Digital Commons Network^™

A Quality Improvement Project On Blood Pressure Measurement: Are We Failing Our Patients?, Michael Baker

Doctoral Projects

Despite billions of dollars invested in research, education, and equipment, high blood pressure remains a significant contributor to mortality rates across the globe. According to the Centers for Disease Control (2019), hypertension was listed as a primary or contributing cause of over a half-million deaths in the United States (Centers for Disease Control [CDC], 2021). Without regard to race, gender, background, or socioeconomic level, this “silent killer” the Mississippi State Department of Health estimated that over 700,000 Mississippi adults were diagnosed with high blood pressure and thousands more at an increased risk each year (MSDH, 2019). Failure to identify and …

Where Have All The Surgical Nurses Gone? Staffing Shortages In Surgical Departments Post Covid-19 Shutdowns, Phoenix Neal

Dissertations

March 2020 changed the healthcare field entirely. When the COVID-19 pandemic swept through the United States in early 2020, it was recommended that surgical departments nationwide shutdown altogether or at least decrease their workloads to exclusively emergent procedures. This step was taken both to save surgical equipment for more critical patients and to offload those staff members from surgical departments to more critical areas in the hospital systems.

This exploratory study was completed to investigate the impact of COVID-19 surgical department shutdowns on current surgical staffing. This research explored different factors such as health insurance availability, childcare availability, shift change, …

Nursing Faculty Perceptions Of Stress, Coping, And Intent To Leave The Profession In The Ongoing Covid-19 Pandemic: A Quantitative Study, Lynlee Morgan

Dissertations

The COVID-19 pandemic impacted all of society to varying degrees; this impact was especially true in higher education due to an overnight transition to distance learning and incessant pivots to meet new guidelines and overcome obstacles. Nursing faculty were significantly impacted due to the responsibility of producing safe, qualified, competent practitioners to provide care in the clinical setting. The limitations in or exclusions from clinical experiences combined with the fact that faculty were managing personal concerns and had never encountered these unprecedented conditions exacerbated the challenge of preparing new nurses. This study was critical due to the faculty role and …

Staff And Provider Education On Diabetic Foot Exams And Foot Care Using The Ophelia Process, Shasta Pickens

Doctoral Projects

Diabetes mellitus continues to grow in global prevalence and consumes an increasing amount of healthcare resources. Persons that live in disadvantaged groups have a higher prevalence due to a lack of understanding and access to care. Diabetes is one of the leading causes of chronic disease and limb loss worldwide. Diabetes foot care is essential, as diabetes can be dangerous to patients’ feet.

The purpose of this doctoral project was to increase diabetic foot care education and foot exams for staff and providers in a federally qualified health center (FQHC). Many people in this rural community do not understand the …

Discussing The Injustice Of The Covid-19 Vaccine Pass Imposed On Medical Consultation In Public Hospitals In Hong Kong, Fung Kei Cheng

Journal of Health Ethics

The COVID-19 pandemic has devastated public health, economy and social life all over the world, especially wherever a vaccine pass scheme has been implemented. Many countries have begun to relax schedules to return to normal activities. In contrast, Hong Kong continues to tighten the utilisation of a vaccine pass for medical services in order to boost vaccination rates. Such a practice not only significantly challenges ethical and operative concerns but also threatens health equity and social justice for healthcare decision-makers and practitioners, consequently hurting public health and community well-being. This discussion analyses the various arguments, reviews vaccine hesitancy and suggests …

Objective Structured Clinical Examination For Arterial Line Placement, Delorean Calloway

Doctoral Projects

The University of Southern Mississippi (USM) is lacking a uniform guideline for arterial line placement. This DNP project promotes the addition of an objective clinical structured examination into the nurse anesthesia curriculum for future student registered nurse anesthetists (SRNAs) to gain comprehension and clinical experience in a simulation lab prior to practicing on real patients. Peer-reviewed literature and evidence-based practices have been researched and organized into a learning tool and checklist to be used as a step-by-step guideline. Having a guideline such as an OSCE in place can increase student competency and foster a culture of safety leading to better …

