Digital Commons Network^™

Chlorhexidine Gluconate Bathing In Hospitalized Patients: Reducing Barriers And Increasing Compliance Rate, Maria R. Dominguez

Master's Projects and Capstones

The organization-wide implementation of Chlorhexidine Gluconate (CHG) bathing protocol is one of many measures used to help reduce hospital-acquired infections (HAI) at the 30-bed, Medical-Surgical Specialties and Palliative Care Unit. CHG bathing compliance rate for the unit for the week of August 14-20 was 82.9%, with a 40.4% refusal rate. This is below the 90% desired performance rate. The purpose of this project is to identify the barriers to CHG compliance and to implement interventions that will aid in reducing these barriers and increase CHG compliance rate. Patient declining was identified as one of the main barriers to CHG bathing. …

Drink Me And Abort Your Baby: The Herbal Abortion Tea, Maya Lewis

Capstones

For most of history every abortion was a herbal abortion. Herbal abortion is exactly what it sounds like––a series of herbs that, if taken at the right time, in the right form and dosage, can induce a miscarriage. It's risky, under researched and rarely supported. But with women's clinic dwindling all over the country and a president elect who wants to repeal Roe v. Wade, herbal abortion might soon make a major come back–– for better or worse.

Link to capstone project: https://medium.com/@maya.lewis/drink-me-and-abort-your-baby-the-herbal-abortion-tea-46aadd15f659

The Future Of Music: Exploring Noise And Pop With Cienfuegos, Reed Dunlea

Capstones

Pop music today has become increasingly filled with sonic elements that are much more abrasive than traditionally acceptable. This piece explores how pop music got to this point, the underground subcultures that it draws influence from, and what's next.

Flight Of The Freshwater Fish, Michael H. Wilson

Capstones

Michael H. Wilson

Capstone Abstract

December 27, 2016

Flight of the Freshwater Fish

The Hudson River provides for millions of people as a path for commercial and private transportation, a source of food and energy, and perhaps most importantly for many living in the tri-state area as a destination for recreation and relaxation. The most overlooked feature of the river is how the wildlife shows clear signs of a changing climate and rapid environmental response to the impacts of global warming on the river.

Entire populations of fish species in the lower Hudson have been forced to leave the river …

Breakdown: Treatment Gaps In New York City's Mental Health System, Christine Brink Kjeldgaard, Noah Caldwell, Mary Hanbury, Mike O'Brien, Joanna Purpich, Anthony Izaguirre

Capstones

Forty years after New York City began to "deinstitutionalize" its mental health system in hopes of building community-based care, the city is still falling short. This investigative project, undertaken by six reporters at CUNY's Graduate School of Journalism, uncovers the treatment gaps facing mentally ill New Yorkers, who are among the most vulnerable in the city. The project follows them to the actual places where they seek care: hospitals, clinics, homeless shelters, prisons and schools.

Alternative Protein Sources In The Diet Modulate Microbiota And Functionality In The Distal Intestine Of Atlantic Salmon ( Salmo Salar ), Karina Gajardo, Alexander Jaramillo-Torres, Trond M. Kortner, Daniel L. Merrifield, John Tinsley, Anne Marie Bakke, Åshild Krogdahl

School of Biological and Marine Sciences

No abstract provided.

The Role Of Ultrasound In The Diagnosis Of Carpal Tunnel Syndrom, Ali Taha Hassan Al-Azzawi

Muthanna Medical Journal

The aim of this study is to confirm the accuracy of sonography in the diagnosis of the carpal tunnel syndrome by measuring the cross-section area of the median nerve. A prospective study of 80 patients suspected of having carpal tunnel syndrome was underwent sonography at Al-Hussein Teaching Hospital in Samawa city from 1/1/2015 to 1/1/2016. The cross sectional area of the median nerve was measured at three levels, immediately proximal to carpal tunnel inlet, at carpal tunnel inlet and carpal tunnel outlet. The average value was measured. The flexor retinaculum was used as a landmark to margin of the carpal …

Pelvic And Breast Examination Skills Curricula In United States Medical Schools: A Survey Of Obstetrics And Gynecology Clerkship Directors., Lorraine Dugoff, Archana Pradhan, Petra Casey, John L. Dalrymple, Jodi F. Abbott, Samantha D. Buery-Joyner, Alice Chuang, Amie J. Cullimore, David A. Forstein, Brittany S== S. Hampton, Joseph M. Kaczmarczyk, Nadine T. Katz, Francis S. Nuthalapaty, Sarah M. Page-Ramsey, Abigail Wolf, Nancy A Hueppchen

