Medicine and Health Sciences Commons^™

First Line Acne Treatment: Comparison Of Cost And Efficacy, Michael P. Mcneil, Karlen E. Luthy, Christine R. Platt, Michael S. Robinson, Janelle L.B. Macintosh

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Acne vulgaris is a common skin concern that may cause permanent disfiguration and encumbering effects on self-esteem and mental health. Additionally, it is often associated with expensive treatment costs for patients. When selecting the most appropriate therapeutic approach, nurse practitioners must also consider the price of the medication. For the majority of mild to moderate cases of acne (both comedonal and inflammatory), effective first-line treatment recommendations include a combination of a topical retinoid, benzoyl peroxide, and a topical antibiotic such as clindamycin. Generic and compounded medications are typically more cost-effective for patients than brand name formulations.

Trauma Team Communication During Trauma Resuscitation: A Literature Review, Paula Barney

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Trauma teams nationwide are tasked with stabilizing and treating severely injured patients. Their work is unpredictable and must be carried out quickly to improve patient outcomes. Effective team communication is imperative. Team members communicating to form shared understanding of patient status and care goals supports high-level team function. Clear communication is essential. Team members should use closed-loop communication when appropriate, use brief and direct statements, and limit noise in trauma rooms. Team leaders support trauma team performance by providing updates on patient status and plans of care and fostering a culture of collaboration between team leaders and team members. Team …

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

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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 …

Preparation And Engagement Throughout Cultural Immersion Experiences: Helping Nursing Students Gain Awareness, Erin Minhondo, Karen H. De La Cruz

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Objectives: This review explores evidence-based methods of increasing cultural awareness in pre-licensure nursing students during cultural immersion experiences (CIEs).

Design: A literature review was conducted in March of 2022.

Data sources: Databases employed included CINAHL and MEDLINE. The search strategy included publication dates between 2017 and 2022, English-only transcripts, and full-text references from academic journals, dissertations, and books.

Review methods: The review assessed for quality by searching relevant articles for bias and ensuring each study was from an accredited journal. Editorials and opinion pieces were omitted.

Results: Three major themes emerged from the literature including pre-departure preparation, in- country …

Pandas: How To Recognize And Intervene, Trevor Brackney, Blaine Winters

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This research paper delves into pediatric autoimmune neuropsychiatric disorder associated with streptococcus (PANDAS). PANDAS causes rapid psychiatric changes in children ages 3 to puberty. These changes are most often obsessive-compulsive disorder (OCD) and/or tics, however, anxiety, agitation, mood disorder, depression, oppositional defiance disorder, attention-deficit hyperactivity disorder, hallucinations, memory/cognitive deficits, enuresis, and sleep disturbances have also been noted. Present-day estimations of PANDAS cases would likely prove to be understated if awareness of PANDAS increased (Centner, 2021). The purpose of this paper is to disseminate awareness and data of a disease that has gone relatively unnoticed in American medicine since being defined …

Hpv Infection And Vaccination: A Question-And-Answer Guide For School Nurses, Mendi England, Karlen E. Luthy, Michael S. Robinson

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This paper provides school nurses with a quick question-and-answer format guide to common HPV-related questions that are often asked by school aged children's parents.

Diagnosis And Initial Management Of Acute Stress Disorder And Post-Traumatic Stress Disorder In The Primary Care Setting, Lindsay Leonard, Blaine Winters

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Purpose: The purpose of this paper is to equip nurse practitioners (NPs) with resources and tools that will help with the early recognition and treatment of Post-Traumatic Stress Disorder (PTSD) and Acute Stress Disorder (ASD) in patients following a traumatic accident.

