Medicine and Health Sciences Commons^™

Surgical Fire Prevention And Management: An Objective Structured Clinical Examination For Nurse Anesthesia, Tate Fazio, Kaleb Killens

Doctoral Projects

Sentinel events in health care are rare events, often corresponding with permanent injury or death. Fires in the operating room (OR) are one type of sentinel event. Although rare due to possible life-threatening injuries to patients and staff, appropriate surgical fire education is critical in nurse anesthesia education, as anesthesia providers play a significant role in surgical fires (Wunder et al., 2020). The development of simulation exercises has the potential for students to experience and become competent in managing high-acuity, low-frequency events, such as surgical fires (Wunder et al., 2020). The Nurse Anesthesia Program (NAP) at The University of Southern …

Implementing Low-Dose Ct Scans To Screen For Lung Cancer In The Primary Care Setting, Monifa Ri'ana Beal

Doctoral Projects

Lung cancer is the leading cause of cancer-related death in both men and women in the United States. By the end of 2023, lung cancer will have been diagnosed in approximately 238,000 Americans and claimed the lives of about 127,000 of those that are diagnosed.(American Cancer Society, 2023) Currently lung cancer accounts for more deaths among Americans than breast, prostate, and colon cancers combined (Centers for Disease Control and Prevention [CDC], 2019). Despite being one of the most preventable cancers in the world, lung cancer continues to be the leading cause of cancer-related death among Americans and more so in …

Preventing Diabetes Through Prediabetes Screening And Treatment In Primary Care, Dewona Beal

Doctoral Projects

Diabetes is an epidemic in the United States. There are three types of diabetes: type 1, 2, and gestational diabetes. Type 2 diabetes mellitus (T2DM) is the most common type of diabetes. This type of diabetes can be prevented or delayed. In persons with T2DM, the body cannot use insulin well to keep blood glucose within normal limits. Several factors, including genetics, lifestyle such as poor diet and physical inactivity, obesity, insulin resistance, hormones, and certain medications, can cause it. A precursor to T2DM is prediabetes. Prediabetes is when blood sugar levels are elevated but not elevated enough to be …

Assessing Social Determinants Of Health In Primary Care, Vicki Carpenter

Doctoral Projects

The social determinants of health encompass the various circumstances and environments in which individuals reside, develop, labor, and experience aging (Social Determinants of Health, 2022). These variables significantly contribute to the existence of health inequities and disparities within populations. In order to effectively mitigate health disparities, it is imperative to consider the various determinants that influence health outcomes, as this consideration is crucial for advancing the goal of achieving health equity. This public health concern encompasses multiple sectors within our society, necessitating the collaboration of various organizations and communities to effectively address and mitigate its impact.

The fundamental …

A Quality Improvement Project On Blood Pressure Measurement: Are We Failing Our Patients?, Michael Baker

Doctoral Projects

Despite billions of dollars invested in research, education, and equipment, high blood pressure remains a significant contributor to mortality rates across the globe. According to the Centers for Disease Control (2019), hypertension was listed as a primary or contributing cause of over a half-million deaths in the United States (Centers for Disease Control [CDC], 2021). Without regard to race, gender, background, or socioeconomic level, this “silent killer” the Mississippi State Department of Health estimated that over 700,000 Mississippi adults were diagnosed with high blood pressure and thousands more at an increased risk each year (MSDH, 2019). Failure to identify and …

Quality Improvement Project To Assist In Implementation Of Prediabetes Screen Protocol, Kyai Forney

Doctoral Projects

Prediabetes is a reversible condition that causes blood glucose levels to be higher than normal, but not high enough to be diagnosed as type 2 diabetes. When one has prediabetes, the cells in the body do not respond normally to insulin, and insulin acts like a key to letting blood sugar into cells to use energy. The pancreas produces insulin to try to get the cells to respond, but eventually, the pancreas has a challenging time keeping up, and the blood sugar level rises causing prediabetes (Lehrman, 2021). A person can have prediabetes for years with no obvious symptoms, so …

