Medicine and Health Sciences Commons^™

Standardizing Patient Handoffs In The Icu – Implementing The “I Put Patients First” Tool., Wislande Joseph

Master's Projects and Capstones

Abstract

Background. Ineffective patient handoff can result in poor nurse communication, increasing the likelihood of adverse events including medication and documentation errors.

Context/Problem. In one 20-bed ICU unit in a northern California community hospital, 48 patient handoffs were observed over 2 weeks. Only 29% occurred at the patient’s bedside; 39.5% used a standardized handoff tool; and 54% included the patient and/or family. These findings indicate significant quality gaps in the unit’s ICU patient handoff processes.

Intervention. The educational intervention consisted of one introductory and two follow-up teaching sessions related to best practices for handoff processes followed by implementation …

Creation Of A Covid-19 Community Testing Team For Home Health And Hospice, Lilah Raja

Master's Projects and Capstones

The novel SARS-CoV-2 strain (COVID-19) was identified in Wuhan, China in December 2019 (Eddy et. al, 2020). The resulting US outbreak has affected the Kaiser Permanente (KP) Oakland health care system. With the threat of COVID-19 highest among immunosuppressed and elderly clients, KP Oakland home health and hospice (HH/HO) department is rapidly mobilizing to provide community and in-home testing for eligible clients. A project was created to build a COVID-19 testing team workflow to provide diagnostic and preventative testing. This project focuses on team-based interventions that will change the pre-existing practice of requiring HH/HO clients to travel to remote testing …

Current Available Computer-Aided Detection Catches Cancer But Requires A Human Operator, Florentino Saenz Rios, Giri Movva, Hari Movva, Quan D. Nguyen

School of Medicine Publications

Introduction: This study intends to show that the current widely used computer-aided detection (CAD) may be helpful, but it is not an adequate replacement for the human input required to interpret mammograms accurately. However, this is not to discredit CAD’s ability but to further encourage the adoption of artificial intelligence-based algorithms into the toolset of radiologists.

Methods: This study will use Hologic (Marlborough, MA, USA) and General Electric (Boston, MA, USA) CAD read images provided by patients found to be Breast Imaging Reporting and Data System (BI-RADS) 6 from 2019 to 2020. In addition, patient information will be pulled …

Whole Health Options And Pain Education (Whope): A Pragmatic Trial Comparing Whole Health Team Vs Primary Care Group Education To Promote Nonpharmacological Strategies To Improve Pain, Functioning, And Quality Of Life In Veterans-Rationale, Methods, And Implementation, Karen H Seal, Kavitha Reddy, Et Al.

2020-Current year OA Pubs

BACKGROUND: The Whole Health model of the U.S. Department of Veterans Affairs (VA) emphasizes holistic self-care and multimodal approaches to improve pain, functioning, and quality of life. wHOPE (Whole Health Options and Pain Education) seeks to be the first multisite pragmatic trial to establish evidence for the VA Whole Health model for chronic pain care.

DESIGN: wHOPE is a pragmatic randomized controlled trial comparing a Whole Health Team (WHT) approach to Primary Care Group Education (PC-GE); both will be compared to Usual VA Primary Care (UPC). The WHT consists of a medical provider, a complementary and integrative health (CIH) provider, …

Low-Dose Psoralen–Uv-A Maintenance Therapy Prolongs Disease-Free Remission Rates In Mycosis Fungoides Patients, Joshua M. Brady

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using Vieyra-Garcia P, Fink-Puches R, Porkert S, et al. Evaluation of Low-Dose, Low-Frequency Oral Psoralen–UV-A Treatment With or Without Maintenance on Early-Stage Mycosis Fungoides. JAMA Dermatology. 2019;155(5):538. https://doi.org/10.1001/jamadermatol.2018.5905 for a patient weighing whether to continue treatment in light of socioeconomic circumstances.

