Medicine and Health Sciences Commons^™

Interactive Educational Program For Purposeful Leader Rounding, Gina Lupi

Walden Dissertations and Doctoral Studies

This education project was to introduce nurse managers to the evidence-based practice of daily purposeful leader rounding on all staff in this acute care facility. The need for practice change was evidenced by low all employee survey and the Survey of Healthcare Experience of Patients (SHEP) results; low retention rates throughout the inpatients units; and an increase of patient safety events in fiscal year 2023. Leadership rounding is an evidence-based practice that increases staff retention by supporting and engaging staff. The purpose of the interactive education was to increase the knowledge and self-confidence of the participants to assist in hardwiring …

The Role Of Sox9 In Epicardial-Mediated Cardiovascular Development And Valve Homeostasis, Andrew Brantley Harvey

MUSC Theses and Dissertations

Congenital heart defects (CHDs) are the most common birth defects in humans, affecting as many as 1% of live births, thereby representing a major public health burden. These defects arise when signaling pathways and mechanical forces guiding heart development are disrupted, either by genetic mutations, aneuploidies, environmental influences, or any combination of these factors. The vast majority of CHDs have undetermined etiologies. Understanding the molecular and cellular mechanisms of normal heart development is critical for unraveling the origins of CHDs and for developing more effective diagnostics and interventional treatments for those affected by cardiovascular diseases of developmental origin.

The epicardium …

Their Stories, Our Testimony: A Narrative Inquiry Into The Remote Teaching Experiences Of Community College Clinical Nurse Educators During The Covid-19 Pandemic, Catherine E. Fenner

Doctor of Education Program Dissertations

This narrative inquiry explored the lived experiences of clinical nurse educators who taught at community colleges during the COVID-19 global pandemic, contributing to the growing body of literature about what nurses endured during the pandemic. The pandemic and the ensuing havoc it caused occurred when the profession faced significant staffing shortages. In the early months of 2020, when the virus was spreading rapidly, many states issued stay-at-home orders requiring nursing programs to pivot to remote learning platforms. Teaching hands-on skills, communication techniques, and time management strategies through virtual and remote pedagogy was a time of confusion for nurse educators, who …

Clinical Practice Guideline For Evidence-Based Patient Appointment Reminders, Rohan Matthews

Walden Dissertations and Doctoral Studies

Clinical practice guidelines (CPGs) are health care interventions used for best care outcomes. With this CPG project, I addressed a practice gap regarding the lack of a systematic approach to patient appointment reminders that resulted in disruption to patient health maintenance in an outpatient community clinic setting. Community and population health are improved with preventative care, wellness, and appropriate health maintenance measures. The practice-focused question central to this CPG was: Will a guideline on patient reminders designed to reduce the frequency of missed appointments in a clinic setting, be approved by a panel of clinical experts for future implementation? The …

Phosphoglycerate Dehydrogenase Regulated By The Mitogen-Activated Protein Kinase Pathway Is An Actionable Vulnerability In Cutaneous Melanoma, Neel Jasani

USF Tampa Graduate Theses and Dissertations

Metabolic alterations play a critical role in shaping tumor growth and development. Many metabolic enzymes are shown to play an important role in different aspects of tumor development, growth, and metastasis. One such enzyme that we are investigating in this project is the Phosphoglycerate Dehydrogenase (PHGDH). The PHGDH gene, encoding the rate-limiting enzyme of the serine synthesis pathway, is located at chromosome locus 1p12 and frequently amplified in melanoma. PHGDH is required for the proliferation of melanoma cells with chromosome 1p12 amplification. However, the role of PHGDH in chromosome 1p12 non-amplified melanoma is poorly understood. In this project, we sought …

Decreasing The No-Show Rate In A Mental Health Clinic., Aina Oyibo

Walden Dissertations and Doctoral Studies

The identified practice problem of high no-show rates within a mental health clinic setting creates immense challenges to patient care continuity and clinic efficiency. This issue, in the context of nursing practice, needs resolution for improved patient outcomes and the best possible utilization of clinic resources. The practice-focused question to guide this doctoral project is: Will staff education on the importance of consistent appointment reminders improve knowledge? This project's intervention in staff education concerning the importance of consistent appointment reminders focuses on telephone reminders. A literature search used CINAHL, MEDLINE, PubMed, Google Scholar, and textbooks. All the articles were peer-reviewed …

Preeclampsia As A Risk Factor For Developing Heart Failure, Blessing Akomas, Confidence Nwalor, Tara Li

Master's Projects

Title: Preeclampsia as a Risk Factor for Developing Heart Failure

Introduction: Preeclampsia affects a significant number of pregnancies worldwide. Preeclampsia has been linked with increased cardiovascular risks for women later in life, thus threatening their life. This literature review examines the existing scientific evidence on the relationship between preeclampsia and the long-term risk of heart failure in postpartum women over a 10-year period.

