Medicine and Health Sciences Commons^™

Conflict Resolution In Healthcare: The Vital Role Of Developing Conflict Management Skills Among Nurse Leaders, Kris Maddalena

Doctor of Nursing Practice Projects

Nurse leaders at the unit level play a vital and indispensable role in acute care settings. Their influence extends beyond administrative tasks, as they significantly impact crucial factors such as nurse retention rates, patient outcomes, and the overall work environment of the unit-level teams. Effective unit-level leadership has been consistently associated with improved outcomes, increased job satisfaction, and decreased turnover among nurses (Aiken et al., 2011). This DNP project is focused on enhancing conflict management skills among unit-level nurse leaders in an acute care setting. The project followed a quality improvement sequence, which included obtaining a needs assessment for unit-level …

Organizational Methods Of Reducing Burnout: The Impact Of Self-Rostering On Work-Life-Integration, Cory Authement

MSN Capstone Projects

With burnout being at an all-time high, organizations must find new ways to prioritize staff wellbeing and promote work-life balance. According to the Emergency Nurses Association (ENA) turnover in emergency departments ranges from 15-30% within the first year of nursing, and 43% within the first three years (Roncallo et al., 2020). These turnover rates cost a 300-bed facility approximately four million dollars in annual expenditure (Hesse, 2016). This level of loss and expenditure is unsustainable for the future of nursing and diverts resources away from our patients.

In recent studies, it was shown that burnout leads to difficulties for nurses …

Improving Clinical Competence With Electronic Medical Record Training In Nursing Students: A Benchmark Study, Ashley Reddock

MSN Capstone Projects

Nursing students are required to do many clinical hours based on their program, the Board of Nursing and their accrediting body. During these clinicals, students are faced with challenges that cause safety concerns due to lack of exposure or knowledge regarding policies and procedures. What seems like a simple task, could be life altering because of inadequate competency.

Performing at an expected level of education and demonstrating integration of knowledge, skills, abilities, and judgement defines competency according to the American Nurses Association (ANA) (2018). Nursing programs are expected to produce competent students, and competent nurses upon graduation. Displaying competency in …

Improving The Mental Health Of Nursing Students By Utilizing A Serenity Room: A Benchmark Study, Megan E. Taylor

MSN Capstone Projects

Research findings consistently show that even though improvements have been made through the years, there is much more work to be done concerning mental health nationwide, especially in nursing. Nurses are the front-line workers in healthcare and face challenging times daily. Mental health-related issues in nursing have increased on a national level since the COVID-19 pandemic (Xiong et al., 2022). A more significant nursing shortage will likely occur without drastic change and support for nurses’ well-being.

The purpose of this paper is to describe a benchmark Capstone project. This benchmark study was conducted with the goal of improving nursing students …

Benchmark: Reducing Surgical Plume Output With Smoke Evacuation, Kaitlynn Olano

MSN Capstone Projects

This project focuses on addressing the critical issue of surgical smoke exposure in operating rooms through the strategic implementation of smoke evacuation systems. The primary objective is twofold: to prioritize the safety and well-being of healthcare professionals and to ensure that patient care remains uncompromised. It strives to reshape the operating room environment, making surgical plume exposure a thing of the past.

Extensive research forms the core of this project. A comprehensive literature synthesis, including systematic reviews, randomized control trials, prospective and cohort studies, and qualitative research, underscores the occupational safety concerns related to surgical plume exposure. This synthesis strongly …

Green Tea Supplementation: An Effective Lifestyle Modification For Cholesterol Management, Samuel J. Nemati

MSN Capstone Projects

Hypercholesterolemia is an insidious disease and the leading factor to the deadliest killer in the United States – cardiovascular disease (Centers for Disease Control and Prevention, 2023a). Over 85 million American adults suffer from elevated cholesterol, and treatment can prove challenging and may require multiple modalities outside just pharmaceutical intervention – such as dietary and other lifestyle changes (Centers for Disease Control and Prevention, 2023b; Goldman, 2023). Green tea – among the most common teas consumed worldwide – exerts a uniquely antihyperlipidemic and cardioprotective effect that suggests its consideration as a potentially-viable nonpharmacological option for hypercholesterolemia (Harvard Health Publishing, 2012; …

Effect Of Doula Care Education On Cesarean Section Rates: A Benchmark Study, Elena Rubio-Mcdonald

