Medicine and Health Sciences Commons^™

Improving Quality And Efficient Communication Between Providers And Nursing - A Psychiatric Sbar Tool (Psych), Karen Lee Richards

Master's Projects and Capstones

IMPROVING QUALITY AND EFFICIENT COMMUNICATION BETWEEN

PROVIDERS AND NURSING - A PSYCHIATRIC SBAR TOOL (PSYCH)

Karen Richards

University of San Francisco

Abstract

Effective communication is the cornerstone of providing safety and quality healthcare. However, nursing and providers often share information inequitably, as these disciplines are trained differently regarding communication. Providers are taught to be brief, accurate and focused while nurses are taught to be descriptive and holistic. These differences have led to disparity in the sharing of valuable patient information, subsequently leading to increased frustration, inefficiency, and medical errors. Multiple studies provide evidence that poor communication is a major contributor …

Exploring The Experience Of Foster Parents As They Care For Children Who Are Making The Transition From The Hospital Into The Foster Home, Maximilian Veltman

Nursing ETDs

This study explored the perceptions foster parents have about their work as caregivers of foster children who are hospitalized and then discharged from the hospital into a foster home. The numbers of children in foster care nationwide has decreased over the past 25 years, yet the proportion of children in foster care who have significant health conditions has increased dramatically (Wang, Edelstein, Waldinger, Lee & Bath, 2011). There has also been significant attrition of qualified foster parents who are able to care for foster children with significant health needs (Pecora, Whittaker, Maluccio, Barth & DePanfilis, 2009; Vig, Chinitz & Shulman, …

Hemostatic Responses To Exercise In A Polycythemia Vera Patient, Allison M. Huschke

Senior Honors Projects, 2010-2019

PURPOSE: To assess the hemostatic responses to exercise in a patient with Polycythemia Vera (PV). METHODS: Six female runners (≥15 miles/week) completed a maximal treadmill test. One subject had PV while the other five subjects made up the comparison group. Blood samples were taken before and within two minutes after exercise. VO2max was also recorded. RESULTS: Pre-exercise Factor VIII and tPA-antigen were similar in the PV subject and comparison group. Factor VIII and tPA-antigen increased dramatically in the PV subject (+100%, +1000%) in relation to the comparison group (+22.9 ± 8.7%, +108 ± 78%) after exercise. Pre-exercise PAI-1 was lower …

The Effect Of Chronic Obstructive Pulmonary Disease On Swallowing, Jessica R. Torres

Senior Honors Projects, 2010-2019

This work is composed of a literature review, research review, and self-reflective essay. The anatomy and physiology of normal swallowing and respiration are reviewed. Additionally, the effect of chronic obstructive pulmonary disease (COPD) on these processes is discussed. The research goal was to determine how lung volume changes adapt the physiology of swallowing in individuals with COPD. The research project was designed and conducted by Teresa Drulia, M.S., CCC-SLP. COPD participants (n=9, mean age=72, 6 male) were compared to older healthy individuals (n=10, mean age= 59, 3 male). Participants completed swallows of 20cc of water at four lung volume conditions: …

Improving Provider Compliance Of The Naepp 2007 Asthma Guidelines Through The Electronic Health Record (Ehr) In A Pediatric Primary Care Practice, Tiffany L. Kidd

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

The Expert Panel Report -3 (EPR3) NAEPP 2007 evidence-based clinical asthma guidelines were developed to provide evidence-based high-quality patient care that leads to improved outcomes. A literature review showed that healthcare providers do not routinely follow the asthma guidelines. The purpose of this project was to develop and implement an evidence-based asthma electronic health record (EHR) template in a pediatric office to improve provider compliance to the guidelines resulting in improved outcomes for children with asthma. The study was conducted over a period of four months from January - April 2016. An EHR asthma protocol template and training for providers …

Examining The Implementation Of The Patient-Centered Recovery Model In Psychiatric Nursing, Nicole K. Rossi

