Medicine and Health Sciences Commons^™

Improving Health Literacy Through Revision Of Educational Materials For Pelvic Health Considerations During Labor & Birth, Stephanie Duzy Ba, Ot/S, Kathryn Burke Otd, Otr/L, Lisa Charron Pt, Dpt

Occupational Therapy Doctorate Capstones

Literature Review:

• Patient inability to comprehend written healthcare information is a communication barrier (Jager et al., 2019). 
• A systematic review of health literacy in pregnant women found that patients need adequate access, understanding, and the ability to apply information (Nawabi et al., 2021). 
• Helping patients understand health information reduces risk of negative outcomes (Foster et al., 2016). 

For obstetric patients, does applying health literacy principles improve readability of patient education materials?

Impact Of ‘Prioritizing You’ Self-Care Program For Adult Female Survivors Of Domestic Violence, Synclaire Mitchell B.S, Ots, Andrea Fairman Ph.D., Mot, Otr/L, Atp, Drp, Janice Hamlin Msw

Occupational Therapy Doctorate Capstones

Objective & Research Questions:

Objective: To develop a program that would address the occupational needs of survivors of DV to support NBTS in preparing the residents for independent living.

Question: How does implementing an occupation-based program improve the following for survivors of DV? • Coping skills • Occupational performance & satisfaction • Self-efficacy for independent living skills

Examining The Effects Of A Psychoeducational Program To Minimize Symptoms Of Parkinson’S Disease Care Partner Burnout, Nicole Graves B.S, Ot/S, Sheridan Ferland Otd, Otr/L, Carolyn Kosiba-Quiterio Cpt, Crs, Cgx, Csf

Occupational Therapy Doctorate Capstones

Background:

Due to progressive nature of disease, Person with Parkinson’s Disease (PwPD) will require increased assistance from a care partner.

Care Partner Burnout: a state of physical, mental, and emotional exhaustion, in which the person exhibits changes in their attitude and decreased life satisfaction.

Symptoms: withdrawn, easily irritable, anxiety, depression, hopelessness, neglecting personal hygiene & health, and fatigue.

Purpose:

1. Advocate for the well-being of the care partners at Rock Steady Boxing East Greenwich

2. Determine the effectiveness of a psychoeducational intervention program geared toward the management of care partner (CP) burnout symptom

Peer Support To Enhance Safe Alcohol Use In University Students: A Quality Improvement Project, Kerri Reynolds

DNP Scholarly Projects

BACKGROUND: College is a period of transition to adulthood where many students experiment with alcohol consumption. Peer educators can bring access to evidence-based alcohol consumption education through student-centric strategies. This quality improvement project aimed to implement an evidence-based training program for college peer educators followed by the delivery of campus alcohol education in a six week period. Feasible ideas for sustainable college peer educator training were generated at this medium-sized public university. The impact of training on six peer educators’ self-reported professional leadership skills, knowledge, and confidence was measured.

METHODS: The Certified Peer Educator (CPE) training program (NASPA) was used …

Integrating Behavioral Health Into Family Medicine: Improving Access To Specialty Care Using A Collaborative Care Model, Christina Stephens

DNP Scholarly Projects

Primary care, an extensive of family medicine remains a key access point for patients entering the healthcare system. Accessing medical care and specialty psychiatric services is limited in rural communities. Patients often find exhaustive wait times, untimely referrals, and reliance on emergency services for crisis management. The primary care provider is able to help their community improve access to behavioral health care by using a collaborative approach. This quality improvement initiative used the framework produced by the AIMS Center at the University of Washington and adopted for use creating an 8-week intensive program in a family medical practice located in …

Empowering Nurse Leaders To Achieve Harmony: Fostering Work-Life Balance, Gilberto Gamba

DNP Scholarly Projects

BACKGROUND: Balancing professional and personal life demands has become a focal point in today’s healthcare organizational culture. Despite the technological advances in providing better and faster healthcare, team members often struggle to achieve work-life harmony while meeting the demands of a growing population of healthcare clients. The evidence highlights nurse leaders as one group for which the identification and implementation of work-life balance interventions is crucial.

