Implementation Of Fast-Track Triage Process To Improve Ambulance Patient Offloading Time (Apot) In A Psychiatric Emergency Services (Pes) Unit, Oke Augustine Umeugoji

Doctor of Nursing Practice (DNP) Projects

Abstract.

Background.

Ambulance delays in hospital EDs have recently been significant in the United States. This delay has been attributed to emergency department overcrowding, a record number of 911 calls, a shortage of ED staff (doctors and nurses), and poor resources available in the communities as alternatives to an ED visit. Local Emergency Medical Service Authorities (LEMSA) monitor and determine the community standards for measuring ambulance offload delays (AOD), usually in minutes.

Problem.

Lengthy ambulance patient offload times and their subsequent impact on EMS have been significant all around the state of California as well as nationwide. The ambulance delay …

Implementation Of Implicit Bias Training In A Doctor Of Nurse Practitioner Program, Macdana Selecon

Doctor of Nursing Practice (DNP) Projects

Background: Implicit bias in healthcare delivery refers to the unconscious mental associations healthcare providers make about patients from various social groups. Numerous studies suggest implicit bias contributes to health disparities primarily amongst marginalized groups. Furthermore, patients report a lower quality of communication from healthcare providers with higher implicit racial bias. In 2021, Assembly Bill 1407 (Nurses: Implicit Bias Courses Act) was passed to address the negative impact of bias on patient outcomes and requires California nursing schools to provide implicit bias training for nursing students.

Problem: All graduate nursing programs do not provide implicit bias (IB) training. As a result, …

“Nadie Nunca Me Habló De Riesgos”: Madres Subrogantes En Eeuu Reclaman Protección, Carla Gloria Colomé Santiago

Capstones

Commercial surrogacy is a growing industry. In the United States, the Centers for Disease Control and Prevention (CDC) reported that by 2020, 90 percent of clinics in the country were offering gestational carrier services. In this report, several surrogate mothers speak of inefficient contracts, poor pay and lack of support, amid a landscape where business takes precedence over the treatment of women.

https://preview.shorthand.com/dN8XSDPrI83UIc8P

Clean Energy Transition Threatens Indigenous Land Rights, Jonnathan M. Pulla

Capstones

Indigenous communities in Jujuy, Argentina are protesting a constitutional reform that could lead to their displacement without consultation or exposure to contamination from extractive projects. The story is told from the perspective of Milagros Lamas, a 19-year-old indigenous woman who joined the movement known as the Third Malón de la Paz.

Childcare License Not Necessary, Jean C. Brannum

Capstones

Most childcare centers need a license to operate, but many states have loopholes that allow fitness center daycares to forego traditional licensing. The variation in rules lets some kids play in dangerous situations.

Keeping It Real: The Evolution Of The Black American Sitcom, Ebony E. Prescod

Capstones

The image of the black person has undergone many iterations in American popular culture. From the mammy of post antebellum America, to blaxploitation, to the black upper class -- what it next for the representation of black people in popular media, especially as it is now being helmed by black creatives. What does the black American of the 2020s look like? Now, what does it look like to be true to the black experience, today?

https://docs.google.com/document/d/1-KpHMb37_khYkOmlR6-gEPGEHLVZA4ND7HwNwhdz6ig/edit?usp=sharing

Evaluation Of Effectiveness Of Cultural Competence Program Implemented As Standard Practice To Improve Nurses’ Cultural Competency (Cultural Awareness, Cultural Cultural Knowledge, Cultural Skill), Improving Patient Care In A Community Hospital, Kendra Elam

Doctor of Nursing Practice (DNP) Manuscripts

The need for a culturally competent healthcare workforce is increasing as diversity increases in the United States’ patient population. Cultural competence is necessary because it helps the healthcare provider to offer the best care to every patient while considering and incorporating their cultural diversity and the patient holistically. Healthcare providers should be culturally competent to provide compassionate, caring, patient-centered care that promotes safety and quality in healthcare, reducing healthcare disparities. Culturally competent care supports social justice and health equity; it encourages health care as a human right. There is evidence that cultural competence and humility in professional development improve providers' …

