Medicine and Health Sciences Commons^™

Supporting Physiologic Labor: Effects Of Hydrotherapy On Labor Outcomes, Ashley Y. Blaine

All Electronic Theses and Dissertations

Background/Purpose: The purpose of this literature analysis was to identify the effects of hydrotherapy use in the first stage of labor. Although hydrotherapy has been well-studied and its benefits well documented, it is use in labor still remains under-utilized in the United States. There has been a recent rise in medical intervention in labor and a coinciding rising cesarean section rate. In an effort to promote physiologic labor, both the American College of Obstetricians and Gynecologists (ACOG) and the American College of Nurse-Midwives (ACNM) have issued statements supporting hydrotherapy use during labor. Theoretical Framework: Katherine Kolcaba’s Theory of Comfort provides …

Neonatal Abstinence Syndrome (Nas) In Neonatal Intensive Care: Breastfeeding May Be Beneficial For Decreasing Nas Severity For Infants, Julie A. Chandler

All Electronic Theses and Dissertations

Background: Neonatal abstinence syndrome (NAS) is defined as hyperactivity of the central and autonomic nervous symptoms in infants from intrauterine exposure to drugs of addiction. There is variability in how NAS is managed in the neonatal intensive care unit (NICU) for infants with NAS, more research should be conducted to discover how breastfeeding may benefit NAS infants in the NICU. Purpose: The purpose of this critical review of the literature is to determine whether neonatal abstinence symptoms of infants diagnosed with neonatal abstinence syndrome (NAS) in the neonatal intensive care (NICU) differed if they were breastfed. Results: Using Meleis’s Transition …

School Nurse Influence On Adolescent Type 1 Diabetic Control, Sara E. Dahling

All Electronic Theses and Dissertations

Diabetes care is complex and requires consistent management of multiple factors (such as insulin, blood sugar and carbohydrate counting). School-aged children typically show poorer metabolic control, indicating a need for helping students to manage their diabetic needs. The purpose of this systematic review is to identify strategies within the care coordination role of the Licensed School Nurse that can be implemented by the school nurse, during the school day, to improve diabetic self-care among children and adolescents. Pender’s Health Promotion Model (Petiprin, 2016) was used as a framework for interventions for the school nurse and provided information about important factors …

Reducing Preterm Birth For Women Of Color Through Group Prenatal Care, Laura C. Early, Aubrey Monson

All Electronic Theses and Dissertations

The purpose of this paper is to critically review the literature to examine if group prenatal care can reduce preterm birth rates in women of color compared to individual prenatal care.

Lifestyle Changes For Women With Gestational Diabetes, Brooklyn Feustel Elkan, Kristen Mccammon

All Electronic Theses and Dissertations

Background/Purpose: The purpose of this paper was to evaluate the current literature to see if there was a common thread in treatment/prevention of the progression of gestational diabetes in pregnant women. Theoretical Framework: Dorthea Orem’s theory, The Self-Care Deficit Theory, was the theoretical framework used in this critical review of the literature. This theory asserts that patients should be self-reliant and responsible for their healthcare. This is achieved by providers giving them options and advice based on evidence to change their lifestyle and take control. This directly relates to managing GDM, because providers can only counsel the patients on changes, …

Postpartum Depression Education Of Doulas For Incarcerated Women, Tatia Marie Hibbs, Mikaela Reed, Claire Sautner

All Electronic Theses and Dissertations

As of 2017, there were 111,360 females in a state or federal correctional facility (Bronson & Carson, 2019). Many women in prison are mothers with 5-10% being pregnant while imprisoned (Baldwin, Sobolewska, & Capper, 2018). Some programs have started in female prisons with the goal to provide opportunities to nourish relationships with their children and educate on prenatal health, mental and physical health, and parenting skills. One of these organizations is the Minnesota Prison Doula Project (MnPDP) which utilizes the skills of doulas to provide supportive care to the incarcerated women of the Minnesota Correctional Facility-Shakopee (MCF-Shakopee). MCF-Shakopee is the …

