Medicine and Health Sciences Commons^™

A Quality Improvement Initiative To Improve Nurse Reassessment And Documentation Of Administered Prn Pain Medication, Stacy L. Brady

DNP Scholarly Projects

BACKGROUND: Effective pain management remains a critical challenge both globally and with the United States, where more than 51 million adults suffer from pain. Veterans are particularly vulnerable due to the lasting impact of service-related injuries. “Pro re nata” (PRN or “as needed”) pain medications are frequently used to manage pain, but timely reassessment and documentation following a PRN pain medication administered is often missed or delayed. Reassessing and documenting the results after the administration of the PRN pain medication is required by The Joint Commission and the Veterans Affairs Providence Healthcare System’s (VAPHS) standard operating procedure (SOP) states reassessment …

Implementation Of Outpatient Cervical Ripening In The Community Hospital Setting: A Quality Improvement Process, April St Hilaire

DNP Scholarly Projects

Background: Cervical ripening is a critical component of labor induction. Outpatient cervical ripening using mechanical dilators offers a safe patient- centered alternative to inpatient management, with potential benefits in efficiency and patient satisfaction and cost savings.

Local Problem: At a community hospital setting with increasing induction rates, prolonged admission-to-delivery times and prolonged patient stays were observed in patients undergoing inpatient cervical ripening, prompting a need for more efficient, patient centered approaches.

Methods: Using the Plan-Do-Study-Act (PDSA) framework, an outpatient cervical ripening protocol was implemented over a 15-week period to compare inpatient versus outpatient cervical ripening using mechanical …

The Effect Of Non-Contact Boxing On Occupational Performance Of Individuals With Parkinson's Disease: A Case Series Design, Ruben Blanco Ot/S, Sheridan Ferland Otd, Otr/L

Occupational Therapy Doctorate Capstones

Parkinson’s Disease (PD) is a neurodegenerative disease that negatively impacts occupational performance due to the effect it has on motor and nonmotor skills. Research suggests that forced intense exercise such as noncontact boxing improves these motor and nonmotor symptoms in individuals with PD. Unfortunately, there is no literature that determines a direct link to noncontact boxing and an improvement in occupational performance for individuals with PD. This study aims to make this direct link using the Rock Steady Boxing (RSB) protocol.

The Impact Of A Community-Based Motor Performance Program On Children And Adolescence With Neurodivergent Conditions, Isabella Catarina Ots, Tania Rose Otd, Otr/L, Brooke Tubbs Otd, Otr/L

Occupational Therapy Doctorate Capstones

Site Description:

Gnome Surf

• A non-profit organization committed to inclusive therapy for all children, regardless of ability or financial background.

• Surf Therapy: Uses the therapeutic elements of water and the joy of surfing to improve physical and mental health. Providence Parks and Recreation.

• Includes a gymnasium, indoor pool, play areas, and multipurpose field.

• After-school program offers rotating programming.

Research Question, Aim, and Purpose:

PICO: What is the impact of community-based motor programming on motor performance in children & adolescents with neurodivergent conditions.

Aims: Enhance participants' motor abilities, socialization, and general well-being through a therapeutic Surf-Fit program. …

Teaching And Learning Approaches To Improve Staff Training At Empowersci, Amanda Bastos Ot/S, Monique Dawes Otd, Otr/L, Cpam

Occupational Therapy Doctorate Capstones

Empower SCI: A non-profit organization for individuals with SCI Mission of Empower SCI: “To propel individuals living with spinal cord injuries on their path to a fully actualized, more independent life through immersive programming and community support” (Empower SCI, n.d.)

Purpose: develop an evidence-based orientation program for new staff and to provide EmpowerSCI with a more uniform and effective training protocol that will improve participant safety and experiences, as well as staff caregiver confidence.

Research Question: How will an evidence-based orientation and training program impact knowledge and task performance in personal care staff at EmpowerSCI?

Impact Of Power Tilt Functions On Users Independence, Functional Reach, And Overall Quality Of Life, Jordan Dodge Ots, Andrea Fairman Phd, Otr/L, Atp, Jennith Bernstein Pt, Atp/Sms, Heather Cianciolo Otr/L, Atp/Sms

Occupational Therapy Doctorate Capstones

Background:

• There is significantly limited information regarding the functional benefits of using power tilt functions.