METHODS: An original tool based on available evidence was developed and used with a group of nurse leaders participating in an educational activity to engage them in behaviors supporting work-life harmony. A post-educational survey …

Optimizing The Assisted Living Experience: Integration Of Value-Based Care To Foster Augmented Resident-Centered Quality, Jennette Pietrzak

DNP Scholarly Projects

Background: Fee-for-Service models are quantity-focused reactive approaches and have historically been at the forefront of healthcare. Value-based models focus on proactive, resident-centered care that is aimed at quality care over quantity. Implementation of ValueBased Care models can positively impact healthcare and fiscal outcomes

Purpose: The quality improvement project aimed to develop, integrate, and implement a valuebased model in Memory Care as an alternative to traditional Fee-for-Service models. The project aimed to improve key performance indicators by reducing hospitalizations, emergency room visits, and falls following the implementation of Value-Based Care (VBC) models.

Method: Data metrics for hospitalizations, emergency room visits, and …

Evaluating The Impact Of Simulation On Perceived Knowledge And Confidence Of New Graduate Nurses (Ngns) In Maternal-Newborn Care, Disa Seymour

DNP Scholarly Projects

Abstract

Background: Nursing education worldwide varies in duration and training process, with nurses often facing rapid immersion into patient care complexities when entering the workforce. While new nurses contribute significantly to the nursing community with contemporary knowledge, their transition to practice can be daunting, necessitating support for both competence and retention. As specialty care settings integrate more new graduate nurses (NGNs) to address workforce shortages, collaboration between leaders and educators becomes crucial. Simulation emerges as a vital tool in building confidence while learning, offering a safe space for skill development and growth of confidence.

Purpose: This project’s objective was to …

Impact Of Personal Continuous Glucose Monitor Use During Hospitalization On Rates Of Hypoglycemia And Provider Confidence, Rebecca Longo

DNP Scholarly Projects

Continuous Glucose Monitors (CGMs) are an essential tool for managing diabetes in the outpatient setting, helping individuals achieve glucose goals. However, CGMs are not currently FDA-approved for use in the hospital setting. Despite this limitation, many individuals continue using their personal CGM during hospitalization or begin using them prior to discharge if the care team believes the technology will support glucose management during and after leaving the hospital.

This project aimed to evaluate whether individuals using personal CGMs during hospitalization experienced less hypoglycemia and whether reviewing CGM data could improve provider confidence in insulin dosing. While initiating CGM use during …

Enhanced Neuroprotection And Neuropromotion In Extremely Premature Infants Through Mindful Hands-On Care And Increased Family Involvement, Kristen Sergott

DNP Scholarly Projects

Background: Medical breakthroughs including antenatal corticosteroids and exogenous surfactants have improved survival in extremely premature and extremely low birth weight (EP-ELBW) infants. Currently, babies as young as 22 weeks’ gestation are being actively resuscitated and provided with intensive care in neonatal intensive care units (NICUs) around the world. As a consequence of premature delivery, fragile and immature newborns are at risk for significant morbidities affecting their multiple organ systems. Additionally, such infants encounter neurodevelopmental trauma induced by recurrent stressful experiences ubiquitous to the NICU. Postnatal stress contributes to alterations in the hypothalamic-pituitary-adrenal (HPA) axis and is associated with alterations in …

The Impact Of Language Preference & Health Literacy On Home Exercise Program Adherence Among Outpatients In Hand Clinics, Samantha Lemus Ot/S, Kathryn Burke Otd, Otr/L, Laura Thibeau Mot/L, Cht

Occupational Therapy Doctorate Capstones

Objectives:

Aim: To increase quality care through improving HEP adherence & comprehension with the use of health literacy strategies and language accessibility Research

Question: What is the Impact of Language Preference & Health Literacy on Home Exercise Program Adherence Among Outpatients in Hand Clinics?

