Medicine and Health Sciences Commons^™

Dnp Final Report: Implementation Of Intraoperative Elements Of Enhanced Recovery After Surgery Protocol In Gynecologic Surgery Patients, Dawn D. Nichols

DNP Final Reports

Gynecologic surgeons at the hospital believe that patients undergoing minimally invasive gynecologic surgery (MIGS) experience an increased length of stay (LOS). Generic enhanced recovery after surgery (ERAS) order sets exist but are not consistently used, nor are the sets specific to MIGS patients. Preoperative education/counseling regarding ERAS is limited in pre-admission testing (PAT) and provider clinics. It is unclear what intraoperative and postoperative components of ERAS are being implemented consistently. The PICOT question to be answered is: In patients undergoing minimally invasive gynecology surgery (P), how will the implementation of Intraoperative ERAS elements (I), compared to the current absence of …

Dnp Final Report: Effects Of Open-Access Scheduling On Patient No-Show Rates In An Outpatient Clinic, Maria Aileen A. Wilkinson Msn, Mba, Rn

DNP Final Reports

No-show rates in a South Texas outpatient clinic have been as high as 16% to 20% which increases wait times to be seen in the clinic and decreases patient access to outpatient care. This no-show rate data has continued despite multiple interventions that have been implemented in an academic health science center. Physical, socio-economic, geographic, and health/lifestyle factors affecting no show or missed appointments are crucial to determining the most appropriate interventions to alleviate this issue. No-show rates are important metrics to improve because it directly affects the organization's revenue, access to care, and appointment wait times. Research evidence regarding …

The Influence Of Smoothness And Speed Of Stand-To-Sit Movement On Joint Kinematics, Kinetics, And Muscle Activation Patterns, Woohyoung Jeon, Xuanliang Neil Dong, Ashley Dalby, Chung-Hyun Goh

Health and Kinesiology Faculty Publications and Presentations

Background: Stand-to-sit (StandTS) is an important daily activity widely used in rehabilitation settings to improve strength, postural stability, and mobility. Modifications in movement smoothness and speed significantly influence the kinematics, kinetics, and muscle activation patterns of the movement. Understanding the impact of StandTS speed and smoothness on movement control can provide valuable insights for designing effective and personalized rehabilitation training programs.

Research question: How do the smoothness and speed of StandTS movement affect joint kinematics, kinetics, muscle activation patterns, and postural stability during StandTS?

Methods: Twelve healthy younger adults participated in this study. There were two StandTS conditions. In the …

Cognitive Behavioral Therapy To Prevent Nurse Burnout In Sub-Saharan Africa, Anna C. Johnson

MSN Capstone Projects

Overall, burnout prevention has been shown to foster nurse resilience, ability to cope with stressors, teamwork, and improving the personal value of “doing good” and “being good”; the effects have been shown to last between 6 months and one year. The current evidence is strong enough to recommend a change to current nursing practice via annual Cognitive Behavioral Therapy (CBT) trainings to strengthen nurse resilience.

This researcher proposes to implement a CBT-based burnout prevention program in Ghana’s capital of Accra in sub-Saharan West Africa. There is ample evidence that African nurses face many of the same burnout issues that nurses …

Educational Campaign: Using Exercise To Prevent Postpartum Depression, Ruth Platt

MSN Capstone Projects

Postpartum depression is one of the most common medical ailments surrounding childbirth. It affects up to 20% of postpartum women and has detrimental effects not only on the mother but her infant and family as well (Navas et al., 2021). Currently, the medical community takes a reactive approach to postpartum depression by screening and treating cases of postpartum depression as they occur. An evidence-based search of peer-reviewed articles found that exercise in the perinatal period had a positive effect on maternal mental health and decreased postpartum depression scores. This is especially true for women who have a history of depression …

Reducing Central Line Infections In Pediatric Critical Care Patients, Callie Lazarine

MSN Capstone Projects

The purpose of this project is to show how early identification of patients who are at high risk for developing central line infections has an impact on infection rates, and how prevention strategies directed towards that patient population could lead to positive patient outcomes and a decrease in central line-associated bloodstream infections (CLABSI). Central line infections are a major hospital-acquired condition within hospital settings. In pediatric critical care areas, central venous catheters are inevitable due to complex diagnoses, patient size, and small vessels. However, CLABSIs have a massive impact on pediatric patients increasing mortality from 4% to 37%, prolonged hospital …

A Benchmark Project On Early Mobility In The Intensive Care Unit, Millicent Odhiambo

MSN Capstone Projects

Introducing early mobility interventions in the Intensive Care Unit (ICU) is a crucial measure to improve patient outcomes and optimize care delivery in the critical care setting. The objective of this project is to tackle the difficulties caused by extended periods of immobility in the Intensive Care Unit (ICU), with the aim of diminishing complications, shortening the duration of ICU stays, and enhancing the functional recovery of patients.

