Medical Education Commons^™

Developing A Clinical Practice Guideline For Surgical Diabetic Patients, Barbie Denise Harbaugh, Diane Whitehead

Walden Faculty and Staff Publications

Diabetes is a recognized risk factor for postoperative infection, acute renal failure, ileus, and lengthy hospital stay. Optimal screening, management, and scheduling of elective surgery for diabetic patients has been shown to improve quality care, decrease complications, and increase the efficiency and lower the costs of preoperative patient care. However, surgery cancellations are common due to inadequate preoperative glycemic control and poor intraoperative glycemic control, which is a recognized risk factor for perioperative or postoperative complications. There were no clinical practice guidelines or optimization protocols for elective surgery patients at a small rural hospital in the Northeast United States. The …

Determining Racial And Ethnic Disparities In Breastfeeding In The United States, Summer Coker

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The benefits of breastfeeding have been thoroughly studied and researched, with the majority of healthcare providers, health organizations and policies, and professionals in health all recommending the practice. Breastfeeding has protective factors for the newborn against infection and mortality. Other benefits for breastfed children include reduced risk of obesity, asthma, and ear infections; enhanced chance of having a higher income; and a stronger immune system that can follow them throughout adulthood (World Health Organization [WHO] 2020). For mothers who breastfeed, there is a reduced risk of developing ovarian and breast cancer, high blood pressure, and type 2 diabetes (Centers for …

The Effect Of The Timing Of A Hospice Referral And The Perceived Quality Of Care By The Family, Caitlin Tran

Nursing | Senior Theses

Hospice care is a specialized type of palliative care for patients with a time-limiting illness. Despite its benefits, hospice remains underutilized. A key reason behind the underutilization are untimely referrals, often made during the last weeks or days of the patient’s life. The purpose of this paper is to investigate the existing barriers towards hospice that play into late referrals and its effect on patient/family satisfaction. This information will be examined to propose a pilot research study for further exploration.

Participation In Mindfulness-Based Stress Reduction Therapy On The Immune Function Of Survivors Of Breast Cancer: A Literature Review And Pilot Study For Clinical Practice, Bianca Marteja

Nursing | Senior Theses

A review of current literature presented in this work suggests that MBSR participation results in NKCA, T-cell and B-cell restoration as well as a reduction in inflammatory biomarkers. While results from these studies are statistically significant, they are, however, relatively small. Furthermore, the reliability and one’s ability to generalize study findings from this literature review is limited by consistently small sample sizes, high attrition, differing forms of MBSR application, and inconsistent adherence to MBSR home practices.

The distribution of a 10-point survey using likert scales occured in a pilot study associated with the aforementioned literature review; this survey evaluated registered …

Plant-Based Diet: How It Affects Health, Sarah Marsland

Senior Honors Projects

This research project aims to investigate the relationship between plant-based dieting and overall health, specifically the prevention and reversal of chronic disease. Two subjects committed to eating a plant-based diet comprised of primarily vegetables, fruits, whole grains and non-processed foods for six weeks. Before beginning, they were asked about their current health status, including a complete health history, and their knowledge of plant-based eating. Throughout the research period, the subjects shared what they were eating, challenges they faced, and any benefits they noticed. Upon completion of the diet, they answered questions about their experience. With this information, the researcher was …

The Need For Change In Emergency Medical Approach When Caring For Individuals With Autism, Hannah Watkins

Undergraduate Theses and Capstone Projects

This paper highlights the need for policy changes and additional training related to caring for individuals with autism in emergency situations. Individuals with autism spectrum disorder are at risk of receiving inadequate care due to the challenges that come with such a complex diagnosis. Depending on the severity of autism for each individual, behavioral outbursts and aggression can often occur due to the overwhelming amount of stimulation in the emergency department environment. While medical professionals have the potential to be a great help during times of crisis, there is often very little training given to providers in regard to delivering …

Development And Validation Of A Scale To Measure Nurse/Medical Resident Physician Collaboration, Bruce St. Amour, W. Brady Dehart

HCA Healthcare Journal of Medicine

Introduction: The purpose of this pilot study is to investigate the reliability of an interprofessional collaboration measurement scale used for nursing interactions with resident physicians. To date, the collaboration between nurses and residents has not been adequately investigated and a validated tool specifically for this purpose is not yet available. Our objective is to adapt a previously validated interprofessional scale for health care settings to the specific nurse/resident physician collaboration.

