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The Write Stuff - Summer 2022 (Vol. 19, No. 3), Research Medical Library

Write Stuff 2022

• Next steps after grant rejection
• Resources on new NIH policy for data management and sharing
• What should you include as supplemental material?
• Tips for collaborating with manuscript authors online
• Unusual terms used in scientific writing and publishing: Overlay journal

Inspire : Vol 5, Issue 7, Department Of Medicine

INSPIRE – Department of Medicine Archives

Content

• Message from the Chair
• Medicine at National and International Forums
• Neurology Connect week
• In-depth- featuring Prof. Dr Ali Zubair
• Featured Faculty – Salma Tajuddin – Senior Instructor – Research section “…love what you do and equally important is denoising in life so you can do what you love!”
• Poem Section
• Publications
• What are Academics Around the World Reading This Month?

Cranial Thickness In Relation To Age, Gender And Head Circumference In Thai Population, Sumas Ruenhuns, Vijarn Vachirawongsakorn

Chulalongkorn Medical Journal

Background: The skull is one of the most studied materials of the human bone. To date, several studies have investigated the range of cranial vault thickness variation in modern human. Objective: To investigate the average thickness of cranial vaults in different positions and their relation to individual variables in the Thai population. Methods: Cranial vaults of 118 male and 59 female cadavers aged over 20 years were eligible for the study. The measurement of the cranial vault was conducted as described: frontal cranial thickness (FCT), occipital cranial thickness (OCT), left and right lateral cranial thickness (LCT). The relationship between the …

Diagnostic Dilemma: Progressive Supranuclear Palsy With Parkinson’S Disease, Siddharth Tewari, Niharika Prasad

Manipal Journal of Medical Sciences

Swallow tail sign is normally present in Substantia Nigra pars compacta due to the hyperintensity of nigrosome 1 containing cells on T2*/SWI sequences. Its absence is highly indicative of Parkinson’s disease.However, nigrostriatal dopaminergic degeneration is seen in progressive supranuclear palsy as well.It is important for neurologists and radiologists to assess the patient’s symptoms and signs to be able to provide the correct diagnosis,in view of further clinical management

Cathodal Transcranial Direct Current Stimulation (C-Tdcs) Primed Intermittent Theta Burst Stimulation (Itbs) Over Left Dorsolateral Prefrontal Cortex For Depression: A Case Report, Ashok Jammigumpula, Pn Abhiram, Vidyashree Ms, Abhishikta S. Naik, Sonia Shenoy, Samir Kumar Praharaj Dr

Manipal Journal of Medical Sciences

Newer treatment modalities such as non-invasive brain stimulation techniques including transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) are being studied for the treatment of depression. In this paper a patient is reported with treatment-resistant depression who responded to treatment with a novel cathodal tDCS primed intermittent theta burst stimulation (iTBS) protocol targeted at the left dorsolateral prefrontal cortex administered over five consecutive days. Possibly, the inhibitory effect of cathodal-tDCS facilitates the excitatory effects of iTBS by homeostatic metaplasticity and improves efficacy by reducing the inter-hemispheric imbalance in prefrontal cortex activity.

Culturally Tailored Diabetes Self-Management Educational (Dsme) Program And Its Impact On Motivation And Self-Efficacy Among Hispanic Adults With T2dm: A Pilot Study, Andrellie P. Van Wageningen

Doctoral Projects

Type 2 diabetes mellitus in the United States is an epidemic that disproportionately affects Hispanics in the state of California. Many factors have been attributed to this phenomenon because of their unique characteristics. As recent studies have pointed out, their social determinants of health, cultural influences, and genetic predisposition often lead to poor health outcomes and impaired quality of life. A targeted approach is critical in promoting increased diabetes knowledge, enabling skills to master self-care activities, and positive self-care behaviors to avert poor outcomes. The purpose of this doctoral project is to examine whether culturally tailored DSME influences an individual’s …

Evaluating The Extent Of Fall Prevention Knowledge Of Direct Care Clinicians In A Post-Acute Hospital Setting: A Quality Improvement Initiative, Joseph Henry Mitchell Jr

Doctor of Nursing Practice Projects

Background: Events, such as falls, continue to maintain permanence in countless public health settings and organizations, attributing to unnecessary resource utilization. Proven methods for mitigating fall occurrences transpire through reliable fall education and by creating programs that directly impact these incidents. These agendas are essential and can lessen undue stress, obligations, and associated fiscal liability.