Modified Early Warning Score In Detecting Clinical Deterioration: A Continuous Quality Improvement Initiative, Robin Daller

Doctor of Nursing Practice (DNP) Manuscripts

Despite considerable emphasis on patient safety and high-quality care in U.S. hospitals for the past two decades, significant challenges remain in the early detection and treatment of clinical deterioration in adult medical-surgical patients contributing to poor patient outcomes, increased resource utilization and increased costs. Modified early warning scoring (MEWS) systems have been used to identify patients at risk of deterioration. The Modified Early Warning System (MEWS) is effective in supporting the early detection and prevention of clinical deterioration of at-risk patients earlier in their hospitalization and potentially save lives (Institute for Healthcare Improvement, 2017). This project implemented MEWs on medical …

Implementation And Evaluation Of Abcdef Bundle In The Surgical Intensive Care Unit (Sicu): A Quality Improvement Project, Carrie Blasko

Doctor of Nursing Practice (DNP) Manuscripts

Intensive Care Unit (ICU) delirium is highly prevalent in this patient population; however, it is a potentially avoidable hospital complication (Vasilevski et al., 2018). The Confusion Assessment Method (CAM) has been used as a tool to measure delirium in the SICU since 2014 (AHN, 2023). The SICU clinicians deliberated if a better assessment and management bundle is available to better identify and manage delirium as a concerning volume of patients continue to experience ICU delirium even with the current delirium assessment tool in place. Upon reflection, SICU clinicians acknowledge a gap in nurses’ knowledge in connection with identifying signs, symptoms, …

Implementation Of A Self-Care Management Program Utilizing Telehealth In Adults With Hypertension, Diann Schmitt

Doctor of Nursing Practice (DNP) Manuscripts

Hypertension (HTN) can lead to heart disease which is the leading cause of death in the United States for men, women, and most racial and ethnic groups. Evidence-based practice supports early recognition of available self-care management (SCM) modalities to impact hypertension improvement and medication adherence. Best practices for heart disease prevention and management include lifestyle modification, reducing out-of-pocket costs, self-management support and education, and self-measured blood pressure monitoring. Successful evidence-based approaches within literature have addressed the modalities and successful outcomes.

The Plan-Do-Study-Act (PDSA) is a quality standard of The Institute of Health Improvement (IHI) was used to conduct this project …

Community Health Worker Certification Program - Motivational Interview, Advocacy, Communication And Conflict Resolution, Stella Antony

Doctor of Nursing Practice (DNP) Projects

Background: Rural residents have health disparities more than urban populations. The significant health inequities in the underprivileged population include a higher incidence of chronic diseases, lack of access to healthy foods, health care, health insurance, unhealthy eating habits, poor socioeconomic status, cultural and language barriers, and lack of health literacy. As locals, Community health workers (CHWs) meet these populations and can improve healthy lifestyle changes and advocate for their community.

Local Problem: The population in Fresno and Tulare County in Central Valley, California, is underprivileged, lacks access to proper health care, and has higher rates of health disparities, including chronic …

Bridging The Gaps: Characterizing Alzheimer's Disease In Native Hawaiian And Pacific Islander Populations, Justina P. Tavana

Theses and Dissertations

This dissertation addresses critical gaps in dementia research in Native Hawaiian and Pacific Islander (NHPI) communities. Focusing on Samoan and Tongan communities, the study successfully adapted and validated the AD8 informant interview and the Clinical Dementia Rating (CDR) scale in native languages, establishing these instruments as reliable tools for detecting cognitive impairment in these populations. The research process prioritized meaningful community engagement and forged partnerships with indigenous professionals, ensuring alignment with and responsiveness to the specific needs of the community. These invaluable connections were the foundation of making this difficult work possible. Subjects assessed with these adapted instruments were enrolled …

