Medicine and Health Sciences Commons^™

Enhancing Education, Awareness, And Resources Related To Aging In Place For Older Adults And Stakeholders Within Community-Based Care, Nevaria M. Rumery

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

Central Lines And Peripherally Inserted Central Line Reeducation, Monica Lyn Gallik

Walden Dissertations and Doctoral Studies

Objective: Will a central line and peripherally inserted central line reeducation program increase the nurses’ knowledge pertaining to dressing changes, cap changes, and chlorohexidine baths? Method: 26 nurses on an observation unit were sent a power point presentation. Of the 26 nurses that received the power point 18 nurses participated. The power point presentation had a pretest and posttest embedded into it. Both the pretest and posttest consist3ed of the same 10 questions. The average of the pretest and posttest were used to calculate the normalized learning gained. Results: The average pretest score was 60, the average posttest score was …

Implications Of Palliative Care Education Amongst Critical Care Nurses And Applicable Screening Criteria For Consultation, Paiten Rask

DNP Projects

Background:
Palliative care is underutilized and/or consulted too late in the patient stay to provide optimal benefits to patients and families. There is a gap in nursing knowledge and confidence surrounding the topic of palliative care and the ability to advocate for specialty involvement for patients.

Objectives:
This project's purpose is to educate registered nurses in critical care about palliative care and introduce the idea of an objective palliative care screening tool. The project involved implementation of pre and post-test analysis of knowledge and confidence following a presentation of educational content. The content also included mock patient scenarios that require …

Implementing A Standardized Education Program To Enhance Nurses' Utilization Of Virtual Nurse Support, Emma Steck

DNP Projects

The rapid expansion of telehealth and virtual nursing support necessitates the development of standardized education programs to optimize the utilization of virtual support systems. This quality improvement project aimed to address the problem of inconsistent and outdated orientation methods for hospital nurses working with virtual registered nurse (ViRN) support staff at a large Midwest hospital. The project engaged over 800 nursing staff across more than 30 inpatient care units, with a focused pilot conducted on three intervention units. The intervention involved the development of an online learning module designed to standardize training and improve utilization of ViRN support. Utilizing the …

Dosimetric Comparisons Of 6mv, 6fff, 10mv, And 10fff On Vmat Planning In Patients With Endometrial Cancer, Madisin M. Depas

Masters Projects

Purpose: This study aimed to evaluate the dosimetric and efficiency impacts of different photon beam energies—6MV, 6 flattening filter free (FFF), 10MV, and 10FFF—on volumetric modulated arc therapy (VMAT) plans for endometrial cancer, with attention to target coverage, organ at risk (OAR) sparing, and treatment efficiency.

Methods: A retrospective analysis was conducted on 25 patients with post-hysterectomy endometrial cancer. Each patient received four VMAT plans with varying energies. Planning metrics assessed included planning target volume (PTV) dose maximum (Dmax), conformity index (CI), heterogeneity index (HI), OAR doses (bladder, bowel, rectum), and total monitor units (MU). Correlations were drawn …

The Processes That Contribute To Readiness To Learn For An Accelerated Nursing Graduate: A Grounded Theory Study, Kaye A.L. Whyte

Theses & Dissertations

The worldwide nursing shortage has led to maintaining an adequate nursing workforce as a global challenge. Increased recruitment efforts have fostered changes to some educational programs, giving rise to the proliferation of Accelerated Nursing Programs (ACCEL). These accelerated nursing programs are a highly successful way of educating future registered nurses, leading to concerns by registered nurses, hospital administrators, and nursing faculty who question the transitional competence of graduates from Accelerated Nursing Programs. The purpose of this study was to understand the transition processes for accelerated nursing graduates. The intended impact of this research was important to nursing for two reasons: …

Staff Education On Culturally Tailored Hispanic Diabetes Management In A Primary Care Community Clinic, Robyn Elizabeth Reeves

Walden Dissertations and Doctoral Studies

The Hispanic population is the fastest-growing ethnic minority in the United States, and they have a 66% chance of developing Type 2 diabetes mellitus (T2DM). Less than half of Hispanic patients with diabetes achieve optimal glycemic control due to cultural barriers and dietary issues. At the project site, a primary care practice in the southeastern United States regarding cultural competency training in diabetes management for Hispanics was identified. The practice-focused question was: Does providing education to primary care staff improve their knowledge of diabetes management among Hispanic patients with diabetes, as evidenced by pre- and post-surveys? In the project, I …