• Insurance, specifically Medicare, will only cover these functions under limited circumstances.

• This project intended to collect further data that highlighted the functional benefits of power tilt functions to further advocate for increased insurance coverage.

Increasing Self-Efficacy Through A Wellness Program For People With Parkinson’S Disease And Their Care Partners, Abby Clark Ot/S, Sheridan Ferland Otd, Otr/L, Carolyn Kosiba-Quiterio Cpt, Crs, Cgx, Sf

Occupational Therapy Doctorate Capstones

Site Description:

Rock Steady Boxing is a nonprofit organization that gives people with Parkinson’s disease the opportunity to improve their quality of life through non-contact boxing, stretching and various exercises (Rock Steady Boxing, 2024). Locally, Rock Steady Boxing East Greenwich (RSBEG) has approximately eighty athletes enrolled.

Aim & Purpose:

Aim: To provide a comprehensive wellness education program on various PD related topics for people who participate in RSB class.

Purpose: To explore the impact of wellness education on self-efficacy to improve physical and mental outcomes for those with PD, thereby addressing a gap in current literature. Question: Does wellness education …

Technology Use By Skilled Nursing Facility Residents To Enhance Leisure Participation And Overall Quality Of Life, Madisyn Frederick Ots, Shannon Strate Otd, Ms, Otr/L

Occupational Therapy Doctorate Capstones

Site Description:

• 120-bed skilled nursing and rehabilitation center located in Providence, RI

• Comprised of 3 units: short-term rehabilitation services, long-term skilled nursing care, and memory care

Research Question: Is technology use an effective form of leisure engagement for improving the quality of life for long-term skilled nursing facility residents?

Project Goals:

•Identify an effective means for enhancing leisure participation amongst residents

•Assess residents’ relationship with technology and identify barriers or oppositions to use

•Provide Steere House with an effective solution to their lack of resident leisure engagement

Impact Of Self-Directed Goals For Long-Term Patients In A Forensic Hospital: A Mixed-Methods Study, Chapin Graham Ot/S, Nancy Dooley Phd, Otr/L, Faota, Natalie Petrucci Msot, Otr/L

Occupational Therapy Doctorate Capstones

Purpose: To determine the impact of self-directed goals for long-term patients in a forensic hospital. This was a single group, pre-and post-test study.

Setting: Rhode Island State Psychiatric Hospital (RISPH). Forensic settings are where people with mental illness who have allegedly committed crimes gain competency to stand trial and undergo treatment for their mental illness.

Evaluating The Effectiveness Of Occupation-Based Programming On The Sexual Health Literacy Of Older Adults Living With Hiv, Riley David Ots, Kathryn Burke Otd, Otr/L

Occupational Therapy Doctorate Capstones

Background:

• Two-thirds of adults aged 65+ express interest in sex, and over 50% report sexual activity as important to their QOL (1).

• Sexually transmitted infection (STI) among adults aged 55+ have more than doubled over the past decade (2).

• Of the 1.1 million people living with HIV (PLWH) in the US, 54% are aged 50+; this age group accounts for 16% of new HIV diagnoses (3).

• OTs are uniquely positioned to address sexual engagement for adult of all ages.

• Promoting safe, pleasurable sexual engagement among aging communities requires access to age-affirming, comprehensive sexual health education. …

Impact Of Multimodal Education On A Caregivers’ Lived Experience In Mobility Options For Children, Nicole La Rochelle B.S., Ot/S, Andrea Fairman Ph.D., Mot, Otr/L, Atp, Drp, Christina Gagosian M.S., Otr/L, Chelsea Maziarz Ms, Otr/L, Cas, Heather Cianciolo Otr/L, Atp/Sms, Jennith Bernstein Pt, Dpt, Atp/Sms

Occupational Therapy Doctorate Capstones

Caregivers desire quick and efficient ways to access educational materials for their child utilizing mobility tools such as the Explorer Mini. There is a lack of research surrounding receptivity to the provision of pediatric power mobility educational materials despite evidence of its benefits. The findings of the Capstone research showcase that when caregiver education is designed universally, caregivers express the ability to make more informed decisions regarding their child's on-time mobility.

PIO QUESTION: How does multimodal education impact caregivers’ lived experience in mobility options for children ages 12-36 months?

