Medicine and Health Sciences Commons^™

Fall 2021

Scientia

A Decade of Progress and Success; Speech Language Pathology Program; COVID-19 Long-Hauler Study; Peer Mentors Initiative; Faculty Update; Expert Engagement: Three CSH initiatives further education and scholarship while supporting communities in need; Strategic Command: Business consultant and med tech expert Stephen Sichak helps others face pandemic challenges; Taking Care: A School of Nursing research team plumbs the pandemic experiences of nurses nationwide

The Effects Of Music Therapy On Pediatric Patients With Congenital Heart Defects In The Pre And Postoperative Setting, Janelle Marie Choy

Nursing | Student Research Posters

Congenital heart defects is a prominent medical occurrence especially in pediatrics. These defects often require surgeries and extensive treatment plans. These treatment plans often include invasive surgeries and extensive treatment plans which can require long recovery times along with potential surgical complications. This study aims to evaluate the effectiveness of music therapy on pediatric patients with congenital heart defects in the pre and postoperative setting and how music therapy can be implemented in treatment plans to yield effective recovery results for these patients. This research is significant as elevated vital signs and preoperative anxiety are associated with an increased need …

Analyzing The Cognitive Complexity Of The Questions On The Advanced Placement Computer Science Principles Exam, Lauren Zirpoli

Seton Hall University Dissertations and Theses (ETDs)

This convergent parallel mixed methods study with qualitative and quantitative content analysis was conducted to analyze and describe the cognitive complexity of the publicly released Advanced Placement Computer Science Principles Exam questions compared to the language of higher-order thinking found in research literature. Hess’ Cognitive Rigor Matrix was used to determine the frequency and percentage of questions categorized as higher-order thinking within each cell of the matrix. The qualitative method consisted of content analysis of the language of each question analyzed, followed by deductive coding, and culminated with categorizing the depth and type of thinking required on Hess’ Cognitive Rigor …

Improving Mental Health Support For Nursing Students Through Mental Health First Aid (Mhfa) Training Of Clinical Faculty, Amy Sands

Graduate Theses, Dissertations, and Capstones

This project aimed to implement a process improvement program at the Louisville campus of Galen College of Nursing to improve the mental health support for nursing students through the training of Clinical Instructors (CIs) in using adult Mental Health First Aid (MHFA) and the ALGEE actions described within that program.

Nursing Students’ Perceptions Of The Impact Of Teamwork And Collaboration On Patient Care, Riana Square

Honors College Theses

Teamwork and communication are two topics that a vast majority of nursing students are introduced to in their first semester of nursing school. Many nursing students have a desire to improve their communication skills and have a better understanding of the inner workings of interdisciplinary collaboration. A study across multiple cohorts of Georgia Southern Nursing students was conducted to explore their perceptions of the correlation between teamwork and patient care outcomes. This study also explores nursing students’ readiness to communicate with other healthcare professionals and the effectiveness of the means to practice these communication skills while in nursing school. It …

Improving Collection Of Second Blood Pressure For Patients In Primary Care Who Present With An Elevated Reading, Jordan Sieh, Elizabeth Sundberg, Tania Arreguin

Doctor of Nursing Practice Projects: College of Nursing

Purpose: Early diagnosis of hypertension is critical to prevent complications such as renal and cardiovascular diseases. Many healthcare facilities do not have a blood pressure training program educating appropriate staff on importance of accurate blood pressure readings and techniques. The purpose of this project is to improve the number of patients with elevated blood pressure reading at the OneWorld Quick Sick Clinic.

Methods: Health aides/Health Assistants/Medical assistants at OneWorld Quick Sick will receive blood pressure training to review proper techniques. During this training they will also be educated on appropriate follow-up blood pressure readings and a new technique to document …

Heart Failure Zone Tool: A Quality Improvement Project, Emily Scahill, Cindy Driggers, Angelica Marquez

Doctor of Nursing Practice Projects: College of Nursing

Purpose

Heart failure is the leading cause of hospital admissions among adults over 65 years old and lack of patient knowledge regarding the self-management of heart failure is a key factor in rising readmission rates. This project enhances inpatient heart failure education using a laminated heart failure zone tool handout to guide heart failure education. The intent was to increase patients’ confidence regarding heart failure self-management and positively impact patients’ knowledge regarding the management of heart failure.