Background: According to the Centers for Disease Control and Prevention (2019), trauma, or unintentional injury, is the leading cause of death for individuals under the age of 45 and the third leading cause of death for all ages of people in the United States. Patients involved in traumatic accidents often develop adverse psychological sequelae such as PTSD and ASD. …

Postural Orthostatic Tachycardia Syndrome (Pots): A Frequently Missed Diagnosis, Aubrey R. George, Blaine A. Winters

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Postural Orthostatic Tachycardia Syndrome (POTS) is a debilitating chronic illness that involves a sustained tachycardia upon standing and affects millions of patients in the United States alone. POTS is most commonly seen in adolescent females and substantially reduces overall quality of life. In 2019, less than a third of all providers had heard of POTS and patients may wait over a decade for a proper diagnosis and treatment. With the intermittent and variable nature of symptoms, 83% of patients reported being misdiagnosed with a psychological condition before receiving a diagnosis of POTS. Understanding the relationship between autonomic compensation and hemodynamic …

Recommendations For Infection Control In Congregate Shelters Following A Natural Disaster, Megan Schultz, Blaine Winters

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Infection control is at the forefront of nurses’ minds, particularly following a natural disaster. Natural disasters often displace people from their homes, requiring them to stay in congregate shelters for a short period of time. The risk of infection is significantly increased in shelters environments. The purpose of this literature review is to determine the appropriate strategies to mitigate the spread of infection in congregate shelters following a natural disaster. Implications for practice are identified.

Empathy Development Among Undergraduate Nursing Students Through Intimate Partner Violence Simulation, Jennifer Benson, Peggy H. Anderson, Gaye L. Ray, Denise Cummins, Michael Thomas

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The purpose of this Intimate Partner Violence (IPV) education quality improvement project was to evaluate the effectiveness of an undergraduate Community Health Nursing course, IPV simulation and learning activities. This experiential learning activity offered participants an opportunity to temporarily view life from the perspective of actual IPV victims/survivors, and review and discuss IPV statistics, at-risk populations, and warning signs.

The quality improvement project was developed using a mixed-methods quality improvement design. A convenience sample of 35 participants allowed matched-sample statistical analysis of the Jefferson Scale of Empathy Health Professions student version (JSE-HPS version) scores. Pre-to-post JSE-HPS version empathy survey scores …

Responding To Parents' Questions Regarding Polysorbate 80, Aluminum, And Thimerosal In Vaccines, Elli Hugh, Beth Luthy

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Vaccines save millions of lives worldwide every year. Nevertheless, misinformation regarding vaccine ingredients circulates on various media platforms and may negatively influence parental decisions regarding childhood vaccinations. Three vaccine ingredients commonly associated with parental vaccine concerns include polysorbate 80, aluminum, and thimerosal. Common misconceptions about polysorbate 80 and neurological sequela exist within the vaccine hesitant community. Additionally, aluminum has been incorrectly connected to chronic disease in children. Though proven that thimerosal does not cause autism, vaccine critics have now inaccurately reformed the argument claiming that it is the combination of thimerosal and aluminum that causes autism. The purpose of this …

Methods To Stop Caffeine Use And Minimize Caffeine Withdrawal Symptoms In The State Of Caffeine Dependence: A Literature Review, Morgan Behling, Blaine Winters

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Caffeine is the most consumed psychoactive drug in the world and those who consume it frequently become dependent. Even if individuals desire to quit caffeine, they may not be able to due to withdrawal side effects, or a lack of knowledge of how to quit. Harmful effects of long-term caffeine consumption include fatigue, irritability, headaches, nausea, and depression. The goal of this literature review was to explore current evidence on different methods to quit or reduce caffeine use and minimize caffeine withdrawal effects in those who are dependent. A literature review of studies from 2014 to 2020 was conducted using …

Addressing Melanoma Risk In Families, Rebecca B. Roy, Deborah O. Himes

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Melanoma is one of the top 10 cancers in the United States. It is an aggressive and potentially fatal skin cancer. Up to 10% of all people diagnosed with melanoma have a positive family history of melanoma and a family history with a first degree relative can increase the risk for family members by 75%. Poor family communications often result in first degree relatives’ lack of knowledge about risk and prevention for melanoma. Considering this lack of knowledge, primary care providers have the opportunity to assess risk; teach and encourage prevention measures; teach and perform skin exams; and refer to …

