Medicine and Health Sciences Commons^™

Nurse Practitioner-Led Care Pods: A Team Communication Enhancement Model, Miranda Saint-Louis, Miranda Saint Louis

Doctor of Nursing Practice (DNP) Projects

Background: Communication has become a key performance measure in the shift to value-based healthcare. Given the impact of communication failures on patient harm, length of stay, and dissatisfaction with care, new models of care with better communication through structured teamwork and interdisciplinary collaboration are needed.

Problem: In a 16-bed geriatric medical/surgical unit of a New York City multispecialty community hospital, the workflow structure unintentionally created inconsistent handoff communication, gaps in continuity of care, missed care events, and inattention to the patient’s priorities in the care plan. A gap analysis identified communication deficiencies that impacted team effectiveness and patient care …

Patients With Covid-19 And Prone Positioning: An Integrative Review, Catherine Jordan

Master of Science in Nursing Final Projects

Aim: Describe nursing research that has studied prone positioning in patients with COVID-19 and the outcomes.

Background: Prone positioning has been a well-studied intervention in patients experiencing acute respiratory distress syndrome. The intervention has proven to provide beneficial physiological effects.

Methods: A comprehensive literature search was conducted using electronic databases. Key search terms were: Covid-19, Coronavirus, outcomes, and prone position. Inclusion and exclusion criteria were outlined and the articles examined for each. Whittemore and Knafl’s (2005) integrative approach was used to conduct this review.

Discussion: This review evaluated the different criteria physicians utilized in their decision to implement prone …

Barriers To Preoperative Warming: Best Practice Guideline, Tyler Comans, Zachary Hays, Caleb Leach

Doctoral Projects

The lack of preoperative warming has a direct relationship to perioperative hypothermia complications which include, but are not limited to: increased infection rate, coagulopathies, and increased myocardial oxygen consumption; all contributing to poor patient and facility outcomes. Implementation of an evidence-based educational module with visual aid can potentially increase the utilization of active warming techniques in the preoperative setting by perioperative staff. The DNP Project investigated barriers to preoperative warming by perioperative staff at a large teaching hospital in the southeastern United States. Barriers were assessed by a voluntary survey sent to 87 perioperative staff members. Twenty-two surveys were completed …

Implementation And Evaluation Of A Registered Nurse Pre-Eclampsia Education Program Within A Women's Urgent Care Center, Amber Vetter

Doctoral Projects

Pre-eclampsia can be a serious development for both mother and fetus during pregnancy. Increased mortality and morbidity rates have been shown in women diagnosed with pre-eclampsia. Higher education for registered nurses on a Women’s Urgent Care (WUC) center will help diagnose the mother more quickly and inevitably receive treatment sooner leading to better outcomes for the birth of her newborn. The educational tools used in the study were a pre-and post-test and an educational video for the registered nurses to watch. A retrospective chart review before and after the intervention will help to see if there is any decrease in …

Minimizing Musculoskeletal Injury Risk In Health Care Professionals With Education On Safe Patient Handling, Aubrey Graves

Honors College Theses

Introduction: Nursing is a high-risk occupation for musculoskeletal injuries due to the strenuous activity of patient handling. These tasks include, assisting a patient in bed, moving a patient from the bed to a wheelchair, and assisting with walking. These work-related tasks can create a large amount of stress on the body, especially the back if proper technique is not utilized and/or if excessive loads are applied. The purpose of this study is to examine if teaching proper body mechanics and the dangers of not performing the tasks properly is an effective way of reducing musculoskeletal injuries.

Methods: The NUR 202 …

Best Practices In Ipe Throughout Literature: Identifying Common Supports, Barriers, And Recommendations For Future Program Development, Megan E. Byrne

Department of Occupational Therapy Entry-Level Capstone Projects

Interprofessional education (IPE) is defined by AOTA (2015) as an “occasion by which students from two or more professions learn about, from, and with each other to improve collaboration and quality of care”. IPE is closely related to and often overlaps with interprofessional collaboration (IPC) within healthcare settings. IPC “occurs when multiple health workers from different professional backgrounds work together with patients, families, [caregivers], and communities to deliver the highest quality of care” (World Health Organization [WHO], 2010, p. 7). The overall aim of IPE is to promote and develop effective IPC thereby improving patient outcomes (Khan, 2016).

