Medicine and Health Sciences Commons^™

Doubling Down On Sepsis: A Quality Improvement Project To Improve Sepsis Bundle Compliance On An Inpatient Oncology Unit, Kayla Slay

Dissertations

Problem: Sepsis is a leading cause of death worldwide, and the second most common cause of death in cancer patients. Early management of sepsis through use of sepsis bundles have been shown to improve patient outcomes, yet bundle adherence is unfortunately inconsistent.

Methods: A two-nurse team, called the Sepsis Sidekicks, was a process improvement initiative to increase compliance with the center for Medicare and Medicaid Services (CMS) sepsis bundle and improve patient outcomes related to sepsis. The observational quality improvement project utilized a Plan-Do-Study-Act (PDSA) model over a six-week period where quantitative data was collected using a retrospective chart review. …

Treatments For Cancer Given Orally: Patients' Perceptions Of Distress Due To Financial Toxicity, Ellen Carr

Dissertations

Purpose/Aims: For adult participants who have received or are receiving treatment for hematologic and solid tumor malignancies given orally, this study describes the relationship between participants’ experience of financial toxicity (FT), the participants’ perception of distress associated with FT, and participants’ self-identified adherence to prescribed treatments in the context of FT.

Background: FT has emerged as an additional source of distress for cancer patients. The costs of treatments given orally can be prohibitively expensive for patients. Therefore, these patients may experience considerable distress and may not adhere to treatments as prescribed.

Method: Descriptive cross-sectional correlational design study of a sample …

Mitochondria Imaging And Targeted Cancer Treatment, Tinghan Zhao

Dissertations

Mitochondria are essential organelles as the site of respiration in eukaryotic cells and are involved in many crucial functions in cell life. Dysfunction of mitochondrial metabolism and irregular morphology have been frequently found in human cancers. The capability of imaging mitochondria as well as regulating their microenvironment is important both scientifically and clinically. Mitochondria penetrating peptides (MPPs), certain peptides that are composed of cationic and hydrophobic amino acids, are good candidates for mitochondria targeting. Herein, a novel MPP, D-argine-phenylalanine-D-argine-phenylalanine-D-argine-phenylalanine-NH₂ (rFrFrF), is conjugated with a rhodamine-based fluorescent chromophore (TAMRA). The TAMRA-rFrFrF probe exhibits advantageous properties for long-term mitochondria tracking of …

Implementation Of National Pediatric Guidelines To Prevent Chemotherapy Induced Nausea And Vomiting In Children With Cancer, Taryn Sandheinrich

Dissertations

Purpose: The purpose of this study was to assess the use of supplemental, as needed (prn) pharmacologic interventions for uncontrolled acute chemotherapy induced nausea and vomiting (CINV) in children with cancer after implementation of new pediatric CINV prophylaxis guidelines. Description of Project: A retrospective chart review was completed on forty-three children admitted to the hospital for chemotherapy during a 3 month period in 2017 to document the use of medications given for acute breakthrough CINV. The pre-implementation group received anti-emetics based on the institutional standard of care. A second retrospective chart review was completed on thirty-three children admitted to …

The Lived Experience Of Intersectionality Among African American Women With Breast Cancer, Teri D. Armour Burton

Dissertations

African American women (AAW) continue to have breast cancer mortality rates that are 42% higher than White women (De Santis et al., 2015). Researchers suggest that an epistemological approach that integrates the biomedical and feminist models would be more effective in addressing health disparities. The concept of intersectionality, which grew out of the Black feminist movement, provides a lens in which to view the lived experiences of AAW with breast cancer. The intersectionality paradigm attempts to address the marginalized, oppressive, intersecting social existence of AAW through the examination of identity, social class, and power.

This qualitative study applied a descriptive …

The Effect Of Professionally-Facilitated Group Support On Psychological Well-Being Among Clients With Cancer, Joann C. Harper Phd, Ms, Rn

Dissertations

Many persons suffer from cancer, some of whom seek psychological relief through group support. Despite the widely held belief that group support helps, its efficacy has not been consistently evident in the scientific literature. The purpose of this study was to compare the effect of professionally-facilitated group support on the psychological well-being of clients with cancer between persons who participated in professionally-facilitated group support with those who did not. A comparison design measured effect by the Psychological General Well-Being (PGWB) index. Each study enrollee was diagnosed with a new or recurrent cancer within 18 months of study entry. ANCOVA was …

Effect Of Relaxation On Neuro-Immune Responses Of Persons Undergoing Chemotherapy, Patricia K. Taylor Pothier Phd, Ms, Rn

Dissertations

Chemotherapy can be considered both a physiologic and a psychological stressor. Anxiety, nausea, emesis, and immunosuppression are commonly associated with chemotherapy, and may adversely affect the outcome or the process of treatment. Chemotherapy-related anxiety can exacerbate negative side-effects. Some psychological stressors, such as anxiety, can result in down-regulation of certain immune functions. Studies have demonstrated that behavioral interventions, such as specific relaxation strategies, can modify stress-related immune modulation. These behavioral interventions have also been shown to decrease the degree of nausea and vomiting associated with chemotherapy. The purpose of this study was to examine whether a relaxation intervention would result …