Improved Tolerability And Efficaciousness Of Miralax-Gatorade When Compared To Golytely In The Outpatient Setting, Bassem Farah

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using Gu P, Lew D, Jung OS, et al. Comparing the Real-World Effectiveness of Competing Colonoscopy Preparations: Results of a Prospective Trial. Am J Gastroenterol. 2019;114(2):305-314. https://doi.org/10.14309/ajg.0000000000000057 for a patient reluctant to undergo colonoscopy screening due to concerns about GoLYTLEY's tolerability.

Deep Learning-Based Cross-Classifications Reveal Conserved Spatial Behaviors Within Tumor Histological Images., Javad Noorbakhsh, Saman Farahmand, Ali Foroughi Pour, Sandeep Namburi, Dennis Caruana, David Rimm, Mohammad Soltanieh-Ha, Kourosh Zarringhalam, Jeffrey Chuang

Faculty Research 2020

Histopathological images are a rich but incompletely explored data type for studying cancer. Manual inspection is time consuming, making it challenging to use for image data mining. Here we show that convolutional neural networks (CNNs) can be systematically applied across cancer types, enabling comparisons to reveal shared spatial behaviors. We develop CNN architectures to analyze 27,815 hematoxylin and eosin scanned images from The Cancer Genome Atlas for tumor/normal, cancer subtype, and mutation classification. Our CNNs are able to classify TCGA pathologist-annotated tumor/normal status of whole slide images (WSIs) in 19 cancer types with consistently high AUCs (0.995 ± 0.008), as …

An Online Resource To Promote Well-Being Among College Students With Social Anxiety Disorder, Valerie Maxine Sanderson, Steven M. Gerardi, Jerilyn Callen

Fall 2020 Virtual OTD Capstone Symposium

Transitioning from high school to college can be a challenge for many students, especially those with social anxiety disorder (SAD). SAD can negatively impact a student’s ability to effectively participate in school. Occupational therapy intervention could be useful to students with SAD but many do not seek out treatment due to fear of stigmatization or discrimination. Not seeking services may place students with SAD at risk of developing unhealthy coping strategies (e.g., avoidant behaviors, alcohol use). The availability of an online resource to support participation in school, without the need to disclose their condition, could be helpful to students with …

Forward Together Update [Vaccine Update & Quarantine Change], December 11, 2020, University Of Northern Iowa

UNI Response to COVID-19

Announces initial plans for the administration of the COVID-19 vaccine once it becomes available to campus and a change in the quarantine protocol for people in close contact with someone with COVID-19.

Addressing The Unspoken Adl: A Professional Development Training, Cadence Starr, Angela Blackwell

Fall 2020 Virtual OTD Capstone Symposium

Sexual activity is the most neglected and unspoken about Activity of Daily Living (ADL) in occupational therapy clinical practice due to lack training on how to address it with clients. Addressing the Unspoken ADL is a professional development training, created to train occupational therapist on how to talk about and include sexuality into evaluations and intervention strategies when working with individuals with spinal cord injury. This poster presentation outlines the completed literature review and development and implementation of Addressing the Unspoken ADL: A Professional Development Training.

Development Of A Universal Design Playroom For Children With Visual Impairments, Alejandra Sanchez, Angela Blackwell, Gina Benevente

Fall 2020 Virtual OTD Capstone Symposium

This project aims to create a safe and inclusive playroom for children 0-4-year-old with visual impairment (VI), and to promote the development in social interaction, motor, and process (thinking) skills. With the use of play, children with VI can improve their developmental skills by their interaction with peers and the environment which will improve their well-being. The Person-Environment-Occupation- Performance Model was used to find dysfunction in the constructs that would limit the performance in play for children with VI. The project renovated the San Antonio Lighthouse for the Blind and Visually Impaired (SALBVI) playroom to accommodate the needs of the …

An Occupational Perspective: Supporting The Paternal Role And Transition Home From The Nicu, Bryana Salazar, Susan Macdermott, Becki Cohill, Karen Park

Fall 2020 Virtual OTD Capstone Symposium

Objective: The purpose of this study is to identify occupational therapy’s role in supporting paternal wellness and mental health through routines and occupations, following the transition from the Neonatal Intensive Care Unit (NICU) back home.

Study Design: Online surveys (n=32) and virtual interviews (n=11) were collected in order to complete a mixed-method design study. Interviews were manually transcribed and coded onto Dedoose. Thematic analysis was conducted in order to derive overall themes.