Methods: A literature search was conducted using CINAHL, PubMed, and Google Scholar. The Melnyk Level of Evidence tool was used to evaluate 10 studies. Identified studies were published between 2019 and 2023. Thematic analysis was used to …

Staff Education On Service Recovery For New Nurse Leaders, Cara Conley

Walden Dissertations and Doctoral Studies

The goal of this staff education project is to improve nurse leaders’ ability to execute service recovery strategies in a hospital setting. The identified practice problem was the lack of structured education for nurse leaders on service recovery, which impacts their effectiveness in managing patient dissatisfaction, potentially leading to compromised patient safety and organizational performance. The practice-focused question was: In nurse leaders, does the implementation of a service recovery education course significantly improve their knowledge on how to perform service recovery? The purpose of the project was to create and implement a structured education course for nurse leaders with 0–5 …

Early Mobility And Delirium Prevention For Intensive Care Unit Patients At Kingman Regional Medical Center, Lyndsey R. Lehman Ms, Otr/L

Masters Projects

Over five million patients are admitted to the intensive care unit (ICU) annually in the United States, with 50-70% of those developing debilitating physical, cognitive, and mental health issues. Occupational therapy (OT) is a holistic profession that provides evidence-based interventions to improve ICU patients’ function and participation in daily occupations by addressing early mobility and delirium. A needs assessment performed for the Kingman Regional Medical Center (KRMC) ICU revealed a lack of knowledge about early mobility and delirium prevention among nursing staff, underutilization and limited understanding of OT services, and KRMC-specific barriers impacting patient care. This author designed and implemented …

Detecting Changes In Cancer-Related Cognitive Functioning Using Mixed-Effects Modeling And Study Design Simulations, Jonathan D. Clapp

USF Tampa Graduate Theses and Dissertations

The purpose of this dissertation is to utilize and compare two existing approaches for modeling nonlinear change in cognitive functioning in cancer patients over time and to assess alternative study designs to better capture chemotherapy-related cognitive impairment using simulation data. Using data from the Thinking and Living with Cancer study, trend analysis with orthogonal polynomials (OP) and piecewise (PW) regressions approaches used to analyze cognitive functioning trajectories. Simulated datasets tested the impact of study design parameters including measurement test-retest reliability (.6 or .8), sample size (100, 200, or 300), and the number of data collection time points (4 or 5) …

Streamlining The Discharge Process On The Telemetry Units To Improve Overall Hospital Throughput, Michelle Corder

Walden Dissertations and Doctoral Studies

This evidence-based staff education project was implemented to address the problem of ineffective discharge processes and delayed discharges within the hospital setting that leads to poor patient flow impacting overall hospital throughput. There was an overall lack of knowledge by registered nurses (RNs) on effectively implementing changes that affect a standardized discharge process that could help improve patient flow and hospital throughput. This staff educational project aimed to improve the staff nurses’ knowledge of the standardized discharge process and its impact on hospital throughput. The practice-focused question that guided this project was as follows: “What is the impact of a …

Evaluating The Impact Of Semiglutide On Weight Loss In Overweight Adults, Justina 0. Umweni-Oyiboke

Walden Dissertations and Doctoral Studies

Obesity is a pressing health issue. By 2030, it is estimated that nearly half of all adults in the United States will be obese. This trend has serious consequences for both physical and mental health. Obese individuals face an increased risk of conditions like cardiovascular disease, type 2 diabetes, fatty liver disease, osteoarthritis, and even depression. In this Doctor of Nursing Practice Project, I evaluated the effectiveness of a quality improvement (QI) initiative at the project site that addressed the practice problem of inadequate weight loss management caused by relying solely on diet and exercise as treatment strategies. The QI …

Baseline Factors And Their Association With Refractive Error And Control In A Pediatric Randomized Clinical Trial Of Overminus Therapy For Intermittent Exotropia, Julianne L. Robinson

