Medical Specialties Commons^™

Promoting Comfort During Ct-Coronary Angiogram, Margo Archer, Dawn Arevalo, Kelly Vazquez

All Publications

No abstract provided.

A Systematic Review: Non-Pharmacological Interventions For Chemotherapy-Induced Nausea And Vomiting, Miranda L. Ayers, Olateju F. Olowe

Williams Honors College, Honors Research Projects

Around 70-80% of patients receiving chemotherapy are at risk of chemotherapy-induced nausea and vomiting (CINV), which can interfere with appetite and the ability to perform normal activities for daily living. When CINV is severe, psychological distress, depression, and physiological impairment occur. Patients may also stop chemotherapy treatments, which can lead to untimely deaths. The aim of this systematic review was to identify, describe, and evaluate the evidence about the use and effectiveness of non-pharmacological interventions, compared to no use of non-pharmacological interventions, on self-reported episodes of CINV among the cancer patients. Twenty articles were reviewed on the use of acupressure, …

Increasing Initiation And Exclusivity Of Breastfeeding In The Hospitalized Postpartum Dyad, Candace L. Rouse

Walden Dissertations and Doctoral Studies

The purpose of this project was to highlight an intervention to increase breastfeeding initiation and exclusive breastfeeding during the birth hospitalization in a coastal mid-Atlantic inner city hospital. Although researchers and national standards promote early initiation and exclusive breastfeeding, there continues to be a significant number of women who do not breastfeed and/or supplement with formula. The advantages of breastfeeding for mother and infant are substantial and include protecting babies from allergens to reducing maternal breast and ovarian cancer. Breastfeeding rates of initiation and exclusivity at the project hospital were below benchmarks set by international, national, and state agencies. The …

Self-Management Education In Hispanic Women With Gestational Diabetes Mellitus (Gdm), Laura B. Hieronymus

DNP Projects

The purpose of this Practice Inquiry Project was to develop, implement, and evaluate the effectiveness of a diabetes self-management education intervention in a population of Hispanic women at risk for gestational diabetes mellitus within a CenteringPregnancy(R) model of care.

Improving Depression Care For Older Home Health Patients, Sarah R. Schirmer

DNP Projects

Rates of depression in older home healthcare (HH) patients are highly prevalent. Although depression in this population is associated with increased rates of re-hospitalization, falls, and suicides, it is frequently under diagnosed and under treated. This Capstone Report examined this problem through three interrelated manuscripts. The first manuscript explored the problem through a review of the literature. This review determined that while there are many barriers to adequate depression care, programs that train clinicians to screen for depression and connect patients to depression care encourage adequate evaluation and treatment and can result in clinically significant changes in depression scores. This …

Measuring Providers’ Adherence To The American Diabetes Association Screening Recommendation For Prevention Of Diabetic Nephropathy, Whitney R. Munroe

DNP Projects

Purpose: The purpose of this study was to evaluate provider adherence to the ADA’s recommendation for an annual screening urinary albumin excretion level to check for the presence of microalbuminuria. A secondary objective was to assess for adequate treatment (i.e. ACE inhibitor or ARB prescription) in those patients with microalbuminuria present.

Methods: A retrospective chart review was conducted on 60 randomly selected patients seen within a primary care practice in an urban university setting between January 1^st, 2014 and December 31^st, 2014. Inclusion criteria included age ≥ 18 years and an active diagnosis of type 2 …

Polypharmacy Practice Inquiry Project, Mary T. Skinner

DNP Projects

“The impending crisis, which has been foreseen for decades, is now upon us.The nation needs to act now to prepare the health care workforce to meet the care needs of older adults.” Institute of Medicine.

