Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

The Utilization Of Exogenous Surfactant In The Neonate, Katherine Thorkildsen

Senior Honors Theses

Respiratory distress syndrome (RDS) is a common consequence of pulmonary immaturity in the lungs of neonates. RDS is the result of the deficient secretion of endogenous surfactant, causing increased surface tension in the alveolar sacs leading to respiratory compromise. RDS is more common in the preterm neonate but can be experienced by neonates at any gestational age. Treatment for RDS formerly consisted of mechanical ventilation and oxygen therapy to treat and relieve symptoms but not the cause. A new treatment method, developed largely in the 1980s and 90s is the use of exogenous surfactant to treat the deficiency exhibited in …

Initial Development Of A Patient-Reported Instrument Assessing Harm, Efficacy, And Misuse Of Long-Term Opioid Therapy, William C. Becker, David A. Fiellin, Anne C. Black, Carol T. Kostovich, Robert D. Kerns, Liana Fraenkel

Nursing: School of Nursing Faculty Publications and Other Works

Guidelines on long-term opioid therapy recommend frequent reassessment of harm, efficacy, and misuse of these potentially harmful and sometimes ineffective medications. In primary care, there is a need for a brief, patient-reported instrument. This report details the initial steps in the development of such an instrument. An interdisciplinary team of clinician-scientists performed four discrete steps in this study: (1) conceptualization of the purpose and function of the instrument, (2) assembly of an item pool, (3) expert rating on which items were most important to include in the instrument, and (4) modification of expert-selected items based on a reading level check …

The Effect Of Therapeutic Horseback Riding On Balance And Self-Efficacy In Children With Developmental Disabilities, Alexandra Smola, Lauren Hurley

Williams Honors College, Honors Research Projects

Therapeutic horseback riding (THR) has positive health related outcomes in children with developmental disabilities. The purpose of this study was to determine the effect of a 10-week THR intervention on balance and task-specific self-efficacy in children with developmental disabilities. Bandura’s social cognitive theory and the physical stress theory guided the quasi-experimental study. A pre-test post-test design (N=20) was implemented with a 10-week THR class at a riding center in Midwest United States. The first research question was: In children with developmental disabilities ages 5 to 18, does one 10-week session of THR affect balance? With time 1 balance mean at …

A Randomized Controlled Trial Of Anesthesia Guided By Bis Vs. Standard Care And Effects On Cognition, Zohn Centimole

Theses and Dissertations--Nursing

Postoperative cognitive dysfunction (POCD) occurs frequently in individuals undergoing major surgery with general anesthesia. POCD adversely affects morbidity and health-related quality of life. Derived electroencephalographic (EEG) monitoring is utilized to guide the anesthesia provider in titration of volatile anesthetics. POCD has been associated volatile anesthetic neurotoxicity. EEG monitors are known to reduce a patient’s total cumulative dose exposure to volatile anesthetics. There is currently little evidence to support utilization of EEG monitors as a guide to reduce the incidence of POCD.

The purpose of this dissertation was to develop and test a technique of general anesthesia, delivered by anesthesia providers …

The Effect Of Therapeutic Horseback Riding On Balance And Self-Efficacy In Children With Developmental Disabilities, Lauren M. Hurley, Alexandra Smola

Williams Honors College, Honors Research Projects

The prevalence of developmental disabilities in children in the United States is a serious problem. Since children with developmental disabilities often show decreased self-efficacy and balance, researchers have studied the effects of interventions in this population. The purpose of this study is to determine the effect of a 10-week THR session on balance and task-specific self-efficacy in children with physical disabilities ages 6 to 18 years old. Bandura’s social cognitive theory and The Physical Stress Theory will guide the quasi-experimental study. A pre-test post-test design will be implemented over a 12 week span at 3 different riding centers in the …

Recognizing Pain Using Novel Simulation Technology, Justin C. Grace

Honors Undergraduate Theses

Effective pain management and time to treatment is essential in patient care. Despite scientific evidence supporting the need to treat pain and an emphasis on addressing pain as a priority, pain management continues to be an unresolved issue. As a member of the health care team, nurses are integral to optimal pain management. Currently, nursing schools have limited innovative or alternative methods for teaching pain assessment and management. Simulation in nursing education provides a unique opportunity to expose students to realistic patient situations and allow them to learn and make mistakes without causing harm. However, modern low- and high-fidelity simulation …

Improving Patient Care Outcomes To Reduce Recurrent Admissions Of Patients With Chronic Obstructive Pulmonary Disease, Lisa Maria Friedrich