Purpose: This DNP project aimed to ascertain and expand unit nurses' fall prevention strategy knowledge in a long-term acute care hospital, bringing awareness of evidence-based practices through a learning addendum.

Methods: This program, based on a descriptive, quasi-experimental, pre-, and post-analysis, strategically …

Improving Workflow Efficiency In A Medical Clinic Utilizing A Competency Evaluation Tool With Skills Checklist, Jillian England Johnson

Doctor of Nursing Practice Projects

Background: Checklists are commonly used in many healthcare settings to validate one’s competency in a skill or task. Competency is essential to help reduce human errors and prevent patient harm, improving patient outcomes while carrying out evidence-based care.

Purpose: The purpose of this DNP project was to improve patient care, patient care outcomes, and workflow efficiency in a charitable clinic by identifying strengths and opportunities for growth among the staff and volunteers through a competency evaluation tool utilizing a skills checklist.

Methods: This quality improvement project included implementing a competency evaluation tool with a skills checklist for staff and volunteers …

Training Sexual Assault Nurse Examiners (Sane) And Patient Advocates To Improve Utilization Of The Alabama Crime Victims Compensation Commission (Acvcc) Program For Sexual Assault Victims, Erica Starling

Doctor of Nursing Practice Projects

Background: Sexual assault is a nationwide problem that often goes unreported. According to the Rape, Abuse and Incest National Network (RAINN), every 68 seconds an American is sexually assaulted. One out of every six women has been a victim of sexual assault in their lifetime. Sexual violence has long-term effects on victims including post-traumatic stress disorder, suicidal ideations and/or attempted suicide, substance use disorder, work and/or family life struggles, unplanned pregnancy, and/or sexually transmitted infections (STI).

Purpose: The purpose of this project is to improve the utilization of the Alabama Crime Victims Compensation Commission Program (ACVCC) for victims …

A Clinical And Community Linkage Benefitting Patients With Chronic Conditions, David B. Clapp

Doctor of Nursing Practice Projects

Background: Connecting healthcare clinics and community resources can improve the health of patients. It is shown that this type of linkage is an effective approach to addressing health concerns and to potentially prevent long-term health issues.

Purpose: The purpose of the DNP project is to promote and provide a clinical-community linkage at a local specialty clinic to determine if the providers find that offering community resources to patients increases their perception of quality of care provided.

Methods: Utilizing a guideline set forth by the CDC, providers within a specialty clinic were provided with a pre-test to determine if their current …

Implementing A Pressure Injury Prevention Bundle To Decrease Hospital-Acquired Pressure Injuries In An Adult Medical-Surgical Unit, Laura Brock

Doctor of Nursing Practice Projects

Background: Pressure injuries affect approximately 2.5 million people in the United States and cost the American healthcare system more than $11.6 billion annually. Healthcare organizations have sanctions placed on them by government agencies to minimize the occurrence of pressure injuries to reduce financial burdens and poor patient outcomes.

Purpose: The project aimed to evaluate the effectiveness of reducing the incidence of hospital-acquired pressure injuries after implementing a pressure injury prevention bundle over eight weeks in a medical-surgical unit in a rural hospital in Alabama.

Methods: This quality improvement project consisted of three key components: educating nurses to …

Addressing Polypharmacy: Implementing The Medication Appropriateness Index Clinical Tool To Increase Deprescribing By Healthcare Providers, Lori Floyd

Doctor of Nursing Practice Projects

Background: Polypharmacy is a national and local issue of concern within healthcare. Deprescribing medications has been identified as a plausible solution for patients experiencing polypharmacy. However, many healthcare providers are unaware of the practice of deprescribing and, if aware, may not be implementing clinical tools for deprescribing effectively. The family medicine clinical site supplies an opportunity for healthcare providers to utilize an evidence-based clinical tool to review medications, identify if inappropriate, and deprescribe if indicated.

Purpose: The purposes of the Doctor of Nursing Practice (DNP) project were to increase deprescribing activity among prescribing healthcare providers and to increase prescribing healthcare …

Implementation And Evaluation Of A Syphilis Screening Tool To Increase Patient Testing For Syphilis Among Adults 18 Years And Older In A Rural Primary Care Clinic, Valeria S. Wiggins

Doctor of Nursing Practice Projects

Background: Sexually transmitted infections (STIs) are an increasing epidemic in the United States (U.S.) that need immediate interventions to reverse the effects of syphilis on the sexual health of adults in rural populations. Many are unaware of the growing rate of syphilis and the overall impact it causes nationally. When syphilis is detected early, it can be easily treated and cured. Rural primary care providers are ideal candidates for implementing education, screening, testing, and treatment.