Materials and Methods

The process included identifying hospitalized patients who had been flagged as a heart failure core measure or had been identified …

Patient-Centered Preimplant Education Session And Bi-Weekly Text Message Adherence Reminders In Patients With A Newly Implanted Cardiomems® Device: A Quality Improvement Study, Elizabeth M. Miller, Alicia Abboud, Audrey Cooper

Doctor of Nursing Practice Projects: College of Nursing

Rationale

Heart failure is a deadly disease, affecting over 6.2 million individuals and costing the United States an estimated 30.7 billion dollars (Virani et al., 2020). By 2023, heart failure costs in the United States are estimated to grow to 70 billion dollars with 75-80% of these costs attributed to inpatient hospitalizations (Heidereich et al., 2022). The CardioMEMs® is a small device placed in the patient’s pulmonary artery via a minimally invasive procedure by an interventional cardiologist. The use of remote patient data from the CardioMEMs® device has been shown to reduce hospital re-admissions, facilitate tailored medication management, detect increased …

Implementation Of A Doula-Supported Postpartum Wellness Toolkit In A Black Community-Based Maternal Wellness Program, Janice Luethje, Leslie Torres

Doctor of Nursing Practice Projects: College of Nursing

Objective: The objective of this project was to expand the areas of focus within a maternal wellness program at a Black community center and to evaluate the satisfaction levels of the doulas who utilized the material during postpartum home visits. The toolkit covers a range of postpartum topics in the areas of nutrition, exercise, sexual health, mindfulness, and social support as well as a postpartum mental health screening tool.

Design: This quality improvement project included three distinct phases: The pre-implementation phase, the implementation phase, and the post-implementation phase.

Setting: The project location was a Black community center in Lincoln, Nebraska. …

Implementing A Standardized Protocol For Early Detection Of Undiagnosed Hypertension Patients, Jenscena Hansen, Chris Bell

Doctor of Nursing Practice Projects: College of Nursing

Introduction: Hypertension is a preventable disease that frequently goes unrecognized and undertreated. Early diagnosis can prevent further comorbidities such as heart disease, stroke, and chronic kidney disease. Implementation of this protocol aims to decrease the number of patients with undiagnosed hypertension and increase the identification of patients with elevated blood pressure who did not have a pre-existing diagnosis of hypertension. The goal of implementing a standardized protocol would help eliminate the number of patients who go undiagnosed.

Methods: This quality improvement design had clinical staff flag patients with elevated blood pressure. Identified patients without a diagnosis of hypertension were educated …

Effects Of An Educational Evidence-Based Website To Improve Breast Health Knowledge And Self-Efficacy Of Breast Self-Examination: Interim Analysis, Mackenzie Koch, Jennifer Cera, Brooke Hancock, Elizabeth Graham

Doctor of Nursing Practice Projects: College of Nursing

Purpose and Aims

Breast disease, whether benign or malignant, encompasses a wide array of diagnoses. Breast self- examination (BSE) is a simple screening assessment that improves early recognition and diagnosis. With changes in the 2021 ACOG practice guidelines from mandatory to optional provider-performed clinical breast examinations (CBE), it is imperative for patients to possess basic breast health knowledge and accurate BSE techniques. Current standard patient education is provided via brochures or pamphlets. An educational multimedia website was created using ACOG guidelines to impart knowledge and demonstrate proper BSE techniques. Aims were to evaluate changes in participant’s (1) breast health knowledge …

Reduction Of Hospital-Acquired Pressure Injuries In The Acute Care Setting, Bailey Rasmussen, Taylor Bacon, Andrew Gross

Doctor of Nursing Practice Projects: College of Nursing

Background: Hospital-acquired pressure injuries (HAPIs) have been a longstanding problem in hospitals nationwide. HAPIs cause significant financial strain to a healthcare system and complications can be devastating to the patient.

Purpose: The purpose of this project was to implement the Standard Pressure Injury Prevention Protocol (SPIPP) 2.0 Checklist for patients in the Intensive Care Unit (ICU). The primary aim of this study was to determine if implementing the checklist would reduce the number of HAPIs.

