Medicine and Health Sciences Commons^™

Home Telemonitoring In Heart Failure, William Huff

MSN Capstone Projects

Heart failure (HF) exacerbation is a major source of hospitalization, mortality, and healthcare cost to home health agencies. Unmonitored accumulative fluid retention between skilled nurse visits, base knowledge deficits in HF pathophysiology and dietary restrictions, and lack of basic monitoring equipment such weighing scales are primary contributors to HF related hospitalizations in the home health setting. It has been discovered that early recognition of decompensating HF can reduce or eliminate HF related hospitalization, mortality, and healthcare costs associated with the management of exacerbation. When a patient is sent to the emergency room (ER) for fluid overload secondary to HF, massive …

Hourly Rounding: The Effects On Fall Rates In Adult Population In Acute Care Setting, Sheyla J. Pellicier Mercucci

MSN Capstone Projects

Falls are one of fourteen categories of hospital-acquired conditions (HACs) listed by the Centers for Medicare and Medicaid Services (2020). Falls are costly and stressful for everyone involved; patients, families, nursing staff and physicians. According to the United States Department of Health and Human Services (2019), about seven hundred thousand to one million hospital admitted patients fall every year. The estimated cost of a fall is about fourteen thousand fifty-six dollars if an injury occurs and can extend patient’s hospital length of stay (LOS) to up to 6.3 more days (Joint Commission Center for Transforming Healthcare, 2019).

When a patient …

Critical Incident Stress Debriefing For Nurses In Emergency And Critical Care Departments, Rachel A. Davis

MSN Capstone Projects

Front-line healthcare workers such as emergency department nurses, trauma nurses, and other nurses working within intensive care services are exposed to significant trauma on the job as they care for their critically wounded and dying patients. While trauma cannot be removed from the job descriptions of such staff members, individuals and their facilities can work together to try and ensure traumatic events do not have significant, lasting effects on the mental well-being of these nurses. Critical incident stress debriefing (CISD) after traumatic events in the workplace has been cited as a relatively inexpensive way to decrease the impact of negative …

Prevent The Preventable: Children With Hypertension Due To High-Sodium Diets., Shana M. Cobb

MSN Capstone Projects

Heart disease in the United States is the number one cause of death and costs $317 billion annually (Centers for Disease Control, [CDCa], 2018). Heart disease is usually considered an adult disease, but today we are finding that more children are developing symptoms of high blood pressure and sodium consumption is the link (Webb, 2017). Health care spending for hypertension is at an all-time high and is expected to triple over the next 20 years (Bussenius, Zeck, Williams, & Haynes-Ferere, 2018). The American Heart Association (AHA) states if sodium consumption was decreased to around 1,500 milligrams (mg) a day, blood …

Controlled Donation After Circulatory Death: Benchmark Study, Marilyn R. Strait

MSN Capstone Projects

Abstract

In potential organ donors after circulatory death (P), does the utilization of an evidence-based critical pathway from identification of potential donor to organ donation (I) versus no utilization of an evidence-based critical pathway (C) increase the rate of organ procurement and the satisfaction of donor families with the donation process (O)? A benchmark study was conducted to answer this question, and in short, yes, it does. The utilization of a critical pathway, when individualized to a local population and hospital’s organization increases the organ procurement rate, the donor family satisfaction with the process, and increases staff satisfaction with the …

Geriatric Medication Adherence, Heather Granados

MSN Capstone Projects

Improved patient education can lead to increased medication adherence in geriatric patients.

