Medicine and Health Sciences Commons^™

Reducing The Second Victim Phenomenon: Promoting Healing With Caritas Coaching, Shanda N. Whittle

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem: The second victim phenomenon is one in which healthcare providers use dysfunctional mechanisms, such as anger, projection of blame, or drugs and/or alcohol to cope with serious mistakes in the absence of a healthier means for healing (Wu, 2000). This phenomenon can be caused by adverse events or other personal/professional crises and can lead to healthcare professional absenteeism, leaving the job or leaving the profession altogether (Burlison et al., 2018; Hirschinger et al., 2015).

Context: The second victim phenomenon was identified as a problem within this DNP student’s organization and support was obtained for conducting the project. A …

Wound Care Education For Primary Care Providers At A Regional Medical Center, Zaira Torres

Doctor of Nursing Practice (DNP) Projects

Problem. Due to the aging population and the high prevalence of chronic diseases such as diabetes and cardiovascular disease, in the US, millions of people suffer from chronic wounds secondary to these chronic conditions. Wound care treatment is very expensive, costing the US health care system approximately $10 billion annually. San Mateo Medical Center treats many patients with wounds. However, the treatment is suboptimal as most primary care providers (PCPs) are not trained to perform wound care according to best practice. This creates several problems such as a large number of referrals to the Vascular Clinic, visits to the emergency …

Evidence-Based Suicide Assessment And Prevention Training For Licensed Nursing Staff, Rose Waithira Zhang Dnp(C), Msn-Fnp-Bc, Bsn, Rn

Doctor of Nursing Practice (DNP) Projects

Section I: Abstract

Problem: Suicide is a major public health concern that kills over 45,000 people in the U.S every year. At a psychiatric hospital in Northern California, several suicide attempts occur every year.

Context: The aim of this DNP project was to train licensed nursing staff at a large safety net psychiatric hospital in Northern California on interventions and best practices in suicide prevention to improve suicide screening, assessment, and detection for an at-risk population.

Intervention: Interventions consisted of training on the appropriate use of (a) the organization’s Evidence-based Suicide Screening and Prevention Protocol and (b) an evidence-based suicide …

Wound And Stoma Care Education For Primary Care Providers, Deanna Garza

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem. Patients with percutaneous endoscopic gastrostomy (PEG) tubes and their families report physical and psychosocial changes associated with complications after gastrointestinal surgeries. They are at particular risk for tube dislodgement, leakage, infection, poor fit, and skin irritation. The lack of specialization and fundamental stoma care knowledge among community health care providers potentially results in unintended consequences, leaving the system inefficient with fundamental inequities of stoma care delivery. While there is an increasing amount of accessibility to specialty centers for other types of wound care, stoma care support resources are scarce and not readily available to patients.

Context: This Doctor …

Reducing Frustration With Wait Times Utilizing Technology And Education: A Patient Satisfaction Improvement Model, Tiffany Brown

Doctor of Nursing Practice (DNP) Projects

Problem: Patients spend considerable amounts of valuable time waiting to be seen by physicians in outpatient clinical settings. Many consider waiting as wasted time, inactive time, or as a lost opportunity which can cause frustration. Research suggests that long clinic wait times have a major impact on patients with cancer causing a significant amount emotional distress. Context: At the hospital and thoracic oncology clinic implementation site which is located in northern California, the target time for a New Patient Visit (NPV) is less than or equal to 90 minutes, and less than or equal to 60 minutes for a Return …

Initiating Prep In Primary Care: Addressing The Adolescent And Young Adult High Risk Populations, Igor G. Mocorro

Doctor of Nursing Practice (DNP) Projects

Problem: Adolescents and young adults (AYA) ages 13 to 24 comprise a quarter of the new HIV diagnoses in the United States. Lack of access to HIV-preventive therapies such as pre-exposure prophylaxis (PrEP) reduces opportunities to prevent HIV infection in this population. Initiating PrEP in AYA significantly reduces the negative health outcomes of HIV, but it is evident that many clinicians are still reluctant to initiate PrEP in AYA patients based on perceived threats and barriers.

