Medicine and Health Sciences Commons^™

Factors Affecting The Quality Of Reporting Dispensing Errors Among Pharmacists, Kelley Latrece Lavallais

Walden Dissertations and Doctoral Studies

Medication dispensing errors, which are the inconsistency between the dispensing of medication to the patient against the prescribed medication, continue to be a public health challenge. Many studies have been conducted to examine their causes, including burnout, illegible handwriting, workload, and interruptions. There have also been studies on the types of medication dispensing errors. This study focused on the reporting of errors. The purpose of this quantitative study involving secondary data analysis was to examine the factors affecting the quality of reporting dispensing errors among pharmacists and the seriousness of the adverse events. The social-ecological model served as the theoretical …

Characterizing The Influence Of Metabolism On Steady State Water Exchange In Yeast As A Potential Mri Diagnostic Biomarker, Samantha Mumford

Dissertations and Theses

Under conditions of ionic equilibrium with the environment a cell maintains a constant volume yet rapidly exchanges water molecules with the extracellular space. The rate constant for steady state water efflux, k_io, can be measured using contrast enhanced magnetic resonance (CE-MR). The active water cycling (AWC) hypothesis is puts forward that k_io is primarily influenced by cellular ATP levels and H⁺ ATPase activity at the cell membrane. Due to the correlation between k_io and ATP levels, k_io is thought to be a probable MRI biomarker for metabolic diseases such as cancer. Yet, the molecular …

An Integrated Review: Faith Community Nurse Transitional Care Model Health Ministry, Youn Kyeong Cummings

DNP Qualifying Manuscripts

The hospital readmission rate is highest among underserved communities, and providing a continuum of care to these populations can yield a greater reduction in the readmission rate. Church and faith-based clinics often help underserved communities, and equipping them with the transitional care model (TCM) and an Advanced Practice Registered Nurse (APRN) with specialized training as a Faith Community Nurse (FCN) can implement whole-person care, improve the health of the community, and reduce hospital readmission.

California has a 14.5% readmission rate. There is uncertainty surrounding the presence of transitional care departments in California's community hospitals, with some of these facilities offering …

Transition Aged Youth Substance Use At Electric Dance Music Events In The Tampa Bay Area: A Qualitative Study Of Awareness And Prevention, Danielle Vinciguerra

USF Tampa Graduate Theses and Dissertations

The study investigates substance use among Transitional Aged Youth (TAY), particularly focusing on Electronic Dance Music (EDM) events in the Tampa Bay area. TAY, defined as individuals aged 18-29, experience significant psychological, biological, and developmental changes, which can lead to increased vulnerability to substance use. The study examines the prevalence and patterns of substance use, specifically ketamine and cocaine, among TAY at EDM events. Exploratory qualitative data collection method was utilized for the study. Applying Social Learning Theory as a framework, the research explores the beliefs, attitudes, experiences, and community influences that contribute to substance use within this demographic. Data …

Association Between Particulate Matter And Copd Among Adults In Alaska, Adeyemi Samuel Alimi

Walden Dissertations and Doctoral Studies

Exposure to high levels of fine particulate matter (PM2.5) is emerging as a crucial risk factor for chronic obstructive pulmonary disease (COPD), a deadly lung disease with a significant public health burden. The Fairbanks North Star Borough (FNSB) in Alaska has one of the worst PM2.5 issues in the United States. The PM2.5 issues in the area are associated with increased wood-burning and temperature inversions in the winter and wildfires in the summer. Given these prevailing PM2.5 issues, this quantitative study was conducted using Alaska BRFSS datasets and a chi-square test to compare the COPD prevalence in the FNSB with …

Reactions To The Mpox Vaccine Regarding Absences And Disruption Of Daily Activities In The United States, Robert Rossi

Walden Dissertations and Doctoral Studies

Since its global outbreak in 2022, the monkeypox (Mpox) virus has infected over 32,000 individuals in the United States, resulting in approximately 58 deaths. Although the JYNNEOS vaccine is effective at disease prevention, it has also been found to cause side effects, such as a disruption in daily activities and/or attendance at work or school. This quantitative, cross-sectional study was conducted to investigate whether differences existed in reactions to the Mpox vaccine, using secondary data from the Centers for Disease Control and Prevention’s V-safe Mpox survey. The two dependent variables were work/school absenteeism and disruption of daily activities, and the …

Evaluation Of An Educational Intervention Focused On Intake And Output Documentation, Ingrid Lea Bloomfield