Change In Empathy Levels Among Practicing Physician Assistants, Matthew P. Horn, Jacqueline Roff, Lisa Xiong

All Electronic Theses and Dissertations

This research sought to determine whether empathy declined with either increased years of physician assistant (PA) clinical experience or increased years of pre-PA healthcare experience (HCE). Although there has been an abundance of research examining empathy level trends among healthcare providers, most of these studies have looked at student empathy and not empathy level changes among practicing healthcare providers. However, among clinical healthcare providers, burnout trends with increasing years of experience (Smith, 2018) and a decline in empathy (Wilkinson, Wittington, Perry, & Eames, 2017); therefore, this project examined the link between years of practice and empathy decline. This cross-sectional study …

Marijuana Use In Pregnancy And The Effects On The Fetus/Infant, Amy Rebecca Hurst, Malia Smylie

All Electronic Theses and Dissertations

The purpose of this paper is to critically examine the literature and evidence that is available surrounding pre-pregnancy and prenatal use of marijuana and the effects it has on the developing fetus/infant. It was found that across most findings that further research needs to be done on the use of marijuana prior to pregnancy, during pregnancy, and postpartum. It has also been found that screening and counseling needs to be done and focused on prior to pregnancy and during pregnancy and postpartum. Healthcare professionals have the opportunity to establish a trusting relationship with their patients and to be able to …

Factors That Affect The Sustainability Of Faith Community Nurse Programs In Christian Faith Communities, Mary K. Martin

All Electronic Theses and Dissertations

Background: With the increasing number of people who are homebound or have chronic illnesses, the faith community nurse (FCN) is able to provide whole person care to people in faith communities. Purpose: The purpose of this critical review of the literature is to identify factors that affect the sustainability of FCN programs in faith communities. Theoretical Framework: Ziebarth’s Evolutionary Conceptual Model for Faith Community Nursing was applied to this literature review. This model allows for the definition of and practice of FCNs to change in order to improve the understanding and acceptance of this nursing specialty. Methods: A critical review …

Hunger Solutions Market Bucks Program Improvement In The Rural Setting: A Research Project, Kollin D. Michels, Nicholas S. Reich, Jeffrey D. Sandquist

All Electronic Theses and Dissertations

Food insecurity – a lack of food required for a healthy and productive life – affects approximately 150 million households in the United States alone (Coleman-Jensen, Rabbit, Gregory, & Singh, 2018). The implications of this are numerous – as individuals who are “food insecure” have a statistically increased risk of numerous health conditions and disorders. In an effort to combat the burden of food insecurity, organizations such as the Supplemental Assistance and Nutrition Program (SNAP) have been created to provide increased access to food items. Furthermore, numerous state organizations have developed additional programs, which incentivize SNAP users to purchase nutrient …

The Effects Of Sexual Abuse On Birth: Obstetric Outcomes, Maternal Experience, And Professional Intervention, Katelyn Alexandra Neufeld, Patricia Nguyen

All Electronic Theses and Dissertations

Background/Purpose: The purpose of this literature review is to determine how a past history of sexual abuse impacts labor and birth and what strategies can be used to help mitigate retraumatization. The desire is that this review will encourage further studies and the creation of guidelines and interventions to be used in maternal care settings. Theoretical Framework: The Neuman Systems Model is a theoretical framework utilized in this paper. It provides a framework for identifying stressors, assessing a patient's response, developing strategies/treatments to move women back toward stability, and adapting practices to reduce triggers from occurring in the first place …

Exploring The Relationship Between Spirituality And Mental Health Among Kenyans Living In The United States: A Review Of Literature, Naomi Omwenga

All Electronic Theses and Dissertations

Background: The increased stigma of mental health in the African population is a major barrier to seeking care. Nurses need to understand the influence of culture and spirituality in caring for this population. Purpose: The purpose of this critical review is to if there is a relationship between mental health and spirituality in a Kenyan population living in the United States. Results: The review consisted of 16 articles. The major findings were divided into 3 areas: mental health and Africa, mental health and spirituality, and spirituality and Africans. The major themes include stigma, lack of resources, immigration, religion and mental …

