Digital Commons Network^™

Second Victim Syndrome: Nurses Suffering In Silence, Matthew Riehm

Dissertations

Medication errors are inherent in health care due to human fallibility and inherent systemic complexities. Nurses are often unjustly blamed after committing a medication error despite the multitude of contributing factors. Formal education and healthcare organizations focus on preventing medication errors, but little has been done to support nurses involved in these tragic incidents. Recent cases, including RaDonda Vaught and Kimberly Hiatt, demonstrated the victimization of nurses after committing medication errors that plague the healthcare system potentially causing profound psychological trauma, often known as Second Victim Syndrome, SVS. There is limited research on the phenomenon of SVS in nursing due …

Impact Of Social Determinants Of Health On Skill Of Involvement: Differences In First Year Adn And Bsn Nursing Students In Rural Oklahoma, Cynthia Brown

Dissertations

The impact of Social Determinants of Health (SDOH) on Skill of Involvement (SOI) has not been adequately studied in nursing education. The skill of involvement is defined by Benner (2022) as necessary to expert-level nursing and it brings humanity, meaningfulness, acute situational awareness, and rapid thinking required for strong clinical decision-making in crisis management of the deteriorating patient. It is important for nurse educators to understand how SDOH impacts SOI on nursing students in order to transform the delivery of nursing education. The purpose of this study was to determine the impact of SDOH on SOIs in first-year nursing students …

The Association Between Emotional Intelligence, Empathy, And Social Determinants Of Health Among Accelerated Bachelor Of Science In Nursing Students: A Multi-State Cross-Sectional Descriptive Study, Kwanza Thomas

Dissertations

This study investigated the association between emotional intelligence (managing and understanding), empathy, and social determinants of health (SDOH) among accelerated Bachelor of Science in Nursing (ABSN) students. Despite the exponential increase in ABSN programs in the United States, little is known about the association between these variables among this nursing student population. A cross-sectional, correlational descriptive design was used to survey 104 students completing ABSN programs in Georgia, Mississippi, Philadelphia, and Texas. Participants self-reported their socioeconomic and programmatic characteristics using a researcher-developed questionnaire. Emotional intelligence (managing and understanding) was measured using two instruments, including the Situational Test of Emotional Management …

Employees' Perception Of The Management Of The Covid-19 Crisis At Najran University, Saudi Arabia, Noora Nasser Alsuhaibani

Dissertations

Problem

During the COVID-19 crisis, particularly in the context of Saudi education, the ability to physically attend schools and colleges was greatly hindered due to the widespread transmission of the virus and the resulting obstacles. The issues necessitated the use of crisis management strategies. Some Saudi universities are capable of implementing an organized plan both before to and during crisis management, whereas others lack this competence. This is a substantial problem. Several universities in Saudi Arabia effectively managed the COVID-19 epidemic, whereas others did not. Furthermore, prior studies on crisis management indicate that administrators exhibit diverse responses. By participating in …

Perceived Power By Nurse Managers In Dialysis Units: A Qualitative Case Study, Janie Griner

Dissertations

Nurses comprise the largest workforce in health care but lack power despite their numbers. Nurses have suffered short-staffing, burnout, job dissatisfaction, unsafe work settings, and cumbersome technology for decades. The dialysis nurse manager is an important component of the dialysis unit and plays a role in the retention and recruitment of nurses. Using a case study approach this qualitative, thematic analysis described dialysis nurse managers’ perception of power in dialysis units. A review of the current research revealed a gap involving dialysis nurse managers’ perception of power in the dialysis unit. The following research question was developed: • How do …

Perceptions Of Stress In Community Clinic Nurses During The Covid-19 Pandemic, Jomeka Smith

Dissertations

The COVID-19 pandemic is one of the largest healthcare crises that has affected the entire healthcare industry. Community health nurses in the front-line roles are greatly threatened by the COVID-19 pandemic that has decimated healthcare systems. The well-being of nurses is vital to perform their full potential of adequate patient care. Increased demands and pandemic related stressors can increase the risk of mental health problems. Nurses work in a variety of healthcare settings, however, the expectations, the fear of the unknown, and changes in demands have largely contributed to the unprecedented stressors that accompany nurses in clinical settings. Stress among …

