Medicine and Health Sciences Commons^™

Implementation Of A Nurse-Led Clinical Algorithm For Pressure Injury Prevention Associated With Non-Invasive Ventilation Medical Device Use, Capri Steinkuhler, Kaitlin Rogge

Doctor of Nursing Practice Projects: College of Nursing

Purpose and Aims

Medical device related pressure injuries (PI) account for as much as 61-81% of all hospital reported wound incidents (Gefen et al., 2020) and are frequently caused by respiratory devices such as non-invasive ventilation (NIV). Use of NIV in critically ill patients dramatically increased during the pandemic. PI are one of the leading causes of injury to hospitalized patients and lengthens hospital stays (National Pressure Injury Advisory Panel [NPIAP], 2019). The NPIAP recommends routine skin assessment under devices, proper mask fit, protective barrier, moisture reduction, and interdisciplinary collaboration to prevent PIs from NIV masks. This feasibility study’s purpose …

Evaluating Nurse Use And Satisfaction With Video-Based Discharge Education For Adults With Heart Failure, Krystyna Simon Rn, Bsn, Molly Hendrickson Rn, Bsn, Windy Alonso Phd, Rn, Fhfsa

Doctor of Nursing Practice Projects: College of Nursing

Background

Heart failure (HF) readmission rates are high and influenced by self-care practices and self-efficacy for managing chronic disease. Using digital education via tablet can help improve the discharge education process and may increase self-care knowledge.

Objective

The purpose of the study is to assess the current discharge processes implemented for HF patients in cardiovascular units at a Midwestern academic medical center.

Methods

Participants for this two-phase study were recruited from two inpatient cardiovascular units within a 700-bed, Midwestern academic medical center. Phase one used a pre-post quasiexperimental design to evaluate a discharge educational intervention using the teach-back method in …

Increasing Communication Of Patient Daily Goals During Interdisciplinary Rounds In An Inpatient Pediatric Cardiac Unit, Sage Bailey

Doctor of Nursing Practice Projects: College of Nursing

Introduction: Ineffective communication between interdisciplinary team members in a pediatric inpatient setting results in poor documentation compliance and decreased staff satisfaction of daily goals. The use of a standardized patient daily goal sheet improves effective communication among interdisciplinary team members. The primary aims of this study were to improve RN satisfaction and knowledge regarding interdisciplinary communication, improve verbalization of patient daily goals in daily rounds, increase the number of daily goals verbally discussed and improve the quality of documentation in the electronic medical record (EMR). Methods: Data were collected on a pediatric academic 30-bed cardiac care unit involving 100 nurses. …

Center Based Cardiac Rehabilitation Outcomes Associated With Covid-19 Pandemic: A Retrospective Comparative Cohort Study, Haley Williams, Kayla Woodworth

Doctor of Nursing Practice Projects: College of Nursing

Background: Traditional cardiac rehabilitation (CR) is a multidisciplinary, multifaceted program for cardiac patients. Throughout the Covid-19 pandemic, health care, including center-based CR (CBCR) programs, were closed to in-person sessions. Even with the return to CBCR participation, patient outcomes may have been affected by this disruption in care. The goal of this study was to determine if CR participation outcomes differed before and after CBCR program closure due to Covid-19.

Methods: A retrospective comparative cohort design was used to examine CR participant outcome data before and after the Covid-19 pandemic. Convenience sampling of CR participants at a large, urban …

Identifying The Effects Of The Covid-19 Pandemic On Individuals With Dual Diagnoses (Mental Health And Substance Use) At Centerpointe Residential Treatment Center, Casey Granger, Dakota Sonderup, William Stowell-Flores

Doctor of Nursing Practice Projects: College of Nursing

Background: Social distancing measures associated with the COVID-19 pandemic began on March 28^th, 2020in the United States. With these implemented measures, the mental health of the population was worsening due to isolation, closures, and fear. Rates of anxiety, depression, and co-occurring substance abuse increased as well. CenterPointe is a behavioral health organization that has a residential treatment facility in Omaha, Nebraska for patients with mental health and substance use disorder dual diagnoses. They utilize the DLA-20 tool with their patients at intake, every 90 days, and at discharge. The DLA-20 is a standardized tool that assesses an individual’s …

Assessing Gender Differences In Usd Students In The Consumption Of Pornography, Abbey Selleck