"Comparative Evaluation Of Breast Radiation Treatment Planning: Volumetric Modulated Arc Therapy (Vmat) Versus Modern Advanced 3d Planning Techniques (Ma-3drt) —Benefits, Limitations, And Clinical Implications", Christopher Kyle Sears

Masters Projects

Abstract 2 Left-sided breast cancer poses significant cardiac and pulmonary risks during radiation therapy, requiring techniques that optimize target coverage while minimizing exposure to critical organs. This study aimed to compare Volumetric Modulated Arc Therapy (VMAT) and Modern Advanced 3D Radiation Therapy (MA-3DRT), specifically Radformation’s EZFluence, in the treatment of left-sided breast cancer with nodal involvement. The objective was to evaluate which technique offers superior organ-at-risk (OAR) sparing, improved target coverage, and practical efficiency for clinical implementation. A retrospective dosimetric analysis was conducted on eight patients, each with an existing MA-3DRT plan. VMAT plans were generated using identical CT simulation …

A Workplace Posture Initiative To Reduce Work-Related Musculoskeletal Disorders, Carrie Isaac

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Work-related musculoskeletal disorders (WRMSDs) are a leading cause of occupational injury and discomfort in industrial workplaces. Although an ergonomic program existed at the project site, a formalized process to detect postural misalignments early had not been established. Relying on employee self-reporting, delayed intervention, and limited opportunities to prevent injuries before they progress.

Aim of the Project: A proactive posture screening program using PostureScreen® was implemented to identify postural deviations that could contribute to WRMSDs. Emphasis was placed on supporting employees through early awareness of posture-related issues and evaluation of alignment improvements following individualized intervention.

Review of the Evidence: Evidence …

Coaching Bilingual Speech-Language Student Clinicians And Spanish-Speaking Caregivers To Use Culturally Adapted Ndbi Techniques For Autistic Preschoolers, Richelle R. Mcguire

Speech and Hearing Sciences ETDs

This study used a cascading coaching model to train bilingual speech-language pathology graduate students and Spanish-speaking caregivers to implement naturalistic developmental behavioral intervention (NDBI) strategies with autistic preschoolers. Two triads, each including a student clinician, minimally vocal child with autism, and caregiver, participated. A monolingual instructor coached student clinicians in culturally adapted NDBI techniques, who then coached caregivers in Spanish. A mixed methods approach evaluated outcomes through single-case experimental design and qualitative interviews. All adult participants increased their use of targeted NDBI skills, with large to very large effect sizes. Qualitative findings suggested areas for improvement (e.g., need for more …

Hyperglycemia And Oral Health: A Review Of Dental Clinicians’ Perceptions And Practices Of Blood Glucose Monitoring In The Dental Office, Kathleen Wozniak

Dental Hygiene ETDs

This study aims to review the current practices and perceptions of dentists regarding the likelihood of dental professionals incorporating blood glucose monitoring into patient care protocol of patients with diabetes mellitus and prediabetes in dental offices. A survey link was shared by DentalOffices, a dental resource center. The survey included a series of questions which aimed to review dentists' current attitudes, practices, and considerations for implementation of in-office blood glucose testing as it relates to the treatment of patients with diabetes mellitus. Forty-seven dentists participated in the survey. This study determined blood glucose testing is not a common protocol or …

Staff Education To Increase The Number Of Continuous Glucose Monitors (Cgms) Prescribed At An Adult Primary Care Clinic For Individuals With Type 2 Diabetes., Josephine Opara

Walden Dissertations and Doctoral Studies

This quality improvement project focused on increasing the use of continuous glucose monitors (CGMs) in primary care for patients with type 2 diabetes. Its goal was to enhance providers' ability to prescribe and manage CGMs effectively. A review of existing literature and a provider survey identified key barriers, such as limited time and insufficient provider education on CGMs. The survey emphasized educational needs related to initiating and prescribing CGMs. Educational materials, including a PowerPoint presentation on prescribing, monitoring, and management, were developed and shared with clinic staff. Consequently, CGM prescriptions increased over the three-month period. The project aimed to improve …

An Analysis Of Employment Patterns And Career Decisions Among Dental Hygienists: In A Transforming Healthcare Landscape, Shirley Calderon Jamarck

