Digital Commons Network^™

Fall Prevention Through Proactive Toileting, Kristin Smith

Master's Projects and Capstones

This paper will summarize the quality improvement falls prevention project conducted by a University of San Francisco Clinical Nurse Leader student. Falls in the hospital setting are an ongoing problem in our healthcare system as they have great physical and financial impacts (Salamon, Victory, & Bobay, 2012). Hospital A, an urban teaching hospital, uses the Schmid scale for determining if a patient is a fall risk which includes the assessment of need for ambulatory aids, history of falls, and impaired cognition among other criteria (Schmid,1990). Fall rates are climbing in the United States and the trend is similar on Hospital …

The Design And Implementation Of A Grief Support Program In A Faith-Based Setting, Susan Mortell

Doctor of Nursing Practice (DNP) Projects

Although grief itself is not a pathological condition, adequate support before and after loss can prevent grief becoming unresolved or complicated. Complicated grief (CG) is often diagnosed when severe bereavement symptoms persist over six months following a loss, and it affects an estimated 3-25% of the general population (Fujisawa, Kato, Miyashita, Nakajima, Ito, & Kim, 2010). Complicated grief can result in longstanding psychological issues such as depression and substance abuse.

One group that is at particular risk for CG is older lesbian, gay, bisexual and transgender (LGBT) individuals. This population is significantly represented in Most Holy Redeemer Catholic Church (MHR) …

The Creation And Implementation Of A Transgender Cultural Competence Nursing Education Toolkit, James Bl Donovan

Doctor of Nursing Practice (DNP) Projects

Healthcare disparities in the transgender populations have been linked to lack of healthcare provider cultural competence (IOM, 2011; Bradford et al., Harbin et al., 2012; Eliason, Dibble, & DeJoseph, 2010; Lim, Brown, & Jones, 2013). Prior research has identified that healthcare providers receive little, if any, transgender cultural competence training during their formal education. A survey of nursing educators at the University of San Francisco School (USF) of Nursing and Health Professions suggested that few educators are providing transgender content or understand the unique healthcare needs of that population. A literature review concluded that little is known about the best …

Implementation Of Food Insecurity Screening In Clinical Setting, Florence Ngozi Soba

Doctor of Nursing Practice (DNP) Projects

This project used the Stetler model of research utilization framework to apply evidence-based findings to clinical settings screening adults with type II diabetes mellitus (T2DM) and low incomes for food insecurity. The project involved the review and critical appraisal of research studies and translation of research-based knowledge into a protocol for the Peach Tree Clinic with respect to the impact of food insecurity on diabetes outcomes in adults with T2DM and low incomes who were at risk of food insecurity. In addition, the proportion of screened at-risk patients who received nutritional counseling was calculated. The proportion of patients with T2DM …

Overcoming Barriers To Screening For Anal Intraepithelial Neoplasia For Persons Living With Hiv, Brandon Hastings

Doctor of Nursing Practice (DNP) Projects

Screening has proven an effective strategy in the management of diseases that plague the population. This technique has proven to be most effective when screening is conducted with those who are most at risk for developing the targeted illness and when the frequency of screening follows set guidelines. Currently there are no nationally recognized screening guidelines for anal intraepithelial neoplasia (AIN). Screening for AIN stands to reduce overall incidence of anal squamous cell carcinoma through destruction of the dysplastic cells before they become cancerous. The goals of this project were to identify the patient population that stands to benefit the …

Addressing Health Disparities In Refugees, Claire E. Lopez

Master's Projects and Capstones

I completed the required 300 hours of my fieldwork internship at the International Rescue Committee (IRC) in Oakland, CA. The International Rescue Committee (IRC) is a non-profit international organization that responds to the world’s worst humanitarian crises and aids displaced individuals in rebuilding their lives in new countries by providing support in health care, finance, education, infrastructure, and resettlement.

