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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 2024 University of Nebraska Medical Center

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 …


Mortality In Medicine, Maren Dougherty 2024 Bridgewater College

Mortality In Medicine, Maren Dougherty

Honors Projects

Practitioners in the medical field attend to health issues across one’s lifespan from birth to death and everything in between. A common conflict in today’s practice of medicine is establishing the true function of medicine. The complete reliance on medicine to ward off death proliferates the biomedicalization of natural life processes, like death. Biomedicalization is the process in which medical authority and its accompanying technology begin to control other aspects of daily life. With medicine’s ultimate goal being to cure disease and fight death, it interferes with the inevitability of human mortality. End-of-life treatment can be taken too far without …


Implementing A Standardized Protocol For Early Detection Of Undiagnosed Hypertension Patients, Jenscena Hansen, Chris Bell 2024 University of Nebraska Medical Center

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 …


Impact Of Medicaid Redetermination On Underserved Populations In Region 7 States: A Review, Brianna Parr 2024 University of Nebraska Medical Center

Impact Of Medicaid Redetermination On Underserved Populations In Region 7 States: A Review, Brianna Parr

Capstone Experience

When the COVID-19 Public Health Emergency ended in May of 2023, Medicaid began the process of redetermination across the states and returned to its original eligibility rules. Because of this, the healthcare status of many Americans was affected, resulting in the loss of healthcare coverage for millions of people. Of those who have lost coverage, children make up almost half of the total. This paper assesses the negative effects of Medicaid redetermination on children and other underserved populations in communities across the four states in Region 7 (Nebraska, Iowa, Missouri, and Kansas) and identifies programs that these states can implement …


Evaluating Nurses’ Turnover Intention And Organizational Commitment Following Stroke Unit Staffing Changes: An Evidence-Based Quality Initiative, Heather Tatusko 2024 Otterbein University

Evaluating Nurses’ Turnover Intention And Organizational Commitment Following Stroke Unit Staffing Changes: An Evidence-Based Quality Initiative, Heather Tatusko

Doctor of Nursing Practice Scholarly Projects

Nurses are known to be overworked, overwhelmed, undervalued, and understaffed at dangerous levels throughout various inpatient hospital units across the United States (U.S.). Hospital registered nurse (RN) turnover is a significant issue that has accelerated since the COVID-19 pandemic, resulting in economic impacts and other burdens for organizations, individuals, and communities. Evidence suggests that evaluating Registered Nurses’ Turnover intention (NTI) and Organizational Commitment (OC) can help maintain a ready and capable team of skilled RNs; however, most healthcare organizations (HCOs) do not collect or analyze NTI and OC data and focus on staffing numbers and monetary incentives to get adequate …


Procedural Oxygen Mask Use For Inpatient Bariatric Endoscopy: A Scoping Review, Makinlee Meadows, Marion Millette, Brittany Morgan, Lauren Pegrim, William Collier Phillips, Dwayne Accardo DNP, CRNA, FAANA, Tracy McClinton DNP, AG-ACNP-BC, APRN 2024 University of Tennessee Health Science Center

Procedural Oxygen Mask Use For Inpatient Bariatric Endoscopy: A Scoping Review, Makinlee Meadows, Marion Millette, Brittany Morgan, Lauren Pegrim, William Collier Phillips, Dwayne Accardo Dnp, Crna, Faana, Tracy Mcclinton Dnp, Ag-Acnp-Bc, Aprn

Doctor of Nursing Practice Projects

Purpose/Background

Hypoxia is a severe adverse event that is often associated with sedated endoscopy procedures, and bariatric patients have a significantly higher risk for complications related to oxygenation during sedation due to pathophysiological changes to the respiratory system. This scoping review compares the rate of hypoxemic events with the use of a binasal cannula versus a procedural oxygen mask during inpatient endoscopic procedures in patients aged 19-64 with a BMI greater than 40.

