Medicine and Health Sciences Commons^™

An Integrated Review: Outpatient Care And Management Of Fever And Neutropenia Among The Pediatric Oncology Population, Sarkis Makarovich

DNP Qualifying Manuscripts

Abstract

In the pediatric population, comprehensive cancer treatment and its associated side effects significantly impact their physical and emotional well-being. Though chemotherapy drugs are valuable agents against cancer cells, they also damage healthy dividing cells, such as bone marrow, thus weakening the immune system. Febrile neutropenia (FN) and associated infections remain the most critical complications of the extensive chemotherapy regimen and can threaten life if not appropriately addressed. Appropriate primary evaluation and treatment of FN in children with cancer includes administering proper broad-spectrum antibiotics. Ongoing research has focused on improving quality of life (QoL); yet, FN has persisted as the …

Factors Predictive Of The Development Of Surgical Site Infection In Thyroidectomy, A Replication Study Of Myssiorek (2018), Kaitlyn M. Kenig

Capstone Experience

The original study aimed to show that thyroidectomy does not result in surgical site infection (SSI) in most cases, and thus routine prescription of antibiotics is not necessary. The study looked to see what risk factors could predict the incidence of SSI. This would highlight those individuals who were at most risk of developing SSI, and then antibiotics would only be prescribed to these individuals instead of all or most individuals who undergo thyroidectomy.

This study used NSQIP data to look at incidence of SSI and look for risk factors that may be predictive of SSI. Only surgeries that were …

Sars-Cov-2 Infectivity, And Interaction With Ace2 In The Human Oral Cavity: A Comprehensive Study, Blake Joseph Henkel

Undergraduate Honors Theses

The oral cavity has the ability to transport infections throughout the body and be infected by bacteria, fungi, protozoa, and viruses, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is the virus that led to the most recent pandemic. SARS-CoV-2 has unique ways of interacting with the human body to infect individuals, which has led researchers and scientists to have limited knowledge on its long-term impact on human health. However, there are ways to identify various oral cavity infections and prevent infection now and in the future. Many studies have been conducted in an attempt to understand the body’s …

Nurses’ Perceptions Of Ppe Compliance Among South Mississippi Medical- Surgical Nurses, Jenna Roush

Honors Theses

Utilizing Personal Protective Equipment (PPE) appropriately is critical in protecting nurses and patients from contracting infectious diseases. Poor compliance with PPE is associated with increased hospital-acquired infections and directly impacts infection control measures. This thesis delves into the perceptions of PPE compliance and awareness among medical-surgical nurses in South Mississippi. A quantitative study utilizing a 28-item survey was implemented. Likert-style and open-ended survey questions were completed by n=28 participants. Univariate analysis was used to determine compliance among each PPE item, awareness and confidence of PPE items, and whether there was a lack of training or a PPE shortage. Based on …

The Use Of Alcohol Impregnated Port Catheters For Decreasing Central Line Infections In Acute Care, Shana M. Coons

Student Scholarly Projects

Practice Problem: Lack of proper sterile protocol for central lines was noted as a problem in the acute care units, causing CLASBI rates to be higher than the national average at the hospital in question.

PICOT: In hospitalized acute care adult patients 18 years of age and older with central lines, how does the use of alcohol impregnated port protectors (AIPPs) compared to current central line sanitation practices affect central-line associated infections (CLASBI) within 10 weeks?

Evidence: The literature evidence suggests that Alcohol Impregnated Port Protectors (AIPPs) decrease CLASBI rates and provide better outcomes for acute care patients with central …

Investigation Of Orthohantavirus Genetics In Rodent Reservoirs And Clinical Samples, Samuel M Goodfellow

Biomedical Sciences ETDs

Orthohantaviruses are negative-sense, single stranded RNA viruses with trisegmented genomes that can cause severe disease in humans and are carried by several host reservoirs throughout the world. In the United States, Sin Nombre orthohantavirus (SNV) is the primary cause of hantavirus cardiopulmonary syndrome (HCPS) with a fatality rate of ~36% and the highest cases occuring in the southwest region. The primary SNV host reservoir is thought to be the western deer mouse, Peromyscus maniculatus, however it has been shown that other rodents can carry different orthohantaviruses. We designed a pan-orthohantavirus detection tool to survey several small mammal populations throughout New …

Michigan Appropriateness Guideline For Intravenous Catheters And The Impact On Utilization And Infection Ratios In Peripherally Inserted Central Catheters, Kasey Smith Bustamante

