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Articles 121 - 150 of 8947
Full-Text Articles in Medicine and Health Sciences
Medication-Assisted Treatment For Patients With Substance Use Disorder And Depression: A Scoping Review, Josiane Deguenon Bsn-Rn, Elisabeth Fritz Bsn-Rn, Jesse Jean Bsn-Rn, Tucker Mckinney Bsn-Rn, Laura Reed Dnp, Aprn, Fnp-Bc, Cne, Fnap
Medication-Assisted Treatment For Patients With Substance Use Disorder And Depression: A Scoping Review, Josiane Deguenon Bsn-Rn, Elisabeth Fritz Bsn-Rn, Jesse Jean Bsn-Rn, Tucker Mckinney Bsn-Rn, Laura Reed Dnp, Aprn, Fnp-Bc, Cne, Fnap
Doctor of Nursing Practice Projects
Purpose/Background
Substance use disorder (SUD) frequently co-occurs with depression and increases relapse risk and healthcare utilization. Although medication-assisted treatment (MAT) is an evidence-based intervention for SUD, outcomes for adults with co-occurring depression remain inconsistently reported due to variation in study designs, treatment settings, and measures. This scoping review examines evidence on MAT use among adults with co-occurring depression and SUD and summarized reported clinical and healthcare utilization outcomes.
Methods
From August 2023 to November 2025, a scoping literature review was conducted on PubMed/MEDLINE, CINAHL, and the Cochrane Library, using MeSH search terms and Boolean operators to link the concepts defined …
Medical Clearance For Behavioral Health Patients In The Emergency Department: A Conceptual Overview Of Practice Variability, James Espinosa, Alan Lucerna
Medical Clearance For Behavioral Health Patients In The Emergency Department: A Conceptual Overview Of Practice Variability, James Espinosa, Alan Lucerna
Rowan-Virtua Research Day
Background: Patients presenting to the emergency department (ED) with behavioral health complaints frequently undergo medical clearance prior to behavioral health evaluation or admission. Substantial variability appears to be found in laboratory utilization, documentation language, and interdepartmental workflow.
Objective: To provide a conceptual overview of variability in medical clearance practices and to synthesize existing guideline recommendations and literature regarding routine laboratory testing in low-risk psychiatric patients.
Methods: Narrative review of professional policy statements, selected peer-reviewed studies, and operational considerations influencing emergency physician practice patterns.
Results: Evidence suggests that routine laboratory testing in psychiatric patients has low diagnostic yield and rarely changes …
Soundscapes (Ambient Sound, Noise, Music And Other Background Sound) In The Emergency Department: An Under-Theorized Environmental Modifier In A Complex Adaptive System, James Espinosa, Alan Lucerna
Soundscapes (Ambient Sound, Noise, Music And Other Background Sound) In The Emergency Department: An Under-Theorized Environmental Modifier In A Complex Adaptive System, James Espinosa, Alan Lucerna
Rowan-Virtua Research Day
Background:
Music and ambient sound (including noise and other sounds) are frequently present in emergency departments (EDs), yet their role as environmental modifiers remains under-theorized. Existing literature largely examines background music, for example, in procedural or perioperative contexts, with limited attention to open, high-density, multi-agent acute care systems.
Objective:
To conceptualize auditory input as a dynamic environmental variable within the ED viewed as a Complex Adaptive System (CAS), integrating neurobiological mechanisms with systems-level implications.
Methods/Conceptual Approach: Narrative conceptual synthesis integrating neurobiology of auditory processing, affective neuroscience, cognitive load theory, and complexity science.
Results:
Conceptual Insights: Auditory stimuli engage distributed neural …
The Obstacles Of Performing A Retrospective Chart Review, Emily Reilly, Robert Hudrick D.O.
The Obstacles Of Performing A Retrospective Chart Review, Emily Reilly, Robert Hudrick D.O.
