Medical Education Commons^™

Medicine Is Humbling, Victoria E. Coutin

be Still

As I near the last couple of months of third-year clinical rotations in medical school, this short letter represents my own reflection on the experiences this year that have shaped me.

During your third year of medical school, every month you may find yourself in a completely new environment. These were some of the thoughts that kept me grounded and helped me better integrate myself into each of these new environments.

Pilot Testing The Effectiveness Of Whether A Survey-Driven Tablet-Based Intervention Increased Willingness Of Black Women To Attend To An Initial Prep Clinic Visit: The Protocol For The Pilot Randomized Controlled Trial Design And Methods, Mandy J Hill, Angela M Heads, Charles Green, Robert Suchting, Angela L Stotts

Faculty, Staff and Student Publications

No abstract provided.

Aapm Report 373: The Content, Structure, And Value Of The Professional Doctorate In Medical Physics (Dmp), Jay W Burmeister, Charles W Coffey, John D Hazle, Neil Kirby, Yu Kuang, Michael A Lamba, Brian Loughery, Niko Papanikolaou

Faculty, Staff and Student Publications

The Professional Doctorate in Medical Physics (DMP) was originally conceived as a solution to the shortage of medical physics residency training positions. While this shortage has now been largely satisfied through conventional residency training positions, the DMP has expanded to multiple institutions and grown into an educational pathway that provides specialized clinical training and extends well beyond the creation of additional training spots. As such, it is important to reevaluate the purpose and the value of the DMP. Additionally, it is important to outline the defining characteristics of the DMP to assure that all existing and future programs provide this …

Lost In Translation: Mitigating The Effects Of Language Barriers On Patient Outcomes, Megan R. Van Dorp

Nursing Research and EBP Day 2022

The purpose of this research was to describe the development, implementation, timeline, and future evaluation of an evidence-based initiative to improve the outcomes of limited English proficiency patients. It was hypothesized that bridging the communication gap between patients of lesser English proficiency and their healthcare providers would increase patients' participation and understanding of their hospital stay. Improving discharge instructions and ensuring comprehension would promote well-being and health as patients are adequately equipped at discharge to assume their own healthcare needs. To test the hypothesis, a literature search was conducted of professional databases. Fifteen scholarly articles contributed to the research base …

Reducing Intubation Time In Adult Cardiothoracic Surgery Patients: A Review Of Data Under The Direction Of A Board Certified Critical Care Intensivist, Rebecca Gooch, Lauren Grip, Chance Nadritch, Kimberly Vent

Nursing Research and EBP Day 2022

Background: Prolonged intubation after cardiac surgery increases the risk of morbidity and mortality and lengthens hospital stays. Factors that influence the ability to extubate patients with speed and efficiency include the type of operation, the patient’s baseline physiological condition, and provider practice patterns. The purpose of this research was to prove that the change of practice patterns that followed the addition of an intensivist lessened extubation times in cardiac surgery patients. It was hypothesized that the interventions brought on by the introduction of an intensivist would greatly reduce the amount of time a patient is intubated while in the intensive …

Assessing Primary Care Rns Impact On Quality Patient Care, Elizabeth Carreira

Nursing Research and EBP Day 2022

The purpose of this work was to examine how a large multi-site primary care based organization established an organizational structure that supported the determination, definition, measurement, and reporting of nursing sensitive indicators (NSIs) specific to ambulatory care nursing. NSIs capture the value of care provided by nurses and are a critical component of ANCC Magnet designation. The organization considered that successful pursuit of Magnet designation in an all ambulatory organization would involve establishing a framework to report NSIs that included defining nursing units and NSIs meaningful to the organization.

A multidisciplinary team led by nursing was established to examine and …

Rn Managed Warfarin Therapy Improves Patient Outcomes, Beth Ormsby, Stacee Marvin, Viktoria Leblanc, Ashley Harris

Nursing Research and EBP Day 2022

Warfarin, an oral anticoagulant, is a “high-risk” medication with narrow therapeutic range and risks for serious complications if not carefully managed. Therapeutic effect is determined using a blood test called the International Normalized Ratio (INR). Evidence shows a higher percentage of Time in Therapeutic Range (TTR) decreases the risk of adverse events including bleeding, hemorrhagic stroke, and death. An optimal TTR is 60 – 70% or higher. Improving TTR by 2.5 - 5% could significantly impact outcomes.

