Medicine and Health Sciences Commons^™

Educating Inpatient Pediatric Registered Nurses On The Setup And Administration Of Prolonged Intravenous Antibiotics And The Reduction Of Medication Errors, Kiara Hayden

Master's Projects and Capstones

Problem The acute care unit microsystem of a California children’s hospital encounters issues involving the incorrect set up and administration of prolonged intravenous (IV) antibiotics and medication errors, such as delivery at the wrong rate or time. These problems can result in negative patient health outcomes, delayed healing, antibiotic resistance, and increased length of hospital stay and costs. Context A collaborative quality improvement (QI) project was launched to target the pediatric population of this particular microsystem. The aim of this project was to standardize prolonged IV antibiotic practices, disseminate knowledge while using evidence-based practice (EBP), and improve patient outcomes. Interventions …

Improving Prolonged Antibiotics Education In A Pediatric Unit, Zerena S. Silva Villamonte

Master's Projects and Capstones

Problem Children’s Hospital A's incidence report tool, iCares, demonstrates that 50% of the issues related to prolonged intravenous (IV) antibiotics are categorized as administration issues. This leads to the medication being delivered at the wrong time or rate. Having these issues increases patient length of stay, increasing hospital costs. Context The microsystems for this quality improvement project include inpatient pediatric patient care units (PCU) 300, 360, and 400. Children’s Hospital A is a 361-bed San Francisco Bay Area hospital. Interventions The Clinical Nurse Leader students implemented a presentation defining prolonged IV antibiotics, their rationale, and a video demonstrating the correct …

Unlocking The Potential Of Peripartum Handoff: Standardizing Nurse Knowledge Exchange (Nke), Kiana Killian

Master's Projects and Capstones

Problem The absence of a structured and standardized handoff during patient transfers may result in the unintentional omission of patient information, medical errors and adverse events. No standardized bedside handoff process, referred to as Nurse Knowledge Exchange (NKE), was observed in Hospital A’s peripartum mesosystem during patient transfers from the Labor and Delivery (L&D) unit to the Postpartum unit. Context Hospital A is a medium-sized urban hospital located in Northern California. The peripartum mesosystem includes 21 postpartum rooms and nine laboring rooms. Intervention Through the recruitment of stakeholder engagement, review of literature supporting evidence-based practices, and a mesosystem assessment, a …

Reducing Indwelling Urinary Catheter Days: Improving Interdisciplinary Communication In A Surgical Intensive Care Unit, Karen M. Wong

Master's Projects and Capstones

Problem Urinary catheter nurse-driven removal protocols (UCNDRPs) are evidence-based algorithms that promote the timely removal of indwelling urinary catheters (IUCs) and prevent catheter-associated urinary tract infections (CAUTIs). Communication barriers hinder consistent implementation of the UCNDRP, resulting in delayed IUC removal and increased risk of CAUTIs. Context This quality improvement project was conducted in a 16-bed surgical intensive care unit (SICU) in an academic medical center in the San Francisco metropolitan area. Interventions Urinary catheter reminder posters displaying the duration of IUC days were placed at the bedside to prompt interdisciplinary communication about IUC indication and removal. An email detailing the …

Transforming Peripartum Nurse Knowledge Exchange (Nke) Through A Standardized Handoff Guide, Lillian Quach

Master's Projects and Capstones

Problem: Medical errors and adverse events can result from inconsistent handoffs during patient transfers. As seen in Hospital A’s peripartum unit, there is no formal policy regarding the handoff process, also known as the Nurse Knowledge Exchange (NKE). This quality improvement project aims to introduce a standardized handoff guide to enhance communication and minimize harmful outcomes following patient transfers.

Context: The setting for this project is an urban hospital in Northern California with nine laboring beds and 21 postpartum beds.

Interventions: The project employed a systemic approach involving stakeholder involvement, literature review, and data analysis to identify areas for improvement …

Increasing Opioid Pain Pre-Assessment And Reassessment Documentation Rate In Medical-Surgical Units, Hae Rim (Helen) Hwang

Master's Projects and Capstones

Problem The fifth vital sign, pain, requires proper pain management in hospital settings, often involving opioids with significant risks of adverse reactions. Appropriate pain assessment and management is vital to ensure safe medication administration and mitigate potential adverse reactions.