Context: Primary care clinics, including school-based clinics, have an opportunity to offer HIV prevention services including PrEP. This project, the Adolescent and Young Adult …

Dnp Final Project: Implementing Teamstepps Training: Using Evidence To Impact Teamwork In An Acute Care Hospital, Nana Baah Adjei

DNP Final Reports

Background: Medical errors are the third leading cause of death in the United States. Patient morbidity and mortality will decrease when institutional efforts result in the implementation of action plans which reduce medical errors. Teamwork, education, and training through structured initiatives are the most effective mechanism to improve patient safety. Purpose: The project aims to impact the perception of communication among newly hired medical surgical nursing and support staff. The acute care hospital is a 200-bed tertiary care hospital. Intervention: The intervention consists of the registered nurses and support staff participating in an innovative, six-hour, interactive TeamSTEPPS fundamentals course. Results: …

The Stories Behind The Struggle: A Closer Look At First Experiences With Opioid Misuse, Khary K. Rigg, Shannon M. Monnat, Katherine Mclean, Ashton Verdery, Glenn Sterner

Population Health Research Brief Series

The opioid crisis is a national public health emergency. Over 47,000 people in the U.S. died of opioid overdoses in 2017. Improving our knowledge about how people first come to misuse opioids can help to inform prevention and treatment interventions. This research brief shows that opioid misuse most often begins before age 25, most people obtain the opioids they misuse from friends and family rather than a health care provider, and experimenting and coping with life stressors are the most common motivations for starting opioid misuse.

Abstract 219: Use Of Machine Learning Models To Identify Atherosclerotic Cardiovascular Disease Patients At Very High Risk For Future Events In A Multi-State Health Care System, Hsin-Fang Li, Amir Ali, Kateri Spinelli, A Sajja, Ss Virani, Ss Martin, Tyler J Gluckman

Articles, Abstracts, and Reports

Background: In the 2018 AHA/ACC Blood Cholesterol Guideline, it is recommended that ASCVD patients be classified as very high-risk (VHR) vs not-VHR (NVHR) to guide treatment decisions. This has important implications for ezetimibe and PCSK9 inhibitor eligibility. We aimed to develop a tool that could assist in more easily identifying VHR patients based on machine learning (ML) techniques. This approach offers a powerful, assumption-free alternative to conventional methods, such as logistic regression, to identify potential interactions among risk factors while incorporating the hierarchy of interaction among variables.

Method: We used EHR-derived ICD-10 codes to identify patients within our health system …

Steam Treatment For Rapid Decontamination Of N95 Respirators And Medical Face Masks, Sarah N. Redmond, Lucas D. Jones, Curtis J. Donskey

Faculty Scholarship

No abstract provided.

Multicenter, Observational Cohort Study Evaluating Third-Generation Cephalosporin Therapy For Bloodstream Infections Secondary To Enterobacter, Serratia, And Citrobacter Species, Caroline Derrick, P. Brandon Bookstaver, Zhiqiang K. Lu, Christopher M. Bland, S. Travis King, Kayla R. Stover, Kathey Rumley, Shawn H. Macvane, Jenna Swindler, Scott Kincaid, Trisha Branan, David Cluck, Benjamin Britt, Kelly E. Pillinger, Bruce M. Jones, Virginia Fleming, V. Paul Dimondi, Sandy Estrada, Brad Crane, Brian Odle, Majdi N. Al-Hasan, Julie Ann Justo

Faculty Publications

Objectives: There is debate on whether the use of third-generation cephalosporins (3GC) increases the risk of clinical failure in bloodstream infections (BSIs) caused by chromosomally-mediated AmpC-producing Enterobacterales (CAE). This study evaluates the impact of definitive 3GC therapy versus other antibiotics on clinical outcomes in BSIs due to Enterobacter, Serratia, or Citrobacter species. Methods: This multicenter, retrospective cohort study evaluated adult hospitalized patients with BSIs secondary to Enterobacter, Serratia, or Citrobacter species from 1 January 2006 to 1 September 2014. Definitive 3GC therapy was compared to definitive therapy with other non-3GC antibiotics. Multivariable Cox proportional hazards regression evaluated the impact of …