Variations To Labor, Maternal, And Neonatal Outcomes Related To Oral Intake During Labor, Amanda J. Stepper

All Electronic Theses and Dissertations

Background/Purpose: The purpose of this critical review of literature was to examine the risks and benefits of oral intake during labor and determine if oral intake is beneficial in promoting and supporting positive labor outcomes and maternal satisfaction without increasing risk associated with aspiration and poor birth outcomes. Theoretical/Conceptual Framework: Maslow’s hierarchy of needs was used to guide this literature review. Abraham Maslow’s theory on the hierarchy of needs determined that basic human needs must be met before needs of a higher order are addressed. Methods: Twenty research articles that were applicable to the scope of oral intake during labor …

The Need For A Physical Therapy Clinic In Pucallpa, Peru, Isabella M. Sutton, Abby M. Waldek, Brylie M. Wiedmaier

All Electronic Theses and Dissertations

In developing countries, complications from traumatic injuries account for a significantly higher number of deaths annually compared to developed countries. Not only are traumatic injuries more likely to occur in developing countries, but limited access to quality healthcare and adequate funds to pay for services make it much more likely for individuals to be left with lifelong disabilities. With that, this community service project worked with Scalpel at the Cross (SATC), an orthopedic medical ministry based in Pucallpa, Peru to expand their ability to provide free orthopedic surgeries and physical therapy following traumatic injuries. The community service project will help …

Opioid Knowledge, Confidence, And Concern Of Bethel University Physician Assistant Students, Lealand A. Torgerson, Travis A. Williams

All Electronic Theses and Dissertations

With more than 130 people dying daily, 47,000 overdose-related deaths per year, and $55 billion in societal costs, the opioid epidemic is producing widespread, catastrophic consequences on the population and healthcare system. Healthcare providers report high concern and lack of confidence that their training prepared them adequately to manage chronic pain with opioid therapy. There is insufficient evidence determining whether educating healthcare providers on opioid prescribing guidelines leads to improved knowledge, confidence, and a decrease in concern. The aim of this study is to assess the knowledge, confidence, and concern of 2020 Bethel University physician assistant (PA) students of opioid …

Retrospective Study Of Warfarin Use In The Centracare Family Health Clinic, Lauren Martens, Jessica Lind

Pharmacy Posters

Introduction:

• Warfarin is FDA approved for a variety of indications
• Recommended INR goal ranges can vary depending on indication
• Appropriate warfarin management is necessary for safety and efficacy of the medication
• Since November 2019, warfarin has been managed by the ambulatory pharmacist in the Family Health Clinic

Purpose:

• To further understand the patterns of use of warfarin within the CentraCare Family Health Clinic
• Specifically, determine the prevalence of warfarin indications and corresponding INR goals.

Evaluation Of Heparin-Induced Thrombocytopenia Antibody Laboratory Use And Anticoagulation Prescribing Patterns, Piper Swanson, Jesse Greenlee, Gregory Schaefer, Paul Huiras

Pharmacy Posters

Introduction

• Heparin-induced thrombocytopenia (HIT) is a rare adverse reaction
• Calculating a 4T score prior to ordering a heparin-PF4 immunoassay is recommended. For a score < 4, HIT probability is low and an assay is not advised
• If high suspicion of HIT (4T greater than or equal to 4), an assay should be ordered, all heparin products discontinued, and a non-heparin anticoagulant initiated.

Purpose

• Determine if heparin immunoassay ordering was indicted according to retrospective 4T score
• Assess anticoagulation prescribing depending on the result of the assay
• Serve as a pre-group for a planned perverse post-HIT order set implementation analysis

Evaluation Of Antibiotic Use And Duration For Febrile Neutropenia, Kayla Jensen, Patricia Aubert, Joy Ward, Ann Wigton

Pharmacy Posters

Introduction:

• Febrile neutropenia (FN) affects over 80% of patients with hematologic cancer and 10% to 50% of patients with solid tumors
• National Comprehensive Cancer Network (NCCN) guidelines recommend empiric broad-spectrum monotherapy until the absolute neutrophil count (ANC) is over 500 cells/uL.
• Extended durations with broad-spectrum agents leads to increased risk of antibiotic resistance, toxicity and C. difficile infection.