Program Evaluation Case Study: Infectious Disease Reporting Training Program Evaluation, Emily Sekkath Veedu

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

The Lexington-Fayette County Health Department (LFCHD) has developed an educational program aimed at Fayette County Public Schools (FCPS) health and athletics staff members to ensure timely reporting and action in the event of an infectious disease outbreak (4). The program was implemented after a methicillin-resistant staphylococcus aureus (MRSA) outbreak occurred in a Kentucky community, with a high school football team presenting several of the cases (4). It was noted by a school nurse that many people attending an informational session lacked knowledge regarding infection control, suggesting a need for intervention in this community. I have evaluated this program in the …

Recent Trends In Stimulant Prescribing In Kentucky, 2021-2023, Jordan Shannon

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

Abstract

Introduction

Prescription stimulants have a long history of clinical use dating as far back as the 1930s. In the United States stimulant prescribing rates have steadily climbed over the last 3 decades. The primary objective is to describe recent (2021-2023) prescribing trends of stimulant medications in the Commonwealth of Kentucky

Methods

Prescription data collected from Kentucky’s prescription drug monitoring (PDMP) database known as the Kentucky All Schedule Prescription Electronic Reporting System (KASPER). Annual and quarterly trends in stimulant prescribing between 2021-2023 were calculated, examined by age, sex, and geographic location.

Results

Stimulant prescribing increased by ~15% where the majority …

An Integrative Somatic Art Therapy Approach: Emdr & Body-Based Practices For Traumatic Stress, Alexis Sorbara

Art Therapy | Doctoral Dissertations

This research project used a mixed method, within subject design to explore how trauma-informed somatic art therapy and Eye Movement Desensitization Reprocessing (EMDR) therapy impacts symptoms of trauma and burnout. There is limited qualitative research on integrating art therapy with EMDR in a group setting. Art therapy can act as a container, or safe holding environment (Winnicott, 1971) for the limitations of EMDR therapy. This research addressed the implications of integrating art therapy and EMDR therapy as a trauma treatment for healthcare professionals. This research study followed the eight phases of EMDR treatment, using a combination of resourcing, a series …

Implementation Of Unit-Based Preceptor Orientation: The Effects On Perceived Orientee Competence And Self-Confidence Of The Precepting Cvicu Nurse, Laura K. Marcum

DNP Projects

Purpose: The purpose of this study was to assess how unit-specific preceptor training impacted the perceived readiness of new graduate nurses, self-confidence of preceptors, and the correlated job satisfaction.

Background: The nurse attrition rate is resulting in inexperience at the bedside. Nursing inexperience leads to lower quality patient care. If improving the efficiency of training and education can improve perceived readiness, then in turn we can increase the longevity of our new nurses. Improving the longevity of nurses has significant implications on the budget of each hospital, the patient outcomes, and the staff’s resulting job satisfaction.

Methods: New graduate nurse …

Say No To Drugs: Nonpharmacologic Interventions For Preventing Delirium In Critically Ill Patients Intubated & Sedated In A Pediatric Icu, Jessica C. Ellzey

DNP Projects

Background. Delirium is an acute clinical syndrome that is characterized by features of disrupted arousal, attention, cognition, sleep, and perception. Delirium is a well-documented phenomenon in critical care settings in both adult and pediatric populations, particularly among patients with length of stay greater than or equal to 48 hours. Delirium has multiple adverse effects, including increased mortality rate, prolonged duration of mechanical ventilation, higher reintubation rates, prolonged intensive care unit (ICU) admission, prolonged hospital admission, short- and long-term cognitive impairment, and posttraumatic stress disorder. There are currently no accepted guidelines or FDA approved medications to treat ICU delirium in the …

Evaluating Healthcare Workers’ Knowledge, Attitudes, And Practices Regarding Language Access Services In The Clinical Setting, Rachel Archibald

DNP Projects

Background: Barriers to accessing and understanding healthcare can place patients with low English proficiency at an increased risk of poor health outcomes. Language-based inequities in healthcare exist due to lack of interpretation and translation services available, lack of healthcare workers’ knowledge of resources, and/or perceptions that these services require too much time or effort. Failing to address barriers affecting this population leaves them vulnerable in the healthcare setting.

Purpose: The purpose of this DNP project was to educate nurses, providers, and staff on an inpatient unit at a rural hospital of the language interpretation resources available, best practices for implementation, …

Evaluating The Effect Of Sleep Hygiene Education On Sleep Quality Among First-Year College Students, Caroline Lowe Cunningham

DNP Projects

Abstract

Background: The American Academy of Sleep Medicine recommends college students should get seven to nine hours of sleep each night. Only one-third currently meet this recommendation. Poor sleep negatively affects academic performance, mood, and interpersonal relationships. Sleep hygiene is recommended to improve sleep quality and quantity.