Chronic Stressors, Obesity Pathogenesis, And The Moderating Effect Of Internalized Weight Stigma; A Quantitative, Illinois Study, Karyn Byrne

Dissertations

The obesity epidemic is a ‘wicked’ problem with a complex web of determinants and outcomes. While generally higher for minoritized populations, prevalence rates manifest in surprising, nonlinear patterns. There is no consensus regarding treatment protocols or mitigation efforts, except that current efforts remain largely ineffective. Much research evidence that a profusion of determinants of health support obesity pathogenesis through various physiological processes and mechanisms, including the allostatic load, mitochondria functioning, the gut microbiome, and epigenetics. Intervening to support markers of the allostatic load (immunity, inflammation, and metabolic health) may provide a more effective treatment outcomes than traditional approaches, which tend …

An Analogue Study Of Expected Working Alliance And Hope With Victims Of Military Sexual Trauma Among Civilian And Military-Oriented Therapists, Alishia D. Salyer

Dissertations

Victims of military sexual trauma (MST) face unique challenges as they pursue mental health treatment and supportive care. Understanding what factors impact potential treatment outcomes is critical in aiding in their recovery (Castro et al., 2015; Kroviak, 2020). Although a substantial amount of research has been conducted to evaluate prevalence and client factors associated with treating victims of MST (Teit et al., 2015; Turchik & Wilson, 2010), little is known about therapists’ factors including therapists’ expectations working with such clients. The purpose of this study was to examine the relationships between therapist type (military-affiliated versus civilian), therapist gender, client gender, …

Targeting Loneliness In Older Adults With Weekly Socialization, Tanja Johnson

Dissertations

Problem: Loneliness related to social isolation among the older adult population has become an increasing health concern with few interventions available for the general population. Loneliness has been directly associated with depression, poorer physical health outcomes, and overall quality of life.

Methods: The purpose of this study is to evaluate loneliness in the older adult population residing in a senior living community in an urban area in Missouri. Weekly one-on-one socialization, ranging from 45-60 minutes, will be implemented over 6 weeks, with pre and post-intervention screening for loneliness with the 28-item Visit-A-Bit (VAB) screening tool. Approval was received by both …

Lost In Interpretation: The Lived Experience Of Nurse Interpreters In The Clinical Setting, Byron Batz

Dissertations

The use of language interpreters in the health care setting constitutes a vital part of provider-patient communication but remains a relatively unexplored phenomenon. Registered nurses (RNs) are often called upon to serve as interpreters when linguistically diverse patients constitute a large segment of the patient population. That RNs serve simultaneously in an interpreter role – in addition to clinical and advocacy roles – is a complex facet of contemporary nursing practice in a diverse U.S. culture. The purpose of this qualitative descriptive study was to examine the lived experience of RNs serving as interpreters in health care institutions in Southern …

The Relationship Among Emotional Intelligence, Coping Strategies, And Occupational Burnout For Child Protective Service Workers, Yvette Longoria

Dissertations

There are low retention rates of child protective service caseworkers and this impacts the quality of care of the families served. The purpose of this study was to examine the relationship between emotional intelligence, coping strategies and occupational burnout for CPS caseworkers. In addition, examining the relationship between education type, education level, and caseload size as it relates to emotional intelligence, coping strategies, and occupational burnout among child protective caseworkers. The theoretical framework utilized was the Transactional Theory of Stress and Coping. A convenience sampling was used to collect participants employed as FBSS or CVS caseworkers at Texas Department of …

What Covid-19 Tweets Reveal About Risk Perception And Safety Preventative Measures And Behaviors Two Years Into A Pandemic, Elizabeth Vargas

Dissertations

The purpose of this study was to examine individuals Covid-19 risk perceptions two years into a long running pandemic. Data was collected analyzing risk perception and safety preventative measures to understand how individuals communicated risk in a health crisis that lasts more than two years. 116,401 tweets were collected from March 7-18, 2022, and analyzed utilizing a qualitative content analysis design. Four main classes were identified from the data which looked at how individuals perceived risk, how individuals determined risk from information that was shared, what preventative measures individuals were utilizing, and how individuals were living after the SARS-CoV-2 pandemic …

