Interprofessional Education Commons^™

Dietary Analysis For Hashimoto’S Thyroiditis: An Integrative Review, Evan Thompson, Alison Hultquist

Master of Science in Nursing Final Projects

Abstract

Hashimoto’s Thyroiditis (HT) is the leading cause of primary hypothyroidism in the United States. In HT, there is an infiltration by lymphocytes which leads to the production of autoantibodies against the thyroid gland. Throughout this integrative review, the aim was to evaluate the effectiveness of micronutrient supplementation and dietary management as adjunct treatments in HT. The purpose was to assist primary care providers in the development of a more holistic plan of care. Literature published within the past seven years was gathered and reviewed from PubMed, CINAHL, and Cochrane Library. Findings indicate that many patients with HT may benefit …

Benefits Of Using An Upright Laboring Position As Compared To Supine In The Second Stage Of Labor And The Impact On The Use Of Assisted Devices, Chelsey Cook

Master of Science in Nursing Family Nurse Practitioner

Abstract: This paper explores the conclusion that women and their infants are at an increased risk for harm when assisted devices are used during the second stage of labor. Traditional practices involving a supine position during pushing have been associated with an elevated likelihood of assisted delivery, necessitating interventions such as forceps, vacuum extraction, or episiotomy. However, emerging evidence suggests that adopting an upright position during labor may help decrease the need for these interventions and positively impact maternal and fetal outcomes.

Although comprehensive research on this topic is limited, the available evidence supports the benefits of an upright position …

Implementation Of A Nurse-Led Clinical Algorithm For Pressure Injury Prevention Associated With Non-Invasive Ventilation Medical Device Use, Capri Steinkuhler, Kaitlin Rogge

Doctor of Nursing Practice Projects: College of Nursing

Purpose and Aims

Medical device related pressure injuries (PI) account for as much as 61-81% of all hospital reported wound incidents (Gefen et al., 2020) and are frequently caused by respiratory devices such as non-invasive ventilation (NIV). Use of NIV in critically ill patients dramatically increased during the pandemic. PI are one of the leading causes of injury to hospitalized patients and lengthens hospital stays (National Pressure Injury Advisory Panel [NPIAP], 2019). The NPIAP recommends routine skin assessment under devices, proper mask fit, protective barrier, moisture reduction, and interdisciplinary collaboration to prevent PIs from NIV masks. This feasibility study’s purpose …

Development Of Neuraxial Anesthesia Educational Videos For Nurse Anesthesia Students, Mackenzie Schutt, Kaylie Lajeunesse

Doctor of Nursing Practice Projects

Development of Neuraxial Anesthesia Educational Videos for Nurse Anesthesia Students

Kaylie LaJeunesse, BSN, RN, SRNA & Mackenzie Schutt, BSN, RN, SRNA

Performance and evaluation of anesthetic procedures, specifically neuraxial anesthesia, are core components of nurse anesthesia curriculums. Teaching methods must provide nurse anesthesia students with the proper tools and knowledge to perform skills confidently and proficiently. Traditional teaching methods have fallen short of providing the necessary instruction for optimal student success. Incorporating video-learning resources on neuraxial anesthesia into course curriculums can significantly improve nurse anesthesia practice by better-preparing students for the clinical setting. Video learning increases student engagement and facilitates …

The Nature Of The Diagnostic Process, Louw Feenstra, J.H.Paul Wilson

Health Professions Education

There is no abstract for this article type.

