Medicine and Health Sciences Commons^™

Enhancing Multidisciplinary Team Knowledge On The Effectiveness Of Heat Therapy For Lower Back Pain In Adults In An Outpatient Clinic, Glenys Hunter

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice project addressed the underutilization of heat therapy for lower back pain management at an outpatient clinic through an educational intervention aimed at enhancing multidisciplinary team knowledge. My project implemented a comprehensive educational program for 12 healthcare providers. The intervention included structured learning sessions with didactic presentations, case discussions, and hands-on demonstrations. Pre- and post-intervention assessments evaluated provider understanding of heat therapy's physiological mechanisms, clinical applications, safety considerations, and treatment protocols. Analysis revealed significant improvements in provider knowledge, with mean scores increasing from 33.33% pre-intervention to 92.25% post-intervention (p<0.001). Recommendations included integrating regular educational sessions into organizational development programs, developing standardized protocols, and creating patient education materials. The project demonstrated the effectiveness of structured educational interventions in improving provider knowledge while supporting broader implementation of non-pharmacological pain management strategies. These findings have implications for enhancing patient care through increased utilization of evidence-based heat therapy interventions

Birth Planning, Audrey K. Gill, Kacie J. Easley

Student Scholarship & Creative Works

This is an informative presentation completed using evidence based practice regarding the importance of birth planning and the use of birth plans. It is used as a tool to educate nurses and healthcare providers about the benefits of implementing birth plan education into their patients portfolio. The birth plan is a written document that involves the collaborative efforts between nurses/healthcare providers and future mothers. It is used in order to personalize and improve the birthing experience for patients. This presentation uses qualitative research, quantitative research, and theoretical framework in order to deem positive results with the implementation of birth plans.

Educating Staff To Use World Health Organization Hand Hygiene Guidelines To Decrease Health Care-Associated Infection, Edith Kplivi

Walden Dissertations and Doctoral Studies

Summary The Doctor of Nursing Practice project was a practice-focused initiative to address increased hospital-associated infections (HAIs) in an outpatient mental health facility. Improper hand hygiene significantly contributes to the spread of HAIs, negatively affecting patient outcomes, increasing healthcare costs, and decreasing patient satisfaction. The practice-focused question was: For nursing staff in an outpatient clinic, will education focused on the World Health Organization (WHO) guidelines on hand hygiene increase knowledge toward the goal of decreasing HAIs? In collaboration with project site leadership, I identified the following gap in practice: Though fundamental hand hygiene practices may be known to healthcare workers, …

Diagnostic Stewardship And The Mitigation Of Treatment Of Asymptomatic Bacteriuria, Raimonda Kathryn Clarke

Walden Dissertations and Doctoral Studies

Urinalyses and urine cultures are being ordered at the facility of concern without regard to patient history/symptomatology, leading to inappropriate treatment of asymptomatic bacteriuria (ASB) and unnecessary antibiotic prescriptions. The following practice-focused question was developed to address this practice concern: Can an educational program focused on diagnostic stewardship and the mitigation of treatment of asymptomatic bacteriuria improve clinician awareness, knowledge, and confidence in identifying and diagnosing asymptomatic bacteriuria in patients over age 65 in the outpatient setting? Thus, the purpose of this doctor of nursing practice (DNP) project was to close the identified knowledge and attitude gap in a moderate-size …

Quality Improvement Initiative Addressing Job Satisfaction Among Nursing Staff Through Mindfulness-Based Stress Reduction, Jagjeet Kaur

Walden Dissertations and Doctoral Studies

The global shortage of nurses has become a pressing issue affecting both developed and developing nations. This widespread scarcity poses significant challenges for the entire nursing profession. The 2023 National Nursing Workforce Survey revealed that an overwhelming 91% of nurses believe the shortage is worsening. As a result, many countries are becoming increasingly worried about their capacity to recruit and retain nursing professionals. The practice-focused question for this project was: Will a mindfulness-based stress reduction education assist nurses in incorporating mindfulness in their daily routine? The primary aim of this project was to enhance job satisfaction among nurses, with the …

