Digital Commons Network^™

Implementation Of Lymphedema Education Toolkit For Nurse Coordinators, Heather Gee

Master's Projects and Capstones

Problem: Lymphedema is a chronic condition that develops secondary to cancer treatments such as chemotherapy, radiation, and surgical removal of affected lymph nodes. This swelling in patient’s limbs can cause discomfort and limit mobility, however lymphedema is often not detected until later stages, delaying treatment and patient education.

Context: This quality improvement project was conducted at Hospital S Women’s Cancer Center, an outpatient center specializing in advanced treatments for breast and gynecological cancers. This center has a multidisciplinary team focusing on both the medical and surgical aspects of oncology treatment.

Interventions: An evidence-based lymphedema education toolkit was created for nurse …

Fostering Interprofessional Collaboration In Community College Mental Health Centers: A Quality Improvement Project, Sara Jane Hamilton

Doctor of Nursing Practice (DNP) Projects

Background The worsening mental health rates among college students in the United States highlight the critical need for campuses to have high-quality comprehensive mental health centers (MHC). This necessity is particularly urgent in community college MHCs, which often lack these attributes. Local Problem An MHC within a large California community college recently introduced telepsychiatry services and is considering integrating a Psychiatric Mental Health Nurse Practitioner (PMHNP) into their team. However, knowledge gaps and limited interprofessional education (IPE) may hinder effective collaboration within the team. Methods A comprehensive literature review was conducted to assess current research on IPE, community college mental …

Education For Primary Care Providers On Advance Care Planning, Lindsey Ward

Doctor of Nursing Practice (DNP) Projects

Background: Advance care planning (ACP) is a discussion of a patient’s end-of-life healthcare wishes. Its purpose is to indicate these wishes clearly should the patient be unable to make their decisions known to providers and family members due to a sudden health decline or medical emergency. Healthcare providers, specifically nurse practitioners, physician assistants, and physicians in the primary care setting, are well-positioned to facilitate these conversations with their older adult patients. However, research states that limited provider knowledge of and confidence in implementing ACP are significant barriers to its application in practice.

Problem: At a primary care clinic in Midtown …

Parents’ Perception Of An Intensive Interdisciplinary Pain Treatment For Amplified Pain Syndrome, Jacqueline Pabis Phd, Sabrina Ung Ma, Jenny Scheurich Phd, Dustin Wallace Phd

Research Days

This study examines overall parent satisfaction with Intensive interdisciplinary pain treatment for youth with amplified pain syndrome. Additionally, it evaluates the relationship between parent-provider communication and satisfaction, as well as with perceived child outcomes.

The Impact Of Health-Related Social Needs On Health Outcomes Among Youth Presenting To A Midwest Pediatric Diabetes Clinic Network, Jasmine Roghair, Emily Dewit, Katelyn Evans, Mitchell Barnes, Heather Feingold, Samantha Jacob, Courtney M. Winterer, Jeffrey D. Colvin, Mark A. Clements, Shilpi Relan, Kelsee Halpin

Research Days

Screening for health-related social needs (HRSNs) is recommended as part of routine diabetes care given the impact of social factors on health outcomes.

Youth presenting to a tertiary diabetes center will have different diabetes-related health outcomes based on positive or negative HRSNs screenings at routine clinic visits.

Baseline data were collected from patients whose parent/guardian completed a HRSN screen as part of their child’s diabetes clinic intake from 9/1/21 to 8/30/22. The screen is a 6-item questionnaire adapted from the Accountable Health Communities HRSNs Screening Tool to screen for HRSNs in 4 domains (housing, utilities, transportation, and food). Longitudinal data …

Meeting Abstracts From The 5th National Big Data Health Science Conference, Bankole Olatosi, Miranda Nixon, Xiaoming Li

Publications

No abstract provided.

Bad Therapy: Conceptualizing The Teaching Of “Thinking Like A Lawyer” As Cognitive Behavioral Therapy, Chelsea Baldwin

St. Mary's Law Journal

Law students and lawyers experience mental illness and substance abuse at higher rates than the general population and other learned professions. This is bad for an individual’s wellbeing as well as their clients and society because mental illness and substance abuse increases stress which in turn decreases effective decision-making and judgment, and in worst case scenarios leads to attrition as individuals choose death by suicide which has cascading social and economic impacts. This Article identifies practices in legal education that likely combine in a causal mechanism, although not a sole cause, to the higher rates of mental illness and substance …

Violence Exposure And Trauma Screener For Youth (Vetsy), Daniel Joseph Flannery, Ivette Noriega, Mark Singer, Jeff Kretschmar

