Medicine and Health Sciences Commons^™

Coffee Break And Breakout Discussions, Coffee

Biology and Medicine Through Mathematics Conference

No abstract provided.

Modeling Hiv With Partnership Models, Kathleen Hoffman

Biology and Medicine Through Mathematics Conference

No abstract provided.

Innovator - Summer 2022

Innovator

05 - The Provost’s Column

08 - Time Machine: John K. Mitchell’s Automaton Chess Player

12 - The Nexus: News at Jefferson

22 - Empowering Amputees to Conquer the Seas

26 - The Legend: Coach Herb Magee ’63, HOF ’11

34 - Common Threads

38 - Pitch Please

44 - Question & Innovate: Natasha A. Trice ’14

48 - The Future is Now Farewell to Dr. Stephen K. Klasko

52 - A Father’s Life Inspires a Son’s Giving

54 - Reimagine

60 - Ram Roundup

64 - Class Notes

72 - In Memory

Evaluating The Baseline Hemoglobin, Albumin, Lymphocyte, And Platelet (Halp) Score In The United States Adult Population And Comorbidities: An Analysis Of The Nhanes, Ryan Antar, Christian Farag, Vincent Xu, Arthur Drouaud, Olivia Gordon, Michael J. Whalen

Urology Faculty Publications

Introduction: As a composite immunonutritional biomarker, the Hemoglobin, Albumin, Lymphocyte, Platelet (HALP) score has shown promise in assessing a patient's overall health status by integrating several routinely collected laboratory indicators. This biomarker has been examined in many different populations of patients and disease states (i.e., cancer), but an integrated, universal rubric using standardized thresholds has not thus far been developed. Pre-existing large population-based databases represent an ideal source to examine the distribution of HALP and the influence of diverse health statuses on this score.

Methods: We conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey …

Using Curriculum Mapping As A Tool To Align The Information Literacy And Evidence-Based Research Learning Outcomes In Nursing Curriculum, Jane Wu

Library Faculty & Staff Scholarship

This research investigated how to use curriculum mapping as a curriculum-integration tool to identify the components of information literacy (IL) and evidence-based practice (EBP) in the nursing curriculum for the future systematic incorporation of information literacy components in teaching EBP. The primary objective is to strengthen information literacy and evidence-based research competency. The ACRL information literacy framework in Higher Education, Information Literacy Competency Standards for Nursing, EBP Competencies, and the EBP research model were used to provide structure to create a map and crosswalk of information literacy and EBP student learning outcomes. We obtained 59 copies of the nursing undergraduate …

Implementation Of An Implicit Bias Training In A Doctor Of Nurse Practitioner Program, Macdana Selecon

DNP Qualifying Manuscripts

Background: Implicit bias in healthcare delivery is the unconscious prejudice individuals might feel about another person or group. All healthcare providers are susceptible to implicit bias which can negatively influence patient-provider communication. Implicit bias is linked to disparities in maternal health outcomes. According to the CDC, the maternal mortality rate for non-Hispanic Black women is 2.9 times higher than the rate for non-Hispanic White women (Hoyert, 2022).

Problem: Implicit bias (IB) training is not provided in all graduate nursing programs. As a result, graduate nursing students are not prepared to manage IB during clinical rotations and post-graduation, thus, are at …

A Patient With Foot Pain Found To Have Leriche Syndrome: A Case Report And Brief Review Of The Literature., Moshe Bengio, Quan Ta, Glenn Goodwin, Megan De Kok, Alexander J. Scumpia

HPD Articles

Leriche syndrome, a rare and critical complication of peripheral arterial disease (PAD), affects the distal abdominal aorta (infrarenal) and, similar to PAD, is a result of plaque buildup in the arterial lumen. The Leriche syndrome triad includes claudication in the proximal lower extremity, decreased or absent femoral pulses, and, in some cases, impotence. This article presents a patient with an atypical presentation of foot pain who was subsequently found to have Leriche syndrome. The patient was a 59-year-old female, a former smoker, who presented to the emergency department (ED) with atraumatic, acute right foot pain. All right lower extremity pulses …

