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

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 ...

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 ...

Effects And Outcomes Of Different Laboring Positions And The Influence From Societal Norms, Amberlyn Heskett

Nursing | Senior Theses

Background

Within labor and delivery, every birth is different. Alarmingly, the U.S. has the highest maternal mortality rate, including death during labor, among developed countries (World Health Organization, 2022). Many maternal deaths may be preventable.

In the U.S., the use of forceps, vacuum-assisted birth, episiotomies, and emergency C-sections are common for women during childbirth. Even though some laboring positions may assist birthing more than others, there often is resistance to allowing various positions due to outside influences, including societal norms, hospital management, and healthcare professional training. Women in labor are vulnerable and look to their nurses for support ...

Childhood And Adolescent Obesity: Related Comorbidities And Interventions, Jasmine Wong

Nursing | Senior Theses

Background

The prevalence of childhood and adolescent obesity in the United States has steadily risen over the years and has become a public health concern. Obesity is defined as a BMI at or above the 95th percentile for children and teens of the same age and sex. Obese children and adolescents are at risk for poor health and poor quality of life. Furthermore, there are numerous comorbidities associated with childhood and adolescent obesity. While some of the associated diseases are acute, others can become chronic and result in lifelong conditions.

Objective

The purpose of the present thesis is to explore ...

Our Early Years Of Life's Effects On Our Future Health And Well-Being, Claudia Gagliano

Nursing | Senior Theses

Many poor health outcomes later into adulthood have been triggered by adverse life events that have occurred during childhood. Most of the general population has experienced some sort of adverse childhood event that has negatively impacted their future health. Adverse childhood events include any traumatic event that has occurred during childhood including maltreatment (sexual abuse, mental abuse, and physical abuse), neglect, parental loss, and peer victimization.

Raising awareness regarding the opportunities to intervene in a child’s life as a means to prevent behavioral, psychological, and substance abuse disorders before they would typically manifest on their own is the ultimate ...

How Is Health Seeking Behavior And Patient Outcomes For Latin Immigrants Affected By Language Barriers, Socioeconomic Status And Health Literacy?, Cassandra Sanchez

Nursing | Senior Theses

Background

Language barriers cause a disconnect between patients and health care workers. What further causes a disconnect is when patients have a lower level of education in addition to having a language barrier. I will be focusing on Latin immigrant individuals in the United States for my research. Many Latin immigrant patients may not have gone to school in their native countries, so their education level is lower making it harder to understand discharge information or patient teaching. When patients are unable to have that health literacy it may lead to negative patient outcomes due to not adhering to medication ...

Factors Impacting Organ Transplant Outcomes, Katelyn Grubich

Nursing | Senior Theses

Organ transplants are crucial to the survival of those on the receiving end. With medicine advancing, so has transplantation. Health care providers are becoming more aware of the strategies necessary to prolong the transplanted organ and how to obtain better outcomes. Heart, lungs, kidney, liver, pancreas, and some where more than one organ are involved, are the types of organ transplants performed.

Providing patients information will allow them to be a part of their treatment and can help to ease their anxiety knowing what is being performed and what can be expected. Health care providers must ensure that patients and ...

Compassion Fatigue: The Impact On Nurses During The Covid-19 Pandemic, Adrian Huynh

Nursing | Senior Theses

Background

Compassion fatigue comes from the physical, emotional, and psychological impact of helping others through stressful and traumatic experiences. It is a form of fatigue linked to burnout and secondary traumatic stress. Many nurses are vulnerable to compassion fatigue from repeated exposure to the trauma of their patients. While compassion fatigue has been a continuing issue, the COVID-19 pandemic has increased the risk and number of nurses developing compassion fatigue. This can affect patient care, workplace and personal relationships, and lead to development of more serious mental health issues.

Objective

To investigate the effects of compassion fatigue on the registered ...

Safe Practices For Preventing Covid-19 Among School-Aged Children, Meleena Reyelle Banda-Garcia

Nursing | Senior Theses

Communicable diseases and infections are common health problems among children. Among the most impactful communicable diseases present today is COVID-19, a disease caused by a virus named SARS-CoV-2, which has forced many school closures due to rapid transmission. Despite children not being the main driving factor of the spread of the disease, severe complications underlying COVID-19 incidence have resulted in increased hospitalization among school-age children.The initial global response to the spread of COVID-19 included the closure of school systems; however as the disease continues to be effectively managed, communities are starting to re-open schools partially or entirely nationwide. Although ...

