Digital Commons Network^™

Efficacy And Safety Of Dpp-4 Inhibitor Use In The Hospital Setting, Brendan Dass

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Current practice in the hospital is to hold oral antidiabetic drugs and administer insulin to prevent adverse reactions. This can lead to issues including hypoglycemic events, high glycemic variability, and poorly controlled blood glucose. Newer incretin analog drugs such as DPP-4 inhibitor do not cause hypoglycemia. A literature review was performed, and the results showed that DPP-4 inhibitors are both safe and effective in the inpatient setting with fewer hypoglycemic events, lower mean BG, and lower glycemic variability. The proposed study will compare patients with type diabetes treated with standard basal-bolus insulin therapy, against those continued on their home DPP-4 …

A Focus On Alarms That Matter To Reduce Telemetry Alarm Fatigue: A Pilot Study, Meghan Mccoy

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Despite ample research with optimistic outcomes on the topic, telemetry alarm fatigue continues to be a complex safety issue within our health care system. The concern of not only nurse safety and satisfaction, but the patient care and positive outcomes remains a problem. The purpose of this proposal is to decrease perceived telemetry alarm fatigue amongst nurses on an inpatient telemetry unit in a small community hospital. This will be accomplished by utilizing an identified best practice, through defaulting a nonactionable telemetry alarm to off. The setting is in on a 21 bed telemetry unit at a small community hospital …

Does Resiliency Training For Acute Care Nurses During Their First Year In Practice Decrease Levels Of Compassion Fatigue?, Ashley Hernandez

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Compassion fatigue (CF) is a term to describe the exhaustion resulting from repeated exposure to stress, leading to both emotional and physical complications. Research investigating nurses experiencing CF demonstrates a decrease in productivity, an increase in medication errors, and decreased patient care. It is also associated with high turnover rates, which are costly for hospitals to absorb. Resiliency training is one intervention recommended to decrease CF. Stress management and resiliency-training programs are being researched to determine if they can give nurses the coping skills needed to combat CF. The purpose of this Quality Improvement Project is to develop an Evidenced …

Nursing Self-Care Through Reiki Practice In The Clinical Setting, Gisela Arguello

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

This pilot proposal project articulates a call to action to lessen nurses' burnout. Extant literature supports Reiki energy therapy to aid with anxiety, stress, and fatigue, which supports the project's purpose of helping teach nurses self-care using the complementary practice of Reiki as an alternative stress reduction tool to promote a healthy work environment that will improve nurses' well-being and their ability to provide optimum patient care.

Method:The study will begin with a short questionnaire to measure initial Reiki knowledge in nurses. Then, nurses will undergo classroom lectures followed by lab instruction and practice. After the study, nurses will …

Gender And Race Of Respondents In Sentencing For Intimate Partner Violence: Are Police Officers More Severely Punished?, Morgan Robichaud

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

The purpose of this study was to examine if the gender or race of the respondent had an impact in the sentencing/parole decisions of the convicted defendant. Utilizing past studies and articles, three hypotheses suggested that participants would hold police officers to a higher standard than their civilian counterparts. Also, the race/gender of the respondent influenced the sentence they provided to the defendant. Participants (n=204) were randomly assigned a police officer or non-police officer scenario where the perpetrator was plead guilty to committing intimate partner violence. They then responded with their sentence determination, parole percentage, restitution amount if any and …

Sexual Health Education For Minority Youth And Young Adults In The Primary Care Setting, Veronica Brimpong

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Sexually transmitted infections (STI) rates in the United States have been on the rise. The Centers for Disease Control (CDC) reports that 1 in 5 people have contracted an STI in their lifetime. Minority young adults and adolescents are at the highest risk for contracting STIs, becoming the target focus group of this quality improvement program (QIP). Various barriers have been identified that have been attributed to this crisis. Through this QIP, STI knowledge and encouragement of STI testing and early treatment among young adults and adolescents at the primary care level could help overcome these barriers and become a …

Implementation Of A Culturally Tailored Educational Intervention For Hispanic Individuals Living With Type 2 Diabetes, Ruth Demelo

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Diabetes is one of the leading causes of morbidity and mortality in the United States (Trout & et al., 2019). The prevalence of diabetes in the Hispanic community is higher compared to other racial groups (Philis-Tsimikas & et al., 2022). It is critical to address the diabetes disparities within our communities and provide Hispanics who have diabetes with the adequate education and health care needed.

