Medicine and Health Sciences Commons^™

The Dehumanization Of The American Healthcare Professional: The Impact Of Technology On The Ever-Evolving World Of Medicine, Carli Maddock 19

Honor Scholar Theses

With the evolution of technology well underway, many of the consequences of its changes to our social interactions between doctor and patient have gone unnoted. With a computer in the room, healthcare professionals may be less likely to listen, touch, or communicate in the same way that they have in the past. This change appears to alter the relationship building process between a doctor and their patient. If trust and faith in the professional are tampered with, this could directly correlate to patient follow-through and outcome. In order to better understand the psychological response to the means of communication, touch, …

Reconstruction Of Sternoclavicular Defect With Completely Detached Pectoralis Major Flap, Jude Opoku-Agyeman, Sergio Perez, Amir Behnam, David Matera

Plastic Surgery Resident Research

Sternoclavicular joint infection is very rare. Osteomyelitis is a known complication of septic sternoclavicular joint. Once this condition is diagnosed, aggressive management including antibiotic and surgical debridement is warranted. Patients are often left with sizeable sternoclavicular defects that may need surgical reconstruction. In this report, we describe the use of a completely detached pectoralis major flap for the reconstruction of a large sternoclavicular defect after resection for osteomyelitis. Briefly, after the debridement of the infected sternoclavicular joint, the pectoralis major was detached from its sternoclavicular attachments and further detached from the humeral attachments rendering it completely detached on a vascular …

A Crisis In The Farming Community: A Pathway To Acceptable, Accessible And Available Mental Health Care In Rural Minnesota, Trevor Frybarger, Laura Koch, Kathy Thao, Taryn Wicks

Master of Social Work Student Policy Advocacy Briefs

Minnesota relies on farmers to put food on our tables and to help drive our economy. The chronic stressors associated with an unstable farm economy is taking its toll on farm families all across Minnesota. Chronic stress can contribute to marital tensions, domestic violence, work disruption, depression, anxiety, and suicide. Minnesota has only 1 mental health counselor dedicated to doing outreach and crisis counseling to farm families. Many mental health professionals lack competency in working in rural communities, including understanding farm related stressors. Minnesota is doing some things right, like the Minnesota Farm and Rural Help Line. But, it needs …

Providing Title Ix Training At A Regional Campus, Kelliann Herman Mba, Margaret A. Hadinger Edd, Ms, Kristin Steffen Msm, Mph, Cph

Department of Education

No abstract provided.

A Multi-Faceted Intervention To Improve Diagnosis And Treatment Rates Of Overweight And Obesity By Nurse Practitioners In Primary Care, Susan Disser

Evidence-Based Practice Project Reports

The United States is amid an obesity epidemic (Institute of Medicine, 2012). Indiana ranks as the tenth most overweight state. (America’s Health Rankings, 2018). Despite guidelines outlining the treatment of obesity, primary care providers seldom use these guidelines (Hayes et al., 2017). In a 2010 study, only 28.9% of obese patients received a diagnosis of obesity and less than 25% of these patients received counseling on diet, exercise, or weight loss (Bleich, Pickett-Blackely, & Cooper, 2011). The purpose of this evidence-based practice (EBP) project is to determine if a multi-faceted intervention consisting of academic detailing, reminders, audit with feedback, and …

Sand Fly–Associated Phlebovirus With Evidence Of Neutralizing Antibodies In Humans, Kenya, David P. Tchouassi, Marco Marklewitz, Edith Chepkorir, Florian Zirkel, Sheila B. Agha, Caroline C. Tigoi, Edith Koskei, Christian Drosten, Christian Borgemeister, Baldwyn Torto, Sandra Junglen, Rosemary Sang

All Peer-Reviewed Publications

We describe a novel virus, designated Ntepes virus (NPV), isolated from sand flies in Kenya. NPV has the characteristic phlebovirus trisegmented genome architecture and is related to, but distinct from, Gabek Forest phlebovirus. Diverse cell cultures derived from wildlife, livestock, and humans were susceptible to NPV, with pronounced permissiveness in swine and rodent cells. NPV infection of newborn mice caused rapid and fatal illness. Permissiveness for NPV replication in sand fly cells, but not mosquito cells, suggests a vector-specific adaptation. Specific neutralizing antibodies were found in 13.9% (26/187) of human serum samples taken at the site of isolation of NPV …