Rowan-Virtua Research Day
Introduction: This research project "Comparing timing of care for skin cancer patients with limited English proficiency who require interpretation during medical visits to patients with English proficiency" was accepted under the CREATE Grant. The hypothesis was that patients who require medical interpretation during their visits would show a longer period of time between noticing a skin lesion to definitive diagnosis. Previous research has shown improved health care outcomes, but has mixed results on patient satisfaction and health care experience. This poster aims to detail the limitations faced during the execution of a retrospective chart review from the perspective of a …
Conceptualizing The Transition From Stable Operations To Turbulent States : Reframing Emergency Department Operations. Learning From Fluid Dynamics And Complexity Science, James Espinosa, David Ho, Alan Lucerna
Conceptualizing The Transition From Stable Operations To Turbulent States : Reframing Emergency Department Operations. Learning From Fluid Dynamics And Complexity Science, James Espinosa, David Ho, Alan Lucerna
Rowan-Virtua Research Day
Background: Emergency departments are frequently described using the language of patient flow, implying smooth and predictable movement of patients through a system versus known obstructions to flow. Clinicians, however, often observe abrupt shifts in operational stability.
Objective: To explore whether concepts from fluid dynamics and complexity science offer a useful framework for understanding these transitions.
Methods: Conceptual synthesis drawing on emergency medicine operations research, human factors, systems science, and fluid mechanics.
Results (Conceptual): Emergency departments exhibit behaviors analogous to systems approaching turbulence, including sensitivity to perturbation, amplification of delays, and nonlinear responses.
Conclusion: Viewing ED operations through the lens of …
Reframing The Ed–Hospitalist Admission As A Clinical Handoff: The Ed To Hospital Admission As A Cross-System Handoff In A Complex Adaptive Clinical Environment. The Case For Systems Approaches To Enhance Safe And Effective Transitions Across A True System Interface, James Espinosa, Alan Lucerna, Henry Schuitema
Reframing The Ed–Hospitalist Admission As A Clinical Handoff: The Ed To Hospital Admission As A Cross-System Handoff In A Complex Adaptive Clinical Environment. The Case For Systems Approaches To Enhance Safe And Effective Transitions Across A True System Interface, James Espinosa, Alan Lucerna, Henry Schuitema
Rowan-Virtua Research Day
Background
Transitions from the Emergency Department (ED) to hospital medicine represent a high-stakes clinical handoff across systems. While often experienced as challenging, these interactions are better understood as occurring between services operating under different cognitive loads, operational priorities, and time horizons. Reframing the ED–hospitalist admission as a structured handoff aligns this process with broader patient safety efforts.
Objective
To characterize the ED–hospitalist admission as a cross-system clinical handoff and to identify practical strategies that enhance safety, clarity, and alignment during this transition.
Methods
Conceptual analysis informed by clinical experience, systems theory, and teaching observations. Key domains of potential misalignment were …
Reducing Pharmacy Callbacks And Improving Workflow Efficiency In The Emergency Department: A Quality Improvement Initiative, Philip .. Carhart, Hannah Culleny, Alexis Schuitema, James Espinosa, Robin Lahr, Sergey Medlenov, Gabriel Meister, Alan Lucerna
Reducing Pharmacy Callbacks And Improving Workflow Efficiency In The Emergency Department: A Quality Improvement Initiative, Philip .. Carhart, Hannah Culleny, Alexis Schuitema, James Espinosa, Robin Lahr, Sergey Medlenov, Gabriel Meister, Alan Lucerna
Rowan-Virtua Research Day
A simple educational intervention combined with structured provider feedback reduced ED pharmacy callbacks by 86%. While individual call duration remained unchanged, the reduction translated into nearly eight hours of provider time saved annually. This study highlights the impact of targeted quality improvement efforts on: • Workflow efficiency • Interprofessional communication • Patient care reliability. Small systems interventions can produce disproportionate operational benefits.
