Honoring Veterans’ Wishes: Efficacy Of An Evidence-Based Shared Decision-Making Tool In Va Icu Goals-Of-Care Discussions, Stephanie Alexander, Anna Astashchanka Md, Venktesh Ramnath Md

Doctor of Nursing Practice Final Manuscripts

Abstract

Introduction: This Doctor of Nursing Practice project aimed to enhance the knowledge and confidence of the San Diego Veterans Health Administration’s (VASD) Intensive Care Unit (ICU) medical providers in goals-of-care discussions (GOCD). Additionally, this project aimed to improve the documentation of these discussions.

Background: Delays in GOCD can lead to futile medical and surgical interventions, inappropriate antibiotic use, and higher rates of mental health conditions in patients and their loved ones. Earlier GOCD are associated with lower ventilation and resuscitation rates, earlier hospice enrollment, reduced ICU admissions, lower financial costs, and better patient and caregiver quality of life. However, …

Staff-Family Communication Methods In Long-Term Care Homes: An Integrative Review, Alexander Stephen, Denise Connelly, Lillian Hung, Janelle Unger

Physical Therapy Publications

Context: Communication methods have been trialled to promote staff-family relations and facilitate person-centred care for residents living in long-term care homes. A review and synthesis of the common methods will inform the development of stafffamily communication methods, policy and best practice guidelines.

Objectives: 1) synthesise and summarise common communication methods, and types(s) of delivery, used for staff-family communication in long-term care homes; and 2) identify any challenges that impacted the implementation of the communication method(s).

Methods: An integrative review was employed to incorporate papers with diverse research designs. It involved a comprehensive database and grey literature search, and study selection …

Implementation Of Lymphedema Education Toolkit For Nurse Coordinators, Heather Gee

Master's Projects and Capstones

Problem: Lymphedema is a chronic condition that develops secondary to cancer treatments such as chemotherapy, radiation, and surgical removal of affected lymph nodes. This swelling in patient’s limbs can cause discomfort and limit mobility, however lymphedema is often not detected until later stages, delaying treatment and patient education.

Context: This quality improvement project was conducted at Hospital S Women’s Cancer Center, an outpatient center specializing in advanced treatments for breast and gynecological cancers. This center has a multidisciplinary team focusing on both the medical and surgical aspects of oncology treatment.

Interventions: An evidence-based lymphedema education toolkit was created for nurse …

Education For Primary Care Providers On Advance Care Planning, Lindsey Ward

Doctor of Nursing Practice (DNP) Projects

Background: Advance care planning (ACP) is a discussion of a patient’s end-of-life healthcare wishes. Its purpose is to indicate these wishes clearly should the patient be unable to make their decisions known to providers and family members due to a sudden health decline or medical emergency. Healthcare providers, specifically nurse practitioners, physician assistants, and physicians in the primary care setting, are well-positioned to facilitate these conversations with their older adult patients. However, research states that limited provider knowledge of and confidence in implementing ACP are significant barriers to its application in practice.

Problem: At a primary care clinic in Midtown …

Improving Nurse Support Of Patient Satisfaction Surveys Through Team Huddle Education, Matthew Price

Master's Projects and Capstones

Problem As a leading cause of death and disability in the US, strokes often require complex, multifaceted care. Often ignored, patient satisfaction is a crucial aspect of this care and is positively linked to key health indicators. Regulatory guidelines underscore the need for stroke-specific patient satisfaction survey (SSPS) utilization in post-stroke care. Context Hospital X is a large Comprehensive Stroke Center in the Bay Area, serving patients with various stroke etiologies and complexities. At present, its Neuro Observational Unit (NOU) does not administer a SSPS. Intervention To address this gap in care, an educational presentation using literature evidence in support …

Implementing The Copm To Create Occupation-Based Interventions In Outpatient Adult Rehabilitation, Kelcee A. Bacon

Occupational Therapy Capstone Presentations

Worldwide, people continue to live longer, with the number of people over the age of 60 predicted to double by 2050; many of those people also have chronic diseases that could benefit from rehabilitation services. Outpatient rehabilitative services, including occupational therapy, have increased occupational performance, strength, mobility, and coordination for those diagnosed with musculoskeletal or neurological conditions. This capstone focused on three components: 1) in-depth clinical practice using occupation-based assessments and interventions with the adult population, 2) understanding the administrative roles of private practice therapists, and 3) creating educational materials to increase knowledge and skills surrounding outpatient occupational therapy for …

