Medicine and Health Sciences Commons^™

Medical Ethics Principles Underscore Advocating For Human Papillomavirus Vaccine, C Mary Healy, Lara S Savas, Ross Shegog, Rebecca Lunstroth, Sally W Vernon

Student and Faculty Publications

Studies have consistently shown that vaccination rates against human papillomavirus (HPV) lag far behind other adolescent vaccinations recommended at the same age, resulting in exposing adolescents to unnecessary future risk of infection, and genital and head and neck cancers. Studies also have demonstrated that a major barrier to vaccination is lack of a strong provider recommendation. Factors that providers offer for failing to give a strong recommendation range from perception that the child is not at risk or the need to explain that the vaccine is not mandated (lack of equity and justice) or respect for parental autonomy. We look …

Intraoperative Dexmedetomidine Administration Effects On Postoperative Pain Scores And Opioid Medication Requirements: Pain Management Expectations Among Crnas, Dorilynn Nicol, Melissa Gheen, Matthew Bodine, Jennifer Patrick

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Abstract

Opioid pain medications are currently viewed as a standard part of pain control in the vast majority of surgical procedures. However, opioid pain medications can have harmful effects on patients leading to increased length of hospital stay, unplanned readmission, and contribution to relapse or development of opioid use disorder. An opportunity for improved practice of pain management lies within opioid alternative pain medications such as dexmedetomidine. Evidence-based literature reviews have shown that dexmedetomidine has promise as an analgesic medication within the perioperative period with fewer harmful side effects. Barriers to more widespread use of this medication include staff unfamiliarity …

Deepening Digital Technologies To Enable Modernization Of China’S Governance Of Health, Tara Qia Sun, Xia Feng, Yuntao Long, Zongben Xu

Bulletin of Chinese Academy of Sciences (Chinese Version)

One significant goal of science and technology innovation is to set our sights on the health and safety of the people. The rapid development of digital technologies provides multiple potentials and path to achieve the modernization of China's health governance. the role of digital technologies on enabling multiple stakeholders (i.e., hospitals, doctors, government, and social groups) to improve the supply capacity, the inclusiveness, fairness, friendliness, and convenience of health service. Second, we explore the four key issues of using digital technologies to enable the governance of health construction of digital health infrastructures, the factors affecting the adoption of digital technologies, …

Improving Glycemic Control During The Covid-19 Pandemic: A Quality Improvement Project, Megan Henderson

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Diabetes is a costly, chronic health condition. The COVID-19 pandemic has significantly impacted the delivery of health care and exacerbated chronic health conditions, such as diabetes. Diabetes is one of the most significant comorbid conditions associated with poor COVID-19 outcomes (Cariou et al., 2020). Control of blood glucose levels during the COVID-19 pandemic has proved challenging to maintain. The purpose of this quality improvement project is to identify gaps in diabetic self-care and then implement a diabetic toolkit to improve self-efficacy of diabetes self-management. According to the American Diabetes Association (2022), self-management of diabetes, education, and support from providers is …

Improving Access For Medicare Inpatient Psychiatric Patients: A Health Policy Analysis, Malinda B. Whitfield

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

The Medicare Inpatient Psychiatric Services (IPS) policy, originally developed in the 1960s and without any significant or meaningful updates since the 1980’s, is physician specific, does not reflect the current model of care for psychiatric inpatients, and is restrictive for psychiatric mental health nurse practitioner (PMHNP) practice. The policy is complex, consists of outdated regulations, and results in millions of dollars in compliance costs for Inpatient Psychiatric Facilities (IPFs) annually (NABH, 2019). Although clearly an important part of the inpatient psychiatric services team, PMHNPs are not identified or defined in the policy (Center for Medicare and Medicaid Services [CMS], 2019). …

The Heart And Soul Of Engagement In The Float Pool Team, Kymberly Dexter

Master's Projects and Capstones

Problem: The assistant nurse manager (ANM) role is considered an entry-level management position and is not intended as a permanent career role. The unintended consequence is that there is a high rate of organizational turnover, making it challenging to build and retain a solid, cohesive, and productive team.

Context: A new manager of a float pool team in a 166-bed community hospital found that with little financial investment, a significant impact is made by holding a safe space for listening to the ANM team and designing education and training around what is most important to frontline managers.

