Medicine and Health Sciences Commons^™

Building Thriving Healthcare Teams Through Organizational Learning, Bret Lyman, Marie M. Prothero, Adrianna L. Watson

Faculty Publications

The purpose of this article is to provide practical steps nurse leaders can use to build thriving healthcare teams through organizational learning. The climate, culture, and activities associated with organizational learning are well-aligned with those needed to build thriving teams. Nurse leaders who leverage this alignment can effectively recruit and retain teams while enhancing their team’s ability to effectively navigate change.

In The Name Of Riwaj: An Ethnographic Study To Explore The Notion Of Women Empowerment Among Bisp Recipients In Rural Sakhro-Sindh, Pakistan, Qurratulain Nasiruddin, Rozina Karmaliani, Nasim Zahid Shah, Tazeen Saeed Ali

School of Nursing & Midwifery

Women empowerment is a national agenda for Pakistan and, one of its manifestations is the nationwide cash transfer program namely Benazir Income Support Programme (BISP). With the help of Bourdieu methodological paradigm of “habitus” this paper analyses empowerment among BISP recipients in their social settings where various social actors such as her husband and wadera of the village dominate her agency but, at the same time, women herself submits her agency to these social actors under the veil of riwaj (social customs). This ethnographic study reveals that the performance of submission among women follows an inner drive for conformation to …

The Wear And Tear Of Racism: Self-Silencing From The Perspective Of Young Black Women, Jewel Scott Phd, Rn, Fnp-C, Kortney Floyd James, Dara D. Méndez, Ragan Johnson, Esa M. Davis

Faculty Publications

Context: Historically, Black women strategically employed silence to endure enslavement to the U.S., and other forms of racial violence. The current study aimed to understand contemporary perspectives on self-silencing. Objective: To explore young adult Black women's experiences of self-silencing and its potential impact on their physical and mental well-being. Methods: Data are from 16 semi-structured interviews with Black women ages 18 to 39 in southwest Pennsylvania conducted between October 2021 - May 2022. We analyzed the interviews using inductive thematic analysis. Results: We identified four themes: “Self-silencing is Inherited,” “Silencing Here and Now,” “Wear and Tear,” and “The Flip Side.” …

Spirituality Education For End Of Life Clinicians: A Quality Improvement Project, Mark S. Valigorsky

DNP Projects

Significance and Background: The focus of this project was to strength the knowledge, comfort, and training of end of life(EOL) clinicians working with patients in the palliative care and hospice environments. While spirituality is considered one of the essential domains of hospice care, it is an area that is often brushed aside by staff and patients and their families. Spirituality is inadequately addressed due to knowledge deficits, time issues, and lack of self-efficacy. Addressing spiritual care is particularly important for patients with chronic and end stage illnesses. Patients and their families view spirituality as a way of coping with suffering. …

Never-Ending Parenting: Challenges Experienced By Caregivers Of Adults With Severe Autism, Andrea Palerino

Dissertations, Theses, and Capstone Projects

Despite the large number of children with autism spectrum disorder (ASD) who are annually aging out of the school-based systems in the United States, much of the academic literature has been focused on the concerns and challenges of preschool or school-aged children with ASD. As a result, there lacks a clear understanding of how primary caregivers of adult children with severe autism spectrum disorder (SASD) utilize various forms of capital to navigate care.

This qualitative descriptive study explored some of the challenges experienced by primary caregivers of adult children with SASD. Convenience sampling was used to conduct semi-structured interviews with …

Gender Role Conflict, Campus Climate, And Satisfaction Among Male Undergraduate Nursing Students, Randelle Sasa

Dissertations, Theses, and Capstone Projects

Background. Gender role conflict (GRC) has been identified in the literature as a contributing factor to male undergraduate students’ dissatisfaction with the nursing program. Utilizing Bandura’s social cognitive theory as guiding framework, this study examined the relationships between GRC, campus climate (CC), satisfaction with the nursing program (SS), and demographic factors among male undergraduate nursing students. Understanding the associations between these variables may inform success initiatives for these at-risk students.