MSN Capstone Projects

A cesarean section (CS) is a vital maternal care intervention when necessary; however, the surgical procedure places childbearing women at direct risk for infection, hemorrhage, thromboembolism, injury to bladder or bowel, post-surgical pain, and complications from anesthesia. The risk of mortality associated with CS is four to five times more likely compared to vaginal delivery. Severe nursing shortages, high patient volumes, and patients with complex pregnancy related health concerns create barriers to the provision of continuous labor support (CLS) by labor and delivery (L&D) nurses. Partnering with certified doulas and implementing the CLS methods they employ may promote spontaneous vaginal …

Cardio-Pulmonary Resuscitation Without The Pulmonary? A Benchmark Project, Fernando A. Rios

MSN Capstone Projects

Cardiac Arrest occurs outside of the hospital setting more than you think. According to MyCares.net, 15% of OHCA happened in a public setting in 2020. Even if you are a trained healthcare professional, it may not be accessible at times in these situations due to different factors such as equipment availability, trained assistance, etc... Having an alternative option to conventional mouth-to-mouth rescue breath CPR would encourage trained and untrained bystanders to perform life-saving interventions to patients until local EMS responders can arrive. The covid pandemic affected everyone inside and outside the medical world. The general population got a real …

Implementation Of Coping Strategies For Compassion Fatigue Through Counseling, Caleb R. Turner

MSN Capstone Projects

Many healthcare organizations are struggling to retain nurses due to the recent COVID-19 pandemic. Understanding common reasons for decreased retention in nursing begins with evaluating job satisfaction and how it can be affected (Cuartero-Castañer, 2021). Compassion Fatigue (CF) and Burnout (BO) are two leading causes of decreased job satisfaction (Compassion Satisfaction (CS)). The Professional Quality of Life Scale (PROQoL) (see Appendix C) is designed to identify individuals at higher risk of CF and BO. Using this scale in conjunction with the Peer-Support coaches in the hospital setting allows nurses to have conversations and communicate effectively with coaches trained to have …

A Provider In Triage To Decrease “Left Without Being Seen”: A Benchmark Project, Taylor B. Weathers

MSN Capstone Projects

As Emergency Departments (ED) continue to fill and become crowed, the attention to care of each patient can be delayed or missed. Back flow into the ED can cause a bottleneck effect for patients coming in, which can lead to an increase in the number of patients who leave without being seen (LWBS). In order to combat the challenges of patient throughput that result in patients leaving prior to care, I am proposing the implementation of a provider in triage (PIT). By placing a provider, either physician or mid-level practitioner, in the triage area will allow patients to been seen …

Evidence-Based Pain Management With Inclusion Of Music Therapy For Post-Surgical Patients: A Benchmark Study, Ashleigh Rowan

MSN Capstone Projects

Improper pain management in the postsurgical patient can delay proper healing, increase frustration for the patient, and prolong hospital stays (Córcoles-Jiménez et al., 2021). Moderate to severe pain can pose a greater risk for complications such as deep vein thrombosis, pneumonia, and delayed recovery (Kolaczko et al., 2019). Music therapy is an underutilized pain intervention in the PACU environment. Music therapy has been shown to lower pain and anxiety scores in many different clinical settings (Lee et al., 2017). Pain management can radically improve a patient’s outlook and recovery (Luo & Min, 2017). Patients who return to wakefulness and receive …

Pre-Shift Mindfulness: An Evidence Based Practice Benchmark Project, Whitney Turner

MSN Capstone Projects

Although a nursing shortage has existed for some time, it seems there is currently a flight of both experienced and young clinicians from the bedside. Over the course of the Covid-19 pandemic, healthcare organizations have seen dramatic increases in turnover and vacancy rates, leading to severe staffing shortages and compromised patient care. Historically, nursing has been a caring, service driven profession, and a calling for millions of professionals. However, nurses are increasingly concerned with their personal wellbeing.

The term “burnout” appeared in the 1970s to describe the consequences of severe stress in “caring” professions, and include symptoms such as exhaustion, …

Massive Transfusion And Shock Index, Kasey House

MSN Capstone Projects

Hemorrhagic shock is one of the leading causes of preventable death in military trauma patients. Literature shows that pre-hospital transfusions of blood products within the combat environment have shown to have a greater likelihood of survival. This has produced a challenge in the pre-hospital setting to have a standardized method of predicting the patient’s need for a massive transfusion. In the last few years, the development of a Massive Transfusion Protocol (MTP) has become the standard to quickly deliver blood products to actively bleeding patients. Every minute waiting to administer blood products increases mortality by 5%.