S.M.A.R.T. Program Implementation To Promote Engagement And Participation In A School Setting, Emily Mickelson

Occupational Therapy Capstone Presentations

The purpose of this capstone project is to educate educational professionals on multi-sensory approaches and to implement the Stimulating Maturity Through Accelerated Readiness Training (S.M.A.R.T.) program to increase students’ engagement in academic learning. This project used pre- and post-tests to determine baseline knowledge. The occupational therapy student participated in S.M.A.R.T. training, and the junior kindergarten students participated in eight-weeks of S.M.A.R.T. program implementation. The students’ pre- and post-test assessments were completed by the students one-week pre-intervention and following eight weeks of program implementation. The educational professionals’ pre- and post-test assessments were completed by the kindergarten teachers before and after receiving …

Minimally Invasive Tissue Extraction: Continued Growth Through Simulation For Obgyn Residents, Angela Frankel, Md, Mph, Melanie Hotz, Md, Patrick Teefey, Md

Department of Obstetrics and Gynecology Posters

Background

• Minimally invasive surgery often requires tissue morcellation for extraction of large surgical specimens.¹
• Surgeon comfort with tissue morcellation in gynecologic surgery is vital in providing a minimally invasive (MIS) approach.
• However, OBGYN residents often feel underprepared to perform this skill independently.²
• While practicing tissue morcellation in the OR is ideal, simulation has been shown to improve resident technical skill without risking increased operative time or associated morbidity.³
• This intervention seeks to build upon a prior simulation exercise, with the ultimate goal of improving OB-GYN resident self-reported comfort with minimally invasive tissue extraction.

Diabetes Health Education For South Jersey Communities, Heaven Chu, Sarah Tamous, Ashhabal Kavvi, Amin Khan

Rowan-Virtua Research Day

Diabetes is a chronic health condition that hinders the body’s metabolic process using insulin to maintain glycemic homeostasis. It is prevalent worldwide, with about 10% of the global adult population affected. Socio-economic and cultural factors and determinants make diabetes and diabetes management more of a health risk for certain populations rather than others. The prevalence of diabetes in the United States is higher than the global average and the risk factors disproportionately affect disadvantaged communities.

This study was designed to investigate health disparities in diabetes among a diverse population sample. The study included researching the disparities of diabetes patients in …

Association Between Depression And Coronary Heart Disease: A Cross-Sectional Study Using Behavioral Risk Factor Surveillance System (Brfss), 2022, Juliana Monono

Capstone Experience

Objectives: To examine the association of depression and coronary heart disease in U.S. adults.

Methods: This cross-sectional study uses the Behavioral Risk Factor Surveillance System (BRFSS), 2022 data for non-institutionalized U.S adults aged 18 and older. The exposure variable is depression, the outcome is coronary heart disease (CHD), and covariates are age, race, education, and physical activity. Performed univariate, bivariate, and multivariate analyses to assess the association between depression and CHD.

Results: The analytical sample size consisted of 427,217 individuals. A total of 88,841(20.7%) of the population reported having coronary heart disease, while 338,376(70.3%) reported having no …

Application Of Ultrasound For Difficult Vascular Access In Obstetric Patients, Carly Mccleland

Doctor of Nursing Practice Projects

This project aimed to create a three-tiered educational program to introduce the benefits of ultrasound application for peripheral IV placement in obstetrical patients. The main goals of this project were to increase successful first-attempt IV placement in obstetric patients who may be difficult to obtain IV access on. The first tier of education consisted of presenting findings from the literature review as an educational PowerPoint to all project stakeholders. The second tier of education included stakeholders practicing using the ultrasound for PIV placement on mannequin arms. The third tier, which is still on going, included implementation of the first two …

Evaluation Of The Feasibility Of A Midwifery Educator Continuous Professional Development (Cpd) Programme In Kenya And Nigeria: A Mixed Methods Study, Duncan Shikuku, Hauwa Mohammed, Lydia Mwanzia, Alice Ladur, Peter Nandikove, Eunice Ndirangu, Alphonce Uyara, Catherine Waigwe, Lucy Nyaga, Issak Bashir

School of Nursing & Midwifery, East Africa

Background Midwifery education is under-invested in developing countries with limited opportunities for midwifery educators to improve/maintain their core professional competencies. To improve the quality of midwifery education and capacity for educators to update their competencies, a blended midwifery educator-specific continuous professional development (CPD) programme was designed with key stakeholders. This study evaluated the feasibility of this programme in Kenya and Nigeria.

