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Title: Friedrich Heinrich Himmel's grande sonate pour deux pianoforte : a performance edition
Creator: Schults-Berndt, Elfie Diana
Date: 1986
Collection: Electronic Theses & Dissertations

Title: The board of directors and strategic planning : a survey of board chairmen
Creator: Henke, John W. (John William)
Date: 1982
Collection: Electronic Theses & Dissertations

Title: The archaeology of the Nanook site : an explanatory approach
Creator: Arundale, Wendy Hanford, 1945-
Date: 1976
Collection: Electronic Theses & Dissertations

Title: The quest for Afro-Brazilians' equal opportunity : the articulations of affirmative action policies and programs by Afro-Brazilian advocacy organizations and the state in Brazil, 1990-2004
Creator: Benedito, Vera Lúcia
Date: 2005
Collection: Electronic Theses & Dissertations

Title: The upper Devonian and lower Mississippian sediments of the Michigan Basin and Bay County, Michigan
Creator: LeMone, David V., 1932-
Date: 1964
Collection: Electronic Theses & Dissertations

Title: Microwave plasma assisted chemical vapor deposition of ultra-nanocrystalline diamond films
Creator: Huang, Wen-Shin
Date: 2004
Collection: Electronic Theses & Dissertations

Title: The adult part-time student role as experienced by some students in extension programs at the University of Alberta, 1970-71
Creator: Zelmer, Amy Elliott, 1935-
Date: 1973
Collection: Electronic Theses & Dissertations

Title: Increasing cervical cancer screening in a rural population through a multifaceted educational intervention
Creator: Boss, Whitney
Date: 2022
Collection: Doctor of Nursing Practice Projects
Description: The purpose of this quality improvement (QI) project was to design and implement a multicomponent evidence-based educational intervention for the patients and providers in a rural health clinic in Mid-Michigan with the goal of increasing the proportion of CCS performed and increasing the amount of CCS appointments being made in women ages 21-64.

Title: Virtual reality as complementary treatment after spinal fusion
Creator: Krueger, Emily (Emily Ann)
Date: 2022
Collection: Doctor of Nursing Practice Projects
Description: Background and Significance: The number of lumbar spinal fusion patients increases each year nationwide. The amount of opioid pain medication used can affect the outcomes, patient satisfaction, and quality of recovery. In this project, emphasis was placed on implementing and using non-pharmaceutical interventions to assist in the management of postoperative pain. Purpose: The purpose of this project was to implement the use of virtual reality to supplement the current postoperative care...
Show moreBackground and Significance: The number of lumbar spinal fusion patients increases each year nationwide. The amount of opioid pain medication used can affect the outcomes, patient satisfaction, and quality of recovery. In this project, emphasis was placed on implementing and using non-pharmaceutical interventions to assist in the management of postoperative pain. Purpose: The purpose of this project was to implement the use of virtual reality to supplement the current postoperative care protocol to minimize the length of stay, increase pain control, and lower opioid usage. Methods: The project was implemented in a neurological unit at a midwestern trauma two hospital. All patients admitted after lumbar spinal fusion surgery performed by the employed neurosurgeons were included in the intervention. Evaluation: Pain scores, length of stay, readmission rates, and morphine milligram equivalencies were documented and compared to patients who had undergone similar surgical procedures before the addition of postoperative virtual reality.
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Title: A project plan : healthy work environment and unit culture
Creator: Woltschlaeger-Brooks, Susanne A.
Date: 2022
Collection: Doctor of Nursing Practice Projects
Description: Background and Review of Literature: A Healthy Work Environment (HWE) has broad implications impacting wellness and retention of team members, recruitment, quality and safety of care delivered, and the overall organizational culture. A review of the literature demonstrates various factors contribute to the presence or absence of a HWE. Purpose: The purpose of this evidence-based quality improvement project is to improve the HWE and ultimately decrease team member churn, increase team member...
