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A Quantitative Investigation Into Isotropic Variations Of Treatment Planning Isocenters To Model Patient Misalignment During Radiation Therapy Delivery And Its Impact On Evaluated Dose Metrics For Hypofractionated Dibh Left Breast Cancer Patients, Mckenzie Gemeiner

Masters Projects

Introduction

This research was conducted for carcinoma of the left breast without nodal involvement using the 3D deep inspiration breath hold (DIBH) treatment technique. Limiting dose to healthy tissues is crucial in radiation treatment planning. The impact of dosimetric uncertainty due to isotropic variations on constraints and goals is often overlooked. This study investigates dose metric differences due to inherent patient misalignment modeled by isotropic variations in treatment planning.

Methods

10 patient subjects were randomly selected with carcinoma of the left breast without nodal involvement, each using the 3D hypofractionated, deep inspiration breath hold (DIBH) technique. All plans had 24 …

Evaluating The Use Of A Standardized Prebriefing Tool With Novice Simulation Facilitators, Ciara Berry

Doctor of Nursing Practice Projects

The International Association for Clinical Simulation and Learning (INACSL) Best Practice Standards related to prebriefing recommends establishing a prebriefing plan to prepare the learners for a simulation activity. A simulation briefing should orient the learner, promote learner engagement, and reinforce psychological safety. The nursing faculty’s unfamiliarity with an established prebriefing tool at the clinical site and reliance on the single simulation educator resulted in self-guided briefings and reduced the faculty facilitators' competency. The quality improvement project aimed to reorient nursing faculty in an associate degree nursing program to a prebriefing tool available at the clinical site. After reorientation, the PI …

Debriefing Orientation For Novice Simulation Faculty, Cindy M. Carter

Doctor of Nursing Practice Projects

Faculty new to the simulation environment lack the knowledge, skills, and confidence to deliver proper debriefing methods. The Doctor of Nursing Practice (DNP) project’s problem is the need for a standardized, evidence-based debriefing process in the undergraduate RN program at the College of Nursing in Oklahoma. The study aims to follow the International Nursing Association for Clinical Simulation and Learning (INACSL) best practices to implement a debriefing simulation for novice faculty to improve faculty self-efficacy with the debriefing process (Decker et al., 2021). The DNP student evaluated faculty using pre-and post-tests containing questions from the Debriefing Assessment for Simulation in …

Navigating Change: Cultivating Faculty Support For Curriculum Revision Through The 4ms Framework, Sarah Dearing

Doctor of Nursing Practice Projects

Public campaigns have increased awareness of Alzheimer’s disease and other dementias, however, education for healthcare providers concerning brain health and appropriate screenings to identify elderly patients at risk is not present. This curricular policy change project outlines the need for faculty buy-in to complete a curriculum change that addresses the lack of geriatric-evidence based education within an Associate of Applied Science in Nursing (AASN) program. Qualitative data identifies the amount of geriatric-evidence based education present in the current AASN curriculum map. Using Lewin’s change management theory (CMT) and the Cognitive-Affective-Social Theory of Learning Environments (CASTLE), an educational module teaching the …

Enhancing Family Nurse Practitioner Education Through End-Of-Life Simulation: A Quality Improvement Project, Deborah Jamison

Doctor of Nursing Practice Projects

Providing compassionate and effective end-of-life care is a crucial skill for Family Nurse Practitioners (FNP) students (Collins & Small, 2019). However, many students experience significant anxiety and lack confidence in such challenging situations. The problem identified for the Doctor of Nursing Practice (DNP) Quality Improvement (QI) project is the lack of training focused on end-of-life care in the FNP program at a College of Nursing (CON) within an academic clinical center. The project’s purpose was to improve confidence and anxiety levels among FNP students in providing end-of-life care. The project aimed to create an inventive and immersive end-of-life simulation with …

Quality Improvement Project: The Bidirectional Relationship Among Type Ii Diabetes Mellitus And Periodontal Disease, Sarah Martinez

Doctor of Nursing Practice Projects

Individuals with Type 2 Diabetes Mellitus (T2DM) are at increased risk for oral health conditions such as periodontal disease. Moreover, there is an established bidirectional relationship that has been well documented in the literature among periodontal disease and T2DM. However, oral health is rarely being discussed with patients who have T2DM from the primary care setting. The objective for this Doctor of Nursing Practice (DNP) project was to bridge the gap in this area by assessing the efficacy of implementing an educational program to promote education and awareness in individuals with T2DM who are at risk for periodontal disease. This …

Improving Hypertension Management In The Family Care Practice Through The Education Of Clinical Staff On Jnc-8 Guidelines, Shiny Michael