The Impact Of Social Determinants Of Health On Hypertension, Lakenya Forthner

Doctoral Projects

ABSTRACT

Nearly 43% of African American men have Hypertension (HTN). HTN is a major reversible health problem for young adult, African American males. Identifying health behaviors to enhance longevity is essential due to the “excess burden of preventable, chronic diseases and premature death among African American men. The “role of social determinants of health (SDOH) on outcomes, and the possible role these determinants play in disparities have largely been ignored” (Haggart, 2018, pp. 2, 8).

Interventions that address SDOH must take a multicomponent approach. Evidence has been established that adhering to a healthy lifestyle reduces the burdens and risks associated …

Psychological Distress During The Covid-19 Pandemic In Nursing Students: A Mixed Methods Study, Mayantoinette Watson

Dissertations

During such an unprecedented time of the largest public health crisis, the COVID-19 pandemic, nursing students are of the utmost concern regarding their psychological and physical well-being. Questions are emerging and circulating about what will happen to the nursing students and the long-term effects of the pandemic, especially now that hospitals are being overwhelmed with COVID-19 cases and patients as well as a significant need for nursing staff (Jividen, 2020). Expectations, demands, change, and the fear of the unknown during this unprecedented time can only contribute to the many stressors that accompany nursing students through laborious clinical and didactic courses …

Implementation Of A Pre-Anesthesia Take-Home Evaluation (Pathe) As A Means Of Process Improvement: A Best Practice Recommendation, Russell Gray, Hunter Brown, Trey Galloway

Doctoral Projects

The pre-anesthesia evaluation (PAE) is a vital component to anesthesia providers when choosing an appropriate anesthetic plan for patients requiring surgery. The PAE, pre-anesthesia risk-factor assessment, and provision of pre-anesthesia instructions are standards of care implemented in order to assess the patient’s likely outcome of surgery and anesthesia as well as stratify any known risk factors to optimize surgical/anesthetic outcomes. Any disruption in this process could potentially lead to decreased patient/provider satisfaction, reduced patient compliance with pre-anesthetic instructions, reduced patient safety, and unnecessary financial burden.

After the completion of a literature review, the need for a best practice recommendation was …

Barriers To Preoperative Warming: Best Practice Guideline, Tyler Comans, Zachary Hays, Caleb Leach

Doctoral Projects

The lack of preoperative warming has a direct relationship to perioperative hypothermia complications which include, but are not limited to: increased infection rate, coagulopathies, and increased myocardial oxygen consumption; all contributing to poor patient and facility outcomes. Implementation of an evidence-based educational module with visual aid can potentially increase the utilization of active warming techniques in the preoperative setting by perioperative staff. The DNP Project investigated barriers to preoperative warming by perioperative staff at a large teaching hospital in the southeastern United States. Barriers were assessed by a voluntary survey sent to 87 perioperative staff members. Twenty-two surveys were completed …

A Safety Net: Early Assessment Of Multiple Social Determinants Of Health Risk Factors In The Pediatric Inpatient Population, Emily Caroline Brister

Doctoral Projects

A lack of protocol for screening of social determinants of health (SDH), specifically for pediatric patients, despite national endorsement, is setting a basis for increased rates of negative health outcomes that can follow individuals into adulthood. The PRAPARE tool, or the Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences, is a guided national effort to assist healthcare centers in the collection of the necessary social data required to care for patients and act upon their social determinants of health (The National Association of Community Health Centers [NACHC], 2019). This project acted to identify if the early assessment …

Synthesis And Self-Assembly Of Amphiphilic Block Copolymers For The Fabrication Of Non-Spherical Polymersomes, Tamuka Chidanguro

