Medicine and Health Sciences Commons^™

Decreasing Extubation Times Using Adaptive Support Ventilation: A Scoping Review, Daphne Thomas, Cole Vest, Luke Wilson, Shannon Witcher, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background:This scoping review explores the effectiveness of adaptive support ventilation (ASV) compared to conventional ventilation modes in reducing postoperative extubation times in adults undergoing general anesthesia with ventilatory support. Ventilator weaning is a critical determinant of recovery and outcomes in intensive care settings. ASV, a closed-loop ventilation mode, automatically adjusts ventilator parameters based on patient-specific respiratory mechanics and demand to optimize the weaning process. Although promising, evidence regarding ASV’s effectiveness remains inconsistent across different patient populations and surgical contexts.

Methods: A systematic literature search was conducted from August 2023 to December 2024 across PubMed, CINAHL, Medline, JAMA, and Google …

Evaluating The Efficacy Of Discharge Education On Readmission Rates In Pediatric Patients With Chronic Conditions: A Scoping Review, Camden Shaw Bsn, Rn, Cpn, Ashely St. Julien Bsn, Rn, Claire Avant Bsn, Rn, Michelle Rickard Dnp, Cpnp-Ac, Chppn

Doctor of Nursing Practice Projects

Abstract Assignment

Purpose/Background

Children with multiple chronic health conditions account for a significant portion of hospital readmission and healthcare expenses. A scoping review was completed to analyze and summarize the available research regarding the effectiveness of discharge education on readmission rates and associated outcomes in children with chronic conditions. The following PICOT question was created: In pediatric patients with chronic disease, how does a discharge education bundle compared to no discharge education bundle affect readmission rates within 30 days of discharge?

Methods

A systematic approach was utilized for analysis to determine article eligibility. The initial search yielded 30 articles; however, …

Task Demands Influence Search Strategy Selection In Otoconia-Deficient Mice, Ryan M. Yoder, Lucas C. Carstensen, Keshav Jagannathan

Psychology

Introduction: The vestibular system plays a crucial role in visual and non-visual navigation. Our recent study found that signals from the otolith organs are necessary for mice’s use of distal visual cues to guide navigation to an invisible goal. Somewhat surprisingly, however, performance was not significantly impaired on some spatial tasks (e.g., Barnes maze reference memory task), questioning the role of otolith signals in visual navigation.

Methods: We report the results of several additional tests of reference memory performance and search strategy use on two versions of the Barnes maze, in an attempt to establish further understanding of the otolithic …

The Impact Of The Utilization Of Shared Decision-Making Tools In Contraceptive Counseling On Patient Satisfaction In Adolescents: A Scoping Review, Akaninyene Ruffin Msn,Fnp-C, Judith Tunney Bsn, Rn, Mary Katherine Fouquier Phd, Aprn, Cnm, Facnm, Margaret Harvey Phd, Aprn, Acnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background

Robust adolescent contraceptive counseling requires deep understanding of the specific context in which adolescents are receiving reproductive health care. As teen pregnancy rates rise, particularly in places across the Deep South, providers must find ways to engage their adolescent patients about their sexual and reproductive health. Professional organizations like the American College of Obstetricians and Gyencologists and the American Academy of Pediatrics both offirm the need for robust contraceptive counseling for adolescents. The purpose of this is to ascertain the impact of utilizing shared-decision making aids during contraceptive counseling on patient satisfaction in adolescent populations.

Methods

A systematic literature …

Evaluating The Efficacy Of The Implementation Of A Food Insecurity Screening Tool In Identifying Risk Amongst Nicu Families, Jessica Daniels Bsn, Rn, Sahtiah Williams Bsn, Rn, Bobby Bellflower Dnsc, Nnp-Bc, Faanp

Doctor of Nursing Practice Projects

Purpose/Background

Infants admitted to the Neonatal Intensive Care Unit (NICU) are critically ill and at risk of increased infections, developmental delays, and higher readmission rates after discharging due to complex health needs when compared to healthy term newborns. Nutrition has been widely recognized as an important predictor of readmission and developmental delay. However, current practice often does not provide any screening for food insecurity (FI) in NICU families, which assumes security and displays a gap in care surrounding discharge planning. This quality improvement project implements the use of an FI screening tool for NICU families to help practitioners identify FI …

Improving Access To Mental Health Care Using Telehealth, Lavern Palmer

Doctor of Nursing Practice Projects

More than half of adults with mental illness in the United States live in mental health deserts—geographic areas with limited access to mental health services and persistent barriers to care. This study investigates the impact of telehealth implementation on patient no-show rates at a rural community clinic in Georgia. The aim was to determine whether the use of telehealth for psychiatric care would decrease the no-show rate of mental health appointments. A retrospective analysis was conducted using patient attendance logs collected 12 weeks before and after the implementation of telehealth services. Quantitative data were analyzed using a Pearson correlation to …

