Digital Commons Network^™

Implementation Of A Mental Health Environmental Risk Assessment Tool, Alan Le

Doctor of Nursing Practice (DNP) Projects

Background: Patient suicide is a serious safety issue, especially in mental health settings since suicides disproportionately affect psychiatric patients. Environmental hazards are a primary contributing factor in patient suicide cases.

Problem: Mental health staff may lack tools and training to perform proper environmental risk assessments, which is the case at a psychiatric crisis residential center in northern California that utilized no environmental risk assessment tool.

Methods: An environmental risk assessment tool was implemented at the site for four months to increase staff confidence, ability to identify hazards and decrease risk of patient suicides.

Interventions: The Suicide and …

Targeting Pre-Operative Booking Processes To Decrease Risks Of "Never Events", Rebecca Lynn Poths, Rebecca Lynn Poths

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem: Wrong patient, wrong procedure, wrong site, and wrong side surgeries are such egregious errors that are known as “never events.” Root cause analyses can pinpoint a failure yet do little to determine if corrective action has reduced the risk of recurrence.

Context: Monitoring surgical cases prospectively to identify weaknesses that could help identify specific risk factors to avert and move toward zero defects. The setting for this quality improvement project is a >300-bed Level III trauma hospital, where the risk of wrong-site surgeries and lack of standardized processes in the surgical pre-operative booking process was of concern to …

Manager Onboarding To Improve Knowledge And Confidence To Lead, Christine (Tina) K. Asiimwe

Doctor of Nursing Practice (DNP) Projects

Background: Primary care (PC) is increasingly the setting for affordable, coordinated, end-to-end patient care, with PC managers in charge of organizational performance. While PC managers are central to high-functioning teams, they often receive inadequate onboarding.

Local Problem: Primary care onboarding competes with other operational priorities and faces time constraints, lack of mentorship, and cost.

Context: At an integrated healthcare system, a need was identified to develop structured, role-specific onboarding for newly hired PC managers to improve knowledge and confidence to lead.

Interventions: Bauer’s Four Cs framework for onboarding guided the development of a manager onboarding program for 12 new PC …

More Than An Athlete: A Qualitative Analysis Of How Student-Athletes Develop Self-Authorship Through Their Experiences In Athletics, Haley Kate Webb

Honors Theses

Within the context of the newly instituted NCAA Name, Image and Likeness legislation, student-athletes are able to profit from their personal brands. This legislation presents newfound exposure to student-athletes. In order to assess the preparedness of student-athletes to benefit monetarily from their personal brands, an analysis of student-athlete development provides beneficial insight regarding their cognitive development. Using self-authorship theory as a guide, this qualitative research used long interviews to explore how student-athletes are developing their identities through their journeys with athletics. The research analyzes the lived experiences told by five athletes from a medium-sized faith-based NCAA Division II university. The …

Improving Lymphedema Self-Management And Screening In Newly Diagnosed Breast Cancer Clients Through The Use Of A Self-Management Lymphedema Toolkit, Kescia Gray

Doctor of Nursing Practice (DNP) Manuscripts

Background and Significance: With breast cancer effecting women at much younger ages and modern treatments prolonging the life span, survivors are at increased risk of developing breast cancer-related lymphedema (BCRL), a chronic, progressive condition that can cause disability.

Purpose: The purpose of the project was to determine the level of knowledge and awareness of BCRL in newly diagnosed breast cancer clients; and to provided education on self-care after treatment, using of a self-management lymphedema toolkit (SMLT), to decrease risks of treatment-related lymphedema, improve self-efficacy, and enhance quality of life (QOL).

