Medicine and Health Sciences Commons^™

Assessment Of Nursing Knowledge Before And After Implementation Of Educational Intervention On Heart Failure, Sarah Scott

Dissertations

Purpose: The purpose of this study was to assess the knowledge of nursing staff on a cardiology unit before and after the implementation of heart failure specific education. Methods: Forty staff nurses on a cardiology unit at a single institution were given The Nurses Knowledge of Heart Failure Education Principles Survey (NKHFEP), a validated tool to assess nursing knowledge of heart failure. A series of four educational sessions were given to the same forty nurses. They were then given the NKHFEP survey a second time to assess change in knowledge post educational intervention. Results: The mean of Pre-education (M = …

Implementing The Cdcs Core Elements Of Outpatient Antibiotic Stewardship Program Into The Urgent Care, Deanna Powelson

Dissertations

Purpose: The inappropriate use of antibiotics has led to the development of antimicrobial

resistance which is a severe threat to the public and an increasing global problem. The

Centers for Disease Control and Prevention (CDC) estimates at least two million illnesses

and 23,000 deaths are caused by antibiotic-resistant bacteria in the United States (CDC,

2014). The purpose of this quality improvement (QI) project was to evaluate the

effectiveness of an antibiotic stewardship program (ASP) on urgent care providers'

prescribing on viral respiratory tract infections (RTIs) including the common cold,

pharyngitis, and bronchitis.

Methods: This QI project implemented the CDCs Core …

An Exploration Of Nicu Nursing Staff Perspective On The Change From Pod To Private Room Patient Care, Julie Nickles

Dissertations

Neonatal Intensive Care Units (NICU) are designed to care for critically ill newborns who require constant care. The design of the NICU may have an impact on not only the patient and their family but also the nursing staff. Historically neonatal intensive care have employed a cohort model of care. In this model multiple infants are in the same room or pod. With success of single room maternity care, the increased need for changes in neonatal care became apparent. Today, new parents desire extended contact with their extremely preterm and often very sick infant. This trend has led a standard …

Aligning With Patient-Centered Medical Home Standards: Depression Screening In Primary Care, Elizabeth Segura

Dissertations

Abstract

Problem: The Patient Centered Medical Home (PCMH) is a model of care that improves the quality and experience of care and decreases cost. Use of a validated depression screening tool for adult patients is a PCMH certification requirement. The purpose of this quality initiative was to obtain baseline data when a depression screening tool was utilized among adult patients in an internal medicine clinic within a Midwestern public health department.

Methods: This was a quality improvement project utilizing a descriptive and observational design. A retrospective medical record review was used to assess the rate of depression screening utilizing the …

Evaluation Of A Youth Emergency Room Enhancement Program For Behavioral Health, Anne Thatcher

Dissertations

Problem. Pediatric mental health complaints and subsequent hospitalizations have been steadily increasing. The Behavioral Health Network (BHN) developed an intensive outreach case management program aimed at reducing youth mental health emergency department (ED) visits and inpatient psychiatric admissions. The Youth Emergency Room Enhancement (YERE) program was a process improvement initiative to provide immediate case management to youth and caregivers for mental health care.

Methods. A Plan-Do-Study-Act (PDSA) method utilizing a retrospective case record review occurred over a six-month period. A convenience sample of youth aged 6-20 years presenting to one of eight healthcare facilities for either ED or inpatient hospitalization …

Assessing The Impact Of Practice Transition On Advance Practice Registered Nurse’S Job Stress And Job Satisfaction, Patricia E. Hendrickson

Dissertations

Problem

The impact of the transition to full practice authority (FPA) on job satisfaction and job stress has not been previously described in the literature.

Method

Job satisfaction, job stress, and practice transition stress data was collected from a sample of 33 Advance Practice Registered Nurses (APRN) working at the VA St Louis Health Care System using Misener Nurse Practitioner Job Satisfaction Survey (MNPJSS), National Institute of Occupational Safety and Health Generic Job Stress Questionnaire (NIOSH-GJSQ), and student-developed practice transition stress questionnaire during the initial phase of FPA transition.