Nurses Confidence And Knowledge Improvement For Sleep In Sleep Hygiene Education, Rawda Nourain

Doctor of Nursing Practice Projects

The purpose of this DNP project was to increase the knowledge and self-confidence of nurses in relation to sleep hygiene practices for psychiatric patients to improve sleep quality and overall mental health. In this study, a pre- and post-intervention design was used for four nurses in a psychiatric unit. The intervention was comprised of teaching the patients about sleep hygiene practices, altering the environment (light and noise reduction), and using non-drug approaches. Knowledge assessments and self-confidence surveys were used to collect the data. All the participants were able to recall the correct sleep hygiene knowledge after the intervention, and all …

Quality Improvement Project Staff Development For Fall Prevention In Community Living Center, Morayo Olatunbosun

Doctor of Nursing Practice Projects

Falls among elderly residents in the community living center continue to be a serious public health concern, increasing mortality, morbidity, and healthcare costs. Despite existing prevention measures, fall-related incidence remains high. The purpose of this quality improvement project is to reduce fall rate in a community living center by implementing structured staff training. A facility needs assessment revealed gaps in fall prevention knowledge, inconsistent protocol use, and limited staff confidence in managing fall risks. In the methodology used to answer the PICOT question, the Donabedian Model guided structure, process, and outcome evaluation, while Kotter’s Change Model informed implementation strategies. The …

Quality Improvement Project Provider Burnout Related To Patient Satisfaction, Sherita Lee

Doctor of Nursing Practice Projects

Provider burnout is a critical issue in healthcare, often intensified by increasing demands to meet patient satisfaction benchmarks. This quality improvement project aimed to examine whether a structured stress reduction program could reduce provider burnout and positively influence patient satisfaction scores in a small outpatient clinic. Guided by the PICOT question—In the clinic setting (P), does the implementation of a stress reduction program for providers (I), compared to no intervention (C), lead to improved patient satisfaction scores (O) over a six-week period (T)? —the project used a pre- and post-intervention design. The intervention included mandatory provider breaks, communication training, and …

Improving Access To Mental Health Care Using Telehealth, Lavern Palmer

Doctor of Nursing Practice Projects

More than half of adults with mental illness in the United States live in mental health deserts—geographic areas with limited access to mental health services and persistent barriers to care. This study investigates the impact of telehealth implementation on patient no-show rates at a rural community clinic in Georgia. The aim was to determine whether the use of telehealth for psychiatric care would decrease the no-show rate of mental health appointments. A retrospective analysis was conducted using patient attendance logs collected 12 weeks before and after the implementation of telehealth services. Quantitative data were analyzed using a Pearson correlation to …

Enhancing Simulation Debriefing In Nursing Education: A Quality Improvement Project, Rebecca Ray

Doctor of Nursing Practice Projects

This quality improvement (QI) project is of utmost importance as it aims to significantly enhance the debriefing process after simulations in an Associate Registered Nursing Program. The project is designed to equip nursing instructors with a comprehensive guide to facilitate debriefing after simulations, thereby improving student learning outcomes, fostering reflection, and enhancing clinical practice. The lack of consistent and practical guidance during the debriefing process after simulation exercises has been identified as a critical challenge in the nursing program. Without proper guidance, the debriefing process may not achieve its intended outcomes, underscoring the necessity of this project. The intervention at …

Quality Improvement Project The Impact Of Weekly Reminders On Clinician Adherence To Standardized Order Sets, Blair Robillard

Doctor of Nursing Practice Projects

Clinical decision support tools are commonly utilized in clinical practice to assist with decision making and encourage use of evidence-based practices. This quality improvement (QI) project addressed the problem of inconsistent use of CDS tools in clinical practice. Specifically, this QI project addressed suboptimal adherence to standardized order sets (SOS) for congestive heart failure (CHF) treatment by hospitalist providers in an inpatient setting. The purpose of this QI project was to evaluate the impact of weekly educational reminder emails, known as nudges, on CHF SOS utilization over six weeks. A pre- and post-intervention design compared SOS usage rates before and …

Impact Of Nursing Burnout On Preceptors During The Transition Phase Of New Graduates Into The Workforce, Janessa Truss