Brain Matters: Cognitive-Behavioral Therapy And Antidepressants For Post-Stroke Depression, Lindsey Anne Smith

MSN Capstone Projects

Stroke is the leading cause of death and disability in the United States, and approximately one-third of these patients will develop post-stroke depression, which is associated with higher rates of morbidity and mortality (American Stroke Association, 2022). Even though post-stroke depression is prevalent, it often goes undertreated. The combination of antidepressants and cognitive-behavioral therapy has shown to be an effective method of treating post-stroke depression. There are cognitive-behavioral exercises that nurses can implement, such as group therapy, acceptance therapy, and cognitive retraining, a method of coaching the patient to replace negative thoughts with positive ones (Byun et al., 2021). With …

Best Practice: Implementation Of A Central Line Bundle To Reduce Central Line-Associated Bloodstream Infections, Alexis N. Montero

MSN Capstone Projects

Central line-associated bloodstream infections (CLABSIs) are among the most frequent health care-associated infections and are reported to be correlated with an increased number of inpatient days, higher cost, and attributable mortality rates (Devrim et al., 2016). For this reason, central line bundles (CLB) have been widely used in hospitals to aid in the decrease of CLABSIs. Through implementation of the prevention strategies included in CLBs, CLABSIs can be reduced by greater than fifty percent (Devrim et al., 2016). A decrease in CLABSIs is clinically significant with the avoidance of negative patient outcomes and a decrease in healthcare costs (Rinke et …

Clinician Education Program: Promoting The Use Of Care Bundles In Reducing The Hospital Length Of Stay And Readmission Rates Of Adult Copd Patients, Nordita R. Bascon

MSN Capstone Projects

Management of COPD patients can cost hospitals approximately $308,502 per month. This is based on a single COPD readmission encounter costing $7,500 and estimated daily expenses of $2,883 (Davis, 2023; Hegwer, 2018). This executive summary outlines a clinician education program held at a community hospital in West Texas to promote patient quality care by encouraging healthcare professionals to use evidence-based chronic obstructive pulmonary disease (COPD) care bundles. Eighteen physicians and nurse practitioners attended the program. Then, a survey was conducted to assess the impact of the proposed program. Most attendees said they would incorporate care bundles in COPD care.

Internal …

Nursing Care Of Individuals Engaging In Non-Suicidal Self-Injury: Impact Of Dialectical Behavior Therapy Skills Reinforcement, Lucas Bridgens

MSN Capstone Projects

As explained by Linehan et al. (2006b), the seriousness of borderline personality disorder can be highlighted by the manifestations of emotional dysregulation, such as impulsive and suicidal and non-suicidal self-injurious (NSSI) behaviors. As the mental health field grows, so too does the knowledge base from which practitioners derive therapeutic interventions with hopes of effectively and safely treating patients while maintaining a culture of dignity and respect. One such treatment modality that has proven to reduce NSSI and improve interpersonal functioning, specifically in patients with borderline personality disorder, is Dialectical Behavior Therapy (DBT) which is a form of cognitive-behavioral therapy developed …

Stepping Into Mindfulness: Enhancing Mental Health For Nursing Student Athletes, Amanda A. Marek

MSN Capstone Projects

This capstone project explores the impact of mindfulness practice on nursing student athletes, aiming to understand how mindfulness techniques can enhance their psychological well-being. The project investigates the intersection of mindfulness and addresses the unique challenges and stressors face by nursing student athletes. The project proposals a research study that focuses on how mindfulness can impact nursing student athletes. There is literature that shows how mindfulness can improve stress and mental disorders for nursing students and student athletes separately, but there is a lack of knowledge on how this may affect nursing students who are also student athletes. Mindfulness based …

Increased Venous Access With Ultrasound Guided Ultralong Iv Placement, Daniel Purifoy

MSN Capstone Projects

Maintaining intravenous (IV) access is a vital part of providing care in critical care areas of nursing. It allows for continuous therapies, blood draws, complicated scans, and emergency treatment when needed. There are current procedures for obtaining IV access that are guaranteed to have a successful attempt and placement of a long catheter in a deeper vein. Patients that have been determined to have difficult venous access have proven to lose access quickly with an IV catheter of less than 3.18cm in length (Moy & Keeyapaj, 2017). These difficulties can cause monetary loss to the patients and hospitals, and damage …

A Plan To Improve Sleep During Critical Care Hospital Stay, Andrea Nutting

MSN Capstone Projects

The purpose of this paper is to bring awareness and possible solutions to the ongoing issue of sleep deprivation in hospitalized patients, specifically patients in the intensive care unit. Sleep deprivation can lead to delay in healing, and therefore delay in discharge. There are also many other issues that coincide with sleep deprivation, such as risk for development of delirium and lack of motivation to participate in care. The ICU is a constant state of distress for not only the staff, but also the family members and ultimately the patient. The stressful environment can inhibit relaxation needed to sleep, which …