While initiating an MTP …

Perceptions And Awareness Of Operating Room Staff Regarding Surgical Smoke: Implications For Safety And Health, Karla Flores

MSN Capstone Projects

In the ever-evolving landscape of modern medicine, surgical procedures have become increasingly complex and reliant on energy-based devices, leading to the ubiquitous presence of surgical smoke in ORs. This phenomenon, while a byproduct of technological advancement, poses significant concerns regarding the health and safety of OR personnel, including surgeons, nurses, anesthesiologists, surgical technicians, and ancillary staff. This paper presents a meticulous examination of the multifaceted impacts of surgical smoke, emphasizing the urgency for comprehensive intervention and systemic change.

The Effects Of Non-Pharmacological Interventions For Behavior And Psychological Symptoms Of Dementia: A Benchmark Study, Rachel R. Williams

MSN Capstone Projects

The management of behavioral and psychological symptoms of dementia (BPSD) in patients who reside in nursing homes can be challenging. These neuropsychiatric behaviors can include but are not limited to aggression, agitation, delirium, depression, and psychosis (Cloak & Al Khalili, 2022). Patients with BPSD often have difficulty expressing their needs due to the disease process, resulting in further complexity when managing behaviors. There are no psychotropic medications to treat BPSD specifically, but many are often prescribed to treat the symptoms or behaviors exhibited by patients. The use of psychotropics, especially long-term can cause a myriad of adverse effects and should …

The Effects Of Education On Influenza Vaccination Uptake, Jazzlyn Lawson

MSN Capstone Projects

Influenza is a viral illness that occurs internationally and peaks in prevalence during the months of October to May. There are several types of influenza viruses: Influenza A, B, C, and D (CDC, 2023). Vaccines are available in the United States as early as the start of the flu season to those who wish to receive it. The influenza virus types covered by the annual flu vaccine include Influenzas A and B types (CDC, 2023). The influenza vaccine is recommended by the CDC with the intent to limit the occurrence and spread of influenza each year. Symptoms of influenza consist …

America Heart Association Guidelines On Telemetry Monitoring To Reduce Alarm Fatigue And Improve Patient Outcomes, Rekike Aster Ehrenberg

MSN Capstone Projects

The excessive use of telemetry monitoring in healthcare has become a widespread concern, leading to increased healthcare costs and alarm fatigue among providers. These issues threaten patient safety and negatively impact patient outcomes. To address these issues, the American Heart Association (AHA) has published guidelines for telemetry monitoring to reduce alarm fatigue and improve patient outcomes.

A three-month benchmark project was conducted using evidence-based methods to implement the AHA guidelines for telemetry monitoring in a medical-surgical unit. The project aimed to serve as a model for others with similar issues. By following the AHA guidelines, patient safety can be enhanced, …

The Impact Of Shared Governance On Work Engagement And Job Satisfaction, Mikayla Adkins

MSN Capstone Projects

In 2023, the National Council of State Boards of Nursing revealed that 100,000 nurses left the workforce during the COVID-19 pandemic and another 900,000 plan to leave by 2027 due to stress, burnout, and retirement. Identifying and implementing practical strategies to reduce voluntary turnover as a result of stress and burnout is a top priority for nursing leaders across the country. Work engagement and job satisfaction have well been documented in the literature as antidotes to occupational stress and burnout in the nursing profession (Schaufeli & Bakker, 2004; Pressley & Garside, 2022). Evidence suggests that implementing shared governance is a …

Enhancing Antenatal Education In Pakistan: An Audit And Recommendations, Maliha Abbas, Shelina Bhamani, Yasmin Kanjani, Lumaan Sheikh

Department of Obstetrics & Gynaecology

Background: Antenatal Education equips parents with knowledge for safe maternal health and infant care. It also reduces fear and anxiety during childbirth. ANE curriculum can vary according to country and institute. It can include classes focusing on childbirth, pain relief techniques, mode of birth, parenting, breastfeeding, breathing techniques, etc. Although ANE is widely practiced in developed countries, there is no standard program in developing countries like Pakistan. This study aims to improve antenatal education at a tertiary care hospital in Karachi, Pakistan potentially proposing an upgraded curriculum as a national standards
Methods: This multiphase study used mix-method design was conducted …