Methods. A cross-sectional survey was developed from valid and reliable instruments. The Gender Role Conflict Scale – Short Form measured GRC; the adapted Inventory of Male Friendliness in Nursing Programs …

Social Identities And Campus Belonging As Predictors Of Flourishing Among College Students, Christine Gilchrist

Dissertations, Theses, and Capstone Projects

Annual data since 2012 shows college students’ flourishing (a measure of psychological well-being) in continuous decline, with 2022 showing the largest decrease. Since the knowledge base of the predictors of flourishing is limited, how college executives can best address this issue is unclear. Variations in flourishing have been observed in studies that examined the relationship between food insecurity (DeBate et al., 2021), race/ethnicity (Lipson et al., 2018, 2022; Nyunt et al., 2022; Parr, 2022), immigration status (Cadenas & Nienhusser, 2021), as well as gender identity and sexual orientation (Parr, 2022). The intersectional impact of demographic and social identities has not …

The Effects Of Music Therapy On Elderly Adults With Dementia, Jeante J. Jackson

Dissertations, Theses, and Capstone Projects

As people age, the brain is more susceptible to changes that diminish cognitive function. In recent years neuroscience has found convergent evidence between music therapy and brain architecture, as it has shown the generation of new connections in the brain or a reorganization and possible strengthening of existing connections already in the brain. However, the literature regarding music training’s effects on executive control, selective attention, and speech processing is lacking particularly when it comes to older populations.

This study investigated Verbal Working Memory, Visuospatial Attention and Task Initiation, and Auditory Selective Attention in a 91-year-old adult (B.P.) diagnosed with dementia. …

Reducing Acute Kidney Injuries In The Cardiovascular Intensive Care Unit By Implementing A Nurse Driven Hydration Protocol, Chelsea N. Singleton

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this project was to implement a nurse-driven hydration protocol to potentially decrease the risk of acute kidney injuries (AKI) in patients undergoing contrast procedures, which in turn should reduce length of stay.

Background

The project was implemented in a CVICU and Cardiac Catheterization Lab (CCL) Lab in an academic center in Houston, Texas.

Methodology

The project utilized Lean Six Sigma methodology and SBAR communication among staff utilizing a nurse-driven protocol to ensure hydration orders were activated during pre- and post- procedure. The staff were educated on how to implement the protocol prior to the start of …

Commencement Program 2023, Loma Linda University

Commencement Programs

CONTENTS

1 | Message from the President

3 | 2023 Events of Commencement

5 | The Academic Procession

6 | Institutional Administration

7 | Board of Trustees

8 | Significance of Academic Regalia

9 | University History Highlights

11 | Criteria for Institutional Awards

13 | Loma Linda University Health and Loma Linda University Honorees

25 | The Program, The School Honorees, and The Speakers

• School of Medicine, 26
• School of Pharmacy, 52
• School of Dentistry, 69
• School of Public Health, 93
• San Manuel Gateway College, 108
• School of Allied Health Professions—Allied Health Studies, Cardiopulmonary Sciences, Clinical Laboratory Science, Communication …

Effect Of Preoperative Skin Cleansing On Instances Of Surgical Site Infections, Katie Armington, Jessica Blank, Madison Waterhouse, Cynthia Gavett, Hailey Tofflemoyer, Rachelle Cassidy, Lindsay Bushnell, Jennifer Barriere, Anastasia Colbath

Nurse Residency

Background

• On a single square centimeter of skin, there can be as many as 10 million aerobic bacteria

• Bacteria on a patient’s skin is the leading cause of infection related to surgery

• 17% of all hospital acquired infections come from surgical site infections

• Surgical site infections cost about $3,000 $29,000 per patient

Building Thriving Healthcare Teams Through Organizational Learning, Bret Lyman, Marie M. Prothero, Adrianna L. Watson

Faculty Publications

The purpose of this article is to provide practical steps nurse leaders can use to build thriving healthcare teams through organizational learning. The climate, culture, and activities associated with organizational learning are well-aligned with those needed to build thriving teams. Nurse leaders who leverage this alignment can effectively recruit and retain teams while enhancing their team’s ability to effectively navigate change.

The Lived Experience Of Using Opiates Among Young Adults, Catherine Mbewe

Dissertations, Theses, and Capstone Projects

The purpose of this research study is to explore the lived experience of using opiates, as described by young adults aged 18 to 25 years. Over the last 2 decades, opioid use disorders (OUDs) and opiate overdose deaths have increased dramatically in the United States. What used to be a problem primarily contained to minority groups in poor inner-city areas is now increasingly common in all races, genders, ages, and classes. There has also been an alarming increase in opiate use—including fentanyl, both legal and illegal—among young adults. While much of the literature has been focused on the opiate use …