Gatekeeper Perspectives On Suicide Prevention, Anne Woolston

All-Inclusive List of Electronic Theses and Dissertations

Suicide is a profound public health problem across the United States that has lasting effects on individuals, families, and their communities (Centers for Disease Control and Prevention [CDC], n.d.b). Suicide affects all ages and is a serious concern across the life span. However, rates of suicidality are higher among youth. Suicide is the eighth leading cause of death among people 55 to 64 years of age, the fourth leading cause of death for people 35 to 54 years of age, and the second leading cause of death for people 10 to 34 years of age (CDC, n.d.a). Recently, more attention …

Associations Among Shopping Methods, Diet Adherence, And Nutrition Knowledge Of Employed Primary Grocery Shoppers In Households With Children, Baylee Schneider

Master's Theses

Obesity is a prominent risk factor for chronic disease, which is the leading cause of death in the United States. Obesity and chronic disease rates continue to rise, requiring a need for prevention and intervention efforts. The future role of dietetics is to provide treatment and prevention through holistic approaches, by understanding individuals’ habits that contribute to the onset of disease, specifically their food choices, grocery shopping methods, and influences that waver these selections. The purpose of this study is to evaluate the relationship between grocery shopping methods (online or in-store), Mediterranean diet adherence, nutrition knowledge, and food purchase patterns …

Evaluating The Effect Of Consumption Of Fermented Foods On Glycemic Control And Markers Of Cardiometabolic Risk Amongst Pre-Diabetic And Type 2 Diabetes Mellitus Adult Patients: A Systematic Review And Meta-Analysis, Alex Makau Muia

Master of Medicine in Family Medicine

Introduction 

Type 2 diabetes mellitus (T2DM) remains a major global health challenge, particularly in resource limited countries where conventional treatments are often inaccessible or unaffordable. While lifestyle interventions can reduce diabetes risk, their efficacy is moderate, highlighting the need for alternative strategies. Fermented foods (FFs), which are widely available and affordable, have been shown to improve glucose metabolism and may offer a promising adjunct in the prevention and management of T2DM and prediabetes.

Methods 

A systematic review and meta-analysis were conducted to assess the effects of fermented food consumption on glycemic control and cardiometabolic risk markers in adults with prediabetes …

A Preliminary Report Of The Carotenoid Assessment In Adults 50 Years Of Age And Older In Louisiana, Mary-Catherine Feazell

Master's Theses

Fruits and vegetables are at the core of a healthy, balanced diet. They assist in preventing the development of chronic diseases such as hypertension, diabetes, cardiovascular disease, and cancer (Fadnes, et al., 2022). Aging is a natural biological process followed by disease, cognitive impairment, and a natural decline of the body’s ability to perform at its best. The older adult population is currently the fastest-growing population globally (El-Shebiney et al., 2022). Vitamin A is crucial for several parts of the body to function correctly. Despite the positive effects of Vitamin A on the body, the recommended dietary intake is not …

Evaluating Performance Of The Pre-Eclampsia Integrated Estimate Of Risk-Machine Learning (Piers-Ml) Model In A Kenya Cohort Of Women With Pre-Eclampsia, Felix Mogire Nyagaka

Master of Medicine in Obstetrics and Gynecology

Introduction 

Pre-eclampsia is a leading cause of significant maternal morbidity and mortality and complicates approximately 2%-4% of all pregnancies. Delivery is the only known definitive treatment. Pre-eclampsia can have unpredictable progression with sudden deterioration leading to severe adverse outcomes.