Honors Thesis

While pornography consumption has been studied many times in the past decade, little has been done on assessing the gender differences behind it. This study sought out to find those differences. A total of 306 University of South Dakota students participated in an online pornography survey. There was 231 females and 75 males. When asked about intentionally consuming pornography, there was 241 responses, 180 females and 61 males. Of those responses, 57 males (93%) and 142 females (79%) said they intentionally consume pornography. As hypothesized, a higher percentage of men said they consumed porn regularly (34%) than did women (4%). …

Translating A Pediatric Weight Management Intervention Into Medically Underserved Areas, Caitlin Golden

Theses & Dissertations

Despite substantial prevention and treatment efforts, childhood obesity remains a pressing public health concern. Disparities persist in obesity prevalence among children of lower socioeconomic status, racial and ethnic minority groups, and those residing in rural areas. The vast majority of efficacious pediatric weight management interventions (PWMIs) have been based in larger cities and urban areas delivered through inter-disciplinary teams in a hospital or medical center, and the degree to which these or other efficacious PWMIs have been translated to, and are feasible in, typical rural or micropolitan areas is unclear. This dissertation describes a dissemination strategy and a systematic approach …

Spatiotemporal Optimization Of Intratumoural Electric Field Modulation For Cancer Therapy, Erin Iredale

Electronic Thesis and Dissertation Repository

The use of anti-cancer non-ablative electric fields is an expanding area of research that includes clinically available external devices for the treatment of glioblastoma (GBM), and a pre-clinical internal system called Intratumoural Modulation Therapy (IMT). IMT uses multiple electrodes implanted within the tumour to apply low intensity electric fields (~1 V/cm) focused on the target region, anywhere in the brain, with no externally visible devices. In this thesis, multi-electrode spatiotemporally dynamic IMT is investigated through computer simulation, numerical optimization, brain phantom and in vitro validation methods. These planning and validation strategies are hypothesized to improve tumour coverage with the necessary …

Referral Triage To Improve Neurology Access, Melinda Mata

Doctor of Nursing Practice Scholarly Projects

The demand for neurology consultation far outweighs the number of specialists, thus causing long wait-times for consultation. Other contributing factors to obtaining timely consultation include, quality of information sent with the referral, insurance authorization, triage process, and appointment availability. This retrospective quality improvement study explored the effects of a referral triage process on reducing appointment wait time. All referrals were sent to one fax number and a new standard referral and triage process was implemented with specific operators with defined roles and responsibilities. The initial results following intervention implementation did not show improvement in wait times. Comparing the new triage …

Health Literacy In Older Adults: Determining Gaps In The Health Literacy Skills Of Older Adults In Saratoga Springs, New York And Suggestions For Effective Interventions, Elizah Jacobs

Self-Determined Majors Final Projects

This study aimed to understand the strengths and limitations of health literacy skills among older adults. The results informed a resource to improve any discovered gaps in health literacy. Participants (n=50) were selected through convenience sampling methods at the Saratoga Senior Center in Saratoga Springs, New York. The Health Literacy Questionnaire (HLQ) was distributed to evaluate health literacy skills among older adults. Measures of means and standard deviations were used to assess strengths and limitations in health literacy skills among nine domains of the HLQ. The results informed the implementation of a resource designed to increase health literacy specifically for …

Immunomodulatory Effects Of Glycerol Echinacea Purpurea Stem And Leaf Extract On Raw 264.7 Murine Macrophages, Maxwell D. Garcia

Undergraduate Theses and Capstone Projects

The eastern and central North American flowering plant Echinacea purpurea (EP) is used by Native Americans as a traditional remedy for upper respiratory illnesses (URI). Active chemical constituents in EP include caffeic acid derivatives, alkylamides, and polysaccharides. The use of EP extracts have been suggested to shorten the duration of upper respiratory illness symptoms. Most studies suggest an immunomodulatory effect on innate immune responses. This research will test the immunomodulatory effects of a 50:50 glycerol:water extraction of EP stem and leaf on LPS-stimulated RAW 264.7 murine macrophages. Results will be compared to previous work using 75:25 ethanol root and 75:25 …

School Psychologists’ Knowledge And Perceived Competence Regarding Concussion Management In Schools, Braelyn Tracy

