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Articles 1 - 30 of 97
Full-Text Articles in Medicine and Health Sciences
Decreasing Patient Fall Rates In The Microsystem, Kevin Dwayne Sanchez Camaya
Decreasing Patient Fall Rates In The Microsystem, Kevin Dwayne Sanchez Camaya
Master's Projects and Capstones
Abstract
Problem: Falls are considered never events, yet continuously occur in the inpatient setting. Falls,
especially falls with injuries, impact the patients, the staff, and the hospital. Falls cause extended lengths of stay, affect the morale of the patients and the staff, and are non-reimbursable events.
Context: There have been an increased rate of falls within a medical/surgical/telemetry unit
microsystem at a Northern California hospital despite standardized screening and prevention tools. The unit can house up to 52 patients and is the designated Covid unit of the hospital at the time of this project.
Interventions: The interventions include optimizing the …
Manager Onboarding To Improve Knowledge And Confidence To Lead, Christine (Tina) K. Asiimwe
Manager Onboarding To Improve Knowledge And Confidence To Lead, Christine (Tina) K. Asiimwe
Doctor of Nursing Practice (DNP) Projects
Background: Primary care (PC) is increasingly the setting for affordable, coordinated, end-to-end patient care, with PC managers in charge of organizational performance. While PC managers are central to high-functioning teams, they often receive inadequate onboarding.
Local Problem: Primary care onboarding competes with other operational priorities and faces time constraints, lack of mentorship, and cost.
Context: At an integrated healthcare system, a need was identified to develop structured, role-specific onboarding for newly hired PC managers to improve knowledge and confidence to lead.
Interventions: Bauer’s Four Cs framework for onboarding guided the development of a manager onboarding program for 12 new PC …
The Resilience Vaccine, Sara Horton-Deutch T. Duffy
The Resilience Vaccine, Sara Horton-Deutch T. Duffy
Master's Projects and Capstones
Healthcare workers have been working in unprecedented circumstances since the declaration of the COVID-19 pandemic. Caregivers have been taxed with burnout. A large healthcare organization’s 26-bed, medical-surgical, telemetry, COVID-19 overflow unit was significantly impacted. Many healthcare organizations have adopted advocacy for attaining joy in work as an extra dimension of the Institute for Health Improvement’s Triple Aim. Adding this fourth aim supports averting caregiver burnout (CBO) while promoting joy in work.
This quality improvement project examined nurse leaders’ interventions that address CBO, promote healthy work environments, and promote joy in work. From June through August 2021, an 8-week resilience program …
Nursing Management To Reduce Hospital Readmissions After Percutaneous Coronary Interventions- Integrative Review, Jeena S. Daniel, Doreen Wagner
Nursing Management To Reduce Hospital Readmissions After Percutaneous Coronary Interventions- Integrative Review, Jeena S. Daniel, Doreen Wagner
Master of Science in Nursing Final Projects
Abstract
Percutaneous coronary interventions (PCIs) are considered life-saving techniques in the event of myocardial infarction and remain the standard of care for managing acute heart attack. Given the success of the procedures, decreased complications, and the economic advantage over open-heart surgery, coronary interventions continue to be the preferred treatment choice. However, amidst the growth and success of these procedures, readmissions after percutaneous coronary interventions have been identified and still prevail among hospitals. Hence, the goal was to conduct an integrative review to identify and synthesize literature on the interventions that help reduce readmissions after percutaneous coronary interventions and illuminate nurses' …
Self-Measured Blood Pressure Monitoring: A Patient Empowerment Project, Alison Cusmano
Self-Measured Blood Pressure Monitoring: A Patient Empowerment Project, Alison Cusmano
Doctor of Nursing Practice Final Manuscripts
Hypertension is a public health issue estimated to affect 112 million adults by 2030. Primary care patients in an outpatient clinic in Southern California with elevated blood pressure readings in the office did not have an organized system for close follow-up. The purpose of this evidence-based project (EBP) was to educate patients on self-measured blood pressure monitoring (SMBP), Dietary Approaches to Stop Hypertension (DASH), diet interventions, and healthy weight loss to improve hypertension rates. Through these interventions, patients developed an understanding of their systolic and diastolic blood pressure goals. Nurse practitioners, medical assistants, and licensed vocational nurses screened for high …
