Medicine and Health Sciences Commons^™

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 …

Increasing Hpv Awareness And 3-Dose Series Compliance Among The Female Population (Ages 11-26) In A Community Health Clinic, Vanessa Orozco

Master's Projects and Capstones

Abstract

The overall goal of this project was to increase HPV 2nd and 3rd dose compliance rates by a combined 10% among the female adolescent population (ages 11-26). This was to be achieved by implementing EBP follow-up calls to not only schedule appointments but also to serve as a reminder for patients to come into previously scheduled appointments. This project was chosen as prior clinic and organization-wide meetings had delineated compliance rates at just 7%. There were various methods employed to implement this project including an initial microsystem assessment, which entailed a Root Cause Analysis, Process Mapping, SWOT analysis, Cost-Analysis, …

Nurses Utilizing The V.O.I.C.E.S. Hiv Prevention Intervention In The Black Church Community, Jason Richard

Theses and Dissertations

The Human Immunodeficiency Virus (HIV) epidemic is a significant problem in the United States, especially in the “Bible Belt” Deep South where the epidemic is hitting this region the hardest. The HIV epidemic in the state of South Carolina is very real, significant, and quite alarming. In fact, the Center for Disease Control and Prevention (CDC) labels South Carolina as an HIV “hot spot.” All racial and ethnic groups are susceptible and impacted by HIV. However, evidence shows that African Americans – especially young adults 18-35, bear the brunt of the burden to the extent that the “new face” of …

Using A Cost Benefit Analysis To Support The Development Of A Comprehensive Business Model For A Pre-Filled, Pre-Labeled, Pre-Diluted, Sterilely Packaged, Ready-To-Use, Syringe-Based Anesthesia Delivery System, Lance B. Kennedy

Doctoral Projects

The foundation of Certified Registered Nurse Anesthetists’ (CRNAs) entire profession is built on the ability to provide anesthetic services using a variety of medications in the safest, most efficient, cost-effective way possible. The purpose of this capstone is to address, via a comprehensive cost benefit analysis, whether pre-filled syringe drug trays are a more cost-effective way to address problems as compared to vial-filled drug trays and to implement the necessary transitions in order to improve outcomes. There are a number of identifiable problems related to anesthesia medication delivery via vial-filled medication, including increased cost of healthcare, decreased patient safety to …

The Effects Of Consistent Exercise On Work Productivity Among Anesthesia Providers, Samuel K. Self

Doctoral Projects

Studies have been done that link various measurements of workplace productivity with varying levels of individual health. A thorough literature review examined the research to find any significant relation between regular exercise (as defined by the American Heart Association) and an improvement in workplace productivity among anesthesia providers. A Qualtrics survey was used to measure specific results regarding exercise activity and work productivity from anesthesia providers. This group included 53 certified registered nurse anesthetists and anesthesiologists. Descriptive analysis, Chi-square test of Independence, Fisher’s Exact test, and Cramer’s V test were all used to analyze the data. One significant correlation was …

Restoring Digestive Health, Kristin M. Corbin, Dnp, Aprn, Fnp-C

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Purpose: The purpose of this translational research project was to outline the healthcare problems associated with Functional Gastrointestinal Disorders and to explore the effectiveness of a gastrointestinal protocol utilized at Atlanta Center for Holistic and Integrative Medicine. The goal of this protocol is to restore digestive health with probiotics, digestive enzymes, and glutamine.

Background: Functional Gastrointestinal Disorders affect one in every four adults in the United States. These disorders encompass a variety of symptoms including diarrhea, constipation, cramping, abdominal pain, flatulence, reflux, and bloating without an identified physiological cause. There is currently no cure for Functional Gastrointestinal Disorders and treatment …

Assessing The Need For A New Oral Care Protocol In The Non-Ventilated Patient Population, Talia J. Johnson

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Abstract

Purpose: Nonventilator-associated hospital acquired pneumonia is a nosocomial infection that has not been heavily researched. With hospital-acquired pneumonia accounting for some of the most frequent nosocomial infections in the United States, it is important to determine ways to decrease rates of infection. The purpose of this study was to determine the rate of nonventilator-associated pneumonia in a hospital patient population, to determine charting compliance of nurses, and to determine whether there was a need for a new oral care protocol.

