Medicine and Health Sciences Commons^™

Crafting Community Solar Programs To Alleviate Energy Burdens And Empower Communities In Virginia, Elizabeth Anne Sekelsky

Master's Projects and Capstones

Low to moderate-income (LMI) groups usually suffer from high energy burdens and community solar is a renewable energy strategy that can save LMI groups on their monthly electricity bills. This research explores the intersection of renewable energy and energy justice, specifically the potential for community solar, energy efficiency, and home weatherization to alleviate Virginia's energy burdens. Included is an analysis of incentives, programs, and Greenhouse gas emission goals for the state, investigations on how low-income groups are receiving aid and what is available to them from programs and utilities, suitable sites for solar based on groups in need, and comparisons …

Supporting South Korea’S Aging Population: How Ai And Iot Acceptance Connects The Young And Old, Bobby Im

Master's Projects and Capstones

In 2024, South Korea surpassed every other nation by becoming the country with the lowest fertility rate (below 0.7%). Population decline will hinder future ability to care for their aging population and although the government and private corporations are investing millions of dollars on developing Artificial Intelligence-Internet of Things (AI-IoT) devices to support the aging, the acceptance levels and the amount of family support required is undervalued. By examining AI-IoT’s current use and role in South Korea’s public health system this paper shows how intergenerational support helps optimize existing procedures and equipment, increases the level of acceptance and use, and …

Impact Of Temperature On Children’S Nutrition: A Comparative Study Of Three Ecological Regions Of Nepal, Prakriti Shakya

Master's Theses

Nutrition obtained during the growth period of childhood significantly influences long-term well-being and overall productivity, ultimately contributing to the economy of a society. However, weather shocks can wreak havoc by damaging crops, changing yields of important crops and disrupting market access, which directly impacts the food intake of both adults and children. When these adverse events occur during childhood, short term and long term inadequacy in nutrition as well as disease incidence can cause malnutrition leading to stunted growth and cognitive impairment that may persist into adulthood, affecting the labor market and increasing health expenditure. To address this issue, we …

The Impact Of Female Political Leadership On Intimate Partner Violence In India, Khushboo Patel

Master's Theses

Abstract:

This study employs an instrumental variable approach to examine the impact of female political leadership on women’s experiences of Intimate Partner Violence (IPV). It finds that in rural areas with more female leaders, incidents of sexual and psychological IPV increase. The analysis investigates the drivers behind this impact, revealing that entrenched gender norms and expectations, such as a husband’s preference for more sons, may exacerbate IPV. Additionally, despite the increase in female leaders, attitudes toward violence remain largely unchanged. These findings highlight the need for research and policy initiatives that not only encourage female political participation but also specifically …

Matrilineal Ethnic Affiliation And Female Empowerment: Investigating Attitudes Towards Female Autonomy And Health In Ivorian Households, Martine Hind Stølan

Master's Theses

Kinship structure is a fundamental aspect of anthropology, however, there is still a gap in literature on its impact on economic research, particularly regarding female autonomy and health. This study aims to address this gap by examining the influence of matrilineal ethnic affiliation on attitudes towards female autonomy and health within Ivorian households. Using data from the 2011 IPUMS Demographic and Health Survey for the Ivory Coast, using female responses, this study investigates the complex dynamics shaping attitudes towards female autonomy and access to health care. Analysis on these aspects is done using ordinary least squares (OLS) and logistic estimations. …

An Integrated Review: Outpatient Care And Management Of Fever And Neutropenia Among The Pediatric Oncology Population, Sarkis Makarovich

DNP Qualifying Manuscripts

Abstract

In the pediatric population, comprehensive cancer treatment and its associated side effects significantly impact their physical and emotional well-being. Though chemotherapy drugs are valuable agents against cancer cells, they also damage healthy dividing cells, such as bone marrow, thus weakening the immune system. Febrile neutropenia (FN) and associated infections remain the most critical complications of the extensive chemotherapy regimen and can threaten life if not appropriately addressed. Appropriate primary evaluation and treatment of FN in children with cancer includes administering proper broad-spectrum antibiotics. Ongoing research has focused on improving quality of life (QoL); yet, FN has persisted as the …

The Effect Of Slow Tempo Music Listening On Incidence Of Delirium In Skilled Nursing Facilities, Sarah Róise Hartman

