Honoring Veterans’ Wishes: Efficacy Of An Evidence-Based Shared Decision-Making Tool In Va Icu Goals-Of-Care Discussions, Stephanie Alexander, Anna Astashchanka Md, Venktesh Ramnath Md

Doctor of Nursing Practice Final Manuscripts

Abstract

Introduction: This Doctor of Nursing Practice project aimed to enhance the knowledge and confidence of the San Diego Veterans Health Administration’s (VASD) Intensive Care Unit (ICU) medical providers in goals-of-care discussions (GOCD). Additionally, this project aimed to improve the documentation of these discussions.

Background: Delays in GOCD can lead to futile medical and surgical interventions, inappropriate antibiotic use, and higher rates of mental health conditions in patients and their loved ones. Earlier GOCD are associated with lower ventilation and resuscitation rates, earlier hospice enrollment, reduced ICU admissions, lower financial costs, and better patient and caregiver quality of life. However, …

Improving Healthcare Workers’ Biohazardous Spill Safe Handling Skills, Zeina Mhanna, Ahmad Tassi

BAU Journal - Health and Wellbeing

All healthcare workers (HCWs) are exposed to biohazardous material. Biohazardous material may come in the form of spills, posing a risk of infection to (HCWs) who are not trained on how to safely handle them. While international guidelines recommend training HCWs on how to safely handle biohazardous spills in order to improve their skills, there are no studies that tackled this recommendation. The aim of this study is to improve HCWs’ biohazardous spill safe handling skills through training, and to evaluate the association between the HCWs’ improvement level and demographical characteristics. The study was conducted in a Southern Lebanese hospital …

Impact Of Provider Obesity Bias And Stigma In Western Medicine, Cassandra A. Da Valle-Chervellera, Madhu Sundarrajan, Lindsay Gietzen

Pacific Journal of Health

Societal obesity stigma is greatly impactful on one’s life that is experiencing obesity. Limited data is available discussing the impact obesity stigma has on care coordination. This is a commentary paper outlining current research addressing obesity stigma in United States medicine. From the limited research, verbal and non-verbal stigma surrounding obesity is prevalent in America. A call to action is vital to begin education with clinical providers. Increased education catalyzes the cultural shift within health care to improve clinical providers’ empathy and care coordination efforts for this vulnerable population. Learning more about obesity stigma and how clinical medical providers can …

Emotion Regulation Strategies And Perceived Emotional Intelligence: The Effect Of Age., Iwanna Sepiadou

Adultspan Journal

The aim of this study was to investigate the relationship between perceived emotional intelligence and the reported use of cognitive reappraisal and expressive suppression. We also investigated the possible effects of age on the aforementioned variables. The total sample consisted of 379 people (158 men, 220 women, 1 unreported). Across participants, 273 were young (20-39 years old) and 106 were middle-aged (40-65 years old). We found statistically significant positive correlations between the dimensions of perceived emotional intelligence and the reported use of cognitive reappraisal and negative primarily correlations between the dimensions of perceived emotional intelligence and the reported use of …

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 …

Identifying Srnas Individual Learning Preferences Utilizing The Vark Learning Inventory Tool, James Eads

Doctor of Nursing Practice Projects

Abstract

All graduates of a doctoral anesthesiology program are required to successfully pass the National Certifying Exam (NCE). Since 2011, the national average passage rate has decreased from 89.1% to 84.1% in 2021 (NBCRNA, 2023). Yamaguchi’s 2022 study revealed that students are positively impacted academically when they implement individual learning preferences. The purpose of this project was to identify individual learning preferences for students enrolled in the U.S. Army Nurse Anesthesiology program. The hypothesis was that students who recognize their preferred learning and incorporate preferred learning techniques would result in an increased percentage of passage rate scores for the NCE. …

Exploring Available Information On The Gut-Brain Axis And Alzheimer’S Disease For Clinicians Making Dietary Recommendations: A Scoping Review, Megan Gibson

Electronic Theses and Dissertations

Abstract: Alzheimer’s Disease (AD) is a complex neurodegenerative disease that requires interprofessional collaboration. Pharmacological options are currently ineffective, increasing the need for preventative strategies to combat the rise of AD. Considerations of gut-targeted interventions have increased as a key component in the prevention of AD, based on the understanding that the state of the gut microbiome can impact cognitive function through the pathway known as the gut-brain axis.

Methods: This scoping review explored information on the gut-brain axis in persons with AD. A comprehensive search was conducted in November 2023. Forty reviews and 13 human studies were analyzed.

Results: There …

Evaluating The Association Of Influenza Vaccination On Long-Term Covid-19 Symptoms In U.S. Adults, Ratnakar Pingili

Capstone Experience

Objective. To evaluate the association of influenza vaccination in the past 12 months with Long COVID effects and clinical and sociodemographic factors.

Methods. Cross-sectional study with data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS), covering 415,132 non-institutionalized U.S. adults with a confirmed COVID-19 diagnosis and influenza vaccination reported within the last 12 months. Logistic regression was conducted between influenza vaccination (exposure) and Long COVID (outcome), controlling for demographic variables, pre-existing health conditions, and socioeconomic status.

Results. Of 120,603 participants, 21.89% reported Long COVID symptoms and 42.04% had received an influenza vaccine. Findings indicate a statistically significant 13% reduction …

Dercum’S Disease: The Clinical Presentation, Diagnosis, Radiological Findings, And Treatment Of A Rare, Debilitating Inflammatory Disorder, Obyda Al-Housni, Constantinos Boufeas, Valori Slane

HCA Healthcare Journal of Medicine

Introduction

Dercum’s disease, also known as adiposis dolorosa, is a rare syndrome characterized by the growth of multiple, and painful, subcutaneous adipose tissues that commonly present in the abdomen and extremities. The scientific community hypothesizes that Dercum’s disease is a combination of neurologic and endocrine disorders. Patients commonly describe it as chronic adipose pain, which manifests as sporadic painful flares throughout their history with the disease.