Interventions: A baseline …

Educating School Nurses To Improve Bowel Continence In Children With Spina Bifida, Mckinley J. Waugh, Tracy L. Brewer, Lisa Wagoner

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Children born with spina bifida, a neural tube defect, can have associated loss of bowel control resulting in bowel incontinence. The National Patient Spina Bifida Registry found that 87% of those living with spina bifida had bowel incontinence, and less than 30% were bowel continent (Sawin et al., 2015; Wiener et al., 2017). Unfortunately, providers may never start a child living with spina bifida on a bowel management program. Evidence suggests that children with spina bifida should begin a bowel management program early, using a stepwise approach. School nurses, who interact with children living with spinal bifida while attending school, …

The Association Of Lower Medication Adherence And Increased Medical Spending, Ryan A. Fuchs

Capstone

Medical prescribing is a common occurrence in daily clinical practice. According to the Centers for Disease Control and Prevention, in 2015-2016 45.8% of the U.S. population used prescription drugs in the past 30 days. (CDC, 2019) Although drug therapy can be effective in treating disease, full benefits are often not realized because many patients do not take their medications as prescribed. There is quite a bit of research out there about non-adherence to medication. Some studies focus on the financial impacts of non-adherence, but most of the studies examine the reasons for medication non-adherence. A gap exists in research about …

Empowering Nurses To Recognize Post-Stroke Depression In The African American Community, Deidra Frisbie, Robin Simon

Doctor of Nursing Practice Projects

African Americans (AA) have the highest prevalence of stroke and death compared to other racial groups in the United States. Post-stroke depression (PSD) affects approximately 1/3 of all stroke patients and is underdiagnosed in the African American community.

Aim: By using a mHealth mobile app and a Psychiatry provider list at discharge, PSD can be identified, and interventions initiated, thus decreasing the sequela of PSD in AA.

Methods: Nurses were provided education on PSD, expressions of depression in African-Americans, cultural humility, implicit bias, and the importance of the nurse's role in developing a therapeutic relationship.

Results: Quantitative analysis revealed the …

Reducing The Risk Of Central Line Associated Blood Stream Infection With Chlorhexidine Gluconate Education, Scarlett Ocon

Master's Projects and Capstones

Problem: A nosocomial central line-associated bloodstream infection is a preventable infection that is costly and potentially fatal. In order to combat bloodstream infections chlorhexidine gluconate wipes have been used as antiseptic. Medical surgical units do not have accessible CHG for bathing purposes. In addition, the staff lacks knowledge of how to use CHG wipes. The current standard bathing practice on this unit consists of using soap and water or disposable washcloths spontaneously without a predetermined time. The aim of this quality improvement project is to educate the registered nurses (RNs) and certified nurse assistants (CNAs) on the benefits of daily …

Sepsis Inservice And Video At An Urban Hospital In California, Angela T. Ho

Master's Projects and Capstones

The emergency department at an urban hospital in California was performing below institutional goals related to sepsis protocols over the past few months. This intervention was targeted at nurses and was composed of a PowerPoint in-service on compliance to SEP-1 protocols and follow-along video on using the correct sepsis order set and documentation in the electronic health record (EHR). Goals included increased compliance to the SEP-1 protocol and documentation, (2) reduced time between the onset of symptoms, recognition, and intervention, (3) decline in sepsis rates and mortality rates, and (4) lower cost of care. Data was collected from the EHR …

Nurse-Led Education On Oral Chemotherapy Medications, Carmen Lucia Glick Alonso

Master's Projects and Capstones

Problem: Breast cancer is one of the leading causes of cancer death among women in the United States. Annually, around 264,000 breast cancer cases are diagnosed in women and 2,400 in men (Centers for Disease Control and Prevention, 2022). According to the American Cancer Society, the risk of a woman in the United States being diagnosed with breast cancer in their life is around 13% (2022).

Context: Along with a cancer diagnosis comes the need to introduce patient education about new oral chemotherapy treatments. As a treatment team member, the oncology nurse plays a vital role in this …

Adverse Childhood Experiences Screening Among Adults In An Inpatient Behavioral Health Unit, Erika Y. Bales, Allyson Neal, Brittany Mcgill

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Adverse childhood experiences (ACEs) are common amongst people of all ages, races, and socio-economic statuses. The consequence of ACEs impact ones mental and physical health and life span. High ACE scores lead to increased risk of suicide, depression, anxiety, and substance abuse. The purpose of this project was to screen adults admitted to an inpatient psychiatric hospital for ACEs. This project sought to determine if there is a relationship between overall ACEs score and impact on health versus length of stay. Ultimately, the aim is to reduce negative health outcome for patients as measured by length of stay. The results …

Interprofessional Education Lab Manual And Workbook, Geraldine Terry

Open Textbooks

This laboratory manual was designed to educate and develop integrated healthcare practices essential in delivering person-centered care. Participants will develop their ability to distinguish the role of their own profession and other healthcare professionals collaborating in the care coordination and case management of patients. The content and team-oriented activities in this manual provide guidance on advancing leadership and communication principles necessary for effective interprofessional communication and team collaboration. The well-researched material is tailored to build on the strengths of participants, while also identifying and encouraging areas for improvement.