Relationship Between Angiotensin-Converting Enzyme Inhibitors And Angiotensin Receptor Blockers Prescribing And Delirium In The Icu-A Secondary Analysis, Malissa A. Mulkey Phd, Aprn, Ccns, Ccrn, Cnrn, Sikandar Khan, Anthony Perkins, Sujuan Gao, Sophia Wang, Noll Campbell, Babar Khan

Publications

As many as 80% of critically ill patients develop delirium increasing the need for institutionalization and higher morbidity and mortality. Clinicians detect less than 40% of delirium when using a validated screening tool. EEG is the criterion standard but is resource intensive thus not feasible for widespread delirium monitoring. This study evaluated the use of limited-lead rapid-response EEG and supervised deep learning methods with vision transformer to predict delirium. This proof-of-concept study used a prospective design to evaluate use of supervised deep learning with vision transformer and a rapid-response EEG device for predicting delirium in mechanically ventilated critically ill older …

“Ain't About The Money, Ain't About The Haircut”: Experiences Of Servant Leadership In Black-Owned Barbershops And Beauty Salons During The Covid-19 Pandemic, Hunter M. Boehme, Robin M. Dawson Phd, Rn, Cpnp-Pc, Tameka Williams, Lídia Gual-Gonzalez, Chloe Rodriguez-Ramos, Natalie Brown, Bryceson Hernandez, Lekendra Kidd, Melissa S. Nolan Ph.D., Mph

Publications

The COVID-19 pandemic had a disproportionate, negative effect on Black Americans. Black-owned barbershops/beauty salons are traditionally trusted, yet little is known regarding how these “virtue locales” were affected by the pandemic. This theory-guided, qualitative descriptive study explored owners' experiences in addressing their clients’ and community well-being during the first pandemic year, revealing four emergent themes: 1) “blessings” and cultural expectations informed a moral imperative to become servant leaders, 2) long-standing relationships resulted in opportunities to engage on topics of physical and mental health, 3) Barbershop/beauty salon-based COVID-19 information and resources led to individual and community empowerment, and 4) Barbershops and …

Getting A Grip On Safewards: The Cross Impact Of Clinical Supervision And Safewards Model On Clinical Practice, Jennifer Hamilton, Amanda Cole, Richard Bostwick, Irene Ngune

Research outputs 2022 to 2026

The Safewards model is used across various mental health settings to reduce incidents of conflict and containment and its efficacy in reducing the use of seclusion and restraint, improving patients' experiences of care, and enhancing safety within clinical settings is well documented (Bowers, Journal of Psychiatric & Mental Health Nursing, 21, 2014, 499). However, there are barriers to successful implementation, including level of staff buy-in (Baumgardt et al., Frontiers in Psychiatry, 10, 2019, 340; Price et al., Mental Health Practice, 19, 2016, 14). This mixed-method study assessed the impact of adopting a Safewards model within a clinical supervision framework in …

The Factors Associated With Caesarean Section At A Rural Hospital In Southwestern Uganda: A Cross-Sectional Study, Lilian Nuwabaine, Mathius Amperiize, Patience Annet Nakalega

School of Nursing & Midwifery, East Africa

Background

Globally, the overall prevalence of caesarean section (CS) is estimated at 18.6%, with 27% in high-income countries and 6% in low- and middle-income countries. There is an increase in trends of CS in Uganda from 8.5% in 2012 to 11% in 2016. No studies have been carried out to account for the high rates of CS at Kisiizi Hospital in Uganda. This study determined the proportion and factors associated with CS delivery at a rural hospital in southwestern Uganda.

Methods

This was a cross-sectional study of 321 immediate postnatal women in a rural hospital in southwestern Uganda. A structured …

Mitigating Risks To Improve Hypertension Medication Adherence In A Medically Vulnerable Population, Donna Hales-Teat

Doctor of Nursing Practice Projects

This project assessed the effect of an evidence-based medication adherence intervention on adherence rates at a Northern Indiana clinic led by a sole nurse practitioner, receptionist, and continuous rotation of graduate nursing students from several nursing programs in the Northern Indiana area. Patient education and comprehension were poor in terms of understanding disease process, treatment options, and disease management that led to poor communication with the medical provider. The process and steps in which patients matriculate through was described by Johnson’s (2002) Medication Adherence Model (MAM) with concepts of purposeful action, pattern behavior, and feedback; these helped to construct, steer, …

Association Between Early Prostacyclin Therapy And Extracorporeal Life Support Use In Patients With Congenital Diaphragmatic Hernia, Akila B Ramaraj, Samuel E Rice-Townsend, Carrie L Foster, Delphine Yung, Emma O Jackson, Ashley H Ebanks, Matthew T Harting, Rebecca A Stark, Congenital Diaphragmatic Hernia Study Group

Faculty, Staff and Student Publications

IMPORTANCE: Prostacyclin (PGI2) is a therapeutic option to treat congenital diaphragmatic hernia (CDH)-associated pulmonary hypertension in neonates. Its use may decrease the need for extracorporeal life support (ECLS).