Walden Dissertations and Doctoral Studies

Heart failure (HF) is the primary reason for hospital admissions in the United States, accounting for almost 6.5 million hospital days per year and for 8.5% of cardiovascular deaths. As part of care delivery and supported by the evidence, providers use intake and output (I&O) to guide a HF patient’s overall treatment plan. Following several reviews in the local organization, it was determined that I&O documentation sheets were incomplete or not completed at all. Thus, organizational leadership determined that an educational intervention focused on I&O monitoring and documentation as part of the HF patient treatment plan would address this gap-in-practice. …

Examining The Relationship Between Ethnocentrism, Perspective-Taking And Cultural Competence In Medical-Surgical Nurses, Lori Ann Palmieri

Seton Hall University Dissertations and Theses (ETDs)

This descriptive correlational study explored the relationships between cultural competence, ethnocentrism, and perspective-taking in practicing medical-surgical nurses living in the United States (US). Participants (N=111) were recruited from the New Jersey Board of Nursing (NJBON) and from the Academy of Medical-Surgical Nurses (AMSN). The survey consisted of three validated instruments a) the cultural competence assessment instrument (CCA-I); b) the generalized ethnocentrism scale (GENE); c) the perspective-taking (PT) subscale of the interpersonal reactivity index (IRI), and d) demographic profile questions. Data were collected via Qualtrics and analyzed with IBM SPSS Statistics (Version 28/29). Ethnocentrism and perspective-taking explained 30.2% of the variance …

Improving Certified Registered Nurse Anesthetists' Preparedness And Intention To Serve On Boards., Jana Bailey

Doctor of Nursing Practice Papers

Abstract

Background: The project was driven by expressed interest in serving on boards by 171 Certified Registered Nurse Anesthetists (CRNAs), expressed lack of preparation, and nurses on boards (NOB) literature recommendations to improve preparation through professional development.

Purpose: To implement a NOB preparation microlearning program for CRNAs who desire to serve on boards but feel unprepared to do so, improve CRNA participants' preparedness and intention to serve on boards, evaluate application of NOB learning, and offer continuing education credit.

Methods: A pre-test/post-test design was used to evaluate preparedness (Sundean Healthcare Index for Preparation in Board Competency [SHIP-BC^©]; Sundean, …

Ophidiomyces Ophidiicola And Texas Snakes: A Field To Bench Study Of Ophidiomycosis, Kenlynn L. Volz

Biology Theses

Ophidiomyces ophidiicola (Oo), the primary cause of Ophidiomycosis, is a fungal pathogen recently detected in Texas snakes. Prior to this study, there were major knowledge gaps regarding Oo growth, spread, and suitable environmental conditions. This study filled those gaps using a field to bench approach involving sampling snakes across Texas, in vitro fungal growth, and ecological niche modeling. 103 snakes were sampled across Texas in 2023 and 2024 and six cases of Oo infection were detected. Results of the growth experiment suggest that Oo prefers more stable temperatures and high humidity to a point and that there is a …

A Phenomenological Study On The Followership And Follower Dissent Experience Of Black/African American Female Healthcare Leaders, Shella M. Miller

PhD in Organizational Leadership

Although followership has traditionally been viewed as self-explanatory and innate, it is critical to leadership success and deserves equal scrutiny. Despite its recognized importance to leadership, followership theory remains underdeveloped and understudied, particularly in relation to intersectional factors, such as race and gender and the followership experience of individuals. This gap is particularly salient in today's diverse healthcare settings, where diverse representation and effective leadership and followership are critical for addressing pressing healthcare challenges, including health disparities. Black/African American women are disproportionately represented in entry-level roles compared to leadership positions within healthcare and often face unique challenges related to their …

The Role Of Leader-Member Exchange In Building High Performers, Akeem J. Robinson

PhD in Organizational Leadership

This qualitative case study examined the critical factors that affect job satisfaction, commitment, and overall performance among high performers recognized as Employee-of-the-Month (EOM) winners within multiple healthcare systems, as well as insights from professionals in human resources, education, and higher education sectors, to provide a broader understanding of leadership dynamics and performance across different industries. By exploring how these award-winning employees perceive and navigate their relationships within the organizational hierarchy and among their peers, the results provide valuable insights into the relational qualities that influence their interactions with both leaders and team members. The study leveraged the leader-member exchange (LMX) …