Studying The Impact Of Hyperlipidemia Monitoring Tools On Referral Rates In Patients Taking Antipsychotics, Jasmyn S. Allen

Doctoral Projects

The purpose of this DNP project is to determine how well an evaluation tool may be used to track hyperlipidemia in patients using antipsychotic medicines who are between the ages of 20 and 50. Elevated lipid contents in the bloodstream, or hyperlipidemia, increase the danger of heart-related illnesses. Antipsychotic drugs, frequently administered for mental health disorders and dyslipidemia, have been connected. The goal is to ascertain whether utilizing an evaluation tool raises the three-month referral rates for hyperlipidemia to primary care (Dayabandara et al., 2017). The foundation of the research is found in several articles collected from different websites. According …

Effectiveness Of Staff Training On Trauma-Informed Care, Brandy Tramel Williams

Doctoral Projects

The connection between experiencing trauma and the development of substance use disorder is widely recognized. Although trauma is more prevalent among individuals with substance use disorders, healthcare professionals have limited access to training focused on trauma informed care. It is crucial for those working in addiction treatment to receive training and education on trauma informed care to understand the impact of trauma and its association with substance use disorders.

This DNP project's objective was to develop and evaluate an educational presentation for staff emphasizing the importance of trauma-informed care in the context of addiction. The effectiveness of this intervention was …

Early Identification Of Barriers To Medication Adherence In The Elderly Population Through The Use Of A Modified Screening Tool, Miranda Joyner, Blake Meranto

Doctoral Projects

Medication nonadherence (MNA) is a major contributor to hospitalizations and accounts for billions of dollars spent every year on health care. Despite medications being prescribed in nearly 75% of healthcare interactions, it is estimated that 33 to 50% of Americans do not take their medications as prescribed, if at all (Bartlett Ellis et al., 2020; Kleinsinger, 2018). The COM-B (Capability, Opportunity, Motivation, Behavior) Model used in this DNP project suggests that an individual must have the capability, opportunity, and motivation to enact a certain behavior, and should any of these areas be lacking, the behavior is unlikely to occur. This …

Pharmacotherapy For Opioid Use Disorder In Mississippi, Amanda Michelle Whitacre

Doctoral Projects

The opioid epidemic is affecting Mississippi’s young to middle-aged adult population in a profound way. Pharmacotherapy for opioid use disorder (OUD) is the gold standard treatment. Despite the FDA-approved evidence-based treatment of pharmacotherapy for OUD, rural areas often lack providers available who will initiate and provide maintenance of this life-saving medication. For this doctoral project, a 36-question survey was developed based on a preliminary literature review. The survey was disseminated to advanced practice registered nurses (APRNs) in the family and psychiatric specialties across Mississippi to assess the barriers to APRNs filling the gap in pharmacotherapy prescribing for OUD. A continuing …

Lateral Decubitus And Prone Positioning: An Objective Structured Clinical Evaluation, David Hesley-Hernandez, James Bailey

Doctoral Projects

Improper positioning of patients in the lateral decubitus or prone positions can lead to significant complications, including but not limited to: airway and invasive line loss, physiologic derangements, soft tissue injury, and peripheral nerve injuries (PNI) (Barash et al., 2017; Butterworth et al., 2018). Chui et al.’s (2018) analysis found that PNIs accounted for 12% of anesthesia malpractice since 1990, making PNIs costly. PNIs effects are not limited to cost and result in increased lengths of stay, increased pain levels, and decreased quality of life (Wojtkiewicz et al., 2015). The massive effect poor positioning can have requires that the anesthesia …

Objective Structured Clinical Examination For Intraoperative Hypotension And Hypertension Management, Andrew Mcginity, James David Ingram

Doctoral Projects

Managing intraoperative hypotension and hypertension is a non-technical skill anesthesia providers need to maintain patient safety. Upon transitioning from didactic training to clinical training, SRNAs may find it difficult to manage a patient’s blood pressure intraoperatively. The ultimate consequence of the delayed or improper treatment of intraoperative blood pressure perturbations is end-organ damage at the patient’s expense. Unintentionally causing a patient harm will lead to an SRNA losing confidence in their abilities. This OSCE is intended to increase SRNA confidence and competence regarding intraoperative hypotension and hypertension management before entering the clinical arena.