Methods: Newly diagnosed breast cancer clients (N=10) from the Breast …

Optimizing Postpartum Care By Ongoing Care Coordination Initiatives (Cci) In Screening And Management Of Postpartum Depression (Ppd) Among Clients In An Obgyn Practice: A Quality Improvement Project., Jennifer Broussard

Doctor of Nursing Practice (DNP) Manuscripts

Background: Postpartum depression (PPD) is defined as physical, emotional, and behavioral changes that occur after the birth of a child. Postpartum depression is complex and a mix of physical, emotional, and behavioral changes (Cleveland Medical Clinic, 2018). Postpartum depression screening is of high importance at a comprehensive postpartum visit. The consequences of a patient suffering postpartum depression can be serious and early recognition and interventions improve outcomes for the patient as well as the infant. Problem: There is a lack of screening for PPD among postpartum clients and this period is critical for the mother and the infant (American College …

Reducing Opioid Related Deaths And Improving Rehabilitation Access Through The Elk Grove Village Cares Program: A Program Evaluation, Rebecca Barron

Doctor of Nursing Practice (DNP) Manuscripts

Abstract The goal of the Elk Grove Village Cares program is to decrease the deaths and overdoses of those who abuse opioids through harm reduction strategies and provide access to treatment. The article is a program evaluation of the Elk Grove Village Cares program. Surveys, interviews and the synthesis of program data is used to evaluate the efficacy of program activities. Results: The rate of death from opioid use has decreased an average of 1.7 deaths since program implementation in 2018. Law enforcement officers (LEO) and the community responded similarly to many survey questions regarding attitudes surrounding addiction. Within the …

Telehealth Appointments To Increase Therapy Compliance In Patients With Mosa, Tracy J. Partington

Doctor of Nursing Practice (DNP) Projects

Background: At the VA Puget Sound Healthcare System, care as usual for patients with a new diagnosis of mild obstructive sleep apnea (MOSA) is a letter directing the patient to call the continuous positive airway pressure (CPAP) clinic to establish ongoing care.

Local Problem: This model has resulted in low therapy compliance and does not afford patients the ability to discuss their diagnosis and treatment options with a licensed healthcare provider. A literature review showed telemedicine interventions increase therapy compliance in patients with MOSA.

Context: The Doctor of Nursing Practice project implemented an evidence-based practice change to improve therapy compliance …

Behavioral Health Patients And Agitation In The Emergency Department: A Synthesis Of Literature, Adam Pelzl

Doctor of Nursing Practice (DNP) Projects

Abstract

Introduction: Patient agitation is a phenomenon that presents itself to the emergency department (ED) on a daily basis. Agitation can manifest from an array of physical or psychological complaints. Behavioral health patients presenting with agitation is a growing subset of the total agitation population within EDs. A better understanding of behavioral health patient agitation in the ED setting is needed to guide best practices in treating this fragile population with therapeutic, patient-centered care.

Methods: A review of literature was conducted on agitation and behavioral health in ED settings, using the search terms emergency department, agitation, restraints, sedation, and behavioral …

Winning The Battle, Winning The War, Malka Herman

William & Mary Law Review Online

This Article analyzes Derrick Bell's interest-convergence theory and its utility for lawyers when litigating for the rights of nondominant groups. The first part of this Article studies four different cases in which plaintiffs or amicus curiae chose arguments that highlighted the ways their interests converged with potential allies. The Article uses these cases as examples of four different ways that a lawyer can engage in interest-convergence litigation. The strategies examined in this Article rest on two axes: dominant/nondominant narrative convergence and natural/unnatural ally convergence. An analysis of the effects of each of these techniques makes it clear that dominant narrative …

Task Classification During Visual Search Using Classic Machine Learning And Deep Learning, Devangi Vilas Chinchankar

Master's Projects

In an average human life, the eyes not only passively scan visual scenes, but most times end up actively performing tasks including, but not limited to, searching, comparing, and counting. As a result of the advances in technology, we are observing a boost in the average screen time. Humans are now looking at an increasing number of screens and in turn images and videos. Understanding what scene a user is looking at and what type of visual task is being performed can be useful in developing intelligent user interfaces, and in virtual reality and augmented reality devices. In this research, …

Philosophical Anthropology And Biblical Interpretation In John Paul Ii’S Theology Of The Body, Shawn Conoboy

Electronic Theses and Dissertations

In the Theology of the Body, through a series of Wednesday Catecheses, John Paul II presents a magisterial understanding of the sacrament of marriage and of marriage and family ethics. At the same time, John Paul II presents a theological anthropology, which forms a basis for the magisterial teaching. His theological anthropology is developed through an exegesis of selected biblical texts, especially Genesis 1-3 and Ephesians 5, and through an application of a philosophical anthropology articulated by Karol Wojtyła. This dissertation draws the connection between the philosophical anthropology of Wojtyła, especially as it is articulated in his major works, …