Methods: In 2019, nurses from two hospitals were contacted via email and were invited to complete an anonymous survey that asked about the nurses’ interaction and collaboration with resident physicians. …

Implementing Inter-Professional Patient-Family Centered Plan Of Care Meetings On An Inpatient Hospital Unit, Nicolas Hernandez, Alice Fornari, Sage Rose, Leanne Tortez

Patient Experience Journal

Inpatient plan of care meetings support efforts to encourage collaborative practice and patient-family centered care and result in an effective strategy to enhance communication and patient satisfaction. Clinical team members participated in patient/family centered plan of care meetings at a community hospital in a selected inpatient unit with full time hospitalist physicians. Quantitative data were gathered pre/post implementation from the external Hospital Consumer Assessment of Health Care Providers (HCAHPS) survey. HCAHPS data were collected independently, specifically for questions related to communication between patients, family members/guardians and the medical team and also the effects of care transition. There was a slow …

Continuous Glucose Monitors To Decrease Hypoglycemia, Sara B. Woodcock

MSN Capstone Projects

Diabetes is a disease that affects millions of people from children to older adults. There is no cure, although it can be managed to prevent complications. Education of student nurses is where they are born and raised to become nurses who save and change lives. Teaching student nurses in depth about diabetes as a disease and the treatments that best fit their specific needs is where educating patients begins. Learning about a secondary option for blood glucose checks can make all the difference for several patients. Multiple finger sticks daily has been the leading way to check blood sugar for …

Hpv Vaccination Knowledge, Attitudes, And Uptake In College Nursing Students, Joanna Marie Plumb, Jeannie Giese, Martha Buckner, David Phillippi, Robin Cobb

DNP Projects

Background: The human papillomavirus (HPV) is a preventable, sexually transmitted infection. The vaccines for HPV are safe and effective, but previous research demonstrated that nursing students have low knowledge levels and vaccine uptake. Low knowledge and attitude levels in nurses and nurse practitioners can influence parental and patient decision making for HPV vaccination. Purpose: The purpose of this scholarly project was to evaluate HPV knowledge and attitudes and their association with vaccination uptake in college nursing students. There is limited research in the United States on HPV knowledge, attitudes, and uptake of the vaccine among nursing students. Methods: This project …

The Influence Of End Of Life Education On Stress, Anxiety, And Attitude Of The Healthcare Profession Student, Chiquesha Davis

DNP Final Reports

Providing comfort and support to the dying patient is a significant part of the dying process. When soothing a patient, who is dying, the goal is to prevent or relieve suffering as much as possible. Respecting the patient's health and quality of life goals and decisions is essential. Healthcare profession students can experience multiple levels of anxiety, stress, and a negative attitude while taking care of the dying patient. The implementation of a successful intervention is at the cornerstone of helping reduce stress, anxiety, and attitude change in healthcare profession students. The application can also have a positive impact on …

Reducing Pressure Injuries In The Intensive Care Setting: Nursing Knowledge And Best Practices Approach, Michelle Harvey

Doctor of Nursing Practice Projects

Background: For many health care organizations, pressure injury (PI) prevention strategies have become a priority focus to improve patient outcomes and associated costs.

Problem: A rural community hospital located in the Eastern U.S. experienced an increase in hospital acquired pressure injuries (HAPIs), predominantly in the intensive care unit (ICU). In 2018, 17.4% of HAPIs occurred in the ICU.

Approach: Implementation of a Quality Improvement project in an adult ICU, providing education and on-going learning activities to nursing staff, and applying a standardized plan of care “bundle” for prevention interventions.