Results: This study delved into the experience of fathers’ post NICU discharge. Five overall themes were identified in this study Adjusting Expectations of the initial transition, …

Self-Regulation For Adolescent Survivors Of Sex Trafficking: An Occupational Therapist’S Perspective, Elyse Harmon, Becki Cohill, Susan Macdermott, Karen Park

Fall 2020 Virtual OTD Capstone Symposium

Adolescent survivors of sex trafficking (SST) are susceptible to being in a continual dysregulated arousal state due to a lack of mastery in self-regulation. During the trafficking experience, many adolescent SST experience severe trauma and are deprived of opportunities that foster essential regulatory capacities needed for occupational engagement. The use of sensory-based approaches that focus on addressing arousal dysregulation and the impact it has on occupation is an evidence-based practice grounded in occupational therapy research.

This capstone sought to support community reintegration for adolescent SST through the development of sensory-based programming that fosters self-regulation, a skill necessary for lifelong occupational …

Development Of A Disaster Preparation Toolkit To Improve Community Resilience, Tiffany Wong

Doctor of Nursing Practice (DNP) Projects

Problem: Natural and man-made disasters happen in all communities and negatively impact the health and safety of populations. Vulnerable populations, such as older adults with comorbidities and disabilities or those aging in place, face greater challenges and have specific needs when faced with disasters. The physical, psychosocial, and cultural characteristics of older adults place them at greater risk during disasters. Emergency preparedness is necessary to build and improve community resilience, as well as to ensure older adults aging in place have the necessary supplies and support to respond to a disaster. Without a proper action plan, recovery efforts during disaster …

2020-12-11_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 …

2020-12-11_Michigandaily_Covidmap, Michigan Department Of Health & Human Services

Daily Michigan COVID-19 Update

The "WHERE WE STAND WITH COVID-19" map was obtained from Michigan's main COVID-19 page: https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily at 3p.m., Monday - Saturday.

The State of Michigan is working around the clock to test and treat COVID-19 patients. Below is the most recent data healthcare experts across the state have compiled.

The image contained a map, indicating total cases by county, and also provides statistics on Total Confirmed Cases, Total COVID-19 Deaths, Daily Confirmed Cases, and Daily COVID-19 Deaths. There …

Message From Dr. Petillo 12/11/20, The Coronavirus Planning Team, John J. Petillo

University Briefings & Virtual Events

Well, it certainly has been an unusual year. They say that every cloud has a silver lining. The silver lining for me in all that we have fought through this semester is YOU. This year has reinforced in a big way what I already knew about you—you care about others and SHU’s mission and values; you are resilient and adaptable; you are creative and find new ways to overcome challenges; you are hard-working and determined in the face of adversity; you are Pioneers in every sense of the word. And, when I say YOU, I am talking about every single …

2020-12-11_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 Hospital Capacity Report for COVID-19, COVID-19 Metrics, Statewide Hospital Available PPE Tracking for COVID-19, as well as the tables PPE Days On Hand and Patient Census.

2020-12-11_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.

The State of Michigan is working around the clock to test and treat COVID-19 patients. Below is the most recent data healthcare experts across the state have compiled. It is updated Monday - Saturday.
This report is provisional and subject to change. City of Detroit and Wayne County are reported separately. MDHHS began tracking probable cases April 5, 2020. FCI indicates federal correctional institute. MDOC indicates Michigan Department of Corrections. Diagnostic tests, including nucleic acid amplification/real-time polymerase chain reaction (NAAT/RT-PCR) and rapid virus antigen detection point of …

Mass Cytometry Defines Virus-Specific Cd4 + T Cells In Influenza Vaccination, Priyanka B Subrahmanyam, Tyson H Holmes, Dongxia Lin, Laura F Su, Gerlinde Obermoser, Jacques Banchereau, Virginia Pascual, Adolfo García-Sastre, Randy A Albrecht, Karolina Palucka, Mark M Davis, Holden T Maecker