Senior Honors Projects, 2010-2019

The Recovery Care Model is the recommended evidence-based model for delivering holistic, patient-centered care for mental health clients. The model is a more therapeutic approach than the traditional medical model and upholds the ideas that psychiatric clients are more than just their illness, should be respected as unique individuals, and provided with hope and empowerment in their care while being given the opportunity for informed and autonomous decision-making. Although research has shown support for the Recovery Care Model, its implementation has not been fully accomplished in all psychiatric facilities. Of all of the members of the health care team, nurses …

Impact Of Nurse Fatigue And Nursing Handoffs On Patient And Nurse Safety, Melody A. Seitz

Nursing Theses and Dissertations

In healthcare today, patient safety continues to be a major concern. Nurse fatigue from long work shifts and inadequate patient handoffs may lead to errors and near errors that harm patients and nurses. The intent of this study was to fill a gap in understanding the effect shift length has on patient safety and maternal newborn nurses’ personal safety. A cross sectional survey design was administered via Qualtrics, a web-based online software program. Participants included two groups of maternal newborn nurses. One group worked 8-hour shifts (N = 70) and the other group worked 12-hour shifts (N = 151). Statistical …

Building Allas: Creation Of An Asthma And Allergies App, Benjamin J. Cochran

Doctor of Nursing Practice Scholarly Project

The purpose of this project was to determine the potential need for an app to allow patients to self-manage their asthma and allergies. Through a substantial literature review, the need for an app as well as a desire for this population to manage their disease was demonstrated. Determination was made to have three separate components to create an all-inclusive app, an education component, an asthma tracker, and a personalized allergy profile. The app was storyboarded before being sent to providers and small focus group for proof of concept and functionality of components. The app, ALLAS, was constructed and housed on …

Educational Needs Of Nurses For Wound Care, Stephanie Adee

Doctor of Nursing Practice Scholarly Project

The purpose of this study was to conduct a needs assessment of registered nurses’ knowledge base and attitudes toward wound care and to be able to customize a wound assessment tool to meet those needs. The visual assessment is an essential part of wound care and performing accurate assessments can lead to making the correct diagnosis, starting appropriate treatment timely, and discharging patients sooner. There are over five million patients suffering from chronic wounds and more cases are added yearly. The nurses need a tool to assist them in their daily assessments. This study utilized an anonymous survey of 23 …

Development And Presentation Of An Employer Sponsored Health Center Proposal, Johnna Costello

Doctor of Nursing Practice Scholarly Project

Employer managed health centers were investigated in order to develop a business proposal to present to a Midwestern city for implementation. Benefits to the employer and employee were investigated and included in the proposal. Companies of varying size have implemented successful onsite health centers and help to increase employee productivity while decreasing the overall cost of health care and health care insurance. Self-insured companies with at least 1000 employees are recommended and will provide the earliest return of investment. Lost productivity is a significant cost to the company, on average a company will spend more on lost productivity than on …

Creating Healthy Urban Environments: Commercial Landscaping, Preference And Public Health, Mary Leibe

University of New Orleans Theses and Dissertations

Landscape development[1] can provide many benefits, including the reduction of stormwater runoff and the creation of habitats for wildlife. It can also provide health benefits. Researchers, such as Roger Ulrich and Rita Berto have demonstrated that views of trees and other vegetation are associated with lower blood pressure and reduced recovery times in hospitals and that environments with more natural elements may lessen mental fatigue (R. Ulrich 1984) and (Berto 2005).

As rebuilding in New Orleans continues 11 years after Hurricane Katrina, landscape development has been limited or lacking, especially in the redevelopment of commercial properties. Two prominent reasons …

Burnout In Radiation Therapy: Examining The Six Leading Influences, Gina C. Passmore

All Theses And Dissertations

Recent studies are highlighting the dangers of burnout amongst healthcare workers, including radiation therapists. Since burnout is associated with an increase in medical errors (Sanchez-Reilly, 2013), it affects both the well-being of the patient and patient satisfaction scores, which are important to a hospital’s reputation. Burnout has a positive correlation with job dissatisfaction and increased employee turnover, making it both a financial and quality issue. Organizations acknowledge that burnout leads to unhappy employees, and unhappy employees are less likely to be engaged in their work, thereby not producing the best “products” (Sehlen, 2009). By examining which components seem to be …