Medicaid Spending Burden Among Beneficiaries With Treatment-Resistant Depression., Dominic Pilon, John J. Sheehan, Holly Szukis, David Singer, Philippe Jacques, Dominique Lejeune, Patrick Lefebvre, Paul E. Greenberg

College of Population Health Faculty Papers

AIM: To evaluate Medicaid spending and healthcare resource utilization (HRU) in treatment-resistant depression (TRD).

MATERIALS & METHODS: TRD beneficiaries were identified from Medicaid claims databases (January 2010-March 2017) and matched 1:1 with major depressive disorder (MDD) beneficiaries without TRD (non-TRD-MDD) and randomly selected patients without MDD (non-MDD). Differences in HRU and per-patient-per-year costs were reported in incidence rate ratios (IRRs) and cost differences (CDs), respectively.

RESULTS: TRD beneficiaries had higher HRU than 1:1 matched non-TRD-MDD (e.g., inpatient visits: IRR = 1.41) and non-MDD beneficiaries (N = 14,710 per cohort; e.g., inpatient visits: IRR = 3.42, p < 0.01). TRD beneficiaries incurred greater costs versus non-TRD-MDD (CD = US$4382) and non-MDD beneficiaries (CD = US$8294; p < 0.05).

CONCLUSION: TRD is associated …

Images Of Nursing From West Michigan: A Photo Essay, Aldina Mahmutovic

Honors Projects

The image of nursing is diverse and complex, with public perceptions influenced by traditional imagery and negative stereotypes. Few recent studies consider how nurses view their professional image. My study aimed to uncover how West Michigan nurses perceive the image of nursing. Approval was given by the local Sigma chapter (Kappa Epsilon at Large), to recruit participants from members, and by Grand Valley's IRB. Via an online REDCap survey, participants submitted an original photo and written narrative. Submissions were searched for underlying patterns using thematic analysis. Themes identified were: (1) nurses establish relationships with unique and vulnerable clients, using their …

Career Pathway Through Exercise Science, Renee Cloeter

Honors Projects

College students have many choices for choosing a major that will lead to a profession or post-graduate school following graduation with a Bachelor’s or Associates degree. For many, making this decision can be daunting and time-consuming as it is important to select the right major for future endeavors. Several students change majors multiple times throughout the course of their college careers causing them to remain in school for an extended period of time to complete graduation. Researching and analyzing potential majors as a new student is a part of the process, but some students may skip this step as there …

Food Insecurity Among College Students, Alison Hige

Honors Projects

Increasing collegiate education costs results in students today facing greater financial stress. As a result, students have to make difficult choices of how to allocate their monetary resources. Sometimes, students prioritize educational costs over nutrition and health necessities, impacting an individual’s ability to obtain adequate food resources. The purpose of this project was to explore the prevalence and impact of food insecurity among college students. The project included conducting a literature review yielding 26 pertinent articles from the keywords “food insecurity” and “college students.” Food insecurity affects a student’s physical and mental health, along with negatively impacting their scholastic abilities. …

Functionality Of The Kidneys, Amber Jourdan

Honors Projects

This project is an informative research paper on the role of the kidneys in the urinary system, as well as issues that arise in the kidneys. A brief introduction is given to explain the general function of the urinary system and the importance of the kidneys. Following that, a section of Acute Kidney Injury explains the disease and possible treatments. Additionally, there is a section on kidney stones, how they are formed, and how treatments are administered when a patient presents with this ailment. This paper is not the only piece of this project. In addition, a visual aid will …

The Proliferation Of Porcine Retinal Ganglion Cells Using Pnu 282987, Rebecca Karl, David Linn

