Capstone & Scholarly Projects: Education & Leadership in Healthcare

STOESSEL, Sara. (2022). This study measured the impact of television during mealtime on the volume of food consumed by children (age 3 to 5 years) in a rural county in the Midwest of the United States of America. The study’s principal focus was on using Mindful Eating Theory (MET) as the framework for the study, and it introduced a single variable of having a television in view during the time of a meal being consumed. This research to further define the impact of meal consumption would advance research on approaches to possibly prevent or reduce risk of childhood obesity, and potentially prevent obesity later in life. Although this study had low response and 1 completed survey, there would be value in future studies conducting additional trials with more participants to evaluate the impact of distractions.

QUINN, Kelsey F. (2022). Problem: Surrogate labor and delivery experience differs from non-surrogate labor and delivery. This project aimed to implement a birth plan toolkit protocol to positively impact surrogates' satisfaction with their labor and delivery process.
Intervention: A birth plan toolkit added two questions, signage for hospital staff, and instructions for the signage use to the surrogacy agency's current birth plan communication email.
Measures: Surrogate mothers completed a five-question survey, and the agency’s client coordinator participated in six interview questions, both to measure satisfaction with the birth plan toolkit.
Results: Eight total survey responses were recorded. Six surrogates answered extremely satisfied, and two answered satisfied with the overall labor and delivery experience (M = 3.75, SD = 0.46). In addition, four surrogates responded not applicable to utilizing the signage, and the other four who utilized the signage were extremely satisfied (M = 4, SD = 0, 50% signage utilization). The client coordinator interview indicated satisfaction with use of the birth plan toolkit.
Conclusion: The birth plan toolkit positively affected the surrogates and the client coordinator. Signage and the birth plan are sustainable and can be adapted for other agencies and labor and delivery centers.

ROZEK, Emily. (2022). There is a shortage of nursing faculty across the United States. Some contributing factors include a lack of confidence in the classroom setting and the transition from expert nurse to novice faculty member. This project investigated the effectiveness of implementing an interdisciplinary mentorship program for novice nurse faculty. Participants were recruited from a small liberal arts university who were considered novice nursing faculty with less than three years teaching experience. For the intervention the novice nursing faculty was paired with an experience faculty member in another college. They were then provided with an 8-week learning plan in which education was provided regarding the faculty role, classroom management, policies and procedures and student relationships. The Nursing Faculty Assessment Survey was utilized, and the novice nursing faculty’s confidence levels were measured pre and post intervention. Four novice nursing faculty members participated in the study. The surveys were distributed by JotForm electronic technology. The results did not demonstrate statistically significance but there was an increase in mean confidence scores when comparing pre and post intervention data, which lends support for the intervention.

FREML, Meagan. (2022). Abstract
A consistent behavior that is universally accepted is that humans continue to get busier, at work, in the home, outside the home and beyond. Finding time to allocate aside from the obligations one already has is arduous. Research supports the idea that individuals who participate in some type of volunteer work report higher life satisfaction. While making time available to participate in volunteer activities may seem impossible in already busy lifestyles, the long-term benefit is positive to both the participant and the recipient of the work being done.
The problem statement guiding this project is certified registered nurse anesthetists (CRNA) who participate in volunteer work compared to those who do not volunteer report higher life satisfaction over a six-week period. Volunteer work can present in any number of opportunities that include nationally organized clubs like the Boys and Girls Club or local food pantries in need of donations or services. Regardless of residence, there are undoubtedly opportunities for community involvement.

EDWARDS, Sherell. (2022). This capstone project focuses on the potential effects of daily wellness activities upon adults living in transitional, affordable housing. Daily wellness activities of the adult population were the focus for a consecutive, three-week period using pre- and post-surveys, personal interviews and a wellness checklist tool. Overall, there was no recognizable, significant impact of the wellness education activities upon the population based upon the pre-survey and post-survey responses. Yet, a closer review of the mean and standard deviation analyses of the individual pre- and post-survey responses indicates there is more to be explored.