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Learning to perform pelvic and breast examinations produces anxiety for many medical students. Clerkship directors have long sought strategies to help students become comfortable with the sensitive nature of these examinations. Incorporating standardized patients, simulation and gynecologic teaching associates (GTAs) are approaches gaining widespread use. However, there is a paucity of literature guiding optimal approach and timing. Our primary objective was to survey obstetrics and gynecology (Ob/Gyn) clerkship directors regarding timing and methods for teaching and assessment of pelvic and breast examination skills in United States medical school curricula, and to assess clerkship director satisfaction with current educational strategies …

Pelvic And Breast Examination Skills Curricula In United States Medical Schools: A Survey Of Obstetrics And Gynecology Clerkship Directors, Lorraine Dugoff, Archana Pradhan, Petra Casey, John L Dalrymple, Jodi F Abbott, Samantha D Buery-Joyner, Alice Chuang, Amie J Cullimore, David A Forstein, Brittany S Hampton, Joseph M. Kaczmarczyk, Nadine T Katz, Francis S Nuthalapaty, Sarah M Page-Ramsey, Abigail Wolf, Nancy A Hueppchen

PCOM Scholarly Works

BACKGROUND: Learning to perform pelvic and breast examinations produces anxiety for many medical students. Clerkship directors have long sought strategies to help students become comfortable with the sensitive nature of these examinations. Incorporating standardized patients, simulation and gynecologic teaching associates (GTAs) are approaches gaining widespread use. However, there is a paucity of literature guiding optimal approach and timing. Our primary objective was to survey obstetrics and gynecology (Ob/Gyn) clerkship directors regarding timing and methods for teaching and assessment of pelvic and breast examination skills in United States medical school curricula, and to assess clerkship director satisfaction with current educational strategies …

Staphylococcus Aureus Biofilms Interfere With Macrophage Antimicrobial Responses Through Differential Gene Regulation, Toxin Production, And Purine Metabolism, Tyler D. Scherr

Theses & Dissertations

Staphylococcus aureus (S. aureus) is an opportunistic pathogen that is a leading cause of both nosocomial and community-associated infections. Armed with a myriad of virulence factors and the propensity to form a biofilm on native tissues and implanted medical devices alike, S. aureus infections represent a very real public health threat, the treatment of which results in an excessive economic burden. S. aureus biofilm infections are notoriously recalcitrant to antibiotic therapy and adept at evading and neutralizing the host immune antimicrobial response. Previous studies from our laboratory have shown that S. aureus biofilms are able to cause persistent …

Approach To Safety Improvement: Focusing On Better Care (Fall Prevention In Medical Surgical/Intermediate Care Unit), Jose Fox Caballes Jr

Master's Projects and Capstones

Patient safety is one of the major concern of any healthcare provider during their patient’s hospital stay. This project addressed the steady trend of fall incidences compared to last fiscal years’ data of an average of 4 falls per month. This trend created urgency to envisioned a plan for solutions to prevent this circumstance from happening. This Clinical Nurse Leader led a project in creating a process in identifying all patients that are high risk to fall (HRTF) prior to their admittance or transfer to Medical Surgical/Intermediate Care Unit and throughout their hospital stay until they are discharged. In addition, …

Ihss: Repackaging Consumer Information, Deloras N. Puran

Master's Projects and Capstones

Currently, qualified Californians with disabilities and aging individuals can receive consumer-directed care through the IHSS program. Despite the strong demand for the program, new consumers are still struggling to begin their service after enrollment.

This study assisted San Francisco In Home Supportive Services Public Authority to understand how new consumers can navigate the IHSS program services after enrollment. Focus group and semi-structured in-depth interviews were conducted to gather feedback from consumers regarding what type of information would they need after enrollment, and how would they want to receive the information. Based on the feedback, written and virtual deliverables were designed …

Discharge Prospectus, Cynthia Y. Vasquez

Master's Projects and Capstones

Background and Purpose:

The goals of the project are to improve the efficiency of the discharge process, to increase bed availability, to decrease readmission rates, and to increase patient satisfaction through implementation of multidisciplinary huddles.

Methods:

The intervention of the huddle took place on a medical-surgical unit at UC Davis Medical Center in the local Sacramento area serving various Medical Services.

This was a prospective pre- and post-quality intervention by utilizing HCAPHS survey, electronic medical record, RN surveys, and discharge data collection.

Results:

Discharges were increased from 15% to 23%. Currently, data is up-to-date for nine months but the project …

Improving Preadmission Testing Nurses' Knowledge Of Aortic Stenosis And Transcatheter Aortic Valve Replacement, Alberta Lynn Canale

Master's Projects and Capstones

Abstract

The purpose of this Clinical Nurse Leader (CNL) project was to reduce gaps in nursing knowledge through staff education. Guided by the CNL theme of educator and information manager, the goals were to increase PreAdmission Testing (PAT) nurses’ knowledge of severe/critical aortic stenosis (AS), transcatheter aortic valve replacement (TAVR) procedure and patient selection, and satisfaction with knowledge by 10%. Rapid growth of the TAVR program has contributed to a gap in nursing knowledge leading to inconsistent patient care and education. An educational program was developed and spread through a series of Plan-Do-Study-Act cycles. Pre- and post- implementation surveys were …

Educating Medication Aides About Safe Medication Administration, Derya Fuller

Master's Projects and Capstones

Educating Medication Aides About Five Rights of Medication Administration Abstract

The objective is resident safety in an assisted living facility with 20 residents; 18 staff members. After discussion with manager (an RN), and observation of aides passing meds, a focus on education of the 5 rights of medication administration was decided on.

