Medicine and Health Sciences Commons^™

Effect Of Nurse-Developed Dyspnea Improvement Education On Home Health Patients, Teresa Gough, Nevin Ozyurt

Doctor of Nursing Practice Projects

In home health patients, dyspnea is one of the quality indicators on the Medicare Outcome and Assessment Information Set (OASIS). Any home health agency that is seeking Medicare certification is required to meet Medicare Conditions of Participation, including compliance with OASIS data collection and transmission of data (Centers for Medicare and Medicaid Services, 2012). At a hospital affiliated home health agency in the Midwest, between November 2015 and October 2016, 82.85% of patients admitted for services received Medicare coverage (Memorial Home Services, 2016). Due to the high Medicare population seen by this home health agency, it is important to show …

Effects Of Transitional Care Management On Hospital Readmissions, Samantha Dunkirk

Doctor of Nursing Practice Projects

Primary care providers are challenged to identify strategies to decrease hospital readmissions. Transitional care management (TCM) services can improve communication and allow primary care providers (PCP) an opportunity to meet with patients just after discharge to assess needs and prevent readmissions. A TCM protocol was evaluated at a large Midwestern clinic to determine if communication improved and readmissions decreased. The protocol consisted of notifying the PCP upon admission and discharge to the hospital, communicating with the patient or family within 48 hours of discharge, and facilitating a follow up visit with the primary care provider within 14 days of hospital …

Diabetic Foot Screening Tool: Utility In A Busy Primary Care Setting, Crystal A. Cusanelli

Doctor of Nursing Practice Projects

Abstract

Problem: Providers in a Midwest rural clinic identified that foot care is often overlooked due to the complexity of diabetic patients and limited time available during office visits.

Purpose: This project examined the utility of an evidence-based, diabetic foot screening tool, provider satisfaction with the tool, and provider perceptions regarding foot care in a busy primary care practice.

Methodology: Providers were instructed on using the screening tool. The tool was utilized on all diabetic patients during office visits over a two-month period. Anonymous surveys were distributed and a focus group was conducted to gather post-implementation outcomes.

Results: Two providers …

Fascia Iliaca Compartment Block Protocol For Hip Fracture, M. Ray Nordyke

Doctor of Nursing Practice Projects

Fascia iliaca compartment block (FICB) is a volume based block used to treat pain associated with hip fractures. An anesthesia group at a central Illinois hospital expressed interest in the creation of an evidenced-based protocol for FICB. After an extensive literature search an evidence-based protocol was designed. The initial implementation of the protocol was a presentation of an informational PowerPoint which discussed the aspects of the protocol presented to the anesthesia staff and the registered nursing staff who assist the anesthesia providers. The protocol was then evaluated with a Likert scale survey completed by the staff. The results from the …

Sphenopalatine Ganglion Block For Post-Dural Puncture Headache Treatment, Wesley Gallagher

Doctor of Nursing Practice Projects

Post-dural puncture headache (PDPH) is defined as an orthostatic, fronto-occipital headache. The incidence of PDPH from neuraxial anesthesia techniques averages 1%. There are several treatments for PDPHs. The gold standard is the epidural blood patch (EBP). The EBP can be costly, requires experience, and is associated with rare, but serious complications. These factors present significant barriers to treating PDPHs. The sphenopalatine ganglion (SPG) block consists of using local anesthetics to block the parasympathetic signals, which flow through the SPG. Current theories suggest that increased parasympathetic outflow is the trigger for many forms of headaches, including PDPHs. Various literature associated with …

Effects Of A Multi-Tiered Approach To Impact Immunization Compliance Of Students Attending A Medium-Sized Public University, Emily Watson, Stephanie Muertz, Kate Traum

Doctor of Nursing Practice Projects

Background: College students in Illinois must comply with laws regarding proof of immunity for specific vaccines. These laws, however, do not guarantee compliance with immunizations. Unvaccinated persons living in highly-vaccinated communities, such as college campuses, are at risk for many preventable diseases. Objective: The primary aim of this project is to collaborate with Southern Illinois University Edwardsville (SIUE) Health Service to develop, implement, and evaluate the effects of multi-tiered interventions to increase immunization compliance rates of first-semester college students. Methods: A brief YouTube video was presented to freshmen students, an eye-catching educational flyer was distributed by advisors and throughout campus, …

