Digital Commons Network^™

Implementation Of A Dual-Registered Nurse Skin Assessment Protocol To Reduce Hospital Acquired Pressure Injuries, Kaylie V. Newbold, Nishita Trivedi, Mckenzie Clendenen, Jariah Mcdaniel

Scholars Week

Hospital-acquired pressure injuries(HAPIs) remain a significant patient safety concern due to gaps in early detection, lack of structured skin assessments, and thorough documentation. This evidence based practice project proposes a dual-Registered Nurse skin assessment protocol, requiring two Registered Nurses to perform a full risk assessment and co-sign documentation, within two hours of hospital admission, and every 12 hours thereafter. Implementing these practices will improve accuracy, reduce missed injuries, further improve the use of other skin assessment tools such as the Braden Scale. This set of interventions promotes early detection, prevention, accountability, and improved patient outcomes, guided by the Health Promotion …

Reducing Nurse Burnout, Kaylee R. Mofield

Scholars Week

I presented an evidence-based project to a healthcare facility with interventions and a suggested policy change to help reduce nurse burnout. One suggested policy change I made was changing the staffing policy. Within this new policy I suggest that if the patient census was 25 patients it calls for 5 nurses, 17-20 patient calls for 4 nurses, 16 or less patients calls for 3 nurses; along with no calling off staff due to census but rather utilizing this staff as a float or resource nurse. Another suggestion I made was nursing leadership holding monthly “check-in” meetings separate from the monthly …

Fast Track In The Emergency Department, Raegan Luechtefeld, Ella Kjellberg

Scholars Week

Emergency departments nationwide all consistently work to improve efficiency and patient care, reduce wait times to be seen and length of stay, decrease overcrowding, and increase both staff and patient satisfaction. One way to utilize evidence-based practice and provide better patient outcomes is to implement “fast tracks” into emergency departments. This is used as a triage tool in order to separate critical patients from ones with minor illnesses and injuries. Fast tracks help to accomplish all of the stated goals by helping the providers and nurses to give more specialized and efficient care. The purpose of this evidence-based practice project …

Decreasing Wound Healing Times By Decreasing Stress Levels, Bayleigh S. Kraus, Colson Burnett, Kelsey Spann

Scholars Week

The relationship between stress levels and delayed wound healing needs to be further investigated, particularly in hospitalized and chronically ill patients. Research shows that psychological stress can impair immune function, reduce tissue regeneration, and prolong inflammation, all of which slow the healing process. It is important to explore how both acute and chronic stress affect different types of wounds, such as surgical incisions, pressure injuries, and diabetic ulcers. Additionally, identifying which stress-reduction interventions are most effective in improving healing outcomes is essential. Understanding these factors can help nurses implement targeted, evidence-based interventions to promote faster recovery.

Implementing Labor Plans To Increase Labor Satisfaction, Allyson G. Johnson, Emma G. Hancock, Kinley Edwards

Scholars Week

This scholarly presentation examines the implementation of a standardized birth plan tool within a healthcare facility to improve maternal birth satisfaction. The project focuses on enhancing patient-provider communication, supporting shared decision-making, and ensuring that patient preferences are clearly documented and respected throughout labor and delivery. Findings suggest that integrating a structured birth plan tool may increase maternal satisfaction and promote more patient-centered obstetric care.

Reducing 30-Day Readmissions: Simplifying Discharge, Olivia Hibbs

Scholars Week

Hospital readmissions within 30 days remain a major challenge for healthcare systems and are often linked to ineffective discharge communication and low patient health literacy. Improving discharge planning through simplified instructions, early education, and the teach-back method can help ensure patients understand their medications, follow-up care, and warning signs after leaving the hospital. Strengthening communication and care coordination during the transition from hospital to home may improve patient outcomes and reduce preventable readmissions.

Meds-To-Beds Improving Medication Adherence, Hannah Draper, Regan Ashby, Ryan Rieke

Scholars Week

The Meds-to-Beds program improves medication adherence by delivering prescribed medications directly to patients before hospital discharge, ensuring timely access and reducing barriers such as transportation or pharmacy delays. By incorporating bedside education from pharmacists, patients gain a clearer understanding of their medications, which enhances confidence and proper use. This coordinated approach has been shown to decrease readmission rates and improve overall patient outcomes.

