Medicine and Health Sciences Commons^™

Identifying Unnecessary And Excessive Use Of Intravenous Heparin For The Treatment Of Intermediate-Risk Pulmonary Embolism, Youssef Elfatatry, Ryan Gardner, Chukwuemezie Kamanu, Ruben Rhoades

Health Equity and Quality Improvement (HEQI) Summit

Problem Statement

- Intermediate-risk pulmonary embolism (PE) is a diagnosis with heterogenous presentations and mortality rates ranging from 2% to 15%.

- European Society of Cardiology (ESC) guidelines recommend low-molecular weight heparin (LMWH) as first line therapy in most patients. Despite this, the use of IV heparin in intermediate-risk PE remains widespread, due to uncertainty regarding patients receiving further procedures and mitigation of bleeding risk.

Project AIM:

- We aim to (1) identify prescribing patterns and outcomes of anticoagulant therapy on admission, and (2) propose and implement a "PE Care Pathway" in EPIC to address uncertainty in risk-stratifying and treating …

Post-Operative Management Of Chronic Subdural Hematomas, Steven R. Glener, Md

Health Equity and Quality Improvement (HEQI) Summit

Primary Objective & Outcome Measures

Objective: Identify standard of care for post-operative subacute to chronic subdural hematomas (cSDH) that undergo burr hole evacuation

Primary outcomes:

• Rate of SDH recurrence requiring re-evacuation or MMA embolization

Secondary outcomes:

• LOS
• Readmission for a medical problem related to chronic subdural evacuation

Inpatient Thrombophilia Workup After Acute Vte: The Tests That Don’T Pay It Forward, Eliakim Munda, Bs, Ruben Rhoades, Md, Ms

Health Equity and Quality Improvement (HEQI) Summit

Background

• Venous thromboembolism is a complex multifactorial disease that is influenced by genetic, environmental and behavioral risk factors.
• Testing for inherited thrombophilia is commonly performed after a VTE event to help identify underlying genetic risk factors and assess the risk of recurrence.
• Despite clinical guidelines advising against thrombophilia testing in patients with acute VTE, these tests continue to be ordered even though lab results are unlikely to alter treatment decisions

Problem Statement

• At TJUH, activity and genetic assays are frequently ordered for patients with acute VTE during admission, increasing the likelihood of false- positive results that may lead to unnecessary …

Evaluating Scheduling Tool To Improve Behavioral Health Counseling Scheduling Rates On Same Day Of Referral, Edward Delesky, Md, Oluwatoni Okuboyejo, Md, Elizabeth Franko, Md, Nwamaka Amobi, Md, Ronak Ahir, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

• Studies suggest 1 in 5 adults in the US suffer from mental illness, with up to 46% of Philadelphia residents reporting poor mental health.
• Care integration beginning with primary care physician evaluation and management is becoming more common.
• Behavioral health counseling (BHC), provided by a primary physician and trained psychologist, is vital in management of mental health conditions.
• Studies suggest same-day scheduling of follow up appointments improves treatment adherence.
• Goal: improve BHC scheduling rates on same-day of initial referral across two practice teams

Reducing Symptomatic Postoperative Hyponatremia After Endoscopic Pituitary Tumor Surgery, Matthews Lan, Md, James J. Evans, Md, Christopher Farrell, Md, Richard Schmidt, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

Problem Statement: Postoperative moderate to severe hyponatremia is the most cause of readmission following transsphenoidal endoscopic resection of pituitary tumors, with reported rates up to 8%. The pathophysiology of water balance after pituitary tumor surgery is as below:

[See figure]

Although postoperative diabetes insipidus (resulting in hypernatremia) is a concern in the immediate postoperative period, this is often transient, and thus it has been proposed to implement a postoperative fluid restriction to prevent delayed hyponatremia

Safe Paralytic Reversal For Neurologic Examinations, Keenan Piper, Md

Health Equity and Quality Improvement (HEQI) Summit

AIM Statement

Institute a protocol for safe administration of sugammadex to obtain neurologic exams with a goal of 90% adherence and three or less agitation-related complications over a 6-month period

Teaming Up For Better Health: An Interprofessional Collaborative Approach To Older Adult Oral Care, Deborah Dowd, Jodie Lopez, Jennifer Goodman