Context This quality improvement (QI) project aimed to enhance opioid assessment and documentation rate above 90% compliance in two medical-surgical units, with a focus on bedside nurses. Nurses play a key role in administering and documenting pain assessments, a practice crucial to managing patient safety and effective pain management specific to opioid use.

Intervention A baseline survey provided nurses’ understanding on …

Application Of Lymphedema Education Toolkit For Nurse Coordinators, Julian K. Miranda

Master's Projects and Capstones

Problem: There is approximately one in five breast cancer survivors affected by breast cancer-related lymphedema (BCRL), a potentially debilitating condition affecting the physical, emotional, social, and financial well-being of individuals. Context: This Quality Improvement (QI) project was conducted at an outpatient facility of Hospital X’s Women’s Cancer Center. Within this microsystem, there are 24 permanent clinical nurse coordinators and advanced practice providers, with 15 nurse coordinators dedicated to care for patients with breast cancer or gynecological conditions. Intervention: The intervention aims to evaluate if a standardized educational tool improves early interventions for patients with lymphedema and knowledge among healthcare providers …

Empowering Nurse-Driven Removal Of Indwelling Urinary Catheters In The Surgical Intensive Care Unit: A Quality Improvement Project, Ellen Ruby Hann

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 …

Implementation Of Lymphedema Education Toolkit For Nurse Coordinators, Heather Gee

Master's Projects and Capstones

Problem: Lymphedema is a chronic condition that develops secondary to cancer treatments such as chemotherapy, radiation, and surgical removal of affected lymph nodes. This swelling in patient’s limbs can cause discomfort and limit mobility, however lymphedema is often not detected until later stages, delaying treatment and patient education.

Context: This quality improvement project was conducted at Hospital S Women’s Cancer Center, an outpatient center specializing in advanced treatments for breast and gynecological cancers. This center has a multidisciplinary team focusing on both the medical and surgical aspects of oncology treatment.

Interventions: An evidence-based lymphedema education toolkit was created for nurse …

She Has Green Eyes & Trauma: Problematic Depictions Of Mental Illness In Young Adult Novels, Diane G. Mcdonough

College Honors Program

This thesis discusses the problematic ways in which male authors write about female mental illness, and the damage that these portrayals can have on adolescent girls who read them. My first two chapters discuss, respectively, Looking for Alaska and Turtles All the Way Down, both by John Green, with reference to two of his other young adult novels, Paper Towns and The Fault in Our Stars. In these chapters, I explore Green’s depictions of female characters who suffer from mental illness. My third chapter focuses on It’s Kind of a Funny Story by Ned Vizzini and The Perks of Being …

Development Of An Endometriosis Toolkit To Support Clinicians In Providing Quality Care For Women, Rachel Hasbun

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Endometriosis is the abnormal growth of endometrium-like tissue outside the uterine cavity, affecting approximately 11% of women in the United States during their reproductive years. Diagnostic challenges stem from its varied clinical presentations, reliance on laparoscopy for definitive diagnosis, and limited awareness among practitioners and patients, potentially leading to diagnostic delays of up to 13 years.

Problem: The complexities of diagnosing endometriosis in primary care and specialty settings, combined with limited provider awareness and a lack of comprehensive resources, hinder timely and accurate identification. This leads to suboptimal treatment and care for women affected by the condition.

Methods: …

Inservice Education: Management Of Fever And Neutropenia Among The Pediatric Oncology Population, Sarkis Makarovich

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: In pediatric cancer patients, comprehensive treatment and its side effects, such as fever and neutropenia (FN), significantly impact physical and emotional well-being. Prompt evaluation and treatment of FN are crucial to prevent complications. Proper training of parents in preventing, recognizing, and managing low-grade fever and administering antibiotics at home or outpatient settings is essential for positive outcomes.

Local Problem: A multidisciplinary pediatric cancer treatment center in Northern California.

Methods: A pre- and post-assessment evaluation was conducted to evaluate the knowledge acquisition of nurses after an educational intervention.

