Community Comes Together to Serve Others

Holiday season proves to be an opportunity to rise above and care for the community

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The institutional Value of Caring permeates every encounter that Clarkson College students, faculty and staff share with one another and the community at large. The holiday season brought opportunities for College community members to live out this Value and serve others.

Employees Support Students During Choose to Give Campaign The largest number of participants ever donated to the ninth annual Choose to Give campaign in fall 2019. The event invites Clarkson College community members to support the College through monetary contributions, and this year, staff had the opportunity to support the Alumni Association Endowed Scholarship Fund and the Anatomage Table Fundraiser. Altogether, 65 employees raised more than $14,500 with nearly $5,000 going toward the Scholarship Fund and more than $9,500 going toward the Anatomage Table Fundraiser (learn more on page 19). Radiography & Medical Imaging Students Support Community Organizations Radiography and Medical Imaging students once again partnered with Calling the Hope Revolution into Service (CHRS) and adopted families in need of assistance during the holiday season. Students raised money to purchase food, clothing, gifts and other items by selling coupon books to College community members, families and friends. Volunteers wrapped the donated items and delivered them to the families in December, just in time for the holidays.

Students and faculty also volunteered for the Ronald McDonald House Charities in November. Volunteers traveled to a Ronald McDonald House in Omaha where they participated in a hands-on activity with children at the house. The kids, many of whom are staying at the house while they or their family members receive medical treatment, enjoyed an afternoon spent creating clay creatures with Clarkson College students and faculty.

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Nursing Students Administer Flu Shots Clarkson College students from the Population Health clinical group administered over 100 shots during a flu shot clinic in early November on the Nebraska Medicine campus. The clinic was part of a campaign dedicated to keeping employees, visitors and guests healthy during flu season. The provided shots were free of charge for all Nebraska Medicine and Clarkson College employees.

PTA Students Participate in Global PT Day of Service October was National Physical Therapy Month, and Clarkson College Physical Therapist Assistant (PTA) students and faculty celebrated by participating in the Global PT Day of Service on Oct. 12. The group gathered clothes, food, hygiene items, shoes and monetary donations for the Heartland Hope Mission in Omaha. The items helped the organization achieve their mission of assisting people living in poverty become food secure and self-sufficient. Students also volunteered during the Special Olympics Nebraska Be Brave 5k held Oct. 20. During the event, participants organized booths featuring games and photo booth activities for athletes and their families. The all-ability event featured a 5k run or walk and one-mile fun run with all of the proceeds benefiting Special Olympics.

SGA Gathers Gifts for Children Each year, Student Government Association (SGA) members celebrate the holiday season by setting up a Giving Tree on campus. The tree contains paper ornaments, each featuring the gender and age of a child as well as their holiday gift wish list. College community participants select ornaments, purchase gifts and return them to campus unwrapped. SGA representatives spent a morning wrapping the presents and delivered them to Children’s Square, an organization that serves children and their families in the Council Bluffs and Omaha areas. The distributed toys, clothing, supplies and gifts brought joy to children during the holiday season. 4

1 / Radiography student volunteers enjoy their time spent serving children residing in a local Ronald McDonald House. 2 / Nursing students share a laugh during a flu shot clinic. 3 / PTA students hosted game and photo booths during the Be Brave 5k. 4 / SGA members proudly pose near the wrapped gift donations in the Residence Hall's student lounge.

Twenty-eight Master’s degree-seeking students presented their Capstone Projects on Dec. 6 at Storz Pavilion on the Nebraska Medicine campus. After working for more than a year on their projects, they shared the final culmination of their efforts with their fellow students, faculty and friends. The Alumni Association ad hoc committee reviewed the students’ submitted project abstracts and awarded first, second and third place winners based on an established rubric. Alumni Association Board member Carla Dirkschneider (’07) presented the certificates to the three winners at the conclusion of the presentations.

Kristal Turpen earned first place for her abstract Effect of PressureRelieving Dressings as Ulcer Prevention Interventions During Cardiothoracic Surgery (advisor Dr. Kathy Harrison). Second place went to Kelli Jacobs for her abstract Analysis of Ambulatory Standardized Rooming and Meaningful Use Compliance (advisor Ms. Carla Dirkschneider). Brandon Smith earned third place for his abstract Evaluation of Methods to Prevent Deep Vein Thrombosis After Total Knee Arthroplasty (advisor Dr. Kathy Harrison).

