Interprofessional Education Commons^™

Say No To Drugs: Nonpharmacologic Interventions For Preventing Delirium In Critically Ill Patients Intubated & Sedated In A Pediatric Icu, Jessica C. Ellzey

DNP Projects

Background. Delirium is an acute clinical syndrome that is characterized by features of disrupted arousal, attention, cognition, sleep, and perception. Delirium is a well-documented phenomenon in critical care settings in both adult and pediatric populations, particularly among patients with length of stay greater than or equal to 48 hours. Delirium has multiple adverse effects, including increased mortality rate, prolonged duration of mechanical ventilation, higher reintubation rates, prolonged intensive care unit (ICU) admission, prolonged hospital admission, short- and long-term cognitive impairment, and posttraumatic stress disorder. There are currently no accepted guidelines or FDA approved medications to treat ICU delirium in the …

Evaluating Healthcare Workers’ Knowledge, Attitudes, And Practices Regarding Language Access Services In The Clinical Setting, Rachel Archibald

DNP Projects

Background: Barriers to accessing and understanding healthcare can place patients with low English proficiency at an increased risk of poor health outcomes. Language-based inequities in healthcare exist due to lack of interpretation and translation services available, lack of healthcare workers’ knowledge of resources, and/or perceptions that these services require too much time or effort. Failing to address barriers affecting this population leaves them vulnerable in the healthcare setting.

Purpose: The purpose of this DNP project was to educate nurses, providers, and staff on an inpatient unit at a rural hospital of the language interpretation resources available, best practices for implementation, …

Home Blood Pressure Monitoring Bundle For Hypertension Outcomes In Adult Patients Receiving Care In Public Health Clinics, Christine Jennifer Victorian

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Hypertension (HTN) that is not adequately controlled leads to cardiovascular disease, stroke, and heart disease. It affects 116 million adults (47%) in the United States (U.S.). The HTN compliance rate in a South Texas public health clinic was 64%, below the national benchmark of 76%. Home blood pressure monitoring (HBPM) was recommended in a joint statement by the American Heart Association (AHA) and the American Medical Association (AMA). Literature evidence revealed that the HBPM bundle increased BP control (< 140/90 mmHg) compliance.

Methods: A quality improvement (QI) bundle was initiated to address the low HTN compliance rate from a quality management perspective. …

Creation Of A Structured Rapid Response Team And Early Rrt Activation, Elizabeth Amaka Azie

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Cardiac arrest, unanticipated admissions to the intensive care unit (ICU), and mortality account for about 50% of serious inpatient adverse events (Ko et al., 2020). Efforts to prevent in-hospital cardiopulmonary resuscitation (CPR) require a system to identify deteriorating patients and include an appropriate interventional response, such as a rapid response team (Andersen et al., 2019). A well-structured rapid response team (RRT) has five categories that include team structure, organizational culture, expertise, communication, and teamwork (Jackson, 2017). A community hospital in Texas has been challenged in its attempts to have a well-structured RRT and had an increase in cardiac arrest. A …

Implementation Of Prognosticator Algorithm For Initiation Of Serious Illness Discussions And Improving The Rate Of Palliative And Hospice Referrals, Joy Isebor

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Context: Early serious illness conversations related to end-of-life and goals of care with seriously ill patients have been associated with improving patients' outcomes and quality of care (Bernacki et al., 2015). However, initiating these serious illness discussions has been challenging in the home-based primary care setting.

Objectives: To train and support home-based primary care clinicians in integrating best practices in serious illness discussions and decision-making engagement among patients sixty-five and older with serious illnesses, optimize the alignment between patient goals and the medical care they receive, improving their quality of life and the rate of palliative care and hospice referrals. …

Guideline For Screening Of Trichomonas Vaginalis Infections In The Correctional Setting, Nahirobi J. Madrid Antunez

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Objective: This guideline project focused on creating a screening guideline for T. vaginalis that would benefit healthcare providers in a correctional healthcare setting for incarcerated females entering the facility.

Methods: A literature review was conducted. The PubMed and MEDLINE search engines, were used to obtain medical, biomedical and life sciences literature, and CINAHL for nursing and allied health resources, Governmental agency sites, such as the Centers for Disease Control and Prevention (CDC), were also explored. Guideline recommendations were extrapolated from the literature review, and then rated by, stakeholders.

Results: Several overarching themes were identified. Screening of asymptomatic women for T. …

Bundle For Left Ventricular Assist Device (Lvad) In The Ed, Tina Morris

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Purpose

Left Ventricular Assist Device (LVAD) is a high-risk, low-volume patient population with admission rates of up to 72%. The purpose of this study was to provide a care bundle to increase the knowledge of the emergency department (ED) staff and decrease the door to consult times to the advanced heart failure (AHF) team for LVAD patients presenting to the ED at a level I trauma center in Texas.

