Medicine and Health Sciences Commons^™

Proposed Evidence-Based Practice Consideration: The Use Of Remimazolam Tosilate Instead Of Propofol For Endoscopic Procedures Under Monitored Anesthesia Care In The Elderly Population, Tayler Lynn Detwiler

Doctor of Nursing Practice Scholarly Projects

Endoscopic procedures are essential for diagnosing and managing gastrointestinal conditions, particularly in a growing elderly population. The selection of sedative agents significantly influences patient safety and procedural outcomes. Propofol, the traditional choice, is successful but associated with risks such as hypotension, bradycardia, and respiratory depression, particularly in elderly patients. This hypothetical Doctor of Nursing Practice (DNP) project explores the use of remimazolam tosilate (RT), a novel ultra-short-acting benzodiazepine, as an alternative to propofol during monitored anesthesia care (MAC) for elderly patients undergoing endoscopic procedures. The project utilizes a randomized controlled trial (RCT) design to compare RT and propofol regarding hemodynamic …

Evidence-Based Practice Guidelines For Lung Protective Ventilation In Adult Patients Undergoing Abdominal Laparoscopic Surgery, Marco A. Spada

Doctor of Nursing Practice Scholarly Projects

The rise in abdominal laparoscopic surgeries has underscored the need for improved ventilation strategies to reduce postoperative pulmonary complications, such as atelectasis, ventilator-induced lung injury, and pneumonia. These complications can increase hospital stays, healthcare costs, and mortality. This final scholarly project investigates the impact of lung protective ventilation in adult patients undergoing abdominal laparoscopic procedures and proposes guidelines for implementation. Lung protective ventilation strategies, including low tidal volume ventilation, individualized positive end-expiratory pressure, and recruitment maneuvers. Current research shows potential in mitigating postoperative pulmonary complications by improving intraoperative oxygenation and lung compliance. Using the Johns Hopkins Evidence-Based Practice model, this …

Evidence-Based Guidelines For Intraoperative Quantitative Neuromuscular Monitoring, Noah Graham

Doctor of Nursing Practice Scholarly Projects

Nondepolarizing neuromuscular blocking agents are routinely used medications vital to anesthetic care. When administering neuromuscular blocking agents, monitoring neuromuscular blockade depth and degree of recovery is a standard of nurse anesthesia practice to facilitate adequate recovery. If not adequately reversed, postoperative residual neuromuscular blockade can cause severe complications. Traditional qualitative neuromuscular monitoring practices largely contribute to the continuing high incidence of postoperative residual neuromuscular blockade, as supported by research that qualitative monitoring methods are insensitive to the depth of blockade and clinical situations, providing unreliable physiologic information. As recommended in practice guidelines by the American Society of Anesthesiologists, quantitative neuromuscular …

Implementation Of Evidenced Based Practice Guidelines For Reducing Emergence Delirium In Elderly Patients Undergoing A Total Hip Replacement, Luke D. Kleinfelder

Doctor of Nursing Practice Scholarly Projects

A total hip replacement is a common surgery for the elderly population, as it is a successful treatment option for hip fractures and end-stage osteoarthritis, a common condition associated with aging. Recovery from surgery is critical, and any postoperative complication can delay recovery, increase cost, lengthen hospital stay, and lead to a poorer long-term surgical outcome. One of the most common and severe postoperative complications for elderly patients following general anesthesia is emergence delirium. Traditional practice focuses on treating the symptoms of emergence delirium reactively instead of proactively and lacks standardized guidelines. Recent literature found a promising decrease in the …

Integrating The Transversus Abdominis Plane Block Into An Eras Protocol For Bariatric Surgery Patients, Jordan Neibarger

Doctor of Nursing Practice Scholarly Projects

This Doctor of Nursing Practice (DNP) project investigates the integration of the Transversus Abdominis Plane (TAP) block into Enhanced Recovery After Surgery (ERAS) guidelines for bariatric surgery patients, aiming to improve postoperative outcomes by reducing opioid consumption, time to ambulation, and hospital length of stay (LOS). Bariatric patients who undergo sleeve gastrectomy or Roux-en-Y gastric bypass (RYGB) frequently encounter challenges with postoperative pain, increasing opioid use, delaying postoperative time to ambulation, and increasing postoperative hospital LOS. Prolonged postoperative hospitalization increases the financial impact on the healthcare system, and bariatric patients who have a longer postoperative LOS have a higher rate …

Proposed Evidence-Based Practice Guidelines For Using Esmolol To Blunt The Sympathetic Stress Response To Laryngoscopy And Intubation, Maya Kurdi