Executive Summary: Clinical Practice Guideline, Bona Eze

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project addressed a gap in practice in an outpatient clinic in the Northeastern United States. The gap in practice was a lack of standardized patient education on self-care management strategies for adult patients with diabetes, leading to increased rates of noncompliance, readmission, and poor health outcomes. The guiding question asked whether an expert panel could evaluate and validate a clinical practice (CPG) developed from current, evidence-based literature and recommendations from the American Association of Clinical Endocrinologists and the American Diabetes Association on self-care management strategies for the adult patient with diabetes. The project followed …

The Role Of Nutrition In Modulating Neurodevelopmental And Mental Health Outcomes In Pediatric Populations: A Review, Athul M. Vikas

Senior Theses

Introduction: Neurodevelopmental and mental health disorders, including Attention-Deficit/Hyperactivity Disorder (ADHD), anxiety, and depression, have risen sharply in prevalence among children and adolescents, creating substantial public health concerns. Traditional interventions, primarily pharmacological and behavioral, offer critical but limited support, underscoring the need for integrated approaches. Recent findings suggest that nutrition may play a significant role in supporting brain development and mitigating mental health risks, offering preventive benefits that complement conventional therapies. This review aims to evaluate the influence of specific nutrients—such as folate, iron, DHA, zinc, and vitamin B12—on neurodevelopmental outcomes, emphasizing the importance of these nutrients during critical growth …

Efficacy Of, And Barriers To, Treatment Options For Pans/Pandas, Kayla E. Pray

Senior Theses

Background: PANS/PANDAS are pediatric autoimmune disorders that cause an acute-onset of OCD-like symptoms and/or severe restricted eating, as well as anxiety, irritation, deterioration of fine motor skills, hyperactivity, and other psychiatric symptoms. An estimated 1-2% of the pediatric population is affected. Currently, there is little research published on the treatment options for PANS/PANDAS and there is no evidence-based consensus on the best treatment option.

Purpose: This study aimed to discover the efficacy of, and barriers to, available treatment options for PANS/PANDAS.

Methods: A convenience sample of individuals diagnosed with PANS/PANDAS or their parent/caregiver was recruited anonymously through Facebook support groups. …

A Historical Analysis Of Infant Mortality In South Carolina From 1920-1970, Allison Ritchie

Senior Theses

This study uses Geographic Information Systems (GIS) to investigate racial and spatial inequalities in South Carolina infant mortality rates (IMR’s) between 1920-1970. In the 20th century, IMR’s declined throughout the United States, primarily due to economic growth, increased sanitation, and improved medical knowledge. Factors such as systemic racism and lack of healthcare access resulted in higher IMR’s for Black infants and infants living in rural areas. In 1920, South Carolina’s Black IMR was 1.5 times higher than the white IMR; by 1970 the difference expanded to 1.9, reflecting a 27% rise. The disparity between Black and white IMR’s increased in …

The Left Ventricle Under Stress: Exploring The Impact Of Gestational Stress On Postpartum Cardiovascular Health, Archana Ramesh

Senior Theses

A woman’s cardiovascular system undergoes several changes to equip it for the physiological demands of pregnancy. The left ventricle (LV) is most susceptible to changes such as increased cardiac output and workload because it is the primary chamber in the heart that pumps oxygenated blood to the entire body. Some mothers may be unable to cope with the physiological demands, and ventricular hypertrophy, along with other cardiac remodeling that takes place during pregnancy, may bring light to underlying cardiovascular disease (CVD). The peripartum period often comes with heightened stress, disproportionately for certain populations, and this stress has been linked with …

Biological Evaluation Of Anti-Cancer Activities Of Novel Small-Molecule Tubulin Polymerization Inhibitors In Prostate And Pancreatic Cancer, Rui Wang

Alternative Theses and Dissertations (AETDs)

Colchicine binding site inhibitors (CBSIs) are an emerging class of microtubule-targeting agents (MTAs) with promising potential for cancer therapy. Traditional MTAs like paclitaxel, docetaxel, and Cabazitaxel, are three FDA-approved taxanes for treating various cancers. Acquired chemoresistance and toxicities caused by chemotherapy are some of the main barriers that limit their clinical outcomes. More effective novel agents and therapeutic strategies are needed to overcome these challenges. Tremendous efforts have been made in discovering novel CBSIs and evaluating many cancer types, reporting their promising potential to treat both primary, resistant, and metastatic cancers including breast cancer, ovarian cancer, lung cancer, and melanoma. …

