Digital Commons Network^™

Reducing Moral Distress Through Improved Interprofessional Collaboration In End-Of-Life Care, Marissa Teresa Perino

Biennial Convention (CONV)

Inadequate interdisciplinary collaboration in end-of-life care can result in moral distress among nurses, reflecting conflicts between core nursing values and physician expectations. This quality improvement project seeks to reduce moral distress by enhancing collaboration between physicians and nurses in providing end-of-life care in a defined microsystem on the Transitional Care Unit (TCU). A pre-survey of registered nurses (RNs) revealed that moral distress occurs when caring for actively dying patients, regardless of their code status. Nurses identified a need for improved communication with physicians to facilitate timely implementation of comfort medication order sets and better address the palliative needs of these …

Angelfish Is Spinning, Anne Elliott

Valparaiso Fiction Review

No abstract provided.

Increasing Colon Cancer Screening Completion Rates Utilizing Patient Navigation In Primary Care: A Quality Improvement Project, Anya C. Pennycooke

Electronic Theses and Dissertations

Colorectal cancer is the second leading cause of cancer-related deaths in the United States. It is highly preventable through routine screening and early detection, yet national data indicate that one in three eligible adults remains unscreened. The purpose of this Quality Improvement (QI) project was to increase colon cancer screening completion rates by implementing a patient navigation program. Kristen Swanson’s Theory of Caring guided the intervention by promoting patient-centered communication. W. Edwards Deming’s Plan-Do-Study-Act (PDSA) model provided the framework for this approach. Patients aged 45-75 years due for colon cancer screening were identified using the electronic health record (EHR) in …

Improving Patient Outcomes Through Implementation Of The Kdoqi Guidelines For Tunneled Dialysis Catheter Placement, Gabriela Echagaray

Electronic Theses and Dissertations

This quality improvement (QI) project aimed to enhance adherence to the Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines for placement of tunneled dialysis catheters (TDCs) in intensive care unit (ICU) patients. The project addressed inconsistent application of best practices related to TDC placement, improved documentation, improved communication using TigerConnect, a reduction in inappropriate catheter placements, and maintenance of a zero hospital-acquired tunneled dialysis catheter-related bloodstream infection (CRBSI) rate. Notably, some patients continued to be admitted with pre-existing community-acquired tunneled catheter-related infections, underscoring the effectiveness of the hospital’s internal infection prevention strategies while highlighting the need for enhanced collaboration with outpatient …

Tree Of Life, Sandra Rogers, Brooke Judd, Mollie Slugantz

Biennial Convention (CONV)

Introduction / Background: Most people understand the term death. However, in the world of organ donation, death can have different meanings. Donation after brain death (DBD) is when there is irreversible cessation of all brain activity due to lack of blood and/or oxygenation. The other form is donation after circulatory death (DCD) in which the patient has not deteriorated to brain death but there still may be an opportunity for families to opt for organ donation. Research has shown that healthcare providers working in intensive care units (ICUs) are not always at ease with DBD and even more uncomfortable with …

A Rare Case Of Severe Disseminated Pyoderma Gangrenosum Of The Upper Body With Concurrent Nasopharyngeal And Inferior Orbital Wall Necrosis, Robert M. Branstetter, Isabel E. Baird, Mohammed S. Rais, Danielle N. Ledet, Megan N. Terrebonne

School of Medicine Faculty Publications

Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis usually linked to autoimmune or inflammatory bowel disease and typically affects the lower extremities. This case is notable for extensive upper-body, oropharyngeal, and nasal involvement in a patient without an underlying autoimmune disorder. A 56-year-old man with chronic cocaine use and stage IV renal cell carcinoma presented with rapidly progressive ulcerations of the face, neck, shoulders, and back, along with nasal septal collapse and oropharyngeal destruction. Prior biopsy demonstrated sterile neutrophilic inflammation without vasculitis, infection, or malignant infiltration, supporting PG as a diagnosis of exclusion. Imaging showed erosive sinonasal disease. He was …

Assessment Of Cognitive Decline During Cancer Treatment: A Mixed-Methods Study, Katy Fisher-Cunningham, Trista Michelle Anderson