Purpose: The Doctor of Nursing Practice (DNP) project aims to increase the frequency of screening patients in rural primary care clinics for high-risk sexual behaviors. …

Implementing A Troponin Trending Toolkit In A Rural Emergency Department To Increase Provider Adherence To Troponin Trending Guidelines, Ace Beam

Doctor of Nursing Practice Projects

Background: Cardiac biomarkers are used for the diagnosis and risk stratification of patients with chest pain and suspected acute coronary syndrome (ACS) (Kamal, 2021). Cardiac troponin is the only biomarker recommended to be used for the diagnosis of acute myocardial infarction (AMI) at this time due to its superior sensitivity and accuracy (Kamal, 2021). Emergency departments routinely provide care for patients presenting with chest pain symptoms and should be prepared to utilize evidence-based guidelines for troponin trending to effectively evaluate these patients.

Purpose: The purpose of the DNP project was to improve emergency department healthcare provider compliance to evidence-based high-sensitivity …

Implementing The 4ds (Diet, Drinks, Drugs, And Dialysis) To Lower Hyperphosphatemia Among Outpatient Hemodialysis Patients, Morgan Atchison

Doctor of Nursing Practice Projects

Background: Hyperphosphatemia, also known as excess phosphate in the blood, is a problem that continually causes health issues for the outpatient hemodialysis population. Hyperphosphatemia yields multiple health comorbidities and can increase mortality (Rastogi et al., 2021).

Purpose: Hyperphosphatemia is directly correlated with end-stage renal disease (ESRD) (Goyal & Jialal, 2020). This project aimed to decrease the incidence of hyperphosphatemia in the chronic outpatient hemodialysis setting. The primary objective of this project was to increase adherence levels to diet, drinks, drugs, and dialysis (4Ds) in those receiving chronic outpatient hemodialysis in the pursuance of achieving and maintaining blood serum phosphorus levels …

Providing Education To Staff Members On Implementing Follow-Up Education At Discharge To Patients With Low Heart Scores, Daniel Burton

Doctor of Nursing Practice Projects

Background: The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) provides accreditation to hospitals, including “heart certification.” The facility was successful at meeting the four measures previously assigned to them. As a result, they were given four new measures. One of these standards is providing discharge education based on “heart scores.”. Only 35% of patients are receiving discharge/follow-up education at discharge from the emergency department (ED).

Purpose: The purpose of this study is to increase the number of patients receiving chest pain education and follow-up instructions in the ED as evidenced by the improvement in documentation of the interventions.

Methods: …

Clabsi’S: Reducing The Rates In An Urban Intensive Care Unit By Consistent Use Of The Central Line Maintenance Evaluation Tool (Clmet), Bridget Smith

Doctor of Nursing Practice Projects

Background: Quality improvement efforts from an urban facility have observed a need for staff education on the central line maintenance bundle and consistent surveillance with the Central Line Maintenance Evaluation Tool (CLMET).

Purpose: To address the practice gap of central line maintenance bundle usage at the bedside by utilizing the CLMET consistently.

Methods: A voluntary didactic program offered to staff and encouraging daily utilization of the CLMET that included real-time feedback by the supervisors.

Results: Pretest grade for the unit (n=13, 82.06) and the post-test grade (n=13, 86.33), which is + 4.27 points after education. Pre-implementation, January 1st through 31st, …

Project Ankle-Brachial Index: Implementation Of An Evidence-Based Peripheral Artery Disease Protocol, Melaney Banks

Doctor of Nursing Practice Projects

Background: Peripheral artery disease (PAD) is a narrowing or blocking of the arteries due to plaque buildup, which prevents oxygen, blood, and other nutrients from getting to the legs. When this buildup reaches a certain point, it becomes atherosclerosis, which is more prevalent in a smoker. Smoking intensifies the problem of plaque buildup if an individual already suffers from PAD. When an individual smokes, the nicotine causes the arteries to constrict and narrow, reducing blood flow further. The ankle-brachial index (ABI) is a simple, cost-effective diagnostic test to identify the presence of PAD which will improve patient outcomes.

