Medicine and Health Sciences Commons^™

Improving Utilization Of Palliative Care For Heart Failure Patients, Devin Tilley

Doctor of Nursing Practice Projects

The purpose of this program was to educate providers regarding palliative care for heart failure patients. Palliative care is underutilized in conjunction with usual heart failure management despite proven benefits of decreased symptom burden, reduced hospitalizations, and improved overall quality of life. Provider education has the ability to improve provider knowledge of palliative care for heart failure patients. A brief education session was given to hospital providers in an acute care setting to evaluate the benefits of provider education on palliative care utilization for heart failure patients. Findings included improved provider confidence in referring heart failure patients to palliative care. …

Thinking Inside The Food Pantry Box, Elizabeth Shoaf

Doctor of Nursing Practice Projects

Background: Prior research has indicated a varying relationship between food security and obesity risk. Food insecurity is a known complication of men and women’s underlying health issues, such as hypertension and diabetes, because of altered food choices.

Objective: Provide healthier food options to the food insecure within the facility’s food distribution boxes, as available, for the two most common health issues (diabetes and high blood pressure).

Methods: Clients at a local food pantry were interviewed individually to learn more about food insecurity and complicating health issues, such as obesity, diabetes, and high blood pressure (hypertension) while simultaneously offering alternative food …

Not A Phase: Lgbtq+ Teens -- How We Can Save A Life, Jennifer Carner

Doctor of Nursing Practice Projects

This DNP project was conducted to address suicide and risk-taking behaviors of LGBTQ teens and how adults can improve the long-term outcomes of LGBTQ teens by being supportive adults. LGBTQ+ teens are at 4 times higher risk of suicide than their non-LGBTQ+ peers (The Trevor Project, 2021). The Suicide Prevention Resource Center, 2008, found a teen having one caring adult in their lives decreases the risk of suicide. The project's goal was to educate adults to increase their comfort levels in terminology, their understanding of the developmental stages of teens, and how to provide protective factors to help reduce the …

Standardized Daily Family Updates To Improve Patient Satisfaction Scores On A Pulmonary Medical Progressive Care Unit, Quentin Butterfield

Doctor of Nursing Practice Projects

Communication remains one of the most challenging aspects of healthcare. COVID-19 added another layer of communication breakdown in the form of visitor restrictions that limited or removed visitation for hospital-positive patients. Guided by the principles of Jean Watson’s theory of human caring, a literature review was performed to determine best practice evidence related to improvements in communication.

A daily family update form was drafted to guide the nurses of a pulmonary medical progressive care unit in providing standardized daily family updates to improve communication through consistency of information shared. Patients identified family members they would like to receive daily updates …

Benefits Of Ambulation In Older Adult Population, Kelsie E. Wilkes

Doctor of Nursing Practice Projects

Background: Loss of mobility is an outcome of aging. Decreased ambulation leads to a loss of mobility and ultimately a loss of independence. There are additional health risks associated with loss of mobility. There can be challenges to facilitating ambulation and mobility in an aging population.

Objective: A literature review of the benefits of ambulation/mobility and the risks of loss of mobility was conducted. The purpose was to promote ambulation/mobility in a community-based setting and educate those caring for the adult population about the importance of ambulation.

Methods: A presentation was provided to staff and participants of …

Implementation Of Lean Principles During Operating Room Turnovers, Makenzie Marshall

Doctor of Nursing Practice Projects

Background

Many operating rooms across the country face the daunting task of making their turnovers between surgical patients quicker and more efficient. Turnover time is defined as the time it takes to clean an operating room and set up the next sterile field between surgical patients. The time begins when the patient leaves the operating room suite and stops when the next patient enters the same suite. Running an operating room is a complex and costly endeavor, and even small shortfalls can have a snowball effect, leading to delays, wasteful spending, and substandard patient outcomes; therefore, it is imperative to …

Minimal Residual Disease In Multiple Myeloma: Potential For Blood-Based Methods To Monitor Disease, Aisling O'Brien, Fiona O'Halloran, Vitaliy Mykytiv