Show moreBackground and Review of Literature: A Healthy Work Environment (HWE) has broad implications impacting wellness and retention of team members, recruitment, quality and safety of care delivered, and the overall organizational culture. A review of the literature demonstrates various factors contribute to the presence or absence of a HWE. Purpose: The purpose of this evidence-based quality improvement project is to improve the HWE and ultimately decrease team member churn, increase team member belonging and engagement as well as likelihood to recommend on a neuroscience clinical unit within a large midwestern Magnet ® designated hospital. Methods: Key interventions were implemented focusing on the fundamental core components of the IHI Framework for Improving Joy in Work: camaraderie and teamwork, choice and autonomy, meaning and purpose, and physical and psychological safety. Implementation Plan / Procedure: Following the IHI Framework for Improving Joy in Work, "What matters to you?"208Aconversations to identify impediments to joy at work were held with team members. Targeted strategies to address impediments were developed and implemented. Results/Interpretation: Effectiveness of the IHI Framework for Improving Joy in Work was evaluated by comparing pre and post implementation data for rolling twelve month transfer and churn percentage, engagement and belonging scores, and likelihood to recommend. The twelve month rolling transfer and churn percentage decreased from August 2021 to January 2022. Belonging and engagement scores decreased from July 2021 to November 2021. Likelihood to recommend decreased from August 2021 to January 2022. Implications/Conclusion: The COVID-19 pandemic impacted the implementation of the IHI Framework for Improving Joy in Work as it proved to be a significant disruption impacting overall stress, staffing levels, and tested the resilience of healthcare organizations across the nation. It is recommended that the neuroscience clinical unit consider continued application of the IHI Framework for Improving Joy in Work as a strategy to recover from the COVID-19 pandemic.
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Title: Providing nurses with a structured approach to emotional support during COVID-19
Creator: Martel, Michael (Michael J.)
Date: 2021
Collection: Doctor of Nursing Practice Projects
Description: The increased demands on healthcare facilities as a result of the COVID-19 pandemic have taken an emotional and physical toll on Healthcare Workers (HCW) including nurses, who are on the front lines of patient care. HCW are at an increased risk of mental health disorders, including depression, anxiety, and post-traumatic stress disorder (PTSD), as a result of repeated exposure to traumatic events, long working hours, workplace violence, and repeated exposure to death and suffering....
Show moreThe increased demands on healthcare facilities as a result of the COVID-19 pandemic have taken an emotional and physical toll on Healthcare Workers (HCW) including nurses, who are on the front lines of patient care. HCW are at an increased risk of mental health disorders, including depression, anxiety, and post-traumatic stress disorder (PTSD), as a result of repeated exposure to traumatic events, long working hours, workplace violence, and repeated exposure to death and suffering. Additionally, nurses have a higher risk of suicide than the general population. A literature review was conducted and identified resilience interventions as a theme. Interventions identified were small group resiliency training, a multiple intervention approach, structured debriefing, and peer-to-peer support. The purpose of this Doctor of Nursing Practice (DNP) project is to implement a strategy to promote resilience with the goal of alleviating fatigue, depression, burnout, anxiety and stress, and mental/physical quality of life. The Battle Buddy intervention consists of a structured process of peer-to-peer support. The Battle Buddy program is widely used by the U.S. Army and was recently implemented in the hospital setting by the University of Minnesota as a response to the COVID-19 pandemic. The Anticipate, Plan, Deter (APD) model and strategies to promote resilience and emotional well-being were made available to the participants. The intervention was piloted with Advanced Practice Registered Nurse (APRN) students in the graduate program of a large Midwestern College of Nursing. The intervention was implemented in phases that include assigning Battle Buddy pairs, providing resources, and structured (optional) Battle Buddy Workshops. An informal Battle Buddy workshop survey was administered following each workshop. The Well Being Index (WBI) was used to survey the APRN students at baseline, six, and 12 weeks after implementation. Despite limited survey responses, the quantitative and qualitative data show that participants benefitted from being able to connect on their own time with a peer who understood their struggles.
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Title: Intraoperative blood glucose management : a quality improvement project
Creator: Baker, Jake (Nurse)
Date: 2022
Collection: Doctor of Nursing Practice Projects
Description: Perioperative hyperglycemia is associated with a myriad of post-surgical complications including an increased incidence of surgical site infections and prolonged hospital stays. The use of an evidence-based perioperative blood glucose management protocol reduces morbidity and mortality in adult patients undergoing surgical procedures. The project team describes a cost-effective quality improvement initiative aimed at improving protocol adherence by integrating an easy-to-use protocol...
