Student Researchers’ Abstracts College of Business



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College of Nursing




Breast Cancer: Fatigue


Cassandra Vasos, Alexandrea Nikollaj, Nataly Navar, and Amanda Butler

Mentor(s): Ellen Moore

Undergraduate

Peg-board Presentation

The purpose of this project is to develop a health literate brochure that can be provided to the population of women diagnosed with breast cancer and dealing with cancer-related fatigue. Fatigue can be debilitating in the lives of breast cancer patients, affecting every aspect of their being. Currently breast cancer patients have limited information at the appropriate literacy level for decreasing or preventing fatigue. This Capstone Course in Nursing evidence-based practice (EBP) project team will develop a PICO (Problem, Intervention, Comparison, Outcome) question, complete an exhaustive search, critically appraise the evidence, and develop an implementation and evaluation plan to assist women with understanding breast cancer and cancer-related fatigue. Our EBP project will result in a health literacy sensitive brochure that will be part of an educational series of pamphlets available to women to explore possible options and remedies to help reduce some of the side effects and patient concerns of women living with breast cancer. We plan to make the brochure available in English and Spanish, and upload it onto the Indiana Center for Evidence Based Nursing Practice (ICEBNP) website for public viewing.

Learning Strategies to Actively Engage Adolescents in Prenatal Classes


L’Oreal Williams, Ophelia Erwin, Megan O’Day, and Anne-mette Lachmann

Mentor(s): Ellen Moore

Undergraduate

Peg-board Presentation

This research project was created to increase the attendance of pregnant adolescents in prenatal education classes. The research question developed was, for the pregnant female between 12 and 18 years of age, what are effective learning strategies to actively engage participants in health promotion activities and prenatal classes to improve patient outcomes for mother and baby? At St. Catherine Hospital in East Chicago, the attendance of adolescent prenatal education classes has been minimal. Adolescents are not seeking education on care during pregnancy. We conducted a literature review of the best available evidence to determine a way to increase the attendance of education classes to promote healthy behaviors. The literature review concluded that the use of technology influences how adolescents engage in their health care. In conclusion, to promote a pregnant adolescent to engage in healthy behaviors technology is a successful way to communicate with teenagers about their health

Evidence-Based Fall Prevention Interventions in a Tertiary Care Setting


Amanda Albin, Megan Anderson, Robert Binford, and Erin Manley

Mentor(s): Roseann Such

Undergraduate

Poster Presentation

Purpose: This project reviews the current literature and identifies a list of the best evidence-based practices to reduce adult in-patient falls.

Background: Patient falls result in injuries, complications, and debilitation. Patient falls can be significantly reduced through the implementation of an evidence-based set (bundle) of interventions across multiple disciplines. After consulting hospital stake-holders, the team observed hospital practice.

Synthesis of Literature: Current literature found the best available evidence on fall prevention interventions.

Results: The result of the literature review reveals many interventions to prevent falls in hospitalized adults including: Assessment, Education, Equipment/Environment, Exercise/Mobility, Medications, Multifactorial Approaches, and Staff Behaviors.

Recommendation/Conclusion/Implications for Practice: At this time the team has no conclusions to publish; the project is still in process.

Keywords: fall, prevent, intervene, hospital



Using the Best Available Evidence to Reduce the Incidence of Skin Reactions due to Radiotherapy for Women Living with Breast Cancer


Jacqueline Alvarado, Gabriel Armada, Stephanie Bales, and Chau Dang

Mentor(s): Ellen Moore and Dolores Huffman

Undergraduate

Poster Presentation

According to the National Breast Cancer Foundation, one in eight women will be diagnosed with breast cancer in their lifetime and each year an estimated 220,000 women will be diagnosed in the US (NBCF, 2014). Many of the women affected by breast cancer will have to undergo radiotherapy treatment. These women must endure treatment five days a week for three to seven weeks and as a result may suffer from radiotherapy-induced skin reactions. Radiotherapy treatments are mainly given by megavoltage radiation, this means that they have a significant amount of penetrating power on the skin (Morgan, 2014). The women undergoing radiotherapy treatments suffer from skin reactions which can range from sunburn-like spots to roughness of the skin (Komen, 2014).

 

Our team started our exhaustive search by researching information about breast cancer patients and skin reactions in a variety of databases. We narrowed the scope of our search to radiotherapy-induced skin reactions in breast cancer patients which resulted in ten articles which we appraised. The evidence overwhelmingly indicated that further research must be done on the topic. The purpose of this evidence-based practice capstone project is to improve patient outcomes with the prevention and/or reduction of radiotherapy-induced skin reactions associated with breast cancer treatment through education, visual aids, and brochures. We expect to develop an easy-to-read, evidence-based, informational, brochure which will provide awareness and facts related to skin reactions, protection of patient’s skin, and prevention techniques applicable for breast cancer patients to consider prior, during, and after radiotherapy treatment.