Increasing Healthcare Providers' Intent To Utilize Alternative And Complementary Pain Management With Their Patients, Holli Boyles
Increasing Healthcare Providers' Intent To Utilize Alternative And Complementary Pain Management With Their Patients, Holli Boyles
Doctor of Nursing Practice Scholarly Project
The purpose of this scholarly project is to increase the willingness of healthcare providers to introduce alternative and complementary pain management to their patients. Two patient video tools were constructed and offered to healthcare providers to evaluate and potentially utilize the final products in their practice. One tool introduced music therapy, the other mindful meditation, along with resources for patients to investigate and learn from on their own. A total of seven healthcare providers responded to the project with a commitment to potentially utilize the final video and provided their feedback on the video tools. No changes were made to …
Screening For Human Trafficking: Best Practice Guidelines And Recommendations For Health Care Providers, Bernadette Portillo
Screening For Human Trafficking: Best Practice Guidelines And Recommendations For Health Care Providers, Bernadette Portillo
Student Scholarly Projects
Human trafficking (HT) is a federal and international crime and is regarded as one of the most pressing human rights issues. Adult and minor victims are trafficked by force (rape, beatings, confinement), fraud, and coercion resulting in profound physical and psychological injuries (Chisolm-Straker et al., 2019, p. 72; Department of Homeland Security, 2020; Vera Institute of Justice, 2014, p. 6). Most clinicians fail to recognize HT victims (Egyud et al., 2017; Leslie, 2018; Mason, 2018; McDow & Dols, 2020; Mostajabian et al., 2019; Patient Safety Monitor Journal, 2017; Stevens & Dinkle, 2020). This policy brief’s purpose is to provide health …
Implementation Of Comprehensive Footcare Program Within Primary Care, Moses Ademola-Ojo
Implementation Of Comprehensive Footcare Program Within Primary Care, Moses Ademola-Ojo
Doctor of Nursing Practice
The incidence of diabetes and its complications is escalating, with over 34.2 million adults in the US having diabetes (CDC, 2020). Despite a decade-long decline in lower-extremity amputations, the incidence is growing (Nichols, 2019), with little emphasis on preventive foot evaluations within primary care. The purpose of this project was the implementation of a multi-faceted program aimed at early identification of lower extremity complications with focused patient education, improved assessment, and documentation, and referral for specialty care. The intervention process included staff training, patient education, foot examination, monofilament testing, pinprick tests, ankle reflex, and tuning fork test. Foot abnormality, loss …
Formalizing An Obstetrical Program For High-Risk Patients: Focus—Diabetes During Pregnancy, Valeria Jimenez
Formalizing An Obstetrical Program For High-Risk Patients: Focus—Diabetes During Pregnancy, Valeria Jimenez
Doctor of Nursing Practice
Within the last 10 years, the number of pregnant women with gestational diabetes increased 56%, and the number of women with Type 1 or Type 2 diabetes before pregnancy increased 37% (CDC, 2018). The management of a pregnancy complicated by diabetes involves a multidisciplinary approach, medical nutrition therapy, glycemic control, and occasionally, pharmacological therapies (Nurain et al., 2019). In 2017, the total cost of diabetes in the United States was $237 billion (Riddle & Herman, 2018). The purpose of this DNP project was to standardize a Federally Qualified Health Care’s (FQHC) High-Risk Obstetrical (OB) Initiative, which attempted to provide in-person …
Formalizing A High-Risk Obstetrical Initiative: Focus—Hypertensive Disorders, Elena Vulgamott Rodrigue
Formalizing A High-Risk Obstetrical Initiative: Focus—Hypertensive Disorders, Elena Vulgamott Rodrigue
Doctor of Nursing Practice
Background: Hypertensive disorders during pregnancy have a detrimental effect on maternal and fetal outcomes, causing low birth weights, preterm births, and stillbirths. During pregnancy, hypertensive disorders affect up to 13% of all pregnancies and make up 10% of all maternal mortality in the United States (Centers for Disease Control and Prevention [CDC], 2019). Purpose: The purpose of this DNP project was to implement and standardize a high-risk obstetrical initiative for hypertensive mothers. Summary of Evidence: Data suggest that increased education and increased surveillance for high-risk obstetric patients decreases the need for obstetric services and decreases the evolution of hypertensive …
