Medicine and Health Sciences Commons^™

Decreasing Extubation Times Using Adaptive Support Ventilation: A Scoping Review, Daphne Thomas, Cole Vest, Luke Wilson, Shannon Witcher, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background:This scoping review explores the effectiveness of adaptive support ventilation (ASV) compared to conventional ventilation modes in reducing postoperative extubation times in adults undergoing general anesthesia with ventilatory support. Ventilator weaning is a critical determinant of recovery and outcomes in intensive care settings. ASV, a closed-loop ventilation mode, automatically adjusts ventilator parameters based on patient-specific respiratory mechanics and demand to optimize the weaning process. Although promising, evidence regarding ASV’s effectiveness remains inconsistent across different patient populations and surgical contexts.

Methods: A systematic literature search was conducted from August 2023 to December 2024 across PubMed, CINAHL, Medline, JAMA, and Google …

Evaluating The Efficacy Of Discharge Education On Readmission Rates In Pediatric Patients With Chronic Conditions: A Scoping Review, Camden Shaw Bsn, Rn, Cpn, Ashely St. Julien Bsn, Rn, Claire Avant Bsn, Rn, Michelle Rickard Dnp, Cpnp-Ac, Chppn

Doctor of Nursing Practice Projects

Abstract Assignment

Purpose/Background

Children with multiple chronic health conditions account for a significant portion of hospital readmission and healthcare expenses. A scoping review was completed to analyze and summarize the available research regarding the effectiveness of discharge education on readmission rates and associated outcomes in children with chronic conditions. The following PICOT question was created: In pediatric patients with chronic disease, how does a discharge education bundle compared to no discharge education bundle affect readmission rates within 30 days of discharge?

Methods

A systematic approach was utilized for analysis to determine article eligibility. The initial search yielded 30 articles; however, …

The Impact Of The Utilization Of Shared Decision-Making Tools In Contraceptive Counseling On Patient Satisfaction In Adolescents: A Scoping Review, Akaninyene Ruffin Msn,Fnp-C, Judith Tunney Bsn, Rn, Mary Katherine Fouquier Phd, Aprn, Cnm, Facnm, Margaret Harvey Phd, Aprn, Acnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Robust adolescent contraceptive counseling requires deep understanding of the specific context in which adolescents are receiving reproductive health care. As teen pregnancy rates rise, particularly in places across the Deep South, providers must find ways to engage their adolescent patients about their sexual and reproductive health. Professional organizations like the American College of Obstetricians and Gyencologists and the American Academy of Pediatrics both offirm the need for robust contraceptive counseling for adolescents. The purpose of this is to ascertain the impact of utilizing shared-decision making aids during contraceptive counseling on patient satisfaction in adolescent populations.

Methods

A systematic literature …

Evaluating The Efficacy Of The Implementation Of A Food Insecurity Screening Tool In Identifying Risk Amongst Nicu Families, Jessica Daniels Bsn, Rn, Sahtiah Williams Bsn, Rn, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background

Infants admitted to the Neonatal Intensive Care Unit (NICU) are critically ill and at risk of increased infections, developmental delays, and higher readmission rates after discharging due to complex health needs when compared to healthy term newborns. Nutrition has been widely recognized as an important predictor of readmission and developmental delay. However, current practice often does not provide any screening for food insecurity (FI) in NICU families, which assumes security and displays a gap in care surrounding discharge planning. This quality improvement project implements the use of an FI screening tool for NICU families to help practitioners identify FI …

Effectiveness Of The Use Of An Opt-Out Script To Increase Hiv Screening In Adolescent Clients In Pediatric Primary Care Clinics In West Tennessee: A Scoping Review, Julie Cupples Msn, Rn, Allison Johnson Ms, Bsn, Rn, Sally Humphrey Dnp, Aprn, Cpnp-Pc

Doctor of Nursing Practice Projects

Purpose/Background

The American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) recommend one-time human immunodeficiency virus (HIV) screening for all adolescents. Pediatric primary care providers are on the front lines of adolescent healthcare and can provide testing that is adolescent-friendly, confidential, and easily accessible. This scoping review aims to synthesize the evidence and assess the literature on the efficacy of using an opt-out script to increase HIV testing in adolescent well-child checks.