Faculty Scholarship

Background: Youth exposed to violence are at serious risk for physical, emotional, behavioral, and mental distress. Reliable and prompt detection is necessary to mitigate the psychological consequences of youth violence exposure and trauma. Objective: To describe the initial creation of the VETSY screener and its construct validity and potential use. Methods: From 2014 through 2022 we surveyed 20,532 at-risk youth aged 8–18 years from a diverse metropolitan community participating in the Defending Childhood Initiative (DCI). Youth completed a 17-item self-report screener. An Exploratory Factor Analysis (EFA) was used to determine the reliability and variable grouping for this brief screener. Violence …

Standardizing Clinical Ethics Consultation Documentation, Yoo Sun (Sunny) Jeong, Stephanie Kukora, Ásdís Finnsdóttir Wagner, Dawn Hood Patterson

Research Days

Background:

Clinical ethics consultations (CECs) require documentation. There is a paucity of literature and resources to guide clinical ethicists in documenting consults. High quality documentation encourages transparency between patients and clinicians, while keeping interdisciplinary team members knowledgeable about evolving care plans. However, there are discrepancies in the details captured in the CEC notes and accompanying recommendations.

Objectives/Goal:

To identify how CECs are documented in the medical record and assess whether there is consistent inclusion of relevant information.

Methods/Design:

Retrospective review of CECs conducted at a free-standing children’s hospital from January 2018- June 2023 was conducted. CECs were captured by cross-referencing …

Emergency Care Of An Older Adult With Complex Care Needs, Muhammad Adnan Khan, Himika Dalia, Michelle Dietz

Journal of Geriatric Emergency Medicine

In this case report, we demonstrate the application of a stepwise guiding approach for older adults with complex care needs who present to the emergency department. It also highlights the challenges encountered during the implementation of these principles, and sheds light on the factors affecting the management of complex older populations. This case report emphasizes the pressing need for the development of a standardized protocol tailored to emergency physicians, addressing the unique needs of complex-multimorbid older adults, and overcoming the system barriers in emergency care.

Improving Awareness And Utilization Of Safety Net Resources After Extremity Firearm Injury, Colleen M. Moreland, Caleb W. Grote, Richard M. Schwend, Julia G. Harris

Research Days

The orthopaedic surgery department can improve follow-on care for pediatric survivors of extremity firearm injuries by creating and implementing a checklist of defined safety net resources.

Medical-Legal Partnerships Reinvigorate Systems Lawyering Using An Upstream Approach, Kate L. Mitchell, Debra Chopp

Articles

The upstream framework presented in public health and medicine considers health problems from a preventive perspective, seeking to understand and address the root causes of poor health. Medical-legal partnerships (MLPs) have demonstrated the value of this upstream framework in the practice of law and engage in upstream lawyering by utilizing systemic advocacy to address root causes of injustices and health inequities. This article explores upstreaming and its use by MLPs in reframing legal practice.

The Perceptions Of A Nurse-Led Telehealth Discharge Program On Continuity Of Care For Pediatric Rheumatology Patients, Adrienne Ramirez

Doctoral Projects

When pediatric rheumatology patients are discharged from a hospital, they are given a complex discharge plan which involves responsibilities in self-managing their care at home. This creates an overwhelming time for patients and families who may have questions or concerns during this time. In order to address this care gap and provide continuity of care, this quality improvement project implemented a nurse-led telehealth discharge visit intervention to 15 pediatric rheumatology patients during the transition from hospital discharge to outpatient care. This quality improvement (QI) project also aims to describe the patients’ perceptions of the nurse-led telehealth discharge intervention on continuity …

Exploring Social Workers Potential Role In Mitigating Maternal Mortality Through Coordinated Care, Jena Brown-Talib

Honors Theses

Maternal health disparities persist as a significant challenge in Mississippi, particularly for African American women. This thesis explores the intersection of coordinated care models and social work interventions in addressing maternal mortality. Coordinated care involves collaboration among physicians, nurses, practitioners, social workers, community health workers, and other support services, aiming to maximize pregnant patients' overall health outcomes.

Analyzing strategies of social workers within coordinated care models is important for improving maternal health outcomes within this study. A qualitative approach was chosen to delve beyond statistics and illuminate the reality of maternal health disparities and the efforts to resolve them. Data …

Barriers, Facilitators, And Competencies In Advocating For Adults With Intellectual Disabilities With Health Disparities, Carol Adams

Electronic Theses and Dissertations

Background: Nurses working in the specialty of intellectual disabilities are positioned to advocate for individuals with intellectual disabilities and other health disparities. This study explored nurses’ perceived competencies, barriers, and facilitators when advocating for improved health status in adult patients with intellectual disabilities.

