Medicine and Health Sciences Commons^™

Early Detection Of Sepsis, Precious Aina

Honors Capstones

Sepsis is a life-threatening condition that occurs because of an infection. Sepsis can lead to shock, SIRS, organ failure, and other emergent conditions. This literature review paper is aimed at determining the early detection of sepsis in patients as well as examining early symptoms of sepsis, the significance of early diagnosis, and the implications for patient safety and treatment. In several studies, they used the early warning scores (EWS) and Machine learning with patients' information, vital signs, prehospital patient data, and physician assessments embedded in it to identify patients at risk for sepsis. One of the studies incorporated a device …

Analysis Of Clinical Outcomes And Cost Effectiveness Of Neuromuscular Blocking Drug Reversal In Patients Classified As Obese, Trevor Mack

Doctor of Nursing Practice Scholarly Projects

Obesity predisposes patients to heightened risks of adverse outcomes following surgery, including residual neuromuscular blockade and postoperative complications. The administration of non-depolarizing neuromuscular agents (NMBAs) is fundamental for muscle relaxation and optimal surgical conditions. However, the subsequent reversal of these blockers with agents like sugammadex or neostigmine is crucial to mitigate these risks. While sugammadex is recognized as a clinically superior choice due to its rapid and more complete reversal, its extensive use is often limited by cost, presenting challenges in obese patients who already face increased susceptibility to complications. This project evaluates the cost-effectiveness of sugammadex versus neostigmine in …

Examination Of Eating Disorder Risks And Body Image Dissatisfaction Among Division Iii Student-Athletes, Maddie Wisener

Masters Theses/Capstone Projects

Eating disorders (ED) and pathogenic behaviors are prevalent concerns among collegiate athletes due to performance pressures and body image expectations. This cross-sectional study examined the risk of ED among 243 student-athletes (Males: 54.9%, Females: 44.3%, Non-Binary: 0.4%) at a private institution in the Midwest. The convenience sample included student-athletes from baseball, basketball, cheerleading, cross country, football, golf, lacrosse, soccer, softball, tennis, track, volleyball, and wrestling teams. The participants were given a demographic survey, the Eating Attitudes Test-26, and Sex-Specific Figural Stimuli Silhouettes to assess eating behaviors and perceived and desired body images. Overall, 22.1% of participants were at risk for …

Development Of A Clinical Pathway For Acute Pain Management As An Element Of The Prevention Of Delirium In Older Adult Trauma Surgery Patients, Stacey Mermigos

Doctoral Scholarly Projects & Capstones

For hospitalized patients, delirium is prevalent and associated with poor outcomes including increased mortality, morbidity, hospital length of stay, and healthcare costs. Although past studies have identified effective interventions to both prevent and manage delirium in critically ill patients, the most widely used evidence is not easily generalized to non-critically ill patients, specifically trauma patients who experience acute pain, serial surgical procedures, and other notable precipitating and predisposing factors. Clinical pathways are structured plans that are useful for encouraging consistent, evidence-based interventions for various medical conditions and situations. At this time, there is no clinical pathway for the prevention of …

A Four-Year Longitudinal Study Of Effectiveness Of Evidence-Based Bundle Practices For Preventing Catheter-Associated Urinary Tract Infections In An Academic Health Care Center, May Mei-Sheng Riley

Doctoral Projects

Catheter-associated urinary tract infections (CAUTIs) significantly contribute to morbidity, prolonged hospitalization, and elevated healthcare costs, underscoring the crucial need for prevention to ensure patient safety. Despite ongoing mitigation efforts, CAUTI prevalence remained a concern in our facility at the time of this study. Catheter insertion and maintenance bundles, a recognized framework utilizing teamwork, collaboration, and focused interventions, were implemented to reduce CAUTIs and improve patient safety. This study evaluated the effectiveness of these bundles in reducing CAUTIs and catheter utilization to identify best practices for enhanced catheter management and care quality.