Purpose

• To evaluate antibiotic prescribing patterns for patients with FN to optimize antibiotic stewardship.

Nursing Annual Report: 2020, Centracare Health

Nursing Annual Report

Message from the CNO

St. Cloud Hospital Statistics

Message from Craig Broman, St. Cloud Hospital President/CEO

Nursing Strategic Plan FY 2020

Message from Tom Schrup, MD/CPO

Education & Certification

Patient Experience

Nursing Care Delivery

Exemplary Professional Practice

Shared Governance

Working Relationships

Professional Development

Nursing Makes a Difference

Diverse Mindfulness Practices For Bipolar Recovery: Qualitative Study Results, Sasha Strong

International Journal of Transpersonal Studies Advance Publication Archive

This study investigated the lived experience of Buddhist-informed mindfulness practice and its utilization in recovery from bipolar disorder (BD) in 9 adult participants. Established mindfulness based interventions (MBIs) decontextualize mindfulness practice from a Buddhist theory base, omitting conceptual frameworks that may have adaptive value in recovery from BD. In interviews, participants reported blending techniques learned from various Buddhist lineages throughout the course of their recovery, as well as a variety of other contemplative practices such as techniques to cultivate adaptive emotions, devotional practices, visualization practices, embodiment practices, investigative practices, and informal daily practice. Mindfulness practice for recovery from BD is …

Healing, Srinivasan Ragothaman

Creative Work

This is a poem reflecting on the current human conditions in the USA, India-China conflict, racism, and other human conflicts. It calls for healing and asks every one to follow the golden rule: treat others as you want them to treat you!

Anger Regulation And Psychosis: Mechanisms Of Impact And Implications For Therapy, Naama Hofman

Theses and Dissertations

Paranoia is strongly associated with anger. This relationship is found across the psychosis spectrum, including individuals at high risk of developing psychosis. The relationship is commonly addressed in the measurement of anger but is rarely addressed in clinical studies. This study explored the relationship between anger regulation and paranoid ideation as well as factors that mediate and moderate this relationship. Specifically, the study examined whether the influence of anger regulation cognitive-behavioral interventions on paranoid ideation changed as aspects of emotional awareness changed. It also examined whether interventions for anger regulation that target different phases of anger generation impacted paranoid ideation …

Gm-1111 Preserves Phagocytic Function Of Macrophages Exposed To Prolonged Hyperoxia Via Interruption Of Hmgb1-Mediated Signaling, Leanne Daley

Theses and Dissertations

Supraphysiological levels of oxygen (i.e. hyperoxia) are used to treat patients with respiratory distress. Prolonged exposure to hyperoxia can impair alveolar macrophage functions and increase susceptibility to ventilator-associated pneumonia (VAP). Hyperoxia-induced alveolar macrophage dysfunction is, in part, mediated by high airway levels of the pro-inflammatory mediator, high mobility group box-1 (HMGB1). An early generation glycosaminoglycan (GAG), 2-O, 3-O desulfated heparin (ODSH), attenuates hyperoxia-compromised innate immunity by preventing the binding of HMGB1 with receptors that activate pro-inflammatory pathways. In this study, we investigated whether the next generation GAG, GM-1111, can attenuate hyperoxia-compromised macrophage function. GM-1111 (100μM) prevented hyperoxia-induced (95% O2 for …

Agal Antigen And Rutinose Glycosides As Model Compounds For The Design Of Classical And Conformational Glycomimetics, Dhwani Ashish Mehta