Influenza C And D Viruses Demonstrated A Differential Respiratory Tissue Tropism In A Comparative Pathogenesis Study In Guinea Pigs, Chithra C. Sreenivasan, Runxia Liu, Rongyuan Gao, Yicheng Guo, Ben M. Hause, Milton Thomas, Ahsan Naveed, Travis Clement, Dana Rausch, Jane Christopher-Hennings, Eric Nelson, Julian Druce, Miaoyun Zhao, Radhey S. Kaushik, Qingsheng Li, Zizhang Sheng, Dan Dan, Feng Li

Nebraska Center for Virology: Faculty Publications

Influenza C virus (ICV) is increasingly associated with community-acquired pneumonia (CAP) in children and its disease severity is worse than the influenza B virus, but similar to influenza A virus associated CAP. Despite the ubiquitous infection landscape of ICV in humans, little is known about its replication and pathobiology in animals. The goal of this study was to understand the replication kinetics, tissue tropism, and pathogenesis of human ICV (huICV) in comparison to the swine influenza D virus (swIDV) in guinea pigs. Intranasal inoculation of both viruses did not cause clinical signs, however, the infected animals shed virus in nasal …

Using Critical Incident Debriefing After Code Blue Events To Support Registered Nurses, David L. Boyd

Doctor of Nursing Practice (DNP) Projects

Using Critical Incident Debriefing after Code Blue Events to Support Registered Nurses

Section I: Abstract

Background: During a code blue event (CBE), the environment becomes highly stressful and intense. Nurses rapidly transition from performing life-saving procedures on their patients to carrying out their usual duties. Without proper debriefing, nurses cannot properly process their emotions leading to increased burnout and secondary traumatic stress (Stamm, 2010).

Local Problem: In 2021, the nurses at Providence Saint John’s Health Center (2021a) responded to 110 CBEs, a 43% increase from 2020. Without a process for critical incident debriefing (CID), these nurses were exposed to trauma …

Trauma-Informed Treatment For Alcohol Use Disorder: Improving Long-Term Recovery, Aline M. Bales

Doctor of Nursing Practice (DNP) Projects

Background: This DNP project aimed to assess the feasibility of implementing trauma-informed care to Ria Health's telehealth AUD MAT recovery treatment model for patients with co-occurring PTSD, targeting high relapse rates due to cravings. Trauma-informed care addresses traumatic histories that can potentiate emotional dysregulation leading to maladaptive coping responses manifesting as cravings with addiction memory.

Methods: An integrated review assessed the prevalence of co-occurrence of AUD and PTSD, assessed interest in Ria Health patients, patients recruited from Ria Health if they mentioned cravings, offered concurrent trauma-informed care with medicated assisted treatment for 16-20 sessions, trauma-informed care used Polyvagal Theory techniques …

Breaking Down Grit: Persistency And Flexibility In The Career Plans Of Military Medical Students., Ryan R Landoll, Krista Highland, Kameha Bell, Anthony R. Artino, Col Lisa K Moores, Michael Soh, Sebastian Uijtdehaage, Steven J Durning, Neil E Grunberg, Ting Dong

Health Sciences Education Research

INTRODUCTION: The field of medicine is experiencing a crisis as high levels of physician and trainee burnout threaten the pipeline of future physicians. Grit, or passion and perseverance for long-term goals, has been studied in high-performing and elite military units and found to be predictive of successful completion of training in adverse conditions. The Uniformed Services University of the Health Sciences (USU) graduates military medical leaders who make up a significant portion of the Military Health System physician workforce. Taken together, an improved understanding of the relationships between burnout, well-being, grit, and retention among USU graduates is critical to the …

Well-Being At A Military Medical School And Implications For Military Retention., Michael Soh, Jessica Bunin, Sebastian Uijtdehaage, Anthony R. Artino, Erin S Barry, Steven J Durning, Neil E Grunberg, Ryan R Landoll, Ashley Maranich, Lisa K Moores, Jessica Servey, Dario Torre, Pamela M Williams, Ting Dong

Health Sciences Education Research

INTRODUCTION: Physical and psychological well-being play a critical role in the academic and professional development of medical students and can alter the trajectory of a student's quality of personal and professional life. Military medical students, given their dual role as officer and student, experience unique stressors and issues that may play a role in their future intentions to continue military service, as well as practice medicine. As such, this study explores well-being across the 4 years of medical school at Uniformed Services University (USU) and how well-being relates to a student's likelihood to continue serving in the military and practicing …

Improving Patients' Perception Of Pain: An Evaluation Of A Nurse Practitioner-Led Chronic Pain Coaching Group, Suzanne A. Levy