Utah Conference on Community Engagement

Oral health is a critical component of overall health, significantly influencing systemic diseases and the quality of life in older adults. Conditions such as xerostomia, swallowing difficulties, and poor oral self-care are associated with aspiration pneumonia. Integrating oral health into healthcare in long-term care facilities (LTCFs) is essential for preventing various conditions and improving quality of life. Effective oral hygiene is crucial in avoiding non-ventilator hospital-associated pneumonia by reducing oral biofilm and lowering the risk of pneumonia. Nurses' knowledge and care in oral health across healthcare settings are vital for positive health outcomes. Revising nursing curricula to incorporate oral health …

Sevier County Adventures - Poster Presentation, Jori Kloosterman, Anna Gilliam

Utah Conference on Community Engagement

"The Sevier County Adventures is a community engagement series of events that are fun for all and center on 4 community-identified needs; mental health, substance abuse, suicide, and parenting/family relationships. Once a quarter in 2025, the USU Sevier County Extension Office and the Central Utah Health Department, in conjunction with other entities, will hold community events to provide resources and information that highlight a specific need from the 4 community-identified needs. 1-Mental Health Game Night – Participants will be given a resource packet with information on local providers and teams will play an escape room game box. 2-Home Run for …

Rays Of Resilience:Tbri® Nurture Group© Intervention For Improved Social-Emotional Development In Head Start, Madison Carlson

Occupational Therapy Capstone Presentations

Children exposed to adverse childhood experiences (ACEs) face challenges that impact their developmental trajectory, family dynamics, and occupational engagement (CDC, 2021a). Rays of Resilience is a trauma-informed occupational therapy capstone project designed to enhance social-emotional skills in preschoolers at a rural Head Start program guided by the TBRI® framework and the Person-Environment-Occupation (PEO) model. Using Nurture Group© small group intervention, collaboration with staff, and engagement with caregivers, this project targeted social-emotional development and relationship building in children with a higher risk of adverse childhood experiences (ACEs). Fifteen students participated in weekly lessons focused on self-regulation, identifying emotions, and communicating wants …

Communication Matters! Exploring Experiences Of Non-English Language Preferred Families In The Neonatal And Pediatric Intensive Care Units, Sana Haq, Erin Cohen, Susan Schmidt, Rochanak Moassabeb, Folasade Kehinde

St. Chris Research Day

No abstract provided.

Mesoderm-Specific Transcript Has A Role In The Systemic Regulation Of Obesity, Maria J. Orellana Rosales

Thinking Matters Symposium

Mesoderm specific transcript (Mest) expression in white adipose tissue (WAT) is variable in genetically identical mice. Previous studies have shown a connection between Mest high expression and propensity for fat mass expansion. WAT and liver crosstalk has been well documented with hormone-like peptides signaling and regulating important metabolic pathways. The aim of this study is to investigate the correlation between these circulating factors and Mest expression in mice after exposure to a high fat diet (HFD). A group of 120 C57B6/J mice, males and females, were exposed to a HFD (Western Diet, 40 kcal% fat) for 4 weeks (8-12 weeks …

Infections And Patient Satisfaction For Walant Hand Surgery In Hospital Procedure Room, Michaela Derby, Kelly N. Mcknight, Robert E. Van Demark Jr.

Scholarship Pathways Program

Background: Wide awake hand surgery has allowed many hand procedures to be moved out of the operating room and into minor procedure rooms while increasing efficiency, maintaining safety, and reducing both patient and hospital costs. The goal of this study was to evaluate patient satisfaction and postoperative complications of wide-awake local anesthesia with no tourniquet procedures performed in a community-based hospital procedure room.

Methods: A total of 786 patients underwent 948 elective hand procedures in a hospital procedure room. At the conclusion of their surgeries, the patients were surveyed regarding their satisfaction. Following surgery, patients were evaluated for postoperative complications …

Silent Sparks: Gaining Clinical Experience To Implement An Occupation-Based Program In A Birth-3 Group With Deaf/Hard-Of-Hearing Children, Sydney Patrow, Moses Ikiugu

Occupational Therapy Capstone Presentations

This capstone project aimed to develop clinical skills and implement an occupation-based program for Deaf and hard-of-hearing (D/HH) children at Metro Deaf School in Saint Paul, Minnesota. Guided by the Dynamic Family Systems Model, Lifespan Development, and Sensory Integration Theory, the project emphasized holistic, family-centered care, skill development, environmental modifications, and promotion of regulation and participation. Clinical skill development was assessed using the Theory Application Assessment Instrument (TAAI) and a site mentor survey. An 8-point improvement from pretest to posttest on the TAAI indicated enhanced theory use skills, and the mentor survey reflected high satisfaction. The program included a five-week …

