Medicine and Health Sciences Commons^™

Registered Nurses’ Images Of Nursing During A Pandemic, Abigail Slaktowski

Honors Projects

The purpose of this research study was to discover any new or transformed images of nursing during the COVID-19 pandemic in the United States. The research question was “What are Registered Nurses’ images of nursing while working during a pandemic?” Registered nurses submitted an image and a brief narrative of the image through REDCap ©, a secure database, describing how the image and culture of nursing is impacted by the COVID-19 pandemic. Using Leininger’s Four Phases of Data Analysis (1991), the five submitted photos and narratives were analyzed. Data analysis revealed fourteen categories, then five patterns, then two final themes: …

A Dnp Quality Improvement Project Addressing Low Hiv Testing Rates Of College Students, Kimberly Griffin

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Abstract

The overall HIV testing rate is very low in the United States. HIV is easily preventable with safe sexual practices, and early HIV screening is effective in identifying individuals affected and assuring linkage to care. The rate of HIV testing among college students reflects the low numbers of the national average. This quality improvement project evaluated attitudes towards HIV testing of undergraduate college students. The project aimed to determine attitudes of college students towards testing as well as relationships between demographic factors, frequency of HIV testing, and attitudes towards testing. A total of 99 undergraduate college students participated in …

Medicine And The Holocaust: My Personal Reflections, Catherine Phamduy

Physicians and the Holocaust Student Books

What you are about to read is an accumulation of my reflections based on thought-provoking questions asked in my class “Medicine and the Holocaust”. You might know a lot about the Holocaust, yet here are just a few bits on my opinion from the standpoint of a medical student.

Medicine And The Holocaust 2020-2021: A Book Of Prayer And Reflections, Hannah L. Carson

Physicians and the Holocaust Student Books

A book of prayer and reflections written for Medicine and the Holocaust course.

New Developments In Hyperbaric Oxygen Therapy, Arden M. Scheetz

Student Publications

Hyperbaric Oxygen Therapy, or HBOT, is a form of treatment based on the inhalation of 100% pure oxygen while subjected to closed chamber or room at pressures greater than sea level (1 atmosphere, ATA) (Howell et al., 2018; Kocaman, 2020). HBOT is administered through either a mono-place chamber or a multi-place chamber. Mono-place chambers are pressurized with oxygen and are equipped to handle a single person at a time. Multi-place chambers, on the other hand, can accommodate up to 20 people at a time, including medical personnel and intubated patients. These chambers are pressurized with air, and pure oxygen is …

Acute Mountain Sickness, Efrain De Leon Angon

Student Publications

Overview of Acute Mountain Sickness including Diagnosis, risk factors and treatment/prevention, as well as the pathophysiology effects of AMS.

Implementing Teamstepps® Training For An Interdisciplinary Healthcare Team To Improve Teamwork, Tina J. Dimarino, Msn, Rn, Cnor, Casc

Doctor of Nursing Practice Projects

Background: Ineffective teamwork and communication increase the risk of adverse patient outcomes. An evidence-based teamwork training intervention was implemented to improve teamwork and communication.

Aims /Objectives: The team participated in a TeamSTEPPS® training program. The aims and objectives were to improve the staff’s attitudes and perceptions of teamwork and communication; pre, post and sustained at 30-days, reduce the number of documented near misses and measure for daily use of the newly acquired skills.

Methods: This is a quality improvement project with a one group, pretest and posttest design. The TeamSTEPPS® intervention was presented to the healthcare team. Participants’ teamwork attitudes …

Mindfulness Training In Mitigating Implicit Bias: Improving Cultural Competency For Nurses Caring For Lgbt Individuals, Daniel Terrell, Msn, Rn, Fnp-Bc

Doctor of Nursing Practice Projects

Background: Equitable care remains a goal of the United States healthcare system, with cultural competency training used as one intervention to mitigate disparities. Cultural competency education is primarily based on racial and ethnic differences, often omitting other marginalized groups. Implicit bias consequences are not addressed in such training programs despite the association with health outcome disparities. Research related to implicit bias has demonstrated the ability to promote malleability in implicit associations.