Seton Hall University Dissertations and Theses (ETDs)

Background: The opioid crisis in the United States warrants an improved standard of practice for managing chronic pain. A large body of evidence highlights a positive correlation between health coaching focused on mindfulness-based interventions and its potential to improve the overall well-being of chronic pain patients. Currently, there are limited resources to address these patients' psychosocial needs, and the primary treatment plan consists of pharmacological management using long-term opioids. Project Aim: The 3M Chronic Pain Coaching Model is a 6-week coaching group focused on mindfulness, meditation, and motivation. This quality improvement project aimed to evaluate how a mindfulness-based chronic pain …

Standardized Patient Education For Patients' Initial Chemotherapy Through An Integrated Telemedicine Platform, Karen D. Dougherty

Seton Hall University Dissertations and Theses (ETDs)

Telemedicine has demonstrated a high level of satisfaction in a variety of health settings as a safe and efficient method of delivering healthcare. The purpose of this project was to implement an Advanced Practice-led Quality Improvement (QI) initiative pilot to evaluate the standardization of chemotherapy education through an integrated telemedicine platform. This Doctor of Nursing Practice (DNP) project used interventions noted in the literature review to assess and evaluate core concepts of knowledge, satisfaction, utilization, and program acceptance. This project aimed to utilize evidence-based processes to increase knowledge about the chemotherapy treatment routine, to raise awareness and develop skills to …

Exploring And Identifying Healthcare Leaders Competencies Required For Effective Decision Making In A High Velocity Environment To Achieve Sustainability Under The Regulatory Compliance Tenets Of The Patient Protection Affordable Care Act, Sylvester Foote

Seton Hall University Dissertations and Theses (ETDs)

Background and Purpose of the Study: Healthcare organizations face challenges in efficiently accommodating increased participant demands with limited resources and capacity. The modern reimbursement environment prioritized the maximization of operational efficiency and the reduction of unnecessary cost (i.e., waste) while maintaining or improving quality. As healthcare organizations adapt, significant pressures are placed on leaders to make difficult operational and budgetary decisions (Hamrock, Eric, et al., 2013).

As healthcare goes through this transformation within its high velocity environment defined as environments in which there is rapid and discontinuous change in demand, competitors, technology and /or regulations, such that information is often …

Creating And Validating A New Survey Instrument To Measure Behavioral Factors Impacting Healthcare Providers’ Assessment Of Binge Eating Disorder, Kathleen Lovey

Seton Hall University Dissertations and Theses (ETDs)

Background and Purpose of the Study. Binge eating disorder (BED) is the most prevalent eating disorder in adolescents and adults, both nationally and internationally. It is highly comorbid with other psychiatric conditions and obesity. Lifetime prevalence rates for the general population in the United States range between 0.4–2.0% for males and 1.3–3.5% for females, respectively. BED prevalence rates are higher in the obese population at 4.5% and up to 27% in obese adults seeking treatment. Despite its prevalence, only 11% of adolescents and 44% of adults with lifetime BED in the United States receive treatment. As general healthcare providers are …

School-Based Development And Implementation Of Adolescent Mental Health Educational Toolkits, Chantel M. Kilford Ms

Doctor of Nursing Practice (DNP) Projects

After the onset of the COVID pandemic, there were significant increases of adolescents with anxiety, behavioral and conduct problems. These disorders have devasting individual, social, and economic ramifications and school-based staff play a key role in identification, assessment, and treatment. Evidence suggested that healthcare providers, school counselors and teachers were not confident or knowledgeable about adolescent mental health. The purpose of the change in practice project was to increase knowledge and confidence among school-based healthcare providers, school counselors and teachers by providing an adolescent mental health tool kit. The toolkit focused on disruptive behavior and other prevalent mental health disorders …

Improving New Nurse Manager Orientation And Onboarding Program, Leanne E. Deegenaars

Doctor of Nursing Practice (DNP) Projects

ABSTRACT

Purpose: Identify and adapt the best evidence for nurse manager orientation and onboarding programs into practice. Assess the program's impact on job satisfaction and retention of new Nurse Managers (NMs) and Assistant Nurse Managers (ANMs).

Background: Constant turnover of ANMs and NMs within local and regional facilities is expensive and negatively impacts nursing leaders' work environment, job satisfaction, and patient outcomes.