Implementation Of Telemedicine In A Level Iii Nicu To Reduce Transfer Of Infants, Jennifer L. Welch

MSN Capstone Projects

In July 2012, a hospital located in North Texas opened its 9 bed Level II Neonatal Intensive Care Unit (NICU). Level II NICU is limited to the admission of infants with a gestational age of 32 weeks and above. There has been tremendous growth and expansion of the NICU resulting in an expansion to 13 licensed beds and gaining Level III NICU designation in 2017. Level III designation enables the care of infants that are 23 weeks or greater and have more complex medical conditions to be cared for. In the current competitive market of health care services, it is …

Impact Of Baby Friendly On Exclusive Breastfeeding: Befriending Baby Friendly, Constance Z. Townson

MSN Capstone Projects

Unless you have personally breastfed a newborn baby or tried to help a struggling breastfeeding mother, chances are you would think breastfeeding is not only natural but comes easily. Breastfeeding is indeed a natural progression following delivery; however, various things can play a role in the success of a mother and newborn baby trying to breastfeed. Issues such as feeding position, waking a sleepy newborn, mothers not recognizing newborn hunger cues, a full day of well-meaning visitors impeding skin-to-skin time with mom, or delayed feedings are just a handful. Sometimes, breastfeeding is so difficult that moms who want to breastfeed …

The Reduction Of Pain Perception Through Music Therapy In Surgical Patients, David Collier

MSN Capstone Projects

The control of pain perceptions of surgical patients is an ongoing problem in trying to control the pain with enough narcotics while not giving too much to depress their respiratory status. Using narcotics increases the risks of several side effects which can negatively impact the patient’s recovery (Fu et. al., 2019). Perioperative music is a nonpharmacological method used to decrease the need for pain medication (Fu et. al, 2019; Kahloul et. al., 2016). The patient is in an anxiety state that causes a heightened state of arousal of the sympathetic system, which in turn releases catecholamines to act on the …

Patient Throughput In The Emergency Department, Daniel Alanis

MSN Capstone Projects

In response to ongoing overcrowding in emergency departments, it is imperative to explore effective strategies for mitigating the capacity crises. The purpose of this project is to investigate and implement throughput strategies for a large level 1 trauma emergency department in Houston’s Texas Medical Center. The proposal involves launching a process improvement project to identify opportunity potential for two main interventions: 1. Patient classification for split clinical pathways 2. Dedicated liaison role for throughput responsibilities. The review aims to answer the question: In emergency department patients, how does the implementation of a dedicated throughput liaison compared to a split flow …

The Impact Of Kangaroo Care On Exclusive Breastfeeding In Premature Infants, Colleen Larue

MSN Capstone Projects

This benchmark project emphasizes the crucial imperative of promoting exclusive breastfeeding among preterm and low birth weight infants in neonatal intensive care units (NICUs). Despite the well-documented benefits, exclusive breastfeeding rates remain disappointingly low. This evidence-based project focuses on early intervention through kangaroo care to bolster exclusive breastfeeding rates, with the overarching aim of enhancing infant outcomes and mitigating risks of mortality and morbidity. Engaging key stakeholders, including NICU leadership, nursing staff, lactation consultants, and families, is paramount for the successful implementation of the program. The project presents a detailed implementation plan encompassing various phases, from admission procedures to sustainability …

Evidence-Based Practice - Oral Mucositis Prevention In Chemotherapy Patients: A Benchmark Project, Carrie Davenport

MSN Capstone Projects

The purpose of this implementation project is to help decrease the rates of mucosal barrier injuries (MBI’s) and oral mucositis (OM) in patients receiving chemotherapy on the oncology unit. In 2022, it was reported that seven MBI’s occurred on an oncology unit in a large county hospital in an urban area. This secondary infection has the potential to increase morbidity, increase treatment costs, lengthen hospital stays, and can have a devastating impact on quality of life (Correa et al., 2019). There is currently no protocol in place at the proposed location for this intervention that will help reduce this potential …

Adding Ofirmev: The Effectiveness Of Multimodal Treatment, Kimberly R. Bilal-Williams

MSN Capstone Projects

This project is on enhancing pain management in total knee arthroplasty (TKA) clients via the intravenous (IV) administration of acetaminophen (Ofirmev) by multimodal regimen. The patient, intervention, comparison, outcome, and time (PICOT) question shaping this initiative looks at frequency and intensity of patients’ pain scores as well as practical outcome measures such as healing and physical therapy during the recovery period ending with discharge. After a thorough literature synopsis, it is evident that multimodal pain management strategies including IV acetaminophen provide a better prospectus in comparison to the ones that solely employ opioids. Research repeatedly demonstrates the use of IV …