I worked as a Health Access/Intensive Case management Intern. As a Health Access Program Intern, it was my job to ensure that refugees coming to the United States had a place to seek medical care, advice, and preventative services. In order …

Improving The Hcahps Score For Pain Well Controlled, Uwaezu J. Umeh

Master's Projects and Capstones

This project took place on a Renal/Endocrine unit of a northern California Hospital. As observed on this unit, pain was not well controlled and this caused the HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) score for ‘pain well controlled’ to be low. Hence, this project sought to address the underlying reasons why pain was not well controlled and to proffer solutions to raise the HCAHPS score to at least 65% from an average of 55%. In order to find the root causes, the nurses were surveyed, the patients and certified nursing assistants (CNAs) were interviewed, and a 24-hour …

Prevention Of Vaccine-Preventable Diseases Through Information And Education At The California Department Of Public Health, Vaisali M. Patel

Master's Projects and Capstones

Immunizations are one of the most important developments in the twentieth century towards the prevention of infectious diseases. Vaccinations against communicable diseases have helped reduce morbidity and mortality all over the world. Despite having numerous vaccines that protect individuals from serious and deadly diseases, vaccination rates in the United States remain at an all-time low. The Information and Education section of the Immunization Branch within the Division of Communicable Disease Control at the California Department of Public Health (CDPH) focuses on working with local health departments, primary care providers, immunization coalitions, and other statewide organizations to increase the rates of …

Combating Hiv/Aids In Marginalized Communities: Papua And West Papua Provinces, Indonesia, Bani Cheema

Master's Theses

My study focuses on foreign aid and local initiatives for HIV/AIDS prevention in eastern Indonesia using the provinces of Papua and West Papua as a case study. The two provinces are home to indigenous tribal groups that are socioeconomically marginalized and most affected by the epidemic. My research investigates behavior change communication as a principal strategy undertaken by multiple organizations for HIV/AIDS prevention in this region. I take a qualitative approach by examining the effectiveness of this strategy in local communities and by revealing social and cultural barriers that impede success. Obstacles that negatively impact prevention efforts include structural violence, …

Berkeley Youth Alternatives Fieldwork Summary Report: Assessing Social Determinants To Improve The Physical Health And Academic Development For Youth In Berkeley, California, Alane M. Cruz

Master's Projects and Capstones

The following paper summarizes the three hundred hour fieldwork experience at Berkeley Youth Alternatives (BYA), a non-profit community-based organization located in Southwest Berkeley that is committed to combating the social determinants that contribute to the prevalent health disparities within their community. The fieldwork internship is a major requirement in completing the Master’s of Public Health (MPH) program at the University of San Francisco (USF), and allows the education and experience gained over the duration of the program to be applied in a real public health setting.

The overall goal of the internship experience was to assess the social determinants of …

Evidence-Based Change In Practice: Development And Implementation Of Type Ii Diabetic Flow Sheet, Kathryn Grimleybaker

Doctor of Nursing Practice (DNP) Projects

Ten percent of the National Health Service annual budget goes to treat complications from diabetes (Lancet, 2010). The American Diabetes Association® (ADA, 2013) estimated that diabetics in the United States incur $176 billion annually in direct medical costs for treatment with hospitalization being the main component of the expenditures. California has the largest population of diabetics and the highest annual cost at $27.6 billion (ADA, 2013). The Healthcare Cost and Utilization Project (HCUP, 2008) found that the average cost of hospitalization in 2008 for a patient with diabetes was $10,937 in contrast to $8,746 for a patient without diabetes. The …

Establishing A Translational Research Center In California's San Joaquin Valley: Principles, Partnerships, And Initial Steps, Rachel R. Cox

Master's Projects and Capstones

The Great Valley Center seeks to promote the social, economic, and environmental well-being of California's Central Valley. UC Merced's Health Sciences Research Institute (HSRI) was established in 2012 to engage in collaborative, multidisciplinary research with a community emphasis in order to rapidly develop, test, and disseminate new ways to improve health. To address the numerous health disparities present in the San Joaquin Valley, HSRI began working toward the development of a regional Translational Research Center, to allow San Joaquin Valley residents access to the latest and most effective interventions and translate findings into community actions. The attached paper is a …

Discovering Community Assets: Master Of Public Health Culminating Experience, Megan E. Sirna