Expansion Of A Comprehensive And Standardized Well-Woman Exam Program In A University-Based Clinic, Gabriela Trevino
Expansion Of A Comprehensive And Standardized Well-Woman Exam Program In A University-Based Clinic, Gabriela Trevino
Doctor of Nursing Practice
Background. Well-woman exams are an opportunity for women to receive focused screening, counseling, education, and care from a healthcare provider. Studies have found that 68% of women received well-woman exams between 2010 and 2016. During COVID-19 well-woman exams decreased by 80% in the United States. Standardized, comprehensive exams facilitate identification of the need for lifesaving care. Objective(s). The purpose of this quality improvement project was to expand a comprehensive and standardized well-woman exam program in a university-based clinic. Methods. Processes were implemented to promote well-woman exams, patient comfort measures, and completion of an evidence-based standardized comprehensive exam …
Improving The Early Detection And Management Of Peripheral Artery Disease In Patients With Diabetes Within The Primary Care Setting, Julyssa Amanda Rodriguez
Improving The Early Detection And Management Of Peripheral Artery Disease In Patients With Diabetes Within The Primary Care Setting, Julyssa Amanda Rodriguez
Doctor of Nursing Practice
Background. Diabetes is a significant risk factor for peripheral artery disease. Individuals with diabetes, greater than 50 years of age, having at least one other risk factor should be screened for peripheral artery disease with an ankle brachial index. Purpose. Improve detection and management of peripheral artery disease in persons with diabetes within primary care. Evidence. Individuals with diabetes and peripheral artery disease have an increased risk of adverse cardiac and limb events, impairing the patient’s quality of life and causing long-term disability (Berger & Newman, 2020). Methods. During a 10-week period, these processes were implemented: (a) screening all patients …
The Physiological Benefits Of A Plant-Based Diet On Cardiovascular Health, Jenevieve Petray
The Physiological Benefits Of A Plant-Based Diet On Cardiovascular Health, Jenevieve Petray
Nursing | Senior Theses
Cardiovascular disease (CVD) is increasingly more prevalent in today’s society and is attributed to an alarming percentage of American hospitalizations and deaths. Americans are unhealthier than ever before, and the main contributor is the Western diet. Diet is a double-edged sword that can offer benefits or detriments to one’s health. CVD encompasses numerous diagnoses originating from various underlying physiological alterations. These alterations are downstream effects of increased body weight and BMI, increased cholesterol levels, decreased insulin sensitivity and increased arterial plaque buildup. Research shows that a plant-based diet has the potential to manage and reverse all fundamental physiological alterations that …
Discerning The True Dilemma Of Diabetes Among Hispanics, Ramon Ponce
Discerning The True Dilemma Of Diabetes Among Hispanics, Ramon Ponce
Nursing | Senior Theses
There is a common misconception that the primary role of nurses is to follow doctors’ orders and treat patients who are currently suffering and experiencing pain. Chronic illnesses such as diabetes can be prevented and better managed if the population who is greatest at risk is better informed and educated on the disease. Different cultures and ethnicities have different foods that unfortunately puts them at risk to get diabetes. Hispanics typically follow a diet that is high in carbohydrates, saturated fats, and sugars that greatly contribute to the development of diabetes. Often, Hispanics are not educated enough to comprehend the …
Bullying Experiences Among Families And Children With Autism Spectrum Disorder, Developmental Delay, Or Varying Ethnicities, Emma Humphrey
Bullying Experiences Among Families And Children With Autism Spectrum Disorder, Developmental Delay, Or Varying Ethnicities, Emma Humphrey
The Eleanor Mann School of Nursing Undergraduate Honors Theses
Bullying perpetration in schools is a significant problem within the United States that has shown to increase mental health issues and adverse outcomes in children. The purpose of this extended literature review is to evaluate the significance of bullying in children with developmental delay (autism spectrum disorder) and majority and minority ethnic groups. The review of literature analyzes implications of bullying within these vulnerable populations and the family factors associated with peer victimization. An analysis from twenty peer-reviewed chosen articles reflects heightened levels of bullying, mental health problems, and negative experiences of all researched populations. The increased amount of victimization …