Results

APRNs were minimally satisfied to satisfied. Job stress from work …

Anthropometrics, Metabolic Syndrome, And Mortality Hazard, Nir Krakauer, Jesse C. Krakauer

Publications and Research

Independent indices (height, body mass index, a body shape index, and hip index) derived from basic anthropometrics have been found to be powerful predictors of mortality hazard, especially when the attributable risks are summed over these indices to give an anthropometric risk index (ARI). The metabolic syndrome (MS) is defined based on the co-occurrence of anthropometric, clinical, and laboratory criteria and is also widely employed for evaluating disease risk. Here, we investigate correlations between ARI and MS in a general population sample, the United States Third National Health and Nutrition Examination Survey. Baseline values of ARI and MS were also …

An Indigenous Framework Of The Cycle Of Fetal Alcohol Spectrum Disorder Risk And Prevention Across The Generations: Historical Trauma, Harm And Healing, Kelly Gonzales, Michelle M. Jacob, Amanda Mercier, Heather Heater, Lindsay Nall Goes Behind, Jillene Joseph, Suzie Kuerschner

OHSU-PSU School of Public Health Faculty Publications and Presentations

No abstract provided.

Nurse-Led Triage Clinic In An Hiv Supportive Housing Apartment Community, Sally Breen

Dissertations

Problem: HIV-positive persons living in supportive housing who were otherwise homeless are reported to have better health outcomes than those who remain homeless. This was a quality improvement project to obtain baseline information regarding the implementation of onsite nursing services for individuals and their families residing in an HIV-positive supportive housing apartment community in an urban Midwestern city. Methods: A nurse triage clinic was implemented in partnership with the Doorways organization. Two registered nurses staffed the clinic two days per week. Data was collected on demographics and clinic utilization over a nine-week period. Results: Of the apartment residents, N=95, the …

Aligning With Patient-Centered Medical Home Standards: Depression Screening In Women's Health, Charity Galgani

Dissertations

Problem: The Patient Centered Medical Home (PCMH) model of care improves health care quality and patient experience of care, and decreases costs. Depression screening is a requirement for becoming a PCMH. The purpose of this quality initiative was to obtain baseline data to describe depression screening rates among female adult patients receiving women’s health care within a Midwestern public health department seeking PCMH recognition.

Methods: The study utilized a descriptive, observational design and was guided by the Plan-Do-Study-Act framework. A retrospective medical record review was used to assess the rate of depression screening utilizing the PHQ-2 and PHQ-9 tools, and …

Endomembrane-Associated Pre-Embedding Immunogold Labeling, Zuzana Nichtova, Celia Fernandez-Sanz, A. Bartok, Sergio De La Fuente, György Hajnóczky, Shey-Shing Sheu, György Csordás

Department of Pathology, Anatomy, and Cell Biology Posters

Aim

To optimize the pre-embedding IG in stable cell lines and primary adult cardiomyocytes to get the most effective visualization of endomembrane/associated proteins: endo/sarcoplasmic reticulum Ca2+ release channels IP3 receptors and ryanodine receptors (IP3R, and RyR2) and the mitochondrial fission protein Drp1.

Azithromycin Therapy Reduces Cardiac Inflammation And Mitigates Adverse Cardiac Remodeling After Myocardial Infarction: Potential Therapeutic Targets In Ischemic Heart Disease, Ahmed Al-Darraji, Dalia Haydar, Lakshman Chelvarajan, Himi Tripathi, Bryana R. Levitan, Erhe Gao, Vincent J. Venditto, John C. Gensel, David James Feola, Ahmed Abdel-Latif

Gill Heart & Vascular Institute Faculty Publications

Introduction

Acute myocardial infarction (MI) is a primary cause of worldwide morbidity and mortality. Macrophages are fundamental components of post-MI inflammation. Pro-inflammatory macrophages can lead to adverse cardiac remodeling and heart failure while anti-inflammatory/reparative macrophages enhance tissue healing. Shifting the balance between pro-inflammatory and reparative macrophages post-MI is a novel therapeutic strategy. Azithromycin (AZM), a commonly used macrolide antibiotic, polarizes macrophages towards the anti-inflammatory phenotype, as shown in animal and human studies. We hypothesized that AZM modulates post-MI inflammation and improves cardiac recovery.

