Steady-State Regulation Of Secretory Cargo Export And Er Homeostasis By Inositol Trisphosphate Receptors And Penta-Ef-Hand Proteins, Aaron J. Held

Graduate Student Theses, Dissertations, & Professional Papers

Constant protein degradation and turnover necessitates constitutive secretion that delivers the correct mix of nascent proteins to their appropriate subcellular destinations. Cells thus exhibit steady-state secretion and the additional ability to adjust secretory flux, though we lack a clear understanding of this critical process. During secretion, the COPII coat is responsible for providing a balance of actively and passively selected ER cargos to enter the secretory pathway. Furthermore, Ca²⁺ -binding proteins have been implicated in regulating this process in response to Ca²⁺ signals. In Chapter 1, we review the secretory pathway and vesicular trafficking, with a focus on …

Gender Diversity Cultural Responsiveness Education In Speech-Language Pathology Graduate Programs: A Pilot Survey, Tara Dickinson, Molly Normandin, Rachel W. Mulheren

Faculty Scholarship

Purpose: Gender-affirming voice therapy aims to align a person’s voice and communication with their gender identity. Historically, transgender and gender-nonconforming (TGNC) individuals have been marginalized and continue to face significant healthcare disparities. The goal of this research was to examine the self-perceived preparedness of recent speech-language pathology (SLP) graduates for working with TGNC clients. A survey was developed to include both multiple choice and open-ended questions. Topics included graduate-level training on working with TGNC individuals, perceived preparedness to work with this client population, educational resources sought by respondents, and suggested improvements for SLP graduate programs. Thirty recent (since 2016) SLP …

Prediction Of Kinase-Substrate Associations Using The Functional Landscape Of Kinases And Phosphorylation Sites, Serhan Yilmaz, Filipa Blasco Tavares Pereira Lopes, Mark R. Chance, Mehmet Koyutürk

Faculty Scholarship

Protein phosphorylation is a key post-translational modification that plays a central role in many cellular processes. With recent advances in biotechnology, thousands of phosphorylated sites can be identified and quantified in a given sample, enabling proteome-wide screening of cellular signaling. However, for most (> 90%) of the phosphorylation sites that are identified in these experiments, the kinase(s) that target these sites are unknown. To broadly utilize available structural, functional, evolutionary, and contextual information in predicting kinase-substrate associations (KSAs), we develop a network-based machine learning framework. Our framework integrates a multitude of data sources to characterize the landscape of functional relationships …

Implementing Change: The Use Of Minocycline-Rifampin Impregnated Central Venous Catheters In Central Line Associated Blood Stream Infection Prevention In Critically Ill Patients, Shawn B. Murray

Master's Theses and Capstones

Introduction: At a large academic healthcare facility in the northeast a Gap Analysis was conducted finding quality improvement opportunities for central line associated blood stream (CLABSI) prevention in critically ill patients. Review of literature reveals the use of minocycline-rifampin impregnated (MNRI) central venous catheters (CVCs) as being an effective intervention in CLABSI prevention.

Methods: Several assessments were conducted regarding the implications of updating the facilities practice to reflect this evidence including AHRQ Gap Analysis Tool, a Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis, Stakeholder Feedback, and Resource Allocation.

Results: Facilitators and barriers were identified in implementing this …

Streamlining The Postpartum Educational Process For Safe And Equitable Patient Care: A Quality Improvement Initiative, Shea N. Cook

Master's Theses and Capstones

Abstract

BACKGROUND:

Postpartum discharge education is essential in the care of mothers, newborns, and their families as they transition from the hospital setting to home. The U.S Department of Health and Human Services has identified postpartum discharge education content as a public health priority to reduce physical and mood-related postpartum complications. Over half of all serious morbidity and mortality complications occur after a postpartum patient leaves the hospital. It is essential that hospitals utilize the best evidence-based practices to maximize the impact of patient education during maternity care in the hospital.

LOCAL PROBLEM:

Within the given microsystem there is a …

Enhancing Nurses' Self-Efficacy In Smoking Cessation Counseling To Improve Patient- Centered Care At A Federally Funded Urgent Care Center: A Quality Improvement Initiative, Adam N. Waller Ii

Master's Theses and Capstones

Background: It is well documented that there is a high prevalence of Veteran tobacco use in the United States. Additionally, providing smoking cessation counseling in an emergency setting is beneficial. The broader Veteran Affairs (VA) macrosystem has a plethora of smoking cessation resources available for Veterans. Within a VA Urgent Care Center (UCC) a quality improvement initiative was conducted that focused on increasing registered nurses (RNs) self-efficacy in providing smoking cessation counseling. Prior to this quality improvement (QI) project, smoking cessation did not occur in this UCC. If RNs have higher self-efficacy more smoking cessation counseling will occur.