Quality Of Death People With Terminal Illnesses Are Turning To An Age-Old Method To End It All: Self-Starvation, Kazi E. Awal, Alyssa Pagano

Capstones

Voluntarily stopping eating and drinking (VSED) is getting more attention in the medical community. Though physician assisted dying legislation passed in two more states in 2016--there are now 7 states where it is legal--the practice, where doctors prescribe a lethal dose of sedatives so that terminally ill patients can end their own lives, is inaccessible to many. But fasting to death is a way for patients suffering from terminal illnesses or other debilitating diseases to end their lives on their own terms that is legal everywhere. As extreme as it sounds, research shows the process can be made comfortable with …

Design Of A Modified Stewart Platform Manipulator For Misalignment Correction, Adekunle Ayoko

Master of Technology Management Plan II Graduate Projects

This thesis work is about the design of a modified Stewart platform manipulator for misalignment correction. The common version of the Stewart platform uses six actuators. The traditional Stewart platform of this kind has a moving top plate and a fixed base plate. However, in this research, the modified design of the traditional Stewart platform is studied. It is designed to be an easy connect-disconnect platform that can wrap around different structures with different cross sections and symmetrically designed. It is able to adjust position easily by using four identical but independent linear actuators populated evenly in two parts fastened …

Promoting An Increase In Preceptors For Nurse Practitioner Students By Providing The Necessary Tools For Preceptorship, Sonja K. Albright, Sonja Albright

Doctor of Nursing Practice Scholarly Project

The purpose of this project was to confirm the difficulties and barriers to precepting nurse practitioner students found in the literature by conducting a focus group with nurse practitioners who were currently precepting and some who were not. Participants were volunteers at a 4-State APN Conference in Joplin, Missouri. The group did confirm the barriers to precepting noted in the research. The most common theme noted during the group was that nurse practitioners felt ill-prepared to precept nurse practitioner students, a concept also noted in the literature. A Voiceover PowerPoint presentation was created based on the research and concepts discussed …

Breakdown: Treatment Gaps In New York City's Mental Health System, Christine Brink Kjeldgaard, Noah Caldwell, Mary Hanbury, Mike O'Brien, Joanna Purpich, Anthony Izaguirre

Capstones

Forty years after New York City began to "deinstitutionalize" its mental health system in hopes of building community-based care, the city is still falling short. This investigative project, undertaken by six reporters at CUNY's Graduate School of Journalism, uncovers the treatment gaps facing mentally ill New Yorkers, who are among the most vulnerable in the city. The project follows them to the actual places where they seek care: hospitals, clinics, homeless shelters, prisons and schools.

Overmedicated: Foster Kids In Crisis, Mary E. Wilson

Capstones

Nearly one in four foster children across the county is taking at least one psychotropic medication-- more than four times the rate for all children.

Psychotropic drugs are chemical substances that act primarily upon the central nervous system where they alter brain function, resulting in temporary changes in perception, mood, consciousness and/or behavior.

Over the last decade the use of psychotropic medications amongst children has more than doubled. It has yet to be determined what permanent affects such drugs have on children as they age, due to a limited number of studies.

http://marywilson1.wixsite.com/overmedicated

Drink Me And Abort Your Baby: The Herbal Abortion Tea, Maya Lewis

Capstones

For most of history every abortion was a herbal abortion. Herbal abortion is exactly what it sounds like––a series of herbs that, if taken at the right time, in the right form and dosage, can induce a miscarriage. It's risky, under researched and rarely supported. But with women's clinic dwindling all over the country and a president elect who wants to repeal Roe v. Wade, herbal abortion might soon make a major come back–– for better or worse.