Step one was doing pre survey of the aides, observing aides passing meds (3 week time frame), and identifying weaknesses. Step two consisted of identifying and talking about various possible safe med problems with staff, and taking steps to remove these potential barriers. Step three was to experiment …

Educating Nurses On The Use Of Bedside Mobility Assessment Tool (Bmat) Through E-Learning/Online Education Module, Wei Li Lee

Master's Projects and Capstones

Background Hospital setting is reviewed the most hazardous workplace comparing to other industries. Nursing assistants and orderlies have the high risk of work-related injury. The study found that the top reason that causes the injuries was due to over-exertion or bodily reaction.

Aim State of California requires hospitals to implement a Safe Patient Handling and Mobility (SPHM) policy as part of an injury and illness prevention program (Department of Industrial Regulations, 2016). Bedside Mobility Assessment Tool (BMAT) is the latest evidence based practice, reliable and valid tool, which helps nurses to assess the patients’ current and ongoing mobility and to …

Improving Pain Reassessment And Documentation Through Nurse Education, Reina Batto

Master's Projects and Capstones

The aim of the CNL Internship Project is to improve quality of patient care and pain management through improved pain reassessment and documentation. The project is to be implemented in the surgical unit of a community hospital in the California Bay Area. The unit has a maximum capacity of 38 beds and is staffed by 47 RNs and 4 LVNs. A nurse survey was conducted to assess the needs of the staff and the unit, and an education plan was created for the unit. Educational materials, including: highlighted academic articles, posters, handouts, and small posted reminders at nurse computers were …

Evaluation Of The Nursing Handoff Process From Emergency Department To In-Patient Unit, Yana Marutyan

Master's Projects and Capstones

Handoff, or transition in care, is known to be a danger point in the patient care process for a long time. Ineffective communication during handoff is one of the most common identified cause of catastrophic or sentinel events in hospitals (The Joint Commission, 2015). Emergency department (ED) to in-patient unit handoff is particularly vulnerable to medical errors due to high workload, time constraints, different approaches to patient care, and lack of established relationships between care providers (Ong & Coiera, 2011; Hilligoss & Cohen, 2012).

The purpose of this project was to examine and review a current process of ED to …

Improving Pain Reassessment Within One Hour Following The Administration Of Pain Medication, Linda N. Baffoe-Twum

Master's Projects and Capstones

Abstract

Pain has been identified as the main reason why patients go to the hospital and are hospitalized. Pain reassessment following administration of pain medication is vital to pain management. This project was conducted in a 24-bed stand-alone inpatient psychiatric facility in an urban area. It was found that pain reassessment in this facility was not consistent with the facility policy and the Joint Commission standard. The patient population in the facility is made up of adults of 18 years and above, with mental health diagnosis such as depression, bipolar disorder, schizophrenia, anxiety, et cetera. Some of the patients also …

Recovery-Oriented Care And Inpatient Psychiatric Nursing Practice, Julia M. Mclaughlin

Master's Projects and Capstones

For the past 15 years, major organizations such as the World Health Organization (WHO), Substance Abuse and Mental Health Services Administration (SAMHSA), and U.S. federal government have been committed to shifting mental health services from the medical model of care to the recovery-oriented model of care (Moller & McLoughlin, 2013). However, not all identified recovery-oriented practices have been fully implemented throughout mental health services, specifically in acute care settings. In 2015, San Mateo Medical Center’s acute psychiatric nursing staff completed McLoughlin’s (2005) Recovery Self-Assessment- Registered Nurse (RSA-RN). Data showed that 34% of nursing staff did not believe that the nurses …

The Immigrants In The Central Coast Of California Need Motivation To Attend Classes And Learn English As Their Second Language, Martin Rodriguez-Juarez

Master's Projects and Capstones

This field project shows that the immigrant community that works in the fields from the Central Coast of California need the motivation to attend adult school to learn English as their second language. A six-week courses is included.