PURPOSE: To conclude which multimodal educational materials are needed to provide …

Incorporating Nostalgia Into Purposeful Activity To Enhance Social Engagement In Skilled Nursing Facilities, Samantha Mcgowan Ots, Shannon Strate Otd, Ms, Otr/L, Suzanne Mcevoy Ctrs

Occupational Therapy Doctorate Capstones

Research Question, Aim, Objective:

PIO Question: How can incorporating nostalgia into purposeful activity impact social engagement of residents in a skilled nursing facility?

Research Themes:

• Long-term care impact social engagement (Lem et al., 2021).

• Nostalgia can be used as a mediator and regulator (Van Tilburg et al., 2015).

• Nostalgia influences behavior and self-esteem

• Nostalgia transforms meaning in life.

• Nostalgia has a positive impact on social connectedness (Reid et al, 2015; Sedikides & Wildschut, 2018).

• Types of nostalgia interventions: Music, Scents, Taste, Image, Written.

Services For Persons With Limited English Proficiency Within Medicaid Home And Community-Based Service Waivers On The East Coast: A Content Analysis, Amina Meky Ots, Andrea Fairman Ph.D., Mot, Otr/L, Atp, Drp, Gina Novario Otd, Otr/L

Occupational Therapy Doctorate Capstones

Objective & Aim:

To analyze limited English proficiency (LEP) resources and assistive technology (AT) services within home community-based service (HCBS) waivers on the East Coast to identify gaps that may impact healthcare access and equity for LEP individuals.

Advocating Ot Services Among Medical Providers, Jazzy Montgomery Bs, Ots, Shannon Strate Otd, Ms Otr/L

Occupational Therapy Doctorate Capstones

Purpose & Aim:

Question: Will developing a continuing education course for occupational therapy practitioners enhance their advocacy skills in promoting occupational therapy services among medical providers?

Aim/Purpose: Develop tools and solutions to advance advocacy skills for OTPs, empowering and equipping them to educate medical providers on the full scope of occupational therapy.

Implementing An Enviornmentally Interactive Restorative Nursing Program, Geraldine Gibson Bs, Ots, Shannon Strate Otd, Ms, Otr/L

Occupational Therapy Doctorate Capstones

Research Question: Will the implementation of an environmentally interactive Restorative Nursing Program increase resident’s participation and improve overall quality of life?

Aim: Through the unique perspective of Occupational Therapy, this projects aims to provide an intrinsic purpose and motivation for residents as well as motivate staff by providing the necessary tools to encourage participation in the residents.

Purpose: To enhance the restorative nursing program at Steere House by incorporating environmentally interactive activities and provide staff training to increase carryover.

The Post-Acute Functional Interventions Impact On Quality Of Life: Spinal Cord Injury, Caitlyn Nicholson Ot/S, Monique Dawes Otd, Otr/L, Cpam

Occupational Therapy Doctorate Capstones

Individuals diagnosed with a SCI are commonly discharged from out-patient OT services after working on functional impairments and not on occupations that are meaningful. This study looks at GAS data from a community-based program, to determine what occupations are important to the SCI population but aren’t being addressed in traditional OT settings, and what about the program helped and/or limited goal attainment.

Occupational Therapy Services Within An Enhanced Psychiatric Rehabilitation Residential Facility, Cole Scott Ots, Nancy Dooley Phd, Otr/L, Faota, Alison Johnson Otd, Otr/L

Occupational Therapy Doctorate Capstones

The Site and Purpose:

Monarch is a company based in North Carolina. Putnam Pike is it’s first Rhodes Island based service. It is recognized as an Enhanced Mental Health Psychiatric Rehabilitation Residential Facility. This was an internal quality improvement project to support this new residential facility.

P.I.O. Question: How do occupational therapy services support the occupational wellbeing of residents with serious and persistent mental illness in rehabilitation residential facilities?

Pelvic Floor Therapy Education For Clients And Practitioners, Kiara Slaughter Otd/S, Kathryn Burke Otd, Otr/L, Leanne Monteiro Pt, Dpt

Occupational Therapy Doctorate Capstones

Site Description:

Highbar PT is an outpatient physical therapy clinic that provides specialized pelvic health therapists in 9 locations.

These therapists address diagnoses related to pelvic floor dysfunction: Pelvic pain, lower back pain, pelvic organ prolapse, urinary and fecal incontinence and urgency, constipation, pain with sex, and erectile dysfunction. Prenatal and postpartum pelvic health dysfunction is also addressed.