Feasibility Of A Mindfulness Education Module For Nurses: An Evidence-Based Practice Project, Executive Summary, Emily Looper, Palmer Gleason, Dr. Katherine Newnam

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Nurse burnout is a well-defined problem that has been exacerbated by the COVID-19 pandemic and negatively affects nurses’ mental health, nursing shortages, patient safety, and quality of care. Evidence shows that mindfulness is an effective strategy for managing stress and decreasing burnout in nurses. This article describes an evidence-based practice project that translated this evidence into practice via a vetted mindfulness educational intervention for nurses in intensive care and acute care settings. The purpose of this project was to assess the feasibility of this educational intervention, processes, and outcomes with the goal to extend the project hospital-wide. Pre-intervention levels of …

Screening For Maternal Postpartum Depression In The Pediatric Primary Care Setting: An Educational Project, Mischelle M. Young, Dr. Robert Cornette, Dr. Lisa Padgett

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Abstract

The birth of a baby can bring about an array of powerful emotions that range from joy and excitement to feelings of anxiety, worry, and depression. A majority of mothers experience postpartum baby blues which normally begins 2-3 days after delivery and can last for up to 2-3 weeks, but some mothers experience a more severe form known as postpartum depression (PPD). PPD can be mistaken for baby blues at first, but the signs and symptoms do not diminish and can continue to worsen. Postpartum depression signs and symptoms include withdrawing from friends and family, severe mood swings, excessive …

The Geriatric Emergency Department At The University Of California San Francisco: Structures, Roles, And Lessons Learned, Todd James

Journal of Geriatric Emergency Medicine

No abstract provided.

Virtual Reality For Pediatric Pain Management, Leonard Paulo

Master of Science in Nursing Family Nurse Practitioner

Abstract: It is well-studied that inadequate pain management is detrimental to the pediatric population because inadequate pain management can lead to noncompliance when pertaining to needle sticks that can carry into adulthood, one out of four adults is estimated to have a fear of needles which often develops in childhood. Evidence-based practice report that the use of distraction is a simple and efficient method to minimize the trauma that some children feel when getting immunization or venipuncture. Under the lens of pain gate theory and capacity theory, Virtual Reality has been studied and shown to minimize pain. VR is …

Innovating Cultural Competence Education For Nurses, Darian A. Frieson, Jennifer Patrick, Walker Ray Corless, Abigail Taylor Coulthard, Rebecca R. Fogerty

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Objective

To improve cultural competency levels of registered nurses on the Mother/Baby unit by educating nurses.

Background

Demographics are shifting in the U.S. with an increase in minority populations. Research has revealed insufficient education or a complete absence of education, resulting in nurses that are not equipped to adequately care for culturally diverse patients.

Methods

The Evidence-Based Practice Improvement (EBPI) Model guided the development and implementation of the project. A cultural competence education module was developed utilizing resources from the U.S. Department of Health and Human Services. Outcomes were measured using a pretest/posttest design tool, the Inventory for Assessing the …

Coping With Congenital Heart Disease: Implementation Of An Evidence-Based Intervention In A Pediatric Cardiac Intensive Care Unit, Victoria M. Raphael, Tracy L. Brewer, Sherry Pye

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Caregivers are exposed to many stressors in the pediatric cardiac intensive care unit (CICU) setting. In caregivers of children diagnosed with congenital heart defects admitted to the CICU, symptoms of psychological distress are prevalent (Doherty et al., 2009). These symptoms include, but are not limited to, feelings of acute and chronic stress, worry, anxiety, and depression. Without intervention, these symptoms can negatively influence the health and behavioral outcomes of the admitted child (Commodari, 2010). Providing support for these caregivers during their child’s admission can reduce the significance of these adverse psychological symptoms and promote both patient and caregiver well-being (Melnyk …

12-06-22 Hsc Committee Meeting Minutes, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

Education Of Staff Nurses On The Implementation Of A Standardized Clinical Care Pathway For Patients Who Undergo Correction Of Pectus Excavatum, Amber Jones, Tracy Brewer, Sally Mcquilkin

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Objective: Educate staff nurses on a new standardized clinical care pathway (SCCP) for Nuss Procedure patients to decrease the length of stay, decrease hospital costs, decrease postoperative complications, and improve pain control. Design: Evidence-based practice improvement initiative. Setting/Local Problem: An inpatient surgery unit at a local pediatric medical center with no previous standardized care plan for Nuss Procedure patients. Participants: All staff nurses working on the inpatient surgery unit of a pediatric medical center. Intervention/Measurements: An SCCP was created by a multidisciplinary care team. All staff nurses on the inpatient surgery unit at a local pediatric medical center were assigned …

Pre-Hospital Conditions Affecting The Hospitalization Risk In Older Adults At The Emergency Department, Karin Erwander, Kjell Ivarsson, Mona Landin-Olsson, Björn Agvall

