Medicine and Health Sciences Commons^™

Potential Prognostic Determinants For Fet::Creb Fusion Positive Intracranial Mesenchymal Tumors, Frank M. Mezzacappa Et. Al.

Graduate Medical Education Research Journal

No abstract provided.

Liposuction For Superficialization Of Deep Hemodialysis Vascular Access: A Novel Application, Currey M. Zalman Et. Al.

Graduate Medical Education Research Journal

No abstract provided.

The Roles Of Mucins Muc5ac And Muc16 In Lung Cancer, Elizabeth Blowers Et. Al.

Graduate Medical Education Research Journal

No abstract provided.

Interactive Learning And Uv Dosimetry As A Means To Improving Sun Safety Knowledge And Behaviors, Elliot Blue Et. Al.

Graduate Medical Education Research Journal

No abstract provided.

Comparison Of Peripheral Biomarker Profiles Across Unique Multimorbidity Patterns In Rheumatoid Arthritis, Chloe Peyton Et. Al.

Graduate Medical Education Research Journal

No abstract provided.

Resident Satisfaction With Didactic Curriculum And Absite Scores After A Major Curriculum Change, Kelsey R. Tieken Et. Al.

Graduate Medical Education Research Journal

No abstract provided.

Standardized Approach To Managing Adhesive Small Bowel Obstructions Reduces Hospital Length Of Stay On The Emergency General Surgery Service, Rachael N. Newton Et. Al.

Graduate Medical Education Research Journal

No abstract provided.

What Do Our Patients Really Know About Dialysis And End Stage Kidney Disease, Debra Wekesa Et. Al.

Graduate Medical Education Research Journal

No abstract provided.

Incidence And Outcomes Of Acute Appendicitis During The Covid-19 Pandemic, Ellen Horstmann Et. Al.

Graduate Medical Education Research Journal

No abstract provided.

Analyzing Predictive Factors For Pathologic Complete Response For Locally Advanced Rectal Cancer, Adam Cloos Et. Al.

Graduate Medical Education Research Journal

No abstract provided.

Predictors Of Trauma Patients Leaving Against Medical Advice, Krysta M. Sutyak Et. Al.

Graduate Medical Education Research Journal

No abstract provided.

Clinically Significant Hypotension In Patients Undergoing Thoracoscopic Lobectomy: A Single-Center, Retrospective Analysis Of Thoracic Epidural Analgesia Versus Liposomal Bupivacaine Intercostal Nerve Blockade, Jason Lizalek Et. Al.

Graduate Medical Education Research Journal

No abstract provided.

Outcomes In Intravenous To Oral Antimicrobial Therapy In Beta-Hemolytic Streptococcus Species, Mackenzie R. Keintz Et. Al.

Graduate Medical Education Research Journal

No abstract provided.

Comparison Of Outcomes For Patients Admitted From The Emergency Department With Focal Vs Multifocal Pneumonia, Glen Clinton Et. Al.

Graduate Medical Education Research Journal

No abstract provided.

Up-Regulation Of Tumor Suppressor Microrna Let-7 In Inflammatory Bowel Disease Is A Novel Molecular Marker For Induction Of Disease Remission, Donghyun Kim Et. Al.

Graduate Medical Education Research Journal

No abstract provided.

From Canvases To Catheters: The Artistic Journey Of A Procedure-Loving Resident Physician, Raquel Lamarche

Graduate Medical Education Research Journal

No abstract provided.

Stellate Ganglion Block For Refractory Raynaud’S Phenomenon- A Case Report, William J. Naber Ii, Derik J. Scribner, Gabriel Howard

Graduate Medical Education Research Journal

Introduction: Raynaud’s phenomenon (RP) is predominately a sympathetically mediated ischemic vasospastic disease involving the distal limbs and is associated with sharp pains, numbness, and dermatological color changes. The symptoms are commonly induced by cold weather, stress, and trauma and it is known to affect 4.85% of the population. There are few well-defined treatments for patients with RP that are refractory to 1st-line therapies. We present a case of intractable RP with corresponding response to stellate ganglion block (SGB) which demonstrates the efficacy profile and safety of SNS blocks in treatment of resistant RP.

Methods: Per Bon Secours Mercy Health …

Early Onset Bullous Emphysema Associated With Polysubstance Use, Kelsey Noble, Julia Griffin

Graduate Medical Education Research Journal

The burden of COPD in the United States is tremendous. This disease is not only among the leading causes of mortality annually, but also takes a heavy financial toll.¹ Bullous emphysema is a severe variant of COPD. The primary identified risk factor for bullous emphysema is tobacco use; however, the impact of other substances is not clearly delineated.² This case presents a patient diagnosed with severe bullous emphysema at age 33 with substantial disease progression over the course of 12 years associated with much scarcer tobacco use than would be expected but a prominent history of methamphetamine and …

Successful Latissimus Dorsi Free Flap Salvage Using Intraoperative Vasopressors: A Case Report, Aubree Ford, Hugo Palacios Vazquez, Sean Figy

Graduate Medical Education Research Journal

Arterial thrombosis is a rare, but dreadful complication in microvascular surgery. Here we report on a case of recurrent arterial thrombosis in a latissimus dorsi (LD) free flap used for scalp reconstruction in an 18-year-old woman who sustained a gunshot wound (GSW) to the head. In the immediate postoperative period, internal and external doppler signals to the flap were lost. Emergent surgical exploration revealed arterial thrombosis, which was emergently explored and successfully repaired. Doppler signals were again lost and the flap was emergently explored for a second time. Following revision of the arterial anastomosis, flap perfusion decreased and appeared to …

Preparing For The Unexpected: Recognizing A Tortuous Thoracic Aorta During Ultrasound-Guided Thoracentesis, Michael Choi, Jessica Roettger, Christopher J. Smith