Currently, no adverse maternal risk prediction model is validated for use in sub-Saharan Africa. The new Pre-Eclampsia Integrated Estimate of Risk Machine Learning (PIERS-ML) model identifies women with pre-eclampsia who are at the lowest and greatest risk of severe adverse maternal outcomes within 48 hours of initial assessment and informs their care. Whereas, it has been validated for use in high …

Correlation Between Fetal Abdominal Wall Adiposity And Neonatal Outcomes, Elaine Murugi Nyaga

Master of Medicine in Obstetrics and Gynecology

BACKGROUND 

Fetal growth is a result of complex interactions between genetic, nutritional, environmental, uteroplacental, and fetal factors which impact on delivery and subsequent neonatal outcomes. Fetal abdominal adiposity serves as an important indicator of fetal growth and body composition. While gestational diabetes mellitus (GDM) can influence fetal fat deposition, understanding how adiposity correlates with birth weight and neonatal outcomes in both GDM and non-GDM pregnancies provides insight into the broader significance of fetal adiposity as a marker of fetal health.

Methodology 

A cross-sectional study was conducted on 269 pregnant women to examine fetal abdominal adiposity, measured as fetal abdominal subcutaneous …

Evaluating Dry Air Personnel Decontamination Of Methyl Salicylate As A Chemical Agent Surrogate In Extreme Cold Environments To Reduce Airborne Risks Using A Manikin, Lance E. Campbell

Theses and Dissertations

This research investigated a mobile air shower as an alternative to water washing for personnel chemical decontamination in Arctic environments, where traditional methods like disrobing and rinsing are impractical. Interest in Arctic operations has grown with recent U.S. military focus on strategic advancements by Russia and China, yet research on air shower effectiveness for chemical decontamination remains limited. This study examined whether a commercial off-the-shelf air shower could effectively decontaminate methyl salicylate (MES), a surrogate for chemical warfare blister agents, from a manikin outfitted in military cold-weather gear. Researchers used a ppbRAE 3000 photo-ionization detector to measure MES concentrations following …

The Clinical Phenotype Of Motor Neurone Disease In A Kenyan Hospital – Based Population, Effie Nailah Kamadi

Master of Medicine in Internal Medicine

Introduction: Motor Neurone Disease (MND) is a rare, disabling and incurable illness marked by relentless degeneration of motor neurons with loss of voluntary motor function and eventual death. In the West, patient demographics and clinical characteristics are well documented. Available African research is mostly for North, West and South Africa with a knowledge gap existing on the East African illness. This study characterized MND phenotype in a Kenyan population.

Objectives: To describe the clinical phenotype and outcomes of MND in a Kenyan hospital-based population.

Methods: The medical charts of all adult MND patients assessed at AKUHN between …

Detection Rate And Patterns Of Biochemical Recurrence Of Prostate Cancer Using 18f-Psma-1007 Pet/Ct At A Tertiary Teaching Hospital In Sub-Saharan Africa., Lynet Wairimu Barasa

Master of Medicine in Imaging and Diagnostic Radiology

Background: Rising PSA levels following local therapy with curative intent are seen in about one third of men previously treated for prostate cancer, indicative of disease recurrence. This is usually not detectable through imaging modalities like computed tomography (CT) or magnetic resonance imaging (MRI). Several studies show high detection rates of recurrence with 18F-PSMA-1007 PET/CT, one of the novel PET imaging modalities for prostate cancer. No studies, however, have been done to show the patterns of recurrence in the Sub-Saharan African population in whom prostate cancer is known to occur earlier and be more aggressive. Biochemical recurrence almost always …

Comparison Of Positivity Rate Of Dual Phase Sestamibi Versus Dual Tracer Pertechnetate/Sestamibi In Identification Of Parathyroid Adenomas., Naomi Chirindo Chikuro

Master of Medicine in Imaging and Diagnostic Radiology

Background 

Parathyroid adenomas are the commonest cause of primary hyperparathyroidism. The primary mode of treatment is surgical excision which can only be achieved with pre surgical localization of adenomas. Ultrasound, CT and MRI can be used but the most sensitive and specific imaging modality is parathyroid scintigraphy with use of Sestamibi labelled with technetium 99 metastable radionuclide. A few studies have been done comparing dual phase, dual tracer and combined dual phase/tracer protocols with an apparent lack of consensus on which is superior.