Master's Projects and Capstones

The Sonoma County Department of Health Services, through Cradle to Career, promotes collective impact around educational attainment and workforce development, and has become a leader in developing a framework for community schools. The first step in developing a community schools model is to understand and inventory what is already going on in the community. This process, known more formally as asset mapping, is a participatory process focused on documenting the strengths and resources of a community. The collaborative nature of the process helps to promote community involvement and build community cohesion. In order to assist schools wanting to begin an …

Trauma Informed Practices For Oakland Unite Service Providers, Maereg D. Haile

Master's Projects and Capstones

Oakland, California - a home to almost 400,000 residents - is the top five most violent cities of the nation. There are lots of factors that greatly contribute to violence including: Poverty, housing/homelessness, unemployment, food insecurity, educational attainment, substance abuse. These factors feed to greater healthy disparities and increased trauma in low-income communities – specifically in east and west Oakland. Measure Y, now called Oakland Unite, is the current violence prevention effort that is set for reauthorization in November 2014. In order for these efforts to continue, Oakland Unite has started looking at comprehensive violence prevention initiatives that includes mental …

Closing The Gap: Achieving Equitable Healthcare Outcomes For Kaiser Permanente Members, Trang T. Phan

Master's Projects and Capstones

The University of San Francisco provides a comprehensive Master of Public Health curriculum to deliver a wide breadth of public health knowledge. The MPH program not only equipped me with the skills and knowledge necessary to be successful, it also allowed me to find my passion. The well-established coursework and knowledgeable professors have instilled within me a passion to achieve health equity for everyone, regardless of their social, economic, or environmental disadvantages. I incorporated this mission into my practicum experience and completed over 400 hours at Kaiser Permanente to focus on eliminating health disparities for the patients, families, and communities …

At Risk For Ptsd: The Public Health Implications Of Trauma, Madeline Peyton

Master's Projects and Capstones

The fieldwork experience is the summation of six semesters of graduate level public health training. At commencement, students are to be proficient in basic data analysis and epidemiological principles, in how environmental risks impact health, and demonstrate strong program planning, evaluation and leadership skills. Throughout, students are encouraged to focus their academic work on an area of public health that interest them and on a problem that they hope to impact in their professional work. I continued in an area I began as an undergraduate student of medical anthropology and explored the systems that interact to influence mental health of …

Hospital Staff Registered Nurses’ Perception Of Horizontal Violence, Peer Relationships, And The Quality And Safety Of Patient Care, Christina Purpora, M. A. Blegen, N. A. Stotts

Nursing and Health Professions Faculty Research and Publications

Objective: To test hypotheses from a horizontal violence and quality and safety of patient care model: horizontal violence (negative behavior among peers) is inversely related to peer relations, quality of care and it is positively related to errors and adverse events. Additionally, the association between horizontal violence, peer relations, quality of care, errors and adverse events, and nurse and work characteristics were determined.

Participants: A random sample (n=175) of hospital staff Registered Nurses working in California.

Methods: Nurses participated via survey. Bivariate and multivariate analyses tested the study hypotheses.

Results: Hypotheses were supported. Horizontal violence was inversely related to peer …

Advantages And Limitations Of Anesthesia And Sedation Practices Used Among Acute Ischemic Stroke Patients During Endovascular Revascularization Therapy, Margaret Korzewski

Doctor of Nursing Practice (DNP) Projects

In order to safely and efficiently perform endovascular revascularization procedures among acute ischemic stroke (AIS) patients, general anesthesia or sedation is often required. However, anesthesia management during these procedures varies significantly worldwide and the procedural logistics have not been established yet. At some institutions AIS patients are intubated and paralyzed, while at other facilities, there is no routine protocol. In 2011 the University Hospital used “action nurses” (critical care float pool nurses) to provide pharmacological paralysis with sedation for intubated AIS patients under direct supervision of the neurointerventionalist. However, clinical outcomes among AIS patients undergoing endovascular procedures were poor. Exclusive …

Motivational Interviewing Education For San Mateo County’S Adolescent Healthcare Providers: Focus On Healthy Diet And Physical Activity, Emilie J. Gruhl