Given the rising tide of people over the age of 65, taking multiple medications or polypharmacy is a becoming more prevalent in older adults. Unfortunately, there are many negative consequences associated with polypharmacy. Specifically, this burden has been associated with greater health care costs and an increased risk of adverse drug events, drug-interactions, medication non-adherence, reduced functional capacity and multiple geriatric syndromes including cognitive impairment. …

Psychobiobehavioral Model For Preterm Birth In Pregnant Women In Low- And Middle-Income Countries, Shahirose S. Premji, Ilona S. Yim, Aliyah Dosani (Mawji), Zeenatkhanu Kanji, Salima Sulaiman, Wangira Musana, Pauline Samia, Kiran Shaikh, Nicole Letourneau

School of Nursing & Midwifery, East Africa

Preterm birth (PTB) is a final common outcome resulting from many interrelated etiological pathways; of particular interest is antenatal psychosocial distress (i.e., stress, anxiety, and depression). In LMI countries, both exposure to severe life stressors and rate of PTB are on average greater when compared with high-income countries. In LMI countries women are exposed to some of the most extreme psychosocial stress worldwide (e.g., absolute poverty, limited social resources). High prevalence of antenatal stress and depression have been observed in some studies from LMI countries. We propose a psychosocial, biological, and behavioral model for investigating the complex multisystem interactions in …

The Specialist Breast Care Nurse's Role In The Indentification And Minimisation Of Distress In A Members' Only, Breast Cancer Focused Online Support Community, Cynthia Witney, Joyce M. Hendricks Phd, Vicki C. Cope Ms

Research outputs 2014 to 2021

Objectives: To show how a specialist breast care nurse (SBCN) can use the distress thermometer to determine an online community member’s distress level and then use the information in their posts and blogs to identify the cause(s) and deal with them appropriately. To highlight the use of a structured written emotional expression (SWEE) format online, as a way of minimising distress. Method: A survey of online community members together with analysis of the content of members’ posts and blogs to determine whether their distress thermometer score had decreased since the SBCN had been online to deal with member distress. Results: …

A Narrative Inquiry: Case Leaders' Perspectives On Resilience In Hospice Care, Gail Renee Ahern

Antioch University Dissertations & Theses

This study is a qualitative inquiry examining the perspective of team leaders within hospice organizations on resilience. The goal of this study was to examine how hospice leaders build resilience for themselves and within the interdisciplinary teams they lead. A framework of three key theories of leadership—servant, spiritual and authentic—was used to help in understanding the similarities and differences of the interviewed leaders and their key themes and practices. The eight leaders interviewed were from a range of hospices in diverse settings and all were directly responsible for leading interdisciplinary teams. In-depth phenomenological interviewing was undertaken until the study reached …

Sleep, Depressive Symptoms And Cognition In Older Adults And Caregivers Of Persons With Dementia, Glenna Shemida Brewster

USF Tampa Graduate Theses and Dissertations

Caregivers of persons with dementia, who are often older adults, report sleep disturbance, high rates of depressive symptoms and may be at risk for impaired cognition. This dissertation examined sleep, depressive symptoms, and cognition in older adults and caregivers of persons with dementia. The aims of the review of literature were to understand, in community dwelling adults 60 years and older, the relationships among sleep parameters (sleep onset latency, wake after sleep onset, sleep efficiency, total sleep time, and general sleep complaints), and the domains of cognition (Executive Function, Attention, Episodic Memory, Working Memory, Processing Speed), and global cognition. Based …

African Immigrant Parents' Understanding Of Their Teenager's Newly Diagnosed Diabetes Status In Western Australia, Annette S. Hart, Sara J. Bayes, S Geraghty

Research outputs 2014 to 2021

Background: Recently Western Australia has seen a rise in African population due to both economic and refugee migration. Concurrently, a rise in the numbers of teenagers of African origin diagnosed with both type 1 and type 2 diabetes and associated complications has been noticeable. Different ethnic background is a known risk factor for poor metabolic control; this trend is reflected in studies wherein people of African origin have been found to have a high risk of developing diabetes. What is evident from health promotion literature is that parents of teenagers with a chronic health condition, when they are well informed …

