Medicine and Health Sciences Commons^™

Enhancing Postoperative Care For Vascular Patients: Pre- And Post-Test Clinical Knowledge Acquisition Of Early Mobilization Education For Interventional Healthcare Providers, Jennifer Wenger

Doctor of Nursing Practice Scholarly Projects

Peripheral vascular disease (PVD) is a chronic, systemic condition that often requires surgical intervention, presenting significant postoperative risks, including complications like thromboembolisms, pneumonia, and delayed functional recovery. Evidence-based practices (EBP), particularly early mobilization guidelines, have proven to improve recovery outcomes but remain inconsistently applied among interventional healthcare providers. The project addresses this critical issue by evaluating the impact of structured educational sessions on interventional healthcare providers’ knowledge and application of mobilization guidelines in postoperative vascular care. Using the John Hopkins Model of Evidence-Based Practice, a quasi-experimental design was adopted to assess the impact of the education. The project includes pre- …

Validating Biomarkers Of Chronic Whiplash-Associated Disorders Through Magnetic Resonance Imaging Techniques, Julia S. Evans, Michael Fishman

SKMC Student Presentations and Publications

No abstract provided.

Early Detection Of Sepsis, Precious Aina

Honors Capstones

Sepsis is a life-threatening condition that occurs because of an infection. Sepsis can lead to shock, SIRS, organ failure, and other emergent conditions. This literature review paper is aimed at determining the early detection of sepsis in patients as well as examining early symptoms of sepsis, the significance of early diagnosis, and the implications for patient safety and treatment. In several studies, they used the early warning scores (EWS) and Machine learning with patients' information, vital signs, prehospital patient data, and physician assessments embedded in it to identify patients at risk for sepsis. One of the studies incorporated a device …

Pulmonary Embolism Response Team In Acute Care Settings: A Scoping Review Of The Evidence, Tia Glover Bsn, Rn, Leslie Asplund Bsn, Rn, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C

Doctor of Nursing Practice Projects

Purpose/Background

Pulmonary embolism (PE) is a critical cardiovascular emergency associated with high morbidity and mortality. Despite its prevalence, traditional PE management often lacks cohesion, leading to suboptimal outcomes. Pulmonary Embolism Response Teams (PERTs) offer a multidisciplinary approach aimed at improving patient outcomes by streamlining diagnosis, facilitating timely interventions, and promoting evidence-based treatment. This scoping review evaluates the evidence supporting PERT efficacy across various clinical and resource-related outcomes with the aim to decrease mortality rates, shorten inpatient length of stay, improve cost efficacy, and minimize adverse events from treatment modalities.

Methods

A comprehensive literature search was conducted using PRISMA guidelines across …

Analysis Of Clinical Outcomes And Cost Effectiveness Of Neuromuscular Blocking Drug Reversal In Patients Classified As Obese, Trevor Mack

Doctor of Nursing Practice Scholarly Projects

Obesity predisposes patients to heightened risks of adverse outcomes following surgery, including residual neuromuscular blockade and postoperative complications. The administration of non-depolarizing neuromuscular agents (NMBAs) is fundamental for muscle relaxation and optimal surgical conditions. However, the subsequent reversal of these blockers with agents like sugammadex or neostigmine is crucial to mitigate these risks. While sugammadex is recognized as a clinically superior choice due to its rapid and more complete reversal, its extensive use is often limited by cost, presenting challenges in obese patients who already face increased susceptibility to complications. This project evaluates the cost-effectiveness of sugammadex versus neostigmine in …

Examination Of Eating Disorder Risks And Body Image Dissatisfaction Among Division Iii Student-Athletes, Maddie Wisener

Masters Theses/Capstone Projects

Eating disorders (ED) and pathogenic behaviors are prevalent concerns among collegiate athletes due to performance pressures and body image expectations. This cross-sectional study examined the risk of ED among 243 student-athletes (Males: 54.9%, Females: 44.3%, Non-Binary: 0.4%) at a private institution in the Midwest. The convenience sample included student-athletes from baseball, basketball, cheerleading, cross country, football, golf, lacrosse, soccer, softball, tennis, track, volleyball, and wrestling teams. The participants were given a demographic survey, the Eating Attitudes Test-26, and Sex-Specific Figural Stimuli Silhouettes to assess eating behaviors and perceived and desired body images. Overall, 22.1% of participants were at risk for …