PIO and Purpose Statements:

PIO: Does increasing readability improve client understanding of pelvic health educational materials?

Purpose Statements:

1. Creation of pelvic health educational tools for internal use for Highbar PT providers

2. Revision and creation of educational material to address the …

The Effect Of Surf Therapy On Mental Health, Sydney Smallwood Ots, Andrea Fairman Ph.D., Mot, Otr/L, Cprp, Atp, Michele Leone Dnp, Lmhc, Rn

Occupational Therapy Doctorate Capstones

Research Question, Aim, and Purpose:

Question: Does Surf therapy help improve positive mental health outcomes in veterans and children who have experienced trauma?

Aim: To examine the relationship between surf therapy and Posttraumatic Stress Disorder (PTSD) symptoms in veterans, active-duty service members, and foster children at COSTA who have experienced trauma.

Purpose: To determine the impact surf therapy at COSTA has on mental health in veterans and foster children who have experienced PTSD

Authentic Leadership: Mentorship For Aspiring Occupational Therapists, Christina C. Wilson Ot/S, Monique Dawes Otd, Otr/L Cpam

Occupational Therapy Doctorate Capstones

Problem: OT students from minoritized backgrounds experience a decreased sense of belonging & have difficulty advocating about their leadership qualities in a way that is recognized by admissions committees.

Purpose: Embed an evidence-based leadership development theory into existing mentorship curriculum to improve undergraduate students’ self-efficacy

Question: What effect does authentic leadership theory-based programming have on leadership skills and self- efficacy in minority undergraduate students interested in healthcare?

Skills Evaluation Of Adjunct Nursing Faculty: A Quality Improvement Project, Ada Dimino Luong

DNP Scholarly Projects

Abstract

BACKGROUND: With rising student enrollment, colleges and universities are relying more on adjunct clinical nursing faculty as Clinical Nurse Educators (CNEs). Recruiting and retaining qualified CNEs is essential to high-quality clinical education. Although clinically proficient, CNEs may face challenges with teaching methods, instructional strategies, and formative feedback. This quality improvement (QI) project evaluated CNE’s competencies and developed a sustainable multimedia educational tool to enhance feedback skills in clinical education.

METHODS: The Academic Clinical Nurse Educator Skill Acquisition Tool (ACNESAT), a validated 40-item Likert-scale instrument created by Shellenbarger and Sebach, was used to assess CNE competencies. Pre and post intervention …

Optimizing Electronic Health Record Capability To Provide Mindfulness Education To Oncology Patients Experiencing Anxiety, Cynthia Arcieri

DNP Scholarly Projects

Background: The impact of a cancer diagnosis is significant. In 2020, the Centers for Disease Control (CDC) reported over 1.6 million new cases of cancer (National Institutes of Health, 2023). Non-traditional approaches to supporting patients should be considered in providing high-quality cancer care. Mindfulness can help reduce stress reactions and may be beneficial for individuals with anxiety (Vinci et al., 2019). To best support patient care in the landscape of mobile health (mHeatlh) technology, it is essential to adopt best practices that promote patient engagement and empowerment.

Purpose: This quality improvement project aimed to provide oncology patients with a cognitive …

A Quality Improvement Project To Enhance Chronic-Condition And Self-Care Knowledge In Adolescents With Spina Bifida, Ann Paris

DNP Scholarly Projects

Background: Spina Bifida is the most common central nervous system disorder in the United States (CDC, 2024). Even with early surgical repair, patients may have chronic, disabling, multisystem needs (Phillips et al., 2017). Adequate care of Spina Bifida requires a multidisciplinary approach. As such, patients with spina bifida require multiple specialty providers, clinic appointments, care-tasks, and interventions (CDC, 2024, Phillips, et al., 2017). Synthesizing information from multiple care providers can be daunting, especially for adolescents as they grow more autonomous in their care, and especially as they enter the age of pediatric-to-adult transition (Psihogios et al., 2015).