USF Tampa Graduate Theses and Dissertations

Intermittent exotropia (IXT) is a condition resulting in an eye deviation away from normal alignment, potentially treatable with overminus lenses. These induce accommodation of the eye, combatting the eye drifting outward. Overminus lenses may help treat IXT but also potentially worsen refractive error. Analyses aimed to find associations of baseline factors as they relate to IXT control outcomes, as well as the risk of worsening spherical equivalent refractive error (SER). One hundred ninety-six participants aged 3 to <11 treated with overminus lenses for 12 months were analyzed to explore associations between age, sex, race, ethnicity, strabismus severity, accommodative convergence/accommodation ratio (AC/A), and baseline SER with outcomes of change in SER and change in control. Analyses included outcomes for both SER and control as continuous and binary outcomes, and a secondary combined outcome. More myopic baseline refractive error and older age were associated with a worsening in SER after 12 months, -0.08 diopters (D) worsening SER per 1 year age increase (95% CI -0.13 to -0.03), and -0.30 D worsening SER per additional 1 D of myopic refractive error (95% CI -0.39 to -0.21). A larger AC/A ratio was associated with better distance control (0.11 points improvement per D of AC/A, 95% CI 0.03 to 0.19). The combined SER and control outcome showed the same factors (age, baseline refractive error, and AC/A ratio) were significantly associated with improving outcomes. Overminus lens therapy may be beneficial for some patients, but further study is needed to explore the results of these exploratory analyses.

Dental Therapy In Washington State: Exploring Dental Hygienists’ Perceptions And Attitudes Towards An Emerging Workforce Model, Soy Mouy Gearheart

Dental Hygiene ETDs

Purpose: This study examines dental hygienists' perceptions of dental therapy in Washington State. Methods: A cross-sectional survey utilizing a Likert-scale questionnaire was conducted among dental hygienists recruited from Washington State Dental Jobs Facebook groups. Descriptive statistics and cross-tabulation analysis examined key variables. Results:Of the 46 participants (n=46), 72% reported that they believed dental therapy could improve access to care in underserved areas. Concerns about current educational standards for safe practice were noted. 11% expressed interest in pursuing a dental therapy degree within the next five years, motivated by interest and career opportunities. Notably, 67% of all male respondents indicated …

Educating Project Site Hospital Nurses On The Code Lavender, Jennifer Swendsen

Walden Dissertations and Doctoral Studies

With this staff education project, I aimed to educate nurses at the project site hospital about the Code Lavender program, a mental health intervention designed to address nurse burnout. Nurse burnout has risen significantly post-COVID-19 pandemic, contributing to high turnover rates and compromising patient care. Nurses are experiencing increased levels of stress, depression, and suicidal ideation, which has led to feelings of being overwhelmed, overworked, and quitting the profession, exacerbating staffing shortages and patient care hazards. The central question of this project was whether staff education on the Code Lavender program would increase nurses’ knowledge, as evidenced by improved posttest …

Best Practice Toolkit For Nursing Staff Caring For Ventilated Patients, Erin Belisle

Student Scholarly Projects

Practice Problem: Best practice tool kits are used to guide better outcomes for ventilated patients and staff members. Many reasons can contribute to requiring a patient to be on mechanical ventilation, but the most common reasons are a trauma event and infection.

PICOT: The PICOT question that guided this project was: In critical care staff such as nurses, respiratory therapists (RT), and critical care providers caring for mechanically ventilated patients (P), what is the effect of implementing a best practice coordination toolkit (I) compared to standard care procedures (C) on the adherence to best practices by critical care providers (O)? …

Staff Education To Improve Medical Adherence Among African American Males With Hypertension, Veronica Ebere Ani

Walden Dissertations and Doctoral Studies

Hypertension (HTN) is the chief cause of cardiovascular disease in the United States. Due to the mortality and morbidity and the increased healthcare costs associated with HTN, nursing staff need to have knowledge to control and help patients manage the condition. HTN disproportionately affects African American men due to non-adherence to medication, lifestyle issues, and health disparities. Nurses can only support patients managing HTN if they have current evidence-based knowledge. Staff knowledge deficit was a significant issue affecting the clinic's management and control of HTN. Providers' knowledge gap was considered a leading factor in patient nonadherence to prescribed antihypertensive medications. …

Hypothermia In Patients With Traumatic Injuries: An Integrative Review, Andrew P. Gribble, David J. Saucedo