Faculty Research 2020

The antiviral response to influenza virus is complex and multifaceted, involving many immune cell subsets. There is an urgent need to understand the role of CD4+ T cells, which orchestrate an effective antiviral response, to improve vaccine design strategies. In this study, we analyzed PBMCs from human participants immunized with influenza vaccine, using high-dimensional single-cell proteomic immune profiling by mass cytometry. Data were analyzed using a novel clustering algorithm, denoised ragged pruning, to define possible influenza virus-specific clusters of CD4+ T cells. Denoised ragged pruning identified six clusters of cells. Among these, one cluster (Cluster 3) was found to increase …

Transformational Leadership For Frontline Leaders, Marta L. Hudson

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem. Transformational leadership (TL) represents the gold standard of leadership styles in contemporary healthcare organizations. The transformational leader's ability to motivate, influence, stimulate, inspire, and attend to followers' individual needs is an antecedent to job satisfaction, quality, and patient safety. The project aimed to improve TL constructs among frontline leaders (managers and assistant nurse managers). Based on the results of a needs assessment, these frontline leaders were provided an opportunity to improve their TL style.

Context. Leadership development is a strategic priority for a medium-sized medical center in a healthcare system in Northern California. Frontline leaders within patient care …

Transcriptional Profiling Of Leukocytes In Critically Ill Covid19 Patients: Implications For Interferon Response And Coagulation, Sean E Gill, Claudia C Dos Santos, David B O'Gorman, David E Carter, Eric K Patterson, Marat Slessarev, Claudio Martin, Mark Daley, Michael R. Miller, Gediminas Cepinskas, Douglas Fraser

Paediatrics Publications

BACKGROUND: COVID19 is caused by the SARS-CoV-2 virus and has been associated with severe inflammation leading to organ dysfunction and mortality. Our aim was to profile the transcriptome in leukocytes from critically ill patients positive for COVID19 compared to those negative for COVID19 to better understand the COVID19-associated host response. For these studies, all patients admitted to our tertiary care intensive care unit (ICU) suspected of being infected with SARS-CoV-2, using standardized hospital screening methodologies, had blood samples collected at the time of admission to the ICU. Transcriptome profiling of leukocytes via ribonucleic acid sequencing (RNAseq) was then performed and …

Trypanosoma Cruzi Modulates Piwi-Interacting Rna Expression In Primary Human Cardiac Myocytes During The Early Phase Of Infection, Kayla J. Rayford, Ayorinde Cooley, Ashutosh Arun, Girish Rachakonda, Yulia Kleschenko, Fernando Villalta, Siddharth Pratap, Maria F. Lima, Pius N. Nde

Publications and Research

Trypanosoma cruzi dysregulates the gene expression profile of primary human cardiomyocytes (PHCM) during the early phase of infection through a mechanism which remains to be elucidated. The role that small non-coding RNAs (sncRNA) including PIWI-interacting RNA (piRNA) play in regulating gene expression during the early phase of infection is unknown. To understand how T. cruzi dysregulate gene expression in the heart, we challenged PHCM with T. cruzi trypomastigotes and analyzed sncRNA, especially piRNA, by RNA-sequencing. The parasite induced significant differential expression of host piRNAs, which can target and regulate the genes which are important during the early infection phase. An …

An Evaluation Of Adolescent Concussion Management And Guidelines By Primary Care Providers In The Outpatient Setting: Dnp Scholarly Project, Mary Beth Newkirk

Doctor of Nursing Practice Scholarly Project

Understanding the pathology of a concussion has been a challenging task for many experts in healthcare. An agreed upon definition has yet to be developed and many health care providers are not properly educated to assess and care for those suffering from a concussion. Management of concussion in adolescents, a vulnerable population, requires even more consideration and training. The purpose of this study was to determine the knowledge current providers in the four-state region regarding sport-related concussion management in the adolescent population, to improve patient care and outcomes, and to improve knowledge learned through exposure to a clinical practice guideline-based, …

Evaluation Of A Fall Prevention Program For Older Adults In A Rural Community, Candice Morris