Purpose: This …

Implementing Hand Hygiene Protocol For Direct Care Staff In An Inpatient Psychiatric Facility To Improve Hand Hygiene Compliance, Juliet Mkpuechina

Doctor of Nursing Practice Projects

Background: Handwashing with soap and running water is one of the most effective ways to prevent diseases and infections spread through touch. Hand hygiene refers to handwashing with soap, water, and other disinfecting agents to prevent infection. According to Chassin et al. (2017), hand hygiene compliance reduces healthcare-associated infections (HAI). Studies show that an increase in handwashing compliance can be correlated to a decrease in healthcare-associated infections. Studies have proven that though it is challenging to link hand hygiene to a reduction in healthcare-associated infections directly to improved hand hygiene compliance, many hospitals have seen a decline in HAIs as …

Utilization Of Remap Conversation Tool To Improve Advance Care Completion In The Home-Based Palliative Care Community Setting, Gwendolyn Starkey

Doctor of Nursing Practice Projects

Background: The World Health Organization and the American Society of Clinical Oncology guidelines endorses mandatory communication skills training in care goals for seriously ill patients (Back et al., 2019). In one survey of primary care providers (PCP), 68% reported no formal training to discuss advance care planning (Comer et al., 2020). Advance care planning is essential to manage chronic conditions in our growing aging population to provide the best patient care. This manuscript aimed to discuss best practices and techniques in advance care planning and optimize skills to provide patient-centered care conversations that honor patient wishes, reduce unwanted hospitalizations, and …

Implementing Antimicrobial Stewardship For Healthcare Providers In An Urgent Care Setting To Reduce Antibiotic Misuse For Respiratory Infections, Ashley Pauldin

Doctor of Nursing Practice Projects

Background: Antimicrobial resistance has been identified as a major threat by the World Health Organization (WHO), and antimicrobial stewardship is a key strategy to overcome resistance. A major contributing factor to this crisis is the inappropriate use of antibiotic prescriptions in outpatient settings. Although evidence-based guidelines on appropriate treatment for acute upper respiratory infections (URIs) have been developed, the need for improving provider and patient awareness and knowledge in the urgent care setting is critical.

Purpose: The purpose of the DNP project was to implement antimicrobial stewardship guidelines in the urgent care facility to decrease the misuse of antibiotic prescribing …

Utilizing Multimodal Communication Strategies To Improve Average Risk Women Veteran Patient Participation In Returning Colorectal Fecal Immunochemical Test Kits, Shuntae Hooten

Doctor of Nursing Practice Projects

Background: Cancer is one of the most dreadful diseases present in today’s world. It is responsible for millions of deaths worldwide. The disease is debilitating to one’s physical and emotional well-being. Cancer impacts not only the affected individual but also those close to them. When colorectal cancer is identified early via preventive screenings, it has a greater chance of responding to treatment, therefore, increasing the chances of survival. The fecal immunochemical test (FIT) kit plays a pivotal role in the early detection of colon cancer. Schreuders et al. (2016) revealed that FIT kits have better adherence, usability, and accuracy, citing …

Evaluation Of The Implementation Of The Munro Pressure Ulcer Risk Assessment Scale To Mitigate Pressure Ulcers In The Perioperative Setting, Sherry Lynn Grandison

Doctor of Nursing Practice Projects

Background: The process of implementing appropriate skin assessment and documentation throughout the patient’s operative experience assists in the early detection of pressure ulcers.

Purpose: This Doctor of Nursing Practice (DNP) project had two goals. The first was to determine a practical tool that would ensure that surgical nurses demonstrate competence and comply with the process of identifying compromised skin integrity, and the second goal was to effectively communicate the findings with other clinical team members.

Methods: The DNP project focused on the use of the Munro Pressure Ulcer Risk Scale Assessment Tool to identify pressure ulcers and to promote collaboration …

Increasing Medical-Surgical Nurses' Skills And Knowledge On Wound Assessment And Documentation Through An Educational Approach, Jewels Knight

Doctor of Nursing Practice Projects

Background: Hospital acquired pressure injury rates are increasing while other hospital acquired condition rates are decreasing. Pressure injuries are expensive and place patients at a higher risk of death. Accurate wound assessment and documentation to satisfy the present on admission indicator could positively affect hospital acquired pressure injury rates.

Purpose: The purpose of this process improvement project was to increase nurses’ skills and knowledge towards proper wound assessment and documentation and to increase nurses’ knowledge on why comprehensive skin assessments and documentation of the observations are important for positive patient outcomes.

