Medicine and Health Sciences Commons^™

Depression Screening For Nursing Home Residents, Victor Chukwuocha

Walden Dissertations and Doctoral Studies

The project focused on depression among nursing home residents, an underrecognized and undertreated condition that affects quality of life. Few studies have been conducted on the subject of depression screening for nursing home residents, resulting in a lack of understanding among the nursing profession on managing specific conditions. At a nursing home, there was a need to address depression. The practice-focused question used in this project addressed the process of the translation of evidence to develop a staff education project for depression to enhance the knowledge of nurses working with nursing home residents. The project followed an evidence-based approach to …

Neonatal Nurses’ Intention To Stay In The Nicu, Carolyn Penn-Griffin

Walden Dissertations and Doctoral Studies

Neonatal nursing leaders and national health care organizations within the United States are concerned about the recent shortage of skilled and experienced neonatal intensive care unit (NICU) nurses that may reduce the quality of care delivered to NICU patients. NICU nurses are passionate about caring for premature and ill full-term infants and providing educational and emotional support for their parents, some NICU nurses remain in the NICU long-term, yet others contemplate leaving the specialty. The purpose of this qualitative interpretative phenomenological research guided by Martin Fishbein and Ajezen’s theory of reasoned action was to explore the lived experiences of NICU …

Mitigating Care Provider Turnover For Children With Developmental Disabilities, Abigail Equinoa

Occupational Therapy Student Capstones

No abstract provided.

Implementation Of A Crna Clinical Faculty Preceptorship Workshop: A Quality Improvement Project., Sarah Veeneman

Doctor of Nursing Practice Papers

Background/Significance: Certified Registered Nurse Anesthetists (CRNAs) undergo extensive didactic and clinical training when earning their doctoral practice degrees. However, there is inconsistency of preceptor clinical training.

Purpose: The purpose of this quality improvement project was to improve the consistency in preparedness of CRNA clinical faculty preceptors who train nurse anesthesia residents (NARs).

Methods: A pre-post approach was used. A MeSH search was conducted that resulted in 13 studies that were examined for quality and applicability for this project. The Plan-Do-Study-Act model was the framework to guide this quality improvement project.

Intervention: Participants attended one 3-hour educational training workshop. …

Implementation Of A Mindfulness Approach To Emotional Regulation In A Public High School., Kaelin Cherise Shay

Doctor of Nursing Practice Papers

According to the Gallup and Walton Family Foundation-State of American Youth Survey for 2023, schools in the United States received an average grade of C+ when it comes to supporting their students’ mental health, highlighting a potential area for improvement in the school system (Wilcoxon & Marken, 2023). This quality improvement project aimed to teach high school students about emotional regulation using a mindfulness platform and evidence-based techniques designed for the school environment. The sessions focused on improving the students’ understanding of emotions and emotional regulation and helping them apply techniques to regulate emotions in a healthy manner.

This project …

Evaluation Of An Educational Training On Telehelath Utilization Rates And Hospital Readmissions In A Home Health Setting., Gabrielle A. Coomer

Doctor of Nursing Practice Papers

Background: Hospital readmissions are on the rise and continue to be a concern within healthcare due to their effects on the quality of care and healthcare costs. Telehealth strategies have been utilized across healthcare settings to improve hospital readmission rates.

Purpose: The purpose of this project was to evaluate the effectiveness of a telehealth training program in increasing telehealth utilization rates and reducing the acute care hospitalization rate within a single home health agency.

Intervention: A 30-minute PowerPoint presentation on the definition of telehealth, goals, and benefits of telehealth, patient eligibility, special considerations for clinicians, billing and coding guidelines, …

Higher-Dose And Adjuvanted Seasonal Influenza Vaccines Can Improve Immunogenicity In People With Hiv, Ethan Gladhill, Heather Rollins, Heather Justice, J. Brumitt

Doctor of Medical Science (DMSc)

Background- People with HIV have proportionally higher mortality and morbidity from seasonal influenza and have a reduced immune response to seasonal influenza vaccines. Improvement of their immune response to influenza vaccines may lead to improved health outcomes.