Methods

A literature review was conducted between October 2022 and August 2024 to collect studies assessing adolescents aged 12-18, provider-led sex education, and …

The Self-Sustainability Of Federally Qualified Health Centers, Javier Vallejo

MUSC Theses and Dissertations

This exploratory data analysis examines the self-sustainability of Federally Qualified Health Centers (FQHCs) using the 2023 Uniform Data Systems (UDS) dataset, focusing on health centers' reliance on government grants as a revenue source. FQHCs provide high-quality healthcare services to medically underserved populations; today, nearly 1 out of every 11 Americans receives some form of care at an FQHC. There is widespread variability in the delivery of care amongst FQHCs. Additionally, funding and reimbursement methodologies vary across states and geographic regions. FQHCs face challenges maintaining operational efficiency amid federal funding shortfalls, shifting reimbursement methodologies, and the lingering impact of the COVID-19 …

Factors Associated With Quality Of Intrapartum Care In Kenya: A Complex Samples Analysis Of The 2022 Kenya Demographic And Health Survey, Lilian Nuwabaine, Earnest Amwiine, Quraish Sserwanja, Joseph Kawuki, Mathius Amperiize, Angella Namulema, Ahmed Sarki, John Baptist Asiimwe

School of Nursing & Midwifery, East Africa

Background

The provision of quality intrapartum care increases women’s utilization of skilled birth attendants in health facilities and improves maternal and newborn health. This study aimed to investigate the factors associated with the quality of intrapartum care using the 2022 Kenya Demographic and Health Survey (KDHS).

Methods

Secondary data from the 2022 KDHS of 11,863 participants, who were selected by multistage stratified sampling, was used. Based on literature and the availability of indicators within the 2022 KDHS, the quality of intrapartum care was operationalized as receiving all the three clinical components of intrapartum care including a mother having a facility-based …

Surgical Specimen Management Protocols In The Pre-Analytical Phase, Jordan L. Hall

Doctor of Nursing Practice Final Project Abstract

Purpose

This quality improvement (QI) project aimed to decrease surgical specimen errors during the pre-analytical phase at the target institution by 50% by January 2025 by developing best practices for specimen labeling and documentation.

Background

The QI project was implemented within a level two trauma center with a 24-suite operating room (OR) in The Woodlands, Texas, which provides care across all surgical specialties except ophthalmology.

Methodology

The target institution changed from nurse-hand-written specimen labels and requisition sheets to electronic medical record (EMR) generated specimen labels and requisition sheets. The change was congruent with the target institution’s shift to a new …

Preserving The Howard Ot Legacy: Inspiring Learning, Documenting History, And Sharing Stories, Marc Mathieu, Joylynne Wills

Howard University, Department of Occupational Therapy Capstone and Faculty Research

Date: 04/23/2025

Student Name: Marc Mathieu

Capstone Project Title: Preserving the Howard OT Legacy: Inspiring Learning, Documenting History, and Sharing Stories

Capstone Faculty Advisor: Dr. Joylynne Willis, OTD, OTR/L

Abstract:

Preservation of institutional history is crucial for creating professional identity, acknowledging foundational accomplishments, and inspiring future generations. Howard University has long been recognized as one of the nation’s most distinguished Historically Black Colleges and Universities (HBCUs) with a legacy of academic excellence and innovation dating back to its founding in 1867. Among its many renowned programs, the graduate occupational therapy (OT) department stands out for its commitment to training …

Central-Line Dressing Protocols: The Effectiveness Of A Standardized Dressing Change Protocol In Reducing Central-Line Associated Bloodstream Infections (Clabsi) In Critically Ill Patients Requiring Central Lines, Cody Jones, Melissa Marino, Ryan Mcfarland, Asia White, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C, Margaret Harvey Phd, Aprn, Acnp-Bc, Chfn, Fhrs

