Medicine and Health Sciences Commons^™

Implementation Of The Generalized Anxiety Disorder 7-Item (Gad-7) Screening Tool In A Mental Health Outpatient Clinic, Ella Bosunglan Gang

Doctoral Dissertations and Projects

Purpose: The prevalent disorder known as generalized anxiety disorder (GAD) can have various negative consequences. GAD harms individuals, families, communities, and society as a whole. People with GAD frequently experience a crippling decrease in their physical and mental health. When generalized anxiety disorders are combined with the pressures of pre-existing medical conditions, the quality of life can be significantly impacted. GAD severely impairs social and functional functioning, resulting in frequent clinic appointments, doctor shopping, emergency room visits, high costs from family and employer treatment, and increased costs for global healthcare spending. Proper diagnosis is essential to effective treatment, and a …

Comparing Student Perceptions In Traditional And Online Anatomy & Physiology Courses At The Community College Level, Benjamin Curtis Wright

Doctoral Dissertations and Projects

This paper is intended to compare student perceptions of learning environments within anatomy & physiology I and II courses at the community college level. Literature suggests that student perceptions vary depending on the learning environment. The purpose of this study stems from very little research within science courses. Students participating in the research will be grouped into two categories based on the type, of course, they are completing: A traditional face-to-face course or a distance education course. All learning materials within the courses are identical. The Distance Education Learning Environments Survey (DELES) will be used to gather data on student …

Impacts Of Telemonitoring On Weight Obesity In African Americans, Miranda Bessem Mbutambe

Doctoral Dissertations and Projects

Obesity has become a complex public health issue among African Americans over the last few decades, due to the health risks it poses to this population. Obesity exposes African Americans to a variety of chronic diseases, including, but not limited to, diabetes and cardiovascular diseases. Owing to the complexity inherent in obesity, healthcare practitioners have developed various strategies and interventions to manage weight among vulnerable populations. In this regard, telemonitoring, a continuous or non-continuous process that allows medical practitioners to remotely monitor, collect, and interpret data necessary for medical follow-up and, if necessary, make medical decisions regarding the health state …

Best Strategies To Address Burnout Among Healthcare Professionals: An Integrative Review, Kimberly Ann Delbo

Doctoral Dissertations and Projects

The purpose of this integrative literature review (ILR) is to provide a comprehensive summary and analysis of past empirical and theoretical literature related to the phenomenon of burnout while sharing a synthesis of literature. This ILR explores, critiques, summarizes, and analyzes best practices and interventions to address burnout and promote engagement and well-being among health care workers within acute care hospitals. The scientific basis for this ILR was the premise that a relationship exists between burnout interventions and organizational cultures which can be positively influenced by relational and social leadership styles that reduce work-related stressors and create positive, professional, healthy …

Implementation Of A Medical Emergency Chain Of Command Protocol In The School Setting, Vikki Shannon Brannon

Doctoral Dissertations and Projects

Medical emergencies occur every day in school settings across America. School nurses have a vital role in providing care for individuals experiencing a medical emergency and leading a multidisciplinary team during a medical emergency event. Since incidences of medical emergencies are commonplace, it is standard to have protocols and guidelines for these events. To address this concern, an evidence-based practice project was implemented in a rural school district in North Georgia. The pilot project was developed and implemented to assess the effectiveness of implementing a “Medical Emergency Chain of Command Protocol.” The protocol was developed to improve the effectiveness and …

How Does The Use Of Telemonitoring In Adult Patients With Uncontrolled Hypertension Improve Blood Pressure Control? An Integrative Review, Lucie Bakop

Doctoral Dissertations and Projects

Hypertension is an evolving problem worldwide and it constitutes a great risk for cardiovascular diseases. Despite the research and new drugs on the market to manage high blood pressure, hypertension remains the leading cause of disability-adjusted life and death worldwide. With many people suffering from hypertension around the world, and the burden of uncontrolled hypertension, it is imperative to find an intervention that can improve blood pressure control. To better target uncontrolled hypertension, the conventional method of management of high blood pressure based on in-person visits has shown some limitations and it must be combined with a contemporary approach that …

The Importance Of Pediatric Provider Awareness Of Social Determinants Of Health And The Impact On Health Outcomes: An Integrative Review, Whitney Lenelle Dowd

