Medicine and Health Sciences Commons^™

Impact Of Nursing Burnout On Preceptors During The Transition Phase Of New Graduates Into The Workforce, Janessa Truss

Doctor of Nursing Practice Projects

There is a massive threat to healthcare systems posed by the growing burnout of inexperienced RNs working in practice transition to new graduate preceptors. Currently, this "Doctor of Nursing Practice (DNP) project" examines the role of the nurse in burnout within Long Term Acute Care (LTAC) facilities through the preceptorship. In the project, burnout factors and their effects on patient care and nursing workforce retention will be investigated, and interventions for burnout and its effects will develop. A mixed methods project involving qualitative and survey and interview analyses of five-year and older patients was performed. Burnout and job satisfaction were …

Quality Improvement Project Empowering Outpatient Providers: A Training Initiative On Social Determinants Of Health, Shannon Wrenn

Doctor of Nursing Practice Projects

Healthcare providers play a critical role in assessing social determinants of health (SDOH), yet many lack the knowledge and confidence to effectively address these factors during patient encounters. Research indicates that SDOH contribute to approximately 80% of health outcomes, yet only 41% of providers feel confident in discussing them with patients. This quality improvement project aimed to improve provider knowledge and confidence about SDOH as measured by pre- and post-education assessments. The SDOH targeted training took place at an outpatient interventional nephrology practice in Memphis, Tennessee. A quasi-experimental, one-group pretest-posttest design was used. Ten clinical staff members participated in an …

The Effect Of Using Pelvic Floor Exercises Administered Through A Smartphone Application In Postpartum Women With Pelvic Floor Dysfunction, Elizabeth A. Russell

Evidence-Based Practice Project Reports

Pelvic floor dysfunction (PFD) affects 50% of postpartum women and can lead to pelvic pain, stress urinary incontinence, fecal incontinence, pelvic organ prolapse, or sexual dysfunction (Grimes, 2023). The purpose of this evidence-based practice project was to determine if the implementation of pelvic floor exercise (PFE) as guided by a smartphone application, to improve adherence and technique of exercises, will improve PFD symptoms and quality of life (QOL). At an OBGYN clinic in northern Indiana, all women who presented for their 6-week postpartum appointment were screened for PFD with the Pelvic Floor Distress Inventory (PFDI-20) and QOL with the Pelvic …

Men’S Preconception Health: Impact On Pregnancy And Awareness Strategies., Kara I. Carr

Honors Capstones

Men’s preconception health plays a critical role in pregnancy outcomes, but it continues to be overlooked in healthcare education. While women are routinely counseled by OBGYN providers on how nutrition, lifestyle, and chronic conditions can affect fertility, men often receive little to no guidance from their primary care providers. This project uses a literature review to look deeper into how limited awareness and involvement in men’s preconception health may impact pregnancy and infant health outcomes. The gap is linked to cultural norms, healthcare practices, and the lack of clear resources for men. This research aims to develop strategies that promote …

What Are The Minimum Dimensions In A Marketing Plan Required For Starting Or Improving Marketing In A Small, New Home Health Agency?, Patrick Baker

MUSC Theses and Dissertations

Objective: To fulfill an unmet need for practical, parsimonious assistance for examples of a practical marketing plan for new, small home health care agencies. The home health (HH) care industry needs customized marketing plans tailored to the unique requirements of small, emerging HH agencies. These plans are essential for navigating the competitive market driven by an aging population and technological advancements. However, the industry's emphasis on this specific aspect is significantly lacking.

Methodology: We reviewed the published literature, numerous books and websites and selected sources that provided practical, small-scale approaches to marketing for health care organizations. We identified specific marketing …

Unlicensed Assistive Personnel’S Attitudes, Knowledge, And Perceptions Of Alternatives To The Application Of Physical Restraints, Gale Marie Knight

Walden Dissertations and Doctoral Studies

The use of physical restraints in mental health care settings is a common practice, yet it poses significant risks to patients’ physical and psychological well-being. The issue of excessive restraint use was addressed through this doctoral project by designing an educational program aimed at promoting alternative strategies. The practice-focused question was: How can an educational program for unlicensed assistive personnel (UAP) impact their knowledge and attitudes towards alternatives to physical restraints? The purpose of the project was to develop and evaluate an education program to improve UAP knowledge and attitudes to reduce reliance on physical restraints. The project was informed …

