Medicine and Health Sciences Commons^™

The Impact Of Mindfulness Meditation On Registered Nurse Burnout, Kelli R. Scheibenhoffer

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Nurse burnout has been reported in hospitals across the nation and is prevalent around the globe. In 2019, the World Health Organization (WHO) declared nurse burnout a condition calling for recognition and treatment. Nurses working in an inpatient setting may experience higher levels of burnout than in other settings. Hospitals with nurse burnout jeopardize the number of functioning employees, patient safety, and quality of care. Introducing preventative factors such as mindfulness could shield nurses, improve patient care, and cut hospital costs. Purpose: This evidence-based project aimed to determine the effect of using meditation via the Headspace app with …

Impacting Rn Intent To Leave By Developing Emotional Intelligence In Frontline Nurse Leaders, Kristin W. Smith

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Registered Nurse (RN) turnover is defined as the frequency at which RNs leave the organization within a specified timeframe (Shimp, 2017). Turnover can correlate negatively to patient satisfaction and outcomes, mortality, and overall healthcare costs (Copanitsanou et al., 2017). Frontline leaders, especially those with high emotional intelligence (EI), can have a significant positive influence over RN turnover, yet there is little focus or standard approach on frontline leader EI development (Mansel & Einion, 2019).

Purpose: This DNP project aims to determine if providing professional development focused on emotional intelligence to frontline nursing leaders will impact RN intent to …

Organizational Readiness For Implementing A Postpartum Depression Screening Protocol In The Nicu, Deanna L. Suber

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Postpartum depression (PPD) is a major depressive disorder that is the most common complication following childbirth, occurring in about 16% of new mothers (Berns et al., 2021). Mothers with infants in the Neonatal Intensive Care Unit (NICU) are 40% more likely to develop PPD but are not typically screened for this complication (Berns et al., 2021; Cherry et al., 2016; Garfield et al., 2021). Implementing a PPD screening protocol in the NICU could help increase the detection of PPD in this population but would first require an evaluation of organizational readiness to ensure sustainability. Purpose: The purpose of …

Evaluating The Use And Effectiveness Of Digital Mental Health Resources For Acute Care Nurses, Ashley M. Turbyfill

Doctor of Nursing Practice Scholarly Projects

Statement: The burnout phenomenon has been exacerbated over the last almost two years due to the COVID-19 pandemic (Maunder et al., 2021). Healthcare organizations must respond by implementing evidenced-based mental health initiatives to increase staff coping skills to reduce stress and emotional exhaustion (Galanis et al., 2021). While the project organization can access large-scale aggregate data about resource usage and its overall mental well-being, they cannot assess what percentage of users are nurses and the personal impact on their mental well-being. Due to these limitations, the organization cannot gauge how the nursing staff uses and responds to offered resources. …

Hybrid-Based Cardiac Rehabilitation: Improving Enrollment, Attendance, And Completion Rates, Victoria S. Yandle

Doctor of Nursing Practice Scholarly Projects

Problem: Barriers exist to enrolling and attending a cardiac rehabilitation (CR) program for patients who have recently experienced a cardiac event. These barriers include insurance status, cost, location, availability, convenience, and transportation. Increasing accessibility to CR through the provision of a hybrid-based cardiac rehabilitation (HBCR) program provides an alternative option that may improve enrollment, attendance, and completion rates in the CR program by removing the barriers of location and transportation. Purpose: The purpose of this project was to determine if a HBCR program was feasible for improving overall enrollment, attendance, and participation rate at Prisma Health Heart Hospital (PHHH). Methods: …

Using A Clinical Reminder Tool To Impact Vitamin D Screening, Mercy Roy

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Chronic pain patients with widespread musculoskeletal pain are not adequately screened for possible vitamin D deficiency by healthcare providers. Purpose: This quality improvement project (Q.I.) aimed to improve the screening rates for vitamin D among healthcare providers by implementing a clinical reminder tool within the documentation section of the electronic medical records (EMRs) in an outpatient federally funded pain clinic located in the Southeastern region of South Carolina. Methods: A clinical reminder template was embedded within the EMR documentation to increase screening for vitamin D levels for chronic pain patients among healthcare providers. Data were collected six weeks …

Effects Of Postcode Debriefing On Nursing Burnout And Patient Survival In The Emergency Department: A Single-Center Quality Improvement Project, Margaret Anne Lee