How Has The Pandemic Exacerbated Nurse Burnout, And What Can Be Done To Improve Their Psychological And Emotional Well-Being?, Lisette Diaz

Nursing | Senior Theses

Background: The COVID-19 pandemic has affected millions of people, both emotionally and physically. Nurses are among the people who are most affected. The nurses' quality of life and the way they provide care has been changed by the pandemic. Nurses are so focused on providing the best possible care for their patients that they neglect to look after themselves.

Objective: The purpose of this literature review is to identify and evaluate how the COVID-19 pandemic has affected nurses and their well-being. The significance of this research was to establish how the ongoing pandemic has impacted nurses’ performance and emotional well-being ...

Rising Costs Of Insulin And Effects Of Self-Management In Type 1 Diabetes, Justine Yadao

Nursing | Senior Theses

Background

Type 1 diabetes, also known as juvenile diabetes or insulin-dependent diabetes is a chronic condition where the pancreas may not be able to produce little to no insulin. This type of diabetes can be attributed to some factors such as age, family history, environmental factors or types of viruses. It is seen more often in children or adolescence but can develop in adults, averaging approximately 5-10% of the population.

Insulin is a type of hormone produced in the pancreas naturally or can be manufactured in the laboratory. People with Type 1 Diabetes need insulin from an exogenous source to ...

The Emerging Epidemic Of Type 2 Diabetes And Obesity Amongst Young Children, Juliana Morales

Nursing | Senior Theses

Background:

In the past years childhood obesity has increased tremendously and currently ⅓ of children in the United States are obese today. Obesity and Type 2 Diabetes are illnesses that can later on lead to more severe health complications when as a child enters adulthood. Children who are obese have a greater risk of developing Type 2 diabetes, and currently more than 80% of children who already are diagnosed with Type 2 diabetes are obese. In school and often by health care providers we are told daily physical activity and healthy diet are the best ways to maintain optimal health ...

The Components Of Vaccine Hesitancy And The Role Of Patient Education In Promotion Of Vaccinations In Newborns, Camille Joy Rayo

Nursing | Senior Theses

Background

Due to an array of reasons relating to vaccine hesitancy, many newborns are without their standardized and recommended vaccinations as a result of their parent’s beliefs. Parents hold the power to vaccinate their children. Nurses must provide reliable information, debunk myths, and pursue pro-vaccination ideas when educating a parent about newborn vaccinations. By doing so, vaccine hesitancy should decrease and vaccination rates should increase. Unvaccinated newborns are put at a greater risk of contracting serious illnesses that may spread to others or even lead to one’s own death.

Objective

To identify common factors regarding vaccine-hesitant parents of ...

Impact Of Self-Care Techniques On Nurse Burnout, Macie Mayrell

MSN Capstone Projects

Nurse burnout is a serious, widespread problem in the healthcare arena. Registered nurses need to understand the importance of self-care to prevent or alleviate nurse burnout. An Evidence-Based Practice Benchmark Study implements a relaxation room on a nursing unit to encourage and promote self-care among acute care nurses.

Using Community-Based Participatory Research To Tailor A Diabetes Education Program To An At-Risk Black Church Congregation In The Mid-Atlantic, Samantha A. Mielke

Doctor of Nursing Practice Projects

Background: Prediabetes and diabetes continue to have a high disease burden in the United States (Lin et al., 2018). Many individuals are unaware of their glucose state or the impact impaired glucose can have on their quality adjusted life years and cost of living. The Centers for Disease Control and Prevention (CDC) has underscored the importance of decreasing the incidence of diabetes and has resources available. Still, many communities, particularly minority populations, can benefit from tailoring programs to their specific populations, where typical approaches may not be as beneficial (Joo & Liu, 2020). Additionally, Black American (BA) congregations often have a unique community-level soft infrastructure and psychological and sociological resources making them ideal sites for implementing education-based interventions (Kavanaugh et al., 2022; McNeill et al., 2018).).

Aim: This study aimed to initiate ...

An Evidence--Based Intervention: Use Of Visual Aids For Patient Education During Bedside Team Rounding, Kristin Clifford, Shay Gruber

Nursing DNP Projects

Abstract Purpose: To increase patient health literacy and satisfaction in hospitalized adult medical-surgical patients through an evidence-based provider intervention (advanced practice providers, APPs, or physicians, MDs) adding visual aids to current verbal patient education methods during daily bedside team rounding (BTR).

Strength of Evidence: A literature review resulted in 15 studies meeting inclusion criteria including two meta-analyses, three randomized control trials, two quasi-experimental studies, five systematic reviews, two descriptive studies, and one clinical practice guideline. Evidence revealed the addition of visual information to verbal and written education methods significantly improves patient knowledge, understanding, and recall of health information and increases ...