Methods

In collaboration with emergency clinical staff, the project team implemented a bundle that included a pathway for the LVAD patients upon presentation to the ED, targeted education for clinical staff …

Scares: A Clinician Guide To Spinal Cord Awareness, Response, And Emergency Support Creation And Implantation Of Scares Protocol Among Hospitalist Advanced Practice Providers, Brittany Biega

DNP Scholarly Projects

While they are more common in patients with oncological disease and trauma, SCE still exist among patients without these comorbidities. Less has been established regarding care protocols in this population. The absence of standardized procedures has been linked to preventable, adverse patient outcomes, including cases of permanent damage due to delayed treatment. This project employs Lean Six Sigma methodologies and Johns Hopkins Evidence- Based Practice to devise a robust SCE protocol, aimed at standardizing care and improving patient outcomes. A multidisciplinary team including general medicine, neurology, neurosurgery, and neuroradiology developed “Spinal Emergency Management Guidelines” protocol, which was implemented within the …

The Impact Of Multidisciplinary Just-In-Time Training On Confidence In The Delivery Of Care In The Humanitarian And Disaster Response Environment, Jennifer Verstreken

DNP Scholarly Projects

Background: Team Rubicon International deploys emergency medical teams with little targeted training on the health and illness patterns common to the geographic region and the type of disasters to which they respond, such as cholera, malaria, and malnutrition. These high-risk, low-incidence illnesses are infrequently seen in Western medical practices. Medical, nursing, and paramedical training programs address these illness patterns in the curriculum. Still, a lack of consistent exposure to the care and treatment of patients with these illnesses can lead to a lack of knowledge and confidence in delivering appropriate care.

Purpose: This quality improvement project aimed to determine if …

A Multidisciplinary Approach To Identify Postoperative Delirium In Geriatric Patients Using A Brain Health Screening Tool, Ashlyn Mccartney

Graduate Theses, Dissertations, and Problem Reports (ETD)

Postoperative delirium (POD) is a common occurrence, effecting nearly 61% of the surgical population recovering from anesthesia. POD increases risk of morbidity and mortality leading to prolonged hospital length of stay by 0.8 to 7.3 days and increased costs by $1,551 to $23,698 (Masharaf et al., 2022; Sethi, 2021). An academic medical center in northern West Virginia (WV) lacks a structured practice/protocol to identify high risk patients and assess POD. An evidence-based solution was developed based on the PICO question: Does a multidisciplinary approach to perianesthetic care utilizing a brain health screening tool, compared to lack of a screening tool, …

Implementation Of A Pilot Quality Improvement Project To Guide The Administration Of Intraoperative Dexamethasone For Postoperative Nausea And Vomiting Prophylaxis In Patients With Diabetes Undergoing Orthopedic Procedures, Brittany W. Hall

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: At a local tertiary care hospital, there was no recommendation to guide anesthesia providers in the administration of intraoperative dexamethasone to patients with diabetes. While dexamethasone is a highly effective antiemetic, it may promote hyperglycemia in patients with diabetes.

Purpose: The purpose of this project was to guide and educate about current recommendations for the administration of dexamethasone for PONV prophylaxis in patients with diabetes.

Intervention: 1) Examined pre-intervention practices of dexamethasone administration. 2) Educated about current and best practices to anesthesia staff. 3) Developed badge buddy cards outlining the guideline. 4) Examined post-intervention practices. 5) Evaluated the effect …

Power Safety Plan Checklist As An Intervention In The Operating Room, Scott John Fankhauser

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Power Safety Plan Checklist as an Intervention in the Operating Room

Scott J. Fankhauser

Background: Intraoperative power failures (IOPF) force anesthesia providers to quickly make decisions to prevent patient harm when equipment does not operate as designed. Familiarity with alternative methods is critical during this decision process to deliver high-quality care during IOPF events. Purpose: The purpose of this project was to assess the impact of a checklist on anesthesia providers’ perceptions regarding continuation of care during an IOPF. Interventions: Pre- and post-intervention surveys were conducted during a simulation and education setting for annual competencies. Methods: The study …

The Unequal Distribution Of Social Risk For Black Men Across The Life-Span. A Novel Framework., Waleed Y. Sami

Adultspan Journal

This conceptual overview offers a comprehensive overview of systemic pathways that negatively impact the mental health of Black Men throughout their lives. Our argument highlights the importance for counselors and mental health professionals to utilize a thorough social risk assessment that considers these pathways in order to effectively address the mental health needs of Black Men while fostering positive working relationships. This overview strongly advocates for the use of context and structural determinants when evaluating mental health symptoms. Without an appropriate understanding of social risk and determinants, counselors may inadvertently perpetuate disparities by decontextualizing symptomology, and reproducing racist discourse.