Objectives: This project assessed a mindfulness meditation exercise intervention on nursing awareness in interacting with lesbian, gay, bisexual, and transgender (LGBT) patients. Additionally, an LGBT health education module that …

A Program Development And Evaluation Project For Provider Use Of Buprenorphine Maintenance, Kyle Olson, Aprn

Doctor of Nursing Practice Projects

Background: Buprenorphine (BNX) is used in Opioid Use Disorder (OUD) deterrence. Optimal long-term duration with BNX is unclear, but evidence shows that there is a high risk for relapse when medicine is discontinued even if maintenance has been stable for some time.

Outcomes: The purpose of this project was to decrease barriers for providers implementing BNX therapy for individuals diagnosed with OUD. Outcomes measured included: (1) knowledge of and barriers to implementing current guidelines, (2) factors preventing use of guidelines, (3) recommendations for BNX maintenance as per guidelines.

Methods: Using a pre-post intervention design, participant knowledge on BNX guidelines, factors …

Implementation Of Diabetic Foot Care Education Quality Improvement Project, Mitaliben R. Gor, Msn Aprn Fnp-C

Doctor of Nursing Practice Projects

Background: A diabetic foot ulcer is a major complication in diabetes mellitus that results in increased mortality, morbidity, costs, and reduced quality of life. In 2015, the prevalence of diabetic foot ulcers was estimated by the International Diabetes Federation to develop annually among 9.1 million to 26.1 million people with diabetes worldwide. Diabetic foot care has economic consequences due to the expenses related to the treatments that arise from prolonged and recurrent hospitalizations and social problems from employment losses.

Purpose: The purpose of this project was to implement diabetic foot care education among diabetes patients in the clinic as a …

Adoption Of Evidence-Based Practices In Stroke Transitions Of Care, Sabena Passarello, Rn, Msn, Fnp-Bc

Doctor of Nursing Practice Projects

Background: Stroke is a leading cause of mortality in the U.S. Individuals who suffer from stroke or transient ischemic attack are at risk for further cerebrovascular events. Prevention requires thorough diagnostic evaluation and care coordination, particularly from inpatient to outpatient settings. Transition of Care programs are effective methods for developing long-term treatment, establishing follow-up, and preventing further complications.

Aims/Objectives: The project purpose was to integrate evidence-based recommendations into a Transitions of Care program for patients with ischemic stroke or transient ischemic attack. The aims were to evaluate whether implementation of Stroke Transitions of Care improved outpatient follow-up and stroke readmission …

A Multi-Faceted Quality Improvement Project Amid A Global Pandemic: Improving Guideline-Consistent Cervical Cancer Screening Rates And Provider Knowledge Of Abnormal Cervical Cancer Screening Results During Reactivation Of A Metro Family Practice Clinic, Taylor Villwock, Agpcnp-Bc

Doctor of Nursing Practice Projects

Background: Despite the evidence-based value of cervical cancer screening, recent updates to guidelines, and general availability of the Papanicolaou (Pap) test, guideline-adherent screening rates remain low. The COVID-19 pandemic further impedes progress as preventive healthcare is delayed and patients are reluctant to enter healthcare facilities.

Objectives: The purpose of this project was to evaluate if provider education and patient reminder letters comprising written education and risk-mitigation efforts improved cervical cancer screening rates and increased providers’ knowledge of appropriate follow-up during reopening of a metro family practice clinic amid the COVID-19 pandemic.

