Outcomes Of Participation In Leisure On Mental Well-Being Of Pediatric Individuals With Trauma Or Prader-Willi Syndrome, Maryclaire Attisano Bs, Ots, Shannon Strate Otd, Otr/L, Monique Williams M.Ed.

Occupational Therapy Doctorate Capstones

This research explored associations of leisure activity engagement for youth who have experienced trauma and individuals with Prader-Willi (PWS). The research suggests a positive correlation between leisure activity engagement and increased mental well-being in both populations.

Objective & Aim:

The research into leisure-activity engagement for individuals with PWS and trauma aimed to facilitate learning, enhance coping mechanisms and increase mental well-being in both populations.

Research Question: Does engagement in therapeutic leisure activities increase the mental well-being of children and adolescents with trauma or Prader-Willi Syndrome?

Developing & Implementing Robotic Pet Interventions For Adults With Dementia, Lisa Benson Ots, Shannon Strate Otr/L, Otd

Occupational Therapy Doctorate Capstones

Dementia is a neurodegenerative condition characterized by physical and cognitive decline, and a major cause of disability and dependency worldwide9. Behavioral & Psychological Symptoms of Dementia (BPSD) include agitation, depression, apathy, wandering and terminal restlessness. Robotic Pet Intervention (RPI) is a relatively new treatment which incorporates interactive robotic animals into therapeutic activities. Features include sound, light and touch sensors, on/off/mute settings, and realistic fur. Documented benefits for dementia care include improvements in BPSD, reduced loneliness7, improved social interaction2,7,8, and reduced need for pain medication3. Although promising, the potential impacts of RPI on adults with dementia are not fully understood.

Research …

A Comparison Of Outcomes For Lipid Emulsions In Total Parenteral Nutrition Among Home Infusion Patients, Gregory W. Wesley-Lynch

DNP Scholarly Projects

This quality improvement project aimed to compare the outcomes of lipid emulsions used in total parenteral nutrition among home infusion patients. The quality improvement project included 45 patients who received four weeks or more of either Intralipid or SMOFlipid. Paired t-tests were used to compare SMOFlipid and Intralipid regarding three liver function test (LFTs) values; (Alkaline Phosphate (ALP), Aspartate transaminase (AST,) and Alanine transaminase (ALT). Results demonstrated that SMOFlipid was superior to Intralipid, resulting in lower LFTs for ALP, AST, and ALT. This study provides evidence to support the use of SMOFlipid over Intralipid in total parenteral nutrition for home …

Implementation Of A Standardized Process To Increase Promotion Of Family Presence During Resuscitation, Eileen Hollis

DNP Scholarly Projects

BACKGROUND: Family Presence During Resuscitation (FPDR), has been studied and recommended as an important and relevant practice for decades, yet it remains controversial with frequent barriers to implementation. The benefits of this practice are numerous; and to truly embrace shared decision making, nurses and providers must encourage patients and families to participate in all aspects of care, even during resuscitation events. As evidence supporting the emotional and psychological benefits of FPDR began to grow, however, a global pandemic brought family presence to an abrupt halt.

METHODS: This quality improvement project’s focus was to standardize a process for offering and allowing …

Utilizing Outpatient Telehealth As A Treatment Approach For Patients With Substance Use Disorder: A Quality Improvement Project, Veronica Kwegyir-Afful

DNP Scholarly Projects

Background: The issue of substance use disorder (SUD) has demonstrated a growing prevalence both in the United States (U.S.) and globally. Effective treatment modalities have been devised for individuals afflicted by SUD, thereby enabling their post-treatment prognosis to be parallel to that of patients with other chronic diseases, such as diabetes. However, several factors or barriers impede individuals with SUD from assessing treatment. These barriers encompass financial constraints stemming from inadequate insurance coverage and high cost, the stigma surrounding SUD, which results in patient's hesitancy to seek treatment treat, adverse societal attitudes, collateral social percussions like work hour losses and …

Implementation Of Virtual Reality For The Laboring Patient: A Quality Improvement Project, Chantal Cole

DNP Scholarly Projects

BACKGROUND: Having a baby can be one of the most challenging and painful experiences a woman has in their lifetime. Being able to choose between a variety of pharmacological and non-pharmacological pain-control methods is important to improve the patient experience and outcomes. This quality improvement project aimed to introduce a virtual reality device into the labor and delivery setting as a non-pharmacological pain control method. The goal was to decrease pain and anxiety levels, decrease the rate of epidural anesthesia use, and decrease the length of time epidural anesthesia medication was running before delivery.

