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Investigating the Impact of Outpatient Mental Health Follow-up Care on Continued Adolescent Suicidality: An Evidence-Based Change Project Proposal
Full text linkThe escalating rates of adolescent suicide globally, coupled with the surge in pediatric hospitalization rates, underscore the urgent need for effective intervention strategies. Despite hospitalization, many patients persist in experiencing suicidal ideation and behaviors, often leading to readmissions. A significant portion of these individuals do not receive adequate outpatient mental health follow-up care post-discharge. As a leading pediatric healthcare institution committed to delivering exemplary care, particularly to those struggling with mental health challenges, the organization’s commitment demands proactive measures.
The attached proposal aims to establish an organizational policy to reduce 30-day readmission rates among adolescents with persistent suicidal thoughts and behaviors. Key strategies involve enhancing patient and caregiver education, promoting adherence to post-discharge care plans, and fostering compliance with outpatient mental health follow-up recommendations. Following the Knowledge-to-Action (K2A) model, the project spans four phases over 18 months, with phase one focusing on policy development, stakeholder engagement, and educational material creation. Pilot testing and data analysis occur during phase two, followed by policy revisions during phase three. Phases two and three are iterative, allowing for repeated cycles of implementation and refinement. The final phase includes a sustained implementation period and a comprehensive feasibility and sustainability assessment for future policy roll-out across Katy, Woodlands, and Austin community campuses.
Regular assessment and feedback mechanisms will monitor policy effectiveness. Data collection and analysis will track 30-day readmission rates and employee protocol adherence. Internal stakeholder feedback will be solicited via electronic surveys to assess the policy’s impact on workflow and perceived patient benefits
A Plan to Improve Sleep During Critical Care Hospital Stay
Full text linkThe purpose of this paper is to bring awareness and possible solutions to the ongoing issue of sleep deprivation in hospitalized patients, specifically patients in the intensive care unit. Sleep deprivation can lead to delay in healing, and therefore delay in discharge. There are also many other issues that coincide with sleep deprivation, such as risk for development of delirium and lack of motivation to participate in care. The ICU is a constant state of distress for not only the staff, but also the family members and ultimately the patient. The stressful environment can inhibit relaxation needed to sleep, which leads to the issue of sleep deprivation. There are various interventions that nurses can take to decrease the stress and stimulation that the intensive care unit creates. It has been discovered that “noise levels in ICUs have been found to be beyond acceptable levels with average daytime sound pressure levels of around 60 A-weighted decibels (dBA) and peak levels \u3e 90 dBA, the equivalent of standing next to a highway” (Simons et al., 2018, p. 2). Considering all the alarms sounding, communication of staff, and the constant movement of providers, the noise level tends to be non-conducive to sleep. Purposeful interventions to address sleep deprivation in the ICU setting include attempts in noise and light reduction for the patients. Some methods of noise reduction that have been tested are the use of earplugs so that the increased noise level of the ICU is dampened for patients to encourage relaxation and rest
A BENCHMARK PROJECT ON EARLY MOBILITY IN THE INTENSIVE CARE UNIT
Full text linkIntroducing early mobility interventions in the Intensive Care Unit (ICU) is a crucial measure to improve patient outcomes and optimize care delivery in the critical care setting. The objective of this project is to tackle the difficulties caused by extended periods of immobility in the Intensive Care Unit (ICU), with the aim of diminishing complications, shortening the duration of ICU stays, and enhancing the functional recovery of patients
Hunter-Killer Peptoid-Peptide Conjugate To Target and Eliminate Cancer Stem Cells
Full text linkIn the contemporary paradigm concerning the emergence of therapy-resistant recurrent cancer, recent studies posit the existence of a limited population of self-renewing malignant progenitors known as cancer stem cells (CSCs). The presence of CSCs explains why tumors often relapse despite clinical remission with initial therapeutic interventions. Consequently, the development of innovative therapeutic modalities specifically tailored to target and eliminate CSCs represents a highly promising strategy for eradicating cancer without the risk of recurrence. In previous research, we successfully developed a synthetic peptoid-based ligand CL-1-19-1 that selectively binds to CSC over non-CSC. However, CL-1-19-1 did not exhibit any significant inhibitory effect on CSC properties. To enhance the CSC-eliminating capabilities of CL-1-19-1, we developed a novel approach by designing a “hunter-killer” peptoid-peptide conjugate. This conjugate combines CL-1-19-1 with a killer peptide sequence (KLAKLAK)2, known for its ability to induce apoptosis by disrupting the outer mitochondrial membrane. We will delve into this conjugate\u27s specific induction of apoptotic cell death in CSCs and explore its therapeutic potential for eradicating CSCs in vivo
USING POSE ESTIMATION TO IDENTIFY GOALKEEPER MOVEMENT TIMING
Full text linkBackground: Markerless human pose estimation has the potential to revolutionize sports analytics by providing detailed insights into athlete movement. The research presented in this thesis explores how open source pose estimation can be utilized to identify goalkeeper dive initiation during soccer penalty kicks.