Department of Biological Sciences Publications

In recent years, the life expectancy of Multiple Myeloma (MM) patients has substantially improved, but this cancer remains incurable with increasing incidence in the developed world. Most MM patients will eventually relapse due to residual drug-resistant cancerous cells that survive treatment, commonly referred to as minimal residual disease (MRD). Methods to improve MRD detection in MM patients are generating considerable interest as a means of monitoring patients' response to treatment. In clinical laboratories, these methods currently require bone marrow aspirates which are invasive and frequently miss detection of localised disease due to the spatial heterogeneity of disease infiltration. By simplifying …

Social Media By Providers And Patients In Healthcare, Madison K. Howell, Jirakamon Silapabanleng

Theses, Dissertations and Capstones

Introduction: Social media platforms such as Facebook, YouTube, and Twitter have been used in various industries to create direct-to-consumer interactive opportunities. 74% of the US population were social media active users. Around 40% of adults gather their health information from Facebook, a free social networking site, which has been available on various devices and can help many organizations advertise their services as well as communicate with their patients. Social networks had a powerful influence in making health decisions because it could be used as a means to spread either positive or negative health information.

Purpose of study: The …

Never Satisfied, Sara Medeiros

The Graduate Review

A written work that pushes against the stigmas of weight loss journeys, non-fiction "Never Satisfied" shows the real struggles and mental toll that weight and appearance can have on any person, especially a woman. It includes common difficulties that not only occurred before weight loss, but after it as well, making it different from the typical success stories that are told. Written by an obsessive-compulsive twenty-two year old female student, it is extremely relatable to college students and young adults.

Choose Foods Low In Sodium Fact Sheet

United States Natonal Institutes of Health: Materials

Choosing and preparing foods that are lower in salt and sodium might help prevent or lower high blood pressure.

Cognitive Load Effect On Moral Decision Making, Elise Crause, Liz Eisenga, Caroline Hopper, Merry Bailey

Science University Research Symposium (SURS)

Cognitive Load Effect on Moral Decision Making

Elise Crause, Merry Bailey, Liz Eisenga, Caroline Hopper

Choices are made each day to determine the outcome of our lives. To better understand the human process of decision making, philosophers and psychologists have examined moral dilemmas. Cognitive load is a type of stress that alters decision-making and the likelihood of choosing a self-motivated behavior over a behavior that benefits another person or group. For this study, moral dilemmas were given in sets of two before and after a cognitive-load-inducing task. The cognitive-load-inducing task required participants to verbally answer subtraction problems until the answer …

Interprofessional Collaboration In High Performing Healthcare Teams, Zilola Khashimova

Physician Assistant Studies | Faculty Scholarship

As healthcare becomes more complicated, it is important for healthcare workers to collaborate and work together as a team to provide high quality healthcare to patients. Interprofessional teams have been widely introduced into healthcare organizations across the nation aimed at achieving patient centered care and increasing the quality of patient care. The introduction of technology like electronic medical records, escribing, telehealth, and telemedicine gave interprofessional collaborators alternative mediums for communication to achieve patient centered care rather than traditional communication mediums. Technology has evolved the way interprofessional collaboration is done in the healthcare field and has created barriers and solutions for …

Providing Healthcare Workers In Medically Underserved Areas: A Case Study, Zilola Khashimova

Physician Assistant Studies | Faculty Scholarship

Introduction: Demographic trends forecast an increasing population of aging, chronically ill patents in rural areas of the Southeastern United States. Most healthcare professionals opt to practice in or near urban areas because of higher incomes and nearness to desirable facilities. This leaves a chronic shortage of healthcare providers in rural areas where they are critically needed. A university located in one of the critically underserved areas started a program to train physician assistants with the idea that most of the students would be residents of the area and tend to stay in the area to practice after graduation.
Purpose of …

