Medicine and Health Sciences Commons^™

Impact Of Resiliency Training On Combating Burnout, Kimberly Labinsky

MSN Capstone Projects

Occupational burnout has long since been a problem but has only recently been acknowledged as the spark behind the fire that has led to our critical nursing shortage. Considering the emotional aftermath of the pandemic and the hardships that a strained economy will bring, we must learn how to extinguish these flames rather than adding fuel to this complex problem. Burnout is causing a vicious cycle within the healthcare workforce that will lead to detrimental effects on quality patient care. We must learn how to break the cycle.

The cycle starts with experienced nurses leaving unprecedented numbers and units primarily …

Adolescents With Depression Capstone Benchmark Project, Myeshia Salter

MSN Capstone Projects

This change project promotes the inclusion of adolescent involvement within the informed consenting process for recommended treatment plans for symptoms of depression. This project proposal will include the adolescent throughout the development of the treatment plan to promote compliance. The incorporation of this plan will encourage autonomy in the adolescent and aid with developing a plan that the adolescent agrees with. The current process does not include the adolescents' desires or opinions, which results in poor efficacy of the treatment plan, thus exacerbating the symptoms of depression.

Polypharmacy Teaching In The Acute Setting, Brandy Marie Duncan

MSN Capstone Projects

Within stable economic societies, polypharmacy has become a phenomenon that can be more harmful, although medications prescribed are with good intentions. Education is integral to nursing responsibilities; it is an intervention tool to help patients affected by polypharmacy. The interest in polypharmacy stems from witnessing the lack of patient education within the acute setting, and the lack poses a greater risk for adverse drug events (ADEs). The healthcare industry’s responsibility is to help alleviate the adverse effects that polypharmacy causes, such as falls, adverse drug reactions, hospitalizations, mortality, and cognitive mental (Fried, 2014).

A new performance improvement project (PI) will …

Dnp Final Report: Implementation Of An Electronic Clinical Placement System For Improving Faculty Workflow And Accreditation Compliance, Janice R. Hawes

DNP Final Reports

Healthcare today is continually evolving and requires healthcare providers to coordinate and work together to provide quality care. Among healthcare changes is the increasing expansion of technological improvements assisting in mainstreaming processes. In the academic setting, these changes are currently needed to help improve faculty workflow and assist in regulatory compliance. The purpose of this paper is to discover if implementing technology in a clinical nursing setting through an evidence-based practice approach will improve nursing faculty workload and aid in accreditation compliance. The design and methodology for this project were developed using the Iowa model of evidence-based practice, the Donabedian …

Exploring Feasibility Of Mhealth To Manage Hypertension In Rural Black Older Adults: A Convergent Parallel Mixed Method Study, Danice B. Greer, Willie M. Abel

Nursing Faculty Publications and Presentations

Objective: The purpose of this study was to explore perceived ease of use, usability, and the feasibility of using mobile health applications to manage hypertension self-care in rural Black older adults with hypertension.

Methods: A convergent parallel mixed method design was used to study a purposeful sample of 30 Black older adults (29 females, 1 male) from rural East Texas. Quantitative data included demographic characteristics and measured blood pressure, height, and weight, along with questionnaires: the Hill-Bone Compliance to High Blood Pressure Therapy Scale, the Krousel-Wood Medication Adherence Scale-4, and the Technology Acceptance Model Questionnaire (adapted). Qualitative data …

Confirming Multiplex Rt-Qpcr Use In Covid-19 With Next-Generation Sequencing: Strategies For Epidemiological Advantage, Rob E. Carpenter, Vaibhav Tamrakar, Harendra Chahar, Tyler Vine, Rahul Sharma

Human Resource Development Faculty Publications and Presentations

Rapid identification and tracking of emerging SARS-CoV-2 variants are critical for understanding the transmission dynamics and developing strategies for interrupting the transmission chain. Next-Generation Sequencing (NGS) is an exceptional tool for whole-genome analysis and deciphering new mutations. The technique has been instrumental in identifying the variants of concern (VOC) and tracking this pandemic. However, NGS is complex and expensive for large-scale adoption, and epidemiological monitoring with NGS alone could be unattainable in limited-resource settings. In this study, we explored the application of reverse transcription-quantitative polymerase chain reaction (RT-qPCR) based detection of the variant identified by NGS. We analyzed a total …

