Medicine and Health Sciences Commons^™

Polypharmacy Teaching In The Acute Setting, Brandy Marie Duncan

MSN Capstone Projects

Within stable economic societies, polypharmacy has become a phenomenon that can be more harmful, although medications prescribed are with good intentions. Education is integral to nursing responsibilities; it is an intervention tool to help patients affected by polypharmacy. The interest in polypharmacy stems from witnessing the lack of patient education within the acute setting, and the lack poses a greater risk for adverse drug events (ADEs). The healthcare industry’s responsibility is to help alleviate the adverse effects that polypharmacy causes, such as falls, adverse drug reactions, hospitalizations, mortality, and cognitive mental (Fried, 2014).

A new performance improvement project (PI) will …

A "Collaborative" Approach To Improving Nurse Turnover, Tiffany M. Nawabi

Master's Projects and Capstones

Problem: A cardiovascular unit is experiencing an increase in RN turnover and decreased NDNQI RN to RN interaction scores.

Context: Several recent studies demonstrate that a collaborative environment of well-being and enhanced RN communication can improve nurse retention rates (Alsufyani et al., 2021), as well as increase job satisfaction (Ylitörmänen et al., 2019).

Interventions: Nursing-led collaborative sessions were launched, consisting of the unit’s clinical nurses, the management team, and interprofessionals. The collaborative meetings provide a forum for the nurses to express their concerns, collaborate, and develop meaningful solutions.

Measures: The first measure is the Human Resource’s nursing retention report, with …

A Quantitative Comparison Of Linac Vs. Cyberknife For Sbrt Prostate Boost: A Retrospective Study, Vicente Miguel Ornelas

Masters Projects

Purpose: The purpose of this study is to retrospectively evaluate the quantitative difference of prostate SBRT boost between LINAC boost and CK boost treatments, with a primary plan using LINAC volumetric modulated arc therapy.

Materials and Methods: Nine prostate cancer patients were treated with a SBRT fractionated schedule of 21 Gy in 3 fractions, given every other day over the course of a week. The LINAC-BOOST were created by the researcher followed the same fractionation schedule, treatment volumes, OAR, and dose constraints as the original CK-BOOST treatment. The CK-BOOST was completed on the Multiplan (v14) TPS, while the LINAC-BOOST was …

Understanding Intelligent Non-Adherence By Measuring The Differences In Knowledge, Attitudes, Beliefs, And Behaviors Of Self-Care In Heart Failure Patients, Marco Mimbela

Seton Hall University Dissertations and Theses (ETDs)

Background and Purpose of the Study: Research shows that six in ten U.S. adults have a chronic disease and four in ten have two or more (CDC, 2018). Of all chronic diseases, heart failure is the leading cause of hospitalization and mortality in the U.S. (Kilgore, Patel, Kielhorn, Maya, & Sharma, 2017). Luckily, this condition can be managed through various self-care practices. Although healthcare providers are educating their patients on these self-care practices, patients are making a conscious decision to non-adhere. This phenomenon is known as intelligent non-adherence and is mostly affected by an individual’s level of knowledge, attitudes, beliefs, …

Spectral Library-Based Single-Cell Proteomics Resolves Cellular Heterogeneity, Lakmini Senavirathna, Cheng Ma, Ru Chen, Sheng Pan

Faculty, Staff and Students Publications

Dissecting the proteome of cell types and states at single-cell resolution, while being highly challenging, has significant implications in basic science and biomedicine. Mass spectrometry (MS)-based single-cell proteomics represents an emerging technology for system-wide, unbiased profiling of proteins in single cells. However, significant challenges remain in analyzing an extremely small amount of proteins collected from a single cell, as a proteome-wide amplification of proteins is not currently feasible. Here, we report an integrated spectral library-based single-cell proteomics (SLB-SCP) platform that is ultrasensitive and well suited for a large-scale analysis. To overcome the low MS/MS signal intensity intrinsically associated with a …

Optimization Of Postoperative Length Of Stay, Sadia Imran

Master's Projects and Capstones

Abstract

Problem: The increased patient postoperative length of stay (LOS) is impacting the throughput of the operating room and resulting in prolonged wait time for new post-anesthesia care unit (PACU) admissions from the operating room. The baseline data indicated that average LOS of laparoscopic cholecystectomy patients after surgery was 153 minutes, which is longer than the regional 90-minute standard.