Master's Projects

Abstract

Background: An estimated 30-50% of severely injured patients with traumatic injuries will experience hypothermia. As a result of hypothermia, several clinical manifestations such as impaired coagulation, dissociation of the oxygen curve, cardiac arrhythmias, reduced cardiac output and death. Little evidence has been published promoting specific patient re-warming protocols and the best rewarming methods, active versus passive. Few studies have focused on the pre-hospitalization treatment for hypothermia and the overall effectiveness of interventions to mitigate hypothermia to reduce morbidity and mortality. Given this knowledge, the aim of this integrative review (IR) is to research and evaluate current practices regarding hypothermia …

Staff Education To Increase Staff Awareness On How Personal Trauma Affects Responses During Restraints, Marygoretti Kibe

Walden Dissertations and Doctoral Studies

The emotional and or physical trauma that individuals sustained while growing up may continue to adversely affect their health as adults, leading to mental health issues, depression, substance use, anxiety and secondary trauma. The prevalence of this trauma widely unacknowledged among mental healthcare staff. Trauma prevention is crucial and can be achieved through educational interventions. In clinical settings, this can prevent staff high turnover, leaving the profession, disengagement, hypervigilance, and overinvolvement. In a mental health clinical setting, this trauma can lead to overuse or misuse of restraints as the trauma staff bring to these situations drives their reactions.

Executive Summary: Staff Education Improving Cultural Competence In Mental Health Providers, Mary Osagie

Walden Dissertations and Doctoral Studies

In the current healthcare environment, providers care for an increasingly diverse patient population and are challenged with the need for cultural competency skills. Evidence indicates that there are gaps related to cultural competency among healthcare providers across all specialties and settings. This paper describes a staff education project that addressed limited cultural competence skills among nurses and staff at an ambulatory mental health clinic on the East Coast. The purpose of the project was to develop, implement, and evaluate a staff education program on cultural competency. The goal was for participants to become more culturally aware and gain knowledge in …

Develop An Education Program Related To Evidence-Based Strategies Nurses Can Use To Decrease Medication Errors In A Nursing Home, Ann N. Akwaraonwu

Walden Dissertations and Doctoral Studies

These medication errors have posed an immense threat to patient safety, regulatory compliance, and staff confidence in healthcare. Therefore, the improved understanding of nursing staff and reduction in medication error rates required targeted education of nursing staff, thus the basis upon which this quality improvement project was implemented at a nursing home facility located in the Northeastern United States. This evidence-based intervention was developed from feedback that indicated a gap in knowledge on best practices related to the administration of medication among nursing staff. These were eight in number: registered nurses, licensed practical nurses, and certified nursing assistants, who had …

The Impact Of Hearing Aid User Speech On Environment Classification And Own Voice Listener Preferences, Robert Andrew Budinsky Iii

USF Tampa Graduate Theses and Dissertations

Hearing aids (HA) have improved over the past few decades with advanced signal processing, such as environment classification and background noise reduction, but are still limited by challenges related to when the user is speaking. These challenges include the potential interference a HA user’s voice has on device environment classification and the potential influence a HA has on own voice (OV) sound quality. However, the effects of OV on HA environment classification and signal processing are not well established, nor are the desired HA program settings regarding OV listening preferences. In this study, a combination of electroacoustic and behavioral methods …

Communication Resilience In Suicide Prevention (Crisp): An Institutional Ethnography Of Community-Based Suicide Prevention In Florida, Kelli R. Agrawal

USF Tampa Graduate Theses and Dissertations

The concept of Communication Resilience in Suicide Prevention (CRISP) offers a conceptual framework for exploring communication strategies in community-based suicide prevention. A constructivist paradigm informs this study and utilizes an approach heavily influenced by Dorothy Smith’s critical feminist sociological work of institutional ethnography (IE). The study intentionally interweaves critical research praxis with a dual etic/emic positionality through constructivist understandings of dialectical sensemaking. It uses the Communication Theory of Resilience (CTR) and Institutional Logics Theory (ILT) as analytic tools of inquiry. The study includes purposive sampling and multiple qualitative methods, including unstructured interviews, text analyses, and observational data. Fifteen unstructured interviews …

Executive Summary: Quality Improvement Initiative Personalized Interdisciplinary Fall Prevention Plan And Fall Rates At An Inpatient Rehabilitation Hospital, Kayla Jackson

Walden Dissertations and Doctoral Studies

Despite ongoing fall prevention strategies, falls continue to be a concern across healthcare organizations. There has been an identified increase in the fall rate at an inpatient rehabilitation facility (IRF) in the southeastern United States. An interprofessional and collaborative approach to fall prevention has been found to lead to a decrease in falls with injury and an increase in the culture of safety. This doctor of nursing practice (DNP) project involved an evaluation of a quality improvement (QI) initiative of a personalized interdisciplinary fall prevention plan at a rehabilitation hospital located in the southeastern region of the United States. The …