METHODS: The four key components of …

Strengthening New Hampshire’S Primary Care Workforce Pipeline: Utilization Of Alternative Scheduling Models, Elizabeth Harrison

DNP Scholarly Projects

Abstract

BACKGROUND: Traditional clinical scheduling coupled with the current reimbursement system have created systematic barriers leading to decreased clinical education opportunities. Alternative scheduling models such as longitudinal integrated clerkships, one preceptor to two students and wave scheduling have the potential to eliminate these barriers and provide financial gains and increased access to care.

INTERVENTION: Interventions to meet this quality improvement project's objectives included (1) pre-intervention planning (2) focus groups, (3) video presentations and (4) a pilot program of alternative scheduling models in clinical practice.

RESULTS: A pilot program utilizing the alternative scheduling models increased the relative value units (RVU) of …

A Quality Improvement Initiative: Addressing Workplace Violence Toward Nurses To Promote A Culture Of Safety In An Inpatient Psychiatric Facility, Ernestina Danso

DNP Scholarly Projects

This quality improvement initiative aimed to address workplace violence against nurses in inpatient psychiatric facilities and promote a culture of safety. The QI project involved 27 participants, including inpatient psychiatric nurses and mental health counselors from Cahill 4 and 7 West units at the Cambridge Campus. The primary objective was to identify challenges that hindered the effective utilization of the Broset Violence Checklist (BVC) tool for referring patients to sensory modulation rooms.

Pre- and post-intervention surveys were conducted to assess participants' self-reported knowledge and barriers to BVC and sensory room utilization. Educational sessions covering workplace violence, debriefing techniques, and the …

A Quality Improvement Initiative To Improve Access And Patient Flow In A Non-Emergency Walk-In Care Clinic, Renee J. Broze

DNP Scholarly Projects

Background: A community-based non-emergency walk-in clinic in Southern New Hampshire experienced high volume and inefficient workflows during the pandemic, causing delays in care, long visit times, and low net promoter scores.

Purpose: Institute an evidence-based approach to improve work efficiency through innovative models of care.

Methods: A literature review on best practices for workflow redesign guided the project. The project instituted an on-demand telemedicine service and a clinic fast-track workflow. A mixed methods approach analyzed pre /post cycle times, net promoter scores, and themes from staff interviews. Pre/post cycle times analyzed 12,767 completed appointments.

Results: There was a statistically significant …

Exploring & Mitigating Workplace Incivility At A Rural Community Hospital, Jacquelyn Ethier

DNP Scholarly Projects

Workplace Incivility (WI) is a well-known challenge in healthcare, with decades of mounting evidence showing the effects on workplace culture, healthcare worker retention and patient safety. The nursing workforce has become increasingly vulnerable to all stressful elements of the work environment. Organizational leadership must develop and deploy mitigation strategies to minimize the negative consequences of these behaviors for nurses, and the entire healthcare team. The purpose of this quality improvement project is to assess the current state of nurse perceptions of WI at a rural community hospital and deploy evidence-based education on strategies to address and mitigate WI. The method …

Facilitating Palliative Care In A Critical Access Hospital System: Implementation Of Screening And Educational Interventions, Michele Lovell

DNP Scholarly Projects

BACKGROUND: The United States health care system faces the dual challenge of an aging population with a concomitant increase in the presence of chronic and serious illness, the care of which accounts for the nation’s largest expenditure of burgeoning healthcare costs. Palliative care is specialized care for people with serious illness aimed at reducing suffering, optimizing quality of life, and enhancing medical decision making. An ample evidence base demonstrates that palliative care increases both quality of care and patient and family satisfaction while also reducing associated costs. The aim of this quality improvement project was to facilitate palliative care services …

Improving Patient Safety And Emergency Department Staff Efficiency In Barcode Medication Administration By Using The Rover™ Mobile Application, Ian Kirit