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Adult patients are at increased risk for central line-associated bloodstream infections when central line utilization rates are increased and are inserted inappropriately, based on patient criteria. Purpose: Determine if utilization of the Michigan Appropriateness Guidelines for Intravenous Catheters (MAGIC) will reduce central line utilization ratios (focusing on peripherally inserted central catheters (PICC)) and reduce risk of central line-associated bloodstream infections among an adult population in the Trauma Surgical Care Unit (TSCU) and Medical Intensive Care Unit (MICU) at a tertiary care center in the South Carolina Pee Dee Region. Methods: The Plan Do Study Act (PDSA) quality improvement …

Use Of Pre-Transplant Cmi To Predict Infection And Mortality Post-Cardiac Transplantmortality Post-Cardiac Transplant, Chetaj A. Mahabir

Theses & Dissertations

This paper discusses a study investigating the relationship between the cell-mediated immunity (CMI) level before cardiac transplant and the incidence of infection and mortality after the transplant. CMI is an important measure of a person's immune system. The study included 126 patients who underwent cardiac transplants between September 2011 and January 2020. Out of these, 21 patients had a low CMI level (<225), and 105 had a high CMI level (≥ 225) before transplant. The mean CMI level in the low CMI group was 175.3, while in the high CMI group, it was 479.9. The two groups were similar except for the lower white cell count and cardiac output in the CMI< 225 groups and the higher Caucasian demographic in the CMI≥ 225 groups. The study concludes that patients with lower CMI levels before cardiac transplant have a higher risk of infection (p=0.052) and mortality (p=0.005) one year after the transplant. The risk of dying for patients with CMI <225 is 12.9 times the risk of dying for patients with CMI ≥ 225 after adjusting for the other covariates in the model. However, this study has some limitations including its retrospective nature, small sample size, and single-center design. Further studies are needed to replicate these findings and investigate the optimal immunosuppressive regimens based on baseline CMI levels.

Adult Post-Cardiac Surgery Deep Sternal Wound Infections, Samantha Porcher, Cole Gatzke

Nursing DNP Projects

ABSTRACT

Purpose and rationale: Deep Sternal Wound Infections (DSWI) are associated with morbidity rates and mortality rates as high as 10% -15% as well as significantly increased hospital costs. The purpose of this project is to decrease current rates of DSWIs in adults undergoing cardiac surgery at a large medical institution.

Synthesis of evidence: The literature shows a strong relationship between elevated HbA1C and DSWI. All articles reviewed for this proposal which implement a sternal vest intervention support its use to prevent DSWI.

Practice change and implementation strategies: The strategy used to implement these evidence-based practice interventions includes …

The Geographic Pattern And Socioecological Factors Of Helicobacter Pylori Infections In The United States, Judith Ann Merryweather

Walden Dissertations and Doctoral Studies

AbstractHelicobacter pylori (H. pylori) is one of the most common human pathogens and may play a role in the development of several distinct diseases, which include gastric ulcer, duodenal ulcer, and gastric cancer. Studying geographic territories of the United States may reveal clusters with high rates of H. pylori infection and perhaps the prevalence of gastric cancer; however, geographic mapping of patterns in the United States is scarce. The purpose of this study was to investigate changes in H pylori infection patterns in the United States between two different time points (2000–2002 and 2016–2018). The primary hypotheses of this study …

Evaluation Of Recovery Level And Surgical Site Infection For Hip Replacement Surgeries, Misha Foster

Walden Dissertations and Doctoral Studies

Surgical site infection (SSI) is one of the most common healthcare associated infections and is a major cause of morbidity and mortality. Existing studies have focused primarily on perioperative intervention strategies to reduce infection risks following total joint replacement (TJA) procedures. However, postoperative (post-op) SSI risk factors may account for a significant percentage of hospital readmissions due to infections at the surgical site. Therefore, the purpose of this study was to examine the association between post-op recovery level and SSI among patients who underwent primary hip arthroplasty procedures. Using the social ecological model, which conceptualizes health broadly and focuses on …

Radioluminescence Based Biochemical Sensing And Imaging Strategies To Measure Local Drug Release And Ph, Gretchen B. Schober

