Medicine and Health Sciences Commons^™

Using Revised Pain Medication Administration Guidelines In Post Anesthesia Care Unit (Pacu): A Program Evaluation, Elizabeth Gerber

Doctor of Nursing Practice (DNP) Manuscripts

Abstract

Purpose: To determine if implementation of revised pain medication administration guidelines in PACU led to improved patient satisfaction scores, lower pain scores at discharge from PACU, lower pain medication and antiemetic medication costs in PACU, and shorter average PACU length-of-stay (LOS) at the clinical site.

Background and Significance: Negative consequences of poorly managed acute postoperative pain include diminished function and quality of life, compromised surgical recovery, extended use of opioids, development of chronic postoperative pain, and increased morbidity and medical costs (Gan, 2017). There is an impetus to minimize narcotic medications administered after surgery, while still providing adequate pain …

‘The First At-Bat Is Never A Grand Slam’: How Huntington's Disease Drug Research Has Matured With The Roche And Wave Setbacks, Kenneth P. Serbin

At Risk for Huntington's Disease

No abstract provided.

The Feasibility Of A Music Listening Intervention On The Incidence, Severity, And Duration Of Delirium In The Older Acute Care Patient: A Feasibility Trial, Mary Kovaleski

Electronic Theses and Dissertations

Background.Delirium is an acute change in cognition in response to some form of noxious insult whichhas been shown to last for up to one year post occurrence and may lead to permanent cognitive decline.As a non-pharmacological treatment, music may aid in improving patient engagement and attention. Method. An integrative review (IR) was used to synthesize current literature examining the effectof a musicinterventionon delirium in older acute care patients. Results. Systematicdatabase searches (2000-2019) yielded fourstudies that included a music listeningintervention.This IR found that collaborative music listening interventions (not music therapy), have been shown to decreasedelirium in the older acute care patient, …

Professional Ethics For College Health Services, Dessa Mrvos

Electronic Theses and Dissertations

College health services provide a crucial resource for campus communities in the United States, substantially affecting student health, safety, and wellbeing. The impact and quality of campus clinical services impact student life through varied approaches to the delivery of services, health innovations, and business models. The role that campus health services plays in dealing with risk mitigation is essential: well-established public health principles of disease prevention, health promotion, and health education are sustained and advanced by campus clinical health services. Despite the widely recognized importance of college health services, there is very little literature on the contribution of ethics related …

From Professor To Patient X, Anne R. Crecelius

Health and Sport Science Faculty Publications

I walked into the classroom feeling nervous. It wasn't my first time teaching undergraduate students about human endocrine physiology. I knew the material well. But today's lecture was different. I pulled up slides depicting a hypothetical cancer patient and told them, “Patient X had a biopsy that detected invasive carcinoma in her breast.” I described the many months of chemotherapy, surgery, and radiation treatments she went through before going into remission. Then I taught the students about the hormonal therapy she was prescribed—drugs her doctor hoped would limit the growth of any remaining cancer cells and prevent a recurrence. On …

Workplace Mistreatment And Mental Health In Female Surgeons In Pakistan, Mahim Malik, Hina Inam, Russell S. Martins, Mahin B N. Janjua, Nida Zahid, Sadaf Khan, Abida K. Sattar, Shaista Khan, Adil H. Haider, Ather Enam

Section of Cardiothoracic Surgery

Background: Despite workplace mistreatment, which includes harassment, bullying and gender discrimination(GD)/bias, being serious problems for female surgeons, there are limited data from lower-middle-income countries like Pakistan. This study explored harassment and GD/bias experienced by female surgeons in Pakistan, and the effects of these experiences on mental health and well-being.
Methods: A nationwide survey was conducted between July and September 2019 in collaboration with the Association of Women Surgeons of Pakistan, an organization consisting of female surgeons and trainees in Pakistan. An anonymous online survey was emailed directly, disseminated via social media platforms (such as Facebook, Twitter and Instagram), and sent …

“Nut” An Anatomical Malignancy! A Solid Tumor Characterized By A Genetic Translocation, Bana Antonios, Ruby Gupta, Nwabundo Anusim, Markie Zimmer, Emma Herrman, Ishmael Jaiyesimi