Graduate Medical Education Research Journal

Ultrasound-guidance has become the standard of care for bedside thoracentesis. This manuscript describes the importance of utilizing point-of-care-ultrasound (POCUS) and color Doppler in avoiding an unusual, but potentially catastrophic aortic puncture during thoracentesis. The case describes a 70 year-old man who presented with one week of shortness of breath. He was found to have a large left-sided pleural effusion on imaging studies. During a bedside POCUS examination, he was found to have a hyperechoic linear structure in his posterior left hemithorax. Ultrasound application of color Doppler revealed a pulsatile flow, confirming visualization of the aorta. The site of needle insertion …

Pelvic Actinomycosis: A Case Report, Jacklyn Locklear, Rachel Gilbert, Neelima Sukhavasi, Elizabeth Sutton

Graduate Medical Education Research Journal

Introduction: Actinomycosis is a bacterial infection caused by the gram positive anaerobic bacteria that most commonly infects the cervicofacial region of the body. Rarely, it can infect the pelvis and typically presents in a nonspecific manner.

Case Report: We present a case of a 43 year old female G6P6006 with Paragard® intrauterine device (IUD) who presented with purulent umbilical discharge and pelvic pain. Initial imaging was concerned for gastrointestinal or ovarian malignancy. Patient underwent diagnostic laparoscopy with pelvic washings and hysteroscopy D&C. Operative pathology returned with results for actinomyces (IUD likely source).

Conclusion: While it is established IUDs can be …

Expedited Recovery Pain Management Pathway For Minimally Invasive Repair Of Pectus Excavatum (Mirpe), Maria E. Tecos, Jessica Goeller, Robert Cusick, Stephen Raynor

Graduate Medical Education Research Journal

Introduction: Pectus Excavatum (PEX) is the most common anterior chest wall deformity. While minimally invasive repair of pectus excavatum (MIRPE) has improved perioperative outcomes, there continue to be opportunities to optimize postoperative pain management and reduce length of stay (LOS). We compared the impact of a multimodal expedited protocol utilizing a combination of systemic and regional analgesia (with single shot paravertebral truncal blocks), along with coping techniques (such as meditation), and physical therapy, with systemic analgesia on LOS and opioid requirements.

Methods: 51 patients underwent MIRPE with an expedited recovery protocol in comparison with 112 historical control patients at a …

Systemic Inflammation Is Associated With Disease Extent And Survival In Oral Cavity Squamous Cell Carcinoma, Brendan Coutu, Dallin N. Christensen, Evan Ryan, Elizabeth Bradford Bell, Weining Zhen, Zafar Sayed

Graduate Medical Education Research Journal

Background: Although systemic immune-inflammation index (SII) correlates with patient survival in various solid malignancies limited information is available in the setting of oral cavity squamous cell carcinoma (OCSCC).

Methods: We retrospectively reviewed 222 patients who underwent a resection of curative intent for patients with OCSCC. SII was determined prior to surgical resection as platelet count × neutrophil count/lymphocyte count.

Results: At a median follow-up of 30.6 months, 2-year disease-free survival (DFS) and overall survival (OS) rates were 63.9% and 76.4%, respectively. A high SII (>1047) was associated with poor performance status and disease extent. A low SII was independently …

Art Of Medicine - 2023

The Art of Medicine

No abstract provided.

Evaluation Of The Effectiveness Of The Ihi Joy In Work Framework Among Nurses, Jezlynn M. Vonnahme

Doctor of Nursing Practice Projects: College of Nursing

Background: Registered nurses are leaving the bedside at alarming numbers with many of them suffering from burnout, a decrease in compassion satisfaction, a lack of joy in work, and/or lack of work-life balance. It is critical these issues within nursing are identified and mitigated in order to reduce the number of nurses planning on leaving the bedside as 33% of nurses are currently considering leaving their role or reducing their hours. This statistic does not help with the current nursing shortage and its prediction to continue to grow with employment needs for nurses expected to increase 9% more than any …

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 …

Implementation Of Chronic Obstructive Pulmonary Disease Action Plan On The Step Down Critical Care Unit: A Pilot Study, Peter Chambers, Kaelee Dameron, Carolyn Kiefer

Doctor of Nursing Practice Projects: College of Nursing

Background: Hospital readmissions due to chronic obstructive pulmonary disease (COPD) exacerbations are a significant economic and resource burden on the United States healthcare system. Current professional guidelines for the prevention of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) include providing patient-focused education with a written action plan such as a COPD Action Plan.

Aims: The primary purpose of this project was to determine if providing an educational intervention to patients admitted for AECOPD would reduce hospital readmission rates for COPD and improve patient outcomes. Method: We performed a quasi-experimental pilot study of 10 participants admitted with a COPD exacerbation …

Pediatric Diabetic Ketoacidosis Fluid Composition And Rate In Care Of Type 1 Diabetic Patients, Gabriel Hansen, Janae Langner, Michaela Tarpley

Doctor of Nursing Practice Projects: College of Nursing

Objective

Complications of diabetic ketoacidosis (DKA) include iatrogenic hyperchloremia and acute kidney injury (AKI). The objective of this study was to evaluate the association of decreasing sodium chloride (NaCl) composition in standard DKA fluid resuscitation and the rates/severity of hyperchloremia and AKI in pediatric patients.

Methods

In December 2020, Children’s Hospital and Medical Center (CH&MC) changed the standard base composition of DKA fluids from 0.9% to 0.675% sodium chloride (NaCl) and increased the fluid resuscitation rate for patients over 30kg as a quality improvement project. A retrospective chart review analyzed patients admitted with DKA from January 2019-December 2021, excluding patients …

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 …

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 …