Development Of A Clinical Pathway For Acute Pain Management As An Element Of The Prevention Of Delirium In Older Adult Trauma Surgery Patients, Stacey Mermigos

Doctoral Scholarly Projects & Capstones

For hospitalized patients, delirium is prevalent and associated with poor outcomes including increased mortality, morbidity, hospital length of stay, and healthcare costs. Although past studies have identified effective interventions to both prevent and manage delirium in critically ill patients, the most widely used evidence is not easily generalized to non-critically ill patients, specifically trauma patients who experience acute pain, serial surgical procedures, and other notable precipitating and predisposing factors. Clinical pathways are structured plans that are useful for encouraging consistent, evidence-based interventions for various medical conditions and situations. At this time, there is no clinical pathway for the prevention of …

A Four-Year Longitudinal Study Of Effectiveness Of Evidence-Based Bundle Practices For Preventing Catheter-Associated Urinary Tract Infections In An Academic Health Care Center, May Mei-Sheng Riley

Doctoral Projects

Catheter-associated urinary tract infections (CAUTIs) significantly contribute to morbidity, prolonged hospitalization, and elevated healthcare costs, underscoring the crucial need for prevention to ensure patient safety. Despite ongoing mitigation efforts, CAUTI prevalence remained a concern in our facility at the time of this study. Catheter insertion and maintenance bundles, a recognized framework utilizing teamwork, collaboration, and focused interventions, were implemented to reduce CAUTIs and improve patient safety. This study evaluated the effectiveness of these bundles in reducing CAUTIs and catheter utilization to identify best practices for enhanced catheter management and care quality.

Preserving What Matters: A Multimodal Approach To Maintaining Fat-Free Mass During Anti-Obesity Medication Based Weight Loss, Sarah Gore

Evidence-Based Practice Project Reports

Weight loss is often associated with reductions in fat-free mass (FFM), which can negatively impact metabolic rate, thermoregulation, bone density, functional capacity, and overall quality of life (Roth et al., 2022; Sedlmeier et al., 2021). This Evidence-Based Practice project aimed to reduce FFM loss in adults prescribed anti-obesity medications (AOMs) for weight management through a targeted, multimodal intervention. Twenty-two patients beginning AOM treatment at a family practice in northwest Indiana were invited to participate, with 19 consenting to enroll. Each participant received personalized guidance, including tailored calorie and protein intake goals to support a hypocaloric, high-protein diet, alongside evidence-based aerobic …

Clinical Guidelines For The Perioperative Management Of Patients With Aortic Stenosis Undergoing Noncardiac Surgery, Owen Diehl

Doctor of Nursing Practice Scholarly Projects

Aortic stenosis (AS) is a common valvular disorder that causes left ventricular (LV) outflow obstruction. The prevalence of AS may increase with the aging population and the widespread availability of diagnostic capabilities like echocardiography. With the increasing patient population diagnosed with AS, the chance of encountering these patients during noncardiac surgery (NCS) increases. Performance of anesthesia is challenging in patients with AS due to the pathophysiological consequences of AS and the hemodynamic changes associated with anesthesia. The patient with AS presenting for NCS is at an increased risk of perioperative major adverse cardiac events (MACEs). This project aimed to determine …

Impact Of Implementing An Updated Cervical Cancer Screening Protocol In The Primary Care Setting, Teri A. Koch

Evidence-Based Practice Project Reports

Cervical cancer is one of the most common types of cancer among women globally. Current screening methods by clinicians include cytology sampling, high-risk human papillomavirus sampling, or co-testing with both methods. These tests may detect cell changes before they become cancerous, yet the uptake of these methods has decreased in recent years (Aginga, 2022; Office of Disease Prevention and Health Promotion, 2023; Popalis et al., 2022; Sung et al., 2021). The primary purpose of this evidence-based practice project was to determine if the implementation of an updated cervical screening protocol improved the linkage of abnormal results to appropriate clinical follow-up …