Jun Upregulation Drives Aberrant Transposable Element Mobilization, Associated Innate Immune Response, And Impaired Neurogenesis In Alzheimer’S Disease, Chiara Scopa, Samantha Barnada, Maria Cicardi, Mo Singer, Davide Trotti, Marco Trizzino

Farber Institute for Neuroscience Faculty Papers

Adult neurogenic decline, inflammation, and neurodegeneration are phenotypic hallmarks of Alzheimer's disease (AD). Mobilization of transposable elements (TEs) in heterochromatic regions was recently reported in AD, but the underlying mechanisms are still underappreciated. Combining functional genomics with the differentiation of familial and sporadic AD patient derived-iPSCs into hippocampal progenitors, CA3 neurons, and cerebral organoids, we found that the upregulation of the AP-1 subunit, c-Jun, triggers decondensation of genomic regions containing TEs. This leads to the cytoplasmic accumulation of HERVK-derived RNA-DNA hybrids, the activation of the cGAS-STING cascade, and increased levels of cleaved caspase-3, suggesting the initiation of programmed cell death …

Changing The Playbook For Immigrant Health, Cheryl Bettigole, Patricia C. Henwood, Sage Myers, Maura Sammon

Department of Emergency Medicine Faculty Papers

Philadelphia’s response to welcoming Afghan evacuees during the COVID-19 pandemic suggests the need for a new approach to immigrant health care.

Empowering New Ob Nurses To Combat Racial Disparities Through Education, Tabitha Poole

Doctor of Nursing Practice Projects

Minority patients are experiencing maternal morbidity and mortality at rates three to four times higher than white patients in America (Valerio et al., 2023). The project aims to measure the impact of anti-racism training on new OB nurses' understanding of racial disparities and their impact on maternal health outcomes. A three-hour educational course, in alignment with evidence-based practices, was provided to the participants. Utilizing a Likert Scale, pre- and post-intervention assessments were administered via Microsoft Forms to measure participants' perception of knowledge of implicit bias and structural racism. Gender, age range, and race/ethnicity were also collected to allow for further …

Platinum Measurements In Dulbecco’S Phosphate-Buffered Saline Are Lower Than In Plasma And Can Be Sampled With Ultrafiltration Probes In Vitro, Marije Risselada, Robyn Mccain

Purdue University Libraries Open Access Publishing Fund

OBJECTIVE

To compare the influence of fluid on carboplatin elution, and assess the feasibility of ultrafiltration (UF) probe sampling

SAMPLE

20 samples of 5 mg carboplatin in 1.0 mL 30% poloxamer 407 eluting in Dulbecco’s phosphate-buffered saline (DPBS) or canine plasma and 6 samples of UF probe sampling in 0.01 mg/mL carboplatin in DPBS or plasma.

METHODS

Carboplatin-gel specimens in dialysis tubing (12- to 14-kDa pores) were placed in 100 mL of DPBS or canine plasma (37 °C and 600 rpm stirring) in a nonlidded and lidded experiment. Samples were collected in decreasing frequency for 96 hours. The 0.01-mg/mL carboplatin …

Wellness Review 2023, Part 1, Brian A. Ferguson, Martin Huecker

Journal of Wellness

Introduction: The 2023 Part 1 summary reviews research on wellness in healthcare professionals published outside of JWellness from January 1, 2023 to June 30, 2023.

Methods: Editors conducted a Boolean search of titles and abstracts in PubMed utilizing keyword identifiers pairing healthcare personnel (providers, nurses, and other staff) with a well-being metric. Of 416 relevant articles, an intriguing and innovative 30 were selected for inclusion, with two additional articles manually curated.

Literature in Review: This sample of the recent literature into healthcare professional wellness included multiple targeted interventions and studies of resilience. Main themes that emerged include: positive systematic healthcare …

Phi-1, An Endogenous Inhibitor Protein For Protein Phosphatase-1 And A Pan-Cancer Marker, Regulates Raf-1 Proteostasis, Jason Kirkbride, Garbo Nilsson, Jee In Kim, Kosuke Takeya, Yoshinori Tanaka, Hiroshi Tokumitsu, Futoshi Suizu, Masumi Eto

