Digital Commons Network^™

Translating Transformative Human Rights Education Through Visual Languages & Informal Spaces, Jazzmin Chizu Gota

Master's Projects and Capstones

This project examines methods, theories, and practices of translating human rights education through multiple vernaculars. Developed as a workshop in sociocultural syntax deconstruction and an educational human rights education website focused on the domestic population of the US, the project focuses on localizing human rights concepts to the public vernacular of the country. Human rights education (HRE) and media and information literacy (MIL) are expanded and redefined as social literacy, or the ability to navigate and decode the present, complex realities that both HRE and MIL were developed to address. Reframing media and visual arts as an archive of past …

Authoritarian Member States In International Organizations, Matt Barg

Master's Theses

This thesis investigates under which conditions do authoritarian Member States exist in International Organizations that require democratic governance in their treaty law. The European Union is used as a case study along with two of its Member States that are in the process of transitioning to democracy from previous authoritarian regimes—Hungary and Romania. This thesis employs stealth authoritarian theory to analyze how a democratizing Member State may violate these laws and revert to authoritarian governance. It also critiques international enforcement mechanisms to consider their effectiveness to enforce their laws and norms as well as prevent an authoritarian reversal. Finally, cultural …

Improving Patient Safety Through Accurate Medication Reconciliation, Dominique Watt

Master's Projects and Capstones

Medication errors due to incorrect medication reconciliation are a very present and serious problem in our microsystem. As an preop/postop outpatient unit, we see an average of 50 patients daily and perform medication reconciliations regularly. The problem is our nurses perform this task inconsistently and often incomplete, leading us to potential medication errors. During my CNL project, I worked with a committee of staff champions and developed a standard work guide for nurses to use in order to effective reconcile patient medications. We used fishbone diagrams, audit tools, surveys and led regular discussions in our huddles in order to develop …

Designing A Care Delivery System Through Interprofessional Coordinated Care In A Medical Neighborhood Setting, Diane P. Kelly

Doctor of Nursing Practice (DNP) Projects

Abstract

The Patient Protection and Affordable Care Act (2010) has two significant aims: to improve the quality of healthcare and in doing so, to lower the cost of healthcare. The Centers for Disease Control and Prevention (CDC) reports that chronic health conditions, such as diabetes, hypertension, cardiovascular disease, and mental health, which in 2005 affected nearly one of every two Americans, continues to increase (CDC, 2010). Chronic health conditions and lack of access to care are both national and local concerns. These challenges will require the exploration of new models for the delivery of care, as needs shift over time …

Using A Strategic Model For Professional Development: The Importance Of Evidence-Based Competencies As A Foundation For Professional Practice., Peggi B. Winter

Doctor of Nursing Practice (DNP) Projects

Abstract

A nursing professional practice model (PPM) is designed to provide a framework for how nursing practices, communicates, leads, collaborates, and provides the highest quality of care as we navigate the complex healthcare system. An infrastructure for learning, competency, and performance needs to be integrated into this model as a foundation for accelerating business and clinical initiatives, promoting standardization, and sharing successful practices. It is now, more than ever, a necessity to have a well-trained, highly competent nursing workforce. Simply having the knowledge and the skill to do a job is insufficient; rather, it is implied that a competency has …

A Population Health Approach For Community Health Improvement, Sandra Gregg

Doctor of Nursing Practice (DNP) Projects

Providence Health & Services (Providence), a not-for-profit Catholic health care system serving five western states, established an organizational vision of Creating healthier communities, together (Providence Health & Services, 2014). This vision served as the catalyst for the alignment of divisional initiatives to positively impact community health status. To effectively achieve its vision, the organization committed to the incorporation of population health principles in the development of an infrastructure to expand the reach and impact of community investments, along with the establishment of effective processes for inter-divisional collaboration and compliance with community benefit mandates. Thus, in 2015, Providence established a community …

Impetus To Transform: Essential Nursing Leadership Development Through Simulation, Mary J. Mette

Doctor of Nursing Practice (DNP) Projects

Abstract

A nurse manager’s ability to effect positive change and inspire others to higher levels of achievement is related to his or her leadership style in the practice setting, as well as the culture present in the organization as a whole. The aim of this Doctor of Nursing evidence-based change in practice project was to create an educational modality that supported training nurse leaders through innovation and creative problem solving in today’s acute healthcare setting.