Biennial Convention (CONV)

Background: Cancer-Related Cognitive Impairment (CRCI), often termed "chemo brain," impacts 50-70% of chemotherapy patients and 12-75% of cancer survivors, with symptoms such as memory difficulties, attention issues, and executive dysfunction potentially lasting up to 20 years. Most research has centered on breast cancer, leaving gaps for other cancer types. Non-treatment factors can also induce CRCI, including the cancer itself. The mechanisms of CRCI share similarities with Alzheimer's disease. Currently, there is no standardized assessment tool for CRCI, emphasizing the need for tailored evaluation methods.

Objective/Specific Aims: This study aims to assess CRCI in patients with current cancer diagnoses and explore …

Exploring The Impact Of Caring For Patients Diagnosed With Iv Drug Use Endocarditis At End Of Life, Kendrea Lea Todt

Biennial Convention (CONV)

Purpose/Problem Statement: Caring for patients with substance use disorder is a challenge for nurses, especially patients who use intravenous (IV) drugs and contract endocarditis. Infective endocarditis is a cardiac infection with a high mortality rate, and yet this disease receives little attention in the media or research. IVDU-IE has been referred to as the Cinderella of Cardiology. Nurses disposition young patients in the prime of their lives to hospice care, funeral homes, morgues, or home to die. The purpose of this modified photo elicitation phenomenological study was to explore the impact of caring for patients diagnosed with IVDU-IE at the …

Tapering Opioids In Older Adults With Chronic Pain, Carolyn D. Concia

Biennial Convention (CONV)

As the older adult population increases, so does the prevalence of conditions associated with chronic pain (Tinnirello et al., 2021). Chronic pain, defined as lasting longer than three months, affects approximately 20.8% (50.2 million) of adults (Nahin et al., 2023; Yong et al., 2022; Zelaya, 2020), of whom almost 20.5 million are age 65 and over (Rickard et al., 2023). Pain is the leading cause of disability, costing up to $635 billion annually (Turk et al., 2022; Institute of Medicine, 2011). Chronic pain in older adults causes significant suffering (Dahlhamer et al., 2016), social isolation (Tsang et al., 2008), increased …

An Interprofessional Approach To Advanced Birth Planning For Special Babies And Parents, Rebel L. Heasley, Maripi M. Dizon

Biennial Convention (CONV)

Introduction: This community hospital in Southeast Texas strives to provide unparalleled care to even the most unique patients. According to the Centers for Disease Control and Prevention (CDC, 2023), Trisomy 13 affects one in every 6,967 births, and Trisomy 18 affects one in every 3,336 births. A more staggering statistic is that one in 33 births is impacted by some form of birth defect in the United States each year (CDC, 2023). There were minor differences in the historical pattern of caring for patients and babies with special circumstances. After delivery, mothers faced with birth defects and fetal demise were …

Poverty Experience To Address Clinical Outcomes In Community Health, Denise Isibel

Biennial Convention (CONV)

Simulation serves as a valuable augmentation to direct clinical care or practice within healthcare settings. In Community health, students spend time in a variety of agencies experiencing a variety of vulnerable populations. One issue that crosses over these populations is poverty.

The poverty rate in America is 11.1 % (Shrider, 2024).A key competency in nursing education related to population health is understanding how poverty affects patients. This simulation related to the poverty allows students to understand many people in poverty are not all homes less but live next door and may be one paycheck away from catastrophe.

The experience starts …

Music’S Transformative Power: A Phenomenological Exploration Of Christian Music’S Role In Enhancing Human Development, Crystal Ann Hubbell

Doctoral Dissertations and Projects

Music is one of the most fundamental expressions of art, communication, and worship, linking to the conscience and personalities across cultures. Music provides a pathway to human emotions where music manifests as a therapeutic component for psychosomatic change. Furthermore, Christian music has not been explored as a therapeutic component for individuals struggling with mental health or cognitive challenges. The purpose of this study was to investigate how Christian music may serve as a therapeutic component of wellbeing in everyday lives of individuals. Using a transcendental phenomenological approach, this study investigated the lived experiences of 10 individuals who have experienced Christian …