Methods and results

Male WT mice (C57BL/6, 6–8 weeks old) were treated with either oral AZM (160 …

Intraoperative Ketamine To Reduce Postoperative Opioid Consumption In Chronic Pain Patients, Allyssa Wutzke

Nursing Capstones

No abstract provided.

Table Of Contents

Journal of the South Carolina Academy of Science

No abstract provided.

Framing Physical Activity: Weight Control Frames And Physical Activity Motivation, Kristin Spurkland

Dissertations and Theses

Public health institutions and popular media frequently frame weight loss and weight control as primary benefits of physical activity. This exploratory, descriptive study examined how respondents rated statements exemplifying three physical activity frames: a weight control frame, a medical frame, and an active embodiment frame. An anonymous, online survey was conducted in March 2018; respondents rated frame statements in terms of inspiring motivation to engage in physical activity, and in terms of perceived credibility. They also provided anthropometric data and physical activity data. Data were analyzed for the entire sample as well as stratified by multiple variables, including body mass …

Anesthetic Considerations For The Parturient With Idiopathic Intracranial Hypertension, Levi G. La Porte

Nursing Capstones

No abstract provided.

Mixed-Methods Research: A Tutorial For Speech-Language Therapists And Audiologists In South Africa, Anna-Marie Wium, Brenda Louw

ETSU Faculty Works

Background: Mixed-methods research (MMR) offers much to healthcare professions on clinical and research levels. Speech-language therapists and audiologists work in both educational and health settings where they deal with real-world problems. Through the nature of their work, they are confronted with multifaceted questions arising from their efforts to provide evidence-based services to individuals of all ages with communication disorders. MMR methods research is eminently suited to addressing such questions.

Objective: The aim of this tutorial is to increase awareness of the value of MMR, especially for readers less familiar with this research approach.

Method: A literature review was conducted to …

Methods For Detecting Cytotoxic Amyloids Following Infection Of Pulmonary Endothelial Cells By Pseudomonas Aeruginosa, Ron Balczon, Michael Francis, Silas Leavesley, Troy Stevens

University Faculty and Staff Publications

Patients who survive pneumonia have elevated death rates in the months following hospital discharge. It has been hypothesized that infection of pulmonary tissue during pneumonia results in the production of long-lived cytotoxins that can lead to subsequent end organ failure. We have developed in vitro assays to test the hypothesis that cytotoxins are produced during pulmonary infection. Isolated rat pulmonary endothelial cells and the bacterium Pseudomonas aeruginosa are used as model systems, and the production of cytoxins following infection of the endothelial cells by the bacteria is demonstrated using cell culture followed by direct quantitation using lactate dehydrogenase assays and …

Open Book Testing In Health Science Education: Student Perceptions And Outcomes In Ultrasound Physics, Kim Michael, Tanya M. Custer

Posters and Presentations: Medical Imaging & Therapeutic Sciences

Objectives: The purpose of this study was to investigate the use of open book exams (OBE) in the education of imaging students and to assess the beliefs and perceptions of the students in regard to the use of open book testing.

Subjects & Methods: Study participants included twenty-seven sonography students enrolled in an academic health sciences center. OBE was implemented in two ultrasound physics courses. Data was collected through focus groups & exam outcomes. Creswell’s procedure for data analysis & representation was followed.

Results: Overall outcomes showed no statistically significant difference between exam grades for the different cohorts with the …

Combatting Domestic Minor Sex Trafficking: An Evaluation Of The My Life, My Choice Program In Kentucky, Chelsea M. Dyer

Morehead State Theses and Dissertations

A thesis presented to the faculty of the Caudill College of Arts, Humanities, and Social Sciences at Morehead State University in partial fulfillment of the requirements for the degree of Master of Arts by Chelsea M. Dyer on July 11, 2018.

