Medicine and Health Sciences Commons^™

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 …

Effects Of Leadership Education And Mentoring For Assistant Nurse Managers, Karen T. Descent

Doctor of Nursing Practice (DNP) Projects

Background: Nurse manager knowledge and leadership styles influence quality of care, patient satisfaction, staff engagement, and retention. Dissatisfaction with the assistant nurse manager (ANM) role can lead to high job turnover with negative influences on patient satisfaction, quality of care, workforce engagement, and achievement of organizational goals.

Local Problem: Two hospitals and one free-standing ambulatory surgery unit of a large integrated healthcare organization experienced high ANM turnover due to role dissatisfaction, ANM frustration with low-quality care in the units they oversaw, and patient satisfaction metrics below the 65th percentile. The regional healthcare system leadership team recognized the need to increase …

Community Health Worker Program: Adverse Childhood Experiences And Early Childhood, Arelis Sandoval

Doctor of Nursing Practice (DNP) Projects

Background: Adverse childhood experiences (ACEs) negatively affect childhood development and long-term health outcomes. Latino children face multiple adversities and social determinants of health compounded by ACEs. Community Health Workers (CHWs) have access to work with families to improve resilience and mitigate the effects of ACEs in this population.

Local Problem: In the Central Valley of California, CHWs provide support and resources to a largely Latino population with increased poverty rates, low educational attainment, lack of health insurance, and many chronic health issues, putting families at a higher risk for ACEs exposure. CHWs need further training to apply ACEs knowledge to …

Reducing 30-Day Heart Failure Hospital Readmissions Through The Implementation Of A Telehealth Education And Screening Program, Madison Geib, Jo Loomis, Maria (Dupi) Gomez Cogan

Doctor of Nursing Practice (DNP) Projects

Heart Failure (HF) is a difficult disease to manage. It requires knowledge on weight monitoring, diet, exercise, medications, and symptom management. With this difficulty, there is a high incidence of HF patient readmissions into the hospital, especially in the first 30-days after discharge, showing that patients are not well equipped to manage their HF on their own at home. A review of the available literature found that some of the most common reasons for readmission include poor discharge planning, a lack of continuation of care, as well as a lack of education and adherence to their medications (Mathew & Thukha, …

Improving Patient Safety For Surgical Clearance: A Preop One Stop Shop, Anna Benedictos

Doctor of Nursing Practice (DNP) Projects

Problem: Medical clearance is required for patients scheduled for surgery, also known as “patient optimization.” Ineffective and inefficient patient optimization is a major contributor to surgery postponements, procedure cancellations, and patient dissatisfaction.

Context: Ambulatory care clinics often lack resources to medically clear patients prior to scheduled surgery. Poor surgical optimization continues to occur on the same day of surgery, resulting in case cancellation or delay in a suburban, 169 bed community hospital with 9 operating rooms and approximately 500 surgical procedures per month.

Interventions: A nurse-led PreOp One Stop Shop (POSS) utilized a standardized checklist to perform preoperative surgical assessment. …

Importance Of Prioritization Of Health Care Data Quality In Managed Care Leadership, Grace V. Crossette-Thambiah

Theses and Dissertations

As we progress towards the fourth industrial revolution, where emerging technologies such as artificial intelligence, machine learning, and the Internet of Things (IoT) are becoming more dominant, the quality of data becomes even more crucial. These technologies rely immensely on data to generate insights and make accurate predictions. Poor quality data can lead to incorrect or incomplete insights, resulting in erroneous decision-making that can have significant consequences. It is essential that data quality is addressed early in the development of these technologies to ensure that they operate successfully and provide accurate insights that can lead to positive outcomes. As such, …

Treatment Of Angular Deformity And Limb Length Discrepancy With A Retrograde Femur Magnetic Intramedullary Nail: A Fixator-Assisted, Blocking Screw Technique, Erik J. Geiger, Adam D Geffner, S Robert Rozbruch, Austin T Fragomen

Rothman Institute Papers

Background: Fixator-assisted nailing techniques that incorporate magnetic internal lengthening nails (MILNs) permit acute deformity correction and then gradual limb lengthening without needing postoperative external fixators.

Purposes: We sought to investigate the safety and accuracy of a fixator-assisted, blocking screw technique using retrograde MILNs for the correction of LLD and limb malalignment.

