Digital Commons Network^™

Improving Wound Care Using The Time Framework, Pavel Kulikov

Doctor of Nursing Practice (DNP) Projects

Abstract

Background and purpose:Although wound care guidelines are available for primary care providers, barriers to assessment and treatment remain. This paper examines current evidence, guidelines, and discusses the need for improved training, education, and a simplified approach to wound management in primary care. The goal of the project was to increase the provider’s comfort level in assessing and initiating wound care treatment in the clinical setting. Methods:An evidence-based wound treatment framework, identified as the TIME (tissue, infection, moisture, epithelial) framework, was selected for the project. The framework was tailored by subject matter experts to provide a distinctive approach …

Making Space For Makerspace: How Adding A Makerspace Can Benefit Art Museum Education Programming, Kaeleigh Thorp

Master's Projects and Capstones

In this capstone project, I advocate for adding makerspaces to art museum education programming. I review the foundational educational concepts of a makerspace which help explain why it is a modern strategy to increasing visitor learning. This includes John Dewey’s theories of experience and education, Howard Gardner’s multiple intelligences theory, George Hein’s studies of museum visitor behavior, and the physiological science of learning. I then propose four key terms essential for visitor learning, and explain how makerspaces successfully incorporate them. The four key terms are: 1. multiple intelligences, 2. direct experience, 3. inquiry based and open ended learning, and 4. …

Looming Large: An Analysis And Evaluation On The Growth Of The Urban Informal Economy In Nigeria., Tamunotonye A. Sekibo Iii

Master's Theses

The Informal Economy looms large! The importance, magnitude and significance of the vast range of socio-economic activities taking place within and across diverse spaces of informality, particularly in nations situated in the Global South; can neither be overstated or underestimated. According to the International Labor Organization (ILO, 2018 p.v), approximately 60% of the world’s employed population - 2 billion people - obtain their source of income through their engagement in informal spaces.

Tall Tales Of Danger And Security: How A Critical Human Security Approach Can Address Major Contradictions Revealed Through A Critical Narrative Analysis Of Dominant U.S. Security Strategies, Stephen Schneider

Master's Theses

Over many generations, humans have developed many perspectives and practices regarding the best ways to recognize and address what they perceive to be dangerous. Stories are used to help shape and narrate perceptions about the world, and they serve to pass on vital information that impacts how a society responds to threats and vulnerabilities. These narratives of danger and security are subjective to the experiences and political intentions of society, and therefore in many ways are partial and biased in their assessments and policies. This results in flawed security practices that may actually exacerbate threats or create new insecurities. What …

Triple Bottom Line As A Method To Increase Business Value And Foster Positive Social And Environmental Change, Jayleene West

Master's Theses

The Triple Bottom Line (TBL) business model has transformed the business world by changing the way businesses operate. By focusing on the people and the environment, businesses have grown to see substantial profit and avoid risks along the way. Companies are using the TBL to build their brand and customer loyalty by enhancing the environment and society. This paper analyzes four companies that are leaders in their industry and are founded on the TBL; Seventh Generation, New Belgium Brewing, Patagonia, and Ben & Jerry’s. Recommendations have been made by performing a literature review on the advantages and disadvantages of the …

Healing Wounds Through Nutrition, Deanna Garza

Master's Projects and Capstones

Abstract

The role of nutrition in wound care is often overlooked. The main reasons why wounds fail to heal are malnutrition, infection, impaired organ function due to co-existing diseases such as diabetes, hypertension, renal disease, and peripheral vascular disease to name a few. These factors have contributed to poor patient outcomes and patient satisfaction, as well as an increase in hospital length of stay. To promote wound healing, fuel from macro and micronutrients are necessary to deliver oxygen and energy for cell regeneration. However, nurses must possess knowledge and understanding of these requirements and the effects of nutrition on wound …

Transitions Of Care: Implementing Early Follow-Up Appointment To Help Decrease Readmission Rate, Lualhati Espina Dursun

Master's Projects and Capstones

Abstract

Problem – The rate of readmission in the country is at a severe level. According to CMS, in 2017 the average national readmission rate was 18.4%(CMS, 2018). Hospitals are penalized for unnecessary readmissions (HRRP, 2018). In addition to the financial burden of readmissions, quality of life is decreased with readmission.