According to the Centers for Disease Control (CDC), many innovative programs and interventions have proven to be effective in the treatment of type 2 diabetes in Latinos and in other minority groups. These innovative, culturally …

Increasing Emergency Department Nurses' Knowledge Of Targeted Temperature Management: A Quality Improvement Project, Victoria Blasi

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Cardiac arrest is a serious medical condition that has a high mortality rate. Currently, there are limited interventions that are known to increase the chance of survival. One recommended intervention is the use of Targeted Temperature Management (TTM) which involves inducing a state of hypothermia post resuscitation and return of spontaneous circulation (ROSC) following cardiac arrest. This procedure is complex and requires use of specific equipment and close monitoring. At times, this procedure is initiated by nurses in the emergency department (ED). TTM is a low-volume, high-risk intervention. The purpose of this quality improvement project is to enhance Emergency Department …

Effects Of Breastfeeding Support Approach On Breastfeeding Decisions: A Quality Improvement Project, Thea Olsen

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

This project aims to address the clinical question of how the type of initial breastfeeding support or education provided by a lactation consultant impacts on the breastfeeding decisions and on the feeling of empowerment regarding her feeding decisions of a new mother. A training class for a cohort of International Board Certified Lactation Consultants (IBCLCs) to teach them how to use motivational interviewing and Swanson's Theory of Caring to guide their lactation education was proposed to address this question. The mothers the IBCLCs work with will be surveyed both before and again after the training to evaluate if changing the …

Monitored Anesthesia Care Versus Moderate Sedation In The Endoscopy Setting: A Retrospective Chart Review, Ilana Oakes

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Sedation is a state of depression in the level of consciousness that is medically induced allowing for decreased consciousness, reduction in sensation, and relaxation. Two methods of sedation administered in the acute care setting of an endoscopy unit are moderate sedation and monitored anesthesia care (MAC). When it comes to recovery from sedation and eligibility to reach discharge criteria whether one method of sedation is superior to the other or if both are comparable is a topic of more research. A retrospective chart review of a hospital�â�€�™s endoscopy unit was conducted to determine if one method of sedation over the …

The Disparity In Adolescent Contraceptive Access Across The United States And Its Impact On Teenage Birth Rates, Lesley Angel

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

This study provides an overview of the research conducted on adolescent contraceptive access across the United States and its impact on teenage birth rates. The study aims to investigate the current state of access to contraceptives for adolescents across different states in the US. Access to contraceptives is crucial to adolescent health because it may play a role in preventing teenage pregnancy. Teenage pregnancy is adverse because the significant social and economic expenses associated with it negatively impact both individual families and society. This study's findings reveal a significant disparity in adolescent contraceptive access across the United States, with some …

Enteral Feeding In Critically Ill Adults: An Evidenced Based Practice Update, Justin Palmer

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

For many patients admitted to the Intensive Care Unit (ICU) nutritional support via an enteral feeding tube will be required at some point during their stay. Extensive research has been conducted on the topic of enteral nutrition and best practices for monitoring and delivery of enteral nutrition have continued to evolve. The purpose of this quality improvement project is to identify best practices for monitoring of enteral nutritional intolerance and increase the percentage of targeted nutrition received by patients. Following a review of the literature an Evidenced Based Practice Update was developed for bedside ICU nurses incorporating key recommendations. The …

Recognition And Response To Opioid Use Among Adolescents In A School Setting, Katherine Mckinnon

