Diseases Commons^™

Implementation Of A Vestibular Disorder Screening Tool In An Urgent Care, Kathleen A. Probst

Dissertations

Implementation of a Vestibular Disorder Screening Tool in an Urgent Care

Kathleen A. Probst

M.S.N., University of Missouri-Columbia, 2007

B.S.N., University of Missouri-Columbia, 2004

A Dissertation Submitted to The Graduate School at the University of Missouri-St. Louis in partial fulfillment of the requirements for the degree

Doctor of Nursing Practice

August 2023

Advisory Committee

Susan Dean-Baar, PhD, RN, CENP, FAAN

Chairperson

Jennifer Vines, DNP, MSN, RN

Troy Dinkel, MD

Copyright, Kathleen A. Probst, 2023

Abstract

Problem: Vestibular disorders disrupt everyday living and can cause reduced quality of life. Guidelines developed to screen for vestibular disorders are not efficient to use …

An Evaluation Of A Multidisciplinary Implementation Of Evidence Based Practice In Prediabetes, Emily Sisco

Dissertations

Abstract

Problem Over 70% of prediabetic patients progress to full diabetes. There are over 80 million American adults who are diabetic. Diabetes is the costliest chronic disease that often leads to many other health issues.

Methods This QI project utilized a descriptive observational design. Quantitative data was collected via retrospective chart review. Primary data collected was documentation of a patient visit to the registered dietician and the hemoglobin A1c (HbA1c) of patients who followed up in the office after the referral.

Results Eight patients followed up to the office for a second visit (n=8). Four patients did see the registered …

Eye Care Protocol In Critically Ill Pediatric Patients On Neuromuscular Blockage, Jinnie Tkach

Dissertations

Abstract

Problem: Patients admitted to the pediatric intensive care unit (PICU) are at increased risk for the development of ocular surface disease (OSD) due to impaired ocular mechanisms while intubated, sedated, and on continuous neuromuscular blockade. The purpose of this project is to prevent OSD and vision impairments by increasing the frequency of eye care in accordance with a PICU eye care protocol.

Methods: An observational descriptive study was conducted utilizing retrospective and prospective chart review. Comparisons were drawn between the 2021 pre intervention group and the 2022 post intervention group regarding the impact of linking lubricating eye ointment orders …

Evaluation Of A Process Change Using An Updated Sedation Protocol, Rachel Allen

Dissertations

Problem: Pediatric delirium is continuing to increase intensive care environments and for patients who require mechanical ventilation and continuous sedative medications. Delirium is harmful to the patient creating lasting neurologic and mental health issues along with prolonged hospitalization and increased healthcare cost

Method: For this quality improvement (QI) project, a descriptive observational study was used to evaluate the implementation of a sedation protocol for patients who are mechanically ventilated and on continuous sedative medications. This was completed with the use of retrospective chart reviews three months prior to implementation and three months after the new protocol was implemented. Nurses were …

Preventing Ocular Surface Disease In The Pediatric Intensive Care Unit, Emily Mallette

Dissertations

Preventing Ocular Surface Disease in the Pediatric Intensive Care Unit

Problem: Ocular surface disease in the Pediatric Intensive Care Unit is a significant problem in intubated patients due to altered eye protective mechanics, leading to exposure of the eye surface and dry eye. The purpose of this quality improvement project was to evaluate how an eye care protocol affected the frequency of artificial tear ointment administration.

Method: A descriptive, cohort design utilizing a retrospective chart review with convenience sampling of intubated children in the PICU from two cohorts was used. Comparisons were made between the preintervention cohort in 2020 and …

Education-Based Interventions Effects On 30-Day Readmission Rates For Patients With Copd, Gina Hand-Eoloff

Dissertations

Purpose: This Quality Improvement (QI) project evaluated the impact of an existing education-based program for Chronic Obstructive Pulmonary Disease (COPD) and its effect on 30-day readmission rates in one hospital in rural Missouri.

Method: A retrospective chart review was completed on 493 patients with an inclusive diagnosis of COPD from June 1, 2018, to March 31, 2019, using a cohort study design and a two-sample t-test analysis. Additional variables were analyzed to determine if there were predictive factors of an elevated risk of readmission.

Results: The two-sample t-test reveals there is no statistically significant difference between the rates of readmission …

Evaluating The Delivery Of Diabetes-Related Care Among The Asian Population, Lyly Bui

Dissertations

Purpose: This project evaluated current practices for Type 2 diabetes mellitus (T2DM) screening and management among Asian Americans (AAs) presenting to a primary care clinic and determined whether these practices adhered to the American Diabetes Association (ADA)’s 2018 guidelines.

Methods: A retrospective chart review was performed to extract data from clinical case records of AAs who visited the Vietnamese Health Center (VHC) between November 1, 2017 and November 1, 2018. Descriptive statistics were utilized to analyze the data.

Results: Of 173 charts reviewed, 76.3% of AAs had no previous T2DM diagnosis and 23.7% had a previous diagnosis. Among those without …

The Influence Of Stressful Life Events On The Development Of Type 2 Diabetes, Joshua Minks

Dissertations

This study examined the relationship between distress and the development of Type 2 diabetes mellitus (T2DM) in the presence of established risk factors. Distress secondary to mental health disparities, stressful life events, and work conditions has been shown to promote insulin resistance and the development of T2DM.

Subjects (N=79) diagnosed with T2DM within the previous six months were recruited from SSM Health Centers and VA Medical Centers in the greater St. Louis area. They completed the Recent Life Changes Questionnaire, ENRICHD Social Support Instrument, and a demographic survey and analyses were conducted to determine differences between the veteran …

A Functional Algorithm For Weight Loss And Obesity Practice: Guide For Clinical Decision-Making For Treating Women, Jennifer A. Tice Williams

Dissertations

ABSTRACT

Background

Overweight and obesity have significant impact and consequences on women leading to reduced quality of life, comorbid conditions and premature mortality. Many healthcare providers lack adequate training and the time to properly treat overweight and obesity. Algorithms have been shown to improve clinical knowledge and save time.

Objectives

To develop an algorithm for weight loss assessment and treatment to aid in the clinical decision-making process while improving the quality of care for overweight and obese clients in an efficient manner that can be replicated.

Methods

After an extensive literature review to identify best-practice guidelines for weight loss a …