Dissertations

Polymersomes, also known as polymer vesicles, have gained a lot of interest over the past two decades. These hollow spherical systems are made via the self-assembly of amphiphilic block copolymers and have found use in a range of areas from drug delivery, to cellular models, to nanoreactors. Their hollow nature allows them to carry hydrophilic cargo in their inner compartment and hydrophobic cargo in their membrane. Over the last decade, increasing efforts have focused on controlling the morphology of polymersomes. Research has shown that polymersome morphology plays an important role for instance in drug delivery, where tubular or rod-like vesicles …

Evaluating Research Centers In Minority Institutions: Framework, Metrics, Best Practices, And Challenges, Angela Sy, Traci Hayes, Kelly Laurila, Carlamarie Noboa, Robbert J. Langwerden, Michelle M. Hospital, Doris A. Andújar-Pérez, Lakesha Stevenson, Suzanne M.Randolph Cunningham, Latrice Rollins, Hala Madanat, Tanya Penn, Shiva Mehravaran

Faculty Publications

The NIH-funded Research Centers in Minority Institutions (RCMI) program is currently funding 18 academic institutions to strengthen the research environment and contribution to health disparities research. The purpose of this multiphase mixed-methods study was to establish a uniform evaluation framework for demonstrating the collective success of this research consortium. Methods included discussions of aims and logic models at the RCMI Evaluators’ Workshop, a literature review to inform an evaluation conceptual framework, and a case study survey to obtain evaluation-related information and metrics. Ten RCMIs participated in the workshop and 14 submitted responses to the survey. The resultant RCMI Evaluation Conceptual …

Implementing Screening To Assess Readiness To Change In Overweight And Obese Patients At A Patient-Centered Medical Home, Jarrod Gant

Doctoral Projects

Obesity is at epidemic levels within the United States (U.S.), but the Southern U.S. has some of the most obese states. Mississippi (MS) is the most obese state in the country (Robert Wood Johnson Foundation, 2018). Factors such as diet, sedentary lifestyle, cultural influences, and socioeconomic status contribute to the state’s citizens being overweight and obese.

Contributing to the state’s obesity is the fact that MS has more people living in poverty than any other state (Center for American Progress [CAP], 2018). Lacking the ability to afford healthy foods and the ability to afford quality healthcare adds to the state’s …

Learning Style Preferences In Undergraduate Speech-Language Pathology And Audiology Students, Callahan Shirk

Honors Theses

Learning styles can be described as an individual’s unique way of assimilating new information based on his/her preferences and methods of acquiring knowledge. The awareness of a student’s learning style preference can be beneficial to both students and instructors. The goal of this project was aimed at identifying the learning style preferences of undergraduates in the Speech-Language Pathology and Audiology programs within the state of Mississippi. The researchers surveyed 137 participants involved in this study by utilizing the Kolb Learning Style Inventory and the VARK Questionnaire. Results from this study revealed that students enrolled as undergraduates in Speech-Language Pathology and …

Simulation As Replacement For Traditional Clinical In Pre-Licensure Nursing Education: Outcomes Of Different Ratios Of Replacement Time For Traditional Clinical With Simulation, Tiffany Zyniewicz

Dissertations

The use of simulation in nursing education has grown over the last 30 years. The National Council of State Boards of Nursing National Simulation Study indicated that up to 50% of traditional clinical hours can be replaced with simulation at a 1:1 replacement ratio and produce the same outcomes. A review of the literature indicated that there is no standard replacement ratio for simulation time to traditional clinical time being used in pre-licensure nursing education in the United States. The purpose of this study was to explore the outcomes of utilizing a 1:1 simulation-to-traditional clinical time replacement ratio and a …

Fake Medical News: The Ethics And Dangers Of Health Product Advertising Disguised As Real News, George A. Gellert

Journal of Health Ethics

Leading national newspapers in the US, challenged financially by the transition from paper to electronic media, are allowing drug and medical product advertisers to format their advertisements to appear like actual, authentic news articles. This news mimicry is intended to deceive consumers, and often makes claims of clinical efficacy and safety that are not evidence based and substantiated. An example of such an advertisement is presented and the clinical implications are considered, including recommendations to public health leadership organizations.