Honors Projects

The retinal ganglion cells (RGCs) from porcine eyes were extracted to work towards a potential therapy for glaucoma. There is not a known cause of glaucoma or the apoptosis of RGCs that cause the eventual blindness associated with glaucoma. The goal of this protocol is to protect the RGCs from dying by adding a nicotinic acetylcholine receptor activator to induce neuronal proliferation and protect against glutamate-induced excitotoxicity. PNU 282987 was used as the nicotinic acetylcholine receptor activator due to its neuroprotective properties. We hypothesized that we would observe the proliferation of RGCs (associated with increased cell numbers) with varying levels …

Club Athletics And Academic Success, Haydn Vandenberg

Honors Projects

The goal of this research is to examine the relationship between club athletics and academic success at GVSU, focusing specifically on how scholarship of club athletes can be improved.

Improving Undergraduate Student Engagement In A Hybrid Research Course, Genevieve B. Elrod

Peer Reviewed Articles

Undergraduate nursing students have traditionally struggled to appreciate and understand research. Traditional teaching and learning methods in the research classroom are not meeting the needs of current students (McCurry & Martins, 2010), and innovations must be sought to overcome students' resistance to research. Efforts to improve the early research utilization skills and attitudes of students is critical if we are to hope for the grounding of their future practice in evidence.

To engage students in one hybrid research course, the faculty member created an innovative “March Madness” assignment that assists students in applying their learning. This article details …

Implementation Of Pharmacogenomics Into Electronic Health Record And Clinical Decision Support, Dharaben Naik

Applied Research Projects

The advent of electronic health records (EHR) and clinical decision support (CDS) has brought numerous changes in the healthcare field and has improved how patients receive care. The field of pharmacogenomics has made many breakthrough discoveries in the last few decades and these new advances have immensely reduced the cost of genetic testing. As advances have been made, researchers have discovered that individuals may respond to a medication differently due to genetic variants. There is a shift in the medical field from a one size fits all model to a personalized medicine model based on genetic information. Institutions have started …

Health Information Exchanges In The Community Pharmacy Setting, Kenneth D. Sykes

Applied Research Projects

The landscape of health care is shifting as new payment models and mandates for health information technology (HIT) rise. There is an unprecedented demand to meet our nation’s health care challenges of access, safety, quality, and cost. To meet these demands, the health care industry has recognized a team-based care model which can introduce the collaborative power through health information exchanges (HIEs). Providers like pharmacists, can detect and resolve medication errors, duplications, and omissions by using HIEs. HIEs give pharmacists the entire view of the patient from the bed-side of the hospital to the community pharmacy. However, the implementation of …

An Assessment Of Utilization Of Prescription Anti-Hypertension Medications Via A Health Records Database, Ryan Payne

Applied Research Projects

Obesity is a growing problem in the United States, though not a new one. It was estimated that over 72 million U.S. adults alone have a diagnosis of obesity. Among all preventable premature deaths, obesity ranks as the second leading cause. Contemporary classifications define obesity as a body mass index (BMI) greater than or equal to 30. Several common comorbidities are widely present in obese populations, particularly hypertension, diabetes, and hyperlipidemia. Among these chronic disease states, hypertension has been identified as the most common and earliest identifiable. The purpose of this study was to make inferences on the prescribing of …

The Disparity Between Scientific Consensus And American Public Opinion Of Genetically Modified Organisms And Genetic Engineering, Matthew A. Cherubino

Student Publications

Genetically modified organisms (GMOs) and genetic engineering (GE) are accepted as safe and useful by the consensus of the scientific community. Their diverse utility has shown promise in addressing major challenges of the 21st century, including world hunger, global warming, and the prevalence of diet-related diseases (e.g. heart disease, cancer, diabetes, etc.). A 2014 Pew Research Center survey revealed that while 88% of scientists agreed that GM foods were safe to eat, only 37% of American consumers agreed. Furthermore, only 35% of U.S. adults trusted scientists to accurately inform the public about GMOs. To explain this disparity, I synthesize information …

Improving Nursing Staffing Methodology And Nursing Sensitive Outcomes With The Addition Of A Patient Centered Acuity Measure, Douglas C. Howard Rn, Ms, Ne-Bc

Doctor of Nursing Practice Projects

Background: Assigning the correct nursing resources to hospitalized patients positively impacts patient outcomes. The current process for matching nurses to patients is highly variable and involves a combination of simple ratios, historical workload data, and expert opinion but lacks objective measurement of the patient’s condition.