Methods This was a mixed methods intervention study using a concurrent nested design. 120 randomly selected midwifery educators from 81 pre-service training institutions were recruited. Educators completed four self-directed online learning (SDL) modules and three-day practical training of the …

Computer Visual Syndrome In Medical Students In Virtual Education Of A Peruvian University During 2021, Rosario Mercedes Meneses Castañeda, Sergio Luis Ramos Rodriguez, Chiara Del Carmen Molfino Jaramillo, Ely Luisa Sánchez Miraval, David Francisco Stein Montoro, Lourdes Guissel Chávez Rodríguez

Revista de la Facultad de Medicina Humana

Introduction: During virtual classes in the context of COVID-19, students were exposed to digital screens for many hours, so they could present computer vision syndrome. Objective: To determine the frequency of computer vision syndrome in sixth-year medical students at Ricardo Palma University during virtual education due to COVID-19 in October and November 2021. Methods: Cross-sectional descriptive study in 147 sixth-year medical students who received virtual education at a Peruvian university during 2021. A non-probability sampling was used for convenience and the SVI was evaluated with the SVI-Q questionnaire, in addition characteristics were evaluated. demographics, visual preventive measures and eye diseases. …

Toward An Identity For The Field Of Doctoral Education In Health Sciences, Lauretta Cathers, Kieran Fogarty, Lynda T. Goodfellow, Christina B. Gunther, Beverly W. Henry, Douglas A. Kuperman, Laura Santurri, G. Zipp

Journal of Innovation in Health Sciences Education

The Association of Doctoral Programs in Health Sciences (ADPHS) was informally established in November 2019, officially incorporated in August 2021, and is currently a 501(c)(3) non-profit organization comprised of the directors of member doctoral programs of health sciences. The ADPHS grew from informal discussions among program directors who agreed that a major problem in the field of doctoral education in health sciences was the lack of a clearly defined and easily articulable identity. The discussions led to the drafting of an informal and nonscientific survey used to help clarify the current health sciences education environment, relevant emerging trends, and the …

Development Of An Evidence-Based Crna Preceptor Training Program, Emmanuel Mensah

Doctor of Nursing Practice Scholarly Projects

A preceptor is an experienced clinician who is expected to facilitate a student's learning experience. Preceptorship is the relationship between a staff nurse and student, focusing on the development of clinical skills and knowledge. Initially introduced by Florence Nightingale in the 1800s, the concept was quickly adopted by nurse anesthetists and is a staple of the anesthesia practice today. As it stands, many Certified Registered Nurse Anesthetists (CRNA) preceptors do not receive formal training in their role, which may lead to a decrease in teaching ability and confidence to face broad teaching-learning issues. A lack of preparation hinders preceptor outcomes …

Empowering Picu Nurses: Enhancing Awareness And Understanding Of Post-Intensive Care Syndrome-Pediatric (Pics-P), Carissa A. Newman, Janelle A. Strain

Research & Creative Achievement Day

Statement of the Problem: Post-intensive care syndrome (PICS-p) threatens the health of children following a Pediatric Intensive Care Unit (PICU) stay. Morbidities associated with PICS-p can affect children's cognitive, functional, social, and emotional domains. Purpose: The project aimed to increase awareness of the term PICS-p, increasing knowledge and understanding among nursing staff, and developing their ability to identify patients at risk for developing PICS-p. Method: The Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Healthcare was used to facilitate this project. 20 PICU nurses completed an educational module with a pre/post quiz to analyze learning outcomes about PICS-p. Interventions: …

Yoga Program For Children At Risk For Trauma: Promoting Self-Regulation And Educational Participation, Sydney Gonzales, Rebecca King

Spring 2024 Virtual OTD Capstone Symposium

This presentation describes implementing a yoga-based program within an early childhood education setting. Occupational therapists can utilize yoga-based activities and advocate for their use in classrooms to promote the positive development of self-regulation and educational participation for at-risk populations.