Developing A Ketamine Infusion Protocol To Treat Complex Regional Pain Syndrome, Nikolas M. Kozul

Doctor of Nursing Practice Projects

Complex Regional Pain Syndrome (CRPS) has been studied under different names dating back to the American Civil War. Despite being studied for over 100 years, CRPS is still not a very well understood disease process and there is no consensus on the best way to treat it (O’Connell, Wand, McAuley, Marston, & Moseley, 2016). One treatment that has shown to be effective in reducing pain scores in patients with chronic CRPS is a multiple day infusion of ketamine (Sigtermans et al., 2009). The purpose of this doctor of nursing practice project was to develop a ketamine infusion protocol for anesthesia …

The Effectiveness Of Implementing A Diabetic Checklist To Improve Patient Care Documentation, Evans Mutua, Edwilyn Colwell

Doctor of Nursing Practice Projects

The Effectiveness of Implementing a Diabetic Checklist to Improve Patient Care Documentation of Treatment and Outcomes.

Diabetes mellitus is a major public health problem worldwide. In 2012, about 29.1 million Americans had diabetes with about 1.4 million Americans being diagnosed with diabetes yearly (CDC, 2017). Diabetes is the 7^th leading cause of death in the United states and in Illinois, the cost is $6,490 per person with a treated population of 774, 600 (CDC, 2017). Complication due to diabetes include; diabetic retinopathy, neuropathy, end stage renal disease, amputations and death.

The American Diabetes Association, provide evidence-based guidelines for the …

Lung Protective Ventilation During General Anesthesia: A Staff Education Project, Carrie L. Hasenstab

Doctor of Nursing Practice Projects

Lung protective ventilation has shown to be an effective strategy of ventilation in perioperative patients. However, anesthesia providers often still employ traditional modes of ventilation. To improve the knowledge and utilization of lung protective ventilation during general anesthesia a clinical practice tool was developed. A PowerPoint educational program was utilized as the initial implementation of the lung protection tool. The practice guide and educational program was presented to anesthesia providers and PACU staff at a Southern Illinois Hospital. A pre/post survey served as the method of evaluation. The pre/post survey assessed the participant’s knowledge and utilization of lung protective ventilation …

Promoting Empowerment And Innovation: A Technology Initiative, Theresa Marcotte

Doctor of Nursing Practice Projects

Improving empowerment through a supportive organizational culture can lead to innovation in practice and promote positive outcomes. Supporting employee empowerment, through a supportive organizational culture and environment, provides opportunities to innovate and creatively meet desired outcomes. Using these concepts, an Associate Degree Nursing Program empowered faculty to address a strategic planning opportunity to improve practice. The innovation, a Technology Initiative, provides opportunities for evidence-based testing practices, leading to improved, first-time pass rates on the National Council Licensure Exam (NCLEX). Technology use in the classroom can improve dissemination of nursing knowledge and retention strategies and therefore improve program retention. The utilization …

The Effect Of Home Health Interventions On Hospital Readmission Rates In Patients With Congestive Heart Failure, Lindsay Reavis

Doctor of Nursing Practice Projects

Heart failure is a common diagnosis that affects millions of people worldwide. Unfortunately, heart failure is associated with a high risk of 30-day hospital readmission rates. Home health nurses have the potential to bridge the gap between discharge and hospital readmission by providing up-to-date patient education on a one-to-one basis. Research indicates home health nurses lack knowledge of the disease process, nurse management of the disease, and treatment. This project focused on an educational session about the pathophysiology of heart failure, fluid/weight monitoring, diet, medications, and exercise with a pre- and post-tests evaluating home health nurses understanding of heart failure. …