Stress As A Contributing Factor For Pediatric Obesity: Literature Review And Internship Experience, Jessica Handley
Stress As A Contributing Factor For Pediatric Obesity: Literature Review And Internship Experience, Jessica Handley
The Eleanor Mann School of Nursing Undergraduate Honors Theses
This article is an examination of how stress drives diet and physical activity behaviors that contribute to pediatric obesity in the United States. An increasing rate of childhood obesity is being reported in the United States and therefore a multitude of studies and reviews have been conducted on the topic. This review of the literature systematically analyzes how stress, diet, and physical activity behaviors contribute to this rising rate of pediatric obesity. An analysis of the chosen articles for review indicates that stress and its counterpart (resilience) tend to be driving forces in how American children and adolescents participate in …
Development And Implementation Of An Evidence-Based Guideline For Spinal Cord Injury/Disorder Patients Requiring Colonoscopy, Tanya D. Young
Development And Implementation Of An Evidence-Based Guideline For Spinal Cord Injury/Disorder Patients Requiring Colonoscopy, Tanya D. Young
Student Scholarly Projects
Practice Problem: Colorectal cancer is one of the leading causes of preventable cancer death in the United States. Spinal cord injury/disorder (SCI/D) patients present with unique challenges for maximizing bowel prep and successful attainment of screening and therapeutic colonoscopy procedures. Current practice for bowel prep regimens does not take into consideration the specific needs of the SCI/D population resulting in significant patient dissatisfaction.
PICOT: The PICOT question that guided this project was in adult patients with spinal cord injuries/disorders requiring colonoscopy (P), how does the development and implementation of evidence-based guidelines for the care of the spinal cord injury/disorder patient …
Addressing The Psychosocial State Of High-Risk Individuals Undergoing Hereditary Cancer Screening By Advanced Practice Registered Nurses (Aprns) In The Community Oncology Setting, Aquilina Kerubo Thompson
Addressing The Psychosocial State Of High-Risk Individuals Undergoing Hereditary Cancer Screening By Advanced Practice Registered Nurses (Aprns) In The Community Oncology Setting, Aquilina Kerubo Thompson
Electronic Theses and Dissertations
Abstract
Neoteric advances in genetics make it possible to define genetic risk in cancer, and there should be methods in place to provide comprehensive genomic care with oncology advanced practice registered nurses bridging this gap. The current scope of nursing practice stipulates genetic and genomic literacy; however, there remains a deficit among advanced practice registered nurses in identifying and addressing psychosocial distress during the genetic cancer risk assessment process. Oncology advanced practice registered nurses must be equipped with the knowledge that the genetic cancer risk assessment also involves protecting patients from the psychosocial repercussions of carrying a hereditary cancer gene …
Improving Data Collection And Documentation In A Post-Discharge Follow-Up Phone Call Program, Lindsay Horihan, Tasha Flicek
Improving Data Collection And Documentation In A Post-Discharge Follow-Up Phone Call Program, Lindsay Horihan, Tasha Flicek
Nursing DNP Projects
Purpose and Rationale: The purpose of this project is to improve a post-discharge follow-up phone call program by creating evidence-based methods of collecting, documenting, and analyzing data that will provide insight of the program’s impact on patient and process outcomes. There was sufficient evidence to support the use of follow-up phone calls as an effective method to limit hospital readmissions within thirty days of being discharged. The literature also revealed patient and process outcomes to be measured as a final step in the program and to provide data for ongoing process improvement. Practice Change and Implementation Strategies: The current phone …
Chronic Disease Management In A Nurse Practitioner Led Clinic: An Interpretive Description Study, Natalie Floriancic
Chronic Disease Management In A Nurse Practitioner Led Clinic: An Interpretive Description Study, Natalie Floriancic
Electronic Thesis and Dissertation Repository
Statement of research problem: Nurse practitioner led clinics (NPLC) in Ontario (ON) represent a model of care that is potentially well-situated to improve primary healthcare delivery. There is currently limited knowledge about this model of cares impact on patients with chronic disease. This study explored current chronic disease management practices implemented by Nurse Practitioners (NP) within NPLCs across ON.