The Anti-Proliferative Effects Of Methotrexate And Novel Ucp1162 On Acute Myeloid Leukemia Cell Lines, Jacqueline Klepinger, Charles Giardina, Didem Ozcan

Honors Scholar Theses

Cancer cells proliferate at rapid rates due to the aberrant activity of proteins involved in regulating the cell cycle. This characteristic allows mutated cancer cells to spread and metastasize, causing lesions to form throughout the body. Two treatment conditions, one classical antifolate methotrexate (MTX) and non-classical, novel antifolate UCP1162, were tested on a panel of acute myeloid leukemia (AML) cell lines to determine if UCP1162 has higher anti-proliferative activity. High dose MTX is used as a first line chemotherapy in common childhood malignancies such as acute lymphoid leukemia (ALL). Methotrexate is excluded from acute myeloid leukemia (AML) treatments based on …

Dnp Final Report: Sedation Protocol Compliance For Improved Outcomes In Intensive Care, Sonya M. Grigsby

DNP Final Reports

Background: Current evidence-based practice guidelines show that lighter sedation reduces mechanical ventilator days (MVD) and intensive care (ICU) length of stay (LOS). Guidelines (2018) for the management of pain, agitation, delirium, immobility, and sleep were released to direct appropriate high-quality care to achieve positive outcomes. However, studies demonstrated there were barriers to compliance of these guidelines.

Objective: To improve compliance with an existing evidence-based sedation protocol in an intensive care, and, thereby, improve patient outcomes (MVD and ICU LOS).

Methods: The three-month quality improvement (QI) project evaluated processes leading to compliance with the guideline. First, nurses were surveyed to determine …

A Training Program For Therapeutic Living Counselors Supervising Self-Medication Among Commercially-Sexually Exploited Children In A Residential Home Setting, Irene Tsimba Zenga

Master's Projects and Capstones

Abstract

Problem: Commercial sexual exploitation of children (CSEC) is a critical human rights and public health issue. Abundant evidence shows that sexually exploited youth are at high risk for medical and psychiatric problems, manifest fright and isolation, and have substantial trauma mitigation needs. A short term residential therapeutic home (STRTP) was created in Northern California to provide holistic care to teens victims of sexual exploitation. A therapeutic team is necessary to provide the medical and mental health requirements of STRTP residents.

Context: This evidence-based change of practice project was conducted at a 15-bed STRTP in Northern California that will house …

Cirrhosis For The Pcp, Krys Foster, Md, Mph

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives:

• Understand the morbidity and mortality associated with Cirrhosis in the United States
• Recognize etiologies and clinical presentation of cirrhosis
• Identify decompensated cirrhosis and approaches to treatment and monitoring

Agenda

• Definition and Epidemiology
• Etiologies
• Clinical Presentation
• Diagnosis and Evaluation/Classification
• Management of Compensated Cirrhosis
• Decompensated Cirrhosis & Complications
• ○ Portal Hypertension ○ Varices ○ Ascites ○ SBP ○ Hepatorenal Syndrome ○ Hepatic Encephalopathy
• Secondary Prevention and Long Term Management
• Conclusions

Louisiana State University Health Sciences Center - 2020 - 146th Commencement, Office Of The Registrar, Lsu Health Sciences Center-No

Graduation & Commencement Programs

The program for the 146th Commencement of LSU Health Sciences Center - New Orleans held May 14, 2020.

Risk Factors For Postpartum Sepsis: A Nested Case-Control Study, Samina Bakhtawar, Sana Sheikh, Rahat Qureshi, Zahra Hoodbhoy, Beth Payne, Iqbal Azam Syed, Peter Von Dadelszen, Laura Magee

Community Health Sciences

Background: The Majority (99%) of maternal deaths occur in low and middle-income countries. The three most important causes of maternal deaths in these regions are postpartum hemorrhage, pre-eclampsia and puerperal sepsis. There are several diagnostic criteria used to identify sepsis and one of the commonly used criteria is systematic inflammatory response syndrome (SIRS). However, these criteria require laboratory investigations that may not be feasible in resource-constrained settings. Therefore, this study aimed to develop a model based on risk factors and clinical signs and symptoms that can identify sepsis early among postpartum women.
Methods: A case-control study was nested in an …

