Medicine and Health Sciences Commons^™

Fall 2021

Scientia

A Decade of Progress and Success; Speech Language Pathology Program; COVID-19 Long-Hauler Study; Peer Mentors Initiative; Faculty Update; Expert Engagement: Three CSH initiatives further education and scholarship while supporting communities in need; Strategic Command: Business consultant and med tech expert Stephen Sichak helps others face pandemic challenges; Taking Care: A School of Nursing research team plumbs the pandemic experiences of nurses nationwide

Depression Screening Tool For Hysterectomy Patients, Dede C. Mihedji

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: The prevalence of hysterectomies in the United States ranges from

5.1 to 5.8 per 1000 women (Harnod et al., 2018). A standardized screening tool for assessing

depression preoperatively could mitigate the worsening of postoperative depressive symptoms in patients scheduled for a hysterectomy.

Local Problem: Currently, there is no standard of practice to routinely screen for depression in preoperative patients scheduled for hysterectomy surgeries. However, as with any surgical intervention, there are risks of long-term complications. Studies have identified that a hysterectomy may increase the risk of cardiovascular events, menopause, depression, and other outcomes (Madueke-Laveaux et al., 2022). …

Mindfulness Based Self Care Toolkit For Psychiatric Healthcare Staff, Harkirat K. Bajwa

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Healthcare professionals (HCPs) are at high risk of stress, burnout, and compassion fatigue (CF). Nearly half of the doctors and one-third of the nurses experience burnout in the United States. The risk becomes more evident during the coronavirus disease (COVID -19) pandemic as more patients and healthcare providers seek mental health services.

Problem: The physical and mental health of HCPs is impacted by burnout and CF, leading to increased practice errors, decreased patient safety, and negative effects on HCPs’ physical and mental health. Mindfulness practice is beneficial to reduce stress and burnout in various populations, but HCPs have …

Attention-Deficit/Hyperactivity Disorder And Teachers, Samantha Ann Tierney, Samantha Ann Tierney

Honors College Theses

Attention-Deficit/Hyperactivity Disorder (ADHD) is a common disorder, estimated to affect 5% of all children and adolescents. The current rate of diagnosis is steadily increasing. This increase in the number of students with ADHD affects educators, who have a large role in the success of students with ADHD. Despite this, many teachers are not prepared to deal with the extra challenges that come with teaching students with ADHD. Teachers may not be properly taught how to deal with children who have ADHD in their classrooms or the role they have in these children’s lives. The purpose of this study is to …

Increasing Pulmonary Artery Catheter Education Among Ccu Nurses: A Quality Improvement Project, Kayla Marie Fisher Rn, Bsn

Doctor of Nursing Practice (DNP) Scholarly Projects

Executive Summary

Title: Increasing Pulmonary Artery Catheter Education Among CCU Nurses: A Quality Improvement Project

Background and Significance: Among the patient population in the Cardiac Care Unit (CCU) at a large academic medical center in Seattle, pulmonary artery (PA) catheters are commonplace. PA catheters are invasive central venous access devices with the ability to measure hemodynamic parameters that reveal information about the functionality and cardiac output of the heart. Should values obtained from PA catheters be incorrectly measured, serious complications could arise. Appropriate management of this device requires specialized expertise which is usually limited to cardiac critical care and surgical …

3d-Wound Imaging: Precise, Consistent, And Efficient, Aubrey Halili

Doctor of Nursing Practice Final Manuscripts

Background: The most common method of obtaining wound measurements is the hand-ruler method. Studies show that the hand-ruler method results in the most inaccurate measurements with the lowest interrater reliability. Studies also show that using 3D-wound imaging yields the most accurate measurements with the best interrater reliability. 3D-wound imaging technology also increases efficiency by allowing users to obtain images and document assessments using one device at the bedside.

