Contraceptive Methods In The United States: The Question Of Abortive Mechanisms, Tara Ferenczy

Senior Honors Theses

This thesis reviews the many methods of contraception available in the United States. Although society’s understanding of women’s health has become a major topic, there is still a significant deficit of information regarding how the accessible methods affect women’s bodies, specifically reproductive tissue. The thesis analyzes numerous contraceptive options focusing specifically on the mechanisms of action to determine whether options have abortifacient properties so that readers may develop educated opinions regarding medical and ethical uses. Information involving strengths and limitations of each technique and the effects on both the female body and the reproductive material assist in understanding the process …

Acute Hyperkalemia: A Novel Strategy To Prevent Insulin Induced Hypoglycemia, Brandon Wu, Eric Harvey

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No abstract provided.

Crnas And Sugammadex Use: A Qualitative Analysis, Natalia Izquierdo Bsn, Rn, Emily Mancewicz Bsn, Rn

Grace Peterson Nursing Research Colloquium

Background: The availability of Sugammadex has increased options for Certified Registered Nurse Anesthetists’ (CRNAs) and their choice of neuromuscular reversal agents, however administration is impacted by a variety of provider and institutional factors.

Objectives: The purpose of this study was to examine and describe the personal and institutional factors impacting the use of Sugammadex in Illinois by CRNAs.

Method: A qualitative study design using an open-ended survey yielded 209 responses. The three main themes that emerged were 1) Why CRNAs choose to use or avoid Sugammadex 2) How CRNAs dose Sugammadex and 3) Practice variations existing within the clinical setting. …

Evaluation Of Pharmacist- Or Nurse-Driven Long-Acting Insulin Titration Protocol In Adult Primary Care Patients With Type 2 Diabetes, Ruth Manzi, Corinn Martineau, Carmine Laporta, Mary Muca, Samantha Marrier, Donald Medd, Jennifer Aronson

Journal of Maine Medical Center

INTRODUCTION

Studies have supported protocolized insulin titration to optimize insulin therapy. We implemented a long acting insulin titration (LAIT) protocol in a primary care setting to aid patients achieve optimal control of their diabetes. The purpose of the study was to evaluate the performance of the LAIT protocol.

METHODS

This retrospective analysis included patients ≥18 years with type 2 diabetes (T2D) and a hemoglobin A1c (A1C) >8% who were managed as outpatients at clinics within our health care system. We collected demographic and clinical data before and after a patient’s enrollment in the LAIT protocol. Our primary outcome measure was …

Quantifying Differences In Pill Swallow Patterns In Adults, Catherine A. Sullivan, Luis F. Riquelme

Annual SHSP Student Research and Scholarship Day

Difficulty swallowing pills has become an increasing complaint among patients visiting swallow evaluation centers across the globe. Deficits are reported in healthy individuals as well as in clinical populations. In the USA, 40% of 679 persons responding to a survey reported difficulty swallowing pills (Business Wire, 2009). In an effort to facilitate pill intake, several modifications have been reported: use of liquid formulations, crushing tablet, opening capsule, whole pill mixed with food or via feeding tube (Cornish, 2005). A survey of 40 nurses revealed the most common modification was to use apple sauce (Riquelme et al., 2009). Current literature on …

Screening For Iron-Deficiency Anemia In The Pediatric Population (Ages 1-17) In Gonaïves, Haiti, Cara Rose Fratianni

Doctor of Nursing Practice Final Manuscripts

Abstract

Purpose: The purpose of this pilot project is to screen for iron-deficiency anemia in pediatric patients (ages 1-17) in a primary school in Gonaïves, Haiti. Patients with anemia will be treated with oral supplemental iron for a period of four weeks according to WHO guidelines (WHO, 2011). All students will be treated empirically for helminths per WHO guidelines, unless treated elsewhere in the last six months (WHO, 2017). Nutritional status will also be assessed using MUAC according to WHO guidelines (2017).