Associations Between Recent Intimate Partner Violence And Receipt And Quality Of Perinatal Health Services In Uttar Pradesh, Jay G. Silverman, Ruvani W. Fonseka, Nabamallika Dehingia, Sabrina C. Boyce, Dharmendra Chandurkar, Kultar Singh, Katherine Hay, Yamini Atmavilas, Anita Raj

Faculty Research, Scholarly, and Creative Activity

Background
India suffers some of the highest maternal and neonatal mortality rates in the world. Intimate partner violence (IPV) can be a barrier to utilization of perinatal care, and has been associated with poor maternal and neonatal health outcomes. However, studies that assess the relationship between IPV and perinatal health care often focus solely on receipt of services, and not the quality of the services received.
Methods and findings
Data were collected in 2016–2017 from a representative sample of women (15-49yrs) in Uttar Pradesh, India who had given birth within the previous 12 months (N = 5020), including use of …

Vaccines, Children, And The Public Health Trust, Christopher Chambers, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives

1. Review the impact of immunizations on the public health over the past 50 years.
2. Childhood Vaccines Now
3. Describe the challenges associated with trying to eliminate “immunizable” diseases. Examples: Invasive Pneumoccal Disease, Neisseria meningitis
4. The Future

Identity Development In Transgender Women Of Color: An Interpretative Phenomenological Analysis, Angel Tseng

Doctoral Dissertations

Transgender women of color have been at the forefront of LGBT rights moments in the U.S. and has been credited for leading the Stonewall resistance (Roberts, 2018). Though much has changed since Stonewall, transgender women of color still face harassment, discrimination, and many other barriers and health risks today. One of the many challenges faced by transgender women of color is identity conflict. The purpose of the study was to examine the identity development processes of transgender women of color. This qualitative research study utilized Interpretative Phenomenological Analysis to explore the lived experiences and narratives of individuals from this community …

Similac Special Care And Elecare Cause Neonatal Gut Injury In Mice, Karishma Rao, Heather L. Menden, Wei Yu, Inamul Haque, Susana Chavez-Bueno, Alain C. Cuna, Shahid Umar, Venkatesh Sampath

Research Days

No abstract provided.

Variability In Naltrexone Biotransformation, Stephani L. Stancil

Research Days

No abstract provided.

Characterization Of The Duodenal Microbiome In Children With And Without Crohn's Disease, Kenneth Schmidt

Research Days

No abstract provided.

Methotrexate Polyglutamates As Biomarkers Of Treatment Response In Ibd Vs. Jia, Ryan Morrow

Research Days

No abstract provided.

Clinical Validation And Diagnostic Rate/Outcomes Of A Dual Molecular Diagnostic Assay For Myotonic Dystrophy 1., Maxime Cadieux-Dion, Isabelle Thiffault, Midhat S. Farooqi, Joseph Alaimo

Research Days

No abstract provided.

Disparities In Access To Services For Children Undergoing Routine Autism/Developmental Screening In Primary Care, Caroline Pittard, Laura Hansen, Cy Nadler, Sarah Nyp

Research Days

No abstract provided.

Feasibility Of Using Cerner Health Facts To Characterize Comorbid Down Syndrome And Autism Spectrum Disorder, Michael Slogic

Research Days

No abstract provided.

Dehydrated Hereditary Stomatocytosis Causing Severe Ascites Leading To Pulmonary Hypoplasia And Respiratory Insufficiency In A Neonate, Michael D. Mcdowell Jr

Research Days

No abstract provided.

Correlation Between Zinc And Hemoglobin F, Oluwaseun Olaiya, Ashley K. Sherman, Nazia Tabassum, Gerald Woods

Research Days

No abstract provided.

Angiopoietin 1 Protects Against Lps-Induced Acute Lung Injury And Alveolar Remodeling In Neonatal Mice, Umar Salimi

Research Days

No abstract provided.