Workplace Violence (Wpv) Prevention Training Program For A Healthcare Organization, Hsing-Wen (Jill) Wang

Doctor of Nursing Practice (DNP) Scholarly Projects

Executive Summary

Background and Significance

Compared to all other industries in the United States, healthcare professionals are at the greatest risk for experiencing work-related violence (Cafaro et al., 2020; U.S. Bureau of Labor Statistics, 2020). Moreover, patient-to-staff violence, also known as Type Two Workplace Violence (Type 2 WPV), has the highest prevalence to healthcare employees in the past decades (Nowrouzi-Kia et al., 2019). Increasing incidence of Type 2 WPV impacts the health status of medical workers mentally and physically and generates substantial costs to organizations and the society (ILO/ICN/WHO/PSI Joint Program on WPV in the Health ...

Implementing A Diabetic Foot Care Program In A Virtual Primary Care Clinic, Zahra Naderi Asiabar

Doctor of Nursing Practice (DNP) Projects

Abstract

Background

Healthcare professionals (HCPs) have a key responsibility in delivering preventative and early intervention diabetes foot management within primary care. Diabetic foot ulcers (DFUs) are a major complication of diabetes and can lead to amputations and other wound issues.

Comprehensive care and treatment of diabetes are most effective when patients can access a supportive connection with providers. Before the pandemic, there were many reasons to utilize a technology-based distance approach to health care. The coronavirus pandemic in 2019 prompted additional reasons for the transition to distant care.

Problem

The yearly screening of a virtual foot exam on patients with ...

Implementation Of A Tele-Triage Protocol In An Emergency Department Setting, Megan Tuetken, Sierra Hamlin, Sydney Spaulding

Doctor of Nursing Practice Projects

Nationwide, the volume of emergency department (ED) visits has steadily increased over the last several decades. This steady increase in volume frequently causes ED crowding and considerable delays in patient evaluation and treatment. Recently, teletriage has been used in emergency departments to evaluate less emergent patient needs while freeing up in-house providers to care for more critical patients. The goal of this DNP project was to develop a protocol for the utilization of teletriage in an Emergency Department in a level 1 trauma center in central Illinois using nurse practitioners to assess patients in the waiting room and order appropriate ...

A Description Of Impostor Phenomenon In Certified Registered Nurse Anesthesiologists, Jeffrey R. Darna

Dissertations

Background: Imposter Phenomenon (IP) is an evolving, multidimensional construct defined as self-perceived intellectual phoniness and professional ineptitude frequently experienced by individuals working in high performance or competitive environments. IP consequences include psychological distress, role under-optimization, and professional paralysis. Certified Registered Nurse Anesthesiologists (CRNAs) are at risk for impostorism; however, IP presence, intensity, and career effects are unknown.

Purpose: The study measured IP in CRNAs and determined the relationship between IP and select sociodemographic and practice variables.

Methods:

Design: A descriptive, cross-sectional correlation design measured IP using an Internet-based survey from a random sample of 170 members of the American Association ...

Effects Of Telephone Follow-Up On Medication Adherence And Rapid Readmission Among Discharged Adults With Schizophrenia Spectrum Disorders (Ssds), Romilynn Danko, Madalyn Cosensci

Doctor of Nursing Practice Final Manuscripts

High rates of 30-day readmission after acute care discharge are a big concern for patients with psychiatric disorders. These high rates not only reflect poor patient outcomes, but also result in higher hospital costs. For adults with schizophrenia spectrum disorders (SSDs), a review of current research shows that non-adherence to medication has been significantly associated with rapid readmissions and that using an intervention such as follow-up telephone calls after discharge can help prevent readmission through increased medication adherence. Using the Iowa model framework as a guide, the purpose of this evidence-based practice project was to pilot a post discharge procedure ...

Implementing Adverse Childhood Experience Screening In An Intensive Outpatient Mental Health Program, Bryan Amaro

Doctor of Nursing Practice Final Manuscripts

Adverse Childhood Experiences (ACES) are linked to damaging events which happen to people when we are young (0-18). ACEs are connected to a phenomenon known as the toxic stress response which can later become the root etiology for many mental health, substance abuse and chronic medical health complications our society faces. ACEs affect all populations and do not discriminate across socioeconomic, racial, ethnic, gender, or geographic lines. Roughly two thirds of Americans have experienced at least one ACE. This project seeks to perform ACE screening at an Intensive Outpatient behavioral health center by screening for ACEs upon all admissions into ...