Implementing A Health Literacy Assessment To Reduce Readmissions, Saiylor M. Beecham, Jewel Render, Bethany Pruitt

Scholars Week

This presentation examines the impact of limited health literacy on patient outcomes, highlighting its role in medication errors and hospital readmissions. Grounded in Dorothea Orem’s Self-Care Deficit Theory, it emphasizes the importance of implementing standardized, non-stigmatizing health literacy assessments to improve nurse-patient communication and patient understanding. Evidence-based strategies such as teach-back methods and plain language education are recommended to enhance patient safety and reduce preventable readmissions.

Femoral Structure And Biomechanical Characteristics In Sanfilippo Syndrome Type-B Mice, Frederick J. Ashby, Evelyn J. Castillo, Yan Ludwig, Natalia K. Andraka, Cong Chen, Julia C. Jamieson, Nadia Kabbej, John D. Summerville, Jose I. Aquirre, Coy D. Heldermon, University Of Florida

Knowledge and Creativity Expo

Sanfilippo syndrome Type-B, also known as mucopolysaccharidosis IIIB (MPS IIIB), accounts for approximately one-third of all Sanfilippo syndrome patients and is characterized by a similar natural history as Type-A. Patients suffer from developmental regression, bone malformation, organomegaly, GI distress, and profound neurological deficits. Despite human trials of enzyme replacement therapy (ERT) (SBC-103, AX250) in MPS IIIB, there is currently no FDA approved treatment and a few palliative options. The major concerns of ERT and gene therapy for the treatment of bone malformation are the inadequate biodistribution of the missing enzyme, N-acetyl-α-glucosaminidase (NAGLU), and that the skeleton is a poorly hit …

Incidental Left Ventricular Fibroma Detected During Pre-Participation Screening In A Young Athlete, Alya J. Al Hashmi, Meetha S. Al Ameri, Asna Ayoob, Hafsa Maryam, Fiza Halima

Journal of the Saudi Heart Association

Primary cardiac fibromas are rare benign tumors that may carry arrhythmic risk. We report a case of cardiac fibroma that was incidentally detected in an 18-year-old athlete with echocardiography and MRI during routine pre-championship screening. Following multidisciplinary heart team discussion and shared decision-making, surgical excision was performed due to potential arrhythmic risk in the setting of high-intensity athletic activity.

Influence Of Serve Type And Speed On Passing Success In Elite Czech Men's Volleyball, Miroslav Krajcigr, Petr Bahenský, David Marko, Sára Šestáková, Ladislav Čepička

Baltic Journal of Health and Physical Activity

Background: Serve effectiveness plays a critical role in volleyball, influencing the opponent’s reception and subsequent attack. While smash serves are powerful, float serves may disrupt the opponent through unpredictable flight patterns. This study examined how serve type and speed affect reception quality in elite men’s volleyball. Methods: A total of 543 serves (254 float, 289 smash) from one Czech Extraliga team across seven home matches were analyzed using video recordings and radar measurements. Serve speeds were grouped into predefined categories. Effectiveness was defined as the sum of effective receptions and aces; error serves were excluded. Reception outcomes were classified as …

Examining The Relationship Between A Positive Obstructive Sleep Apnea Diagnosis And Referring Symptoms Of The Pregnant Patient, Christina Emerson, Beth Tremblay

Knowledge and Creativity Expo

PROBLEM: Many healthcare providers do not routinely screen pregnant individuals for obstructive sleep apnea (OSA), contributing to its underdiagnosis and potentially leading to various pregnancy-related health issues. Currently used OSA screening tools, such as the Berlin Questionnaire, STOP-BANG Questionnaire, and Epworth Sleepiness Scale, often demonstrate poor predictive value in pregnant women due to the dynamic physiological changes of pregnancy and the differing presentation of OSA in this population.

PURPOSE: To examine the relationships between a positive OSA diagnosis, patient characteristics, and the symptoms among pregnant patients referred for sleep studies.

EBP QUESTIONS: 1) Is there a relationship between certain referring …

Predicting Trauma Admission In Anticoagulated Geriatric Patients Presenting With A Ground Level Fall, Y-Nhi H. Bui Ms, Trevor Glad Bmus, Dylan Jack Bs, Michael Martyak

Knowledge and Creativity Expo

Our study undertook a rigorous investigation into an expanding trauma patient population, tackling some of the significant challenges with this patient population in trauma triage. Our research has not only addressed key questions, but has also paved the way for future inquiries by offering innovative perspectives. This presentation is particularly important given the current advancements and interests in geriatric trauma. We hope that our findings will influence ongoing projects and spark collaborations among diverse research communities.

Heterotopic Pancreas Masquerading As Barrett’S Esophagus, Suravi Khanal, Shama Bhandari, Anish Paudel

Tower Health Research Day

No abstract provided.