Show morePerioperative hyperglycemia is associated with a myriad of post-surgical complications including an increased incidence of surgical site infections and prolonged hospital stays. The use of an evidence-based perioperative blood glucose management protocol reduces morbidity and mortality in adult patients undergoing surgical procedures. The project team describes a cost-effective quality improvement initiative aimed at improving protocol adherence by integrating an easy-to-use protocol algorithm, order sets, and practice reminders into an existing electronic health record system.
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Title: Improving pediatric influenza vaccination rates in the primary care setting
Creator: Kositzke, Channan M. (Channan Marie)
Date: 2022
Collection: Doctor of Nursing Practice Projects
Description: Background and Significance: Caregiver vaccine hesitancy (VH) is a barrier to pediatric health. Current pediatric vaccination rates nationwide fall below the national recommendations. Understanding contributors to individualized hesitancy while employing motivational interviewing (MI) techniques can reduce caregiver hesitancy, improve influenza vaccination rates, decrease pediatric disparities, improve community health, and reduce healthcare costs. Purpose: The purpose of this quality...
Show moreBackground and Significance: Caregiver vaccine hesitancy (VH) is a barrier to pediatric health. Current pediatric vaccination rates nationwide fall below the national recommendations. Understanding contributors to individualized hesitancy while employing motivational interviewing (MI) techniques can reduce caregiver hesitancy, improve influenza vaccination rates, decrease pediatric disparities, improve community health, and reduce healthcare costs. Purpose: The purpose of this quality improvement (QI) project was to reduce caregiver influenza vaccine hesitancy through provider education and the use of MI techniques with the MOTIVE-Flu (Motivational Interview Tool to Improve Vaccination Adherence) algorithm point of care tool. The intended outcome goal was to increase seasonal influenza vaccination rates by 10% when comparing the participating providers 2020 (without the intervention) to the 2021 (with the intervention) vaccination acceptance rate. Methods: A literature review guided the selection of the tools and techniques selected, which substantiated the effectiveness of MI within the pediatric population in the primary care setting. De-identified aggregate data was reviewed and provided by the organizational data manager and the participating Medical Assistant (MA). Statistical analysis was provided via Michigan State University (MSU). To assist with MI techniques and the MOTIVE-Flu tool use education was completed by the participating MA's, provider, and nurse practitioner student. Implementation: Implementation occurred from October 2021 to December 2021 within peak influenza vaccine administration season. The intervention occurred during all pediatric primary care visits for children aged six months through seventeen years. The Knowledge into Action Framework guided the development and monitoring process with bi-weekly clinical staff progress, evaluation, and support. Implications: Practical implications include reducing pediatric influenza morbidity and mortality, reducing the spread of influenza within the community, and decreasing healthcare costs. Keywords: Vaccine, Hesitancy, Motivational Interviewing, Pediatric, Primary Care.
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Title: Utilization of a transitional care team for medication reconciliation in geriatric primary care
Creator: Brooks, Tanya
Date: 2022
Collection: Doctor of Nursing Practice Projects
Description: Background and Significance: According to the Institute of Medicine (IOM), medication-related errors lead to mortality and adverse effects such as allergic reactions, avoidable side effects, drug interactions, and unnecessary cost (IOM, 2000). Even with the predominant use of computerized provider order entry (CPOE) and clinical decision support systems (CDSS), medication discrepancies are still problematic today. There is substantial evidence available to demonstrate the benefits of using a...