Purpose: The purpose of this project is to make the process of assessing wounds more efficient by decreasing the time spent on photographing, measuring, and documenting wound assessments by implementing the use …

School-Based Development And Implementation Of An Educational Toolkit, Chantel M. Kilford Ms

Doctor of Nursing Practice (DNP) Projects

The purpose of this evidence-based change in practice is to increase knowledge and confidence among healthcare providers and teachers within a high school setting by providing an educational tool kit about behavioral disorders in children. The disorders that will be focused upon are conduct disorder, oppositional defiant disorder, and common co-morbidities of these disorders. There will be education about an appropriate childhood, evidence based mental health assessment tool that assesses childhood mental health, including how to score the tool and interpret the results. Evidence suggests that healthcare providers and teachers are not confident or knowledgeable about identification, assessment, and behavioral …

Breastfeeding After Maternal Anesthesia: A Guideline Development, Megan Berens

Doctor of Nursing Practice Scholarly Projects

Postoperative breastfeeding recommendations for lactating mothers by anesthesia providers are inconsistent and often inaccurate. Inappropriate recommendations have led to withholding of breastmilk to the infant, unnecessary disposal of breastmilk, surgical delay, exposure of an infant to high levels of drugs in breastmilk, and early cessation of breastfeeding. The purpose of the scholarly project was to develop a set of evidenced-based practice guideline recommendations and a proposed implementation plan for anesthesia providers to use in support of breastfeeding mothers who recover from surgery. Many studies in the literature indicate that there are inconsistencies in postoperative breastfeeding recommendations by anesthesia providers. When …

Creating A Culturally Adaptable Comprehensive Sexuality Education Teacher's Manual, Stephanie Carteciano

Student Works

Purpose: The purpose of this project was to create a culturally adaptable comprehensive sexual education teacher’s manual by (a) standardizing content using The United Nations Educational, Scientific and Cultural Organization’s (UNESCO) 2018 International Technical Guidance on Sexuality Education (CSE), (b) providing evidence-based CSE pedagogy in the form of classroom activities, and (c) including adaptable teaching methods to fit diverse cultural contexts.

Development: The manual lessons were derived from UNESCO’s 2018 International Technical Guidance on Sexuality Education, and the pedagogy followed Anderson and Krathwohl’s revision of Bloom’s Taxonomy. Health information was obtained from various medical and university resources. We surveyed eight …

Adult Post-Cardiac Surgery Deep Sternal Wound Infections, Samantha Porcher, Cole Gatzke

Nursing DNP Projects

ABSTRACT

Purpose and rationale: Deep Sternal Wound Infections (DSWI) are associated with morbidity rates and mortality rates as high as 10% -15% as well as significantly increased hospital costs. The purpose of this project is to decrease current rates of DSWIs in adults undergoing cardiac surgery at a large medical institution.

Synthesis of evidence: The literature shows a strong relationship between elevated HbA1C and DSWI. All articles reviewed for this proposal which implement a sternal vest intervention support its use to prevent DSWI.

Practice change and implementation strategies: The strategy used to implement these evidence-based practice interventions includes …

Increasing Student Engagement: Case-Based Teaching And Learning, Necole Leland, Lisa Nicholas

UNLV Best Teaching Practices Expo

Case-based learning (CBL) is an active learning approach using hypothetical or real life problems that help learners develop clinical judgment and problem-solving skills (Bastable, 2023). CBL can be used in multiple settings, including the classroom, the clinical environment, and simulation. CBL can be used in most disciplines to bring real life scenarios to life for learners. Learners identify the problem in the case, develop multiple approaches to solving problems, discuss different viewpoints or assumptions, propose alternate decisions, and weigh consequences (Young & Paterson, 2007). CBL helps make connections that transfer theoretical knowledge to practical application (Billings & Halstead, 2020). CBL …

Accessibility, Acceptance, And Equity: Examining Disability-Linked Health Disparities As Nursing And Communication Scholars, Sarah Parsloe, Stacey M. Carroll

Nursing Communication

People with disabilities (PWD) experience health disparities, often related to contextual factors beyond the physical differences in body structure and function. The purpose of this article was to develop a research agenda for nursing and communication scholars that explores how developing accessible and empowering communication environments in healthcare contexts might mitigate disability-linked health disparities. We focused on two broad research objectives: developing both accessible communication environments and empowering communication environments in healthcare settings. Elements proposed as comprising accessible communication environments were: making health literacy accessible, addressing complex communication needs, and communicating the embodied experience of disability. Empowering communication environments were …