Intervention: This Doctor of Nursing Practice (DNP) project aimed to enhance …

Exploring Hispanic Immigrant Parents Literacy Needs In Navigating Life With Children In The United States, Michelle Lowry

Seton Hall University Dissertations and Theses (ETDs)

The responsibility of raising a child is demanding on all parents, but immigrant parents with limited literacy skills in English may find parenting even more demanding than native born parents. Hispanic immigrant parents are rarely consulted about their literacy needs. Furthermore, they are often overlooked as experts on their own needs. Using two of the most widely accepted models of literacy, The Simple View of Writing and The Simple View of Reading, this study explored Hispanic immigrant parents' literacy needs in the United States. The current study was conducted on N=30 Hispanic Immigrant parents, ages early 30s to mid 70s. …

Exploring The Perceptions Of Adolescents And Young Adults With Sickle Cell Disease Regarding The Use Of A Mhealth Technology App To Support Their Transition From Pediatric To Adult Care And Adult Self-Management Practices, Jamillah Mansaray

Seton Hall University Dissertations and Theses (ETDs)

Background and Purpose of the Study: The transition from pediatric to adult self- care management practices for Adolescents and Young Adults (AYAs) with SCD is a pivotal period in their life. According to the literature, there is a positive interest and intention toward utilizing mHealth technology apps to support the transition and adult self-management practices. However, mHealth technology apps with appropriate SCD transition and adult self-management features does not currently exist for the AYA population and has not been reported on in the literature. The purpose of thisembedded mixed method study is to explore in AYA’s with SCD, …

Teacher Voices: Stress And Coping Mechanisms Among The Teaching Profession, Jasmine Suttles

Education | Master's Theses

Stress is a natural response that occurs in our body when we feel overwhelmed, and it can manifest in both positive and negative instances. The teaching profession is not exempt from this phenomenon, as it is unique in that educators have multiple roles to play and have to manage and interact with many students simultaneously. Teachers have been described as "exasperated by heavy loads of emotional labor in the classroom" (Ferguson et al., 2022). This "heavy load" can place the teaching profession at risk of stress and burnout if self-care is not addressed or mental health resources are not offered. …

Assessment Of Gait, Balance, And Falls In Individuals With Neurodegenerative Diseases, Lauren Tueth

WUSM Theses and Dissertations – All Programs

Neurodegenerative diseases are a group of disorders that impact the brain and lead to neuronal degeneration. This degeneration causes many different symptoms, which are often grouped into motor, cognitive, and psychiatric domains. Individuals with these disorders can experience symptoms from multiple domains at the same time, but little is known about how these distinct symptoms may impact each other.

In Chapter 2, we explored the intersection of balance and cognitive impairment in individuals with Alzheimer disease (AD). AD is traditionally discussed in the context of the dementia symptoms, but people with AD also experience motor deficits. Falls are a huge …

Measurement Of And Contributors To Developmental Coordination Impairment, Jeffrey D. Konrad

WUSM Theses and Dissertations – All Programs

Movement drives childhood development. As motor skills improve across development, a child becomes capable of greater interactions with their physical and social environment. Children with motor impairments miss out on these interaction opportunities and their development across a variety of domains can suffer. There is accumulating evidence that poor motor competence relates to an array of developmental outcomes such as educational achievement, reading skills, social development, and emotional regulation. Two developmentally important motor impairments are poor motor competence and hyperactivity which are associated with Autism Spectrum Disorder (ASD), Developmental Coordination Disorder (DCD), and/or Attention Deficit Hyperactivity Disorder (ADHD). Critical to …

Reducing Delirium In Post-Surgical Patients Through Pre-Operative Risk Assessment Screening: A Policy Option, Skye Porter Berg Msn, Fnp

Doctor of Nursing Practice Final Manuscripts

One of the major complications and reasons for prolonged stay amongst patients who undergo surgery is related to the occurrence of hospital associated delirium. Unfamiliar environment, previous comorbidities, age and anesthesia can alter and affect cognitive status in the general population. While there is substantial evidence previously listing high risk patients through demographics as well as prior medical history, this study collectively gathers information based upon prior evidence-based practice data to determine the benefit of prescreening patients through use of a predictive indicator tool. Based on the literature review and inclusion data gathered from fifty patients undergoing surgery, it was …

Implementing Animal-Assisted Therapy During Psychiatric Intakes, Rebecca Dorne

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based project is to determine if Animal-Assisted Therapy (AAT) causes improvements in veterans’ feelings of anger, anxiety, depression, and suicidality in the acute psychiatric setting during psychiatric evaluations. The project aims to provide veterans with an additional way to experience short-term relief from symptoms while discussing their symptomology with mental health providers.