Clabsi Prevention Methods, Noah Heine, Talon Cockrel

Scholars Week

Infection and the risk thereof is one of the major concerns regarding patient outcomes in the health care facility. One of the interventions with the highest causes of infection is the use of central lines. These lines provide necessary venous access for medication administration but can cause infections called CLABSI or Central Line Acquired Bacterial Infection. The purpose of our article was to research CLABSI prevention methods and provide a new policy using these safe effective methods. These new methods include the use of stat locks for central line securement, using antimicrobial lines, and flushing/locking the central line with a …

Impact Of Perioperative Dexamethasone On Hospital Length Of Stay And Glycemic Control In Patients With Type 2 Diabetes Undergoing Total Hip Arthroplasty, Vanessa Williams, Mohammad J. Uddin Ansari, Amruta Jaju, Stacey Ward, Daniel O'Keefe, Jumana Abdelkarim, Nicole Montes, Ula Tarabichi, Albert Botchway, Michael G. Jakoby Iv

Journal of Patient-Centered Research and Reviews

Purpose: This study aimed to evaluate effects of perioperative dexamethasone on hospital length of stay (LOS) and glycemic control for patients with type 2 diabetes mellitus undergoing total hip arthroplasty (THA).

Methods: We performed retrospective case review of THA performed in adults (≥ 18 years old) with type 2 diabetes at Springfield Memorial Hospital (Springfield, IL) immediately before (2013), during (2014), and after (2015) publication of consensus guidelines for use of perioperative dexamethasone. Hospital LOS was the primary endpoint. Capillary blood glucose by hospital day, proportion of patients treated with insulin, and median insulin dose by hospital day …

Bundle Up To Improve Cauti, Jennifer Anderson, Valorie Dearmon

DNP Manuscripts

Catheter Associated Urinary Tract Infections (CAUTIs) are a leading cause of healthcare acquired infections. Strong evidence for CAUTI best practices exists, however, the struggle to translate best practice evidence into everyday practice remains a challenge. Catheter associated urinary tract infection rates continue to be a problem despite organizational efforts to implement best practice guidelines; the challenge is to effectively translate and embed best practices into everyday practice. The Centers for Medicare and Medicaid Services (CMS) will no longer reimburse hospitals for expenses associated with hospital acquired CAUTI; moreover, hospitals are subject to penalties for high rates of hospital acquired CAUTIs. …

Training In The Use Of Interpretive Services For Patients With Limited English Proficiency, Kristina Wooten

Symposium of Student Scholars

In clinical settings, there is a disconnect between health care professionals (HCPs) and patients with limited English proficiency (LEP). HCPs rely on ad hoc interpreters to communicate with patients with LEP (e.g. nurses using untrained friends and family or nursing students to interpret care information). Refusing to use or misusing professional interpreters and other interpretive services may lead patients with LEP to avoid seeking necessary care, misunderstand their diagnoses and treatment regimens, and fail to return for follow-up care. This increases the already existing health care disparity between patients who speak English and patients with LEP. Studies show that if …

Effects And Outcomes Of Different Laboring Positions And The Influence From Societal Norms, Amberlyn Heskett

Nursing | Senior Theses

Background

Within labor and delivery, every birth is different. Alarmingly, the U.S. has the highest maternal mortality rate, including death during labor, among developed countries (World Health Organization, 2022). Many maternal deaths may be preventable.

In the U.S., the use of forceps, vacuum-assisted birth, episiotomies, and emergency C-sections are common for women during childbirth. Even though some laboring positions may assist birthing more than others, there often is resistance to allowing various positions due to outside influences, including societal norms, hospital management, and healthcare professional training. Women in labor are vulnerable and look to their nurses for support during the …

Early And Progressive Mobility: A Program Implementation Strategy For High Acuity Patient Care Locations, Stefani Poland

Student Scholarly Projects

Despite an increase in the promotion of early progressive mobility, its decrease in hospital-acquired complications and improvement of patient outcomes, there remains a reluctance in staff commitment to daily evaluation and implementation. This is largely due to the fact nurses or other interprofessional staff are the primary individuals responsible for this change in process. A lack of confidence in staff to correctly identify patients that meet criteria and anxiety regarding the safe transfer or mobilization of patients, particularly in high acuity settings have been identified as major barriers. The PICOT question that guided this program development of a CBO toolkit …

Partnering To Advance Health Equity And A Welcome Opportunity To Gather: Proceedings From The 28th Annual Conference Of The Health Care Systems Research Network, Robert T. Greenlee