Preserving What Matters: A Multimodal Approach To Maintaining Fat-Free Mass During Anti-Obesity Medication Based Weight Loss, Sarah Gore

Evidence-Based Practice Project Reports

Weight loss is often associated with reductions in fat-free mass (FFM), which can negatively impact metabolic rate, thermoregulation, bone density, functional capacity, and overall quality of life (Roth et al., 2022; Sedlmeier et al., 2021). This Evidence-Based Practice project aimed to reduce FFM loss in adults prescribed anti-obesity medications (AOMs) for weight management through a targeted, multimodal intervention. Twenty-two patients beginning AOM treatment at a family practice in northwest Indiana were invited to participate, with 19 consenting to enroll. Each participant received personalized guidance, including tailored calorie and protein intake goals to support a hypocaloric, high-protein diet, alongside evidence-based aerobic …

Clinical Guidelines For The Perioperative Management Of Patients With Aortic Stenosis Undergoing Noncardiac Surgery, Owen Diehl

Doctor of Nursing Practice Scholarly Projects

Aortic stenosis (AS) is a common valvular disorder that causes left ventricular (LV) outflow obstruction. The prevalence of AS may increase with the aging population and the widespread availability of diagnostic capabilities like echocardiography. With the increasing patient population diagnosed with AS, the chance of encountering these patients during noncardiac surgery (NCS) increases. Performance of anesthesia is challenging in patients with AS due to the pathophysiological consequences of AS and the hemodynamic changes associated with anesthesia. The patient with AS presenting for NCS is at an increased risk of perioperative major adverse cardiac events (MACEs). This project aimed to determine …

Impact Of Implementing An Updated Cervical Cancer Screening Protocol In The Primary Care Setting, Teri A. Koch

Evidence-Based Practice Project Reports

Cervical cancer is one of the most common types of cancer among women globally. Current screening methods by clinicians include cytology sampling, high-risk human papillomavirus sampling, or co-testing with both methods. These tests may detect cell changes before they become cancerous, yet the uptake of these methods has decreased in recent years (Aginga, 2022; Office of Disease Prevention and Health Promotion, 2023; Popalis et al., 2022; Sung et al., 2021). The primary purpose of this evidence-based practice project was to determine if the implementation of an updated cervical screening protocol improved the linkage of abnormal results to appropriate clinical follow-up …

A Multi-Modal Intervention To Improve Identification, Management, And Prevention Of Early Childhood Caries In The Primary Care Setting, Rieley M. Hull

Evidence-Based Practice Project Reports

Early childhood caries (ECC) is the most prevalent chronic childhood disease and, if untreated, can lead to significant long-term health and social consequences, posing a substantial healthcare burden (AAPD, 2023; ADA, 2023; USPSTF, 2021; WHO, 2022). This evidence-based practice (EBP) project aimed to implement a multi-modal intervention to reduce ECC risk factors, prevent new dental caries, and halt the progression of existing dental caries. Conducted in a pediatric primary care setting in West Michigan, the project included patients five and under who received an oral examination and dental caries risk assessment following the AAP’s guidelines. Based on their oral health …

Improving Communication And Job Satisfaction: Utilizing Team Strategies And Tools To Enhance Performance And Patient Safety (Teamstepps) For Interventional Service Areas, Sukhbinder Kaur Sangha

Doctoral Projects

Purpose: Improved communication and job satisfaction among staff are essential for those working in high-stress critical care environments like the cardiac catheterization laboratory (Cath Lab). The purpose of this investigation was to utilize the quality improvement initiative Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) to improve attitudes and job satisfaction in the Cath Lab. Method: A total of 30 subjects participated in a TeamSTEPPS educational intervention. After obtaining informed consent, a demographic survey, a pre- and post-test TeamSTEPPS Teamwork Attitudes Questionnaire (T-TAQ) and Job Satisfaction Survey (JSS) were administered. The post-test included open-ended questions for feedback …

Addressing Gaps In The Continuum Of Care: A Quality Improvement Project Focused On Adolescent Youth With Depression Symptoms At A School-Based Health Clinic, Leah Nigon

Theses and Graduate Projects

This Doctor of Nursing Practice (DNP) quality improvement project aimed to address gaps in the continuum of care for adolescents experiencing depression symptoms at a school-based health clinic (SBHC) within an alternative learning community school (ALCS) in southeast Minnesota. Adolescent depression rates are on the rise and are only exacerbated by systemic barriers and social determinants of health, requiring improved mental health care access. Guided by Madeleine Leininger’s Culture Care Theory, the project focused on improving follow-up care for students with elevated depression scores on the Patient Health Questionnaire-9 (PHQ-9-M). A tracking system was developed, and the SBHC nurse contacted …