Context: To deliver more efficient care, the healthcare team determined that improving LOS for laparoscopic cholecystectomy patients would increase patient care experience, improve department efficiency, and decrease healthcare cost (Health Catalyst, 2018).

Intervention: The microsystem adopted the continuous improvement methodology to …

Investigating The Correlation Between Lpr & Obesity, Andrew S. Franklin Bs, Chad A. Nieri Bs, M. Boyd Gillespie Md

Longitudinal Scholar's Project

Objectives: To determine whether Drug-Induced Sleep Endoscopy (DISE) findings of Laryngopharyngeal Reflux (LPR) correlate with obesity, gender, Epworth Sleepiness scale, and OSA severity.

Study design: Single center retrospective cohort study.

Methods: Patients greater than 18 years of age who underwent DISE by one surgeon at a tertiary care center from July 2016 to July 2022 were included. DISE findings, patient characteristics, demographics, polysomnogram(s), and Epworth Sleepiness Scale(s) were extracted. Fisher’s exact test was used to compare categorical variables, and independent sample t-test was used to compare continuous variables. All statistical analyses were performed using IBM SPSS Statistics 28.

Results: …

Cross-Sectional Analysis Of The Relationship Between Adherence To The Mediterranean Diet And Mental Wellness, Gabrielle A. Jasmin

Department of Nutrition Student Projects

The Mediterranean Diet (MD) is a well-known healthy dietary pattern that continues to be recommended by literature due to its benefits of preventing chronic diseases and enhancing the overall health of the general public. With an abundance of literature focusing on the physical health benefits of MD, this study aimed to assess whether there is an association between adherence to MD and mental wellness, specifically levels of depression and anxiety. A random sample of 100 participants consented to complete an online survey to assess their adherence to MD and levels of depression and anxiety through the validated questionnaires of 14-item …

Clinical Simulation Training To Increase Medical Surgical New Graduate Registered Nurse (Ngrn) Confidence And Competence When Caring For Deteriorating Patients: A Quality Improvement Project, Tammy Schwaab

Doctor of Nursing Practice (DNP) Manuscripts

Problem: Patient harm from preventable cardiac arrest continues despite implementation of Rapid Response Teams (RRT) in the hospital setting. Medical surgical NGRNs lack adequate practice experience to prepare themselves with the competency skills necessary to manage high acuity patients in a complex healthcare environment. An awareness of a lack of readiness for practice leads to low NGRN self-confidence. Deficiencies in NGRN self-confidence and clinical competence lead to an inability to recognize and respond to patient complications with subsequent ineffective use of the RRT. Failure to Rescue (FTR) is one of the top three medical errors committed by NGRNs. Current evidence …

Temporal And Sex-Linked Protein Expression Dynamics In A Familial Model Of Alzheimer's Disease, Filipa Blasco Tavares Pereira Lopes, Daniela M. Schlatzer, Rihua Wang, Xiaolin Li, Emily Feng, Mehmet Koyutürk, Xin Qi, Mark R. Chance

Faculty Scholarship

Mouse models of Alzheimer's disease (AD) show progression through stages reflective of human pathology. Proteomics identification of temporal and sex-linked factors driving AD-related pathways can be used to dissect initiating and propagating events of AD stages to develop biomarkers or design interventions. In the present study, we conducted label-free proteome measurements of mouse hippocampus tissue with variables of time (3, 6, and 9 months), genetic background (5XFAD versus WT), and sex (equal males and females). These time points are associated with well-defined phenotypes with respect to the following: Aβ42 plaque deposition, memory deficits, and neuronal loss, allowing correlation of proteome-based …

Establishment Of Unit Based Council Using A Shared Governance Toolkit, Viji George

Student Scholarly Projects

Practice Problem: Shared governance (SG) is an organizational structure that provides healthcare professionals control over their professional practice. Lack of a unit-based council (UBC) was noted as a problem disrupting the shared decision-making and problem-solving approach.

