Digital Commons Network^™

Assessing Social Determinants Of Health In Primary Care, Vicki Carpenter

Doctoral Projects

The social determinants of health encompass the various circumstances and environments in which individuals reside, develop, labor, and experience aging (Social Determinants of Health, 2022). These variables significantly contribute to the existence of health inequities and disparities within populations. In order to effectively mitigate health disparities, it is imperative to consider the various determinants that influence health outcomes, as this consideration is crucial for advancing the goal of achieving health equity. This public health concern encompasses multiple sectors within our society, necessitating the collaboration of various organizations and communities to effectively address and mitigate its impact.

The fundamental …

A Quality Improvement Project To Increase Awareness And Utilization Of Employee Assistance Program Services Among Healthcare Providers, Scarlet Gould

Doctoral Projects

Mental health distress among healthcare providers (HCP) is a common problem, yet Employee Assistance Programs (EAP) are consistently underutilized. Unmanaged workplace stress can lead to problems such as provider burnout and increased rates of turnover, which can result in decreased access to patient care. The purpose of this project was to increase awareness and utilization of EAP services by using the Plan-Do-Study-Act cycle (PDSA) for quality improvement. Nurse Practitioners at a community-based hospital were provided with a PowerPoint^® presentation via email that contained information regarding the facility’s employee assistance program, mental health wellness education, as well as ways to …

Encouraging Medication Compliance By Implementing A Medication Adherence Tool, Regina Taylor

Doctoral Projects

Medication non-adherence has been a common and challenging problem in health care, especially among mental health patients. Studies show medication compliance among psychiatric patients has been at a lower rate than patients with physical conditions. Non-compliance with medications has been one of the considerable contributions to rapid psychiatric hospital readmission. Rapid readmissions have been costing health care billions of dollars annually. The stigma behind mental health has a large contribution to why mental health patients are non-compliant with their psychotropics. Utilization of the Medication Adherence Rating Scale (MARS) on a patient to evaluate the patient's willingness and ability to take …

An Objective Structured Clinical Examination For Anesthetic Management Of Pheochromocytoma, Shiar Rahaim

Doctoral Projects

Pheochromocytoma, whether recognized or unrecognized, has the potential to cause severe cardiovascular complications during surgery. This paper focuses on the creation and importance of an Objective Structured Clinical Examination (OSCE) and a short trigger film focused on the anesthetic management of pheochromocytoma. This OSCE intends to help prepare students to recognize and treat undiagnosed or improperly managed pheochromocytoma in the didactic phase of their learning so as to better prepare them for the possible real-life scenario.

The pathophysiology of pheochromocytoma regarding the catecholamines epinephrine and norepinephrine are discussed along with their potential to wreak havoc on the patient. The treatment …

Implementing A Systematic Depression Screening In The Primary Care Setting, Cassandra Moore

Doctoral Projects

The Advanced Practice Nurse is responsible for providing quality care and treatment for the whole person. 3 John 1:2 KJV states, “I wish above all things that you may prosper and be in health, even as your soul prospers” (King James Bible, 2023, para. 2). To prosper and be in health refers to a holistic approach in which the mind, body, and spirit of an individual is considered. Mental health care is an integral part of the holistic health approach.

Mental illness affects approximately one in five adults (52.9 million) in the United States alone (National Institute of Mental Health …

Employee Experiences With Leaders’ Influence On Autonomous Motivation: A Mixed Methods Study, Melissa Wheat

Dissertations

Organizational performance and success require employee motivation (Delaney & Royal, 2017; Devarapalli & Hinkes, 2016; Good et al., 2022; Howard et al., 2016; Mohamud et al., 2017; Olafsen et al., 2018; Ryan & Deci, 2017; Van den Broeck et al., 2021; Wiley, 1997). However, organizational leaders fail to effectively motivate employees to engage in the workplace and achieve high performance (Delaney & Royal, 2017; Fisher, 2009; Good et al., 2022; J. D. Jensen, 2018; Pappas, 2021; Webb, 2007; Workers Are Motivated by Different Drivers and Needs, 2022). This study explored employee experiences with leaders’ influence on autonomous motivation to …