Primary Prevention Of Nicotine Use In The Pediatric Population, Katie N. Ashton

Honors Capstones

This project explores how to prevent nicotine use, particularly e-cigarette use, among adolescents. Nicotine use has been on the rise since e-cigarette devices have been created. This makes it convenient to use nicotine products rather than going outside to light a cigarette. Nicotine use in adolescents is increasing as it is more convenient to use, and many may not understand the adverse health effects of using these devices. Any nicotine use can cause brain, heart, and lung damage. This project explores the factors that encourage adolescents to use nicotine such as the variety of flavors that e-cigarettes are made of …

Staff Education On Medication Reconciliation, Ivana Priscilla Adwoa Antwiwaa Buamah

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice education project focused on improving staff knowledge of medication reconciliation through an evidence-based educational intervention in an outpatient clinic. Medication reconciliation is crucial for ensuring accurate and consistent medication lists across care transitions, helping to prevent errors, such as omissions, duplications, dosing mistakes, and drug interactions. The project’s central question was whether staff education on an evidence-based approach to medication reconciliation would improve staff knowledge. A pre- and post-education survey was used to measure changes in staff knowledge after a PowerPoint presentation. Results showed a significant increase in staff knowledge after the intervention; the participants’ …

Raised Spirits The Visceral Journey Of Black Generational Female Trauma And The Transcendent Healing Power Of Spiritual Dance, Wendy Ann Powell

Theses and Dissertations

Black female bodies have endured sustained trauma globally since the transatlantic slave trade, and it continues into 2025. The collective consciousness has carried the generational burden and mobilized it within the womb. Powell uses this intergenerational knowledge to frame the basis for spiritual dance practices as a healing praxis.

One Can Only Dream, Sophia V. Yacca

Theses and Dissertations

One Can Only Dream is an interactive installation in which players are invited to navigate a liminal, dream-like game, engage with a branching series of questions, and introspect upon the relationships between unconscious expression, conscious self-perception, and the inherent difficulty of depicting, sharing, and understanding subconscious thought.

Rooted in both my personal experience with a rare neurophysiological condition and in my desire to create, this project examines dreams not only as a medical and cultural phenomenon, but also as a means to form identity, reflect trauma, and inspire creativity. Drawing from modern interactive storytelling and my lived experiences, this work …

Behavioral Responses To The Medicare Part D Coverage Gap And Its Closure, Selene Urbatsch

Theses and Dissertations

The author examines how exposure to the Medicare Part D coverage gap affects future prescription drug use and whether the closure of the gap under the Affordable Care Act (ACA) altered beneficiary behavior. Using 2007–2019 MEPS data, the analysis compares Part D enrollees to similarly aged, privately insured individuals, producing first-differences and difference-in-differences estimates. Before the ACA, exposure to the gap was associated with 4.9 fewer prescription fills relative to comparable non-Part D individuals. After the ACA, the effect fell to a reduction of 2.2 generic fills, with no significant decline in branded use. Sudden out-of-pocket cost increases prompted sharp …

Out From Under: Stories Of Endometriosis, Prisca Edwards

Theses and Dissertations

Six individuals. One diagnosis. In Out From Under, people living with endometriosis gather for an art-centered workshop. Through collage and conversation, they transform isolating medical experiences into paths of connection and collective healing.

Endometriosis affects approximately one in ten women of reproductive age, yet diagnosis is often delayed by nearly a decade. During this time, many suffer from debilitating symptoms without adequate care or accessible treatment. Out From Under explores the lived experience of endometriosis through the lens of socially engaged documentary filmmaking. Participants share their medical histories, emotions, and frustrations in a structured yet open environment designed for intimacy, …

The Connection Between The Gut Microbiome And Joint Pain, Masooma Shamsi

Honors Capstones

Background – Gut microbiome impacts joint pain in osteoarthritis. Studies show the relationship between abundance and diversity of gut microbiome and pain. The objective of this study is to summarize the evidence on the effect of gut microbiome on pain.

Methods – Literature search was conducted through PubMed and CINAHL databases. Search terms include gut microbiome + joint pain. Articles that had terms joint pain, gut dysbiosis, or inflammation from the gut were included. Articles included information regarding abundance and diversity of the gut microbiome.