Screening For Childbirth-Related Posttraumatic Stress Disorder Using The City Birth Trauma Scale: A Pilot Project, Meredith Kazato

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this project is to identify birthing people with childbirth-related posttraumatic stress disorder (CB-PTSD) symptoms using the City Birth Trauma Scale (CBTS). Once identified, at risk birthing people will receive verbal education about CB-PTSD and a social work consultation, if necessary.

Background: A birth is deemed traumatic, and thus fulfills one of eight criteria of posttraumatic stress disorder (PTSD), when during labor, delivery, and/or immediately postpartum, the birthing person perceives themselves and/or their baby’s life to be in danger and/or are at risk of being critically injured. These events include but are not ...

Improving Same Day Surgery Patient Outcomes Through A Nurse Practitioner Led Telephone Follow-Up Call, Jessica Cooke, Kamila Zasowska

Doctor of Nursing Practice Final Manuscripts

Background: On average, patients experience one to seven problems post-hospital discharge leading to increased unplanned emergency room visits, hospital readmission, and worse outcomes. The average cost of a single hospital admission is $15,477, an emergency room visit $1,389, and treatment for a surgical site infection $10,443-$25,546. Additionally, the Center for Medicare and Medicaid Services (CMS) imposes fines on hospital systems with high readmission rates. Currently, the Southern California hospital this project was implemented at has a 15.5% hospital-wide unplanned 30-day readmission rate with a national average of 15.2%.

Purpose: The purpose of this ...

Improved Monitoring Of Depression And Suicidal Ideation In Low-Income Adolescents Through Evidenced Based Provider Education, Sunday Adeyeye

Doctor of Nursing Practice Final Manuscripts

Background: Adolescents from low-income status experience more prevalent thoughts of suicide than their financially secure peers. Nearly 15% considered taking their own life. Suicidal ideation among adolescents in California ranges from 4% to 67%. Depression and suicidal thoughts are underdiagnosed among adolescents, with higher disparities among minority and lower socioeconomic backgrounds.

Purpose: This project involved consistent screening of high-risk adolescents for potential depression and suicidal ideation using a patient health questionnaire recommended by the U.S. Preventive Services Task Force screening.

Process: This project involved adolescents 12–18 years old who had visited a federally qualified healthcare center in San ...

Forestalling: Decreasing Super-Utilizers In The Emergency Department Using Case Management Strategies, Kelly Chambers, Megan Gilmartin, Martha Narasimhan-Narayanan

Doctor of Nursing Practice Final Manuscripts

In 2019, it was estimated there were 18 million avoidable emergency department (ED) visits, totaling $32 billion in unnecessary healthcare spending. Super-utilizers (SU), individuals that seek care in the ED 3 or more times per year, account for a disproportionately large segment of healthcare consumption and costs. These patients inefficiently access the healthcare system and often fail to get the follow-up care that could prevent them from repeat ED visits.

This evidence-based project aimed to reduce unnecessary ED visits by at least 25% annually and have no use of the ED during the intervention period, by implementing social and medical ...

Improving Completion Rate Of Identifying Seniors At Risk (Isar) Screening Tool In Emergency Department (Ed) Setting, Ashley Clark

Doctor of Nursing Practice Final Manuscripts

Background: Patients age 65 and older are identified as being an at-risk population for readmissions to the hospital within 30 days. Evidence based practice has shown that completing the Identifying Seniors At Risk (ISAR) screening tool can help to identify the needs of these patients so they can age in place at home with the proper resources. The screening tool consists of 6 questions. A score of 3 or more on the ISAR is deemed high-risk and a consult with case management should be considered. The average completion rate in an emergency department was identified as being 33%. The goal ...

Implementation Of Nola Pender’S “Clinical Assessment For Health Promotion Plan” To Increase Patient Self-Efficacy, Weight Loss And Health Promoting Behaviors Such As Improving Nutrition And Increased Physical Activity In Obese Women In A Weight Loss Clinic, Christine Ngwazini

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to review research-based studies on Nola Pender’s Health Promotion Model for weight loss and implement the evidence. The goal was to increase patient self-efficacy, weight-loss, and health promoting behaviors such as improved nutrition and increased physical activity among obese women in a weight loss clinic.

Background: Obesity leads to an increased risk of heart disease, stroke, type 2 diabetes, cancer, and premature death (CDC, 2020). From 2016 to 2017, 42.4% of people in the United States were obese (2020). Worldwide, over 650 million people ...