Preoperative Education For Cardiac Surgical Patients Benchmark Study, Jackson W. Payne

MSN Capstone Projects

Heart surgery is a term that scares a lot of people and rightfully so, as the heart is one of, if not the, most vital organ in the human body. So naturally, one can imagine the amount of fear and anxiety that patients feel when they are told they need heart surgery. This fear and anxiety is not unwarranted, either. Heart surgery, in most cases, is a major and highly complex operation with a lot of potential complications and negatives. Despite this, the majority of the time the benefits do outweigh the risks and patients elect to go forward with …

Machine Learning Approach For Cardiovascular Risk And Coronary Artery Calcification Score, C. R. Aditya, Naveen C. Sattaru, Kumaraguruparan Gopal, R. Rahul, G. Chandra Shekara, Omaima Nasif, Sulaiman Ali Alharbi, S.S. Raghavan, S. Arockia Jayadhas

School of Medical and Biological Sciences Faculty Publications and Presentations

Coronary artery calcification (CAC) could assist in the discovery of new risk elements for coronary artery disorder. CAC evaluation, on the other hand, is difficult due to the wide range of CAC in the populations. As a reason, evaluating and analysing data among research have become complicated. In the Research of Inherited Risk Factors for Coronary Atherosclerosis, we used CAC information to test the effects of different analytical methodologies on the correlation with recognized cardiovascular risk elements in asymptomatic patients. Cardiac computed tomography (CT) is also seeing an increase in examinations, and machine learning (ML) could assist with the growing …

A Deep Learning Framework For Earlier Prediction Of Diabetic Retinopathy From Fundus Photographs, K. Gunasekaran, R. Pitchai, Gogineni K. Chaitanya, D. Selvaraj, S. Annie Sheryl, Hesham S. Almoallim, Sulaiman Ali Alharbi, S.S. Raghavan, Belachew Girma Tesemma

School of Medical and Biological Sciences Faculty Publications and Presentations

Diabetic patients can also be identified immediately utilizing retinopathy photos, but it is a challenging task. The blood veins visible in fundus photographs are used in several disease diagnosis approaches. We sought to replicate the findings published in implementation and verification of a deep learning approach for diabetic retinopathy identification in retinal fundus pictures. To address this issue, the suggested investigative study uses recurrent neural networks (RNN) to retrieve characteristics from deep networks. As a result, using computational approaches to identify certain disorders automatically might be a fantastic solution. We developed and tested several iterations of a deep learning framework …

Dnp Final Report: Executive Rounding And How It Affects The Completion Of A Quality Checklist And Quality Indicators: An Evidence-Based Practice Project, Ruben P. Castillo

DNP Final Reports

A question of inquiring led to the development of PICOT questions and a systematic search that recognized an executive leadership rounding process healthcare initiative need to improve the quality of care for patients, QI (quality improvement) initiatives such as reducing CAUTI (community-acquired urinary tract infections) and CLABSI (central-line associated bloodstream infections) in the medical floor population project was developed. The compelling internal and external evidence makes it vital to examine the following question, In acute care inpatients (P), how does an executive leaderships (manager &/or director), quality-indicator rounding plan (I) compare to no rounding plan (C) affect consistent completion of …

Dnp Final Report: Physical Activity In Bariatric Surgery Patients: An Evidence-Based Quality Improvement Project, Amber Buehler

DNP Final Reports

Background: Research evidence supports that increasing physical activity has been shown to reduce weight and prevent weight regain after bariatric surgery. There is currently no specific exercise recommendation or program at the Center for Metabolic and Weight Loss Surgery at Dallas.

Objective: To implement an evidence-based project surrounding physical activity to reduce weight regain in patients 12 months post bariatric surgery.

