Medicine and Health Sciences Commons^™

Depression And Anxiety Of Care Partners During The Emergency Department Visit Of Older Adults With Cognitive Impairment, Nancy Glober, Anthony Perkins, Joshua Chodosh, Karen Connor, Sujuan Gao, Frank Messina, Malaz Boustani, Soo Borson, Nicole R. Fowler

Journal of Geriatric Emergency Medicine

Background: Older adults with cognitive impairment (CI) are more likely to visit the emergency department (ED) than those without CI. They are also more likely to suffer poor outcomes after an ED visit. Family and friends who serve as care partners contribute significant time and resources to the care of these patients and may need particular attention to their emotional needs during and after the ED encounter. In this study, we examined the association between patient and care partner characteristics on care partner depression and anxiety at the time of the ED visit.

Methods: Baseline data from 640 patient-care partner …

Evidence-Based Practice Guidelines: Anesthesia For Total Knee And Hip Arthroplasty, Amanda Kleinfelder

Doctor of Nursing Practice Scholarly Projects

Abstract

Total knee and hip arthroplasty are the two most common orthopedic surgeries in the United States. Traditional perioperative practice is multidisciplinary, with each professional, including anesthesia, making decisions based on their current knowledge or past experience. Postoperative complications pose a threat to any patient undergoing a surgical procedure. Enhanced Recovery After Surgery (ERAS) protocols were developed to streamline best practice guidelines during the perioperative period. ERAS pathways aim to decrease postoperative complications, accelerate recovery after surgery, decrease narcotic use and promote early mobilization and discharge from the hospital. The aim of this project is the development of evidence-based practice …

Exploring Barriers To Rural Practice: A Pilot Study, Caitlin Vu

Educational Specialist, 2020-current

There is a shortage of mental health professionals in rural areas around the world. Current literature on barriers to healthcare professionals choosing to practice in rural areas mainly focuses on medical professionals, with few studies examining the barriers to rural practice for mental health professionals. Along with examining the perceived barriers and enablers to rural mental health practice, researchers wanted to further examine the reliability of the revised Barriers to Rural Mental Health Practice instrument. Researchers distributed the survey to mental health professionals across the United States. Preliminary findings support high internal reliability for the total scale and three of …

Expressive Therapies And Resiliency – Resistance In Mental Health: A Literature Review, Gabrielle Lopez

Expressive Therapies Capstone Theses

This review evaluates the current literature on psychological resistance amongst human service professionals experiencing burnout and the effect of Expressive Arts interventions on resiliency. Concepts include identifying the main symptoms, risk factors, causes, and treatments for burnout in education faculty, medical staff, and clinicians. Qualitative, quantitative, and meta-analysis studies are included to identify the most prevalent intervention frameworks for reducing stress including Arts-Based and Mindfulness-compassion based techniques. The effectiveness of Arts-based tools on strengthening identity, self-esteem, emotional regulation, and meaning-making in combating burnout is presented. Based on analysis of the literature, the author proposes a three-step intervention framework for utilizing …

Neuroqueering Art Therapy: Bringing Neurodivergent Gender Diversity Into The Creative Arts Therapy Room: A Literature Review, Avital Eisen

Expressive Therapies Capstone Theses

Recent research across disciplines has established the significance of the overlap between neurodivergence and gender diversity, a truth long espoused by the community. Acting on this research, some mental health disciplines have begun addressing neurodivergent transgender and gender diverse people as a unified population in their research, but the field of art therapy has not yet followed suit. Theoretical frameworks of intersectionality, queer theory, and disability justice highlight the importance of centering the unique experiences and needs of neurodivergent gender diversity. Using these frameworks, this literature review synthesizes community knowledge with art therapy research on both neurodivergence and gender diversity, …

Perceived Barriers Of Early Mobilization In The Intensive Care Unit, Melissa Sonderman, Emily Miles, Joshua Ferge

Doctor of Nursing Practice Projects: College of Nursing

Purpose

Early mobilization of Intensive Care Unit (ICU) patients can improve patient outcomes but also includes barriers to implementation. Nebraska Medicine has continued to have ongoing quality improvement initiatives like the ABCDEF liberation bundles and early mobilization that have been attempted but have never fully come to fruition. This project surveys Nebraska Medicines ICUs staff to better understand attitudes, knowledge and behavior regarding early mobilization using a validated tool. The aim was to identify barriers, so the organization could better understand the needs of ICU staff for future implementations of early mobility and related assessment tools.

Materials and Methods

A …

Examining Young Adult E-Cigarette Users By Device Type: A Latent Class Analysis, Mufazzela Tabassum

Health, Human Performance and Recreation Undergraduate Honors Theses

Examining Young Adult E-Cigarette Users by Device Type: A Latent Class Analysis

Purpose. This study examined which factors influence the type(s) of e-cigarette devices someone uses and if there are heterogeneous groups of young adult e-cigarette users.