Electronic Theses and Dissertations

A concussion is a type of traumatic brain injury that can have a serious effect on a young, developing brain. Following a concussion, it is common for children and adolescents to experience difficulties in the school setting. Schools may be the ideal setting to address some of the problems children experience as schools employ some personnel with expertise and experience in assessment and intervention. If return to learn is put to the side, students experiencing concussion signs and symptoms could potentially have long-term cognitive problems. School psychologists play a key role in the prevention and assessment of, and intervention for …

Introducing A Trauma-Informed Care Model To Address Racial Disparities In Perinatal Outcomes Among African American Women, Mariah K. White

Honors College Theses

Racial disparities in maternal and infant health have remained an issue within the United States despite efforts to advance and improve our health system. Most maternal deaths are preventable, especially with early and adequate maternal care. Infant mortality occurs for several reasons, but inadequate care usage increases the risk for adverse outcomes. Prenatal care usage within the United States has been inadequate for numerous years, most commonly among African American women, despite its known benefit. Low prenatal care usage among African American women can be attributed to community barriers, social injustices, trauma, discrimination, and health care mistrust. Trauma is common …

Increasing Education And Awareness Of Patients Who Identify As Transgender In Primary Care​, Cindy Wallace

Doctor of Nursing Practice Projects

Background. Lesbian, gay, bisexual, and individuals who identify as transgender and queer (LGBTQ) often experience negative healthcare encounters (Parameshwaran et al., 2017). According to the Williams Institute of Law (2022), there are 1.3 million adults who self-identify as transgender. This education project utilized a pre/post-test design to explore attitudes, practices, and knowledge of primary care providers when interfacing with individuals who identify as transgender in primary health care settings.

Theoretical Framework. This project was guided by Lewin’s Change Theory.

Methods. Primary care providers in an urban community health clinic received a pre and post-education survey. A teaching session was delivered …

Post-Partum Deprssion: An Educational Intervention For Nursing Staff In A Rural Hospital Obstetrics, Tonya Jewell

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Postpartum depression (PPD) is a type of depression that has occurred in women during pregnancy or after the delivery of a child. In the United States, approximately 13.2% of postpartum women were diagnosed with postpartum depression. Research indicated that early identification of PPD led to the best outcomes for postpartum mothers. Routine postpartum depression education and screening for postpartum depression did not exist in the perinatal unit at a Southeast Georgia rural hospital. Lack of nursing knowledge and skill were two barriers identified to screening patients for PPD and providing discharge education. The study provided an educational intervention to provide …

A Reform Of Treatment: An Analysis Of The American Asylum Movement, Sam Lipert

Graduate Dissertations and Theses

The nineteenth century was a revolutionary period for the medical field in America. While there was little regulation of the practice of medicine, there was a push towards the greater incorporation of science in the latter half of the century, and training in formalized schools increasingly became a symbol of legitimacy for physicians. This applied not only to practitioners of physiological medicine, but those who practiced psychiatric medicine as well. The nineteenth century saw both the birth and the death rattles of the American asylum, and it ushered in a new understanding of the insane – it promoted the idea …

Implementing An Emr System In A Small Psychiatric Practice, Brandy Mccrudden

Doctor of Nursing Practice Projects

Electronic medical records (EMRs) can aid in improving surveillance, monitoring, adherence to practice guidelines, improving communication, and reducing medical errors. The adoption of EMRs in psychiatry and mental health settings has been slow despite the offered benefits. This project aimed to develop an implementation and training plan to successfully transition from paper charts to EMRs in a psychiatry practice. An extensive literature review was conducted on the adoption of EMRs in mental health settings, and a guideline for implementation was created to overcome identified barriers. Implementation guidelines included a planning phase, staff training plan, and rollout using a phase-in approach. …

Caring For The Adult Patient With Autism: Development Of Staff Education And An Online Toolkit For Healthcare Providers, Kristen Conkle

Doctor of Nursing Practice Projects

There are disparities in knowledge among healthcare workers when caring for adult patients with autism spectrum disorder (ASD). Lack of knowledge about the characteristics of this population and strategies to enhance care pose a barrier to treatment during hospitalization. A computer based educational module was developed and assigned to staff at a community hospital. An online toolkit for healthcare providers was developed to aid staff in recognition of triggers and supplied adjunct methods for communication. A pre and posttest of healthcare provider knowledge and stigma regarding autism was performed. Achievement of the training was robust among staff; of the one …

A Multifaceted Approach To Promoting Speaking Up Behavior In A Community Hospital, Carrie Carls

Doctor of Nursing Practice Projects

Introduction

This project describes results of a multifaceted approach to promoting Speaking Up Behavior (SUB) among nurses in a community hospital. Patient safety outcomes, perception of healthy work environment, and nurse retention are connected to caregiver communication.