Valproate Use Is Associated With Higher Mortality And Hepatic Decompensationin Patients With Masld/ Mash: A Multinational Analysis, Donghyun Ko, Do Han Kim Md, Wilhelm S. Basegoda Md, Jose A. Porres, Luis M. Nieto Md, Pedro Palacios Argueta Md, Paul T. Kroner Md, Frank J. Lukens Md

Posters

Valproate is a widely used anti-seizure medication for treating epilepsy. However, it significantly impacts lipid metabolism by interfering with the beta-oxidation pathway of fatty acids in mitochondria. This disruption is expected to accelerate the progression of metabolic dysfunction-associated steatotic liver disease (MASLD) and steatohepatitis (MASH) in patients on chronic valproate therapy. The aim of this study is to determine whether the chronic use of valproate increases the risk of liver-related and cardiovascular events

Valproate Use Is Associated With Lower Hepatic And Cardiovascular Outcomes When Compared To Levetiracetam In Patients With Masld/Mash: A Multinationalanalysis, Donghyun Ko, Do Han Kim Md, Wilhelm S. Basegoda Md, Jose A. Porres, Luis M. Nieto Md, Pedro Palacios Argueta Md, Paul T. Kroner Md, Frank J. Lukens Md

Posters

Valproate and levetiracetam are commonly used to manage epilepsy. While valproate is well-documented to significantly affect lipid metabolism, less is known about the effects of levetiracetam. Given this, worse outcomes in MASLD/MASH are anticipated in patients treated with valproate.

The aim of our study is to compare hepatic and cardiovascular outcomes in MASLD/MASH patients treated with valproate versus levetiracetam.

Implementing An Art-Based Occupational Therapy Program To Enhance Mental Health And Well-Being For Domestic Violence Survivors, Kameron A. Sievert

Occupational Therapy Capstone Presentations

Domestic violence significantly impacts the mental health and well-being of survivors and their children, often leading to disruptions in engagement and performance of occupations. This capstone project aimed to address these challenges by developing a therapeutic craft-based occupational therapy program at a domestic violence shelter. The program was guided by the following theories: Person-Environment-Occupation Model, Recovery Framework, and Trauma-Informed Care Distinct to Occupational Therapy. Current literature and a needs assessment at the site revealed gaps in therapeutic programming and child-related resources. Adult-specific and family-oriented program sessions were designed to facilitate opportunities for self-expression and building coping skills, with modifications made …

Occupational Therapy Intervention Program Addressing Mental Health For Student Athletes Navigating Transition And Recovery, Taylor K. Pfrommer

Occupational Therapy Capstone Presentations

This capstone project aimed to develop and evaluate an occupation-based mental health program for student-athletes navigating the transitions in and out of sports. Guided by the Model of Human Occupation (MOHO), Occupational Adaptation (OA), and Self-Determination Theory (SDT), intervention sessions contained six one-on-one sessions focused on identity reformation, building adaptive responses, and restructuring a meaningful routine. A mixed-methods approach was used to evaluate outcomes from two participants using the Brief-COPE, Athletic Identity Measurement Scale (AIMS), Canadian Occupational Performance Measure (COPM), satisfaction surveys, and thematic analysis of qualitative feedback. Results indicated growth in self-awareness and emotional expression for both participants. Participant …

Clinical Outcomes For Patients With Obstructive Shock With Pe In Octogenarians, Nonagenarians, And Centenarians: An Analysis Of The National Inpatient Sample, Tony Elias, Fady Beshara, Daniel Basta, Mena Elmalh, Matthew Ebrahim, Taha Wasim Syed, Olga Sarah, Abdallah Hussein

Rowan-Virtua Research Day

One of the most common causes of obstructive shock is massive pulmonary embolism. I these patients with compounded morbidities and limited filling of the heart we sought to sample databases to analyze the inpatient outcomes of the population.