Methods

The scoping review includes control trials with and without randomization, case-control/cohort studies, systematic reviews, and qualitative/descriptive studies. With limited research regarding the PICOT, extending the age …


Comparing The Effects Of The Induction Of Anesthesia With Etomidate To The Induction Of Anesthesia With Midazolam On The Incidence Of In-Hospital Mortality: A Scoping Review, Madison Hayes BSN, RN, Ashley Lynch BSN, RN, Scott Jamison BSN, RN, Mary Joiner BSN, RN, Gray Seymour BSN, RN, Dwayne Accardo DNP, APRN, CRNA, Tracy McClinton, DNP, APRN, AGACNP-BC, EPB-C 2024 University of Tennessee Health Science Center

Comparing The Effects Of The Induction Of Anesthesia With Etomidate To The Induction Of Anesthesia With Midazolam On The Incidence Of In-Hospital Mortality: A Scoping Review, Madison Hayes Bsn, Rn, Ashley Lynch Bsn, Rn, Scott Jamison Bsn, Rn, Mary Joiner Bsn, Rn, Gray Seymour Bsn, Rn, Dwayne Accardo Dnp, Aprn, Crna, Tracy Mcclinton, Dnp, Aprn, Agacnp-Bc, Epb-C

Doctor of Nursing Practice Projects

Purpose/Background

The induction of anesthesia using hypnotic sedatives, such as etomidate and midazolam, is common practice. Etomidate and midazolam are commonly employed in the induction of anesthesia in the septic patient population, each with its unique advantages and drawbacks. This scoping review aims to synthesize evidence on the effects of anesthetic induction with etomidate versus midazolam in adult septic patients, focusing on the incidence of mortality and associated adverse effects during hospitalization. The purpose is to establish a standard of care for anesthetic induction in this population.

Methods

A literature review was conducted from September 2022 to March 2023 utilizing …


Medicinal Treatment Versus Dialysis In End Stage Renal Disease Patients With Perioperative Hyperkalemia: A Scoping Review, Haley Bishop, BSN, RN, Hannah White, BSN, RN, Matthew Wilhaucks, BSN, RN, Ashton Weaver, BSN, RN, Christin Simpson, BSN, RN, Margaret Harvey, PhD, ACNP-BC, CHFN 2024 University of Tennessee Health Science Center

Medicinal Treatment Versus Dialysis In End Stage Renal Disease Patients With Perioperative Hyperkalemia: A Scoping Review, Haley Bishop, Bsn, Rn, Hannah White, Bsn, Rn, Matthew Wilhaucks, Bsn, Rn, Ashton Weaver, Bsn, Rn, Christin Simpson, Bsn, Rn, Margaret Harvey, Phd, Acnp-Bc, Chfn

Doctor of Nursing Practice Projects

No abstract provided.


Referral To In-Person Smoking Cessation Counseling As A Smoking Cessation Aid, Annie Mandrell BSN, RN, Matthew Keathley BSN, RN, Lewis Linden BSN, RN, Laura Reed DNP, APRN, FNP-BC, CNE 2024 University of Tennessee Health Science Center

Referral To In-Person Smoking Cessation Counseling As A Smoking Cessation Aid, Annie Mandrell Bsn, Rn, Matthew Keathley Bsn, Rn, Lewis Linden Bsn, Rn, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Referral to In-Person Smoking Cessation Counseling as a Smoking Cessation Aid

Purpose/Background

Smoking increases an individual’s risk of acute and chronic disease morbidity and mortality, as well as creating a financial burden for the individual and healthcare system. In the United States, tobacco smoking is the leading cause of preventable death. There are an estimated 5 million tobacco-related deaths each year due to tobacco smoking. Additional healthcare costs are also seen due to the need for increased treatments, medical supplies, and staffing. Previous research for smoking cessation resources has primarily focused on traditional primary care offices. Research shows that in-person …


A Conceptual Model Of Organizational Compassion In Healthcare, Rachel Thienprayoon, Eli Awtrey, Teresa Pestian, Beth A. Lown, Naomi Winick, Jason Kanov 2024 Cincinnati Children's Hospital Medical Center

A Conceptual Model Of Organizational Compassion In Healthcare, Rachel Thienprayoon, Eli Awtrey, Teresa Pestian, Beth A. Lown, Naomi Winick, Jason Kanov

Journal of Wellness

Introduction: In healthcare, while the suffering of patients is often evident, the suffering of clinicians receives less focus. Some sources of clinician distress are directly related to constant exposure to patient suffering, but others are caused by the health care system, and thus potentially preventable. Looking at clinician suffering through the lens of compassion fosters a new paradigm of individual, team, and organizational capabilities, and moves the responsibility to alleviate this suffering from the individual onto the organization and team. Yet research into the impact of organizational compassion in healthcare has been extremely limited.