Doctor of Nursing Practice Projects

Purpose/Background

In the Intensive Care Units (ICU), central lines are an essential way of life. However, central lines have risks such as central line-associated bloodstream infections (CLABSI), which increase hospital stays and mortality. CLABSI significantly impacts patient outcomes in critical care, increases mortality and morbidity, increases medical costs, increases hospital-acquired infections, and reduces hospital reimbursements. Typically, antimicrobial dressing has been associated with decreased mortality and improved CLABSI rates. The scoping review will evaluate the literature and examine the effectiveness of various antimicrobial dressing strategies on CLABSI rates. This study aims to synthesize these findings to develop improved CLABSI prevention protocols …

Using Visual Discharge Instructions: How Comics Can Improve Healthcare And Outcomes For Limited English Proficient Patients, Alexandra R. Streeter

Honors Thesis

The purpose of this thesis is to demonstrate how graphic medicine could be a useful tool for communicating medical discharge instructions to populations with Limited English Proficiency (LEP). It is divided into three parts. First, it provides an overview of the biggest struggles LEP patients encounter in healthcare, which often occur around discharge instructions and medication changes. Second, the paper explores what graphic medicine is and how it has been used in healthcare. The last part of this paper consists of original graphic medicine artwork that addresses key issues for LEP populations during discharge with the goal of offering a …

Improving Home Healthcare Interdisciplinary Team Communication, Nishea Andrea Flores

Doctor of Nursing Practice Final Project Abstract

PURPOSE This Quality Improvement (QI) proof-of-concept project aimed to enhance communication within interdisciplinary healthcare teams (IDTs) in home healthcare settings through the creation and implementation of the .ACT tool (Ask, Context, Timeframe), designed to reduce communication barriers and improve team collaboration.

BACKGROUND Fragmented communication in home healthcare leads to inefficiencies in care delivery. The .ACT tool was created to standardize and simplify communication, ensure clarity in task delegation and timelines, improve coordination, and reduce errors.

METHODOLOGY A phased implementation strategy followed the Consolidated Framework for Implementation Research (CFIR) and Iowa Implementation Sustainability Framework (IISF), focusing on staff engagement …

Desmoplastic Small Round Cell Tumor: An Update Of Current Management Practices, Ahmed Gawash, Alexa Simonetti, Brandon J Goodwin, Alissa Brotman O'Neill

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Desmoplastic small round cell tumor (DSRCT) poses a diagnostic challenge, initiating with imaging techniques like ultrasound, CT, MRI, and PET scans, with CT being the primary choice for abdominal tumor visualization. Despite advances, the absence of a standardized staging system complicates the diagnostic process.

METHODS: A comprehensive literature review and search strategy, encompassing databases like PubMed and Cochrane was performed.

RESULTS: Systemic chemotherapy, notably the P6 regimen, is the cornerstone of DSRCT treatment, while other options, including CDK4/6 inhibitors, antibody-drug conjugates, and anlotinib present varying efficacy. A novel chemotherapeutic agent, ONC-201, exhibits promise, inhibiting tumor growth in preclinical models. …

Culturally Competent Diabetes Management Guide For African Immigrants, Bryce Hunderman

Doctoral Dissertations & Projects

Abstract

Background: Culturally competent care is a cornerstone in medicine to address health disparities and improve outcomes for vulnerable populations. Suboptimal diabetes management was noted within a federally qualified health center in the Midwest along with a lack of culturally competent diabetes education available for African immigrants. The research question for this project is: Will a culturally appropriate diabetes management guide that addresses barriers to diabetes management improve African immigrant’s understanding and abilities to manage diabetes within a federally qualified health center in the Midwest?