A survey was administered to 48 frontline managers in a Northern California healthcare system to access the gaps and voids in their ability to integrate …

The Role Of A Psychiatric Mental Health Nurse Practitioner As Part Of A Mobile Health Unit For The Homeless Population, Joan Alviar Fraino

Doctor of Nursing Practice (DNP) Projects

An estimated 2.3 to 3.5 million people are homeless in the U.S., often living with chronic medical and mental illnesses. The underserved population, such as the homeless, continues to experience gaps in services, resulting in poor healthcare outcomes and readmission to the hospital setting. They often present in crisis through the emergency room, contributing to an already overburdened healthcare system. Increased spending and overutilization of healthcare services continues to rise in the United States (U.S.). Due in part to advancements in technology and expanded health insurance coverage, American healthcare continues be one of the most expensive commodities in the U.S. …

Development And Implementation Of A Violence Risk Assessment Tool, Mira Aidasani-Diwata

Doctor of Nursing Practice (DNP) Projects

The purpose of this quality improvement project was to provide a means to effectively assess patients as they are admitted to the hospitals and to effectively communicate a patient’s violent tendencies within the healthcare setting. Workplace violence is a serious problem that affects all healthcare professionals. Although serious assaults and homicides attract more media attention, the majority of workplace violence consists of non-fatal assaults. Nurses, aides, and patient care technicians suffer the most non-fatal assaults resulting in injury. Due to the growing incidence of assault and injury among healthcare workers, some states are calling for additional study on workplace violence. …

The Creation And Implementation Of Guidelines For The Appropriate Termination Of Patient-Provider Relationships, Rowena D. Nolasco

Doctor of Nursing Practice (DNP) Projects

Primary care providers have terminated patient-provider relationships when they deem them no longer therapeutic. Healthcare providers are increasingly considering this an acceptable practice. However, the criteria for this decision remain unclear. As providers discharge challenging or difficult patients from their practices, questions to support this decision arise. Discharged patients face displacement and healthcare is disrupted. This project will (a) describe problematic patient-provider relationships and its effects, (b) identify possible alternatives to the firing of patients, (c) list appropriate reasons for termination, and (d) present recommended procedures to avoid allegations of medical abandonment. The project's product is an Appropriate Discharge or …

Fnp Led Mobile Health Services For The Homeless Population, Tenzin D. Lama

Doctor of Nursing Practice (DNP) Projects

A small percentage of the U.S. population uses the greatest portion of the healthcare services. Homeless people are often such a group of “super-utilizers” of the healthcare system. Due to multiple medical and psychosocial conditions, people experiencing homelessness face numerous barriers to accessing healthcare, thus leading increased utilization of hospitals and emergency departments (EDs) services. Many of these events are preventable through improved primary care interventions. The literature on Respite/Recuperative Care, Transitional Care, and Mobile Health interventions have shown effectiveness in providing safe and quality care to homeless individuals during the critical transitional period post hospital discharge while also reducing …

Patient-Reported Outcomes Screening For Improved Patient Wellness: A Cancer Center Initiative, Alison Morris

Doctor of Nursing Practice (DNP) Projects

Background: People experiencing serious illness have significant unmet physical, emotional, social and spiritual needs. The Quality Oncology Practice Initiative (QOPI) requires patients to be screened for emotional wellbeing and pain by their second oncology visit. This project details one cancer center’s quality improvement initiative to (a) implement electronic screening of every cancer patient by their second oncology visit, (b) design processes for ongoing assessment and intervention of need(s), and (c) develop measurable and sustainable evaluation metrics to ensure that palliative care needs are met. Methods: In June 2015, we launched electronic collection of patient-reported outcomes (PROs) using the Patient Reported …

Depression Screening And Early Intervention On The Post-Stroke Patient, Marco Oliver Dugan Lopez