Sugammadex Protocol, Brenna M. Thomas

Doctor of Nursing Practice Projects

Sugammadex is a new medication used for the reversal of muscle relaxation induced by rocuronium, vecuronium, and pancuronium. Sugammadex is available for use at St. Anthony’s Memorial Hospital in Effingham, IL. However, they did not have a protocol regarding the use of this medication. A sugammadex protocol was written for the operating room (OR) staff after a thorough, evidence based literature review was completed. The OR staff included certified registered nurse anesthetists, anesthesiologists, registered nurses, and pharmacy. The protocol was implemented and evaluated with a pretest, an educational PowerPoint regarding sugammadex, and a posttest. A paired samples t test was …

Patient Care Advocacy Through Electronic Communication, Jared T. Holton, Scott A. Kahre

Doctor of Nursing Practice Projects

Patient advocacy is a primary role of the Certified Registered Nurse Anesthetist (CRNA). While engaged in the legislative process, CRNAs have failed to materialize significant gains in political potency on a national scale. This project involved the development of prototype software for mobile communication devices to augment the CRNA community’s ability to advocate for patients in the healthcare policy arenas. After a demonstration of the software to key leaders of the American Association of Nurse Anesthetists (AANA), an anonymous survey was distributed to the AANA executive administrators. All six executives in attendance for the demonstration of the software completed and …

Postoperative Delirium Education, Aaron Wede

Doctor of Nursing Practice Projects

Surgical patients, aged 65 and older, comprise the largest surgical population. Increased age correlates with an increased incidence of postoperative delirium. Postoperative delirium (POD) can drastically increase healthcare costs, length of hospital stay, and overall morbidity and mortality. A clinical reference tool was created to have available for perioperative staff members at a 200-bed community hospital in the Midwest. The tool describes risk factors, prevention methods, and treatment options for POD. The initial implementation of the project was achieved with a PowerPoint presentation which was created to summarize the information found in the literature review and to instruct perioperative staff …

Obstructive Sleep Apnea: A Staff Educational Program And Protocol, Aaron Michael Quach

Doctor of Nursing Practice Projects

Obstructive sleep apnea (OSA) is a common sleep breathing disorder. Despite its prevalence, OSA often goes undiagnosed. This can result in negative sequelae. By educating healthcare providers about OSA, screening patients, and altering the plan of care, better outcomes will arise and complications can be minimized.

The purpose of this project was to develop an obstructive sleep apnea educational program and protocol based on available current literature for anesthesia providers at a community hospital. The educational project and protocol consisted of an informational PowerPoint, pretest and posttest surveys, an OSA screening tool and identification of a high risk OSA patient …

Analysis Of Genes Encoded By A Chromosomal Insert In Rickettsia Philipii, Sydney A. Wright

Honors College Theses

Background: Spotted Fever group rickettsiae are obligate intracellular arthropod-borne bacteria. Rickettsiae are globally distributed yet typically confined to the distribution of their vector(s). Rickettsia rickettsii and Rickettsia philipii are closely related human pathogens endemic to the United States and cause similar febrile illness with differing morbidity and mortality. Genomic comparison found the presence of a 19 kilobase insert containing eleven genes in Rickettsia philipii. The functions of proteins encoded by this insert are speculated to affect virulence and pathogenicity.

Materials and Methods: Bioinformatic analysis was performed to identify functional motifs in four proteins encoded by the insert. Homologous proteins …

The Behavioral Response Of Mosquitoes To Different Snake Odors, Caitlyn E. Hicks

Honors College Theses

Due to it causing high mortality rates, Eastern Equine Encephalitis (EEEV) is considered to be one of the most medically important encephalitic viruses in the Eastern United States. In order to be able to control the transmission of this virus, understanding of vector behavior and feeding preferences is necessary. In this study, the response of Culex nigripalpus to different snake skin odors was tested to determine if this species of mosquito responded to particular snake species. Culex nigripalpus showed the greatest response to Copperhead (Agkistrodon contortrix) and Cottonmouth (A. piscivorus) snakes, as compared to other venomous …

Epidemiology News, Georgia Southern University

Biostatistics, Epidemiology & Environmental Health Sciences: News & Publications (2011-2018)

• Georgia Southern Examines Muscle-Strengthening and Aerobic Activities and Mortality in Cancer Survivors

Non-Linear Analysis Of Visual-Motor Tracking Pre- And Post-Heading In Collegiate Female Soccer Athletes, Sonia Delbusso

All Graduate Plan B and other Reports, Spring 1920 to Spring 2023

Context: There has been minimal examination of the long-term effects of sub-concussive events, particularly related to non-linear aspects of motor performance. Examining the structure of performance, using nonlinear techniques, following sub-concussive events may lend insight into subtle, but significant changes in motor behavior.