Interview With Orca Award Winner David Hage, Unl Chemistry; Drug-Protein Interactions, Mark Griep, David Hage

UNL ORCA Interview Series

Prof. David Hage was awarded the ORCA in 2018. He was born in La Crosse, Wisconsin, and earned a bachelor’s in chemistry at the University of Wisconsin in La Crosse. Next, he earned a doctorate from Iowa State University and did postdoctoral work at the Mayo Clinic in Rochester, Minnesota. In 1989, he joined UNL as an assistant professor of chemistry and quickly rose through the ranks. He has won many awards and, for the past 13 years, has been the James Hewet University Professor of Chemistry. Allow me to share some remarkable facts about Dave before we get into …

Dyadic Internalized Stigma, Resilience, And Psychological Distress Among People With Hiv And Their Family Members: An Actor-Partner Interdependence Mediation Model Analysis, Fanghui Shi, Xueying Yang, Shan Qiao Ph.D., Cheuk Chi Tam Ph.D., M.S., M.A., Shuaifeng Liu, Yuejiao Zhou, Xiaoming Li Ph.D.

Faculty Publications

Despite robust evidence showing the mediation role of psychological resilience in the impacts of HIV-related stigma on psychological distress, most studies were conducted from an intrapersonal perspective. Limited studies have examined the dyadic effects of HIV-related stigma and resilience on psychological distress for people with HIV (PWH) and their family members. This study aimed to explore the actor-partner effect and the mediation role of resilience in the relationship between internalized stigma and psychological distress among PWH and family members dyads. Between October 2023 and December 2023, a total of 800 PWH-family member dyads were recruited from two urban cities and …

A Livelihood Intervention Improved Nutritional, Mental Health And Sexual Health Outcomes Among Hiv-Affected Adolescents In Western Kenya: Results From The Shamba Maisha Randomised Controlled Trial, Sheri D. Weiser, Lila Aziz Sheira, Pauline Wekesa, Jennifer Monroe Zakaras, Edward A. Frongillo Jr. Ph.D., Elly Weke, Jason M. Nagata, Amy A. Conroy, Marguerita Lightfoot, Torsten B. Neilands, Lisa M. Butler, Elizabeth A. Bukusi, Craig R. Cohen, Maricianah Atieno Onono

Faculty Publications

Introduction Interventions that address household-level factors, including food insecurity (FI) and poverty, may reduce HIV risk and improve sexual and reproductive health (SRH) among adolescent girls and young women (AGYW).

Methods This cluster randomised controlled trial in Kenya assessed AGYW living in households of adults enrolled in Shamba Maisha (SM). SM was a multisectoral agricultural livelihood intervention designed to improve HIV health. At the trial end, we used linear and logistic regressions to compare differences between the intervention and control arms in FI, and mental health among AGYW-caregiver pairs and SRH outcomes among the AGYW, accounting for clusters with robust …

Assessing Type 2 Diabetes Mellitus, Christine A. Mccaulay

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice capstone project presents the development and evaluation of a clinical practice guideline (CPG) for the assessment and management of Type 2 Diabetes Mellitus in adults. The project addresses the ongoing challenge of diabetes-related complications and hospitalizations, highlighting the critical role of personalized patient education and the integration of smartphone technology for home monitoring. Central to this initiative was the question of whether an expert panel would endorse an evidence-based guideline for diabetes monitoring using innovative technology, as evaluated by the AGREE II tool. A robust review of the literature supported the guideline’s development, with high-quality …

Reducing Social Isolation In Elderly Hospice Patients Through Structured Social Interventions, Ashley Babayan

Walden Dissertations and Doctoral Studies

This doctoral project was conducted as a quality improvement organizational change initiative aimed at reducing social isolation among elderly hospice patients through structured social interventions. Social isolation is a significant psychosocial concern in hospice populations and is associated with increased emotional distress, depression, and decreased quality of life. Despite hospice care’s holistic philosophy, structured and standardized social engagement interventions are inconsistently implemented across settings, creating a gap in practice. The practice-focused question guiding this project was: In elderly hospice patients experiencing social isolation, how do structured social interventions (regular visits, group activities, and emotional support systems), compared to standard hospice …

Strategic Planning Time Horizons And Hospital Performance Outcomes, David Meyer

MUSC Theses and Dissertations

Background: Despite widespread adoption of strategic planning in healthcare, empirical evidence linking strategic planning time horizons to hospital financial and quality performance outcomes remains limited. Healthcare executives invest substantial resources in strategic planning processes, yet lack evidence-based guidance on whether longer or shorter planning horizons yield enhanced financial and quality-related results.