Link to capstone project: https://medium.com/@maya.lewis/drink-me-and-abort-your-baby-the-herbal-abortion-tea-46aadd15f659

A Green Oasis: What Makes Community Gardens Worth Saving? While Researchers Amass Evidence Of Benefits, Advocates Develop New Strategy To Prove Their Value., Joel Wolfram

Capstones

Green Valley Community Garden in Brownsville, Brooklyn, is one of about a dozen gardens on land owned by the New York City Department of Housing Preservation and Development that are being uprooted by plans to build affordable housing. The gardeners are fighting back to prevent the garden’s destruction, saying that the food-producing green space is a source of healthy eating in a community with high rates of health problems, like diabetes and obesity. Researchers are attempting to tease out the public health benefits of community gardens as one metric of their value, but the science is still catching up with …

Preying On The Desperate, Karen M. Savage

Capstones

In this story, I investigate the marketing and sale of concentrated hydrogen peroxide to individuals who are desperate to cure serious health maladies. The story follows an online marketer who was warned by the FDA more than ten years ago to stop claiming hydrogen peroxide ingestion could cure cancer and other ailments. But in spite of the warning and subsequent FDA investigation, the individual continues to claim high strength hydrogen peroxide helps with brain tumors and leukemia and he can now be tied to several different websites marketing various “brands” of high strength hydrogen peroxide. Another marketer distributes hydrogen peroxide …

Elizabeth Seton Pediatric Center: A Residence For Children With Severe Disabilities, Tatiana D. Flowers

Capstones

The Elizabeth Seton Pediatric Center cares for some of the most medically complicated children in North East area of the United States. The facility, in Yonkers, New York, currently houses 137 residents, who all need 24-hour care and treatment. Many residents live with multiple physical and neurological (brain) disorders, which occurred either at birth or from a traumatic injury or accident. There is an admissions process at Elizabeth Seton Pediatric Center, and only the most severe applicants are accepted.

Target Validation And Pharmacological Characterization Of Novel Nmdar Modulators, Kiran Sapkota

Theses & Dissertations

The N-methyl-D aspartate receptors (NMDARs) are ligand-gated ion channels, which play important roles in learning and memory. Excessive activity of NMDARs is implicated in damage due to stroke and neurodegenerative diseases, whereas hypoactivity of NMDARs contributes to schizophrenia. The initial goal of my dissertation is to evaluate the potential role of the GluN2D-containing NMDARs in neuropathological, behavioral and cognitive alterations associated with schizophrenia and characterize the pharmacology and mechanisms of action of NMDAR modulators which could potentially be used to modulate these receptors in schizophrenia.

A subanesthetic dose of the NMDAR antagonist ketamine elicits symptoms of schizophrenia. This property led …

The Use Of Electroacupuncture For Cervical Ripening In Pregnant Women, Becky A. Nauta

Theses & Dissertations

The purpose of this study was to compare cervical ripening outcomes, based on Bishop scoring methodology, of pregnant women receiving usual care treatment (UC) with those receiving electroacupuncture plus UC. A sample of 36 pregnant women completing their 39^th week of gestation was randomized into one of the two groups. The women in the UC group continued to meet with their provider on a weekly basis until delivery. The women in the electroacupuncture plus usual care group met with their provider on a weekly basis and also received electroacupuncture treatments: three in the 39th gestational week and two in …

Adoption Of Medication Management Technologies By U.S. Acute Care Hospitals After The Hitech Act, Aastha Chandak

Theses & Dissertations

Medication errors and adverse drug events (ADEs) are a significant public health concern in the United States as they pose a threat to patient safety. The medication management process is a complicated process in U.S. acute care hospitals, consisting of a series of steps such as ordering, transcribing, dispensing and administration and each step is prone to medication errors.The use of technology is considered to be an important intervention in improving the medication management process and thereby reducing medication errors and ADEs and further improve patient safety. The Health Information Technology for Economic and Clinical Health (HITECH) Act, implemented in …

Chemosensitization Effect Of Sp1017 On Multiple Myeloma, Hangting Hu

Theses & Dissertations

Multiple myeloma (MM) is a hematological malignancy of plasma cells that are predominantly located in bone marrow (BM). Despite recent improvements in MM treatment by introduction of several novel agents includingimmunomodulatory drugs, proteasome inhibitors and the use of the drug combinations, MM remains incurable and almost all patients eventually relapse or become refractory to the current treatment regimens. So the current challenge of MM treatments is to maintain treatment response, prevent relapse and eventually prolong survival.