Methods. This study first quantitatively explored if there are heterogeneous groups of e-cigarette users by utilizing data from an online cross-sectional survey. E-cigarette users (n = 595) were able to participate in the survey if they were 18-29 years of age, used an e-cigarette for 1-5 days in the past 30 days, own their own e-cigarette, and live in the United States. Participants …

A Potential Klebsiella Bacteriocin With Efficacy Toward The Enterbacteriaceae Family, Kasey Barber

Undergraduate Honors Theses

Drug resistance is unfortunately becoming a prevalent issue in the course of patient treatment, ranging from chemotherapy resistance to antimicrobial resistance. The Centers for Disease Control and Prevention (CDC) estimated in 2016 that at least 23,000 people die every year in the United States from an infection with an antibiotic-resistant organism (Munita, et al, 2016). Carl Friedlander was the first scientist to describe Klebsiella pneumoniae in 1882 as an encapsulated bacillus after isolating the bacterium from the lungs of patients who had died from pneumonia (Ashurst and Dawson, 2022). Klebsiella pneumoniae is the type species for the Klebsiella genus and …

Integration Of Adverse Childhood Experiences In Adulthood Through Dance Movement Therapeutic Techniques, Kimberly Hoj

Expressive Therapies Capstone Theses

Expanding knowledge about how to self-regulate when faced with challenging circumstances has the potential to benefit individuals and communities, especially in our post-pandemic environment with increasing needs for mental health support. This thesis provides a psychoeducational basis for use of dance movement therapeutic techniques to integrate adverse childhood experiences. The literature review refines an understanding of big T and little t trauma as it relates to mental illness, polyvagal theory, nervous system regulation, the window of tolerance, body armoring, somatic psychotherapy, trauma- informed care, adverse childhood experiences and post-traumatic growth.

This thesis culminates in a personal arts-based autoethnography informed by …

Major Factors Of Sustaining Recovery After Relapse From A Substance Use Disorder, Amanda Tei Sandhurst

Electronic Theses, Projects, and Dissertations

Relapse is a common and often-expected occurrence among individuals with substance use disorders. Relapse can be defined as returning to a problematic behavior after abstaining for a period of time (Marlatt & Witkiewitz, 2005). It is the inability to maintain life in sobriety and is not an isolated event, but rather a process (Gorski & Kelley, 1996). The problem with relapse is that it can result in continued substance use and abuse, which can then lead to other major consequences. This study looks at ten individuals in recovery who experienced a past relapse after having a period of abstinence and …

Social Influences On Quitting E-Cigarette Use: A Mixed Method Analysis, Olivia Peterson, Page Dobbs

Health, Human Performance and Recreation Undergraduate Honors Theses

Social Influences on Quitting E-Cigarette Use: A Mixed Method Analysis

Page Dobbs, Olivia Peterson, Erin Arthur, Jessica Seymore, Jenn Veilleux, Robert Davis, Mance Buttram, Mufazzela Tabassum

Words: 250/250

Introduction. Young adult e-cigarette users report peers as a reason for using these products; however, it is unclear how social influences are associated with attempting to quit e-cigarettes. The purpose of this mixed-methods study was to examine the relationship between social factors and quitting e-cigarettes.

Methods. E-cigarette users from a large southern university were recruited to take part in an explanatory, sequential mixed-methods study. First, participants (n=423) completed a cross-sectional survey about …

Final Scholarly Project: Development Of Evidenced-Based Practice Guidelines For Female Patients Undergoing Anesthesia For Breast Cancer Surgery, Alexa High

Doctor of Nursing Practice Scholarly Projects

In the United States, the rate at which cancer is diagnosed is on the rise. In women, breast cancer is the second most common cancer diagnosis, following skin cancer, with approximately one in eight women developing breast cancer in their lifetime. When a patient receives a breast cancer diagnosis, the oncologic team will discuss the most suitable treatment plan for the patient, this often includes chemotherapy, radiation therapy, and surgery. Within the last few decades, research has shown that there may be a correlation between anesthetic medications and breast cancer metastasis. This project aims to create an evidence-based anesthesia guideline …

Development Of Evidence-Based Clinical Practice Guidelines For The Prevention Of Peripheral Neurological Injury During Robotic-Assisted Prostatectomies For Patients In The Steep Trendelenburg Position, Tyler Wolpert

Doctor of Nursing Practice Scholarly Projects

Robotic-assisted surgery (RAS) is becoming more prevalent in modern surgical practice and is currently being utilized in a range of surgical specialties from colorectal and gynecological procedures to bariatrics and orthopedics. Every surgical procedure has potential risk to patients, however robotic-assisted laparoscopic prostatectomies (RALP) in the steep Trendelenburg (ST) position poses unique risk for peripheral nerve injury (PNI). Despite attempts to reduce the incidence rate of PNI during RALP, injuries are still occurring to patients causing patient harm and anesthesia provider litigation. The implementation of a CRNA based safety checklist may reduce the incidence rate of PNI and provider litigation …

Development Of Evidence-Based Practice Anesthesia Guidelines For Brain-Dead Organ Donors, Kelly Dzialowski