Methods

Interventions included development of a structured SUB communication and debriefing tool, SUB administrative policy, leadership rounding and verbal support for SUB, formal recognition of SUB, and SUB education including role-playing activities. Cross-sectional surveys evaluating nurse comfort and confidence with SUB using validated tools were implemented before and after the multifaceted interventions.

Results

The bedside nurse voluntary turnover rate reduced from 14.5% to …

Second-Victimhood Among Anesthesia Providers & The Effects On Patient Outcomes, Erika Aitken

Doctor of Nursing Practice Projects

Anesthesia providers work in environments promoting productivity with tremendous pressure to begin the next case regardless of any recent adverse events that may have occurred (Wands, 2021). Certified nurse anesthesiologists (CRNAs) potentially struggle with a lack of recognition, a high number of hours, inadequate work-life balance, and limited professional advancement, which all contribute to high stress levels within the field (Andrade & Dantas, 2015). A healthcare professional involved in an unexpected adverse event, medical error, or patient-related injury is labeled as a second victim. Thirty anesthesia providers from a central Illinois hospital viewed a PowerPoint presentation, completed a survey, and …

Compassion Fatigue And Burnout In Mission Trip Providers, Camille Roland

Doctor of Nursing Practice Projects

Compassion fatigue (CF), burnout (BO), lack of compassion satisfaction, and impaired mental health have had catastrophic effects on nurses, providers, and support staff in the past few years due to COVID-19, labor shortage, an influx of critically ill patients, and long hours. Compassion fatigue was coined by Figley as a state of exhaustion and dysfunction biologically, psychologically, and socially because of prolonged exposure to compassion stress. Related concepts identified as burnout and secondary traumatic stress (STS) play an inclusive role in one’s ability to cope with daily environmental stressors causing physical, emotional, and mental breakdown. The link between …

Sti Education For Adolescents, Maryann Van Ryn, Lucy Nyrongo

Doctor of Nursing Practice Projects

Adolescents make up the majority of STI cases in the United States; however, most STI education has not targeted them and their unique needs. This quality improvement project aimed to create an evidence-based educational tool for sexually transmitted diseases (STIs) for adolescents in a pediatric clinic. Next, we created a dynamic QR code to access the flyer digitally on a patient's mobile device. The QR code was printed and placed in an accessible location in the office. The dynamic QR code allowed us to capture data on the total number of scans and provided the demographics of the scanners and …

Introduction Of A Spinal Care Pathway Triage Protocol In The Secondary Care Setting, Tonicia I. Boston

Doctor of Nursing Practice Projects

Background: Back pain is considered the leading cause of disability worldwide. Providing effective multidisciplinary care for clients with chronic back pain (CBP) has been an ongoing issue globally. Improper care management of CBP creates personal, economic, and societal burdens that significantly affect patients, their families, and the healthcare system. Purpose: This quality improvement project aimed to successfully integrate a spinal care pathway (SCP) electronic decision support tool (e-tool) into a multidisciplinary spinal care program, to improve providers’ satisfaction with care delivery and their satisfaction with CBP patient outcomes. Methods: This DNP project used an evidence-based quality improvement (EBQI) design to …

Utilizing Gastric Point-Of-Care Ultrasound Assessment For Patients With Questionable Npo Status, Carolina Botero

Doctor of Nursing Practice Projects

Perioperative aspiration is a rare but serious complication with high morbidity and mortality for patients. This event often occurs from anesthetic depression of protective airway reflexes. NPO guidelines are implemented before anesthesia to eliminate the presence of any gastric contents. However, patients with certain comorbidities may still persist with a full stomach before an anesthetic. Patients may complicate matters further by not following NPO instructions, the patient’s NPO status may be unknown, or the timing of surgery may prevent adequate NPO times. In these situations, the anesthesia provider is faced with the difficult decision to alter, delay or potentially cancel …

Active Learning Techniques To Improve Emotional Intelligence Among Student Registered Nurse Anesthetists, Sydney Bontz

Doctor of Nursing Practice Projects

Students enrolled in nurse anesthesia programs are challenged to meet rigorous and lengthy clinical and didactic requirements throughout doctoral-level curriculums. Historically, admission into nurse anesthesia programs has been based on categories such as academic performance, intensive care nursing experience, and the curriculum vitae. However, emerging research has exhibited emotional intelligence as an essential skill for varying situations that may be encountered. Additionally, training can be utilized to increase emotional intelligence levels (Lolaty et al., 2012).