Objectives

This study aimed to compare the positivity rates of the mentioned parathyroid scintigraphy protocols and identify …

The Prevalence And The Predictors Of Diabetes Distress In Patients With Type 2 Diabetes Attending Diabetes Clinics At A Tertiary Private Hospital In Nairobi, Kenya., Soulthy Azamkhan Mohamed

Master of Medicine in Family Medicine

Background Diabetes distress encompasses a spectrum of emotional and psychological challenges faced by individuals managing diabetes, including anxiety, stress, depression, frustration, and feelings of helplessness. This distress arises from the constant demands of monitoring blood sugar levels, managing medications, adhering to dietary restrictions, engaging in regular physical activity, and navigating potential complications. Social and emotional factors such as stigma, discrimination, and concerns about future health further contribute to this burden. Factors like fear of hypoglycemia, financial strain, fluctuating blood sugar levels, anxiety about complications, and impacts on personal relationships exacerbate diabetes distress. Left unaddressed, diabetes distress can lead to poor …

Comparison Of The Use Of Therapeutic Plasma Exchange To Intravenous Immunoglobulin For Autoimmune Neurological Conditions At A Tertiary Hospital In Kenya., Swafiya Salim Busaidy

Master of Medicine in Internal Medicine

Background 

Plasma exchange (Barth et al.) and Intravenous Immunoglobulin (Barth et al.) have emerged as favored therapeutic options for autoimmune neurological conditions. Neurological conditions cause high morbidity and mortality in the sub-Saharan region. The utilization of these treatment options in Sub-Saharan Africa remains relatively unknown. We can determine the most efficient treatments with minimal cost implications by comparing the two treatment modalities in our setup.

Methods 

This retrospective descriptive chart review took place at Aga Khan University Hospital. It encompassed all patients admitted between 1st January 2011 and 31st December 2023 who had a neurological condition that necessitated treatment with …

Diagnostic Accuracy Of 18f-Fdg Pet-Ct Compared To Ultrasound In Identification Of Metastatic Axillary Lymph Nodes In Newly Diagnosed Breast Cancer Patients., Sarah Muthii Kibe

Master of Medicine in Imaging and Diagnostic Radiology

Background: Determination of axillary lymph node metastasis is a crucial part of breast cancer staging as it is the most important marker of overall recurrence and survival. Although axillary ultrasound (AUS) is the imaging reference standard, it has a wide range of sensitivity necessitating evaluation of other imaging modalities that may be used as adjuncts.18F-FDG PET-CT is recommended for use in metastatic and recurrent breast cancer with infrequent use in early disease due to its low spatial resolution for small axillary lymph nodes. The aim of this it study is to evaluate the diagnostic accuracy of axillary ultrasound compared …

Retrospective Cohort Study Of Pure Tone Audiometry Hearing Changes Associated With Ototoxic Metals And Solvents, Continuous Noise And Impulse Noise Exposures At Robins Air Force Base From 2001-2019, Ronald Diaz Cataldo Ramos

Theses and Dissertations

Utilizing DOEHRS-IH and DOEHRS-HC, a retrospective epidemiological study was performed on Robins AFB personnel to investigate relative risks of hearing loss associated with exposures to continuous noise, impulse noise, and ototoxic metals and solvents. An analysis of variance identified age, frequency octave, era and exposure type as influencers of hearing threshold shifts. Risk ratios showed higher risk of hearing loss for exposures to continuous noise + impulse noise + ototoxic metals as well as continuous noise + impulse noise at low frequencies (500Hz and 1,000Hz), and lesser risk for exposures to continuous noise + impulse noise and continuous noise + …

Air-Based Chemical Patient Decontamination Methodologies For Arctic Regions Using Methly Salicylate As A Chemical Agent Surrogate On A Litter-Bound Manikin, Marcus D. Shadd