Patient Placement Matters: The Impact Of Unnecessary Lateral Movement On Patients, Jacqueline Strinden

Doctor of Nursing Practice (DNP) Projects

Patient Placement Matters: The Impact of Unnecessary Lateral Movement on Patients

Abstract

Background: National trends to decrease the number of licensed beds have created inpatient capacity constraints which have resulted in increased unnecessary lateral patient movement events, which contribute to decreased patient safety and quality of care. The incidence of adverse events increases significantly when multiple unnecessary lateral relocations result from secondary efforts to relieve hospital capacity constraints and improve efficiency.

Problem: At a 352 acute care hospital, 12,906 patient movement events were evaluated over a baseline period of three months resulting in an average of 1.48 unnecessary lateral patient …

An Analysis Of University Students’ Self-Labeling And Perception Of Feminism, Emilie Seibert

Honors Projects

This project investigates students’ perceptions of feminism, whether or not they identify as feminist, and how closely their ideals align with basic feminist ideals. There is currently no research that investigates self-labeling as a feminist among the current generation of college students in the United States. Despite the immense benefits to holding a feminist identification, it is estimated that only about 21% of the United States population identifies as feminist (Swirsky & Angelone, 2014, p. 230). Understanding the perspectives of current students is important as they have the potential to become activists and impact the future of the feminist movement. …

Factors Associated With Omani’S Schoolteachers’ Reporting Behavior Of Suspected Cases Of Child Abuse And Neglect, Zeinab N. Alazri

Theses & Dissertations

Child abuse and neglect is a global problem that can result in severe negative consequences for victims and their societies. Numerous initiatives have been launched by the United Nations Children's Fund (UNICEF) to combat this problem. Recently, Sultanate Oman, an Arab country, has mandated schoolteachers to report suspected abuse and neglect cases to comply with UNICEF's recommendations. As schoolteachers spend a great deal of their time with children, they are in a good position to recognize and report suspected abuse and neglect cases so the victims can get the needed help and treatment. There is a dearth of information about …

Giving Birth At A Critical Time: Assessing Perinatal Depression Among Syrian Refugees In Low Resource Settings, Nada Alnaji

Theses & Dissertations

Refugee mothers are at an increased risk of suffering from stress and mental health conditions during the first year after giving birth to a child. The objective of this study is to enhance the early identification of treatable mental health conditions among perinatal women living within humanitarian settings. The central hypothesis is that a culturally specific approach can be helpful for the long-term success of mental health efforts. In this study, we use qualitative interview methods to understand the cultural paradigms and predisposing factors for perinatal depression related to being a Syrian refugee in Lebanon during the COVID-19 pandemic. In …

Using Prompt Delay And Instructive Feedback To Teach Pretend Play Skills To Children With Autism Spectrum Disorder, Gabriella R. Van Den Elzen

Theses & Dissertations

Pretend play involves carrying out routines, acting out roles, referencing absent or imaginary properties of objects, or substituting one object for another. Pretend play skills emerge in typically developing children by preschool age but are often absent or delayed in children with autism spectrum disorder (ASD). In the present study, we evaluated use of prompt delay, instructive feedback, and prompt delay with instructive feedback for the acquisition and maintenance of pretend play skills with children with ASD. Throughout training, we conducted free-play probes to evaluate generalization to a naturalistic setting. The results of the current study suggest that combining the …

Northern Dene Astronomical And Sky-Related Knowledge: A Comparative Anthropological Study, Chris M. Cannon

Anthropology

The sky and its contents are routinely overlooked in Northern Dene ethnology as a meaningful part of linguistic and cultural knowledge. However, more than 11 years of primary fieldwork learning with and from elders, speakers, and culture bearers from 12 Northern Dene groups across 32 communities in Alaska and Canada has shown that astronomical knowledge is deeply rooted in both practical and sacred ways of knowing. With a focus on detail and breadth, this comparative ethnological study utilized an experience-based approach to investigate the ways in which Northern Dene Peoples perceive, conceptualize, and integrate the sky and its contents into …

Hatred And Harm: The Influence Of Digital Pimps And The Miseducation Of The Hyper-Masculine Man, Justin Lantier-Novelli

