Casey Gelderman's portfolios

Pace Path

The Pace Path combines intentional co-curricular opportunities with the academic experience to en...
7 portfolios

Thesis Abstract

Staphylococcus aureus, is a typically commensal bacterium that is present on the skin, hair, and mucosal membranes of most of healthy humans. Although humans regularly associate with many different bacteria on a daily basis, some members of the genus Staphylococcus, S. aureus in particular, can invade host tissues when the cutaneous tissue is compromised. This can lead to a multitude of superficial or deep infections that can cause serious health complications. The ability of S. aureus to become resistant to antibiotics in a short amount of time is of great concern to the medical community. Antibiotic resistance of S. aureus has become a significant problem in countries around the world and few reserve antibiotic remain for humans. Penicillin was the first antibiotic to be used to treat resistant S. aureus, but within thirty years, penicillin-resistant strains were considered a pandemic. Overuse and unnecessary applications of antibiotics in general has led to the overall evolution of resistance in S. aureus. Methicillin has become one of the last antibiotics used to treat penicillin-resistant strains of S. aureus. Methicillin-resistant S. aureus, or MRSA is now considered an epidemic as hospitalizations for this infection has tripled over the last decade. Staphylococcus aureus becomes resistant to antibiotics by acquisition of the MecA gene via horizontal gene transfer. The MecA gene allows for overproduction of penicillin binding proteins, which reduces the effect of β-lactam antibiotics on cell wall synthesis.

            College students, especially college athletes, are more prone to MRSA infections due to tight living spaces and poor hygiene habits. This study was conducted to determine if the student-athletes at Pace University are exposed to these strains of bacteria through contact with communal use facilities, specifically gym equipment and surfaces used in athletic competition. Samples were taken from locations around campus where athletes work out and compete. Surface isolates were diluted in distilled water and isolates were grown on blood agar plates. Blood agar plates were chosen as a selective medium for isolation of S. aureus strains. Most strains of S. aureus are β-hemolytic bacteria, meaning they completely lyse red blood cells. Bacteria that showed the β-hemolytic characteristic by having zones of clearing were chosen for colony PCR, where the MecA gene was amplified. Samples that were positive for the MecA gene were identified if a band at 310 base pairs were visualized via gel electrophoresis. Key isolates of S. aureus that contained the MecA gene as well as ones showing beta-hemolysis were identified by sequencing the 16srRNA gene.

EBP Practice Improvement Proposal

Our group proposed implementing a medication checklist into existing electronic medical records in order to reduce medication errors. We saw a lack of evidence published specifically in rehabilitation healthcare settings. First hand, we saw a high potential for medication error, as each patient received up to 20 medications at a time, and most patients had altered level of consciousness. “Pop-up” windows would appear inside the EMR when a nurse is administering drugs that require pre-administration assessments. The goal is to prevent nurses from working around the barcode system. The next step in this project is to evaluate the specific hospital policies about the process of reporting medication errors. When an error is made, encouraging an educational environment rather than a disciplinary philosophy is crucial. It allows us to collect accurate data and adjust the secondary checklist to help nurses based on common errors that are being made, and ultimately benefits our patients.

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