Theses and Dissertations

This study evaluated a mobile air shower for patient decontamination without disrobing or rinsing, an alternative for Arctic conditions where water is scarce. A manikin in extreme cold weather gear was exposed to 10 µL of methyl salicylate (MeS), a sulfur mustard surrogate, and placed in a horizontal chamber on a military litter. Airborne MeS was measured using a ppbRAE 3000 detector to assess inhalation risk for the patient and decontamination team. Three methods were tested: an air-knife system, paper towels, and no decontamination, with 10 trials each (30 total). ANOVA analysis showed significant reductions in airborne MeS with air-knife …

Personal Decontamination Of Copper Oxide Powder As A Radiological Surrogate On Ambulatory Patients In Arctic Environments: Assessing Residual Airborne Risks After Air Shower Or Vacuum Decontamination Of A Manikin, Quinn G. Pelichoff

Theses and Dissertations

This study assessed air-based decontamination methods for treating patients exposed to dry radiological contamination while minimizing reaerosolization during disrobing, particularly in extreme cold environments. A full-size manikin,  simulating an able-bodied Airman, was dressed in military-issue extreme cold weather gear and coated with 28 grams of Copper Oxide. The manikin underwent one of three treatments: HEPA vacuuming, a mobile personal air shower, or no treatment (control). After treatment, researchers removed the uniform and used optical particle counters to measure airborne dust concentrations that could pose risks during disrobing. Each method was tested ten times (30 trials total). Statistical analyses (ANOVA, Tukey’s …

A Study Of Secondary Traumatic Stress In Health Care Professionals In Long-Term Care., Bethany Proudfoot

Doctor of Social Work Capstone Projects

Secondary traumatic stress (STS) is a significant concern for healthcare professionals in long-term care (LTC) settings. This study explores the impact of STS on clinical staff, addressing the research question: How has STS affected employees within the LTC sector, and what resources or support can be provided to mitigate its effects? The study utilized a mixed-methods approach, combining survey data from clinical staff across five LTC facilities in Ohio, incorporating the survey data measuring levels of STS and qualitative responses. Findings revealed that 64% of participants experienced high to severe levels of STS, with symptoms including anxiety, depression, sleep disturbances, …

The Predictors Of Success For Pre-Licensure Bsn Students: An Exploratory Analysis Of Assessment Methods, Nihimu Nkechinyere Evulukwu

Doctor of Nursing Practice Projects

Background

Success in the National Council Licensure Examination (NCLEX-RN) on the first attempt is essential for continued program accreditation, sustainability, and maintaining the national nurse workforce. Admission policies and assessment methods contribute to student enrollment and success. This Doctor of Nursing Practice (DNP) project evaluated the admission requirements of cognate and overall GPAs and assessment requirements of Health Education System Incorporated (HESI) scores in the School of Nursing to determine the best predictors of the first-time NCLEX-RN pass rates. This project aimed to determine whether the use of admission requirements in the School of Nursing Bachelor of Science in Nursing …

Effect Of Exercise On Posture, Neck Proprioception And Balance In Older Adults, Mohammad Khaleghifar

Loma Linda University Electronic Theses, Dissertations & Projects

Background:

Falls are one of the most frequent and serious problems facing older adults. Approximately 30-40% of people over 65 years of age fall each year. The frequency of falls increases with each decade beyond this threshold and approximately 20-30% of older adult fallers require hospitalization, assuming an increased risk of mortality. Postural balance and stability involve cooperation between visual, proprioceptive and vestibular sensory systems to achieve a motor response. Disturbance in any of these systems can result in abnormal postural orientation and lead to instability or dizziness. Among these systems, proprioception provides sensory input from the peripheries to …

"Our Vision Is That Black Mothers And Birthing People, Fathers, And Partners Are Safe, Honored, And Respected Throughout Pregnancy And Parenthood": Black Birth Workers' Agenda For Black Maternal Health In Oregon, Sarah Marguerite Applin