Methods: Using a qualitative interpretive description methodology, eleven in-depth semi-structured interviews were conducted with nurse practitioners practicing within NPLCs in Ontario.
Results: Results indicate NPLCs successfully support patients with chronic disease through provision of on-site multidisciplinary care, continuity in service provision …
Evaluation Of Telemedicine As An Option For Providing Safe, Accessible, Care To Young Adults In A University Setting, Diane Lynch
Evaluation Of Telemedicine As An Option For Providing Safe, Accessible, Care To Young Adults In A University Setting, Diane Lynch
Seton Hall University Dissertations and Theses (ETDs)
Previously underutilized, telemedicine has been implemented within a wide variety of health settings as a safe and efficient way of delivering healthcare during the COVID-19 pandemic. Maintaining operations during the pandemic made implementation of telemedicine an important aspect of college and university health center reopening plans. The purpose of this project was to evaluate the acceptance and quality of a telemedicine program implemented at the health center of a medium sized private university.
Data were collected via patient and staff surveys to measure satisfaction with the program and a retrospective review of electronic medical records was conducted to obtain data …
Increasing Knowledge Of Fibromyalgia Diagnostic Criteria Using A Screening Tool In Primary Care, Diane Morris
Increasing Knowledge Of Fibromyalgia Diagnostic Criteria Using A Screening Tool In Primary Care, Diane Morris
Doctoral Projects
ABSTRACT
Fibromyalgia (FM) is a chronic pain condition that is second only to osteoarthritis. Fibromyalgia dramatically impacts the quality of life, with its many symptoms requiring a multidisciplinary approach to treatment. The recommendation is that patients with fibromyalgia are treated in primary care, as are other chronic diagnoses such as hypertension and diabetes, with referrals to other disciplines as needed. However, some primary care providers may not recognize fibromyalgia as a valid diagnosis, have received inadequate formal training in fibromyalgia, and have limited awareness of diagnostic criteria.
According to the research, as many as 3 out of 4 people with …
Decreasing Unintentional Pregnancies For Tennesseans, Paula M. Todd
Decreasing Unintentional Pregnancies For Tennesseans, Paula M. Todd
Electronic Theses and Dissertations
In 2018, 49% of all pregnancies in the United States were unintended, with women with a lower- income status being five times more likely to experience an unplanned pregnancy. Tennessee has a high rate of unintended pregnancies, particularly among the uninsured, low-income, and rural teen populations; some 22% of these unintended pregnancies end in abortion. Oral or transdermal contraceptives that are affordable and accessible for women of childbearing age can reduce unintentional pregnancies. The addressed gap in clinical practice was that contraceptives are not currently available over the counter in Tennessee pharmacies without a prescription, which necessitates a costly medical …
Food Addiction And Obesity, Lisa Ling
Food Addiction And Obesity, Lisa Ling
Electronic Theses and Dissertations
The obesity rate in the U.S. adult population has increased to epidemic levels despite attempts to decrease obesity through evidence-based knowledge, clinical practice guidelines, medical interventions, and individual efforts. For certain individuals, food addiction behaviors such as food cravings, loss of control, and binge eating contribute to obesity and require a different approach to care. Little work has been done on adding the possibility of food addiction to obesity screening and treatment. This study utilized a quasi-experimental quantitative pre- and postsurvey research design based on Lewin’s change theory. Nurse practitioners were surveyed regarding the provider’s perceptions, attitudes, and beliefs about …
Mindfulness-Based Cognitive Therapy Staff Training Program To Tackle Postpartum Depression, Helen Xumin Chen
Mindfulness-Based Cognitive Therapy Staff Training Program To Tackle Postpartum Depression, Helen Xumin Chen
Doctor of Nursing Practice (DNP) Projects
Abstract
Background: Women in the process of childbirth go through significant physical and psychological changes. The internal changes along with other external factors can be overwhelming. There is a high rate of new mothers suffering from postpartum depression (PPD) as a result. Problem: High prevalence of PPD is a public health crisis. The condition has a negative impact on the mother-baby unit and the wellbeing of the whole family. Aside from the implications on the health of new mothers and babies, PPD is also costly to the economy. Methods: Mindfulness-Based Cognitive Therapy (MBCT) is a common and effective intervention for …