Effectiveness Of End-Of-Life Strategies To Improve Health Outcomes And Reduce Disparities In Rural Appalachia: An Analytic Codebook, Radion Svynarenko, Guoping Huang, Theresa L. Profant, Lisa C. Lindley

Faculty Publications and Other Works -- Nursing

Appalachia is one of the most medically underserved areas in the nation. The region has provider shortages and limited healthcare infrastructure. Children and adolescents in this area are in poor health and do not receive the needed quality care. Implementation of section 2302 of the 2010 Patient Protection and Affordable Care Act (ACA) enabled children enrolled in Medicaid/Children's Health Insurance Program with a terminal illness to use hospice care while continuing treatment for their terminal illness. In addition to being more comprehensive than standard hospice care, this relatively new type of care is more culturally congruent with the end-of-life values …

Heart Safe Community Update: Presentation, Mary Mccormack Dnp, Aprn, Fnp-C

Faculty Works: Nursing

Heart Safe Community Project update presentation at the School of Nursing & Health Sciences department meeting on 1/19/23 at Molloy University.

Parental Contextual Factors And Decision-Making Related To Periviable Birth: An Integrative Review, Amy L. Wright, Elizabeth Mens, Gausiha Rathitharan

The Qualitative Report

Parents facing a periviable birth, or birth before 25 weeks of gestation, commonly engage in antenatal consultation with healthcare providers to determine a plan of care. Parents’ pre-existing contextual factors, beliefs, and values influence their decisions regarding birth and the care of their infant. This study aims to understand the role of parental contextual factors and best-practices to their integration during antenatal consultation The Whittemore and Knafl (2005) approach to conducting an integrative review along with thematic analysis was employed to determine and present the findings. Results describe three themes related to how contextual factors influence parental decision-making: personal values …

Optimizing Your Capstone Experience: A Guidebook For Allied Health Professionals, Virginia E. Koenig

Open Touro Textbooks

This guidebook is designed for allied health professional students. Each chapter in this guidebook provides students with useful information, tools, and examples that will support them before, during, and after their capstone journey. This is a one of a kind resource that can be used in a variety of professional academic settings. The primary goal of this guidebook is to support students throughout their capstone experience and to help them understand how the capstone process will enrich both their personal and professional advancement.

Review Of Storytelling In Queer Appalachia: Imagining The Unspeakable Other, Sandra L. Cotton Dnp, Rn, Anp-Bc, Fnap, Laurie A. Theeke Phd, James Messer

Journal of Appalachian Health

The Journal of Appalachian Health is committed to reviewing published media that relates to contemporary concepts affecting the health of residents of Appalachia. Improving the health in the region of Appalachia means knowing our people as they live and thrive in communities. The book reviewed here, Storytelling in Queer Appalachia: Imagining the Unspeakable Other (Edited by Glasby, Gradin, and Ryerson), is a must read for people who wish to gain insight on the real experience of being queer in Appalachia.

Using Hierarchy Of Needs To Build Care Team Engagement, Catherine Palleschi, Katherine Skroski, Samantha Canonico, Hailey Frager, Mary Beeaker

Maine Medical Center

Cardiology Intensive Care & Cardiovascular Interventional Care teams provide superb care to critically ill cardiac patients at Maine Medical Center. Covid Pandemic revealed the importance of caregiver physical and mental health wellbeing, as well as engagement in order to continue to provide outstanding care to patients. Leadership devised innovative ways to improve team engagement and ensure that care team members' needs are met.