Emergency Department Homeless And At Risk Homeless Screening Benchmark Study, Emily Mulder

MSN Capstone Projects

Individuals experiencing homelessness drastically overutilize emergency department (ED) services compared to non-homeless individuals (Ku et al., 2014). Many unhoused individuals have serious medical and psychosocial needs, which are chronic in nature, and become exacerbated due to poor management while living on the streets (Ku et al., 2014). The health needs of such individuals would be best managed through primary care continuity. However, care coordination becomes complex when a patient does not have a physical address or knowledge of available community resources (Mitchell, León, Byrne, Lin, & Bharel, 2017). By understanding the unique barriers that homeless and at risk homeless patients …

Nurse Residency Program: A Critical Care Benchmark Project, Dana Wagner

MSN Capstone Projects

Nursing school is arguably one of the most challenging degree plans in existence. The level of professionalism and intelligence of newly graduated nurses (GNs) is exceptional, and the expectation is that they will excel in whatever field of nursing they choose. That said, navigating the theory-practice gap between school and a GN’s first job can be extremely intense, especially in specialty areas such as critical care. According to Belvins (2016), both The Joint Commission and the Institute of Medicine recognize that many GNs are not prepared for fast-paced, high-acuity healthcare environments. The recommendation is the implementation of additional education and …

Implementation Of A Patient Acuity Tool And The Impact On Nurse Satisfaction, Amber M. Denson

MSN Capstone Projects

Increased workloads contribute to nurse stress, affect nurse-patient relationships, and can ultimately lead to nurse turnover (O’Connell, Nettleton, Bunting, & Eichar, 2020). Nurse satisfaction can also be influenced by nurse-patient assignments (Allen, 2019). Implementation of a patient acuity tool (PAT) to balance workload and evenly distribute patient acuity in nurse-patient assignments can improve nurse job satisfaction, quality of care, and nurse retention (Firestone-Howard, Gonzalez, Dudjak, & Rader, 2017; Al-Dweik & Ahmad, 2019).

Discussions were held on a 20-bed medical-surgical unit in an acute care hospital with stakeholders that included the nurse manager, charge nurses and bedside nurses at staff meetings …

Self-Engagement To Decrease Blood Pressure Readings And Decrease Non-Compliance., Teresa G. Townes

MSN Capstone Projects

Hypertensive patients are the patients that are seen in every aspect of health-care. They are seen in outpatient clinics, home health, in-patient settings, and in home health. Many times these patients have an abundance of education to absorb and many medications to take on a daily basis. The interest of how these patients are engaged in their own health-care and how it affects their blood pressure readings.

Many patients may know that they take a medication for their blood pressure, but they might not remember the name, dosage, or frequency of the medication. When a patient cannot recall their medications, …

Mindfulness Meditation For Nursing Students, Christine Cho

MSN Capstone Projects

This capstone project discusses an eight-week Mindfulness Meditation Program for nursing students. It can be implemented virtually or face-to-face in either the didactic or clinical portion of a course. This capstone project was implemented virtually. The purpose of the project is to introduce mindfulness meditation to nursing students to build resilience and reduce stress. The weekly topics include: Orientation, Being Fully Present, Responding Mindfully Without Judgment, Communication, Teamwork, Compassion, Balanced Life, and Closure. Pre- and post-assessments of anxiety, stress, and mindfulness are evaluated with the Burn Anxiety Inventory (BAI), Perceived Stress Scale (PSS-10), and Mindfulness Attention Awareness Scale (MAAS). Mindfulness …

Early Initiation Of Palliative Care, Ann R. Phillips

MSN Capstone Projects

The overall aim of this project, based upon the best available evidence, clinical experience of oncology nurses, and patient preferences for information about palliative care, is to propose the creation and initiation of a protocol which empowers oncology/palliative care nurses to be able to initiate early discussions about palliative care for patients with advanced stage cancer (III-IV) diagnoses.

By having frank conversations surrounding palliative care early on in the treatment process, patients are better able to make informed decisions about treatment, depending on the trajectory their disease takes. Such conversations provide patients with a clearer picture of what is likely …

Enhancing Perceptions Of Labor Experiences Through Evidence-Based Education, Sherrie Fontenot

MSN Capstone Projects

The cesarean section (C-section) rate has risen dramatically in the past several decades both in the United States and throughout the world. Domestically, the C-section rate has risen from 4.5% in 1965 to 32.2% in 2014 (National Partnership for Women & Families [NPWF], 2016a). Worldwide, roughly 19% of births occur via C-Section (Betrán et al., 2016). Concurrently, the induction rate has also increased, doubling in the United States between 1990 – 1998 (Davey & King, 2016). As of 2014, about 23% of all women had their labors induced in the United States (NPWF, 2016b). Furthermore, the trend toward electively inducing …