Seton Hall University DNP Final Projects

Purpose:Transitional care is time-limited, with the goal of ensuring safety and health continuity for at-risk patients with chronic obstructive pulmonary disease (COPD) as they move from one setting to the next. An acute care episode of COPD ranges from relatively healthy adults to adults with multiple chronic conditions or those in the end-of-life phase. The primary quality concern of an urgent need to improve health care is in response to the gaps of sufficient experience to manage patients with COPD, leading to hospital readmissions. Implementation of standards of care for the improvement of health-related quality of life (HRQL) of COPD …

Cerebral Oximetry Readings In The Sitting Position Versus Supine Position For Patients Undergoing General Anesthesia, Christopher Turner

Doctoral Projects

Problem: Inadequate cerebral blood flow is a significant risk for patients undergoing surgery in the sitting position. Placing the patient in a sitting position may cause a drop in pressure at the level of the brain when compounded with induction and maintenance of general anesthesia. These changes may cause a decrease in cerebral blood flow and oxygenation. Inadequate perfusion for a prolonged period of time could produce negative neurological consequences in the short and long term postoperative period.

Purpose: The purpose of this project is to determine if there is a significant drop in cerebral oximetry, from baseline, when patients …

An Exploration Of Nurse Adherence To Ventilator-Associated Pneumonia Bundle Interventions: A Quantitative Study, Alexis Luna

Senior Theses

Ventilator-associated pneumonia (VAP) poses a significant health risk to patients on mechanical ventilation in hospital intensive care units (ICU). It is the responsibility of the nurse to implement VAP bundle interventions to decrease the prevalence of VAP in mechanically ventilated patients. The objective of the study was to measure nurse perception of adherence to VAP bundle interventions of oral hygiene, head-of-bed elevation, spontaneous breathing trials, daily sedation vacations, and peptic ulcer and deep vein thrombosis prophylaxis. A descriptive study involving a sample population of 28 ICU nurses at 3 hospitals in northern California was conducted. A 57-item questionnaire was developed …

Preparedness Of Hospitals In The Republic Of Ireland For An Influenza Pandemic, An Infection Control Perspective, Mary Reidy, Fiona Ryan, Dervla Hogan, Seán Lacey, Claire Buckley

Department of Mathematics Publications

When an influenza pandemic occurs most of the population is susceptible and attack rates can range as high as 40–50 %. The most important failure in pandemic planning is the lack of standards or guidelines regarding what it means to be ‘prepared’. The aim of this study was to assess the preparedness of acute hospitals in the Republic of Ireland for an influenza pandemic from an infection control perspective.

Impact Of Standardized Oral Health Assessment On Preventing Ventilator-Associated Events, Juana Ambriz De Williams

Evidence-Based Practice Project Reports

Ventilator-associated pneumonia (VAP) is a common but preventable health-care associated infection that affects up to 20% of mechanically ventilated adult patients, resulting in estimated mortality rates ranging from 13% to 55% (Chahoud, Semaan, Almoosa, 2015; Melsen et al., 2013). In an effort to reduce morbidity, mortality and related costs, the Centers for Disease Control and Prevention (CDC) and the National Healthcare Safety Network (NHSN), proposed ventilator-associated pneumonia prevention as a national patient safety goal. In 2014, amid growing concerns that the subjectivity of existing definitions had led to inconsistent reporting, thereby impeding efforts to reduce VAP, the CDC refocused surveillance …

The Effectiveness Of Implementing Standard Of Care Best Practices Including Use Of Daily Incentive Spirometry To Improve Dyspnea And Quality Of Life In Adults With Chronic Obstructive Pulmonary Disease (Copd), Christine Gallagher

Doctor of Nursing Practice (DNP) Program

Chronic obstructive pulmonary disease (COPD) is a common preventable and treatable disease characterized by symptoms of dyspnea, cough, and wheezing. Many patients with COPD are on daily medications for their symptoms yet these symptoms continue to persist, impairing their quality of life. Patients with COPD experience respiratory muscle weakness that contributes to dyspnea and an inability to participate in daily activities. GOLD (2014) guidelines state that the goal of therapy in these patients is to reduce symptoms, increase participation in activities, and restore the highest level of independent functioning. The guidelines recommend the use of inspiratory muscle training (IMT) in …

Wirelessly Connected Sensor Acquisition System For Remote Nursing Applications, Yuhua Hu

Dissertations, Theses and Capstone Projects (Full IR Collection)

Taking advantage of the equipment used in the "Remote Nursing" project, nurses can watch patients' status remotely. The equipment, which is installed in the patient's ward or home, can monitor them and their environment. This project demonstrates this using a microcontroller system that interfaces to a video camera and temperature and humidity sensors in the room. Also a servomotor is installed to control the position of the camera. The microcontroller communicates wirelessly with a PC.