Quantification Of Opportunities For Early-Stage Paramedicine Students To Practice Clinical Skills During Clinical Placements Compared With An Equal Dose Of Simulation-Based Workshops, Brennen W. Mills, Owen B. Carter, Cobie Rudd, Jodie Mills, Nathan Ross, Joanne D. Ruck

Research outputs 2014 to 2021

Introduction A reported advantage of simulation-based learning environments (SLE) over clinical placements (CPs) is that the former can provide a greater number and breadth of opportunities to practice level-appropriate clinical skills compared with the random patient presentations provided during the latter. Although logical and widely accepted as fact, we find no published evidence to demonstrate the magnitude, nor indeed veracity, of this assumption. We therefore sought to quantify the clinical skills practiced by entry-level paramedicine students attending a well-selected CP compared with an equal dosage of SLE.

Methods N=37 first-year paramedicine students completed activity diaries during 3 days of CP …

Impact Of Improving Throughput In The Emergency Department, Katherine J. Edrington

Doctor of Nursing Practice (DNP) Projects

The purpose of this project was to evaluate the patient experience in the emergency department (ED) and in the inpatient setting while correlating increased throughput and patient outcomes at a suburban Acute Care facility in Ohio. The culture in the organization has lacked accountability and ownership of the patients. The ED admitted length of stay (ALOS) was 358 minutes in the beginning of 2013. For the first time in the organization’s history, the ED ALOS is now typically less than the recommended benchmark of 300 minutes. A report of findings among ED’s surveyed showed the ALOS best practice is 244 …

Ent Educational Patient Bedside Tool, Alina M. Toma

Master's Projects and Capstones

Early educational and discharge preparations are an advantage to patients, the interdisciplinary team, and hospital. It was determined that lack in communication and coordination among staff members led to inadequate patient teaching, therefore an educational tool that is kept at the bedside may facilitate accountability and smoother transition to home.

The aim of the project is to improve the education of patients with tracheostomies and laryngectomies, and enhance staff communication and coordination by December 2014.

Analysis methods used included Failure Mode Effects Analysis (FMEA), fishbone diagram, process map, and SWOT analysis. The social learning theory is the framework chosen for …

One Year Review Of High Flow Oxygen Delivery System Outcomes, Susan Carvin Rrt-Accs, Kenneth Miller Med, Rrt-Nps, Diane Horoski, Robert Leshko Bs,Rrt, Rita Pechulis Md, Fccp

Patient Care Services / Nursing

No abstract provided.

The Utilization Of Independent Lung Ventilation Via High Frequency Percussive Ventilation (Hfpv) During Extracorporeal Membrane Oxygenation (Ecmo), Kenneth Miller Med, Msrt, Rrt-Accs, Nps, Ae-C, Faarc, Rita Pechulis Md, Fccp, James K. Wu, Chad Traub Rrt-Accs, Dorothea T. Watson Do

Patient Care Services / Nursing

No abstract provided.

The Utilization Of The Pressure Volume Tool To Determine The Lower Inflection Point During Extracorporeal Membrane Oxygenation (Ecmo), Kenneth Miller Med, Rrt-Nps, Rita Pechulis Md, Fccp, James K. Wu, Dorothea T. Watson Do

Patient Care Services / Nursing

No abstract provided.