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Emergency department (ED) nurses are routinely exposed to stressful events, including cardiac arrest codes. The American Heart Association stresses the importance of structured debriefing as a continuous quality improvement strategy for patient care. Furthermore, literature shows that debriefing after codes is associated with improved teamwork, decreased nursing burnout, and reduced staff turnover. Purpose: This quality improvement project implemented a structured postcode debriefing tool in the ED after codes to determine if it improved nurse burnout and patient survival rates. Methods: A structured postcode debriefing tool was administered after codes in the ED. All registered nurses employed in the …

Decreasing Pressure Injuries From Respiratory Devices In The Pediatric Intensive Care Unit, Samantha Nicole Elliott

Doctor of Nursing Practice Scholarly Projects

Problem: Patients developing pressure injuries while admitted to the hospital has become a nationwide problem. The national annual cost of treating pressure injuries is $11 billion dollars, with up to $70,000 dollars for stage four pressure injuries (Cooper et al., 2020).

Purpose: The purpose of this project was to implement the use of a silicone foam dressing under respiratory devices, monitored using kamishibai cards (k-cards) to decrease pressure injuries. K-cards are a rounding tool that staff can use to identify barriers that prevent the standard of care.

Intervention: A pre-study, three-month period, was compared to the implementation period in the …

Enhancing Quality Of Life For Ovarian Cancer Patients, Kelly Marie Liguori

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Ovarian cancer is associated with a delayed onset of symptoms and late diagnosis and therefore has increased morbidity and mortality (Momenimovahed et al., 2019). These patients face multiple health complications, frequent hospital admissions, and may suffer from an overall poor quality of life (Marks, 2020). Purpose: This project aimed to determine if implementing FACT-O, a patient-reported quality-of-life screening tool, led to increased pastoral care consults and patient-reported quality-of-life for ovarian cancer patients. Methods: Iowa Model of Evidence-Based Practice was used for this project. Upon admission to 3Tower at CMC Main during a 3-month period, all patients with ovarian …

Screening For Prediabetes In The Inpatient Setting, Mikayla Jordan Moore

Doctor of Nursing Practice Scholarly Projects

Problem Statement: Many patients that utilize the hospital system do not see a primary care provider and, therefore, miss important screenings. The hospital system can provide convenient screenings, or screenings conducted whenever a patient encounters the health system regardless of their chief complaint (Obinwa et al., 2020).

Purpose: Determine whether convenient prediabetes screenings administered to admitted patients on an Intermediate Critical Care Unit (ICCU) detect prediabetes at a higher rate than no formal screenings.

Methods: Participants will be sampled from those admitted to an intermediate critical care unit at a large acute-care facility.

Inclusion Criteria: Any adult patient (>18 …

Antineutrophil Cytoplasmic Autoantibody-Associated Glomerulonephritis As A Possible Side Effect Of Covid-19 Vaccination., Edva Noel, Urmiya Rashid, Rizwan Rabbani, Waqas Ahmad Khan, Yves-Smith Benjamin, Iris Lee

Internal Medicine Resident Research

Vaccination is the principal tool aimed at curbing the COVID-19 pandemic that has, so far, affected tens of millions of individuals in the United States. The two available mRNA vaccines developed by Pfizer-BioNTech and Moderna possess high efficacy in preventing infection and illness severity. However, there are multiple side effects associated with these vaccines, some impacting different organs. Renal pathology is variable, with increasing cases of glomerulonephritis being observed. We report a rare acute kidney injury case due to antineutrophil cytoplasmic autoantibody (ANCA)-mediated glomerulonephritis after administering a second dose of the Pfizer-BioNTech mRNA SARS-CoV-2 vaccine. Aggravation and/or development of autoimmunity …

An Update And Report Failure Of Surgical Syndactyly Repair In Harlequin Ichthyosis., Elias H Kahan, Brian Temple, Logan Carr, Elizabeth Zellner

Plastic Surgery Resident Research

Harlequin ichthyosis (HI) is a rare congenital skin disorder caused by irregular epidermal differentiation. Syndactyly in HI is associated with thick hyperkeratotic skin flexion and angulation deformity of the hand and fingers resulting in limited function of the upper extremity. Traditional syndactyly release is limited as full-thickness skin grafts typically used in reconstruction are composed of diseased skin and require donor sites in a patient predisposed for adverse wound healing. This case report is a follow-up to a previous viewpoint written about digital escharotomies in a newborn with HI and outlines a second and fourth webspace syndactyly release with a …