Approach: Our conceptual model of organizational …


Evaluating The Efficacy Of Universal Depression Screenings In The High School Setting, Telisha Anthony MSN, FNP-BC, Jennifer Thorsen BSN, RN, Jackie Sharp DNP, PMHNP-BC, Sharon Little DNP, FNP-BC 2024 University of Tennessee Health Science Center

Evaluating The Efficacy Of Universal Depression Screenings In The High School Setting, Telisha Anthony Msn, Fnp-Bc, Jennifer Thorsen Bsn, Rn, Jackie Sharp Dnp, Pmhnp-Bc, Sharon Little Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Depression in adolescents is rising each year. Early detection of depression has been shown to result in better health outcomes and success in school. This scoping review aims to evaluate the implementation of universal depression screenings in the high school setting and how this detection of depression and initiation of treatment.

Methods

From August 2022 to November 2023, we used the Medline, PubMed, Elsevier, Google Scholar, and PsycINFO databases, using specific keywords related to depression in adolescents. Of the 38 articles found, 10 were chosen after extensive article critique. The publication dates ranged from 2014-2023, were full-text, and from …


Evidence-Based Practice Education For Nurses Caring For Oncology Patients With Chemotherapy-Induced Peripheral Neuropathy: A Quality Improvement Project., Natalie N. Ellis, Pamela Hardesty 2024 University of Tennessee, Knoxville

Evidence-Based Practice Education For Nurses Caring For Oncology Patients With Chemotherapy-Induced Peripheral Neuropathy: A Quality Improvement Project., Natalie N. Ellis, Pamela Hardesty

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

BACKGROUND: Nurses are one of the primary sources of information for patients during their healthcare journey. Patient education can mean the difference between a positive and negative outcome. Oncology patients undergoing chemotherapy are an especially vulnerable population and education and preparation for potential side-effects related to chemotherapy is important. There are several ways to control chemotherapy-induced side effects (CISE). One of the debilitating side effects can be chemotherapy-induced peripheral neuropathy (CIPN). While difficult to manage, the support of nursing staff to encourage patients to take an active role in their care could help decrease the risk of CIPN and improve …


The Impact Of Social Determinants Of Health On Adherence To Urinary Tract Infection Treatment: A Scoping Review, Barrett S. Patel, MS, BSN, RN, Emily A. Gentry, BSN, RN, Sally Humphrey DNP, APRN, CPNP-PC, Bobby Bellflower DNSc, NNP-BC, FAANP, FNAP 2024 University of Tennessee Health Science Center

The Impact Of Social Determinants Of Health On Adherence To Urinary Tract Infection Treatment: A Scoping Review, Barrett S. Patel, Ms, Bsn, Rn, Emily A. Gentry, Bsn, Rn, Sally Humphrey Dnp, Aprn, Cpnp-Pc, Bobby Bellflower Dnsc, Nnp-Bc, Faanp, Fnap

Doctor of Nursing Practice Projects

Purpose/Background

Urinary tract infections (UTIs) are a common diagnosis among children. Patients must fully comply with treatment regimens to reduce the risk of recurring UTIs and prevent long-term complications. This scoping review aims to evaluate the literature and examine the association between screening for social determinants of health (SDH) and adherence to UTI treatment.

Methods

A thorough literature search via PubMed, Cochrane Library, Elsevier Clinical Key, CINAHL, and JAMA was conducted with the following keywords: Pediatric UTI, Adherence to Treatment Plans, Social Determinants of Health, Social Needs Screening, and others. Ten articles were appraised for their evidence and quality. The …


Patient Throughput In The Emergency Department, Daniel Alanis 2024 University of Texas at Tyler

Patient Throughput In The Emergency Department, Daniel Alanis

MSN Capstone Projects

In response to ongoing overcrowding in emergency departments, it is imperative to explore effective strategies for mitigating the capacity crises. The purpose of this project is to investigate and implement throughput strategies for a large level 1 trauma emergency department in Houston’s Texas Medical Center. The proposal involves launching a process improvement project to identify opportunity potential for two main interventions: 1. Patient classification for split clinical pathways 2. Dedicated liaison role for throughput responsibilities. The review aims to answer the question: In emergency department patients, how does the implementation of a dedicated throughput liaison compared to a split flow …


Reducing Central Line-Associated Bloodstream Infections (Clabsi) With Chlorhexidine-Impregnated Dressings, Sara Garcia 2024 University of Texas at Tyler

