STUDENT: Moriah Bistran

PROJECT ADVISOR: Michael Evans

Patient violence toward nurses is common throughout hospitals. The violence is often going unnoticed and not being reported. Multiple risk assessment tools are being evaluated on medical-surgical floors to identify potentially violent patients before they have a violent encounter with a nurse. The purpose of this literature review is to analyze relevant literature related to the topic and describe the effectiveness of the risk assessment tools implemented on medical-surgical floors. All of the research was performed through the Penn State Libraries database. A variety of key words were used to narrow the search. The words and phrases included; violence, nurses, physicians, healthcare workers, violence risk assessment tools, hospitals, patients, and nurse violence. From there, the search was narrowed down to five main articles which were used to analyze the topic of patient violence toward nurses in a hospital setting. As expected, there are risk assessment tools to identify potentially violent patients before they act out. However, there is not enough evidence-based practice protocol to confirm one, single risk assessment tool to identify all violent patients on the medical-surgical units in hospitals. Further research and evidence-based practice protocol will need to be performed to confirm a single, effective risk assessment tool.

STUDENT: Kellen Kraky

PROJECT ADVISOR: Michael M. Evans

ABSTRACT

Health care reform has significantly increased patient demand for primary care. Patients receive primary care from nurse practitioners (NPs) as well as physicians. Current scope of practice laws limit patients’ direct access to NPs. Most states have practice laws which restrict NPs from practicing at the top of their education. As the demand for care grows more rapidly than the supply of providers, a projected primary care physician shortage is imminent. These restrictions on NPs are confounding the primary care shortage. Innovative solutions to this problem must be created and implemented to meet the primary care needs of the population.
Purpose
The purpose of this study is to reduce the primary care provider shortage by demonstrating that NPs should be utilized in this capacity.
Methods
A thorough literature review was conducted utilizing PubMed, CINAHL, and Cochrane Library. Search terms included: nurse practitioner; primary care; outcome assessment, health care; and health outcomes. Studies were limited to those published in the English language within the last ten years.
Results
The literature review search returned 94 results. After reviewing the titles, abstracts, and reference lists, a total of five articles were selected for inclusion in this research study. Three of the five articles were systematic reviews, and two were retrospective studies.
Conclusions
Primary care delivered by NPs leads to equal or better health outcomes. Scope of practice law revisions are needed to allow patients direct access to quality primary care provided by NPs.

STUDENT: Amanda Mattina

PROJECT ADVISOR: Michael M. Evans

ABSTRACT

Lyme disease if not caught early enough can cause serious health problems and disrupt a persons way of life. Unfortunately, many times the disease gets misdiagnosed because it acts as many other diseases such as, multiple sclerosis and fibromyalgia. Fortunately, if the disease is caught early it can be easily treated with antibiotics. Unfortunately, Often times patients will continue to have joint issues. Therefore, the purpose of my paper is to gather literature to find an intervention for adults that involves massage therapy to help with joint pain associated with Lyme disease. A review of literature was conducted to locate all possible scholarly articles. This included PubMed and CINAHL using keywords such as massage therapy, Lyme disease and joint pain. Inclusion criteria were 18 years old and older who experience joint pain associated with Lyme disease. Exclusion criteria include younger than 18 years old and recently involved in an accident, have any open wounds or deep vein thrombosis. Upon completion of the literature review, 28 articles were reviewed and four articles were retained because of the relevance to this research. After reviewing the articles it is concluded massage therapy can be useful for joint pain associated with Lyme disease. Lyme disease can be a complex disease if not diagnosed correctly and cause many hard ships for patients for the rest of their lives.

STUDENT: Raymond J. Dugan

PROJECT ADVISOR: Michael M. Evans

ABSTRACT

Ventricular arrhythmias are lethal, irregular heart rhythms that are present in almost 20% of adult patients in cardiac arrest. The two types of ventricular arrhythmias that can manifest in cardiac arrest are pulseless ventricular tachycardia and ventricular fibrillation. Without appropriate treatment, to include defibrillation, cardioversion, and pharmacological interventions, a patient does not stand any chance of attaining return of spontaneous circulation, or ROSC. The two medications that are currently recommended by the American Heart Association (AHA) to treat ventricular dysrhythmias are Amiodarone and Lidocaine. While both medications are listed in cardiac algorithms published by the AHA, there is no direct evidence that either Lidocaine or Amiodarone have a higher efficacy for converting ventricular arrhythmias, and the choice of which drug to administer rests on the provider. Some providers prefer Amiodarone to Lidocaine for the sole purpose of convenience and lessened chance of a drug calculation error. Amiodarone is administered as a standard dose in cardiac arrest, regardless of patient weight. In contrast, Lidocaine is a weight-based drug, requiring that the dose be individually calculated by the provider for each patient encounter. The purpose of this paper is to examine and synthesize the literature surrounding the studies comparing the use of Lidocaine to Amiodarone, as well as the patient outcomes in the groups who received each drug. The studies and articles reviewed show that there is still a large amount of discrepancy as to which drug is more effective, and that more research needs to be conducted.