All Dissertations

In this dissertation we describe methods for measuring infection relevant biochemical analytes using radioluminescent and ultrasound luminescent materials. Films and nanoparticles fabricated with europium doped gadolinium oxysulfide (Gd₂O₂S:Eu³⁺) are used to quantitatively measure radiolabeled pharmaceutical concentration, specifically tritium labeled vancomycin (³H-vancomycin). Europium and dysprosium doped strontium aluminate is used to fabricate an ultrasound modulated, pH sensing film. These methods are indicated for theranostic evaluation of implant associated infection. Bacterial biofilms are inherently resistant to traditional antibiotic treatment and can coat biomedical implants. These biofilm related infections are difficult or impossible to eradicate …

Reducing Catheter-Associated Urinary Tract Infections In The Pediatric Intensive Care Unit, Maria Smith

Dissertations

Problem: CAUTIs (catheter-associated urinary tract infections) are a common hospital-acquired condition (HAC) that increase length of hospital stays, hospital costs, and risk for patient mortality. CAUTI rates in a PICU increased in 2021 from the year 2020. A rapid cycle PDSA revealed nurses were not using soap and water for foley catheter care, which is the recommended cleanser by the Centers for Disease Control and Prevention (CDC).

Methods: An observational descriptive design was used to evaluate foley catheter cleaning and CAUTI rates. PICU nurses completed behavior surveys regarding foley catheter cleaning practices. An education intervention occurred when nurses answered anything …

Nursing Students’ Perspectives On The Covid-19 Vaccines: Moderna, Pfizer, And Johnson And Johnson, Savannah M. Workman

Honors College Theses

There are very few things that everyone in the world shares in common, but there is one thing that has recently plagued our entire world and has impacted each person’s life. The first case of COVID-19 occurred in the United States in January of 2020. In the United States during March of 2020, life as we knew it changed. Restrictions were put in place, schools closed, food and supply chain shortages occurred, travel was banned, and we were warned to stay away from others as they could be symptomatically or asymptomatically carrying the novel coronavirus. Since the time of quarantine …

Tick Surveillance And Pathogen Detection In Eastern South Dakota, Holly E. Black

Honors Thesis

Tick-borne diseases threaten the health of humans, animals, and ecosystems, but surveillance efforts are lacking in some regions. Throughout 2019, 2020, and 2021, we conducted tick surveys aimed at determining the status of the black-legged tick (Ixodes scapularis), the American dog tick (Dermacentor variabilis) and the lone star tick (Amblyoma americanum) in eastern South Dakota. Each year, ticks were collected using a flagging method and identified in the lab. A subset were tested for the presence of Borrelia burgdorferi, the causative agent of Lyme disease, by polymerase chain reaction (PCR). Dermacentor variabilis was the most commonly identified tick, …

Effect Of Covid-19 On The Wellbeing Of Healthcare Professionals In Public Isolation Hospitals In Egypt, Shaimaa Sabbah

Theses and Dissertations

One of the most vulnerable groups severely hit by the COVID-19 pandemic has been the Healthcare Professionals (HCPs), especially the physicians, pharmacists, and nurses who work in public Isolation hospitals. The Egyptian medical syndicate declared the death of more than 600 physicians from February 2020 till January 2022. In the meantime, the Egyptian government has worked on different policies for relieving the negative effects of the pandemic on this vulnerable group; however, easing restrictions, no total lockdown implementation, and monitoring bureaucracy has negatively affected the wellbeing of those HCPs. The study aims to figure out recommended policies to protect HCPs’ …

The Three-Way Interplay Among Early Life Exposures, The Gut Microbiome, And Outcomes In Infancy, Yuka Moroishi

Dartmouth College Ph.D Dissertations

The bidirectional relationship between the gut microbiome and immune system plays an important role in host immune status: the immune system provides the gut microbiome the optimal environment to thrive in, and the gut microbiome helps regulate the immune system. This relationship is especially important in infants, whose immune system is still premature and rely on innate immunity.

We investigated the three-way interplay among early-life exposures, the developing gut microbiome, and outcomes in infancy from the general population in New Hampshire, US. We used prospective cohort data from the New Hampshire Birth Cohort study to 1) determine whether timing of …

Predictors Of Very Late Onset Infection In Kidney Transplant Recipients At Least Ten Years Post Transplant, Harry Cheung

Yale Medicine Thesis Digital Library

Although there have been improved outcomes for kidney transplant recipients, infection is still a leading cause of morbidity and mortality for long-term kidney transplant survivors (LTKS). This thesis and study aims to investigate the epidemiology of very late onset infections (>10 years post-transplant), or VLOI and clinical markers that can predict these infections.