Doctor of Nursing Practice Projects

Hypertension is a major public health challenge, contributing significantly to global morbidity and mortality. Despite the availability of JNC-8 guidelines, adherence in clinical practice is often lacking. This project aimed to improve hypertension management in a primary care setting by educating clinical staff on the JNC-8 guidelines to enhance adherence to evidence-based practices. The primary purpose of this project was to address the lack of knowledge and suboptimal hypertension control through targeted educational interventions for clinical staff. The methodological approach involved a pre- and post-intervention design, with educational sessions conducted for medical assistants. Data on blood pressure control and staff …

Increasing High-Alert Medication Administration Competence In Undergraduate Nursing Students Using An Unfolding Obstetrical Simulation, Jenna A. Warf

Doctor of Nursing Practice Projects

This DNP project aimed to increase medication competence in undergraduate nursing students through an unfolding high-fidelity simulation. Before the implementation of this project, students at the project site had experienced minimal exposure to obstetrical nursing care and medication administration. This quality improvement project occurred at a community college in Texas, with undergraduate nursing students (n=18). The participants completed an Evolve pretest, unfolding high-fidelity simulation, Simulation Effectiveness Tool-Modified (SET-M) survey, and an Evolve posttest. The unfolding simulation consisted of a three-part simulation with a preeclamptic obstetrical patient that started at a physician’s office, progressed to triage, and ended as an inpatient …

A Quantitative Investigation Into The Daily Variation Of Bladder And Rectum Volumes Among Prostate Cancer Patients Receiving Radiation And When It Violates Dose Constraints At Any Given Fraction., Joseph Pape

Masters Projects

When planning radiation therapy treatments for prostate cancer, the bladder and rectum are important organs at risk (OAR). The purpose of this retrospective study was to establish guidelines for bladder and rectal volumes for men receiving hypofractionated radiation therapy to their prostate and seminal vesicles. Ten patients were included in the study and radiation doses to the bladder and rectum were recorded based on the daily change in the OAR volumes. The bladder and rectal volumes were contoured on each patient’s daily treatment CBCT and those volumes were compared to that on the treatment planning CT. The results showed that …

Prostate Specific Antigen-Based Cancer Screening In The United States, Treves M. Dennis

Walden Dissertations and Doctoral Studies

In 2012, the U.S. Preventive Services Task Force revised its prostate cancer screening recommendations to advocate against the routine use of prostate-specific antigen-based testing. This cross-sectional study of a large dataset from the Surveillance, Epidemiology, and End Results Program compared PSA-based diagnoses made from 2006 to 2011 to those from 2013 to 2018. The study aimed to address the impact of the change in recommendation on survival and stage at diagnosis in prostate cancer patients. The socioecological model was used as the theoretical foundation for the study. A total of 205,129 men diagnosed with prostate cancer comprised the study population. …

Pregnancy Intention, Perinatal Depression, Birth Weight, And Premature Delivery Among Black Women, Chantay Philease Mcneil

Walden Dissertations and Doctoral Studies

Perinatal depression among Black women results in significant public health burdens, interacting with systemic disparities to create disproportionate risks of adverse birth outcomes. The present study explored the moderating effect of pregnancy intention on the relationship between perinatal depression and adverse birth outcomes such as low birth weight and preterm delivery among Black women living in the southern United States. Using secondary data from the 2016-2020 Pregnancy Risk Assessment Monitoring System (PRAMS), data were analysed from 9825 black women across eight southern states including Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, Tennessee, and Virginia. The statistical approach included chi-square tests and …

Developing A Summer Enrichment Program For School-Aged Children: The Role Of Occupational Therapy In Summer Experiences, Morgann Lonczak

Department of Occupational Therapy Entry-Level Capstone Projects

Participation in summertime experience for youth have become increasingly popular in most recent years. With the growth in summer experiences including summer camp participation, there is a need to determine the role of occupational therapy in this emerging practice area to best serve the community. A 16-week capstone experience was completed under the supervision of Great Strides Rehabilitation occupational therapy staff. The capstone project aimed to fill a gap in summertime experiences by designing and implementing an occupational therapy led enrichment program to achieve the best outcomes for children and youth. A six-week enrichment program was successfully developed, and two-weeks …

Occupational Therapy's Role For Individuals With Long-Term Neurological Conditions, Courtney Ahle