Dental Hygiene ETDs

The purpose of this study was to identify the factors contributing to dental hygienists’ consideration of changing careers, retiring early, or feeling burned out. A 26-question survey was emailed to members of the American Dental Hygienists’ Association, with 742 responses meeting inclusion criteria. Participants evaluated aspects of their careers, including job satisfaction, wages and benefits, personal growth, work-related stress, burnout, work-life balance, and retirement plans. Results revealed that one-third of respondents planned to leave the profession, citing burnout, physical strain, and limited career growth as reasons. High correlations were found between job satisfaction and feeling valued, professional accomplishment, and growth …

Microneedle-Based Lc-Ms/Ms Profiling Of Dermal Interstitial Fluid Reveals Early Lipid Dysregulation Contributing To Painful Neuropathy In Prediabetic And Type 2 Diabetic Rats, Srinivasa Rao Gadam

Biomedical Sciences ETDs

Painful diabetic neuropathy (PDN), a complication of type 1 and type 2 diabetes, also occurs in obesity and prediabetes, with dyslipidemia as a modifiable risk factor. The distal-to-proximal neuropathy pattern and length-dependent intraepidermal nerve fiber loss suggest peripheral contributions. We hypothesized that elevated neurotoxic lipid intermediates—diacylglycerols (DAG), free fatty acids (FFA), and acylcarnitines (CARs)—in the dermal interstitial fluid (ISF) drive metabolism-associated hyperalgesia in prediabetic and diabetic rats. Using a microneedle array (MIA) with LC-MS/MS, we profiled ISF and serum lipids from high-fat diet (HFD) and HFD + streptozotocin (STZ) rat models alongside Hargreaves testing. ISF lipid changes appeared earlier (weeks …

Exploration, Expansion, And Optimization Of Bacteriophage Virus-Like Particle Vaccines, Andzoa N. Jamus

Biomedical Sciences ETDs

Bacteriophage virus-like particles are highly immunogenic, self-assembling platforms used for various vaccines. This work shows efforts to explore new vaccine candidates against Chlamydia trachomatis, targeting proteins that play critical roles in attachment and entry into the host cell, as well as in pathogenesis and bacteria proliferation. This work also shows the optimization of previously identified candidates, by investigating how altering routes of immunization can change the antibody profiles elicited, both systemically and locally. Finally, this work shows the establishment of various Chlamydia infection models in an effort to expand the ways in which vaccine efficacy can be investigated, particularly …

Immune Regulation In Fungal Airway Inflammation And Host Defense, Ruoning Wang

Biomedical Sciences ETDs

Asthma is a chronic inflammatory disease of the lungs characterized by complex pathophysiological mechanisms and diverse endotypes, primarily categorized as T helper type 2 cell (Th2)-high and Th2-low asthma. Despite significant advances in understanding asthma pathogenesis, the mechanisms governing the pulmonary immune system’s response to external challenges have not been fully understood. To address these gaps, this comprehensive project was designed to investigate the interplay between fungal infections and specific CD4⁺ T cell populations in asthma. Our findings suggest that fungal infections can contribute to neutrophilic asthma by promoting the migration of platelet-myeloid aggregates into the lungs. We also …

Localization Of Alpha Power Deficits In First Episode Psychosis, Crystal A. Garcia, Juan Bustillo

Biomedical Sciences ETDs

The purpose of this study was to determine where in the brain there may be a difference in brain activity in patients during their first episode of psychosis (FEP) compared to healthy controls (HCs) while performing an auditory oddball task. Time-frequency analysis allows for spectral decomposition where the signal measured by magnetoencephalography (MEG) is used to characterize changes in neural oscillations and their synchronization over time and region. Previous EEG studies report reduced alpha (8-12Hz, 70-160ms) power but most studies focused on patients with chronic schizophrenia and with limited source localization.