La Cesárea Y El Parto Natural: Las Opiniones De Profesionales De La Salud En La Provincia De Buenos Aires / Cesarean Section And Natural Birth: The Opinions Of Health Provinces In The Province Of Buenos Aires, Jacqueline Chipkin

Independent Study Project (ISP) Collection

Introduction: The ways in which women of society give birth have the power to influence maternal-infant health and shape the economy of the healthcare system. Today, the rates of cesarean sections are increasing throughout the world. In Argentina, on average, more than 35% of pregnant women received cesarean sections in 2008, with large differences observed in the rates between the public and private health sectors. The World Health Organization (WHO) has established that healthcare systems should only employ a cesarean section if labor cannot progress safely. According to this standard, the organization estimates that cesarean sections should only be utilized …

Food Choices And Practices During Pregnancy Of Immigrant Women With High-Risk Pregnancies In Canada: A Pilot Study, Gina M A. Higginbottom, Helen Vallianatos, Joan Forgeron, Donna Gibbons, Fabiana Mamede, Rubina Barolia

School of Nursing & Midwifery

Background: Immigrant women may be regarded as a vulnerable population with respect to access and navigation of maternity care services. They may encounter difficulties when accessing culturally safe and appropriate maternity care, which may be further exacerbated by language difficulties and discriminatory practices or attitudes. The project aimed to understand ethnocultural food and health practices and how these intersect in a particular social context of cultural adaptation and adjustment in order to improve the care-giving capacities of health practitioners working in multicultural perinatal clinics.
Methods: This four-phase study employed a case study design allowing for multiple means of data collection …

Government Efforts And Personal Opinion Explain The Medicalization Of Pregnancy And Childbirth Through Time In Lower Mustang, Nepal, Ruth Baker

Independent Study Project (ISP) Collection

The way that women approach pregnancy and childbirth in rural Nepal has seen an amazing change in the past twenty to thirty years. The medicalization of this entire process, from pre-­‐ to post-­‐natal care, comes with government efforts for the increased education of women about family planning, nutrition, hygiene, and the proposed benefits of institutional versus in-­‐home delivery. In 9 villages of Lower Mustang, interviews conducted with Government Health Post workers, Female Health Volunteers, and women of different ages sought to discern personal experience and opinion about pregnancy and childbirth from the perspective of both local women and those with …

Integrated Diabetes Oncology Care, Janelle M. Sharma Dnp, Crnp, Gregory R. Harper Md, Phd, Cara Habeck Rn, Cde, Cathy A. Coyne Phd, Mph, Roya Hamadani Mph, Hope Kincaid Mph, Cph, Ada M. Rivera Ba, Gretchen A. Perilli Md, Nicole R. Sully Do

Patient Care Services / Nursing

No abstract provided.

Malignant Hyperthermia, Chase Contri

Nursing Student Class Projects (Formerly MSN)

Although very rare, occurring one out of every 100,000 anesthesia cases, malignant hyperthermia is a hypermetabolic disorder that anesthesia providers screen and interrogate patients prior to every case they are administering anesthesia. Many research studies about anesthesia induced malignant hyperthermia have explored new methods of testing for the genetic susceptibility for malignant hyperthermia and into hospital based protocols when a patient starts to show the signs and symptoms of the metabolic disorder. This new knowledge and understanding has decreased patient mortality of anesthesia induced malignant hyperthermia from eighty percent to five percent over the past three decades (Rosenberg et al, …

Malignant Hyperthermia, Devin Poncsak

Nursing Student Class Projects (Formerly MSN)

A crisis of malignant hyperthermia is a medical emergency, and must be treated immediately with a coordinated, multidisciplinary team response in order to give the patient the highest chance for a successful recovery (Dirksen, Van Wicklin, Mashman, Neiderer, & Merritt, 2013). Malignant hyperthermia is defined by Bandschapp & Girard (2012), as “a disturbance of the skeletal muscle calcium homeostasis, triggered by volatile anaesthetics and depolarizing muscle relaxants.” Once a vulnerable patient is exposed to one of these triggering agents, a pathologic hypermetabolic response ensues, and the patient has a rapid increase in oxygen consumption and expired carbon dioxide, hyperthermia, acidosis, …

The Pathophysiology Of Tumor Lysis Syndrome In Oncology Patients, Jessica Richardson

Nursing Student Class Projects (Formerly MSN)

