Digital Commons Network^™

Do-Not-Hospitalize Orders In Assisted Living Facilities: Perspectives From Direct Care Workers, Alanna Kates Dancis Dr.

Doctor of Nursing Practice Scholarly Projects

Context: Do-not-hospitalize (DNH) orders in assisted living facilities (ALFs) are often misunderstood, ignored, or countermanded by direct care workers (DCWs), potentially leading to residents being sent to the hospital against their wishes.

Objectives: The primary purpose of this study was to gather sufficient qualitative data to create an intervention that would help prevent DCWs from sending residents with DNH orders to the hospital against their wishes. To accomplish this goal, the study centered on three research objectives: 1) to understand more fully how DCWs interpret DNH orders; 2) to determine if carrying out DNH orders causes moral distress for DCWs; …

Incidental Metastatic Lung Cancer In A Patient Being Treated For Community-Acquired Pneumonia: The Case For Lung Cancer Screening In Rural America, Carl T. Heinrich Iv, Stephen Stabbert, Dayan Sanchez, Jayton A. Lim, David Martin, Suporn Sukpraprut-Braaten

GME Publications

Lung cancer is the leading cause of cancer deaths in the United States. Efforts to decrease the number of deaths over the last decade have included the publication of guidelines by the United States Preventive Services Task Force (USPSTF) recommending annual low-dose computed tomography (LDCT) scanning in patients meeting specific criteria in order to facilitate the detection and classification of potential cancers, allowing for earlier and possibly curative intervention. Unfortunately, not every patient who meets these criteria will receive LDCT surveillance due to low socioeconomic status, geographic barriers, and limited access to healthcare related to the growing shortage of primary …

An Analysis Of Burnout And Wellness Of Healthcare Workers Based On Patient Population And Healthcare Worker Location, Spencer Brandenburg

Undergraduate Theses

Healthcare workers, even with all of the positive work that they do, often suffer from increased burnout and decreased wellness/quality of life. This problem is not new and has been steadily worsening for many years, however, there are factors which impact burnout and wellness that have not been analyzed or have produced mixed results in prior burnout and wellness literature. There has been little to no research done on the impact of patient population demographics on burnout and wellness in healthcare workers, and the research analyzing the impacts of demographic healthcare worker location has consistently produced mixed results often based …

2023 April 21 - Board Of Trustees Academic, Research, And Student Success Committee Agenda And Minutes, Board Of Trustees, East Tennessee State University

Board of Trustees Agendas and Minutes

No abstract provided.

Design Considerations Of The Aged As It Is Applied To Senior Housing, Amanda Mcnally

Liberty University Research Week

Undergraduate

Applied

Increasing Access To Doulas In Oregon: A Delphi Study, Courtney Elizabeth Crane

Dissertations and Theses

Doulas are trained, nonmedical support professionals that provide continuous emotional, informational, physical, and practical support before, during, and after childbirth. Doula care has been shown to reduce the cost of birth-related healthcare, reduce adverse birth outcomes, and increase patient satisfaction and positive birth experience. In 2011 Oregon became the first state to authorize payment expenditures of doula care through Medicaid as a strategy to reduce birth-related health disparities and increase culturally and linguistically appropriate healthcare delivery. The intention of the set of policies and administrative rules was to mandate access to doulas and other types of Traditional Health Workers (THWs) …

Spiritual Care Within The Field Of Healthcare, Summer Sirrine

Honors Theses

This thesis can be interpreted as a fundamental and comprehensive resource that addresses major discussion points of spiritual care (SC) within the healthcare setting. It begins with definition of SC, information surrounding its value within healthcare, the qualifications necessary to practice it, simple yet effective tools and questions to perform SC, as well as acknowledgment of notable barriers and complications, and how those can be dealt with. SC correlates with not only the patient’s physical and mental health, but how it may impact medical practice, depending on how much an individual’s spirituality, religion, etc. affects their life. Healthcare providers should …

Evaluating The Efficacy Of An Acuity Stratification Tool In Community Based Palliative Care, Madison K. Niederer

Doctoral Dissertations & Projects

Background: Community-based palliative (CBPC) care teams strive to optimize the quality of life of patients living with serious illness while also providing value-based care. An acuity tool was previously implemented at a CBPC site to promote resource allocation and improve follow-up care. Initial implementation failed, and re-implementation was undertaken.