Purpose: The purpose of this DNP project was to determine the effect of implementing a sleep hygiene educational intervention in classes intended for first-year college students at the University of Kentucky.

Methods: This quasi-experimental project utilized the Pittsburg Sleep Quality Index to assess participants’ sleep before an in-person sleep hygiene education and after …

Rural And Urban Clinician Views On Covid- 19’S Impact On Substance Use Treatment For Individuals On Community Supervision In Kentucky, Carrie B. Oser, Maria Rockett, Sebastian Otero, Evan Batty, Marisa Booty, Rachel Gressick, Michele Staton, Hannah K. Knudsen

Center on Drug and Alcohol Research Faculty Publications

Background The COVID-19 pandemic produced system-level changes within the criminal legal system and community-based substance use disorder (SUD) treatment system with impacts on recovery efforts. This study examines rural and urban clinicians’ perspectives of COVID-19 on SUD treatment delivery for people on community supervision.

Methods Virtual qualitative interviews were conducted between April and October 2020 with 25 community supervision clinicians employed by Kentucky’s Department of Corrections (DOC), who conduct assessments and facilitate community-based treatment linkages for individuals on probation or parole. Transcripts were analyzed in NVivo using directed content analysis methods.

Results Clinicians were predominantly white (92%) and female (88%) …

Scales For Participant Alliance With Recovery Coach (Sparc): Initial Development And Pilot Test, Amanda Fallin-Bennett, Martha Tillson, J. Matthew Webster, Carrie B. Oser, Jennifer Edwards Becan, Kevin Knight, Jeremy Byard, Michele Staton

Center on Drug and Alcohol Research Faculty Publications

Recovery coaches are individuals with lived experience with recovery from substance use disorder who typically engender a greater sense of trust than found with other types of healthcare providers. However, there currently are no validated tools that measure the connection between recovery coaches and their participants. The purpose of this study was to describe the initial development of the Scales for Participant Alliance with Recovery Coach (SPARC) to measure recovery coach connection or alliance, including initial psychometric analyses. Measurement development began with five scales of the Client Evaluation of Self Treatment (treatment participation, treatment satisfaction, rapport, peer support, and social …

Implementation Of Advanced Airway Management Course: A Pilot Quality Improvement Project For Improved Emergency Outcomes For Operating Room And Pacu Nurses, Elizabeth Patry

DNP Scholarly Projects

Background: Airway management has always been central to critical care; it is a complex skill to learn and necessary for patient survival. To properly care for a patient’s airway, the provider must fully understand airway anatomy including upper and lower anatomy and how they work together to allow for oxygen transportation (Day, 2022). Unfortunately, many nursing school curriculums and department orientations are not able to provide the level of education and training necessary. Due to an extreme nursing shortage, many hospitals are not able to provide in depth orientations upon hire and annual review, this lack of professional support affects …

Effectiveness Of Diversion Tube On Peripheral Blood Culture Contamination Rates From Intravenous Catheters In A Community Hospital Emergency Department, Anne Meginniss

DNP Scholarly Projects

BACKGROUND: Obtaining blood cultures is routine care for patients who are suspected to have sepsis. Contaminated blood cultures can lead to increased healthcare costs for patients suspected of sepsis. Reducing contaminated specimens could improve the quality of care delivered as well as increase patient satisfaction.

AIM: This quality improvement project aimed to reduce the number of contaminated blood cultures in a community hospital emergency department by using an initial specimen diversion tube to meet the new national benchmark of below 1% contamination rate.

METHODS: Twenty-seven diversion specimens were collected over an eight-week period via initial intravenous catheter insertion in a …

Enhancing Safety Surveillance During Clinical Trials: The Development Of A Safety Data Review Handbook To Support Pharmacovigilance Clinicians, Lauren Wilson

DNP Scholarly Projects

Abstract

BACKGROUND: Pharmacovigilance (PV) Sciences include activities related to safety surveillance of pharmaceutical products, and is critical for developing safe and effective medications, vaccines and medical devices. Safety monitoring starts with preclinical research and continues through clinical trial and post marketing phases. PV scientists ensure patient safety during clinical trials through regular review and analysis of safety data. Regulations have become increasingly complex, leading to inadequately defined methods for reviewing large clinical trial safety datasets. Inconsistent safety data review (SDR) practices can result in delayed detection of adverse drug reactions (ADRs) or safety signals.