Methods: A culturally competent diabetes management guide for African immigrants was created. We …

Implementation & Evaluation Of A Self-Measured Blood Pressure Monitoring Program To Improve Hypertension Management, Sarah Marie Geoghan Marold

Doctoral Dissertations & Projects

Introduction: Hypertension affects nearly half of the population in the United States and, if left untreated, can precipitate chronic and life-threatening conditions. Self-measured blood pressure (SMBP) monitoring is an effective solution to diagnosing and managing blood pressure. The aim of this QI project was to improve hypertension management in a Midwest urban healthcare clinic by implementing an SMBP program. Methods: A quality improvement project and evaluation of the implementation of an SMBP program in a small urban Midwest healthcare clinic. Results: A total of 32 patients received SMBP monitors, 25 patients were included in the final data …

Sbirt Workflow, Dory Hart Emery, Tory Gamage, Sara Watts, Carol Mcclure, Anne Barker, Liz Berry, Liz Anderson

Operations Transformation

SBIRT stands for Screening – Identify patients with unhealthy substance use. Brief Intervention – A collaborative conversation that raises a person’s awareness of substance use and its consequences and encourages behavioral changes. Referral to Treatment – Actively link patients to resources when needed. It is a substance use screening tool that we ask patients 18 yrs. old and older to fill out once a year when having their CPE or AWV. SBRIT has been recognized as an integral part of primary care. It is an approach that delivers prevention, detection, and early intervention for individuals at risk of substance use …

Exploring How The Affordable Housing Market In Charleston County, South Carolina Impacts The Retention And Recruitment Of Healthcare Workers, Roger Aaron Williams

MUSC Theses and Dissertations

This dissertation explores the impact of the affordable housing market in Charleston County, South Carolina, on the retention and recruitment of healthcare workers. The study addresses the critical shortage of affordable housing and its implications for healthcare institutions, focusing on support staff such as medical assistants, certified nursing assistants, and other essential roles. Through a comprehensive survey of healthcare workers, the research identifies the extent of housing challenges, including financial strain, long commutes, and job dissatisfaction. The findings highlight the significant correlation between housing affordability and workforce stability, emphasizing the urgent need for targeted housing solutions. The dissertation reviews current …

Scoping Review Of Algorithms For Electronic Fetal Monitoring, Katherine Sabatier, Kate Fouquier Cnm, Phd, Facnm

Doctor of Nursing Practice Projects

Purpose/Background

The purpose of this scoping review is to review the use of an algorithm in evaluating continuous external fetal heart rate (FHR) monitoring in labor as opposed to clinician judgment for improved fetal outcomes, including earlier recognition of abnormal tracings (Clark et al., 2017). FHR monitoring was created to evaluate for fetal hypoxia in labor and has become standard practice (Gyllencreutz et al., 2018). One of the goals of the use of cardiotocography is to decrease hypoxia-induced fetal metabolic acidemia and neurologic injury. There are multiple options for individual or computer-based algorithms in evaluating FHR to reduce fetal acidemia …

Evidence-Based Practice Guidelines For Perioperative Insulin Pump Usage And Glycemic Control During The Perioperative Period, Duane Robinson

Doctor of Nursing Practice Scholarly Projects

According to the International Diabetes Federation, Diabetes Mellitus (DM) affects approximately 537 million people, representing approximately 10% of the worldwide population aged 20 to 79. Approximately 400,000 people with DM use continuous subcutaneous insulin infusion (CSII) pumps. CSII pump therapy mimics pancreatic insulin release, aiding in maintaining adequate insulin levels. Individuals with DM are more likely to require surgery than individuals without the disease. Among diabetics, people with Type 1 DM (T1D) are more likely to need medical interventions than individuals with Type 2 DM (T2DM). CSII therapy maintains blood glucose levels within a programmed range and decreases blood glucose …

Perinatal Mood And Anxiety Disorders (Pmads): A Scoping Review, Christina Willis Bsn, Rn, Nia Wells Bsn, Rn, Miranda Smith Bsn, Rn, Kate Fouquier Cnm, Phd, Facnm

Doctor of Nursing Practice Projects

Purpose/Background Perinatal Mood and Anxiety Disorders (PMADs), including postpartum depression, anxiety, and psychosis, significantly impact maternal and infant health. This scoping review consolidates current literature on PMADs, emphasizing prevalence, risk factors, screening, and treatment. The primary aim is to identify research gaps and inform clinical guidelines to enhance perinatal care.