Design: A retrospective electronic record review was performed to determine the rate of nonventilator- associated hospital acquired …

Reinventing The Medical Request Process In A Correctional Healthcare Setting, Leah Murphy

Master's Projects and Capstones

This project was developed as part of a Clinical Nurse Leader course of study with the goal of gathering and evaluating microsystem data, and the creation and implementation of a process improvement project. The project was conducted in a correctional setting which houses male and female detainees with a wide variety of medical needs. The project addressed long wait times for detainees who have submitted a request for services from the medical department. The goal of this project was to reduce wait times for medical requests, and provide service for a greater number of patients. This project is needed because …

A Quality Improvement Project To Increase Diabetes Self-Efficacy In A Rural Primary Care Clinic Through Patient Utilization Of A Diabetic Logbook, Margo D. Sutton

Doctor of Nursing Practice (DNP) Projects

The prevalence of type 2 diabetes mellitus (T2DM) has increased substantially in the United States in recent years. Teaching self-management to diabetic patients is essential to help them control their chronic disease. Albert Bandura’s theory of self-efficacy is commonly used in chronic disease self-management programs and is the theoretical framework upon which this Doctor of Nursing Practice (DNP) pilot project was built.

This evidence-based change in practice project took place in a rural primary care clinic in the central valley of California, and involved the development of a diabetes logbook, which was a tool for patients to use to learn …

Impact Of Standardized Oral Health Assessment On Preventing Ventilator-Associated Events, Juana Ambriz De Williams

Evidence-Based Practice Project Reports

Ventilator-associated pneumonia (VAP) is a common but preventable health-care associated infection that affects up to 20% of mechanically ventilated adult patients, resulting in estimated mortality rates ranging from 13% to 55% (Chahoud, Semaan, Almoosa, 2015; Melsen et al., 2013). In an effort to reduce morbidity, mortality and related costs, the Centers for Disease Control and Prevention (CDC) and the National Healthcare Safety Network (NHSN), proposed ventilator-associated pneumonia prevention as a national patient safety goal. In 2014, amid growing concerns that the subjectivity of existing definitions had led to inconsistent reporting, thereby impeding efforts to reduce VAP, the CDC refocused surveillance …

The Identification Of Maltreatment In Children With Disabilities: An Education Program, Jessica Leigh Ahmann

Nursing Capstones

No abstract provided.

Neurological, Nutritional And Cognitive Effects Of Environmental Lead Exposure In Infants And Children, Melissa Bianchi

Nursing Student Class Projects (Formerly MSN)

Environmental lead exposure is a pertinent public health risk that affects our rural population in Wyandot County, Ohio. Children exposed to lead hazards through toys, home remodeling and contaminated soil and water are at a greater risk for developing neurological, cognitive and behavioral issues than are children not exposed to lead (Cecil et al., 2011). Wyandot County parents are not adequately educated on the risks and consequences of elevated blood lead levels in their children. As a child advocate and director of the Women, Infant and Children program for Wyandot County there is an obligation to educate and inform parents …

Preparedness Of Nurses For Malignant Hyperthermia, Melissa Flemming

Nursing Student Class Projects (Formerly MSN)

Malignant hyperthermia (MH) is a potentially life threatening disorder that occurs following exposure to certain inhaled anesthetics such as halothane, isoflurane, sevoflurane, desflurane, enflurane, ether, and methoxyflurane alone or in combination with the depolarizing muscle relaxant, succinylcholine (Seifert,, Wahr, Pace, Cochrane, & Bagnola, 2014, p. 189). Patients experiencing malignant hyperthermia may progress to death if it is not recognized and treated early. Patient outcomes improve the earlier an intervention is given. Malignant hyperthermia is not a common condition and, therefore, nurses are frequently unfamiliar with the common signs, symptoms, and treatments. Malignant hyperthermia can occur in a variety of settings …