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 …

Point Of Care Ultrasound For The Diagnosis Of A Pneumothorax: An Objective Structured Clinical Examination, Shelby Dye, Hannah Fortenberry

Doctoral Projects

A pneumothorax is a complication that can result from skills performed by anesthesia providers. Prompt recognition can be achieved by the use of an ultrasound and can potentially improve patient outcomes. At The University of Southern Mississippi’s (USM) Nurse Anesthesia Program (NAP), no current objective structured clinical examination (OSCE) for detecting a pneumothorax by point of care ultrasound (POCUS) exists. USM’s NAP recognized the need for an evidence-based OSCE for the detection of pneumothorax with POCUS. The gap in knowledge prompted the development of the demonstrational video and OSCE template to potentially increase student confidence in the clinical setting.

The …

Improving Screening Mammography Recommendation And Referral In Primary Care Through Implementation Of A Provider Prompt, Christon Elfring

Doctoral Projects

In the United States, breast cancer has been established as the second most prevalent cancer among women (Centers for Disease Control [CDC], 2022a). There may be no symptoms present in the early stages of breast cancer and a low potential to spread during the early phases (World Health Organization [WHO], 2021). Mammography is the only test that has been shown to reduce deaths from breast cancer as it allows for early detection when cancer is in its most treatable stage improving survival and lessening the need for extensive treatment (American College of Radiology [ACR], n.d.). While the effectiveness of screening …

Perceptions Regarding Service/Volunteerism In Postsecondary Education With Students With Intellectual Disabilities, Coraliz Martinez

Honors Theses

The purpose of this study is to analyze the perceptions postsecondary education programs for students with intellectual disabilities have on the topic of service learning and volunteerism. The goal is to analyze college programs in the Southeast portion of the United States to determine if this topic is incorporated into their curriculum and analyze their perception of the topic. Twenty-six staff members from different postsecondary education programs completed a questionnaire that analyzed their program as a whole. The data indicates that the programs that incorporate service/volunteerism within their program prioritize service/volunteerism and state it has made a positive impact on …

Diver Perceived Value And Satisfaction On The Mississippi Gulf Coast, Ka'lon Duncanson

Honors Theses

The Mississippi Gulf Coast is known for its coastal beauty and the tourism that comes from the recreational activities associated with the water. However, there appears to be an underserved segment of the tourism industry. The coast provides opportunities for local scuba divers to take part in a range of diving activities, but there is minimal support for this tourism activity in Mississippi. There is a need for greater understanding about what local divers value in their diving experiences and how this might lead to greater satisfaction with this activity. Along with overall perceived value, the argument is made that …

Transitioning To College: First-Generation African American College Students' Mental Health Beliefs And Coping Strategies, Kadija Polk

Dissertations

Mental health issues such as depression and anxiety are a growing concern on college campuses. However, college students typically underutilize mental health treatment (Ebert et al., 2019). First-generation African American college students are at an increased risk of developing mental health issues, but the research related to this population’s mental health is insufficient (Eakins & Eakins 2017; Gibbons et al., 2019 Williams et al., 2020). The transition to college is full of stressors that many first-generation students may feel unequipped to handle. However, there is limited research that focuses on how the transition to college affects first-generation African American college …

Objective Structured Clinical Examination (Osce) For Transversus Abdominis Plane (Tap) Block Utilizing Ultrasound Technique, Gursharn Dhaliwal, Anesha Handshaw

Doctoral Projects

The purpose of this doctoral project was to create a learning and evaluation tool on Transversus Abdominis Plane (TAP) blocks to be used by students in the Nurse Anesthesia program (NAP) at The University of Southern Mississippi (USM). Students can use this tool to help facilitate learning and skills in regional anesthesia techniques. An Objective Structured Clinical Examination (OSCE) for ultrasound-guided TAP blocks was created and evaluated by the USM NAP faculty and current second and third-year NAP students. Participants were provided with an OSCE template outlining the steps, educational resources, and equipment needed to perform a TAP block. The …