This project is focused on hardware rather than software. It is to test the video camera and sensors being used over the microcontroller through the …

Using Education And A Prevention Protocol Tool To Decrease The Incidence Of Pressure Ulcers In A Nursing Home, Kristina L. Scalzitti

Evidence-Based Practice Project Reports

Over 1.3 million persons are residents in nursing homes (NHs); one in ten have pressure ulcers. The purpose of this evidence based practice project was to determine if implementation of a pressure ulcer prevention tool, along with staff education, decreases the incidence of pressure ulcers within the NH. Florence Nightingale’s Environmental Model and the Stetler Model were used to guide this project. The setting was a NH in northwest Indiana. Eleven nurses attended a 15 minute educational session on pressure ulcer prevention and implementation of the Pressure Ulcer Prevention Protocol Intervention (PUPPI) tool. PowerPoint slides were distributed and flyers about …

Diabetes Type 2 Self-Management Education Program: Short Messaging From Patient Portal To Web-Enabled Device, Lynn S. Holcomb

Evidence-Based Practice Project Reports

Only one in eight adults with diabetes reaches target goals for disease management, which can lead to clinical complications, costly both economically and in quality and duration of human life. The standard of care is a quarterly 15-minute face-to-face visit-- arguably inadequate to impart self-care knowledge. The purpose of this EBP project was to deliver a 30-day diabetes self-management education program (DSMEP) utilizing widely accessible web-based technology to facilitate adults with diabetes to reach targeted goals. Using the Chronic Care Model as a framework, the DSMEP design was based on an extensive literature review of the delivery of DSMEP in …

The Effect Of An Educational Intervention On Oral Anticoagulation Therapy Knowledge In Primary Care, Elizabeth D. Deck

Evidence-Based Practice Project Reports

It is estimated that three million people in the United States are on oral anticoagulation therapy (warfarin). Populations studied have been found in therapeutic range 64% of the time (Pernod, Labarere, & Bosson, 2008). The low percentage of therapeutic range is attributable to (a) adherence, (b) monitoring infrequency, (c) Vitamin K antagonists, and (d) the effects of aging and comorbidities. The purpose of this evidence-based practice (EBP) project was to examine whether an educational intervention would improve the knowledge of patients receiving warfarin therapy. Roy’s model for patient adaptation and the Stetler Model for EBP were used as frameworks for …

Oral Wellness: Using Occupational Therapy To Enhance Oral Hygiene Delivery In Long-Term Care, Lauryn J. Banovitz, Liberty Bellah, Rosemarie Lion

Dissertations, Masters Theses, Capstones, and Culminating Projects

Based on current literature, oral health in long-term care (LTC) facilities is frequently of low priority and does not follow evidence-based best practices. Poor oral health reduces the quality of life of older adult residents and patients and can lead to systemic diseases, such as cardiovascular disease, stroke, and pneumonia, the leading cause of death in LTC. Occupational therapists can play an instrumental role as oral care consultants, and educators, and can act as resource guides to raise the standards of oral care in LTC facilities.

This capstone project explored ways in which occupational therapy, a profession traditionally designated for …

Attitudes Towards An Evidence-Based Clinical Decision Support Tool To Reduce Exposure To Ionizing Radiation, Raymond Zakhari

Faculty Publications and Presentations

Patients who suffer minor brain injuries experience unnecessary ionizing radiation in the form of a non-contrast head CT scan despite the dearth of evidence supporting standard CT scans for all brain injuries. Exposure to ionizing radiation increases the incidence of certain types of cancer. This evidence-based practice change project assesses the attitude of clinicians towards evidence-based clinical decision support tools, specifically the Canadian CT head rule. The use of highly sensitive clinical decision support tools is supported in the literature to help healthcare providers mitigate the risk associated with unnecessary use of CT scan imaging studies. The project was conducted …

Implementing And Evaluating A Clinical Information Interface Between An Electronic Medical Record And A Patient Classification System, Tanya Osborne-Mckenzie

Doctor of Nursing Practice (DNP) Projects

As a result of the Affordable Care Act and the Institute of Medicine’s initiatives, hospitals are challenged to improve outcomes as efficiently as possible. How does the national initiative of RNs partnering with other healthcare professionals to improve the quality of patient care at a lower cost, cascade down to individual organizations? One answer may come by focusing on nurse staffing in acute care hospitals. Considering the impact RNs have on patient quality outcomes and the bottom line of hospitals, appropriate management of the RN workforce is one of the most important areas hospitals can focus on in order to …

Increasing Compliance Of Personal Protective Equipment S Election And Use For Isolation Precautions Among Rns & Nas On A Med-Surg Unit, Megan R. Alsmeyer

Master's Projects and Capstones

Background: Due to the high potential of transferring infectious diseases and/or organisms among patients, themselves, and the community, healthcare workers (HCWs) must be knowledgeable and confident in selecting the appropriate type of personal protective equipment (PPE), and the use in technique when putting on (donning) and removing (doffing) PPE based on the level of isolation precautions required for the patient being cared for.