Background: The prevalence of depression is 20% higher in veterans than in that of the general population. Similarly, it has been shown that 23% of all veterans using VA care have had PTSD at some point in their lives. In the Psychiatric Emergency …

The Enzymatic Regulation Of Contraction-Induced Toll-Like Receptor 4 Shedding From C2c12 Myotubes, Rebekah C. Gridley

Health, Exercise, and Sports Sciences ETDs

Stimulated contractions are shown to increase toll-like receptor 4 (TLR4) release from C2C12 myotubes in vitro. The purpose of this study was to determine if the release of TLR4 from myotubes is controlled by proteolytic membrane cleavage. A broad-spectrum metalloprotease inhibitor was used to test this hypothesis in a C2C12 cell culture model, and TLR4 concentrations in the cell culture supernatant were measured via enzyme-linked immunosorbent assay (ELISA) following stimulated myotube contractions.

ELISA analysis revealed TLR4 concentrations below the sensitivity threshold of the ELISA kit for all experimental conditions. In confirming the effectiveness of the electrical pulse stimulation (EPS) treatment, …

The Relationship Between Autistic Traits, Autistic Camouflaging, And Adults’ Representations Of Abstract And Social Concepts, Henry Tomiser, Katja Wiemer Dr.

Honors Capstones

Concrete concepts (e.g., BUTTON) can be experienced directly by the senses, whereas abstract concepts (e.g., FRIENDSHIP) cannot. Additionally, the mind may represent abstract concepts using more introspective, social, and emotional information than concrete concepts. Social difficulties are one defining feature of autism, and autistic individuals may use social camouflaging to hide these difficulties, but the precise nature of social processing in autism is not known. This study aims to explore possible links between autistic traits, autistic camouflaging, and mental representations of concepts. Participants gave open-ended definitions for concepts varying in concreteness and social content via an online survey. Responses were …

Youth Interest In Reusable Menstrual Hygiene Products: An Opportunity For Improving Menstruation Management, Makenna R. Eccles

College Honors Program

Adolescents experience inconsistent menstrual hygiene material access that is exacerbated by poverty and results in menstruation management difficulty, health risks, and interruptions to school attendance. The study centered the adolescent menstruation management experience through qualitative interviews to identify management difficulties and to assess knowledge, interest, and perceived feasibility of implementing reusable menstrual hygiene materials such as reusable sanitary pads, period underwear, menstrual cups, and menstrual disks to improve both menstrual hygiene access and menstrual management experiences. Inductive and deductive coding was used to analyze interview data and identify key themes. Adolescents expressed interest in reusable menstrual hygiene materials due to …

Exploring Complex Daily Tasks In Preclinical Alzheimer Disease, Audrey A. Keleman

WUSM Theses and Dissertations – All Programs

Alzheimer disease (AD) is a slowly progressive neurodegenerative disorder marked by a gradual decline in cognitive functions and ability to perform daily activities. AD begins with a clinically silent period in which pathological abnormalities accumulate in the brain before cognitive impairments occur (i.e., while individuals remain cognitively normal [CN]). This stage is known as preclinical AD and can last up to two decades. It can be identified by measuring biomarkers of AD using neuroimaging or biofluid techniques. In the United States alone, it is estimated that nearly 46 million individuals are in the preclinical stage of AD and at risk …

Improving Treatment Adherence Of Chronic Disease Management In Patients Presenting To The Interventional Pulmonary Perioperative Services With Telephone Follow-Ups, Victoria Dao, Desiree Camille Nanat

Doctor of Nursing Practice Final Manuscripts

Abstract

Purpose of Project: The purpose of this evidence-based practice (EBP) project was to review research-based evidence systematically and to implement evidence-based change in practice in the clinical setting. The goal is to improve treatment adherence in patients with obesity, hypertension (HTN), type 2 diabetes mellitus (T2DM), and obstructive sleep apnea (OSA) by providing telephone follow-ups within 30 days post-perioperative discharge.