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

The Role Of Occupational Therapy In Long Covid Rehabilitation, Lisa H. Hamilton

Department of Occupational Therapy Entry-Level Capstone Projects

This capstone project explores the integration of Occupational Therapy (OT) into primary care settings, focusing on chronic conditions such as long COVID and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). These conditions are often misunderstood by both healthcare providers and the broader community due to their complex and multifaceted symptoms, which necessitate specialized care. The project aimed to create resources and educational materials tailored to the needs of patients and rehabilitation professionals, to enhance the management of these challenging conditions. Additionally, the project placed a strong emphasis on advocacy for individuals with "invisible disabilities," aiming to raise awareness and improve accessibility to …

Remote Work Ergonomics: A Doctoral Capstone Experience, Kaynath Bhamani

Department of Occupational Therapy Entry-Level Capstone Projects

As remote work becomes increasingly prevalent, ensuring effective ergonomic practices in home-based work environments has emerged as a critical concern. This paper attempts to explore challenges that are associated with remote work and proposes solutions for creating healthier home office environments.

Increasing Parent Participation In Nicu Care And Preparation For Discharge, Biancah A. Derival

Department of Occupational Therapy Entry-Level Capstone Projects

My capstone project aimed to understand the current evidence that examines the benefits of NICU parental participation to increase preparedness for discharge and provide educational resources to parents and professionals. The first half of my project entailed a revision of hospital provided material to create a weekly developmental timeline that parents can understand. During the second half, educational materials were collected to address parental concerns including early intervention resources, sensory activities/strategies, and age-appropriate toys, safe sleep, and tummy time. Families can incorporate this information in the NICU and the home environment. The resources were revised into physical handouts to take …

Understanding Occupational Therapy’S Role In Injury Prevention For Pickleball Players And Communities, Kelly Lambert

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

An Anxiety And Coping Mechanism Educational Program For Children And Adolescents, Amanda Garrett

Department of Occupational Therapy Entry-Level Capstone Projects

The following capstone project encompassed creating and implementing an educational program focusing on anxiety and coping mechanisms for adolescents 12-15 years of age at the YMCA in Largo, Florida. The academic program focuses on six different types of anxiety, which are generalized anxiety, social anxiety, test anxiety, feelings of panic, feelings of stress, and health anxiety, all in a PowerPoint format. Each of these topics also included a coping mechanism that the teens completed after learning about each different type of anxiety. These coping mechanisms included journaling, creating a stress ball, participating in a yoga class, completing a scavenger hunt …

Development Of An Intensive Outpatient Program (Iop) For Adolescents Of American Military Members Deployed Overseas To Support Mental Health, Aaron N. Brion, Tyler J. Russo

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

Trauma Informed Care In Hippotherapy, Erin M. Deren

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

Advocating For The Role Of Occupational Therapy In A Community-Based Setting Through The Use Of Journaling For Individuals With Chronic Mental Illness, Taylor Muzik-Eversdijk

Department of Occupational Therapy Entry-Level Capstone Projects

Individuals who battle severe mental illness (SMI) experience a range of deficits that affect various aspects of daily life, including activities of daily living (ADLs), instrumental activities of daily living (IADLs), social participation, sleep and rest, education, work, leisure, and play. Research suggests that journaling can help individuals with SMI express their emotions and provide a healthy outlet for coping with symptoms. This doctoral capstone project aimed to identify the unique needs of individuals with SMI and explore how journaling and other occupational therapy (OT) interventions could expand the scope of practice within Boley Centers' assertive community treatment (ACT) teams …

Enhancing Occupational Therapy Doctoral Capstone Planning: Integrating 2023 Standards Into Curriculum, Samantha Edwards

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

Occupational Therapy With Refugees And Asylum Seekers, Hana Listes

Department of Occupational Therapy Entry-Level Capstone Projects

The capstone project aimed to define the role of occupational therapy in the reintegration of refugee families in Jacksonville, Florida, in collaboration with Muslim American Social Services. The project focused on utilizing occupational therapy to identify and address barriers faced by refugees during their resettlement process. Following assessment of barriers, culturally sensitive intervention strategies were implemented to improve independence and participation in meaningful daily activities. Interventions focused on the development of targeted programs that addressed challenges such as language barriers, access to resources, and cultural adjustment. Implications of the project aim to advocate for occupational therapy as a stakeholder in …

Increasing Operating Room Efficiency Through Decreased Turnover Times, R. Keith Wolfskill

Student Scholarly Projects

The Operating Room (OR) is the financial engine of the modern hospital or surgical center. Over 40% of the hospital's cost is invested in the OR, but the facility recoups a monetary return of around 60-70%. Turnover time is a crucial factor in reducing costs. Uncontrolled, it can inflate operating costs, but when managed effectively, it can boost surgeon, patient, and staff satisfaction, enhance patient safety, and significantly reduce operational costs. The literature underscores the importance of reducing the time between operating room turnovers to improve OR efficiency. A key strategy that research consistently shows to be effective is the …