The Use of an Evidence Based Teaching Guide in the Simulation Lab: Abstract


Nicole Reid, Kaitlyn Whiting, Erica Edwards, and Carly Rodgers

Mentor(s): Gail Wegner

Undergraduate

Poster Presentation

Background: Currently in nursing education, students take courses from different clinical instructors, leading to skills techniques being taught from two year old textbooks and instructor personal experience. Thus not all students obtain the same knowledge or skill applications or the most current best available evidence. The purpose of our project is to create an initial teaching guide based on evidence to be used by all instructors in the nursing simulation lab.

Synthesis of the Evidence: Twenty three scholarly resources were utilized. Although some sources were inconclusive in identifying complete step by step skill procedure, the majority of the evidence showed similar consistent step by step skill procedures.

Practice Changes Planned: An initial teaching guide covering the first eight skills will be constructed. Each skill will demonstrate a step by step procedure. A print copy in a binder and an electronic copy on a USB drive will be produced.

Controlling NV-HAP: A Previously Overlooked Opportunity to Reduce Costs and Improve Patient Care


Michael Loehr, Bianca Vargas, Carolina Rivera, Linda Pena, and Jennifer Patino

Mentor(s): Jennifer Dobbin

Undergraduate

Poster Presentation

The aim of this research is to implement an oral care protocol to reduce the incidence of non-ventilated hospital acquired pneumonia (NV-HAP). Research has shown that NV-HAP is responsible for an annual estimated cost of 1.7 million dollars (Quinn et al., 2014). The Centers for Disease Control (CDC) report approximately 157,000 cases of NV-HAP in the United States annually (CDC, 2009). Due to the variety of factors related to NV-HAP, it is a problem that is not easily addressed. Despite the complexities of this problem, the research indicates that an oral care protocol is fundamental to addressing NV-HAP. To address this change, proposed key aspects of the oral care protocol include: assessing patients’ mouths every two to four hours, changing suction equipment every 24 hours, brushing patients’ teeth every 12 hours, rinsing the oral mucosa with an antimicrobial solution every two to four hours, applying lip moisturizer every four hours, and suctioning patients’ mouths as needed (Robertson & Carter, 2013). Closely monitoring the protocol over the next year as it is implemented in order to evaluate its’ effectiveness and to make revisions as needed is planned as an element of the implementation.

Evaluating Early Warning System Tools for Sepsis in the Emergency Department


Cassondra Rukes, Curtis Stammis, Jillian Finley, and Richard Orzel

Mentor(s): Gail Wegner

Undergraduate

Poster Presentation

Sepsis is a response to an infection. Untreated, it will lead to organ failure and to death. Hospitals are implementing early warning system (EWS) screening to detect sepsis earlier and prevent deterioration of patients. The purpose of this project is to evaluate the effectiveness of two tools – National Early Warning Score (NEWS) and Systemic Inflammatory Response Syndrome (SIRS) – in identifying and decreasing sepsis for patients in the Emergency Department (ED). A review of literature and chart audits was conducted to identify effectiveness in recognizing deterioration in ED patients. The literature review yielded inconclusive evidence about the best EWS screening tool to use in the ED. However, research does indicate positive results about the use of NEWS and SIRS in some hospital settings. Based on our findings, our action plan is to recommend to hospital administration which of the two screening tools was most effective in recognizing deterioration and sepsis in ED patients.

A Comprehensive Methodological Approach to Nurse Competency Training in the Use of the National Early Warning System (NEWS) to Improve Sepsis Outcome


Alexander Serrano, Basharat Inayat, Raja Safi, and Patrick Fritza

Mentor(s): Gail Wegner

Undergraduate

Poster Presentation

Background: A Northwest Indiana hospital has initiated a campaign to control the number of sepsis reported on a medical surgical unit, and are currently in the initial stages of implementing a revolutionary National Early Warning Score (NEWS) tool to provide better detection methods in combating sepsis.

Aim: The primary purpose is to collaboratively design, concoct, a comprehensive, and effective teaching curriculum using best Evidence Based Practice (EBP) to guide nurses in recognizing and treating sepsis in a timely manner.

Method: A review of the literature and appraisal of best evidence in teaching via two venues: Three dimensional (3D) animation models with case study, and standard narrative PowerPoint, as well as post-testing will occur.