Outcomes: The approach resulted in improved documentation of flotation of heels, …

Pilot Project: Developing A Standardized Evidence-Based Education Process For Nurses To Enhance New Medication Eduction Of Hospitalized Patients With Heart Failure, Michele Ann Crotteau

Doctor of Nursing Practice Projects

Problem Description: Research has shown that health information is difficult for the average adult to understand while clear communication helps patients feel involved and increases adherence to treatment. The Joint Commission recommends Health Literacy (HL) assessment and the use of the Teach Back Method (TBM). Medication errors that occur between the RN and elderly patient are preventable when the RN communicates effectively about the patient’s medications. A paucity of research exists evaluating TBM for nurse-patient communications. This Quality Improvement (QI) Pilot Project (PP) took place over 3-months, aimed to improve new medication education to elderly patients with Heart Failure (HF). …

Healthcare Provider Overlap On Evidenced-Based Practice In Intubated Patients Using The Theoretical Domain Framework: A Case Study, Katie Bull

CUP Ed.D. Dissertations

Intubation by endotracheal or tracheostomy means is a common life-saving intervention bearing significant, yet preventable risk. Evidence-based practice (EBP), intended to mitigate risk, is often inconsistently adhered to by healthcare providers (HCPs) due to a variety of factors, leaving patients vulnerable to adverse outcomes such as ventilator-associated pneumonia or tracheostomy-related stenosis. A review of the literature identified socially related barriers resulting from overlapping roles and expectations of primary HCPs. Little research has been conducted to understand the impact of overlap on EBP adherence. Using the Theoretical Domains Framework (TDF), this case study explored HCP overlap in one critical care unit …

Utilization Of A Concurrent Query Form To Improve Clinical Documentation In A Va Facility For Patients With Stroke Or Tia, Lisa A. Keefner

Electronic Theses and Dissertations

Caring for stroke patients diagnosed with acute ischemic stroke (AIS) and transient ischemic attack (TIA) at Veterans Health Administration (VHA) acute care hospitals is a very complex process that centers on accurate documentation. Inaccurate or missing documentation leads to patient safety issues, lower quality care, and inaccurate Veteran Equitable Resource Allocation (VERA) classification for reimbursement. This pilot project’s 3 problems of interest include improving provider response to clinical queries about documentation, capturing national metrics collected by the VHA, and accurately representing veterans in VERA classification. Based on a review of the literature available on patient treatment file (PTF) accuracy and …

The George Floyd Of Healthcare, Sheila P. Davis, Phd, Fnp-C, Faan, Lsm-Bc, Gary Davis, Md

Journal of Health Ethics

Authors explore the infamous murder of an unarmed black man, George Floyd, and juxtaposition it to systemic racial practices in healthcare as documented by the Institute of Medicine Report: Unequal Treatment. The current COVID-19 pandemic is presented as a situation which has the potential to ignite unresolved discriminatory healthcare practices. Proposed are policies which could possibly mitigate this phenomenon.

Examining Instructional Methods In End-Of-Life Nursing Education: Lecture Vs. Simulation, Jonathan M. Benson

Electronic Theses and Dissertations

Undergraduate nursing programs have historically glossed over end-of-life care, if their curricula addressed it at all. This lack of instruction can leave practicing nurses feeling poorly prepared to deliver this specialized care. Feeling incompetent and lacking confidence may lead to poorer attitudes regarding this nursing specialty. Thus, effective continuing education activities are paramount in equipping nurses to provide this care and improve attitudes towards caring for terminally ill patients and their families. The purpose of this study was to examine how registered nurse attitudes towards end-of-life care are impacted using a simulation-based learning experience compared to a traditional face-to-face lecture …

Application Of The Unified Theory Of Acceptance And Use Of Technology Model To Predict Dental Students' Behavioral Intention To Use Teledentistry, Jafar H. Alabdullah, Bonnie L. Van Lunen, Denise M. Claiborne, Susan J. Daniel, Cherng-Jyh Yen, Tina S. Gustin

Dental Hygiene Faculty Publications

Abstract

Teledentistry is an innovative technology that can be used to improve access to care and oral health outcomes. Dental students’ intention to use teledentistry after completing dental school has not been investigated.

Purpose

The unified theory of acceptance and use of technology (UTAUT) was used to predict intentions to use teledentistry among 4th-year U.S. dental students. Methods A cross-sectional approach was performed for a 7-week period in Spring 2019. All U.S. dental schools (N = 66) were invited to participate and 16 schools agreed to participate. An anonymous survey link was emailed to academic deans for dissemination to students. …

Student Experiences With Engagement In A Nursing And Physical Therapy Interprofessional Education Simulation, Sarah Koplow, Melissa Morris, Shari Rone-Adams, Heather Hettrick, Bini Litwin, Lisa B. Soontupe, Archana Vatwani