DNP Scholarly Projects

BACKGROUND: The Emergency Department (ED) is one of the busiest areas in the hospital. Patients are often acute, and it can get chaotic at times. Such a complex environment requires an effective and efficient system to increase staff efficiency and elevate patient safety. Patient and medication scanning has been a continuing issue with the current barcoding process using the in-room scanners and workstations on wheels (WOWs). In reviewing the Barcode Medication Administration (BCMA) weekly audit report, scanner broken and scanner not available are the most frequently used reasons for not scanning patients and medications. Additionally, WOWs can be hard to …

Development & Implementation Of An Adaptive Sports Program At Johnson & Wales University, Francesca Corsinetti Ot/S, Justin Laferrier Pt, Phd, Ncs, Ocs, Scs, Atp, Cscs, Aib-Vr, Monique Dawes Otd, Otr/L, Cpam

Occupational Therapy Doctorate Capstones

Research states that high frequency and duration of participation in adaptive sports for those with a physical disability has been found to benefit participants’ quality of life physically, emotionally, cognitively, socially, and psychologically (Townsend et al., 2020).

Research shows that participation of those who are physically disabled in adaptive sports can positively increase self-image, self-efficacy, confidence, and other psychological components.

Objectives:

Create and implement a sustainable, inclusive, multifaceted, multidisciplinary adaptive sports program to improve engagement, life roles, psychological and physiological factors, and quality of life in those with physical disabilities at JWU, in RI and neighboring states.

To improve the …

Enhancing Growth And Development Of Outpatient Rehabilitation Services In Underserved Communities, Sage Hollingsworth Ots, Shannon Strate Otd, Otr/L

Occupational Therapy Doctorate Capstones

CareLink’s outpatient program has been growing significantly over the last few years, with an increase in staff and contracts with customers. Due to this expansion, they could benefit from determining ways of enhancing and continuing to grow their program. The programs have expanded so quickly, and there is an opportunity to focus on surveying the current outpatient rehabilitation staff and customers in regards to satisfaction.

Question: How effective is CareLink at meeting the needs of their outpatient staff and customers?

Purpose: To enhance growth in CareLink’s outpatient rehabilitation program and develop strategic solutions based upon staff and customer survey responses

Epidemiology Of Sars-Cov-2 Breakthrough Infections In Kentucky March 1st 2021 - December 31st, 2022, Harrison Hynes

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Objective: Provide epidemiologic overview of SARS-CoV-2 breakthrough infections in Kentucky considering both demographic and geographic variables.

Background: We believe descriptive information of breakthrough cases for a defined population will provide public health practitioners with useful information relating to SARS-CoV-2 infection control and vaccination efforts.

Methods: We obtained SARS-CoV-2 case data from the Kentucky Department for Public Health COVID-19 case repository, which mirrors National Electronic Disease Surveillance System (NEDSS) data. The study sample used for analysis comprised 147,000 individuals who tested positive for SARS-CoV-2 in Kentucky between the dates of March 1^st, 2021 and December 31^st, 2022. …

Saint Louis, Missouri Maternal Mortality Prevention Program: Rose Program, Abbi Peck

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

In the United States, maternal mortality has become a growing public health concern after recent studies revealed significant disparities in maternal health outcomes when compared to other high-income countries (The Commonwealth Fund, 2020). The World Health Organization (WHO) defines maternal mortality as the death of a pregnant woman or the death of a woman within 42 days of delivery, miscarriage, termination, or ectopic pregnancy (Centers for Disease Control and Prevention, 2022a). From 2017-2019, the maternal mortality in Saint Louis, Missouri, the state’s largest and most populated metropolitan area, was determined to be 36.4 maternal deaths per 100,000 live births. This …

Physical Inactivity And Single-Female Caregivers, Johanna Hoch, Rachel Hogg-Graham Dr., John Lyons Dr., Maureen Jones Dr.