Improving Palliative Care Knowledge And Intentions Among Great Plains American Indians: Efficacy Results From A Randomized Clinical Trial Testing A Culture-Centric Palliative Care Message, Mary J. Isaacson, Kah Meng (Charlie) Soh, Christopher S. Wichman, Gina Johnson, Kelly Le Beaux, Semhar Michael, Lisa Sparks, Karla M. Hunter

Communication Faculty Articles and Research

Background

Methods

Results

Improving Palliative Care Knowledge And Intentions Among Great Plains American Indians: Efficacy Results From A Randomized Clinical Trial Testing A Culture-Centric Palliative Care Message, Mary J. Isaacson, Kah Meng (Charlie) Soh, Christopher S. Wichman, Gina Johnson, Kelly Le Beaux, Semhar Michael, Lisa Sparks, Karla M. Hunter

Communication Faculty Articles and Research

Background

Methods

Results

Pacific Rxtracts - December 2025, Pacific Rxtracts

Pacific RxTracts

Articles:

• FDA Approves Nerandomilast: A New Era in Idiopathic Pulmonary Fibrosis Treatment
• Brand New Approach to Addressing the Unmet Need of Cholestatic Pruritus
• Prep for Success with Lactulose
• Caution with Reported Allergies: Increased Risk of Surgical Site Infection with Non-β-Lactam Antibiotics
• Eltrombopag Redefines Treatment for Newly Diagnosed Pediatric ITP Combination for Extensive-Stage Small Cell
• Advancing Treatment for HER2-Positive Breast Cancer: Trastuzumab Deruxtecan plus Pertuzumab
• Comparison in Efficacy of Abiraterone and Enzalutamide in US Veterans with mHSPC
• Revumenib: A First-in-Class Menin Inhibitor for Relapsed or Refractory Acute Myeloid Leukemia
• Ziftomenib: A Menin Inhibitor Redefining Precision Therapy in NPM1-Mutated AML
• The Future …

Medicaid Funding And Health-Related Social Needs: A Policy Analysis, Passion Ilea

Dissertations and Theses

The U.S. has disproportionately high health care spending compared to other high-income nations and comparatively poor health outcomes. The Centers for Medicare and Medicaid Services (CMS) have recently increased emphasis on addressing Medicaid member social needs. CMS believes addressing health-related social needs (HRSN) may reduce costs and improve health outcomes for Medicaid members. CMS has begun to test theories regarding the impact of member HRSN on health care by designing federal mechanisms to address HRSN, such as in lieu of services and settings-funded services, and by encouraging state Medicaid programs to develop their own approaches, such as Flexible Services. Information …

Alzheimer's Medications And Polypharmacy Management In Advanced Dementia And Hospice Care, Rana Senlik, Robert Martin

Advocate GME

No abstract provided.

Reimagining Death And Rituals Through Design: Memorial Diamond Jewellery As A Speculative Probe, Yiwen Cheng, Jie Sun

IASDR Conference Series

Death remains one of the most enduring cultural taboos, often met with silence and avoidance across both Western and Eastern societies. Although design research has increasingly engaged with death through the lens of thanatosensitive design, it has largely focused on supporting the bereaved, leaving the perspectives and agency of the dying themselves under explored. This study explores the memorial diamond as a speculative medium for reimagining death rituals and the relationships between the deceased and the bereaved. Using a research through design approach, we engaged speculative design as both a future-oriented lens and a creative method to examine these phenomena. …

A Study On Supporting Administrative Procedures Related To Death And Inheritance -Focusing On Entry Items In Ending Notes, Ryoichi Tamura, Shintaro Yamada

IASDR Conference Series

This study aims to reduce the burden of administrative procedures related to death and inheritance by focusing on entry items in ending notes and identifying related challenges in terms of understanding and information sharing. Thirty-four ending notes were analyzed, and their entry items were organized into 25 categories. Using Hayashi’s Quantification Theory Type III and cluster analysis, the notes were classified into three groups to clarify their characteristics. Questionnaire surveys of older and middle- aged adults revealed levels of awareness, willingness to communicate, and desire to understand each item, leading to the classification of entry items into six types with …