Doctoral Dissertations and Projects

Social determinants of health have become a global concern over the past several years. Efforts to reduce negative health outcomes related to social determinants of health are of high priority. Awareness of this issue by providers, especially pediatric providers, must be considered to help combat this major concern. A researcher seeks through an integrative review to determine provider perspective on social determinants of health, impact of social determinants of health on outcomes, and ways of integrating social determinants into prescriptive practice. The integrative review will inform stakeholders about the importance of pediatric provider assessment of social determinants of health and …

An Education Intervention Project In Community Clinics To Improve The Identification Of Patients With Pulmonary Alveolar Proteinosis And To Correctly Identify The Type Utilizing The Differential Diagnostic Algorithm, Catherine J. Poisson

Doctoral Dissertations and Projects

With over 7000 types, rare diseases affect 25-30 million Americans and contribute to over one trillion dollars in healthcare-related costs. Prescribers lack the knowledge to improve awareness, identification, and treatment of rare diseases. Pulmonary alveolar proteinosis is a rare disease in which patients present with symptoms such as dyspnea, fatigue, and respiratory infections. Diagnosis can take four to 92 months. A differential diagnostic algorithm published in the literature can guide clinicians in identifying the type of pulmonary alveolar proteinosis the patient has. In addition, if the clinicians perform a laboratory test called the granulocyte-macrophage autoantibody test, this test provides 100% …

Focused Group Meetings To Promote Job Satisfaction For Emergency Department Advanced Providers, Kendra Osei-Wusu

Doctoral Dissertations and Projects

Objective: Over the last few years, the pattern of increased burnout, operating under adverse environments, and being under- appreciated as led to a decrease in job satisfaction among emergency room providers(physicians, advanced practicing nurses, and physician assistants). Therefore, this scholarly project examined if small focused group discussions among emergency room providers will help combat poor job satisfaction scores and increase the well-being of the practitioners that keep the emergency room functioning. Methods: Using a quasi-experimental design, 10 providers that work in the emergency department at Lifebridge Health were randomly selected. Baseline well-being and job satisfaction rates were measured prior to …

Correlation Of Psychospiritual Factors And Suicide In The Military, Michael Odinaka Ugbor

Doctoral Dissertations and Projects

Military is a profession that requires stable mental state as a prerequisite for active military life. However, suicide rate among active members and veterans has significantly increased despite traditional measures such as psychotherapies, medications and government sponsored incentives. The purpose of this quantitative study was to examine the correlation of psychospiritual factors (spiritual, religious factors and psychological beliefs) and suicide risks among military members. Participants were 18 years or older and members of the United States military base stationed in Kentucky. Data collection involved the used a paper-based survey to measure spiritual and religious affiliations and activities, church attendance, prayer …

Implementation Of Provider Education Regarding Exercise As Adjunctive Treatment For Common Mental Health Diagnoses, Lauren Grace Martin

Doctoral Dissertations and Projects

Mental and physical health are inextricably linked. The advent of the Covid-19 pandemic reduced physical activity levels while worsening mental health symptoms. Pharmacological treatments are frequently used to treat mental health conditions; however, side effects can worsen metabolic issues. There is significant evidence that exercise can improve mental health conditions. The purpose of this project was to utilize provider education as an intervention to increase the use of exercise as an adjunctive treatment in the psychiatric treatment plan. This project was implemented at Nevada Mental Health, an outpatient behavioral health clinic in Las Vegas, Nevada. The investigator conducted a chart …

Managing Tuberculosis In Refugee Populations, Roselyn Fierkens

Senior Honors Theses

Tuberculosis (TB) is an airborne-transmitted infectious disease, responsible for more global deaths than HIV. Multidrug-resistant strains are developing, which heightens the need for swift eradication. Current data states that 71.4% of all TB cases in the United States occur in foreign-born individuals, so populations traveling from TB endemic areas are a key target population for prevention strategies. Various screening procedures exist, but no successful standard is in place. Beyond prevention and treatment strategies, adaptations to cultural communication differences are integral to successful medical interventions. This synthesis of TB pathophysiology, treatments, risk factors, and cultural considerations is intended for use in …

Nursing Considerations For Post-Traumatic Amnesia After A Traumatic Brain Injury, Hannah Grant