Context – Early or timely outpatient follow-up after hospitalization has been projected as a means of decreasing readmission rates.

Interventions – Integrating follow-up appointment to the current care transition - HUB process as a means in reducing readmission rates.

Measures & Results – Identified high-risk patients that need timely …

Watch & Learn - A Teacher's Guidebook For Film-Based Esl Course, Xiaoxue Zhu

Master's Projects and Capstones

Educators in the 21st century are continuously discovering more engaging teaching tools to facilitate language learners. In today's increasingly developing visual world, film stands out from other traditional materials for its unique features, such as the visuality and authenticity. With appropriately designed activities, film could be a valuable resource in teaching English as a second language (TESOL) setting, and also a perfect tool for inspiring cross-cultural communication and promoting critical thinking skills.

However, research has shown that ESL teachers feel reluctant to use film as a significant component in their classrooms even though they have recognized and affirmed the benefit …

Expanding The Definition Of Provenance: Adapting To Changes Since The Publication Of The First Aam Guide To Provenance Research, Katlin Cunningham

Master's Projects and Capstones

In 2001 the American Alliance of Museums (AAM) published The AAM Guide to Provenance Research. However, in the past seventeen years there have been several new developments in the provenanceresearchfield, and an updated guide has yet to be released. I propose that several changes be made to create an updated version. For this project, I tested this guide in two ways: first, to see how our understanding of provenance has changed since 2001 and second, to use a case study to assess whether the recommended basic research guide and principles still apply to today.

In the first …

Detection And Melting Of Surface-Bound Dna Using A Purely Electrochemical Approach, Denny Ho

Master's Theses

In this thesis, we demonstrate an electrochemical approach for monitoring the electric-field induced melting of surface-bound double-stranded DNA. The electrochemical routine involves repeated chronoamperometry pulses to melt the duplex and square wave voltammetry to monitor the extent of melting. We utilize a scanning potential and constant potential technique to generate melting curves and access the stability and kinetics of the DNA duplexes. Our method uses a mixed monolayer of thiol-modified DNA oligomers and mercaptohexanol on gold electrodes, are subsequently incubated with target DNA covalently modified with electroactive methylene blue. Under room temperature, 10 mM Tris, and optimized electrochemical parameters, DNA …

The Integration Of Syrian Refugees In Turkey Via Education, Aysenur Hacioglu

Master's Theses

The Syrian conflict, which was initiated as a pro-democratic movement against Bashar Assad’s government, has displaced millions of people both internally and externally. Since the beginning of the conflict, 6.6 million people are internally displaced, while 5.6 million people seek refuge in other countries. Many Syrians scattered to neighboring countries, principally Turkey, Lebanon, Jordan, Iraq, and Egypt. Turkey, who shares the longest borderline with Syria, hosts 63 percent of the total number of Syrian refugees, currently at more than 3.5 million (UNHCR, 2018b). However, Turkey as the country with the highest number of refugees in the world does not legally …

The Investigation Of The Chlorine Initiated Oxidation Of 2-Phenylethanol And Stability Of Superalkali Lithium Substituted Silyls., Adam Otten

Master's Theses

This thesis investigates the combustion potential of 2-phenylethanol and the superalkali properties of small lithium substituted silicon compounds. All combustion experiments were performed at the Advanced Light Source of Lawrence Berkeley National Laboratory at the Chemical Dynamics Beamline 9.0.2. The chlorine initiated oxidation of 2PE was investigated at 298 and 550 K using a multiplex photoionization mass spectrometer, coupled with the tunable vacuum ultraviolet radiation. Reaction products were identified using kinetic time traces and photoionization spectra.