PICOT: In an adult acute care unit lacking a UBC structure (P), what is the effect of the implementation of a SG toolkit (I) compared to no SG toolkit (C) on the establishment of a SG UBC within a period of 10-weeks (T)?

Evidence: The literature evidence suggest that SG enables nurses to engage as a partner with nursing leaders within …

A Conceptualisation Of Resilience Among Cancer Surviving Employed Women In Malaysia, Melati Sumari, Nordinah Mohd Kassim, Nor Safatul Aznin A.Razak

The Qualitative Report

This study examines the experiences faced by employed female cancer survivors when developing resilience. We used a phenomenological approach to understand these experiences and challenges. A total of ten participants with different types of cancer participated in this research, which was carried out using semi-structured interviews. Social media was used for triangulating the data collected. The meanings of resilience were monitored through the particpants’ social media accounts (namely, Facebook and Instagram) from the time of diagnosis until they returned to work. Data were analysed using thematic analysis. Five themes emerged from the data collected: (a) resilience through painful experience, (b) …

Miracle Of Microrna-Driven Cancer Nanotherapeutics, Goknur Kara, Banu Arun, George A Calin, Bulent Ozpolat

Faculty, Staff and Student Publications

MicroRNAs (miRNAs) are non-protein-coding RNA molecules 20-25 nucleotides in length that can suppress the expression of genes involved in numerous physiological processes in cells. Accumulating evidence has shown that dysregulation of miRNA expression is related to the pathogenesis of various human diseases and cancers. Thus, stragegies involving either restoring the expression of tumor suppressor miRNAs or inhibiting overexpressed oncogenic miRNAs hold potential for targeted cancer therapies. However, delivery of miRNAs to tumor tissues is a challenging task. Recent advances in nanotechnology have enabled successful tumor-targeted delivery of miRNA therapeutics through newly designed nanoparticle-based carrier systems. As a result, miRNA therapeutics …

A Delphi Study Of The Skills Necessary For A Speech-Language Pathologist Or Occupational Therapist To Be Successful In A Leadership Position, Jessica Miller

Dissertations

Purpose: The purpose of this Delphi study was to identify the skills necessary for a speech-language pathologist or occupational therapist to be successful in a leadership position using an expert panel. In addition, the purpose was to rate the identified skills based on importance and lastly to determine the activities experts recommend to acquire the top-rated skills. Methodology: This study used a three-round Delphi method to collect data from expert leaders in speech-language pathology and occupational therapy. In Round 1, the expert panel was asked to identify the skills necessary to transition from a speech-language pathologist or occupational therapist to …

Malignant Hyperthermia, Jessica Joos

Nursing Student Class Projects (Formerly MSN)

Being a proficient anesthesia provider requires vigilantly monitoring for any complications that may arise during the anesthetic period. Malignant Hyperthermia (MH) is one such complication. Succinylcholine, a neuromuscular blocking agent, and volatile anesthetic gases can initiate an MH reaction. In MH, ryanodine receptors are stimulated to release excess calcium, which causes muscle hypermetabolism. This process causes the patient to develop highly elevated temperatures, hypoxia, hypercarbia, and muscle rigidity. Left untreated, MH can be fatal. Treatment requires discontinuation of the triggering agent, administering dantrolene, providing 100% oxygen, and managing complications such as acidosis, hyperkalemia, and arrhythmias. MH is a manageable complication …

Hellp Syndrome: Hemolysis, Elevated Liver Enzymes, Low Platelets, Kimberly Roman

Nursing Student Class Projects (Formerly MSN)

The research provided was to understand a rare, life-threatening condition that occurs in pregnant women or recently postpartum women. The topic searched was HELLP Syndrome, an acronym for Hemolysis, Elevated Liver Enzymes, and Low Platelets. This syndrome is named this due to the underlying conditions in women who experience this disorder. Women can recover from HELLP Syndrome if detected early and treated appropriately, but symptoms are vague and difficult to diagnose. The best way to understand and detect this disorder is by promoting awareness and understanding the mechanisms and treatment involved. A search was conducted about the topic through research …

Diabetes Mellitus Type 2, Jyoti Adhikari

Nursing Student Class Projects (Formerly MSN)