A single-center, retrospective study of a cohort of patients (≥18 years old) who underwent kidney transplantation between 2003-2009 and survived for at least 10 years post transplantation was conducted. The primary outcome studied was the occurrence of VLOI. The data collected included transplant data, patient co-morbidities, …

History Of Allergy, Atopy, Infectious And Autoimmune Disease And Risk Of Multiple Myeloma, Tony B. Zbysinski Iii

All ETDs from UAB

Multiple Myeloma (MM) is a plasma cell malignancy, which is defined in part by antibodies and complexes of immunoglobulin (Ig) heavy and light chains (IgH and IgL). Previous associations of immune-stimulating conditions such as allergic, autoimmune, and infectious conditions and the risk of multiple myeloma (MM) are inconsistent. However, these studies were conducted in populations of European ancestry, leaving the possibility that these conditions may contribute to the excess risk of plasma cell proliferative disorders observed among Black Americans. Therefore, we assessed MGUS, a precursor condition to myeloma, and MM risk related to a history of allergy, atopy, infections and …

Review Of Age-Related Trends Of Infection Among People Hospitalized Hospitalized For Infection With Concurrent Substance Use, Julia Catherine Lucia Gregorio

Honors Theses and Capstones

Background: Opioids and related injections are the most common drug associated with infection (Capizzi et al., 2020). Overall, data overwhelmingly shows infection and overdose rates on the rise in recent years (Kaiser Family Foundation, 2019).

Methods: The aim of this study was to identify trends between age and concurrent infection rates related to substance use from 2012 to 2019. This quantitative study utilized data from the NH Hospital Discharge Summaries (Office of Health Statistics, 2021). Specifically, trends among three age groups (young adults (18-34), middle-aged (35-54), and older adults (55+)) who were admitted to an inpatient unit or the emergency …

Review Of Age-Related Trends Of Infection Among People Hospitalized For Infection With Concurrent Substance Use, Julia Catherine Lucia Gregorio

Honors Theses and Capstones

Abstract

Background: Opioids and related injections are the most common drug associated with infection (Capizzi et al., 2020). Overall, data overwhelmingly shows infection and overdose rates on the rise in recent years (Kaiser Family Foundation, 2019).

Methods: The aim of this study was to identify trends between age and concurrent infection rates related to substance use from 2012 to 2019. This quantitative study utilized data from the NH Hospital Discharge Summaries (Office of Health Statistics, 2021). Specifically, trends among three age groups (young adults (18-34), middle-aged (35-54), and older adults (55+)) who were admitted to an inpatient unit or the …

Evaluation Of Stratified Antibiograms For Use In Laboratory And Antimicrobial Stewardship, Linsey Donner

Theses & Dissertations

Antibiograms are critical for choosing empiric antimicrobial therapy. Cumulative antibiograms, which aggregate susceptibility data, can mask differences within specific patient subsets or clinical syndromes. This dissertation was done to determine if antibiotic susceptibilities showed substantial differences when comparing stratified antibiograms to cumulative antibiograms.

Antibiotic susceptibility data was retrospectively obtained from Nebraska Medicine January 1, 2017 – December 31, 2019 for Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Staphylococcus aureus, and Enterococcus faecalis. The University of Nebraska Medical Center’s web antibiogram clinical decision support tool was used to export the data. Bacteria-antibiotic susceptibility rates of stratified antibiograms …

Examination Of The Association Between C - Reactive Protein(Crp) And Covid-19 Infection Severity And Length Of Hospitalization, Abdulahi Aremu Ayanwale

Open Access Theses & Dissertations

Chronic stress can lead to many systemic complications and low-grade systemic inflammation including increased levels of inflammatory cytokines, such as C-reactive protein (CRP). CRP is a marker of systemic inflammation and is associated with depression and perceived stress. Elevations can result in ineffective immune responses, thereby increasing the risk of complications and mortality from infections. Recent evidence suggests that uncontrolled inflammatory responses associated with COVID 19 are a major determinant of disease severity.  The COVID 19 is transmitted from one person to another through droplets from coughing, sneezing, talking, touching droplets on surfaces and contamination by hand-to-mouth routes. The mechanism …

Methods Of Educating Nursing Students On Proper Handwashing To Enhance Infection Control During The Covid Pandemic, Yulanda King

Doctor of Nursing Practice Projects

Background: Medical professionals have commonly been urged to use soap and water to sanitize their hands to prevent contamination and disease transmission. However, thorough handwashing requires a couple of minutes to clean hands thoroughly. Considering that health professionals must sanitize their hands' multiply times during a day, handwashing consumes a significant amount of time away from bedside care. Time spent away from patients may also result in a substantial decrease in the quality of healthcare services provided by the medical institution.