Methods- CINAHL and Medline were searched using the terms “high dose influenza AND HIV”, “high antigen AND influenza vaccine”, “influenza vaccine AND HIV AND immunogenicity”, “influenza vaccine AND HIV AND adjuvant”, and “adjuvanted influenza vaccine AND HIV”. Articles were selected based on criteria of investigating higher-dose (30μg or higher) or adjuvanted influenza vaccines …

Daily Alarm Rounds: Enhancing Interdisciplinary Communication And Reducing Perceived Alarm Burden In Bedside Nurses., Shelby Mangeot

Doctor of Nursing Practice Papers

Purpose: The Joint Commission established alarm management as a national patient safety goal in 2013 and has continued this goal through 2023 (2022). This goal mandates hospitals to prioritize alarm system management and establish evidence-based techniques to manage and reduce nuisance alarms. The purpose of this quality improvement project was to provide bedside nurses with education about excessive alarm burden and evidence-based alarm management techniques, then implement a daily bedside alarm rounding tool to enhance interdisciplinary communication and address patient alarm limits during daily rounds.

Methods: After extensive review of the literature, prompts discussing daily alarm limits were added to …

Lgbt Cultural Competence Education For Nurse Leaders In A Large Metropolitan Healthcare System: Quality Improvement, Trevor Mcguffin, Andrew Mitchell

Doctor of Nursing Practice Papers

Background: In the United States, seven percent of adults identify as LGBT. The LGBT population is disproportionately affected by health disparities and barriers to care when compared to the cis-heterosexual population. Due to healthcare providers’ limited LGBT health education and experience, inconsistencies in LGBT culturally competent care perpetuate health disparities and barriers to care for the LGBT population.

Purpose: The purpose of this quality improvement project was to educate nurse leaders on LGBT cultural competency and facilitate nurse leaders’ behavior change.

Methods: This quality improvement project consisted of three LGBT cultural competence modules and two guided behavior change pathways. Outcomes …

Addressing Caregiver Burden Among Oncology Caregivers: An Educational Intervention., Alexandria Salois

Doctor of Nursing Practice Papers

The incidence of cancer is on the rise, the number of cancer diagnoses are increasing at an alarming rate with advanced technologies and available evidence. Cancer care has also shifted from the inpatient setting to mostly outpatient. With this, a large portion of the responsibility has been transferred to the caregiver of that patient (Kent et al., 2019). Historically, caregivers have not been at the forefront of research, however, the concept of caregiver burden is beginning to emerge. A gap exists in addressing the needs of caregivers in both evidence-based data and with the local community cancer support group, Gilda’s …

Evaluation And Implementation Of Mindfulness Module To Reduce Burnout Among Emergency Department Nurses: A Quality Improvement Project, Katie Waltrip

Doctor of Nursing Practice Papers

BACKGROUND: Nurses working in the ED experience higher burnout rates than those working in other healthcare settings. Defined as emotional exhaustion, depersonalization, and a low sense of personal accomplishment, burnout is associated with increased work absences and turnover and decreased patient satisfaction and quality care. Burnout must be examined and addressed for emergency nurses to continue providing quality care.

PURPOSE: This quality improvement project aimed to evaluate burnout among nurses working in the ED prior to and immediately following a 9-week mindfulness-based intervention.

METHODS: A Plan-Do-Study-Act model was utilized along with application of supporting evidence from the literature and an …

Promoting Healthy Habits Among Children In A Residential Facility., Tiffany Jones

Doctor of Nursing Practice Papers

Background: Childhood obesity has been a significant public health concern in the United States. The prevalence of obesity among children and adolescents has increased over the past few decades. There are serious implications for immediate and long-term health. It poses serious health risks and economic challenges.

Setting: This quality improvement project will take place at a residential psychiatric treatment facility and therapeutic foster care program for children and adolescents with mental health or behavioral issues. This facility is in the suburbs of Louisville, Kentucky.