Methods …

Reducing Clabsi Rates Through Education On Maintaining Cvc Dressing Integrity: A Quality Improvement Initiative, Hanna I. Lentine

Master's Theses and Capstones

BACKGROUND: Central line-associated bloodstream infections (CLABSIs) are a type of hospital-acquired infection (HAI). They arise as a complication from patients having a central venous catheter (CVC) placed. CVCs can provide numerous benefits for patients who require long-term venous access or hemodynamic monitoring. Acquiring a CLABSI can place patients at higher risk for complications, increased length of stay, and mortality. Reducing the risk of infection is imperative for all patients, but especially those who are more vulnerable to opportunistic infections, such as those in critical care units.

LOCAL PROBLEM: This quality improvement project took place at a 234-bed, level II trauma …

Using Education To Improve Timeliness And Efficiency Of Medication Administration In An Inpatient Hospital Setting: A Quality Improvement Project, Kevin Christopher Lane

Master's Theses and Capstones

Background: Timeliness of medication administration is important for optimal patient care. Technology, interdepartmental communication, and nursing workflow influence on-time delivery of medications. Improving knowledge through PowerPoint™ education and visual aids such as medication alert placards improves interdepartmental communication and positively influences nursing workflow leading to improved medication delivery times.

Local Problem: Nurses spend considerable time looking for and administering medications to patients on the unit. A goal was established to reduce the amount of time nurses spent looking for medications by 5% after implementing PowerPoint™ education to improve workflow.

Methods: This project used the Plan-Do-Study-Act (PDSA) strategy for implementation. …

Assessing And Improving Pediatric Nurses' Documentation Of Childhood Immunization Status Using The Electronic Health Record, Katherine Engalichev

Master's Theses and Capstones

BACKGROUND: Adherence to the standardized childhood immunization schedule put forth by the American Academy of Pediatrics is the gold standard for decreasing vaccine-preventable disease morbidity. The first step to improving adherence with the recommended immunization schedule is identifying children who are under-immunized. The inpatient setting offers an opportunity to screen pediatric patients for immunization status. A survey was administered to nurses working on an inpatient pediatric unit to gauge nurse self-report of Cerner™ Electronic Health Record (EHR) use for immunization documentation, their perceptions regarding EHR ease of use for documenting pediatric immunization status, attitudes towards documenting immunization status, and perceived …

Using Education To Improve Nurse Perceptions On Rounding To Increase Patient Safety And Efficiency Of Care On A Behavioral Health Unit: A Quality Improvement Project, Shannon Alty

Master's Theses and Capstones

Abstract

Background: Hourly rounding completed by nursing staff are routinely completed on most inpatient hospital units. Evidence suggests that hourly rounding can improve patient outcomes, patient satisfaction rates, communication, minimize patient requests and improve the nurse patient relationship (Halm, 2009). Additional evidence suggests that inpatient psychiatric patients often feel disconnected from their nurse and hourly rounding is recommended to build the nurse-patient relationship (DaSilva, 2017). However, for successful implementation, nurse perceptions of rounding must be obtained.

Local Problem: Hourly rounding is a standard of practice, however, was not being consistently completed. Assessing the nurse perceptions regarding rounding, was imperative understand …

Employing Chronic And Rare Disease Printed Drug Information Related To Health Literacy To Improve Patients Perceived Knowledge In An Outpatient Setting: A Quality Improvement Initiative, Mikaela Dowd

Master's Theses and Capstones

Abstract

Background: An infusion center in a critical access hospital provides education to patients and their families to address health literacy which supports shared decision-making and patient centered care. This education includes medication knowledge to support self-care. The goal of this project was to create printed drug education rack cards (DERC) for patients to review prior to their first treatment to increase their perceived confidence in drug knowledge. There are many different aspects to consider for each drug treatment given within the microsystem including side effects, administration schedules, and lab and diagnostic procedures. Many of these aspects are unknown to …

Promoting Safety Of Medication Administration And Reducing Medication Errors Using Photographic Patient Identification In An Inpatient Psychiatric Setting: A Quality Improvement Initiative, Kyla Kelly