The Effect Of Breathy And Strained Vocal Quality On Vowel Perception, Sarah Nieman

Speech and Hearing Sciences ETDs

INTRODUCTION: Research into speech intelligibility in dysarthria historically focuses on articulation deficits. However, voice quality deficits associated with motor speech disorders may also impact speech perception. This study investigates how breathy and strained vocal quality affects vowel identification and ratings of vowel goodness.

METHODS: A healthy speaker recorded vowels with normal, simulated breathy and simulated strained voice quality. Acoustic, physiologic, and perceptual measures confirmed the presence of the desired voice deficits. 16 volunteer listeners participated in three perceptual tasks: vowel identification, vowel goodness ratings, and voice quality ratings.

RESULTS: In the voice quality rating task, listeners detected voice quality deficits …

Alternatives In Magnesium Sulfate Treatment Courses: An Investigation Of Physician Prescribing Behaviors, Erin Williams

Dissertations

Problem: The gold standard for managing preeclampsia in the postpartum patient is 24- hours of magnesium sulfate as this is the time the patient is most susceptible to experiencing a seizure (American College of Obstetricians & Gynecologists, 2013). However, these patients are at an increased risk for experiencing adverse health outcomes, as well as interruptions in maternal-infant bonding due to the mother requiring a higher level of care. Methods: A one group pretest-posttest design was conducted to gain a better understanding of the current practice while also assessing the willingness of physicians to change prescribing behavior after receiving the research-based …

Prophylactic Antibiotic Use In Female Patients With Pelvic Floor Reconstructive Surgery: A Retrospective Comparative Effectiveness Study, Courtney E. Turnbough

Dissertations

Problem: The purpose of this project was to determine the most effective prophylactic antibiotic to decrease the number of patients who have urinary tract infections (UTIs) after pelvic floor reconstructive surgery in a gynecological reconstructive surgery practice.

Methods: This was a retrospective chart review from 2015-2017 that included 732 subjects from a single practice. All patients underwent pelvic floor reconstructive surgery, with or without a midurethral sling placed. Patients also had a catheter and vaginal packing postoperatively. Patients who had a culture-proven UTI within the six-week postoperative period were noted.

Results: There were less UTIs (χ2 = 12.119, df = …

Measurements That Matter: Assessment & Management Of The Symptoms Of Chronic Illness Using The Integrated Palliative Outcome Scale (Ipos), Deborah Jeffery

Dissertations

ABSTRACT

Measurements that Matter: Assessment and Management of the Symptoms of Chronic Illness Using the Integrated Palliative Outcome Scale (IPOS)

Background: The mission of the Advanced Illness Management (AIM) program at the Visiting Nurse Association of Greater St. Louis (VNA) is to relieve the burden of serious illness by providing exceptional care to patients and families through symptom management. A validated symptom tool was needed for holistic assessment.

Purpose: This is a quality-improvement project aimed at enhancing symptom management in patients experiencing advanced illness in a community-based palliative care program. Provider use of the Integrated Palliative Outcome Scale (IPOS) as …

Implementation Of National Pediatric Guidelines To Prevent Chemotherapy Induced Nausea And Vomiting In Children With Cancer, Taryn Sandheinrich

Dissertations

Purpose: The purpose of this study was to assess the use of supplemental, as needed (prn) pharmacologic interventions for uncontrolled acute chemotherapy induced nausea and vomiting (CINV) in children with cancer after implementation of new pediatric CINV prophylaxis guidelines. Description of Project: A retrospective chart review was completed on forty-three children admitted to the hospital for chemotherapy during a 3 month period in 2017 to document the use of medications given for acute breakthrough CINV. The pre-implementation group received anti-emetics based on the institutional standard of care. A second retrospective chart review was completed on thirty-three children admitted to …

Implementing A Caps Simulation To Increase Nursing Education Practice Students’ Self-Awareness Of Attitudes And Beliefs About Poverty, Melissa Ehmke

Dissertations

Problem. The purpose of this project is to determine if college students who are currently in nursing school, will benefit from the addition of a poverty simulation to positively influence their self-awareness and individual-level beliefs and attitudes towards poverty, therefore being able to serve those in poverty fully and guide them to appropriate resources.