Comprehensive Analysis Of Adverse Events Following Covid-19 Vaccination: Insights From Diverse Data Sources, Yiming Li

Dissertations and Theses (Open Access)

This dissertation investigates adverse events (AEs) associated with COVID-19 vaccinations through a multi-faceted approach involving structured and unstructured data. The study is organized into three specific aims, each contributing to a comprehensive understanding of vaccine safety. Aim 1 focuses on the temporal and spatial analysis of AEs reported in the Vaccine Adverse Event Reporting System (VAERS). We performed a detailed temporal analysis to detect patterns over time, revealing a significant increase in reported AEs shortly after the vaccine rollout. Spatial analysis highlighted regional variations in AE reporting, with higher frequencies observed in middle and north regions of the United States …

Cardiovascular Biomarkers Using Deep Learning And Retinal Imaging For The Assessment Of Systemic Disease, Ivan Coronado

Dissertations and Theses (Open Access)

Fundus photography is a radiation-free, non-invasive imaging modality widely employed to assess both ocular and systemic diseases in population-level applications. Traditional methods for extracting cardiovascular biomarkers rely on quantifying vascular features in these images to identify indicators of disease. However, these approaches often depend on manual clinical expertise, which can be costly and time-consuming, making them impractical for large-scale datasets. Deep learning offers a compelling alternative to traditional techniques by enabling the automated processing of extensive datasets with high accuracy. Despite its advantages, deep learning models often function as "black boxes," making it challenging to interpret the features they prioritize …

Enhancing Inclusivity In Primary Care On A College Campus, Amanda Finkle Plyler

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Individuals who identify as lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ+) face higher health disparities and are less likely to seek healthcare due to fear of being misgendered or judged by staff. Purpose: The purpose of this DNP project was to implement an intervention for college students seeking care at Student Health Services (SHS) that includes a question addressing preferred pronouns during establishment of care, creating the opportunity for staff to address patients appropriately and to provide gender-affirming care. Method(s): A pre and post intervention patient satisfaction survey related to sexual orientation and gender identity (SOGI), …

Assessing The Impact Of Mindfulness-Based Stress Reduction (Mbsr) On Emergency Nurses' Absenteeism And Receptive Awareness Of And Attention To What Is Taking Place In The Present, Rachael Moore Drake

Doctor of Nursing Practice Scholarly Projects

Problem: The changing terrain of modern healthcare has made emergency nurses' well-being a top priority. Within the small community hospital where this project was conducted, the issue of employee work-related stress was identified through managers' feedback and employee surveys. Purpose: Leaders employ a comprehensive mindfulness program based on assessed employee needs to understand the practical interventions to address work-related stress. This project implemented mindfulness-based stress reduction (MSBR) interventions and assessed emergency nurses' absenteeism and receptive awareness of and attention to what is taking place in the present. Method: The project utilized the Mindful Attention Awareness Scale (MAAS) to assess emergency …

Identifying Adolescent Depression In The Public School System, Laura Lee Griffith

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Twenty percent of United States adolescents experience major depression at some point. Elevated school dropout rates, substance abuse, chronic disease, mortality and morbidity rates, and impaired growth remain because 60 % of adolescents with unidentified depression do not receive treatment. Purpose: This evidence-based project identified adolescents aged 16-19 in a South Carolina high school who had symptoms of depression. Counseling and resource information were provided for students with scores of 10 or greater, or thoughts of self-harm on the PHQ-9. Method: Students were screened using the PHQ-9. Data was organized in Excel and analyzed using the T-tests and …

The Impact Of A Visual Remote Patient Monitoring Device (Leaf) On Hospital-Acquired Pressure Injuries (Hapi), Tyler Andrew Gunther

Doctor of Nursing Practice Scholarly Projects

Problem Statement: The Critical Care Department at a large academic hospital in the Southeast has experienced a significant increase in healthcare-acquired pressure injuries (HAPIs), contributing to elevated mortality rates. Factors such as insufficient adherence to turning protocols and resource limitations impact patient safety, thus increasing the potential for adverse outcomes and increased costs. Purpose: The purpose of this DNP scholarly project was to evaluate the impact of a turn monitoring device, specifically the LEAF system by Smith and Nephew, on HAPI incidence in the critical care setting. The project aimed to address the identified barriers to compliance, enhance patient safety, …

Implementation Of Eat Sleep Console For Neonatal Abstinence Syndrome: A Quality Improvement Project, Harley Addison Kennington