Justice

The purpose of this research project is to measure the effects of a correlation between exposure to violent, hardcore sexually-explicit Internet materials, or SEIM (also known as pornography), and behaviors and attitudes that demean, degrade, subjugate, and abuse women and girls resulting in systemic gender inequality. Research is based on peer-reviewed journal articles, subject-matter publications, crime statistics, personal interviews with experts, and meta-analyses of previous research on related topics. The research has demonstrated a very strong correlation between exposure to SEIM and hyper-masculine attitudes and behaviors of gender-inequality toward women, beginning at one end of the spectrum with verbal micro-aggressions …

Implementing A Proctored Aleks-Based Adaptive Learning Strategy To Evaluate Student Preparedness And Predict Success In Calculus I At The University Of Alaska Fairbanksanks, Md Azizul Islam

Mathematics and Statistics

In Fall 2016, the Department of Mathematics and Statistics (DMS) at the University of Alaska Fairbanks (UAF) initiated a study to determine if the Assessment and LEarning in Knowledge Spaces Placement, Preparation, and Learning test (ALEKS PPL), given under proctored conditions, can be an effective tool for measuring student preparedness and predicting success in Calculus I while controlling for enrollment and demographic information. The study includes 583 students who took a Calculus I course in Fall 2016, Fall 2017, Spring 2018, Fall 2018, Spring 2019, and Spring 2020 semesters and took a Proctored ALEKS PPL test (PAPL). Of the 583 …

A Public Health Ethics Approach To Substance Use Disorder, Adele Flaherty

Electronic Theses and Dissertations

The goal of the dissertation is to undertake an analysis of substance use disorders that focuses on a public health ethics perspective. The ethical argument focuses upon justifying the use of harm reduction and is primarily concerned with the current opioid crisis. While substance abuse/misuse over the course of history has been identified as a public health concern, this dissertation presents substance use disorders over the course of the lifespan, examining various contexts in which it can affect daily living and health outcomes. It achieves this by analyzing substance use disorders through the lens of the socioecological model of public …

Decreasing Maternal Breastfeeding Dissatisfaction During The Night Shift Related To Lactation Support, Robyn Caston

Master's Projects and Capstones

Abstract

Problem

This paper will discuss the Clinical Nurse Leader (CNL) project's specific aim: to decrease maternal dissatisfaction during the night shift related to lactation support in a high-risk maternal department.

Context

Research has shown that adding lactation support improves the decision to exclusively breastfeed and increases the duration. Breastfeeding for all infants starting at birth and continuing until at least 6 months of age has been recommended by the World Health Organization, UNICEF, and the American Academy of Pediatrics. Many studies about lactation support have demonstrated the health benefits to mothers and their infants.

Interventions

A baseline survey will …

Seeking Visionary: Ginsberg And The Beat Influence On Progress, Mark Howard

English Department Theses

This thesis examines and reevaluates the impact of poet Allen Ginsberg and his Beat Generation counterparts on defining and portraying societal progress through countercultural literature and how they themselves may damage the impact of their works. Beat poets like Ginsberg may not act as the best representation of the counterculture due to unethical and immoral behaviors that take away from the credibility and impact of their work. In addition, the Beat Generation itself must be reevaluated for clarity in who should be associated with the original Beat writers as modern critics’ use of the beat terminology has lumped in artists …

The Necessity Of Implementing A Wellness Curriculum Into Physician Assistant Programs, Jessica K. Erim, Darryl Bines Jr.

Physician Assistant Capstones, 2020-current

Purpose: In response to the decline of mental health and wellness of students within medical school programs, recent research has been exploring the effects of implementation of wellness curriculums. The purpose of this review is to highlight the research that has been conducted in the medical school environment and to establish the need for further research. This review will specifically discuss the implementation of a student-led wellness curriculum at James Madison University’s Physician Assistant Program and its impact on students. Methods: A thorough search was conducted using Google Scholar using specific inclusion and exclusion criteria (see Table 1). …

Baseline Bmi, Gender, & Age As Predictive Factors For Intragastric Balloon Weight Loss Outcomes, Nirali Shah, Miranda A. Myers-Burton

Physician Assistant Capstones, 2020-current

Objective: To determine whether obese and morbidly obese patients aged 18-75 with a lower baseline BMI (BMI 30-39.9 kg/m2) who received an intragastric balloon (IGB), have a higher percentage of total body weight loss (%TBWL) and percentage of excess weight loss (%EWL) compared to those with a higher baseline BMI (BMI > 40 kg/m2). Secondary objective was to ascertain whether gender and age are also predictors of weight loss outcomes following an IGB procedure.