Diabetes Mellitus is a metabolic disorder that affects millions of people. The trend continues to be upward. Youth and children are not exempt from this. It is a chronic metabolic disorder characterized by persistent hyperglycemia. Causes are impaired insulin secretion, resistance to the peripheral action of insulin, or both. There are three types of diabetes: type 1, type 2, and gestational. Type 2 DM accounts for around 90% of all cases of DM. In type 2 DM, the body's response to insulin diminishes causing insulin resistance. It is commonly seen in people older than 45 years old but increasingly seen …

Hashimoto Thyroiditis, Ojaswi Bhattarai

Nursing Student Class Projects (Formerly MSN)

Hashimoto's thyroiditis (HT) is a type of autoimmune disease marked by thyroid-specific autoantibodies, which cause immune cells and antibodies to attack and kill thyroid cells. As a result, the body's mechanisms slow down, resulting in fatigue, coldness, weight gain, dry skin, and hair loss, among other symptoms. Although the exact cause of HT is unknown, it is thought to be caused by a combination of genetics, environment, physical activity, immunology, dietary intake, and epigenesis. High serum antibody concentrations against one or more thyroid antigens, as well as widespread lymphocytic infiltration of the thyroid, are clinical manifestations. Typically, HT is treated …

Lgbtq+ Microaggressions In Clinical Skills Training., Andrew Givens, Gita Jaikumar, Hayden Norris, Jacqueline Tran, Elisha Vanzant, Bhawana Yadav, Emily Noonan, Linda Fuselier, Laura Weingartner

Undergraduate Research Events

BACKGROUND

Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people experience health disparities. Implicit bias and mistreatment by healthcare providers can also lead LGTBQ+ people to delay care or avoid it entirely. Clinical skills training in the care of LGBTQ+ patients is therefore critical to health equity. Standardized patient (SP) encounters allow medical students to be assessed as providers in a mock clinical setting.

METHODS

The study population was rising third-year medical students at the University of Louisville School of Medicine in 2022. Out of 149 total encounters, coders reviewed all encounters with gender diverse SPs (n=86) and coded microaggressions, which …

Coronavirus Update 8-4-2022, The Coronavirus Planning Team

University Briefings & Virtual Events

With most students coming to campus in just a few weeks, we want to fill you in on our COVID protocols as we start the year.

Iadls In Acute Care, Taylor Brownlie

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

Reducing The Fear Of Falling Through A Novel Fall Prevention Education Group, Eloise K. Palm

Department of Occupational Therapy Entry-Level Capstone Projects

For older adults with fall risk or a history of falling, would novel fall prevention education reduce the fear of falling and enhance confidence in self to improve engagement in desired occupations? This capstone project was centered around answering that question. The setting this took place in is an inpatient rehabilitation hospital with the older adult patient population. Specifically, this includes stroke, traumatic brain injury, spinal cord injury, cardiac, orthopedic, and generally deconditioned patients. The proposed focus area being program development.

A focus on program development was demonstrated through assessing a patient’s fear of falling (FOF) at evaluation via the …

Needs-Assessment Questionnaire Development Through The Interviews Of Mothers Post Neonatal Intensive Care Unit (Nicu) Discharge: A Qualitative Study, Cierra Robinson

Department of Occupational Therapy Entry-Level Capstone Projects

Current literature shows a gap in documenting the experiences and needs of mothers after being discharged home from the neonatal intensive care unit (NICU) (Lakshmanan et al., 2019). However, the literature that does exist suggests, following discharge from the NICU, parents and caregivers of infants' report feelings of stress and anxiety and lower levels of competence in caring for their infants (Lakshmana et al., 2019; Lee et al., 2019). There are discharge programs in existence that focus on providing services and resources for mothers, however, there is a lack of exposure, resources, introduction of programs to healthcare practitioners, and a …

Implementation Of Basic Life Skills And The Effectiveness Of A Cooking Group, Meghan Cote