Purpose: The purpose of this study is to provide an accessible, low-cost heuristic methodology for identifying goalkeeper dive initiation.
Methods: This study uses high-definition single camera broadcast footage (1080p resolution, 50 frames per second) of all 41 penalty kicks attempted during the 2022 FIFA Men’s World Cup. We isolated each penalty kick from kicker run-up to kick outcome and recorded frames of goalkeeper dive initiation and flight. After creating and applying a homography matrix derived by identifying goalpost corners, we identified the goalkeeper’s skeletal keypoints through pose estimation. From these keypoints, we derived frontal plane kinematics for the torso and legs. Using a heuristic methodology, we identified local extrema for each kinematic variable. We isolated the last observed extrema prior to goalkeeper flight for each variable and used OLS regression to identify the most significant predictor of labeled dive initiation.
Results: We found that the last local extrema of the centroid’s y-value was the strongest predictor of labeled commitment to the dive side with an R2 of .998 and a p-value of 0.00. The results of this research are preliminary, but they demonstrate the effectiveness of pose estimation in identifying the initiation of goalkeeper movement during live game play using single camera broadcast footage
DNP Final Report: BALANCING SELF-CARE AND PATIENT CARE: AN INTERVENTION TO ENHANCE WELL-BEING FOR ACUTE CARE NURSES
No full textThis project delves into the profound impact of the COVID-19 pandemic on healthcare and nursing, focusing on the well-being of nurses within the context of acute care settings. Poor well-being leads to increased levels of burnout and the evidence-based practice project aimed to increase the perception of well-being.
The formulated PICOT question driving this project was: In acute care nurses (P), how does the use of Acceptance and Commitment Therapy (ACT) program (I) compared to no Acceptance and Commitment Therapy (ACT) (C) impact nurses’ perception of well-being (O). The evidence substantiates that ACT interventions effectively elevate perceptions of well-being, as demonstrated through the utilization of diverse survey tools.
During the implementation phase an evidence-based intervention ACT was implemented over several weeks in a busy academic medical center in the Southeast, targeting nurses on medical units.
The outcomes demonstrated a substantial positive impact, elevating well-being perceptions from a pre-intervention mean score of 3.48 to 4.32 post-intervention on a 5-item Likert scale. Utilizing a rigorously designed survey by Sexton et al. (2018), the intervention focused on emotional resilience, addressing challenges, circumstances, setbacks, and fostering a positive view. In busy nursing units, the ACT-based intervention proved effective, enhancing the resiliency of nurses and healthcare workers. These outcomes highlight the pivotal role of evidence-based interventions in creating a supportive work environment. The project also demonstrated the ease of sustainability of such practices, asserting their enduring impact on healthcare professionals\u27 well-being and, consequently, the quality of patient care
DNP Final Report: IMPROVING TRANSGENDER FEMALE\u27S COMMUNICATION DURING HEALTHCARE ENCOUNTERS
No full textTransgender females historically described difficulty communicating with healthcare providers. There is a perceived fear of being discriminated against or being misgendered during healthcare encounters (Johnson et al., 2019). In 2017, Seelman reported that 6,450 transgender patients have had difficulty communicating their healthcare needs to their medical providers because of fear, being refused care because of their gender identity, verbal abuse, or a violent experience. Concerns were that patients who do not communicate their healthcare needs or disclose healthcare information are at risk of incorrect decisions being made in their medical treatment. To address this issue, a PICOT question was constructed to begin the process of literature searches and reviews necessary for identifying the appropriate resources, relevant to usable evidence significant to producing answers to the problem identified to structure the project. The mnemonic explanation of PICOT was: (P) In transgender females to females (MtF) who are receiving medical intervention for gender affirmation or post-gender affirmation maintenance (I) does use of a standardized prepared communication note (C) compared to no prepared note (O) to improve the patient\u27s self-reported communication with health care providers (T) in 90 days (about 3 months) of implementation. Information was gathered from the search, and the best intervention was selected. The project was implemented at a clinical site that provided care to transgender females. A post-survey tool was used to measure results: 2 (16.66%) of the 12 participants strongly agreed 100% to all questions. Although participation in the project was lower than expected, the benefits of the intervention showed improved communication hesitancy, reduced medical errors, improved self-advocacy, and improved patient participation in their healthcare. Subsequently, the intervention was determined to be sustainable if incorporated into the clinical intake assessment process
ANALYSIS OF POLICY IMPLEMENTATION: IMPROVING READING PROFICIENCY OUTCOMES FOR ALL STUDENTS