Detecting Early Operational Turbulence In The Emergency Department Using Fourier And Wavelet Analysis: A Conceptual Framework For Signal-Informed Anticipation And Prediction In The Ed Complex Adaptive System, James Espinosa, David Ho, Alan Lucerna
Detecting Early Operational Turbulence In The Emergency Department Using Fourier And Wavelet Analysis: A Conceptual Framework For Signal-Informed Anticipation And Prediction In The Ed Complex Adaptive System, James Espinosa, David Ho, Alan Lucerna
Rowan-Virtua Research Day
Background:
We theorize that Emergency Departments (EDs) function as complex adaptive systems characterized by nonlinear interactions, oscillatory demand patterns, and abrupt phase transitions from stable flow to turbulent states. Traditional dashboards rely on threshold metrics that detect instability after degradation becomes visible. Many ED data streams are significantly retrospective as well as compression-averaged into temporal systems such as days, months, quarters or even years. Signal processing methods—particularly Fourier and wavelet analysis—offer the framework for detecting latent oscillatory shifts preceding overt operational change from laminar to transitional to turbulent flow states. This could lead to better methods of adaptation.
Conceptual Framework: …
Congruence (Healthy Adaptation And Resilience) Under Stress: A Human Systems Model For Healthcare Microsystems Integrating Virginia Satir’S Communication Theory With Clinical Microsystems And Complex Adaptive Systems Using The Emergency Department As A Model Of Adaptive Team Function, James Espinosa, Alan Lucerna
Rowan-Virtua Research Day
Background:
Emergency departments operate as complex human systems under continuous cognitive, emotional, and operational stress. Healthcare delivery occurs within clinical microsystems—small frontline units where patients, clinicians, and staff interact directly. While microsystem theory has provided an operational framework for improving quality and safety, less attention has been given to the relational communication dynamics within these systems.
Objective:
To integrate Virginia Satir’s human systems theory with clinical microsystem theory and complex adaptive systems thinking in order to better understand communication patterns, team dynamics, and adaptive functioning within emergency medicine residency programs and ED clinical teams.
Conceptual Framework:
Satir described several communication …
The Safety Paradox Of Emergency Department Shift Length: Why The Relationship Between Hours Worked And Patient Safety Is More Complex Than It Appears, James A. Espinosa Md, Alan Lucerna
The Safety Paradox Of Emergency Department Shift Length: Why The Relationship Between Hours Worked And Patient Safety Is More Complex Than It Appears, James A. Espinosa Md, Alan Lucerna
Rowan-Virtua Research Day
Background: Emergency department shift duration has long been debated as a determinant of patient safety. While longer shifts may increase cognitive fatigue, shorter shifts may increase the frequency of patient handoffs, which themselves introduce communication risk. Objective: To conceptualize emergency department shift length as a safety paradox arising from the balance between fatigue and handoff-related communication risks. Conceptual Framework: We propose the Emergency Department Shift Length Safety Paradox model illustrating the nonlinear relationship between shift duration and patient safety. Implications: Optimal shift design may depend on balancing fatigue risk and communication risk within a complex adaptive healthcare system. Conclusion: Emergency …
Emergency Medicine As A Complex Adaptive System Apprenticeship: A Conceptual Framework For Understanding The Development And Emergence Of Systems Leaders From The Field Of Emergency Medicine, James Espinosa, Alan A. Lucerna, Henry Schuitema
Emergency Medicine As A Complex Adaptive System Apprenticeship: A Conceptual Framework For Understanding The Development And Emergence Of Systems Leaders From The Field Of Emergency Medicine, James Espinosa, Alan A. Lucerna, Henry Schuitema
Rowan-Virtua Research Day
Background
Emergency physicians are frequently observed to assume leadership roles in hospitals and health systems. Prior literature, including policy and leadership analyses from the American College of Emergency Physicians, has described this phenomenon and highlighted the emergency department’s central position within hospital operations. However, most explanations focus on enumerating leadership competencies rather than identifying the developmental mechanism through which those competencies emerge.
Objective
To propose a conceptual framework explaining how emergency medicine training functions as an apprenticeship in managing complex adaptive systems.