Doctor of Nursing Practice (DNP) Projects

Statistics in the United States (US) have shown an increase in the prevalence of Cardiovascular Disease (CVD) or risk for developing CVD. Approximately 78 million American adults, 20 years and older, have hypertension, 31.9 million have elevated serum cholesterol levels, and 68.2 million use tobacco products. Within California, San Francisco (SF) was ranked 8th among counties with adult residents that have CVD. It is estimated that approximately 1.02% of these individuals will have a stroke each year and 16.25% will die from stroke. Of those that survive, it is estimated that at least half will develop neurologic deficits, and at …

Improving The Patient Experience By Implementing Patient-Centered Care In A Community Hospital, Richard A. Billingsley Dnp, Mha, Rn

Doctor of Nursing Practice (DNP) Projects

Health care is a complex business currently undergoing extensive reform. These changes require new methods of care deliver and ways in which health care organizations are operating. At the forefront of this change effort is the 2010 Patient Protection and Affordable Care Act, which is transforming health care from a volume-based, fee-for-service process to the delivery of services that have value, improve quality outcomes, increase satisfaction, elicit greater efficiency, demonstrate improved safety outcomes, show cost-effectiveness, promote better access to services, and result in high reliability between providers and organizations. The goal of providing a more positive health care experience is …

Improving Patient Satisfaction, Wait Times, And Access To Care In A College Health Setting; Expanding The Rn Role As Prescribing Agent With Standardized Procedures, Kimberly D. Perris

Master's Projects and Capstones

The CNL theme for this project is Nursing Leadership, Advocate for the Profession and is inspired by the Institute of Medicine’s call for all nurses to work to the maximum scope of their practice. The specific aim was to demonstrate RN confidence working independently, and proficiency using one RN protocol to provide hormonal contraception with an overall aim of improving patient satisfaction and access to care. This project took place in a rural university student health center where family planning and contraception services are the number one service provided.

The RN visit project has been multidisciplinary and collaborative in creating …

Staff Education: Nutrition Education In The Intellectually /Developmentally Disabled Community, Claire C. Bradley-Davalos Msn Rn

Master's Projects and Capstones

The objective of my project is to develop staff education regarding a nutrition initiative developed to address the 44% obesity rate among clients in our care. My target population is direct care staff working in the Intellectually/Developmentally Disabled (IDD) community, and high functioning clients who live independently in the community. The staff knowledge was tested pre- and post-education to demonstrate knowledge retained. Staff are required to get a score of 80 or better to pass. Test results are interpreted to see which content areas need further teaching or clarification. Initial results indicate that four areas of education need to be …

Reducing Clostridium Difficile, Norabel V. Zafra

Master's Projects and Capstones

This CNL project aims to reduce the number of laboratory identified Clostridium Difficile Infections (CDI) events by 20% by December 2015. This CNL projects focuses on reducing CDI in an 8 unit bed specifically designated for medically ill geriatric patients above 70 years old residing in the West Texas region. A majority of the geriatric patients living with multiple co-morbidities require maximum assistance with activities of daily living and medication management. The geriatric patients will be discharge to a skilled nurse facility, long-term acute care, rehabilitation, independent living, or home with home health. A variety of methods such as reinforcing …

Building Awareness Of The Mental Health Issues Of Asian American College Women, Julie S. Baek

Master's Projects and Capstones

The purpose of this project is to build awareness of the mental health issues of Asian American college women. The National Alliance on Mental Illness (2009) reports among all women between the ages of 15 to 24, Asian Americans have the second highest suicide rates across all racial or ethnic groups whereas only 27 percent of them seek a professional help. Very little is known about what makes this population of students take their own lives at higher rates than their ethnic counterparts because of a model minority myth and lack of studies and attention. The project aims to develop …

Reduced A1c Levels Through Diabetes Self-Management Strategies In The Teen Population: A Systematic Review, Nicole O'Neil