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

The opioid crisis is a public health emergency. Education policy leaders, including school nurses, must be at the forefront of advocating for change regarding state-level initiatives in response to this epidemic. Currently all 50 states have a policy in place that allows for the administration of naloxone in a school setting by a designated healthcare professional. Some states have even included opioid misuse education in their middle and high school health education curriculum. Rhode Island does have a policy that indicates schools at all levels should procure naloxone and administer it in the case of a suspected overdose, but has …

Addressing Housing Insecurity: Policy Analysis Of Managed Care Organizations And Healthcare Providers, Andrea Hernandez

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

An average of 4,000 Rhode Islanders experience homelessness and housing insecurity each year. A policy analysis of screening tools for Social Determinants of Health (SDOH) was conducted for Neighborhood Health Plan of Rhode Island (NHPRI), Inland Empire Health Plan, The Veteran Health Administration (VHA), The Medicaid Medical Directors Network (MMDN), Executive Office of Health and Human Services (EOHHS), RI Office of Housing and Community Development, U.S. Department of Housing and Urban Development, Keiser Permanent School of Medicine Health Systems Science, Canadian Observatory on Homelessness, and primary care offices in Indianapolis, Florida, and Indiana. The analysis revealed ineffective screening when addressing …

Promoting Acceptance Of A Community Doula Program For Black Women Among Labor And Delivery Nurses: An Educational Intervention, Victoria Ogunleye

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

A trend of increased maternal mortality, both locally and nationally, among Black women has become a significant public health and social justice issue with a notable increase documented in recent years. Doula support programs have been demonstrated as an innovative method of improving maternal child health outcomes for this population. This quality improvement proposal project uses the Social Ecological Model, including individual, interpersonal, community, and societal factors, to design an educational intervention for labor and delivery nurses at an acute care women'™s hospital. The education will be developed with the aim of increasing labor and delivery nurses'™ knowledge of the …

Cognitive Representations Of Moral Behavior In Dyadic Interactions, Thomas A. Fogarty Jr.

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

This study addressed the nature of moral perceptions in dyadic interaction. Moral behavior has typically been studied as an individual difference; however, theory supports that moral perception often occurs in a dyad or two-person group. Therefore, the current research addresses moral responses using the Social Relations Model (SRM) to analyze perceived moral behavior between members of a dyad. The SRM estimates moral behavior expressed (actor), moral behavior elicited (partner) and moral behavior in unique two-person dyadic arrangements (relationship). This study used a research design called the idiographic key person design. Participants nominated and assessed moral behavior with 3 friends and …

Seesawing: An Evaluation Of The Educational Aspirations And Attainments Of College-Aged Biwoc, Sara Gilkenson

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

There are disparities in achievement for Black, Indigenous, and Women of Color (BIWOC) both during college as well as beyond completion due to insufficient preparation before matriculation. Researchers have attributed this struggle of aligning attainment and aspiration to financial constraints, culture shock, and overcoming an academic and social learning curve. However, many institutions have naively created programming and scholarship to aid these barriers, yet retention and graduation rates for BIWOC students are still lower than their white counterparts. These gaps that are characterized by race and ethnicity are persistent, leading institutions to wonder how effective their support systems are. This …

Utilizing Evidence-Based Best Practices In Reducing Second And Thirdhand Smoking-Related Morbidity And Mortality In Children, Gail Davis

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Background: Exposure to environmental tobacco smoke is a leading cause of respiratory illness in children. Although evidence-based best practices to improve outcomes are well-documented, they are inconsistently implemented.

Purpose/Specific Aims: The purpose of this project was to improve provider implementation of evidence-based best practices in environmental tobacco smoke exposure reduction in children. The overarching aim was to reduce related morbidity and mortality. Specific aims included increased knowledge and skill related to best evidence-based practices, and fostering implementation in practice.