Experiences Of Counselors Who Assist Women In Midlife Who Display Depressive Symptoms: A Transcendental Phenomenological Study, Carla Pestana

Dissertations

In this dissertation, I present a transcendental phenomenological study conducted with 12 counselors who worked with women in midlife who displayed depressive symptoms. The purpose of this study was to understand the lived experiences, clinical and personal, of licensed professional counselors (LPCs) who worked with women in midlife who displayed depressive symptoms. Through the study, I sought to recognize the essence and themes that emerged from these LPCs who worked with this population. Moreover, this study was designed to obtain a better understanding of how these LPCs managed their feelings and thoughts, how they helped when working with these women, …

Internet Pornography Use, Loneliness, And Adult Attachment Patterns Among Asian Indian Young Adults: An Explanatory Sequential Mixed Methods Design, Anish Baby

Dissertations

Internet pornography consumption among Asian Indian Americans, an ethnic minority group, is largely underrepresented in current scholarly literature despite their growing population in the United States. The purpose of this research was threefold: (a) to measure the prevalence of internet pornography use among Asian Indian American young adults and adults; (b) to explore the relationship between internet pornography use, loneliness, and attachment patterns; and (c) to describe the lived experience of problematic porn consumers. Using an explanatory sequential mixed methods design, I conducted this study in two distinct phases: quantitative followed by qualitative. In the quantitative phase, I employed an …

Inviting The Outside In: Nature's Contribution To Counselor Wellness, Naomi Medina

Dissertations

The positive influence of nature on client wellness and psychological health (BonhamCorcoran et al., 2022) is well reflected in the emergence of nature-based counseling interventions such as wilderness therapy, walk talk therapy, and horticulture therapy, among other counseling modalities that involve aspects of the natural world (Lewis et al., 2022). This suggests that the inclusion of nature within the counseling session could also contribute to the wellness of the counselor. The purpose of this research was to determine the extent to which presence of nature contributes to counselor wellness and which of the five senses may play a greater role …

Predictors Of Chronic Traumatic Encephalopathy In Nfl Players: A Meta Analysis Review, Eisha Vora

Dissertations

Chronic traumatic encephalopathy (CTE) is a progressive neurodegenerative disease that emerges as a result of repetitive mild traumatic brain injury and has been studied within athletes of all sports. Repetitive blows to the brain are associated with many pathological changes and an emergence of tau pathology, all of which can lead to presentation with cognitive dysfunction, behavioral changes, and further motor decline in the later stages. After passing the inclusion criteria, a meta-analysis comprising four articles was computed using Comprehensive Meta-Analysis Version 3. Two hypotheses were examined: (a) the earlier the age of exposure to football, the greater the likelihood …

Atrial Fibrillation Management In Hispanic Adults, Tania Borja

Dissertations

Background: Research has found atrial fibrillation (AF) to be the primary or a contributing cause of death on 183,321 death certificates, and an underlying cause of death for 26,535 Americans in 2019. Findings indicate an increased AF diagnosis in White people compared to racial and ethnic minorities, contrasting widespread findings of increased prevalence of cardiovascular disease and ischemic strokes in minorities. Significant disparities—by race and socioeconomic status in disease distribution and access to testing and lifesaving treatments—have been documented, specifically associated with social determinants of health (SDOH); i.e., the conditions in which people are born, grow, live, work, and age. …

Effects Of A Self-Forgiveness Intervention On Recovery From Substance Use Disorders, Michael Saltzman

Dissertations

Previous research has highlighted the relationship between shame, guilt, and problematic substance use (Gueta, 2013; Luoma et al., 2019; McGaffin et al., 2013; Rahim & Patton, 2015). Self-forgiveness has been associated with positive outcomes for individuals in recovery with substance use disorders (SUDs), though only one prior study has explored the effects of a selfforgiveness intervention for individuals in treatment (Scherer et al., 2011). This study examines the effects of a self-forgiveness intervention on state shame and guilt, state self-forgiveness, and drug avoidance self-efficacy, and it is the first intervention study to focus on self-forgiveness for individuals with SUDs receiving …