The hypotension and hypertension management tools and …

Blind Spot: Implicit Bias In Health Care And Its Awareness Among Nursing Students At The University Of Southern Mississippi, Debora Skaliks

Doctoral Projects

While prejudice and bias are eminent topics in our society, implicit bias or unconscious bias is not as easily detected. Even though implicit bias may be a familiar concept to many, numerous healthcare workers frequently do not recognize the extent of harm such biases can impose on patients' health and outcomes. The Blind Spot DNP project exposed in this research paper explores the relentless question of the correlation between implicit bias awareness, implicit bias education, and its impact on health care. This Doctor of Nursing Project (DNP) project aimed to analyze whether implicit bias education and testing could increase unconscious …

Improving Patient Outcomes In Substance Use Disorder Through Behavioral Therapy In Depression Development And Impacts Of Social Determinants Of Health During And After Substance Use Treatment, Jerry Ryan Armstrong, Chyanne Napp

Doctoral Projects

Substance Use Disorder (SUD) is a growing problem in the United States (U.S.) and worldwide and relapse is a common occurrence among those facing SUD. Limited scholarly research has been published addressing evidence-based treatment improvement strategies. This study focused on improving SUD treatment through the incorporation of depression tracking from admission to and discharge from inpatient treatment, as well as the incorporation of social determinants of health education during treatment, with an evaluation of relapse rates 30-days after inpatient treatment discharge. Results indicated a significant improvement in depression scores from admission to discharge. Results also revealed improved knowledge regarding social …

Objective Structured Clinical Evaluation For Volume Control And Pressure Control Ventilator Modes, Brian Bailey, Anthony Newsom

Doctoral Projects

The purpose of this doctoral project was to create a tool to teach student registered nurse anesthetists (SRNAs) in The University of Sothern Mississippi’s (USM’s) anesthesia program about pressure control and volume control ventilator modes, and how to use them. To accomplish this goal an Objective Structured Clinical Examination (OSCE) was developed. The framework used for creating this OSCE was Kolb's Theory. Kolb's Theory uses a four-stage learning cycle in which the learner encounters a new experience, reflects on the observations of said new experience, conceptualizes or modifies a concept based on this experience, and then applies their idea to …

Telemedicine Perception: An Identification And Evaluation Of Factors Contributing To The Use Of Telemedicine Services, Katherine Lewing

Doctoral Projects

A morbidity and mortality report made by the Centers for Disease Control (CDC) on the impact of telehealth services during the COVID-19 pandemic throughout 2020 noted several instances in which telemedicine tools had contributed to improved patient outcomes, including: increasing the availability of care to patients otherwise left with little access to health care, decreasing unnecessary patient visits, and reduced disease exposure to patients and staff directly at risk (CDC, 2020).

As the utilization of telemedicine becomes more important and prevalent in U.S. health care systems, it is important to recognize factors that inhibit patient usage. Factors such as inadequate …

Objective Structured Clinical Examination For Arterial Line Placement, Delorean Calloway

Doctoral Projects

The University of Southern Mississippi (USM) is lacking a uniform guideline for arterial line placement. This DNP project promotes the addition of an objective clinical structured examination into the nurse anesthesia curriculum for future student registered nurse anesthetists (SRNAs) to gain comprehension and clinical experience in a simulation lab prior to practicing on real patients. Peer-reviewed literature and evidence-based practices have been researched and organized into a learning tool and checklist to be used as a step-by-step guideline. Having a guideline such as an OSCE in place can increase student competency and foster a culture of safety leading to better …