Enhancing Patient Throughput From Emergency Department To Inpatient Unit With Electronic Handoff Implementation, George Hanania

Master's Projects and Capstones

Background: This evidence-based improvement project aimed to address communication issues during information exchange among healthcare professionals and the operational impacts of ineffective nurse-to-nurse reports among the emergency department (ED) to the inpatient units at a northern California hospital-based system hospital in San Leandro. The impacts of miscommunication and ineffective ways of giving nurse-to-nurse reports over the phone can result in delays in treatment and diagnosis, leading to ED overcrowding and decreased throughput.

Problem: Communication issues during information exchange, specifically operational impacts of ineffective nurse-to-nurse report/handoff between the ED and inpatient units.

Interventions: This project aimed to implement an electronic handoff …

Interprofessional Collaboration For Nurse Leaders: Practical Applications To Enhance Team Effectiveness On Telemetry, Paul Alegria

Master's Projects and Capstones

Abstract

Background: According to the Interprofessional Education Collaborative (IPEC), there are four core competencies that promote team engagement and collaboration among professionals: 1. Establish shared values 2. Clarify roles and responsibilities 3. Effective communication 4. Teamwork. Together, the competencies create structure and team integration that potentiates favorable outcomes in work culture and patient care when operating in complex, quality-based care settings. The setting for this quality improvement project is on a telemetry unit, assistant nurse manager (ANM) team in the greater Sacramento region of California.

Problem: The Gallup Q12 is an employee engagement survey that identifies inter-relational domains of influence …

A Comparative Analysis Of Helical Tomotherapy Planning With Active Versus Total Bone Marrow Sparing Using Dual-Energy Computed Tomography, April E. Premo

Masters Projects

Purpose: This study aims to compare helical tomotherapy (HT) plans using active bone marrow (ABM) sparing contouring versus traditional bone marrow (BM) sparing contouring using dual-energy computed tomography (DECT) in the treatment of gynecologic (GYN) cancers. The goal is to evaluate the effects of using ABM contours in optimization on organs at risk (OAR) and planning target volumes (PTVs).

Methods: The study involved creating HT plans for GYN cancer patients, utilizing both ABM and BM contouring techniques. DECT was used to distinguish between active and inactive bone marrow. Dosimetric comparisons were made between BM and ABM sparing plans. Statistical analyses …

Implementing Joy In Practice And Addressing Nurse Burnout, Courtney Repetto

Master's Projects and Capstones

Abstract

Background: This quality improvement project, a beacon of hope in the face of nurse burnout, examined its effects and how nurse leader engagement and the transformative Joy in Practice Initiative can promote wellness, joy in practice, and significantly improve patient outcomes. Problem: According to the Institute of Healthcare Improvements (IHI) 2019 National Forum on Quality Improvement in Healthcare (IHI, 2019), burnout can be characterized by depersonalization, emotional exhaustion, and lack of personal accomplishment. Since the COVID-19 pandemic, nurse burnout rates have been at an all-time high, posing a significant threat to patient care. This has revealed alarming results: Nurse …

Improving Utilization Of Interqual Among Case Managers/Patient Care Coordinators At Santa Clara Medical Center, Czar Binuya Viesca

Master's Projects and Capstones

Problem: The utilization management department at Santa Clara Medical Center had low compliance with InterQual criteria, at 35%. This resulted in inconsistent care decisions, poor resource allocation, and regulatory penalties, affecting patient care and performance.

Context: The project aimed to enhance InterQual utilization, aligning with Santa Clara Medical Center's goals of evidence-based, patient-centered care. The initiative was guided by Jesuit values and ANA ethical standards, focusing on service, justice, excellence, patient advocacy, and professional responsibility.

Interventions: The project implemented three main interventions: comprehensive training programs, regular audits, and performance recognition. These interventions aimed to address gaps and ensure the …

Improving Patient Care Experience By Increasing Medication Communication, Honey Varghese

Master's Projects and Capstones

Background: Patient [DA1] care experiences profoundly impact a hospital's competitiveness and financial viability. Effective communication about medications and their potential side effects is not just a communication strategy but a powerful tool that signifies safe patient care, leads to improved health outcomes, improves medication compliance, and reduces readmissions related to medication side effects and non-compliance.

Problem: Effective communication about medications and their potential side effects is a significant indicator of safe patient care and improved health outcomes. The cardiac telemetry unit of a medical center in Northern California has not met the regional benchmark related to medication communication.

Context: The …