Journal of Patient-Centered Research and Reviews

In April 2022, the Health Care Systems Research Network (HCSRN) — a consortium of 20 research institutions affiliated with large health systems spread across the United States (and one in Israel) — held its 28th annual conference in Pasadena, California, with 275 researchers, health care colleagues, and external academic partners in attendance. With a conference theme of “Promoting Collaboration and Partnerships to Advance Health Equity,” the scientific program was assembled by a multisite planning committee with input from representatives of informal local host Kaiser Permanente Southern California. Objectives of the annual conference are to showcase scientific findings from HCSRN projects …

Gender Dysphoria Versus Acute Psychosis: Can One Properly Diagnose Gender Dysphoria Solely During Acute Psychosis?, Kristy A. Fisher, Samantha Scemla, Clara L. Alvarez Villalba, Jessica Kroin

HCA Healthcare Journal of Medicine

Gender dysphoria occurs when a discrepancy between one’s sex assigned at birth and one’s gender identity causes distress or impairment in function, which can lead ultimately to seeking treatment in the forms of psychotherapy, hormonal therapy, and/or gender-affirming surgery. Clinical care guidelines also recommend pharmacological treatment of psychiatric comorbidities if indicated. A review of the current literature demonstrates comorbidity between gender dysphoria and psychosis, including cases of gender dysphoria with schizophrenia and the occurrence of gender dysphoria symptoms during manic or psychotic episodes. The existing literature has yet to specifically examine gender dysphoria amongst individuals with schizoaffective disorder. The authors …

Reducing Pediatric Procedural Pain Using Virtual Reality, Emily Davis, Carmen Bandy

Scholars Week

Above all else, children require stability in their lives in order to develop a healthy perspective of the world. Feelings of instability can come from something as small as a change in schools. In the practice of pediatric medicine it is especially important to avoid these feelings of instability, which can lead children to develop healthcare-anxiety. Healthcare settings can be exceptionally emotionally taxing to children, because the children have a complete lack of control over their environment. This lack of control combined with fear and potentially pain can be incredibly distressing. While it is easy to disregard a child’s anxiety …

Psycho-Emotional Education For Occupational Therapists Supporting Individuals Assuming The Role Of Family-Caregiver For People With A Traumatic Brain Injury (Tbi), Laura Dawn Lippman, Caitlyn E. Baird, Natalie L. Billharz

2022 Celebration of Scholarly Works

The purpose of this research was to identify the psycho-emotional needs of family-caregivers of individuals who sustained a traumatic brain injury (TBI), and measure if there was a change in knowledge among occupational therapists, and occupational therapy students following a two-hour seminar covering topics identified in the literature. The topics covered in the seminar included the concept of ambiguous loss, the importance of validating emotions, the caregiver grieving process, and the importance of providing caregiver resources. To measure the change in knowledge, researchers utilized primarily a quantitative research design using pre- and post-test questionnaires with Likert- scale questions. The questionnaire …

Barriers To Preoperative Warming: Best Practice Guideline, Tyler Comans, Zachary Hays, Caleb Leach

Doctoral Projects

The lack of preoperative warming has a direct relationship to perioperative hypothermia complications which include, but are not limited to: increased infection rate, coagulopathies, and increased myocardial oxygen consumption; all contributing to poor patient and facility outcomes. Implementation of an evidence-based educational module with visual aid can potentially increase the utilization of active warming techniques in the preoperative setting by perioperative staff. The DNP Project investigated barriers to preoperative warming by perioperative staff at a large teaching hospital in the southeastern United States. Barriers were assessed by a voluntary survey sent to 87 perioperative staff members. Twenty-two surveys were completed …

Effectiveness Of Point-Of-Care Ultrasound Education For Advanced Practice Providers, Nicole Brumfield

DNP Projects

Abstract

Background: Provider shortages and demands for inpatient providers have led to an increase in the utilization of Advanced Practice Providers (APPs). The increased use and specialization of APPs has brought attention to education and skills that have been instituted for other provider types but remains missing from the APP curricula. One such example is point-of-care ultrasound (POCUS) education. This technology and skill set have been shown to enhance clinical skills, confidence levels, and provide useful information for the provider to enhance clinical decision making for the patient.