A Mutational Analysis Of Thatisin: How Single Point Mutations Impact The Biosynthetic Process Of A Group 16 Graspetide, John F. Boynton Jr

Chemistry and Chemical Biology ETDs

Abstract:

Graspetides are a family of Ribosomally synthesized and Post-translationally modified Peptide (RiPP) natural products named for their ATP Grasp Macrocyclases. We identified several Graspetide Biosynthetic Gene Clusters containing common double glycine cleavage motifs and attempted characterization of the mature Graspetides. One of the resulting peptides, Thatisin, has a topology with two interlocking macrolactones installed by a single ATP Grasp Ligase named ThtC. Here we use single and double point mutations to observe the impact or variation on the installation of these macrocycles. Alanine scan mutagenesis is used to assess leader peptide residues in the precursor peptide ThtA to determine …

Understanding Black American Pastors' Leadership Role And Interaction With Public Health During Covid-19, Stacy L. Tolbert

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic tested the leadership, response, and resilience of Black American pastors and their communities. These pastors played a crucial role in supporting their communities to lessen the impact the virus had on underlying health conditions and socioeconomic hardships that were exacerbated by the pandemic. Despite their efforts, Black American pastors frequently encountered challenges helping their community. The current research sought to understand the lived experiences of Black American pastors during the pandemic and their interactions with public health institutions to secure resources for their communities through Interpretative Phenomenological Analysis (IPA). The study was guided by the research question, …

Nursing Turnover Based On Age, Race, And Gender In Community Hospitals In Michigan, Laura Lawhorn

Walden Dissertations and Doctoral Studies

Hospitals struggle to maintain nursing staff to meet patient needs for a population that requires continuous care and experiences multiple illnesses. The purpose of this quantitative study was to investigate the variations in reasons for leaving the nursing profession (dependent variable) based on age, race, and gender (independent variables) within community hospitals in Michigan. The theoretical framework for this study was the Nursing Neuman Systems Model, which posits that nursing comprises four key components: environment, individual, nursing practice, and health. A correlational research design was utilized to address the research question and analyze the relationships between the variables. The secondary …

Implementation Of A Diabetic Complication Educational Intervention For Staff At A Community-Based Clinic, Virginia K. Dennis

Walden Dissertations and Doctoral Studies

Even though there are many modalities put in place to manage diabetes and its complications, there have been many barriers to reducing the complications associated with diabetes in health care institutions. In this educational intervention to reduce diabetes and its complications, a staff education program was implemented to enhance staff knowledge about diabetes and the complications associated with it. The staff education program was implemented at a community-based clinic for a DNP-prepared nurse, three RNs, and five medical assistants (MAs) working at the clinic. A pretest and a posttest were administered to assess the impact of the educational session. The …

Fathers Using Light Touch On Their Infants And Its Effects On Postnatal Paternal Depression, Christopher Dirkes

DNP Projects

Background:
During the postpartum period there are multiple resources available to address maternal postpartum depression. However, there are limited resources available to help fathers during this transition period. Currently, limited data is available for best practice to decrease postnatal paternal depression, and increase paternal bonding and comfortability when caring for the infant.

Method:
Fathers were recruited from a Midwestern Public Health Department. After recruitment, fathers were provided with in-home education on how to perform a light touch intervention. Pre-intervention qualitative and quantitative surveys were provided at this time. Fathers were then asked to record their emotions as well as infant …

Implementation Of Intimate Partner Violence Education To Improve Practice And Attitude Amongst Healthcare Providers, Abigail Nguyen, Breanna Carpenter

DNP Projects

Background
Intimate partner violence (IPV) is a serious and costly public health issue. It is vital that patients are screened at least annually for intimate partner violence. Screening increases disclosure of abuse and allows primary care clinicians to provide comfort, education, and resources to patients experiencing IPV. Evidence strongly suggests that a major barrier to regular screening for IPV is a lack of knowledge and comfort amongst healthcare providers.

Purpose
This project’s purpose was to provide educational tools for healthcare providers related to the importance of screening for IPV, guidelines for most effective screening, common IPV misconceptions, and local resources. …

Association Between Sociocultural Factors, Obesity, And Depression In The Hispanic/Latino Population, Maia Junco

Walden Dissertations and Doctoral Studies

The increasing prevalence of obesity and mental health disparities among Hispanic/Latino populations in the United States underscores the need to understand how sociocultural factors shape physical and psychological health. The purpose of this study was to examine how acculturation, diet quality, and fiber intake affect BMI and depressive symptoms over time. The study was guided by acculturation theory and the biopsychosocial model. The study used longitudinal secondary data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) with a sample of N=8,816, including adults who completed examination visits, 1 (2008–2011) and 2 (2014–2017). Path analysis was conducted to assess direct …