Methods: This study employed an exploratory sequential mixed-methods design combining executive survey data with archival performance data. A REDCap survey was administered to 22 hospital CEOs, CFOs, and other C-suite executives between January and February 2026. Survey responses were matched to publicly available financial and quality performance data from …

Measurable Gains In Understanding Interprofessional Competencies: Insights From Medical Student Clerkship Observation Of A Nicu Graduate Follow-Up Clinic, Grace Berentson, Liliana Bronner, Neil Kalsi, Paige Hardy, Brianna Brei, Kerry Miller

Posters and Presentations: Family Medicine

No abstract provided.

Outcomes With Single Tremelimumab Regular Interval Durvalumab (Stride) For Unresectable Hepatocellular Carcinoma In The Us Veterans Administration, Shalini Bansal, Priya Amin, Courtney Williamson, Stephen Valerio, David Kaplan

Student Papers, Posters & Projects

Background: HIMALAYA demonstrated that STRIDE (Single Tremelimumab Regular Interval Durvalumab) significantly improved overall survival (OS) compared with sorafenib in participants with unresectable hepatocellular carcinoma (HCC). This retrospective, real-world cohort study evaluated outcomes with STRIDE in veterans with HCC. Methods: Patients diagnosed with HCC between 1 January 2008 and 28 February 2024 who received ≥1 dose of STRIDE for unresectable disease were included. Data were collected from the Veteran Affairs Corporate Data Warehouse. Safety and efficacy were evaluated overall and for subgroups of patients with Child–Pugh A versus Child–Pugh B cirrhosis, viral versus non-viral HCC, and those with versus without prior …

Socioeconomic Disparities In Readmission Outcomes And Cardiac Procedures Among Atrial Fibrillation Hospitalizations, Muhammad U. Almani, Muhammad Yousuf, Noor Fatima, Muhammad Q. Ullah, Muhammed Arshad

Einstein Health Papers

Introduction: Atrial fibrillation (AF) remains one of the leading dysrhythmias incurring hospitalization. We set out to determine the impact of socioeconomic status (SES) on in-hospital cardiac procedures and the readmission outcomes in patients with AF. Methods: The National Readmission Database (NRD) was searched for adults with a primary diagnosis of AF between 2010 and 2019. We determined unplanned AF-specific readmission within 30 days. Median neighborhood household income was assessed by patient zip code as quartiles: low income (Q1), middle income (Q2), upper-middle income (Q3), and high income (Q4). Differences in in-hospital cardiac procedures during the index hospitalization and probability of …

Donor Sex And Platelet Storage Change The Therapeutic Effects Of Platelet-Derived Extracellular Vesicles On Endothelium, Mandeep Kaur, Malvika Gupta, Sowmya Shree Gopal, Charles E. Wade, Jessica C. Cardenas, Amit K. Srivastava

Cardeza Foundation for Hematologic Research

Platelet-derived extracellular vesicles (PEVs) play an active role in vascular protection and repair and are being explored as a viable alternative to platelet therapy. Because platelet function and stability are shaped by donor sex and storage conditions, these same factors are likely to influence the PEVs they release. Understanding these influences is key to developing PEVs into a safe and dependable therapeutic option. In this study, we investigated how donor sex and platelet storage affect the therapeutic properties of PEVs. To address this, PEVs were isolated from platelets of healthy male and female donors. Platelets were either processed immediately after …

What Factors Influence Health Professions Trainees’ Preferences For Employment In Rural Appalachia? A Qualitative Study To Inform The Design Of A Discrete Choice Experiment, Chris Gillette, Jan Ostermann Ph.D., Aylin A. Aguillar, Sarah O'Neal, Chris Everett, Dawn Caviness, Esita Patel, Laiton Steele, Dawn Goel, Quazi Minhaz Tabassum

Faculty Publications

Optimizing the geographic allocation of health care providers has the potential to improve health care access and health outcomes for rural populations. To inform the design of a discrete choice experiment (DCE) survey to elicit health professions trainees' preferences for rural practice, this formative research aimed to: (1) elicit factors that influence job selection among health profession trainees, including medical residents physician assistant (PA) and nurse practitioner (NP) students, (2) identify how these trainees evaluate trade-offs for rural job placement and (3) inform attribute selection for inclusion into a future DCE to identify health professions trainees’ preferences for rural practice. …

Utilizing Proactive Rounding With Nursing Leadership To Improve Patient Satisfaction Scores In An Adult Medical-Surgical Unit, Lily A. Bogyah

Student Scholarly Projects

Practice Problem: Patient satisfaction is a key quality indicator that reflects patients’ perceptions of care and the healthcare system’s performance. Patient satisfaction scores at the project site were significantly lower than the national benchmark, particularly on the adult medical-surgical unit.