Bridging The Gap: A Structured Curriculum For Occupational Therapy Students On Level Ii Fieldwork In Acute Care, Caroline Cameron, Otr/L

Post-Professional Occupational Therapy Doctorate Culminating Presentations

Introduction: Students achieve entry-level competence through didactic education and fieldwork (Accreditation Council for Occupational Therapy Education [ACOTE], 2023). However, transitioning from student to practitioner can be challenging (Mason et al., 2020). Research has identified challenging areas globally across fieldwork settings environment (Knecht-Sabres et al., 2013; Mason et al., 2020) and specifically in the acute care. These challenges indicate a compelling need to cultivate lacking skills and close the gap between students' didactic curriculum and clinical placement in acute care, where supervisors have the highest expectations for students (Kemp & Crabtree, 2018).

Objectives: This project aimed to develop an educational program …

Empowering Occupational Therapists: Integrating 3d Printing Into Rehabilitation For Spinal Cord Injury Patients, Juliana Sullivan, Ms, Otr/L, Cbis

Post-Professional Occupational Therapy Doctorate Culminating Presentations

Introduction: Individuals with spinal cord injury (SCI) encounter significant challenges in performing activities of daily living (ADLs). Adaptive equipment (AE) is widely recognized as essential for enhancing ADL participation, which in turn improves quality of life, autonomy, and long-term functional outcomes (Sturm et al., 2021). However, access to AE is hindered by barriers such as lack of personalization, lesion level, financial limitations, and limited rehabilitation access (Hertig-Godeschalk et al., 2017). 3D printing to create custom AE can increase patient satisfaction, adherence, and participation (Schwartz et al., 2019). Occupational therapists (OTs) working in inpatient rehabilitation focus on maximizing patient independence before …

A Multi-Modal Intervention To Improve Identification, Management, And Prevention Of Early Childhood Caries In The Primary Care Setting, Rieley M. Hull

Evidence-Based Practice Project Reports

Early childhood caries (ECC) is the most prevalent chronic childhood disease and, if untreated, can lead to significant long-term health and social consequences, posing a substantial healthcare burden (AAPD, 2023; ADA, 2023; USPSTF, 2021; WHO, 2022). This evidence-based practice (EBP) project aimed to implement a multi-modal intervention to reduce ECC risk factors, prevent new dental caries, and halt the progression of existing dental caries. Conducted in a pediatric primary care setting in West Michigan, the project included patients five and under who received an oral examination and dental caries risk assessment following the AAP’s guidelines. Based on their oral health …

Solute Transport From Synovial Fluid To Articular Cartilage And Subchondral Bone At Different Stages Of Osteoarthritis In A Live Mouse Model, Mengcun Chen, Yanmei Yang, Mingshu Cui, Bin Wang

Center for Translational Medicine Faculty Papers

OBJECTIVE: This study aims to (1) identify a simplified method to preserve sample integrity and maintain original fluorescence distribution; (2) assess the diffusivity of small and large molecules within articular cartilage (AC), calcified cartilage (CC), and subchondral bone (SB); and (3) investigate the changes in solute transport at various stages of osteoarthritis (OA) in a destabilization of the medial meniscus (DMM) murine model.