Results: Overall, the direct implication of the teaching plan is to initiate change in the clinical assessment directly tied to affecting sepsis rates, and mortality at the hospitals.

Conclusion: It is expected that this innovative teaching project will provide nurses with the knowledge, tools, and comprehensive understanding regarding prompt recognition of sepsis. Not only will this assist in reducing treatment cost and readmission, most importantly will greatly improve patient outcomes.

Guidelines to Improve Oral Health in Women with Breast Cancer


Kaylee Holt, Kinsey Gallagher, Paige Williams, and Jasmine Roland

Mentor(s): Ellen Moore and Dolores Huffman

Undergraduate

Poster Presentation

According to the American Cancer Society (2015), breast cancer is the most common cancer among American women. About 1 in 8 women in the US will develop invasive breast cancer during their lifetime. In women living with breast cancer who are receiving chemotherapy, oral mucositis remains one of the most painful complications. According to the Oral Cancer Foundation (2014), oral mucositis can lead to several problems such as: severe pain, nutritional problems (inability to eat), and increased risk of infection due to open sores in the mucosa. Oral mucositis, also known as stomatitis, is a white discoloration of the mucous membranes that can transform into redness, edema, and lesions. These lesions can develop into large painful ulcers that can seriously hinder nutritional health.

The purpose of this evidence-based project is to improve patient outcomes through the prevention, management, and treatment of oral mucositis. Creating a brochure with the best available evidence provides a clear explanation and guidelines for the breast cancer patient related to oral health care. This brochure can be published and used widely as a teaching tool for women living with breast cancer.

PICO(T) Question / Amongst patients with breast cancer, how can establishing an oral health care regimen prevent, manage, and treat mucositis during chemotherapy treatment?

Evidence-Based Learning Strategies to Actively Engage the Pregnant Adolescent in Health Promotion Activities to Improve Patient Outcomes for Mother and Baby


Ophelia Erwin, Anne-mette Lachman, Megan O’Day, and L’Oreal Williams

Mentor(s): Ellen Moore

Undergraduate

Poster Presentation

A healthcare facility expressed concern on the lack of attendance in prenatal classes for a targeted population of 12 to 18 year old expecting mothers. The purpose of this evidenced- based project was to recommend effective learning strategies to actively engage participants in prenatal classes to improve patient outcomes for mother and baby. An extensive literature review was conducted using CINAHL, Medline, Healthsource and Johanna Briggs Institute (JBI) 25 articles were chosen for appraisal. Out those 25 articles, 15 of those were chosen to be the best available evidence to increase attendance. After an exhaustive search we established that more research is needed in this topic. In conclusion there was strong correlations between “technology” (i.e. mobile phone applications, social networks and media) and working in small groups, which led to an increase in adolescent participation regarding their health.

Kangaroo Care in Special Care Nursery


Lauren Richter, Eryn Schweiger, Caitlin Kowaleski, and Jordan Hendrickson

Mentor(s): Jennifer Dobbin

Undergraduate

Poster Presentation

Purpose: To implement Kangaroo Care in the newly opened Level II Nursery at St. Mary Medical Center.

PICO Question: In infants that require Level II specialized care immediately after birth what is the effectiveness of kangaroo care versus current standard incubator care on improving infant outcomes?

Background: A skin-to-skin policy for wellborn term babies has been implemented within St. Mary Medical Center's Labor, Delivery, Recovery, and Postpartum (LDRP) unit. The unit has not however, written or implemented a "kangaroo care" policy for the new Level II Nursery. The purpose of this capstone group's Evidence Based Practice (EBP) project is to write a policy for the Level II Nursery that calls for kangaroo care with both mothers and fathers in these special care nursery circumstances.

Synthesis of Evidence: The research found these six common themes or improved outcomes regarding Kangaroo care: Baby-friendly, improved breastfeeding, improved thermoregulation, decreased infection rates, decreased hospital length of stay, and cost-effectiveness.

Results: According to the evidence, it will be beneficial to implement Kangaroo care into the Level II Nursery for several reasons.

Conclusions: Kangaroo care provides better infant outcomes than standard infant care, even in preterm babies. This capstone group has set up the pathway the unit needs in order to successfully implement the practice, which will be monitored at a later date by a different capstone group. / Keywords: “kangaroo care,” “kangaroo mother care,” “KMC,” “skin-to-skin,” “skin to skin,” “SSC,” “baby friendly,” “baby-friendly,” bab*, infan*, neonat*, breastfeeding, thermoregulation, temperature, infection, nosocomial, sepsis, “hospital stay,” cost





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