Determining The Bioaccumulation Of Minor Cannabinoids In Zebrafish Larvae, Kamdyn A. Holt

Honors Theses

Due to the increasing prevalence of cannabis product availability and usage in the modern United States, particularly among pregnant individuals, evaluating the bioaccumulation of minor cannabinoids to further understand the adverse effects of cannabinoids during early development is critical. This study quantitated the uptake of eight minor cannabinoids ((∆8-tetrahydrocannabinol (∆8-THC), ∆9-THC, ∆10-THC, cannabidiol (CBD), cannabigerol (CBG), cannabinol (CBN), tetrahydrocannabivarin (THCV), and hexahydrocannabinol (HHC)) in zebrafish larvae following water-borne 2 µM exposures from 6 to 96 hours post fertilization (hpf). Larvae were homogenized at 96 hpf and analyzed using a gas chromatography- mass spectrometry (GC-MS) method developed in this study. Bioconcentration …

The Impact Of Automated Text Messaging System Education On The Self-Efficacy Of Medical Office Staff, Jim Jorgensen

Doctor of Nursing Practice Projects

Inadequate patient bowel preparation is a leading cause of canceled or repeated colonoscopies, negatively impacting both outcomes and healthcare costs. While automated text messaging systems have improved patient adherence in other clinical areas, they remain underutilized by endoscopy staff due to low self-efficacy. This quality improvement project aimed to evaluate the effect of structured education on the self-efficacy of endoscopy nursing staff in using an automated text messaging system for outpatient colonoscopy preparation at a rural VA Medical Center (VAMC). Guided by Bandura’s Social Cognitive Theory and using the Plan-Do-Study-Act model, this project implemented a one-day, hands-on training session with …

An Educational Intervention Focused On The Importance Of Nurse Leader Rounds, Shantelle Mobley

Walden Dissertations and Doctoral Studies

Nurse leader rounding (NLR) is essential in most healthcare organizations as NLR has been associated with improved nurse recruitment and retention, increased patient satisfaction, and increased quality of care. In the local organization, leadership identified that there was a lack of knowledge and awareness of NLR among nurse managers and charge nurses. Thus, the purpose of this Doctor of Nursing Practice (DNP) project was to determine if an education intervention focused on structured NLR increased knowledge and awareness among charge nurses and nurse managers. Thirty-seven individuals were invited to participate in the educational intervention. With the support of leadership, 34 …

Effects Of Acute Exercise On Cognition: Consideration Of Potential Moderators, Elizabeth G. Gaines, Mckenzie M. Cotten, Elizabeth Reese Carwile, Mary Griffin Jackson, Marascalco Liston, Lucy Wilson

Honors Theses

The present thesis aims to determine the effects, if any, of six potential moderators on the effects of acute moderate-intensity exercise on cognitive functioning. The modes of exercise undertaken by the participants included treadmill (Experiment 1) and stationary bike (Experiment 2) exercise. Participants in each experiment either exercised or rested for twenty minutes and then participated in either a memory recall task or cognitive functioning (“Stroop”) task. The bouts of either exercise or rest on the stationary bike were followed by a rest period during which the participant would be exposed to either standard air oxygen levels (normoxia) or hypoxic …

Quality Improvement Project Improving Tele-Sitter Usage In The Surgical Trauma Pcu, Stephanie R. Stone

Doctor of Nursing Practice Projects

This project aimed to improve the knowledge and usage of virtual patient sitters/tele-sitters for surgical trauma progressive care nurses in the surgical trauma progressive care unit through the implementation of nursing education, utilizing evidenced based teaching strategies. Nurse leaders identified a need for staff education among the surgical trauma registered nurse staff population. The goal of the project was to increase knowledge of virtual patient sitters/tele-sitters and how to order them, improve the understanding of the benefits of utilizing the device and to increase the overall usage of the devices on the surgical trauma progressive care unit patients that would …

The Impact Of High Deductible Health Plans On Mental Health Treatment, Kristian D. Dambrino, Laura Gray, R. David Phillippi

DNP Projects

Background and Rationale: High Deductible Health Plans (HDHPs) are designed to reduce overall healthcare spending by shifting more upfront costs to patients to discourage overutilization of care, yet HDHPs often increase financial burden, particularly in outpatient mental health care. Patients covered by HDHPs often face substantial out-of-pocket costs before reaching their deductible. This can lead to potential delays or discontinuation of psychiatric treatment. Financial transparency interventions by the mental health provider may mitigate these barriers through more-informed patient decision-making regarding payment options. This project evaluates the impact of a financial transparency intervention on reducing payment responsibility for HDHP patients in …