Doctor of Nursing Practice Projects

There is a massive threat to healthcare systems posed by the growing burnout of inexperienced RNs working in practice transition to new graduate preceptors. Currently, this "Doctor of Nursing Practice (DNP) project" examines the role of the nurse in burnout within Long Term Acute Care (LTAC) facilities through the preceptorship. In the project, burnout factors and their effects on patient care and nursing workforce retention will be investigated, and interventions for burnout and its effects will develop. A mixed methods project involving qualitative and survey and interview analyses of five-year and older patients was performed. Burnout and job satisfaction were …

Quality Improvement Project Empowering Outpatient Providers: A Training Initiative On Social Determinants Of Health, Shannon Wrenn

Doctor of Nursing Practice Projects

Healthcare providers play a critical role in assessing social determinants of health (SDOH), yet many lack the knowledge and confidence to effectively address these factors during patient encounters. Research indicates that SDOH contribute to approximately 80% of health outcomes, yet only 41% of providers feel confident in discussing them with patients. This quality improvement project aimed to improve provider knowledge and confidence about SDOH as measured by pre- and post-education assessments. The SDOH targeted training took place at an outpatient interventional nephrology practice in Memphis, Tennessee. A quasi-experimental, one-group pretest-posttest design was used. Ten clinical staff members participated in an …

Effectiveness Of The Use Of An Opt-Out Script To Increase Hiv Screening In Adolescent Clients In Pediatric Primary Care Clinics In West Tennessee: A Scoping Review, Julie Cupples Msn, Rn, Allison Johnson Ms, Bsn, Rn, Sally Humphrey Dnp, Aprn, Cpnp-Pc

Doctor of Nursing Practice Projects

Purpose/Background

The American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) recommend one-time human immunodeficiency virus (HIV) screening for all adolescents. Pediatric primary care providers are on the front lines of adolescent healthcare and can provide testing that is adolescent-friendly, confidential, and easily accessible. This scoping review aims to synthesize the evidence and assess the literature on the efficacy of using an opt-out script to increase HIV testing in adolescent well-child checks.

Methods

A literature review was conducted between October 2022 and August 2024 to collect studies assessing adolescents aged 12-18, provider-led sex education, and …

The Effect Of Using Pelvic Floor Exercises Administered Through A Smartphone Application In Postpartum Women With Pelvic Floor Dysfunction, Elizabeth A. Russell

Evidence-Based Practice Project Reports

Pelvic floor dysfunction (PFD) affects 50% of postpartum women and can lead to pelvic pain, stress urinary incontinence, fecal incontinence, pelvic organ prolapse, or sexual dysfunction (Grimes, 2023). The purpose of this evidence-based practice project was to determine if the implementation of pelvic floor exercise (PFE) as guided by a smartphone application, to improve adherence and technique of exercises, will improve PFD symptoms and quality of life (QOL). At an OBGYN clinic in northern Indiana, all women who presented for their 6-week postpartum appointment were screened for PFD with the Pelvic Floor Distress Inventory (PFDI-20) and QOL with the Pelvic …

Men’S Preconception Health: Impact On Pregnancy And Awareness Strategies., Kara I. Carr

Honors Capstones

Men’s preconception health plays a critical role in pregnancy outcomes, but it continues to be overlooked in healthcare education. While women are routinely counseled by OBGYN providers on how nutrition, lifestyle, and chronic conditions can affect fertility, men often receive little to no guidance from their primary care providers. This project uses a literature review to look deeper into how limited awareness and involvement in men’s preconception health may impact pregnancy and infant health outcomes. The gap is linked to cultural norms, healthcare practices, and the lack of clear resources for men. This research aims to develop strategies that promote …

What Are The Minimum Dimensions In A Marketing Plan Required For Starting Or Improving Marketing In A Small, New Home Health Agency?, Patrick Baker

MUSC Theses and Dissertations

Objective: To fulfill an unmet need for practical, parsimonious assistance for examples of a practical marketing plan for new, small home health care agencies. The home health (HH) care industry needs customized marketing plans tailored to the unique requirements of small, emerging HH agencies. These plans are essential for navigating the competitive market driven by an aging population and technological advancements. However, the industry's emphasis on this specific aspect is significantly lacking.