Conference Presentation Abstracts

NUT midline carcinomas are rare poorly differentiated tumors driven by t(15,19) rearrangements and clinically characterized by rapid progression and high mortality. A 49 year-old-male with no comorbidities, presented with acute worsening of chronic cough, new onset hemoptysis and left sided chest pain for 2 weeks. Workup revealed NUT midline carcinoma of the lung as confirmed by next-generation sequencing that revealed the presence of a NUTM1-BRD4 fusion. He was diagnosed with NUT midline lung cancer clinical stage IIIB. The tumor was not amenable to surgical resection, therefore, he was started on concurrent chemoradiation with weekly carboplatin and paclitaxel for 5 weeks. …

Type 1 Cryoglobulinemia Secondary To Primary Plasma Cell Leukemia, Antonio Faieta, Khatoon Tawhida

Conference Presentation Abstracts

Primary plasma cell leukemia (pPCL) is a rare and aggressive form of plasma cell dyscrasia that comprises 1% of the plasma cell dyscrasias. Even more rare is its association with type 1 cryoglobulinemia which management can be challenging. A 63-year-old African American male with no past medical history presented with severe burning pain in his legs, necrotizing rash, constitutional symptoms and severe acute kidney injury (AKI). HIV, hepatitis B and C were negative. Serum electrophoresis revealed an M-spike of 5.67, IgG of 7000, free lambda of 152.10 with a K/L of 0 and cryoglobulin of 81%. CT revealed extensive lytic …

Rare Case Of Recurrent Hyperhemolysis Syndrome (Hhs) And Methemoglobinemia In A Patient With Sickle Cell Anemia, Ashbina Pokharel, Pradeep Khanal, Dilip Khanal, Samikshya Pandey, Bipin Ghimire

Conference Presentation Abstracts

Hyperhemolysis syndrome (HHS) is a rare but serious and potentially life-threatening complication of red blood cell (RBC) transfusion and has been described in both sickle cell disease and non-sickle cell disease patients. It is characterized by destruction of both donor and host RBC. Methemoglobinemia is another rare condition leading to cyanosis, tissue hypoxia and potentially death. We present a middle-aged female with sickle cell anemia who developed methemoglobinemia and hyperhemolysis after a surgical procedure. 41 yo female with sickle cell anemia (SC type) was hospitalized for elective right total hip resection arthroplasty. Patient received 3 units blood transfusion during the …

Very Late Relapse Of Hodgkin Lymphoma 18 Years After Remission, Bana Antonios, Markie Zimmer, Emma Herrman, Shiva Shrotriya, Ishmael Jaiyesimi

Conference Presentation Abstracts

A 72-year-old male with a history of protein C and protein S deficiency, factor V Leiden mutation, DVT/PE, and stage IIIB nodular sclerosis Hodgkin lymphoma (diagnosed 18 years back) presented with shortness of breath. EKG showed complete heart block and a transvenous pacemaker was placed. Laboratory studies showed severe normocytic anemia with hemoglobin of 6.2 g/dL, WBC of 2.6 bil/L, platelets of 113 bil/L, and INR of 2.8. The direct antiglobulin test was positive for Anti-IgG and negative for Anti-C3D. LDH was normal and haptoglobin was elevated, contrary to hemolysis. Computed tomographic scan of the abdomen and pelvis showed extensive …

Potts Puffy Tumor: A Rare Complication Of Rhinosinusitis, Bipin Ghimire, Omar Jameel, Sumesh Khanal, Ryan Owen, Ashbina Pokharel, Samiksha Pandey

Conference Presentation Abstracts

Pott's puffy tumor is a sub-periosteal abscess of the frontal bone with associated osteomyelitis. It arises as a complication of untreated or partially treated frontal sinusitis. Overall prevalence has decreased due to timely treatment with antibiotics. It is largely limited to the pediatric population and is rare in adults. A 46-year-old Caucasian male with a history of chronic rhinosinusitis presented with one-week history of progressive painful swelling over the left forehead without any other systemic signs of infection. He was started on intravenous ampicillin-sulbactam and given one dose of dexamethasone due to concern for intracranial involvement. Facial CT showed 3 …

A Broken Heart: A Case Of Stress Induced Cardiomyopathy Precipitated By Community Acquired Pneumonia, Adam Foglesong, Abdulla Kara Balla, A Neil Bilolikar