Methods: This project took place over a four-week period at a Midwest hospital in the ICU. Data were collected via patient chart …

Perceived Barriers Of Early Mobilization In The Intensive Care Unit, Melissa Sonderman, Emily Miles, Joshua Ferge

Doctor of Nursing Practice Projects: College of Nursing

Purpose

Early mobilization of Intensive Care Unit (ICU) patients can improve patient outcomes but also includes barriers to implementation. Nebraska Medicine has continued to have ongoing quality improvement initiatives like the ABCDEF liberation bundles and early mobilization that have been attempted but have never fully come to fruition. This project surveys Nebraska Medicines ICUs staff to better understand attitudes, knowledge and behavior regarding early mobilization using a validated tool. The aim was to identify barriers, so the organization could better understand the needs of ICU staff for future implementations of early mobility and related assessment tools.

Materials and Methods

A …

Respiratory Illnesses In Women And Children From Ghana: Problem Identification And Intervention, Stephanie Dale

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Rural communities in the upper east region of Ghana currently cook with traditional coal pots that produce increased levels of smoke resulting in rapid fuel consumption, increased air pollution, and high levels of respiratory illness in the women and children who use them. New stoves have been developed that remain similar to the traditional ones in use but are designed to provide a variety of benefits such as lowering the cost of fuel, reducing air pollution, and decreasing rates of respiratory illness in women and children. The purpose of this research study was to identify why women have not begun …

Exploring The Lived Experience Of Self-Care In Young Adults With Type 2 Diabetes, Holly Berry-Price

Electronic Theses and Dissertations

Introduction

The prevalence of prediabetes in adults aged 18 or older was as high as 38% between 2017-2020. Youth-onset T2DM is a more aggressive phenotype than T2DM that occurs later in life. Young adults with T2DM have poorer health outcomes, lose an average of 15 years of life, all resulting in significant economic burden impacting the person. Current self-management interventions do not improve health outcomes in young adults with T2DM.

Purpose

The purpose of this research was to explore the self-care experiences of young adults living with T2DM.

Methods

Existential hermeneutic phenomenology informed the research. Inclusion criteria as follows: adults …

Development And Implementation Of An Evidence Based Practice Guideline Related To The Management Of Adult Angioedema, Megan Przybysz

Doctor of Nursing Practice Scholarly Projects

Angioedema (AE) is a potentially life-threatening medical condition that occurs with a higher frequency than medical providers may expect, with the emergency department (ED) serving as the usual first point of medical contact for patients. Any hesitation in recognizing AE or inconsideration of the disease process in differential diagnoses may lead to a dangerous delay of care. Due to the potential rapid progression of airway obstruction in AE, inexperienced providers should not attempt intubation, instead deferring to providers experienced in alternative airway techniques (i.e., anesthesia providers). The primary goal of this project is to develop an evidencebased practice guideline for …

An Evidence-Based Strategy For The Use Of Simulation To Assess Situation Awareness In Applicants To Nurse Anesthesia Programs, Angela Lee

Doctor of Nursing Practice Scholarly Projects

Medical errors are considered one of the top causes of patient death. Closed claims analysis reveals an estimated 50% of claims are associated with preventable events by the anesthesia provider. Errors in anesthesia leading to critical incidents are associated with errors in situation awareness (SA). Identification of human factor variables, such as SA, provides an analysis of observable behavior and intuition necessary to guide crisis management, maintain clinical performance, and mitigate errors in patient safety. The human factor components of human error and SA play critical roles in patient safety and overall clinical anesthesia practice. The viability of simulation assessment …

Development Of An Evidence-Based Crna Preceptor Training Program, Emmanuel Mensah

Doctor of Nursing Practice Scholarly Projects

A preceptor is an experienced clinician who is expected to facilitate a student's learning experience. Preceptorship is the relationship between a staff nurse and student, focusing on the development of clinical skills and knowledge. Initially introduced by Florence Nightingale in the 1800s, the concept was quickly adopted by nurse anesthetists and is a staple of the anesthesia practice today. As it stands, many Certified Registered Nurse Anesthetists (CRNA) preceptors do not receive formal training in their role, which may lead to a decrease in teaching ability and confidence to face broad teaching-learning issues. A lack of preparation hinders preceptor outcomes …

Preprocedural Ultrasound For Labor Neuraxial Anesthesia: Evidence-Based Practice Recommendations, Nicholas Anderson