Method: This project consisted of offering an educational …

Using The Cdc’S Healthcare Personnel And First Responders: How To Cope With Stress And Build Resilience During The Covid-19 Pandemic Education Resources To Reduce Burnout Of Intensive Care Nurses At An Urban Acute Care Hospital, Elizabeth Gilbert

Doctor of Nursing Practice Projects

Background: Nurse burnout is a serious problem, as documented by many studies. Burnout has been shown to lower quality of life, performance level, and organizational commitment while also increasing a nurses' desire to leave the job. Despite this knowledge, nurse burnout continues to be present, especially among nurses who work in intensive care units (ICUs). Hospitals need ICU nurses to care for critically ill patients; therefore, it is essential to educate ICU nurses on burnout and initiate measures to decrease burnout in this vulnerable population.

Purpose: The goals of this study are to explore nurse burnout in the medical intensive …

The Effectiveness Of A Virtual Shared Medical Appointment On Opioid Safety Education Participation In The Veteran Population Within A Va Health Care System, Jana Falkner

Doctor of Nursing Practice Projects

Background: From 2019 to 2021, there has been an increase in opioid prescribing, leading to the current death rate of 136 Americans per day from an opioid overdose (Centers for Disease Control and Prevention [CDC], 2021). In response to these shocking statistics, a Veterans Administration (VA) health care system initiated a face-to-face interdisciplinary opioid safety shared medical appointment (SMA). Although the face-to-face Opioid Safety SMA was successful in increasing opioid safety awareness, participation, and attendance for the SMA have declined over the last year.

Purpose: The purpose of the DNP project was to improve attendance for veterans participating in the …

Reducing Hospital Readmissions Through A Standardized Heart Failure Educational Program For Community Based Nurse Case Managers, Greta Abernathy

Doctor of Nursing Practice Projects

Background: Heart failure is a high-risk health condition that impacts a patient's heart, causing it to pump at a weaker pace than a healthier person's heart (Mayo Clinic, 2020). Associated with frequent hospital admissions, heart failure affects millions of Americans in the United States (Fleg, 2018) and results in repeated readmissions, costing thousands of dollars per admission and decreased quality of life.

Purpose: This DNP project aims to implement an evidence-based educational model of care for nurse case managers within a community setting focused on Heart Failure (HF) that will improve the heart failure patient's ability to self-manage their disease …

The Use Of The Centers For Disease Control (Cdc) Outpatient Antibiotic Stewardship Program To Reduce Unnecessary Antibiotic Prescriptions Written For Sinusitis In A Rural Urgent Care Clinic Setting, Melanie Maddox

Doctor of Nursing Practice Projects

Background: The discovery of antibiotics has been a significant success in fighting bacterial infections. According to the Centers for Disease Control (CDC), in 2018, inappropriate prescribing of antibiotics contributed to antibiotic-resistant conditions, which led to 2 million infections, and has killed about 23,000 Americans annually (Chaney, 2018: CDC, 2019). By 2050, 10 million people are expected to die globally due to bacterial resistance, with the cost potentially reaching $100 trillion (WHO, 2019).

Purpose: The purpose of the DNP Project is to decrease unnecessary antibiotic prescriptions for the diagnosis of sinusitis in a rural urgent care clinic and increase provider awareness …

A Multi-Modal Strategy To Activate Pronation For Acute Respiratory Distress Syndrome Patients, Meredith Mccrorie

Doctor of Nursing Practice Projects

Background: Acute Respiratory Distress Syndrome (ARDS) is an acute pulmonary process that compromises the health of patients in the Intensive Care Unit (ICU). ARDS can progress to irreversible fibrosis causing the lungs to become noncompliant, adversely affecting ventilation or gas exchange (Buckley et al., 2019). An ARDS diagnosis accounts for 30-40% mortality rate which is an improvement from 60% in the last two decades. The clinical course of this disease is highlighted by Acute Hypoxic Respiratory Failure (AHRF) evidenced by chest radiographs revealing bilateral dense consolidations. Manual pronation of ARDS patients has shown an increase in alveolar function with end …

Utilizing Multimodal Education To Impact Provider Documentation Of Post-Anesthesia Evaluation In A Rural Hospital, Jennifer Coffman

Doctor of Nursing Practice Projects

Background: Hospital policy, Centers for Medicare and Medicaid Services (CMS), and The Joint Commission (TJC) require a post-anesthesia evaluation to be completed and documented no later than forty-eight hours following surgery or any other procedure requiring anesthesia. This evaluation is required any time general, regional, or monitored anesthesia has been administered to the patient and must be completed by a certified anesthesia provider. One rural hospital facility’s post-anesthesia documentation compliance has declined to 79%, compared to the previous quarter’s report of 95%.

Purpose: The Doctor of Nursing Practice (DNP) project aimed to improve post-anesthesia documentation through a multimodal educational intervention. …