It was hypothesized that an algorithm based approach to Warfarin management by a consistent team of RN’s would improve TTR and outcomes.

To …

Ehealth@Home: Avoiding Readmissions For Heart Failure Patients, Krysta Harrington

Nursing Research and EBP Day 2022

The purpose of this evidence-based project was to reduce readmission rates for congestive heart failure (CHF) patients. It was hypothesized that targeted, nursing led care would reduce readmission rates. To test the hypothesis, we engaged patients post-discharge to enroll in eHealth@Home. eHealth@Home is a program at Rochester Regional Health (RRH) that serves high need CHF patients with frequent acute care utilization. These patients receive intensive monitoring and follow-up from a dedicated eHealth nurse, nurse practitioner and community health worker who work in tandem with a patient’s RRH provider to ensure that seamless and quality care is delivered. Visits were done …

Development And Implementation Of An Ambulatory Nursing Shared Governance Council, Patricia K. Fioravanti, Maria Larner

Nursing Research and EBP Day 2022

The purpose of this work was to research, develop, and implement an ambulatory nursing shared governance council (ANSGC) to support the pursuit of Magnet designation within the Primary Care and Specialty Institute (PCASI) ambulatory care nursing environment at Rochester Regional Health. PCASI is comprised of over 115 practices located throughout 8 counties. Literature supports shared governance as a mechanism to increase nurse engagement, nurse retention, improve patient outcomes and promotes partnership between front line nurses and administration. Nursing Shared Governance is a pillar of the American Nurses Credentialing Center (ANCC) Magnet culture and a critical component of Magnet designation.

PCASI …

Immune-Related Adverse Event Management For Oncology Patients, Mary Beth Casselbury, Lori Davis, Sharon Wilson

Nursing Research and EBP Day 2022

Rapid advances in cancer immunotherapy using Immune Checkpoint Inhibitors have led to significantly improved survival of patients. Immunotherapy is also associated with multiple immune-related adverse events (irAE’s). The purpose of this research is to determine if reinforced patient education regarding early recognition/management of side effects/adverse events decreases serious immune-related events. It is hypothesized that utilizing a patient education plan may determine if these interventions can manage immune-related adverse events and thereby decrease the severity of these events.

Our team reviewed literature addressing follow-up care for Oncology patients receiving Immunotherapy. To promote efficient management of immune-related adverse events several major oncology …

A Depression Screening Protocol For Acute Stoke Patients: A Quality Improvement Project, Celia Mcintosh

Nursing Research and EBP Day 2022

Background: Depression after stroke is common and is associated with poor functional recovery, suicidal ideation, decreased quality of life, and increased mortality. Despite this knowledge, poststroke depression (PSD) is often underdetected and thus undertreated. PSD is clinically important for the caregiver, the family, and the stroke survivor. Inconsistencies in screening and treatment practices may further contribute to these negative outcomes.

Purpose: The purposes of this evidence-based clinical scholarship project were to (1) determine the efficacy of an evidence-based depression screening protocol in improving early detection and treatment of PSD and (2) identify if there were any relationships between the protocol …

Nurse Driven Early Mobility In The Intensive Care Unit: Mobility Protocol And A Designated Mobility Champion, Intensive Care Unit, Newark-Wayne Community Hospital, Newark, Ny

Nursing Research and EBP Day 2022

Decreased mobility in hospitalized patients can lead to various health consequences, including increased morbidity and mortality. In the Intensive Care Unit (ICU), patients are not mobilized as frequently or as often as possible. Barriers to mobilization include limited resources such as time and staffing, perceived risk, and insufficient training in safe patient handling. This quality improvement initiative aimed to increase out-of-bed mobility in ICU patients, address activity orders at interdisciplinary rounds, and trial a designated mobility champion. The America Association of Critical-Care Nurses (AACN) Early Progressive Mobility (EPM) protocol and Bedside Mobility Assessment Tool (BMAT) were adopted and used to …

Experiences Of Nurses And Nurse Leaders During The First Year Of The Covid-19 Pandemic: An Integrative Review, Jessica Powell