Examining The Efficacy Of Treatments For Complex Regional Pain Syndrome, Michael Podcasy

Capstone Showcase

Complex Regional Pain Syndrome (CRPS) is a disease that affects the sensory, motor, sudomotor, vasomotor and trophic systems of patients. The pathophysiology is currently unknown and the diagnostic criteria that is used, the Budapest criteria, has its own shortcomings. This had led to hurdles in the research of the disease and well as a lack of high-quality studies on the efficacy of the many treatments currently being used to treat CRPS today. This poster explores those concepts.

Herniated Nucleus Pulposus Radiculopathy In Athletes, Elizabeth G. Massel

Capstone Showcase

Herniated nucleus pulposus (HNP), commonly referred to as intervertebral disc (IVD) herniation, is the second most common cause of neck and back pain, and most common cause of radiculopathy. The purpose of this CME article is to provide guidance on the medical management and secondary prevention of HNP in athletic populations, and highlight the pathophysiological process of mechanical overload putting athletes at a proportionately higher risk of the disease. It will address the unique pathophysiology of overuse-related HNP, as opposed to underuse, with the mechanical overload on vertebral discs associated with many sports. It will also review, with more emphasis …

A Comparison Of Concurrent Training And Moderate Intensity Continuous Training In Patients With Coronary Artery Disease, Amanda Alfaro-Chaverri, John Quindry, Charles Dumke, Brian Loyd

Graduate Student Theses, Dissertations, & Professional Papers

Moderate intensity continuous training (MICT) is the most studied method in cardiac rehabilitation (CR) for patients with coronary artery disease (CAD). Traditionally, resistance training has been utilized as a secondary role in CR. Recent interest in the topic suggests that MICT and resistance training should be applied collectively, an approach termed concurrent training (CT). The collective understanding of the potential of CT in CR patients is currently lacking.

Purpose: The aim of this professional paper is to analyze scientific evidence regarding the efficacy and safety of CT versus MICT. The analysis will focus on five primary measurements: exercise capacity, cardiovascular …

Promoting A More Diverse And Inclusive Research Workforce Through The Research Scholars Program, Nancy Schoenberg, Jimmy Robinson, Margaret J. Mcgladrey, Lisa A. Cassis, Darwin Conwell, Kevin J. Pearson, Lisa R. Tannock, Donna Wilcock, Stephanie White

Markey Cancer Center Faculty Publications

Background

Novel and comprehensive approaches are needed to address shortcomings in the diversity and inclu- siveness of the scientific workforce. In response to this need and informed by multiple programs and data sources, we created the Research Scholars Program (RSP). The RSP is a yearlong program for early-career faculty with an overall objective to overcome barriers to the academic success, retention, progression, and promotion of groups underrepre- sented in biomedical and behavioral research. The goal of the RSP is to increase research confidence and productivity, build a supportive research community, and reduce isolation by providing personal and group research enrichment …

Improving Dental Students' Knowledge And Confidence In Treating Tobacco Use, Victoria Pierce

DNP Projects

Background: Tobacco use can lead to numerous chronic health conditions. Healthcare professionals in the dental field are in a unique position to broach this issue with patients. Research shows that dental students do not feel equipped to provide tobacco cessation care, citing lack of education on the subject among their top reasons for this.

Purpose: The purpose of this project was to evaluate changes in dental students’ knowledge and confidence related to treating tobacco use after participation in an educational intervention about the 5A’s, behavioral counseling, and first-line prescription medications.

Methods: This quality improvement initiative utilized a quasi-experimental survey design …

Twelve Tips For Using The Understanding By Design® Curriculum Planning Framework, Alana D Newell, Cara A Foldes, Alison J Haddock, Nadia Ismail, Nancy P Moreno

Faculty, Staff and Students Publications

BACKGROUND: Health professions faculty engaged in curriculum planning or redesign can struggle with developing courses or programs that align desired learner outcomes, such as competencies to be applied in a clinical setting, with assessment and instruction.

AIMS: Our medical school implemented the Understanding by Design (UbD) framework to achieve alignment of outcomes, assessments and teaching during the renewal of our four-year curriculum. This article shares our strategies and practices for implementing UbD with teams of faculty curriculum developers.

DESCRIPTION: The UbD framework is a 'backward' approach to curriculum development that begins by identifying learner outcomes, followed by the development of …

The 6 Degrees Of Curriculum Integration In Medical Education In The United States, Julie Youm, Jennifer Christner, Kevin Hittle, Paul Ko, Cinda Stone, Angela D Blood, Samara Ginzburg

Faculty, Staff and Students Publications

Despite explicit expectations and accreditation requirements for integrated curriculum, there needs to be more clarity around an accepted common definition, best practices for implementation, and criteria for successful curriculum integration. To address the lack of consensus surrounding integration, we reviewed the literature and herein propose a definition for curriculum integration for the medical education audience. We further believe that medical education is ready to move beyond “horizontal” (1-dimensional) and “vertical” (2-dimensional) integration and propose a model of “6 degrees of curriculum integration” to expand the 2-dimensional concept for future designs of medical education programs and best prepare learners to meet …