University Honors Theses

Black women and Birthing People (BWBP) face disproportionate rates of mortality within the United States healthcare system. BWBP are three times more likely to suffer a pregnancy-related death than White women. Therefore, addressing and consulting with BWBP about the birthing experience that BWBP sustains when they are bearing children is imperative. The inclusion and application of this key knowledge and understanding should be emphasized and at the root of further development toward reproductive justice. This participatory story was led by Dr. Roberta Hunte. Interviews and focus groups with Black birth workers, birthing people, and public health professionals were conducted in …

Management Of Aggressive And Disruptive Behavior In The Emergency Department Using De-Escalation Techniques And Simulation: A Quality Improvement Project To Improve The Knowledge And Confidence Of Emergency Department Nurses And Clinical Staff, Ernestine Darby-Littlejohn

Electronic Theses and Dissertations

Abstract

Approximately 40% of all healthcare workers have reported episodes of violence by patients over the last 2 years. This Veteran’s Health Agency reported 824 disruptive events reported in the last 5 years, of which 56 occurred in the emergency department. Research shows that interventions are not always timely, resulting in the clinical staff requesting the Veteran’s Health Agency Police to intervene when a veteran’s level of stress is escalating. The gap in practice is shown to be related to a lack of knowledge in the clinical staff in managing high stress levels exhibited by some veterans, limited knowledge of …

Nursing Leaders’ Perceptions Of A Revised Patient Dismissal Policy, Judi L. Brendle

Walden Dissertations and Doctoral Studies

Patient aggression related to behavioral health and emotional issues is an ongoing concern in primary health care. Disruptive patient behaviors include a broad spectrum of outward conduct, from verbal violence to physical assault. The focus of the Doctor of Nursing Practice project was a quality improvement project. The purpose encompassed improving the perception of primary care nursing leaders and provider practice leadership by enhancing the current organizational policy on patient dismissal from practices. Analytical strategies included pre- and post-surveys to determine the perception of the nursing supervisors and provider practice leadership. Survey questions encompassed an understanding of the original policy, …

Our Song: Virtual Group Songwriting With Medical Professionals, Seneca Block

Expressive Therapies Dissertations

This study investigated healthcare workers experiences in hospital provided virtual songwriting groups. Groups were led by a board-certified music therapist and prompted by one of three chosen themes from the hospital’s motto: to heal, to teach, to discover. Specifically, this work aimed to understand the role of songwriting as an arts-based intervention and its impact on aspects of workplace community with healthcare workers.

Post group interviews were conducted and analyzed, which resulted in the emergence of seven major themes including: Sense of Purpose, Point of Connection and Community, Positive Engagement and Collaboration, Enhancing Mood State and Evoking Emotions, Impact of …

Staff Education Project Staff Education To Encourage The Accurate Use The Dynamic Appraisal Of Situational Aggression In A U.S. State Psychiatric Facility, Tracy Ann Reid-Saunders

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project involved the development and implementation of a staff education program to enhance the use of the Dynamic Appraisal of Situational Aggression (DASA) tool. The aim of the project was to address the inconsistent and inaccurate applications of the DASA tool by health staff, leading to missed opportunities for early intervention to address patient aggression and increased risk of violence to both staff and patients. The importance of addressing this issue within the context of nursing practice rests on the DASA tool’s importance as a means for nurses to assess patients with aggressive behavior, …

More Than Numbers: Black Adolescents’ Journey With Type 1 Diabetes Management, Vanessa Di Felice

Walden Dissertations and Doctoral Studies

Black adolescents with Type 1 diabetes mellitus (T1DM) face significant health disparities, yet their unique treatment journeys remain largely underreported. This phenomenological qualitative study explored the lived experiences of Black adolescents with T1DM. The study addressed two research questions examining how these individuals experience and navigate T1DM self-management, self-efficacy beliefs, and perceived barriers and facilitators to optimal self-care. Virtual semi-structured interviews were conducted with 15 Black adolescents with T1DM recruited from a pediatric hospital in Washington, DC. The study utilized Bandura's social cognitive theory as the theoretical framework. Thematic data analysis identified four key themes: (1) character development through knowledge …