Objective: Address barriers to acuity tool uptake and provide education on correct acuity tool documentation to improve the number of patients that receive prescribed follow-up care.

Setting/Subjects: An urban CBPC service in the Midwestern United States with a patient panel of 443 patients. Subjects include nurses, social workers, providers, and patients. …

Nursing Retention: Improving The Work Environment Among The Registered Nurse And Unlicensed Assistive Personnel, Nina Jean Hudgins

Masters Projects

Nurse retention is a major issue that many healthcare organizations are facing. The increase of nurses leaving the acute care setting is leaving a strain on the nursing profession and patient care, and it has caused many organizations to undergo financial hardships. Wages, leadership, and the work environment play a vital role in nurse retention. This article describes a quality improvement project in which a cancer hospital in a Mid-western urban community focused on improving the work environment to improve nurse retention.

Hospice Care For Cars, Jase Graves

Erma Bombeck Writers' Workshop Blog

My car is currently in hospice. I’m trying to keep it comfortable and provide a reasonable amount of care, but I’ve accepted that it’s probably approaching the end of its life.

Palliative Care In The Neonatal Population, Raegan Miller

MSN Capstone Projects

In more than 90% of cases of neonate deaths, terminal comfort care was provided in a Neonatal Intensive Care Unit (NICU) (Soni et al., 2011). Palliative care teams are increasing, but not enough organizations have embraced the need for better palliative care guidelines. Nor do many organizations know when, how, or if palliative care should even be introduced. These events lead to comfort care measures being underutilized in the NICU for most newborn infants with life-limiting and life-threatening conditions. Neonatal palliative care is discussed more than in years past, but little research has been dedicated to how early palliative care …

A Program To Improve The Quality Of Life Of Caregivers Of Older Adults With Chronic Conditions: A Pilot Study, Lori Reynolds, Brandi Buchanan, Shannon Crabtree, Elton Bordanave

The Open Journal of Occupational Therapy

Background: Among the nearly 41.8 million family caregivers of older adults 50 years of age and older in the United States, only 30% of caregivers report receiving the education, resources, and support they need to feel competent in their role. Many existing programs focus on dementia-related caregiving, and programs are needed to address the caregiving needs of individuals with chronic conditions.

Method: A pilot study using a mixed methods design was conducted with eight participants. The pre and post. measure, Adult Carer Quality of Life (AC-QoL), and post program individual interviews were conducted.

Results: Six of the …

Usage Of Tranexamic Acid For Treatment Of Subdural Hematomas., Michael Wu, Hassaan Wajeeh, Marissa N. Mcphail, Omar Seyam, Jamie Flora, Hoang Nguyen

HPD Articles

The collection of blood in the subdural layer within the cranium is classified as a subdural hematoma. Prevalence of subdural hematomas is most common among older populations with the current standard of treatment being invasive surgical evacuation for patients presenting with acute subdural hematomas with a midline shift greater than 5 mm on computed tomography (CT).Tranexamic acid (TXA) has been identified as an alternative, non-invasive option to treat patients presenting with subdural hematoma who are not suitable for surgical intervention. The presenting case involves a 90-year-old female who arrived with a code stroke with the chief complaint of right lower …

Multidisciplinary Collaboration To Improve Decision-Making For Feeding Tube Insertion For Patients With Als, Gabriela Lopes, Lauren Tabor Gray, Donovan Mott, Eduardo Locatelli, Andrea Charvet

InterLACE Research Showcase

No abstract provided.

Occupational Therapy In End-Of-Life Care, Shannon Sudrla

Student Capstone Papers

Patients at the end-of-life (EoL) experience functional decline in response to terminal illness and the active dying process, inhibiting participation and engagement in meaningful daily activities. Occupational therapy practitioners (OTP) are equipped to address patients’ occupational needs and desires despite their declining capacities; however, the absence of occupational therapy (OT) services in EoL care leaves patients’ occupational needs unmet, directly affecting their quality of life. The literature demonstrates the need for enhanced education and training among occupational therapy students (OTS) and practitioners to better prepare them to work with terminally ill patients who face progressive functional decline and imminent death. …

State Of The Art Of Interactive Drumming, Robert J. Damm

CoE Publications

No abstract provided.