A Qualitative Exploration Of The Lived Experiences Of Graduate Students With Histories Of Mental Health Diagnoses Navigating Clinical Psychology Doctoral Programs, Hannah Flanery

Dissertations and Theses

In general, graduate students experience unhealthy stress levels throughout their graduate careers. Clinical psychology doctoral students experience additional stressors related to intensive training in providing psychological-related services to clients. There is a gap in the literature in understanding how clinical psychology doctoral students with a personal history of mental health effectively navigate highly stressful graduate programs. This dissertation explored the experiences of clinical psychology Ph.D. students who 1) have a history of mental health diagnoses and 2) experience current psychological distress as they manage educational/training demands and administer psychological interventions to clients. A phenomenological qualitative approach was utilized to fully …

Investigation Of Zinc And Iron In Wildflower Honey, Savannah Simpson

Honors Theses

Honey acts as a valuable food source for both animals and humans. When found in contaminated environments, there is an increased likelihood that honey samples will have high metal concentrations. It has been discovered that honey concentrations in metals can be different based on location. This experiment aims to determine the amount of two valuable metals, zinc, and iron, in various honey sources. These metals can be important to the human body because they help boost immunity and allow the body to carry out the functions required for survival. However, if these elements are present in copious quantities, then it …

Trauma-Informed Evangelism: Cultivating Communities Of Wounded Healers, Mark Teasdale

Witness

No abstract provided.

Depression Screening Tool For Hysterectomy Patients, Dede C. Mihedji

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: The prevalence of hysterectomies in the United States ranges from

5.1 to 5.8 per 1000 women (Harnod et al., 2018). A standardized screening tool for assessing

depression preoperatively could mitigate the worsening of postoperative depressive symptoms in patients scheduled for a hysterectomy.

Local Problem: Currently, there is no standard of practice to routinely screen for depression in preoperative patients scheduled for hysterectomy surgeries. However, as with any surgical intervention, there are risks of long-term complications. Studies have identified that a hysterectomy may increase the risk of cardiovascular events, menopause, depression, and other outcomes (Madueke-Laveaux et al., 2022). …

Implementing An African American Cultural Awareness Program For Skilled Nursing Facility Staff, Adekemi T. Adedipe

Doctor of Nursing Practice (DNP) Projects

Background: Patient care is most effective when patients and providers establish a therapeutic connection in a cultural context. Nurses’ lack of awareness of a cultural context for patient care impairs establishing a therapeutic provider/patient relationship, with care of lesser quality and poorer health outcomes as consequences.

Local Problem: Staff at a Northern Californian skilled nursing facility (SNF) caring for African American patients with mental illness lacked self-awareness of the cultural context of care. Staff did not consider cultural constructs of care in treating patients and developing care plans.

Methods: Educational intervention to increase the cultural competence of a skilled …

A Quality Improvement Project On Anxiety Management Before Ketamine-Assisted Psychotherapy, Kiera Paulo

Doctor of Nursing Practice (DNP) Projects

Background: This Quality Improvement project sought to determine if a brief progressive muscle relaxation (PMR) session could decrease patient anxiety before receiving intramuscular (IM) injections for ketamine-assisted therapy. Problem: The Kerstin Helgason, NP clinic does ketamine-assisted therapy, and many patients express anxiety beforehand, either due to a fear of needles or nerves surrounding the medication treatment. Intervention: This project implemented a brief progressive muscle relaxation therapy for patients with anxiety before receiving their IM injection. Measures: The patient’s anxiety levels were measured before and after the PMR therapy using a five-point Likert scale ranging from none to very severe. Results: …

Developing And Implementing An Infection Prevention Practice Fellowship Program, Sejal Naik

Doctor of Nursing Practice (DNP) Projects

Developing and Implementing an Infection Prevention Practice Fellowship Program

Abstract

Background: The COVID-19 pandemic placed huge demands on infection prevention programs (Blanchard et al., 2022), seriously taxing a profession already mired with progressively increasing workload and responsibilities (Bryant et al., 2016).