Yale School of Medicine Physician Associate Program Theses

Delirium is a syndrome characterized by acute fluctuations in cognition and inattention that significantly affects older adults due to increased age and cognitive impairment. In hospital settings, music listening has shown to be a feasible and effective intervention used to decrease delirium incidence. However, music listening interventions targeting delirium in skilled nursing facilities have not been studied. The objective of this study is to compare music listening to usual care in skilled nursing facilities as a method to decrease incident delirium development. Specifically, this will be a randomized control trial comparing daily slow tempo music listening to usual skilled nursing …

Effect Of Empagliflozin In Adult Patients With Metabolic Dysfunction-Associated Steatohepatitis, Peilin Austin Liu

Yale School of Medicine Physician Associate Program Theses

Metabolic dysfunction-associated steatohepatitis is a severe form of liver disease marked by fat accumulation, inflammation, and scarring, often advancing to cirrhosis. Currently, there are limited therapies to treat this condition. Empagliflozin, a Sodium-glucose cotransporter 2 Inhibitor, that blocks renal reabsorption of glucose, has shown efficacy in reducing liver fat accumulation. However, there are currently no large-scale studies have investigated the effect of empagliflozin in treating metabolic dysfunction-associated steatohepatitis using histological findings. We propose a randomized controlled trial to study the effect of empagliflozin on the resolution of Metabolic dysfunction-associated steatohepatitis. We will recruit participants with histology-confirmed metabolic dysfunction-associated steatohepatitis and …

Effect Of A Multispecies Probiotic With Fluconazole On Oral Candidiasis In Subjects With Hiv, Nicole Romaneschi

Yale School of Medicine Physician Associate Program Theses

Oropharyngeal candidiasis is the most prevalent opportunistic infection among people living with HIV. Fluconazole is the recommended treatment for the disease in immunocompromised patients, but its efficacy is waning with growing resistance of candida, the yeast that causes candidiasis. Studies have shown that probiotics decrease oral candida load, but research about the use of probiotics in HIV-positive individuals with oropharyngeal candidiasis is limited. This study will investigate whether probiotics taken with fluconazole lead to increased remission of oropharyngeal candidiasis signs and symptoms in subjects with HIV when compared to fluconazole monotherapy. Participants will be treated with a two-week fluconazole course …

The Effects Of Acupuncture On Retention Among Patients With Opioid Use Disorder On Methadone, Joshua Horowitz-Benoit

Yale School of Medicine Physician Associate Program Theses

The opioid crisis has resulted in an unprecedented loss of life in the United States and around the world and contributes to the socioeconomic devastation of various underserved and minoritized communities. Methadone is an evidence based, Food and Drug Administration approved treatment that reduces cravings and blunts the euphoric effects of illicit opioids. The drop-out rates from methadone programs, especially in the first 6 months of treatment, remain high. Acupuncture is a millennia old component of traditional Chinese medicine that has been shown to aid in a variety of disease states, including opioid use disorder. The objective of this study …

This (Dis)Abled Person: Professional Receptiveness Towards Future Slps With Disabilities, Billy Allen

Theses & Honors Papers

With increasing levels of diversity within the United States, having the field of speech-language pathology better reflect and represent the changing demographic shifts in society is critically important. Little attention has been given toward the prospect of individuals with disabilities serving in the field despite focused efforts to increase the presence of professionals from racial, ethnic, and cultural backgrounds. This study investigated the receptiveness of practicing speech-language pathologists (SLPs) or communication sciences and disorders (CSD) graduate faculty towards the prospect of individuals with disabilities working as SLPs within the field or entering graduate-level CSD programs. A survey collecting quantitative data …

Asthma And Peak Flow Assessments Based On Nhlbi Asthma Guidelines, Julia Gliceria Almario Regalado

Doctor of Nursing Practice (DNP) Projects

Background: Asthma exacerbations are consequences of poor asthma control. Asthma guidelines-grounded interventions can improve adherence to asthma guidelines and assessments in primary care settings. The goals of asthma management are to optimize asthma control, minimize the risk of asthma exacerbations, and minimize the adverse effects of asthma medications.

Local Problem: A primary care practice in Northern California had frequent office visits for acute asthma symptoms. Ongoing asthma control monitoring is a key performance indicator of high-quality asthma care.