Objectives: This project evaluated change in selected quality indicators and the daily unit-level management of nursing resources after implementing the Troubled Outcome Risk (TOR) into existing nursing staffing methodology in a Department of Veterans Affairs hospital.

Methods: TOR provides objective measurement of individual patient allostatic load. Daily calculation of TOR scores for each patient on …

Opioid Dosing’S Impact On Numeric Pain Rating Scale And Urine Toxicology Results, Christine Couperus–Mashewske Fnp-Bc, Rn

Doctor of Nursing Practice Projects

Background: Concerns about opioid prescribing in the United States have been rising (Centers for Disease Control and Prevention [CDC], 2016). Assessing pain scores, along with urine toxicology screenings can provide information to both patients and providers about prescription opioids.

Objectives: The purpose of this retrospective chart review study was to compare numeric pain scores and urine toxicology results between two different groups of patients who were being prescribed daily≥ 90mg opioid dosing.

Methods: This retrospective chart review sample was of 134 adult chronic pain patients at one pain management clinic. Patients’ average numeric pain rating while using opioids for a …

Evaluation Of Patient Throughput In An Outpatient Pediatric Hematology, Oncology, And Bone Marrow Transplant Clinic, Samantha Depadova Msn, Rn, Anp-C, Ocn

Doctor of Nursing Practice Projects

Background: Outpatient oncology clinics are complex environments. The multi-step, sequential nature of oncology treatment contributes to delays. Prolonged wait time impacts patient compliance, satisfaction, and staff satisfaction.

Objectives: To assess throughput in the outpatient pediatric oncology clinic and explore staff’s assessment of throughput and their opinions of what might be improved.

Methods: Our descriptive-comparative study used retrospective reviews to measure four time intervals for 312 visits at our mid-Atlantic outpatient clinic. Patient and appointment factors were explored. Mean interval times were calculated and differences impacting throughput were analyzed using ANOVA. Prospective survey data were obtained from 22 clinic staff …

Analysis Of Parental Attitudes Of Adolescent Vaccinations In The Retail Health Care Setting, Patrick William Denning Mph, Msn

Doctor of Nursing Practice Projects

Background: The tetanus-diphtheria-acellular pertussis, meningococcal, and human papillomavirus vaccines have been recommended for adolescents since 2005. Retail health clinics can increase the delivery of vaccinations by reaching patients outside the traditional healthcare system.

Objectives: To measure parental attitudes of adolescent vaccinations utilizing the Vaccine Confidence Scale (VCS) and assess reasons parents decided to vaccinate or not. Attitudes were compared to previous studies. Our long-term purpose was to develop targeted interventions to increase adolescent vaccinations.

Methodology: A descriptive survey design measured the parental attitudes of adolescent vaccinations from total VCS scores and subscale scores of benefits, harms, and trust. A qualitative …

Effects Of Teach-Back Method Of Education On Knowledge Of Heart Failure Self-Care Management And Post-Discharge Knowledge Retention, Ama Awuah-Asamoah Msn, Rn, Acnp

Doctor of Nursing Practice Projects

Background: Approximately forty to eighty percent of patient education is immediately forgotten, and about fifty percent of retained information is inaccurate; knowledge is an essential bridge between patient teaching, comprehension and knowledge retention by using the teach- back method (Farris, 2015; Rouse et al., 2016; Stamp et al., 2014).

Objectives: The purpose of this study was to compare teach-back education method versus standard education and care, on knowledge of heart failure (HF) self-care management at discharge and retention of knowledge at three to ten days post discharge.

Methods: A non-probability convenience sampling of 22 HF patients, 65 years and older, …

J Mich Dent Assoc April 2019

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA’s 6,200+ members across the state. No publication reaches more Michigan dentists!.