Conceptual Model
The emergency department (ED) operates as a highly dynamic environment characterized by nonlinear patient inflow, interdependent …
Reframing Outpatient-To-Ed Transitions As A Patient Safety Interface: Recognizing, Structuring, And Preserving Signal Across Clinical Boundaries Conceptualizing The Call-In To Ed Referral Model As A Handoff Of Care Model, James Espinosa, Alan Lucerna, Henry Schuitema
Reframing Outpatient-To-Ed Transitions As A Patient Safety Interface: Recognizing, Structuring, And Preserving Signal Across Clinical Boundaries Conceptualizing The Call-In To Ed Referral Model As A Handoff Of Care Model, James Espinosa, Alan Lucerna, Henry Schuitema
Rowan-Virtua Research Day
Background
Transitions of care are recognized sources of patient safety risk. Structured handoff processes have improved communication reliability in inpatient and emergency department (ED) settings. However, outpatient-to-ED referrals—despite representing a transfer of care—are not consistently conceptualized or operationalized as formal handoffs.
Objective
To reframe outpatient-to-ED referrals as clinical handoffs occurring across a system boundary, and to propose a conceptual and operational framework to improve safety through recognition, structure, and signal preservation.
Methods
Conceptual analysis informed by clinical experience, systems thinking, and existing literature on handoffs and patient safety. Comparative evaluation of structured (ED→ED, ED→inpatient) versus less-structured (outpatient→ED) transitions.
Results
Outpatient-to-ED …
Designing Patient Update Intervals In The Emergency Department: A Queueing-Theory And Operational Science Model Of Patient Updates And Progress Signaling To Improve Patient Experience, James Espinosa, Alan Lucerna, Henry Schuitema
Designing Patient Update Intervals In The Emergency Department: A Queueing-Theory And Operational Science Model Of Patient Updates And Progress Signaling To Improve Patient Experience, James Espinosa, Alan Lucerna, Henry Schuitema
Rowan-Virtua Research Day
Background Patients in the Emergency Department (ED) frequently experience uncertainty while awaiting diagnostic results, reassessment, and disposition. Even when clinical processes are progressing, prolonged informational silence may create the perception of that those processes are not advancing.
Objective To develop a conceptual and operational mathematical, queuing-theory based model linking bedside communication, conversational time, and informational silence to patient experience.
Methods A back-of-the-envelope operational model was constructed to estimate the time required for bedside update communication during a typical physician shift. A queueing-theory framework was applied to examine how intervals between informational updates influence perceived waiting burden. Concepts from queueing theory …
El Papel Del Bilingüismo En La Atención Médica A Pacientes Hispanohablantes, Ariela Deleon
El Papel Del Bilingüismo En La Atención Médica A Pacientes Hispanohablantes, Ariela Deleon
Student Scholar Symposium Abstracts and Posters
Spanish-speaking patients in the United States frequently face significant barriers to quality healthcare due to language differences between themselves and their providers. This project examines how English-Spanish bilingualism among healthcare professionals meaningfully improves the quality of care delivered to Spanish-speaking patients. To analyze this, the project draws on a review of academic literature on bilingualism, language concordance, medical interpretation, and health outcomes, as well as interviews with healthcare professionals across various fields who possess different levels of Spanish fluency and regularly work with Spanish-speaking patients. This project argues that bilingualism among healthcare providers is not merely a supplementary skill but …
Nurse-Driven Infusion Protocols In Diabetic Ketoacidosis: A Scoping Review, Nicholas Morrell Pierce Msn, Rn, Cen, Ccrn, Mary Cassandra Scott Bsn, Rn, Ccrn, Cen, Alvertis Demetreis Warren Bsn, Rn, Ccrn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C
Nurse-Driven Infusion Protocols In Diabetic Ketoacidosis: A Scoping Review, Nicholas Morrell Pierce Msn, Rn, Cen, Ccrn, Mary Cassandra Scott Bsn, Rn, Ccrn, Cen, Alvertis Demetreis Warren Bsn, Rn, Ccrn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C
Doctor of Nursing Practice Projects
Purpose/Background
Diabetic ketoacidosis (DKA) is a high-risk acute emergency requiring timely insulin titration, intensive monitoring, and coordinated interdisciplinary care. Traditionally, management relies on provider-driven insulin infusion adjustments, which may introduce delays and workflow inefficiencies. Emerging nurse-driven insulin infusion protocols aim to standardize care, improve safety, and enhance clinical efficiency. The purpose of this scoping review was to evaluate existing evidence comparing nurse-driven versus provider-driven insulin infusion protocols in the management of adult patients with DKA.