Methods A literature search followed PRISMA guidelines from August 2022 to November 2024. Databases searched included PubMed, CINAHL, Scopus, and Google Scholar, using terms such as "perinatal mood disorders" and "maternal mental health." Inclusion criteria were English-language studies from the past decade addressing PMADs during pregnancy and up to one …

Longitudinal Assessment Of Moral Distress And Burnout During Pediatric Residency In A Canadian Site: Low Prevalence But Notable Risk Of Attrition, Kenneth S. Lee, Dianna C. Louie, Elaine O. Cheung, Peter Dodek, Dylan King, Kimee Chong

Journal of Wellness

Introduction: Although more than half of pediatric residents report burnout, the incidence of moral distress, the course of moral distress and burnout during residency, and associations between this course and personal characteristics of residents are unknown. The purpose of this work was to examine the incidence, temporal course, and associations of moral distress and burnout in pediatric residents.

Methods: In the pediatric training program of British Columbia Children’s Hospital, all residents were invited to complete the Moral Distress Scale-Revised thrice yearly, and the Maslach Burnout Inventory annually, between July 2016 and October 2018. In addition, residents reported a measure of …

Exploring The Lived Experiences Of Menstrual Hygiene Management Among In-School Visually Impaired Adolescent Girls In Rwanda: A Phenomenological Study, Marie Laetitia Ishimwe Bazakare, Gerard Kaberuka Kaberuka, Aimable Nkurunziza, Justine Bagirisano, Godfrey Katende

School of Nursing & Midwifery, East Africa

Background In low-income countries, many menstruating persons continue to face numerous challenges regarding menstrual hygiene management. Visual impairment further compounds the difficulties faced by in-school adolescent girls, but little is known about its consequences in Rwanda. Objective To explore the lived experiences of menstrual hygiene management among in-school visually impaired adolescent girls in Rwanda. Design descriptive phenomenology. Methods This study was conducted in four specialized educational institutions for visually impaired students in Rwanda. We conducted four focus group discussions with 25 visually impaired adolescent girls selected purposively. The seven steps of Colaizzi’s method were used to analyze the data. Results …

Challenging Race-Based Health Care Discrimination: A New Private Right Of Action, Aaron Pinkett

Northwestern University Law Review

The Hippocratic Oath calls on doctors to “do no harm.” Yet we know from extensive public health research that clinicians repeatedly cause harm to Black patients by dismissing their medical concerns, misdiagnosing them, and undertreating their pain. These practices of differential treatment for Black patients have led to steadily increasing racial disparities in health care outcomes throughout the United States. Title VI of the Civil Rights Act of 1964 prohibits this type of disparate impact, but modern Supreme Court jurisprudence forecloses opportunities for affected parties to seek legal relief—despite the clearly established legislative intent of Title VI. However, another legal …

The Importance Of Well-Being For College Students, Benjamin Williamson, Dr. Mary Jan Greer, Phd, Otr

Spring 2025 OTD Capstone Symposium

Provided education on well-being, enabled independence, and improved quality of life, specifically for college students in this setting.

Advocate for Sustainable Programs:

Advocated for more programs to address the needs of college students and integrated all 8 dimensions of wellness into their current lifestyle

Support Academic Advancement:

Addressed college students' needs for overcoming occupational adversities which affects the longevity and academic success of college students

Motivate College Students:

Provided accessible and occupation-based resources that supported participating college students in independently improving their occupational roles

Advance Holistic Based Strategies:

Incorporated holistic based strategies that apply to each occupational role affecting participating …

Life Course Analysis: How Social Needs And Family Dynamics Impact Clinical Decision-Making, Vito Agrusa, Laila N. Abdallah, Bryen Turco

Clinical Research in Practice: The Journal of Team Hippocrates

The authors explore Life Course Analysis and how social needs (including pet care), changing demographics, and loneliness affect inpatient hospitalization and clinical decision making.