HOSKIN, Christine. (2022). Problem: Obtaining continuing education (CE) hours is a component of maintaining licensure in the healthcare profession; however, time constraints make it challenging to meet the CE requirements. Alternative approaches to obtaining CE credits are necessary. This project aimed to determine how on-demand micro-programs impact participation rates, preferences, and effectiveness in dentists seeking continuing education credit. Methods: Dentists licensed in the United States were eligible for participation. Participants self-enrolled in a free on-demand webinar over the course of 3 months. After viewing the webinar, participants completed a quiz and a survey to determine participation rates, preferences, and effectiveness. Results: One-hundred fifty-three participants viewed the on-demand dental webinar; while, 87% (N=133) met the inclusion criteria for analysis. Forty-seven percent (N=98) of participants preferred traditional 1-hour CE on-demand programming, versus 26% (N = 54) preferred the 30-minute on-demand program. Ninety-nine percent (N = 131) of participants reported that the program met the learning objectives and the format was effective. Ninety-five percent (N = 122) of the participants plan to incorporate new risk-reduction strategies within their practice after completing the program. Ninety-eight percent (N = 130) of participants reported the program positively influenced knowledge, competence, and performance, while 97% (N = 129) felt the content would improve patient outcomes. Conclusions: On-demand micro-programming was an effective method to deliver content based on participation rates and effectiveness; however, participants preferred traditional 1-hour programming.

SCHULTZ, Andrea. (2022). Critical blood and blood products are used every two seconds in the United States to help cancer patients, accident and burn victims, transplant recipients, and individuals suffering from chronic and rare conditions. Unlike other medical treatments, blood products cannot be developed in a laboratory. Instead, these life-saving products can only be manufactured after generous volunteer donors give their blood. Without a safe and adequate blood supply, the healthcare system is unable to support patients with the treatments that they require. Due to a significant reduction in blood donation directly related to the COVID-19 pandemic, the United States has recently entered a national blood crisis resulting in the worst blood supply shortage in over a decade. This educational intervention was introduced to increase blood donor recruitment and retention and ultimately contribute to a safe and adequate national blood supply. The intervention consisted of 150 educational handouts that were distributed to three organizations. A comparison of pre-intervention and post-intervention blood donation attempts was performed. The results of the comparison (t = 0.9698, df = 55, p = 0.3364) indicated a mean difference between the pre-intervention and post-intervention means that is not statistically significantly different. This shows that a simple educational campaign alone might not be enough to increase blood donation attempts and maintain the blood supply.

VATWANI, Archana. (2022). The purpose of this project is to provide an educational opportunity outside of Doctor of Physical Therapy students’ curriculum to increase their awareness and understanding of cultural competence. The study was conducted at a single institution study on one campus of a large university in the southern United States. Subjects for this study were first year DPT students (DPT1s) at the FLL campus. Forty students (40) DPT1s participated in the pre-assessment. Utilizing the zoom video platform, the planned intervention was a one session live 90-minute educational opportunity focused on cultural competence and followed with a post-assessment. Thirty-two (32) DPT1's participated in the post-assessment. The outcome measure utilized for the pre, and post assessment was the California Brief Multicultural Competence (CBMCS) scale. Percentiles ranks were calculated for the aggregate data of sub-scales Multicultural Knowledge, Awareness of Cultural Barriers (‘Awareness Cultural’), Sensitivity and Responsiveness to Consumers (‘Sensitivity Responsiveness’), Socio Cultural Diversities, and Total Score. Group comparisons were conducted using a Welch t-test for unequal variances. The percentile rank analysis indicated an improvement in the Multicultural knowledge (p < 0.035) and awareness of cultural barriers (p <0.001) subscale post intervention. Although Sensitivity and Responsiveness to Consumers (p <0.155) and Socio-Cultural Diversities (p <0.058) were not statistically significant, the total score (p <0.010) did indicate improvement in overall multicultural competence. The knowledge acquired through the teleintervention would assist students in the future to adapt and succeed for competent patient care. Findings indicate an overall increased cultural competence awareness and understanding.