Methods: The 12-week program will consist of 3 times weekly 1 hour virtual exercise classes led by the Nurse Practitioner and/or Nurse. Patients will be screened for current physical activity via survey using the IPAQ at the beginning and …

Dnp Final Report: Skilled Nursing Facility Readmissions: An Evidence-Based Telemedicine Innovation Project, Debra B. Graham

DNP Final Reports

Background: Nationally, 20% of patient readmissions occur within the first 48 hours after arrival to a skilled nurse facility (SNF), and 40-68% of these readmissions are potentially avoidable. Since 2016, the Centers for Medicare and Medicaid penalized SNFs when their return to hospital (RTH) percentages was above national benchmarks. The four SNFs in this project experienced rising transfer rates and diminished RTH percentages since 2017, despite using in-house providers Monday through Friday. Furthermore, there was no provision to address patients’ changes in conditions after hours.

Purpose: This evidence-based practice (EBP) project aimed to standardize the care provided to …

Dnp Final Report: An Evidence-Based Hesi Exit Exam Remediation Plan, Nancy Mcclurg

DNP Final Reports

In a small East Texas associate degree nursing program, the average pass rate for the National Council of State Board exam fell and was below both national and state averages for three years. In an effort to identify students who may need extra preparation prior to taking the licensure exam, the college administers the HESI Exit Exam during the last semester of the program. For the last three years, between 28 and 37% of the senior class did not achieve a passing score on the exam. The project’s purpose was to evaluate the effect of a remediation plan which consisted …

Dnp Final Report: Seal The Deal In Dementia Care, Christian D. Garrett

DNP Final Reports

Background: Individuals with dementia are often burdened with behavioral problems, which augment health care costs and burden of disease. Treatment of behavioral symptoms with pet therapy is acknowledged to be emotionally beneficial. Robotic pets have demonstrated similar promising effects without the undesirable outcomes of traditional pet therapy. Robotic pet therapy offers an effective replacement to traditional pet therapy.

Objective: The DNP scholarly project rigorously appraises the effectiveness of the SAR, PARO, an FDA approved biofeedback device, for non-pharmacological treatment of dementia-related symptoms.

Methods: An experimental design with repeated measures guided the study. Pre- and post- measures included reliable, valid tools …

Dnp Final Report: Sane Finder: A Web-Based Mobile Solution To Identify The Location Of Currently Available Sexual Assault Nurse Examiners (Sane) For First Responders, Brenda D. Herrmann

DNP Final Reports

Society views sexual assault as one of the most horrific crimes committed by one human being against another, but the “rescue” has the potential to make the experience even more difficult for the victim, in essence re-traumatizing them (Nugent-Borakove et al., 2006). In the United States in 2018, almost 140,000 victims reported being sexually assaulted (U.S. Department of Justice - Federal Bureau of Investigation, 2019). In Texas, over 6 million individuals have been sexually assaulted in their lifetime (Busch-Armendariz et al., 2015). Getting victims to a specially trained sexual assault nurse examiner (SANE) as quickly as possible improves outcomes. SANEs …

Dnp Final Report: Psychosocial Screening For Oncology Patients, Robyn V. Beard

DNP Final Reports

Background: Patients with cancer often face severe distress related to fear of death, body disfigurement, financial stress, and lack of support system. This distress may lead to physical and emotional symptoms that bring patients to seek care at emergency departments, delay care or make poor health choices, and increase utilization of prescription drugs. With the already over burdened healthcare system, addressing these psychosocial needs is vital to improving patients outcomes as well as improving healthcare expenditure. Purpose: The purpose of this evidence based practice project was to improve perceived quality of life for oncology patients through detailed screening and behavioural …

Dnp Final Report: Education Impacting Delirium Knowledge And Recognition, Lynn A. Cox

DNP Final Reports

Background: Delirium is a disturbance of consciousness with an acute onset that varies from hours to days. Patients with delirium have a risk of increased length of stay, increased mortality, morbidity, and long-term cognitive effects. Therefore, the following PICOT question arises: In registered nurses in the acute care setting (P), how does education on use of the CAM (Confusion Assessment Method) tool (I) compared to those units not receiving education (C) affect recognition of delirium (O1) and use of the CAM tool (O2) over 6 weeks? (T)