Background Summary: Malnutrition contributes significantly to the problem of iron-deficiency anemia, with one in four children exhibiting stunting …

Prevalence Of Syphilis Disease Throughout Some Expatriate Workers In Iraq, Israa Mamdooh Subhi, Abdul-Raheem Yahya Mahdi

Al-Esraa University College Journal for Medical Sciences

Syphilis is a sexually transmitted infection caused by the spirochete Treponema pallidum. Syphilis has been a major infection in man throughout recorded history and has challenged clinicians with its many clinical manifestations. It can also spread to other people by kissing or close body contact. The disease begins with sores and then could spread to other parts of the body through its stages (primary, secondary, tertiary and latent stages) and can also reach the heart and nervous system, and it may be fatal. The data on this disease in Iraq is limited and literature is scanty. A total of 70 …

Nefopam Versus Ketorolac For Post-Operative Pain Control In Cesarean Section, Shireen Kh Almuradi, Ali H. Mosleh, Ghison Ik Al-Adal

Al-Esraa University College Journal for Medical Sciences

More than 230 million people undergo surgery each year worldwide, and the number is increasing annually. Surgery commonly causes postoperative pain that should be alleviated as soon and as effectively as possible to reduce suffering, promote the healing process and rehabilitation, and prevent complications. However, clinical pain management after surgery remains far from successful despite the dramatically increased scientific evidence in this area. Many patients suffer from severe pain after surgery. Aim: The aim of this study is to compare between ketorolac and nefopam when administered intravenously as post-operative analgesia in cesarean section. Patients and methods: 60 patients, who were …

Exposed Root Coverage After Soft Tissue Tumor Removal Using Two-Step Surgery Technique (Case Report), Nafhat Almisk Amer Saleh, Yousif Laith Mahmood

Al-Esraa University College Journal for Medical Sciences

When intra-oral lesions in soft tissue reach the gingival margin, they can produce aesthetic problems during their presence and after their removal. Periodontal plastic surgery can be used in the correction of the gingival contour using many different techniques. This is a case report of a peripheral ossifying fibroma removal in the interproximal area between the maxillary left central and lateral incisors. The procedure also included the coverage of the exposed root in the affected area using two surgical stages: the first stage involved keratinized gingival tissue augmentation surgery with a free gingival graft concurrent with the removal of the …

Detection Of Van B Gene In Staphylococcus Spp. Isolated From Food In Baghdad/Iraq, Zina A.S Hadi, Mohamed F. Al-Marjani

Al-Esraa University College Journal for Medical Sciences

Seventy-three Staphylococcus spp. isolates were recovered from bacterial samples including poultry, foods, sewage, and soil. Antibiotic susceptibility tests were conducted on all environmental isolates for Methicillin and Vancomycin. The results showed that 39 Staphylococcus spp. isolates (53.42%) were resistant to Methicillin, while 26 isolates (35.61%) were resistant to Vancomycin. The minimum inhibitory concentration (MIC) range of Vancomycin was found to be between 2-512 µg/mL. Plasmid DNA extraction from Methicillin and Vancomycin-resistant isolates revealed that some isolates had one plasmid band. Detection of Vancomycin resistance genes (vanA and vanB) showed the presence of the vanB gene in isolate No. ESf44 with …

Betamethasone Gel Compared With Lidocaine Gel To Reduce Tracheal Tube Related Post-Operative Airway Symptoms, Mustafa Bs Atatfah, Ali H. Mosleh, Ghisan Ik Al-Adal

Al-Esraa University College Journal for Medical Sciences

Background: The commonest method to secure the airway in general anesthesia is the use of cuffed Endotracheal Tube (ETT). However, the recovery is often complicated by ETT-induced airway and circulatory reflexes, which can lead to potentially dangerous complications. Many studies and researches have been focused on the prevention of these emergence phenomena (EP); nevertheless, the problem is still far from a final solution. Aim: To compare the efficacy of Lidocaine gel vs. Betamethasone gel in attenuating the ETT-induced EP. Patients and methods: 51 patients chosen for elective intermediate average duration operations and classified in class 1 & 2 of the …

Dementia: Types, What They Are And How They Differ, Jessica N. Schnetzer

Honors Thesis

Dementia: types, what they are and how they differ centers on the known and unknown complexities of dementia. Dementia is a very complex cognitive disease that consumes the brain, an organ of which we know very little about. Even so, this common disorder is actively being researched and is the topic of special interest of this thesis research. Described are Alzheimer’s disease, Creutzfeldt-Jakob disease, Frontotemporal dementia, Huntington’s disease, Korsakoff’s syndrome, Lewy body dementia, Parkinson’s dementia, and Vascular dementia, focusing on what they are, their specific risks, diagnosis, treatment, and their differing progressions. Guidance of this study provided by thesis director …