Transdisciplinary Evaluation Of Telehealth Experiences Of Diabetic Participants’ And Their Coaches’ In “Stopping Diabetes In Its Tracks” (Sdit) A Descriptive Mixed- Methods Customer Experience Map Journey, Cindy Delgado

CGU Theses & Dissertations

Introduction: This study captured the experiences of diabetic patients and their coaches during the Covid- 19 transition to virtual delivery. Previous research has focused on the feasibility and effectiveness of in-person versus telehealth delivery of Diabetes Prevention Program (DPP). However, few studies have merged perspectives from the field of ethnic studies, public health, and customer service research during a pandemic to understand the experience of telehealth from end-users. Methods: A mixed-methods evaluation was conducted using interviews and quantitative surveys to provide insight into personal perspectives to in-person and telehealth experience. A customer-experience journey map (CXJM) was then created of Stopping …

Classification Performance And Feature Space Characteristics In Individuals With Upper Limb Loss Using Sonomyography., Susannah Engdahl, Ananya Dhawan, Ahmed Bashatah, Guoqing Diao, Biswarup Mukherjee, Brian Monroe, Rahsaan Holley, Siddhartha Sikdar

Biostatistics and Bioinformatics Faculty Publications

No abstract provided.

Socioeconomic Determinants Of Antibiotic Resistance, Kausar Jama

Theses and Graduate Projects

Background: Antibiotics were first developed to treat wounded soldiers and cases of pneumonia in World War II. By the 1940s, antibiotics became widely used to treat several infectious processes. It was not long after antibiotics were being used frequently by clinicians that resistant strains began to emerge. Today, antibiotic resistance is a growing global health concern seen in many parts of the world. There are many factors that contribute to the prevalence of antibiotic resistance.

Purpose: This paper aims to demonstrate how socioeconomic factors play a role in the development and spread of antibiotic resistance. The literature review …

Intermittent Fasting And Reduction Of Cardiovascular Disease Risk, Ethan Dekam

Theses and Graduate Projects

Background: Cardiovascular disease remains one of the leading causes of death worldwide. Intermittent fasting is a unique intervention that is beginning to be studied more extensively for weight loss, positive alterations in serum lipid profile, and improvement of insulin resistance which are all modifiable risk factors for the development of cardiovascular disease.

Purpose: The research question at the center of this literature review is: does the addition of intermittent fasting reduce the risk of developing cardiovascular disease? The reduction of cardiovascular disease was studied through alterations in weight, cholesterol, and diabetic labs.

Methods: A comprehensive literature review …

Incorporating Quality Improvement And Problem-Solving Into A Unit Safety Huddle, Kay M. Rowles

Theses and Graduate Projects

The complex nature of healthcare creates significant risks of harm to patients. Safety huddles are a mechanism some hospitals utilize to raise awareness of safety concerns and minimize risks. Typically occurring at the start of each shift, safety huddles generally take the form of a brief, structured discussion with visual management for information sharing. In addition, safety huddles create a safe space for nursing staff to escalate concerns, supporting a culture of safety. This quality improvement project describes the expansion of a safety huddle process that has become a mere ritual at the start of each shift on a 25-bed …

A Role For Cox Inhibition In The Prevention Of Progression Of Barrett’S Esophagus To Esophageal Adenocarcinoma, John Speakman

Theses and Graduate Projects

Background: Barrett’s esophagus is the most significant predictor of the development of esophageal adenocarcinoma. The current treatment recommendation is a proton pump inhibitor to control acid reflux, yet there remains a significant number of individuals who progress to cancer. More can be done to prevent this progression.

Purpose: To this end, this paper seeks to answer the following PICO question: P: Patients with Barrett’s esophagus not yet esophageal adenocarcinoma; I: Standard PPI treatment with the addition of Aspirin; C: Standard PPI treatment only; O: Prevention of progression of Barrett’s esophagus to esophageal adenocarcinoma.