Methods: A multi-faceted quality improvement project included a 3-month …

Increasing Mental Health Competency In School Nurses, Jennifer M. Walsh Msn, Cpnp, Cne

Doctor of Nursing Practice Projects

Background: Mental health concerns in the pediatric population have increased over recent years, even more so due to the COVID-19 pandemic. Time from onset of symptoms to treatment is over eight years, leaving less than 25% receiving care. Virginia ranks 47th for pediatric mental health care. School nurses spend a significant amount of workload on MH issues but often report being untrained to deal with these issues. Aims: Implement a quality improvement pilot program for school nurses designed to increase competency of identification, management, and referrals for students with mental health concerns. Outcomes measured domains of knowledge, attitude, and competency …

Prep Education Intervention, Kristina Jung Msn, Fnp-Bc

Doctor of Nursing Practice Projects

Background: The nation’s HIV infection rate is alarming, yet only a small percentage of eligible individuals are prescribed pre-exposure prophylaxis (PrEP). This sluggish PrEP uptake may be related to lack of knowledge among non-HIV specialist providers. Thus, interventions toexpand providers’ use of PrEP as an HIV prevention strategy are needed.

Objectives: The project aim was to develop an intervention to improve retail nurse practitioners’ (NP) knowledge for PrEP clinical practice, comfort screening for “at-risk HIV” patients, confidence prescribing PrEP, and likeliness to prescribe PrEP in the next six months.

Methodology: An online PrEP tutorial was implemented for retail clinic NPs. …

Improving Nurse Manager Job Satisfaction: An Urban Academic Quality Improvement Project, Patricia A. Winston, Ms, Rn, Nea-Bc, Fache

Doctor of Nursing Practice Projects

Background: It is important that the nurse managers are able to contribute to organizational vision, mission, and goals by influencing others, sharing the vision, and implementing it (Boyce, 2018). They are pivotal to the successful accomplishments of the hospital mission. The issue of recruiting, developing and retaining nurse managers is one that challenges many health care institutions, hospitals, hospitals, and health systems. The literature regarding this concern was reviewed and the paucity of useful science in this regard led to question of how to improve the job satisfaction and job retention of nurse managers at urban academic medical centers.

Objective: …

Quality Improvement Initiative: Implementing A Nurse Peer Mentorship Program, Vepuka E. Kauari

Doctor of Nursing Practice Projects

Introduction: Formal mentoring programs are valuable experiences for the mentor and the mentee. They provide nurses with the ability to develop professional networks while refining their competency. Nurses should be properly mentored in focusing skills in addition to addressing their emotional needs. The purpose of this quality improvement project was to promote and evaluate the effectiveness of an existing mentoring program on intent to stay, perceived competency, and job satisfaction.

Methods: Institutional Review Board approval was obtained. A convenience sample of new nurses with less than 2 years’ experience in an academic medical center was recruited to assess their intent …

The Effect Of Covid-19 On The Mental Health Of College Athletes, Molly Mcardle

Senior Theses

This research aimed to explore how the mental status of student athletes at the University of South Carolina has been affected by the unprecedented COVID-19 pandemic. A total of 61 student athletes between the ages of 17 and 24 participated in the study and completed a series of questions including the Depression-Anxiety-Stress Scale 21 (DASS-21) and the Group Environment Questionnaire (GEQ). Independent samples t-tests and descriptive analyses were used for comparisons between gender and age. The results showed that female athletes reported statistically significantly higher levels of anxiety and stress than male athletes (p = 0.049 and p = …

10-Minute Ebd: Artificial Intelligence In Orthodontics, Jayne Kessel Dds

The Journal of the Michigan Dental Association

This Ten-Minute Evidence-Based Dentistry Article provides an example of the implementation of the EBD search process with trusted search engines for the identification of the best literature through critical appraisal to answer a clinical question. "For patients receiving orthodontic care, is an AI-generated treatment plan as likely to achieve acceptable outcomes?" Orthodontic treatment planning is a complex and time-consuming process that requires a high degree of expertise. Artificial intelligence (AI) has the potential to assist orthodontists in this process by automating some of the tasks involved, such as cephalometric analysis, surgery decisions, extraction decisions, and anchorage decisions.

A recent systematic …

Dentistry And The Law: Unreasonable Non-Compete And Damages Provisions In Employment Contracts, Dan Schulte Jd

The Journal of the Michigan Dental Association

Non-compete and liquidated damages clauses in dental employment contracts must adhere to specific limits for enforceability. Courts require reasonable geographic and temporal constraints on non-competes, typically within patient-served areas under two years. Liquidated damages should reflect actual losses, especially in cases where damages are difficult to gauge. Courts may still reject these provisions if they find breaches or inequity. Employers are advised to strike a balance between safeguarding their interests and fostering positive work environments.