Critical Pedagogy And Peace Education In International Service-Learning: A Curriculum Exploring Race, Positionality, Power, And Privilege, Lissette A. Lizárraga

Master's Projects and Capstones

My project is an international service-learning curriculum intended to address the neocolonial implications that are perpetuated when sending predominately white, affluent participants abroad. My curriculum unpacks whiteness, privilege, the white savior complex, and American immigration history. Using race, power, and privilege, I explore how these themes relate to acquiring awareness and understanding of participants' societal positioning. Through this lens, my aim is that students can become aware of how systemic oppression works to disenfranchise certain groups, while others remain in power. With this awareness, students can become more mindful, aware, conscious, and critically engaged with their host communities through an …

Doula Support As A Means To Improve Birth Outcomes For Minority Women, Christina Bao Ngoc Thich

Master's Projects and Capstones

Ethnic minorities such as African Americans, American Indians, Hispanics, Laotions, Hmongs, and Alaskan Natives have higher rates of cesarean delivery, pre-term birth, fetal demise, perinatal laceration, and congenital abnormalities than their white counterparts. Continuous labor support by way of doula care has been recommended for all pregnant women as a means to prevent adverse birth outcomes. Despite this, the population most in need of such support in unable to access doula services due to low socioeconomic status, availability of services, and cultural inaccessibility. This paper focuses on my capstone experience with UCSF and Roots of Labor Birth Collective as we …

Fall Prevention In Acute Psychiatric Patients, Jeannette Deano

Master's Projects and Capstones

Patient falls have been an issue in hospital settings for many years. Patient falls not only lead to increased costs for the hospital, but affects the safety and care for patients. Many studies have assessed potential, contributable factors leading to falls, fall risk assessment tools, and fall prevention interventions in different settings. However, there are limited studies done in inpatient psychiatric settings. The acute-psychiatric unit at a large metropolitan hospital has seen an increase in falls in the last year, yet current interventions have not addressed this issue.

The purpose of this project is to conduct an assessment of the …

Feminist Herstory Through Indian English Literature, Suryaa Rangarajan

Master's Projects and Capstones

This project explores how the definition of femininity is deeply intertwined with the concept of nationalism, and the performance of cultural duty in order to protect the sanctity of marriage and family. Beginning with investigating how laws and policies have held women back in their status as second-class citizens, unable to exercise their right to feel safe, the chapter will delve into the roles that critical pedagogy and third world feminism play in achieving sustainable equity in India. These policies and theoretical frameworks provide a foundation for my curriculum design project, which uses Indian English feminist literature to amplify monolithic …

Pharmacovigilance In Post-Marketing: Risk Assessment And Reporting Standards, Tiffany Jee

Master's Projects and Capstones

While there has been new targeted drug therapies released into the market over the recent years, pulmonary arterial hypertension (PAH) remains to be a rapidly progressive disease with poor prognosis. Over time the arteries stiffen and tighten subsequently leaving the heart to pump harder to try and provide enough blood to the body. The extra stress of the increased pumping leads to weakening and enlargement of the heart. The endothelin targeted therapy, Letairis (ambrisentan), is an oral tablet proven to improve quality of life in patients suffering from PAH, WHO Group I – functional class II and III by helping …

Motivational Interviewing In General Dental Practice: A Review Of The Evidence, E. J. Kay, D. Vascott, A. Hocking, H. Nield

Peninsula Dental School

No abstract provided.

The Role Of The Unusual Threonine String In The Conversion Of Prion Protein, Romany Abskharon, Fei Wang, Kayla J. Vander Stel, Kumar Sinniah

University Faculty Publications and Creative Works

The conversion of normal prion protein (PrP) into pathogenic PrP conformers is central to prion disease, but the mechanism remains unclear. The α-helix 2 of PrP contains a string of four threonines, which is unusual due to the high propensity of threonine to form β-sheets. This structural feature was proposed as the basis for initiating PrP conversion, but experimental results have been conflicting. We studied the role of the threonine string on PrP conversion by analyzing mouse Prnpa and Prnpb polymorphism that contains a polymorphic residue at the beginning of the threonine string, and PrP mutants in which threonine 191 …

Using Multi-Modal Education In A Public Health System To Increase Rates Of Cervical Cancer Screening, Christina Nardi

Doctor of Nursing Practice (DNP) Projects

While Papanicolaou (Pap) screening has been implemented since the 1950’s, and is linked to decreased rates of cervical cancer, national screening rates are still below the national target screening rate. In Contra Costa County (CCC), the current cervical cancer screening rate is 50.92% (Contra Costa Health Services [CCHS], 2016a). This is far below the national goal of 93% and the first benchmark of 54.33% needed in order to receive state funding under the California Department of Health Care Services (DHCS) Medi-Cal 2020 waiver. The Medi-Cal 2020 waiver has a 5-year Public Health Incentives and Redesign in Medi-Cal (PRIME) program requiring …

"A Very Old Woman Indeed": The New Woman As Surprising Continuation Of Victorian Values, 1890-1914, Sarah Tkach

Historical Perspectives: Santa Clara University Undergraduate Journal of History, Series II

No abstract provided.