Musculoskeletal Injuries In The Austere Setting: A Pilot Training For Student Nurses, Diego H. González

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Registered Nurses (RNs) make up the largest proportion of healthcare workers in the United States. As such, RNs are frequently involved in responding to emergencies in austere settings such as natural disasters and wilderness environments. Many injuries in the austere setting are categorized as musculoskeletal. Currently, nursing programs do not provide any curricular training on austere medicine. This leaves nurses unprepared to face the challenge of responding to emergencies in the austere environment.

Purpose: Create and pilot test an effective training for a nursing program at a private university in the Western United States on musculoskeletal injuries in the austere …

Tapering Buprenorphine, Alexis Diane Snyder

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Opioid use disorder (OUD) is increasing in incidence in the United States. Buprenorphine is the mainstay of medication-assisted treatment for OUD. Nurse practitioners play an essential role in solving the opioid epidemic and are increasingly relied on to prescribe buprenorphine. Even though buprenorphine is considered a long-term therapy, many patients request to taper off the drug. Evidence suggests that tapering from buprenorphine is frequently unsuccessful and remains as a challenge. The purpose of this article is to provide the best available evidence regarding the taper of buprenorphine in patients with OUD. Considering a buprenorphine taper should begin by evaluating if …

Empowering Nurse Practitioners To Make Health Policy Change: A Guide To Successful Passage Of Legislation In Utah, Heather Merrill, Lacey Eden, Karlen Beth Luthy

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Introduction: There is growing political apathy among nurses. This trend must be reversed to make meaningful change in healthcare. In 2017, the authors championed a bill, House Bill 308 Substitution 2 (HB 308 Sub 2), which passed in the Utah Legislature.

Guide: This health policy paper details the process of enacting HB 308 Substitution 2 to guide Nurse Practitioners in enacting legislation. The steps detailed to enact legislation are based on the acronym CHANGE which stands for collecting data, hinge, associations, negotiate, gather, and expect to be the expert. Basics of the legislature are also explained such as timing, the …

Recommendations For Perioperative Care Of Adolescents At Risk For Suicide, Rachelle Huber Dustin Rn, Bsn, Blaine A. Winters Dnp, Acnp-Bc

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Suicide is one of the leading causes of death for the adolescent population, and as such, should be addressed when adolescents have any contact with the healthcare system, including perioperative appointments. Although some surgical facilities screen patients with a history of suicide attempt or severe mental health conditions, many adolescents who have died by suicide do not have official mental health diagnoses or history of previous suicide attempt. Because of the impact surgery can have on mental health, each adolescent should be screened for suicide risk during pre-surgical consult appointments to assess suicide risk and take proper precautions, as needed. …

Talking To Your Patients About Antibiotics: What Nurse Practitioners Need To Know, Danae M. Titensor, Katreena Collette-Merrill

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Antibiotic resistance is a growing threat to our current ways of treating infections. The overuse of antibiotics is a major contributor to this threat, especially with the prevalence of unnecessary prescriptions written for upper respiratory infections (URIs). Better education tools are needed for providers and patients regarding antibiotic resistance. The purpose of this project was to use evidence-based practice to produce an educational video about antibiotic resistance. Following a review of the literature, a 6-minute video was made using Mayer’s cognitive theory of multimedia learning. A convenience sample of 15 family nurse practitioner (FNP) students, from one master’s program, participated …

Prehabilitation Prior To Cabg, Casey Bunker, Neil Peterson

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Background and Purpose: Globally, coronary artery disease (CAD) affects 126.5 million adults. To decrease mortality, coronary artery bypass graft (CABG) surgeries are often performed. CABGs have inherent risks such as financial burden, physical complication, and emotional stress. Cardiac rehabilitation programs help decrease complications postoperatively. However, few interventions are performed preoperatively. Prehabilitation (prehab) programs have been created to address this gap in other types of surgeries. Prehab is the purposeful implementation of physical activity before a procedure to improve perioperative outcomes. Prehab prior to CABG has not been well studied previously. Furthermore, it is unknown if families should support a sedentary …