Purpose: The evidence-based practice project described nurse education and pilot implementation using the …

Dnp Final Report: Using Standardized Surgical Bundles To Reduce Post Cesarean Section Infection: An Evidence-Based Practice Project, Amy L. Wagner

DNP Final Reports

A new mother has so many stressors and a post cesarean section infection should never have to be one of them. The infection rate at MHTW is double the national average at 1.85. This evidence-based practice project looks at the implementation of a pre-surgical bundle in women undergoing cesarean section to reduce overall risk of developing a post cesarean section infection. This evidence shows that the combination of a standardized bundle including infection specific education for the patient and family, pre- and post-surgical bathing, elimination of jewelry worn by patients and staff, antibiotic timing, Chlorhexidine skin prep, and a vaginal …

Dnp Final Report: Mission Cyborg: An Ebp Project Integrating Hybrid Learning In An Undergraduate Nursing Course, Mary A. Thomas

DNP Final Reports

In modern times it is an expectation of students that technology be incorporated into how they receive their education. The COVID-19 pandemic brought to light how pure reliance on traditional face-to-face (F2F) learning can be detrimental to student learning. Many institutes of higher education had already implemented hybrid/blended learning prior to the pandemic and saw no difference in their NCLEX-RN pass rates. This evidence-based practice project gathered, reviewed, and synthesized evidence in order to determine if implementing different teaching strategies would maintain or improve student performance on both unit exams and end of course exit exams.

Dnp Final Report: Adolescent Support For Healthy Living, Kristin S. Hudson

DNP Final Reports

Adolescents often make decisions that negatively impact their health and wellness. They do this for many reasons including impulsivity, underdeveloped communication and coping skills, feelings of invincibility, and a perceived lack of support. In adolescents, how does education and training related to risky behaviors compared to no education affect knowledge, skills, and understanding (KSU) of high-risk behaviors three months after instruction? Thirteen peer- reviewed articles were utilized in the body of evidence. A curriculum-based intervention was implemented. Outcomes include an overall increase in KSU in six key concepts including contraception, substances abuse, sexually transmitted diseases/infections, teen pregnancy, peer pressure, and …

Medical Cannabis: Alternative To Opioids For The Treatment Of Chronic Pain, Brenda F. Seaton

MSN Capstone Projects

There is a growing body of evidence to suggest that cannabinoids (CBD) are beneficial for a range of clinical conditions, including chronic pain, sleep disorders, osteoarthritis inflammation, anxiety, depression, and enhanced quality of life. For patients with chronic pain and arthritis inflammation, traditionally pain-relieving medications, including opioids, have been prescribed for pain relief but with increased risks of addiction and adverse effects with poor outcomes. Medical cannabis use is an emerging treatment alternative to prescription opioids and as an adjunctive to diminish the use of opioids addiction. This project objectively reviews the works of literature on the challenges of proposing …

Central Line Associated Blood Stream Infection (Clabsi) Prevention Through Designated-Nurse Peripherally Inserted Central Catheter (Picc) Line Dressing Change, Belinder Atabongafac

MSN Capstone Projects

The goal of this review is to show ways in which a nurse can have influence in the patient’s life by caring for their PICC line. The rate of hospital-acquired infections is related to the care that patients get while admitted in the hospital. All hospital acquired infections can and should be prevented. This is also true for central line associated blood stream infections (CLABSI). The care provided to a patient with a PICC line, including how their line is taken care of, decides if the line gets infected, and if the patients get an infection. When patients get a …

Asthma Education With Asthma Action Plan, Lois K. Sanders

MSN Capstone Projects

MSN capstone project in which pediatric asthma patients were given audio visits for the purpose of formulating asthma action plans.