STUDENT: Kaléi Kowalchik

PROJECT ADVISOR: Michael M. Evans

ABSTRACT

Functional somatic syndromes, including disease such as fibromyalgia and chronic fatigue syndrome, often contain unexplained medical symptomology which remains invisible to the onlooker. The nature of the presentation of these syndromes cultivates more bias from healthcare workers, resulting in a dysfunctional care cycle for the patient. Literature was analyzed to determine best practices for care of this population in a medical/surgical setting This information will be presented in a case study format.
Methods
A review of literature was conducted searching for evidence surrounding caring for patients with functional somatic syndrome in the medical/surgical setting. All databases related to the health sciences were searched to locate scholarly evidence sources. The search terms of functional somatic syndromes, and acute care and medical/surgical nurses were utilized.
Results
Twelve articles were reviewed for their relevancy to this project. They showed that the following areas were pertinent to caring for patients with functional somatic syndromes in a medical/surgical setting: utilizing palliative care, understanding the individuality of each patient, taking patient reports seriously, and combining areas of pharmacotherapy, exercise, and psychological therapies throughout the treatment plan.
Conclusions
By incorporating aspects of palliative care and interdisciplinary team based approaches, patients will be able to better manage their functional somatic syndrome.

Second Place in Category #2 – Nursing Injury & Disease

STUDENT: Kaléi Kowalchik

PROJECT ADVISOR: Michael M. Evans

ABSTRACT

The Department of Health and Human Services has declared the opioid epidemic a public health emergency, as 11.5 million people were estimated to misuse prescription opioids in 2016. Moreover, approximately 40% of hospital admissions have substance abuse disorders. Substance abuse disorder is present when a patient has a compulsive urge to continue using opiates after they are no longer required medically to treat the patient. Patients who suddenly stop opioids will suffer from withdrawal symptoms and these symptoms increase suffering in the patient and enhance the level of care required. As the numbers for opioid misuse continues to increase, resources involving better pain management in healthcare facilities, preventative addiction counseling specific to opioid misuse, and better research must be available for healthcare providers, patients, caregivers, and their families to combat this epidemic. Therefore, a literature review was conducted looking for the most up-to-date and relevant information on addressing the increasing number of opioid addicts present within the medical-surgical setting. The scholarly databases CINAHL, PubMed were searched using the keywords and limiters opioid, addicted, medical-surgical, nursing and peer-reviewed, since 2009, and English language. From the reviewed literature, best practices recommendations were compiled for medical-surgical nurses when caring for opioid addicted patients in an acute care setting. Best practice recommendations included: utilize compassion, educate on harm reduction, utilize a collaborative approach, provide information on local resources, address the family, and assess treatment readiness. Medical-surgical nurses can use these recommendations to provide this population with safe compassionate care.

First Place in Category #2 – Nursing Injury & Disease

STUDENT: Megan Lucey

PROJECT ADVISOR: Margret Hatch

ABSTRACT

With organ failure being the one of the leading causes of death, there is a demand for organ transplantation. However, this demand exceeds availability. According to the Health Resources & Services Administration, there were over 113,000 people on the transplant waiting list in 2019 with only 36,528 transplants performed in 2018. Due to the donor shortage, there is a limited supply of organs, resulting in many people dying while waiting for one. Even when organs are available for transplant, there is a risk of rejection by the patient’s body and specific criteria required for an organ to be matched to a recipient. To help solve the donor organ shortage, biological artificial organs grown from stem cells are being developed. For this study, a literature search was conducted on artificial organ technologies and the impacts they have on patients in need. Artificial organs grown from a person’s own stem cells offer a promising solution to the issues of organ shortage and complications of transplant rejection. Functional animal organs, such as rat kidneys and lungs have been grown successfully. With a growing waiting list for organ transplants, persons need their voices to be heard and family members and healthcare professionals need to advocate for this new technology. The current unavailability of organs suitable for transplant makes artificial organs a viable option for organ failure patients. Through artificial organs, persons in need of a transplant would no longer be another name on a waiting list but instead would become a life saved.

STUDENTS: Megan Lucey, Kaléi Kowalchik, Lucy Adams

PROJECT ADVISOR: Michael M. Evans

ABSTRACT

Sickle cell anemia (SCA) is an inherited blood disorder that causes the hemoglobin molecules in red blood cells to be defective. This causes the blood cells to have shorter lifespans and block blood vessels, resulting in anemia, fatigue, inadequate blood supply, and painful vaso-occlusive crises. Affecting approximately 100,000 individuals in the United States, SCA has an estimated annual medical care cost of $1.1 billion. SCA predominately affects African Americans, with an estimated 1 out of 365 births diagnosed with the disease. People of color typically face implicit bias from healthcare providers and are viewed with a more negative attitude than other patients. In addition, people with SCA are viewed as “drug-seeking” because the disease’s treatment for the symptoms of severe pain is opioids. The intensified stigma from the rising opioid crisis results in pain not being managed properly and decreased quality of care in SCA patients. To address the complex issues surrounding treatment of SCA, a hypothetical case study is presented which describes the events of an SCA patient who was admitted to a medical-surgical unit following a vaso-occlusive crisis. A literature review was conducted using the scholarly databases CINAHL and PubMed to find the best practices for SCA patients. From the literature review, best practices included more education on SCA for healthcare professionals, utilization of alternative treatments, enhanced medical management, and better care coordination. Using this case study and recommended best practices, medical-surgical nurses can provide SCA patients with higher quality care.