An Evidence-Based Approach To Understanding And Treating Electronic Cigarette Use In The Adolescent Population, Adelaide Amini

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ABSTRACT

An Evidence-Based Approach to Understanding and Treating Electronic Cigarette Use in the Adolescent Population

Adelaide Laurel Amini College of Nursing, BYU Master of Science

Electronic cigarette (e-cigarette) use is popular among adolescents and leads to high levels of nicotine exposure in this population. E-cigarette use by teenagers can lead to development of nicotine addiction, chronic lung disorders, and lifelong incidence of depression, anxiety, and attention-deficit disorder. Thus, it is vital that nurse practitioners understand electronic cigarette devices and their effects on adolescent health, as well as treatment guidelines regarding nicotine dependence specific to e-cigarettes. An educational module detailing the …

The Intersection Between Sexual Assault And Mental Illness: Psychiatric Nurse’S Role, Shylettera Davis, Leslie Miles, Julie Valentine, Linda Mabey

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The Intersection between Sexual Assault and Mental Illness: Psychiatric Nurse’s Role

Shylettera Davis

College of Nursing, BYU

Master of Science

Background: Mental illness (MI) affects one in five Americans. Individuals with severe MI are frequently victims of crime, which includes sexual assault (SA). It is well established that individuals with severe MI are more vulnerable for SA victimization. What is not recognized is if this vulnerability for SA extends to other less serious types of MI.

Aim: To identify and synthesize findings from the literature for any connections between having a MI and increased vulnerability for SA victimization, specific mental …

Improving The Detection Of Rheumatic Heart Disease In Children Residing In Samoa, Shay Harding

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Improving the Detection of Rheumatic Heart Disease in

Children Residing in Samoa

Shay Harding

College of Nursing, BYU

Master of Science

Rheumatic Heart disease (RHD) is the most common cause of heart related illness in individuals under 25 years of age and is a major health concern on the Pacific Islands of Samoa (Saxena et al., 2017). RHD related mortality among Samoan children is disproportionally high relative to the rest of the world; it is estimated to impact 10 out of every 1000 children there (Allen et al., 2017). The health care system in Samoa is limited in its resources, …

Hereditary Cancer Syndrome Recognition And Testing For The Primary Care Nurse Practitioner: Beyond Brca, Hanford Shuman, Deborah Himes

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Hereditary cancer syndromes, resulting from mutations of tumor-suppressor genes, can significantly increase risk for breast cancer. While Hereditary Breast and Ovarian Cancer Syndrome caused by BRCA1/2 mutations is well known, less well-known hereditary cancer syndromes also exist. This clinical practice feature focuses on three other syndromes including, Li-Fraumeni, Cowden, and Peutz-Jeghers. This article will help prepare nurse practitioners to recognize key features of these syndromes and understand testing criteria. Additionally, this article discusses barriers to diagnosing hereditary cancer syndromes and the role of primary care nurse practitioners in ordering genetic tests and making genetic referrals for optimal patient care.

Type One Diabetes Mellitus In Immigrant And Minority Pediatric Populations, Kristina Nielson

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Type 1 diabetes mellitus (T1DM) is a prevalent chronic illness affecting children and adolescents. Globally, it is estimated that at least 1 million children under the age of 19 years are affected by T1DM. Immigrants and minorities have worse diabetic outcomes than the majority population. The purpose of this article is to identify common challenges in children with T1DM who are part of immigrant or minority populations. Major health challenges for children with T1DM who are immigrants or minorities include issues regarding access to healthcare, communication, and cultural adaptation. Access of children with T1DM to high-quality healthcare and new diabetes …