Doctor of Nursing Practice Scholarly Projects

Central neuraxial blockade (CNB) is the most widely used method of anesthesia provided to laboring patients and includes epidural, spinal, combined spinal-epidural, and caudal techniques. Studies have shown that using preprocedural ultrasound is a safe and effective tool to facilitate the placement of neuraxial needles, especially in patients with predicted difficulty. With the prevalence of obesity increasing, laboring patients with predicted difficulty of neuraxial needle placement is increasing as well. In addition, the traditional method of palpation and visualization of anatomical landmarks to place neuraxial needles can produce inaccurate results due to inconsistencies between patients. Use of preprocedural ultrasound to …

Empowering Picu Nurses: Enhancing Awareness And Understanding Of Post-Intensive Care Syndrome-Pediatric (Pics-P), Carissa A. Newman, Janelle A. Strain

Research & Creative Achievement Day

Statement of the Problem: Post-intensive care syndrome (PICS-p) threatens the health of children following a Pediatric Intensive Care Unit (PICU) stay. Morbidities associated with PICS-p can affect children's cognitive, functional, social, and emotional domains. Purpose: The project aimed to increase awareness of the term PICS-p, increasing knowledge and understanding among nursing staff, and developing their ability to identify patients at risk for developing PICS-p. Method: The Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Healthcare was used to facilitate this project. 20 PICU nurses completed an educational module with a pre/post quiz to analyze learning outcomes about PICS-p. Interventions: …

The Effect Of Nurse Staffing On Patients Perceived Care, Jenna Racey, Victoria Newman, Erin Wojtkowski, Jillian Crews

Student Scholar Showcase

In discharged patients, how do fully staffed units compared with short-staffed units affect patient satisfaction levels during their inpatient experience? From the literature review, it was found that as nurse staffing declined, so did the patient-perceived quality of care and their loyalty to the respective hospitals. Also, as the percentage of assistant nurses to registered nurses increased, the patients reported poor care and decreased nursing guidance. While more research is needed on this prevalent issue, a recommendation of how nurse staffing issues could be changed is to increase nurse staffing visibility, especially in units with poor reported patient outcomes in …

Protocols For Postpartum Hemorrhage, Nicole A. Mitchell, Wilbur Greene, Samantha Claxton, Lydia Lester

Student Scholar Showcase

The purpose of this study was to examine the relationship between the protocols for postpartum hemorrhage and lack of implementation, how race may play a role in care, the different effect on maternal lives; physically and mentally, and more effective treatment options. Many women all over the world struggle with postpartum hemorrhaging as it is a life-threatening complication that can follow giving birth. There are standard protocols set in place for different facilities that relay how the healthcare professionals should act in that situation. The PICOT question, “In child-bearing women, how do protocols for postpartum hemorrhage compared with a lack …

Optimizing A Clostridium Difficile Screen For Intensive Care Unit Admissions, Mary Katherine V. Natour, Jennifer Smith

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: Clostridium difficile infection is one of the most common healthcare-associated infections. Careful screening upon hospital admission enables clinicians to mitigate the spread and sequelae of this illness through early intervention and isolation but this screening must be accurate and highly sensitive to maximize benefit.

Local problem: The site for this project, an ICU in Tennessee, currently employs a highly sensitive but nonspecific tool to detect CDI. This has resulted in low accuracy, low staff compliance, low patient morale, and unnecessarily high personal protective equipment (PPE) costs.

Methods: Levin’s evidence-based practice improvement model was chosen to guide this project from …

Antibiotic Stewardship In Patients With Viral Upper Respiratory Illness: Improving Quality Measures In Retail Health, Meredith A. Nolan, Robin Harris, Clay Smith

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: Millions of people will die from antibiotic-resistant bacterial infections in the next 30 years. Retail health providers are pivotal in this global epidemiological problem.

LOCAL PROBLEM: Setting included 15 retail health clinics operated by Vanderbilt University Medical Center in Middle Tennessee. Project examined provider education, patient engagement, and commitment to antibiotic stewardship, components of the CDC's Core Elements of Outpatient Antibiotic Stewardship framework. Specific aims were that providers would have a significant reduction in the percentage of antibiotics prescribed for viral illness over the study period.

METHODS: Using the Evidence-Based Practice Improvement Model, a Quality Improvement …

Reducing Copd Readmissions Through The Implementation Of A Guideline-Based Clinical Pathway: An Evidence-Based Practice Improvement Project, Hannah F. Hall, Allyson Neal, Samantha Bauer

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide. It is characterized by airway inflammation and damage that inhibits appropriate airflow. Exacerbations of COPD (ECOPD) hasten disease progression and have profound impacts on the patients.