Department of Occupational Therapy Entry-Level Capstone Projects

The culminating project for this doctoral capstone experience (DCE) assessed the need to implement a cooking group within the inpatient rehab setting at Lakeland Regional Hospital for adults reintegrating into the community. The focus area identified for this DCE is program development. The component of program development consists of a cooking group with a pre and post-survey for active participants to complete. The purpose of the survey will determine each participant's viewpoints on their current capabilities before and after participating in one cooking group, along with their views of the outcome of the cooking group as a means of beneficial …

Resources For Parents Of Children With Feeding Issues, Miranda Gutierrez

Department of Occupational Therapy Entry-Level Capstone Projects

Occupational therapy provides a client-centered approach to enhance engagement in valued life occupations. Activities of daily living, specifically eating and swallowing, fulfills basic physiological needs and creates a social relationship between a parent and/or caregiver and their child. Stress associated with caring for children with feeding difficulties can physically and emotionally strain the family. There is a greater need for opportunities to learn more about managing feeding and eating issues in children, especially with varying presentations across multiple conditions seen in the pediatric setting. The outcome of this capstone final culminating project included online evidence-based resources and general advice from …

Neither Tumor-Infiltrating Lymphocytes Nor Cytotoxic T Cells Predict Enhanced Benefit From Chemotherapy In The Dbcg77b Phase Iii Clinical Trial, Elahe Shenasa, Elisabeth Specht Stovgaard, Maj-Britt Jensen, Karama Asleh, Nazia Riaz, Dongxia Gao, Samuel Leung, Bent Ejlertsen, Anne-Vibeke Laenkholm, Torsten O. Nielsen

Section of General Surgery

Recent studies have shown that immune infiltrates in the tumor microenvironment play a role in response to therapy, with some suggesting that patients with immunogenic tumors may receive increased benefit from chemotherapies. We evaluated this hypothesis in early breast cancer by testing the interaction between immune biomarkers and chemotherapy using materials from DBCG77B, a phase III clinical trial where high-risk premenopausal women were randomized to receive chemotherapy or no chemotherapy. Tissue microarrays were evaluated for tumor-infiltrating lymphocytes (TILs) assessed morphologically on hematoxylin and eosin-stained slides, and by immunohistochemistry for CD8, FOXP3, LAG-3, PD-1 and PD-L1. Following REMARK reporting guidelines, data …

Status Epilepticus, David Green

Conference Presentation Abstracts

No abstract provided.

2022-08-05_Michiganoverview_Covidbedppe, Michigan Department Of Health & Human Services

Michigan COVID-19 Hospital Data

Contains the tables Statewide Hospital Capacity Report for COVID-19, COVID-19 Metrics, Statewide Hospital Available PPE Tracking for COVID-19, as well as the tables PPE Days On Hand and Patient Census.

An Occupational Therapy Guidebook For Individuals With Substance Use Disorder, Cassidy B. Ardoin-Barnett, Steven M. Gerardi

Summer 2022 Virtual OTD Capstone Symposium

Individuals with substance use disorder (SUD) experience barriers and challenges that impact their daily occupational performance, engagement, well-being, and quality of life. In addition to disrupting and distorting an individual’s unique occupational outcomes, SUDs can limit, replace, and dictate an individual’s daily meaningful activities, habits, routines, and skills that support healthy occupational engagement. Occupational therapy (OT) practitioners have a unique and valuable role in SUDs treatment as they are equipped to identify these barriers and implement strategies for supportive skill development or restoration. Based on the literature review conducted, OT practitioners do not have an OT practice guideline, protocol, or …

Pineal Cyst Apoplexy And Memory Loss: A Novel Complication, Areez Shafqat, Hanin Jaber Algethami, Shameel Shafqat, Syed Shafqat Ul Islam

Medical College Documents

An 8-year-old boy presented to our hospital complaining of a bilateral headache associated with episodes of anterograde amnesia. He had a road traffic accident 3 years ago when a computed tomography (CT) scan revealed traumatic brain injury. In addition, a small pineal cyst (PC) was noted with minor intramural calcifications. A follow-up CT a day later demonstrated increased density in the pineal gland of 60 Hounsfield Units, suggestive of apoplectic changes in the PC. However, the patient was lost to follow-up and presented with memory loss a year and a half later, upon which CT and magnetic resonance imaging revealed …