Current research …

Partnering With Hospital Providers To Facilitate Handoff For Persons With Dementia In The Acute Care Setting, Vanessa Jeune

Student Scholarly Projects

Practice Problem: Individuals with Alzheimer's disease and related dementias cannot verbalize their care needs during transitions of care (TOC) and rely on their home caregivers (HCs) for advocacy. The lack of communication between clinicians in one setting and HCs can lead to detrimental health outcomes for the length of stay.

PICOT: The PICOT question that guided this project was: With the assistance of family nurse consultants (P), how does the implementation of standardized care needs communication tool for support persons of persons with dementia (I) vs. no standardized process (C) enhance the ability for the support person to …

Implementation Of An Interprofessional Fall Prevention Program To Reduce Falls On An Older Adult Inpatient Psychiatric Unit, Teresa Woodson

Doctor of Nursing Practice

Background. Falls are the most reported incidents in the hospital setting, especially among older adults. According to the National Database of Nursing Quality Indicators (NDNQI), the number of falls in inpatient psychiatric units is 13-25 per 1,000 patient days, compared to 4 per 1,000 days for medical-surgical units. This DNP project aims to implement an interprofessional fall risk team to reduce falls in an older adult inpatient psychiatric unit. Problem. The psychiatric inpatient units had a total of 31 falls, with 13 (40%) occurring on the older adult unit. Interventions. Education of nursing staff, providers, and physical therapy (PT) …

An Exploration Of Effective Patient Education With An Emphasis On Concussion, Kayla M. Ruopp

Health, Human Performance and Recreation Undergraduate Honors Theses

Concussion is a prevalent healthcare issue in the US, with approximately 1.6-3.8 million sports and recreation-related concussions each year in all ages. A concussion can be defined as a traumatic brain injury caused by biomechanical forces. When an athlete sustains a concussion, a physiologic cascade of events occurs. The most common signs and symptoms of a concussion include: loss of balance, disorientation, headache and confusion. Concussion assessments are important in order to determine the presence of an impairment and there are a multitude of tests that clinicians can use in order to isolate each type of damage. Studies have shown …

Troubling Service User Involvement In Health Professional Education: Toward Epistemic Justice, Stephanie Leblanc-Omstead

Electronic Thesis and Dissertation Repository

It has become increasingly popular in health professional education to solicit the contributions and involvement of people who have firsthand or ‘lived’ experiences of using mental health services – a practice hereafter referred to as service user involvement (SUI). SUI is founded on the premise that service users ought to be involved in the development and evaluation of services and systems they experience, which includes the education of future health professionals. Despite the momentum this practice has gained in a range of international contexts, SUI is often conceptualized, organized, and implemented uncritically, and with tremendous inconsistency across health professional education …

Attributes And Characteristics Of The Physician-Physician Assistant Organizational Leader Relationship, Victoria S. Louwagie

Graduate Dissertations and Theses

Purpose: The aim of this study was to evaluate and better understand the attributes and characteristics of the influential physician, the dual-roled physician assistant (PA)leader and how this relationship impacts the PA leader and the PA leader-physician relationship. These dual-role PA leaders may possess additional formal job titles and duties while also having direct reports.

Method: We surveyed PA leaders at a large academic medical center and its associated health system. The survey instrument evaluates perceptions, attitudes and characteristics of the PA leader, influential physician, and their relationship.

Results: There were 34/56 PA organizational leaders that responded to the survey …

Debriefing With Pearls & Watson’S Caritas, Heather A. Uccello

Seton Hall University Dissertations and Theses (ETDs)

Debriefing, an important aspect of students’ clinical experience, is a reflective, critical thinking analysis and communication strategy that provides rapid feedback after either a simulated or genuine clinical event. To teach this higher-level critical thinking skill throughout the learning process, nursing programs require specific methodology and faculty expertise. The National League for Nursing supports nurse educators having a theory-based strategy, formal training, and ongoing competency evaluation. Informed by Jean Watson’s Theory and the Promoting Excellence and Reflective Learning in Simulation standardized debriefing tool methodology, this project outlines a framework that nursing schools can use to potentially improve the debriefing process …