Methods: The quality improvement evidence-based observational project examined the effectiveness of interventions. The pre-and post-survey assessments collected clinician knowledge and adherence, and …

Nurse-Led Telehealth Visits For Patients With Multiple Sclerosis During The Covid-19 Pandemic And Beyond, Eun Hye Kim

Doctor of Nursing Practice (DNP) Projects

Background: Nearly one million individuals are affected with Multiple Sclerosis (MS) in the United States, and it was estimated the annual economic burden of multiple sclerosis in the U.S. at over $85.4 billion in 2022.

Problem: During the outbreak of COVID-19, the number of nurse-led patient education sessions has decreased due to the conversion of in-person clinic visits to telehealth visits. Despite the widespread use of telehealth for MS patients post-COVID-19 pandemic, limited data is available about the use of nurse-led telehealth visits with a standardized workflow.

Method: A quality improvement project was implemented at the MS clinic in Northern …

Fostering Interprofessional Collaboration In Community College Mental Health Centers: A Quality Improvement Project, Sara Jane Hamilton

Doctor of Nursing Practice (DNP) Projects

Background The worsening mental health rates among college students in the United States highlight the critical need for campuses to have high-quality comprehensive mental health centers (MHC). This necessity is particularly urgent in community college MHCs, which often lack these attributes. Local Problem An MHC within a large California community college recently introduced telepsychiatry services and is considering integrating a Psychiatric Mental Health Nurse Practitioner (PMHNP) into their team. However, knowledge gaps and limited interprofessional education (IPE) may hinder effective collaboration within the team. Methods A comprehensive literature review was conducted to assess current research on IPE, community college mental …

Implementing Diabetic Eye Care Education For Healthcare Professionals, Misun Serena Moser

Doctor of Nursing Practice (DNP) Projects

Background: Diabetic retinopathy (DR) is the most common cause of diabetic eye complications and a leading cause of preventable vision loss in American adults. Skaggs et al. (2017) reported that DR screening prevents vision loss by 95%. The evidence reports that only 60% of people with diabetes have attended the recommended DR screenings (Flaxel et al., 2020). Emerging evidence supports patient education about diabetic eye care and its guidelines by health care professionals (HCPs) as the main facilitator to accomplish this goal (Khair et al., 2020; Moinul et al., 2020). Healthcare professionals are pivotal in encouraging or discouraging DR screening …

Education For Primary Care Providers On Advance Care Planning, Lindsey Ward

Doctor of Nursing Practice (DNP) Projects

Background: Advance care planning (ACP) is a discussion of a patient’s end-of-life healthcare wishes. Its purpose is to indicate these wishes clearly should the patient be unable to make their decisions known to providers and family members due to a sudden health decline or medical emergency. Healthcare providers, specifically nurse practitioners, physician assistants, and physicians in the primary care setting, are well-positioned to facilitate these conversations with their older adult patients. However, research states that limited provider knowledge of and confidence in implementing ACP are significant barriers to its application in practice.

Problem: At a primary care clinic in Midtown …

Increasing The Optimal Usage Of The Gad-7 And Phq-9 Screening Tools To Better Detect Co-Occurring Disorders In An Alcohol Use Disorder Clinic, Lauren Swansick

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Co-occurring disorders include substance use disorders and mental health conditions. These disorders affect 21.5 million individuals. Mental health screening tools, such as the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Scale (GAD-7), are effective in screening individuals for depressive and anxiety mental health conditions within addiction settings.

Problem: Of those with an anxiety disorder, 20-40% will be diagnosed with an alcohol use disorder (AUD). Depressive disorders are the most common mental health conditions that can occur alongside an AUD. A literature review revealed that the PHQ-9 and GAD-7 are used in addiction treatment settings; however, not as …

Educating Pediatric Registered Nurses On The Administration Of Prolonged Intravenous Antibiotics, Kasandra Rezler

Master's Projects and Capstones

Abstract

Problem According to Children’s Hospital A's incident reporting system, 50% of problems related to prolonged intravenous antibiotics were classified as administration issues. When mistakes are made in this process, the antibiotic is then delivered at the wrong rate or the wrong time, which is problematic. Additionally, findings from a needs assessment survey highlight a critical need for targeted interventions, such as an educational video, to reduce administration errors associated with prolonged IV antibiotics. Context Within Children’s Hospital A, the microsystems targeted by this quality improvement project consist of inpatient pediatric patient care units (PCU) 300, 360, and 400. Children’s …