Methods: Forty-one patients (13 patients with genu varum and 28 patients with genu valgum) with LLD treated with fixator-assisted, blocking screw retrograde MILN reconstruction were included. Preoperative LLD, mechanical axis deviation, and joint orientation angles were compared with values at the end of treatment, and bone healing indices were …

Exploring The Perceptions Of English-Speaking West African Born Registered Nurse Graduates From United States Entry Level Nursing Programs Regarding Academic Factors That Contribute To Retention And Success In United States Nursing Programs, Afua Ampiaw

Seton Hall University Dissertations and Theses (ETDs)

Background: The United States (U. S.) population is becoming more racially and ethnically diverse. To ensure equity in healthcare access and outcomes between majority and majority populations, there is need for minority representation in the health professions including nursing to reflect their representation in the general population. Nevertheless, ethnic minorities are underrepresented in the nursing profession. One of the many issues identified to compound this problem is the lack of retention and success of ethnic minority people in U.S. nursing programs. While the English-Speaking West African (ESWA) population in the U.S. forms about 5% of the 45 million immigrant population …

How Pediatric Emergency Department Nurses Initiate And Provide Care To Children And Families With Limited English-Proficiency, Caroline Meza

Seton Hall University Dissertations and Theses (ETDs)

Effective pediatric emergency care requires ongoing communication between the pediatric patient and their family. There may be additional challenges for pediatric emergency nurses (PENs) to consider in their efforts to provide safe quality nursing care to pediatric patients and families with limited English proficiency. The purpose of this study was to explore and describe the experience of PENs who are engaged in providing care to pediatric patients and families with limited-English proficiency (LEP) in a pediatric emergency department. Using an interpretive description method, semi-structured interviews conducted with 15 PENs and five certified professional medical interpreters (CPMIs) were analyzed. The study …

Exploring Balance Assessment Practices And Utilization Of Academy Of Geriatric Physical Therapy Clinical Guidance Statement In Fall Management By U.S.-Practicing Physical Therapists: A Mixed-Methods Approach, Franceah Palencia-Quijano

Seton Hall University Dissertations and Theses (ETDs)

Background: Falls and balance impairments in older adults are major public health concerns. Physical therapists (PTs) play a major role in preventing and managing falls in the U.S. healthcare system. PTs are doctoral healthcare professionals who evaluate and treat balance impairments that impact prevalence of falls. As autonomous practitioners, PTs should incorporate evidence-based tools in balance assessment and management of falls. The American Physical Therapy Association (APTA) recommends PTs utilize evidence-based tools such as the (a) Academy of Geriatric Physical Therapy (AGPT) Clinical Guidance Statement (CGS) in Community-Dwelling Older Adults (CDOA and (b) the APTA balance tests and measures in …

Exploring Community College Health Science Adjunct Faculty's Perception Of Culturally Responsive Teaching Practices And Implementation Readiness, Catherine Sirangelo

Seton Hall University Dissertations and Theses (ETDs)

Introduction. Millions of students enroll in public community colleges in the United States. They are often first-generation or first in their family to go to college. They are often culturally and linguistically diverse, with English not being their first language. They often choose a community college because of its high-quality, lower cost, and successful implementation of programs to assist and acclimate them to post-secondary education. Students look to community college as a first step into a professional healthcare career. Health Science faculty teaching at community colleges are either full-time or part-time (adjunct) contingency faculty. Adjunct faculty are often content experts …

Exploring The Relationship Between Nurse Supervisor’S Servant Leadership Behavior And Nursing Employee’S Self-Assessment Of Engagement And Burnout In Nigeria, Michael Otuwurunne

Seton Hall University Dissertations and Theses (ETDs)

Burnout is a problem among workers in Nigeria, especially among nurses (Ozumba, & Alabere, 2019). This study examined whether there was a significant relationship between the employee perception of the servant leadership behaviors of the nurse supervisor and the employee’s self-rating of burnout: exhaustion and disengagement, and servant leadership behaviors of the nurse supervisor, and engagement: vigor, dedication, and absorption. Exhaustion refers to an intensive physical, affective, and cognitive strain while disengagement refers to the distancing of oneself from one’s work, and experiencing negative attitudes toward the work object, work content, or one’s work in general (Demerouti et al., 2001). …

Early Sepsis Recognition: Improving Sepsis Education In A Medical-Surgical/Telemetry Unit, Kathileen Tran

Master's Projects and Capstones

Problem: This quality improvement project aimed to increase sepsis education and bundle compliance within the medical-surgical/telemetry unit to improve sepsis mortality and morbidity rates.

Context: A microsystem assessment was completed by Clinical Nurse Leader (CNL) students in the medical-surgical/telemetry unit at Hospital X located in the San Francisco Bay Area. This microsystem cares for patients diagnosed with sepsis, congestive heart failure (CHF), electrolyte imbalance, and alcohol withdrawal.