Venous Thromboembolism Prevention, Heidi K. Gibson

MSN Capstone Projects

Venous thromboembolism (VTE) prevention is important to patients, families, and healthcare institutions. Education is key in prevention VTE. This educational capstone project poses the question as to what type of educational material is most beneficial in decreasing VTE and also increasing VTE protocol compliance rates among nurses. The paper addresses the following PICOT question: In staff nurses (P) how does venous thromboembolism prevention education (I) compared to no venous thromboembolism prevention education (C) affect compliance with the established thromboembolism protocol (O) during the three months following completion of the required education for the intervention group (T)?

A Closer Look At Muscle Breakdown: An Overview Of The Causes, Complications, And Diagnostics Of Rhabdomyolysis, Jamie Holchin

Senior Honors Theses

Rhabdomyolysis is the rapid breakdown of myocytes in skeletal muscle. This condition can be triggered by a variety of things including crush injury, drugs, prolonged exercise, and venom. Although the causes can vary, the general pathophysiology of rhabdomyolysis is similar. Increased intracellular calcium ion levels instigate the breakdown of cellular and certain organelle membranes of muscle cells. Reactive oxygen species form, ATP is depleted, and the sarcoplasmic reticulum, which regulates muscle contraction, is also damaged. Necrosis ensues, leading to toxic intracellular components spreading throughout the body. Rhabdomyolysis can then lead to several complications including acute renal injury and heart arrhythmias, …

2020-04-19 Daily Unm Global Health Covid-19 Briefing, Christophe G. Lambert, Shawn Stoicu, Ingrid Hendrix, Anastasiya Nestsiarovich, Praveen Kumar, Nicolas Lauve, Rachel D. King, Samuel Anyona, Evans Raballah, Cristian Bologa, Alexendra Yingling, Orrin Myers, Andrew S. Rowland, Douglas J. Perkins

HSC Covid 19 Briefings

Executive Summary:

NM highlights. Census under-counting. Zip code cases. NM Volunteers needed. Jury trials suspended. Tracking NM cases. Tribal susceptibility & response. Shortages: Legal guidance. Life insurance pause. US case geography. Korean 2.1% reinfection. International policy review. Research disruption. Neuropsychiatric sequelae looming. Case undercounting. Antibody test utility. Air travel infection. FDA serologic test guidance. Household transmission. Human behavior & public health. Military leadership principles. Systematic review quality. Clozapine consensus. Guidelines for: nasopharyngeal swabs, tracheostomy, intubation, extubation, managing laryngectomy patients, stroke thrombectomy, cardiac surgery, neuroanesthesia, coagulopathy management, ECMO, radiology safety, nuclear medicine, gastroenterology, and grief in palliative care. Hydroxychloroquine and antivirals …

Sound Exposure Characterization For Student Musicians: A Hearing Loss Prevention Initiative, Heather Maze, Antony Joseph

AuD Capstone Projects - Communication Sciences and Disorders

There is an increased risk for occupational and recreational noise induced hearing loss (NIHL) and tinnitus among those who are exposed to prolonged and elevated sound intensities. For musicians, education and hearing conservation programs are rarely accessible. The purpose of this project was to measure, quantify, and more clearly understand the exposure risk for student musicians. Dosimetry and area sound level data were used to evaluate the exposure levels of students in a university music department while they practiced in ensemble rooms and a concert performance hall. Sound maps were used to illustrate the most intense positions in each music-practice …

“Save My Baby”: The Lived Experience Of Hospitalized Pregnant Women With A Threat Of Preterm Birth, Dua' Yousef Al-Maharma, Inaam A. Khalaf, Fathieh Abu-Moghli, Sajeda Alhamory

The Qualitative Report

Activity restriction in hospital to prevent preterm birth (PTB) is widely used as the first step of treatment. It is associated with adverse physiological and psychological effects on maternal and fetal health that might persist years after birth. A sample of 10 pregnant women who were hospitalized for being at risk for PTB were purposively recruited to describe their lived experience via semi-structured in-depth interview. Five themes were identified, the maternal role establishment and suspending responsibilities, the women's perception of fear of uncertainty and finding support, dissatisfaction of care, the change of routine life and family relationships, and the cultural …