Effect of Pressure-Relieving Dressings as Ulcer Prevention Interventions During Cardiothoracic Surgery by Kristal Turpen Pressure ulcers (PU) present a significant risk in health care settings. PU development is a “never event” by Medicare and reflects an indicator of poor quality care. Research is limited on intraoperative interventions used for PU prevention. The study used a retrospective chart review in a single academic institution for patients undergoing cardiothoracic surgeries to understand the effect of the current intraoperative pressure ulcer-prevention methods in place. Data analyzed included intra- and postoperative skin assessments, procedure type, length, development of postoperative PU, and whether or not a pressure-relieving dressing was used. Additional data included any postoperative pressure reduction strategies. Results indicated that out of the 182 surgical patients included, 89.56% received the intervention and 10.44% did not. Patients experiencing a PU post-operatively were eight out of 182 or 4.40%, respectively. Conclusion: Those with the PU prevention dressing showed an incidence rate of 3.68%, while those without intervention experienced an incidence rate of 10.53%. The phi correlation coefficient shows only a negligible inverse relationship to the use of the intervention, and Fisher’s exact test did not provide sufficient evidence to reject the null, but it shows the probability that the null hypothesis is due to random chance to be less than 20%. Cross tabulation showed that the Braden Scale was not a strong predictor of ulcer risk in patients. Findings are suggestive of a need for further research and education on use of the Braden scale and PU prevention interventions. The positive effects of incidence rates show a clinical benefit to patients.

Analysis of Ambulatory Standardized Rooming and Meaningful Use Compliance by Kelli Jacobs The HITECH Act of 2009 has changed the approach of modern health care delivery. Through implementation of electronic health records (EHRs), regulatory entities are able to easily obtain and assess patient specific data to evaluate quality of care. However, hospital systems have faced implementation barriers and struggle to meet quality measure definitions. A midwestern academic medical center also identified barriers within the ambulatory clinic setting which inhibited meaningful EHR use and regulatory reporting. Ambulatory clinics across the medical center had independent, unstandardized rooming processes that resulted in inconsistent communication and data collection. However, studies have shown that the use of a standardized rooming workflow can increase safety and quality of care. A quantitative descriptive study of ambulatory clinic encounters for patients ages 18 and older was conducted to determine if a standardized rooming and documentation process could increase an organization’s ability to capture meaningful use (MU) requirements for body mass index (BMI) and tobacco screening, thereby affecting compliance. Prior to rooming standardization, the organization captured 61% of MU BMI and tobacco screening data elements. Analysis of rooming documentation found an average of 73% compliance within the research timeframe after standardized rooming was implemented; however, changing MU measure definitions made it difficult to draw direct comparisons between documentation compliance and BMI or tobacco measure performance. Recommendations consist of completing a culture assessment to evaluate complacency, which can lead to a decline in compliance, and conducting further research in an attempt to gather additional information which would allow for evaluation of a direct correlation between a standardized rooming process and MU measurement performance.

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BARBARA ANDERSON Caregiver Knowledge of Lead & Cadmium in Children’s Toys & Jewelry Following Review of a Nurse-Designed Educational Pamphlet, advisor Dr. Aubray Orduña

JENNIFER ARMSTRONG Effectiveness of Cricoid Pressure in Rapid Sequence Induction, advisor Dr. Sophie Feng

SHEILA AUGUSTINE The Implementation of an Advanced Beneficiary Notification (ABN) within an Electronic Health Record (EHR), advisor Ms. Carla Dirkschneider

CASSANDRA BOEHNING Effectiveness of Long- & Short-Term Contraceptives on Unintended Short-Interval Pregnancy in Teens, advisor Dr. Aubray Orduña

MICHAEL BRAGG Ketamine Administration & the Incidence of Postpartum Depression After Elective Caesarean, advisor Dr. Sophie Feng

JESSICA BRANTON A Correlation of Hospital Admissions of Home Health Patients with COPD & Associated Risk Factors, advisor Dr. Mary Lynn Vogel