Implementation Of A Sustainable Peer Mentor Program In Student Registered Nurse Anesthetists (Srnas)”, Kristin Cox

Doctoral Projects

Evidence has shown that Student Registered Nurse Anesthetist’s (SRNAs) stress is perceived as above average and is correlated with substandard patient care during clinical courses (Chipas et al., 2012). Some studies have indicated SRNAs experience low self-efficacy during clinical, which could lead to difficulty in thinking clearly or responding to clinical situations (Imus, Burns, & Weglarz, 2017). Peer mentoring has shown to result in stress reduction and improvement in self-efficacy in students (Barker et al., 2012; Giordana & Wedin, 2010). Despite the current evidence, a nurse anesthesia program in the southeastern United States did not have an organized peer mentor …

Provider Based Interventions To Mitigate Risk For Opioid Pain Medication Abuse Among Adult Patients In A Primary Care Setting, Sheree Lamara Conley-Donaldson

Doctoral Projects

Mental and substance use disorders are predicted to exceed all physical disease processes causing major disability by 2020. Misuse and overdose of opioid pain medications is a significant public health concern in the United States. Approximately 1 in 4 patients receiving prescription opioids in primary care settings struggle with misuse. Half of all opioid prescriptions are written by primary care providers, including nurse practitioners. The purpose of this DNP project was to determine if nurse practitioner providers are implementing evidence-based practice guidelines including screening, brief intervention, and referral to treatment (SBIRT) to mitigate risk of prescription opioid pain medication misuse …

Utilizing Culturally Congruent Educational Interventions To Improve Native American Diabetic Outcomes, Laurie Ann Hamilton

Doctoral Projects

Native Americans suffer from diabetes type II at a proportionately higher rate than other populations. Management of diabetes in this population is problematic and compounded by multiple influences such as socioeconomic, cultural and linguistic variables. The purpose of this DNP project was to investigate cultural influences on Native American diabetic outcomes.

Do cultural influences act as barriers to diabetic medication, diet and education understanding? Would a Native American nurse applied education on medication, diet and exercise improve diabetic outcomes in a 3 month period?

A convenience sample of 6 Native American participants obtained at a primary care clinic were given …

Opioid Use In The Cesarean Section Patient With The Preoperative Administration Of Intravenous Acetaminophen, Dana Edwards Bernardo

Doctoral Projects

Cesarean sections are one of the most common surgical procedures and there are no current guidelines for the management of postoperative pain control (Darvish, Ardestani, Shali, & Tajik, 2013). Unresolved pain in this population can lead to long lasting problems, such as chronic pain and depression (Booth, Harris, Eisenach, & Pan, 2015). The goal of multimodal therapy with IV acetaminophen for CS mothers was to ensure a rapid and safe recovery process with reduced adverse complications and shortened hospital length of stay. The independent t-test was used to compare the mean time for length of stay, first request of pain …

Does Theory Translate In The Trenches Of Short Term Mission Work?, Rhonda D. Hensley

Journal of Health Ethics

Despite numerous criticisms in the literature on the ethics and sustainable outcomes of short term international mission trips, there can be positive outcomes for volunteers and for recipients of short term mission care efforts. Utilizing a theoretical framework that addresses efforts to promote sustainability can lead to a structured, productive, and satisfying experience. With effective host country partnerships and an organized model of care delivery, international mission volunteers can provide highly effective health care services that are specific to the health and cultural needs of the host community.