Nursing Research and EBP Day 2022

This research aimed to examine the experiences of nurses and nursing leadership who worked through the COVID-19 pandemic. Understanding their experiences will help better support those suffering from burnout. An integrative review was done by searching three databases in February 2022. Search terms included: burnout, compassion fatigue, Nurs*, leadership, and COVID-19. A total of 288 studies were retrieved, with 11 eligible for review. Seven themes were identified: information, safety, psychological and physical impacts on nurses, patient needs vs. pandemic needs, acknowledgment, protective factors and positive things from their experience, and changes in responsibilities. Understanding the nurses’ and nurse leaders’ experiences …

Licensed Practical Nurses Working To Maximum Scope Of Practice, Lindsey Sippel, Lauren Sicker, Jessie Schiffhauer, Kristee Aliten

Nursing Research and EBP Day 2022

BACKGROUND: Nurses on 4800, a medical-surgical unit, were feeling overwhelmed by an increasing patient load due to Registered Nurse (RN) vacancies. No not only was staff morale at a low, but the staff was concerned about the impact on patient care. Nursing staff on 4800 consists of RNs as well as Licensed Practical Nurses (LPNs). As the team contemplated the high nurse:patient ratio, they identified that LPNs were not working to the full scope of their practice. The team began to wonder if ensuring that LPNs could work at the highest level of their scope of practice if this would …

The Safe Stay Program: For Care Of The Pediatric Patient Boarding In The Emergency Department, Kellie Rorke

Nursing Research and EBP Day 2022

The purpose of this evidence-based project was to explore alternative methods to address the process for admitted patients boarding in the pediatric emergency department. It was hypothesized that creating an intentional program of vigilance for safe care of the boarding pediatric patient via a pediatric admission care RN (PAC-RN), supported by interventions including on time medication administration, monitoring, and admission process education. Could reduce adverse events, total inpatient length of stay, morbidity and mortality and improve overall patient/family satisfaction.

A systematic literature search to review patient boarding in the emergency department was conducted. The literature reviewed supported the implementation of …

Development Of Share: Supportive Holistic Anxiety Reducing Experience In Critical Care, Benjamin Lindsay, Judith V. Treschuk

Nursing Research and EBP Day 2022

The purpose of this research/EBP was to develop an evidence-based Interdisciplinary Family-Centered Communication and Support Program in the Surgical/Neuro Intensive Care Unit intended to provide the support that family members and patients need when admitted to the Surgical/Neuro Intensive Care Unit.

It was hypothesized that there is a way to support patients and their family members during their admission to the RGH SICU/NCCU through evidence-based practice decreasing their anxiety and dissatisfaction with communication with the interdisciplinary team. To test the hypothesis, an electronic literature review was completed in March 2021 and May 2021 for the most current research on family-centered …

Early Mobilization For Critically Ill Adults: An Integrative Review, Jarvis Mcgrath

Nursing Research and EBP Day 2022

Objectives: Despite emerging evidence on the health benefits of early mobilization (EM) among critically ill patients, immobility and perceived barriers to EM persists. This integrative review aimed to summarize existing data on nurse-led EM, including how EM is defined, how EM protocols were developed, and key components of their protocol.

Methods: The protocol for this integrative review was developed in consultation with a trained librarian. A comprehensive search was conducted using the databases CINAHL, Embase, and ProQuest Nursing and Allied Health in April 2021. 6% of results were independently screened by 2 reviewers and the remaining were screened by a …

Evidence-Based Practice Liaisons: Supporting Ebp Across The Health System, Tami A. Hartzell, Susan Stell

Nursing Research and EBP Day 2022

No abstract provided.

Nicu Discharge Readiness, Sarah Kiley, Megan Adams, Jennifer Pacheco-Leyva, Paula Sedita, Brooke Swinton, Michele Wells

Nursing Research and EBP Day 2022

After days, weeks or months in the neonatal intensive care unit (NICU), families can be overwhelmed by the discharge preparation and the transition to home. Literature supports that inadequate preparation for discharge from the NICU increases family anxiety, risk for hospital readmission and emergency room visits, as well as infant care issues at home such as feeding difficulty. This quality improvement project was identified to improve and enhance discharge readiness in the NICU.

The project started with the development of a discharge readiness committee. After reviewing the literature, the committee met to identify areas in need of improvement which included …

Medical Student Sensitivity Training On The Differences In Sex Development, Paul Endres, Deborah Ziring, Dimitrios Papanagnou

Student Papers, Posters & Projects

No abstract provided.