An Exploration Of Behavioral Sex Differences Due To A Parkinsonian Gene, Pdr-1, In C. Elegans., Adriana Mulet Miranda, Mary B. Kroetz, Paul J. Kiser

Undergraduate Theses

Parkinson’s disease is a debilitating neurodegenerative disease of the central nervous system classified by the loss of dopaminergic neurons. Males and females exhibit different symptoms however, the cause remains unknown. Through the use of a model organism, C. elegans, we will investigate an ortholog of a Parkinsonian gene, pdr-1, to explore whether or not there are statistical differences between the hermaphrodites and males through known behavioral assays such as Swimming Induced Paralysis and Basal Slowing Rate. In order to compare gender differences, we successfully conducted CRISPR, where we inserted the him-8 mutation, resulting in an increased population …

Quality Improvement Project Improving Tele-Sitter Usage In The Surgical Trauma Pcu, Stephanie Stone

Doctor of Nursing Practice Projects

This project aimed to improve the knowledge and usage of virtual patient sitters/tele-sitters for surgical trauma progressive care nurses in the surgical trauma progressive care unit through the implementation of nursing education, utilizing evidenced based teaching strategies. Nurse leaders identified a need for staff education among the surgical trauma registered nurse staff population. The goal of the project was to increase knowledge of virtual patient sitters/tele-sitters and how to order them, improve the understanding of the benefits of utilizing the device and to increase the overall usage of the devices on the surgical trauma progressive care unit patients that would …

Relation Of Persistent Organic Pollutant Exposure With Autism, Gender, Age, And Body Mass Index, Tekle Mitiku

Walden Dissertations and Doctoral Studies

Approximately one third (37%) of children in the United States are impaired with autism spectrum disorder (ASD) resulting in intellectual disability, and about 1 in 6 children in the United States has one or more developmental disabilities. The economic burden of ASD is estimated to be over $40 billion lost per year. The purpose of this study was to determine the relationship of polybrominated diphenyl ether derivatives (PBDEs) with ASD, age, gender, and body mass index (BMI). The conceptual framework of the study was based on the physiologically based pharmacokinetic theory that the body burden of PBDEs’ free radicals may …

Food Insecurity And Childhood Obesity: College Students' Past And Present Eating Habits, Morgan A. Schmidt

Honors Thesis

Childhood obesity rates have become an increasing concern in the United States. It has been declared an epidemic due to the increasing number of children who are affected by obesity every year. While many factors can cause obesity, the primary factor is an individual’s dietary choices. This paper presents a literature review on eating habits and the long-term effects of childhood dietary choices on an individual’s body mass index (BMI), specifically among college students. It includes survey results that quantify college students' current eating habits compared to childhood ones. Additional factors influencing eating habits were evaluated, including the National School …

The Psychological Effects Of Domestic Violence And Nurse's Role, Cindy Tran

Honors Capstones

This research highlights the significance of domestic violence and how the detrimental effects on psychological health can lead to negative coping mechanisms and severe injuries that lead to death if unaddressed. Healthcare professionals and healthcare facilities have a significant role in treating and identifying domestic violence victims. This research seeks to answer the question,“Do individuals who experience domestic violence abuse have an increased risk of developing negative psychological health concerns and what is the nurse’s role in the care for these victims?” Through a review of literature accessed through databases such as EBSCO and PubMed, there is evidence that domestic …

Clinical Practice Guideline For Patient Education On Indwelling Catheters In The Home, Lyndsy Bolstad

Walden Dissertations and Doctoral Studies

Home healthcare agencies transition patients from the hospital to the home where caregivers may assist in providing care for indwelling Foley catheters. About half of urinary tract infections are in the presence of an indwelling catheter. The agency for which this Doctor of Nursing Practice project was developed does not have an evidence-based clinical practice patient education guideline (CPPEG) for the care of the indwelling catheter to prevent infection. The practice-focused questions were: (a) What evidence-based literature supports the development of a CPPEG for patient education on the care of the Foley catheter in the home and (b) Will the …