Instituting An Educational Module To Improve Knowledge Of Local Anesthetic Systemic Toxicity Among Anesthesia Providers, Alisha Marie Linehan, Chad Andrew Mcclure, Steven Taylor Moon, Shukhratilla Ibragimov Shamshitdinov, Julie Newton Bonom, Jason Michael Buehler

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

Local anesthetic use in the perioperative period is increasing in the United States as healthcare providers seek alternatives to opioid-based pain management. While increased use of local anesthetics has many benefits, their use also increases the risk of Local Anesthetic Systemic Toxicity (LAST), which is a serious and potentially life-threatening complication. A search of the literature indicates there is a considerable gap in knowledge of LAST among healthcare providers, including Certified Registered Nurse Anesthetists (CRNAs) and anesthesia residents. This knowledge gap is combined with a lack of standardized approaches to identifying and treating this complication. Identifying and treating LAST is …

Metabolomics Of A Neonatal Cohort From The Alliance For Maternal And Newborn Health Improvement Biorepository: Effect Of Preanalytical Variables On Reference Intervals, Lena Jafri, Aysha Habib Khan, Muhammad Ilyas, Muhammad Imran Nisar, Javairia Khalid, Hafsa Majid, Aneeta Hotwani, Fyezah Jehan

Department of Pathology and Laboratory Medicine

Background: The study was conducted to determine reference interval (RI) and evaluate the effect of preanalytical variables on Dried blood spot (DBS)-amino acids, acylcarnitines and succinylacetone of neonates.
Methodology: DBS samples were collected within 48-72 hours of life. Samples were analyzed for biochemical markers on tandem mass spectrometer at the University of Iowa. Comparison of RI across various categorical variables were performed.
Results: A total of 610 reference samples were selected based on exclusion criteria; 53.2% being females. Mean gestational age (GA) of mothers at the time of delivery was 38.7±1.6 weeks; 24.5% neonates were of low birth weight and …

Screenings To Decrease Pediatric Suicide, Jordan Bridges, Dana Schildmeyer, Amanda Austin, Laura Boesken

Posters-at-the-Capitol

This project aimed to examine the current practice related to mental health and depression screenings in pediatric patients. The benefits of implementing screening in schools in identifying depression and suicide risks sooner were also considered. This project focused on the correlation between earlier mental health screening and identification of these mental health disorders earlier in the life of pediatric patients and suicide rates. Current, published literature notes mental health screening in the pediatric population in schools is an effective method to facilitate monitoring and early intervention in detecting a mental illness. Schools implementing mental health screenings can result in increased …

Home Visitation To Prevent And Reduce Postpartum Depression, Anna Bauer, Madison Polley, Laura Boesken Dnp, Msn, Rn

Posters-at-the-Capitol

Postpartum depression (PPD) occurs in 13-19% of women worldwide, and is a stigmatized medical condition affecting maternal and infantile long term outcomes. The purpose of this evidence-based practice project was to determine if women at high risk for PPD are affected by home visitation programs from discharge up to three years postpartum. CINHAL Ultimate, Google Scholar, and Medline databases were used. Current evidence supports the use of home-visitation programs for postpartum women to decrease the prevalence and the symptoms of PPD by allowing nurses access into homes to provide early intervention for PPD. In addition to providing care for prevention …

Using Doctoral Education And Research-Based Learning To Advance The Nurse Leader, Kara R. De La Fosse

The Journal of Advancing Education Practice

Nurse leaders perform in highly autonomous positions in two dimensions; academia, and the clinical setting with the awesome responsibility to serve and protect others. To guide nursing practice, research-based skills are crucial to ensure leadership decisions are founded in evidence-based practice. Random controlled studies are gold-standard in healthcare compared to correlation or descriptive studies and employ a systematic review to strengthen findings (Schmidt & Brown, 2021). Research skills are prominent in numerous components of the leadership scope to perform at a stellar level.

