Medicine and Health Sciences Commons^™

Viscoelastic Monitoring In Major Hepatic Surgery: An Evidence-Based Practice Project, Randy Kinietz

Doctor of Nursing Practice Scholarly Projects

Patients undergoing major hepatic surgery are at high risk for intraoperative transfusion of allogenic blood products. These patients are at increased risk due to pre-existing hepatic pathology, surgical stress, and the complexity of surgical procedures. While blood product transfusion may be necessary to support hemostasis and hemodynamics, it is not without risk. Current literature states that viscoelastic monitoring is superior to traditional laboratory values when guiding transfusion during major hepatic surgery. Viscoelastic monitoring is a term used to describe the measurement of change in viscoelastic properties of whole blood during clot formation. There are two readily available point-of-care types – …

Routine Evaluation With Gastric Ultrasound To Reduce Gastric Aspiration (Regurga), Joel Jackson

Doctor of Nursing Practice Scholarly Projects

When a patient undergoes anesthesia, there are inherent risks that the providers should protect the patient from. Despite adherence to fasting guidelines established by the American Society of Anesthesiologists (ASA), patients undergoing anesthesia continue to experience intrapulmonary aspiration of gastric contents. There are several factors that delay gastric emptying, including coexisting disease, trauma, pain, and opioid use. Gastric ultrasound assessment of the gastric antrum is a relatively new technology in anesthesia and can be used to assess the gastric antrum and provide information to anesthesia providers regarding the risk of aspiration in the perioperative period. The primary aim of this …

Recommending An Eras Guideline For Patients Undergoing Total Joint Arthroplasty, Kahl Knapke

Doctor of Nursing Practice Scholarly Projects

Enhanced recovery after surgery (ERAS) is a comprehensive guideline that guides patients' care throughout their surgical journey. ERAS is intended to reduce the body’s response to the many stressors of surgery. ERAS is proven effective in various specialty surgical areas, including orthopedics. Orthopedic surgery rates increase parallel with the patient population ages, indicating a need for more joint replacements. Implementing an ERAS guideline reduces healthcare costs to the patient and hospital facility by reducing the length of stay (LOS) and complications postoperatively. The investigation revealed a lack of consistent direction of care, and the developed approach for patients undergoing joint …

Guidelines For The Optimal Assessment Of Airway To Predict Difficult Intubation, Morgan Kleinfelder

Doctor of Nursing Practice Scholarly Projects

Managing the airway is the cornerstone of anesthesia care. However, difficult airway or intubation is not clearly defined. A major complication with a difficult airway is a cannot intubate, cannot ventilate (CICV) situation, which is reported to be as high as 10%. In addition, according to the American Society of Anesthesiologists (ASA) Closed Claim Study, "Adverse respiratory events are the most common type of injury, with difficult intubation [DI] and ventilation contributing to most of the cases. Twenty-eight percent of all anesthesia deaths are related to a CICV situation. As anesthesia evolves, basic airway assessments were developed and include mallampati …

Evaluating Nurses’ Turnover Intention And Organizational Commitment Following Stroke Unit Staffing Changes: An Evidence-Based Quality Initiative, Heather M. Tatusko Phiri

Doctor of Nursing Practice Scholarly Projects

Nurses are known to be overworked, overwhelmed, undervalued, and understaffed at dangerous levels throughout various inpatient hospital units across the United States (U.S.). Hospital registered nurse (RN) turnover is a significant issue that has accelerated since the COVID-19 pandemic, resulting in economic impacts and other burdens for organizations, individuals, and communities. Evidence suggests that evaluating Registered Nurses’ Turnover intention (NTI) and Organizational Commitment (OC) can help maintain a ready and capable team of skilled RNs; however, most healthcare organizations (HCOs) do not collect or analyze NTI and OC data and focus on staffing numbers and monetary incentives to get adequate …

Educating Nurses On Frequent Oral Care For Mechanically Ventilated Patients: An Evidence-Based Practice Project Proposal, Grace Alford, Susan Butz, Ruth Chavez, Joy Shoemaker

Doctor of Nursing Practice Scholarly Projects

The final scholarly project proposal is to implement oral care education for nurses in an intensive care unit (ICU). The proposal aims to create a guideline for an investigator to implement oral care recommendations for mechanically ventilated patients in order to reduce ventilator-associated pneumonia (VAP). The proposal consists of obtaining VAP data and oral care charting data for the unit studied, steps for providing oral care education, and analysis recommendations. Oral care involves swabbing the patient’s mouth every two hours with a swab and mouthwash. Oral care education would include handouts and direct teaching. The proposal aims to increase oral …