Methods
A scoping review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. From August 2023 through November 2025, …
Improving Emergency Department Throughput: Implementation Of A Nurse-Driven Protocol In Pediatric Fast-Track Patients Presenting With Fever, Kerrigan A. Teeple
Improving Emergency Department Throughput: Implementation Of A Nurse-Driven Protocol In Pediatric Fast-Track Patients Presenting With Fever, Kerrigan A. Teeple
Evidence-Based Practice Project Reports
Overcrowding in the emergency department presents significant operational challenges and is associated with adverse patient outcomes (Gottlieb et al., 2020). Despite throughput initiatives, increasing patient acuity and rising census levels continue to strain emergency department efficiency. This quality improvement project evaluated whether implementing a fever-reduction standing order protocol could reduce door-to-provider and door-to-disposition times for pediatric fast-track patients presenting to the emergency department. A review of evidence across 6 databases identified nurse-initiated standing orders as a best-practice strategy to expedite care, improve throughput, and reduce delays in disposition. Guided by this evidence, a standing order protocol for acetaminophen administration was …
Increasing Medication Adherence In Those With Hypertension, Holly Kimiecik
Increasing Medication Adherence In Those With Hypertension, Holly Kimiecik
Evidence-Based Practice Project Reports
Hypertension is a chronic condition characterized by persistently elevated blood pressure and remains a significant contributor to morbidity and mortality in the United States. According to the Centers for Disease Control and Prevention (2024), approximately 47.7% of U.S. adults have hypertension, yet only about one in five achieve blood pressure control below 130/80 mm Hg. Medication adherence plays a critical role in managing hypertension and preventing complications. Adults aged 18 years and older prescribed antihypertensive medications from a primary care clinic in Valparaiso, Indiana, participated in this six-week quality improvement intervention. Evidence from a comprehensive literature review supports combining patient …
Airborne Fungal Monitoring In Healthcare Environments: A Systematic Review, Dana L. Surwill, Patricia Cruz, Mark P. Buttner, Jennifer R. Pharr, Nancy Lough, Theresa T. Roehr
Airborne Fungal Monitoring In Healthcare Environments: A Systematic Review, Dana L. Surwill, Patricia Cruz, Mark P. Buttner, Jennifer R. Pharr, Nancy Lough, Theresa T. Roehr
Environmental & Global Health Faculty Research
Background: Fungal infections pose a significant threat to public health, with over 6.55 million cases and 2.55 million deaths annually. Exposure to fungal spores in indoor environments primarily occurs through inhalation or direct contact with surfaces. Monitoring is critical for early detection and prevention of outbreaks, yet routine airborne fungal testing is not universally mandated across healthcare settings. Methods: A systematic review of peer-reviewed articles from four databases was conducted to identify current airborne fungal monitoring guidelines and best practices for sample collection, culture media, incubation conditions, and results interpretation. Results: Eighteen articles met the inclusion criteria, and four studies …
Heads Up! Designing A Nursing Assessment Tool For Early Recognition Of Intracranial Hypertension Post Head Injury, Sergio A. Dondiego
Heads Up! Designing A Nursing Assessment Tool For Early Recognition Of Intracranial Hypertension Post Head Injury, Sergio A. Dondiego
Honors Capstones
This meta-analysis identifies noninvasive clinical predictors of intracranial hypertension (IH) post head trauma to develop a multi-criteria IH screening tool designed for nurses to wear on their badge reels. High-sensitivity predictors were prioritized to assist in early IH suspicion. Findings suggest that radiographic-measured abnormalities including an optic nerve sheath diameter (ONSD) 5.6 mm and signs of significant head trauma via computed tomography (CT) were highly effective for predicting IH and were therefore defined as major criteria for the assessment tool. Other significant examination findings include a Glasgow Coma Scale (GCS) score 8 and atypical pupillary reactivity. While age showed conflicting …