Ethical Considerations When Conducting Research With Older Adults, Karen Arrant

Journal of Interprofessional Practice and Collaboration

The ethical issue exists between the researcher’s passion for the study focus and the human rights of the participant. This manuscript provides a case study, an actual illustration, but names were changed to protect anonymity. Objectives include examining the researcher’s perspective and personal beliefs, identifying the process to recruit participants, the ethical manner to disseminate information, and identifying ethical principles during the study process.It is mandatory that minute attention is given to the details of caring for the safety and welfare of study participants.

The Lived Experience Of Pregnancy As A Black Woman In America: A Descriptive Phenomenological Case Study, Jodie C. Gary, Sharon L. Dormire, Jamil Norman, Idethia S. Harvey Drph

Journal of Interprofessional Practice and Collaboration

PURPOSE: Health disparities in childbearing black women in the United States have continued through multiple decades despite overall improvements in pregnancy-related outcomes for other ethnicities. Pregnancy outcomes for black women include greater risks of maternal mortality, severe morbidity, as well as preterm and low birthweight infants. From a person-centered perspective, the description of the lived experiences of adversity for pregnant black women is missing from the literature. This omission is believed to attribute to the continued health disparities in this population.

METHODS: While the study was originally designed using focus group methodology for data collection for a larger number of …

Timely Follow Up Care After Initiation Of Adhd Medication In Children: A Quality Improvement Project, Rebecca Haas

DNP Scholarly Projects

Background: Enhancing medication safety, strengthening compliance and mitigating side effects requires close monitoring. A child, defined by Centers for Medicare and Medicaid Services, as being between the ages of 6 years and 12 years of ages, with Attention Deficit Hyperactivity Disorder (ADHD) must have an initial medication visit within 30 days of a first-time trial of ADHD medication. Increasing staff awareness of organizational policy of expected timeframe for medication checks and annotating appointment slots as initial medication checks will decrease the number of days between the first-time trial of ADHD medication and a child’s medication assessment. Methods: The Model for …

The Effects Of Scheduling Acetaminophen And Methocarbamol Administration On Postoperative Opioid Use And Related Side Effects Among Cardiac Surgery Patients, Whitney Jamison

DNP Projects

The Effects of Scheduled Acetaminophen and Methocarbamol Administration on Postoperative Opioid Use and Related Side Effects Among Cardiac Surgery Patients

ABSTRACT

Purpose

Opioid therapy is commonly prescribed to combat surgical pain in hospitals across the United States and is associated with many negative side effects including dependence and nausea. The purpose of this study was to retrospectively examine the effects of scheduling acetaminophen and methocarbamol administration postoperatively throughout the cardiac surgery patients’ hospital stay. Through retrospective chart reviews, the aims of postoperative opioid use, postoperative opioid use according to hospital length of stay, antiemetic use, and opioid prescription at discharge …

Evaluating Controlled Substance Documentation In An Electronic Medical Record, Delora Brooks

Dissertations

The Centers for Disease Control and Prevention (CDC) directives issued in 2016 gave guidelines for safely prescribing opiates; however, primary source discussions about methods used for documenting opioid and controlled substance monitoring within an electronic medical record (EMR) are limited (Hussain, Nelson, Polston & Zheng, 2019). This leaves individual providers to determine the appropriate way to document. Inconsistent documentation may not protect providers or organizations from regulatory, civil or criminal liability. As stated by Raveesh, Nayak & Kumbar (2016), “The best way to handle medico-legal issues is by preventing them”. Even with the advent and widespread use of EMRs, documentation …

International Conference On Medicine And Nursing & Pharmaceutical And Natural Sciences, University For Business And Technology - Ubt

UBT International Conference

UBT Annual International Conference is the 8th international interdisciplinary peer reviewed conference which publishes works of the scientists as well as practitioners in the area where UBT is active in Education, Research and Development.The UBT aims to implement an integrated strategy to establish itself as an internationally competitive, research-intensive university, committed to the transfer of knowledge and the provision of a world-class education to the most talented students from all background. The main perspective of the conference is to connect the scientists and practitioners from different disciplines in the same place and make them be aware of the recent advancements …

Implementation Of Trauma Service Guideline For The Use Of Phenobarbital In The Management Of The Non-Icu Trauma Patient At Risk Or Experiencing Severe Alcohol Withdrawal, Joseph Rappold, Julianne Ontengco, Stephen Tyzik, Suneela Nayak, Ruth Hanselman, Amy Sparks

Operations Transformation

The trauma service in a large academic tertiary medical center admits a large proportion of patients with the secondary diagnosis of alcohol use disorder. Given the successful use of phenobarbital in the critical care unit for withdrawal prophylaxis and treatment of acute withdrawal, a quality improvement project was established to create and implement guidelines for the non ICU patient.