Results – 5 selected articles show the relationship between diversity and abundance in the gut …

The Impact Of Mentorship On Burnout Among Novice Nurse Faculty, Lucas Gless

Doctor of Nursing Practice Projects

Burnout among novice nurse educators contributes to increased rates of faculty turnover and vacancies in nursing education. This is especially significant in rural settings. This quality improvement project aimed to determine the impact of mentorship on novice nurse educators’ perception of burnout at a rural community college in East Texas. Utilizing a mixed methods design, novice nurse educators with less than two years of academic nurse education experience were assigned experienced faculty mentors over an eight-week period. The Maslach Burnout Inventory-Educators Survey (MBI-ES) measured emotional exhaustion, depersonalization, and personal accomplishment, both before and after the intervention. Data analysis, using the …

Quality Improvement Project Prevention Of Perioperative Pressure Injury Utilizing Scott Triggers Education, Assessment, And Interventions, Lisette Miller

Doctor of Nursing Practice Projects

Abstract

The quality improvement project was initiated to educate perioperative staff on the evidence-based practice of Scott Triggers to reduce perioperative hospital-acquired pressure injuries (HAPIs). The purpose of the project was to provide Scott Trigger’s education to perioperative nurses for the reduction of perioperative HAPIs utilizing Scott Trigger's risk assessment tool and recommended interventions. Using a quantitative quasi-experimental design, the project consisted of two separate three-month data collection sets, one set collected pre-educational intervention, and the second set collected post-educational intervention. The project proved the use of the Scott Triggers high-risk assessment tool and utilization of the recommended interventions to …

Quality Improvement Project Impact Of Multidisciplinary Patient Education On Heart Failure 30-Day Readmission Rate, Jeanne P. Williams

Doctor of Nursing Practice Projects

Patients diagnosed with heart failure are at an increased risk for readmission to the hospital within 30 days of discharge, and their care costs are projected to continue to increase. This Doctor of Nursing Practice (DNP) quality improvement (QI) project aimed to implement an evidence-based initiative to mitigate the increased heart failure 30-day readmission rate on a 30-bed medical-surgical telemetry unit in an acute care facility. Using the teach-back communication method, multidisciplinary patient education was implemented to prepare patients diagnosed with heart failure to manage their condition once discharged home. The theoretical and implementation frameworks used were Lewin’s Change Model, …

Entry-Level Physical Therapists’ Perceptions Of Initial Employment, Richard G. Hubler Jr.

Seton Hall University Dissertations and Theses (ETDs)

As physical therapy (PT) grows as an autonomous profession within the ever-changing healthcare system of the United States, PT educators strive to provide students all the training that they require for a career in professional clinical practice. Although graduates of PT education programs receive a doctoral degree, their preparedness to succeed in their early career is unclear. The purpose of this qualitative research study is to investigate the perceptions of entry-level physical therapists (PTs) toward early professional practice and their initial employment choices. Entry-level PTs that have been employed full-time for one year or less were interviewed to gain an …

Parental Vaccine Hesitancy And The Decision To Vaccinate Children Against Covid-19, Jessica Mckee

Walden Dissertations and Doctoral Studies

While there is a significant body of literature regarding vaccine hesitancy, there is a gap in the literature on its impact to parents’ decisions to vaccinate their children against a pandemic pathogen. The purpose of this study was to examine the relationship between parental vaccine hesitancy, measured using the health belief model (HBM) theoretical framework constructs of the Vaccine Hesitancy Scale (VHS; the degree to which an individual trusts in vaccine efficacy, safety, the reliability and trustworthiness of vaccine programs, community impact, perceived risks, and the importance of childhood vaccinations), and parents’ decision to vaccinate their children against COVID-19 with …

Executive Summary: Development Of An Evidence-Based Prevention Bundle To Reduce Falls On An Inpatient Psychiatric Detoxification Unit, Ramatu Dougrey Jalloh

Walden Dissertations and Doctoral Studies

Following a 16% increase in patient falls from 2023 to 2024 in an inpatient psychiatric detoxification unit, a quality improvement education project was implemented to assess the impact of an evidence-based fall prevention bundle on fall rates and nursing compliance. Nurses received education through a PowerPoint presentation to enhance understanding and implementation of the bundle, which included Edmonson reassessments after high-risk medication administration, ISHAPED bedside shift handoffs, care plan updates, and SWIFT daily safety huddles. Posttests identified that the objective score of 80% knowledge for nurses was met. During the 10-week implementation, the goal was 100% compliance with all bundle …