Quality Improvement For Patients With Alcohol Withdrawal Syndrome Starts With An Evaluation Tool, Jessica Bass

Doctoral Projects

Patients with alcohol withdrawal syndrome (AWS) have adverse outcomes to the traditional methods of assessing for and treating withdrawal within the intensive care unit (ICU), which includes a standardized treatment plan. Some negative outcomes include acquiring costly and dangerous hospital-acquired infections, safety concerns, and traumatic experiences that deter further treatment. More individualized assessments and treatments are needed to prevent or decrease the severity of AWS from occurring in critical care settings, which will facilitate more positive outcomes and experiences for the staff and patients. The Minnesota detoxification scale has been shown to be a more appropriate tool for the critical …

Improving Diagnosis And Treatment Of Prediabetes Among Primary Care Providers By Increasing Awareness Of Prediabetes Education, Sonia Walker

Doctoral Projects

Prediabetes is a precursor to diabetes and requires treatment most of the time. Prediabetes is a health condition characterized by high blood sugar levels, but it has not developed into type 2 diabetes mellitus (T2DM). According to the Centers for Disease Control and Prevention (CDC) recent estimates, about 88 million Americans have prediabetes (CDC, 2020). This project's main aims were to determine the effectiveness of implementing a structured prediabetes education intervention in diagnosing and screening prediabetes among primary care providers caring for African American females (AA) aged 30 to 60 years. Moreover, to evaluate the outcomes of implementing the educational …

Improve Primary Care Advanced Practice Nurse's Knowledge Of Depression By Educational Interventions And Treatment Recommendations, Dorothy Adams

Doctoral Projects

Poor medication adherence is one of the significant barriers to treatment for depression, often due to fears about side effects and insufficient knowledge among nurses. Educating primary care advanced practice nurses can help to improve understanding about symptoms of depression and the treatment recommendations. Education can help engage the primary care advanced practice nurses to improve patient understanding and thereby support better adherence measured as improved refill rates and follow-up reports. The refill rates will show if the patients under the primary care advanced practice nurses ‘care have been following the medications prescribed in the right frequency and dosage. The …

Decreasing Hospital Readmission With Post-Hospital Discharge Primary Care Clinic Appointments, David Snodgrass

Doctoral Projects

ABSTRACT

The Centers for Medicare and Medicaid Services (CMS) continue to apply costly financial penalties for hospital readmission. Hospital readmission can stem from multiple causes which can lead to poor health outcomes or increased healthcare financial costs. However, with the use of an implemented 14-day post-hospital follow-up appointment with a primary care provider, hospital readmission could be reduced, and patient care improved. The multiple factors that can lead to hospital readmission include non-adherence to medication, socioeconomic factors, patient-related factors, condition-related factors, or health system-related factors. Through the implementation of post-hospital discharge follow-up visits within 14 days of discharge, hospital readmissions …

A Quality Improvement Project: Streamlining The Post-Surgical Process In Total Knee And Hip Replacements With An Evidence-Based Guidance And Practice Protocol, Bianca Bullie

Doctoral Projects

ABSTRACT

The rates of total joint replacements, such as total knee arthroplasty (TKA) and total hip arthroplasty (THA), are on the rise in the United States and are expected to rise further in the next 20 years (Singh et al., 2019). Implementing an ERAS protocol coupled with current orthopedic practices will decrease a vast number of postoperative issues such as length of hospital stays, the financial burden on the facility, and overall patient satisfaction. The DNP project proposed a multidisciplinary protocol to standardize the care of patients undergoing THA or TKA and identified if this surgical process would be adopted …

Improving Compliance With Treatments For End-Stage Renal Disease Patients On Hemodialysis, Susan Blakeney

Doctoral Projects

According to Blumrosen et al. (2020), the dialysis population cost expenditure is greater than “seven percent of the Medicare budget at nearly $40 billion a year” even though this population is “less than one percent of the Medicare population” (p. 1436). Additionally, the renal disease population is growing in the United States and internationally which contributes to rising healthcare costs around the globe (Levin, 2018).