Methods: Twenty-five nurses working in the specialty of intellectual disabilities were interviewed using semi-structured interviews, and the data were analyzed using thematic analysis.

Results: Barriers identified in advocacy were: Funding, Communication, Negative Perceptions and Misperceptions, Lack of access, and Diagnostic Overshadowing. Nurses were also facilitated in advocating for improved health status in people with intellectual disabilities. Facilitators …

Defining Faculty’S Role In Supporting Student Mental Health Needs In Higher Education, Erica B. Riba

Student Theses

The subject of mental health among college students has been prevalent for decades. Today, college students are facing more challenges to mental wellness than ever before. Faculty are often the first and only point of contact for many students. Faculty have a role to play in supporting student mental health, but that role has not been clearly defined. This study aims to bring clarity to some of these critical issues and offers a lens into this broad topic from faculty themselves. A mixed-methods design was used for this study. 889 people who have downloaded The Jed Foundation’s Faculty Guide to …

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 …

How Can Art Therapy Help Individuals With Chronic Illnesses? A Literature Review, Emily Heidler

Expressive Therapies Capstone Theses

This literature review examines the influence of art therapy on the self-esteem of individuals who suffer from chronic pain. The research question was: How can art therapy help individuals with chronic illnesses? Through an exploration of the topics of art therapy, chronic pain, parenting style, and self-esteem, it was noted that there is a gap in literature about art therapy’s influence on self-esteem resulting from chronic pain. However, an analysis of the literature reveals that art therapy can influence the self-esteem of individuals who suffer from chronic pain. Art therapy can influence this population by providing a sense of belonging, …

A Beginner's Guide To Gerontological Counseling: A Summary Of Considerations For Counselors Providing Psychotherapy To Older Adults In Rural Settings, Kelly D. Higgins

Educational Specialist, 2020-current

The elderly population continues to rapidly increase in the United States, leading to a significant need for mental health care among older adults. While older adults experience significant role changes, increased potential for physical and cognitive limitations, and heightened social isolation, all of which contribute to an increased psychiatric need, very few counselors are specially trained to provide adequate geriatric treatment. This is especially true in rural populations, where accessibility limitations are often more significant and mental health professionals are few and far between. This project provides a brief review of the literature regarding these various considerations, challenges, and areas …

Best Practices In The Care Of Older Adults During An Unplanned Acute Observation Stay, Jonny Macias Tejada, Michael Malone

Journal of Geriatric Emergency Medicine

No abstract provided.

Student Community Outreach For Public Education (Scope): Senior Smiles And Wellness Event 2023, Katie Hagan, Serena Ly

Excellence Day

The Senior Smiles Health & Wellness Fair is a community health outreach event sponsored by SCOPE, Student Community Outreach for Public Education, at University of the Pacific Arthur A. Dugoni School of Dentistry. The event is held annually in San Francisco at the School of Dentistry’s campus. Generally, over 100 members of San Francisco’s senior citizen population with limited access to healthcare attend this event. This annual event provides limited healthcare services and education, fostering better health practices among this vulnerable population. In May 2023, the 28th annual Senior Smiles Health & Wellness Fair successfully served over 200 senior citizens …

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 …

Expressive Therapies And Resiliency – Resistance In Mental Health: A Literature Review, Gabrielle Lopez

Expressive Therapies Capstone Theses

This review evaluates the current literature on psychological resistance amongst human service professionals experiencing burnout and the effect of Expressive Arts interventions on resiliency. Concepts include identifying the main symptoms, risk factors, causes, and treatments for burnout in education faculty, medical staff, and clinicians. Qualitative, quantitative, and meta-analysis studies are included to identify the most prevalent intervention frameworks for reducing stress including Arts-Based and Mindfulness-compassion based techniques. The effectiveness of Arts-based tools on strengthening identity, self-esteem, emotional regulation, and meaning-making in combating burnout is presented. Based on analysis of the literature, the author proposes a three-step intervention framework for utilizing …

A Scoping Review Of Drama-Based Interventions With Migrant Populations For Health Outcomes, Cassandra Doria

Expressive Therapies Capstone Theses

This scoping review investigates the breadth and nature of literature that currently exists on the topic of utilizing drama-based interventions with migrant populations for therapeutic goals. This author searched for empirical studies on the topic and charted data to understand the quality, number, and type of studies that have been done, and risk factors for epistemic injustice or misrepresentation of marginalized participants. A brief overview of methods, results, and discussions of articles revealed the most prevalent outcomes, limitations, and forms of data collection. Social connection and belonging, education, communication skills, empathy, identity reconstruction, meaning making, and adaptive adjustment to the …