Glutathione And Glutaredoxin In Redox Regulation And Cell Signaling Of The Lens, Marjorie F. Lou

School of Veterinary and Biomedical Sciences: Faculty Publications

The ocular lens has a very high content of the antioxidant glutathione (GSH) and the enzymes that can recycle its oxidized form, glutathione disulfide (GSSG), for further use. It can be synthesized in the lens and, in part, transported from the neighboring anterior aqueous humor and posterior vitreous body. GSH is known to protect the thiols of the structural lens crystallin proteins from oxidation by reactive oxygen species (ROS) so the lens can maintain its transparency for proper visual function. Age-related lens opacity or senile cataract is the major visual impairment in the general population, and its cause is closely …

Lgbtq+ And Dental Education: Analyzing The Present And Recommendations For The Future, Colin M. Haley, Diana V. Macri, Herminio L. Perez, Scott B. Schwartz

Publications and Research

LGBTQ+ populations constitute increasing proportions of children, adolescents, and adults in the United States. Compared to their heterosexual counterparts, this group suffers from health inequities, including oral health. The report “Oral Health: Advances and Challenges” identified the LGBTQ+ community as an underserved population which faces significant barriers in accessing oral health care. Coverage of LGBTQ+ topics in formal education settings in both dental schools and dental hygiene programs is scarce, which contributes to inequities within this group. Increasing curriculum content related to LGBTQ+ populations is of utmost importance to promote optimal patient-provider interactions while improving oral health outcomes. Ensuring equity …

Loma Linda Nurse - Vol. 30, Loma Linda University School Of Nursing

Loma Linda Nurse

FEATURES

4 | Elizabeth Bossert— Reflecting on a Journey

8 | Gloria Huerta— A Vision for Leadership

10 | Dawn Graves—First Flight

12 | The Path to Excellence

16 | Nursing Anesthesia Around the Globe

LLUSN HIGHLIGHTS

20-25 | ALUMNI NEWS

26-29 | HOMECOMING

30-33 | ACADEMICS

34-35 | FACULTY UPDATES

Venous Thromboembolism In Musculoskeletal Oncology Surgery, Ahna Donahue, Keenan Sobol, John A. Abraham

Rothman Institute Papers

Abstract

Venous thromboembolism (VTE), including both deep venous thrombosis (DVT) and pulmonary embolism (PE), is a major complication of musculoskeletal surgery in general, and the risk is heightened in musculoskeletal oncology surgery. Despite the well-known association between cancer and VTE, the mechanism promoting this pathology is not entirely well understood. It is estimated that nearly all cancer patients will experience from some form of VTE, whether or not clinically relevant, during the course of their disease. Nonetheless, numerous studies have analyzed the occurrence and prevention of VTE in patients with cardiovascular disease or suffering trauma, but very few have specifically …

Larger Perioperative Opioid Prescriptions Lead To Prolonged Opioid Use After Hand And Upper Extremity Surgery: A Multicenter Analysis, Clay B Townsend, Justin A Ly, Ryan Judy, Matthew Sherman, Nick Elmer, Christine Conroy, Hesham M Abdelfattah, Mark K Solarz, Katharine Woozley, Asif M Ilyas

Rothman Institute Papers

Introduction: The opioid epidemic remains an ongoing public health crisis. The purpose of this study was to investigate whether surgeons' prescribing patterns of the initial postoperative opioid prescription predispose patients to prolonged opioid use after upper extremity surgery.

Methods: This multicenter retrospective study was done at three academic institutions. Patients who underwent carpal tunnel release, basal joint arthroplasty, and distal radius fracture open reduction and internal fixation over a 1.5-year period were included. Opioid prescription data were obtained from the Pennsylvania Prescription Drug Monitoring Program website.