Senior Honors Theses

A period known as post-traumatic amnesia (PTA) often follows a traumatic brain injury (TBI). PTA is characterized by anterograde and retrograde amnesia, confusion, disorientation, and agitation. The duration and severity of PTA is a key indicator of the long-term prognosis after a TBI, so proper assessment and nursing care of a PTA patient is crucial. TBIs range from mild to severe, but primarily affect the fronto-temporal lobes. In PTA, both neural lesions and white matter damage within the parahippocampal region can cause PTA. A nurse must perform a thorough assessment of a TBI patient, but, since PTA is a key …

Characterizing The Cutaneous Microbiome Of Eurycea Lucifuga As A Potential Defense Against Chytridiomycosis, Madeline Key

Senior Honors Theses

Chytridiomycosis is an emerging infectious disease that is significantly reducing global amphibian populations. The disease is caused by Batrachochytrium dendrobatidis (Bd), a fungus that lethally modifies amphibian skin. Recent research has suggested that the cutaneous microbiome of individual amphibians may play a role in susceptibility to the pathogen. In this study, twelve cave salamanders (Eurycea lucifuga) were collected. Cutaneous bacteria from each salamander were isolated and identified using Sanger Sequencing. Additionally, a Bd-challenge assay was performed to determine each isolate’s antifungal activity. Results indicated many microbial isolates possessed inhibitory capabilities against Bd, which may …

Worried Sick: Understanding The Implications Of Stress On A Physiological Level, Julia Saia

Senior Honors Theses

Stress is prevalent among many individuals in today’s society. A literature review was conducted to investigate the physiological effects of stress, including the biomarkers of stress and how these interact with various body systems. The stress response is a protective mechanism to prepare the body to adequately respond to a perceived threat. However, when this response is prolonged, it begins to have a maladaptive effect on the body and can cause more harm than good. This literature review sought to compile what is known regarding the general effects of chronic stress and its impact on the nervous, immune, digestive, and …

Therapeutic Exercise Programming For Nonspecific Low Back Pain, Kendal F. Huepper

Senior Honors Theses

Nonspecific low back pain is a prevalent cause of injury and disability in the world today. However, most people with this condition continue to live in discomfort because they do not know how reduce their pain. Exercise is one of the many ways that those with lumbar pain can find relief. By combining a wide variety of exercises that have been shown to reduce pain while increasing strength, range of motion, activity, and functionality, this thesis attempts to create an evidence-based generalized therapeutic exercise program that those with nonspecific low back pain can utilize to live an active and healthy …

The Overlooked Care Plan- Nursing Mindset Related To Self-Care: An Integrative Review, Marie Mulford

Doctoral Dissertations and Projects

COVID-19 brought to light many things worldwide. One of the pressing issues was the increased rates of burnout, depression, and suicidal risk among nurses. This called for examining nurses’ work experiences and overall well-being during the Coronavirus pandemic. Furthermore, it was revealed that the nursing mindset regarding self-care was overlooked. This integrative review will inform stakeholders about the “overlooked care plan.” This review will be a call to action built on existing knowledge and facilitate policy for the nursing profession. Building upon nursing science, informative research, and facilitating policy initiatives, this review will serve as a call to action for …

Nursing Instructors Preparing Nursing Students To Cope With Distractions When Administering Medications: A Phenomenological Qualitative Study, Michael Thurman Frazier

Doctoral Dissertations and Projects

The purpose of this hermeneutic qualitative study was to discover and describe how nursing instructors teach nursing students to cope with interruptions and distractions while administering medication. The hermeneutic phenomenology approach is appropriate for discovering what nursing instructors teach their students about distraction in the classroom, simulation laboratory, and clinical setting. The study’s guiding theory was Kolb’s experiential learning theory. Nursing instructors from associate and bachelor’s degree programs from across the United States were recruited to participate in this study. The participants completed questionnaires about medication administration instruction, expanding on their answers in semi-structured, one-on-one interviews. All participants had the …

Communicating The Value Contributions Of Pathology And Laboratory Medicine (Palm) To Healthcare Administrators, Evidence Of Value From A Multiple Cases Study, Susan K. Edralin