The Impact Of Social Determinants Of Health And Acculturation On Quality Of Life In Older Chinese American Adults With Chronic Pain: A Quantitative Study, Chi Lam

Dissertations

Despite a rapid increase in the older Chinese American adult population, there are very few research studies examining the impact of social determinants of health and acculturation on the quality of life in older Chinese American adults. The purpose of the study was to determine the impact of social determinants of health and acculturation on quality of life in older Chinese American adults with chronic pain. This quantitative, descriptive correlational study utilized Madeleine Leininger’s Transcultural Theory as its theoretical framework. Two research questions guided this study: (1) Was there a difference in the quality of life in older Chinese American …

Vaccine Hesitancy, Provider Time, And Decision To Vaccinate, Kenneth Shackelford

Dissertations

Problem: To date, there is a significant gap in the literature involving studies evaluating the time healthcare providers spend educating vaccine-hesitant caregivers about the necessity for their child’s immunizations. Due to alarming resurgence rates of vaccine-preventable diseases in children, this project aimed to answer the following question: In vaccine-hesitant caregivers of newborns through six months of age, what is the effect of provider discussion time on vaccine administration (item) at well-child visits during the child’s first six months of life?

Methods: Using a descriptive observation design, pre-collected data on provider discussion time and vaccine administration was evaluated retrospectively from …

Intimate Partner Violence Screening In The Emergency Department, Rebecca Stuerman

Dissertations

Problem: Intimate partner violence [IPV] is a public health concern that affects one in three women worldwide. IPV can be addressed through identification and early intervention with minimal risk to the patient. The emergency department is an important setting for screening given the frequency with which people who experience abuse may present with IPV-related injuries and other related concerns (depression, suicidality, etc.). Successfully implementing a validated tool for screening and providing early access to resources and referrals may help to mitigate the longterm negative impacts of IPV. The need for increased staff education was a major barrier to screening for …

Evaluation Of Dirfloortime® On Mother’S Depression, Anxiety, And Stress, Hailey Vanderleest

Dissertations

This paper reports the results of a retrospective record review and qualitative questionnaires of mothers of children with neurocognitive disorders such as autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). The aim was to examine the relationship between DIRFloortime® use in children with ASD and ADHD and PHQ-8 scores for depression, GAD-7 scores for anxiety, and PSS-10 scores for perceived stress among the children’s mothers. The results showed no statistical significance between DIRFloortime® use in children and PHQ-8, GAD-7, and PSS-10 scores for mothers. Qualitative questionnaires did report improvements in quality of life. Implications for the need of evidence-based developmental …

Daily Sbar Sheet For Pediatric Patients With Central Lines, Jordan M. Enzwiler

Dissertations

Problem: The patient’s daily central line Theraworx baths were not being documented and completed at a mid-Missouri teaching hospital. After completing a retrospective chart review for 2022, 8.35% (n=90) of daily central line Theraworx baths were documented. Daily central line baths decrease central line-associated bloodstream infections (CLABSI), prolonged hospital stays, and costs.

Methods: The quality improvement (QI) project utilized a pilot retrospective and prospective pre-post-design. A retrospective chart review on daily central line Theraworx baths was conducted on patients two years and older within the pediatric service line who had a central line. A situation, background, assessment, and recommendation (SBAR) …

Effect Of Confusion Assessment Scores On Identifying Delirium In Intensive Care Patients, Kayla Jacobs

Dissertations

Delirium in intensive care unit (ICU) patients can lead to increased length of stay in the hospital, increased risk of complications, increased polypharmacy, family distress and increased rate of mortality (Vasilevskis et al., 2018). Research has shown that addressing modifiable risk factors can improve survival rate by up to 15%, and routine screening for delirium in ICU patients leads to decreased patient anxiety, reduced in-hospital mortality, early recognition, and treatment of delirium (Krewulak et al., 2021 ; Vasilevskis et al., 2018). This quality improvement project used evidence-based intervention to increase accurate documentation of the confusion assessment method in the ICU …

Implementing Trauma-Informed Care Curriculum In A Doctoral Nursing Program, Mary D. Brown

Dissertations

Purpose: Trauma is highly prevalent with 70% of individuals encountering at least one traumatic event during their lifetime and approximately 30% experiencing four or more events (Wheeler & Phillips, 2021). Despite the dramatic impact of trauma, there is minimal literature to assist nurses in caring for patients with a trauma history. The purpose of this project was to evaluate the implementation of a virtual, asynchronous trauma-informed care (TIC) educational program for Doctor of Nursing Practice (DNP) students at a midsized, Midwestern public university using knowledge, attitudes, and competency scores as outcome measures.