Local Problem: The lack of formal orientation and onboarding at the focus facility impacts the retention and job satisfaction of NMs. The sunsetting of a regional hub model of new NM orientation and onboarding led to a just-in-time …

Determining Care Delivery Model Feasibility Using Discrete-Event-Simulation, Tanya Scott

Doctor of Nursing Practice (DNP) Projects

Background: The need for inpatient pediatric psychiatric services to address the growing issue of pediatric mental health in a multi-state integrated hospital enterprise is straining the system’s capacity to provide timely mental health care.

Local Problem: Lack of access to specialty pediatric psychiatric treatment for dual diagnosis medi-psychiatric care management is a patient quality and safety issue. Insufficient capacity contributes to longer emergency room boarding times and inpatient length of stay for patients who have a mental illness.

Methods: Use of digital simulation methodology to analyze the behavior of a dynamic event-driven care delivery workflow and to optimize quality patient …

Responding To A Deteriorating Patient: An Educational Intervention For Outpatient Clinic Nurses, Angela N. Ikeme

Doctor of Nursing Practice (DNP) Projects

Responding to a Deteriorating Patient:

An Educational Intervention for Outpatient Clinic Nurses

Background: Dynamic and evolving healthcare practices require nurses to continually acquire knowledge and confidence to provide optimal care. Organizations that recognize nurses’ educational needs and develop strategies to meet them empower nurses to improve the quality and safety of patient care.

Local Problem: The need for a continuing education program to improve outpatient clinic nurses’ knowledge, skills, and self-confidence prompted the implementation of this project.

Method: Single cohort education intervention as a test of change to assess the knowledge and confidence participants acquired in a pre- and …

Responding To A Deteriorating Patient: An Educational Intervention For Outpatient Clinic Nurses, Angela N. Ikeme

Doctor of Nursing Practice (DNP) Projects

Responding to a Deteriorating Patient:

An Educational Intervention for Outpatient Clinic Nurses

Background: Dynamic and evolving healthcare practices require nurses to continually acquire knowledge and confidence to provide optimal care. Organizations that recognize nurses’ educational needs and develop strategies to meet them empower nurses to improve the quality and safety of patient care.

Local Problem: The need for a continuing education program to improve outpatient clinic nurses’ knowledge, skills, and self-confidence prompted the implementation of this project.

Method: Single cohort education intervention as a test of change to assess the knowledge and confidence participants acquired in a pre- and …

Save The Children Community Health Worker Program – Adverse Childhood Events Prevention, Jieun Lee

Doctor of Nursing Practice (DNP) Projects

Background: Adverse childhood experiences (ACEs) are potentially traumatic events that occur between the ages of 0 to 17 in which are directly associated, in a dose–response manner, to many of the most common and serious health problems in the United States.

Local Problem: 62% of California residents have experienced at least one ACE, and 16% have experienced at least four ACEs. ACEs are linked to nine of the ten leading causes of death in the United States Adults with four or more ACEs are 37.5 times more likely to attempt suicide, 3.2 times more likely to have chronic lower respiratory …

Implementing An Infant-Driven Feeding Practice Model, Ann P. Nguyen

Doctor of Nursing Practice (DNP) Projects

Neonatal feeding practices have been the focus of many quality improvement studies due to large variations in care practices. Traditionally, the model for neonatal feeding has been a volume-based approach, one that focuses on a prescribed quantity consumed rather than the infant’s physiologic and developmental maturity (Fry et al., 2018). Recent literature has emphasized the benefits of a more developmentally supportive feeding approach in neonatal intensive care units (NICU), the infant-driven feeding model (IDF).

The IDF model focuses on individualized care, quality of the feed, and continuous assessment of feeding cues both before and during the feeding experience. Current literature …

Improving Health Outcomes For Lgbtq+ Youth Through Provider Education, Marissa Simko

Doctor of Nursing Practice (DNP) Projects

Background and Problem: LGBTQ+ adolescents and young adults (ages 12-25 years) are known to have higher rates of physical and mental health concerns compared to heterosexual and cisgender youth. Within the LGBTQ+ youth community, rates of suicidality, substance misuse, homelessness, and STIs are higher than in the general population. LGBTQ+ youth have greater challenges accessing healthcare and higher rates of healthcare discrimination. This paper presents a quality improvement project focused on improving evidence-based practices in LGBTQ+ healthcare through the development and implementation of a LGBTQ+ youth centered educational workshop for healthcare providers.