Kimmel Cancer Center Faculty Papers

Raf-1, a multifunctional kinase, regulates various cellular processes, including cell proliferation, apoptosis, and migration, by phosphorylating MAPK/ERK kinase and interacting with specific kinases. Cellular Raf-1 activity is intricately regulated through pathways involving the binding of regulatory proteins, direct phosphorylation, and the ubiquitin-proteasome axis. In this study, we demonstrate that PHI-1, an endogenous inhibitor of protein phosphatase-1 (PP1), plays a pivotal role in modulating Raf-1 proteostasis within cells. Knocking down endogenous PHI-1 in HEK293 cells using siRNA resulted in increased cell proliferation and reduced apoptosis. This heightened cell proliferation was accompanied by a 15-fold increase in ERK1/2 phosphorylation. Importantly, the observed …

Duchenne Muscular Dystrophy: Age, Disease Stage, And Patient-Reported Quality Of Life, Sheila Jagers

Walden Dissertations and Doctoral Studies

No abstract provided.

Intouch Week Of December 4, 2023, New York Medical College

InTouch

• Get to Know Dr. Schluger, the New SOM Dean
• NYMC Celebrates Faculty Authorship at 30th Annual Recognition
• NYMC's Giving Tuesday Success Fuels Clinical Skills and Simulation Center Expansion
• Students Shine at 2023 Multidisciplinary Community Outreach
• NYMC Looks at the Future of the Life Sciences at the Innovation in Research Conference
• Study Finds Racial Disparities in Postoperative Outcomes for Cervical Stenosis

Hnf4Α Isoforms Regulate The Circadian Balance Between Carbohydrate And Lipid Metabolism In The Liver, Jonathan R Deans, Poonamjot Deol, Nina Titova, Sarah H Radi, Linh M Vuong, Jane R Evans, Songqin Pan, Johannes Fahrmann, Jun Yang, Bruce D Hammock, Oliver Fiehn, Baharan Fekry, Kristin Eckel-Mahan, Frances M Sladek

Faculty, Staff and Student Publications

Hepatocyte Nuclear Factor 4α (HNF4α), a master regulator of hepatocyte differentiation, is regulated by two promoters (P1 and P2) which drive the expression of different isoforms. P1-HNF4α is the major isoform in the adult liver while P2-HNF4α is thought to be expressed only in fetal liver and liver cancer. Here, we show that P2-HNF4α is indeed expressed in the normal adult liver at Zeitgeber time (ZT)9 and ZT21. Using exon swap mice that express only P2-HNF4α we show that this isoform orchestrates a distinct transcriptome and metabolome via unique chromatin and protein-protein interactions, including with different clock proteins at different …

Plasma Exchange Reduces Aβ Levels In Plasma And Decreases Amyloid Plaques In The Brain In A Mouse Model Of Alzheimer's Disease, Santiago Ramirez, Suelyn Koerich, Natalia Astudillo, Nicole De Gregorio, Rabab Al-Lahham, Tyler Allison, Natalia Pessoa Rocha, Fei Wang, Claudio Soto

Faculty, Staff and Student Publications

Alzheimer's disease (AD) is the most common type of dementia, characterized by the abnormal accumulation of protein aggregates in the brain, known as neurofibrillary tangles and amyloid-β (Aβ) plaques. It is believed that an imbalance between cerebral and peripheral pools of Aβ may play a relevant role in the deposition of Aβ aggregates. Therefore, in this study, we aimed to evaluate the effect of the removal of Aβ from blood plasma on the accumulation of amyloid plaques in the brain. We performed monthly plasma exchange with a 5% mouse albumin solution in the APP/PS1 mouse model from 3 to 7 …

Examining The Potential Of Vitamin C Supplementation In Tissue-Engineered Equine Superficial Digital Flexor Tendon Constructs, Michael J Mienaltowski, Mitchell Callahan, Nicole L Gonzales, Angelique Wong

Faculty, Staff and Student Publications

Because equine tendinopathies are slow to heal and often recur, therapeutic strategies are being considered that aid tendon repair. Given the success of utilizing vitamin C to promote tenogenesis in other species, we hypothesized that vitamin C supplementation would produce dose-dependent improvements in the tenogenic properties of tendon proper (TP) and peritenon (PERI) cells of the equine superficial digital flexor tendon (SDFT). Equine TP- and PERI-progenitor-cell-seeded fibrin three-dimensional constructs were supplemented with four concentrations of vitamin C. The gene expression profiles of the constructs were assessed with 3'-Tag-Seq and real-time quantitative polymerase chain reaction (RT-qPCR); collagen content and fibril ultrastructure …