Doctoral Dissertations and Projects

Hospital administrators were interviewed to explore their perceptions of the strategic alignment of PaLM value-based activities (VBAs). Hospital based PaLM leaders were interviewed to explore their communication of the VBAs. This study identified a misalignment between the assessments utilized by healthcare administrators for PaLM services and the value contributions of laboratorians. PaLM leaders offered insight into the laboratory’s value chain. Three themes emerged from the data: PaLM VBAs, PaLM communication efforts, and PaLM VBA strategic alignment. Together these findings suggest that hospital laboratorians offer untapped value in healthcare, and hospital administrators failing to recognize this value miss opportunities to improve …

Certified Nursing Assistant Turnover In The Long-Term Care Facility Industry, Michael Leroy Gregory

Doctoral Dissertations and Projects

Employee turnover in long-term care facilities results in increased operational costs and a reduction in the quality of care delivered. The purpose of this correlational study was to investigate the relationships between employee turnover intention of certified nursing assistants working in long-term care facilities and employee compensation, engagement, job satisfaction, motivation, perceived work stress during the COVID-19 pandemic, and work environment. The population of interest consisted of CNAs over the age of 17, with at least two years of experience working in the central Texas long-term care industry. Herzberg’s motivation-hygiene theory served as the theoretical framework underpinning this study. Multiple …

What Screening Schedule Or Algorithm Has Shown To Be Beneficial In Early Identification Of Perinatal Depression: An Integrative Review, Olivia Grace Hull

Doctoral Dissertations and Projects

Within the health care industry, mental illness has become a growing national concern, especially within the realm of obstetric care. As a vulnerable population, pregnant and postpartum women require appropriate screening and treatment for depression as warranted. Within the United States, there is an increasing concern around undiagnosed and untreated perinatal depression because of the lack of adequate screening and treatment plans. Perinatal depression that remains unrecognized contributes not only to long-lasting effects on the women, but also to adverse developmental effects in infants and an overall burden on the family unit. In addition, perinatal depression is associated with various …

Best Practices For Implementing Critical Care Orientation Programs For Newly Graduated Nurses After Reduced Hands-On Clinical Experience Due To The Covid-19 Pandemic: An Integrative Review, Anne-Marie Hinish

Doctoral Dissertations and Projects

The academic-practice gap has been described in the literature for years. Poorly implemented transition to practice can negatively impact patient outcomes, newly graduated nurses, and the nursing profession. Abbreviated prelicensure clinical experiences due to the COVID-19 pandemic have exacerbated the academic-practice gap’s impact on new nurse confidence, competence, safety, and retention. This integrative literature review aimed to identify best practices for developing and implementing a standardized new graduate nurse orientation program in the critical care setting that addresses and supports the transition from student to practitioner in an era of reduced hands-on clinical experiences due to the COVID-19 pandemic. Evidence …

The Effect Of Isolation On The Mental Health Of Older Adults, Christina Yates

Senior Honors Theses

As individuals age and lose mobility and cognitive functioning, many require full-time care which their loved ones are unable to provide. This often results in placement into long-term care facilities, and these facilities are notorious for being understaffed. Physical health becomes the only priority, depriving the client of having their mental and emotional needs fulfilled. Family and friends may decrease visitation due to distance or convenience. In 2020, the Covid-19 pandemic closed the doors of many facilities to nearly all visitors. Thus, the only individuals the residents of these facilities experienced interaction with were overworked staff members looking intimidating in …

Pediatric Autoimmune Neuropsychiatric Disorder Associated With Streptococcal Infection (Pandas): A Qualitative Study Of Parental Perceptions Of Factors In Remission, Janice Diane Weddle

Doctoral Dissertations and Projects

Pediatric autoimmune neuropsychiatric disorder associated with streptococcal infection (PANDAS) starts as the child’s body has an inappropriate reaction to the immune response for streptococcal infection. PANDAS is characterized by the sudden onset of neuropsychiatric disorders, including obsessive-compulsive disorder (OCD), anxiety, chorea movements, and tics. Previous research has drawn conflicting conclusions on PANDAS treatment efficacy and long-term treatment outcomes leaving remission rates unclear. The purpose of this qualitative phenomenological case study was to explore parents’ perceptions of factors related to PANDAS remission. Parents of children diagnosed with PANDAS were recruited through Facebook PANDAS support groups and the National Institute of Mental …