Adipocyte/Progenitor Communication Axis Controls Beige Adipogenesis., Briana Noel Cortez, Nabil Rabhi, Kathleen Desevin, Jean Z. Lin, Stephen R. Farmer

Research Colloquium

The unique capacity of inguinal white adipose tissue (iWAT) to brown has emerged as a promising therapeutic approach for treating obesity and its adverse complications. Both white and beige adipose arise from a subpopulation of perivascular adipocyte progenitor cells (APC) expressing SM22 (Smooth Muscle Protein 22-Alpha). However, the early signaling events controlling ACP differentiation to beige adipocytes are still unknown.

To uncover the stromal cells heterogeneity during beige adipogenesis, we performed a single cell RNA-sequencing of iWAT under control condition, treatment with β3-adrenergic receptor (ADRB3) agonist or exposure to cold. ScRNA-seq revealed the landscape of APCs undergoing beige adipogenesis. We …

Inequities In The Rehabilitation Process Of Musculoskeletal Injuries In Maine, Devon A. Grant

Thinking Matters Symposium

Since 2016, Maine’s population has grown as a result of migration and a welcoming of refugees. Changes in state demographics influence the population’s and individuals’ social determinants of health (SDOH) (ie., “where people live, learn, work, and play”) and health literacy (ie., a person’s ability to find, understand, and use information to inform health-related decisions). This project aims to identify the health inequities or disparities throughout Southern Maine in the care of injuries to the lower extremity, such as the knee or ankle, as well as explore factors that influence the healthcare outcomes of athletes in surrounding communities. This study …

The Impact Of High Deductible Health Plans On Mental Health Treatment, Kristian D. Dambrino, Laura Gray, R. David Phillippi

DNP Projects

Background and Rationale: High Deductible Health Plans (HDHPs) are designed to reduce overall healthcare spending by shifting more upfront costs to patients to discourage overutilization of care, yet HDHPs often increase financial burden, particularly in outpatient mental health care. Patients covered by HDHPs often face substantial out-of-pocket costs before reaching their deductible. This can lead to potential delays or discontinuation of psychiatric treatment. Financial transparency interventions by the mental health provider may mitigate these barriers through more-informed patient decision-making regarding payment options. This project evaluates the impact of a financial transparency intervention on reducing payment responsibility for HDHP patients in …

Occupational Therapy Assessment & Intervention In The Neonatal Intensive Care Unit At Shawn Jenkins Children’S Hospital, Lauren G. Murphy

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

BACKGROUND: There is a current lack of literature and evidence to supply neonatal intensive care unit (NICU) occupational therapists with appropriate standardized assessments and interventions. This project aims to explore at which age occupational therapy services will be most beneficial and widely accepted by NICU team members. Goals of this project include understanding current best occupational therapy practices, providing the NICU with the most up to date research and outcomes of interventions and assessments on the high risk neonatal and pediatric populations, improving communication and collaboration skills to engage with all NICU team members, and leading educational sessions about evidence …

Utilization Of Digital Platforms To Enhance Usability And Knowledge For Fieldwork Educators; Increasing Access To The Intentional Fieldwork Education Model (Ifwem), Patrick C. Lewis

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Fieldwork education plays a pivotal role in shaping student outcomes in occupational therapy programs. The effectiveness of fieldwork education is significantly influenced by the fieldwork educator's communication style, teaching approach, learning preferences, competency, self-efficacy, and level of preparedness. The Intentional Fieldwork Education Model (IFWEM) and its associated IFWEM course provide an evidence-based framework designed to enhance fieldwork educators’ competency, self-efficacy, and preparedness prior to student fieldwork. In collaboration with the creators of the IFWEM, efforts were made throughout this capstone project to increase the usability, availability, and accessibility of the current IFWEM course. This project aimed to create a more …

Supporting Families And Providers Of Children With Low Vision/ Cvi Through Comprehensive Resource And Website Development, Alexandria D. Mcdonald

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Cerebral/Cortical Visual Impairment (CVI) is the most prevalent cause of visual impairment in children. Children with CVI face unique challenges that significantly affect their development and participation in daily life. This capstone project aimed to support both therapists and families of children with CVI by fostering a deeper understanding of the condition and enhancing access to evidence-based resources. Guided by the Person-Environment-Occupation-Performance (PEOP) model, the project focused on identifying existing gaps in available materials, then addressing them through the creation of tailored resources and the development of a comprehensive, user-friendly website.