Master's Theses and Capstones

Abstract

Background: Medication errors pertaining to patient wristband workarounds in a behavioral and mental health inpatient unit can affect patient outcomes, safety and can even be fatal. The proper verification of the five rights of medication administration, patient acuity, diagnosis, and unit staffing can impact the need for patient wristband workarounds to occur. Improving staff and patient education and reducing the need for wristband workarounds through the utilization of patient photographic identification significantly reduces the number of medication errors relating to wristband workarounds during the medication administration process. Additionally, a significant reduction in the time it takes to administer medications …

Using Education To Promote Waste Segregation And Waste Reduction In The Operating Room: A Quality Improvement Initiative, Sarah E. Landgraf

Master's Theses and Capstones

Background: The operating room (OR) is known to be one of the largest producers of medical waste and of the surgical specialties, orthopedic surgery tends to the largest portion of this. Waste from the OR can be mitigated by recycling non-contaminated materials. This reduces the number of raw materials needed to create new products, decreases landfill use, and lowers hospital costs.

Local Problem: It was observed that a gap in knowledge existed related to recyclables in the OR of a large medical center in New England. Also, it was observed that there was potential for waste and recycling to be …

Implementing Education For Maternity Nurses To Improve Nurses’ Knowledge, Attitudes, And Practices Regarding Postpartum Depression: A Quality Improvement Initiative, Haley Merrill

Master's Theses and Capstones

BACKGROUND: Postpartum depression (PPD) is the most common complication of childbirth, but often goes undiagnosed. Adequate patient education on PPD increases the patient’s knowledge and supports enhanced communication between patients and provider. Maternity nurses have continued interaction with new mothers and are in a vital position to educate patients regarding PPD. However, maternity nurses may lack confidence in delivering the appropriate education and resources for PPD to postpartum women.

LOCAL PROBLEM: Within the given microsystem, there was currently a gap that existed between PPD education for nurses and the delivery of PPD patient education.

METHODS: Utilizing the Plan-Do-Study-Act model, a …

Improving Initial Pain Assessments Upon Arrival To The Post Anesthesia Care Unit By Implementing The Critical Care Pain Observation Tool, Molly Jacques Ms, Rn

Master's Theses and Capstones

Abstract

Background

Pain assessments in the post-anesthesia care unit (PACU) are crucial to recovery, the discharge process, patient outcomes, length of stay, and readmission rates. It is one of the main responsibilities of PACU nurses to adequately assess and treat pain when patients are in phase one and two of recovery after surgery. A thorough and accurate pain assessment tool is needed for these critically ill patients because not all of them are able to verbally express discomfort.

Local Problem

The problem that was identified during this quality improvement project was inconsistent initial pain assessments in the PACU. Patients arrive …

Improving Patient Safety Associated With Intramuscular Injections By Educating Nurses On Recommended Practice: A Quality Improvement Project, Alex Annutto

Master's Theses and Capstones

Background: Intramuscular (IM) injections are used to deliver medication quickly and efficiently. However, the Centers for Disease Control has changed their guidelines on how to administer medication using the IM injection route. A quality improvement was conducted at Wildcat Hospital that focused on increasing healthcare professionals’ IM injection knowledge.

Methods: A pre-intervention survey was administered to RNs, LPNs, and Paramedics to assess their knowledge and IM injection technique. After the initial survey, an educational PowerPoint was presented to staff and management. This was followed with pamphlets that reviewed the information covered in the presentation. A post-intervention survey was administered to …

Improving Communication Between The Emergency Department And Prehospital Emergency Medical Services Through The Use Of A Secure Messaging Application: A Quality Improvement Project, Jacob G. Petlon

Master's Theses and Capstones

Background: Communication between emergency medical services (EMS) and the emergency department (ED) is a key part of treating patients being transported by ambulance. This communication is moving away from traditional radio and cell phone calls to the use of secure text-based apps. These apps can generate metrics and provide real time location information that is not available using traditional methods. Increased use of these apps can improve communication between EMS and receiving EDs.

Local Problem: Wildcat hospital introduced the EMS communication app Twiage in May of 2023. There is low utilization of the app and some EMS and ED …

Reshaping Nurses’ Attitudes Toward Hourly Rounding To Increase Patient Safety And Instill Values-Based Care: A Quality Improvement Initiative, Jacqueline Juhn

Master's Theses and Capstones

Background: Hourly rounding is a form of intentional rounding (IR) to standardize care for patients to prevent adverse outcomes. Visiting patient rooms every hour and documenting any changes in client status is used as a general format for hourly rounding. Research reveals consistent hourly rounding is strongly linked with value for performance of this form of IR. Nurses’ Perceptions of Patient Rounding Scale (NPPRS) is a tool for assessing nurses’ value for their work. An educational video combined with NPPRS were utilized to create change for patients to continue to receive care that is safe, high quality, and cost-effective.