METHODS: Fluorescent dyes of small and large molecules were injected into the knee joints of live mice. Joints were harvested and rapidly frozen immediately post-euthanasia. Optimal dye concentrations and dwelling times were determined through exploratory studies. Mice …

Improving Communication And Job Satisfaction: Utilizing Team Strategies And Tools To Enhance Performance And Patient Safety (Teamstepps) For Interventional Service Areas, Sukhbinder Kaur Sangha

Doctoral Projects

Purpose: Improved communication and job satisfaction among staff are essential for those working in high-stress critical care environments like the cardiac catheterization laboratory (Cath Lab). The purpose of this investigation was to utilize the quality improvement initiative Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) to improve attitudes and job satisfaction in the Cath Lab. Method: A total of 30 subjects participated in a TeamSTEPPS educational intervention. After obtaining informed consent, a demographic survey, a pre- and post-test TeamSTEPPS Teamwork Attitudes Questionnaire (T-TAQ) and Job Satisfaction Survey (JSS) were administered. The post-test included open-ended questions for feedback …

Alzheimer’S Disease Protective Allele Of Clusterin Modulates Neuronal Excitability Through Lipid-Droplet-Mediated Neuron-Glia Communication, Xiaojie Zhao, Yan Li, Siwei Zhang, Ari Sudwarts, Hanwen Zhang, Alena Kozlova, Matthew J Moulton, Lindsey D Goodman, Zhiping P Pang, Alan R Sanders, Hugo J Bellen, Gopal Thinakaran, Jubao Duan

Duncan NRI Faculty and Staff Publications

Background: Genome-wide association studies (GWAS) of Alzheimer's disease (AD) have identified a plethora of risk loci. However, the disease variants/genes and the underlying mechanisms have not been extensively studied.

Methods: Bulk ATAC-seq was performed in induced pluripotent stem cells (iPSCs) differentiated various brain cell types to identify allele-specific open chromatin (ASoC) SNPs. CRISPR-Cas9 editing generated isogenic pairs, which were then differentiated into glutamatergic neurons (iGlut). Transcriptomic analysis and functional studies of iGlut co-cultured with mouse astrocytes assessed neuronal excitability and lipid droplet formation.

Results: We identified a putative causal SNP of CLU that impacted neuronal chromatin accessibility to transcription-factor(s), with …

Prognostic Value Of Serum And Bronchoalveolar Lavage Fluid Galactomannan Levels In Invasive Aspergillosis: An 8-Year Experience At A Tertiary Cancer Center, Saliba Wehbe, Anne-Marie Chaftari, Ray Hachem, Hiba Dagher, Andrea Haddad, Ann Philip, Ying Jiang, Ramia Zakhour, Peter Bakht, Jishna Shrestha, Peter Lamie, Robin Sherchan, Jennifer Makhoul, Patrick Chaftari, Issam I Raad

Faculty, Staff and Student Publications

Background: Invasive aspergillosis (IA) is a life-threatening fungal infection that primarily affects immunocompromised individuals and has high morbidity and mortality rates, necessitating timely diagnosis and treatment. This study aimed to evaluate the prognostic utility of serum and bronchoalveolar lavage (BAL) fluid galactomannan levels, as well as galactomannan kinetics, in patients with IA.

Methods: We retrospectively reviewed the medical records of patients who were diagnosed with proven or probable IA from March 2016 to April 2024 at a tertiary cancer center. The collected data included patient characteristics, baseline and peak galactomannan levels in serum and BAL fluid, galactomannan trends, and …

Antibiotic De-Escalation In The Intensive Care Unit: Rationale And Potential Strategies, Sarah Singer Matuszak, Lauren Kolodziej, Scott Micek, Marin Kollef

2020-Current year OA Pubs

Antibiotic de-escalation (ADE) is important to help optimize antibiotic use and balance the positive and negative effects of antimicrobial therapy. ADE should be performed promptly, and infections should be treated with the shortest course of antimicrobials as clinically feasible to avoid unnecessary use of broad-spectrum antimicrobials. Several tools have been developed to increase efficient ADE, including rapid diagnostic tests (ex. multiplex PCR), MRSA nasal PCR/culture, and biomarkers. Multiplex PCR and MRSA nasal PCR/culture have been associated with reductions in inappropriate antibiotic use. Procalcitonin, a biomarker, has been associated with shorter antimicrobial durations in some studies; however, widespread use may be …