Patients with oncological conditions are at an increased risk of developing a wide variety of complications from chemotherapy that they would not otherwise be exposed too. One such life threatening complication is tumor lysis syndrome, which is an oncology emergency that frequently lands patients in the intensive care unit. Tumor lysis syndrome (TLS) occurs most frequently after the initiation of chemotherapy or other chemotoxic drugs during the patients’ treatment course [8]. It causes faster than normal tumor cell breakdown and release of intracellular contents into the general circulation. [8]. This leads to a very predictable development of electrolyte imbalances to …

Pseudocholinesterase Deficiency, Ross Gerken

Nursing Student Class Projects (Formerly MSN)

Pseudocholinesterase deficiency is a rare genetic or acquired variation in the metabolism of choline esters such as the neuromuscular blockers succinylcholine, mivacurium, and ester local anesthetics. Pseudocholinesterase deficiency genetically is transmitted in an autosomal recessive pattern with the frequency of apnea from a genetic abnormality of pseudocholinesterase between 1:480 and 1:3200 people (Ok et al., 2013). An extended period of neuromuscular blockade results from these medications than what is clinically expected. The signs and symptoms which occur are apnea and paralysis hours longer. This condition is rare but must be known and understood by the clinician in order to provide …

Understanding The Mystery Of Brain Death, Natalie A. Felter

Nursing Student Class Projects (Formerly MSN)

Lack of understanding of brain death has contributed to recent controversial cases (Copnell, 2014). The cases of Jahi McMath and Marlise Munoz were the focus of national news, causing an intense debate among the public and healthcare professionals (Copnell, 2014). The concept of brain death is a mystery to the public (Powell, 2014). Copnell (2014) found that 60% of family members who had been told their loved one was brain dead believed that they were still alive. Health professionals not having a clear grasp of brain death’s definition and assessment can lead to increased confusion in family members (Powell, 2014).

Early-Onset Familial Alzheimer Disease, Laura J. Murphy

Nursing Student Class Projects (Formerly MSN)

An Alzheimer’s diagnosis is an overwhelming and devastating diagnosis for both patients and families. Now imagine if this diagnosis was made at age 55. Instead of looking forward to retirement and grandchildren, these people are preparing for a debilitating disease that will rob them of their memory, cognitive and functional abilities. Early-onset familial Alzheimer’s disease (EOFAD) affects people before the age of 65. Although extremely rare, some exhibit symptoms as early as in their 30s. One of the things most frustrating about this disease is so little is known about its cause. That and the fact there is no cure. …

Sports Related Traumatic Brain Injuries, Ky Parrott

Nursing Student Class Projects (Formerly MSN)

Traumatic Brain Injuries (TBI) are the leading cause of long-term disability and injury death in the United States of America (Dash, Oh, Santiago, & Wade, 2012, p. 108). It is estimated that approximately 75% of all TBI’s are sports related. Recently, sports related TBI’s have received increased awareness due to the $765 million settlement between 18,000 retired football players who suffer from long-term concussive injuries and the National Football Association (NFL) (Mason, 2013, p. 267). Education regarding the pathophysiology of TBI’s is beneficial to understanding what changes the brain is enduring and why it is important to protect the brain, …

Tension Pneumocephalus, Nicole Liebner

Nursing Student Class Projects (Formerly MSN)

Pneumocephalus is defined as the presence of air within the cranial vault; tension pneumocephalus occurs when air within the cranial vault becomes trapped and causes a mass effect or increased pressure, damaging the brain (Patel, Idicula, Carrau, & Prevedello, 2013). Small amounts of air within the cranial vault can be reabsorbed or metabolized by the body over a few days without causing symptoms, however, in tension pneumocephalus the air cannot escape, causing extensive neurological symptoms (Webber-Jones ,2005). Thus, asymptomatic pneumocephalus can be a common finding following a cranial surgery, where as tension pneumocephalus is extremely rare (Webber-Jones, 2005). Markam (1967) …