Evaluating The Impact Of Glp-1 Receptor Agonists On Perioperative Aspiration Risk: The Role Of Preoperative Fasting Duration, Caitlin Maureen Carter Bsn, Rn, Adam Wade Johnson Bsn, Rn, Allison Whitney Jones Bsn, Rn, Joseph Kaesberg Bsn, Rn, Kelly Maura Watson Bsn, Rn, Bobby Bellflower Dnsc, Nnp-Bc, Faan, Faanp, Fnap
Evaluating The Impact Of Glp-1 Receptor Agonists On Perioperative Aspiration Risk: The Role Of Preoperative Fasting Duration, Caitlin Maureen Carter Bsn, Rn, Adam Wade Johnson Bsn, Rn, Allison Whitney Jones Bsn, Rn, Joseph Kaesberg Bsn, Rn, Kelly Maura Watson Bsn, Rn, Bobby Bellflower Dnsc, Nnp-Bc, Faan, Faanp, Fnap
Doctor of Nursing Practice Projects
Purpose/Background
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly prescribed for diabetes and obesity due to their metabolic benefits; however, these medications delay gastric emptying, raising concern for increased residual content (RGC) and aspiration risk during anesthesia. Current perioperative fasting and medication management guidelines for patients taking GLP-1 RAs remain inconsistent, creating uncertainty for anesthesia providers. This scoping review aimed to synthesize current evidence on the relationship between GLP-1 RA use and perioperative gastric safety, with particular focus on fasting duration and aspiration risk.
Methods
A scoping review was conducted in accordance with PRISMA-ScR guidelines. Searches were performed using the …
Measuring Disability Prevalence In Healthcare: A Study Comparing Two Disability Measures, Kristen L. Milefchik, Rhonda K. Dailey, Sharon Milberger
Measuring Disability Prevalence In Healthcare: A Study Comparing Two Disability Measures, Kristen L. Milefchik, Rhonda K. Dailey, Sharon Milberger
Developmental Disabilities Network Journal
People with disabilities experience significant health disparities and interventions are needed to address them. Measuring disability prevalence is an essential aspect of designing effective, data-driven healthcare strategies. Accurately measuring disability prevalence is challenging given disability is a complex phenomenon, with biological, social, environmental, and cultural components. Previous studies have compared a variety of disability status measurements and found that measurements were incongruent with each other. This study examines the concordance between disability status using two different measures: the nationally recognized American Community Survey (ACS-6) functional difficulty questions and one disability identity question. We used data from 3,621 adult patients participating …
Evidenced-Based Practice Guideline Development: The Addition Of Adjunctive Dexmedetomidine In Brachial Plexus Blocks For Upper Arthroscopic Surgery, Mylene Louail
Doctor of Nursing Practice Scholarly Projects
Dexmedetomidine (DEX) is an alpha-2 adrenergic agonist increasingly studied as an adjunct in brachial plexus blocks (BPBs) to enhance postoperative pain management. This project examines the efficacy of DEX as an adjunct in BPBs for upper extremity arthroscopic surgeries, focusing on its ability to extend analgesia duration, reduce opioid use, and enhance patient satisfaction. With analgesic and sedative properties, DEX can improve postoperative pain management with minimal side effects, providing shortened hospital stays, decreased costs, and better patient outcomes. Using the Iowa Model for evidence-based practice, baseline data on postoperative pain, analgesia duration, and opioid use will be collected from …
Remimazolam As A Sedative For Endoscopic Procedures: A Scoping Review, Hamzha Aysheh, Megan Henderson, Megan Hinkle, Sara Holton, Spencer Turner, Dwayne Accardo Dnp, Ccrn, Faana
Remimazolam As A Sedative For Endoscopic Procedures: A Scoping Review, Hamzha Aysheh, Megan Henderson, Megan Hinkle, Sara Holton, Spencer Turner, Dwayne Accardo Dnp, Ccrn, Faana