The Overlooked Mission-Transitional Care Programs For Veterans In Civilian Settings: An Integrative Review, Cynthia Louise Gonzales

Doctoral Dissertations and Projects

The number of veterans within the United States continues to increase. With the addition of healthcare laws, veterans can seek care within the Veterans Health Administration (VHA) and civilian settings. The collaboration among multiple healthcare providers must ensure veterans are provided safe and efficient care when transitioning from provider to provider. Transitional care programs (TCPs) are effective strategies to ensure that veterans receive safe and efficient healthcare. The VHA employs interventions across their healthcare settings to facilitate optimal care. A variety of TCPs were discovered during the review. Most TCPs were used in VHA settings, which revealed an opportunity to …

The Impact Of Increased Interdisciplinary Communication On Hospital Admission Rates In The Geriatric Population: An Integrative Review, Molly K. Langston

Doctoral Dissertations and Projects

The medical complexity of geriatric residents puts them at an increased risk of hospital readmissions related to coronary artery disease, myocardial infarction, chronic obstructive pulmonary disease, and diabetes, along with other chronic diseases. Geriatric residents of assisted living, skilled nursing, and memory care facilities should hold a particular interest to stakeholders, as the simple intervention of increasing early communication and correspondence regarding chronic diseases can have a great impact on quality improvement outcomes as well as financial burden of the institution. Additionally, interdisciplinary communication can be individualized to meet the needs of each geriatric resident in order to reduce the …

An Icu-Specific Pressure Injury Risk Assessment Tool To Improve Outcomes, Solange Flore Kamdem

Doctoral Dissertations and Projects

Aim: To use an ICU-specific pressure injury (PI) risk assessment scale to promptly identify the risk for PIs in critically ill patients and promptly implement the appropriate PI prevention interventions to decrease the incidence rate of pressure injuries over 11 weeks.

Background: The risk of developing PIs is 3.8 times higher in the ICU patients than in other patient populations. The state of illness and or treatments increase their odds of developing hospital-acquired pressure injuries (HAPIs). The Braden scale currently in use may not identify the risk early enough to provide preventive interventions. An ICU-specific tool is needed to screen …

Impact Of Emergency Department Triage Sepsis Screening Algorithm And Treatment Order Sets: An Integrative Review, Danielle Marie Tester

Doctoral Dissertations and Projects

Sepsis is a life-threatening condition that can lead to tissue damage, end-organ damage, and death if left untreated. The Centers for Disease Control and Prevention defines sepsis as a severe response to an infection. Sepsis is prominent health concerns worldwide, as it continues to be a leading cause of mortality despite having access to health care. This has impelled many health care organizations to improve sepsis-related care and sepsis outcomes by formulating core measures to improve patient care. The purpose of this integrative review is to discuss if initiation of an emergency department triage sepsis screening algorithm and treatment order …

Does Screening Of Patients In The Home Health Setting Prevent Sepsis Readmissions?, Heather Michelle Cook

Doctoral Dissertations and Projects

The purpose of this evidence-based project is to reduce 30-day readmission rates of patients diagnosed with septicemia by using a symptom screening tool in the home health setting. Sepsis is a life-threatening and costly healthcare burden. Through this project the home health department staff were educated on the pathology of sepsis, and the use of the adult sepsis screener to identify at risk patients early and manage their symptoms thereby reducing 30-day hospital readmission rates of patients diagnosed with sepsis.

The Use Of Self-Efficacy Evaluations, Self-Care Evaluations, And Motivational Interviewing To Improve Glycated Hemoglobin Values In Type 2 Diabetes Mellitus, Meredith Ann Kelley

Doctoral Dissertations and Projects

When improperly managed, type 2 diabetes mellitus is a serious and chronic health condition with far-reaching repercussions for individuals, families, and societies. In the United States, 34.2 million individuals live with diabetes, and 90%-95% have type 2 diabetes. While the United States healthcare system faces the monumental task of improving diabetic care outcomes and associated costs, publications have established that motivational interviewing (MI) can improve self-efficacy and associated self-care behaviors of type 2 diabetics, resulting in improved hemoglobin A1c values. Thus, this scholarly project’s intent was to track participant hemoglobin A1c values over three months, measure participant self-efficacy and self-care …