Master's Projects and Capstones

This project utilized current evidence-based practices to improve the diabetes education in the endocrine clinic for the adolescent population ages 15-18. Based on a clinic audit, an average hA1C level of 8.1% was revealed. The goal was to decrease these levels from 8.1% to 7.9% within 90 days through the implementation of the revised diabetes brochure. Evidence suggests the following: DSME improves clinical outcomes and quality of life; an A1C level >7% is associated with increased risks of complications ; teaching aimed at lowering glycemic levels have decreased numerous complications; there is a need to ensure age appropriate, family-centered care, …

Building A Framework For Professional Nursing Practice Across The Continuum Of Care, Elizabeth S. Bigby

Doctor of Nursing Practice (DNP) Projects

Nursing professional practice models are designed to unite and align nurses under one vision, set of values, and a professional practice model. The goal of this project was to implement and enculturate a professional practice model of nursing with assistant nurse managers and leaders across the continuum of care at an urban medical center and associated ambulatory medical offices. Staff engagement has been shown to improve satisfaction and decrease turnover and implementation and enculturation of a professional practice model improves engagement. The target population was nurse managers and leaders as they needed to embrace professional practice before the project was …

Adapting To Rising Sea Levels In San Francisco Bay: The Potential For Thin Layer Sediment Application To Enhance Tidal Marsh Resiliency Through This Century, Scott K. Hine

Master's Projects and Capstones

The research here focuses on two projected century sea-level rise scenarios (100 and 180 cm/century) and the potential to offset elevation loss to sea-level rise by supplying deteriorating tidal marsh habitat with a thin layer of dredge sediment via high-pressure spray disposal within San Francisco Bay. This adaptation strategy is then analyzed for potential integration into the Bay’s long term management plan for dredge material disposal. The Marsh Equilibrium Model (Morris, 2012) is used to evaluate elevation deficits for existing tidal marsh habitat around San Pablo Bay against future century sea-level rise scenarios and model marsh resiliency following elevation enhancement. …

Prioritizing The Management Of Arundo Donax: Recommendations For Removal And Revegetation In California Riparian Habitats, Matthew S. Waterworth

Master's Projects and Capstones

The highly invasive grass species, giant reed (Arundo donax), has been a major contributor to riparian habitat degradation in California for over 50 years. Several modes of vegetative reproduction have allowed this alien species to take advantage of fluvial processes and rapidly spread within California watersheds. A. donax dramatically alters hydrologic regimes, displaces native vegetation, and removes food and habitat for native wildlife. It is widely accepted that removal of this invasive on a watershed scale is critical to restore natural riparian processes and facilitate the reestablishment of native flora and fauna. The following study analyzed the efficacy of …

Supplementing Esl Classroom Activities With Social Media For Young Adult Learners, Clair M. Yeo

Master's Projects and Capstones

The classroom material currently utilized in English as a second language (ESL) classrooms is often disconnected from the real world. Publishers of ESL instructional materials often attempt to bridge this gap by including topics on popular news, films, songs, and famous persons at the time of printing. However, these are often outdated as quickly as they can be printed. As such, many ESL teachers face the challenge of keeping ESL classroom material relevant to the real world while seeking to maintain students’ interests in what they are learning.

The purpose of the project is to make use of social networking …

Prospectus Elements: Increasing Pediatric Immunization Rates, Catherine Le

Master's Projects and Capstones

There has been a recent outbreak of Measles and the majority who contracted the disease were unvaccinated (CDC, 2015). An increase in pertussis cases from 2013 to 2014 have occurred as well from 28,639 cases to 32,971 in 2014 (CDC, 2015). This is endangering the community, and putting infants and the younger generation at risk. Increasing immunization rates for patients to be fully immunized has become crucial. Being fully immunized not only reduces their chances of getting these diseases, but also helps the rest of the population who are too young to get these vaccines (Daly, Matthew F. & Glanz, …

Reinforcing Teach-Back Method Regarding Pain Management For Non-Verbal Patients And Their Families, Renee Krystle Doll Lazaro