A root cause analysis demonstrated several issues to include inconsistent clinical decision documentation. As a result, several countermeasures were initiated to address the various issues.

Post implementation of countermeasures, a decrease in the amount of severe alcohol withdrawal as well as …

Commencement Program 2019, Loma Linda University

Commencement Programs

CONTENTS

1 | Message from the President

3 | 2019 Events of Commencement

5 | The Academic Procession

7 | Significance of Academic Regalia

9 | The Good Samaritan

10 | University History Highlights

12 | Loma Linda University Song - "Healing Love"

13 | Criteria for Institutional Awards—Loma Linda University and Loma Linda University Health

15 | Loma Linda University Health and Loma Linda University Honorees

34 | The Programs, The School Honorees, and The Speakers

• School of Medicine, 35
• School of Pharmacy, 66
• School of Dentistry, 79
• School of Allied Health Professions - Allied Health Studies, Cardiopulmonary Sciences, …

Optimizing An Order Set To Streamline Health Care Delivery In The Emergency Department For Patients Requiring Hiv Post-Exposure Care, Marlisha Smith

Doctor of Nursing Practice Final Manuscripts

Background: The Centers for Disease Control and Prevention (CDC) updated guidelines to support efforts to decrease the number of Human Immunodeficiency Virus (HIV) incidences. The principle method for risk reduction utilized in the guidelines is the 28-day non-occupational post-exposure prophylaxis (nPEP) antiretroviral course administered within 72 hours of exposure. Despite this recommendation, adherence to a full 28-day course nPEP is very low nationally. Root cause analysis completed at the study site indicated that the use of an outdated order set caused unwarranted variability in care which accounted for failure in the delivery of appropriate nPEP care and low medication adherence. …

The Effect Of The Implementation Of A Quarterly Triad Tool In The Pain Clinic Setting On The Assessment And Mitigation Of Risks In Patients On Chronic Opioid Therapy, Caroline Asava

Evidence-Based Practice Project Reports

The concurrent use of opioids and benzodiazepines (BZDs poses a formidable challenge for clinicians who manage chronic pain. While the escalating use of opioid analgesics for the treatment of chronic pain and the concomitant rise in opioid-related abuse and misuse are widely recognized trends, the contribution of combination use of BZDs, alcohol, and/or other sedative agents to opioid-related morbidity and mortality is underappreciated, even when these agents are used appropriately. Patients with chronic pain who use opioid analgesics along with BZDs have a defined increase in rates of adverse events, overdose, and death, warranting close monitoring. To improve patient outcomes, …

A Multifaceted Approach To Antibiotic Stewardship In The Outpatient Clinical Setting For Bronchitis, Elizabeth A. Weaver

Evidence-Based Practice Project Reports

Antimicrobial resistance is a world-wide health crisis (Infectious Disease Society of America [IDSA], 2016; World Health Organization [WHO], 2017) expedited by the overuse/inappropriate use of antibiotics. In the outpatient setting it has been determined that approximately 60% of antibiotic therapies are prescribed (Centers for Disease Control and Prevention [CDC], 2016). Antibiotic stewardship is the coordinated effort to improve the use of antibiotic therapies, minimize misdiagnosis and delayed diagnosis and select appropriate antibiotic drug regimens (IDSA, 2016). The purpose of this evidence-based practice project was to evaluate the effects of an antibiotic stewardship program (presentation, survey collection, bimonthly e-mail reminders, patient …

Responding To Opioid Use Disorder: Identifying The Therapeutic Commitment Of Maine Nurse Practitioners, Jordan S. Porter