An Objective Structured Clinical Examination (Osce) For Adductor Canal Block (Acb) And Interspace Between The Popliteal Artery And Capsule Of The Knee (Ipack) Block, Michael Berg, Jake Penick

Doctoral Projects

Ultrasound-guided regional anesthesia techniques are valuable tools for anesthesia providers to learn and implement in their practice. Two specific blocks that student registered nurse anesthetists (SRNAs) need to utilize are the Adductor Canal Block (ACB) and the Interspace between the Popliteal Artery and Capsule of the Knee (iPACK) for total knee arthroscopy (TKA). Teaching these blocks to SRNAs in the clinical setting may be difficult as they will be under higher pressure to perform since they will be practicing on live patients. Understanding this stress led to a review of current Nurse Anesthesia Program (NAP) curriculum at The University of …

An Objective Structured Clinical Examination For Pediatric Inhalation Induction And Nasotracheal Intubation, Laura Beth Hailey, Alexa Hogan

Doctoral Projects

Inhalation induction and nasotracheal intubation are two vital parts of anesthesia when caring for the pediatric population. Student Registered Nurse Anesthetists (SRNAs) must be knowledgeable of the significant differences in anesthetizing an adult versus a child and be able to perform the skills associated with putting the pediatric population to sleep. These specialized skills may be challenging to perform on an actual patient without simulation and practice. The Nurse Anesthesia Program (NAP) faculty at The University of Southern Mississippi (USM) recognized that there was a gap between learning about the skills in didactic courses and successfully performing in clinical.

This …

Cricothyrotomy And Transtracheal Jet Ventilation Best Practices For Nurse Anesthesia, Kevin Marchant, Tony Sistrunk

Doctoral Projects

The doctoral project aimed to develop a mechanism that could be used to complete cricothyrotomy and transtracheal jet ventilation at The University of Southern Mississippi Nurse Anesthesia Program. The basis for this doctoral project was an objective structured clinical evaluation (OSCE) for achieving a cricothyrotomy and transtracheal jet ventilation. Best practice techniques were analyzed and executed in the creation of this OSCE.

Performing cricothyrotomy and transtracheal jet ventilation in a simulation environment before clinical practice allows student registered nurse anesthetists (SRNA) a greater degree of confidence while preserving patient safety. Increased competency and patient safety in the clinical setting were …

Quality Improvement Project To Assist In Implementation Of Prediabetes Screen Protocol, Kyai Forney

Doctoral Projects

Prediabetes is a reversible condition that causes blood glucose levels to be higher than normal, but not high enough to be diagnosed as type 2 diabetes. When one has prediabetes, the cells in the body do not respond normally to insulin, and insulin acts like a key to letting blood sugar into cells to use energy. The pancreas produces insulin to try to get the cells to respond, but eventually, the pancreas has a challenging time keeping up, and the blood sugar level rises causing prediabetes (Lehrman, 2021). A person can have prediabetes for years with no obvious symptoms, so …

Anesthetic Management For Brain-Dead Donors During Organ Procurement Procedures: Best Practice Recommendations, Cindel Mayerhoff

Doctoral Projects

Americans today face an increased need for organ transplants as lifesaving measures. Regardless of patient circumstances or comorbidities, the need for a transplant is more significant than ever before, but it far exceeds the number of available transplantable organs. For this reason alone, each organ procurement case should be meticulously managed; therefore, the role of the CRNA during organ procurement cases of brain-dead donors (BDD) is crucial. Maintaining organ viability for transplant is essential in laying the foundation for the recipient's successful outcome. However, many organ procurement procedures often occur in rural hospitals or at odd hours so some anesthesia …

Studying The Impact Of Hyperlipidemia Monitoring Tools On Referral Rates In Patients Taking Antipsychotics, Jasmyn S. Allen