Show moreBackground and Significance: According to the Institute of Medicine (IOM), medication-related errors lead to mortality and adverse effects such as allergic reactions, avoidable side effects, drug interactions, and unnecessary cost (IOM, 2000). Even with the predominant use of computerized provider order entry (CPOE) and clinical decision support systems (CDSS), medication discrepancies are still problematic today. There is substantial evidence available to demonstrate the benefits of using a transition of care (TOC) team for timely, appropriate medication reconciliation (MR) utilizing multiple intervention modalities. Purpose: This quality improvement (QI) project attempted to determine if the implementation of a TOC team utilizing a telephone-based MR system in a geriatric primary care setting improved identification of medication discrepancies and improved seven-day follow-up (FU) appointments following an inpatient admission. Methods: The TOC team at the geriatric primary care clinic was educated about the improved MR intervention tool and data collection process via a PowerPoint presentation. The data was collected via an Excel spreadsheet and analyzed for improvement upon identified medication errors and follow-through with timely FU appointments. The plan-do-study-act (PDSA) cycle was utilized for implementation. Results: A QI project was implemented in a geriatric primary care setting including 74 patients, 18 of which received the intervention. The implementation was carried out over a total of 12 weeks. Error identification increased from 0.71 errors per patient in the control group to 1.22 in the intervention group. Of the patients contacted via MR phone calls, 88.8% scheduled FU appointments; only 38.8% were within the goal time frame of seven days. The average time to FU during the implementation period was 9.1 days. Conclusion: The TOC team utilizing a telephonic MR improved identification of medication errors and overall FU rates. However, the TOC team did not positively impact the seven-day FU during MR from an inpatient hospitalization visit back to the outpatient setting. Results also indicated an improvement in the time spent per phone call. Keywords: care transition, transition of care team, medication reconciliation, seven-day follow-up, outpatient/ambulatory primary care.
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Title: A quality improvement project for post-COVID-19 patients through reminder phone calls
Creator: Sweeney, Danielle
Date: 2022
Collection: Doctor of Nursing Practice Projects
Description: Background and Review of Literature: COVID-19 is a devastating illness that has detrimental health, financial and emotional consequences. Healthcare providers are utilizing questionnaires such as the PROMIS-29 form to help guide management of long term symptoms. Calling patients prior to their appointment as a reminder to complete their forms has proven to increase patient compliance with form completion. Purpose: The purpose of this quality improvement project was to increase the PROMIS-29...
Show moreBackground and Review of Literature: COVID-19 is a devastating illness that has detrimental health, financial and emotional consequences. Healthcare providers are utilizing questionnaires such as the PROMIS-29 form to help guide management of long term symptoms. Calling patients prior to their appointment as a reminder to complete their forms has proven to increase patient compliance with form completion. Purpose: The purpose of this quality improvement project was to increase the PROMIS-29 form response rate prior to the COVID-19 recovery care appointment, in hopes of improving care for patients living with post-COVID-19 conditions. Methods: This project was implemented at a large Midwest healthcare organization's primary care clinics. The Doctor of Nursing Practice (DNP) students called patients within 72 hours prior to their appointment, to remind them to complete the PROMIS-29 form on their MyChart portal. Implementation Plan/Procedure: The DNP students completed HIPAA training and utilized a script provided by the large Midwest healthcare organization when calling patients. A weekly report was provided by the community partner that includes a list of patients who needed to be called, according to the "post COVID follow up" visit type. The DNP students traveled to the large Midwest healthcare organization's administration building to conduct phone calls. Pre-intervention and post-intervention surveys were sent to the providers to determine the success of the intervention. Implications/Conclusion: Various project limitations impeded the ability to determine the success of the intervention however, the project proved helpful in determining that other reminder modalities may be of benefit to explore in the future. Keywords: Patient, Remind, Phone, Text, Email, Call, Form, Paperwork.
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Title: Assessment of self-care and education in patients with type 2 diabetes mellitus
Creator: Monroe, Kristen M. (Kristen Mae)
Date: 2022
Collection: Doctor of Nursing Practice Projects
Description: Background and Significance: The annual cost of diagnosed type 2 diabetes mellitus (DM2) in the United States is $327 billion, with individuals with DM2 spending 2.3 times more on health care than individuals without DM2. Education, such as Diabetes Self-Management Education and Support (DSMES) programs, and self-care support, utilizing tools such as the Summary of Diabetes Self-Care Activities (SDSCA) Measure, are the cornerstones of improving care and outcomes for patients with DM2. Purpose...