Background: Obesity, HTN, T2DM, and OSA continue to pose significant challenges to the United States healthcare system. Nonadherence to prescribed management of these chronic diseases is prevalent among patients presenting to the perioperative department of a regional academic hospital …

Influence Of Social Media On Mothers’ Decision-Making Regarding Vaccinations, Wendy Michele Patterson

Walden Dissertations and Doctoral Studies

This study involved determining why mothers hesitate to vaccinate their children and where they get their information about vaccinations. This descriptive qualitative study guided by the health belief model explored the influence social media has on mothers’ perceived barriers to vaccinating their children. A descriptive qualitative approach was used, and one-on-one audio interviews were conducted via Zoom or in person with 19 participants. Participants were mothers 19 or older, had children between zero and 18, made medical decisions for their children who resided in their household, and sought information about vaccinations via healthcare providers, social media platforms, friends, or family. …

The Lived Experiences Of High-Performing Black Male Students With Advanced Placement Courses, Griselda Almonte-Delgado

Seton Hall University Dissertations and Theses (ETDs)

Black male students are underrepresented in Advanced Placement (AP) courses. Studies on the perspective and experiences of high performing Black male students with Advanced Placement (AP) is limited. Available research indicates that high performing Black students are enrolled at half the rate of White students both nationally and locally in Advanced Placement (AP) courses (Dept. Of Civil Rights, 2021). Research uncovers multifaceted factors influencing enrollment, ranging from personal motivation to systemic barriers. To qualitatively address this dissonance, this research used Attribution Theory as its framework to examine the lived experiences and perceptions of eight high performing Black male students from …

Hiv Preventive Care Services For Pregnant Women In Kenya Before And During The Covid-19 Pandemic, Modesta Vesonder

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic significantly affected access to prenatal and postnatal care services for pregnant women living with HIV (PWLHIV) in counties in the Central, Eastern, and Rift Valley regions of Kenya. Many PWLHIV in some counties in Kenya faced challenges in accessing treatment services. In urban counties such as those in the Central region, HIV preventive care services were accessed with minimal disruption. Counties in the semi-arid of Eastern and Central regions experienced some disruptions in the provision of HIV preventive care services for PWLHIV. The periods under consideration were before the COVID-19 pandemic (2019) and during the COVID-19 pandemic …

Toothbrushing And Flossing Sequence: The Most Effective Way To Reduce Dental Plaque Biofilm, Kimberly Ann Obiedo

Dental Hygiene ETDs

Dental plaque biofilm remaining on oral structures causes disease processes such as gingivitis, periodontitis, and dental caries. This study's purpose was to determine which sequence of dental biofilm removal is more effective, toothbrushing followed by flossing or flossing followed by toothbrushing. The study was conducted using an experimental approach with a split mouth design. A pre and post plaque index score was determined for each participant using Ramfjord’s tooth assignment and all data was recorded on a plaque control data sheet. Thirty-two adults were eligible to participate in the study. The average results of the primary plaque score were 78% …

Evaluating On-Screen Edit Checks For Improving The Quality Of Healthcare Data, Emel Seker

Theses and Dissertations

This study investigates the impact of on-screen edit checks (OSECs) on reducing data entry errors in Electronic Data Capture (EDC) systems, addressing a gap in existing literature on the efficacy of OSECs. Employing a crossover experimental design, the research utilizes deidentified neonatal opioid withdrawal data from the ACT NOW CE study. Twenty participants were divided into two arms to enter data into an electronic case report form (eCRF): one arm began with OSECs enabled and the other without and transitioned to the opposite halfway through. Each participant processed 20 cases, yielding a total of 130,815 data points across 285 questions …

The Perceptions Of A Nurse-Led Telehealth Discharge Program On Continuity Of Care For Pediatric Rheumatology Patients, Adrienne Ramirez

Doctoral Projects

When pediatric rheumatology patients are discharged from a hospital, they are given a complex discharge plan which involves responsibilities in self-managing their care at home. This creates an overwhelming time for patients and families who may have questions or concerns during this time. In order to address this care gap and provide continuity of care, this quality improvement project implemented a nurse-led telehealth discharge visit intervention to 15 pediatric rheumatology patients during the transition from hospital discharge to outpatient care. This quality improvement (QI) project also aims to describe the patients’ perceptions of the nurse-led telehealth discharge intervention on continuity …