Athletic Training Educators’ Perceptions Of Interprofessional Education And Educational Strategies Used To Infuse Ipe Within Athletic Training Programs: A Mixed Methods Approach, Christina Orozco Nevers

Seton Hall University Dissertations and Theses (ETDs)

BACKGROUND: As athletic trainers (ATs) educators and professionals we recognize the importance of preparing our students to practice as part of an interprofessional team and acknowledge that this training must begin while they are in the academy. Although there is lots of information about interprofessional education (IPE) in various other healthcare professions (HCPs), there is limited information about how AT educators are infusing IPE into the curriculum. To maximize the development of interprofessional teaming practices in healthcare we must first understand the most effective ways to infuse IPE in AT professional programs given how compact the curriculum is. Educators must …

The Holistic Self-Care Learning Experience Of Rn-To-Bsn Students: A Phenomenological Study Of Meaning And Value, Elaina C. Mahlan

Doctor of Education (Ed.D)

The health of the nursing workforce is a critical aspect of high-quality health care and community health promotion, but extensive research indicates that too many nurses neglect selfcare and suffer negative health outcomes. While nursing education must provide self-care learning experiences to improve the health of nurses, the value and influence of a learning experience must be interpreted from the learner’s point of view. The purpose of this phenomenological study was to elicit the personal value that RN-to-BSN students ascribed to a self-care learning experience within a holistic nursing course at a public university. The holistic nursing paradigm offers a …

A Transformative Journey: The Lived Experience Of Healthcare Learners Participating In Pain Management Education, Zoe A. Leyland

Electronic Thesis and Dissertation Repository

There is little emphasis on pain management education for healthcare providers. In September 2019, the Master of Clinical Science (MClSc) program in Advanced Healthcare Practice at Western University in London, Ontario introduced a new, “Interprofessional Pain Management” (IPM) field. The program follows a competency-based framework, and the learners are all practicing healthcare providers with a special interest in pain. Part of the purpose of this thesis is to describe the process of development and implementation. The objective is to provide educators and healthcare providers an in-depth look at how the pain education is experienced. This includes exploring the lived experience …

The Adequacy Of Pa Didactic Psychiatric Education, Dean Berzins

Theses and Graduate Projects

With a shortage of mental health specialists, primary care providers, which increasingly include physician assistants (PAs), must be able to adequately recognize, diagnose, and treat common mental health disorders. Unfortunately, providers are not currently able to meet this challenge and frequently underdiagnose and undertreat psychiatric conditions. This paper examined the amount of didactic education in psychodiagnostics PA students receive compared to the amount of didactic psychodiagnostics training psychotherapists students receive in graduate school. Results indicated that while psychotherapists have, on average, more classroom time, the difference in seat time between PAs and psychotherapists is less than double, but the assigned …

Osteoporosis Implications For The Aging Adult, Grace Alford

Nursing Student Class Projects (Formerly MSN)

This poster describes the pathophysiology, symptoms, implications for care, and treatment of osteoporosis for advanced practice RNs. The research was conducted within health-related databases. The literature review narrowed the search to only include the pathophysiology, interventions, and care for osteoporosis. Literature was restricted to within the past five years. The research showed that osteoporosis reduces mineral density in bones and can be adequately treated within a short amount of time. It is important for nurses and advanced practice providers to be aware of current guidelines, screenings, and treatments for osteoporosis.

Improving Onboarding And Role Transition For Advanced Practice Providers, Leighann Ebenezer

Nursing (graduate) Student Scholarship

BACKGROUND: APPs are increasingly being integrated into various health care settings and the role continues to gain popularity and utility as a solution to the shortage of physicians. Successful onboarding of APPs has been identified as an important factor in the role transition and integration of APPs into their team and organization.

PROBLEM: When hired, APPs are often not onboarded successfully to the detriment of the provider and the organization. Despite the evidence for comprehensive onboarding programs, APPs continue to receive insufficient onboarding that ignores their unique scope of practice.