The Self-Sustainability Of Federally Qualified Health Centers, Javier Vallejo

MUSC Theses and Dissertations

This exploratory data analysis examines the self-sustainability of Federally Qualified Health Centers (FQHCs) using the 2023 Uniform Data Systems (UDS) dataset, focusing on health centers' reliance on government grants as a revenue source. FQHCs provide high-quality healthcare services to medically underserved populations; today, nearly 1 out of every 11 Americans receives some form of care at an FQHC. There is widespread variability in the delivery of care amongst FQHCs. Additionally, funding and reimbursement methodologies vary across states and geographic regions. FQHCs face challenges maintaining operational efficiency amid federal funding shortfalls, shifting reimbursement methodologies, and the lingering impact of the COVID-19 …

Organization Change Process Initiative Recurrent Emergency Room Visits By Mental Health And Substance Use Patients, Julie Marie Tucker

Walden Dissertations and Doctoral Studies

The rising rates of patients diagnosed with mental health and substance use disorders (MHSUD) signify a critical national crisis, worsened by the COVID-19 pandemic, as reported by the United States Department of Health and Human Services. This increase has reduced access to essential resources and treatment options, resulting in overcrowded emergency rooms (ER) and extended wait times. Addressing these issues is vital for nursing practice, as they significantly influence patient care and health outcomes, especially for vulnerable populations. This doctoral project explores whether an organizational change designed to raise awareness of updated community resources impacts MHSUD patient visits to the …

Studies To Understand The Stability And Liabilities Of Legumain-Cleavable Antibody-Drug Conjugates, Michele Yi

Undergraduate Honors Theses

Antibody-drug conjugates (ADCs) offer targeted drug delivery of potent cytotoxic payloads, minimizing systemic toxicity. However, the stability of the linker is integral to ensure that there is minimal off-target payload release and little systemic toxicity. This study analyzes the physical and biological stability of our new legumain-cleavable vs traditional cathepsin-cleavable antibody-drug conjugates (ADCs), with a focus on hydrophobicity, thermal stability, aggregation, and biological payload release. Our findings indicate that decreased hydrophobicity of the legumain-cleavable ADCs compared to cathepsin-cleavable ADCs is correlated with decreased aggregation (predicting lower uptake by liver macrophages and therefore slower clearance and less systemic toxicity) and lower …

The Analysis Of Reference Standard Storage Failures Through The Use Of Ibuprofen, Hope Vonder Brink

Honors Projects

Reference standards are commonly used in drug chemistry. They are used to calibrate the instruments and serve as a known point of reference for analysts’ ability to compare unknowns. Drugs can degrade over time or through environmental factors, causing contaminants to be present. In the event of environmental degradation while in storage, such as the exposure to high heat, it would be beneficial to have a database of known breakdown products in common drug reference standards for analysts’ reference. Using ibuprofen as an exemplar drug, this study attempted to identify the thermal breakdown products of ibuprofen and introduce the proposed …

The Conservative Approach To Informed Consent: The Evidentiary Model And An Antidote To The Problem Of Framing Effects In Medical Decision-Making, James D. Polk

Honors Theses

Since the latter part of the 20th century, there has been a gradual but significant shift of the doctor-patient relation from paternalism to a more patient-centric approach. As such, informed consent – the legal and moral requirement that a physician fully disclose relevant details to their patient and gain their consent – is a central doctrine to patient-centric care. Gone are the days of the doctor governing the patient: the patient is now considered a valuable and important decision-maker. Achieving informed consent is the foundation of patient centric medicine. Therefore, it is of the utmost importance that philosophical consideration be …

Electronic-Based Determinants Of Health Screening On An Inpatient Behavioral Health Unit, Anyaku O. Okpara

Dissertations

Problem: Approximately 14.1 million Americans are diagnosed with a Serious Mental Illness (SMI). These individuals experience death 10-20 years earlier compared to the general population, primarily due to chronic medical comorbidities and unmet health-related social needs (HRSNs). Mortality rates, increased healthcare utilization, and frequent readmissions in patients with multiple, unmet HRSNs are likely to remain high unless developments such as the incorporation of standardized, multi-domain, social determinants of health (SDOH) screenings into electronic health records (EHRs). The purpose of this quality improvement (QI) project, guided by the Institute for Healthcare (IHI) model for change utilizing the Plan-Do-Study-Act (PDSA) cycle, was …