Purpose: …

Occupational Performance In Technology Use For Older Veterans, Gianna Battista Ot/S, Andrea Fairman Ph.D., Mot, Otr/L, Atp, Drp, Julie Faieta Ph.D., Mot, Otr/L

Occupational Therapy Doctorate Capstones

The digital divide impacts the older adult population's ability to access online health information or utilize technology effectively. Occupational Therapy (OT) services can support education and training in digital literacy for older adults to increase self-efficacy with daily activities using technology. The VVCMatch assessment tool was created to determine telehealth readiness by evaluating cognitive, physical, and digital literacy ability among Veterans in the HBPC program using the VA Video Connect app (VVC).

PIO Question: Does technology education increase confidence in the navigation of technology devices in older adults 60+?

Air Pollution Exposures And Cognitive Function Among Older Americans, Clarisse Nyondo Okoma

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

Background: New findings indicate that environmental factors, such as air pollution, could contribute to cognitive decline among older adults. Nonetheless, extensive longitudinal studies in the U.S. investigating this connection are few and far between.

Objective: This study assessed the relationship between long-term exposure to ambient air pollutants and cognitive function in older adults in the United States.

Methods: We examined data from the Health and Retirement Study (2010-2018), which included 234,250 observations from adults aged 50 and older. Cognitive performance was evaluated based on immediate and delayed word recall, a 27-point cognitive summary score, backward from 20, and …

Implementing An Opioid Overdose Education And Naloxone Distribution (Oend) Program Among Law Enforcement Officers In Lee County, Ky, Keelie Jolly

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

This grant proposal describes an implementation strategy for introducing an OEND training program among law enforcement officers (LEOs) to reduce opioid overdose deaths. The goal of the project is to increase LEOs' awareness and knowledge of opioid overdose and Naloxone administration and usage of Naloxone.

Rct Pre-Post Training Analysis Of The Vipcorps Maternal Mortality Prevention Course With A Focus On Intimate Partner Violence (Ipv), Rose A. Wood

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

Maternal mortality rates rob families across the U.S. of a mother figure, and each death is preventable. The U.S. has the highest maternal mortality rate of high-earning countries. This study assesses the effects of the VIPCorps program, a course on the top 3 risk factors of maternal mortality, on improving knowledge and attitudes towards victims of IPV. Students in helping professions at the University of Kentucky (n = 223) were recruited via on campus advertising and remotely allocated to either the VIPCorps program or a mock maternal mortality training control. Generalized linear modeling was used to estimate the difference in …

Improving End-Of-Life Care: A Nursing Education Initiative, Spring C. Kingsley

DNP Projects

Background: This study addresses the gap in education and training for medical intensive care unit (MICU) nurses regarding the care of hospice patients. The traditional medical model of healthcare prioritizes illness treatment, often leading to inadequate end-of-life support and increased hospitalization during patients' final days. The rise of in-hospital hospice programs, or scatter-bed hospice models, highlights the need for nurses to enhance their skills in providing end-of-life compassionate care. The MICU at the University of Kentucky’s Chandler Hospital serves as a focal point for this initiative, given its role in caring for critically ill patients who require hospice attention.

Purpose: …

Development Of An Educational Toolkit For Washington State Nursing Professionals Regarding Climate-Related Impacts On Health, Margaret "Maggie" Pinson

DNP Scholarly Projects

BACKGROUND: Most healthcare professionals (HCPs) know that climate change poses a serious threat to human health, but few physicians and nurses actually discuss climate-related impacts on health with their patients. This knowledge-practice gap poses a risk to patient safety.

PROBLEM: Patients who are unaware of environmental threats to health may develop new illnesses, experience unnecessary exacerbations of underlying health problems and may die.

METHODS: A quality improvement intervention that addressed the educational needs of HCPs as described in the literature was developed and hosted on an online survey platform.

INTERVENTION: Preintervention survey questions captured baseline attitudes, beliefs, and knowledge. The …

Enhancing Resilience In Oncology Nurses Through The Implementation Of A Peer Support Program, Denise M. Robinson-Smith

DNP Scholarly Projects

ABSTRACT

Background: Oncology nurses face high rates of burnout and compassion fatigue, contributing to significant turnover and threatening the stability of the oncology nursing workforce. The projected increase in cancer incidence and the resulting demand for oncology services underscore the urgent need for interventions that enhance nurse resilience. Local Problem: At a major hospital in Jacksonville, Florida, it was found that oncology nurses face a significant gap in emotional support, especially during critical incidents such as patient deaths or traumatic events. Existing resources were insufficient to address the unique stressors faced by this team. Methods: A quality …