Full text linkThis dissertation investigates the implementation and impact of reading improvement initiatives mandated by Texas House Bill 3 (2019) within a Texas school district. By applying improvement science principles, the study employs a mixed-methods embedded research design to evaluate the alignment of district practices with the Science of Reading and assess the effectiveness of systemic approaches in enhancing student reading outcomes. The research identifies statistically significant improvements in reading achievement, particularly in kindergarten, following the adoption of a phonics curriculum and mandated reading assessment tools. However, the findings also reveal challenges, notably the disconnect between policy understanding and practical implementation among educators. While qualitative data reflects a positive reception of curriculum changes, there is notable dissatisfaction with the Texas Reading Academies platform due to its lack of tailored professional development. The study underscores the need for more effective communication, explicit guidance on policy initiatives, and a systemic approach to implementation and ongoing professional development. Recommendations include revising professional development plans to extend learning beyond the Texas Reading Academies, refining processes and communication for policy interpretation, and scaling successful interventions to higher grades. Emphasizing the importance of incorporating user-centered perspectives in the design of improvement initiatives, the insights from this study provide valuable direction for aligning policy initiatives to better meet district-specific needs and support the practical application of research. Evaluating the impact of these policy initiatives across all organizational levels will enable stakeholders to develop a cohesive implementation plan that maximizes their potential. Ultimately, the findings highlight the critical role of policy guidance and professional development strategies in bridging the gap between policy understanding and practical application
FORAGE PREFERENCE IN TWO GEOGRAPHICALLY CO-OCCURRING FUNGUS GARDENING ANTS (FORMICIDAE): A NOVEL DIETARY DNA APPROACH
No full textExisting biological techniques, when applied in novel ways or to novel systems, can be used to overcome long-standing obstacles. Limitations resulting from traditional methods of forage material identification make resource partitioning impractical to study in non-leafcutting fungus gardening ants. This thesis explores the use of dietary DNA (dDNA) metabarcoding as a method of forage material identification in ant fungus gardens. We hypothesize that dDNA analysis will be sufficient to identify forage material in the gardens of co-occurring species Trachymyrmex septentrionalis and Mycetomoellerius turrifex. Furthermore, we hypothesize that T. septentrionalis and M. turrifex will forage on significantly different substrate material, and that ant colonies at different locations will forage on significantly different substrate material. To test these hypotheses, we collected T. septentrionalis and M. turrifex fungus gardens and sequenced their contents using primers designed for use with dDNA analyses. Our results demonstrate that fungus garden dDNA analysis can be successfully used to identify the foraged substrate of fungus gardening ants. While we did not find a significant difference between T. septentrionalis and M. turrifex foraged substrate material, ant colonies at different locations did forage significantly different substrate material
Developmental Positioning in the NICU
Full text linkFor at least the past decade, one in ten infants born in the United States have delivered prematurely or before the 37th week of gestation (March of Dimes, 2024b). As a result, there are a variety of both short- and long-term effects on the infant that include both physical and neuromotor developmental delays requiring follow-up after discharge (March of Dimes, 2024b). The extent of these delays depends on how early the infant is born and any associated congenital factors; however, the care provided in the Neonatal Intensive Care Unit (NICU) may help reduce the effects or length of these delays.
While developmentally appropriate care is widely welcomed internationally, there remains to be inconsistencies in its use across various NICUs (Tas Arslan & Akkoyun, 2021). This goal of this paper is to answer the question of whether the implementation of an education program utilizing a standard positioning assessment tool for NICU nurses will decrease these inconsistencies and improve short- and long-term neuromotor outcomes in premature infants. A literature review and subsequent synthesis of 12 articles were performed to provide an overview of recent research around the topic. A detailed plan for implementation is included along with an expected timeline of approximately 12 weeks including time for data collection and analysis. While the project was not complete at the time this paper was written, it is expected that nurse knowledge of the benefits of developmental positioning will increase as will the consistency of its use in the NICU. Should this assumption hold true, the recommendation is for NICUs to adopt a formal education program centered on developmental care and supportive positioning of the neonate to help improve developmental outcomes and alleviate the economic burden of post-discharge care