Using A Cost Benefit Analysis To Support The Development Of A Comprehensive Business Model For A Pre-Filled, Pre-Labeled, Pre-Diluted, Sterilely Packaged, Ready-To-Use, Syringe-Based Anesthesia Delivery System, Lance B. Kennedy

Doctoral Projects

The foundation of Certified Registered Nurse Anesthetists’ (CRNAs) entire profession is built on the ability to provide anesthetic services using a variety of medications in the safest, most efficient, cost-effective way possible. The purpose of this capstone is to address, via a comprehensive cost benefit analysis, whether pre-filled syringe drug trays are a more cost-effective way to address problems as compared to vial-filled drug trays and to implement the necessary transitions in order to improve outcomes. There are a number of identifiable problems related to anesthesia medication delivery via vial-filled medication, including increased cost of healthcare, decreased patient safety to …

The Effects Of Consistent Exercise On Work Productivity Among Anesthesia Providers, Samuel K. Self

Doctoral Projects

Studies have been done that link various measurements of workplace productivity with varying levels of individual health. A thorough literature review examined the research to find any significant relation between regular exercise (as defined by the American Heart Association) and an improvement in workplace productivity among anesthesia providers. A Qualtrics survey was used to measure specific results regarding exercise activity and work productivity from anesthesia providers. This group included 53 certified registered nurse anesthetists and anesthesiologists. Descriptive analysis, Chi-square test of Independence, Fisher’s Exact test, and Cramer’s V test were all used to analyze the data. One significant correlation was …

End Of Year Ethical Considerations: 2015, Sheila P. Davis

Journal of Health Ethics

No abstract provided.

Promoting Behavior Changes In Patients With Type 2 Diabetes Through Shared Medical Appointments, Shonda Lanette Williams

Doctoral Projects

Diabetes Mellitus (DM) is a chronic disease that affects many individuals in the United States. It was reported that a total of $245 billion is spent annually on both direct and indirect health care costs associated with the treatment of diabetes and diabetic related complications. Diabetes related complications can be prevented or delayed if proper education is done and individuals are willing to practice positive behavior changes and self-manage their disease. The purpose of this doctoral capstone project was to promote behavior changes in patients with diabetes through diabetes self-management education (DSME) in shared medical appointments (SMAs).

This project was …

The Impact Of Technology Attitudes And Skills Of Rural Health Clinic Nurses On The Level Of Adoption Of Electronic Health Records In Mississippi, Jennifer Lynn Styron

Dissertations

The evolution of health information technology continues to reform the delivery of efficient, safe, and equitable healthcare in the United States. One such example is the emergence of electronic health records (EHRs) and the discerning emphasis placed on using this technology in meaningful ways. While the integration of EHRs into daily practice impacts all healthcare professionals, nurses remain a prominent driver in the successful adoption and usage of these systems. It is therefore imperative to understand the impact of nurses’ technology attitudes and skills on the level of EHR adoption in Mississippi.

This quantitative study examined the technology attitudes and …

A Comparison Of Testosterone With Prostate Specific Antigen And Prostatic Acid Phosphatase For The Serodiagnosis Of Prostate Cancer In Adult Males, Annie Chu

Honors Theses

Prostate cancer is the second most common cause of death from cancer in men. The American Cancer Society has estimated that there were 240,890 newly diagnosed cases in 2011 and 33,720 deaths from prostate cancer. Diagnosis of this disease has traditionally been done by measuring prostate specific antigen (PSA) levels through sero-chemical testing. The purpose of this study is to compare serum testosterone levels to PSA levels and Prostatic Acid Phosphatase (PAP) levels in the search for new and more accurate technology. This study shows that testosterone was not efficient in correctly diagnosing those with prostate cancer. It had a …

Does Psychopathy Predict Future Risky Sexual Behavior?, Jessica Jade Fulton

Dissertations

Risky sexual behavior (RSB), such as having sex with an unknown partner, is associated with a variety of negative consequences including sexually transmitted diseases and unplanned pregnancy. Previous research (e.g., Fulton, Marcus, & Payne, 2010) suggests that psychopathic personality traits as assessed by the Psychopathic Personality Inventory (Lilienfeld & Andrews, 1996) are associated with RSB. Self-Centered Impulsivity (SCI), which is characterized by impulsivity, irresponsibility, and reckless behavior, was positively associated with RSB among men and women. In contrast, Fearless Dominance (FD), which is characterized by fearlessness, manipulativeness, and social dominance, was positively associated with RSB among men but not women. …