Methods: This project was organized in …

The Dedicated Education Unit: Increasing Capacity And Confidence, Heather Marie Van Housen

Doctor of Nursing Practice (DNP) Projects

Background: In the American Association of Colleges of Nursing (AACN) 2020 annual survey, nursing schools turned away 66,274 entry-level applications to baccalaureate nursing programs in the United States due to a faculty shortage and clinical placement sites (AACN, 2021).

Local Problem: Hospitals need more qualified nurses to meet community needs. The need for clinical faculty and additional clinical placement sites disrupts the workforce pipeline through local nursing schools. A new approach to clinical education is needed to prepare more students for the growing complexities of independent nursing practice.

Methods: Dedicated Education Unit (DEU) implementation to expand pre-licensure nursing student clinical …

Improving Outcomes In Persons Who Inject Drugs: A Multidisciplinary Healthcare Initiative, Carla S. Martin

Doctor of Nursing Practice (DNP) Projects

Background: Outpatient parenteral antimicrobial therapy is the standard of care for patients who require long-term antimicrobial therapy but is not considered a safe discharge option for persons who inject drugs (PWID). Many PWID leave against medical advice before completing therapy, resulting in high emergency department utilization and frequent readmissions.

Local Problem: A 646-bed academic and Level I trauma center where opioid overdoses are 6.5 times higher than the state average experiences disproportionately high PWID admissions. Prolonged hospitalization for the duration of antimicrobial therapy increases costs and reduces access for other acute care patients.

Methods: A prospective cohort of PWID discharged …

Predicting The Risk Of Falling With Artificial Intelligence, Ann Aquino

Doctor of Nursing Practice (DNP) Projects

Predicting the Risk of Falling with Artificial Intelligence

Abstract

Background: Fall prevention is a huge patient safety concern among all healthcare organizations. The high prevalence of patient falls has grave consequences, including the cost of care, longer hospital stays, unintentional injuries, and decreased patient and staff satisfaction. Preventing a patient from falling is critical in maintaining a patient’s quality of life and averting the high cost of healthcare expenses.

Local Problem: Two hospitals' healthcare system saw a significant increase in inpatient falls. The fall rate is one of the nursing quality indicators, and fall reduction is a key performance indicator …

Assuring A Continuum Of Care For Heart Failure Patients Through Post-Acute Care Collaboration, Purnima Krishna

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Heart failure (HF) patients have a high risk of rehospitalization after discharge from acute care. Post-discharge management of HF patients requires coordinating services outside the hospital, such as skilled nursing and home health care to address patients’ complex needs.

Local Problem. High HF readmission rates negatively impact a hospital’s efficiency and pose a risk of financial penalties. In the project setting, the HF patients discharged to skilled nursing facilities and home health agencies had a higher rate of 30-day readmission than patients discharged to home.

Methods: Fourteen post-acute care (PAC) facilities were selected for the interventions. The …

Implicit Bias In Nursing: Raising Awareness, Fostering Change, Jeanette C. Sandoval

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Extensive research evidence demonstrates that implicit bias can lead to differential treatment of patients based on race, gender, weight, age, income, language, and insurance status. Evidence-based interventions that couple implicit bias mitigation with therapeutic communication skills can contribute to the delivery of equitable care.

Local Problem: Implicit bias in healthcare occurs when unconscious behavior that is not favorable to the patient population served perpetuates unequal treatment and contributes to poor healthcare outcomes.

Methods: Knowledge of implicit bias in the nursing staff was assessed through a validated and reliable survey tool before and after participation in an online LMS …

Enhancing Nurse Manager Resilience With A Resilience-Enhancing Toolkit, Rosarina A. J. Pelikan

Doctor of Nursing Practice (DNP) Projects

Background: Nurse managers have one of the most stressful jobs in nursing leadership. They experience more burnout and are more likely to leave the job or leave the nursing profession altogether, leading to vacancies or burned-out leaders.

Local Problem: The organization experienced high nurse manager turnover. Of 12 positions, four have more than two years of experience, three have less than two years, and five are filled with interims.

Context: Strategies to address burnout are decreasing stressors or arming leaders with skills to withstand stressors. The organization offers programs that address burnout but are designed to be used outside of …