Purpose: This project evaluates the current policy and procedure for appropriate use of handwashing versus hand sanitizer in the …

Coccidioidomycosis (Valley Fever) Awareness, Kelly Dzialowski

Nursing Student Class Projects (Formerly MSN)

The overall purpose of this poster is to describe the fungal infection, Coccidioidomycosis, and bring awareness to this infection. The poster describes the history of the infection, pathophysiology, risk factors, and clinical presentation. Diagnosis, treatment, and complications of coccidioidomycosis are also addressed. The poster discusses the implications for nursing practice, information about the search for a vaccine, and comparisons of coccidioidomycosis and Covid-19. Finally, the conclusion discusses the key points within the poster and the importance of prompt and accurate diagnosis.

Glycoprotein 340 Expression In Dry Eye Disease And Ocular Surface Infection, Kwaku Antwi Osei

All ETDs from UAB

Glycoprotein 340 (Gp340) is a 340-kDa multi-domain pattern recognition receptor (PRR) belonging to the scavenger receptor cysteine-rich superfamily of proteins. On the ocular surface, Gp340 is expressed in the tear film, lacrimal gland, cornea, and conjunctiva. By their nature, PRRs detect pathogen-associated molecular patterns (PAMPs) on microbial organisms and damage-associated molecular patterns (DAMPs) released from injured, stressed, necrotic, and apoptotic cells. This, in turn, induces the expression of nuclear factor-κB- and the interferon regulatory factor-dependent expression proinflammatory cytokines and chemokines, eliciting both innate and adaptive immune response activation. Thus, as a PRR, Gp340 has the potential to modulate microbial infection …

Surgical Site Infection Rates After Implementation Of The Surgical Care Improvement Project Initiative, Victor Lao De Guzman Jr

Walden Dissertations and Doctoral Studies

Surgical site infections (SSIs) reflect a serious complication in modern healthcare and are a substantial burden to healthcare systems and service payers worldwide in terms of patient morbidity, mortality, and additional costs. The Surgical Care Improvement Project (SCIP), introduced in 2006, was developed by the Centers for Medicare and Medicaid Services to reduce SSI rates by 25%. However, SCIP was retired in 2015. Given the considerable financial burden of SSIs and because SSIs may be prevented using evidence-based measures, it was worth revisiting and re-evaluating the quality improvement efforts brought about by the success of the evidence-based SCIP initiative. This …

Microorganisms In Presumed Aseptic Revision Hip And Knee Arthroplasty, Michael E. Neufeld

Electronic Thesis and Dissertation Repository

The role and clinical significance of microorganisms in presumed aseptic revision total hip (THA) and knee arthroplasty (TKA) is unclear. The primary aim of this thesis was to determine the prevalence and infection-free survival of presumed aseptic revisions with unexpected positive intraoperative cultures (UPC) by analyzing the largest cohorts of UPC in the literature. Secondarily, a prospective pilot study using modern molecular techniques with an emphasis on stringent control of contamination was designed to determine how frequently microorganisms are present on implants of presumed aseptic revisions, as well as their location and association with reason for revision.

The prevalence of …

Total Joint Replacements And Prevention Of Surgical Site Infections, Mari Rearley

Nursing Student Class Projects (Formerly MSN)

Surgical site infections continue to be a leading cause of postoperative complications in hospitals across the nation. Although much progress has been made in preventing postoperative infections, it continues to be cost intensive within the medical institution. It also reduces patient satisfaction and quality of life. The majority of joint replacement surgeries are considered to be elective, which provides an opportunity to plan ahead to provide education to the patient and make other necessary changes to ensure high quality care is provided at all times. Each phase of surgery has the potential to greatly impact the desired outcome and improve …

Sepsis: Early Identification Of Sepsis, Natasha Asante

Nursing Student Class Projects (Formerly MSN)

Sepsis is a life threatening emergency and it is the body’s extreme response to an infection (CDC, 2019). Sepsis continues to be a problem for all medical institutions globally due to its high mortality rate. Sepsis can be caused by any pathogen and may arise from pneumonia, urinary tract infections and infections in the skin or soft tissue (Nagalingam, 2018). As sepsis progresses, it can lead to organ dysfunction, tissue damage and death. The progression of sepsis can be categorized in 3 stages, that is Systemic Inflammatory Response Syndrome (SIRS), severe sepsis and septic shock. Septic shock is the most …