Results: Postoperatively, 30.1% of the patients (191/634) filled ≥1 additional opioid prescription, and 14.0% …

Likeability And Perceived Effectiveness Of Messages Designed To Encourage Physical Activity Participation Among Older Adults, Michelle I. Jongenelis, Ben Jackson, Robert U. Newton, Simone Pettigrew

Research outputs 2022 to 2026

Issue addressed: Older adults are significantly less likely than their younger counterparts to engage in physical activity. Comprehensive policies to support healthy ageing thus need to include components encouraging greater participation in physical activity in later life. This study tested potential messages for use in health communication campaigns aimed at increasing physical activity among older adults. Methods: Twelve written messages designed to encourage older adults to increase their levels of physical activity were rated by Australians aged 60-92 years (n = 369; 54 % female) on the variables of likeability and perceived effectiveness. Results: Ratings for all the tested messages …

Cardiovascular Outcomes And Trends Of Transcatheter Vs. Surgical Aortic Valve Replacement Among Octogenarians With Heart Failure: A Propensity Matched National Cohort Analysis, Yasar Sattar, David Song, Talal Almas, Mohamed Zghouzi, Usama Talib, Abdul-Rahman M Suleiman, Bachar Ahmad, Junaid Arshad, Waqas Ullah, Muhammad Zia Khan, Christopher M Bianco, Rodrigo Bagur, Muhammad Rashid, Mamas A Mamas, M Chadi Alraies

Division of Cardiology Faculty Papers

Background: Heart failure (HF) is a complex clinical syndrome with symptoms and signs that result from any structural or functional impairment of ventricular filling or ejection of blood. Limited data is available regarding the in-hospital outcomes of TAVR compared to SAVR in the octogenarian population with HF.

Methods: The National Inpatient Sample (NIS) database was used to compare TAVR versus SAVR among octogenarians with HF. The primary outcome was in-hospital mortality. The secondary outcome included acute kidney injury (AKI), cerebrovascular accident (CVA), post-procedural stroke, major bleeding, blood transfusions, sudden cardiac arrest (SCA), cardiogenic shock (CS), and mechanical circulatory support (MCS). …

The Frog Sign Revisited, Christopher J. Ho, Reginald T. Ho

Division of Cardiology Faculty Papers

The frog sign is a classic physical examination finding of typical atrioventricular nodal re-entrant tachycardia. We present the case of a 78-year-old man with recurrent, symptomatic supraventricular tachycardia referred for ablation in whom the frog sign was observed during physical examination.

September / October 2022, Randy Curry, Cindy Brooks

RURAL ROCKS

PLS presents the 7^th Annual Substance Use Disorder Seminar with Dr. Jake Nichols.

Era Project Summary Of Argument Before Pa Supreme Court On Whether Medicaid Abortion Ban Amounts To Sex Discrimination, Center For Gender And Sexuality Law

Center for Gender & Sexuality Law

This morning, the Pennsylvania Supreme Court heard oral arguments in Allegheny Reproductive Health Center v. Pennsylvania Department of Human Services, a case in which reproductive rights advocates have challenged the state’s ban on Medicaid funding for abortion (Coverage Ban), arguing that the ban violates the state constitution’s explicit prohibitions against sex discrimination.

Alzheimer's Disease, Dylan L. Weber

Student Publications

An overview of the background, etiology, pathophysiology, clinical features, diagnosis, treatment and prevention of Alzheimer's disease.

Tourism-Oncology: More Than A Treatment, Ozge Buyuk, Gulsah Akkus

University of South Florida (USF) M3 Publishing

Medical tourism is a growing global niche market all over the world. In this study, which intends to assess the status of "tourism-oncology," texts obtained longitudinally from digital and social media were analyzed for content. Tourism-oncology has evolved as an economic activity within the context of medical tourism in Turkey. The research revealed that (i) oncology was among the top five, (ii) lung cancer was the cancer type that results in the most travel, (iii) the user profiles shared on social media were mostly those of travel agencies and health-consulting businesses, (iv) Istanbul, Antalya, Ankara, Izmir, and Mugla were the …

The Relationship Between Balloon Tourism And Well-Being, Serkan Bertan

University of South Florida (USF) M3 Publishing

The relationship between balloon tourism and well-being was analyzed in this study. In line with this purpose, a questionnaire was implemented on people living at Pamukkale destination. The reason for selecting Pamukkale was its importance as one of the most prominent localities with many hot air balloon activities. Structural equation model was used in this study which was conducted to determine the relation between well-being and the effects of and support for balloon tourism. The sample was determined with random sampling method. Data were analyzed through PLS-SEM method. Economic, cultural and environmental impacts were found to be positively affecting the …