Syphilis ‘The Great Imitator’, Leslie Gompf

Nursing Student Class Projects (Formerly MSN)

Syphilis, a sexually transmitted disease, which is seen in many different patient populations, is on the rise in the United States. According to Chan et al. (2015), “In 2012, the Rhode Island Department of Health (RIDOH) reported 68 cases of infectious syphilis, a 300% increase from 2006. This trend is observed across the country.” More recently if you live in the Columbus area you may have seen an increasing number of billboards focused directly on testing for sexually transmitted diseases and markedly focused on syphilis. Syphilis can affect patient populations across genres, ethnicities and socioeconomic backgrounds. Which in turn makes …

Pathophysiology And Treatment Of Life-Threatening Angioedema, Stephen J. Hoffman

Nursing Student Class Projects (Formerly MSN)

Angioedema is a potentially lethal swelling of the interstitial space from extravasation of intravascular plasma (Wood, Choromanski, & Orlewicz, 2013). Angioedema may present in any medical setting with a broad range of severity. Angioedema is commonly seen in emergency departments and intensive care units. According to Barbara, Ronan, Maddox, & Warner (2013), “angioedema is of particular importance to anesthesiologists, as it may present at any point in the perioperative period and it may rapidly become life-threatening if it involves airway compromise” (p. 335). Anesthesia professionals may also respond to airway management emergencies throughout the hospital setting and may treat angioedema …

An Online Survey Of The Healthcare Needs Of Undergraduate Students At An Urban University, Linda Graf

College of Science and Health Theses and Dissertations

There is a growing body of evidence that reveals mounting need for radical modification of college health services for young adults in the United States. The health issues for this population, which are exacerbated by inadequate access to healthcare include alcoholism, depression, unintended pregnancy, disordered eating, sexual assault and sexually transmitted infections. Utilizing the College Student Health Survey developed by University of Minnesota’s Boynton Health Service, this study specifically focused on analyzing the health care needs of undergraduate students at a large, urban, university. Access and utilization of healthcare services for this population were also examined. An online survey was …

Cultural Competence Among Nursing Faculty, Colleen Marzilli

Nursing Theses and Dissertations

Research of culture and cultural competence in nursing faculty is vitally important when considering the state of the United States health care system and health disparities that can be reduced through culturally competent care. Recent studies address cultural competence among nurses, but there is limited information exploring cultural competence in nursing faculty. A concept analysis of "cultural competence" using Rodger's method further established the need to examine cultural competence from the perspective of nursing faculty, who are responsible for educating future nurses in culturally competent care. The purposes of this study were to determine the level of cultural competence in …

Promoting Completion Of Advance Directives In A Hispanic Religious Congregation: An Evidence-Based Practice Project, Luis Daniel San Miguel, Mary Jo Clark

Doctor of Nursing Practice Final Manuscripts

Background: Hispanics utilize more aggressive medical treatment at the end of life and are less likely to receive end-of-life care consistent with their wishes than nonHispanic Whites. Hispanics are less likely than nonHispanic Whites to have an advance directive (AD). Increasing AD completion among Hispanics can promote end-of-life care consistent with their wishes, diminish healthcare disparities, and eliminate unnecessary healthcare spending. Objectives: To promote completion of advance directives by increasing knowledge, positive attitudes, and comfort with advance care planning (ACP) among Hispanics through culturally sensitive interventions. Intervention: The project was conducted in Spanish and implemented among a …

Improving Dental Care To The Elderly In A Nursing Home, Cara M. Licavoli

Master's Projects and Capstones

The project is about the collaboration between Peninsula Health Care District (PHCD) and Apple Tree Dental (ATD) in a team approach to address the current issues of improving dental care of frail and elderly patients in nursing home facilities. The specific aim is to improve dental care of clients at the San Mateo County nursing home facility by 100% by May, 2015. The methods use in this project was the adaptation and implementation of existing dental/oral health assessment tools, that is nurse driven for patient assessment upon admission to the nursing facility. The process includes staff education regarding the adapted …

The Relationships Among School Nurse To Student Ratios, Self-Efficacy For Type 1 Diabetes Management, And Glycemic Control In Adolescents, Lori Wilt

Seton Hall University Dissertations and Theses (ETDs)

Type 1 diabetes mellitus (T1DM) is one of the most common chronic diseases of childhood. Adolescents with T1DM experience decreased treatment adherence, poor glycemic control, and acute complications more frequently than adults. Self-efficacy is the belief that one can carry out specific behaviors in specific situations and is the major determinant of intention, and has been shown to influence diabetes self-management in the adolescent.