Ot's Role With Survivors Of Sexual Assault, Myracle N. Carter, Cassandra M. Nelson

Spring 2024 Virtual OTD Capstone Symposium

Sexual assault can lead to a multitude of symptoms that can negatively impact an individual’s occupational participation and quality of life. However, the literature and programming surrounding the use of occupational therapy (OT) with survivors of sexual assault is limited or outdated. Therefore, this program was created to be a resource and guide to increase the use of OT with survivors. This program included a total of five modules, which provided education and occupation-based activities to the participants to increase their occupational participation, specifically in work and education, and their overall quality of life. Following the conclusion of the implementation …

A Guide For Supplemental Education On Seating And Positioning For Parents And Caregivers Of Individuals With Cerebral Palsy, Grace Johnson, Mary Jan Greer, Franchesca Cox

Spring 2024 Virtual OTD Capstone Symposium

An educational program that educates caregivers and families on the importance of proper seating and positioning during play, feeding, bone development and growth, speech, reaching, toy manipulation, handwriting and interacting with peers.

The Lived Experiences Of Student Nurses During Simulation Of Perinatal Loss, Paloma Alejandra Peña

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to understand the experiences and perceptions of undergraduate nursing students in providing care following a perinatal loss simulation. The theories that guided this study included Malcolm Knowles’ Theory of Andragogy and the National League for Nursing Jeffries Simulation. The selected theories provide structure for adult learners’ need to experience situational learning activities that are relevant to their job while building upon the foundation of students’ knowledge. Incorporation of Knowles’ and Jeffries’ theories guides the qualitative study of the simulation of a perinatal loss and the experiences of nursing students in providing care during …

The Relationship Between Holistic Admissions Criteria And Program Ranking Among Occupational Therapy Entry-Level Programs, Kristian Taylor, Cat-Tien Nguyen, Jenny Grant, Mary B. Brewster, Mary A. Barrett, Teal Benevides, Sharon M. Cosper

The Open Journal of Occupational Therapy

Holistic admissions criteria are one strategy to be more inclusive of students with a variety of experiences, cultures, and beliefs. The purpose of this study is to evaluate the relationship between holistic admissions criteria and occupational therapy program ranking. We used a retrospective cross-sectional cohort descriptive study design of occupational therapy programs in the United States to understand whether top performing programs employ holistic admissions criteria. Secondary descriptive analysis from the top and bottom 50 ranked occupational therapy programs in 2020 U.S. News & World Report (Morse et al., 2020) was completed. We used a nominal scale to classify programs …

Barriers That Affect Equity In The Occupational Therapy Admissions Process: Student And Faculty Perspectives, Quinn P. Tyminski, Lenin Grajo

The Open Journal of Occupational Therapy

The use of holistic admissions in higher education has been demonstrated to increase the diversity of incoming student classes; yet, in occupational therapy (OT) research, admissions processes remain under-explored. This phenomenological study aimed to explore the process of OT admissions from the perspective of students, faculty, and staff at a single OT program with the goal to create a more inclusive, equitable, and holistic process. Focus groups were conducted with first-year students, and an online survey was sent to faculty to explore perspectives on the admissions process, necessary qualities for an OT graduate student, and suggestions for increasing inclusion and …

The Impact Of Patient And Provider Education On Statin Therapy Initiation And Adherence In Type Ii Diabetics, Jane Harlan Bsn-Rn, Lindsey Jacobsen Bsn-Rn, Emily Easterly Bsn-Rn, Mitch King Bsn-Rn, Laura Reed Dnp, Aprn, Fnp-Bc, Cne

Doctor of Nursing Practice Projects

Purpose/Background

Type 2 diabetes mellitus (T2DM) is a common, chronic disease that increases the risk of coronary artery disease and stroke fourfold, which makes protecting cardiac function a priority. The American Diabetes Association (ADA) and American Heart Association (AHA) recommend the prescription of statins to reduce cardiovascular complications. Unfortunately, provider and patient adherence to this recommendation is poor.This study aimed to determine if shared-decision making and patient follow-up within a 6 month period of being newly diagnosed with T2D has an effect on the initiation rate of statin therapy.

Methods

In this retrospective study we requested data from the University …

African American Women’S Perceptions Of A Group Based, Diabetic Medical Nutritional Therapy Intervention: A Qualitative Study, Megan Mcmahon, Laura Gray

DNP Scholarly Projects

Background: African American women exhibit lower rates of attaining recommended diabetes management goals such as optimal blood sugar, cholesterol, and blood pressure numbers compared to other racial and gender groups. As a result, they bear a disproportionate burden of the adverse outcomes associated with poorly managed type 2 diabetes, including increased complications and mortality rates compared to other demographic groups. Despite favorable qualitative findings regarding group-based interventions for African American women with other chronic diseases, a notable gap in the literature exists regarding the women’s perceptions of a group-based medical nutritional therapy tailored to type 2 diabetes. Purpose: This scholarly …