Case Presentation

We share the case of a 32-year-old woman who presented to the emergency department for an acute episode of left lower extremity pain and swelling associated with a previously diagnosed history of …

Implementation Of An Education Program To Decrease Inpatient Falls, Elizabeth M. Carpenter, Jewyl Gibson

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

BACKGROUND: Inpatient falls are affecting 1 million patients across the United States every year with 25% of fall resulting in injury. Approximately 25% of falls are preventable with accurate assessment and appropriate fall precaution interventions. According to the literature, obtaining an accurate fall risk assessment is the first step in inpatient fall prevention.

LOCAL PROBLEM: Patient falls increased on 2 cardiac stepdown units in a level III trauma center in Knoxville, Tennessee. From 2020- 2022, the combined units experienced a 48% increase in patient falls. Nursing leadership identified staff knowledge deficits and inaccurate scoring of fall assessments as primary contributors …

Patients’ Perceptions Of Interprofessional Collaboration: A Scoping Review, Robynne Gilchrist Miss, Aayesha Kholvadia Dr, William (Bill) Burdick Prof

Patient Experience Journal

Collaboration has emerged as a pivotal element within an intentional person-centred healthcare framework. However, there is a need for evaluative feedback from patients to enhance interprofessional collaboration and its outcomes. The objective of this review was to describe the state of knowledge on the perspectives of patients living with a chronic condition regarding their experiences of interprofessional collaboration. A scoping review across five online databases (EBSCOhost, Google Scholar, PubMed Central, ScienceDirect, and Taylor & Francis Online; February 2023) identified all peer-reviewed literature published in English between the years 2018 and 2023 that reported on patients’ perspectives of, and experiences with, …

Education Of The Effects Of Obesity Medications And A Stepwise Approach To Mitigate Prevalence And Encourage Lifestyle Medicine For Primary Care Physicians, Kiely M. Curran

Department of Nutrition Student Projects

My Capstone project is an Educational Manual that emphasizes a healthcare team approach to the treatment and management of obesity. The Educational Manual consists of a standardized protocol in management of obesity in patients and a document with summarized references for primary care providers; and a simplified document for patient education. There is a growing interest in the usage of obesity medications. The purpose of my Capstone project is to provide a simplified manual for the primary care provider to reference to make knowledgeable and patient-centered decisions in the prescription of obesity medications and decisions in weight-management. My methodology included …

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 …

Working Under Pressure: Evidence-Based Risk Assessment And Pressure Injury Prevention In The Pediatric Intensive Care Unit, James A. Hutcheson Iv, Allyson M. Neal

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

Background: The hospital-acquired pressure injury (HAPI) can have physiologic, psychologic, and financial sequelae. Children are at increased risk secondary to immature physiology, developmental differences, and severity of illness. Evidence suggests presence of medical devices exponentiates HAPI risk.

Local Problem: Upward trends in HAPIs revealed nearly 50% are device related in the project setting, an urban Pediatric Intensive Care Unit. The Braden QD Scale was identified as best evidence for HAPI risk assessment. This initiative aimed to observe the ability of the Braden QD Scale as a predictor of HAPI risk as compared to current practice utilizing the Braden Q …

Improving Outcomes For Persons With Opioid Use Disorder By Introducing Buprenorphine In The Emergency Department, Emily Caroline Wegenka, Mary Johnson, Thomas Vajen

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

BACKGROUND: Opioid related death is the leading cause of accidental death in adults younger than 50 years old in the United States (US) with approximately 130 opioid related deaths daily. Emergency department (ED) visits for a non-fatal overdose, the one-year mortality is 4.7-5.5%. Studies show increased access to medications for opioid use disorder (MOUD) decrease morbidity and mortality related to OUD. Additionally, there is evidence that initiating MOUD in the ED increases engagement in outpatient follow up, also reducing morbidity and mortality associated with OUD.

LOCAL PROBLEM: The setting for this practice improvement project was a non-profit, rural …

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 …

Best Screening: Introducing The Neonatal Assessment Visual European Grid To Nicus In Tennessee, Gabrielle Sledge

OTD Capstone Projects

Blind Early Services Tennessee (BEST) is an early intervention agency that serves children ages 0-5 with visual impairments across Tennessee. BEST serves over 200 children and families across the state offering early intervention (BEST Start), parent empowerment (BEST Advocate), and family support (BEST Together) programming. The purpose of this project was to assist in the implementation of an early identification initiative (BEST Screening) using the Neonatal Assessment Visual European Grid (NAVEG). The NAVEG is a newborn vision screening shown to identify neurological risk for visual impairments. The long-term goal of this program is to promote the screening and early identification …

Health Professional Students Receiving Osteopathic Manipulative Treatment: An Interdisciplinary And Interprofessional Activity To Improve Attitudes Towards Osteopathic Medicine And Interprofessional Collaboration, Nicole Neiman, Justinas Joksas, Erica Sickel, Anne Marie Zeller

Research Day

No abstract provided.

Typhlitis In A Neutropenic Patient, Alice He Bs, Wern Lynn Ng Md, Lay She Ng Md, Si Yuan Khor Md, Chandi Garg Md

Tower Health Research Day

No abstract provided.