Objective: This study examined the effect of performing a bout of headers on visual motor control in a group of female soccer athletes. We specifically examined the amount of error during visual-motor tracking (root mean squared error; RMSE), the regularity of the movement structure (sample entropy; SampEn), and the lag present between the target signal and the …

Fatal Case Of Ttp In Patient With Underlying Pulmonary Aspergillosis, Shimool A. Rabbani, Ankit Shah, Joan Wiley, Jay Kirkham

Rowan-Virtua Research Day

A 70-year- old Caucasian male with history of renal transplant on tacrolimus presented with 5-days of fevers, productive cough, and confusion. Patient was initially diagnosed with pneumonia, presumed bacterial, but soon noted to have worsening neurologic status, renal failure, and respiratory failure requiring mechanical ventilation. He further developed thrombotic microangiopathy (TMA); TMA along with the other clinical findings led to diagnosis of Thrombotic Thrombocytopenic Purpura (TTP). Despite aggressive treatment of TTP with plasmapheresis, patient expired on day five of his hospitalization. Fungal cultures from a bronchoscope performed on day three of hospitalization that resulted postmortem grew many aspergillus flavus and …

Gist- An Unusual Case Of Gi Bleeding, Lucy Joo, Justin Derosa, Drew Chiesa, Darshan Roy

Rowan-Virtua Research Day

This is a unique case of a female who was diagnosed and treated with a GIST (gastrointestinal stromal cell tumor) of the stomach.The purpose is to deliver awareness and education to clinicians of this rare malignancy by emphasizing its presentation and characteristics.

Effects Of Vitamin D Supplementation, Keith R. Anacker, Adarsh K. Gupta

Rowan-Virtua Research Day

Vitamin D (1,25-dihydroxycholecalciferol) is known to be a fat soluble vitamin. We hypothesized that losing weight would thus cause an increase in serum vitamin D levels. To investigate this, a retrospective chart review was performed in which data including sex, age, race, serum Vitamin D levels, body weight and more, of 200 Rowan SOM Family Medicine patients for up to 6 doctor’s office visits each were collected. These data were then analyzed using Microsoft Excel and IBM SPSS. We found while there was a significant positive correlation between weight loss and serum Vitamin D levels, there was not a significant …

A Case Of Signet Ring Cell Colon Carcinoma Initially Presenting As Acute Diverticulitis, Justin Derosa, Jonathan Foster, Drew Chiesa, Darshan Roy

Rowan-Virtua Research Day

This is a unique case of a female with an acute bout of diverticulitis who six weeks later on follow up colonoscopy, was found to have signet ring cell colon carcinoma. The purpose is to deliver awareness of this rare type of colon malignancy, emphasize the continued need for screening colonoscopy, and to provide the reader with a distinct and thought provoking spin on the conventional diagnosis of diverticulitis.

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Healthcare Provider Attitudes Toward Personalized Care Plan Development, Kafi Rudolph, Adarsh Gupta

Rowan-Virtua Research Day

Background: Prevention care plans are created by healthcare workers to direct patient care and are guidelines to optimize patient health. The care plans include actions patients can take to prevent worsening of chronic conditions and potentially decrease hospitalizations. The current research project was conducted to assess satisfaction of using automated personalized care plans among healthcare providers, which can increase office visit efficiency.