Master's Projects and Capstones

Pain has been known to have physiologic, psychologic and emotional consequences. Education in pain management has been part for standard care for nurses. The purpose of this study was to reinforce teach-back techniques with nurses when delivering pain management education with non-verbal patients in order to improve patient outcomes in the adult ICU. By using the teach-back method, the nurse will be able to hone a more collaborative approach in dealing with pain, encourage autonomy and include the patient/family in making informed decisions regarding treatment for pain. Reinforcement regarding teach-back was focused on teaching points, and rewording teach-back cues to …

Urban Stormwater Management: Treatment Of Heavy Metals And Polycyclic Aromatic Hydrocarbons With Bioretention And Permeable Pavement Technologies, Viktoriya Sirova

Master's Projects and Capstones

Urban stormwater runoff is a major non-point source of pollutants release into the environment. Pollutants of concern include sediments; heavy metals; polycyclic aromatic hydrocarbons (PAHs); petroleum hydrocarbons; and chlorinated organic compounds, such as pesticides and polychlorinated biphenyls. Conventional stormwater management practices are designed to dispose of the runoff as quickly as possible, not to treat the pollutants. Low Impact Development (LID) concept is an alternative approach to the conventional framework that attempts to recreate hydrologically functional landscape mimicking pre-development regimes. This research paper assesses the effectiveness of two LID technologies, bioretention and permeable pavements in treating PAHs and common urban …

Hepatitis C: A Perspective Through The Social Ecological Model, Sandra H. Vulis

Master's Projects and Capstones

Hepatitis C virus (HCV) is a major global public health problem. The Center for Disease Control and Prevention (CDC) estimates that the Hepatitis C virus (HCV) affects 3.2 million Americans and 500 million people from a global standpoint (CDC, 2012). HCV contributes to significant morbidity and mortality with about 1 million deaths due to liver disease (World Hepatitis Alliance, 2010). Chronic liver disease has origins ranging from acquired, infectious, toxic and metabolic causes. Long-term consequences include cancer, cirrhosis (scarring of the liver), and liver failure. Given the substantial data attributable to HCV-related liver disease, it is necessary to develop an …

Global Health Security Agenda Legal Landscape Assessment, Natasha M. Nussbaum

Master's Projects and Capstones

The Global Health Security Agenda (GHSA) was created on February 13, 2014, to improve country's ability to detect, prevent and respond to emerging health threats. Eleven action packages were created. The detection action package included antimicrobial resistance, zoonotic diseases, national biosafety/biosecurity and immunization. The prevention action package included establishing a national laboratory system, strengthening real-time biosurveillance, advancing timely and accurate disease reporting and establishing a trained global health security workforce.The response action package focused on establishing emergency operation centers, linking public health and law enforcement and enhancing medical countermeasures/personnel deployment.

The following paper summarizes the components performed for the GHSA …

Enhancing Esl Instruction Through Reflective Teaching: A Resource Guide For Administrators Of Intensive English Programs, Wesley Weston

Master's Projects and Capstones

Reflective teaching practices are meaningful and practical ways for administrators to support and encourage ongoing professional development among ESL teachers. Today, the global demand for English instruction has greatly surpassed the supply of qualified and experienced teachers. Many ESL teachers, therefore, can benefit significantly from continuous professional development, especially at Intensive English Programs preparing international students for higher education in the US.

Administrators can help further teacher development through the implementation of microteaching, peer observations, and surveys. These methods effectively foster professional growth by stimulating reflective inquiry, which promotes personal learning, behavior modification, and better performance. Furthermore, these practices help …

A Literacy-Level Curriculum For Adult Spanish-Speaking English Language Learners With Limited Formal Education, Kirsten L. Keihl

Master's Projects and Capstones

Many Spanish-speaking adult immigrants in the United States face an immediate need to learn English, but also suffer from a lack of formal education as many did not complete middle school or high school. These learners need a curriculum that is tailored specifically to their needs. This project provides a communicative curriculum for teaching English and Spanish literacy, English speaking and listening skills, and basic classroom skills utilizing native language instruction when helpful using learning strategies and authentic materials that are appropriate for adults. It also addresses sociocultural and sociopolitical concerns of this population and utilizes culturally relevant materials.