KATE BROSSARD Providers’ Perceptions of the Use of Smartphone Technology in the Management of Atrial Fibrillation in Cardiac Patients, advisor Dr. Steve Hardiman

WILLIAM BROWN Ondansetron for Postoperative Nausea & Vomiting: Does Timing of Administration Increase Efficacy?, advisor Dr. Jayne Cromer ERIN BRUGGEMAN Optimal Timing of Ondansetron Administration for the Prevention of Postoperative Nausea & Vomiting in Laparoscopic Cholecystectomy, advisor Dr. Sophie Feng

RENA CHEERS Simulation: A Confidence Builder in Medication Administration, advisor Dr. Chris Seckman

ANDREW DOSTER Intravenous Dexamethasone & Pain Scores in Outpatient Upper Limb Surgeries Receiving Peripheral Nerve Blocks, advisor Dr. Jayne Cromer

ANDREA FAULKNER The Millennial Nursing Workforce: Challenges with Retention, advisor Dr. Layna Himmelberg KYLE JENNINGS Comparison of Phenylephrine Infusion & Phenylephrine Bolus for the Treatment of Spinal-Induced Hypotension in the Parturient Undergoing Cesarean Section, advisor Dr. Jayne Cromer

ELAINA KNOWLES The Use of Intraoperative Magnesium Sulfate on Postoperative Pain & Opioid Consumption During an Abdominal Hysterectomy, advisor Dr. Ann Glow

JESSICA KRUCKENBERG An Exploration of Nurses’ Knowledge of Delirium, advisor Dr. Laura Smith

ANDREW KUMMER Perioperative Antiemetic Dosing of Intravenous Dexamethasone, advisor Dr. Sophie Feng

LUKE GOEDERT Prevention of Postoperative Nausea & Vomiting: Minimum Effective Dose of Intravenous Dexamethasone, advisor Dr. Jayne Cromer

WILLIAM GREGURAS JR. Nursing Perception of Safe Communication Methods: Comparison of Nursing Safety Huddles Versus Text Messaging, advisor Ms. Valerie Palarski

KARI HIGGINS Effect of Early Breastfeeding Initiation on Breastfeeding Exclusivity, advisor Dr. Nina Wardell

ABIGAIL HOEFER Impact of Video Monitoring on Falls & Falls with Injury on Hospitalized Patients, advisor Dr. Sue Haddock KYLE LARSON Postoperative Coronary Artery Bypass Grafting (CABG) Pain Interventions & Patient Level of Pain Control, advisor Dr. Steve Hardiman

ANETA MERGEN Identification of CAM-ICU Positive Patients & Effects of Delirium Interventions: A Chart Review, advisor Dr. Kia Miles

CHYNESSA MYERS Interprofessional Simulation: A Rural Kansas Allied Health Approach, advisor Dr. Nina Wardell

DARIAN NORDHUES Comparison of Effectiveness of Either Statin Therapy or Lifestyle Modification Using Retrospective, Longitudinal Evaluation of 10-Year Risk Estimator Plus Tool, advisor Dr. Mae Timmons CHELSIE NUTSCH Improving Awareness of Stethoscope Cleaning Among Nursing Students, advisor Dr. Mary Lynn Vogel

ABBIE OSTRIHONSKY Postoperative Analgesics Requirements in Caesarean Deliveries: Efficacy of the Transverse Abdominis Plane (TAP) Block, advisor Dr. Ann Glow

SARA PARK Endotracheal Cuff Pressure & the Incidence of Postoperative Sore Throat in Patients Undergoing General Anesthesia, advisor Dr. Sophie Feng

HOLLY PEARSON Business Plan: Rapid Assessment Unit Implementation, advisor Dr. Siti Arshad-Snyder

RYAN PIRRAGLIA Impact of an ED Triage Nurse Greeter on the Initial Provider Examination, advisor Dr. Steve Hardiman

SHELBY RADEMACHER Assessment of Female Breast Cancer Patients’ Distress Level & Patient Problems While Receiving Intravenous Chemotherapy, advisor Dr. Mae Timmons

MARY RAYNOR Preoperative Ibuprofen & its Effect on Pediatric Patients Undergoing Tonsillectomy, advisor Dr. Sophie Feng