Deliverables included a digital resource library/website with over 40 …

Empowering Future Practitioners: Using Constructivist Learning Strategies To Teach Occupational Therapy’S Role In Oncology Rehabilitation, Erin L. Latimer

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

This capstone project developed educational materials on occupational therapy’s role in oncology rehabilitation for first-year OT students at an accredited program. The deliverables included a lecture and lab session, guided by the constructivism theory and 5 Es educational model, to integrate foundational oncology content into early curricula. By addressing this gap, the project aims to better prepare future OTs to serve cancer survivors. Goals included enhancing students’ knowledge of oncology’s continuum of care and improving clinical reasoning during evaluations. Students completed a Pre-Quiz (testing general oncology/pathophysiology knowledge), Post-Quiz (lecture-specific questions), and Post-Survey (34 respondents). Results showed strong comprehension, with one …

Capturing Women's Birth Experiences Through Photos, Kristen Montgomery, Betsy Crabtree, Samantha Grayson, Alyssa Harmon, Rachael Robbins, Sarah Shelton, Hannah Sobas, Alexis Taliaferro, Nolan Willard

Epsilon Sigma at-Large Research Conference

Purpose: Each year 3.5 to 4 million women give birth in the United States. Childbirth is a life-changing event that induces various emotions in women. Many women report having a negative experience due to short staffing, inadequate care, and a loss of autonomy. Aims: The aim of the study was to understand what factors contribute to a positive or negative birth experience.

Methods: A descriptive qualitative study was conducted using photo elicitation. Photos were collected from participants and included a description of how the photo represented the participant’s experience. Demographic data were collected through a survey. Participants …

Utilizing The Mdq For Bipolar I Screening In The Primary Care Environment, Jamie Strozier

Epsilon Sigma at-Large Research Conference

Abstract- Utilizing the MDQ for Bipolar I Screening in the Primary Care Environment

Bipolar disorder is a chronic mental health condition characterized by episodes of depression, mania, or mixed symptoms, affecting approximately 5.7 million adults in the U.S. and 40 million individuals worldwide. Despite its significant impact, bipolar disorder is frequently misdiagnosed as major depressive disorder (MDD) in primary care settings, leading to inappropriate treatment and worsening patient outcomes. Research indicates that 78% of bipolar patients are initially misdiagnosed, with only 32% of primary care providers (PCPs) screening for the disorder. This quality improvement project aims to enhance bipolar disorder …

Environmental Concerns Of Women In Appalachia, Kristen Montgomery, Adebayo Adeeko, Jessica Binns, Sarah Hall, Paula Hawkins, Allyson Newer, Michaela Outlaw, Karenna Turley

Epsilon Sigma at-Large Research Conference

Purpose: Environmental contamination is rampant in the United States and other parts of the world. There are potential health implications related to environmental contamination.
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Aims: The purpose of this study was to investigate how concerned women in Appalachia are regarding the environment. The following research question was addressed: What concerns do women have regarding the environment? The objective of this study was to understand how women perceive their environment and to evaluate what concerns they have regarding the environment. We also evaluated demographic factors to see if any demographics contributed to particular concerns related …

A Jewel In The Crown Is Better Than Money In The Pocket": Historical Data On The Role Of Midwives In Caring For Families In Southern Appalachia, Kristen Montgomery

Epsilon Sigma at-Large Research Conference

Background: Midwives have provided care to women since the beginning of time. Early midwives had little training but learned their craft from experienced women. Later, formal training became available. Midwives have a rich history in Appalachia.

Purpose: to explore the rich history of all types of midwives in Appalachia.

Methods: Materials from the Archives of Appalachia were reviewed. Both written and oral materials were evaluated. This included a review of the document, identification of themes, and then comparing those themes with previously identified themes. Documents were reviewed in a random order by two researchers who met to discuss results.

Results: …

Kentucky House Bill 159: Health Care Policy Analysis, Lindsey Frasure

Epsilon Sigma at-Large Research Conference

Lindsey Frasure MSN-Ed., RN

Lincoln Memorial University, Caylor School of Nursing

DNP Student

An Educational Presentation: Kentucky House Bill 159: Health Care Policy Analysis

Abstract:

Purpose/Background: Kentucky House Bill 159 is a bill that passed through the state congress in 2024. It is known as the decriminalization bill. The aim of this presentation is to analyze and discuss the bill in its entirety, why the bill continues to be important in healthcare, implications for nursing, the future of nursing, and advocation for change. The significance of the presentation is to educate fellow healthcare professionals on the importance of policy …