Design: Systematic literature review

Methods: Literature searches of PubMed and SpringerLink were conducted using the search terms: “intragastric balloon, weight loss, and “BMI” and then limited to …

The Effect Of Platelet Rich Plasma On The Treatment Of Androgenetic Alopecia Compared To Placebo, Mackenzie D. Comstock, Hannah E. Stephenson

Physician Assistant Capstones, 2020-current

Objective: To assess the efficacy of plasma rich proteins (PRP) compared to placebo in the treatment of androgenetic alopecia (AGA).

Design: Systematic literature review

Methods: Searches were done in PubMed utilizing the terms PRP, plasma rich protein, autologous activated PRP, autologous activated plasma rich protein, androgenetic alopecia, placebo, hair count, hair density, hair follicles, hair loss, therapeutic effect, growth factors, dermatology, and regenerative medicine. Articles were excluded if they were published before 2013, involved animal studies, compared minoxidil only in their research, included only female participants, non-English articles, studies with no quantifiable data, review research articles, and injections besides the …

Ketamine As A Treatment Modality For Treatment-Resistant Depression, Tracy Wulff, Shen Cao

Physician Assistant Capstones, 2020-current

Many recent studies have demonstrated the ability of ketamine, an NMDA receptor antagonist, to produce antidepressant effects that may be effective in helping reduce treatment-resistant major depression. In particular, three double-blinded randomized control trials have been conducted to assess the viability and effectiveness of this medication for treatment. This systematic literature review will analyze these studies and determine if the overall research indicates that ketamine is useful in improving depression as measured by the Montgomery–Asberg Depression Rating Scale (MADRS)¹.

Objective: Assess the effectiveness of IV Ketamine in reducing treatment-resistant major depressive disorder as measured by the Montgomery–Asberg …

Surgical Site Infections And Hand Hygiene Discharge Teaching, Jesus A. Rodriguez Hernandez

Master's Projects and Capstones

Problem: During the span of a nine-month period, the PACU of a perioperative unit in an acute care hospital in the East Bay Area saw an incidence of 13 surgical site infections (SSIs). SSIs have been associated with negative patient health outcomes, diminished quality of life, and increasing healthcare costs.

Context: The PACU consisted of 20 beds and a competent staff of registered nurses, medical assistants, patient care technicians (PCTs), and management staff. It served mostly adults from diverse backgrounds receiving elective and emergent surgeries.

Intervention: A Standardized 3-Step Hand Hygiene Discharge Teaching model with nurse self-audits for every surgical …

Reducing Postpartum Maternal Falls: A Quality Improvement Project, Sarah L. Iroz

Master's Projects and Capstones

Falls are an unfortunate, common occurrence in the healthcare system and are often not thought to be a problem in the obstetrics population. Key stakeholders in a Northern California hospital brought the issue of maternal falls to leaders of the quality improvement team on the maternity unit. In the last three years, there have been 23 falls on the maternity floor, making their fall rate above the national average. It is the purpose of this project to aid the quality improvement team in reducing postpartum maternal falls over the next three years. After conducting a unit assessment, performing a literature …

The Ecology Of Mental Health And The Impact Of Barriers On Mental Health Service Utilization, Alisha Aggarwal

Theses & Dissertations

Mental health has emerged as a major public health concern in recent times with several disparities and barriers related to adequate health service utilization. Different age groups experience diverse symptoms and face distinct barriers in accessing and utilizing healthcare. Policies like Mental Health Parity and Addiction Equity Act and the Patient Protection and Affordable Care Act were launched to improve insurance coverage and delivery of mental health services. However, a large gap of unmet needs exists for adequate mental health service utilization in the country. This dissertation aims to describe the financial and non-financial barriers to mental health service utilization …