Identification And Treatment Of Ipv/Nonfatal Strangulation By First Responders, Mary L. Turner

Walden Dissertations and Doctoral Studies

Ineffective and inconsistent education focusing on domestic violence (DV)/intimate partner violence (IPV)/nonfatal strangulation identification and treatments results in first responders’ failure to move patients to a higher level of care, resulting in possible delayed complications. The purpose of the Doctor of Nursing practice (DNP) project was to determine if an educational program increased first responders’ knowledge and improved treatment of DV/IPV/nonfatal strangulation patients. Roger’s diffusion of innovation theory provided the framework throughout the educational process. The Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) tool was utilized to score the participants’ knowledge prior to and after the education. The …

Executive Summary: Quality Improvement Initiative Implementing Fixed Water Dispensers In An Inpatient Psychiatric Hospital, Elycia Victoria Hernandez

Walden Dissertations and Doctoral Studies

The current hydration system using water pitchers was outdated and inefficient, leading to potential risks of contamination, inconsistent hydration, and increased staff workload in this inpatient psychiatric facility. Psychiatric patients may struggle to access adequate hydration due to cognitive or behavioral limitations. Addressing this gap is essential for improving patient care, enhancing operational efficiency, and ensuring consistent access to clean water. This DNP scholarly project was an evaluation of an interprofessional team-based quality initiative to replace traditional water pitchers with fixed water dispensers in an acute inpatient psychiatric facility. The primary practice-focused question was: Will an interprofessional team reach consensus …

Staff Education To Enhance Nurses’ Knowledge In Managing Alcohol Withdrawal, Nodeen Nicoal Glen

Walden Dissertations and Doctoral Studies

Summary Summary This DNP clinical practice staff education was developed to address the lack of nursing knowledge, and skills needed to assess and manage alcohol withdrawal effectively in an observation unit. Ineffective assessment and management of patients’ withdrawal symptoms may result in deterioration of their condition and require further aggressive treatment. The project aimed to educate nurses on evidence-based strategies for assessing and managing alcohol withdrawal using an evidence-based assessment tool. Sixteen nurses participated in the program to increase their understanding of alcohol withdrawal and the use of the Richmond Agitation-Sedation Scale (RASS). They completed a pretest before participating in …

Socioecological Factors Influencing The Anticipated Medical Help-Seeking Time For Breast Cancer Among Women In Togo, A Sub-Saharan Country, Komi Blewussi Aheto

Walden Dissertations and Doctoral Studies

Breast cancer remains a leading cause of death in sub-Saharan Africa (SSA). The burden of the disease in the region is partly attributed to delayed health-seeking, resulting in advanced disease presentation, delayed diagnosis, poor outcomes, and low survival. This quantitative cross-sectional study was conducted to investigate the socioecological factors that influence the anticipated medical health-seeking time for women in SSA experiencing breast cancer symptoms. The socioecological model (SEM) theoretical framework guided this study. A questionnaire was used to collect data from randomly selected (N = 343) women aged 18 years and older with no personal or familial history of breast …

Educating Mental Healthcare Staff On Using The Phq-9 In Telehealth, Anoopa M. Jacob

Walden Dissertations and Doctoral Studies

I developed a quality improvement staff educational program aimed at addressing the inconsistent use of the Patient Health Questionnaire (PHQ-9) at the project facility, which could adversely affect the quality and continuity of patient care. The need for the program was prompted by the increasing use of telehealth services and the necessity for consistent mental health evaluation tools. I aimed to educate mental health staff about evidence-based practices using the PHQ-9 in telehealth to enhance the quality of care for patients with depression in remote settings. Analytical methods included administering pre- and postintervention tests to measure changes in staff knowledge …

Evaluation Of A Primary Care Community Health Center’S Mammogram Program In Relation To Current Evidence-Based Practice., Brianna Childress

Doctoral Dissertations & Projects

Breast cancer is the second leading cause of cancer deaths among women over 50 years of age. Although mammograms have been proven to be effective in early detection of breast cancer, compliance rates are declining in the United States making it an objective for Healthy People 2030 to achieve and maintain a national compliance rate of 80.3%. For early detection of breast cancer among women between 50 to 74 years old to occur, an effective breast cancer screening program is vital. To understand why mammogram compliance rates were below the national average at a primary care community health center in …