Local Problem: East Tennesseans experience higher rates of COPD than the rest of the state. Community members at the project site identified that the inpatient management of ECOPD is inconsistent and discordant with the 2023 Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. The purpose of this project was to reduce readmissions and increase guideline concordance by developing an algorithm …

Implementation Of A Standardized Suicide Screening Process In A University Student Health Clinic: A Quality Improvement Project, Addie Grace Strong, Kathryn Dambrino, R. David Phillippi, Linda Wofford

DNP Scholarly Projects

Background: Suicide is a leading cause of death among college age students, prompting the need for evidence-based screening tools like the Columbia Suicide Severity Rating Scale (C-SSRS) to enable early detection and timely intervention. Inconsistencies in suicide screening may pose a risk of missed intervention opportunities. This Doctor of Nursing Practice project specifically aimed to improve the quality and consistency of suicide screening in a university student health clinic by implementing the C-SSRS tool into the clinic workflow during mental health appointments. Methods: Employing a quality improvement framework, this scholarly project followed the Institute for Healthcare Improvement Model for Improvement …

Improving Dementia Symptoms Through Personalized Music, Lindsay Grainger

SC Upstate Research Symposium

Alzheimer's disease and related dementia (ADRD) is a prevalent, costly, and complicated disease. With over 6 million Americans affected and the cost of treatment soaring to over $320 billion dollars annually, there is a growing need for low-cost interventions to treat symptoms. Routinely listening to personalized music selections has been shown to reduce agitation—the most common symptom of Alzheimer’s disease and related dementia. The purpose of this study was to provide a personalized music listening (PML) intervention of thirty minutes to 10 nursing home residents with dementia. Thirty-minute PML sessions occurred multiple times a week over six weeks. The inclusion …

Hgs-3 The Influence Of A Tandem Cycling Program In The Community On Physical And Functional Health, Therapeutic Bonds, And Quality Of Life For Individuals And Care Partners Coping With Parkinson’S Disease, Leila Djerdjour, Jennifer L. Trilk

SC Upstate Research Symposium

Purpose Statement: Several studies have shown that aerobic exercise can have a positive impact on alleviating symptoms experienced by individuals with Parkinson's disease (PD). Despite this evidence, the potential benefits of exercise for both PD patients and their care partners (PD dyad) remain unexplored. This research project investigates the effectiveness, therapeutic collaborations, and physical outcomes of a virtual reality (VR) tandem cycling program specifically designed for PD dyads.

Methods: Following approval from the Prisma Health Institutional Review Board, individuals with PD were identified and screened by clinical neurologists. The pre-testing measures for PD dyads (N=9) included emotional and cognitive status …

Comparisons Of Using Alcohol, Coping Strategies, Anxiety, And Depression Between Usa And Taiwanese College Students, Pi-Ming Yeh Associate Professor, Cheng-Huei Chiao Professor, Jennchang Liou Professor

Epsilon Sigma at-Large Research Conference

Purpose: In this study, we compared United States (US) and Taiwanese college students’ using alcohol, coping strategies, anxiety, and depression.

Research Questions:

1. What were the differences in demographic characteristics, using alcohol, coping strategies, anxiety, and depression between US and Taiwanese college students?

2. What were the relationships between US and Taiwanese college students’ using alcohol, coping strategies, anxiety, and depression?

3. How much of US and Taiwanese college students’ anxiety and depression were predicted by their use of alcohol, coping strategies?

Methods: Four hundred and one US and 180 Taiwanese college students were recruited in this study. This was …

The Effects Of Age, Employment, Marriage, And Education On Academic Motivation In Undergraduate Nursing Students, Jessica Hamm Msn Rn Phd Student

Epsilon Sigma at-Large Research Conference

The Effects of Age, Employment, Marriage, and Education on Academic Motivation in Undergraduate Nursing Students

Purpose: The amount of research on non-cognitive variables affecting motivation is limited in nursing students. By using Self-Determination Theory, faculty can determine what motivates students to learn which will allow the creation of a learning environment that promotes student achievement.

Aim: To determine the effect age, marriage status, employment, and education level have on academic motivation in nursing students in the third semester of a baccalaureate nursing program within the framework of Self-Determination Theory.

Method: A descriptive correlational design was used to identify the effect …