Internet Journal of Allied Health Sciences and Practice

Purpose: Interprofessional Education (IPE) incorporated into healthcare discipline instruction has been shown to be successful in improving the understanding perceptions of complimentary professions. The purpose of this mixed method study was to measure differences in perceptions of early Baccalaureate of Science in Nursing (BSN) students and Doctor of Physical Therapy (DPT) with participation in a immersive interprofessional education experience. Method: Students completed a pre and posttest survey consisting of the Readiness for Interprofessional Learning Scale and several short answer qualitative questions. Cohorts of BSN and DPT students participated in a computerized mannequin simulation experience or a hybrid simulation. Results: Students …

Implementing A Multicomponent Intervention To Improve Nursing Knowledge Of Delirium And Interprofessional Communication Of Delirium In Intensive Care Patients, Daniel Bryan Williams

DNP Projects

PURPOSE: The purpose of this project is to evaluate the implementation of a standardized delirium education program, delirium assessment protocol, and a standardized CAM-ICU reporting method. The goal of the project is to improve nursing delirium knowledge, CAM-ICU documentation compliance, and interdisciplinary discussion of patient’s delirium status during Multidisciplinary Rounds (MDR). This project has four distinct objectives. 1) Implement a standardized delirium assessment and communication protocol within the Lexington VAHCS ICU. 2) Increase the nursing knowledge and self-confidence of assessing ICU delirium, by 50% using a multifaceted educational approach. 3) Achieve a 90% documentation compliance rate for the CAM-ICU delirium …

Evaluation Of A Concussion Management And Discharge Education Training Module For Emergency Department Nurses, Carmen Frede

DNP Projects

Purpose: The purpose of this project was to improve the Emergency Department (ED) nurses’ knowledge on identifying patients at risk for concussions and delivering effective concussion discharge education using an educational training intervention.

Methods: This project used a descriptive, non-randomized pre-post survey design. Participation involved three stages: a pre-education survey to assess baseline concussion education knowledge, an educational intervention consisting of a narrated PowerPoint presentation, and a post-education survey to evaluate knowledge on concussion discharge education. The intervention was delivered online via the UK Canvas educational platform.

Results: The majority of nursing staff participants were female (97%) and had a …

Engaging Patients To Prevent Harm: Implementation Of Hospital Acquired Pressure Injury Prevention Education Videos, Sarah Buschmann

DNP Projects

PURPOSE: The purpose of this proposal is to evaluate the introduction of pressure ulcer prevention videos to at risk adult patients in the intensive care unit within the acute care health setting.

METHODS: The study design is a retrospective chart review to analyze the effect of the pressure ulcer prevention videos on the number of pressure ulcers and incidence rate while comparing Jackson/Cubbin scores. As pressure ulcers continue to rise, patient education through the Get Well Network is a required intervention. This project is relevant in reducing pressure ulcers and increasing patient safety. Data collection took place from July 1 …

Effectiveness Of A School-Based Asthma Education Program For 8-10-Year-Old Children, Laura Hunt

DNP Projects

Background: Asthma is the most common chronic condition to affect children in the United States Five million children throughout the United States and approximately 112, 000 children in Kentucky are living with the diagnosis of asthma (CDC, 2017; CHFS, 2017). Based on current rates 1 out of 10 elementary school-age students will likely have asthma (CDC, 2019). Educating elementary-age students about asthma and symptoms of an asthma exacerbation is very important and could save a life.

Methods: A school-based asthma education program targeting children in third and fourth grades was implemented at two elementary schools in Central Kentucky. The asthma …

Nurse Driven Enteral Nutrition Protocol For Mechanically Ventilated Patients, Deena Shewekah

DNP Projects

Introduction: Delayed enteral nutrition in critically ill patients increases the risk of complications and poor outcomes. Current evidence-based guidelines recommend initiation of enteral nutrition within 24-48 hours of intensive care unit (ICU) admission. The quality improvement (QI) project aim was to examine whether enteral nutrition was initiated within 24- 48 hours of mechanical ventilation after implementation of QI intervention in order to determine practice change.

Methods: The QI protocol was introduced to the Cardiovascular ICU (CVICU) at UK Chandler Hospital (UKHC) nurses via an education session. A post-education electronic survey identified the nurse’s understanding of the protocol. To identify nursing …

Device Related Concerns Pertaining To Primary Caregivers Of Lvad Patients, Nicole Smith, Carissa Smith

DNP Projects

Abstract

PURPOSE: The purpose of this project was to focus on caregiver education with an emphasis on caregiver concerns regarding the LVAD; additionally, evaluating the efficacy of an educational video acknowledging those device-related concerns identified by caregivers. The goal of this project is to improve caregiver knowledge and decrease the rate of device related concerns among the primary caregivers.