Conference Presentation Abstracts

Takotsubo cardiomyopathy or stress-induced cardiomyopathy is a syndrome characterized by a transient reduction of systolic cardiac function generally in response to emotional or physical stressors. Stress-induced catecholamine excess is believed to be the main factor driving myocyte dysfunction. Most patients are female and postmenopausal. We present a case of a 62-year-old Caucasian male with a past medical history of hypertension who presented to the ED with the chief complaint of squeezing chest pain followed by multiple episodes of productive cough and epigastric discomfort. ECG showed sinus tachycardia with premature supraventricular complexes. Chest X-ray showed severe pulmonary vascular congestion. Labs showed …

Essential Competencies For Occupational Therapy In End-Of-Life Care, Karmella Bognot

UNLV Theses, Dissertations, Professional Papers, and Capstones

Occupational therapists carry an abundance of expertise in helping patients and caregivers navigate the end-of-life journey. The lack of knowledge of OT’s role impacts occupational therapy utilization and service provision in hospice. It reduces opportunities for this population to increase their understanding on how to maintain quality-of-life. The more a patient is able to do lessens the burdens shouldered by the caregiver. Education on pain management and promoting comfort are typical priorities addressed; however, not enough training is focused on maximizing independence or engagement in occupations. Competencies encompass a unique set of skills, knowledge, and abilities necessary for successful performance …

Promoting Secure Attachment In Parent-Child Dyads: A Head Start Approach, Summer Annette Bradley

Art Therapy Counseling Final Research Projects

This grant proposal focuses on a partnership with SIUE Head Start centers in providing educational child-rearing resources, community building and parent-child dyad work to promote a more secure attachment in parent-child relationships. This proposed art therapy program will serve up to fourteen parent and child dyads within an academic year period at the estimated cost of $91,005. This program utilizes the existing Head Start staff members and enrolled families who have already expressed the need for attachment-based work.

SIUE Head Start currently serves 1,181 students who are 3-5 years of age under the curriculum and program outline of the National …

Increasing Patient Access To Medication-Assisted Treatment Programs For Opioid Use Disorder, Matthew J. Bednarchik

Doctor of Nursing Practice Projects

The project sought to explore the perceived need for Medication-Assisted Treatment (MAT) for opioid use disorder among primary care providers in a rural central Illinois county. This project’s primary goal was to measure the prevalence of OUD in the community and the likelihood of primary care providers referring to an outpatient MAT program. A secondary objective was to utilize the survey results as a tool for the development of a MAT program. A cohort of twenty-five primary care providers were invited to participate in a survey to assess the perceived prevalence of OUD as well as the need for increased …

Increasing Compliance And Patient Outcomes In Hypertensive Patients Using The Hill- Bone High Blood Pressure Compliance Scale, Lauren Huff, Allyson Barbee, Julie Milton

Doctor of Nursing Practice Projects

Hypertension has been globally rated the most common non-communicable disease as well as the most common cause of premature death (Johnson, et al., 2019). The identified problem of focus for this project was to increase medication compliance within hypertensive patients as well as increase provider knowledge of compliance issues with the utilization of the Hill-Bone High Blood Pressure Compliance Scale. We administered a case study via Qualtrics to Illinois nurse practitioners via the ISAPN email list-serve. We provided an anonymous pre-and post-survey to each participant regarding their current area of practice, patient history taking behaviors, and views on the ease …

Implementation Of A Standardized Care Pathway For Ureteral Stents Patients Across The Continuum Of The Acute And Ambulatory Setting: A Quality Improvement Project, Ibukunoluwa Afolabi

Doctor of Nursing Practice Projects

Ureteral stents are one of the most used urologic devices to create and preserve ureteral patency. Side effects after ureteral stent placement have a high prevalence, and stent related pain has been reported to affect over 80% of patients. This Quality Improvement Project aimed to develop a standardized care pathway through education and pharmacological management for patients after ureteral stent placement. Specific goals included reducing readmission rates to the emergency department (ED), reducing the patient’s phone calls to the urology clinic, and improve patient satisfaction. The protocol developed for the project included discharging patients with an alpha- blocker, an anti-cholinergic, …

Addressing Referral Discrepancies For Hyperglycemia Diagnosis Codes, Brooke Buffington, Aubrey Parnell, Abigail Brohammer