SINGH, Arvin. (2022). Transportation, and particularly patient transportation is a critical dependency for people to reach their destinations across the country. This is especially true because many American cities are not designed well for foot traffic, biking or non-vehicular transportation; not even factoring distance into the equation. Health care systems are required to submit community health needs assessments (CHNA) every three years and community benefit reports every year. These require systems to ensure they survey their communities to understand the needs of the citizenry. When producing these reports, systems often see transportation and/or access to care as a top issue in the community. Systems take different approaches to address these issues, and many are haphazard and ineffective or their solution is outdated and highly inefficient. The purpose of this project was to address the following question: in patients who miss their healthcare appointments, is RideShare scheduling more effective than a traditional cab service in increasing satisfaction, outcomes, and operational efficiencies? This project allowed the system to take a look at the current infrastructure and weigh this against potential alternatives that could help with efficiency/satisfaction and cost savings and, in this case, RideShare. The study was conducted within an academic medical system, with patients located within one of the cardiology offices. The intervention included pre and post surveys, measures of timeliness, cost savings, satisfaction, and patient complaints. The team had approximately 100 participants for the pilot project. The findings were dramatic and all five measures showed significant improvement versus baseline and hypothesized outcomes. In the future, the team will need a longer pilot time, better baseline data, and a per-ride cost rather than a global cost basis. The success of the project cannot be understated and its implications could positively impact all of the academic system.

GREENE, Gina, (2022). Problem: The project was to implement opioid overdose education for high school students using the fiction novel Heroine by Mindy McGinnis as context. The problem statement was “In high school students, does an opioid overdose education program taught as part of a literature unit using a fiction novel about opioids increase student knowledge level of opioid overdoses, increase student knowledge of First Aid for opioid overdoses, increase willingness to provide First Aid for opioid overdoses, and improve self-efficacy to provide First Aid for opioid overdoses?”
Intervention: Students read the book Heroine by Mindy McGinnis over a month-long literature unit. On two different days, students received health education about opioid addiction, opioid overdoses, and First Aid for opioid overdoses including Narcan administration.
Measures: Students were given a pre-test survey and a post-test survey with six questions measuring attitude and nine questions measuring knowledge. Attitude questions were further broken down into self-efficacy and willingness to provide care. The post-test survey also had two questions about the effectiveness of the novel.
Results: Participant knowledge scores increased 87.6%, attitude scores increased 144%, self-efficacy scores improved 250% and willingness scores improved 86%.
Conclusions: Educating students about opioid overdoses and First Aid for opioid overdoses in conjunction with the novel Heroine by Mindy McGinnis showed statistically significant improvements in knowledge of opioid overdoses and First Aid for opioid overdoses, improved self-efficacy, and increased willingness to provide First Aid for opioid overdoses.

VOGT, Kaitlyn. (2022). Problem: The Institute of Medicine (IOM) identifies that nursing education plays a critical role in adequately preparing new graduate nurses to possess skills and knowledge to provide safe patient care, reduce risks and improve patient outcomes in patients in the transforming and demanding United States healthcare system. Nursing curriculum has integrated high-fidelity simulation into nursing education to foster nursing students’ preparedness for the transition to clinical practice. High-fidelity simulation has been identified as an effective active learning strategy to replace traditional clinical settings to promote clinical reasoning. Intervention: The purpose of this project was to evaluate the effectiveness of a high-fidelity simulation experience on senior baccalaureate nursing students’ self-confidence, self-efficacy, and clinical reasoning. Measures: This quantitative study examined pre-survey and post survey scores measuring self-confidence, self-efficacy, and clinical reasoning before and after participating in a high-fidelity simulation scenario resulting in cardiac arrest. Results: Results indicated statistically significant improvement in self-efficacy pre-survey scores (M = 14.82, SD 1.24) and post survey scores (M = 17.46, SD 1.99); t (27) = 5.53, p < .001, self-confidence pre-survey scores (M = 16.03, SD 1.95) and post survey scores (M = 18.07, SD 2.05); t (27) = 4.71, p < .001, and clinical reasoning pre-survey scores (M = 15.25, SD 1.40) and post survey scores (M = 17.67, SD 1.94); t (27) = 5.75, p < .001, after participation in a high-fidelity simulation. Conclusions: Findings suggest that utilization of high-fidelity simulation in nursing curricula can improve nursing students’ self-confidence, self-efficacy, and clinical reasoning in preparation to transition to nursing practice.