Reducing Central Line-Associated Bloodstream Infections (Clabsi) With Chlorhexidine-Impregnated Dressings, Sara Garcia

MSN Capstone Projects

Mitigating and eradicating central line-associated bloodstream infections (CLABSI) is a vital patient safety priority. These healthcare-associated infections lead to patient fatalities and incur costly, preventable expenses. Therefore, it is imperative to assess central venous catheter (CVC) maintenance protocols to mitigate the likelihood of infection. Federal guidelines advocate using chlorhexidine (CHG) dressings to lower this risk (Centers for Disease Control and Prevention, 2017). A comprehensive central line maintenance bundle includes incorporating a CHG dressing as a critical measure in reducing the risk of CLABSI (Buetti et al., 2022). Consequently, the escalating infection rates underscore the necessity for implementing CHG dressings (Buetti …


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 2024 University of Tennessee Health Science Center

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 …


Lai Antipsychotics Vs. Oral Antipsychotics: Treatment Adherence, Relapses, And Readmissions, Natalie N. Lewis BSN, RN, Mallory F. Johnson BSN, RN-BC, Tyler N. Halle-Todd BSN, RN, Natalie N. Ragland BSN, RN, Sharon H. Little DNP, APRN, FNP-BC, Jacqueline Sharp DNP, APRN,PMHNP-BC 2024 University of Tennessee Health Science Center

Lai Antipsychotics Vs. Oral Antipsychotics: Treatment Adherence, Relapses, And Readmissions, Natalie N. Lewis Bsn, Rn, Mallory F. Johnson Bsn, Rn-Bc, Tyler N. Halle-Todd Bsn, Rn, Natalie N. Ragland Bsn, Rn, Sharon H. Little Dnp, Aprn, Fnp-Bc, Jacqueline Sharp Dnp, Aprn,Pmhnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Schizophrenia is a lifelong illness with recurrent and often debilitating symptoms that may impair daily functioning, cognition, behaviors, socialization, emotions, and expression. It is recognized as a global mental health burden that affects the individual, their family, and society. Medication nonadherence and resulting relapse detrimentally affect the patient’s physical and mental health and quality of life. They are associated with increased hospitalization and emergency room visits, substance use, suicide, and homelessness. Current guidelines endorse second-generation antipsychotics such as Risperidone and Aripiprazole as the first-line treatment for most cases of psychosis. However, long-acting injectable (LAIs) atypical antipsychotics are a promising …


Effects Of A Compassion Fatigue Workshop On Psychiatric Mental Health Nurses, Johnnie Elizabeth Bower BSN, Mary Johnson DNP 2024 University of Tennessee, Knoxville

Effects Of A Compassion Fatigue Workshop On Psychiatric Mental Health Nurses, Johnnie Elizabeth Bower Bsn, Mary Johnson Dnp

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

BACKGROUND: Compassion fatigue (CF) is a collection of symptoms associated with exposure to traumas experienced by other people. Nursing is one of the professions that experiences CF from recurrent exposure to patient and family distress and from potential acts of abuse at work. Nurses working in behavioral health are one of the highest at risk for CF. Of newly graduated behavioral health nurses, 17.5% leave the field after one year and 33.5% leave after two. Signs of CF include hopelessness, feelings of inadequacy, anxiety, depression, fatigue, and increased absenteeism. Training in self-care techniques and mindfulness builds nurse resilience and …


Assessment Of Condylar Morphology In Various Facial Types-Cbct Study, DR.SHRUTI PATIL 2024 SDM College of Dental Sciences and Hospital, A constituent Unit of Shri Dharmasthala Manjunatheshwara University, Dharwad, Karnataka, India

Assessment Of Condylar Morphology In Various Facial Types-Cbct Study, Dr.Shruti Patil

Annual Research Symposium

Mandibular condyle being part of the TMJ complex, its volume and shape play a pivotal role in treatment stability and outcomes in orthodontic and orthognathic patients over long term periods. Different loading patterns would result in different morphology of the TMJ. The association with different facial types and understanding the relationship between condylar position, morphology and jaw base divergence is limited. This study’s objective is to assess the condylar structure which includes condylar height, width and height of the fossa in different jaw base divergences.

A cross-sectional study was conducted in which 90 patients undergoing Orthodontic treatment were selected and …


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 2024 University of Tennessee Health Science Center

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 …


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