Here we demonstrated that Pluronic block copolymers ((Pluronic L61: Pluronic F127 = 1:8 w/w, SP1017) significantly increase cytotoxicity of proteasome inhibitors (Bortezomib, BTZ or …

Bone Loss Quantification Following Extraction In Rats: A Foundation For Grafting And Regenerative Studies, Emily Willett

Theses & Dissertations

Background: Loss of the alveolar ridge width and height following extraction is well-documented and several techniques, including grafting, have been proposed to reduce bone loss. Purpose: To characterize the pattern of bone turnover and inflammation after extraction and to initiate a study of the effect of grafting and local administration of simvastatin (SIM). Methods: Thirty-two retired-breeder rats underwent extraction of the right maxillary first molar and standard surgical defect creation under inhalation anesthesia. The left side of each animal served as the unmanipulated control. Comparison of groups (n=8, ANOVA) was done at days 0, 7, 14, and …

Effects Of Flash-Free Technique On Plaque Retention, White Spot Lesions, And Bracket Failure: A Randomized Clinical Trial, Payam Ishani Afousi

Theses & Dissertations

A side effect of orthodontic treatment is the development of white spot lesions (WSLs). This thesis attempted to evaluate the effects of the use of APC™ Flash-Free (FF) and conventional adhesives in bonding of orthodontic brackets on plaque formation and retention, WSL development, and bracket failure in-vivo. This was accomplished by collecting plaque samples from around orthodontic appliances and analyzing them using ATP-driven bioluminescence; scanning enamel surfaces using the Canary System™ to evaluate WSL development, and counting the number of spontaneous debonding of brackets of the 4 maxillary incisors in the first 6 months of treatment. It was found …

Cervical Spine Angles, Craniocervical Posture, Neck Length, And Oropharyngeal Airway Analyses Of Sleep Apnea Patients In Both Supine And Upright Positions: A Retrospective 3-D Imaging Study, Brian Tuan Luong

Theses & Dissertations

Obstructive sleep apnea (OSA) is one of the most common respiratory disorders. Previous airway studies of OSA subjects have largely relied on 2-D radiographs.

The purpose of this study is to use 3-D imaging to the analyze the relationships among cervical spine angles, craniocervical posture, cervical spine length and the oropharyngeal airway volume in OSA patients in both the supine and upright positions.

Twenty-eight OSA subjects with 3-D imaging were included. Airway, craniocervical posture, spine angles, and spine length were assessed using Dolphin 11.8. Correlation analyses were utilized to detect associations among the recorded and measured variables. Mean differences were …

Barriers To Pediatric Triage Guideline Compliance: A Survey Of Nebraska Emergency Departments, Jonathon J. Gruba

Theses & Dissertations

Nebraska emergency departments may be underprepared for a mass casualty event involving a large number of children, as indicated by the results from the 2013 Emergency Medical Services for Children’s (EMSC) Pediatric Readiness Project (PRP) report. This was primarily evident by the lack of existence of a pediatric triage policy among Nebraska emergency departments. Utilizing a survey, this study attempted to identify the emergency departments in Nebraska that followed the EMSC guideline of having a pediatric triage policy, as well as to identify possible barriers to guideline adherence among those that did not have the policy.

It was found that …

Development Of Cxcr4-Inhibiting Nanoparticles For The Treatment Of Metastatic Cancer, Yan Wang

Theses & Dissertations

Metastasis is the main cause of cancer mortality and morbidity, leading to several million deaths every year. Less than 20% of pancreatic cancer (PC) patients are candidates for surgery due to spread beyond the pancreas. Desmoplasia presents substantial barriers to perfusion, diffusion, and convection of antitumor therapeutics into the PC tissues. We focus on developing novel therapies that regulates tumor microenvironment, chemosensitizing tumor to therapeutics and preventing metastasis.

Gene therapy is emerging as a promising new therapeutic agents for cancer treatment. A targeted, systemic, effective and safe gene delivery system should be developed. CXCR4/SDF-1 axis plays a crucial role in …