Quality Improvement Project: Reducing Hospitalizations In The Long-Term Care Setting, Nenna Nzeocha

Doctor of Nursing Practice Projects

Hospitalizations in the long-term care setting can lead to higher costs incurred by skilled nursing home residents and a poorer quality of life. This quality improvement (QI) project evaluated whether an educational intervention on the Reducing Avoidable Facility Transfers (RAFT) model impacted hospitalization rates in the skilled nursing facility (SNF), while also assessing the confidence level of facility staff on the intervention. The project utilized Lewin’s change theory and the Donabedian model framework and was aimed at developing interventions that impact hospitalizations in the SNF using the RAFT model. A quasi-experimental design was used and consisted of a pre-and-post implementation …

Culturally Diverse End-Of-Life Simulation And Perceptions In Undergraduate Nursing Students, Jodi Kay Olson, Mary Pesch, Julie Keller-Dornbusch

Biennial Convention (CONV)

End-of-life (EOL) patient care is a challenging reality that nearly all nurses will face during their careers. Preparing nursing students for these situations can alleviate anxieties related to patient death (Venkatasalu et al., 2015). Simulation-based learning is an effective approach for teaching complex scenarios like EOL care (Cannity et al., 2021), with numerous studies highlighting improved confidence and competence in students who participate in EOL simulations (Gillan et al., 2014; Tamaki et al., 2019; Venkatasalu et al., 2015; Lewis et al., 2016; Jablonski et al., 2020). However, the lack of cross-cultural variations in death and dying highlights the need for …

Quality Of Life And Mental Health: A Qualitative Exploration Of Perceived Factors That Impact Older Adults, Chasiti Herring

All-Inclusive List of Electronic Theses and Dissertations

Enhancing quality of life and well-being is a universal phenomenon across the lifespan. As the population ages, older adults are in great need of supportive services to enhance quality of life and their ability to manage their mental health. The purpose of this study is to examine the quality of life (QoL) of older adults. This study aimed to provide valuable research in the area of QoL through the exploration of perceived factors that impact the older adult population. This exploratory qualitative research study consisted of 10 older adult participants between the ages of 65 and 95. Research recruitment prioritized …

Engage, Assess, Intervene, Evaluate: Barriers Facing The Elderly Population, Isabel Anderson, Gracie Brown, Mari Langton

Student Projects

This study examined barriers faced by older adults in Orange City, Iowa, through a mixed-methods community practice project incorporating assessment, implementation, and evaluation. During the assessment phase, researchers conducted interviews with elderly residents and professionals, gathered observational data, and facilitated community dialogue using the Nominal Group Technique. Key themes included social isolation, transportation challenges, financial strain, limited health literacy, and difficulty transitioning from independence to assisted living. A strong cultural emphasis on independence often discouraged help-seeking, while fragmented agency communication and rural limitations in specialized care further complicated service navigation. Asset mapping and power analysis highlighted community cohesion, faith-based support, …

Post-Discharge Transitions Of Care Pharmacists Follow-Up Impact On Patient Care, Lesly Rapado, Sara Panella, Elaina Rosario, Emilie Collongette, Faaria Quadri, Beatriz Jimenez-Cadilla, Amanda Gronniger

Nursing & Health Sciences Research Journal

Introduction: This quality improvement project assessed the impact of a newly implemented transitions of care (TOC) pharmacist service at a large health system. The service involves a comprehensive review of recently discharged value-based care individuals, including chart review and, when necessary, telephonic follow-up by the pharmacist 3-6 days post-discharge.