Journal of Geriatric Emergency Medicine

BACKGROUND: The Emergency Department (ED) is a common route to hospitalization for critically ill and older adults. Older patients are admitted to hospital at a higher rate and have longer length of stay (LOS) when hospitalized. To be able to confront an increasing aging population, meet their medical needs and influence rising costs of health care, there is a need to focus on the older population. In Scandinavia, few studies are made that focus on the geriatric population at the ED. It is essential to early identify risk factors for hospitalization at the ED to improve the medical care for …

Increasing Equitable Access To Care: Implementation Of Universal Palliative Care Screening In The Intensive Care Unit, Sarah Weaver

Student Scholarly Projects

Practice Problem: At a small community hospital in Virginia, there is an absence of standardized screening processes for identifying intensive care unit (ICU) patients with unmet palliative care needs, contributing to delayed and unequitable access to palliative care consultations.

PICOT: The PICOT question that guided this project was “In adult ICU patients, how does implementing a palliative care screening tool upon ICU admission, as compared to standard ICU admission protocol, affect palliative care consultations within an 8-week time frame?"

Evidence: This project was guided by consensus reports from the World Health Organization and the Centers to Advance …

Training In The Use Of Interpretive Services For Patients With Limited English Proficiency, Kristina Wooten

Symposium of Student Scholars

In clinical settings, there is a disconnect between health care professionals (HCPs) and patients with limited English proficiency (LEP). HCPs rely on ad hoc interpreters to communicate with patients with LEP (e.g. nurses using untrained friends and family or nursing students to interpret care information). Refusing to use or misusing professional interpreters and other interpretive services may lead patients with LEP to avoid seeking necessary care, misunderstand their diagnoses and treatment regimens, and fail to return for follow-up care. This increases the already existing health care disparity between patients who speak English and patients with LEP. Studies show that if …

High Anxiety In Pediatric Oncology Patients? What About Art Therapy?, Rebekah Love

Symposium of Student Scholars

Anxiety and depression are becoming more prevalent in the pediatric population today. In addition to the general pediatric population experiencing an increased risk of mental illness, children with an oncology related diagnosis have an even heightened risk. Most pediatric oncology patients reported fear or worry daily, which is cited to be most severe when they had an appointment or went to the hospital for a fever. It is imperative we discover interventions to lessen the anxiety and depression pediatric oncology patients experience daily. A literature review revealed conclusive interventions have not been determined. The purpose of this research is to …

Alternative Precautionary Measures Yielding Lower C. Diff Infection Rates In Healthcare Facilities, Matthew Kramer

Symposium of Student Scholars

Background: An international healthcare concern is the persistent spread of Clostridium difficile, a Gram-positive spore forming bacterium that is responsible for the most common hospital-acquired infection, amongst patients.

Objective: A systematic review was performed to summarize evidence that the interventions utilized in healthcare facilities which indicate a patient’s precautionary status are insufficient, outdated, and commonly lead to infection in neighboring patient rooms. Databases such as PubMed, NCBI, Google Scholar, and APHA’s Medical Care were searched, covering the period from 2017-2022. Studies were included if their focus concentrated on C. diff and the precautionary measures taken by employees at healthcare …

Stretching To Reduce Chronic Back Pain In Nurses & Care Partners, Jennifer Monyhan

Symposium of Student Scholars

DO PRE- AND POST-SHIFT HUDDLE STRETCHING EXERCISES REDUCE CHRONIC LOWER BACK PAIN AMONG NURSES AND CNAS OVER A THREE- TO SIX-MONTH PERIOD?

Abstract

Many nurses and care partners develop job-related chronic lower back pain due to constantly repositioning immobile patients, changing linens, and bathing patients. These strenuous job requirements involve bending and lifting, as well as standing for extended periods of time during long shifts. This proposal will investigate the effectiveness of a targeted, thirty-second stretching session incorporated into each shift change huddle, for employees beginning their shift as well as employees ending their shift, on reports of lower back …

10-11-2022 Hsc Committee Minutes, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

Decreasing Pain In Pediatric Patients During Intravenous Catheter Insertions On The Pediatric Inpatient Surgery Unit, Breonna Scott, Robert Cornette, Tammy Childers

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Abstract

As healthcare in the United States transforms, the voice of advocacy for pediatric patients is also evolving. The act of inserting a peripheral intravenous (IV) catheter for medical care of a pediatric patient is one of the most common invasive procedures in the healthcare industry. However, the preventable pain accompanying such a common procedure is often overlooked. Pediatric patients are different than adults due to the lack of physiological and psychological development. When a peripheral intravenous catheter is inserted without pain prevention interventions, there are long-term and short-term consequences for the patient and family. In turn, there are many …