Doctor of Nursing Practice Projects
Purpose/Background
Propofol is commonly used for procedural sedation during endoscopic procedures because of its rapid onset and short duration; however, its use is frequently associated with adverse effects such as hypotension, hypoxemia, respiratory depression, bradycardia, and injection site pain. As diagnostic endoscopic procedures continue to increase, particularly among older and medically complex patients, there is a growing need for sedative agents that provide effective sedation while minimizing perioperative risk. Remimazolam, a novel ultra–short-acting benzodiazepine metabolized by tissue esterases, has demonstrated favorable hemodynamic stability and a reduced adverse effect profile in recent literature. The purpose of this evidence-based quality improvement project …
Discharge Education Bundles And Evaluating The Effect On Readmission And Satisfaction Rates: A Scoping Review, Jane Campo Bsn, Rn, Charlotte Edwards Bsn, Rn, Mary Catherine Hall Bsn, Rn, Sarah Moore Bsn, Rn, Allison Walker Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C
Discharge Education Bundles And Evaluating The Effect On Readmission And Satisfaction Rates: A Scoping Review, Jane Campo Bsn, Rn, Charlotte Edwards Bsn, Rn, Mary Catherine Hall Bsn, Rn, Sarah Moore Bsn, Rn, Allison Walker Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C
Doctor of Nursing Practice Projects
Purpose/Background
Transitioning children with a chronic medical condition from hospital to home is a critical and difficult process, leaving many families feeling anxious and unprepared. Nationally, 1 in 7 pediatric patients are readmitted within thirty days, making readmission rates an important quality indicator with both clinical and financial implications. To address these challenges, multiple discharge bundles have been developed; however, their effectiveness has not been consistently evaluated. The aim of this project is to summarize the current literature and highlight its positive outcomes, with the intention of promoting further research, reducing 30-day readmission rates, and increasing parental satisfaction (Shermont et …
Impact Of Nitrous Oxide Analgesia On Labor Experience, Kierra Jones Rn, Bsn, Elyzabeth Morales Rn, Bsn, Lanitra Ray Rn, Bsn, Rhonda Johnson Dnp, Cne, Cnm, Facnm
Impact Of Nitrous Oxide Analgesia On Labor Experience, Kierra Jones Rn, Bsn, Elyzabeth Morales Rn, Bsn, Lanitra Ray Rn, Bsn, Rhonda Johnson Dnp, Cne, Cnm, Facnm
Doctor of Nursing Practice Projects
Purpose/Background
Nitrous oxide (N₂O) has re-emerged in the United States as a labor analgesia option that supports mobility, autonomy, and patient-centered care. As nurses increasingly support low-intervention and physiologic birth approaches, understanding the effectiveness and safety of nitrous oxide for low-risk laboring individuals is essential. This scoping review examines current evidence on nitrous oxide use during labor, focusing on maternal pain management, satisfaction, and neonatal outcomes to inform evidence-based nursing and midwifery practice.
Methods
A scoping review was conducted using PubMed, CINAHL Complete, and the Cochrane Library between September and October 2023. Inclusion criteria consisted of English-language studies published within …
Waring Library Society Newsletter, Summer 2026, Waring Library Society, Waring Historical Library, Medical University Of South Caroilna, Jude Arendall, Joann Livingston Zeise, Brooke Fox
Waring Library Society Newsletter, Summer 2026, Waring Library Society, Waring Historical Library, Medical University Of South Caroilna, Jude Arendall, Joann Livingston Zeise, Brooke Fox
The Waring Library Society Newsletters
In this issue, the Waring Library Society welcomes its new President and shares updates on recent and upcoming renovations to Waring Historical Library. Waring Historical Library's staff reflect on insights gained from a recent sabbatical, and highlight several events and engagements the Waring has been part of this season.