OBJECTIVE: To evaluate the association of early PGI2 therapy with ECLS use and outcomes among patients with CDH.

DESIGN, SETTING, AND PARTICIPANTS: This was a cohort study from the CDH Study Group (CDHSG) registry of patients born from January 2007 to December 2019. Patients were from 88 different tertiary pediatric referral centers worldwide that contributed data to the CDHSG. Patients were included in the study if they were admitted within the first …

Influence Of Depression And Interpersonal Support On Adherence To Antiretroviral Therapy Among People Living With Hiv, Jerry John Nutor, Akua O. Gyamerah, Robert Kaba Alhassan, Henry Ofori Duah, Rachel G.A. Thompson, Natalie Wilson, Orlando Harris, Jose Gutierrez, Thomas J. Hoffmann, Monica Getahun, Glenn-Milo Santos

College of Nursing Faculty Research and Publications

Background

Poor adherence and under-utilization of antiretroviral therapy (ART) services have been major setbacks to achieving 95-95-95 policy goals in Sub-Saharan Africa. Social support and mental health challenges may serve as barriers to accessing and adhering to ART but are under-studied in low-income countries. The purpose of this study was to examine the association of interpersonal support and depression scores with adherence to ART among persons living with HIV (PLWH) in the Volta region of Ghana.

Methods

We conducted a cross-sectional survey among 181 PLWH 18 years or older who receive care at an ART clinic between November 2021 and …

Carboplasty, A Minimally Invasive Procedure For Knee Osteoarthritis: Surgical Technique And Clinical Evidence, Antonio Madrazo-Ibarra, David A. Kolin, Tracey Hunter, Joseph A. Ogyaadu, Henry Ofori Duah, Henry O. Tutu, Anthony Bandoh, Prudence Nutsuklo, Kwadwo Boachie-Adjei, Kaitlin M. Carroll, Amoli Vad, Eric Zhao, Vijay B. Vad

College of Nursing Faculty Research and Publications

Knee osteoarthritis affects ~16% of adults in the world and is considered one of the most incapacitating diseases. Despite the advances in scientific knowledge and biological treatments in the field of orthopedics, available nonsurgical treatments for knee osteoarthritis are limited and still ineffective in delaying or stopping the progression of arthritis. Biologics such as platelet-rich plasma, bone marrow aspirate, and progenitor cells have emerged as potential treatments for osteoarthritis; however, the results are still not as expected. Carboplasty is a new treatment that involves the application of bone marrow aspirate into the bone-cartilage interface and intra-articularly, with the intention of …

The Early Impact Of Covid-19 On Intensive Care Nurses’ Personal And Professional Well-Being: A Qualitative Study, Kelly Calkins, Jill L. Guttormson, Natalie S. Mcandrew, Holly Losurdo, Danielle Loonsfoot, Shania Schmitz, Jacklynn M. Fitzgerald

College of Nursing Faculty Research and Publications

Objective

To describe the impact of the COVID-19 pandemic on intensive care nurses personal and professional well-being.

Research Methodology/Design

A descriptive, qualitative design was used. Two nurse researchers conducted one-on-one interviews via Zoom or TEAMS using a semi-structured interview guide.

Setting

Thirteen nurses who were working in an intensive care unit in the United States participated in the study. A convenience sample of nurses who completed a survey in the larger parent study provided an email and were contacted by the research team to participate in interviews to discuss their experiences.

Main Outcome Measures

An inductive approach to content analysis …

Fostering Resilience In Children Of United States Navy Seals Using A Social Media Platform, Riley Walker

Doctor of Nursing Practice Final Manuscripts

Background: Having resilience helps children overcome, cope, and manage stressors that they encounter throughout life and provides intrinsically protective factors to help a child thrive in the face of adversity.

Local problem: Children of United States Navy Sea, Air, and Land Operators (SEALs) face consistent stress as their parent is away from home more than 240 days per year doing high-risk training exercises.