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Physical activity is vital for human health. However, many adults in the United States and beyond do not reach the pre-determined recommended levels of activity needed for health benefits. Single-female caregivers present a unique and vulnerable population that is often more inactive than their partnered peers or single-male caregivers. The primary purpose of this cross-sectional investigation was to identify the prevalence of physical inactivity in single-family, female-led households and determine differences in personal factors and social determinants of health between single-female caregivers who indicated they were physically active compared to single-female caregivers who indicated they were not physically active. A …

Implementation Of A School-Based Adolescent Pregnancy Prevention Program In Harlan County, Kentucky, Jaycea Frederick

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Kentucky has the 6^th highest rate of adolescent pregnancy in the United States and Harlan County ranks among the highest rates in the state. Adolescent pregnancy is a public health problem and costs taxpayers in the United States around $9.4 billion each year. Overall, there have been declines in adolescent pregnancy but the national average soars above those in other Western industrialized nations such as the United Kingdom. Implementing a comprehensive sexual health education program in a public school setting is an efficient strategy to reach numerous adolescents and influence sexual health knowledge and help to delay the initiation …

Strategies To Mitigate Nurse Turnover, James Edward Cooper Jr

Walden Dissertations and Doctoral Studies

Registered nurse turnover is a severe problem for all healthcare organizations because it negatively affects financial growth, patient care, and reputation, ultimately resulting in financial losses. Grounded in Herzberg’ two-factor theory, the purpose of this qualitative multiple-case study was to explore strategies hospital leaders use to mitigate RN turnover. The participants included three hospital leaders from three different hospitals in the southeastern United States who mitigated RN turnover. Data were collected from semistructured interviews and company documents and analyzed using Yin’s five-phase data analysis process. Three themes emerged: nurse engagement, job satisfaction, and trust in leadership mitigated RN turnover. A …

An Association Of The Transgenerational Implications Of Redlining And Obesity On Pediatric Type Ii Diabetes, Carlin Dexter Nelson

Walden Dissertations and Doctoral Studies

s the prevalence and incidence of childhood obesity has increased, so has the number of cases of pediatric Type 2 diabetes mellitus (T2DM). Although made unconstitutional in 1968, the transgenerational implications of redlining can be observed in disinvestments resulting in neighborhood detraction. Utilizing the 2019–2020 National Children’s Health Survey, the purpose of the study was to evaluate the relationship between obesity, T2DM, and neighborhood detraction elements as well as assessed indicators of T2DM in non-institutionalized children 6 through17 years of age (N = 34,725). The social determinants of health perspective served as the conceptual framework for the study. Results indicated …

Neighborhood Factors, Cardiovascular Illness, Mental Health, And Aging In The United States, Brenda Billings

Walden Dissertations and Doctoral Studies

The inability to age in place among people 65 years old and older is a public health problem in the United States. However, it is unknown what neighborhood factors (i.e., trust, safety, shared values) impact the communities that are struggling to support individuals looking to stay in their homes as they age. The purpose of this quantitative correlational study was to examine the relationship between neighborhood factors (i.e., trust, safety, and shared values), cardiovascular illness (i.e., heart attack and stroke), mental health (i.e., depression), and aging in place, controlling for sex, age, marital status, educational level, employment status, and race. …

Cultural Identity Of And Implications For Later Generational Hispanic And Latino Populations In The United States, Tara Bustamante

Art Therapy | Master's Theses

This study explores the Hispanic and Latino/x/e cultures within the United States, with a particular focus on the concept of identity within these communities and its implications for third and later generations. Data were collected during the pandemic via an online survey and art directive. The student researcher used the Identity Denial Scale (Albuja et al., 2019) to measure how often the participants’ identity is denied within the United States and then used an art therapy prompt to invite participants to create their own self-portrait in conjunction with their authentic self and self-image. Qualitative data were also used in response …

Evoking The Art Of Nature, Tessa R. Evans Keime

Art Therapy | Master's Theses

This international study aimed to investigate the therapeutic potential of nature-based art therapy, an innovative approach that combines artmaking with the healing power of nature. The research aimed to examine the synergistic effects of nature and artmaking, as well as the impact of the eco-art experience on adult individuals' connectedness to nature, emotional well-being, and existential understanding, while addressing gaps in literature.

Employing an arts-based research design, participants took part in a nature-art-making session, and their experiences were evaluated through pre- and post-art questionnaires, as well as an analysis of their artistic creations by trained inter-raters. The nature art-based experience …

Impact Of A Parent Education Program On Parents Of Children With Complex Congenital Heart Disease Prior To Discharge Home, Laura Elkhoury

DNP Projects

Abstract

Background and Purpose: Children with complex medical needs, such as children with complex congenital heart disease, are at risk for hospital readmission, morbidity, and mortality related to disease complications. Parents must be adequately prepared to care for their children following hospital discharge to prevent hospital readmission and complications. This study seeks to evaluate the impact of an education intervention on parental knowledge and stress related to caring for their child with complex medical needs.

