Capstone Papers and Posters

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    Evaluating Healthcare Providers’ Practices of Screening for Bullying in Pediatric Patients
    ( 2019-07) Atcher, Mark ; Dr. Stephen Hardiman
    Bullying is a common occurrence in the United States that is experienced by the adolescent population. Bullying and suicidal behaviors are closely linked, and healthcare providers have a responsibility to be involved in the screening and management of bullying and suicidal behavior (Center for Disease Control and Prevention, 2014). Screening for bullying starting at six years of age is a recommendation by the American Academy of Pediatrics. The purpose of this research paper was to improve healthcare providers’ screening of bullying and to improve the healthcare provider’s ability to identify adolescents who are being bullied. The outcome of this project was to evaluate healthcare providers practices and perceptions on screening for bullying. In addition, the project was designed to determine if frequent screenings for bullying compared to annual screenings for bullying would assist providers in identifying adolescents who are being bullied or identifying bullies. The most significant finding of the study was that 100% of participants in the study agreed that bullying was an issue the adolescent populations faced. While the study had limitation with the sample size, the results indicate a need for further research on screening for bullying in the adolescent population. The findings of the study should be used to determine further research on how best practice guidelines for healthcare providers can lead to frequent screening for bullying in the adolescent population and to provide educational materials to assist providers in screening at-risk adolescents.
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    The Perceptions of Implementing a Narcan Take Home Kit
    ( 2019-07) Mackrill, Jenny ; Dr. Stephen Hardiman
    Prescription opioid use is a recommended treatment for different types of pain (Dowell, Haegerich, & Chou, 2016). The risk of potential overdose is increased in patients prescribed opioids when several factors are present; chronic opioid therapy, males, older age, taking multiple prescriptions especially benzodiazepines, mental health disorders, lower socioeconomical status, when prescribed dose is 100 mg of morphine equivalents or greater per day, history of illicit opioid use, previous opioid overdose, and alcohol use (WHO, 2014; Ray & Lukens, 2017). The purpose of this project was to pilot implement a Narcan Take-Home Kit Program and identify the obstacles, perceptions, and barriers of the providers prior to implementation of the program. A questionnaire consisting of thirteen questions, consisting of a Likert scale, was distributed to the providers of a pain clinic. The outcome of the project was favorable. Providers agreed that Narcan can be safely administered by a lay person and did not feel legally responsible for the use. The project response was small; future studies are needed to identify obstacles, perceptions, and barriers of the implementation of a Narcan Take Home Kit.
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    Outpatient Preoperative Prophylactic Antimicrobial Use and Surgical Site Infection Rates
    ( 2019-07) Zima, Ashlie ; Dr. Jane Langemeier
    In the United States, most postoperative orthopedic surgical site infections (SSIs) and prophylactic antimicrobial use research are hospital-based. However, 50% of the orthopedic procedures occur outpatient and postoperative SSI research is lacking (Berríos-Torres et al., 2017). Hospital-based preoperative prophylactic intravenous antibiotics administration supports decreased SSI rates (Al-Mulhim, Baragbah, Sadat-Ali, Alomran, & Azam, 2014). The research question posed was: For the adult patient undergoing an orthopedic surgical procedure at an outpatient facility, what is the effect of preoperative prophylactic antimicrobials on postoperative surgical site infection rates within the first 30-days? This descriptive study examined a convenience sample of adults, following an orthopedic procedure, administered a preoperative prophylactic intravenous antimicrobial for a postoperative SSI at an outpatient surgical facility. Guiding the research was Meleis’ transitions theory which examines the transitional experience throughout the surgical encounter to reduce associated risks (Omar, 2017). Of the 149 orthopedic cases reviewed between January 1, 2019-April 30, 2019, N = 103 patients met the inclusion criteria. The various intravenous antimicrobials and the doses administered were Cefazolin 1 gram, Cefazolin 2 grams, Clindamycin 600mg, Clindamycin 900mg, Vancomycin 1 gram, and Rocephin 1 gram. The study found 1 (0.01%) SSI documented for a patient administered Rocephin; significantly, 99.9% administered a preoperative prophylactic antimicrobial experienced no SSI within 30-days postoperatively. Future research recommendations include investigating the type, dose, and time of preoperative antibiotic administrations, and all surgical procedures performed at an outpatient surgical facility.
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    Sun-Safety Education in Female Adolescents: Exploring Relationships between Education and Future Sun Safe Practices
    ( 2019-07) Bilek, Rachel ; Dr. Jane Langemeier
    Skin cancer is the most common occurring form of cancer in the United States; 1 in 5 develop skin cancer by the age of 70 (Centers for Disease Control, [CDC] 2017). The American Cancer Society (2017) states exposure to ultraviolet (UV) radiation from sunlight and tanning bed lamps increase the risk of skin cancer development. UV exposure is a modifiable lifestyle behavior; the problem is the need for health curriculum aimed at skin cancer prevention behaviors and sun safe guidelines for the school-aged child. The quasi-experimental pre and post-test design explored how a nurse-led SunWise safety presentation effected adolescence girls age 16-17 on sun-safe behaviors. Developed by the Environmental Protection Agency (2016), the SunWise program included avoidance of sunburns and tanning beds, wearing sun protective clothing, and checking the UV outdoor index for increased risk of harm to minimize UV exposure. Pender’s health promotion model conceptually aligned the study, focusing on the adolescent’s future ability to apply sun safety to personal behavior changes. The two-tailed t-test analysis (n = 8) calculated a statistically significant t-score at the alpha level of .05 = 6.148. Study recommendations include expanding the sun safe education to reach children much younger within school health curriculums. Future research recommendations include longitudinal studies on the effectiveness of sun safe educational practices on the development of skin cancer over a patient’s life-time.
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    Primary Care Providers' Knowledge of Cancer Survivorship Care Plans
    ( 2019-07) Hergert, Kayla ; Dr. Katherine Kirkpatrick, Advisor
    As treatment for cancer improves, the number of cancer survivors continues to grow. Cancer survivors are at an increased risk of cancer reoccurrence, mortality, and decreased quality of life. Primary care providers can help provide survivorship care and education to cancer survivors by using a survivorship care plan created by the patient’s oncology team. The purpose of this study was to determine if primary care providers perceive an increase in their knowledge of providing survivorship care when they receive a survivorship care plan for their patient. The research was conducted by using a quantitative descriptive research design with non-probability, convenience sampling. The survey included a 10-question Likert scale with two open-ended questions and was sent to the Internal Medicine providers at Nebraska Medicine. The survey asked questions to determine if providers perceived an increase in their knowledge in providing survivorship care when using a survivorship care plan. The primary care providers who participated agreed that the survivorship care plan increased their knowledge of survivorship care, increased their knowledge of surveillance testing needed for their patients, and increased their knowledge of what cancer treatment their patient received. It was recommended that further research be conducted to include a larger sample size and to include family medicine providers.