HUMPHREYS, Vanessa. (2022). Due to rising obesity levels in adolescents, there is the need to promote positive health behaviors in school-aged youth. In addition, educators also face the challenge of preparing learners with the necessary knowledge, skills, and interests to pursue science, technology, engineering, and mathematics (S.T.E.M.) education and career pathways. To address these challenges, the capstone project incorporated indoor tabletop gardening activities into weekly human physiology science lessons. Pre- and post-surveys assessed preference for and frequency of vegetable consumption, along with examining how the gardening activities impacted students’ perception of science (engagement and science identity). After the one-month intervention, there was no significant difference in overall mean scores for the pre- (M = 193.12, SD = 17.99) and post-survey (M = 197.22, SD = 23.44) responses; t(49) = -.368, p = 0.357. Although the overall data did not show a significant difference after the intervention period, there was a slight increase in the mean responses for each subsection of the survey, with frequency of vegetable consumption demonstrating the greatest change (+1.46). The indoor tabletop nature of this intervention allows for the ease of replication in different educational, community, and/or public health settings. Future studies which increase participant number, have a longer garden intervention period, “stricter” checks for validity of responses, more in-classroom sharing of recipes, and/or taste-tests could help strengthen outcomes and help determine future avenues of curriculum design.

KURIAN, Aji. (2022). Overview: early detection of dysphagia is a well-established practice in the care of stroke patients. The swallow screen is a quick, minimally invasive assessment to determine the risk of aspiration, and the process helps to identify who can receive oral intake and who needs further evaluation. Approximately 50% of acute stroke patients’ aspirate, causing pneumonia that accounts for 15%-25%
of deaths associated with stroke (Rofes et al., 2013). Problem: the compliance with dysphagia screens was suboptimal in a large urban south-central hospital in the United States. Intervention: The retrospective two-part educational intervention that was to be evaluated for this study was implemented as part of the stroke center's quality improvement. It included an online dysphagia
course assigned to all nursing staff, followed by a clinical demonstration on conducting dysphagia evaluations. Purpose: the purpose of this retrospective capstone study was to determine if a comprehensive educational program impacted self-reported change in knowledge and compliance with performing dysphagia screening before oral intake in patients who had or were suspected of
having a stroke. Measures: the data that would have been utilized was the medical center’s monthly stroke database software, which monitors the rate of compliance. Self-reported change in knowledge was to be measured via a question that would have been included on a quiz administered to nurses who received the educational intervention. Results: the project was not implemented due to inability to obtain full site approval. Conclusions: although the analysis could not take place for this project, the retrospective intervention may help to improve compliance with dysphagia screening within the institution in the future and arm the nurses with the necessary procedural skills to perform the dysphagia study on every stroke encounter.

WILLIAMSON NEELY, Yvonne. (2022). This project examined the impact of digital self-care for secondary teachers exposed to emotional labor. Self-selected coding facilitated the process of delivering teachers’ pre-intervention responses to a 30-item Likert scale survey that gauged the positive and negative aspects of helping others. Teachers manipulated the app over a 30-day period. Paired sample t-tests presented the statistical significance of 17 teacher’s pre and post intervention in the area of resilience, burnout, compassion satisfaction, and secondary traumatic stress scores. Conclusions were based on teachers' chance behavioral health risks in a trauma-informed environment combined with a digital application that altered negative outcomes to positive ones. Implications of positive results in all categories provide evidence for sharing a digital application along with self-care routines with teachers at other trauma-informed school sites, and eventually districtwide.

CURLEY, Darlene J. (2022). Problem: In 2012 there were 97 state nurse legislators serving in 39 states. In 2021, there was no centralized tracking of the number of state nurse legislators. Purpose: The purpose of this project was to develop an inventory tool to track the number of state nurse legislators in order to determine the number of nurse legislators in a given year. Organizing Construct: Nurses in politics and state health policy making. Methods: Searched 50 state legislature websites, 50 state nursing association websites, Google Scholar, and telephone and electronic outreach to 50 state nursing association executive directors, directors of government affairs, and policy committees. Measures: Developed an Excel worksheet to track state nurse legislators in all 50 states: name of nurse legislator, link to legislative profile, senator or representative, political party, date elected, length of a term, state term limit designation, health committee assignments, and legislative capacity ranking. Results: In 2022, there are 76 state nurse legislators serving in 36 states; there are 14 states lacking nurse policy makers. Conclusions: Over the past ten years, the number of state nurse legislators have decreased and the number of states without nurse policy makers has increased. It is time for a national commitment and strategy to recruit and elect nurse legislators in all 50 states.