Development Of A Rotem-Guided Transfusion Algorithm In Cardiothoracic Surgery Patients, Kourtney Jane Snyder

Doctor of Nursing Practice Scholarly Projects

Abstract

Cardiothoracic surgical patients are at an increased risk for bleeding complications for various reasons, including induction of hypothermia, initiation of the coagulation cascade, degradation of the coagulation factors, mechanical destruction of platelets, and a systemic inflammatory response due to cardiopulmonary bypass (CPB). The American Society of Anesthesiologists recommends rotational thromboelastometry (ROTEM)-guided transfusion algorithms for perioperative blood management; however, there remains a heavy reliance on conventional coagulation laboratory values. Utilization of the following PICOT question will guide this project: In cardiothoracic surgical patients, how does the use of ROTEM versus traditional coagulation laboratory tests (PT, INR, aPTT, ACT, platelet count, …

Development Of Evidence-Based Clinical Practice Guidelines For The Prevention Of Peripheral Neurological Injury During Robotic-Assisted Prostatectomies For Patients In The Steep Trendelenburg Position, Tyler Wolpert

Doctor of Nursing Practice Scholarly Projects

Robotic-assisted surgery (RAS) is becoming more prevalent in modern surgical practice and is currently being utilized in a range of surgical specialties from colorectal and gynecological procedures to bariatrics and orthopedics. Every surgical procedure has potential risk to patients, however robotic-assisted laparoscopic prostatectomies (RALP) in the steep Trendelenburg (ST) position poses unique risk for peripheral nerve injury (PNI). Despite attempts to reduce the incidence rate of PNI during RALP, injuries are still occurring to patients causing patient harm and anesthesia provider litigation. The implementation of a CRNA based safety checklist may reduce the incidence rate of PNI and provider litigation …

Educating Nurses On Frequent Oral Care For Mechanically Ventilated Patients: An Evidence-Based Practice Project Proposal, Grace Alford, Susan Butz, Ruth Chavez, Joy Shoemaker

Doctor of Nursing Practice Scholarly Projects

The final scholarly project proposal is to implement oral care education for nurses in an intensive care unit (ICU). The proposal aims to create a guideline for an investigator to implement oral care recommendations for mechanically ventilated patients in order to reduce ventilator-associated pneumonia (VAP). The proposal consists of obtaining VAP data and oral care charting data for the unit studied, steps for providing oral care education, and analysis recommendations. Oral care involves swabbing the patient’s mouth every two hours with a swab and mouthwash. Oral care education would include handouts and direct teaching. The proposal aims to increase oral …

Education Of The Effects Of Obesity Medications And A Stepwise Approach To Mitigate Prevalence And Encourage Lifestyle Medicine For Primary Care Physicians, Kiely M. Curran

Department of Nutrition Student Projects

My Capstone project is an Educational Manual that emphasizes a healthcare team approach to the treatment and management of obesity. The Educational Manual consists of a standardized protocol in management of obesity in patients and a document with summarized references for primary care providers; and a simplified document for patient education. There is a growing interest in the usage of obesity medications. The purpose of my Capstone project is to provide a simplified manual for the primary care provider to reference to make knowledgeable and patient-centered decisions in the prescription of obesity medications and decisions in weight-management. My methodology included …

Evidence-Based Practice Guidelines For The Surgical Patient With Obstructive Sleep Apnea, Aaron Mcneilan

Doctor of Nursing Practice Scholarly Projects

Obstructive Sleep Apnea (OSA) is a medical condition which many people may be affected by but may be unaware of the presence of the condition. The incidence of OSA has increased in direct correlation with the rising rate of obesity in the general population. While chronic conditions may arise if OSA goes untreated, patients with OSA also have an increased risk for acute complications following surgical procedures such as airway obstruction, hypoxia, brain damage, and death. Many anesthetic medications administered during surgery exacerbate the pathological consequences of OSA, predisposing patients to adverse respiratory events during the recovery period following a …

A Survey Of Nurse Preceptor Preferences Regarding Training Topics: A Descriptive Study, Janice Yao Valadez

Doctoral Projects

Background: The nurse preceptor role can be as challenging and demanding as it is critical in the context of nursing shortages and burnout. The improvement of nurse preceptor training, based on preferences expressed by the nurses fulfilling this role, therefore represents a potentially important part of the solution to these problems.