Enteral Nutrition Protocol For Pediatric Burn Patients: A Quality Improvement Initiative, Margaret Tepe

Doctoral Projects

Objective: This quality improvement project was conducted to determine the efficacy of an enteral feeding protocol to improve nutrition supplementation in pediatric burn patients.

Methods: Non-ICU patients with >10% total burn surface area requiring enteral nutrition supplementation were fed within 12 hours of admission or with the first sedated dressing change, whichever took place first. Pre (n = 3) and post (n = 5) implementation of the enteral feeding protocol data were obtained. Data were collected via chart audit and survey.

Results: Patients and nurses had similar characteristics; and nurses had similar nutrition practices. Total intake of calories (93.8%) and …

A Budget Impact Analysis Of A Tobacco Control Program In A Community Mental Health Clinic, Thuy-Nhi Nguyen

Doctoral Projects

Objectives: This project evaluation aimed to determine if the tobacco cessation program, American Lung Association’s Freedom From Smoking (ALAFFS), within the designated community mental health organization (CMHO) is affordable and sustainable through a budget impact analysis.

Methods: The study modeled the impacts on the costs of facilitator training, staff salaries/time, program workbooks, program supplies, bus passes, and other supplies and materials. The Medicaid reimbursement rate used for tobacco cessation group therapy was included. The budget impact analysis projected financial consequences of the presence of training costs and number of smokers with severe mental illness who attended the program.

Results: The …

Improving Care Coordination For The Homeless Population Using Systematic Quality Improvement, Rutendo Nyasvisvo

Doctoral Projects

Background and Objectives: Care coordination for the homeless population is challenging due to the complexity of healthcare and the uncertain life circumstances of the homeless individual. Objectives were developed to guide care coordination for the homeless by utilization of the free clinic to create PCP referrals, appointments and tracking follow-up care to increase appointment attendance and improve health outcomes for the homeless individual.

Design: A quality improvement project.

Setting: A faith-based non-profit homeless shelter organization in the Midwestern United States.

Participants: Participants include 25 homeless guests, 5 staff members including a clinic coordinator, 3 registered nurses and 1 licensed practical …

Utilizing Educational Materials To Change Vaccine Compliance In Children Under 24 Months Of Age, Kelsey M. Arnold

Doctoral Projects

Background: Childhood vaccinations are critical to preventative care for the pediatric population. The goal for the clinic’s combination 10 insurance quality measure, which reflects the number of fully vaccinated children by 24 months of age, is to be greater than 68%.

Purpose: This quality improvement project sought to implement evidence-based interventions to improve childhood vaccine compliance by increasing the parent/caregiver’s knowledge about vaccines and increasing the communication with their healthcare provider.

Methods: A parent friendly vaccine schedule, information pamphlet, interactive video, and survey were given to parents/caregivers during well-child visits. A total of 117 parent/caregiver surveys were collected. Vaccine compliance …

Improving Handover Process For Stroke Patients Transferring From Emergency Department To Interventional Radiology: A Quality Improvement Project, Megan Buchman

Doctoral Projects

Background: A standardized handover process is needed for stroke patients transferring from the Emergency Department to Interventional Radiology.

Local Problem: Emergency Department and Interventional Radiology had different handover processes.

Methods: A quality improvement project was conducted in a large Magnet® designated midwestern health system. Participants included emergency department and interventional radiology nurses and stroke patients. Pre/post-quality and post implementation measures were obtained.

Interventions: The interventions included utilizing a standardized handover tool between departments, calling report prior to patient transfer, and turning in handover tool following stroke case to ensure compliance. Two cycles of the Plan-Do-Study-Act Cycle were completed.

