record for odontological and anthropological analysis, forensic investigations and identification. The association between anthropometric indices and ABO blood grouping have been reported in the past, however, the association between ABO blood groups and odontometric indices is yet to be comprehensively explored. This study aimed to establish the correlation of ABO blood groups with odontometric indices and extraoral hard tissue landmarks for personnel identification.

Advanced Techniques For Tooth Pulp Rna Extraction In Forensic Investigations-A Systematic Review, Kuntala Mondal, Sv Sowmya, Dominic Augustine

Annual Research Symposium

Teeth are fundamental structures in a forensic context due to their high strength and specificity. It is challenging to obtain high quality RNA from pulpal tissues. It has been described that pulp RNA degradation could be an indicator of post-mortem interval. Researchers have been in the quest to develop optimal techniques for tooth RNA extraction. The systematic review aimed to determine the most reliable method of RNA extraction from dental tooth pulp for forensic investigations.

Assessment Of Micrometastasis In Lymph Nodes Of Oral Squamous Cell Carcinoma –Attaining Excellence Through Immunohistochemistry, Dr Dominic Augustine, Sowmya Sv, Kuntala Mondal

Annual Research Symposium

Cervical lymph node metastasis is the most important prognostic factor in Squamous Cell Carcinoma of Head and Neck (SCCHN). Lymph node prognostic determinants hold immense significance in influencing both patient’s survival outcomes and the propensity for recurrence. The current study aimed to evaluate the diagnostic accuracy of Cyclin D1 and Pan-CK for the detection of lymph node micrometastasis in oral squamous cell carcinoma tissue sections and re-evaluate the tumor staging.