METHOD: The Ottawa Model of Research Use, a knowledge translation …

Examining Predictors Of Attitudes And Knowledge Of Registered Nurses And Nursing Students In Tennessee Toward Pregnant And Perinatal Women With A Substance Use Disorder, Jessica Patrylo

Electronic Theses and Dissertations

Substance use disorders (SUDs) among pregnant and perinatal women continue to be a national public health crisis. Furthermore, nursing students and perinatal nurses have historically negative and punitive attitudes toward this vulnerable population of women. As nurses are primary care providers for pregnant and perinatal women, this is troublesome as perinatal patients express feeling stigmatized by nurses whom they should be able to trust. This contributes to the reluctance of women to seek needed medical and prenatal care. Tennessee was the first state to criminalize drug use in pregnancy and has higher neonatal abstinence syndrome (NAS) rates, which were more …

Will Implementing Human Trafficking Education And Screening Tools Increase The Number Of Identified Trafficked Victims And Survivors In The Healthcare Setting?, Yadira Landeros De Santiago

Theses and Graduate Projects

Introduction: Eighty-eight percent of human trafficking survivors report seeking healthcare while trafficked, yet less than 10% of physicians have been trained to identify human trafficking victims. The United States Department of Health and Human Services acknowledge the serious problem of health professionals lacking the education to identify and treat human trafficking patients. Healthcare providers are missing opportunities to intervene partially because of the barrier to identify human trafficking patients.

Background: Currently, there is no required standard for curriculum on human trafficking. Analysis of pre- and post-survey responses demonstrated a significant increase of confidence in identifying and caring for trafficked patients. …

Intimate Partner Violence Education For High School Students, Morgan Foster

Dissertations

Problem Adolescents are at risk for experiencing intimate partner violence (IPV). As early as seventh grade, over half of adolescents have reported being in a romantic relationship. Adolescent screening for and education of IPV is minimal, and only the Healthy Relationships Quiz developed by the U.S. Department of Health and Human Services [HHS] screens young adolescents across all aspects of IPV, including psychological and sexual violence. The purpose of this project was to develop an IPV education plan for high school students in a health course.

Methods An educational lesson plan for IPV was created for high school teachers.

Results …

Transition Of Care Program: A Quality Improvement Project, Sara Gigliotti

Nursing (graduate) Student Scholarship

BACKGROUND: Unplanned hospital readmissions are a burden on healthcare expenditure. There is a paucity in research at the sub-acute level of care, where many patients receive services following a hospitalization, to decrease readmission rates. This project aimed to determine whether a formal transition of care program (TCP) in a sub-acute rehabilitation (SAR) center decreased unplanned hospital readmissions of adults within 30 days of discharge to home.

METHODS: A literature review identified evidence-based interventions used to develop a formal TCP in a SAR center. The Ottawa Model of Research Use was used for the quality improvement (QI) project. Data was collected …

A Multimodal Educational Approach For Caregivers Of A Febrile Child: A Quality Improvement Project, Claire Catherine Jones

Nursing (graduate) Student Scholarship

Background: Insufficient caregiver knowledge regarding the physiology and correct management of fever in children contributes to adverse health outcomes in children.

Problem: Lack of multimodal education and resources for caregivers on the management of febrile children leads to medication dosing errors, overutilization of medical resources, and caregiver ambiguity when caring for their child.

Methods: A multimodal educational approach (MEA) on discharge education for the care of a febrile child directed towards caregivers who presented to a pediatric emergency room in Eastern PA, was implemented, and caregiver knowledge and caregiver’s perception of preparedness at time of discharge was measured.

Intervention: The …

Improving Patient Outcomes With Post-Op Education For Nurses Caring For Patients Undergoing Total Joint Replacement, Amanda Collier

Doctor of Nursing Practice Projects

Background: Surgical site infections (SSI) are the third most reported nosocomial infection causing an increased length of stay, increased healthcare cost, and a substantial increase in morbidity. A SSI is an infection developing within 30 days of surgery without using an implant and within one year of surgery utilizing any form of implant. Typically SSI occurs at the time of incision. However, poor postoperative wound care can lead to an SSI.

Purpose: This project aims to educate nursing staff on care of the total joint replacement (TJR) patient to reduce readmission rates for postoperative SSI.