Doctor of Nursing Practice Scholarly Projects

Direct laryngoscopy (DL) and endotracheal intubation (ETI) are standard procedures performed during general anesthetic induction, which provoke a sympathetic stress response that can result in intraoperative hemodynamic instability. Traditional agents like lidocaine and fentanyl, commonly used to mitigate the stress response, have limitations and can lead to adverse effects. Recent literature suggests that esmolol, an ultra-short-acting, cardio-selective beta-1 adrenergic receptor antagonist, may be an effective alternative due to its rapid onset, short duration, and minimal side effects. This final scholarly project (FSP) aims to develop evidence-based practice guidelines for using esmolol as an adjunctive induction agent. A systematic literature review …

Heads Up! Designing A Nursing Assessment Tool For Early Recognition Of Intracranial Hypertension Post Head Injury, Sergio A. Dondiego

Honors Capstones

This meta-analysis identifies noninvasive clinical predictors of intracranial hypertension (IH) post head trauma to develop a multi-criteria IH screening tool designed for nurses to wear on their badge reels. High-sensitivity predictors were prioritized to assist in early IH suspicion. Findings suggest that radiographic-measured abnormalities including an optic nerve sheath diameter (ONSD) 5.6 mm and signs of significant head trauma via computed tomography (CT) were highly effective for predicting IH and were therefore defined as major criteria for the assessment tool. Other significant examination findings include a Glasgow Coma Scale (GCS) score 8 and atypical pupillary reactivity. While age showed conflicting …

Understanding And Measuring Functional Communication In Adults Living With Alzheimer's Disease And Related Dementias, Sarah Toledo

Honors Capstones

Functional communication declines across all stages of dementia and directly affects quality of life, yet traditional standardized assessments may not fully capture everyday communication abilities. This capstone examines how functional communication in older adults living with dementia can be conceptualized and measured beyond standard tools. The study analyzes previously recorded video conversations between adults with dementia and student partners. Conversations are transcribed and coded using two observational measures: the Verbal and Nonverbal Interaction Scale–Care Recipient (VNVIS-CR) and the Adapted Measure of Participation in Conversation for Dementia (MPC-D). Gestures, facial expressions, responsiveness, and engagement are included in the analysis, and double …

A Retrospective Look At Self-Reported Mental Health Prevalence In Division Iii Student-Athletes, Jacob F. Neri

Masters Theses/Capstone Projects

Mental health concerns among collegiate athletes have gained increased attention, but there has been limited research focus on Division III student-athletes. This study aimed to examine the self-reported prevalence of anxiety, depression, anger, stalking/harassment, abuse/assault, alcohol/substance abuse, self-harm, suicide ideation, and suicide attempt to identify contributing factors amongst this population. A retrospective, cross-sectional study was conducted looking at data collected from the student-athlete mental health history & well-being questionnaire that was administered as part of their pre-participation exam (PPE) prior to the beginning of each academic year. A total of 554 Division III student-athletes were included in the study. Results …

Enhancing The Diversity And Number Of Certified Registered Nurse Anesthetists: A Proposed Pipeline Program For Underrepresented Students, Alexis Lamoreaux

Doctor of Nursing Practice Scholarly Projects

The underrepresentation of minority groups in the Certified Registered Nurse Anesthetist (CRNA) profession impacts healthcare providers’ diversity and cultural competence. This Final Scholarly Project (FSP) proposes a pipeline program to increase diversity within the CRNA field by providing academic support, mentorship, and clinical exposure to students from underrepresented backgrounds. Given the shortage of anesthesia providers, especially in underserved areas, improving access to the CRNA profession for minority students is critical for enhancing patient outcomes. This FSP suggests establishing mentorship and skill development concepts through a 12-month structured program that targets minorities, first-generation college students, or those from rural backgrounds. The …

A Case Comparison Of Vo₂Max And Lower Extremity Injury In Collegiate Wrestlers, Kole J. Kendall

Masters Theses/Capstone Projects

ABSTRACT

A CASE COMPARISON OF VO₂MAX AND LOWER EXTREMITY INJURY IN COLLEGIATE WRESTLERS

Kole Jacob Kendall

Otterbein University

Westerville, OH

The purpose of this study was to examine the relationship between preseason aerobic capacity (VO₂max) and lower extremity injury prevalence in Division III collegiate wrestlers. In this two-participant case comparison, Participant 2 sustained a lower extremity injury and demonstrated the lower VO₂max value (37.5 mL·kg⁻¹·min⁻¹), whereas Participant 1 remained uninjured and demonstrated the higher VO₂max value (40.8 mL·kg⁻¹·min⁻¹). Although statistical analysis was not feasible because of the limited sample size, this pattern suggests a possible association between lower aerobic capacity …