Doctor of Nursing Practice Scholarly Project

This project set out to evaluate fall prevention interventions for older adults in a rural community. A literature review was performed to identify evidence-based fall prevention programs that could be modified to meet the needs of the community. Stopping Elderly Accidents, Deaths, and Injuries (STEADI), the Otago Exercise Program, and Stepping On were selected as the most appropriate fit for the needs of this project. The researcher combined and modified the programs in order to bring the intervention to participants in the community. The modified fall prevention intervention successfully reduced key fall risk factors in the participants that completed the …

Social Determinants Of Discrimination And Access To Health Care Among Transgender Women In Oregon, Jonathan Garcia, Richard A. Crosby

Health, Behavior & Society Faculty Publications

Purpose: Transgender women in the United States experience health disparities and limited access to gender-affirming health services. This study describes the social determinants of health that shape access to health services for transgender women in Oregon, a state with a high tally of gender-affirming policies.

Methods: We conducted qualitative interviews with 25 transgender women between 18 and 39 years of age. Interviews explored the social, economic, cultural, and legal factors that shape access to health. A Qualtrics survey captured sociodemographic characteristics. We identified facilitators and barriers to accessing gender-affirming services using thematic analysis of qualitative data.

Results: Our participants perceived …

Enhancing Quality Of Life For Individuals With Dementia Through A Virtual Ot Based Equine-Assisted Activities Program, Lauren Fearn, Becki Cohill, Karen Park, Martha Gipson

Fall 2020 Virtual OTD Capstone Symposium

Individuals living with dementia typically experience progressive, cognitive, and functional decline which limits their ability to communicate and fully perform activities (Pimouguet el al., 2019). Horses have been shown to benefit individuals with dementia by improving well-being, physical health, functional capacity, and social relationships (Fields et. al., 2019). A 6-week OT based virtual equine-assisted activities program was conducted to determine if participation in equine-assisted activities could improve the quality of life of individuals with dementia. Outcomes of the program resulted in improvements in mood, energy level, engagement, communication, memory, socialization, and overall quality of life.

FromSubjectReceivedSizeCategoriesLauren FearnAbstract for Poster7:11 PM26 …

Thaw Publications, Carl Landwehr, David Kotz

Computer Science Technical Reports

In 2013, the National Science Foundation's Secure and Trustworthy Cyberspace program awarded a Frontier grant to a consortium of four institutions, led by Dartmouth College, to enable trustworthy cybersystems for health and wellness. As of this writing, the Trustworthy Health and Wellness (THaW) project's bibliography includes more than 130 significant publications produced with support from the THaW grant; these publications document the progress made on many fronts by the THaW research team. The collection includes dissertations, theses, journal papers, conference papers, workshop contributions and more. The bibliography is organized as a Zotero library, which provides ready access to citation materials …

Implementation And Evaluation Of Whole Health Opioid Safety Shared Medical Appointments In A Veteran Population: A Quality Improvement Study, Sherry Cox

Doctor of Nursing Practice (DNP) Projects

Problem: The most recent data from the Centers for Disease Control and Prevention (CDC, 2018b) suggest that 130 Americans die from an opioid overdose each day, thus creating an unprecedented number of opioid-related deaths in the United States to date.

Context: Of particular interest to the author and this DNP project is that Veterans are twice as likely to die from an opioid overdose, compared to the average American, making this epidemic a priority for Veterans Health Administration (Wilkie, 2018).

Interventions: The author developed a 9-session Opioid Safety Shared Medical Appointment (SMA) program to reduce opioid reliance in …

Program Implementation For New Graduate Nurses To Go From Moral Distress To Moral Courage And Beyond, Melinda Furrer

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem: Moral distress is a widespread issue across all nursing professions: from new graduate nurses to nurses with many years of experience. New graduate nurses are susceptible to moral distress and leaving the profession within the first year. Nationally, there has been a 27.7% turnover within the population of new graduate nurses with less than one year of experience (Nursing Solutions, Inc., 2019).

Context: This Doctor of Nursing Practice (DNP) quality improvement (QI) project consisted of implementing a program to help new graduate nurses build moral courage. The QI project encourages self-empowerment, moral courage, and resiliency among new resident …