Methods: A modified version of the +RN Learning Needs Assessment tool was administered to 24 nurse preceptors who precepted in the nurse residency program on two campuses of a not-for-profit Western US hospital, regarding their preferences for topics to be covered in preceptor training, as well as the sequence …

Adaptive Leadership: Nurse Executives Building Organizational Adaptive Capacity During Times Of Crisis, Challenge, And Change, Kristian Poitier

Dissertations

Purpose: The purpose of this exploratory phenomenological study was to identify and describe the strategies used by nurse executives in acute care hospitals to build an adaptive capacity based on the five key characteristics of adaptive leadership identified by Heifetz et al. (2009).

Methodology: This qualitative phenomenological study identified and described the perceived impact of adaptive leadership on building an organization’s adaptive capacity as perceived by nurse executives in acute care hospitals, for-profit and not-for-profit, with the title of chief nursing officer (CNO) or chief nurse executive (CNE) in Southeast, West, and North Florida. The researcher was part of a …

A Multimodal Intervention To Aid In Smoking Cessation, Lauren Druzbicki

Evidence-Based Practice Project Reports

The Centers for Disease Control and Prevention (CDC; 2023a) notes there are 28.3 million smokers in the United States. In Indiana alone, nearly 29% of adults currently use tobacco, with 19% of the total being cigarette smokers (Indiana Department of Health, 2022). The purpose of this evidence-based practice (EBP) project was to implement a multi-modal intervention to aid in smoking cessation in adults aged 18 and older who are cigarette smokers. The intervention included physician/nurse advise using the ask, advise, refer (AAR) model, the SmokefreeTXT program, and FDA approved smoking cessation medications. The project took place at a primary care …

Proposal: How Does The Total Sugar Intake Impact Cognitive Function In Children 10 Years Of Age?, Andrew O. Laidlaw, Camila Arrieta, Shoshana Yachnes

Department of Nutrition Student Projects

The effects that high sugar intake has on cognitive function is an ongoing topic in research today. Although most studies point to a negative relationship between the variables, the evidence is not conclusive enough to be able to confirm its true effect. While evidence finds an association between high sugar intake and chronic diseases, its impact on cognitive function is yet to be determined. The purpose of this proposed research study is to examine how total sugar intake impacts the cognitive function in children. Fifty children, age 10, will be randomly chosen from schools in South Florida for a cross-sectional …

Research Proposal: The Effects Of Creatine Supplementation On High School Athletes, Rebecca Kerr, Lacaya Evans

Department of Nutrition Student Projects

Creatine is commonly used among the adolescent athletic population. The prevalence rates are higher for anaerobic sports, for example, wrestling, football, and hockey. While creatine is a supplement of choice for many young athletes, its effects on performance are not well researched. Though studies point toward it being effective and safe, with few negative side effects documented, further analysis is needed to ensure it will not affect teens’ development. Therefore, this study aims to examine how creatine supplementation by high school athletes affects muscle development and its safety. Distributing creatine supplements to youth raises ethical concerns. Therefore, this study will …

Research Proposal: Turmeric Supplementation And Inflammation Reduction In Adults With Rheumatoid Arthritis, Alyssa Lietz, Jennifer Haynes, Hunter Taylor

Department of Nutrition Student Projects

Rheumatoid arthritis (RA) is an autoimmune and inflammatory disease that affects roughly 1% of the world's population. While disease-modifying antirheumatic drugs (DMARDs) are mostly used for the treatment of RA, aiming to alleviate symptoms and prevent disease progression, there are limitations such as causing gastrointestinal toxicity and economic burden. In contrast, traditional Chinese medicine, specifically supplements containing turmeric, has gained attention for its potential to mitigate RA symptoms and delay disease progression. Turmeric, with its long history of medicinal use dating back thousands of years, offers a cost-effective and accessible alternative to DMARDs. The purpose of this research is to …

Steps To Success: The Lived Experiences Of College Students On The Autism Spectrum, Magdalene Pearl