Theses and Dissertations

αGal or Galili epitope (αGal(1→3)βGal(1→4)GlcNAc) is a natural trisaccharide associated with cell-surface glycoproteins of certain mammalian and non-mammalian cells. The saccharide is not expressed by humans and anti-αGal antibodies account for ~1% of the total circulating antibodies in sera as a result of our constant exposition to the antigen from food and intestinal flora. Our interest in αGal relies on its involvement in a variety of pathologies including red meat allergy, hyperacute xenotransplant rejection, and parasitic and bacterial infections. In particular, we have an interest in developing structurally simple glycomimetics for engaging in high-affinity binding αGal-recognizing receptors such as the …

Investigation Of Percutaneous Drug Pharmacokinetics In Yucatan Mini-Pig Utilizing Microdialysis: Development Of An In Vitro - In Vivo Relationship With Metronidazole Topical Dermatological Drug Products, Benjamin Alexander Kuzma

Selected Full-Text Dissertations 2020-

The use of dermal microdialysis (dMD) to evaluate bioavailability (BA) and bioequivalence (BE) of topical dermatological drug products (TDDP) has shown promising results; however, studies conducted thus far have been inconclusive conceivably due to large inter- and intra-subject variability, in addition to the inability of short experiments to completely characterize the dermis pharmacokinetics (PK). By using multiple test sites on the same subject, and replicate probes at each test site, it is feasible to compare the dermal pharmacokinetics (dPK) of a drug from different products in parallel on the same subject, which in turn will help to control variability. Moreover, …

Implementation Of Proper Lead Selection Based On Ecg Practice Standards In Hospitalized Patients, Teresa Jahn, Nicole Hubbard, Samantha Pohlmann, Lauren Hoeschen, Shayna Lahr

Nursing Posters

Ensure adult patients in a 36 bed Telemetry Unit and 14 bed Cardiac Intensive Care Unit (CICU) with the diagnosis of STEMI and NSTEMI are being monitored in the appropriate leads to detect acute or silent ischemia and arrhythmias.

Meeting The Educational Needs Of The Busy Bedside Nurse: Curbside Education An Innovative Program, Ashley O'Connell, Kayla Waldoch, Amy Junes

Nursing Posters

• Seek out educational needs of staff based on current changes, trends and new hires
• Provide on the spot reinforcement of skills, policies, education and policy changes for all staff
• Implement skill stations, including "off shifts", to increase staff cohesiveness and preparedness in emergent and nonemergent scenarios

Huddle To Enhance Patient Progression Of Care, Melinda Jennings, Kristi Patterson, Jennifer Salzer

Nursing Posters

CentraCare (CC) is committed to improving patient flow and is now using the Geometric Mean Length of Stay (GMLOS) Index as our primary measure of success. This is a Key Performance Indicator that is monitored by the Patient Flow Steering Committee and Executive Leadership. In recent years, SCH GMLOS Index is higher than expected.

Providing Education Regarding Antimicrobial Stewardship For The Bedside Nurse, Anna Boeke

Nursing Posters

• Two million people acquire drug resistant bacteria and around 23,000 die from infection-related resistance each year (CDC, 2018a) and Up to 50% of antibiotics are incorrectly prescribed, including usage, dosage, and duration (CDC, 2017)
• Clostridium difficile (C.diff) is a common problem seen in the hospital
• Antimicrobial stewardship (AMS) as a proven method of addressing the problem of antibiotic resistance by education, multidisciplinary efforts, and refined resource utilization
• The biggest problem is nursing staff are unsure how to participate in AMS!

Reduced Frequency Monitoring Post-Stoke Treatment, Melissa Freese

Nursing Posters

In 2020, the nation was faced with a pandemic that quickly depleted health care resources. Standards of care were reviewed to identify opportunities to reduce the burden on healthcare resources. One of the standards of care that was reviewed nationally and locally at the St. Cloud Hospital (SCH), was the postalteplase/ thrombectomy patient placement and monitoring.

The standard of care for the placement and monitoring of post-alteplase patients was established during the 1996 NINDS trial and has not been studied since. Very minimal literature is available on the standard of care for patient placement and monitoring post-thrombectomy.