Development And Implementation Of An Evidence-Based Practice Guideline Regarding Cricoid Pressure, William Carson Ii

Doctor of Nursing Practice Scholarly Projects

Cricoid pressure (CP) has been a standard of practice since the 1960s. The purpose is to reduce aspiration of gastric content into the lungs in high-risk patients undergoing induction of general anesthesia. Aspiration has been identified as the most common cause of airway-related mortality for patients undergoing general anesthesia. The cause of airway-related mortality can be correlated to the application of CP. Incorrect application of CP may lead to adverse clinical events and outcomes. It has been demonstrated that when administering CP in a simulation-based environment, providers are applying pressure to the incorrect anatomical location and/or applying the incorrect amount …

Medically Accurate Evidence-Based Sex Education And Abstinence-Only Sex Education: Impact On Teen Pregnancies In The United States, Nicole Chiu

Nursing | Senior Theses

The U.S. has funded abstinence-only programs to combat pregnancy rates for a long time. With numerous factors contributing to teen pregnancies, there have been a lot of ways that people have decided to try to decrease the number of teen pregnancies. For example, schools have either decided that they intend to fully educate their teenage students using medically accurate evidence-based sex education or come from a more conservative approach and give abstinence-only education. The objective of this investigation is to identify whether evidence-based sex education or abstinence-only sex education is more effective at combating teen pregnancy and abortion rates. This …

What Impact Does The Ability To Access Healthcare Have On Maternal Outcomes In Africa?, Helena Harris

Nursing | Senior Theses

Background: Maternal mortality rates reflect health inequities in access to obstetric care in some parts of the world including many African countries. Geographical barriers and limited number of skilled human resources have put women in rural areas at a significantly higher risk of maternal mortality.

Research Question: What impact does the ability to access healthcare have on maternal outcomes in African rural areas compared to urban cities?

Methods: A literature review was performed of credible databases. Six articles were reviewed extensively highlighting the purpose, strengths, and limitations of each study. Refer to Appendix A for the literature review table.

Findings: …

The Impact Of Sleep Deprivation In Nurses On Psychomotor Skills, Memory, And Medical Errors, Luke Asprec

Nursing | Senior Theses

Nurses are often subjected to working long shift hours, doing overtime, or being on the night-shift. These factors often predispose nurses to inadequate sleep, which impacts memory, cognition, and mental health. This is significant because nurses depend on their psychomotor skills and clinical judgment to deliver effective nursing care. Each decision made is vital to the safety of the patient. Previous research studies have shown the negative effects of sleep deprivation on impaired concentration, judgment, and long-term health such as obesity, diabetes, and hypertension. While there is significant data in the general population, the specific effects of sleep deprivation in …

Exploring The Effects Of Different Types Of Diets On Preventing And Managing Diabetes Mellitus Type 2, Ma. Patricia Diorel Peig

Nursing | Senior Theses

Diabetes is a major health problem that is becoming an epidemic in major countries of the world. Diabetes can affect people of all ages and of all races. However, there is a higher risk of developing diabetes for certain groups of people. As of today, there is still no cure for diabetes. The treatment plan for patients diagnosed with diabetes is to control the level of blood glucose through different interventions. The progression of diabetes is influenced by food behaviors, and diet control is an important aspect of management of this disease. There are different types of diet recommended that …

The Relationship Between Self-Efficacy And Informed Decision-Making On Primiparous Women During The Birthing Process, Morgan R. Fillipo

Nursing | Senior Theses

Childbirth is a very intense and vulnerable experience, especially for first-time mothers. Across the globe, the prevalence of traumatic and unsatisfying births has become an increasingly troublesome issue for women. There is extensive evidence of maltreatment, and a large portion of the problem has to do with the client’s medical team. To combat this dilemma, the best course of action would be to prepare women for this possibility by increasing the client’s self-efficacy and decision-making abilities. Self-efficacy, also known as confidence in one’s skills, is an important trait to have when it comes to patients being able to advocate for …

Growing Into The Nursing Role: Exploring The Challenges New Nurses Face And How Residency Programs Address These Problems, Jan Ashley Escosio

Nursing | Senior Theses

Background: The first year of nursing practice is filled with growth and anxiety. Novice nurses face many challenges. A high turnover rate for new nurses creates a need for this issue to be addressed. New nurse residency programs may ensure nurses remain available to meet the community’s needs.

Objective: The purpose of this paper is to understand challenges new nurses face and how residency programs can address them. Two questions guiding the research are:

• What are the challenges new nurses face during their transition to practice (TTP)?
• How do New Graduate Nurse Residency Programs address these problems to shape confident …