Interventions: Due to time constraints, an intervention was not implemented; however, the students provided recommendations for interventions to the leadership team for follow up. The recommended interventions encompass implementing sepsis protocol reference cards, …

Mental Health Services: Reaching The Homeless, Gurdeep Mann

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Serious mental illness (SMI) and substance use disorder (SUD) are two common findings among the majority of those experiencing homelessness in the Stanislaus County.

Local Problem: Emergency shelters typically do not provide mental health services on-site, however, a collaboration between First Behavioral Health Urgent Care Center (FBH) and We Care Program Turlock (WCPT) was established to provide mental health services on-site.

Method: The WCPT case manager as part of a Doctor of Nursing Practice (DNP) quality improvement project implemented Assertive Outreach Model interventions to increase utilization of mental health services and established long-term relationships.

Interventions: Frequent contact with …

Health Services Use Among Formerly Incarcerated Louisiana Medicaid Members Within One Year Of Release, Ashley Wennerstrom, Olivia K. Sugarma, Bruce Reilly, Andrea Armstrong, Angel Whittington, Marcus A. Bachhuber

School of Public Health Faculty Publications

OBJECTIVES: To determine the association between enrollment in Medicaid prior to release compared with post-release, and the use of health services and time to the first service use after release among Louisiana Medicaid members within one year of release from Louisiana state corrections custody. METHODS: We conducted a retrospective cohort study linking Louisiana Medicaid and Louisiana state corrections release data. We included individuals ages 19 to 64 years released from state custody between January 1, 2017 and June 30, 2019 and enrolled in Medicaid within 180 days of release. Outcome measures included receipt of general health services (primary care visits, …

Therapeutic Gardening For Addiction Recovery, Hayley Milleson

Master's Projects and Capstones

The following study examines the potential benefits of implementing therapeutic gardening and outdoor activities as a supplemental resource for adult males with a history of substance abuse issues who have been affected by the criminal justice system and are seeking sobriety while in a residential treatment program. The goal is to investigate how therapeutic gardening can add to traditional addiction treatment methods. Through a review of current evidence-based practice, this study focuses on how alternative interventions such as therapeutic gardening and outdoor activity can improve overall mental health and well-being, promote a sense of community, improve social connections, alleviate stress …

Exploring Sepsis Bundle Compliance In The Medical-Surgical/Telemetry Unit, Kerry Rebecca Reinbold

Master's Projects and Capstones

Abstract

Problem: Sepsis creates complications for patients and nursing staff. Increasing sepsis bundle compliance has been shown to decrease patient mortality. This quality improvement project utilized a self-administered questionnaire to better understand the opinions of nursing staff on the Medical-Surgical/Telemetry unit and explore ways to improve sepsis bundle compliance.

Context: The microsystem is a 32-bed Medical-Surgical/Telemetry unit at Hospital X, a 244-bed, not-for-profit hospital serving the Bay Area of California.

Interventions: A questionnaire distributed to nursing staff on the unit was the primary intervention. Through microsystem assessment, questionnaire results, and direct conversations with staff; active and passive data were obtained. …

Louisiana State University Health Sciences Center - 2023 - 149th Commencement, Office Of The Registrar, Lsu Health Sciences Center-No

Graduation & Commencement Programs

The program for the 149th Commencement of LSU Health Sciences Center - New Orleans held May 18, 2023.

Guaranteed Income And Financial Treatment Trial (Gift Trial Or Giftt): A 12-Month, Randomized Controlled Trial To Compare The Effectiveness Of Monthly Unconditional Cash Transfers To Treatment As Usual In Reducing Financial Toxicity In People With Cancer Who Have Low Incomes, Meredith Doherty, Jonathan Heintz, Amy Leader, David Wittenburg, Yonatan Ben-Shalom, Jessica Jacoby, Amy Castro, Stacia West

Department of Medical Oncology Faculty Papers

Cancer-related financial hardship (i.e., financial toxicity) has been associated with anxiety and depression, greater pain and symptom burden, treatment nonadherence, and mortality. Out-of-pocket healthcare costs and lost income are primary drivers of financial toxicity, however, income loss is a pronounced risk factor for cancer patients with low incomes. There has been little progress in developing an income intervention to alleviate financial toxicity cancer patients with low incomes. Unconditional cash transfers (UCT), or guaranteed income, have produced positive health effects in experiments with general low-income populations, but have not yet been evaluated in people with cancer. The Guaranteed Income and Financial …