School nurses are in a unique position to influence self-efficacy for type 1 diabetes management in adolescents. Although previous research has shown that school nurses positively influence student health outcomes in a variety of ways, there …

Nurses' Self-Efficacy For Managing Elder Abuse, Alana Anderson

Nursing Theses and Dissertations

Elder abuse is a serious issue that negatively affects physical and mental health in a significant portion of the older population. Abuse of older adults is not adequately detected or reported. Nurses have frequent contact with older victims of abuse, providing them the opportunity to play a significant role in detecting, reporting, and intervening in such cases. Nurses are reluctant to intervene due to lack of education on elder abuse and lack of self-efficacy in their ability to properly manage elder abuse. This quantitative, descriptive study was designed to determine whether educational content on elder abuse, perceived capability, and self-efficacy …

The Effect Of An Educational Intervention On Knowledge And Intent To Participate In Cervical Cancer Screening, Ann Marie Trapp

Evidence-Based Practice Project Reports

Globally, cervical cancer ranks third among cancers affecting women (Arbyn et al., 2013). In the United States, approximately 12,000 women are diagnosed with cervical cancer and approximately 4,000 women die yearly (Centers for Disease Control and Prevention, 2014). Papanicolaou (Pap) screening is an effective means of detecting precancerous cell changes of the cervix with early cervical cancer diagnosis carrying a 91% five-year survival rate (Gonzalez et al., 2012). The purpose of this evidence-based practice project was to identify interventions that increase adherence to cervical cancer screening and to implement best practices to reduce unnecessary deaths related to late diagnoses of …

The Contemporary Use Of Nurse Practitioners In U.S. Emergency Departments, Jeffrey L. Bevan

Doctor of Nursing Practice Scholarly Projects

Problem: The increased demand for emergency care in the United States (U.S.) has been well-documented and there is growing utilization of nurse practitioners in U.S. emergency departments. However, little is known about the nurse practitioner (NP) role in the emergency department setting within the past five years.

Purpose: The purpose of this project was to describe the demographic characteristics of patients, patient conditions treated, diagnostic tests ordered, and procedures performed by nurse practitioners in a national sample of U.S. emergency departments.

Methodology: This secondary analysis used a non-experimental quantitative, descriptive exploratory design to review data from the National Hospital Ambulatory …

Promoting Oral Health Knowledge In African American College Students, Terri Huff-Simmons

Doctor of Nursing Practice Scholarly Projects

Objective. The primary aim was to assess African American college student's knowledge of oral health and healthcare access.

Methods. The project was a quantitative descriptive study using a pre and posttest design. A pre questionnaire containing items regarding oral hygiene and oral health based on the recommendations of the American Dental Association (ADA) as well as questions about access to oral healthcare was distributed to African American college students to measure their knowledge. A demographic questionnaire was distributed. Students participated in a 20-30 minute oral health educational program. A post-test was given 4-6 weeks after the initial pre-test.