Know Thyself: A History Of Ancient Neuroscience, Alex Delano

Departmental Honors & Graduate Capstone Projects

Neuroscience is often described as one of the youngest bodies of science, but documented study of the brain begins as early as the Neolithic period. The ancient Mediterranean was a hub for science, mathematics, philosophy, and literature, all disciplines necessary for the study of the brain. Evidence of neurosurgical procedures like trepanation and craniotomy began in the Neolithic period and were practiced and improved upon throughout the ancient Mediterranean. The first detailed studies on brain anatomy were carried out in the 3^rd century BCE in Greece which created a necessary structure for future scientists to build on. While many …

Enhancing Hospital Throughput With The Power Of Reminders: Implementing A Discharge Before Noon Strategy At An Urban Teaching Hospital, Jessie Ventura

Doctoral Projects

The doctoral project deploys a "Discharge Before Noon" strategy at an urban teaching hospital to resolve discharge delays and improve patient throughput efficiency. Hospitals experiencing overcrowding must prioritize timely patient discharges to enhance clinical results and operational performance. The project adopted the PARIHS framework to steer implementation through its emphasis on evidence-based practices, contextual factors, and facilitation strategies. The research gathered discharge data and team coordination results before and after the intervention period. The findings revealed elevated discharge numbers before noon and substantial progress in interdisciplinary team collaboration. The initiative indicated an optimizing trend for discharge procedures, even though statistical …

A Multimodal Intervention To Improve Treatment And Clinical Outcomes In Children With Recurrent Otitis Media, Daniel Courtaney

Evidence-Based Practice Project Reports

Acute otitis media is the number one cause for primary health care visits and antibiotic prescriptions in the pediatric population (El Feghaly & Jackson, 2023). Upwards of 27% of children experience multiple episodes of otitis media (OM) that meet recurrent otitis media (ROM) diagnosis criteria (Pelton & Marchisio, 2023). Guided by the Iowa Model (Iowa Model Collaborative, 2017), the project’s purpose was to implement a multimodal intervention to decrease recurrent OM and repeat clinic visits. A comprehensive literature search of 5 databases yielded 16 sources ranging from levels I-IV (Melnyk & Fineout-Overholt, 2023). Using the AGREE II and JBI Critical …

Staff Education For Infection Control Prevention, Beatrice I. Cesar

Walden Dissertations and Doctoral Studies

This project was a quality improvement staff education program to address the increase in hospital-acquired infections in the project facility. The hospital administrator identified that staff were overwhelmed and may not be consistently implementing appropriate infection control practices. If infection control practices are not addressed in hospitals system, there would be a much higher rate of hospital-acquired diseases among hospitalized patients and the staff. A staff education program about evidence-based strategies relating to infection control prevention was implemented to increase the nurses’ knowledge about strategies to decrease the spread of infection in the project facility. Eleven registered nurses participated in …

Staff Education To Enhance The Diagnosis Of Depression In Older Adults, Abiola Oyenwen Izekor

Walden Dissertations and Doctoral Studies

The aim of this staff education project was to improve provider knowledge on using the Geriatric Depression Scale (GDS) for screening depression in older adults. Geriatric depression is often underdiagnosed due to atypical symptoms and reliance on generalized tools such as the Patient Health Questionnaire-9 (PHQ-9), leading to delays in treatment and increased health care costs. To address this gap, I collaborated with a librarian to conduct a literature search, initially identifying 149 articles and refining them to 20 for review. I followed the analysis, design, development, implementation, and evaluation (ADDIE) model to structure the educational intervention. The training included …

Staff Education To Improve Staff Knowledge And Attitudes Regarding Aggressive Patient Behaviors, Roya Khoshbakht

Walden Dissertations and Doctoral Studies

Aggressive behavior among psychiatric patients threatens safety and quality in healthcare, causing physical and psychological harm to staff and contributing to burnout and high turnover rates. This Doctor of Nursing Practice (DNP) project addressed gaps in staff knowledge and attitudes, particularly among nurses, regarding aggression management and de-escalation techniques through a comprehensive education program on the causes of aggression, warning signs, and effective strategies. The evidence-based practice (EBP) question was, Will staff education on evidence-based strategies for preventing and managing aggressive behavior improve staff knowledge and attitude? Project team members used the Johns Hopkins Evidence-Based Practice (JHEBP) model to develop …