Implementing Nurse Education On Evidence-Based Birthing Positions For First And Second Stages Of Labor To Promote Fetal Descent, Momoko Ueda

Master's Projects and Capstones

Cesarean deliveries can increase the risk of maternal and newborn complications. A cost-effective method to reduce unnecessary cesarean deliveries is through maternal repositioning during the first and second stages of labor. Research has shown that flexible sacrum positions such as standing, squatting, kneeling, lunging, hands and knees, side-lying, and use of a peanut ball reduces the duration of labor, lowers rates of cesarean deliveries, and promotes fetal descent. This project aims to increase nurse confidence in these evidence-based labor positions by implementing nurse education in the labor and delivery unit at a Bay Area County hospital. A pre-survey identified current …

Improving Timely Sepsis Care Through Staff Education Within The Emergency Department, Shirley Chen

Master's Projects and Capstones

Problem: This project was implemented to decrease patient fallout rates through timely compliance with sepsis management according to the SEP-1 bundle. The SEP-1 bundle is already implemented in the emergency department. However, a microsystem assessment indicated barriers are preventing the achievement of the SEP-1 bundle milestones.

Context: This 16-bed emergency department (ED) at an urban Bay Area hospital provides 24-hour emergency services to individuals who suffer from medical injuries, accidents, and other serious health conditions. A random audit of the electronic health system (EHS) revealed that this emergency department consistently fails to meet the sepsis management time goals by 90%. …

Educating Nursing Staff On Evidence-Based Maternal Positioning To Promote Fetal Descent During The First And Second Stages Of Labor, Mary Ray Fouad

Master's Projects and Capstones

The aim of this project was to determine whether educating Labor and Delivery (L&D) nurses on maternal positions would increase their confidence their implementation to reduce the risk of cesarean sections (c-sections, CS) and progress the first and second stages of labor. Previous studies have shown that upright positions reduce the length of both labor stages by promoting more effective uterine contractions. Although L&D nurses may be familiar with the labor positions, they may not have confidence in their utilization as the education and practice of the birthing positions is not standardized. At a Bay Area county hospital, L&D nurses …

Therapeutic Gardening For Mental Health In Substance Use Recovery, Stephanie E. Schafer

Master's Projects and Capstones

Abstract

As the clinical nurse leader (CNL) in this project, I used the “[CNL]

Essential 1: Background for Practice from Sciences and Humanities” (Competencies and Curricular Expectations for Clinical Nurse Leader Education and Practice, 2013) and its competencies to focus on designing nursing care for a clinical or community-focused population based on biopsychosocial, public health, nursing, and organizational sciences and to synthesize evidence for practice to determine appropriate application of interventions across diverse populations. With the help of the CNL competencies and collaboration with the healthcare team, we created and implemented a therapeutic garden for residents in a substance use …

Educating Medical-Surgical Nurses In A Large Hospital Organization On Sepsis Bundle Elements, Christopher N. Guinto

Master's Projects and Capstones

Problem: Results from a voluntarily anonymous pre-survey about sepsis revealed that a majority of the seventeen nurses assessed themselves below an "expert knowledge '' level. The survey results present an opportunity to improve the nurses’ knowledge and confidence in nursing response and improve patient outcomes with sepsis.

Context: The quality improvement (QI) project was conducted on a medical-surgical unit in a large Northern California hospital.

Intervention: A QI team initiated evidenced-based practice research and created an educational sepsis handout for nurses to increase sepsis knowledge and confidence.

Measures: The self-assessment pre-survey would be compared to the responses from the post-survey. …

Single-Frame Deep-Learning Super-Resolution Microscopy For Intracellular Dynamics Imaging, Rong Chen, Xiao Tang, Yuxuan Zhao, Zeyu Shen, Meng Zhang, Yusheng Shen, Tiantian Li, Casper Ho Yin Chung, Lijuan Zhang, Ji Wang, Binbin Cui, Peng Fei, Yusong Guo, Shengwang Du, Shuhuai Yao

Faculty, Staff and Student Publications

Single-molecule localization microscopy (SMLM) can be used to resolve subcellular structures and achieve a tenfold improvement in spatial resolution compared to that obtained by conventional fluorescence microscopy. However, the separation of single-molecule fluorescence events that requires thousands of frames dramatically increases the image acquisition time and phototoxicity, impeding the observation of instantaneous intracellular dynamics. Here we develop a deep-learning based single-frame super-resolution microscopy (SFSRM) method which utilizes a subpixel edge map and a multicomponent optimization strategy to guide the neural network to reconstruct a super-resolution image from a single frame of a diffraction-limited image. Under a tolerable signal density and …