Additionally, the stability of small superalkali silicon-lithium compounds has also been investigated. All structures and energetics were calculated using the CBS-QB3 composite method.

The …

Nursing Engagement In Policy Development And Advocacy, Marketa Houskova

DNP Qualifying Manuscripts

At present, professional nursing does not benefit from strong policy development and advocacy influence in the United States. There are 425,000 licensed registered nurses in California, which is nearly twelve percent of the national nursing workforce. Yet only five percent of nurses serve on hospital boards, and legislative efforts to advance full practice authority for advanced practice RNs fail year after year in California and other states. Although nursing ranked most trusted and ethical profession for the past 16 years (Gallup 2017) and enjoys much respect in society, its collective voice is not being heard by decision-makers and legislators. This …

Medication Error Prevention: Improving Patient Health Outcome, Brigitta Van Ewijk

Master's Theses

Medication administration errors were reported to have an error rate of 60% in early research mainly in the form of the wrong dose, time, or rate. Working conditions were found to be one of the main contributors to these errors. Recognizing and reporting medication errors are key to the implementation of the reduction of this critical health problem (Hughes & Blegen, 2008). DataRay Inc. (n.d.), states that almost one in five medication doses administered in hospitals is given in error. The two most common errors were (1) dispensing medicine at the wrong time (43% of incidents) and (2) omitting a …

Reexamining Overuse Of Frequent Observation For New Admissions On Psychiatric Units To Increase Nurse/Patient Engagement, Samuel Novela

Master's Theses

People in California who suffer from mental health conditions are often admitted involuntarily to hospitals on 72 hour psychiatric evaluation holds if they are deemed imminently dangerous to themselves, or others, or are gravely disabled. Observational patient safety checks are performed and based on patient acuity and hospital standards. Variations exist among different clinical settings with regard to best practices and the patient subpopulations that may warrant less frequent safety checks. Nurses experience different levels of satisfaction with regard to frequency of safety checks because there is no national consensus on which subsets of patients may require them. A senior …

The Spirit Is Willing, But The Flesh Is Weak: Contemporary Pan-Africanism And The Challenges To A United States Of Africa, Adesola Adeyemo

Master's Theses

Establishing a ‘United States of Africa’ to the average individual is deemed as a mythical idea in contemporary Africa, irrespective of the popularity of this idea several years ago. Today, the idea is idealized as overambitious – considering the balkanized state of the continent post-colonialization. Because of this, attempts made since then have favored enforcing regional integration over continental integration. Undeniably, this idea would not have come into being if it wasn’t for the concept of Pan-Africanism - which has for long guided the political and socio-economic policies created on the continent. The goal of this research is …

Defying The Gravity Of Falls On Msu, Alvin Joseph Abad

Master's Projects and Capstones

Falls are a leading cause of injury and death for adult males in the United States and have been an ongoing problem on the Medical Surgical Unit (MSU). Therefore, the aim of this project is to increase fall prevention education and communication on MSU in order to ultimately improve fall rates. Although there are currently fall prevention processes already in place, these may not be sufficient as demonstrated by recent fall metrics. Many RNs on MSU are fairly new nurses; and their enthusiasm and adaptability may be an advantage for this evidence-based project. Furthermore, the management team seems to be …

Creating A Culture Of Learning: Improving Patient Mobility In A Medical-Surgical Unit, Camille Cabalsa

Master's Projects and Capstones

Abstract

PROBLEM: Hospitalization, especially among older adults aged 65 or over, can result in decreased mobility and functional decline. This decreased mobility can lead to accelerated bone loss, falls, increased length of stay, and delirium. In this medical-surgical unit, a pattern reflecting lack of adequate patient mobility has persisted over one year.