Purpose: The purpose of this project is to boost physical activity and improve knowledge about nutrition …

Improving Transitions In Care Through Early Discharge Planning: A Quality Improvement Initiative., Sarah Markgraf

Doctor of Nursing Practice Papers

Background: A substantial body of evidence has shown transitions in care are one of the weakest links in healthcare networks, especially for older adults with complex comorbidities. Residents receiving short-term rehabilitation (i.e., rehab) transitioning to home from a skilled nursing facility (SNF) are the most vulnerable in the first 30 days post-discharge for adverse resident events, including avoidable rehospitalization. Avoidable rehospitalizations cost Medicare billions of dollars annually and lead to poor resident outcomes. Early discharge planning in SNFs for short-term stay rehabilitation has decreased rates of avoidable rehospitalizations, improved quality of life in geriatric residents, and improved care partners' perceived …

A Parenting-Skills Intervention To Mitigate Adverse Childhood Experiences For Children Of Parents In Substance Use Disorder Recovery., Makayla S. Haas

Doctor of Nursing Practice Papers

Abstract

Background: Parents recovering from substance use disorder (SUD) are prone to neurobiological alterations that affect parental emotional regulation, increasing occurrence of harsh parenting, heightened stress, and relapse. Children with parents who suffer from SUD experience adverse childhood experiences (ACE), predisposing them to negative health and lifestyle risks. Implementing a parenting-skills intervention for parents in recovery can promote positive-parenting, reduce parenting stress, improve the parent-child relationship, and mitigate the effects of ACEs.

Setting: ChooseWell Communities (CWC), a sober-living community, in Louisville, KY served as the project site. Participants at CWC are sober parents with primarily young children under 5 years …

Improving Treatment And Follow-Up Care For Patients Who Screen Positive For Depression In Family Practice: A Quality Improvement Project., Jennifer D. Hooper

Doctor of Nursing Practice Papers

Background: Depression is a prevalent condition requiring systematic approaches for effective treatment and follow-up in primary care. This quality improvement project aimed to enhance care for patients screening positive for depression at an academic family practice with a diverse patient population and a comprehensive electronic health record (EHR) system.

Purpose: The primary objective was to assess whether a provider educational session and the implementation of an optional depression treatment and follow-up algorithm could improve timely and appropriate care for patients with positive PHQ-9 screenings.

Setting: The project was conducted at an academic family practice office.

Methods/Procedures: The intervention included a …

Improving Pressure Injury Nurse Awareness And Decision-Making In The Cardiac Intensive Care Unit: A Quality Improvement Project., Sarah G. Moreno

Doctor of Nursing Practice Papers

Abstract

Background/Significance: Hospitalized patients with pressure injuries have 5 times greater death compared to a patient without a pressure injury. A needs assessment identified the problem of pressure injuries in the CVICU with the goal to improve nurse awareness and decision-making to decrease pressure injuries in the CVICU.

Purpose: The purpose of this project was to increase nurse awareness of pressure injury prevention via an education workshop and evidence-based pressure injury decision tree in the Cardiovascular ICU.

Methods: A MeSH search was conducted to identify pressure injury interventions and nurse awareness of pressure injuries which resulted in 17 …

Reducing Stress And Improving Mindfulness Practices Among Mental Health Professionals Through Guided Meditation., Liara G. Patton

Doctor of Nursing Practice Papers

Abstract

Background: Chronic exposure to psychological stress places mental health providers in a vulnerable position when coping skills are not learned or available. Mental health providers are at risk for both mental and physical illness due to the empathetic demands of their client’s stressors. The deficit in adequate coping skills can cause provider-client relationships to suffer and create an undesirable work environment.

Setting: This project took place in Somerset, KY, at a mental health company called A New Beginnings Achievement Center (ANBAC). Twenty-six employees work at ANBAC, all of whom are involved in providing mental health services to developmentally delayed …

Focused Interventions To Decrease Inpatient Falls, Alyssa Nicole Watchmaker Smith

Doctor of Nursing Practice Papers

Background: Falls are the most commonly reported safety incidence in the hospital setting (Morris R. et al., 2017). Because falls may be a result of many factors, evidence shows that multicomponent fall interventions best reduce fall rates (Bargmann et al., 2020; Dykes et al., 2010; Dykes et al., 2020; Strini et al., 2021). In this project, a needs assessment identified a need for fall prevention strategies to reduce fall rates on inpatient units.

Setting: A step-down/telemetry Cardiovascular Intervention Unit (CVI) (15 beds) and Cardiovascular Unit (CVU) (12 beds) in a suburban private hospital.