Doctoral Projects

The purpose of this DNP project is to determine how well an evaluation tool may be used to track hyperlipidemia in patients using antipsychotic medicines who are between the ages of 20 and 50. Elevated lipid contents in the bloodstream, or hyperlipidemia, increase the danger of heart-related illnesses. Antipsychotic drugs, frequently administered for mental health disorders and dyslipidemia, have been connected. The goal is to ascertain whether utilizing an evaluation tool raises the three-month referral rates for hyperlipidemia to primary care (Dayabandara et al., 2017). The foundation of the research is found in several articles collected from different websites. According …

An Objective Structured Clinical Examination (Osce) For Pec-Ii And Intrapec Block For Breast Augmentation Surgery, Kaleb Smith

Doctoral Projects

Ultrasound-guided regional anesthesia techniques are valuable tools for anesthesia providers to learn and implement in their practice. Two specific blocks that student registered nurse anesthetists (SRNAs) need to utilize are PECS-II and the Intrapec block for reconstructive breast augmentation and mastectomies. Teaching these blocks to SRNAs in the clinical setting may be difficult as they will be under higher pressure to perform since they will be practicing on live patients. Understanding this stress led to a review of the current Nurse Anesthesia Program (NAP) curriculum at The University of Southern Mississippi (USM) and found a gap in the education, which …

Assessment Of Appropriate Antibiotic Usage After Intervention To Increase Antibiotic Stewardship In A Rural Health Care Setting, Mayci Mccloud Speights

Doctoral Projects

Antibiotics are a powerful and useful tool prescribed by healthcare providers to treat bacterial infections in patients. However, when antibiotics are unnecessarily prescribed or improperly consumed or not consumed by patients, antimicrobial resistance (AMR) can ensue. Antibiotic resistance (ABR) is an urgent public health threat and is, unfortunately, the root cause of many deaths in the United States every year. According to the Centers for Disease Control (CDC), in the United States, more than 2.8 million antimicrobial-resistant infections occur each year, and more than 35,000 people die as a result (Centers for Disease Control [CDC], 2022a). Even further, when infections …

Effectiveness Of Staff Training On Trauma-Informed Care, Brandy Tramel Williams

Doctoral Projects

The connection between experiencing trauma and the development of substance use disorder is widely recognized. Although trauma is more prevalent among individuals with substance use disorders, healthcare professionals have limited access to training focused on trauma informed care. It is crucial for those working in addiction treatment to receive training and education on trauma informed care to understand the impact of trauma and its association with substance use disorders.

This DNP project's objective was to develop and evaluate an educational presentation for staff emphasizing the importance of trauma-informed care in the context of addiction. The effectiveness of this intervention was …

A Quality Improvement Project: Implementing A Sleep Disturbance Screening Questionnaire In A Primary Care Clinic, David Elder Hamby

Doctoral Projects

At present time, it is estimated that 50-70 million Americans suffer from some form of sleep disturbance (disrupted sleep) and subsequently, sleep disorders (formal diagnosis) (Hanson & Huecker, 2022), which has a direct correlation between sleep disorders and many existing common comorbid conditions. Patients commonly report experiencing excessive daytime sleepiness, inability to focus or concentrate, generalized fatigue, decreased libido, and lability of emotions. As a person ages, there is an increasing trend in the reduction of quality and quantity of sleep. Due to Americans living longer, the number of Americans living with sleep disturbance has significantly ballooned in recent decades. …

Early Identification Of Barriers To Medication Adherence In The Elderly Population Through The Use Of A Modified Screening Tool, Miranda Joyner, Blake Meranto

Doctoral Projects

Medication nonadherence (MNA) is a major contributor to hospitalizations and accounts for billions of dollars spent every year on health care. Despite medications being prescribed in nearly 75% of healthcare interactions, it is estimated that 33 to 50% of Americans do not take their medications as prescribed, if at all (Bartlett Ellis et al., 2020; Kleinsinger, 2018). The COM-B (Capability, Opportunity, Motivation, Behavior) Model used in this DNP project suggests that an individual must have the capability, opportunity, and motivation to enact a certain behavior, and should any of these areas be lacking, the behavior is unlikely to occur. This …