Myeloid Sarcoma: A Rare Cause Of Small Bowel Obstruction, Jonathan Sedeyn, Karlbuto Alexandre, Alan J. Sheinbaum, Adeshola Fakulujo

Rowan-Virtua Research Day

Myeloid sarcoma is a rare and aggressive tumor of myelogenous origin that uncommonly presents in the small bowel. Here we describe the case of a 29 year old male with a two week history of worsening abdominal pain associated with nausea and bilious vomiting. The patient displayed tenderness in the epigastric and periumbilical region with grossly normal lab values. On CT he was found to have a small bowel obstruction with a transition point in the pelvis. Exploration revealed a small bowel mass located approximately 12 cm from the ileocecal valve. Pathological analysis showed large malignant cells with a high …

A Case Of Synchronous Colorectal Carcinoma Manifested As Three Separate Colon Masses, Alyssa Imperatore, Linda Szczurek, Alan Shienbaum

Rowan-Virtua Research Day

Colorectal cancer is the second leading cause of cancer-related deaths in the United States amongst cancers that affect both genders. Synchronous colorectal cancer is greater than one primary lesion detected on initial presentation and occurs about 5% of the time.

This is a 78 year-old female with past medical history of left-sided breast cancer treated with neoadjuvant chemotherapy who presented with symptomatic anemia found to have a hemoglobin of five and positive fecal occult blood test. Patient was transfused and taken for EGD/colonoscopy, which showed three polypoid rectal lesions and three separate colon masses. Preliminary pathology showed high grade dysplasia …

Osteopathic Manipulative Medicine In Pregnancy, Xinhua Chen, Maria Nguyen, Sophia Vogiatzidakis

Rowan-Virtua Research Day

Women experience physiologic and structural changes during pregnancy. Osteopathic manipulative medicine (OMM) involves the examination of the whole patient, including body, mind, and spirit. This involves treatment of any stresses placed on the body, including the structural changes in the maternal body. Clinical studies thus far on OMM in pregnancy have shown when used during pregnancy, it improves musculoskeletal pain such as low back pain, and may positively affect some labor and delivery outcomes. The purpose of this study was to evaluate the effectiveness of OMM during pregnancy in reducing the rate of cesarean section and several other labor and …

Maps-Snma Shad.O.W D.O. Day Rowan Som Pipeline Program: A Pilot Study, Taiwo Ajumobi, K. Millar, Hina Mujadad, Yessica Manzo, Tashawni Channer, Cassandra Ramirez, Nkechiyere Eboka, Paula Watkins, Linda Boyd

Rowan-Virtua Research Day

Prior to being a medical student, a majority of pre-medical students have not encountered the course load intensity, academic rigor, and time management required by a medical school curriculum. Diversifying the workforce has been shown to have benefits, especially at the micro or patient level, since having racial or ethnic concordance between providers and patients has been associated with increased levels of satisfaction and improvements in certain clinical outcomes. The number of MDs increased to 841,321 or 91.8% versus 72,961 DOs or 8.0% creating the need for minorities to be knowledgeable of both MD and DO paths to becoming a …

A Rare But Life Threatening Case Of Labile Blood Pressures In Pregnancy, Kelsey Carrio, Aarti Aggarwal, Susan Mcgroarty

Rowan-Virtua Research Day

Pheochromocytoma is a rare but life threatening adrenal secreting tumor. The infrequency with which it is encountered makes pheochromocytoma, especially in pregnancy, a formidable diagnostic challenge.

Although a pheochromocytoma is rare, it is good to keep it in differential diagnosis as a possible cause of labile BP with headaches and significant orthostatic BP. It is critical to recognize this condition to institute an appropriate therapy & surgical intervention to prevent mortality.

Metastatic Breast Cancer Presenting As Painless Jaundice, Daniel S. Wilen, Donald J. Mcmahon, Brian J. Blair, Joanne Kaiser-Smith, Darshan B. Roy

Rowan-Virtua Research Day

Breast cancer is the most commonly diagnosed cancer in women in the United States. Treatment options are wide-­‐ ranging based on a multitude of factors, including extent of disease and receptor positivity. Following treatment, a relapse-­‐free interval ≥ 2 years carries a more favorable prognosis.

We present a case involving a female with history of breast cancer and relapse-­free interval of 15 years who unfortunately presented with metastatic disease involving the liver, bone, and lymph nodes.