Methods: This retrospective evaluation compared two groups: pre-implementation (September 1st, 2023 - January 30th, 2024) and post- implementation (March 1st, 2024 - July 30th, 2024) of TOC pharmacist service, focused on patient evaluations 3-6 days post-discharge. The primary outcome was a composite of 30-day re-hospitalization rates including urgent care, emergency department, …

From Awareness To Action: Improving Advanced Directives With The Five Wishes In College Aged Young Adults, Dina M. Giovanetti

Electronic Theses and Dissertations

This quality improvement project aimed to increase early education, initiation, documentation, and completion rates of advance directives (ADs), specifically the Five Wishes, among college-aged young adults (18–24 years old) in a concierge primary care setting. The project addressed the low engagement and completion rates of ADs in this population, which can result in inadequate end-of-life care planning. The initiative involved training all staff members through collaborative instruction, informational sessions, and personalized provider-patient discussions. A convenience sample of eligible patients was identified via chart review. Inclusion criteria included English-speaking young adults aged 18–24, regardless of comorbid conditions who were members of …

Implementing Primary Care Fall Prevention With The Steadi Algorithm Toolkit, Roslyn Pechet

Electronic Theses and Dissertations

Falls among older adults remain a leading cause of morbidity and mortality, especially in underserved populations. The Centers for Disease Control and Prevention (CDC) developed the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) toolkit to help providers systematically identify and address fall risks. The purpose of this Doctor of Nursing Practice (DNP) project was to implement and evaluate integration of the CDC STEADI toolkit within primary care at Palm Beach Program of All-Inclusive Care for the Elderly (PACE) Greenacres. The aim was to train the interprofessional leadership team to use the STEADI program to enhance knowledge, confidence, screening, and implementation …

Retrospectively Examining The Probability Of Acute Skin Failure Among Hospitalized Patients With Hospital-Acquired Pressure Injuries, Tori C. Hatch, Jeanine M. Salamone, Pierna F. Vaughner, Natalie Bermudez

Nursing & Health Sciences Research Journal

Introduction: Acute skin failure (ASF) in hospitalized patients is a growing concern and a product of multisystem organ failure. Unlike hospital-acquired pressure injuries (HAPIs), ASF is not preventable despite prevention measures. The Skin Failure Clinical Indicator Scale (SFCIS) was recently developed to assess the probability of ASF. The purpose of this study was to retrospectively examine the probability of and factors associated with ASF in hospitalized individuals with HAPIs.

Methods: Data were collected from the electronic health records of in-patients with stage 3 or greater HAPIs over two years. Collection included demographics, comorbidities, COVID status, wound staging, injury location, SFCIS, …

Assessment Of Stroke Priority Status On Door-To-Reversal Time And Outcomes In Anticoagulant Associated Intracranial Hemorrhage, Kayla Mitzel, Jonathan Kline, Thomas J. Wolfel, Erika Dittmar, Nina Cruz, Felipe De Los Rios La Rosa, Heidi Clarke

Nursing & Health Sciences Research Journal

Background: The emergent reversal of anticoagulation in the setting of intracranial hemorrhage (ICH) is critical, and it is essential that comprehensive stroke centers adhere to the American Heart Association (AHA) metrics for door-to-reversal within the designated 90 minutes. The objective of this review is to evaluate individuals classified as stroke alert priority 1 and non-stroke alert and compare AHA metrics for door-to-reversal times and clinical outcomes when diagnosed with ICH.

Methods: Single-center observational, retrospective review that compared stroke alert priority 1 individuals to non-stroke alert individuals who were diagnosed with an ICH and taking an anticoagulant prior to admission. The …

Bias And Disparities In Neonatal End-Of-Life Care, Tamiko Younge, Daria Murosko, Simranjeet S Sran, Terri Major-Kincade

Faculty, Staff and Student Publications

No abstract provided.

The Spiritual Care Of Hospice Patients With Cognitive Deficits, Shane Sullivan

Doctor of Ministry Theses and Dissertations

ABSTRACT How can a hospice chaplain know whether their presence and ministry make a meaningful difference when visiting patients with dementia or other serious cognitive impairments? This project thesis seeks to answer that question conclusively. The theological foundation of this project centers on the doctrine of the imago Dei—the image of God—as it relates to individuals who are dying with cognitive deficits. Specifically, it explores how a person who is helpless and near death continues to reflect the image of God. The project intervention described here is the creation of a specialized training guide for hospice chaplains at Bridge Hospice …