CONTEXT: Northwest (NW), a 42-bed community hospital medical-surgical unit- part of an integrated regional health care delivery system, has not been maximizing the mobilization of their patients for the past year based on internal data.The improvement project described in this paper focused on creating a culture of continuous …

The Destruction Of Unesco World Heritage Sites Aleppo And Palmyra In Syria Due To Civil War: Accessioning And Cataloging The Satellite And Drone Imagery Into A Museum Collection, Colette P. Militello

Master's Projects and Capstones

This Museum Studies capstone will discuss the civil war inside Syria, and the destruction of UNESCO World Heritage Sites Aleppo and Palmyra. This paper will examine the historical importance of these sites, and the drone and satellite imagery data used to confirm the destruction. This paper will argue that for full preservation of these cultural heritage sites that this imagery data should be accessioned into a museum collection with the use of professionally-trained registrars. This paper will explore this idea further by arguing that this imagery data collected by companies and governments should be handed over with full copyright to …

Keep The Beat With Heart Failure Education: A Quality Improvement Project, Brenda L. Peterson

Master's Projects and Capstones

Abstract

Problem: Heart failure (HF), also known as congestive heart failure (CHF), is the number one diagnosis-related group (DRG) for people 65 years of age and older in the United States. This disease group is complicated and debilitating, requiring frequent hospitalizations with high mortality rates. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has identified CHF as an area for improvement in hospitals.

Context: This was a quality improvement project for an integrated medical center in the Central Valley, California with over 19,000 HF patients. In 2018, for patients 65 years and older, HF is the third-most admitted DRG …

Improving The Staff Responsiveness By Bundling Care, Practicing Proactive Authentic Hourly Visits, And Using The Four P’S, Robert Vega

Master's Projects and Capstones

Abstract

Problem

Staff responsiveness is an important Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Star Rating composite tool that hospitals monitor because it is consumer-driven information. The intent is that the HCAHPS composite promotes patient satisfaction, contributes to the prevention of harm, and can save millions of dollars (Danaf et al., 2017). On admission, the patient is orientated to their room, provided a nurse call light button to use, and told not to get out of bed alone and to wait for their nurse (Mitchell et al., 2014). On Three North, a gap exists in the delay it …

Music Education And Its Impact On L2 Learning, Johanna Nilsson

Master's Projects and Capstones

English Language Learners are disproportionately underrepresented in secondary music classes in the United States. They are systematically excluded due to overly restrictive schedules, high emphasis on test scores and academic remediation, real and perceived cost of participation, and the types of courses that are offered at most secondary schools. At the same time, musical intervention research has revealed that musical ability is linked to literacy, pronunciation, and vocabulary retention, all aspects of second language acquisition. By excluding English Language Learners from music education, we could be denying them a tool that could positively impact their language acquisition. However, most of …

Improving Nursing Communication Outcomes Through The Tell-Us Card, Nina Park, Laura Le, Brittney Pilker, Jillian Cule, Maricarmen Reyes, Jeffrey Salao

Master's Projects and Capstones

Nursing communication plays a pivotal role in patient-centered care. However, statistics have shown that failures in communication exist in more than 20% of all hospital settings (Sethi & Rani, 2017). Within the explored microsystem, a gap in patient communication was identified through the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys. Reports revealed that the microsystem was performing at 69%, which is 11% below the national average for nursing communication (Centers for Medicare and Medicaid Services [CMS], 2018). After performing a microsystem assessment, there was a measurable communication opportunity between the patients and nurses. It was determined that …

Community, Preservation, And Street Art: A Proposal For San Francisco’S Mission District, Marissa Nadeau

Master's Projects and Capstones

The Latinx community is an integral part of San Francisco’s rich history. From Mexican missions in the late 1700s to an influx of immigrants from various Latin countries starting in the early 1900s, the Mission District (‘the Mission’) of San Francisco has served as a hub for this mix of residents, fondly called “Raza,” emphasizing the people of a community rather than the country they have come from. Wars and issues dealt in their homelands were close to the hearts of the entirety of the Latinx population of the Mission, and their voices and opinions were heard through a type …

Root Cause Analysis To Improve Incident Reporting In An Ambulatory Care Setting, Lisa Ann Duncan

Doctor of Nursing Practice (DNP) Projects

Problem: The subject organization (SO) is a Federally Qualified Health Center (FQHC) with an internally developed incident reporting system. The SO wanted to improve patient and employee safety using data from incident reports, but the incident reporting system did not give enough information to recognize patterns and develop countermeasures.