Results: No …

“Warm Handoff” To Increase Enrollment In A Maternal Infant Health Program, Samantha Worthem

Doctoral Projects

Introduction: In a Midwest Health Department’s (HD) Maternal Infant Health Program (MIHP), infant death rate has been on a steady incline at 4.8 deaths per 1,000 in 2019 (Michigan Department of Community Health, 2020). Implementation of a “warm handoff” between the local HD and Michigan Department of Health and Human Services (MDHHS) was created to increase enrollment and visits. During warm handoffs, health care providers work together within the same setting to provide evaluation and care to patients and clients (Musselman et al., 2018).

Methods: This program evaluation reviewed data retrospectively from March 31 to September 30, for 2019 and …

Improving The Screening And Care Of Hospitalized Adults With Obstructive Sleep Apnea Through Standardized Workflow Processes, Elizabeth Henschel

Doctoral Projects

BACKGROUND: Adults can be screened for obstructive sleep apnea in acute care settings using the validated STOP-BANG questionnaire. Healthcare providers can treat patients with confirmed or suspected obstructive sleep apnea to reduce risk for complications during hospitalization or after surgery.

PURPOSE/ RELEVANCE TO HEALTHCARE QUALITY: To determine if the standardization of obstructive sleep apnea screening and patient care workflows improves process efficiency saving nursing time and healthcare expenses.

METHODS: Quality improvement project included an organizational assessment of healthcare system setting to define clinical problem; determined appropriate evidence-based interventions; and implemented strategies guided by quality improvement models.

INTERVENTION: Updated inpatient units …

Addressing Social Determinants Of Health In Community-Based Palliative Care, Mary D. Chenge

Doctoral Projects

Background and Objectives: Addressing social determinants of health (SDOH) in the medical community has recently started; however, there is yet to be a standardized format for addressing the social needs of patients. Consequently, a protocol was developed to address SDOH to increase screening rates, social work referrals, and capture depression reimbursement.

Methods: The quality improvement project was implemented using the Plan-Do-Study-Act framework at an urban Community-Based Palliative Care organization in the Midwestern United States. Participants included office staff and 140 patients (two separate sets of 70 randomly selected patients pre/post-implementation). A protocol was developed for screening 11 SDOH using an …

Sickle Cell Disease: Development Of An Acute Pain Management Program In A Hematology/Oncology Practice, Elizabeth Pohl

Doctoral Projects

Background: Patients with sickle cell disease experience can experience acute episodes of severe pain that require prompt pain medication. Treating uncomplicated, acute sickle cell disease pain in the emergency department setting has been shown to be costly and lead to higher rates of hospitalization than similar care in a dedicated outpatient setting.

Objectives: The aim of this article is to outline the program development efforts undertaken to apply current literature findings and evidence-based practice guidelines to create a program development toolkit and business plan for a sickle cell disease acute pain management program in an outpatient hematology practice.

Methods: A …

Improving Adolescent Risk Assessment And Provider Follow-Up In Primary Care, Darby R. Disselkoen

Doctoral Projects

Purpose: The purpose of this quality improvement project was to improve preventive care for adolescent patients by implementing standardized, routine screening for risk-taking behaviors and improving provider response to identified risks using the Rapid Assessment for Adolescent Preventive Services tool and resources for providers to reference during discussions about risk.

Methods: Quality improvement methodology was utilized at a midwestern pediatric primary care office to implement a practice workflow for staff to follow during annual, adolescent wellchild exams beginning at age thirteen.

Results: Analysis of project results demonstrated a significant increase in routine screening for adolescent risk behaviors compared to the …

Evaluation Of A Chewing Gum Protocol For Postoperative Spinal Patients, Lauren E. Vachon

Doctoral Projects

Aims and objectives: The purpose of this project was to evaluate if the implementation of a chewing gum protocol improved bowel motility, decreased ileus rate, length of stay, bowel and pain medication use, and hospital costs in post-surgical spinal patients in a suburban hospital.

Background: Postoperative bowel dysfunction is a major source of health problems, including abdominal pain, ileus, increased length of stay, pain medication use, and healthcare costs.

Design: Retrospective cohort study with a focus on program evaluation of the previously implemented chewing gum protocol. An audit of the electronic health record compared outcomes in patients five months before …