Indeterminate Benefit Of Long-Term Beta-Blocker Use After Acute Myocardial Infarction For Some Patients, Logan S. Thayer, Khush Hussain, Nicholas Apostolakis, Gretchen Swift, Arifbillah Sarowar, Mohammad Al-Hadidi, Scott Yaekle

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Yndigegn T, Lindahl B, Mars K, et. al., Beta-blockers after myocardial infarction and preserved ejection fraction. N Engl J Med. April 7 2024;390:1372-1381. https://doi.org/10.1056/NEJMoa2401479

for a patient showing 55% left ventricular ejection fraction after myocardial infarction.

Impact Of Cde Referral On A1c Control In Adult Type 2 Dm Patients., Alivia Watts Bsn, Rn, Yesica Sanchez Bsn, Rn, Morgan Hilliard Bsn, Rn, Laura Reed Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

Type II Diabetes Mellitus is a chronic health condition impacting many adults in Tennessee. Certified Diabetic Educators (CDEs) are specifically trained in educating and addressing the health care needs of patients with diagnoses of Type I or Type II Diabetes. Research has shown that education conducted by CDEs leads to improved outcomes and self- care in those with diabetes (Bowen, et al., 2016, King et al., 2019). Not only are CDEs cost effective services leading to a decrease in healthcare costs, but they also aid in the improvement of hemoglobin A1C (Hgb A1C) levels and decrease complications associated with Type …

Expanded Patient Reach At New Student Run Free Medical Clinic Location, Olivia Krol, Hana Warmflash, Alex Foster

OHSU-PSU School of Public Health Annual Conference

Background: Critical to modern medical education, student run free medical clinics (SRFCs) are present at more than 75% of AAMC member institutions. SRFCs educate students while providing low-barrier, free healthcare to underserved populations. SRFCs provide unique leadership and health systems management opportunities not traditionally emphasized in training, including leading logistical and operational changes.

In this project, we highlight the impact of a student-led operational initiative that transitioned our clinic from the River District Navigation Center (RDNC) to the Resource Center (RC), improving accessibility.

Methods:

Deidentified patient data from medical clinics from January 2024 to February 2025 were analyzed using RStudio …

Evaluating The Effectiveness Of A Non-Pharmacological Sleep Bundle For The Prevention Of Delirium In Geriatric Patients In The Intensive Care Unit: A Scoping Review, Morgan Wilkins Bsn, Rn, Vanessa D'Amico Bsn, Rn, Alyssa Goyda Bsn, Rn, Seema Janga Bsn, Rn, Kaylin Story Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Delirium is an acute disorder yielding cognitive deficits, such as disruption in attention and awareness. It impacts approximately 50% of individuals over the age of 65 who are admitted to the hospital and is prevalent with patients in the intensive care unit (ICU). ICU delirium is associated with adverse outcomes, including higher morbidity, prolonged hospital stays, and chronic neurocognitive deficits. Research demonstrates that implementation of a non-pharmacological sleep bundle can reduce the overall occurrence of delirium. The purpose of this scoping review is to examine the efficacy of a non-pharmacological sleep bundle on the incidence of ICU delirium in …

Improving The Rates Of Sexually Transmitted Infection Diagnosis By Increasing Provider Knowledge About Testing, Lauren Cunningham

Student Scholarship & Creative Works

There has been a significant increase in sexually transmitted infection (STI) rates since 2021. Though this issue is nationwide, rural providers require education regarding testing, screening, and transmission of disease processes. The infections with the most significant increase are gonorrhea, chlamydia, and syphilis. The purpose of this project was to provide education to providers regarding local STI statistics, in addition to when to and not to test for sexually transmitted STI infections. Education was provided to three Advance Practice Nurse Practitioners about disease signs and symptoms, transmission, and local STI statistic rates. STI testing rates were observed three months prior …