Doctor of Nursing Practice Scholarly Projects

Organ donation is a gift of life for both donors and recipients that can come from living donors, donors after cardiac death, or brain-dead donors (BDDs). Treating the donors with optimal care throughout the entire donation process is crucial due to organ supply shortages. Organs from BDDs are a large contributor to the number of organs donated each year and require critical care from the time of admission, declaration of brain death, and throughout the organ procurement surgery. Although each BDD requires meticulous care for successful retrieval and donation, there is a lack of evidence-based practice (EBP) guidelines for anesthesia …

Viscoelastic Monitoring In Major Hepatic Surgery: An Evidence-Based Practice Project, Randy Kinietz

Doctor of Nursing Practice Scholarly Projects

Patients undergoing major hepatic surgery are at high risk for intraoperative transfusion of allogenic blood products. These patients are at increased risk due to pre-existing hepatic pathology, surgical stress, and the complexity of surgical procedures. While blood product transfusion may be necessary to support hemostasis and hemodynamics, it is not without risk. Current literature states that viscoelastic monitoring is superior to traditional laboratory values when guiding transfusion during major hepatic surgery. Viscoelastic monitoring is a term used to describe the measurement of change in viscoelastic properties of whole blood during clot formation. There are two readily available point-of-care types – …

Development And Implementation Of An Evidence Based Practice Guideline Related To The Management Of Adult Angioedema, Megan Przybysz

Doctor of Nursing Practice Scholarly Projects

Angioedema (AE) is a potentially life-threatening medical condition that occurs with a higher frequency than medical providers may expect, with the emergency department (ED) serving as the usual first point of medical contact for patients. Any hesitation in recognizing AE or inconsideration of the disease process in differential diagnoses may lead to a dangerous delay of care. Due to the potential rapid progression of airway obstruction in AE, inexperienced providers should not attempt intubation, instead deferring to providers experienced in alternative airway techniques (i.e., anesthesia providers). The primary goal of this project is to develop an evidencebased practice guideline for …

Recommending An Eras Guideline For Patients Undergoing Total Joint Arthroplasty, Kahl Knapke

Doctor of Nursing Practice Scholarly Projects

Enhanced recovery after surgery (ERAS) is a comprehensive guideline that guides patients' care throughout their surgical journey. ERAS is intended to reduce the body’s response to the many stressors of surgery. ERAS is proven effective in various specialty surgical areas, including orthopedics. Orthopedic surgery rates increase parallel with the patient population ages, indicating a need for more joint replacements. Implementing an ERAS guideline reduces healthcare costs to the patient and hospital facility by reducing the length of stay (LOS) and complications postoperatively. The investigation revealed a lack of consistent direction of care, and the developed approach for patients undergoing joint …

Evidence-Based Practice Guidelines For The Surgical Patient With Obstructive Sleep Apnea, Aaron Mcneilan

Doctor of Nursing Practice Scholarly Projects

Obstructive Sleep Apnea (OSA) is a medical condition which many people may be affected by but may be unaware of the presence of the condition. The incidence of OSA has increased in direct correlation with the rising rate of obesity in the general population. While chronic conditions may arise if OSA goes untreated, patients with OSA also have an increased risk for acute complications following surgical procedures such as airway obstruction, hypoxia, brain damage, and death. Many anesthetic medications administered during surgery exacerbate the pathological consequences of OSA, predisposing patients to adverse respiratory events during the recovery period following a …

Development Of A Rotem-Guided Transfusion Algorithm In Cardiothoracic Surgery Patients, Kourtney Jane Snyder

Doctor of Nursing Practice Scholarly Projects

Abstract

Cardiothoracic surgical patients are at an increased risk for bleeding complications for various reasons, including induction of hypothermia, initiation of the coagulation cascade, degradation of the coagulation factors, mechanical destruction of platelets, and a systemic inflammatory response due to cardiopulmonary bypass (CPB). The American Society of Anesthesiologists recommends rotational thromboelastometry (ROTEM)-guided transfusion algorithms for perioperative blood management; however, there remains a heavy reliance on conventional coagulation laboratory values. Utilization of the following PICOT question will guide this project: In cardiothoracic surgical patients, how does the use of ROTEM versus traditional coagulation laboratory tests (PT, INR, aPTT, ACT, platelet count, …

General Anesthesia Clinical Practice Guidelines For Patients With Posttraumatic Stress Disorder, Bradley Closson

Doctor of Nursing Practice Scholarly Projects

General anesthesia is an induced state of unconsciousness administered by anesthesia providers to obtain patient amnesia, analgesia, and akinesia. Adult patients with posttraumatic stress disorder (PTSD) are at risk for general anesthesia-related complications throughout the perioperative setting. Emergence delirium is a clinically significant postoperative complication that patients with PTSD have an increased risk of developing. Postoperative complications of emergence delirium include patient or medical staff injury, surgical site damage, prolonged postanesthesia care unit (PACU) stay, and increased medical care costs. Evidence demonstrates that implementing preventive interventions decreases the incidence of emergence delirium. There are no standardized, evidence-based general anesthesia guidelines …