Building The Foundation For Equitable Diabetes Education: Examining Trust And Digital Access In Rural And Unreserved Population, Niasia Hazelton Smalls
Building The Foundation For Equitable Diabetes Education: Examining Trust And Digital Access In Rural And Unreserved Population, Niasia Hazelton Smalls
MUSC Theses and Dissertations
Disparities in patient portal use undermine equitable chronic disease management, particularly for adults with diabetes in rural and historically underserved communities. This explanatory sequential mixed-methods study examined the associations among trust in the healthcare system and patient portal use among U.S. adults, using nationally representative data from the Health Information National Trends Survey (HINTS) 2023 (N = 3,711), supplemented by semi-structured interviews with frontline healthcare providers. Bivariate analyses revealed that adults with diabetes reported lower trust (83% vs. 86%, p = 0.003) and lower portal use (62% vs. 66%, p = 0.014) compared to those without a diagnosis. Multivariate logistic …
The Effects Of Sugammadex Vs. Neostigmine On Intraoperative Heart Rate In Pediatric Patients Under Two Years: A Scoping Review, Saumel Abston, Jackson Cobb, Elle Dean, Tanner Dillard, Pauline Dinh, Dwayne Accardo Dnp, Crna, Faana, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn, Fhrs
The Effects Of Sugammadex Vs. Neostigmine On Intraoperative Heart Rate In Pediatric Patients Under Two Years: A Scoping Review, Saumel Abston, Jackson Cobb, Elle Dean, Tanner Dillard, Pauline Dinh, Dwayne Accardo Dnp, Crna, Faana, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn, Fhrs
Doctor of Nursing Practice Projects
Purpose/Background
Neuromuscular blockade (NMB) reversal is a critical component of anesthesia care, particularly in infants under two years of age who have immature autonomic regulation and heightened vagal tone, predisposing them to bradycardia. Neostigmine, the traditional reversal agent, is associated with parasympathomimetic effects such as bradycardia, requiring anticholinergic co- administration. Sugammadex, a selective relaxant binding agent, offers rapid and predictable reversal of aminosteroidal neuromuscular blocking agents with less cholinergic side effects. Although the safety profile of sugammadex is well established in older pediatric populations, limited evidence exists regarding its cardiovascular effects in infants under two years of age.
Methods
A …
Improving Access And Early Identification Of Anxiety Disorders Through Annual Gad-7 Screening In High Schools: A Scoping Review, Joshua Richard Yumul Bsn, Rn, Cindy Thao Msn, Rn, Justin Doyle Borden Bsn, Rn, Rebecca Lizette Johnston Bsn, Rn, Bobby Bellflower Dnsc, Nnp-Bc, Faan, Faanp, Fnap
Improving Access And Early Identification Of Anxiety Disorders Through Annual Gad-7 Screening In High Schools: A Scoping Review, Joshua Richard Yumul Bsn, Rn, Cindy Thao Msn, Rn, Justin Doyle Borden Bsn, Rn, Rebecca Lizette Johnston Bsn, Rn, Bobby Bellflower Dnsc, Nnp-Bc, Faan, Faanp, Fnap
Doctor of Nursing Practice Projects
Background: Anxiety disorders affect nearly one-third of adolescents in the United States, yet many cases remain undiagnosed due to inconsistent screening and limited access to school-based mental health services. The Generalized Anxiety Disorder 7-item (GAD-7) questionnaire is a validated screening tool, but its routine use in high school settings is not well established.
Purpose: This scoping review aimed to synthesize current evidence on the use of the GAD-7 in high schools to support early identification of anxiety disorders and improve access to mental health care.
Methods: A comprehensive literature search was conducted using PsycINFO, ERIC, PubMed, CINAHL, and Google Scholar. …
The Effect Of Facial Adiposity On Hypothetical Medical Treatments As A Function Of Disgust, Lindsey Duran
The Effect Of Facial Adiposity On Hypothetical Medical Treatments As A Function Of Disgust, Lindsey Duran
Biological Sciences Undergraduate Honors Theses
Perceivers are capable of estimating the health of individuals through cues to facial adiposity, with such inferences having accuracy in recognizing worse chronic health among those exhibiting greater adiposity. Nonetheless, these inferences could extend beyond health assessments into subsequent anti-fat prejudice based on perceptions of such individuals as pathogenically threatening. Although potentially functional in ancestral contexts, modern healthcare settings could render this functional stigmatization a liability that results in worse medical care toward those with higher adiposity. In this study, I tasked medical workers to evaluate male and female hypothetical patients at high and low levels of facial adiposity, particularly …