Doctor of Nursing Practice Projects

Diabetes mellitus and prediabetes affect 34 million and 88 million Americans, respectively. The early detection and management of elevated blood glucose levels is fundamental to preventing comorbid complications. While other countries have published referral guidelines, the United States is lacking in practice standards. At a central Illinois healthcare institution, the diagnosis code for elevated blood glucose (R73) was noted at a higher rate than endocrinology referrals. The purpose of this retrospective investigation was to explore the root causes of this disproportion through deidentified patient data. The average number of wait days for an endocrinology appointment was investigated and found to …

Care Of The Healthcare Provider, Kari Hullinger, Emily Moscardelli

Doctor of Nursing Practice Projects

Evidence has shown a strong correlation between a healthy provider and the positive care that the provider can promote to others. Many evidence-based health promotion programs have been implemented throughout many health systems. These programs have shown improvement of the providers’ overall health. And in return, these providers are able to better care for their patients. Detailed reports have shown many health consequences that healthcare providers have acquired due to long hours, intense training, lack of time, lack of sleep, and the concept of always putting their patients first. A health system in Springfield, Illinois was examined to determine if …

Improving Depression Awareness And Screening In A Community College, Shelly Baldwin

Doctor of Nursing Practice Projects

Depression is a serious and disabling mental health problem impacting nearly 265 million people worldwide. Approximately 17.3 million U.S. adults aged 18 or older suffered at least one major depressive episode in the last year. Of those afflicted, individuals 18-25 years of age had the highest prevalence of depression. Undiagnosed or untreated depression can lead to long-term disability or suicide which is the 2^nd leading cause of death for 10–34-year-old persons. Early recognition of depressive symptoms can improve long-term outcomes of individuals by enhanced connection to mental health services. The overall goal of this project was to improve depression …

Evaluation Of High Fidelity Simulation Debriefing Methods For Nurse Anesthesia Students, Zachary Standefer, Alex Davie

Doctor of Nursing Practice Projects

Simulation for Student Registered Nurse Anesthetists has become an educational tool that provides valuable learning experiences that integrate problem-solving, prioritization, and critical thinking skills. Debriefing is an essential aspect of the simulation learning process. The debriefing period allows the debriefer to direct the students’ self-reflection and provide individualized feedback. Faculty members delivering the simulation curriculum at a midwestern university, with over 75 nurse anesthesia students, sought education regarding the various simulation debriefing methods. After conducting a literature review for the best evidence supporting debriefing methods, faculty education was implemented in the form of an interactive computer-based learning (CBL) module. The …

Improving Patient Outcomes By Preventing Airway Injuries Associated With Video Laryngoscopes, Alexis Jones, Kay Williamson

Doctor of Nursing Practice Projects

Video laryngoscopy poses a higher risk of airway injury than direct laryngoscopy when used for difficult intubations in the operating room. Education related to manufacturer guidelines, in addition to, routine simulation practice are vital to improving efficacy and patient safety when using video laryngoscopes. The purpose of this project was to provide education to anesthesia providers regarding the potential risk of airway injury through a presentation and mid-fidelity simulation experience. An in-person PowerPoint presentation was delivered to anesthesia providers, along with a simulation experience using an intubation trainer manikin to demonstrate the proper technique when using the GlideScope and McGRATH …

Lung-Protective Ventilation Across The Lifespan: Implementation Of An Intraoperative Protocol For Adults And Pediatrics, Megan Reynolds, Rachel Riddle

Doctor of Nursing Practice Projects

Traditional ventilation strategies have been shown to lead to the development of lung injury and postoperative pulmonary complications. Lung-protective ventilation (LPV) strategies for adults include low tidal volumes of 6-8 mL/kg based on ideal body weight, moderate levels of positive end-expiratory pressure (PEEP), incremental recruitment maneuvers routinely and as needed, and low fraction of inspired oxygen. Recommendations for pediatrics are similar, with some suggesting a more liberal limit for tidal volumes of less than 10 mL/kg based on predicted body weight. However, adoption of LPV strategies is not universal. Completed objectives of this practice project included thoroughly reviewing literature relating …

Implementing A Validated Developmental Screening Tool In A Rural Pediatric Primary Care Clinic To Enhance Early Diagnosis Of Developmental Delays From Birth To 36 Months, Melissa A. Armstead