Local Problem: In a rapidly changing environment, infection preventionists (IPs) contend with pandemic surges, emerging infections, and supply chain disruptions. The NCAL Region of an integrated health system experienced IP turnover, and in the absence of a formal training program, newly hired IPs experienced variable to no opportunities to develop their competencies.

Methods: A literature review on infection prevention …

December 15, 2023 Ereporter, University Of Alabama At Birmingham

eReporter (campus newsletter)

No abstract provided.

[Excerpt From] Critical Conversations In Healthcare: Scripts & Techniques For Effective Interprofessional & Patient Communication (3rd Ed.), Cheri Clancy

Sigma Publications: Book Excerpts

This item record pertains to an excerpt from Critical Conversations in Healthcare, 3rd Edition, which is provided free of charge by the publisher.

About this book: Critical Conversations in Healthcare, Third Edition, provides scripts and scenarios to facilitate better, more effective communication in healthcare settings.

Protocol To Build A Drug-Testing Pipeline Using Large Populations Of Drosophila Melanogaster, Jay Deloriea, Cassandra Millet-Boureima, Chiara Gamberi

Biology

As a small animal that recapitulates many fundamental aspects of human disease, Drosophila lends itself to probing the biological activity of molecules and drug candidates. Here, we present a protocol to build a drug-testing pipeline in Drosophila. We describe steps for generating synchronous populations of Bicaudal C mutants by genetic crossing and wild-type fly culturing for controlled compound administration and exemplary phenotypic assays. For complete details on the use and execution of this protocol, please refer to Millet-Boureima et al.,¹ Millet-Boureima et al.,² and Gamberi et al.³

Optimal Control Of Ion Exchange Process For Chromate Removal And Protein A Chromatography For Antibody Extraction, Fadi Ghanem

Theses and Dissertations

Ion exchange resins are widely used in the extraction of hazardous chemicals as well as the recovery of precious molecules. Therefore, an early breakthrough from the resin system can lead to toxic compounds affecting the drinking water quality or inefficient use of costly resins. Hence, accurate modeling of the ion exchange process and control strategy can enable decisions that assist in avoiding leakage when facing fluctuations in the inlet contaminant concentrations. In this work, the ion exchange process is modeled via the method of moments where the system uncertainties are captured via stochastic modeling using Ito processes. The flow rate …

Using A Three-Dimensional Theoretical Orientation Matching Model To Predict Therapeutic Outcomes, Daniel Rhodes

Electronic Theses and Dissertations

Matching helpers and clients in a therapeutic setting is inefficient and ineffective. So far, there are no significant and enduring variables that reliably match helpers and clients that lead to positive therapeutic outcomes. This study attempts to match helper and client using theoretical orientation. It uses a quantitative methodology to predict therapeutic outcomes given match quality in the therapeutic dyad. Participants were 30 dyadic pairs—consisting of one helper and one client—who had a pre-existing therapeutic relationship. Each was given an assessment tool, used to measure their theoretical orientation to psychotherapy. Results showed no statistically significant relationships between theoretical orientation match …

Understanding Unacceptable Graduation Outcomes For Historically Excluded Trio Student Support Services Students, Erica Willis

Electronic Theses and Dissertations

The primary purpose of this mixed-methods study is to define the problem and to understand the system that has been leading to unacceptably low graduation outcomes for historically excluded Trio Student Support Services (Trio SSS) students at Mid-Atlantic University (MAU), a pseudonym. To achieve the primary purpose extant documents and institutional data that can shed light on system processes and institutional conditions that perpetuate disparities in graduation outcomes, particularly for historically excluded racial groups that exist at the intersection of first-generation status and/or low socioeconomic status, will be analyzed. The secondary purpose of this study is to identify potential change …