Purpose: The purpose of this evidence-based project …

Improving The Integration Of Whole Health Into A Veterans Affairs Outpatient Primary Care Clinic., Diana Lynn Blair

Doctor of Nursing Practice Papers

Abstract

The annual $4.1 trillion price tag for healthcare with a simultaneous decline in patient health outcomes is the catalyst to change the current healthcare culture from disease-focused to a Whole Health wellness and prevention model. Transforming to preventative care would remedy the current costly healthcare system, thus Veterans Health Administration (VHA) set forth a mandate to implement Whole Health (WH) system wide. The purpose of this project was to provide a training program that facilitated the implementation of WH and improve the documentation of WH in the electronic health record (EHR). A needs assessment provided to the Fort Knox …

Ot Clinical And Cultural Preparedness Working With Gender Diverse Clients, Arthur Lui

Occupational Therapy Student Capstones

No abstract provided.

Queering Parenthood Through The Lens Of Occupational Science, Cassey Dela Pena

Occupational Therapy Student Capstones

No abstract provided.

Intergenerational Programming: An Initiation For Implementation For Individuals With Dementia, Joshua Dano

Occupational Therapy Student Capstones

No abstract provided.

The Incorporation Of Universal Design For Learning And Sensory Support In A School Setting, Hailey Houck

Occupational Therapy Student Capstones

No abstract provided.

Empowering Mothers: Navigating Nicu Levels And Ot Supports, Ramandeep Dhillon

Occupational Therapy Student Capstones

No abstract provided.

Decreasing Overall Breast Cancer Risk Through Assessment, Treatment, And Prevention Of Vitamin D Deficiency In The Adult Population, Rachel Jamison

Doctor of Nursing Practice Scholarly Project

The primary objective of this study is to examine the effectiveness of an educational initiative aimed at enhancing nurse practitioners' understanding and recognition of vitamin D deficiency. The purpose of this program is to equip them with the skills to screen, diagnose, and manage this condition to mitigate the overall risk of breast cancer in patients. Vitamin D deficiency is a prevalent global health issue that affects over one billion people, and it can manifest at any stage of life without showing any symptoms, making it challenging for healthcare providers to detect. However, even mild or prolonged deficiencies can lead …

Exploring The Functional Significance Of A Yap1 Missense Variant Of Uncertain Significance In Caenorhabditis Elegans, Nathan Jones

Theses

Polycystic ovary syndrome (PCOS) is a complex disorder with various implications, such as polycystic ovaries, visceral obesity, and increased risk of cancer. YAP1 was recently identified as a gene of interest in the development of PCOS. Researchers have established that single nucleotide variants in YAP1 are likely to play a role in PCOS development. This project aims to provide insight into the potential impact of a YAP1 variant of uncertain significance (VUS). Studies in C. elegans have established yap-1 as a nematode ortholog for human YAP1. A YAP1 VUS was identified through ClinVar, YAP1 c.1015A>G (p.Asn339Asp). Evolutionary conservation …

Promoting Mental Wellness In First-Generation College Students, George Cardenas

Occupational Therapy Student Capstones

No abstract provided.

Un-Barre-D: Decreasing Barriers To Participation For Individuals With Parkinson’S Using Ballet, Lauren Jew

Occupational Therapy Student Capstones

No abstract provided.

Amplifying Success: Providing Ot-Based Support For Deaf And Hard Of Hearing Children In The School Setting, Liana Mae Atizado

Occupational Therapy Student Capstones

No abstract provided.

Multi-Omic Single-Cell Integration For Understanding T Cell Responses In Acute Myeloid Leukemia, Poonam Desai

Dissertations and Theses (Open Access)

In recent years, translational initiatives have gained significant traction within the medical community. Clinical parameters alone have been insufficient to fully understand the intricate mechanisms governing patient responses to disease and therapy. Additionally, single-cell technologies have rapidly advanced to a point where generation of large patient-based datasets is financially and logistically feasible. The integration of clinical information with multi-omic single-cell technologies enables the formation of data-driven hypotheses pertaining to the mechanisms of disease progression and therapeutic resistance. Acute Myeloid Leukemia (AML) is a rapidly-progressing cancer of the bone marrow with poor prognoses and dismal outcomes. Of the adult patients that …