Transmission Pathways Of Campylobacter Jejuni Between Humans And Livestock In Rural Ethiopia Are Highly Complex And Interdependent, Nitya Singh, Cecilie A N Thystrup, Bahar Mummed Hassen, Menuka Bhandari, Gireesh Rajashekara, Tine M Hald, Mark J Manary, Sarah L Mckune, Jemal Yusuf Hassen, Helen L Smith, Jonathan C Marshall, Nigel P French, Arie H Havelaar, Caged Research Team Members

2020-Current year OA Pubs

BACKGROUND: Campylobacter jejuni and C. coli are the most common causes of bacterial enteritis worldwide whereas symptomatic and asymptomatic infections are associated with stunting in children in low- and middle-income countries. Little is known about their sources and transmission pathways in low- and middle-income countries, and particularly for infants and young children. We assessed the genomic diversity of C. jejuni in Eastern Ethiopia to determine the attribution of infections in infants under 1 year of age to livestock (chickens, cattle, goats and sheep) and other humans (siblings, mothers).

RESULTS: Among 287 C. jejuni isolates, 48 seven-gene sequence types (STs), including …

Healthcare Leadership In Western Societies: Religion, Politics, And Rhetoric, Nelly D. Figueroa-Herrera

Pepperdine Journal of Communication Research

No abstract provided.

Post-Discharge Telephone Intervention With A Clinical Pharmacy Specialist For Gastrointestinal Medical Oncology Patients, Jane E. Rogers, Michael Leung, Amanda Sirisaengtaksin, Jennifer Zadlo, Van Nguyen, Morgan Mace, Wendy Covert, Makenna Smack, Stacy Diao, Zhou Fang, Andrea Landgraf, Mariela Blum Murphy

Advances in Cancer Education and Quality Improvement

Background: Oncology patients are a vulnerable population with medication-related problems spanning across care settings. Gastrointestinal medical oncology (GIMO) patients often have unique medication challenges due to extensive treatment history. High-quality medication reconciliation aids in preventing medication discrepancies and potential adverse events during transitions of care. We conducted a pilot post-hospital discharge intervention with clinical pharmacy specialists for GIMO patients.

Objective: The primary objective was to identify the frequency of medication discrepancies.

Methods: GIMO patients discharged from our hospital were identified and called within 7 days of discharge. Clinical pharmacy specialist telephone encounters occurred between December 2021 and February 2022.

Results: …

Factors Associated With Emergency Difficult Tracheal Intubation And Difficult Airway Management In A Non–Operating Room Setting At A Cancer Treatment Center, Jackson Su, Neil Bailard, Jens Tan, Jeffrey Lim, Catherine Vu, Wenli Dong, Gang Zheng

Advances in Cancer Education and Quality Improvement

Difficult tracheal intubations are reported more often in the emergency non−operating room setting than in the operating setting. To identify the factors associated with emergency difficult intubation (DI) and difficult airway (DA) management in hospitalized patients with cancer, we conducted a single-center retrospective study in hospitalized patients who underwent emergency intubations in a non−operating setting from 2016 to 2019 at a cancer treatment center. Cases of DI (inability to visualize the vocal cords and/or >2 intubation attempts) and DA (DI, advanced airway device use, and/or need for a surgical airway) were included. We reviewed 763 cases; the DI and DA …

Evaluating The Impact Of A Renal Dosing Refreshable Sidebar Report On Appropriateness Of Antimicrobial Dosing At A Large Acute Care Cancer Hospital, Emily Fox, Jovan Borjan, Nancy Vuong, Hannah Aune, Claire Marten, Joshua Hendrickson

Advances in Cancer Education and Quality Improvement

Background: Appropriate antimicrobial dosing is vital in the treatment of patients with infectious diseases, though adherence to guideline recommended doses is often suboptimal.

Outcomes: This study was conducted to evaluate the impact of a renal dosing refreshable sidebar report, which displayed recommendations from a previously developed institutional antimicrobial dosing guide at the time of antimicrobial order entry. The primary outcome was adherence to daptomycin dosing guideline recommendations before and after implementation.