Pou4f1-Tbr1 Transcriptional Cascade Controls The Formation Of Jam2-Expressing Retinal Ganglion Cells, Takae Kiyama, Halit Y Altay, Tudor C Badea, Chai-An Mao

Faculty, Staff and Student Publications

More than 40 retinal ganglion cell (RGC) subtypes have been categorized in mouse based on their morphologies, functions, and molecular features. Among these diverse subtypes, orientation-selective Jam2-expressing RGCs (J-RGCs) has two unique morphologic characteristics: the ventral-facing dendritic arbor and the OFF-sublaminae stratified terminal dendrites in the inner plexiform layer. Previously, we have discovered that T-box transcription factor T-brain 1 (Tbr1) is expressed in J-RGCs. We further found that Tbr1 is essential for the expression of Jam2, and Tbr1 regulates the formation and the dendritic morphogenesis of J-RGCs. However, Tbr1 begins to express in terminally differentiated RGCs around …

Cxcl8/Cxcr2 Signaling Mediates Bone Marrow Fibrosis And Is A Therapeutic Target In Myelofibrosis, Andrew J Dunbar, Dongjoo Kim, Min Lu, Mirko Farina, Robert L Bowman, Julie L Yang, Young Park, Abdul Karzai, Wenbin Xiao, Zach Zaroogian, Kavi O'Connor, Shoron Mowla, Francesca Gobbo, Paola Verachi, Fabrizio Martelli, Giuseppe Sarli, Lijuan Xia, Nada Elmansy, Maria Kleppe, Zhuo Chen, Yang Xiao, Erin Mcgovern, Jenna Snyder, Aishwarya Krishnan, Corrine Hill, Keith Cordner, Anouar Zouak, Mohamed E Salama, Jayden Yohai, Eric Tucker, Jonathan Chen, Jing Zhou, Timothy Mcconnell, Anna R Migliaccio, Richard Koche, Raajit Rampal, Rong Fan, Ross L Levine, Ronald Hoffman

Faculty, Staff and Student Publications

Proinflammatory signaling is a hallmark feature of human cancer, including in myeloproliferative neoplasms (MPNs), most notably myelofibrosis (MF). Dysregulated inflammatory signaling contributes to fibrotic progression in MF; however, the individual cytokine mediators elicited by malignant MPN cells to promote collagen-producing fibrosis and disease evolution are yet to be fully elucidated. Previously, we identified a critical role for combined constitutive JAK/STAT and aberrant NF-κB proinflammatory signaling in MF development. Using single-cell transcriptional and cytokine-secretion studies of primary cells from patients with MF and the human MPLW515L (hMPLW515L) murine model of MF, we extend our previous work and delineate the role of …

Building Sustainable Environmental Activism Programs For Youth, Aminah Habib

Master's Projects and Capstones

As the negative impacts of climate change become more and more common across the United States, many youth are experiencing eco-anxiety or other negative mental health impacts due to the state of the environment. Engaging with activism has been named as a potential mitigator of the negative impacts of climate change among youth, but the relationship between activism and youth well-being is an emerging area of research. To explore this relationship, this scoping review explored and synthesized available literature to inform the next steps. In addition to the community-level and society-level contributions that come from youth activism, there are also …

Bridging The Gap: Educating Medical-Surgical Unit Nurses In A Large Hospital Organization On Sepsis Bundle Elements, Meara J. Matthews

Master's Projects and Capstones

Problem: Sepsis is a life-threatening response to infection that remains one of the leading causes of death worldwide. Based off results obtained from a pre-education survey of nurses on a medical-surgical unit in a large hospital organization, there is an opportunity to increase knowledge and confidence level regarding sepsis and care of septic patients so that nurses are prepared to detect sepsis early and intervention can begin.

Context: The project is being conducted in a medical-surgical unit at a large hospital organization in Northern California. The data from the survey includes 17 nurses on the unit who completed the pre-education …

Improving Timely Sepsis Care Through Staff Education Within The Emergency Department, Spencer Forest

Master's Projects and Capstones

Problem: This quality improvement project aims to increase SEP-1 sepsis bundle compliance among nursing staff at a 16-bed emergency department through targeted continual staff education on sepsis screening and best practices. Currently, the unit is experiencing cases of sepsis fallout and is not meeting the 90% threshold on three treatment metrics as defined by the institutional sepsis bundle time goals. Bundle compliance that adheres to the time goals decreases incidences of sepsis fallout and overall days in the hospital, while increasing positive patient health outcomes.

Context: A microsystem assessment was completed along with a staff gap survey to determine areas …