Methodology: We reviewed the published literature, numerous books and websites and selected sources that provided practical, small-scale approaches to marketing for health care organizations. We identified specific marketing …

Heavy Metals In Spices From Lancaster, Pa: Arsenic, Cadmium, And Lead Exposure Risks And The Need For Regulation, Andrew Huff, Hoi Lam, Anuj Ghimirey, Jay Goldring, Michelle Pimentel, Harriet Okatch

College of Population Health Faculty Papers

Heavy metal exposure is associated with adverse health effects in children including impaired cognitive functioning. Studies have identified spices as a potential source of heavy metals. However, in Lancaster, PA no such studies have been conducted. Hence the aim of this study was to quantify arsenic (As), cadmium (Cd) and lead (Pb) in spices from Lancaster, PA. Spices were either purchased from stores in Lancaster or obtained as donations from families in Lancaster. As, Cd, and Pb were quantified using inductively coupled plasma-mass spectrometry. The Wilcoxon rank sum test was used to compare the median heavy metal concentrations in store-purchased …

Compassion And Partnerships On An Interprofessional Team, Hannah E. Autenrieth

CAIEP Spring Showcase 2025

Person-Centered Care and Motivational Interviewing can enhance communication, collaboration, and acceptance when working on an Interprofessional Team. The Spirit of MI can help foster a nonjudgemental safe space for the consumer in healthcare and social services, and the team itself. MI can help meet the person where they are, and better recognize systems of power and oppression.

Unlicensed Assistive Personnel’S Attitudes, Knowledge, And Perceptions Of Alternatives To The Application Of Physical Restraints, Gale Marie Knight

Walden Dissertations and Doctoral Studies

The use of physical restraints in mental health care settings is a common practice, yet it poses significant risks to patients’ physical and psychological well-being. The issue of excessive restraint use was addressed through this doctoral project by designing an educational program aimed at promoting alternative strategies. The practice-focused question was: How can an educational program for unlicensed assistive personnel (UAP) impact their knowledge and attitudes towards alternatives to physical restraints? The purpose of the project was to develop and evaluate an education program to improve UAP knowledge and attitudes to reduce reliance on physical restraints. The project was informed …

Determining The Bioaccumulation Of Minor Cannabinoids In Zebrafish Larvae, Kamdyn A. Holt

Honors Theses

Due to the increasing prevalence of cannabis product availability and usage in the modern United States, particularly among pregnant individuals, evaluating the bioaccumulation of minor cannabinoids to further understand the adverse effects of cannabinoids during early development is critical. This study quantitated the uptake of eight minor cannabinoids ((∆8-tetrahydrocannabinol (∆8-THC), ∆9-THC, ∆10-THC, cannabidiol (CBD), cannabigerol (CBG), cannabinol (CBN), tetrahydrocannabivarin (THCV), and hexahydrocannabinol (HHC)) in zebrafish larvae following water-borne 2 µM exposures from 6 to 96 hours post fertilization (hpf). Larvae were homogenized at 96 hpf and analyzed using a gas chromatography- mass spectrometry (GC-MS) method developed in this study. Bioconcentration …

The Impact Of Automated Text Messaging System Education On The Self-Efficacy Of Medical Office Staff, Jim Jorgensen

Doctor of Nursing Practice Projects

Inadequate patient bowel preparation is a leading cause of canceled or repeated colonoscopies, negatively impacting both outcomes and healthcare costs. While automated text messaging systems have improved patient adherence in other clinical areas, they remain underutilized by endoscopy staff due to low self-efficacy. This quality improvement project aimed to evaluate the effect of structured education on the self-efficacy of endoscopy nursing staff in using an automated text messaging system for outpatient colonoscopy preparation at a rural VA Medical Center (VAMC). Guided by Bandura’s Social Cognitive Theory and using the Plan-Do-Study-Act model, this project implemented a one-day, hands-on training session with …

An Unusual Complication Of Diverticular Bleed: Dysphagia And Food Impaction From Black Esophagus, Nicholas Noverati, Beatriz Torre, Maria Mostyka, Cuckoo Choudhary, Christopher Henry, David Kastenberg, Stephanie Moleski

Division of Gastroenterology and Hepatology Faculty Papers

INTRODUCTION: Acute esophageal necrosis, or black esophagus, is a rare clinical phenomenon typically seen in older men after an acute triggering event. It may present with dysphagia due to stricturing or dysmotility, a complication of severe esophageal inflammation.

CASE PRESENTATION: Here we describe a case of a woman with several cardiovascular risk factors who developed black esophagus following diverticular-related hemorrhagic shock and presented with chest pain followed by dysphagia and food impaction likely as a result of mucosal sloughing and altered esophageal motility. The diagnosis was confirmed endoscopically and pathology revealed coagulative necrosis due to ischemia.