Psychosocial Interventions Among Patients With Cancer And Their Family Caregivers In The Sub-Saharan Region: A Systematic Review, Ting Guan, Yousef Qan’Ir, Jamie Conklin, Chifundo Colleta Zimba, Agatha Bula, Wongani Jumbo, Kondwani Wella, Patrick Mapulanga, Samuel A.M. Bingo, Evelyn Chilemba, Jennifer Haley, Nilda Peragallo Montano, Ashley Leak Bryant, Lixin Song

Social Work - All Scholarship

Cancer is becoming a public health issue in the Sub-Saharan Africa (SSA).

This systematic review aims to synthesise psychosocial interventions and

their effects on the health outcomes of adult cancer patients and their

family caregivers in SSA. We identified eligible publications in English

language from PubMed, Cumulative Index of Nursing and Allied Health

Literature Plus with Full Text, Embase, APA PsycInfo, Scopus, and

African Index Medicus databases. We included psychosocial

interventions targeted adult cancer patients/survivors or their family

caregivers in SSA. This review identified five psychosocial interventions

from six studies that support adult cancer patients and their family

caregivers in …

Psychology Grads Helping Those Who Need It Most, Dave Moore

UNH Today Archive

No abstract provided.

A Quality Improvement Initiative To Improve Follow-Up Time And Reduce Readmissions And Emergency Department Utilization For Oncology Patients, Delaney Serfling

MUSC Theses and Dissertations

Hospitals across the nation are facing extreme challenges with overcrowding. Unplanned readmissions and emergency department use are two significant contributors to this urgent issue. Historically, oncology patients are high utilizers of emergency department services, and have elevated numbers of unplanned readmissions. This is especially true of gastrointestinal medical oncology patients. In an effort to move the needle in the right direction, an operational quality improvement initiative to decrease emergency department utilization and unplanned readmissions was conducted. This pilot project took place over a three-month period, and consisted of protecting time for advanced practice providers (APPs) and updating inefficient workflows. The …

2023 April 10 - University Council Agenda And Minutes, University Council, East Tennessee State University

University Council Agendas and Minutes

No abstract provided.

A Structured Life Review Intervention To Improve Life Satisfaction In Home Health Service Patients: A Feasibility Study, Leah Graf

University Scholar Projects

Two million older adults in the U.S. suffer with depression. Adults who live with the difficulties of depression concurrently experience dissatisfaction with life. Life review is a systematic recollection of past events. Dr. Robert Butler postulated that, as the elderly and those with terminal illness approach the end of their lives, there is a resurgence of life experiences in the conscience (1963). A successful life review conducted by an active listener assists the individual to process unresolved conflicts and attain ego-integrity in the final stage of life. Home health services have become an increasingly accepted option for managing chronic illnesses …

The Weekly Challenger, April 6, 2023, The Weekly Challenger, Et Al

Weekly Challenger Newspaper Collection

The April 6, 2023, issue of The Weekly Challenger.

Trial Of Endovascular Thrombectomy For Large Ischemic Strokes, Amrou Sarraj, Ameer E. Hassan, Michael G. Abraham, Santiago Ortega-Gutierrez, Scott E. Kasner, M Shazam Hussain, Michael Chen, Spiros Blackburn, Clark W. Sitton, Wondwossen G. Tekle

School of Medicine Publications

Background: Trials of the efficacy and safety of endovascular thrombectomy in patients with large ischemic strokes have been carried out in limited populations.