Methods: A comprehensive literature …

Does Probiotic Supplementation Improve Depression/Anxiety Outcome Measures?, Kathryn M. Decleene

Theses and Graduate Projects

Background: Depression and anxiety continue to be a healthcare burden worldwide. Current depression and anxiety treatments include medications and psychotherapy; however, for many patients this is not enough. Literature has recently come out detailing the gut-brain axis and its potential impact on mental health.

Purpose: This literature review sought to answer the question if probiotics could play a role in the treatment of depression and anxiety. Specifically, does supplementation with a probiotic improve clinical outcome measures of depression, anxiety, or both? Methods: A comprehensive literature review was conducted using PubMed and Google Scholar using the search terms probiotics, …

Lower Extremity Risk Assessment In Athletes Following A Traumatic Brain Injury, Carlos D. Villalpando

Theses and Graduate Projects

Background: According to the Centers for Disease Control and Prevention, Concussions are a major health disorder. Continued research regarding the impact of concussions on athletes has led to an increased risk for lower extremity injury across a variety of populations following head trauma. Guidelines from the CDC use a self-reported symptom and cognitive examination for return to play.

Purpose: Current recommended guidelines increase the risk of lower extremity injury due to failure of identifying neurological deficits that persist following a concussion. This literature review aims to identify if athletes diagnosed with a concussion are at an increased risk …

Lowering Depression Symptoms In Adults: Exploring Nonpharmacologic/Non-Talk Therapy Based Approaches, Alyssa A. Raiolo

Theses and Graduate Projects

Background: Depression has a high prevalence, affecting more than 300 million people worldwide.1 Antidepressants and talk therapy are the current mainstays for treatment. Given the high prevalence of depression, there is value in the research regarding further treatment options.

Purpose: A literature review of studies exploring additional treatment modalities to lower depression symptoms in adults.

Methods: A comprehensive literature review was conducted using with the search terms <(adults) AND (depression, low mood, mental health) AND (pharmacologic, SSRI, SNRI) OR ( physical activity, fitness, exercise), OR (time outdoors, UV exposure, phototherapy) OR (non-talk therapy)>. Inclusion criteria were studies that were published from 2015 to the present. Exclusion criteria were studies not in English.

Conclusions: Aside from the currently recommended approaches to treating …

Sound And Silence For Patients With Dementia, Jess Porteous

Theses and Graduate Projects

Dementia, a condition that causes cognitive and physical impairments in the aging population, is becoming a global health issue as life expectancy continues to rise. Ineffective and inhumane interventions, such as physical and chemical restraints, are often used in acute hospitalizations due to safety concerns stemming from behavioral and psychological symptoms of dementia. Nurses often feel overwhelmed by the complex needs of patients with dementia and may suffer from moral injury while trying to care for them with limited interventions. Fortunately, integrative therapies such as mindfulness meditation, energy therapies, and sound healing, show promising results for patients with dementia. Resonant …

Comparing Efficacy Of Denosumab To Bisphosphonates In Fragility Fractures, Ronald Toledo Cardoso

Theses and Graduate Projects

Background: Osteoporosis is a disease of the bones with decreased bone mineral density and bone mass, leading to poor bone quality/structure, increasing the risk of fragility fractures. Pharmacological treatment is recommended to decrease risk of fractures. Current first line treatment is with bisphosphonates; however, alternative treatment includes denosumab. Both bisphosphonates and denosumab are antiresorptive drugs but differ in mechanism of action. Bisphosphonates remain as first line treatment.

Purpose: The purpose of this literature review is aimed at the PICO question in adults with osteoporosis, what is the efficacy of denosumab compared to bisphosphonates in decreasing the risk of …

Integration Of Sexual Assault Nurse Examiners (Sane’S) Care Program, Erin B. Mehta

Theses and Graduate Projects

Sexual assault is a public health issue, especially for individuals experiencing homelessness, violence, and victimization. Barriers to post-sexual assault health care must be addressed to ensure individuals experiencing homelessness receive effective and adequate care. Traditionally found in Emergency Departments, Sexual Assault Nurse Examiners (SANEs) offer patient-centered, comprehensive health care to sexual assault survivors. To reduce barriers for individuals experiencing homelessness, SANEs must be accessible where health care services are utilized. Guided by Jean Watson’s Theory of Human Caring and trauma-informed principles, this project aims to embed a SANE program into a homeless-specific Midwest Health Care Center. The SANE program will …