Design Methods: This …

Patient-Perspective Task Performance: Creating Contextually Relevant Student Clinical Training Through The Use Of Patient Experience, Candice L. Freeman

STEMPS Theses & Dissertations

Patient-centered and patient-focused care purports that patients are at the center of all clinical decisions made for optimal medical outcomes. Optimal medical outcomes originate from accurately and reliably executed task performance by healthcare professionals trained to administer highly specific care for each patient condition. Many of these executed tasks are performed in the presence of the patient; this is defined as direct patient care. However, there are equally important tasks executed that are not performed in the presence of the patient; the performance of diagnostic laboratory testing is an example of such tasks.

Clinical training of healthcare laboratory professionals begins …

The Assessment Of Clinical Reasoning In Preceptors Across The Athletic Training Profession, Gary Wayne Cohen Jr.

Health Services Research Dissertations

Clinical reasoning (CR) is defined as a complex multi-factorial metacognitive process for diagnosis formulation. Clinical reasoning begins as a student and develops over a career. Students are typically taught an analytical approach defined as hypothetico-deductive reasoning (HDR). Expert clinicians use a non-analytical approach defined as the Knowledge Based Model (KBM) of CR. It is accepted that clinicians use the KBM with cases that they have more experience to streamline the evaluation process. Unfortunately, because of the nuance of CR there have been limited investigations within athletic training to evaluate CR outside of the student population.

The overarching purpose of this …

The Experiences Of Women As Latinx Osteopathic Medical Students, Dana L. Weiss

Theses and Dissertations

In existing literature, researchers have predominantly examined issues related to minoritized groups by juxtaposing differences and outcomes among groups without attention to the diversity of experiences, challenges and strengths. This has had a limiting focus on the experiences specific to women as Latinx medical students, and has created a gap which restricts knowledge about experiences of perceived support and barriers within osteopathic medical school. This research provided an opportunity to think more deeply and critically about the experiences for women as Latinx osteopathic medical students. The data collected in this qualitative phenomenological study was gathered from participants as they narrated …

Female Infertility In The United States And India: An Analysis Of Treatment Barriers And Coping Strategies, Devneet Singh

Honors Theses

This research studies barriers to accessing fertility treatment in the United States (U.S.) and India, as well as the coping strategies infertile women use. Barriers include reproductive health knowledge, cost, and politics, while coping is affected by cultural stigma, family, and religion. These two countries were chosen for their different cultural contexts, healthcare systems, and political infrastructure. Ten fertility specialists across both countries were interviewed as expert informants. Reproductive health knowledge was the most important barrier to accessing care in both countries, with similar gaps in understanding when and what type of care to utilize, though social media can educate …

Improving Identification Of Seniors At Risk Tool Adherence To Identify Emergency Department Readmissions In Older Adults, Joy Gao

Doctor of Nursing Practice Final Manuscripts

The purpose of this evidence-based project (EBP) is to improve the emergency department (E.D.) staff adherence in completing the Identifying Seniors at Risk (ISAR) screening tool. The specific aim is to improve electronic health record (EHR) data collection to enhance the identification of older adults that are frequent utilizers of the E.D. at a local community hospital in Southern California. Based upon the most recent National Hospital Ambulatory Medical Care Survey, patients ages 65 and older make up 32% of all E.D. admissions. These patients also represent 50% of the moderate to severely ill patients seen in the E.D. …

Making Room: Addressing The Counter-Therapeutic Nature Of Psychiatric Hospitalization Through Containment- Based Group Expressive Therapy, Max Sandor Copans

Expressive Therapies Capstone Theses

The process of hospitalization and the environment of a typical psychiatric hospital is often counter-therapeutic. To challenge this problem, clinicians may introduce the concept of psychological containment. To elaborate, being hospitalized anywhere can be disorienting, frightening and even traumatic. This problem is only further exacerbated in psychiatric hospitals where patients may be disorganized, manic, or struggling with psychosis. Furthermore, psychological containment is essentially the ability for psychiatric patients to prevent their intense emotions from effecting others negatively, and to act with resiliency when other patients are unable to contain their own disruptive behaviors. This paper utilizes both an initial literature …