Methods: This program evaluation (PE) project was an …

Implementation Of A Situation, Background, Assessment, Recommendation (Sbar) Patient Handoff Tool In The Electronic Medical Record (Emr), Kristen L. Chandler

Dissertations

Abstract

Purpose and Problem: Handoffs that are poorly conducted are implicated in 80% of preventable adverse events in healthcare facilities. Within a Pediatric Rehabilitation Facility in Maryland Heights, Missouri it was observed that nurse handoffs were not conducted and lacked the use of a standardized evidence-based tool, resulting in nurse dissatisfaction with the handoff process and miscommunication. Recognized by the World Health Organization, The Joint Commission, and Agency for Healthcare Research and Quality, the Situation, Background, Assessment, Recommendation (SBAR) evidence-based tool is effective in improving handoff communication, improving nurse satisfaction, reducing adverse events, and promoting patient safety. The purpose of …

Evaluation Of Simulation On Medication Errors In The Pediatric Intensive Care Unit, Carrie Clark

Dissertations

Problem: Medical errors are the third leading cause of death in the United States, the most common medical error being medication error. Pediatric patients are at an increased risk of medication error due to medication dosage calculation and the use of frequent high hazardous drugs.

Methods: The quality improvement (QI) project implemented the use of descriptive observational design using retro and prospective data. The data was collected over a 4-week and 4-week period by gathering data via safety and environmental management survey (SEMS).

Results: The data gathered consisted of an increase in medication errors of 150%. The data collected yielded …

Improving Pediatric Asthma Outcomes Through Pictorial Asthma Action Plans, Julia Donovan

Dissertations

Problem: Asthma is the leading chronic disease of children and the leading cause of childhood emergency department (ED) visits, hospitalizations, and missed school days. Asthma action plans (AAPs), including photographs or pictures of asthma medications, symptoms, triggers, and devices, have improved parents’ understanding of their child’s asthma and have increased their comfort level in caring for their child.

Methods: An interventional pre-post study with a mixed-method research design, at a large, urban, primary care pediatric clinic with two locations, evaluated the effectiveness of a pictorial AAP on a child’s asthma control. A pictorial AAP was provided, and a childhood asthma …

Implementation Of A Structured Discharge Checklist For Children Admitted To The Hospital With Acute Asthma, Nicholas Fleming

Dissertations

Abstract

Problem: The transition process from a hospital setting to home is critical for pediatric patients and their families. However, there is no standardized process to ensure asthma discharge orders and asthma action plans are printed at the time of discharge

Methods: This observational quality improvement project utilized a pre-and-postimplementation of the Kamishibai Card (K-Card) process for pediatric discharge checklist compliance in an inpatient pediatric general medicine unit. This project used a sample of all children aged 2 years to 21 years with an asthma diagnosis admitted to the inpatient general medicine pediatric unit. This project included an …

Extubation Readiness Test In A Pediatric Cardiac Intensive Care Unit, Mary K. Holyoke

Dissertations

Extubation Readiness Test in a Pediatric Cardiac Intensive Care Unit

Abstract

Problem: The lack of standard extubation readiness tests (ERTs), that are practiced in pediatric ICUs to monitor extubation readiness, clinicians have the difficult task of weighing the risk versus benefit of extubation. ERTs can aid clinicians in deciphering patients ready to be successfully extubated and have shown to decrease length of mechanical ventilation and decrease extubation failures.

Methods: The quality improvement (QI) project utilized a descriptive observational design to assess the effects of the implementation of an ERT in a pediatric cardiac ICU. This project used a convenience sample …