Local …

Establishing A Protocol To Address Workplace Violence And Increase The Perceptions Of Safety Among Emergency Department Nurses: A Quality Improvement Initiative, Devan M. Robidoux

Master's Theses and Capstones

Background: Violence against emergency department nurses has become a widespread phenomenon that can greatly impact a nurse's job satisfaction and performance. Research has been scarce in examining the relationship between workplace violence and its underlying consequences. There remains a disconnect between precursors of violence against nurses perpetrated by patients and the cultural expectation that violence is a part of the nurses job and, subsequently, what they signed up for when going into the field. Nurses learn that having a greater understanding of the value in the lived experience of their patients leads to better quality delivery of care. However, culturally …

Support Their Sleep: Enhancing Nurses' Knowledge And Implementation Of Non-Pharmacological Sleep Protocols To Improve Patient Rest, Recovery, And Reduce Cognitive Impairment., David C. Barry

Master's Theses and Capstones

Background: Sleep and rest play an influential role in promoting recovery and healing in humans. Hospitalized patients are at risk for altered sleep from hospitalization, illness, and stimulation from a hospital environment. Non-pharmacologic interventions preformed by nurses can help to improve sleep and sleep environment for patients.

Local problem: There was no protocol or available information regarding patient sleep promotion for nurses to references when caring for patients.

Methods: Nurses in the microsystem (n=8) were administered a pre/post questionnaire containing Likert scales and a short quiz containing knowledge-based questions. Questionnaires were distributed to nurses prior to and after …

Giving Effective And Timely Hospice Education To Lessen Participant Stress (Get Helps), Caroline Rose Carter

Master's Theses and Capstones

In 2022, 1.72 million people chose to use hospice as their end-of life care. This is a 6.8% increase from 2019, and the number of patients who choose to use hospice is increasing (Summers, 2022). The aim of this quality improvement (QI) study was to decrease levels of stress reported by the patient and informal caretakers by combining the information from the hospice program’s admission packet and other approved handouts, while standardizing the verbiage through a Flesch-Kincaid readability scale to an eighth-grade reading level. Pre-survey perceived stress scores averaged 22.97 on a modified Perceived-Stress Scale, and the mean of the …

Reducing Violence In The Workplace: A Quality Improvement Project, Molly Mcqueeney

Master's Theses and Capstones

Abstract

BACKGROUND: Violence in the United States has significant impacts on the healthcare system. On average, there are about 7.8 per 1,000 workers yearly that experience violent injuries (Grossman & Choucair, 2019). In 2016, it was estimated that approximately $429 million was added to treat and prevent injuries to healthcare workers (Grossman & Choucair, 2019). By implementing the Broset Violence Checklist (BVC) as a screening tool for early identification of risk for violence, there is a possibility for a reduction in the number of violent occurrences in the workplace.

LOCAL PROBLEM: Within the given microsystem, there is a lack of …

A Rare Case Of Covid Encephalitis In A Vaccinated Patient, Christian Pena, Hari Movva, Hector Arredondo, Alberto Pena, Erik Hinojosa, Michael Rotko, Jorge Nadal, Michelle Lopez

MEDI 9331 Scholarly Activities Clinical Years

Background and Purpose: SARS-CoV-2 infection is known to cause primarily respiratory symptoms, however, neurological disorders such as anosmia and stroke have been seen. Encephalitis is a rare complication of COVID-19 with a reported incidence of less than 1%¹. Most patients develop both COVID-19 symptoms and encephalitis symptoms during the same period¹. In addition, the majority of reports are from patients with no prior vaccination. Here, we present a case of encephalitis 2 weeks after mild COVID-19 in a fully vaccinated male.

Case Presentation: A 68-year-old Hispanic male was brought to the ED due to new onset gaze deviation, generalized tonic …

Fatty Acid Therapy And Implications For Spinal Cord Injury Treatment: A Literature Review, Philippe J. Dentino

MEDI 9331 Scholarly Activities Clinical Years

Introduction: Spinal Cord Injuries (SCI) are catastrophic injury to spinal neurons that cause a tremendous socioeconomic and public health burden on individuals globally. The role of fatty acids in treatment of SCI is not well understood and poorly standardized across treatment provision. This review seeks to explore the role of fatty acids in neurorecovery and propose emerging themes in SCI treatment with fatty acids.