Functional Cynicism, Michelle Fried

Electronic Theses and Dissertations

Trait cynicism, or “cynical hostility” as measured by the Minnesota Multiphasic Personality Inventory’s Cook-Medley Scale, is defined and studied as characteristics associated with psychopathology, interpersonal conflict, and negative health outcomes including heart disease and cognitive decline. Likewise, “organizational cynicism” is operationalized in industrial/organizational psychology for the purpose of describing and identifying an undesirable employee type in the workplace. This research proposes an alternative assessment. It reconnects cynicism with its roots in ancient philosophy by asking if cynical attitudes, despite their negative valence ascribed in the modern literature and conventional opinion, may serve a practical purpose. This study of Functional Cynicism …

Changing The Face Of Reading Instruction: Do Culturally Relevant Passages Increase The Effects Of The Repeated Reading Intervention For Middle School Black Girls With Reading Difficulties (Bgrds)?, Olajumoke Edith Oshokoya

Electronic Theses and Dissertations

Research has shown that fewer studies have focused on improving the reading abilities of middle school Black girls (Morris, 2007). As BGRDs progress through K – 12 grades, they increasingly rely on basic and advanced reading skills (i.e., oral reading fluency [ORF] and comprehension) to learn. Providing BGRDs with engaging reading passages that are relevant to their prior knowledge, background, interests, and experiences, is more likely to motivate them to read, and eventually improve their reading skills (Cartledge et al., 2015). While there is a growing body of literature focused on Black students’ experiences, currently no study has explored the …

Air-Jet Bioprinting Of Stem Cell-Encapsulated Alginate Micro-Droplets For Organoid Biomanufacturing, Mirabella B. Stump

Electronic Theses and Dissertations

Biomanufactured 3D-organoids show promise for modeling and treating various conditions, particularly insulin-dependent diabetes mellitus (type-1 diabetes). Pancreatic islet organoids serve as sustainable sources of insulin-producing β-cells, potentially restoring insulin regulation in patients and providing a long-term solution for diabetes. Hydrogel droplet printing is an emerging technique in regenerative medicine due to its advantageous tunability and biocompatibility; however, challenges of consistency, quality control, and scalability persist. To address these issues, we developed a novel air-jetting based droplet bioprinting system for the generation of monodispersed alginate micro-droplets. The objective of this project was to incorporate human induced pluripotent stem cells (hiPSCs) into …

The Contribution Of Principlism To Foster Ethical And Clinical Reciprocity In Resolving Healthcare Dilemmas, Dominic Glorioso

Electronic Theses and Dissertations

Principlism is an ethical method that uses an analytical framework based on a set of principles that can function as guidelines for healthcare professionals. The term was made

famous by the work of two bioethicists, Tom L. Beauchamp and James F. Childress. Their book, Principles of Biomedical Ethics and its multiple editions described a set of norms that are basic

for biomedical ethics. The first edition of their book was published in 1979, and the ninth edition in 2019. Its persistence and durability speak for themselves. In addition, their writings made

famous the four bioethical principles of respect for Autonomy, …

The Implications Of The Halogen Atom On The Physical Stability Of Amorphous Solid Dispersions, Mustafa Bookwala

Electronic Theses and Dissertations

Amorphous solid dispersions (ASD), although a promising formulation strategy for poorly water-soluble drugs, are susceptible to rapid, spontaneous recrystallization owing to their metastable nature. Non-covalent interactions (NCI) between the drug and polymer are known to help prevent ASD physical destabilization. Conventionally, hydrogen-bonding (H-bonding) is considered important for ASD formation and persistence. However, carbon-bound halogen atoms, which are frequently present on drug molecules and can form specific halogen-bonds (X-bond) with the polymer, remain relatively unexplored with respect to their ability to stabilize ASDs. It was, therefore, hypothesized that the presence of a peripheral Br on bromopropamide, and Cl on chlorpropamide will …