Methods: This was a pre- and post-quasi-experimental study at a 600-bed acute care cancer hospital. Adult patients (≥18 years old) that received daptomycin from February-April 2021 (pre-intervention phase) and …

Volume 11 Full Text, Bjur Staff

Butler Journal of Undergraduate Research

No abstract provided.

The Impact Of Norepinephrine Exposure On Microglia Il-1b Production, Mikyas Telahun, Meah Katz, Kristy Bagley

Research and Creativity Symposium

Neuroinflammation, driven by proinflammatory cytokines, is linked to Alzheimer’s Disease (AD). Norepinephrine (NE) activates microglial adrenergic receptors, potentially increasing IL-1β production. This study investigates the effects of NE exposure on IL-1β production in human microglial cells, using adrenergic receptor-specific antagonists to isolate the effects of α1-AR, α2-AR, β2-AR, and combined α1& β2 -AR pathways. Microglia were treated with 100nM antagonists and exposed to control (0μM), medium (1 μM) or high (10 μM) NE concentrations. Media was collected at 3, 6 and 9 days, and protein content was standardized using a BioRad Protein Assay. IL-1β levels were quantified via ELISA (Sigma). …

Differences In Anxiety Presentation Amongst Collegiate Athletes, Alyssa Garabedian

Honors Projects in Biological and Biomedical Sciences

Anxiety affects millions of individuals, spanning from mild symptoms to life-halting disorders. The symptoms and experiences individuals face in terms of anxiety vary depending on their demographics, as well as living conditions. Athletes are affected by anxiety in different ways than typical non-athlete individuals. Athletes have an entirely different realm of life to consider when thinking about anxiety, and that is, their sporting, competitive life. This study analyzes the symptoms and characteristics of anxiety in college athletes differing by gender and sport type. The data collected through a survey of collegiate athletes at Bryant University will be used to determine …

Smoking Cessation Education In Caregivers Of Pediatric Patients Hospitalized With Asthma Exacerbation, Maya Emptage, Kaitlynn Lineberry, Suzanne Kayali, Bobby Bellflower Dnsc, Nnp-Bc, Faanp, Michelle Rickard Dnp, Pnpac-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Pediatric asthma is rising globally, currently affecting over 300 million individuals and projected to reach 400 million by 2025. This scoping review aims to summarize existing evidence on the impact of providing smoking education to caregivers during hospitalization on reducing pediatric asthma exacerbations, with the goal of encouraging further research.

Methods

The search spanned from August 2022 to November 2024, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Inclusion criteria focused on studies involving human participants and caregivers of children receiving smoking cessation education in relation to asthma exacerbation and hospital admission. Databases searched included …

Addressing Gaps In The Continuum Of Care: A Quality Improvement Project Focused On Adolescent Youth With Depression Symptoms At A School-Based Health Clinic, Leah Nigon

Theses and Graduate Projects

This Doctor of Nursing Practice (DNP) quality improvement project aimed to address gaps in the continuum of care for adolescents experiencing depression symptoms at a school-based health clinic (SBHC) within an alternative learning community school (ALCS) in southeast Minnesota. Adolescent depression rates are on the rise and are only exacerbated by systemic barriers and social determinants of health, requiring improved mental health care access. Guided by Madeleine Leininger’s Culture Care Theory, the project focused on improving follow-up care for students with elevated depression scores on the Patient Health Questionnaire-9 (PHQ-9-M). A tracking system was developed, and the SBHC nurse contacted …

Primary Prevention Of Nicotine Use In The Pediatric Population, Katie N. Ashton

Honors Capstones

This project explores how to prevent nicotine use, particularly e-cigarette use, among adolescents. Nicotine use has been on the rise since e-cigarette devices have been created. This makes it convenient to use nicotine products rather than going outside to light a cigarette. Nicotine use in adolescents is increasing as it is more convenient to use, and many may not understand the adverse health effects of using these devices. Any nicotine use can cause brain, heart, and lung damage. This project explores the factors that encourage adolescents to use nicotine such as the variety of flavors that e-cigarettes are made of …