Methods: This project involved a quasi-experimental quality improvement design involving an educational intervention on the scope and nature of the problem, …

The Effects Of Paternal Figures' Parenting Style And Involvement On Masculinity And Coping Styles For Sons, Matthew G. Burns

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Of the three parenting styles created by Baumrind (1966), the authoritarian style has been largely associated with fathers due to previously reinforced unhealthy masculine norms. However, there has been a change in masculine behaviors and ideology in which fathers have taken on a more nurturing role (Lin & Billingham, 2014). Specifically, the son's coping style and masculinity will vary greatly depending on the paternal figures‚Äô behavior during childhood and further (Addis & Cohane, 2005; Cherry & Gerstein, 2021). One hundred and fifty participants were recruited to take part in this study that is examining paternal gender role conflict and parenting …

Impact Of A Screening And Resource Intervention On Social Determinants Of Health Outcomes Among Mental Health Patients In The Emergency Department, Denise Brennan

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Objective
This study evaluated the impact of a social determinants of health (SDOH) screening and resource connection for adult mental health patients in the emergency department (ED) on identifying the SDOH needs of the ED mental health community, connecting patients with resources, and the outcomes of ED utilization and boarding.

Method
A quasi-experimental, pretest - posttest design was employed. Participants were screened by emergency nurses to identify SDOH needs. Patients who identified a need were connected to resources. A two-week follow-up was offered to evaluate resource connections.

Results
There were 36 patients who agreed to participate of 51(70.5%) who were …

Program Planning: Bridging End-Of-Life Care For Unhoused Individuals With Mental Illness, Theresa Dalomba

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Background: Unhoused individuals who struggle with Severe and Persistent Mental Illness (SPMI) and/or substance use disorder (SUD) often have inadequate End of Life (EOL) care compared with those who have stable housing. Purpose/Specific Aims: This Program Development Project aims to develop a comprehensive strategy to provide compassionate end-of-life care and medical respite services for vulnerable populations, including the unhoused, mentally ill, incarcerated, and medically fragile individuals.

Methods: The plan will include assessment of the infrastructure needed to ensure that the unhoused have equitable access to care, comparable to that of individuals with stable housing. This will involve budget projections for …

Icu Liberation Bundle: Nursing Attitudes And Potential Barriers To Implementation, Adam Hobbins

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Background: Intensive Care Unit (ICU) survivorship is often marked by lasting complications such as delirium, morbidity, debilitation, and increased incidence of 6-month mortality. Aside from direct organ and life support through critical illness periods, this survivorship remains a key area of opportunity for improved outcomes through evidenced-based intervention. One such intervention is the ICU Liberation Bundle, a package of elements proven to improve survivor outcomes. The literature is abundant with evidence for its effectiveness, but also speaks to lack of universal implementation and whole-bundle compliance at the point of care.

Purpose/Specific Aims: To explore barriers to ICU Liberation Bundle …

Exploring Nurses' Confidence In Supporting Family Presence During Resuscitation In The Emergency Department: A Quality Improvement Project, Vanessa Hampson

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Cardiac arrest is a common event in hospitals and integrating family presence during highly stressful situations such as resuscitation and invasive procedures can be problematic for members of the interprofessional team. The purpose of this quality improvement project is to explore nurses' confidence in supporting family presence during resuscitation. A sample of 27 out of 50 registered nurses voluntarily participated in the survey. Utilizing a modified NCSBN confidence survey, confidence levels were lower when asked about interventions, communication, and policy prior to any education recommendations about family presence during resuscitation. This study provides insight into why nurses may or may …

Effectiveness Of De-Escalation Strategies On Psychiatric Patients In The Acute Care Setting, Jennifer Lepage

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

The use of restraints has been a controversial topic for decades in the healthcare field. Due to the fast paced and challenging environment in the acute care setting, there is frequent use of restraints when health care providers are faced with aggressive and threatening patient behavior. A review of the literature found that restraints can have many harmful physical and emotional effects. Several non-invasive alternatives as well as various de-escalation techniques to decrease restraint use have been proposed. The purpose of the systematic review was to identify the effectiveness of de-escalation strategies used to de-escalate aggressive behavior in adults over …