PICOT: The PICOT question that guided this project was: In patients on an adult medical-surgical unit (P), how does the use of proactive patient rounding conducted by nurse leaders (I) versus current practices alone without such rounding (C) affect patient satisfaction scores over an eight-week period (T)?

Evidence: A literature review of multiple studies found that implementing daily nurse leader …

Practice Patterns And Inpatient Outcomes In Lung Abscess: A Cross Sectional Study, Saikou Saidy, Ali Iqbal, Saqib H. Baig

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

Background: Lung abscess is typically managed with antibiotics, but drainage procedures are sometimes performed when there is inadequate clinical response or when source control is needed. Real-world inpatient practice patterns remain incompletely described in contemporary U.S. data. Our aim was to evaluate national inpatient practice patterns, predictors of procedural intervention, and associated in-hospital outcomes and resource utilization among patients hospitalized with lung abscess managed conservatively, with bronchoscopic drainage, or with percutaneous drainage.

Methods: Using the National Inpatient Sample (NIS) (2016–2018), we identified adult (18 years and older) hospitalizations with a principal diagnosis of lung abscess [International Classification of Diseases, 10th …

Monitoring Relapse In Post-Transplant Acute Myeloid Leukemia Requires Integrated Assessment, With Flow Cytometry Showing The Highest Efficacy, Wei J Wang, Sa A Wang, Hong Fang, Qing Wei, Shimin Hu, Sanam Loghavi, Gheath Al-Atrash, Chenxuan Zang, Peng Wei, Jeffrey L Medeiros, Wei Wang

Faculty, Staff and Student Publications

No abstract provided.

An Integrated Germline And Somatic Genomic Model For Coronary Artery Disease, Xiong Yang, Min Seo Kim, Xinyu Zhu, Md Mesbah Uddin, Tetsushi Nakao, So Mi Jemma Cho, Satoshi Koyama, Tingfeng Xu, Laurens F Reeskamp, Rufan Zhang, Zhaoqi Liu, Yunga A, Paul S De Vries, Ramachandran S Vasan, Eric Boerwinkle, Alanna C Morrison, Bruce M Psaty, Russell P Tracy, Susan R Heckbert, Michael H Cho, Jeong H Yun, Nicholette D Palmer, Donald W Bowden, Joanne M Murabito, Daniel Levy, Nancy L Heard-Costa, George T O'Connor, Lewis C Becker, Brian G Kral, Lisa R Yanek, Laura M Raffield, Bertha Hidalgo, Jerome I Rotter, Stephen S Rich, Kent D Taylor, Wendy S Post, Charles Kooperberg, Alexander P Reiner, Braxton D Mitchell, Sharon L R Kardia, Jennifer A Smith, Patricia A Peyser, Lawrence F Bielak, Dong Keon Yon, Hong-Hee Won, Donna K Arnett, Albert V Smith, Stacey B Gabriel, Patrick T Ellinor, Nhlbi Trans-Omics For Precision Medicine (Topmed) Consortium, Pradeep Natarajan, Minxian Wang, Akl C Fahed

Faculty, Staff and Student Publications

Multiple germline and somatic genomic factors are associated with risk of coronary artery disease, but there is no single measure of risk that integrates all information from a DNA sample. To address this gap, we develop an integrated genomic model that includes six germline and somatic genetic drivers for coronary artery disease, including polygenic risk score, genetically-proxied proteomic/metabolomic risk scores, and clonal hematopoiesis of indeterminate potential. We evaluated its predictive power in the UK Biobank (N = 391,536), and validate it using data from the TOPMed program (N = 34,177). The 10-year coronary artery disease risk based on the integrated …

The Development Of A Framework To Classify Medication Deprescribing Among Patients With Type 2 Diabetes In Primary Care Practices, Puja B Gandhi, Yoav Jacob, Joeita F Macfield, Gia Merlo, Stefanie M Meyer, Shivani S Patel, Caroline Rhéaume, Kara L Staffier, Madeline Watson, Micaela C Karlsen

Faculty, Staff and Student Publications

No abstract provided.