Methods: The study design is a quasi-experimental, nonequivalent control pre-test/post-test design. The pre-test was administered prior to the educational intervention, with the post-test …

Disaster Relief And Humanitarian Logistics: Three Essays, Peter H. Imbriale

2023

The increased frequency and impact of natural disasters and other humanitarian crises—including events such as the COVID-19 pandemic—makes studying disaster relief and recovery particularly important. One relevant area of research in this space is humanitarian logistics. This dissertation provides insights into disaster relief logistics by exploring the government’s role in humanitarian logistics, examining the government’s efforts to address COVID-19 medical supply chain challenges, and determining how to lessen the impact of supply chain bottlenecks from unwanted post-disaster donations. Chapter one (sole-authored) is a literature review of the role of governments in humanitarian logistics. Although governments are vital stakeholders in nearly …

Using Data And Evidence To Improve Quality Of Life For Patients With Alzheimer’S Disease, Ying Wang

2023

As an irreversible, progressive brain disorder, Alzheimer’s disease (AD) imposes a severe burden upon patients and their caregivers, as well as the healthcare system. Of the ten leading causes of death in the United States, Alzheimer’s disease is the only one without a pharmacological intervention that has been proven to cure or delay the onset of the disease. Aging is the primary risk factor contributing to Alzheimer’s disease in the elderly. With an aging population that continues to grow, the challenges for the healthcare system surrounding AD become more and more serious. My dissertation aims to contribute to a better …

Improving Patient Access To Gastroenterology Through A Nurse-Practitioner-Led Clinic: A Quality Improvement Project, Kayla Northam

DNP Scholarly Projects

The United States has a critical healthcare access issue for gastroenterology patients. Delays in treatment can lead to expensive complications, including emergency room visits, hospitalization, and surgery. Creating a rapid-access clinic (RAC) for gastroenterology so that patients can obtain a quick and efficient evaluation of their symptoms in a shorter appointment time can help decrease the delay in care and generate more revenue for the hospital. Over 8 weeks in 2023, Dartmouth Hitchcock Medical Center Department of Gastroenterology used a telemedicine-only RAC to see patients for 20 minutes rather than the traditional 60-minute period. As a result, the RAC saw …

Evidence-Based Suicide Assessment And Managment Training For Mental Health Professionals, Clara Abit

DNP Scholarly Projects

Background: Suicide is a significant public health concern both nationally and globally. While the suicide rate has been decreasing in recent years, evidence shows that the rate of suicide among teenagers and adolescents has been on the rise. Teenage suicide accounts for 14% of all deaths by suicide in the United States, calling for effective interventions in various settings. However, inadequate knowledge of the potential signs and risk factors of suicide hinders mental healthcare professionals' ability to recognize at-risk patients.

Purpose: The project's objective was to evaluate the effects of the intervention on mental health workers' knowledge, skills, and screening …

The Role Of Parental Military Status And Educational Attainment On Mental Health Service Usage Among Children And Adolescents, Cierra Jones Williams

Walden Dissertations and Doctoral Studies

A lack of mental health services for children and adolescents has been linked to significant health problems in adulthood. Researchers have investigated factors that influence usage of mental health services among children and adolescence, but significant gaps persist regarding use of mental health service among military-connected youth. This quantitative study was conducted to examine if parental military status and parental education affected the usage of mental health services among children and adolescents ages 3–17 in the United States. Multivariable logistic regression was used to analyze secondary data from the combined 2019–2020 National Survey of Children’s Health. After adjusting for income, …

Challenges In Discharge Planning For Adults Transitioning From An Inpatient Psychiatric Level Of Care Experiencing Homelessness, Deanna` R. Mccaskill

Walden Dissertations and Doctoral Studies

Mental illness and the homeless population are a growing concern in the United States. Homeless individuals utilize emergency rooms and acute inpatient stays more than those with housing. Social workers play a vital role in discharge planning, starting on the first day of admission. This action research study explored the challenges of social workers developing discharge plans for adults transitioning from an inpatient psychiatric level of care experiencing homeless. The theoretical framework implemented in this study was systems theory. Data were collected from 12 purposively selected master’s level social workers in the format of individual and focus group interviews. Eight …