Interests And Decent Work’S Account Of Well-Being And Job Performance In A Lower Social Class Sample, Benjamin J. Wright

Dissertations

There is a need for more accurate information regarding the work-related experiences of individuals from lower social class backgrounds. The present study seeks to evaluate the degree to which important career-related variables (e.g., interest congruence, decent work) account for differences in subjective well-being (SWB) and job performance (e.g., occupational citizenship behavior [OCB], task performance) for a sample of adults from lower social class backgrounds. A novel approach to evaluating the objective indicators of social class for individual study participants was implemented to collect a sample of 365 participants, 105 of which were included in analysis. A path analysis was conducted …

A Study Of The Relationship Between Fdi Inflows And Entrepreneurial Activity At The Country Level, Jeff Cohu

Dissertations

This dissertation focuses on the relationship between FDI inflows and entrepreneurial activity at the country level in a 3-essay format. Building on the competing theories of knowledge spillover theory of entrepreneurship (KTSE) and the occupational choice model (OCM), this research seeks to determine if FDI inflows and entrepreneurship are complimentary or competing phenomenon.

Essay 1 analyzes the existing comparative entrepreneurship measures available through a correlation matrix using panel study data from 172 countries and territories from 2006 to 2019. This essay finds that the available measures of comparative entrepreneurship are not as highly correlated as anticipated and that there are …

Human Capital Flight: Determinants Of Out-Migration Decisions Among Mississippi’S College Graduates, Felicia M. Bowens

Dissertations

In today's knowledge economy, the retention of skilled and college-educated workers is vital to the economic stability and long-term competitiveness of any region (Bernhard, 2007; Ehrke, 2014; He et al., 2016; Khaomin et al., 2022; Miller & Collins, 2022; Moretti, 2012; White et al., 2022; Winters, 2011). As the global economy evolves, Mississippi must continue accumulating and cultivating a workforce ready to meet the demands of today's labor markets. However, with the out-migration of Mississippi's college graduates post-graduation, the state continues to lose a valuable resource, its human capital (Miller & Collins, 2023; Miller & Collins, 2022; Mississippi Economic Council, …

The Impact Of Social Determinants Of Health And Acculturation On Quality Of Life In Older Chinese American Adults With Chronic Pain: A Quantitative Study, Chi Lam

Dissertations

Despite a rapid increase in the older Chinese American adult population, there are very few research studies examining the impact of social determinants of health and acculturation on the quality of life in older Chinese American adults. The purpose of the study was to determine the impact of social determinants of health and acculturation on quality of life in older Chinese American adults with chronic pain. This quantitative, descriptive correlational study utilized Madeleine Leininger’s Transcultural Theory as its theoretical framework. Two research questions guided this study: (1) Was there a difference in the quality of life in older Chinese American …

A Rudimental Drumming Vocabulary Applied To The Folk Music Of Argentina, Justin Sherrod

Dissertations

This dissertation examines the methods and approaches used by Argentine percussionist Mr. Sebastian Hoyos to incorporate rudimental drumming into the composition Soy de Salta: Suite para percusión criolla y orquesta. The study demonstrates the steps taken to employ Argentinian folk music content through four folk styles: Baguala, Zamba, Chacarera, and Carnavalito. The bombo legüero, one of Argentina's most well-known and essential folk percussion instruments, plays a supportive and dominant role in Soy de Salta, introducing rudimental components into the music. This original research therefore addresses rudiments, variations of rudiments, and simple and complex writing styles for the snare drum …

The Effects Of Stepped Care On Burnout For University Counseling Center Clinicians, Madison Estrada

Dissertations

The ability of university counseling centers (UCCs) to meet the increased demand for service by students is becoming an increasing concern. While UCCs are seeing more students than ever, this increased demand has not been met with an increase in resources. As such, UCC clinicians are at a greater risk for developing burnout. However, according to the Demand – Control – Support Model, this risk could be reduced if UCC staff were afforded higher degrees of control over the resources they do have and received adequate support and acknowledgement for the work they accomplish. Through surveying 339 UCC clinicians in …