Reducing Central Line-Associated Bloodstream Infections (Clabsi) With Chlorhexidine-Impregnated Dressings, Sara Garcia

MSN Capstone Projects

Mitigating and eradicating central line-associated bloodstream infections (CLABSI) is a vital patient safety priority. These healthcare-associated infections lead to patient fatalities and incur costly, preventable expenses. Therefore, it is imperative to assess central venous catheter (CVC) maintenance protocols to mitigate the likelihood of infection. Federal guidelines advocate using chlorhexidine (CHG) dressings to lower this risk (Centers for Disease Control and Prevention, 2017). A comprehensive central line maintenance bundle includes incorporating a CHG dressing as a critical measure in reducing the risk of CLABSI (Buetti et al., 2022). Consequently, the escalating infection rates underscore the necessity for implementing CHG dressings (Buetti …

Discharge Preparedness For The Type 1 Diabetic Patient, Nathan W. Sewell

MSN Capstone Projects

The purpose of this paper is to highlight the individual who suffers from type 1 diabetes, because there appears to be a disparity in the equity of their healthcare needs as compared to other chronic illness. Type 1 diabetes is a progressive illness that places a tremendous burden on the person inflicted with it, including emotional, physical, and financial strains, and these burdens contribute to an emotional condition known as diabetic distress (Orben et al., 2022). This distress impacts the individual’s self-efficacy, and they see more frequent exacerbations of their diabetes like diabetic ketoacidosis (DKA) (Fisher et al., 2018; Hood …

Investigating The Impact Of Outpatient Mental Health Follow-Up Care On Continued Adolescent Suicidality: An Evidence-Based Change Project Proposal, Kimberly Feifel

MSN Capstone Projects

The escalating rates of adolescent suicide globally, coupled with the surge in pediatric hospitalization rates, underscore the urgent need for effective intervention strategies. Despite hospitalization, many patients persist in experiencing suicidal ideation and behaviors, often leading to readmissions. A significant portion of these individuals do not receive adequate outpatient mental health follow-up care post-discharge. As a leading pediatric healthcare institution committed to delivering exemplary care, particularly to those struggling with mental health challenges, the organization’s commitment demands proactive measures.

The attached proposal aims to establish an organizational policy to reduce 30-day readmission rates among adolescents with persistent suicidal thoughts and …

Academic Performance Among Pharmacy Students Using Virtual Vs. Face-To-Face Team-Based Learning, Osama A. Shoair

Pharmacy Faculty Publications and Presentations

Introduction

This study compares pharmacy students’ performance using face-to-face (FTF) team-based learning (TBL) vs. virtual TBL across multiple courses and different academic levels while accounting for student demographic and academic factors.

Methods

The study included pharmacy students from different academic levels (P1–P3) who were enrolled in three didactic courses taught using FTF TBL and virtual TBL. Multiple generalized linear models (GLMs) were performed to compare students’ performance on individual readiness assurance tests (iRATs), team readiness assurance tests (tRATs), team application exercises (tAPPs), summative exams, and total course scores using FTF TBL vs. virtual TBL, adjusting for students’ age, sex, race, …

The Effect Of A Positive Work Culture In Emergency Service Nurses: An Ebp Proposal, Brianna M. Fitzgerald

MSN Capstone Projects

This paper aims to address the spirit of inquiry of the effect a safe work environment has on compassion fatigue in nurses in the emergency department (ED). The World Health Organization promotes an eager approach to the battle of compassion fatigue in frontline healthcare workers, stating, "Unless this is addressed, it will further add to the global nursing workforce shortage." (Stafford et al., 2022, p. 1853). Unfortunately, 69% of nurses under the age of 25 report burnout from working conditions (American Nurses Association, 2022). Improving nurses' job satisfaction and motivation levels is necessary to increase the effectiveness of nursing services …

Modality And Terminology Changes For Behavioral Health Service Delivery During The Covid-19 Pandemic: A Systematic Review, Kimberly S. Elliot, Eman H. Nabulsi, Nicholas Sims-Rhodes, Vandy C. Dubre, Emily Barena, Nelly Yuen, Michael Morris, Sarah Sass, Bridget Kennedy, Karan P. Singh

Healthcare Policy, Economics and Management Faculty Publications and Presentations

Introduction: The COVID-19 pandemic prompted healthcare professionals to implement service delivery adaptations to remain in compliance with safety regulations. Though many adaptations in service delivery were reported throughout the literature, a wide variety of terminology and definitions were used. Methods: To address this, we conducted a PRISMA review to identify service delivery adaptations across behavioral healthcare services in the United States from March 2020 to May 2022 and to identify variations in terminology used to describe these adaptations. We identified 445 initial articles for our review across eight databases using predetermined keywords. Using a two-round screening process, authors used a …