Empathy For Provider And Patient, Virginia Jefferies, Jane Lassetter Phd, Rn

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Nurse Practitioners (NPs) increasingly feel pressure to diagnose and treat patients in shorter timeframes. Simultaneously patients’ satisfaction with care impacts reimbursement from Medicare and Medicaid. Improving empathetic skills can encourage patients to openly communicate leading to more accurate and timely diagnosis and treatment, which improve patient outcomes and satisfaction. Empathetic providers find work more satisfying and experience less depression and increased quality of life. This article presents the benefits of empathy to patients and NPs and offers guidance for incorporating empathy into practice. By implementing the behaviors discussed herein, NPs can develop practical skills that benefit both patient and provider.

Coolsculpting Or Cryolipolysis, A Guide For Primary Care Providers, Miryam Harper, Jane Lassetter

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A desire for the ideal body image has influenced development of a non-surgical body shaping procedure known as CoolSculpting, or cryolipolysis. The purpose of this clinical feature is to inform nurse practitioners regarding the risks and benefits of cryolipolysis so they can educate their patients. Cryolipolysis is a safe, effective method of reducing small areas of unwanted fat. Side effects are minimal and include pain, redness, bruising, and swelling. Results are seen within twelve weeks, but long-term effects are unknown. There are contraindications, and it is relatively expensive; however, it may be a safer option than invasive surgery.

Use Of New Oral Anticoagulants In Preventing Ischemic Stroke In Patients With Atrial Fibrillation, Travis Hunt, Blaine Winters, Rod Newman

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Atrial fibrillation (AF) affects millions of Americans and puts them at increased risk for ischemic stroke. It is important for providers to recognize AF and know when it is appropriate to treat patients with anticoagulation. There are several options available for anticoagulation. Warfarin is the most widely used anticoagulant. Other alternatives to warfarin are new oral anticoagulants (NOACs) which are increasingly prescribed in recent years. It is vital providers know the differences between warfarin and NOACs, and what is the most appropriate anticoagulant to use for their patient with AF. The purpose of this paper is to review the clinical …

Continuous Glucose Monitoring: An Overview For Nurse Practitioners, Casey Neeley, Donna Freeborn

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Continuous glucose monitoring (CGM) is a revolutionary addition to diabetic management for patients with type 1 diabetes mellitus (T1DM). CGM, when used properly, improves overall glycemic control. In the short term, CGM decreases incidences of hypoglycemic events and improves day to day blood glucose control. In the long term, CGM decreases hemoglobin A1c levels and decreases incidences and severity of long term complications of diabetes. When patients are educated and supported by providers on the use of CGM, patients with T1DM can achieve optimal glycemic control.

Adult Vaccination Rates In The Severely Mentally Ill Population: An Improvement Project In An Outpatient Setting In Utah, Nathalia H. Williams, Leslie Miles, Beth Luthy, Lacey Eden

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Background: Adults who suffer with severe and persistent mental illness (SPMI) rarely access medical care to address basic medical needs, so they are subsequently less likely to receive preventive vaccines. The aim of this project was to increase the rate of vaccines among the SPMI population. This project started in 2011 and still is ongoing. It took place in an outpatient community mental health center (CMHC) which serves about 4,200 SPMI clients. Personnel managing the project included registered nurses from the local health department, staff from the CMHC, and volunteer nursing students.

Methods: A review of the literature identified a …

Evidence-Based Strategies For Treatment And Referral Of Chronic Pain In Primary Care, Morgan Ann Bateman, Katreena Collette-Merrill

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Chronic pain is an ever present issue in the United States, with more people suffering from it than heart disease, cancer, and diabetes combined. Chronic pain is the most frequent complaint in primary care, and it poses significant challenges to both primary care providers (PCPs) and their patients. At the root of many of these challenges is the prescription and management of opioid prescription drugs used to treat chronic pain. Opiate misuse, abuse, and diversion are serious risks of opiate prescribing. Risk assessment tools are available to aid the PCP in determining the severity of risk for potential patient abuse, …