The goal of this doctoral project was to provide emotional intelligence training for first-year student registered nurse anesthetists (SRNAs) at a mid-size University in the …

Establishing A Diabetes Self-Management Resource For The Self-Pay Client In A Rural Clinic, Emily Birkhead

Doctor of Nursing Practice Projects

Self-management of type 2 diabetes mellitus remains a prominent health concern across the United States. Adherence to treatment plans, medication, and glucose monitoring are often limited by out-of-pocket costs for the client. Diabetes Self-Management Education (DSME) is a set of domains that includes: medication adherence, glucose monitoring, nutrition, exercise, and effective coping mechanisms. DSME programs are provided across the United States helping those with Type 2 diabetes mellitus on their daily habits and management of the condition. DSME programs are largely unavailable to rural communities due to cost and distance barriers, resulting in diabetes education not being readily available in …

Examining Asian Americans' Perceived Barriers To Healthcare Access, Kathleen Nguyen, Jennifer Ramos

Honors Thesis

This research aimed to examine Asian Americans and their perceived barriers to healthcare access. Asian Americans, due to not being a homogenous ethnic group, experience health disparities that are different to those that other ethnic groups experience. Compared to whites in America, Asian Americans are less likely to have job-based insurance coverage and because of this are then less likely to be insured (Brown et al., 2000). Additionally, the most common perceived barriers to accessing healthcare for Asian Americans are cultural attitudes, financial and socioeconomic status, as well as language barriers. These barriers found in the literature served as the …

The Breath As A Holistic Regulator: An Expressive Arts Therapy Community Project, Jacobita Munoz

Expressive Therapies Capstone Theses

This capstone offers the idea that evolution has challenged appropriate breathing and led humans to breathe incorrectly, thus negatively affecting their physical and mental health. As breath can damage the body, it can also serve as a regulator of the mind and body. This thesis points out the multiple effects when uniting controlled respiration, drumming and nature sounds. Breathing, music and nature have many things in common. These include repetition, pattern, awareness of the present moment and relaxation. They all contain a rhythm, and they offer self-regulatory skills. Music-based expressive arts therapies intervention is postulated to provide breathing techniques, united …

A Social And Ecological Approach To Mosquito Species Distribution Across Land Use In Bangor, Maine, Megan L. Schierer

Electronic Theses and Dissertations

Mosquitoes are ubiquitous pests and infectious disease vectors. However, not all mosquito species bite humans, or are competent pathogen vectors between bloodmeal hosts. Along with climatic variables like temperature and rainfall, mosquito species distribution is determined by aquatic habitat availability for juvenile mosquito development, and terrestrial habitat and host availability for adult mosquitoes. There is variation in the preferred aquatic habitat for gravid female oviposition and subsequent larval development. Some mosquito species’ oviposition and development are associated with ephemeral water sources (e.g., floodplains), others prefer more permanent water sources (e.g., bogs or vernal pools). Other mosquitoes have evolved to occupy …

The Effects Of Peers For Young Adults On Anxiety And Quality Of Life For Young Adults With Autism Spectrum Disorder, Alysha Cecile Dagg

Electronic Theses and Dissertations

Social skills deficits as well as comorbid anxiety are two characteristics commonly experienced by people with Autism Spectrum Disorder - Level 1 (ASD-1; American Psychiatric Association, 2013). These characteristics are also both contributors to a lower quality of life for young adults (Smith et al., 2019). The current study aimed to identify how the quality of life and anxiety are affected by social skills intervention, specifically the PEERS® for Young Adults program (Laugeson, 2017). PEERS® for Young Adults is an evidence-based social skills intervention intended to support individuals with ASD-1 (Laugeson, 2017). Prior research has demonstrated its success in both …