Methods: Resilience education to mothers of children whose fathers are United States Navy SEALs delivered virtually on a social media platform. Pre- and post- intervention surveys using the Likert scale were conducted to measure the mothers’ understanding …

Nurse-Led Post Stroke Depression Screening (Psd) For Patients With Acute Stroke Using Patient Health Questionnaire-9 (Phq9), Stefan Panov

Doctor of Nursing Practice Final Manuscripts

Introduction: This Evidence-Based Practice Doctor of Nursing Practice project aimed to implement a nurse-led post-stroke depression (PSD) screening using Patient Health Queastionnaire-9 (PHQ-9) in a 12-bed progressive care neuro-stroke unit at a tertiary care hospital. The first goal of this project was to detect stroke patients at risk for depression who met specific inclusion criteria. The second goal was to provide depression education, initiate social work and medical referrals, and start pharmacological treatment to reduce the medical and socioeconomic burden associated with untreated PSD before discharge from the hospital.

Background: Globally, stroke is a prominent cause of death and disability. …

Wound Care For Unhoused Youth, Diana Altman, Monse Villasenor, Grace Fry, Maddy Johnson, Matthew Messenger

Nursing Leadership in Community Engagement Projects

Wound Care For Unhoused Youth

Introduction

We partnered with a non-profit organization designed to serve the unhoused youth, ages 18-25, who have a day program as well as an overnight shelter. They have 30 beds and reserve 20 of those beds for individuals who are “residents,” who commit to staying for several nights and work towards finding more permanent options. The other 10 beds are for individuals to use for a single night, but these are not always guaranteed, you must sign up to save a spot. The day program has various activities ranging from painting to resume workshops and …

Women’S Shelter Health Needs Assessment, Asmait Woldu, Kelly Dona, Anna Frediani, Andrea Herrejon-Duran

Nursing Leadership in Community Engagement Projects

Women’s Shelter Health Needs Assessment

Introduction

Homelessness is currently one of the biggest societal issues in the United States and evidence indicates it is increasing, particularly for women (McGeough et al., 2020). A group of nursing students from Seattle Pacific University teamed up with a women’s homeless shelter in a Metropolitan city. The agency provides shelter and warm meals as well as laundry, toiletries, bus tickets and more. But even with the resources that they do provide, the residents have other needs that are not fully met, particularly with regard to their health. This is due in large to a …

Benefits Of Using An Upright Laboring Position As Compared To Supine In The Second Stage Of Labor And The Impact On The Use Of Assisted Devices, Chelsey Cook

Master of Science in Nursing Family Nurse Practitioner

Abstract: This paper explores the conclusion that women and their infants are at an increased risk for harm when assisted devices are used during the second stage of labor. Traditional practices involving a supine position during pushing have been associated with an elevated likelihood of assisted delivery, necessitating interventions such as forceps, vacuum extraction, or episiotomy. However, emerging evidence suggests that adopting an upright position during labor may help decrease the need for these interventions and positively impact maternal and fetal outcomes.

Although comprehensive research on this topic is limited, the available evidence supports the benefits of an upright position …

Amniotic Fluid Embolism Diagnosis & Treatment Pathway, Jeremy May

Doctor of Nursing Practice Projects

Access to care in rural areas can prove difficult for any patient, but especially for the expecting mother. Healthcare providers in these rural settings often lack the staffing and experience to effectively recognize and treat rare obstetric emergencies. Amniotic fluid embolism (AFE) is a rare medical emergency that requires healthcare providers to rapidly diagnose, monitor, and treat the sequela of resulting symptoms in the obstetric patient. After a literature review, a teaching session was developed and implemented as part of the annual training for 20 nursing staff at a small 50-bed rural hospital in central California. An 8-question pre-test was …

Group-Based Interventions Using A Low-Fat Diabetes Diet To Improve Self-Efficacy And Hba1c Levels In African American Type 2 Diabetics, Linda Baker-Bynum

Doctor of Nursing Practice Projects

Background and Problem

Type two diabetes mellitus (T2DM) is a chronic medical condition of impaired glucose metabolism that has significantly impacted the health of Americans. According to Centers for Disease Control and Prevention (CDC), T2DM is the seventh leading cause of death making up over 270,000 deaths in 2017 (CDC, 2020a). There are noted disparities among African Americans who are disproportionately affected by T2DM more than Caucasians. African Americans account for 13% of the population in the United States of which 11.7% are diagnosed with T2DM as compared to Caucasians who make up 76.3% of the population of which 7.5% …

Self Management Programs And Its Effects On Blood Pressure, Thao Vo

Master of Science in Nursing Family Nurse Practitioner

No abstract provided.