Optimization Of Triage Documentation In A Large Urban Emergency Department, Monica Reynoso-Prieto

Master's Projects and Capstones

Problem California ranks ninth nationwide in terms of longest emergency department wait times. The project aims to reduce patient triage times by refining the workflow of triage documentation, achieved through strategic rearrangement of triage documentation questions. Context This quality improvement project took place in the emergency department of a large urban Bay Area hospital. Intervention The intervention was implementation of changes to the triage documentation based on staff feedback from an opinion survey, such as: elimination of redundant questions, consolidation of related categories, and logical reorganization of triage topics. Measures Measures used in the project were triage times and pre …

Refining Triage Documentation Practices In A Metropolitan Emergency Department, Jack A. Moody

Master's Projects and Capstones

Problem California ranks ninth nationwide for its lengthy emergency department wait times, presenting a pressing challenge for healthcare facilities. Context This quality improvement project, set in the emergency department of a large urban hospital in the Bay Area, aimed to address this issue by targeting workflow efficiency through the reduction of triage times. Intervention The intervention centered on implementing changes to the triage documentation, informed by staff feedback obtained through an opinion survey. Proposed modifications included the elimination of redundant questions, consolidation of related categories, and a logical reorganization of triage topics. Measures Key measures utilized in the project included …

Increasing Adherence To A Nurse-Driven Removal Protocol To Reduce Indwelling Urinary Catheter Days, Hannah K. Brosnan

Master's Projects and Capstones

Problem

Nurse-driven removal protocols (NRDPs) have been shown to reduce indwelling urinary catheter (IUC) days and prevent catheter-associated urinary tract infections (CAUTIs). Communication barriers prevent consistent implementation of the NDRP, leading to delayed IUC removal and increased risk of CAUTIs.

Context

The project was conducted in a 16-bed adult surgical intensive care unit (ICU) at a teaching hospital in a major metropolitan area.

Interventions

Urinary catheter reminder posters displaying IUC days were posted at each bedside to prompt discussion of IUC indication and removal. An email describing the project background was sent to all nurses and physicians by the unit …

Enhancing Pain Documentation In Medical Surgical Units: Integrating Supportive Tools With Pain Nursing Education, Mariana Arias

Master's Projects and Capstones

Problem: Pain management in in-patient care, particularly involving opioids, is critical due to the associated risks. Proper pain assessment is essential to ensure safe medication administration and mitigate adverse effects.

Context: This quality improvement (QI) project aimed to improve opioid assessment and documentation rate above 90% compliance in two medical-surgical units, focusing on bedside nurses who play a crucial role in patient safety and effective pain management.

Interventions: A baseline survey provided nurses' understanding on compliance criteria and assessment timing. Interventions included visual reminders, informational posters, and instructions on how to access individual compliance reports.

Measures: A post intervention survey …

Enhancing Peripartum Care Through Standardized Nurse Knowledge Exchange, Gabriela Ochoa

Master's Projects and Capstones

Problem Inconsistent handoff practices during patient transfers can cause mistakes and adverse outcomes. Hospital A's peripartum unit has no set policy for Nurse Knowledge Exchange (NKE) during transfers. This project will introduce a standard handoff guide to enhance communication and prevent harmful results after patient transfers.

Context The quality improvement project was conducted in a peripartum mesosystem within an urban hospital in Northern California. This specific area of the hospital comprised 21 postpartum rooms and nine laboring rooms.

Intervention The project involved a methodical strategy that encompassed engaging stakeholders, conducting a literature review, and analyzing data to pinpoint areas for …

Increasing Awareness And Communication To Decrease Catheter Days In The Surgical Intensive Care Unit, Kamila Fortney

Master's Projects and Capstones

Problem Nurse-driven removal protocols (NRDPs) have been shown to reduce indwelling urinary catheter (IUC) days and prevent catheter-associated urinary tract infections (CAUTIs). Communication barriers prevent consistent implementation of the NDRP, leading to delayed IUC removal and increased risk of CAUTIs. Context The project was conducted in a 16-bed adult surgical intensive care unit (ICU) at a teaching hospital in a major metropolitan area. Interventions Urinary catheter reminder posters displaying IUC days were posted at each bedside to prompt discussion of IUC indication and removal. An email describing the project background was sent to all nurses and physicians by the unit …