Purpose: The purpose of this project was to evaluate the effectiveness of …

An Unexpected Outcome Of A Pediatric Simulation Encounter For Occupational Therapy Students., Anne H. Zachry, K. Booker, S. B. Lancaster

Faculty Presentations

This presentation reviewed how to plan and implement a pediatric simulated educational experience to align with the targeted course learning objective(s). Participants learned how to incorporate best practices into simulation education in order to advance occupational therapy education.

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 …

A Needs Assessment For The Utilization Of Child Life Specialist Bereavement Support Services In An Emergency Veterinary Hospital Setting, Jared R. Negin-Fryers

Graduate Theses/Dissertations

Studies indicate that there is an affective attachment bond, and related emotional involvement that exists between the companion animal and their human owners. Patient companion-animal death within the veterinary hospital, is a daily occurrence, with death rates per patient being significantly higher than in human health care. This comparatively higher death rate is due to the commonplace utilization of professionally sanctioned euthanasia to relieve animal pain and suffering. Companion animal death, may elicit grief reactions that are identical to what is experienced upon the death of a family member. A void currently exists in family centered veterinary care in terms …

Oral Contraceptives As Possible Acl Injury Prevention Method, Haley Schweizer

Capstone Showcase

ABSTRACT

Introduction: Anterior Cruciate Ligament (ACL) injuries are an upsetting setback for many athletes that require a long and costly recovery process. The injury rates are four times greater in women than men. Preventative measures that help to prevent ACL injuries are limited to stretching and strengthening. Therefore, this review aims to investigate if oral contraceptive [I] usage provides a possible new avenue for prevention of ACL injury [O] in young female athletes (ages 18-30) [P] compared to those that do not take oral contraceptives [C].

Methods: A literature review was performed though PubMed, Google Scholar, SCOPUS Database, and ClinicalKey …

Elbow Injury Prevention In Youth Dominican Baseball Players: A Training Intervention Pilot Study, Chelsey Erbaugh Franz, Dawn Hall-Bibb, Myra Stockdale, Aliya Thompson, Bailey Biggs

Internet Journal of Allied Health Sciences and Practice

Background: Research suggests deficits in shoulder and elbow strength and flexibility may explain the role of elbow injuries in overhead athletes, specifically ulnar collateral ligament (UCL) injury in baseball players. Significant damage to this ligament typically requires operative care for continued activity in the sport. Several studies have demonstrated the success of rehabilitation programs post-surgery; however, few studies have examined the role of UCL injury prevention programs. A recognized upper extremity (UE) injury prevention method is the Thrower’s Ten Program. This program may create elbow stability when pitching and throwing, theoretically reducing the risk of UCL injury. Purpose: The purpose …

Multiple Regression Models To Analyze Length Of Hospitalization Due To Nosocomial Infections In U.S. Hospitals, Ernest M. Oleksy

The Downtown Review: An Interdisciplinary Journal Written and Peer-Reviewed by Mandel Honors College Students at Cleveland State University

Nosocomial diseases are a serious concern and detriment to hospitals’ abilities to provide appropriate patient care. Bearing this in mind, an effort must be made to determine whether infection surveillance and control programs have reduced the rates of nosocomial infection at U.S. hospitals. The data that were studied were obtained as part of the Study on the Efficacy of Nosocomial Infection Control (SENIC) and used to develop a model of what variables most contribute to a patient’s length of stay at the Cleveland Clinic (Quade et al, 1980).