Clinical Education Program For Hair Removal To Reduce Surgical Site Infections, Madison Smith, Dana Todd

Student Scholarship & Creative Works

Abstract

Surgical site infections (SSIs) significantly impact surgical patients and with one contributory to their development is hair removal method, education about surgical hair removal methods is minimal in continued educational programs. The purpose of this project was to provide an educational program that discussed hair removal methods to reduce surgical site infections. The staff was educated on methods for hair removal in surgical patients, recommendations from manufacturers of the product, hospital policies regarding hair removal and governing organizational guidelines. Over two days for a 10-hour shift each day, a poster board and a 15-30-minute presentation then a pre/post-test was …

Evaluating The Effectiveness Of Telehealth Interventions In Managing Type 2 Diabetes Among Adults In Underserved Rural Areas, Taylor Lemke

Nursing Capstones

Managing Type 2 diabetes (T2D) in underserved rural areas presents ongoing challenges due to limited healthcare access and provider shortages. Telehealth interventions, such as remote monitoring, mobile health applications, and virtual consultations, have emerged as promising strategies to enhance care delivery. This systematic review evaluated the effectiveness of telehealth in improving glycemic control and patient satisfaction among adults with T2D in rural settings. Recent studies, including randomized controlled trials, cohort studies, and systematic reviews published between 2019 and 2025, were analyzed. Overall, telehealth was associated with reductions in hemoglobin A1c (HbA1c), improved medication adherence, and increased patient engagement. High levels …

Quality Improvement Project Building Confidence In Critical Thinking Through Faculty Implementation Of Simulation, Melissa Morris

Doctor of Nursing Practice Projects

Simulation provides nursing students with experiences that are as effective as clinical experiences in a non-threatening environment. Clinical experiences such as obstetrics, pediatrics, and mental health have been observation only at the project site. With observation-only clinicals, students do not have opportunities to master skills specific to nursing, which bridge theory to practice. The purpose of this Quality Improvement (QI) project focuses on educating nursing faculty who may not be simulation experts to learn the skills to build and implement simulations that align with the International Nursing Association Clinical and Simulation Learning (INACSL) simulation standards. The Primary Investigator (PI) utilized …

Supreme Court Case Study: The Variation In Rates Of Miscarriage Management Care And Post-Abortion Care Across The Us Before And After The Supreme Court Decision, Ted Sibrian Jr.

MUSC Theses and Dissertations

The paper examines abortion care and the management of miscarriages following the Roe v. Wade decision in restrictive states that do not allow medical intervention due to the vague legal terms. This research evaluates the need to establish protocols for providers when faced with nonviable pregnancies requiring medical intervention. Additionally, the paper highlights the impact across the US on women’s health outcomes by emphasizing the care for miscarriage management. This multi-method paper reviews the current literature on miscarriage management and spontaneous abortion MarketScan® data from commercially insured individuals with an age range of 18-50 years old by regions across the …

Proteomic Comparison Of Canine Gallbladder Versus Hepatic Neuroendocrine Neoplasms, Nadia Richmond

LSU Master's Theses

Hepatobiliary neuroendocrine neoplasms (HBNENs) are uncommon tumors in people and dogs, and the limited understanding of their biologic behavior often poses a diagnostic and prognostic challenge in the clinical setting. Though only a low number of cases have been described in dogs, there is evidence to indicate that primary gallbladder NENs may carry a more favorable prognosis compared to primary hepatic NENs. The emergence of liquid chromatography-mass spectrometry (LC-MS) in proteomic analysis has permitted large-scale analysis of neoplastic proteomes, allowing for better understanding of tumor pathophysiology while simultaneously enabling the rapid identification of protein biomarkers. Previous work in our laboratory …

Blood Flow Restriction And The Achilles Tendon, Lacey Jajko, Anja Whitehouse

Masters Projects

Background: Blood flow restriction (BFR) is gaining popularity in strength gains and muscle hypertrophy.

Purpose: The study aimed to assess if BFR can change Achilles tendon size and to compare the size of the tendon based on the thigh or calf placement of the cuff.

Methods: Participants received an ultrasound guided measurement at baseline, mid-intervention, and post-intervention to assess the cross-sectional area of the tendon. Participants completed a six week BFR intervention where the cuff was randomly assigned to either thigh or calf placement on the non-dominant leg. Participants completed multiple repetitions of straight and bent knee calf raises with …