Methods: We performed a prospective, randomized, open-label, adaptive, international trial involving patients with stroke due to occlusion of the internal carotid artery or the first segment of the middle cerebral artery to assess endovascular thrombectomy within 24 hours after onset. Patients had a large ischemic-core volume, defined as an Alberta Stroke Program Early Computed Tomography Score of 3 to 5 (range, 0 to 10, with lower scores indicating larger infarction) or a core volume of at least …

The Application Of Virtual Reality Scenarios Coupled With Education And Recognition Of Soul Injury Can Promote Pathways Of Care For Healthcare Workers And The Public Affected By The Present Covid-19 Pandemic And Subsequent Variants., Jamie Anne Marcus

FDLA Journal

Historical learning from the 1918 Pandemic assists with grasping and focus of the present one. Engaging multi-disciplinary healthcare students in virtual reality scenarios with visual inclusion of Soul Injury staging will promote new pathways of care for healthcare workers, families, and the public affected by the present Pandemic. Virtual reality scenario simulation success is supported by social presence, social learning, and media richness theories. The Covid-19 and variant Pandemics effects include, insurmountable loss of life, loss of economic stability, loss of normal lifestyle, family function, and culture. Therefore, development of The Soul-Injury-Pathway-of-Care for patients, ancillary healthcare workers, families, and the …

Facilitators And Barriers To Evidence-Based Cancer Pain Management, Linda H. Eaton

Dissertations

Evidence-based pain management (EBPM) is essential in relieving cancer pain. This dissertation explores nurse-level and organization-level factors for adopting, implementing, and sustaining EBPM practices. A descriptive cross-sectional mixed methods design involving two inpatient oncology units was used for this study.

Reducing Delirium And Functional Decline In Hospitalized Older Adults: Implementation Of Cocare Help, Kara Marie Roman, Aaron Mestemaker

Masters Projects

Background: Delirium is a common disturbance in cognition among older adults in the hospital setting. It is associated with negative outcomes and high costs for patients, families, and hospital systems. Use of a reliable screening tool and evidence-based strategies such as CoCare: HELP demonstrates delirium prevention and functional decline in many geriatric hospitalized patients.

Objectives: This study examines the impact of implementing aspects of CoCare: HELP on two pilot units in an urban Midwestern hospital. Pre- and post-implementation measures of delirium rate, 30-day admission rate, length of stay, falls with injuries, safety attendant orders, restraint numbers, use of antipsychotics, and …

Quovadis Grant-Jackson

African American Funeral Programs

No abstract provided.

Advanced Care Planning For Hospitalized Patients Following Clinician Notification Of Patient Mortality By A Machine Learning Algorithm, Stephen Chi, Seunghwan Kim, Matthew Reuter, Katharine Ponzillo, Debra Parker Oliver, Randi Foraker, Kevin Heard, Jingxia Liu, Kyle Pitzer, Patrick White, Nathan Moore

2020-Current year OA Pubs

IMPORTANCE: Goal-concordant care is an ongoing challenge in hospital settings. Identification of high mortality risk within 30 days may call attention to the need to have serious illness conversations, including the documentation of patient goals of care.

OBJECTIVE: To examine goals of care discussions (GOCDs) in a community hospital setting with patients identified as having a high risk of mortality by a machine learning mortality prediction algorithm.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study took place at community hospitals within 1 health care system. Participants included adult patients with a high risk of 30-day mortality who were admitted to 1 …

Obligatory Leaf Litter Spiders: An Ignored Guild?, Ryan Whitt, Sean O'Keefe

2023 Celebration of Student Scholarship - Poster Presentations

There are over 100,000 described species of arachnids in the world; these include spiders, scorpions, ticks, mites, etc. There are some 45,000 described species of spiders worldwide, with 3,800 species known from within the United States. Spiders can be classified into several guilds, including sensing web weavers, sheet web weavers, space web weavers, orb web weavers, specialists, ambush hunters, and ground hunters. A guild for spiders is defined as a group of spiders that exploit similar resources using similar behaviors in the same habitat. We are interested in assessing the spiders that are obligatory leaf litter dwellers – these are …

Remote Cardiac Device Monitoring: Process Proposal, Sheri L. Houser

IPS/BAS 495 Undergraduate Capstone Projects

The purpose of this project is to evaluate an alternative solution for the current process of obtaining data from patients with implanted cardiac devices. The cardiology physicians have been frustrated by our partnership with an external organization to monitor and report information obtained through remote monitoring. Ideally the staff would be clinic employees who would work directly with the patients and physicians to obtain the information necessary for high quality patient care and be accountable to the standards set by our practice. This would be a significant process change that was evaluated from a financial standpoint to demonstrate a positive …