Doctor of Nursing Practice (DNP) Projects

Motivational interviewing has been endorsed by San Mateo County as an evidence-based effective form of behavior change counseling. Eighty percent of pediatric healthcare providers in San Mateo County have been trained in motivational interviewing, however 70% of the providers use it less than 50% of the time. The goal of this project was to reeducate the adolescent providers of San Mateo County in motivational interviewing with an emphasis on individualized training and feedback, directed toward healthy diet and exercise. Results of the quality improvement project showed an average 2.5-point increase in provider confidence on a zero to ten-point scale, and …

Randomized Controlled Trial Of A Positive Affect Intervention To Reduce Stress In People Newly Diagnosed With Hiv; Protocol And Design For The Iriss Study, J T. Moskowitz, A W. Carrico, M A. Cohn, L G. Duncan, Cori Bussolari, K Layous, J R. Hult, A Brousset, P Cotten, S Maurer, M E. Pietrucha, M Acree, J Wrubel, M O. Johnson, F M. Hecht, S Folkman

School of Education Faculty Research

Increasing evidence suggests that positive affect plays an important role in adaptation to chronic illness, independent of levels of negative affects like depression. Positive affect may be especially beneficial for people in the midst of severe stress, such as the diagnosis of human immunodeficiency virus (HIV). As medical treatments for HIV have improved, the number of people living with HIV has increased, and prevention strategies tailored specifically to people living with HIV have become a priority. There is a need for effective, creative, client-centered interventions that can be easily disseminated to community treatment settings, but there are currently few established …

The Impact Of Prison Arts Programs On Inmate Attitudes And Behavior: A Quantitative Evaluation, Larry Brewster

Public and Nonprofit Administration

California has been a leader in prison fine arts programs. Arts-in-Corrections, the granddaddy of them all, enjoyed a highly successful 30 year run until its closure in 2010 as a result of the state's budget crisis. This study evaluates three demonstration projects modeled after AIC, and prison theater programs offered through The Actors' Gang's Prison Project and Marin Shakespeare. Inmates from San Quentin, Soledad, New Folsom and CRC, Norco state prisons participated in the study. Pre-and Post surveys designed to measure changes in attitudes and behavior were administered at the start and finish of each 12-week arts program. The surveys …

A Review Of Recent Perspectives On Biomechanical Risk Factors Associated With Anterior Cruciate Ligament Injury, Gerwyn Hughes

Kinesiology (Formerly Exercise and Sport Science)

There is considerable evidence to support a number of biomechanical risk factors associatiated with non-contact anterior cruciate ligament (ACL) injury. This paper aimed to review these biomechanical risk factors and highlight future directions relating to them. Current perspectives investigating trunk position and relationships between strength, muscle activity and biomechanics during landing/cutting highlight the importance of increasing hamstring muscle force during dynamic movements through altering strength, muscle activity, muscle length and contraction velocity. In particular, increased trunk flexion during landing/cutting and greater hamstring strength are likely to increase hamstring muscle force during landing and cutting which have been associated with reduced …

Clinical Leadership And Asymmetric Information: The Impact Of Physician Advice On Smoking Cessation, Courtney Keeler

Nursing and Health Professions Faculty Research and Publications

A knowledge gradient exists between experts in a given field and consumers of that knowledge. When the need arises, not knowing the best path, an average individual typically relies on the advice of an expert. Given the steep knowledge gradient between patient and provider, clinicians play an essential role in the clinical setting, acting as both a health leader and a health facilitator; however, this asymmetric information implies that clinical providers face an acute pressure not only to advise but to advise correctly. This paper explores the importance of physician advice within the context of smoking cessation, addressing two specific …

Trauma And Violence Exposure Among Asian American And Pacific Islander Children, Dhara Thakar Meghani, Pratyusha Tummala-Narra, Asian American Psychological Association

Nursing and Health Professions Faculty Research and Publications

No abstract provided.