Assessing The Risk Of Low Energy Availability In Ncaa Division Iii Female Soccer Players, Emma C. Sturts

Masters Theses/Capstone Projects

Low Energy Availability (LEA) can occur when an athlete’s energy intake is insufficient to meet the physiological demands of training as well as normal physiological functions. Female soccer players may be at an increased risk of developing LEA due to the high exercise energy expenditure paired with decreased energy intake. The purpose of this study is to assess the prevalence of LEA among Division III female soccer players. Division III female soccer players (n = 11) completed the Low Energy Availability in Females Questionnaire (LEAF-Q). 45.5% (n = 5) of the participants were classified as “At Risk” for LEA. Of …

Investigating The Prevalence Of Eating Disorder Risk And Body Image Dissatisfaction Among Division Iii Track And Field Athletes, Ravyn S. Goodson

Masters Theses/Capstone Projects

Context: Eating disorder (ED) risk, and body image dissatisfaction (BID) are increasingly recognized concerns in collegiate athletes due to sport-specific and sociocultural pressures. However, limited research has looked at these factors within NCAA Division III track and field athletes.

Objective: To examine the prevalence of eating disorder risk and body image dissatisfaction among division III track and field athletes and explore differences based on gender and event group Design A quantitative, cross-sectional survey design

Setting: NCAA division III athletic program within the Ohio Athletic Conference (OAC), during the 2025-2026 competitive season.

Participants: A total of 32 NCAA Division III track …

Empowering Voices: A Qualitative Exploration Of Shared Governance Among Healthcare Workers In Clinical Practice, Ayman Alhazaymeh

Doctoral Projects

This project intervention evaluated the implementation of shared governance (SG), focused on partnership council activities and staff perception. The shared governance framework has several pillars, such as Partnership, Equity, Ownership, Accountability, and Shared Decision-Making, to support the design of healthcare organizations for excellent patient care (Porter-O’Grady, 2009). To effectively evaluate the SG implementation and ensure the ongoing success of the SG process, the author investigated staff contributions and actively sought feedback. He provided templates and guidelines for the partnership council and collected staff feedback. Murray et al. (2016) stated that the partnership council reported empowering staff to implement innovative solutions …

Exploring Identity Through Clay: A Humanistic Art Therapy Case Study With A Blind Chinese Adoptee, Virginia Jade Leicht

Expressive Therapies Theses

This qualitative case study explored how working with clay in art therapy can help support a blind man’s identity exploration. This paper addresses the problem of many traditional therapeutic approaches within the art therapy realm: They rely too heavily on visual engagement, which can limit the accessibility and opportunities for self-exploration and identity development for those who are blind. The study was grounded in current research and foundational theories based on the humanistic art therapy approach. Clay is considered an accessible medium that engages multiple senses and allows for emotional exploration and meaning making, specifically through tactile and sensory-based engagement …

How Do Autobiographical Memory Abilities Compare With Other Cognitive Functions In An Adult Presenting With Hsam (Highly Superior Autobiographical Memory) And Autism? A Case Study., Emilia Rzeszutek, Dr. Jamie Mayer

Honors Capstones

Autism Spectrum Disorder (ASD) is a condition widely researched in relation to social communication differences and challenges in areas such as memory and executive functioning. Many areas of research highlight ASD’s deficits, shortcomings, and risk factors. However, research has begun to recognize that autistic individuals demonstrate cognitive strengths that differ from typical patterns of functioning. An example of such ability is Highly Superior Autobiographical Memory (HSAM), a rare phenomenon characterized by the ability to recall specific life events with remarkable accuracy and detail. This study was conducted on a 25-year-old male diagnosed with ASD and presents with characteristics of HSAM. …

Developing Engagement Programming To Increase Leisure Participation Among Individuals Living With Cognitive Impairments, Anthony Valentino, Bethany Horne Otd, Ms, Otr/L

Occupational Therapy Doctorate Capstones

Low-cost leisure activities are implemented at The Bridge Center to increase engagement and promote health and well-being. This program incorporates occupational therapy perspectives to promote engagement through meaningful activities to expand people with cognitive impairments opportunities. The results of this project will provide intrinsic benefits to people with cognitive impairments and aid the development of future projects at The Bridge Center.