Endoscopic Retrograde Cholangiography Using A Colonoscope In A Pediatric Liver Transplant Patient With Roux-En-Y Biliary Anastomosis, Nadia Ibrahimi, Thomas M. Attard, Ryan T. Fischer, Voytek Slowik, Richard J. Hendrickson, Bhargava Mullapudi, Moises Alatorre-Jimenez, Syed Jafri

Posters

Introduction: Biliary ducal sequelae including occlusions, strictures, leaks, or necrosis frequently complicate pediatric liver transplantation. The underlying etiology includes prolonged intraoperative ischemia or postoperative arterial inflow obstruction. In adult patients the role of endoscopic retrograde cholangiography (ERC) is well established in the management of biliary complications post-liver transplantation. In contrast, in the pediatric population, due to the combination of small patient size and the complexity of Roux-en-Y anastomotic techniques, ERC has been described as difficult or virtually impossible. This limits the options available for managing biliary duct complications to percutaneous techniques Endoscopic management of biliary complications in pediatric patients with …

Repeat Tracheal Aspirates In Pediatric Intensive Care Patients: Frequency, Resistance And Antimicrobial Use, Edward Lyon, Jennifer Goldman, Brian Lee, Margaret Campbell, Rangaraj Selvarangan, Elizabeth Monsees

Posters

Background: Tracheal aspirates (TA) are frequently obtained in the pediatric intensive care unit (PICU); however, no data exists on the frequency or clinical management of multiple TA cultures on the same PICU patient. In this study, we describe the frequency of repeat TAs in PICU patients, the emergence of multidrug resistant organisms (MDRO), frequently cultured pathogens of TAs, and associated antibiotic prescribing patterns. Methods: We identified 70 PICU patients between 2018-2019 who met our criteria for retrospective chart review with ≥2 TAs obtained during their hospitalization. The following information was collected: patient demographics, number of TAs per patient, microbiology with …

Effect Of Different Polishing Systems On Surface Roughness And Color Stability Of Lithium Disilicate Ceramics, Mahmoud Al Ankily, Fatma Makkeyah

Dentistry

Objective: This study aimed to investigate the effect of two polishing systems on the surface roughness and color stability of lithium disilicate ceramic. Materials and Methods: Forty disc-shaped lithium disilicate samples were constructed and cemented into a cavity prepared onto the labial surface of freshly extracted bovine teeth; The samples were divided into four groups (10 samples per group); C: Control, SS: Scaling only, SE: Scaling followed by polishing using Eve Diapro lithium disilicate polishers, SD: Scaling followed by polishing using Diatech ShapeGuard ceramic polishing plus kit. The surface roughness was measured before scaling, after scaling and finally after the …

Intestinal Parasite Prevalence In Fecal Samples In Nebraska Dog Parks, Kristianna Muller

Honors Program: Senior Projects (Public)

From February to April 2022, fecal samples were collected from eight dog parks in the Omaha and Lincoln, NE areas. A total of 160 samples were collected and assessed for the presence of intestinal parasites. The zinc sulfate double centrifugal flotation technique was used to determine infection. Out of the 160 samples, ten were positive for parasite contamination (6.25% prevalence). The most observed parasites were hookworms, found in 3.75% of all samples (6/160). Cystoisospora, Giardia, Toxocara canis, and Toxascaris leonina were all found only once, for a prevalence of 0.625% each. Compared to other studies, our infection …

Morphometric Measurements Of Posterior Cranial Fossa And Craniovertebral Junction In Chiari I Malformation With And Without Syringohydromyelia, Pawitra Imemkamon, Supada Prakkamakul, Ketsuda Jakchairoongruang

Chulalongkorn Medical Journal

Background: Syringohydromyelia occurs about 30.0 - 85.0% in patients with Chiari I malformation (CMI). The syrinx formation is supposed to be a result of disturbed cerebrospinal fluid flow dynamics, which is associated with the degree of mechanical blockage that may be related to posterior cranial fossa (PCF) and craniovertebral junction anatomy. Objective: Our study aimed to determine the morphometric difference in PCF and craniocervical junction between the CMI patients with and without syringohydromyelia. Methods: Thirty CMI patients (16 with syringohydromyelia; 14 without syringohydromyelia) and 16 healthy subjects were also recruited. PCF and craniocervical junction measurements of 5 distances and 5 …