Screening For Suicide In Veterans With Cancer, Dina E. Mcneil

Doctor of Nursing Practice Projects

Veterans are at a higher suicide risk than the general population. Veterans with cancer are at a 47% higher risk for suicide. The Veterans Health Administration has an annual suicide screening requirement, but no requirement for more frequent assessment in this high-risk population. Clinical staff may also be hesitant due to fear and anxiety, serving as a barrier to screening. The objective of this project was to educate oncology clinical staff about risk factors for suicide in veterans with cancer, the use of the Columbia-Suicide Severity Rating Scale (C-SSRS), referral processes, and local resources, and intended to increase the number …

Home Based Primary Care Program Evaluation Of Loneliness, Depression, And Multimorbid Conditions Of Older Midwest Veterans, Renee R. Sullivan

Doctor of Nursing Practice Projects: College of Nursing

Objectives: This program evaluation of Veteran Administration’s (VA) Home-Based Primary Care Program (HBPC) measured the differences in loneliness, diagnoses of Major Depressive Disorder (MDD), Post Traumatic Stress Disorder (PTSD), Anxiety, and Traumatic Brain Injury (TBI) and multimorbid conditions in rural and urban older adult veterans compared with older adult community-dwelling veterans. The correlations of loneliness using the 11- Item Revised University of California Los Angeles (R-UCLA) Loneliness Scale will describe the relationship of loneliness to mental health diagnoses, multimorbid conditions, demographic data, caregiver presences and the number in-person and phone contacts with the HBPC providers of a Midwestern Veterans Administration …

Providing A Latch Key: Increasing Lactation Education For Medical Students, Elizabeth Wagman, Bs, Santosh Coorg, Md, Cheryl Godcharles, Md, Nabblem-C

Health Equity and Quality Improvement (HEQI) Summit

Background

• Problem Statement: Current Healthy People 2030 data suggests that only up to 25% of infants are exclusively breastfed at six months of life, but target rates are upwards of 40%. Though this trend is multifactorial, an actionable solution is to increase lactation education for residents and medical students to better equip them to counsel patients.
• Project AIM: We aim to increase provider comfort in lactation counseling by implementing lactation education, resources, hands-on training, and postpartum follow-up strategies for Thomas Jefferson University pre-clerkship/ rotating medical students and OB/GYN residents.

Implementation Of Pediatric Behavioral And Developmental Health Screening Tools At Student-Run Free Clinics In Philadelphia Shelters, Renee Li, Jasmine Miller, Martin Henry, Do, Bob Motley, Md, David Beckmann, Md, Mph

Health Equity and Quality Improvement (HEQI) Summit

Background & Project Aims

• Children experiencing homelessness (CEH) are at increased risk for behavioral health problems: 78% show behavioral problems, academic delays, or depression.¹

• Recent research suggests an increased prevalence of Autism Spectrum Disorder (ASD) among people experiencing homelessness.^2,3

• Psychosocial challenges are exacerbated by limited access to behavioral health and developmental disability screening, which is essential for early intervention.^4-6

• Recent studies have found that behavioral health screening in shelters is feasible, can generate a large number of referrals, and can be carried out by a student-run clinic without significantly disrupting workflow.^7,8

Promoting Physiologic Birth By Improving Access To Doulas, Karen Schwartz

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Birth in the United States (U.S.) leans towards a medicalized approach, overlooking the advantages of physiologic birth. Physiologic birth is a natural approach to childbirth, without medical interventions. Intrapartum nurses play an integral role in caring for women during labor by providing continuous labor support. Competing nursing tasks, exacerbated nursing shortages and increased nurse to patient ratios have made it increasingly challenging for intrapartum (IP) nurses to provide continuous labor support to their patients. The aim of this DNP project is to gain insight into the beliefs of IP nurses regarding childbirth and how these beliefs impact their approach to …

Molding The Self: Understanding Adoptees' Identity Formation, A Literature Review, Carolyn Brazil

Expressive Therapies Capstone Theses

The topic under investigation focuses on the complex process of identity formation in adoptees, particularly those in transracial and international adoption scenarios. Grounding this topic in theory, the author draws from psychological and sociological perspectives. The literature illustrates key factors in adoptees' identity formation, and it emphasizes the importance of family involvement and cultural connections in integrating identities, as well as the role of cultural ties in understanding racial identities. The conclusion from this study reveals the complexities and clinical considerations of adoptee identity formation, showing their challenges in combining birth and adoptive cultures. It underscores the value of art …