The Efficacy Of An Educational Program On The Benefits Of Aquatic Therapy: An Occupational Therapy Perspective, Matile Kaplan, Kathryn Burke Otd, Otr/L

Occupational Therapy Doctorate Capstones

Aquatic therapy has been a therapeutic modality since 2400 B.C and offers multisystem physiological effects including cardiovascular, musculoskeletal, immune, gastrointestinal, and more. The aquatic environment offers buoyancy, hydrostatic pressure, resistance, and drag force to ease engagement and recovery. Individuals have a higher rate of participation in aquatic therapy compared to on-land therapy, although referral rates are low due to the existing perceptions and insufficient awareness of the benefits.

Educating Birthing Professionals About The Benefits Of Occupational And Physical Therapy In The Acute Postpartum Period, Jayde Monteiro, Kathryn Burke Otd, Otr/L

Occupational Therapy Doctorate Capstones

Purpose: Across all developed countries, the US has the highest maternal mortality rate. The acute postpartum period is considered the first 6 weeks after birth and is often the most prevalent time medical complications arise. Currently there is a trend of OT and PT referral after these complications have already happened negatively impacted patients. To bring awareness and relevance to acute postpartum OT and PT, birthing professionals need more education to gain knowledge on how therapy can produce successful recovery outcomes in their patients. The research question "How does online educational programming increase birthing professionals’ knowledge about the benefits of …

Choosing Your Line: Training Adaptive Ski Instructors How To Facilitate Occupational Participation For Individuals With Complex Communication Needs., Jordan E. Chizmadia, Monique Dawes Otd, Otr/L Cpam

Occupational Therapy Doctorate Capstones

The project will explore communication methods for individuals with complex communication needs (CCN) in adaptive skiing, focusing on alternative communication methods and the development of a Picture Exchange Communication System. A communication training program for ski instructors will be implemented. Findings will advance occupational therapy by highlighting the role of self-directed communication and autonomy in promoting occupational engagement for individuals with CCN.

Advancing Social-Emotional Wellness In Adolescents Through Structured Physical Fitness Programming, Serena Mora, Tania Rose Otd, Otr/L, Amy Wheadon Otd, Otr/L

Occupational Therapy Doctorate Capstones

Neurodivergent (ND) adolescents tend to struggle with participating in physical activity (PA) compared to their neurotypical (NT) peers. Current programs available that focus on PA are competitive and can add anxiety to an already difficult adjustment. This doctoral capstone project investigates the effect of participation in PA on social emotional well-being in ND adolescents. An 8-week PA program was created and implemented in this pre-post test quasi-experimental study.

Investigating The Sensory Needs Of Bereaved Children In A Therapeutic Group Setting, Eleanor Gemma, Bethany Horne Otd, Ms, Otr/L

Occupational Therapy Doctorate Capstones

Childhood bereavement is experienced by one in eleven children by age eighteen and is associated with a range of symptoms that impact function (Judi’s House, 2024; Stikkelbroek et al., 2016). Bereaved children often show increased internalizing symptoms for more than two years following loss and demonstrate challenges with self-regulation, which can impact a child’s participation in their everyday environments (Edgar-Bailey & Kress, 2010; Stikkelbroek et al., 2016). While dysregulation has been researched in children exposed to other forms of trauma, it and the resulting sensory needs of bereaved children are largely unexplored. This occupational therapy capstone project utilized mixed methods …

Effectiveness Of Occupation-Based Mindfulness Strategies For Older Adults Experiencing Anxiety Or Depression, Jennifer G. Macnie, Kathryn Burke Otd, Otr/L

Occupational Therapy Doctorate Capstones

The purpose of this capstone is to gain an understanding of how sensory-based mindfulness strategies impact feelings of anxiety and depression amongst older adults living in an assisted living facility. Anxiety and depression are extremely prevalent among residents in assisted living facilities, with depression affecting 29% of older adults and anxiety affecting 20%. In light of the fact that mental health amongst older adults is often overlooked in assisted living facilities, it is necessary to evaluate the potential benefits of mindfulness strategies on feelings of anxiety and depression amongst this population. An investigation of how sensory based mindfulness strategies impact …

Advancing Neurodiverse-Affirming Care: Educating Caregivers To Improve Knowledge And Confidence​, Olivia Miller, Bethany Horne Otd, Ms, Otr/L

Occupational Therapy Doctorate Capstones

This capstone project aimed to implement a six-week education course on neurodiverse-affirming care to caregivers of neurodiverse children at Extraordinary Kids Therapy outpatient clinic in Chepachet RI. The goal of this capstone project was to increase confidence and knowledge of neurodiverse-affirming care in the caregivers participating in the course. To analyze the impact of the education course, pre and post surveys, along with semi-structured asynchronous zoom interviews were administered and analyzed.