Alternating Pressure Overlay Systems, Maris Rathgeb

MSN Capstone Projects

Although preventable, pressure injuries are an overwhelming problem in the healthcare system and can lead to poor quality of life, increased length of hospitalization, and unsatisfactory patient outcomes. Many cardiac surgeries take anywhere from six to twelve hours, and patients are completely immobilized for the entire length of time. Alternating pressure overlays placed on the operating room table provide tissue offloading with inflating and deflating nodes, leading to micro-movements on high pressure bony prominences. The intervention PICO question to be answered in this paper is: In intraoperative patients (P), how does the use of an alternating pressure surface (I) compared …

Benchmark Project Cryotherapy To Prevent Chemo Induced Peripheral Neuropathy, Stephanie Davis

MSN Capstone Projects

As a nurse working in chemotherapy infusion, I have a direct role in symptom management. For patients receiving Taxanes, the most common adverse effect reported by patients is peripheral neuropathy. According to one meta-analysis, Taxane-induced peripheral neuropathy (TIPN) has very high incidence ranging from 11 to 87% and severely impairs patients’ quality of life (Jia et al., 2021). Patients may experience pain, weakness, loss of sensation, decrease in ability to perform ADLs, increased falls among many other impairments as a result. We understand the importance of performance status in oncology patients. This can lead to dose reductions or held treatments …

Appointment Reminder System Benchmark Study, Anthony Rawlinson

MSN Capstone Projects

The average appointment “no-show” rate is 23% across 105 studies (Dantas et al., 2018). These “no-shows” cost an estimated 150 billion dollars a year to the American healthcare industry (Ruiz-Hernandez et al., 2020). Previous estimates place the cost of one no-show event at a primary office in the range of $125 to $274 (Aysola et al., 2020). These missed appointments not only cause a loss in office revenue, but also harm the patients missing the appointment (Marbouh et al., 2020). Some of the repercussions patients suffer from are longer wait times for appointments, higher Emergency Room (ER) admission rates, and …

Resuscitation Of Hypovolemic Trauma Patients: Controlled /Hypotensive Resuscitation Vs. Conventional Resuscitation, Pamala D. Mcgowan

MSN Capstone Projects

The manner in which clinicians have used to resuscitate hemorrhagic trauma patients has been a continuous repetitive cycle over time. The cycle has gone from “run the fluids wide open in the patient” to “less is more in the patient”. As more evidence-based practice (EBP) emerges, reasons for ‘less is more’ become acutely evident. Large fluid volume resuscitation is highly suspicious for the exacerbation of the lethal triad of trauma: hypothermia, acidosis, and coagulopathy, thereby increasing bleeding and mortality (Cotton et al., 2006). The increased risk of bleeding also worsens the complications associated with trauma resuscitation. This all creates a …

Change Of Policy Regarding Evidence Based Practice Interventions In Postpartum Hemorrhages And Promotion Of Standardization Of Care, Danielle Fulton

MSN Capstone Projects

Postpartum Hemorrhages are occurring at a devastating rate and require intervention, as postpartum women can die from hemorrhages. This project aims to establish interventions that should be a set policy, to help decrease the rate in which postpartum hemorrhages occur and the morbidity rate.

Health Literacy In Acute Care Benchmark Study, Micah Duke

MSN Capstone Projects

Poor health literacy levels directly correlate to poor patient discharge adherence and to an increase in repeat emergency department visits and healthcare costs. In addition, poor health literacy levels are directly correlated to a decrease in patient health outcomes. Studies clearly demonstrate that determining patient health literacy levels can be used to develop appropriate discharge instructions and education that will improve patient adherence and health outcomes, thus reducing emergency department readmissions and healthcare costs.

The purpose of this benchmark project is to implement procedures for consistently obtaining patient health literacy levels, along with language preferences, using the HLS-SF12 and to …

Safe Patient Handling And Mobility Olympics, Johnny R. Cortez

MSN Capstone Projects

The focus of this study is the implementation of a Safe Patient Handling and Mobility (SPHM) program titled SPHM Olympics. The study reviews the necessary components and background necessary to implement the project as well as evaluation tools to monitor the impact of the program on the safety of culture at Houston Methodist West (HMW). The program originated from the SPHM committee’s need to improve the utilization of SPHM equipment and techniques by clinical staff throughout the hospital as evidenced by the substantial number of clinical staff suffering from musculoskeletal disorders and HMW clinical staff’s current views that SPHM techniques …