Dosimetric Effects Of Pinnacle³ Version 18.0 Advanced Auto-Planning Settings In Oropharyngeal Vmat Optimization, Emily Sanden

Masters Projects

This study evaluated the impact of Pinnacle³ version 18.0 auto-planning advanced settings modulation amount, monitor unit (MU) level, and dose fall-off priority on volumetric modulated arc therapy (VMAT) plan quality for bilateral oropharyngeal cancer. A total of 64 plans were generated using all possible combinations of low, medium, high, and very high settings for each parameter. A standardized base of tongue case was optimized once per plan using a single-time point approach, with planned target volume 1 (PTV1) (6996 cGy) and planned target volume 2 (PTV2) (5412 cGy) coverage evaluated. Each parotid gland, the spinal cord, brainstem, and the oral …

Staff Education On Evidence-Based Transitional Care Interventions Toward The Goal Of Reducing Readmission Rates, Adebowale A. Oyebamiji

Walden Dissertations and Doctoral Studies

The staff education project was implemented in a behavioral health hospital in the Midwestern region of the United States. The behavioral healthcare setting experiences poor transitional care, resulting in high readmission rates of psychiatric patients. Poor transitional care is associated with inadequate knowledge of evidence-based transitional care strategies among psychiatric nurses. The practice-focused question was: For staff in an inpatient mental health unit, will education on evidence-based transitional care interventions improve knowledge toward reducing readmission rates? The project aimed to enhance psychiatric staff knowledge on evidence-based transitional care interventions to reduce readmission rates. The analysis, design, development, implementation, and evaluation …

Impact Of Prostate Volume On Dose Fall-Off And Organ-At-Risk Exposure In Vmat For Prostate Cancer, Zhikang Jiang

Masters Projects

Prostate cancer remains one of the most prevalent malignancies among men, with radiotherapy, particularly VMAT—playing a central role in its management. VMAT allows for highly conformal dose delivery, but treatment planning must strike a careful balance between achieving steep dose gradients around the prostate and minimizing radiation exposure to nearby organs at risk (OARs), such as the bladder and rectum. This study aimed to evaluate how prostate volume influences dose fall-off characteristics and OAR dose exposure in VMAT treatment plans, providing insights into optimizing radiotherapy for patients with varying prostate sizes. A retrospective analysis was conducted on 50 prostate cancer …

Food Literacy Program Among Adults In A Primary Care Setting, Marie K. Williams

Student Scholarly Projects

Practice problem: The increase in preventable chronic diseases is associated with food illiteracy, which arises from a lack of understanding of nutritional value and dietary guidelines (Silva et al., 2023).

PICOT: (P) In adult primary care patients aged 30-75 years, (I) does the implementation of evidence-based food literacy program (C) compared to standard practice (O) improve food literacy (T) in eight weeks?

Evidence: Using a validated food literacy questionnaire effectively measures improvements in food literacy. Customized programs that fill knowledge gaps are essential for enhancing overall food literacy. Intervention: Customized educational tools were provided to participants based on their knowledge …

Staff Education To Use The Teach-Back Method To Decrease Congestive Heart Failure Readmissions, Carlita Tucker

Walden Dissertations and Doctoral Studies

This staff education project focused on educating staff to use the teach-back method to decrease congestive heart failure (CHF) readmissions. It is essential to address this issue within the context of nursing practice because CHF patients have left the hospital without adequate knowledge of their care plans, which compromised their self-care and increased their chances of returning to the hospital. This project employed the teach-back method, which is an effective communication process involving the patient reiterating what the staff has told them. The practice-focused question which guided the project was: For staff in an acute care hospital, will evidence-based training …

Staff Education To Improve Fall Prevention Practices In The Home Health Setting, Chinemelum Okoye

Walden Dissertations and Doctoral Studies

Falls among adults aged 65 and older represent a significant public health concern, as they are the leading cause of injury and hospitalization within this demographic. According to the Centers for Disease Control and Prevention (CDC), nearly one in four older adults experiences a fall annually, leading to over 3 million emergency department visits. In home health settings, the risk of falls is heightened due to uncontrolled environments and insufficient staff training. This quality improvement project assessed the effectiveness of an educational intervention aimed at fall prevention strategies for home health staff, including registered nurses (RNs) and certified nursing assistants …