NATALIE ROBERTS Influence of Education on Emergency Room Nurses’ Attitudes & Knowledge Towards Nonpharmacologic Complementary & Alternative Modalities in Pain Management, advisor Ms. Valerie Palarski

December Capstone Project Summary continued from page 22

Evaluation of Methods to Prevent Deep Vein Thrombosis After Total Knee Arthroplasty by Brandon Smith Every year, thousands of total knee and total hip surgeries are being performed. A total knee or total hip surgery are among the highest risks for people to develop a Deep Vein Thrombosis (DVT) post-surgically (Kreutzer, Minami, & Yang, 2016). Preventing these potentially lifethreatening clots is one of the highest priorities for surgical facilities and physicians performing these procedures (Qing-ping Li et al., 2017). The purpose of this study is to understand which form(s) of DVT prophylaxis is most effective for a patient throughout the pre- and post-surgical process. The study used a retrospective study analyses of existing clinical data to gather data on the different interventions and their effectiveness at preventing DVTs during the surgical process. This study looks at the use of Graduated Compression Stockings (GCS) and aspirin, as we have limited knowledge on GCS and aspirin therapy in the prevention of DVTs (Qingping Li et al., 2017). The patient surgeries took place at a level two hospital with 107 patients meeting criteria. Results showed out of all the patients 3% developed a DVT. There was little difference between using either aspirin (9% developing a DVT) or GCS (0% developing a DVT) post surgically but did find 50% of the patients that did not use any form of DVT prophylaxis developed a DVT. Overall, the results showed the superior standard of treatment after a total knee or hip arthroplasty is a combination of both GCS and aspirin. Further evaluation in determining the cause of DVTs would be beneficial to providing the best evidenced-based knowledge in preventing DVTs post surgically.

DECEMBER 2019 Capstone Projects

VANESSA RODRIGUEZ Postoperative Analgesia for Cesarean Section: Effectiveness of Ketamine, advisor Dr. Adrienne Rochleau

DANIELLE ROSE Parental Nutrition Education: Comprehending Nutritional Guidelines to Reduce Childhood Obesity Risk, advisor Dr. Chris Seckman

TIFFANIE SMITH Primary Care Nurse Practitioner Awareness & Recommendation to Use the Autism Healthcare Accommodation Tool (AHAT) to Enhance Communication During Primary Care Visit of Patients with Autism Spectrum, advisor Dr. Sandi Woods

ROSS SUKUP Building an Oncology Rehabilitation Service Line in Acute Inpatient Rehabilitation, advisor Dr. Janet Henriksen PATTI TOMB Central Venous Catheter Education & Sterile Care Practices, advisor Dr. Laura Smith

SAMANTHA TRIBA Effects of Ondansetron on Preventing Hypotension in Parturient Prior to Spinal Anesthesia, advisor Dr. Ann Glow

KELSEY TWEET Intravenous Dexmedetomidine to Decrease Coughing, advisor Dr. Sophie Feng BECKY WOLF Business Plan: Feasibility & Value of Adding Fluoroscopic Examinations to an Academic Hospital Affiliated Outpatient Imaging Center, advisor Ms. Carla Dirkschneider

AMANDA WOLFF Sepsis Fluid Administration to Prevent Vasopressor Support, advisor Dr. Katie Kirkpatrick

COLLONTEEN THOMPSON Business Plan: Nebraska Medicine Gentle Beginnings Birthing Center, advisor Ms. Carla Dirkschneider AMANDA WASSENAARCAROLAN The Role of Smoking Cessation Education in the Knowledge of MedicalSurgical Nurses, advisor Dr. Sandi Woods

Certificate in Medical Imaging Informatics Meghan O’Grady λΣ**** Spencer Simpson

Associate of Science in Physical Therapist Assistant Makayla Stephanie Blank * Anna Tori Bornemeier Rachel Lora Field ** Sara Marine Ginkens **** Kenna Heath **** Christopher Jonathon Hernandez **** Amanda Hilmer * Martinique Hubbard Nicole Marie Langel *** Jerad Leifeld ** Aubrey Ann Lenz **** Ashley Myers *** Tori Padgett *** Mattea Roslansky ** Jacob Sasse **** Angela Strabala ****