Results. …

Personal Hygiene Self-Management Of Chronically Unsheltered Homeless Women, Stephanie Lynn Durfor

Theses and Dissertations

ABSTRACT

PERSONAL HYGIENE SELF-MANAGEMENT OF CHRONICALLY UNSHELTERED HOMELESS WOMEN

by

Stephanie L. Durfor

The University of Wisconsin, Milwaukee, 2015

Although the subpopulation of chronically unsheltered homeless women is a small percentage of the overall homeless population, this vulnerable group of women is very high risk for poor health status and negative health outcomes. Unsheltered homeless women are significantly higher risk for assault, physical/mental disorders, and substance/ alcohol abuse compared to women residing in shelters or transitional housing. In the midst of a challenging physical and social environment, chronically unsheltered homeless women must manage their personal hygiene on a daily basis. …

Oral Wellness: Using Occupational Therapy To Enhance Oral Hygiene Delivery In Long-Term Care, Lauryn J. Banovitz, Liberty Bellah, Rosemarie Lion

Dissertations, Masters Theses, Capstones, and Culminating Projects

Based on current literature, oral health in long-term care (LTC) facilities is frequently of low priority and does not follow evidence-based best practices. Poor oral health reduces the quality of life of older adult residents and patients and can lead to systemic diseases, such as cardiovascular disease, stroke, and pneumonia, the leading cause of death in LTC. Occupational therapists can play an instrumental role as oral care consultants, and educators, and can act as resource guides to raise the standards of oral care in LTC facilities.

This capstone project explored ways in which occupational therapy, a profession traditionally designated for …

The Voices Of The People: Lower Sioux Indian Community Members Speak Out On What They Need And Want In A Primary Health Care Clinic On The Reservation, Darin Michael Prescott

UNLV Theses, Dissertations, Professional Papers, and Capstones

American Indian/Alaska Native (AI/AN) people who live on reservations or in urban areas typically receive their health care in clinics that are operated by their tribe or are affiliated with Indian Health Service (IHS), a federal agency that provides care to AI/AN people. The Lower Sioux Indian Community (LSIC) is a federally recognized tribe located in southwest Minnesota near Morton, MN. LSIC members currently receive health care from outside providers at various locations near the reservation. The outsourced services include primary care, emergency care, hospitalization, surgery, dentistry, and podiatry. Because the providers are independent groups and do not work for …

Nursing Students' Understanding And Enactment Of Resilience: A Grounded Theory Study, Andrew T. Reyes

Electronic Thesis and Dissertation Repository

The purpose of this study was to explore nursing students’ understanding and enactment of resilience. Stress is considered to be a major factor affecting the health, well-being, and academic performance of nursing students. Resilience has been extensively researched as a process that allows individuals to successfully adapt to adversity and develop positive outcomes as a result. However, relatively little is known about the resilience of nursing students. A constructivist grounded theory study design was used. In-depth individual interviews were conducted with 38 nursing students enrolled in a four-year, integrated baccalaureate nursing degree program at a university in Ontario, Canada. Face-to-face …

Child Sex Trafficking-Recognition, Intervention, And Referral: An Educational Framework To Guide Health Care Provider Practice, Cathy L. Miller

Nursing Theses and Dissertations

Awareness of the plight of children and adolescents who are sexually exploited and trafficked for financial gain has gradually garnered the attention of the public, law enforcement, and health care providers. The discussion is slowly changing to recognize these exploited children and adolescents as victims and not criminals. Marginalization of this population is slowly changing to advocacy. However, with awareness comes responsibility for the health care system to provide improved recognition, intervention, and referral of this population. Increased health care provider responsibility demands a scientifically based framework to guide the development of health care provider education programs. To date, there …

Inhalation Anesthesia Vs. Total Intravenous Anesthesia For Ambulatory Dental Surgery In Children, Kristin D. Neal

Theses, Dissertations and Capstones

Abstract: The purpose of this study was to compare inhalation anesthesia with sevoflurane versus Total Intra Venous Anesthesia (TIVA) with propofol infusion as it relates to the quality of recovery including postoperative pain, Post Operative Nausea and Vomiting (PONV), and Post Anesthesia Care Unit (PACU) Length Of Stay (LOS) in pediatric patients undergoing ambulatory dental surgery. Introduction: Pediatric dental procedures are increasingly performed in an outpatient setting under general anesthesia due to inadequate cooperation, circumstantial anxiety, and other behavioral and health issues. Commonly used inhalation anesthetics, such as sevoflurane, can induce hyperalgesia in children. While sevoflurane increases the risk PONV, …