Show moreBackground and Significance: The annual cost of diagnosed type 2 diabetes mellitus (DM2) in the United States is $327 billion, with individuals with DM2 spending 2.3 times more on health care than individuals without DM2. Education, such as Diabetes Self-Management Education and Support (DSMES) programs, and self-care support, utilizing tools such as the Summary of Diabetes Self-Care Activities (SDSCA) Measure, are the cornerstones of improving care and outcomes for patients with DM2. Purpose: The purpose of this quality improvement project was to implement a standardized self-care assessment and educational intervention for a mid-Michigan internal medicine clinic's adult patient population over 18 years of age with DM2 and hemoglobin A1c (HbA1c) greater than 9% and improve patient self-care. Methods: The Plan, Do, Act, Study (PDSA) Cycle and the Chronic Care Model were used as a framework to guide the project. Eligible participants were identified by clinic staff and received self-care education. Evaluation: The validated SDSCA tool was utilized to assess self-care pre- and post- educational intervention. A two-tailed paired t-test was then performed to compare pre- and post-intervention scores. Outcomes: Of 25 eligible patients in the clinic, 13 patients participated in the initial phase with 3 patients lost to follow-up, leaving 10 patients included in data analysis. A statistically significant improvement was seen in DM2 self-care with mean scores increasing from 4.1 days/week to 4.8 days/week (t = -6.5, p < 0.01). Implications/Conclusion: Identification of specific areas of patient educational needs can improve self-care in patients with DM2 and improve their overall health outcomes.
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Title: Reducing pediatric pain during immunizations
Creator: Bradley, Paul (Paul Michael)
Date: 2022
Collection: Doctor of Nursing Practice Projects
Description: Background: Immunizations are often associated with pain and fear in the pediatric population. These negative emotions can have lasting effects on a patient's willingness to receive future medical care, including immunizations. Therefore, it is important to attempt to minimize the amount of pain and fear during all vaccination encounters. Purpose: A small West Michigan rural clinic had no formal process or tools for reducing pediatric pain during vaccinations. After an extensive literature...
Show moreBackground: Immunizations are often associated with pain and fear in the pediatric population. These negative emotions can have lasting effects on a patient's willingness to receive future medical care, including immunizations. Therefore, it is important to attempt to minimize the amount of pain and fear during all vaccination encounters. Purpose: A small West Michigan rural clinic had no formal process or tools for reducing pediatric pain during vaccinations. After an extensive literature review, it was decided to implement Buzzy®, a thermomechanical device, into the clinic's standardized practice for all pediatric immunizations. The goal was to improve the pediatric vaccination experience within the clinic. Methods: Using the PDSA model, two DNP students provided an in-service to the medical assistants on the use of the device. Education was also provided on the data collection tool that included an unvalidated survey assessing the parent/guardian's perception of their child's past and current vaccination experience, as well as the patient's pain level using one of three validated pain scales. Participants between the ages of 0-18 years and their parents/guardians had to be willing to use the Buzzy® device in order to enroll. Data was collected from October 2021 to January 2022. Results: Forty-five participants agreed to participate in this evidence-based practice (EBP) project. Participants' average pain score was mild with the use of Buzzy® at 2.9 out of 10. The average experience with Buzzy® was found to be significantly higher than the previous average vaccination encounter (p=.04). Finally, 95% of participants recommended continued use of Buzzy®. Conclusion: The implementation of Buzzy® during pediatric immunizations improved the immunization experience in a rural West Michigan clinic. These significant results support the continued use of Buzzy® at the clinic.
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Title: Improving perioperative nausea and vomiting prophylaxis protocol compliance
Creator: Franz, Allison
Date: 2022
Collection: Doctor of Nursing Practice Projects
Description: Postoperative nausea and vomiting (PONV) is a significant concern in anesthesia practice. Evidence-based guidelines have sought to provide recommendations on identifying patients at risk for PONV and mitigating its effect with multimodal antiemetic strategies. An anesthesia department within a large teaching hospital uses the Anesthesiology Performance Improvement and Report Exchange guidelines to identify and manage patients at risk for PONV. These guidelines are intended to integrate best...