Online Theses and Dissertations

Young adults on the autism spectrum are likely to experience an occupational imbalance after graduating high school. This is evidenced by the approximately 37% to 50% of youth with autism who report unemployment or not continuing their education after high school and their researched struggles with managing mental health conditions, living independently in the community, and engaging in social activities. In order to better understand the perspectives of young adults with autism experiencing an occupational imbalance after graduating high school, this thesis aims to explore the experiences of college students with autism using a qualitative approach. College students with autism …

Effectiveness Of Virtual Reality In Anesthesia Machine Education, Heather Milder, Rachel Geisendorfer

Doctor of Nursing Practice Projects

The anesthesia machine is an essential part of anesthesia practice, as it connects the patient to the provider and provides a constant stream of vital information. Therefore, the Certified Registered Nurse Anesthetist (CRNA) should be trained to utilize and troubleshoot the anesthesia machine to deliver high-quality patient care. Education about the anesthesia machine begins with Student Registered Nurse Anesthetists (SRNAs) through various learning opportunities. Immersive virtual reality simulation has emerged as a potential educational aid to engage active learners. This project aimed to determine the effectiveness of utilizing the immersive virtual reality simulator SIMVANA for first-year Southern Illinois University Edwardsville …

Emr Templates For Age-Appropriate Well-Child Pediatric Visits, Alison Drerup, Kelsey Piper

Doctor of Nursing Practice Projects

The world of pediatric medicine is continually evolving. The Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) regularly update guidelines to have the most current information available to providers and their patients. The overwhelming majority of primary care offices have transitioned to electronic medical records (EMRs) for charting purposes. Templates included in EMRs ease the workflow and documentation process for providers. In the primary care setting, templates include essential information discussed at well-child visits, such as developmental milestones, vaccination schedules, and anticipatory guidance. The project’s purpose was to update the age-specific well-child templates at …

Student Veterans’ Transition To Nursing Education: Barriers And Facilitators, Bruce P. Hunter, Steven Busby Dr., Jeannie Giese Dr., David Phillippi Dr.

DNP Projects

Student Veterans’ Transition to Nursing Education: Barriers and Facilitators

Abstract

The transition for student veterans from military service to higher education can be a challenging endeavor, especially for those pursuing an education in nursing. While the experiences and perspectives of each student veteran is unique, their successful integration into an academic environment can be influenced by a complex array of barriers and facilitators. This mixed-methods study aims to explore the themes and concepts that can be found in the transition experiences of student veterans in nursing education, with a focus on identifying the barriers they face and the facilitators that …

Promoting Mental Health And Well-Being Among Undergraduate Nursing Students: A Practice Guideline, Armen Mailyan

DNP Projects

Poor mental health and well-being among undergraduate nursing students negatively affects social dynamics, communication, decision making, and stress management, thus compromising the quality of healthcare delivery and patient care outcomes. It is imperative that nursing programs support students to develop positive self-care, resilience, and mental health skills while in school to foster their well-being, enhance their academic success, and to promote high-quality, patient-centered care in their future practice. The purpose of this Doctor of Nurse Practice (DNP) project was to develop a mental health and well-being practice guideline with a comprehensive set of evidence-based interventions for academic nursing programs to …

Nutritional Deuterium Depletion And Health: A Scoping Review, Nicole Korchinsky

Department of Nutrition Student Projects

Background: Deuterium depletion is an untapped area of energy metabolism and health.

Objectives: The purpose of this scoping review is to examine the health effects through deuterium depletion via deuterium-depleted water and a deuterium-depleted diet (ketogenic).

Methods: A protocol process approach was used to retrieve current research in deuterium depletion.

Results: 15 research articles were used. Deuterium depletion was found to have beneficial health effects in the following conditions: cancer prevention, cancer treatment, depression, diabetes, long-term memory, anti-aging, and sports performance.

Conclusion: Even with limited data, consistent deuterium depletion was seen across all conditions reviewed. …

Research Proposal: The Effects Of Dietary Zinc On Adhd Signs And Symptoms In Teenage Females: A Randomized Controlled Trial, Sarai Logan, Andrea Villalba Torres, Amanda Miller

Department of Nutrition Student Projects

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder marked by inattention, hyperactivity, and impulsivity. ADHD presents difficulties for adolescents, affecting numerous areas of life. Recent research suggests a relationship between zinc deficiency and ADHD symptoms, encouraging interest in dietary interventions utilizing zinc. However, there is missing research regarding effects of zinc use for ADHD symptoms in young girls as the generalized research is geared toward boys who express ADHD characteristics differently. The objective of this study is to explore if zinc-rich diets may improve signs/symptoms in girls 13 to 17-years-old with ADHD. An intervention design will be adopted with …