Building Adolescents' Social Emotional Wellness Through Physical Fitness Programming, Serena Mora, Tania Rosa Otd, Otr/L

Occupational Therapy Doctorate Capstones

Neurodivergent (ND) adolescents tend to struggle with participating in physical activity (PA) compared to their neurotypical (NT) peers. Current programs available that focus on PA are competitive and can add anxiety to an already difficult adjustment. This scoping review investigates the effect of participation in PA on behaviors and well-being connected to ND conditions.

A Multifaceted Approach To Managing Agitation In Assisted Living Residents With Dementia ​, Emily Hamed

Occupational Therapy Doctorate Capstones

Purpose: Dementia is a growing concern and will continue to increase. One symptom of dementia is agitation, which can be disruptive in an assisted living facility (ALF) and can impact quality of life for residents and caregivers/staff. Evidence shows that creating a conducive environment and equipping staff with skills can lead to better resident outcomes (Wong et al., 2024). This capstone project aims to address agitation by implementing physical and social environmental modifications in an (ALF). Design: This quasi-experimental mixed methods design will be conducted in an ALF to measure resident agitation pre and post intervention and staff confidence in …

“Empowering Peer Mentorship” Developing Best Practices Of Peer Mentoring At Empowersci Inc., Caitlyn Menard, Monique Dawes Otd, Otr/L Cpam

Occupational Therapy Doctorate Capstones

Each Year, 250,000-500,000 people sustain a spinal cord injury (SCI) , facing challenges in social participation, quality of life, activities of daily living (ADLs), returning to work, and unmet needs in mental health, self-efficacy, and community mobility (Beauchamp et al., 2016 & Divanoglou et al., 2017). While interdisciplinary rehabilitation and peer mentorship aim to support adaptation, growth, and independence, there remains a lack of standardization in adequately preparing individuals for the peer mentor role (Rocchi et al., 2022). Aim: EmpowerSCI is a nonprofit organization that aims to bridge the gap in rehabilitation by offering in-person, holistic residential programming. EmpowerSCI currently …

Teacher Perceptions Of The Impact Of Sensory Integration And Processing On Student Occupational Engagement, Kyla Campbell, Colleen Cameron Whiting

Occupational Therapy Doctorate Capstones

Sensory Integration (SI) is defined as the brain's ability to organize and respond to information within the body and environment. School-aged children begin school with varying difficulties in SI and processing, which affects their social and academic performances. The field of occupational therapy (OT) promotes engagement in meaningful activities, in which going to school and participating in activities is vital to a child's development and wellbeing. The school setting is the second-largest employer of occupational therapy practitioners (OTPs) in the United States. Children with SI and processing difficulties have decreased participation in the classroom compared to their peers with typical …

Understanding Occupational Therapy Referral Patterns And Knowledge Gaps Among United States Medical Providers, Zachery Edwards, Shannon Strate Otd, Ms Otr/L

Occupational Therapy Doctorate Capstones

Medical providers in the United States (US) have limited education and understanding of occupational therapy’s (OTs) full scope of practice (SOP), contributing to reduced access to OT services and potential negative consequences for client outcomes, interprofessional collaboration, and the profession’s viability (Rouch et al., 2022; Vij, 2023). This study aimed to examine US medical providers perspectives on OT utilization and identify areas of desired knowledge. Qualitative data was attained via a national survey administered to medical providers with analysis focused on responses to question three (Q3): “Why don't you refer clients to OT?” (n=424) and question six (Q6): “If you …

Utilization And Impacts Of Pediatric Caregiver Programming On Therapeutic Engagement And Wellbeing: A Pilot Program, Venisa Rodriguez, Tania Rose Otd, Otr/L

Occupational Therapy Doctorate Capstones

Purpose: The proposed doctoral capstone aims to measure the utilization and impacts of pediatric caregiver programming on therapeutic engagement and wellbeing. A scoping literature review and needs assessment of pediatric caregivers of children receiving OT services found that limited access to quality, caregiver-specific resources and programming impact the wellbeing of caregivers, their ability to care for their child, and their confidence and ability to engage in the therapeutic process. The literature points to a want and need for caregiver-specific programming and the use of a family-centered care approach to improve caregiver and child outcomes.

Design: This study will utilize a …