Doctor of Nursing Practice Projects

Abstract

Evaluation of childhood development with a validated screening tool has been the gold standard for best practice recommended by the American Academy of Pediatrics (AAP) since 2006. A rural pediatric clinic was the setting for this quality improvement project. The goals of the project were to 1) increase the number of children identified with developmental delays, 2) identify children with delays earlier, and 3) maximize the number of children receiving early intervention (EI) services between the ages of birth to 36 months. The Ages and Stages Questionnaire (ASQ-3) was the selected screening tool adopted by the clinic in June …

Implementing An Evidence-Based Multifactorial, Multidisciplinary Fall Prevention Program In A Nursing And Rehabilitation Center To Reduce Fall Rates Among Patients, Tincy Poovathur

Doctor of Nursing Practice Projects

Falls are the leading cause of morbidity and mortality in the elderly in the United States. Patients in long-term care facilities are at increased risk for falls, accounting for 20 percent of fatal falls that require hospitalization. The economic and social burden of falls and fall-related injuries is significant. Fall-related injuries and their resulting expenditures are expected to increase substantially with the increasing aging population making this a problem of high priority. The literature recommends and supports incorporating evidence-based fall prevention initiatives into long-term care facility safety programs to address this problem. Based on the literature review and the facility's …

Presurgical Optimization Videos For Patients Undergoing Elective Spine Surgery, Megan Knetzer

Doctor of Nursing Practice Projects

Spine surgery is a growing healthcare trend with more than 199,000 lumbar fusions alone being performed in the United States in 2015 and annual costs of more than $10 billion. Spine surgery represents a major life-altering event for patients, with high complication rates and extensive recovery periods for which patients often feel unprepared. Presurgical optimization and education have the potential to decrease medical complications, improve outcomes, and reduce patient anxiety related to surgery. The purpose of this project was to implement presurgical education videos focused on modifiable risk factors for patients undergoing spinal surgery at an urban academic medical center. …

The Impact Of A Cultural Competence Assessment Tool On Teaching Strategies In The Dnp Curriculum At Southern Illinois University Of Edwardsville, Katarina Dobrosavljevic

Doctor of Nursing Practice Projects

Providing culturally competent and culturally congruent care to patients leads to better outcomes and reduction of poor outcomes due to health disparities. Providing care that is not culturally congruent can contribute to communication barriers, resulting in deficient diagnostic testing, miscommunication about etiologies, treatment plans that are not individualized, and discounting of patient's ideas. Individuals from diverse cultures face health disparities which contribute to inadequate care and poor outcomes. The purpose of this project was to survey former graduates of the Southern Illinois University of Edwardsville (SIUE) family nurse practitioner (FNP) program to assess their level of cultural competence and areas …

The Misuse Of Convenient Care And Importance Of Establishing A Primary Care Provider, Bailey M. Johnston, Amanda Lt Hawkins

Doctor of Nursing Practice Projects

Over the last decade, there has been substantial increase in the use of urgent care (UC) and convenient care (CC) clinics nationwide. While these clinics are valued and serve a purpose in our communities, more patients are utilizing their services exclusively in place of primary care (PC), resulting in millions of Americans not receiving essential preventative care and chronic disease management. An extensive literature review evaluated current and effective interventions used to decrease inappropriate use of CC clinics, while simultaneously exploring strategies in increasing patient compliance with routine comprehensive health management. Based on literature review findings, an education-based project was …

Implementation Of A Mental Health Screening In A Gastroenterology Office, Kayla Craig

Doctor of Nursing Practice Projects

The growing prevalence of depression in gastrointestinal patients is the reason why outpatient offices, gastrointestinal offices included, need to screen for mental health problems in their appointments. Many outpatient settings don't have a standard tool to screen for depression in patients, and therefore many patients are not being treated or diagnosed with depression in the process. The PHQ-9 has been shown to have strong validity and specificity in diagnosing depression in the outpatient setting.

Media Use Management With Toddlers And Preschoolers: Introducing Screen Time Recommendations In Pediatric Primary Care, Kaitlyn Mcgough

Doctor of Nursing Practice Projects

As the field of technology has advanced, screens have become easier than ever to access both for adults and their children in the form of smartphones, tablets, laptops, televisions, and more. This advancement has brought on unforeseen challenges for families as they grapple with understanding and implementing healthy boundaries between their children and technology. By their second year of life, 50% of children will have interacted with some form of media, and research is beginning to reflect that there is a measurable effect of screen time on toddler development. The need for intervention has continued to grow, as children are …