Stroke Prevention In Patients With Non-Valvular Atrial Fibrillation: The Watchman Device Versus Warfarin, Emma Delaney

Theses and Graduate Projects

Atrial fibrillation is a common heart arrhythmia that leads to an increased risk of stroke. Warfarin was the original anticoagulant that would be used as the treatment for atrial fibrillation. However, there are people who have contraindications to anticoagulation or are a high fall risk and shouldn’t be on Warfarin. The Watchman Device was originally designed in 2005 as a way to close the left atrial appendage where clots are usually present with atrial fibrillation. The watchman may be a superior way to help reduce the risk of stroke compared to the traditional use of Warfarin. Purpose: Literature review …

What Alternative Models Are Effective In Improving Health Outcomes In Children With Obesity In The United States?, Kelsey Reineke

Theses and Graduate Projects

Background: Obesity in children has increased at an alarming rate in the past three decades and has been associated with multiple comorbidities. This literature review has been focused on pediatric obesity management research utilizing Family-Based Therapy, community-centered interventions, behavioral modifications, and implementations for management within the Primary Care setting.

Purpose: There has not been an established standard of care for children suffering from obesity. This investigation was focused on the question; What alternative models are effective in improving health outcomes in children with obesity in the United States?

Methods: A comprehensive literature review was conducted using Pub …

Effective Pharmacological And Non-Pharmacological Treatments For Sleep Disturbances And Fatigue In Patients Who Have Experienced A Mild To Severe Traumatic Brain Injury, Mika Muras

Theses and Graduate Projects

Background: In the United States alone, an estimated 1.5 million people sustain a head injury every year.1 With improved recognition of traumatic brain injuries by healthcare providers, the number of patients diagnosed with a traumatic brain injury (TBI) is only increasing. Unfortunately, many patients who sustain a TBI, regardless of the severity, experience sleep disturbances, insomnia, fatigue, and daytime sleepiness.

Purpose: For the purposes of this systematic review, the focus will be primarily on the comparison of nonpharmacological treatments of sleep disturbances or fatigue secondary to a TBI. In addition, the focus will include recent studies on pharmacological …

Dual Antiplatelet Therapy With Ticagrelor Vs Clopidogrel In Patients With Acute Coronary Syndrome, Binh Vu

Theses and Graduate Projects

Background: Dual antiplatelet therapy (DAPT) is an effective secondary prevention and an essential component of treatment after patients suffering from acute coronary syndrome (ACS). Recently, clinicians rapidly switched to DAPT with ticagrelor as the preferred treatment option after it was introduced in 2011. Compared to clopidogrel, ticagrelor is not a prodrug and does not require metabolic activation to inhibit the platelet P2Y12 receptor. It is the first reversible oral P2Y12 receptor antagonist; and its effect on platelet inhibition is more pronounced compared to clopidogrel.

Purpose: The purpose of this comprehensive review was to evaluate the efficacy and safety …

In Individuals Aged 9-26, Will Increasing Provider And Parent Education About The Human Papillomavirus (Hpv) Vaccine Increase The Rate Of Hpv Vaccination, Jessica Thonack

Theses and Graduate Projects

Background: HPV is the most common sexually transmitted infection (STI) affecting millions of individuals in the United States (US). Since the introduction of the HPV vaccine, infections have declined. Yet, many adolescents remain unvaccinated.1 This review analyses the vital role of provider and patient education in increasing the rate of HPV vaccination, and what strategies can be implemented to improve HPV vaccine coverage.

Purpose: The purpose of this review is to describe the factors that affect HPV vaccination numbers and how to increase HPV vaccination rates. In individuals aged 9-26, will increasing provider and parent education about the …