DISCUSSION: Acute esophageal necrosis …

Fluorescent Labeling And Size-Dependent Uptake Of Mesoporous Silica Nanoparticles In Ovarian Cancer Tumor Spheroids, Kimberly R. Berardis

Honors Scholar Theses

Ovarian cancer is the most lethal gynecologic malignancy, with most patients presenting at an advanced stage. While surgical debulking improves survival, nonresectable tumors (<1 cm) contribute significantly to morbidity and remain difficult to treat. Nanocarrier-based drug delivery systems offer an innovative approach to targeted therapy and palliation. In vivo models have demonstrated that intraperitoneally delivered mesoporous silica nanoparticles (MSNs) preferentially accumulate in tumors with low systemic exposure, enabling targeted chemo- and radiotherapy.

MSNs are particularly suited for radiotherapeutic delivery, as their strong interactions with tumor extracellular matrices drive selective uptake. Additionally, they exhibit excellent stability under neutron flux, allowing for loading with stable isotopes and irradiation immediately prior to administration. High radionuclide retention after dilution further minimizes systemic exposure and toxicity.

A key …

Design Solutions For Common Problems In Senior Living Facilities, Mary Schmidt

Senior Honors Theses

With the aging population of the United States, the prevalence of dementia rises along with its challenges for individuals in long-term care facilities. As cognitive function deteriorates, dementia patients face growing difficulties in performing daily activities. Common issues such as wayfinding, wandering, exit attempts, agitation, and a generally low quality of life plague most dementia patients at long-term care facilities. Design features can improve quality of life, safety, and coherence for residents with dementia at assisted living facilities. This paper examines existing research to present various design strategies that can enhance daily life for dementia patients in long-term care facilities. …

An Educational Intervention Focused On The Importance Of Nurse Leader Rounds, Shantelle Mobley

Walden Dissertations and Doctoral Studies

Nurse leader rounding (NLR) is essential in most healthcare organizations as NLR has been associated with improved nurse recruitment and retention, increased patient satisfaction, and increased quality of care. In the local organization, leadership identified that there was a lack of knowledge and awareness of NLR among nurse managers and charge nurses. Thus, the purpose of this Doctor of Nursing Practice (DNP) project was to determine if an education intervention focused on structured NLR increased knowledge and awareness among charge nurses and nurse managers. Thirty-seven individuals were invited to participate in the educational intervention. With the support of leadership, 34 …

Effects Of Acute Exercise On Cognition: Consideration Of Potential Moderators, Elizabeth G. Gaines, Mckenzie M. Cotten, Elizabeth Reese Carwile, Mary Griffin Jackson, Marascalco Liston, Lucy Wilson

Honors Theses

The present thesis aims to determine the effects, if any, of six potential moderators on the effects of acute moderate-intensity exercise on cognitive functioning. The modes of exercise undertaken by the participants included treadmill (Experiment 1) and stationary bike (Experiment 2) exercise. Participants in each experiment either exercised or rested for twenty minutes and then participated in either a memory recall task or cognitive functioning (“Stroop”) task. The bouts of either exercise or rest on the stationary bike were followed by a rest period during which the participant would be exposed to either standard air oxygen levels (normoxia) or hypoxic …

Solution-Focused Brief Group Counseling As An Effort To Reduce Phubbing Behavior Among High School Students, Awalya Siska Pratiwi, Arbin Janu Setiyowati, Im Hambali, Siti Syazwani Zulkuple

Jurnal Kajian Bimbingan dan Konseling

The act of phubbing has been observed to disengage from their surroundings, often finding greater comfort in solitude with their mobile phones. The research objective was to ascertain the efficacy of solution-focused brief group counseling to reduce phubbing behavior in high school students. This study employed a quasi-experimental quantitative research methodology with a pretest-posttest control group design. A total of 10 students, exhibiting a high level of phubbing behavior, were divided into two groups: the experimental group and the control group. The results of the Two-Independent-Sample Test-Mann-Whitney U test are presented in the Asymp .sig column, with a value of …

The Potential Of Brain Organoids In Addressing The Heterogeneity Of Synucleinopathies, Xiao-Jun Diao, Claudio Soto, Fei Wang, Yu Wang, Yun-Cheng Wu, Abhisek Mukherjee

Faculty, Staff and Student Publications

Synucleinopathies are a group of diseases characterized by neuronal and glial accumulation of α-synuclein (aSyn) linked with different clinical presentations, including Parkinson's disease (PD), Parkinson's disease with dementia (PDD), Dementia with Lewy Bodies (DLB) and Multiple system atrophy (MSA). Interestingly, the structure of the aSyn aggregates can vary across different synucleinopathies. Currently, it is unclear how the aSyn protein can aggregate into diverse structures and affect distinct cell types and various brain regions, leading to different clinical symptoms. Recent advances in induced pluripotent stem cells (iPSCs)-based brain organoids (BOs) technology provide an unprecedented opportunity to define the etiology of synucleinopathies …