This month's issue features candidates for MDA Officers, Trustees, and ADA Delegates, a continuation of our 100th anniversary celebration, and ethical issues in corporate practice.

Improving Patient Handover From The Pediatric Emergency Department To The Pediatric Intensive Care Unit, Kathryn Devinney

Doctoral Projects

Patient safety can be at risk during registered nurse handover, particularly when transitioning between high risk areas. According to The Joint Commission (2017), a standardized transition process should be implemented during patient handover. The purpose of this paper was to evaluate the effect of a standardized process with a cognitive aid on handover between a pediatric emergency department and an intensive care unit. Objectives of the project were to decrease conversion time in the emergency department, increase standardized process utilization, and improve patient outcomes, registered nurse perception and satisfaction, and patient proxy satisfaction. This evidence-based quality improvement project took place …

Pathways To A Sustainable Community Health Worker Program In A Rural Native American Community, Hannah R. Duby

Doctoral Projects

Introduction: American Indian/Alaska Native (AI/AN) people have some of the greatest health disparities of any other citizen group in the U.S. (National Indian Health Board [NIHB], 2018). As liaisons between community members and health services, community health workers (CHWs) play an important role in reducing disparities in AI/AN communities (Indian Health Service [IHS], 2018). CHWs in the organization of interest are not being used to their full potential as the documentation of their care is not accessible to the primary care providers (PCPs) for care coordination and the program is threatened by issues related to sustainability.

Objectives: The purpose of …

Improving Heart Failure Care Plan Coordination Across The Health Care Continuum, Amy Veltkamp

Doctoral Projects

Heart failure costs the United States 31 billion dollars each year, with much of those costs attributed to hospital admissions. Coordinating care across the health care continuum is a critical factor in improving heart failure care and reducing readmissions. An organizational assessment was conducted using the Burke and Litwin Causal Model of Organizational Performance and Change. The quality improvement project implemented a longitudinal plan of care (LPOC) across 10 hospitals and numerous ambulatory care sites at a large Midwestern health organization. Nurse care managers (NCMs) were the focus of this project due to their high-level of involvement in care coordination. …

Increasing Screening And Education For Human Trafficking In The Obstetric Department, Chibwe Caroline Powell

Doctoral Projects

Background: Human Trafficking, is a human rights violation with global public health implications. HT is associated with multiple health problems. Healthcare providers working in obstetrics departments are in a unique position to interact with trafficked persons. Lack of specific HT screening tools, training and education have been identified as barriers to recognizing HT victims.

Objectives: The purpose of this quality improvement project was to increase victim identification and referrals by improving screening through implementation of an interdisciplinary screening tool into the EHR workflow and providing HT education.

Methods: This project examined the impact of implementing a HT screening tool and …

Interprofessional Collaboration To Improve Discharge Planning, Erica L. Spalding

Doctoral Projects

Historically, health care professionals collaborated solely with other professionals within the same discipline. However, evidence shows collaboration between all disciplines involved in patient care leads to improved patient outcomes. Interprofessional collaboration can reduce costs and improve patient care, yet is used inconsistently in health care systems. Interprofessional collaboration was not fully used on two medical-surgical units in a large health system in the Midwest, particularly during the discharge planning process. This project aimed to standardize rounds on two units as part of a larger initiative to standardize rounds across all units within the system. The clinical question to be answered …

Evidence-Based Toolkit For Reduction Of Overdose Risk In Primary Care Patients On Opioid Therapy, Katelin A. Aris

Doctoral Projects

Introduction: Opioids are powerful pain killing medications that can be highly addictive and can cause risk for overdose and even death (Michigan Prescription Drug and Opioid Task Force, 2015). Many primary care providers treat patients with acute and chronic pain, although it is recognized that many receive inadequate training in pain management and feel unprepared in the complexities of caring for these patients (Becker, Bair, Picchioni, Starrels, and Frank, 2018). To treat these patients safely, provider education and adherence to guidelines put forward by these initiatives is essential.

Methods: An evidence-based prescribing toolkit was devised using guidance from the literature …