METHODS: This project is a single center cross-sectional, pre-post-test implementation design to determine the efficacy of device related concerns education on primary caregivers’ knowledge and concerns. A 16-point device related concerns scale was designed to appraise primary caregiver concerns. The scale …

Improving Low Health Literacy In Poststroke Patients By Educating The Health Care Staff, Marthilde Brzycki

Electronic Theses and Dissertations

Abstract

Lack of health literacy in the poststroke patient population is a serious issue; with the addition of the homeless population to that group, the result may be devastating. According to the American Heart Association and American Stroke Association (AHA/ASA, 2016), stroke is considered the primary cause of death and one of the chief reasons for disability in the United States, and nearly75% of strokes occur in those who are 65 years of age or older. Nurse practitioners are vital, providing necessary training and stroke education to the nursing and other health care staff. This DNP project was initiated to …

I Was Determined To Breastfeed, And I Always Found A Solution: Successful Experiences Of Exclusive Breastfeeding Among Chinese Mothers In Ireland, John Kearney, Qianling Zhou, Haoyue Chen, Katherine Younger, Tanya M. Cassidy

Articles

Background: The prevalence of exclusive breastfeeding for at least 4 months was previously found to be very low among Chinese immigrants in Ireland, at 5.8% (Zhou et al., Front Public Health 6:351, 2018). This study investigates the successful experiences of Chinese mothers living in Ireland who exclusively breastfeed for between four and 6 months.

Methods: Participants were recruited from the sample of the Ireland Chinese Mother Survey. Qualitative in-depth interviews were conducted with fourteen participants in their homes or public places.

Results: A content analysis revealed that various factors contributed to a successful experience of exclusive breastfeeding among the group …

Reducing Pressure Ulcers In Emergency Department Boarding Patients, Youa Yang

Nursing and Health Professions Faculty Research and Publications

CRMC is a level one trauma and teaching hospital in Fresno, California. CRMC’s emergency department (ED) is licensed for 84 beds. When hall beds are added this ED can go up to 110 beds. CRMC sees over 9,000 patients a month. Due to an increase in hospital census and length of stay, this ED has a daily average of 30 inpatients boarding. In December of 2018, this ED had one hospital acquired pressure ulcers (HAPU). Barriers to preventing HAPU’s in the ED are rooms that are not big enough to accommodate hospital beds, inexperienced new nurses who are unaware of …

Preparing Healthcare Staff For Cardiac Arrest Codes In The Outpatient Clinical Setting: Code Drill Training Improves Patient Outcomes, Rowan Edwards, Rn

Master's Projects and Capstones

Preparing Healthcare Staff for Cardiac Arrest Codes in the Outpatient Clinical Setting: Code Drill Training Improves Patient Outcomes

The acuity of care provided in outpatient clinical settings across the United States continues to rise. It is estimated that more than 350,000 cardiac arrests occur outside of a hospital each year (AHA, 2019). For the purpose of this clinical nurse leader (CNL)-lead quality improvement project, the relevant focus is directed towards improving the knowledge, physical skills and perceptions of healthcare staff within an urgent care center (UCC) regarding the application of advanced rescue skills. It is important to note that the …

Improving Discharge Medication Education On A Sepsis Unit: A Quality Improvement Project, Kayla Melton, Maria Noguez, Fabiola Lopez, Jillian Eisenberg, Deanna Lee

Master's Projects and Capstones

Ineffective discharge education plays a role in increased readmission rates, adverse drug events, and worsened patient outcomes post-hospitalization. When combined, the resulting financial burden on America’s healthcare system is exorbitant, as is the physical and mental toll on unsuspecting patients. To close the current gaps in discharge teaching, this project is incorporating the teach-back method and utilizing updated medication handouts.

Starting on the sepsis unit of a large, local medical center – the Clinical Nurse Leader (CNL) interns employed assessment tools to identify areas for improvement. The data revealed rushed, incomprehensive discharge medication education and reflected in low HCAHPS scores …