Doctor of Nursing Practice Scholarly Projects

Problem Statement: A level III NICU and mother-baby unit within an inpatient hospital in the Southeast United States transitioned from the Finnegan Neonatal Abstinence Scale (FNASS) to the Eat, Sleep, Console (ESC) for treating Neonatal Abstinence Syndrome (NAS). Prior to ESC implementation, there was limited nursing education of ESC practice guidelines or consideration for proper implementation protocol. Purpose: The purpose of this evidence-based quality improvement project was to reintroduce nursing staff to the ESC NAS Care Tool and ESC charting guidelines within the NICU and mother-baby units. Methods: This project followed the PDSA process – Plan, Do, Study, Act, underscored …

Increasing Pre-Procedure Communications To Decrease Colonoscopy Cancellations, Natalie Brooke Midkiff

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Colonoscopies play a vital role in early colorectal disease detection and prevention. Yet, the field of gastroenterology faces a persistent challenge - frequent procedure cancellations and incomplete examinations due to suboptimal bowel preparation. This not only compromises the effectiveness of colonoscopies but also poses potential health risks.

Purpose: This project aimed to reduce procedure cancellations and incomplete examinations by regularly communicating pre-procedure instructions and reminders through text messages and phone calls.

Inclusion Criteria: The criteria were clearly defined, targeting patients aged 18 and older who needed colonoscopies. This focus ensured the project's relevance to specialized gastrointestinal intervention. Establishing …

Identification Of Obstructive Sleep Apnea Symptoms Among Veterans In The Primary Care Setting, John Dominic Rosella Iv

Doctor of Nursing Practice Scholarly Projects

Untreated obstructive sleep apnea (OSA) has long-term cardiovascular and metabolic health implications, impacting quality of life and increasing health expenditures. Veterans have a higher prevalence rate of OSA attributed to an aging population and higher rates of comorbid conditions. The problem of under recognition of OSA symptoms partly relates to clinicians needing to elicit relevant symptoms routinely. At the same time, the lack of primary-care-based screening protocols contributes to the percentage of undiagnosed OSA. The purpose of this evidence-based project was to implement routine screening to identify OSA risk among veterans in primary care settings in South Carolina. The method …

Depression In Individuals With Chronic Liver Disease: Improving Screening In The Outpatient Setting, Kayla Corine Wright

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Individuals with chronic conditions such as chronic liver disease experience higher rates of depression, often underdiagnosed and placing high risk demographics in jeopardy of adverse outcomes, including worsening prognosis, decreased quality of life, and increased symptomatology.

Purpose: Evidence advocates for routine depression screening within high-risk patient populations. This paper outlines the implementation of a quality improvement initiative aimed at enhancing depression screening at a selected outpatient liver clinic within an extensive hospital system by implementing the PHQ-9 questionnaire during patient clinic visits, where no standardized screening protocol was previously in place.

Methods: The Plan-Do-Study-Act cycle guided the implementation …

Predicting Access Barriers And Facilitators To Pediatric Specialty Care Among Children With Complex Chronic Conditions, Elisabeth Vestal

MUSC Theses and Dissertations

Children with complex chronic conditions (CCC) face healthcare inequities when accessing pediatric specialty care. Social or economic barriers may exacerbate the challenges faced by families with a child/children with CCC and include increased geographical distance to specialty services, familial poverty, inadequate neighborhood resources, and food insecurity. Understanding how social and economic factors may impact equitable access to care are essential in improving health outcomes for children with CCC. The first manuscript in this compendium is an integrative review focused on the barriers and facilitators of accessing pediatric specialty care for rural dwelling children with CCC. The second manuscript presents a …

Aging Skeletal Muscle: Influence Of Obesity And Role Of The Exercise Responsive Nuclear Receptor Nor-1, Hector G. Paez

Alternative Theses and Dissertations (AETDs)

Skeletal muscle mass and function are critical components of overall health and quality of life. Advanced age is associated with skeletal muscle disease characterized by a loss of muscle mass, function, and quality. Indeed, low muscle mass and function is associated with poor disease outcomes and greater mortality, greater incidence of falls, and a high fiscal and societal cost. Aging contributes to a decline in skeletal muscle health through several intrinsic and extrinsic mechanisms including impaired nutrient sensing, mitochondrial dysfunction, inflammation, physical inactivity, and proteostatic imbalance. Obesity, an increasingly prominent public health concern, is becoming more common in the elderly …