Analysis Of The Osteopathology In A Captive-Born Spectacled Bear, Savannah Vaz

Georgia College Student Research Events

Osseous tissue contains the preserved record of an organism’s diseases and injuries that can be uncovered by examination of the present skeletal abnormalities. This study provides a thorough inspection of osteopathology and its etiology in a modern ursid with a known medical history. The skeletal remains of a captive-born spectacled bear (Tremarctos ornatus) were analysed for gross pathologies that manifested during the life of the animal. All observed osteopathologies were correlated with diseases experienced in the life of the individual, most of which were age-related. However, pythiosis, the grounds for his euthanization, may have contributed to some of the pathologies …

2020-04-18_Michiganoverview_Covidcounts, Michigan Department Of Health & Human Services

Michigan COVID-19 Confirmed Cases by Date of Onset Data

Data was captured from the Cumulative Data link of Michigan's Coronavirus webpage, under the url https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173_99207---,00.html.

The website contained the table Count of Confirmed COVID-19 Cases by Date of Onset , sorted by Michigan Preparedness Region. It also contained 18 charts, including the count of confirmed Covid-19 cases by date of onset in the state overall as well as in each preparedness region,and the normalized rate of Covid-19 cases per 1,000,000 residents in both the state and in each preparedness region.

2020-04-18_Michiganoverview_Covidbedppe, Michigan Department Of Health & Human Services

Michigan COVID-19 Hospital Data

The webpage was obtained from Michigan's Coronavirus Cumulative Data page, under the link Data About Places. Data is self-reported by hospitals daily to the EM Resource System per MDHHS Director Robert Gordon's Emergency Order.

Contains the tables Statewide Available Bed Tracking for COVID-19, COVID-19 Metrics, Statewide Available PPE Tracking for COVID-19 (Statewide Available PPE and Bed Tracking), as well as the table Reports of Congregate Setting Respiratory Outbreaks in 2020 by County.

Training Evaluation For Introductory Ocean Lifeguard Instruction: A Practical Example From California, William A. Koon, Ryan M. Gates, Jack Futoran

International Journal of Aquatic Research and Education

Ocean lifeguards have several responsibilities that require precise training. California State Parks is one of the largest providers of open water lifeguard services in the United States, and trains approximately 200 new lifeguards per year. As part of our lifeguard training section’s quality improvement efforts, we conducted a training needs assessment to help determine how well our introductory ocean lifeguard training curriculum prepared lifeguards to perform job related tasks upon successful completion of the training program. We surveyed both first year and seasoned lead lifeguards on operational needs, training gaps, and specific subject areas. We identified several areas where our …

2020-04-18_Michiganoverview_Covidsymptoms, Michigan Department Of Health & Human Services

Michigan COVID-19 Syndromic Surveillance System Data

The Syndromic Surveillance System Data report was obtained from Michigan's COVID-19 dashboard, from under the link "​Coronavirus Symptoms": https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily.

Syndromic Surveillance System data is obtained from approximately 183 facilities participating in syndromic surveillance (132 Emergency Departments (ED), 51 Urgent Cares) across the State of Michigan. The reporting is based on individuals who present at EDs and may not be representative of the overall population. The coronavirus-like symptoms query searches visit free-text (chief complaint, triage notes, and clinical impression) for fever or …

2020-04-18_Michiganoverview_Covidstats, Michigan Department Of Health & Human Services

Cumulative Michigan COVID-19 Data

The COVID Overview page was obtained from Michigan's main COVID-19 page: https:/www.michigan.gov/coronavirus/0,9753,7-406-98163-520743--,00.html. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily at 3p.m., with COVID-19 results included as of 10 a.m.