Show morePostoperative nausea and vomiting (PONV) is a significant concern in anesthesia practice. Evidence-based guidelines have sought to provide recommendations on identifying patients at risk for PONV and mitigating its effect with multimodal antiemetic strategies. An anesthesia department within a large teaching hospital uses the Anesthesiology Performance Improvement and Report Exchange guidelines to identify and manage patients at risk for PONV. These guidelines are intended to integrate best practices into anesthetic care and improve overall surgical outcomes. The anesthesia department currently has a PONV protocol in place that aligns with the guidelines but has not achieved their compliance benchmark. This evidence-based quality improvement project describes interventions proposed to increase compliance with the PONV protocol. To address poor PONV compliance, an anonymous survey was developed to assess anesthesia provider's current familiarity with the new PONV guidelines and identify misconceptions. A visual feedback system was implemented using a preliminary confidential list that anonymizes staff. This allowed individual providers to identify their own performance in relation to their peers in a non-punitive way. The results of this quality improvement project demonstrate that the proposed interventions increased departmental compliance.
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Title: Development and implementation of an enhanced recovery after surgery protocol for women undergoing a mastectomy
Creator: Braun, Michael
Date: 2022
Collection: Doctor of Nursing Practice Projects
Description: This evidenced-based practice initiative includes the development and implementation of an evidence-based enhanced recovery after surgery (ERAS) guideline with a specific focus on the incidence of postoperative nausea and vomiting (PONV) and opioid administration in the postoperative setting. The clinical question was in adult women, age 18 years or greater, undergoing a mastectomy procedure, does the implementation of an ERAS guideline lower the incidence of PONV and reduce morphine...
Show moreThis evidenced-based practice initiative includes the development and implementation of an evidence-based enhanced recovery after surgery (ERAS) guideline with a specific focus on the incidence of postoperative nausea and vomiting (PONV) and opioid administration in the postoperative setting. The clinical question was in adult women, age 18 years or greater, undergoing a mastectomy procedure, does the implementation of an ERAS guideline lower the incidence of PONV and reduce morphine milligram equivalent (MME) requirements in a post-anesthesia care unit (PACU)? Patients undergoing breast cancer surgery have multiple risk factors and the reported incidence of PONV reaches up to 80%. Over half of post-surgical breast cancer patients develop neuropathic pain syndromes. A mastectomy ERAS guideline was developed then applied to the perioperative course of 22 patients. It was found that following an ERAS guideline reduced the incidence of PONV by 17% and reduced the average MME by 13.5 equivalents. Project implications include potential cost savings, reduced PACU length of stay, and improved patient outcomes.
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Title: Increasing point of care testing for glycated hemoglobin A1c levels in a family health clinic
Creator: Wielgos, Elizabeth
Date: 2022
Collection: Doctor of Nursing Practice Projects
Description: Background: Adults with type 2 diabetes mellitus (DM) have and continue to increase significantly within the United States (U.S.). The current recommended glycated hemoglobin A1c (HbA1c) goal for a nonpregnant healthy adult is a value of 7% to lower the risk of DM-related complications (American Diabetes Association [ADA], 2021). Because a goal of 7% may not be feasible in many cases due to other variables, each person with diabetes should have an individualized goal and treatment plan based...
Show moreBackground: Adults with type 2 diabetes mellitus (DM) have and continue to increase significantly within the United States (U.S.). The current recommended glycated hemoglobin A1c (HbA1c) goal for a nonpregnant healthy adult is a value of 7% to lower the risk of DM-related complications (American Diabetes Association [ADA], 2021). Because a goal of 7% may not be feasible in many cases due to other variables, each person with diabetes should have an individualized goal and treatment plan based on their health history and age (ADA, 2021). Compared to a lab draw, which can take hours to days before the provider can see the results, point of care testing (POCT) is more convenient because it produces results in minutes. Purpose: The goal of this quality improvement project was to enhance patient outcomes by introducing an algorithm to ensure that patients with diabetes were effectively managed according to the American Diabetes Association's current recommendations using POCT. Results: The data were subjected to Chi-square and T-tests, but no statistical significance was found. However, analysis of the data revealed many findings consistent with clinical significance. Conclusion: After analysis of the data from this quality improvement (QI) project, findings showed there was a positive correlation between POCT for HbA1c and an increase in values <9%. It was recommended staff continue to apply the algorithm to analyze the long-term outcomes of utilizing POCT for HbA1c in the family medicine clinic.
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