Methods: A PICO was designed and online databases were searched for relevant articles. A total of 55 studies were deemed appropriate for the review and summarized into thematic elements including ) Cellular Transport 2) Neuroprotection 3) …

Resilience Training For Healthcare Professionals: A Literature Review, Michelle Dictor

Master's Projects

Purpose: An exploration of various resilience training programs to determine if there is a significant impact on the psychological resilience of health care professionals.
Method: An electronic systematic review using San Jose State University’s OneSearch database search engine was completed. The review contains published research articles between 2011-2022. Nine published articles were reviewed and used for this systematic review.
Results: There is limited data related to resilience training and resources in accredited nursing programs. Resilience training programs are both a feasible and acceptable way of building psychological resilience among interdisciplinary health care professionals.
Conclusion: Mindfulness-based resilience training programs can be …

Cabg Vs. Pci: Greater Outcomes For Severe Coronary Artery Disease, Haejin Cho

Master's Projects

Coronary artery disease is the leading cause of mortality in the United States. The lifetime probability of developing coronary artery disease after 40 is 40% in men and 32% in women. Cardiac revascularization for patients with complex coronary artery disease is performed commonly. Two common procedures for cardiac revascularization are coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI). The purpose of this systemic review is to compare long-term outcomes of CABG and PCI in patients with severe artery disease. This review concluded that PCI was associated with higher rate of repeat revascularization compared to CABG, but the incidence …

Efficacy Of Gabapentin Versus Benzodiazepines In The Management Of Alcohol Withdrawal Syndrome, Douglas R. Fredona

Master's Projects

Alcohol abuse, complicated by a dependency relationship, is the third leading modifiable cause of death in the United States. In patients with chronic alcohol use disorder who experience a sudden cessation or significant decrease in alcohol consumption, half will experience symptoms of alcohol withdrawal syndrome. Benzodiazepines are the typical first line treatment for alcohol withdrawal. However, benzodiazepines carry with them significant risks and side effects. As a result, ongoing research has taken place to find either an alternative treatment or a method of reducing total benzodiazepine dosage during treatment. Gabapentin is a medication that is primarily used for seizure control …

A Systematic Review: Relationship Between Medication Adherence And Hypertension, Monica Chan

Master's Projects

Chronic diseases are defined as conditions that are present for over one year and limit activities of daily living or require ongoing medical attention. Heart disease is the number one leading chronic disease in the United States, making up one third of all deaths. In turn it costs the health system $216 billion per year (Center for Disease Control and Prevention, 2023). Uncontrolled blood pressure is a key risk factor for heart disease and stroke. 1 in 2 adults will need to take prescription medication to control blood pressure and lower the risk of having a cardiovascular event. This systematic …

Effectiveness Of Standardized Vs. Individualized Cancer Treatment Education, Jija Issac

Master's Projects

As the number of cancer diagnoses continues to increase and is expected to keep rising, it becomes imperative to explore avenues to optimize patient education. Research has consistently demonstrated that effective education plays a crucial role in improving patient outcomes. Through my previous experiences in various outpatient oncology infusion centers, I have observed significant variations in the methods employed for delivering patient education across different facilities. In this literature review, I explored the effects of standardized chemotherapy education and individualized chemotherapy education on patients in outpatient oncology clinics. The predominant themes across these studies encompass patient awareness of anticipated symptoms, …

Standardizing Patient Transfer Process Among Nurses From Labor & Delivery To Mother-Baby Unit: A Quality Improvement Project, Kiratraj Kaur Grewal

Master's Projects

Purpose: To implement and evaluate the efficacy of a standardized patient transfer process among registered nurses (RN) from Labor & Delivery (L&D) to Mother-Baby Unit (MBU) using PDSA cycle to improve RN satisfaction and reduce patient transfer time
Conceptual Framework: PDSA Cycle
Setting: Labor & Delivery and Mother-Baby Unit of a tertiary care hospital
Methods: The project consisted of collecting both objective (estimated patient transfer time from L&D to MBU) and subjective data (anonymous nursing pre- and post-intervention surveys). Standardization of transfer process included implementing a transfer checklist, patient transfer tool, updating the workflow, and a sample patient transfer video. …