Development And Evaluation Of Trauma Informed Care Education For Licensed Nurses, Kristina O'Meara

Epsilon Sigma at-Large Research Conference

Trauma informed care nursing education is crucial. Trauma informed care is a method of providing health care which understands the likelihood of past and present traumatic events in patients and families. The experience of past or present trauma often led to chronic diseases, substance abuse disorder, fragmented health care, fears surrounding health care, chronic stress, and other negative health consequences. The purpose of this project is to increase licensed nurses’ awareness and ability to practice trauma informed care in clinical practice, as well as promote policy initiation within the health care facilities. Method planning integrated the Knowledge to Action Cycle. …

Health Literacy And Diabetes Outcomes In Adults With Type 2 Diabetes In Southwest Virginia, Casandra Reyes Arellano

Epsilon Sigma at-Large Research Conference

Purpose: To determine if a quality improvement project involving individualized, one-on-one Diabetes education will improve health literacy and Diabetes outcomes in adults with Type 2 Diabetes in a rural primary care clinic. Diabetes is a chronic condition affecting the United States with 9.6% of Virginia’s population living with Diabetes.

Aims: To improve patient’s Diabetes literacy scores, BMI, and Hemoglobin A1c levels through Diabetes education.

Processes: There are pre- and post-education phases. Data to be collected at the end of both phases consist of DNT15 scores, BMI, and A1c. In the pre-education phase, BMI was obtained, DNT15 was administered, and Diabetes …

Education And Advocacy For Universal Design And Accessibility In Housing, Apisara Vairojanakich, Amy Lyons-Brown, Molly Wuebker

Spring 2024 Virtual OTD Capstone Symposium

In the United States, there is a lack of adequate numbers of universally designed and accessible houses in the housing market for the older population and people with disabilities. Many barriers, such as financial support and lack of knowledge for housing-related professionals, can prevent this population from participating in home occupations. The project developed educational products, including the universal design housing experience booklet, universal design housing checklist, and universal design blueprints. These products were delivered through the blog post on Uncurbed LinkedIn website. The needs assessment was conducted to provide the guidelines for the chapters in the booklet and checklist. …

Educational Lessons From A Pandemic: Lecture Recording And Learning Outcomes, Melissa Lesser, Lora Packel

Internet Journal of Allied Health Sciences and Practice

Purpose: The use of lecture capture (LC) in higher education classrooms has increased, especially since the onset of the COVID-19 pandemic; however, its effectiveness as a learning strategy is largely untested in graduate students. In undergraduate students, the use of LC has mixed findings related to academic performance. Some studies show no improvement in assessment or course grades while others show small gains. The purpose of this study was to investigate the impact of LC on academic performance in graduate doctor of physical therapy students (DPT). Methods: In module 1, students received two virtual synchronous lectures which were recorded …

Student Perspectives On Transition From Bachelor’S To Master’S Degree For Professional Athletic Trainers: Advantages And Disadvantages, Bobbi A. Severt, Michael B. Phillips, Janet Kesterson Isbell

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study is to understand the perspectives of students interested in a career in athletic training on the degree change and what they perceive as advantages and disadvantages to pursuing a master's level professional degree in athletic training. Method: A case study was conducted using an interpretivism framework informed by a constructionism theoretical stance. A focus group of six current undergraduate pre-athletic training students and individual interviews of three pre-athletic training graduates along with current and historical documents were used to collect data. An inductive approach was used to analyze data along with reflexive thematic analysis …

Extending Knowledge On Biosecurity In Small-Scale And Backyard Systems In The United States, Juliette Di Francesco, Amber Itle, Craig Mcconnel, Ragan Adams, Roselle Busch, Richard Van Vleck Pereira, Terry W. Lehenbauer, Beatriz Martínez-López, Alda F. A. Pires

The Journal of Extension

The number of small-scale and backyard operations has increased in the United States during the past decade, but there is currently a lack of outreach efforts and readily-available educational materials targeting these farming systems. We developed a webinar series on biosecurity to provide training for small-scale and backyard producers, and training tools that can be used by local veterinarians and extension educators to disseminate knowledge and consistent recommendations more effectively. Fewer people attended the webinars than registered, suggesting a gap between interest in biosecurity and commitment to the topic. Participants in the webinar series reported a high level of satisfaction …