Context: Supervisors welcomed the opportunity to learn more about incident report follow-up and conducting root cause analysis (RCA). Members of the Safety Committee were eager for data to use to develop countermeasures to improve patient and employee safety. Decreases in employee injuries can save the SO from increases in the …

Implementing Ihi Joy In Work Framework To Decrease Turnover Among Unit Leaders, Allison Reid

Doctor of Nursing Practice (DNP) Projects

Problem: A medical center in an integrated health care system in Northern California has experienced high turnover for unit level leaders employed in an acute care setting. The role of unit level leaders (managers, assistant managers, and supervisors) in this organization is complex, often stressful, and includes 24/7 accountability. These leaders must simultaneously deliver on organizational goals, patient safety, quality, budgets, and staff satisfaction (Loveridge, 2017). Increasing resilience can help these leaders cope with stress and find joy in their work, making them less likely to leave their leadership positions (Hudgins, 2016).

Context: According to Loveridge, the turnover rates of …

Teamstepps: A Foundation For Shared Governance In A High-Risk Obstetrical/Neonatal Service Line, Genevieve Wright

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem: Declining registered nurse (RN) engagement in the maternal child health (MCH) department, despite improvements in RN staffing, some reductions in nurse-patient ratios, the addition of support staff resources, and a focus on quality and safety.

Context: The project setting is an MCH department of a 184-bed community hospital, part of a large national organization, serving a diverse population in Northern California. The initial stakeholders included RNs, managers, and assistant managers; the team was later expanded as the project developed (see Appendix A).

Intervention: The original aim of this project was to improve nurse engagement among frontline nurses through …

Implementation And Evaluation Of A Nurse-Driven Protocol For Urinary Catheter Management, Analynn Cisneros

Doctor of Nursing Practice (DNP) Projects

Problem Description: Hospitals compromise quality care and the health of its patients by subjecting the patients to risks that are preventable, such as nosocomial infections (IOM, 1999). The most preventable infection is a catheter-associated urinary tract infection (CAUTI) (Tenke, Meizei, Bode, and Koves, 2016). CAUTIs remain prevalent in the acute care setting (CDC, 2016).

Context: Prior to the implementation of this DNP project, the organization of focus did not have a nurse-driven protocol in place to guide urinary catheter management. Joint Commission mock surveyors recommended a protocol be implemented. A nurse-based protocol would benefit this Magnet hospital. Implementing …

Improving Management Of Obstetrical Emergencies: Using Simulation-Based Training, Amira Amatullah

Doctor of Nursing Practice (DNP) Projects

The aim of this Executive Leadership Doctorate in Nursing Practice project was to assess the effectiveness of simulation-based training as a strategy to ensure patient safety and quality care by improving the knowledge and confidence of obstetric nursing staff. Collateral goals included the development of a simulation-based interactive training program to improve staff response to obstetric emergencies and the establishment of an Interprofessional Simulation Training Center.

The use of simulation-based training is widely accepted ans used in healthcare education. Several benefits of simulation-based training include a learner-centered approach, safe acquisition of technical skills training and development of effective communication skills. …

Nursing Partnership With Patients, Parents And Families For Safety Through Simulation, Courtnay Caufield

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem: The importance of communication between nurses, patients, and their family members with respect to treating each other as partners in safety cannot be overstated. It is imperative that families and patients feel empowered to speak up and report clinical errors at any time and be able to communicate effectively to prevent harm and encourage communication.

Context: This is especially important in the acute care setting, where patients may be in contact with multiple people and processes daily. Attention to this safety partnership can be established through improvements in patient satisfaction scores, which are usually collected from patients and …