Project Purpose: The purpose of this project is to determine whether assessing the knowledge and actual practice with observing, and utilizing an innovative approach of video and educational tools to isolation precautions would improve the consistency of …

Lessons Learned In Caring For Patients Treated With Therapeutic Hypothermia, Catherine H. Swedberg Rn, Kelly A. Wolfenden Rn, Bsn, Cci, Jeffrey Martin Rn, Carolyn Ordway Msn, Rn, Crnp

Patient Care Services / Nursing

No abstract provided.

Effects Of An Apn-Led Amiodarone Clinic On Adherence To Recommended Monitoring Guidelines, Melissa Bartoszewicz

Evidence-Based Practice Project Reports

Evidence shows that patients receiving amiodarone therapy have not adhered to monitoring guidelines set forth by the Heart Rhythm Society. Uncertainty with responsibility for monitoring has led to the development of pharmacist-managed or multidisciplinary-managed outpatient amiodarone clinics. Some limitations have been identified in the pharmacist-managed outpatient clinics that may be overcome by advanced practice nurse (APN)-managed clinics. The purpose of this EBP project was to determine what effects an APN-led amiodarone clinic would have on adherence to amiodarone monitoring guidelines. Using the PICOT format, the clinical question was developed: Does enrollment in an amiodarone clinic compared with “usual care” change …

The Effect Of Telephone Follow-Up On Pain Experienced By Patients After Knee Replacement Surgery, Laurie J. Jones

Evidence-Based Practice Project Reports

Hospital length of stays are decreasing throughout the U.S. in an effort to contain healthcare costs, but these measures can be detrimental to patients. Those who get knee replacement surgery are finding their length of stay reduced from an average of 3 to 4 days to 24 to 48 hours, which can affect pain control and interfere with rehabilitation and recovery. This affects many people, as more than 632,000 knee replacements occur each year (American Academy of Orthopedic Surgeons, 2008). The purpose of this evidence-based project was to evaluate the effect of telephone follow-up on pain experienced by knee replacement …

High-Dose Interleukin-2 Administration In The Oncology Medical-Surgical Setting – An Innovation To Impact Cost Efficiencies, Clinical Outcomes And The Ideal Patient Experience, Deidre L. Kutzler Rn, Megan L. Derr Rn

Patient Care Services / Nursing

No abstract provided.

Chhs July E-Newsletter, Dr. John Bonaguro, Dean, Vashon S. Wells, Editor, Wku College Of Health & Human Services

College of Health & Human Services Publications

No abstract provided.

The Effects Of Nursing Care On The Patient Experiencing A Stillborn Birth, Katherine Totten

Senior Honors Theses

Childbirth has the potential of being one of the most joyous and fulfilling experiences a woman goes through in her entire life. Being a mom, driving the kids to soccer practice, and sitting around the Christmas tree with the family can easily be seen as an ideal life. Conversely, the negative experiences with childbirth are rarely discussed. There is an overlooked category: moms who conceive but lose the baby in the womb. Not only are these women overlooked, but also the hospital care they receive proves inconsistent with the latest research. Nurses and doctors should be aware of the latest …

Examining Nurses' Knowledge And Attitudes About Pain Management Using An Online Survey, Linda G. Alley Phd, Rn, Michelle D. Flores, Hannah D. Paxton Rn, Mph, Kathy Baker Mph, Rn, Carol A. Foltz Phd, Jen Wike Mph, Mba, Jeffrey Etchason Md

Department of Community Health and Health Studies

No abstract provided.

Adaptive Support Ventilation Reduces The Number Of Ventilator Changes From Initiation To Liberation, Bryn S. Pencil Bs, Rrt-Accs, Kenneth Miller Med, Rrt-Nps, Courtney Edwards Md

Patient Care Services / Nursing

No abstract provided.

The Inconsistency Of Providing Ventilation With A T-Piece Style Resuscitator: A Bench Model Study, Robin L. Angus Bs, Rrt-Nps, Kenneth Miller Med, Rrt-Nps, Chris Fenstermaker Ms, Rrt-Nps

Patient Care Services / Nursing

No abstract provided.

Practitioners' Use Of Clinical Practice Guidelines: An Evidence-Based Approach, Sondra Michelle Phipps Santana

UNF Graduate Theses and Dissertations

Pre-diabetes is a serious health problem in the United States. Distinguished by plasma glucose levels that are above the normal threshold, patients with pre-diabetes are 10 times more likely to develop type 2 diabetes. Patients with pre-diabetes suffer the same complications as patients with diabetes including diabetic retinopathy, nephropathy, and microalbuminuria.

There is considerable evidence to support the idea that early identification and aggressive treatment of pre-diabetes has the potential to delay disease progression. The American Diabetes Association’s clinical practice guideline recommends management of with lifestyle modification and metformin for patients who are at risk for developing type 2 diabetes. …