Methods. Bachelor of Science in Nursing (BSN) and Doctoral Nursing Practice (DNP) students participated in a three-hour Community Action Poverty Simulation (CAPS). A twenty-one item Attitude Toward Poverty Scale short form (ATPS) survey was completed pre and post-simulation participation.

Results. Significant improvements resulted in three of …

Evaluation Of Educating Registered Nurses Prior To Implementing New Evidence-Based Protocol: Enhanced Recovery After Surgery (Eras), Lisa Brooks

Dissertations

Evidence-based protocols promote standardization of care and patient safety. The inclusion of major stakeholders is imperative to the success of implementation of a new protocol. The “Enhanced Recovery After Surgery” (ERAS) protocol was implemented at the Veterans Administration Medical Center – St. Louis prior to formal education of direct-care registered nurses (RNs), a major stakeholder group. Due to the lack of knowledge, the RNs who were expected to implement and adhere to the ERAS protocol were not prepared and displayed a lack of confidence. Subsequently, an educational training intervention was designed and executed with thirty-five RN participants. Prior to this …

Perspectives In Immunotherapy: Meeting Report From The Immunotherapy Bridge (29-30 November, 2017, Naples, Italy)., Paolo A Ascierto, James Brugarolas, Luigi Buonaguro, Lisa H Butterfield, David Carbone, Bruno Daniele, Robert Ferris, Bernard A Fox, Jérôme Galon, Cesare Gridelli, Howard L Kaufman, Christopher A Klebanoff, Ignacio Melero, Paul Nathan, Chrystal M Paulos, Marco Ruella, Ryan Sullivan, Hassane Zarour, Igor Puzanov

Articles, Abstracts, and Reports

Immunotherapy represents the third important wave in the history of the systemic treatment of cancer after chemotherapy and targeted therapy and is now established as a potent and effective treatment option across several cancer types. The clinical success of anti-cytotoxic T-lymphocyte-associated antigen (CTLA)-4, first, and anti-programmed death (PD)-1/PD-ligand (L)1 agents in melanoma and other cancers a few years later, has encouraged increasing focus on the development of other immunotherapies (e.g. monoclonal antibodies with other immune targets, adoptive cell transfer, and vaccines), with over 3000 immuno-oncology trials ongoing, involving hundreds of research institutes across the globe. The potential use of these …

Neural Constraints Affect The Ability To Generate Hip Abduction Torques When Combined With Hip Extension Or Ankle Plantarflexion In Chronic Hemiparetic Stroke, Natalia Sánchez, Ana M. Acosta, Roberto López-Rosado, Julius P. A. Dewald

Physical Therapy Faculty Articles and Research

Stroke lesions interrupt descending corticofugal fibers that provide the volitional control of the upper and lower extremities. Despite the evident manifestation of movement impairments post-stroke during standing and gait, neural constraints in the ability to generate joint torque combinations in the lower extremities are not yet well determined. Twelve chronic hemiparetic participants and 8 age-matched control individuals participated in the present study. In an isometric setup, participants were instructed to combine submaximal hip extension or ankle plantarflexion torques with maximal hip abduction torques. Statistical analyses were run using linear mixed effects models. Results for the protocol combining hip extension and …

Implementation Of Continuous Quality Improvement In Aboriginal And Torres Strait Islander Primary Health Care In Australia: A Scoping Systematic Review, Karen Gardner, Beverly Sibthorpe, Mier Chan, Ginny Sargent, Michelle Dowden, Daniel Mcaullay

Research outputs 2014 to 2021

BACKGROUND: Continuous Quality Improvement (CQI) programs have been taken up widely by Indigenous primary health care (PHC) services in Australia and there has been national policy commitment to support this. However, international evidence shows that implementing CQI is challenging, impacts are variable and little is known about the factors that impede or enhance effectiveness. A scoping review was undertaken to explore uptake and implementation in Indigenous PHC, including barriers and enablers to embedding CQI in routine practice. We provide guidance on how research and evaluation might be intensified to support implementation.

METHODS: Searches were conducted in MEDLINE, CINAHL and the …