Note on cumulative counts: This report is provisional and subject to change. As public health investigations of individual cases continue, there will be corrections to the status and details of referred cases that result in changes to this report.
Note on the deaths: Deaths must be reported by health care providers, medical examiners/coroners, and recorded by local health departments …

Drowning Of Pet Owners During Attempted Animal Rescues: The Avir-A Syndrome, John Pearn, Amy E. Peden, Richard Charles Franklin

International Journal of Aquatic Research and Education

The rescuer who drowns can result from the attempted rescue of a human or an animal. We report here a total population analysis of all drowning fatalities for the 14-year period 1–July-2002 to 30-June-2016 which involved an attempted rescue of an animal. Cases were drawn from the Royal Life Saving National Fatal Drowning Database, which in turn, derived its data primarily from the National Coronial Information System (NCIS). Eight people drowned, all adults (ranging in age from 19-74 years), in the attempted rescue of an animal. Seven of the animals were domestic pet dogs, and in two cases farm animals. …

A Study Of Cholera Transmission, Urmi Ghosh-Dastidar

Open Educational Resources

A recent cholera outbreak in Haiti brought public attention to this disease. Cholera, a diarrheal disease, is caused by an intestinal bacterium, and if not addressed in a timely manner may become fatal. During the project described here, the students will learn how to solve and address a practical problem such as cholera transmission using various mathematical tools. Students will learn to develop a differential equation model based on practical scenarios, analyze the model using mathematics as well as numerical simulation, and finally describe the results in words that are understandable by the people who are not specialists in this …

Scrotal And Penile Erythrodysesthesia Associated With Neoadjuvant Capecitabine Chemoradiation., Julie Dricken, Erica Pettke, John A Griffin, Henry Y Li, Vivek Mehta

Articles, Abstracts, and Reports

Capecitabine, a prodrug of fluorouracil, is a component of many chemotherapy regimens used to treat a wide variety of malignancies. One of the most common adverse reactions experienced by those who have been exposed to capecitabine is palmar-plantar erythrodysesthesia (PPE). PPE is a cutaneous manifestation of chemotherapy-related drug toxicity that has signs and symptoms of erythema, edema, pain, ulceration, or desquamation of the palms of the hands and soles of the feet. The signs and symptoms occur with varying severity. There are few reports of the genitalia being similarly affected. The following case describes a patient with locally advanced rectal …

Demonstrating The Role Of Occupational Therapy In Hospice Care Through Fall Prevention Intervention Program Development, Lauren Schar

OTD Capstone Projects

Demonstrating the Role of Occupational Therapy in Hospice Care through Fall Prevention Intervention Program Development

Combating Sars-Cov-2: Leveraging Microbicidal Experiences With Other Emerging/Re-Emerging Viruses, M. Khalid Ijaz, Syed A. Sattar, Joseph R. Rubino, Raymond W. Nims, Charles P. Gerba

Publications and Research

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Wuhan City, China, late in December 2019 is another example of an emerging zoonotic virus that threatens public health and international travel and commerce. When such a virus emerges, there is often insufficient specific information available on mechanisms of virus dissemination from animal to human or from person to person, on the level or route of infection transmissibility or of viral release in body secretions/excretions, and on the survival of virus in aerosols or on surfaces. The effectiveness of available virucidal agents and hygiene practices as interventions for disrupting …

The Population Health Outcomes And Information Exchange (Phoenix) Program - A Transformative Approach To Reduce The Burden Of Chronic Disease, Steven J. Korzeniewski, Carla Bezold, Jason T. Carbone, Shooshan Danagoulian, Bethany Foster, Dawn Misra, Maher M. El-Masri, Dongxiao Zhu, Robert Welch, Lauren Meloche, Alex B. Hill, Phillip Levy

Urban Studies and Planning Faculty Research Publications

This concept article introduces a transformative vision to reduce the population burden of chronic disease by focusing on data integration, analytics, implementation and community engagement. Known as PHOENIX (The Population Health OutcomEs aNd Information EXchange), the approach leverages a state level health information exchange and multiple other resources to facilitate the integration of clinical and social determinants of health data with a goal of achieving true population health monitoring and management. After reviewing historical context, we describe how multilevel and multimodal data can be used to facilitate core public health services, before discussing the controversies and challenges that lie ahead.