Nonviolent Communication Training Increases Empathy In Baccalaureate Nursing Students: A Mixed Method Study, Marcianna Nosek, Elizabeth Joy Gifford, Brendan Kober

Nursing and Health Professions Faculty Research and Publications

Background: Ineffective communication among healthcare team members is associated with decreased collaborative efforts and adverse patient outcomes. The impact of empathy on collaboration with colleagues and patient interaction has been previously demonstrated. Studies have yet to measure the impact of (Nonviolent Communication [NVC]) on empathy in nursing students.

Purpose: The purpose of this mixed methods study was to test a communication intervention (NVC) with baccalaureate student nurses to examine its effect on empathy.

Methods: A mixed methods single group pre/post test design incorporating the Interpersonal Reactivity Index (IRI) to measure empathy was used. A paired samples t test was calculated …

Creating A Strategic Partnership For Educating Nurse Practitioner Students About Sexual Health, Stefan Rowniak

Nursing and Health Professions Faculty Research and Publications

Sexual health is an essential and often neglected component of primary care. Nurse practitioners are ideal members of the healthcare team to be providing sexual health information, diagnoses, and treatments. Unfortunately, this is an area that has been lacking in the education of all healthcare providers. This paper describes a program that incorporates sexual health into the curriculum for nurse practitioner students through collaboration between the university school of nursing and the local health department. Given the increasing shortage of clinical sites and the need to train nurse practitioners to be competent in the delivery of sexual health, this is …

Dimensions Of Religiousness And Cancer Screening Behaviors Among Church-Going Latinas, Jennifer D. Allen, John E. Perez, Claudia R. Pischke, Laura S. Tom, Alan Juarez, Hosffman Ospino, Elizabeth Gonzalez-Suarez

Psychology

Churches are a promising setting through which to reach Latinas with cancer control efforts. A better understanding of the dimensions of religiousness that impact health behaviors could inform efforts to tailor cancer control programs for this setting. The purpose of this study was to explore relationships between dimensions of religiousness with adherence to cancer screening recommendations among church-going Latinas. Female Spanish-speaking members, aged 18 and older from a Baptist church in Boston, Massachusetts (N = 78), were interviewed about cancer screening behaviors and dimensions of religiousness. We examined adherence to individual cancer screening tests (mammography, Pap test, and colonoscopy), …

Growing Up With Hiv In Kisumu, Kenya: Participatory Action Research With Young People Living With Hiv, Zoe Alexis Hobbs Marinkovich

Doctoral Dissertations

Forty-one percent of new HIV infections are in young people between the ages of 15-24 (Masquillier, et al., 2012). In addition to new infections, advances in medications are now making it possible for children born with HIV to survive into adolescence and adulthood (Bland, 2011; Gray, 2010). Due to the growing population of youth living with HIV, there is an increased need for adolescent-appropriate care and intervention. While many studies have examined the role of education in preventing HIV transmission for HIV-negative youth in the Sub-Saharan context, few have focused on the education and experiences of young people living with …

First-Year Male Students' Adherence To Traditional Male Gender Roles And Their Attitudes Toward Bystander Approach Behaviors To Stop Sexual Assault, Kamal M. Harb

Doctoral Dissertations

Sexual assault on university campuses may affect any person at any time. However, university-aged women are disproportionally affected by it, with 25% of women reporting being assaulted on campus, and 84% to 97.8% of them perpetrated by young, heterosexual men known to the victim. To curb sexual assault on the university campus, research studies have advocated for the bystander approach. It encourages bystanders (observers) to intervene and ultimately stop a potentially dangerous situation in which a friend or stranger may experience a sexual assault. Despite its popularity, research studies evaluating the bystander approach have reported, at best, modest success with …

Exploring The Experiences Of Latina/Os In Graduate Health Science Programs: A Qualitative Study, Mijiza Malane Sanchez

Doctoral Dissertations

This qualitative study conducted at a Northern California university explored how six Latino/a health science professionals navigated their academic trajectory. The six participants identify as Latino/a and shared their journeys to the health sciences. This study examined how participants utilized their community cultural wealth to navigate the complexities of campus climate during their pursuit of a graduate or professional degree in the health sciences. Research data included narratives from in-depth interviews with the six participants and a focus group.

The key findings of this study illustrate the profound significance of mentorship in the pursuit of health science careers. This study …