The purpose of this Doctor of Nursing Practice (DNP) project was to identify the factors or reasons hemodialysis patients miss treatments or only stay for partial treatment. Hemodialysis patients are required to have treatments three …

Full Practice Authority: Determining Readiness Among Nurse Practitioner Students In Mississippi, Betty Hoffman

Doctoral Projects

Full practice authority has been granted to nurse practitioners by many states. These practitioners are educated and trained as full primary providers of health care. Full practice authority for nurse practitioners is not granted in Mississippi, which currently ranks in the lowest positions for health care in the United States. The low ranking can be attributed to a lack of providers and access to services.

This project seeks to explore attitudes and understanding of nurse practitioner students in the State of Mississippi regarding full practice authority. A survey will be electronically distributed to determine what is already known and understood …

Implementation Of A Pre-Anesthesia Take-Home Evaluation (Pathe) As A Means Of Process Improvement: A Best Practice Recommendation, Russell Gray, Hunter Brown, Trey Galloway

Doctoral Projects

The pre-anesthesia evaluation (PAE) is a vital component to anesthesia providers when choosing an appropriate anesthetic plan for patients requiring surgery. The PAE, pre-anesthesia risk-factor assessment, and provision of pre-anesthesia instructions are standards of care implemented in order to assess the patient’s likely outcome of surgery and anesthesia as well as stratify any known risk factors to optimize surgical/anesthetic outcomes. Any disruption in this process could potentially lead to decreased patient/provider satisfaction, reduced patient compliance with pre-anesthetic instructions, reduced patient safety, and unnecessary financial burden.

After the completion of a literature review, the need for a best practice recommendation was …

Evidence-Based Update In Practice Development Of A Nursing Checklist For Documentation Of Pediatric Pre-Operative Fall Safety Measures, Susan Shemper

Doctoral Projects

ABSTRACT

Fall safety is an important component of patient care in the healthcare setting. Communication and implementation of fall safety measures are a critical part of the plan of care for each patient. Pre-operative pediatric patients have an increased risk of falls due to sedation, under-developed motor skills, and fall safety education. It is important for the pre-operative nursing staff to evaluate and implement a plan of care, including fall safety measures, according to each patient’s needs. The Joint Commission, (additionally known as TJC), is a United States based nonprofit, tax-exempt 501(c)(3) organization that accredits more than 22,000 U.S. healthcare …

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 …

Objective Structured Clinical Evaluation For Supraclavicular And Femoral Nerve Blocks Utilizing Ultrasound Guidance For Student Nurse Anesthetists, Mitchell Fowler, Christopher Bond

Doctoral Projects

The purpose of this DNP project was to create a tool to teach and evaluate student registered nurse anesthetists (SRNAs) at TheUniversity of Southern Mississippi (USM) on supraclavicular and femoral nerve blocks to promote safety in the clinical setting. An objective structured clinical evaluation (OSCE) for ultrasound-guided supraclavicular and femoral nerve blocks was created as the basis for this project. Best-practice techniques as identified by the AANA’s 14^thstandard of nurse anesthesia practice were researched and used in the development of the OSCE to promote a culture of safety for SRNAs and patients (AANA, 2019).

A culture of safety …

Best Practice Recommendation On Anesthesia Involvement In Preoperative Interdisciplinary Rounding On Surgical Inpatients, Elizabeth Davis

Doctoral Projects

Healthcare professionals are always seeking methods to improve patient care and patient outcomes and increase efficiency while reducing errors. By improving communication through the implementation of interdisciplinary communication, improved care quality, fewer variations in care, and enhanced collaboration among the healthcare team may be an outcome (Hoke & Falk, 2012). While anesthesia is involved in patient care throughout the perioperative period, their expertise may impact the patient’s outcome and quality of surgical care. With the involvement of anesthesia in interdisciplinary rounding, the patient may be optimized, and the plan of care may be more appropriate and individualized.

The potential for …