Continuous Epidural Analgesia For Postoperative Pain Management: A Policy Analysis, Madison Nowell

Doctoral Projects

Postoperative pain management is a necessary component of the care of every surgical patient. Epidural analgesia is a widely used method to provide excellent postoperative pain relief and enhance postoperative recovery (Sawhney, 2012). Epidural analgesia is associated with fewer side effects than alternative pain management techniques; however, when epidural catheters are managed improperly, or pain is inadequately assessed, epidural analgesia fails to provide adequate pain relief (Deni et al., 2016). More than 80% of surgical patients experience moderate to severe postoperative pain, and 28 to 50% of these patients have a pain score greater than 6 out of 10 at …

Radical Social Ecology As Deep Pragmatism: A Call To The Abolition Of Systemic Dissonance And The Minimization Of Entropic Chaos, Arielle Brender

Student Theses 2015-Present

This paper aims to shed light on the dissonance caused by the superimposition of Dominant Human Systems on Natural Systems. I highlight the synthetic nature of Dominant Human Systems as egoic and linguistic phenomenon manufactured by a mere portion of the human population, which renders them inherently oppressive unto peoples and landscapes whose wisdom were barred from the design process. In pursuing a radical pragmatic approach to mending the simultaneous oppression and destruction of the human being and the earth, I highlight the necessity of minimizing entropic chaos caused by excess energy expenditure, an essential feature of systems that aim …

Cancer Survivorship: Promoting A Lifetime Of Health, Janelle Coleman-Smith

Master's Projects and Capstones

Abstract

Introduction Cancer survivors can face post-cancer treatment effects that need addressing throughout their care trajectory. Education provided to stakeholders and patients will be beneficial in preventing fragmented care, increasing patient satisfaction, and expanding ongoing supportive clinical survivorship care. Methods An adapted Dr. Joanne Lester survivorship needs survey was given to n=7 post-cancer treatment patients within a northern California cancer patient advisory committee. The survey results were analyzed to identify common underserved chronic long-term survivorship needs. Based on the data, an evidence-based educational component was included within a booklet to enhance future survivorship care. Additional surveys were sent to stakeholders …

The Pathway To The Use Of A Structured And Supported Approach To Debriefing, Anne H. Zachry, S. B. Lancaster

Faculty Presentations

Debriefing plays a critical role in the transfer of knowledge in simulation education. Various methods are used in the debriefing process based on a variety of factors; this presentation sheds light on the pathway to the use of a structured and supported approach as traversed in the Department of Occupational Therapy at the University of Tennessee Healthcare Center as well as reflections and lessons learned along the way. Engagement in this session will allow learners to further develop their debriefing skills through exposure to information about strategies to use in the debriefing process that can be used as part of …

Improving Type And Screen Specimen Collection Prior To Elective Surgery, Nordx Blood Bank Staff, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman

MaineHealth Maine Medical Center

To avoid delays in the availability of compatible blood for elective surgery patients requiring transfusion, a type and screen specimen should be completed at least 24 hours prior to surgery. Baseline metrics in an acute care inpatient blood bank demonstrated a significant number of cases with no type or screen completed.

The objective of this KPI was to prevent any delays in providing compatible blood products to scheduled surgical patients. Several internal and external system issues were identified as a result of a root cause analysis and a number of actions were initiated.

Outcomes have been positive. Data collection post …

Vocal Function Exercises For Normal Voice: With And Without Semi-Occlusion, Megan Suzanne Brown

Theses and Dissertations--Communication Sciences and Disorders

The primary purpose of this investigation was to explore the effects of varying degrees of vocal tract semi-occlusion in Vocal Function Exercises (VFEs) on attainment of pre- established maximum phonation time (MPT) goals in individuals between the ages of 18 and 45 with normal voice. Individuals were randomized into three experimental groups: the traditional VFE with a semi-occluded vocal tract (SOVT), modified /o/ with partial occlusion, and modified /a/ without significant occlusion. For six weeks, the participants completed the four exercises two times each, twice daily on corresponding vocal tract postures assigned by group. Results indicated significant change in percent …

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 …