METHODS: This quality improvement project used …

Rocky Mountain Spotted Fever, An Old Disease With A “Second Life”, Anna Walick, Lorenza Beati Ziegler

Eagles Talking About the Public’s Health

No abstract provided.

Digital Health Disparities And The Unmet Challenges Of Access And Literacy, Pranavi Akkinepally, Jackie Mesenbrink, Tilicia Mayo-Gamble

Eagles Talking About the Public’s Health

No abstract provided.

Bringing Large Language Models To Ophthalmology: Domain-Specific Ontologies And Evidence Attribution, Aidan Gilson

Yale Medicine Thesis Digital Library

Background: In the landscape of medical innovation, Large Language Models (LLMs) represent a groundbreaking advancement, holding substantial promise for reshaping healthcare practices. These models demonstrate remarkable proficiency in assimilating and processing extensive medical literature, facilitating rapid information retrieval. Nevertheless, when applied to the specialized domain of ophthalmology, LLMs encounter significant hurdles owing to the intricacies inherent in this field. Ophthalmology, characterized by the intricate interplay of ocular anatomy, diverse disease manifestations, and nuanced diagnostic subtleties, poses considerable challenges for these generalized models. Compounding these challenges is the inherent limitation of the ophthalmological corpus itself, which remains notably narrower compared to …

Population Attributable Fraction Of Reproductive Factors In Triple Negative Breast Cancer By Race, Rachel Jaber Chehayeb

Yale Medicine Thesis Digital Library

Age-adjusted incidence rates of triple negative breast cancer (TNBC) are higher in Black women than in non-Hispanic White (White) women. The disproportionate incidence of TNBC in Black women partially drives the 40% higher mortality rate from breast cancer in Black women compared to White women. Several studies have identified lack of breastfeeding and younger age at first birth as risk factors for TNBC. There are large differences in breastfeeding uptake, breastfeeding duration, and the distribution of age at first birth across racial groups in the US: only 44% of Black women breastfeed for 6 months or longer, compared to 60% …

Health Status Changes After Stenting For Stroke Prevention In Carotid Artery Stenosis, Jonathan Kluger

Yale Medicine Thesis Digital Library

Background: Clinical trials for carotid artery stenosis treatments have focused primarily on mortality, stroke, and myocardial infarction (MI), but less is known about the effects of carotid revascularization on health status. Our three aims were (1) to establish minimal clinically important differences (MCIDs) as thresholds for meaningful patient-reported clinical improvement for those undergoing transfemoral carotid artery stenting (TF- CAS), (2) to study the distribution of changes in health status 30 days after TF-CAS, and (3) to describe the clinical characteristics of patients who improved significantly after treatment.Methods: Using the Stenting and Angioplasty with Protection in Patients at High Risk for …

“Teen Health” Empowers Informed Contraception Decision-Making In Adolescents And Young Adults, Christina Lepore

Yale Medicine Thesis Digital Library

Adolescents and young adults (AYAs), here defined as aged 13-25 years, face uniquechallenges in accessing sexual and reproductive health information. Interactive internet resources provide a free, private and personalized opportunity to help AYAs make informed contraception choices. We designed an original website called “Teen Health” to provide age-appropriate and evidence-based SRH education to AYAs, as well as an interactive contraception education tool (CET). We introduced “Teen Health” to AYAs in a clinical setting and observed trends in contraception preference after website exposure. We hypothesized that “Teen Health” would support informed contraception decision-making.

A convenience sample of AYAs were recruited from …

Regulation And Payment Of New Medical Technologies, Osman Waseem Moneer

Yale Medicine Thesis Digital Library

Our health care system should promote the development and useof innovative medical products, while simultaneously discouraging the marketing and adoption of unsafe or unnecessary products. In the United States, two federal agencies within the Department of Health and Human Services are responsible for administering policies directed toward these aims. The Food and Drug Administration (FDA) evaluates safety and effectiveness for market authorization of medical technologies while the Centers for Medicare & Medicaid Services (CMS) determines whether coverage is “reasonable and necessary” for its beneficiaries. Through a series of three investigations, this thesis evaluates federal policies for the regulation and payment …