Enhancing Nurse Awareness Of A Stroke Patient Satisfaction Survey And Their Significance In Practice, Amanda Dao

Master's Projects and Capstones

Problem As a leading cause of death and disability in the US, strokes often require complex, multifaceted care. Often ignored, patient satisfaction is a crucial aspect of this care and is positively linked to key health indicators. Regulatory guidelines underscore the need for stroke-specific patient satisfaction survey (SSPS) utilization in post-stroke care. Context Hospital X is a large Comprehensive Stroke Center in the Bay Area, serving patients with various stroke etiologies and complexities. At present, its Neuro Observational Unit (NOU) does not administer a SSPS. InterventionTo address this gap in care, an educational presentation using literature evidence in support …

Improving Nurse Support Of Patient Satisfaction Surveys Through Team Huddle Education, Matthew Price

Master's Projects and Capstones

Problem As a leading cause of death and disability in the US, strokes often require complex, multifaceted care. Often ignored, patient satisfaction is a crucial aspect of this care and is positively linked to key health indicators. Regulatory guidelines underscore the need for stroke-specific patient satisfaction survey (SSPS) utilization in post-stroke care. Context Hospital X is a large Comprehensive Stroke Center in the Bay Area, serving patients with various stroke etiologies and complexities. At present, its Neuro Observational Unit (NOU) does not administer a SSPS. Intervention To address this gap in care, an educational presentation using literature evidence in support …

Reducing Barriers To Timely Indwelling Urinary Catheter Removal, Huyen T. Nguyen

Master's Projects and Capstones

Problem Nurse-driven removal protocols (NRDPs) have been shown to reduce indwelling urinary catheter (IUC) days and prevent catheter-associated urinary tract infections (CAUTIs). Communication barriers prevent consistent implementation of the NDRP, leading to delayed IUC removal and increased risk of CAUTIs. Context The project was conducted in a 16-bed adult surgical intensive care unit (ICU) at a teaching hospital in a major metropolitan area. Interventions Urinary catheter reminder posters displaying IUC days were posted at each bedside to prompt discussion of IUC indication and removal. An email describing the project background was sent to all nurses and physicians by the unit …

Standardizing Nurse Knowledge Exchange In The Peripartum Mesosystem, Gabrielle Ann Romena

Master's Projects and Capstones

Problem Handoff report is a significant source of medical error, as reported by the Joint Commission. As it stands, Hospital A’s peripartum mesosystem has no standardized policy regarding the Nurse Knowledge Exchange (NKE) process. Context Hospital A is an urban tertiary care medical center in San Francisco, with its peripartum mesosystem divided into two floors with a total of 35 dedicated beds. Intervention Stakeholder engagement, literature review, and mesosystem analysis identified potential barriers to bedside NKE. To address the identified causes, the project implemented a standardized handoff guide and staff education. Measures The outcome measured was comprehensiveness of NKE as …

Raising The Bar: Optimizing Peripartum Handoff Through Standardized Nurse Knowledge Exchange (Nke), Kimberly Martinez Rn

Master's Projects and Capstones

Problem Hospital X’s peripartum microsystem has no policy guiding the Nurse Knowledge Exchange (NKE) process. Variability in handoffs during patient transfers could lead to medical errors and adverse events. This quality improvement (QI) project aims to pilot a standardized handoff guide to improve nurse communication and avoid adverse patient outcomes following patient transfers. Context The setting for this QI project was a peripartum mesosystem at an urban hospital located in Northern California with 21 postpartum rooms and nine labor rooms. Intervention The project employed a systematic approach that involved engaging stakeholders, analyzing microsystems, reviewing literature, and analyzing data to identify …

Pain Assessment And Reassessment Documentation Improvements In Medical-Surgical Units, Alicia Espinoza

Master's Projects and Capstones

Problem Pain management is essential when providing quality care, and adequate documentation of pain assessment and reassessment with administration of opioid pain medications by nurses is necessary for patient safety and satisfaction. Context Nurses play a pivotal role in providing safe and effective administration of opioid pain medication and documentation of pain assessments. This quality improvement (QI) project aimed to increase opioid medication administration assessment and documentation compliance rate for nurses to 90% or greater in two medical-surgical units. Intervention A knowledge check survey was utilized to assess nurse understanding of required data needed to document, and timing for documentation …