DNP Projects

Background: Buprenorphine, an underutilized pharmacotherapy, can play a key role in closing the substantial opioid use disorder (OUD) treatment gap in the United States. Although 2016 US legislation authorized trained nurse practitioners (NPs) to obtain the Drug Enforcement Agency waiver to prescribe buprenorphine for OUD, many NPs do not have the waiver, and a large proportion of waivered NPs do not prescribe to capacity. Purpose: To identify the therapeutic commitment of Maine NPs to OUD as well as understand why Maine NPs do not adopt and utilize buprenorphine for the treatment of OUD. Review of Evidence: Commitment …

Application Of Beers Criteria And A Brown Bag Event To Increase Prescribing Safety In Older Adults, Kristen Garza

Evidence-Based Practice Project Reports

With older adults making up about 14.5% of the U.S. population, polypharmacy may be an unintended consequence of adhering to clinical practice guidelines (Kim & Luck Parish, 2017). Effective polypharmacy interventions are needed in the primary care setting to increase prescribing safety and lower the risk of adverse drug events among older adults. The application of the Beers criteria, in conjunction with a brown bag medication reconciliation event, was initiated as focused interventions for a private primary practice without electronic health records. Outcomes included medication reduction, identification of possible inappropriate medication, decrease of medication dosages, and identification of duplicate medication. …

Implementing Use Of The Moss (Michigan Opioid Safety Score) Tool And Interventions To Reduce Opioid-Related Overdose Events In High Risk Patients, Michelle J. Kloss

Doctoral Projects

Opioids are among the most common pharmacological class of therapeutic medications prescribed to alleviate pain across all healthcare settings. However, opioid-related adverse events are a growing problem contributing to an increase in morbidity and mortality. Current hospital practice does not utilize a pre-opioid administration screening tool to assess patient risk of adverse events related to opioid administration. The implementation of the Michigan Opioid Safety Score (MOSS), an evidence-based risk assessment tool which utilizes patient characteristics as well as respiratory assessment for the prediction and early detection of opioid-induced adverse events. This quality improvement project evaluated the effectiveness of the MOSS …

Case Presentation On Congestive Heart Failure And Pulmonary Edema, Tetiana Soloviova, Denise Aris

Publications and Research

No abstract provided.

Evaluating Ways To Reduce Errors In Medication Reconciliations Performed By Nurses In A Rural Hospital Setting, Kalen T. Freeman

MPA/MPP/MPFM Capstone Projects

Medication reconciliation, also known as “med recs”, are an important part of a patient’s care during their hospitalization. A med rec is when hospital personnel generate a list of the medications the patient takes at home. Med recs are vital in the hospital admission process because home medications need to be restarted at appropriate times to fully care for the patient. Also, mistakes in a home medication list can lead to serious consequences in the patient’s health. This study focuses on med recs being performed at Marcum and Wallace Hospital in Irvine, Kentucky. More specifically, the study explores the different …

Peer Health Educators On Campus: Teaching Safe Medication Practices, Baylee Q. Bryan, Olga O. Vlashyn, Stephanie A. Deremiah, Murphy K. O'Toole, Katherine M. Joseph, Jane E. Krause

Purdue Journal of Service-Learning and International Engagement

Baylee Q. Bryan, Olga O. Vlashyn, Stephanie A. Deremiah, and Murphy K. O’Toole are advanced professional students in the Doctor of Pharmacy program at Purdue University, graduating in May 2019. Katherine M. Joseph is a senior in the School of Nursing, graduating in December 2018. Jane E. Krause (Clinical Associate Professor of Pharmacy Practice, Purdue College of Pharmacy) served as a faculty mentor for this project. In this article, the authors describe their service-learning project intended to increase awareness on campus regarding prescription drug abuse and misuse.

Hotspotting Without A Patient, Mirna Rezkalla, Bs, Pharmd Candidate, Nicole Lenegan, Bsn, Rn, Elena Umland, Pharmd

College of Pharmacy Posters

Introduction

• Interprofessional (IP) teamwork is the foundation for successful patient care outcomes. Numerous issues can arise from poor teamwork stemming from the lack of acknowledgment and appreciation of the roles of each healthcare provider.
• Throughout our training in school, students often become focused on their own profession and develop biases or perceptions of the other members of other healthcare disciplines.
• The Hotspotting program provides students the opportunity to eliminate biases and clarify perceptions.