Cultivating Resilience In Adolescence: How Educational Environments Can Support Positive Youth Development During Identity Exploration, Heather I. Arndt, Genesis G. Larin, Gladis Abigail Munguia, Henry William Perez, Dianne Preciado

LMU Theses and Dissertations

Adolescence is a critical stage of human development, one that can be especially challenging for teens that are navigating certain vulnerabilities in their identity formation. With the World Health Organization stating that 14% of 10–19 year-olds experience mental health conditions, educational environments are increasingly needed to address mental concerns in their curriculums. This qualitative research project used a combination of art based inquiry and narrative analysis to answer the following question, “How can educational environments promote resilience and positive youth development during adolescent identity exploration?” Findings illuminated several emergent themes that culminated in the following four recommendations for educational environments; …

Preyemary Care Optical Coherence Tomography: Increasing Adherence To Retinopathy Screening, Henry Junior Peña

Doctoral Dissertations & Projects

Background: Diabetic retinopathy (DR) is a leading cause of preventable blindness in working age adults in the United States. Nonadherence to screening recommendations persists due to significant barriers. Early detection is crucial to mitigate economic burdens and improve patient outcomes. This quality improvement project aimed to increase DR screening access for patients with diabetes at an urban Midwest safety net clinic by implementing an optical coherence tomography (OCT) screening program. Methods: A 12-week, cross-sectional study design using convenience sampling to recruit adult diabetic patients, type-1, or type-2, at a Midwest primary care clinic. Intervention involved retinal imaging scans of participants …

Proposal: Antioxidants’ Impact On Preventing Oxidative Stress-Related Conditions In Oral Health, Sophia Franco, Beanna Cumella, Emily Lopez-Martin, Julia Birman

Department of Nutrition Student Projects

Oxidative stress-related conditions result from an imbalance of reactive oxygen species (ROS) as harmful free radicals overwhelm our body’s supply of antioxidants. Excess free radicals cause damage to cells, DNA, or protein, creating oxidative stress. The purpose of this presentation is to evaluate the contribution of antioxidant-rich mouthwash in improving the antioxidant capacity of saliva and the prevention of oxidative stress-related conditions in oral health among the adult population. A randomized control trial will be conducted in Nova Southeastern University's dental clinic. A total of 200 participants will be included in the study; 100 will receive the control mouthwash containing …

Female Athlete Triad And Bone Stress Injuries, Amanda Nguyen

Honors College Theses

The Female Athlete Triad is still an ongoing and developing diagnosis that analyzes low energy availability, and its impact on menstrual dysfunction and bone mineral density in women. Through researching I analyzed what the Female Athlete Triad was, how it impacts our body and performance, and specifically how it relates to bone stress injuries. It was found that athletes with low energy availability are more likely to develop menstrual dysfunction, leading to low bone mineral density due to the negative impacts that both low energy availability and menstrual dysfunction have on important hormones. With low bone mineral density and compensations …

"Salir Adelante": Improving The Quality Of School Entrance Physicals For Immigrant Minors, Jennifer Sternberg, Elizabeth Morse

DNP Projects

The purpose of this QI project was to improve the delivery of school physicals in the setting of an -friendly non-profit safety-net clinic by creating a patient-centered clinical pathway to improve focused screening and referrals for newly arrived migrant children and their families by routinely assessing and addressing behavioral health care (BH) and social determinants of health needs (SDoH).

Using QI methodology and Donabedian’s Structure Process Outcomes framework, the project team implemented a clinical pathway that included an immigration-focused history of present illness, systematic behavioral health (BH), and social determinants of health (SDoH) screenings embedded within an electronic health record …

Effects Of The Sudden Reduction Of Social Enrichment On A Novel Rat Model Of Approach Orientation, Emily Feldman

Undergraduate Honors Theses

The goal of the present study was to evaluate the effects of a reduction in social enrichment by measuring behavioral changes in the Elevated Plus Maze (EPM) in male and female rats of High Approach (HAO) and Low Approach Orientation (LAO). The results indicated that at baseline, both total arm entries and open arm entries were affected by Approach Orientation and Sex. The percent change in closed arm entries in female LAO was sensitive to a sudden transition from high to standard social enrichment, whereas those in the female HAO and both male groups were behaviorally unaffected. The female LAO …