Does Preoperative Incentive Spirometry Use Reduce The Incidence Of Postoperative Pulmonary Complications After Cabg Surgery: A Systematic Review, Sandy C. Dass

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Coronary artery bypass graft (CABG) surgeries are often associated with postoperative pulmonary complications such as atelectasis. This complication can lead to increased length of stay, morbidity, and mortality. There is substantial information about the impact of incentive spirometry postoperatively; however, the use of incentive spirometry preoperatively is understudied. This systematic review aims to determine if preoperative incentive spirometry use reduces the incidence of postoperative pulmonary complications after CABG surgery such as atelectasis, pleural effusions, pneumonia, and pulmonary embolism. Inclusion criteria included randomized controlled trials with the inclusion criteria of patients 18 years of age or older undergoing a CABG procedure, …

Orientation Of The New Graduate Nurse In Critical Care: Understanding The Barriers And Facilitators, Tiffaney Cayton

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Background: The COVID-19 pandemic has affected the nursing field and how nurses care for their patients. Recent nursing shortages in critical care are causing organizations to depend on new graduate nurses to fill these needs. The critical care environment's safety depends on nurses' ability to provide safe, quality care in a demanding, complex environment and current orientation processes do not adequately support this influx of new graduate nurses entering critical care.

Purpose/Specific Aims: This quality improvement project aimed to identify new graduate and experienced precepting nurses'™ perceived barriers and facilitators regarding the orientation process within the critical care setting.

Methods: …

Increasing Referral To Cardiac Rehabilitation, Ashley Claire Arnold

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Background: Heart disease is the leading cause of death in the United States (US), killing 610,000 Americans each year (CDC, 2017). Cardiac rehabilitation (CR) is a Class I recommendation by the American Heart Association and American College of Cardiology Foundation for patients after coronary artery (Thomas et al., 2018). Completing a 12-week cardiac rehabilitation program after coronary revascularization can reduce all-cause mortality by 20% to 50% (Sandesara et al. 2015). Despite the proven benefits of CR, only 14-35% of heart attack survivors attend CR (Balady et al. 2011; Ades, et al., 2017; AHA, 2017).

Purpose/Specific Aims: There is a gap …

The Impact Of Implicit Racial Bias In The United States Education System: A Systematic Review, Indira Bela Reid

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Attitudes and behaviors towards people based on race, gender, sexual orientation, and religion can create stereotypes that set the tone for how people are viewed and treated in society. These stereotypes over time become implicit or explicit bias. DeShazo et al. (2020) stated that bias based on skin color, religion, immigrant status, gender, and ethnicity are deeply rooted in the American culture and have existed within the infrastructure of American medicine as scientific racism was taught at the best medical schools from the beginning. Edgoose et al. (2019) states that implicit or unconscious bias derive from our attempt to rapidly …

Debriefing After An Adverse Event, To Decrease Second Victim Phenomenom: A Systematic Review, Nicolle Shelton

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

The healthcare system is changing continuously, and these changes can benefit the systems and at times can cause distress related to an increase in acuity of patients, decrease in staff, evolving diseases and limited resources. Adverse events can cause stress for the staff that participated in the event, such as an increase in moral distress and a decrease in work satisfaction. This systematic review will review five studies on how debriefing after an adverse event can decrease moral distress which will decrease the likelihood of the participant becoming the second victim phenomenon

Phenobarbital Vs Lorazepam: A Comparison Of Alcohol Withdrawal Syndrome Treatments, Antonio Marcos Jardim

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

The wide use of alcohol and its consequent problems in our society have contributed to an estimated 1.2 million hospital admissions, 85,000 deaths, and a cost above $250 billion to our health care system every year. Benzodiazepines such as lorazepam have long been the preferred choice of treatment for alcohol withdrawal symptoms (AWS) in the hospital setting. However, alternative treatments like phenobarbital could possibly improve outcomes in terms of efficacy and safety. A systematic review was conducted to compare and synthesize the current evidence as it relates to the effectiveness of phenobarbital and lorazepam in decreasing AWS and total hospital …