Testing A New Workflow To Integrate The Voice-Of-The-Customer In Readmission Analysis For Skilled Nursing Facility Readmissions From Home, Stephanie Edurese Bilbao
Testing A New Workflow To Integrate The Voice-Of-The-Customer In Readmission Analysis For Skilled Nursing Facility Readmissions From Home, Stephanie Edurese Bilbao
Master's Projects and Capstones
Abstract
There are multiple layers of oversight across the healthcare delivery system. Measuring acute hospital readmissions has been identified as an important outcome measure of quality care. Our patients are one of the major stakeholders in the healthcare system. One role of a clinical nurse leader is to integrate evidence-based leadership practices that identify and assess outcomes, mitigate risk, enhance health promotion, deliver highly effective patient care, and ensure transparent relationships with stakeholders. Rationales for examining and re-designing the readmission analysis workflow based on the customer’s experience are discussed in this paper. The global aim of the project is to …
Use Of A Remote Patient Home Telemonitoring System (Engage Practice Solutions) In A Rural Health System To Decrease Rural Patients’ Utilization Of Acute Healthcare Services: A Quality Improvement Project, Christopher Baker
Doctor of Nursing Practice (DNP) Manuscripts
Individuals in rural areas of the U.S. have less healthcare access in large part due to access barriers, and include travel and wait time, distance to a provider, cost, transportation, and social and cultural components. Rural individuals have been found to be in poorer health and have higher rates of being uninsured and having chronic disease. These disparities lead to rural individuals requiring more expensive acute care once they are at the point of receiving care. A significant burden is placed on the individual and health system. The rates of emergency department (ED) use in rural areas increased 70% from …
Chronic Obstructive Pulmonary Disease, Aaron Mcneilan
Chronic Obstructive Pulmonary Disease, Aaron Mcneilan
Nursing Student Class Projects (Formerly MSN)
The following poster presentation provides a brief overview of the disease process of Chronic Obstructive Pulmonary Disease (COPD). COPD is one of the leading causes of disability and death worldwide, and its incidence does not appear to be declining. The most common factor causing COPD is cigarette smoking, which is modifiable. Other contributors are environmental air pollutants which some people may encounter depending on where they live or their occupation. This presentation is a culmination of information from different scholarly sources which discuss the symptoms, pathophysiology, causes, management, and prevention of COPD.
Polycystic Ovarian Syndrome: Pathophysiology And Chronic Health Implications, Makilah Witt
Polycystic Ovarian Syndrome: Pathophysiology And Chronic Health Implications, Makilah Witt
Nursing Student Class Projects (Formerly MSN)
Polycystic Ovarian Syndrome (PCOS) is the most common endocrine disorder affecting women of reproductive age. If untreated, women suffer a myriad of secondary sequala and chronic diseases. The prevalence of PCOS is rising and greatly impacts patients' physical, mental, and emotional health, diminishes community health, and increases healthcare costs. However, many providers fail to properly diagnose patients, understand how this disease impacts women, or provide appropriate interventions to prevent chronic health problems. This paper outlines the pathophysiology of PCOS, identifies signs and symptoms, and provides recommendations for treatment and holistic patient care for the role of the Advance Practice Nurse.
Reduction Of Clabsi In Telemetry Patients Through Limiting Central Line Blood Draw, Caselyn Lok
Reduction Of Clabsi In Telemetry Patients Through Limiting Central Line Blood Draw, Caselyn Lok
Student Scholarly Projects
CLABSI is known to be one of the many healthcare-associated infections that has led to an increase in health complications, length of hospital stays, and increased in healthcare cost. There is about 25000 bloodstream infection that occurs annually (Haddadin, Annamaraju, & Regunath, 2020). The PICOT question that guided this project was “How does limiting blood-draw from central venous catheter lines influence the rate of central-line associated bloodstream infections (CLABSI) post-implementation compared to rate of CLABSI pre-implementation after eight weeks?” CLABSI prevention bundles were already being used to guide healthcare providers in handling CVC access. There were 15 scholarly articles that …