Bachelor of Science in Health Care Business Craig Allen Divis Σ* Bianca E. Hernandez Σ Rama M. Razo

Bachelor of Science in Medical Imaging Paige Ryann Dennis λΣ Julia Gibler **** Brandon Herring λ* Austin Hodges λ* Dana Marie Killpack λ Brooke Kneifl Meghan O’Grady λΣ**** Spencer Simpson Molly Kay Walsh *** Hannah Marie Whiting λ**** Hannah Willms λ Kirsten E. Wisniewski λ*** Noah Marshall Albert Wright λ****

Bachelor of Science in Nursing Laura Ann Adoukonou Emma Louise Clapp Brittany Arizona Decker McChesney †Σ Nadia Risa DeGraw Kyllee Elaine Fix †Σ**** Amanda Kaye Glenn Σ**** Desirae Grotjohn-Small †Σ** Steven Hayden Jr. Rebecca Herbek **** Emily Hernandez BreAnna Kathlene Holmes Amanda Jo Hoskinson Σ Adrian Jimenez †Σ* Bria Oliver Madelyn Joan Pechar †Σ*** Brittany Peters Devan Ridenoure Σ Miranda Schilling *** Gabriell Schmeeckle Paige Simunaci †*** Rachelle Sladek Maria Guadalupe Sotuyo Megan Scott Spencer †Σ Courtney Stahl Yoselin Suarez * Jordan Thompson ** Skylar Ashton Walker Σ Anna M. Weiler Katie West Σ Mary Wettengel *** Joseph Wolff Jeffrey A. Zuehlke

Bachelor of Science in Physical Therapist Assistant Nathan Miles Adams **** Amy Austin **** Janice Chase **** Jacqui Christine Hendrickson Σ**** Katelyn Huenink * Madison Alexandra Malzahn ** Shane Ryan Meyers ** Kaleb Dale Richter **** Halie Trimble Σ ****

Master in Health Care Administration Sheila Augustine Kelli Jacobs Σ Holly M. Pearson Ross Andrew Sukup Collonteen Renee Thompson Becky Lynn Wolf

Master of Science in Nursing Barbara Anderson Jennifer Armstrong Cassandra Boehning Michael Bragg Jessica Branton Kate Elizabeth Brossard William Brown Erin Marie Bruggeman Rena S. Cheers Andrew Doster Andrea Marie Faulkner Luke Thomas Goedert William James Greguras Jr. Kari Nicole Higgins Abigail Hoefer Kyle Jennings Elaina Knowles Jessica Marie Kruckenberg Andrew Ray Kummer Kyle David Larson Aneta Mergen Chynessa Myers Darian Marie Nordhues Σ Chelsie Victoria Nutsch Abbie Ostrihonsky Sara Anne Park Ryan Pirraglia Shelby Rademacher Mary Raynor Natalie Roberts Vanessa Rodriguez Danielle L. Rose Tiffanie Smith Patti Tomb Samantha Frances Triba Kristal Ann Turpen Kelsey Anne Tweet Amanda Wassenaar-Carolan Amanda Wolff

Post-Master’s Certificate in Health Care Administration Michelle L. Hart Blake Erin Hough Academic Honors Academic honors are conferred on Bachelor of Science and Associate of Science degree candidates who, upon graduation, distinguish themselves by maintaining a high cumulative grade point average. To qualify for academic honors, a student must have completed the minimum required residency hours. Honors are distinguished as follows: **** Summa Cum Laude: 3.85 and above *** Magna Cum Laude: 3.75 through 3.84 ** Cum Laude: 3.65 through 3.74 * With Distinction: 3.50 through 3.64

Honor Societies Honor societies at Clarkson College include: λ Member of Delta Chapter Lambda Nu National Honor Society for the Radiologic and Imaging Sciences † Member of Omicron Epsilon Chapter Sigma Theta Tau International Honor Society of Nursing Σ Member of National Society of Leadership and Success Sigma Alpha Pi Interdisciplinary Honor Society

Note: Honors designations were based upon current information at press time. Clarkson College apologizes for any errors or omissions.